SECTION C

Additional Operations

The basic procedure for acquiring images and sending images to the output devices is
covered in section B. This Section includes some additional operations that can be
performed during image acquisition.

CONTENTS

SECTION C ADDITIONAL OPERATIONS................................................................................... 1

W ORKING WITH THE CURRENT STUDIES ........................................................................................ 2

ADJUSTING TECHNIQUE SETTINGS .............................................................................................. 10
ADDITIONAL OPERATIONS IN VIEW W INDOW ................................................................................ 18

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Working with the Current Studies

The Exam window with the selected study/studies is showed as below.

Study Control Panel

Figure 1: Exam window

When the study (ies) opens in the EXAM interface, you can perform following procedures.

To Add a New Study

1. Click “New Study” button located in the top left of Study Control Panel, shown in the
following figure:

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Figure 2: New study button

2. The New Study window displays, as shown below. Specify the Accession Number
and select a procedure.

Figure -3: New Study window

3. To save the study information, click the “OK” button.

To clear the study information and reenter it, click the “Clear” button.

To cancel entry of the study information, click the “Cancel” button.

When the study is added successfully, it will be indicated in the Study Control Panel as the
following figure.

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Figure -4: the new study displayed

To Edit Study Information

With Edit Study function, you could edit study information when you find it is incorrect.

1. Click “Edit Study” button located in the middle top of Study Control Panel, shown in
the following figure:

Figure 5: Edit Study button

2. The Edit Study window displays, as shown below. Modify the information according
to actual requirements.

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Figure 6: Edit Study window

To save the study information, click the “OK” button.

To clear the study information and reenter it, click the “Clear” button.

To cancel entry of the study information, click the “Cancel” button.

To Add a New View

If you want to recapture an image that is already included in the study, you can add a new
view.

1. Click “New View” button located in the right top of Study Control Panel, shown in
the following figure:

Figure 7: New View button

2. New View window displays, as shown below.

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Figure 7: New View window

3. You can select a desired view from drop-down list. The drop-down list only contains
views of the current procedure.

To save the view information, click the “OK” button.

To cancel entry of the view information, click the “Cancel” button.

4. You can now select this view to acquire image.

Figure 8: New View added

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NOTE: The new added view(s) information just stored in the memory before capturing, so
when close the study without capture image(s) for the new added view(s), the new
view(s) would not exist when you re-open the study.

To Change the Order of Image Acquisition

Image area displays the views to be acquired and thumbnails (minimized views) of
images already acquired, as shown below.

Figure 9: Image Area

By default, the views to be acquired are arranged sequentially from left to right as images
are acquired. However, you can change the exposure order just by clicking on the icon
of the view you want to take next.

To Switch between Studies

You can have multiple studies open at a time for the current patient. All the studies are
listed in Study List on the Study Control Panel. The current study is displayed with a
different color.

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Figure 10: Study List

You can switch between studies by clicking the related item in Study List, and the new view
icons associated with this study appear on the Image Area.

Figure 11: The new view displayed when current study is changed

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To Close Current Studies

Users can close current studies by clicking the Close button located in the right bottom of
EXAM window.

 For study with not all the images being captured, the closing operation will change
the status of this study into IN PROGRESS, and return to Worklist window. You can
proceed on taking exposures by retrieving the study from worklist page;

For study with all the images being captured, the closing operation will change the status of
this study into COMPLETED, and return to Worklist window. The completed study will exit
in the worklist page for a certain period, and you can supper add exposures to the study by
retrieving the study from worklist page.

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Adjusting Technique Settings

In the Exam window, the Technique Settings panel is shown as below:

Figure 12: Technique Settings panel

From the Technique Settings panel you can:

 Adjust exposure settings manually.

 Adjust exposure settings using AEC (Automatic Exposure Control); this includes selecting
one or more AEC fields, and adjusting default density settings.
 Select a focal spot size.
 Select a patient size setting.
 Check the Heat status of the tube.
 Check the orientation of the Bucky

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Each of these controls is described in detail in the following sections.

