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Imagecast iPACS Viewer Manual

1. S T Mag 114 RT 650 00 Za l Wi 1210 WL 350 L T 3500 00 99 ET 102 00 Window splitters can be dragged to enable different view sizes for each series B e Contidential 2005 IDX Systems Corporation All rights reserved Predefined Screen Layouts Using the IDX Imagecast iPACS Viewer Layout The following table shows displays the predefined screen layouts available Predefined Screen Layouts Function Button Description 1x1 Screen Layout 3 One image or one series is displayed in the entire main view 1x2 Screen Layout tm The main view is split vertically allowing two images series to be displayed side by side 2x1 Screen Layout The main view is split horizontally allowing two images series to be displayed one above the other 2x2 Screen Layout m The main view is split both horizontally and vertically allowing four images series to be displayed at the same time Examples of the predefined screen layouts are shown below 1x1 Screen Layout a o0 lel 18 xi File View Image Tools Ortho Help jo xi amp smigi ss xe eco si amp Q2e G amp tAs292 d dOosnmiuls eos4AaldalnDmast gi ge t o e emm E lo as P Window Wit J Window Leve 4 Detaut A skULLaeneraPA 0 X 1 O5 Qae h NRQAGO E WwW Oxd 761 AOO D m S880 SBS Or
2. E EE 38 Window Width and Level eere nmn 40 Ina Para a aibi sedeo E NH Ree IEEE E UHR EFE DINE 44 B ie ia ree PTT ETT 50 cardiology Cne der Tm MTM 53 gai d icuUesiM mem 57 O ela TETTE OTT 58 ETA A D Leo pee oxen ERICH IDEE AT AEE AE E T T 63 OrthoPlanner Optional Reet ee ee ts etn ee es eet cnet ene eee 78 SRI seen A ENET A E A PE E 88 Confidential 2005 IDX Systems Corporation All rights reserved wamwe 14 Using the IDX Imagecast iPACS Viewer Be IDONEA NETT 117 KPEE tO ecc m 126 PUA lee E sie TREE 128 GODS an MT oia unm QM UEEPS MEDIE MM ria 132 Legum a CU OND TOROBBI LL sardvancw ad anus duupi viva rIN EON COR usi a Pra DUE S 137 Local LICENSE e redet eee OH eee eee eet eet ee Eee ners eer 147 Wee tog Eas ye od R E eee ener MEN DIEI UR II OL DM 148 Keavpoard SPOUT pa TOT 150 B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Introduction 15 Introduction iPACS is a state of the art PACS that enables viewing lossless images in real time The iPACS server processes the study images from the PACS archive in virtually real time The iPACS server streams the study to the user s iPACS Viewer using Imagecast Pixels on Demand technology iPACS enables the Radiology Department to share images with others who need them such as consulting specialists and referring physicians in real time and w
3. All images in Active Study All open studies 5 In the Purpose field select one of the following Transfer to another location institution Teaching Presentation Selecting this option automatically anonymizes the study Patient s personal copy 6 Select Anonymize to remove identifying patient information from the burned images Click the Parameters button to select the following study parameters to anonymize Patient Name Patient ID Date of Birth Accession Number e The Anonymize field is only automatically selected by default when the Teaching Presentation purpose is selected For any other purpose the user must manually select this option e Regardless of this setting reports are not anonymized 7 Select Include Finalized Report to include the study s reports on the CD DVD Reports are not anonymized 8 Click OK 9 The CD Burner application opens Use the Add or Remove buttons to add remove studies or reports for burning The size of the composition is shown in the status bar in the lower right hand corner B E Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Creating a CD DVD optional 139 LEE wx SIS Write CD view Add Remove 08 01 2001 at Wilton Medical Arts Ke 08 01 2001 CT 4 807 S E 07 02 2000 at RAVBAM I 07 02 2000 CT H PROBS KAIHY 01 01 1900 at U
4. Switch Playback Order Cine Range IS Switches from forward to backward or from backward to forward Run the cine from a specific slice location to another Show Hide Speed Bar ayy Opens or closes the cine speed bar Actual Speed Magnification Displays actual speed of cine in frames per second fps Displays the magnification that the image is currently shown I ES a M Confidential 2005 IDX Systems Corporation All rights reserved Speed Bar Link Cine Loops Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Cardiology Cine Optional Open close the speed bar by clicking on Show Hide Speed Bar on the Cine Top bar Change to Acquisition Rate button When cine is run the speed bar allows you to control the viewing rate The default speed in which cine is run is the acquisition rate from the DICOM file If there is no acquisition rate in the DICOM file the cine is run in the default rate as defined in your settings The acquisition rate is shown at the bottom of the floater Acq fps You can change the actual frames per second using the slider You can return to the acquisition rate by pressing on the Change to Acquisition Rate button 12 When linking cine loops any action using regular tools will be applied to all linked cine loops This includes tools from any one of the cine top bars suc
5. 4 Two perpendicular lines are drawn to the horizontal line 5 Drag the end points of the perpendicular to change their length and position on the horizontal line 6 The difference in length of the two perpendicular lines is displayed Confidential 2005 IDX Systems Corporation All rights reserved E BEN 88 Using the IDX Imagecast iPACS Viewer Settings Settings o To change your preferences click on the Settings button in the toolbar These settings will be stored on your computer and will be used every time you open the iPACS Viewer Hanging Protocol Settings Optional The Hanging Protocol defines how you want the iPACS Viewer to automatically open the studies or series This includes screen layout series layout zoom windowing and orientation The Hanging Protocol Wizard consists of three steps 1 Hanging Criteria Determines when the Hanging Protocol will be automatically applied upon opening a study 2 Screen Arrangement How the study will open across monitors 3 Series Arrangement How the different series of the study will open within the above screens When Default Hanging Protocol or other Hanging Protocols are activated the images are opened directly in the main view according to the applied Hanging Protocol Creating new Hanging Protocols is an optional license based feature If you don t have the appropriate license you will only be able to change the default Hanging Protoco
6. iPACS Burner BEES x Either there is na writing device or vou da not have sufficient rights bo write bo the disc Please atach a writing device or ask your administrator to provide burning rights to vau If the size of the study is greater than the entered media you will get the following error message Imagecast Cardiology Burner i X AN One of the studies in the composition is too big to be written ta Ehe current disc Please try writing to a disc with more Free space Contidential 2005 IDX Systems Corporation All rights reserved B EE 142 Creating a CD DVD optional How to Burn to Multiple Disks Using the IDX Imagecast iPACS Viewer If you have several studies and together they are greater in size than the entered media you will have the option of splitting the studies into several discs fa Imagecast Cardiology Burner l x 3535 Write cD VIEW Add _ Remove l 1111772004 at rer ee Ke 11 17 2004 US H fal 11 17 2004 at Unspecified MEER e 11 17 2004 US 4 BAILEY NICOLE Ta tl 7118 1995 at Unspecified ST ANTHONY HOSPIT RN Ke 7 18 1995 5C MR Br 4 SCENARIOS TESTIMAGE E T 11 16 2004 at Unspecified Ke 11 16 2004 US Ej A Composition Size 592 11 MB You can see the Composition Size in the lower right hand corner of the screen Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Creating a CD DVD optional
7. 35 mile icc RE 36 Mut Monitor 8o ioa mmc 36 Image 26 15 38 Pree TERCER vcs ences 38 B rger Y 39 Window Width and Level aieessixDn dm eH dE EI IF RII EN EERE EET DH DIET TEIHS 40 Window Width WW Slider eee eee 41 Window Level WL SUBE aseo iir RR E DER EROR A EI ERFR PAY REF QGSS 41 Preset WW WL Listbox cene 42 ligni ea TETUR 42 Windowing BHO no E TEEQEL DAE aai 42 NEC TON ar ol A odii vM MM MEME 42 FOE IDOL ETA 43 Image PN hte le cates ceca ai Hte REPLIED NON IEEE rence NEN E HER BEEF HEIN 44 LIE TBI obiedipRH DS MEREEEER REC REOU ERA IQ RFT EO RE UIDEDEE 44 Jub nan M H 45 ee POO c 45 xiii P T N 45 Li No e cU 46 HEA ai PNE E A A AEE ETA TETT 47 A E IT TT 49 CEP a TTT 49 KE UPON sates yarns awe 49 Big cage UB sm oo m 49 Pe aan Rm ecco eee 50 S 0 00 ae ec eee ee ee ee 50 Cine Image Toolbar scsccscsessecesscceseearsecarsecarsnesseneueeneues 50 Cardialogy Cine TODEODALD a ssspisteiivbt ei Gppedoadis hex PIDE F Fa 53 Cardiology Cine Toolbar eeeeeneernnne 54 sis ccde EN m 55 unk GNO LONDE TNR UTERE 55 M a a ES T m 57 Soe POSION ci e STRUM 58 Usno a CCI er oO RIT 58 WES LAT 4 T 61 VG 1 8 Ls 0 0c ln ae ee ene a er en ee eee eee eevee eee eee 63 2 9 eo abe T eRe ne tive on ere ee eee ieee 63 TE
8. Using the IDX Imagecast iPACS Viewer 137 Creating a CD DVD optional Creating a CD DVD optional 3 Burns selected study images and reports on a CD DVD for distribution There are two stages of the CD Burn e Compose the CD directory for burning selecting images or studies along with their reports You can also choose to anonymize the patient information before burning e Do the actual burn on the CD How to Burn to a Single Disk Please review User Limitations for Burning CD DVD on page 144 before attempting to burn create a CD DVD To Burn a Single CD DVD 1 Click on the CD Burn button 2 The Prepare for CD window opens Prepare For CD x Location cso ocuments and Settingssyaels amp pplication Jataslm m Save C All Selected images All images in Active Series C All images in Active Study C All Open Studies Number of Images 1 Optians Purpose Transfer to another location institution C Teaching Presentation atient s personal copy Anorymize Parameters v Include Finalized Report Add te existing composition Cancel Contidential 2005 IDX Systems Corporation All rights reserved B EE an el 138 Using the IDX Imagecast iPACS Viewer Creating a CD DVD optional 3 In the Location field choose a location for the CD contents 4 In the Save panel select one of the following All Selected images All images in Active Series
9. CT f T WM i Re 49 a 503 p 6 4 3 4 d Y 4 1 04 MM 52 UE i 4 5 J amp 69 55 E q 1 d ez Poe fe 53 53 ZUM i v Res Dy eo A s Y ler FE E x DIAGNOSTIC IMAGING n 350 WL 50 Pixel Intensity Tool amp Click on the Pixel Intensity button on the toolbar to activate the Pixel Intensity annotation tool To Measure the Pixel 1 Click on the Pixel Intensity button and then click on the Intensity of a Point on image in the main view the Image Confidential 2005 IDX Systems Corporation All rights reserved B EE Using the IDX Imagecast iPACS Viewer 70 Annotations 2 The pixel intensity in Hounsfield unit appears on the image 3 You can move the annotation by selecting the Select tool and clicking on it The measurement is automatically updated 4 Press ESC to exit the annotation tool 5 You can delete the pixel intensity annotation by clicking on it and pressing delete key on the keyboard or right clicking on the annotation and choosing Delete from the pop up menu 6 You will be asked to confirm deletion of the annotation This can be turned off by checking Don t ask me again The Pixel Intensity Annotation can be saved as a DICOM Overlay on the server so other users can view it as well In the following we measure pixel intensity of the kidneys iPACS Viewer E 8 x File View Image Tools Ortho Help io x8 olf i Bl
10. DSL LAM or Fast LAM is determined according to monitored speed Set Ehe lower limit speed Far the different streaming models speed below LAN lower limit adapts the OSL model LON Lower Limit 5 Mbps Fast LON Lower Limit 70 Mbps Cancel Display optional Settings Changes the size and color of screen elements in the Viewer This is especially useful for high resolution monitors and grayscale monitors Settings NNNM Overlays Thumbnails Magnifinder System Smart Cache Hanging Protocols Modality Presets Cine Streaming Mode Display DICOM Printer Orthopedic Templates Change the size and color of screen elements font bars and buttons size overlays calor Fonts and Buttons size C Large C Medium Small Gray Scale Color Clor C Gray Scale Contidential 2005 IDX Systems Corporation All rights reserved B EE Using the IDX Imagecast iPACS Viewer 102 Settings DICOM Printer Settings Optional iPACS Viewer allows you to define multiple DICOM Printers if the iPACS server is installed with the appropriate license Each printer definition creates a driver file which can be exported and distributed to other users The driver can be customized to fit the specific DICOM printer in the department SS ti Overlays Thumbnails Magnifinder System Smart Cache Hanging Protocols Modality Presets Cine Streaming Mode Display DICOM Print
11. Full Screen or click on the Full Screen button The image is displayed without the toolbars using the whole screen area for maximal display B E Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Displaying Images 25 To return to the previous state of the Viewer double click on the image again or press on Enter or right click to open the pop up menu and choose Return to Main View Updating Images Study content can change for several reasons e A new series is added to the study e A study demographic is changed by quality control QC e A secondary capture SC is added to the study e An annotation GSPS presentation state is added to the study If study content changes on the server while a study is being viewed an Refresh button will appear on the thumbnail of the specific study and a message will be shown ilan HEAD Study Date 11 May 1993 Refresh Button Contidential 2005 IDX Systems Corporation All rights reserved E BEN Using the IDX Imagecast iPACS Viewer 26 Displaying Images Study Update 4 study you are viewing has been updated on the PACS To reload the study click on the Refresh button al in the thumbnail Preview Paene Dont show this message again For this study while loaded in the viewer the refresh autkan will still appear Click OK to close the message box Then click on the Refresh button to reload th
12. sxime amp oegitmiAs4o2do0 jg itu eosA wie IE o a OOS ES QE E Big Window Width K Window Leve FM ur z dg M e 2 2 E xie 1 Er E oo Procedure Side Right B e Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer 79 OrthoPlanner Optional 2 In the Procedure Side field select Left or Right from the drop down list 3 In the Procedure Name field select one of the displayed procedures such as Total Hip Replacement or Total Knee Replacement Hex a5 HE Procedure Side Right Procedure Mame Total Elbow Replacement Total Hip Replacement Total Knee Replacement Total Shoulder Replacement 4 In the Manufacturer Name field select the manufacturer whose templates you want to work with REF 34 H Procedure Side Fight Procedure Mame Total Knee Replace Manutacturer Marne Biamet Depuy enith Mephew Confidential 2005 IDX Systems Corporation All rights reserved B EE Using the IDX Imagecast iPACS Viewer 80 OrthoPlanner Optional 5 In the Family Title field select the family title of the template that you want to work with RE 34 H Procedure Side Right Procedure Mame Total knee Replace Manufacturer Marne Biomet Family Title Maxim Knee Bearing Repicci Knee h 6 In the Product Title field
13. Annotation can be saved as a DICOM Overlay on the server so other users can view it as well Accuracy of the measurements depends on original pixel size and correct zoom factor For example if original pixel size is 1 mm per pixel in zoom factor of 1 4 the accuracy is 4mm In a zoom factor of 1 1 the accuracy is x1mm If there is no DICOM pixel spacing information for the image the measurement will be in pixels You can calibrate the image using some marker captured on the image Confidential 2005 IDX Systems Corporation All rights reserved E BEN Using the IDX Imagecast iPACS Viewer 72 Annotations In the following image we measure the bone Fle ew image Tools Help D E ajm S k Aaa tall al y oada Al Oaa MAE laa x Li x Gimir Dabo ZE A ug 1557 4 J CR Ellipse Tool C3 Click on the Ellipse button on the toolbar to activate the annotation tool To Measure an Ellipse on 1 Clicking in the main view opens a measurement ellipse the Image 2 To change the width and height of the ellipse click on one of the measurement squares and drag the mouse until you reach the desired size 3 The mean pixel intensity in Hounsfield units for CT the area and the perimeter of the ellipse is written near the ellipse 4 Click ESC to exit the annotation tool 5 You can delete the ellipse annotation by clicking on it and pressing delete key on the keyboard or right clicking on the annotation and choosing Delete f
14. Corporation All rights reserved I ES d M Using the IDX Imagecast iPACS Viewer Image Manipulation 4 Click on each of the series that you want to link together 5 All series linked together will have the words Link Group added to the lower right hand corner of the image 6 Press ESC to exit from Link mode To Add a Series to an 1 Click on the arrow next to the Link button HJ Existing Link Group 2 Select Link Tool 3 Click on one of the images in the Link Group that you want to connect to 4 Click on the new image that you want to add to the group 5 The words Link Group added to the lower right hand corner of the new image 6 Press ESC to exit from Link mode Unlink Tool 3 Click on the Unlink button to unlink connected series To unlink a linked series 1 Click on the arrow next to the Unlink button on the toolbar 2 Select one of the following Unlink All unlinks all connected series Unlink Active Group unlinks only series of the selected group if more than one linked group exists Select Tool Iz Changes the cursor to the select tool Pan Tool 1 Panning can be used to move the ROI Region of Interest on the preview pane or on the main view To Move to a Different 1 Click the Pan button 2 Part of an Image f 2 Cursor changes to Hand Tool l Without Changing 3 T Magnification 3 Click and drag the image or the ROI to the desired location Confidential 2005 IDX Systems
15. DICOM printer To Customize DICOM 1 Define a DICOM Printer in the Settings dialog box Print 2 To select images in the main view click in the box upper right hand corner A check mark appears ET i 181 x File View Image Tools Ortho Help oar el x S CIEL ile Di eie lb iim Q Ola WA S00 aE tit 7 Os aR A ks Window Level S Ti SMITH HAROLD M PIKR750000 PIKROOO3 CT EM EM a p y _ 1 m O n2 e TI m iT fh ma E mM m e e ow A 4 rA o 4 ES IOCOCCE EJ 4 TTE Em es c5 oO CD ta KENNEWICK GEN HOSPITAL PQCT Mag 58 26 Jan 1 oo NU lt ww S00 1 45 87 KVP 140 00 WL 200 B E Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Printing an Image 125 3 Click on DICOM Print to open the DICOM Print dialog box x Print Details vw Print Overlays Advanced Rows 1 zl Columns 1 el Grow Shrink E Number of Pages 2 C Allimeges in Active Series All Selected images To sect an image 7 check the bos in its wu tap right corner A Number of Selected Images 2 Printer D icamFrinter M Properties AE Title PRINTERAE Hast 12 0 0 7 Cancel 4 Select to Print All images in Active Series Images need not be specifically selected All
