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AC1456
2015-03-16
All rights reserved. No part of this manual may be reproduced or copied in any form by
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Contents
AC1456 | 2015-03-16 i
About High Detail Visualization (HDV) Software......................................................................... 40
Pneumothorax Visualization Software ......................................................................................... 41
Bone Suppression Software ........................................................................................................... 42
Bone Suppression Indications For Use ..................................................................................... 42
Prior Images .................................................................................................................................... 43
Prior Image Display Feature..................................................................................................... 43
Use Prior Images ....................................................................................................................... 43
Prior Image Controls................................................................................................................. 44
Retrieve Prior Images ............................................................................................................... 44
Express Viewer Screen .................................................................................................................... 47
Image Viewer Screen...................................................................................................................... 49
Use the Image Viewer Screen .................................................................................................. 49
Tech Assist Toggle Button........................................................................................................ 50
Reprocess Image Button........................................................................................................... 50
Markers Overview..................................................................................................................... 50
Image Orientation and Appearance ....................................................................................... 53
Black Surround Mask................................................................................................................ 55
Grid Support Feature................................................................................................................ 60
Noise Suppression..................................................................................................................... 60
View/Look Adjustment Tab...................................................................................................... 61
Magnification Tab .................................................................................................................... 62
Crop Box Adjustment Tab ........................................................................................................ 62
How to Create an Image Copy................................................................................................. 67
Image Processing ...................................................................................................................... 67
Image Adjustment Tab............................................................................................................. 69
Measurement Tools .................................................................................................................. 69
Use the Comment Tab.............................................................................................................. 71
Image Review.................................................................................................................................. 72
About the Image List Screen .................................................................................................... 72
Flagged Image List.......................................................................................................................... 75
Flag an Image for Review ........................................................................................................ 75
How to Select a Destination .......................................................................................................... 77
How to Change the Destination .............................................................................................. 77
How to Change the Arrow Direction ............................................................................................ 78
Multi-Format Printing Overview.................................................................................................... 79
Custom Page Layouts ............................................................................................................... 79
Multi-Format Print Buttons ...................................................................................................... 81
How to Place an Image in a Multi-Format Cell ....................................................................... 83
How to Adjust Images in a Multi-Format Print....................................................................... 83
How to Change a Multi-Format Print Layout ......................................................................... 84
Print Destinations for Multi-Format Printing.......................................................................... 84
Text Options of Multi-Format Printing ................................................................................... 85
How to Position an Internal Text Box ..................................................................................... 85
How to Create a Text Overlay for a Multi-Format Print .............................................................. 87
Utilities ............................................................................................................................................ 88
Change Password............................................................................................................................ 89
Register Badge................................................................................................................................ 90
System Status .................................................................................................................................. 91
Software Updates ........................................................................................................................... 92
Pending Job Management............................................................................................................. 93
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Contents
Enterprise Wireless
Image information is transmitted wirelessly from a DRX Detector to the Console. To
ensure security for a wireless exchange, Carestream Health provides certificate-based
authentication between devices. The certificate is an electronic document that identifies
a user and confirms the identity of that user to another party. See Enterprise Wireless
with a Wireless Detector.
Bone Suppression
Bone Suppression Software allows the user to view an image that minimizes the evidence
of posterior ribs and clavicles, allowing a clearer view of chest organs such as the lungs.
It reduces the need for a second X-ray or a CT scan, with a lesser dose to the patient as a
result. These benefits apply to all Companion images. See Bone Suppression Software.
AC1456 | 2015-03-16 1
IHE Radiation Exposure Monitoring
The system creates, sends, and stores the data needed to create a structured report. This
data is the radiation dose a patient receives during the study after the Technologist
selects End Study on the Patient Input or Image Acquisition screen.
The structured report option must be enabled on the system in order to use the feature.
See X-ray Radiation Dose Reporting Overview.
Free Rotation
The Free Rotate feature is a tool that allows the user to slightly rotate an image that is
not oriented optimally on the Image Viewer screen. The control appears on the Printer
tab, located under the Rotate Clockwise and Rotate Counterclockwise buttons. See
About the Free Rotate Feature.
Multi-Modality Acquisition
This feature allows the user to directly connect two Classic/Elite CR readers together or a
Classic/Elite reader with a DR System. This is useful when CR cassettes are used as a
receptor in a study and then can be processed in the same room that the exposure was
taken. The Key Operator enables the option on the Option Registration screen. Only one
Console will be used, so the systems will share the same Work List, images, database, and
so forth. Multi-Modality Acquisition is only supported by the Classic/Elite CR Systems.
Technique Scaling
This information applies to the DRX-Evolution and DRX-Revolution Mobile X-ray Systems
only.
The Technique Scaling Tool lets the Key Operator take an optimized set of techniques for
a type of receptor and increase or decrease them automatically to create techniques for
another type of receptor. The tool can be used to create CsI, GOS, or CR techniques from
the existing techniques file. See About Technique Scaling.
2 AC1456 | 2015-03-16
creating a custom layout is to copy an existing layout and modify it See Multi-Format
Designer Table.
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Export Exposure Settings on DRX-Evolution and DRX-Revolution Systems
This feature allows the user to export exposure information to a spreadsheet for
inspection at a later time.
IPv6 Configuration
Internet Protocol Version 6 is a network protocol that is available if a facility determines
that new IP Addresses are needed in their system, because the number of computers
accessing the Internet will soon exceed the number of IP addresses available. IPv6
provides billions of new addresses. If IPv6 is used by the facility, it will provide a
non-standard IP address format for their computers.
4 AC1456 | 2015-03-16
Copyright Statement
Copyright Statement
CARESTREAM is a trademark of Carestream Health, Inc.
This document is copyrighted with all rights reserved.
Copyright Law
Under the copyright laws, this document may not be copied, in whole or in part, without
the written consent of Carestream Health, Inc. Under the law, copying includes
translating into another language or format.
Note
Notes provide additional information, such as expanded explanations, hints, or reminders.
Important
Important highlights critical policy information that affects how you use this manual and this
product.
Caution
Caution points out procedures that you must follow precisely to avoid damage to the system or
any of its components, yourself or others, loss of data, or corruption of files in software
applications.
AC1456 | 2015-03-16 5
Copyright Statement
Caution
Federal law restricts this device to sale by or on the order of a physician.
Caution
If you witness or become aware of a potential safety issue with this equipment, take the
appropriate safety measures and report this to your Carestream Service representative
immediately.
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Log On and Out of the System
1. Select the User Name field and type in your user name.
2. Select the Password field and type in your password.
3. Select Logon.
If your system is configured without user names and passwords, select Tech Logon.
Register Badge
This procedure assumes you already have a user account. User accounts must be created
by the Security Administrator before a proximity badge can be registered.
1. Log into the system.
2. Navigate to Utilities > Register Badge and select Register Badge.
3. Scan the badge by swiping it across the badge reader.
When the system reads the badge, you will hear a beep.
4. When asked if you want to associate the badge to your account, select OK.
5. Follow the on-screen instructions to register your proximity badge.
Once configured, the user can log in by passing the badge across the reader without
entering their user name and password on the Login screen.
The user will log out the previous user when using this feature.
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Log On and Out of the System
Change Password
You can change your password in a DIRECTVIEW system at any time. Remember to create
a password that conforms to the number and type of characters set for passwords in your
facility by your Security Administrator.
1. At the Main Menu, select Utilities.
2. Select Change Password.
3. Enter your old password.
4. Enter your new password.
5. Confirm your new password by entering it again (exactly the same way).
6. Select Change Password.
Note
If you have forgotten your password, contact the Security Administrator. Your Security
Administrator can reset your password so that you can change it if needed.
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Quick Reference
Quick Reference
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Quick Reference
Common Buttons
Buttons that are displayed in color on the screen are active. Buttons that are displayed in
gray on the screen are inactive.
Icon Button Name Description
Accept All Accepts all images in a study and sends them to destinations.
Accept Image Sends the image immediately to the destinations set up by the
Key Operator. Selected after you have viewed an image and
find it satisfactory.
Add Lets you add a multi-format print and opens the Multi-Format
Multi-Format Configuration screen. This button becomes active when an
Print image is available to go to a destination.
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Quick Reference
Change Changes the format for printing the images in the study and
Multi-Format opens the Multi-Format Configuration screen. This button
Print becomes active when an image is available to go to a destina-
Configuration tion.
Assign Image Assigns the image to a new or existing patient record or study.
Main Menu Exits the screen and returns you to the Main Menu. Provides
quick access to other functions. This button appears on every
screen.
Delete View Deletes the selected View. If no view is selected, the button is
disabled.
Save Changes Saves all changes made on the screen, copying them to the
database.
Reject Image Immediately removes the image from the system. The Patient
information remains on the system database. Select Reject
Image if an image must be retaken due to motion or clipped
anatomy. The Key Operator can review rejected images. Based
on Key Operator settings, the image may not be deleted imme-
diately.
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Quick Reference
Re-deliver Image Delivers an image that has been delivered previously, and
allows the user to select another destination. The current desti-
nation selection is used to re-deliver an image.
Find Study Immediately sends the query criteria to the HIS/RIS. Returns a
Remotely list of studies that match those criteria to the Work List from
the HIS/RIS and the local Modality database.
Clear Fields Deletes all information entered in fields on the screen. Fields
with predefined values will be reset to the default value.
Reprocess Applies the processing changes you have selected and modifies
the image.
Unassign Image Disconnects the image from the current patient data. When
selected, toggles to Assign Image so that you can assign the
correct patient information.
Log On Allows access to the Modality. Enter your User Name and Pass-
word and then click Log On to activate your account. If your
Key Operator does not require a password, select Tech Log On
to log in automatically.
Log Out Closes your account in the System until you log on again.
Quick Menu Located in the lower-left corner of every screen on the System,
it gives quick access to functions and the recent patient exams.
Shut Down Provides options to shut down power to the console. The Shut
Down button displays different options depending on the log
on password used. For example, Service personnel see different
options than technologists.
Images Failed to Takes you to the Image Review screen and automatically fil-
Deliver ters images that failed to deliver to their destination. The num-
ber of images at this status appears on the Images Failed to
Deliver button on the Main Menu.
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Quick Reference
New Patient Select New Patient when the patient you are searching for
does not exist in the local system or in the hospital's HIS/RIS.
New Study Creates a new study for the patient currently displayed on the
screen. The patient demographic information is copied from
the original study. The Accession Number, Procedure Code,
and Patient Location fields are not copied with New Study.
Begin Study Sends a message to the HIS/RIS that the study is started. This
button appears when New Patient is selected or when a
patient is selected from the Work List.
End Study Appears when the study has started. Select End Study to set
the study to complete. A message is sent to the HIS/RIS to
notify the billing function that the study is complete.
Continue Lets you go on to the next function without saving the changes
Without Saving you have made. It appears on the Confirm Changes dialog.
Touchscreen Usage
Note
The touchscreen is very sensitive. Any inadvertent interaction with the screen may give you
unexpected results, so take care to select the targets carefully.
When you are logged on, the Main Menu button appears on every screen.
To make a menu choice, select the center of the button.
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Quick Reference
Use only your finger or mouse to select buttons to prevent damage to surface of the
touchscreen.
The Quick Menu appears in the lower-left corner of every screen.
When the touchscreen deactivates because it was not used for a certain length of time,
touch the screen to reactivate it.
The date and time appear on every screen.
Note
The basic Classic CR system is shipped with a flat panel, non-touchscreen monitor. A touchscreen
monitor is available as an upgrade on a Classic CR system.
Multi-touch Monitor
The Multi-touch Monitor allows interaction with the screen with gestures, such as pinch
and pull to zoom and rotate. The user places two fingers on the screen and spreads them
apart or pulls them together to manipulate the zoom feature. Rotation may be done by
placing one finger on the image and pulling it left or right to rotate into position.
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Quick Reference
An icon in the title bar on the Patient Input or Image Acquisition screen displays when
this feature is enabled.
There are two identifiers that the Key Operator can use to configure Patient Verification:
Patient ID
Name with Date of Birth
To Be Verified
Waiting for the wristband to be scanned with the 2D bar code reader.
The wristband has been scanned with the 2D bar code reader and the Patient IDs do not
match.
User searches for another patient or enters data for a new patient using the 2D bar code
reader.
Is a Match
Patient ID on the wristband matches the patient ID in the system. The patient verification
is complete.
User proceeds with the exam.
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Quick Reference
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Use the Patient Work List Screen
Colors
Work List colors highlight the status of a patient order. The Key Operator can customize
the colors and their meaning for a particular facility from Key Operator Functions >
System Configuration > Color Preferences.
Standard colors are as follows:
Color Study Status on the Console
Blue Scheduled
Black Started
Green Arrived
Gray Complete
Navigation Buttons
Button Function
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Use the Patient Work List Screen
Scheduled
Started
Complete
Discontinued
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Use the Patient Work List Screen
Icon Meaning
New Exam
Perform a Search
Returning large volumes of data can cause system slowdowns. For best results, select
a narrow time window filter of Today.
Select Find Study Remotely to search the database, and to query the HIS/RIS
immediately.
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Use the Patient Work List Screen
No Search Results
Check the criteria carefully for errors in spelling, accurate time window, correct
patient ID, and so forth.
Select New Patient, which will take you to the Patient Work List screen to enter
the information.
Note
If emergency patient information is not available or emergency circumstances do not allow the
time to enter data, immediately proceed to using the Trauma function.
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Use the Patient Work List Screen
The Recent Exam Indicator appears in the upper-right corner of the screen when the Key
Operator activates the layout. The number indicates how many new exams there are. If
you touch the icon only the patients that have been added since the last log in will be
listed.
The Recent Exam Indicator appears in the upper-right corner of the Patient Work List
screen when the Key Operator activates the Add Patient Location and Recent Exam Filter
layout. If you touch the icon, only the patients who have been added since the last log in
will be selected.
Prerequisites:
If no patient information is in the Hospital Information System/Radiology Information
System (HIS/RIS) or local database, follow this procedure:
Prerequisites:
A patient was X-rayed recently, but the record cannot be found. The information is in the
system and accessible through the Quick Menu.
1. Select Quick Menu. A brief list of patient records appears in the Quick Menu.
2. Select the Name, Accession Number, or ID field for the patient record you need to
use.
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Use the Patient Work List Screen
Prerequisites:
The user is unable to locate a patient who already is registered in the system.
Prerequisites:
The patient is in an emergency condition and you must enter data quickly. The Key
Operator must configure the Trauma option.
1. Select Trauma.
2. Select a Trauma ID.
Postrequisites:
If you do not see a Trauma button, consult with your Key Operator.
Note
The Trauma button does not appear unless the Key Operator has configured it. On CR Systems,
the Trauma feature is a purchasable option.
There are at least two options for finding an image you cannot locate quickly. Both
options begin at the Main Menu.
1. At the Main Menu, select Image Review.
2. Filter the database for the patients image by selecting the appropriate study status
(All, Unassigned, Delivered, and so forth).
3. Select the Image.
Note
From the Patient Work List screen, select the study and select the image.
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Use the Patient Work List Screen
You can modify the patient, exam, and image data at any time up until the image is
delivered.
You can modify the patient, exam, and image information up until the image is
delivered.
1. Select a field.
2. Select Backspace.
Or select Clear All Fields at the bottom of the screen to delete information in all
the fields.
The pre-defined information in all fields will be reset to the default value when
you select Clear All Fields.
AC1456 | 2015-03-16 23
About the Image Acquisition Screen
Patient Input
Input and view information about the exam.
Provides:
Mandatory Patient Information
Optional Patient or Image Information
Multi-Format Print access
View Selection
Start, Delete, Complete, or End Study
Accept or Reject Image
Receptor Selection
Select and activate a Receptor.
On DRX-Evolution Systems, select Table Bucky, Table top, or Wall Stand
Focal Spot
Select Small Focal Spot
Select Large Focal Spot
Patient Size
Opens a tab menu of patient sizes for adults
Opens a tab of children sizes if the Pediatric Support Option is activated
Techniques
View information about the power, operational mode, and signal quality of a
receptor
Change the exposure duration. (Except on DRX-1 Systems. They do not have
generator controls.)
Detector Status
View status information about the selected detector.
Study Management
Manage data about the image.
Edit image data.
Manage the study.
Use navigational controls.
24 AC1456 | 2015-03-16
About the Image Acquisition Screen
Note
This will happen automatically when the first image is acquired for the study.
11. When the detector has a status of Ready, use the two-position prep/exposure switch.
12. View the preview image. If the image is incorrect, reject the image and make the
necessary adjustments to obtain an image that looks accurate in the preview.
13. When you see a status of Need Approval or Need Destination, touch the image to
go to the Image Viewer screen.
14. Work with the final image in Image. When satisfied, accept the image.
15. After completing work in the Image Viewer, you automatically return to the Image
Acquisition screen.
16. Proceed to the next image in the study.
AC1456 | 2015-03-16 25
About the Image Acquisition Screen
After each view is captured, the icon is replaced with a thumbnail image that represents
an exposed image.
Note
Images captured using the DRX System Detector and Console are automatically processed
following exposure.
Touching a thumbnail image takes you to the Image Viewer screen for that image.
A blue square in the procedure name box indicates that the procedure is configured for
multi-format pages.
Note
When taking an exposure, employ the use of appropriate radiation protection and safety
measures for you and your patient. Refer to the CARESTREAM DRX-1 System Safety and
Regulatory Information with Hardware User's Guide for product safety information.
1. In the exam room, look at the detector surface for an identification mark.
2. Put the detector in a Bucky or position the detector for a tabletop exam.
3. At the Console, access the Image Acquisition screen.
4. Prepare the patient information.
5. Prepare the study procedures.
6. Touch and activate the Detector Icon that matches the identification label on the
detector.
7. Position the equipment and patient.
8. Give the patient the proper breathing instructions.
26 AC1456 | 2015-03-16
About the Image Acquisition Screen
9. On the prep/exposure switch, press and hold the button halfway down to the prep
position.
10. After the status bar indicates the detector is Ready, press the button completely to
take the exposure.
11. When the exposure is complete, release the prep/exposure button. The image is
processed automatically.
12. Give the patient the proper breathing instructions.
13. Use the Console to preview images, accept the images, and select destinations for the
images.
AC1456 | 2015-03-16 27
Patient Input Screen
The Patient Input screen or the top half of the Image Acquisition screen lets you
enter, modify, or view information about the patient, study, or image. To enter the
information manually:
1. Use the bar code scanner to enter information, or touch the field and enter the
information from the virtual keyboard.
2. Enter the required information in the required fields.
3. Enter optional information if available.
Optional fields are not highlighted and do not have to be filled in order to
complete the study.
The Key Operator determines which fields are considered optional.
4. Select Save Changes.
A pop-up warning appears if the software changes an invalid birth date to a valid one
when the Technologist enters a birth date on the Patient Input screen.
Select a data field and scan a bar code to place its value in the field. The system is capable
of recognizing and automatically placing the values. This feature is the system's ability to
automatically recognize certain data fields and enter the information without selecting
that field in advance.
The bar code reader must be configured correctly and the Key Operator must configure
the Console to recognize Accession Number, Patient ID, and Tech ID bar codes. This
allows the Modality to:
28 AC1456 | 2015-03-16
Patient Input Screen
Expedite data entry by reading bar codes for selected fields and place those values
into the fields.
Automatically place the correct value in the correct field if you read an Accession
Number, Patient ID, or Tech ID. This opens the patient study automatically.
The bar code automatically executes a local query to retrieve Work List or patient
records that match the value read.
Additional exam information is information that the Key Operator has decided not to
require in order to proceed with the patient's exam. You can complete the patient's
record without this information. The fields are configurable by the Key Operator,
depending on the needs of the facility. Enter optional information from the three tabbed
palettes as shown on the Patient Input screen or in the section of the Image
Acquisition screen.
To begin a Study from the HIS/RIS, select Study Data. Do one of the following:
Scan the bar code on the requisition or enter patient information in any of the
available fields.
Select or enter the patient name at the Work List.
The patient information and the Technologists ID fill in automatically on the Patient
Input or Image Acquisition screen if the Key Operator has configured it to do so.
1. Touch the field and enter the information. The Technologists ID fills in automatically
if the Key Operator has configured this feature.
The Key Operator may specify data fields that are required to be completed for every
exam. Required fields are identified by a colored highlight.
2. Enter the required information in highlighted fields.
Required fields must be completed before you proceed with the exam.
3. Enter optional information, if available.
Optional fields are not highlighted and do not have to be filled in order to complete
the exam. The Key Operator determines which fields are considered optional.
4. Enter more information on the More Information and Image Acquisition tabs.
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Patient Input Screen
The patient record retains the patient data without the images.
When all of the images have been acquired and accepted, you should end the study by
selecting End Study on the Patient Input or Image Acquisition screen.
If your system is using Modality Performed Procedure Step (MPPS) for Scheduled
Workflow, selecting End Study sends a message to the HIS/RIS Modality Performed
Procedure Step Manager that the procedure has ended, and changes the status of the
exam in the Modality is Completed.
The system creates, sends, and stores a structured report of the dose of irradiation a
patient receives when the Technologist selects End Study on the Patient Input or
Image Acquisition screen after a study is complete.
The structured report option must be enabled on the system in order to use the feature.
If your facility has a HIS/RIS and your Modality has the optional Procedure Mapping
feature, the Key Operator can associate procedure codes to automatically populate the
necessary views for a study. The HIS/RIS must populate the procedure code field on the
Image Acquisition screen so that the Views populate automatically.
1. From the Main Menu, select Study Data.
2. Search for the patient using the Patient Work List screen.
3. Select the patient from the Patient Work List screen.
The patient information and the Views for the procedure automatically appear on
the Image Acquisition screen.
4. Enter information on the More Information and More Image Data tabs if needed.
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Patient Input Screen
If your facility has purchased the optional Procedure Mapping feature, you can complete
the View selection process as follows.
1. From the Main Menu, select New Patient.
2. Manually enter the patient data and complete all of the highlighted required fields.
3. If you know the Procedure Code, enter it in the Procedure Code field and select
Enter.
The system automatically enters the procedure name in the Procedure Name field
and the associated Views automatically appear.
If you do not know the Procedure Code, do the following:
a. Select Procedure Name.
b. Select a region from the Primary Category tab.
c. Select a body part from the Secondary Category tab.
d. Select a Procedure.
The Views for the procedure appear on the Image Acquisition screen.
4. Enter information on the More Information and More Image Data tabs if needed.
1. Select a field.
2. Select Backspace.
3. Enter the correct information from the virtual keyboard.
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Patient Input Screen
Note
Enter the actual patient information when it becomes available on the Patient Input or Image
Acquisition screen. If the image is delivered, you must unassign the image from the Trauma ID
and assign the image to the correct patient information.
Trauma Button
The purpose of the Trauma button is to display the pre-configured trauma patients that
have been configured by the Key Operator. The Trauma button opens a keyboard with
default information to use for emergency patients. This information is pre-configured by
the Key Operator. When selected, this button:
Fills the patient information you select automatically into the Patient Input or
Image Acquisition screen.
Enables you to enter the actual patient information when it becomes available.
If your system is configured for the Trauma feature, the required fields in the Exam
Information tab populate quickly in emergency situations. The Exam Information tab
is located on the Patient Input or Image Acquisition screen.
Prerequisites:
The patient is in an emergency condition and you must enter data quickly. The Key
Operator must configure the Trauma option.
1. Select Trauma.
2. Select a Trauma ID.
Postrequisites:
If you do not see a Trauma button, consult with your Key Operator.
Note
The Trauma button does not appear unless the Key Operator has configured it. On CR Systems,
the Trauma feature is a purchasable option.
32 AC1456 | 2015-03-16
Patient Input Screen
Views
Define a View
A View is a pre-set image type that a radiographer can select. It consists of position,
projection, and image processing preferences. On DRX-Evolution and DRX-Revolution,
selecting a View also selects the technique. It is the basic element in the CR or DR image
chain.
Views are associated with procedures on the Image Acquisition and Patient Input
screens with the optional Procedure Mapping. When the Key Operator creates a View,
it appears on the Image Acquisition or Patient Input screen.
