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DIRECTVIEW V5.

7D Online Help Topics

AC1456
2015-03-16
All rights reserved. No part of this manual may be reproduced or copied in any form by
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information retrieval systemswithout written permission.
Contents

CARESTREAM DIRECTVIEW System Software V5.7 New Features


Copyright Statement ........................................................................................................................ 5
Copyright Law............................................................................................................................. 5
Safety and Health Compliance .................................................................................................. 5
Contact Carestream Health, Inc. ................................................................................................ 5
Notices and Conventions............................................................................................................ 5
21 CFR Chapter 1, Subchapter 3 ................................................................................................ 6
Log On and Out of the System ........................................................................................................ 7
How to Log On without a Proximity Badge.............................................................................. 7
How to Log Out of the Modality ............................................................................................... 7
Register Badge............................................................................................................................ 7
Change Password........................................................................................................................ 8
Quick Reference................................................................................................................................ 9
Main Menu Functions................................................................................................................. 9
Common Buttons...................................................................................................................... 10
Touchscreen Usage ................................................................................................................... 13
Patient Information Bar ........................................................................................................... 14
Patient Verification Mode........................................................................................................ 14
Find the Software Version ....................................................................................................... 16
Use the Patient Work List Screen................................................................................................... 17
Status Icons on the Patient Work List Screen.......................................................................... 18
How to Set Up a Query ............................................................................................................ 19
Patient Search Techniques ....................................................................................................... 19
Locate Patient Information...................................................................................................... 21
About the Image Acquisition Screen............................................................................................. 24
Use the Image Acquisition Screen ........................................................................................... 25
Image Acquisition and Capture Overview .............................................................................. 25
What is Extended Exposure Mode........................................................................................... 26
How to Acquire Images with a DRX Detector ........................................................................ 26
How to Acquire Images with a Cassette ................................................................................. 27
Patient Input Screen ....................................................................................................................... 28
Use the Patient Input Screen ................................................................................................... 28
How to Enter Trauma Patient Information............................................................................. 31
Views ......................................................................................................................................... 33
How to Review and Accept Individual Images ....................................................................... 34
How to Assign an Image to a Patient............................................................................................ 36
How to Assign an Image to Different Patient ........................................................................ 36
How an Image Becomes Unassigned ....................................................................................... 36
Tube and Line Visualization Software .......................................................................................... 38
How to Select the Tube and Line Option................................................................................ 38
Troubleshooting the Tube and Line Visualization Software ................................................. 39

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About High Detail Visualization (HDV) Software......................................................................... 40
Pneumothorax Visualization Software ......................................................................................... 41
Bone Suppression Software ........................................................................................................... 42
Bone Suppression Indications For Use ..................................................................................... 42
Prior Images .................................................................................................................................... 43
Prior Image Display Feature..................................................................................................... 43
Use Prior Images ....................................................................................................................... 43
Prior Image Controls................................................................................................................. 44
Retrieve Prior Images ............................................................................................................... 44
Express Viewer Screen .................................................................................................................... 47
Image Viewer Screen...................................................................................................................... 49
Use the Image Viewer Screen .................................................................................................. 49
Tech Assist Toggle Button........................................................................................................ 50
Reprocess Image Button........................................................................................................... 50
Markers Overview..................................................................................................................... 50
Image Orientation and Appearance ....................................................................................... 53
Black Surround Mask................................................................................................................ 55
Grid Support Feature................................................................................................................ 60
Noise Suppression..................................................................................................................... 60
View/Look Adjustment Tab...................................................................................................... 61
Magnification Tab .................................................................................................................... 62
Crop Box Adjustment Tab ........................................................................................................ 62
How to Create an Image Copy................................................................................................. 67
Image Processing ...................................................................................................................... 67
Image Adjustment Tab............................................................................................................. 69
Measurement Tools .................................................................................................................. 69
Use the Comment Tab.............................................................................................................. 71
Image Review.................................................................................................................................. 72
About the Image List Screen .................................................................................................... 72
Flagged Image List.......................................................................................................................... 75
Flag an Image for Review ........................................................................................................ 75
How to Select a Destination .......................................................................................................... 77
How to Change the Destination .............................................................................................. 77
How to Change the Arrow Direction ............................................................................................ 78
Multi-Format Printing Overview.................................................................................................... 79
Custom Page Layouts ............................................................................................................... 79
Multi-Format Print Buttons ...................................................................................................... 81
How to Place an Image in a Multi-Format Cell ....................................................................... 83
How to Adjust Images in a Multi-Format Print....................................................................... 83
How to Change a Multi-Format Print Layout ......................................................................... 84
Print Destinations for Multi-Format Printing.......................................................................... 84
Text Options of Multi-Format Printing ................................................................................... 85
How to Position an Internal Text Box ..................................................................................... 85
How to Create a Text Overlay for a Multi-Format Print .............................................................. 87
Utilities ............................................................................................................................................ 88
Change Password............................................................................................................................ 89
Register Badge................................................................................................................................ 90
System Status .................................................................................................................................. 91
Software Updates ........................................................................................................................... 92
Pending Job Management............................................................................................................. 93
Contents

Firmware Updates .......................................................................................................................... 94


How to Install Firmware Updates ............................................................................................ 94
Image Recovery............................................................................................................................... 95
Patient CD Media Jobs ................................................................................................................... 96
How to Create a Patient Media Job Manually........................................................................ 96
How to Delete a Patient Media Job ........................................................................................ 97
Delivery Preferences Configuration .............................................................................................. 98
Select USB Destination ................................................................................................................. 100
Detector Calibration..................................................................................................................... 101
Detector Calibration Screen Overview .................................................................................. 101
How Often Should I Calibrate the Detector ......................................................................... 102
Calibration Types, Frequency, and Duration ........................................................................ 102
How to Calibrate the Detector .............................................................................................. 103
How to Set Up for an X-ray CalibrationDRX Detectors .................................................... 103
How to Add a Previously Registered Detector ..................................................................... 104
Equipment Management ............................................................................................................. 105
Equipment Management Screen Overview .......................................................................... 105
How to Enable or Disable a Registered Detector ................................................................. 106
About the General Radiography (GR) Bridge ....................................................................... 106
How To Warm Up the X-ray Tube ............................................................................................... 108
Log Viewer .................................................................................................................................... 109
Key Operator Functions ............................................................................................................... 110
How to Delete All Patient Records .............................................................................................. 111
How to Delete a Patient Record ............................................................................................ 111
How to Prevent Deletion of Patient Records When the Hard Drive is Full ......................... 111
Manage Patient Exam Records Navigational Controls ......................................................... 112
Statistics......................................................................................................................................... 113
How to View Technologist Statistics ..................................................................................... 113
Destination Summary Statistics.............................................................................................. 113
Download Statistics ................................................................................................................ 114
View Equipment History ........................................................................................................ 116
Detector Shock Statistics ........................................................................................................ 117
Cassette Statistics.................................................................................................................... 117
Erase Statistics......................................................................................................................... 118
Monitor Configuration Introduction........................................................................................... 119
How Do I Order a VERILUM CHROMA 5 Pod? ...................................................................... 120
How Do I Measure the Luminance for Gamma? .................................................................. 120
How Do I Measure the Luminance for Tracking? ................................................................. 120
Calibrate the Touchscreen ..................................................................................................... 121
Why Cant I Get to the Touchscreen Calibration Screen? .................................................... 121
What is a DICOM GSDF-Calibrated Monitor? ....................................................................... 122
System Configuration Menu ........................................................................................................ 123
Backup and Restore Configurations............................................................................................ 124
How to Back Up Configurations ............................................................................................ 124
Transfer Configuration Information ..................................................................................... 125
Feature Backup Prompt.......................................................................................................... 125
Restore Procedure Mapping Configurations ........................................................................ 125
Option Registration...................................................................................................................... 127
Copy Log History........................................................................................................................... 128
How to Copy Log Files............................................................................................................ 128

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Contents

How to Delete Log History..................................................................................................... 128


Import Configuration ................................................................................................................... 129
Import Configuration ............................................................................................................. 129
DR Detector Configuration .......................................................................................................... 131
DR TQT - Setting the Beam Output ....................................................................................... 131
DR TQT - Calibration Techniques Setting for CsI Detector................................................... 131
DR TQT - Calibration Techniques Setting for GOS Detector ................................................ 131
How To Warm Up the X-ray Tube ............................................................................................... 132
DR TQT - Total Quality Tool Analysis........................................................................................... 133
DR TQT - Flat Field Analyses Measurements ......................................................................... 133
DR TQT - How to Do a Flat Field Analysis ............................................................................. 133
DR TQT - Dark Noise Analysis................................................................................................. 133
DR TQT - How to Do a Phantom Analysis ............................................................................. 133
DR TQT - View the Flat Field Test Results.............................................................................. 134
DR TQT - Results Screen - Flat Field ....................................................................................... 134
DR TQT - Results Screen - Dark Noise Test ............................................................................ 136
DR TQT - Results Screen - Phantom Test ............................................................................... 137
DR TQT - How to Export TQT Test Results............................................................................. 138
System Configuration Menu ........................................................................................................ 139
View Configuration Screen .......................................................................................................... 140
How to Change a View .......................................................................................................... 140
How to Delete a View ............................................................................................................ 141
How to Change the Look of a View ...................................................................................... 141
What is a Look? ...................................................................................................................... 142
The Family of Looks................................................................................................................ 143
How to Change a Tutor Image .............................................................................................. 143
How to Globally Change the Default Tutor Image .............................................................. 144
View Attributes for Unassigned Images................................................................................ 144
Configure Default Display for Unassigned Images............................................................... 144
Navigation and Function Buttons on the View Configuration Screen................................ 145
Procedure Mapping...................................................................................................................... 147
About Procedure Mapping Configurations .......................................................................... 147
Procedure Mapping Using the Procedure Code Workflow ................................................. 148
How to Configure Predefined Procedures ............................................................................ 148
Navigation and Function Buttons on the Procedure Mapping Configuration Screen ....... 149
How to Configure Supine Long-Length Imaging Procedures .............................................. 149
List Configuration......................................................................................................................... 150
Navigation and Function Buttons on the List Configuration Screen................................... 150
Layout Configuration ................................................................................................................... 151
Layout Configuration ............................................................................................................. 151
Image Viewer Editors ............................................................................................................. 151
Patient Names Editor.............................................................................................................. 152
Markers Editor ........................................................................................................................ 152
Tech Assist ............................................................................................................................... 153
Patient Work List Editor ......................................................................................................... 158
Patient Input Editor................................................................................................................ 159
Tube Head Acquisition Screen Editor .................................................................................... 160
Work List Editor on the Tube Head Display .......................................................................... 161
Display Configuration Screen ...................................................................................................... 162
How to Configure Fit to Screen or Fit to BSM Display ......................................................... 164

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Companion Images................................................................................................................. 164


Image Processing Preference Editor ............................................................................................ 168
Image Processing Preference Configuration......................................................................... 168
Considerations Before Changing Preferences ...................................................................... 169
How to Make Changes to a View Name ............................................................................... 170
How to Make Changes to Multiple Views within the Same Category ................................ 171
Troubleshooting Image Quality............................................................................................. 171
Trauma Defaults ........................................................................................................................... 173
Navigation and Function Buttons on the Trauma Defaults List .......................................... 173
How to Locate a Trauma Patient ........................................................................................... 174
Reject Reasons .............................................................................................................................. 175
Reject Reasons Configuration................................................................................................ 175
How to Add a Reject Reason ................................................................................................. 175
How to Delete a Reject Reason ............................................................................................. 175
How to Reject an Image......................................................................................................... 176
Destination Profile Configuration ............................................................................................... 177
Destination Profile Screen...................................................................................................... 177
What is a Destination Profile? ............................................................................................... 177
What is the Default Profile? .................................................................................................. 178
Why the Default Destination Cannot Be Deleted ................................................................ 178
How to Add a New Destination Profile................................................................................. 178
How Destination Profiles are Assigned to Images................................................................ 179
How to Edit a Destination Profile.......................................................................................... 179
Text Box Editor Screen ................................................................................................................. 180
How to Add a Field in a Configurable Text Box ................................................................... 180
How to Edit a Field in a Configurable Text Box ................................................................... 181
How to Select a Configurable Text Box ................................................................................ 181
Configure a Multi-Format Image Internal Text Box ............................................................. 182
Configure a Multi-Format Image Exterior Text Box ............................................................. 182
How to Format a Multi-Format Page Footer .............................................................................. 183
How to Format a Single Image Page Footer............................................................................... 184
Delivery Preferences Configuration ............................................................................................ 185
Automatic View Selection............................................................................................................ 187
Detector Angle Indexing........................................................................................................ 187
How to Configure Patient Size Indexing for Pediatric View Selection ............................... 189
Grid Indexing .......................................................................................................................... 190
How to Configure the Network................................................................................................... 191
IPv6 Configuration.................................................................................................................. 192
Destination Configuration Overview .......................................................................................... 193
RIS/PACS Web Page ...................................................................................................................... 194
Recall Prior Image Configuration ................................................................................................ 195
Priors Image Configuration.................................................................................................... 195
HIS/RIS Configuration ................................................................................................................... 200
Configure Polling HIS/RIS Query ............................................................................................ 200
HIS/RIS Remote Query ............................................................................................................ 200
Configure HIS/RIS Query Options .......................................................................................... 201
How to Use the Bar Code Configuration Screen ........................................................................ 203
Bar Code Configuration Examples......................................................................................... 203
Proximity Badge Configuration Using Auto Detect ................................................................... 205
System Maintenance .................................................................................................................... 206

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Contents

How to Configure Regional Preferences..................................................................................... 207


Customizable Field Description ................................................................................................... 208
How to Import Custom Tutor Images.......................................................................................... 209
About Tutor Images ............................................................................................................... 209
How to Change the Tutor Image from View Configuration ............................................... 209
How to Globally Change the Tutor Image............................................................................ 210
How to Assign Custom Tutor Images .................................................................................... 210
How to Select the Default Tutor Image Type ....................................................................... 210
How to Change the Default Tutor Image ............................................................................. 211
How to Configure Color Preferences .......................................................................................... 212
About the Technique Settings Configuration Screen ................................................................ 213
About the Technique Settings Configuration Screen .......................................................... 213
System Receptor Types ........................................................................................................... 213
About Changing Technique Settings for a Receptor ........................................................... 213
How to Save Optimized Techniques and Create a New Default ......................................... 214
How to Filter the Views on the Technique Settings Configuration Screen ........................ 214
How to Use Copy and Paste on the Technique Settings Screen .......................................... 215
How to Perform Multiple Edits on the Technique Settings Configuration Screen............. 216
How to Export Techniques on the Technique Settings Configuration Screen.................... 216
How to Configure Generator Technique Settings ................................................................ 216
About Technique Scaling ....................................................................................................... 217
Long-Length Imaging Configuration .......................................................................................... 218
Long-Length Imaging Configuration .................................................................................... 218
How to Configure for Long-Length Imaging........................................................................ 218
Grid Type Configuration .............................................................................................................. 220
Grid Configuration ................................................................................................................. 220
How to Define the Parameters of a Grid .............................................................................. 220
Auto Position Configuration........................................................................................................ 221
Detector Settings Screen .............................................................................................................. 222
How to Create a Text Overlay for a Multi-Format Print ............................................................ 223
Configurable Text Box Options ................................................................................................... 224
How to Configure Remote Devices ............................................................................................. 225
How to Create a Shortcut to the Remote Access Software ................................................. 225
X-ray Radiation Dose Reporting Overview ................................................................................. 226
Report List Screen ................................................................................................................... 227
Report Destination Status Screen .......................................................................................... 228
How to Configure DICOM Destinations for Dose Reporting ............................................... 228
What Happens When You End A Study ................................................................................ 229
How to Create an Image Copy..................................................................................................... 230
View Category Management....................................................................................................... 231
How to Edit Regions, Exams, and Views ............................................................................... 231
Firmware Updates ........................................................................................................................ 232
How to Install Firmware Updates .......................................................................................... 232
Scheduled Workflow Configuration ........................................................................................... 233
Scheduled Workflow Configuration ..................................................................................... 233
Scheduled Workflow Alternatives ......................................................................................... 233
Select Scheduled Workflow ................................................................................................... 234
Storage Commitment Function ................................................................................................... 235
How to Configure Auto Display in QA Mode ............................................................................. 236
Pass-through Mode ................................................................................................................ 236

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About Displaying in QA Mode............................................................................................... 236


How to Accept All Images in QA Mode ................................................................................ 236
How to Accept Individual Images in QA Mode .................................................................... 237
How to Configure the Edges of a Surround Mask ..................................................................... 238
Scheduled Workflow Configuration ........................................................................................... 239
Firmware Updates ........................................................................................................................ 240
Snapshot Log Files ........................................................................................................................ 241
How to Capture a System Snapshot Log ............................................................................... 241
Scanner Options Screen................................................................................................................ 242
Pediatric Support Option ............................................................................................................. 243
Pediatric Sub-Populations ...................................................................................................... 243
How to Configure Patient Size for View Configuration ...................................................... 244
Patient Size Icons .................................................................................................................... 244
What is a View .............................................................................................................................. 245
How to Create a View ............................................................................................................ 245
How to Delete a View ............................................................................................................ 246
How to Find a Look Name ..................................................................................................... 246
How to Change the Default Characteristics of an Image?................................................... 246
Delivery Preferences Configuration ............................................................................................ 248
DICOM Specification for Dates and Times Recorded in the System .......................................... 250
How to Configure Before and After Views................................................................................. 251
Image Processing .......................................................................................................................... 252
Adjusting Image Quality Controls In Preference Editor ....................................................... 252
How to Reset Image Processing Controls .............................................................................. 252
Adjust Image Quality.............................................................................................................. 252
How to Configure Trauma Exam Buttons ................................................................................... 253
How to Move a Trauma Exam Button ................................................................................... 253
Region of Interest (ROI) Tool ....................................................................................................... 254
Region of Interest Tool .......................................................................................................... 254
How to Access the Region of Interest Tool ........................................................................... 254
Configure the Region of Interest Tool .................................................................................. 255
How to Hide or Restore Buttons on Trauma Defaults List......................................................... 256
V4343 Detector Reports ............................................................................................................... 257
Beam Detect.................................................................................................................................. 258
Configure a System for Beam Detect Timeout ........................................................................... 259
How to Use Beam Detect ............................................................................................................. 260
About Linear Tomography........................................................................................................... 261
How to Use Linear Tomography ............................................................................................ 261
The Detector EnvironmentPRO Detectors ............................................................................... 263
How to Activate a Detector ................................................................................................... 263
Using the Detector ................................................................................................................. 263
How to add a DetectorPRO Detectors ............................................................................... 264
How to Remove a DetectorPRO Detector ......................................................................... 264
Detector IdentificationPRO Detector................................................................................. 265
Detector RulesPRO Detector .............................................................................................. 265
Calibration Types, Frequency, and Duration ........................................................................ 266
How to Set Up for an X-ray CalibrationPRO Detector ...................................................... 267
Run the Dark Calibrations ...................................................................................................... 267
Run X-ray CalibrationsPRO Detector ................................................................................. 267
Wireless Operation ................................................................................................................. 269

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Wireless Icons for Mobile Systems ......................................................................................... 269


Requirements for Wireless Operation................................................................................... 270
Overview for Adding or Removing a DetectorPRO Detector........................................... 270
Detector Battery Charge SymbolsPRO Detector ............................................................... 271
Troubleshooting Detectors: Checklist ................................................................................... 272
Troubleshooting Detectors: Calibration FailurePRO Detector ......................................... 273
Troubleshooting Detectors: Communication ErrorsPRO Detector................................... 273
Troubleshooting Detectors: Inactive Detector...................................................................... 274
Troubleshooting Detectors: Inadequate PowerPRO Detector ......................................... 275
Troubleshooting Detectors: Detector Not AvailablePRO Detector.................................. 276
Troubleshooting Detectors: Line Artifacts - PRO Detectors ................................................. 276
Troubleshooting Detectors: Detector Not AvailablePRO Detector.................................. 277
Troubleshooting Detectors: White ImagePRO Detector .................................................. 278
Troubleshooting Detectors: Overdue Calibration ................................................................ 278
Troubleshooting Detectors: Sub-Optimal Image Quality..................................................... 279
Equipment Management ScreenPRO Detectors ............................................................... 279
Equipment ManagementPRO Detector ............................................................................. 279
Equipment Management Screen ........................................................................................... 280
Detector OverviewDRX Detectors............................................................................................ 281
How to Activate a Detector ................................................................................................... 282
The Detector EnvironmentDRX Detectors ......................................................................... 282
Using the Detector ................................................................................................................. 283
Detector IdentificationDRX Detectors ............................................................................... 283
How to Position the DetectorDRX Detectors .................................................................... 284
Auto Detector Orientation .................................................................................................... 284
Fast PreviewDRX Detectors ................................................................................................ 285
How to Enable or Disable Fast PreviewDRX Detectors ..................................................... 285
DRX Detector RulesDRX Detectors..................................................................................... 286
Calibration Types, Frequency, and Duration ........................................................................ 287
Run the Dark Calibrations ...................................................................................................... 287
Run X-ray CalibrationsDRX Detectors ................................................................................ 288
How to Perform X-ray Express Calibration ........................................................................... 288
Tether Interface ...................................................................................................................... 289
Wireless Operation ................................................................................................................. 291
Change Battery ....................................................................................................................... 294
How to Add or Remove a DetectorDRX Detectors ........................................................... 294
Detector Battery Charge SymbolsDRX Detectors .............................................................. 295
What is Detector Migration? ................................................................................................. 296
How to Wake Up the Detector .............................................................................................. 296
How to Enable or Disable a Registered Detector ................................................................. 296
Troubleshooting Detectors .................................................................................................... 297
About Sleep ModeDRX Detectors ...................................................................................... 305
DR Total Quality Tool Overview .................................................................................................. 307
DR TQT - What Should I do if a TQT Test Fails? .................................................................... 307
DR TQT - Flat Field Analysis.................................................................................................... 308
DR TQT - Configuration Workflow ........................................................................................ 308
DR TQT - Calibration Techniques Configuration .................................................................. 309
DR TQT - Configuration Parameters...................................................................................... 309
DR TQT - Acquisition Technique Configuration ................................................................... 310
How to Use the Prep/Expose Switch............................................................................................ 311

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Detector Calibration..................................................................................................................... 312


How Often Should I Calibrate the Detector ......................................................................... 312
What Calibration Type Should be Performed? ..................................................................... 312
How to Calibrate the Detector .............................................................................................. 312
How to Set Up for an X-ray CalibrationDRX Detectors .................................................... 313
Detector Selection on the Acquisition Screen ............................................................................ 314
DR Long-Length Imaging ............................................................................................................. 315
DR Long-Length Imaging Indications for Use ....................................................................... 315
Optional Equipment Used to Perform DR Long-Length Imaging Exams ............................ 316
Using the Manual Stitch Editor.............................................................................................. 318
About Cancelling an Automatic DR Long-Length Exam ...................................................... 321
How to Perform a DR Long-Length Exam for the DRX-Evolution System .......................... 321
When a DR Long-Length Exam is Cancelled ......................................................................... 322
Overhead Tube Crane (OTC) Long-Length Icons for Automatic DR LLI .............................. 324
Understanding SID and SOD for a Long-Length Exam......................................................... 325
Configure the System to Print Long-Length Images ............................................................ 326
Long-Length Imaging Views .................................................................................................. 326
DRX-Evolution System DR Long-Length Imaging Menu ...................................................... 326
DRX-Evolution Automatic DR Upright Exam ........................................................................ 326
DRX-Evolution DR Manual Exam Using a Motorized Wall Stand ........................................ 328
How to Configure DRX-Evolution DR Supine Exams ............................................................ 330
Long-Length Imaging for the DRX-1 System ........................................................................ 331
Stitching Software for the DRX-Revolution System ............................................................. 332
Tube Head Software..................................................................................................................... 334
Tube Head Login Screen .............................................................................................................. 335
Icons on the Tube Head Display .................................................................................................. 336
Cart Driving Access ....................................................................................................................... 338
How to Configure Cart Driving Access .................................................................................. 338
Tube Head Privacy Screen ...................................................................................................... 338
Tube Head Patient Work List Screen ..................................................................................... 339
Tube Head Image Acquisition Screen.................................................................................... 340
Tube Head Image Review Screen .......................................................................................... 343
Tube Head Image Utilities Screen.......................................................................................... 343
Generator Controls....................................................................................................................... 345
How to Adjust the kVp and mAs ........................................................................................... 345
Tube and Grid Alignment System (Option) ................................................................................ 347
How to Align the Tube and Grid ........................................................................................... 347
Patient Information Bar ............................................................................................................... 349
Auto-Associate Feature ................................................................................................................ 350
How to Initiate Auto-Associate from the Patient Input Screen........................................... 350
Scan Status Screen Overview ....................................................................................................... 351
Scan Status Tab ....................................................................................................................... 351
How to Use the Erase Cassette Tab ............................................................................................. 353
About the Local User Interface (LUI) ........................................................................................... 354
Local User Interface (LUI) Main Menu ................................................................................... 354
How to Use the Volume Settings Tab ................................................................................... 356
About High Resolution Scanning ................................................................................................ 357
How to Load Cassettes on the Classic/Elite Systems ................................................................... 358
How to Shut Down the Classic/Elite CR System .......................................................................... 359
How to Load Cassettes on the CR 975 and Max CR Systems...................................................... 360