16. Delete Files will not remove files of studies currently open e Memory Set the amount of memory used by iPACS Viewer Memory changes will be applied only after the iPACS Viewer is restarted SmartCache Settings IPACS Viewer uses Pixels On Demand technology to stream the study data to your workstation SmartCache streams additional study data while you are viewing an image This allows for the best possible efficiency in your workflow Confidential 2005 IDX Systems Corporation All rights reserved B EE 116 Using the IDX Imagecast iPACS Viewer Settings I ES d M SmartCache allows you to set the level of automatic data transfer to the Viewer in idle time SmartCache brings all the data of the studies open in the preview pane to your workstation even the series that are not currently selected for viewing UC NEN a xi Streaming Mode Display DICOM Printer Orthopedic Templates Hanging Protocols Modality Presets Cine Overlays Thumbnails Magnitinder System smartLache Mane Maximum I L I None Detais sent only upon interactive user request Optimal Data is sent in background for activated studies opened ance in main view Recommended setting hd aximum Data it sent in background for all studies There are three levels of SmartCache 1 None Data is sent to the workstation only upon interactive user request 2 Optimal Data is sent in the background for a
17. Note If you have selected images manipulated the image applied measurements or annotations these settings will not be saved when you move between series B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings 93 14 Select Display Criteria The Display Criteria determine the hanging order of the images or studies For example if you open two studies you can set the Time Ordering criteria such that the latest study always opens on the right Match Whole Word lIf entering values for certain criteria in the edit box you can force to match whole word only in the Display Criteria Advanced Define a Display Criteria according to a specific DICOM Tag 15 Select Properties that you want the study to open with e Zoom Zoom Factor can be set as Fit To Screen 2il 1 1 1 2 1 4 1 8 e Inverse WW WL Default Preset from the Modality Windowing is set according to the default values as received from the modality at the time of acquisition Specific Modality Preset Windowing can be set according to a predefined Modality Preset e Orientation Flip Vertical or Horizontal Justify Right Center or Left 16 Click Finish to complete the creation of the Hanging Protocol When a study is opened in the Viewer while another study is already loaded the Hanging Protocol is not applied automatically and the
18. Protocol definitions e Export Exports the Hanging Protocol into an xml file with extension hpr Confidential 2005 IDX Systems Corporation All rights reserved B EE 90 Using the IDX Imagecast iPACS Viewer Settings To Create a New Hanging Protocol I ES d M Arrows allow changing priorities between Hanging Protocols If a study opened corresponds to more than one existing hanging protocol the one with the highest priority will be applied Creating Editing a Hanging Protocol Click New to create a new Hanging Protocol or Edit to change an existing one 2 he Hanging Protocol Wizard dialog box opens 3 Enter a Name for the Hanging Protocol For example MR Studies Select desired Hanging Criteria for example Modality equals Click Add Criteria to add it to the Hanging Criteria list Use this hanging protocol for studies that fulfill the selected hanging criteria Hanging Protocol Wizard X Studies which Fulfill the selected criteria will hawe this Hanging Protocol applied to them astomatically Define Hanging Protocol Mame MR Studies Select desired Hanging Crizeria then click Add Criteria to add to list below MR Add Criteria Number af Studies Match whale ward Hanging Criteria List In order to apply Ehe Hanging Protocol studies must Fulfill ALL of the criteria Multiple criteria use a logical AND between them Modality MR Pelete triteria Back Nex
19. Selected images Images can be from several studies UI The Number of Selected Images in the main view is indicated OD Select Unselect to Print Overlays 7 Set the number of Rows and Columns desired in the printed page For example choosing two rows and two columns will result in a 2x2 layout or four images printed per page 8 Select Grow Shrink font according to the DICOM Printer 9 The resulting Number of Pages is displayed 10 Select which DICOM Printer will be used for this print job from the drop down listbox 11 Click OK to send the images to the printer 12 The Printing Status icon will appear in the lower right hand corner of the iPACS Viewer 139 P 139 To Cancel a DICOM Print 1 Double click on the Printing Status icon P Job in Progress Confidential 2005 IDX Systems Corporation All rights reserved B EE 130 Using the IDX Imagecast iPACS Viewer Printing an Image To Set Advanced DICOM Print Settings To Set the Printer Properties I ES d M 2 The Cancel DICOM Print dialog opens Cancel DICOM Print X DICOM Print is currently printing Would you like to Cancel current DICOM Print job Cancel all DICOM Piiril juls Cancel 3 You can cancel the current DICOM Print job or all DICOM Print jobs 1 Select to print with or without Print Overlays on the image 2 Click on the Advanced button to open the Print Overlays dialog box 3 Se
20. Streaming Mode Display DICOM Printer Hanging Protocols Modality Presets Cine Playback Order Forward C Backward C Bounce oom Far Cine Playback Keep Curent Zoom Default Zoam 1 1 Optimization Type Optimized for speed Pixel Replication C Optimized for quality Linear Interpolation Default Speed E fps Force Lossless The following can be selected e Playback Order Forward First to Last First to Last Default Backward Last to First Last to First Bounce First to Last Last to First First to Last e Zoom for Cine Playback Keep Current Zoom Default Zoom Fit To Screen 2il 1 1 cea 1 4 1 8 Contidential 2005 IDX Systems Corporation All rights reserved B EE 9g Using the IDX Imagecast iPACS Viewer Settings e Optimization Type Optimized for speed Pixel Replication runs cine at fastest rate possible but with lower quality Optimized for quality Linear Interpolation runs cine at high quality but at a slower rate e Default Speed 1 30 frames per second Default 5 fps Available computer memory and current resources can limit actual fps e Force Lossless Check in order to view the Cine in Lossless View meaning all data received for the current window level Cine for Cardio Settings For Cardio users only in the Cine tab you can define Playback Order Zoo
21. Tantra cence ses 66 hip T ew PRECES 68 Pixel Intensity TOO ierra ra btt Extr rie FR cu C ra rea 69 Confidential 2005 IDX Systems Corporation All rights reserved Contents 5 Wu Baers estes 71 EIE TEL onsec ner diaiveitabtel a DUREE VPN RNERDI 72 Bic aa 4M TRUE 73 psa bo Mee cr ene 74 Ree qo 76 Delete All Annotations ccscsscsesecsececsecrsseceseranseecesnentsass 77 Display Hide Overlays NER E 77 OrthoPlanner Optional eee mmn 78 Tae zai TITRE 78 How to Create a Template Report eee 84 Angle Between Two Lines nee 85 Cobb Angle For Spine Scoliosis eee 86 Transischial Line For Total Hip Replacement 86 BERE unns P E CEA REEPOLE DEDE AED LEUR FOI E TY 88 Hanging Protocol Settings Optional 88 Modality Presets Settings eere 95 Cine non Cardio SECS e id evesica pad axedExx based PENNE EE FAM RER 97 Cine for Cardio Settings en eee eae 98 Streaming Mode SettingS sesssssssssnsnernnnnrsrsnsnsnnnnrnenens 100 Display optional Settings eren 101 DICOM Printer Settings Optional 102 Orthopedic Template Settings Optional 106 Overlay Settings Lussicsexesvex
22. While saving an animated gif appears in the status bar of the viewer to show that images are being sent to the server To cancel the save task double click on the gif on the status bar iPACS Viewer XI PACS Viewer is currently uploading Files to the server Pressing lt es gt will cancel the upload Are vou sure you want bo continue Yes Ma Confidential 2005 IDX Systems Corporation All rights reserved 136 Using the IDX Imagecast iPACS Viewer Saving an Image When saving is complete the viewer will display a message saying A new secondary capture image is being added to this study To view this image you can close and re open the updated study Note there may be a short delay before the new image can be viewed iPACS iewer File View Image Tools Ortho Help le Q Ox SG6SG Fi G Ge e S k O QQe Ol Qa ASOD OFA rile ros4Rlal Ps qo a4 c g J Window Level J IDetautt oe fhe ESSI IE I 82808 378 3258 ee E i 3D HEAD OJ X RAD 600 BROAD WAY ES SIGNA Mag 100 LUTAN 5 Each secondary capture created as a new DICOM series Each SC is created as a new DICOM series with same StudyUID as the original study Next time you open the study a new series defined as SC is added to the study B E Confidential 2005 IDX Systems Corporation All rights reserved
23. and measurement annotations that were written on the image These annotations become DICOM Overlays on the server After save other users will be able to see the DICOM Overlays on the images You can save the annotations for all series opened in the main view or just the active series indicated by a red frame around the image window You can add a description describing your annotations Once annotations are saved they become DICOM Overlays their color changes and they can no longer be edited or deleted Confidential 2005 IDX Systems Corporation All rights reserved ai d asi lief Using the IDX Imagecast iPACS Viewer 134 Saving an Image Save Annotations on Server e i B e Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Saving an Image 135 Save Snapshot on Server Secondary Capture Saves the active view as a DICOM Secondary Capture SC and sends this image to the server The snapshot includes the images currently displayed on the active view including all the images for series layout more than 1x1 the measurements and annotations MIPACS Viewer 18 x File view Image Tools Ortho Help jeE Ox S46G Hi GO RV S OQQeO SU MSOO UA False rosa als J Window Level efa SEATTLE RAD 600 BROADWAY GEN SIGNA Mag 100 Wi 1210 WL 350 Display showing that image is being sent to the server
24. disappears once all data has been received B E Contidential 2005 IDX Systems Corporation All rights reserved Qualicator Using the IDX Imagecast iPACS Viewer Image Quality The Qualicator appears on the upper right hand corner of each image slice in the main view It indicates the level of quality of the image during streaming as compared to the original image Qualicator States Symbol Name Description Lossy During streaming until Lossless View quality is achieved the quality is Lossy Visually lossless is achieved well before Lossless View However since there is no mathematical definition of Visually lossless iPACS Qualicator stays Lossy Lossless view In 1 1 resolution all data has been received for the current Region of Interest at the current 8 bits display of the image taking into account the current Window Width Lossless In 1 1 resolution all the data for the current region of interest has been received Each pixel is exactly identical to the same pixel in the original image All data received For resolution different than 1 1 all the data for the current view has been received Lossless state cannot be defined because original image in this scale doesn t exist This indicator will also be displayed if the original image received by the iPACS Server is lossy for example lossy jpeg or the aspect ratio is not 1 1 and interpo
25. driver dpr file 3 Click Open to import the printer definition to the local computer To Export a DICOM 1 Click Export Printer Driver Contidential 2005 IDX Systems Corporation All rights reserved B EE Using the IDX Imagecast iPACS Viewer 104 Settings 2 Click Save to save the printer definition as a driver file dpr To Ensure that the 1 Click Echo DICOM Printer as Been 2 The iPACS Viewer will send a DICOM C ECHO to the printer Defined Properly and is Working 3 The result of the DICOM C ECHO will appear in a message box 4 If the DICOM C ECHO was unsuccessful check your printer settings and try again To Edit the DICOM 1 Select a DICOM Printer from the drop down list box 3 The printer Info dialog box opens and you can edit the DICOM Printer settings here To Delete a DICOM 1 Select a DICOM Printer from the drop down list box Printer Setting 2 Click on Delete X 3 Confirm the deletion of the DICOM Printer To Change Specific 1 Click Advanced in the DICOM Printer tab of the Settings Settings in the DICOM dialog Printer s Definition 2 he Advanced Settings dialog box opens for that printer 3 Add a new attribute by selecting its category and then clicking on New Attribute 4 Delete an attribute by selecting it and then clicking on Delete Attribute X 5 Revert back to all defaults by clicking on the Restore Defaults button B E Confidential 2005 IDX System
26. e3x3 e4x4 e Customize Choosing Customize opens the Custom Layout dialog box where you can input the number of rows and columns desired in the series layout The following shows the same CT with different Series Layouts Fie View Image Tools Ortho Help o pele MP QAQ O BUA lrae7084 7 4 00G 08 8 CO DER oa 6 x A2GH E Di dk SO LO Window with ae Window Leve J Olta 03 0 ge a E E AVE ABDOMEN M ilawE ABDOMEN O0 XI Study Date 14 Oct 1996 10 Oct 1976 CT C CONT tz chu st Roch td 6000 14 Oct 1996 ST 1n nn KVP 120 00 CHU St ROCH 6000 14 Oct 1996 ST 1n nn KWP 120 00 3 1 Lu CHU St ROCH 6000 14 Oct 1996 ST 10 00 KVP 120 00 ST 10 00 KVP 120 00 Ready Confidential 2005 IDX Systems Corporation All rights reserved E BEN Using the IDX Imagecast iPACS Viewer 36 Layout Full Screen Zl The active view is enlarged in Full Screen The image is displayed without the toolbars using the whole screen area for maximal display Multi Monitor Optional In order for the multi monitor option to be displayed there must be more than one monitor connected you must have multi monitor permission and iPACS server must be installed with the appropriate license Default Monitors Click on the Default Monitors button to open the viewer on several monitors as defined in the default hanging protocol The Defaul
27. iPACS Viewer Image Information iPACS Viewer File View Image Tools Help SO d Bsle o h O AQtOlGu S i 3D HEAD OJ X 3b i 3 J Study Date 11 May 1993 E pem PATIENT INFO Patient Name 3D HEAD Patient ID 586 658 8805 Patient BirthDate Patient Sex M STUDY INFO Study Date 11 May 1993 Study Time 140416 Study ID 1 2 840 113619 2 1 1 318792063 474 737146178 965 Sludy Desuripliuri BRAIN ORBITS Referring Physician HAYNES Reading Physician KJOS Accession Number Institution Mame SEATTLE RAD 600 BROADWAY Department Le S SEATTLE RAD 600 BROADWAY GENESIS_ lA 11 May 1993 T ST 3 00 A gt 4 C p Mag 126 RT 650 00 j y 1 Wi 1210 m P 7 F ET 17 00 WL 350 Clicking on the Study Info button opens a separate window with the following data Patient Information e Patient Name e Patient ID e Patient Birth Date e Patient Sex Study Information e Study Date e Study Time e Study ID e Study Description e Referring Physician e Reading Physician e Accession Number B e Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer e Institution Name e Department Series Info 3D HEAD 1 X PATIENT INFO Patient Name 30 HEAD Patient ID 536 568 8805 Patient EirthDate Patient tex MM SERIES INFO series Description T1 SAGITALS Modalty MR Body Fat Image Tepe ORIGINA
28. is the Warning icon Warnings indicate danger to a patient Warning Confidential 2005 IDX Systems Corporation All rights reserved Proper Usage of Imagecast Products P a A cass wave occ vans tee cae DTE IDEE EQ ek eat E MEE PS 10 Imagecast iPACS Image Viewer Safe Usage Statement 11 xta Te TS T TIT TT 12 Confidential 2005 IDX Systems Corporation All rights reserved iB INS Proper Usage of Imagecast Products 10 Overview Overview Imagecast medical software applications aid in the delivery of healthcare by assisting authorized personnel in their daily workflow and by assisting qualified providers in the interpretation of medical data To ensure proper use of the system users should read the product manuals and receive training Certain sections of Imagecast products are of particular importance and can pose a potential problem if users are not properly trained The following sections describe e The responsibilities of you the customer and IDX regarding potential issues e Cautions to alert you to potential issues on which to focus during training and regular use of the system If you do not understand these responsibilities and cautions or how they affect you contact your Imagecast application manager or the Imagecast Support Center B E Confidential 2005 IDX Systems Corporation All rights reserved Proper Usage of Imagecast Products Imagecast iPACS Image View
29. it again at a later date If your temporary files is enabled you will be able to view the previously viewed study immediately and locally without streaming For example you viewed a series in 1 2 resolution and then closed the iPACS Viewer The next time you open the same series all information that was received previously will be available locally on your computer All data already received up to 1 2 resolution will be immediately available Any information beyond that resolution will arrive by streaming settings eee xi Hanging Protocols Modality Presets Cine Streaming Mode Display DICOM Printer Orthopedic Templates Overlays Thumbnails I agnifinder System Smart L ache Tempora Files M Enable Current location C Documents and Settings ael4pplication Data Amount of disk space to use Change Location Delete Files Memory Amcunt af memor usage fe IB SMB Cancel In the Temporary Files tab you can define the location of the Viewer temporary files and the amount of disk space to use Set the high limit of disk space to use When the temporary directory reaches the high limit it will delete the Least Recently Used LRU files until it reaches a certain percentage of the high limit usually 30 The following are displayed e Enable If checked allows temporary files to be stored on your local computer If disabled all temporary files currently B e Contiden
30. on the left mouse button and drag the mouse horizontally The change is reflected in the WL slider on the Windowing toolbar and in the Overlay Annotations bottom right hand corner 1 Click on Save Current Preset button or click on right mouse button to access the pop up menu and select Window gt Save Current Confidential 2005 IDX Systems Corporation All rights reserved Edit Windowing To Enter the Window Width WW and Window Length WL Values Manually Using the IDX Imagecast iPACS Viewer 43 Window Width and Level 2 The New Preset Window opens New Preset Window X Modality MA Preset arme Test Shortcut F2 Window width 4358 Window Level KE Cancel 3 The New Preset is defined for that Modality with the currently displayed windowing 4 Define a name for the preset and shortcut if desired 1 Click on the Edit Windowing button 3 2 The Edit windowing dialog box opens x windon width 1525 Window Level 503 OF Cancel 3 Enter values in the Window Width and Window Level fields 4 Click OK to implement your changes Contidential 2005 IDX Systems Corporation All rights reserved B EE 44 Using the IDX Imagecast iPACS Viewer Image Manipulation Image Manipulation Link Tool When viewing several studies or series you can link images series together in order to perform actions simultaneously When two or more images series are linked i