Why would you want to change the View name for the current image?
For example, you did a Chest PA on a Chest Lateral thumbnail. You will want to change
the name of the View and then reprocess with the Chest PA processing.
1. Select the View name field.
2. Choose a primary category, secondary category, and a View.
3. If you have auto-reprocess turned on, you are done. If not, select Reprocess Image.
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Patient Input Screen
If the Key Operator has configured the system with the Views needed, in most instances
the View selection is complete once the procedure is selected.
Note
Data fields may be configured to accept a certain number of characters, character types, or a
sequence of characters based on DICOM. Some data fields have menu selections so the data is
set for you.
34 AC1456 | 2015-03-16
Patient Input Screen
4. Select Accept All to send all the Views that have acquired images to the selected
destinations.
Subsequently, acquired images will not be automatically delivered as a result of the
previous Accept All selection.
The Technologist can reject an image based on the quality of the image. When the
Administrative Analysis Reporting Software option is purchased and enabled, each time
an image is rejected, a reason must be selected. This reason is recorded and becomes a
record in Technologist Statistics. The image is evaluated at the Image Viewer screen.
The Key Operator can edit the default list.
An image may be rejected for the following reasons:
Clipped Anatomy
Motion
Positioning Error
Artifact
Technique
Duplicate
Test/Service/Blank
Once the image is evaluated, and you decide it should be rejected, do the following:
1. Select Reject.
2. Choose a reject reason.
3. Select Reject.
The rejected image then appears on the Rejected Image List screen. It may be accessed
by the Key Operator. The Key Operator may configure the system so that the
Technologist can access the screen as well, for further evaluation at another time.
Note
If the Administrative Analysis Reporting Software is not used, the Technologist will answer Yes or
No to a pop-up asking if the image should be rejected, without being prompted for a reason.
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How to Assign an Image to a Patient
36 AC1456 | 2015-03-16
How to Assign an Image to a Patient
Note
Unassigned images must be assigned to a patient before delivery. You cannot assign an image
once it is in Delivered status. You will have to make a copy of the image in order to do so. See
How to Make an Image Copy for more information.
Note
Unassigned images must be assigned to a patient before delivery.
1. From the Main Menu, select the Images Not Assigned button.
2. Select the image from the list to open the Image Viewer screen.
3. At the Image Viewer screen, select the Look/Adjustment tab.
4. Select the View Name field to correctly designate the appropriate algorithm.
5. Select Reprocess Image.
6. Select Save Changes.
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Tube and Line Visualization Software
Note
If the Tube and Line Visualization Software is purchased, the High Detail Visualization (HDV)
feature is automatically included. The HDV feature provides a higher contrast image so that detail
is easier to see. This feature is intended for Views other than chests and abdomens.
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Tube and Line Visualization Software
The Virtual Keyboard does not appear Enable Tube and Line Visualization Software.
The Companion View does not change
The Companion View is unchanged Caused by selecting Close on virtual keyboard.
Turn off the Companion Image created for a Select Clear to eliminate a Companion Image.
given View, but create it for other Views
Do not create Companion Images automatically Do not check the box in front of any of the Com-
panion Images listed in the Auto Create Compan-
ion Image Type check box on the Display
Configuration > Image Viewer tab.
Companion Image button is not selectable Change the View to one that supports a Tube/Line
View, then reprocess the image.
Ask the Key Operator to assist.
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About High Detail Visualization (HDV) Software
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Pneumothorax Visualization Software
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Bone Suppression Software
Caution
Measurement of pathology in the bone-suppressed companion image is not recommended.
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Prior Images
Prior Images
Note
One button is listed on the right side of the screen for each prior image.
3. Select the button to load a prior image into the preview panel to the left of this list.
4. View the image.
5. Determine whether to use the same techniques that were used to create this image,
or whether to change the technique to improve on these results when the image is
acquired.
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Prior Images
Tool Result
Copy the technique for the prior image to the Image Acquisition screen if
desired (DR only).
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Prior Images
Automatically Retrieve When the Study is Added to the Work List or the
View is created
When this third mode is selected, the Retrieve Priors for Work List Items Matching
the Following Criteria check box will be enabled. It is not available in any other
retrieval mode.
Note
The system will search for the number of images and time limit the Key Operator has configured
as a default, such as two images processed in the past two weeks. Prior image Views may be
configured for certain body parts only.
When the Prior Image Retrieval feature is enabled, a new icon is added to the tutor
image.
This display indicates that the system is actively searching for prior images, but none have
been found. The icon is disabled and the animated cursor indicates that the search is in
progress. The icon does not indicate the presence of priors.
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Prior Images
This display indicates the number of prior images that have been retrieved
Selecting this icon opens the Prior Images screen. If additional images are actively being
retrieved, the icon as well as the Prior Images screen will be updated to reflect the
additional images as they are retrieved into the system.
This display indicates that the user can manually request to retrieve priors for this image,
even if the system is in another retrieval mode.
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Express Viewer Screen
Note
For more image editing tools, select Advanced Viewer. Once you access the Image Viewer
screen, you cannot toggle back to the Express Viewer screen.
Icon Description
Pneumothorax View
Applies image processing that makes it easier to see a patient's
pneumothorax in the displayed image.
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Express Viewer Screen
Icon Description
Histogram
A graph of the distributions of pixel values in the image. The X-axis
is exposure from low to high. The Y-axis is frequency of occur-
rence.
Flip Buttons
When selected, they transpose individual images horizontally or
vertically.
Rotate Buttons
When selected, an individual image turns clockwise or counter-
clockwise at 90 degree intervals.
Markers
The markers palette appears with a crosshair target.
View Name
Change the view name for the current image.
Edit Mask
Edit the mask points so that you can change the shape of the Black
Surround Mask.
Reprocess
The current image if the View name or Black Surround Mask has
changed.
This button is not visible if the system is configured to reprocess
images automatically.
If Tech Assist software is enabled, this button lets you toggle back
and forth between the standard view and the CNR/Anatomy
Clipping view.
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Image Viewer Screen
Note
The user can select any of these options from the Image Viewer screen. Fit to Screen, Fit to
BSM, and Full Screen viewing are always available to the user and can be selected regardless of
how the system is configured to zoom by default.
The Full Screen Viewing feature maximizes the visibility of the image by allowing the
image to fill the entire screen. The control is accessed from the Image Viewer screen.
The image can be panned while zoomed; however, no other edits can be mademarkers
cannot be placed or moved on the image.
The Full Screen viewing feature:
Causes the image to fill the entire screen
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Image Viewer Screen
Allows the user to zoom in and out in 10 % increments while the image fills the screen
(up to a maximum of 200 % zoom)
Allows the user to exit Full Screen mode and return to the normal Image Viewer
screen view.
Full Screen viewing causes the image to fill the screen so that the controls on the Image
Viewer screen are no longer visible.
1. Select the Full Screen button to use the entire screen as image display area.
a. Use the + button to zoom the image up to 200 %.
b. Use the button to make the image smaller.
2. Select Back to return to the Image Viewer tool pallet.
If Tech Assist software is enabled, this button lets you toggle back and forth between
the standard image view and the CNR/Anatomy Clipping view.
Reprocess the current image if the View name or the Black Surround Mask has changed.
This button is not visible if the system is configured to reprocess images automatically.
Markers Overview
The markers palette appears when you touch an image on the screen.
There are many markers to choose from on the Markers palette. You can move and
delete markers on the image by touching the image and then touching a marker. The
markers are divided into groups to make them easy to find. You access them from the
sub-tabs at the bottom of this palette.
When you apply a marker, and then flip or rotate the image, an arrow marker will still
point to the area you designated. A text marker will read correctly.
Once you select Save Changes, the marker becomes a permanent part of the image. It
appears on a workstation or on a print.
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Image Viewer Screen
Markers can be created in a file that is used as an overlay on an image. If selected on the
Delivery Preferences screen, the Key Operator can select Marker Overlay to Storage
on the Destination Configuration screen and send the marker to the PACS as a
separate file.
Favorites
Others
Time
Measures
This procedure applies to the Image Viewer screen. You can add an unlimited number
of markers to an image. Once a marker is added to an image, it will be visible when it is
sent to a destination. Markers can be used more than once on a single image.
1. From the Image Viewer screen, select the Markers tab.
2. Select the marker type icon (Time, Measures, and so forth).
3. Select the desired location on the image.
4. Select Save Changes.
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Image Viewer Screen
This procedure applies to the Image Viewer screen. A marker can be removed from an
image before or after it is saved to the Modality database.
1. Select a marker on the image. The marker is highlighted when selected.
2. Select the Trash Can.
The Free-Form Text marker lets you add 32 characters of text to the image. You can add
the text marker to an image or change the marker already in place. The text marker
becomes part of the image and is retained when sent to destinations.
To add a Free-Form Text marker:
1. From the Image Viewer screen, select the Markers tab.
2. Enter the desired information in the text field from the keyboard for your system.
3. Select the desired location on the image.
Note
When you add a Free-Form Text marker, use the keyboard to enter text in the Free-Form text
field. You must select Enter every time the Free-Form text field is changed.
Note
To remove the text marker, select the text marker on the image, then select the Trash Can.
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Image Viewer Screen
Rotating and flipping the image lets you change the orientation of an image before it is
sent to destinations.
1. From the Image Viewer Screen, select the Print tab.
2. To rotate the image clockwise, select the Rotate CW button. To rotate the image
counter clockwise, select the Rotate CCW button.
The image rotates in increments of 90 degrees.
You can see the change in the Image Viewer window.
3. To flip the image, select the Flip Horizontal or Flip Vertical button.
You can see the change in the Image Viewer window.
4. Select Save Changes.
The change you make to image orientation appears at the destination.
Use the Pan and Zoom features to evaluate images. To return to normal view, select Fit
to Screen.
There are a variety of ways to pan the image:
Use the arrows to move the viewing window to different areas of the image.
Select the image and drag across.
Select the thumbnail and drag across.
Drag the highlighted viewing window to another area.
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Image Viewer Screen
Zoom Mode
You can enlarge the image by selecting a zoom level on the Magnification tab on the
Image Viewer screen.
When the image is in zoom mode you can add markers and change image processing
characteristics.
The zoomed image is for viewing only. A zoomed image does not go to the destination.
1. At the Image Viewer screen, select the Invert Grayscale check box.
2. To print the image, select Save & Accept Image.
3. To remove the effect, clear the Invert Grayscale check box.
The histogram is a graph of the distributions of pixel values in the image. The X-axis
is exposure from low to high. The Y-axis is the frequency of occurrence.
A normal exposure produces an S-shaped contrast curve across the histogram. If
image processing fails, the histogram displays a straight diagonal line and the image
displays very low contrast. This is an indication that no additional image processing
has been applied to the image.
Displays changes in contrast such as changing from standard view, tube and line view,
and pneumothorax view for DIRECTVIEW
Note
A different Look or different collimation will generate a different curve, as well.
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Image Viewer Screen
The Free Rotate feature is a tool that allows the user to slightly rotate an image that is
not oriented optimally on the Image Viewer screen. The control appears on the Printer
tab, located under the Rotate Clockwise and Rotate Counterclockwise buttons.
When Free Rotate is selected, a crosshair and circle target appears, centered on the
image. The circle has four blue anchors. The user can select one of the anchors and drag
the anchor clockwise or counterclockwise until the image is oriented properly.
Surround Mask causes the unexposed areas around the image to be displayed black and
makes soft tissue and low contrast detail more visible. Mask placement normally
corresponds to the placement of collimator blades.
If two images are exposed on one phosphor screen, they are processed as two separate
images. Image quality is optimized for each exposure field, and the images are delivered
exactly as they appear on the system monitor. A Black Surround Mask and the Exposure
Index are applied to each exposure field separately.
Make adjustments as desired.
Show Mask Applies Automatic Surround Mask and makes
it visible.
Circle or Rectangle Controls Locates where on the image the mask should
be applied.
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Image Viewer Screen
* Use this feature if there is a Surround Mask failure and you want to enlarge the mask quickly, or if you move a
point off the image and you cannot get it back.
This feature can be configured in View Configuration to treat certain (or all) Views always as single exposures.
To find a mask point when it is off the image, you can change the magnification so you
can see the points.
1. At the Image Viewer screen, select the Magnification tab
2. Select 25 % zoom.
3. Select the Surround tab.
4. Select Edit Mask.
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Image Viewer Screen
5. Move the circular or rectangular control points on the mask on the smaller image.
Black Surround Mask reduces viewing flare. The mask helps you see soft tissue and low
contrast information. Automatic mask placement normally corresponds to the placement
of collimator blades.
Note
If you have the optional Automatic Surround Mask feature, automatic mask is ON by default. The
Show Mask check box is checked.
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Image Viewer Screen
Manual Surround Mask is used when Automatic Surround Masking is not sufficient.
1. From the Image Viewer screen on the Surround Mask tab, check the Edit Mask
check box.
2. Change the shape of the mask:
Select a circle (corner) or rectangle (side) on the mask, then drag it to another
location.
Select a side and select another location on the image.
Use the green arrows on the editor to move a selected side or edge.
3. Select Reprocess.
4. Select Save Changes.
To reset the Black Surround Mask back to its original position, navigate to the Image
Viewer screen and select Reset.
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Image Viewer Screen
To change the shape and size of the Black Surround Mask, select the circles on the corners
of the mask or the edges of the mask and pull or push the mask into the desired shape.
To change the shape and size of the Black Surround Mask, select the circles on the corners
of the mask or the edges of the mask and pull or push the mask into the desired shape.
Reprocessing modifies the image by applying the processing changes you have selected.
Reprocessing an image resets the contrast, brightness, and latitude value to the defaults
of the current View Name. When you change the View and select Reprocess Image, the
image processing is performed again using the new image processing parameters for the
new View.
Reprocessing is an option that should only be used when you want to change the look of the
image.
Reasons to Reprocess
You are not satisfied with the current look of the image.
Surround Mask has been applied.
Increasing or decreasing the size of the mask to the edge of the collimation.
Masking out unneeded anatomy, to optimize on the visible anatomy.
Poor collimation leaves unwanted objects in the image. Edit the Surround Mask and
reprocess to improve image quality.
When you modify the View Name on the Image Viewer screen.
Note
You cannot reprocess an image if the image has been accepted and delivered across the network.
You must create a copy of the image, modify the copy, and send it to the proper destinations. In
addition, an image must be delivered before you can make a copy of it.
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Image Viewer Screen
Note
It is important that grid artifacts are not visible on the radiologists workstation at the PACS. Grid
artifacts may be visible on the Console, but as long as they are not visible at the PACS, the
algorithm is working as designed.
Grid Suppression Software is an optional feature that can detect the presence of a
grid and can suppress the visual effects of grid artifacts. The Key Operator can configure
this feature.
Noise Suppression
Noise Suppression is also known as Low Exposure Optimization. It is intended to help
when a facility wants to use lower dose. The Key Operator has access to how much noise
suppression is applied to a View.
Reduces the appearance of quantum (white) noise in areas of low exposure.
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Image Viewer Screen
Note
Image quality must be evaluated as the dose decreases. The Key Operator might need to increase
noise suppression in that case.
1. If the current View is incorrect for the image select the View Name field and enter
a new name.
2. To display the black areas of the image as white and the white areas as black, select
the Invert Gray scale check box.
This may be helpful when identifying line placements.
3. If the software detects a grid, checking the Grid Suppression check box will suppress
grid artifacts from the image.
4. To suppress noise, place a check in the Noise Suppression check box to reduce the
appearance of noise in low exposure areas.
Note
If the View has the Grid Suppression and/or Noise Suppression options enabled, these features
are automatically applied.
5. Select Save Changes before closing the Image Viewer screen.
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Image Viewer Screen
Magnification Tab
The Magnification Tab lets you change the level of magnification that you see in the
image as displayed in the Image Viewer window and move the view by the selection of
different points on the screen.
When the image is in zoom mode you can add markers and change image processing
characteristics.
1. Select a zoom level (200%, 100%, 50%, 25%).
Zoom level is based on normal screen view.
The zoomed image is for viewing only. A zoomed image does not go to the
destination.
2. Move the area of view by selecting the image, thumbnails or arrows, or by dragging
across the image.
3. Increase or decrease the magnification of the image for viewing on the Modality.
4. Select Fit to Screen to exit Pan and Zoom mode and to make all areas of the image
accessible for viewing.
5. Select Fit to BSM to zoom the image to fit inside the Black Surround Mask (BSM). This
feature is for viewing, only.
True-size True-size produces the same size image you would get if you were
using a film-screen system. Use the crop box to determine what
part of the image will be printed.
Manual Crop Manual Cropping lets you adjust the amount of anatomy that is dis-
played on the film. The area inside the crop box determines the dis-
play. The aspect ratio of the crop box depends on the film size
selected. You can enlarge the crop box to include more anatomy,
but it will reduce the magnification.
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Image Viewer Screen
Feature Description
Crop Box Orientation Changes the orientation of the crop box from portrait (vertical) to
landscape (horizontal).
Arrows Moves the crop box to another part of the image as you select the
arrows.
True Size
This mode delivers the image data needed to provide a true size representation of the
image based on the destination. The crop box that is displayed on the user interface
(yellow) represents the most restrictive cropping needed for all destinations.
Printer - Only data within the crop box is sent.
PACS - Full acquisition data is sent.
Console Printer PACS
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Image Viewer Screen
Manual Crop
This mode allows adjustment of the crop box. The crop box cannot be resized in such a
way where the images would be larger than true size when printed.
Printer - Only data within the crop box is sent.
PACS - Only data within the crop box is sent.
Console Printer PACS
Automatic Crop
This mode automatically sets the crop box (yellow) to bound the Black Surround Mask.
Printer - Only data within the crop box is sent. The printer will minimize the image if the
anatomy is larger than the selected film size, but will print true size if the anatomy is
equal to or smaller than the film.
PACS - Only data within the crop box is sent.
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Image Viewer Screen
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Image Viewer Screen
Shrink to Fit
This mode delivers the full image data to the destination. The destination may reduce the
image size if necessary.
Printer - Full acquisition data sent.
PACS - Full acquisition data sent.
DIRECTVIEW Console Printer PACS
Manual Cropping lets you adjust the amount of anatomy that is displayed on the film.
The area inside the crop box determines the display. The aspect ratio of the crop box
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Image Viewer Screen
depends on the film size selected. You can enlarge the crop box to include more
anatomy, but it will reduce the magnification.
1. From the Main Menu, select Image Review.
2. Select an image to open the Image Viewer or Express Viewer screen.
3. Select the Print Format Field and select Manual Crop.
4. Select the Crop Box Adjustment tab.
You can drag the edges of the crop box to change the size of the box, or use the
arrows to adjust the position of the crop box.
5. Select Save Changes.
Image Processing
These two parameters can be used to fine-tune the image quality. Brightness makes an
image lighter or darker. Latitude controls the number of shades of gray that are visible
in the image.
1. Select Simple toolbar.
2. Select Brightness/Latitude.
3. Click the image and:
drag up or down to make the image lighter or darker
drag side to side to increase or decrease the latitude
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Image Viewer Screen
Note
Brightness, Latitude and Contrast shouldnt need to be adjusted if the image processing is set up
correctly. If there is a constant need to adjust these parameters, the default parameters or the
technique might need to be adjusted.
Note
In System Settings > Image Processing, the administrator can choose to have Window/Level
in place of Brightness/Latitude.
Prerequisites:
Before making any image processing adjustments, make sure that the correct View has
been selected. An incorrect View could cause an Image Processing failure. If the View is
correct, proceed with the adjustments.
If image processing does not perform on an image, the Modality will automatically revert
to Window/Level Mode instead of the standard Image Viewer controls, allowing you
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Image Viewer Screen
to modify the contrast and brightness of the image. The image will appear unusually low
in contrast. The Histogram will display a straight diagonal line.
If you see the message IPL Parameters failed, the system displays an unprocessed
image. It may look too dark or too light, and is unusually low in contrast. You can adjust
the image using the Window/Level tools.
Measurement Tools
This feature provides three different tools (Distance, Angle, Cobb Angle) that let you
make measurements on the image. It is accessed from the Image Viewer screen.
Important
The Measurement Tools calculate angles and distances between specified points at the film plane.
The system does not make adjustments to the measurements based on the relative positions of
the tube, patient and Receptor. The reported values from the measurements are directly
calculated at the Receptor plane without any compensation of geometric magnification.
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Image Viewer Screen
This tool measures an angle from three selected points on the image.
1. Select the Angle icon on the Measurement Tools Tab.
2. Select the first, second, and third points on the image to form the drawing of the
angle.
a. To move the Angle Tool, use the directional arrows on the Measurement Tools
Tab.
b. To change the Angle Tool, select the points and select another location for each
point.
c. To remove the Angle Tool, select the angle on the image and then select the
trash can.
This tool measures the angle of intersection between two lines drawn on the image. It is
used to determine the angle of a curved shape, such as a hip or spine.
1. Select the Cobb Angle icon on the Measurement Tools Tab.
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Image Viewer Screen
The Comment Tab allows the radiographer or Key Operator to create a record of
comments about the image. In addition, the Comment Tab lets you edit the laterality
of an image after it is acquired. This is important if the image was flipped or rotated in
the Image Viewer or if the laterality had not been noted elsewhere.
Patient and Image comments are tertiery, and they may or may not display in PACS. If
comments are entered but do not display in PACS, the PACS vendor must be notified. For
printing, the text box can be modified to include these comments.
Allergies, Pregnancy status, and Grid selected fields have been added to this tab.
1. Select the Image Comments box.
2. Use the Keyboard to enter the comment.
3. Select Save Changes.
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Image Review
Image Review
The Image List screen allows you to locate and view patient studies, sorting by delivery
status. Go to Main Menu > Image Review > Image List screen.
The Image List screen allows you to locate, view, accept or reject images after
acquisition.
1. Enter patient information such as Patient Name, Patient ID, Accession Number,
Tech ID or Acquisition Date at the top of the screen by scanning the bar coding or
by entering the data manually.
2. Select a filter to search by image status:
All Studies This filter generates links to all non-delivered studies with the cri-
teria you entered, such as Patient Name, Patient ID, Accession
Number, Tech ID, or Acquisition Date.
Need Approval This filter generates links to all images that have not been
accepted.
Unassigned Images This filter generates links to all images that do not have a patient
assigned to them. This filter is linked to the Images Not
Assigned button that appears on the Main Menu.
Failed Delivery This filter generates links to all images that have been accepted
and sent to destinations, but failed. You can access this group
from a button on the Main Menu screen at any time.
Pending Delivery This filter generates links to all studies that have been accepted
and sent but the CR/DR has not heard back from the
destination-delivery in progress.
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Image Review
Need Destination This filter generates links to all studies that have been accepted
but not assigned a destination.
Delivered Images This filter generates links to all images that have been delivered
to printers and workstations. A delivered image cannot be
changed or reprocessed unless a copy of the image is made.
Filter Description
All Studies This filter generates links to all non-delivered studies with the criteria
you entered, such as Patient Name, Patient ID, Accession Number, Tech
ID, or Acquisition Date.
Need Approval This filter generates links to all images that have not been accepted.
Unassigned This filter generates links to all images that do not have a patient
assigned to them. This filter is linked to the
Images Not Assigned button that appears on the Main Menu.
Failed Delivery This filter generates links to all images that have been accepted and
sent to destinations, but failed. You can access this group from a
button on the Main Menu screen at any time.
Pending Delivery This filter generates links to all studies that have been accepted and
sent but the CR/DR has not heard back from the destination-delivery is
in progress.
Need Destination This filter generates links to all studies that have been accepted but not
assigned a destination.
Delivered Images All images that have been delivered to printers and workstations. A
delivered image cannot be changed or reprocessed unless a copy of
the image is made.
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Image Review
Occasionally, EVP Plus Software may not fully predict the parameters for an image. When
this happens, it produces a Review Needed status.
