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Vtools User Manual

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Vtools User Manual

Software for hospital user manual

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Available Formats

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Vision Tools Workstations

User Manual

Vision Tools

User Manual
Doc Ver : 1.15

Note :
This manual is intended for use with all Vision Tools Family of products , describing all features and
modules available in the application .
According to the specific Vision Tools product you have , features and modules will be disabled or
enabled according to your licensed application and the product family member (e.g. multiview ,
radview, sonopro, mammoview ,.....etc.) most of the features will be available in the MultiView
version of the product as it is a general viewer for all modalities.

MILLENSYS Contacts

©MILLENSYS Page 1 of 136

Web site
- www.millensys.com

Email
- Sales : sales@millensys.com
- Support : support@millensys.com

All material contained in this document is copyright MILLENSYS.

MILLENSYS and Vision Tools Logo are trademarks of MILLENSYS.
Microsoft and Windows are trademarks of Microsoft Corporation in the United States and other
countries.
The information presented in this document is correct at time of going to press. However, it is subject to
change without notice.
This document may not be photocopied, reproduced or translated into another language, in whole or in
part, without the consent of MILLENSYS.

Application User Guide.

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Table of Contents
TABLE OF CONTENTS.............................................................................................. 3
1 INTRODUCTION ........................................................................................ 6
1.1 VISION TOOLS FAMILY OF PRODUCTS............................................... 7
• VISION TOOLS MULTIVIEW | PACS WORKSTATION ........................... 7
• VISION TOOLS RADVIEW | FOR RADIOGRAPHY CR/ DR MACHINES ... 7
• VISION TOOLS MAMMOVIEW | FOR MAMMOGRAPHY MG / CR/ DR
MACHINES ................................................................................................ 7
• VISION TOOLS OPERA PRO | FOR X-RAY AND ANGIOGRAPHY
MACHINES ................................................................................................ 8
• VISION TOOLS CTVIEW | FOR COMPUTED TOMOGRAPHY "CT"
MODALITIES.............................................................................................. 8
• VISION TOOLS MRVIEW | FOR MRI MODALITIES .............................. 8
• VISION TOOLS CATHVIEW | FOR VASCULAR CATHLAB MODALITIES .. 8
• VISION TOOLS 3DVIEW | ADVANCED VISUALIZATION 3D
APPLICATION. ........................................................................................... 9
• VISION TOOLS SONOPRO | FOR COLOR DOPPLER AND ECHO
ULTRASOUND MACHINES.......................................................................... 9
• VISION TOOLS ENDO | FOR ENDOSCOPY, LAPAROSCOPY,
ARTHROSCOPY, …, MACHINES................................................................... 9
• VISION TOOLS GVIEW | FOR NM MACHINES .................................... 9
2 LOGIN SCREEN ........................................................................................ 10
2.1 MAIN SCREEN AND NAVIGATION ................................................... 10
3 EXAM LIST (WORKLIST\DIRECTORY) ....................................................... 11
3.1 MAIN SCREEN AND NAVIGATION ................................................... 11
3.2 QUICK SEARCH TOOL ..................................................................... 12
3.3 QUICK TOOLS................................................................................. 12
3.4 ADVANCED SEARCH ....................................................................... 13
3.5 CREATE USER FILTERS .................................................................... 13
3.6 IMPORTING STUDIES...................................................................... 14
3.7 VIEW MENU................................................................................... 15

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3.7.1 PATIENT DATA VIEWING ...................................................... 15

3.7.2 VIEW CHART REPORTS ......................................................... 15
CHARTS SETTINGS ..................................................................................... 16
3.8 ARCHIVE MULTIPLE PATIENTS ........................................................ 17
3.9 ARCHIVE SELECTED PATIENT TO CD-DRIVE ..................................... 17
3.10 CREATING CINE DICOM CD ........................................................ 18
3.11 ARCHIVE MANAGER .................................................................. 19
3.12 TRANSFER MENU ...................................................................... 20
4 IMAGE VIEWER ...................................................................................... 21
4.1 MAIN SCREEN AND NAVIGATION ................................................... 21
4.2 STUDY\SERIES\IMAGE NAVIGATION ............................................... 22
4.3 SAVE\EXPORT IMAGES ................................................................... 23
4.4 IMAGE MANIPULATION ................................................................. 25
4.5 WINDOW\IMAGE SELECTION ......................................................... 27
4.6 IMAGE LOCKING FUNCTIONS ......................................................... 28
4.7 IMAGE ANNOTATION ..................................................................... 28
4.8 SERIES SYNCHRONIZATION (FOR CT AND MRI) ............................... 31
4.9 HANGING PROTOCOLS ................................................................... 32
4.10 VIEWING SETTINGS ................................................................... 39
4.11 IMAGE PROCESSING .................................................................. 42
4.11.1 APPLYING FILTERS ................................................................ 42
4.11.2 IMAGE INVERT\ROTATE\RESIZE\CROPPING......................... 43
4.12 MEASUREMENT TOOLS ............................................................. 43
4.13 DISPLAY IMAGE INSET\SCAN LINES (FOR CT AND MRI) ............... 45
4.14 FILMING .................................................................................... 48
4.14.2 ADD IMAGE TO FILM ............................................................ 49
4.14.3 FILM PRINTING ..................................................................... 50
4.14.4 FILM PRINTING QUEUE ......................................................... 50
4.14.5 CHANGE PRINTING SETTINGS ............................................... 50
4.14.6 WINDOWS PRINTING ........................................................... 51
4.14.7 CUSTOMIZED TEMPLATE PRINTING ...................................... 53
4.15 FILM DESIGNER ......................................................................... 58
5 OPTIONAL ADVANCED POST PROCESSING TOOLS .................................. 59
5.1 MPR (MULTI-PLANAR RECONSTRUCTION) (FOR CT ONLY)............... 59
5.2 MIP (MAXIMUM INTENSITY PROJECTION) (FOR CT ONLY)............... 59
5.3 IMAGE STITCHING (OPTION FOR XRAY CR AND DR ONLY) ............... 65
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TO EXIT STITCH WINDOW AND GO BACK TO WINDOWS MODE ............... 66
5.4 QCA (QUANTITATIVE CORONARY ANALYSIS) (OPTION FOR CATHLAB
ONLY) ..................................................................................................... 67
5.5 QLVA (QUANTITATIVE LEFT VENTRICLE ANALYSIS) (OPTION FOR
CATHLAB ONLY) ...................................................................................... 70
5.6 VOLUME RENDERING TECHNIQUE (VRT) (OPTION FOR CT ONLY) .... 76
5.6.1 GALLERY ............................................................................... 77
5.6.2 UNDERSTANDING GUI .......................................................... 78
5.6.3 SEGMENTATION ................................................................... 78
5.6.4 ANNOTATIONS AND MEASUREMENTS ................................. 84
5.6.5 CAPTURING RECONSTRUCTION ............................................ 85
5.6.6 VIRTUAL COLONOSCOPY ...................................................... 88
5.6.7 CAPTURING RECONSTRUCTION ............................................ 94
5.6.8 VESSEL ANALYSIS.................................................................. 96
6 ADVANCED REPORTING TOOLS (OPTION) ............................................ 107
6.1 MAIN SCREEN AND NAVIGATION ................................................. 107
6.2 VIEW EXISTING REPORTS ............................................................. 108
6.3 WRITE REPORTS USING EXITING TEMPLATE ................................. 109
6.4 TEMPLATE\SECTIONS MANAGEMENT .......................................... 110
6.5 VOICE NOTE RECORDING ............................................................. 111
6.5.1 VOICE PLAYBACK FUNCTIONS ............................................ 111
6.5.2 VOICE RECODING\EDITING................................................. 111
6.6 MANAGE REPORT VERSIONS ........................................................ 112
6.7 MANGE USER PROFILE SETTINGS ................................................. 113
6.7.1 MANAGE USER PROFILE ..................................................... 113
6.7.2 CUSTOMIZE DEFAULT SETTINGS ......................................... 114
6.7.3 DICTATION TAB, DICTATION SHORTCUTS........................... 126
7 USER PROFILE SETTINGS....................................................................... 127