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How to Configure Remote Devices ............................................................................................. 361


How to Create a Shortcut to the Remote Access Software ................................................. 361
How to Configure ROP Links ....................................................................................................... 362
About the Remote Patient Data Entry System ........................................................................... 363
How to Enter Patient Data Using RPDES............................................................................... 363
How to Complete a Study from the Remote Patient Data Entry System ............................ 363
CR Long-Length Imaging Online Help ........................................................................................ 364
About CR LLI Exam Optimization .......................................................................................... 364
How to Enter Data for CR LLI Exams ..................................................................................... 365
About Determining the SID for LLI Exams ............................................................................ 366
CR Total Quality Tool ................................................................................................................... 367
What is CR TQT? ..................................................................................................................... 367
CR TQT - Determine the Exposure ......................................................................................... 367
CR TQT - System Test Overview ............................................................................................. 368
CR TQT - Cassette Test Prerequisites...................................................................................... 372
CR TQT - How to Create a Flat Field Exposure ...................................................................... 374
CR TQT - How to Create a Flat Field Exposure ...................................................................... 375
CR TQT - TQT Position a Test Phantom ................................................................................. 375
CR TQT Perform Phantom Image Test ................................................................................ 375
CR TQT - Erased Image Test ................................................................................................... 376
CR TQT - Perform Erased Image Test..................................................................................... 377
CR TQT - When to Append the TQT Session ......................................................................... 377
CR TQT - Pixel Size Test .......................................................................................................... 377
CR TQT - Scan Linearity Test................................................................................................... 378
CR TQT - MTF Test................................................................................................................... 378
CR TQT - Pixel Position Test.................................................................................................... 379
CR TQT - Exposure Response Test .......................................................................................... 379
CR TQT - Test Result Indicators .............................................................................................. 381
CR TQT - Phantom Image Test Failure................................................................................... 381
CR TQT - How to Evaluate Flat Field Image Tests ................................................................. 383
TQT Troubleshooting ............................................................................................................. 385
How to Export TQT Data........................................................................................................ 385
Film-Printer Calibration Test Procedure ................................................................................ 385
Workstation Display Calibration Test Procedure.................................................................. 386
Bar Codes ...................................................................................................................................... 388
How to Reset the Bar Code Reader to Factory Defaults ...................................................... 388
Bar Code Programming.......................................................................................................... 388
How to Change the Bar Code Data Field Size ...................................................................... 388
Program Hand-Held Bar Code Reader Preferences .............................................................. 388
Program the PS2 Keyboard Bar Code Reader ....................................................................... 389
Program the PS2 Keyboard Bar Code Reader and Add Suffix ............................................. 391
Program the PS2 to USB Keyboard Bar Code Reader ........................................................... 392
Program the PS2 to USB Keyboard Bar Code Reader and Add Suffix ................................. 393
Program the Keyboard Wedge Bar Code Reader and Add Suffix ....................................... 394
Program the Keyboard Wedge Bar Code Reader ................................................................. 396
Program the USB as Serial Bar Code Reader ......................................................................... 398
Program the Serial Bar Code Reader..................................................................................... 399
How to Find a Bar Code ......................................................................................................... 400
Bar Code Programming Samples 1 ........................................................................................ 401
Bar Code Programming SamplesNumbers 05 .................................................................. 402

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Bar Code Programming SamplesNumbers 69 .................................................................. 403


Bar Code Programming SamplesLetters AF ..................................................................... 405
Bar Code Programming Samples 5 ........................................................................................ 406
Bar Code Programming SamplesReread Delay ................................................................. 407
Bar Code Programming Samples 7 ........................................................................................ 408
Troubleshooting the Hand-Held Bar Code Reader............................................................... 409
HIBC Bar Codes ....................................................................................................................... 409
Character Delimited Bar Codes.............................................................................................. 410
Configure the System to Read Character Delimited Bar Codes ........................................... 410
Configure the System to Read HIBC Bar Codes .................................................................... 411
ExampleStrip Middle Characters from Bar Code............................................................... 412
Data Entry with the Bar Code Reader ................................................................................... 413
2D Bar Code Programming .................................................................................................... 413
Program the 2D Bar Code Reader ......................................................................................... 414
ASCII 39 Mode......................................................................................................................... 415
How to Add a Prefix or Suffix Bar Code................................................................................ 415
Fixed Mount Bar Code Programming.................................................................................... 416
Automatic Trigger Mode ....................................................................................................... 417
Fixed Mount Bar Code Programming.................................................................................... 418
Carestream and IEC Exposure Indicators Overview .................................................................... 419
Exposure Indicators ................................................................................................................ 419
Carestream Exposure Index.................................................................................................... 419
CARESTREAM Exposure Index for DRX and PRO 3543/3543C CsI Detectors ....................... 421
CARESTREAM Exposure Index for DRX and PRO 3543/3543C GOS Detectors..................... 422
IEC Exposure Index for DRX and PRO 3543/3543C CsI Detectors ......................................... 423
IEC Exposure Index for DRX and PRO 3543/3543C GOS Detectors ...................................... 424
IEC Exposure Index ................................................................................................................. 424
Deviation Index Chart ............................................................................................................ 425
System Workflow.......................................................................................................................... 426
Modality Performed Procedure Step (MPPS) ........................................................................ 426
Remote Monitoring Services (RMS) ............................................................................................. 428

AC1456 | 2015-03-16 xi
Contents

xii AC1456 | 2015-03-16


CARESTREAM DIRECTVIEW System Software
V5.7 New Features
Beam Detect
Beam Detect is a feature that allows the detector to be active when it detects an X-ray
beam. The technologist signals the generator directly from the exposure switch at the
Console, and the detector activates when it senses the X-ray beam. Beam Detect is
available with DRX Plus and PRO detectors only. See Beam Detect.

Enterprise Wireless
Image information is transmitted wirelessly from a DRX Detector to the Console. To
ensure security for a wireless exchange, Carestream Health provides certificate-based
authentication between devices. The certificate is an electronic document that identifies
a user and confirms the identity of that user to another party. See Enterprise Wireless
with a Wireless Detector.

X-ray Express Calibration


The X-ray Express calibration is a short calibration for the DRX Plus detector and can
reduce the time it takes to perform calibration. X-ray Express Calibration takes
approximately five minutes to perform. See How to Perform X-ray Express Calibration.

New Carestream Detectors


Introducing the DRX Plus and PRO 3543/3543C detectors. The DRX Plus offers the ability
to swap out the battery without losing connectivity, a reset button for a soft reboot, and
LEDs to quickly identify detector status. See Detector OverviewDRX Detectors and
Detector OverviewPRO Detectors.

Bone Suppression
Bone Suppression Software allows the user to view an image that minimizes the evidence
of posterior ribs and clavicles, allowing a clearer view of chest organs such as the lungs.
It reduces the need for a second X-ray or a CT scan, with a lesser dose to the patient as a
result. These benefits apply to all Companion images. See Bone Suppression Software.

High Detail Visualization Software


High Detail Visualization Software (HDV) provides a Companion Image that is optimized
for HDV purposes or latitude for any View. Most Companion Images are used for chest
and abdomen Views. The Key Operator can configure the HDV View to appear
automatically, or it can be configured to be selected manually by the technologist from
the Image Viewer screen. See High Detail Visualization Software.

AC1456 | 2015-03-16 1
IHE Radiation Exposure Monitoring
The system creates, sends, and stores the data needed to create a structured report. This
data is the radiation dose a patient receives during the study after the Technologist
selects End Study on the Patient Input or Image Acquisition screen.
The structured report option must be enabled on the system in order to use the feature.
See X-ray Radiation Dose Reporting Overview.

Free Rotation
The Free Rotate feature is a tool that allows the user to slightly rotate an image that is
not oriented optimally on the Image Viewer screen. The control appears on the Printer
tab, located under the Rotate Clockwise and Rotate Counterclockwise buttons. See
About the Free Rotate Feature.

Full Screen Viewing


The Full Screen Viewing feature maximizes the visibility of the image by allowing the
image to fill the entire screen. The control is accessed from the Image Viewer screen.
The image can be panned while zoomed; however, no other edits can be mademarkers
cannot be placed or moved on the image. See Full Screen Viewing.

Import Image System Type Data


From a Backup/Restore file, instead of importing all data, the user can load select
techniques, image processing, and/or procedure codes for specific receptors from the
Import Configuration screen and import just those items. See Import Configuration.

Multi-Modality Acquisition
This feature allows the user to directly connect two Classic/Elite CR readers together or a
Classic/Elite reader with a DR System. This is useful when CR cassettes are used as a
receptor in a study and then can be processed in the same room that the exposure was
taken. The Key Operator enables the option on the Option Registration screen. Only one
Console will be used, so the systems will share the same Work List, images, database, and
so forth. Multi-Modality Acquisition is only supported by the Classic/Elite CR Systems.

Technique Scaling
This information applies to the DRX-Evolution and DRX-Revolution Mobile X-ray Systems
only.
The Technique Scaling Tool lets the Key Operator take an optimized set of techniques for
a type of receptor and increase or decrease them automatically to create techniques for
another type of receptor. The tool can be used to create CsI, GOS, or CR techniques from
the existing techniques file. See About Technique Scaling.

Multi-Format Print Custom Page Layouts


The Key Operator can configure new custom multi-format layouts on the Delivery
Preferences screen. By default, when the Key Operator enters the screen, there is a
blank canvas and a 2 x 2 cell placed in the top left corner of the canvas. Another way of

2 AC1456 | 2015-03-16
creating a custom layout is to copy an existing layout and modify it See Multi-Format
Designer Table.

Remote Access Software Support


Remote Access Software allows the Key Operator to run the Console from a remote
location.
The Remote Access Software must be loaded onto the Key Operators computer before
accessing the Console. The software supports WINDOWS XP, WINDOWS 7, and
WINDOWS 8.

Image Preference Editor


The Image Preference Editor now supports free text annotation, text that can transfer
information such as changes to and image and send it to a PACS. See Image Preference
Editor.

Rejected Images Available to the Technologist


The Key Operator can configure the system so that the Technologist can access the
Rejected Image List. See Rejected Image List.

Markers in the Overlay Plane


Image annotations such as markers and measurements are sent to the PACS in separate
files called an Overlay. These overlay files can be used by the PACS if it is configured to
receive them. Previously, these annotations were part of the image. See Markers
Overview.

Resend All for Failed Image Delivery


Previously, images that did not reach their destinations for various reasons had to be
resubmitted for delivery one at a time. Now they can be sent in a group to destinations.
This is useful when delivery was failed because of a network problem and all of the
images are waiting to be delivered again. See Image List.

Zoom to BSM for Initial Image Viewer Display


In the Display Configuration screen, the Key Operator can configure the Image Viewer
to open with an image zoomed Fit to Screen, or zoomed so that the image automatically
appears larger. See Display Configuration.

Time Display on all Screens


With V5.7 Software, the time displays in the upper-right corner of each screen.

Support for Wide Screen Multi-touch monitor


A new monitor supports the use of gestures to access the screen. These gestures include
pinching and expanding the fingers to make an image larger or smaller. Free rotation is
also available, where small changes in rotation can be achieved by dragging the image
in a circle clockwise or counterclockwise.

AC1456 | 2015-03-16 3
Export Exposure Settings on DRX-Evolution and DRX-Revolution Systems
This feature allows the user to export exposure information to a spreadsheet for
inspection at a later time.

IPv6 Configuration
Internet Protocol Version 6 is a network protocol that is available if a facility determines
that new IP Addresses are needed in their system, because the number of computers
accessing the Internet will soon exceed the number of IP addresses available. IPv6
provides billions of new addresses. If IPv6 is used by the facility, it will provide a
non-standard IP address format for their computers.

4 AC1456 | 2015-03-16
Copyright Statement

Copyright Statement
CARESTREAM is a trademark of Carestream Health, Inc.
This document is copyrighted with all rights reserved.

Copyright Law
Under the copyright laws, this document may not be copied, in whole or in part, without
the written consent of Carestream Health, Inc. Under the law, copying includes
translating into another language or format.

Safety and Health Compliance


This equipment has been tested for and complies with the following Safety and Emissions
Standards. Certificates of Compliance and Declarations of Conformity have been issued
as shown below.

Contact Carestream Health, Inc.


Before you contact Technical Support for assistance, see one of your dealers trained
personnel to solve the problem.
If you need further assistance, contact your local Service representative.

Notices and Conventions


The information herein is based on the experience and knowledge relating to the subject
matter gained by Carestream Health, Inc. prior to publication. No patent license is
granted by this information. Carestream Health reserves the right to change this
information without notice, and makes no warranty, express or implied, with respect to
this information. Carestream Health shall not be liable for any loss or damage, including
consequential or special damages, even if loss or damage is caused by Carestream
Healths negligence or fault.

Note
Notes provide additional information, such as expanded explanations, hints, or reminders.

Important
Important highlights critical policy information that affects how you use this manual and this
product.

Caution
Caution points out procedures that you must follow precisely to avoid damage to the system or
any of its components, yourself or others, loss of data, or corruption of files in software
applications.

AC1456 | 2015-03-16 5
Copyright Statement

Authorized European Representative

Carestream Health France


1, rue Galile
93192 NOISY-LE-GRAND CEDEX
FRANCE

Importer for European Union


Carestream Health Netherlands B.V.
Bramenberg 12
3755 BZ Eemnes
The Netherlands

Caution
Federal law restricts this device to sale by or on the order of a physician.

Caution
If you witness or become aware of a potential safety issue with this equipment, take the
appropriate safety measures and report this to your Carestream Service representative
immediately.

21 CFR Chapter 1, Subchapter 3


This product complies with 21 CFR Chapter 1, Subchapter 3.

6 AC1456 | 2015-03-16
Log On and Out of the System

Log On and Out of the System


The System allows users to log on by using their proximity badge, which eliminates the
need to log onto the system with a user name and password. The user can also log on
using a name and password on the primary screen.
The System Administrator can configure the registered badge feature.

How to Log On without a Proximity Badge


Prerequisites:
This procedure assumes that you have a user account.

1. Select the User Name field and type in your user name.
2. Select the Password field and type in your password.
3. Select Logon.
If your system is configured without user names and passwords, select Tech Logon.

How to Log Out of the Modality


1. Select Quick Menu (button on the left-bottom of any screen) to bring up the menu.
2. Select Logout.

Register Badge
This procedure assumes you already have a user account. User accounts must be created
by the Security Administrator before a proximity badge can be registered.
1. Log into the system.
2. Navigate to Utilities > Register Badge and select Register Badge.
3. Scan the badge by swiping it across the badge reader.
When the system reads the badge, you will hear a beep.
4. When asked if you want to associate the badge to your account, select OK.
5. Follow the on-screen instructions to register your proximity badge.

Once configured, the user can log in by passing the badge across the reader without
entering their user name and password on the Login screen.
The user will log out the previous user when using this feature.

AC1456 | 2015-03-16 7
Log On and Out of the System

Change Password
You can change your password in a DIRECTVIEW system at any time. Remember to create
a password that conforms to the number and type of characters set for passwords in your
facility by your Security Administrator.
1. At the Main Menu, select Utilities.
2. Select Change Password.
3. Enter your old password.
4. Enter your new password.
5. Confirm your new password by entering it again (exactly the same way).
6. Select Change Password.

Note
If you have forgotten your password, contact the Security Administrator. Your Security
Administrator can reset your password so that you can change it if needed.

8 AC1456 | 2015-03-16
Quick Reference

Quick Reference

Main Menu Functions


The Main Menu contains menu choices that give the technologist access to software
functions in the system. The table displayed here lists the general common functions you
may find in each menu section. Your system may display a different set of functions
depending on the equipment you are using and the features installed on your system.
Menu Name Functions

Study Data Patient Work List


Locate Patients
Patient Input
Enter Patient Data
Image Acquisition
Acquire Images

Image Review Image Viewer


View and evaluate images
Advanced controls for image appear-
ance and orientation
Express Viewer
View and evaluate images
Basic controls for image appearance
and orientation
Image List
List of images sorted and retrieved by
delivery status

AC1456 | 2015-03-16 9
Quick Reference

Menu Name Functions

Utilities Change Password


Register Badge
System Status
Software Updates
Image Recovery
Patient Media Jobs
Select USB Destination
Log Viewer
Detector Calibration
DRX-1, DRX-Evolution, DRX-Revolu-
tion
Equipment Management
DRX-1 Quality Tool Results
DRX-1 Only
Tube Warm-up
DRX-Evolution Only

Common Buttons
Buttons that are displayed in color on the screen are active. Buttons that are displayed in
gray on the screen are inactive.
Icon Button Name Description

Accept All Accepts all images in a study and sends them to destinations.

Accept Image Sends the image immediately to the destinations set up by the
Key Operator. Selected after you have viewed an image and
find it satisfactory.

Add Lets you add a multi-format print and opens the Multi-Format
Multi-Format Configuration screen. This button becomes active when an
Print image is available to go to a destination.

Delete Deletes the current multi-format layout in the Multi-Format


Multi-Format Configuration screen. Lets you select a new multi-format lay-
Print out, if desired.

10 AC1456 | 2015-03-16
Quick Reference

Icon Button Name Description

Change Changes the format for printing the images in the study and
Multi-Format opens the Multi-Format Configuration screen. This button
Print becomes active when an image is available to go to a destina-
Configuration tion.

Multi-Format Indicates whether the image is currently in a multi-format print.


If it is not, the icon is a blue rectangle. If an image is set up to
print in a multiple format, the icon will display multiple format,
and the image is sent to the printer when the last image is
accepted.

Add View Adds a new View to the displayed study.

Assign Image Assigns the image to a new or existing patient record or study.

Back Returns you to the previous screen or function. If you have


made changes, the Back button toggles to Cancel.

Cancel Returns you to the previous function without changing to


another screen. It toggles to the Back button after you have
selected Save Changes. Displays the Confirm changes dia-
log. It does not immediately leave the screen.

Main Menu Exits the screen and returns you to the Main Menu. Provides
quick access to other functions. This button appears on every
screen.

Delete View Deletes the selected View. If no view is selected, the button is
disabled.

Save Changes Saves all changes made on the screen, copying them to the
database.

Reject Image Immediately removes the image from the system. The Patient
information remains on the system database. Select Reject
Image if an image must be retaken due to motion or clipped
anatomy. The Key Operator can review rejected images. Based
on Key Operator settings, the image may not be deleted imme-
diately.

AC1456 | 2015-03-16 11
Quick Reference

Icon Button Name Description

Re-deliver Image Delivers an image that has been delivered previously, and
allows the user to select another destination. The current desti-
nation selection is used to re-deliver an image.

Find Study Immediately sends the query criteria to the HIS/RIS. Returns a
Remotely list of studies that match those criteria to the Work List from
the HIS/RIS and the local Modality database.

Clear Fields Deletes all information entered in fields on the screen. Fields
with predefined values will be reset to the default value.

Reprocess Applies the processing changes you have selected and modifies
the image.

Unassign Image Disconnects the image from the current patient data. When
selected, toggles to Assign Image so that you can assign the
correct patient information.

Log On Allows access to the Modality. Enter your User Name and Pass-
word and then click Log On to activate your account. If your
Key Operator does not require a password, select Tech Log On
to log in automatically.

Log Out Closes your account in the System until you log on again.

Quick Menu Located in the lower-left corner of every screen on the System,
it gives quick access to functions and the recent patient exams.

Shut Down Provides options to shut down power to the console. The Shut
Down button displays different options depending on the log
on password used. For example, Service personnel see different
options than technologists.

Images Failed to Takes you to the Image Review screen and automatically fil-
Deliver ters images that failed to deliver to their destination. The num-
ber of images at this status appears on the Images Failed to
Deliver button on the Main Menu.

Select Provides destinations to select from.


Destination

12 AC1456 | 2015-03-16
Quick Reference

Icon Button Name Description

Destination Displays the general status of each destination, regardless of


Status the image. For example, last delivery status, last delivery date
and time, and so forth.

Change Changes the selected destination for an image or study.


Destination
Profile

Print Sends an image or a multi-format image to a selected printer.


The profile set for the image typically has a printer selected, or
transfers to a default location.

New Patient Select New Patient when the patient you are searching for
does not exist in the local system or in the hospital's HIS/RIS.

New Study Creates a new study for the patient currently displayed on the
screen. The patient demographic information is copied from
the original study. The Accession Number, Procedure Code,
and Patient Location fields are not copied with New Study.

Begin Study Sends a message to the HIS/RIS that the study is started. This
button appears when New Patient is selected or when a
patient is selected from the Work List.

End Study Appears when the study has started. Select End Study to set
the study to complete. A message is sent to the HIS/RIS to
notify the billing function that the study is complete.

Continue Lets you go on to the next function without saving the changes
Without Saving you have made. It appears on the Confirm Changes dialog.

Create a Copy Copies a delivered image. This function is available when an


of an Image image has been delivered. You must create a copy of the image
before you can make changes to a delivered image.

Touchscreen Usage

Note
The touchscreen is very sensitive. Any inadvertent interaction with the screen may give you
unexpected results, so take care to select the targets carefully.
When you are logged on, the Main Menu button appears on every screen.
To make a menu choice, select the center of the button.

AC1456 | 2015-03-16 13
Quick Reference

Use only your finger or mouse to select buttons to prevent damage to surface of the
touchscreen.
The Quick Menu appears in the lower-left corner of every screen.
When the touchscreen deactivates because it was not used for a certain length of time,
touch the screen to reactivate it.
The date and time appear on every screen.

Note
The basic Classic CR system is shipped with a flat panel, non-touchscreen monitor. A touchscreen
monitor is available as an upgrade on a Classic CR system.

Multi-touch Monitor
The Multi-touch Monitor allows interaction with the screen with gestures, such as pinch
and pull to zoom and rotate. The user places two fingers on the screen and spreads them
apart or pulls them together to manipulate the zoom feature. Rotation may be done by
placing one finger on the image and pulling it left or right to rotate into position.

Patient Information Bar


The Patient Information Bar appears at the bottom of every image in the Image
Viewer screen and provides the current patient information for the displayed image.
When the Patient Information bar is selected, it opens the patient record on the
Patient Input screen.
The information on the Patient Information bar includes:
Patient Name
Patient ID
Accession Number
Cassette ID
Exposure Index
Date/Time
View Name
You can select the previous image or the next image in the study by selecting the arrows
on the Patient Information bar.
The Patient Information bar changes color depending on the status of the image. For
example, the bar may be green for an image that is assigned and orange for an image
that is unassigned.

