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Visage 7 Web Client User Manual

1. 10 Overview of the Visage 7 product 13 otarting and Ending the Program 19 Scree Mesinas hacia nee ub M Mead LM OM IE 19 5 T 21 Integrated Windows authentication 22 Call up from another software program sess 22 Changing your password guasto tancum he Pastas RI M 23 Logging off from the web server sseesssesseeeeeennene nnne nnne nnne nnn nnne nis 23 The Visage 7 Web Client Window 25 21022110 25 FU SINE WINGO T 1 077 27 ottdviseres nior ue Raga endi ia IR 34 PrEVIEW c S 42 REDO WIE OW Eeauscefots sages isset beau 50 1 Table of Contents MIGWOERSC dude EDU o4 COMP ANC 66 MIP MEPISVIGWOE EEA E 67 Worklist Expert Reading Lade Pc ad c edo tion ran 74 Display Protocol Viewer Expert 81 Appendix 91 List of su
2. 24 The Visage 7 Web Client Window ROI Rectangle Permits evaluation of rectangular regions of interest ROIs in grayscale images While this tool is active the mouse pointer looks like this T Measured values are indicated in exact square millimeters mm in CT and MR images estimated square millimeters mm P or in pixels pix if ROI measurement in millimeters is possible The relative error of the elliptical or rectangular ROI measurements is 2 pixels shorter radius or shorter side For example Shorter radius or shorter side measurement error 10 pixels 20 20 pixels 10 50 pixels 496 100 pixels 2 Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still Density Profile Permits evaluation of a density profile along a straight line an arrow indicates the direction While this tool is active the mouse pointer looks like this R Create Annotation Opens a selection list with annotation functions Arrow Annotation Allows you to annotate images with arrows Text Annotation All
3. Quick Zoom Permits temporary zooming of a portion of an image As soon as you release the mouse button the image returns to its original size While Quick Zoom is active the mouse pointer looks like this L 4 Previous Annotated Image Scrolls up in the stack of loaded images and shows the next image containing annotation graphics or annotation text Next Annotated Image Scrolls down in the stack of loaded images and shows the next image containing annotation graphics or annotation text Measurement Functions Opens a selection list with measurement functions Distance Measurement Permits measurement of distances in images While this tool is active the mouse pointer looks like this mT Measured values are indicated in exact millimeters mm in CT and MR images estimated millimeters mm or in pixels pix if no distance measurement in millimeters is possible Visage 7 Web Client The Visage 7 Web Client Window Display Protocol Viewer Expert Reading Visage 7 Web Client The accuracy of distance measurements is 2 pixels Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum accuracy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display doe
4. 61 86 Deselect all Images DICOM Print icon 56 83 Deselect all previews icon 37 DICOM Information icon 37 57 83 DICOM Print icon 56 83 DICOM Quick Send icon 31 37 57 107 108 76 DICOM Send icon 31 37 57 76 Display as 3D volume icon 37 45 62 77 88 Display Mode icon 61 82 Display Protocol Viewer icon 26 Display protocols list worklist 79 Display Reports icon 63 Display Scenes icon 63 Distance Measurement icon 59 84 Dual monitor 21 E Edge Enhancement icon 58 83 Edit Report icon 57 82 Encrypted Data Transfer icon 36 77 Encryption 12 Export Images icon 57 83 Export Patient icon 32 Favorites 20 Filter parameters 28 75 Fit into Segment icon 58 87 Forward icon 31 76 G Gamma Adjustment icon 62 82 H Help icon 26 Hide show filter criteria icon 28 75 Hide Show Image Text icon 57 82 Index Image preview 41 47 Image Preview icon 26 Image Preview on off icon 37 Integrated Windows authentication 22 Intended use 3 Interactive Cine Mode icon 62 88 Invert icon 58 87 L Launching Application icon 32 37 45 TT Layout conventions 15 License management 6 Load all series as one icon 36 Load into viewer 1 icon 35 Load into viewer 2 icon 35 Load to Compare Mode icon 35 Lock Toolbar icon 55 8
5. Done 6 Trusted sites Visage 7 Web Client The Visage 7 Web Client Window otudy series window Information area study series window Patient Name Patient ID Date of Birth This area of the study series window provides information about the loaded patient Name of the loaded patient Identification number of the loaded patient Date of birth of the loaded patient Toolbar study series window HE Visage 7 Web Client In the study series window you will start most of your processing steps with the icons of the toolbar But note that a popup menu is also available for selecting imag es in the image preview area Previous Patient Shows the studies and series of the patient above the patient currently selected in the pa tient list Next Patient Shows the studies and series of the patient below the patient currently selected in the pa tient list Show all Studies When Visage 7 Web Client is called from another application via the OEM interface this icon shows all studies of the current patient Load into viewer 1 The selected study series presentation state or individual images are loaded into viewer 1 Load into viewer 2 The selected study series presentation state or individual images are loaded into viewer 2 Load to Compare Mode Loads the first two series of a selected study or two selected series or two images into compare mode side by side Load to Compare Mode Loads th
6. Load to Compare Mode Loads the first two series of a selected study or two selected series or two images into compare mode top and bottom Load all series as one Click this icon before you load an entire study into one of the viewers to merge all images of this study into one viewing series Compression Level A Transfers images with compression level A In compression level A the images are usually only slightly compressed and without loss of quality Your system administrator defines the compression rules Visage 7 Web Client 43 Preview window 44 The Visage 7 Web Client Window Compression Level B Transfers images with compression level B which compresses the images even more Note that compressed images do not contain the full volume of data of the original The di agnostic quality of the images is affected as a result Encrypted Data Transfer The images are transmitted encrypted Non encrypted Data Transfer The images are transmitted without encryption Query Report Requests a report on the currently selected study from the configured report network node If a report on the selected study already exists on the Visage 7 server the report is down loaded again and the existing report is overwritten Use Local Cache If this icon is activated the images you download from the web server are stored in your lo cal cache memory When you load images into a viewer Visage 7 Web Client sea
7. Shows or hides display of individual slices In the 3D overview segment only Shows or hides the volume box in the overview segment In the slice segments only Shows or hides the slice cursor in a slice segment Selects MPR as the volume calculation method default Selects MIP as the volume calculation method Resets all processing steps and again shows the images in a segments as they were when first loaded Removes the data set from the basic MIP MPR viewer All segments are then empty In the basic MIP MPR viewer you can activate processing modes in the segments via the keyboard 1 Click on a segment 2 Then press the corresponding key The display switches or the new operating mode is shown bottom left in the seg ment 3 Now perform the processing step with the mouse Activates interactive windowing with the mouse Activates interactive image zooming with the mouse Activates interactive image panning with the mouse Visage 7 Web Client The Visage 7 Web Client Window Basic MIP MPR viewer 1 2 3 Mouse clicks Visage 7 Web Client In the 3D overview segment only Allows you to rotate the orientation cube in any direction with the mouse In the slice segments only Allows you to move the slice currently shown in the slice segment along two standard axes Do not accidentally click on the slice cursor line In the slice segments only Allows you to change the slice thickness of the image shown
8. 62 A Access control 10 Angle Measurement icon 59 85 Archive Protection icon 36 Archiving 9 Arrow and Text Annotation icon 86 Arrow Annotation icon 86 Audit trails 12 Authentication 10 Auto logoff 11 24 Auto Hide Toolbar icon 55 82 Automatic Synchronization with 3D vol ume icon 38 45 62 77 88 B Backwards icon 31 76 Basic MIP MPR viewer 67 overview segment 69 slice cursor 0 slice segments 70 Basic MIP MPR Viewer icon 26 35 Biplane scenes 48 Bouncing Cine icon 61 88 C Calibrate Distance icon 60 85 Cancel Data Query icon 30 76 Cancel loading icon 56 82 Change Group Assignment icon 31 76 Change Procedure Step icon 36 77 Change Toolbar Location icon 55 Change User Assignment icon 31 76 Cine Mode Backward icon 61 88 Cine Mode Forward icon 61 88 Cine Mode Speed icon 61 88 Cine Mode Stop icon 61 88 Client installation 8 Color map icon 62 88 Compare mode 66 Compare Mode horizontal icon 26 Compare Mode vertical icon 26 Compression Level A B icon 36 Constancy check 4 Copy to Clipboard icon 56 83 Create Annotation icon 86 Customer specific translation 20 D Data protection 10 Data security 10 Delete object icon 36 Delete Patients icon 31 Density Measurement icon 60 85 Density Profile icon
9. Comment Visage 7 Web Client Here you can filter the patient list according to the patient s ward or the name of the institu tion where the patient was examined Click the icon next to the filter parameter Location Select a Ward or Institution Name Here you can sort the patient list according to the date when the patients data were trans ferred to the web server Today lists all patients whose studies were transferred to the web server today Yesterday lists all patients whose studies were transferred to the web server yesterday The last X days lists all patients whose studies were transferred to the web server during the last X days Date lists all patients whose studies were transferred to the web server on that particular day From date to date lists all patients whose studies were transferred to the web server with in the stated period All lists all patients irrespective of when their studies were transferred to the web server Here you can filter the patient list according to the processing status of procedure steps SCHEDULED lists all patients whose studies contain procedure steps that are scheduled for interpretation IN PROGRESS lists all patients whose studies are currently being reviewed in one of the Visage 7 Web Client installations in your network DISCONTINUED lists all patients whose studies contain procedure steps with interpreta tion status discontinued COMPLETED lists
10. Patient s identification number Date of birth in YYYY MM DD format M male F female O other unknown Modalities used to examine the patient Comment text about the patient Yes a report exists on the Visage 7 server for one of this patient s studies No no report exists on the Visage server In the study series window you can query for reports on configured report network nodes Yes this patient cannot be deleted No this patient can be deleted Date and time of the study in the format YYYY MM DD and hh mm ss 24 hour clock If more than one study exists the date of the most recent study is displayed Date and time when the patient data was sent to the Visage server Visage 7 Web Client The Visage 7 Web Client Window Patient window Response list network node Patient Name Patient ID Study Date Date of Birth Sex Accession Num ber Study De scription Number of Images Referring Physi cian Archive Status Patient Com ment Visage 7 Web Client If you selected a network node as the data source instead of querying the local Vis age server you will see the response list of the DICOM node instead of the local patient list Here a patient name may be listed more than once as each entry repre sents exactly one study Tip You cannot load patient data directly from the response list of a DICOM node into the study series window You must first copy a patient to the local databas
11. YYYY MM DD and hh mm ss 24 hour clock Name of the referring physician Comment text about the study Accession number of the study Study s identification number Visage 7 Web Client The Visage 7 Web Client Window Report Procedure Step Status Performer Priority Non viewable Series Series list Type 3D Volume Modality Number of Imag es Highest Image Number Preloaded images Organ Description Visage 7 Web Client Study series window no report is stored on the Visage server for this study 1 2 3 one or more reports are stored on the Visage 7 server for this study When you display or edit the report the most recent of these report versions will be shown Indicates whether a procedure step exists for this study Visage 7 only supports procedure steps of the type nterpretation in this software version Indicates the status of the procedure step scheduled in progress discontinued or com pleted Indicates the name of the Visage 7 Web Client user who is currently reviewing the images of this study or who completed this procedure step Low medium or high You can use this column to sort the study list for example Number of series that cannot be displayed This tab card lists all series that are stored on the web server for the current study With Show Thin Slice Series selected both the original scan series thin slice series and thick slice series are li
12. versal availability of data one step further Visage 7 Web Client makes radiological study data which includes DICOM image data and reports available at the clinical workplace In this context the central web server functions as temporary storage medium of im age data usually for the duration of a patient s stay at the hospital e g 2 4 weeks and as an image distribution center Moreover Visage also extends beyond the hospital and its internal data network With appropriate authorization the web server can be accessed from the outside as well making use of the Internet This way referring physicians can quickly and easi ly call up information on the examination results of their patients Accessibility via the Internet also proves helpful in critical situations where the opinion of an addition al external expert is required The use of a secure data transmission protocol and additional data encryption op tions ensure high data security for this kind of data distribution via the Internet Visage servers are web servers with a database to which the relevant image ma terial is transmitted after examination or reporting An internationally standardized transmission protocol as defined in the DICOM standard is used for this purpose Note Visage will not be able to guarantee the availability of data if studies series that have been transferred by other network partners contain errors As a rule the image data remains on the
13. Clipboard Copies the currently displayed images to the clipboard From there you can paste the cop ied images into another Windows program e g a presentation or NetMeeting program Visage 7 Web Client The Visage 7 Web Client Window Viewers o Du Visage 7 Web Client DICOM Send Opens a dialog box Select the address es in your DICOM network to which you want to send the selected image or all loaded images DICOM Quick Send Sends the selected image or all loaded images to one or several DICOM nodes immediate ly Your system administrator has defined these addresses for you Export Images Exports the currently displayed images to a directory on your local PC You can save the im ages as DICOM images or in BMP or JPEG format When images were saved in BMP or JPEG format they may no longer be suitable for diagnosis DICOM Information Shows the DICOM information of the current image Hide Show Image Text Shows or hides text in the image Edit Report Opens an existing report for editing or creates a new study report on the web server Zoom Allows you to enlarge or reduce the displayed images steplessly using the left mouse but ton While Zoom is active the mouse pointer looks like this Quick Zoom Permits temporary zooming of a portion of an image As soon as you release the mouse button the image returns to its original size While Quick Zoom is active the m
14. DB only x Visage PACS Web Start Data Query Cancel Data Query x Retrieve Study from x DICOM Node ria ti Query Patient m DICOM Send 94 Visage 7 Web Client Appendix Overview of functionality supported by client types Client type View Client type Classic Client type Expert Client type Expert Reading Forward x x x Backward x x x 44 Set Delete Protection x X Remove Delete Protec x tion 32 Delete Patients x x Change Group Assign ment Change User Assign X ment Export Patient Launching Application x ze Visage 7 Web Client 95 Overview of functionality supported by client types Appendix Study series window or worklist Client type View Client type Classic Client type Expert Client type Expert Reading Presentation state tab x x x card Previous Patient x x X 5 Next Patient x x Show all Studies x x x Load into viewer 1 x x ail Load into viewer 2 x x X KE Load to Compare Mode LH Load to Compare Mode x E Load to Basic MIP x MPR Viewer HE Load all series as one iB 96 Visage 7 Web Client Appendix Overview of functionality supported by client types Client type View Client type Classic Client type Expert Client type Expert Reading Refresh x x X Delete object X Change Procedure Step Archive Protection only with
15. DICOM images or in BMP or JPEG format DICOM Information Shows the DICOM information of the current image Predefined Level Presets If different window or filter values are predefined for the current image type you can call them up here and apply them to the loaded images Reset Window Level Resets the window and filter values back to default values i e the values with which the im ages were loaded Windowing If this icon is pressed you can use the mouse to change the grayscale display brightness contrast in the images While Windowing is active the mouse pointer looks like this Xo Edge Enhancement This filtering enhances the contrast in images While Edge Enhancement is active the mouse pointer looks like this NA 83 Display Protocol Viewer Expert Reading 84 The Visage 7 Web Client Window Pan Allows you to move the image in the segment If the portions of the image disappear off the screen after enlargement you can pan them back into view While Pan is active the mouse pointer looks like this Ny Magnifying Glass Allows you to enlarge a portion of an image by factor 2 As soon as you release the mouse button the enlargement is no longer displayed While Magnifying Glass is active the mouse pointer looks like this Zoom Allows you to enlarge or reduce the displayed images steplessly using the left mouse but ton While Zoom is active the mouse pointer looks like this
16. Image processing Information in the slice segments Slice cursor Color coding 70 The Visage 7 Web Client Window After you have loaded the data set the slice segments first show the anatomical standard views e Transverse standard view upper left yellow border e Sagittal standard view upper right red border e Coronal standard view lower left green border You can ascertain the position and orientation of the two other slices by the color of the Slice cursor and from the orientation labels You can use the slice cursor to move through the volume data set You can observe the changes in orientation and position of the slices displayed in the 3D overview segment To obtain a better view of details in the displayed slices you can change different display parameters in the slice segments e g window zoom pan Orientation labels Orientation and position of the slice in the up per right seg ment Orientation and position of the slice in the low er left segment Current calcu lation method Current operat M nemod p MPR 1 00 mm Current slice thickness Example Upper left segment after loading images transverse slice The slice cursor in a slice segment shows you the orientation and position of the slices that are currently shown in the two other slice segments On the slice cursor ayellow cursor line corresponds to the slice image in the upper left segment e cursor lin
