Iq-Lite: User Manual
Iq-Lite: User Manual
Iq-Lite: User Manual
USER MANUAL
Version 2.8.0 INT EN 001R
1 INTRODUCTION ............................................................................................................................................................. 6
1.1 System requirements ....................................................................................................................................................7
1.1.1 Minimum system requirements ...........................................................................................................................7
1.1.2 Recommended system requirements ..............................................................................................................7
1.1.3 Specific system requirements for Unicode languages ..................................................................................8
1.1.4 DICOM storage format for media .....................................................................................................................8
3 CONFIGURATION ........................................................................................................................................................ 11
7 INDEX ........................................................................................................................................................................... 74
IMAGE Information Systems Ltd. does not accept liability for the illegal or improper use of the described
software (see the End User License Agreement).
iQ-LITE is part of iQ-VIEW, which is certified as a medical device for image processing, diagnosis, archiving and
communication according to Council Directive 93/42/EEC concerning medical devices and according to
FDA 510(k). Nevertheless, diagnosis can only be made using special high-resolution displays.
The contents of this manual are the property of IMAGE Information Systems Ltd. and may not be reproduced
by any method, electronic or photographic, without the express written permission of the copyright holder.
Throughout this manual trademark names are used. Rather than put in a trademark symbol at every
occurrence of the trademark name, we state that we are using the names only in an editorial fashion and to
the benefit of the trademark owner with no intention of infringing upon the trademark.
We are dedicated to improving and enhancing the software of our medical imaging and communication
system. Consequently, the information in this manual is subject to change without notice. Current information
about product improvements can be found on the iQ-VIEW homepage: http://www.image-
systems.biz/products/iq-system-pacs/iq-view.html or IMAGE Information Systems Home Page www.image-
systems.biz.
iQ-LITE is a portable CD image viewer that enables the user to view, manipulate and print images that have
been exported from an iQ-VIEW or iQ-VIEW PRO Workstation or from another workstation, modality or PACS
with the help of iQ-ROBOT or a different CD/DVD robot system or burning station.
A copy of iQ-LITE is saved with each set of images burned to a CD or DVD from iQ-VIEW or iQ-ROBOT. It
automatically opens when the CD or DVD is loaded on a PC (provided that the auto-run function is enabled
on the system).
iQ-LITE provides a convenient way for physicians and other medical professionals to copy and save patient
studies/images processed by an iQ-VIEW Workstation. When providing copies of these studies to referring
physicians and/or patients, iQ-LITE provides an integrated, simple way to view the information stored on the
CD/DVD – without the use of any 3rd party software.
WARNING 1:
When receiving medical image data, it is important to know whether compression has been used. If images
were lossy compressed an appropriate information will be shown in the text overlay of the image when
displayed in the viewer. The DICOM header data also indicates the form and rate of compression. Such lossy
compressed images may no longer have diagnostic quality!
WARNING 2:
Due to a fair number of internal and external dependencies, the support of DICOM encapsulated PDF (as an
SOP class) is still limited in this software version. The manufacturer cannot guarantee the full functionality of
DICOM encapsulated PDF objects throughout the application and, therefore, does not assume liability for any
incorrect behavior.
WARNING 3:
Please note that iQ-LITE is a 32 bit application. It can therefore not allocate more than 2 GB RAM to process
DICOM images. This may lead to limitations in processing huge multi-frame objects. The following effects are
possible:
– It might become impossible to correctly decompress images that were stored in compressed form on the
medium. This will result in failures to view these images in the viewer.
– Uncompressed objects stored on the medium might still be too big for the viewer to handle this data
successfully. This will result in a corrupted image display and issues while trying to process this data (e.g.
browsing through the series, zooming, windowing, etc.).
To keep the effects on iQ-LITE and on the opportunity to read these objects as low as possible, we recommend
the following actions:
– The creator of such media should not burn data onto the medium in compressed form. According to the
recommendations concerning the creation of patient media, data should be exported to media always in
uncompressed form. This is especially important in cases such as this. Best use Little Endian Explicit as exporting
transfer syntax.
– If it is possible that you receive iQ-LITE media with such huge multi-frame data volumes, please use a 64 bit
Windows 7 operating system and more than 4 GB RAM.
– Be sure to limit the number of other processes and applications running at the same time as iQ-LITE, so that
the full 2 GB RAM can really be allocated to the processing of these objects.
iQ-LITE is only permitted for diagnostic use if all applicable legal requirements in your country are
met. Please consult your authorized local distributor before using the application for diagnostic
purposes.
NOTE:
It might be necessary that some data from the patient CD/DVD must be cached on the local hard disk to be
able to correctly display certain objects. Therefore, make sure that the user has sufficient rights to temporarily
write data onto the hard disk.
The user should best be a local administrator on the computer.
Specific system requirements for use with Unicode languages (Japanese, Russian, etc.) include:
NOTE:
A complete list of all generally supported specific character sets (i.e. DICOM objects already encoded with a
specific character set) can be found in the main application’s (iQ-VIEW) DICOM Conformance Statement.
Nevertheless, the adherence to the above-mentioned system requirements still remains.
Please also pay attention to the hardware requirements for the supported Microsoft® Windows® versions:
Microsoft® Windows® 7:
http://www.microsoft.com/windows/windows-7/get/system-requirements.aspx
The web content on the CD can be viewed using the following web browsers:
Internet Explorer (any version, preferably latest version for used OS)
Mozilla Firefox (any version, preferably latest version for used OS)
DICOM data should always be copied onto media in an uncompressed format (transfer syntaxes Little Endian
Explicit or Little Endian Implicit). This is recommended also by radiological societies.
It ensures high compatibility with other systems, e.g. when the data shall be imported into existing systems. The
support of compressed transfer syntaxes, on the other hand, cannot be expected.
The iQ-LITE software is usually provided on a patient CD, DVD or memory stick. It does not need to be installed.
The viewer opens automatically when the medium is inserted into the computer, provided that the auto-run
command was written onto the medium and the auto-run function is enabled on the system.
If the software does not start automatically, select the correct drive (e.g. CD, DVD or memory stick drive) in
Windows® Explorer and double-click the file “Lite.exe” to start the viewer manually.
The web content, if burned onto the CD in addition to the DICOM images and the iQ-LITE viewer, can be
accessed by double-clicking onto the INDEX.HTM file and will be opened in the default or specifically selected
internet browser.
Since the iQ-LITE software does not have to be installed before using it, but runs directly from the portable
medium (CD, DVD or memory stick), there is no need to uninstall the application. Simply remove the medium
from the computer following the instructions to do so.
The iQ-LITE software does not need a particular license to run from a medium. When you are provided with a
patient CD, DVD or memory stick, you may open the viewer as often as you wish or need. There is no limitation
in running the software.
However, the iQ-LITE viewer is limited in functionality and features. For the fully equipped radiological
workstation, including all features, we recommend using iQ-VIEW or iQ-VIEW PRO. If you are interested in
purchasing either of these applications, please contact IMAGE Information Systems Ltd. or a local reseller.
Contact information to local resellers can be found at www.image-systems.biz. A trial version of the software
may also be downloaded at www.image-systems.biz.
There is no need to configure the software before using it. All necessary configuration settings are already
provided with the patient CD, DVD or memory stick.
The software includes functions that can be customized for a running viewer session.
NOTE:
It might be necessary to cache some data from the patient CD/DVD onto the local hard disk in order to
correctly display certain objects. Therefore, make sure that the user has sufficient rights to temporarily write
data onto the hard disk.
In the study table all studies that are available on the medium (and registered in the DICOMDIR) are listed.
When opening iQ-LITE, only the Study Table will be opened. The Preview Icons panel is closed and may be
opened if desired. See below for further information on the use of the Preview Icons panel.
NOTE:
Acrobat Reader or another PDF reader must be installed on the system to open and view the iQ-LITE user
manual, which is available as a PDF file directly on the iQ-LITE medium (MANUAL.PDF).
Study level = the most important information provided at the study level, such as patient name, patient ID,
accession number, study description, referring physician, etc.
Series level = information about the available series in a study, e.g. series description, modality information,
etc.
Image level = allows access to a preview of each image in a series, including the possibility to use window
leveling, but also gives information about the number of frames in case of multi-frame images (e.g. US).
To see the next level underneath a study, click the “+” box on the far left side. This will open the study to show
the various series, including any relevant information. By clicking on the “+” to the left of a series, the image
level will open, revealing a table of all available images in that series.
Clicking the arrow button beside an image will open the chosen image in a preview window.