Patient Verification Mode


Patient Verification mode is enabled by the Key Operator and provides an icon on the
title bar that tells the user whether or not the information on the patient's wristband
matches the information displayed on the Patient Input or Image Acquisition screen.
The patient ID is verified by scanning the patient wristband with the 2D bar code reader.

14 AC1456 | 2015-03-16
Quick Reference

An icon in the title bar on the Patient Input or Image Acquisition screen displays when
this feature is enabled.
There are two identifiers that the Key Operator can use to configure Patient Verification:
Patient ID
Name with Date of Birth

To Be Verified

Waiting for the wristband to be scanned with the 2D bar code reader.

Does Not Match

The wristband has been scanned with the 2D bar code reader and the Patient IDs do not
match.
User searches for another patient or enters data for a new patient using the 2D bar code
reader.

Is a Match

Patient ID on the wristband matches the patient ID in the system. The patient verification
is complete.
User proceeds with the exam.

AC1456 | 2015-03-16 15
Quick Reference

Find the Software Version


There are two ways to find the system software version.
Select the Carestream icon at the top-left corner of any screen. The following
information is displayed:
Computer Name
IP Address
Server Name
Model/Software Version
Serial Number
You can also navigate to Utilities > System Status and view the model/software
version in the list on the left side of the screen.

16 AC1456 | 2015-03-16
Use the Patient Work List Screen

Use the Patient Work List Screen


The Patient Work List screen appears by default when the user selects the Study Data
menu. This provides the user with quick access to patient status. The Patient Work List
may be customized so that patient information can be organized in different ways. The
different categories are used to filter the information as the user desires.
The Patient Work List screen is used to locate, identify, and notify the user of the status
of every patient and study in the local system database. The HIS/RIS or patient
information used by selecting the Work List screen and displayed there as well.
Each column on the Work List screen has a different function. Each function is a criteria
that can be selected to filter the list. The more specific the search criteria, the easier it is
to find the patient record you seek. If more than one record matches the information
used in the query, the system will present a list of all matching records.

Colors
Work List colors highlight the status of a patient order. The Key Operator can customize
the colors and their meaning for a particular facility from Key Operator Functions >
System Configuration > Color Preferences.
Standard colors are as follows:
Color Study Status on the Console

Blue Scheduled

Black Started

Green Arrived

Red Failed Update

Gray Complete

Navigation Buttons

Button Function

Trauma Opens the Trauma menu

Report List Opens the Dose Reporting List

Clear Fields Clears all selected fields

New Patient Opens a New Patient record

AC1456 | 2015-03-16 17
Use the Patient Work List Screen

Status Icons on the Patient Work List Screen


Icon Meaning

Scheduled

Started

Complete

Discontinued, with MPPS error

Discontinued

Started with MPPS error

Complete, with MPPS error

18 AC1456 | 2015-03-16
Use the Patient Work List Screen

Icon Meaning

New Exam

Dose Report Failed

How to Set Up a Query


Patient Query is done on the Patient Work List screen. The text boxes at the top of the
screen are selected to filter the lists. The Key Operator configures the layout of the filter
fields, and the field with the first focus.
All of the text boxes on the Patient Work List screen are user input fields. When a field
is selected, the virtual keyboard appears so that the information can be entered
manually, if the information does not appear automatically.
To find a study quickly:
1. Set up a query from one of the filters at the top of the Patient Work List screen, such
as Patient Name, Patient ID, Accession Number, Study Status, Time Window,
and so forth. The information will list the studies in ascending or descending order by
selecting the filter again. The filters in the text boxes remove entries from the list.
2. Select a study from the Patient Work List screen.
The Image Acquisition or Patient Input screen opens with that patient and study
data.

Patient Search Techniques

Perform a Search
Returning large volumes of data can cause system slowdowns. For best results, select
a narrow time window filter of Today.
Select Find Study Remotely to search the database, and to query the HIS/RIS
immediately.

AC1456 | 2015-03-16 19
Use the Patient Work List Screen

No Search Results
Check the criteria carefully for errors in spelling, accurate time window, correct
patient ID, and so forth.
Select New Patient, which will take you to the Patient Work List screen to enter
the information.

Note
If emergency patient information is not available or emergency circumstances do not allow the
time to enter data, immediately proceed to using the Trauma function.

Study Status Field Search Criteria


Lets you select from the following study states:
Scheduled
Arrived
Started
Scheduled/Arrived/Started
Scheduled/Arrived
Completed
Failed Update
Canceled
All

Time Field Search Criteria


Today
Today to Tomorrow
Yesterday to Tomorrow
Past Week to Tomorrow
Unrestricted

Unrestricted Search Criteria


Unrestricted means that time will not be used as a selection criteria when searching for
a patient.

Modality Field Search Criteria


CR
DX
RT
All
If you select ALL, patient records for all Modalities are returned.

20 AC1456 | 2015-03-16
Use the Patient Work List Screen

Locate Patient Information

Recent Exam Indicator

The Recent Exam Indicator appears in the upper-right corner of the screen when the Key
Operator activates the layout. The number indicates how many new exams there are. If
you touch the icon only the patients that have been added since the last log in will be
listed.
The Recent Exam Indicator appears in the upper-right corner of the Patient Work List
screen when the Key Operator activates the Add Patient Location and Recent Exam Filter
layout. If you touch the icon, only the patients who have been added since the last log in
will be selected.

How to Locate a New Patient

Prerequisites:
If no patient information is in the Hospital Information System/Radiology Information
System (HIS/RIS) or local database, follow this procedure:

1. Select New Patient.


2. Use the Image Acquisition screen to enter information and create the new patient
record.

How to locate a Recent Patient

Prerequisites:
A patient was X-rayed recently, but the record cannot be found. The information is in the
system and accessible through the Quick Menu.

1. Select Quick Menu. A brief list of patient records appears in the Quick Menu.
2. Select the Name, Accession Number, or ID field for the patient record you need to
use.

AC1456 | 2015-03-16 21
Use the Patient Work List Screen

How to Locate a Past Patient

Prerequisites:
The user is unable to locate a patient who already is registered in the system.

1. Locate the patient using a bar code reader.


a. Navigate to the Main Menu or to the Image Review screen.
b. Scan the bar code of the Accession Number, Patient ID, or Patient Name.
2. Locate the patient using the Work List screen.
a. View the Work List screen.
b. Select the row for the patient record you need to use.

How to Locate a Trauma Patient

Prerequisites:
The patient is in an emergency condition and you must enter data quickly. The Key
Operator must configure the Trauma option.

1. Select Trauma.
2. Select a Trauma ID.

Postrequisites:
If you do not see a Trauma button, consult with your Key Operator.

Note
The Trauma button does not appear unless the Key Operator has configured it. On CR Systems,
the Trauma feature is a purchasable option.

How to Find an Image

There are at least two options for finding an image you cannot locate quickly. Both
options begin at the Main Menu.
1. At the Main Menu, select Image Review.
2. Filter the database for the patients image by selecting the appropriate study status
(All, Unassigned, Delivered, and so forth).
3. Select the Image.

Note
From the Patient Work List screen, select the study and select the image.

22 AC1456 | 2015-03-16
Use the Patient Work List Screen

Modify Patient Information

You can modify the patient, exam, and image data at any time up until the image is
delivered.

How to Modify Information from the Patient Work List Screen

You can modify the patient, exam, and image information up until the image is
delivered.
1. Select a field.
2. Select Backspace.
Or select Clear All Fields at the bottom of the screen to delete information in all
the fields.
The pre-defined information in all fields will be reset to the default value when
you select Clear All Fields.

AC1456 | 2015-03-16 23
About the Image Acquisition Screen

About the Image Acquisition Screen


The Image Acquisition screen provides a control panel for exposure. The screen is
divided into three sections for preparation, status, and management.

Patient Input
Input and view information about the exam.
Provides:
Mandatory Patient Information
Optional Patient or Image Information
Multi-Format Print access
View Selection
Start, Delete, Complete, or End Study
Accept or Reject Image

Receptor Selection
Select and activate a Receptor.
On DRX-Evolution Systems, select Table Bucky, Table top, or Wall Stand

Focal Spot
Select Small Focal Spot
Select Large Focal Spot

Patient Size
Opens a tab menu of patient sizes for adults
Opens a tab of children sizes if the Pediatric Support Option is activated

Techniques
View information about the power, operational mode, and signal quality of a
receptor
Change the exposure duration. (Except on DRX-1 Systems. They do not have
generator controls.)

Detector Status
View status information about the selected detector.

Study Management
Manage data about the image.
Edit image data.
Manage the study.
Use navigational controls.

24 AC1456 | 2015-03-16
About the Image Acquisition Screen

Use the Image Acquisition Screen


This information applies to DRX Systems only.
1. Enter information for the patient record or the exam using the Patient Input
section:
Patient Information
Exam Information
2. Touch the Image Acquisition tab to prepare the study and view the list of available
detectors.
If your system has multiple detectors, use the Detector icon to identify the
detector you want to use for the study.
The Detector icon matches the identification mark on the surface of the detector.
3. Use the navigational controls to add images to the default study.
4. Select the fields and use the virtual keyboard to enter information about each image
5. Use the navigational controls to prepare multiple studies for one exam.
6. Select the study you want to complete.
7. Touch and activate a detector.
8. Go to the equipment and position the patient.
9. From the Console, enter Image Area Dose, kVp and mAs, etc.
10. Select Begin Study

Note
This will happen automatically when the first image is acquired for the study.
11. When the detector has a status of Ready, use the two-position prep/exposure switch.
12. View the preview image. If the image is incorrect, reject the image and make the
necessary adjustments to obtain an image that looks accurate in the preview.
13. When you see a status of Need Approval or Need Destination, touch the image to
go to the Image Viewer screen.
14. Work with the final image in Image. When satisfied, accept the image.
15. After completing work in the Image Viewer, you automatically return to the Image
Acquisition screen.
16. Proceed to the next image in the study.

Image Acquisition and Capture Overview


Patient exposure takes place at the Image Acquisition screen. Patient exposure is
controlled by a two-position prep/exposure switch on the side of the Console.
The bottom area of the Image Acquisition screen shows icons that represent the views
you will capture for the exam.

AC1456 | 2015-03-16 25
About the Image Acquisition Screen

After each view is captured, the icon is replaced with a thumbnail image that represents
an exposed image.

Note
Images captured using the DRX System Detector and Console are automatically processed
following exposure.
Touching a thumbnail image takes you to the Image Viewer screen for that image.
A blue square in the procedure name box indicates that the procedure is configured for
multi-format pages.

Note
When taking an exposure, employ the use of appropriate radiation protection and safety
measures for you and your patient. Refer to the CARESTREAM DRX-1 System Safety and
Regulatory Information with Hardware User's Guide for product safety information.

What is Extended Exposure Mode


Extended Exposure Mode (EEM) is a User-selectable setting which enables the exposure
equipment to accept X-rays for a longer period of time. Operating at longer duration
energy/exposure levels allows for more effective imaging of:
Dense body areas (i.e., hips)
Patients with large body mass
Other specialized exam techniques
In addition, EEM can be used to increase the energy levels of mobile exposure units which
tend to be less powerful than in-room equipment.

How to Acquire Images with a DRX Detector


Prerequisites:
Look at the status bar in the middle of the screen for information about the detector
state.

1. In the exam room, look at the detector surface for an identification mark.
2. Put the detector in a Bucky or position the detector for a tabletop exam.
3. At the Console, access the Image Acquisition screen.
4. Prepare the patient information.
5. Prepare the study procedures.
6. Touch and activate the Detector Icon that matches the identification label on the
detector.
7. Position the equipment and patient.
8. Give the patient the proper breathing instructions.

26 AC1456 | 2015-03-16
About the Image Acquisition Screen

9. On the prep/exposure switch, press and hold the button halfway down to the prep
position.
10. After the status bar indicates the detector is Ready, press the button completely to
take the exposure.
11. When the exposure is complete, release the prep/exposure button. The image is
processed automatically.
12. Give the patient the proper breathing instructions.
13. Use the Console to preview images, accept the images, and select destinations for the
images.

How to Acquire Images with a Cassette


1. At the console, access the Image Acquisition screen.
2. Prepare the patient information.
3. Prepare the study procedures.
4. Deactivate the detector. Select the option for using CR cassettes or film/screen
cassettes (generator icon).
Status information for a third-party generator does not display on the Console.
5. Position the equipment and patient.
6. Give the patient the proper breathing instructions.
7. On the prep/exposure switch, press and hold the button halfway down to the prep
position.
8. After the rotor is running at the proper speed, press the button completely to take
the exposure.
9. When the exposure is complete, release the prep/exposure button.
10. Give the patient the proper breathing instructions.
11. Work with the appropriate equipment to process the image(s) on the cassette.
Image information does not display on the Console.

AC1456 | 2015-03-16 27
Patient Input Screen

Patient Input Screen

Use the Patient Input Screen


The Patient Input screen lets the user input all of the demographic data needed to
perform an exam. The user inputs the patient and exam data that identifies the patient
if the information does not automatically appear from the HIS/RIS. Tutor Image icons
display when a View or a procedure is requested. Prior images and/or companion images
are indicated as icons inset into the image. You can:
Enter patient information
Begin and end a study
Perform workflows
Display a patient study
Edit patient information with the Editing button
Select an image to review in the Image Viewer screen
Accept an image and send it to destinations such as workstations or printers

How to Enter Patient, Study, or Image Information

The Patient Input screen or the top half of the Image Acquisition screen lets you
enter, modify, or view information about the patient, study, or image. To enter the
information manually:
1. Use the bar code scanner to enter information, or touch the field and enter the
information from the virtual keyboard.
2. Enter the required information in the required fields.
3. Enter optional information if available.
Optional fields are not highlighted and do not have to be filled in order to
complete the study.
The Key Operator determines which fields are considered optional.
4. Select Save Changes.
A pop-up warning appears if the software changes an invalid birth date to a valid one
when the Technologist enters a birth date on the Patient Input screen.

How to Enter Information With a Bar Code Reader

Select a data field and scan a bar code to place its value in the field. The system is capable
of recognizing and automatically placing the values. This feature is the system's ability to
automatically recognize certain data fields and enter the information without selecting
that field in advance.
The bar code reader must be configured correctly and the Key Operator must configure
the Console to recognize Accession Number, Patient ID, and Tech ID bar codes. This
allows the Modality to:

28 AC1456 | 2015-03-16
Patient Input Screen

Expedite data entry by reading bar codes for selected fields and place those values
into the fields.
Automatically place the correct value in the correct field if you read an Accession
Number, Patient ID, or Tech ID. This opens the patient study automatically.
The bar code automatically executes a local query to retrieve Work List or patient
records that match the value read.

Enter Additional Exam Information

Additional exam information is information that the Key Operator has decided not to
require in order to proceed with the patient's exam. You can complete the patient's
record without this information. The fields are configurable by the Key Operator,
depending on the needs of the facility. Enter optional information from the three tabbed
palettes as shown on the Patient Input screen or in the section of the Image
Acquisition screen.

How to Begin a Study

To begin a Study from the HIS/RIS, select Study Data. Do one of the following:

Scan the bar code on the requisition or enter patient information in any of the
available fields.
Select or enter the patient name at the Work List.

The patient information and the Technologists ID fill in automatically on the Patient
Input or Image Acquisition screen if the Key Operator has configured it to do so.

How to Begin a Study Using Manual Input

1. Touch the field and enter the information. The Technologists ID fills in automatically
if the Key Operator has configured this feature.
The Key Operator may specify data fields that are required to be completed for every
exam. Required fields are identified by a colored highlight.
2. Enter the required information in highlighted fields.
Required fields must be completed before you proceed with the exam.
3. Enter optional information, if available.
Optional fields are not highlighted and do not have to be filled in order to complete
the exam. The Key Operator determines which fields are considered optional.
4. Enter more information on the More Information and Image Acquisition tabs.

AC1456 | 2015-03-16 29
Patient Input Screen

How to Begin a Study for a Patient Already in the System

1. Select Study Data.


2. Select Find Study Remotely.
3. Select the Patient Name from the Work List.

The patient record retains the patient data without the images.

What Happens When You End A Study

When all of the images have been acquired and accepted, you should end the study by
selecting End Study on the Patient Input or Image Acquisition screen.
If your system is using Modality Performed Procedure Step (MPPS) for Scheduled
Workflow, selecting End Study sends a message to the HIS/RIS Modality Performed
Procedure Step Manager that the procedure has ended, and changes the status of the
exam in the Modality is Completed.
The system creates, sends, and stores a structured report of the dose of irradiation a
patient receives when the Technologist selects End Study on the Patient Input or
Image Acquisition screen after a study is complete.
The structured report option must be enabled on the system in order to use the feature.

How to Complete a Study from the HIS/RIS with Optional Procedure


Mapping

If your facility has a HIS/RIS and your Modality has the optional Procedure Mapping
feature, the Key Operator can associate procedure codes to automatically populate the
necessary views for a study. The HIS/RIS must populate the procedure code field on the
Image Acquisition screen so that the Views populate automatically.
1. From the Main Menu, select Study Data.
2. Search for the patient using the Patient Work List screen.
3. Select the patient from the Patient Work List screen.
The patient information and the Views for the procedure automatically appear on
the Image Acquisition screen.
4. Enter information on the More Information and More Image Data tabs if needed.

30 AC1456 | 2015-03-16
Patient Input Screen

How to Complete a Study from Optional Procedure Mapping without the


HIS/RIS

If your facility has purchased the optional Procedure Mapping feature, you can complete
the View selection process as follows.
1. From the Main Menu, select New Patient.
2. Manually enter the patient data and complete all of the highlighted required fields.
3. If you know the Procedure Code, enter it in the Procedure Code field and select
Enter.
The system automatically enters the procedure name in the Procedure Name field
and the associated Views automatically appear.
If you do not know the Procedure Code, do the following:
a. Select Procedure Name.
b. Select a region from the Primary Category tab.
c. Select a body part from the Secondary Category tab.
d. Select a Procedure.
The Views for the procedure appear on the Image Acquisition screen.
4. Enter information on the More Information and More Image Data tabs if needed.

How to Modify Information from the Patient Input or Image Acquisition


Screen

1. Select a field.
2. Select Backspace.
3. Enter the correct information from the virtual keyboard.

How to Enter Trauma Patient Information


Prerequisites:
The patient entered the facility in an emergency situation and the actual patient
information is not available.

1. Select Study Data.


2. Select Trauma.

AC1456 | 2015-03-16 31
Patient Input Screen

3. Select a Trauma ID from the Trauma tab.


The pre-configued patient information fills in automatically on the Patient Input or
Image Acquisition screen.

Note
Enter the actual patient information when it becomes available on the Patient Input or Image
Acquisition screen. If the image is delivered, you must unassign the image from the Trauma ID
and assign the image to the correct patient information.

Trauma Button

The purpose of the Trauma button is to display the pre-configured trauma patients that
have been configured by the Key Operator. The Trauma button opens a keyboard with
default information to use for emergency patients. This information is pre-configured by
the Key Operator. When selected, this button:
Fills the patient information you select automatically into the Patient Input or
Image Acquisition screen.
Enables you to enter the actual patient information when it becomes available.
If your system is configured for the Trauma feature, the required fields in the Exam
Information tab populate quickly in emergency situations. The Exam Information tab
is located on the Patient Input or Image Acquisition screen.

How to Locate a Trauma Patient

Prerequisites:
The patient is in an emergency condition and you must enter data quickly. The Key
Operator must configure the Trauma option.

1. Select Trauma.
2. Select a Trauma ID.

Postrequisites:
If you do not see a Trauma button, consult with your Key Operator.

Note
The Trauma button does not appear unless the Key Operator has configured it. On CR Systems,
the Trauma feature is a purchasable option.

32 AC1456 | 2015-03-16
Patient Input Screen

Views

Define a View

A View is a pre-set image type that a radiographer can select. It consists of position,
projection, and image processing preferences. On DRX-Evolution and DRX-Revolution,
selecting a View also selects the technique. It is the basic element in the CR or DR image
chain.
Views are associated with procedures on the Image Acquisition and Patient Input
screens with the optional Procedure Mapping. When the Key Operator creates a View,
it appears on the Image Acquisition or Patient Input screen.

Change View Name

Why would you want to change the View name for the current image?
For example, you did a Chest PA on a Chest Lateral thumbnail. You will want to change
the name of the View and then reprocess with the Chest PA processing.
1. Select the View name field.
2. Choose a primary category, secondary category, and a View.
3. If you have auto-reprocess turned on, you are done. If not, select Reprocess Image.

How to Add Views to a Procedure

1. Select Add View.


2. Select the Primary Category.
3. Select the Secondary Category.
4. Select all of the desired Views for the study.
5. Select Save Changes.

AC1456 | 2015-03-16 33
Patient Input Screen

Set Up Views to the Procedure

If the Key Operator has configured the system with the Views needed, in most instances
the View selection is complete once the procedure is selected.

Procedure Mapping Using the Add View Workflow

1. Manually enter required information in highlighted fields with the virtual


keyboard, or use the bar code reader. Required fields must be completed before you
proceed with the exam.
2. Enter optional information if available. Optional fields are not highlighted and do
not have to be filled in order to complete the exam. The Key Operator determines
which fields are considered optional.
3. Select the Procedure Name field if this field is not populated from the RIS. After
selecting the field, use the keyboard tab to manually name the procedure. The
procedure then appears on the Work List.
4. Select Add View.
5. Select a region from the Primary Category.
6. Select a body part from the Secondary Category.
7. Select all of the views in the study, and then select Save Changes.
8. Enter information on the More Information and More Image Data tabs if needed.

Note
Data fields may be configured to accept a certain number of characters, character types, or a
sequence of characters based on DICOM. Some data fields have menu selections so the data is
set for you.

How to Review and Accept Individual Images


After acquisition, a thumbnail image appears on the Patient Input screen.
1. Select the thumbnail image to display it for review on the Image Viewer screen.
2. Select Accept Image to send the image to the appropriate network destinations.

How to Review and Accept all Images in a Study

After acquisition, thumbnail images appear on the Patient Input screen.


1. Select one of the images to open the image on the Image Viewer screen.
2. View the other thumbnail images using the arrow buttons on the Patient
Information Bar.
3. Select the Patient Information Bar to return to the Patient Input screen after
reviewing all of the images.

34 AC1456 | 2015-03-16
Patient Input Screen

4. Select Accept All to send all the Views that have acquired images to the selected
destinations.
Subsequently, acquired images will not be automatically delivered as a result of the
previous Accept All selection.

How to Reject an Image

The Technologist can reject an image based on the quality of the image. When the
Administrative Analysis Reporting Software option is purchased and enabled, each time
an image is rejected, a reason must be selected. This reason is recorded and becomes a
record in Technologist Statistics. The image is evaluated at the Image Viewer screen.
The Key Operator can edit the default list.
An image may be rejected for the following reasons:
Clipped Anatomy
Motion
Positioning Error
Artifact
Technique
Duplicate
Test/Service/Blank
Once the image is evaluated, and you decide it should be rejected, do the following:
1. Select Reject.
2. Choose a reject reason.
3. Select Reject.

The rejected image then appears on the Rejected Image List screen. It may be accessed
by the Key Operator. The Key Operator may configure the system so that the
Technologist can access the screen as well, for further evaluation at another time.

Note
If the Administrative Analysis Reporting Software is not used, the Technologist will answer Yes or
No to a pop-up asking if the image should be rejected, without being prompted for a reason.

AC1456 | 2015-03-16 35
How to Assign an Image to a Patient

How to Assign an Image to a Patient


1. From the Main Menu, select the Assign Image button at the bottom of the image
to be assigned.
2. Go to the Image List screen or choose the Unassigned Images indicator at the top
of the screen.
If a new patient needs to be added, the image is selected, the View is added, then you
will enter the new patient information.
3. At the Patient Work List screen, do one of the following:
Enter the search criteria to search for the correct patient.
Select New Patient.
4. Select Add View.
If New Patient was selected, enter the patient information.
5. Select Save Changes.