17. You must first copy the patient to the local database with this icon This icon is dimmed while the data source web server is selected or while no patient is se lected in a network response list Query Patient He This icon is active if a patient was selected in the local patient list and then a DICOM partner was selected in the data source drop down list The patient name and the patient ID of this patient are copied into the search criteria boxes and the search for this patient is started on the DICOM partner Forward For better overview the patient list does not display all patients found at a time After a very generic patient search that results in more patients found click this icon to page through the list of all patients found Backward 44 Click this icon to page backward through the list of all patients found DICOM Send Opens a dialog box Select the address es in your DICOM network to which you want to send the selected patient s 53 DICOM Quick Send Sends the selected patient s to one or several DICOM nodes immediately Your system administrator has defined these addresses for you E Change Group Assignment The Change Group Assignment dialog box opens Here you can define which user groups have access to the selected patients Change User Assignment m 5 The Change User Assignment dialog box opens Here you can define which users have access to the selected patients 76 Vis
18. a report was received from the HIS RIS in the format DICOM Structured Re port it may contain footnote information which is not immediately visible in the HTML report version shown in the report window Move the mouse pointer over these icons which indicate hidden footnote text to show this information in a tooltip Report editor You activate the report editor with this icon in the toolbar of the image display sec tion Once you have switched over from view only to editing mode a toolbar appears above the report text with basic text editing and text formatting functions Note You can only edit the report text white background but not the report header gray background Visage 7 Web Client The Visage 7 Web Client Window Report window Report editor toolbar B faria 9 gt m Image display Viewer toolbar Position indicator bar Visage 7 Web Client Save Saves your changes to the report back to the web server Cancel Undoes your editing and displays the report as you last saved it or as it was stored on the web server before you started editing it Font family and size Allows you to change the font family and size for selected report text Cut Copy Paste These icons allow you to cut copy and paste text in your report Icons for editing characters With the icons Bold Italic Underline Strikethrough Superscript and Subscript you can change the format properties of selected chara
19. an Ya Visage 7 Web Client In the worklist you start all processing steps with the icons on the toolbar User defined filter You can select a predefined filter here Reset to Default Filter Activates the filter defined as the default filter Set Filter Properties The Personal Settings dialog box opens You can define your own filters here Reset Filter Settings All the filter parameters you entered are removed Click Start Data Query to display the un filtered patient list again Reset Input Fields All the search criteria you entered are removed Click Start Data Query to display a longer patient list again 75 Worklist Expert Reading The Visage 7 Web Client Window Visage PACS Web v Data source Here you select where to search for data on the local web server database or on a DICOM network node Start Data Query e Starts a data query with the current filter and search criteria in the selected data source As a result the patient list of the web server or a response list from a DICOM node will be displayed Cancel Data Query n A query currently in progress is stopped All patients found so far are displayed E Retrieve Study from DICOM Node i If you did not request data in the local database but on a network node you will see the re sponse list of the DICOM node in the patient window If you find the patient you are looking for in this list you nevertheless cannot work with this data immediately
20. are displayed side by side and in which you can also edit a report Tip Your system administrator can define that the report with image view is the pre ferred viewer This means that it will automatically pop up when you double click a study or series in the study series or preview window for which a report exists on the Visage 7 system If no report is available locally and a report interface has been configured with au tomatic report query Visage 7 Web Client will automatically search the HIS RIS for the report every time you load images Use these icons on the navigation bar to switch to the report window or report with image view The icons are active if you have selected a study for which a report is available in the study series window Tip You must first load images into viewer 1 or viewer 2 before switching over to the report with image view Otherwise the image section of this view will remain blank and only the report text will be shown Or Click the Edit Report icon in the toolbar of one of the viewer windows to create a new report Visage 7 Web Client now shows the report with image window whose report section is in editing mode Tip If your hospital works with a HIS RIS and normally uses this system to create and manage reports the Edit Report icon will most likely not be available in your client installation Instead the system will automatically query the report node for the lat est report version a
21. available in six languages You choose a language when you call the Visage 7 Web Client login screen 1 Connect to the Internet or Intranet 2 Start the Internet Explorer 3 Enter the address URL of the Visage 7 server http servername for the default user interface language http servername de for the German program version http servername en for the English program version http servername fr for the French program version http servername es for the Spanish program version http servername it for the Italian program version http servername pt for the Portuguese program version 19 Calling up the login screen Starting and Ending the Program Customer specific translation Shortcuts Visage PACS Downloading the user manual Microsoft Windows Vista 20 Servername is a placeholder for the name of the Visage 7 server on the network URLs that follow the convention of previous software versions http serverna me visagepacs en or http servername radin are also still valid If a customer would like to have the user interface translated into any other lan guage than those listed above a separate directory is available for this The customer specific directory cs contains a version of the user interface that can be translated into other languages The address of the login page in this case is http servername cs for customer specific program version To speed up the call
22. has been loaded that contains suitable image data Show All Scoutlines Shows all scoutlines in the reference image Show Border Scoutlines Shows only the first and last scoutline in the reference image Show Border and Current Scoutlines Shows the scoutline of the current image and the first and last scoutline in the reference im age Show Current Scoutline Shows only the current scoutline in the reference image Display Mode Opens a selection list with different layouts Select for example the 2x2 view The image display is divided into 4 segments in this ex ample Depending on the number of images that are loaded up to 4 images will be dis played at one time Cine Mode Backward Plays back the loaded images like a movie The playback direction is backward Cine Mode Stop Stops movie playback Cine Mode Forward Plays back the loaded images like a movie The playback direction is forward Cine Mode Speed If the slider is far left movie playback stops If the slider is far right the movie is played back at maximum speed Bouncing Cine If you click this icon the movie will run without interruption When playback reaches the last image the movie runs backward to the first image then forward again etc 61 Viewers mm Angio mode 62 The Visage 7 Web Client Window Interactive Cine Mode When Interactive Cine Mode is active the images of a series or scene will play back when you
23. in this slice segment interac tively Do not accidentally click on the slice cursor line Enlarges or reduces the image so that it fits optimally into the image segment Shows the image in its original size In the 3D overview segment only Shows or hides all slices in the overview segment In the 3D overview segment only Shows or hides display of individual slices In the 3D overview segment only Shows or hides the volume box in the overview segment In the slice segments only Shows or hides the slice cursor in a slice segment Resets all processing steps and again shows the images in all segments as they were when first loaded In the basic MIP MPR viewer you can also switch operating steps and calculation modes using mouse clicks 1 Left click on the display of the operating mode in a segment to scroll forward through the operating modes Or Right click to scroll backward through the operating modes 2 Left click on the display of the calculation method in the lower right corner of the segments to switch between MPR and MIP 73 Worklist Expert Reading The Visage 7 Web Client Window Worklist Expert Reading i Single or dual monitor Information area worklist Filter parameters ana search criteria Navigation bar System messages Toolbar worklist Data source Monitor selection Display protocols list Patient list local or Response list network node Study list worklist 14 Wh
24. is monitored A message informs users that their actions may be monitored The following activities are recorded if the audit trail option has been activated by the system administrator e Changes to access rights with accessing user date and time e Viewing printing or deleting patient data e Changes to archived images with time date and user Login and logout and failed attempts to log in e Service sessions local or remote e Software updates as well as backup and restore In addition the highest original number of images is recorded to compare the cur rent number of images Audit trails must be kept for a number of years It is the responsibility of the system administrator to ensure that the relevant log files are archived according to the re quirements that apply to your institution and country The system administrator is the only user who has access to the audit trails via a dedicated viewer For larger systems a separate database server can be made available for audit trails With Visage 7 data is transmitted in accordance with the SSL Secure Socket Lay er standard For this purpose a security certificate which is essential to guarantee the security of data transfer is installed automatically on your computer the first time you start the program Data is then automatically transmitted over a secure connec tion Furthermore it is advisable to additionally encrypt the images using the en cryption function
25. platform the system administrator can also activate the audit trail option This ensures that the system follows the strict regulations concerning patient data protection and data security according to US law Note For security reasons it is not permitted to make changes to the product Visage 7 and its database Contravention of this will lead to all guarantees being revoked and under some circumstances may even be violating applicable laws Access control and authentication Access to data Access to program functions 10 Visage 7 employs a user management concept that controls both access to study data and the availability of program functions Each user must log in on to a Visage client with a user name and password The Visage server checks these entries Only if they match is access to the system granted Access rights to study data are defined by the system administrator on the Visage 7 server The basic idea is that only those users who are involved in a particular case should have access to study data Access authorization ensures that users can only view data for which they have ac cess rights In addition to restricting access to data the system administrator can also make cer tain program functions available to some users but not to others This way every user will find only those icons and functions on the user interface that he or she real ly needs Controlling the range of functions available for each use
26. screen with the right mouse button 3 Select Change Password from the popup menu 4 Enter your user name and your old password as usual and press RETURN You are now prompted to enter a new password on the login screen Enter the new password in the New Password box 6 Enter the new password a second time in the Confirm box and press RETURN Use the new password from now on when logging in Tip If the login screen popup menu does not contain the Change Password item ask your system administrator to configure this for you Logging off from the web server Logging off from the You should always log off from the Visage 7 system ew If images are currently being loaded please cancel loading with the Esc key before you log out 4 Click this icon in the lower part of the navigation bar This logs you off from the Visage 7 system The Visage 7 Web Client login screen is displayed again P Click this icon in the top right corner of the program window This logs you off from the Visage 7 system and also closes the Internet Explorer Visage 7 Web Client 23 Logging off from the web server Starting and Ending the Program Tip If you are working with a 1024x768 screen resolution the logoff icon in the lower left hand corner of the navigation bar may not be visible Press F11 for a full screen display of the Internet Explorer in this case In this view the logoff icon is always available Tip Your sy
27. the images they contain 4 visage PACS Microsoft Internet Explorer E Bl File Edit View Favorites Tools Help Ea Patient Name MR Abdomen Patient ID 23003 Date of Birth 2000 01 01 a3 als Bo fe Q let E E ax T1 OB Modality MR Images 28 Organ Date Time 2005 12 20 12 02 48 Visage 7 Web Client The Visage 7 Web Client Window Preview window Information area preview window Patient Name This area of the preview window provides information about the loaded patient Name of the loaded patient Patient ID Date of Birth ID of the loaded patient Date of birth of the loaded patient Toolbar preview window In the preview window you will start most of your processing steps with the icons of the toolbar But note that a popup menu is also available for selecting images Previous Patient Shows the studies and series of the patient above the patient currently selected in the pa tient list Next Patient Shows the studies and series of the patient below the patient currently selected in the pa tient list Load to Viewer 1 The selected study series or individual images are loaded into viewer 1 Load to Viewer 2 The selected study series or individual images are loaded into viewer 2 Load to Compare Mode Loads the first two series of a selected study or two selected series or two images into compare mode side by side
28. the previous series of the current study and displays its images With multiframe im ages the previous scene is loaded Next Series Loads the next series of the current study and displays its images With multiframe images the next scene is loaded Previous Presentation State Shows the previous presentation state of this patient and study Next Presentation State Shows the next presentation state of this patient and study The Previous Next Presentation State icons are dimmed if only one presentation state ex ists for this study or if no presentation state has been loaded Cancel loading Stops loading images Select Images Offers options for selecting images for printout on a DICOM printer Select all Images Selects all loaded images for DICOM print Range Selection Opens a dialog box for range selection Deselect all Images Undoes the current selection for DICOM print no images are selected after you click this icon Print Allows you to print images on a connected DICOM or Windows printer Windows Print Opens the Windows Print dialog box and prompts you to select a printer and print settings All images currently displayed on the screen will be printed DICOM Print Opens the DICOM Print dialog box and prompts you to select a printer and print settings Only those images that are marked for DICOM print solid green box in the lower right hand corner of the image segment will be printed Copy to
29. up procedure for subsequent logins you can create shortcuts to the login screen 1 Enter the URL of the Visage server in the Internet Explorer address bar 2 Select Favorites Add to Favorites in the Internet Explorer menu Or Reduce the Internet Explorer window so that it no longer covers the entire screen and click this icon in front of the URL and drag it onto your Windows desktop 3 Select Visage 7 Web Client in the Favorites menu of the Internet Explorer Double click the Visage 7 Web Client icon on your desktop next time you want to call up the Visage 7 Web Client login screen 1 Click on the text link Download user documentation on the login screen The link takes you to a web page where you will find the user manual as pdf file in the language you have selected for the user interface 2 You can download the pdf file from here onto your local PC in order to view it on line or print it out When you are calling the login screen from a Windows Vista system for the first time Visage 7 Web Client cannot be installed automatically 1 Follow the link to a download web page that will be displayed instead of the login Screen 2 Click the link Visage7 WebClientlnstall msi on this page This link will help you with installing Visage 7 Web Client on your computer Visage 7 Web Client Starting and Ending the Program Standard system login Standard system login Dual monitor Multiple sessions Automatic clie
30. view https servername en iwa classic https servername en iwa expert https servername en iwa 2monitor https servername en iwa expertreading Call up from another software program 22 If you are working with other clinical applications on your PC you might be able to call up Visage 7 Web Client directly from such a program e g a hospital or radiolo gy information system HIS RIS or electronic patient browser If Visage 7 has been integrated in the other clinical software application the pro gram will start automatically whenever you select one or more images and call up image display You do not have to enter your login data every time you call up image display in this case The selected images are immediately displayed in the Visage 7 Web Client viewer window If your Visage installation includes the Visage 7 Client license both clients will be called up automatically when you select a patient and study on the HIS RIS for which 3D volume data are available on the Visage 7 system Joint OEM call of Visage 7 Web Client Starting and Ending the Program Changing your password course requires that the HIS RIS has been configured to call Visage 7 with the cor rect parameters and that your Visage user account holds appropriate user rights Changing your password You should change your password from time to time for data security reasons 1 Open the Visage 7 Web Client login screen 2 Open the popup menu of the login
