SYNAPSE3D UserManual PDF

Synapse 3D V5 User Manual : Z72N100354B
User Manual
Base Tools
Cardiac Tools
Perfusion Analysis
Lung and Abdomen Analysis
Liver and Kidney Analysis
Nodule Analysis
Colon Analysis
Tensor Analysis
Optional Tools
Software Version V5.3US

October, 2018
Contact Information:
United States of America:
FUJIFILM MEDICAL SYSTEMS, U.S.A., Inc.
419 West Avenue
Stamford, CT 06902, U.S.A.
Manufacturer:
FUJIFILM Corporation
26-30 Nishiazabu 2 Chome
Minato-ku, Tokyo, 106-8620, Japan
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This User Manual describes in detail precautions pertaining to operation procedures and operations so that
Synapse 3D (hereinafter, workstation) functions can be properly comprehended and be used more efficiently. For
those using this workstation for the first time, operate the workstation after first reading the User Manual . Please
verify that this User Manual matches the software version for Synapse 3D that is to be used.
(Note) The name Synapse 3D is the system name of related products. The " Synapse 3D Base Tools" product is the
baseline product package of Synapse 3D . The " Synapse 3D Cardiac Tools" product is the optional product
package of Synapse 3D for cardiac application. This User Manual is created specific for " Synapse 3D Base Tools"
and " Synapse 3D Cardiac Tools". However throughout this User Manual , the name " Synapse 3D " is used
generally where product name needs to be referred except where the full product name " Synapse 3D Base Tools"
or " Synapse 3D Cardiac Tools" is necessary.
Export Restrictions Applying to Synapse 3D
For models to which export restrictions apply, government approval obtained through due procedure is required in
order to export or otherwise remove such models from Japan.
Note that the same restrictions apply not only to the main unit but also to after-sale parts, service manuals and
service training (for exporting or transferring technology) when such items are dispatched or shipped to foreign
countries and when service training is given for trainees from foreign countries.
Fujifilm copyright and trademarks
The Copyright (c) 1997-2018 of SYNAPSE software belongs to FUJIFILM MEDICAL SYSTEMS, U.S.A., Inc. and
FUJIFILM Corporation.
The Copyright (c) 2010-2018 of Synapse 3D software belongs to FUJIFILM Corporation.
This computer program is protected by copyright law and international treaties. Unauthorized reproduction or
distribution of this program, or any portion of it, is strictly prohibited. Synapse is a registered trademark of FUJIFILM
Medical Systems, U.S.A., Inc. and FUJIFILM Corporation.
Other holder's trademarks
Microsoft, Windows, Windows 7, Windows 8, Windows 8.1 and Windows 10 are the registered trademarks of US
Microsoft Corporation in the U.S.A. and other countries.
All other company names and product names described in this manual are the trademarks or registered trademarks
of their respective holders.
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Precautions and Disclaimers
1. No part or all of this manual may be reproduced in any form without prior permission.
2. The information contained in this manual may be subject to change without prior notice.
3. FUJIFILM Corporation shall not be liable for malfunctions and damages resulting from installation, relocation,
remodeling, maintenance, and repair performed by dealers other than those specified by FUJIFILM
Corporation.
4. FUJIFILM Corporation shall not be liable for malfunctions and damages of FUJIFILM Corporation products
due to products of other manufacturers not supplied by FUJIFILM Corporation.
5. FUJIFILM Corporation shall not be liable for malfunctions and damages resulting from remodeling,
maintenance, and repair using repair parts other than those specified by FUJIFILM Corporation.
6. FUJIFILM Corporation shall not be liable for malfunctions and damages resulting from negligence of the
precautions and operating methods contained in this manual.
7. FUJIFILM Corporation shall not be liable for malfunctions and damages resulting from use under
environment conditions outside the range specified for this product, such as the power supply, installation
environment, etc., as described in this manual.
8. FUJIFILM Corporation shall not be liable for malfunctions and damages resulting from natural disasters, such
as fires, earthquakes, floods, lightning, etc.
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NOTICE
BEFORE USING THE SOFTWARE PROVIDED BY FUJIFILM CORPORATION, PLEASE READ THIS END USER SOFTWARE
LICENSE AGREEMENT CAREFULLY. ONLY IF YOU AGREE TO THIS END USER SOFTWARE LICENSE AGREEMENT, YOU
WILL BE ABLE TO USE THE SOFTWARE.
End User Software License Agreement
This End User Software License Agreement (this "Agreement") is an agreement between FUJIFILM Corporation
("FUJIFILM") and you regarding grant of licenses to FUJIFILM's product " Synapse 3D " that consists of the software
("Software") and relevant documents and materials ("Documentation"), and the licenses to the Software and
Documentation by FUJIFILM to you shall be contingent upon your acceptance of all the terms and conditions
provided herein. Any use of the Software and/or the Documentation by you shall be deemed such your acceptance.
The Software and/or Documentation shall include any updates, upgrades, modified versions, additions and copies
thereof provided to you by FUJIFILM.
1. License.Subject to the terms and conditions of this Agreement, you are granted a limited, non-exclusive,
non-transferable and non-sublicensable license to install permitted number of copies of the Software on
server computers and use the Software and the Documentation only through computer networks connected
to said server computers.
2. Ownership.It is acknowledged and agreed that FUJIFILM or such third party suppliers as indicated on or in
the Software or the Documentation retain all title and rights to the Software and the Documentation,
including any copies thereof, and no title or rights to the Software or the Documentation is transferred or
licensed to you except as expressly set forth herein.
3. Restriction on Use.You may: (i) make and retain one extra copy of the Software for backup purposes only;
and (ii) copy the Documentation only as reasonably necessary for user reference and backup purposes. Each
copy of the Software and Documentation made by you shall contain the same proprietary notices, labels,
and marks as the original thereof without any alteration. You shall not: (i) sell, sublicense, assign, lease,
encumber or otherwise transfer the Software or the Documentation or the rights granted hereunder; (ii)
reverse engineer, decompile, disassemble or create derivative works of the Software; (iii) remove or alter any
proprietary notices, labels or marks on or contained in any part of the Software or the Documentation; (iv)
make any copies of the Software or the Documentation except as permitted above; or (v) install the Software
on any computer other than as permitted by this Agreement. As a condition of the use of the Software by
you, you hereby represent and warrant that you shall not use the Software for any purpose that is unlawful
or prohibited by this Agreement. You agree to abide by all applicable laws and regulations in your use of the
Software.
4. Export Control.You shall comply with all export and re-export restrictions and regulations imposed by the
government of the United States and other relevant countries or regions ("Export Restrictions"). You shall
not knowingly transfer, directly or indirectly, any restricted software or technical data received hereunder or
the direct product of such data, to any country or region identified as an embargoed destination or country
in the Export Restrictions, unless prior written authorization is obtained from FUJI and each appropriate
United States or other government agencies. This Section shall survive the expiration or termination of this
license agreement.
5. GNU Libraries.The provisions of Sections 1 through 3 of this Agreement shall not be applicable to the GNU
libraries that are included in the Software and use of such GNU libraries(FOX, xmlrpc++) are governed by the
GNU LESSER GENERAL PUBLIC LICENSE VERSION 2.1. The provision of Section 3(ii) of this Agreement shall
not be applicable to the AmeUtils which is included in the Software and designed to work with above GNU
libraries, and you may modify this AmeUtils for your own use and reverse engineer the same for debugging
such modifications.
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6. Update and Upgrade.FUJIFILM may, at its sole discretion, make any update or upgrade of the Software
available; provided, however, that FUJIFILM shall have no obligations to make any update or upgrade of the
Software available.
7. Limited Warranty.FUJIFILM hereby warrants that the Software shall operate in substantial conformity with
the then current Documentation, when used in strict compliance with such Documentation. Except as
otherwise agreed upon between FUJIFILM and you, the foregoing warranty shall be effective only for one (1)
year following your receipt of the Software (hereinafter referred to as "Warranty Period"). The foregoing
warranty is conditioned upon installation and use of the latest version of the Software released by FUJIFILM
in strict compliance with the then current Documentation. If the Software is found to fail to perform as
warranted in the Warranty Period, FUJIFILM shall use commercially reasonable efforts to correct such
Software. THE FOREGOING STATES THE SOLE AND EXCLUSIVE REMEDIES TO WHICH YOU ARE ENTITLED
FOR FUJIFILM'S BREACH OF WARRANTY. FUJIFILM HEREBY DISCLAIMS ANY OTHER WARRANTIES WITH
RESPECT TO THE SOFTWARE AND DOCUMENTATION, EXPRESS OR IMPLIED, INCLUDING WITHOUT
LIMITATION ALL WARRANTIES REGARDING MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND
NON-INFRINGEMENT.
8. Limitation of Liability.TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, FUJIFILM SHALL NOT BE
LIABLE FOR ANY INDIRECT, SPECIAL, EXEMPLARY, PUNITIVE, INCIDENTAL, OR CONSEQUENTIAL DAMAGES
OF ANY KIND (INCLUDING WITHOUT LIMITATION, LOST PROFITS OR LOST DATA), WHETHER SUCH
DAMAGES ARE BASED ON CONTRACT, TORT (INCLUDING NEGLIGENCE), PRODUCT LIABILITY OR
OTHERWISE (INCLUDING ANY DAMAGES WHICH ARE IN ANY WAY CONNECTED WITH ANY USE OF THE
SOFTWARE OR DOCUMENTATION), EVEN IF IT HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
9. Termination.All the rights granted to you hereunder shall automatically terminate upon your breach of any
provision herein.
10. Term.This Agreement is effective until the date when you cease to use the Software, unless earlier
terminated in accordance with Section 9 hereof.
11. Obligation upon termination.Upon termination or expiration of this Agreement, you shall cease use of the
Software and Documentation and destruct all copies of the Software and Documentation in your possession,
including any of backup copy.
12. General Provisions.This Agreement shall be governed by and construed according to the laws of Japan,
excluding its conflict of laws rules.
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Introduction
Safety symbols in this manual
This document (User Manual ) describes basic workstation operations. For the detailed usage of analysis
applications, see online help after starting each analysis application.
In this document (User Manual ), the following symbols are used as necessary for explanatory notes. Their
meanings are as shown below. Observe the warnings and notes when using the workstation.
Warning Indicates an instruction that a user must follow to use the product safely.
Caution Indicates an operation that requires a caution to use the product safely.
Note Indicates operational information, additional information, detail information,

specifications, or other information that may be helpful.
Images used in this description are intended as examples. Note that these images do not necessarily conform to
the image examples used in the descriptions for all of the data to be analyzed.
Explanations in this document (User Manual ) are based on operations in Windows 7, Windows 8, and Windows
Vista. In the case of an OS other than Windows 7, Windows 8, and Windows Vista or Windows 7, Windows 8, and
Windows Vista with non-prescribed settings, the operation method may be different.
In images saved as DICOM images by using Synapse 3D , signal values may not match those of the original images
under some conditions, as when Rescale Intercept (0028,1052) or Rescale Slope (0028,1053) in the DICOM
information are not the prescribed values. Caution is required when dealing with operations such as signal value
measurement using the saved image.
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For Safe Operation

1. Precautions Before Operating This Workstation
1.
Before using this workstation, please read "For Safe Operation" carefully so that you can operate it
correctly. Whenever you operate this workstation, be sure to observe all precautions. Failure to do so
may subject you to injuries or cause property damage.
2.
The medical institution where the equipment is installed is responsible for its use and maintenance.
This workstation should not be used by persons other than suitably trained physicians or staffs. Rx
only in the United States (Federal law restricts this device to sale by or on the order of a physician)
2. Precautions When Using Electrical Equipment
1.
Always use the workstation with computers that meet local electrical and mechanical safety
standards and regulations, including environmental regulations. When discarding the hardware, the
user must comply with environmental regulations valid in each country or region. The environmental
regulations include, but not limited to, the EC directive [2002/96/EC] of the European Parliament and
of the Council of 27 January 2003 on waste electrical and electronic equipment (WEEE Directive).
2.
Computers approved for use with the workstation meet IEC 60950 or equivalent standards. However,
they do not conform to IEC 60601-1, which is required for medical equipment installed in patient
environments. Thus, the workstation must not be used in patient environments.
3.
Computers used with the workstation are electrical equipment. To use the equipment correctly and
prevent any danger, please observe the following electrical equipment use precautions: Observe the
following precautions when installing the computer.
1. Install the equipment in a dry place away from water.
2. Install the equipment where it will not be adversely affected by atmospheric pressure,
temperature, humidity, ventilation, sunlight, dust or the presence of salt, sulfur or like
substances in the air.
3. Make sure the equipment will remain stable on a level surface and not be subjected to
vibration or shock.
4. Do not install the equipment in places where chemicals are stored or gases emitted.
5. Supply the frequency, voltage and amperage specified for the computer.
6. Connect the ground wire correctly.
7. Connect all cables correctly and completely.
8. If the computer is installed in a dusty environment, dust will accumulate in the power supply
section, possibly causing smoke or fire. Install the equipment in a place free from such
influence.
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4.
If there is trouble with the computer, do not attempt to fix it randomly. Instead, indicate the problem
as appropriate and entrust repairs to a professional.
5.
The supply voltage to the computer is 100 - 240 volts depending on the model and region. Do not
remove the cover or remodel the computer.
6.
Explosion Precautions Since this equipment is not explosion-proof, do not use combustible and
explosive gases near the equipment.
7.
Electromagnetic Interference Precautions
Computers used with the workstation comply with the electromagnetic compatibility (EMC)
standards or directives for typical computers. However, there is no guarantee that interference will not
occur in a particular installation. If the computer is used in an environment such as in the vicinity of
devices not compliant with the EMC standard, interference may occur and cause the computer or
other devices to malfunction.
3. Precautions When Connecting Network
1.
Connect to the Ethernet Network of 1000BASE-T, 100BASE-TX, or 10BASE-T prescribed in the IEEE
standard 802.3. Do not connect telephone lines to LAN connector. Only UTP-type straight LAN cables
of 4-pair Category 5E cable (CAT 5E) or higher are appropriate for connection to this connector.
2.
After connecting this system to the network with other systems, confirm that the other systems are
not affected. If they are affected, take countermeasures such as network separation.
3.
When a setting of the network to which the equipment is connected has been changed, check that
the change does not affect the system operation and take measures if necessary. The setting change
may include the following:
1. Change of connection destination
2. Addition of devices
3. Removal of devices
4. Update of devices
5. Upgrade of devices
4. Precautions When Using the Workstation
1.
The workstation is intended as a supplemental means of observing radiological images. It can be
used only in instances where decisions are also possible without relying on the workstation. No
decisions on diagnosis, treatment, or other matters that may affect patient health must be based
solely on use of the workstation.
2.
For exported images;
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When images are emailed, printed, or otherwise exported from the workstation, users must ensure
that recipients understand the information presented here. The precise appearance of the image is
dependent on the characteristics and settings of the hardware, including monitors, used. The notes
and cautions in this document related to the interpretation of displayed images apply equally to these
exported images.
3.
For studies to be used;
Users must be fully conversant with the limitations of the basic imaging modality and of ensuing
image processing. This includes understanding the limitations of the initial series acquisition, image
processing technology used, and image display methods. Also, be aware that medical imaging is valid
only when appropriate measures have been taken to obtain optimal images with correct orientation
and correct patient identifiers.
4.
For Image processing;
1. The user must keep the limitations of 3D image processing in mind when viewing 3D images.
Small pathologies may go undetected because the interslice distance is too great relative to
the size of the pathology. The creation of a 3D image using interpolation of data points
between image slices based on the original image can create a smooth-looking 3D image. The
user must interpret the apparent lack of pathology in the context of the inherent limitation in
the resolution of the original slice images as scanned.
2. Artifacts may appear in the image depending on the amount of image processing. When using
an image processing method, fully understand its characteristics.
3. When anatomical features of interest are emphasized, other features may be hidden. Allows
users to hide anatomical features to emphasize anatomy of interest. Users must take into
account any actions and software behaviors of this type when interpreting displayed images.
5.
Workstation management:
1. Set and install medical imaging equipment connected to the workstation properly, using the
installation specifications. If not, some errors may occur.
2. The installation, upgrade, system maintenance, system administration, and administration shall
only be performed by trained personnel.
3. When preparing training materials, refer to the latest version of the service manual, user
manual, and other documentation.
6.
Workstation operation:
1. Check the workstation before use to make sure that it operates normally.
2. In extended use of the workstation , take a 10 to 15 minute break after every hour to rest your
eyes and hands.
3. Do not turn off the power to the computer while using the workstation.
4. Perform the shutdown procedure specified in the operating system to end operation.
5. Do not change settings of the pre-installed Windows.
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6. If the computer is forcibly terminated while using the system due to a power outage or other
reasons, data may be lost. It is recommended to use an uninterruptible power supply system. If
a power outage occurs and an uninterruptible power supply system is in use, terminate the
workstation as soon as possible.
7. When leaving an image displayed for a long time during operation, use the screensaver. If it
does not start running, contact your service engineer. If an image has been displayed for a
long time, even after the display changes, the image may be visible as a residual image on the
next display. The video card may become quite hot depending on the screensaver in use,
causing a malfunction.
7.
Workstation hardware and software:
1. Do not install any hardware onto the workstation other than those designated by FUJIFILM
Corporation.
2. Do not install any software onto the workstation other than those designated by FUJIFILM
Corporation.
3. Do not uninstall originally installed software. Do not install any software other than that
originally installed.
8.
Since the backlight (fluorescent tube) of the LCD monitor has a limited lifetime, the luminance
(emitted light amount) of the screen decreases as running time increases, and it may eventually make
viewing difficult. Check that the emitted light amount of the LCD backlight is appropriate before
starting operation. If not, contact your service engineer.
9.
Use of LCD monitors:
1. White or black spots may appear on the LCD monitor. This is part of the normal wear and tear
of an LCD, and it is not a failure of the LCD monitor. These spots caused by LCD characteristics
appear in the fixed place at any time. Recognize their existence to prevent misinterpreting
them as possible medical abnormalities.
2. When the display resolution is too low, it may make viewing difficult. Make sure the settings
are appropriate for use.
3. When the luminance or contrast of the screen is set excessively high or low, it may make
viewing difficult. Make sure the settings are appropriate for use.
4. A color image may not be displayed with the correct gradation (grayscale) when viewed on a
grayscale monitor. Use a monitor that is appropriate for handling the images.
5. When interpreting an image on the monitor, be aware of the purpose and differences in the
image on the film. Image interpretation should be performed at responsibility of the user.
6. For image interpretation via the monitor, use high-definition and high-quality monitors as
much as possible. If the angle of view is not appropriate for image interpretation, it may affect
correct image interpretation.
10.
Check the angle of view, and adjust the monitor angle if necessary. Before interpreting an image,
operate the workstation so that images are displayed at the appropriate size. Always check the image
size in the display scale.
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11.
Regarding the direction and the object orientation in image;
1. The image display direction depends on the DICOM information attached to the image by the
medical equipment used to produce the image. When interpreting an image, make sure the
direction of the image is correct.
2. When displaying images in which it is hard to differentiate the left from the right (such as
images of kidneys and head), use the "L" or "R" displayed with the cube to confirm the
orientation of the image.
The following image is displayed by reversing the right and left orientation of original image.
12.
For measurements;
1. Inappropriate analysis results and measurements may be output if inappropriate points or lines
are used for the basis of analysis or measurement in applications. Set them appropriately.
2. When performing measurement, specify the coordinates and the units carefully.
3. For measurement, the workstation uses the DICOM information attached to the image by the
medical equipment used to produce the image. Medical practice using the measurement
results should be performed at the user's own responsibility.
4. Use the workstation taking into account errors between an image and the measurement result.
An image used for measurement may have errors in the length of the subject depending on
the image capturing method.
5. Note that if you measure the distance or other things on a saved image of CPR, the
measurement is performed on a curved surface.
13.
To prevent unauthorized access to workstation and patient information, use security features or
mechanisms following established procedures.
14.
For installation environment;
1. When disposing of the computer, make sure to erase patient information that may be
recorded in the magnetic disk (HDD) before disposal.
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2. Installing the monitor in a place where strong light is emitted may prevent correct viewing
because the display is either directly exposed to the light or reflects the light. Install the
equipment in a place free from such influence.
3. Using the computer in a place where a strong magnetic field is present may cause the
displayed image to be distorted. Install the equipment in a place free from such influence.
4. A plasma monitor constitutively emits a small amount of infrared radiation from the panel
surface. Therefore, any equipment operating near the monitor that uses infrared rays may be
affected. When installing a plasma monitor, check that it does not affect neighboring devices. If
the monitor interferes with devices nearby, change the orientation of their
transmitting/receiving section to prevent the interference.
15.
When an error occurs;
1. If the workstation malfunctions, take action by following the messages displayed on the screen.
2. If an error occurs in the workstation, turn off the power, indicate that the equipment is faulty
by posting a notice or other means, and then contact your service engineer.
16.
Use of Wi-Fi:
1. Follow precautions regarding the Wi-Fi environment.
2. Wireless devices cannot access the server in areas where wireless signals cannot be received.
3. When the wireless signal is not strong enough, it may not be possible to use the system as
expected. Check the wireless signal status before use.
4. When Wi-Fi is used, set up encrypted communication following facility security policies.
5. Make sure Wi-Fi is used in an environment where security measures are in place. Failure to do
so poses a risk of personal information leaks from unauthorized access. Implement several
security measures on an urgent basis.
17.
Notes on devices equipped with batteries:
1. In environments where electrical grounding or wiring may not be reliable, use the tablet's
internal battery.
2. Disconnect tablet from electric outlets when they will not be used over an extended period.
3. Charging may not be possible or may take longer under some conditions of use, temperature,
or humidity.
4. Do not charge the tablet battery in hot or humid environments.
18.
Install antivirus software, following facility security policies.
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Indications for Use

Indications for Use for Synapse 3D Base Tools
Synapse 3D Base Tools is medical imaging software that is intended to provide trained medical professionals, with
tools to aid them in reading, interpreting, reporting, and treatment planning. Synapse 3D Base Tools accepts
DICOM compliant medical images acquired from a variety of imaging devices including, CT, MR, CR, US, NM, PT,
and XA, etc. This product is not intended for use with or for the primary diagnostic interpretation of Mammography
images. Synapse 3D Base Tools provides several levels of tools to the user:
• Basic imaging tools for general images, including 2D viewing, volume rendering and 3D volume viewing,
orthogonal / oblique / curved Multi-Planar Reconstructions (MPR), Maximum (MIP), Average (RaySum) and
Minimum (MinIP) Intensity Projection, 4D volume viewing, image fusion, image subtraction, surface
rendering, sector and rectangular shape MPR image viewing, MPR for dental images, creating and displaying
multiple MPR images along an object time-density distribution, basic image processing, CINE,
measurements, annotations, reporting, printing, storing, distribution, and general image management and
administration tools, etc.
• Tools for regional segmentation of anatomical structures within the image data, path definition through
vascular and other tubular structures, and boundary detection.
• Image viewing tools for modality specific images, including CT PET fusion and ADC image viewing for MR
studies.
Indications for Use for Synapse 3D Cardiac Tools

Synapse 3D Cardiac Tools is medical imaging software used with Synapse 3D Base Tools that is intended to provide
trained medical professionals, with tools to aid them in reading, interpreting, reporting, and treatment planning.
Synapse 3D Cardiac Tools accepts DICOM compliant medical images acquired from a variety of imaging devices
including, CT, MR, NM, and XA. This product is not intended for use with or for the primary diagnostic
interpretation of Mammography images. Addition to the tools in Synapse 3D Base Tools, Synapse 3D Cardiac Tools
provides the tools for specific clinical applications which provide targeted workflows, custom UI, targeted
measurements and reporting functions including:
• Functional cardiac analysis for CT left ventriculography images: which is intended to evaluate the functional
characteristics of heart.
• Functional cardiac analysis for non-contrast MR heart images: which is intended to evaluate the functional
characteristics of heart.
• Coronary artery analysis for CT coronary arteriography images: which is intended for the qualitative and
quantitative analysis of coronary arteries.
• Coronary artery analysis for MR heart images: which is intended for the qualitative and quantitative analysis
of coronary arteries.
• Calcium scoring for non-contrast CT heart images: which is intended for non-invasive identification and
quantification of calcified atherosclerotic plaques in the coronary arteries using tomographic medical image
data and clinically accepted calcium scoring algorithms.
• Cardiac Fusion: which is intended to analyze cardiac anatomy and pathology with a fused image of
functional data (e.g. NM image, Bulls eye) and anatomical data.
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• Aortic Valve Analysis for contrast CT heart images: which is intended for visualization of the heart, aorta
regions, and contour of the aorta, measurement of the vicinity of the aortic valve, measurement of the
calcification area in the aorta.
Indications for Use for Synapse 3D Perfusion Analysis

Synapse 3D Perfusion Analysis is medical imaging software used with Synapse 3D Base Tools that is intended to
provide trained medical professionals, with tools to aid them in reading, interpreting, reporting, and treatment
planning. Synapse 3D Perfusion Analysis accepts DICOM compliant medical images acquired from CT and MR. This
product is not intended for use with or for the primary diagnostic interpretation of Mammography images.
Addition to Synapse 3D Base Tools, Synapse 3D Perfusion Analysis provides the parameter images by post-
processing of dynamic scanned CT arteriography and magnetic resonance (MR) images acquired with contrast
agents to aid the assessment of cerebral (CT and MR), myocardial (CT) and abdomen (CT) blood flows. The
parameter images are Blood Volume (BV), Blood Flow (BF), Mean Transit Time (MTT), and Time To Peak (TTP).
Indications for Use for Synapse 3D Lung and Abdomen Analysis

Synapse 3D Lung and Abdomen Analysis is medical imaging software used with Synapse 3D Base Tools that is
intended to provide trained medical professionals, with tools to aid them in reading, interpreting, reporting, and
treatment planning. Synapse 3D Lung and Abdomen Analysis accepts DICOM compliant medical images acquired
from CT. This product is not intended for use with or for the primary diagnostic interpretation of Mammography
images. Addition to Synapse 3D Base Tools, Synapse 3D Lung and Abdomen Analysis is intended to:
• use non-contrast and contrast enhanced computed tomographic images of the lung, provide custom
workflows and UI, and reporting functions for lung analysis including boundary detection and volume
calculation for pulmonary nodules in the lung based on the location specified by the user, segmentation of
bronchial tubes in the lung, approximation of air supply region by the user specified bronchial tube,
identifying, displaying and processing low absorption regions in the lung.
• use non-contrast CT images and calculate subcutaneous fat and visceral fat areas in 2D and both volumes in
3D.
• analyze a bronchus path to reach a lung nodule using the volume data collected with CT, and simulate
insertion of bronchoscope into the path.
Indications for Use for Synapse 3D Liver and Kidney Analysis

Synapse 3D Liver and Kidney Analysis is medical imaging software used with Synapse 3D Base Tools that is
intended to provide trained medical imaging professionals, including Physicians and Radiologists, with tools to aid
them in reading, interpreting, reporting, and treatment planning. Synapse 3D Liver and Kidney Analysis accepts
DICOM compliant medical images. This product is not intended for use with or for the primary diagnostic
interpretation of Mammography images. Addition to Synapse 3D Base Tools, Synapse 3D Liver and Kidney Analysis
uses contrast enhanced images of the body and provides custom workflows and UI, and reporting functions for
liver and kidney analysis including, liver and peripheral organ segmentation, and tumor segmentation. Also
segmentation of intrahepatic and peripheral vessels as well as the approximation of vascular territories is provided
using contrast enhanced computed tomographic images.
Indications for Use for Synapse 3D Nodule Analysis

Synapse 3D Nodule Analysis is medical imaging software used with Synapse 3D Base Tools that is intended to
planning. Synapse 3D Nodule Analysis accepts DICOM compliant medical images acquired from CT and PT.
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This product is not intended for use with or for the primary diagnostic interpretation of Mammography images.
Addition to Synapse 3D Base Tools, Synapse 3D Nodule Analysis is intended to;
• use non-contrast and contrast enhanced computed tomography (CT) images, provide custom workflows and
UI, and reporting functions for nodule analysis including boundary detection of nodules based on the
location specified by the user, measurement of nodules, temporal comparison of nodule images, and fusion
of a CT nodule image on a PT nodule image.
• use positron emission tomography (PT) images, provide custom workflows and UI, and reporting functions
for nodule analysis including SUV measurement of nodules with sphere VOI based on the location specified
by the user, temporal comparison of nodule images, and fusion of a PT nodule image on a CT nodule image.
Indications for Use for Synapse 3D Colon Analysis

Synapse 3D Colon Analysis is medical imaging software used with Synapse 3D Base Tools to accept, display, and
process DICOM compliant 2D and 3D medical images acquired from CT for the purpose of viewing of a colon to
detect polyps, masses, cancers, and other lesions. It is intended to be used by trained medical professionals in
reading, interpreting, reporting and screening. Addition to the general 2D and 3D image processing and
measurement tools available in Synapse 3D Base Tools, Synapse 3D Colon Analysis provides custom workflows, UI,
and reporting functions for colon analysis, including colon segmentation, detection of the centerline of colon, fly-
through of the entire colon, various rendering and visualization of colon, comparing both prone and supine views,
and electronic cleansing.
Indications for Use for Synapse 3D Tensor Analysis

Synapse 3D Tensor Analysis is medical imaging software used with Synapse 3D Base Tools to accept, display, and
process DICOM compliant 2D and 3D medical images acquired from MR for the purpose of viewing of local water
diffusion properties and directional dependence of the diffusion in the white matter. It is intended to be used by
trained medical professionals in reading, interpreting, reporting, screening and treatment planning. Addition to the
general 2D and 3D image processing and measurement tools available in Synapse 3D Base Tools, Synapse 3D
Tensor Analysis provides custom workflows, UI, and reporting functions for tensor analysis with neck and head MR
images. It includes display of diffusion and FA color map images, white matter tractography, dynamic review in MR,
vessel and body visualization with registration of MR, CT, XA, PET and NM.
Indications for Use for Synapse 3D Optional Tools

Synapse 3D Optional Tools is medical imaging software used with Synapse 3D Base Tools that is intended to
planning.Synapse 3D Optional Tools accepts DICOM compliant medical images acquired from a variety of imaging
devices including CT, MR. This product is not intended for use with or for the primary diagnostic interpretation of
Mammography images. Addition to the tools in Synapse 3D Base Tools, Synapse 3D Optional Tools provides :
• Imaging tools for CT images including virtual endoscopic viewing.
• Imaging tools for MR images including delayed enhancement image viewing, diffusion-weighted MRI data
analysis.
Contraindications
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None known.
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Intended Users
Synapse 3D is intended to be used by trained medical professionals, including Physicians, Radiologists, and
Radiological Technologists.
Training Requirements
The users of Synapse 3D must be properly trained for use based on the user manual. Please ask the local FUJIFILM
representative or the FUJIFILM distributor from who you purchased Synapse 3D for training availability.
Significant Physical Characteristics

Synapse 3D is a software medical device runs on Windows operating system. Hardware (computer, disk storage,
monitor, and network) and software (type of Windows operating system and database software) for Synapse 3D
shall be selected within the specification described in the Synapse 3D product specification. Synapse 3D block
diagram that describes physical connection of each component is found in “Product Configuration” page of this
User Manual .
Operating Principle
Synapse 3D is medical imaging software that is intended to provide trained medical professionals, with tools to aid
them in reading, interpreting, reporting, and treatment planning. Synapse 3D accepts DICOM compliant medical
images acquired from a variety of imaging devices including, CT, MR, CR, US, NM, PT, and XA, etc.
Basic imaging tools include, 2D viewing tools for 3D image data such as, orthogonal / oblique / curved Multi-Planar
Reconstructions (MPR), Maximum (MIP), Average (RaySum) and Minimum (MinIP) Intensity Projection, volume
rendering and 3D volume viewing, 4D volume viewing, regional segmentation of anatomical structures within the
image data, path definition through vascular and other tubular structures, fusion processing to view blended two
images, and various types of measurement. These image processing is used commonly in Synapse 3D clinical
applications and by using these processing, a user can process image data in 2D, 3D or 4D format, and can display
and view the results.
In a typical clinical application, such as the cardiac application, Synapse 3D segments heart when displaying the
target image data using the image recognition algorithm called as segmentation. Then, left ventricle inner wall is
determined for both diastolic and systolic phases. Using the volume data inside of the inner wall of left ventricle,
various cardiac functional parameters are calculated.
In order to analyze the coronary artery, Synapse 3D extracts the coronary artery from the segmented heart image
data using the dedicated algorithm for this purpose. Then a cross-section of coronary artery along the path is
displayed in 2D form by CPR processing. When a stenosis is found, the ratio of diameter (stenosis ratio) between
the target location and the normal position is measured.
In the liver analysis, Synapse 3D segments liver when displaying the target image data using the image recognition
algorithm called as segmentation. Then, Synapse 3D extracts vessels in liver using the dedicated algorithm for this
purpose. Assuming that each portion in liver is fed from the nearest vessel, Synapse 3D determines the volume and
boundary in liver that belongs to each vessel. This result is displayed on a monitor and may be used by a user for
diagnosis.
Likewise, by combining the basic image processing and the specifically designed image processing for each
purpose, Synapse 3D provides users with clinical information for other organs and body parts.
Images newly created by Synapse 3D can be saved on a server through DICOM interface.
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Significant Performance Characteristics

Performance of Synapse 3D depends on the following elements.
• CPU performance (Number of CPUs, GHz, Cache memory size, etc.)
• Size of memory
• Speed of disk storage
• Network performance
• Other devices connected to Synapse 3D when importing or exporting data
The requirements for hardware (computer, disk storage, monitor, and network) and software (type of Windows
operating system and database software) for Synapse 3D shall be selected within the specification described in the
Synapse 3D product specification. Above described performance characteristic may be referred for the selection.
When multiple Synapse 3D clients are used simultaneously with Synapse 3D server/client configuration, the
maximum number of client connection is restricted as defined in the product specification. However a user may still
feel slowness while other users operate the system.
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Product configurations
The product Synapse 3D consists of the following two modules: Synapse 3D Server for 3D image construction and
analysis, and Synapse 3D Client. The following configuration is a connection example among Synapse 3D Server
and image modalities and SYNAPSE Server (image data server) and Synapse 3D Client. The number of Synapse 3D
Servers varies according to the maximum number of concurrent connections. In the case of multiple servers, high
performance is realized with a server cluster where one machine works as the master server and the others work as
slave servers. When the master server receives a login request from a Synapse 3D Client, the master server can
select a login server automatically by confirming each server's login status.
CT, MR, PET, and XA etc. DICOM image generator device
DICOM compatible printer
SYNAPSE Server ( image data server）
Synapse 3D Server
Synapse 3D Client
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Contents
Chapter 1. Basic Operations (Server/Client) ....................................................................................... 22
1.1 Basic Operations ............................................................................................................................................................. 22
1.1.1 Client Computer Startup/Shutdown................................................................................................................................ 22
1.1.2 Server Startup/Shutdown.................................................................................................................................................... 23
1.1.3 Leaving the Workstation during an Operation ............................................................................................................ 25
1.1.4 Start up the Workstation..................................................................................................................................................... 26
1.1.5 Shut down the Workstation ............................................................................................................................................... 27
1.1.6 Conference Mode .................................................................................................................................................................. 28
1.1.7 Web Viewer ............................................................................................................................................................................. 29
1.2 Online Help ....................................................................................................................................................................... 33
1.2.1 Start up Online Help ............................................................................................................................................................. 33
1.2.2 Usage of Online Help ........................................................................................................................................................... 33
1.2.3 Close Online Help .................................................................................................................................................................. 35
1.3 Server Configuration ..................................................................................................................................................... 36
1.3.1 Log in to the Server Setup Screen.................................................................................................................................... 36
1.3.2 Administration Menu ........................................................................................................................................................... 37
Chapter 2. Daily Care and Maintenance .............................................................................................. 56
2.1 Client Check Sheet ......................................................................................................................................................... 57
Chapter 3. Synapse 3D ........................................................................................................................... 59
3.1 Study Screen .................................................................................................................................................................... 59
3.1.1 Local Data Screen ................................................................................................................................................................. 60
3.1.2 Remote Server Screen .......................................................................................................................................................... 89
3.2 Common Operations .................................................................................................................................................... 92
3.2.1 Basic Screen ............................................................................................................................................................................. 93
3.2.2 Print and Save .......................................................................................................................................................................121
3.2.3 Console ...................................................................................................................................................................................130
3.2.4 System Settings ....................................................................................................................................................................137
3.3 Base Tools .......................................................................................................................................................................175
3.4 Tools ..................................................................................................................................................................................214
3.4.1 Window Width and Level ..................................................................................................................................................214
3.4.2 Zoom and Pan ......................................................................................................................................................................222
3.4.3 Measurement ........................................................................................................................................................................225
3.4.4 Annotation .............................................................................................................................................................................237
3.4.5 Object Extraction and Removal .......................................................................................................................................245
3.4.6 3D Clip.....................................................................................................................................................................................261
3.4.7 SUV Evaluation .....................................................................................................................................................................270
3.4.8 Organ Extraction and Removal .......................................................................................................................................275
3.4.9 Position and Rotation.........................................................................................................................................................304
3.4.10 Mask Edit..............................................................................................................................................................................310
3.4.11 Reformat ..............................................................................................................................................................................317
3.4.12 Movie ....................................................................................................................................................................................329
3.4.13 Rendering ............................................................................................................................................................................343
3.4.14 Surface Display...................................................................................................................................................................348
3.4.15 Mask management ...........................................................................................................................................................353
3.5 Cardiac Tools (Option) ...............................................................................................................................................362
3.6 Perfusion Analysis (Option)......................................................................................................................................385
3.7 Lung and Abdomen Analysis (Option) ................................................................................................................400
3.8 Liver and Kidney Analysis (Option) .......................................................................................................................409
3.9 Nodule Analysis (Option)..........................................................................................................................................419
3.10 Colon Analysis (Option) ..........................................................................................................................................423
3.11 Tensor Analysis (Option) ........................................................................................................................................426
3.12 Optional Tools (Option) ..........................................................................................................................................430
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Chapter 1. Basic Operations (Server/Client)

1.1 Basic Operations
OS elements may vary, due to factors such as upgrades. If so, actual operations may be different from the
following description.
1.1.1 Client Computer Startup/Shutdown

Use of the workstation requires that you log in to Windows after startup. When finished, always shut down
Windows to ensure security.
Log in to Windows 10
1. Turn on the PC and monitor.
2. Drag on the lock screen.
3. Enter the user name in the following screen.
4. Enter the password and click .
5. After you have successfully logged in, the desktop is displayed.
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Shut down Windows 10

1. Shut down the workstation.
2. Click on the taskbar.
3. Click .
4. Select [Shut Down].
1.1.2 Server Startup/Shutdown

System operation requires that you log in to Windows as a user with administrative privileges. When finished,
always log off to ensure security.
Log in to Windows Server

1. Turn on the server and monitor if they are off.
2. Press Ctrl+Alt+Delete on the lock screen.
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3. On the following screen, enter the user name of a user with administrative privileges.
4. Enter the password and click .
5. After you have successfully logged in, the desktop is displayed.
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Log off from Windows Server
1. Click the button on the taskbar.
2. From the Start screen, click the user icon and select [Signout].
Shut down Windows Server
Before these operations, shut down all workstations connected to the server.
1. Press Ctrl+Alt+Delete.
2. Click in the lower right.
3. Select [Shut Down].
4. Select a suitable reason from the combo box, and then select [Continue].
1.1.3 Leaving the Workstation during an Operation

In order to prevent unauthorized access when leaving the workstation or system during an operation, ensure that
you perform user lock. Cancel the user lock when you wish to resume operation.
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User Lock Feature of Windows
1. Click the button on the taskbar.
2. From the Start screen, click the user icon and select [Lock].
1.1.4 Start up the Workstation

After logging in to Windows, start up the workstation with the following procedures.
1. Double-click the following Start screen icon.
2. Enter the user name and password and press the [Start] button when Internet Explorer starts up.
At this time, if [Remember me?] is checked, the user name and password are automatically entered at the
next login. However, this function cannot be used for the administrative user account. When there are
multiple servers, you can select the server to login if necessary.
3. The workstation starts up and the study list screen is displayed.
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When the server selection is set to automatic, the server to log in is that with the lowest workload. Also, no matter
which server you log in, the same data is available.
1.1.5 Shut down the Workstation

Shut down the workstation with the following procedures.
1. Click in the upper right of the study list screen.
2. Click [OK] when the confirmation window appears.
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1.1.6 Conference Mode
To use the conference mode, you may have to configure additional settings or purchase additional options, and
in some cases this mode may not be available depending on your network configuration.
When the conference function is available, the [Attend conference] button is displayed in the upper right of the
login screen.
When the button is clicked, the screen moves to the dedicated login page. Enter the user name and password to
log in. When the login succeeded, the following page is displayed.
When users having the privileges to publish the conference have logged into the server and is using the
workstation, the list of the users is displayed in this page. By clicking the [Attend] button at the user name whose
conference you want to attend, the screen of the workstation that the user (host user) is currently operating is
displayed on the client monitor. When the host user operates on the workstation, the screen will be updated on the
client monitor in real time.
In addition to the workstation screen, the following dialog appears on the client monitor.
The conference can be closed by clicking the [Disconnect] button.
Only the host user can operate the workstation. Other users can browse only.
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1.1.7 Web Viewer
Use of the Web Viewer requires configuration of additional settings and purchase of separate options.
When the Web Viewer is available, the [Web Viewer] button is displayed in the upper right of the login screen.
When the button is clicked, the screen moves to the dedicated login page. Enter the user name and password to
log in. When the login succeeded, the following page is displayed.
To search in Web Viewer content, perform the following procedure.
1. Specify search conditions
Select either [Patient ID] or [Patient name] as the main search condition. The other search conditions below
can be used in combination as conditions for advanced searches.
2. Click the [Search] button
Patient ID Search for patient IDs beginning

with a specified string.
Patient name Search for patient names beginning
Study date and time For search results, display only the
([Start date] to [End data for which the date of exposure
date]) matches the entered date in the text
column. [Start date] and [End date]
become available by checking or
unchecking the checkbox. The date
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can also be selected from the

calendar displayed by selecting an
input field.
For example, setting [Start date] to
"2000/01/01" and [End date] to
"2006/12/21" will display images
captured between January 1, 2000
and December 21, 2006.
Types For search results, display only the
data of a specified type.
Select All (all data), Offline VR, or 3D
PDF.
Sorting Conditions Search results can be sorted
according to your specified
conditions. As sorting conditions,
you can specify type, patient name,
patient ID, study date and time, age,
sex, creation date time, or series
description. Results can be sorted in
ascending or descending order.
"* search" can be used to search patient names and patient IDs. With this, the study data having a part of texts
can be searched.
Example: Search results for AKA include AKASHI TOSHIKO and AKABOSHI JIROU.
Example: Search results for AKA* include AKASHI TOSHIKO and AKABOSHI JIROU.
Example: Search results for *OKI include MOTOKI TAROU and OOKI KUNIKO.
Specifying sorting conditions in advance will apply your conditions to all search results, which is convenient if they
span multiple pages.
You can also sort search results within a page after matching content is listed, by clicking column headers.
In some cases, a message may be displayed indicating that no data is available for your search. The following are
conceivable causes of this.
• The server is down
Check the status of the server, and start it if it has not started up.
• There are too many search results
Specify search conditions, or start the workstation and change the setting of [Days of retrieve date to be
displayed for full search] in [Database] of [Environment settings] in [System settings].
Content list information display

The following information shown in the content list, as acquired from the content.
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Types Content created as [ Offline VR] or [ 3D PDF] is displayed with an icon

indicating the type of content.
Patient name Indicates patient names in reference studies for the content created.
Patient ID Indicates patient IDs in reference studies for the content created.
Study date and time Indicates the study date and time of reference studies for the content created.
Age Indicates patient ages in reference studies for the content created.
Sex Indicates patient sexes in reference studies for the content created.
Creation date time Indicates when the content was created.
Series description Indicates series information generated when the content was created.
Click an [Open] button in the content list to display the content.
Offline VR 3D pdf
Content accessed by holding the Ctrl button as you click the [Open] button is displayed in a new tab, as
controlled by browser functions.
Similarly, content accessed by holding the Shift button as you click the [Open] button is displayed in a new
window.
Click a [Download] button in the content list to download the content to the client computer.
Downloaded content can be displayed as follows.
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Offline VR
1. Extract all contents of the downloaded zip file (including folders) using
your archive extraction utility.
2. Navigate to the extracted folder in File Explorer and use an HTML5-

compatible browser to open the index.html file.
3D pdf
1. Open the downloaded PDF file in Adobe Acrobat Reader.
2. If playback of 3D content is disabled, enable it.
3. Click the Play button to play the 3D content.
Offline VR supports the following operations. Convenient viewer operations are possible using shortcut keys.
Rotation Drag in the direction of rotation. Otherwise,

press the arrow keys (↑↓←→).
Pan Hold the Shift key and drag in the direction
of panning. Otherwise, hold the Shift key
and press the arrow keys (↑↓←→).
Zoom Operate the mouse wheel. Otherwise, press
the Page Up key.
Reduce Operate the mouse wheel. Otherwise, press
the Page Down key.
Rotate toward a specific Click the cube in the lower right of the
axis. screen and select the direction of rotation.
Otherwise, press the key corresponding to
the direction (APLRFH).
Show/hide
supplementary Click the button in the lower right of
information the screen. Otherwise, press the space bar.
Reset display position Hold the Ctrl key and press the 0 key.
and zoom
Restore the original
orientation Click the button in the lower right of
the screen.
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1.2 Online Help

1.2.1 Start up Online Help
When the workstation is running, click the button at the upper right of the window to access
online help for the current application.
Online help can also be started by pressing the [F1] key.
1.2.2 Usage of Online Help

Select the topic you wish to view from the left side of the online help window. Help for the selected topic will be
displayed on the right side of the window.
Click the [Search] button at the lower left of the window to search through all pages in online help. Enter the text
you wish to search for in the text box and click the [Search] button.
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A list of matching results will be displayed. Select a search result to display the corresponding online help page.
In the top part of the online help window, in addition to the "Back" and "Next" buttons, the search function to
search the contents in the current page is available.
The functions of each button are as follows.
Search the current page for text entered in the text box and highlight the matching results.
Remove highlighting from text that was highlighted from searching.
Return to the previous page that was displayed.
Go forward to the next page that was displayed.
If [Sync help content with current operation] is set to ON while the online help window is displayed, help items
are switched automatically in correspondence to actions performed in the application.
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1.2.3 Close Online Help

Click [Close] at the lower right of the online help window to close the online help.
Online help will be closed automatically when the workstation is shut down.
Depending on factors such as your configuration of workstation and so on, contents on unsupported features
may exist in online help.
Depending on your system, actual screens may differ from online help screenshots in this manual.
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1.3 Server Configuration

The workstation administrator can configure the settings of the various services running on the server PC.
1.3.1 Log in to the Server Setup Screen

Management of image data in the workstation and communications with DICOM devices can be performed with
various services running on the server PC. When these functions do not work properly, check the status of the
services by following the procedures below.
The procedures below could affect on the operation of the workstation. Set up the services only when the setup is
absolutely necessary.
1. On the Start screen, double-click the following icon.
2. Internet Explorer starts up and the login screen appears. Click the [Environment settings] button at the upper
right of the screen.
3. The login screen for administrator appears. Enter the user name and password of Synapse3D having the
administrative privileges to log in.
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1.3.2 Administration Menu

When the login succeeded, the top page for the administrator is displayed and the menu list below is displayed at
the left. The screen can be switched to each setup page.
At the right of the screen, the current environmental settings of the server are displayed.
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Hardware Display the information (Server PC name and IP address) of the PC being used in the system.
information
DICOM Service Display the main settings (AE title and port), the status of the service, and HDD storage
information (total capacity and free space) of the current DICOM service.
Remote Display the status of the service that manages workstation running status, memory usage, and
Workstation the number of login users, as well as the service that performs various analyses and image
Service processing as DICOM images are received. The automatic execution of the service does not
work when settings are not proper, even if the service has started up.
For details on using the Remote Workstation Service, contact a support representative.
The settings are divided into [Maintenance] and [Workstation Setting]. The following section describes with respect
to each item.
Maintenance
On the per-user setup page, you can search for the user whose settings you want to configure by prefix-matching
the user's name. In addition, by clicking the button attached to [Batch configuration], you can batch-configure the
settings for the users on the page you are viewing.
If the number of registered users is large and each setup page consists of multiple pages, the saved settings are
applied only to the displayed users. Therefore, be sure to save the settings before switching the page.
License
Licensed functions that are installed are listed.
- 38 -
User Management
With this setting, the Synapse3D users who use this workstation are managed. The administrator can
register/delete the users who use the Synapse3D. In addition, by using User Management, the various settings and
customization information of the workstation can be managed with respect to each user.
When the [Register User] button is clicked, the following screen appears. Enter the necessary information for the
user registration.
- 39 -
Enable Uncheck this checkbox when temporarily disabling a created user.

