@ GE Medical Systems HiSpeed ZX/i CE." Operator Manual Revision 0 Original Draft in English Copyright®2001 by General Electric Company‘Though ‘beam becomes asourceok ied rato. jeausesdamage to human ts ‘Therefore, adequate precautonsmustbetakento jor ungualtedpersonsromoperatingthisequipment ‘or exposing themselves or others tots radiation. Before operation, persons qualified and authorized equipment shouldbe familar withthe Recommendations ‘ofthe Intemational Commission on Radiological Protection, contained in Annals Number 26 ofthe ICRP, and wh applicable national standards,Table of Contents Image Works System Chapter 1 - Chapter 2 - Chapter 3 - Chapter 4 - Introduction + Overview + Start Image Works + Types of Windows Getting Started + Overview + Image Works Brower The Browser Menus + Viewer Menus and Controls Image Control Pane! Selecting, Sorting and Displaying Images + Overview + Selecting and Sorting Images + Displaying Images Using the Viewer + Displaying Sorted Images ‘+ Paging through Displayed Images + Closing the Viewer or a Mini Viewer + Deleting Images from Image Disk Manipulating Images + Overview + Setting Window Width/Levets ‘+ Magnifying Displayed Images + Changing Image Orientation + Scrolling an Image + View Selection + Normal Display 1-2 3-1 ant 3-7 3-7 3-7 3-10 3-11 at 4-2 44 4-4 4-5 4-5 4-6Image Works Chapter 5 - Chapter 6 - Chapter 7 - Saving Manipulated Images Magnitying Glass Changing Custom Viewing Settings ‘Comparing two Series Cross Reference Mode Annotating Images Overview ‘Adding User Annotation . Removing and Restoring Image Annotation Duplicating User Annotation Analyzing Images Overview Drawing Graphics Obtaining Measurements Accuracy of On - View Measurements Removing and Restoring Image Graphics Film Composer Overview Lase Camera Activating the Film Composer Selecting Output Device Selecting Filming Parameters Loading Images in the Film Composer Erasing Film Frames Printing mages Clearing the Film Composer Film Composer Status Line 4-6 4-6 4-7 aon 4-12 5-1 5-2 5-5 5-5 6-1 6-2 6-8 6-9 6-10 74 7-2 7-3 7-4 7-4 7-7 7-9 7-9 7-9 7-10Image Works Chapter 8 - Chapter 9 - Chapter 10 - Networking + Overview '* Information Concerning Connection + Selecting a Remote Host + Transmitting Data to a Remote Host + Removing Host Names from the Workstation’s Configuration File + Network Queues . . Archiving + Overview . + Composition of Archiving Option + Restoring Images from OD + Labelling a MOD .. + Saving Images on MOD + Ejeoting a Disk from the OD Drive + Archive Queues Image Combi + Overview + Save Series + Set Selection . + Maximum Pixel Value Extraction + Image Addition + Image Subtraction . ‘+ Minimum Pixel Value Extraction + Binding Series 9. ont 9-2 9-6 9-8 9-10 9-10 10-1 10-2 10-3 10-4 10-6 10-8 10-10 10-10Image Works Blank pageCHAPTER 1 Image Works System Introduction Overview The Image Works is a multi-tasking, multi-functional, stand-alone, single-user workstation. It has its own dedicated computer and image data base. It supports image display, manipulation, and film composing functions. Image Works can be networked to serve as a common workstation for CT, MR and X-ray products. it can also be networked to Advantage Windows workstations andjor GE Independent Consoles, and certain other equipment that uses the DICOM standard. See your GE Support Engineer. Note: Image Works handles Advantage and DICOM image formats. However, there are differences in layout between these formats. Hardware This software application runs on a standard Image Works platform. It uses the platform's system for film output. It accepts image data acquired on any CT or MR system compatible with Image Works. Conventions for this Manual Note: Throughout the text in this manual, we have used certain type styles and symbols to differentiate between one tool or graphic and another. The conventions we have used are as follows: a Menu titles appear in bold face (e.g., Application Menu), a Menu options appear in bold face, within brackets (e.g., [Exit], a On-screen tools appear in bold face, within braces (e.g., {Scroll Bar}), 2. Graphical buttons appear in bold face, within parentheses (e.g., (View)), On-screen prompts and messages appear in italics (e.g., Login:), User typed-in responses appear in bold face italics (e.g., root), and Keyboard hardkeys and mouse buttons are underlined (e.g., Enter or lett) o 1-1Image Works System Start Image Works Image Works can be accessed by clicking on the [Image Works] icon on the upper left comer of the screen in either Scan or Display mode. fe ‘Sean Display Image seny Works =| |b Service Shutdown DO — pees ERE sie 2 [=e] S| se BH oo STV. Revi Layouts es stele ‘auto Fm anual Film Composer "ComposerImage Works System Types of Windows There are three major windows in Image Works. They are; a Browser, a Viewer, Mini Viewer, The Browser The Browser window, (hereafter simply called “The Browser’), is the primary tool you will use to select images for display and manipulation i Hl en z i A 8 Setocnan Remove Son Network Arce Queve Message Z Cart pe oar EP ES TT pe [na wa ce PATTER | A: Examination List B: Series List C: Image List [mmiucmz) In the upper right corner of the screen there are four function [nana] _ buttons. use (Restart Browser) to open the Browser menu when the —eE first-time attempt fails. use (Restart Display) to open the Display menu when the first-time attempt fails.Image Works System Use (Img Update) to update images taken with older HiSpeed version. At the top of the Browser, you will find a menu bar, which offers pull-down menus. Refer to the CHAPTER 2 for the details. ‘The Browser contains three lists showing the exams, series, and images presently on the image disk: The Examinations list displays a list of available exams, The Series list displays a list of the series contained in the selected exam, The Images list displays a list of images within the selected series. CT, MR and X-ray specific parameters are displayed. Note: The Date column in the Examinations list reflects the acquisition date. The lower right corner of each list displays the total number of items (exams, series or images) contained in the list. Above the Series list, the currently selected exam is described by the exam number, exam date and patient's name. At the bottom of the Browser window is a line of text which provides you with a continuous report of the number of images currently stored on the image disk. It also updates disk space availability. This is indicated as the number of 512 x 512 or 256 x 256 matrix images that can be added to the image disk. The exact number varies with the acquisition matrices of all the CT, MR and X-ray images on the disk [3] The Browser also contains Application Selection Buttons, located [-aaaS) 0” the right side of the Browser window, which are used to run the various image display and manipulation applications that are Dente available on your system. f Edit Patient Since (Viewer), (Mini Viewer), (Add/Sub), (Film), (Functool), (Rfmt Detl), (Rfmt Stnd) and (Edit Patient) are part of the basic Fusetool | display system, these buttons are always present, and their use is WMiniViewer) described in the following sections. F Fim Navgeier | Your system may not show (DentaScan), (3D), or (Navigator) since [ Rimi Det_} these are optional features. mt Sing Viewer f 1-4Image Works System Viewer Click on the (Viewer) button on the right side of the Browser to open the following Viewer. The Viewer is one way to display and manipulate the images you selected from the Browser lists. It contains an image display area and an image control panel. Image control panel fan sets ¢ Image display area Display pom Text Page o ‘The image display area is used for viewing images in the series previously selected on the Browser. This entire area can be formatted to display one single image or it can be divided up to display multiple sequential images in the series. Note: The date annotation in the upper right corner of each view reflects the exam acquisition date. a The image control panel on the left hand side of the Viewer is used to set up and manage images on the image display area. To close the Viewer you have to return to the Browser. 1-5Image Works System Mini Viewer Click on Mini Viewer. the (Mini ewer) button on the right side of the Browser to open the The Mini Viewer is another way to display and manipulate the images you selected from the Browser lists. It contains an ima display area Image control panel mn SS Senes eo [a] S| [A ect ane a Diepiay Normal Fupmoware ge control panel and image Image display area Click on the (Quit) button on the Image control panel to close the Mini Viewer.Image Works System Other Application Buttons 3D Please refer to the 3D section. Add/Sub Please refer to the chapter 10 {Image Combination]. Edit Patient Please refer to the following pages. Functool Please refer to the following pages. Film Please refer to the chapter 7 [Film Composer]. Navigator Please refer to the Navigator section, Rfmt Det! or Rfmt Stnd Please refer to the Reformat section. 1-7Image Works System Edit Patient 1-8 This function allows you to edit patient data after examinations. The following things should be noted. The data you wish to edit must come from the system you use. Patient weight can not be changed. Patient ID can be changed only when “trauma” or “2” is in ID data field. It may take about one minute and 45 seconds to renew the whole exam that includes 100 images. Data edit can be repeated many times. tis highly recommended that retro recon be done before you edit the patient data. tis highly recommended that archive, networking or filming be done after you edit the data. a Ifthe exam you wish to edit is displayed in the autofilm viewport or free viewport, you can not enter Edit Patient function. @ You can not enter Edit Patient when the exam you wish to edit is being used. The following message will appear. Error Detected ‘The exam selected can not be edited because itis currently in use. Bo G Ifyou edit the exam that includes saved 3D models, those 3D models will be deleted from the exam. Also, you can not enter Edit Patient after you selected 3D model. The following message will appear. Error Detected Edit Patient Data failed to read the current selection: delete if a0 mode! BoImage Works System In order to enter Edit Patient, first select an exam on the Browser, then click on the (Edit Patient) button, The following menu will appear. Select (Edit Patier nt Images). it Patient Application Please select one of the Edit Patient Applications Edit Patient ] [View Edit a im Cancel (Cancel) to cancel. A ‘Caution a) Networked, archived and filmed copies ‘of the original exam will have to be removed. ») Use only the latest edited version ofthis exam. (0) 3D Models in this exam, it any, will be ‘deleted in the edited exam. Accept Cancel If you choose (Accept), the following message wil continue, or select (Caneel) to cancel. The following message will appear. Select (Accept) to continue, or select ll appear. Select (Accept) to ZA Kastor Reminders 8) Copies of the exam may have been produced with Auto Network, Auto Archive and Auto Film, ») All reconstructed images should be generated before editing this exam, ©) The exam in the Patient Schedule must be ‘manually updated. ‘Accept Cancel 1-9Image Works System Once you accept the warning message, the following Patient Data menu will appear. Patient Information Exam Number Cc Patient ID. (———} co Patient Name sx C) Birthday age CI Referring Physician Radiologist Operator History | | Exam Description Cc Edited by Reset Selected Value Reset All Values Accept] [ Cancel Click on the data field you wish to edit, then type in new data. You can not proceed further unless you enter at least three letters into “Edited by” field. After the edit, if there is any field you wish to undo, click there and select (Reset Selected Value). If you wish to undo all edited fields, select (Reset All Values). If you are satisfied with the edit, select (Accept) or click on (Cancel) to cancelImage Works System If you select (Accept) on the previous page, the following confirmation message will appear. Create a new exam with the specified changes ? ‘Accept Cancel Ifyou select (Accept), the old exam will be replaced by the edited exam During the process where the old exam is deleted and the newly edited exam is created, the following percentage countdown menu appears. Closing application. 100% ————= Percentage of images Upon the completion, the newly edited exam will be listed in the Browser. The newly edited exam will be annotated with “e+ number’ in the Description area of the Browser. The number indicates how many times the exam was edited. When you select (View Edit Log) in the following menu, an edit log will be displayed. Eur Patient Application Please select one of the Edit Patient Applications Edit Patient] [~ View Edit images oa Cancel If you wish to exit from Edit Patient Application menu, select (Cancel). 1-11Image Works System Functool 1-12CHAPTER 2 mage Works System Getting Started Overview Learning about the various menu systems and controls offered by Image Works is important for using the system effectively. This section provides an overview of all the workstation’s menus and controls, complete with general descriptions, so that you can see at a glance where you need to go to use a particular function This section also describes the methods you can use to manipulate windows. By changing a window's location on the screen (and its size and shape where applicable), you will be able to work with a variety of windows and images simultaneously. Image Works Browser Image Works menu and control are shown in the Browser menu. Fa pe eptcaton Secon Rorove Son Neto civeGuave Unies Manage Z 7 Sara hoe TT) meas] | Sie eerie ~=— [a] ra =| | a [rast ] = al Comore] \ Ged c ‘A: Examination List B: Series List C: Image List 21Image Works System The Browser Menus Application Selection Remove Sort Network Archive Queue Utilities Message Amenu bar, at the top of the Browser, offers the following pull-down menus: ‘The Application menu enables you to refresh (update) the Browser lists. ‘Application | Rotresh ists The Selection menu provides access to the multiple selection [ selection \ functions. Please refer to Chapter 3 for each function. ] Select al examinations | select a series Select archived exame ‘Select unarchived exams Remove examination | series or images from the image disk. Please refer to Chapter 3. for each function, Remove The Remove menu provides access to the remove functions. These functions allow you to delete the currently selected exam, Remove series Femave imageSort ‘Sort examinations by exam number Sort examinations by patent nama Sor examinations by date Sort examinations by modality | Sort examinations by achive status ‘Son images by mage number ‘Sortimages by location Image Works System The Sort menu allows you to sort listed and displayed examinations and images. Please refer to Chapter 3 for each function a coos Exam number Patient name (alphabetical order) Date Modality (CT or MR) ms a Archive status (Y=Yes, N=No, U=Unknown) Son images by tigger a. Image number [Sexiansbreantne | 5 Location name by exam]. The question appears : (Create Create anonymous patient by image anonymous patient by exam 2). If you choose (Yes), the exam you selected is copied and listed as “Anonymous 2x” ‘The same procedure can be applied to series or image. Message ‘The Message menu item is used to open a window that provides a a ‘summary list of all the messages that have arrived since the Browser was opened. The word (updating) appears to the right of this menu title whenever Image Works database is being updated. Note: The word (updating) does not disappear immediately after completion of data base updating, 2-4Image Works System Viewer Menus and Controls The Viewer is launched from the Browser window. Select the desired exam and series (and a subset of images if you don't want to view the entire series), then click left on the (Viewer) button on the right side of the Browser window. Image Control Panel The Viewer screen contains numerous image display and manipulation controls which are grouped into an Image Control Panel. This control panel is located on the left side of the Viewer screen. It contains, starting from the top and moving downward Cia] ) om oo sees C5) CH Cea | me ooo mage Cee | Cs [a] (S] 4 c=] ES) | == me Enhance Normal x | [Feterone*] [rupinotae] Format image ue" series || Page || mio - || eras |[-cra> || Pm Save Teer Screen rte 2-5Image Works System Function of each button is as follows. (Browser) Browser_[ Click left on the (Browser) button at the top of the Viewer Image Control Panel to leave the Viewer screen and return to the Browser window, while leaving the Viewer application active. (Film Composer) Film Composer] Click left on this button to display the Film Composer menu which allows you to either to call up the Film Composer window, or to print the current page, a Multi Image Display (MID), or the current