How to Assign an Image to Different Patient


You can move an image from one patient to another by unassigning it from one patient
and reassigning it to another patient.
1. At the Image Viewer screen, open the image to be moved.
2. Select the Unassign Image button.
3. Select the Assign Image button.
4. At the Patient Work List screen, do one of the following:
Enter the search criteria to select the correct patient.
Select New Patient.
5. Select Add View.
If New Patient was selected, enter the patient information.
6. Select Save Changes.

How an Image Becomes Unassigned


The following information applies to CR systems only.
Unassigned images result when one of the following situations occur:
The cassette is scanned without first associating the cassette with a patient, such as in
a trauma situation.
A View icon is not selected when an image is scanned and the auto-associate feature
is enabled.
The image is manually unassigned from the original patient.

36 AC1456 | 2015-03-16
How to Assign an Image to a Patient

Note
Unassigned images must be assigned to a patient before delivery. You cannot assign an image
once it is in Delivered status. You will have to make a copy of the image in order to do so. See
How to Make an Image Copy for more information.

How to Unassign an Image

You can Unassign an image from a patient ID or a trauma ID.


1. Select the image to be unassigned.
The image opens in the Image Viewer screen.
2. Select the Unassign Image button.
The patient information is removed from the image. The image information is
retained with the image.

Note
Unassigned images must be assigned to a patient before delivery.

How to Assign a View to an Unassigned Image

1. From the Main Menu, select the Images Not Assigned button.
2. Select the image from the list to open the Image Viewer screen.
3. At the Image Viewer screen, select the Look/Adjustment tab.
4. Select the View Name field to correctly designate the appropriate algorithm.
5. Select Reprocess Image.
6. Select Save Changes.

AC1456 | 2015-03-16 37
Tube and Line Visualization Software

Tube and Line Visualization Software


This is a feature that uses optimized image processing parameters to increase the
contrast and edge enhancement of the chest image and make it easier to determine if
the end points of Tube or Picc lines is properly placed. When Tube or Picc line detection
is requested, a second, or Companion Image is created. You can verify the position of the
tube or picc line with this image. You can only deliver this new image to a PACS
workstation or film along with the standard processed image.
The Key Operator can configure a View to create a Companion Image automatically at
image acquisition time, or the Technologist can request the Companion Image manually
for selected Views from the Image Acquisition screen if this option is configured by the
Key Operator.
When the Tube and Line Visualization Software is purchased, High Detail Visualization
(HDV) view is also available. This Companion Image provides a higher detail and contrast
to any View.

How to Select the Tube and Line Option


This procedure assumes that the need for the Tube and Line procedure is necessary.
1. Select the Tube and Line icon on the Image Viewer screen .
A message: Creating... appears as the image is processed. All buttons except
the Main Menu and Back are disabled.
A high-contrast version of the image appears.
If you apply markers, masking, measurement tool settings, etc. to the original
image, those changes will also be applied to the Companion Image. Any
changes to the Companion Image are also applied to the Standard Processed
Image.
Changes to image processing, Window/Level sliders or the Noise Suppression
check box affect the displayed image only.
Any reprocessing changes for one image will not cause a reprocessing of its
Companion Image.
2. Select Accept Image.
The Standard Processed Image and the Companion Image are delivered to
the selected destinations. This is the only way the Companion Image can be
delivered.
The thumbnails for the Standard Processed Image and the Companion Image
can be viewed on the Patient Input or Image Acquisition screen.

Note
If the Tube and Line Visualization Software is purchased, the High Detail Visualization (HDV)
feature is automatically included. The HDV feature provides a higher contrast image so that detail
is easier to see. This feature is intended for Views other than chests and abdomens.

38 AC1456 | 2015-03-16
Tube and Line Visualization Software

Troubleshooting the Tube and Line Visualization Software


Scenario Action

The Virtual Keyboard does not appear Enable Tube and Line Visualization Software.
The Companion View does not change
The Companion View is unchanged Caused by selecting Close on virtual keyboard.

Turn off the Companion Image created for a Select Clear to eliminate a Companion Image.
given View, but create it for other Views
Do not create Companion Images automatically Do not check the box in front of any of the Com-
panion Images listed in the Auto Create Compan-
ion Image Type check box on the Display
Configuration > Image Viewer tab.

Companion Image button is not selectable Change the View to one that supports a Tube/Line
View, then reprocess the image.
Ask the Key Operator to assist.

AC1456 | 2015-03-16 39
About High Detail Visualization (HDV) Software

About High Detail Visualization (HDV) Software


Companion Views are a copy of the original, standard image. No additional patient
exposure is needed to produce these images. Electronic markers, Free Text Annotations,
and masking are copied between images. Companion images are intended to
supplement, not replace the standard image.
High Detail Visualization (HDV) provides a Companion Image that is optimized for HDV
purposes or latitude for any View. Most Companion Images are used for chest and
abdomen Views. The Key Operator can configure the HDV View to appear automatically,
or it can be configured to be selected manually by the technologist from the Image
Viewer screen.
The HDV View is available with the purchase of Tube and Line Visualization Software.

40 AC1456 | 2015-03-16
Pneumothorax Visualization Software

Pneumothorax Visualization Software


Pneumothorax is the presence of air between the two layered membrane that separates
the lungs from the chest wall. This condition generally causes the lung to collapse. A
chest X-ray confirms the diagnosis.
Pneumothorax imaging optimizes the image processing of a chest image so that it is
easier to detect a pneumothorax.
DIRECTVIEW software provides an option to automatically create a companion image.

AC1456 | 2015-03-16 41
Bone Suppression Software

Bone Suppression Software


Bone Suppression Software allows the user to view an image that minimizes the evidence
of posterior ribs and clavicles, allowing a clearer view of chest organs such as the lungs.
It reduces the need for a second X-ray or a CT scan, with a lesser dose to the patient as a
result. These benefits apply to all Companion images:
For Technologists:
Requires no additional dose or imaging time
Requires no additional setup or exposures
Performed with the same process as other functions indicated by Companion Images
For Radiologists:
Provides an automatic additional rendering designed to suppress the appearance of
ribs and clavicles and enhance the visualization of soft tissue
Accessed easily by toggling between the standard visualization and soft tissue for
improved reading efficiency; both images can be viewed on PACS with no additional
workstation needed
Available for all chest images taken with DRX systems using DIRECTVIEW System
Software V5.7 and higher.

Bone Suppression Indications For Use

Indications for Use


The software's intended use is to assist diagnosis of chest pathology by minimizing
anatomical distractions such as the ribs and clavicle.

Caution
Measurement of pathology in the bone-suppressed companion image is not recommended.

42 AC1456 | 2015-03-16
Prior Images

Prior Images

Prior Image Display Feature


The Prior Image Display feature lets the user temporarily import and view images and
information from patient's previous exams (recall time frame is configured by the Key
Operator), including technical information such as the technique used. This enables the
user to quickly copy or change the settings before acquiring the image, using the
previous exam as a reference.
This is achieved by requesting the images from the patients last exam from the PACS or
locally from the CR or DR system. The images are retrieved and made available for review.
Pertinent data will be extracted from the DICOM header when it is available.

Use Prior Images


Prior retrieval data are used before the image is acquired.
1. Retrieve the prior images.
The image(s) will appear as a window on the Patient Input screen.
2. Select the Priors icon.
The Prior Images screen opens.

Note
One button is listed on the right side of the screen for each prior image.
3. Select the button to load a prior image into the preview panel to the left of this list.
4. View the image.
5. Determine whether to use the same techniques that were used to create this image,
or whether to change the technique to improve on these results when the image is
acquired.

AC1456 | 2015-03-16 43
Prior Images

Prior Image Controls

Tools to Control Prior Images

Tool Result

Rotate the prior image 90 clockwise

Rotate the prior image 90 counterclockwise

Flip the prior image horizontally

Flip the image vertically

Copy the technique for the prior image to the Image Acquisition screen if
desired (DR only).

Retrieve Prior Images


The search for prior images must meet certain criteria. The retrieval method is configured
by the Key Operator. One of three retrieval methods may be configured for your system:

Manually Retrieve Prior Images


In Manual Retrieval mode, the software begins to search for prior images when the Prior
Images icon in the thumbnail is selected. The software searches for the prior images for
that body part when the user selects the icon.

Automatically Retrieve Prior Images when the Study is Opened


When this mode is selected, the software will automatically search for prior images for
the indicated body parts when a study is selected from the Patient Work List screen.

44 AC1456 | 2015-03-16
Prior Images

Automatically Retrieve When the Study is Added to the Work List or the
View is created
When this third mode is selected, the Retrieve Priors for Work List Items Matching
the Following Criteria check box will be enabled. It is not available in any other
retrieval mode.

Note
The system will search for the number of images and time limit the Key Operator has configured
as a default, such as two images processed in the past two weeks. Prior image Views may be
configured for certain body parts only.

Prior Image Retrieval Functions

When the Prior Image Retrieval feature is enabled, a new icon is added to the tutor
image.

The icon displays one of the following conditions:

SearchingNo prior images received

This display indicates that the system is actively searching for prior images, but none have
been found. The icon is disabled and the animated cursor indicates that the search is in
progress. The icon does not indicate the presence of priors.

AC1456 | 2015-03-16 45
Prior Images

RetrievingAt least one prior image retrieved

This display indicates the number of prior images that have been retrieved
Selecting this icon opens the Prior Images screen. If additional images are actively being
retrieved, the icon as well as the Prior Images screen will be updated to reflect the
additional images as they are retrieved into the system.

EnabledFor Manual mode

This display indicates that the user can manually request to retrieve priors for this image,
even if the system is in another retrieval mode.

46 AC1456 | 2015-03-16
Express Viewer Screen

Express Viewer Screen


The Express Viewer screen provides a large View pane to use tools that are available
by default, and where they are. For example, touching the image will bring up the
Marker/annotation tools.
If configured, the Express Viewer screen appears instead of the Image Viewer screen.
The compete set of image processing functions still reside on the Image Viewer screen,
including the functions described here, and can be accessed by pressing the
Advanced Viewer button.

Note
For more image editing tools, select Advanced Viewer. Once you access the Image Viewer
screen, you cannot toggle back to the Express Viewer screen.

Icon Description

Standard Image View


Default view
Applies standard image processing to the displayed image.

Tube and Line View


Applies image processing that makes it easier to see the tube or
line in the displayed image.

Bone Suppression View


Displays an image that minimizes the evidence of posterior ribs,
allowing a clearer view of chest organs such as the lungs.

Pneumothorax View
Applies image processing that makes it easier to see a patient's
pneumothorax in the displayed image.

High Detail Visualization View


Provides a companion Image that is increased in contrast and detail
for any View. Companion Images are used for chest and abdomen
Views.

AC1456 | 2015-03-16 47
Express Viewer Screen

Icon Description

Histogram
A graph of the distributions of pixel values in the image. The X-axis
is exposure from low to high. The Y-axis is frequency of occur-
rence.

Flip Buttons
When selected, they transpose individual images horizontally or
vertically.

Rotate Buttons
When selected, an individual image turns clockwise or counter-
clockwise at 90 degree intervals.

Markers
The markers palette appears with a crosshair target.

View Name
Change the view name for the current image.

Edit Mask
Edit the mask points so that you can change the shape of the Black
Surround Mask.

Reprocess
The current image if the View name or Black Surround Mask has
changed.
This button is not visible if the system is configured to reprocess
images automatically.

Used with Black Surround Mask.

If Tech Assist software is enabled, this button lets you toggle back
and forth between the standard view and the CNR/Anatomy
Clipping view.

48 AC1456 | 2015-03-16
Image Viewer Screen

Image Viewer Screen

Use the Image Viewer Screen


On the Image Viewer screen, any accessed image in the system appears before
modification. Radiographers or Key Operators can perform any of the following
functions before sending an image to its destination:
Review an image and decide to accept or reject it.
Make adjustments to the image quality before sending the image to its destination.
Add markers, measurements, or comments to images.
Quickly review an image each time a thumbnail image is selected from anywhere in
the system.

Image Viewer Display Options

At the Key Operator Functions > System Configuration > Display


Configuration > Image Viewer tab, the Key Operator can configure the Console to
display the following zoom options to appear on the Image Viewer screen by default:
Fit to ScreenDisplays the matrix of pixels of the entire pixel matrix in the Image
Viewer pane.
Fit to BSMDisplays only the pixel matrix within the Black Surround Mask. This
displays the matrix of pixels inside the view area, and the picture looks bigger.
Full Screen viewingDisplays the image without borders in the entire area of the
screen.
Full Screen viewing also eliminates the tool tabs. Use the Back button to make them
reappear.

Note
The user can select any of these options from the Image Viewer screen. Fit to Screen, Fit to
BSM, and Full Screen viewing are always available to the user and can be selected regardless of
how the system is configured to zoom by default.

Full Screen Viewing

The Full Screen Viewing feature maximizes the visibility of the image by allowing the
image to fill the entire screen. The control is accessed from the Image Viewer screen.
The image can be panned while zoomed; however, no other edits can be mademarkers
cannot be placed or moved on the image.
The Full Screen viewing feature:
Causes the image to fill the entire screen

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Image Viewer Screen

Allows the user to zoom in and out in 10 % increments while the image fills the screen
(up to a maximum of 200 % zoom)
Allows the user to exit Full Screen mode and return to the normal Image Viewer
screen view.

How to Use the Full Screen Viewing Feature

Full Screen viewing causes the image to fill the screen so that the controls on the Image
Viewer screen are no longer visible.
1. Select the Full Screen button to use the entire screen as image display area.
a. Use the + button to zoom the image up to 200 %.
b. Use the button to make the image smaller.
2. Select Back to return to the Image Viewer tool pallet.

Tech Assist Toggle Button

If Tech Assist software is enabled, this button lets you toggle back and forth between
the standard image view and the CNR/Anatomy Clipping view.

Reprocess Image Button

Reprocess the current image if the View name or the Black Surround Mask has changed.
This button is not visible if the system is configured to reprocess images automatically.

Markers Overview
The markers palette appears when you touch an image on the screen.
There are many markers to choose from on the Markers palette. You can move and
delete markers on the image by touching the image and then touching a marker. The
markers are divided into groups to make them easy to find. You access them from the
sub-tabs at the bottom of this palette.
When you apply a marker, and then flip or rotate the image, an arrow marker will still
point to the area you designated. A text marker will read correctly.
Once you select Save Changes, the marker becomes a permanent part of the image. It
appears on a workstation or on a print.

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Image Viewer Screen

Markers can be created in a file that is used as an overlay on an image. If selected on the
Delivery Preferences screen, the Key Operator can select Marker Overlay to Storage
on the Destination Configuration screen and send the marker to the PACS as a
separate file.
Favorites

Others

Time

Measures

How to Add Markers

This procedure applies to the Image Viewer screen. You can add an unlimited number
of markers to an image. Once a marker is added to an image, it will be visible when it is
sent to a destination. Markers can be used more than once on a single image.
1. From the Image Viewer screen, select the Markers tab.
2. Select the marker type icon (Time, Measures, and so forth).
3. Select the desired location on the image.
4. Select Save Changes.

The marker remains in place until you change its position.

How to Use Free Markers and Annotations

This information is for using markers on the Express Viewer screen.


On the view pane window on the Express Viewer screen, select the point on the image
where you would like to place a marker to make the Marker shortcut menu appear.
Add a MarkerSelect a marker. The marker will be placed on the image in place
of the circle.

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Image Viewer Screen

Move a MarkerSelect a marker on the image and drag it to another location.


Delete a MarkerTap the marker and a Trash Can appears so that you can delete
the marker.

How to Move a Marker

This procedure applies to the Image Viewer screen.


1. Select the marker on the image. The marker is highlighted when selected.
2. Select the new location on the image.

How to Remove a Marker

This procedure applies to the Image Viewer screen. A marker can be removed from an
image before or after it is saved to the Modality database.
1. Select a marker on the image. The marker is highlighted when selected.
2. Select the Trash Can.

How to Add the Text Marker

The Free-Form Text marker lets you add 32 characters of text to the image. You can add
the text marker to an image or change the marker already in place. The text marker
becomes part of the image and is retained when sent to destinations.
To add a Free-Form Text marker:
1. From the Image Viewer screen, select the Markers tab.
2. Enter the desired information in the text field from the keyboard for your system.
3. Select the desired location on the image.

Note
When you add a Free-Form Text marker, use the keyboard to enter text in the Free-Form text
field. You must select Enter every time the Free-Form text field is changed.

Note
To remove the text marker, select the text marker on the image, then select the Trash Can.

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Image Viewer Screen

Image Orientation and Appearance

Rotate and Flip the Image

Rotating and flipping the image lets you change the orientation of an image before it is
sent to destinations.
1. From the Image Viewer Screen, select the Print tab.
2. To rotate the image clockwise, select the Rotate CW button. To rotate the image
counter clockwise, select the Rotate CCW button.
The image rotates in increments of 90 degrees.
You can see the change in the Image Viewer window.
3. To flip the image, select the Flip Horizontal or Flip Vertical button.
You can see the change in the Image Viewer window.
4. Select Save Changes.
The change you make to image orientation appears at the destination.

Pan and Zoom

Use the Pan and Zoom features to evaluate images. To return to normal view, select Fit
to Screen.
There are a variety of ways to pan the image:
Use the arrows to move the viewing window to different areas of the image.
Select the image and drag across.
Select the thumbnail and drag across.
Drag the highlighted viewing window to another area.

How to Pan Across the Image

There are a variety of ways to pan the image:


Use the arrows to move the viewing window to different areas of the image.
Select the image and drag across.
Select the box on the thumbnail showing the zoomed area currently shown in the
viewer and drag across.
Drag the highlighted viewing window to another area.

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Image Viewer Screen

Zoom Mode

You can enlarge the image by selecting a zoom level on the Magnification tab on the
Image Viewer screen.
When the image is in zoom mode you can add markers and change image processing
characteristics.
The zoomed image is for viewing only. A zoomed image does not go to the destination.

Invert the Grayscale

The inverted image provides an alternate view of image detail.

How to Invert the Grayscale

1. At the Image Viewer screen, select the Invert Grayscale check box.
2. To print the image, select Save & Accept Image.
3. To remove the effect, clear the Invert Grayscale check box.

What Does the Histogram Represent?

The histogram is a graph of the distributions of pixel values in the image. The X-axis
is exposure from low to high. The Y-axis is the frequency of occurrence.
A normal exposure produces an S-shaped contrast curve across the histogram. If
image processing fails, the histogram displays a straight diagonal line and the image
displays very low contrast. This is an indication that no additional image processing
has been applied to the image.
Displays changes in contrast such as changing from standard view, tube and line view,
and pneumothorax view for DIRECTVIEW

Note
A different Look or different collimation will generate a different curve, as well.

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Image Viewer Screen

About the Free Rotate Feature

The Free Rotate feature is a tool that allows the user to slightly rotate an image that is
not oriented optimally on the Image Viewer screen. The control appears on the Printer
tab, located under the Rotate Clockwise and Rotate Counterclockwise buttons.
When Free Rotate is selected, a crosshair and circle target appears, centered on the
image. The circle has four blue anchors. The user can select one of the anchors and drag
the anchor clockwise or counterclockwise until the image is oriented properly.

Black Surround Mask


A Black Surround Mask (BSM) reduces viewing flare. Applying the Black Surround Mask
causes the unexposed areas around the image to be displayed black and makes soft tissue
and low contrast detail more visible. Mask placement typically corresponds to the
placement of collimator blades. If you have the Automatic Surround Mask feature,
automatic mask is ON by default. The Show Mask check box is checked.

Use the Surround Mask Tab

Surround Mask causes the unexposed areas around the image to be displayed black and
makes soft tissue and low contrast detail more visible. Mask placement normally
corresponds to the placement of collimator blades.
If two images are exposed on one phosphor screen, they are processed as two separate
images. Image quality is optimized for each exposure field, and the images are delivered
exactly as they appear on the system monitor. A Black Surround Mask and the Exposure
Index are applied to each exposure field separately.
Make adjustments as desired.
Show Mask Applies Automatic Surround Mask and makes
it visible.

Edit Mask Applies Manual Surround Mask and adjusts


the mask. Select the check box to apply

Circle or Rectangle Controls Locates where on the image the mask should
be applied.

Arrows Moves the mask shape you created to


another area of the image.

Reset Returns the mask to the last saved position.

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Image Viewer Screen

Set to Corners Places the mask points in the four corners of


the image.*

Treat as Single-Exposure Image Overrides masking when the system inter-


prets a single exposure as multiple images, or
improperly masks multiple exposures on a
single image.

* Use this feature if there is a Surround Mask failure and you want to enlarge the mask quickly, or if you move a
point off the image and you cannot get it back.
This feature can be configured in View Configuration to treat certain (or all) Views always as single exposures.

How to Access Black Surround Mask Points Off the Screen

To find a mask point when it is off the image, you can change the magnification so you
can see the points.
1. At the Image Viewer screen, select the Magnification tab
2. Select 25 % zoom.
3. Select the Surround tab.
4. Select Edit Mask.

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Image Viewer Screen

5. Move the circular or rectangular control points on the mask on the smaller image.

Automatic Black Surround Mask

Black Surround Mask reduces viewing flare. The mask helps you see soft tissue and low
contrast information. Automatic mask placement normally corresponds to the placement
of collimator blades.

Note
If you have the optional Automatic Surround Mask feature, automatic mask is ON by default. The
Show Mask check box is checked.

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Image Viewer Screen

How to Apply the Black Surround Mask

Manual Surround Mask is used when Automatic Surround Masking is not sufficient.
1. From the Image Viewer screen on the Surround Mask tab, check the Edit Mask
check box.
2. Change the shape of the mask:
Select a circle (corner) or rectangle (side) on the mask, then drag it to another
location.
Select a side and select another location on the image.
Use the green arrows on the editor to move a selected side or edge.
3. Select Reprocess.
4. Select Save Changes.

How to Reset the Black Surround Mask

To reset the Black Surround Mask back to its original position, navigate to the Image
Viewer screen and select Reset.

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Image Viewer Screen

How to Adjust the Black Surround Mask

To change the shape and size of the Black Surround Mask, select the circles on the corners
of the mask or the edges of the mask and pull or push the mask into the desired shape.

How to Configure Surround Mask Enlargement

Edit Black Surround Mask

1. Select Edit Mask.


2. Adjust mask points.
3. If Auto-Reprocess is enabled, you are done. Otherwise, select Reprocess Image.

How to Adjust the Black Surround Mask

To change the shape and size of the Black Surround Mask, select the circles on the corners
of the mask or the edges of the mask and pull or push the mask into the desired shape.

Reprocess the Image

Reprocessing modifies the image by applying the processing changes you have selected.
Reprocessing an image resets the contrast, brightness, and latitude value to the defaults
of the current View Name. When you change the View and select Reprocess Image, the
image processing is performed again using the new image processing parameters for the
new View.
Reprocessing is an option that should only be used when you want to change the look of the
image.

Reasons to Reprocess
You are not satisfied with the current look of the image.
Surround Mask has been applied.
Increasing or decreasing the size of the mask to the edge of the collimation.
Masking out unneeded anatomy, to optimize on the visible anatomy.
Poor collimation leaves unwanted objects in the image. Edit the Surround Mask and
reprocess to improve image quality.
When you modify the View Name on the Image Viewer screen.

Note
You cannot reprocess an image if the image has been accepted and delivered across the network.
You must create a copy of the image, modify the copy, and send it to the proper destinations. In
addition, an image must be delivered before you can make a copy of it.

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Image Viewer Screen

Reasons Not to Reprocess


Do not reprocess the image if visible collimation lines are desired.

Reprocessing after Using Edit Mask


Reprocess Image becomes active when you modify the Surround Mask with Edit
Mask. The Region of Interest (ROI) is redefined based on the current location of the
mask if you select Reprocess Image. This may improve the appearance of the image, but
not as much as collimating to the body part.

Auto Reprocess Image


The Key Operator can set the system to automatically reprocess the image by selecting
Display Configuration > image Viewer > Auto Reprocess Image.

Grid Support Feature


Use this feature to automatically suppress:
Visible grid artifacts on the monitor when viewing CR/DR images.
Moir patterns when the image is minified and reduced line artifacts when the image
is magnified.