By clicking the respective entry in the table header, the available studies can be sorted by patient name,
modality, patient ID, study date, etc. – in both ascending and descending order. The sorting direction is noted
in the column heading by an up or down arrow and is reversed when the heading is clicked another time.
The selection of studies in the study table follows the usual Windows® logic of using [CTRL] and [SHIFT] for
selecting. Making selections at the series level requires alternative methods:
Select an individual study either by clicking anywhere in the study entry or by clicking the checkbox in the
first column.
Multiple studies can be selected together by either using [CTRL] to mark the studies separately or using
[SHIFT] to mark all studies between the first item selected and the last one. Alternatively, the checkboxes of
the desired studies can be selected in the first column.
Select an individual series by clicking the “+” next to the study in which the series belongs and marking the
checkbox in front of the desired series entry.
To select multiple series of one study, simply mark the checkboxes of all required series after displaying
them by clicking the “+” next to the appropriate study containing the series.
Using the same method, individual series from different studies can be selected.
Right-click the table header in the study table to open a sub-menu where all studies
available on the medium can be selected or unselected at once.
If only one study or one series is selected from the study list, one of the following options can be used:
If more than one study or series (or combination of studies and series) is selected, click the “View”
button to load the entire selection into the viewer. Double-clicking a selection will only load the
study/series under the mouse pointer.
The Preview Icons panel can be opened and closed using the switch in the upper left corner of the
panel (vertical when the panel is open and horizontal when the panel is closed).
The preview icons panel shows the preview images of the currently marked study or series. If a study is marked,
previews of all series of that study are shown. On the series level, more than one series can be selected and
the images of these series are displayed as preview thumbnails.
NOTE:
The preview thumbnails display in the study browser is only possible if the web content (HTM pages) including
the JPEG images was also burned on the medium. Otherwise, this panel will not exist.
4.1.3 CACHING
If “Cache images on hard disc” is activated (at the bottom of the viewer), images from the medium will
temporarily be saved to the hard disc. With this setting activated, access of the images will initially take a little
longer, but browsing them afterwards will be faster.
If “No caching” is checked, the images will be read directly from the medium and are not saved to a
temporary directory on the hard disc. Access to such studies is faster but browsing is slower.
To load a single study or series into the viewer, select the study / series and click the “View” button
or double-click the study / series. To load multiple studies or series into the viewer, select them in
the study list and click the “View” button. For more information on how to select studies, see
section 4.1.1.3 Selecting studies and series.
For detailed information on how to use the viewer application as well as a description of all available features
and processing functions, see chapter 4.2 Viewer).
The series preview bar can be used to get an overview over the studies loaded into the viewer. It gives
information about the series of the loaded studies and allows the navigation between studies.
WARNING:
The series preview bar of iQ-LITE can only display up to 99 series. It is not possible to correctly load studies that
contain more than 99 series. In those very rare cases where such a study is provided on the medium, you may
select a number of series in the study browser to load into the viewer instead of loading the entire study.
The viewer will display either one or two series preview bars. On a single display system, just one preview bar
will be displayed when only one study is loaded into the viewer. If several studies are loaded, at first only one
preview bar will open with the series information of the first study, but it is possible to open a second one,
displaying the next study.
In the series preview bar, all available series of a study are displayed with
one thumbnail representing each series. The series currently active in the
image processing area will be shown with a yellow frame in the series
preview bar for easier orientation.
Each series thumbnail displays a number that corresponds to the number of images included in the series. In
case of multi-frame images, the number of available frames will be displayed.
The series thumbnails in the preview bar can be used to populate the views in the image processing area –
both on single and dual display systems – by:
Dragging a series from the preview bar to an available view of your choice
Double-clicking a series thumbnail to load it into the currently active view (blue frame)
Below is a description of the various buttons that may be found in the series preview bar. They are only visible,
if more than one study is loaded into the viewer:
Clicking the forward button will open the next study in the image processing area (on the primary
display in dual display systems).
Clicking the backwards button will open the previous study in the image processing area (on the
primary display in dual display systems).
Clicking the plus button, on single-monitor systems, opens a second series preview bar with the
thumbnails of the second study loaded into the viewer. If more than two studies are loaded, a click on
the plus button opens a sub-menu with all other available studies for selection. On dual display systems,
the second preview bar is automatically shown on the second display. A click on the plus button can
be used to open further loaded studies.
For this button the second preview bar must additionally be open. It is used to close the second series
preview bar on single display systems. It is not possible to close the second preview bar when working
with dual displays.
Depending upon the needs of the user, it is possible to configure the size of the series preview bar. More space
can be given to the image processing area by reducing the size of the preview bar. On the other hand, better
viewing of the images in the preview bar can be achieved by enlarging its size.
You can easily hide or show the series preview bar by using the switch on the left side of the series
preview bar.
=
Between the series preview bar and the image processing area a tab bar is displayed that contains a study
tab for each study currently loaded into the viewer.
Each tab states information about the study to easily identify a study. It contains (if available):
Patient name
Patient date of birth
Kind of study (modality information)
Study description
Study date
Clicking another study tab will load the study into the image processing area (on dual display systems: image
processing area of the primary display). If all study tabs do not fit on the screen, use the arrow buttons ( )
to navigate.
By default, iQ-LITE automatically sorts the studies loaded together into the viewer according to the study date
and time, starting with the most current study and ending with the oldest. The study tabs are listed in the same
order with the most current study displaying first on the primary display.
The image processing area is the main work area of the viewer window in which the loaded images are
displayed and processed (refer to section 4.2 Viewer). Changes (e.g. windowing, zooming/panning,
flipping/rotating, etc.) and additions (e.g. measurements and annotations) to images are made in the image
processing area.
When the viewer is opened with the selected data, the studies are loaded into the image processing area as
follows:
One study is loaded on a single display setup the study is displayed in the image processing area.
One study is loaded on a dual display setup the study is displayed in the image processing area of the
primary viewer display only (not spread across two displays).
Two or more studies are loaded on a single display setup the first study is displayed in the image
processing area; the others can be selected via their study tabs.
Two or more studies are loaded on a dual display setup the first study is displayed on the primary
display, the second study on the second display; the others can be selected via their study tabs.
The ruler on the right side of each view indicates the size of the displayed image (also available in
the Print manager). The measurement is given in centimeters (cm), each segment comprising 1
cm; the total length being 4 cm.
The ruler is not shown if the “Pixel Spacing” attribute or Ultrasound region calibration information is
missing in the DICOM header of the image.
The yellow markers in the images are orientation indicators. These indicators help to determine the orientation
of an image, e.g. right or left, top or bottom. The indicators will remain in the correct position even if an image
is flipped or rotated. Indicators will be denoted as follows:
R = right
L = left
H = head
F = foot
A = anterior
P = posterior
When a study contains more than one series or a series includes several images, it can be helpful to divide the
image processing areas into several views. Therefore, it is possible to see several series at once or to compare
series with each other. In addition, a series can be split within one view to display all of its images or to show
the individual frames of a multi-frame image. These tiles can be individually selected by clicking them. A blue
frame is displayed around the selected tile.
The screen-tiling function allows splitting the image processing area both on the series level and on
the image level. On the series level, the image processing area will be divided into the selected
number of views. On the image level, the active view itself will be divided into segments.
The same tiling options are available on both the series and image levels:
When accessing the screen tiling options via the “Tools” menu, the same sub-menu will open for the selection
of the appropriate tiling.
NOTE:
When using tiling at the image level, browsing will occur from one image to the next, not from one page (of
images) to the next page. For example, with a 2x2 image tiling, images 1 through 4 will appear first. When
browsing forward, images 2 through 5 will appear next, instead of the next “page” of images with images 5
through 8.
“Automatic tiling”: During the loading process of a study, the application counts the number of available
series and automatically divides the image processing area into the appropriate tiling. The automatic tiling
is activated by default and cannot be deactivated.
“Automatic loading”: The viewer automatically loads the different series of one study into the preset tiling:
e.g. the first series when working with a 1x1 tiling, two series with a 2x1 or 1x2 tiling. In combination with
“Automatic tiling” all available series are loaded automatically in the appropriate tiles. The automatic
loading is activated by default and cannot be deactivated.
The bottom toolbar offers the opportunity to easily access the most important image processing functions with
just one click.
iQ-LITE toolbar
Moving the mouse to the bottom of the screen will display the bottom toolbar. The individual functions of the
buttons are described in the respective sections of this user manual. Some buttons have settings that are
accessible by right-clicking the button.
