User Manual - Medis medical imaging systems
Contents
1. 3 1 Click to open the application menu and Select Settings gt Main or click 2 On the Background subtraction tab from the Subtract background flow drop down list select ROI 4 area and close the settings dialog Getting Started i E E on I 3 Inthe toolbar select and then select or db 4 In the Phase or Modulus View trace a contour in an area where you expect no flow Make sure that you do so as close to the vessel as possible 5 Press CTRL C and then CTRL SHIFT V This copies the contour to the other images 6 Check the area in all images to verify that it does not cover areas where flow is to be expected Edit the contours if necessary V You can move a contour as follows Select its ROI icon in the toolbar then press CTRL and use the left mouse button to move the contour 7 Any results that you now view are corrected for background flow QFlow 8 0 Quick Start Manual 17 Getting Started 7 Creating reports This chapter explains e How to view a Medis Suite report e How to manually add a snapshot to the Medis Suite report e How to create a text or XML report Reports contain a summary of patient and study information and a number of analysis results You can create plain text reports XML reports or a Medis Suite report To view a Medis Suite report Flow results and distance measurements are automatically added to a Medis Suite report You can access a Medis Suite report by selecting t2. QFlow 8 0 Quick Start Manual October 9 2015 9 07 250 80 1 v1 0 Medis medical imaging systems bv Schuttersveld 9 2316 XG Leiden the Netherlands http www medis nl Medis medical imaging systems bv Medis medical imaging systems Inc Schuttersveld 9 9360 Falls of Neuse Road Suite 103 2316 XG Leiden Raleigh NC 27615 2484 P O Box 384 USA 2300 AJ Leiden the Netherlands Telephone 31 71 522 32 44 Telephone 1 919 278 7888 Fax 31 71 521 56 17 Fax 1 919 847 8817 E mail support medis nl E mail support medis nl Web www medis nl Web www medis nl Legal Notices Copyright Notice 2003 2015 Medis medical imaging systems bv All rights reserved This manual is copyrighted and is protected by worldwide copyright laws and treaty provisions No part of this manual may be copied reproduced modified published or distributed in any form or by any means for any purpose without prior written permission of Medis medical imaging systems bv Permission is granted to freely print unmodified copies of this document as a whole provided that copies are not made or distributed for profit or commercial advantage Trademark Acknowledgments QFlow is a registered trademark of Medis Associated BV in the United States and in other countries DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications relating to digital communications of medical information All oth
3. South America Medis medical imaging systems Inc E mail support medis nl Telephone 1 919 278 7888 working days 9 00 17 00 EST Europe Africa Asia and Australia Medis medical imaging systems bv E mail support medis nl Telephone 31 71 522 32 44 working days 9 00 17 00 CET QFlow 8 0 Quick Start Manual Introduction This manual is organized as follows Getting Started Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Starting QFlow Describes how to start QFlow and how data is loaded The QFlow Workspace Describes the sections of the main window Reviewing Studies Explains how to browse the images in the Modulus View and Phase View and how to perform some basic image manipulations It also explains how to select an image and how to switch between phase and modulus images in the Thumbnail View Performing Vascular Flow Analyses Explains how to perform a vascular flow analysis how to apply background correction and how to view analysis results Creating reports Explains how to create and view reports Getting Started 3 Starting QFlow This chapter explains how e How QFlow is started and how data is loaded into QFlow QFlow can be started from Medis Suite Series that have been loaded in Medis Suite can be selected and dropped onto the QFlow icon using the left mouse button which will start QFlow Exactly 1 phase and 1 magnitude image series need to be selected and dragged onto the QFlo
4. and down allows you to scroll through the slices Getting Started Or e Press the left and right mouse button simultaneously and move the mouse from left to right to scroll through the phases Pressing the left and right mouse button and moving the mouse up and down allows you to scroll through the slices To zoom in or out e Inthe toolbar click You can zoom in by pressing the left mouse button and moving the mouse down You can zoom out by pressing the left mouse and moving the mouse up Or e Press to zoom in or to zoom out Or e Press the left and middle mouse buttons and move the mouse down to zoom in or move the mouse up to zoom out To pan e Inthe toolbar click x You can pan by pressing the left mouse button and dragging the mouse Or e Press the middle mouse button and drag the mouse 0 Panning only works when the images are zoomed in To adjust the window width and level e Inthe toolbar click In the Phase View or Modulus View hold down the left mouse button and drag Or e Press the right mouse button and drag the mouse To select the Edit mode e Inthe toolbar click i l In the edit mode you are able to draw contours distance measurements profile lines etc Getting Started 6 Performing Vascular Flow Analyses This chapter explains how to e Perform a vascular flow analysis e Apply background correction e View analysis results Now that we have reviewed the serie
5. FDA Food and Drug Administration under the provisions of Section 510 k of the Food Drug and Cosmetic Act Caution Federal law restricts this device to sale by or on the order of a physician QFlow complies with the requirements of the Canadian Medical Devices Regulations and has been licensed as a Class Il medical device Conventions Used The following conventions are used throughout this manual to indicate mouse and keyboard actions and to refer to elements in the user interface Mouse Click Press and release the primary mouse button If you are left handed you may have set the right mouse button as your primary mouse button Right click Press and release the secondary mouse button If you are left handed you may have set the left mouse button as your secondary mouse button Middle click Press and release the wheel button or the middle mouse button If you have a two button mouse press and release the left and the right mouse button simultaneously Double click Press and release the primary mouse button twice Keyboard SHIFT CTRL click Press and hold down the SHIFT CTRL key on your keyboard while you click a button or object CTRL O Press and hold down the CTRL key on your keyboard while you press O then release both keys This example opens the dialog window for opening a study Typographical Conventions On the Display tab select Names of buttons fields menus menu options and tab names the Hide a