31. reflected in the Preset drop down box on the toolbar and in the pop up menu Settings NE xi Overlays Thumbnailz hagnifinder System Smart Cache Streaming Mode Display DICOM Printer Orthopedic Templates Hanging Protocals Modality Presets Cine Modality cr 3 X ti Preset Vindow Window Abdomen Bone 2500 500 F3 Cerebrum 120 40 F4 Liver 150 50 F5 Luna 1500 500 FB Mediastinam 300 a0 Fr Pelvis 400 40 F PosteriorFossa 250 al Fa Click to select row Double click to edit row To Add a New Preset 1 In the Modality field select a modality Window Setting 2 All Modality Presets will be displayed in the table 3 To add a new Preset Window double click on an empty row 4 Click the row to select it You can edit an item delete an item and move an item up and down according to your personal preferences Contidential 2005 IDX Systems Corporation All rights reserved B EE 96 Using the IDX Imagecast iPACS Viewer Settings 5 Double click on the row to edit an existing field The Edit Preset Window opens In this way change the preset name WW or WL Edit Preset Window X Modality CT Preset hame Liver Shortzut F5 Window width i Hn Window Level po Cancel 6 Click OK to save your changes Use the following buttons when editing Modality Window Presets e Create a new Preset setting e Edit a Preset Window setting e X Delete Delete th
32. select the product title of the template that you want to work with REF z E Procedure Side Fight Procedure Mame Total Knee Replace Manutacturer Mame Bomet Family Title Maxim Knee Bearin Product Title Primary Tibial Bearir Add Template 7 Click Add Template to add it to the list of templates B e Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer OrthoPlanner Optional 81 8 A list of properties specific to the template chosen is displayed Select the values desired to place the template on the image EF Procedure Side Right Procedura Mame Total Knee Replace Manutactirer Marne Biomet Family Title Maxim Knee Bearin Product Title Primary Tibial Bearir Ade Template Primary Tibial Bearings Insert Size 10 Tray Size To rotate the template Press CTAL lett mouse button or press on mouse scroll wheel Contidential 2005 IDX Systems Corporation All rights reserved ioi E Exit Templating Mode Button Create Report Template List and properties Delete Template button ai d asi lief Using the IDX Imagecast iPACS Viewer 82 OrthoPlanner Optional iPACS Viewer File View Image Tools Ortho Help ICA x SE Hi Fo Sel el k OQAQtO BE MSOOH S rt2os 4 Rl Fale je Oe8 O08 BB B B Big window am ea Fe ihe ch
33. to an NDA with IDX you are not authorized to access this document The information contained herein is confidential and should not be used disclosed or duplicated for any purpose other than developing information system plans within IDX customer organizations Duplication and or distribution of this document beyond IDX customer organization information systems and management executives are not allowed without express written consent from IDX Trademarks IDX Imagecast IDXrad IDXConnectR Mammography Administration Module and MAM are trademarks or registered trademarks of IDX Investment Corporation All other brand and product names are trademarks or registered trademarks of their respective companies Copyright Notice Copyright 2005 IDX Systems Corporation All rights reserved Disclaimers This document is provided to you for information purposes only The information in this document is subject to change without notice Except as specifically set forth in separate written agreements between you and IDX all information contained in this document is provided entirely AS IS To the maximum extent permitted by law IDX MAKES NO WARRANTY OF ANY KIND DISCLAIMS ALL EXPRESS IMPLIED AND STATUTORY WARRANTIES AND ASSUMES NO LIABILITY FOR ANY DAMAGES OF ANY TYPE IN CONNECTION WITH THIS DOCUMENT OR ANY INTELLECTUAL PROPERTY IN IT European Representative c Obelis Av deTervueren 34 Brussels Belgium Co
34. 1 30 frames per second Default 5 fps Available computer memory and current resources can limit actual fps e Force Lossless Check in order to view the Cine in Lossless View meaning all data received for the current window level e Fwd Bwd Steps Determines how many slices to jump forward or backward when using the Step Forward Step Backward buttons e Synchronize Linked Cine When two cines are linked together choose Long Run restart when longest run is finished Short Run restart when shortest run is finished Confidential 2005 IDX Systems Corporation All rights reserved ai is asi lief 100 Using the IDX Imagecast iPACS Viewer Settings I ES a M Streaming Mode Settings Streaming Mode selects the bandwidth adaptation model that best corresponds to the current network connection speed The purpose of Streaming Mode is to automatically choose the streaming model according to client s bandwidth In the Settings dialog box Streaming Mode settings are set for a specific server The changes will be implemented when the next study is opened When the bandwidth is more or less constant the required model can be set once in the settings using manual To open the Settings dialog box for the specific server click on the Settings 5 or Streaming Mode buttons In this tab the following values appear e Server Displays name of the last server that was connected In the drop down li
35. 143 If the total size of the studies is more than the capacity of the media CD DVD the following window appears Write to Multiple Discs I x writing all 4 studies requires 692 11MB of disk space There is 7 6 00MB space available an he current disc You will neec z disks of OOMB to burn all the requested studies Multiple media settings C Begin with study Studies 1 ka 3 will be written to the current disc Select the multiple media settings e Begin with the first study e Begin with study number Click Burn to start the burning process of the first disc EX Imagecast Cardiology Burner BE xl eI X 3 D Wrnte CD view Add Remove IG ESCENARIO4 TESTIMAGE 11 17 2004 at Unspecified Ke 11 17 2004 US S E 11 17 2004 at Unspecified SS 11 17 2004 Us 1 9 BAILEY NICOLE C 7 18 1995 at Unspecified ST ANTHONY HOSPIT i s 7 10 1995 5C MR H SCENARIOS TESTIMAGE E 11 16 2004 at Unspecified C5 11 16 2004 US Process status Adding files to project Viewerlnitiator dll Progress Cancel Multiple Burn Progress Burning studies 1 through 3 ha Done Composition Size 892 11 MB A The burner cannot split one study in two CD discs For Example if there is a single study that is greater than 650MB then the user can burn this study only on DVD Confidential 2005 IDX Systems Corporation All rights reserved B EE 144 Using the IDX Imagecast iPACS Viewer Creat
36. 6 Creating a CD DVD optional DVD Discs Supported by a Specific DVD Drive DVD RW Drive DVD RW Drive DVD R RW Drive coh oppi Me DVD R Disc Reads amp writes Reads Reads amp writes Reads amp writes DVD RW Disc Reads amp writes Reads Reads amp writes Reads amp writes DVD R Disc Usually reads Reads amp writes Reads amp writes Reads amp writes DVD RW Disc Usually reads Reads Reads amp writes Reads amp writes DVD R DL Disc Usually reads Reads Reads Reads amp writes Using the IDX Imagecast iPACS Viewer Local License 147 Local License Not required when the viewer is used as part of the Imagecast PACS for Cardiology There is an option in the Viewer to install a local license This license is used to enable certain license dependent features of the Viewer To install a local license 1 Click Help gt License gt Install License 2 Browse to the location of the License dat file as provided by your administrator and click Open 3 If the license is up to date and suitable for your computer the success message will be shown 4 If the local license has expired the following message is received IPACS Viewer X Your license has expired Please contact your vendor fou can renew it or uninstall your license Contidential 2005 IDX Systems Corporation All rights reserved ai d asi lief Using the IDX Imagecast iPACS Viewer 148 Create Licen
37. A succession of the slices that belong to the same orientation frame of reference and imaging parameters from MR or CT Double clicking the preview opens a number of slices in the main view depending on the preset series layout Page Stack and Cine modes are available Study A single or group of images series acquired in a single procedure for the same patient All images and series for that study are opened in the preview pane for easy selection and viewing B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Getting Started 17 Getting Started After a study has been selected from the worklist the Imagecast iPACS Viewer automatically opens the images for that patient The Imagecast iPACS Viewer displays the study s previews on the preview pane on the left hand side of the screen and the images are opened in the main view according to the default hanging protocol To open another image in the main view of the viewer double click or drag on the preview you want to select Refer to the graphic below File View Image Tools Ortho Help Horizontal SH xi nmigijss xejecj x ej amp qegjg AsXo2odc gitsi eos amp aA Blasi Toolbars f G O 2 C CD EJ EB ED E CJ EE Bia Wnaow win J Window Level I gt s TANAKA HANAKO Preview Pane Main View Horizontal Toolbars The horizontal toolbar
38. ACS Viewer Window Width and Level Preset WW WL Listbox Invert Color Windowing Button To Change the Window Width To Change the Window Level Save Current Preset To Save the Current Window Width and Level as a Modality Preset I ES d M Default Displays a list of preset WW WL values The preset WW WL values are changed according to the modality of the image in the active view These values are defined in the Modality Presets which are found in the Settings dialog box By default preset values are defined for the CT modality Other modalities have no predefined values New preset window values can be defined in the Settings dialog box or from the pop up menu Window gt Save Current If an image has a Look Up Table LUT defined for it in the DICOM Header LUT is listed in the Preset listbox The image will be displayed using the predefined LUT Inverts the gray levels of the image Black is displayed as white and vice versa Clicking the button again returns the image to its Original state To change the WW and WL click on the left mouse button and drag the cursor across the image Cursor changes to windowing tool Pressing the mouse wheel and moving it on the image will also perform WW WL changes W Click on the left mouse button and drag the mouse vertically The change is reflected in the WW sliders on the Windowing toolbar and in the Overlay Annotations bottom right hand corner Click
39. Bottom Right corner e Linked Group if image is linked e Calibrated if calibration is done e Magnification e WW e WL B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Image Information 123 Overlays can be toggled on and off using the Overlay Annotations button iPACS Viewer 81 x File View Image Tools Ortho Help eM xi amp smEilss iesolmejRmaeguteasoodcojlg Esee ods4Ald4Wu Ps Q CI E EB EB B EB Bi window at over Window Level T 7 ia w e s i HAND AP upper extre O X 1 Overlay Off iPACS Viewer File View Image Tuus Orlliu Help la xl cux xi smgilss 5ejee jsiemaeg iaitA ooo amEsi eo amp dA ig u 3H Overlay On Confidential 2005 IDX Systems Corporation All rights reserved B EE an el 124 Using the IDX Imagecast iPACS Viewer Image Information Study Report Click on Study Report in the toolbar in order to open the Add Report window for the active study In some cases of integration this option is disabled The Add Report window opens in the right hand side of the screen next to the Viewer In the report window you can view previously written reports and add new reports iPACS Viewer loj x ERIE iBl xl File View Image Tools Ortho Help oe xj amp mlEgil ss xejee sje
40. Corporation All rights reserved E BEN 46 Using the IDX Imagecast iPACS Viewer Image Manipulation Zoom Tool To Use the Zoom Tool I ES d M 4 Continuously increases and decreases the magnification level according to the mouse movements on the image 1 Click on the Zoom button amp or right click on the image and select the Zoom Zoom Tool from the pop up menu 2 Click on the image to be zoomed 3 Do one of the following Move the mouse up the image to increase the magnification Move the mouse down the image to decrease the magnification e The zoom level of the image can be increased up to 6400 magnification level e The image is centered on the clicking location To increase the zoom level once by a factor of two while retaining the previous cursor right click the image and select Zoom Zoom In from the pop up menu To decrease the zoom level once by a factor of two right click the image and select Zoom Zoom Out from the pop up menu ay Pan Zoom out Window Fit To Screen 2 Flip Rotate ift i 1ResoluSon 1 EE LAPSI E Zoom Tool Fa Series Layout PCi Magnifinder M E Cine m _ Full Screen Enter wy Display Hide Overlays A Measurements k 7 Calibration Save Copy to Clipboard Ins Close Advanced a Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer 47 Image Manipulation The follo
41. EB EB Es Q window wath 7 Window Levei E fbetaut ta VO 3 BE S 1 i RSNA Demo Medical O X RSNA Demo Medical Mammogram F JPEG2000 M G1 RG USF 26 Jan 1996 Ready The settings for the Magnifinder are e Zoom factor x2 X4 X8 x 16 e Size Small Medium Large e Close The Magnifinder defaults are set in the Settings dialog box B E Confidential 2005 IDX Systems Corporation All rights reserved Fit To Screen 1 1 Resolution Restore Image Unselect All Images Using the IDX Imagecast iPACS Viewer Image Manipulation Clicking again the Magnifinder 4 button removes the Magnifinder from the main view You can also close the Magnifinder by unselecting it in the pop up menu Click on the right mouse button in the main view outside of the Magnifinder area in order to access the pop up menu Zooms in on image to greatest possible magnification for the current screen layout so that the image fits to the part of the screen it appears in Sets the image to 1 1 resolution Every pixel displayed corresponds to a pixel of the original image Only at this resolution is lossless quality achieved in other resolutions all available data is streamed amp Returns the active image to its original position zoom orientation and window Clears all images that were selected for DICOM printing or save Co
42. IDX Imagecast iPACS User Manual Software Version 5 2 Document Version 1 Published September 2005 Confidential 2005 IDX Systems Corporation All rights reserved B i Contact Information Please send any inquiries or feedback about this document to imagecast_docs idx com Please include the document name and version with your inquiry or comments Confidentiality and Proprietary Rights This document is the confidential property of IDX Systems Corporation IDX No part of this document may be reproduced in any form by photostat microfilm xerography or any other means or incorporated into any information retrieval system electronic or mechanical without the written permission of IDX Inquiries regarding copying and or using the materials contained in this document outside of the limited scope described herein should be addressed to the e mail address listed above IDX reminds you that there may be legal ethical and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as IDX You should obtain explicit written consent from both the patient and IDX before you disclose sensitive patient information to IDX Limitations and Conditions of Use IDX furnishes this document to you a current IDX customer as IDX confidential information pursuant to a non disclosure agreement NDA between you and IDX If you are not i a current IDX customer and ii subject
43. IDX Systems Corporation All rights reserved B EE 30 Using the IDX Imagecast iPACS Viewer Image Navigation To Use Stack Mode Thumbnail Scrolling I ES a M Previous Series Click to display the previous series of the study Next Series Click to display the next series of the study If the Scroll Between Series setting is enabled in the Hanging Protocol you can automatically scroll between series using the mouse wheel Stack Mode Browses through slices of a series according to the mouse movements on the image 1 Click the Stack Mode button Ly 2 Click on the image 3 Move the mouse up and down on the image in order to browse through the series slices On the upper portion of the preview pane the series number and range of series are written S34 af 1 MR 4b If the number of slices available is more than shown the Previous Thumbnails Page and Next Thumbnails Page buttons are enabled Previous Thumbnails Page 4 In the image preview displays the previous page of thumbnail slices in the series The tooltip of the button shows the number of images in the series Next Thumbnails Page k In the image preview displays the next page of thumbnail slices in the series The tooltip of the button shows the number of images in the series Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer 31 Image Navigation Thumbnail Mode Large T
44. LIPRIMARY series Number 1 Series Dale 11 May 1995 series Tme 140416 Laterality DICOM Overlays Info ipacs ipacs 20050703 122443 Image Information 119 Mote this Finding Clicking on the Series Info button in the main view opens a separate window with the following data Patient Information e Patient Name e Patient ID e Patient Birth Date e Patient Sex Series Information e Series Description e Modality e Body Part e Image Type e Series Number e Series Date e Series Time Contidential 2005 IDX Systems Corporation All rights reserved ai d asi lief Using the IDX Imagecast iPACS Viewer 120 Image Information e Laterality e Protocol Name e Manufacturer e Model Name e Station Name e Contrast Bolus Agent e Rows e Columns e Bits Allocated e Bits Stored e Window Width e Window Center e Pixel Spacing For CR e Plate Type e Phosphor Type e Cassette Orientation e Cassette Size e Sensitivity For MR e Scanning Sequence e Repetition Time e Echo Time e Echo Train Length e Inversion Time e Trigger Time e Magnetic Field Strength e Sequence Variant For CT e KVP Kilovolt Peak in mA e Gantry Detector Tilt e Table Height e Exposure in mA e Filter Type e Rotation Direction B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer 121 Image Information For NM e Actual Frame Duration e Counts Ac
45. NORMAL or REVERSE Bits Allocated 0028 0100 Automatic Bits Stored 0028 0101 Automatic High Bit 0028 0102 Automatic Pixel Representation 0028 0103 Automatic Do not change any parameter without specific instructions from your system administrator or printer technician Changes in the DICOM printer parameters can cause the print function to stop working In case of malfunction restore the default settings and try again Orthopedic Template Settings Optional If the iPACS server is installed with the appropriate license for the Ortho Module and you have Ortho Permissions you can download Orthopedic Templates of different manufacturers to use in the Viewer settings eee x Overlays Thumbnails Magnifinder System SmartCache Hanging Protocols Modality Presets Line Streaming Mode Display DICOM Frinter Orthopedic Templates To display updated or new Orthopedic Templates select a server fram the list server Brie NLIS x NN in Local T euplele Mew ar Updated Templates on Server rz Total Hip Replacement E Total Knee Replacement gm Total Elbow Replacement E Total Shoulder Replacement Select the templates and click Download B e Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings 107 To Download the Ortho 1 Select a server from the list Templates 2 Click Go 3 A list of all available tem
46. OLR chest O ee er CE rE E PF LINE B e Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer 77 Annotations Delete All Annotations amp Deletes all annotations on active images You will be asked to confirm deletion of the annotations Checking Don t ask me again can turn this off Display Hide Overlays a Displays hides all overlays on all displayed images or series B E a Confidential 2005 IDX Systems Corporation All rights reserved an el 78 Using the IDX Imagecast iPACS Viewer OrthoPlanner Optional OrthoPlanner Optional The orthopedic module optional allows orthopedic surgeons to use specific measurement tools for diagnosis and for planning total joint replacements Templating Templating allows you to perform surgical planning for total joint replacement Templating includes the exact selection and positioning of digital templates on the image as well as creation of an Ortho report for preoperative planning Before starting digital planning on image you need to calibrate the image Exact instructions regarding downloading Digital Templates can be found in Orthopedic Template Settings Optional on page 106 To Begin Using Digital 1 Click on Ortho Templating P on the toolbar to open the Templates Templating dialog box la x File View Image Tools Ortho Help eA x amp m 5ij ss ejecsj