Note
It is important that grid artifacts are not visible on the radiologists workstation at the PACS. Grid
artifacts may be visible on the Console, but as long as they are not visible at the PACS, the
algorithm is working as designed.

Grid Suppression Software

Grid Suppression Software is an optional feature that can detect the presence of a
grid and can suppress the visual effects of grid artifacts. The Key Operator can configure
this feature.

How to Apply Grid Suppression

1. At the Image Viewer screen, select the View/Look Adjustment Tab.


2. Select the Grid Suppression check box.
3. Select Save Changes.

Noise Suppression
Noise Suppression is also known as Low Exposure Optimization. It is intended to help
when a facility wants to use lower dose. The Key Operator has access to how much noise
suppression is applied to a View.
Reduces the appearance of quantum (white) noise in areas of low exposure.

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Image Viewer Screen

Preserves the diagnostic image quality of the whole image.


Preserves the diagnostic image quality of the whole image.
This feature can be enabled/disabled by View in the View Configuration

Note
Image quality must be evaluated as the dose decreases. The Key Operator might need to increase
noise suppression in that case.

View/Look Adjustment Tab


The View/Look Adjustment Tab lets you select a new View Name if the current View
Name assigned to the image is producing poor results. Each View Name carries with it
contrast and brightness settings, latitude and noise settings that determine what the
image will look like. If the View Name is not assigned to the correct View, the results
will be unsatisfactory.

How to Change Settings on the View/Look Adjustment Tab

1. If the current View is incorrect for the image select the View Name field and enter
a new name.
2. To display the black areas of the image as white and the white areas as black, select
the Invert Gray scale check box.
This may be helpful when identifying line placements.
3. If the software detects a grid, checking the Grid Suppression check box will suppress
grid artifacts from the image.
4. To suppress noise, place a check in the Noise Suppression check box to reduce the
appearance of noise in low exposure areas.

Note
If the View has the Grid Suppression and/or Noise Suppression options enabled, these features
are automatically applied.
5. Select Save Changes before closing the Image Viewer screen.

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Image Viewer Screen

Magnification Tab
The Magnification Tab lets you change the level of magnification that you see in the
image as displayed in the Image Viewer window and move the view by the selection of
different points on the screen.

How to Use the Magnification Tab

When the image is in zoom mode you can add markers and change image processing
characteristics.
1. Select a zoom level (200%, 100%, 50%, 25%).
Zoom level is based on normal screen view.
The zoomed image is for viewing only. A zoomed image does not go to the
destination.
2. Move the area of view by selecting the image, thumbnails or arrows, or by dragging
across the image.
3. Increase or decrease the magnification of the image for viewing on the Modality.
4. Select Fit to Screen to exit Pan and Zoom mode and to make all areas of the image
accessible for viewing.
5. Select Fit to BSM to zoom the image to fit inside the Black Surround Mask (BSM). This
feature is for viewing, only.

Crop Box Adjustment Tab


The Crop Box Adjustment Tab on the Image Viewer screen lets you change the way the
image prints.
Feature Description

True-size True-size produces the same size image you would get if you were
using a film-screen system. Use the crop box to determine what
part of the image will be printed.

Manual Crop Manual Cropping lets you adjust the amount of anatomy that is dis-
played on the film. The area inside the crop box determines the dis-
play. The aspect ratio of the crop box depends on the film size
selected. You can enlarge the crop box to include more anatomy,
but it will reduce the magnification.

Best Fit Rotates the image 90 degrees counter-clockwise to maximize film


usage.

1 cm Scale Displays and prints reference marks at 1 cm intervals relative to the


receptor plane. The system places the scale on two adjacent sides of
1-up or a Multi-format print.

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Image Viewer Screen

Feature Description

Crop Box Orientation Changes the orientation of the crop box from portrait (vertical) to
landscape (horizontal).

Arrows Moves the crop box to another part of the image as you select the
arrows.

Crop Modes Illustrated

True Size
This mode delivers the image data needed to provide a true size representation of the
image based on the destination. The crop box that is displayed on the user interface
(yellow) represents the most restrictive cropping needed for all destinations.
Printer - Only data within the crop box is sent.
PACS - Full acquisition data is sent.
Console Printer PACS

Best Use of Film


This mode delivers the full image data to the destination. The destination may reduce the
image size if necessary.
Printer - Full acquisition data sent.
PACS - Full acquisition data sent.

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Image Viewer Screen

Console Printer PACS

Manual Crop
This mode allows adjustment of the crop box. The crop box cannot be resized in such a
way where the images would be larger than true size when printed.
Printer - Only data within the crop box is sent.
PACS - Only data within the crop box is sent.
Console Printer PACS

Automatic Crop
This mode automatically sets the crop box (yellow) to bound the Black Surround Mask.
Printer - Only data within the crop box is sent. The printer will minimize the image if the
anatomy is larger than the selected film size, but will print true size if the anatomy is
equal to or smaller than the film.
PACS - Only data within the crop box is sent.

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Image Viewer Screen

Console Printer PACS

Cassette Automatic Crop


This mode automatically sets the crop box to the smallest fixed crop box that bounds the
Black Surround Mask. It minimized the anatomy included in the crop box.
Printer - Only data within the crop box is sent.
PACS - Only data within the crop box is sent.
Console Printer PACS

Fixed Crop Box


This mode sets the crop box to one of the following predefined sizes: 8 x 10, 10 x 12,
24 x 30, 35 x 35, 35 x 43, 17 x 43.
Printer - Only data within the crop box is sent.
PACS - Only data within the crop box is sent.

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Image Viewer Screen

Console Printer PACS

Shrink to Fit
This mode delivers the full image data to the destination. The destination may reduce the
image size if necessary.
Printer - Full acquisition data sent.
PACS - Full acquisition data sent.
DIRECTVIEW Console Printer PACS

How to Use Manual Cropping

Manual Cropping lets you adjust the amount of anatomy that is displayed on the film.
The area inside the crop box determines the display. The aspect ratio of the crop box

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Image Viewer Screen

depends on the film size selected. You can enlarge the crop box to include more
anatomy, but it will reduce the magnification.
1. From the Main Menu, select Image Review.
2. Select an image to open the Image Viewer or Express Viewer screen.
3. Select the Print Format Field and select Manual Crop.
4. Select the Crop Box Adjustment tab.
You can drag the edges of the crop box to change the size of the box, or use the
arrows to adjust the position of the crop box.
5. Select Save Changes.

How to Create an Image Copy


An image copy is used to modify a delivered image. This means that you can change the
image processing, add a marker, or otherwise change the image that has been accepted
and delivered to destinations, such as a printer or a PACS workstation. In order to modify
a delivered image, you must first create a copy of the image and then modify the copy.
A delivered image cannot be altered any other way.
1. Search for a delivered image on the Image Acquisition screen, or the Image
Review screen.
2. Select the image.
The Image Viewer screen appears.
3. Select Create Copy of Image.
4. Modify the copy using the tools on the Image Viewer screen.
5. Select Save & Accept Image.

Image Processing

Adjust Brightness and Latitude

These two parameters can be used to fine-tune the image quality. Brightness makes an
image lighter or darker. Latitude controls the number of shades of gray that are visible
in the image.
1. Select Simple toolbar.
2. Select Brightness/Latitude.
3. Click the image and:
drag up or down to make the image lighter or darker
drag side to side to increase or decrease the latitude

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Image Viewer Screen

drag in an oblique angle to adjust the brightness and latitude simultaneously

Note
Brightness, Latitude and Contrast shouldnt need to be adjusted if the image processing is set up
correctly. If there is a constant need to adjust these parameters, the default parameters or the
technique might need to be adjusted.

Note
In System Settings > Image Processing, the administrator can choose to have Window/Level
in place of Brightness/Latitude.

How to Fix Low Contrast Images

Prerequisites:
Before making any image processing adjustments, make sure that the correct View has
been selected. An incorrect View could cause an Image Processing failure. If the View is
correct, proceed with the adjustments.

1. Select Window/Level Mode on the Image Viewer screen, Image Adjustment


Tab.
a. Raise the Window slider control to decrease contrast.
b. Lower the Window slider control to increase the contrast.
c. Raise the Level slider control to increase the brightness.
d. Lower the Level slider control to decrease brightness.
2. Select Save Changes and Save & Accept Image when adjustments are complete.

This correction does not require reprocessing.

Fix Image Processing Error

If image processing does not perform on an image, the Modality will automatically revert
to Window/Level Mode instead of the standard Image Viewer controls, allowing you

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Image Viewer Screen

to modify the contrast and brightness of the image. The image will appear unusually low
in contrast. The Histogram will display a straight diagonal line.

Low Contrast Images due to IPL Parameters Failure

If you see the message IPL Parameters failed, the system displays an unprocessed
image. It may look too dark or too light, and is unusually low in contrast. You can adjust
the image using the Window/Level tools.

Image Adjustment Tab


You can make the following adjustments on the Image Adjustment Tab:
Brightness
Latitude
Detail Contrast
Reset
Window/Level Mode
If you see the message IPL Parameters failed, the system displays an unprocessed
image. It may look too dark or too light, and is unusually low in contrast. You can adjust
the image using the Window/Level tools.

Measurement Tools

This feature provides three different tools (Distance, Angle, Cobb Angle) that let you
make measurements on the image. It is accessed from the Image Viewer screen.

Important
The Measurement Tools calculate angles and distances between specified points at the film plane.
The system does not make adjustments to the measurements based on the relative positions of
the tube, patient and Receptor. The reported values from the measurements are directly
calculated at the Receptor plane without any compensation of geometric magnification.

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Image Viewer Screen

How to Use the Distance Measuring Tool

This tool measures the distance between two points.


1. Select the Distance icon on the Measurement Tools Tab.
2. Select a point to anchor the tool.
3. Select another point on the image to form the line.
a. To move the Distance Tool, use the directional arrows on the Measurement
Tools Tab to move the line.
b. To change the Distance Tool, select the points and select another location on the
image.
c. To remove the Distance Tool, select the line on the image and then select the
trash can.

How to Use the Angle Measuring Tool

This tool measures an angle from three selected points on the image.
1. Select the Angle icon on the Measurement Tools Tab.

2. Select the first, second, and third points on the image to form the drawing of the
angle.
a. To move the Angle Tool, use the directional arrows on the Measurement Tools
Tab.
b. To change the Angle Tool, select the points and select another location for each
point.
c. To remove the Angle Tool, select the angle on the image and then select the
trash can.

How to Use the Cobb Angle Measuring Tool

This tool measures the angle of intersection between two lines drawn on the image. It is
used to determine the angle of a curved shape, such as a hip or spine.
1. Select the Cobb Angle icon on the Measurement Tools Tab.

2. Select a point on the image.


3. Select a second point to form a line.
4. Select another point on the image.

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Image Viewer Screen

5. Select a second point to form a second line.


The Cobb Angle is calculated for the arc between two lines.
a. To move the Cobb Angle Tool, use the directional arrows on the Measurement
Tools Tab.
b. To change the Cobb Angle, select the points in the lines and drag to another
location.
c. To remove the Cobb Angle, select the angle or lines on the image and then select
the trash can.

Use the Comment Tab


The Comment Tab allows the radiographer or Key Operator to create a record of
comments about the image.

Add Image Comments

The Comment Tab allows the radiographer or Key Operator to create a record of
comments about the image. In addition, the Comment Tab lets you edit the laterality
of an image after it is acquired. This is important if the image was flipped or rotated in
the Image Viewer or if the laterality had not been noted elsewhere.
Patient and Image comments are tertiery, and they may or may not display in PACS. If
comments are entered but do not display in PACS, the PACS vendor must be notified. For
printing, the text box can be modified to include these comments.
Allergies, Pregnancy status, and Grid selected fields have been added to this tab.
1. Select the Image Comments box.
2. Use the Keyboard to enter the comment.
3. Select Save Changes.

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Image Review

Image Review

About the Image List Screen


The Image List screen allows you to sort images by delivery status on the local database.

Image List Screen

The Image List screen allows you to locate and view patient studies, sorting by delivery
status. Go to Main Menu > Image Review > Image List screen.

How to Use the Image List Screen

The Image List screen allows you to locate, view, accept or reject images after
acquisition.
1. Enter patient information such as Patient Name, Patient ID, Accession Number,
Tech ID or Acquisition Date at the top of the screen by scanning the bar coding or
by entering the data manually.
2. Select a filter to search by image status:

Image Status Filter Description

All Studies This filter generates links to all non-delivered studies with the cri-
teria you entered, such as Patient Name, Patient ID, Accession
Number, Tech ID, or Acquisition Date.

Need Approval This filter generates links to all images that have not been
accepted.

Unassigned Images This filter generates links to all images that do not have a patient
assigned to them. This filter is linked to the Images Not
Assigned button that appears on the Main Menu.

Failed Delivery This filter generates links to all images that have been accepted
and sent to destinations, but failed. You can access this group
from a button on the Main Menu screen at any time.

Pending Delivery This filter generates links to all studies that have been accepted
and sent but the CR/DR has not heard back from the
destination-delivery in progress.

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Image Review

Image Status Filter Description

Need Destination This filter generates links to all studies that have been accepted
but not assigned a destination.

Delivered Images This filter generates links to all images that have been delivered
to printers and workstations. A delivered image cannot be
changed or reprocessed unless a copy of the image is made.

How to Search with the Image List Screen

1. Navigate to Study Data > Image Review > Image List.


2. Enter patient information at the top of the screen by bar coding or enter manually
using the keyboard
3. Search the resulting list by patient data such as Patient's Name, Patient ID,
Accession Number, Tech ID, or Acquisition Date. These filters are located across
the top of the window.
4. Select a filter to search by image status:

Filter Description

All Studies This filter generates links to all non-delivered studies with the criteria
you entered, such as Patient Name, Patient ID, Accession Number, Tech
ID, or Acquisition Date.

Need Approval This filter generates links to all images that have not been accepted.

Unassigned This filter generates links to all images that do not have a patient
assigned to them. This filter is linked to the
Images Not Assigned button that appears on the Main Menu.

Failed Delivery This filter generates links to all images that have been accepted and
sent to destinations, but failed. You can access this group from a
button on the Main Menu screen at any time.

Pending Delivery This filter generates links to all studies that have been accepted and
sent but the CR/DR has not heard back from the destination-delivery is
in progress.

Need Destination This filter generates links to all studies that have been accepted but not
assigned a destination.

Delivered Images All images that have been delivered to printers and workstations. A
delivered image cannot be changed or reprocessed unless a copy of
the image is made.

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Image Review

How to Correct Review Needed Status

Occasionally, EVP Plus Software may not fully predict the parameters for an image. When
this happens, it produces a Review Needed status.
1. In the Image Viewer screen, check the contrast and brightness of the image.
2. Use the brightness, latitude, and detail contrast controls to correct the image.

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Flagged Image List

Flagged Image List


The Flagged Image List provides a quick and easy way to export images from the
system for further evaluation. The Flagged Image List looks very much like the
Image List.
You can search the list using the bar code scanner to input Patient Name, Patient ID,
Accession Number, Tech ID, or Acquisition Date (or enter manually).
Place checks in the check boxes on the list to indicate which images you want to harvest.
Images can be harvested with PHI (Protected Health Information) or without PHI.

Flag an Image for Review


If an image requires additional review, you can mark it and save it to a database for
review later.

How to Flag an Image for Review

From the Image Viewer screen, do the following:


1. Select the Quick Menu in the lower left corner of the screen.
2. Select Flag for Review.
3. Select Save Changes.

The image is saved for review by the Key Operator or by Service. The Key Operator views
flagged images on the Flagged Image screen.

How to Locate a Flagged Image

1. Log in as the Key Operator.


2. Go to the Key Operator menu.
3. Select Flagged Image List.

How to Harvest Images

To harvest images:
1. Filter the list using the search filters:
All Images
Flagged Images
Rejected Images
2. Use the check boxes to the left of each thumbnail to select the image of interest or
Select All images.
3. Select Harvest Selected Images.

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Flagged Image List

4. Select a destination folder.


5. Select Select.
6. When the Beginning to Harvest Images pop-up screen appears with the message
If harvesting to removable media, please do not remove the media
until harvesting is complete, select OK.
A transfer icon appears at the top of the screen to indicate that the transfer is in
progress. The icon disappears when the transfer is complete and a pop-up message
confirms that the harvest was successful.

Postrequisites:
Select the Unflag the Image after Harvesting check box to return the image to the
workflow.

How to Harvest Images to a DVD/CD

To harvest images to a DVD or CD:


1. Filter the list using the search filters:
All Images
Flagged Images
Rejected Images
2. Use the check boxes to the left of each thumbnail to select the image of interest or
Select All images.
3. Select Harvest Selected Images.
4. Select a destination folder.
5. Select CD ROM.
6. Select Select.

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How to Select a Destination

How to Select a Destination


Images can be sent to destinations:
Automatically, which can be configured by the Key Operator based on the
Destination Profile filters (Body Part, Physician, Cassette Size, and so forth).
Manually, by the radiographer selecting the destination using the Select
Destination button.
1. At the Image Viewer screen, select Select Destination.
2. Select a different or additional destination from the screen.
3. Select the check box of the new destination.
4. Select Save Changes.
5. Select Back.
6. Select Accept to deliver the image to printers and workstations.
You can only configure multiple copies for hard copy (printer) devices.

How to Change the Destination


When you select Harvest Selected Images, a screen appears for you to select the
destination directory.
1. Select the directory pull-down menu to see the available directories and select a
directory.
2. Select an existing folder or select New Folder and give it a name.
3. Highlight the folder you want and select Select.
The selected images are copied there.

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How to Change the Arrow Direction

How to Change the Arrow Direction


This information applies to the Image Viewer screen.
1. Select the Arrow icon, either from the marker panel, or from the image.
2. Click or touch once on the image for each 45 clockwise rotation.

78 AC1456 | 2015-03-16
Multi-Format Printing Overview

Multi-Format Printing Overview


Multi-Format printing gives you the ability to print multiple images on one piece of film.
You can select from the images in a single study or images from all studies for that
patient. You can combine the images into one of many different layouts on one page,
and then print exactly what you see. Multi-format images are only delivered to print
destinations.
On the Multi-format Print Configuration screen, images or tutor images appear at the
right of the screen. The original list of tutor images or thumbnails contains images from
the current study. Select the Display All Patient Images check box to display all images
in all studies for that patient. The scroll bar displays a fraction that indicates the number
of the page you are viewing relative to the total number of pages that are available, such
as one out of three (1/3).
The Page Setup tab lets you set the layout of the print.
The Image Adjustment tab lets you modify each image in the print. Each image
responds independently when image adjustments are applied from the Image
Adjustment tab.
When all the images have been acquired, positioned, modified, and oriented, they
are ready to be printed.
When you create a multi-format print:
Image aspect ratio is maintained once a destination is selected.
Images from any cassette size can be placed together.
Images are printed crosswise or lengthwise in many different layouts.
Images are saved and printed with selected image processing parameters, markers,
and orientation.

Custom Page Layouts


Go to Key Operator Functions > System Configuration > Display Configuration >
Custom Page Layouts tab.
The screen opens with a blank canvas grid. This grid is divided into a 12 x 12 space with
a 3 x 3 cell placed and selected in the upper left corner. This is the minimum dimension
of an image cell. The Key Operator will design a new custom Multi-Format by creating
cells of various sizes and arranging them on this grid. Once configured and saved, the
new multi-format will appear as a choice on the Multi-Format Configuration screen.
The Key Operator can also delete an existing format from the Custom Page Layouts
tab.
A layout can be any combination of horizontal or vertical cells, symmetrically or
asymmetrically placed. The following icons are displayed on the screen:

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Multi-Format Printing Overview

Icon Meaning Definition

Blank Page Use the grid without any specific format.

Copy Existing Layout Select an existing layout to start designing from.

Add Cell A new cell is placed in the top-most, left-most space avail-
able in the current layout. If there is not at least a 2 x 2 grid
area available anywhere on the grid, the Add Cell button
will be disabled.

Delete Cell Delete a cell from the layout.

Directional Arrows Move the row and column placement of the cell one grid
unit in any allowed direction.

Delete Existing Layout Displays the currently defined layouts and allows the user
to choose an existing layout to delete (confirmation
required).

Cell Width Adjust the cell width by touching the +/- buttons, which
adjusts the size in whole grid (2 x 2) units.

Cell Height Adjust the cell height by touching the +/- buttons, which
adjusts the size in whole grid (2 x 2) units.

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Multi-Format Printing Overview

Multi-Format Print Buttons


The Multi-Format Print Configuration screen provides the following functions.
Button Name Description

Add Multi-Format Print Displays 25 default layouts to choose from

Delete Multi-Format Print Deletes the selected format

Switch Position Organizes images in the selected format by switch-


ing images from one cell to another.

Rotate Turns the image clockwise or counter-clockwise at


90 degree intervals.

Flip Transposes individual images horizontally or verti-


cally.

Invert Displays black areas as white and white areas as


black.

Window/Level Changes brightness and contrast in one image.


Touch the image and move your finger up and
down to change brightness and back and forth to
change contrast.

Magnification Increase or decrease magnification.

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Multi-Format Printing Overview

Button Name Description

Manual Zoom Enter a number to change magnification by a per-


centage.

Measurement Scale Applies a measurement scale to an X and Y axis


inside the border of a selected image on the right
and lower sides of the print.

True Size Displays the image as its actual size.

Scale to Fit Scales the image to fit in any area.

Justification Moves an image to the left, center, or right position


in its cell.

Portrait/Landscape Toggle button changes the orientation of the entire


multi-format print. Does not change the orienta-
tion of individual images.

Multi-Format Indicates the image is currently in a multi-format.

non-Multi-Format Indicates the image is not in a multi-format.

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Multi-Format Printing Overview

How to Place an Image in a Multi-Format Cell


Prerequisites:
If you want to print the images in a multi-format print as true size, you must select the
True Size radio button for each individual image before you create the multi-format
print.

1. Go to the Multi-Format Print Configuration screen.


From the Patient Input screen, select the Change Multi-Format
Configuration button.
From the Image Viewer screen, select the multi-format icon.
2. Select a layout.

One of the cells will be highlighted. The image you select will go into the highlighted
cell.
3. Touch or click any cell to highlight it. You can change the location of each image
later, if desired.
4. Select a thumbnail image from the image list at the right side of the screen.
5. Select the Display All Patient Images button to see all of the images in the
patient's other studies. The border of each selected image changes color as the image
appears in the highlighted cell in the layout. Use the scroll bar to view all of the
pages. The scroll bar indicates the page being viewed and the total number of pages;
for example, page one of two will be displayed 1/2.
6. Repeat steps 34 to select the rest of the images to fill in the layout.

Note
Any cells not used will print black.

How to Adjust Images in a Multi-Format Print


Prerequisites:
If you want to print the images in a multi-format print as True-Size, you must select the
True Size radio button for each individual image before you create the multi-format

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Multi-Format Printing Overview

print. This is true unless the Key Operator has set True Size as the default for
Multi-Format prints.

The functions on the Image Adjustment tab apply to each image independently.
1. Select an image from the layout.
2. To adjust an image, select any of the following buttons. These functions are described
in Multi-Format Print Buttons.
Switch Position
Rotate or Flip
Invert
Zoom in or out
Window/Level
Magnification
Measurement Scale for reference
True-Size or Scale to Fit
Justification (move image left, center, right in cell)
Portrait/Landscape

How to Change a Multi-Format Print Layout


If you have started a multi-format print and then change your mind about the layout,
you can select a different layout without starting over.
1. From the Multi-format Configuration screen, select Change Multi-Format.
2. Select a new multi-format layout.
3. Select the image and new location.
4. Select Save Changes.

Print Destinations for Multi-Format Printing


Multi-format images are only delivered to print destinations.
You can print multi-format images regardless of the printer type and film size.
Click Select Destination to deliver the image to a specific printer. Place a check mark
next to the destination on the Select Destination screen.
Select Print 1-up if you want a separate print of each image in the layout.
Select Mark all images in the print as delivered if desired.