Adjusting KVP

The range of KVP adjustment is confined by the generator. For CPI generator, it is from 40
～150kVp.

Figure 13: KVP setting

To adjust the KVP value, click on the arrow buttons located to the right of the KVP value
field. The KVP value increases and decreases in steps of 1 KVP. Pressing and holding the
button causes displayed KVP value to increase or decrease automatically until the button
is released. If the KVP value reaches maximum or minimum, the value will remain
unchanged, and a warning message will appear for reminding.

Adjusting Exposure timing using TIME settings

You can manually specify exposure timing by setting the MA and the TIME value. When
using the Time settings (shown below), the exposure is terminated when the specified
time value is reached. This mode is used when a specific time must be achieved, such as
in a breathing study or for stop motion. Regarding the reciprocal grid’s requirement on
exposure window, the TIME value should be guaranteed above 50 when the system
employs reciprocal grid.

To specify the exposure by Time setting, make sure the Time button in the Exposure
Control panel is selected (shown below), then click on the arrow buttons located to the
right of MA/TIME value field to set the desired values. The value increases and decreases
in steps of one unit. Pressing and holding the button causes the value to increase or
decrease automatically until the button is released. If the value reaches maximum or
minimum, the value will remain unchanged, and a warning message will appear for
reminding.

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With the Time button selected, the Mas controls are dimmed. Since the TIME settings
and Mas setting are dependent to each other. Changing MA/TIME values causes the
MAS value changes.

Figure 14: TIME Setting

Adjusting Exposure timing using Mas setting

You can manually specify exposure timing by setting the MAS value (shown below). With
Mas button selected, the exposure is terminated when the specified MAS value is
reached.

To specify the exposure by Mas, ensure the Mas button in the Exposure Control panel
is selected, and then click on the arrow buttons located to the right of MAS value field to
set the desired value. The value changes by one unit each time that you click on an up or
down arrow. Pressing and holding the button causes the value to increase or decrease
automatically until the button is released. If the value reaches maximum or minimum, the
value will remain unchanged, and a warning message will appear for reminding.

Figure 15: MAS Setting

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With the Mas button selected, the Time controls are dimmed. Since the Time settings and
Mas setting are dependent to each other. Changing MAS value causes the MA/TIME
value changes.

Changing AEC Settings

The Automatic Exposure Control (AEC) system monitors X-radiation dosage which is
passing through ion chambers and automatically terminates the exposure after the
X-radiation dosage reaches a predetermined amount of radiation.

NOTE: The default density (0) is calibrated for normal contrast and density levels. Larger,
heavily muscled patients will require an increase in density. Smaller, lightly muscled
patients will require a decrease in density. However, only use this density adjustment if
the image is grainy. If an image is too dark or light, adjust the ESA settings (refer to the
followed topic "Changing the ESA Settings of an Acquired Image"); do not adjust AEC.

Typically you use the AEC and detector field default settings. You can override them
under special circumstances (for example, the patient has only one lung).

Figure 16: AEC Settings

NOTE: When using the AEC function, the patient must be positioned over the enabled AEC
field and the radiation field must be larger than the AEC field. In cases the preferred
radiation field is smaller than the AEC field, manual techniques are recommended.

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You can select AEC detector fields in each ion chamber individually or in any combination.
You can vary the density setting between +5 and -5 (0 is neutral).

To change the density setting, click on the up or down arrow button located to the right
of DEN value field, as shown above. The value increases or decreases by 12.5% each
time, as indicated in Table 1.

Table 1: Density Settings, as Percent of MAS

Density Setting Percent of MAS

+5 162.5%
+4 150.0%
+3 137.5%
+2 125.0%
+1 112.5%
0 100%
-1 87.5%
-2 75.0%
-3 62.5%
-4 50.0%
-5 37.5%

If the AEC system attempts to exceed the backup Mas limit setting,
the exposure is terminated and the message “AEC BACKUP MAS” is
displayed in the Message Panel of Exam window.