47. X Systems Corporation All rights reserved B EE Using the IDX Imagecast iPACS Viewer Annotations 6 You can delete a Free Hand annotation by clicking on it and pressing the delete key on the keyboard or right clicking on the Free Hand annotation and choosing Delete from the pop up menu 7 You will be asked to confirm deletion of the annotation This can be turned off by checking Don t ask me again The Free Hand Annotation can be saved as a DICOM Overlay on the server so other users can view it as well iPACS Viewer 8 x File view Image Tols Ortho Help xj amp 8pijssmejci jlhvWeauogegutmAasoodcog ueeoosSAaxeu Pa Ou O08 Bw Eel E3558 Bia Window Width ERU CCFETERZNT Window Level a re pest ta WV IO S 4H Bl SMITH HAROLD M EI PikR750000 PIKROOO3 i SMITH HAROLD CT C D E E Ta n2 NM ph 888 n2 m 88 mo uD ECEEEEELETI e to C2 A to e See fe E E d 4 4 o D BHB cs k KENNEWICK GEN HOSPITA PQCT 26 Jan 1995 KWP 140 00 1 45 187 Angle Tool Click on the Angle button on the toolbar to activate the annotation tool To Measure an Angle on 1 Click on the left mouse button at the desired start point the Image 2 Draw the first line of the angle by moving the mouse Another single click sets the corner of the angle 3 Draw the second line of
48. al delete display hide and save annotations Toolbar Ales vofsgaeiaga Ortho optional Enables you to open Orthopedic Templating measure the angle between two lines Cobb angle and Transischial line Pd Ee n Screen Layout Enables you to customize the layout of images in the main view change series layout and open images full screen lgomemgggisi Hanging Protocol optional Allows you to open Hanging Protocol tab apply Hanging Protocol and save as Hanging Protocol FS E B Window Sliders Allows you to control the Window Width and Window Level displayed on the monitor and select the Modality Window Presets Windowing Enables you to invert color change to windowing cursor save current windowing as preset edit windowing and apply original LUT Window Victh window Level C fa t A Settings Enables you to open Streaming Mode tab open Settings dialog access the online Help and About By default the Viewer opens with only the Image Manipulation Annotations Screen Layout and Hanging Protocol File view Image Tools Help CO ShB S h MQQ O RU Z ale 6 Ogas olg DIE E BB ES GH FE Ee B Every toolbar can be customized according to your preferences They can be turned on or off moved to a different location or floated above the application Confidential 2005 IDX Systems Corporation All rights res
49. amp qeg mueljas o2odc al iPACS Study Report P e zx lr LI EH ra ta OQ E Bi Window wet Gorg So noe Window Level F oot td 10 co no Physician Mary Green 5 2 R Patient Name SKULL general P 2 gt Accession G 827236 E Date of Exam 08 22 1997 13 54 00 i SKULL general PA DJ X i Date of Report 2 17 2005 11 32 03 Type report below or browse to attach file Browse Print Save Clear U Z K U Leuven 5140 22 Aug 1997 Ready msi Local intranet A B E Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Image Information 125 Set Next Status v Sets the next study status on the server for the study currently in the active view of the Viewer The default statuses of the study can be Unread Viewed Read The Set Next Status button changes the status from Unread to Viewed and from Viewed to Read After clicking on Set Next Status you get the following message IPACS iewer X The status change has been sent to Ehe server Don t stow me this message again In some cases of integration this option is disabled The names used for the study s statuses are configurable by the system administrator and may vary Contidential 2005 IDX Systems Corporation All rights reserved ai d asi lief Using the IDX Imagecast iPACS Viewer 126 Pop Up M
50. by e Study Date e Patient Name e Opening Order settings eee xi Streaming Mode Display DICOM Printer Orthopedic Templates Haring Probout Modality Piesels Cirie Overlays Thumbnails hagnifinder System Smart Cache Sortinc Sort by Patient Mame Opening Order Ascending Descending For iPACS Cardio there is an additional ability to display small or large thumbnails of the series If Large Thumbnails is selected and a series is opened you can choose to display the e First Image e Middle Image e Last Image Contidential 2005 IDX Systems Corporation All rights reserved B EE Using the IDX Imagecast iPACS Viewer 112 Settings Study Date Patient Mame Opening Order E Fe Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings 113 Magnifinder Settings In the Magnifinder tab you can define the zoom factor and size of the magnifying square The following can be selected e Zoom Factor 2 Default 4 8 16 e Size Small Medium Large Default Confidential 2005 IDX Systems Corporation All rights reserved E REN Using the IDX Imagecast iPACS Viewer 114 Settings System Settings Temporary files are stored on your local computer and help you view studies faster the next time you open them Once you have viewed a study with the iPACS Viewer you may want to view
51. ctivated studies An Active study is a study that has been opened at least once in the main view This is the recommended setting 3 Maximum Data is sent in background for all studies even if they are only opened in the preview pane SmartCache streams data only during idle time thus it will not disturb the normal usage of the Viewer Server performance can be reduced if SmartCache is set to maximum Only those users for whom on demand streaming is not appropriate for their workflow should use SmartCache Maximum SmartCache Optimal is the default for all users Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer 117 Image Information Image Information Patient Series and Study Information i Opens the info dialog box that contains Patient Study and Series Information for the active image series This information is retrieved from the image DICOM header E Study Info The info button appears both on the toolbar where you can choose to display Study or Series info for the currently active image On the top bar of each image or series same button is used for Study Info The Study Info displays the Patient and Study Information while the Series Info displays the Patient and Series Information i an HEAD O x Study Date 11 May 1993 Contidential 2005 IDX Systems Corporation All rights reserved B EE 118 Using the IDX Imagecast
52. cumulated e Scan Length e Scan Velocity e Table Height e Table Transverse e Whole Body Technique For XA e Angle of Acquisition Primary Angle LAO 209 or RAO lt 0 Secondary Angle CRAN 209 or CAUD lt 0 If the study contains DICOM Overlays the following is listed for each overlay e Color e Creator e Date e Description Overlays a Overlays are displayed on the image according to the modality and the defaults set in the settings dialog box e Overlay Off Hide all displayed overlays including Cut Lines Localizer LR Markers DICOM Overlays and Study Details e Overlay On Show overlays according to the defaults set in the Settings dialog box Overlays Annotations include e Cut Lines e Localizer Slice Indicators e R Markers e DICOM Overlays e Study details Top Left corner e Series Number Confidential 2005 IDX Systems Corporation All rights reserved E BEN Using the IDX Imagecast iPACS Viewer 122 Image Information e Patient Name and Sex e Patient ID e Patient Birth Date e Accession Number e Modality e C Contrast If no contrast was used NONE is written If contrast was used the name of the contrast is written Bottom Left corner e Institution Name e Manufacturer Model e Study Date e ST Slice Thickness e KVP For CT e RT Repetition Time For MR e ET Echo Time For MR e T Inversion Time For MR Top Right corner e Slice number
53. de Cine Speed D Bar Step Backward B For cardio cine Step Forward F For cardio cine Menu Open File CTRL O Print File CTRL P DICOM Print CTRL D Save File CTRL S Settings CTRL T Show Hide Menu Bar CTRL M Copy to Clipboard CTRL C or Insert Study Report CTRL R Help Fi Opens the manual Confidential 2005 IDX Systems Corporation All rights reserved B E a 151 Using the IDX Imagecast iPACS Viewer 152 Keyboard Shortcuts B E Confidential 2005 IDX Systems Corporation All rights reserved Annotations 63 Anterior Posterior 66 AP 66 Arrow Tool 68 M Calibration Tool 63 Cardiology Cine Toolbar 54 Cine non cardio 50 Cine Slider 54 Cine Speed Slider 51 Create License Request 148 Custom Screen Layout 34 Customize Cine Range 52 Cut Lines 61 D Displaying Series 22 Displaying Single Images 21 DVD Drive Disc Compatibility 145 Edit Windowing 43 Edit Windowing 43 Ellipse Tool 72 Fit To Screen 49 Flip 57 Free Hand Tool 73 Full Screen 36 Image Manipulation 44 Image Orientation 57 Image Quality 38 Invert Color 42 L LAT 66 Lateral 66 Layout 32 Confidential 2005 IDX Systems Corporation All rights reserved ai is asi lief 154 Index Layout Series 35 Line Tool 71 Link Cine 55 Link Tool 44 Local License 147 Localizer 58 Lossless 39 Lossy 39 M Magnifinder 47 Measure Area Ell
54. e selected Preset window setting e t Move Item Up Move the selected item up on the list This change is reflected in the Preset drop down listbox on the toolbar and in the pop up menu e Move Item Down Move the selected item down on the list This change is reflected in the Preset drop down listbox on the horizontal toolbar and in the pop up menu By default the CT modality has the following values e Default Returns to the default WW WL of the image that was embedded in the image DICOM header If no value is indicated in the original DICOM file the Default value is set according to the dynamic range of the image e Default 2 Returns to the secondary default WW WL of the image if it exists in original DICOM image e Abdomen WW 350 WL 50 Shortcut F2 e Bone 2500 500 Shortcut F3 e Cerebrum 120 40 Shortcut F4 e Liver 150 50 Shortcut F5 e Lung 1500 500 Shortcut F6 e Mediastinum 300 50 Shortcut F7 e Pelvis 400 40 Shortcut F8 e PosteriorFossa 250 80 Shortcut F9 Other modalities have no default preset window values You can add as needed B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings 97 Cine non Cardio Settings In the Cine tab you can define Playback Order Zoom Optimizations Default Speed and Image Quality Settings NNNM Overlays Thumbnailz Magnifinder System Smartlache
55. e study To manually refresh all You can also manually refresh all studies opened in the Viewer by studies opened in the choosing File gt Refresh All Studies from the menu All opened viewer studies will be closed and reloaded from the server Using Toolbars The toolbars provide quick access to all of the iPACS Viewer s functions Toolbars Available in the iPACS Viewer Page 1 of 2 Description Toolbar File gH SOx S64S 480 i Enables you to open local studies save burn to CD close all studies windows print DICOM print open study report set next status and open information Image Manipulation E E I m es 5 l MQAQ O0 RG Enables you to scroll between series enable stack mode run cine link and unlink series select pan zoom magnify an area fit to screen change to 1 1 resolution restore original and unselect all images Image Orientation haoog Enables you to flip the image vertically and horizontally rotate left or right and reset to original orientation B E Contidential 2005 IDX Systems Corporation All rights reserved Toolbars Available in the iPACS Viewer Page Using the IDX Imagecast iPACS Viewer Displaying Images 2 of 2 Description Annotations Enables you to calibrate images create text annotations draw arrows measure pixel intensity measure Line measure ellipse draw freehand measure angle measure Cardio Thoracic ratio option
56. ed function immediately 4 All suspect patient and exam report records should be carefully scanned by the application manager for problems IDX Responsibilities Once IDX is contacted about potential issue we will do our best to resolve it in a timely manner IDX performs the following steps when notified of an issue regarding a potential issue 1 IDX determines the nature of the reported problem by attempting to recreate the problem at IDX 2 If it is determined that no problem exists the organization is advised to resume normal procedures IDX carefully documents all steps taken 3 If it is determined that a problem exists that is the problem reported is not due to user error IDX advises the application manager to stop using the affected function 4 IDX resolves the issue and carefully documents all steps taken 5 IDX notifies the application manager that users can resume using the affected function B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast IPACS Viewer IUD DOCU icis ep EH EREERDHUEENEPEPIDRINEOEUDEEPEHEEROPELEPEDUOARUEAE EAE DAL EEDEMENVG 15 Eglises ERU IT P 16 Ce he er Cl NET TOUT 17 Pee Fone Novi TION secocccsssaesnernsnnseenesuseseevenscansuauctuedeetescecesseanenans 19 A eA IEEE enis esac nse PidUE Gea re cance tiene nee eee ue seen 21 Ge D sire ies ites seen RX 29 E a E CCCII n 32 Ea A i c
57. ee cuum lo s z al Procedure Side Right Procedure Name Total Knee Replace w Manufacturer Name Depuy v FamilyTitle PFC Total Knees Product Title PFC Tibial Compone Add Template PFC Tibial Component PFC Femoral Component To rotate the template Press CTAL left mouse button or press on mouse scroll wheel U Z K U Leuven 5140 25 Aug 1997 U 2 K U Leuven 5140 25 Aug 1997 9 The template will be drawn according to the Plane orientation set by you AP or LAT If images in both planes are opened and calibrated the template will be displayed on both When you right click on the template a special popup menu is displayed with the following options e Template Parameters and their values e Flip e Delete B e Confidential 2005 IDX Systems Corporation All rights reserved aam Using the IDX Imagecast iPACS Viewer OrthoPlanner Optional 83 5 1 Knee AP F oo 29 Jun 1964 120 CR P Calibrated U 2 K U Leuven Mag 19 5140 Wy 4035 25 Aug 1997 wL 2047 Whenever the size of the template is updated from the Templating window or from the right click menu the template on the image will change according to the new template parameters chosen Selecting Delete will remove the template from the image and the Template List How to Move and Rotate the Template To Move the Template Click and drag the template to the new l
58. eed Slider Window To change the speed of the cine move the slider back or forth Default speed is according to your preferences Maximum speed is 30 frames per second The actual number of frames per second is displayed at the bottom of the window Actual fps is limited by computer memory and current resources Acquisition rate or default frames per second is displayed in the lower part of the window Current Cine Settings Button Fe Opens a menu where you can choose the settings for the cine currently running ELTE ce Scale Backward Customize Range Bounce e Playback Order Forward First to Last First to Last Default Backward Last to First Last to First Bounce First to Last Last to First First to Last e Scale Fit To Screen Default 2 1 1 1 1 2 1 4 1 8 If a scale is not available in the current window it is grayed out e Customize Range Opens the Customize Cine Range dialog box Contidential 2005 IDX Systems Corporation All rights reserved B EE Using the IDX Imagecast iPACS Viewer 32 Cine non cardio Customize Cine Range From To Customize Cine Range Ed C Al tf From 1 Ta 130 Cancel To run the cine from a specific slice location to another enter slice numbers in the From To input boxes The default shows the whole series from the first to the last slice When entering a new value in From or To the cine
59. eek PQeae O Ra hASOOH BSaralervcs4 Rl FAO Pa 4 a006 EB E Ol E Bi window vat _ Window Levei j Abdomen 350 50 rz ia e3 i PRITCHET LAURIE OX s 1 KVP 120 00 B e Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Annotations H Line Tool 22 Click on the Line button on the toolbar to activate the line annotation tool To Draw a Line on the 1 Click on the left mouse button at the desired start point and Image drag the line up to the end point of the measurement 2 Drawing is allowed only in one image slice area where the first point of the line has been drawn 3 The start point of the line cannot be changed during the line drawing The line can be updated afterwards by clicking on it 4 The line measurement is written in a text box near the end point of the line It is updated during the line drawing By default the measurement is in cm It can be changed to mm inches or pixels in the Settings dialog box 5 Press ESC to exit the annotation tool 6 You can delete the line annotation by clicking on it and pressing delete key on the keyboard or right clicking on the annotation and choosing Delete from the pop up menu 7 You will be asked to confirm deletion of the annotation This can be turned off by checking Don t ask me again The line
60. el To Save an Image 1 Select a location where to save the images 2 Select one of the following All Selected images only checked images are saved All images in Active Series all images in active series are saved All images in Active Study all images in active study are saved Active Series Snapshot screenshot taken of active series window snapshot shown with annotations current windowing and image manipulation 3 Select one of the following formats JPEG saves without annotations DICOM with DICOM header from original file BMP saves without annotations B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Saving an Image 133 4 If you choose JPEG format you can set the quality of the saved jpeg image from 0 to 100 Higher quality means a larger file size Lower quality means a smaller file size 5 Anonymize If you choose DICOM format you can anonymize the study by clicking the Parameters button There you can enter an anonymous Patient Name Patient ID Date of Birth and Accession Number Anonymize Parameters X Patient Mame John Doe Patient ID QuorncornOEI Date of Birth 4 6 2005 Accession Mo IRR RR RR cel Save as DICOM TIf the original file is a multi framed image the file is saved like the original as one large DICOM file Save Annotations on Server Saves the text
61. enu Pop Up Menu Right clicking on the image in the main view opens a pop up menu that contains the following functions Zoom e Zoom In e Zoom Out e Fit To Screen e 1 1 Resolution e Zoom Tool e Magnifinder Pan Window e Manual e Preset According to the values in the Settings dialog box e Default e Default 2 e LUT e Edit e Save Current e Invert Color Flip Rotate e Flip Horizontal e Flip Vertical e Rotate 90 Left e Rotate 90 Right e Reset Orientation Restore Image Series Layout elxi e1x2 e2x2 e2x3 e 3x3 e 4x4 B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Pop Up Menu 127 e Custom Cine Full Screen or Return to Main View Display Hide Overlays Measurements e Text e Free Hand e Line e Angle e Ellipse e Pixel Intensity e Arrow e Cardio Thoracic e Delete All Calibration Save e Save images on local disk e Save Annotations on Server e Save Snapshot on Server Copy to Clipboard Orthopedic Tools optional e Angle between two lines e Cobb Angle e Transischial Line e Templating Close Contidential 2005 IDX Systems Corporation All rights reserved E BEN Using the IDX Imagecast iPACS Viewer 128 Printing an Image Printing an Image Print 5 Prints the selected image from the main view using a Windows printer DICOM Print optional Prints the selected images from the main view using a