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Multi-Format Printing Overview

Text Options of Multi-Format Printing


The Multi-Format Print Configuration screen provides the following text options.

Text Overlay
The Text Overlay radio button displays a text overlay in four corners of the multi-format
print. The overlays contain information from the DICOM header associated with that
particular patients study. The content of the overlay, location, and font size is configured
by the Key Operator in the Configurable Text Boxes screen.
While the text overlays cannot be edited directly on the Multi-Format Print
Configuration screen, you can use the Text Overlay radio button to choose between
new overlays, traditional text boxes, or having no text.

Include Page Footer


This check box adds a page footer across the bottom of the page. The page footer is
configured by the Key Operator. It may contain text and logos.

Text Annotations
To add text to a multi-format print, select a point on the image where you want the
annotation to appear. Then type your annotation in the free-form text box. You can also
select markers and stamps to annotate the print.

Add Text to Individual Images


Select the Text Box radio button to display an image internal text box on an individual
images in the layout. The text will be cropped to fit the bounds of the image internal box.
To change the location and orientation of the text box, select the Edit Location button.

How to Position an Internal Text Box


You can locate the Internal Text Box in eight different locations, horizontally or
vertically, in each corner of the image on the Image Viewer screen.

Note
The Multi-Format Image Internal Text Box appears inside each image area on a multi-format print.
1. At the Image Viewer screen, select the Print tab.
2. Select the Internal Text Box check box.
3. Select the point on the image where you want to place the text box.
You can move the text box to any corner or any inside edge to avoid covering
anatomy.
The Internal Text Box can be up to 160 mm wide. Its content depends on the length
of the data fields and the size of the font.
4. Select Save Changes.

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Multi-Format Printing Overview

5. Select Save & Accept Image to send the image to the selected printer.

Note
If the Internal Text Box is set as a default, the user only needs to touch the image where they want
the text box to be.

86 AC1456 | 2015-03-16
How to Create a Text Overlay for a Multi-Format Print

How to Create a Text Overlay for a Multi-Format Print


1. Navigate to Key Operator Functions > System Configuration > Configurable
Text Boxes > Multi-Format Print Text Overlay.
2. Select a region from the Overlay format section. A selection is highlighted in green.
3. Select a field.
4. Enter free form text from the virtual keyboard or, select the DICOM fields tab and
select a field from the list.
5. Select the Assign Field button to add the criteria to the selected field in the form.
6. Use the arrow keys to see all of the fields, or check Show most common DICOM
fields only check box to narrow the search.

AC1456 | 2015-03-16 87
Utilities

Utilities
Utilities are functions that the Technologist can access and perform without needing a
special password or permission. Utilities differ depending on the system you are working
on. Your system may provide choices for some or all of these functions:
Change Password Log Viewer

System Settings Detector Calibration

Software Updates Equipment Management

Image Recovery DRX-1 Quality Tool Results (DRX-1 System


only)

Patient Media Jobs Tube Warm-up (DRX-Evolution only)

Select USB Destination

88 AC1456 | 2015-03-16
Change Password

Change Password
You can change your password in a DIRECTVIEW system at any time. Remember to create
a password that conforms to the number and type of characters set for passwords in your
facility by your Security Administrator.
1. At the Main Menu, select Utilities.
2. Select Change Password.
3. Enter your old password.
4. Enter your new password.
5. Confirm your new password by entering it again (exactly the same way).
6. Select Change Password.

Note
If you have forgotten your password, contact the Security Administrator. Your Security
Administrator can reset your password so that you can change it if needed.

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Register Badge

Register Badge
This procedure assumes you already have a user account. User accounts must be created
by the Security Administrator before a proximity badge can be registered.
1. Log into the system.
2. Navigate to Utilities > Register Badge and select Register Badge.
3. Scan the badge by swiping it across the badge reader.
When the system reads the badge, you will hear a beep.
4. When asked if you want to associate the badge to your account, select OK.
5. Follow the on-screen instructions to register your proximity badge.

Once configured, the user can log in by passing the badge across the reader without
entering their user name and password on the Login screen.
The user will log out the previous user when using this feature.

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System Status

System Status
The System Status screen provides information on system communications and access
to logs about the modalities.
When your Service Representative requests a report, log files are contained under the
following tabs:
Summary
.NET CLR
Hot Fixes
Assemblies
MIM Core
The Snapshot Log Files button captures the current logs and dates them so that when
they are retrieved later, they will identify the status of the system at that time. Select this
button any time there are issues with the Modality performance and every time you need
to call Service.
Use the Summary tab to check if a Modality is communicating with the HIS/RIS. When
the lights on the Device Column are green under HIS/RIS, the Modality is communicating
with the HIS/RIS.
Use the System Status screen to view the status of the prior image retrieval job queue.
You can also clear the outstanding requests in the queue.

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Software Updates

Software Updates
This option expands the capabilities of the Key Operator to install system upgrades that
were formerly performed by a Service Representative.

Prerequisites:
The user receives a message from the system stating that Updates are Available. This
is an alert that software updates are available and have been sent to your system from a
remote location.
You must be logged in as a Key Operator in order to install software updates.

1. From the Main Menu, select Utilities.


2. Select Software Updates.
3. At the Software Updates screen, check the red or green color bars at the top of the
screen.
4. When the Ready to Install light turns green, select Install Update.
One of the following conditions may occur:
Ready to Install, green lightThe prerequisites have been met for this update.
Prerequisites Not Met, red lightFurther action required before this installation
can begin.
5. If the updates are delivered on a CD or a removable USB drive, insert into the
appropriate drive and select Find on Removable Media.
If the prerequisites are not met:
Check to see what the prerequisites are. They are listed in the lower half of the
screen.
Check to see if a previous update was not installed.
Call Service.

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Pending Job Management

Pending Job Management


Cancel Pending Jobs let the user clear all pending jobs in the system.
Press Cancel Pending Jobs and the pending jobs are removed from the
Image Review list.
A destination can be selected or deselected.

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Firmware Updates

Firmware Updates
The system can determine whether or not the active DRX-1 detector has current firmware
installed. If it does, the detector can be used normally. If it does not have current
firmware, then the firmware must be updated before you can use the detector.
The Key Operator can install firmware updates without contacting Service. After
updating software using the Software Update screen, the Install Firmware Updates
screen appears if a firmware update is necessary.

How to Install Firmware Updates


1. Navigate to the Firmware Update screen.
2. Select the receptor to be updated.
3. Select Yes to the firmware update message.
4. Follow the on-screen instructions.
The firmware update process is indicated by a progress bar.

Note
The receptor must be tethered during a firmware update.

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Image Recovery

Image Recovery
The user can recover images that have not been delivered from the Utilities section of the
software.
1. Navigate to Utilities > Image Recovery.
Image Recovery lists all of the images on the system and provides the following:
Acquisition Date
Patient ID
Accession Number
2. Select the image to be recovered.

The image returns to the system as an unassigned image.

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Patient CD Media Jobs

Patient CD Media Jobs


Creating a Patient CD is an optional feature that lets you easily create a CD (or DVD) of
a single patient study, or all studies for a single patient. The images recorded on the CD
are in both a DICOM DIR format and JPEG (.jpg) format. The Patient CD lets you transport
images and structured X-ray Radiation Dose Reports easily, and allows viewing by anyone
having a computer with a DICOM Viewer.
You can compose a Patient CD on a Console, but the media is actually created at the
Console containing the CD writer. Only systems having this optional feature will display
the Patient Media Jobs screen or the Export Image menu option in the Quick Menu.
Creating a Patient CD does not interfere with normal operations. There is no effect on
the Graphic User Interface (GUI) and the time it takes to move from screen to screen.
You can view images on a personal computer using DICOM Viewer software (available
free at http://medical.nema.org/).

How to Create a Patient Media Job Manually


1. Select a blank, non-formatted CD or DVD.
Images cannot be appended to other sessions.
2. On the Image Acquisition screen, create a patient record and acquire images.
3. Select the Quick Menu.
4. Select Export Images.
5. If multiple studies were created, a pop-up message asks you to select one of the
following:
Write all images in this study to CD. Only save images for the
opened study.
Write all images from all studies to CD. Save images for all
studies for this patient.
6. Select OK.
The CD request is added to the Patient Media Jobs Menu. You can also access this
function in Main Menu > Utilities > Patient Media Jobs.
The Patient Media Jobs screen appears.
7. If multiple CD jobs exist, select the desired row from the list and select Export.
The status for the selected job changes from Ready > Burn CD > Burning CD > Done.

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Patient CD Media Jobs

8. Select Back to return to the Utilities menu.


To return to the Patient Input screen, use the Quick Menu to select the patient
record.
Writing images to the Patient CD does not change the delivery status of any image.

Note
If enabled, structured X-ray Radiation Dose reports can be added to a Patient Media job.

Note
For CR Systems only, when you are performing a Backup and Restore function, make sure that
the user at the Remote Operations Panel (ROP) does not initiate a Patient CD.

How to Delete a Patient Media Job


1. From the Patient Media Jobs screen, select the job you would like to delete.
2. Select Delete.
3. A pop-up screen will display, Are you sure you want to remove?

The job is deleted from the screen.

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Delivery Preferences Configuration

Delivery Preferences Configuration


Delivery Preferences lets you configure the default settings for the following information
delivery selections.
Field Description

Hospital Name The hospital name that you want to associate with the images.

Hospital Address The address of the hospital that you want to associate with the
images.

Operating Mode The default operating mode:


QA Mode
Auto Display
Pass-Through Mode
QA by Study (DR)

Pixel Spacing The pixel spacing for workstations that require the (0018, 1164)
Imager Pixel Spacing or require the (0018, 1164) Pixel Spacing
fields.

Relative X-ray Exposure The Carestream Health Exposure Index or the IEC Exposure Index.
DICOM Tag ID (0018,
1405)

Delivery Tab Options Use uppercase for all DICOM fields on delivery.
Send all images in L/F orientation. This means the workstation
will not rotate the image when it is received. Sends patient
orientation tag (0020:0020).
Remove print destinations from 1-up when creating new
Multi-Format prints.
Scale mark to storage.
Use CR IOD. It means always use the CR DICOM IOD, instead of
DX or MG IOD.
Translate Body Part and Projection.
Allow non-conforming DICOM.
Label Patient CD using LIGHTSCRIBE.
Edit the AE Title IP address and port for their DICOM destina-
tions.

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Delivery Preferences Configuration

Field Description

Image Instance Tab The general image instance number:


Every image is its own Series. Instance Number is always 1.
Every image is its own Series. Instance Number is unique.
Every image is in the same Series. Instance Number is unique.

Note
The Image Instance tab has different configurations to help with
foldering at the PACS. Consult your PACS Administrator to
determine which setting is required for your PACS system.

Patient Media Tab Include Media Viewer on CD.


Include CARESTREAM Image Suite Viewer on CD.
Acquire Solutions Review Application.
Write Patient CD immediately.
Write Dose Report to Patient Media.

Report Tab Configure a list of destinations that support structured Report


storage.

Custom Page Layouts Configure a custom Multi-Format layout from a blank page or
Tab from a copy of a layout.
Customize by cell width and cell height.
Use the arrow keys to move the cell up, down, left, or right.
Add or delete a cell from the layout.
Delete the existing layout.

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Select USB Destination

Select USB Destination


This feature lets you register a USB flash drive with the CR or DR system, and transport
an image to a destination such as a PACS by physically carrying the image. This is useful
if the connection to the PACS is down.

Note
A USB can only be used for a single acquisition device. If configured for a second CR or DR the
original file will be overwritten and it will no longer work on the original device.
A formatted, named USB flash drive is required. (Do not use the default flash drive name.)
A USB destination must be configured for the USB device in the Select Destination screen.
Delivering to a USB device will update the status of the image to Delivered.

100 AC1456 | 2015-03-16


Detector Calibration

Detector Calibration

Detector Calibration Screen Overview

Calibration Requirements
A battery must be inserted into the detector.
You must have security access to the Detector Calibrations screen.
The virtual keyboard settings must be enabled.
Use a 0.5 mm copper or 1 mm aluminum filter for X-ray calibration.
You must run calibrations when you add and register a new DRX detector to the
system for the first time, and when calibration prompts appear on the system
Console.
Only an authorized service representative can adjust the Technique Settings shown on the
Detector Calibration screen.

Calibration Recommendations
Verify that the battery is inserted into the detector.
Verify the identity of the detector.
Do not touch Abort Calibration during calibration.
Do not move the detector during the calibration process.
Do not navigate to another menu or screen until the calibration is complete and
successful.
Use the Calibration Progress Bar to track the exposures completed out of the total
number of required exposures. Complete all the exposures.

Calibration Types, Frequency, and Duration

Calibration Type Frequency Duration X-ray Needed

Offset Refresh Daily Less than 5 minutes No

X-ray Every 6 10 or more minutes Yes


months

Calibration History
Each time you run a calibration, the System Console logs the date and time in a
calibration history. The Console uses the calibration history to generate messages which
remind you to run the next calibration.

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Detector Calibration

Calibration Results
Successful CalibrationWhen a calibration is successful, new calibration files are
created for the selected detector and are ready to be used by the system. Successful
calibration helps to support optimal image quality.
Aborted Calibration or Calibration FailureWhen a calibration fails, no changes are
made to the calibration files for the selected detector.
If calibration fails, see Troubleshooting Detectors: Calibration Failure in the online help.

How Often Should I Calibrate the Detector


Perform detector calibration every six months or if the system prompts you to do a
calibration. If you are using a DRX Plus detector, the calibration is required annually. If
the detector is dropped, a new calibration will be needed at that time.

Calibration Types, Frequency, and Duration


DRX Plus Detector
Family Calibration Type Frequency Duration

Dark Calibration Daily Less than 1 minute

X-ray Full Annually 10 minutes

X-ray Express As needed 5 minutes

DRX-1 Detector Family Calibration Type Frequency Duration

Dark Calibration Daily Less than 5 minutes

X-ray Full Every 6 months 10 or more minutes

PRO Detector Family Calibration Type Frequency Duration

Dark Calibration Daily Less than 5 minutes

X-ray Full Every 6 months 20 or more minutes

Note
Perform detector calibration if the system prompts you to do so. If the detector is dropped, a new
calibration will be needed at that time.

Note
The Dark calibration must be performed if the Key Operator for the site has disabled the
automatic daily dark feature, or if automatic Dark calibration fails for a specific period of time:
DRX Plus Detector Family: after the calibration fails for 10 weeks

102 AC1456 | 2015-03-16


Detector Calibration

DRX-1 Detector Family: after the calibration fails for 10 days.


PRO Detector Family: after the calibration fails for 10 days.

How to Calibrate the Detector


This information applies to the DRX-Evolution, DRX-Revolution Mobile X-ray System, and
the DRX-Ascend Systems.

Important

You must keep the detector away from other electronic devices during calibrations.
Only an authorized Service Representative can adjust the settings on the upper-half of the
Detector Calibration Screen.
1. At the main menu, select Utilities > Detector Calibration.
2. Select the detector type: Wall Stand Bucky or Table Bucky.
3. Select the Calibration Type check box.
4. Follow the instructions on the screen to calibrate the detector.
5. Select Begin Calibration.

How to Set Up for an X-ray CalibrationDRX Detectors

Important
The X-ray calibration must be performed every six months or after a significant shock to the
detector.
The user must activate the exposure button for approximately 15 exposures.
The dark calibration must be completed successfully before performing the X-ray calibration.
1. Set the SID to 183 cm (72 in.) and remove the grid.
2. Check that the collimator blades are open to expose the filter.
3. Insert the 0.5 mm copper and the 1.0 mm aluminum filter onto the collimator, with
the copper side facing the tube.
4. Ensure that nothing is in the beam path.
5. Do the steps in the How to Calibrate the Detector procedure.
6. When the calibration is complete, remove the filters from the collimator.

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Detector Calibration

How to Add a Previously Registered Detector


Prerequisites:
The bar code scanner configuration settings must be enabled on the system console.

Required equipment:
Bar code scanner
Keyboard
1. At the Equipment Management screen, select Add Detector.
2. Scan the bar code serial number label, or enter it from the virtual keyboard.
3. Select Save Changes.

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Equipment Management

Equipment Management
From the Main Menu, select Utilities > Equipment Management.
The Equipment Management screen is used by the technologist to enable or disable a
detector in the System. It allows the Key Operator to add or remove a detector from the
system.
See the following topics for additional information:
How to Enable or Disable a Registered Detector
Adding and Registering a Detector

Access Point Tab


The Access Point acts as a wireless hub for connectivity to a secure hospital network.
The technologist can view the network setting for the Access Point.
The Key Operator can change the Access Point configuration, based on the rules set by
the customer. The customer site will provide the IP address, Server, and determine the
access allowed by Carestream.

Equipment Management Screen Overview


The Equipment Management screen is used by the technologist to enable or disable a
detector in the system. It allows the key operator to add or remove a detector from the
system
The Access Point tab
The Access Point (AP) is a wireless hub that provides connectivity to a secure hospital
network.
The key operator configures the network setting for the radius server using the virtual
keyboard to complete the following fields:
IP Address
Port Number
Wireless Password
Choose AP Model
The key operator can change the configuration for the AP based on the rules set by the
customer.
The customer provides the IP address, server, and determines the access allowed.

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Equipment Management

How to Enable or Disable a Registered Detector


Use this task to enable or disable combinations of up to three previously-registered
detectors on a Console. This task is also known as Detector Migration.

Prerequisites:
If enabling a detector, insert the battery into the detector before starting these steps.

1. From the Console Main Menu, select Utilities > Equipment Management.
You will be presented with the list of the detectors currently registered on the system.
Icon Detector status

The detector is enabled and available for use with the console.

The detector is registered but disabled for use with the console.

2. To change a detector's availability with the console, first select that detector's row.
3. Select either the Enable Detector or Disable Detector button.
Various status messages will be displayed during the process. A dialog message will
be displayed confirming the success or failure of the operation.

Postrequisites:
When disabling a detector, once the process completes you should remove the detector
battery.

About the General Radiography (GR) Bridge


Navigate to Main Menu > Utilities > Equipment Management > GR Bridge.
The GR Bridge displays the following:
Current Value
New Value
Serial Number
Installation Date
To remove the Bridge connection, select Remove Bridge.
Equipment Statistics

Serial Number

Installation Date

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Equipment Management

Equipment Statistics

Manufacturer

Model Name

Logical Name

Status

Actuation Count

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How To Warm Up the X-ray Tube

How To Warm Up the X-ray Tube

Caution

Always use the instructions in the Tube Warm-Up screen. See Utilities > Tube Warm-up
for information.
The tube warm-up exposure factors are preprogrammed. Only the Key Operator can adjust
them.
Producing X-rays with a cold or improperly warmed tube shortens the life of the X-ray tube.
Do not acquire images without warming the tube.

Note
You can use the control on the collimator keypad to turn on the collimator lamp and check if the
collimator shutter is open or closed. The light indicates that the lamp is operational and the
shutters are open.
1. Close the collimator shutters.
2. At the Main Menu, select Utilities > Tube Warm-up.
3. Make a series of exposures 3 seconds apart until the message
Tube Warm-up completed displays.
4. Select Back.

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Log Viewer

Log Viewer
The Log Viewer screen lets the user view the content of all pop-up messages displayed
on the system, and the exact time they appeared.
The user can copy the log history to a USB flash drive for review. To do this, select the
message and select the Copy Log History button.
Select the Older File or Newer File buttons to view other files.

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Key Operator Functions

Key Operator Functions


Manage Patient Exam Records

Statistics

Monitor Configuration

System Configuration

Flagged Image List

Backup Restore

Option Registration

Copy Log History

Import Configuration

DR Detector Configuration

Tube Warm-up

DR TQT Analysis

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How to Delete All Patient Records

How to Delete All Patient Records


Go to Key Operator Functions > Manage Patient Exam Records .
1. Select Delete All Patients from the Manage Patient Exam Records query page to
delete all patients from the system.

Caution
There is no recovery from this command. It deletes even records that have been protected.

How to Delete a Patient Record


Go to Key Operator Functions > Manage Patient Exam Records.
1. Enter the search criteria such as Accession Number, Patient ID, Patient Last
Name, and Patient First Name.
2. Select Find Study.
3. Select the Delete box next to the record to be deleted.
4. Select the Delete Patients button at the bottom of the screen to remove the patient
records from the system.

How to Prevent Deletion of Patient Records When the Hard Drive is


Full
1. Navigate to Key Operator Functions > Manage Patient Exam Records.
2. Enter the search criteria such as Accession Number, Patient ID, Patient Last
Name, Patient First Name.
3. Select Find Study.
4. Select the Protected check box for the selected study. Repeat for each study to be
protected from deletion by the Disk Manager when the hard drive is full.
5. Select the Protect Patients button at the bottom of the screen.

Caution
The Protected records are not protected from the Delete All Studies action.

Note
Names and exams that have an Available, Pending Delivery, or Failed Delivery status cannot be
deleted until they are corrected.

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How to Delete All Patient Records

Manage Patient Exam Records Navigational Controls


Control Description

Clear All Fields Removes all the information in the search criteria fields.

Delete All Patients Deletes all patient information on the system.

Delete Unassociated Images Deletes all images that have no database references.

Find Study Locates the study that matches the search criteria.

Main Menu Exits current screen and returns you to the system Main
Menu.

Back Returns you to the previous screen.

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Statistics

Statistics

How to View Technologist Statistics


The Reject Analysis and Reporting Software compiles radiographer statistics based on
Tech ID.

Go to Key Operator Functions > Statistics > Technologist Statistics.

1. Select the list that you would like to view:


TechView all of the statistics for the selected radiographer.
ViewsView all of the statistics for all of the views for the selected radiographer.
Image ListView all of the statistics for all of the images done by the selected
radiographer with the selected view, or view each of the images for the selected
radiographer.
2. To change the order of the list, select the header bar of the Tech, Views, or Image
List window. You can sort any column. A triangle appears over the column that is
being sorted and indicates ascending or descending order.
3. To view the images, select the magnifying glass.
The Image List data contains information for the past year. Only those images that
still exist on the System can be viewed. The images are delivered images.
4. To save the data, download the statistics to a USB drive, hard drive, or other storage
device.

How to Change the Order of the Technologist Statistics List

1. Go to Key Operator Functions > Statistics > Technologist Statistics.


2. Select the header bar of the Tech, Views, or Image List window.
3. Click the triangle that appears over the column to sort the data. The triangle indicates
ascending or descending sort order.

Destination Summary Statistics


Destination Summary Statistics updates the status of the destinations listed and the
status of the devices as you go to the screen.
Destination Summary Statistics lets you check the status of destinations if you are getting
a repeated failed delivery and identifies problem destinations quickly.

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Statistics

Viewing Destination Summary Statistics

Destination Summary Statistics update the status of the destinations listed and the status
of the devices as you go to the screen. You can check the status of destinations if you are
getting a repeated failed delivery. Problem destinations are identified quickly.

Download Statistics
The Download Statistics screen lets you do the following:
Allows CR/DR Systems to pull the reject data from other configured systems.
Select a date range and download all statistics to a spreadsheet for data
management.
Add or delete device IP addresses in the system from which to download statistics.

How to Download Statistics

1. Go to Key Operator Functions > Statistics > Download Statistics.


2. Select the Add Device IP Address button.
3. Enter the computer names of the devices you want to get statistics for, and select the
devices.
The computer name can be viewed on the System Status screen, or by touching the
icon in the upper-left corner of each screen.
4. Enter the from/to date range.
5. Select Retrieve Statistics.
6. Navigate to the location to which you want to save the statistics.
7. Select Save File As. This is the location where the statistics should be saved.

How to Download Statistics Remotely

Prerequisites:
The CR devices from which data will be obtained must have Administrative Analysis
and Reporting Software activated on the System.

1. At the Remote Key Operators computer, open MICROSOFT INTERNET EXPLORER.


2. In the address window, enter the IP address of one machine you choose to be the host
machine.
The host will get the data from all other machines (for example: http://192.168.1.1).
3. To the end of the IP address, add :56333/
For example, a complete entry would look like this: http://192.168.1.1:56333/
4. Log in as a Key Operator at the Remote Key Operator computer.