series. (Paging) Paging _{ This allows you to prescribe movie loop. (Compare) Compare | This button is used to enter the Compare mode, which allows. viewing of several series independently on the Viewer. (Image Analysis) Image This button allows you to enter Reformat or Add/Sub function. Analysis (Presets) Presets The Presets W/L function allows you to select one of six preset windowing Width/Level settings. (Exam, Series, Image) next/prior Exam [2] [] These buttons allow you to go directly to the next or previous exam or series in the Browser lists without having to return to the Browser Series [=] and then re-open the Viewer screen. Click on either (-) or (+) button image C2] [E] 10 90to previous or next exam series or image, respectively. Note: If you have moved down to the last series in the exam and you then lick left on the down arrow button, the Viewer automatically “loops around’ to the first series in the same exam. Likewise, if you are in the first series in the exam and you click left on the up arrow button, the Viewer automatically “loops around’ to the last series in the same exam 2-6Image Works System Image slider [CERT You can also use Image slider to go through images forward or * backward by sliding it right or left. Zoom slider Zoom: 1.8 This slider allows you to zoom an image by sliding it right or let. Magnifying glass a Click left on the magnifying glass button to use the | button to activate the magnifying glass (a movable square region on the View which provides 2X magnification) Scroll ‘ Click left on the image scroll button to use the right mouse button for N) | image seroling. Rectangular Matte Rect. | Use this button to eliminate certain area of an image other than the Matte | designated rectangular area. Grid Use this button to put a grid on an image. The grid interval is adjusted in the User Prefs icon. 2-7Image Works System Annotation A This button allows you to put an annotation on an image. Eraser 8 This button allows you to erase a certain selected annotation on an image. (Erase All) Erase | This button allows you to erase all graphics and annotations on all All| images. (Hide / Show) This button allows you to temporarily hide any kind of graphics or annotations on an image. Once graphics or annotations are hidden, the button turns to (Show). Click on it to show graphics or annotations again. Hide (Measure) This button allows you to create and edit graphical and text Measure | annotations for some measurments. (Format) ‘The Format function is used to select the number of sequential Format _] images in a series to be displayed on the image display area. This button provides eight options of display format. Default format for Viewer is four on one and one on one for Miniviewer. (Image Enhance) image { This button allows you to put enhancing filter on an image and it also Enhance allows you to enhance a gray scale. 2-8Image Works System (Reference Image) Relerence| This button allows you to display a Scout image in the lower right image. | corner that shows a line indicating axial location. Hl (Display Normal) Display | This button allows you to restore a normal display of an image. Normal (Flip/Rotate) Use this button to flip or rotate an image. Flip/Rotate| ame f (Film Series) Film This button allows you to print all or some of the current series on a Series | film. (Film Page) Film This button allows you to print all images currently displayed in the Page | Viewer. (Film MID) im This button allows you to print Multiple Image Display on a film. MID 2-9Image Works System (Save Screen) Save This button is used to save a manipulated image as a new series in Screen | the current exam, (User Prefs) User {Click left on this button to open the Preferences command window Prefs_| which is used to custom-set the following functions: Amount of annotation (on the screen and on film), Function of right mouse button (scroll or magnifying glass) Scales ("tick marks”) on views shown or hidden 2 Changing preset W/L values Command Accelerator [1 The keyboara-controtied command accelerator field allows you to Perform certain functions rapidly by typing commands on the keyboard followed by pressing the Enter key. To enter a command, first activate the command accelerator field by moving the mouse pointer inside it and clicking left, then type the command and press the Enter key. ‘To open an on-screen list of all the commands, type ? in this field and press the Enter key. Use the {Scroll Bar} on the right side of the list to move up and down init. To close the list, click left on the (Cancel) button at the bottom of the list. Note: Instead of closing the list and then typing the desired command manually from the keyboard, you can have the command entered automatically by clicking left on it. The list closes and the command appears in the command accelerator field. Type the desired parameters (if any) from the keyboard, then press the Enter key. 2-10Image Works System Atable of available commands is given below. COMMAND. ‘ABBR, DESCRIPTION 7 [open a list of those commands with abbrevia- tions and descriptions MOVIE LOOP COMMANDS ees [erate eee eo a an Te paging_interval ci ‘set interval between cine loop frames ( images, 2=every second image.eto) paging pa |runacine loop with given range (image numbers) and rate (frames per second) EXAM/SERIES SELECTION next_exam Te | goto next examin Browser Text_series 7S [goto next series in Browser previous_exam pe | goto previous exam in Browser previous_series PS | got previous series in Browser ANNOTATION LEVEL, annotation_none ‘an ___| display no annotations ‘annotation_partial ‘ap __| display partial annotations: ‘annotation full at ‘display full annotations film_annotation_none [fan___ [no annotations on film film_annotation_partial fap __| partial annotations on fim film_annotation_full faf___ | full annotations on fim (Continued)Image Works System COMMAND, DESCRIPTION IMAGE MANIPULATION autoft return to autoft zoom factor tip Jef_right fr tip image horizontally tlip_top_botiom {to [fp image veticaly rotate_left a Totate image left by 90 deg rotate_right a Totate image right by 80 deg, normal no [return image to normal orientation and autoft zoom factor scroll =x> scroll image by x and y pels [format fo set display format to speciied number of rows and columns reset is eset to display of images as they were re- Ceived on worksation window level wi | set window level value window _width ww ___|setwindow width value ‘zoom 70 [setzoom factor invert inv [inverse video ‘COMMAND ABBR DESCRIPTION GRAPHICS arr oross_ret s/ or eter to "Cross reference Mode” = -interval cross_ref_off Roxr | No cross reference for designated image Teport_cursor 6 make report cursor graphics Scout image of series X "_X_[Show Scoutimage on reference image tick_marks / jim [turn scalettick mark) on or off FILMING -oee print_page P| capture page fer firing print_series prs __| print selected series text_page_exam te ‘open Scan data text page with exam informa: tion [iext_page_series is ‘open scan data text page with series informa: tion 2-12Image Works System COMMAND DESCRIPTION MISCELLANEOUS mouse_mode / ‘set right mouse button mode to scroll or mag: ritying glass quit ‘quit Viewer or Mini Viewer ‘save state 38 [store save data parameters for images from first image to last one si ‘select specified image as primary select_mage ‘sel_image_of_interest ‘elect specified image as primary and displayit (on top left view 2-13Image Works System Blank pageCHAPTER 3 Image Works System Selecting, Sorting and Displaying Images Overview Now that you have a general understanding about how the Image Works operates, you are ready to begin displaying images. In this section, we provide step-by-step instructions to guide you as you select, sort, and display images. Topics covered include Selecting the exams, series, and images you want o display from the Browser lists, Calling up the Viewer or Mini Viewer application for image display, <2. Paging through displayed images - manually or using a movie loop, Sorting images according to echo sequence, location, image number, date of scan, trigger, or patient name (vs. scan order), and then displaying them in that order, and @_ Removing images from your system disk. Selecting and Sorting Images When selecting images for display, you will be working from the Browser window. This Browser window is displayed automatically when you log onto the Image Works. You will note that, in the Examinations list of the Browser, exams without patient names are displayed as no-name-xxx. The xxx is a numerical suffix the workstation applies to distinguish different exams. In the Series list, both MR and CT series show the series number, total number of images, scanning range, and type of series (prospective, retrospective, etc.). In addition, CT images indicate reference, while MR images show the acquisition plane and pulse sequence used. In both the Series and Image lists, pertinent data acquisition parameters are displayed. These parameters are annotated in the same way that they are on the CT HiLight or HiSpeed Advantage and MR Signa Advantage systems. When you enter the Browser, the workstation automatically highlights (selects) the first exam in the list, the first series of that exam, and the first image of that series. 3-1Image Works System Procedure: Selecting Images for Display 3-2 To select a new exam, place the cursor on the exam of your choice. Then click ‘once with the left mouse button. The series list displays a list of series within the newly selected exam, Place your cursor on the series of your choice; click once with the left mouse button to highlight it The third list gives the images within the selected exam and series. Using the left mouse button, click on the image you would like to display. 'f the currently highlighted options are not the ones you would like to display, you can scroll through the listed exams, series and images to find another selection, using the{seroll bars}. Lp] \Image Works Works Procedure: Multiple Selection Note: Multiple selection of exams, series and images on the Browser is useful for item management (Remove, Archive Save, Network Push, etc.) whereas multiple selection of images can also be used to select a reduced group of images in a series to be used by the viewing application. ‘To select more than one exam, hold the Control key down and click the left mouse button on each exam you wish to select. The same procedure can be used to select multiple series or multiple images. To deselect a previously selected item, again hold the Control key down and click the left mouse button on the item you wish to deselect. Ifyou select multiple exams or multiple series, the list of their components (series or images) will not be displayed in the Browser. For example, if multiple exams are selected in the Browser, the series and image list displays will appear empty. Selection of a new item with the left mouse button will reset the current selection. For example, if more than one exam is currently selected and you click the left mouse button on an exam (without pressing the Control key), that exam will be the only one selected. You can select a sequential range of exams, series or images using the Shift key. To do so, select the first item you desire (click on the item with the left mouse button). Next move the cursor to the last item you wish to select. Hold the Shift key down and click the left mouse button. All the items between the first and last items that you selected are now highlighted (selected). rr, another way to select a sequential range of items is to press and hold left on the first desired item, drag to the last desired item, and release the left mouse button. 3-3Image Works System Procedure: Selecting All Exams, Series or Images To select all the images, series or exams in the Browser, follow this procedure: ‘Selection Click left on the Selection menu in the Browser menu bar. Seiectal eaminatons | Select one of the following three options: lessrrenes [Select all examinations] selects all the examinations in the list, | Setect images [Select all series] selects all the series in the currently Select actives exams | Selected exam, — | Cnarivedoand [Select all images] selects all the images in the currently selected exam and series. [Select archived exams] selects all archived exams that are marked with "Y (Yes)” [Select unarchived exams] selects all unarchived exams that are marked with “N (No)" Note: Archive status “U (Unknown)" is reported when that exam originates from other station, Sorting Examinations and Images [son For ease of access, you can sort examinations by exam number, patient name, date and modality(CT or MR). ‘Sor examinations by exam number [ Son examinations by patient name Images appear in the Browser lists (by default) by increasing image number. Most of the time, that is probably the way you will want them sorted. ‘Sor examinations, by date ‘Sort examinations by modality ‘Sor examinations by archive status ‘Sor images by But there may be exceptions. For instance, with MR images, you might want to display a sequence of all second echo images in a given series. The workstation can do that for you, sorting and displaying MR images in order of echo. szeserunte_| Note: This option is only available for MR images with more than Sen mages by one echo. See your MR product manual for a detailed = — description of sorting by echo vs. sorting by scan sequence. on images | —_ TF tis also possible to sort MR images by trigger dolay. roger ‘Sot images by scan time, 3-4Image Works Works Procedure: Sorting Examinations By Exam Number, Patient Name, Dat, Modality or Archive status. To sort examinations by examination number, patient name, date and modality, ‘follow this procedure: Click Jeft on the Sort menu in the Browser menu bar. Te eras Select one of the following four options: [Erecomnanber “Soteramnaions | [Sort examinations by exam number] sorts entries in the by patentneme__} Examinations list of the Browser in the order of the examination numbers in the first column in the Browser list. ‘Sor examinations by date Sort examinations by modality Sort examinations Dy archive status [Sort examinations by patient name] sorts entries in the Examinations list of the Browser by alphabetical order of patient names. This is the default sort mode for the Examinations list when the Browser is first activated, [Sort examinations by date] sorts entries in the Examinations list of the Browser in reverse chronological order according to exam starting time and date, [Sort examinations by modality] sorts entries in the Examinations list of the Browser by CT or MR. [Sort examinations by archive status] sorts entries in the Examinations list of the Browser by archive status. (Yes) indicates that examination is archived. N(No) indicates that examination is not archived. U(Unknown) indicates whether that examination is archived is unknown since the examination originates from other station. Click Jeft on one of these four options. 3-5Image Works System Procedure: Sorting Images by Number, Location, Echo, Trigger Delay or Scan Time First select the series of which images you wish to sort. [Sor +) Then click left on the Sort menu in the Browser menu bar. ‘Sotimagesby —) [Sort images by echo] (MR series only) sorts images in an MR image number series by increasing echo number, then increasing image number. All | Senimagesy | first echos are listed first, second echos listed next, etc. [Serragesty Son mages Dy thgger Sonmageny | [Sort images by image number] sorts images in the series by Scantme.”___| increasing image number. This is the default sort mode when a series is first selected on the Browser. [Sort images by trigger] (MR series only) sorts images in an MR series by trigger delay. [Sort images by location] sorts images in the series by increasing location, [Sort Images by scan time] sorts images in the series by scan time. Click left on one of these two (or four for MR series) options. Once you select an image sorting mode and open the Viewer or a Mini Viewer, that Viewer or Mini Viewer displays images in that order only. In other words, when you open a Viewer or Mini Viewer, itis locked into the current sort mode. When you need to return to the default sort mode, go back to Sort menu, then select [Sort images by image number] again. You may then re-open the Viewer or open another Mini Viewer. The series will now be sorted (and displayed) by image number.Image Works Works Displaying Images Using the Viewer Once you have chosen the desired exam, series and image on the Browser, you can use either the Viewer or a Mini Viewer to display the images. ami ‘Once the Viewer has come up on the screen, you can select the desired display format by clicking left on the Format button in the image control panel and then clicking left on the desired format from the eight options in the drop-down menu. Note: You can also use the keyboard to obtain other display formats, by means of the format command in the command accelerator field. Type format followed by the number of rows and the number of columns, separated by spaces, then press the Enter key. Note: The annotation level is automatically reduced when the selected display format does not allow space for full annotation. If all available annotation is not visible when you're viewing images, changing to a larger display format allows you to obtain more annotation. Displaying Sorted Images Once you have started the Viewer, you can display and page through these sorted images, using the methods described earlier. Paging through Displayed Images Once you have opened the Viewer and selected a format with one or more displayed images, the workstation allows you to page through the series of displayed images. You can page backward or forward by clicking left on the left-arrow and right-arrow buttons in the image paging control panel (in the center of the image control panel), by using the {scroll bar} or by using the Prior /Next keys on the keyboard. 