31. will always load the original scans When the option is deselected the system will load a thick slice series instead of the original thin slice series if such a thick slice series is available on the Visage 7 server Display as 3D volume Shows the selected study in the Visage 7 Client for advanced 3D evaluation Automatic Synchronization with 3D volume Select this option to ensure that both the Visage 7 Web Client and the Visage 7 Client will always show images of the same patient Tf Worklist Expert Reading The Visage 7 Web Client Window Monitor selection Here you select the monitor configuration you are working with that is whether you are working with a single or dual monitors This selection also filters the display protocols list When you select 7 Monitor Landscape for example only those protocols are listed that have been optimized for single monitors with landscape display 1 Monitor Landscape Select your monitor configuration and filter for the display protocols list All protocols shows all display protocols irrespective of their orientation and suitability for a particular monitor configuration Patient list local The local patient list shows all patients found in the web server database who match the search criteria and to whom you have access The patient list contains only one entry for each patient even if several studies exist for this patient Tip You can sort the list by clicking on
32. 2 Login Favorites 20 from another software program 22 integrated Windows authentication 22 multi session 21 standard procedure 21 with shortcut 20 Login screen 19 Logoff 23 Logoff icon 26 Loop All icon 63 Magnifying Glass icon 57 84 Mark study as read icon 62 82 Maximum intensity projection MIP 67 Measurement Functions icon 59 84 Mirror icon 58 87 Monitor selection worklist 78 MPPS Modality Performed Procedure oteps 48 Multiframe images 47 Visage 7 Web Client Index Visage 7 Web Client 6 0 Multiplanar reconstruction MPR 67 Multiple sessions 21 Multi session operation 11 N Navigation bar 25 Network node response list 33 78 Next Annotated Image icon 58 84 Next Frame icon 63 Next Patient icon 35 55 Next Presentation State icon 56 Next Scene icon 82 Next Series icon 56 Next Study icon 56 Next Viewer Layout icon 82 Non encrypted Data Transfer icon 36 7T O Original size icon 58 87 P Pan icon 58 84 Password 21 change password 23 Patient list local 32 Patient list local worklist 78 Patient window 27 Patient Window icon 25 Photofiles 47 Plane A B icon 62 Position indicator bar 65 Predefined Level Presets icon 58 83 Preferably load thin slices icon 77 Preload Study icon 37 Preview window 42 Previous Annotated Image ico
33. 2008 01 18 11 ABDOMEN 0000002019 1978 10 10 M 2008 01 16 11 Biplan Paul 192837455 1957 05 25 M 2008 01 16 11 CANOPUS BEN 29191 1985 09 18 2008 01 16 11 Dilow Raleigh amp 281101 1911 01 01 M 2008 01 16 11 HAND PATIENT 2 9946122 M 2008 01 16 11 HSA Circle of WW 421876 M 2008 01 16 11 INSTAN JERRY 8171 F 2008 01 16 11 Case 1940 03 05 F 2008 01 16 11 j B Procedure Step sas perom Study Date Time Modalities in Study Study Description 1997 04 28 11 58 32 RF Query Finished 12211 12 E 6 Trusted sites Visage 7 Web Client The Visage 7 Web Client Window Worklist Expert Reading Information area worklist Worklist User name This area of the patient window shows the user name you are logged in with Hide show filter criteria Use this icon for collapsing or expanding the filter parameters and search criteria section of the screen Active window where you are now User currently logged in Filter parameters and search criteria In the worklist view of the patient window you can filter the patient list and search for specific patients and studies in just the same way as you can in the patient window of the client types View Classic and Expert Therefore refer to the following sections for details about filter and search criteria e Filter parameters on page 28 e Search criteria on page 29 Toolbar worklist
34. 5 03 17 F HC ANEVRYSME NEURO 08 Angiologie Angi 1999 07 01 o CT anonym pt anonym pt 1900 01 01 ALTOMANTERACTIV 1924 01 26 M KA ABDOMEN 0000002019 1978 10 10 M CT Paul 192837455 1967 05 25 M KA BEP 29191 1985 09 18 Dillow Raleigh Ada 291101 1911 01 01 M GM HAND PATIENT 2 9946122 M CR o HSA Circle of Willis 421876 M CT 2 INSTAN JERRY 8171 F CT Interesting Case Testpatient 1940 03 05 F CR Joe s Shoulder 646464 MR Johnson Roberta 123 45 6789 1923 10 16 F XA Lancelot Kaycee Ma 234567 1880 05 07 F CR Larry s L Spine 656565 MANUS DEXTER 1952 04 23 M KA MDP CHILD 01 FLTOPOS 1997 03 11 F RF 2 PLTOPUS 1920 03 05 RE zl 2l Query Finished 6 Trusted sites 2f Patient window The Visage 7 Web Client Window Information area patient window Filter parameters 28 Patient List User name Study Date Modality Physician This area of the patient window shows the user name you are logged in with Hide show filter criteria Use this icon for collapsing or expanding the filter parameters and search criteria section of the screen Active window where you are now User currently logged in Here you select criteria for filtering the patient list Here you can select a period After a database query the patient list will only show patients examined over this period Today li
35. COM nodes immediate ly Your system administrator has defined these addresses for you Display as 3D volume Shows the selected data in the Visage 7 Client for advanced 3D evaluation 37 otudy series window All 2 Study list 38 Online Status Archive Status Archive Protec tion Study De scription Study Date Time Referring Physi cian Study Comment Accession Num ber Study ID The Visage 7 Web Client Window Automatic Synchronization with 3D volume Select this option to ensure that both the Visage 7 Web Client and the Visage 7 Client will always show images of the same patient Marked images filter You can filter the study series lists so that only images marked with a star or flag or both are displayed These flags are however only available in a Siemens diagnostic environment This list shows all studies of the patient selected in the patient list for archive option only The online status tells you about the availability of the study in the local database v Completely available Partially available Not available for archive option only The archive status tells you about the availability of the study in the archive v Completely archived Partially archived Not yet archived for archive option only Yes study cannot be archived No study can be archived Description of the study Date and time of the study in the format
36. Visage Web Client User Manual VISAGE MAGING C 1275 This software is CE compliant and is defined as a class lla medical device in accordance with Medical Devices Directive 93 42 EEC All product and company names are trademarks or registered trademarks of the respective companies oome of the specifications described herein may not be currently available in all countries Please contact your local sales representative for the most current infor mation Caution US federal law restricts this device to sale by or on the order of a physician or properly licensed practitioner Visage is the successor of the Visage PACS CS product family Information in this manual may be subject to changes without prior announcement ud Manufacturer US Distributor Visage Imaging GmbH Visage Imaging Inc Lepsiusstrake 70 300 Brickstone Square 12163 Berlin Germany Suite 201 Phone 49 0 30 700968 0 Andover MA 01810 USA www visageimaging com www visageimaging com Support and Safety Contact Phone 49 0 30 700968 30 Email support visageimaging com Copyright Visage Imaging GmbH All rights reserved Document Version 27 00 Table of Contents Visage 7 Web Client oystem Overview 3 Hended 6 T n 3 Colistancy Chee st harrahs rete akan me ed tiem pets sete CE meter t ete 4 musei A R P 4 Data protection and data
37. Visage server only for as long as a pa tient is undergoing treatment or is an actual in patient How long data will be stored on the Visage server depends on the storage capacity of the RAID system and on the license Please be sure to dimension your RAID in accordance with the data volumes in your institution Data storage in Visage is based on the FIFO first in first out principle Changes to patient data result in the data being given a new time stamp Once the storage capacity of the system has been reached the oldest data is automatically deleted in order to create space for new image material The data can be reloaded from the hospital s archive at any time if needed Visage 7 Web Client allows you to log on to the Visage 7 server and to access the data that is stored on the server using the HTTP HTTPS protocol Data can be accessed in two different ways e From the various wards or departments of a hospital via the intranet or Product overview 3D Thin Client option oystem Overview From outside the hospital that is from physicians practices via the Internet fast transmission rates are recommended Visage 7 Web Client use the Microsoft Internet Explorer as a web browser To implement the functions required for editing images special software compo nents are used that are based on ActiveX By using standard Internet technology it is therefore possible to use standard PCs as viewing stations With the additi
38. a column header Patient Name Name of the patient Patient ID Patient s identification number Date of Birth Date of birth in YYYY MM DD format Sex male F female other unknown Insertion Date Date and time when the patient data was sent to the Visage server Response list network node If you selected a network node as the data source instead of querying the local Vis age server you will see the response list of the DICOM node instead of the local patient list Here a patient name may be listed more than once as each entry represents exactly one study 78 Visage 7 Web Client The Visage 7 Web Client Window Worklist Expert Reading Tip You cannot load patient data directly from the response list of a DICOM node into the display protocol viewer You must first copy a patient to the local database by double clicking the patient entry or with the Retrieve Study from DICOM Node icon For an explanation of columns in the response list from a network node refer to sec tion Response list network node on page 33 Display protocols list Here you find a list of all display protocols that are suitable for the selected monitor configuration and study data Display Protocol Name of the display protocol which usually includes a description of how many viewports will be available in the viewer as well as an indication of the display layout used in these viewports Description More detailed description f
39. age 7 Web Client The Visage 7 Web Client Window Worklist Expert Reading v Lp Visage 7 Web Client Launching Application Starts another web application if your system administrator has configured this for you The icon is only active if you have selected a patient Change Procedure Step Procedure steps are tasks in the diagnostic reading workflow With Visage 7 Web Client you can follow up on the task interpretation from scheduling this task to completion For studies for which no procedure step exists Creates a new procedure step and allows you to assign the new procedure step a priority For studies for which a procedure step exists Allows you to delete the procedure step mark it as completed or reset it to scheduled or change its priority Encrypted Data Transfer The images are transmitted encrypted Non encrypted Data Transfer The images are transmitted without encryption Compression Level A Transfers images with compression level A In compression level A the images are usually only slightly compressed and without loss of quality Your system administrator defines the compression rules Compression Level B Transfers images with compression level B which compresses the images even more Note that compressed images do not contain the full volume of data of the original The di agnostic quality of the images is affected as a result Preferably load thin slices When this option is selected the system
40. ains a number of additional icons They provide special display functions for evaluating XA scenes Plane A Switches to plane A for biplane angio scenes Plane B Switches to plane B for biplane angio scenes Visage 7 Web Client The Visage 7 Web Client Window Viewers Image area Icons Visage 7 Web Client gt d amp Loop All Successively plays back all loaded scenes of a study If you click the Previous Series or Next Series icon during playback the movie will jump back to the last scene or on to the next scene Previous Frame Scrolls to the previous frame individual image of the multiframe Next Frame Scrolls to the next frame individual image of the multiframe Display Reports Displays the report images originating from the XA environment which are assigned to a scene Display Scenes Switches back from displaying the report images to displaying the multiframe scene The image area shows the loaded images with the selected size and in the selected layout The size of this area depends on the screen resolution and the actual size of the application window Once you have loaded images or started manipulating images icons may appear in the upper right hand corner of the image segments These icons alert you to infor mation you should consider when interpreting the images Lossy compressed image The quality of the image may have been affected artifacts The quality percentage is indic
41. all patients whose studies contain procedure steps with interpretation status completed Here you can enter search criteria for a database query If you do not remember a name or number you can use wildcards in your search E g Mil to find Miller Milford Miltner or mil to find all the above and also Hamilton or AB 34 to find AB1234 AB0034 and AB11345678 Searches for a patient by name Enter the patient name in the format ast name first name middle name prefix suffix For ex ample Doe John Jack Dr for Dr John J Doe Searches for a patient ID Searches for a patient whose studies contain a specific comment 29 Patient window Date of Birth Study ID Study Description Accession Num ber The Visage 7 Web Client Window Searches for a patient by date of birth Use the date format indicated next to the search box Your system administrator can con figure this format for you Also remember to enter the complete date of birth here day month year You cannot for example search by year of birth only Searches for a patient with this study ID Searches for a patient with this study description Searches for a patient with this accession number Toolbar patient window No Filter wh a Visage FACS Web P 30 In the patient window you will start all processing steps with the icons of the toolbar User defined filter You can select a predefined filter here Rese
42. archive op tion Compression Level A x E Compression Level B x Pa Encrypted Data Trans x fer 5 Non encrypted Data x X Transfer rj Query Report X L Use Local Cache x x x TE Visage 7 Web Client 97 Overview of functionality supported by client types Appendix Client type View Client type Classic Client type Expert Client type Expert Preload Study Reading a x n Image Preview on off Truncate Thumbnails for Large Series Deselect all previews DICOM Information Launching Application 58 DICOM Send 2 DICOM Quick Send Display as 3D volume X 3D JA 98 Visage 7 Web Client Appendix Synchronize with 3D volume 3D Show Hide Thin Slice Series Marked images filter All bd Viewers Change Toolbar Loca tion Auto Hide Toolbar Lock Toolbar H Previous Patient ri Next Patient Previous Study Visage 7 Web Client Client type View X X Client type View X Overview of functionality supported by client types Client type Classic Client type Classic Client type Expert Client type Expert Client type Expert Reading X Client type Expert Reading 99 Overview of functionality supported by client types Appendix Client type View Client type Classic Client type Expert Client type Expert Reading Next Study x Previous Serie
43. ated next to the icon This warning triangle remains visible even if the image texts are hidden When loading images into one of its viewers Visage 7 Web Client checks the DICOM head er information in every single image If this DICOM header information does not agree with the patient and study data stored in the Visage 7 database for one or several images this icon is displayed in the upper right hand corner of the affected images If you have manipulated a presentation state image this icon appears in the upper right hand corner It warns you that the current image no longer corresponds to the image saved in the presentation state at the diagnostic workstation This icon in the upper right hand corner of the image segment indicates that calibration has been applied to distance lines in this image 63 Viewers Apply to All Auto Apply to All Undo Show Hide Overlays Hide Show Shutter Delete Measurement Annotation Delete all Measurements Delete all Annotations Delete all Measurements and Annotations Select Image Remove Image Selection Hide Show ECG 64 The Visage 7 Web Client Window This icon indicates that the displayed images do not originate from an original scan series thin slice series but were generated by a Visage 7 thick slice compilation rule For your convenience the image area of the Visage 7 Web Client viewers offers a popup menu for quick and eas
44. ately to an MIP based display Unlike other Visage 7 Web Client windows the basic MIP MPR viewer does not pro vide a toolbar for calling operating functions In the basic MIP MPR viewer you work with e Popup menu e Keyboard e Mouse clicks If you are working in dual monitor mode the basic MIP MPR viewer is only shown on the left monitor 67 Basic MIP MPR viewer The Visage 7 Web Client Window visage PACS Microsoft Internet Explorer E 181 File Edit View Favorites Tools Help FX Patient Name Joe s Shoulder Patient ID 646464 Date of Birth 2 Study Description Study Date 1997 02 20 09 25 48 Information area Slice segments MPR 1 00 MM C 670 1340 MPR 1 00 MM Slice cursor 3D overview segment Navigation bar MPR 1 00 MM Rotate Done 8 6 Trusted sites Information area basic MIP MPR viewer This area of the basic MIP MPR viewer provides information about the loaded pa tient and study Patient Name Name of the loaded patient Patient ID ID of the loaded patient Date of Birth Date of birth of the loaded patient Study descrip Description of the study tion Study Date Time Date and time of the study in the format YYYY MM DD and hh mm ss 24 hour clock 68 Visage 7 Web Client The Visage 7 Web Client Window Basic MIP MPR viewer 3D overview segment Color coding after loading Color coding after moving Image processing Information i
45. b Client re port editor In the text only report window you can only view but not edit a report Note Note that when you edit and save a report in the Visage 7 Web Client report editor this will only change the report stored on Visage but not update the report ver sion stored in the HIS RIS for this study Visage 7 Web Client 91 Report window Header information Report text Footnotes 52 The Visage 7 Web Client Window Visage 7 can receive and display DICOM Structured Reports The layout in which these structured reports are shown in Visage 7 Web Client can be configured by Customer Service However if Customer Service makes any layout changes at your request you must validate these changes to ensure that all relevant report information is actu ally shown in the HTML report translation of these reports Report text display The header of the loaded report shows data about the patient and examination for example accession number study ID patient name and patient ID This data rep resents the information stored for this study and patient in the HIS RIS Compare this data with the patient information in the viewer section if you are work ing in the report with image window or with the patient s information in the study se ries window to ensure the information in the HTML report is up to date If the report is too long for the report window use the scroll bar to scroll through the report text When