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Statistics

5. Select Key Operator Functions > Statistics > Download Statistics.


6. At the Download Statistics screen, select Add Device IP Address.
7. Add the IP address of all of the Consoles from which you want to collect data.
8. Select Save Changes.
9. Select the check box for the devices you want to get information from.
10. Enter the From Date and To Date to determine the date range.
11. Select Retrieve Statistics.
12. Choose one of the following:
Stats
TQT Stats
13. Select View statistics or Save File As.
14. Select a drive or the WINDOWS desktop.
15. Select New Folder.
16. Name the folder.
17. Select Save.
18. Highlight the file in the list.
19. Touch the Select button. This returns you to the Download Statistics screen.
20. Open the Admin Reporting Template from the Administrative Analysis and
Reporting Software CD.
21. Save to the desktop of the Remote Key Operator.
22. Open the template.
23. At the prompt, select Enable Macros.
24. Select Import Data from the worksheet.
25. Select the EXCEL spreadsheet saved to a drive or on the desktop.
26. Select Yes to overwrite the existing record.

Exporting Data for Analysis

With the optional Administrative Analysis and Reporting Software, you can
retrieve data from multiple CR or DR Systems, download it to a PC, and analyze it using
pre-configured templates for MICROSOFT EXCEL 2000 or higher. The interactive reports
can be configured, rearranged, analyzed, saved, and appended as you choose.
The Administrative Analysis and Reporting Software compiles all statistics by
radiographer based on the Tech ID.

Report Statistics
The report contains the following views:

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Statistics

TechProvides a view of all the statistics for a particular radiographer.


ViewsProvides a view of all the statistics for a selected radiographer.
Image ListProvides a view of all the statistics for all of the images done by the
selected radiographer with the selected view. You can view each of the images for
the selected radiographer using the magnifying glass.
This data contains information for the past year.
Only those images that still exist on the System can be viewed.
The images are delivered images.

Download Statistics From Multiple Systems

Navigate to Key Operator Functions > Statistics > Download Statistics.


Download Statistics lets you:
Log into multiple CR or DR Systems and retrieve all statistics.
Select a date range for the statistics you retrieve.
Add or delete the IP addresses of devices from which to download statistics.

Add a Device to Download Statistics

1. Select the Add Device button.


2. Enter the AE title/IP Address of the device you want to get statistics for.
3. Select the device.
4. The computer name can be viewed on the System Status screen, or by touching the
icon in the upper-left corner of any screen on the device to which you are
connecting.
Repeat these steps for each device you want to add.

View Equipment History


Navigate to Key Operator Functions > Statistics > Equipment History
The Equipment History screen lists the following information, if available, for the
detector, generator, and X-ray tube:
Serial Number
Installation Date
Manufacturer
Mode Name
Logical Name
Status
System tab
The System tab tells the number of actuations, exposures, and patients.

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Statistics

Actuation Count increases every time the generator makes an exposure.


Exposure Count increases with every detector acquisition.
Patient Count increases with every patient procedure that has at least one
associated image.

Detector Shock Statistics


The Detector Shock Statistics screen provides a report of instances of significant shock
that can occur during the use of a CARESTREAM DRX-1 detector, such as inadvertent
rough handling, or dropping a detector.
Detector shock values are collected automatically as long as a detector has a battery
installed. The Estimated column represents the estimated time of the shock if the
battery is not in place during the shock.
Detector shock statistics are logged for the user logged in, and include:
Serial number
Icon
Shock date and time
Shock Value
- High
- Medium
- Low
Console name
User name
Estimated

Note
If a significant shock is reported, the user must recalibrate the detector.
If the detector cannot be calibrated, call Service.

Cassette Statistics
The Cassette Statistics screen lets you view the performance of a cassette and identify
possible problems with cassettes.
The Cassette ID column identifies the cassette. The screen also shows the number of scans
for each cassette, how many images were accepted or rejected, and the percent rejected
for each cassette ID.
The total of each column appears at the bottom of the screen.
You can use this information to remove a cassette from service if necessary.

Note
This information is for CR Systems only.

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Statistics

Erase Statistics
Go to Key Operator Functions > Statistics > Erase Statistics.
The Erase Cycles screen tracks the number of scans/erases done with each pair of lamps.
The Actuation Count displays the total scans on the system.

Note
The Batch Erase Count displays the number of cassettes that have been erased by going into the
Batch Erase Mode ( CR 825/850/975/Max CR Systems) or Manual Erase Mode (Classic/Elite CR
Systems). This number is separate from the actuation count.
You can use this screen to identify a problem with the erase lamp assembly if the erase
lamps are burning out sooner than expected.

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Monitor Configuration Introduction

Monitor Configuration Introduction


Monitor Configuration checks the minimum and maximum luminance, as well as
luminance levels in-between. It calibrates color values and the monitor to provide a
consistent viewing standard so that images display the same way throughout your
system.
Perform only the following two tests:
1. Luminance TrackingThis test computes an index for each video display and tells
how well the video system matches a specific luminance response model. Tracking
checks the computed index, the white level, the black level, and luminance values for
red, green, and blue primaries.
2. Luminance Gamma CorrectionCorrects in conformance with the DICOM Part 14
Grayscale Standard Display Function or other gamma models for your system.
Required equipment:
1. All monitors for CR or DR Systems, and Remote Operations Panels.
2. The VERILUM CHROMA Photometer.
Perform these tests with a low level of ambient light.
Perform these tests at the following intervals:
1. Measure the Luminance for Tracking every two to four weeks.
2. Measure the Luminance for Gamma every three months.

Why Cant I Start the Test?


The test targets may be grayed out.
On the bottom of the VERILUM Main Menu, the message cannot open pod or
determine pod type may appear. The pod must be plugged into a USB port before you
start the application. If this happens, return to the Key Operator System Configuration
menu, plug in the pod, and select Monitor Configuration again.

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Monitor Configuration Introduction

How Do I Order a VERILUM CHROMA 5 Pod?


To obtain a VERILUM CHROMA 5 Photometer (required), go to the Web site:
http://www.image-smiths.com.

The product is VERILUM V5.2 Software with CHROMA 5 Pod. You do not need to install
the software on the Modality in order to use the photometer.

How Do I Measure the Luminance for Gamma?


Prerequisites:
Check the SMPTE test pattern on the Monitor Configuration screen before testing
Luminance for Gamma.
Verify that you are able to see all 10 shades of gray around the pattern.
Verify that you can see the 5 % and 95 % low contrast patches. They are the slightly
darker white and slightly lighter black squares inside the 2 squares in the middle of the
bottom row of the gray scale.

1. Launch the VERILUM Software.


2. Place the VERILUM CHROMA 5 Photometer in the center of the square target.
3. Select Continue.
4. Hold the pod firmly but gently in the center of the target until the test progress
indicator reaches 33.
Do not press too hard!
5. Select Close.

Postrequisites:
Check the SMPTE test pattern on the Monitor Configuration screen after testing
Luminance for Gamma.

How Do I Measure the Luminance for Tracking?


Prerequisites:
Check the SMPTE test pattern on the Monitor Configuration screen before testing
Luminance for Tracking.
Verify that you are able to see all 10 shades of gray around the pattern.
Verify that you can see the 5 % and 95 % low contrast patches. They are the slightly
darker white and slightly lighter black squares inside the 2 squares in the middle of the
bottom row of the gray scale.

1. Launch the VERILUM software.


2. Place the VERILUM CHROMA 5 Photometer in the center of the square target.

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Monitor Configuration Introduction

3. Select Continue.
4. Hold the pod firmly but gently in the center of the target until the test progress
indicator reaches 17.
Do not press too hard!
A graph signifies the end of the test.
5. Select Close.

Do not save the information to a MACBETH Color Chart. Luminance for Tracking is a
black-and-white test.

Postrequisites:
Check the SMPTE test pattern on the Monitor Configuration screen after testing
Luminance for Tracking.

Calibrate the Touchscreen


Once calibrated properly, a monitor's touchscreen should not need to be recalibrated for
the remaining life of the monitor.
1. From a position directly viewing the monitor, use your finger to select and release
each of the red targets as they appear on the screen.

Caution
Selecting the screen in areas other than the red targets may cause the screen to behave
unpredictably.
2. Touch the screen and drag your finger across it to check the cursor's response.
3. Select OK if the cursor follows your finger, or select Return to repeat the calibration
process.
4. When the calibration is complete, select OK to return to the interface.

Note
If the calibration times out and no changes are made, the system remains at the current
calibration

Why Cant I Get to the Touchscreen Calibration Screen?


The touchscreen calibration program guides you through a careful calibration process so
the cursor will respond accurately to a precise selection on the interface.
If you cannot get to the monitor calibration screen or select the test targets, try accessing
the screen with the mouse. If the touchscreen cannot be accessed because it has been put
far out of calibration, call Service.

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Monitor Configuration Introduction

What is a DICOM GSDF-Calibrated Monitor?


Grayscale Standard Display Function (GSDF) is a standard designed for high-quality
output from computer monitors used to view X-ray images. The calibration procedure is
listed in the DICOM Standard Part 14.

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System Configuration Menu

System Configuration Menu


System Configuration groups most of the functions that the Key Operator configures.
The following sections appear in Key Operator Functions > System Configuration.
CR, DRX-1, and DRX-Revolution Systems will not have all of these choices in their menu.
View Configuration Network Configuration

Procedure Mapping Configuration Destination Configuration

List Configuration RIS/PACS Client Configuration

Layout Configuration Prior Images Configuration

Display Configuration System Maintenance

Image Processing Preferences Regional Configuration

Trauma Defaults Customizable Field Descriptions

Reject Reasons Import Tutor Images

Destination Profiles Configuration Color Preferences

Configurable Text Boxes Image Correction Preferences

Delivery Preferences Technique Settings

Remote Device Configuration Long-Length Configuration

Configurable Text Boxes Grid Type Configuration

Delivery Preferences Auto Position Configuration

Remote Device Configuration DRX Detector Settings

Automatic View Selection

AC1456 | 2015-03-16 123


Backup and Restore Configurations

Backup and Restore Configurations


The Backup and Restore screen provides a mechanism to save and preserve a machines
configuration settings, especially in the event of a system failure. You can restore the
machine to a prior state following installation of new software or recover from
accidental changes in settings.

Note
When making a backup file, it is a good idea to include the date for future reference.
Because of the unique attributes of different DIRECTVIEW systems, there are some
limitations to which configuration information can be transferred between machines.
The software automatically restricts the restoration of the configurable items as
described in How to Transfer Configuration Information to Different Machines.
The description identifies the conditions under which selected items can be transferred
between machines.
Backed-up settings can always be restored to the machine from which they were created.
You can back up configurations to a particular drive and restore them to this or another
machine.
You can back up information to either the machine hard drive or to the removable media
suitable to the machine computer (may include CD, DVD, USB, or floppy disk devices).
Backup and restore is also used to share within a facility to keep the same information
on each console.

Note
If you restore Security settings from one system to another, the Password will restore, along with
the expiration date. This means that a fresh backup is required.

Important
Always back up the console before you restore or import anything from anywhere!

Note
See Import Configuration for information on backing up and restoring only specific procedure
codes and techniques.

How to Back Up Configurations


1. Insert or connect the media to receive the backup file.
2. Select the check boxes of the categories of configuration information that you want
to back up, or Select All.
3. Select the Backup/Restore directory to select a Drive to save the backup to.
4. To create a folder for the backup file, select New Folder and enter the folder name.
5. Highlight the folder name and click Select.

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Backup and Restore Configurations

6. Click Backup.
7. When the progress bar indicates the transfer is complete, select OK.
When user and security settings are restored from a backup, the software will provide
an option to restore or reset passwords at that time.

Transfer Configuration Information


The description identifies the conditions under which selected items can be transferred
between machines.
Backed-up settings can always be restored to the machine from which they were created.
You can back up configurations to a particular drive and restore them to this or another
machine.
You can back up information to either the machine hard drive or to the removable media
suitable to the machine computer (may include CD, DVD, USB, or floppy disk devices).

Feature Backup Prompt


When the Key Operator makes changes to any feature or function in System
Configuration and exits the screen, the system will pop-up a prompt that asks Do you
want to backup your changes? Answering Yes to this prompt will send a backup
file of the entire section you changed to a specified folder that Service can access. This is
useful when small changes are made between the times that the Backup and Restore
feature is used, and provides a safeguard in case there should be an unexpected event
that requires re-imaging before the Backup and Restore procedure has been
performed.
For example, if you made a change such as changing a language, saving the changes, and
answered Yes to the prompt, the entire Regional Configuration section would be
backed up. Selecting No would not affect the change you made, but the backup file will
not be created.

Note
This only does a backup of the specific configuration. We recommend a full system backup after
all changes have been made.

Restore Procedure Mapping Configurations


When restoring Procedure Mappings, the system will present two choices.

To Restore Procedure Mapping configurations:


1. Choice 1Delete ALL Procedures and Views.
Then Restore Procedures and Views from Backup radio button.
This choice clears the database by deleting all Procedure Mappings, Views and
categories before restoring the new ones.

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Backup and Restore Configurations

2. Choice 2Keep NEW Procedures and Views.


Then Restore older Procedures and Views from Backup radio button.
This choice combines all previous and new Procedure codes and Views.

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Option Registration

Option Registration
Prerequisites:
You will need a set of Activation Codes from Carestream Health, Inc.

The Key Operator can add or remove purchased options using the Option Registration
screen.
1. Go to Key Operator Functions > Option Registration.
The screen displays all of the available options for that system.
2. Enter all Activation Codes one at a time into the text box.
If the code is entered manually, the Add Code button adds the code to the list of
codes to the right.
If you type a code incorrectly, the system will recognize the error. The text box will
not clear and an error message will be displayed.
If you use the bar code reader, the code is automatically added to the list.
When an option code is entered and activated (Activate Option) from this list, the
features and benefits of that option become temporarily available on the system. The
options stay active for several days.
3. Insert any USB drive into the System.
4. Select the Export Request button.
5. Select the USB drive as the destination directory for the Activation file. The file
named OptionActivationRequest.xml is saved to the USB drive.
6. From a personal computer, e-mail the OptionActivationRequest.xml file to
activation@carestreamhealth.com.
An Activation File is automatically e-mailed back to the sender. This file is a key that
matches the hardware and software that identifies your system. The file cannot be
used with any other device.
If there is no access to e-mail or the network is down, the options stay active for
several days to give you time to send the Option Activation Request and retrieve
the Activation File from a remote computer.
7. Place the Activation File on the USB drive.
8. Insert the USB drive into the System.
9. From the Key Operator Functions > Option Registration screen, select the
Import Activation file.
10. Select the source directory for the Activation File (USB drive).
The Activation File is copied to the local hard drive.
The system verifies the signature and activates the options as specified in the
Activation File.

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Copy Log History

Copy Log History


The Copy Log History screen lets you copy log files to removable media to be sent to a
Service Engineer.

How to Copy Log Files


1. Select the check boxes of the log files that you want to copy. Touch Select All if you
want to copy all of the files in the list.
2. Click in the field below Destination Directory and choose an existing location or
create a New Folder, and then click Select.
3. Select Copy Log Files.

How to Delete Log History


1. Select the check boxes of the log history files that you want to delete or click Select
All if you want to select all of the files in the list.
2. Select Delete Log Files.

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Import Configuration

Import Configuration
Navigate to Key Operator Functions > Import Configuration.
The Import Configuration screen provides a function that allows the user to selectively
import Imaging System Type (IST) data such as techniques, image processing parameters,
and procedure codes into a system.
The imported View or procedure data will be applied to a matching View or procedure.s

Note
If a matching View or procedure is not found, it will not be created.
The software displays a list of data that is not imported.
This import allows the user to
Restore Procedure Mapping and Views
Import image processing for the ISTs in use on the Console
Restore techniques (if needed)

Import Configuration
The import data function uses the data from the backup data from the Backup/Restore
function. Instead of restoring or transferring all of the data from a backup file, the user
selects only the imaging system types they want to import. The user can import
techniques, image processing parameters, and procedure codes.
1. Navigate to Key Operator Functions > Import Configuration.
2. Locate the Backup file containing the configuration you wish to import from the
drive selection and tree view.
3. Select the file.
4. Select the Load button to upload data from the Backup/Restore .zip file to the
Console.

Note
There is no Cancel button to stop this process. However, you can select the Back button to leave
this screen and stop the process.
5. Select the configurations (procedure codes, image processing parameters, and
techniques) you want to import by selecting the receptor and the check box for each
item.

Note
The list of items to choose from depends on the contents of the Backup file and the configurations
that the Console supports. For example, you would not have the option to restore DRX image
processing to a CR system.

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Import Configuration

6. Select the Import button to import the configurations.


The screen will gray out and a progress bar will display as the files are imported.
If there are no common imaging types in the Backup/Restore .zip file, the user can
choose another file from which to import. The Import button will remain grayed out
until a compatible file is found.

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DR Detector Configuration

DR Detector Configuration

DR TQT - Setting the Beam Output


The purpose of this screen is to determine the beam configuration and input the SID and
kVp that will be used for TQT Analysis. This is also where the exposure factors needed for
detector calibration are determined.
1. Place the detector on the floor and set up the equipment as if to calibrate the
detector.
2. Use the radio button to select cm or uGy measurement.
3. Click the Actual SID Value field and enter the actual SID value using the virtual
keypad.
4. Use the up and down arrows on the kVp generator control at the top of the screen
to obtain a value as close as possible to the Aim kVp, and enter the value in the
Actual kVp field.
5. Select Next Page.

Important
Set Beam Output is used with DRX-1 and DRX Plus detectors. Set
Beam Output is not used with PRO detectors.

DR TQT - Calibration Techniques Setting for CsI Detector


The screen displays the techniques to use for the CsI Detector.
This procedure requires a dosimeter (exposure meter).
Run this procedure again if the beam output changes.
For systems with a generator interface, the generator controls display with the mAs
active.
Follow the on-screen instructions to acquire the calibration technique setting.
Depending on the make and model of the dosimeter and the exact configuration of the
equipment setup, it may be necessary to make an adjustment to the measured exposure
to account for the effect of backscattered X-rays.

DR TQT - Calibration Techniques Setting for GOS Detector


The screen displays the techniques to use for the GOS Detector.

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How To Warm Up the X-ray Tube

How To Warm Up the X-ray Tube

Caution

Always use the instructions in the Tube Warm-Up screen. See Utilities > Tube Warm-up
for information.
The tube warm-up exposure factors are preprogrammed. Only the Key Operator can adjust
them.
Producing X-rays with a cold or improperly warmed tube shortens the life of the X-ray tube.
Do not acquire images without warming the tube.

Note
You can use the control on the collimator keypad to turn on the collimator lamp and check if the
collimator shutter is open or closed. The light indicates that the lamp is operational and the
shutters are open.
1. Close the collimator shutters.
2. At the Main Menu, select Utilities > Tube Warm-up.
3. Make a series of exposures 3 seconds apart until the message
Tube Warm-up completed displays.
4. Select Back.

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DR TQT - Total Quality Tool Analysis

DR TQT - Total Quality Tool Analysis


DR TQT is supported by DRX-1 and DRX Plus detectors, only.

DR TQT - Flat Field Analyses Measurements


DR Flat Field analyses are used to characterize DR imaging system response to X-rays. This
is accomplished by a collection of signal, noise, uniformity metrics, and sensitivity
performance measurements. These are useful for tracking both detector performance
and some aspects of X-ray source setup.
Flat Field tests measure a Signal Value and Noise Level for each of the four images.
The signal and exposure (mR) are calculated to determine the sensitivity of the
detector.
These tests determine Noise Uniformity, so that the image will be flat:
Bad PixelsTo detect and correct pixels and lines that may appear in the Flat Field
image. Some artifacts may be corrected by calibrating the detector. (The longer the
time between calibrations, the more artifacts may appear.)
Pixel ShiftThe readout of chip differences within the structure of the detector may
form lines.

DR TQT - How to Do a Flat Field Analysis


Go to DR TQT Main Menu > DR TQT Analysis.
1. Select a detector.
2. Follow the on-screen instructions to acquire the four required Flat Field images.
3. Acquire each image using the exposure switch when the status bar turns green and
displays the Ready message.
4. Click Next Page to continue.

DR TQT - Dark Noise Analysis


DR TQT Dark Noise Analyses are used to characterize DR detector noise floor
characteristics. This is accomplished by a collection of Dark Noise averages, variations,
and uniformity performance measurements. These are useful for tracking both detector
performance and some aspects of environmental noise robustness.
Dark Noise Analysis is done automatically, collecting two dark images off the detector,
subtracting them, and running an analysis on the created dark noise image.

DR TQT - How to Do a Phantom Analysis


Phantom Analysis requires an exposure of a DR TQT phantom that must be placed in
front of the detector.
Follow the on-screen instructions including:

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DR TQT - Total Quality Tool Analysis

Supplied filters
DR TQT Phantom
1. Follow the instructions on the screen and place the DR TQT Phantom on top of the
detector.
2. Acquire the image.
When the image is acquired, the Start Analysis button becomes available.
3. Click Start Analysis.

Note
The analysis takes a few minutes to complete.
4. When the analysis is complete, view the results on the screen.

DR TQT - View the Flat Field Test Results


The Flat Field tab on the DR TQT Results screen lets you view test results from Flat Field
analyses runs and the baseline results, if available.
1. Select Flat Field.
The detector serial numbers appear in the Detector list box for detectors that have
results.
2. Select the detector serial number for which you want to view results.
3. At the top of the screen, select the results By Date or Reports.
A list of values appears in the display value list boxes.
4. Select one of the following:
Overall ResultTo view a summary of the test results.
Per ImageTo view the detailed results for each image.

DR TQT - Results Screen - Flat Field


The Results screen displays the detailed results for the test just run or for a test selected
through the Data Results screen.

Overall Results - Flat Field

Detector Serial Number

Sensitivity (Value and Status) (ADC/mR)

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DR TQT - Total Quality Tool Analysis

Overall Results - Flat Field

Image Quality Signal Uniformity (number of images that passed


signal uniformity test) and status
Noise Uniformity (number of images that passed
noise uniformity test) and status
SNR Uniformity (number of images that passed SNR
uniformity test) and status

Within Region of Interest Intra ROI Signal Asymmetry


Intra ROI Noise Asymmetry

Between Region of Interest Signal Uniformity


Noise Uniformity

Per Image Results - Flat Field

Detector Serial Number

Analysis Date and Time

Level Group

Exposure (mR, mAs)

Image Quality Average ROI Signal (ADC), Spread, Uniformity


(max-min), Uniformity percent (with status and
limit)
Average ROI Noise, Spread, (ADC, Std Dev), Unifor-
mity (max-min), Uniformity percent (with status and
limit)
Average ROI SNR, Spread (Std Dev), Uniformity
(max-min), Uniformity percent (with status and
limit)
Minimum SNR Value
SNR Threshold Value and status

Artifacts Horizontal and Vertical Lines


ASIC Edges Visible (Horizontal and Vertical if apply)
Gate Driver Edges Visible (Horizontal and Vertical if
apply)
Inter ROI Signal and Noise Uniformity (Row and
Column values)

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DR TQT - Total Quality Tool Analysis

DR TQT - Results Screen - Dark Noise Test


This part of the DR TQT Results screen displays the results from the Dark Noise analysis
runs and the baseline results, if applicable.
Overall Results - Dark Noise

Detector Serial Number

Sensitivity (Value and Status) (ADC/mR)

Image Quality Signal Uniformity (number of images that passed


signal uniformity test) and status
Noise Uniformity (number of images that passed
noise uniformity test) and status
SNR Uniformity (number of images that passed SNR
uniformity test) and status
SNR Magnitude (number of images that passed SNR
magnitude test) and status

Artifacts ASIC Edges Visible


Gate Driver Edges Visible
Panel Lines Visible
Intra ROI Signal and Noise Asymmetry
Inter ROI Signal and Noise Uniformity (Row and
Column displayed if failures)

Per Image Results - Dark Noise

Detector Serial Number

Analysis Date and Time

Level Group

Exposure (mR, mAs)

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DR TQT - Total Quality Tool Analysis

Per Image Results - Dark Noise

Image Quality Average ROI Signal (ADC), Spread, Uniformity


(max-min), Uniformity percent (with status and
limit)?
Average ROI Noise, Spread, (ADC, Std Dev), Unifor-
mity (max-min), Uniformity percent (with status and
limit)
Average ROI SNR, Spread (Std Dev), Uniformity
(max-min), Uniformity percent (with status and
limit)
Minimum SNR Value
SNR Threshold Value and status

Artifacts Horizontal and Vertical Lines


ASIC Edges Visible (Horizontal and Vertical if apply)
Gate Driver Edges Visible (Horizontal and Vertical if
apply)
Inter ROI Signal Uniformity (Row and Column
values)

DR TQT - Results Screen - Phantom Test


The Phantom tab on the DR TQT Results screen lets you view phantom analysis results
from the most recent phantom analysis runs. This is similar to the sensitivity display for
Flat Field.
Test Results - Phantom

Detector Serial Number The detector serial numbers appear in the Detector list
box for detectors that have results. Select the detector
serial number for which you want to view results.