3-7Image Works System 3-8 Paging Button Paging | You can open the cine loop control panel window by clicking left on the (Paging) button located at the upper left of the image control Panel. A sequential “projection” of a selected range of images in the Series at a speed of up to 30 images (frames) per second can be set up and executed using the cine loop control panel. Paging swat ([] ROO End go FPS kKt_a Z] tempore — [A] Spat Select Series Cancel ‘The various buttons and controls in this control panel are described below: ‘Start slider This slider allows you to choose the first image in the series for paging, Clicking left on the right or left arrow increases or decreases the number, respectively. End slider This slider allows you to choose the last image in the series for paging. Clicking left on the right or left arrow increases or decreases the number, respectively. FPS slider This slider allows you to set the desired movie frame rate. Hold left on the slider and drag left or right to the desired rate in frames per ‘second. This can be done prior to or during loop execution. Note: If you leave the speed slider on 0, it wll go to 10 images/second by default upon loop start-up.Image Works Works Spatial Button Click left on this button to obtain a repeating cine loop from front to back, then back to front. An image set consisting of four images, for example, appears in the following order: 1, 2, 3, 4, 4, 3, 2, 1, et. Click left on this button to obtain this type of movie loop. Temporal Button Click left on this button to obtain a continuous cine loop. For example, an image set consisting of four images appears in the following order: 1, 2, 3, 4, 1, 2, 3, 4 etc. Click left on this button to obtain this type of movie loop. GO! Button This button allows you to start the cine loop prescribed by the settings of the above-mentioned controls, Click left on this button to start the cine loop. Before the cine loop starts running at the selected rate, there is a time delay while the workstation loads the sequence of images. Note: In the case of multiple image format display of a single series, the cine loop always appears in the upper left view. When the cine loop is running, an fps field appears on the left of the fps slider. It provides the true cine loop rate in frames per second, which may be less than the speed selected with the fps slider. Note Select Series Button This button allows you to select another series for paging, Cancel Button This button allows you to exit from paging. 3-9Image Works System Closing the Viewer or a Mini Viewer When you are finished working with an image, and you would like to close the Viewer or Mini Viewer, follow the appropriate procedure below: Procedure: Closing the Viewer prior to selecting another series Click left on the (Browser) button in the lower left corner of the Viewer screen. ‘The workstation iconifies the Viewer application and returns you to the Browser. Procedure: Closing a Mini Viewer Click left on the (Quit) button in the lower right corner of the Mini Viewer window. ‘The workstation quits the Mini Viewer application. 3-10Image Works Works Deleting Images from Image Disk Occasionally, you may want to remove an image, series, or entire exam from the image disk to make room for others. In this section, we describe how you can do this using the Remove menu (located on the Browser menu bar). Note: Once you have deleted an exam, series, or image from disk, itis gone forever. Use care in making your decisions. It is recommended that you not delete images which have been networked or filmed until you verify that these tasks have been successfully completed. Procedure: Removing Images, Series, or Exams First select the exam, series, or image you want to remove using the left mouse button to click on the desired selection to highlight it, Click and hold left on the Remove menu. A pull-down menu appears. This menu is for making your delete request. Do you want to delete images from the workstation disk by exam, by series, or by image? Drag the cursor to highlight your selection and release left. The Remove menu title appears in gray and cannot be used if a selected item is in use by the Viewer or a Mini Viewer, if itis being used by a network “Push” operation, or if it is being used by an archiving ‘A confirmation window asks you to verify your selection. To proceed with the delete process, click left on [OK]. Or, to cancel the delete process, click left on [Cancel]. The workstation removes the highlighted item from system disk, and automatically updates the Browser lists. Note: Incase you turn off the main power to the system immediately after removing a great number of images, when you boot up the system next time, there still may be some images unremoved. When you want to remove some 3,000 images, wait at least 5 minutes before turning off the power. It may take around 30 minutes to remove some 18,000 images. To maintain the stability of the system, reboot the system once a day.Image Works System Blank page 3-12CHAPTER 4 ——————____________Image Works System Manipulating Images Overview This section explains how to change the way your images are displayed in the Viewer or a Mini Viewer. Just a few of the possibilities: Scrolling an image around within the Viewer or Mini Viewer, o Using the view selection feature to perform most display functions (window width/level, magnification/reduction, image scroll, etc.) on selected images within a series, without affecting the other images in that series, a Removing user-applied annotation, graphics, min/mag factor, and image orientation functions, using the Display Normal function, a Viewing two series independently on the Viewer (compare mode), a Viewing the cross reference of one series on another within the Viewer. Note: When you apply the image manipulation functions explained in this chapter (Manipulate, Flip, Rotate, Window W/L, etc.) to an image in a movie loop, the system applies them to all the images in the image set. atImage Works System Setting Window Width/Levels (W/L) You can adjust window W/L to control which pixel values are visible in your images, with what degree of contrast, in three ways: a By making a selection from a palette of preset w/l values, By using the middle mouse button to make interactive adjustments, or, By using the keyboard up-, down-, left-, and right-arrow keys. MR Images: ww WL Minimum value ° - 82.767 Maximum value +65 535, +32 767 CT Images: ww wi Minimum value 0 - 82.767 Maximum value +65 535 +32 767 Procedure: Using Preset Selections to Adjust W/L MR Images: CT Images: W/L_Button W/L Value W/L Button W/L Value 1 40/20 Abdomen. 400/40 2 100/50 Head 100/35 3 200/100 Lung 1.000/-700 4 100/500 Mediastinum 350/40 5 2000/1000 Spine 300/35 6 4000/2000 Vertebrae 2.000/350 To change window W/L values using the preset W/L buttons: Presets | Click left on the preset W/L button of your choice. The workstation automatically applies these values to your displayed image(s) ‘Abdomen Head Lung Mediastinum Spine Vertebra 4-2Image Works System Procedure: Using the Mouse to Adjust W/L Interactively Increase lve + a om oe Ss eee 4 Coram] mege co co] Decrease, 4s — tees ae ee ee ’ Decrease level ij iQ} Ls} Le} [A Sec] | Ls JL To use the mouse to change W/L values in an image or group of images on the Viewer or Mini Viewer: Select the view(s) whose windowing you wish to modify. See "View Selection” below. Place your cursor on the view you wish to use as a real-time “monitor” of your windowing changes. Then, using the middle mouse button, press and drag on the image as illustrated above. Note that the cursor changes into the graphic shown above. Release the mouse button once you obtain the values you want. All selected images are updated. Note If you perform windowing with the mouse on an unselected view, all unselected views will be affected by the windowing, and all selected views will NOT be affected. Window/Level sensitivity increases as the cursor moves away from the point where the middle mouse button was depressed. To decrease sensitivity at any point, simply release and re-press the middle mouse button. 4-3Image Works System Procedure: Using Keyboard Arrow Keys to Adjust W/L To adjust W/L using the keyboard arrow keys: Gi To increase width, press the keyboard right-arrow (—>) key, 2 To decrease width, press the keyboard lett-arrow (—) key, 2 To increase level, press the keyboard up-arrow (1). a To decrease level, press the keyboard down-arrow (J) key, Note: Pressing an arrow key briefly provides a single increase/decrease by two, whereas holding an arrow key down continuously provides accelerated increase/decrease until the key is released. Note: The change is first applied to the primary view (blue border) and then propagates to the other selected views when you stop pressing the arrow keys for a few moments. Magnifying Displayed Images Zoom: 1.8 The Image Works allows you to enlarge or reduce the size of your = image(s) using the Viewer or Mini Viewer zoom controls, Note: The zoom factor value displayed above the zoom slider is with respect to the number of pixels in the original image as it arrived on the workstation. Note: When you reduce an image, the workstation automatically reduces the quantity of annotations, if necessary, to avoid overflowing the display area. For example, if all available annotation is not visible when you're viewing a CT scout image, magnifying the image allows you to obtain more annotation When you magnify an image, you can use the cursor to move the image around within its frame, See “Scrolling an Image”, in this chapter. Changing Image Orientation Using the (Flip/Rotate) button in the Viewer or Mini Viewer, you can change the orientation and size of images in the Viewer or a Mini Viewer. Flip/Rotate @ Flipping the image(s) from left to right, or from top to bottom. Rotating the image(s) by 90 degrees, in either a clockwise (right) or counter-clockwise (left) direction Ptelel;Image Works System Scrolling an Image Sometimes an image is not displayed in its entirety, for instance when you have magnified (i.e. zoomed in on) an image ‘Whenever a portion of an image is outside the view, you can scroll the image around in one of two ways: Click left on the image scroll button(paim icon), then scroll the desired image by pressing right on it and dragging (if the image is selected, all selected images will propagate when you release right, whereas if itis not selected, there is no propagation to other images), a While pressing and holding the Shift key on the keyboard, scroll the primary view (blue border) by pressing the keyboard arrow keys corresponding to the desired scrolling direction (when you release the Shift key, the scrolling propagates to all selected images) Note: To scroll on a movie loop, the loop must first be running. View Selection Views can be selected for creation of text or graphical annotations, or for windowing independently of the other images in the series. To select a view, simply click left anywhere on it. Its border becomes blue, and it is called the primary view. Only one view can be the primary view at a time. The primary view (blue border) is the view that receives text or graphical annotations when such annotations are called up from the Draw panel. If you then click left on another view, it in turn becomes the primary view (blue border) and the previous primary view becomes what is called a secondary view (yellow border) Ifyou successively click left on various images, you will build up a group consisting of secondary views and one primary view. To select a view as primary and deselect all other views, double-click left on the desired view. To select a view as primary and all other views as secondary, triple-click left on the desired view. Procedure: Independent Windowing on Selected Views ‘Once you have selected the desired views as described above, you can perform windowing with the middle mouse button as described above in “Procedure: Using the Mouse to Adjust W/L Interactively” above. Only the selected views will be affected by your windowing adjustments. 45Image Works System Returning an Image to Normal Display The workstation allows you to restore normal image orientation and autofit zoom factor following orientation and zoom operations. isplay [This is done by clicking left on the (Display Normal) button Normal | Saving a Manipulated Set of Selected Images Once you have manipulated or analyzed an image, you can save it in its updated form. ‘When you do so, the selected image is stored in a new series in the same. ‘examination and is listed in the Browser with the same series number but with SSAVE marked in the Type column of the Series list. sae This is done by selecting the desired image as primary (blue border), Screen _] and then clicking left on the (Screen Save) button. The new Series/image will be available on the Browser within a short time. Note: If you subsequently save another image from the same original series, it is added to the end of the existing “SSAVE” series, and the value inthe Imgs column for the existing series increments by one. Magnifying Glass The magnifying glass function provides a moveable square zone on a view in the Viewer or Mini Viewer which gives a 2X magnification of the view. ‘There are two ways to activate the magnifying glass: Move the mouse pointer to the part of the view you're interested in, and press and hold the Shift key on the keyboard, then activate the magnifying glass by Pressing the middle mouse button (to deactivate magnifying glass, release Shift key and middle mouse button) or, ce Ifthe magnifying glass button is not already activated, click left on it, then move the mouse pointer to the part of the view you're _ interested in, and activate the magnifying glass by pressing the tight mouse button (to deactivate magnifying glass, release right mouse button).Image Works System Changing Custom Viewing Settings User Profs The following functions can be customized via the (User Prefs) button: a Amount of annotation (on the screen and on film), Function of right mouse button: image scrolling or magnifying glass, Tick marks on views shown or hidden, o Grid preference setting Series binding On/Off ‘Square viewports On/Oft | Changing preset W/L names and values. ooog Click left on the (User Prefs) button in the Viewer or Mini Viewer to open the ‘command window which gives access to these functions. nena “Tek Marks ight mouse button ‘Screen Film © Shown © Scrolling Hidden | Magnify glass No annotation QNo annotation © Partial annotation © Partial annotation © Full annotation © Full annotation Grid Prefs Series binding © Custom annotation} | © Custom annotatior 7 ‘© Series binding ON Leaid © Series binding OFF} Customize Customize Square viewport Presets © Square viewports On Modality CTs] © Sauate viewport Of to wividin —__wievel icone (00 at cet [Head [100 [1059-__Set current ong [000 —— aor —— “Set current [edasinan—— 350. os ——~ “setae {Sane [300 —— [1055 —— “Seteurrent Apply ‘Save as defautts| Cancel 47Image Works System Annotation level This part of the command window allows you to set the amount of medical annotation information on the screen and on film Click left on (No annotation), (Partial annotation), or (Full annotation) under the Screen heading to set the amount of annotation on screen. Do the same under the Film heading to set the amount of annotation on film You can also customize annotations for your own site.Click left on (Customize) icon, then the following menu opens. Select your own choices and click on (OK). ‘You can access those annotations by selecting (Custom annotation). Customize hospital Patient Patient id esi ‘scan time scan geometry top bottom 10. left 11. right \W. Windowing G. Graphic results SeNogRena oooooooo00000 Ok Cancel Right mouse button This part of the command window allows you to customize the use of the right mouse button on views. Click left on (Scrolling) to use the right mouse button for image scrolling. This is the standard use for the right mouse button. See “Scrolling an Image Around” above in this chapter. Click left on (Magnify glass) to use the right mouse button to activate the magnifying glass. See "Magnifying Glass” above in this chapter. Tick marks This part of the command window allows you to turn the on-view tick marks on or off. Click left on (Shown) to turn on the tick marks, or on (Hidden) to turn them off 4-8Image Works System Grid Prefs This part of the command window allows you to view the grid setteing. Click left on (View) to look at the grid. Series binding This part of the command window allows you to turn the series: binding on or off. Click left on (Series binding ON) to activate the function, or on (Series binding OFF) to deactivate it. Presets This part of the command window allows you to custom-set the six wil preset buttons in the Viewer or Mini Viewer. First, click left on the (Modality) button and select [CT] or [MR] from the list that pops up, according to which modality you wish to custom-set. To store the current w/l values being used by the primary view in the Viewer or Mini Viewer (the view with a blue border), click left on the (Set current) button corresponding to the preset button desired. The w/width and w/level fields change to the values used by the primary view. To enter a w/width or w/level value manually, move the mouse cursor into the field you want to change, double-click left to select it and enter the numeric value you want from the keyboard, To change a preset button title that will appear on the Viewer or Mini Viewer, move the mouse cursor into the title field you want to change, double-click lef to select it and enter the alphanumeric title you want from the keyboard. 