46. book icon to display a topic and show subheadings 2 Click the page with the question mark icon to display the text of a help page in the right half of the window You can search for index entries here 1 Enter a word you want to search for Or scroll through the alphabetical index 2 Double click an index entry to display the information about it This tab card permits a full text search 1 Enter a word to search for 2 Press the RETURN key All help topics containing this word will be listed On this tab card you can set bookmarks for help topics that are of particular interest to you 1 Display the topic you want to add to the Favorites list 2 Click Add In various help topics you will find links that will take you to more detailed informa tion about a subject Text links are shown in blue and underlined Links in overview graphics are shown in italics Use the next and previous icons in the footer of each help topic to scroll through the online help system topic by topic Visage 7 Web Client oystem Overview Help window toolbar Show H Hide Back c Forward Options Visage 7 Web Client Overview of the Visage 7 product documentation The upper part of the help window shows a number of icon buttons Use these but tons to adapt the help window scroll through topics and print topics Shows the online help tab cards if they are hidden and then changes to the Hide button Hides the onli
47. bration range 0 05 cd m to 10 000 cd m Product overview Visage is a client server application It comprises the following components e Central Visage 7 server s in the hospital and e Visage 7 Web Client clients in the wards in special departments or in the physi cians practices e Visage Clients optional In this section you will find information on e System architecture e License management e System requirements e Hints for Visage 7 Web Client installation e Archiving with the archive option System architecture In a hospital all radiological patient data is collected on a central web server for ex ample for the duration of the patient s stay Each modality used to examine the pa tient sends the study data not only to a long term archive but also to the web server If physicians require information on patients and their examinations they can call up an Visage client from anywhere within the hospital intranet and will find the re 4 Visage 7 Web Client oystem Overview Web server Web clients Visage 7 Web Client Product overview quired study information there In order to make sure the patient information on the web server is complete and up to date physicians can query other nodes in the net work for recent examination data Whereas a HIS RIS only makes administrative data generally available throughout the hospital the Visage 7 solution takes the idea of central data collection and uni
48. ce you have loaded images or started manipulating images icons may appear in the upper right hand corner of the image segments These icons alert you to infor mation you should consider when interpreting the images Lossy compressed image The quality of the image may have been affected artifacts The quality percentage is indicated next to the icon This warning triangle remains visible even if the image texts are hidden When loading images into one of its viewers Visage 7 Web Client checks the DICOM head er information in every single image If this DICOM header information does not agree with the patient and study data stored in the Visage 7 database for one or several images this icon is displayed in the upper right hand corner of the affected images The display protocol may define the sort order for the images of a series in the display pro tocol viewer according to certain criteria If images cannot be sorted according to these cri etria the system alerts you to this fact with this icons This icon in the upper right hand corner of the image segment indicates that calibration has been applied to distance lines in this image This icon indicates that the displayed images do not originate from an original scan series thin slice series but were generated by a Visage 7 thick slice compilation rule For your convenience the image area of the Visage 7 Web Client viewers offers a popup menu for quick and easy access to frequent i
49. configured this for you The icon is only active if you have selected a study DICOM Send Opens a dialog box Select the address es in your DICOM network to which you want to send the selected series or image s DICOM Quick Send Sends the selected series or image s to one or several DICOM nodes immediately Your system administrator has defined these addresses for you Display as 3D volume Shows the selected data in the Visage 7 Client for advanced 3D evaluation Automatic Synchronization with 3D volume Select this option to ensure that both the Visage 7 Web Client and the Visage 7 Client will always show images of the same patient Information about the study The colored header bar of the study shows the following information study description date time referring physician study ID Tip Click on the study information bar to select all images of this study or to invert the current selection of images Double clicking on the study information will load the entire study into viewer 1 Information about a series In the image preview thumbnails are grouped by series Series header bars show the following information about a series series description modality number of images examined organ date time additional series information Visage 7 Web Client 45 Preview window Additional series information 46 The Visage 7 Web Client Window Tip Click on the series information bar to select all images of this
50. cters Icons for paragraph editing With the icons Align left Center Right you can change the alignment of the paragraph in which the text cursor rests at the moment With Numbering you can create numbered lists with Bullets you can create lists with bul lets Use Increase Indent and Decrease Indent to indent paragraphs or to remove inden tion The image section in the report view contains all those images from the current study that you have loaded into a viewer The image display in the report window provides you with the same image display and editing functions as any of the viewer windows Use the icons on the toolbar above the image display to change the display of the loaded image to evaluate image information and to print images oee also Toolbar viewer The position indicator bar below the image display shows you which image of a loaded series is currently visible oee also Position indicator bar viewer 53 Viewers Viewers Viewers 1 and 2 Modality specific options Dual monitor Information area Toolbar viewers Image area Navigation bar Position indicator bar viewer 54 The Visage 7 Web Client Window The viewer windows integrate all functions required for reviewing images In the viewer windows you can scroll through the loaded images select a screen layout best suited to your problem optimize image display of individual or all loaded images for the duration of the current Visag
51. dy Loads all images of a selected study into the local cache for the duration of your session When you subsequently load these images into a viewer and move on to this viewer the im ages are displayed immediately This icon is only active if Use Local Cache has also been selected Image Preview on off Switches display of the image area on or off Truncate Thumbnails for Large Series Toggles thumbnail display for large series one or all thumbnails per series are shown in the image preview section Show Thin Slice Series When this option is selected the series list will list both thin slice series original scan series and thick slice series generated image series which permit faster loading and browsing When this option is deselected only thick slice series are shown in the series list Select all previews Selects all images in the preview area Deselect all previews Deselects all images currently selected in the preview area DICOM Information Shows the DICOM information of the image selected in the preview area Launching Application Starts another web application if your system administrator has configured this for you The icon is only active if you have selected a study DICOM Send Opens a dialog box Select the address es in your DICOM network to which you want to send the selected study or studies or series DICOM Quick Send Sends the selected study or studies or series to one or several DI
52. dy as thumbnails in the right screen half of the study series window A presentation state comprises all those images of a study that the reporting physi cian considered particularly important Presentation states are compiled at the diag nostic workstation that sends the study to the web server A presentation state also preserves the image display settings such as window val ues or zoom pan settings that were used at the time when the presentation state was created Presentation states are usually available in both compression levels A and B unless matrix reduction has been configured for any of the images they refer to In that case no presentation states are available for that particular compression level and the study may contain a different number of presentation states for level A and B In dual monitor mode the study series window is shown on the left monitor The right monitor shows the preview area It is not possible to hide the preview area in dual monitor operation E Visage PACS Microsoft Internet Explorer l B E 18 x Ele Edit Favorites Tools Help Ea EN Patient Name Joe s Shoulder Patient ID 646464 Date of Birth eae Tes e Sx MQ als BS oc Study Date Time Study Date Time 1997 02 20 09 25 48 Referring Physician ID 3 1997 02 20 09 Onine Archive Archive Protecti Study Description m m 8 fe l
53. e 7 Web Client session and evaluate image information Visage 7 Web Client offers you two viewer windows The layout of the windows and the function of the toolbar icons are identical in both viewers Depending on the modality of the loaded images the toolbar of the viewer may con tain a number of extra icons e Standard mode all modalities except for XA e Angio mode XA In dual monitor operation the viewer is spread across both monitors It contains an additional scroll bar on the left monitor for navigating through the loaded images This is synchronized with the right scroll bar E Visage PACS Microsoft Internet Explorer 18 x File Edit Favorites Tools Patient Name CT Abdomen Patient ID 23007 Date of Birth 2000 01 01 x 2 Study Description CT Abdomen Study Date 2006 10 31 11 35 35 Visage PACS IU qm 7T 1 o amp S BOE UAO t teg 2 Ed Emm DE EE 30 30 esf C TE EJ 5 T amp 4 Done B Trusted sites Visage 7 Web Client The Visage 7 Web Client Window Viewers Information area viewer Patient Name Patient ID Date of Birth Study descrip tion Study Date Time Toolbar viewer Visage 7 Web Client This area of the viewer provides information about the loaded patient and study Name of the loaded patient ID of the loaded patient Date of birth of the loaded patient Descriptio
54. e Edit wiew Favorites Tools Help atient Name Joe s Shoulder Patient ID 646464 Date of Birth Study Description Study Date 1997 02 20 09 25 48 Visage gosos ca 7 71 h m3 17 11 GI uu OoO amp ueEur B om uebiis Vet Y In Za Ex p mm J OD le gt fF D al 30130 gif E me 3030 gs 4 e Q h E Query finished Visage 7 Web Client The Visage 7 Web Client Window Basic MIP MPR viewer Basic MIP MPR viewer E Calculation method 3D operation Dual monitor Visage 7 Web Client The basic MIP MPR Viewer can calculate a volume data set from suitable CT and MR series You can move freely through this volume data set viewing new slice images in any plane or orientation Note The basic MIP MPR viewer is a display mode only It allows you to calculate and display new slice images However it does not provide measurement tools and you cannot save the recalculated images back to the web server If you require advanced 3D evaluation functions contact your Sales Representa tive concerning the Visage 7 Client option The Visage 7 Web Client basic MIP MPR viewer gives you a choice of two 3D cal culation methods e Multiplanar reconstruction MPR This method is the default method used by the program e Maximum intensity projection MIP You can switch each of the four views separ
55. e an Expert license and the required user privileges If your administrator has activated this function for you you can log on to several workstations with the same user data and continue on one workstation with the work you started on another one Every time you log onto the Visage server the server automatically checks wheth er a more recent version of the client software is now available Client update starts automatically unless your system administrator has disabled this option A mes sage is displayed in this case 21 Integrated Windows authentication Starting and Ending the Program Integrated Windows authentication If your client is connected to the hospital network Windows domain you can work with Visage 7 Web Client without entering a user name and password Your Win dows login will be used instead Note Integrated Windows authentication is only possible for users whose accounts were imported in the Visage 7 system from Windows and for whom the integrated Windows authentication privilege has been set by the system administrator Before calling Visage 7 Web Client via integrated Windows authentication for the first time Start the Internet Explorer and call up the standard Visage 7 Web Client login screen once e g http servername en After that use the following URL for calling Visage 7 Web Client via integrated Win dows authentication https servername en iwa Or https servername en iwa
56. e by double clicking the patient entry or with the Retrieve Study from DICOM Node icon Name of the patient Patient s identification number Date of the study in YYYY MM DD hh mm ss format Date of birth in YYYY MM DD format M male F female O other unknown Job number of the patient in the HIS RIS hospital or radiology information system Description of the study States how many images are stored for this study on the selected network node Name of the referring physician archive option only Here you can monitor the status of archiving of this study The archive status tells you about the availability of the study in the archive L F Completely archived a Partially archived L Not yet archived Comment text about the patient 33 otudy series window The Visage 7 Web Client Window Study series window 23 Series and presentation state tab cards Dual monitor Information area stu dy series window Toolbar study series window Study list Image preview Navigation bar Series list Presentation state list 34 The study series window contains all studies series and presentation states of the patient currently selected in the patient list You use the study series window to select a study series individual images or a presentation state for display in one of the image viewers To facilitate image selec tion you can display the images of a stu
57. e corresponds to the slice image in the upper right segment a green cursor line corresponds to the slice image in the lower left segment Visage 7 Web Client The Visage 7 Web Client Window Basic MIP MPR viewer Slices in the volume data set Popup menu Apply to All Windowing Zoom Pan Rotate SliceShift Visage 7 Web Client You can use the slice cursor of the three slice segments to move through the vol ume data set and display the recalculated slice images If you move the center of the slice cursor you will move the entire slice cursor in the image This moves two view planes simultaneously in the volume data set and shows new slice im ages in both of the other slice segments If you click near to the point of intersection on the cursor line you will only move a single cursor line That will take you through the volume data set along the two other standard axes and up date the view in one of the other slice segments If you click a long way from the point of intersection on the cursor line you can rotate the slice cursor This rotates the cross hair updates the views in the two other slice segments and gener ates slice images with non standard views in them Tip You can monitor all your slice cursor movements in the 3D overview segment This gives you a clear overview of the slices through the volume data set that are cur rently being displayed in the slice segments Right click on a slice
58. e first two series of a selected study or two selected series or two images into compare mode top and bottom Load to Basic MIP MPR Viewer Loads the selected series into the basic MIP MPR viewer Only CT or MR series that are suitable for 3D reconstruction can be loaded into the basic MIP MPR viewer 35 otudy series window dB 36 The Visage 7 Web Client Window Load all series as one Click this icon before you load an entire study into one of the viewers to merge all images of this study into one viewing series Refresh The study series window is updated Delete object Pops up a dialog box and allows you to select what you want to delete from the web server the entire study the study reports if available or a presentation state or one or several se lected series only Archive Protection Sets or removes archive protection for the selected study Change Procedure Step Procedure steps are tasks in the diagnostic reading workflow With Visage 7 Web Client you can follow up on the task interpretation from scheduling this task to completion For studies for which no procedure step exists Creates a new procedure step and allows you to assign the new procedure step a priority For studies for which a procedure step exists Allows you to delete the procedure step mark it as completed or reset it to scheduled or change its priority Compression Level A Transfers images with compression le
59. e highlighted by a white border for DICOM print DICOM print selection is indicated by a solid green box in the lower right hand corner of the image segment Removes the current image from the DICOM print selection Calls one of two available test images for performing a display quality check of your monitor Allows you to select a mode for synchronized scrolling Shows or hides measurement and annotation graphics stored in an image Tip The SMPTE images you can display here are not suitable for calibration of DICOM printouts Use Testlmage SMPTE 1k instead You find this test case in the patient list If no patient of this name exists in your patient list ask your system adminis trator to insert this test case into the Visage 7 system from your installation medi um We recommend that you protect the Testlmage SMPTE 1ktest case against deletion so that it will not be deleted automatically when disc space is running low Visage 7 Web Client Appendix List of supported modality types and abbreviations Abbreviation CR CT DR DX ES GM IO MG MR NM OT PR PT PX RF RT SM SR US XA XC Visage 7 Web Client Modality Computed Radiography Computed Tomography Digital Radiography Digital Radiography Endoscopy General Microscopy Intra oral Radiography Mammography Magnetic Resonance Nuclear Medicine Other Presentation State Positron emission tomography PET Panoramic X Ray Radio Fluoroscopy Radiotherapy I
