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VitreaLT 4.1.

52 Release

Copyright 1997-2014 Vital Images, Inc. All rights reserved. Date of Publication March 2014.
VitreaAdvanced protected by U.S. Patents 5,986,662; 6,130,671; 6,219,059; 7,031,504; 7,136,064; 7,362,329; 7,574,029; 7,590,272;
7,660,481;7,929,748;7,991,210; 8,214756; 8,249,687 Other Patents Pending in the U.S. and other countries.
VitreaWorkstation protected by U.S. Patents 5,986,662; 6,130,671; 6,219,059; 7,031,504; 7,136,064; 7,362,329; 7,574,029; 7,590,272;
7,660,481;7,929,748;7,991,210; 8,214756; 8,249,687 Other Patents Pending in the U.S. and other countries.

VPMC-13433A VitreaLT 4.1.52 Release Notes

This publication is valid for VitreaLT 4.1.52 and later software versions.
No part of this work may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic or mechanical, including
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Vital Images, Vitrea, ViTAL, and ViTAL U are registered trademarks of Vital Images, Inc.
All other marks are property of their respective owners.
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If this software or documentation is delivered to any unit or agency of the U.S. Government other than DOD, it is delivered with Restricted Rights and
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is delivered to NASA, it is delivered with Restricted Rights subject to the restrictions set forth in 18-52.227-86(d) of the NASA FAR Supplement.
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This software and the information in this software including, but not limited to, the ideas, concepts and know-how are proprietary, confidential and trade
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This software is a licensed product of and is distributed by Vital Images, and may only be used according to the terms of that license on the system
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VitreaLT 4.1.52 Release Notes VPMC-13433A

Table of Contents
INTRODUCTION ............................................................................................................................................... 1
CONTACT US ................................................................................................................................................... 1
REGION EDITING CAUTIONS AND NOTES .................................................................................................... 1
ADDITIONAL CAUTIONS ................................................................................................................................. 2
GENERAL NOTES ............................................................................................................................................ 2
KNOWN SOFTWARE LIMITATIONS (4.1.52) .................................................................................................. 2
KNOWN SOFTWARE LIMITATIONS (4.1.51) .................................................................................................. 3
KNOWN SOFTWARE LIMITATIONS FROM PREVIOUS RELEASES ............................................................. 3
KNOWN ISSUES (4.1.52) ................................................................................................................................. 4
KNOWN ISSUES (4.1.51) ................................................................................................................................. 5
KNOWN ISSUES FROM PREVIOUS RELEASES ............................................................................................ 6

VitreaLT 4.1.52 Release Notes VPMC-13433A


This document contains the following information:

a listing of Region Edition Cautions and Notes for the VitreaLT release;
a listing of Additional Cautions for the VitreaLT release;
a listing of General Notes for the VitreaLT release; and
a description of the known software limitations and known issues for the VitreaLT release.

CAUTION: For general Safety and Regulatory Considerations, refer to the appropriate Education and Reference Guide.

CAUTION: Federal law restricts this device to sale by or on the order of a physician, as directed by 21 CFR 801.109(b)(1).

Contact Us

For general, non-technical support questions, contact us through our Web site:
For customer technical support, contact us at:
o In the U.S., call the Customer Support line at 1.800.208.3005; or
o Outside the U.S., contact your Vital Images distributor; or
o Send an email to
To provide feedback about this document or other Vital Images product documentation, send an email to
Contact Customer Support for a printed version of the release notes, education and reference guide, or installation guides.

Region Editing Cautions and Notes

Products Description

General Vitrea does not allow using the Sculpt tool to edit any of the following existing regions: nodules, polyps, tumors, or
Sculpting brain perfusion summary map regions. Use the Edit tool to edit these regions.
Lung Protocols Vitrea does not allow the Sculpt tool to edit an existing nodule. Use the Edit tool to modify existing nodules.
All Applications Vitrea reserves certain names for protected or non-editable regions. If you attempt to name a non-protected region to
a protected region name, Vitrea will include a numeral at end of the name. For example, if you attempt to rename a
region called Other to Tumor, Vitrea will change it to Tumor-0.

VitreaLT 4.1.52 Release Notes VPMC-13443A

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Additional Cautions

Products Description

All Applications When reviewing snapshots on the VitreaLT system or on a system to which they were exported, always verify the
snapshots are for the intended patient.
All Applications It is possible to have multiple patient reports open at one time. The VitreaLT software will display a warning when it
detects a situation when this might occur. Always verify the report being viewed is for the intended patient.