4-9Image Works System (Apply) vs. (Save as defaults) vs. (Cancel) buttons 4-10 Once you have set everything in the command window as you want, you can make use of your new settings in one of three possible ways: Click [eft on the (Apply) button to apply the new settings ONLY to the Viewer or Mini Viewer from which you called up the command window. In this case, the new settings are enabled only for that Viewer or Mini Viewer, and only until you quit that Viewer or Mini Viewer. The new settings are not saved for any future use of the the Viewer or Mini Viewers. Click left on the (Save as defaults) button to replace the old stored settings with the new settings. In this case, your new settings will be used as default values by all uses of the Viewer or Mini Viewer. J Click left on the (Cancel) button to completely discard your new settings. In all three cases given above, the command window is closed as soon as you lick on the buttonImage Works System Comparing two Series (VIEWER ONLY) To set up the compare mode, which allows you to view any two series independently on the Viewer, proceed as follows: 3 Select the desired first set of image(s) on the Browser and open the Viewer normally, Click left on the (Compare) button in the Viewer. The Browser window re-appears, 3 Select the desired second set of image(s) on the Browser and click left on the (Viewer) button. The Viewer screen returns with the compare mode activated, When the compare mode is activated, the Viewer displays the two selected series. Click left on the desired format button in the upper left corner of the Viewer screen: either one or two images can be displayed from each series, and the two series can be displayed side by side or one above the other. Note: A separate set of image scroll (Prior/Next) buttons appears at the bottom of the Viewer for each of the two series. However, the Page Up and Page Down keys on the keyboard affect both series simultaneously. To quit the compare mode, click left on the (Cancel Compare) button at the bottom of the Viewer. The Viewer returns to normal operation with the first series displayed, 4-11Image Works System Cross Reference Mode The Viewer or a Mini Viewer can be set up to display cross reference lines on a view which represent the slices in a different series. Note: Cross reference lines may overlap annotations. For this reason, when filming, it is recommended to film the reference view twice: once with cross reference deactivated and once with it activated. For the Viewer, there are two ways to set up cross reference lines, depending on whether the compare mode is activated. The following two sections describe these two cases. Cross Reference in Compare Mode (VIEWER ONLY) Once you have set up the Viewer in compare mode (see “Comparing two Series (VIEWER ONLY)" above), you can activate the cross reference mode as follows: a Choose the view on which you would like to display cross reference lines. Select this view as the primary view (blue border) by clicking left on it, a Type the command xr on the keyboard and press Enter. The cross reference lines appear on the primary view. They are numbered according to the slice numbers of the corresponding series, a To view a particular slice represented by a cross reference line on the primary view, click left on that line; the corresponding slice appears on the part of the Viewer displaying the corresponding series. To deactivate the cross reference mode, type the command noxr on the keyboard and press Enter. The cross reference lines disappear. 4-12Image Works System Cross Reference Not in Compare Mode When using the Viewer without the compare mode (i.e. when using the Viewer normally) or a Mini Viewer, you can activate the cross reference mode as follows: Choose the view on which you would like to display cross reference lines. Select the view as the primary view (blue border) by clicking left on it, Type the command: xr s/-: where is the desired series number as displayed on the Browser, is the first image number in the range, is the last image number in the range, and is the increment between cross referenced images represented. Press Enter to validate the command. The cross reference lines appear on the primary view. They are numbered according to the slice numbers of the corresponding series. To deactivate the cross reference mode, type the command noxr on the keyboard and press Enter For example: xrs3 activates the cross reference mode with series no. 3 (all images, interval of one image), or xr $3/10-60:5 activates the cross reference mode with series no. 3, from image no. 10 to image no. 60, at and interval of 5 images. 4-13Blank page Image Works SystemImage Works System CHAPTER 5 Annotating Images Overview You will work with two kinds of annotation on the Image Works Workstation: the information which the workstation provides about exams, series, and images, and the annotation that you add to images. This section discusses both types of annotation, including: @ How to add your own annotation to an image, and 3 How to remove annotation temporarily (i.e. hide it), so that you can view an image more clearly, a How to remove annotation permanently. Understanding Annotation Much of the annotation on both CT and MR images is self-explanatory: data identifying the patient, hospital, physician(s), and image parameters. See your CT ‘or MR product manual for an explanation of the abbreviations used in image annotation. Note: If the caret ( *) character is entered into the patient name field on the medical imaging system, itis replaced with a space on the Image Works workstation, 5-1Image Works System Adding User Annotation The Image Works allows you to add your own annotations, for example comments or observations, to an image to draw attention to a specific region of anatomy, By using this user annotation capability, you can add multiple areas of annotation to an image and then delete that annotation later, if you choose. An annotation can also include an on-screen arrow for pointing out specific structures, Procedure: Adding User Annotation 5-2 Select the image onto which you want to add annotation by clicking left on it (it becomes the primary view and has a red border around it A | Sisk letten the (A) button in the Viewer or Mini Viewer. A white box and arrow graphic appear on the selected image. oO The box graphic provides the field for entering text, while the arrow allows you to Point out a specific structure, You are ready to begin entering the text for your annotation. To do so, first move the mouse pointer onto the view and type the text from the keyboard. Note: The mouse pointer MUST stay on the view for the duration of annotation text entry. As you type, the box expands to accommodate the text.Image Works System You can start a new line of text by pressing the Enter key. ~ os ~ ae - [Reweanpetd| thasis the and line To move the box and/or arrow after entering your annotation, follow the procedure given below. Click and hold left on the annotation and drag it to the new location. Release the mouse button to deposit the box. The arrow's stem rotates and changes in length (‘rubber band” effect) as it follows the annotation, while its point remains in its original location. 5-3Image Works System To move the arrow's point, click and hold left on it. Then drag it across the image Lunti it is pointing at the structure that you are interested in. Release the mouse button to deposit the point in its new location, Note: If you want a freestanding text annotation, without an arrow, press and hold left on the arrows point and drag it into the box. When you release the mouse button, the arrow is no longer visible. ‘When you have finished adding your annotation and positioning it, you can deselect it by pointing outside it and clicking left. The box disappears and the entire annotation turns brown. 5-4Image Works System Procedure: Deleting User Annotation Once you have added annotation, you can then remove it as follows: Click left on the annotation that you wish to remove. The entire annotation becomes red and the box reappears around the text. Click left on the eraser button in the Draw panel of the Viewer or Qa | Mini Viower. The selected annotation disappears Procedure: Deleting All User Annotation You can also remove ALL added annotation from ALL images: Erase | Click left on the (Erase all) button in the Viewer or Mini Viewer. All All annotations disappear from all images. Removing and Restoring Image Annotation You can remove image annotation temporarily by clicking left on the Hide (Hide) button. All annotations and graphics disappear from the image and the (Hide) button becomes the (Show) button. To restore hidden annotations and graphics to the image, click left on the (Show) button. All hidden annotations and graphics are restored to the image and the (Show) button again becomes the (Hide) button. Duplicating User Annotation If you need to repeat the same user annotation in several places, you can do so as follows: 2. Click left on the annotation that you wish to duplicate. It becomes red and the box reappears around the text, 1 Select the desired target view for the duplicate annotation by clicking left on it (the target view can be any view in the Viewer or in any Mini Viewer), 5-5Image Works System Blank pageCHAPTER 6 Image Works System Analyzing Images Overview ‘Sometimes it is important to know exact measurements; for instance, the distance between two points on an image, the size of an angle, or the area of a particular region of interest. The Image Works allows you to analyze images in a variety of ways to obtain the measurements you need. Your options include: Defining a Region of Interest (ROI), o Measuring the area, mean, standard deviation, and minimum and maximum pixel values within an ROI, a Measuring the distance between two points, a Measuring an angle, a Measuring the pixel intensity value at a specific point on the image, a Removing and restoring image graphics, a Duplicating image graphics. Note ROI, distance and angle measurements are ONLY possible if the viewing format is 2 x 2 or less for the Viewer, and 1 x 1 for the Mini Viewer. Note that once you have analyzed an image, you can save it under a new heading. Each graphic on a view is assigned a number. This number also appears to the lett ofits statistics data (distance, area, mean, etc.) in the lower right corner of the view. In this way, several graphics can be defined on a view and the statistics of each one can be easily distinguished from the others. Note: The black background outside the reconstruction circle of CT images uses a value of -1024 for all calculations. 6-1Image Works System Drawing Graphics ‘To draw a graphic on a view, first select the view as primary by clicking left anywhere on it Measure | lick left on the (Measure) button in the Viewer or Mini Viewer, then click left on one of the seven graphic buttons (straight line distance, angle, rectangular area, smooth curve area, free draw area, or [t F ellipse area). The corresponding default graphic appears in'blue on AI A the view, and its statistics appear in the lower right corner of the =] view. Report Cursor sc To obtain a report cursor on the selected view, click left on the 6-2 3% corresponding button in the Draw panel. The report cursor appears as an "X” symbol in the center of the view. In the upper left corner of the view the pixel value (V), and the anatomical coordinates (Left, Right, Superior, Inferior, Anterior and Posterior) in mm, corresponding to the current position of the report cursor, are displayed. To move the report cursor, click and hold left on it and drag it to the desired Position. The V and anatomical coordinate values in the upper right corner of the view are updated in real time. Note: Regardless of the zoom factor being used to view images, report cursor information is calculated based on the pixel from the original, UNZOOMED image data as they arrived on the Image Works workstationImage Works System Straight Line Distance . | To obtain a straight line distance graphic on the selected view, click axl lett on the corresponding button in the Draw panel. x, To resize the line, drag left on either endpoint (box) to move it. The other endpoint stays fixed and the segment resizes as you drag (rubber band). The statistics data for the straight line appear in the lower right corner of the view and include distance in mm and angle in degrees of the line with respect to the vertical axis. Note: See “Accuracy of On-View Measurements” below in this chapter for information about measurement accuracy. To move the entire line without resizing, drag left anywhere on it except the endpoints to move it. Angle To obtain an angle graphic on the selected view, click left on the corresponding button in the Draw panel To resize the angle, drag left on any one of the three points (boxes) 1+. defining the angle to move it. The other two points stay fixed and the ‘% segment(s) of the angle resize as you drag (rubber band) ‘The statistics data for the angle appear in the lower right corner of the view and include the angle in degrees. Note See “Accuracy of On-View Measurements" below in this chapter for information about measurement accuracy. ‘To move the entire angle without resizing, drag left anywhere on it except the three defining points to move it. 6-3Image Works System Rectangle Area g To obtain a rectangle area graphic on the selected view, click left on % the corresponding button in the Draw panel. [7 To resize the rectangle, drag left on one of the four comer points t |, (boxes) of the rectangle to move it. The other three points stay fixed + "ty and the rectangle resizes as you drag (rubber band) The statistics data for the rectangle appear in the lower right corner of the view and include: @ Minimum and maximum pixel values [MIN, MAX] within the rectangle, @ Mean pixel value (‘mean’) within the rectangle, Standard deviation ('sd’) of the pixel values within the rectangle (this provides a measure of variability according to pixel values), Q Area (‘area’) enclosed by the rectangle, in mm2. To rotate the rectangle, drag left on one of the its four rotation points SJ.) (Small dashes located inthe middle of each side). , Note: The ROI area measurement can vary by up to 5% as a result of this rotation, T 2 1 _ To move the rectangle, drag left on the rectangle’s center point +4 (small “+” symbol located at the center of the rectangle) or anywhere on the sides of the rectangle except its four corner points and four rotation points. 6-4Image Works System Smooth Curve Area { To obtain a smooth curve area graphic on the selected view, click lett Sy, onithe corresponding button in the Draw panel This graphic appears initially with one point (box). To add a point to the end of the curve, move the mouse pointer to the desired location for the new point (it must NOT be on the curve), hold down the Shift key and click lef. ‘To add a point between two existing points on the curve, move the mouse pointer to the desired location for the new point (it must be ON the curve), hold down the Shift key and click left. ? To move a point on the smooth curve, drag left on it. All other points LZ stay in their original position and the curve resizes as you drag x Note: To close the endpoints of a smooth curve, first add the last point near (but not on top of) the first point, then move it on top of the first point. The statistics data for the smooth curve appear in the lower right corer of the view and include: 3 Minimum and maximum pixel values [MIN, MAX] within the smooth curve, | Mean pixel value (‘mean’) within the smooth curve, Standard deviation (‘sd’) of the pixel values within the smooth curve (this provides a measure of variability according to pixel values), @ Area (‘area’) enclosed by the smooth curve, in mm, To move the smooth curve, drag left anywhere on it except the points (boxes). To delete a point on the smooth curve, while holding down the Shift key, click left on the point to be deleted. 