User name Specify the user name to log in.
User full name Specify the full name of the user. The full name is mainly written in the signature space of the
report.
Password Specify the login password.
Confirm Reconfirm the login password. Enter the same login password again.
password
Copy setting Specify the original user settings to be copied. The specific user setting or pre-specified initial
from setting can be copied to create a new user.
Role Specify either of "Administrator" or "User". When "Administrator" is specified, various settings
described on this manual are available for the user.
Authority Use this setting to restrict specific functions. Functions, such as specifying the priority login and
removing the privileges to delete the images, can be restricted.
Setting Set whether this will be a user that can be selected in [Copy setting from].
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publicity
Conference This function can be specified only when the conference function is enabled. This setting
publicity specifies whether or not to publish the screen of this user to other participants in the
conference.
Comment Enter arbitrary comments.
In addition, when the [Edit User] button is clicked, the following screen appears, where the user information can be
edited.
Although the editable information is almost the same as that of the user registration, items for copying settings are
increased. This is a function for those items to copy the settings of the application and the color template of a
specific user to that of the user who is currently edited. Use this function to synchronize the color template among
users, and so on.
If characters from local languages, other than English alphabet, are used to enter user names, the system may not
operate correctly. Use the English alphabet as much as possible.
- 41 -
On the user registration and editing pages, you can simultaneously configure the Participation/Nonparticipation
setting for [User group], and the Allow/Deny settings for [Study group] or [Application].
Member Group Management

This function allows you to manage users in a group, which makes it possible to perform the batch copying of color
templates or various settings in units of groups.
The following edit screen is displayed by pressing the Add or Edit button. On this screen, a group name or users in
the group can be selected.
- 42 -
For all of the users who belong to the registered user group, it is possible to specify application settings for specific
users or perform the batch copying of color templates.
- 43 -
Study group and general application usage can also be allowed or denied on the basis of user groups.
Even when you have allowed or denied study group and general application usage in settings for specific users in
a group, group authorization takes precedence.
Service Management
With this function, two services (the DICOM and remote workstation services) are started, stopped, or restarted.
Also, with the function, the communication between this workstation and the connected DICOM devices (check
with DICOM echo or PING command) can be checked. The check with PING can check if the workstation and the
devices are connected each other on the network. The check with DICOM echo can check if the DICOM
communication is working properly each other.
When the other servers do not support the PING command or DICOM echo command, the check with PING or
DICOM echo will fail even if the network connection is configured properly.
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Process Management
The list of users currently logged in can be checked. The memory usage and the communication ports of each
connection can be checked. It is also possible to forcibly disconnect a connection that is unable to communicate
properly for some reason.
If you forcibly disconnect the connection at this point, the operation status of the logged-in user will be lost.
Confirm that disconnecting the connection will not be a problem, before you forcibly disconnect it.
Log Management
The logs include the operation log and the application log. The operation log can be utilized for the image
information management in a hospital. The application log is used to feed back the information on the workstation
malfunctions to our company.
Operation logs
With the operation logs, a log of various operations performed on this workstation can be obtained. The
searchable conditions are as below.
Patient ID, User name Specify the search condition to data with a specific patient ID or with a specific
Synapse3D user.
Operation date, Study Specify the search condition to date on which the Synapse3D user operated or study date
date of the exposure image.
Operation type Specify the operation to be searched. The searchable operations are as below.
• All
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• Delete
• Delete from recycle bin
• Import
• Export
• Receive
• Send
• Pick
• Login/Logout
• Export misc
• Print
Search results Specify whether to output the search results to the monitor or to download as a csv file.
Application logs
For each user, logs can be obtained when unintended behaviors occurred on this workstation. Please send the logs
to our company, and we will use the logs to identify the causes of the unintended behaviors.
Workstation Setting
Various settings on the use of workstation can be configured.
Security Policies
Password rules and account locking conditions can be specified.
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Password Complexity
Minimum Password Specify the minimum number of characters required for passwords. The supported
Length range is 1–64 characters.
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Types of Characters Specify how many types of characters must be included in passwords. Up to four types
Required of characters can be required, including uppercase letters, lowercase letters, numbers,
and symbols.
Number of User Name Restricts users from reusing part of their user name or full name in their password. The
Characters Prohibited in supported range is 0–64 characters, and the specified number of characters from the
Password user name or user's full name cannot be used in their password. Specifying 1 will
prevent the use of any characters from the user name or user's full name in a password,
and specifying 0 will disable this function.
Number of Unused Requires passwords that include characters not used in previous passwords. The
Characters Required in specified number of unused characters must be used in the new password. The
Password supported range is 0–64 characters.
Restrict Available Restricts the symbols that passwords can include. This setting prevents incompatibility
Symbols with external systems that do not support passwords with certain symbols.
Password Expiration Date

Password Expiration Period of validity for general users' passwords. Specifying 0 days will disable this
Date (Users) function.
Password Expiration Period of validity for administrators' passwords. Specifying 0 days will disable this
Date (Administrators) function.
Require Password Requires users to change their password manually the first time they log in, after the
Change at Initial Login administrator's password is changed.
Password Expiration Specify the number of days before password expiration when users are notified about
Reminder Timing the impending expiration. Users are notified the specified number of days before their
password expires, when they log in. Specifying 0 will notify users only after their
password has expired. At that time, they cannot use the system again until they change
their password.
Password Logging
Number of Passwords Prevents users from reusing previous passwords. Specify the number of passwords
Logged to Prevent logged to prevent reuse. The supported range is 0–100, and specifying 0 days will
Reuse disable this function.
Waiting Period After Specify the period that users must wait before changing their password again. Specify
Password Changes an ample waiting period to prevent users from clearing the password log by repeatedly
changing their password. Specifying 0 hours will disable this function.
Account Locking
Number of Failed Logins Specify the number of failed user login attempts until an account is locked. Specifying
Until Account is Locked 0 attempts will disable this function.
Failed Login Period Specify the period for which failed user login attempts are recorded for the purpose of
locking accounts. When the maximum number of failed login attempts is reached
within this period, the account is locked. Specifying 0 minutes will disable this function.
Auto Account Unlock Specify the period after which locked accounts are automatically unlocked. Specifying 0
Period minutes will require unlocking by administrators on the user administration screen.
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Save images
Settings for saving images can be configured.
Initial series number when The initial number can be specified for the series number generated when creating
saving as DICOM file the DICOM captured images.
Account for original image Specify whether to account for series numbers of original images when issuing
when numbering series series numbers.
User-specific image saving The initial number can be specified for the series number generated when creating
settings the DICOM captured images with respect to each user who uses this workstation.
Automatic logout
The automatic logout is a function to automatically terminate the workstation when there was no response from
the users for a predetermined time. All users who use the workstation can share the common setting. Individual
setting by user is also possible. It is possible to specify whether to enable the automatic logout function, the
amount of idle time that elapses before the automatic logout is determined to be necessary, and whether to save a
snapshot in the automatic logout.
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Automatic logout can be configured for individual users and groups, but if both are configured, user group
settings take precedence.
Terminal Setting
The settings of each terminal that are set for each user who uses the workstation can be confirmed. Also, the
network bandwidth usage per user can also be limited. Note that when the in-hospital network load is heavy, this
setting can reduce the load on one hand and can slow the response of the workstation on the other hand.
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By clicking the [Add] button, a new setting can be added. The necessary information for the setting is as below.
Client machine name Specify the name of the terminal (computer) to be specified. If left blank, it applies to
all terminals.
User name Specify the user to which the terminal setting is applied. All users can also be specified.
Always run under the Specify [ON] to force use of device settings of the specified terminal or [OFF] to restore
following conditions the previous running state.
Always in front Specify whether the workstation is always displayed in front when running.
Show maximized Specify whether or not to show the maximized screen when the workstation starts up.
When the screen is maximized, press the ESC key to cancel the maximized display.
Horizontal layout Specify "ON" for the monitor in portrait orientation and "OFF" for the monitor in
landscape orientation.
Window configuration Specify the location of the window on the monitor when the workstation started up.
This setting is used mainly for multi-monitor environment. The setting can also be used
with multiple monitors.
Study Group
Image data can be shown or hidden for specific users. The group created in this screen can be set for each image
data at the study list screen of the workstation. This makes it possible to control so that a user would not see the
data unless the study group to which the user belongs is permitted to use the data.
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When the [Add] button is clicked, the display turns to the one below where the study group name and the
privileges for the study group to use the images can be specified for each user.
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A specific study group can also be assigned automatically to data sent from a specific AE.
Application Control
The users who can use the applications can be restricted for each application.
With the [Edit] button of each application, the users who use the analysis of the application can be specified. By
default, all users can use the applications.
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Tablet Client Control

When tablets are used, authorization for startup via the tablet can be assigned to each user.
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Chapter 2. Daily Care and Maintenance

Perform daily maintenance and care to keep the device in normal working condition.
Perform checks daily to check if the device can start up normally without problems and if devices started up and
the workstations to which they are connected to can be updated normally. Clean the display daily.
Use the "Client Check Sheet" when performing daily maintenance.
The following items are listed in the "Client Check Sheet".
• Check: Record the date on which checks are performed and the results.
• Cleaning: Record the date on which the display was cleaned.
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2.1 Client Check Sheet

Please perform checks regularly to keep the device in normal working condition. Make copies of this sheet for use.
Checks
Item Interval Results

Does the device start up Daily
normally?
Can data be sent and Daily

received normally with the
connected device?
Is there any abnormality Daily

occurred in the device
(especially in HDD)?
Cleaning
Part Interval Date

Display Daily
How to check the abnormality of the device
Descriptions of any fatal errors that occur on the sever PC are displayed on workstations at startup. On standalone
computers, error messages are displayed in the taskbar. Immediately contact a service engineer from our company
when any error indication appeared.
Example of the error indication at workstation Example of the error indication on a stand-alone PC
startup monitor
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Chapter 3. Synapse 3D
3.1 Study Screen
The main functions that can be performed in the study screen are shown below.
• Search for and manage local data
• Preview images
• Start up an application
• Send images to the remote server
• Search and retrieve images from the remote server
• Output DICOM images
• Add DICOM images
• Register images with the print preview
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3.1.1 Local Data Screen

Local data refers to the image data stored in the workstation. With this screen, the image analysis can be
performed for the local data. The local data screen is configured as shown below.
A Search DICOM Search for an image in the local disk.

files domain
B Study list Display the study list that matches the search result.
domain
C Other study Display the study list that has the same patient ID as the selected study.
domain
D Series list Display the series that belong to the selected study.
domain
E Image list Display the image list that belongs to the selected series.
domain
F Select server Specify the server that is to be searched. The local disk is displayed first, and the others
domain are the remote servers.
G Image preview Display the selected image. Cine playback, specifying the range when reading the
domain image, adjusting the density, and the simple measurement, etc. can be performed.
H Image input list Register and cancel the image to be read, and switch the registered images.
I Image Perform various operations related to images such as adding the image, outputting to
operation external media, registering the images to the print preview, and sending to the remote
domain server, etc.
J Application Start up the application.
startup domain
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K System Frame The frame for operation of the entire system.

Switching applications by study, switching to the study list screen, displaying a dialog
such as the print preview, setting the workstation, displaying the help, confirming of the
DICOM server status, and terminating of the workstation can be performed.
The following note applies only when separate searching by first or last name is enabled in the service settings.
Searching by first name only, without specifying a last name, will find not only matching first names but also
matching middle names, prefixes, and suffixes in DICOM information.
After the system starts up, nothing may be displayed on the study list, or no image is displayed in the preview. The
following are conceivable causes of this.
• The destination where image files have been saved does not exist
• The local server is down
Check the status of the server, and start it if it has not started up.
• There are too many search results
Either set the search conditions in the search DICOM files domain, or change the setting of [Days of retrieve
date to be displayed for full search] in [Database] of [Environment settings] in [System settings].
Select servers
The local server and the remote server to be connected with the workstation can be switched.
A shortcut for the remote server can be registered from the right-click menu of the remote server button.
Search Images in the Local Disk

To search in the local disk, perform the following procedures.
1. Select [Local] in the select server domain
2. Set the search conditions in the search DICOM files domain
As a search condition, either [Name] or [ID] can be selected. The other search conditions below can be used
in combination as conditions for advanced searches.
ID Search for patient IDs beginning with a specified string.

Patient IDs recently searched can be called up by clicking the
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button beside the text box.

Name Search for patient names beginning with a specified string.
Patient names recently searched can be called up by clicking
the button beside the text box.
If separate searching by first or last name is enabled in the
settings, separate input fields are displayed, with one for last
names followed by one for first names.
Date For search results, display only the data for which the date of
([Start date] to [End exposure matches the entered date in the text column. [Start
date]) date] and [End date] become available by checking or
unchecking the checkbox. In addition, the date can also be
selected with the calendar in the button.

For example, setting [Start date] to "20000101" and [End date]
to "20061221" will display images captured between January 1,
2000 and December 21, 2006.
Modality For search results, display only the data generated by the
specified modality.
Status For search results, display only the data of a specified type.
ALL (all data), Done (data including snapshots, movies, reports,
captured data, and AR), and None (data excluding the "Done"
data from the "ALL" data) can be selected.
Comment For search results, search the comments registered in the study
list with a partial search. As for the extent of searching,
searching targets not only [Comment] information in study and
series lists but also [Study description] information and
snapshot comments.
Comments recently searched can be called up by clicking the
button beside the text box.
Group For search results, display only the data of the specified group.
The following dialog appears when [Edit group registration] is
selected from the button menu beside the text box. In this
dialog, the group list to be specified for the search can be set.
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Groups can be set for each study in the study list by [Change
Group] on the right-click menu.
Custom Search Search database using preset condition. Search conditions can
be registered in [System settings] → [Environment settings] →
[Database] → [Preset search condition].
"* search" can be used to search patient names and patient IDs. With this, the study data having a part of texts
can be searched.
Example: Search results for AKA* include AKASHI TOSHIKO and AKABOSHI JIROU.
Example: Search results for *OKI include MOTOKI TAROU and OOKI KUNIKO.
To use the group search, registering study groups previously is required.
List Domain
The local data registered in the database are displayed in the study list domain, the other study domain, the series
list domain, and the image list domain on the local data screen.
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Study list
In the study list, the results of each study are displayed in one line. Because the result is displayed by study, if
multiple studies are performed on the same patient, the results are displayed in multiple lines. Additionally, the
total number of studies shown in the current list is indicated on the top of the study list.
Operation in the study list

Various operations are possible from the following buttons at the top right of the study list.
When the Link with Synapse has been set, specify whether or not to search also the Synapse
database. (This icon is only displayed when [Link with Synapse] has been specified.)
Display the archive viewer. Archived studies can be loaded from the archive area to the study list.
The archive viewer is described below on this help page.
Anonymize the image information included in the study.
Study data can be protected or unprotected.
Protected images are labeled with a icon in the [Protection] category of the list. It cannot be
deleted.
Data can also be protected by selecting [Protection] from the right-click menu.
Comments for a study can be registered and edited.
These can also be performed by selecting [Comment] from the right-click menu.
Delete studies. Note that deleted data cannot be restored.
A dialog listing the images to be deleted appears. To delete other images, either select the relevant
image in the study list and click the button in the dialog, or select the image in the study
list and drag it to the dialog. To cancel image deletion for specific images, select the image and click
the button.
Data can also be deleted by selecting [Delete] from the right-click menu.
The related study list can be shown/hidden.
These icons are displayed only when studies with the same patient ID exist.
Even when the study data are not protected, if study data to be deleted include a protected series, it is necessary
to unprotect the series first.
When, for example, deleting an image being retrieved via DICOM communication, deletion of the image may
sometimes fail. Wait until retrieval has been completed before deleting the image.
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CSV exporting of search results

Search results can be exported to a CSV file by selecting [Save selected search results as CSV] from the right-click
menu. Before performing this operation, select results to export.
Display information of the study list

Various information from the study is displayed in the study list. This display information can be changed from
[Study/Series list setting] in [Database] of [Environment settings] of [System settings]. Most of the information is
obtained from DICOM images, but some information specific to Synapse 3D such as the following is also available.
Type When at least one " Captured Image," " Movie," " Report," " AR," or
" Snapshot" has been created with series images in the study, these icons are
displayed.
Protection A checkmark is displayed when users put a protection flag on the data that the
users do not want to delete.
Send When at least one of images (captured images, etc.) included in the study has
been sent to other DICOM servers, the identification number of the server to
which the image was sent is displayed.
Update date Display the date and time when the most recent images of the study were loaded
into Synapse 3D .
The date and time is updated not only when the image is received from other
DICOM servers via the DICOM communication but also when a new series is
added by registering snapshots and saving captured images.
Comment Display comments that users added to the study.
W Print When at least one of images (captured images, etc.) included in the study has
been printed from a Windows printer, the identification number of the Windows
printer is displayed.
D Print When at least one of images (captured images, etc.) included in the study has
been printed from a DICOM printer, the identification number of the DICOM
Group Display groups that users set for the study.
Data Source Display the name of the DICOM device that is the source of the data.
Number of images Display the number of images included in the study. Does not include the number
of snapshots, for example.
Note that printing with the Windows printer is judged to be successful when the print is registered to the
Windows Spool, and this flag appears.
In addition, as another information, the free space of a disk in which images are stored is also displayed.
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Series list
A series list displays all of the series data associated with the currently selected study. When multiple studies have
been selected, this list is completely blank.
Also, if another study for a selected patient exists in the local disk, a related study list can be displayed. With the
related study list, confirming past study data and other study information for the currently selected patient and
displaying those data is possible.
Operation in the series list

At the upper part of the series list, the following operation buttons and information are displayed.
The list of applications that satisfy the automatic application startup condition can be
displayed/hidden.
Any series that meet the conditions specified for auto startup of an application are labeled with an
icon for that application in the list. Selecting an icon and clicking the [Start Application] button or
double-clicking an icon will start the application with the series of images that meet the conditions.
To display the automatic application startup list, you need to specify a condition for the automatic
application startup in the [System settings].
Display of the series list can be switched to thumbnail display or string display.
Separation of series and combination of separated series can be performed. These operations can
be performed by selecting [Separate images] and [Combine images] from the right-click menu. The
division of series is only effective in this system.
After selecting an image for separation in the series list, select the separation method from the pull-
down menu of the button.
• Divide by phase
Separate into each time phase.
• Divide by slice
Separate into each slice position.
A series can be protected or unprotected.
Protected images are labeled with a icon in the [Protection] category of the list. It cannot be
deleted.
Data can also be protected by selecting [Protection] from the right-click menu.
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Comments for a series can be registered and edited.

These can also be performed by selecting [Comment] from the right-click menu.
(However, this function may not be available, depending on how [System settings] is configured.)
Delete series. Note that deleted data cannot be restored.
A dialog listing the images to be deleted appears. To delete other images, either select the target
data from the series list and then click the [Register] button in the dialog or select the target data
from the series list and drag it to the dialog. When an image is not to be deleted, select that image
and then click the [Release] button.
Data can also be deleted by selecting [Delete] from the right-click menu.
The image list can be shown/hidden.
When separating images, optimum separation does not necessarily occur. When the optimum separation was not
done, manually select and separate the image.
When at least one protected series is included, the entire study data are excluded from the auto deletion target.
When, for example, deleting an image being retrieved via DICOM communication, deletion of the image may
sometimes fail. Wait until retrieval has been completed before deleting the image.
Change the series number

The series number can be changed from [Change series number] of the right-click menu. Specify the series number
after the change on the displayed [Change series number] dialog. This series number change can be performed
only for the image data.
Import general format images

In the right-click menu, you can also import general images into the study from [Import general format images].
When you import BMP or PNG files, the files are added to the study as a new series.
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Anonymize snapshots
Snapshots can be anonymized by selecting [Export snapshot as anonymized] from the right-click menu when a
snapshot is selected. Images used in the snapshots are also automatically anonymized. You can specify the
destination folder and patient name and ID after anonymizing.
Display information of the series list

Same as for the study list, various kinds of information of the corresponding series are displayed in the series list.
This display information can be changed from [Study/Series list setting] in [Database] of [Environment settings] of
[System settings]. Most of the information is obtained from DICOM images, but some information specific to
Synapse 3D such as the following is also available.
Protection A checkmark is displayed when users put a protection flag on the data that the
users do not want to delete.
Send When at least one of images (captured images, etc.) included in the study has
been sent to other DICOM servers, the identification number of the server to
which the image was sent is displayed.
Comment Display comments that users added to the series.
(However, this function may not be available, depending on how [System
settings] is configured.)
W Print When at least one of images (captured images, etc.) included in the study has
been printed from a Windows printer, the identification number of the Windows
D Print When at least one of images (captured images, etc.) included in the study has
been printed from a DICOM printer, the identification number of the DICOM
Note that printing with the Windows printer is judged to be successful when the print is registered to the
Windows Spool, and this flag appears.
Image list
An image list displays all of the image data associated with the current series. When multiple series have been
selected, this list is completely blank. Also, images can be selected in 2-image intervals, 3-image intervals, and so
on, from the right-click menu on the list.
At the upper part of the image list, the following operation buttons and information are displayed.
Only the specified image is divided into separate series. The division of series is only effective in this
system.
When combining separated data, either select the series to combine in the series list domain and
click the button, or select [Combine images] from the right-click menu. The selected multiple
series reverts to a single series.
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To select multiple studies, series, and images, select images while holding the Shift key or the Ctrl key on the
keyboard.
Observe Images in the Local Disk

A selected image can be displayed in the image preview domain. The following operations can be performed in the
preview screen.
These buttons are used to select specific range of images in the image list while observing the
images. First, display the first image in the range for selection and click the button. Next, display
the last image and click the button to select the images enclosed in the region.
Cine playback of a series selected from the image list is performed. is

displayed as the controller. From left to right, the controls are [Play cine backward], [Pause], [Play cine
forward], and [Auto reverse play].
Images can be read with the region of the image specified.
The window width and level values are automatically retrieved from the DICOM header and are
applied to the image. This function can be switched to ON or OFF.
Browsing and outputting the DICOM header information can be performed.
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The straight line measurement can be performed for the image currently displayed. It can be deleted
from the right-click menu.
The signal value measurement can be performed for the image currently displayed. It can be deleted
from the right-click menu.
The display position, zoom rate, window width, window level, etc. of the image can be changed with the mouse.
Wheel scroll An image to be displayed can be changed within the same series.
Right button drag The window level and width of the selected image can be set.
Left button drag The selected image can be panned to change the center of the display.
while holding the Shift
key
Wheel scroll The zoom rate for the selected image can be changed.
while holding the Shift
key
The paging, window width and level of an image can be changed also by moving the slider.
Page Paging the images within the selected series can be performed.
Width The window width of the selected image can be set.
Level The window level of the selected image can be set.
When the button of the preview screen is ON when you adjust the window width and level and page
through images, adjusted values are reset to [Window Center] and [Window Width] in the DICOM header
information. To use the changed window width and level values after paging, cancel this function.
Browsing DICOM header information
The DICOM header information of a displayed image can be browsed. Clicking the button at the top of the
preview region displays the DICOM header information of the image. By entering values to the [Group], [Element],
and [Name] fields of the Data element in the dialog, the information to be referred to can be searched. Also, the
header information can be output as a CSV file.
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Operations on Local Disk

Send an image to the remote server
Any image managed in the database can be sent to the connected remote server.
2. Select the study, series, and image to be sent
3. Click the [Send] button in the image operation domain
4. Select [Send to]
5. Click the [Send] button
6. Confirm the sending condition and result in the send status
Images to be sent are displayed in the list. To send other images, either select the relevant image in the study list
and click the button in the dialog, or select the image in the study list and drag it to the dialog. To cancel
image sending for specific images, select the image and click the button.
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The list showing the status of sending is displayed at the bottom of the dialog when the sending is started. The
items shown in the list are as below.
Order Display the sending order. The list can also be sorted in ascending and
descending order.
Status
• Sending
Indicates that the data is currently being sent.
• Finished
Indicates that sending finished properly.
• Error
Indicate that the communication failed.
• Warned
Indicates that communication itself was established but the sending of

data failed for some reason.
Target Displays the image sending destination.

Information Display the patient name of the image.
Error information In case image transfer is unsuccessful, error information is displayed.
The actual sending is processed from the top of the list; however, analysis and other operations can be performed
even while the data is being sent. Canceling requests being sent or awaiting transfer can be attempted by selecting
the requests in the "Send status" list and clicking the button.
Note that if a file specific to Synapse 3D (snapshot, movie, report, etc.) is sent to SYNAPSE, the file is stored in
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SYNAPSE simply as a secondary capture image, and the snapshot information, movies, and report information are
deleted to decrease the data volume.
Output image from the local disk

A DICOM image can be output to an arbitrary folder on the hard disk. When outputting an image, it can be output
together with a simple viewer, and also the patient data (patient name, patient ID) can be changed (anonymized).
The image can be zoomed, or the window width and level can be changed with the simple viewer.
Output the data with the following procedure.
2. Select the study, series, and image to be output
3. Click the [Export] button in the image operation domain
4. Configure the various settings for outputting the data (changing the patient name or patient ID, exporting of
a simple viewer or not)
5. Click the button
6. Set the output destination, format, etc.
Images to be output are displayed in the list. To output other images, either select the relevant image in the study
list and click the button in the dialog, or select the image in the study list and drag it to the dialog. To
cancel image output for specific images, select the image and click the button.
The items to be set when outputting data are shown below.
Export simple viewer When [Export as a DICOM image] is selected from the pull-down menu of the
button, export the simple viewer with the image.

Anonymize DICOM Set whether or not to change the patient name and patient ID.
information
• ON
Anonymize the image. The anonymous name is generated automatically,

but an arbitrary patient name and ID can also be entered.
• OFF
Output the data without anonymizing.
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Even if the file is anonymized, patient information may be embedded as an illustration in a captured file or
personal information may exist in the DICOM header or other part that is not anonymized. Be very careful using a
DICOM image which was anonymized by this workstation at an external location.
Depending on the settings of the workstation, the data registered in the database is sometimes automatically
deleted. Therefore, periodically send the necessary data to other servers.
When a file is anonymized, private tag information in the DICOM header or part of the tag information may
sometimes be deleted. Consequently, functions which use this information, such as the analysis function, may not
be able to be used.
If an image list to be output contains snapshots, movies, and/or reports, such kinds of DICOM information cannot
be anonymized.
To enter double-byte character in an anonymous patient name, enter the name in the pattern "English=double-
byte characters."
Example: FUJI TAROU=富士太郎
Output method to the local disk
Data can be exported to a local disk by clicking the button. The following method can be selected as an
output method to the local disk.
Export as a DICOM Output the image in DICOM format. Specify the output destination folder.
image
Export as a general Output a single image at a time. The following formats are supported.
image (JPEG, BMP, etc.)
• JPEG Files
• BMP Files
• PNG Files
Specify the output destination folder, prefix for the file, and file format.
Export as a movie Output a single series as a movie file. The following formats are supported.
• MPEG Files
• H.264 Files
• WMV Files
• AVI Files
• QT Files
Specify the frame rate of movies, output destination folders, and file formats.
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The exported movie is compressed, thus the image quality deteriorates. Note that some areas may no longer be
visible.
When selecting [Export as a general image (JPEG, BMP, etc.)] or [Export as a movie] for a movie, the file is output
as a movie in the saved format, regardless of the specified file format, frame rate, etc.
When [Export simple viewer] is set to ON, if an image is exported in DICOM format, a DICOMDIR file is also
produced. If a DICOMDIR file output by a different manufacturer already exists in the output destination medium,
the DICOMDIR file will be written to the existing DICOMDIR file, and the image may not be displayed in the other
manufacturer's viewer. Therefore, when additionally outputting an image, be sure to write the image to a medium
used exclusively by this workstation.
Anonymization on a study list

An image can also be anonymized directly from the study list domain. Select the study to anonymize and either
select [Anonymize] from the right-click menu or click the button.
Change the text of [Patient name] and [Patient ID] and click the [Change] button to anonymize the data. At this
time, the user can select to keep the original or delete it.
Even if the file is anonymized, patient information may be embedded as an illustration in a captured file or
personal information may exist in the DICOM header or other part that is not anonymized. Be very careful using a
DICOM image which was anonymized by this workstation at an external location.
When a file is anonymized, private tag information in the DICOM header or part of the tag information may
sometimes be deleted. Consequently, functions which use this information, such as the analysis function, may not
be able to be used.
If snapshots, movies, and/or reports are contained in the same studies, such kinds of DICOM information cannot
be anonymized.
Register the local data in the print preview

Selected positioning images and tomographic images can be registered in the print preview. By registering in the
print preview, the position of the tomography image can be drawn on the positioning image as a reference line.
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Register in the print preview with the following procedure.
2. Select the series and images that you wish to register in the print preview
3. Click the [Printer] button in the image operation domain
Add images to the local disk

DICOM images can be added to the local disk from an external media such as an optical medium or a hard disk.
2. Click the [Add] button in the image operation domain
3. Specify the drive and folder containing the images, and click the [OK] button
After the files in the folder are checked, the image data are imported in the background.
When the study group has been registered in advance, you can specify the study group for the data to import.
If a DICOMDIR file exists in the specified folder, the image data can also be imported using this file. In this case,
only the data for a specific patient can be imported. If a DICOMDIR file is not used, all of the DICOM files in the
specified folder are imported.
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During data importing, the button is displayed. When the button is clicked, images imported up to
that point are registered in the database.
All files specified for importing are copied and saved to the database. Therefore, the images in the database are
not deleted even if the original files are moved or deleted.
A Lossy JPEG image can be imported and displayed, but it cannot be sent to another server, etc.
If the disk usage of a drive containing the images exceeds 95%, no more images can be added. When managing a
large quantity of images, it is necessary to delete unnecessary images in order to increase the available storage
capacity.
Archive Viewer
Studies in the study list can be backed up by saving a copy to a folder specified in the settings.
To prepare for study archiving, specify a destination folder from the web administration screen.
Access the system settings of the web administration screen, and in the setting to the save images, specify the
destination folder as the archive path. This folder must be accessible from the server or standalone computer.
Next, select a study in the study list and click from the right-click menu to save a copy of the study in the
archiving destination. Studies that are archived also remain in the study list as local data. The data exists in both
locations, at the destination and in the study list.
A list of archived studies can be displayed in the archive viewer. The archive viewer is accessible from the
button above the study list.
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Archived study searching in the archive viewer is possible by patient name, patient ID, or study date. After selecting
a study in the list, click the [Retrieve] button to load it from the archiving destination to local data in the study list. If
the study has been deleted from local data, loading it from the destination enables it to be used again.
Archived studies can be deleted in the destination by selecting them in the archive viewer and clicking the delete
button.
Start Up an Application
Select the image to be used in the analysis from the list, and start the application with the following procedure.
1. Select an image to be processed from the study list and series list
2. Click the button in the image input list domain to add the image to the list
Otherwise, click the button in the image input list domain and drag the image to the image input list
dialog.
(When registering images of the same study, the application can be started up by selection alone, without
registering the images.)
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3. To clear registered data, click the or button. Click the [Start Application] button, select the body
area for analysis, and click the application button
Otherwise, click the [User-defined] button registered as a shortcut or the [Recent] button
Applications can be registered as a shortcut from the right-click menu on the User-defined button.
When the images to be used are one series, the application can be started by double-clicking the series in the
series list.
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The image orientation index (cube) is displayed in the image frames of 2D and 3D images. The image orientation
index (cube) is marked with the letters A (anterior), P (posterior), R (right), L (left), H (head), and F (foot) which
indicate the orientation of the image. When displaying organs that are symmetrical in the left-right direction in the
body (kidneys, head, etc.), confirm the front-rear, left-right, and up-down orientations of the image using the
DICOM header information, image, cube, or other information, as indexes.
This workstation might process images that are not orthogonal in the 3 axes (X, Y, Z) of the images (for example,
the images that affixed gantry angles in CT like the image below on the left). The 3D display can be utilized for
these images after the coordinates are converted so that coordinate axes becomes orthogonal. However, since the
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coordinates that were converted used the signal values which were interpolated from the original image, be careful
when using these images, to check whether or not they are being displayed normally. In addition, since the original
image is changed and read via interpolation, be careful because information such as details of the original data
might be lost, and artifacts might be generated.
In the 3D display and oblique view, when tilting the plane orientation or changing the 3D view direction, angles
such as RAO and CAU, etc. are displayed at the lower right of the window. These numbers show the angle that
rotated on the left and right axes of patient after rotating on the body axes for patient as the following figure.
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If the position, orientation, and other data are not recorded in a multi-frame image as the specified DICOM
information, the image may not be displayed properly. Therefore, before using a multi-frame image, check the
DICOM image header information and the displayed image, and confirm that the orientation of the read image is
correct.
Images supported for analysis and management by this workstation have a signal value in the range of -32768 to
32767. Images with signal values exceeding this range cannot be displayed correctly. The measure of these images
can be set in [Image load] of the [System settings].
If an image that exceeds the range between -32768 and 32767 is read, the value displayed by measurement, may
differ from the value inside the DICOM image.
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Auto execution
Specified applications can run in the background and save snapshots.

Additionally, results from background processing can be saved as intelligent information for image processing that
involves region extraction in specific parts or image registration intelligent information. The intelligent information
produced this way can be used on application startup.
Perform auto execution as follows.
1. Select images for use with auto execution from the study or series lists
2. Click the [Auto execution] button. Click the target body area, and then click either the application button or
the intelligent information button
Queue information for auto execution is displayed in the list. To cancel auto execution, click the button.
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Snapshots and intelligent information produced by automatic processing can be checked in the study or series lists.
A preview of snapshots generated by automatic processing is displayed as follows.
Automatic separation of images

When reading an image in the workstation, special processing is sometimes carried out. The following are typical
examples.
• Images containing multiple phases in one series
In an image of CT or MR for functional cardiac analysis or a CT image of the liver region generated with
several timings of contrast, multiple phases may exist in a series.
• Images whose interval in a series is not constant
• Images whose interval is "0"
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These are images such as dynamic data obtained by continuously exposing a plane for a fixed period.
These image data cannot be directly displayed as a 3D display. Therefore, it is necessary to specify how to read the
data.
In this workstation, one of the following three types of reading methods can be selected when starting an
application.
The details of each reading method are shown below.
Forcibly load all Read forcibly as single volume data. By reading the image forcibly, image position
information, etc. will be inaccurate, so the measurement, etc. cannot be
performed properly.
Load one phase
Select an image to read from the multiple phases that are included in the series.
Load one slice

Divide the image that is included in the series by plane, and specify the plane to
be read. The images cannot be displayed three-dimensionally because all the
images are the images in the same position. These can be read forcibly as 3D
data, however, three-dimensional measurement cannot be performed properly.
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When [Forcibly load all] or [Load one slice] is selected, the image position information is no longer accurate.
Because the results of measurement are incorrect, do not use these functions.
When images are separated by auto separation, separation may fail, or the application may start with an incorrectly
separated image. When reading a series containing multiple phases or multiple volumes, confirm that the auto
separation is performed correctly.
Reading in decreased resolution

In case of a lack of memory, an image may too large to read at its actual resolution. In this case, the following
dialog is displayed.
When the [Yes] is clicked, the image is read at a reduced size by reducing the resolution of the image. When the
[No] is clicked, the image cannot be read, so reduce the number of images to read or the reading range as follows.
If an image is read with reduced resolution, information of the details may be lost.
Reading an image using the range specification function

When, because there are many images to be read, the capacity of the memory is insufficient, images may not be
read with their original resolution. In such a case, only the necessary part of the images can be read with their
original resolution by specifying the reading in range on a two-dimensional plane.
This method can be used only when the slice interval is constant.
Specify the reading range with the following procedure.
1. Select the image to be analyzed on the local data screen
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2. In the image preview domain of the local data screen, click the button
3. Specify the necessary region for analysis in the image preview domain on the local data screen by dragging
the mouse
Start dragging from the position that is to be the starting point and release the mouse button at the
position that is to be the end point, in order to determine the region. After a region has been determined,
the region can be changed by dragging the points.
4. Click the button in the image input list domain
5. Click the [Start Application] button, select the body area for analysis, and click the application button
Open additional applications

This workstation can start up to five applications simultaneously.
If one or more applications have been running, it is possible to specify whether to delete or keep them when
opening a new application. Also, at that time, if an image created using the application remains in the capture box,
it is possible to specify whether or not to delete the image.
Link with Synapse

The workstation enables you to access the Synapse database directly from the study list of Synapse 3D , through
linkage with Synapse. When a Link with Synapse has been set, the data existing in Synapse database is also
displayed as the result of a local data search.
Whether or not the data is in Synapse can be confirmed by checking the series list column. As shown below, the
Synapse icon "A" is displayed before a series in Synapse.
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When a series in Synapse is used to open an application, the application starts up once the data is sent from the
Synapse database to the Synapse 3D server.
For the patient name of data only in Synapse, only the first character is capitalized and the rest are not, and the
patient ID is always capitalized.
The study description for the CR study of data only in Synapse is displayed as "Body Part Examined, Study
Description".
When data only in Synapse include series of multiple modalities in one study, only the modality that is received
first is displayed.
If the same multi-frame image is sent to Synapse and Synapse 3D from a modality, the images may be displayed
as two different series in the Synapse 3D series list.
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3.1.2 Remote Server Screen

The term "remote server" refers to a DICOM server or modality device (CT, MR, etc.) connected to a workstation in
the DICOM format. By retrieving data from a remote server, image analysis can be performed on the data.
A Search DICOM Search the data on the remote server.

files domain
B Study list Display the study list that matches the search result.
domain
C Series list Display the series that belong to the selected study.
domain
D Image list Display the images that belong to the selected series.
domain
E Select server Specify the server that is to be searched. The local disk is displayed first, and the others
domain are the remote servers.
F DICOM Display the retrieval status of the current image.
retrieving status
domain
G Operation panel Retrieve the data on the remote server.
H System Frame The frame for operation of the entire system.
Switching applications by study, switching to the study list screen, displaying a dialog
such as the print preview, setting the workstation, displaying the help, confirming the
DICOM server status, and terminating the workstation can be performed.
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Remote Server Image Search

In order to perform image analysis on the workstation, it is necessary to retrieve images from a remote server.
Images can be searched from a remote server with the following procedure.
1. Select the remote server to be searched
2. Enter the search conditions in the search DICOM files domain
As a search condition, either [Name] or [ID] can be selected. The other search conditions below can be used
in combination as conditions for advanced searches.
ID Search for patient IDs beginning with

a specified string.
Name Search for patient names beginning
Date For search results, display only the
([Start date] to [End data for which the date of exposure
date]) matches the entered date in the text
column. [Start date] and [End date]
become available by checking or
uncheking the checkbox. In addition,
the date can also be selected with
the calendar in the button.

For example, setting [Start date] to
"20000101" and [End date] to
"20061221" will display images
captured between January 1, 2000
and December 21, 2006.
Modality Search the data generated by the
specified modality.
Comment If the other server is Synapse 3D ,
comments can be searched.
Preset Search database using preset
conditions.
If displaying search results takes some time, searching can be canceled by clicking the button at the
upper right of the study, series, or image lists.
Separate server settings are needed when searching for patient names and IDs that include 2-byte characters.
When an image list is not displayed, even if a series is selected, the image data belonging to the series are not
searched. As a result, data can be searched faster.
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With "starts with" matches, the beginnings of the entered search conditions and target images are cross-checked
and matching images are found. For example, a "starts with" search of "3D" will include results such as "3D
Viewer." With this search, words such as "Viewer 3D" are not included in the search results.
Image Retrieval from a Remote Server

After searching is performed on a remote server, data can be selected from the search results and saved to a local
server.
1. Select the image to be retrieved in the study list, series list, and image list after the study is finished
2. Click the [Retrieve] button in the operation panel
3. Confirm the retrieval status and result
In the [DICOM retrieving status] list, all of the requests for retrieval up to the present moment are displayed.
Order Display the sending order. The list can also be sorted in ascending and descending order.
Status
• Retrieving
Indicate that the data is currently being retrieved.
• Finished
Indicate that the retrieval finished properly.
• Error
Indicate that the communication failed.
• Warned
Indicate that communication itself was established, but that the retrieval of data failed
for some reason.
Target Display the destination of the image retrieval.

Information Display the patient name of the image.
When the [Retrieve] button is clicked, the request is added at the bottom of the image retrieval status list. Since the
actual data retrieval is performed from the top of the list in the background, the analysis, etc. can be performed for
the image of studies which have been retrieved even when other data are being retrieved.
Also, the requests whose data have been retrieved or have not yet been retrieved can be canceled by selecting the
request in the [DICOM retrieving status] list and clicking [Cancel] button.
Note that if the data which have already been received (Study Instance UIDs, etc. are identical) are received once
again, the existing data will be overwritten.
To select multiple studies, series, and images, select the data while holding the Shift key or the Ctrl key on the
keyboard.
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3.2 Common Operations
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3.2.1 Basic Screen

When an application is started, a screen similar to the one shown below is displayed. The arranged frames partly
differ according to the application, but the screen construction is approximately the same.
A System Frame The frame for operation of the entire system.