1. In the Image Viewer screen, check the contrast and brightness of the image.
2. Use the brightness, latitude, and detail contrast controls to correct the image.
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Flagged Image List
The image is saved for review by the Key Operator or by Service. The Key Operator views
flagged images on the Flagged Image screen.
To harvest images:
1. Filter the list using the search filters:
All Images
Flagged Images
Rejected Images
2. Use the check boxes to the left of each thumbnail to select the image of interest or
Select All images.
3. Select Harvest Selected Images.
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Flagged Image List
Postrequisites:
Select the Unflag the Image after Harvesting check box to return the image to the
workflow.
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How to Select a Destination
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How to Change the Arrow Direction
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Multi-Format Printing Overview
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Multi-Format Printing Overview
Add Cell A new cell is placed in the top-most, left-most space avail-
able in the current layout. If there is not at least a 2 x 2 grid
area available anywhere on the grid, the Add Cell button
will be disabled.
Directional Arrows Move the row and column placement of the cell one grid
unit in any allowed direction.
Delete Existing Layout Displays the currently defined layouts and allows the user
to choose an existing layout to delete (confirmation
required).
Cell Width Adjust the cell width by touching the +/- buttons, which
adjusts the size in whole grid (2 x 2) units.
Cell Height Adjust the cell height by touching the +/- buttons, which
adjusts the size in whole grid (2 x 2) units.
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Multi-Format Printing Overview
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Multi-Format Printing Overview
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Multi-Format Printing Overview
One of the cells will be highlighted. The image you select will go into the highlighted
cell.
3. Touch or click any cell to highlight it. You can change the location of each image
later, if desired.
4. Select a thumbnail image from the image list at the right side of the screen.
5. Select the Display All Patient Images button to see all of the images in the
patient's other studies. The border of each selected image changes color as the image
appears in the highlighted cell in the layout. Use the scroll bar to view all of the
pages. The scroll bar indicates the page being viewed and the total number of pages;
for example, page one of two will be displayed 1/2.
6. Repeat steps 34 to select the rest of the images to fill in the layout.
Note
Any cells not used will print black.
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Multi-Format Printing Overview
print. This is true unless the Key Operator has set True Size as the default for
Multi-Format prints.
The functions on the Image Adjustment tab apply to each image independently.
1. Select an image from the layout.
2. To adjust an image, select any of the following buttons. These functions are described
in Multi-Format Print Buttons.
Switch Position
Rotate or Flip
Invert
Zoom in or out
Window/Level
Magnification
Measurement Scale for reference
True-Size or Scale to Fit
Justification (move image left, center, right in cell)
Portrait/Landscape
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Multi-Format Printing Overview
Text Overlay
The Text Overlay radio button displays a text overlay in four corners of the multi-format
print. The overlays contain information from the DICOM header associated with that
particular patients study. The content of the overlay, location, and font size is configured
by the Key Operator in the Configurable Text Boxes screen.
While the text overlays cannot be edited directly on the Multi-Format Print
Configuration screen, you can use the Text Overlay radio button to choose between
new overlays, traditional text boxes, or having no text.
Text Annotations
To add text to a multi-format print, select a point on the image where you want the
annotation to appear. Then type your annotation in the free-form text box. You can also
select markers and stamps to annotate the print.
Note
The Multi-Format Image Internal Text Box appears inside each image area on a multi-format print.
1. At the Image Viewer screen, select the Print tab.
2. Select the Internal Text Box check box.
3. Select the point on the image where you want to place the text box.
You can move the text box to any corner or any inside edge to avoid covering
anatomy.
The Internal Text Box can be up to 160 mm wide. Its content depends on the length
of the data fields and the size of the font.
4. Select Save Changes.
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Multi-Format Printing Overview
5. Select Save & Accept Image to send the image to the selected printer.
Note
If the Internal Text Box is set as a default, the user only needs to touch the image where they want
the text box to be.
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How to Create a Text Overlay for a Multi-Format Print
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Utilities
Utilities
Utilities are functions that the Technologist can access and perform without needing a
special password or permission. Utilities differ depending on the system you are working
on. Your system may provide choices for some or all of these functions:
Change Password Log Viewer
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Change Password
Change Password
You can change your password in a DIRECTVIEW system at any time. Remember to create
a password that conforms to the number and type of characters set for passwords in your
facility by your Security Administrator.
1. At the Main Menu, select Utilities.
2. Select Change Password.
3. Enter your old password.
4. Enter your new password.
5. Confirm your new password by entering it again (exactly the same way).
6. Select Change Password.
Note
If you have forgotten your password, contact the Security Administrator. Your Security
Administrator can reset your password so that you can change it if needed.
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Register Badge
Register Badge
This procedure assumes you already have a user account. User accounts must be created
by the Security Administrator before a proximity badge can be registered.
1. Log into the system.
2. Navigate to Utilities > Register Badge and select Register Badge.
3. Scan the badge by swiping it across the badge reader.
When the system reads the badge, you will hear a beep.
4. When asked if you want to associate the badge to your account, select OK.
5. Follow the on-screen instructions to register your proximity badge.
Once configured, the user can log in by passing the badge across the reader without
entering their user name and password on the Login screen.
The user will log out the previous user when using this feature.
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System Status
System Status
The System Status screen provides information on system communications and access
to logs about the modalities.
When your Service Representative requests a report, log files are contained under the
following tabs:
Summary
.NET CLR
Hot Fixes
Assemblies
MIM Core
The Snapshot Log Files button captures the current logs and dates them so that when
they are retrieved later, they will identify the status of the system at that time. Select this
button any time there are issues with the Modality performance and every time you need
to call Service.
Use the Summary tab to check if a Modality is communicating with the HIS/RIS. When
the lights on the Device Column are green under HIS/RIS, the Modality is communicating
with the HIS/RIS.
Use the System Status screen to view the status of the prior image retrieval job queue.
You can also clear the outstanding requests in the queue.
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Software Updates
Software Updates
This option expands the capabilities of the Key Operator to install system upgrades that
were formerly performed by a Service Representative.
Prerequisites:
The user receives a message from the system stating that Updates are Available. This
is an alert that software updates are available and have been sent to your system from a
remote location.
You must be logged in as a Key Operator in order to install software updates.
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Pending Job Management
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Firmware Updates
Firmware Updates
The system can determine whether or not the active DRX-1 detector has current firmware
installed. If it does, the detector can be used normally. If it does not have current
firmware, then the firmware must be updated before you can use the detector.
The Key Operator can install firmware updates without contacting Service. After
updating software using the Software Update screen, the Install Firmware Updates
screen appears if a firmware update is necessary.
Note
The receptor must be tethered during a firmware update.
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Image Recovery
Image Recovery
The user can recover images that have not been delivered from the Utilities section of the
software.
1. Navigate to Utilities > Image Recovery.
Image Recovery lists all of the images on the system and provides the following:
Acquisition Date
Patient ID
Accession Number
2. Select the image to be recovered.
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Patient CD Media Jobs
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Patient CD Media Jobs
Note
If enabled, structured X-ray Radiation Dose reports can be added to a Patient Media job.
Note
For CR Systems only, when you are performing a Backup and Restore function, make sure that
the user at the Remote Operations Panel (ROP) does not initiate a Patient CD.
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Delivery Preferences Configuration
Hospital Name The hospital name that you want to associate with the images.
Hospital Address The address of the hospital that you want to associate with the
images.
Pixel Spacing The pixel spacing for workstations that require the (0018, 1164)
Imager Pixel Spacing or require the (0018, 1164) Pixel Spacing
fields.
Relative X-ray Exposure The Carestream Health Exposure Index or the IEC Exposure Index.
DICOM Tag ID (0018,
1405)
Delivery Tab Options Use uppercase for all DICOM fields on delivery.
Send all images in L/F orientation. This means the workstation
will not rotate the image when it is received. Sends patient
orientation tag (0020:0020).
Remove print destinations from 1-up when creating new
Multi-Format prints.
Scale mark to storage.
Use CR IOD. It means always use the CR DICOM IOD, instead of
DX or MG IOD.
Translate Body Part and Projection.
Allow non-conforming DICOM.
Label Patient CD using LIGHTSCRIBE.
Edit the AE Title IP address and port for their DICOM destina-
tions.
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Delivery Preferences Configuration
Field Description
Note
The Image Instance tab has different configurations to help with
foldering at the PACS. Consult your PACS Administrator to
determine which setting is required for your PACS system.
Custom Page Layouts Configure a custom Multi-Format layout from a blank page or
Tab from a copy of a layout.
Customize by cell width and cell height.
Use the arrow keys to move the cell up, down, left, or right.
Add or delete a cell from the layout.
Delete the existing layout.
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Select USB Destination
Note
A USB can only be used for a single acquisition device. If configured for a second CR or DR the
original file will be overwritten and it will no longer work on the original device.
A formatted, named USB flash drive is required. (Do not use the default flash drive name.)
A USB destination must be configured for the USB device in the Select Destination screen.
Delivering to a USB device will update the status of the image to Delivered.
Detector Calibration
Calibration Requirements
A battery must be inserted into the detector.
You must have security access to the Detector Calibrations screen.
The virtual keyboard settings must be enabled.
Use a 0.5 mm copper or 1 mm aluminum filter for X-ray calibration.
You must run calibrations when you add and register a new DRX detector to the
system for the first time, and when calibration prompts appear on the system
Console.
Only an authorized service representative can adjust the Technique Settings shown on the
Detector Calibration screen.
Calibration Recommendations
Verify that the battery is inserted into the detector.
Verify the identity of the detector.
Do not touch Abort Calibration during calibration.
Do not move the detector during the calibration process.
Do not navigate to another menu or screen until the calibration is complete and
successful.
Use the Calibration Progress Bar to track the exposures completed out of the total
number of required exposures. Complete all the exposures.
Calibration History
Each time you run a calibration, the System Console logs the date and time in a
calibration history. The Console uses the calibration history to generate messages which
remind you to run the next calibration.
Calibration Results
Successful CalibrationWhen a calibration is successful, new calibration files are
created for the selected detector and are ready to be used by the system. Successful
calibration helps to support optimal image quality.
Aborted Calibration or Calibration FailureWhen a calibration fails, no changes are
made to the calibration files for the selected detector.
If calibration fails, see Troubleshooting Detectors: Calibration Failure in the online help.
Note
Perform detector calibration if the system prompts you to do so. If the detector is dropped, a new
calibration will be needed at that time.
Note
The Dark calibration must be performed if the Key Operator for the site has disabled the
automatic daily dark feature, or if automatic Dark calibration fails for a specific period of time:
DRX Plus Detector Family: after the calibration fails for 10 weeks
Important
You must keep the detector away from other electronic devices during calibrations.
Only an authorized Service Representative can adjust the settings on the upper-half of the
Detector Calibration Screen.
1. At the main menu, select Utilities > Detector Calibration.
2. Select the detector type: Wall Stand Bucky or Table Bucky.
3. Select the Calibration Type check box.
4. Follow the instructions on the screen to calibrate the detector.
5. Select Begin Calibration.
Important
The X-ray calibration must be performed every six months or after a significant shock to the
detector.
The user must activate the exposure button for approximately 15 exposures.
The dark calibration must be completed successfully before performing the X-ray calibration.
1. Set the SID to 183 cm (72 in.) and remove the grid.
2. Check that the collimator blades are open to expose the filter.
3. Insert the 0.5 mm copper and the 1.0 mm aluminum filter onto the collimator, with
the copper side facing the tube.
4. Ensure that nothing is in the beam path.
5. Do the steps in the How to Calibrate the Detector procedure.
6. When the calibration is complete, remove the filters from the collimator.
Required equipment:
Bar code scanner
Keyboard
1. At the Equipment Management screen, select Add Detector.
2. Scan the bar code serial number label, or enter it from the virtual keyboard.
3. Select Save Changes.
Equipment Management
From the Main Menu, select Utilities > Equipment Management.
The Equipment Management screen is used by the technologist to enable or disable a
detector in the System. It allows the Key Operator to add or remove a detector from the
system.
See the following topics for additional information:
How to Enable or Disable a Registered Detector
Adding and Registering a Detector
Prerequisites:
If enabling a detector, insert the battery into the detector before starting these steps.
1. From the Console Main Menu, select Utilities > Equipment Management.
You will be presented with the list of the detectors currently registered on the system.
Icon Detector status
The detector is enabled and available for use with the console.
The detector is registered but disabled for use with the console.
2. To change a detector's availability with the console, first select that detector's row.
3. Select either the Enable Detector or Disable Detector button.
Various status messages will be displayed during the process. A dialog message will
be displayed confirming the success or failure of the operation.
Postrequisites:
When disabling a detector, once the process completes you should remove the detector
battery.
Serial Number
Installation Date
Equipment Statistics
Manufacturer
Model Name
Logical Name
Status
Actuation Count
Caution
Always use the instructions in the Tube Warm-Up screen. See Utilities > Tube Warm-up
for information.
The tube warm-up exposure factors are preprogrammed. Only the Key Operator can adjust
them.
Producing X-rays with a cold or improperly warmed tube shortens the life of the X-ray tube.
Do not acquire images without warming the tube.
Note
You can use the control on the collimator keypad to turn on the collimator lamp and check if the
collimator shutter is open or closed. The light indicates that the lamp is operational and the
shutters are open.
1. Close the collimator shutters.
2. At the Main Menu, select Utilities > Tube Warm-up.
3. Make a series of exposures 3 seconds apart until the message
Tube Warm-up completed displays.
4. Select Back.
Log Viewer
The Log Viewer screen lets the user view the content of all pop-up messages displayed
on the system, and the exact time they appeared.
The user can copy the log history to a USB flash drive for review. To do this, select the
message and select the Copy Log History button.
Select the Older File or Newer File buttons to view other files.
Statistics
Monitor Configuration
System Configuration
Backup Restore
Option Registration
Import Configuration
DR Detector Configuration
Tube Warm-up
DR TQT Analysis
Caution
There is no recovery from this command. It deletes even records that have been protected.
Caution
The Protected records are not protected from the Delete All Studies action.
Note
Names and exams that have an Available, Pending Delivery, or Failed Delivery status cannot be
deleted until they are corrected.
Clear All Fields Removes all the information in the search criteria fields.
Delete Unassociated Images Deletes all images that have no database references.
Find Study Locates the study that matches the search criteria.
Main Menu Exits current screen and returns you to the system Main
Menu.
Statistics
Destination Summary Statistics update the status of the destinations listed and the status
of the devices as you go to the screen. You can check the status of destinations if you are
getting a repeated failed delivery. Problem destinations are identified quickly.
Download Statistics
The Download Statistics screen lets you do the following:
Allows CR/DR Systems to pull the reject data from other configured systems.
Select a date range and download all statistics to a spreadsheet for data
management.
Add or delete device IP addresses in the system from which to download statistics.
Prerequisites:
The CR devices from which data will be obtained must have Administrative Analysis
and Reporting Software activated on the System.
With the optional Administrative Analysis and Reporting Software, you can
retrieve data from multiple CR or DR Systems, download it to a PC, and analyze it using
pre-configured templates for MICROSOFT EXCEL 2000 or higher. The interactive reports
can be configured, rearranged, analyzed, saved, and appended as you choose.
The Administrative Analysis and Reporting Software compiles all statistics by
radiographer based on the Tech ID.
Report Statistics
The report contains the following views:
Note
If a significant shock is reported, the user must recalibrate the detector.
If the detector cannot be calibrated, call Service.
Cassette Statistics
The Cassette Statistics screen lets you view the performance of a cassette and identify
possible problems with cassettes.
The Cassette ID column identifies the cassette. The screen also shows the number of scans
for each cassette, how many images were accepted or rejected, and the percent rejected
for each cassette ID.
The total of each column appears at the bottom of the screen.
You can use this information to remove a cassette from service if necessary.
Note
This information is for CR Systems only.
Erase Statistics
Go to Key Operator Functions > Statistics > Erase Statistics.
The Erase Cycles screen tracks the number of scans/erases done with each pair of lamps.
The Actuation Count displays the total scans on the system.
Note
The Batch Erase Count displays the number of cassettes that have been erased by going into the
Batch Erase Mode ( CR 825/850/975/Max CR Systems) or Manual Erase Mode (Classic/Elite CR
Systems). This number is separate from the actuation count.
You can use this screen to identify a problem with the erase lamp assembly if the erase
lamps are burning out sooner than expected.
The product is VERILUM V5.2 Software with CHROMA 5 Pod. You do not need to install
the software on the Modality in order to use the photometer.
Postrequisites:
Check the SMPTE test pattern on the Monitor Configuration screen after testing
Luminance for Gamma.
3. Select Continue.
4. Hold the pod firmly but gently in the center of the target until the test progress
indicator reaches 17.
Do not press too hard!
A graph signifies the end of the test.
5. Select Close.
Do not save the information to a MACBETH Color Chart. Luminance for Tracking is a
black-and-white test.
Postrequisites:
Check the SMPTE test pattern on the Monitor Configuration screen after testing
Luminance for Tracking.
Caution
Selecting the screen in areas other than the red targets may cause the screen to behave
unpredictably.
2. Touch the screen and drag your finger across it to check the cursor's response.
3. Select OK if the cursor follows your finger, or select Return to repeat the calibration
process.
4. When the calibration is complete, select OK to return to the interface.
Note
If the calibration times out and no changes are made, the system remains at the current
calibration
Note
When making a backup file, it is a good idea to include the date for future reference.
Because of the unique attributes of different DIRECTVIEW systems, there are some
limitations to which configuration information can be transferred between machines.
The software automatically restricts the restoration of the configurable items as
described in How to Transfer Configuration Information to Different Machines.
The description identifies the conditions under which selected items can be transferred
between machines.
Backed-up settings can always be restored to the machine from which they were created.
You can back up configurations to a particular drive and restore them to this or another
machine.
You can back up information to either the machine hard drive or to the removable media
suitable to the machine computer (may include CD, DVD, USB, or floppy disk devices).
Backup and restore is also used to share within a facility to keep the same information
on each console.
Note
If you restore Security settings from one system to another, the Password will restore, along with
the expiration date. This means that a fresh backup is required.
Important
Always back up the console before you restore or import anything from anywhere!
Note
See Import Configuration for information on backing up and restoring only specific procedure
codes and techniques.
6. Click Backup.
7. When the progress bar indicates the transfer is complete, select OK.
When user and security settings are restored from a backup, the software will provide
an option to restore or reset passwords at that time.
Note
This only does a backup of the specific configuration. We recommend a full system backup after
all changes have been made.
Option Registration
Prerequisites:
You will need a set of Activation Codes from Carestream Health, Inc.
The Key Operator can add or remove purchased options using the Option Registration
screen.
1. Go to Key Operator Functions > Option Registration.
The screen displays all of the available options for that system.
2. Enter all Activation Codes one at a time into the text box.
If the code is entered manually, the Add Code button adds the code to the list of
codes to the right.
If you type a code incorrectly, the system will recognize the error. The text box will
not clear and an error message will be displayed.
If you use the bar code reader, the code is automatically added to the list.
When an option code is entered and activated (Activate Option) from this list, the
features and benefits of that option become temporarily available on the system. The
options stay active for several days.
3. Insert any USB drive into the System.
4. Select the Export Request button.
5. Select the USB drive as the destination directory for the Activation file. The file
named OptionActivationRequest.xml is saved to the USB drive.
6. From a personal computer, e-mail the OptionActivationRequest.xml file to
activation@carestreamhealth.com.
An Activation File is automatically e-mailed back to the sender. This file is a key that
matches the hardware and software that identifies your system. The file cannot be
used with any other device.
If there is no access to e-mail or the network is down, the options stay active for
several days to give you time to send the Option Activation Request and retrieve
the Activation File from a remote computer.
7. Place the Activation File on the USB drive.
8. Insert the USB drive into the System.
9. From the Key Operator Functions > Option Registration screen, select the
Import Activation file.
10. Select the source directory for the Activation File (USB drive).
The Activation File is copied to the local hard drive.
The system verifies the signature and activates the options as specified in the
Activation File.
Import Configuration
Navigate to Key Operator Functions > Import Configuration.
The Import Configuration screen provides a function that allows the user to selectively
import Imaging System Type (IST) data such as techniques, image processing parameters,
and procedure codes into a system.
The imported View or procedure data will be applied to a matching View or procedure.s
Note
If a matching View or procedure is not found, it will not be created.
The software displays a list of data that is not imported.
This import allows the user to
Restore Procedure Mapping and Views
Import image processing for the ISTs in use on the Console
Restore techniques (if needed)
Import Configuration
The import data function uses the data from the backup data from the Backup/Restore
function. Instead of restoring or transferring all of the data from a backup file, the user
selects only the imaging system types they want to import. The user can import
techniques, image processing parameters, and procedure codes.
1. Navigate to Key Operator Functions > Import Configuration.
2. Locate the Backup file containing the configuration you wish to import from the
drive selection and tree view.
3. Select the file.
4. Select the Load button to upload data from the Backup/Restore .zip file to the
Console.
Note
There is no Cancel button to stop this process. However, you can select the Back button to leave
this screen and stop the process.
5. Select the configurations (procedure codes, image processing parameters, and
techniques) you want to import by selecting the receptor and the check box for each
item.
Note
The list of items to choose from depends on the contents of the Backup file and the configurations
that the Console supports. For example, you would not have the option to restore DRX image
processing to a CR system.
DR Detector Configuration
Important
Set Beam Output is used with DRX-1 and DRX Plus detectors. Set
Beam Output is not used with PRO detectors.
Caution
Always use the instructions in the Tube Warm-Up screen. See Utilities > Tube Warm-up
for information.
The tube warm-up exposure factors are preprogrammed. Only the Key Operator can adjust
them.
Producing X-rays with a cold or improperly warmed tube shortens the life of the X-ray tube.
Do not acquire images without warming the tube.
Note
You can use the control on the collimator keypad to turn on the collimator lamp and check if the
collimator shutter is open or closed. The light indicates that the lamp is operational and the
shutters are open.
1. Close the collimator shutters.
2. At the Main Menu, select Utilities > Tube Warm-up.
3. Make a series of exposures 3 seconds apart until the message
Tube Warm-up completed displays.
4. Select Back.
Supplied filters
DR TQT Phantom
1. Follow the instructions on the screen and place the DR TQT Phantom on top of the
detector.
2. Acquire the image.
When the image is acquired, the Start Analysis button becomes available.
3. Click Start Analysis.
Note
The analysis takes a few minutes to complete.
4. When the analysis is complete, view the results on the screen.
Level Group
Level Group
Detector Serial Number The detector serial numbers appear in the Detector list
box for detectors that have results. Select the detector
serial number for which you want to view results.
Contrast-Noise Ratio CNR for Patch 15 with values, limit, and status.
Note
Contact Service to import test results.
Laterality Brightness
Rotation Sharpness
7. Select Show View Details to edit all configurations of the View at once, or use the
Column Selection radio buttons to control which columns are displayed in the View
list.
8. Select the Global Edit check box to apply the changes you make to every row of the
Category selected.
9. Select Save Changes.
Note
If the Views are associated with a procedure, make sure that deleting them will not affect
Procedure Mapping.
1. Navigate to Key Operator Functions > System Configuration > View
Configuration.
2. Deselect all Views to make sure that no additional Views are unexpectedly selected.
3. Select the check box of the View with a similar body part and projection that you
want to delete.
4. Select Delete Checked Views to delete the selected View(s).
A confirmation dialog shows what Views will be deleted.
Note
Views are erased from the system when you delete them from the View Configuration. Deleting
Views from View Category Management moves Views to the Uncategorized category so they
can be added back into a category later, if desired.
Note
Use the Zoom feature to evaluate detail/sharpness while making image processing changes.
What is a Look?
Looks are different recipes for processing the images that take into consideration the
degree of brightness, latitude, detail contrast, sharpness, and noise that radiologists like.
Every institution chooses its Look from a family of Looks provided by Carestream Health,
Inc. and can then customize exams to its own taste using the Image Processing
Preference Editor.
Premium Image Processing 1 Default Look from the factory. Base models
used in clinical study. Noise suppression con-
sistent with Low Exposure Optimization.
the screen.
2. Select the Tutor Image for that View.
The Tutor Image panel opens.