6-5Image Works System Ellipse Area To obtain an ellipse area graphic on the selected view, click left on \ the corresponding button in the Draw panel. To resize the ellipse, drag left on one of the four boxes just outside the ellipse. The ellipse resizes as you drag (rubber band) ‘The statistics data for the ellipse appear in the lower right corner of the view and include: a Minimum and maximum pixel values (MIN, MAX] within the ellipse, @ Mean pixel value (‘mean’) within the ellipse, @ Standard deviation (‘sd’) of the pixel values within the ellipse (this provides a ‘measure of variability according to pixel values), 1 Area (‘area’) enclosed by the ellipse, in mm2, To rotate the ellipse, drag left on one of its four rotation points (small dashes located in the middle of each side) to rotate the ellipse. Note: The ROI area measurement can vary by up to 5% as a result of this rotation. To move the ellipse, drag left on the its center point (small “+” symbol located at the center of the ellipse) or anywhere on the sides of the ellipse to move the ellipse.Image Works System Free Draw Area =| To obtain a free drawn area graphic on the selected view, click left on the corresponding button in the Draw panel. The graphic appears initially with one point (box). Drag left on this box to move it to the desired starting point. To start drawing, while holding down the Shift key, drag left on the box. Or, to define a series of segments, while holding down the Shift key, click left on each desired segment endpoint location. To remove the most recently created segment, press the Back Space key. The workstation may take a few moments to delete the segment. The statistics data for the free drawn curve appear in the lower right corner of the view and include: 3 Minimum and maximum pixel values [MIN, MAX] within the free drawn curve, a Mean pixel value (‘mean’) within the free drawn curve, a Standard deviation (‘sd’) of the pixel values within the free drawn curve (this provides a measure of variability according to pixel values), a Area (‘area’) enclosed by the free drawn curve, in mm? To move the free drawn curve, drag left anywhere on itImage Works System Obtaining Measurements Once you place a graphic on a view, the workstation automatically computes the appropriate measurements and statistics and displays them in the lower right corner of the view. The measurements and statistics computed and displayed depend on the type of graphic being used. When you use a report cursor, the workstation computes the pixel intensity value Vand the report cursor's anatomical coordinates. ‘When you use a straight line distance graphic, the workstation computes both the ‘segment's length in mm and the angle the segment creates in relation to the horizontal axis, in degrees. ‘When you use an angle graphic, the workstation computes the size of the defined angle, in degrees. When you use a rectangle, smooth curve, ellipse, or free drawn graphic, the workstation computes the following measurements: @ The AREA enclosed by the graphic in mm2, The MEAN value of the pixels enclosed by the graphic, The minimum and maximum (MIN, MAX] pixel values enclosed by the graphic, The standard deviation (SD) of the pixel values enclosed by the graphic, which Provides a measure of variability according to pixel values. The workstation automatically updates each of these measurements anytime you modify the graphics. Note: When a Screen Save image is being viewed, the report cursor is accompanied by pixel intensity value V only, and all other graphics are accompanied by NO measurements and statistics. 6-8Image Works System Accuracy of On-View Measurements This section provides information about the accuracy of measurements obtained with on-screen graphics. Note: Regardless of the zoom factor being used to view images, region of interest statistics are calculated based on the pixels from the original, UNZOOMED image data as they arrived on the Image Works workstation. Accuracy with straight line distance graphic Measurement accuracy using the straight line distance graphic is equal to the displayed length +/- image pixel size. Accuracy with angle graphic Measurement accuracy using the angle graphic is equal to the displayed angle value +/- 10 degrees for an angle measured between segments which are five times larger than the image pixel size. Accuracy improves as the length of the segments increases. Accuracy with region of interest area graphics ‘Area measurement accuracy using a region of interest graphic (rectangle, smooth curve, ellipse or free draw) is equal to the displayed area value +/- the circumference of the region mutiplied by (image pixel size)? / 2. Mean and standard deviation values for the intensity of the pixels in the region are also affected by this accuracy. Region of interest statistics are based on the pixels INSIDE the graphic defining the region. 6-9Image Works System Removing and Restoring Image Graphics The Image Works workstation allows you to remove image graphics temporarily, or permanently, depending on your needs. Here's how: Procedure: Removing and Restoring Image Graphics 6-10 Erase f you wish to remove graphics from all views temporarily, click left on Hide the (Hide) button. All graphics disappear from all views and the (Hide) button becomes the (Show) button. To restore hidden graphics to all views, click left on the (Show) button. All graphics re-appear on all views and the (Show) button becomes the (Hide) button again { you wish to remove a graphic from the view permanently, select it Bg. by clicking left on it, then click left on the eraser button. Or, press the Cut key on the left side of the keyboard. See “Duplicating Image Graphics” below in this chapter. Note: If you click left on the eraser button without first selecting a graphic object, the report cursor, if there is one, is erased. Or, to remove all graphics from all views permanently, click left on the (Erase all) button in the Draw panel This removes all graphics from all views. (You cannot restore graphics which you have removed via the (Erase all) button.)CHAPTER 7 —_— Image Works System Film Composer Overview The Image Works workstation allows you to send the images you have displayed, analyzed, and manipulated to a laser camera for film output or to a printer for paper output. To do so, your workstation must be linked to an appropriate output device. See your GE Sales Representative and Service Engineer for details. In this chapter, the word “film” or “sheet of film” means either a sheet of film or a sheet of paper, depending on the output device being used. ‘The Image Works workstation gives you a choice of print formats so that you can lay out your images in different ways on each film, depending upon your needs. Your format choices typically include 1x1, 2x2, 2x3, 3x4 and 4x5, although others are possible depending on the type of output device being used. The workstation also allows you to place images from multiple viewing applications (i.e. different Mini Viewers, 3D, Reformat, etc.), and thus multiple studies, on the same film. ‘There are three primary steps to the filming process: setting filming parameters, loading the images, and printing, Setting filming parameters means telling the workstation: a How many images (typically up to twenty) you would like printed on each sheet of film, a How many copies (up to ten) you would like of each film, a Whether you would like to activate printing of your films manually (by clicking on a button) or automatically (as soon as all film frames in the Film Composer are full) Loading simply means displaying your image(s) within one or more viewing applications, and then telling the workstation where you want each image to be placed on the film. Printing is the act of transferring the image(s) onto a sheet of film once you have completed the first two steps. There is also a “Print Series” function available in the Viewer or Mini Viewer. It allows you to set up printing of all or part of the series currently being viewed. See “Print Series Function” later in this chapter. 74Image Works System Laser Camera See the documentation provided by the manufacturer of the laser camera for a description of the parts and controls on this camera and for general operating instructions. Note that there are adjustments you can make on the camera to tailor the. Presentation of your images. These can include density and contrast adjustments, your choice of black or clear for blank frames, and borders between frames. These values are typically set by your GE Service Engineer and are not adjusted during routine filming, Paper Printer 7-2 ‘See the documentation provided by the manufacturer of the paper printer for general operating instructions.Image Works System Activating the Film Composer If you are using the Viewer or a Mini Viewer, activate the Film Composer by clicking left on the (FilmComposer) button in the Viewer or Mini Viewer. The Film Composer window appears in the lower right corner of the monitor. Or, go to the Browser and click left on the (Film) button. Fim Composer S| Laser Camera Options Clear Fel Print Current status is: The print queue is empty. 7-3Image Works System Selecting Output Device Before setting film parameters or composing a film, you must select the desired cutput device (typically a choice between a laser camera and a paper printer) Laser Camera 740 this, press and hold left on the current output device name at 1c the top of the Film Composer window, then select the desired device from the list that pops up. The output device name, as well as the available (Formats) buttons, are updated according to your selection. Note: The output device can be changed when images are loaded in the Film Composer if the currently selected (Formats) button is compatible with the new output device being selected. Setting Filming Parameters Format The film format is set by clicking left on the desired (Formats) button in the Film Composer window. Note: The available formats may vary depending on the type of laser imager or printer being used ‘The number of filming frames in the Film Composer is updated according to your choice of format. (For example, the drawing above left shows a3 x 4 film format selected.)Image Works System Options | Next click left on the (Options) button in the Film Composer window. “x! A window entitled “Print options” pops up: Print options | sige format: Greyscate: Auto printing ‘Auto lear page: 5] oe Icon labels: Expose order Trego Ee a [epiBotom Number of copies “1 BH Dane Slide format The Film composer can be set up to produce images in slide format. Slide format: Press and hold left on the (Slide format) button in the Print options ‘of aa | Window and select [On] or [Off] from the list that pops up. ——* Note: If the selected output device does not support the slide format function, this function is not available and the (Slide format) button appears in grey. Greyscale Greyscale: If you want a greyscale printed along the side of every sheet of film, 1 click left on the (Greyscale) button in the Print options window and Of = 1% select [On] from the list that pops up. ‘To deactivate the gray scale, repeat as above, but select [Off] from the list that pops up. Press and hold left on the (Greyscale) button in the Print options window and select [On] or [Off] from the list that pops up. Note: If the selected output device does not support the greyscale function, this function is not available and the (Greyscale) button appears in grey. 7-5Image Works System Auto printing The Film Composer can be set up to print your film automatically as soon as all film frames in it are full ‘Auto printing: Press and hold left on the (Auto printing) button in the Print options off ca | Window and select [On] or [Off] from the list that pops up. — ~ Auto clear page The Film Composer can be set to automatically clear all its film frames immediately following printing, Auto clear page: Press and hold left on the (Auto clear page) button in the Print on ca | OPtions window and select [On] or [Off] from the list that pops up. a — ~ Icon labels Icon labels: Press and hold left on the (Ieon labels) button in the Print options window and select either [E/S/l] or [Image] from the list that pops up to put either Exam/Series/Image number or Image itself, respectively, into the frame. Expose order Expose order: Press and hold left on the (Expose order) button in the Print Left/Right | options window and select [Left/Right, Top/Bottom] or [Right/Left, Top/Bottom 8 Bottom/Top] from the list that pops up. Image =| Number of copies Number of copies: To set the number of copies to be printed of each film, click left on ile the (+) or (-) button to the right of the Number of copies field in the iy Print options window to increase or decrease the number by one, respectively, Or, move the mouse cursor into the field, double click left to select it and enter the desired number from the keyboard. Note: The maximum possible number of copies is 10. Closing the Print options window To close the Print options window, click left on the (Done) button. Done. | The window closes and all the settings in it are enabled.Image Works System Loading Images in the Film Composer This section describes the various ways of loading images onto the Film Composer. Bear in mind that you must perform all image manipulation or analysis functions ‘on these images before filming them. Note: Annotations on filmed images appear according to the film annotation level selected in the User Prefs command window, should filmed annotations overlap or run off the edge of film frames, either reduce the film annotation level or change the film format to accommodate the film annotations. Note: The appearance of images in film frames in the Film Composer is not identical to the appearance of those images in the viewing application. Note: If an image is reduced to a size smaller than the available viewing area on the Viewer or Mini Viewer, and then filmed, itis enlarged so as to completely fil the film slot that it occupies. Caution: Verify that films are acceptable before deleting the images used to produce them. Drag-and-drop image loading When you are ready to load an image being viewed into the Film Composer, move the mouse pointer onto it, press and hold left and drag to the desired available film frame in the Film Composer. Release left to deposit the image. A few seconds later a miniature reproduction of the image appears in the film frame. Repeat this drag-and-drop procedure as many times as you wish to complete the film grid. It is not necessary to fill all the film frames (unless you activated (Auto printing), nor to place images into consecutive frames. Filming keyboard accelerator (F1 key) Instead of dragging and dropping an image into the Film Composer as described above, you can load it by moving the mouse pointer onto it and pressing the 1. function key on the keyboard. The image is placed in the next available film frame in the Film Composer. ‘The advantage of this method is that it can be quicker than dragging and dropping. However, you cannot skip film frames using this method. 