Switching applications by study, a switching screen to a study list, displaying dialogs such
as print preview, configuring workstation, displaying the help, and exiting from the
workstation can be performed.
B Stage Frame The patient information being used with the application is displayed in the most left side
and the list of the opened applications next.
Other applications to use with the current image can be started by clicking the
button.
At the end, the analysis procedure buttons are displayed. Analysis can be advanced by
clicking the buttons in order.
C Application The frame for operating the entire application currently opened.
Frame Used for operations such as executing macros, creating reports, or saving analysis status,
or resetting.
D Main Frame The frame where images are displayed.
The layout varies for each analysis.
E Tool Bar Display the usable tool buttons. When each button is clicked, the corresponding
operation screen appears in the tool frame.
F Tool Frame Display the operation screen for the selected tool.
G Template Display a frame in which the window width, level, color template information, mask
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Frame processing, display method, etc. for the selected image can be changed.
The default setting of the analysis application is "hidden".
Stage Bar
The patient information (patient name and patient ID) being used with the application currently selected is
displayed in the most left side.
Next, a list of the applications being used with the current patient data is displayed. Up to five applications can be
opened for one patient data. Applications can be terminated by right-clicking the application icon.
At the end, the analysis stages of the selected application are displayed. Basically, the analysis can be performed by
following the analysis stages from left to right. The stages vary depending on the analysis application.
(Example) Stage bar for coronary analysis
Main Frame
The frame where an analysis screen is displayed, and where images are observed and analyzed using various tools
and functions. One frame in the main frame is called an image frame.
Shortcut bar
When the mouse cursor is moved on the currently selected image frame, a button to start up the shortcut bar
appears at the top, bottom, left, and right of the frame. When the button at a position where you wish to display
the shortcut bar is clicked, the shortcut bar is displayed at the position. Even after the shortcut bar is displayed, by
clicking a button to start up the shortcut bar at any position, the shortcut bar can be moved to the position of the
button.
Upper position of an image frame Display example of the shortcut bar
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When the button in the shortcut bar is clicked, the [Shortcut bar display setting] dialog is displayed.
By checking or unchecking the respective checkbox, showing or hiding a button in the shortcut bar can be set.
Clicking the button next to each item will display the [Setting of key bindings] dialog.
Currently selected key
A key which can be registered. A new shortcut can be registered.
An already registered key. As long as a registered shortcut is not cancelled, a new shortcut key
cannot be registered.
When the cursor is moved onto a button and left there for a while, the tool tip of the registered
function is displayed.
When a registered key is clicked after the setting of key bindings, the corresponding function can be called. For
example, if you register window width and level to the "W" key, pressing the "W" key in the image frame will switch
to the window width and level tool from the current tool.
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Example of shortcut bar for standard functions

The available functions to be arranged on the shortcut bar vary depending on the selected image frame. In
addition, many function buttons other than the followings appear depending on the analysis functions to be used.
Close the shortcut bar.
Maximize the image in the image frame to fill the entire main frame.
Send the image in the image frame to the capture box as a color image.
Send the image in the image frame to the capture box as a high-resolution color image.
Send the image in the image frame to the capture box as a monochrome image.
Send the image in the image frame to the capture box as a high-resolution monochrome image.
Send the image of the entire main frame to the capture box.
Rotate the image counterclockwise.
Rotate the image clockwise.
Reverse the image vertically.
Reverse the image horizontally.
Perform paging by moving the slider.
Display a simple settings dialog box for the captured image.
Displays the dialog box to specify the slab thickness (arbitrary plane (oblique plane) only).
Display the volume of the mask region (3D display only).
Display the rotated image as the cine display to only the side direction (3D display only).
Return the "Zooming and Panning" for the image frame and the information of "Window Width and
Level" etc. to the initial state when the image was read.
Undo the mask operation.
Redo the mask operation.
Display the current mask region as overlay on the 2D image. To hide the mask region, click the button
again.
The current mask region is cleared.
Change the rendering method (3D, SSD, MIP, MinIP, and RaySum) of a 3D image (3D display only).
Capture the current frame and pass it to an external system. Drag this button to another system (such
as a reporting system) to send a captured image to the other system. The same captured image is also
copied to the clipboard.
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Capture the entire main frame as a single image and pass it to an external system. Drag this button to
another system (such as a reporting system) to send a captured image of the main frame to the other
system. The same captured image is also copied to the clipboard.
Use this button to change the position of image frames. By clicking and dragging an image frame to
another image frame and releasing the left button, the positions of the image frames are replaced.
Depending on the analysis application, some buttons in the table above cannot be used or other buttons not in
the table can be used.
Shortcut key
Basic operations such as zooming, panning, etc. also can be performed directly using the keyboard.
"Ctrl+C" on the Copy the image in the selected image frame to the clip board.
keyboard
"Ctrl+D" on the Display a simple settings dialog box for the captured image.
keyboard
"Ctrl+Z" on the Call the function to undo the mask operation.
keyboard
"Ctrl+Y" on the Call the function to redo the mask operation.
keyboard
"A" on the keyboard Display the 3D image in the AP (anterior-posterior) direction.
"P" on the keyboard Display the 3D image in the PA (posterior-anterior) direction.
"L" on the keyboard Display the 3D image in the LR (left-right) direction.
"R" on the keyboard Display the 3D image in the RL (right-left) direction.
"H" on the keyboard Display the 3D image in the HF (head-feet) direction.
"F" on the keyboard Display the 3D image in the FH (feet-head) direction.
"↑" on the keyboard Rotate the 3D image in the upward direction. For 2D image, perform paging in
the forward direction.
"↓" on the keyboard Rotate the 3D image in the downward direction. For 2D image, perform paging in
the backward direction.
"→" on the keyboard Rotate the 3D image in the right-hand direction. For 2D image, perform paging in
the forward direction.
"←" on the keyboard Rotate the 3D image in the left-hand direction. For 2D image, perform paging in
the backward direction.
F1 The response can be selected in the system settings. Refer to the [Operation]
section of [System settings].
F2 Send the selected image to the capture box as a color image. For the sent image,
adjustment of the window width and level cannot be performed in print preview.
The information (results for measuring tool, the text and figure tool, etc.) on the
image can be sent to the capture box.
F3 Send the selected image to the capture box as a monochrome image. For the sent
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image, adjustment of the window width and level can be performed in print
preview. The information (results for measuring tool, the text and figure tool, etc.)
on the image is not sent to the capture box.
This function cannot be used for color images such as 3D etc.
F4 Capture the entire main frame as one image, and send to the capture box.
F5–F12 Preset the value of the window width and level, and the value can be retrieved. By
Numeric keypad holding the Shift key and any key from F5 to F12, the value of the selected 2D
image window width and level can be registered to the key. When clicking the
registered key, the value of preset window width and level is applied to the 2D
image.
This registration and retrieval can be registered individually for each modality.
For the PET image supporting the SUV measurement, the upper and lower SUV
limit values can be registered and retrieved.
When capturing the entire main frame with the F4 key, if images for multiple studies exist in the screen, a dialog
appears for selecting a study to which the data is to be attached when the data is saved as a DICOM image.
Show/hide image information

Patient information, cube, and scale displayed in each image frame in the main frame can be set. Show/Hide for the
following information can be switched to by selecting [Display image information] from the right-click menu on the
image.
Hide all Patient information, analysis information, scale, and cube are all hidden.
Show all Patient information, analysis information, scale, and cube are all shown.
Show/Hide study Show or hide the study information.
information
Show/Hide analysis Switch the analysis information (the volume display in the [Observation] stage for
information the liver analysis application) to show/hide.
Show/Hide scale bar Switch the scale in the right-side of image frame to show/hide.
Show/Hide cube Switch the cube in the right-side of image frame to show/hide.
Show/Hide Show or hide measurement and annotation in an image frame.
measurement and
annotation
Show/Hide colorbar Switch the color bar on the left-side of image frame to show/hide. This menu is
only shown when the color bar is displayed.
Show/Hide rotation Switch the rotation center in 3D image frame to show/hide. It is shown only
center during mouse operation (3D display only).
Change corner The display information on the four corners can be switched to the predetermined
information information. This setting can be configured with "System settings".
The unit under the scale represents the increment between scale marks. It does not indicate the total length.
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Initial display setting

ON/OFF status and settings of each button, the display status of the group box displayed in the tool frame, etc. can
be registered as an initial value and can be reset. When registered, the setting becomes active from the next startup.
The setting can be configured by selecting [Default setting] → [Initial display setting] from the right-click menu on
each image frame.
Show captured area

Explicit display of the captured area in each image frame of the main frame can be set. Show/Hide for captured
area can be switched by selecting [Show captured area] from the right-click menu on each image frame.
Output file to the desktop

Each image in the main frame can be saved in a general-purpose image format. Select [Other] → [Save captured
image] from the right-click menu on each image frame. Enter the required information in the [Output filename]
dialog, and output the image.
As personal information of the patient may be included in image, sufficient care is required in handling it when
outputting it to the desktop or copying it to the clipboard.
Save mask applied image

In the 3D viewer application, a signal value specified by user can be forcibly stored into a hidden area (non-masked
area), and the image is saved as a new series image, by selecting [Other] → [Save mask applied image] on the right-
click menu on each image frame.
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In "Save mask applied image", the signal value actually taken will be replaced with a signal value specified by a
specific user. Be careful about handling the saved images.
Application Frame
From the application frame, you can execute macros, reset the analysis status, create reports, save snapshots, or
perform other tasks for the currently running application.
Change the layout of the main frame. This might not be displayed depending on the analysis
application.
Display the live template. For details, refer to the chapter of the live template.
Macros can be registered, executed, or deleted.
Reset the application status to the initial status at the time of reading the image.
Create a report. For details, refer to the explanations for reports of each application.
Save the current work status (mask region, various measurements, annotations, etc.). A saved work
status file is called a snapshot. The current work status can be restored by opening the snapshot even
after the application is terminated.
Method for saving snapshot

When the snapshot is saved, the following attributes can be set.
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Snapshot name Enter the name of the snapshot. In the study list, the entered name will be
displayed in the series list.
Snapshot type When multiple applications are opened, which application is to be saved can be
specified individually. When a snapshot has been saved once or more in the past,
whether or not to overwrite the snapshot can also be specified.
In addition, only when "Specify existence of image when saving snapshot" in
"Save image" of "Workstation setting" is set to "Yes", the following attributes can
be set.
• With original image
In addition to the mask region and each measuring result etc., the original
image is also saved as a single DICOM file at the same time. Therefore, if
the original image is deleted from the local data, the data in process can be
restored only from this snapshot. However, the file size is larger.
• Without original image (Default)
Save various measurement results and other information. File sizes are
smaller and saving is faster than [With original image]. However, if the
original image does not exist in the local PC, the snapshot cannot be
opened.
A saved snapshot is displayed on the study window as one series belonging to the respective study.
A snapshot does not save all the information. Therefore, a part of the display attributes, operation steps, etc. are
not restored.
Using macros
Macros are convenient when you always perform the same operations for particular image data.
Creating macros
Selecting to create a new macro from the macro button displays the following dialog.
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Before creating the macro After creating the macro
First, enter a macro name. Click the macro registration button to start recording the macro. In this mode, only
buttons and operations that can be used in a macro are available, and all tasks you do are automatically added to
the macro. To attach a message or image at a particular step as you create the macro, use the text box at the
bottom of the dialog, or paste a desired captured image in the image frame.
When the button in the dialog is in a selected state, image rotation is recorded relative to the initial rotation
state.
After you have finished all steps for the macro, click the register button again. Macro processing is now registered.
You can also assign your macro to a keyboard shortcut. Click the [Save] button to save the macro.
Executing macros
Macros you create can be executed by clicking the macro button and selecting the macro from the pull-down
menu. If you have assigned a keyboard shortcut, simply press the specified keys to execute the macro.
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Clicking [Execute] will display the macro dialog described above and automatically execute the macro on the
current image.
Editing macros
Steps in registered macros can be checked by clicking [Modify], which will display the macro dialog described
above. In this dialog, steps can be added or removed between existing steps or at the end by clicking the [Insert] or
[Add] buttons. Selecting a desired macro and then selecting [Pause] from the right-click menu will pause a macro in
progress when the selected macro is reached. In this modification mode, you can also check each step in a macro
by executing each command, one after another.
Organizing macros
The following dialog to organize the macro menu is displayed when you click the macro button and select [Setting]
from the pull-down menu.
A hierarchical structure is created on the left side of the dialog, with the macros and sub-levels of the selected level
listed at right. To change the items in the hierarchy, drag items from the right to a level on the left. The hierarchy
you create here is the basis for how the macro button pull-down menu is organized.
Add a new level below the selected level.
Rename the selected level.
Delete the selected level/macro. However, the button is displayed as unavailable if that level includes
macros in a lower level.
Make a copy of the selected macro.
Move the selected item up.
Move the selected item down.
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Tool Bar
This is the region where the buttons of each tool are displayed. When these buttons are clicked, a dedicated
operation screen is displayed for the tool frame and various additional functions can be used.
Buttons such as the ones shown below are arranged at the top and bottom of the toolbar.
The tool frame can be switched to Show/Hide.

The template frame can be switched to Show/Hide.
Tool Frame
This region displays the operation screen for the currently selected tool. The frame contents are switched each time
the tool is switched.
Template Frame
The template frame can be used for operating and managing the mask region, template setting for 3D image
volume rendering, change of the rendering method, adjustment of the 2D image window width and level, and
other settings. The contents displayed in this region are switched according to the selected image frame and the
application.
The functions divided into the following groups can be used in the template frame.
Mask management Effective with any Management of up to 12 masks, multimask display,

image operations between masks, etc. can be performed.
Rendering Effective with The 3D rendering method and the rendering method for
oblique and 3D plane display with slab thickness can be specified.
image
Mask operation Effective with any Mask operations such as Dilate, Erode, Invert, as well as Undo
image and Redo can be performed.
Template Effective with any 3D image templates can be changed or edited. For 2D
image images, WL presets can be selected.
Others Effective with any Some filters can be applied to an image. The rendering
image accuracy while a 3D image is moving also can be specified.
For details on mask management, refer to Mask management
For details on rendering, refer to Rendering
Depending on the analysis application, some of the above groups may not be used.
Mask Operation Group

The basic operations for the mask region can be performed.
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Display the mask region of a 3D rendering target as an overlay on the 2D image. Switch show/hide
with the button, and also its overlay rate can be specified with the slider.
Dilate 1 voxel for the current mask region.
Erode 1 voxel for the current mask region.
The current mask region can be inverted.
The current mask region is cleared, and the original image can be displayed to completely fill the
screen.
Undo the previous mask operation.
Cancel undoing the previous mask operation.
The mask operation history can be seen without returning the operation back and forth each time
with the [Undo] and [Redo] button. The history of up to 8 operations can be managed.
The 2D image information of the original image may become difficult to see when displaying the mask region by
clicking [Display mask].
Template Group
2D image template
The 2D image template appears when the 2D image frame is selected. The settings of the registration and retrieval
of presets for window width and level, the adjustment of window width and level, the mask display rate, etc. are
displayed.
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Select WL preset
Registered presets can be retrieved from the icon list of the window width and level. Window width and level can
be registered by exposed body part, etc.
Window width, window level, and the pseudo-color information of the currently selected image can
be registered as a preset.
Delete the currently selected preset.
Exported preset files can be imported.
The current preset can be exported.
WL preset icons can be dragged to change the order of the presets.
Edit WL
When the template group button is clicked, the dialog for editing window width and level with the image
histogram appears.
On a graph, when each of two control points is dragged, the control points can be dislocated. When the center
between two control points is dragged, the window level can be changed while the window width remains as it is.
In addition, the display range can be changed with the slider at the bottom.
3D image template
When the image frame of a 3D image is selected, the icon list of the preset color templates and group of buttons
for editing templates are displayed in the template frame.
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Select color template

A color template can be applied to the current 3D image by clicking the color template you wish to apply in the
icon list of the color templates. Color templates also can be managed in groups by the exposed body part, etc.
The color template for the currently selected image can be registered as a preset.
The current color template can be deleted.
2D images are displayed in color based on color templates applied to 3D images. Because the opacity
value is ignored, a portion hidden in the 3D image is colored in the MPR color display.
Copy the current color template.
Paste the current color template.
Exported color template files can be imported.
The current color template can be exported.
Edit color
Details of the current color template can be changed by clicking the button in the template group.
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The white curve on the graph is a histogram plotting the signal value and the appearance frequency for that signal
value. A higher value indicates a larger number of voxels with that signal value.
The yellow line on the graph is an opacity line showing the signal value and the opacity for that signal value.
Opacity means how opaque the respective signal value is, and with a lower opacity, the voxel having that signal
value becomes more transparent with volume rendering. When this value is 0, it becomes completely transparent
and the voxels are no longer displayed in the result of volume rendering. When it is 1, it is completely opaque, and
it is semitransparent with the value between 1 and 0.
The colored bar region under the graph shows the color corresponding to the signal value. This decides the color
with which a given signal value is drawn with volume rendering. The color can be changed by clicking the color
specification region and changing the assigned color. By double-clicking on the graph, a new color border line can
be created at that position.
The shape of the opacity line can be selected from the button group on the right side of the graph. The opacity
display range can be changed with the vertical slider.
An opacity line with an arbitrary shape can be created. The shape of the opacity line can be modified
by dragging on the histogram.
Place the control point on the color border line, and create the opacity line. The shape of the opacity
line can be modified by dragging the control point vertically.
The opacity line in the right-upward direction can be created. The shape of the opacity line can be
modified by dragging the two control points horizontally.
The opacity line in the right-downward direction can be created. The shape of the opacity line can be
modified by dragging the two control points horizontally.
The opacity line that has the convex shape in the upward direction can be created. The shape of the
opacity line can be modified by dragging the four control points horizontally.
The opacity line that has the convex shape in the downward direction can be created. The shape of the
opacity line can be modified by dragging the four control points horizontally.
The color template display range can be adjusted, opacity lines can be moved, and other operations are available
from the sliders below the histogram.
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Display range of color Specify the signal range to show on the graph.
template
Center of opacity curve You can specify a position centered between two control points on
(Level) the opacity line.
Width of opacity curve You can specify the spacing between two control points on the
(Width) opacity line.
Rate of upper side of You can specify the proportion of the trapezoid's shorter base to its
opacity trapezoid curve longer base, whether on top or bottom.
(%)
Width of lower side of You can specify the length of the trapezoid's longer base, whether
opacity trapezoid curve on top or bottom.
Additionally, you can add, delete, and move border lines from the right-click menu on the histogram.
Create border line A new border line is set at the location of the specified value.
Modify border line The border line can be moved to the position of the specified value.
Delete current border The border line can be deleted.
line
Delete selected border Multiple border lines can be deleted by enclosing the group of border lines to be
lines deleted by right-dragging.
Delete all border lines All the set border lines can be deleted.
Cancel Close the right-click menu.
The following special operations can be performed for color template information by clicking the button.
Convert template to Without changing the opacity line, the assigned colors become black and white.
monochrome
Pseudo-color Pseudo-colors are applied to the color template. When the pseudo-color is
specified, the window width and level are also to be specified, and the specified
pseudo-color is applied to that range.
Fit opacity range to view When an opacity line that slants upward to the right, downward to the right, or
projects upward or downward is selected, a curve is created so that the control
points are arranged at regular intervals in the color template display range.
When opacity control points are outside the frame, use the window width and level tool to shift the color
template or use the special operation [Fit opacity range to view] function to display the control points in the frame.
Change color template properties
Click the button to view the [Color properties] dialog.
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Shade display setting for 3D images, adjustment of background color, shininess, direction, opacity, etc. can be
performed in this dialog. Each parameter can be changed by moving the slider, inputting the numerical values, etc.
• Shading
Specify whether or not to shade the 3D image. When shading, an object is displayed more sterically by using
the surface normal line information of the object.
• BG color
Set the background color for a 3D image. The color is applied by clicking the displayed color button.
• Ambient
In the real world, as light (sunlight, room light, etc.) is shined into areas where direct light cannot reach via
the indirect reflection of light, constant luminance is maintained. By the ambient light, the image can be
displayed as if an object is lightened from every direction. The value of ambient can be set within the range
of 0.00 to 1.00. When the value is closer to "1.00", the surface of the image will be displayed brighter.
When set to 0.25 degrees When set to 0.75 degrees
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• Diffusion
The attribute of light that is reflected diffusely on the surface of a 3D object. When the light comes in from a
vertical direction, it will be brighter, and when the light comes in closer to the horizontal direction, it will be
darker. The value of diffusion can be set within the range of 0.00 to 1.00. When the value is closer to "1.00",
the regions that reflect the light diffusely will be displayed brighter.
• Specular and Shininess
The attribute of light that displays glossiness on the surface of a 3D object. The amount of specular
reflection can be set within the range of 0.00 to 1.00. When the value is closer to "1.00", the image will be
glossy. The value of shininess can be set within the range of 0.01 to 1.00. When the value is closer to "0.01",
the specularly reflected region will be broadened.
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Set to Specular 1.00, Shininess 1.00 Set to Specular 1.00, Shininess 0.05
• Decay
When shining light into the darkness in the real world, close by areas get brighter and far away areas get
darker. Decay of light via the value of decay in accordance to the distance from the viewpoint can be
simulated. The value of decay can be set within the range of 0.000 to 1.000. When the value is closer to
"1.000", the farther region from the camera position is displayed darker.
This attribute can be set for the [SSD] rendering.
When [Decay] is specified, an object such as a block-shaped border line may be displayed more finely
depending on camera position, orientation, etc.
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• Opacity
The transparency for the set opacity line is set. The value can be set within the range of 0.00 to 1.00. When
the value is close to "0.00", the 3D image for the target mask region is displayed transparently.
• Gradation
The mixture rate of neighboring colors divided by the border line is set. The value for the gradation can be
set within the range of 0.00 to 1.00. When the value is closer to "1.00", the color near the border line is
mixed and displayed smoothly.
• Change lighting
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The direction of light can be changed. The initial position of light is set parallel to the sight direction. The
direction can be changed to a direction other than in the line of sight (up to 45° up, down, left, and right
from the front). Drag on the sphere, and the released position is set to the lighting position. The shading is
changed according to the lighting position. Click the [Initialize lighting] button when initializing the position
to the original point.
• Self shadow
In the real world, when light brightens a person or an object, shadows are reflected on the wall, ground, and
itself. The "Self shadow" reflects those shadows onto the 3D object. When the lighting direction is changed
to a direction other than the sight direction with the [Shade] rendering, the shadow reflects on the object
itself.
When [Self shadow] is set to ON When [Self shadow] is set to OFF
When the display method for a 3D image is [No shade] (when the [No shade] button is selected for [Shading]),
the attributes [Ambient], [Diffusion], [Specular], and [Shininess] and the light direction cannot be changed.
The danger of volume rendering

Volume rendering means assigning virtual colors and opacities to signal values of actual images (HU values for CT
image) for three-dimensional visualization. In this case, color and opacity can be specified subjectively by the user,
and caution is required when a third person makes judgments based only on the volume rendered image.
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For example, when the volume rendering is performed for tubular volume data with the signal values 300 and 400,
note that if opacity "0" is set for the signal value 300, and opacity "1" is set for the signal value 400 as shown in the
following figure, the display becomes smaller than the original size.
In 3D display, the shape of displayed objects changes according to opacity, color settings, and other factors. Note
that blood vessels or organs may be displayed finer or smaller than actual size.
Live template
When the button in the tool bar is clicked, the results of applying all color templates and WL presets in the
current group to the displayed image are displayed as thumbnails. How the image will be displayed can be verified
with the thumbnails.
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Etc. Groups
The following operations can be performed for images or screens.
Filter A filter reducing the image noise can be applied to an original image. For images
with a bad S/N ratio, images with low contrast, etc., 3D display of the images may
result in the unclear borders of the target locations. By applying this smoothing
filter, the noise of the original image can be reduced and the borders of the 3D
display can be displayed comparatively smoothly. The filter strength can be
selected from [Soft], [Medium], [Strong], and [Contour smoothing]. And also, the
edge enhancing filters can be used.
Image quality during The image quality of the 3D display during operation (panning, zoom-in, zoom-
motion out, rotation, etc.) is set. The display resolution increases with a higher quality, but
the image update becomes slower. The image quality increases in the order
shown below.
[Very low] → [Low] → [Medium] → [High] → [Very high]
Contour smoothing filter

A contact portion between a bone and blood vessels cannot be displayed with smooth surface in 3D image due to
characteristics of the volume rendering, even if the area of blood vessels at the contact portion are completely and
correctly extracted as a mask. In such case, by using filter, the signal values of areas except blood vessels (mask) are
temporarily set to 0 (zero), and an image only of the blood vessels are virtually generated; thus a smooth 3D image
of the blood vessel area can be displayed.
When [Contour smoothing] is set to OFF When [Contour smoothing] is set to ON
Low dose noise reduction

Low-dose CT images may be affected by particular type of noise. Such noise can be reduced by this filter, to
produce images less affected by the noise of low-dose CT imaging.
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When [Low dose noise reduction] is set to OFF When [Low dose noise reduction] is set to ON
Because this filter is designed to reduce the noise sometimes found in low-dose images, it may not reduce certain
patterns of noise, or noise that was enhanced by reconstruction functions.
When [Filtering] is applied, the signal values of the original image are changed. Each measuring value also differs
from the original value. Especially, when using this filter, note that the [Contour smoothing] filter is for visualizing
the image in 3D, setting the signal values of the area other than the targeted area to 0, and changing the signal
values of the peripheral area of the targeted area.
When an image is captured as a monochrome image or reformatted with the [Filtering] applied and saved as a
DICOM image, the signal values are saved differently from the original image because of the filer. When the signal
value is measured for the image, note that the results will be different from the conventional measuring values.
When an image is captured as a monochrome image or reformatted with the [Filtering] applied and saved as a
DICOM image, you may not be able to identify whether the saved image was created with the filtered image or
with the original image in condition that the display status of the image was not appropriate. Please be careful to
deal with the saved image.
System Frame
The system frame can be used to display the study list screen, print preview/capture box, or system settings, to
close workstation applications, or to access online help. The system frame also shows a list of running applications,
a memory usage pie chart, the current user's login name, DICOM communication status, status of the local server,
and the current time.
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Display the study list. This can be used to display a study list on an application during work. The
screen can be switched to the study list without exiting from the application.
Display the capture box/print preview. A captured image can be saved to a local disk as a general-
purpose image or as a DICOM image, and it can be transferred to the network. An image can also be
added to print preview and can be printed by a Windows printer or a DICOM printer.
Display online help. The help screen for the presently working application screen, etc. is displayed.
Display the system settings. The settings for the presently working application, etc. can be changed.
Exit from the workstation after exiting from all applications.
Application switching
This workstation can start up to five applications simultaneously. To switch applications, click the application icon in
the system frame.
Display present time and connection status

When the workstation is receiving images from a remote server or when it is transmitting to a remote server, the
communication status is displayed in the system frame. The present time of the PC is displayed when the
workstation is not communicating.
When the local server is down, "Local server is down" is displayed.
In the normal state, an enlarged view can be displayed in a tool tip by hovering the cursor over an element.
Some time after the last snapshot was saved, a message to save another snapshot is displayed in analysis that
supports snapshots.
Note that the current time in the system frame may be inaccurate when the computer battery is low, or in other
situations. To avoid assigning the same ID to images created by the system if the time in the system frame is frozen,
resolve this issue immediately.
Display of the amount of memory

The amount of memory presently being used by the workstation is displayed as a pie chart. When there is no more
free memory, additional applications cannot be started and work may be impaired, so unnecessary applications
should be exited.
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Basic Operation in Each Viewer

Axial, coronal, sagittal and oblique plane display
Mouse operation Revision

Wheel scroll Move the display plane front and back.
Right-drag Adjust the window width and level.
Left-drag while holding the Pan the plane display.
Shift key
Wheel scroll while holding the Change the zoom rate of plane display.
Shift key
Right-click while holding the Temporarily switch between 3 modes: "Window width and level" → "Zoom
left button rate" → "Pan."
Click the center button and Perform cine playback forward and backward depending on whether the
drag vertically mouse is placed over or under the center of the image frame.
Drag vertically while holding Perform high-speed paging.
the center button
Drag horizontally while holding Change the slab thickness only when the oblique cross section is displayed.
the center button
3D display

Wheel scroll
Change the zoom rate.
Vertical right-drag Pan the set color template.

Left-drag while holding the Shift key Pan the 3D display position.
Right-click while holding the left Temporarily switch between 3 modes: "Shift color template" → "Zoom
button rate" → "Pan."
Left-drag over the center area of the Rotate the 3D image to the direction the mouse was moved.
screen
Click the center button and drag Rotate automatically leftward and rightward depending on whether
horizontally the mouse is placed left or right of the center of the image frame.
Horizontal left-drag over the upper Rotate the 3D image horizontally.
and lower edge of the screen
Vertical left-drag over the left and Rotate the 3D image vertically.
right edge of the screen
Left-drag over any corner of the Rotate the 3D image while the front view does not change.
screen
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Curved MPR plane displaying

Right-drag Adjust the window width and level.
Left-drag while holding the Shift key Pan the plane display.
Wheel scroll while holding the Shift Change the zoom rate of plane display.
key
Right-click while holding the left Temporarily switch between 3 modes: "Window width and level" →
button "Zoom rate" → "Pan".
Drag horizontally while holding the Change the slab thickness.
center button
Left-drag over any corner of the screen Rotate the curved MPR image.
The operation may be different from the basic operations mentioned above depending on the application used.
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3.2.2 Print and Save

The captured image is printed by the DICOM printer or a Windows printer. It can also be saved as a DICOM image
or as a general-purpose image. Printing and saving can be performed in the system frame.
Open the Image Save/Print dialog. The captured image can be saved as a DICOM image or as a
general-purpose image and printed by the DICOM printer or a Windows printer.
An image is registered to the capture box or to the print preview by capturing the image in each application. The
image can also be sent directly from the study list.
In the Image Save/Print dialog, print information is managed for each patient. To switch the print information of a
patient being analyzed to that of another, use the combo box at the upper left of the dialog. To delete all the print
information of the patient, click the "Delete" button.
In the Image Save/Print dialog, when the print function is not used, the print preview can be hidden. This setting
can be switched by switching ON/OFF the [Show print frame] button at the lower left of the dialog.
[Show print frame] is "ON" [Show print frame] is "OFF"
A Preview Zoomed display of the image selected in the capture box.

B Capture Box List of the images sent to the capture box.
C Storage region Save an image as a DICOM image, send image to external DICOM devices, etc.
D Print Preview Print preview is displayed in the selected layout.
E Print controller region Set the various settings for printing.
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Capture Box
The images captured in each application are sent to the capture box. The capture box can be used to verify the
captured images, to save only required images as DICOM images, or to send images to a different server.
Thumbnails of color images sent to the capture box are labeled with in the upper-right corner.
Display settings for information in corners

The information displayed in corners when images are captured can be hidden in the capture box. This status can
be changed from the right-click menu on an thumbnail, and the current display status is indicated by an icon ( ) in
the upper left of the thumbnail.
Save as a DICOM image and print the image in the captured state. (Default)
Save as DICOM image and print the image including information displayed in corners.
(Displayed with yellow )
Save as DICOM image and print the image without information displayed in corners.
(Displayed with gray )
When an image is captured with corner information hidden, displaying or hiding the corner information cannot be
changed.
Edit captured images

Arbitrary lines or texts can be added to captured images by selecting "Edit image" from the right-click menu on an
icon image in the capture box.
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The following various image editing can be performed.
Draw a straight line, specifying line width, a type (dotted or solid), and color (a signal value for a
monochrome image).
Draw a line freehand, specifying line width, a type (dotted or solid), and color (a signal value for a
monochrome image).
Draw a rectangle, specifying line width, a shape (frame only or paint out), and color (a signal value for
a monochrome image).
Draw an oval, specifying line width, a shape (frame only or paint out), and color (a signal value for a
monochrome image).
Write texts, specifying a font, a font size, and color (a signal value for a monochrome image).
In addition, the following operation can be performed for each object drawn on the image.
Move the selected object.
Resize the selected object. However, freehand lines and texts cannot be resized. Ovals can be
changed in size by picking up around the corner of its circumscribed rectangle.
Copy the selected object. While the copy button is on, drag each object to generate a copy and
move the copy.
Undo the last operation.
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Redo the undone operation.
Delete all the drawn objects.
By default, information shown on an image when it was captured, such as information in the corners, memory
display, and cube display, are all hidden. To show them, check the "Show information on image" checkbox.
Additionally, by clicking the button at the lower left of the dialog, you can reset or register the current
drawing attributes (such as line width, font, and other details) as defaults.
Once the image is saved and the dialog is closed, the drawn objects are written to the image. Therefore, note that,
even if the Image Edit dialog is opened again, the written information cannot be deleted.
Operate the capture box

The following operations can be performed with the buttons at the bottom of the capture box.
Move the selected image one position forward.
Move the selected image one position back.
Change the series description of the selected image. The series description can be specified by
directly entering texts or selecting the pre-registered texts.
Delete the selected image from the list.
Select all the images in the list.
Add the selected images to print preview.
Besides the above, when selecting three images or more on the list and displaying the right-click menu, the
number of selected images can be narrowed to one to nine. In addition, when a captured image is a fused one of
multiple modality images, the modality type of the image to be saved can also be changed from the right-click
menu on the image.
When an image is deleted from the capture box, the print preview screen is cleared once. Therefore, deleting
images while printing is not recommended.
Images can be pasted into the report dialog from the right-click menu when the image is selected. However, the
menu is not displayed unless the report dialog is displayed.
Save images
The selected image can be saved by clicking the [Save] button after the image save method has been specified via
the combo box in the storage region. The save method can be selected from the following.
Save as a general image Save the selected image in a general-purpose image format such as JPEG,
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PNG and BMP.

Save as a DICOM image on local Save the selected image as a DICOM image on local disk. The series No. is
disk reissued.
Save as a DICOM image and Save the selected image as a DICOM image on local disk and send it to
send to XXXX the specified server (XXXX).
When saving as a DICOM image on local disk, the numbering method (Auto/Manual) can be changed in the
system settings.
Multiple images can be selected simultaneously by selecting the images in the capture box while holding the Ctrl
key or Shift key on the keyboard.
Print Preview
In the print preview, images can be output to the DICOM printer or a Windows printer in the selected layout.
Operations on a preview image

The following operations can be performed on a preview image.
Zooming The image can be zoomed in or out by operating the mouse wheel on the image.
Changing window width Window width and level can be changed by dragging the mouse up, down, left, or
and level right on the image while holding the right button. However, this operation cannot
be performed on a color image captured with the F2 key, etc.
Panning Image can be panned by dragging up, down, left or right on the image.
Switching images When the mouse cursor is moved to the four corners on the image, the shape of
the cursor changes. With the cursor, drag an image frame to another frame and
release the left button to switch the positions of the frames.
Converting color image A color image can be converted to monochrome. This operation converts the
to monochrome color image to a monochrome image, but not to a 2-byte image.
Resetting zooming and The zooming and panning components can be reset to the initial value from the
panning right-click menu.
Set zoom rate The zoom rate of images can be specified numerically from the right-click menu.
Changing displayed ON/OFF of the corner information, the scale information, and the cube
information information can be specified from the right-click menu.
Specifying positioning A positioning image for drawing a reference line can be specified. For details, refer
image to "Draw reference lines".
The following operations can be performed for images in print preview from the tool bar at the top. These
operations are applied only to images selected in the preview screen.
Insert a blank frame before the selected frame. When multiple frames have been selected, the blank
frame is inserted before the frame lastly selected.
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Select all the data sent to the print preview.
Reset all the selection on the print preview.
Delete the selected frame.
Delete the presently displayed page.
Delete all the data sent to the print preview.
Specify whether or not to draw boundary lines between images when printing.
Specify whether or not to create the footer region under the print region. In the footer region, logo,
patient name, patient ID, and page No. are printed.
Specify whether or not to create a margin on the left side of the print region.
Select a method for drawing reference lines on a positioning image (scout image). The button gets
effective only when there are images for which reference lines can be drawn.
Register the current display conditions of the frame, footer, and margin, and information of the printer
to output as an initial value, or reset them. The print preview with the registered settings is displayed
from the next startup.
Display the DICOM print queue dialog.
Multiple images can be selected simultaneously when images are selected in [Preview] while holding the Ctrl key
or Shift key on the keyboard.
Draw reference lines

The position of tomogram images can be drawn as reference lines on a positioning image by dragging the
positioning image and the tomogram images from the study list and sending them to print preview. Reference
lines are drawn with the image numbers of the corresponding tomogram images.
Although, basically, the positioning image is automatically detected, it can also be explicitly specified from the
right-click menu on the print preview image.
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The reference lines are displayed between images for which the Frames of Reference UID described in the DICOM
header information match.
DICOM print queue

The [DICOM print queue] dialog opens when the DICOM print queue dialog display button is clicked in print
preview.
In the [DICOM print queue] dialog, a list of print instructions to the DICOM printer is displayed. The meanings of
each status are shown below.
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Sending Displayed while being printed.

Finished Displayed when printing has been finished.
Error Displayed when printing failed.
Canceled Displayed when printing was canceled with the [Cancel] button.
None Indicate that the image has not yet printed.
Printing can be canceled by selecting data waiting to be printed or being printed and clicking the [Cancel] button.
However, depending on the timing, it might not be canceled in time.
Output to DICOM or Windows printer

The following procedures are performed for printing with the DICOM printer or a Windows printer.
1. Select the print layout with the [Layout selection]
2. Switch the display page by moving the [Page control] slider and preview each page
3. Select the printer via [Target printer]

By selecting [DICOM file], you can also save the print image as-is, as a DICOM file.
4. Specify the pages to be printed via [Print page]
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All Print all the pages.

Current Print only the current page.
page
Specify Print only the specified range of pages by entering the starting and ending page numbers in
page the text field.
5. With [Others], set the information necessary for printing
Copies Specify how many copies to print.

Print direction Specify the print orientation (Portrait or landscape).
Film Specify the film size to print.
6. Click the [Start printing] button to start printing
[Film] is available only when the target printer is a DICOM printer. In addition, images might not be printed as
specified due to reasons such as operational differences among printers models, the size of film specified cannot
be used, etc.
To output to a Windows printer, the Windows printer must have been registered and connected to the PC.
Depending on the PC settings and the connection status, normal printing may not be possible.
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3.2.3 Console
Enables observation integrating images and analysis results.
Startup
Console mode can be started in either of the following ways.
Note that a console display preset must be registered in advance on the settings screen. Refer to the [System
settings] for details.
Startup from study lists

Startup from study lists is possible as follows.
1. Register a console preset in [System settings]
2. In [System settings], select a preset for initial console display
3. In the study list, double-click the study to display in a console view
Switching between normal analysis mode and console mode

• Switching from normal analysis mode to console mode
Two methods of switching are available, and you can switch from the viewer as follows. Note that only items
available to switch to in analysis states compatible with console mode are shown.
1. In analysis currently displayed, right-click a viewer showing an image
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2. From [Analysis mode], click [Console]
Switch from the frame as follows.
1. Register a console preset in [System settings]
2. In [System settings], select a preset for initial console display
3. Start up analysis and perform analysis as needed
4. Click the button to add analysis
5. Click the button to switch to console mode
• Switching from console mode to normal analysis mode
Two methods of switching are available, and you can switch from the viewer as follows.
1. In analysis currently displayed, right-click a viewer showing an image
2. From [Analysis mode], click [Normal analysis mode]
Switch from the frame as follows.
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1. Click the button to switch modes
2. Click the button to switch to analysis mode
The button for switching from analysis mode to console mode is only displayed under conditions when switching
is possible.
Nothing is displayed unless the corresponding images or snapshots exist, even if analysis is arranged using a
preset.
Basic operation
Analysis and display operations are available from the context menu.
Home Enables switching to the analysis mouse mode set as the home function.
(Application)
Specific functions Provides specific functions for analysis or mouse tools. Available options depend on the
current mouse mode.
Analysis For analysis that can be compared to past studies, choose a past study to switch to
comparative display.
To switch to the current study, click the selected results to clear the selection status, or
click [Return to current study display].
Measurement Enables measurement corresponding viewer content.
Annotation Enables annotation corresponding to viewer content.
For details on specific analysis functions involved in display and operations, refer to each analysis item.
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Change images or snapshots
Click the button at the top right of the main frame to display a list of studies and associated images and
snapshots for the current analysis and the same patient ID.
The study for a different patient may be displayed as the study of the same patient in the related study list if the
both patients have the same patient ID.
Change images or snapshots as follows.
1. Select an analysis task or study in the study list
2. Select an image, snapshot, or analysis task
Images DICOM images.
Snapshots Saved snapshots. An analysis icon is shown in the upper left.
Analysis The currently opened analysis. Choose from tasks currently shown in
task console mode or currently under analysis in analysis mode.
3. Drag to the frame for display
Multiple DICOM images to use at startup can be selected, in the following ways.
• Double-click images in the list
The images are registered, and a mark indicating selection is shown in the upper right of the images.
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• Register images in the image dialog
Click the button on the right edge to view the image registration dialog.
Images can be dragged to register them. When images are registered, the dialog display button changes to
a button.
List operations are as follows.
Delete Remove the selected image.
Delete All Remove all registered images.
3D Viewer starts up if a DICOM image is selected. Selecting multiple images will start Oncology Viewer.
Starting new analysis

General analysis can be started in the same frame where images are used in current analysis.
To view general applications that are available, select [Applications] in the context menu.
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Ending normal analysis

Analysis running normally can be ended when necessary.
Analysis can be ended by selecting a task in the study list and right-clicking the analysis.
Register layouts
Display layouts in some analysis can be registered by selecting [Default setting] → [Layout] from the right-click
menu. The display layout can be read or reset.
It can also be applied to analysis that is started from images, when synchronized startup is used.
Preset
Console display follows presets. Display can be switched all at once using a preset, and display can be registered to
presets.
Switch presets
Select a registered preset in the system settings to switch to the display registered in the selected preset.
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Register presets
Click the register button to register the current analysis, layout, and analysis mode or layout of each analysis
to the currently selected preset.
The registered information will be applied the next time you apply the preset.
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3.2.4 System Settings

Set the behavior and display of workstation.
Configure settings in the [System settings] dialog, accessed by clicking the button in the system frame.
Click the [Apply] button to apply changes. Depending on the settings that were changed, you may be asked to
restart the workstation.
The settings can be reset to the recommended settings by clicking the [Initialize] button which is displayed when a
specific item is selected.
Depending on the settings, you may need to restart the workstation to apply changes.
General
Set the general settings of the workstation.
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GUI design Set the screen design of the workstation.
• Dark
The tone of the entire screen design becomes dark.
• Light
The tone of the entire screen design becomes light.
Language Set the language used by the workstation.
• System default
Use the default language of the operating system.
• ENGLISH/JAPANESE (individual languages)
Use the selected language.
Extend undo buffer Set the possible number of undoes for mask editing.
• OFF
The number of undoes is limited to one undo.
• ON
The number of undoes can be set to eight undoes. The amount of memory
used per image increases accordingly.
Timing on saving initial

• When application is closed (Auto)
display settings
Save the settings as a default when the application is closed.
• When user instructs (Manual)
Save the settings as a default with the right-click menu on the image frame
([Others] → [Initial display setting] → [Register]).
Save tool selection in Specify whether to save the tool selection state when initial display settings are
initial display settings saved.
Thumbnail slices for Specify the number of slices that can be paged on the image selection dialog in a
paging range of 1–20.
Show all the messages Reset the setting of messages for which [Do not ask me again] has been checked
again on the dialog to display the messages again.
Initialize all settings Reset all settings in [System settings] to their initial factory settings.
Product information As information on the product, the version No. of the workstation, UDI
information, and the usable applications can be verified. Also, the libraries used in
the workstation and the support information are displayed.
Even when [Extend undo buffer] is set to [ON], the number of undoes may become less than eight when mask
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editing is performed during multi-mask display. Also, when the free memory capacity is not sufficient, the undo
buffer cannot be expanded and undo may not be possible.
When the [Initialize all settings] button is clicked, all color templates, tool settings, and all information are reset to
factory settings. Be careful when using this feature.
Template
Set the template for the 2D and 3D display.
Edit template groups

A group of multiple templates by body part or purpose is managed as a template group. The template group is
prepared for each modality. The template groups for the 2D and 3D can be edited individually as [Window width
and level] group list and [Color template] group list respectively.
Add a new group.
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Rename the selected group.
Set condition to show the group.
Delete the selected group. All templates contained in the group will be deleted.
Change the order of the selected group.
Change the order of the selected group.
Clicking the button to modify group display conditions opens the following dialog. A template group matching all
registered DICOM header conditions is selected by default.
Template settings
Set settings for templates.
Register template name

• OFF
automatically
Enter a name when registering a color template.
• ON
A template name is automatically assigned when registering the color

template.
Load background color

• OFF
from color template
When a color template is selected, the information for color components
and opacity line is applied, but the background color is not applied.
• ON
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When a template is selected, the background color as well as the

information for color components and opacity line are applied.
Update color template

• OFF
in real time when
editing When editing a non freehand opacity line, the editing result is shown on
the 3D image after the mouse button is released.
• ON
During opacity line editing, the editing result is shown in real time on the
3D image.
When freehand shape has been selected as the opacity line setting method, the editing result is applied after the
mouse button has been released, regardless of the setting for [Update color template in real time when editing].
Pseudo-color setting
Set the pseudo-colors used by the workstation. The following dialog is displayed when the [Pseudo-color setting]
button is clicked.
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Extra color Display all usable pseudo-color names.

Used color Display the pseudo-color names used by the workstation. The pseudo-colors
displayed here are displayed in the same order as in the pseudo-color selection
list of the [Window Width and Level (WL)] tool.
[→] Move the pseudo-color selected in the [Extra color] list to the [Used color] list.
Return the pseudo-color selected in the [Used color] list to the [Extra color] list.
[↑] [↓] Change the display order of the pseudo-color selected in the [Used color] list.
The settings are applied instantly when the [Apply] button in the [Pseudo-color setting] dialog is clicked.
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Classification-color setting
Set the classification colors used by the workstation. The following dialog is displayed when the [Classified-color
setting] button is clicked. A correspondence table of the signal values and colors for the Classification color display
is created, here.
Add a new classification.
Edit contents of the selected classification.
Copy the selected classification.
Delete the selected classification.
Move the selected classification up.
Move the selected classification down.
The names displayed in [Classified-color] of the tool frame of the [Window Width and Level (WL)] tool can be
changed from the classification name. Each line of the list on the left side shows the upper and lower limits of the
signal value, and the color on the left end of the line shows the field within the range.
The displayed color can be changed from the upper right part. The range of the signal value can be changed by
selecting a value and entering a number or using [Upper/Lower limit].
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Database
Set settings for database and study lists.
Automatically update
• OFF
study list upon receiving
new data Even when operations such as adding of images to a local disk or receiving
of images from a remote server are performed, the study list is not updated
as long as buttons such as the [All] button or the [Search] button are not
clicked. However, the study list is updated for snapshot saving and capture
image saving.
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• ON
The study list is updated automatically when images are added to a local
disk, when images are received from a remote server, when snapshots are
saved, or when capture images are saved, among other operations.
Days of retrieve date to When the [All] button is clicked on the local data screen, only the studies obtained
be displayed for full within predetermined number of days are displayed. When 0 (zero) is set, all the
search studies are displayed. Setting to 0 or large numbers increases the studies to
display, but lengthens the time to update the screen.
Maximum number of This is displayed only when the settings for the [Link with Synapse] have been set.
Synapse studies shown Set the maximum number of studies to display when the search results for
SYNAPSE are displayed in the study list.
Confirm when search
• OFF
condition for remote
server is empty Do not display a confirmation message when searching a remote server
without any search conditions. It may take time to respond.
• ON
Display a confirmation message saying whether or not to search when the

remote server is searched without any search conditions.
Representation of
• Single byte representation
patient names
Display only alphabetical notations.
• Ideographic representation
Display only ideographic notations.
• Phonetic representation
Display only phonetic notations.
• All
Display all information.
Format for export Specify the uncompressed format "Explicit VR Little Endian" or "Do not Change",
which depends on the setting on the DICOM server.
Use analysis result Specify whether to use the search from analysis results.
search
Folder structure for
• Output date/Patient ID(upper 8 character)
image output
Create an output date/time folder at the upper level and a name folder in it
using the first 8 characters of the patient ID, and store images in that
folder.
• Patient ID(upper 8 character)/Output date
Create a name folder using the first 8 characters of the patient ID at the
upper level and an output date/time folder folder in it, and store images in
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that folder.
• Patient ID/Output date[DICOM3 nonconformity]
Create a name folder using the patient ID at the upper level and an output
date/time folder folder in it, and store images in that folder. Note that the
length of folder names in this format does not conform to DICOM3
specifications.
When "Do not Change" is specified for the format for external output and the save format for DICOM images has
been set to Lossless JPEG on the DICOM server setting, output data may not be able to be retrieved by
workstations of other manufacturers.
Study/Series list setting

The following dialog is displayed when the [Study/Series list setting] button is clicked.
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Items to display in the study list in desktop or tablet versions are shown in the upper section, and items to display
in the series list are shown in the lower section. Checked items are displayed in the study list screen sequentially
from the top. Set the items to display in the study/series list by checking or unchecking the check column of each
item. The display order of the selected items also can be changed with the [↑] and [↓] button.
The settings are applied instantly when the [Apply] button in the [Study/Series list setting] dialog is clicked.
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Preset search condition

The following dialog will be displayed when the [Preset search condition] button is clicked.
A list of the set search conditions is displayed on the left, and the search conditions can be set on the right. The set
search conditions are added to the list if the search conditions have been set, a name has been entered into the
text column of [Condition name], and the [Add] button has been clicked. In addition, existing search conditions can
be deleted and over written, and the display order of the selected search condition can be changed with the [↑] and
[↓] buttons.
The following can be specified for Start date/End date.
YYYYMMDD The entered year, month, and day are applied.

TODAY The search execution date is applied.
Value of "-" (minus) The date with the entered number of days subtracted from the final date is
applied.
The settings are applied instantly when the [Apply] button in the [Preset search condition] dialog is clicked.
Output all DB comments

The comments entered into the study list or series list column can be output as one file. In addition, reading a
comment from an output file and applying the comment to the current local data is possible.
DICOM communication
The DICOM communication settings for the local servers, the remote servers, and the DICOM printers can be
confirmed. Also, whether or not communications with the remote server and the DICOM printer are established can
be confirmed.
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C-ECHO can be sent to the target device by selecting the target device and clicking the [Send Echo] button.
Communication always fails with devices not compatible with C-ECHO.
Remote server used in conjunction

You can configure the server to link for use within the application. When applications compatible with a linked
remote server are used, searching for related studies is not limited to local databases but includes studies on linked
remote servers.
Image load
Set settings for image loading.
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Modality information Specify whether image modalities are determined using [SOP class] or [Modality]
for loading image strings.
Assign a shortcut key to Assign the WL resetting to one of the numeric keys (0–9) with NumLock activated.
WL reset
Display method for Specify whether to display only the latest snapshot or all snapshots.
snapshots in same study
Additionally, the following settings are available for loading in each modality.
Default WL value in case Values to be applied when the DICOM header information does not have window
of no WL value in width and level values are specified. When the DICOM header information has
DICOM information window width and level values, the values in the DICOM header information are
applied.
Set default WL value Specify whether to set the default WL value as a percentage.
as % (NM only)
Assign the shortcut keys The preset window width and level to be assigned to the F5 to F12 keys are
(except for RTDOSE) specified. For the PET image supporting the SUV calculation, the upper SUV and
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lower SUV values are specified as preset values.