3. Select a Gold, Silhouette, or Custom tutor image.
4. Select Show View Details.
5. Select an Internal Text box if desired.
6. Select Change Tutor Image.
7. Select Back.
Buttons
Name Description
Show View Details Click to view the settings such as Noise Suppression, Detail Contrast,
Latitude, Brightness, and Sharpness.You can change settings such as,
Grid Suppression, Raw, Surround Mask, the indicator color, True-size,
Tick Marks, Skin line detection, and cropping type.
Select the tutor image to change the tutor image for the View.
Select Internal Text Box to add a text box configuration to the View.
Select the tutor image to place the Text Box.
Select the External Text box setting to be at the bottom, left, or off.
Delete Checked Select the check box of the Views you want to delete and then select
Views Delete Checked Views. A confirmation message appears. If the Views
are associated with a procedure, make sure that deleting them will not
affect Procedure Mapping.
Copy/Paste Selects the check boxes of up to three Views you want to copy and then
Checked Views select Copy Checked Views. Rename the View and modify it if
desired. Select a Primary Category and a Secondary Category where
you want to place the View.
View Category Add or delete Primary, Secondary Categories, or Views. Use the far right
Management column arrows to move highlighted items to arrange how the Regions,
Exams, and Views display. The order of the items in the column will dis-
play left to right, top to bottom at the Patient Input screen or Image
Acquisition screen.
Check All Selects all check boxes. One row is always selected.
Main Menu Exits the current screen and returns to the system Main Menu.
Name Description
Keyboard Activates the keyboard when you touch a button. The button becomes
active for editing. Type the information from the virtual keyboard.
Color Select the colors of the buttons from over 200 individual colors.
Body Part* Provides three tabs containing all body parts in use to create a View.
Projection* Provides three tabs containing all projections in use to create a View.
Tutor Image Selects the graphic tutor image that represents the View. Both Gold and
Silhouette images are available by default. You can add custom tutor
images by clicking on the Custom button and selecting tutor images
imported by the Key Operator. These images must be assigned one at a
time for each View. Use the Backup and Restore feature to save and
retrieve these View configurations.
*You can use the virtual alphanumeric keyboard to change body part, projection, or
position. After saving, the new item appears in the appropriate keyboard.
Procedure Mapping
Copying Procedures
Procedures can be copied. If the Left Hand and Right Hand have different codes, the Key
Operator can enter one, copy it, and modify the name and procedure code.
When the patient information is selected from the Work List, the codes are included in
the list. The Views for that procedure appear automatically on the Patient Input screen.
1. From the Main Menu, select Study Data.
2. Search for the patient using the Patient Work List screen. You can type the first
letter of the name to view the list.
3. Select the patient from the Work List.
The patient information and the Views for the procedure appear on the Patient Input
screen.
above/below them will move the selected procedure/View to up or down one line at
a time.
8. Select Save Changes.
Change Multi-Format Lets you add a multi-format configuration to the procedure, such as
Configuration 2-up lengthwise to 4-up crosswise.
Change View Quick access to View Configuration. Lets you add, delete, and mod-
Configuration ify views for use in procedure mapping. Select the Back button in
View Configuration to return to Procedure Mapping.
Turn Edit On Lets you edit the procedure. Select this button to make changes
such as name, category (body part, position) procedure code, desti-
nation, and auto position.
Save Changes Completes the action by writing changes to the local database.
Main Menu Exits the current screen and returns you to the system Main Menu.
List Configuration
The Key Operator can pre-configure lists using buttons and tabs to provide a convenient
and standard list for radiographers to pick from when entering Department Name,
Referring Physician, or Tech ID.
The Key Operator can also configure a list button to not display and later restore the
display of the button. You can change button colors or move button positions on the
same tab.
Buttons
Name Description
New Tab Selects the matrix size based on the number of items you will have in
your list. Choose from 4 x 5, 5 x 5, 6 x 5, 7 x 5, and 8 x 5. You can enter
up to five tabs of data per list.
Delete Tab Deletes the tab of information from the list. You will be prompted to
confirm the deletion. There is no recovery from deleting a tab.
Show Button Displays the button in the list in the interface. Toggles to Hide Button.
Hide Button Hides the button display on the interface. Toggles to Show Button.
Main Menu Exits the current screen and returns to the system Main Menu.
Name Description
Keyboard Activates the keyboard when you touch a button. The button becomes
active for editing. Type the information from the virtual keyboard.
Color Selects the colors of the buttons from over 200 individual colors. Select
the color you desire.
Move Moves the button to another position on the tab. You cannot move the
button to another tab.
Layout Configuration
Layout Configuration
This screen provides easy access to layout editors. With these editors the Key Operator
can configure what, where, and how the information will display for all functions on
various screens. To access this screen go to Key Operator Functions > System
Configuration > Layout Configuration.
RPDES Editor
Use to configure the layout of the Remote Patient Data Entry System (RPDES).
Disabled Editors
These editors will not appear on the tabs in the Image Viewer screen.
Enabled Editors
These editors will appear on the tabs in the Image Viewer screen in the order they
appear in the list. In other words, the first editor's icon will appear on the first tab
icon on the Image Viewer screen. The second will appear on the second tab, and so
forth.
1. Navigate to Key Operator Functions > System Configuration > Image Viewer
Editors
2. Select an editor from the Enabled Editors list.
The editor will be highlighted when selected.
3. Select the arrows to the bottom of the list to move the editor to the Disabled Editors
list.
The arrows at the bottom move the selected editor to the left or right of the list.
4. Select Save Changes.
This selection removes the editor from the Image Viewer Screen.
The tabs on the Image Viewer screen will reflect the changes immediately.
Note
The tab display on the Image Viewer screen will collapse or expand depending on the size and
shape of the monitor.
Markers Editor
The Markers Editor lets you customize the marker palette on the Image Viewer screen.
Using the Markers Editor you can do the following:
Add markers
Delete markers
Customize markers
Rearrange markers
Select a transparent background for text markers
Tech Assist
On the Layout Configuration screen, the Tech Assist tab allows the Key Operator to
configure the following Tech Assist software features:
Tech Assist for Chest Anatomy
Anatomy Clipping Regions
Exposure Value Display
Tech Assist Sensitivities
Feature Description
Enable Tech Assist on Image When checked, Tech Assist for Contrast Noise Ratio and anat-
Viewer for chest anatomy omy clipping warnings are enabled. The check box is
regions unchecked by default.
Automatically display Tech Displays a status or warning in the form of a Safe Color or an
Assist overlay when a prob- Alert Color that the Key Operator chooses. Used to display the
lem is detected status, or warnings that the threshold has reached for Con-
trast Noise Ratio (CNR) and anatomy clipping.
Display Tech Assist overlay The areas that may be clipped can be only seen by selecting
only when requested the toggle button on the patient information bar on the
Image Viewer or Express Viewer screen.
Indicates the typical regions of anatomy that may be excluded, or clipped, in a chest
X-ray.
Provides a prediction of the likelihood that a particular area might be clipped as
illustrated by the above graphic. The regions that are likely to be clipped are designated
by rectangles around the chest.
The likelihood that the region may be clipped is represented numerically, as sensitivity
levels, 0.01.0.
The Key Operator determines how sensitive the warning indicator should be by selecting
a particular rectangle and moving the slider toward More Warnings or Fewer Warnings.
The numeric value changes as the area is set to more sensitive or less sensitive.
The current values for each region are shown in the graphic.
These rectangles appear on the image in the Image Viewer or the Express Viewer screens
if clipping occurs.
The Contrast Noise Ratio (CNR) indicator alerts the user when the combination of low
contrast and excessive noise will not produce an optimum image. The analysis occurs
when the image is processed or reprocessed.
The indicator is located in the upper left quadrant of the Image/Express Viewer
screen. It can be configured to appear automatically, or viewed by toggling back and
forth manually.
The System calculates the CNR for chest images only and records the CNR for inclusion
in the image statistics. The default value is 0.3.
The Key Operator configures the threshold value. For example, if the CNR indicator is
green, but you are not satisfied with the images, move the slider to change the ratio
higher until the images are satisfactory. If the indicator is red, then the value is too
high.
Move the slider toward More Warnings to increase the sensitivity of the tool.
This feature indicates the typical regions of anatomy that may be excluded, or clipped, in
an X-ray.
It provides a prediction of the likelihood that a particular area might be clipped as
illustrated by the above graphic. The regions that are likely to be clipped are designated
by rectangles around the chest. The likelihood that the region may be clipped is
represented numerically, as sensitivity levels, 0.01.0.
The Key Operator determines how sensitive the warning indicator should be by selecting
a particular rectangle and moving the slider toward More Warnings or Fewer
Warnings. The numeric value changes as the area is set to more sensitive or less sensitive.
The default is shown in the graphic.
These rectangles appear on the image in the Image Viewer or the Express Viewer
screens.
The Contrast Noise Ratio (CNR) indicator alerts the user when the combination of low
contrast and excessive noise will not produce an optimum image. The analysis occurs
when the image is processed or reprocessed.
The indicator is located in the upper-left quadrant of the Image Viewer and Express
Viewer screens. It can be configured to appear automatically, or to be viewed by
toggling back and forth manually.
The System calculates the Contrast Noise Ratio for chest images only and records the CNR
for inclusion in the image statistics.
The default value is 0.3.
The Key Operator configures the threshold value. For example, if the CNR indicator is
green, but if you are not satisfied with the images, move the slider to change the ratio
higher, which provides a more optimal CNR target. If the indicator is red, then the value
is too high.
Move the slider toward More Warnings to increase the sensitivity of the tool and
improve the image.
You can view the result of the warnings by viewing a (clipped) image on the Image
Viewer or Express Viewer screens. Rectangular outlines display the anatomy clipping
regions on the image. See the image below.
The Key Operator can disable the anatomy clipping feature by clearing the Enable Tech
Assist on the Image Viewer for chest anatomy regions check box.
Radio
Button Name Description
Normal Text box This label is assigned by default to all optional text boxes
with no assigned status. This is not required.
Read Only Text box appears as a label. Assign to text boxes that will
display information that the user cannot change. Not edit-
able.
Read Only Label Text box appears as a label. Assign to a text box that hides
the information.
Select New Lay- Choose this button to change the text boxes that appear
out on the Patient Input screen. After making all selections,
select Save Changes.
Note
This information is for DRX-Revolution Mobile X-ray System only.
Note
This information applies to the DRX-Revolution Mobile X-ray System only.
Patient Query
Configures the primary search method for finding a patient study by selecting radio
buttons:
Local
Remote
Local then Remote
Select the default status criteria for the technologist to use for a Patient Query.
Select the Status from the panel at the bottom of the screen.
See the topic Patient Search Techniques for more information.
Patient Input
Configures the Procedure Step/Study Configuration that the system uses to organize and
deliver patient information. The Key Operator may choose the following by selecting an
option button:
Create new procedure steps from Patient Input
Create new studies from Patient Input
Configures the application of profiles in the system. The Key Operator may choose the
following configuration for profile application by selecting the option button:
Profile change applies to current study only
Profile change applies to all incomplete steps for this patient
Configures the Tutor Image style by selecting the appropriate option button:
Gold
Silhouette
Configures Patient Input options by selecting the desired check box:
Require confirmation to end a procedure step
After accepting all images in one or more procedure steps or studies, set the status to
Completed
Auto populate Tech ID with logged in user
Auto populate Tech ID from previous study
Display Tutor images
Patient Link
Displays a list of patients that are listed in the Quick Menu, with the functions such as
Shutdown, Logout, Snapshot Log Files, Image Export List, and so forth. The actual
number of patients allowed is set under Number of Shortcuts. You access the Shortcut
menu by selecting the Quick Menu icon located in the lower-left corner of every screen.
The Key Operator may configure the shortcut menu to display:
Patient Link Enabled check box. Select patient studies that have been done recently
from the Quick Menu for faster access.
Repeat Patients check box. If a patient has more than one study, they will be listed
for each study.
Button Sort Order
Most recently accessed item appears at the top of the list.
Most recently accessed item appears at the bottom of the list.
Image Viewer
Configures the display choices on the Image Viewer screen:
Display ID window on the Image Viewer window. Select to display the ID window
on the Image Viewer screen. You can use this to identify the orientation of the
receptor during the exposure.
Use Express Viewer button, toggling to the Express Viewer for a selection of
simple, common tools.
Automatically Reprocess Image so that the user will not have to press the
Reprocess button after modifications such as masking.
Default Zoom Mode
Fit to ScreenDisplayed image from the receptor fits the Image Viewer window.
Fit to BSMImage from the receptor displays only what is viewable within the
Black Surround Mask, so the image appears larger.
Region of Interest
ROI is the tool that displays the mean, minimum, maximum and standard deviation
values for the code values within the area specified by the user on the image.
DimensionThe size of the area that defines the ROI when the user touches a point on
the image is determined here. You can select from the following using the option
button:
10 %
Custom
Customize the size of the area by selecting the ROI Width and Height arrows on the
slider controls, displayed in centimeters.
Other
Audio Volume slider controlCustomize the volume of the sound by selecting the
arrows on the slider controls. You can determine the volume by listening to the sound of
the chime as you move the control.
Blue Tint slider controlUse the slider control to set the amount of blue tint to add to
images displayed on the CR, DR, or ROP.
Keyboard Clicks check boxAllows an audible click when a virtual keyboard is
selected. The level of sound is determined by the default setting in Audio Volume.
Companion Images
A Companion Image is an image that is optimized for certain conditions, such as the Tube
and Picc Line procedure, Pneumothorax, Bone Suppression, or High Detail Visualization
(HDV). A small image appears in the lower-right corner of the thumbnail image on the
Patient Input or Image Acquisition screen. This picture within a picture lets the user
know that a Companion Image is available that is linked to the standard image for that
View. The Companion Image displays processing that is optimized for that condition.
Companion Images are primarily created for chest and abdomen Views.
The Companion Image can only be sent to PACS or printers with a standard image. A
Companion Image can be deleted alone, but if the standard image is deleted, both
images are deleted. Electronic markers and annotations are replicated on the standard
image. Both the standard and companion images are viewable in the PACS, and no
additional workstation is needed for use.
When a system is configured to create a Companion View, the user can create one as
needed from the Image Viewer by choosing the correct icon. All of the companion
image icons that were linked by the Key Operator will display.
Standard image
Tube and Picc image
Pneumothorax image
Bone Suppression image
High Detail Visualization image (HDV)
While a Companion View is being generated, a pop-up message Creating... indicates
that the image is processing, and the Image Viewer screen is grayed out.
Once a Companion View is created, the thumbnails displayed on the Image Acquisition
screen will reflect the original image and whichever Companion Views have been
created.
4. Navigate to the Key Operator Functions > System Configuration > View
Configuration screen.
5. Select the Raw, Linked Views, Skin Line Detection, Surround Mask, Surround
Mask Enlargement option buttons.
This icon will appear in the Linked Views column on the View Configuration screen
when the Linked Views option button is selected. The user will only see the
Companion Views that are related to the selected View. For example, if the
pneumothorax Companion View is selected for chests, abdomen Views will not
appear.
6. Select the Views for which you would like a particular Companion Image to be linked.
7. Select View Configuration Details from the bottom of the screen.
8. On the View Configuration Details screen, select the Linked Views tab.
9. Select the companion View that you would like to link to from the displayed buttons.
Tube and Picc Line
Pneumothorax
Bone Suppression
None
A list of Views for the selected Companion Image appears at the bottom of the
screen. These Views have been optimized as Companion Images.
10. Select the specific anatomic View for each companion image from the tabbed menu
at the bottom of the screen.
Only chest Views are displayed for chests, and only abdomen Views are displayed for
abdomens.
When the View is selected by the Technologist at acquisition, the companion View will
automatically be created or available for the user to create as needed.
The Key Operator configures the system to display Companion Images for
Pneumothorax, Tube and Picc Line, and High Density Visualization Views.
1. Navigate to Key Operator Functions > System Configuration > Display
Configuration > Image Viewer tab.
2. Select from the following:
Automatically create all companion views on image acquisition
Create companion views when requested by the Tech on the Image
Viewer
You can choose to have the Companion Image automatically display after the image
is acquired, or create it manually by selecting the button from the Image Viewer
screen.
Select New View Lets you select a Primary Category, Secondary Category, or an individ-
ual View. When you select an entire Category, the changes you make
affect every View in that category.
View Before & After Displays the image before adjustment and after.
Zoom Use Zoom to evaluate images. To return to normal view, select Zoom
to clear the check box.When the image is in Zoom mode, you can
change the viewing area by panning or changing the view by selecting
the image area by selecting a point on the image and dragging across
the image area. If you change image processing characteristics save
your changes.
Region of Interest Lets you determine the Exposure Index of any point on the image. The
mean, max, min, and standard deviation of the exposure for the
selected location is displayed in a rectangle around the selected Region
of Interest.
Free Form Text The Free Form Text annotation field brings up a keyboard so that you
can easily identify changes to images on PACS.
Main Menu Exits the current screen and returns to the Main Menu.
Back/Cancel The Cancel button returns you to the previous function without
changing to another screen.The Cancel button toggles to the Back
button after you have selected Save Changes.
The Image Processing Preference Editor provides controls so that you can change the
look of images from the Primary Category (all images in an anatomical region) to a
Secondary Category (all body parts of that type) or from an individual View. The Image
Processing Preference Editor lets you determine the Look of the images based on your
preference.
1. Go to Key Operator Functions > System Configuration > Image Processing
Preferences.
2. To use the Editor, click the Select New View button and select a Primary Category.
3. Select a Secondary Category.
4. Select a View.
If you select Close after selecting a Primary or Secondary Category, your changes will
apply to all of the Views in that category.
5. Select Change Look.
Select one of the pre-configured looks first to approximate the desired Look.
6. Adjust the individual slider controls to fine-tune the desired effect.
7. Select View Before and After to compare your changes.
8. Select View After Only to see your selection.
9. Select Deliver to send the image to a destination for evaluation.
10. Select Save Changes.
There is no confirmation on the status of the delivered image.
Prerequisites:
You must be logged in as a Key Operator in order to access the Preference Editor
screen.
1. Ask the Radiologist to give you the names of patients for the View Name that needs
adjusting.
2. Go to the Image Review screen and find the image (using the search field at the top
right of the screen).
3. Enter the last name of the patient.
4. Select the Close button (to close the keyboard).
5. Select the Delivered Images button.
6. Make sure that it has been processed with the correct View Name.
To do this, checking the View Name in the Patient Information bar underneath the
image.
7. Select the Preference Editor button at the bottom of the screen.
Accessing the Preference Editor this way will only apply changes to that View Name.
Important
Never make IPL changes based on a single image. Be sure to evaluate at least 35 images of the
same body part. After making IPL changes, be sure that you reprocess at least 5 images with the
new parameters. Important to remember: First, do no harm!
Trauma Defaults
The Key Operator can configure categories for patients who enter the Emergency Room
who do not have complete identification or analysis of their condition. These categories
are default designations, such as gender and approximate age, that will be changed later
when the information is available. The Trauma defaults are selected when the patient is
admitted.
Buttons
Name Description
Change Trauma Opens the Patient Data form on the Patient Input screen. Lets you edit
Defaults the default patient data for the selected trauma button. Enter the
required data that represents this default ID.
New Tab Selects the matrix size based on the number of items you will have in
your list. Choose from 4 x 5, 5 x 5, 6 x 5, 7 x 5, and 8 x 5. You can enter
up to five tabs of data per list.
Delete Tab Deletes the tab of information from the list. You will be prompted to
confirm the deletion. There is no recovery from deleting a tab.
Show Button Displays the button in the list in the interface. Toggles to Hide Button.
Hide Button Hides the button display on the interface. Toggles to Show Button.
Main Menu Exits the current screen and returns to the system Main Menu.
Name Description
Keyboard Activates the keyboard when you touch a button. The button becomes
active for editing. Type the information from the virtual keyboard.
Color Selects the colors of the buttons from over 200 individual colors. Select
the color you desire.
Name Description
Move Moves the button to another position on the tab. You cannot move the
button to another tab.
1. Select Trauma.
2. Select a Trauma ID.
Postrequisites:
If you do not see a Trauma button, consult with your Key Operator.
Note
The Trauma button does not appear unless the Key Operator has configured it. On CR Systems,
the Trauma feature is a purchasable option.
Reject Reasons
Note
If the Reject Reasons option is not purchased, the Radiographer will simply select Accept or
Reject without providing a reason.
The rejected image then appears on the Rejected Image List screen. It may be accessed
by the Key Operator. The Key Operator may configure the system so that the
Technologist can access the screen as well, for further evaluation at another time.
Note
If the Administrative Analysis Reporting Software is not used, the Technologist will answer Yes or
No to a pop-up asking if the image should be rejected, without being prompted for a reason.
The Criteria fields are prioritized by the order they are listed on the Profile
Configuration screen. You can change the order using the second set of Up and Down
arrows. Default must always be last.
Category
Department Filter
Physician Name
Cassette Size
Machine Name
Output (for Multi-Format Printing)
The Filter fields are prioritized by the order they are listed on the Profile Configuration
Screen. You can change the order by using the second set of Up and Down arrows.
Default must be last.
When an exam is routed, the information contained in the patient record is compared to
the information contained in the criteria Filters field of all defined profiles, similar to
performing a query. If the image matches more than one profile, the system assigns the
first profile in the list that matches all criteria to that image.
Profiles can be assigned from Procedure Mapping or manually on the Patient Input
screen, Image Acquisition screen, and Select Destination screen.
Note
There must always be one default profile.
Note
To prevent Trauma exams from being delivered to Mandatory Destinations, make sure you
leave one of the Required for Delivery fields blank.
Add a Row
If you have the maximum number of rows, the Add Row buttons will not be active.
Delete an unnecessary field to add a row, or select a different text box.
Note
If a field is optional and it does not have a value, then the field is removed from the text box. If
all of the fields on a line are optional and blank, then the text box will get shorter. This is useful
if you want to include a field such as Image Comments in the text box when it has a value, but
you do not want to make the text box unnecessarily large; for example, for the time when there
are no comments.
Note
Text boxes appear on the print only. They do not appear when the image is viewed on a
workstation.
To select the appropriate Text Box, consider the type of image area that is displayed. You
can make the selection or the Key Operator can select a default Text Box for any given
View. The Key Operator can configure a text box to automatically fill in with data, such
as Hospital Name, Exposure Index, or View.
Select the Internal Text Box when you want the information to appear within the image
and when you must be able to print to any printer. The Text Box can be moved to any
corner or any inside edge to avoid covering any anatomy.
Select the External Text Box when you want to position the label outside the image area;
therefore, it never interferes with anatomy. However, the box takes up space on the film,
and the system crops additional image data compared with printing without an External
Text Box. Thus, an External Text Box affects True-Size printing.
The Single Image External text box can be up to 120 characters wide.
At the top of each Text Box Editor screen is a template for the text box that you select.
The data fields are represented by question marks: ?????????????
The maximum width and height of the text box are listed in the background next to the
sample box.
On the Multi-Format Configuration screen, a user can select the Include Page Footer
check box to add a footer across the bottom of the page of any print that is selected for
destinations. The Key Operator can configure the Page Footer using these steps.
1. Go to Key Operator Functions > System Configuration >
Configurable Text Boxes > Multi-Format Page Footer > Page Footer Layout.
2. Footer Fields - Select up to 12 data fields, displayed in 3 columns of 4 rows each.
3. To edit a field, you can do either of the following:
Select the DICOM Fields tab to choose from a list of DICOM fields. Select a field
from one of the three regions in the layout, select a DICOM field, and then select
Assign Field.
Click any footer field and enter free form text from the virtual keyboard
4. Font and Font Size - Select the text box and choose the font and size from the
pop-up menus.
5. To position a field in the Left, Center, or Right column, select the field and in
Selected Region Alignment select a position.
6. To add a graphic or logo to the footer, in Logo/Graphic select the square to display
the root directory from which to select a file. Locate the file and click Select.