60. ed Tip Tips provide additional useful information about a topic Tips for example help you organize your work more efficiently Note Notes mark text that you should pay special attention to A note may for example emphasize a piece of information relating to the safety of functions but where no direct danger is involved Caution is used to indicate the presence of a hazard which can cause personal Injury to a patient or damage to the equipment Information on using the online help systems Visage 7 Web Client The Visage 7 Web Client and Visage 7 Client user interfaces and the Visage 7 ad ministration platform feature an online help system each 15 Overview of the Visage 7 product documentation oystem Overview Calling up online help Tab cards Contents Search Favorites Links to other topics Scrolling from topic to topic 16 You can Call up the online help system from any Visage 7 Web Client window Click the help icon on the Visage 7 Web Client navigation bar along the left edge of the window to open the context sensitive online help system The context sensitive online help displays the help topic relevant to the window that is active when it is called The left half of the Visage 7 Web Client online help window shows tab cards for quick access to the help contents This tab card contains a table of contents similar to that of a printed book 1 Double click the
61. elp system also contains task oriented step by step instructions e The Visage 7 Client user documentation The user manual pdf file and or printed manual provides a complete descrip tion of all Visage 7 Client functions Visage Client also features an online help system which you can call up from the Help menu The various help topics explain the user interface of the client software Tip You can download the user documentation as pdf files Follow the corresponding link on the login screens The Visage administrator documentation supports system administrators in a hos pital It helps them with user management and adapting the system to changes in the overall network environment if this becomes necessary The Visage 7 administrator documentation also helps service personnel with initial system configuration tasks right after system installation or update Administration Manual This document is available as a pdf file on your installation medium You can print out this document if you prefer reading on paper e The administration platform Online Help System The Visage 7 administration platform features a context sensitive online help system The context sensitive help topics explain the parameters you will find and the settings you can make on the various configuration screens Whenever relevant background information on selected topics is also given in the online help sys tem Installation instructi
62. en you call Visage 7 Web Client with client type Expert Reading the patient win dow is shown in worklist view Tip Filter this list according to interpretation status SCHEDULED for a quick and easy overview of all studies that are scheduled for reporting Your user profile stores your monitor configuration This means the system will re member whether you worked with a single monitor or dual monitors during your last Visage 7 Web Client session Z Visage PACS Microsoft Internet Explorer 81 x File Edit View Favorites Tools Help ay 2 Worklist Dr X cane Study Date All Patient Name Study ID PACS 3 T cs Modality All Patient ID Study Description v Physician All Patient Comment Accession No 8 Location All Date of Birth vyv mmDD cm v Insertion Date All v Interpretation Status All 37 Patients found NH e No Filter Vt v TX Visage PACS PACS Web M ae RRQ 2009 3D 30 8 mn E ez 1 Monitor Landscape M EEEE Vale UI C m iy FI rumeur tescripion Monitors Mm A ILI INT TOP FLTOPO1 1922 07 24 2008 01 16 11 Series View One series per view 1 XS 7 Brank Viewports Use drag and dropt 1 Amato Terence 000012 1965 03 17 F 2008 01 16 11 ANEVRY SME NEURO 2008 01 16 11 Angiologie Angi 1999 07 01 2008 01 16 11 anonym pt anonym pt 1900 01 01 2008 01 16 11 1924 01 26 M
63. ent image to fit it optimally in the image segment Original size Resets the loaded image to its original size Previous Annotated Image Scrolls up in the stack of loaded images and shows the next image containing annotation graphics or annotation text Next Annotated Image Scrolls down in the stack of loaded images and shows the next image containing annotation graphics or annotation text Visage 7 Web Client The Visage 7 Web Client Window Viewers Measurement Functions Opens a selection list with measurement functions Distance Measurement Permits measurement of distances in images While this tool is active the mouse pointer looks like this mT Measured values are indicated in exact millimeters mm in CT and MR images estimated millimeters mm or in pixels pix if no distance measurement in millimeters is possible The accuracy of distance measurements is 2 pixels Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum accuracy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still Angle Measurement Permits measurement of angles in images While this tool is active the m
64. er Expert Reading The Visage 7 Web Client Window Toolbar display protocol viewer 82 e uU c gB g B amp qm Auto Hide Toolbar Lock Toolbar Hides or redisplays the viewer toolbar If the toolbar is hidden move the cursor over the area where it would normally be shown to redisplay it temporarily and to access its icons Display Mode Opens a selection list with different layouts Here you can switch from stack mode to tile mode in the currently selected viewport Select for example the 2x2 view The viewport is divided into 4 segments in this example Depending on the number of images that are loaded up to 4 images will be displayed in the selected viewport at one time Next Viewer Layout Loads the next viewer layout defined in the currently active display protocol Previous Viewer Layout Loads the previous viewer layout from the currently active display protocol Previous Scene Loads the previous scene of a series containing several multiframe images or scenes Next Scene Loads the next scene of a series containing several multiframe images or scenes Hide Show Image Text Shows or hides text in the image Gamma Adjustment Opens a dialog box for the adjustment of the gamma curve of images This adjustment ap plies to all Visage 7 Web Client image viewers Cancel loading Stops loading images Mark study as read Sets the status of the procedure step for this study to completed This
65. es the so called floating licenses concept This means that a license is not bound to a particular user name or a dedicated workstation or PC A license for 10 users means that 10 users can work with a Visage 7 Web Client or Visage 7 Cli ent at any one time If an 11th user tries to log on he or she is told to try again later Once one of the original 10 users logs off logon of the 11th user will be permitted Of course licenses can be upgraded Visage 7 Web Client oystem Overview Upgrade Client types Product overview When upgrading an installation the old license becomes invalid The new Visage 7 license which comes with the upgrade must be installed If a larger data volume was licensed in a previous version this may lead to the old est data being deleted from the system after the new license has been installed de pending on the auto delete settings defined by the system administrator Visage 7 Web Client provides different client types with different levels of functional ity e Visage 7 Web Client View with essential image viewing functions Visage 7 Web Client Classic offering more image handling and review func tions e Visage 7 Web Client Expert with full functionality e Visage 7 Web Client Expert Dual Monitor with Expert functionality plus sup port of two monitors e Visage 7 Web Client Expert Reading with all the features required to use Vis age Web Client for primary reading The client type Expe
66. fe 20 300 Brickstone Square Suite 201 450 Swan Street Richmond 12163 Berlin Germany Andover MA 01810 USA 3121 Victoria Australia phone 49 0 30 700968 0 phone 1 888 338 4724 phone 61 3 9429 8800 1 978 319 4641 For contact information and a list of our world wide office locations visit www visageimaging com Visage Imaging is a wholly owned subsidiary of Pro Medicus Ltd www promedicus com
67. h you are supposed to move the mouse can be configured by your sys tem administrator Display as 3D volume Shows the selected study in the Visage 7 Client for advanced 3D evaluation Automatic Synchronization with 3D volume Select this option to ensure that both the Visage 7 Web Client and the Visage 7 Client will always show images of the same patient Color Map Allows you to display the loaded images with another color map that highlights your current diagnostic problem in a better way Image area with viewports 88 For most display protocols the image area of this viewer is subdivided into several viewports Viewports are semi independent viewer segments which you use to compare images and series from the same or different studies Viewports can be linked for synchronized scrolling All other image navigation and manipulation functions apply only to the images in the viewport that is currently ac tive highlighted by a colored border Visage 7 Web Client The Visage 7 Web Client Window Display Protocol Viewer Expert Reading Icons 21 au a o C o 3 2 c Apply to All Auto Apply to All Visage 7 Web Client Double click a viewport to show it fullscreen Double click a second time to return to the viewport s original size and location Use the or number 1 8 keys on your keyboard to display more viewports or to hide viewports or to switch between predefined layouts On
68. he Change Group Assignment dialog box opens Here you can define which user groups have access to the selected patients Change User Assignment The Change User Assignment dialog box opens Here you can define which users have access to the selected patients 31 Patient window 297 ze The Visage 7 Web Client Window Export Patient The data of the selected patient s is exported The data is first written to a directory on the server and then written to CD or DVD depending on the configuration If you use a CD or DVD producer station disks can be recorded automatically Next to the icon the volume of data that is stored for the selected patient s in the Visage 7 database is displayed Launching Application Starts another web application if your system administrator has configured this for you The icon is only active if you have selected a patient System messages This part of the patient window shows important messages from the system Patient list local Patient Name Patient ID Date of Birth Sex Modalities Patient Comment Report Delete Protect Study Date Insertion Date 32 The local patient list shows all patients found in the web server database who match the search criteria and to whom you have access The patient list contains only one entry for each patient even if several studies exist for this patient Tip You can sort the list by clicking on a column header Name of the patient
69. ibility Although the web and thin client technologies allow the software to be run on a vari ety of hardware platforms for diagnostic purposes the user must make sure that the display hardware used for reading the images complies with state of the art diag nostic requirements and currently valid laws Only DICOM for presentation images can be used on an FDA approved monitor for mammography for primary image diagnosis Only uncompressed or non lossy compressed images must be used for primary im age diagnosis in mammography Constancy check oystem Overview Constancy check Visage 7 is a category A diagnostic imaging device DID for which the equipment used and the ambient conditions at the installation site must meet special require ments ROV German X Ray Ordinance dated January 8 1987 in the version dated June 18 2002 amending the R V and other atomic energy ordinances Imaging devices of this category are labeled accordingly The user is required to perform a monthly constancy check on these imaging devic es in compliance with 16 per DIN 6868 57 DIN V 6868 57 2000 Image quality assurance in diagnostic X ray departments Acceptance testing for image display devices The characteristic and reference values for the constancy check shall be defined during the acceptance test The reference values shall be ascertained using the us er s test instruments luminance meter at least class B DIN 5032 7 with valid cali
70. icon is only active if a procedure step exists for the study whose images are currently shown in the viewer Edit Report Opens an existing report for editing or creates a new study report on the web server Select Images Offers options for selecting images for printout on a DICOM printer Select all Images Selects all loaded images for DICOM print Visage 7 Web Client The Visage 7 Web Client Window Display Protocol Viewer Expert Reading Visage 7 Web Client Range Selection Opens a dialog box for range selection Deselect all Images Undoes the current selection for DICOM print no images are selected after you click this icon Print Allows you to print images on a connected DICOM or Windows printer Windows Print Opens the Windows Print dialog box and prompts you to select a printer and print settings All images currently displayed on the screen will be printed DICOM Print Opens the DICOM Print dialog box and prompts you to select a printer and print settings Only those images that are marked for DICOM print solid green box in the lower right hand corner of the image segment will be printed Copy to Clipboard Copies the currently displayed images to the clipboard From there you can paste the cop ied images into another Windows program e g a presentation or NetMeeting program Export Images Exports the currently displayed images to a directory on your local PC You can save the im ages as
71. iewers SMPTE 1 2 Show Hide Mea surements and Annotations Calls one of two available test images for performing a display quality check of your monitor Shows or hides measurement and annotation graphics stored in an image Tip In this client type you can only create measurements and you can delete measure ments or annotation graphics only temporarily and for the duration of the current session You cannot save these changes back to the web server Saving measure ments and annotations back to the web server is possible in client type Expert Reading only Tip The SMPTE images you can display here are not suitable for calibration of DICOM printouts Use Testlmage SMPTE 1k instead You find this test case in the patient list If no patient of this name exists in your patient list ask your system adminis trator to insert this test case into the Visage 7 system from your installation medi um We recommend that you protect the Testlmage SMPTE 1ktest case against deletion so that it will not be deleted automatically when disc space is running low Position indicator bar viewer Light green bar White bar Dark green bar Dark gray bar Visage 7 Web Client You will usually have more images loaded than can be displayed simultaneously in the selected layout The position indicator bar at the bottom edge of the screen tells you which images are visible and which are still in the background These images are visible on the
72. isplay is stag gered only according to these value pairs e g image type The original image sequence within an MPPS series is retained Visage 7 Web Client The Visage 7 Web Client Window Preview window study 2 Exam Set Date Time 2001 01 24 16 11 58 Referring Physician Physician Ref MPPS 1 054 Sub 1 program ID 20010124161427 Modality L Scenes LAD 38 CRA 4 LAD 38 CRA 4 Image preview popup menu A popup menu is available in the image preview section to help you select images and show image information Select Selects the thumbnail the cursor is currrently pointing to Deselect Deselects the thumbnail the cursor is currrently pointing to Select all Selects all images of a study or series if the cursor points to the study or series title bar or if the cursor points to anywhere between thumbnails Deselect all Deselects all images of a study or series depending where the cursor is currently pointing Invert Selection Inverts the selection i e selects the currently unselected images of a study or series de pending where the cursor is currently pointing Image Info Shows information about the image type and compression level settings for an image Visage 7 Web Client 49 Report window The Visage 7 Web Client Window Report window 50 Visage 7 Web Client can display both images and reports Visage 7 Web Client provides a text only view and a view in which images and re port text
73. mage Slide Microscopy SR Document Ultrasound X Ray Angiography External camera Photography 91 Overview of functionality supported by client types Appendix Overview of functionality supported by client types Navigation bar Client type View Client type Classic Client type Expert Client type Expert Reading Patient window x x X Worklist Study series window x Preview window x E Report window X X Report with image Viewer 1 x Viewer 2 x 92 Visage 7 Web Client Appendix Overview of functionality supported by client types Client type View Client type Classic Client type Expert Client type Expert Reading Compare mode x X vertical Compare mode x X horizontal Basic MIP MPR Viewer x E Display protocol viewer Status information x x x Patient window or worklist Client type View Client type Classic Client type Expert Client type Expert Reading Hide show filter criteria X Filter parameters all Search parameters all x x User defined filter x Filter Visage 7 Web Client 93 Overview of functionality supported by client types Appendix Client type View Client type Classic Client type Expert Client type Expert Reading Reset to Default Filter x X TI Set Filter Properties X Na Reset Filter Settings Reset Input Fields Data source local
74. mage processing functions Right click in the image display area Note Note that many image display functions are available from both the toolbar and popup menu Others functions are available only from the toolbar or only from the popup menu The following table describes only those functions that have not al ready been explained in the context of the toolbar Applies the last editing step to all images of a loaded series When this option is selected all image editing steps are applied to all images of a loaded series immediately and not just to one image alone 89 Display Protocol Viewer Expert Reading Undo ShowlHide Overlays Hide Show Shutter Delete Measurement Annotation Delete all Measurements Delete all Annotations Delete all Measurements and Annotations Select Image Remove Image Selection SMPTE 1 2 Synchronized Scrolling Show Hide Mea surements and Annotations 90 The Visage 7 Web Client Window Undoes the last editing step Shows overlays if any have been created for the loaded images Shows or hides a shutter if a shutter was created for the loaded image Deletes a selected measurement or annotation graphic Deletes all measurement graphics in the currently selected image Deletes all annotation graphics in the currently selected image Deletes all measurement or annotation graphics in the currently selected image Selects the current image i e the imag
75. med to Visage can be configured so that a logged in user is logged off from the system af ter a configurable period of time with no user interactions This prevents licenses from being unnecessarily blocked and stops any unauthorized persons accessing data if a user has logged on but has forgotten to log off again If configured a user may log on to Visage 7 more than once from different PCs Multi session operation allows users to work from more than one clinical workplace simultaneously and view the same data there Each session makes use of and thereby blocks one license Remote access for service purposes must be granted explicitly It is therefore up to you if and to what extent you wish to grant access rights to service Full Access Service has read and write permissions This means that service personnel can analyze problems and can solve these problems or change settings Service ac cess 15 logged e Limited Access Service has read permission only e No Access Service has no access 11 Data protection and data security oystem Overview Audit trails Encryption 12 Note Please note that with full access service is granted unlimited access Under cer tain circumstances this may include patient data which has not been anonymized Logging of user actions in Visage 7 occurs in so called audit trails Audit trails are recordings of access controlled actions They are the proof that access to patient data