7-7Image Works System Page filming keyboard accelerator (F2 key) The page filming feature allows you to load a whole page (i.e. all displayed images in the viewing application) of images into the Film Composer. The Film Composer must be empty before this function can be used. If it isn't, use the (Clear) button in the Film Composer window. See “Clearing the Film Composer” below. Move the mouse pointer onto any image in the viewing application and press the 2 function key on the keyboard. The images are loaded into the frames in the Film Composer in the order in which they are displayed in the viewing application. Note: The viewing application format and Film Composer format must be identical for page filming to function. If they are different when you press 2, the Film Composer automatically changes format to match that of the viewing application. If the viewing application format is unavailable on the Film Composer, a message pops up and informs you of this when you press the F2 key. Note: If you are using the Viewer, you can also activate page filming by clicking {eft on the (Capture Page ) button in the lower left corner of the monitor. MID filming keyboard accelerator (F3 key) 7-8 Multi Image Display (MID) filming allows you to put the entire displayed image content of the viewing application into one film frame in the Film Composer. Note: Since all the displayed images are placed into a single film frame in the Film Composer, the resolution of an MID film is not as good as the resolution obtained when the same set of images are filmed using page filming, Move the mouse pointer onto any image in the viewing application and press the 3 function key on the keyboard. All the currently displayed images are placed into the next available film frame in the Film Composer. The images are displayed in the frame in the same order as they appear in the viewing application. No changes are made to either the image or user annotation when the images are loaded as an MID frame in the Film Composer. Note: MID frames and single image frames can be freely mixed on the same sheet of film. Note: If you are using the Viewer, you can also perform MID filming by clicking left on the (Film MID ) button in the lower left corner of the monitor.Image Works System Erasing Film Frames To erase the image in a film frame in the Film Composer, click left on it. The message “Do you really want to delete this image" pops up. Click left on (Yes) to erase, or (No) to cancel the erase operation. Printing Images To print the content of the Film Composer, click left on the Print | a Print) button in it The status line at the bottom of the Film Composer changes to “Printing...” and the image data are sent to the print queue. The output device will print your film when your data reach the top of the queue. See “Print Queue" below. Note: This procedure is only necessary if either Auto printing is not activated in the Print options window (see “Auto Printing” above) or you want to print the Film Composer content before its film frames are all ful Clearing the Film Composer Giear | _Toerase all the images in the Film Composer, click left on the (Clear) button in it. The message “Clear the current page” pops up. Glick left on (OK) to proceed with the clear operation, or (Cancel) to abort the clear operation. Note: If Auto clear page is activated in the Print options window (see “Auto clear page” above), the Film Composer is automatically cleared immediately atter printing. 7-9Image Works System Film Composer Status Line The status line at the bottom of the Film Composer keeps you informed of various Conditions in the filming process (print queue empty, printing, film supply low, output device not connected, etc.) Status messages are displayed in different colors depending on their nature: a Green status message indicates a normal condition (e.g. printing), Yellow status message indicates a warning condition (e.g. film supply low), a Red status message indicates a blocking condition (e.g. film tray empty or output device not connected) Some status conditions are accompanied by an arrow button. If you &I click left on this button, a window pops up giving more information about the condition. Whenever the output device status changes (e.g. from idle to active, active to idle, disconnected, etc.) a message is sent to the Messages window. To open this window, click left on the Message Menu on the main Browser. Print Series Function The print series function allows you to set up printing of all or part of the series currently being viewed with the Viewer or Mini Viewer. To do this, proceed as follows: a Select the desired series on the Browser and open the Viewer or a Mini Viewer, Insure that the Film Composer is activated (it does not have to be visible on the screen), Fim Sens] ©P2" the Print Series command window by clicking left on the (Film Series ) button in the Viewer, pressing the E4 function <>} key on the keyboard or typing either print. series or prs in the command accelerator field in the Viewer of Mini Viewer and pressing the Enter key, Fat In the Format box in the Print Series command window, click left on Use Fim Compose the (Use Film Composer) button to print using the currently iewerFomet__ selected format on the Film Composer, which allows you to keep any ~ images already in it, or on the (Viewer Format) button to print using the current Viewer or Mini Viewer format, which requires the Film Composer to be initially empty, ie. cleared, 7-10Image Works System Image Selection In the Image Selection box, hold and drag left on each end of the mF slider to define the range of images in the series to be printed, a) ZX print al images In the Interval box, click left on (Print all images) to print all Nie images in the selected range, (1 / 2) to print every other image Ou only, or (1 / 3) to print every third image only, print Series w 2_ Click left on the (Print Series) button to launch printing, or the _PrintSeries \ " (Glose) button to abandon printing and close the Print Series command window. Close Once you have launched printing, the Current Print Jobs field shows: the status of the job(s) launched. ‘Cancal A | To halt all printing launched from the Print Series command window, rT click left on the (Cancel All) button. Print Series: Format Image Selection © Use Film Composer 19 © Viewer Format 1 9 Interval Current Print Jobs: © Print al images No Current Job oe S13 Cancel All Print Series| Close Note: The Film Composer does not have to be called up or visible on the screen for the Print Series function to operate. 711Image Works System Putting Text Pages on Film You can generate an exam or series text page and send it to the Film Composer for printing. The procedure for doing this is given below: @ Inthe command accelerator field in the Viewer or Mini Viewer, type the command te for exam text page, or ts for series text page (if only certain images in the current series were selected on the Browser for viewing, data {from those images only will appear on the text page) and press Enter. The Text Page command window pops up, Ifthe text page data occupy more than one page, you can scroll through them by clicking left on the up- and down-arrows in the Text Page command window, To send the text page to the next available frame(s) in the Film Composer, click left on the (Film) button in the Text Page command window. Note: Each Film Composer frame containing a text page appears as a stylized black-text-on-white-background page. G To close the Text Page command window, click left on the (Quit) button. At this point you can continue filling the frames of the Film Composer as described above in this chapter; frames containing text are handled in exactly the same way as any other image-containing frame in the Film Composer. 7-12CHAPTER g ——————_________Imege Works Syster_ Networking Overview Networking gives you (or anyone else on your network) the ability to transfer images between workstations and/or medical imaging systems quickly and easily. Note that we use “transfer” as a generic term for moving image data between stations. When we want to be more specific, we say “transmit” or “push” for the action taken when you send images from your station to another; and “receive” or get" for the act of retrieving images from another station onto your station. But there are other advantages as well. For instance, you can routinely off-load display, manipulation, and filming activities from a medical imaging system to the Image Works workstation. This improves the productivity of the medical imaging system. It also eliminates the problems associated with the hand-delivery of films to the people who need to work with them. From the Image Works workstation, you can send examinations, series, and images to, or retrieve them from, other systems on your network. The workstations and imaging systems networked to the Image Works workstation are termed “hosts.” Currently, the Image Works workstation may be networked to CT Advantage-level, Pace, CT9800, Sytec 6000/8000 (Prospeed) and 3000i consoles/products as well as MR Advantage-level and Vectra consoles/products via the GE Medical Systems Network. For more information regarding networking your Image Works products with other medical imaging systems or products, contact your local GE Field Service Engineer. Caution: The workstation will not always inform you if the system has failed to completely transfer all the data requested. Therefore, checking with the source or destination host is recommended to verify that the data transferred successfully. (The system will tell you if the network is active however.) Note: The host names stored in the configuration file of your workstation's computer software are entered by your GE Service Engineer. Consult your GE Service Engineer for your list of hosts and their assigned code names. While the Image Works workstation allows you to remove host names from network memory, use caution when doing so. If you inadvertently delete a host name from your configuration file, only your GE Service Engineer should restore it, Note: Image Works handles Advantage and DICOM image formats. However, there are differences in annotation and Browser list data presentation between these formats. 8-1Image Works System Information Concerning Connection with DICOM Equipment When a network connection between an Image Works workstation and DICOM equipment is being configured, the DICOM equipment has to be configured with an “application name" and “DICOM port number’. Use the Image Works workstation’s host name as this “application name” for the DICOM port number. [Rewer [Ping DICOM host] enables you to confirm the physical link oc between the Image Works system and DICOM equipment. Receive ‘When the physical link is complete, the pop-up message appears. Click on [OK Ping DICOM host, ‘Send examination a Send series ! 000% Dicom Host Alive | Send image OK Select remote host When the physical link is not complete, the pop-up menu appears as follows. Then, click on [OK] to once exit the procedure and reconfirm the link. Attention ! Connection error: 000% OkImage Works System Selecting a Remote Host Receive Click left on the Network menu in the Browser menu bar and select [Select remote host] or [Selected host: xxxx] from the list Ping DICOM host that pops up: Send examination | [Select remote host] | send series If this is the first time that you are selecting a remote host during this session (since starting up the main application), [Select remote host] appears as the bottom option in the list. [Selected host: xxxx] On the other hand, if you have already selected a remote host during this session, this option will read [Selected host: 20x] Note: If 00’ is the name of the host that you want, it is already selected, 's0 you can skip the rest of this section and continue with your networking operation. Regardless of the option name, selecting it does the same thing: open the Remote host selection window. Remote host selection 1_|___Remote | “Remote ost ist | [ucr_oco) | | | nmei_oco | || | zwne ico | oo \| mot ret ancien EZ) |] This window provides a list of the workstations and medical imaging systems currently networked to your workstation. Click left on the name of the host in the list with which you want to transfer data, The host name becomes highlighted. Click left on (Ok) to have the current selection become the selected host. The Remote host selection window closes. r, click left on (Cancel) to cancel your selection and exit the Remote host selection window without making any change to the current selection. 8-3Image Works System Transmitting Data to a Remote Host (Network Push) Note: This function is not supported for a Signa 4.x, CT9800 or any GE-YMS system as remote host. To send exams, series, or images from your Image Works workstation to another workstation or imaging system on your network, first check that there is enough Foom on the remote system’s disk to accommodate the images being sent. See the user documentation provided by the manufacturer of the remote system. On the Browser, select the desired exam(s), series or image(s) to be sent. Select the remote host to which you want to send data, [rece ing DICOM hos ‘Send image Click left on the Network menu on the Browser, then click left on [Send examination}, [Send series], or [Send image] depending ‘on what you want to send. Select remote host ‘A confirmation window pops up and prompts you “Push selected examination(s)/series/image(s)?”. Click left on (OK) to proceed, or click left on (Cancel) to cancel the push operation. The items selected on the Browser for sending are transferred from your Image Works workstation to the remote host. Note: During the sending process, the Network menu title on the main Browser becomes Network (active). It returns to Network when the sending process is finished. Note: If the remote host cannot be reached, a pop-up message will report that fact. Verify the remote host is operational, check the network cabling, and call your GE Field Engineer if the problem persists. 8-4Image Works System To verity that your items have arrived on the remote host, you can look for them ‘on the Remote Browser as follows: o Wait for the sending process to finish, which is indicated by the Network (active) menu title on the main Browser returning to Network (or check the network queue; see “Network Queues" below), @ If the Remote Browser is not already open, click left on the Network menu in the main Browser menu bar and select [Query remote host] from the list that pops up, Thopicason | a Update the display of items listed in the Remote Browser lists by _ clicking left on the Application menu in its menu bar and selecting ]Retesh usts y [Refresh Lists] from the list that pops up (note that the time of last refresh shown at the bottom of the Remote Browser updates accordingly), Jour a Now examine the Remote Browser for the items you sent, When you've finished using the Remote Browser, close it by clicking left on the Application menu in its menu bar and selecting [Quit] from the list that pops up. 8-5Image Works System Removing Host Names from the Workstation’s Configuration File Note: Use care when removing host names via the workstation's Remote host selection window. If you inadvertently delete a host name, your GE Field Service Engineer can restore it. Click left on the Network menu in the Browser menu bar and select [Select remote host] or [Selected host: xxxx] from the list that pops up. The Remote host selection window pops up. Remote host selecton[ EET —} | (Hae) (oro) [Ups] eos | Click left on the name of the host that you want to remove. The host name becomes highlighted, Click left on (Remove) at the bottom of the Remote host selection window. A confirmation message pops up. Click left on (OK) to remove the host from the configuration file. The host is removed from the Remote host selection window. rr, click Jeft on (Cancel) to cancel the remove operation. (Note that the Remote host selection window contains buttons labeled (Add) and (Update). These buttons are for use by your GE Field Service Engineer to add New nodes to the host list or update existing ones.)Image Works System Network Queues Its not necessary to wait for one push or get operation to be completed before you set up the next one, because when you set up a push operation, itis placed into the push queue, and when you set up a get operation, it is placed into the pull queue. These two queues are ‘waiting lines” for requests to be carried out. Qua) ___ ToView the requests waiting in the queues, click left on the Queue menu on the main Browser, then select [Network] from the T archive list that pops up. | Network ‘A window pops up for each of the three network servers currently ax performing transfers: “Advantage” and “Dicom”. No window pops up for network servers that are not performing transfers, Note: The network server used for a transfer depends on the type of equipment (i.e. the type of remote host) with which the transfer is, being done, and was configured by your GE Field Service Engineer when your Advantage Windows workstation was installed. If none of the network servers is performing transfers, the message All Network queues are empty pops up. Click left on (OK) to remove the message. Note: When images are being “pushed” from one Advantage Windows station to another Advantage Windows station, the receiving station shows the job on its SdC NET pull queue. 