When a tool is selected a yellow frame appears around the button to show that it is currently active. In some
cases the yellow frame can also indicate that an image was modified using a particular function:
A yellow frame around “Color scheme” means that color scheme changes were made to an image (e.g.
inverted).
A yellow frame around “Flip/Rotate” indicates that an image has been rotated or flipped. Additional
indicators will be added to the text overlay of the affected image(s) denoting the modification.
A yellow frame around “Text overlay” is visible when the text overlay is active. This setting is on by default
when a study is loaded into the viewer.
Usually the bottom toolbar is hidden to increase the space available for image display in the image
processing area. It only appears when the mouse is moved to the bottom of the screen.
However, it is also possible to fix the toolbar so that it is constantly visible and does not automatically hide. Do
note that since settings cannot be stored permanently on a medium, the settings will not be remembered for
the next start of the application.
iQ-LITE comes with a default bottom toolbar containing twelve general image processing tools as well as the
“Close viewer” button. While it is possible in iQ-VIEW / PRO to configure this toolbar, this option is not available
in the iQ-LITE version.
iQ-LITE toolbar
The side toolbar contains additional functions that may be helpful to the user. The buttons in this toolbar are
fixed and can neither be removed nor configured. To access the toolbar, move the mouse to the left side of
the screen.
Usually the side toolbar is hidden to increase the space available for image display in the image processing
area. It only appears when the mouse is moved to the left side of the screen.
However, it is also possible to fix the toolbar so that it is constantly visible and does not automatically hide. Do
note that since settings cannot be stored permanently on a medium, the settings will not be remembered for
the next start of the application.
By moving the mouse to the left border of the screen, the hidden side toolbar will open and offer the following
functions:
4.2.5.2 SYNC
“Sync” synchronizes different series at the current position, even if the images of those series have
a different slice thickness. Activating the button will synchronize all series displayed in the image
processing area.
All views are included in the synchronization; each view will show a small icon in the upper right corner to
indicate its status. To deactivate the function, click the “Off” button at the bottom of the side toolbar (refer to
section 4.2.5.6 Off).
The synchronization of series is also possible by selecting multiple series in the image processing area. The
activated (reference) series is the view with blue frame. To select additional series, hold the [CTRL] key down
while left-clicking other series’ views. A second left-click on a view with the [CTRL] key pressed will deselect a
series.
The icon will be displayed for those views included in the synchronization. The mouse wheel or [] and []
arrow keys can now be used to scroll through the series in a synchronized way. The currently selected tiling
scheme determines how many series are allowed to synchronize with the reference series.
It is possible to switch between the reference series and another or work within the images (e.g. adding
measurements, adjusting the windowing) without losing synchronization.
To exclude a view from being synchronized, either click the icon within the respective view or left-click the
view while pressing the [CTRL] key. To deactivate the synchronization entirely, click the “Off” button at the
bottom of the side toolbar (refer to section 4.2.5.6 Off).
4.2.5.3 BIND
Using the “Bind” tool, all currently loaded series of one study will be virtually bound together in one
view. This allows the user to scroll through all series without switching from one view to the next. The
view will automatically switch to the next series when it reaches the last image in the current series.
Two common examples would be to easily browse through brainstem and brain tissue as if they
were one series or to browse through a whole MRI with a lot of sequences.
The “Scope” (or viewport) function determines whether changes made to an image (e.g. windowing,
zoom/pan, flip/rotate, etc.) are applied only to the current image or to all images in the series.
The “Scope” sub-menu is accessible by right-clicking the “Scope” button or by hovering over the little black
corner of the button with the mouse. Once the sub-menu is displayed, select “Series” to apply changes on the
series level or “Image” to only change individual images.
“Series scope”: Modifications made to the currently active image will be applied to that image as
well as all other images in the series. This includes modifications such as windowing, zoom/pan,
flip/rotate, color schemes and image filters.
“Image scope”: Modifications made to the currently active image will only be applied to that
particular image. This includes modifications such as windowing, zoom/pan, flip/rotate, color
schemes and image filters.
NOTE:
The scope selected for one series will be used globally for all other series of the same study. If the scope
selected for one series is changed while processing a different series, the scope-based changes of the first
processed series will be reset.
If tiling is done at the image level and “Image scope” is used, the image desired for modification may be
selected by clicking the tile that displays that image. A blue frame will be shown around the selected tile. Now
image processing functions such as filters or flip/rotate can be applied to the image:
“Lines” is a scoutpilot function for easier orientation within a study. It is particularly helpful in multi-
slice studies taken from different section planes. When activated, the position of the current slice
will be displayed in the other series and section planes.
NOTE:
iQ-LITE offers an additional orientation tool – the scoutpilot. For information about this tool, see section 4.2.15
Orientation tools.
Lines display
The following example shows this clearly: the third series is the reference series (blue frame). Scoutlines are
applied to series 1 and 2. Since the section plane in series 3 is in a non–orthogonal, oblique relation to the
other planes, the scoutlines displayed in series 1 and 2 cannot be shown in a line but need to include the
obliqueness. They are therefore displayed as parallelograms.
Under certain circumstances the oblique lines display may complicate the orientation. The iQ-VIEW
workstation offers a 3D position display for easier orientation (not available in iQ-LITE). However, another
scoutlines mode may be used to additionally display the intersecting lines or to only display the intersecting
lines and remove the display of the oblique plane projection (refer to section 4.2.15.3 Scoutlines configuration).
In other cases, a frame (sometimes incomplete) is shown around a series that seems to have been acquired in
exactly the same section as the reference series.
This happens when the field of view and the section alignment are different or if a non-orthogonal cross-
section was used. In this case the section plane is again slightly oblique, leading to this type of lines display. This
may occur especially in manually planned MRI exams.
The application checks to see if the viewports (the field of view plus the section alignment) of the images are
mostly identical (tolerance limit +/- 5 pixels). If the viewport is within this tolerance limit, no frame will be
displayed.
4.2.5.6 OFF
The “Off” button turns off the side toolbar functions “Sync”, “Bind” and “Lines”.
File
Tools
Additional settings
Image filter
Image selection
Navigation
Help
The main tools and functions listed in the menus are also available as toolbar buttons. However, since all tools
are not available in the bottom toolbar, it may become necessary to use the respective menu item instead.
Other functions are only accessible using the menus.
The individual functions of menu items are described in the respective sections of this user manual.
NOTE:
Some menu items are grayed out, as these functions are only available in the iQ-VIEW or iQ-VIEW PRO
software, but not in the iQ-LITE viewer. These functions will not be described in this manual.
Click the “x” button in the upper right corner of the window
Select the “Close viewer” button on the left side of the bottom toolbar
Click the “File” menu and select “Close viewer”
To return to the study browser it is not necessary to close the viewer. Both applications can run simultaneously
and the study browser can be brought to the front without specifically closing the viewer.
This is possible if the viewer and study browser are placed on different displays or if, on a single display, the
study browser window is smaller than the viewer window (no full-screen). New studies can be selected from
the study list and will automatically load into the viewer window.
Another method is to click the “File” menu and select “Bring Study Browser to front”. This moves the study
browser from the background to the front and places the viewer into the background.
Alternatively, the Windows task bar can be used to switch from the viewer window tab to the study browser
tab and back again.
By default, the viewer opens only on one display. If two displays are available and they are connected to the
computer, the viewer can be set up to view across both displays. To configure the viewer to use dual monitors:
Make sure that the viewer window is not maximized (no full screen).
Click the “Additional settings” menu and select “Display setup”.
Select “Dual” from the sub-menu.
The viewer window will automatically resize to fit the two screens. In the rare case that this does not
happen automatically, simply drag the window across the two screens by grabbing the window frame
with the mouse. Adjust the position and the size of the viewer window, if necessary.
Do note that since settings cannot be stored permanently on a medium, the dual display settings will not be
remembered the next time the application is started. The settings will only be used as long as the application is
kept open.
In more and more imaging centers the traditional lightbox, where the radiologist is able to hang images on
film, can no longer be found. However, there are still various instances where the radiologist is forced to look at
images on film. This puts the radiologist in the position of needing a lightbox but not having one handy near his
or her workstation.
iQ-LITE offers the “Lightbox window” – a white screen that can be put anywhere on the available displays and
can function as a replacement of the traditional lightbox. This way, the radiologist is able to more easily
compare studies on film with those available as softcopy on the iQ-LITE viewer.
WARNING:
Please note that the lightbox window function offered in iQ-LITE does not correspond with a radiological film
viewing box. It may, therefore, only be permitted for diagnostic use if all applicable legal requirements
regarding diagnostic film viewing in your country are met. Please consult your authorized local distributor
before using this function for diagnostic purposes.