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1 Introduction

Vision Tools is a powerful stand-alone PACS workstation for viewing, processing and managing medical images
from different modalities (FDA 510K cleared).
With its archiving capabilities, static and dynamic image viewing, variety of processing tools, printing features and
reporting, the Vision Tools MultiView application can be considered as an ideal solution for most doctors and users
who need to increase their daily diagnosis productivity aiming to an improve of the provided patient healthcare
service.
Vision Tools suites almost all of the daily activities of any physician in a low cost of ownership and high content
solution that is scalable to any organization.
Stay up-to-date with MILLENSYS automatic updates feature that keeps the Vision Tools application updated to the
latest version with new features and bug-fixes.
Combining Vision Tools with MILLENSYS Cloud PACS "Vision Tools Workspace" decreases the diagnosing time
through the powerful included tools leading to an increase the productivity of all the users dealing with PACS.

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1.1 Vision Tools Family of products

Vision Tools has a wide variety of workstation software that suites almost all modalities
described as the following

• Vision Tools MultiView | PACS workstation

The Vision Tools MultiView system is a complete digital station that can handle up to
four different machines at the same time. Very cost effective in that one MultiView
station can be a complete medical imaging network by itself. It also supports medical
monitors.

• Vision Tools RadView | For Radiography CR/ DR

Machines
Vision Tools Radview is a powerful viewing station for CR/DR machines. Vision Tools
Radview is provided with the Visual Filming feature which let the user make an
impressive looking film in just few seconds.

• Vision Tools MammoView | For Mammography MG /

CR/ DR Machines
Vision Tools MammoView is a very powerful and scalable viewing station for
mammography. Provided with mammo hanging protocols , CAD overlay display , Visual
Filming feature which let the user make an impressive looking film in just few seconds
plus a sophisticated mammography structured reporting tool.

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• Vision Tools Opera Pro | For X-ray and Angiography

Machines
OperaPro station can convert the non-dicom C-ARM and X-ray into a dicom one
providing huge amount of functions and facilities for image information, archiving and
processing. The OperaPro system can do online and offline DSA "Digital Subtraction
Angiography" and Road Mapping. The study can be archived on a DICOM 3.0 CD-R
media with just one button click.

• Vision Tools CTview | For Computed Tomography "CT"

Modalities
Ideal workstation for CT machines to acquire, view and process CT images and report.
Vision Tools CTview system can print CT images direct to any DICOM printer. This is a
major effective function of CTview that any non-dicom CT machine could print CT films
on newer dicom printers [wet/dry] or 3M Protocol legacy imagers.

• Vision Tools MRview | For MRI Modalities

Ideal workstation for MRI machines to acquire, view and process MRI images and
report whether it’s DICOM or Non-Dicom. Print images directly to any dicom printer
[wet/dry] or 3M Protocol legacy imagers.

• Vision Tools CathView | For Vascular CathLab

Modalities
Powerful and complete digital cine processing station that can do digital image and cine
loop acquisition directly from the CathLab machine (whether it is an analog or a digital
one), cine playback, frame forwarding, rewinding, pausing, all this using an infrared
remote control unit [wireless]. All patient study can be archived on a DICOM 3.0 CD-R
media with just one button click.

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• Vision Tools 3Dview | Advanced Visualization 3D

application.
3D volume reconstruction for Ultrasound, CT, MRI images. Added on any of the vision
tools workstations to provide 3D volume render and provide functions for adjustment
and processing in 3D. Recently Virtual Endoscopy feature has been added.

• Vision Tools SonoPro | For Color Doppler and Echo

Ultrasound machines
Designed to be very powerful for acquiring [more than 250,000 images], viewing and
processing color US images and complete Cine loops. Superior quality multi format
color image printing on glossy papers [up to 16 images per page]. Reporting tool to
view and edit patient reports with automatic reporting tool.

• Vision Tools Endo | For Endoscopy, laparoscopy,

arthroscopy, …, Machines
It is a powerful system to acquire, view and process Endoscopy images and long cine
loops. Write patient report in automatic way. Superior quality image printing on glossy
papers [up to 24 images per page]. Archiving patients on CD-R.

• Vision Tools GView | For NM Machines

Acquire, view and process NM images and patient reports. Print color NM images with
superior quality on glossy papers.

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2 Login Screen

2.1 Main Screen and Navigation

The Main Screen of Vision Tools is the screen which the program begins with and from
which the user can reach any tool that can be used in the program like study image
browsing, image manipulation & processing files & cine loops, printing films,
writing/dictating reports and returns as well and many other tools that will be
explained in details.

Figure 1.1 - Main Workspace Screen

The multilingual core of the Vision Tools is very important to have a localized version of
Workspace to suite every country.

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3 Exam List (Worklist\Directory)

3.1 Main Screen and Navigation

Figure 1.4 - Main Screen for Exam List

Default patient list grid is showing default\most commonly used columns including
demographics and exam details

Users can customize their own grids, searching filters, customize icon features, opening
patient history, burning CD's, importing studies and sending studies to other DICOM
server from their user profile, this will be described later in the manual.

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3.2 Quick Search Tool

Figure 1.5 - Inline Search

Quick search above the grid is a tool helps query studies using most common fields
such as modality type, facility\branch, study\exam date...etc.

3.3 Quick Tools

use the mouse right click button to select quick
tools .

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3.4 Advanced Search

By using advanced search button [from search menu ] will give you more search fields
to search on studies.

Figure 1.6 - Advanced Search

This tool is used to define more search criteria to get specific studies for diagnosing and
reporting, after applying your search criteria

3.5 Create User Filters

All users can save their own search criteria to be as a search filters and to be used
faster later on.

From advanced search (Figure 1.6) - Users will define any search criteria then select
[Add] to type a name for your own fast search filters (as shown in Figure 1.7).

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Figure 1.8 - Saved Search Filters

All saved search filters will be saved automatically to each user's profiles and will be
displayed as buttons above the grid as shown on Figure 1.8
In order to activate them just press on the button, this will trigger the search criteria
defined

3.6 Importing Studies

Import patients and add them to the patients’ database [from files / import
menu or from shortcut import button] from a certain folder whether the
patients’ files are DICOM or with p_info.inf file. After choosing this
option an Import Studies form will appear, choose the type of the patient
file and whether to copy the patients to the patients’ directory or to
leave them, in case of copying choose whether to delete the original files or
not.

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3.7 View Menu

The view menu deals with the viewing of the patients’ data and statistical
charts giving reports about the patients, exams, doctors, machines, modalities
and combined reports.

3.7.1 Patient Data Viewing

1. Open Patient Data: This option will open the selected cine loop from
the data list box in the cine tool.
2. Open Image Display Tool: This option will open the images of the selected
patient in the display tool.
3. View Selected patient Images: This option will open the selected patient
images in a list beside the patient list.

3.7.2 View Chart Reports

This option enables the user to make many statistical analyses on the
radiology department as a whole. These statistics are:
1. Number of patients per machine.
2. Number of patients per exam.
3. Number of patients per exam for a specific machine.
4. Number of patients per doctor.
5. Number of patients per reference doctor.
6. Number of patients per modality.