62. er Orthopedic Templates BOX Printer Irfa AE Title PRINT SCP Fort 104 IF Address 172 15 0 51 Mew Echo Import Export Em Advanced Cancel To Define a DICOM 1 Click on Settings on the toolbar Printer 2 Click the DICOM Printer tab in the Settings dialog box B e Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings 103 3 Click New to open the Add Printer wizard Define Your Printer Printer M ame PinteiName Viewer E Title RTL Prin Printer AE Title PRINTER SCP Printer Hast 1200 7 Printer Part 104 4 Fill in the following fields Printer Name Any name that fits your department Viewer AE Title The DICOM Application Entity Title usually not changed Printer AE Title The DICOM Application Entity Title of the DICOM printer as provided by the system administrator Printer Host IP Address As provided by the system administrator Printer Port As provided by the system administrator 5 Click Finish to complete the Wizard 6 The newly defined DICOM Printer will appear in the drop down list iPACS Viewer creates a printer driver file dpr with the above values This file can be created once for the local DICOM Printer exported and distributed to other users To Import a DICOM 1 Click Import Printer Driver 2 Browse to the location of the printer
63. er Safe Usage Statement H Imagecast iPACS Image Viewer Safe Usage Statement The Imagecast iPACS Viewer should be used by a licensed radiologist or cardiologist If utilized by a non radiologist cardiologist it should be in conjunction with a primary diagnosis report or during a consultation with a licensed radiologist cardiologist The monitor should be properly configured calibrated and placed in a location without direct sun or lighting The computer needs to be inspected by the system administrator on a periodic basis to verify proper operation Safe Usage Environment Your hardware for operating the viewer must be approved by IDX and maintained in accordance with the manufacturer s specifications Prior to using Imagecast iPACS Viewer your computer system must be set up in the proper environment for viewing images and you must ensure that your computer monitors have been properly configured To configure your monitors carefully follow the monitor manufacturers specifications and or instructions for monitor calibration If the monitors used in conjunction with Imagecast IPACS Viewer are not properly calibrated Imagecast iPACS Viewer has not been properly configured and should not be used to render clinical diagnoses When Not to Use Imagecast iPACS Viewer Do not use this product if e You know that the computer system you are using is clearly malfunctioning e Your application manager instructs you n
64. erved ai is asi lief 2 28 Using the IDX Imagecast iPACS Viewer Displaying Images To Turn Off a Toolbar 1 Click on View Toolbars in the main menu 2 Uncheck the toolbar you want to turn off To Arrange Toolbars 1 Click on View Toolbars Arrange Toolbars 2 Select to arrange the toolbars to the Top Left Bottom or Right of the Main View Toolbar on top Toolbar on left aip xr n amp aeBgusmAa oonsmE 67tz50b 49 74 m u3 3 m Pie Fus remm inum i H PR robe Pes Phe OS aro ge BR C Fs g3 e da iP Bae o Hib xoEt r B eoo fkeOS o p was BE oO he s Foav idu 0171 n Bait O be ABTOD Bt Bg p au Ing ee QU EE ss ii p p ort Toolbar on bottom Toolbar on right B E Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer 29 Image Navigation Image Navigation The common image navigation tools are displayed below Previous Series Next Series Image st for Cardiology Viewer Spears Cathy MRN Heart Cent 00 00 000001234 file Vey Image Tools Help oo Bie Pl OQQSO BEF 7 o Previous and TS iol xli Next Study Date 05 Mar 1998 thumbnails buttons Small thumbnails Large thumbnails Series Scrolling The Previous and Next Series buttons are located on the Image Manipulation toolbar Confidential 2005
65. erved To Change the Local Security Policy for CD Drive Access to All Users on a Machine To Undo this Change Using the IDX Imagecast iPACS Viewer Creating a CD DVD optional 145 5 Select API to use as IMAPI which will allow the restricted user to burn to CD DVD Burning More Options X APT to use v Buffer underrun protection Verify CD DVD after export Simulate will not write to Ehe disc Permanent Solution This method has the following restrictions e Autorun Autoplay is disabled on the computer for all the users and for any disc e The burning API provided in Windows XP IMAPT cannot be used This means restricted users can NOT burn DVDs This method allows all restricted users on that machine to burn CDs 1 Login as an Administrator 2 Double check on the file AccessCD reg Usually found at the installation folder of the Viewer 3 Restart the computer 4 Log in as a restricted user now you should be able to burn CDs 1 Login as an administrator 2 Double click on the file UnaccessCD reg Usually found at the installation folder of the Viewer 3 Restart the computer DVD Drive Disc Compatibility Table The below table describes the DVD Discs supported by a specific DVD Drives This explains why you cannot burn some disks in some systems Confidential 2005 IDX Systems Corporation All rights reserved B EE Using the IDX Imagecast iPACS Viewer 14
66. eui eo Using the IDX Imagecast iPACS Viewer d Keyboard Shortcuts Keyboard Shortcuts Keyboard Shortcuts Page 1 of 2 Command Keyboard Shortcut Comments Display and Image Manipulation Magnifinder M Zoom In Zoom Out Restore Image R Activate new view TAB On main view left to right Invert Color I 1 1 resolution 1 Fit to Screen 2 Full Screen ENTER Show Hide Overlays A Windowing Presets F2 F12 Windowing Tool W or C Multi Monitor Display Y Turn Off Active Tool ESC Navigation Go to First Images G or HOME Go to Last Image END Next Page PAGE UP Previous Page PAGE DOWN Next Series N Previous Series P Next Series Single e Down Arrow e Right Arrow e Mouse Wheel Down Confidential 2005 IDX Systems Corporation All rights reserved B c Using the IDX Imagecast iPACS Viewer Keyboard Shortcuts Keyboard Shortcuts Page 2 of 2 Command Navigation continued Keyboard Shortcut Comments Previous Series Single e Up Arrow e Left Arrow e Mouse Wheel Up Next Line Sequence Previous Line Sequence e Down Arrow e Right Arrow e Mouse Wheel Down e Up Arrow e Left Arrow e Mouse Wheel Up Cine Shortcuts Play Pause SPACE BAR Increase Speed Right Arrow Decrease Speed Left Arrow Stop S Switch Playback Order BACKSPACE Show Hi
67. fe n 15 CT Twin ae ae Wi 120 KVP 120 00 6 M E B E Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Window Width and Level The same study using the modality preset CT window settings for bone 18 x File View Image Tools Ortho Help OG el e e k MO QQ O BUA a ae 2 ee sH 5x5 0D i dh O O Gh window wath Tee REE Window Level e 2500 500 Olt ia IO 6 SOu 1 S 9 ilPROBsT KATHY D X nos ME ROBS C A v Study Date d zi Aid Sa of 2 ct 4b 190 1 2 pey n2 ze mM pr fh R ze i ay b M E Fx E co E A 13 EM FX Fx ES E E gt E gt AR gt pm E m E gt E gt E EN ao y e b c a E d GceacococooooQ EM c CT Twin d ST 1 30 Wi 2500 EEECECEEEEECEOO CC ACAIACACECALOIOL OL OL O19 KVP 120 00 Ready Window Width WW Slider window Width value move the slider to the right of the WW back or forth Change takes effect immediately Window Level WL Slider Window Level value move the slider to the right of the WL back or forth Change takes effect immediately Contidential 2005 IDX Systems Corporation All rights reserved 41 42 Using the IDX Imagecast iP
68. h as Play Pause etc For example if you click on Pause all cine loops will be paused If you zoom on one of the loops all loops will be zoomed When two cine loops are linked they might not have the same exact series length You can define if you want to stop when the shortest cine has finished or to wait if until the longer cine has completed This is determined by you in the Settings gt Cine tab Select Synchronize Linked Cine e Long Run restart when longest run is finished e Short Run restart when shortest run is finished B E a 55 56 Using the IDX Imagecast iPACS Viewer Cardiology Cine Optional To Link All Cine Loops Together To Link Certain Cine Loops to One Another I ES a M You can have more than one linked cine group WW WL will be applied separately to each cine loop even if they are linked E Click the arrow next to the Link button 2 Select Link All 3 Thecine loops will now play together synchronizing according to your settings 4 Press ESC to exit from Link mode Click the arrow next to the Link button amp 9 Select Link Tool The cursor changes to the link cursor Click on each of the cine loops that you want to link together All series linked together will have the words Link Group added to the lower right hand corner of the image U BR W N e 6 Press ESC to exit from Link mode 7 Those cine loops will now play together synchroni
69. humbnails Mode In the image preview displays an enlarged single thumbnail of the series Small Thumbnails Mode In the image preview displays small multiple thumbnail images of the series Large thumbnail Small thumbnail ilRE NOLDS MARY JE O X ilRE NOLDS MARY JE O X Study Date 14 Jun 2001 Study Date 14 Jun 2001 Switch between small and large thumbnail mode by right clicking on the thumbnail and choosing the desired option Contidential 2005 IDX Systems Corporation All rights reserved E BEN 32 Using the IDX Imagecast iPACS Viewer Layout Layout The screen layout can be changed in order to view images or series in the main view either one by one side by side one above another 2x2 at a customized screen layout or full screen To change the screen layout click on the Screen Layout buttons on the toolbar m S amp amp amp The default screen layout is set in the Settings dialog box according to the default Hanging Protocol For more information refer to Hanging Protocol Settings Optional on page 88 The following image shows four different series opened in screen layout 2x2 Screen Layout toolbar 12 x File View Image Tools Ortho Help PS O BBle o R MQAQG O BaF se r2of4Rlal A 5 x 464 5 v i As 02 db Window itn umm Window Level ta 7 03 Sd i 3D HEAD 0 x AS ELT 3D AD Study Date 11 May 1993 A S omnee m g pem
70. ich is indicated by a red border will be displayed on the other non parallel series opened in the main view Fie View Ime Took Ortho Help oou G 0 amp S 90Ux5t80 59o o a4 w o0namegemHo um geO Ox 64 091 AOD wem J Wesiow Lovet EM etna o y O avsi OF F FSEOu 1 30 HEAD Dx Study Date 11 May 1293 Fie View Image Took Ortho Help OO Bsi e bh ARAOR BOrtro gsto AZ ODCHGAE SO BHR jeH 6 64 00 1 ADDO BS wem wmm UTE Datin ydo rt n do ilan mran A x Study Date 11 May1393 PET MR Pla Confidential 2005 IDX Systems Corporation All rights reserved ai d asi lief 62 Using the IDX Imagecast iPACS Viewer Slice Positioning Cut Lines have several possible states Cut Lines v Display Show All C Show Extremes C Show First e Display Display all cut lines If unselected hides all cut lines e Show All Show all cut lines corresponding to all displayed slices in the active series Default e Show Extremes Show only the first and last cut lines of the displayed slices in the active series e Show First Show only the first cut line of the displayed slices in the active series Changing the settings of cut lines in the Settings gt Overlays dialog box will apply to all of the series displayed B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Annotations 63 A
71. ick on the image in the Annotation on the Image main view 2 The first click will draw the end point of the arrow drag the mouse in the image to elongate the arrow and the end point is the head of the arrow 3 Drawing is allowed only in one image slice area where the first point of the arrow has been drawn 4 Click ESC to exit the annotation tool 5 You can edit an Arrow annotation by double clicking on the arrow or right click and choosing Edit from the pop up menu Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Annotations 69 6 When editing the Arrow the points will be highlighted and you will be able to move them 7 You can delete an Arrow annotation by clicking on the arrow and pressing delete key on the keyboard or right clicking on the Arrow annotation and choosing Delete from the pop up menu 8 You will be asked to confirm deletion of the annotation This can be turned off by checking Don t ask me again The Arrow Annotation can be saved as a DICOM Overlay on the server so other users can view it as well iPACS iewer E lej x File View Image Tools Ortho Help EM 5ddx amp Bpijss mecsocjlmaaegis amp tmas oodscogtsesos4Aa essa f 49 8 008 EAR EH A Bi window et 7 Window Leve atecomen corz da X lo amp A PRI Renal Anaio PRO Renal Angio M 63s
72. ies of the study appear on the localizer image in different colors Default e Active Series Only the slice indicators of the active series appear on the localizer image Cut Lines Cut lines have four possible states e Display Display all cut lines If unselected hide all cut lines e Show All Show all cut lines corresponding to all displayed slices in the active series Default Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings e Show Extremes Show only the first and last cut lines of the displayed slices in the active series e Show First Show only the first cut line of the displayed slices in the active series LR Markers Left Right markers are indicated on the image in order to help in orientation of the image The following can be used e H Head e F Feet e S Superior e I Inferior e A Anterior e P Posterior e R Right e L Left You can display the LR markers as follows e Display Display all LR markers If unselected hide all LR markers e 2 markers Display right and bottom markers only Default e 4 markers Display all four markers You can set the format of the LR markers as follows e H F Use Head Feet annotation Default e S I Use Superior Inferior annotation Contidential 2005 IDX Systems Corporation All rights reserved B EE 109 110 Using the IDX Imagecast iPACS Viewer Set
73. increases the time it takes for the burn process to complete Simulate will not write to the disc Select this option to make a test run of the burn process Burning More Options X OPT bo use Internal API R ecammended v Buffer underrun protection v Verify CD DVD after export Simulate Will not write to the disc Lancel 16 Click OK to close the Burning More Options window 17 In the When the burning operation is complete section select the following as desired Bring window to the top Display a message Eject the disk 18 In the When the burned CD is inserted section select the following as desired Open all the studies in the Viewer Browse studies and reports I ES d M Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Creating a CD DVD optional 141 19 Click Burn to start burning creating the CD DVD EX Imagecast Cardiology Burner ioj x AM Wrnte CD View Add Remove E E 11 05 1993 at SEATTLE RAD 600 BROADWAY L KS 11 05 1993 MR SC Process status Burning data to disc 25 completed s NENNEN 9 ha Done Composition Size 21 52 MB A The images are burned on a CD DVD along with the autorun viewer This viewer has limited capabilities and optional features are not included If there is no writing device on the local computer you will get the following message
74. ing a CD DVD optional I ES d M User Limitations for Burning CD DVD Allowing Windows Restricted User to Burn CD DVD By default only users with MS Windows Administrator privileges will have access to burning CDs DVDs from the iPACS Viewer However there are two ways restricted users can be given access for burning CDs DVDs If a Restricted user tries to do media export using the default CD DVD burner options then a message will be displayed to the user iPACS Burner x Either there is na writing device or vou do nat have sufficient rights to write ta Ehe disc Please atach a writing device or ask your administrator to provide burning rights to you User can try one of the following options for a Windows Restricted user to be able to do Media Export Temporary Solution Valid for Single Session This method has the following restrictions e The user can only burn a single CD at a time The multiple CD scenario will not be supported e The user will be able to burn DVD only with Windows XP SP2 previous versions don t support Windows IMAPI for DVD Burn e The Windows IMAPI method is less reliable than the default method thus the user is more likely to experience an error during the burn process As a Windows Restricted User 1 Click Write CD 2 The Burn Options window opens 3 Click More Options button 4 The Burning More Options window opens Confidential 2005 IDX Systems Corporation All rights res
75. ipse Tool 72 Area Free Hand Tool 73 Distance Line Tool 71 Mean Pixel Intensity Ellipse Tool 72 Mean Pixel Intensity Free Hand Tool 73 Perimeter Ellipse Tool 72 Perimeter Free Hand Tool 73 Pixel Intensity 69 Measure Marker Calibrate Using 64 Multi Monitor 36 a Orientation of the Image 66 Orientation Image 57 Orientation Reset 57 Oversize Calibrate Using 65 Pixel Intensity Tool 69 Positioning Slice 58 Predefined Screen Layouts 33 Preset Widow Widths and Levels 42 Progress Indicator 38 proper usage Imagecast product 9 proper usage statement 10 Qualicator 39 Quality Image 38 B ES d M i Reset Orientation 57 Resolution 1 to 1 49 Restore Image 49 Rotate Left 57 safe usage environment 11 Save Current Widow Width and Level Preset 42 Scout 58 Screen Layout Custom 34 Predefined 33 Select Tool 45 Series Layout 35 Series Scrolling 29 Slice Positioning 58 Speed Bar 55 Switch Playback Order 54 Text Tool 66 Thumbnail 31 Thumbnail Navigation 30 Tools Arrow 68 Calibration 63 Ellipse 72 Free Hand 73 Line 71 Link 44 Magnifinder 47 Pan 45 Pixel Intensity 69 Select 45 Text 66 Unlink 45 Zoom 46 Unlink Tool 45 Unselect All Images 49 usage proper 9 10 Confidential 2005 IDX Systems Corporation All rights reserved Index 155 i When Not to Use Imagecast iPACS Viewer 11 Window Width and Level 40 Windowing Edit 43 Saving 42 Windowing Button 42 Z
76. is stopped It is run again with the new settings after you click OK B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Cardiology Cine Optional 23 Cardiology Cine Optional The Cardiology Viewer provides all viewing functions in Cine mode You can run Cine on several series or studies at the same time When opening a study in the Cardiology Viewer if it has a defined acquisition rate it is automatically run in Cine mode 18 xl File View Image Tools Ortho Help 8S hele e a k O QQ O BUFASale rvo g43lai4A COS SS 8 nln A a ICA G x0 ED i dk SOD df SO as wincow wiat TE J Window Level F petsut z t da X dos 2 ilHart Lohny R O xl Study Date 11 Jan 2001 S3 of 1 07 May 1928 U W Hospital and Clinics Wag 53 U W Hospital and Clinics PHILIPS INTEGRIS H WW 256 PHILIPS INTEGRIS H 11 Jan 2001 11 Jan 2001 s DB aD Mf s s LB rm ws Hart Lohny R M 0215017 U WwW Hospital and Clinics Wag 52 U Ww Hospital and Clinics PHILIPS INTEGRIS H Wi 256 PHILIPS INTEGRIS H 11 Jan 2001 V 28 11 Jan 2001 Ready During Cine you can manipulate the image as needed including e Zoom e Windowing e Invert Color e Fit To Screen e 1 1 Resolution e Pan e Show Hide Overlays e Change Orientation Contidential 2005 IDX Systems Corpo