While the lightbox window is open, the viewer is fully accessible and all image processing functions can be
used.
Left-click into the white field to access the window status functions.
You can then set the window into full-screen mode, move it to another position on the display(s) (by
clicking the title bar and dragging it with the mouse) and change the window size (by adjusting the
window frame with the mouse).
Multi-frame and single-frame DICOM images are treated equally. The stack and cine mode functions work for
both; series of both can be shown in a sequence. It is also possible to display the individual frames of a multi-
frame image (sequence) in different tiles, to select specific frames and to export or print them.
The viewer offers a variety of ways to navigate between different images, series and studies loaded into the
viewer. They can be accessed using the “Navigation” menu.
The options in the “Navigation” menu may be used to navigate within a series, study or all studies loaded in
the viewer. In addition, either the next or previous patient study from the current study list (in the study browser)
can be loaded into the viewer.
“Next image”: opens the next image of the series in the currently active tile.
“Previous image”: opens the previous image of the series in the currently active tile.
“Next multi-frame object in series”: used for series consisting of several multi-frame objects. Instead of
switching from one frame to the next, “next multi-frame object in series” will jump to the next object in the
series, independent of the number of frames in the current object. If single-frame objects (= images) are
included in the series, they will be considered an object as well.
“Previous multi-frame object in series”: used for series consisting of several multi-frame objects. Instead of
switching from one frame to the previous, “previous multi-frame object in series” will jump to the previous
object in the series, independent of the number of frames in the current object. If single-frame objects (=
images) are included in the series, they will be considered an object as well.
“First image in series”: opens the first image of a series in the currently active tile.
“Last image in series”: opens the last image of a series in the currently active tile.
“Next series”: opens the next series in a study in the currently active tile.
“Previous series”: opens the previous series in a study in the currently active tile.
“First series in study”: opens the first series in a study in the currently active tile.
“Last series in study”: opens the last series in a study in the currently active tile.
“Next study”: opens the next study in the currently active tile (if more than one study is loaded into the
viewer).
“Previous study”: opens the previous study in the currently active tile (if more than one study is loaded into
the viewer).
“Next study in study list”: loads the next study from the current study list (in the study browser) into the
viewer.
“Previous study in study list”: loads the previous study from the current study list (in the study browser) into
the viewer.
The hanging protocols navigation is disabled as the hanging protocols management is only included in iQ-
VIEW PRO.
Some of these navigation options are available as default viewer shortcuts (see chapter 6 List of Shortcuts).
In the viewer, individual series can be selected from the thumbnails in the series preview bar. Either double-
click or use drag and drop to transfer the series into an available view of the image processing area.
When more than one study is loaded into the viewer, a switch can be made between the available studies by
changing tabs. By clicking another study tab, the images from the new study will load into the image
processing area.
If, however, comparisons are to be made between several series in different studies, it is necessary to keep the
current series in the image processing area and only to add the desired series from another study.
To accomplish this, select the sign in the series preview bar to open the preview bar of the second study. If
more than two studies are loaded, a sub-menu will pop up so the appropriate study can be selected. The
second series preview bar will show the series thumbnails of the additional study. The series needed can now
be dragged into the appropriate view in the image processing area. Alternatively, double-clicking the series
will load it into the currently active view. This is an easy way to manage the comparison of studies.
NOTE:
On dual display systems with two studies loaded, one will open on the primary display while the other will
automatically display on the second screen. This makes it even easier to compare different studies with each
other.
As an example, to compare two studies in a 2x1 mode, use the screen tiling function located either in the
bottom toolbar or in the “Tools” menu and select the option 2x1 on the series level. For more information, see
section 4.2.3.2 Screen tiling options. The views in the image processing area will display the first study. Place the
When images, series or studies are to be exported to another image format (e.g. JPEG, BMP, TIFF or RAW), a
video file (AVI) or a Windows® printer, it is sometimes necessary to first mark these images for export. This is the
case when the following types of files are to be exported:
Individual images can be marked or unmarked by clicking the box in the upper right corner of each view.
When an image is marked, the box will turn red. Further selection options are available in the “Image
selection” menu:
Using the “Image selection” menu it is possible to mark images on a series or study level. Options include:
It is further possible to mark the currently active image (“Select active image”) and to “Clear current
selection” to reset all selections.
Especially in multi-slice studies, such as CT or MRI exams orientation within the different section planes can be
difficult. This is where orientation tools such as scoutpilots and lines displays can be helpful. iQ-LITE offers several
orientation tools to aid the users.
The “Lines” mode in the side bar (hidden on the left side of the screen) is essentially a scoutpilot function that
simplifies the orientation in a study by displaying the position of the current slice (active frame) within the other
series and section planes. It is particularly helpful in multi-slice studies taken from different section planes. Lines
can be activated easily without having additional windows open which may impede the view in the image
processing area.
NOTE:
For further details, please refer to section 4.2.5.5 Lines.
4.2.15.2 SCOUTPILOT
The scoutpilot tool is a position indicator that provides the user with positional information about images. This
function allows users to orient themselves within a series.
Scoutpilot example
When opened, the scoutpilot always shows the currently active image (blue frame).
Using the center mouse-button (or scroll wheel), it is possible to change the window level.
By pointing to the border of the image (the zoom zone), the mouse pointer turns into a magnifier and
allows zooming within the image. While the mouse is a magnifier, hold the left mouse button down and
move the mouse up and down to zoom in and out, respectively.
While pointing in the center of the image (the pan zone), the mouse pointer turns into a hand. Hold the left
mouse button down and move the mouse to pan the image.
“Refresh”: This button can be used to reset windowing, zoom and pan changes made in the image or
to select a new image as the reference image. To select a new image as the reference image, start by
scrolling the view in the image processing area down to the image you want to use as reference. It
must be the active image (blue frame). Then, click the scoutpilot’s refresh button to update the
reference image.
By default, iQ-LITE projects the section planes in its “Lines” and “Scoutpilot” display, leading to the display of
rectangles or parallelograms – if the section planes are oblique. It is also possible to modify the display settings
by:
“Mode: plane projection”: This is the default setting. If activated, the scoutlines functions will display only
the projection of the section planes.
“Mode: plane intersection”: If activated, the scoutlines functions will display only the lines where the
section planes cut (intersect) each other.
“Mode: plane projection and intersection”: If activated, the scoutlines functions will display both the
projection of the section planes and the intersection lines.
The line weight may be changed to adapt to a higher or lower display resolution. For high-resolution displays it
may be more comfortable to use bolder lines. The following options are available:
Please note that the user-defined settings are only available for the current iQ-LITE session. Do note that since
settings cannot be stored permanently on a medium, any settings changed from the default will not be
remembered for the next start of the application. Thus, it may be necessary to configure the scoutlines display
again.
Presentation states (PR) are independent DICOM SOP instances containing information on how a particular
image should be displayed. The presentation state may contain, for instance, windowing, zooming and
panning values, information about rotation or flipping and other visual display elements defined in the DICOM
standard. What presentation states do not contain is pixel data. Therefore, PR can only be used in
combination with an existing DICOM image.
It is important to note that iQ-VIEW – which is the basis for the iQ-LITE viewer – only supports its own presentation
states. While images retrieved from other DICOM stations may already contain presentation states, iQ-VIEW will
not be able to make use of these presentation states.
As a result, iQ-LITE media created with the radiological workstation can only contain PR files that have been
created and stored with an iQ-VIEW PRO station. Presentation states of other manufacturers will be ignored
during the export and will therefore not be placed on the medium.
PR created for studies within iQ-VIEW PRO will be correctly used within iQ-LITE.
In iQ-LITE, modifications made to an image (e.g. window level changes, zooming/panning, flipping/ rotating
and adding of measurements and annotations) will be treated as a presentation state. They will, however,
only be cached for the current viewer session and are deleted when the viewer is closed. The next time the
images are loaded, they will be displayed again with their original pixel data.
NOTE:
Due to the use of presentation states in iQ-LITE the handling of some image processing features, such as
zooming and panning, have slightly changed in comparison to earlier iQ-LITE versions (up to version 2.5.0c).
These adaptations were necessary to adhere to the specifications laid down in the DICOM standard.
It is possible to remove changes made to an image (e.g. windowing, zoom/pan, flip/rotate, etc.). These
presentation states can be deleted using the “Reset” button in the bottom toolbar or by choosing “Reset
current view” in the “Tools” menu. Alternatively, “Clear presentation states” in the “Tools” menu can also be
used.