Pseudo-color Whether or not to display the image with a specific pseudo-color applied is
specified.
Enable to change the Specify whether to enable adjustment of the SUV correction coefficient or to
SUV correction always correct by body weight.
coefficient (PT only)
The following settings are also available for RTDOSE.
Settable minimum and Specify the minimum and maximum dose values that can be set, in Gy.
maximum of dose value
(GY).
Settable minimum and Specify the minimum and maximum dose values that can be set, in percents.
maximum of dose value
(%).
Display gray unit Choose [Gy] or [cGy] as the unit used for dose display.
Regardless of the settings, the default WL values for 8-bit images are 256 for the window width and 128 for the
level value.
Save images
Set settings for saving capture images and movies.
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SOP class of the capture

• Mixed
image
When a monochrome capture image is saved, the SOP class inherits the
SOP class of the original image. When a color capture image is saved, the
SOP class is saved as SC (Secondary Capture).
• All secondary
The SOP class of a captured image is always saved as SC (Secondary

Capture).
Information to be
• Image only
embedded to
monochrome captured The graphic information drawn on the image including comments and
images measurement are not applied to the monochrome captured image.
• Include other information
The graphic information such as comments and measurement drawn on

the image are embedded directly into the image. As for [Cube], [Scale], and
[Corner information], whether or not to embed the graphic information can
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individually be specified. This information is saved in monochrome. When

binary data is selected, it is saved at either the maximum or minimum
value. When multi-tone is selected, it is embedded in multi-tone format.
Save slice thickness

• OFF
when saving DICOM
images For the Slice Thickness (0018, 0050) of DICOM, a slice thickness of the
original image is saved.
• ON
For the Slice Thickness (0018, 0050) of DICOM, the specified slice (slab)
thickness is saved. However, when the specified slice (slab) thickness is
smaller than the slice interval or the pixel size, the smaller value of them is
saved. The original slice thickness is saved to the Derivation Description
(0008, 2111).
Save as
• ON
MONOCHROME1 when
saving wl reversed Save WL reversed images as MONOCHROME1 images.
image
• OFF
Save WL reversed images as MONOCHROME2 images.
Add extra information Set a series description when the DICOM images are saved to the workstation.
to series description
• None
The original series description is set.
• Append
Add extra information at the end of the original series description.
• Overwrite
Delete the original series description and set only the extra information.
Select information to Set the items to be set for the series description as extra information for creating
add images.
Maximum file size per Set the max. file size for saving as a DICOM file. When a snapshot and a movie to
single DICOM image be saved as a DICOM file exceeds this file size, these files cannot be saved. When
(MB) sending data to another remote server, the transmission may fail when the file
size is large, so a limit is set for the maximum size of DICOM files which can be
created by a workstation.
Method to increment Set the series No. incrementing method when saving DICOM images.
series number when
• Manual
saving as DICOM file
Save images, making it possible to enter the series number to the image
set to be saved. When the [Auto] button is ON in the series number setting,
a new series number different from that of other series is generated to save
the image.
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• Auto
Generate a new series number different from that of other series to save
the image set as a new series.
Input series description Specify how series descriptions and numbers are entered when DICOM images
and number in are saved by a macro.
executing macro
• Input for each execution
Enter series descriptions and numbers manually when DICOM images are
saved.
• Use information of macro creation
Use series descriptions and numbers entered at the time of macro creation
when DICOM images are saved.
Confirm to save Specify whether to display a confirmation message about saving snapshots when
snapshot when closing the application is closed.
application
• OFF
Do not display a confirmation message about saving snapshots.
• ON
Display a confirmation message about saving snapshots.
The method to deal with Specify whether original images are saved with snapshots.
original image when
• NOT include original image
saving snapshot
Always save snapshots without the original image (according to [Without
original image]).
• Include original image
Always save snapshots with the original image (according to [With original
image]).
• Ask when saving
Select [With original image] or [Without original image] snapshots are

saved.
Default method to save Specifies the default settings for saving when you want to re-save a snapshot that
snapshot if the old you created.
snapshot has been
• Save as new
existed
Save it as a new snapshot without deleting the original snapshot.
• Overwrite
Delete the original snapshot by overwriting it with the new snapshot.
STL format for saving Specify the save format for STL file output.
surface data
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• Binary STL
Output the STL file in binary
• ASCII STL
Output the STL file in ASCII
• Color STL
Output the STL file in ASCII format with color information.
MPEG bit-rate (Kbps) Set the data volume per second when saving movies in MPEG format. The image
quality is enhanced with greater values, but the file size also increases.
H.264 bit-rate (Kbps) Set the data volume per second when saving movies in H.264 format. The image
quality is enhanced with greater values, but the file size also increases.
Compression quality of Set the image quality when saving movies in WMV format. The image quality is
WMV (1-100) enhanced with greater values, but the file size also increases.
JPEG quality (1-99) Set the quality of image saving when images in JPEG format. The image quality is
enhanced with greater values, but the file size also increases.
Compression setting for Select the compression program when saving movies in AVI format.
AVI movie
Target Limit of contour Choose [No limit], [Every contour], [Every ROI], [Every slice], or [Total] as the
points when saving method of limiting the number of contour points when RT structure sets are
Structure Set saved.
Target of limit number Specify the maximum number of contour points when RT structure sets are saved.
of contour points when
saving Structure Set
RT ROI Interpreted Type Specify the RT ROI Interpreted Type used.
setting
The signal values in an image is directly changed when [Include other information] is specified in [Information to
be embedded to monochrome captured images]. Therefore, be careful about handling the image. Also, note that it
is against the DICOM3 standard in a precise sense.
Capture and Print

Set settings for capture and print.
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Storage for captured

• Capture box and report
images when making
report When the [Report settings] dialog is displayed, the captured images are
added to both the capture box and the report screen.
• Confirm on each occasion
When the [Report settings] dialog is displayed, a message appears to

confirm whether the captured image is added only to the capture box or
both the capture box and the report screen.
• Add image only to report
When the [Report settings] dialog is displayed, the captured image is

added to the report screen. When the [Report settings] screen is not
displayed, the captured image is added to the capture box.
Method for saving

• A4 Size
report as captured
image Capture reports as images with A4 proportions.
• Square size(white)
Capture reports as square images. White is embedded in the margins of

the report.
• Square size(black)
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Capture reports as square images. Black is embedded in the margins of the

report.
Action when printing or

• Keep dialog shown
saving on report dialog
The dialog remains open.
• Close dialog
The dialog is closed automatically once the button to execute processing is

clicked.
Add image to print

• OFF
preview when sending
the image to capture Captured images are added to the capture box.
box
• ON
Captured images are added to both the capture box and the print preview.
Save DICOM images Save the printed image as a DICOM image. The saved DICOM image is saved as a
automatically when new image series of a study to which the original image of the capture belongs.
printing
Action when printing Set the print processing of the blank part where no image is arranged the print
empty space preview.
• Fill with white image
The empty space is printed white.
• Fill with black image
The empty space is printed black.
Action when deleting Set the handling of deleted frames when images have been selected and deleted
image from print in the print preview.
preview
• Add empty space
The deleted frames become blank.
• Delete empty space
The images following a deleted frame are moved up.
Icon size in capture box Three sizes are available for thumbnail icons in the capture box.
Size calculation method Specify calculation method for captured image size.
for captured image
• Fixed square size
Capture a square image with a size specified in [Size of one side of

captured image].
• Auto-calculated size
Capture an image in a size specified by a short side with [Size of one side
of captured image] and a long side with a multiple of [Adjustment step for
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capturing image].
Size of one side of Set the size of the captured image in pixel. Choose from two sizes, the normal
captured image (256- capture resolution or high-resolution capture.
2048)
Adjustment step for When [Size calculation method for captured image] is set to [Auto-calculated
capturing image size], specify an adjustment size of a long side of the captured image. As an
example, when [Size of one side of captured image] is 512, and [Adjustment step
for capturing image] is 256, the capture size will be 512 x 512, 512 x 768, or 512 x
1024 depending on the aspect ratio of the target image for capturing.
Blank margin ratio for Even when the aspect ratio of the image to be captured differs from that of the
captures print preview frame, the image with a specified margin is captured to avoid
unnecessary blank space in printing.
Size of one side of full Set the size of screen captures captured by pressing the F4 key, in pixels.
screen captured image
(512-2048)
Size calculation method Specify the method of calculating image size for full-screen captures.
for capturing task card
• Fixed square size
Capture a square image with a size specified in [Size of one side of full
screen captured image].
• Displayed size
Capture an image in a size specified by a short side with [Size of one side
of full screen captured image] and a long side with a multiple of
[Adjustment step for capturing image].
With [Save DICOM images automatically when printing], images printed successfully are saved as DICOM images.
Images for which printing failed are not saved.
Automatic calculation of the image capture size

With this system, the frame size for image display is not a square. Because of this, when the size is captured as is,
DICOM images in various sizes are created. If [Size calculation method for captured image] is specified with [Fixed
square size], only inside of the square in the frame is captured, and the entire frame of the portrait cannot be
captured. In such a case, the entire frame of the portrait can be captured by specifying the calculation method to
be [Auto-calculated size].
The following example illustrates the processing for a 640×850 viewer with [Size of one side of normal captured
image] set to "512" and [Adjustment step for capturing image] set to "128."
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First, the image ratio is changed so that the shorter side becomes 512 pixels. In this case, the width is the shorter
side, so that this is set to 512 pixels. And, when the size is changed while maintaining the aspect ratio of the viewer,
the height becomes 680 pixels. Next, the largest size less than 680 pixels, and "512 plus a multiple of the pixel size
of 128 pixels" will be calculated. In this case, the size is set 512 + (128 x 1) = 640 pixels, and 512 x 640 is used for
the size of the captured image. This size is assumed to be the viewer size, the image is generated and captured
based on the size. As a result, parts at the top and bottom of the captured image will be missing.
As another problem, the aspect ratio of the viewer displaying the image to be captured can differ from the aspect
ratio of the frame in printing. In this case, blanks occur at the top and bottom or at the left and right. In
consideration of such cases, capturing is done with a larger size than that of the actual capture target, and when
displaying on a printer screen with a different aspect ratio, the extra region is displayed so as to avoid blank regions.
This corresponds to [Blank margin ratio for captures] and is specified as a ratio relative to the aspect ratio of the
original viewer size.
Image Display
Set settings for image display.
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Frame thickness Set the thickness of the image frame.

Font size of corner Set the font size for patient information displayed in the image frame.
information
Line interval of corner Set the line spacing for patient information displayed in the image frame.
information
Character highlight for Set the extent to highlighting the character contour for easier viewing of patient
corner information information at the four corners of the image frame.
Display position of Set the display position for the viewer name.
viewer name
Size of the central Set the size of the margin at the intersection of axes.
margin of cross lines
Draw the cross lines Specify how reference lines of cross-sectional planes are drawn on the three
only on the edges of the orthogonal cross-sections view and oblique view.
viewer
• OFF
Lines are drawn from edge to edge on the screen, leaving a space
equivalent to the [Size of the central margin of cross lines] setting near the
intersection of the three orthogonal cross-sections.
• ON
Restrict the drawing area to near the edges of the image frame. However,
mouse operations on lines are still possible.
Visualize mouse Specify the method for visualizing the areas near the axes where mouse
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operation area in operations can be used when the oblique view is displayed.
oblique view
• OFF
No visualization of the mouse operation area.
• ON
Visualize the mouse operation area only when the mouse cursor is on the
axes.
Definition of orthogonal
• Human body-based
direction
In case that the image is captured being inclined, specify top, bottom, left,
and right to the patient body. For example, when a head image that is
captured being tilted is viewed from the "front", the specification of an
orthogonal direction of the face image faces the anterior direction.
• Image-based
In case that the image is captured being inclined, specify top, bottom, left,
and right to the image. For example, when a head image that is captured
being tilted is viewed from the "front", a status where the image is inclined
from the "front" by the tilted angle is specified as anterior.
Character string for Change the texts that show a direction displayed on the cube showing an image
cubic orientation display direction.
Window width, level Set the order to display the window width and level when displaying them.
display
The method for setting Specify how the window width and level of NM images are displayed.
Window width/level of
• Value
NM images
Display the window width and level according to the value.
• %
Display the window width and level according to the proportion.
Use lossy compression Specify whether to use lossy compression for images being updated, when viewed
in HTML version in a browser.
• OFF
Do not use lossy images.
• ON
Use lossy images. Specify the image quality of lossy images in [Lossy
Quality].
Interpolation method of Specify the interpolation processing used to display cross-section images.
cross-section image
• Linear
Use linear interpolation.
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• Cubic
Use cubic interpolation.
Use different settings Specify whether to manage corner display in viewers differently for normal
between current display screens and captured images.
and captured image
Corner information setting

The DICOM information displayed in the image frame is set. The following dialog is displayed when the [Corner
information setting] button is clicked.
Add a new set of information for display.
Delete the current set of information.
Edit the current set of information.
Move the current set of information up in the list.
Move the current set of information down in the list.
Clicking an added or edited button displays the following dialog. Specify the DICOM information to display in the
image frame.
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The set of information specified for corner display can be switched by accessing [Display information] → [Change
corner information] from the right-click menu on images.
Name Enter a name for the set of information to display.

All information Display a list of the DICOM information which can be displayed at the four corners of an
image.
Display Display a list of the DICOM information which are set to be displayed at the four corners
information of an image frame.
[→] Add an item selected for [All information] to [Display information].
Cancel the selected display information item.
[↑] [↓] Change the display order for the selected display information item.
[TL][TR][BL][BR] Set one of the four corners at which of the selected display information item is to be
displayed.
Modality button Set the modality at which the selected display information item is to be displayed.
The settings are applied instantly when the [Apply] button in the [Corner information setting] dialog is clicked.
Information that can be displayed is essentially obtained from DICOM header information, but some information
specific to Synapse 3D such as the following is also available.
Viewer Name Display the viewer name defined for each viewer.
Angle Of Display the current rotation angle with LAO, CAU, etc. on the 3D and oblique viewers.
Rotation
Slab Thickness Display the current slab thickness on the oblique viewer.
Display Field Of Display the width and height of the current viewer in mm. During [Show captured area],
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View the width and height of the captured range is displayed.
Operation
Set settings for image operation.
F1 key operation Specify whether the F1 key on an analysis screen is used to show/hide the report
dialog or the help dialog.
Position of shortcut bar Specify whether to display the four shortcut bars of the active image frame inside
or outside (not overlapping) the image frame.
Grab range of control Specify the range (small, medium, or large) used to determine that a control point
point etc. is being grabbed.
Reverse paging Specify how pages of 2D images are scrolled in response to rotating the mouse
direction wheel, dragging with the middle mouse button, or pressing the "↑" or "↓" keys.
Paging for planes with the check box checked is performed in the opposite
direction of the initial setting.
About the operation for
Reverse paging direction
three oblique planes
Specify [Reverse paging direction] operation for each plane when the three
oblique planes are used.
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• OFF
Do not reverse paging.
• ON
Reverse the paging direction for all planes.
• Each plane
Enables selection of check boxes to specify whether paging is reversed for

each plane.
View axis rotation
Specify whether to enable operations that freely rotate the selected plane.
Rotation around cross line
Specify whether to enable operations to rotate the selected plane around an axis.
Reverse mouse motion The window width specification operation by dragging the mouse left and right is
effects on window width reversed.
Reverse mouse motion The window level specification operation by dragging the mouse up and down is
effects on window level reversed.
Reverse oblique tilting Reverse the change operation for the direction of the normal line of an oblique
operation plane.
Mouse operation mode Configure mouse operations used with the system.
Mouse operation Configure preset mouse operations.
Mouse operations
Configure preset operations in response to mouse actions.
Add a new preset.
Edit the process of the selected preset.
Duplicate the selected preset.
Delete the selected preset.
Clicking an add or edit button displays the following dialog. Specify operations in response to mouse actions.
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Preset name Enter a name for the mouse operation preset.

Left Button Specify the operation in response to left-clicking.
Specify [None], [Rotation], [WL], [Zoom], [Pan], [Paging], [Paging(Plane)+Rotation(3D)],
or [Slab thickness].
Middle Button Specify the operation in response to clicking the middle button.
Specify [None], [Special], [WL], [Zoom], [Pan], [Paging], [Paging(Plane)+Rotation(3D)], or
[Slab thickness].
Right Button Specify the operation in response to right-clicking.
Specify [None], [WL], [Zoom], [Pan], [Paging], [Paging(Plane)+Rotation(3D)], or [Slab
thickness].
Left and Right Specify the operation in response to clicking the left and right button together.
Button Specify [None], [WL], [Zoom], [Pan], [Paging], [Paging(Plane)+Rotation(3D)], or [Slab
thickness].
Wheel Specify the operation in response to rotating the wheel.
Specify [None], [Zoom], [Paging], or [Paging(Plane)+Zoom(3D)].
Double click Specify the operation in response to double-clicking.
Specify [None], [Maximize], or [Cine].
Operations are described below.
None The action has no effect.

Rotation Rotate the image.
WL Change the window width and level (for planes) or color template (for 3D
images).
Zoom Enlarge the image.
Pan Pan the image.
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Paging Perform paging (for planes) or move along the path (for CPR or virtual
endoscopic images).
Slab thickness Change the thickness of planes.
Paging(Plane)+Zoom(3D) Perform paging (for planes) or zooming (for 3D images).
Maximize Maximize the screen.
Cine Start cine playback.
Special Switch between paging and slab thickness operations, based on the direction of
dragging. Additionally, clicking starts automatic playback.
When mouse operations other than default operations have been configured, clicking the cube or corners and
dragging rotates the plane or 3D view.
Note that some restrictions apply to operations, depending on the type of image display or analysis.
Volume Rendering
Set settings for volume rendering.
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Quality of volume Set the image quality of 3D images during movement (during 3D display rotation,
rendering during panning, zooming, etc.). The image quality is enhanced in the order of [Very low]
operation → [Low] → [Medium] → [High] → [Very high], however the image update time is
lengthened accordingly.
Quality of virtual Set the image quality of virtual endoscopic view during movement (during 3D
endoscope during display rotation, panning, zooming, etc.). The image quality is enhanced in the
operation order of [Very low] → [Low] → [Medium] → [High] → [Very high], however the
image update time is lengthened accordingly.
Quality of Multi-3D Set the image quality of multi-3D images during movement (during 3D display
rendering during rotation, panning, zooming, etc.). The image quality is enhanced in the order of
operation [Very low] → [Low] → [Medium] → [High] → [Very high], however the image
update time is lengthened accordingly.
Quality of MIP display Specify the depthwise sampling interval for MIP display.
Mouse wheel behavior
• Default
for MIP display
Same operation as for non-MIP display.
• Horizontal rotation
Rotate horizontally.
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• Opposite horizontal rotation
Rotate horizontally in the opposite direction.
Dynamic progressive Adjust volume rendering and multi-3D image quality automatically so that the
image refresh interval screen update interval becomes the specified value. When 0 is specified, the
(ms) above set image quality is used at all times.
Method of calculating Set the shade display at the surface of the mask cut plane region.
mask surface normals
• From voxel
The normal line of the surface at the cut plane is calculated from the pixel
value of the neighboring voxel, and shading is performed. The processing
time is shorter in comparison with [From mask], but the surface of the cut
plane is displayed with roughness.
• From mask
The normal line of the surface at the cut plane is calculated from the mask
of the neighboring voxel, and shading is performed. In comparison with
[From voxel], the roughness of the mask boundary surface is suppressed.
When the mask has been cut in an inclined direction to the voxel, a
stepped grid shape will be displayed.
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Asynchronous volume
• OFF
rendering
When the 3D image is displayed again, operations such as the mouse
operation is disabled until the image with an image quality set as that
during movement is displayed.
• ON
When the 3D image is displayed again, the image display information is

updated before the image with an image quality set as that during
movement is displayed, and operations such as the mouse operation can
continued.
Move rotation center

• OFF
with pan
Keep rotation center at the image center, even if the 3D display has been
panned.
• ON
Move the rotation center to the screen center when 3D display has been
panned.
Speed of 3D rotation Set a degree of the rotation of the 3D image to the mouse travel when changing
the direction of the 3D image with the mouse.
Initial wheel speed in VE Set the initial travel of the virtual endoscopic camera when rotating the mouse
wheel.
Auto fly-through in VE Set the initial value of the [Fly-through] mode in the [Virtual endoscope] stage of
the 3D viewer.
• OFF
When rotating the mouse wheel on the virtual endoscopic image, the
camera position is moved in the viewing direction of the camera.
• ON
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When rotating the mouse wheel on the virtual endoscopic image, the
camera position is moved from the current position to the direction in
which there is no object to observe.
In lumens, it moves along the center of the lumens.
Initial display state of a

• Show inside
spherical object clip
Initial display state is to show inside spherical clip in spherical object
clipping mode.
• Show outside
Initial display state is to show outside spherical clip in spherical object

clipping mode.
Apply object clip for

• OFF
each mask
When multimask is displayed, the 3D object is clipped in the same range
for all the masks.
• ON
When multimask is displayed, a different clip can be applied to the 3D

object for each mask.
Synchronization method Specify the mouse operation used to adjust right up/down color templates.
for right up/down type
• independent
color template
Pan overlays by moving the mouse forward/backward, and adjust the
orientation by moving the mouse left/right. The color remains unchanged.
• synchronized
Pan overlays and colors by moving the mouse forward/backward, and

adjust the orientation by moving the mouse left/right.
Behavior in parallel Specify adjustment behavior in response to mouse operations for a right up/down
mouse move for right type color template in a 3D view.
up/down type color
• None
template
Dragging left or right has no effect.
• Adjust opacity
Dragging left or right adjusts opacity.
Synchronization for the

• OFF
icon in mask
management and Even when the 3D display changes, the mask management icon is not
current 3D display updated.
• ON
Update the mask management icon in response to changes of the 3D
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display.
Initial display state of Specify the surface-based calculation of SMIP display.

SMIP
• Damping
Dampen pixel values based on the distance from the surface.
• Depth
Restrict display to pixel values included in a range of distances from the

surface.
Interpolation method of Specify the method of interpolation for volume rendering.

volume rendering
• Image 1
Calculate interpolation based on pixel values and masks.
• Image 2
Calculate interpolation based on pixel values and apply improved

processing for mask edges.
• Color
Calculate interpolation based on color, with a color template applied to

pixel values.
Console
Set settings for console mode.
Preset Edit presets displayed in console mode.

Start up preset Specify the preset applied initially in console mode.
Launch by double Specify whether to start up in console mode when a study is double-clicked.
clicked a study
Edit preset
Configure presets by arranging how analysis is displayed on the screen.
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In [Name], switch to the preset to edit.
Add a new preset.
Edit the name of the selected preset.
Overwrite the selected preset.
Edit preset layouts as follows.
1. Adjust the number of divisions in the frames you will arrange
2. Select a position in which to arrange analysis
3. Select an analysis and drag it to a frame

(The same color is applied to analysis and the region arranged in the layout.)
4. Arrange analysis to fill all available regions
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Regions you have arranged can be removed by right-clicking analysis in the list.
When no analysis is currently selected, selecting a region arranged in the layout will select the corresponding
analysis.
When analysis has already been arranged and that analysis is currently selected, selecting the corresponding
position in the layout will remove the arranged analysis.
Analysis you have arranged can be cleared by clicking [Reset].
The same analysis can be arranged.
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3.3 Base Tools

Outline of 2D Viewer
Icon in the "Select application" window
Icon in the tool bar
In 2D Viewer, original 2D images and 2D planes (axial, sagittal, coronal plane images) read as three-dimensional
images are displayed. Images of one study and images of multiple different studies having the same patient ID can
be displayed.
The main functions are shown below.
• Cine playback and the playback speed can be changed (max. 30 frames/second)
• Synchronization of density adjustment, panning, and zooming among multiple images
• Synchronization of coordinate positions among multiple images
• Change (reconstruction) the displayed plane
• Display of the average image
• Batch capture of images in a series
In 2D Viewer, following tools are available.
Icon Tool name Outline

Window Width and Level (WL) The image density can be controlled.
Zoom and Pan The image can be zoomed and panned.
Measurement The distance, area, etc. can be measured on the image.
Annotation Annotations can be drawn on the image.
SUV Evaluation The average and SD, etc of SUV can be measured.
Start up 2D Viewer
Select images for analysis from the list using the following procedure.
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1. Select images to be analyzed from the study list and series list
2. (Click the button in the image input list to add)
3. Click the [Start Application] → [2D Viewer] buttons
The image registered in the image input list is displayed in the mainframe right after starting up the 2D Viewer.
The images which can be displayed in 2D Viewer are judged by the SOP class in the DICOM header information.
The compatible SOP classes are shown below.
• CR Image Storage
• CT Image Storage
• MR Image Storage
• PET Image Storage
• NM Image Storage
• XA Image Storage
• US Image Storage
• US Multi-frame Image Storage
• SC Image Storage
• Enhanced CT Image Storage
• Enhanced MR Image Storage
Icon in the "Select application"

window
3D Viewer can display normal 3D display or virtual endoscope display from the buttons on the stage bar. With the
[Virtual endoscope] stage, objects far away are shown smaller and nearer objects are shown larger, just as with an
actual endoscope (generally a gastroscope, colonoscope, laparoscope, etc.).
A minimum of five slice images are required for the input image.
Note that when an image is volume rendered (with or without 3D viewer), the information of the two slices above
and below the slice to be rendered will not be displayed.
In 3D Viewer, following tools are available. Depending on the factory settings, some of the tools are not available.
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Window Width and Level The image density can be controlled.
(WL)
SUV Evaluation The average and SD, etc. of SUV can be measured.
Object Extraction and The mask region can be edited by using smart cut etc.
Removal
3D Clip The display region can be specified for the 3D image.
Organ extraction/removal The ROI such as an organ can be extracted or removed.
Position and Rotation The current position and display direction can be specified for 2D and
3D images.
Mask edit
The mask region can be edited by specifying circle, etc.
CPR The CPR image along the specified center line can be created.
Reformat Plane images in an arbitrary direction can be created.
Movie A movie of 2D or 3D images can be generated.
Start up the 3D Viewer

Select images for the analysis from the list in the following procedures.
1. Select images to be rendered from the study list and series list
Switch the 3D Viewer Stage

With 3D Viewer, the 3D display method can be switched with the buttons on the stage bar.
3D Displays 3D parallel projection.
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Virtual endoscope Displays 3D central perspective projection.
Outline of 3D Viewer With VE

window
3D Viewer With VE can display normal 3D display or virtual endoscope display from the buttons on the stage bar.
With the [Virtual endoscope] stage, objects far away are shown smaller and nearer objects are shown larger, just as
with an actual endoscope (generally a gastroscope, colonoscope, laparoscope, etc.).
Note that when an image is volume rendered (whether or not 3D Viewer With VE is used), the information of the
two slices above and below the slice to be rendered will not be displayed.
In 3D Viewer With VE, the following tools are available. Depending on the factory settings, some of the tools are
not available.

(WL)
Object Extraction and The mask region can be edited by using smart cut, etc.
Removal
3D images.
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Mask edit
Start up 3D Viewer With VE

3. Click the [Start Application] → [3D Viewer With VE] buttons
Switch the 3D Viewer With VE Stage

With 3D Viewer With VE, the 3D display method can be switched with the buttons on the stage bar.
3D Displays 3D parallel projection.

Virtual endoscope Displays 3D central perspective projection.
Read an image of multiple phases, and play back the image based on its time information. Also, output the 3D cine
image as a movie.
• Observation of axial, sagittal, coronal planes or oblique planes
• Cine playback
• Output cine movies
The conditions for the input image are as follows.
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Image conditions Images exposed in multiple phases

Each phase consists of 5 slices
In 4D Viewer, following tools are available.

(WL)
Removal
3D images.
Mask edit
Start up 4D Viewer
The time information for cine playback is retrieved from the DICOM header information. However, depending on
the exposure equipment, the software version, settings, etc., retrieval of the time information may not be possible,
or inaccurate time information may be retrieved.
Image examples used for analysis are shown below.
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• Multiple phase images that exist in one series
• Single phase images that exist in each series
• Two of the above conditions exist and are segmented into multiple series
Select the respective data from the series list and perform analysis. An error may be caused and the application
may not start when the scanner images, positioning images, images with different positions, number of images or
pixel sizes between phases are read.
When the total duration is 5 sec. or more, the following dialog box is displayed after an image is read.
Reduce total duration By reducing total duration, image

observation can be performed at faster than
normal speed. However, as the conventional
information for the time axis may be lost, be
careful when observing the movie. When the
checkbox is checked, the total duration after
reduction can be set.
Set regular interval When the checkbox is checked, the images
between all phases are played at regular intervals between each
phase.
Outline of 3D Comparison

window
3D Comparison supports and dsplays, multiple series side by side, with synchronization.
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• Simultaneous display of images in multiple series
• Synchronizing the current position of multiple images by identifying the image position
• Synchronizing various operations between images
• Display of the average image
• Histogram measurement at the same position between images
In 3D Comparison, following tools are available.

(WL)
Removal
Mask edit
3D images.
Start up 3D Comparison
Select images to be analyzed from the list in the following procedure.
1. Select an image to be analyzed from the study list and series list
3. Click the [Start Application] → [3D Comparison] buttons
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Outline of Dynamic Data Viewer
In Dynamic Data Viewer, a time-intensity (time-density) curve can be monitored from an image exposed for a
period of time with CT, MR, etc.
• Monitor the time intensity curve
• Calculate various measuring values
Recommended modality CT, MR

Recommended image Image exposed for a period of time using a contrast medium (Dynamic)
Body part to be None
analyzed
Analysis image Images without extreme body motion artifacts
conditions Images with little noise
In Dynamic Data Viewer, following tools are available.

Start up Dynamic Data Viewer

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2. Click the button in the image input list to add the image to the list
3. Click the [Start Application] → [Dynamic Data Viewer] buttons
Outline of Fusion
Fusion enables fused display of images of two different modalities (CT/PET, CT/MR, CT/SPECT, etc.), or images of
the same modality but different exposure methods, exposure times, and so on. You can fuse images on the three
orthogonal planes of axial, coronal, and sagittal planes, and on three oblique planes.
• Fuse images with different modalities or different exposure sequences
• Fuse three orthogonal planes of axial, sagittal, and coronal
• Fuse three oblique planes
• Automatic and manual registration of images
• Arrange layouts of images for reading
• Comparison with past analysis results and report output
Recommended image Data exposed via multiple phases and different sequences
Body part to be Entire body
analyzed
Analysis image None
conditions
In Fusion, following tools are available.

(WL)
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Removal
3D images.
The [Object Extraction and Removal] and [Organ extraction/removal] tools cannot be used unless the setting of
the [Enable use of 'Edit Mask' plugin] under the [General] of [Fusion] in the [System settings] is set to [ON].
Start up Fusion
3. Click the [Start Application] → [Fusion] buttons
4. Confirm the upper and lower images
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Confirm which image is to be the upper image and which image is to be the lower image. In general, set
shape images to the lower image, and functional images to the upper image.
In Fusion, when the image size (FOV, height and width) of the upper image is different from the one of the lower
image, the upper image size is automatically adjusted so that the upper and lower images fit in their apparent sizes.
Switch the Fusion Stage

In Fusion, you can change screen display in various ways for appropriate reading by selecting the buttons on the
stage bar.
Registration Automatically or manually register the gap between the upper and lower images.
Oblique Observation Display oblique plane and 3D view of the fusion image between the upper and
lower images.
Reference Reading Display a list of orthogonal planes of the fusion image between the upper and
lower images.
Comparison Reading Display the upper, lower, and fusion images for each of the axial, coronal, and
sagittal planes. Display a list of axial, sagittal, or coronal planes.
MPR Reading Display the upper, lower, and fusion images for each of the axial, coronal, and
sagittal planes. Operations are synchronized among the three planes.
Outline of Nuclear Medicine Viewer
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In Nuclear Medicine Viewer, you can fuse and display CT images (structural images) and nuclear medicine images
(functional images). Images with little breathing deviation or position deviation are used as input images. You can
fuse images on the three orthogonal planes of axial, coronal, and sagittal planes, and on three oblique planes.
• Fuse structural images captured by CT and functional images captured using nuclear medicine imaging
equipment.
• Measurement of SUV
Recommended image Images with small deviation

analyzed
Analysis image Only a pair of CT and PET/NM images can be analyzed
conditions
In Nuclear Medicine Viewer, the following tools are available.

(WL)
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3D images.
Start up Nuclear Medicine Viewer

3. Click the [Start Application] → [Nuclear Medicine Viewer] buttons
When the Nuclear Medicine Viewer is started, fusion display is performed with the CT image as the lower image
and the nuclear medicine image as the upper image. When the image size (FOV, height and width) of the upper
image is different from the one of the lower image, the upper image size is automatically adjusted so that the
upper and lower images fit in their apparent sizes.
Switch the Nuclear Medicine Viewer Stage

In Nuclear Medicine Viewer, you can change screen display in various ways for appropriate reading by selecting the
buttons on the stage bar.
Registration Automatically or manually register the gap between the nuclear medicine and CT
images.
Oblique Observation Display oblique plane and 3D view of the fusion image between the nuclear
medicine and CT images.
Reference Reading Display a list of orthogonal planes of the fusion image between the nuclear
medicine and CT images.
Comparison Reading Display the nuclear medicine, CT, and fusion images for each of the axial, coronal,
and sagittal planes. Display a list of axial, sagittal, or coronal planes.
MPR Reading Display the nuclear medicine, CT, and fusion images for each of the axial, coronal,
and sagittal planes. Operations are synchronized among the three planes.
Outline of 3D Compositor

window
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The 3D Compositor can fuse up to five series in the same space and display the volume rendered images. Even in
case of position differences among images, the registration can be performed automatically or manually.
• Fusion of up to five 3D series in the same space and display the 3D volume rendered images
• Fusion of up to five 3D series in the same space and display a volume rendered virtual endoscopic view
Recommended image
• Volume data exposed at a separate time phase (e.g. CT images of the liver
exposed at multiple time phases)
• CT images of the bone region and MRI images of the soft tissue
• MRA images of the artery and phase contrast images of the vein
• Images exposed by different modalities
In 3D Compositor, following tools are available.

(WL)
Removal
3D images.
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The [Object Extraction and Removal] and [Organ extraction/removal] tools cannot be used in the [2D Registration]
stage.
Load Images
3. Click the [Start Application] → [3D Compositor] buttons
4. Confirm the input image
Select [Origin] or [Overlay].
Switch 3D Compositor Stage

3D Compositor advances the analysis by selecting the button on the stage bar.
Multi 3D Edit Fuse multiple images in the same space and display volume rendered multi-3D
images.
2D Registration Adjust the positional relationship between images.
Multi 3D Endoscope Fuse multiple images in the same space and display the volume rendered virtual
endoscope images.
Outline of General CPR
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window
General CPR displays a curved planar reconstruction (CPR) image along a user-specified center axis of hollow
organs.
The main functions are as follows.
• Display of axial, sagittal, and coronal images
• CPR path creation
• Modification of CPR center line and contour
• CPR image display
• Measurement of stenosis ratios
• Color-coded display from color mapping analysis
• Virtual stent graft
• Catheter analysis
• Saving CPR and orthogonal plane images
A CPR image is created from an original image as a curved plane image along a specific axis, so the measuring
values cannot be calculated correctly except near the center axis.
In General CPR, the following tools are available.

(WL)
Removal
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3D images.
Mask Edit
Start up General CPR

1. Select images for use with General CPR from the study or series list
2. (Click the button in the image input list to add the image to the list)
3. Click the [Start Application] → [General CPR] buttons
When started up from another application, the following dialog is displayed, and the mask region from the other
application can be used at startup. Up to four mask regions can be transferred. Similarly, any path information used
by the source application is transferred automatically.
Transferred mask regions are copied into this application, so any editing done to them will not affect the mask
regions in the source application.
- 192 -
Path information is not transferred from some source applications.
Switch the General CPR Stage

With General CPR, the CPR analysis method can be switched with the buttons on the stage bar.
General CPR Create paths for a variety of hollow organs and use them in CPR observation.
Aorta CPR Create aorta paths and use them in observation specifically for the aorta.
Carotid CPR Create carotid paths and use them in observation specifically for the carotid
artery.
Panorama CPR Create panorama CPR images orthogonal to a specified slice and use them in
observation.
Outline of MPR Reformat

window
MPR reformat enables you to create a plane along a straight line or in the shape of a fan on 2D images, so that you
can print or save as a new image. The length, interval, etc. of cutout can be saved and labeled as a preset.
• Create and save arbitrary planes
In MPR Reformat, the following tools are available.

(WL)
3D images.
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Start up MPR Reformat

3. Click the [Start Application] → [MPR Reformat] buttons
When images in multiple series are loaded, the number of images, the exposure position, orientation, and FOV
must match.
Outline of Slicer
Slicer is an application for observing slice images of the spine. You can create slice images by setting slice lines on
volume data.
• Display slice images
• Layouts specialized for observing a large number of slice images
• Automatic generation of a slice image with the spine detection
• Output slice images to DICOM or Windows printers
• Switch between multiple images
Recommended image None

Body part to be analyzed Centrum, extremities, and spine
Analysis image None
conditions
In Slicer, following tools are available.
- 194 -

(WL)
3D images.
Start up Slicer
1. Select images on which Slicer is going to be used from the study list and series list (one or two series)
3. Click the [Start Application] → [Slicer] buttons
When images in multiple series are loaded, the number of images, the exposure position, orientation, and FOV
must match.
Outline of Combination
With the Combination, you can adjust positions and orientations of images that are captured over wide area and
separated as different series, and can handle, display, and save them like a single image. For example, you can
perform the followings: connecting or MIP-processing a head and a neck images captured by MRI, and combining
and connecting images captured by different means (such as TRA and SAG, parallel-imaged head and parallel-
imaged abdomen). The images do not need to be overlapped, but needed to be captured at continuing positions.
The connected or combined image can be used with other applications.
• Display the orthogonal section and MIP that are created by combining different series.
• Save DICOM images after combining.
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Supported modalities CT, MR

Recommended image
The recommended images are CT or MR images that are created in a wide area
and by dividing the images while being interlocked with a bed.
Images without extreme body motion artifacts
In combination, following tools are available.

Start up Virtual Combination

1. Select the image to be combined in the study list, and series list
3. Click the [Start Application] → [Combination] button
This application can load up to 10 series images.
Processing to equalize signal values

When [Change pixel value before displaying images] is configured to [ON] with this application, a dialog is
displayed which adjusts signal values to equalize them between the series. When apparent intensity is different
between the series, adjust the intensity and perform the signal conversion process.
Before conversing window width and level After conversing window width and level
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Display of images on the dialog can be selected from [MIP] and [Slice] of [View type]. Select a suitable layout.
[View type] [Slice] [View type] [MIP]
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Switch the Combination Stage

In the image combination, the operation stage can be switched by selecting the buttons on the stage bar.
Layout Images (2D) Adjust, combine, and display the images of each series only with the positions and
orientations of the loaded images.
Layout Images (3D) Adjust, combine, and display the images of each series in three-dimension.
View Images Combine and display the image without adjusting the positions and orientations.
Outline of 2D Fusion

window
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In 2D fusion, you can fuse and save two series of images.
• Blended display of 2D and 3D images
• Save created fusion images as a DICOM file
In the 2D fusion application, the following tools are available.

Object Extraction and Removal The mask region can be edited by using smart cut etc.
Start up 2D Fusion
3. Click the [Start Application] → [2D Fusion] button
4. Confirm the upper and lower images
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Confirm which image is to be the upper image and which image is to be the lower image.
If the upper image is a color image, you can select the [Transparent mode], which makes part of the upper image
transparent when the fusion image is displayed.
Outline of Vessel Extraction

window
In Vessel Extraction, the blood vessel region is semi-automatically extracted from the post-contrast image by
removing the bone region using the pre-contrast image. Vessel Extraction is an application for only CT. You cannot
use this application with images of other modalities.
• Display three planes (axial, sagittal, and coronal) and respective 3D images
• 3D display of the brain vessel extraction result
• Stereoscopic display using two 3D images with differing angles
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Supported modalities CT
Recommended image 2 series of head CT images (pre- and post-contrasts)
Body part to be Head
analyzed
Reconstructed function Function with which soft tissue can be observed
Analysis image Contrast of bones has to be the same between pre- and post-contrasts.
conditions
In Vessel Extraction, following tools are available.

(WL)
Removal
3D images.
Mask edit
Start up Vessel Extraction

1. Select images for Vessel Extraction from study list or series list
3. Click the [Start Application] → [Head] → [Vessel Extraction] buttons
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4. The following dialog appears, and set a type of input image (Pre-contrast or Post-contrast) to each of the
input image
Switch the Vessel Extraction Stage

Vessel Extraction advances the analysis by selecting the button on the stage bar.
Registration Register pre- and post-contrast images.

Confirmation Confirm the bone region before extracting the brain vessel.
Vessel Extraction Display a 3D image from which the bone region is removed using pre- and post-
contrast images.
Outline of Sector MPR

window
In Sector MPR, a sector MPR image can be observed using the CT and MR images that were exposed in single and
multiple phases. If multiple phase images are used, the sector MPR image can be observed while the cine is played
back. You can use the virtual ultrasound application to simulate, to some extent, certain aspects of an actual
ultrasound study, such as how and where to place the probe, and which organs can be checked.
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• Display of sector MPR images
• Cine playback of sector MPR images
• Display of pseudo light decay shading
• Measuring on sector MPR images

Recommended image Single phase or multiple phase images
Body part to be Heart, upper and lower abdominals
analyzed
conditions
In Sector MPR, following tools are available.

(WL)
Removal
3D images.
Start up Sector MPR

3. Click the [Start Application] → [Chest] or [Abdomen] → [Sector MPR] buttons
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Switch the Sector MPR Stage

With Sector MPR, the operation stage can be switched by selecting buttons on the stage bar.
Free Operation Operate a mouse view plane and generate an image such as a sector MPR image.
Measurement Make measurements conveniently on sector MPR images.
Outline of Dental MPR
In Dental MPR, panorama images along row of teeth and cross section images of alveolar bones can be displayed
from images exposed with CT. And these images can be printed out.
• Display cross sections
• Display panorama images of alveolar bones
• Output to DICOM or Windows printer
Recommended image CT images targeting the alveolar region
Images with narrow intervals of slices along the body axis
In Dental MPR, following tools are available.

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Start up Dental MPR

3. Click the [Start Application] → [Head] → [Dental MPR] buttons
Switch the Dental MPR Stage

In Dental MPR, you can switch the stage by selecting the button on the stage bar.
Viewer Mode Configure the settings for creating panorama images and cross section images
from the input images.
Print preview Display the print preview of panorama images and cross section images, and print
them out to a printer.
Outline of ADC Viewer
In ADC Viewer, apparent diffusion coefficients are calculated and visualized from information on signal values of
diffusion-weighted images collected with MR.
• Display ADC Map and EADC Map images
• Measure ADC values in ROIs
• Pseudo-color display of ADC Map images
• Blending display of ADC Map images and background images
• Automatic/Manual registration of ADC Map images and background images
Supported modalities MR
Recommended image Diffusion-weighted image
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Body part to be analyzed None

Analysis image b-values of the input images are known.
conditions
In ADC Viewer, following tools are available.

(WL)
3D images.
Start up ADC Viewer

3. Click the [Start Application] → [ADC Viewer] button
4. In the "Input image setting" dialog, select either [Diffusion-weighted image], [Background image], or [Do not
use]
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5. When you select [Diffusion-weighted image], set known b-values
6. Click the [OK] button
ADC values cannot be calculated accurately unless b-values are set correctly. Be sure to set correct b-values when
you create ADC Map images.
Outline of Tx Map
The Tx Map application performs specific calculations from signal value information collected from MR images and
presents the information visually.
• Display the T2* Map
• Measure T2* values in ROIs
• Monitor the T2* Map time intensity curve
• Pseudo-color display of T2* Map images
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Recommended image Chronological images

In Tx Map, the following tools are available.

Start up Tx Map
3. Click the [Start Application] → [Tx Map] buttons
4. In the "Input image setting" dialog, select the type of analysis, and then select either [Use] or [Disuse] for
each image
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When creating a Tx Map, make your selection ensuring a uniform slice interval.
Switch the Tx Map Stage

Tx Map advances the analysis by selecting the button on the stage bar.
Measurement Tx values can be calculated by arranging an ROI on a 2D image. 2D display with

an overlaid Tx map using a threshold or ROI is also possible.
Cartilage extraction Extract bone and cartilage regions, and display cartilage regions as a Tx map over
bone regions.
Outline of Surface Viewer
Surface Viewer creates and displays a polygon mesh from the bounding surface determined by threshold
processing of volume data, using the marching cubes algorithm. The application is used to generate multiple
polygon meshes, edit them, and save them to external files.
Note that when an image is volume rendered, the information of the two slices above and below the slice to be
rendered will not be displayed.
In Surface Viewer, the following tools are available. Depending on the factory settings, some of the tools are not
available.

(WL)
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Removal
3D images.
Mask Edit
Start up Surface Viewer

3. Click the [Start Application] → [Surface Viewer] buttons
Switch the Surface Viewer Stage

Surface Viewer advances the editing by selecting the button on the stage bar.
Registration Adjust the relative positions of images.

Mesh Edit regions using organ extraction and mask editing, and specify parameters to generate
extraction polygon meshes.
Mesh edit Display multiple extracted meshes, edit them, and save them to external files.
Outline of Breast Analysis
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In Breast Analysis, you can observe parameter images from dynamic mammary gland MR data, as well as kinetic
curves.
• Create parameter images
• Create kinetic curves
• ROI measurement
• Display related images in a reference view
• Output reports conforming to BI-RADS MR
Recommended modality MR
Recommended image Dynamic images exposed over a period of time using a contrast medium
Body part to be Breast
analyzed
In Breast Analysis, the following tools are available.

(WL)
Removal
3D images.
Start up Breast Analysis

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3. Click the [Start Application] → [Breast Analysis] button
Outline of Prostate Viewer
Prostate Viewer enables prostate MR T2WI, DWI, ADC map, computed DWI, DCE, and T1WI observation.
• Prostate measurement
• Comparative observation of prostate MR images
• Lesion measurement, ROI measurement
• ADC map, computed DWI, and time intensity curve generation
• Output reports conforming to PI-RADS
Recommended modality MR
Recommended image Axial plane T1WI, T2WI, two DWIs with different b values, and DCE data
Body part to be Prostate
analyzed
In Prostate Viewer, the following tools are available.