77. ith lossless quality regardless of the user s bandwidth Imagecast iPACS Viewer includes the following features e Image Preview Pane e Study Information e Series Display Modes Page Stack or Cine e Customized Window Width and Level e Pan Zoom Flip and Rotate e Magnifinder e Qualicator e Measurement Tools e Hanging Protocol e Localizer optional e Cut Lines e Link Series e User Preferences e DICOM Print optional e Multi Monitor Support optional e Study Report e Annotations e Save as DICOM optional e Orthopedic Module optional e Cardiology Module optional e Diagnostic Workstation optional e CD Burn optional Confidential 2005 IDX Systems Corporation All rights reserved E BEN Using the IDX Imagecast iPACS Viewer 16 Terminology Terminology Common terms are used throughout the Imagecast iPACS viewer when referring to selecting and reading exams In order to better understand Imagecast iPACS viewer functionality refer to the following table Common Imagecast Cardiology Viewer Terminology Term Definition Image Preview Initial preview representation of the image series that opens in the preview pane Use this preview to select specific series or slices in a series to view and pan on an image Image A single 2D image such as a SC CR XR or DR Double clicking the preview opens the image in main view where it can be manipulated orientated and measured Series
78. k OK to close the dialog box and the text will appear on the image Contidential 2005 IDX Systems Corporation All rights reserved Press ESC to exit the annotation tool You can edit a text annotation by double clicking on the text or right click and choosing Edit from the pop up menu You can delete a text annotation by clicking on the text and pressing delete key on the keyboard or right clicking on the text annotation and choosing Delete from the pop up menu You will be asked to confirm deletion of the annotation This can be turned off by checking Don t ask me again The Text Annotation can be saved as a DICOM Overlay on the server so other users can view it as well ai is asi lief 68 Annotations i re rie o 3 56E i y e E 21 E o oe E a n2 D D C2 A fe E fa fe E d Esi Esi 1 45 7387 Ready Arrow Tool To Add an Arrow Using the IDX Imagecast iPACS Viewer An example of the of the text annotation tool is shown below l x peme o h MaatOwea ad 5 0 blja 14 SACS LEN S 1 SMITH HAROLD M PIKR 750000 PIKROOOS CT C Insert Insert Text T this finding Cancel KENNEWICK GEN HOSPITAL PQCT 25 Jan 1335 KVP 140 00 Mag 11756 ww 800 WL 200 Powered by Bl Real Timelmage 6 Click on the Arrow button on the toolbar to activate the arrow annotation tool 1 Click the Arrow button and then cl
79. k on additional monitors This will open the iPACS Viewer across multiple monitors 4 Click OK This setting is saved between viewer sessions For more details regarding how to define a Hanging Protocol see Hanging Protocol Settings Optional on page 88 Confidential 2005 IDX Systems Corporation All rights reserved B EE 38 Using the IDX Imagecast iPACS Viewer Image Quality Image Quality When an image or series is opened in the main view a Progress Indicator appears on the status bar below the image A Qualicator appears in the upper right hand corner of the image or each slice The image s quality continues to improve as data is streamed until the highest possible quality is achieved x File View Image Tools Ortho Help 2S Bl S R MOQQ O BUlFA Faleros 4RlFA ODUG BAR o x m 05 Sa 08 i C Sod iow wa Window Level 4 Hei SL e CLE fo wegen a c MeO REY S a tie heey he Olt te E dos 2 2 GOu co 1 i COTE DENISE O x EM Study Date 31 Jul 2001 S3 of 1 a 2 a e E e COTE DENISE F 106 19 Jan 1951 MR 12 IK 31 Jul 2001 ST 4 00 RT 10 00 ET 5 00 Ready Progress Indicator The progress indicator WEsmmEN shows the percentage of the image data already received from the server A single progress indicator is displayed in the status bar below the main view for all displayed images in a series The progress indicator
80. l B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer 89 Settings UC NEN xi Overlays Thumbnails I agnifinder System Smart Cache Streaming Mode Display DICOM Frinter Orthopedic Templates Hanging Frotocols Modality Presets Line Edit or create new Hanging Protocol that defines the user s display preferences for specific types of imaging procedures Selection State determines if the Hanging Protocol will be automatically applied when opening studies Selection State Name Ja Automatic Default LIS Automatic Default zs Automatic Default MA Automatic Default CH Automatic Default CT Automatic Default Hanging Protocol Edit Copy Delete Apply Import Export OF Cancel e Selection State If Automatic is checked the Hanging Protocol will be automatically applied if the study fulfils the Hanging Criteria If Automatic is not checked Hanging Protocol is only applied if manually selected New Opens a window that allows definition of a new Hanging Protocol e Edit Opens a window for altering an existing Hanging Protocol e Copy Saves the current Hanging Protocol under a new name e Delete Deletes the selected Hanging Protocol e Apply Applies the selected Hanging Protocol on the studies currently opened in the Viewer e Import Imports an existing hpr xml file with Hanging
81. l other studies e X Close Study closes the study and removes it from the preview pane For the active study the Patient Name and Study Date will be in red and the thumbnail will be enclosed by a red square Confidential 2005 IDX Systems Corporation All rights reserved E BEN 20 Using the IDX Imagecast iPACS Viewer Preview Pane Navigation Different Preview Pane states are shown below One Thumbnail All thumbnails maximized Minimize All Cascaded i a3D HEAD amp ni x ij3p HEAD El x i an HEAD Bl x Study Date 11 May 1993 Study Date 11 May 1993 Doe Jahn Bn x Study Date 26 Jun 1595 Study Date 11 May 1993 knee Lat mn x Study Date 25 Aug 1337 i Daoe Jahn Study Date 26 Jun 1595 d Knee LAT Study Date 25 Aug 1 337 aldose John Bn x Study Dzte 26 Jun 1595 4 KneeLat mmn x Study Dete 25 4 ug 1 997 B e Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Displaying Images 21 Displaying Images Displaying Single Images To display a single image double click or drag the preview image into the main view In single images the ROI Region of Interest that is displayed in the main view is indicated on the image preview by a green rectangle The active image is indicated by a red rectangle around the image preview You can change the magnification of the image in the main view u
82. lation must be performed Contidential 2005 IDX Systems Corporation All rights reserved B E a 39 40 Using the IDX Imagecast iPACS Viewer Window Width and Level Window Width and Level The Window Width WW and Window Level WL allow you to control the range of gray levels to be displayed on the 8 bit monitor from 12 16 bit images Adjusting the window width and level can be done in following ways e Use the WW and WL Sliders located on the toolbar e Use the Windowing button on the toolbar or from the pop up menu to change the cursor to the Windowing tool By dragging your mouse horizontally and vertically you can change the WW and WL respectively e Use the Modality Preset Window Settings for images to emphasize different tissues The following study uses the Modality Preset CT Window Settings for Cerebrum Window Width Slider Window Level Slider Preset WW WL Listbox l x B helo o s 8 QQ G Eg 2W Ox amp 6 amp 8 9ij Aas 02d LRF Y 40 6 0 SO as leRosBsr karuv O x zg Study Date f Sl of 2 CT abl p 1 2 File View Image Tools Ortho Help guEseeo axqijoumnatgmE PSR m ALGoooooo CT C CONTRAST gt P1 x Dx b MA S EFFFFFEFPFFEFI M x1 lt i EM FX CCEC a E M 4 M 4 perd EGEEEEESESESSSES S L EM E fa z wc 2 E c C
83. lect to print with Study Details Localizer Scout Lines L R Markers or Annotations Print Overlays I X Display vw Study Details v Lacalizer Scout Lines all images in the study vw LA Markers v Annotations Cancel 1 Click on Properties next to the printer name 2 The Properties dialog opens 3 You can change the following e Film size e Medium Type e Film Orientation e Border Density e Empty Image Density e Polarity Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Printing an Image 131 4 These changes are reflected in the Advanced Printer settings in the Settings dialog box wed ue 2i a 8 SINXTTIN D icomPFrinter Confidential 2005 IDX Systems Corporation All rights reserved E REN 132 Using the IDX Imagecast iPACS Viewer Saving an Image Saving an Image ll The Save button allows you to save images in one of the following ways e Save images on local disk e Save Annotations on Server e Save Snapshot on Server Save Images on Local Disk Saves images from the main view to a local file in various formats pave E x Location CTEMP P Save Options Format DICOM JPEG DICOM Duality BMF C AJ Selected images All images in Active Series C All images in Active Study C Active Series Snapshot v Anonvsmize Parameters Number af Images 87 Canc
84. lice indicators of that series change to green 2 8 x File View Image Tools Ortho Help ox SH Hi O ORV o k MO QQ O RO MSOOS DOr e70S4 R77 AB Ba S ex OO EJ EB B il CJ ES Ee Big window iat vr Window Level Je amp x S 1 Ss gt il ENGEL JULIA FSS Ol X BASS ENGEL JULIA F 55 F wWR2398502 CT Wilton Medical Arts SOMATOM PLUS lt os 2004 KWP 140 00 A L 4 M Wilton Medical Arts 9 Wilton Medical Arts E OM PLUS lt DIR Lan 2nn4 M KWP 140 00 N 1474 MBB The space between the slice indicators on the localizer is proportional to the difference in the original image position of the different series as indicated in the DICOM header Confidential 2005 IDX Systems Corporation All rights reserved B EE 60 Using the IDX Imagecast iPACS Viewer Slice Positioning 5 ENGEL JULIA F755 F CT Wilton Medical Arts SOMATOM PLUS 4 Mag 137 08 Jan 2001 250 KVP 140 00 wL 50 Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Slice Positioning 61 Using Cut Lines When viewing studies iPACS Viewer can display cut lines of the active slices on series from other directions For example axial slices on sagittal slices and vice versa Cut lines are limited to slices of the same study The cut lines of the active series wh
85. m Optimizations Default Speed Image Quality and Cine Synchronization UC NE a xi Overlays Thumbnails hagnifinder System Smart Cache Streaming Mode Display DICOM Printer Orthopedic Templates Hanging Protocols Modality Presets Cine Playbacs Order Foward C Backward C Bounce oom for Line Playback Keep Current Zoom f Default Zoom 1 1 Optimizetion Type Opimized for speed Pixel Replication C Opimized for quality Linear Interpolation Default Speed 5 fps Force Lossless Fwd Bwd Steps E Synchronize Linked Cine Lorg Run restart when the longest run is finished C Short Run restart when the shortest run is finished B e Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer 99 Settings The following can be selected e Playback Order Forward First to Last First to Last Default Backward Last to First Last to First Bounce First to Last Last to First First to Last e Zoom for Cine Playback Keep Current Zoom Default Zoom Fit To Screen 2 1 1 1 1 2 1 4 1 8 e Optimization Type Optimized for speed Pixel Replication runs cine at fastest rate possible but with lower quality Optimized for quality Linear Interpolation runs cine at high quality but at a slower rate e Default Speed
86. mage is not scaled at the modality level it is then necessary to calibrate the image using Measure Marker This measures a known distance on the image and calibrates the image according to your input If you select Measure Marker the cursor changes to the line tool lt gt and you can draw a measurement line along a known distance The actual measurement according to the current calibration is displayed B e Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Annotations 65 The following image shows how to use the Measure Marker option to measure a known distance In this case the R L indicator is always two centimeters il av Y O s 1x When you finish drawing the line the Calibration Measurement dialog opens to enter the known distance Calibration Measurement x Please enter the distance 2 em After you click OK the image calibration is updated and all measurements on the image are changed to their new values including the measurement of the calibration distance Using Oversize Oversize is enabled only when the image is already scaled at the modality Image calibration is performed at the table height so that there might be a slight difference in the calibration at the actual plane of the surgery planning It is therefore recommended that the user always enter a calibration factor using Oversize even when the image is scaled in the
87. mage manipulation and orientation changes are concurrently performed on all connected images series l x Fie View Image Tools Ortho Help GO Bele S RP OQQ O BA Airaevosg47A4 OOS SAS O HRR c a 3 gt idk SDD Window vith Eh eka ik a rcm eet ja WV i ilrvsoN BRADLEY O X Study Date 04 Feb 1995 S 1 of 8 MR gt 1 2 3 S 2 YSON BRADLEY M GE1 40 GEo004 MR GE1140 lt GE0004 MR JOHYS HOPKINS 04 F2b 1995 ST 3 00 JOHNS HOPKINS 04 Feb 1995 Link Group 1 i E bx La A2 Link Group 1 lt a ST 3 00 Y y Mag 114 AN ET 19 00 ww 1356 Q Mag 114 Wi 1429 he wL 714 ET 13 00 IT 0 30 ie IT 0 00 S44 F TYSON BRADLEY M GE140 GE0004 EX x TYSON BRADLEY M GE1140 GEooo4 MR MR JOHNS HOPKINS 04 Feb 1995 i ST 3 00 ET 95 00 IT 0 00 Link Group 2 Mag 114 i JA ET 95 00 IT 0 30 JOHNS HOPKINS Link Group 2 Mag 114 Wi 1429 WL 714 Ciok on the images you would like link and rclcasec the button To Link Series Together 1 Click the arrow next to the Link button 2l You can select Link All or Link Tool e Link All connects all series opened in the main view e Link Tool allows you to decide which series to link 2 Select Link Tool 3 The cursor changes to the link cursor es Confidential 2005 IDX Systems
88. modality Confidential 2005 IDX Systems Corporation All rights reserved B EE 66 Using the IDX Imagecast iPACS Viewer Annotations Text Tool I ES d M If you select Oversize the current calibration is updated according to the oversize value All measurements on the image of the calibrated study will be updated The default value for the Oversize of a hip or knee image is 115 Orientation of the Image The Orientation of the image must be set either as AP or LAT e AP Anterior Posterior An X ray image taken from front to back e LAT Lateral An X ray image taken from the side After Calibration is performed the word Calibrated is added to the lower right annotation on the image showing that the image is calibrated The calibration and plane orientation are specific for the series If you open two series they will need to calibrate them separately The calibration is not saved between sessions If you close the study and open it again they will need to calibrate the images again l Click on the Text button on the toolbar to activate the Text annotation tool Confidential 2005 IDX Systems Corporation All rights reserved To Write a Text Annotation on the Image Using the IDX Imagecast iPACS Viewer Annotations 67 Click on the Text button and then click on the image in the main view 2 The Insert Text dialog box opens and you can enter the text 3 Clic
89. nfidential 2005 IDX Systems Corporation All rights reserved E BEN 49 50 Using the IDX Imagecast iPACS Viewer Cine non cardio Cine non cardio Cine Button Cine Image Toolbar B ES d M When viewing a large number of slices from a CT or MR it is often helpful to view them in as an automatic cine loop Viewing in Cine loop helps give an overview of the entire body part When clicking on the Cine button in the toolbar cine starts in the main view Cine is disabled for single images Image quality is improved as more cine loops are played Cine is run in scale and quality according to the settings from the Cine Settings button Default values are according to those set in the Settings dialog box For more information refer to Cine non Cardio Settings on page 97 o To change the general cine settings click on the Settings Button located on the toolbar Select the Cine tab from the Settings dialog box Play Stop F Play Stop the cine Play the cine according to the required playback order as set in the settings tab Cine starts from the first displayed slice of the active series Stop the cine When resuming play the cine continues from the paused slice location Show Hide Speed Bar Opens and closes the Cine Speed Slider window Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Cine non cardio ol Cine Sp
90. nnotations Calibration Tool Calibration can be done at the modality level at the time of image acquisition and then adjusted to the exact plane of the image Calibration can also be done manually using a known distance on the image On the Annotations tool bar there is a button for calibration E and selection of orientation plane AP LAT The calibration of images is performed per series not per study S t knee AF F oo 29 Jun 1564 120 CR Calibrated U 2 K 0 Leuven re Mag 11 5140 wew 4095 25 Aug 1937 WL 2047 To Manually Calibrate 1 Open the image in the main view the Image 2 Click the Calibration E button Confidential 2005 IDX Systems Corporation All rights reserved B EE 64 Using the IDX Imagecast iPACS Viewer Annotations 3 The Calibration dialog opens Calibration Measure Marker C Oversize 115 Use Measure barker if there i an object on the image with a known size Use Oversize il the image is already calibrated by the modality and you need to adjust the calibration to the corect plane Orientation Plane AP LAT Cancel 4 Select the method of Calibration Measure Marker or Oversize 5 Select Orientation Plane AP or LAT 6 The word Ca ibrated is added to the lower right corner on the image If the image has no pixel spacing in the DICOM header Oversize is disabled and calibration can only be done using Measure Marker Using Measure Marker If the i
91. nspecified Sj 01 01 1900 CT g Done Composition Size 16 43 MB A 10 Click Write CD to open the iPACS Burner window Burn Options X Click Burn to stert the recording process Recording device G 1 7 0 LITE ON LTR 482465 SUS9 Whiting 5 peed d T More Options When the burning operation rs complete When the burned CD ts inserted Bring he window to the top Open all the studies inthe Viewer v Display a message Browse studies and resorts v Eject tie disk 11 In the Recording Device field select the device to burn images to 12 In the Writing Speed field select the writing speed 13 Click More Options to display the Burning More Options window 14 In the API to use field select one of the following Internal API Recommended Contidential 2005 IDX Systems Corporation All rights reserved ai d asi lief 140 Using the IDX Imagecast iPACS Viewer Creating a CD DVD optional IMAPI Refer to User Limitations for Burning CD DVD on page 144 for more information about which API to use 15 On the Burning More Options window select the following as desired Buffer underrun protection Selecting this option helps to prevent errors when burning a CD DVD but increases the time it takes for the burn process to complete Verify CD DVD after export Selecting this option verifies that the contents of the CD DVD where burned correctly but
92. ntents Gude CONVENTIONS ueoavoibnppgaddd do ar edo ance ab Goo Go nebl 7 Proper Usage of Imagecast Products 9 UNT UB ous pP EE DRREREHHRREORUEUP LEBEN ERE FERE steerer 10 Imagecast iPACS Image Viewer Safe Usage Statement 11 Safe Usage Environment iunior eic einer iene 11 When Not to Use Imagecast iPACS Viewer 11 KISERA aE 1 e aiia eed re S oe eL NEM E Ree MUS 12 Your Responsibilities cassis 12 IO Repone IDIIN eee ene ee OS eee eer er 12 Using the IDX Imagecast IPACS Viewer 13 goga elt eir a y RR 15 causes REPE c 16 RE SLE nodi bore Een R T 17 Preview Pane Navigation eeeeeeeeerenennn nnns 19 Peale Rie AEE c ERIT TIT 21 Displaying Single Images eee 21 DEBENT EE i pu E ene Dee PES IDEE dS DIM MES ee 22 Displaying in the Main View eee 23 Displaying Images Full SCPBBIuso ssi on orco ane Ge ER 24 Updating IMages NITET 25 Ueno TIOS riir 26 DoE N R Pr 29 sol cages well ws MR em ne te eee ry ne ete One Nan He ees eee nee eee 29 TOMOE rO raaa EA 30 Confidential 2005 IDX Systems Corporation All rights reseve gt O BPA 4 Contents I ES d M THOIRODSE MOOO siririna 31 L R Ea Tree 32 Predefined Screen Layouts cscscssesecsececseenesececerseearsesares 33 Lem Seen LAVO on 34 PE N