A reset will also delete measurements and annotations made in the images. Additionally, these can be
deleted manually or by using the “Tools” menu. For more details on the treatment of measurements, please
see section 4.2.21 Measurement and annotation tool.
The text overlay provides patient, study and series information necessary to identify images displayed in the
image processing area. It is activated by default when images are loaded into the viewer. This is done to
insure that important information, such as lossy image compression, is always recognized by the user.
The text overlay can be activated and deactivated both from the button in the bottom toolbar and from the
“Text overlay” entry in the “Tools” menu.
“Text overlay”: Is used to hide the text overlay information that is activated by default. Clicking this
button will toggle between activating and deactivating the text overlay.
If an image displayed in the image processing area has been lossy compressed, this information will be shown
in the text overlay, provided that the necessary details were correctly stored in the image information.
Compression information will only display if the text overlay is activated.
Complete compression information of an image is shown in the DICOM header dump. See also section 4.2.29
DICOM header information for more information.
WARNING:
Lossy compressed images may have no diagnostic quality.
By default, “Bitmap overlay” display is enabled. If activated, a potential bitmap overlay in an image is
displayed. If the bitmap overlay is not needed, simply deactivate this function. It functions independently from
the text overlay.
This function can only be accessed by clicking “Bitmap overlay” in the “Tools” menu.
By default, “Look-up tables” display is enabled. iQ-LITE is able to interpret potentially embedded look-up tables
in order to display a DICOM image the way it is displayed on the source machine (another form of
center/window information).
This function can only be accessed by clicking “Look-up tables” in the “Tools” menu.
Shutters created with the viewer’s shutter tool are handled as presentation states. However, shutters can also
be embedded within the DICOM header of an image and are, therefore, handled differently. This may be the
case with shutters created in images in the iQ-VIEW “Import” dialog or with images to which shutters were
already applied at the modality.
By default, “Embedded shutters” display is enabled. As a result, iQ-LITE is able to interpret potentially
embedded shutter sequences in order to hide a specific part of a DICOM image. If the function is disabled,
the entire image will become visible again.
This function can only be accessed by clicking “Embedded shutters” in the “Tools” menu.
Stack and cine mode make it possible to manually or automatically browse through all images of a series (or
even the complete study when used in combination with the “Bind” mode; see section 4.2.5.3 Bind).
Both the stack and the cine modes are available by using the respective toolbar buttons in the bottom toolbar
or the “Stack mode” and “Cine mode” entries in the “Tools” menu.
The stack mode is always activated by default and can be used even if other processing functions
are activated. Browsing through images with the stack mode is possible in different ways.
With the following options, one image after another of the series will be displayed, which is useful when
wanting to browse all the images of the series:
Use the mouse scroll-wheel to move through a series. This function is not available if “scroll zoom” is
activated.
Use the up and down arrow keys on the keyboard to scroll to the next or previous images.
With the following options, images of the series will be skipped to move faster from one position in the series to
another. This can be useful if you wish to go to a particular area quickly:
Select the “Cine mode (stack)” button in the tool bar or the “Stack mode” function in the “Tools” menu.
Then move the mouse up and down while keeping the left mouse button pressed to browse through a
series.
Use the scrollbar to the right of every view to scroll through a series of images by pulling the controller up
and down.
For more navigation options see section 4.2.11 Navigating between images, series and studies.
With DICOM multi-frame images (e.g. angiographic or ultrasound images) as well as single-frame
images (e.g. CT, MR), the series can be run automatically as a sequence. Either right-click the
“Cine mode” button in the bottom toolbar or select “Cine mode” from the “Tools” menu to access
the cine mode sub-menu:
“Start autoplay”: Cine mode will begin playing automatically. A separate cine mode player (cine
control) opens to control the cine playing.
“Pause autoplay”: The pause button temporarily suspends the cine play. A second click restarts the cine
play from where it was paused.
“Stop autoplay”: The stop button stops the cine play and closes the cine control.
The “Cine control” can be moved to a different part of the screen by clicking anywhere in the gray area of
the control and dragging it to another position.
Further settings:
“Direction”: The cine can either be played “Forwards” or “Backwards”. Select the respective entry from
the sub-menu or move the controller in the cine control either to the right (including the correct frame
rate) for forwards playing or to the left (including the correct frame rate) for backwards playing.
“Frame rate”: Using the entry in the cine mode sub-menu several pre-defined frame rates can be selected
for the cine run (6, 12, 24, 32 fps = frames per second). The default frame rate is defined in the DICOM
header for multi-frame images or is 25 fps for single-frame images.
The direction and the frame rate can also be adjusted in the cine control itself by moving the indicator bar
while the cine is running.
In many cases, the brightness and contrast for the DICOM images are already well-set when the images are
created at the modalities. Sometimes, however, it might be necessary to change the window level of images,
e.g. when the series is too dark or the contrast is not good enough to see specific tissues.
iQ-LITE offers three ways of changing the center/window level of DICOM images:
Dynamic windowing
The use of window presets
A fine-tuning windowing mode
Using the “Scope” function, described in section 4.2.5.4 Scope, it is possible to apply window changes to a
whole series or to an individual image only:
Select “Image scope” to only change the center/window values of a particular image.
Select “Series scope” to apply windowing changes made in one image to all images of the same series.
NOTE:
Window changes made will be reset when the scope is changed (from series to image or from image to
series). Windowing can then be applied again according to the newly selected scope.
Dynamic windowing is the default form of window leveling in iQ-LITE. When windowing within a series, dynamic
windowing calculates the changes in the center/window values based on the original center/ window values
as they are stated in the DICOM information of each image. As a consequence, all images of a particular
series may have different center/window values. This most often occurs in MR series where the contrast and
brightness vary from image to image.
Example: One image has original W/C values of 700/300 and a second has original values of 730/310. If the
window value of the first image is increased by 15 and the center value is decreased by 15 (new: 715/285),
then the values of the second image will also be increased (window) and decreased (center) by 15 (new:
745/295).
Since dynamic windowing is on by default in iQ-LITE, this function is easily accessed in different
ways:
While pointing to an image, click the center mouse-button (scroll-wheel) and move the mouse
up/down and left/right. This option is also available if other tools are currently selected.
Select the “Windowing (dynamic)” button in the bottom toolbar. While pointing to the image,
click the left mouse button and move the mouse up/down and left/right.
Click the “Tools” menu and select “Windowing.” While pointing to the image, click the left
mouse button and move the mouse up/down and left/right.
When the windowing function is activated using the toolbar button or the menu item, the shape of the mouse
pointer will change to indicate the use of windowing.
A second possible form of applying center/window changes to images is to use pre-defined window presets.
The iQ-VIEW radiological workstation comes with a number of window presets. Users can also define their own
and add them to the presets list. The configuration file in which these presets are stored is also copied to the
medium during its creation. As a result, any presets established in iQ-VIEW are also available for use in iQ-LITE.
Furthermore, iQ-LITE includes auto-contrast functions and an ROI window.
The window presets pop-up menu can be accessed by right-clicking the “Windowing (dynamic)” button on
the bottom toolbar or by selecting “Window presets” in the “Tools” menu:
Additional or customized settings may be available if the iQ-VIEW user has created other settings not initially
included in the default list.
“Custom settings”:
Select “Custom settings“ to change the existing presets or to add others. A configuration window will open
displaying the current presets. From here, presets can be added (“Add”), deleted or modified (“Clear” and
“Change”). Once the necessary changes have been made, click “Save and exit” to save any changes and
close the custom settings window. Please keep in mind that these settings cannot be stored permanently on
the medium and will only be used as long as iQ-LITE remains open.
“Auto contrast”:
Auto contrast applies an auto-contrast on the current image (with “Image scope”) or on a whole series (with
“Series scope”) only. The other series remain unaffected.
Additionally, there is an auto-contrast function available for applying an auto-contrast to all loaded studies.
Once applied, the auto-contrast will remain in effect until being deactivated again.
NOTE:
The window presets can also be used in combination with tiling on the image level (several images in one
view). This is possible with scope on the series and image levels as well.
In most cases, the regular dynamic windowing is sufficient for setting the brightness and contrast of an image
to its best visual quality. However, iQ-LITE also offers a mode with which it is possible to change the
center/window values in one-step intervals. This makes it possible to fine-tune the windowing.