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Start up Prostate Viewer

3. Click the [Start Application] → [Prostate Viewer] button
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3.4 Tools
3.4.1 Window Width and Level
The density of images can be controlled. The method for controlling density varies depending on the types of
images (2D or 3D). This tool can be used by selecting [Window Width and Level (WL)] from the right-click menu on
the image frame or from the shortcut bar, or by selecting the icon in the tool bar.
Control Density of Images

Following two methods for controlling the density of 2D images and MIP, SMIP, MinIP, and RaySum 3D images are
available.
• Drag on the main frame.
• Move the slider bar in the tool frame.
Width and Level Move the slider to change or set window width and level.
Gamma Gamma value of images can be set for 2D images and for MIP, SMIP, MinIP, and
RaySum 3D images. Set the gamma value by entering the value in the slider. The
smaller the value the darker (blacker) the image becomes and the larger the value
the brighter (more white) the image becomes. To restore the brightness to the
original image after changing the gamma value, click the button in the upper
right.
Reset Reset the values for window width and level to the ones in DICOM header
information. When there are multiple values, you can choose one from the pull-
down menu accessed by clicking the button in the upper right. When the
information on window width and level does not exist, the default values specified
in the system settings are applied.
The window width and level can be reset also from the right-click menu in the
image frame.
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The gamma value setting items are not displayed in the default setting. To use them, enable the gamma value
setting items in the system settings.
The range of window width and level which can be set in the tool frame is determined by the signal range of the
read image. Therefore note that the window width and level display values for the image frame and tool frame
might vary if the default values are applied when the window width and level values are not included in the
DICOM header information, and the signal values are out of the range set by the tool frame.
Pseudo-color and classified color

In addition to monochrome display, you can specify pseudo-color display for 2D images and MIP, SMIP, MinIP, and
RaySum 3D images. Specify either [Pseudo-color] or [Classified-color].
Pseudo-color Assign different colors for different density levels in the image. By assigning
suitable pseudo-colors, subtle differences in the density level can be expressed in
colors and can be easily observed. [Pseudo-color] can also be selected from the
right-click menu on 2D image frames.
Classified-color
Configure the classification setting for combinations of colors and signal values in
advance to have the specified colors displayed as an overlay for respective signal
ranges. [Classified-color] can also be selected from the right-click menu on 2D
image frames.
Without classified-color
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With classified-color
To change the available colors for pseudo-colors, click in the system frame. In the [System settings] dialog,
click [Template] on the [Environment settings] tab, and then click [Pseudo-color setting] and [Classified-color
setting].
Note that pseudo-color display may result in an unexpected image for the modality, which may lead to oversights
or misdiagnosis.
Preset
Register commonly used window widths and levels as presets. Window widths and levels can be registered as
presets. Click to register the current window width and level. Click to overwrite the preset on the selected
line. Click to delete the selected preset in the list.
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Density adjustment for PET images when SUV measuring is possible

When SUV measuring is possible for PET images, the density can be adjusted with the SUV value. The density is
adjusted by specifying the upper limit SUV and the lower limit SUV of the display range. SUV upper and lower limits
can also be registered and called up.
Density adjustment for dose maps

Density can be adjusted for Gy or cGy doses of images from an RTDOSE modality. The density is adjusted by
specifying maximum and minimum doses of the display range. Maximum and minimum doses can also be
registered and called up.
SMIP damping setting

The damping coefficient of the display parameters for SMIP display can be set from [Damping] in the tool frame.
Smoothing / Edge enhancement
Edge enhancement Original 2D image Smoothing
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Smoothing and edge enhancement can be applied to 2D images. Set types and intensities of filters by moving the
slider. To reset smoothing and edge enhancement to the original status, click the button.
Smoothing / Edge enhancement will not be applied to image planes inserted into the 3D images.
Note that the corner of the image is also enhanced when edge of the oblique plane or CPR plane is enhanced.
Note that the measuring result of the signal values differ from the one of the original image when an image is
smoothed or edge enhanced, captured as a monochrome image, and saved as a DICOM image. This is because
the signal values of a rendered image are changed by the filter for smoothing / edge enhancement.
Note that smoothing and edge enhancement changes image appearance and may result in loss of subtle
differences in contrast or shapes or cause image artifacts, which might lead to oversights or misdiagnosis.
When an image is captured as a monochrome image or reformatted with [Gamma] and [Smoothing / Edge
enhancement] applied and saved as a DICOM image, you may not be able to identify whether the saved image was
created with the filtered image or with the original image in condition that the display status of the image was not
appropriate. Please be careful to deal with the saved image.
Difference in image appearance from gamma adjustment

Gamma values are used to change how the grayscale shading of monochrome images in 256 shades of gray
appears on monitors, using a nonlinear function. Make sure you understand the principle well when using this
function.
Small gamma value Large gamma value
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Shift Color Template

For 3D images with an applied color template (VR with or without shadow), opacity lines can be panned by
dragging up or down on the image frame. You can also shift color templates from [Shift color template] in the tool
frame.
When dragging downwards Original status When dragging upwards
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On SSD rendered 3D images, range of upper and lower SSD threshold values can be changed by dragging
horizontally. Also, the upper and lower SSD threshold values can be shifted by dragging vertically. The threshold
setting can be changed also from [Threshold of SSD] in the tool frame.
Operation for superimposed images

For superimposed images used for fusion or other applications, the operation target for window width and level
can be switched between lower image and upper image from [Target image] in the tool frame.
Setting of Window Width and Level
Configure settings related to window width and level. Click the button in the system frame, and select
[Window Width and Level (WL)] in the [System settings] dialog.
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Mouse sensitivity Set the sensitivity of the density control versus the distance through which the
mouse is moved.
The sensitivity can be selected from [Very fast], [Fast], [Normal], [Slow], or [Very
slow]. [Fast] means that the changes in the window width and level values are
greater than those of [Normal], while [Very fast] means that the changes are even
greater. Conversely, [Slow] means that the changes in the window width and level
values the changes are lesser than those of [Normal], while [Very slow] means that
the changes are even lesser.
Enable gamma setting Set whether or not to display the gamma value setting controller. When set to
[OFF], the controller for gamma value setting is not displayed in the tool frame.
When set to [ON], the controller for gamma value setting is displayed in the tool
frame.
Enable smoothing and Set whether or not to display the smoothing/edge enhancement controller. When
edge enhancement set to [OFF], the controller is not displayed in the tool frame. When set to [ON],
setting the controller is displayed in the tool frame.
To apply the changes made to the items with an * beside them on the actual screen, the workstation needs to be
restarted.
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3.4.2 Zoom and Pan
With the [Zoom and Pan] tool, you can zoom in/out and pan images. Regardless of types of images (2D or 3D),
operations are almost same. This tool can be used by selecting [Zoom and Pan] from the right-click menu on the
image frame or from the shortcut bar, or by selecting the icon in the tool bar.
Mode of Operation
Operation in response to dragging can be switched to zooming, panning, or loupe display by selecting the
[Pointing zoom], [Pan] or [Loupe] button under [Operation mode] in the tool frame. Operation can also be switched
to [Pointing zoom], [Pan], or [Loupe] from the right-click menu. [Loupe] enables locally zooming in on 2D or 3D
images. Click the [Loupe] button and click or drag the spot for local observation to zoom in locally around that
position.
Before using the loupe While using the loupe
By default, loupe functionality is not available. The relevant setting item must be enabled in the system settings.
Zoom In and Out

You can zoom in/out from the tool frame in the following procedure.
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• Use the preset zoom ratios
When you click the [x0.5], [x1.0], [x1.5], [x2.0], or [x5.0] button in the tool frame, the zoom ratio displayed on
the clicked button will be applied to images. Also, you can select a preset zoom ratio from the right-click
menu [Set zoom rate] on the main frame.
• Move the slider in the tool frame
The larger the value the more the image is zoomed in, and the smaller the value the more the image is
zoomed out.
• Specify Display Field Of View (DFOV) from the tool frame
Zoom ratio can be specified by specifying the size of shorter side of the viewer (height or width) in mm.
Panning
Dragging on an image pans in the direction and distance dragged. Select [Pan] under [Operation mode] in the tool
frame or from the right-click menu and drag the image.
Additionally, you can set the panning distance in the following slider.
In a straight CPR image, if the orientation is [Horizontal view], the image can only be panned left-right, and if the
orientation is [Vertical view], it can only be panned up-down.
With applications such as 3D Viewer, the 3 planes in the orthogonal view are interlocked and are panned together.
Setting of Zoom and Pan
Configure settings related to Zoom and Pan. Click the button in the system frame, and select [Zoom and Pan]
in the [System settings] dialog.
Mode of zoom and pan Mouse operation for zooming and panning can be set to either Synapse 3D
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mode or SYNAPSE compatibility mode. For Synapse 3D mode, turning the mouse
wheel zooms in or out, while for SYNAPSE compatibility mode, the response set in
the system settings is performed.
Use short side length Specify whether to define the zoom rate by specifying the actual short side length
setting in the viewer.
Use loupe Specify whether to use loupe functionality.
Zoom rate of loupe Set the zoom rate for inside the loupe when [Loupe] is to be used.
Size of loupe Set the aspect size of the loupe when [Loupe] is to be used.
restarted.
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3.4.3 Measurement
Measure the length and signal value etc. of the Region Of Interest (ROI) and Volume of Interest (VOI) in the 2D or
3D image. Click the button in [Measuring method] on the tool frame to select a measuring method, and perform
the operation. This tool can be used by selecting [Measurement] from the right-click menu on the image frame
besides by selecting the icon in the tool bar.
Type of Measuring Line and ROI/VOI

Following ten types of measuring lines and ROI/VOI are available.
Icon Measurement Outline

name
Line Measure the distance between the 2 points. Determine the measuring line by
measurement clicking the position that is to be the start point on the image, and then drag and
release it on the position that is to be the end point. After the determination, the
measuring line can be changed by dragging the start point or the end point. By
double clicking on the start point or the end point, the display is switched to that
slice.
Optionally, a scale can be displayed on the measuring line, and measuring lines
orthogonal to the measuring line can be displayed.
Polygonal line Measure the length of a polygonal line connecting multiple points. Click the
measurement position that is to be the start point on the image, and then click arbitrary points
(setting multiple points are possible). Finally, determine the measuring line by
double-clicking, by pressing the Enter key, or by selecting [Finish] from the right-
click menu on the position that is to be the end point. After the determination, the
measuring line can be changed by dragging each point. However, this function
cannot be used for CPR images. Also, by double-clicking each point, the display is
switched to that slice.
Optionally, the length of each segment of a polygonal line can be displayed, and a
scale can be displayed on the line from the start point to the end point.
Angle
Measure the angle. Following three modes are available.
measurement
• 3-point measurement
Determine the angle to be measured by clicking the position to be the start

point on the image, the center point of the fan, and the position that is to be
the end point in order.
• Projected 3-point measurement
Perform 3-point measurement on the projection plane. This function is

available only for 3D display.
• 4-point measurement
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Measure the angle between two lines which do not intersect.
After the determination, the angle to be measured can be changed by dragging

each point.
However, this function cannot be used for CPR images.
Pixel value Measure the signal value of one pixel of the image. Determine the measuring point
measurement by clicking the position to be measured. After the determination, the measuring
point can be moved by dragging the center of the cross.
Rectangle Measure the area and signal value in the rectangular region. Click the position that
measurement is to be the start point on the image. Drag it to adjust the size of the ROI, and
release the button to determine the measuring region. After the determination,
panning can be performed by dragging the center of the ROI. The size of the
measuring region can be changed by dragging each apex of the rectangle.
However, this function can be performed only on the plane image and not on the
3D image.
Ellipse Measure the area and signal value in the elliptic region. Click the position to be the
measurement center of the circle in the image. Drag it to adjust the size of the ROI, and release
the button to determine the measuring region. After the determination, panning
can be performed by dragging the center of the ROI. The size of the measuring
region can be changed by dragging each apex of the rectangle circumscribing the
ellipse, and the measuring region can be rotated by dragging a position where the
ROI and the rectangle are in contact. However, this function can be performed only
on the plane image and not on the 3D image.
Polygon Measure the area and signal value in the polygonal region. Click the position that is
measurement to be the start point on the image, and then click arbitrary positions successively.
At the end, double-click a position to be a terminal point, press the Enter key or
select [Finish] from the right-click menu to fix the measurement region. After the
determination, panning can be performed by dragging the center of the ROI. The
measuring region can also be changed by dragging each apex of the polygon.
However, this function can be performed only on the plane image and not on the
3D image.
Freehand Measure the area and the signal value in the region set to an arbitrary shape. Click
measurement the position that is to be the start point on the image, and drag it. At the end,
double-click a position to be a terminal point, press the Enter key or select [Finish]
from the right-click menu to fix the measurement region. After the fixation, ROI can
be panned by dragging its center and can be changed in its shape by dragging on
the border line of ROI. Also, switching to the auto detection mode in which the
outline of the region to be measured can be automatically detected. However, this
function can be performed only on the plane image and not on the 3D image.
Box Measure the volume and signal value in the box region. Click on the position that is
measurement to be the start point on the slice image. Drag it to adjust the size of VOI, and
release the button to determine the measuring region. After the determination, the
measuring region can be panned by dragging the center of the VOI, and the size of
the measuring region can be changed by dragging on the border line of the VOI.
Also, the measuring region can be displayed on the 3D image.
Sphere Measure the volume and signal value in the spherical region. Click on the position
measurement that is to be the start point on the slice image. Drag it to adjust the size of VOI, and
release the button to determine the measuring region. After the determination, the
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measuring region can be panned by dragging the center of the VOI, and the size of
the measuring region can be changed by dragging on the border line of the VOI.
Also, the measuring region can be displayed on the 3D image.
With 3D image or an oblique plane etc., the measured segments are displayed as segments that are projected
onto the projection plane. Therefore, note that the apparent length of the segments etc. may differ from the length
of the actual segment. Also, when measurement has been performed in the 3D image, the measuring control points
might not have been specified at the intended position. Therefore, when measurement has been performed in the
3D image, perform changing the display orientation, etc. after measuring to confirm that the measuring control
points have been specified at the intended positions.
When the measured signal values are used directly for diagnosis, confirm before use that these signal values
coincide with values measured with the software etc. belonging to the modality. Especially the signal values of
images taken with MR or PET, NM modalities may require signal value correction depending on the modality
manufacturer, the device model or the type.
The signal value to be measured with [Pixel value measurement] is the signal value of the pixel corresponding to
the center position of the cross.
With rectangle, ellipse, polygon, freehand, box, and sphere measurements, the measuring result cannot be
displayed when a part of the measuring target region is outside the image.
Since the line measurement for CPR is performed for sampling by dividing the measuring line into a fine polygonal
line, a slight difference from the actual length may result.
Displaying the border with ROI and VOI with the measurement tool may differ from the visible shape. Actually, as
shown in the following figure, measurement is not performed for the region inside the border line, but for the
region of the pixels (voxels) belonging to the border line. Therefore, in the case of extremely small regions, the area,
volume, and other statistical values cannot be measured accurately and a large error is caused.
Also, when the circumferential length is displayed as the measuring result, the perimeter is calculated from the
drawn contour line. Since the area/volume is calculated according to the following method, the measured
area/volume may be the same even if the contour line differs slightly.
Measure on the fusion image

When measuring on the fusion image, the result for measurement will be calculated on the upper and lower
images individually.
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When measuring a fusion image, the area, volume, etc. may differ between the upper and the lower images
because of the differences in the number of voxels in the ROI/VOI.
Select, Delete, and Copy Measuring Line and ROI

Click the label for the measuring result to switch the selection when multiple measuring lines and ROIs are on the
image. The position of the label can be moved by dragging. The label position can be specified for each viewer. As
shown in the following figure, the display of the label changes when it is selected.
Not selected Selected
The following operations can be performed for the displayed measuring lines and ROIs.
Delete Delete the selected measuring line and ROI. The same operation is possible by
selecting [Delete] from the right-click menu on the label of the measuring result.
Delete All Delete all the measuring lines and ROIs.
Copy Copy the selected measuring line and ROI. Since the copied measuring line and
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ROI follows the movement of the cursor, click on the desired position to paste it.
The same operation is possible by selecting [Copy] from the right-click menu on
the label of the measuring result.
Display setting
Display settings can be configured individually for each measuring object. When a measuring object is selected on
the image, the setting contents are displayed on the tool frame. When the settings are changed, they are applied to
the selected measuring object. The setting items are as shown below.
Font Specify the font type and size.

FG color Specify the color for the measuring object, the measuring value, and the outer
frame.
BG color Specify the background color of the label of the measuring result. When this item
is checked, the background color of labels becomes the specified color.
Text frame Display the outer frame of the label of the measuring result with the Text color
when this item is checked. When the check is removed, the outer frame is hidden.
CP color Specify the text control point color.
Display option Specify the scale display method for line measurement and polygonal line
measurement. The options differ for line measurement and for polygonal line
measurement. The scale interval follows the setting in the [System settings]
dialog. Line measurement: No option, Show scale, Show cross section line
Polygonal line measurement: No option, Show scale, Show section length
Show measurement Display a message saying (Warning: This measurement is not looking at depth) in
warning the label of the measuring results when this item is checked.
Show 4-point angle Display a message saying (Warning: This measurement is not looking at depth) in
measurement warning the label of the measuring results when this item is checked.
Cursor size Specify the cross line interval for signal value measurement.
Size input Specify the size of ROI directly. The [Size input] dialog is displayed, and the length
and width, the length in the XYZ orientation, and the radius can be specified. The
same operation is possible by selecting [Size input] from the right-click menu on
the label of the measuring result.
The approximate area displayed in the [Size input] dialog is the value calculated directly from [Width] and [Height]
or [Horizontal radius] and [Vertical radius]. The value in this dialog slightly differs from the value obtained from the
sampling numbers.
The display options are set for all the measuring objects the type of which is the same as that of the measuring
object for which the display setting is being configured. Configuring the settings for individual measuring object is
not possible.
Even when outer frame display is unchecked, the outer frame is displayed if the measuring object is selected.
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The correspondence between the measuring object type and the display setting items is shown below.
Line measurement Font, Text color, BG color, Text frame, CP color, Display option
Projected line Font, Text color, BG color, Text frame, CP color, Show measurement warning,
measurement Display option
Polygonal line Font, Text color, BG color, Text frame, CP color, Display option
measurement
3-point measurement Font, Text color, BG color, Text frame, CP color
Projected 3-point Font, Text color, BG color, Text frame, CP color, Show measurement warning
measurement
4-point measurement Font, Text color, BG color, Text frame, CP color, Show 4-point angle measurement
warning
Pixel value Font, Text color, Cursor size
measurement
Rectangle measurement Font, Text color, BG color, Text frame, CP color, Size input
Ellipse measurement Font, Text color, BG color, Text frame, CP color, Size input
Polygon measurement Font, Text color, BG color, Text frame, CP color
Freehand measurement Font, Text color, BG color, Text frame, CP color
Box measurement Font, Text color, BG color, Text frame, CP color, Size input
Sphere measurement Font, Text color, BG color, Text frame, CP color, Size input
Copy to all images

The [Copy to all] button can be used in the 2D-viewer application and the 3D comparison application. When the
[Copy to all] button is clicked, ROI measurements can be copied to all the displayed image frames.
Before copying After copying
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Copy to all images is a simple copying function copying the presently selected ROI shape to the other presently
displayed images. Copying to exactly the same position requires use of images with exactly the same exposure
conditions (image size, FOV, image exposure interval) and display of the same slice position.
Unit of Signal Value

The unit of signal value to be displayed as a measuring result is determined automatically by the DICOM header
information of the read image. In the [Unit of signal value] in the tool frame, the unit of the displayed signal value is
displayed. If the image is the PET image, the [Change] button is displayed at the right end, and the unit for the
signal value displayed as measuring results can be switched.
The following types of units are available.
--- The signal value to which the Rescale information in the DICOM header
information is applied.
Stored value The value of image data stored in the DICOM file.
Shifted stored value Display a value that is obtained by internally converting the stored values in the
workstation when an image with Rescale Slope and Rescale Intercept applied
exceeds the range from -32768 to 32767. Values exceeding the range are
processed as specified in workstation settings.
Shifted value The signal value that is obtained by applying the Rescale information to the
shifted stored value.
Normalized value The value that is obtained by correcting the stored value with the Rescale slope
normalized with the average of the multiple Rescale slopes when slices have
different Rescale slopes.
SUV Display the Standard Uptake Value. When the correction method has been
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specified, bw, lbm, bsa, ibw is added after SUV.

The measuring result in the SUV unit can be displayed only for a PET image with
the parameters required for the calculation in the DICOM header information.
Note that depending on the modality, its software version, and the settings etc.,
SUV calculation may not be possible or an inaccurate measuring result may be
displayed.
Gy / cGy Display Gy or cGy values from measurement of images from an RTDOSE modality.
The unit displayed is determined by the [Display gray unit] setting for RTDOSE
images in [Image load] in the system settings.
The meaning of the unit of the signal values, which is determined according to the DICOM header information,
greatly differs for each unit. Assess the measuring results after comprehending the meaning of the units.
Even with almost identical images, the DICOM header information may differ when the modalities are different for
each image or when the software version or the settings are different even with the same modality. Note that the
units for the signal value may differ for each image.
Mask Measurement
The area in the displayed plane and entire volume etc. can be calculated for the current mask. Also, this function
can only be used in the 3D viewer application.
Total histogram Display the measuring result for the entire current mask region.
Slice histogram Display the measuring result for the mask region on the current slice. This
function can only be used when the [Orthogonal] is selected.
Since the value of the volume, etc. and histogram displayed by total histogram and slice histogram are calculated
only from the mask region, it is different from the region that is visible in the 3D image.
Graph of Measuring Information

When the [Show graph] button is clicked in the tool frame, the profile curve (line measurement and polygonal line
measurement) and histogram (rectangle measurement, ellipse measurement, polygon measurement, freehand
measurement, box measurement, sphere measurement, total histogram, and slice histogram) can be displayed.
For a profile curve, the horizontal axis shows the distance from the start point, and the vertical axis shows the signal
value. By dragging on the graph, the distance between the start point and the end point and the signal value of
each point are displayed, and those two points are displayed on the image.
For the histogram display, the horizontal axis shows the signal value, and the vertical axis shows the area. When
dragging on the graph, the signal values of the start point and end point are displayed, and the measuring
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information in its range is displayed at the bottom of the graph. Also, the start point and the end point can be set
with the slider displayed by right-clicking on the graph.
Profile curve Histogram display
Bin width
Images with significant noise may cause a jagged histogram display. In this case, signal values within a certain
range can be integrated and aggregated to display this range as a unit on the graph, in order to show a smoother
histogram.
Range fit
According to the measured values, the display range of the horizontal and vertical axes is adjusted automatically.
The user can choose to fit the scale of each axis or manually specify the display range of each axis by turning the
[Range fit] button ON or OFF.
When the upper and lower images are fused in the fusion application etc., the [Fit in lower] and [Fit in upper]
buttons are displayed instead of the [Range fit] button. When the [Fit in lower] button is enabled by clicking, the
display range of the horizontal axis and vertical axis is adjusted according to the image information (profile curve,
histogram) of the lower image. When the [Fit in upper] button is enabled by clicking, the display range of the
horizontal axis and vertical axis is adjusted according to those of the upper image.
Save the graph

The calculated measuring result can be saved by the following two methods.
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Send the graph of measuring results to the capture box as a captured image.
Output the measuring results to a CSV file or text file.
The signal values displayed in the profile curve and histogram are not the pixel values of the nearest the sampling
position, but the interpolated values.
Half width
When the mouse is dragged on a profile curve, the values of the intersection point between left and right boundary
lines and the profile curve can be displayed. A half width of the region is displayed at the upper part of the region
by using this function to specify the range where the value becomes the half value of the peak signal value of the
profile curve.
Bin width
Displays a histogram with specified interval added. This is available in measurements showing graph except for
[Line measurement] and [Polygonal line measurement].
Display Time-Intensity Curve

In the application such as 4D Viewer to which images of multiple time phases can be input, when the measuring
results for the region is displayed as a graph, the time-intensity display of its measuring results can be performed.
When the [Time change] button at the bottom of the graph is clicked, the graph changes from the current
measuring result histogram to the time-intensity curve of the average value in the region.
Histogram display Time-Intensity display
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Setting of Measurement
Configure various settings for measurement. Click the button in the system frame, and select [Measurement]
in the [System settings] dialog.
Continuous specification
• OFF
of measurement
line/ROI Selection of the measuring method is canceled once a measurement is
performed. To perform the measurement in the same measuring method,
the measuring method must be selected again.
• ON
The selection of the measuring method is not canceled and measurement

can be performed continuously with the same measuring method.
When the measuring line and ROI have been created while holding the Ctrl key,
the same type of measurements can be created continuously regardless of the
[Continuous specification of measurement line/ROI] setting.
Automatic edge fitting
• OFF
for freehand
measurement When the ROI is set with freehand measurement, the position where
dragging has been performed is set as the boundary of the ROI.
• ON
When the ROI is set with freehand measurement, the boundary of the
region between the last specified position and the current position of the
mouse cursor is estimated automatically.
Automatic edge fitting for freehand measurement is enabled only for the
orthogonal view.
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Update the current

• OFF
position
Do not update the current position in viewers after measurement
operations.
• ON
Update the current position in viewers after measurement operations.
Show the line/polygon

• OFF
measurement results on
the left bottom corner The measuring value is displayed near the line/polygonal line
measurement.
• ON
Only the number is displayed near the line/polygonal line measurement.

The measuring value is displayed at the lower left corner.
Show projection
• OFF
The measuring result is displayed only on the measured plane.
• ON
Always display the measuring result even on a plane different from the
measured plane.
In areas outside the vicinity of the measured plane, the measurements of
lines, polygonal lines, angles, and boxes are displayed semi-transparently.
Scale interval Specify the scale interval when a scale is displayed for lines/polygonal lines. When
Variable is specified, the scale interval becomes the same as that displayed on the
right end of the image.
Display item Set the items displayed in the label of the measuring result for rectangle, ellipse,
polygon, freehand, box, and sphere measurements. The items with a checkmark
are displayed in the label of the measuring result.
The selectable items are Max. value, Min. value, Total, Number, Area/Volume,
Perimeter, Average, SD, Kurtosis and Skewness.
restarted.
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3.4.4 Annotation
Draw annotations on 2D or 3D images. Perform the operation after selecting each drawing method from the
button in [Annotation type] on the tool frame. This tool can be used by selecting [Annotation] from the right-click
menu on the image frame or by selecting the icon in the tool bar.
Type of Annotation
Arrow
Draw an arrow annotation. An arrow annotation can be drawn by clicking the arbitrary position on images. The
position of the arrow annotation can be changed by dragging a tip of the arrow. Also, when the tail end of an
arrow is dragged, the orientation and the length of the arrow can be changed with the focal point being the base
point.
The following settings can be customized for arrow annotation.
FG color Set the color of the arrow. Set the color in the [Change color] dialog opened by
clicking the button or double-clicking the color palette.

BG color Set the background color of the arrow. Set the color in the [Change color] dialog
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opened by clicking the button or double-clicking the color palette. The arrow
background can be hidden by checking the [BG color] checkbox OFF.
Width Set the width of the arrow. The arrows width widens the larger the value is.
Spot radius The focal point can be displayed at the tip of an arrow by checking the [Spot
radius] checkbox ON. The radius of the focal point enlarges the larger the value is.
The focal point can be hidden by checking the [Spot radius] checkbox OFF.
Point
Draw a point annotation. A point annotation can be drawn by clicking the arbitrary position on images. The
position of a point can be changed by dragging on the center of the point.
The following settings can be customized for point annotation.
FG color Set the color of the point. Set the color in the [Change color] dialog opened by

BG color Set the background color of the point. Set the color in the [Change color] dialog
opened by clicking the button or double-clicking the color palette. The point
background can be hidden by checking the [BG color] checkbox OFF.
Diameter Set the diameter of the point. The diameter of the point enlarges the larger the
value is.
Line
Draw a line annotation. A line annotation can be drawn by clicking an arbitrary position on images. The position of
the line annotation can be changed by dragging the center of the line. Also, when the tail end of a line is dragged,
the orientation and the length of the arrow can be changed.
The following settings can be customized for line annotation.
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FG color Set the color of the line. Set the color in the [Change color] dialog opened by

BG color Set the background color of the line. Set the color in the [Change color] dialog
opened by clicking the button or double-clicking the color palette.

Line width Set the width of the straight line. The width of the line widens, the larger the value
is.
The inside of line annotations is always filled with the background color.
Curved line
Draw a curved line. Control points for a curved line can be placed by clicking an arbitrary position on images.
Double-click to confirm the curved line. The shape of the curved line can be changed by dragging the control
points. Selected control points can be deleted from the right-click menu. Control points can be set on different
orthogonal cross-sections or on planes of your choice.
The following settings can be customized for curved line annotation.
FG color Set the color of the curved line. Set the color in the [Change color] dialog opened
by clicking the button or double-clicking the color palette.

BG color Set the background color of the curved line. Set the color in the [Change color]
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dialog opened by clicking the button or double-clicking the color palette.

Show control points Show the position of control points in the curved line.
Line width Set the width of the curved line. The width of the curved line widens, the larger
the value is.
Curved line annotation is shown in 3D, as a three-dimensional curved line.
Cylinder
Draw a cylinder annotation. A cylinder annotation as shown below can be drawn in 3D by clicking the arbitrary
position. Planes of the cylinder are shown on each slice.
By dragging on the cylinder, you can rotate it, and by dragging on a cylinder axis, you can move the cylinder along
the axis.
The following settings can be customized for cylinder annotation.
Color Set the color of the cylinder. Set the color in the [Change color] dialog opened by
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Diameter (mm) Specify the cylinder diameter, in mm.

Length (mm) Specify the cylinder length, in mm.
Balloon
Draw a text (label) of the balloon. The focal point and the label can be drawn by clicking the arbitrary position on
images. Input text with the keyboard and press the Enter key to confirm. After confirming, the position of the focal
point can be changed by dragging it. Also, the position of the label can be moved without changing the position of
the focal point by dragging the label. The text can be edited by clicking the selected label.
The following settings can be customized for balloon annotation.
Font Set the font used in the label. Set the font in the [Font] dialog opened by clicking
the button. In [Size], also set the font size.

FG color Set the color of the text. Set the color in the [Change color] dialog opened by

BG color The background color of text can be changed by checking the [BG color]
checkbox ON. Set the color in the [Change color] dialog opened by clicking the
button or double-clicking the color palette. The text background can be

hidden by checking the [BG color] checkbox OFF.
Width Set the width of the arrow. The arrows width widens the larger the value is.
Keyword Entered text can be registered as keywords, for use later as needed. Input text can
be registered by clicking the [Register] button. When retrieving the registered
text, select the text to use from the pull-down menu of the [Select] button. The
selected text will be arranged in the center of the selected image frame. Also,
when selecting the label, the text of the label can be replaced with the selected
text.
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Text
Draw a text (label) annotation. A label can be drawn by clicking the arbitrary position on images. Input text with the
keyboard and press the enter key to confirm. After confirming, the position of the label can be changed by
dragging it. Also, the text can be edited by clicking the selected label.
The following settings can be customized for text annotation.
Font Set the font used in the label. Set the font in the [Font] dialog opened by clicking
the button. In [Size], also set the font size.

FG color Set the color of the text. Set the color in the [Change color] dialog opened by

BG color The background color of text can be changed by checking the [BG color]
checkbox ON. Set the color in the [Change color] dialog opened by clicking the
button or double-clicking the color palette. The text background can be

hidden by checking the [BG color] checkbox OFF.
Frame The label frame can be displayed by checking the [Frame] checkbox ON and can
be hidden by checking the [Frame] checkbox OFF.
Keyword Entered text can be registered as keywords, for use later as needed. Input text can
be registered by clicking the [Register] button. When retrieving the registered
text, select the text to use from the pull-down menu of the [Select] button. The
selected text will be arranged in the center of the selected image frame. Also,
when selecting the label, the text of the label can be replaced with the selected
text.
Delete or Copy Annotations

Drawn annotations can be copied and deleted in the tool frame.
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Delete Delete the selected annotations. Annotations can be deleted also by selecting
[Delete] from the right-click menu on each annotation.
Delete All Delete all the annotations.
Copy Copy the selected annotations. The copy of the selected annotation will be
displayed on the image by clicking the [Copy] button. The copied annotation
moves along with the cursor, and can be arranged on the arbitrary clicked
position.
Select Annotations
When a positioned annotation is selected, the display settings of the selected annotation are displayed in the tool
frame. When the display settings in the tool frame are changed, the change is reflected in the display settings of
the selected annotation.
Annotation Presets
When the annotation type and display settings are registered to a preset, the display setting can be omitted at the
next time. To use a preset, select a preset from the list and draw a new annotation on the viewer without
configuring display settings. Annotation presets are set from the tool frame.
Add The annotation type and the display settings shown in the tool frame are
added to the presets. At the time of registration, a dialog for input of the
preset name is displayed. Registration is completed by clicking the OK
button after the input.
Delete Delete the selected preset.
Rename Rename the selected preset.
Move up Move the selected preset up.
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Move down Move the selected preset down.
Presets are applied to newly positioned annotations.
Setting of Annotations
Configure settings related to the annotation. Click the button in the system frame, and select [Annotation] in
the [System settings] dialog.
Keep annotation type

• OFF
selected
When an annotation is drawn, the annotation type will be unselected. To
draw the same type of annotation, select the annotation type again.
• ON
Insert the same type of annotation continuously until the annotation type
is unselected.
Synchronize current
• OFF
position
Do not update the current position in viewers after annotation
arrangement operations.
• ON
Update the current position in viewers after annotation arrangement

operations.
Edit keywords Add a new keyword.
Delete the selected keyword.
Move the selected keyword up in the

list.
Move the selected keyword down in the
list.
restarted.
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3.4.5 Object Extraction and Removal
The Object Extraction and Removal tool is for editing the mask region in the 3D view. Editing such as extraction or
removal can be performed for a specified region on an image or an aligned region of voxels.
For the Object Extraction and Removal tool, select each extraction method from the buttons for [Edit the mask on
the 3D view] in the tool frame to operate. This tool can also be switched by selecting it from the right-click menu
on the image frame or from the shortcut bar besides from in the tool bar.
Operation Method for Object Extraction and Removal

Smart select
With Smart select, a region connected to a clicked point can be extracted or removed.
When the mouse cursor is moved close to the editable region, the shape of the mouse cursor changes. By clicking
the region with the shape, the region to be extracted or removed is displayed as multi-mask display on the 3D
image and as overlay display on the slice image.
Following operations are possible after the region has been selected.
Extract Extract the selected region.

Delete Remove the selected region.
Undo Cancel the last selection of a region.
Redo Redo the processing canceled by [Undo].
Cancel Cancel all selections of regions.
Dilation/Erosion size Extract or remove the selected region which is dilated according to the specified
after extraction size.
Move the deleted When managing deleted regions as separate masks, specify whether to move the
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region to unused mask region to the unused mask region automatically.
During region selection After deletion of the selected region
The criteria for the judgment as to whether or not a region is connected to the clicked position depend on the
display method for the clicked image as shown in the following table.
2D display Judged by the window width and level.

3D display (VR) Judged by whether or not the opacity is more than a certain value.
3D display (SSD) Judged by the SSD threshold.
3D display (MIP, SMIP, Judged by the window width and level.
MinIP, RaySum)
When the setting is configured to confirm the specified region, it is always possible to select multiple regions.
By repeatedly change the window width and level and selected regions, the region to be extracted or deleted can
be selected minutely.
Smart cut
With smart cut, objects in the region specified by mouse operation can be extracted or removed.
Region specification
Determine a region by the creation methods for regions shown in the following table.
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The points clicked on the image are connected with a straight line, and the enclosed region becomes
the target of extraction or removal. The region is determined by executing extraction or deletion by
double-clicking, pressing the Enter key, or from the right-click menu.
The points clicked on the image are connected with a smooth curve, and the enclosed region
becomes the target of extraction or removal. The region is determined by executing extraction or
deletion by double-clicking, pressing the Enter key, or from the right-click menu.
Select a region by free hand. Click the position that is to be the start point on the image, then drag
the mouse and voluntarily specify the region. When the mouse button is released, the region is
determined.
When the smart cut is used during the [Multimask], the [Applied only to an active mask] is displayed in the tool
frame. When selecting the checkbox, execute the editing only for the active mask. When clearing the checkbox,
execute editing for all of the masks in the multi-mask display.
System settings can be configured to display an icon as shown below in the center of the 3D image before a
region is specified. When dragging is started from inside this icon, the 3D object can be rotated. By dragging
(clicking) from outside the icon, region specification operation becomes possible.
When [Confirm the region specified by region extraction] is set to [ON] in the system settings, the specified
region can be edited. In the case of a region specified by control points, the control point positions can be
modified, and control points can be added or deleted. In the case of a region specified by a free curve, a new
curve is drawn by clicking near the region and dragging. Additionally, in this case, multiple smart cut regions can
be arranged at once.
Smart tracking
With Smart tracking, the region connected to a clicked point can be edited while the range is adjusted by dragging,
etc.
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Extraction target selection

Select either [Vessel] (tubular conformations) or [Region] for the target region of extracting (removing). If [Vessel]
has been selected, only tubular tissues are extracted. If [Region] has been selected, extraction is performed
assuming that extraction target is the region with a group of specific signal values.
Extraction mode selection

Select the extraction mode for the present mask from the following three modes.
Extract new Delete all the present masks and extract a new mask region.
With [Extract only inside current mask] set to ON, extraction is restricted to within
the current mask. Set to OFF, extraction targets the entire image.
Add region Add the extracted mask region to the present mask region.
With [Extract current mask] set to ON, extraction includes the current mask. Set to
OFF, the current mask is excluded from extraction.
Delete region Remove the extracted mask region from the present mask region.
Extraction method selection

If the extraction target is a blood vessel, following two methods are available.
Tracking Extract a region, tracking a tubular region with the similar signal values as that of
the specified point.
Classifying Considering the contour contrast information, signal values, shape, etc. of vessels
obtained in advance, the region judged as vessels is expanded. For the classifying
type, also extraction level can be selected from the following three levels;
[Accuracy], [Normal], and [Tracking]. Specifying [Accuracy] results in less
unextracted or excessively extracted regions, and specifying [Tracking] results in
less stops in the middle of tracking. Additionally, smaller vessels can also be
extracted by selecting [Search small vessels].
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Start of extraction
With the initial setting, extraction procedure starts by dragging the mouse from the position of the extraction
target.
By dragging a mouse vertically, an extraction range can be changed. Also, by adjusting the slider of the [Specify the
range of extraction] in the tool frame after stop dragging the mouse, the extraction range can be adjusted. The
larger the number of the slider is, the broader the extraction range is. To determine the region conclusively, click
the [OK] button. As with smart select, selecting [Move the deleted region to unused mask], deleted regions can be
registered as separate masks.
Before extracting the region (Extract new) After extracting the region (Extract new)
Before adding the region (Add region) After adding the region (Add region)
Before removing the region (Delete region) After removing the region (Delete region)
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Similarity of the signal value in [Region], [Vessel], and [Tracking]

In [Region] mode, [Vessel] mode, and [Tracking] mode, it is judged whether or not the region has the similar signal
values to those of the region clicked by the user by the following conditions. More flexible region extraction is
possible comprehending and using these conditions.
2D display Judged by the window width and level.

3D display (VR) Judged as follows according to the modality with which the image was exposed.
• CT image
Depending on the setting of the [Track using WL (CT)] in the [Setting],

judged by the window width and level, and the value of opacity.
• Images other than a CT image
Judged by whether or not the opacity is more than a certain value.
3D display (SSD) Judged by the SSD threshold.

3D display (MIP, SMIP, Judged by the window width and level.
MinIP, RaySum)
An unexpected region, such as the back of a visible surface, might be added or removed.
Surface digger
With surface digger, digging processing to the specified depth can be performed on the surface of an object in the
specified region.
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The processing target region can be specified by four types of operations. In addition to the same three types as
those of the [Smart cut] selection, the following method also can be selected.
Auto Specify a single point, and the continuous surface region from that point is extracted.
extraction
Operation for Surface digger

To configure multiple regions simultaneously, enclose the regions while holding the Ctrl key, and then click
[Execution]. The following tasks are available at this time.
Undo Remove the last specified region.

Redo Recover the region removed by [Undo].
Cancel Remove all specified regions and return the digger processing for which [OK] has
not been clicked yet to the original.
Execute Execute surface digger into the specified region.
During region specification After deciding digger processing
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When [Continuous operation] of [System settings] has been set to [ON], the digging depth can be changed after
digging processing by mouse wheel operation or by slider operation. After changes, complete the processing by
selecting [OK] from the right-click menu or from below the depth slider in the tool frame.
Dilation and erosion of mask region
Dilate or erode the mask region. Perform the operation by using the [Mask operation] button.
Operation for dilation/erosion of the mask region

To configure multiple regions simultaneously, enclose the regions while holding the Ctrl key. The following tasks
are available for the regions.
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Cancel Remove all specified regions.
Dilation Dilate the mask region. If the [Size] value is larger, the region to be dilated in one
operation will be larger.
Erosion Erode the mask region. If the [Size] value is larger, the region to be contracted in
one operation will be larger.
The same operations are possible with the [Dilation] or [Erosion] buttons in the color template frame. In this case,
the extent is set to "1."
When [Dilation] or [Erosion] is clicked without specifying any region, dilation or erosion processing is performed
for the entire mask.
Threshold range extraction
Regions with the signal value in a specified range are extracted. The extraction target region is limited within the
current mask region, so the mask region will not be larger than the current one.
When [Threshold range extraction] is selected, the 3D image is displayed in SSD color, and regions within the
specified threshold range are displayed as overlay displace on the slice image.
Slice image 3D image
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The processing target region can be specified by three types of operation. By clicking the [Invert] button, you can
also specify whether to extract inside or outside of the specified signal range.
Operation for threshold range extraction

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Execute Extract the region inside the specified threshold range.
When [Execute] is clicked without specifying any region, specified threshold range extraction is performed for the
entire mask.
Even when [Continuous operation] of [System settings] has been set to [ON], the 3D image color status returns to
the status before processing once the threshold range extraction mode is exited. Here the extraction status can be
confirmed.
Opacity range extraction
On the VR display, regions with the opacity within the specified range are extracted. The extraction target region is
limited within the current mask region, so the mask region will not be larger than the current one.
The processing target region can be specified by three types of operation. By clicking the [Invert] button, you can
also specify whether to extract inside or outside of the specified opacity range.
Extraction mode selection

Select the extraction mode for the present mask from the following two modes.
Extract Extract an AND region consisting of the current mask region and extracted region.
Delete Remove the extracted mask region from the present mask region.
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Operation for opacity range extraction


Execute Extract the region inside the specified opacity range.
When [Execute] is clicked without specifying any region, opacity range extraction is performed for the entire mask.
Remove small object
On the VR display, remove a region whose volume is equal to or smaller than a specified value. The extraction
target region is limited within the current mask region, so the mask region will not be larger than the current one.
The processing target region can be specified by three types of operation.
Operation for small object removal

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Execute Remove regions smaller than the specified volume.
When [Execute] is clicked without specifying any region, small objects can be removed for the entire mask.
Setting of Object Extraction and Removal
Configure various settings related to "Object Extraction and Removal". Click the button in the system frame,
and select [Object Extraction and Removal] in the [System settings] dialog.
Select edit and Region edit
Treatment of clipping When 3D clipping is used, set the behavior of specifying a clipping region. This
region setting is applicable for smart select, smart cut, threshold range extraction, opacity
range extraction, and remove small object. Smart tracking and mask region
operations are always executed regardless of the clipping regions.
• Inside and outside
Extract the mask region regardless of the clipped range.
• Only inside
Extract the mask region only within the clipped range.
• Remove outside
Extract or remove the mask region within the clipped range, and remove
the mask region outside the clipped range.
Centering after Set whether or not to display the center of gravity of the mask region in the
extraction center of the display after extracting or removing a region.
• OFF
Displays as it is without moving the center of the display after extracting or

removing.
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• ON
Change the center of the display after extracting or removing.
Continuous operation Specify this for continuous processing in the same mode after extraction or
removal in each mode.
Use the function to Manually removed mask regions are retained separately, and display can be
show removed region. switched between the current view and removed mask as needed. After editing of
some kind, the [Show removed region] button in the tool frame can be used to
display removed regions.
Min. selectable opacity Set the minimum opacity of a selectable region in extracting or removing the
selected object on the VR display. This setting is applicable only for smart select,
smart tracking, and removing small objects.
Confirm the object Set whether or not to confirm the selected region in multi-mask display with
specified by object smart select.
extraction
• OFF
Icons of smart select for extraction and removal are displayed. The
operation is executed soon after region selection.
• ON
Multiple selected regions can be confirmed on the 3D multi-mask display.

Select extraction or removal from the tool frame.
Overlay mask color for Possible to set when [Confirm the object specified by object extraction] has been
object extraction. set to [ON] for smart select.
Set the color for multi-mask display of the selected region.
Overlay mask opacity Possible to set when [Confirm the object specified by object extraction] has been
for object extraction. set to [ON] for smart select.
Set the opacity of the selected region.
Max number of undo in Possible to set when [Confirm the object specified by object extraction] has been
object extraction set to [ON] for smart select.
Set the max. number of times [Undo] can be performed while multiple regions
are selected.
Confirm the region Set whether or not to extract or remove multiple specified regions at a time with
specified by region smart cut.
extraction
• OFF
Icons of smart cut for extraction and removal are displayed. The operation
is executed soon after region specification.
• ON
Multiple regions can be specified. Select extraction or removal from the

tool frame.
Show rotation area in Enables display of an area for rotating objects during region extraction.
the center of display
• OFF
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Objects can be rotated by dragging the cube in the lower right of the
image.
• ON
Objects can be rotated by dragging a rotation area displayed in the center

of the screen.
Confirm the extraction Set whether or not to confirm the direction for extraction or removal when
direction on MPR for extraction processing is executed on a slice image with smart cut.
region extraction
• OFF
Smart cut processing is executed for all slice positions, regardless of the
slice position where a region has been specified.
• ON
A dialog as shown below is displayed, and you can specify the direction in
which smart cut processing is to be performed from the slice position
where a region has been specified.
Execute detail ROI

• OFF
extraction
Normal ROI extraction is done.
• ON
When you use this function with magnified image, a specified processing
for precise extraction of ROI is done. The limit of the magnification rate can
be changed as "Minimum zoom rate for execution".
Smart tracking
Number of Set the direction for dilating regions.

neighbors
• Sphere
A region is dilated in spherical shape centering around the voxel set as the extraction
seed point.
• 6 neighbors
A region is dilated towards the direction of the voxels sharing planes with the voxel
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set as the extraction seed point.
• 18 neighbors
A region is dilated towards the direction of the voxels sharing sides with the voxel set
as the extraction seed point.
• 26 neighbors
A region is dilated towards the direction of the voxels sharing vertices with the voxel
set as the extraction seed point.
Track using When any point on a 3D image (VR of CT image) is clicked, the system judges if the image
WL (CT) has at least a certain degree of opacity. This setting item sets the window width and level to
be used after this judgment. Using the window width and level set here, the system judges
whether or not the region is continuous any point.
Threshold When the [Extraction target] is set to the [Vessel] and any point on a 3D image (VR other
than an SSD or CT image) is clicked, the boundary of the region to be extracted is calculated
from the signal values. This threshold is used for the judgment of the boundary when the
extraction seed point is specified on a 3D image. Generally, the narrower the range, the
greater the selectivity is for the extraction.
WL range When the [Extraction target] is set to the [Vessel] and any point on a 2D and 3D image (VR of
CT image) is clicked, the boundary of the region to be extracted is calculated from the
window width and level. Generally, the narrower the range, the greater the selectivity is for
the extraction.
Use standard This setting item is used as a criterion for obtaining a standard deviation from neighbors of
deviation * k the voxels at the extraction seed point and enlarging continuous region. This value is
multiplied by the standard deviation. The larger the value, the wider the continuous region. A
value between "0.5" and "3.0" can be set.
Max. search Set the range to be calculated for the continuous region from the extraction seed point. If
range the larger the value is, the wider the range of the continuous region becomes.
restarted.
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3.4.6 3D Clip
The [3D Clip] tool can set the clipping range for a 3D display and straightened CPR. This tool can be used by
selecting [3D Clip] from the right-click menu on the image frame or by selecting the icon in the tool bar.
Display range
By setting the clipping range for a 3D display, the image can be clipped so that a fixed range of the image is
displayed in a front-back, left-right, and up-down orientation. The clipping range can be configured in either of the
following ways.
• Setting on the image frame
The clipping range is indicated by dotted lines on 2D images. On 3D images, moving the mouse cursor near
the edges of a clip shows the clip boundary lines. When the mouse cursor is moved along the dotted lines,
the dotted lines change to solid lines. The clipping range can be set by dragging.
Description of the clipping range on 2D display 3D display
• Settings in the [Clipping range] in the tool frame
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Input and set the clipping range by moving each of the front-rear, left-right, and up-down sliders.
You can also specify whether to use the inside or outside of the clip region for [Display side].
Inside 3D display for the region enclosed by a

dotted line.
Outside 3D display for outside the region
enclosed by a dotted line.
Operation
Operations related to 3D clipping can be performed.
Reset Initialize the clipping range and special clip.
Overlay MPR Set whether or not to overlay a 2D display on the 3D clipped plane. Also,
overlay a 2D display for the plane cut by the mask region.
Centering Position the 3D display at the center of the image frame. When the mask
region has been set by a smart cut, etc., the clipping range is set at that
part, and positioned at the center of the image frame.
Extract Leave only the region currently displayed by clipping on the 3D display
and cut out the other regions.
When overlaying MPR, the 2D plane and 3D image can be observed simultaneously as shown below.
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Click the [Extract only the visible area] button to release the special clipping after extraction.
Special Clipping
When a special clip is used for a 3D display, the visible area of the special shapes can be set in addition to the clip
in the clipping range.
• Arbitrary plane clipping
• Face clipping
• Sphere clipping
• VOI clipping
Arbitrary plane clipping
The arbitrary plane clipping can clip a 3D display via a plane with an arbitrary position and orientation.
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The visible area for the arbitrary plane clipping is specified on the 2D display.
The visible area formed by an arbitrary plane clipping is described by three lines which indicate the position,
orientation, and thickness of the plane on a 2D display. If the mouse cursor is moved over the three lines, the shape
of the mouse cursor changes. If the mouse is dragged with that status, the visible area of the arbitrary plane
clipping can be specified.
This mouse cursor is displayed when the cursor is moved close to the crosshairs cursor centered in
the three lines.
The center position of the plane clip can be moved.
This mouse cursor is displayed when the cursor is moved close to both end lines of the three lines.
The thickness of the plane clip can be changed. The thickness can also be set by moving a slider or
entering a value for the [Plane thickness] in the tool frame.
This mouse cursor is displayed when the cursor is moved close to the centerline of the three lines.
The orientation of the plane clip can be changed.
Description of an arbitrary plane clipping on 2D display 3D display
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The effect of dragging on the 3D display can be set via the [Rotate 3D object] and [Rotate clipped plane] buttons
of [Mouse operation for 3D view] in the tool frame.
Rotate 3D object Change the orientation of a 3D object by dragging on the 3D display.