General Notes

Products Description

All Applications The software permits modifying certain advanced settings in Volume Builder that govern how volumes are built from
DICOM images. These advanced settings should not be modified. Certain modifications can lead to situations in
which measurements are incorrect once the built volumes are loaded in Vitrea.

Known Software Limitations (4.1.52)

Softread is not capable of loading multi-frame CT data
Softread instant manipulators do not work as designed over remote desktop sessions
Softread snapshot functionality will not work for patient names of greater than 37 characters
Softread snapshots cannot be taken of derived stacks (Subtraction for instance)
Softread does not support multi-byte character sets

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Known Software Limitations (4.1.51)

Spiral, Helical, and Jog Shuttle Support for 2D Brain Perfusion (VIM-1625)
Vitrea 2D Brain Perfusion supports standard axial scans with no table motion for all scanner manufacturers.
Vitrea 2D Brain Perfusion supports helical shuttle scans from both GE and Siemens scanners, except for scans that have slice levels
greater than 50 or scans that are sent as more than one series. Helical shuttle has not been validated for any other scanner
Vitrea 2D Brain Perfusion supports jog shuttle scans for GE scanners, except for scans that have slice levels greater than 30 or scans
that are sent as more than one series. Jog shuttle has not been validated for any other scanner manufacturer.
When loading unsupported wide-coverage data in Vitrea 2D Brain Perfusion, the perfusion maps may not be accurate. Known behaviors
include a potential for perfusion differences between the top half of the scan and the bottom half of the scan.
Snapshots of images generated in VScore that use Interpolation must interpolate all contours (SUSENG-2483)
When you select Interpolate while drawing contours and then draw additional contours and do not select Interpolate before
attempting to take a Snapshot, an on-screen dialogue box will inform you that all contours must be interpolated in order to take a
Snapshot. No Snapshot may be taken of an image created through use of interpolation unless you interpolate all contours.

Known Software Limitations from Previous Releases

Windows 8 is not supported as of the 4.1.52 Release
Snapshot restorability limitations (VIT-7309, VIM-1433, VIC-669, VIM-1695)
In certain cases, snapshots are not restorable:
1. Snapshots created in version 4.1.52 will not be readable or useable in previous versions of the product.
2. Snapshots sent as monochrome will not be restorable.
3. Snapshots taken when disparate patients are loaded (i.e. not identified as the same person) will not be restorable.
4. Snapshots created in 4.1.51 ECF-based VitreaWorkstation for XA studies with dicomSnapMode ON will not be restorable when
using the 4.1.52 VIMS based VitreaWorkstation.
5. When restoring to VitreaCore, not all attributes of advanced applications can be restored.
6. Snapshots restored into Myocardial Perfusion/Analysis will not display the 2-color bar upon restore. This feature has been
depreciated and is no longer utilized in the product.
Snapshots created in 4.1.51 ECF based VitreaWorkstation that are migrated to a 4.1.52 VIMS based VitreaWorkstation will display the
migration timestamp on all snapshots.
NOTE: Snapshots that do not have DICOM Snapshot Mode enabled will not migrate from previous versions of VitreaWorkstation.
The 4.1.52 software release is currently unable to restore Colon, TAVR, 4D Brain Perfusion and Stent Planning snapshots in VitreaCore.
CT Brain Perfusion 2D Jog Shuttle (VIM-1587)
Vitrea CT Brain Perfusion 2D supports jog shuttle scans for GE scanners, except for scans that have slice levels greater than 30 or
scans that are sent as more than one series. Jog shuttle has not been validated for any other scanner manufacturer.
When loading unsupported wide-coverage data in Vitrea CT Brain Perfusion 2D, the perfusion maps may not be accurate. Known
behaviors include a potential for perfusion differences between the top half of the scan and the bottom half of the scan.
Siemens scanners that acquire three slice CT Brain Perfusion are not supported.
Circle of Willis (COW) Protocol: Jog Shuttle does not build one volume (SUSENG-2710)
The shuttle jog builds two volumes instead of one volume.
Jog Shuttle is not supported in COW protocol.