To use fine-tuning:
Color remapping assigns a color to each gray tone of an image, therefore rendering any grayscale image
(MONOCHROME1 and MONOCHROME2) in color. Using colors, areas with low contrast can be better
displayed. Color remapping is particularly useful in nuclear medicine and it is for this reason that iQ-LITE also
provides a number of nuclear medical color schemes.
NOTE:
Color remapping will be reset when the scope is changed (from series to image or from image to series). The
modifications can then be applied again according to the newly selected scope.
“Color scheme” offers several general options: normal grayscale output (“B/w”), inverted
grayscale output (“B/w negative”), color remapping (“Color remap”) and inverted color
remapping (“negative color remap”). In addition, these NUC color schemes are available:
iQ-LITE offers a variety of measurement and annotation tools that make it possible to easily add markings to
images (distances, angles, ROI, etc.). These tools are available both as toolbar buttons and menu entries.
The measurement and annotation tools can be accessed in the following ways:
Click the “Tools” menu and select “Measurement tools” to access the sub-menu displaying all functions.
Select the “Measurement tools” button on the bottom toolbar. A right-click on the button (or hovering
over the little black corner) opens a sub-menu all measurement and annotation functions can be found.
“Distance”: The distance tool is used to measure a distance. To use the tool, point to the position
where the measurement should begin and hold the left mouse button down while dragging the
mouse to the end point. Releasing the mouse button will show the results in millimeters.
During the drawing of the distance line, the current measurement value is displayed and constantly updated.
In addition, a center marker is displayed in ever distance line, indicating half of the measured distance.
NOTE:
If the result is not given in millimeters but in pixels (pxl), the pixel spacing is missing in the affected image (or US
Region Calibration for ultrasound images). The pixel spacing or region calibration values are needed by iQ-LITE
to know how big a pixel is in the image. This information is needed to calculate distance.
“Ratio”: The ratio tool is used to measure a ratio between two distances. To use the tool, draw the
first distance (A) and then the second (B). The result is given as a percent (%) of A/B. The length of
the two distances is also shown.
NOTE:
If the length of the lines is not given in millimeters but in pixels (pxl), the pixel spacing is missing in the affected
image (or US Region Calibration for ultrasound images). The pixel spacing or region calibration values are
needed by iQ-LITE to know how big a pixel is in the image. This information is needed to calculate the length of
the two lines.
“Perpendicular distance”: The perpendicular distance tool is used to measure the short and long
axis of tumors in 2D. Two distance lines are drawn in a right angle towards each other.
“Point-to-line distance”: The point-to-line distance tool is used to measure the distance between a
defined point and a drawn line in an orthogonal angle. This tool can be used, for example, for
evaluating a spinal rotation scoliosis.
“Angle”: The angle tool is used to measure an angle. To measure angles, draw the first line as if
drawing a distance measuring line. The second line does not necessarily have to intersect the first
line. The resulting measurement values represent the acute and obtuse angle.
As soon as the second ray of the angle measurement is started, iQ-LITE displays the current measurement
value. While the line is drawn the value is constantly updated.
Cobb’s angle is a method of measuring the degree angle of the spinal curve. The technique to measure the
scoliosis curve consists of four lines constructing a geometric figure.
“Interior angle”: The interior angle tool is used to measure an interior angle in a right-angled
triangle, i.e. an acute angle adjacent to the hypotenuse. This tool can, for example, be used for
the measurement of joint angles of the wrist.
“Square ROI”: With the square ROI tool it is possible to measure the density in a selected
rectangular area (ROI). To use this tool, place the mouse at the upper left corner of the area to
measure; hold the left mouse button down; and drag diagonally until the appropriate area is
selected. When the mouse button is released, a rectangle will be drawn over the specified area
and the mean, maximum and minimum density values will be given. For CT images the results are
displayed in Hounsfield Units (HU). In addition, the results will state the standard deviation.
“Circular ROI”: Measuring density in a selected elliptical/circular area (ROI) is possible using the
circular ROI tool. To use this tool, place the mouse in the center of the area to be selected; hold
the left mouse button down; and drag the mouse outward from the center to create an
ellipse/circle around the desired area. When the mouse button is released, the mean, maximum
and minimum density values will be given. For CT images the results are automatically displayed in
Hounsfield Units (HU). In addition, the results will state the standard deviation.
NOTE:
A perfect circle (not an ellipse) can be achieved by holding the [SHIFT] key while drawing the ROI area with
the mouse.
“Polygonal ROI”: Using the polygonal ROI tool, it is possible to measure both the density and size of
a selected freehand area.
4.2.21.11 SHUTTERS
“Shutter”: The shutter tool makes it possible to select a specific rectangular area of an image while
blackening out the rest of the image. The blackened-out areas are not deleted from the image.
They are only hidden. To use this tool, place the mouse at the upper left corner of the area to
view; hold the left mouse button down; and drag diagonally until the appropriate area is selected.
When the mouse button is released, only the selected area will be visible.
NOTE:
The shutter cannot be used in combination with a user-defined rotation (“Enter custom angle”).
4.2.21.12 ANNOTATIONS
“Annotation”: The annotation tool allows the user to make annotations on images. To use this tool,
point the mouse at the area where the annotation should begin. (Longer annotations should start
farther to the left.) While holding the left mouse button down, drag the mouse to draw a line on
the image to the area to be annotated. When the mouse button is released, an arrow will be
displayed and the annotation dialog will open.
Enter text and click “OK”. Annotations are displayed only to the border of the image. The longer the
annotation, the farther the arrow should start on the left side. The annotation text will begin at the starting
point of the arrow.
Example of an annotation
NOTE:
If no text is entered on the annotation screen, the arrow will remain anyway. This is implemented by design to
allow for adding arrows that denote specific areas in the image.
In some cases, especially when creating measurements and annotations within small structures, measurements
may end up very close to each other and the calculated values may overlap. Since this makes values difficult
to read, iQ-LITE will automatically move the values to avoid an overlap.
To insure that each value can still be matched to the measurement where it belongs, a red frame is put
around any value that was moved and a line connects the value to the corresponding measurement.
“Clear”: The clear tool can be used to erase individual measurements or annotations made in an
image. To use this tool, select the “Clear” function, then click the measurement or annotation to
be erased. After it turns red, click again the item to remove the measurement or annotation.
“Clear all measurements”: All measurements made in all studies loaded into the viewer are removed with
one click.
“Clear last measurement”: The last measurement made in an image is removed.
NOTE:
All measurements and annotations made in a series (one view) can be deleted by using the “Reset” button or
by selecting “Clear presentation states” from the “Tools” menu. However, both tools will reset ALL changes in
the active series, not only the measurements and annotations.
“Modify”: The modify tool allows current measurements and annotations to be modified. To use
this tool, select the measurement or annotation to be modified. The markers displayed on each
measurement or annotation can then be used to drag and drop the measurement/annotation
into the correct position.
Distance measurements: Grab the center marker with the mouse to move the whole line into a new
position or use the start and end markers of the line to change the length and position of the starting and
ending points.
Ratio measurements: Use the start and end markers of the two lines to change the length and position of
the starting and ending points.
Angle measurements: Grab the center marker to change the position of where the two lines cross or use
the start and end markers of each line to move the lines into the correct position.
Cobb’s angle: Use the markers at the end of each line to correct the line positions. The perpendicular lines
will be adapted automatically by iQ-LITE.
Square and circular ROI: Grab the center marker to move the whole area (rectangular or
elliptical/circular) or use the line markers to change the size of the area.
Shutter: Grab the center marker to move the whole shutter or use the markers in the upper left and lower
right corners to change the shutter’s size.
Annotations: Grab the center marker to move the annotation and arrow to a new location or use the
marker at the arrow tip to change the length and tip position. The annotation text field will open after
each move to allow the text to be changed.
“Copy”: Offers the opportunity to copy measurements and annotations already made in one
image to other images, either of the same series or a different series. This function may be
particularly helpful in multi-slice studies.
“Calibrate”: The calibrate function calibrates measurements for CR images while considering the
oversize in the images.
The regular “magnifier” is the magnifying tool used in iQ-LITE. iQ-VIEW PRO includes an additional, special
“magnifier window” for magnifying regions of interest in a separate window. This function is, however, disabled
in iQ-LITE.
The regular magnifier function can be accessed by clicking the “Magnifier” button in the bottom toolbar or by
selecting “Magnifier” from the “Tools” menu.
“Magnifier”: After selecting the magnifying function, the mouse pointer turns into a magnifying
glass. By holding down the left mouse button while moving over an image, the image area is
magnified at twice its current size at the position of the mouse.
NOTE:
Measurements and annotations made in an image are still visible using the magnifier.