93. ocation To Rotate the Template 1 Select the template with the mouse 2 Press down on the mouse scroll wheel 3 The cursor changes to the rotate cursor 4 Move the mouse in a circular path OR 1 Select the template with the mouse 2 Press CTRL and the left mouse button 3 The cursor changes to the rotate cursor Confidential 2005 IDX Systems Corporation All rights reserved B EE 84 Using the IDX Imagecast iPACS Viewer OrthoPlanner Optional 4 Move the mouse in a circular path The template moves with the image if the image is panned and rotates flips if the image is rotated or flipped You can move or rotate the template while in Template Mode If you have done measurements on the image you may not be in Template Mode To return to Template Mode click on the Ortho Templating button on the toolbar Save Template After you have selected and placed the template properly on the image you can save this information in several ways e Save as Annotation Save the template as an annotation on the image The template is saved as a Presentation State file on the server and can be viewed by other users e Save as Report Generate a report that includes the details of the template manufacturer part number etc and a screenshot of the template on the image e Copy to Clipboard Copy the image with the template to the clipboard where it can be pasted into an image editor program and saved How to Crea
94. ocol Wizard The Figure below represents the previously set Screen Layout of the main view Click an an ind vidual window below and then set its preferred display criteria layout and properties Open images on all windows 7 v Open images on this window Display Criteria Series Layout Series Layout sets how the series is displayed within Display Criteria determine the hanging order the selected window Select desired Display Criteria then click 4dd Criteria to add to list below ty mj gy EB mg Rons 2 Columns 2 Match whole word scroll between Series Add Griteria Properties zoom Fi to Screen v E Inverse E Default Preset from the Modality C Specific Madality Preset Cr abdomen 350 Orientation Flip None Justify Center Advanced lt Back Mex Finish emen 10 Open images on all windows When the Hanging Protocol is applied the series images automatically open on all windows 11 Open images on this window When the Hanging Protocol is applied the series images automatically open on this window 12 Select Series Layout Every time you open a series in the selected view it will open with the preset series layout You can set your own working preferences for each modality Set the number of Rows and Columns up to 16x16 13 Scroll Between Series If this setting is enabled you can automatically scroll between series using the mouse wheel
95. onfidential 2005 IDX Systems Corporation All rights reserved User input Key names System prompts and messages Field labels Guide Conventions This manual uses bold text to indicate user input For example Enter T to specify today This indicates that you must type T and then press ENTER on the keyboard A specific key on the keyboard is indicated in all caps capital letters For example Press ENTER to submit your password This indicates that you must press the ENTER key on the keyboard to perform the specified task System prompts and messages in text are shown in ta ics as follows No Information Found This indicates that the words No Information Found are displayed in the application Fields that require input or item selection appear in bold text For example In the Attending field select a provider This indicates that the word Attending is a field label in which users must enter the name of the attending provider Buttons Button names appear in bold text For example Click Save This indicates that the word Save is the button name and the user must click this button on the window Button names are also shown in bold text when used in a sentence as follows The Save button allows you to save information entered on the window to the Imagecast database Contidential 2005 IDX Systems Corporation All rights reserved iB INS 8 Guide Conventions Check boxes and radio but
96. oom Tool 46 Confidential 2005 IDX Systems Corporation All rights reserved E BEN 156 Index B E Confidential 2005 IDX Systems Corporation All rights reserved
97. ort as an rtf file on the server Other users can view the report through the Study Browser Hj Print Report Print the report to the local windows printer Angle Between Two Lines lt Measures the angle between two lines You select the angle tool and then clicks on the two lines that you want to measure the angle between them The resulting angle between the two lines will be displayed Confidential 2005 IDX Systems Corporation All rights reserved B EE 86 Using the IDX Imagecast iPACS Viewer OrthoPlanner Optional Cobb Angle For Spine Scoliosis gt Measures the Cobb angle used for spine scoliosis angle where the two lines drawn on the spine meet d a E add a E p E 7 T E E Transischial Line For Total Hip Replacement 4 Draws a transischial line on the image and measures the difference in height of the two perpendicular lines Transischial line is used to compare right and left lesser trochanter positions to determine leg length 1 Click on the Transischial Line button on the toolbar To Draw a Transischial Line on the Image B Fe Confidential 2005 IDX Systems Corporation All rights reserved L Using the IDX Imagecast iPACS Viewer OrthoPlanner Optional 87 2 Click on the image A horizontal line with two holding points will be drawn on the image 3 The horizontal line can be rotated as needed using the holding points
98. ot to use the application e An error or warning message is displayed by the application e You are aware of any system problems or malfunctions Always notify your application manager of any potential system problems or availability issues as soon as possible Never render a primary diagnosis on images if you are using a monitor that was not certified or calibrated for Caution diagnostic purposes Confidential 2005 IDX Systems Corporation All rights reserved E BEN 12 Proper Usage of Imagecast Products Responsibilities Responsibilities Both you the customer and IDX share in the responsibility of ensuring that potential problems encountered with the software are addressed in a timely fashion As a customer you are responsible for reporting any and all potential problems you encounter with Imagecast applications Your Responsibilities When you the customer encounter a potential problem with the software you need to report the issue to IDX in a timely fashion The following steps should be performed when reporting an issue to IDX 1 You should write down the accession or document identification number related to the problem a description of the problem and contact your application manager immediately 2 The application manager contacts the Imagecast Support Center and reports the problem and accession number or document id number 3 The application manager notifies all users to stop using the affect
99. plates will be displayed 4 Templates are sorted according to Procedure and Manufacturer 5 Check the box next to an individual template or a family of templates 6 Click Download to begin downloading the Ortho Templates to your computer 7 The Downloading Orthopedic Templates dialog box opens with the amount of templates chosen for download and their progress 8 After downloading is complete you can use the downloaded templates for Ortho Templating Contidential 2005 IDX Systems Corporation All rights reserved E BEN 108 Using the IDX Imagecast iPACS Viewer Settings Overlay Settings KNEES j In the Overlays Tab you can set all the overlay options of the images The options include displaying Localizer Cut Lines LR Markers Measurements Study Details and DICOM Overlays UC NE xl Smart ache Streaming Mode Display DICOM Printer Hanging Frotacals Modality Presets Cine Overlays Thumbnailz hagnifinder System Cut Lines v Display 6 Show All Show Extremes C Show First Localizer All Series Active Series LA Markers v Display Format 2 markers H F C 4 markers C sf Display Measurements in jv Line jw Free Hand Ellipsc L Angle Measurement Units em v Display Study Details v Display Dicom Overlays Localizer You can display the slice indicators on the localizer as follows e All Series All slices indicators of all ser
100. ration All rights reserved B EE Using the IDX Imagecast iPACS Viewer Cardiology Cine Optional To change windowing using the mouse press on the middle mouse wheel and drag across the image To use measurement tools you must stop the cine Cardiology Cine Toolbar Cardiology Cine Toolbar Name A multiframe study which has no acquisition rate defined for it in the DICOM header will not start cine automatically The Cardiology Cine toolbar includes the following functionality Button Description Cine Toolbar 5S Sg Ga bl te 10096 Series Number Indicates which series is being displayed Cine Slider imn The slider shows the position of the current slice being displayed in cine The tool tip of the slider shows the exact slice number in the series The slider also serves as a progress indicator The background bar shows the progress of received data Previous Cine in Changes the series displayed in the main view to previously run cine Next Cine rz Changes the series displayed in the main view to next cine to be run Step Backward Li Moves the cine back by predefined number of slices as set in the Settings gt Cine tab Step Forward Moves the cine forward by predefined number of slices as set in the Settings gt Cine tab Play Stop Go to First Image m Plays the cine or stops the cine Jumps to the first image of the cine loop
101. rom the pop up menu 6 You will be asked to confirm deletion of the annotation This can be turned off by checking Don t ask me again The Ellipse Annotation can be saved as a DICOM Overlay on the server so other users can view it as well B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Annotations 73 In the following we measure the aorta iPACS Viewer 181 x File View Image Tols Ortho Help eX 6G Hi G S PBleol kh MOQQeO aulm eOO5 BAorilsereo0sg4 Rl FAB e 4 a 00S EB AE C EE EE E mao van _ window Level f aomen cssusuy rz v D z da 1 lo S 1 i PRITCHET LAURIE 0 XI KWP 120 00 Free Hand Click on the Free Hand button on the toolbar to activate the Free Hand annotation tool To Add a Free Hand 1 Click on the Free Hand amp button and then click on the Annotation on the Image image in the main view 2 Draw the shape by keeping the left mouse button pressed on the image Drawing is allowed only in one image slice area where the first point of the shape has been drawn 3 The shape will close automatically between its start point and its end point 4 Click ESC to exit the annotation tool 5 You can edit a Free Hand annotation by double clicking on it or right click and choosing Edit from the pop up menu Confidential 2005 ID
102. s Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings 105 To Change a Printer Select a property and click on Edit 7 Those properties defined as Property Automatic will automatically chose the appropriate value among those defined for it El Film Session z Print Priority 2000 0020 MED Medium Type 20000030 PAPER Film Eos z Fim Onentation 20710 0040 PORTRAIT Fim Size ID 2010 0050 8_5INs11IN a s SM a m Muir Attribute o x j Attribute Name Cancel Fim Size ID Default salue 8 5INx1 1IM Restore Supported Values BINS OIM 8 SINSTTIN TONES 2IN TONNES TAIN TTINST AEN 1 The properties of the DICOM printer can be set as follows e Film Session Print Priority 2000 0020 HIGH MED or LOW Medium Type 2000 0030 PAPER CLEAR FILM or BLUE FILM e Film Box Film Orientation 2010 0040 PORTRAIT or LANDSCAPE Film Size ID 2010 0050 Various film sizes default 8 5INX11IN Magnification Type 2010 0060 REPLICATE BILINEAR CUBIC or NONE Border Density 2010 0100 BLACK or WHITE Empty Image Density 2010 0110 BLACK or WHITE Min Density 2010 0120 0 Max Density 2010 0130 300 Trim 2010 0140 YES or NO Contidential 2005 IDX Systems Corporation All rights reserved B EE Using the IDX Imagecast iPACS Viewer 106 Settings e Image Box Polarity 2020 0020
103. s contains the main menu bar and the toolbars used for image manipulation and analysis Confidential 2005 IDX Systems Corporation All rights reserved B EE an el Using the IDX Imagecast iPACS Viewer 18 Getting Started Preview Pane The preview pane contains the preview thumbnail images series of the studies Main View The main view displays the expanded images series of the studies B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Preview Pane Navigation 19 Preview Pane Navigation Use the Study Title Bar found at the top of each study preview to open close and cascade thumbnail images in the preview pane Imagecast for Cardiology Viewer Bowe Tes File View Image Tools Help he b MQQAB O 4 Study Title Bar te ak Howe TEs The Study Title bar consists of the following e i Study Info opens study info dialog box e Patient Name displays the patient s last name The tool tip on the Patient Name also displays Study Info e Study Date displays the date of study acquisition e Minimize closes any open previews study minimized to a single title bar in the preview pane e E Cascade opens the thumbnail images in the preview pane by dividing the length of the preview pane among the various opened studies e O Maximize opens all preview images of the study the length of the whole preview pane minimizes al
104. se Request Create License Request Not required when the viewer is used as part of the Imagecast PACS for Cardiology Create a permanent license request After the permanent license request has been created it must be sent to your system administrator in order to receive a permanent license for the iPACS Viewer 1 Select Help gt License gt Create License Request 2 The License Request application opens Double click on the fields to edit them RealTimeImage License Request License Hequest Temporary License C AProgram Files A T image PACS w eb pp sLieense dat Browse Serial Humber i County i Create State i City i Company Hame Company Department Common M ame Email Address Product ID i IPACSPRISM Concurrent Users 1000 Total Users Integer 100 Expiration Date Date Saturday January O7 2006 Cancel Help B e Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer 149 Create License Request RealTimeImage License Request License Request Temporary License CAD ocuments and Settings wael Desktop license dat Bronse Serial Coun State City Comp Comp Corr Email Prod Conc Total Expire Field Min ia ets Seral Number BEGIN CERTIFICATE REQUEST MIILATCECZYCAGQASHDEMMAaGATUEChMDBLHRJdM G wwsCg vr EVOGDEwNS KnzIhvcMHAHFRRBEAPqvnslfa Dni RAMAH CAN Pht H N Ferr dHNgrokw ect sohary FR gUdsHt
105. series layout is set according to the applied Hanging Protocol In a series the selected slices are indicated on the image preview by adjacent green rectangles These rectangles indicate which slices of the series are currently being displayed in the main view You can also temporarily reverse the order of the slices of the study displayed Right click on the series in the preview pane and select Reverse Order for that series x File View Image Tools Ortho Help B OBR S R MOQAQ O BG Boirale vosga4l 7 n pAn B i 3D HEAD Bl X Study Date 11 May 1993 Reverse Order Large Thumbnails SEATTLE RAD 600 BROADWAY G G yo RT 650 00 wi 1210 ET 17 00 WL 350 Sa es EI Screen Layout 1x2 Series Layout 2x2 RT 3600 00 ET 17 00 B e Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Displaying Images 23 l x File View Image Tools Ortho Help OO hsle S k OQQ O BGA 7084 7 4 00808 8 oE ea io C x amp th ED i dh SDD db Window wan vr Vee ee p pet t ta y 4103 Sd i 3D HEAD jDmx Study Date 11 May 1993 44 ul S Mn 4b SEATTLE RAD 600 BROADWAY SEATTLE RAD 600 BROADWAY GENESIS_SIGNA 11 May 1993 ST 3 00 RT 650 00 ET 17 00 S 350 GENESIS_SIGNA 11 May 19 P3 Screen Layout 1x2 Series Layou
106. sing a Localizer Scout If a CT study includes a localizer the Viewer will display it in the preview pane according to its series number When a series is selected the slice indicators appear on the preview pane of the localizer as green lines As you scroll through the slices in the main view the change in position is indicated in the localizer This allows for easy location of slice position 18 x File View Image Tools Ortho Help GO Bale o k MO QQ H BAA se 70848 4 4 O0GSE8 8 O HER I H R amp i dk zo db Window wiatn RUDI Window Level T petsut Olt ia 403 2 0 6 a i ENGEL JULIA rF 5 O X oe A LU ur Lil 3 of6 cE A CT C NONE gt Lx LS a A Mag 39 WW 64 WL 40 A het SEN If you select the localizer image for display in the main view slice indicators of the study are displayed on the localizer image Slice indicators of the active series are shown in green You can set in the Settings dialog box whether to display all slice indicators of all series or only of the active series B E Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Slice Positioning 39 Each series of the study is designated with a different color for easy reference If a particular series is active after the localizer is opened in main view the s
107. sing the Zoom tool amp il i ls h tala suxi amp ajmilss ieje seaeaesiasA ooo Buezods4Almi iZa Pa SQ as QOQmemstusg E E Bi window wiatr J Window Level jme OST RP CRUS o 2 5 1 il RSNA Demo Medical I B x RSNA Demo Medical Mammogram F G2000 MG JPEG2000 M G1 RG m Region of Interest ROI indicated by green rectangle Active image indicated by red rectangle Wi 4095 da On the image preview the cursor changes to the hand tool allowing you move the ROI green rectangle to pan across the image To move the ROI click and hold the green rectangle and move it across the image preview The ROI displayed in the main view changes appropriately You can also pan directly on the main view using the Pan hand tool Ready Confidential 2005 IDX Systems Corporation All rights reserved ai eui eo 22 Using the IDX Imagecast iPACS Viewer Displaying Images Displaying Series To select a series double click or drag the desired slices in the preview pane The active series is indicated by a red rectangle around the image preview The series is opened in the main view according to the preset screen layout as defined in the applied Hanging Protocol 1x1 1x2 etc The screen layouts allow opening multiple series on the same screen for series or study comparison The series layout determines how many slices of the series will be displayed at the same time Default
108. st box are all the servers that were connected in the past e Monitored Speed Displays the connection speed for the specified server Displayed in Kbps Mbps or Gbps In case there is not enough data to estimate the connection speed NA Not Available will be displayed e Bandwidth Adaptation Automatic iPACS automatically chooses the bandwidth model according to detected connection speed Manual you set the bandwidth model that iPACS will work with according to a known connection speed DSL and below model suitable for low bandwidth below a specified threshold set by default to below 5 Mbps LAN model best suitable for medium bandwidth between the defined thresholds set by default between 5Mbps and 70 Mbps Fast LAN model best suitable for fast bandwidth above the defined threshold set by default to above 70 Mbps No Progressive Streaming removes progressiveness during viewing providing full quality and full resolution images but at a delay to viewing Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings 101 Click Advanced to manually configure Streaming Mode This opens the Streaming Mode Configurations dialog where you can set the lower speed limits for LAN and Fast LAN models This should be used only if recommended by your support Streaming Mode Configurations X When Streaming Mode is in Automatic Mode the madel