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Known Software Limitations from Previous Releases, continued

VitreaAdvanced Servers and VitreaWorkstations require at least 12GB of RAM to support the Liver application.
Segmentation and vessel analysis limitations when analyzing CT data with contrast and reconstructed at 80-100 kV
There may be degraded performance of the segmentation and vessel analysis algorithms used in VitreaAdvanced and
VitreaWorkstation when analyzing CT studies with contrast which have been reconstructed at 80-100 kV. Applications and related tools
which may be affected are: Generic CT (Vessel Probe Tool and Extend, Automatic Bone Removal, Vessel Grow, and Bone Pick), CT
Coronary Analysis (auto coronary vessel tracking), Endovascular Stent Planning, Transcatheter Aortic Valve Replacement, Cardiac
Functional Analysis, Cardiac Multi-Chamber Functional Analysis, EP Planning, Myocardial Analysis, Myocardial Perfusion, and Liver
Incorrect result is shown when loading a Lung Density Analysis dataset with only one lung (VIT-8540)
This is a limitation as the software assumes there are two lungs and always tries to separate them and label left and right.
Microsoft Internet Explorer 10 is not a supported internet browser for the 4.1.52 release. (VIM-1640)
SQL Server 2005 Express Edition limits the total available DICOM data storage to 1 TB (VIM-1685 and VIM-1691)
DICOM data storage is limited to 1 TB due to SQL Server 2005 Express Edition having a 4 GB database size limitation. This issue is
usually encountered when running VitreaWorkstation fX on Windows XP.
As a workaround, upgrade the Windows Operating System to Windows 7 for a VitreaWorkstation or upgrade to Windows Server 2008
R2 for a VES system. SQL Server 2008 R2 provides up to 2TB of DICOM storage and is used by default on Windows 7. SQL Server
Standard Edition should be used in situations where the SQL database size is expected to be larger than 10 GB.
Vital does not generate Encapsulated PDF DICOM data (VIM-1644)
Vital does not have the capability of generating Encapsulated PDF DICOM data. Therefore, any generated Encapsulated PDF evidence
from third party software will be in a Secondary Capture and will properly display in the Vital Reporting tray.
NAS path is permanent
The Network-Attached-Storage (NAS) path is permanent. Customers that wish to replace or rename the NAS path must keep the
original hostname or reprocess all patient data.
Older Licensing Technology Not Supported
The introduction of new licensing technology in Vitrea 4.1.51 will require that any users running a version prior Vitrea 4.1.51 system to
obtain an updated license in order to use later versions of the product.
Multi-volume fusion limitations with older GPUs
Multi-volume fusion of more than three volumes is not supported on older graphic cards (Examples: Quadro FX3500 and ATI FirePro
V5800). Vitrea will only allow three volume Multi-volume fusion with the older graphic cards and will allow up to four volumes with the
newer graphic cards.
IPv6 is not supported at this time (SUSENG-3084, SUSENG-3303, VIM-1738)
Internet Protocol version 6 (IPv6) is not supported at this time.

Known Issues (4.1.52)

Improper Softread Report page formatting for all screen resolutions (VIT-11388)
This issue occurs when you set the monitor to any desired screen resolution, load a study into Softread, and click the Go to report page
button. Although the report page screen displays, it does not fit to the screen, dialogue is blocked, and some functions are cut off.
As a workaround, click the Maximize button and the Softread report page displays correctly with no overlap and nothing is blocked.

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Known Issues (4.1.51)

2D Brain Perfusion/Brain Analysis Batches (VIM-1467)
If you create a collage batch for 2D Brain Perfusion or Brain Analysis studies with DICOM Snap Mode enabled, every instance within
the batch will have a separate series instance UID. When such a batch is exported to any other DICOM archive, the images within the
batch will not be stackable. Please call Vital Customer Support to disable DICOM Snap Mode or disable manually by setting the
following registry key to false: HKEY_LOCAL_MACHINE\Software\Vital Images\Vitrea. Set DicomSnapMode = False.
For some Colon studies in which the Generic CT is selected automatically, the preset images in the Gallery are blank
As a workaround, move to the Viewer tab and return to the Gallery. The preset images will be present.
For some Carotid/COW cases, auto bone removal does not work when the Generic CT Protocol is selected
The proper procedure for removing bone from a Carotid/COW case is to start from the Carotid/COW protocol.
In obliquely acquired scans, regions may be incorrectly acquired when using MPR contours
As a workaround, the user can still use the sculpt tool to make edits to regions.
An incomplete set of Snapshots is exported from one Vitrea to another in some multiple volume cases
As a workaround, an administrator should set DicomSnapMode to true and the export of Snapshots will work. However, if
DicomSnapMode is set to true on a Vitrea, series descriptions cannot be changed and force secondary capture and force
monochrome do not work.
The sculpt tool cannot be used when Vascular applications are launched using the applications tab
As a workaround, the sculpt tool can be selected either by launching the study from the series tab instead of the Applications tab or by
first selecting the reset button while in the study.
After saving Snapshots to CD/DVD on one Vitrea and importing them onto another Vitrea, the user is unable to display or
restore Snapshots/batches/movies from the study directory or Report tab
As a partial workaround, burn the CD/DVD from the Report page. Reports and DICOM images can be viewed on the study viewer
without issues.
When exporting a study with evidence from one Vitrea to another, the evidence does not appear on the new report page
As a workaround, the evidence can be viewed on the Vitrea from which the study was exported.
When trying to archive a study to CD/DVD with data compression enabled, the operation fails. The log shows that the
application was unable to compress the files
As a workaround, archive to CD/DVD without enabling data compression.