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Charts Settings

1. Legend: Show or hide the chart details which appear in a box to the left
of the chart.
2. Wall: Show or hide the background.
3. 3D: View the chart in 2 dimensions or volumetric 3 dimensions.
4. Colored: View the chart with colors or with grey color only.
5. Back Color: Change the background color.
6. Axis: Show or hide the axis of the chart.
7. Include empty items: Show or hide the items with no data.
8. Chart Type: View the chart as column or pie.
9. Rotate: Rotate the pie chart.

The charts can be printed from the Print button and can be copied
to the clipboard so that the user can use it in any application, this
can be done from the Copy button in the left bottom of chart form.

To return to the patient’s list of the directory tool press the

Hide button.

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3.8 Archive Multiple Patients

This option is used to archive many patients at the same time, it will open the
archive patients form which enable the user to archive all or some of the patients
data. The following steps explain how to use this option:
1. Select the archiving location, CD-ROM drive is default.
2. Select the patients to be archive, either the selected patients only or all
of the patients in the list.
3. Select the data to be archived.
4. Type the name, number and comment for the burned CD.
5. Press Archive button.

3.9 Archive Selected Patient to CD-Drive

1. Archives the current patient data to CDs.
2. On selecting this option a message will appear to inform total patient
data size in megabytes and total number of CDs required to complete this
task.

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3.10 Creating Cine DICOM CD

1. This option converts the cine loops of the selected patient to the
DICOM format and makes a DICOM dir file in the CD. This option can be
accessed from the main tool bar by pressing Create Cine DICOM CD .
2. After choosing this option a DICOM Cine Archive Tool form will appear.
3. Select one cine loops or more by holding the Ctrl key down and clicking on
the desired cine loops in the cine loops list, to select all of the cine cine
loops click on the Select All button below the cine loops list.
4. Click on show settings on the left bottom corner of the form to view
some extra settings for the created CD.
5. The images list at the right displays all the cine loops, if you double click on
any it will be played to the left of the images list.
6. The images list buttons are used to refresh, update, load and stop
loading the list.
7. To burn the CD press Create DICOM CD button.

Note:
To create an image DICOM CD select a patient then right click the mouse and
choose the Archive to CD-R option. A message will appear to inform total
patient data size in megabytes.

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3.11 Archive Manager

1. The archive manager option enables the user to know inforamtion about
all archived CDs.
2. The archived CDs appear in the Archive list.
3. The archived cases on the selected CD appear in the Archive details list.
4. The user can search for a specific CD within these CDs with the CD
number, comment, name and also within a certain period, press the
search button after entering the search keys in the appropriate fields to
begin search.
5. The user can search within the archived cases on the selected CD or
within all of the CDs for a specific case by Search in Displayed Details and
Search in All Details button. These two buttons will open the Custom
Query form to enter the search keywords to find the desired case.

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3.12 Transfer Menu

The Transfer menu is used if the VTools workstation is connected to a DICOM
server.

1. Send Selected Images to Dicom Server: This option will open the DICOM
Connections form which enables the user to send the selected images to the required
DICOM server from the list, the user can add or delete any DICOM server from this
form. After choosing the required server press the Send button or cancel the whole
process from the Abort button or by closing the form.

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4 Image Viewer

4.1 Main screen and navigation

The Image Tool will open on the assigned monitors (According to default settings
or default hanging Protocol)
The user can choose to view more than one image
in the main screen by choosing the Windows menu
then specifying the number of images to appear in
the main screen.

Default Mouse Actions *

Left Button Click: Pan selected image(s) by clicking

and holding the left click button and moving the
mouse.
Right Button Click: Change WW\WL or (B\C) of
selected image(s) by clicking and holding the right
click button and moving the mouse.
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Center Button Click: Zooming selected image(s) by clicking the center click button
and moving mouse forward (zoom in) and back (zoom out).
Center button scroll: this will change browsing of images down scroll will browse
next image and up will bring previous image
* User can change the mouse actions as desired.
4.2 Study\Series\Image Navigation

• Study Navigation:
-In case of more than one study found in TimeLine: Viewer will display
first the study that user already selected from patients list\worklist.
Other studies could be opened as mentioned in section 7.2

• Series Navigation:
- To view any series just “Drag & Drop” by left click.
-“Series Restricted Display”: If enabled, series will be displayed only on the
Window to which user dragged and dropped the series not to all windows.
Also user will not be able to browse the next series in the same window.

• Series Description:

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Under each series there is a description written in the form “(XX)|YY”
where “XX” represents the series number and “YY” represents number
of images of the series.
Example: (4750)|73 means that series number is 4750 and this series
has 73 images.

• Image Navigation:
To navigate images: By mouse scroll, Image Navigation Buttons or
keyboard shortcuts. Keyboard shortcuts could be configured in profile
settings.
- Image Navigation Buttons:

- Images list could be displayed as numbers or thumbnails according to user

profile settings.

4.3 Save\Export Images

There are some image saving and exporting options in “File” menu

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- Save as: Save selected image to directory without annotations and
modifications like zooming and without image information.

- Save in Current Series: Save modified image (with annotations, zooming &
WW/WL) to current selected series.

- Save Display as: Save image to directory with annotations and modifications
like zooming and with image information.

- Save Display in Current Series: Save modified image (with annotations,

zooming & WW/WL) to current selected series.

- Export Current Series As AVI: To save series list as a cine.

- Export Images As PPT: this function will export image to Microsoft

PowerPoint, Note: Microsoft PowerPoint should be installed on the PC

- Export All Images

As JPEG: Export all study images to directory.

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-

4.4 Image Manipulation

- Zooming:
• By mouse as mentioned in section 7.1
• By “Zoom bar”/”Zooming Options Buttons”

- Maxi
mize/Minimize:
Double click to maximize and double click to minimize. Also from

maximize\minimize button in the top left corner of each window\image.

- WW/WL:
• By mouse: Change WW\WL or (B\C) of selected image(s)by clicking
and holding the right click button.
• WW/WL Presets:

• In
addition to using mouse in changing WW/WL, user can select window
from “Window Presets” menu. User also can edit, delete and create
new ones.

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• In case of image have 2 or 3 ww\wl sent in the DICOM images and
created by the modality, user will be able to switch between these
windows through “W1”, “W2” and “W3” buttons.

• Pan Image: By clicking and holding the left click button.

• Navigate/Scroll Images: By mouse scroll. Also user can do it by left click
(hold) button (must set it first from right click menu options)

- Image Restore:
To restore original image, select “Restore Original” from right click menu.

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4.5 Window\Image Selection

- By default all windows\images are selected but only one is active.
Active window\image is highlighted by Gray color borders.

- One click on any window\image will set it to be active window\image.

- User can select\deselect one or more windows\images from the top left
selection mark.

- For fast selection:

One window\image selection: use the option

“Select Only This Window’ from the right click
menu.

Select/Unselect All, Select Current Row or Select

Current Column: From “Edit” menu

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4.6 Image Locking Functions

LOCK WINDOW WIDTH\LEVEL

Lock WW\WL feature is used to fix WW\WL adjustment while user browsing of
images. To enable\disable it go to Menu->Edit menu->Select Lock Window/Color
Adjustments or Press Button Lock WW\WL on the Toolbar

LOCK ZOOM

Lock Zoom feature is used to fix zooming adjustment while user browses images.
To enable\disable it go to Menu->Edit menu->Select Lock Zoom/Pan Adjustments
or Press Button Lock Zoom/Pan on the Toolbar

4.7 Image Annotation

There are many annotations that user can put on images like Arrow, Texted Arrow,
Text, Line, body marks and others.

ANNOTATION SETTINGS
In Order to change font and drawing settings From to Menu->Edit menu->Drawing
Settings and Menu->Edit menu->Font Settings.
Drawing Settings for the drawings like arrows and rectangles.
Font settings used to change settings of the text font of annotation.