7. Click Footer Preview to see the fields and graphics as they will appear in the footer.
On the Multi-Format Configuration screen, a user can select the Include Page Footer
check box to add a footer across the bottom of the page of any print that is selected for
destinations. The Key Operator can configure the Page Footer using these steps.
1. Go to Key Operator Functions > System Configuration > Configurable Text
Boxes > Single Image Page Footer.
2. Footer Fields - Select up to 12 data fields, displayed in 3 columns of 4 rows each.
3. To edit a field, you can do either of the following:
Select the DICOM Fields tab to choose from a list of DICOM fields. Select a field
from one of the three regions in the layout, select a DICOM field, and then select
Assign Field.
Click any footer field and enter free form text from the virtual keyboard
4. Font and Font Size - Select the text box and choose the font and size from the
pop-up menus.
5. To position a field in the Left, Center, or Right column, select the field and in
Selected Region Alignment select a position.
6. To add a graphic or logo to the footer, in Logo/Graphic select the square to display
the root directory from which to select a file. Locate the file and click Select.
7. Click Footer Preview to see the fields and graphics as they will appear in the footer.
Hospital Name The hospital name that you want to associate with the images.
Hospital Address The address of the hospital that you want to associate with the
images.
Pixel Spacing The pixel spacing for workstations that require the (0018, 1164)
Imager Pixel Spacing or require the (0018, 1164) Pixel Spacing
fields.
Relative X-ray Exposure The Carestream Health Exposure Index or the IEC Exposure Index.
DICOM Tag ID (0018,
1405)
Delivery Tab Options Use uppercase for all DICOM fields on delivery.
Send all images in L/F orientation. This means the workstation
will not rotate the image when it is received. Sends patient
orientation tag (0020:0020).
Remove print destinations from 1-up when creating new
Multi-Format prints.
Scale mark to storage.
Use CR IOD. It means always use the CR DICOM IOD, instead of
DX or MG IOD.
Translate Body Part and Projection.
Allow non-conforming DICOM.
Label Patient CD using LIGHTSCRIBE.
Edit the AE Title IP address and port for their DICOM destina-
tions.
Field Description
Note
The Image Instance tab has different configurations to help with
foldering at the PACS. Consult your PACS Administrator to
determine which setting is required for your PACS system.
Custom Page Layouts Configure a custom Multi-Format layout from a blank page or
Tab from a copy of a layout.
Customize by cell width and cell height.
Use the arrow keys to move the cell up, down, left, or right.
Add or delete a cell from the layout.
Delete the existing layout.
Note
On DRX-Revolution Mobile X-ray Systems, Automatic View Selection will also chose supine,
erect, or semi-erect based on the receptors angle.
Note
For example, if you select the blue indicator as illustrated above, and place it at 30 , Supine is
then defined as any angle from 030
You can configure the angle the detector will be when the View should be supine,
semi-erect, and erect. Select the highest limit and enter it into the appropriate text box.
Note
This information applies to the DRX-Revolution Mobile X-ray System only.
Note
You can also enter the value in the text box using the virtual keyboard.
Grid Indexing
Navigate to Key Operator Functions > System Configuration > Automatic View
Selection > Grid Indexing tab.
Select the Automatically change View based on the presence of a grid check box
if Grid Indexing is desired.
The image processing for Views that are used with a grid can vary widely. Grid
Indexing optimizes the image processing for Views that use a grid. The Key Operator
can activate the Grid Indexing option by checking the Grid Indexing check box.
Grid Indexing software automatically detects the presence of the CARESTREAM Grid
Alignment electronic grid or a stationary grid. After the image has been processed,
the View will automatically be processed with the correct View (non-grid or grid). It
will change the View name on the thumbnail on the Image Acquisition screen to a
Grid view.
If the Grid Alignment electronic grid is not detected, the image is processed with the
non-grid Views.
Note
This information applies to the DRX-Revolution Mobile X-ray System only.
On the DRX-Revolution system, if the Grid Alignment electronic grid is connected to the
detector, the system selects a Grid View automatically.
If the user is using a non-electronic grid, they can select the Grid check box on the Image
Acquisition screen, and that will be processed as a Grid View. Selecting this check box
changes the exposure techniques for the View before image acquisition
If the Grid check box is not selected, the system will still detect the grid and change to a Grid
View when processing after the acquisition process.
The Key Operator can disable the Tube and Grid Alignment software by clearing the Grid
Indexing check box.
The Key Operator can delete or copy Views on the View Configuration screen without
affecting the optimized grid Views. See View Configuration.
IPv6 Configuration
Internet Protocol version 6 (IPv6) is the latest revision of the Internet Protocol (IP), the
communications protocol that provides an identification and location system for
computers on networks and routes traffic across the Internet. IPv6 was developed by the
Internet Engineering Task Force (IETF) to deal with the long-anticipated problem of IPv4
address exhaustion.
IPv6 adds the option of a new network protocol that allows more flexibility when
configuring the network. If the hospital determines that there is a need for more IP
addresses than are currently available, the option will be enabled and the hospital will
provide the additional address.
Configure Destinations
Destinations can be changed, copied, or deleted on this screen.
The Key Operator can edit the IP address and AE Title fields by clicking in the column and
entering the change.
Search Tab
PACS Tab
1. Navigate to Key Operator Functions > System Configuration > Prior Images
Configuration.
2. To enable or disable the Prior Images feature, check or clear the Enable retrieval of
prior images check box.
3. Select a radio button to set the retrieval method from the following choices:
Manually retrieve prior images
In manual retrieval mode, the Prior Images icon is always displayed on the View
thumbnails for the indicated body parts. The user must select the Prior Images
icon to initiate the retrieval for the prior images for that body part.
Automatically retrieve prior images when the study is opened
When this button is selected, the software searches for the prior images when an
exam is selected from the Modality Work List.
Automatically retrieve when the study is added to the Work List or a
View is created
If additional criteria are needed to further restrict the images for which priors are
retrieved, check the Retrieve priors for Work List items matching the
following criteria option button and enter the Modality Work List Field value
and criteria.
When Modality Work List matching is used, it means that priors will be
automatically retrieved for the indicated body parts for which the Work List data
matches. For indicated body parts in which the Work List data does not match, you
will still be able to retrieve priors, but you must do this manually.
4. If you select the third option in step 2, a check box is enabledRetrieve priors for
Work List items matching the following criteria. Continue with steps 45;
otherwise, you are done.
5. Select a radio button to set the type of matching that should occur from the following
choices:
Exact match only
Any item starting with the text
Any item containing the text
6. From the list box on the left, select the body parts for which prior images should be
retrieved.
To add a body part, click Add and select a body part from the keyboard.
To remove a body part, select the body part and then click Remove.
To specify alternative names for each body part, use the virtual keyboard to enter
another name in the list box on the right and select Add or Remove. Multiple
alternate names can be used for the same body part.
This section allows the user to configure the search criteria for prior image retrieval.
Navigate to Key Operator Functions > System Configuration > Prior Image
Configuration > Search tab.
The search for prior images must meet certain criteria. For example, the system will
search for the number of images within a period of time that the Key Operator has
configured as a default, such as two images processed in the past two weeks. Prior image
Views may be configured for certain body parts only. The search for Priors can be
narrowed by Department name or Modality type.
Search Interval Sets the number of weeks or days in history to search for prior
images. The default value is 2, entered numerically.
Units Sets the search interval to either days or weeks. The default
value is weeks.
Date of birth must match If checked, the patients date of birth must match the patient
records from the PACS.The Patient ID and Patient Last Name
are always used for retrieving priors. When the date of birth
must match check box is selected, then the date of birth must
also match. By default, the check box is not checked.
Retrieve prior images from Specifies which modality records to retrieve from the PACS. By
exams performed on the fol- default, CR, DX, and PR are checked. PR indicates Grayscale
lowing modalities Presentation State.
This section allows the user to configure the PACS from which Priors Images will be
retrieved.
Navigate to Key Operator Functions > System Configuration > Prior Image
Configuration > PACS tab.
Provide the following information:
Field Description
AE Title Enter the AE Title of the PACS from which to retrieve prior images.
IP Address Enter the IP Address of the PACS from which to retrieve prior images.
PACS Port Enter the port of the PACS from which to retrieve prior images. The
default value is 2104, entered numerically.
Local AE Title Select an AE Title for the PACS to identify the Console. It must be differ-
ent from the Computer name or there will be conflicts with Storage Com-
mitment. This value is also used to configure the Console at the PACS,
since the Console will now be acting as a storage device for prior images.
Local Port The default value is 5041 and should not need to be changed. This value
is also used to configure the Console at the PACS, since the Console will
now be acting as a storage device for prior images.
When the Prior Image Retrieval feature is enabled, a new icon is added to the tutor
image. The icon displays one of the following conditions:
SearchingNo pri- This display indicates that the system is actively searching for prior
ors retrieved images, but none have been found yet. The icon is disabled and
the animated cursor indicates that the search is in progress. The
icon does not indicate the presence of priors.
RetrievingAt This display indicates the number of prior images that have been
least one prior retrieved. Clicking on this icon opens the Prior Images screen. If
retrieved additional images are actively being retrieved, the icon as well as
the Prior Images screen will be updated to reflect the additional
images as they are retrieved into the system.
Enabledfor Man- This display indicates that you can manually request to retrieve
ual mode priors for this image, even if the system is in another retrieval
mode.
Systems and Images Compatible with the Prior Image Retrieval Feature
HIS/RIS Configuration
The Modalities use DICOM Work List Management to receive study information from
the hospitals HIS/RIS.
The Remote Query, Polling Query, and Optionstabs let you set up your System to
communicate with the HIS/RIS in any combination of the options presented in these tabs.
Using Remote Query, the system sends an immediate request for records to the
hospitals HIS/RIS system, queried from the Work List screen.
Using Polling Query, the System requests records at a defined time interval. A polling
query allows the System to communicate with the Radiology Information System (RIS) to
display the Patient Work List. You can also query the RIS for individual patients.
With either polling choice, there are additional configuration options for the PACS
broker and for Procedure Mapping.
Postrequisites:
Review additional configuration choices in Configure Remote HIS/RIS Query and
Configure HIS/RIS Query Options.
The Remote Query, Polling, and Options tabs let you set up your system to
communicate with the HIS/RIS in any combination of the tables in the following links:
Remote Query Active Select to permit a Query of the HIS/RIS from
the CR or DR System.
5. In the HIS/RIS Procedure Mapping section, select the DICOM field your RIS uses to
send the Procedure Code.
Requested Procedure
DICOM Field Name DICOM Tag Code Sequence
*If you enable your system for Scheduled Workflow, Performed Protocol Code is
selected automatically, and is not configurable.
Go to Key Operator Functions > System Configuration > Bar Code Configuration
1. Enter the Prefix, Data Size, and Suffix information for the data that you wish to
configure.
Leave the Data Size field blank if you want to accept any size data.
2. Select Save Changes.
3. At the Bar Code Configuration Menu, select Bar Code Programming.
4. Select the feature that you wish to program or a category of information for which
bar codes are displayed.
5. Scan the sample bar code for that feature with the hand-held bar code reader.
Example 1
For example, if the Patient ID bar code is a series of characters such as Pid00001-XX and
you need to change it to 01, the following three options are available to you on the
screen:
Data
Field Strip Size Strip Prefix Size Strip Suffix Strip Size
Patient ID X 3 X 000 2 X - X 2
Patient ID X 6 2 X 3
Example 2
The following example of a 128 bar code indicates a Prefix of -+@# and a data set of
1234567801234.
By configuring the bar code, you can output only the data portion of the code,
1234567801234.
Additional Notes
When you designate Strip, the removal is performed from left to right on the Bar Code
Configuration screen.
The same configuration rules apply for the Accession Number, Procedure Code, and Tech
ID fields.
If the fields contain the same number of digits (Prefix Strip Size + Data Size + Suffix Strip
Size), then the first field name appears in the Test Field.
If there is a conflict with the 10-digit Cassette ID field and another field that is 10-digits
in length, make the Cassette ID field 11 digits.
System Maintenance
System Maintenance lets you set the minimum limit for use of disk space, balancing
between performance and image retention. This lets you determine the criteria used by
the system to automatically erase images or delete patient records.
Field Description
Language Select a language for the system to display using the multilingual
international keyboard.
Time Zone Select the time zone that the modality resides in using the interna-
tional time zone keyboard.
Date Format Select a default format for the date (M=Month, D=Day, Y=Year)
MM/DD/YYYY
DD/MM/YYYY
YYYY/MM/DD
Decimal Separator Select a symbol to use as a decimal using the alphanumeric keyboard.
Data Separator Select a symbol (such as . / - , ) to separate data using the alphanu-
meric keyboard.
Time Separator Select a symbol (such as : ) to separate time using the alphanumeric
keyboard.
Current Date Enter the current date using the numeric keyboard.
Current Time Enter the current time using the numeric keyboard.
Note
Custom tutor image size is limited to no larger than 170 pixels square (170 x 170).
Configuration screen. The Key Operator selects the receptor type when configuring the
techniques for each View and patient size.
A facility may use GOS, CsI, and CR receptors in their system. The Key Operator can
configure the system so that the user can use any of these receptor types when creating
a study.
The System provides techniques for all receptor types for every View and patient size in
the system. For example, when the user selects a GOS detector, the system recognizes the
detector type and automatically selects the appropriate techniques for the GOS or the CsI
type. With Technique Scaling, the differences between the receptors are calculated and
automatically balanced so that the results will be consistent with each receptor type.
This action only saves the default for the optimized View, patient size, and receptor that
are selected when the Store Techniques button is selected.
Filter On
Filter Off
Copy
Paste
Note
When the Copy/Paste feature is used, it will copy and paste all patient sizes for the selected View.
Important
Not all technique parameters can be changed this way. Grid, filter, and field size can be changed.
mAs, AEC, kV, or time cannot be changed.
3. Select Save Changes.
Note
The arrows allow the user to change the exposure factors for Small, Medium, and Large.
The Q-Rad and DRX-Rad systems include an online positioning guide.
4. Select the Edit button in the Positioning Guide box and select the corresponding
study.
5. Select Save Changes.
Note
Technique scaling may not be accessed by the Technologist.
Note
QA Mode: Delivers composite images after inspection.
Pass-through Mode: Delivers composite images automatically without inspection.
Grid Configuration
When you configure a grid, fields that can be edited include:
Grid Classification (focused, fixed, parallel, crossed)
Absorbing Material
Spacing Material
Focal Distance
Aspect Ratio
Thickness
Pitch
The information configured here will be included in the DICOM header and sent to the
PACS.
The Wall Stand is required for the Auto Position option. Auto Position configuration lets
you pre-set equipment locations for exams. The number of positions depends on the
equipment you are using. You can associate an unlimited number of procedures with
these exams.
To configure the DRX-Evolution System for Auto Position:
1. Navigate to Key Operator Functions > System Configuration > Auto Position
Configuration.
2. Select the Enable Auto Position check box.
3. Select a detector by touching the Detector box and selecting Wall Stand, Table, or
none.
4. Touch a position button. The name changes to an editable format.
5. Touch Clear Position to remove the name.
6. Type a new name.
7. Touch Procedure Associations.
8. Select a procedure from the Associate Procedures menu to associate with this
position, or select Clear Associations to create new associations.
9. Select Save Changes.
Detector Sleep
Inactivity Timeout text box
Enter numeric value, in minutes, using the virtual keyboard.
Disable check box
Disables Sleep mode. Detector is always active.
Enterprise Wireless
Credential Expiration Warning Threshold text box
Enter numeric value, in days, using the virtual keyboard.
Determines the number of days left to update the certificate authentication.
Allow Tech to Disable Enterprise Wireless check box
The technologist will be able to disable the connection to the hospital network server
when this check box is checked.
When communications with a hospital network break and disable the DRX-1
detector, the technologist can disable network connections and proceed with the
exam using the detector locally. After the network issue is passed, the technologist
can rejoin the hospital network.
Note
The radiographer can select other text box formats on the Multi-Format Configuration screen.
At each ROP:
1. Select the link to the CR System on which you just made changes.
2. Once the ROP is linked, select Key Operator Functions.
3. Select Fetch ROP Links to add the new links you created in step 6 above.
4. Select Quick Menu and ROP Links to display the new links.
Prerequisites:
Remote Access Software must be set up on the Key Operators computer.
DAP Value
The key information needed to calculate X-ray radiation dose is the DAP value.
This information is collected when a digital system is integrated with the generator, as
with the DRX-Evolution. Alternatively, the DAP and/or OEM generator can be integrated
with the CARESTREAM DIRECTVIEW Console via an X-ray Generator Integrator box, or
the dose related data can be manually entered by the user.
Parameters related to exposure such as kVp, mA, and others are included with the Dose
Report and provide useful information for interpreting dose information. If these
parameters are not automatically communicated to the Console, they should be
manually entered.
Destination Configuration
The Key Operator configures the properties for each destination and destination type on
the Key Operator Functions > System Configuration > Destination
Configuration screen. All of the destinations on the system are listed at the top of the
page. The properties for the selected destinations are listed at the bottom of the page.
The Key Operator configures the destination to support Structured Report Storage by
setting the property to True.
Delivery Preferences
The Key Operator configures the system to send data to certain destinations on the Key
Operator Functions > System Configuration > Delivery Preferences screen. A tab
called Reports lists only the destinations that are configured to support structured
report data storage. A structured report is created from this data by a Radiation Exposure
Monitoring (REM) PACS or a third-party destination.
In addition, on the existing Patient Media tab, a check box is available to select Write
Dose Reports to Patient Media.
Note
If the report data doesnt meet the criteria, the study will not display.
Selecting a study opens the Report Destination Status screen for the report data
associated with the selected study.
The user can resend all failed Dose Report data by selecting Resend All Failed from the
bottom of the screen.
Report Delivery
Resending the dataThe user can repeat the attempt to deliver a Dose Report whether
the delivery is successful or unsuccessful.
Canceling a reportThe user can cancel a report if the delivery is pending.
The purpose of this procedure is to configure the DICOM destination(s) that will receive
the Dose Report data.
1. Navigate to Key Operator Functions > System Configuration > Destination
Configuration.
2. In the Destination Type column, select Store.
3. Enter the required network information, such as AE Title, Port Number, and so
forth, for each DICOM destination to be configured for Dose Reporting.
4. Set the property setting DICOMSupports DICOM Structured Support Storage
to True.
This indicates that the destination supports receiving structured reports.
5. To configure DICOM Communication Properties:
a. Continue from step 4. Set the property setting DICOMSupports DICOM
Structured Support Storage to True.
b. Enter information for communication settings such as Maximum Retries,
Response Timeout, and so forth.
The configuration settings for the DICOM device(s) are saved successfully for Dose
Reporting.
Firmware Updates
The system can determine whether or not the active DRX-1 detector has current firmware
installed. If it does, the detector can be used normally. If it does not have current
firmware, then the firmware must be updated before you can use the detector.
The Key Operator can install firmware updates without contacting Service. After
updating software using the Software Update screen, the Install Firmware Updates
screen appears if a firmware update is necessary.
Note
The receptor must be tethered during a firmware update.
Study Based-Workflow
When the system is configured for Study-based Workflow, the user generates both a
Study Instance Unique Identifier (SIUID) and a new Procedure Step each time New Study
is selected for that patient.
When the user scans a cassette and selects Save Changes, the New Study button
appears. To set the study to completed, select End Study.
Configuration Image Identifier
Note
The destination must support Storage Commitment for the Modality to use this feature, and the
feature must be enabled by Service.
Pass-through Mode
In Pass-through mode, all images are routed directly to destinations without inspection.
When Pass-through mode is configured, you can select the Pause the Pass-through
function on the Scan Status screen to inspect an image. When you are done inspecting
the image, select Resume Pass-through to continue scanning and to allow images to
go to destinations without inspections.
In QA mode, the radiographer must view and approve the image before distributing it
across the network.
Firmware Updates
The system can determine whether or not the active DRX-1 detector has current firmware
installed. If it does, the detector can be used normally. If it does not have current
firmware, then the firmware must be updated before you can use the detector.
The Key Operator can install firmware updates without contacting Service. After
updating software using the Software Update screen, the Install Firmware Updates
screen appears if a firmware update is necessary.
As a user or Key Operator, selecting this button completes the task. A snapshot of the
System Log will be generated, which can then later be accessed by Service to diagnose
system problems.
The Key Operator can copy the logs in the Key Operator Functions menu under Copy
Log History.
Pediatric Imaging
Minimizing the pediatric dose is especially important, as this segment of the population
is most sensitive to X-ray radiation. The choice of acquisition parameter settings has a
strong impact on the delivered dose and image quality.
For example, increasing the mAs setting (the milliamperes x seconds product, that is,
number of X-rays) will proportionally increase the dose to the patient. Similarly,
decreasing the source-to-patient distance will also increase the dose to the patient.
Adjustment of the kVp setting (that is, peak energy of the X-rays) results in more complex
dose and image quality dependence and trade-offs, which in turn depends significantly
on patient size.
For example, decreasing the kVp improves contrast, but increases entrance dose,
especially in larger patients that require more X-rays to achieve a sufficient signal at the
detector. As a result, we suggest that smaller pediatric patients (newborns and infants)
be imaged at lower kVp (< 65 kVp) to maximize contrast and detail. Note that in this case,
the mAs should be adjusted accordingly. We also suggest that larger and obese pediatric
patients be imaged at a higher kVp to decrease noise.
Pediatric Sub-Populations
DIRECTVIEW System Software offers a range of chest and abdomen Views to select for
pediatric patients. Pediatric patient size is categorized in sub-populations:
Very Low Birth WeightLess than 1.5 kg (3.3 lb)
Low Birth WeightGreater than 1.5 kg (3.3 lb) and less than 2.5 kg (5.5 lb)
NewbornBirth to 1 month
InfantGreater than 1 month to 2 years
ChildGreater than 2 years to 11 years
PreadolescentGreater than 11 years to 13 years
AdolescentGreater than 13 years to 21 years
Note
To edit the maximum value for each category and set new defaults, select the displayed maximum
value and input a new value from the virtual keyboard.
Infant
Note
When a Pediatric View is selected on the Patient Input screen, the tutor image displays as a
pediatric patient rather than an adult patient.
What is a View
A View is a pre-set image type that a radiographer can select to represent an exam. It is
the basic element in the digital image chain.
Views are associated with procedures on the Patient Input screen or Image
Acquisition screen and in optional Procedure Mapping.
When you create a View, it appears on the Patient Input screen or Image Acquisition
screen as soon as you add it and save it on the View Configuration screen.
For every View, there is an associated look and customized changes for each of the
preference editor controls. These can be seen, but not modified, in the View
Configuration screen.
Position Raw
9. Select Show View Details to edit all configurations of the View at once, or use the
Column Selection radio buttons to control which columns are displayed in the View
list.
10. Select Save Changes.
Note
If the Views are associated with a procedure, make sure that deleting them will not affect
Procedure Mapping.
1. Navigate to Key Operator Functions > System Configuration > View
Configuration.
2. Deselect all Views to make sure that no additional Views are unexpectedly selected.
3. Select the check box of the View with a similar body part and projection that you
want to delete.
4. Select Delete Checked Views to delete the selected View(s).
A confirmation dialog shows what Views will be deleted.
Note
Views are erased from the system when you delete them from the View Configuration. Deleting
Views from View Category Management moves Views to the Uncategorized category so they
can be added back into a category later, if desired.
Note
If the Views are associated with a procedure, make sure that changing them will not affect
Procedure Mapping.
1. Navigate to Key Operator Functions > System Configuration > View
Configuration.
2. Deselect all Views to make sure that no additional Views are unexpectedly selected.
3. Place a check mark in the Select column of the View that you want to change.
4. Select the characteristic that you want to change, such as Rotation.
5. Select the preferred setting from the pop-up menu.
6. Select Save Changes.
Hospital Name The hospital name that you want to associate with the images.
Hospital Address The address of the hospital that you want to associate with the
images.
Pixel Spacing The pixel spacing for workstations that require the (0018, 1164)
Imager Pixel Spacing or require the (0018, 1164) Pixel Spacing
fields.