Rotate clipped plane Change the orientation of the clipped plane object by dragging on the 3D display.
Adjusting the orientation of a plane on the 2D display with [Rotate 3D object based on the clip] selected rotates
the 3D display so that the normal direction of the clipped plane faces the front.
Face clipping
The face clip can form a 3D display of a region deeper than the set distance away from the front, the line of sight
direction.
The distance from the front, which indicates the visible area with the face clipping, is set either by moving the
[Distance from front (mm)] slider or by turning the mouse wheel on the image. Select the [Specify the depth (mm)]
to restrict display to the area set with the slider, from the clip position.
The direction of the face clipping plane is set so that the display always remains perpendicular to the visual axis
when the mouse is dragged over the 3D display and the 3D display rotates. The position and direction of the face
clipping are indicated by the solid line on the 2D display.
Description of a face clipping on 2D image 3D display
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Sphere clipping
The sphere clip can form a 3D display clipped by a sphere with any arbitrary position and radius.
The visible area for the sphere clipping is specified on the 2D display.
The visible area determined by a sphere clipping is described with the size and position of the sphere on the 2D
display. When the mouse cursor is moved over the line, the shape of the mouse cursor changes. If the mouse is
dragged with that status, the visible area of the sphere clipping can be specified.
This mouse cursor is displayed when the cursor is moved close to the apex of the rectangle
circumscribed by the circle.
The radius of the sphere to be displayed can be changed. It can also be set by moving the slider or
entering a value for the [Radius of sphere (mm)] in the tool frame.
This mouse cursor is displayed when the cursor is moved close to the crosshairs cursor at the center
of the circle.
The center position of the sphere to be displayed can be moved.
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Description of a sphere clipping on 2D display 3D display
From [Display side], you can specify either the inside or outside of the sphere clipping region as the region to
display.
Inside 3D display for the region surrounded by the solid line displayed on the 2D display.
Outside 3D display for outside the region surrounded by the solid line displayed on the 2D
display.
The effect of dragging on the 3D display can be set via the [Rotate 3D object] and [Move sphere] buttons of
[Mouse operation for 3D view] in the tool frame.
Rotate 3D object Change the orientation of a 3D object by dragging on the 3D display.

Move sphere Move a sphere on the plane in 3D display orientation by dragging on the 3D
display.
VOI clipping
The VOI clipping can zoom on and display a portion of the image in 3D.
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The visible area can be set by moving the slider or entering a value for the [Side length of VOI (mm)] in the tool
frame.
When the mouse cursor is moved close to the center of the crosshairs cursor on a 2D image or over the plane to
be clipped on a 3D image, the shape of the cursor changes. The visible area can also be set by dragging the mouse
with that status.
Description of VOI clipping on 2D display 3D display
Using the 3D movie dialog
A dialog for registering key frames can be displayed from the [Movie] tool. For key frame registration dialog
instructions, refer to [Create movies with the free rotation mode] in the [Movie] tool help.
Display setting for straightened CPR

Only a certain range can be displayed with reference to the center line in the straightened CPR display.
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Set whether or not to display only a certain range in [Limit the display width]. Following two methods for setting
the display width are available when set to [ON].
• Setting on the image frame
The clipping range is described with the dotted lines on a straightened CPR. When the mouse cursor is
moved on the dotted lines, the shape of the cursor changes. The visible area can also be set by dragging the
mouse with that status.
Description of clipping range on a straightened CPR
• Setting in [Display width (mm)] in the tool frame
Move the slider to enter a value and set the clipping range.
3D Clip Settings
Configure settings related to 3D Clip. Click the button in the system frame, and select [3D Clip] in the [System
settings] dialog.
Overlay MPR on the edge of the When [Overlay MPR] is ON, set whether to display MPR on the edge of
mask the mask.
• OFF
Display MPR only on the edge of the clip.
• ON
Display MPR on the edge of the clip and the edge of the mask.
Always show clipping range on Set whether to show the edge of the clip on the 3D display.
3D
restarted.
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3.4.7 SUV Evaluation
The Standard Uptake Value (hereinafter SUV) is used as an index to evaluate the degree of accumulation of the
marking agent in the tumor and each tissue. The [SUV Evaluation] tool can measure the SUV maximum value,
average value, and standard deviation in 3D regions.
When clicking on an image for which SUV evaluation is possible, the ROI is displayed, and the SUV evaluation result
for the 3D region within the ROI is displayed on the image and in the tool frame. When the center point is dragged,
the ROI is moved, and when the circumference is dragged, the radius is changed.
SUV threshold for displaying areas within ROI

Highlight the region with the SUV which exceeds the threshold value.
Threshold: 0.5 Threshold: 1.5
SUV evaluation is performed inside the highlighted region, in regions not grayed out. Changing the threshold
therefore updates evaluation results.
ROI radius
The radius of the sphere, which is the measuring range for SUV measuring, is set in units of millimeters.
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Display settings
Adjust viewer display settings as needed. These settings are also accessible from the right-click menu on the screen.
Current evaluation When this option is selected, the max. SUV, the average SUV, and the SUV
values standard deviation are displayed near the ROI.
Reference line of cross- When this option is selected, reference lines are displayed from the center of the
sectional planes ROI in all directions in viewers.
Registered region When this option is selected, contours of regions subject to evaluation in ROIs
contour registered in the [List of SUV evaluation results] are displayed on MPR images.
SUV evaluation result
Correction method Select from Body weight, Lean body mass, Body surface area, or Ideal body
weight. The SUV display units for the corner information and the pseudo-color bar
top and bottom are SUVbw, SUVlbm, SUVbsa, and SUVibw respectively.
Modify correction Edit dialog for Patient height, Patient weight, and Sex is displayed. When there are
parameters empty columns, only Body weight can be selected as the correction method.
Maximum SUV The max. value of the SUV within the ROI.
Average SUV The average value of the SUV within the ROI.
SUV standard deviation The standard deviation of the SUV within the ROI.
Peak Maximum value of SUV mean values for a 1 cm3 spherical region in the ROI.
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Displayed when you have set [Calculate SUV peak] to [ON] in the settings.
Volume (MTV) The volume of the highlighted region in the ROI. Displayed as MTV when
[Calculate TLG] is set to [ON].
TLG TLG is calculated by multiplying average SUV by volume. Displayed when
[Calculate TLG] is set to [ON].
When selecting the SUV correction method, it is necessary to set the use of modification of the SUV correction
factor of PET images in advance by system setting.
List of SUV evaluation results

The multiple SUV evaluation results can be registered in a list. The row name, maximum, average, SD, volume, and
threshold correspond to the ROI name, maximum SUV, average SUV, SUV standard deviation, and volume of the
region evaluated, as well as the highlight display threshold when registered.
Register the evaluation result in the list. The ROI is displayed on the image, maintaining the position
and the radius at the time of registration. Results can also be registered by double-clicking. However,
registration is not possible unless the center of the ROI is highlighted.
Delete the evaluation result from the list. The ROI display is also deleted at the same time.
Rename evaluation results.
Send the display contents of the list as an image to the capture box.
Save the display contents of the list in CSV format.
Calculation of parameters registered to the list is only based on separate regions for which the center of the ROI
lies in the highlighted region of the ROI. However, parameters shown next to ROIs are calculated from the entire
highlighted area in the ROI. Values of parameters registered in the list may therefore differ from on-screen values.
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For circular ROIs as shown above, calculation of parameters registered to the list is only based on the area in green.
However, calculation of parameters shown next to ROIs also includes the peripheral areas on the left and right of
the ROI. As for region borders, the determination to include these areas in calculations is based on whether the
center of the voxel lies within the region.
You can jump to planes with registered evaluation results by selecting an item in the list.
SUV evaluation can only be performed on a PET image that has the necessary parameters in the DICOM
information. Depending upon the modality, the software version, or the settings, it may not always be possible to
perform SUV calculation or the results of calculation may be inaccurate.
Comparison of SUV evaluation with past data

When you compare current data with past results in applications supporting the SUV Evaluation tool such as 3D
Viewer or Fusion, the current data is automatically evaluated to show the correspondence with evaluation results
registered in past data.
There may be some discrepancies between registered positions of current and past data, due to different image
sizes or other factors. In this case, re-register current data as needed.
SUV Evaluation settings
Configure various settings related to SUV Evaluation. Click the button in the system frame, and select [SUV
Evaluation] in the [System settings] dialog.
Calculate SUV peak

Specify whether to calculate SUV peaks.
Calculate TLG
Specify whether to calculate TLG. When set to [ON], [Volume] in SUV
evaluation results is displayed as [MTV].
Register the SUV evaluation

• OFF
result by double-click
operation Evaluation results can only be registered from the add button of [List
of SUV evaluation results].
• ON
Evaluation results from the center of the current ROI can be registered
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by double-clicking.
Show the current evaluation

• OFF
on the left bottom corner
For the current position, show evaluation results in the viewer.
• ON
For the current position, show evaluation results in the lower left of
the viewer.
Show the evaluation results

• OFF
on the left bottom corner
Registered evaluation results are only shown in the list.
• ON
Registered evaluation results are shown in the lower left corner of the
viewer.
Show items Select the items to show in viewer corners. Can be used when at least one of
the options [Show the current evaluation on the left bottom corner] or [Show
the evaluation results on the left bottom corner] is set to [ON].
Synchronization of the
• OFF
current position and ROI
Paging does not change the position in the center of the ROI.
• ON
The position in the center of the ROI follows paging.
Change the ROI radius with

• OFF
a mouse wheel
The ROI radius does not change with the mouse wheel.
• ON
The ROI radius can be changed using wheel operations within an ROI
on the plane. The amount of change per wheel operation can be set.
Copy past study evaluation Specify whether to register evaluation results from past studies to
position to current corresponding positions in current studies, for past comparison. When
registered, evaluation results from past studies are registered with the same
name.
If past and present studies have different exposure areas, the corresponding
positions may not match. Thus, check carefully.
restarted.
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3.4.8 Organ Extraction and Removal
Extract or remove ROI such as organs. Perform the operation for each extraction method by selecting the
extraction method from the [Extraction mode] button in the tool frame. To restore the state before object
extraction or removal, click the template frame button, and click the button to redo the operation.
Three main modes are available. Use [Segmentation] mode for automatic or semi-automatic extraction of organ
regions from the original image, [Recognition] mode to identify extracted organs or vessels, or [Preset] mode to
manage a series of organ extraction operations as presets.
With any extraction method, accurate region extraction or removal may not be possible due to the extraction
settings, image exposure, patient physique, posture, lesions, or other factors. After extraction or removal, always
check the extracted or removed region.
Selection of images for extraction
When RT Assist starts up and the upper image can be used for organ extraction, you can chose either the upper
or lower image for extraction.
Bone extraction
Automatically removes or extracts bone regions from the head/neck and chest/abdominal/foot CT images. Select
an operation mode from [Remove] and [Extraction].
Before bone extraction/removal After bone removal After bone extraction
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Extraction method
Select [Extraction method] for removing or extracting bone regions. [Extraction method] has 2 options, which are
characterized as shown below. Select a suitable method depending on the situation.
Classifying In comparison with the Tracking method, this method takes longer time but
removes and extracts bone regions with higher precision.
Tracking Removes and extracts bone regions while showing the process. This method
completes a removal/extraction process in a shorter time than the Classifying
method.
Body part extraction (Classifying)

Select the [Body part] to extract from the following options.
Head/Neck Removes or extracts a bone region as a head/neck image.

Chest/Abd./Foot Removes or extracts a bone region as a chest/abdominal/foot image.
Auto Identifies the body part (the head/neck or chest/abdominal/foot) from the image,
and removes or extracts the bone region as an identified part image.
Extraction level (Classifying)

The granularity of pixels processed in bone region removal and extraction can be changed from the [Extraction
level] in the tool frame. More memory is consumed if a finer level is selected. If removal or extraction of bone
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regions cannot be performed, for instance due to an error caused by insufficient memory, change to a coarser level
and try removal or extraction of bone regions again.
When [Head/Neck] is selected in [Body part], if the chest area is included in the image, removal or extraction of
bone regions may not be successfully completed. If you want to process an image including the chest area, select
only the head/neck as the image range from the study list, and reload the image before performing removal or
extraction of bone regions.
Extraction level (Tracking)

When [Tracking] is selected as the [Extraction method], the degree of the region to be considered as bone can be
changed from [Extraction level] in the tool frame. The bone region for removal or extraction is expanded in the
following order:
[Min.] → [Small] → [Normal] → [Large] → [Max.]
If some bone regions remains not removed or extracted, change the extraction level to a larger one, or if bone
regions are extensively removed or extracted, change the extraction level to a smaller one, and then perform
removal or extraction of bone regions again.
Plaque area mask (Tracking)

Bone removal and extraction is possible with simultaneous automatic extraction of the plaque area. The mask for
saving the extraction result can be selected.
Unless at least the following conditions are satisfied, removal or extraction of bone regions may not be successfully
completed.
• The body surface must be inside the effective field of view (hereinafter abbreviated as FOV).
• The image shall be from the clavicle to the foot.
When [Classifying] is selected for the method of bone region removal or extraction, correct results may not be
obtained from data of which the pixel scales of the target images are 2 mm or more.
When [Classifying] is selected for the method of bone region removal or extraction, correct results may not be
obtained from non-contrasted data.
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Bed removal
Automatically removes the bed region from a CT image. This is especially useful for MIP display when the
chest/abdominal area is scanned.
Before bed removal After bed removal
Brain extraction
Automatically extracts the brain from a head CT image.
Before brain extraction After brain extraction
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Heart extraction
The heart region is extracted automatically from chest CT images. Unless the lung field region (air region) is
included in the FOV, extraction of the heart region is not performed properly.
Before extracting heart After extracting heart
When an image covers a wide range including the aortic arch or the abdomen, extraction of the heart region may
not be performed properly.
When [Remove unnecessary area above heart region] is set to [Remove], depending on the image exposure
condition, the effect of the contrast, the patient posture, lesions, etc., removal of unnecessary regions may not be
performed properly. The coronary artery, the ventricle, the atrium or a part of the heart muscle may be removed.
Colon extraction
The colon region is extracted automatically from the upper and lower abdomen CT image exposed with air injected
into the colon.
Before extracting the colon After extracting colon
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Lung field extraction
Automatically extracts the lung region (bronchus and lung) and lung surface from a chest CT image. Please select
an extraction target from [Whole lung] and [Lung surface].
Before extracting the lung field After lung extraction (Whole lung) After lung extraction (Lung surface)
Bronchus extraction
The bronchus region is extracted automatically from chest CT images. There are two types of extraction methods
(fast and detailed). When [Fast] is selected, the bronchus region is extracted quickly. On the other hand, when
[Detailed] is selected, a longer time is required, but a more detailed bronchial region is extracted.
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Before extracting bronchus After extracting bronchus (Fast) After extracting bronchus (Detailed)
When extracting the bronchus, a region other than the bronchus may be detected mistakenly, and the extraction
may take longer time. In such a case, click the [Cancel] button to stop processing.
For bronchus extraction, use images for which the reconstruction functions for mediastinum display are used,
instead of the function for lung display.
Liver extraction
The liver region is extracted automatically from the abdomen CT images.
Before extracting liver After extracting liver
Tumor extraction
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The tumor region is extracted semi-automatically from CT images. Tumor extraction can only be performed on
orthogonal views (axial, sagittal, coronal planes). When the oblique view is displayed, switch it to an orthogonal
view first.
1. (Select the organ to be extracted)
2. Select the extraction mode
3. Extract the region
4. Correct the region
Extracted region
Following two types of region to extract can be select. Select either one according to the region to be extracted.
Lung nodule Used to extract nodes in the lung field.

Tumor Used to extract tumors mainly in the liver.
Target organ options are not displayed unless [Automatic selection of region type] is set to [OFF] in the system
settings. By default, [Lung nodule] or [Tumor] is determined automatically.
Extraction mode
Following two extraction modes are available. Select either one according to the purpose.
Extract new Extract the tumor region as a new region. The present mask region is deleted.
Add region The extracted tumor region is added to the present mask region.
The region can be extracted by dragging the diameter of the lung nodules or the tumor to be extracted in either
the axial, sagittal, or coronal plane.
Before extraction After extraction
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Depending on the shape of the region or the image signal values, the required region may not be extracted. In
such a case, set the seed points by clicking on the boundary line of the not extracted region and click the [Start
correction] button to correct the region. When a seed point has been set on a wrong position, it can be deleted by
selecting [Delete] from the right-click menu on the seed point. To set the points from the beginning, select [Clear
seed point] from the right-click menu to clear all the seed points.
Boundary control point setting After extraction
After completing the extraction of one tumor, the extraction can be finished by clicking the [Finish extraction]
button, or switching the extraction region type or [Extraction mode].
Extract vessel
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The contrast-enhanced blood vessel region is extracted semi-automatically from CT or MR images.
1. Select the extraction method
2. Select the extraction mode
3. Track the vessel
Or automatically extracts small vessel regions.
Extraction method
Following three extraction methods are available for blood vessel region. Select either one according to the vessel
region to be extracted.
Single point Tracks the vessels based on the specified point and tracking direction to extract
their regions.
2 points Tracks the path between the two specified points to extract its region.
Small vessel Automatically extracts small vessel regions.
Single point
The following two methods are available for extracting vessel regions by tracking a single point. Select either one
according to the vessel region to be extracted.
Tracking (General) Use this method when there is a significant difference in signal values between
the target vessel and neighboring tissue, as for the abdominal artery.
Tracking (Portal) Use this method when there is a significant difference in signal values between
the target vessel and neighboring tissue, as for the hepatic vein and portal vein.
When [Single point] is selected as the extraction method, click the position of the start point for tracking on a 2D or
3D image. Then, click it again after moving the mouse cursor so that the arrow head faces towards the tracking
direction to start tracking of vessels. When tracking completes, the tracked region is extracted.
Click at the tracking start position Set the arrow tip in the tracking direction
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Tracking the blood vessel After extracting the blood vessel
2 points
When [2 points] is selected as the extraction method, select a path extraction method from the following two
options.
Tracking A path is searched while displaying the processing progress. In comparison with
the classifying type, search processing is completed in a shorter time.
Classifying In comparison with the tracking type, the processing requires more time, but a
path is searched with higher accuracy.
When [2 points] has been selected as the extraction method, click on two positions to start tacking on 2D or 3D
display in order to start searching a path between the 2 points. When the searching of the path is finished, the
blood vessel region running through the path is extracted.
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Click two points for searching a path After extracting the blood vessel
Extraction mode
When [Single point] or [2 points] is selected, select the extraction mode. Select from the following two modes
depending on your purpose:
Extract new Extracts the tracked vessel region as a new region. The present mask region is
deleted.
Add region Adds the tracked vessel region to the present mask region.
Depending on the start point and the direction for tracking, the extraction result may differ each time. Depending
on the tracking start point, the direction for tracking, and the image signal value distribution, an unintended region
may be tracked. In such a case, click the [Stop extraction] button to stop the process after the blood vessel is
tracked to some extent.
Small vessels
Automatically extracts small vessel regions from an abdominal CT image. This function is intended for small vessel
extraction only, and larger vessels are not extracted. If necessary, use bone removal or other functions to extract
thick vessels separately, and then merge the results with small vessel extraction results.
Before vessel extraction After small vessel extraction
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Vessel image after bone removal Vessel image after bone removal + Small vessel extraction
Hip joint extraction
The femurs and the pelvis area are extracted from the CT images containing the hip joint parts.
Extracted region
With hip joint extraction, the extraction target region can be selected as [Both], [Left], or [Right].
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Extraction mode
When [Both] has been selected as the extraction region, the extraction mode can be selected from the following.
Auto The hip joint is classified and extracted automatically.

Manual The center of the head of the femur is set on axial, sagittal, and coronal plane, and
extraction is performed on the basis of the set point.
When [Left] or [Right] has been selected, extraction is always performed in [Manual] mode, and [Auto] mode
cannot be selected. Set the center of the left and the right head bone for extraction. If the center of the head bone
has been set erroneously to a wrong position, the position can be corrected by dragging the control point, or [Clear
seed point] can be selected from the right-click menu and the center of the head bone icon can be set from the
beginning.
Setting the centers of the head Setting the center of the head bone Setting the center of the head bone
bones of both feet of the left foot of the right foot
Extraction result (both feet) Extraction result (left foot) Extraction result (right foot)
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When [Manual] has been selected for [Both], always specify the center of the left head bone first and then the
center of the right head bone.
Pelvis area output mask

When hip joint extraction is performed as it is, the femurs are saved in the present mask. The output target mask
must be set for the pelvis area.
Further, in case of extraction of the hip joint contrast-enhanced CT images, the blood vessel region is saved divided
randomly with the pelvis side mask or the femur side mask. As far as possible, [Bone extraction] should be
performed in advance to perform [Hip joint] with the blood vessel region removed. It is also possible to specify the
target mask for [Hip joint] as the present mask or as clearing all and performing a new extraction.
When [ON] has been selected, extraction is performed for the current mask, and when [OFF] has been selected, all
masks are cleared and a new extraction is performed.
Femur Pelvis
Spine extraction
The spine region is extracted from CT images.
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Spine area output mask

In spine extraction, when spine area output masks are set, each vertebra from the head is displayed in the set
masks one by one from the smaller number of the mask. When no spine region output masks are set or when only
one spine region output mask is set, the entire spine region is output to the present mask or the set mask.
Before spine extraction No spine region output mask

or only one specified
Spine region output mask set as 1 and 2 Spine region output mask set as 1 and 2
Mask #1 Mask #2
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Surface extraction
Surface region when a 3D image is reconstructed from input images is extracted.
Thickness
The thickness of the extracted surface can be set by moving the slider or by entering a value.
Before extracting surface After extracting surface (Thickness = 5)
The thickness size which can be specified with surface extraction is the voxel number. Therefore, even when the
same thickness is specified, the thickness may appear differently with each image.
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Bone separation
Bones are removed and extracted one by one from the CT or MR image. This can be used in places with small,
intricate bones, such as wrist joints or leg joints. You can also use this function to accurately remove and extract the
cavity regions in bone masks and the mask regions of spongy tissues. Select an operation mode from [Remove]
and [Extraction].
With CT images, bones to extract can be specified on a 3D image or 2D slice view. With MR images, bones to
extract can be specified on a 2D slice view. The following shapes are available for the method.
Circle/sphere Remove and extract the bones in the region within the circle or sphere that
appears when you drag on the bone region of interest. (Not available for MR
images.)
Polygonal line Enter a control point, and then remove and extract the bones within the region
surrounded by the polygonal line.
Curved line Remove and enter a control point, and then extract the bones within the region
surrounded by the curved line.
Freehand Remove and extract the bones within a region surrounded by a freehand line,
drawn by dragging the mouse.
At the site of a joint, such as a wrist or ankle joint, you might want to specify multiple bones separately. In that case,
it is possible to exclude the already-extracted bone region from the bone regions to be extracted subsequently.
Specify the mask number that contains the bone mask where extraction was already done. In this way, you can
extract bones in complex regions with multiple bones.
You can also specify the level of precision of removal and extraction of the bone mask region. You can specify
whether to remove and extract the mask region right up to the border of the bone region, or to remove and extract
a mask area that is a bit larger. You can choose from three levels, [Coarse], [Moderate], and [Fine].
Coarse Remove and extract the bone mask rather broadly.

Moderate Remove and extract a suitable region as the bone mask.
Fine Remove and extract the bone mask right up to the border of the bone region.
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As a result of specifying and then removing and extracting the bone region, you may be left with too much or too
little. If so, you can add to an insufficient region, or delete what is unnecessary.
The following example illustrates selecting an unwanted bone for [Delete region] in a case where two joined bones
were extracted together in Extraction mode.
When unwanted bone is extracted When unwanted bone is specified for [Delete region]
When the removal and extraction, or modification of the region is done, click the [Finish extraction] button and
confirm the region.
For faster processing, narrow down the clipping range. Processing should be performed with the narrowest
possible clipping range.
Tube extraction
Enables semi-automatic extraction of tubular tissue such as pancreatic or urinary ducts. After specifying the path
from above the slice, specify the diameter of start and end points to extract the region. Additionally, you can check
path positions on the plane image by using the current position slider.
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Extract the region in the specified path. When [New] is selected, the region is extracted after clearing the mask, and
when [Add] is selected, the extracted region is added to the current mask.
Specifying a path (2D) After extraction (3D)
Pulmonary vessel extraction
Pulmonary vessels are extracted from CT images.
Pulmonary vessels output mask

In pulmonary vessel extraction, a pulmonary artery and pulmonary vein output mask is specified before executing
extraction.
Before pulmonary vessel extraction Results of pulmonary artery extraction Results of pulmonary vein extraction
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Spinal cord extraction
The spinal cord region is extracted automatically from the thoracoabdominal CT images.
After spinal cord extraction
Kidney extraction
The kidney region is extracted automatically from the abdomen CT images. Available only when RT Assist is
running.
Contrasted state
Select [Contrasted] or [Non Contrasted], depending on the image used for extraction.
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Extraction mode
Two modes are available for working with extracted regions, as follows. Select either one according to the purpose.
Before kidney extraction After kidney extraction
Bladder extraction
The bladder region is extracted semi-automatically from the pelvic CT images. Available only when RT Assist is
running.
The region can be extracted by dragging the diameter of the bladder in the axial, sagittal, or coronal plane.
Before bladder extraction After bladder extraction
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Body part recognition

Automatically identifies the names of various detailed organs or blood vessels on the mask image in which specific
organs or vessels have been extracted.
Cerebral vessels
Automatically extracts cerebral vessels on an image in which the cranial bone has been removed, and separates
them into arteries and veins.
Before cerebral vessel recognition After cerebral vessel recognition
Cerebral veins output mask

In cerebral vessel recognition, the cerebral arteries are output on the current mask. For the cerebral veins, the
output mask must be specified.
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Preset
The target organs are extracted according to the extraction process registered in advance. Registered presets can
be edited, deleted, or reordered.
Register a new preset.
Edit the selected preset.
Move the selected preset up.
Move the selected preset down.
Preset setting
The preset setting dialog can be displayed by clicking the [Register] or [Edit] button. In the preset setting dialog, an
extraction process can be registered, and settings related to the display of results can be configured.
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Register a new entry.
Edit the selected entry.
Delete the selected entry.
Move the selected entry up.
Move the selected entry down.
Edit entry
The entry edit dialog can be displayed by clicking the [Register] or [Edit] button. In the entry edit dialog, you can
specify details such as the extraction mode, target mask, mask name, extraction method, body part, and extraction
level.
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Extraction mode Select the extraction mode. The extraction mode can be selected from each of the
extraction processing, Erosion, Dilation, or Operation.
Target mask Select the mask to be processed.
Apply color template Check the checkbox ON and set the color of the color template to apply. The
color is set in the [Live color template] dialog, opened by clicking the [Change]
button. The color template selected here is applied temporarily to the main screen
until completion of preset setting. The selected color template is applied to the
output mask.
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When the extraction mode is set as [Mask operation], two calculation target masks for input and one calculation
target mask for output, or a total of three masks have to be set as target masks.
In the following example, the setting is configured to save bone extraction results to target mask 1, to save
bronchus extraction results to target mask 2, and to display a multi-mask after extraction.
Bone extraction result (mask 1) Lung field extraction result (mask 2) Preset extraction result
(multi-mask display)
Setting of Organ Extraction and Removal

For the organ extraction and removal, setting items are different for each extraction method. In the common
settings, configure the setting of the common setting items for all the extraction methods.
Common settings
Magnitude of Set the strength of the image noise reduction filter to be applied before each
smoothing region extraction.
The filter strength can be selected from No Smoothing, Smoothing (Soft),
Smoothing (Normal), or Smoothing (Strong).
Dilation/Erosion size Sets the dilation/erosion size for the mask region after each region has been
after extraction extracted.
The setting of [Dilation/Erosion size after extraction] works as the erosion size only for cerebral extraction and
works as the dilation size for other extraction processes.
In order to calculate the mask region volume of each region, set [Dilation/Erosion size after extraction] to 0.
Bone removal/extraction setting

Specifies settings for bone removal/extraction with the Tracking method. These settings do not affect bone
removal/extraction with the Classifying method.
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Threshold for seed point Set the signal value of the region where the seed point is to be located.
Sampling interval of Set the interval for arranging the seed points.
seed points
Max. search range Set the search range for a continuous region from the seed point.
Number of neighbors Set the direction of dilating region in the bone extraction.
• 6 neighbors
The region is dilated towards the direction of the voxels shared with the
planes for the voxel set as the seed point.
• 18 neighbors
sides for the voxel set as the seed point.
• 26 neighbors
apexes for the voxel set as the seed point.
Fill-in after extraction Set whether or not to perform the correction after bone region extraction.
Fill-in sampling interval Set the sampling interval for correction processing when [Fill-in after extraction] is
set to [ON].
Colon extraction setting
Threshold of colon Set the threshold value for the colon region. The region within the threshold
range becomes candidate for extraction.
Tumor extraction setting
Automatic selection of When extracting a tumor region, specify whether you want to manually choose
region type between [Lung nodule] or [Tumor], or else have it determined automatically.
Vessel extraction setting
Search for branch Set whether or not to search for branches when tracking a blood vessel path.
When set to [OFF], branch is not searched and only one path is extracted.
Types of outline fitting Set the type of indicator for estimating the blood vessel diameter when tracking a
blood vessel path. The tracked blood vessel path is displayed in the mask region
with the estimated diameter.
• Original image information
The signal value of the original image is used as an indicator to identify the
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contour part.
• Display information
Window width, level, opacity, and other visible display information are used
as indicators for specifying the contour part. As the settings for window
width, level, opacity, etc. influence the tracking result, extraction must be
performed under suitable parameters.
Threshold of vessel Set the signal value range to be recognized as the blood vessel region when
region [Types of outline fitting] is set to [Original image information].
Output format of the Specify how arteries and veins are separated in cerebral vessel extraction.
result after extracting
arteries and veins
restarted.
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3.4.9 Position and Rotation
On the axial, sagittal, and coronal plane, the current position in the display can be changed, the signal value can be
displayed, the direction of the oblique plane and 3D view can be changed, and the direction of the 3D view can be
preset.
The orientation of the 3D view can be switched to the locked direction by clicking the button on the shortcut
bar.
Operation Method When Selecting the Orthogonal View

When selecting orthogonal views (axial, sagittal, and coronal planes), the following operations can be performed.
• Change the current position
The current position indicated by the cursor on the 2D display can be changed by dragging the cursor or by
moving the slider in the tool frame.
• Display the information for the current position
The coordinates of the current position and the signal values at these coordinates are displayed. When the
lower image and upper image are displayed as an overlay by the fusion application etc., the coordinates of
the current position and the signal values at these coordinates are displayed for the upper image and the
lower image respectively.
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coincide with values measured with the software etc. belonging to the modality. Especially the signal values
of images taken with MR or PET, NM modalities may require signal value correction depending on the
modality manufacturer, the device model or the type.
Operation Method When Selecting the Oblique Plane

When selecting the oblique plane, the following operations can be performed.
• Change the orientation of the oblique plane
The orientation of the oblique plane can be changed with the buttons in the tool frame. The orientation of
an oblique plane can be changed by the angle specified in the text column of [Angle (deg.)] by clicking the
direction buttons or the clockwise/counterclockwise button. [Angle (deg.)] can be selected from a preset. To
edit the preset, select [Edit Registered Angle (deg.)].
• Change the current position
The current position indicated by the cursor on the 2D display can be changed by dragging the cursor.
• Display the information for the current position
The coordinates of the current position and the signal values at these coordinates are displayed. When the
lower image and upper image are displayed as an overlay by the fusion application etc., the coordinates of
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the current position and the signal values at these coordinates are displayed for the upper image and the
lower image respectively.
coincide with values measured with the software etc. belonging to the modality. Especially the signal values
of images taken with MR or PET, NM modalities may require signal value correction depending on the
modality manufacturer, the device model or the type.
• Display setting
When [Display the current position on 3D display] has been checked, the cursor is displayed in the 3D view
to indicate the current position. The current position can be changed by moving the cursor. When the
checkbox is not checked, the cursor is not displayed, and the current position cannot be changed.
Operation Method When Selecting the 3D View

When selecting the 3D view, the following operations can be performed.
• Rotate the 3D view
A 3D view can be rotated with the buttons in the tool frame. The 3D view can be rotated by the angle
specified in the text column of [Angle (deg.)] by clicking the direction buttons or the
clockwise/counterclockwise button. [Angle (deg.)] can be selected from a preset. To edit the preset, select
[Edit Registered Angle (deg.)].
The orientation of the 3D view can be changed in the respective direction by clicking the [A], [P], [L], [R], [H],
or [F] buttons.
• Input an angle of angio
The angle of rotation can be entered based on LAO/RAO or CAU/CRA orientation.
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• Display setting
When [Display the current position on 3D display] has been checked, the cursor is displayed in the 3D view
to indicate the current position. The current position can be changed by moving the cursor. When the
checkbox is not checked, the cursor is not displayed, and the current position cannot be changed.
Preset Rotation/Capture Save

When an oblique plane or 3D view has been selected, images can be rotated using a preset and the rotated image
can be saved.
When a group is selected from the pull-down menu at the upper part of the list, the presets for the display
orientation registered for that group are displayed in a list. When the preset is selected, the display orientation will
be applied to the oblique plane or the 3D view. Operations for list editing etc. are performed with the buttons of
the tool frame.
The present display orientation is registered as a preset to the selected group.
Rename the selected preset.
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The selected preset is moved up in the list by one position.
The selected preset is moved down in the list by one position.
When multiple items are selected from the list and the [Capture image] button is clicked, all are captured with the
selected rotation applied. When [Relative angle] is selected as the rotation method, rotation is applied based on the
current image display status.
Select [DICOM image] or [Capture box] as the destination, and select [Normal resolution] or [High resolution] as
the resolution. You can also specify whether to enable WL modification when MIP, SMIP, MinIP, or RaySum has
been selected as the rendering method for monochrome images or 3D view.
As these display directions are calculated from image information, the expected display direction may not be
realized, depending on exposure conditions etc.
Grid Display
When the [Grid display] button is clicked, a grid with fixed intervals is displayed on the 2D image with the current
position at the center.
By dragging a straight line through the current position, the grid orientation can be rotated. After rotation, the grid
rotation can be returned to the initial state by clicking the [Reset] button on the right side of the [Grid display]
button. Also, the scale interval of the grid can be specified in the text column.
Setting of Position and Rotation
Configure settings related to the position and rotation. Click the button in the system frame, and select
[Position and Rotation] in the [System settings] dialog.
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The preset group name can be registered in [Rotation group].
Specify the group name, and add the group.
Delete the selected group. By deleting the group, the presets registered in the group will also be
deleted.
Rename the selected group.
The selected group is moved up in the display list by one position.
The selected group is moved down in the display list by one position.
restarted.
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3.4.10 Mask Edit
A mask region with a spherical or circular shape can be added to and deleted from the mask region with the mask
edit tool. Following methods for adding and deleting the mask regions are available.
Fill-in Mask by filling in a bounded region relative to a mask region. This method can be used
only for the 2D orthogonal view.
Circle Add or delete a circular mask region. This method can be used only for the 2D
orthogonal view.
Sphere Add or delete a spherical mask region. This method can be used for both 2D and 3D
views.
Spheral Delete a spherical mask region of a specific length. This method can be used for both 2D
digger and 3D views of images of CT, MR, NM, and XA modalities.
ROI Create ROIs on multiple slices and add or delete the range enclosed by the ROI. This
method can be used only for the 2D view.
Edit by Fill
In edit by fill, you can add or delete a broad mask area all at once by filling in a specific bounded region.
In the tool frame, you can specify whether to add or delete the mask, and whether to fill in two or three dimensions.
Add Add by filling in, all at once, a bounded region in which the mask is not filled.
Delete Delete by filling in, all at once, a bounded region in which the mask is not filled.
2D Fill in the specified region only on the specified slice, and then add or remove the
region.
3D Fill in the closed three-dimensional region, including the specified point, and then
add or remove the region.
The operation can be undone or redone a number of times from the tool frame.
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Undo Cancel the last mask edit operation and return to the previous state.
Redo Cancel [Undo] and return to the past mask edit state.
Edit using a Circular Region

A circular mask region can be added to or deleted from the mask by clicking the image frame. The 2D circular mask
is edited only on the clicked page. As the mask region can be edited for each page, the mask can be edited in detail.
Also, by dragging the mouse on the image, the mask can be edited by the shape of the dragged track.
The following settings can be configured in the tool frame.
Add Add the mask region by clicking on the image frame.

Delete Delete the mask region by clicking on the image frame.
Radius Specify the size of the circle for editing the mask. While moving the slider, the edit
cursor with the specified size is displayed on the image.
The operation can be undone or redone a number of times from the tool frame.
Undo Cancel the last mask edit operation and return to the previous state.
Redo Cancel [Undo] and return to the past mask edit state.
Edit using a Spherical Region

A circular mask region can be added to or deleted from the mask by clicking the image frame. With the clicked
position as the center, the mask is edited to a three-dimensional sphere.
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Add Add the mask region by clicking on the image frame.

Delete Delete the mask region by clicking on the image frame.
Radius Specify the size of the sphere for editing the mask. While moving the slider, the
edit cursor with the specified size is displayed on the image.
Slice positions are updated as you move the cursor in sphere-based editing, so that the three-dimensional
position of the cursor can be displayed. Additionally, by pressing the arrow key, you can change the image frame
for editing without changing the three-dimensional position of the sphere, which also enables you to move the
cursor.
Edit by spheral digging

Adding to or deleting from the mask by spheral digging is possible by clicking the image frame. With the clicked
position as the center, the mask is edited to a specific length in the shape of a three-dimensional sphere.
Backward Add the mask region by clicking on the image frame.

Forward Delete the mask region by clicking on the image frame.
Cancel Cancel the editing operation.
Finish Confirm the editing operation.
Oblique Display a reference slice perpendicular to the spheral digger editing direction.
Radius Specify the radius of the sphere for editing the mask. While moving the slider, the
edit cursor with the specified size is displayed on the image.
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Speed Specify the length of mask to delete per wheel operation.
Slice positions are updated as you move the cursor in spheral digger editing, so that the three-dimensional
position of the cursor can be displayed. Additionally, by pressing the arrow key, you can change the image frame
for editing without changing the three-dimensional position of the sphere, which also enables you to move the
cursor.
Edit within the ROI

For editing within the ROI, an ROI is specified on the slice and a mask is added or deleted. When the [ROI] button is
clicked from the tool frame, a dialog box for editing mask by ROI specification is displayed. When ROIs are created
for two slices, ROIs are also created on the intermediate slices so that the slices with created ROIs are connected
smoothly. After creating ROIs, the region enclosed by the ROIs can be extracted or deleted.
The mask editing dialog by ROI specification is composed of following screens.
A Image preview ROIs are created and edited in the image frame displayed large in the upper part.
domain Image paging can be done by moving the slider at the center. By clicking the [<][>]
buttons on the right side of the slider, the displayed slice is changed to the one on
which ROI has been created. When pages between the slices with created ROI are
displayed, "Interpolated ROIs" is displayed on the image frame.
B Operation method This is the domain for selection of the ROI creation method.
domain
C ROI list domain This is the domain for displaying the created ROIs. [Modification] mode is reached
automatically when an ROI is selected.
D ROI edit domain This is the domain for ROI deletion etc.
E Region processing This is the domain for reflecting the mask domain by editing operations such as
domain extraction, addition, or deletion after determining an ROI.
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Extraction by ROI specification

Perform the following procedure to extract region by creating an ROI.
1. Select the ROI creation mode from the operation method domain
Freehand ROI creation with free curved lines.

By dragging on the image, a curved
line is drawn following the mouse
track. The ROI is determined by
double-clicking or by selecting
[Determine ROI] from the right-click
menu. When the mouse button is
released once after dragging and
the mouse cursor is moved, a line
fitting the image edge is created.
Control point ROI creation with a curved line
smoothly connecting the clicked
points. Place control points by
clicking on the image and
determine the ROI by double-
clicking or by selecting [Determine
ROI] from the right-click menu. The
position of placed control points
can be adjusted by dragging.
2. Click on the image and create an ROI
Page the image and create ROIs on multiple slices. On slices between the created ROIs, ROIs are created by
interpolation from the ROIs before and after the slice.
3. Reflect to the mask
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After the required ROIs all have been set, click [Extract], [Add], or [Delete] to reflect the ROIs to the mask
region.
Extract The previous mask region is deleted

and the ROIs become a new mask
region.
Add The ROIs are added to the previous
mask region.
Delete The ROIs are deleted from the
previous mask region.
The dialog box for mask editing within the ROI can be closed according to the following two methods.
Close temporarily Close the dialog with the ROIs created in the [Mask Edit] dialog being kept.
Because ROIs are retained, you can resume ROI-based mask editing by opening
the dialog again.
End edit Close the dialog after deleting the ROIs created in the [Mask Edit] dialog.
Delete the ROI

Not required ROIs can be deleted with the [Delete] or the [Delete all] button.
Delete Delete an ROI selected in the ROI list.
Delete All Delete all ROIs.
ROI modification
For modification, click the [Modification] button and go to [Modification] mode. When an ROI to be modified is
selected from the ROI list, [Modification] mode is entered automatically.
Freehand ROIs can be modified in two ways. With [Redraw], drag the part to modify with the mouse to create a
modified ROI based on the path traced. With [Pick], start dragging on an existing ROI to move and modify the
contours. For modification of an ROI created by placing control points, drag the control points.
Additionally, by clicking [Modify interpolated ROIs] while "Interpolated ROIs" is displayed on the image frame, you
can edit the ROIs displayed on the image frame, which are treated as freehand ROIs.
Setting of Mask Edit
Configure settings related to mask edit. Click the button in the system frame, and select [Mask Edit] in the
[System settings] dialog.
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Target opacity value When the sphere edit is operated for 3D view, the edit can be performed only in a
region that exceeds a certain value of opacity. This setting item specifies the
minimum target opacity value for the region to be edited.
Spheral digger setting
Limit by the signal value Specify whether to limit spheral digger editing by signal values.
Target area (Signal Spheral digger editing can be performed only in a region within the range of
value) signal values. This setting item specifies the range of target signal values for the
region to be edited.
Target area (Opacity) Spheral digger editing can be performed only in a region that exceeds a certain
value of opacity. This setting item specifies the minimum target opacity value for
the region to be edited.
Delete only connected Specify whether to restrict spheral digger editing to mask areas where the mask is
area connected to the base point.
restarted.
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3.4.11 Reformat
The reformat tool is a tool for creating a plane along a straight line or in the shape of a fan on 2D and 3D images
and for printing or saving the plane as a new image. The length, interval, etc. of cut-out straight line can be preset
and called.
The slice may not be specified due to the image display condition.
Operation Procedure
To create a reformat image, determine the cutting position, orientation and interval, and execute the reformat.
Determine the position, direction, and interval Execute the reformat
The basic procedure for creating a reformat image is as follows.
1. Select the type of reformatting
Select from straight line, fan, or circle. A plane is generated according to the selected type.
2. Place a slice on a 2D or 3D image with the reformat position and orientation specified
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For straight line or circle reformatting, drag the mouse on the image frame. For fan reformatting, click the
start point, the center point, and the end point in this order.
3. Specify interval, slices, and size (FOV)
Specify the interval (mm), the number and the size of slices to be created. You can call presets or directly
input to specify them.
4. Click the [Display reformatted image] button
The reformat dialog opens.
5. Click the [Save] button
The dialog opens. In the dialog, select the destination and image type, and save.
For details of each operation, refer to "Function in the Tool Frame" and "Function in the Reformat Dialog".
Function in the Tool Frame

The reformat tool frame is used to select the shape, to set the interval and the length, to call preset settings, etc.
Type of reformatting
The type of reformatting can be selected from the following three types.
Reformat by slicing with a straight line. The reformat image of a slice orthogonal to the specified
straight line or parallel to it can be created. The specification of orthogonal or parallel can be
changed from the setting dialog. Drag on the image frame to create these slices. In this mode, other
slices can be placed after a slice has been placed.
Reformat by slicing in the shape of a fan. The reformat images of the various orientations, which have
the center part of the fan in common, can be created. The slice is placed by clicking the start point,
the center point, and the end point on the image frame. In this mode, only one slice can be placed.
Reformat by slicing in the shape of a circle. The reformat images, which have the center part of the
circle in common, can be created. The slice is placed by dragging on the image frame. In this mode,
only one slice can be placed.
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After placing the slice in the image frame, the position and orientation can be changed via dragging. The effect of
dragging depends on the position where the dragging is started. The shape of the mouse cursor changes
according to the effect of dragging.
Place new linear, fan, or circular slices.
Shift the slices. This mouse cursor is displayed on the inside of the rectangle for linear slices, inside of
the fan for fan-shaped slices, and inside of the circle for circular slices. It is also displayed over slice
information, and positions in the slice information can be fine-tuned by shifting them.
Change the slice orientation, position, and size by moving the blue control point. This mouse cursor
is displayed near the blue control point.
Change the range of the cut-out plane in horizontal direction. This mouse cursor is displayed at the
end part of the rectangular shape with linear reformat.
For straight line reformatting, the straight line is rotated for the center of the straight line. This mouse
cursor is displayed at the four corners of a rectangle.
When placing a linear reformat on the axial, sagittal or coronal plane, the straight line within five degrees in the
respective axis direction is interpolated so that the straight line will be parallel to that direction. For example, to
draw a straight line in an arbitrary direction without interpolation, select the [Oblique] for 3D viewer and place the
straight line on the oblique plane.
Reformat operation
The slices can be deleted and copied with the buttons in the tool frame.
Delete the selected slice.