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Drawing Settings Font Settings

ANNOTATION DRAWING
Select the annotation from “Annotations” menu or annotations shortcut in the
toolbar then start draw it directly on image using mouse left button click.
Note: Shortcuts could be configured from profile settings.

Toolbar Shortcuts Menu

Annotations drawing example:

(Arrow, Text Arrow, Text &
Body Mark)

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ANNOTATION COPY\PASTE\SAVING

• To copy\paste specific drawn annotation:

- Select “Selection Tool” from Annotations toolbar icons to select the drawn
annotation.
- Right click on any annotation and select “Copy”.
- Go to target image if the copied annotation will be pasted to another image.
- Select “Selection Tool” again.
- Left click and select “Paste”.

• To copy\paste all drawn annotations:

- Select “Copy Annotations” from Annotations menu.
- Go to target image if the copied annotations will be pasted to another image.
- Select “Paste Annotations” from Annotations menu.
- To save images with annotations review section 7.4

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4.8 Series Synchronization (for CT and MRI)
In right click menu select “Link/unlink selected windows” to apply/disable
synchronized viewing.

After applying:
After applying linking you will notice change in highlighted image border, for
synchronized windows

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Note: In order to link series, the windows should me Series Restricted Mode,
means each window would be configured to load certain series

4.9 Hanging Protocols

Compare studies – Create new hanging protocol:
Ex: will create a hanging protocol to compare current study with first prior study.
Screen 1 – current study - one series – one image
Screen 2 – first prior study - one series – four images

Step 1: Open “Hanging Protocols Manager”

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Step 2: Click “New” to add new hanging protocol

Step 3: Add screen in order to display this protocol on multiple screen , default it
will be displayed in only one screen

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Step 4: modify screen, this function is used to define no of windows in each screen,
select screen from the tree view on left , then modify no of rows and columns to
specify horizontal and vertical windows.

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Step5: select monitors, select each screen will be displayed on which physical
computer monitor, select screen from left tree, the press Screen Display, select
from Run This Screen On to select the monitor

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Step 6: in order to specify special selection of image to be displayed at which
window,Assign screen to current\prior study (User could compare current study
with up to 4 prior studies).

Step7:
Click “Next” 2 times then write hanging protocol name and save.

This new hanging protocol will appear in “H.Protocols” menu where user can select
and apply

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• To set this hanging protocol to be default one: Set is as automatic (Step6)

and after saving move it up to be in the top of the menu.
• Edit hanging protocol: either from “Hanging Protocols Manager” or
“Hanging Protocol Editor” which will open directly the displayed hanging
protocol to be edited.

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4.10 Viewing Settings

CHANGING DISPLAYING WINDOWS
User can change displaying windows and displaying images per each window.

CHANGING DISPLAYING WINDOWS:

Select the window from “Windows” menu. User can also add shortcuts for specific
windows to the shortcuts toolbar.

To select other design not found in the menu, select “Other Layouts” from the
menu then “Insert_Rows_Col”.

CHANGING DISPLAYING IMAGES PER WINDOW:

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Also from “Windows” menu then “Divide selected Windows To” or from the
shortcut button.

This is how windows will appear after applying “For Images”

from the “Windows” menu.

VIEW MPR\3D

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MPR\3D modules could be viewed from “Windows” menu as well as shortcuts
toolbar.
Note: this will require to have license to open MPR\3D modules, please system
administrator is giving the logged in user to open these modules from system
administration tool

“Windows” menu Shortcuts

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4.11 Image Processing

4.11.1 Applying Filters

From “Process” menu select and apply filters on the selected images.
And once user selects any option in the menu,
“Filters” window will open, in the tools panel
Either to apply predefined filters, from dropdown menu, and also used can select
filter save it as preset filter to be used in the future.

“Filters” window

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4.11.2 Image Invert\Rotate\Resize\Cropping

Image Invert, Rotate, Resize and cropping tools are found in “Process” menu and
could be added to shortcuts toolbar.
Rotate tools:

Resize Window: Cropping tools

4.12 Measurement Tools

“Measurements Tools” are found in “Process” menu and also are added by default
to shortcuts toolbar.

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• Distance
- Select Distance from the list.
- Move the mouse to the start point.
- Left click with holding.
- Move the mouse to the end point.
- Stop left click holding and measured distance will be written by the end
of the line.

• Angle
- Select Angle from the list.
- 3 left clicks: first one at the angle head point, second one at the end of
the first line and the third one at the end of second line.

• Rectangular Area & Ellipsoid Area

- Select the tool from the list.

- Left click with holding at the first point.
- Move the mouse to the end point.
- Stop left click holding and measured area will be written.

• Calibration tool
If image is not calibrated, measurements couldn’t be taken until user
calibrates the image.

- Select calibration tool from the list (Or user will be prompted to open it
when trying do measurements on non-calibrated image).
- Draw distance line on the image and write the distance
- After that you can use the measurement tools

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4.13 Display Image Inset\Scan Lines (for CT and MRI)

“Image Inset & Scan Lines” are found in “Process” menu and also are added by
default to shortcuts toolbar.

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• Inset from active image

This option will take the active image, and will use it as an inset image in all
selected images

• Inset automatic insertion:

Will automatically detect localizers of the study, if study have multiple localizers
system will display images to select one of them to apply inset on selected images .

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• Display scan lines from active

This option will take the active image, and will it apply scan lines to it

• Auto Display scan lines

Will automatically detect localizers of the study, if study have multiple

localizers system will display them to select one of them to display scan
lines of selected images on it.

• Image Inset\Scan Lines could be panned, moved, reset in position and

deleted (Select needed action from the menu).

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4.14 Filming

4.14.1.1 Create new film

To create new: Click “Filming Menu” and select “Film Designer” or click “Film
Designer” directly.

A new film design page will open

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4.14.2 Add image to film

To add images to film, drag and drop series to the film

To add a specific image to specific cell: Just 2 mouse clicks in order, the first one on

the film cell and the second one on the image number or image thumbnail (Images
could be listed as numbers or thumbnails according to user profile settings).

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4.14.3 Film Printing

• To print the current film only click the “Print Film” button

• User can create more than one film and print all of them by
one click on the “Print All Films” button.

4.14.4 Film Printing Queue

User can add films to print queue to print them later by the
“Queue Current Film” button or “Queue All Films” button.

To check status of the print queue click the “Open Print Queue”
button and the next screen will open

4.14.5 Change printing settings

User can select the printer, change film format and change film size

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4.14.6 Windows Printing

In addition to “Filming” user could print on windows\DICOM printers. All windows

printers defined will appear in printers list with DICOM printers.
DICOM Printers name will start with [DICOM] before printer name

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4.14.7 Customized template printing
User is able to create new templates through “Film Template Design” tool.
To open “Film Template Design” tool:

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Once the user click on the button two windows will open, Design window & saved
templates list.

Design Controls:
Her how to create a template with 2 windows. The first window for the scout
image and the second window for the axial series (2 * 2 images).

Click “New Template” button

Split the form

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Select the second window and divide it to 4 images

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Click “Save Template” button then write the template name and
click “OK”

This new template will be added to the saved templates list so that user
could select it later directly.

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4.15 Film Designer

Mouse functions:
• Action on images: Like Windows mode.
• Selection: User can select specific sell, row or column by mouse.

Right click menu:

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5 Optional Advanced Post Processing Tools
5.1 MPR (Multi-Planar Reconstruction) (for CT only)
Multi Planar Reconstruction (MPR) allows images to be created from the original
axial plane in either the coronal, sagittal, or oblique plane as well as special curved
and rotating plans.
MPR offer additional advantages for radiologist towards easier approach for
diagnosis as:
View Lesions from different angles
Better localization of lesions within the volume
Measurement of lesions on different axis

5.2 MIP (Maximum intensity projection) (for CT only)

MIP (Maximum intensity projection) on the other hand offers a very convincing
way to visualize CT Angiography cases, as its idea based on showing the highest-
attenuation voxels along lines projected through the volume data set, you can
control the projection direction and slap thickness easily using the MPR cross lines.