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Known Issues from Previous Releases

Unable to edit contours carotid vessel probe after abdomen or other type study (SUSENG-2738)
As a workaround, if you are processing a study in the Vascular: Aorta Stent CT protocol and know you will be probing vessels and
editing contours in another protocol later on, you should clear the Wall checkbox in Vessel Tools prior to leaving the Aorta Stent
protocol. Or if you experience the defect while editing contours, you do not have to restart Vitrea to get the functionality back. Instead,
you can load a study in Vascular Aorta Stent CT protocol, clear the Wall checkbox and reload the study.
Vessel names are not maintained in the MPR views (SUSENG-3248)
The vessel names are missing, however the image and visualization information provided is correct.
As a workaround, use the Annotation tool to label the MPR image.
Snapshots can display with red X on Report page when returning to Study Directory if nonstandard nasroot for patient data is
used (SUSENG-3408)
The software cannot use a nasroot of \\hostname\patients and the standalone cannot change the e:\Vitreadata folder to be e:\Patients.
When loading functional cardiac CT data into CT Cardiac Functional Analysis application the segmentation can be initialize
incorrectly resulting in an incomplete graph (SUSENG-3628)
As a workaround, drag and orient the LV axis into the correct position/orientation and then click the Compute button to update the
segmentations. You may have to further adjust the mitral valve plane or apex plane on one or more phases to a final, correct
configuration and click Compute. Once the LV axis and planes have been properly adjusted, contours may need to be edited in one or
more phases in order to achieve the final segmentations and calculations.
Reporting UI errors when IE ESC is not turned off for Users (SUSENG-3643)
During install and configuration, the system will generate errors because the rights required to access a specific file are not available
when IE ESC is not turned off for Users.
Calcium Scoring (CACS): Unable to take snapshots after deleting all interpolated contours (VIT-8518)
This issue occurs in the Cardiac: Ca Scoring CT protocol with 2D VScore preset and after deleting all interpolated contours. A warning
message is displayed you must interpolate all contours to take a snapshot. As a workaround, reset or reload the series and redo the
workflow or restore the snapshot if taken.
CT Myocardial protocol: Contour edits sometimes not saved (VIT-3280)
Occasionally, in the CT Myocardial protocol when you make contour adjustments, select compute, the contours change back to the
previous position. This occurred when the adjustments made were not accepted.
A dialog displays for you to analyze and determine if further adjustments to contours need to be made. You can continue to adjust the
location of the contours by using the Edit option under Cardiac Analysis as needed.

MyoAnalysis polar map image has report page graphic captured instead of the polar map (VIT-9108)
This occurs when you complete the following workflow:
1. Load MyoAnalysis protocol.
2. Wait for segmentation/calculation to complete.
3. Take snapshots of different views and quickly go to the Report page.
4. Examine the snapshots and polar maps on the report slide tray.
Sometimes the two generated polar map images display as the background of the Report or Viewer page. As a workaround, toggle
between the Viewer tab and the Report tab to regenerate the polar map images.
Transcatheter Aortic Valve Replacement (TAVR): Ruler and circumference measurements difficult to measure/edit (VIT-8366)
This issue occurs when the ruler and ROI measurements overlap. Combined ruler and ROI measurements are difficult to edit unless one
is moved out of the way.
As a workaround, complete the workflow in a different order, such as drawing the rulers first or drawing the rulers to extend beyond the
ROI and adjust accordingly.
Non-cardiac protocols: Orientation position angles not displayed (VIT-8227)
When loading non cardiac protocols and selecting the 3D preset, the orientation is not displayed.
As a workaround, C-Arm angles (a different format of the orientation) can be found in other protocols such as Cardiac: Arteries
and Vascular: Stent Planning.