6. Stare OFOW 5 seyl ke una n n WR NE SEN W k E KAK EB E 00W k n 4 The QFlow Workspace e eee ee ee eee eee eee eee 5 REVIEWING Studies eee xe ee eee eee eee eee eee 6 Performing Vascular Flow Analyses 7 Creating TeDOr S sara QFlow 8 0 Quick Start Manual Introduction About QFlow QFlow is the Medis software solution for the quantitative analysis of velocity encoded MR studies It enables cardiologists radiologists and technicians to quantify arterial and transvalvular blood flow QFlow features automatic contour detection easy to use functionality for editing contours flow analyses of vessels flow analyses of valves flow analyses of cerebral spinal fluid reporting This Quick Start Manual outlines the basics of working with QFlow You can find more details and more instructions for example on performing transvalvular analyses and on performing more types of background correction in the QFlow User Manual Introduction 2 Support Medis is committed to offering high quality products and services If you have questions about the software or if you would like to make suggestions for improvements in the software or in the documentation please contact the Medis helpdesk If you contact the Medis helpdesk by e mail mention the name of the software and the version number in the subject field To look up the version number of your software select gt About North and
7. e a second third or fourth vessel in the same series click pen in the toolbar and repeat steps 3 through 5 for each vessel e 7 Click 2 or press CTRL D to automatically detect contours in the other images of the series You can detect contours for all vessels you marked in one go Click the arrow next to Q this icon AF9 and from the submenu select Detect Contours of All ROIs This detects contours for all vessels regions of interest you marked in the entire series 8 Check if all contours have been detected correctly Make sure to edit incorrect contours O ABPO or press CTRL D again to automatically redetect the contours Click To view analysis results ik l 1 Click EN press F7 or select View gt Graph from the application menu This displays the Volume diagram Click a point in the curve to display the corresponding image in the Phase View and Modulus View 2 Select the diagram of your choice from the Show drop down list To add or hide curves in flow diagrams In the diagram window click 9 or to show or hide the corresponding curves in the diagram To apply background correction using the ROI4 area method If needed you can apply background correction The ROI4 area method is one of four methods for background correction that are available ae Refer to the QFlow User Manual for instructions on performing background correction using one of the other methods
8. e actions to create a snapshot to detect or draw contours and to edit or delete them Menu S The application menu is accessible through the button and can be used for example to reset the layout to view graphs to view reports to view study parameters to change settings to detect and edit contours to undo or redo actions and to cut copy and paste elements Getting Started 5 Reviewing Studies This chapter explains how to e Browse the images in the Modulus View and Phase View e Select an image e Switch between phase and modulus images in the Thumbnail View e View the series in the Movie window e Scroll through the images e Zoom in or out e Pan e Adjust the window width and level e Select the Edit mode To browse the images e Use the arrow keys on your keyboard to browse the images in the Modulus View and Phase View To select an image e Click an image in the Thumbnail View to select it This displays the image in the Phase and Modulus Views To switch between phase and modulus images in the Thumbnail View C e Click to open the application menu and Select View gt Modulus Images or View gt Phase Images To view the series in the Movie window e Click in the toolbar or press F5 To scroll through the images e Inthe toolbar click i Pressing the left mouse button and moving the mouse from left to right allows you to scroll through the phases Pressing the left mouse button and moving the mouse up
9. er brand product and company names mentioned in this document are trademarks or registered trademarks of their respective owners Intended Use QFlow is software intended to be used for the visualization and analysis of MR images of the heart and blood vessels QFlow is intended to support the following visualization functionalities cine loop and 2D review performing caliper measurements QFlow is also intended to support the following analyses MR velocity encoded flow quantification QFlow is also intended to be used for MR velocity encoded flow quantification of cerebral spinal fluid These analyses are based on contours that are either manually drawn by the clinician or trained medical technician who is operating the software or automatically detected by the software and subsequently presented for review and manual editing The results obtained are displayed on top of the images and provided in reports The analysis results obtained with QFlow are intended for use by cardiologists and radiologists to support clinical decisions concerning the heart and vessels Indications for Use QFlow is indicated for use in clinical settings where more reproducible than manually derived quantified results are needed to support the visualization and analysis of MR images of the heart and blood vessels for use on individual patients with cardiovascular disease Finally QFlow can be used for the quantification of cerebral spinal fluid in MR ve