Sometimes individual images or entire series need to be enlarged to improve the visibility of diagnostically
relevant tissues and structures. Moving images around in their views (panning) may also be necessary – for
example, to adjust them for easier comparison to another series.
Using the “Scope” function, described in section 4.2.5.4 Scope, it is possible to apply zoom and pan changes
to a whole series or to an individual image only:
Select “Image scope” to only change the zoom factor or position (pan) of a particular image.
Select “Series scope” to apply changes in the zoom factor or position (pan) for one image to all images of
the same series.
NOTE:
Any zoom and pan changes made will be reset when the scope is changed (from series to image or from
image to series).Zoom/pan can then be applied again according to the newly selected scope.
It is important to note that the zoom and pan features in iQ-LITE have changed in comparison to earlier
software versions (up to iQ-LITE 2.5.0c).
Due to the presentation states (PR) now used to display and cache changes in DICOM images, the zoom/pan
feature has been modified to adhere to the specifications established in the DICOM standard.
Therefore, zoom out will only scale down to a “fit-in” size and not smaller since this is not defined in the DICOM
standard. It is, however, possible to view an image smaller than its “fit-in” size by applying a 1:1 zoom.
Panning images can still be done even if the images are not zoomed but are scaled to fit the screen. This
allows for the adjusting of images to the same height in case one is displayed lower than the other.
To zoom (adjust the size) or pan (move) images, either click the “Zoom/Pan” button on the bottom toolbar or
select “Zoom/Pan” from the “Tools” menu.
“Zoom/Pan”: When activated, the zoom/pan function can be used to dynamically zoom and pan
images using the mouse. The middle area of the image acts as the “pan zone”. The mouse pointer
turns into a hand icon when pointing there. By clicking in the middle of the image and moving the
mouse up/down or right/left, the image will be moved. The periphery of the image acts as the
“zoom zone”. The mouse pointer turns into a magnifier icon when pointing there. By clicking on the
periphery and moving the mouse up and down, the image can be easily zoomed.
In addition, a sub-menu is available with different zooming presets. The sub-menu is accessed by right-clicking
the “Zoom/Pan” toolbar button or by right-clicking directly on the image processing area (after having
selected the function):
“Fit in”: This is the default setting. Images are scaled to fit into the available view. The higher the tiling, the
smaller the images will be displayed.
“1x (original)”: The images are displayed in their original size.
“1.5x”: The images will be zoomed to one and a half times their size.
“2x”: The images will be zoomed to two times their size.
“2.5”: The images will be zoomed to two and a half times their size.
“3x”: The images will be zoomed to three times their size.
The “Scroll zoom” function is available in the “Tools” menu. Once the feature is activated, the scroll-wheel of
the mouse can be used to dynamically zoom the currently active image.
When moving the scroll-wheel of the mouse upwards, the image is enlarged. When moving the scroll-wheel of
the mouse downwards, the image is made smaller. This behavior is similar to the general zoom function.
Using the “Scope” function, described in section 4.2.5.4 Scope, it is possible to apply flip and rotation changes
to a whole series or to an individual image only:
NOTE:
Flipping and rotation will be reset when the scope is changed (from series to image or from image to series).
The modifications can then be applied again according to the newly selected scope.
The flipping and rotation options are accessible by clicking the “Flip/Rotate” button in the bottom toolbar or
by selecting “Flip/Rotate” in the “Tools” menu.
“Flip/rotate”: Activating the Flip/Rotate function opens a sub-menu containing all flipping and
rotation options:
“Flip vertically”: Flips the image vertically. A specific marker is added to the text overlay to
indicate the flipping. *
“Flip horizontally”: Flips the image horizontally. A specific marker is added to the text overlay to
indicate the flipping.
“90° rotation clockwise”: Rotates the image in a 90 degree angle to the right.
“180° rotation”: Rotates the image in a 180 degree angle.
“90° rotation counter-clockwise”: Rotates the image in a 90 degree angle to the left.
Click “Reset current view” from the sub-menu to reset the flipping and rotation changes. The images will return
to their original position. Alternatively, the general “Reset” button on the bottom toolbar or the menu item
“Reset current view” found in the “Tools” menu can be used to reset the modifications. Note, however, that
the latter options also remove all other modifications made to the image(s).
NOTE:
When rotating or flipping zoomed images, any zoom or pan changes will be reset. This also applies to the
“Reset current view” function within the flip/rotate context menu. However, it is possible to re-apply the zoom
after the image has been rotated.
In cases where the rotation presets are not sufficient or the images only need to be adjusted slightly, e.g. to
turn them upright, a customized rotation can be helpful. iQ-LITE offers the option to rotate images in a user-
defined way by using the “Enter custom angle” option in the “Flip/Rotate” sub-menu.
“Flip/Rotate”: To rotate the image to a specific angle, select “Enter custom angle” from the sub-
menu. A dialog box opens where the desired angle can be entered. Either type the angle in the
text box or use the up and down arrows to choose the correct angle, then click “Accept”. The
image (and all images of the same series if series scope is chosen) will be rotated accordingly. The
image is rotated clockwise.
NOTE:
Please note that it is not possible to use the square and circular ROI measurements tools in images that have
been rotated to a custom angle. If ROI measurements were made in an image before it is rotated, the
measurements will no longer be visible. However, they are not deleted and will be displayed again when the
image is rotated using a standard rotation setting.
For the post-processing and quality improvement of images, a number of image filters are available in the
viewer.
Using the “Scope” function, described in section 4.2.5.4 Scope, it is possible to apply image filters either to a
whole series or to an individual image only:
NOTE:
Image filters will be reset when the scope is changed (from series to image or from image to series). The
modifications can then be applied again according to the newly selected scope.
The available options can be accessed by clicking the “Image filter” button in the bottom toolbar or from the
“Image filter” menu.
“Image filter”: Upon activation, a sub-menu opens with the following options:
Sharpen
Edge enhance
Noise reduction
The “Reset” option removes all applied filters and returns the image(s) to their original state.
4.2.26.1 RESET
If modifications made in an image are no longer needed or need to be changed, it is possible to reset the
changes and start anew. The reset function is available both in the bottom toolbar (“Reset” button) and also
by selecting “Reset current view” in the “Tools” menu.
“Reset”: Selecting the reset function removes all changes made to an image and restores the
original image (e.g. if the image was windowed, zoomed, rotated). In addition, all measurements,
annotations and shutters are removed. Modifications can also be deleted separately. Please see
section 4.2.21.14 Erasing measurements and annotations for further information.
“Clear current view” is used to not only remove changes made in an image, but to empty an entire view in
the image processing area. To access this option:
DICOM images loaded into the viewer can be exported to other image formats – JPEG, BMP and TIFF – as well
to an AVI video format for use in a case presentation. iQ-LITE will export the images as well as the modifications
applied to them (measurements and annotations, windowing, zoom/pan, flip/rotate, color remap, etc.).
Export options are only available as a menu entry. To export images, click the “File” menu and select “Export
image(s)”. A sub-menu offers the following possibilities:
“Current image”: exports only the currently active image (blue frame)
“Whole series”: exports the entire series where the current image belongs
“Whole study”: exports the complete study currently active in the viewer
“All studies loaded”: exports all studies currently available in the viewer
“Current selection”: exports a selection of images, series or studies. A selection must be made before using
this export function.
“Export to AVI”: allows the exporting of either the current series or a previously made selection of images
into an AVI video file
“Export as AVI” can be used to export a sequence of images, e.g. an ultrasound series, as a video file in the
AVI format. Select “Export as AVI” from the sub-menu and the “Save as video file” dialog will open.
Select between “Current series” or “Current selection” for exporting. (Current series is the default
selection.)
NOTE:
The images will be converted into AVI in the order in which they were selected in the viewer.
Set the size of the video frame (X and Y for width and height). When changing one value, the other will
change accordingly to maintain the proportions of the images.
Set the “interframe delay” in milliseconds. The interframe delay defines the time that passes between two
frames. The lower the value, the faster the individual frames will be shown.
Select “Compression” if the video file should be compressed. By choosing a compression setting, the file
will become smaller and more suitable for inclusion in presentations.
NOTE:
The available options for compressing AVI files are dependent on the codecs installed on the workstation. As a
result, the list of compression options may differ from station to station. The manufacturer cannot guarantee
the correct functioning of the various codecs and, therefore, recommends using the Windows default codec
“cvid Cinepak Codec.” The use of a corrupted, incompletely/incorrectly installed or incompatible codec may
lead to undesired effects in iQ-LITE.