To open the MPR Module you need to select the required series from the left
series panel then Press the MPR button from the top toolbar

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1- Orientation cube: showing the image ordination in 3D to give a precise
information to the user.
2- Cross cut lines (color coded) each line will be represented on the view
port of the same color
3- Slice thickness: that will be used in during the image reconstruction and
rendering, this can be changed editing this number or manipulating the
vertical slider on the right of the image box.
4- Blend Mode: the is the blending method used while blending pixels of the
selected slice thickness
a. Max: The highest intensity pixels will be shown (contrast
enhanced objects, calcium plaques…)
b. Min: The lowest intensity pixels will be shown (Air, Fat…)
c. Avg: The average of all pixel intensities will be shown which will
give an overlapped image similar to the ordinary X-ray images.

As show in the below CTAngio case MIP is offering a superior advantage in

visualizing high intensity objects.

And this image showing average blending mode with X-ray like effect.

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Millensys MPR Module offers re-construction in

Orthogonal planes (Axial, Sagittal, and Coronal)
Oblique and double oblique (Obliquity in multi plans)
Curved (to straighten and visualize curved objects like vessels)
All of these variations give great flexibility tools toward identifying and localizing
lesions.

The screen shot bellow shows to apply the double oblique concept to visualize the
vertebral column as whole in one slice.

And this shows the ability of curved MPR to straighten and visualize the Aorta in
one slice

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MPR Series Creation:

Like MPR real-time browsing, MPR module has the ability to generate new series
from whatever projection and axis needed.

For Orthogonal series creation we can set the start and the end of the series and
fine tune from other viewports to have the exact location needed, then adjust the
slice thickness, spacing and the series label then click generate the application will
automatically calculate the reset and generates the series images, from the forth
viewport, user can review the series if it is ok, the pressing save will physically save
this newly generated series to this patient study.

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And in this screen shows how to create a new series from a curved plan for better
capturing of curved objects centered throughout the series.

And here we used the Spiral to rotate around the Aorta and get all possible capture
from 360 degree view

Tools panel guide:

1- Orthogonal MPR Mode
2- Oblique–double oblique MPR mode
3- Curved MPR mode
4- Reset all cut lines position
5- Reset all changes
6- Show hide options

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1- Orthogonal MPR series mode

2- Curved MPR series mode
3- Spiral MPR series mode
4- Total distance in mm (series start-end)
5- Slice spacing
6- Slice thickness
7- No of images to be created
8- Series title
9- Generate series preview
10- Save series
11- Delete the generated series preview

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5.3 Image Stitching (Option for Xray CR and DR only)

For better clinical diagnosis user can use the stitching option in Image Tool to
create composite image starting from its component images to get a complete
panoramic image which cannot be captured in a single scan .
For two images like below , stitching is used to create one image combining both
images in a smooth way

image stitching can be opened from Windows / Image Stitch menu.

following these steps:

The user should first choose Image Stitch option from Windows menu
2- The user then should select the first (upper ) from the tool box (Thumbnails)
3- Then selecting the lower image(s) maximum 2 images ( Total 3 individual
images)
4- Then using the stitch tools to align images and stitching them into one Image
5- After stitching the selected images user can save the output image (Stitched
image) using the save button.

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Please refer to the below figure for discovering Stitch tools
Move Image
To move image Right, Left , Up and Down (Also are done by mouse left click )
Zoom Image
To Zoom Image In and Out (Also are done by mouse middle click )
Rotate Image
To rotate image Clockwise and Anticlockwise (Also are done by mouse right click )
Auto Crop
Eliminates the unwanted black area around the image.
Save image
To save constructed (Stitched )image in a new series in the original study.
Reset
To clear the stitch window
Exit Stitch
To Exit Stitch window and go back to Windows mode

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5.4 QCA (Quantitative Coronary Analysis) (Option for
Cathlab only)
For using QCA feature you should open an angiography case and do the following,
a. Select any image from series or a frame from a cine loop (by pausing cine
loop using double click mouse action) that you would like to apply QCA
upon it,

b. Go to Process -> Cathlab then select Stenosis (QCA),

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c. In figure below, you should scroll to reach desired frame then press on
QCA button.

d. After that you will calibrate the image by using left click mouse on
catheter area and type the number of catheter used during the operation.

e. Finally you will draw the path that required to be analyzed from point of
perspective.

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5.5 QLVA (Quantitative Left Ventricle Analysis) (Option
for Cathlab only)
For using QLVA feature you should open a cardiac case and do the following,
a. First open the study and select required cine loop.

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b. To open QLVA go to Process -> Cathlab then select QLVA.

c. In figure below, you will follow few steps to get QLVA analysis,

d. First you should select ESV (End Systolic Volume) frame (by scrolling in
cine loop) then press on ESV button,

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e. Then you should scroll to get EDV (End Diastolic Volume) frame (by
scrolling in cine loop) then press on EDV button

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f. Then press this button Calculate LVA to continue,

g. Then you should draw line on catheter for calibration,

h. After that you will need to draw ESV & EDV outline on selected frame as
below, press on 1 button then draw outline for ESV.

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i. Then Press on 2 button to draw outline for EDV,

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j. Then Press done button to get your required analysis,

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5.6 Volume Rendering Technique (VRT) (Option for CT
only)
VRT module is one of MillenSys product, in scientific visualization and computer
graphics, volume rendering is a set of techniques used to display a 2D projection of
a 3D discretely sampled data set.
A typical 3D data set is a group of 2D slice images acquired by a CT, MRI, or
MicroCT scanner. Usually these are acquired in a regular pattern (e.g., one slice
every millimeter) and usually have a regular number of image pixels in a regular
pattern. This is an example of a regular volumetric grid, with each volume element,
or voxel represented by a single value that is obtained by sampling the immediate
area surrounding the voxel.

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5.6.1 Gallery

3Dview application module comes with a wide variety of presets that store the
settings used to create the 3D images. 3Dview has Real-time Preview of presets;
when you browse a preset, the preview window will show the effect of applying
that preset to your currently loaded volume dataset. You can create customized
presets. Presets can store more than just window width and level; all imaging
parameters can be saved in a preset allowing for highly customized capabilities.

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5.6.2 Understanding GUI

5.6.3 Segmentation

Segmentation refers to the process of partitioning a digital image into multiple

segments, The goal of segmentation is to simplify and/or change the
representation of an image into something that is more meaningful and easier to
analyze, Image segmentation is typically used to locate objects and boundaries
(lines, curves, etc.) in images. More precisely, image segmentation is the process of
assigning a label to every pixel in an image such that pixels with the same label
share certain visual characteristics.
The result of image segmentation is a set of segments that collectively cover the
entire image, or a set of contours extracted from the image. Each of the pixels in a
region is similar with respect to some characteristic or computed property, such as
color, intensity, or texture. Adjacent regions are significantly different with respect
to the same characteristic(s). When applied to a stack of images, typical in Medical
imaging, the resulting contours after image segmentation can be used to create 3D

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reconstructions with the help of interpolation algorithms.

So we will start using our segmentation threshold tool, which know as one of the
simplest method of image segmentation. This method is based on a clip-level (or a
threshold value) to turn a gray-scale image into a binary image. The key of this
method is to select the threshold value (or values when multiple-levels are
selected).