10. he Report tab in Medis Suite 3e Refer to the Medis Suite User Manual for instructions on how to customize a Medis Suite report To manually add a snapshot to the Medis Suite report QFlow allows you to create a snapshot from an image or a graph and to add the snapshot to a Medis Suite report 1 Press the right mouse button on an image or a graph and select the right mouse button menu 2 Select Add To Results 3 The snapshot is added to the Medis Suite report To create a text or XML report C 1 Click to open the application menu and select View gt Report or press F9 2 To create a text or XML report click Plain text or XML If you are creating a text report you can select the results you are interested in by selecting the corresponding check boxes under Contents
11. ll drawings option are capitalized and in bold View gt Movie A sequence of menu options that you select to perform a specific task is indicated by angular brackets OFlow77 xml Text that you type or that appears on the screen such as file names and file locations is displayed in Courier New Symbols Used Mie K e do QFlow 8 0 Quick Start Manual Reference Points to related documentation or to related sections in the document that may be relevant in your situation Tip Provides helpful information or an alternative working method Note Brings additional information to your attention Caution Tells you to be careful when performing a task Warning Warns you for a potentially dangerous situation in the image representation or analysis which may lead to incorrect results You are advised to follow the instructions to avoid this Table of Contents Legal NOVICES acct yara a An k y Ku Wa Ke Kek b y ka Wa k y KRA baw iena CONVENTIONS S Q Aa wa ka ke kake W k y le k ke k a k y eya kec a Typographical CONVENTIONS E kek ke ee eee ee ee eee e FADE OF CONTEM x L y se wa bene a ONA WAV SOR Y WO SEN XA SN ESR V CD EN n IT TO dC Ll Ol ay a tiara tare h k Va ans Za d k k k k Xu biya 1 ADOUUTOFIOW s a3554 nilo libici 2 SUDDO A yaba we kew E SNN ha KE dine awa N ee lele W n a y Dar W sa GETING Started alici 3
12. locity encoded flow images When the quantified results provided by QFlow are used in a clinical setting on MR images of an individual patient they can be used to support the clinical decision making for the diagnosis of the patient In this case the results are explicitly not to be regarded as the sole irrefutable basis for clinical diagnosis and they are only intended for use by the responsible clinicians WARNINGS i You are explicitly recommended to measure flow parameters only in sequences that are validated for flow measurements Reliable measurement results can only be obtained with validated acquisitions i QFlow must be used by cardiologists radiologists or trained technicians who are qualified to perform cardiac analysis If the analysis results are used to reach a diagnosis the results must be interpreted by a qualified medical professional In clinical practice QFlow should not be used for purposes other than those indicated in the section Intended Use E Users must make sure to read this manual to become familiar with the software and be able to obtain reliable analysis results European Regulations QFlow is qualified as a class Ila medical device It complies with the requirements of the Dutch Medical Devices Decree Besluit Medische Hulpmiddelen Stb 243 1995 and the European Medical Device Directive 93 42 EEC North American Regulations QFlow has been cleared for market in the United States by the
13. s we are going to perform a vascular flow analysis using the automatic contour detection ae If you want to perform a transvalvular flow analysis you have to create contours manually For detailed instructions refer to the QFlow User Manual Automatic contour detection is performed based on the settings specified in the Contour Detection Settings window You can access these settings by selecting Settings gt Contour Detection Settings from the application menu When you are using the analysis to obtain results on the average flow velocity make sure that contours are present in every phase To perform a vascular flow analysis 1 Select the image that shows most contrast between the vessel and the background 2 Click in the toolbar 3 Click 4 Inthe Phase or Modulus View click to select the center point of the vessel you want to analyze 5 Verify that the contour is correct V The maximum velocity pixel within the contour in this phase is marked by an orange square the minimum velocity pixel is marked by a blue square To create a new contour you can place the center point again ml kaz To draw or edit the contour click q or dh and trace the contour in the Modulus or r F Phase View or click and drag the contour To reshape the contour right click in the view select Contour Shape and select one of the reshaping options from the submenu Getting Started 6 If you want to analyz
14. w app The selected series are then displayed in QFlow The following image shows how a phase and a magnitude image can be dropped simultaneously onto the QFlow icon Medis Medis Suite 1 0 15 0 d4 Mm OeeKved Series Browser 9 QFlow requires both phase and modulus series An error occurs if only one of these types is loaded Getting Started 4 The QFlow Workspace This chapter explains e The contents of the QFlow workspace The QFlow main workspace consists of a set of toolbars a phase view a modulus view and a thumbnail view The application menu is accessible through a menu icon in the toolbar t RICCA Phase view The phase view shows a velocity image of the selected series Modulus View The modules view shows a modules image of the selected series Thumbnail View The thumbnail view shows thumbnail images of the selected series The thumbnail view shows either phase images or modulus images This can be configured through through the application menu The thumbnail marked with the red border corresponds to the image displayed in either the phase view or the modulus view Toolbar The toolbar area consists of a Medis Suite toolbar and several QFlow toolbars The QFlow toolbars can be used to access the application menu to start a movie to show a graph to access the main settings and to perform some basic image manipulations like panning or zooming The QFlow toolbars can also be used to undo and redo som
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