Relative X-ray Exposure The Carestream Health Exposure Index or the IEC Exposure Index.
DICOM Tag ID (0018,
1405)
Delivery Tab Options Use uppercase for all DICOM fields on delivery.
Send all images in L/F orientation. This means the workstation
will not rotate the image when it is received. Sends patient
orientation tag (0020:0020).
Remove print destinations from 1-up when creating new
Multi-Format prints.
Scale mark to storage.
Use CR IOD. It means always use the CR DICOM IOD, instead of
DX or MG IOD.
Translate Body Part and Projection.
Allow non-conforming DICOM.
Label Patient CD using LIGHTSCRIBE.
Edit the AE Title IP address and port for their DICOM destina-
tions.
Field Description
Note
The Image Instance tab has different configurations to help with
foldering at the PACS. Consult your PACS Administrator to
determine which setting is required for your PACS system.
Custom Page Layouts Configure a custom Multi-Format layout from a blank page or
Tab from a copy of a layout.
Customize by cell width and cell height.
Use the arrow keys to move the cell up, down, left, or right.
Add or delete a cell from the layout.
Delete the existing layout.
Image DateDICOM tag (0008,0023) Content Date The date the image pixel data
creation started. Required if the
image is part of a series in which
the images are temporally
related.
Image TimeDICOM tag (0008,0033) The time the image pixel data
creation started. Required if the
image is part of a series in which
the images are temporally
related.
Image Processing
6. Click another location in the image to move the Region of Interest box.
The Region of Interest is the mean code value of exposure, indicated in a square area
drawn around the point you selected on the screen.
The display reads:
Mean:1229.00, 0.49 O.D.
Min:1045.00, 0.37 O.D.
Max:1384.00, 0.61 O.D.
St. Dev: 47.20, 0.04 O.D.
The first value in each row is Pixel Location and the second value is optical density
(OD).
Note
The Key Operator can configure the size of the Region of Interest window in Display
Configuration.
Beam Detect
Beam Detect is a feature that allows the detector to be active when it detects an X-ray
beam. Typically, a fixed detector is cabled from the Console to the generator, along with
another cable from the generator to the detector. A wireless detector such as the DRX-1
System detector makes an exposure when the user presses the Prep/Expose switch,
signaling the detector and the generator at the same time.
With the Beam Detect feature, the technologist signals the generator directly from the
exposure switch at the Console, and the detector activates when it senses the X-ray beam.
The detector will continuously make short duration acquisitions, once activated by the
X-ray beam, depending on the duration of the X-ray.
A system can be configured either for the Beam Detect feature or not. It cannot be
configured for both, and Beam Detect is designed to be used with CARESTREAM
DIRECTVIEW System Software V5.7D and higher. Beam Detect cannot be used for
long-length imaging studies.
There is no interface between the workstation and the generator. The wireless detector
makes an exposure when the technologist presses the prep/expose switch connected to
the generator and the detector is signaled by the presence of the X-ray beam.
The DRX-1, DRX-1C, DRX 2530C, TDR, and DRX 2530-01 detectors are not supported for
the Beam Detect feature. The serial number of the detector is checked by the system.
Only the DRX Plus and PRO detectors support the Beam Detect feature at this time.
Note
Only the DRX Plus and PRO detectors support the Beam Detect feature at this time.
Note
Only the DRX Plus and PRO detectors support the Beam Detect feature at this time.
Note
If the Power Saver option is enabled, a green circle will display to show progress as the time
elapses. You have 2 minutes to make an exposure.
The Deactivate button replaces the Activate button on the screen.
5. Acquire the first image.
The detector moves to an Idle state, and stay idle until the full resolution image
transfers to the Console.
The detector then transitions from Idle to Activated, and the system Status displays
Ready, assuming all other factors are normal.
The detector is ready for the next exposure.
Note
Only the DRX Plus and PRO detectors support the Beam Detect feature.
(yellow border)
Inactive The detector is not selected. You cannot use the Console
and the detector for image acquisition.
(gray background)
Note
If you want to take exposures using a cassette, you must deactivate the detector and select the
Generator icon.
3. Put the detector in a Bucky or position the detector for a tabletop exam.
4. At the Console, access the Image Acquisition screen.
5. If not previously activated, touch the Status Control that matches the identification
label.
6. Add or modify exam information.
7. Add or delete views.
8. On the prep/exposure switch, press and hold the button halfway down to the prep
position.
9. When the generator is prepped, press the button completely to take the exposure.
Note
You can press the button completely without holding in the prep position. However, the
generator must delay firing until the generator and the detector finish their preparation processes.
Detector Icon
This icon identifies a detector that is registered for use in the system. The icon
corresponds to a unique identification label on the physical detector. The detector icon
is applied during the detector registration process.
Detector Identity
You must select and activate a specific detector on the Console prior to taking an
exposure.
Always verify the identity of the detector you are using for an exam prior to taking
an exposure.
Each detector must have a complete identity, which includes an identification label
and a detector icon.
Detector Calibration
You must calibrate each detector daily.
If the Key Operator does not configure the system to calibrate automatically, it will
have to be calibrated manually.
You must calibrate the detector when requested by the software.
Note
Perform detector calibration if the system prompts you to do so. If the detector is dropped, a new
calibration will be needed at that time.
Note
The Dark calibration must be performed if the Key Operator for the site has disabled the
automatic daily dark feature, or if automatic Dark calibration fails for a specific period of time:
DRX Plus Detector Family: after the calibration fails for 10 weeks
DRX-1 Detector Family: after the calibration fails for 10 days.
PRO Detector Family: after the calibration fails for 10 days.
Important
The X-ray calibration must be performed every six months or after a significant shock to the
detector.
The user must activate the exposure button for 32 exposures.
The dark calibration must be completed successfully before performing the X-ray calibration.
1. Set the SID to 183 cm (72 in.) and remove the grid.
2. Ensure that nothing is in the beam path.
3. Do the steps in the How to Calibrate the Detector procedure.
9. Select Begin Calibration to access the Calibration Progress Bar and the Status Bar
with a Ready status.
A message will prompt you to take the exposure.
10. Use the pre/exposure button to take the exposure.
11. Follow the prompts until all the necessary exposures are completed.
12. When the message, Calibration Successful appears, select OK.
Wireless Operation
Icon Description
Wireless Operation
This symbol indicates that the detector and Console are successfully
communicating wirelessly.
Signal Strength
The strength of the wireless signal affects how quickly the detector
can transfer images to the Console.
Good signal.
Excellent signal.
Icon Description
Note
The yellow buttons in the image appear if the user logs in as Service only.
Navigate to Utilities > Equipment Management > Detector.
Use the information in the following table to complete the fields on this screen.
Field Description
Status Group Allows you to remove a detector from the available detector list.
Click on any item in the row to select a detector.
Status A green dot with a white check mark indicates that the detector is
added for use on this console.
Icon Identifies each detector in the system by number and color of the
icons assigned label which are selected by the Key Operator and
affixed to the detector.
Detector Details Displays the following information about the selected detector:
Serial number
Model
Sensitivity
Important
Use the Console to monitor the level of charge in the battery. The battery charge icons on the
detector help you determine whether the detector has adequate power to capture images.
25 % charged
50 % charged
75 % charged
100 % charged
Note
The checklist is not a substitute for preventative maintenance, repair, or troubleshooting for the
equipment by qualified service personnel. For critical repairs or situations outside the scope of
basic troubleshooting, please contact Service for assistance.
Inadequate Power
REQUIREMENTS:
Make sure the beam path is clear.
Make sure a battery is inserted into the detector.
Make sure the virtual keyboard settings are enabled.
Do not move the detector during the calibration process.
Use the correct SID.
Use the correct technique.
Make sure collimation is beyond detector edges.
Place the detector away from noise sources.
Note
If the calibration procedure continues to fail, contact the Center of Excellence (COE) for
assistance.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
The generator is selected. This option deactivates the detector and allows you to use
cassettes to capture an image.
RECOMMENDED ACTIONS:
1. Select the detector icon on the console.
2. After you activate the detector, use the Status bar to see the status of the detector.
The detector must be in the Ready (green) state.
Detector Preparing for Yellow The detector is warming up. Press and
Exposure hold the button on the prep/exposure
switch in the prep position.
Detector Completed Pre- Yellow The detector is ready. Press the button
paring on the prep/exposure switch to the
exposure position.
Not Ready: Exposures Dis- Grey The exposures for the requested view
abled are complete. You can add a view, or
continue to the next view
and exposure.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
Note
If the detector is rotated the image will also rotate, the key operator can change image rotation
underKey Operator > System Configuration > View Configuration.
Note
Other factors that can contribute to line artifacts:
Grids
Calibration
Position
Technique
Orientation
Note
If the problem persists, call the Center of Excellence (COE) for assistance.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
The DRX Detector Status Control also provides you with other important information
about:
Detector orientation
Detector identity
Battery life
Detector awake or asleep
Wireless or wired communications
Wireless signal strength
Note
This information does not apply to the PRO detectors. See Detector OverviewPRO for
information on the PRO detectors.
(yellow border)
Inactive The detector is not selected. You cannot use the Console
and the detector for image acquisition.
(gray background)
Note
If you want to take exposures using a cassette, you must deactivate the detector and select the
Generator icon.
Note
You can press the button completely without holding in the prep position. However, the
generator must delay firing until the generator and the detector finish their preparation processes.
Detector Icon
This icon identifies a detector that is registered for use in the system. The icon
corresponds to a unique identification label on the physical detector. The Detector Icon
is applied during the detector registration process.
Note
Only enabled detectors will appear on the Image Acquisition or Detector Calibration screens.
If you dont see the icon of the detector you want to use, follow the Detector Migration process.
See Detector Migration for details.
Choose and activate the correct detector for the image study
Register or enable a new detector for use on the system
Disable or remove a detector for use on a system
Verify that you are performing calibrations on the correct detector
Note
This information does not apply to the PRO detectors.
Portrait
Landscape
Note
The Fast Preview image uses alternative image processing and may have a different appearance
than the image provided with the standard preview.
Note
The PRO detectors run in Fast Preview automatically. This feature is not configurable with the PRO
detectors.
Detector Identity
You must select and activate a specific detector on the Console prior to taking an
exposure.
Always verify the identity of the detector you are using for an exam prior to taking
an exposure.
Each detector must have a complete identity, which includes an identification label
and a Detector Icon.
Detector Registration
You must register each detector on a DRX-1 System. Each Console supports up to
eight registered detectors, with three active at any one time.
You cannot exceed the eight-detector limit on one Console.
Assign a purpose and location for each detector.
For example, one detector is always in the wall stand Bucky, one detector is always in
the table Bucky, and one detector is always mobile and used for tabletop exams or
placed on the patient.
Detectors do not need to be powered on to be registered.
Caution
Before enabling a detector, ensure no other detectors are being enabled or disabled at the same
time as this can cause communication issues.
You must enable each detector on the DRX-1 System it will be actively used on.
A detector can only be enabled on one DRX-1 System at one time, but may be
registered on multiple Consoles.
Detector Calibration
You must calibrate each detector daily.
If the Key Operator does not configure the system to calibrate automatically, it will
have to be calibrated manually.
You must calibrate the detector when requested by the software.
Note
Perform detector calibration if the system prompts you to do so. If the detector is dropped, a new
calibration will be needed at that time.
Note
The Dark calibration must be performed if the Key Operator for the site has disabled the
automatic daily dark feature, or if automatic Dark calibration fails for a specific period of time:
DRX Plus Detector Family: after the calibration fails for 10 weeks
DRX-1 Detector Family: after the calibration fails for 10 days.
PRO Detector Family: after the calibration fails for 10 days.
Postrequisites:
Flat Field Analysis is started automatically as part of X-ray calibration.
See Flat Field Analysis for details.
Note
When major shock has happened to the detector, only Full X-ray calibration is allowed.
Verify that Set Beam Output has been done before you do X-ray Express calibration.
Set Beam Output is a Key Operator function and can be done only by Service or a Key
Operator.
1. Navigate to Utilities > DRX Detector Calibration.
2. From the menu in the Calibration Type tab, select X-ray Express calibration.
3. Follow the on-screen instructions to set up the detector.
4. Enter the technique settings shown on the screen into the generator.
Note
For non-Beam Detect mode, use the interface on the Console.
For Beam Detect mode, use the generator switch.
5. Make eight exposures as directed in the on-screen instructions.
Note
X-ray Express calibration does not take the place of Full Calibration. DRX Plus detectors are
calibrated annually.
Tether Interface
The DRX Evolution Wall and Table Buckys automatically tether the detector when the
detector is inserted in portrait orientation. When tethered, the tether interface provides
power and data transfer. Wireless operation does not occur when the detector is
connected to the tether. The detector battery is charging when in this orientation.
If you disconnect the tether interface, the DRX detector automatically defaults to
wireless operation.
Icon Description
Tether Interface
The detector is presently connected to the tether interface
at a Bucky location. The detector transfers image data and
receives power through the tether interface.
Charging
The tether interface cable is charging the battery inside the
detector.
Note
A battery must be inserted in the detector for correct operation. When you use the tether
interface, the power supplied through the tether also charges the battery.
If the tether interface cable is damaged, you can order a separate replacement cable.
Wireless Operation
Icon Description
Wireless Operation
This symbol indicates that the detector and Console are successfully
communicating wirelessly.
Signal Strength
The strength of the wireless signal affects how quickly the detector
can transfer images to the Console.
Good signal.
Excellent signal.
Icon Description
Important
Monitor the battery power carefully. The only power source for the detector is the battery.
6. If you have acquired an image and the wireless communication encounters an error,
Refer to Troubleshooting Detectors: Communication Errors.
Image information is transmitted wirelessly from a DRX Plus detector to the Console. To
ensure security for a wireless exchange, Carestream Health provides certificate-based
Note
If a detector is configured with a certificate and is moved to a Console that does not expect it, the
detector will not work.
Access Point
Change Battery
You can change the detector battery without causing the detector to reboot or lose
wireless connection.
Remove the battery and replace it within 15 seconds and the detector will continue to
run. If the battery is removed for more than 15 seconds, the detector will shut down.
Note
If left undisturbed, the detector will remain active until the battery runs out.
Note
The yellow buttons in the image appear if the user logs in as Service only.
Navigate to Utilities > Equipment Management > DRX-1 tab.
Use the information in the following table to complete the fields on this screen.
Field Description
DRX-1 Status Group Allows you to add or remove a detector from the avail-
able detector list. Click on any item in the row to select
a detector. Use the scroll bar arrows to display more
detectors.
Important
Use the Console to monitor the level of charge in the battery. The battery charge icons on the
detector help you determine whether the detector has adequate power to capture images.
25 % charged
50 % charged
75 % charged
100 % charged
Prerequisites:
If enabling a detector, insert the battery into the detector before starting these steps.
1. From the Console Main Menu, select Utilities > Equipment Management.
You will be presented with the list of the detectors currently registered on the system.
Icon Detector status
The detector is enabled and available for use with the console.
The detector is registered but disabled for use with the console.
2. To change a detector's availability with the console, first select that detector's row.
Postrequisites:
When disabling a detector, once the process completes you should remove the detector
battery.
Troubleshooting Detectors
The checklist below offers basic corrective actions for common error situations. Refer to
the corresponding Troubleshooting topic(s) for corrective action.
Note
The checklist is not a substitute for preventative maintenance, repair, or troubleshooting for the
equipment by qualified service personnel. For critical repairs or situations outside the scope of
basic troubleshooting, please contact Service for assistance.
Inadequate Power
SYMPTOMS: A message on the Console indicates that the calibration failed. The Image
Quality is not optimal.
RECOMMENDED CORRECTIVE ACTIONS:
1. Calibrate the detector.
2. Verify that a battery is inserted into the detector.
3. Verify the identity of the detector.
4. Do not touch Abort Calibration during calibration.
5. Do not navigate to another menu or screen until the calibration is complete and
successful.
6. Use the Calibration Progress Bar to track the exposures completed out of the total
number of required exposures. Complete all of the exposures.
7. For Daily Dark Calibration, keep the detector away from potential noise sources.
8. Protect the detector from X-ray exposures during the calibration.
REQUIREMENTS:
A battery is inserted into the detector.
Virtual keyboard settings are enabled.
0.5 mm copper / 1 mm aluminum filter is used for X-ray calibration.
Do not move the detector during the calibration process.
Use the correct SID.
Use the correct technique.
Note
If the calibration procedure continues to fail, contact the Center of Excellence for assistance.
SYMPTOMS: The Status bar shows a Not Ready: Detector Unavailable message.
You see one of the following symbols:
Note
For DRX Plus detectors, press and release the Reset button.
3. Wake up the detector.
4. Connect the tether (if purchased).
If you are using the DRX detector in the wireless mode to acquire images and lose
communication after the image is acquired, you can use the DRX System Tether
Interface to retrieve the acquired image.
To use the tether interface to retrieve image data on the detector:
a. Place the detector in the Bucky.
b. From the Bucky, connect the tether interface cable head to the detector.
c. From the Console, confirm that the tether connection is successful.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
The generator is selected. This option deactivates the detector and allows you to use
cassettes to capture an image.
RECOMMENDED ACTIONS:
1. Select the detector icon on the console.
2. After you activate the detector, use the Status bar to see the status of the detector.
The detector must be in the Ready (green) state.
Detector Preparing for Yellow The detector is warming up. Press and
Exposure hold the button on the prep/exposure
switch in the prep position.
Detector Completed Pre- Yellow The detector is ready. Press the button
paring on the prep/exposure switch to the
exposure position.
Not Ready: Exposures Dis- Grey The exposures for the requested view
abled are complete. You can add a view, or
continue to the next view
and exposure.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
SYMPTOMS: You are unable to take an exposure. You see the following symbol:
DRX-1The green LED on the detector flashes in a pattern of five rapid pulses.
DRX PlusThe Power LED will light magenta.
RECOMMENDED CORRECTIVE ACTIONS:
1. Provide power to the detector with a fully charged battery.
2. Do one of the following:
Replace the low or depleted battery with a fully charged battery.
If multiple detectors are registered on your System, check the battery status for
another detector. If another detector has adequate power, select and use that
detector for your exam.
Use the detector in a Bucky in the Portrait orientation so it can be charged.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
SYMPTOM: The Image Acquisition screen does not show a new detector.
RECOMMENDED CORRECTIVE ACTIONS:
1. Verify that a battery is inserted in the detector.
A detector requires a battery. Without a battery, the detector is turned off. Verify
that a charged battery is inserted into the physical detector.
2. Verify that the detector is registered for the System you are using.
Registration for one detector does not automatically transfer across multiple DRX
System Consoles in one location.
a. You must manually register the detector on the specific DRX System that you plan
to use for the exam.
b. The detector is registered if the identification mark on the detector corresponds
to the detector identity shown on the Console.
c. You can register up to eight detectors on one Console.
3. Determine whether the system has reached the maximum limit for detectors.
You can register a maximum of eight detectors concurrently to one Console.
a. View the number of existing detectors.
b. If eight detectors are already registered on the Console, remove an existing
detector.
c. Register the new detector.
4. Verify that the detector has been enabled for use on the Console.
Does the detector show this icon next to it in the Equipment Management
screen.
If no, refer to the topic Detector Migration.
If yes, continue to the last step.
5. Perform a reboot on the Console.
The changes from the registration process do not take effect until after you reboot
the Console system.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
Note
Other factors that can contribute to line artifacts:
Grids
Calibration
Position
Technique
Orientation
Note
If the problem persists, call the Center of Excellence (COE) for assistance.
SYMPTOMS: Image quality is not optimal. A message on the console indicates that the
calibration is overdue.
RECOMMENDED CORRECTIVE ACTIONS:
1. Go to Utilities > Detector Calibration.
2. Select and activate a specific detector.
3. Select Calibration Type to access the virtual keyboard.
4. Select a specific calibration type.
5. Look at the Date/Time Last Calibrated for each calibration type.
6. Run calibrations as necessary.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
Note
If the problem persists, contact the Center of Excellence (COE) for assistance.
Depending on your workflow needs, Sleep mode can be enabled and disabled, and the
duration time before entering Sleep mode can be configured.
Note
DRX-1 and DRX Plus detectors have Sleep mode. PRO detectors do not have the Sleep mode
feature.
Prerequisites:
You must be logged in as a Key Operator.
Note
DRX-1 and DRX Plus detectors have Sleep mode. PRO detectors do not have the Sleep mode
feature.
Note
DRX-1 and DRX Plus detectors have Sleep mode. PRO detectors do not have the Sleep mode
feature.
What is DR TQT?
DR TQT is a DR imaging system quality performance monitoring tool. It supplies support
for features such as:
Beam output
Image capture
Image export
Image import
Data export
Data trend charting
DR TQT analyzes signal, noise, and resolution characteristics for DR detectors.
Following X-ray Calibrations, Flat Field Analysis occurs with 4 exposures at 4 techniques.
Calibration with X-ray should be performed monthly. It takes approximately 30 minutes
and requires approximately 16 exposures.
1. Set the SID to 182 cm (72 in.) for Wall Stand and 132 cm (52 in.) for Table (fixed
detector).
2. Remove the grid.
3. Verify that the collimator blades are completely open.
4. Insert the 0.5 mm copper / 1.0 mm aluminum filter onto the collimator, with the
copper side facing the tube.
5. Ensure that nothing is in the beam path.
6. Select Begin Calibration to access the Calibration Progress Bar and the Status Bar
with a Ready status.
A message will prompt you to take the exposure.
7. Do not move the detector.
8. Use the pre/exposure button to take the exposure.
9. Follow the prompts until all the necessary exposures are completed.
10. When the message, Calibration Successful appears, select OK.
11. Remove the filter.
DR Detector Configuration
1. Set Beam Output
2. Calibration Technique Setting for CsI Detectors
3. Calibration Technique Setting for GOS Detectors
4. TQT Configuration
Technique Configuration
DR Acquisition Technique Configuration
5. Tolerance Configuration
DR TQT Analysis
1. DR TQT Analysis
Flat Field Image Acquisition
Phantom TQT Image Acquisition
2. Data Results Review
DR TQT Results
3. Import/Export Test Results
Note
The status bar turns from green, to yellow, to blue to signal the ready, prep, and acquisition
stages. For details, see Understanding the Status Bar.
Approximately three seconds after the exposure is completed, the Image Viewer screen
appears.
Detector Calibration
Note
The daily dark calibration must be performed if the Key Operator for the site has disabled the
automatic daily dark feature or if automatic daily dark fails for 10 days.
Important
You must keep the detector away from other electronic devices during calibrations.
Only an authorized Service Representative can adjust the settings on the upper-half of the
Detector Calibration Screen.
1. At the main menu, select Utilities > Detector Calibration.
2. Select the detector type: Wall Stand Bucky or Table Bucky.
3. Select the Calibration Type check box.
Important
The X-ray calibration must be performed every six months or after a significant shock to the
detector.
The user must activate the exposure button for approximately 15 exposures.
The dark calibration must be completed successfully before performing the X-ray calibration.
1. Set the SID to 183 cm (72 in.) and remove the grid.
2. Check that the collimator blades are open to expose the filter.
3. Insert the 0.5 mm copper and the 1.0 mm aluminum filter onto the collimator, with
the copper side facing the tube.
4. Ensure that nothing is in the beam path.
5. Do the steps in the How to Calibrate the Detector procedure.
6. When the calibration is complete, remove the filters from the collimator.
DR Long-Length Imaging
Long-Length Imaging(LLI) is used to measure angles and bone length. It is a system that
creates a composite image from a series of component images for scoliosis, full spine, or
leg-length procedures.
Caution
The DR Long-Length Imaging Software Module relies on the end user to specify individual fiducial
markers on each component image that is used to build the composite stitched image. If these
points are not properly located, the resulting composite image may not accurately represent the
actual patient anatomy.
The radiographer creates component images manually, or with automatic equipment
depending on the procedure and the system.
Console software for LLI aligns, orders, and stitches component images to form the
composite image, regardless of the equipment being used. Once the system acquires
two or more component images, the software begins to stitch the images together.