76. move the mouse pointer over the image area This gives the impression of a mov ie being played back Mouse up or right play forward Mouse down or left play backward Mouse stopped still image The direction in which you are supposed to move the mouse can be configured by your sys tem administrator Gamma Adjustment Opens a dialog box for the adjustment of the gamma curve of images This adjustment ap plies to all Visage 7 Web Client image viewers Show Hide Presentation State Toggles image display from presentation state image to original referenced image and vice versa The icon is only active if you have loaded a presentation state Display as 3D volume Shows a loaded series in the Visage 7 Client for advanced 3D evaluation The icon is only active when you are reviewing a series for which a 3D volume data set is available on the server Automatic Synchronization with 3D volume Select this option to ensure that both the Visage 7 Web Client and the Visage 7 Client will always show images of the same patient Mark study as read Sets the status of the procedure step for this study to completed This icon is only active if a procedure step of status scheduled exists for the study whose images are currently shown in the viewer Color Map Allows you to display the loaded images with another color map that highlights your current diagnostic problem in a better way In angio mode with XA images loaded the toolbar cont
77. n 58 84 Previous Frame icon 63 Previous Patient icon 35 55 Previous Presentation State icon 56 Previous Scene icon 82 Previous Series icon 56 Previous Study icon 55 Previous Viewer Layout icon 82 Print icon 56 83 Q Query Patient icon 31 76 Query Report icon 36 Quick Zoom icon 57 84 R Range Selection DICOM Print icon 06 83 Refresh icon 36 Remove Delete Protection icon 31 Report images 47 Report window 50 Report Window icon 26 Report with Image icon 26 Reset Filter Settings icon 30 75 Reset Input Fields icon 30 75 Reset to Default Filter icon 30 75 Reset Window Level icon 58 83 Response list network node 33 Response list network node worklist 78 Retrieve Study from DICOM Node icon 31 76 ROI Ellipse icon 60 85 ROI Rectangle icon 60 86 Rotate icon 58 87 S oave Annotations icon 87 Search criteria 29 Second opinion 5 109 Select all Images DICOM Print icon 56 82 Select all previews icon 37 select Annotation Measurement icon 87 select Images icon 56 82 series information 45 series list 39 set Delete Protection icon 31 Set Filter Properties icon 30 75 Shortcut 20 Show 61 87 Show All Scoutlines icon 61 87 Show all Studies icon 35 Show Border and Current Scoutlines icon 61 87 Sho
78. n of the study Date and time of the study in the format YYYY MM DD and hh mm ss 24 hour clock With the icons of the viewer toolbar and the popup menu in the image display area you scroll through the loaded images change the screen layout and optimize the image display The viewer toolbar is shown as one two or three rows of icons depending on your screen resolution and the number of configured icons Note The selection of available icons depends on what images are loaded XA images or others and on how the system administrator has configured the user interface for you Change Toolbar Location Moves the toolbar from above to left of the image area i e horizontal to vertical and vice versa Auto Hide Toolbar Lock Toolbar Hides or redisplays the viewer toolbar If the toolbar is hidden move the cursor over the area where it would normally be shown to redisplay it temporarily and to access its icons Previous Patient Shows the first study and series of the patient above the patient currently selected in the pa tient list Next Patient Shows the first study and series of the patient below the patient currently selected in the pa tient list Previous Study Loads the previous study of the current patient and displays its images 55 Viewers d g gp 56 The Visage 7 Web Client Window Next Study Loads the next study of the current patient and displays its images Previous Series Loads
79. n the overview segment Visage 7 Web Client When suitable data is loaded into the basic MIP MPR viewer a volume data set is calculated from the acquired slice images The volume is shown as an orientation cube in the overview segment Immediately after you have loaded a 3D data set the anatomical standard views are shown in the slice segments The orientations of these slices are shown as follows on the orientation cube e Surface with yellow border transverse standard view e Surface with red border sagittal standard view e Surface with green border coronal standard view Using the S ice cursor you can change the orientation and position of slices in the slice segments The slices always remain mutually orthogonal This calculates and displays new slice images The slices then no longer correspond to the anatomical standard views The following now applies e Surface with yellow border upper left segment e Surface with red border upper right segment e Surface with green border lower left segment To obtain a better view of the orientation and position of the display slices you can rotate the orientation cube in each direction and change display parameters such as window values This is done with the mouse Lossy compression of images Transverse slice Coronal slice Sagittal slice Current calcu Current operat lation method ing mode 69 Basic MIP MPR viewer Slice segments Slice cursor
80. nd display it view only every time you load images Consult your system administrator for details about how your system has been configured with respect to report handling Visage 7 Web Client The Visage 7 Web Client Window Report window Dual monitor Dual monitor operation does not support the text only view When you call the report with image view in dual monitor mode the left monitor shows the image window the right monitor shows the report E Visage PACS Microsoft Internet Explorer E 8 xl File Edit View Favorites Tools Help E Patient Name CT Abdomen Patient ID 23007 Date of Birth 2000 01 x Information area viewer Description CT Abdomen Study Date 2006 10 31 11 35 35 ZLE lie A ionNumber RSNA2006 S24 GS BBO S amp S EO 18 20110 ass AccessionNumber Sot E3 E mS 8 SDE patientID 23007 Viewer toolbar pe 30 ej PatientName CT Abdomen ReadingPhysician InsertionDate April 05 2007 12 53h Radiology Report Diagnosis Abdominal pain Report text 1 Question Image display Mass Navigation bar Examinations CT abdomen with oral i v contrast Findings The size and shape of the liver are normal Post contrast views Done B Trusted sites Report text When you call one of the report windows with the navigation bar icons the report text is shown view only From the report with image window you can move on to the Visage 7 We
81. ne help tab cards if they are shown and then changes to the Show button Returns to the previous topic Returns to the next topic after you have clicked Back Prints the current topic on the set printer Shows a menu with more help functions 17 Overview of the Visage 7 product documentation oystem Overview 18 Visage 7 Web Client otarting and Ending the Program This section tells you how to start Visage 7 Web Client log onto the server and close Visage 7 Web Client properly at the end of each session Depending on your system configuration the type of data connection you are using to access the web server and the settings made by your system administrator you will use one of the following methods for calling up Visage 7 Web Client and logging onto the Visage system When you have finished working with Visage 7 Web Client do not forget to log off from the system again Calling up the login screen Standard languages Visage 7 Web Client Before attempting to start Visage 7 Web Client make sure Microsoft Internet Explor er is installed on your PC see also System requirements on page 7 Visage 7 Web Client will not work with older versions of the Microsoft Internet Ex plorer or Web browsers of other manufacturers When you log onto the system Vis age 7 Web Client checks whether the correct browser is installed If it is not a message tells you which browser you need The Visage 7 Web Client user interface is
82. nstead the data you last loaded to that window is displayed If you are working with two monitors the navigation bar appears at the left edge of the left monitor and on the right edge of the right monitor It contains the same icons on both monitors Audit Warning A message is displayed It informs you that only authorized users are permitted to use Vis age 7 Web Client and that all your actions may be recorded This icon is displayed only if the audit trail license is installed and display of this icon has been configured Patient Window Lists all patients that were found by the last database query You can select a patient here to display his or her study list next When you have logged on to the client type Expert Reading the patient window is shown in worklist view 25 Navigation bar 26 rr 2 The Visage 7 Web Client Window Study Series Window Shows all examinations and series of the selected patient If you activate the preview area you will see preview images of the selected study or series in the right half of the window Image Preview not for dual monitor Shows one or all series of an examination as thumbnails You can select individual images or one or more series and load them into the viewers Report Window If a report is stored on the Visage 7 server for a selected study you can view the report text in this window Or Report with Image Yo
83. nt update Visage 7 Web Client After you have entered the address of the Visage 7 server the Visage 7 Web Client login screen is shown 1 Select one of these client types View Classic Expert Expert Dual Monitor or Expert Reading Or Call up the Visage 7 Web Client login screen in your preferred client type e g http servername en view for client type View http servername en classic for client type Classic http servername en expert for client type Expert http servername en 2monitor for client type Expert Dual Monitor http servername en expertreading for client type Expert Reading 2 Enter your user name and password Visage 7 Web Client makes a distinction between upper and lower case letters 3 Press the RETURN key or click the Login button The Visage 7 Web Client patient window opens If you are unable to log in either the maximum permissible number of users may be logged in at the moment or your license does not support the selected client type In this case try logging on again a few minutes later or select another client type If Visage 7 Web Client still does not start check the network connection or con tact your system administrator In dual monitor mode you work with two monitors simultaneously The operating ele ments and screen areas of Visage 7 Web Client are distributed over two monitors This makes working with Visage 7 Web Client easier Dual monitor mode is only available if you hav
84. ntain single images or multiframe images You will recognize multiframe images by the dog ear shown in the top right corner of the thumbnail XA report or XA series may contain report or photofile images with image evaluation information photofile images Report photofile images are displayed next to the corresponding multiframes as separate series LAD 38 CRA 4 Visage 7 Web Client 47 Preview window Biplane scenes Truncated series MPPS Modality Performed Procedure Steps 48 The Visage 7 Web Client Window XA scenes that have been recorded in biplane mode contain image pairs You can recognize biplane scenes in the image preview by the fact that two multiframe imag es are close together RAD 33 D LAO 58 CRA 1 For very large series so called truncated thumbnail display mode can be enabled in the image preview see Truncate Thumbnails for Large Series icon in the toolbar One image from the middle of the series followed by three dots is shown in the im age preview for such long series Support of MPPS Modality Performed Procedure Steps can either be activated or deactivated by your system administrator If MPPS support is deactivated the display of the series is staggered according to the SeriesInstancelD and using possible value pairs e g image type If MPPS support is activated however the MPPS ID is used to group series to gether with further value pairs If no MPPS ID is available then the d
85. of Visage 7 Web Client for transmission For Visage 7 Web Client users who access the web server over the Internet the system administrator can set data encryption as a default for each data transfer Visage 7 Web Client oystem Overview Overview of the Visage 7 product documentation The system administrator can also make sure that these Internet users cannot de activate data encryption themselves Overview of the Visage 7 product documentation The Visage 7 product documentation distinguishes between three user groups and the tasks that these groups typically perform Clinical users These users access the Visage 7 server from a Visage 7 Web Client or Visage 7 Client in order to review 2D 3D or report data Visage 7 Web Client or to view and process 3D volume data Visage 7 Client The Visage 7 Web Client and Visage 7 Client user documentation addresses this user group oystem administrator The system administrator of the hospital will perform system maintenance and adapt server configuration and database settings to changes in the system and network environment This user group works on the administration platform The Visage administrator documentation addresses this user group Service personnel This user group will install the system and subsequently perform initial system configuration This group will need the installation manual for system installa tion and the administration documentation for initial system c
86. onal Visage 7 Client product option the system also supports distribu tion of 3D image data generated from state of the art scanning modalities A 3D render server application server processes the 3D data and makes it avail able over an intranet or Internet connection for 3D image viewing and evaluation The actual DICOM data remains on the 3D application server and is not transferred to the 3D clients Instead of image data a stream of compressed screen content is transmitted during interaction which allows for safe and consistent access even to large volumes of 3D data License management Licenses Every Visage installation comes with a license code Without it the software will not run The license code serves as copy protection and controls which product options are enabled This includes e he maximum number of DICOM connections for calling importing data from the network onto the Visage 7 system and for sending data from the Visage 7 sys tem e How many users may access data on the server simultaneously per client type e The maximum data volume on the system e Activation deactivation of the audit trails The availability of an archive option The availability of the HL7 Health Level Seven option The availability of the GSM Global Session Manager option The availability of the worklist server option The availability of the failover option The accessibility of the Visage 7 Client Visage us
87. onfiguration In this section you will find an overview of the available product documentation as well as information on how to work with the Visage 7 user manuals online guide and online help systems User and administrator documentation User documentation Visage 7 Web Client The Visage product documentation addresses the information needs of each of these user groups The Visage 7 Web Client and Visage Client user documentation addresses clinical users It comprises The Visage 7 Web Client user documentation In these documents clinical users will find a complete description of the Visage 7 Web Client user interface and program functionality In the printed user manual this document you will find a complete description of all Visage 7 Web Client functions 13 Overview of the Visage 7 product documentation oystem Overview Administrator documentation Service documentation Release notes 14 The online guide offers additional information and task oriented descriptions presented in a step by step style Online guides are available on your installation medium in English and German Visage 7 Web Client also features a context sensitive online help system which you can call up right from the user interface The context sensitive help topics explain all the user interface elements and features of the currently dis played screen in your native language For the English and German user inter face the online h
88. ons for single server systems are available on your installation medium Installation instructions for cluster systems and CS systems are available for Visage Imaging service personnel only Release notes contain additional useful information about the software They focus on technical details You can find the release notes document on your installation medium Visage 7 Web Client oystem Overview Overview of the Visage 7 product documentation Information on using the Visage 7 manuals Document structure Layout conventions Tips notes warnings In order to help you locate relevant information in the Visage 7 manuals quickly they are subdivided into chapters In the Visage 7 Web Client user manual and online guide each chapter address es a specific task or group of tasks relevant to your daily work with the product For experienced users The Visage Web Client Window section serves as a concise reference guide The Table of Contents and Index sections help you locate a topic quickly To help you find and interpret the appropriate information the following visual orien tation aids are used here e Operating steps Single step actions are presented as plain text 1 Operating steps in sequences of actions are numbered e Bold text Names of windows menus and functions are shown in bold typeface Sections of text given particular emphasis are also highlighted in bold type Tips notes and warnings are highlight
89. or a display protocol Monitors Indicates whether this display protocol supports single or dual monitor configuration Orientation Indicates whether this display protocol supports landscape or portrait displays Ranking Suitability ranking of a display protocol for the study data selected in the patient or study list section of this window This column may be hidden Study list worklist Lists all studies that are available on the Visage 7 server for the selected patient Procedure Step Indicates whether a procedure step exists for this study Status Indicates the status of the procedure step scheduled in progress discontinued or com pleted Performer Indicated the name of the Visage 7 Web Client user who is currently reviewing the images of this study or who completed a procedure step Priority Low medium or high You can use this column to sort the study list for example Study Date Time Date and time of the study in the format YYYY MM DD and hh mm ss 24 hour clock Visage 7 Web Client 79 Worklist Expert Reading The Visage 7 Web Client Window Modalities in Modalities used to examine the patient Study Image Series Number of series in this study Study Descrip Description of the study tion Referring Physi Name of the referring physician cian Accession Num Job number of the patient in the HIS RIS hospital or radiology information system ber Study ID Study s identification number Reading Phy