Selecting the Focal Spot Size

To select the focal spot size, click on the corresponding size button. The selected button
is highlighted by a white border.

NOTE: If the selected Focal Spot Size is not compatible with the tube and focal spot, the
system inhibits exposure and displays an overload condition. An overload condition
may exist if the technique selected exceeds the maximum or is below the minimum
allowable X-ray tube focal spot rating. The tube parameters are consistent with the
X-ray tube manufacturer's rating charts.

Figure 17: Focal Setting

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Selecting the Patient Body Type

To select a body type, click on the icon for the required type—paediatric, Small, Medium,
and Large. The selected button is highlighted by a white border.

Figure 2: Patient Size

NOTE: If heat units exceed the recommendation of the X-ray tube manufacturer, a warning
message will display to notify you of this condition. You will not be able to take more
exposures until the tube cools down.

Heat Units Status

The current heat units (HU) percentage is displayed in the Technique Settings panel, as
shown below.

Figure 18: HU Status

Detector Temperature

The current detector temperature is displayed in the Technique Settings panel, as shown
below.

Figure 19: Detector Temperature

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Bucky Orientation

If the Bucky can rotate, its orientation is displayed in the Technique Settings panel, as
shown below.

Figure 20: Bucky Orientation

Generator

The status of generator is displayed in the Technique Settings panel, as shown below.

Figure 21: Generator Status

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Conventional Mode

In Exam window, any time you click the Conventional Mode button, the system will
switch to Conventional X-ray Mode.

Figure 22: The Conventional Mode button

Figure 23: Conventional Mode window

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Additional Operations in View Window

After taking an exposure, the acquired image will be loaded into the View Window
automatically for processing.

Figure 24: The View window

You can perform the following processes as:

 Verify patient and exposure information.

 Selecting ESA or IT.
 Cropping the image.
 Changing the look-up table (LUT) or Exam-Specific Algorithm (ESA) of the image.
 Adding comments to the image. The comments will be sent with the image to DICOM
workstations.
 Adding markers to the image.
 Rotating or mirroring the image.
 View the image in full size.

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Cropping an Image

When an image has been captured and is displayed in the View window, you can crop the
image for output to a DICOM print or storage device.

When you accept the image, the full image along with any cropping information, is stored
in the local disk and can be recalled for cropping again within a period of time. Meanwhile,
the cropped image is sent to the DICOM output device.

To display the crop lines (if not already displayed), click the Crop button in the View
Panel of the View window. Two pairs of vertical and horizontal crop lines display in the
image area. The cropped image is defined by the rectangle formed by the intersection of
the four crop lines.

Figure 24: two status of Crop button (Crop and Remove Crop)

To move a crop line, put mouse on the line, when the mouse shape is changed to
horizontal or vertical arrow, press the left button of mouse and drag the line to the desired
position.

To move a corner of crop rectangle, put mouse on the corner, when the mouse shape is
changed to diagonal arrow, press the left button of mouse and drag the two lines of the
corner to the desired position.

To move the crop rectangle as a whole, put mouse on the interior area of the rectangle,
press the left key of mouse and drag the rectangle to the desired position when the mouse
shape is changed to hand shape.

To remove the crop lines and not crop the image, click the Remove Crop button in the
View Panel. After Crop button being clicked, the button is changed to Remove Crop.

To change another crop size, choose one item from the clip size drop-down list ，the
items in the drop down list represent standard film size with inch being unit.

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Figure 25: Crop Size List

Selecting ESA or IT

The Digital Radiography Operation Console supports both ESA algorithms to adjust the
image contrast and Inverse Topography (IT) algorithms to enhance the image based on
the anatomy selected. If current applied algorithm is ESA, the title of the button is ESA.
You can click it to apply IT algorithm instead. If current applied algorithm is IT, the title of
the button changes to IT. You can click it to apply ESA algorithm instead.