Carestream Health only supports alpha rotation (tube angles) rather than Z
translation (linear tube movement from head to toe) for optimal LLI imaging.
An image overlap to include 32.40 mm (1.27 in.) of common anatomy between
component images is required for optimal stitching.
The use of a reference object (such as a radiopaque ruler with lead markings) in the
component images may be necessary when stitching with fiducials.
Caution
The ruler should never be used for distance measurements in the image.
Patient motion must be minimized during the two-to-five exposures needed to create an
LLI exam.
The Manual Stitch Editor allows manual adjustments to composite images if desired.
When manually adjusting stitched results, the user should zoom to an appropriate magnification
for visual assessment.
The user should begin with reference points (external fiducial markers such as a ruler) in the
overlap region. Final adjustments should be made based upon the alignment of the anatomy.
Carestream Health system solutions and is available as an integrated feature within the
DIRECTVIEW software.
Caution
Federal law restricts this device to sale by or on the order of a physician.
Exposure Overlap Guides are used in DR manual upright exams to place the detector
properly at the top, middle, and bottom of a long-length exam. These guides ensure that
there is adequate image overlap for stitching the composite image.
The overlap guide has three triangles and three color strips to use as detector positioning
guides.
The points of the triangles indicate the position of the center of the detector for each
exposure. The color strips indicate the amount of overlap between each exposure.
1. Center the red laser over the region of interest (ROI).
2. Line up the point of the middle triangle on the overlap guide with the red laser and
affix the guide to the patient stand.
3. For the first exposure, center the detector on the point of the upper triangle.
4. Take the first exposure.
5. Center the detector on the point of the middle triangle.
6. Take the second exposure.
7. Center the detector on the point of the bottom triangle.
8. Take the third exposure.
Patient Stand
The performance of the DR Long-Length Imaging system is optimized with the use of a
patient stand. If you choose another patient stand, be sure to evaluate the best
conditions for image quality.
The patient stand is constructed so that you can position the patient in front of the Wall
Stand detector for upright exams. A center line is marked on the back of the stand so that
you can align the center of the Bucky with the center of the stand.
The stand is on wheels for easy movement. To lock the stand in place, press one of the
red foot pedals, and all four wheels will lock at once.
Use the scale on the Patient Stand handle to determine the object to image distance
(OID)the distance from the midline of the anatomy of interest to the detector.
An accurate OID is important for stitching precision.
1. Position the patient and measure the distance to the detector.
2. Input the measurement in the More Image Data tab on the Patient Input screen.
Note
The CARESTREAM DR Long-Length Patient Stand base can be lifted so that the patient can stand
on the floor if necessary
The Image Viewer screen opens with the composite image in the Viewer window.
1. While viewing the stitched image, select the Edit Stitched Image check box.
2. You can now adjust the image stitching three ways:
Use the cursor to drag-and-drop the image in place, either on the main viewer screen or
the small viewer panel at the right of the screen.
Use the arrow keys to move the image to make fine adjustments. One touch of the arrow
key moves the image one pixel. Pressing the Control (Ctrl) key and touching the arrow
moves the image five pixels.
Select the Use Fiducials check box. This removes automatic stitching and lets you
manually re-stitch the composite.
Be sure to pan and zoom the image before selecting Use Fiducials, because once selected,
the cursor changes to a crosshair, and it is not possible to pan the image without
unintentionally selecting a reference point. Only the small image panel will allow
panning once Use Fiducials is checked.
1. Select a point in the overlap area (such as a point on the ruler) and click once.
2. Select a point in the second image and click again.
The image aligns to those two reference points.
Note
If a radiopaque ruler is used in the image, selecting identical points is simple. Use the arrow keys
to adjust the image pixel-by-pixel if necessary.
3. Select Save Changes when the image stitching is complete.
4. Select Save & Accept to deliver the image.
Important
The ruler should never be used for distance measurements in the image.
Note
Use the longest SID within the focal range of the grid being used.
d. Use the laser line from the collimator to point on the lowermost part of the
anatomy to be exposed.
e. Press the LLI Lower Limit button on the OTC. The button turns green.
f. Use the arrow buttons to select the Object to Image Distance (OID) on the OTC.
g. Press the Set button.
The OTC and detector move into position to take the first exposure.
Important
All desired technique changes for any of the component images must be made before pressing
the prep/expose switch and initiating the acquisition series.
3. Press and hold the prep/expose switch until all images are acquired.
The system automatically exposes and moves to the next position until all images are
acquired.
Important
If images are acquired in the wrong order, you must unassign the image(s) and then assign them
in the correct order.
Reset
Touch this button to reset the values on the OTC.
The Reset button is enabled and available when the anatomy to be
imaged is defined during automatic acquisition.
The Reset button is disabled after the first image is acquired.
Set Active
After the upper and lower limits have been set, the Set button
becomes active.
Set Button
After the Set button is pressed, any manual changes in the acqui-
sition hardware positions will abort the exam. You will have to
start over.
The Set button remains disabled until the upper and lower limit
selections are made.
Do not make any adjustments to the collimation or to the position
of the tube/detector at this time.
Toggle
Touch this icon to toggle from DR Long-Length Imaging Mode to
General Radiography Mode.
Note
Immobilize the patient to reduce patient motion with an LLI exam.
1. Select an LLI procedure at the Console.
2. Use Auto Center to center the tube to the Wall Stand. Use the longest SID within the
focal range of the grid being used.
3. Position the patient stand in front of the Wall Stand.
4. Select an LLI View.
5. Position the patient on the patient stand.
Note
To facilitate manual stitching, adjust the ruler so that it is in front or behind the patient, so that
the ruler can be seen in the image without affecting the view of the anatomy. However, if the
ruler is needed for determining patient size, insert the ruler mid-line, or include an object of
known size for reference.
Note
Immobilize the patient to reduce patient motion with an LLI exam.
Note
The detector remains in portrait orientation for scoliosis exams. For leg-length exams, insert the
LLI grid and rotate the Bucky to landscape orientation.
1. Select an LLI procedure at the Console.
2. Set up the DRX-Evolution System.
3. If you are using a DRX detector, insert it in portrait orientation so that it is tethered.
4. Insert the appropriate grid. If the Bucky is in landscape orientation, the LLI grid is
necessary.
5. Manually center the X-ray tube to the Wall Stand. Use the longest SID within the focal
range of the grid being used.
6. Position the patient stand in front of the Wall Stand by aligning the midline on the
Bucky with the midline on the patient stand.
7. Press the red foot pedal on the patient stand to lock all four wheels in place.
8. Position the patient.
If you are performing a scoliosis exam with a patient of average height, have them
step on the stand.
If you are performing a scoliosis exam with a tall patient, raise the floor of the
stand back and ask the patient to stand on the floor so that the Bucky can image
the top of the spine.
If you are performing a leg-length exam, attach the removable step stool so that
the patient is raised and the Bucky can image the ankle.
9. Using the overlap guide, determine the number of images you will need to complete
the LLI exam.
10. Position the overlap guide on the patient stand in the correct location and line the
Bucky up with the overlap guide.
11. Adjust the handles, straps, and ruler as desired.
12. Determine the center of the region of interest using the overlap guide and position
the X-ray tube pointing straight at that point
13. Angle the tube so that it aligns with the first location on the overlap guide.
Carestream Health only supports using alpha rotation (tube angles) for optimal LLI
stitching.
14. Adjust the collimation width.
15. Adjust the technique for all thumbnails if desired
16. Instruct the patient to hold still for a leg-length exam (hold breath or maintain
shallow breathing for a scoliosis exam).
17. Acquire the first image.
18. Angle the tube and center to the second position on the overlap guide.
19. Press Auto Center to move the Wall Stand into the correct position.
20. Acquire the second image.
21. Angle the tube and center to the third position on the overlap guide.
22. Press the Auto Center to move the Wall Stand into the correct position.
23. Acquire the third image.
24. Instruct the patient to relax and breathe.
25. The images automatically stitch to form the composite image.
26. Select the thumbnail of the composite image to view it on the Image Viewer screen.
27. If necessary, manipulate the image stitching using the Manual Stitch Editor. You
can also add angle measurement, cobb angles, and rulers to the image using
Measurement Tools.
Note
To facilitate manual stitching, adjust the ruler so that it is in front or behind the patient, so that
the ruler can be seen in the image without affecting the view of the anatomy. However, if the
ruler is needed for determining patient size, insert the ruler mid-line, or include an object of
known size for reference.
Note
Immobilize the patient to reduce patient motion with an LLI exam.
1. Select an LLI procedure on the system Console.
2. Select an LLI View.
3. Click the thumbnail to open the Image Acquisition screen.
4. Select the Table detector.
5. Move the table to the lowest position.
6. Set the SID to 132 cm (52 in.) at the tube controls. Carestream recommends the
longest SID possible for best results, within a range of 100250 cm (39 x 98 in.).
The SID may be set manually or by applying Auto Position.
7. Insert the DRX detector into the table Bucky to the most superior position.
8. Position the patient.
9. Angle the tube so that the red laser points to the uppermost limit of the region of
interest.
10. Press the Upper limit icon.
11. Angle the tube so that the red laser points to the lowermost limit of the region of
interest.
12. Press the Lower Limit icon.
13. Press Set.
14. Press and hold down the Prep/Exposure switch until all exposures are made.
The images stitch to form the composite image.
15. Select the thumbnail of the composite image to view it on the Image Viewer screen.
16. If necessary, manipulate the image stitching using the Manual Stitch Editor. You
can also add angle measurements, Cobb angles, and rulers to the image using
Measurement Tools.
Note
Immobilize the patient to reduce patient motion with an LLI Exam.
1. Set up the DR System.
2. Insert the detector in the appropriate orientation for the exam.
3. Manually center the X-ray tube to the center of the region of interest.
4. Position the patient stand in front of the Bucky with the detector and align the
midline on the Bucky with the midline on the patient or the patient stand.
5. If the patient stand is used, press the red foot pedal on the patient stand to lock all
four wheels in place.
6. Position the patient.
a. If you are performing a scoliosis exam with a patient of average height, have them
step on the stand.
b. If you are performing a scoliosis exam with a tall patient, raise the floor of the
stand back and ask the patient to stand on the floor so that the Bucky can image
the top of the spine.
c. If you are performing a leg-length exam, attach the removable step stool so that
the patient is raised and the Bucky can image the ankle.
7. Adjust the handles, straps, and ruler as desired.
8. Position the overlap guide on the patient stand in the correct location and line the
Bucky up with the overlap guide.
9. Using the overlap guide, determine the number of images you will need to complete
the LLI exam.
The overlap guide will remain in this position throughout the exam.
Note
To facilitate manual stitching, adjust the ruler so that it is in front or behind the patient, so that
the ruler can be seen in the image without affecting the view of the anatomy. However, if the
ruler is needed for determining patient size, insert the ruler mid-line, or include an object of
known size for reference in the plane of the anatomy.
For more information on stitching adjustment, see Manual Stitch Editor in the
CARESTREAM DIRECTVIEW Online Help.
Important
The detector must be placed on a flat, rigid surface.
4. Position the tube over the patient, centered to the area of interest. Carestream
Health recommends a 183 cm (72 in.) SID, or the maximum SID you can achieve within
the range of your grid.
5. Using only the rotational buttons on the tube, angle the tube so that it is centered
over the detector.
6. Open the collimator blades to expose the full detector.
7. Complete the first exposure, and reposition the detector for the second exposure.
8. Using the rotational buttons, angle the tube and ensure that it is centered over the
detector.
Make sure that the collimator buttons are open to expose the full detector.
Important
It is crucial that the detector is not rotated between exposures, because the stitching software
does not correct for any difference caused by rotation of the detector.
9. Complete the second exposure.
If you are doing a two-image study, you are finished. If you are doing a three-image
study, reposition the detector and the tube for the third image and complete the
third exposure.
After all the images are acquired, the stitching software will combine the images to
form a single stitched image. Use the Manual Stitch Editor to adjust the image
stitching in either the left and right or the up and down direction.
For more information on stitching adjustment, see Manual Stitch Editor in the
CARESTREAM DIRECTVIEW Online Help.
Note
You cannot enter data using the tube head screens; you can select icons to perform functions.
Note
This information applies to the DRX-Revolution Mobile X-ray System only.
The cart in the graphic above is in the docked position and the column is collapsed.
When the cart is in drive mode, no images can be taken.
The cart may be driven under three conditions:
Allow driving only when logged into the system.
Allow driving without logging on by touching the Drive icon, which will activate the
drive system.
Allow driving without logging on by touching the Drive icon, and entering the drive
code.
Note
This information applies to the DRX-Revolution Mobile X-ray System only.
Note
This information applies to the DRX-Revolution Mobile X-ray System only.
The Privacy screen may appear when you log on. It is an interactive screen that shows
the status of batteries in the DRX-Revolution system, communications, and access to all
of the tube head functional buttons.
Note
You cannot enter data using the tube head screens; you can select icons to perform functions.
Note
This information applies to the DRX-Revolution Mobile X-ray System only.
The Image Acquisition screen is located on the tube head display and it performs the
same function on the primary display. It appears when the user prepares to take an X-ray.
It contains all of the controls needed to set up an exam and acquire an image.
Detector status
Selected detector
Detector battery status
Wireless status
Detector name
Icon/Area Description
Focal spot
Patient size
View thumbnail
Log on
Log out
Icon/Area Description
Utilities
Changes made to screens in the Utilities section will become effective after you select
the Back button.
Generator Controls
The generator controls are active if the detector selection is Generator Only.
The user sets the kVp and mAs values.
See How to Adjust the kVp and mAs.
1. At the Image Acquisition screen, touch the arrows to raise (up) or lower (down) the
kVp values. The blue arrows change the value by one unit. Gray arrows are not
selectable.
The kVp adjustment ranges from 40 to 150 kVp. Maximum power must never exceed
80 KW. Exposures near the 80 kW power level may also be limited to less than the
maximum exposure time.
2. Select the radio button to control mAs and use the arrows to change the value.
The mAs adjustment ranges from 0.1 to 320.0 mAs. Maximum power must never
exceed 80 kW. Exposures near the 80 kW power level may also be limited to less than
the maximum exposure time.
Note
You can adjust the mAs value or the exposure time.
With mAs selected, the mAs value remains constant and the exposure is terminated
when the pre-selected value is reached.
With Time selected, the exposure is terminated when the time value is reached. This
mode is used when a specific time must be achieved, such as in a breathing study or
for stop motion.
Caution
The Tube and Grid Alignment System accuracy can be adversely affected by interference from
nearby metal objects. For example, alignments for Supine exams on ED trauma stretchers can
sometimes exhibit excessive interference from the metal bed structure beneath the mattress pad.
A warning is displayed on the Grid Alignment screen if significant interference is detected when
aligning under these conditions.
Carestream Health recommends that the grid holder always be used on top of a mattress that has
a minimum thickness of 7.6 cm (3.0 in.)
Two Grid Alignment systems within 6 m (20 ft) of each other may cause grid alignment
interference.
4. Select the target Source to Grid Distance (SGD), such as 102.0, 112.0, or 127.0 cm
(40.2, 44.1, or 50 in.).
5. Select the bed type on the screen, either ED for a trauma gurney, or ICU for an
intensive care bed.
6. Use the buttons on the back and front sides of the collimator handles to release the
brakes and position the X-ray tube as you would for any exam. The tube angle and
detector angle indicators and the collimator light can be used as guides for
positioning.
7. Position the grid frame a minimum of 61 cm (24 in.) away from the cart and any other
metal objects of similar size or larger, and at least 15 cm (6 in.) away from any edge
of the mattress while in use.
8. Use the buttons on the back side of the collimator handles to release the brakes for
the boom, column, and turntable. There are three positioning indicators that will aid
in getting the X-ray tube aligned to the grid frame at the target SGD.
Up/Down
Left/Right
In/Out
All indicators are relative to you as you are holding the collimator handles in front of
you.
9. Move the tube head position as required to center each of the three indicators. The
arrows on each position will light up to provide guidance to help you move the tube
so that the white bar stays in the center of each box. The boxes turn green when good
alignment is achieved.
10. Use the buttons on the front side of the collimator handles to release the rotation
brakes so that you can point the tube in the correct direction.
Note
Do not press the back side buttons. Doing so will cause the system to lose alignment.
11. Point the collimator at the patient anatomy using the light, and collimate the beam
down as you normally would for any exam.
Auto-Associate Feature
This information applies to CR Systems, only.
The Key Operator can configure a Classic/Elite CR System or a CR 825/850 System to
automatically associate the Cassette ID to a View thumbnail, which eliminates the need
to use an external bar code reader for this purpose.
Note
The Modality must be operating independently from a Remote Operations Panel (ROP). When a
ROP is defined as an external device to one of the Modalities, the Auto-Associate button is
disabled.
To enable the Auto-Associate feature, go to Key Operator Functions >
System Configuration > Next Page > Scanner Options and select the
Auto-Associate Enabled check box.
Note
If you do not select a View prior to inserting the cassette, the image will be unassigned.
2. Insert the cassette.
When the cassette is scanned, the image is automatically associated with the View
thumbnail that was selected (highlighted) when the scan began. The system
automatically highlights the next View after the cassette scanning process has
started.
3. Insert the next cassette.
4. Repeat until each View is scanned.
Note
When the Auto-Associate feature is enabled, if a cassette bar code gets accidentally scanned, the
accidental information will not be used by the system. The image file sent to other devices will
contain only the Cassette ID of the scanned cassette, not the ID of the cassette that was
accidentally scanned.
Each cassette is automatically associated with the View that was selected when the
cassette is inserted.
Scan Status Displays the last scanned image. From this tab
you can assign the image, access the Patient
Input screen and the Image Viewer screen.
Note
Only the Scan Status tab is available on the console of the Classic/Elite CR Systems without the
Easy View display. The Erase Cassette tab, System Recovery tab, and Erase Lamp tab
functions are available on the Local User Interface (LUI) of the Classic/Elite CR Systems.
Progress Bar Displays the progress of the scan from the start to com-
pletion.
Pause Pass-through/Resume These buttons appear if the Key Operator has configured
Pass-through Functions the system for Pass-through Mode. These buttons allow
you to inspect an image before accepting and sending to
destinations, and then resume Pass-through Mode.
Name Description
Image Viewer Screen Opens the Image Viewer screen to modify the image
quality.
Assign Image Opens the Patient Query screen to assign patient infor-
mation to the image.
Patient Information Bar Opens the Patient Input screen to view or change
patient information.
Important
Make sure that you want to erase a cassette. Erasing deletes any image on the phosphor screen.
The system cannot scan a cassette with an image while in Erase Mode.
1. Select the Erase Cassette tab on the Scan Status screen.
2. Insert the cassette into the CR System.
3. Select Erase Cassette.
The mechanical Start button on the front of the CR 975 or Max CR Systems is not
active during the Erase Mode.
Important
Do not insert cassettes containing patient images into the CR 975 or Max CR Systems while they
are erasing cassettes.
Utilities
Erase Cassettes
Cassette will be Erased Insert the cassette and the erasing of the
phosphor screen in the cassette begins imme-
diately and then released.
2. Select System Shutdown/Power Off and select OK. The CR computer shuts down.
3. Turn off the power switch on the side of the Classic/Elite CR System.
Caution
The CR 950/975 has moving parts. Avoid contact with the belt.
1. Push a cassette all the way into one of the drive belt slots.
2. Set the cassette into the transport mechanism.
3. Make sure the cassette is perpendicular when loaded and pushed all the way to the
back of the slot.
You can load up to eight cassettes of all sizes at one time.
At each ROP:
1. Select the link to the CR System on which you just made changes.
2. Once the ROP is linked, select Key Operator Functions.
3. Select Fetch ROP Links to add the new links you created in step 6 above.
4. Select Quick Menu and ROP Links to display the new links.
Prerequisites:
Remote Access Software must be set up on the Key Operators computer.
To access the Remote Device Configuration screen, go to Key Operator Functions >
System Configuration > Remote Device Configuration.
1. To enter a remote device, select New Device.
The virtual keypad appears.
2. Enter the IP address of the remote device.
3. Select Edit ROP Links.
The ROP Links Configuration screen appears.
4. Select Add ROP Link to add the IP address of a CR System. An IP address must have
the format of X.X.X.X where X is a number between 0 and 255.
The CR Systems listed on the ROP Links Configuration screen appear on the ROP
Links screen on the Remote Operations Panel.
5. Select Delete ROP Link to remove a CR System from the ROP Links Configuration
screen and the ROP Links list.
6. Select Save Changes or Save to All.
Note
A password is required when logging into the CR from the customer computer. A RPDES system
must have a fixed IP address or the link with the CR System may be lost if the customer computer
is rebooted.
How to Complete a Study from the Remote Patient Data Entry System
The following information applies to CR Systems only.
When the System is connected to the Remote Patient Data Entry System (RPDES), the
connection lets you access the Patient Input screen and pre-populates the Work List.
Enter the information for all required fields.
Grid
Two grids have been optimized for LLI image quality:
DIRECTVIEW Long-Length Grid for Vertical Cassette Holder
DIRECTVIEW Portable Grid
Carestream Health has not tested other grids; so if you use another grid, make sure to
evaluate the best conditions for image quality:
Grid ratio8:1
103 LP
You can order extra front panels for mounting standard long-length grids.
Caution
Handle the grid with care. Dropping or bumping the grid causes serious internal damage that
produces permanent, unacceptable imaging artifacts.
Collimation
Use vertical collimation for long-length imaging exams. The image stitching algorithm
uses the non-image area at the sides of the phosphor screen to correctly align the image
information.
The software looks for sharp edges in each of the sub-images to combine when applying
the stitching algorithm. Therefore, if you collimate closely when performing a
long-length exam, your results will improve.
Cassettes
Use the minimum number of cassettes required to capture the desired image. Large
unexposed areas can degrade image quality.
Filtration
Use an intensity profile compensation filter (wedge filter) to pre-attenuate images.
1. Enter Patient data into the CR Modality the same way you do for a standard study.
2. Select a View or a Procedure.
If the Procedure Mapping option is enabled, enter the procedure codes for the
long-length image on the Patient Input screen.
3. Scan a CR long-length cassette bar code that begins with 9105 for long-length
vertical cassettes and 9112 for portable cassettes.
If you are processing a long-length portable cassette, a dialog box appears with the
message: Choose a patient position for this long-length exam, Erect
or Supine.
4. Enter the number of long-length imaging cassettes used for the exposure.
Make sure you select cassettes that have consecutive numbers, such as 1, 2, and 3. The
software will not let you select cassettes that would leave a gap in the combined
image, such as 1 and 3 or 1 and 4.
5. Bar code the remaining cassettes.
6. Enter the exam data.
7. Select Save Changes.
You cannot change the number of cassettes selected; however you can select
Delete View and start again.
Automatic
The SID for the portable long-length cassette is determined when you place the X-ray
tube a specific distance from the Bucky/cassette.
Override
You can override this setting for the View as desired from the More Image Data button
on the Patient Input screen.
SID Ranges
Enter the correct SID values:
DIRECTVIEW CR Long-Length Vertical Cassette HolderHas a recommended SID of
183 cm (72 in.). You can set the default SID value from 150 to 229 cm (60 to 90 in.)
1 cm, depending on site and grid requirements. You must enter SID values in
centimeters (cm).
DIRECTVIEW CR Long-Length Portable CassetteHas a recommended SID of 150 cm
(60 in.). You can set the default SID value from 101 to 183 cm (40 to 72 in.) 1 cm,
depending on site and grid requirements. You must enter SID values in
centimeters (cm).
Note
Your staff radiographers can move the tube from the default position for an exam, but must
override the default distance and enter the measured SID when entering exam information. The
composite LLI image can become distorted when the incorrect SID is entered. Therefore, it is
imperative for optimum image quality that the SID be measured accurately within 1 cm of the
correct SID values.
What is CR TQT?
The following information applies only to CR Systems.
The Total Quality Tool (TQT) is a comprehensive, quality assurance system that
evaluates various aspects of image quality on CR Systems and CR cassettes. With a few
quick steps, you can verify that the system is functioning within its normal operating
specifications.