8-7Image Works System Retest ‘To subsequently update the status of the two queues in a particular window, click left on its respective (Refresh) button. Each line in a queue represents a job to be executed. Jobs consisting of an entire exam take on the form “exam no.”, those consisting of an entire series take on the form “exam no./series no.” and those consisting of a single image take on the form “exam no,/series no,/image no.” followed, in all cases, by the remote server name in parentheses [(ic_imo) in the figure on the previous page is an example] and one of the following three status messages: 2 (Active) for the job currently being executed, (Pending) tor jobs waiting to be executed, _(Paused) for temporarily paused jobs. Note: Note: Note: Resume Gioar Gut fan entire exam or series is being pushed or pulled, only one job is executed for the entire exam or series, respectively, But, if only certain series in an exam, or certain images in a series are being Pushed or pulled, a separate job is executed for each series or image, respectively. Limiting the number of jobs in any one queue to 100 is recommended. To temporarily suspend execution of requests in a queue, click left on its respective (Pause) button. All pending jobs now have the (Paused) status, but the active job continues until completion. if you pause the Pull queue and then initiate more network get jobs, those jobs are placed in the queue in front of the paused jobs and executed immediately. To continue execution of requests in a paused queue, click left on its respective (Resume) button. All jobs return to their original status and execution continues. To permanently remove a job, select it by clicking left on it, then click left on the queue’s respective (Clear) button. A confirmation window Pops up. Click left on (OK) to proceed, or click left on (Cancel) to abort the clear operation. To close a queue window, click left on its (Quit) button.CHAPTER 9 Image Works System Archiving Overview The archiving option allows you to save and/or restore large amounts of image data on optical disks (ODs). ODs can either be of the Write Once Read Many (WORM) or Magnetic Optical Disk (MOD) type. Note: With the archiving option, data can only be restored from a WORM disk. This option can be used to import data from ODs coming from a large part of the GEMS MA(CT installed base, as well as from GE-YMS systems (equipped with Pioneer brand 5-1/4" OD drives only) The archiving option provides full read/write inter-operability with Signa 5.X, CT Advantage or CT/MR Independent Console systems. Composition of Archiving ‘An Image Works workstation equipped with the archiving has a 5-1/4” OD drive connected to it. Also, the archiving software is installed on the workstation, which is indicated by the presence of Archive on the Browser menu bar. Note We strongly recommend reading the user documentation provided by the manufacturer of the OD drive prior to using it. 9-1Image Works System Restoring Images from OD Before attempting to restore images from OD to the Image Works workstation, be sure that your are in compliance with the restrictions given in the following section: Restrictions for Restoring Images from OD The ability to restore images from OD to the Image Works workstation depends on two factors: a OD type, Image format. Details of OD types and image formats supported by the Image Works workstation restore functions are given in the next two sections: OD Types Readable by Image Works The following OD types can be used to restore image data from the OD to the Image Works workstation: 5-1/4" MOD labelled on any Genesis OC/IC, 5-1/4” WORM disk written on any Genesis OC/IC, Q 5-1/4” MOD labelled with Image Works, Q 5-1/4” MOD labelled on a GE-YMS system equipped with a Pioneer brand OD drive, Image Types Readable trom OD to Image Works Images of the following types can be restored from OD to the Image Works workstation: a All Genesis images, a GE-YMs, Image Works 9-2Image Works System Procedure: Restoring Images from OD After ensuring that the OD and images comply with the restrictions given above, proceed as given below to restore images. First, check that there is enough room on your image disk(s) to accommodate the images being restored. Information about disk space is displayed at the bottom of the Browser. Bear in mind however that this information is approximate and that it may take a few minutes to update following addition or deletion of images. Next, determine which side of the MOD contains the images you want to restore (side A or side B) and insert it in the OD drive accordingly (see user documentation provided by the manufacturer of the OD drive). Click left on the Archive menu on the Browser, then click left on [Restore]. ‘An Archive Browser appears on the screen. It displays the exams, series and images on the OD side in the OD drive, in much the same way as the main Browser displays the available items on the Image ‘Works workstation Note: The Archive menu appears as Archive (active) if other items are already in the process of being saved or restored from the current OD side in the drive, but the menu is still available. Your request will simply be saved in a queue, and executed as soon as the other requests ahead of it are completed. See “Archive Queues” below. S ‘chive browser attached to OD: 2 Selesion Rerove Son Netware Ousve Message a oy STON See ee) a a Dee eo ee een ao 9-3Image Works System Now you must select the examinations, series or images that you want to restore from the disk. To help you do this, you can use the Sort menu and Selection menu on the Archive Browser as described below: [ seecton To select all items in a list on the Archive Browser, click left on the \ XX Selection menu on the Archive Browser, then click left on [Select all examinations], [Select all series], or [Select all images). All the items in the chosen list on the Archive Browser are highlighted To sort items on the Archive Browser according to certain criteria, click left on the Sort menu on the Archive Browser, then click left on [Sort examinations by patient name], [Sort examinations by trigger], [Sort images by location], or [Sort images by image number]. The items will reappear in the list, sorted according to your choice. ‘Sort images by ey ‘Sort images by location ‘Sort images by image number Resto | Onceall the items that you want to restore are selected on the x. Archive browser, click left on the Restore menu on the Archive Testore Browser, then click left on [Restore examination], [Restore series], Samieton or [Restore image] depending on what you want to restore. The items selected on the Archive Browser for restoring are read from the OD in the OD drive to the Image Works workstation. Note: The word (updating) appears to the right of the Message menu title in the main Browser menu bar whenever the Image Works data base is being updated. (The word (updating) does not disappear immediately after completion of data base updating.) Note: All restored images appear on the main Browser images list with “Yes” in the Archive column.Image Works System To eject the MOD from the OD drive, it must first be “detached” via the [Detach] option in the Archive menu on the main Browser. See “Ejecting a Disk from the OD Drive” below for details. Tronicaon | Te.duitthe Archive Browser, click left on the Application menu on the Archive Browser, then click left on [Quit]. ‘aut Note: The Archive Browser is quit automatically when the [Detach] option in the Archive menu of the main Browser is executed See “Ejecting a Disk from the OD Drive” below. 9-5Image Works System Labelling a MOD Brand new MODs must be labelled before they can be used with the Image Works workstation. Also, you can use this procedure to re-label a MOD which contains data that you don't need anymore. Caution: When a MOD is re-labelled, all existing data on it are permanently lost. Caution: When a MOD is labelled on an Image Works workstation, it can only be read and written with a Signa 5.X, CT Advantage or CT/MR Independent Console with Genesis software version 4.1 or later. A MOD labelled on an Image Works workstation CANNOT be read on such systems with Genesis software versions earlier than 4.1. To label a MOD, first decide which side you want to label (side A or side B) and insert it in the OD drive accordingly (see user documentation provided by the manufacturer of the OD drive) a Click left on the Archive menu on the Browser, then click left on [rome [Label]. A window entitled “Format Window” pops up. Restore Save sees ‘Save image Label ____} Detach = Format Window 2 Device [PIONEER Device enter [or Comments [MR images Side A Lape CANCEL Note: The Device field shows the OD drive type. This is set up during installation, and requires no intervention from the user. 9-6Image Works System Click left on the Device Identifier field and enter a value of your choice. This value identifies the MOD side being labelled. Click left on the Comments field and enter your comments from the keyboard Typically, information about the type of images, MOD side, or other pertinent information of your choice are used. (The text in this field will appear at the bottom of the Archive Browser during selection of images to be restored from this MOD side.) The maximum number of characters allowed in this field is 160. Click left on the (LABEL) button to begin the labelling process. Click left on (Yes) to proceed with labelling or (No) to abandon. To abort the labelling process, click left on the (CANCEL) button in the Format Window.Image Works System Saving Images on MOD Before attempting to save images on MOD with the Image Works workstation, be sure that your are in compliance with the restrictions given in the following section: Restrictions for Saving Images on MOD The ability to save images on MOD with the Image Works workstation depends on two factors: @ MOD type, a Initial source of images. Details of MOD types and image sources supported by the Image Works workstation save functions are given in the next two sections: MOD Types Writeable by Image Works The following MOD types can be used to save image data from the Image Works workstation: 5-4/4" MOD labelled on a Signa 5.x, CT Advantage or CT/MR Independent Console, @ 5-1/4” MOD labelled with Image Works. Image Types Writeable to MOD by Image Works Images from the following sources, once on the Image Works workstation, can be saved on MOD: a Signa 4.x, Signa 5.X, CT Advantage or CT/MR Independent Console, u a CT9800, GE-YMS CT scanners with Advantage Net, Image Works 1.2 (except saved 3D objects as indicated by 3D OBJ in the Type column of the series list on the main Browser), oImage Works System Procedure: Saving Images on MOD After ensuring that the MOD and images comply with the restrictions given above, proceed as given below to save images. Note: If your MOD is brand new, or if you want to re-label it (and consequently lose all the data on it permanently), follow the instructions for labelling given in “Labelling a MOD" below before proceeding. First, decide which side of the MOD you want to save images on (side A or side B) and insert it in the OD drive accordingly (see user documentation provided by the manufacturer of the OD drive). On the Browser, select the desired exam(s), series or image(s) to be saved. Finally, click left on the Archive menu on the Browser, then click Jeft on [Save examination], (Save series], or [Save image] depending on what you want to save. The items selected on the Browser for saving are written onto the MOD in the OD drive. Note: The Archive menu appears as Archive (active) if other items are already in the process of being saved or restored, but the menu is still available. Your request will simply be saved in a queue, and executed as soon as the other requests ahead of it are completed. See “Archive Queues” below. Note: Items being saved cannot be deleted from the Image Works workstation until their saving is completed. This is seen by the gray Remove menu title on the Browser whenever items being saved are selected. (Once an image has been saved, the word “Yes” appears in the Archive column of its respective entry in the images list of the main Browser. When archived images are networked directly to another Image Works station, they also appear as archived on that station’s Browser. This allows all Image Works users to keep track of which images have and have not been saved on MOD, However, when images are networked from a non-Image Works workstation, the ‘word “No” appears in the Archive column of the Browser of the receiving Image Works workstation, regardless of whether or not they have been archived previously. To eject the MOD from the OD drive, it must first be “detached” via the [Detach] option in the Archive menu on the Browser. See “Ejecting a Disk from the OD Drive” below for details. 9-9Image Works System Ejecting a Disk from the OD Drive Once an OD has been used for save or restore operations, it cannot be ejected from the OD drive unless you first perform a detach operation as described below: ‘che | __ Fifst, click left on the Archive menu on the main Browser, then click ee left on [Detach]. A confirmation window pops up and asks you Detach media? (If images are in the process of being restored from the OD, the message is Detach media: restore images process will ‘be stopped.) Click left on (OK) to proceed, or click left on (Cancel) to abort the detach operation. You can now eject the OD from the OD drive by pressing the eject button on its front panel. See the OD drive manufacturer's documentation for details. | the [Detach] option in the Archive menu appears in gray lettering, this means that the OD is already detached, and you can proceed directly with ejecting it from the OD drive, Archive Queues Itis not necessary to wait for one save or restore request to be carried out before you set up the next one, because when you set up a save request, it is sent to the Archive Save queue, and when you set up a restore request, itis sent to the Archive Restore queue. ‘These two queues are “waiting lines" for requests to be carried out. To view the requests waiting in the queues, click left on the { aveue i Queue menu on the main Browser, then click left on [Archive] \ 3X An “Archive” window pops up, displaying both the Archive Save Queue and the Archive Restore Queue. 9-10Image Works System S ‘archive e ‘Archive Save 6513/1 Pending 63/2 (Pending 881313 (Pending) 3609 (Pending) 2739 (Pend) Pause Resume Clear ‘Archive Restore 2387 (Active) 548/109 Pending) Pause eaume Giear ates aut The content of the Archive Save and Archive Restore Queues shown in this window is up to date at the moment when it pops up. To subsequently update the status of the two queues, click left on the (Refresh) button. Note: Jobs in the Restore queue have priority over those in the Save queue. Save jobs are only serviced when the Restore queue is empty.Image Works System Each line in a queue represents a job to be executed. Jobs consisting of an entire exam take on the form “exam no.", those consisting of an entire series take on the form “exam no./series no.” and those consisting of a single image take on the form “exam no./series no /image no." followed, in all cases, by one of the following three status messages: Active) for the job currently being executed, (Pending) for jobs waiting to be executed, 2 (Paused) for temporarily paused jobs. Note: If an entire exam or series is being saved or restored, only one job is executed for the entire exam or series, respectively. But, if only certain series in an exam, or certain images in a series are being saved or restored, a separate job is executed for each series or image, respectively. Note: Limiting the number of jobs in any one queue to 100 is recommended. To temporarily suspend execution of requests in a queue, click left on its respective (Pause) button. Alll jobs now have the (Paused) status. To continue execution of requests in a paused queue, click left on its respective (Resume) button. All jobs return to their original status and execution continues, To permanently remove a job, select it by clicking left on it, then click left on the queue's respective (Clear) button. A confirmation window pops up. Click left on (OK) to proceed, or click left on (Cancel) to abort the clear operation To close the queue window, click left on the (Quit) button. Note: The Archive Restore Queue is deleted on system shutdown or following an Archive - [Detach] operation (see “Ejecting a Disk from the OD Drive” above), whereas the Archive Save queue is maintained under either of these conditions. 9-12CHAPTER 10 Image Works System Image Combination Overview ‘The image combination function allows you to perform various operations on one or two sets of images selected on the Browser and place the resulting images in a new series, To activate this function, click left on the (Add / Sub) button in the Browser. The Image Combination command window pops up. [S]mage Combination ose [55 Seta [J ee a i i Either one or two sets of images must be selected before any image combination functions can be performed. See “Set selection" below. If only one set is selected, each operation performed produces ONE resulting image. If two sets are selected, images in the two sets are paired according to physical location in the patient's body. Unpaired images in either set are ignored. Each operation performed produces ONE resulting image PER PAIR. See the appropriate sections below for details about each type of operation. The images resulting from each operation are generated in the exam defined by the left-hand (Select Set) button. 