Figure 3: ESA /IT button

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Changing the ESA/IT Setting or Adjusting the LUT

When previewing an image, you can modify the LUT settings of the image. The LUT
controls the minimum and maximum densities used in the printed or viewed image.

When the system is installed, customized default ESA (Exam Specific Algorithm) settings
are configured for each procedure type. The image’s original LUT is created by applying
the procedure’s specified ESA settings to the image data.

Typically, you need to change the LUT only for patients with health conditions that may
affect the image quality, such as emphysema for chest views.

To modify an image’s LUT, drag one of the three square handles of the graph line until
the image shows the way you want. If the top or the bottom one is moved out of display
are and is invisible, one the middle one can be dragged. You can also press and hold the
right mouse button, and move the mouse on image preview area to change the LUT.
Vertical movement changes window width of LUT, horizontal movement changes window
level of LUT.

Figure 27: ESA curve

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To change the ESA/IT setting used for the image, choose the desired ESA setting from
the drop-down list:

Figure 28: Drop-down list of ESA/IT setting

Working with Comments

Figure 29: Comment button

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By clicking Comment button, you can add a customized label which will be displayed on
the image, or add a text comment into the Image Information (DICOM info).

Click Comment button, Add Image Information window displays as the following figure.
You can add information into image in this window.

Figure 30: Add Image Information page

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To add a customized label:

1. If the label information you want to add is in the predefined list, choose the
associated checkboxes;
Otherwise, choose the checkbox for Other Reason and input the information into the
text field;
2. Click Label button to add the label(s). The Add Image Information window closes
and the label(s) display(s) on the image Area of View window.

Figure 31: The image with added New label

To add a text comment:

If the comment information you want to add is in the predefined list, choose the
associated checkboxes; otherwise, choose the checkbox for Other Reason and input the
information into the text field;

Click Comment button to add the comment(s). The Add Image Information window
closes and no comments display(s) on the image area of the View window. To see the
added comments please refer to the topic “To View Additional Information” in Section

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D. When adding a text comment, the comment will be sent along with the image data to
display workstations, and hardcopy output devices. Display workstations at your site may
or may not offer the capability to view text comments. Also, the comment fields may
not be selected for display on the printed images from a hard copy device. When you
review the local image using DROC application, you can preview the image icon and the
comments information.

To discard entry of comments, click Cancel button. The Add Image Information
window closes and no comments are added on the image.

NOTE: It is up to four markers and/or comments that could be added on the image.

Adding Markers to an Image

These markers can be used to designate left and right, the position of the patient.

Figure 32: Marker buttons

To add a marker to the image, click on the marker button. The added marker displays on
the top left corner of the image. The added marker could be dragged to wherever you
want on the image within the cropping area.

NOTE: It is up to four markers and/or comments that could be added on the image.

Removing the Marks and Comments

Clicking Remove button that located under Add Comments button, all of added markers
and comments are removed from the image.

Figure 33: Remove button

Rotating the Image

The image can be rotated 90° (right) or 270° (left) clockwise as required. It is

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recommended that, if the image is rotated, you use markers to designate either left or right
rotation.

Figure 34: Image Rotate buttons

Mirroring the Image

The image can be mirrored by clicking Mirror button.

Figure 35: Image Mirror button

Checking the Patient and Exposure Information

In Information Area of the View window, you can see the patient/study information and
the real exposure dose which could be displayed when use AEC

Figure 36: Information Area

Viewing Full Size Image

Figure 37: Full Size/Fit to Window button

Click the Full Size button; you can view the image in full size by holding the left mouse
key pressed and moving mouse to desired direction. In Full Size mode you can only view
the image, cannot permitted to crop, rotate and do other operations. To enable such
operations, you must return to Fit Window mode. After Full Size button is clicked, it
changes to Fit to Window button. By click Fit to Window button, you can return to Fit

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Window mode. And the button changes to Full Size button.

Figure 38: Full Size viewing

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