1- Adjust the Segmentation Threshold (CT Number):-

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2- After Adjusting Threshold users will need to go to segmentation tool to select

the desired object or object to be segmented :-

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3- Next step is to modify CT number using threshold tool (for not loosing time
details of the segmented object or vessel):-

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4- In some cases user likes to see the removed object (with different opacity
level):-

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5- Finally user can construct different views from the constructed 3D volume:-

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5.6.4 Annotations and Measurements

Annotation & Measurement tools allow users to add annotation, measure distance
and adding bookmarks, which help users saving their work on safe environment.

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5.6.5 Capturing Reconstruction

VRT capturing feature used for capturing output of 3D reconstructed volume,

Capturing feature having three modes.

1- Manual Capturing Mode:-

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2- Automated Capturing Mode:-

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3- Snap Shot Capturing Mode:-

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5.6.6 Virtual Colonoscopy

Virtual colonoscopy is one of MillenSys Product, which considered being a

minimally invasive, safe and more comfortable procedure for colon screening.
Recent studies have shown it to be comparable to conventional colonoscopy for
finding polyps larger than one centimeter.
With virtual colonoscopy, 100% of the colon surface can be seen. It is estimated
that physicians only see 70%-80% of the colon surface with conventional
colonoscopy.

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5.6.6.1 Gallery

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5.6.6.2 Understanding GUI

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5.6.6.3 Selecting Colon

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User should select the colon by clicking on any part of the colon with the left
mouse click while holding the control button
The colon then will be selected automatically as shown in the above image.
The user can repeat the same procedure to manually add unselected parts of the
colon
When colon is completely selected the user should click Accept Path.

5.6.6.4 Fly-Through

This option allows the user to move through the bowel looking for abnormalities as
if performing a normal colonoscopy.

User can start Fly-Through process by :

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1- Defining the volume (Prone, Supine or Both)
2- Defining the Direction of the Fly-Through (Anus-Caecum or Caecum-Anus)
3- Defining the speed
Then click

5.6.6.5 Annotations and Measurements

User can add annotations to the generated Virtual Colonoscopy preview as well as
using the ruler tool to measure needed measurements
(Please refer to the below image).

User can delete specific annotation/measurement using Delete Selected

Annotation or all of them using the Delete All button.

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5.6.7 Capturing Reconstruction

Using Fly-Through capture the user can capture the resulted Virtual Colonoscopy in
the form of cine or a series of images
To start capturing the user should click the Capture tab in the tool box, then the
user should select whether to save output as Images or Cine.
User can also define the frame rate of the output cine in frames per second.

To start capturing the user should click Start

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The user can also capture all the views presented on the monitor by checking in
the Capture All Views
Check box, the result will be similar to the below image.

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5.6.8 Vessel Analysis

Vessel Analysis Module is One of MillenSys Products, Vessel Analysis for CT comes
with new analysis & follow-up tools (thrombus segmentation, pre/post abdominal
stent analysis), and facilitates workflow with new tools like aorta & iliac auto
tracking or one-click vessel analysis. Decrease your runoff processing time by 75 %.

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5.6.8.1 Gallery

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5.6.8.2 Vessel Analysis Objectives

• Measuring Vessel Length.

• Measuring Vessel Cross Sectional Area.

• Measuring Angle of Curved Vessel.

• Capturing Resultant Image Including Measurements.

• N.B.: In order to obtain best result for vessel analysis, follow these
recommendations :-

1. No. of images / slices must be sufficient for best interpolation (Modality

Protocol).
2. The spacing (gap) between images /slices should be sufficient (Modality
Protocol).
3. Vessel should be injected with high contrast media.
4. Choosing threshold to distinguish Vessel from Bone.

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5.6.8.3 Segmentation

1. Open Vessel Analysis Module (Click Here).

2. Once you open Vessel Analysis MPR created on the fly [On the left side],
And Vessel Analysis Tool Box [On the right side].

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3. Choose any view from the left side and enlarge it (By double click on the view),
as from this enlarged view we will choose our start point and End point of the
vessel.
In our Example we will work on Coronal view. In some studies we need to do minor
changes in Threshold in order to isolate vessel from bone.

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4. Click on Add Point to start selecting Vessel (start and End points), then do Mouse
Left Click at the Start Point then scroll up or down and Mouse left click at the End
point, Notice that when you are selecting tracking points on the vessel, there is a
vertical view for the vessel is being created.

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5- After determining tracking points on the vessel click "Analyze Vessel".

6- Due to conversion of Hounsfield (CT number) between Bone and Vessel injected
with high contrast media, vessel cross section curve may need modification as the
program might join part of bone with the vessel area (depend on vessel injection
and threshold values). So user need to manually edit the wrong curve; Follow steps
shown in image below.
Click on "Edit Contour”, in case the user wants to modify created vessel curve and
draw tracking points on the vessel circumference.

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5.6.8.4 Annotations and Measurements

Measuring a Vessel Length

1. Determine desired Vessel.

2. Then follow steps as shown in image below.

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Measuring a Vessel Cross Sectional Area

1. Determine desired Vessel.

2. Then follow steps as shown in image below.

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1. Determine desired Vessel.

2. Then follow steps as shown in image below.

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5.6.8.5 Capturing Reconstruction

After applying measurements on vessels, users can capture resultant image from
Capture TAB (Check image below).

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6.1 Main screen and navigation

Add Signature button

Click on this button to add the signature

Clinical Notes button

Click on this button to view the clinical notes of the study

Print report button

Click this button to print the report.

Save Report
Click this button to save the report partially (Report work flow)

Need Verification Button

Click this button to save the report after editing and waiting for verification
(Report work flow)

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Verified Button
Click this button to verify the report (Report work flow ).

Image Tab
Click this tab to view a thumbnail of the images or key images to add it to the report.

Templates Tab
Click on this tab view, add, edit or delete the templates of the report.

Reports tab
Click this tab to view the status of the report for the study.

6.2 View existing reports

In order to open exiting written reports, click on
Reports tab
You will see already written report; you can see also
report last Status

Partial: Just saved and not finished yet

Complete Not Verified: Completed but not verified yet
Verified: Report was verified by doctor

By default first report will be loaded in the Report

Editor section
Double click on any other report to view the report

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6.3 Write reports using exiting template
In order to open write reports using
existing template, click on Templates
tab
You will see list of sections, this is the
way to group the template

Under the Section Grid, once you

select one of the sections

List of all associated templates will be

displayed

Search for the template desired either by scrolling between them or by writing its
name or part of its name and system will filter the list of templates

To use the template double click on it, to load in the word editor

In Order Merge template to the existing word editor content select the template
you need to merge its content, then press right click then press Merge Template
to Current

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6.4 Template\Sections Management
In order to manage sections or template
Right click on section list press Add\Edit
Sections

A new form will be displayed to enter

sections or templates needed

In order to add new section follows these

steps

- Write section name

- In order you need another user
Access the same section check his
name from the right list
- Click the top Add button.

In order to add templates to exiting section

- Select section
- Click the template section Add
button.
- Browse to select templates from
local network or local PC.

In order to share with other

- Select section.
- Mark authorized users.
- Click Edit button.

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Voice recording window is found under

Reports tab

Double click on the recorded voice note to

start playing, or select and press Play button

System have ability to auto replay by enable

Auto Replay check box

Use Play\Stop\Forward\Rewind for play back

functions

Note: Voice recording module could be integrated with Phillips Mike and foot
pedal.
For recording and transcript functions

6.5.2 Voice recoding\Editing

In order to start recording either press on Record button, or keyboard shortcut can
be assigned from the profile settings in order to start recording.
Once start recording, recoding minutes counter will be displaying total time during
your recording session
Once finished press Stop Button, system will then upload the voice note file to the
server and refresh the list with new Voice Note line, with its time

Recorded voice could be edited after saving where user can play the recorded voice,
stop at the point from which record needs to be edited, start recording over it.