109. study is not opened in the main view Default Hanging Protocol Default Hanging protocol has screen layout 1x1 series layout 1x1 default Modality Preset Zoom equals Fit to Screen and Justify equals Center Contidential 2005 IDX Systems Corporation All rights reserved E BEN Using the IDX Imagecast iPACS Viewer 94 Settings Open Hanging Protocol Tab Opens the Hanging Protocol tab in the Settings dialog box There you can create edit copy apply import delete and export Hanging Protocols Apply Hanging Protocol Optional After images are opened in the main view you will be able to apply a Hanging Protocol A drop down for Hanging Protocol opens when clicking on Apply Hanging Protocol All the pre defined Hanging Protocols will be displayed The Default Hanging Protocol will always appear as the last one in the list EJ E Fia Default US Default x4 I Default MR Default CR Default CT Default Hanging Protccal Save as Hanging Protocol Optional Big Creates a Hanging Protocol based on the current Viewer settings The Hanging Protocol created records Modality as Hanging Criteria screen layout series layout and modality window presets B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings 25 Modality Presets Settings In the Modality Presets tab you can define window level presets for each modality The changes are
110. t gt Finish cancel Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings 21 6 Click Next to define monitor and screen layout Hanging Protocol Wizard Click on a monitor to select it es the default opening screen Note the numbering of the rronitors is according to their location Screen Layout DO u a e m g Rows h x Columns 2 The screen layout will be applied on all selected monitors lt Back next gt Finish Cancel 7 If you have more than one monitor you can select which monitors to open the Viewer on Just click on the monitor you want to act as the default opening screens Hanging Protocol Wizard Click on a monitor to select it as the default opening screen Note the numbering of the monitors is according to their location Screen Layout BO m ag tms Rows h xj Columns 2 The screen layout will be applied on all selected monitors pk wet me Len 8 Screen Layout The screen layout can be set in order to always open images or series in the main view Set the Confidential 2005 IDX Systems Corporation All rights reserved B EE 92 Using the IDX Imagecast iPACS Viewer Settings number of Rows and Columns up to 4x4 Note that this setting is applied across all monitors 9 Click Next to continue defining criteria for the Hanging Protocol Hanging Prot
111. t 1x2 and 2x3 Displaying in the Main View When an image preview is selected it opens in the main view Default screen layout and default series layout are according to the applied Hanging Protocol In the main status bar below the image a Streaming Progress Status Bar appears showing the progress of the received image data The image s quality is improved as data continues to stream until the highest possible quality is achieved In the upper right hand corner of the image or of each series a Qualicator displays the current image quality There is also a checkbox used to select images for DICOM Print and Save Confidential 2005 IDX Systems Corporation All rights reserved B EE 24 Using the IDX Imagecast iPACS Viewer Displaying Images In the lower right hand corner of the image the Magnification Level of the image is also indicated as well as Calibration and Linked Group number File View Image Tools Ortho Help mE p B j m Use check box to select images eA xi amp amp Hi ss aejeo h MQAQeO Ba lase A SOu Aas vo8g4 S FAB ODS BBE OlOl t tV for DICOM print lo sa Window Width aA ee Window Level and save i SKULL general PA 0 X Qualicator Ready BEENEEEEENEEN BENE Progress bar Displaying Images Full Screen To open the image full screen double click on the main view or press on Enter or right click to open the pop up menu and choose
112. t Monitors button is shown on the Screen Layout toolbar Select Monitors Click on the Select Monitors button to open the select monitors dialog The monitor configuration is shown below Click on the monitors you want the Viewer to open on temporarily Maximize If the Viewer is open only on one monitor clicking the Maximize button Bl will open the iPACS Viewer full screen on that monitor only If the Viewer is spread across several monitors clicking on Maximize Bl will open the iPACS Viewer full screen on those monitors B e Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Layout 37 Multi Monitor in Hanging Protocol The Multi Monitor configuration is automatically detected and displayed in the default Hanging Protocol Hanging Protocol Wizard Click an a monitor to select iE as the default opening screen Note the 1umbering of the monitors is according to their location Screen Layout B m sg sg m s Rons h H Columns 2 The screen layout will be applied on all selected monitors Back ne gt Finish Cancel To Use the Multi Monitor 1 Open the default Hanging Protocol and click Next to go to Option the multi monitor screen 2 Click on a monitor to select it as the default opening screen The iPACS Viewer will automatically choose the left most monitor by default 3 To select more than one monitor clic
113. te a Template Report After the templates have been selected and placed on the image you can generate a report The report contains patient information template information and an image of the template positioned on the x ray To Generate a Template 1 Perform any measurements desired on the image Report 2 Select templates and position them on the image 3 Click on the Create Report 3 button in the Templating floater B e Contidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer OrthoPlanner Optional 85 4 Areport is generated and opened in the Ortho Report window iol ej si sj wed Feb 1616 28 26 2005 Surgery Planning for Total Knee Replacement on Right side Planned by John Smith Patient Name knee AP Patient ID 007 Accession Humber 120 Templates PFC Tibial Component FamilyTitle PFO Total Knees Manufacturer Name Depuy PartNumber 299702696 Size B Product Title PFC Tibial Component Tray Type Keel PFC Femoral Component FamilyTitle PFO Total Knees Manufacturer Name Depuy PartNumber 2897027582 Size B Product Title PF C Femoral Component Image Calibration AP Oversize factor 115 0098 E oc Knee AP F 007 z8 Jun 1364 120 CR 5 After the report is generated choose to Save to Local File Save the report as an rtf file on the local machine Other users cannot view the report ls Save to Server Save the rep
114. the angle by moving the mouse B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Annotations 75 4 Clicking the mouse button again at the desired end point ends the angle measurement 5 The measurement in degrees is written in a text box inside the angle near the inner corner Tt is updated during the measurement process 6 Drawing is allowed only in the image area when the first point has been drawn 7 Click ESC to exit the annotation tool 8 You can delete an Angle annotation by clicking on it and pressing the delete key on the keyboard or right clicking on the Free Hand annotation and choosing Delete from the pop up menu 9 You will be asked to confirm deletion of the annotation This can be turned off by checking Don t ask me again The Angle Annotation can be saved as a DICOM Overlay on the server so other users can view it as well In the following we measure the spinal curvature iPACS Viewer i 581 x File View Image Tools Ortho Help cGWxl amp smrilss meiedsojihiemoaeggtutuasoodogEse eeosa we gu amp Se 2 C3 ID EJ EB A ER QE Ee Bi Window wat a fmm M Level j s ze de w le 8 Tsm i NAGASHIMA TAKANI Bl X NAGASHIMA T amp IKANORI M 4 FUJIOOO14 03 1950 FUJI PHOTO FILM CO W W 1024 39000 s Confidential 2005 IDX Systems Corporation All rights reser
115. tial 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings 115 stored on your computer will be deleted and no temporary files will be saved in the future e Current Location Displays the exact location on the computer where the Viewer temporary files will be stored Usually C Documents and Settings lt username gt Application Data iPACS Viewer Viewer temporary files e Amount of disk space to use Sets the physical amount of disk space to use for the temporary files During the installation it is set to half of the amount of the free disk Space available of the local drive as indicated in the current location If disk space has reached its limit you cannot open a new study unless they clear the temporary files or increase the amount of disk space to use The following message appears when the disk space has reached its limit iPACS Viewer l x The space allocated Far temporary Files usage does nat meet your current needs Please Increase the amount of temporary Files disk space before opening ary more studies e Change Location Click on this button to change the location of the temporary files After changing file location all temporary files will be deleted and all open studies will be closed New files will be saved in the new location e Delete Files Click on this button in order to delete the Viewer temporary files currently on your computer
116. tings I ES a M Display Measurements Display measurements on the image next to the following annotations e Line e Ellipse e Free Hand e Angle If the option is unchecked the measurement will not be displayed by default next to the annotation You can display an individual measurement by using the right click menu on the specific annotation Measurement Units Set the unit of measure to be displayed when using the measurement tools You can display measurement in e mm e cm Default e inches e pixels If the Pixel Spacing tag does not exist in the DICOM Header the measurement unit will be displayed in pixels Display Study Details Displays or hides the overlay annotations on the study These study details include patient information study information slice number and windowing level Display DICOM Overlays Displays or hides the DICOM overlay on the study These study details include text Free Hand ellipse pixel intensity and arrow annotations They can come from the original study as received by iPACS or as saved by the iPACS users Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Settings 111 Thumbnail Settings In the iPACS Viewer you can configure the Thumbnails to display according to your personal preferences When opening several Studies in iPACS the thumbnail images in the preview pane can be sorted ascending or descending
117. tons Pressing keys simultaneously Icons B ES P Check box I and radio button names appear in bold text For example l Save to Report Directory Radio buttons are round buttons used to select amp one of a group of mutually exclusive options Check boxes are square boxes that are selected to turn on W or cleared to turn off an option More than one check box can be selected Radio buttons and check boxes are sometimes referred to as fags as they indicate whether or not an option is selected This manual uses the following format to indicate that you must press two keyboard keys simultaneously to perform the specified task SHIFT F5 This indicates that you must press and hold the SHIFT key and then press the F5 key on the keyboard to perform the specified task Icons are used to indicate important messages or information These icons indicate Notes Examples Cautions and Warnings as follows This is the Notes icon Notes alert you to specific points of interest Notes that appear in procedural tables are preceded with the word Note or Notes as appropriate Procedural table notes are not marked with icons This is the Example icon Examples contain information about how you can use certain features of Imagecast Example applications This is the Caution icon Cautions indicate danger to the integrity of the data Cautions that appear in procedural Caution tables are preceded with the word Caution This
118. uOd5jmUnbeyghdR kF ssihlz 2sEV aL 5 g nbPmi yy sO MaAdN cS bk F MAIBE a0 CRIADBSLY Oz aM rS MjuPdT r H sgE W pgamsHpe amp gMBAAR gagqtMIKmewrEadl amp 40DbiRABM IKJBOUCCahFd FBE VmbLlM2RTwI IQsFBULFELLIJTw IdacTzHbBHR awi dk bE RBO kE bHYabT hCQUFBOTHMBYEIUYUpRU2T kdGA dW Gh nw F ESNA MTBU al RAR cE YT Waray EZ S mF OLY E SOY kY GONFA dF ph bE ARJAYUZCUYYGOIFYARJAYUZCUYY GOIFYARJAYOU2ZCUVY GOIF A kJ AWU ARJAYUZCUYYGOIFYARJAYOUZCUYY GOIFYARJAYOU2ZCUYY GOIF A kJ AWU ARJAYUZCUYVGOIFYARJAYOUAZCUYY GOIF R kJ AY UZCUM GOIF A kJ AWU ARJAYUZCUYYGOIFYARJAYOUZCUYY GOIF R kJ AY UZCUM GOIF A kJ AWL ARJAYUZCUYYGOIFYARJAYUZCUYY GOIF R kJ AY UZCUM GOIF A kJ AWL ARJAYUZCUYYVGOIFYARJAYU2ZCUYY GOIFYARJAYOUACUYY GOIF YA kJ AWU ARJAYUZCUYYGOIFYARJAYOU2ZCUYY GOIF R kJ AY UZCUM GOIF A kJ AWL 3 Click Create to create a permanent license request Save Send luxe vel RARJAYU2CUY GOIF RAKJA YUACUYY OOI R kJ AY UZCUWV GOIF YA kJA N and send it later RealTimeImage License Request License Request Temporary License CAD ocuments and Settings wael Desktop license dat Browse Field License Request Serial Coun State City Comp Comp L omrr Email Prod Conc Total Expire e license dat 4 Click Save in order to save the permanent License Request File name LicenseReg da Save as hype Lizense Request Files dat Cancel Contidential 2005 IDX Systems Corporation All rights reserved 2 ai d
119. ud OEP piOn E t 7064 44 00 Contidential 2005 IDX Systems Corporation All rights reserved 1x2 Screen Layout Pim m bap lun bis Hudy oS FE C 2 T FG1 seo th T war we Oe oo 8 e teeta rari GE ADH as Or 4900 ARQO GOD WwM Ox 657601 a4d050 m Mre eE a E ET T a r N EET E P je du bem aj amp 37044 Od reme em ai d asi lief 33 34 Using the IDX Imagecast iPACS Viewer Layout Custom Screen Layout The main view can be split into a customized number of windows up to 4x4 To set a customized 1 Click on the Custom Screen Layout button 4 number of windows 2 A 4x4 grid opens 3 Move the mouse over the grid until desired number of windows is selected 4 Click the mouse and the screen layout of the main view changes Do la x File View Image Tools Ortho Help e e x 1e S F i P Em Ble jka a a e oltja sS IAB s e amp 4 2 AlB 5 do zo TAB ws IE E Eig Window wit A window Level J Abdo dig A los Cancel 1 10 7 10 EBBEA EMEN Ready B E Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Layout 35 Series Layout Opens up a dialog box where you can choose the layout of the displayed series slices Possibilities include elixi e 1x2 e2x2 e2x3
120. vE uin Cia eda E Ras prdd d ax Pix EM EM 108 Elrthgenzbe we 6 ct S o LS 111 Magnifinder Settings uusssasssewskekre besxdaca eu Fei Tr PESE rbd da Eta 113 ce ad N LU ne One ner ee Peete mee eer Ty eee eee eer eee 114 SmartCache Settings cospreexbektesibpecbii bri ve mcn ob eene 115 Bu DESDE PECORE DEDERE POE DEED LATE DCO HEIDE DRERERIE 117 Patient Series and Study Information 117 EVE Linc A MP MINE ER PII MEME 121 vais R O E eee 124 eds Lbs T PI 125 POD Ly tht eU 126 PA EE TRETEN TEENS 128 zin e en ere er er 128 DICOM Print optional cosesstiesisa vibus pom RS vd Hi Mn AE Re RN 128 BEI BEBIDAS Gear usns Uh PE Uri MER 132 Save Images on Local Disk eee 132 Save Annotations on Server uu OUR COH RS UNO DO EON 133 Save Snapshot on Server Secondary Capture 135 Creating a CD DVD optional aseciuxkiex xv pue QUE FIERI M dus UH 137 How to Burn to a Single DISK wcesiccestisnssnitcsancrtiimcnardesanesaes 137 How to Burn to Multiple Disks eee 142 User Limitations for Burning CD DVD eese 144 Local ea ROME 147 Confidential 2005 IDX Systems Corporation All rghisreserved BPA 6 Contents Create License Request cccccsscsscccvevevcnsrensneeseneuenenensuensususenuaes 148 De BAIE oi SOME ERU E DUE E 150 Hal a pw cee Be B E C
121. ved B EE 76 Using the IDX Imagecast iPACS Viewer Annotations Cardio Thoracic Tool amp Click on the Cardio Thoracic button on the toolbar to activate the Cardio Thoracic annotation tool This tool measures the Cardio Thoracic ratio the percent difference between two line lengths To Measure the Cardio Thoracic Ratio on the Image Draw two lines on the image using the Line tool Click on the left mouse button on the first line 1 2 3 Click the mouse button again on the second line 4 A line is drawn between the two selected lines 5 The measurement in percentage is written in a text box between the two lines 6 Drawing is allowed only in the image area when the first point has been drawn 7 Click ESC to exit the annotation tool 8 You can delete a Cardio Thoracic ratio annotation by clicking on it and pressing the delete key on the keyboard or right clicking on the Free Hand annotation and choosing Delete from the pop up menu 9 You will be asked to confirm deletion of the annotation This can be turned off by checking Don t ask me again The Cardio Thoracic ratio can be saved as a DICOM Overlay on the server so other users can view it as well In the following we measure the Cardio Thoracic ratio Fle Yew Image Tos Orio Help ud x S th i Jg e iom sa l Q dfi Besa AGOe Rihal eos al aA OB ODSER IO EE Q sz Wedecan Winlow Levet f a im MN
122. wing screen shot shows the same CT slice at different Zoom levels E zisixi File View Image Tools Ortho Help m E m m EN S 9 e e o ihi eaegtelgt seeo 4Aas AjOmgj rmg B Om d O 8 amp AD i MSOO d wrcowwatn da V dO s SOu S ilave ABDOMEN O x ERR Study Date 14 Oct 1996 10 Oct 1978 CT C CONT CHU St ROCH CHU St ROCH 8000 j 8000 ST 10 00 WW 350 ST 10 00 KVP 120 00 WL 35 KVP 120 00 Ready Magnifinder Clicking the Magnifinder 4 button changes the cursor to a magnifying glass E When you click on the image the area is magnified in a magnification square Cursor changes to the four way cursor r You can drag the Magnifinder on the image When you stop dragging the Magnifinder is updated from the server up to lossless or all data received quality A Qualicator is displayed on the Magnifinder square to display its instantaneous quality Confidential 2005 IDX Systems Corporation All rights reserved E BEN 48 Using the IDX Imagecast iPACS Viewer Image Manipulation The size and magnification factor of the Magnifinder are set when clicking on the right mouse button A secondary pop up menu is opened This menu appears only when the Magnifinder tool is activated 18 x File View Image Tools Help je xX mE i c5 9 echis amp lat tu X AsX 5209d BE amp 6 amp A IS IEP AL 0 CD EJ
123. zing according to your settings Confidential 2005 IDX Systems Corporation All rights reserved Using the IDX Imagecast iPACS Viewer Image Orientation Image Orientation The Image Orientation toolbar has the following tools Image Orientation Tools Name Button Description oe Ah zo Flip Horizontal E Flips the image horizontally along the vertical axis Flip Vertical Flips the image vertically along the horizontal axis Rotate Left RE Rotates the image 90 to the left Rotate Right 5 Rotates the image 90 to the right Reset Orientation d Resets the image to its initial orientation An example of the tools effects are shown below l x File View Image Tools Ortho Help SEX S6SG Fi FOF Fles h PQQtOlBOAFOO H F Et os4 5 Wu i i P 12 C CD E3 EB GB B QE EE Eid wenn etm HAE Ww ever 0 Eo Peta da 37 e s l nx a S 44 i JPEG 2000 Medica V ET X SRR er TET JPEG 2000 Medical Mammogram F 1 JPEG2000 M G1 r JPEG2000 M G1 Y RG RG USF Wy 095 USF 26 Jan 1996 Vi 2047 26 Jan 1996 5 1 JPEG 2000 Medica Mammogram F JPEG 2000 Medical Mammogram F JPEG2000 M G1 JPEG2000 M G1 RG r RG Vv Contidential 2005 IDX Systems Corporation All rights reserved E BEN 5 58 Using the IDX Imagecast iPACS Viewer Slice Positioning Slice Positioning U

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