10-1Image Worls System Save Series Resulting images are assigned a series number and starting image number given by the Current Save Series field in the upper right corner of the Image ‘Combination command window. By default, images resulting from subsequent operations are added onto the end of the same series. To place images resulting from subsequent operations into a new series, click left on the (New Save Series) button. This increments the save series number by one and displays the Save Series and Save Image fields in the upper right corner of the Image Combination command window. You can then either accept the numbers in these two fields or click left on either of them, use the Back Space key to delete them, and enter the desired numbers from the keyboard. ‘The series resulting from image combination operations are distinguished from other series in the Browser via one of the following two indications in the Browser series list Type column: “Proc” appears in the Browser series list Type column if the images in the series are the result of processing pairs of images having identical locations in the patient’s body, “Comb” appears in the Browser series list Type column if the images in the series are the result of a combination of images having different locations in the patient's body. Since “Proc” series contain images resulting from processing pairs of images having identical locations in the patient's body, such series can be used like any other series of acquisition images, i.e. geometrical measurements, reformatting, 3D reconstruction, etc. Caution: Since “Comb” series contain images resulting from a combination of images having different locations in the patient’s body, the absolute anatomical coordinates accompanying these series (shown both in the Browser and on the displayed images) are not accurate. Only relative geometrical measurements (i.e. distance, angle or area) made within a resulting image are accurate. Note: Even though “Proc” and “Comb” series can, in certain cases, be “pushed” via the network, or transferred via archive MOD disk, to other console types, they can be displayed, analyzed and manipulated on Image Works workstations ONLY. 10-2CHAPTER 10 mage Works System Set Selection With the Image Combination command window open as described above, select the image(s) on the Browser that you wish to define as Set 1. (The images do not have to be consecutive in the Browser list.) Sais Sat y,| Now dik at onthe left-hand (Select Set) button in the Image ————_ Combination command window. Data about the selected images replace the title of the button, and appear in the form exam no,/series no./image no(s) If applicable, repeat the procedure for the second set, but use the right-hand (Select Set) button. To change a set selection, repeat the procedure with a different selection on the Browser and the set selection updates automatically Glos Seleston| To clear a set selection, click left on the (Clear Selection) button in eer on} the Image Combination command window. The titles of the (Select Set) buttons are restored. 10-3Image Worls System Maximum Pixel Value Extraction Maximum pixel value extraction is an operation that consists of finding maximum image intensity values pixel by pixel. Two types of maximum pixel value extraction are possible: a Extraction on one set alone, 2 Extraction between two sets. Maximum pixel value extraction on one set alone This type of extraction finds the maximum pixel intensity, pixel by pixel, from ‘among all the images selected via the left-hand (Select Set) button. The resulting image is placed in a series bearing the series number and image ‘number given by the Current Save Series field in the upper right corner of the Image Combination command window. To perform this operation, proceed as follows: Insure that both (Select Set) buttons are cleared. If necessary, click left on the (Clear Selection) button to clear all selections, Define the first set as described in “Set selection” above, Check that the series number and image number given by the Current Save Series field are as you like; if necessary, change them as described above, [AT Dic let on the (MAX) button to select the maximum pixel value ®- extraction mode, ‘| Click left on the (=) button to perform the operation and generate the -) new image. The new image is available shortly in the Browser for use by viewing applications 10-4CHAPTER 10 Image Works System Maximum pixel value extraction between two sets This type of extraction finds the maximum pixel intensity values, pixel by pixel, of all pairs of images between the two selected sets corresponding to the same physical location in the patient's body. The resulting images are placed in a series bearing the series number and image number given by the Current Save Series field in the upper right corner of the Image Combination command window. To perform this operation, proceed as follows: a Define the two sets as described in “Set selection” above, a Check that the series number and image number given by the Current Save Series field are as you like; if necessary, change them as described above, Click left on the (MAX) button to select the image addition mode, » "| Stk on the (=) button to perform the operation and generate the J new image. The new images are available shortly in the Browser for use by viewing applications. 10-5Image Worls System Image Addition Image addition is an operation that consists of adding image intensity values pixel by pixel. Two types of image addition are possible: Image addition on one set alone, Image addition between two sets. ion on one set alone Image addi SUM OF ALL IMAGES SELECTED VIA THE LEFT-HAND (Select Set) BUTTON ONLY This type of addition adds the image intensity values, pixel by pixel, of all the images selected via the left-hand (Select Set) button. For normalization Purposes, each resulting pixel value is divided by the number of images in the selected set, The resulting image is placed in a series bearing the series number and image Number given by the Current Save Series field in the upper right corer of the Image Combination command window. To perform this operation, proceed as follows: Ensure that both (Select Set) buttons are cleared. If necessary, click left on the (Clear Selection) button to clear all selections, Define the first set as described in “Set selection” above, Check that the series number and image number given by the Current Save Series field are as you like; if necessary, change them as described above, Lea) Click left on the (+) button to select the image addition mode, —= »J Click left on the (=) button to perform the operation and generate the new image. The new image is available shortly in the Browser for use by viewing applications. 10-6CHAPTER 19, —————______________Image Works sytem Image addition between two sets [FIRST SET + SECOND SET] IN PAIRS This type of addition adds the image intensity values, pixel by pixel, of all pairs of images between the two selected sets corresponding to the same physical location in the patient's body. By default, equal weighting is applied to the two pixels in each pair, but you can change the weighting via the Ratio slider. In all cases, for normalization purposes, each resulting pixel value is divided by two. The resulting images are placed in a series bearing the series number and image number given by the Current Save Series field in the upper right corner of the Image Combination command window. To perform this operation, proceed as follows: Define the two sets as described in “Set selection” above, a Check that the series number and image number given by the Current Save Series field are as you like; if necessary, change them as described above, a | Click left on the (+) button to select the image addition mode, If necessary, drag left on the Ratio slider to obtain other than the default equal weighting of pixel values between the two series; drag leftward to increase the weighting on the images selected on the left-hand (Select Set) button or drag rightward to increase the weighting on the images selected on right-hand (Select Set) button (if you move the Ratio slider to one extreme, the images selected on the opposite (Select Set) button have zero weight in the addition operation), Click left on the (=) button to perform the operation and generate the new images. The new images are available shortly in the Browser for use by viewing applications. 10-7Image Worls System Image Subtraction Image subtraction is an operation that consists of subtracting image intensity values pixel by pixel. Two types of image subtraction are possible: Image subtraction between two images in one set alone, Image subtraction between two sets. A selectable “Accept Negative Pixels” function is available for either type of subtraction. This function, when enabled, allows negative pixel values in the resulting image(s). (If this function is not enabled, all negative pixel values are set to zero.) Image subtraction between two images in one set alone [FIRST IMAGE - SECOND IMAGE IN SELECTED SET] This type of subtraction subtracts the image intensity values, pixel by pixel, of the second image selected in the Browser defined via the left-hand (Select Set) button from the first image selected in the Browser defined via the same (Select Set) button. The resulting image is placed in a series bearing the series number and image number given by the Current Save Series field in the upper right corner of the Image Combination command window. To perform this operation, proceed as follows: Ensure that both (Select Set) buttons are cleared. If necessary, click left on the (Clear Selection) button to clear all selections, 1G Define the first set as described in “Set selection” above (be sure that only ‘TWO images are selected on the Browser), Check that the series number and image number given by the Current Save Series field are as you like; if necessary, change them as described in “General information” above, o Click left on the (Accept Negative Pixels) button if you want the resulting image to contain negative values, — Click left on the (-) button to select the image subtraction mode, » _| Click let on the (=) button to perform the operation and generate the new images. The new image is available shortly in the Browser for use by viewing applications. 10-8CHAPTER 190, ——————_______!mage Works System Image subtraction between two sets [FIRST SET - SECOND SET] IN PAIRS This type of subtraction subtracts the image intensity values, pixel by pixel, of all pairs of images between the two selected sets corresponding to the same physical location in the patient's body. For each pair, the pixel values from the set defined by the right-hand (Select Set) button are subtracted from the pixel values from the set defined by the left-hand (Select Set) button. By default, equal weighting is applied to the two pixels in each pair, but you can change the weighting via the Ratio slider. ‘The resulting images are placed in a series bearing the series number and image number given by the Current Save Series field in the upper right corner of the Image Combination command window. To perform this operation, proceed as follows: Define the two sets as described in “Set selection” above, 3 Check that the series number and image number given by the Current Save Series field are as you lke; if necessary, change them as described above, Cl Click left on the (-) button to select the image subtraction mode, a Hfnecessary, drag left on the Ratio slider to obtain other than the default equal weighting of pixel values between the two series; drag leftward to increase the weighting on the images selected on the left-hand (Select Set) button or drag rightward to increase the weighting on the images selected on right-hand (Select Set) button (if you move the Ratio slider to one extreme, the images selected on the opposite (Select Set) button have zero weight in the addition operation), J Click left on the (=) button to perform the operation and generate the % new images. The new images are available shortly in the Browser for use by viewing applications. 10-9Image Worls System Minimum Pixel Value Extraction Minimum pixel value extraction is an operation that consists of finding minimum, image intensity values pixel by pixel. Two types of minimum pixel value extraction are possible: Extraction on one set alone, @ Extraction between two sets. The procedure for performing these extractions is identical to that given \%- above for maximum pixel value extraction, The only difference is that you must click left on the (MIN) button instead of on the (MAX) button. Binding Series You can create a new series which consists of copies of selected images from one or more existing series. Save State information is not maintained in the new series generated in this way. To perform this operation, proceed as follows: Note a Ensure that both (Select Set) buttons are cleared. If necessary, click left on the (Clear Selection) button to clear all selections, Define the first set as described in “Set selection” above, Check that the series number and image number given by the Current Save Series field are as you like; if necessary, change them as described above, C—=_) Click left on the (BIND) button to select the series binding mode, — Click left on the (=) button to perform the operation and generate the new images. The new images are available shortly in the Browser for use by viewing applications, You can concatenate copies of images from other series to the end of this new series by following the same procedure, being sure to set up the Save Series and Save Image field values correctly prior to clicking left on the (=) button. Closing the Image Combination Command Window To close the Image Combination command window, click left on the QUT yg | (Quit) button 10-10A I Annotation level, 4-8 Image Combination, 10-1 Archiving, 9-1 Image Addition, 10 -6 Image Subtraction, 10-8 Set Selection, 10-3 c Changing Image Orientation, 44 M Magnifying Displayed Images, 4-4 D Networking, 8-1 Free Draw Area, 6-7 DICOM, 8-2 Rectangle Area, 6-4 Report Cursor, 6-2 Smooth Curve Area, 6-5 s Straight Line Distance, 6-3 Selecting and Sorting Images, 3 - 1 Format, 3-7 F seroll bars, 3-2 Selection menu, 3-4 Composer, 7-1 Sort menu, 3-4 ‘Auto cles page, 7-6 ‘Auto printing, 7-6 Expose order, 7-6 Format, 7-4 Greyseale, 7-5 U Toon abel, 7-6 Number of copies, 7-6 Slide Format, 7=5 User Prefs, 4-7 Setting Window Width/Levels, 4-2 User Annotation, 5-2Table of Contents Reformat Chapter 1 - Starting the Reformat Package + Overview 14 ‘+ Image Series Requirements 14 + Series /Image Selection . 1-2 ‘+ Starting the Reformat Application 1-2 Chapter 2 - Reformat Main Control Panel + Overview . 2-1 ‘+ Reformat Main Command Window (Fig.1) a-1 FILE menu GRAPHICS menu Display Pref menu (Cursor/Annotations) Display Pref menu (Identify mmslices) Display Pref menu (Color/Window) Display Pref menu (Graphics Options) Batch menu TiltRotate Select button Oblique Mode Select button Windowing Parameter Preset buttons View Type buttons Moverent/Rotation Increment buttons. PHN BVND woaeann sunny S8sss Chapter 3 - Other Command Window + Overview 5 5 3-1 ‘+ Graphics Command Window (Fig.10) a-t Clear trace button 3-3 Clear point button 3-3 Create trace button 3-3 Delete trace button 3-3 ‘Show trace button 3-3 Display button 3-4 Color button: 3-4 Style button 3-5 Trace edit button 3-6 Trace rotation and translation box 3-6 Font type button 3-6 Attach to cursor button 3-6 Drag and drop annotation text field 3-7 Cursor position display 3-7Reformat Package Chapter 4 - Total Length display Last segment length display Polygon area display Angle display Measurement annotation CLOSE button On - View Operation Overview View Selection 8D Cursor Main On-View menu Orientation Annotation Patient Name Annotation Window Level and Window Width ‘Annotation . Slice Annotation Field of View Annotation Creating and Editing Traces 4-7 4-8 4-8 4-9 Rotating Models in Oblique Views with the On - Screen Trackball Displaying and Manipulating Plane Traces Mult: Projection Volume Reconstruction (MPVR) Profile View Volume Histogram View Cross Section Histogram View Batch Filming 4-13 ata 4-16 418 4-20 4-25 4-30Chapter 5 - Keyboard Operations Overview F1 Function Key: Filming F2 Function Key: Page Filming F3 Function Key: MID Filming D Key: Clear Last Point Control+U Keys: Clear Trace Shift Key: Moving the 3D Cursor Shift Key: Creating Traces Reformat PackageReformat Package Blank pageCHAPTER 1 Reformat Package Starting the Reformat Package Overview This chapter explains how to start the Reformat application from the Image Works platform and prepare for image manipulation and analysis. Image Series Requirements Its not possible to perform reformatted cut plane reconstruction on just any set of images available on the Image Works Browser. Certain requirements must be fulfilled for the images to be eligible for use by the Reformat application: 2. Field of view(FOV), matrix size and display center must be the same for all images in the set, Orientation and gantry tilt should be the same for all images in the set, Tilted acquisitions are not supported for right/left decubitus patient orientations, o There MUST NOT be two images corresponding to the same location in the set, o