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6.6 Manage report versions
Once save report, system keep track for the report versions, so each save click
system will save this report with single entry
In order to review if needed for the sack of review and comparison

Each saved version is saved by the name of the User who saved this version, time
and the status of the report while saving this version

To view these version check the reports grid, as the left there is Versions button

Double Click on Versions the button to view the versions section

User profile contains header & footer settings,

toolbar settings, page setup settings and
shortcut settings.

In order to change user profile follow these steps

- Press options button on the right top
corner
- A list of options will be displayed
- Select Settings

After changing profile settings it should be

uploaded: Click “Options” button then select
“Upload user profile”.

After pressing Settings button a popup of settings will be displayed

Consisting of tabs for the different settings options

After changing the settings press save button

Note: some settings need the restart of the Reporting tool in order to apply the
settings

General Tab, Application Options

Use Microsoft Word, checked to use Microsoft Word Editor as our word processor
if not checked system will use built in word processor

Download Templates (Automatic at startup), this option will cache list of templates
assigned to the login user at the startup of the application, if not enabled the
template section will be empty list

Download Study Status (For Report Status like study status), this will download the
translated names of the Partial\Complete Not Verified\Verified

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Download Chosen Templates and Doctor Procedure, this will cache predefined
templates linked to certain procedure codes, this option is not used unless we did
the configuration and link certain procedures to load certain templates

Download Signature, when this option is enabled, at the startup of the application
system will download user’s signature, the signature is used in the Verify Process

Prompt to save while template navigation, this option will save the current written
report incase user start loading another template to avoid losses of written report.

Template Override Current Report, using this option if template is loaded it will
replace curent written report

Remove report temp file if the report uploaded successfully, option to save local
computer storage area, once report was uploaded successfully system will delete
the local cached report Default Location for local cache is
C:\Millensys\MiWebView\Reports

Make Mireport Application always on top, this will make the application to be on
the top of all other application on the user desktop.

Send Report as HL7(in case of HIS Integration), option in case user need to send
the verified report to another third party application such as HIS or PACS system

Template search by beginning of template name, if enabled the search on

template name in the template name search tool, will be always start with written
word not contains text

Update Vtools/Workspace Study Status, incase of launching reporting tool from

C:\MillenSys\MiWebView\Reports Vtools, once report status is changes this will
notify opening application to change status instead of pressing refresh button to
update

Prompt on Re-Printing Printed Reports, this option is enabled it will notify user
when printing already printed report, that the report was already printed

Default Report file type, This defines the Microsoft Word File type used incase we
have MS Word 2003 and Less, Only valid format is .doc, starting from 2007 version
we can use .docx version, please take in consideration that if you have only one PC

General Tab, Graphics Option

Patient Panel Color, This is the background color under the patient name in the
main report interface

Speed buttons Panel, This number of rows for the toolbar tools on the main report
interface, One Row is the default option, it can be increased

It can be increase by two\three rows

General Tab, Monitor Options

Active Monitor, This is the default monitor user needs the report to start on,
specially designed incase local computer having multiple monitors attached to it

General Tab, Tabs Manager

Enable History Mode, This option will enable the prior reports tab, once enabled a
new tab will be displayed after next startup of the application, showing the patient
old written reports

Prompt if
the printing
report is not verify, this option will notify user if he try to print a report which is
not saved yet

After print close file and return to patients list, this option is enabled once print
report tool will be minimized and give user ability to return again to launching
system with website or another application

Save before print, this option will trigger the save option before printing to avoid
printing unsaved reports

Print Tab, Picture Options

Use default Image Format, if enabled inserted image from clipboard will be
inserted in its default width\height this option is not recommended since
sometimes the pasted images are big

It this option is No, so the image will be resized before adding to the report
Layout, define the image style in the word
Width, define max width for the image, system will calculates the height
Resolution, this is the inserted image resolution in dot per inch (DPI)

Report Tab, Page Setup

In this setup page user can define the Word Page, Custom Setup
Define default header and footer distances from edges
Define either page is Landscape or Portrait (Default portrait)

Report Tab,
Report Header

In this setup screen user can define the Patient Header, header displayed at the
top of the report
The settings are divided into three sections
- Text before Patient Data

Insert Line before header, if this option is enabled a line will be drawn using the
Height settings, and color settings

Insert File, this settings is used to put logo or preceding text at the top of the
header, what is written in the textbox is the location where the file of the header
should be located at the local computer, make sure that the file is always located
in this location on all PCs is used by this user
Text, in this text box user can but instead of file some text to be added at the top
of the header in order to have enter some text and you need new line please put
#13 it will be replaced by New Line in the header

Ex:
If we need to make report text as follows

Radiology Department
Patient Report

Patient Name: Pat Name

I will put in the Text Field,

Radiology Department#13Patient Report

I will put lines after text 1

So this will put text and add line after the text before the header

Report Header, Patient Data

Insert Patient header automatically, if this option is enabled the system will insert
header at the top of the report, if not enabled nothing will be inserted at the top

Headers and footers different first page, if enabled first report page header will
have the header and other pages will not contains the report header (this is not
recommended)

Patient Info in table\Patient Info In Lines, select which is desired either to display
patient data in the header in a table view or just write data in lines and no outer
table desired
In case Patient Info in table is enabled some settings can be then defined
Show Inner Lines, Either displays Inner border for the table
Show Outer Borders, either display table outer border of not
Table auto Fit behavior, either fit content to the table or fit table to the window
% Width of the first column, this is the percentage of the first column, this is used
if the information displayed in the first column is larger in width to the data
displayed in the second one
Background color, is the color of the table background
Table Style, these settings is to apply table styles in Microsoft word, when style 1 is
the first table template style in Microsoft word

In case of Patient Info in Lines is enabled some settings can be then defined
Shift Header Content by, this is no of pixels to shift header with while displayed in
lines this is used to center the header at the middle of the page
Line Spacing, this define the spacing between patient header lines

Report Header, Text before patient data

Insert Line after header, if this option is enabled a line will be drawn using the
Height settings, and color settings

Text, in this text box user can add after the header and you need new line please
put #13 it will be replaced by New Line in the header

Ex:
If we need to make report text as follows

Patient Name: Pat Name

Radiology Department
Patient Report

I will put in the Text Field,

Radiology Department#13Patient Report

I will put lines before the text 0

So this will leave no lines and put text after that

Report Tab, Report Header Customized Fields

Select Fields from left column and add it to right column

Columns on the right are the columns that will be displayed in the report header
To modify Prefix of the word like, changing Pat . Name to Name:

1- Select the Pat.Name from the left panel

2- Click one click on the Pat.Name, it will be changed to edit mode inside the
grid, write Name: then click again to exit edit mode
3- Select the Name: from left grid and press > arrow to add to right side

In order to modify the order of fields in the patient header

1- Press << to move fields from right to left and reset the order
2- Select each field and press > to add them to the right grid
3- Make sure you are putting them in the order desired
4- Put in consideration normally the Patient Header Normally display two
data fields per line, so first two fields will be inserted to the first line of
the header and so on.