This operation can also be performed from the right-click menu.
Delete all the slices already set.
This operation can also be performed from the right-click menu.
Copy the selected slice.
Place the copied slice in the image frame.
The slice cannot be pasted if a slice is already placed in the fan and circular reformat because only one slice can
be placed in those reformats. To paste the new slice, delete the existing slice.
When pasting, if the image size and scale of the original are different from the ones of the copy destination, the
slice is not pasted to the same position.
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Reformat property
Specify the individual reformat properties.
• Line property
• Fan property
• Circle property
Sort slice
When placing multiple slices via linear reformat, page numbers are assigned to
the slices in the order they were placed. When the [Sort slice] function is used,
each slice is assigned a page number according to the position of the slice.
However, as the page numbers are assigned for each slice, the page numbers may
be shifted forward or backward when multiple slices are overlapping.
The pull-down menu is displayed when the button is clicked, and then select the
direction you wish to sort.
• R-L direction
Image numbers are assigned from right to left.
• A-P direction
Image numbers are assigned from anterior to posterior.
• H-F direction
Image numbers are assigned from top to bottom.
Rotate counterclockwise
This function can be used for the straight line reformatting.
The straight line reformat is rotated 90 degrees counterclockwise.
Rotate clockwise
This function can be used for the straight line reformatting.
The straight line reformat is rotated 90 degrees clockwise.
Reference line
Switch display/hide for reference lines for easier understanding of plane position
and center position.
This operation can be used only for linear reformatting.
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Invert in/out
This function can be used for the fan-shaped reformatting.
Switches between the inside and outside for creation of the reformat image.
Reformatting info.
Switch display/hide for the reformat setting conditions (number of slices, interval,
etc.).
With reference line Without reference line
Configure reformat settings

Configure settings of planes to be reformatted.
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Definition of slice Select which item to specify from among the interval, the number of slices, or
both of them.
Thickness
Set the thickness of the reformat images. To set the thickness, enter a value into
the text column or move the slider.
Interval Specify the cut-out interval in mm for a linear reformat, and specify the cut-out
interval in degrees for a fan-shaped or a circular reformat.
Slices Specify the number of slices to be cut-out.
Sync thickness and
Synchronization of the slice thickness with the changes in the slice interval can be
interval
specified. When [Sync thickness and interval] is enabled, the slice thickness for a
linear reformat becomes the same value as the slice interval, and no gaps are
caused between the created reformat images.
Rendering
Select the rendering mode for the thickness region when a thickness has been
specified for reformat images.
Size of slices
The size of the reformat image to be created with the linear reformat can be set.
The reformat image size can be changed by directly entering numerical value here
or by manipulating the linear reformat range displayed on the image with the
mouse. Also, the size can be changed by displaying the reformat image and
zooming in/out the image.
When a fan-shaped or circular reformat image is created, the slice size cannot be
entered in the reformat setting, but the size of the reformat image to create is
displayed based on the range changed with the mouse.
Presets of reformat
The preset settings can be used for the number and interval of slices and size (FOV). Refer to "Configure reformat
settings" for the registration method. To retrieve registered settings, select the settings you wish to retrieve from
the Preset list. Contents of the reformat settings will be changed to ones of the selected preset.
When [Sync thickness and interval] is enabled, the thickness of the slice set in the preset settings is disregarded
and the thickness is set based on the slice interval.
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Display reformat image

When the [Display reformatted image] button is clicked after placing the slice, the [Reformat] dialog opens, and the
reformat image can be saved, etc.
Undo/Redo
To restore the previous state during slice placement, click the button in [Undo/Redo] in the tool frame. To
execute the undone operation again, click the button. These operations can be performed up to a maximum
of 8 times.
Function in the Reformat Dialog

In the [Reformat] dialog, the created reformat images are displayed.
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Layout
Change the layout of the image display region. The layout can be switched in a
range between 1×1 and 4×4 by dragging the button on the shortcut bar of
the image frame.
Display reference image

Display a reference image in the lower left of the reformatted plane image. By
clicking the button on the shortcut bar in the image frame, you can display a
reference image in the lower left of the image.
Page
Page the images.
Cine
With a 1×1 layout, cine playback of images is possible. When the [Cine] button is
clicked, the following pull-down menu is displayed, and the playback starts
automatically.
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To end cine playback, click somewhere other than the pull-down menu.
• Play backward.
• Pause.
• Play forward.
• After playing all the way to the last frame, cine playback starts in the
reverse direction.
Save
Save the reformat image. Select the saving method in the displayed dialog.
Finish reformat
The arrangement and the created reformat images are discarded, and the
[Reformat] dialog is closed.
Close temporarily
The dialog is closed temporarily while the arrangement and the created reformat
images are kept.
When saving movie file in MPEG format, the movie file may not be saved with the specified playback speed,
depending on the number of images etc.
Save reformat image

Select the storage destination, the image type and [Series description] in the [Save setting] dialog opened when
the [Save] button in the [Reformat] dialog is clicked. When the [Save] button is clicked, the reformat image is saved
based on the settings.
Specification of the save destination
Movie file Specify the movie playback speed and storage destination, and save as a movie
file, such as an MPEG file. Saved files can be registered as DICOM images to a
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local database.
DICOM image Create a new series, and save it to the local database as a DICOM image.
Capture box Send the reformat image to the capture box.
Enabling changing of WL
(Enable WL change) OFF Save as color images. The window width and level of the images saved as color
images cannot be adjusted in another DICOM viewer or this workstation.
(Enable WL change) ON Save as monochrome images. The window width and level of the images saved as
monochrome images can be adjusted in another DICOM viewer or this
workstation.
Specifying series description

The series description can be specified by directly entering texts or selecting the pre-registered texts.
Setting of Reformat
Configure settings related to reformat. Click the button in the system frame, and select [Reformat] in the
Show dialog when the

• OFF
reformat line is set
After placing the slice into the image frame, the reformat dialog is
displayed when the [Display reformatted image] button is clicked.
• ON
After placing the slice into the image frame, the reformat dialog is
displayed automatically.
Slice definition methods

• Orthogonal to a line
for linear reformatting
Define a slice orthogonal to the specified straight line.
• Parallel with a line
Define a slice parallel to the specified straight line.
Save method for

• Do not save
reference image
At the time of DICOM saving, the reference images showing the slice
position are not saved.
• Save in same series
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position are saved to the same series as the slice images.
• Save in another series
position are saved to a series different from the slice images.
Preset setting
Register a new preset.
Edit the contents of the preset selected in the list.
Delete the preset selected in the list.
The preset setting dialog is displayed when [Add] or [Edit] is clicked. Configure the settings such as an interval, and
click [Register] to register them into the list of [Preset setting].
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Name Enter a name of the preset.

Definition of slice Select which item to specify from among the interval, the number of slices, or
both of them.
Interval of slices Specify the interval of slices.
Number of slices Specify the number of slices to be cut-out.
Thickness Specify the thickness of slice to be cut-out.
Size of slices Specify the FOV of slices to be cut-out.
restarted.
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3.4.12 Movie
Use the Movie tool to create 2D or 3D movies, VR panoramas for offline viewing, or DICOM cine clips, to send
movies to the capture box, and for other operations.
Offline VR refers to movies created from 3D images captured from a variety of angles in advance that can be
downloaded to local computers or tablets for viewing from a browser. In the browser, viewing captured 3D images
from the point nearest the user's designated orientation simulates operations in 3D space.
2D Movie
For 2D images, you can create a movie file that plays the specified range forward.
To create a 2D movie, click a 2D image and specify the range with the slider bar in the tool frame. You can also set
the slice interval and the slice thickness synchronization setting in the tool frame. The slice interval is specified by
the number of slices for orthogonal planes, and it is specified by an interval (mm) for oblique planes.
The movies are saved after having specified the range. You can also save in reverse order. For details, refer to "Save
Movies".
Using the [Speed] slider, you can also set the cine playback speed.
For an orthogonal plane For an oblique plane
Play backward.
Stop.
Play forward.
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After playing all the way to the last frame, cine playback in the reverse direction.
3D Movie
Mainly two methods are available for creating 3D movies.
To create simple movies, use the [Simple rotation] and to create elaborate movies, use the [Free rotation].
Create movies with the simple rotation mode

In the simple rotation mode, you can create simple movies with rotations of the 3D display in the specified
direction. You can specify the rotation direction, the rotation magnitude (angle), and the number of frames saved.
Following two methods are available.
Angle and frames Specify the direction, the degrees, and the number of frames.
(Example: To the right, 360 degrees, save 20 frames)
Interval and frames Specify the direction, the degree of interval, and the number of frames.
(Example: To the right, save 20 frames in intervals of 10 degrees)
You can register in advance as presets. Refer to [Setting of Movie Creation] for the preset registration method.
Create a movie after all movie creation conditions have been set. For details, refer to "Save Movies".
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Create movies with the free rotation mode

Click a 3D display from which you wish to create a movie. Click the [Open 3D movie dialog] button displayed in the
tool frame.
The 3D image from which a movie is created is the image selected when [Open 3D movie dialog] is clicked in the
tool frame. To create a movie with another 3D image, close the 3D movie dialog once, and then select another 3D
image from which you wish to create a movie, and open the 3D movie dialog again.
Create movies with key frames

The basic method for creating 3D movies with the free rotation mode is to register key frames. For example,
register an image facing the front as the first key frame, register an image facing the right as the second key, and
save the movie. Then, a movie smoothly changing its orientation from the front to the right is created. Between key
frames, you can change not only the orientation, but also the zoom rate, color template, clipping, and other
properties. Start creating a movie when the preparations have been completed by repeating key frame registrations
for the required number of times. For details, refer to "Save Movies".
To register a key frame, set the orientation and zoom rate for the target 3D image, and click the [Add] button in the
[3D movie] dialog. The added key frame is registered in the [Key frame list]. Use the following buttons to delete a
key frame or to insert a key frame between existing key frames.
Frame interval Specify the number of images between key frames. This value is applied when a
key frame is added. Even after addition, you can change this number by selecting
the frame interval in the key frame box. A larger frame interval results in a
smoother change over a longer time.
Preset Apply a preset, or register the current key frame as a preset. For details, refer to
[Create movies with presets].
Preview Use the current key frame to create a preview or movie. For details, refer to [Save].
Create Movie
Register the current 3D display as the last key frame in the [Key frame list].
Register the current 3D display as a key frame in front of the key frame selected in
the list.
Overwrite the key frame selected in the list and register the current 3D display as
the key frame.
Delete the key frame selected in the list. Deletion cannot be undone.
Delete all the key frames in the list. Deletion cannot be undone.
Use the [Record] mode. For details, refer to "Create movies with the record
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mode."
When you double-click a key frame, the orientation and the color status at the time the key frame was added are
restored to the 3D image. It is convenient to use this function when you make fine modifications such as the key
frame orientation and the color status.
Create movies with the record mode

To register key frames, you can use the record mode in addition to the individual manual registration. In record
mode, rotating, zooming, or other operations made for the 3D image are registered in the [Key frame list], without
clicking the [Add] button. The operations to be registered in the [Key frame list] in record mode are as follows:
• Modification of the color template (color, each parameter for shade, and opacity)
• Panning and Zooming
• Change in orientation
To use the record mode, click the [Record] button. The record mode is turned OFF when you click the [Record]
button again. When the record mode is turned ON, a key frame is registered automatically each time the 3D display
status changes. After the registration ends, the movie creation preparations are completed when the record mode
is set to OFF. For the movie creation afterwards, refer to "Save Movies".
Create movies with presets

By clicking the [Preset] button, you can choose to register or apply a preset. A preset is a predefined operation
such as one rotation of an image. By applying presets to a 3D image, the image is processed and registered as a
key frame according to the operations defined in the presets.
Perform the following operations to create 3D movies with presets.
1. Select the 3D display image frame
2. Click the [Preset] button and select a preset
A key frame is added according to the contents of the selected preset.
You can register a key frame registered in the movie key frame list as a preset. To register a preset, register a key
frame in the movie key frame list, click the [Preset] button, and then click [Register]. After you enter the preset
name, the key frame is registered as a preset.
Create movies for special clipping

By enabling [Line-of-sight clipping], you can use the following dialog. This dialog is used when creating movies in
which the clipping distance gradually increases or decreases.
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Key frames at only two positions are registered in the dialog, at the beginning and end of clipping. With the
[Interval (mm)] slider, you can specify the distance for gradually changing the clipping distance. Otherwise, by
selecting the [Normal] button, you can use the regular key frame dialog.
All key frames you have registered in the normal or special clipping dialogs are discarded if you switch to the
other dialog.
Save Movies
After setting the 2D display save range or registration of the key frames, save the movie.
You can verify the created movie before it is saved by clicking the [Preview] button.
Following saving formats are available.
Movie file Save as a movie file, such as an MPEG file. Saved files can be registered as DICOM
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images to a local database.

DICOM image Create a new series in the study list window, and add individual frames of the
image to the series.
Capture box Add individual frames of the image to the capture box.
When creating a movie using images of multiple phases, Phase change ON/OFF can be selected.
Phase change (OFF) A movie is created for the currently displayed

phase.
Phase change (ON) A movie is created for multiple phases by
switching phases during movie creation.
For saving, perform one of the following procedures according to the format to save.
• When creating a movie file
1. Select [Movie file] for [Storage]
2. Click the [Create Movie] button
3. Select an output method
When you select [Movie file], you specify the output destination after saving.
When you select [DICOM image], the saved image will be registered to the local database.
4. Select the type of output file
5. Specify the frame rate (frames per second)
6. Click the [OK] button to save
The created movie will be played in the dialog. You can stop the creating process by clicking the
[Cancel] button in the lower part of the dialog.
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Depending on the format of the movie file, a movie is created not with the specified playback speed, but
with a playback speed close to the specified value because of limitations of that file format.
A movie file cannot be created when a movie file with the same name is played back. Terminate the movie
player software, and create the movie file.
• When saving DICOM-format still pictures as consecutive still pictures
1. Select [DICOM image] for [Storage]
2. Set "Enable WL change"
When creating a movie from a 2D image or a MIP, SMIP, MinIP, or RaySum rendering 3D image,
[Enable WL change (ON)(OFF)] can be set.
Enable WL change (OFF) Save as color images. The

window width and level of the
images saved as color images
cannot be adjusted in another
DICOM viewer or this
workstation.
Enable WL change (ON) Save as monochrome images.
The window width and level of
the images saved as
monochrome images can be
adjusted in another DICOM
viewer or this workstation.
3. Set [Resolution]
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5. Add a series description as needed, and save the movie
You can stop the creating process by clicking the [Cancel] button in the lower part of the dialog.
• When saving with [Capture box]
1. Select [Capture box] for [Storage]
2. For the saved image, set "Enable changing WL"
When creating a movie from a 2D image or a MIP, SMIP, MinIP, or RaySum rendering 3D image,
[Enable WL change (ON)(OFF)] can be set.
Enable WL change (OFF) Save as color images. The

window width and level of the
images saved as color images
cannot be adjusted in another
DICOM viewer or this
workstation.
Enable WL change (ON) Save as monochrome images.
The window width and level of
the images saved as
monochrome images can be
adjusted in another DICOM
viewer or this workstation.
3. Set [Resolution]
5. Click the [OK] button to send the movie to the capture box
You can stop sending by clicking the [Cancel] button in the lower part of the dialog.
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Create offline VR images

You can create a 3D virtual reality image for offline viewing. Unlike normal movies, the observation point in offline
VR panoramas can be changed in real time with the mouse using a browser.
Create an offline VR image as follows.
1. Click the [Offline VR] button on the tool frame, and then select a 3D image frame for offline VR image
creation
2. Select the image compression type
As image compression types, JPEG and PNG are available. In general, JPEG saves space compared to PNG,
but image quality is reduced. JPEG image quality can be set in [System settings] > [Environment settings] >
[Image save] > [JPEG quality (1-99)]
3. Select the number of samples
With offline VR panoramas, you can specify the level of detail of panoramas created from captured 3D
images, which is based on the polyhedron sampling setting. A larger number of samples enable more
detailed interaction but produces larger files that you may not be able to open in a browser.
4. Set the image size
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A larger output size improves the image quality, but more time is required for the creation. The size of the
saved movie also becomes larger.
5. Click the [Create VR] button
6. Select an output method
When you select [Movie file], you specify the output destination after saving.
When you select [DICOM image], the saved image will be registered to the local database.
Play Movie Files Saved as DICOM images

A movie file saved as a DICOM image is registered in the local database and displayed in the series list region on
the local data window. To play the movie, perform the following procedures.
1. Select an image to play back in the series list region and image list region
2. Click the [Start Application] button, or double-click the selected image
The movie viewer starts and plays the movie.
Setting of Movie Creation
Configure settings for creating movies. Click the button in the system frame, and select [Movie] in the
Settings for simple rotation movie

Configure the settings for the creation of a simple rotation movie. There are simple rotation move preset settings.
As the setting items, you can perform the following operations.
Add a new preset.
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Change the display order of the selected preset.
When the [Add] or [Edit] button is clicked, the dialog box to edit the preset is displayed. Refer to "Create movies
with the free rotation mode" for the setting items.
Settings for free rotation movie

Configure the settings for the creation of a free rotation movie. The setting items are shown below.
Free rotation movie You can create a preset with free specification of direction, rotation, and zoom
preset rate.
Apply preset item When applying a preset created from a key frame, set whether or not to apply the
clip state and the color template at the time of creation.
Operation for key Three types of operations after creation of a movie are available: delete the key
frames after creating a frames, leave them as they are, or confirm each time.
free rotation movie
When a key frame preset is applied to the multi-3D viewer, color template status is not applied, regardless of the
[Apply preset item] setting.
You can perform the following operations for preset settings for free rotation movie presets.
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Add a new preset.
Change the display order of the selected preset.
When the [Add] or [Edit] button is clicked, the dialog box to edit the preset is displayed. You can perform the
following operations in the "Edit preset" dialog box.
Add a currently set motion at the end of the list.
Add the set motion before the selected motion.
Overwrite the selected motion.
Delete the selected motion.
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Change the order of the selected motion.
After defining the operation, click the [Apply] button to register the preset name.
Select the operation type from Direction, Rotation, and Zoom.
• [Orientation]
The [Orientation] operation changes the 3D display to the specified direction. Different than [Rotation], no
matter which direction the 3D display was oriented to before the operation, the direction will be
instantaneously changed when this operation is performed. You can change the direction of the rotation
guide with the [A], [P], [L], [R], [H], [F], and arrow buttons. With the arrow buttons, you can change the
direction of the rotation guide little by little.
• [Rotation]
The [Rotation] operation smoothly rotates the 3D display.
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Rotation direction Specify the rotation direction for 3D

display.
While the [→] button is being pressed,
the image rotates to the right.
Rotation angle Specify the angle of rotation. A value
between 0° and 360° can be set.
Number of frames Specify the number of frames over which
this motion is to be performed.
• [Zoom]
The [Zoom] operation changes the zoom rate for the 3D display. The 3D display is changed by the zoom
rate specified in the [Zoom rate] over the number of frames specified in the [Number of frames].
restarted.
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3.4.13 Rendering
In this work station, 2D and 3D images can be displayed via various rendering modes. The rendering mode can be
selected from the [Rendering] tab in the template frame, by selecting [Rendering] from the right-click menu on the
image, or from the [Change 3D rendering mode] on the shortcut bar.
Provides a typical volume rendering view.
Provides a maximum intensity projection (MIP) rendering view.
Provides a surface rendering view.
Provides an MIP rendering view only around object surfaces.
Provides a minimum intensity projection (MinIP) rendering view.
Provides a ray summation (RaySum) rendering view.
With the 2D Display

With oblique or CPR, the three rendering modes of [MIP], [MinIP], or [RaySum] can be selected. Further, the plane
thickness can be changed by changing the [Thickness setting] under the [Rendering] tab in the template frame.
With the 3D Display

With the 3D display, the six rendering modes of [VR], [SSD], [MIP], [SMIP], [MinIP], or [RaySum] can be selected.
Further, the color template can be shifted by changing the [Shift color template] under the [Rendering] tab in the
template frame.
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[VR], [No shade] rendering

Volume rendering display without shading. As no shading is added, this is a rendering mode with visually low relief,
but it is effective when the target object has low contrast and is difficult to extract in 3D.
[VR], [Shade] rendering

Volume rendering display with shading. As sections struck by the light at a vertical angle are displayed the
brightest, the target object can be displayed with more visual relief.
[SSD] rendering
A rendering mode to display the surface of objects within the predefined threshold value range. The range of the
threshold can be set by changing the [Threshold of SSD] under the [Rendering] tab in the template frame.
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[MIP] rendering
A rendering mode to display the max. signal values on the projected path. The [Width] and [Level] of the window to
be applied to the MIP image can be changed by the [Rendering] tab in the template frame. (For PET images which
SUV measurement is possible, the density is adjusted by the lower and the upper limit of SUV)
[SMIP] rendering
A rendering mode to display the max. value of the signal value based on the distance from the surface. The [Width]
and [Level] of the window to be applied to the SMIP image can be changed by the [Rendering] tab in the template
frame. (For PET images which SUV measurement is possible, the density is adjusted by the lower and the upper
limit of SUV) Additionally, select [Damping] for distance attenuation or select [Depth] for no attenuation, and then
specify the distance from the surface.
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[MinIP] rendering
A rendering mode to display the min. signal values on the projected path. The [Width] and [Level] of the window to
be applied to the MinIP image can be changed by the [Rendering] tab in the template frame. (For PET images
which SUV measurement is possible, the density is adjusted by the lower and the upper limit of SUV)
[RaySum] rendering
A rendering mode to display the average signal values on the projected path. The [Width] and [Level] of the
window to be applied to the RaySum image can be changed by the [Rendering] tab in the template frame. (For PET
images which SUV measurement is possible, the density is adjusted by the lower and the upper limit of SUV)
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In the MIP mode, even if an image is displayed with the same orientation as in the VR mode, it might appear to be
oriented differently. The display orientation is not different, or either one of the images is not wrongly processed.
Pay attention to the guide (dice) that indicates the orientation of the image display and judge the image
orientation.
The following images are an example of the VR mode and MIP mode in the same orientation. The letters indicating
the orientation of the image is on each side of the guide (dice): A (anterior), P (posterior), R (right), L (left), H (head),
and F (feet).
VR mode MIP mode
In the MIP mode, the image orientation cannot be differentiated easily. Refer to the guide (dice) of the image
orientation at the edge of the image, and judge the image orientation correctly.
Front/rear display in the MIP mode Rear/front display in the MIP mode
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3.4.14 Surface Display
Surface Display is an application to create and display polygon model by the Marching Cubes algorithm from the
bounding surface set by threshold processing to volume data, and then output the polygon model to external files.
Display surface
Setting a surface boundary threshold using the [Extraction range] slider and then clicking the [Surface display]
button creates a polygon model from the surface area based on the threshold and displays the surface rendering.
The target area for the surface creation is within the mask of the bit that is currently displayed. Display the mask to
confirm the target region for the calculation.
SSD Surface display
SSD (Zoom) Surface display (Zoom)
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Due to smoothing or reduction of faces, the shapes of fine structures such as vessels or bronchus may be broken
or lost. Be sure to confirm that the created surface has the appropriate shape.
Display color can be selected when [Color STL] is selected in [STL format for saving surface data], in [Image save] of
[System settings].
To change the threshold after displaying a surface, the surface display has to be temporarily OFF by clicking the
[Surface display] button.
If the surface display target is broad, creating a surface may take time.
Output STL files

After displaying the surface, clicking the [Save] button outputs a polygon model in the STL format. After specifying
the file name and output format, specify the scaling rate to output the file.
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Specify options
In the [Options] group, specify how the surface should be created.
Creation type Specify the shape of the surface to be created.
• Curved surface
Creates a polygon having a smoothed surface boundary according to the

signal value.
• Blocks
Creates a polygon in which one voxel is a box.
Resolution Specify the sampling resolution of the surfaces created. If 0 is specified, a surface
mesh at the original image resolution is generated. Larger values create smoother
surfaces, but the processing time and resulting data increases exponentially.
Smoothing Specify the smoothness of the curved surfaces created. As the number gets larger,
a smoother surface is generated. If 0 is specified, no smoothing is performed.
Reduce faces Specify how much to reduce the number of faces on the created curved surface
while retaining the original appearance as much as possible. The extent of
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reduction can be specified in a range of 0–99, with 0 signifying no reduction.

Extraction target Specify the divided structures that you wish to target for surface creation.
• All shells
The surface for all structures is created.
• Largest shell only
The surface is created by excluding all but the specific structure that makes
the surface area maximum.
Fill up holes Specify whether an inner hole, if any, should be filled up when creating the
surface.
When [Largest shell only] is specified for [Extraction target], holes are always filled
up.
The number of faces making up the created surface can be confirmed in [Surface information].
Due to a difference in methods for counting faces in the STL file receiver software (software attached to 3D
printers, etc.), the number of surfaces may be different from that counted by the software on the receiver side.
Due to the limitations of STL file receiver software (software attached to 3D printers, etc.), data may not be loaded
correctly, depending on various conditions such as multiple structures, inner holes, and too many faces. Select the
appropriate options to output to files. For the behavior of receiver software, please contact the software developer.
Select parameters
Within the [Select parameters] group, you can create the surface by transforming, using the specified
transformation parameters, the coordinates of the STL to be created. For example, you could use this feature if you
wanted to generate STL files individually from two different 3D images, but you wanted to leave their relative
positional relationships registered using [Fusion], and wanted to apply those registration parameters. Here you can
load the transformation parameters that were output by [Fusion].
Because origin coordinates differ between "Fusion" and "STL files", the loaded [Select parameters] are displayed
with different values than the transformation parameters specified in [Fusion].
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Setting of surface display
Configure settings related to surface display. Click the button in the system frame, and select [Surface
display] in the [System settings] dialog.
Direction of an axis for a Specify the X, Y, and Z axis directions to output data to an STL file.
STL file If the front/back or top/down directions change when the output STL file is
loaded to other software, the axis directions must be changed.
Flip directions of faces The direction of a surface is flipped when the data is output to an STL file.
for a STL file If a face direction changes when the output STL file is loaded to other software,
the face direction must be changed.
restarted.
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3.4.15 Mask management

In the "Mask", multiple mask regions can be swapped, and calculations between the mask regions can be
performed.
Concept of the Mask

The mask region is the region displayed in the 3D image. For example, the smart cut is used to cut off the right half
as shown in the center part of the following figure. Even though the original image shows the entire image, the
mask region has only the left half, the 3D image also shows only the left half. In the same way, when the lower half
of the mask is cut, the 3D image shows only the upper half as shown in the bottom part of the figure. Thus, the
mask region is used for displaying only a part of the original image.
Also, multiple mask regions can exist in the same image. In the figure, the mask region in the center part is only
one half, while the mask region in the upper part shows the entire original image. In this case, the entire original
image can be displayed again by swapping the mask of the upper part. Normally, twelve mask regions are provided,
and they can be swapped for each other. The mask currently displayed is called the Active Mask.
Swap Active Mask

Swapping the mask and operations for the mask can be performed via the [Mask management] displayed at the
lower side of the tool frame. The Mask management window has buttons indicating the mask regions, and the
buttons are numbered from the left. The active mask can be swapped by clicking these buttons.
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Also, multiple color templates can be assigned to each mask region. When the active mask is swapped, the color
template assigned to the new active mask is applied to the 3D image. The mask buttons can be divided into the
following three types.
Displayed with an outline. This indicates that this mask is the active mask, and smart cut and
other editing operations are executed for this mask.
The mask region is registered but the mask is not active.
Unedited mask.
Also, the mask can be copied. In the following example, mask 1 is indicated as an active mask, and to copy this
mask region to mask 3, click the button on mask 3.
Change of opacity
Set the opacity using the [Opacity] slider. The larger the value, the more opaque the active mask region will
become.
Icon Image Update

Normally, numbers are on the buttons, but you can view the image registered to the mask as an icon on the button
by clicking the button. In this state, when the mouse cursor is moved onto a button changed into an icon, a
large icon is displayed as tool tip. To update the icon image for each mask, individual updating is possible from the
right-click menu of the respective mask button.
Mask Name Registration

Each mask can be given a name from the right-click menu of the respective mask button. By doing so, information
can be shared between multiple users for what has been extracted to the masks. The name is displayed as a part of
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the tool tip when the mouse cursor is moved onto the button. As the input history of mask names is memorized,
the previously listed mask names can be selected from the second time on.
Mask Deletion
The mask information registered to a mask can be deleted from the right-click menu of each mask button.
However, the mask information of active masks cannot be deleted. To delete the information, temporarily activate a
different mask, and then delete the original mask from its right-click menu.
Reverse Removal
Reverse removal is the function for registering of a mask as the reference before subtracting the "reversed present
mask" from the "reference mask". For example, when a mask is reversed after bone removal, the removed parts are
displayed and can be confirmed. When the Reverse button of the mask frame is clicked, the same procedure is
performed but in this case, reversion is performed for the full display of the image, so the bed removed initially, etc.
will also be displayed. For reverse removal, the target is the mask at the time of registration, so this problem can be
avoided.
The procedures for bone removal while using reverse removal to confirm the removal contents are shown below.
1. Click the button before executing the automatic bone removal function (after bed removal)
2. Click the automatic bone removal function
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3. Click the button to confirm the removed content
The parts removed by automatic bone removal are displayed. Confirm that blood vessels are not included in
the removed parts.
Delete any left out vessels by smart tracking, etc.
4. Click the button again to confirm the vessel extraction result
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Repeat the application of "Reverse" if there are still parts where vessels are cut off. (On the other hand, if
there is excessive extraction of bones, delete these portions by smart tracking or other means.)
Multi Mask Display

Normally, only one mask region is displayed in the 3D image. However if the multimask is used, a 3D image can be
displayed with multiple mask regions mixed together.
In the above figure, Mask 1 shows only the upper 1/3 of the original image, and Mask 2 shows only the lower 1/3
of the image. Also, different color templates can be applied to each mask. In the figure, different color templates
have been applied to Mask 1 and Mask 2, so the colors of each part in the display result are also different. At this
time, when both Mask 1 and Mask 2 are displayed via multi-mask, the upper part and the lower part of the original
image are displayed in each color, and a multi-masked image without the center part is displayed.
To display multiple mask images simultaneously, after editing each mask region, click the [Multimask] button and
select mask regions to display.
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The mask regions under this button are displayed in the multi-mask display.
The mask regions under this button are not displayed in the multi-mask display.
In the multi-mask display, the opacity of each mask can be configured. To change the opacity of different masks,
change the active mask then set the opacity using the [Opacity] slider.
In the multi-mask display, the background color of the active mask is applied.
Layer Display
With layer display, an image is created for each mask region, and these images are combined to form a single
image in a 3D view.
Layers are arranged starting from the mask region with the lowest mask number in front. Adding a check to the
upper left of the button marks the layer for display, and up to four mask regions can be marked for display. Use the
[Opacity] slider to specify the overlay ratio between these mask regions and the region behind them.
Mask Calculation
When the mask calculation is used, processes such as extracting the common part within two masks can be
performed. Mask calculation can be used when the [Multimask] button is OFF.
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In mask calculation, the images in the top row and the second row are the input. Only the masks of the top row are
the input for reversing. To perform the mask calculation, perform the following procedures.
1. Click the button
2. Select the logical formula for calculation between images from the [Mask operator]
NOT The target mask region is reversed.

ADD At least one of the existing regions
among the target mask regions is
made into a new mask region.
SUB The target mask region in the lower
row is subtracted from the target
mask region in the upper row.
AND The parts that are common to both
target masks are made into a new
mask region.
XOR The mask regions of both target
masks are added and remove the
regions which are common to both
masks. The remaining region is
made into a new mask region.
3. Select the masks to input from the top row and the second row (only the top row for reversal)
4. Select the mask to which the calculation result is registered from the bottom row
5. Click the [Execute] button
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Mask Storage
Normally, 12 mask regions can be swapped, but by clicking the button, you can use eight additional regions.
These additional regions are swapped for the active mask when being used.
The buttons in the upper row perform copying of the mask in the same way as the button in the "Mask". When a
button is clicked, the contents of the active mask are copied to the clicked mask region.
The buttons in the middle row display the mask of additional region. When a button is clicked, the contents of
active mask and contents of clicked mask are swapped.
To initialize the masks in the [Mask storage] dialog, click the [Clear] button.
If there is not enough space in the memory, stocks cannot be used.
Saving Contour Information as a DICOM-RT File

Mask region contours of stock masks in 3D Viewer or 3D Viewer with VE can be saved as a DICOM-RT file as
follows.
1. Move the mask with contours to save to a stock mask
2. Click the [Save contour as DICOM-RT] button, or select to save contours as a DICOM-RT file from the right-
click menu on a mask
Clicking the [Save contour as DICOM-RT] button to save contours will save all stock mask contours as a
DICOM-RT file.
Saving contours from the right-click menu will save contours of the mask you clicked as a DICOM-RT file.
3. Enter the Structure Set Label and click the [OK] button
The information you enter is saved as the value of DICOM tag number (3006,0002), Structure Set Label.
4. For each contour to save, select the RT ROI Interpreted Type
The information you select is saved as the value of DICOM tag number (3006,00A4), RT ROI Interpreted Type.
The registered mask name is saved as the value of DICOM tag number (3006,0026), ROI Name, in the DICOM-RT
file.
If mask names have not been registered, names such as ROI-1, ROI-2, and so on (starting with the mask left of the
stock mask) are saved as ROI names.
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Saving will fail if DICOM files of the original images of masks do not include information needed to create
DICOM-RT files.
If mask regions on the slices include holes, the contours saved have those holes filled in. Thus, the contours may
not be saved as expected. When this information will be applied in planning treatment, always check the results of
saving before use.
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3.5 Cardiac Tools (Option)

Outline of Coronary Analysis CT

window
Coronary Analysis CT uses CT images to extract the path of the target blood vessels and performs evaluation of the
coronary arteries.
• Automatic extraction of the heart
• Automatic extraction of coronary arteries
• Color-coded display of plaque (hard plaque and soft plaque)
• Measure coronary artery stenosis ratios
• Display coronary artery CPR images
• Save coronary artery CPR and orthogonal plane images
• Modify coronary artery paths and heart region
• Various types of 3D displays for observation of coronary arteries
Recommended image Contrast-enhanced CT images taken under ECG synchronization
Body part to be Heart
analyzed
Exposure condition Small slice-interval images
Reconstructed function Function with which the soft tissue can be observed
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The best exposure conditions to expose heart differ for each manufacturer. Expose images with the exposure
conditions recommended by each manufacturer.
In Coronary Analysis, the following tools are available.

(WL)
Removal
3D images.
Mask edit
Start up Coronary Analysis

1. Select images for use with Coronary Analysis from the study or series list
3. Click the [Start Application] → [Chest] → [Coronary Analysis] buttons
Switch the Stage in Coronary Analysis

Coronary Analysis MR advances the analysis by selecting the buttons on the stage bar.
Slice view Observe coronary arteries on oblique planes.

Heart Extraction The heart region is extracted automatically from the loaded images. You can
delete unneeded regions other than the heart region, and you can also add
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unextracted region.
General Observation Observe coronary arteries in various ways specialized for observation of coronary
arteries.
Path Observation Observe registered coronary artery paths at once.
Related XA Observation Vessel contrast images with the same patient ID are displayed together.
The [Slice view] stage is available only when it is configured to be used.
Outline of Coronary Analysis MR

window
Coronary Analysis MR uses MR images to extract the path of the target blood vessels and performs evaluation of
the coronary arteries.
• Display axial, sagittal, and coronal images
• Automatic extraction of coronary arteries
• Color mapping analysis
• Measure coronary artery stenosis ratios
• Display coronary artery CPR images
• Save coronary artery CPR and orthogonal plane images
• Modify coronary artery paths and heart region
• Various types of 3D displays for observation of coronary arteries
Recommended image Images exposed under electrocardiogram synchronization
Images with high contrast between interior and exterior of the blood region
analyzed
Exposure condition Images with narrow slice gaps or narrow interval of slices
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Other Images with high S/N ratio in which you can clearly observe coronary arteries
In Coronary Analysis MR, following tools are available.

(WL)
Removal
3D images.
Mask edit
Start up Coronary Analysis MR

1. Select images for which Coronary Analysis MR is going to be used from study list or series list
3. Click the [Start Application] → [Chest] → [Coronary Analysis] buttons
Switch the Stage in Coronary Analysis MR

Coronary Analysis MR advances the analysis by selecting the buttons on the stage bar.
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Slice View Observe coronary arteries on oblique planes.

Heart Extraction The heart region is extracted automatically from the loaded images. You can
delete unneeded regions other than the heart region, and you can also add
unextracted region.
General Observation Observe coronary arteries in various ways specialized for observation of coronary
arteries.
Path Observation Observe registered coronary artery paths at once.
Related XA Observation Vessel contrast images with the same patient ID are displayed together.
The "Slice View" stage is available only when it is configured to be used.
Outline of Cardiac Function CT
Cardiac Function CT is an application for cardiac function evaluation which obtains the contour of ventricle and
myocardium from CT images constructed by the multiple time phases and calculates ejection fraction, end-diastolic
volume, end-systolic volume, stroke volume etc.
The contours of the ventricle and myocardium can be set by automatic extraction based on the image information
or by user input or modification. The calculated result can be displayed as a graph or bulls eye images and can be
printed as a report.
• Automatic extraction of the contours of ventricle and myocardium which are required cardiac function
analysis
• Display the long axis and short axis images of the heart
• 3D mapping display of analysis results
• Volume measurement and display of the bull's eye for ventricle and myocardium
• Measuring of various cardiac function evaluations
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Recommended image Contrast-enhanced CT image exposed under electrocardiogram synchronization

Images with thin slice thickness and narrow interval
analyzed
Reconstructed function Function with which the soft tissue can be displayed
When the contrast effect in the ventricle is inconsistent, the integrity of the analysis data may decrease.
In Cardiac Function, following tools are available.

(WL)
Removal (unable to use except in [4D cine playing] stage)
3D images.
Start Up Cardiac Function

3. Click the [Start Application] → [Chest] → [Cardiac Function] button
The number of images must be the same in all phases. Also, when the position information (e.g. bed position,
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image position), image size information (e.g. pixel size), etc. are not the same for images between phases, proper
analysis may not be able to be performed.
When images from multiple phases exist in a series, the application starts up after dividing the series automatically
for each phase when the images are loaded as they are.
The time information of cine play is retrieved from the DICOM header information. However, the time information
may not be retrieved depending on the imaging equipment, software version/setting of the imaging equipment,
etc.
Switch the Cardiac Function Stage

Cardiac Function MR advances the analysis by selecting the button on the stage bar.
4D cine playing Set the left heart center axis and play movies of 2D and 3D images.
Ventricle Display Display the image after setting the contour.
Result Display various results such as the EF curve.
Short Axis Modification Modify the contour of the ventricle and the myocardium on the short axis images.
Long Axis Observation Observe the contour of the ventricle and the myocardium on the long axis
images.
Outline of Cardiac Function MR
Cardiac Function MR is an application for cardiac function evaluation that obtains ventricle and myocardium
boundaries from MR images consisting of multiple time phases and calculates ejection fraction, end-diastolic
volume, end-systolic volume, stroke volume, and other information.
The contours of the ventricle and myocardium can be set by automatic extraction based on the image information
or by user input or modification. The calculated result can be displayed as a graph or bulls eye images and can be
printed as a report.
• Semi-automatic extraction of the contours of ventricle and myocardium which are required cardiac function
analysis
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• Volume measurement and display of the bull's eye for ventricle and myocardium
• Calculation of the ventricle capacity from a long axis image with the Area-Length method
Cardiac Function MR can be used with 2D short axis images, 2D long axis images, or 3D images.
2D short axis analysis

In 2D short axis analysis, load and analyze images exposed in a short axis direction. In the following figure, the blue
planes represent the images to be loaded.
Recommended image Image exposed under electrocardiogram synchronization
Left ventricle short axis cine images of multiple slices including the area from the
base to apex
Images with narrow slice gaps
analyzed
Other High S/N ratio image. Requires a minimum of two slices.
2D long axis analysis

In 2D long axis analysis, cine images exposed in the long axis direction such as a two-, three-, or four-chamber view
are loaded and analyzed. In the following figure, the blue planes represent the images to be loaded. Although
multiple slice images can be loaded, only one is used for analysis.
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Recommended image Image exposed under electrocardiogram synchronization
Left ventricle long axis cine images including the area from the base to apex
analyzed
Other High S/N ratio image.
3D analysis
In 3D analysis, an image in which the entire heart has been exposed is loaded; short axis images of the ventricle are
reconstructed and analyzed. In the following figure, the blue cube represents the image to be loaded, and the
yellow planes represent the reconstructed short axis images.
Recommended image 3D heart cine image
Images with thinner slice thickness
analyzed
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Other High S/N ratio image. Requires a minimum of five slices.
The best exposure conditions differ for each manufacturer. Expose images with the exposure conditions
recommended by each manufacturer.
In Cardiac Function, following tools are available.

(WL)
3D images.
Start Up Cardiac Function MR

3. Click the [Start Application] → [Chest] → [Cardiac Function] button
etc.
Switch the Cardiac Function MR Stage

Cardiac Function MR advances the analysis by selecting the button on the stage bar.
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Initialize Specify the center of the left ventricle and play the movie.
Ventricle Display Display the image after setting the contour. (Only for 3D analysis)
Analysis Results Display various results such as the EF curve. (For 2D short axis analysis and 3D
analysis)
Short Axis Modification Modify the contour of the ventricle and the myocardium on the short axis images.
(For 2D short axis analysis and 3D analysis)
Long Axis Observation Observe the contour of the ventricle and the myocardium on the long axis
images. (For 2D short axis analysis and 3D analysis)
Contour Setting Set the contour of the ventricle, and display the analysis results. (Only for 2D long
axis analysis)
Outline of Calcium Scoring
Calcium Scoring displays the plaque area of the coronary artery by color, and calculates the quantitative value of
plaque by using the Agatston score method.
• Calculation of the Agatston score based on the Agatston score method
• Threshold value setting for scoring
• Specification for the plaque area in 2D and 3D images
Recommended image A simple CT image exposed under electrocardiogram synchronization
analyzed
Exposure condition Image with thickness of 3 mm and 3 mm slice interval
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Contrast-enhanced CT images cannot be analyzed properly.
The scoring value is corrected for images that are not 3 mm thick with 3 mm slice interval.
In Calcium Scoring, following tools are available.

(WL)
Removal
3D images.
Start up Calcium Scoring

3. Click the [Start Application] → [Chest] → [Calcium Scoring] button
Switch the Calcium Scoring Stage

Calcium Scoring advances the analysis by selecting the button on the stage bar.
Heart Extraction The heart region is extracted automatically or manually from the read image.
Perform the deletion of unneeded regions, addition of the unextracted regions,
etc.
Scoring Select plaque areas required for calculating the calcium score, and display the
calculation result.
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Outline of Cardiac Fusion
In the cardiac fusion, the image comprising characteristics of both the functional image and structural image can
be generated by overlaying the images.
• Display the axial, sagittal, and coronal plane images
• Overlay display of a functional image and a structural image
In Cardiac Fusion, following tools are available.

(WL)
Removal (Unable to use in the [Registration] stage)
(Unable to use in the [Registration] stage)
3D images.
(Unable to use in the [Registration] stage)
Start up Cardiac Fusion

The cardiac fusion can overlay coronary analysis images as structural images and cardiac function analysis results or
SPECT images as functional images. Required images and applications are as follows.
Applications for creating a Coronary Analysis CT

structural image Coronary Analysis MR
Applications for creating a Cardiac Function CT
functional image Cardiac Function MR
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4-Chamber Analysis
Functional images NM image (Myocardium SPECT image)
As the application to create structural images, coronary analysis must be performed to the stage where the blood
vessel path is extracted. For applications producing functional images such as cardiac function analysis etc., the
analysis must be advanced to a state where reference can be made to the analysis results. Regarding NM and
functional images, NM and images with a patient ID matching that of the structural images must exist in the local
database.
To start cardiac fusion, select [Cardiac Fusion] from the application frame, making sure there are structural and
functional images with the same patient ID. When there are multiple images for each application, a dialog as shown
below is displayed and the image to be used is selected.
When there are multiple images for applications producing structural images and functional images, a dialog as
shown below is displayed and the phase to be used is selected.
When the phase positions of the structural image and the functional image for one pulse differ widely etc., a fused
image with incorrect position information may be created and accurate registration cannot be performed. When
starting cardiac fusion, select the images so that the phase positions of the image of the application producing a
structural image and the image of the application producing a functional image are very close together.
As for NM , images with the same patient ID as the structural images are searched in the local database when the
Cardiac Fusion application is started. If there is more than one NM or image in the local database, an image
selection dialog is displayed. Moving an NM or image to the Stress field or Rest field and clicking [OK] will start the
Cardiac Fusion application. In this dialog, the display name of each image (Stress, Rest, etc.) can also be changed.
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Note that character strings such as "Stress base" in the combo box for the mask operator calculation method in
the [Observation] stage are not changed even if the display name of each image is changed within this dialog.
If the same patient ID has been assigned for different patient studies, it is recognized as a study of the same patient
and it is displayed in the related study list.
Analysis results etc. displayed in the cardiac fusion are created from the images of each application displayed at the
time of cardiac fusion startup. Because of this, when the analysis results are edited in the cardiac function analysis
etc. after cardiac fusion is started up, changes may not be reflected in the image displayed in the cardiac fusion.
When editing has been performed by using the original application, exit cardiac fusion once and start it again.
When cardiac fusion is started after starting Coronary Analysis CT from Cardiac Function CT or 4-Chamber Analysis,
registration is not performed because the same image is used. Thus, the [Registration] stage is not displayed.
Outline of MR Flow Analysis

window
In MR flow analysis, the blood flow volume and the flow velocity per heart rate velocity of an arranged ROI can be
calculated.
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• Display analysis table (flow volume analysis and flow velocity analysis)
• Display blood flow velocity image
• Display original image, phase image, or absolute value image
• Display original image, phase image, or absolute value image, overlapped with the blood flow velocity image
• Display the result of the flow volume analysis and the flow velocity analysis by the time intensity curve
Recommended image Images of one-phase captured by the phase-contrast method
analyzed
Analysis image It is needed to include original or absolute images in the same position and phase
conditions as the phase image
In MR Flow Analysis, following tools are available.

Start up MR Flow Analysis

3. Click the [Start Application] → [MR Flow Analysis] button
Outline of Aortic Valve Analysis
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window
Aortic Valve Analysis is an application for measuring various aspects of the vicinity of the aortic valve by extracting
the heart and aorta regions from the input CT images.
This application allows the confirmation of the size of the aorta, and the performance and calcification of the aortic
valve to support an aortic valve replacement.
• Automatic extraction of the heart and aorta regions
• Automatic detection of the contour of the aorta
• Measurement of the vicinity of the aortic valve
• Measurement of the calcification area in the aorta
analyzed
Exposure condition Small slice-interval images
In Aortic Valve Analysis application, the following tools are available.

(WL)
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Removal
3D images.
Mask Edit
Start up Aortic Valve Analysis

1. Select the target image for Aortic Valve Analysis from the study and series lists
3. Click the [Start Application] → [Chest] → [Aortic valve analysis] buttons
Switch the Stage in Aortic Valve Analysis

Aortic Valve Analysis advances the analysis by selecting the buttons on the stage bar.
Annulus plane setting Specify the bottom surface of the aortic valve, and determine axes for
measurement.
Measurement Perform measurements around the aortic valve.
3D observation Perform 3D observation, as for calcified volumes.
Path planning Perform CPR observation in the aorta.
Outline of 4-Chamber Analysis
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4-Chamber analysis is an application that extracts left and right ventricles, atria, and myocardium region from CT
images consisting of the multiple time phases, calculates cardiac function parameters such as ventricular ejection
fraction, and enables observation of transitions in ventricle and atrial volume.
Ventricular, atrial, and myocardial regions can be extracted automatically based on image information, or extracted
and modified based or user input. The calculated result can be displayed as a graph or bulls eye images, and it can
be printed as a report.
• Automatic extraction of ventricular, atrial, and myocardial regions
• 3D surface rendering of ventricular, atrial, and myocardial regions
• Automatic extraction of the contours of ventricle and myocardium which are required for cardiac functional
analysis.
• Volume measurement and bull's eye display of ventricle, atrium, and myocardium
• Non-rigid phase registration
Recommended image Contrast-enhanced CT image exposed under electrocardiogram synchronization
Images with thin slices and narrow gaps
analyzed
Reconstructed function Function with which the soft tissue can be displayed
When the contrast effect in the ventricle is inconsistent, the integrity of the analysis data may decrease.
In 4-Chamber analysis, the following tools are available.
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(WL)
Removal (Not available except in the [Display region] stage)
3D images.
Mask edit
(Not available except in the [Display region] stage)

Start up 4-Chamber Analysis

3. Click the [Start Application] → [Chest] → [4-Chamber Analysis] button
etc.
Switch to 4-Chamber Analysis Stage

To proceed with 4-Chamber analysis, select the button on the stage bar.
Display region Set the left heart center axis, extract left and right ventricles, atria, and
myocardium region, and play movies of 2D and 3D images.
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Ventricle analysis Display cardiac function analysis results for the left and right ventricle, such as the
EF curve.
4-Chamber analysis Display cardiac function analysis results for the left and right ventricle and atrium,
such as the EF curve.
Outline of Cardiac Ablation Analysis
Cardiac Ablation Analysis is an application that extracts left and right ventricles, atria, and myocardium regions
from CT images consisting of the multiple time phases, besides extracting the pulmonary vein based on the left
atrium region, in pre-operation simulation for ablation, and in post-operation observation.
Additionally, the gullet region can be extracted to provide an understanding of the position relative to the left
atrium.
• Automatic extraction of ventricular, atrial, and myocardial regions
• Extraction of the pulmonary vein based on the left atrium region
• ROI-based extraction of the gullet region
• 3D view inside the pulmonary vein
• Virtual endoscopic view of inside the pulmonary vein
• Observation of display planes in a virtual endoscopic view
Recommended image Single-phase contrast-enhanced CT image of the left artery, and contrast-
enhanced CT image exposed under electrocardiogram synchronization
Images with thin slice thickness and narrow interval
analyzed
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In Cardiac Ablation Analysis, the following tools are available.