After all options have been set, click the “Save as AVI” button to give the file a name and start
exporting the selected data as an AVI file.
WARNING:
The creation of an AVI file can take a while depending on the number of images selected to be converted. A
progress bar will indicate when the process will be finished. The dialog will close automatically when the AVI
file is complete. Please do not interact with the program at this time, such as clicking the close button (“x”), as
this may lead to undesired results.
“Print manager”: All images that have been loaded into the viewer, including secondary captures
and structured reports already available on the medium, can be sent to the Print manager where
they can be printed on a connected Windows® printer. Images will be printed with all of their
changes in presentation states (measurements and annotations, windowing, zoom/pan,
flip/rotate, color remap, etc.).
For more information about printing DICOM images on paper printers, please read chapter 4.3 Windows Print.
Click the “File” menu and select “Print manager.” The entire study currently active in the viewer is
transferred. Alternatively, specific images can be selected in the viewer to be transferred.
NOTE:
For instructions on how to select images, series and studies in the viewer, see section 4.2.14 Selection of
images, series and studies.
The DICOM header of an image shows all DICOM related information about the current image in the image
processing area (blue frame), such as patient information, study, series and image information. Additional
information includes meta tags and other values defining the structure and display of the image.
The DICOM header can be accessed by selecting “DICOM header dump” in the “Tools” menu or by using the
default shortcut [H] in the viewer.
Three different tables are available in the “DICOM header viewer”: the “List view”, the “Tree view” and the
“Summary”.
“List view” gives an overview of all available DICOM tags (attributes) and their values.
The tree view table gives a more structured overview of the DICOM tags and values of an image. The tags are
collected into their respective attribute groups. Groups can then be opened to reveal the individual tags and
values or closed if not needed. By default, the various levels are closed.
In “Tree view” it is not possible to modify individual attribute values. For modifications, please use the “List
view.”
Click the “+” to open a level with its underlying sections and display all corresponding attributes with
their respective values.
In addition, the DICOM header data, as displayed in the “Tree view”, can be saved as an XML file to a
directory of your choice (“Save as XML”). This file may then also be printed with the print functions provided by
Windows printers.
4.2.29.3 “SUMMARY”
In the “Summary” table, it is possible to select an assortment of DICOM tags (up to six) whose values can be
available at a glance. Do note that since settings cannot be stored permanently on a medium, any settings
changed from the default will not be remembered for the next start of the application.
As an example, the text fields or text overlay displays for certain tags, like “Study comments,” may not be long
enough to show all of the information contained in the field. Another use would be to view private tags or
Worklist procedure tags. In both cases, the “Summary” view offers an easy solution.
NOTE:
Acrobat Reader must be installed on the system to open and view the iQ-LITE user manual, which is included
as a PDF file on the medium (MANUAL.PDF).
“About”: Opens a window where version information about the iQ-LITE software as well as contact
information for questions or bug reports is displayed. Clicking the window opens a support email form that
can be used to contact a local reseller for bug reports, technical advice, etc.
NOTE:
Please note that a standard email client (Outlook, Outlook Express, etc.) must be installed and configured to
automatically open an email form.
With iQ-LITE, DICOM image data can be printed using a Windows® printer. To output individual images, series
or studies , the studies must first be loaded into the viewer.
Once loaded, the print manager can be accessed by selecting “Print manager” from the “File” menu of the
viewer. The print manager window can also be accessed using the default shortcut [P] or by using the “Print
manager” button on the bottom toolbar. All methods lead to the print manager opening and transferring the
selected images into the preview:
Print manager
Changes made in images during their processing in the viewer are transferred into the print manager as well.
This allows the images to be printed with their modifications, e.g. added measurements and annotations,
window level changes, flipping/rotation, zoom/pan.
The printer, paper format and orientation must be selected from the drop-down menus in the upper part of
the print manager screen before printing:
“Printer”: Select the appropriate printer for printing the images. Any local or networked Windows® printer
can be chosen.
NOTE:
Please note that, in general, printouts of DICOM images, particularly paper printouts, may not be of a
diagnostic quality and should, therefore, not be used to provide diagnostic findings.
For higher quality printouts, the use of PostScript printers is recommended.
Clicking the “Printer settings” button after selecting a specific printer brings up the typical
Windows® printer properties to change settings for the printer.
“Paper format”: This option is only available for DICOM print. As DICOM print is not available in iQ-LITE, this
option is grayed-out.
“Orientation”: Choose between portrait or landscape orientation for printing. The print manager preview is
changed accordingly.
On the right side of the Print manager screen, several options are available regarding the output and layout:
“Layout”: The layout determines how many images will print on a single page. The desired layout can be
selected from the drop-down box:
The print preview will be adjusted accordingly. The rows and columns number is limited to “7” (49 images
per page maximum).
The “+” and “–” buttons are grayed out in iQ-LITE. They are normally used to add new layouts or delete
existing layouts and store this for later use. As it is not possible to store information on a medium, these
options are not available.
“Page controller”: The page controller gives information about how many pages will be needed for
printing the selected images. If more than one page will print, the slider bar can be used to navigate
between viewing the different pages. Drag the slider to the desired page or click in the page controller
bar to the left or right of the indicator to move one page at a time in the respective direction.
“Print text overlay”: The text overlay for the images will be printed if checked.
“Print page header”: The page headers with the patient information will be printed if checked.
NOTE:
If images from more than one study/patient are selected for print, the page header will only print the details of
the first study. To avoid confusion, be sure to keep the “Print text overlay” activated and deactivate the “Print
page header.”
“Text background”: Activating this option will put a black bar behind all elements of the text overlay so
that the white text overlay will always be readable, even if the images are very bright.
“Reduce print job size”: In the standard Windows® print mode, print jobs from iQ-LITE can sometimes
become very large (up 100 MB). This may lead to longer transmission times to a Windows® printer or buffer
overflow errors if the printer does not have enough memory. Checking the “Reduce print job size” may
prevent these issues by transmitting less data to the printer.
“Real-size print”: Using the “Real-size print” option, it is possible to print images on a DICOM printer in real
size (1:1 print). This function is only available in iQ-VIEW / PRO.
The editing of images in Print manager can be done on the image or series level (except for drag/drop and
the deletion of images). The selection is made using the “Scope” buttons at the top of the screen:
“Image scope”: Select scope on the image level if modification (window or zoom/pan) should
only happen to a single image.
“Series scope”: Select scope on the series level if the entire series should be modified (window or
zoom/pan).
Various tools can be used to edit the images shown in the preview windows. The active tool is displayed with a
yellow frame.
“Zoom/Pan”: An image can be moved by pointing to the middle of it (pan zone) and pressing the
left mouse button while moving the mouse. The mouse pointer turns into a hand when pointing to
the middle of the image. To enlarge the image, point to the periphery of the image (zoom zone)
and hold the left mouse button down while moving the mouse up (to enlarge) and down (to
minimize). The mouse pointer becomes a magnifier symbol when pointing to the edge of the
image. The zoom/pan will affect only the selected image or the entire series, depending on the
scope selected (image or series).
NOTE:
Please note that due to the presentation states (PR) now used to display and cache changes in DICOM
images, the handling of zoom/pan has changed to adhere to the specifications laid down in the DICOM
standard. Therefore, zoom out will only scale down to a “fit-in” size and not smaller since this is not defined in
the DICOM standard. Panning continues to work even if the images were not zoomed first.
“Windowing”: The brightness and contrast of an image can be manually adjusted by pressing the
left mouse button and moving the mouse up/down or left/right while hovering over the image. The
mouse pointer turns into a circle with a white and black side when the tool is activated.
Windowing changes will affect only the selected image or the entire series, depending on the
scope selected (image or series).
“Drag/Drop”: With drag/drop, images can be moved into another position (tile) if a layout is
chosen that contains more than one image per page. Note, however, that images can only be
moved within the filled tiles. For example, in a 3x3 tiling with only 6 tiles filled, images can only be
switched in the first 6 tiles. The last 3 tiles cannot be used.
“Delete”: The delete function removes either single images or entire series, independently of the
set scope (image or series). Upon activation, the mouse pointer will change into an eraser symbol
when hovering over an image. The following options are available:
Once the delete tool is activated, click the individual image or one that is part of the series to be
deleted. This only removes the image(s) from the Print Manager and does not affect what is
displayed in the viewer.
NOTE:
One image must always remain in the preview to avoid blank printed pages.
After selecting the various print options discussed above, click the “Print” button to send the print
job to the selected Windows® printer.
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