Study Date, This option define the way to display study date, either display day and
time of just the Day Only

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Patient Name, the way of displaying the patient name, settings to make name all in
capital or first character is only capital or all small or leave as it is

Hide ref. phy. Field if no data in it, this option when enabled, if the report data
does not include referring physician name, so the filled will be displayed in the grid
as empty filed, or it can show the Ref.Phy. Prefix with no data after that

Show warning Message for Empty Header Content, this option will give warning
message to the user when creates new report for the patient, incase settings of
the header is enabled but no field was defined to be inserted automatically

Report Tab, Report Body

Defined report font settings such as , Paragraph Alignment, Text Direction, Text
Font

Lines before text, no of lines added at the top of the body before the text

Write “Not Approved” word while printing “Unverified Report” , this will write the
word not approved at the end of the report, just before printing and it will be
removed after wards

Report Tab, Report Footer

Same as report header, you can define fields that can be displayed in the Footer
Section, define what should be added in the Footer Section

Insert Page Number, this will automatically insert page number in footer section

Insert Signature, if enabled system is asking when to add signature, you can define
ether by Verify Action or with Complete Not Verified and with Partial Save

Report Tab, Report Printing

In these settings, will pressing print, does system automatically print all report
pages or just select the current page or custom selection by the mouse

Dictation Tab, Dictation Options

Save temporary voice notes in voice dictation tool, if enabled system will just save
voice notes and it will not be saved on the server, I will be just saved in the location
defined
F/R Step, this is the playback speed factor, 1 is default without slowness or
speediness

6.7.3 Dictation Tab, Dictation Shortcuts

Enable shortcuts, this will enable the Play\Record\Stop shortcuts

To define the shortcuts define the shortcuts in the text box

Manage Toolbars
To manage toolbar click Options and select Customize Toolbar
Just drag and drop required function from “Actions” menu to the toolbar

7 User Profile Settings

User profile is roaming profile, means it will be applied from anywhere once user
will logged in
User profile is divided to profile settings for the main applications, other profiles
for Advanced Viewers\Advanced Report tools

After pressing viewer Settings button a popup of settings will be displayed

Consisting of tabs for the different settings options

General Tab,
Cache directory; This Path for cache Studies on local PC used when open the
case in advanced viewer

Preference URL; in case of decentralized architecture system, images is saved

in two copied, one copy is on my local\near server the other will be sent to the
Datacenter, this URL is pointing to near server check is it might contain
requested study before asking the datacenter or remote server to download it

Empty cache directory now; press this button to trigger the Clear the Cache
directory immediately

Use Fast Local Mode; this option to retrieve images using shared network
access it is faster mode of accessing the file, it is enabled by default, it is only
active if you are using Advanced Viewer(Local) Mode in the user login

Smart switch to Remote Mode When local Network Can't Reached, this option
is used to dedicate if you left your location inside the local network, so system
will start getting files using normal http communication protocol.

Prompt user when Quality is not available;

User will login he select certain image quality to start downloading the image
using this quality if this quality does not exists on the selected study, if this
option is enabled system will notify user that compression type requested is
not available on the server, please select another quality type, if disabled he
will not be notified every time, but system will automatically detect the next
available quality to download with.
Image Tab

General

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Resize image before load; this enable the resizing of images by either
enlarging or decreasing image size based on the modality\image setup, this is
recommended only in case of printing images and the quality of printed
images on film is not good.

Load Thumbnails with Image Tool; this will load thumbnails for the series
when open new study for viewing.

Show Slider (Track bar) on each Image windows; this option will enable the
trackbar slider with every windows inside the image tool, this bar is used in
browsing of images and also used in case of cine loops to control the preview
and scroll in the cine loop.

Cache Image in memory; if this mode is enabled, images after loading them in
the viewer they will be cached in the PC memory, in order to be accessed
quickly if I will browse them continuously in this session, It enabled whenever
the image will be request again it will be recalled from local cache directory

Lock WW/WL; if enabled it will make default settings for WW\WL is locked,
user can change this settings from the viewer after opening the studies.

Center WW_WL if LUT values exists; This will auto adjust the ww\wl once open
an image if it was not provided in DICOM file.

Lock Zoom; if enabled it will make default settings for Zoom\Pan Option is
locked, user can change this settings from the viewer after opening the
studies.

Reverse Series Sort; normally series are displayed sorted by series numbers
from small number to large number, if enabled this will reverse the order
Automatically Split Multiphase series (CT only), this will automatically split CT
cases for Multiphase cases.

Load to selected windows; if enabled images will be loaded to the selected

image windows only if not enabled image will be loaded sequentially on all the
image windows.

Auto Detect MPR Module; if enabled system will check PC graphics card , if it
have good capabilities to launch our MPR module it will be launched

Use enhancement MPR Module; this option will force usage of enhanced MPR
module instead of using basic MPR module

Person Name Encoding; using this module to change the way of displaying the
patient name either display it First Middle Last, or Leave it at it is in Dicom
Files

Auto Fit on Load; if enabled image will be displayed fitted not zoomed or
panned

Smart Mammo Image Fit on Load; if enabled mammo cases (Modality Type
MG), related to special modalities to remove and trim spaces on the outer side
spaces

Auto Load Image When Change Windows; load image when Increase or
Decrease Number of Windows

Show Image Compression; Show image compression type and compression

ratio on image information

Display Image Overlay; show Dicom displayed diagram (Dicom LUT) if exists in
the Dicom Image

Show Image Number; to display the number of image beside Thumbnails

Load to selected Images only; this will load image on the selected images only
not on all the displayed images

Hide Image Borders; this will hide gray frame outside the images which
contains the slidebar and some buttons

Select All windows after open; select all window of image tool, to be used
directly with mouse actions once the image tool was loaded

Keep WW/WL; Zoom and flip when series change ,if make change on images
(WW/WL,Zoom and flip) and scroll in new series last configure ww\wl and
zoom\pan configuration still not change on displayed images

Use PT Specific WW/WL for PT Image; when open PT Image load with Specific
Width and window level

Image Tab->Image Information ,

Show patient information on image; Enable/Disable Showing Information of

patient\study\series in Images
Info. Transparent; if enabled image will be displayed on the image will not have a
background color, else it will hide the image details and I will have background
color

Info Back Color; this will select the default background color of image information,
incase it is requested to be not transparent

Font Types; normal the image information, is displayed in three levels of fonts,
from this settings user can define the setup of each of them

Image Tab->Measurements

Measurement Text; this option to change text Font, background and Color

Link style; Draw Link Line in the center of textbox or nearest corner of the textbox

Automatic Font size; Adjust font size automatically relational to the image size

Image Scale option; Select either we need to display the scale ruler on which side
of image , also we define line width; Line shift percentage from the border lines of
the image

Icon Width; control of width size of Icon body mark

Icon Height; control of Height size of Icon body mark

Home Directory; This Path For folder include Body Mark Icons

Image Tab->Scan Image

Image Output Format; specify default output image format if we scan an image.

Image Output Bits Per Pixel; Define the resolution of the scanned image bits per
pixel, normally it is not more than 12 bits per pixel

Scanoscope Line Width; define width when draw scanscope lines

Scanoscope Font Size; this define font size grade from 0-10
Inset Line Width; define default width of the inset lines drawn on images
Inset Line Color; define color of inset
Inset Line Style; define line style either doted, solid line…etc
Inset border width; define border width of inset
Inset Image Position; define default location of the inset

Image->Image Render
Settings used for exported images during save display as\ Image Printing

Enable frame around Annotation; incase annotation while printing is not visible
this will make a border around it to show the content “this will be slow operation”
Select background color; incase background frame enabled , select its color from
this settings
Enable Inset On Top; this will always make inset to be displayed over the image
incase we exported image including inset displayed to it.

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Enable frame around Information; incase image information while printing is not
visible this will make a border around it to show the content “this will be slow
operation”
Enable Text Shadow; Instead of make surrounding frame over the image, this will
just draw the same information shifted by defined pixels it is better to make its
color different than default image information
Film->General

User from this setup can delete film printing formats that is no longer needed by
the user
Select the format , press delete
Inorder to add format, select the format from combobox, and press add button to
add it to the current selection

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Connected Monitors
In this view user can enable the monitors that will be used by the program to view
images
To enable montor enable the monitor, If the monitor not connected to PC , so the
monitor will be enabled and if the screen is GrayScale enable the check box
GrayScale, this will enhance preview and refesh rate over the Gray Scale Screens