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Known Issues from Previous Releases, continued

Large Tumor Probe Tool (VIT-7765)
When probing a tumor, you select the large size and then manually adjust the size by clicking -" to reduce the tumor. In certain cases,
the size increases, rather than decreases.
As a workaround, select -" again and the appropriate size is reflected.
CT Liver Analysis: When loading a multi-phase series, the phase buttons are not properly displayed at the bottom of the
screen with a 1280x1024 monitor resolution (VIT-5925)
This issue is resolved for English. As a workaround for other languages, change the monitor resolution. If this is not possible, please
contact Vital Customer Support.
Body Perfusion: Different version snapshot restore fails/does not complete
If you complete Body Perfusion snapshots on Vitrea Standalone workstation and export to another machine, the snapshot fails or does
not complete.
As a workaround, open the original series and retake the snapshots.
CT Fat Application: Auto generated images are black for single slice data (VIT-7942)
This issue occurred with the following workflow:
1. Launch single slice data into CT Fat preset.
2. Select the Report tab.
3. The report should populate with auto generated images.
The Auto generated images are completely black.
As a workaround, take snapshots and drag into the report to replace the blank images.
Inconsistent behavior when using Autoskin within the CT Fat application (VIT-8882)
When you launch a study using the CT Fat preset, select Autoskin, select Segment, select Autoskin again and then select Replace,
the regions and measurements are affected. If you select Segment and then Autoskin, the Autoskin does not affect results or regions
from initial fat segmenting.
Burning CD/DVDs in Windows XP: Progress bar stops at 99% (VIT-7891)
The CD/DVD disk burn is finished and ejects, however the progress bar shows 99%. You perceive the CD/DVD is missing a file when
the status does not correctly display 100%. This only occurs in Windows XP.
License server connection unavailable: Pressing gallery tab hangs application (VIT-8403)
This issue may occur when taking a group of snapshots, batches, etc. and you lose the license connection and go back to the Gallery
before the workflow was finished.
As a workaround, the evidence is populated when you click Back to the Study Directory.

Media Manager import fails with extremely large size DICOM files (>2 GB) (VIT-6268)
MediaManager import fails with large (2 Gigabyte) DICOM files. This size would typically be reached with approximately 4,000 images.
As a workaround, you can use other tools to import the patient study such as sending the dataset directly from the modality to PACS.
Help links in Demonstrations sections cause VitalBrowser to crash (VIT-3836)
In VitreaAdvanced, if the Help tab is selected, followed by a link within the Help-Demonstrations section, followed by a link in the
selected Help-Demonstrations page, the Help tab will be blank and will not return until VitreaAdvanced is restarted. The defect will only
occur on machines running Microsoft XP (Vitrea workstations or VitreaAdvanced Servers). It is caused by a 2006 Microsoft security
update (#923789) related to the use of Adobe Flash.
There are two alternatives for a system administrator to fix this problem:
Uninstall Microsoft KB #923789. The next time a Help-Demonstrations link is opened, you will be prompted to either download the
associated video or to install Adobe Flash. This will have to be done on each VitreaAdvanced Server and/or Vitrea Workstation
Manually install the latest version of Adobe Flash which will overwrite the incorrect Microsoft patch.

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Known Issues from Previous Releases, continued

Lung Density Undo after sculpting and creating a new region removes all segmentation (VIT-8708)
This issue occurs when you:
1. Load a dataset into Lung CT/Lung Density Analysis.
2. Select Show Volume for both left and right lung regions after segmentation completes.
3. Clear the Show checkboxes for Base and Airways in the anatomy section. Only the L Lung and R Lung should be visible in the
volume view.
4. Using the Sculpt tool, draw a contour inside the borders of one of the lungs in the volume view.
5. In the 3D Sculpt dialog, select Other from the dropdown list of the field next to the AddTo button and then click the AddTo button.
6. Click Undo (F11) once.
7. All segmentation is undone and only the base region is shown is shown in the Anatomy list.
As a workaround, merge the other region back to the left lung region instead of undo or reset the view. You can also redo (press
F12) to restore the segmentation.
The Vitrea Administration Tool will report that remote administration is not allowed when pointing to a remote license server. (VIM-1534)
In some cases, the installer will not be able to create proper temporary folders needed for services. If you suspect that services are not
working correctly, please contact Customer Support. (PLT-3795)

VitreaLT 4.1.52 Release Notes VPMC-13443A

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