(WL)
Removal (Not available in the [Observation] stage)
3D images.
Mask edit
(Not available in the [Observation] stage)

Start up Cardiac Ablation Analysis

3. Click the [Start Application] → [Chest] → [Cardiac Ablation Analysis] button
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etc.
Switch the Cardiac Ablation Analysis Stage

Cardiac Ablation Analysis advances the analysis by selecting the button on the stage bar.
Display region Set the left heart center axis, extract left and right ventricles, atria, and
myocardium region, and play movies of 2D and 3D images.
Peripheral region Extract the pulmonary vein, gullet, and other arbitrary regions.
Observation Virtual endoscopy or other observation from a starting point centered on the left
atrium, to observe the pulmonary vein shape and peripheral regions.
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3.6 Perfusion Analysis (Option)

Outline of Brain Perfusion CT
Brain Perfusion CT analyzes the changes in cerebral blood flow from the dynamic scan images of CT for the same
slice and calculates CBV (Cerebral Blood Volume), CBF (Cerebral Blood Flow), MTT (Mean Transient Time), and TTP
(Time To Peak) from the analysis results. Brain Perfusion CT is an application only for CT. This application does not
support images of other modalities.
• Automatic registration
• Position detection and correction of arteries and veins
• Calculation of CBV, CBF, MTT, and TTP
• Analysis result list display
CBV, CBF, MTT are calculated by deconvolution method.
Recommended image CT perfusion images exposed with the contrast medium (images exposed for a
period of time)
Body part to be Head (entire brain or from lower edge of the base nucleus to the upper edge of
analyzed the lateral ventricle)
Analysis image Images exposed in the period of time before the contrast medium enters the
conditions blood vessel and until it leaves the blood vessel
(Example: Image from 5 sec before injection of the contrast medium until 60 to 90
sec afterwards)
Images with little noise
Images with continuous intermittent exposure
In Brain Perfusion CT, following tools are available.
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The value obtained by perfusion is a value calculated according to a given calculation model. Because of the
differences between the calculation model and the human body, the calculated values do not necessarily reflect the
values of the actual human body.
As there are various methods for the calculation and action models used by perfusion, the analysis results of this
workstation may differ from those of other manufacturers.
In registration of images exposed at the different time and date, note that the position of the blended images
might be misaligned even if registration has been performed properly.
Please follow the labeling of the contrast agent or the modality and take the responsibility for dose management
on each facility when using a contrast agent. Please read the INDICATIONS, USAGE, DOSAGE AND
ADMINISTRATION of the contrast agent to confirm whether it is usable for Brain Perfusion CT.
Please follow the imaging protocol described in the labeling of the used modality or the facilities.
Start up Brain Perfusion CT

3. Click the [Start Application] → [Head] → [Brain Perfusion] button
With the recommended settings, the time interval between the images is retrieved automatically when they are
read, and the analysis result is calculated in consideration of the time interval. When the time interval could not be
retrieved automatically, an error is displayed, and the time interval set in advance is applied forcibly. Even when the
time interval could be retrieved, an error is displayed when the time interval of each image differs by 0.1 sec or
more.
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Since the time interval may not correctly be retrieved depending on the device or data, confirm the time for each
phase from [Phase list] in the tool frame.
Switch the Brain Perfusion CT Stage

Brain Perfusion CT advances the analysis by selecting the button on the stage bar.
Vessel Positioning Set ROIs of the artery and vein to be used to calculate analysis values.
View Result Display analysis results of CBV, MTT, CBF, TTP, etc.
Result List Display analysis results of CBV, MTT, CBF, TTP, etc. in a list.
The usage of subject device is not limited to a specific manufacturer’s scanner and it can be used just by installing
on a Windows-based PC workstation and receives data by DICOM communication from Modalities (CT) or PACS in
which CT DICOM dataset is stored. About the scan settings for CT perfusion, the tube voltage (kVp) and tube
current (mA) should be set as low as possible to reduce the radiation dose. The CT images that are taken in the
setting ranged from 80 kVp to 120 kVp for tube voltage and from 100 mA to 350 mA for tube current can be
postprocessed by the subject device.
Reference information on performance:

The performance testing was conducted to show the accuracy for Brain perfusion (CT). The data used for
performance testing are defined as follows.
Input data (Pi): an image which is created using an arbitrary CT signal value.
Reference data (Pt): a value derived from perfusion calculation model using the input data (Pi).
Result data (Pc): a value calculated by Synapse 3D Perfusion Analysis using the input data (Pi).
Error: ((Pt - Pc) / Pt)*(100%).
Pass criteria: the error is within ± 1%.
Based on the above definitions for the performance testing data, the accuracy of calculating the parameters CBV
(Cerebral Blood Volume), CBF (Cerebral Blood Flow), MTT (Mean Transit Time) and TTP (Time To Peak) by
deconvolution method was tested and the pass criteria was satisfied.
Outline of Brain Perfusion MR
Brain Perfusion MR analyzes the changes in cerebral blood flow from the dynamic scan images of MR for the same
slice and calculates CBV (Cerebral Blood Volume), CBF (Cerebral Blood Flow), MTT (Mean Transient Time), and TTP
(Time To Peak) from the analysis results. Brain Perfusion MR is an application only for MR. This application does not
support images of other modalities.
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• Automatic registration
• Blend with the ADC Map
Recommended image MR perfusion images exposed with the contrast medium (images exposed for a
period of time)
Body part to be Head (entire brain or from lower edge of the base nucleus to the upper edge of
analyzed the lateral ventricle)
sec afterwards)
In MR Perfusion, the following tools can be used.

The value obtained by perfusion is a value calculated according to a given calculation model. Because of the
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ADMINISTRATION of the contrast agent to confirm whether it is usable for Brain Perfusion MR.
Start up Brain Perfusion MR

3. Click the [Start Application] → [Head] → [Brain Perfusion] button
4. Check the input images
If you registered both perfusion images and diffusion images, select [Perfusion image], [Diffusion without
MPG], [Diffusion with MPG], [Diffusion(mixed)], or [FLAIR] for each image.
When images to load for perfusion are organized into series by time phase, they are displayed as a list. Click
listed images and select [Perfusion image], [Diffusion without MPG], [Diffusion with MPG], [Diffusion(mixed)],
or [FLAIR] for each image.
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5. Select [Diffusion(mixed)] images
If you specified [Diffusion(mixed)] for loaded images, the relevant series is broken down and displayed as a
list. In these images, select images for [Diffusion without MPG] and [Diffusion with MPG].
read, and the analysis result is calculated in consideration of the time interval. When the time interval could not be
retrieved automatically, an error is displayed, and the time interval set in advance is applied forcibly. Even when the
time interval could be retrieved, an error is displayed when the time interval of each image differs by 0.1 sec or
more.
Since the time interval may not correctly be retrieved depending on the device or data, confirm the time for each
phase from [Phase list] in the tool frame.
Depending on the exposure methods, misalignment of body parts, body movement or the difference of exposure
time, the relative position for diffusion images and perfusion images may misaligned. Note that images will be
fused as they are without performing registration for the misalignment caused by such reasons.
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As the accidental errors are neglected, please note that images will be fused as they are even there is a little
difference between the images orientation information.
Switch the Brain Perfusion MR Stage

Brain Perfusion MR advances the analysis by selecting the button on the stage bar.
Vessel Positioning Set ROIs of the artery and vein to be used to calculate analysis values.
View Result Display analysis results of CBV, MTT, CBF, TTP, etc.
Result List Display analysis results of CBV, MTT, CBF, TTP, etc. in a list.

The performance testing was conducted to show the accuracy for Brain perfusion (MR). The data used for
Error: ((Pt - Pc) / Pt)*(100%).
Outline of 4D Perfusion

window
Analyzes cerebral blood flow over time (in 4D), using multi-phase 3D whole-brain images. CBV (cerebral blood
volume), CBF (cerebral blood flow), MTT (mean transient time), and TTP (time to peak) are calculated as analysis
results. 4D Perfusion is an application only for CT. It does not support images of other modalities.
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Recommended image Whole-brain CT perfusion images exposed with the contrast medium (images
exposed for a period of time)
Body part to be Head (whole brain)
analyzed
sec afterwards)
Images with the same spatial resolution in X, Y, and Z directions (images with
isotropic voxels)
In 4D Perfusion, the following tools can be used.

The value obtained by 4D perfusion is a value obtained according to a specific calculation model. Because of the
Because there are various methods for the calculation and action models used by 4D perfusion, the analysis results
of this workstation may differ from those of other manufacturers.
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ADMINISTRATION of the contrast agent to confirm whether it is usable for 4D Perfusion.
Start up 4D Perfusion
3. Click the [Start Apps.] → [Head] → [4D Perfusion] button
read. If the time interval of each image differs by 0.1 sec or more, it is interpreted as scan data with an irregular
interval. In this case, data is interpolated and the analysis result is calculated accounting for the time interval. When
the time interval could not be retrieved automatically, an error is displayed, and the default time interval set in
advance is applied forcibly.
Depending on the modalities and the data, the time interval may not be retrieved. Confirm the [Scan interval] on
the settings screen.
Switch the 4D Perfusion Stage

4D Perfusion advances the analysis by selecting the button on the stage bar.
Vessel Positioning Specify positions of the artery and vein used to calculate analysis values.
View Result Display analysis results of CBV, MTT, CBF, TTP, and so on.
Result List List analysis results of CBV, MTT, CBF, TTP, and so on.
current (mA) should be set as low as possible to reduce the radiation dose. The CT images that are taken in the
setting ranged from 80 kVp to 120 kVp for tube voltage and from 100 mA to 350 mA for tube current can be
postprocessed by the subject device.
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The performance testing was conducted to show the accuracy for 4D perfusion (CT). The data used for performance
testing are defined as follows.
Error: ((Pt - Pc) / Pt)*(100%).
Outline of Abdominal Perfusion
Analyzes the blood flow of abdominal organs over time (in 4D), using multi-phase 3D abdomen images. TBV (tissue
blood volume), TBF (tissue blood flow), MTT (mean transient time), and TTP (time to peak) are calculated as analysis
results. Abdominal Perfusion CT is an application only for CT. This application does not support images of other
modalities.
• Calculation of TBV, TBF, MTT, and TTP
TBV, TBF, MTT are calculated by deconvolution or maximum slope method.
Recommended image CT abdominal perfusion images exposed with the contrast medium (images
exposed for a period of time)
Body part to be Abdomen
analyzed
(Example: Image from 5 sec. before injection of the contrast medium until 60 to
90 sec. afterwards)
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Images with the same spatial resolution in x, y, and z directions (images with
isotropic voxels)
In Abdominal Perfusion, the following tools can be used.

Mask Edit
The value obtained by abdominal perfusion is a value obtained according to a specific calculation model. Because
of the differences between the calculation model and the human body, the calculated values do not necessarily
reflect the values of the actual human body.
Because there are various methods for the calculation and action models used by abdominal perfusion, the analysis
results of this workstation may differ from those of other manufacturers.
In the case of non-rigid registration, since the image to be registered is deformed for the registration, the original
image information may be lost. Please keep this in mind when observing the deformed image.
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ADMINISTRATION of the contrast agent to confirm whether it is usable for Abdominal Perfusion.
Start Up Abdominal Perfusion

3. Click the [Start Application] → [Abdomen] → [Abdominal Perfusion] button
the time interval could not be retrieved automatically, an error is displayed, and the default time interval set in
advance is applied forcibly.
Depending on the modalities and the data, the time interval may not be retrieved. Check the [Phase list].
Switch the Abdominal Perfusion Stage

Abdominal Perfusion advances the analysis by selecting the button on the stage bar.
Vessel Positioning Specify positions of the artery and vein used to calculate analysis values.
View Result Display analysis results of TBV, MTT, TBF, TTP, and so on.
Result List List analysis results of TBV, MTT, TBF, TTP, and so on.
current (mA) should be set as low as possible to reduce the radiation dose.

The performance testing was conducted to show the accuracy for Abdominal Perfusion (CT). The data used for
Error: ((Pt - Pc) / Pt)*(100%).
Based on the above definitions for the performance testing data, the accuracy of calculating the parameters TBV
(Tissue Blood Volume), TBF (Tissue Blood Flow) , MTT (Mean Transit Time) and TTP (Time To Peak) by
deconvolution and maximum slope methods was tested and the pass criteria was satisfied.
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Outline of Cardiac Perfusion CT
Analyzes myocardial blood flow using multi-phase 3D heart images. MBV (myocardial blood volume), MBF
(myocardial blood flow), MTT (mean transient time), TTP (time to peak), PE (peak enhancement), and PER (peak
enhancement ratio) are calculated as analysis results. Cardiac Perfusion CT is an application only for CT. This
application does not support images of other modalities.
• Position detection and correction of arteries
• Visualization of intensity changes in each phase
• Calculation of MBV, MBF, MTT, TTP, PE, and PER.
• Myocardial territory extraction
• Visualization of myocardium region analysis results
MBF, MBV, MTT are calculated by deconvolution method.
analyzed
Analysis image Images exposed in the period of time before the contrast medium enters the left
conditions ventricle and until it leaves the blood vessel
Images with multiple heart beats, with only one phase per beat
In Cardiac Perfusion CT, the following tools can be used.

(WL)
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Removal
3D images.
Mask Edit
The value obtained by Cardiac Perfusion CT is a value obtained according to a specific calculation model. Because
of the differences between the calculation model and the human body, the calculated values do not necessarily
reflect the values of the actual human body.
Because there are various methods for the calculation and action models used by Cardiac Perfusion CT, the analysis
results of this workstation may differ from those of other manufacturers.
ADMINISTRATION of the contrast agent to confirm whether it is usable for Cardiac Perfusion CT.
Start Up Cardiac Perfusion CT

3. Click the [Start Application] → [Chest] → [Cardiac Perfusion] button
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the time interval could not be retrieved automatically, an error is displayed and the time interval is set to 1 second.
Depending on the modalities and the data, the time interval may not be retrieved. Check the time interval for each
phase in [Phase list].
Switch the Cardiac Perfusion CT Stage

Cardiac Perfusion CT advances the analysis by selecting the button on the stage bar.
Specify the artery Specify the position of the artery used to calculate analysis values.
position
View Result Display analysis results of MBV, MTT, MBF, TTP, PE, PER, and so on.
Long Axis Setting Set the long axis of the left ventricle.
Contour Modification Edit contours of the outer and inner membranes of the myocardium to specify the
myocardial region.
Myocardial Display analysis results for the myocardial region.
Observation
current (mA) should be set as low as possible to reduce the radiation dose.

The performance testing was conducted to show the accuracy for Cardiac perfusion (CT)). The data used for
Error: ((Pt - Pc) / Pt)*(100%).
Based on the above definitions for the performance testing data, the accuracy of calculating the parameters MBV
(Myocardial Blood Volume), MBF (Myocardial Blood Flow), MTT (Mean Transit Time), TTP (Time To Peak), PE (Peak
Enhancement) and PER (Peak Enhancement Ratio) by deconvolution method was tested and the pass criteria was
satisfied.
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3.7 Lung and Abdomen Analysis (Option)

Outline of Lung Analysis/Airway

window
In Lung Analysis/Airway, the various types of analysis for lung nodules, bronchi, lower attenuation areas, etc. can be
performed using the volume data collected by CT.
• Automatic and semi-automatic extraction of the lung field and lung lobe
• Extraction of the contact area between the lung field and diaphragm
• Semi-manual extraction and volume calculation for nodules existing in lung field
• Extraction of bronchus regions and measurement of diameter of bronchi
• Color-coded display of signal values for lung field region
• Calculation of Goddard score
• Analysis of low attenuation clusters
• Various displays enhancing lung region observation
Recommended image CT images including a lung field region
Analysis image Images including one or both lungs in FOV
conditions Images without extreme body motion artifacts
Evaluation of nodules, low attenuation areas, and clusters may be inaccurate for images with a poor S/N ratio, such
as images with edge enhancement. The analysis result may be affected by the presence or absence of image
contrast-enhancement, the respiratory phase, differences in the slice thicknesses, etc.
In Lung Analysis/Airway, following tools are available.
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(WL)
Removal
Mask Edit
3D images.
Startup Lung Analysis/Airway

1. Select an image for which the lung analysis/airway is performed from the study list and series list
3. Click the [Start Application] → [Chest] → [Lung Analysis/Airway] buttons
Switch the Lung Analysis/Airway Stage

Lung analysis/airway advances the analysis by selecting the button on the stage bar.
Nodule Extraction Extract nodules in lung field region semi-automatically and display various
information of nodules (volume, signal values, etc.).
Lung Extraction Extract the lung field region automatically or semi-automatically from the loaded
images. Perform the deletion of unneeded regions other than the lung field, the
addition of the unextracted region, etc. Extract the contact area between the
extracted lung field and diaphragm. Additionally, extract the bronchus and edit
this image.
Bronchus Edit bronchi, modify a contour of a bronchi wall, and label bronchi.
Registration Perform registration with related images, loaded separately.
LAA View Assign a color to each signal value in the lung field region and overlay the result
on the 2D image. Also, calculate the volume of each signal value.
Cluster Perform the cluster analysis of low attenuation regions.
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Outline of 2D Fat Analysis

window
For the 2D fat analysis, the area of the subcutaneous fat and visceral fat in one plane (2D) can be calculated.
• Calculation of the area of the subcutaneous fat and visceral fat in one plane
• Calculation of the circumference of the body surface in one plane
• Frequency distribution of subcutaneous fat and visceral fat
• Automatic detection of subcutaneous fat and visceral fat
• Output of designated report for fat measurement
• Calculation of the BMI value
Recommended image A simple CT image with a slice thickness of approx. 5.0mm without gaps, and little
noise
Body part to be Upper edge of the liver to upper edge of the connection of the pubis
analyzed
Contrast-enhanced images and the images that are not exposed in the supine position cannot be analyzed
properly.
In 2D Fat Analysis, following tools are available.

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Start up 2D Fat Analysis

3. Click the [Start Application] → [2D Fat Analysis] buttons
Switch the 2D Fat Analysis Stage

2D Fat Analysis advances the analysis by selecting the button on the stage bar.
(When input consists of a single image, the results stage is automatically displayed.)
Extraction Setting Set to perform a fat analysis.

Result Divide the fat region into two regions: the subcutaneous fat and visceral fat
regions. Display information such as each area of fat.
Outline of 3D Fat Analysis

window
3D Fat Analysis calculates areas and volumes of subcutaneous fat and visceral fat in the multi planes (3D). The
result can be displayed as a graph, and the fat quantity at each slice position can be confirmed.
• Three-dimensional analysis of subcutaneous fat and visceral fat
• Calculation of the area of subcutaneous fat and visceral fat for each slice
• Calculation of the circumference of the body surface
• Calculation of the fat ratio｛(visceral fat + subcutaneous fat) / volume of the measuring range｝within the
analysis range
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• 3D mapping display of the subcutaneous fat and visceral fat measuring values
• Graph display of the analysis result
• Semi-automatic detection of subcutaneous fat and visceral fat
• Output of designated report for fat measurement
• Calculation of the BMI value
Recommended image A simple CT image with a slice thickness (interval) of approx. 5.0mm without gaps,
and little noise
(For psoas major muscle analysis, slice thickness (interval) not exceeding 1.5mm is
recommended.)
Body part to be Upper edge of the liver to upper edge of the connection of the pubis
analyzed
Contrast-enhanced images and the images that are not exposed in the supine position cannot be analyzed
properly.
In 3D Fat Analysis, the following tools are available.

(WL)
Removal (Unable to use except in the [Confirmation] stage)
3D images.
Mask Edit
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Start up 3D Fat Analysis

3. Click the [Start Application] → [3D Fat Analysis] buttons
Switch the 3D Fat Analysis Stage

3D Fat Analysis advances the analysis by selecting the button on the stage bar.
Extraction Setting Set the range to perform a fat analysis. The range that can be set is between the
upper edge of the liver and upper edge of the connection of the pubis.
Confirmation Remove the fat region that is neither the visceral fat nor the subcutaneous fat
region in a specified analysis range.
(For the purpose of removing unnecessary portions in images, such as arms.)
Fat For the specified region, divide the fat region into two regions: the subcutaneous
fat and visceral fat. Display a volume and area for each plane.
Psoas major muscle Extract the psoas major muscle region and display the area of each slice, as well as
the volume in a specified range.
Outline of Lung Analysis Resection

window
In lung resection analysis, the lung field region, pulmonary artery, pulmonary vein, bronchus, and other regions are
extracted using contrasted CT images, and the result is displayed in 3D. Lung resection can also be simulated by
extracting and segmenting the territories of pulmonary vessels and bronchi.
• Automatic and semi-automatic extraction of the lung field and lung lobe
• Extraction of the contact area between the lung field and diaphragm
• Semi-manual extraction of tumors existing in lung field and volume calculation
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• Extraction of the pulmonary artery, pulmonary vein, and bronchus
• Calculation of the territories of pulmonary vessels and bronchi of the lung field region
• Manual modification of lung field region
Recommended image Images including the lung field region with contrasted pulmonary vessels
In Lung Analysis Resection, following tools are available.

(WL)
Removal
Mask edit
3D images.
Start up Lung Analysis Resection

3. Click the [Start Application] → [Chest] → [Lung Analysis Resection] button
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Switch the Stage in Lung Analysis Resection

Lung Analysis Resection advances the analysis by selecting the button on the stage bar.
Lung Extraction Extract the lung field region semi-automatically from the images. Perform the
deletion of unneeded regions other than the lung field, the addition of the
unextracted region, etc. Extract the contact area between the extracted lung field
and diaphragm. Additionally, extract the bronchus and edit this image.
Tumor Extraction Extract tumors in lung field region semi-automatically and display various
information (volume, signal values, etc.).
Registration Perform image registration for additional chest images you load. (Becomes
available once you have loaded additional images.)
Vessel Extraction Extract pulmonary arteries and pulmonary veins, and construct paths.
Region Division Calculate territories of the pulmonary vessels and bronchi in the lung field region,
and segment the lung field region manually.
Outline of Lung Analysis Scope

window
With Lung Analysis Scope, you can search an optimum bronchus path to reach a lung nodule by using the volume
data collected with CT, and simulate insertion of bronchoscope into the path.
• Automatic extraction of the lung field and bronchus
• Semi-automatic extraction of lung nodule, setting of lymph node
• Automatic search for optimum bronchus path to access the lung nodule
• Virtual endoscopic image display along the bronchus path
Recommended image CT images including a lung field region
In Lung Analysis Scope, following tools are available.
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(WL)
Removal
Mask edit
3D images.
Start up Lung Analysis Scope

1. Select an images for Lung Analysis Scope from the study list and series list
3. Click the [Start Application] → [Chest] → [Lung Analysis Scope] button
Switch the Lung Analysis Scope Stage

Lung Analysis Scope advances the analysis by selecting the button on the stage bar.
Path Creation Automatically extract the lung field region and bronchus field from input images.
Semi-automatically extract nodules in the lung field region, and automatically
search for an optimum bronchus path to access a nodule.
Path Check Virtual endoscopic images along the optimum path are displayed. You can check
the path by displaying thumbnails of branch points and by creating a movie of the
path.
Mapping Extend the ends of bronchus and extract points where the extension meets the
lung surface. Enables a general understanding of the lung region affected by the
bronchus under observation.
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3.8 Liver and Kidney Analysis (Option)

Outline of Liver Analysis

window
Liver Analysis extracts the liver and nearby vessel regions from contrast-enhanced CT or MR images and displays
the results as 3D images. In addition, the dominant region of the extracted liver region, portal vein, and veins can
be extracted and divided into areas, and a hepatectomy simulation can be performed.
• Semi-automatic extraction of the liver region
• Semi-automatic or manual searching for paths of tubular structures
• Simultaneous display of liver, blood vessels, bile duct, tumors, bladder, body surface, bones, and other
regions
• Volume calculation for liver, tumors, gallbladder, and other regions
• Extraction of the vascular territories in liver
• Extraction through tumor scooping in the liver region
• Manual modification of vascular territories
• Observation and measurement through sector MPR of the liver region
Supported modalities CT (+MRCP with cholangiography, asialo scintigraphy), MR

Recommended image A contrast radiography image set of max. 5 phases
Body part to be The liver region
analyzed
Exposure condition Images with thin slice thickness and narrow interval
Other There is no position deviation between phases caused by breathing, the
distribution of signal values in the liver region is uniform, and there is contrast
between the vascular system and the liver region.
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Liver Analysis is intended mainly for analysis of CT images from intravenous contrast radiography. Therefore,
accurate analysis may not be possible when CTA (CT angiography), CTAP (CT during arterial portography) or other
images not meant to be analyzed by liver analysis are used for the analysis.
Non-rigid image registration in Liver Analysis aligns images across phases, compensating for changes in position
or shape, provided that CT images from the session are available. However, accurate registration between phases
is not possible when the position changes significantly between phases. To the extent possible, ensure exposure
with minimal changes in position due to breathing or other factors.
In Liver Analysis, the following tools are available.

(WL)
Removal
3D images.
Mask Edit
Start up Liver Analysis

3. Click the [Start Application] → [Abdomen] → [Liver Analysis] buttons
4. Confirm image input settings
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Specify settings such that the image and phase (early and later arterial phases, portal vein phase, equilibrium
phase, and others) correspond with each other.
Analysis can be performed even with one phase, but for extraction of surrounding organ regions, better analysis
results are obtained by using images of multiple phases. Particularly, it is recommended to use the arterial phase
for extraction of arteries and to use the portal vein phase for extraction of the portal vein.
Depending on the image, images including multiple phases in one series may be registered in the database. Even
in such a case, images are automatically divided by phase when images are read.
Switch the Liver Analysis Stage

Liver Analysis advances the analysis by selecting the button on the stage bar.
Liver Extraction Extract the liver region automatically or manually from the image.
Registration Register images for each phase.
Surrounding Organ Extract blood vessels and various surrounding organs in the liver region
Extraction automatically or manually.
Observation Use the extracted liver or surrounding organ region to perform various operation
simulations.
Sector MPR Use the extracted liver or surrounding organ region to measure distances or
perform other tasks on the sector MPR image for liver observation.
Outline of Liver Analysis MR
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window
Liver Analysis MR displays MR multi-phase contrast-enhanced images and reference images. You can also make
calculations for liver region using specified formula and visualize the calculation results.
• Display of multi-phase contrast-enhanced images and reference images
• Extraction of the liver region and spleen region
• Visualization of calculation results
• Manual modification of vascular territories
Recommended image Multi-phase contrast-enhanced images (at least 1 phase, no more than 8 phases)
and reference images such as T1- and T2-weighted images (up to 4 series)
Body part to be The liver region
analyzed
Other Multi-phase contrast-enhanced images do not have large position deviation
between phases caused by breathing; the distribution of signal values in the liver
region is uniform.
In Liver Analysis MR, following tools are available.

Mask edit
- 412 -
Start up Liver Analysis MR

3. Click the [Start Application] → [Abdomen] → [Liver Analysis] button
Specify multi-phase contrast-enhanced images as [Phase 1 to Phase 8] in the order of the exposure, T1- and
T2-weighted images as [Reference image 1 to Reference image 4], and images not to be used as [Do not
use].
The time interval between images is retrieved automatically when they are read, and the analysis result is
calculated in consideration of the time interval. If the time information cannot be retrieved automatically,
predefined time information is applied. As correct time information is not applied to some images, be sure to
confirm [Time] displayed at the bottom left of each image.
in such a case, the images are automatically divided by phase when they are read.
Switch the Liver Analysis MR Stage

Liver Analysis MR advances the analysis by selecting the button on the stage bar.
View Images Compare and observe multi-phase contrast-enhanced images and reference
images.
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Liver/Spleen Extraction Semi-automatically or manually extract the liver region and spleen region.
Calculation Result Make calculations for the extracted liver region in accordance with the specified
formula, and visualize the calculation results.
Outline of Kidney Analysis

window
Kidney Analysis extracts the kidney, renal cortex, and regions including various surrounding organs from contrast-
enhanced CT images and displays results as 3D images. In addition, further extraction of the extracted kidney
region and arterial territory region extraction are possible, regions can be divided, and nephrectomy simulations
can be performed.
• Semi-automatic extraction of the kidney region
• Semi-automatic or manual searching for paths of tubular structures.
• Simultaneous display of kidney, blood vessels, urinary duct, tumors, renal calculus, body surface, bones, and
other regions
• Volume calculation for kidney, tumors, renal calculus, gallbladder, and other regions
• Extraction of the vascular territories in the kidney
• Extraction through tumor scooping in the kidney region
• Manual segmentation of the kidney region
• Observation and measurement through sector MPR of the kidney region
Recommended image A contrast radiography image set of max. 4 phases
Body part to be Kidney region
analyzed
Exposure condition Images with thin slice thickness and narrow interval
Other There is no position deviation between phases caused by breathing, the
distribution of signal values in the kidney region is uniform, and there is contrast
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between the vascular system and the kidney region.
Kidney Analysis is intended for analysis of intravenous contrast-enhanced CT images. Therefore, accurate analysis
may not be possible when other images not intended for kidney analysis are used.
Non-rigid image registration in Kidney Analysis aligns images across phases, compensating for changes in
position or shape, provided that CT images from the session are available. However, accurate registration between
phases is not possible when the position changes significantly between phases. To the extent possible, ensure
exposure with minimal changes in position due to breathing or other factors.
In Kidney Analysis, the following tools are available.

(WL)
Removal
3D images.
Mask edit
Start up Kidney Analysis

3. Click the [Start Application] → [Abdomen] → [Kidney Analysis] button
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Specify settings such that the image and phase (Artery, Corticomedullary, Nephrographic, or Excretory)
match.
Analysis can be performed even with one phase, but for extraction of surrounding organ regions, better analysis
results are obtained by using images of multiple phases. Specifically, it is advisable to use the arterial phase for
extraction of arteries, the corticomedullary phase for extraction of the renal cortex, and the excretory phase for
extraction of the urinary duct.
in such a case, images are automatically divided by phase when images are read.
Switch the Kidney Analysis Stage

Kidney Analysis advances the analysis by selecting the button on the stage bar.
Kidney Extraction Extract the kidney region automatically or manually from the loaded image.
Surrounding Organ Extract blood vessels and various surrounding organs in the kidney region
Extraction automatically or manually.
Observation Use the extracted kidney or surrounding organ region to perform various
operation simulations.
Sector MPR Use the extracted kidney or surrounding organ region to measure distances or
perform other tasks on the sector MPR image for kidney observation.
Outline of Kidney Volumetry

window
- 416 -
In Kidney Volumetry, the left and right kidneys are extracted, and observation is possible by measuring the volume
of that region. This can be compared to past results to observe changes in volume over time.
The volume calculated in Kidney Volumetry is calculated from mask regions extracted as regions under analysis.
Note that the actual volume may be different due to the influence of the extracted region, the image exposure
conditions, etc.
• Semi-automatic extraction (CT only) and editing of the kidney region
• Measurement in the kidney region
• Observation of the kidney region over time

Recommended image Non-contrast CT and MR images that include the kidney region
Analysis image Images including both kidneys in the FOV
In Kidney Volumetry, the following tools are available.

(WL)
Removal
3D images.
- 417 -
Mask Edit
Start up Kidney Volumetry

3. Click the [Start Application] → [Abdomen] → [Kidney Volumetry] button
Switch the Stage in Kidney Volumetry

With Kidney Volumetry, the observation method can be switched with the buttons on the stage bar.
Extract region Extract kidney regions.

Observation Observe results of extraction.
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3.9 Nodule Analysis (Option)

Outline of Oncology Viewer
Oncology Viewer enables fused display of images of two different modalities (such as CT or PET), or images of the
same modality but different exposure methods, exposure times, and so on. You can fuse images on the three
orthogonal planes of axial, coronal, and sagittal planes, and on three oblique planes.
Additionally, tumor lesions can be measured and evaluated using WHO, RECIST, PERCIST, and other criteria.
• Fuse images with different modalities or different exposure sequences
• Measurement of lesions
• Evaluation according to tumor evaluation criteria (WHO, RECIST1.0, RECIST1.1, mRECIST, Choi criteria,
Cheson criteria, and PERCIST)
• Comparison with the past studies and display of them
• Output of status of approval, determination, and overall determination of studies
• Management of user authority
Recommended image Data exposed via multiple phases and different sequences
Tumor evaluation images acquired over time (up to four series)
- 419 -
analyzed
Analysis image None
conditions
In Oncology Viewer, the following tools are available.

(WL)
Removal
3D images.
Mask Edit
In stages other than the Lesion Evaluation stage, the [Object Extraction and Removal] and [Organ
extraction/removal] tools cannot be used unless the setting of the [Enable use of 'Edit Mask' plugin] under the
[Common settings] of [Fusion] in the [System settings] is set to [ON].
Start up Oncology Viewer

3. Click the [Start Application] → [Oncology Viewer] buttons
4. Check the upper and lower images (when using multiple types of images including or other than PET and CT
images)
- 420 -
Confirm which image is to be the upper image and which image is to be the lower image. In general, set
shape images to the lower image, and functional images to the upper image.
If you will not specify an upper image, start up with the Lesion Evaluation stage.
In Oncology Viewer, when the image size (FOV, height and width) of the upper image is different from the one of
the lower image, the upper image size is automatically adjusted so that the upper and lower images fit in their
apparent sizes.
Depending on the exposure conditions, errors may occur in measurement results. It is desirable to use images
exposed with the same exposure conditions such as anatomical exposure range, with or without injection of
contrast medium, slice thickness, and reconstruction pitch.
This application controls user authority. Before use, specify authorized users in the user authority setting. For
details, refer to [User authority-related] of [Setting].
Switch the Oncology Viewer Stage

In Oncology Viewer, you can change screen display in various ways for appropriate reading by selecting the
buttons on the stage bar.
Registration Automatically or manually register the gap between the upper and lower images.
Oblique Observation Display oblique plane and 3D view of the fusion image between the upper and
lower images.
Reference Reading Display a list of orthogonal planes of the fusion image between the upper and
lower images.
Comparison Reading Display the upper, lower, and fusion images for each of the axial, coronal, and
sagittal planes. Display a list of axial, sagittal, or coronal planes.
MPR Reading Display the upper, lower, and fusion images for each of the axial, coronal, and
sagittal planes. Operations are synchronized among the three planes.
- 421 -
Lesion Evaluation Measure and evaluate lesions, and output the reports.
- 422 -
3.10 Colon Analysis (Option)

Outline of Colon Analysis

window
Colon analysis semi-automatically creates the colon path from the CT image, and the virtual endoscope display etc.
can be observed comparing the supine position image and the prone position image.
• Automatic extraction of the intestinal canal region
• Automatic search of the path in the intestinal tract
• Observation of the entire colon and the lumen
• Comparative observation of supine position image and prone position image
• Local observation of the lesion area
• Lesion area pick-up function
• Special 3D display such as colon unfolded cube view display, straight open display, straight cross-section
display, etc.
• Digital cleansing function
• Plane observation of lesion area
• Simultaneous display of colon and surrounding organs
• Torous enhancement display
Recommended image Image exposed with sufficient air filled into the colon
Body part to be Colon
analyzed
Exposure condition Images with narrow intervals of slices along the body axis
Image position Images in a supine or prone position
(R-Lateral and L-Lateral can also be loaded)
- 423 -
In colon analysis, the following tools can be used.

(WL)
Removal (Unable to use except in the [Colon Extraction] stage and [Peripheral
View] stage.)
3D images.
Mask edit
Start up Colon Analysis

3. Click the [Start Application] → [Abdomen] → [Colon Analysis] button
4. Specify settings so that the image and view (supine, prone, R-Lateral, or L-Lateral) match.
- 424 -
Analysis is also possible for one series.
Switch the Stage in Colon Analysis

Colon Analysis advances the analysis by selecting the button on the stage bar.
Colon Extraction Extract the colon field region semi-automatically from the images. Perform the
deletion of unneeded regions other than the colon field, the addition of the
unextracted region, etc.
Path Creation The path required for observation of the colon region is created semi-
automatically.
Normal View Observation with virtual endoscope display is performed along the path for colon
observation. It is also possible to observe various colon images such as an image
of the colon straightened and cut open along the colon path, the development
displaying of a dice in the center of the camera position, etc.
Polyp Observation The slice of the lesion area picked up in the normal view stage can be observed.
Peripheral View A 3D image with the extracted colon region and superimposed surrounding
tissues of the colon like bones, blood vessels, lesion area, etc. can be observed.
- 425 -
3.11 Tensor Analysis (Option)

Outline of Craniotomy/Tensor Analysis

window
Craniotomy/tensor analysis enables tensor analysis from diffusion-weighted MR images and tractography-based
extraction and observation of white matter tractography pathways. Additional images (mainly CT images) can be
loaded, and skin, bone, brain parenchyma, tumor, and cerebral vessels can be extracted in craniotomy simulations.
• Display FA and diffusion colormap images
• Extract and observe white matter tractography
• Calculate FA value, number of fibers, area, and volume in the specified ROI
• Simultaneous display of white matter tractography and skin, bone, brain parenchyma, tumor, artery, vein,
and other regions
• Craniotomy simulations involving cutting of skin and bone regions, brain surface clipping by depth, and
tumor plane clipping
As tractography output is sensitive to the seed point and ROI (Region of interest) selection, sufficient care is
required.
Supported modalities Tensor Analysis: MR

Craniotomy Simulation: MR, CT, XA, PET, NM
Body part to be Head and neck region
analyzed
Recommended image Contrast-enhanced CT images, MR images
Supported Scanner model in Tensor Analysis: including Titan, Visart(Toshiba),
MAGNETOM Symphony (Siemens), Ingenia(Philips) et al.
Supported imaging sequence in Tensor Analysis:Diffusion Weighted
Imaging(DWI)
In craniotomy/tensor analysis, the following tools are available.
- 426 -

(WL)
Measure The distance, area, etc. can be measured on the image.
Removal
3D images.
Mask edit
Start up Craniotomy/Tensor Analysis

3. Click the [Start Application] → [Head] → [Craniotomy/Tensor Analysis] button
4. In the "Input image setting" dialog, confirm the image input settings.
Browse input images and specify the type of image (b=0 image, diffusion-weighted image, or Do not use).
- 427 -
5. Confirm usage of MPG (motion probing gradient) axis information in the DICOM header information.
A confirmation dialog is displayed when input images have MPG axis information in the header information.
Specify whether or not to use this information.
Depending on the version of the imaging equipment, it may not be possible to obtain correct MPG axis
information, which will prevent accurate analysis results. In this case, click [No] and select a pattern from the
list of preset MPG axis patterns.
6. Select an MPG axis pattern.
If there is no MPG axis information in the DICOM header information of input images, or if you will not use
this information, select a preset MPG axis pattern for input images from the list of patterns displayed for the
model of equipment used to capture input images.
- 428 -
For input images used in tensor analysis, accurate analysis results require MPG axis information from the
time of image exposure. Caution is advised, because there is a risk that images may be misinterpreted.
7. If no MPG axis information to be used is available, a message to this effect is displayed, and you are advised
to configure the MPG setting in the setting dialog and restart the application
MPG (Motion Probing Gradient) is the gradient magnetic field to acquire the Diffusion Weighted Images.
Switch the Craniotomy/Tensor Analysis Stage

With Craniotomy/Tensor Analysis, the operation stage can be switched by selecting buttons on the stage bar.

Tractography Extract and observe white matter tractography.
Organ extract Extract cerebral blood vessel regions or various surrounding organs.
Observe Use the skin, bone, or blood vessel region or white matter tractography observed
to clip organs and observe in a multi-3D display. Movement is possible even
without a CT image.
Simulation Use the extracted skin, bone, or blood vessel region or white matter tractography
to perform operation simulations. Movement is not possible without a CT image.
- 429 -
3.12 Optional Tools (Option)

Outline of IVIM
In IVIM, apparent diffusion coefficients and diffusion coefficients for which the perfusion has been considered are
calculated simultaneously and visualized from information on signal values of diffusion-weighted images collected
with MR.
• Display ADC Map, EADC Map, D Map, D* Map, and f Map images
• Measure ADC values, D values, D* values, and f values in ROIs
• Pseudo-color display of ADC Map, EADC Map, D Map, D* Map, and f Map images
• Blending display of ADC Map, EADC Map, D Map, D* Map, f Map images and background images
Recommended image Diffusion-weighted image
analyzed
Analysis image b-values of the input images are known.
conditions The number of diffusion-weighted images with different b-values is larger than 3.
The total number of input images is less than 15, including a background image.
In IVIM, following tools are available.

(WL)
- 430 -
3D images.
Start up IVIM
3. Click the [Start Application] → [IVIM] buttons
4. In the "Input image setting" dialog, select either [Diffusion-weighted image], [Background image], or [Do not
use]
5. When you select [Diffusion-weighted image], set known b-values
Values cannot be calculated accurately unless b-values are set correctly. Be sure to set correct b-values when you
create IVIM Map images.
- 431 -
Outline of Delayed Enhancement

window
Extract myocardial enhanced area from 2D, 3D MR delayed enhancement images, display enhanced area in bull's
eye, and calculate the volume. Delayed Enhancement is to be used for research purposes only - not for clinical use.
• Display of area and volume of the enhanced area
• Display of the enhanced area in the bull's eye
• Display of area and volume of the enhanced area within both the inner side and outer side of the
myocardium
• Display of the enhanced area in the bull's eye within both the inner side and outer side of the myocardium
• Display of the surface ratio and the volume occupancy ratio of the enhanced area
In delayed enhance analysis, 2D and 3D images can be managed.
In 2D analysis, short axis images are loaded and analyzed. In the following figure, the blue planes represent the
images to be loaded.
Recommended image Delayed enhancement images of the short axes of the left ventricle after the
injection of a contrast medium
Body part to be Left ventricle
analyzed
Analysis image Delayed enhancement images of the left ventricle
- 432 -

No. of images loaded 3
together (However, images must have the same number of slices.)
In 3D analysis, an image in which the entire heart has been exposed is loaded; short axis images of the ventricle are
reconstructed and analyzed. In the following figure, the blue cube represents the image to be loaded, and the
yellow planes represent the reconstructed short axis images.
Recommended image 3D delayed enhancement images of the heart after the injection of a contrast
medium
analyzed
Analysis image 3D delayed enhancement images spanning the entire heart
No. of images loaded 3
together (However, images must have the same number of slices.)
In Delayed Enhance, following tools are available.

(WL)
- 433 -
3D images.
When receiving gadolinium-based contrast agents (GBCAs) for magnetic resonance imaging (MRI) which may be
retained in body, please read the labeling of GBCAs or Medication Guide issued by FDA.
Start up Delayed Enhancement

3. Click the [Start Application] → [Chest] → [Delayed Enhancement] buttons
Switch the Stage in Delayed Enhancement

Delayed Enhancement advances the analysis by selecting the buttons on the stage bar.
Axis Setting Set the long axis.

Contour Setting Set and modify contours on short axis images.
3D View Observe the analysis results on 2D and 3D images.
Compare Comparative observation of slices at the same position, when you have loaded
multiple images.
Outline of Endoscope Simulator
Endoscope Simulator extracts organ and vessel regions from contrast-enhanced CT images and displays the results
in 3D using virtual endoscopy.
• Automatic and semi-automatic extraction of body surface, bone, pancreas, spleen, and abdominal arteries
and veins
• Simultaneous display of extracted regions
- 434 -
• Virtual endoscopy based on virtual endoscope insertion and target observation positions
Recommended image Contrast-enhanced images of up to 2 phases
Body part to be Abdomen region
analyzed
In Endoscope Simulator, the following tools are available.

(WL)
Removal
3D images.
Mask edit
Start up Endoscope Simulator

3. Click the [Start Application] → [Abdomen] → [Endoscope Simulator] button
- 435 -
Specify settings such that the image and phase (arterial and venous phases) match.
Switch the Endoscope Simulator

Endoscope Simulator advances the analysis by selecting the button on the stage bar.

Extraction Extract various organs and blood vessels in the image automatically or manually.
Observation Observe a virtual endoscopic view of the extracted organs and blood vessels.
- 436 -

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Synapse 3D V5 User Manual : Z72N100354B

Software Version V5.3US

Export Restrictions Applying to Synapse 3D

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Other holder's trademarks

Precautions and Disclaimers

End User Software License Agreement

Note Indicates operational information, additional information, detail information,

For Safe Operation

2. Precautions When Using Electrical Equipment

1. Install the equipment in a dry place away from water.

6. Connect the ground wire correctly.

7. Connect all cables correctly and completely.

3. Precautions When Connecting Network

1. Change of connection destination

4. Precautions When Using the Workstation

5. Do not change settings of the pre-installed Windows.

1. Follow precautions regarding the Wi-Fi environment.

4. Do not charge the tablet battery in hot or humid environments.

Indications for Use

Indications for Use for Synapse 3D Cardiac Tools

Indications for Use for Synapse 3D Perfusion Analysis

Indications for Use for Synapse 3D Lung and Abdomen Analysis

Indications for Use for Synapse 3D Liver and Kidney Analysis

Indications for Use for Synapse 3D Nodule Analysis

Indications for Use for Synapse 3D Colon Analysis

Indications for Use for Synapse 3D Tensor Analysis

Indications for Use for Synapse 3D Optional Tools

• Imaging tools for CT images including virtual endoscopic viewing.

Significant Physical Characteristics

Significant Performance Characteristics

• CPU performance (Number of CPUs, GHz, Cache memory size, etc.)

• Speed of disk storage

• Other devices connected to Synapse 3D when importing or exporting data

CT, MR, PET, and XA etc. DICOM image generator device

DICOM compatible printer

SYNAPSE Server ( image data server）

Chapter 1. Basic Operations (Server/Client)

1.1.1 Client Computer Startup/Shutdown

2. Drag on the lock screen.

3. Enter the user name in the following screen.

4. Enter the password and click .

5. After you have successfully logged in, the desktop is displayed.

Shut down Windows 10

2. Click on the taskbar.

4. Select [Shut Down].

1.1.2 Server Startup/Shutdown

Log in to Windows Server

2. Press Ctrl+Alt+Delete on the lock screen.

4. Enter the password and click .

5. After you have successfully logged in, the desktop is displayed.

Log off from Windows Server

1. Click the button on the taskbar.

Shut down Windows Server

2. Click in the lower right.

3. Select [Shut Down].

1.1.3 Leaving the Workstation during an Operation

User Lock Feature of Windows

1. Click the button on the taskbar.

1.1.4 Start up the Workstation

1. Double-click the following Start screen icon.

3. The workstation starts up and the study list screen is displayed.

1.1.5 Shut down the Workstation