90. ouse pointer looks like this TA The accuracy of angle measurements depends on the length of the shorter of the two angle legs The longer the angle legs are the better the accuracy For example Length of shorter angle leg measurement error 10 pixels 12 20 pixels 6 50 pixels 2 5 100 pixels 1 1 Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still Visage 7 Web Client 59 Viewers 60 MU The Visage 7 Web Client Window Calibrate Distance Permits calibration of distances in images While this tool is active the mouse pointer looks like this To Density Measurement Permits measurement of grayscale values pixel values in images While this tool is active the mouse pointer looks like this ROI Ellipse Permits evaluation of circular or elliptical regions of interest ROIs in grayscale images While this tool is active the mouse pointer looks like this ROI Rectangle Permits evaluation of rectangular regions of interest ROIs in grayscale images While this tool is active the mo
91. ouse pointer looks like this k Magnifying Glass Allows you to enlarge a portion of an image by factor 2 As soon as you release the mouse button the enlargement is no longer displayed While Magnifying Glass is active the mouse pointer looks like this ko 57 Viewers 58 The Visage 7 Web Client Window Pan Allows you to move the image in the segment If the portions of the image disappear off the screen after enlargement you can pan them back into view While Pan is active the mouse pointer looks like this Ny Windowing If this icon is pressed you can use the mouse to change the grayscale display brightness contrast in the images While Windowing is active the mouse pointer looks like this Xo Edge Enhancement This filtering enhances the contrast in images While Edge Enhancement is active the mouse pointer looks like this NA Predefined Level Presets If different window or filter values are predefined for the current image type you can call them up here and apply them to the loaded images Reset Window Level Resets the window and filter values back to default values i e the values with which the im ages were loaded Invert Inverts the grayscale display of an image Bright areas are now shown dark and dark areas are shown light Rotate Rotates the current image 90 clockwise Mirror Mirrors the current image about its vertical axis Fit into Segment Resizes the curr
92. ows you to annotate images with text Arrow and Text Annotation Creates a combined arrow plus text annotation Circle Annotation Allows you to draw a circle around an area of interest Visage 7 Web Client The Visage 7 Web Client Window Display Protocol Viewer Expert Reading af AB i 5 LB ode Visage 7 Web Client Spine Labeling Allows you to label vertebrae or intervertebral spaces in images Clicking this icon opens the Spine Labels dialog box In this dialog box you can select what you want to label whether you want to proceed from top to bottom or from bottom to top and if you want to label vertebrae consecutively or only every second or third Select Annotation Measurement Allows you to select an annotation graphic in order to move or to delete it or to change its display properties Save Annotations Saves any annotations you have created in the currently loaded data back to the web serv er Original size Resets the loaded image to its original size Fit into Segment Resizes the current image to fit it optimally in the image segment Mirror Mirrors the current image about its vertical axis Rotate Rotates the current image 90 clockwise Invert Inverts the grayscale display of an image Bright areas are now shown dark and dark areas are shown light Show Scoutlines Shows the position of selected images on the corresponding reference images Note that this icon will only become acti
93. patient is se lected in a network response list Query Patient This icon is active if a patient was selected in the local patient list and then a DICOM partner was selected in the data source drop down list The patient name and the patient ID of this patient are copied into the search criteria boxes and the search for this patient is started on the DICOM partner DICOM Send Opens a dialog box Select the address es in your DICOM network to which you want to send the selected patient s DICOM Quick Send Sends the selected patient s to one or several DICOM nodes immediately Your system administrator has defined these addresses for you Forward For a better overview the patient list does not display all patients found at a time After a very generic patient search that results in more patients found click this icon to page through the list of all patients found Backward Click this icon to page backward through the list of all patients found Set Delete Protection Delete protected patients cannot be deleted neither automatically by the program nor man ually by the user Remove Delete Protection Cancels delete protection for the selected patient s Delete Patients The selected patient s is are deleted from the local database if delete protection is not ac tive The status bar shows the progress of deletion You cannot continue your work until deletion has been completed Change Group Assignment T
94. pported modality types and abbreviations 91 Overview of functionality supported by client 92 Index 107 Visage 7 Web Client oystem Overview Intended use Visage 7 Web Client Visage is a software product for the distribution of image and report data via intra net or Internet Visage is ideal both for complex requirements of large hospitals and for special ists practices The system can be customized to provide the optimum solution for each customer In this section you will find an overview of the Visage 7 system and the Visage 7 Web Client and its data security concept and an introduction to the Visage 7 user documentation available for this software Visage is a system for distributing viewing processing and archiving medical im ages within and outside health care environments TheVisage server receives image data in DICOM format via the hospital network This provides universal connections to archives modalities and workstations The supported modalities are listed in the DICOM Conformance Statement Visage is to be used only by trained and instructed healthcare professionals It can support physicians and or their medical staff in providing their own diagnosis for medical cases The final decision regarding diagnoses however resides with the doctors and or their medical staff in their own area of respons
95. r also adds to data security The availability of potentially critical functions such as making specific pa tient data available to other users or deleting data that is no longer needed can be restricted to more experienced users When a function is disabled on a user level the icon or input field for that function is also disabled Visage 7 comes with a number of preset user levels with predefined functionalities The Visage 7 system administrator can adapt these user levels to your require ments Visage 7 Web Client oystem Overview Login and password User profiles Auto logoff Multi session operation Service access permissions Visage 7 Web Client Data protection and data security To ensure that user accounts and their passwords are effectively protected from un authorized access passwords are encrypted and if this has been configured e passwords will expire failed login attempts are recorded and multiple failed login attempts will cause a user account to be locked Note Recording logins and other actions only makes sense if all users on the system have their own user names and passwords Tip You should change your password from time to time for data security reasons The working environment of each user user profile is saved on the server when you log out This supports roaming which means that you can log in from any com puter and find exactly the working environment you are accusto
96. rches the local cache first and only retrieves data from the web server if no images are found in the local cache This option speeds up your workflow if you need to load and review one study several times during one Visage 7 Web Client session It is recommended for networks with low data transfer rates Preload Study Loads all images of a selected study into the local cache for the duration of your session When you subsequently load these images into a viewer and move on to this viewer the im ages are displayed immediately This option is only active if Use Local Cache has also been selected Truncate Thumbnails for Large Series Toggles thumbnail display for large series one or all thumbnails per series are shown in the image preview section Show Thin Slice Series When this option is selected the series list will list both thin slice series original scan series and thick slice series generated image series which permit faster loading and browsing When this option is deselected only thick slice series are shown in the series list Select all previews Selects all images in the preview window Deselect all previews Deselects all images currently selected in the preview window DICOM Information Shows the DICOM information of the selected image Visage 7 Web Client The Visage 7 Web Client Window Preview window ze Launching Application Starts another web application if your system administrator has
97. rent examination status These flags are only available in a Siemens diagnostic environment Prepared Reported vV Signed off Unknown If a new exam status has not yet been issued status New this column remains empty Contains an icon that indicates the current report status in the HIS RIS These flags are only available in a Siemens diagnostic environment P Dictated Written Validated Presentation state list Label Description Content creator Creation Date Time 40 This tab card lists all presentation states that are stored on the web server for the current study and with the currently selected compression level A or B Presentation state label as entered on the diagnostic workstation where the presentation state was created Descriptive text for this presentation state Name of the user who created the presentation state object Date and time when the presentation state was created in the format YYYY MM DD and hh mm ss 24 hour clock Visage 7 Web Client The Visage 7 Web Client Window otudy series window No of ref imag es Image preview Visage 7 Web Client Number of referenced images in this presentation state object The image preview of the study series window shows the images of the selected study or series as miniature images thumbnails You use the preview area to select images or series You can select an entire study complete series a presen
98. riteria System messages Toolbar patient window Jata source Patient list local or Response list network node Navigation bar Visage 7 Web Client In the patient window you can search for the patient whose images you wish to re view You can search for the patient in the local database web server or in the database of a configured DICOM partner Entering filter and search criteria will make searching easier Note To ensure the confidentiality of patient data the system administrator will as a rule restrict which examinations you are able to access As a referring physician you may for example only be able to view the data of your own patients When you are working in dual monitor mode the patient list is soread over both monitors The filter elements are shown on the left monitor only E Visage PACS Microsoft Internet Explorer 18 x File Edit View Favorites Tools Help aw Patient List dr x v Study Date All PaiennName 000 p Modality All PatientID ss Study Description 0 PalentComment AcessinNo 00 Location All Date of Birth v Insertion Date All 37 Patients found Be Lx BR Visage PACS Web ae m gt MB mmm 22 nean e sae Tretorn T Report Delete Protect LI INT FLTOPO1 1922 07 24 F Abdomen Kidney DB 1947 12 01 M RF Amato Terence 000012 196
99. rking with high resolution monitors your system administrator can configure the display of Visage 7 Web Client so that larger font sizes and icons are shown Other Network link or ISDN analog modem Loudspeakers microphone and web cam optional for use with Microsoft Net Meeting Software Hints for Visage 7 Web Client installation During installation the Visage 7 server is listed as a Trusted Site To ensure that the Visage 7 Web Client ActiveX components can be installed on the client computer you must set the security level for Trusted Sites in the relevant network zone intra net or Internet to Medium or Low The security level High would prevent ActiveX components from running In order to change the security level for Trusted Sites 1 Open the Internet Options menu Tools gt Internet Options dialog box in the Internet Explorer 2 Click the Security tab card Visage 7 Web Client oystem Overview Product overview 3 Click Trusted Sites and Custom Level 4 Check the settings for Trusted Sites and change them if necessary 5 Also be sure to disable Use PopUp Blocker if you are working with Windows XP Service Pack 2 or higher In order to add a Trusted Site manually 1 Enter the Visage 7 Web Client URL e g http servername en in the Internet Explorer address bar 2 Select and copy the URL Ctrl C 3 Open the Internet Options menu Tools Internet Options dialog box in the Internet E
100. rt Reading is avail able with the Expert licence For a detailed comparison of the client types refer to the Appendix If your installation does not support one of these license types an error message will be displayed when you try to log in System requirements Server Clients Visage 7 Web Client When describing system requirements we make a distinction between server and clients For a specification of the hardware and software requirements for Visage 7 servers please contact your sales representative These are the minimum hardware and software requirements for Visage 7 Web Cli ent PCs Operating system and software Microsoft Windows 7 or Microsoft Windows XP or Microsoft Windows Vista Microsoft Internet Explorer 6 7 or 8 Microsoft NetMeeting optional equipment for teleconferencing Product overview oystem Overview Computer processor Intel Pentium with at least 500 MHz Intel Pentium IV 2 GHz recommended RAM 256 MB more memory may be required depending on the size of your images Hard disk At least 2 GB free hard disk space Graphics card Resolution of at least 1024x768 pixels true color Monitor 17 color monitor 21 recommended or grayscale monitor Note Mammographic images may only be interpreted using an FDA approved monitor that provides at least 5 Mpixel resolution and meets other technical specifications reviewed and accepted by the FDA U S only Tip If you are wo
101. s X x x pi Next Series x x x ik Previous Scene x x x x pi Next Scene Ton Previous Presentation x x State H Next Presentation State X x x B Previous Annotated x x x x age A Next Annotated Image x X A Cancel loading x 100 Visage 7 Web Client Appendix Overview of functionality supported by client types Client type View Client type Classic Client type Expert Client type Expert Reading Select Images wr Windows Print DICOM Print Copy to Clipboard x x DICOM Send DICOM Quick Send x X Export Images DICOM Information Hide Show Image Text x x Zoom aL Quick Zoom L Visage 7 Web Client 101 Overview of functionality supported by client types Appendix Client type View Client type Classic Client type Expert Client type Expert Reading Magnifying Glass X x Windowing X Edge Enhancement x Predefined Level X x x x sets e Reset Window Level x x x x vad Invert x x Rotate x x x rf kh Mirror x x x Alb Fit into Segment 102 Visage 7 Web Client Appendix Overview of functionality supported by client types Client type View Client type Classic Client type Expert Client type Expert Reading Original size Itt Measurement Func x x x tions mT Sho
102. s not permit exact pixel selection the inaccuracy can be greater still Angle Measurement Permits measurement of angles in images While this tool is active the mouse pointer looks like this TA The accuracy of angle measurements depends on the length of the shorter of the two angle legs The longer the angle legs are the better the accuracy For example Length of shorter angle leg measurement error 10 pixels 12 20 pixels 6 50 pixels 2 5 100 pixels 1 1 Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still Calibrate Distance Permits calibration of distances in images While this tool is active the mouse pointer looks like this To Density Measurement Permits measurement of grayscale values pixel values in images While this tool is active the mouse pointer looks like this ROI Ellipse Permits evaluation of circular or elliptical regions of interest ROIs in grayscale images While this tool is active the mouse pointer looks like this Te i Display Protocol Viewer Expert Reading 86
103. screen This image is selected Loaded images are not visible Image not yet loaded only appears during loading 65 Compare mode The Visage 7 Web Client Window Compare mode Image display and editing Dual monitor Information area viewer Toolbar viewer Viewer 1 Viewer 2 Navigation bar 66 Compare mode shows the two viewers side by side or one above the other You can easily compare two series in this way Use these icons on the navigation bar to switch to compare mode vertical i e side by side or compare mode horizontal i e top and bottom As far as image display and processing is concerned you can work in both screen halves in just the same way as if a viewer were displayed full screen Tip The toolbars above or to the left of each image view contain the same icons and access the same functions as in one of the full screen viewer windows with one exception Showing scoutlines in suitable CT or MR images is only possible in compare mode but not in any of the full screen image viewers or the report with image view If configured scoutlines are shown by default when you load suitable series into compare mode In dual monitor mode the two viewers are displayed on the two monitors viewer 1 on the left and viewer 2 on the right monitor Z Visage PACS Microsoft Internet Explorer 4 10 x x Patient Name Joe s Shoulder Patient ID 646464 Date of Birth X Fil
104. segment or on the 3D overview segment A popup menu appears with all the processing options that are possible here Applies a processing function in the current segment to all other segments too In the overview segment only possible for windowing Activates interactive windowing with the mouse Activates interactive image zooming with the mouse Activates interactive image panning with the mouse In the 3D overview segment only Allows you to rotate the orientation cube in any direction with the mouse In the slice segments only Allows you to move the slice currently shown in the slice segment along two standard axes Do not accidentally click on the slice cursor line 71 Basic MIP MPR viewer SliceThickness View Fit into Segment Original size Full size Show All slices Slice1 2 3 Volume box Slice cursor MPR MIP Reset Unload Keyboard 72 The Visage 7 Web Client Window In the slice segments only Allows you to change the slice thickness of the image shown in this slice segment interac tively Do not accidentally click on the slice cursor line Opens a submenu Enlarges or reduces the image so that it fits optimally into the image segment Shows the image in its original size Displays the current segment in full window size The other three segments are then hid den In the 3D overview segment only Shows or hides all slices in the overview segment In the 3D overview segment only