TQT is an optional feature for CR Systems. If the TQT option is not activated, contact
Carestream Health for purchase information.
Carestream Health recommends the use of the Total Quality Tool as part of a quality
control program for CR Systems. Additional quality control tests should be incorporated
into the quality control program as required by local regulations.
The Total Quality Tool does not directly evaluate or provide a quality control capability
for the X-ray equipment used or output destination devices (such as workstation
monitors) connected with the CR System. Quality control procedures for other
components in the imaging chain must be followed at the recommended intervals
according to the manufacturer's instructions.
The CR System must be calibrated at the recommended intervals according to instructions
from Carestream Health, Inc. All components in the imaging chain (such as the X-ray
equipment, workstation monitors, or film printers) must be calibrated at the
recommended intervals according to the manufacturer's instructions.
Note
80 kVp ( 1) is mandatory. You can adjust the mAs to produce the correct exposure level.
The dosimeter should show an exposure level of 10.0 mR 0.2.
CR TQT - Collimation
The field of exposure must completely cover the cassette's surface area for proper
collimation for General Radiography.
Position of the dosimeter:
Phantom Image Test Tests the image quality of the system. The calculated
exposure of appropriate test phantom is required.
Flat Field Image Test Tests Field Uniformity, Streaks, and Speed Deviation.
Erased Image Test The Erase Image test is performed using erased cas-
settes only and does not require an X-ray exposure.
System Noise Test The System Noise test is performed using erased cas-
(Classic CR only) settes only and does not require an X-ray exposure.
Discard Test Discards the results of the last test performed in the
current session.
Cassette Test Opens Cassette Screen Test page for Flat Field Image
Test.
Cassette Size Use the keyboard to select the size and type of the
cassette you are testing.
Main Menu Select the Main Menu button to close the Total
Quality Tool, end the current session, and return to
the CR System Main Menu.
When you open the CR Total Quality Tool (TQT) and run a test, you begin a new session.
You can use the TQT Main Page to:
Select and run image tests and view test results.
Discard results of the last test performed in the current session.
Start a new session or append to the last session.
Access a summary of prior test results.
Access another page for testing individual cassettes.
Option Description
Phantom Image Test Tests the image quality of the system. The calculated exposure
of appropriate test phantom is required, so use a cassette
exposed with a standard dose phantom. Insert the cassette
when prompted.
Flat Field Image Test Tests the field uniformity, streaks, and speed deviation. Once the
Phantom Image Test is complete, TQT automatically prompts
you to load the cassette for the Flat Field Image Test. Use the
same exposure settings as the Phantom Image Test, but do not
use a test phantom.
Erased Image Test Automatically prompts you to load the cassette for the Erased
Image Test. The Erase Image test is performed using erased cas-
settes only and does not require an X-ray exposure.
System Noise Test Automatically prompts you to load the cassette. System Noise
tests are performed using erased cassettes only and do not
require an X-ray exposure.
Discard Test Discards the results of the last test performed in the current ses-
sion.
Cassette Test Opens the Cassette Screen Test page for the Flat Field Image
Test.
Cassette Size Lets you use the keyboard to select the size and type of the cas-
sette you are testing.
Option Description
Main Menu Select the Main Menu button to close the Total Quality Tool,
end the current session, and return to the CR System Main
Menu.
Back Select Back to return to the previous page within the current
session.
System Noise is measured only with the CR Total Quality Tool because the CR System
operates in a special hardware mode in which the signal associated with system
electronic noise is amplified and measured. The erased cassette is scanned a second
time with the CR System in this hardware configuration.
The full 2-D noise power spectrum is computed for the resulting image and the 1-D
spectra parallel to the fast- and slow-scan directions are estimated. Median methods
are used to estimate the average of each of the 1-D noise power spectrum over spatial
frequency. This technique is insensitive to noise spikes. The global maximum of the
full 2-D noise power spectrum is then estimated.
Test your CR cassettes to verify that the cassette quality is within acceptable limits.
Tests that are done on multiple machines can be accumulated, consolidated, and
reported over an indefinite period of time. This feature lets you perform long-term trend
analysis.
1. Obtain a complete list of cassette IDs for all cassettes in your inventory.
2. Answer the following questions:
a. Has someone already started a cassette test?
b. Which cassettes have not been tested?
c. Should test results for the cassettes you want to test be appended to the previous
session or should you start a new session?
When you want all of the cassettes in your inventory to be tested and organized under
one session, you need to check and verify that every cassette has been tested at least
once.
1. Go to the Cassette Screen Test Results page to see those cassettes that have
already been tested and those that still need to be tested.
The Cassette Screen Test Results page displays the date, time, cassette ID, size, and
type of each cassette tested as well as individual subtest results.
2. Check the cassette IDs on your inventory against the IDs displayed on the
Cassette Screen Test Results page.
Use the Total # Cassettes Tested field on the Cassette Screen Test Page 3 which
includes each tested cassette only once; multiple tests of a cassette are excluded from
the total.
3. When the Total Number of Cassettes Tested equals the total number of cassettes
in your inventory, you have tested all cassettes at least once and can end the session.
Note
Do not load a cassette until AFTER you have initiated the testing process by selecting Flat Field
Image Test. Wait for the system message Load Cassette and then load the cassette.
Field Uniformity Error Reported as the maximum code value difference between
the sub-images.
Corrective Action
If the CR System has passed all four image tests, any cassettes that fail one or more of the
cassette tests should be set aside.
1. Inspect the screen for damage.
2. Clean the screen using the cleaning instructions.
3. Repeat the test.
4. If the cassette still fails, remove it from use.
Result Description
Field Uniformity Error Reported as the maximum code value difference between the
sub-images.
3. Collimate the beam of light so that the edges of the light fall on the outer edges of
the cassette.
4. Expose the cassette using the same positioning, filter, and exposure values used to
create the Phantom Test Image, but do not use the test phantom.
Postrequisites:
Once the Phantom Image Test is complete, TQT automatically prompts you to Load
Cassette for the Flat Field Image Test. Use the same exposure settings as the
Phantom Image Test, but do not use a test phantom.
erased CR cassette is used to verify adequate erasure and the absence of stray light
sources.
For this test, the same cassette that was used for the uniformity test is re-scanned.
Because exposure level dependent erasure is the final step of the reading process, the
cassette should be fully erased when reading is completed. Code values read from the
cassette are spatially filtered to eliminate outliers due to small dust particles. The
maximum code value in the resulting data is found.
Note
When you decide to append to a previous session, you select the Append to Previous Session
check box on the Cassette Screen Test Results page.
Pixel Size is the average center-to-center distance between pixels. Image segmentation
methods are used to automatically detect the location of the edges of the apertures
along the top, bottom, right, and left of the phantom test image. For each side of the
image, a linear least-squares fit of the detected locations is made to the known relative
locations of the edges. The average slope that you calculated for the top and bottom
rows of apertures measures the average fast-scan pixel size, and the average slope
calculated for the left and right columns of apertures measures the average slow-scan
pixel spacing. Pixel Size is reported as a percentage deviation in Pixel Size Error Fast and
Pixel Size Error Slow.
Corrective Action
1. Note whether the Pixel Size error is Fast or Slow
2. Verify that the phantom is properly exposed and not under-collimated.
3. Repeat the test and record any failed values.
Corrective Action
1. Note if the Scan Linearity is Fast Scan or Slow Scan.
2. Verify that the phantom is properly exposed and not under-collimated.
3. Repeat the test and record any failed values.
representation of the Line Spread Function (LSF) is obtained. The pre-sampled MTF is
computed from the Fourier transform of the sub-pixel LSF.
The MTF test results are reported in the Total Quality Tool.
MTF is reported at two frequencies for each of the two scan directions. These frequencies
depend on pixel size. The results include:
Fast-scan MTF @ 95 % of Nyquist
Fast-scan MTF @ 50 % of Nyquist
Slow-scan MTF @ 95 % of Nyquist
Slow-scan MTF @ 50 % of Nyquist
Corrective Action
1. Record results.
2. Call Service.
square area in the center of the phantom test plate has minimal attenuation. The smaller
square area directly below the central square has uniformly high attenuation. Areas to
the left and right of the central square have a middle value of attenuation. In each of
these areas, the average of the code values in a square 2 x 2 cm is computed. The
expected attenuation of the phantom test plate is used to predict the exposure response
for these three levels of attenuation under the specified X-ray beam conditions.
The Exposure Response Test results are reported in the Total Quality Tool.
The error in the average code value (CV) for each of the three levels of attenuation is
reported in the Total Quality Tool as: Low-Exposure Response Error (CV), Mid-Exposure
Response Error (CV), and High-Exposure Response Error (CV). These are compared with
the expected code values based on the predicted attenuation of the test phantom.
Corrective Action
1. Verify that the phantom is properly exposed and not under-collimated.
2. Verify that the exposure conditions are correct:
0.5 mm Cu + 1 mm Al filtration
80 kVp
10.0 mR 0.2 (0.08760 mGy 0.00175 mGy)
3. If high-exposure result is PASS and mid- or low-exposure results are FAIL, check kVp.
4. If high-, mid- and/or low-exposure results are FAIL, check mR (mGy).
5. Inspect the screen. If the screen has discolored, repeat the test with a second cassette.
6. Verify that the phantom is oriented properly on the cassette.
7. Repeat the test and record failed values.
8. Call Service.
The pixel Aspect Ratio is calculated for the left side, center, and right side of scan lines in
the fast-scan direction.
The local fast-scan pixel size is measured by the center-to-center distances between
apertures in the test phantom.
Left Side: Use the first and third apertures.
Center: Use apertures on either side of the center.
Right Side: Use first and third apertures from the end of the scan line.
The Aspect Ratio is then computed as the ratio of the average slow-scan pixel size to the
local fast-scan pixel size.
The Aspect Ratio Error is the percentage deviation from the designed aspect ratio (unity)
for the left, center, and right sides of the image.
The Average Aspect Ratio Error is computed as the ratio of the Average Slow-Scan Pixel
Size to the Average Fast-Scan Pixel Size.
Aspect Ratio is reported as the Aspect Ratio Error Left, Aspect Ratio Error Middle, Aspect
Ratio Error Right, and Aspect Ratio Error Average; each is expressed as a percentage of
the designed aspect ratio.
Corrective Action
1. Note if the Aspect Ratio Error is Left, Middle, Right, or Average.
2. Verify that the phantom is properly exposed and not under-collimated.
3. Repeat the test and record any failed values.
5. Inspect the screen. If the screen has discolored, repeat the test with a second cassette.
6. Verify that the phantom is oriented properly on the cassette.
7. Repeat the test and record the failed values.
8. Call Service.
1. Record results.
2. Call Service.
Field Uniformity 1. The X-ray heel effect can affect the test results. Verify that the X-ray heel
effect is not significant.
2. Verify that the cassette is properly exposed and not under-collimated.
3. If the heel effect is satisfactory and a FAIL condition persists, call Service.
Line Position Noise 1. Verify that the cassette is properly exposed and not under-collimated.
2. Verify that the exposure conditions are correct:
0.5 mm Cu + 1 mm Al filtration
80 kVp
10.0 mR 0.2 (0.08760 mGy 0.00175 mGy)
3. Repeat the test.
4. Record the values.
5. Call Service.
TQT Troubleshooting
To resolve a condition that results in a Warning or a Failure:
1. Study the graphs.
The graphs provided for each subtest make it easy to see if the results are a gradual
trend or a sudden shift in performance.
2. Repeat the tests.
Warnings and Failures could be the result of procedural errors, and they should be
verified by repeating the tests.
3. Determine the general cause.
Determine whether the Warning or Failure is caused by the CR System or the cassette.
4. Take corrective action as appropriate.
Note
Keep running production, based on the independent evaluation of image quality results.
Bar Codes
Postrequisites:
Once the bar code reader has been reset, you must reprogram it.
Note
You can make all of your changes on the Bar Code Configuration screen and then select Save
Changes when finished.
Short Beep
Note
If the scan is successful, the reader will emit a tone. If it is not successful, it will emit a buzzing
sound.
4. Scan the appropriate bar code to select an operational mode for the reader:
Automatic TriggerScan this bar code if you want the reader on all of the time.
Manual TriggerScan this bar code if you want the reader LEDS turned off until
you touch the trigger.
5. If you use Automatic Trigger Mode, scan the appropriate bar code to select the time
delay between reading the same bar code:
Short (default)
Medium
Long
Extra Long
Add Prefix 9
9 0
4 0
4 0
4 Save
Add Suffix 9
9 0
4 0
4 Save
Program the PS2 Keyboard Bar Code Reader and Add Suffix
In addition to Programming the PS2 Keyboard Bar Code Reader, if the Add # to Cassette
IDs to make them 11 digits check box is selected, scan the bar codes in the following
order: from left to right and top to bottom. This affects Carestream Health Cassette ID
bar codes only, which are interleaved 2 of 5 bar code types.
Add Suffix 6
5 2
3 0.
4 0.
4 0
4 Save
Add Prefix 9
9 5
B Save
Add Suffix 9
9 5
D Save
Program the PS2 to USB Keyboard Bar Code Reader and Add Suffix
In addition to Programming the PS2 to USB Keyboard Bar Code Reader, if the Add # to
Cassette IDs to make them 11 digits check box is selected, scan the bar codes in the
following order: from left to right and top to bottom. This affects Carestream Health
Cassette ID bar codes only, which are interleaved 2 of 5 bar code types.
Add Suffix 6
5 2
3 5
D Save
Program the Keyboard Wedge Bar Code Reader and Add Suffix
In addition to Programming the Keyboard Wedge Bar Code Reader, if the Add # to
Cassette IDs to make them 11 digits check box is selected, scan the bar codes in the
following order: from left to right and top to bottom. This affects Carestream Health
Cassette ID bar codes only, which are interleaved 2 of 5 bar code types.
Add Suffix 6
5 2
3 0
4 0
4 0
4 Save
Add Prefix 9
9 0
4 0
4 0
4 Save
Add Suffix 9
9 0
4 0
4 0
4 Save
If the Add # to Cassette ID to make them 11 digits check box is checked, scan the
following bar code:
Add Suffix Via Data Formatter
Serial
If the Add # to Cassette IDs to make them 11 digits check box is checked, scan the
following bar code:
Add Suffix Via Data Formatter
Country Code
Test
Add Prefix
Add Suffix
Number 0
Number 1
Number 2
Number 3
Number 4
Number 5
Number 6
Number 7
Number 8
Number 9
Save
Letter A
Letter B
Letter C
Letter D
Letter E
Letter F
Full ASCII On
Auto Trigger
Manual Trigger
Reread Short
Reread Medium
Reread Long
Note
If the scan is successful, the reader will emit a tone. If it is not successful, it will emit a buzzing
sound.
1. The HIBC Field column is a standard list of all HIBC fields. It is fixed and filled in by
default. It lists all of the fields in the HIBC bar code in alphabetical order.
2. The DICOM Field column is a list of the data that is used by Carestream to populate
patient demographic fields.
3. The Test Scan Data column is the result of an actual scan of the test 2D bar code.
The lower list box, DICOM Field, contains a list of all DICOM fields Carestream uses in its
Patient Input and Work List screens.
The objective is to map the DICOM data with the corresponding fields in the HIBC
column.
Note
Do not scan the test bar code more than once. If you scan it twice, it will fail.
3. Identify the delimiter and enter it in the Delimiter Character text box. This notifies
the system that the data is parsed by that character. The default delimiter is |.
For example, the data may appear |Johnson | Robert | 123456 | 23423480 |
M |meaning: | Patient Last Name | Patient First Name | Patient ID | Accession Number
| Gender |
4. From the DICOM Field list box, select the first field that appears in the test data
string.
In the example above, it would be Patient Last Name. Use the right arrow to move
it to the top position in the Configured Fields list box. Patient First Name would
follow in the list.
Note
The order is important. Follow the test data string and map the corresponding fields in the order
that they appear.
If an item in the Test Scan Data string is not used by Carestream, does not make sense, and/or
does not appear in the DICOM Field list, scroll down the list and select Unmapped Field and
move it into the Configured Fields list box. The unmapped field acts as a placeholder, and when
the system parses the data, that field will be ignored.
5. Enter the Gender term that appears in the Test Scan Data text box as described
above.
6. Select Save Changes when done.
7. Confirm your configuration by viewing the format of the data in the Data Parsed
from Test Scan text box.
8. Select Save Changes.
Note
Do not scan the test bar code more than once. If you scan it twice, it will fail.
3. Compare the known values in the HIBC column with the corresponding values in the
Test Data column.
a. If data in the HIBC field, the DICOM field, and the Test Data field match, the
configuration is complete.
b. If the DICOM field does not match the Test Data field and the HIBC field, select
the correct DICOM field from the bottom DICOM Field list box and select the
Assign Field button to map it correctly.
c. Remove a field by highlighting it and selecting the Unassign Field button.
Note
The order is important. Follow the test data string and map the corresponding fields in the order
that they appear.
If an item in the Test Scan Data string is not used by Carestream, does not make sense, and/or
does not appear in the DICOM Field list, scroll down the list and select Unmapped Field and
move it into the Configured Fields list box. The unmapped field acts as a placeholder, and when
the system parses the data, that field will be ignored.
Acces- 1 X B 8 X 00 1
sion
Number
Legend:
Prefix = B
Data = AC-01752-1
Suffix = 0
Prerequisites:
Insert the BLUETOOTH adapter into a USB port on the System computer.
Note
Ambient light and the display settings for the monitor can prevent you from successfully scanning
on-screen bar codes. Increase the brightness and contrast of the monitor if necessary and point
the reader straight at the bar code.
7. Select Pair with Reader to authorize the connection.
8. Scan the Save Settings bar code.
ASCII 39 Mode
The American Standard Code for Information Interchange (ASCII) codes represent text in
computers, communications equipment, and other devices that use text. Most modern
character-encoding schemes are based on ASCII, though they support many additional
characters.
For example, to configure the bar code to contain lowercase letters, or some other
symbols that are not available in Full ASCII Off, Full ASCII On has to be turned on.
Code 39 is restricted to 43 characters. In Full ASCII Code 39 Symbols 09, AZ, , and
-are the same as their representations in Code 39. Lowercase letters, additional
punctuation characters and control characters are represented by sequences of two
characters of Code 39.
1. To turn the ASCII Code 39 on, scan the Code 39 ASCII On bar code.
2. To turn the ASCII Code 39 off, scan the Code 39 ASCII Off bar code.
Prefixes are characters (up to ten digits) preceding data which serve as mapping keys. Bar
codes that are read into the system and contain prefix characters will populate the
designated fields on the Patient Input, Image Acquisition, and Patient Work List
screens.
For example, you might configure the Prefix for the Accession Number via Key Operator
Functions > System Configuration > Bar Code Configuration as such:
Strip enabled (checked)
Prefix as ACN
Data size of 6
When you have configured a bar code so that the Prefix or Suffix is not used, or an
alternate prefix and suffix are used, you must program the reader to use the new
configuration.
Field Settings
Scan the Automatic Trigger bar code if you want the scanner on all of the time.
Scan the Manual Trigger bar-code if you want the scanner LEDs off until you touch
the trigger.
Go to Key Operator Functions > System Configuration > Bar Code Configuration.
To configure the time delay allowed between reading the same bar code, select from the
following and scan the appropriate bar code:
Short (default)
Medium
Long
Extra Long
Note
This feature is only available in Automatic Trigger mode.
Field Settings
Exposure Indicators
The Carestream Exposure Index allows the radiographer to match the exposure to the
desired speed class of operation. The speed class is set in a given department by
consulting with an interpreting radiologist. The radiologists feedback on sample images
helps determine the level of image noise he or she can accept. It is important to note,
that as speed class increases, the amount of image noise will increase. Once an acceptable
noise level is established, a radiographer can identify the speed class of operation for the
imaging system and the corresponding technique charts. It is the responsibility of the
radiographer to select a technique that provides enough exposure to reduce the amount
of noise while adhering to ALARA standards.
The exposure index is indirectly proportional to the speed class of operation. If you are
using the Carestream Exposure Index values, for every 300 exposure index increase,
the speed class is reduced by half. In other words, if the exposure index increases from
1400 to 1700, the speed class is reduced from a 400 speed class to a 200 speed class. If you
are using the Internal Electrotechnical Commission (IEC) Exposure Index values,
when the deviation index reaches +3, the speed class is reduced by half. Regardless of
which exposure indicators are selected, as the exposure index increases, the dose to the
patient increases.
The Exposure Index charts are designed to provide the radiographer with a guide to
determine the proper Carestream Exposure Index or IEC Exposure Index based on
the speed class of operation selected for your department, or particular procedures.
than Digital Radiography (DR) systems. Therefore, your facility may choose to operate
your CR at a different speed class than the DR.
Once an acceptable noise level is determined by the radiologist, the corresponding speed
class may be identified for each range of kVp exams needed (for example, infant skull
may be exposed with 65 kVp). The chart for the Carestream Exposure Index will then
indicate a target range for that exam based on kVp and speed class. For example, if 400
speed class of operation is selected for the infant skull, the target EI should be between
1290 and 1390.
DRX 2530C Exposure Index Target Ranges
Speed Class 5055 kVp 5262 kVp Exams 6375 kVp 76100 kVp
Exams Exams Exams
Notes and Conditions: On average, images captured on the DRX-1 (CsI) from several U.S.
sites were acquired with speeds in the Bold regions. These charts do not pertain to data
acquired outside the U.S. due to differing beam conditions.
Notes and Conditions: On average, images captured on the DRX (GOS) from several U.S.
sites were acquired with speeds in the Bold regions. These charts do not pertain to data
acquired outside the U.S. due to differing beam conditions.
IEC Exposure Index for DRX and PRO 3543/3543C CsI Detectors
Table 3: IEC Exposure Index vs. Speed Class of Operation
for DRX and PRO 3543/3543C CsI Detectors
800 71 84 96 104
900 62 74 85 92
1000 55 65 75 81
Notes and Conditions: On average, images captured on the DRX (CsI) from several U.S.
sites were acquired with speeds in the Bold regions. These charts do not pertain to data
acquired outside the U.S. due to differing beam conditions.
IEC Exposure Index for DRX and PRO 3543/3543C GOS Detectors
Table 4: IEC Exposure Index vs. Speed Class of Operation
for DRX and PRO 3543/3543C GOS Detectors
800 68 78 98 105
900 59 69 86 93
1000 52 61 76 82
Notes and Conditions: On average, images captured on the DRX-1 (GOS) from several U.S.
sites were acquired with speeds in the Bold regions. These charts do not pertain to data
acquired outside the U.S. due to differing beam conditions.
resulting exposure was ~26 % higher than the target EI. Our DI was 1.2 so we can
estimate that we are slightly higher, perhaps closer to 30 %. Although it is a good image,
it is merely an indicator to the radiographer that he or she may be able to reduce their
exposure factors the next time they perform that particular exam and still acquire an
acceptable image and reduce the dose to the patient.
0 Correct
System Workflow
System Workflow refers to the way images are communicated and displayed to Hospital
Information Systems after actions such as Start Study and End Study.Scheduled Workflow
and Scheduled Workflow Alternatives are set by the Key Operator.
Scheduled Workflow
Scheduled Workflow is configured by the Key Operator to let the System communicate
with the HIS/RIS every time a procedure starts, ends, or is discontinued.
When your system uses Scheduled Workflow, it reduces the steps necessary for you to
complete an exam.
Scheduled Workflow allows the user to communicate directly with the RIS without
going to a separate computer, and defines schedules and imaging acquisition
procedures.
A Key Operator configures the System workflow to organize the way images are
accounted for. Your system is configured one of these two ways:
Study-Based Workflow
You generate a Study Instance Unique Identifier (SIUID) and a New Procedure
Step each time you select New Study for that patient.
When you scan a cassette and select Save Changes, the New Study button appears.
Select End Study to set the study to completed.
A Key Operator configures the System Workflow to organize the way images are
accounted for. Your system is configured one of these two ways:
Configuration Image Identifier