105. series or to invert the current selection of images Double clicking on the series information will load the entire series into viewer 1 CT Series scanned with contrast medium For CT series the abbreviation WC on the right edge of the series information bar indicates that these images were scanned with contrast medium WO indi cates that this series was scanned without contrast medium If a CT series contains both images that were scanned with and without contrast medium then Visage 7 Web Client splits up this series The images are displayed grouped as two separate series seres CT Series CT Images 1 Organ Mediastin Date Time 19 WC Series CT Series CT Images 1 Organ Mediastin Date Time 19 MR T1 T2 series For MR series Visage 7 Web Client indicates if the series contains T1 or T2 weighted images If an MR series contains both T1 and T2 weighted images then Visage 7 Web Client splits it up The images are displayed grouped according to their T1 T2 weighting Visage 7 Web Client The Visage 7 Web Client Window Preview window serez ME Series Modality ME Images 1 Organ Date Time 1997 11 04 12 T1 Series ME Series Modality ME Images 1 Organ Date Time 1887 11 04 13 T2 Thumbnails The way the thumbnails themselves are presented also provides information about image types and acquisition data Multiframe images oeries of some modalities can co
106. si Name of the physician who read this study on the system that sent the data to Visage 7 cian Study Comment Comment text about the study 80 Visage 7 Web Client The Visage 7 Web Client Window Display Protocol Viewer Expert Reading Display Protocol Viewer Expert Reading Toolbar display protocol viewer Thumbnail browser Navigation bar Image area with viewports In client type Expert Reading the display protocol viewer replaces the viewer and report windows of the other client types The display protocol viewer is particularly well suited for primary reading When reviewing images of a current and previous study be sure to show image texts in the display protocol viewer This will help you distinguish the two studies in the various viewports Be sure you have correctly identified the current study when reporting on the image data E Visage PACS Microsoft Internet Explorer File Edit View Favorites Tools Help Haor amp mue tst 0 GA AMA hay 2 1997 02 1997 02 12322 a Internet Thumbnail browser Visage 7 Web Client The thumbnails in this section of the screen represent the series you selected from the worklist The series thumbnails are grouped by study if you have loaded more than one study You can load series into the viewports of the image area from here drag amp drop 81 Display Protocol View
107. sted in the series list When this icon is not selected only thick slice series are displayed E Thin slice series original scan series series with a large number of images Thick slice series generated image series series with a smaller number of images Visage 7 Client option only Indicates if a 3D volume data set is available for this series on the system Only series with a 3D volume data set can be loaded into the Visage 7 Client Modality used to create the series Total number of images of this series on the web server Highest available image number For modalities that work with single frame images comparing the Number of images and the Highest Image Number helps you determine if all images of this series have been trans ferred to the web server Number of images in the local cache Examined organ or body part Description of the series 39 otudy series window Performing Phy sician Series Date Time Series number Marked images Exam status Report Status The Visage 7 Web Client Window Name of the performing physician Date and time of creation of the series in the format YYYY MM DD and hh mm ss 24 hour clock Number of this series within the study In these columns you will find information about whether images in this series have been marked with a star or a flag only relevant if the imaging systems in your hospital support marking images Contains an icon that indicates the cur
108. stem administrator can configure an HTML link to an Internet page after manual logoff Automatic logoff If Visage 7 observes no activity for a certain time default setting 15 minutes a message box appears You are prompted to confirm that you wish to continue work ing If you do not answer you will be logged off automatically after a few seconds The license you were using is now available for another user Only the system administrator can change the automatic logout time 24 Visage 7 Web Client The Visage Web Client Window This section describes the screen layout and the windows you use when working with Visage 7 Web Client You will find a brief functional description of the individual windows the icons and other elements here You open the Visage 7 Web Client windows via the navigation bar on the left hand side of the screen Tip The online guide which is available in German and English and which you re ceived as a PDF file on your Visage installation medium provides more detailed information and instructions for working with Visage 7 Web Client If you are work ing with an English or German user interface you can also download the online guide from the login screen Navigation bar Dual monitor AN i Visage 7 Web Client Using the icons on the navigation bar you can quickly switch to any of the other Vis age 7 Web Client windows Switching to another window will not load any data into that window I
109. sts all patients examined today Yesterday lists all patients examined yesterday The last X days lists all patients examined over the last X days Date lists all patients examined on this day From date to date lists all patients examined within the stated period All lists all patients irrespective of examination date Here you can filter the patient list according to modality Click the icon next to the filter parameter Modality Check one or more modalities After a new database query only patients examined with this modality or these modalities will be shown Here you can filter the patient list according to the name of the referring performing and or reporting physician Click the icon next to the filter parameter Physician Check the box Referring physician Performing physician and or Reporting physician and type the name of the physician Or type A for all physicians whose name begin with A for example Or Open a list of all names by clicking on the icon behind an entry field A list drops down with all referring performing or reporting physicians of the studies you have access to Se lect a name If you are searching in the network the patient list can only be filtered according to the refer ring physician Visage 7 Web Client The Visage 7 Web Client Window Patient window Location Insertion Date Interpretation Status Search criteria Patient Name Patient ID Patient
110. t to Default Filter Activates the filter defined as the default filter Set Filter Properties The Personal Settings dialog box opens You can define your own filters here Reset Filter Settings All the filter parameters you entered are removed Click Start Data Query to display the un filtered patient list again Reset Input Fields All the search criteria you entered are removed Click Start Data Query to display a longer patient list again Data source Here you select where to search for data on the local web server database or on a DICOM network node Start Data Query Starts a data query with the current filter and search criteria in the selected data source As a result the patient list of the web server or a response list from a DICOM node will be dis played Cancel Data Query A query currently in progress is stopped All patients found so far are displayed Visage 7 Web Client The Visage 7 Web Client Window Patient window mi 44 32 Visage 7 Web Client Retrieve Study from DICOM Node If you did not request data in the local database but on a network node you will see the re sponse list of the DICOM node in the patient window If you find the patient you are looking for in this list you nevertheless cannot work with this data immediately You must first copy the patient to the local database with this icon This icon is dimmed while the data source web server is selected or while no
111. tation state or individual images from one or several se ries and then load them into a viewer With large series that contain a large number of images and slow data transmission lines selecting and loading only those imag es that are relevant to your diagnostic problem will save time Moreover the image preview contains information about the study series and the images they contain Refer to the preview window for details about e Information about the study e Information about a series e Thumbnails e mage preview popup menu 41 Preview window The Visage 7 Web Client Window Preview window Information area preview window Toolbar preview window Information about the study Information about a series Thumbnails Navigation bar 42 The preview window shows the images of the selected study or series as miniature images thumbnails Unlike the preview area of the study series window this preview window shows the thumbnails over the full width of the browser window You use the preview area to select images or series You can select an entire study complete series or individual images from one or several series and then load them into a viewer With large series that contain a large number of images and slow data transmission lines selecting and loading only those images that are relevant to your diagnostic problem will save time Moreover the image preview contains information about the study series and
112. u can display images of a study together with the report text Viewer 1 Displays the images of a selected study series or individual selected images in viewer 1 Viewer 2 Displays the images of a selected study series or individual selected images in viewer 2 Compare Mode vertical Splits the screen down the center and displays the images loaded in viewer 1 on the left hand side and the images loaded in viewer 2 on the right hand side Compare Mode horizontal Splits the screen across the center and displays the images loaded in viewer 1 in the upper half of the screen and the images loaded in viewer 2 in the lower half Basic MIP MPR Viewer Displays the basic MIP MPR viewer only possible for image data that is suitable for 3D re construction Display Protocol Viewer Shows the loaded images in a screen layout that has been optimized for primary reading This icon and viewer are only available if you have logged on to the client type Expert Read ing Status information Displays information about all data transfer jobs in the network as well as a list of all logged On users Help Calls a context sensitive online help topic with an explanation of the window that is currently active Logoff Logs you off from the Visage 7 server Visage 7 Web Client The Visage 7 Web Client Window Patient window Patient window Fi Dual monitor Information area patient window Filter parameters Search c
113. use pointer looks like this Measured values are indicated in exact square millimeters mm in CT and MR images estimated square millimeters mm P or in pixels pix if ROI measurement in millimeters is possible The relative error of the elliptical or rectangular ROI measurements is 2 pixels shorter radius or shorter side For example Shorter radius or shorter side measurement error 10 pixels 20 20 pixels 10 50 pixels 4 100 pixels 2 Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still Visage 7 Web Client The Visage 7 Web Client Window Viewers 24 i gt m ode Visage 7 Web Client Density Profile Permits evaluation of a density profile along a straight line an arrow indicates the direction While this tool is active the mouse pointer looks like this T Show Scoutlines compare mode only Shows the position of selected images on the corresponding reference images Note that this icon is only shown in the viewer toolbars in compare mode It will only become active if a CT or MR study
114. ve if a CT or MR study has been loaded that con tains suitable image data Show All Scoutlines Shows all scoutlines in the reference image Show Border Scoutlines Shows only the first and last scoutline in the reference image Show Border and Current Scoutlines Shows the scoutline of the current image and the first and last scoutline in the reference im age Show Current Scoutline Shows only the current scoutline in the reference image 87 Display Protocol Viewer Expert Reading E a 3T The Visage 7 Web Client Window Cine Mode Backward Plays back the loaded images like a movie The playback direction is backward Cine Mode Stop Stops movie playback Cine Mode Forward Plays back the loaded images like a movie The playback direction is forward Cine Mode Speed If the slider is far left movie playback stops If the slider is far right the movie is played back at maximum speed Bouncing Cine If you click this icon the movie will run without interruption When playback reaches the last image the movie runs backward to the first image then forward again etc Interactive Cine Mode When Interactive Cine Mode is active the images of a series or scene will play back when you move the mouse pointer over the image area This gives the impression of a mov ie being played back Mouse up or right play forward Mouse down or left play backward Mouse stopped still image The direction in whic
115. vel A In compression level A the images are usually only slightly compressed and without loss of quality Your system administrator defines the compression rules for your system Compression Level B Transfers images with compression level B which compresses the images even more Note that compressed images do not contain the full volume of data of the original The di agnostic quality of the images is affected as a result Encrypted Data Transfer The images are transmitted encrypted Non encrypted Data Transfer The images are transmitted without encryption Query Report Requests a report on the currently selected study from the configured report network node If a report on the selected study already exists on the Visage 7 server the report is down loaded again and the existing report is overwritten Visage 7 Web Client The Visage 7 Web Client Window otudy series window uo ya fad Z Visage 7 Web Client Use Local Cache If this icon is activated the images you download from the web server are stored in your lo cal cache memory When you load images into a viewer Visage 7 Web Client searches the local cache first and only retrieves data from the web server if no images are found in the local cache This option speeds up your workflow if you need to load and review one study several times during one Visage 7 Web Client session It is recommended for networks with low data transfer rates Preload Stu
116. w Border Scoutlines icon 61 87 Show Current Scoutline icon 61 87 Show Thin Slice Series icon 37 44 Show Hide Presentation State icon 62 opine Labeling icon 87 Standard languages 19 otandard login 21 otart Data Query icon 30 76 otatus information icon 26 Study information 45 Study list 38 Study series window 34 otudy Series Window icon 26 oystem architecture 4 oystem requirements 7 T Teleradiology 4 Text Annotation icon 86 Thumbnail browser 81 Thumbnails 47 Toolbar patient window 30 75 preview window 43 study series window 35 viewers 55 Truncate Thumbnails for Large Series icon 37 Index U Use Local Cache icon 37 User name 21 User profiles 11 V Viewer 1 54 Viewer 1 icon 26 Viewer 2 54 Viewer 2 icon 26 Viewport 88 W Warning icon calibration 63 89 DICOM header information 63 89 lossy compressed image 63 89 presentation state image manipula tion 63 sort order of images 89 thick slices 64 89 Windowing icon 58 83 Windows Print icon 56 83 Worklist Expert Reading 74 Z Zoom icon 57 84 Visage 7 Web Client VISAGE IMAGING REF VI LEG MANWEB EN Visioneering Science for Life Copyright Visage Imaging GmbH European Headquarters US Headquarters Pro Medicus Headquarters Visage Imaging GmbH Visage Imaging Inc Pro Medicus Ltd Lepsiusstra
117. w Scoutlines com x pare mode only n Display Mode X H Previous Viewer Layout HI Next Viewer Layout np HI Cine Mode Backward x x X 4 Cine Mode Stop Cine Mode Speed x x I Bouncing Cine x 5 Visage 7 Web Client 103 Overview of functionality supported by client types Appendix Client type View Client type Classic Client type Expert Client type Expert Reading Interactive Cine Mode x x X Gamma Adjustment Show Hide Presenta x X tion State Edit report Display 3D volume x 3D M Automatic Synchroni x x zation with 3D volume 30 Plane x Plane B x Loop All x fai 104 Visage 7 Web Client Appendix Client type View Previous Frame mm E Next Frame Display Reports Display Scenes Hide Show ECG Mark as read E Synchronized scrolling Create Annotation A Select Annotation Mea surement E Save Annotation af AB Visage 7 Web Client Overview of functionality supported by client types Client type Classic Client type Expert Client type Expert Reading 105 Overview of functionality supported by client types Appendix 106 Visage 7 Web Client Index Visage 7 Web Client 3D Automatic Synchronization with 3D volume 38 45 62 77 88 Display as 3D volume 37 45
118. xplorer 4 Click Trusted Sites and Sites 5 Paste the URL in the Add this Web site to the zone box Ctrl V 6 Click Add and then close the dialog box with OK Note For installation administrator privileges are required on the client computer Tip At some sites Visage 7 Web Client is distributed in the Windows Domain with a so called MSI Package If this is the case Visage 7 Web Client will be installed auto matically no user interaction is required here Archiving with the archive option Visage 7 Web Client With the archive option data is sent to the archive according to a configurable schedule These archive options are available e Archiving on RAID hard disks e Archiving on SAN and NAS devices Which archiving method is used will depend on your requirements the hardware used and the configuration of archive option Tip Archiving is always performed in the background As a user you will not actively in tervene in archiving However you can monitor the status of archiving in the study list and exclude studies from archiving Data protection and data security oystem Overview Data protection and data security Data relating to individuals is subject to data protection In this regard please en sure compliance with all applicable laws and regulations in your country Visage provides extensive security mechanisms that help you assure data protec tion and data security On the administration
119. y access to frequent image processing functions Right click in the image display area Note Note that many image display functions are available from both the toolbar and popup menu Others functions are available only from the toolbar or only from the popup menu The following table describes only those functions that have not al ready been explained in the context of the toolbar Applies the last editing step to all images of a loaded series When this option is selected all image editing steps are applied to all images of a loaded series immediately and not just to one image alone Undoes the last editing step Shows overlays if any have been created for the loaded images Shows or hides a shutter if a shutter was created for the loaded image Deletes a selected measurement or annotation graphic Deletes all measurement graphics in the currently selected image Deletes all annotation graphics in the currently selected image Deletes all measurement or annotation graphics in the currently selected image Selects the current image i e the image highlighted by a white border for DICOM print DICOM print selection is indicated by a solid green box in the lower right hand corner of the image segment Removes the current image from the DICOM print selection Shows or hides the ECG curve in the image only possible for XA images containing ECG information Visage 7 Web Client The Visage 7 Web Client Window V

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