Horizontal Modulation Transfer MTF @ 1 cycl/mm


Function (MTF) MTF @ 2 cycl/mm
MTF @ 3 cycl/mm
MTF @ 50 Nyquist
MTF @ 95 Nyquist

Vertical Modulation Transfer Same as above for Vertical MTF


Function (MTF)

Contrast-Noise Ratio CNR for Patch 15 with values, limit, and status.

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DR TQT - Total Quality Tool Analysis

DR TQT - How to Export TQT Test Results


You can export TQT results to a multi-session CD-ROM or DVD, or to a USB device.
1. From the DR TQT Results screen, select the Utilities tab.
2. Chose one of the following:
Select the serial number of the detector for which you want to export results.
Select All to export all results.
3. Click Browse in the Export Results section.
4. Select a location to export results to.
5. Select an export location from the list of available drives.
6. Click Start Export.

A message appears when the export is complete.

Note
Contact Service to import test results.

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System Configuration Menu

System Configuration Menu


System Configuration groups most of the functions that the Key Operator configures.
The following sections appear in Key Operator Functions > System Configuration.
CR, DRX-1, and DRX-Revolution Systems will not have all of these choices in their menu.
View Configuration Network Configuration

Procedure Mapping Configuration Destination Configuration

List Configuration RIS/PACS Client Configuration

Layout Configuration Prior Images Configuration

Display Configuration System Maintenance

Image Processing Preferences Regional Configuration

Trauma Defaults Customizable Field Descriptions

Reject Reasons Import Tutor Images

Destination Profiles Configuration Color Preferences

Configurable Text Boxes Image Correction Preferences

Delivery Preferences Technique Settings

Remote Device Configuration Long-Length Configuration

Configurable Text Boxes Grid Type Configuration

Delivery Preferences Auto Position Configuration

Remote Device Configuration DRX Detector Settings

Automatic View Selection

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View Configuration Screen

View Configuration Screen

How to Change a View


Navigate to Key Operator Functions > System Configuration > View
Configuration > View Configuration.
1. On the View Configuration screen, select a View.
2. Select Show View Details to edit the attributes of a single View.
You can also view the standard naming and encoding convention (SNM3 Codes) for
identifying body part, position, and orientation in the DICOM header.
3. Reduce the number of Views in the list by selecting the Category radio buttons.
4. Select the field that you want to change.
If you change the View name it will not affect the image processing for the View,
which is set up using the Image Processing Preference Editor.
5. Select the radio button to display the parameters for the View.
6. Select the item that you want to change and enter a new value from the tabbed
keyboard. Repeat for each parameter you want to change.
You can change the following configurations:
Color Skin Line Detection

Body Part Surround Mask

Projection Surround Mask Detection

Position Surround Mask Enlargement

Laterality Brightness

Auto Position Latitude

Tutor Image Contrast

Rotation Sharpness

Print Format Target EI

Tick Marks Look

Internal Text Box Noise

Page Footer Grid Suppression

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View Configuration Screen

Crop Type Noise Suppression

Raw Linked Views

7. Select Show View Details to edit all configurations of the View at once, or use the
Column Selection radio buttons to control which columns are displayed in the View
list.
8. Select the Global Edit check box to apply the changes you make to every row of the
Category selected.
9. Select Save Changes.

How to Delete a View

Note
If the Views are associated with a procedure, make sure that deleting them will not affect
Procedure Mapping.
1. Navigate to Key Operator Functions > System Configuration > View
Configuration.
2. Deselect all Views to make sure that no additional Views are unexpectedly selected.
3. Select the check box of the View with a similar body part and projection that you
want to delete.
4. Select Delete Checked Views to delete the selected View(s).
A confirmation dialog shows what Views will be deleted.

Note
Views are erased from the system when you delete them from the View Configuration. Deleting
Views from View Category Management moves Views to the Uncategorized category so they
can be added back into a category later, if desired.

How to Change the Look of a View


Prerequisites:
Read this before you make a change in the Preference Editor.

1. Go to Key Operator Functions > System Configuration > Image Processing


Preferences.
2. To use the Editor, click Select New View.
3. Select a Primary and a Secondary Category, and View that already exists in the
system (or close the window at the desired level).
If you select Close after selecting a Primary or Secondary Category, your changes will
apply to all of the Views in that category.

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View Configuration Screen

4. Select Change Look to select a starting point for correction.


5. View the images provided. Use the Up or Down arrows to see all of the sample Looks.
6. Select Accept this Look if the sample image displays the image processing results
that you would like to see for images with that View.
7. Adjust the individual slider controls to fine-tune the desired effect.
8. Select View Before and After to compare your changes.
9. Select View After Only to select a printer or a workstation to send the image for
evaluation.
10. Select Deliver to send the image to a destination for evaluation.
There is no confirmation on the status of the delivered image.
11. Select Save Changes.

Note
Use the Zoom feature to evaluate detail/sharpness while making image processing changes.

What is a Look?
Looks are different recipes for processing the images that take into consideration the
degree of brightness, latitude, detail contrast, sharpness, and noise that radiologists like.
Every institution chooses its Look from a family of Looks provided by Carestream Health,

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View Configuration Screen

Inc. and can then customize exams to its own taste using the Image Processing
Preference Editor.

The Family of Looks


Look Name Description

Baseline Image Processing Mimics Non-EVP Plus processing.

Fixed Image Processing Models which have fixed rendering parame-


ters. Noise suppression is the same as above.

Premium Image Processing 1 Default Look from the factory. Base models
used in clinical study. Noise suppression con-
sistent with Low Exposure Optimization.

Premium Image Processing 2 Default Look biased to produce brighter,


sharper, more detailed renderings with cus-
tom noise suppression.

Premium Image Processing 3 Default Look biased to be higher in contrast


(less latitude and more detail with custom
noise suppression.)

Premium Image Processing 4 Default Look biased to provide on average


slightly greater latitude and detail than the
CR Premium look with custom noise suppres-
sion.

Premium Image Processing 5 Default Look is biased so that it is less digital


in appearance, in line with a medium latitude
analog film Look.

Premium Image Processing 6 Multiple uses depending on the View. For


example, there are different sets of image
processing parameters for breast Views,
Views for extremities that include surgically
placed hardware, and parameters that have
been optimized for the pediatric Views.

Premium Image Processing 7 Sharper than Premium Image Processing 1.

Premium Image Processing 8 Provides the appearance of extra-sharp


edges.

How to Change a Tutor Image


1. With the View selected, click Go to View.
The View Configuration screen appears. The selected View appears at the top of

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View Configuration Screen

the screen.
2. Select the Tutor Image for that View.
The Tutor Image panel opens.
3. Select a Gold, Silhouette, or Custom tutor image.
4. Select Show View Details.
5. Select an Internal Text box if desired.
6. Select Change Tutor Image.
7. Select Back.

The tutor image is changed for that View.

How to Globally Change the Default Tutor Image


Navigate to Key Operator Functions > System Configuration > View
Configuration
1. Select the Global Edit check box.
2. Select one of the images in the Tutor Image column.
3. In the Tutor Style tab, select Gold or Silhouette Tutor Image.
The tutor image style for all Views changes automatically.

View Attributes for Unassigned Images


When an image is unassigned, it has no View attributes assigned to it. When you assign
the image, it still does not take on the attributes of the selected View. For example, the
Text Box would not appear, even though the assigned View has a text box as an attribute.
In the View Configuration screen, you can assign attributes so that all unassigned
images are configured.

Configure Default Display for Unassigned Images


1. In the View Configuration screen, select Unassigned Default.
2. Configure the default display of all unassigned images as needed for the following
features:
Color
View Name
Tutor Image
Look Name
Grid Suppression
Noise Suppression
Raw
Skin Line Detection

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View Configuration Screen

Internal Text Box


Cropping Type
Surround Mask

Navigation and Function Buttons on the View Configuration Screen

Buttons

Name Description

Show View Details Click to view the settings such as Noise Suppression, Detail Contrast,
Latitude, Brightness, and Sharpness.You can change settings such as,
Grid Suppression, Raw, Surround Mask, the indicator color, True-size,
Tick Marks, Skin line detection, and cropping type.
Select the tutor image to change the tutor image for the View.
Select Internal Text Box to add a text box configuration to the View.
Select the tutor image to place the Text Box.
Select the External Text box setting to be at the bottom, left, or off.

Delete Checked Select the check box of the Views you want to delete and then select
Views Delete Checked Views. A confirmation message appears. If the Views
are associated with a procedure, make sure that deleting them will not
affect Procedure Mapping.

Copy/Paste Selects the check boxes of up to three Views you want to copy and then
Checked Views select Copy Checked Views. Rename the View and modify it if
desired. Select a Primary Category and a Secondary Category where
you want to place the View.

View Category Add or delete Primary, Secondary Categories, or Views. Use the far right
Management column arrows to move highlighted items to arrange how the Regions,
Exams, and Views display. The order of the items in the column will dis-
play left to right, top to bottom at the Patient Input screen or Image
Acquisition screen.

Check All Selects all check boxes. One row is always selected.

Uncheck All Clears all check boxes.

Save Changes Saves the change to the local database.

Main Menu Exits the current screen and returns to the system Main Menu.

Back Returns to the previous screen.

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View Configuration Screen

Tab Controls at bottom of screen

Name Description

Keyboard Activates the keyboard when you touch a button. The button becomes
active for editing. Type the information from the virtual keyboard.

Color Select the colors of the buttons from over 200 individual colors.

Color Palette Select from a full color palette of blended hues.

Body Part* Provides three tabs containing all body parts in use to create a View.

Projection* Provides three tabs containing all projections in use to create a View.

Position* Provides all positions in use to create a View.

Flip/Rotate Flips or rotates, and lets you select the degree.

Tutor Image Selects the graphic tutor image that represents the View. Both Gold and
Silhouette images are available by default. You can add custom tutor
images by clicking on the Custom button and selecting tutor images
imported by the Key Operator. These images must be assigned one at a
time for each View. Use the Backup and Restore feature to save and
retrieve these View configurations.

*You can use the virtual alphanumeric keyboard to change body part, projection, or
position. After saving, the new item appears in the appropriate keyboard.

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Procedure Mapping

Procedure Mapping

About Procedure Mapping Configurations


Procedure Mapping is a way to set up a series of Views to automatically display when a
study is started. The Key Operator selects a series of Views that he or she would like to
be used for a particular procedure, then assigns this set of Views to that procedure. (The
procedure is named, and will be used whenever a study for that body part is requested.)

An example of Procedure Mapping


For example, a procedure for a hand exam might be a PA Hand, an Oblique Hand, and a
Lateral Hand. Whenever that Procedure is selected, the system will automatically display
the selected Views. The Views will appear on the Patient Input screen and the
Technologist will be able to complete the study without having to search for Views
associated with that procedure.

Procedure Mapping using Procedure Codes


Procedure Mapping is requested by the procedure code provided by the Radiology
Information System (RIS) instead of the procedure name. Procedure codes need to be
entered carefully, because they are case sensitive; added spaces or characters will make
that procedure fail to show the Views.

Copying Procedures
Procedures can be copied. If the Left Hand and Right Hand have different codes, the Key
Operator can enter one, copy it, and modify the name and procedure code.

Moving a Procedure from One Category to Another


Procedures be mapped in one category and then moved to another by using the Move
button to begin mapping again, then Save Changes. The Turn Edit On button is used
when using Procedure Mapping and after each time Save Changes is selected.
Procedure Mapping is a purchased option for CR Systems, but automatically available for
DR Systems.

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Procedure Mapping

Procedure Mapping Using the Procedure Code Workflow


Prerequisites:
If your facility supplies Procedure Codes, the Key Operator can automate hospital codes
that represent procedures with the data entry on the CR System.

When the patient information is selected from the Work List, the codes are included in
the list. The Views for that procedure appear automatically on the Patient Input screen.
1. From the Main Menu, select Study Data.
2. Search for the patient using the Patient Work List screen. You can type the first
letter of the name to view the list.
3. Select the patient from the Work List.

The patient information and the Views for the procedure appear on the Patient Input
screen.

How to Configure Predefined Procedures


Go to Key Operator Functions > System Configuration > Procedure Mapping
Configuration. The facility needs a HIS/RIS that associates procedure codes with their
procedures. The Key Operator automates study workflow when the procedure codes are
mapped to the Views the facility does for each procedure.
1. Choose an existing Category or select Add and then enter a Region.
For example: Thorax, Spine, Upper extremity, or Lower extremity.
2. Choose an existing Exam or select Add and then enter an Exam.
For example: Adult Chest, Pediatric Chest, Sternum, or Ribs.
3. Modify an existing Procedure Name (select Turn Edit On) or select Add and then
enter a Procedure Name.
4. Enter a Procedure Code to match the code sent by the HIS/RIS in the Procedure Code
field on the Patient Input or Image Acquisition screens. This will automatically
populate the views when selecting a patient record.
5. You can select a Destination Profile. Leave this field blank for the CR Modality.
6. Select Add in the Views box, then enter the desired Views for the procedure. You
can add Views from different categories. Select Delete to remove highlighted Views
from a procedure.
7. Use the second column of arrows (located to the right of the Views) to rearrange the
order in which the Views are displayed at the Patient Input screen or Image
Acquisition screens. Arrows with a double line above or below them will move the
selected procedure/View to the top/bottom of the list. Arrows with a single line

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Procedure Mapping

above/below them will move the selected procedure/View to up or down one line at
a time.
8. Select Save Changes.

Navigation and Function Buttons on the Procedure Mapping


Configuration Screen
Button Description

Change Multi-Format Lets you add a multi-format configuration to the procedure, such as
Configuration 2-up lengthwise to 4-up crosswise.

Change View Quick access to View Configuration. Lets you add, delete, and mod-
Configuration ify views for use in procedure mapping. Select the Back button in
View Configuration to return to Procedure Mapping.

Turn Edit On Lets you edit the procedure. Select this button to make changes
such as name, category (body part, position) procedure code, desti-
nation, and auto position.

Save Changes Completes the action by writing changes to the local database.

Main Menu Exits the current screen and returns you to the system Main Menu.

Back Returns to the previous screen.

How to Configure Supine Long-Length Imaging Procedures


Go to Key Operator Functions > System Configuration > Procedure Mapping
Configuration.
1. Select the Lower Extremity Category.
2. In the Procedure column, add Supine Leg Length.
3. Select Save Changes.
4. Select Add in the Views box, then enter Leg Length AP Supine View.
5. Select Table Detector.

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List Configuration

List Configuration
The Key Operator can pre-configure lists using buttons and tabs to provide a convenient
and standard list for radiographers to pick from when entering Department Name,
Referring Physician, or Tech ID.
The Key Operator can also configure a list button to not display and later restore the
display of the button. You can change button colors or move button positions on the
same tab.

Navigation and Function Buttons on the List Configuration Screen

Buttons

Name Description

New Tab Selects the matrix size based on the number of items you will have in
your list. Choose from 4 x 5, 5 x 5, 6 x 5, 7 x 5, and 8 x 5. You can enter
up to five tabs of data per list.

Delete Tab Deletes the tab of information from the list. You will be prompted to
confirm the deletion. There is no recovery from deleting a tab.

Show Button Displays the button in the list in the interface. Toggles to Hide Button.

Hide Button Hides the button display on the interface. Toggles to Show Button.

Save Changes Saves the change to the local database.

Main Menu Exits the current screen and returns to the system Main Menu.

Back Returns to the previous screen.

Tab Controls at bottom of screen

Name Description

Keyboard Activates the keyboard when you touch a button. The button becomes
active for editing. Type the information from the virtual keyboard.

Color Selects the colors of the buttons from over 200 individual colors. Select
the color you desire.

Color Palette Selects from a full color palette of blended hues.

Move Moves the button to another position on the tab. You cannot move the
button to another tab.

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Layout Configuration

Layout Configuration

Layout Configuration
This screen provides easy access to layout editors. With these editors the Key Operator
can configure what, where, and how the information will display for all functions on
various screens. To access this screen go to Key Operator Functions > System
Configuration > Layout Configuration.

Image Viewer Editors Tab


Use to add, remove, or reorder the editors that appear on the tabs in the Image Viewer
screen.
The order of the editing icons and their functions are configurable. The most frequently
used editors can be accessed quickly with organization.

Markers Editor Tab


Use to organize the markers that appear on the Image Viewer and Express Viewer
screens.

Tech Assist Tab


If enabled, the Tech Assist feature provides indicators that appear on the Image Viewer
or Express Viewer screens or the Patient Information bar.

Patient Names Tab


Use to configure single and multiple byte names.

Patient Work List Tab


Use to configure the layout for the Work List and the default focus field.

Patient Input Tab


Use to configure the layout of the fields and tabs on the Patient Input and Image
Acquisition screens.

RPDES Editor
Use to configure the layout of the Remote Patient Data Entry System (RPDES).

Image Viewer Editors


The Image Viewer Editors tab is used to add, remove, or reorder the editors in the
panels in the Image Viewer to reflect your preferences and enhance your workflow.
The Image Viewer Editors tab is divided into two parts:

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Layout Configuration

Disabled Editors
These editors will not appear on the tabs in the Image Viewer screen.
Enabled Editors
These editors will appear on the tabs in the Image Viewer screen in the order they
appear in the list. In other words, the first editor's icon will appear on the first tab
icon on the Image Viewer screen. The second will appear on the second tab, and so
forth.

How to Disable an Image Viewer Editor

1. Navigate to Key Operator Functions > System Configuration > Image Viewer
Editors
2. Select an editor from the Enabled Editors list.
The editor will be highlighted when selected.
3. Select the arrows to the bottom of the list to move the editor to the Disabled Editors
list.
The arrows at the bottom move the selected editor to the left or right of the list.
4. Select Save Changes.
This selection removes the editor from the Image Viewer Screen.

The tabs on the Image Viewer screen will reflect the changes immediately.

Note
The tab display on the Image Viewer screen will collapse or expand depending on the size and
shape of the monitor.

Patient Names Editor


Use the Patient Names Editor to configure the format that will determine how patient
names will display on the Patient Work List screen, Image Review screen, and on the
patient information bar.
1. Select the format you prefer for the patient name display by selecting the radio
button located to the left of your choice.
2. Select Save Changes.

Markers Editor
The Markers Editor lets you customize the marker palette on the Image Viewer screen.
Using the Markers Editor you can do the following:
Add markers
Delete markers

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Layout Configuration

Customize markers
Rearrange markers
Select a transparent background for text markers

Tech Assist

Tech Assist Software

On the Layout Configuration screen, the Tech Assist tab allows the Key Operator to
configure the following Tech Assist software features:
Tech Assist for Chest Anatomy
Anatomy Clipping Regions
Exposure Value Display
Tech Assist Sensitivities

Tech Assist for Chest Anatomy

Feature Description

Enable Tech Assist on Image When checked, Tech Assist for Contrast Noise Ratio and anat-
Viewer for chest anatomy omy clipping warnings are enabled. The check box is
regions unchecked by default.

Automatically display Tech Displays a status or warning in the form of a Safe Color or an
Assist overlay when a prob- Alert Color that the Key Operator chooses. Used to display the
lem is detected status, or warnings that the threshold has reached for Con-
trast Noise Ratio (CNR) and anatomy clipping.

Display Tech Assist overlay The areas that may be clipped can be only seen by selecting
only when requested the toggle button on the patient information bar on the
Image Viewer or Express Viewer screen.

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Layout Configuration

Anatomy Clipping Regions

Indicates the typical regions of anatomy that may be excluded, or clipped, in a chest
X-ray.
Provides a prediction of the likelihood that a particular area might be clipped as
illustrated by the above graphic. The regions that are likely to be clipped are designated
by rectangles around the chest.
The likelihood that the region may be clipped is represented numerically, as sensitivity
levels, 0.01.0.
The Key Operator determines how sensitive the warning indicator should be by selecting
a particular rectangle and moving the slider toward More Warnings or Fewer Warnings.
The numeric value changes as the area is set to more sensitive or less sensitive.
The current values for each region are shown in the graphic.
These rectangles appear on the image in the Image Viewer or the Express Viewer screens
if clipping occurs.

Exposure Value Display


Three choices are provided to configure the Exposure Index:
IEC Exposure Index
IEC Exposure Index and Carestream Health Exposure Index
Carestream Health Exposure Index

Tech Assist Sensitivities


Two features are offered in this section.
1. Exposure Deviation Index
A target IEC Exposure Index is shown for each View on the View Configuration screen.
The Exposure Deviation Index describes how far from the target EI a given exposure
is.
Use the slider controls to set the threshold for each View. The default value is 3.0. The
scale increments by 10 %.
Fewer warnings indicate that the threshold will be met within a higher range.

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Layout Configuration

2. Contrast Noise Ratio (CNR) Indicator

The Contrast Noise Ratio (CNR) indicator alerts the user when the combination of low
contrast and excessive noise will not produce an optimum image. The analysis occurs
when the image is processed or reprocessed.
The indicator is located in the upper left quadrant of the Image/Express Viewer
screen. It can be configured to appear automatically, or viewed by toggling back and
forth manually.
The System calculates the CNR for chest images only and records the CNR for inclusion
in the image statistics. The default value is 0.3.
The Key Operator configures the threshold value. For example, if the CNR indicator is
green, but you are not satisfied with the images, move the slider to change the ratio
higher until the images are satisfactory. If the indicator is red, then the value is too
high.
Move the slider toward More Warnings to increase the sensitivity of the tool.

Tech Assist Software Features

Navigate to Key Operator Functions > System Configuration > Layout


Configuration Tech Assist tab.
The Tech Assist software offers the following features:

Display Tech Assist Overlay


This feature provides two options:
1. Automatically display Tech Assist overlay when a problem is detected
If this option is selected, a status or warning in the form of a Safe Color or an Alert
Color is displayed on the Image Viewer or Express Viewer screen to indicate that
the threshold has been maintained or reached for Contrast Noise Ratio (CNR) and
that the probability is that clipping has or has not occurred.
The Key Operator chooses the Safe and Alert colors from the Layout Configuration
screen color palette, which appears when a color square is selected.
2. Display Tech Assist overlay only when requested
With this option, the areas that may be clipped can only be seen by selecting the
toggle button on the patient information bar on the Image Viewer or Express
Viewer screen.

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Layout Configuration

Tech Assist Sensitivities in Anatomy Clipping Regions

This feature indicates the typical regions of anatomy that may be excluded, or clipped, in
an X-ray.
It provides a prediction of the likelihood that a particular area might be clipped as
illustrated by the above graphic. The regions that are likely to be clipped are designated
by rectangles around the chest. The likelihood that the region may be clipped is
represented numerically, as sensitivity levels, 0.01.0.
The Key Operator determines how sensitive the warning indicator should be by selecting
a particular rectangle and moving the slider toward More Warnings or Fewer
Warnings. The numeric value changes as the area is set to more sensitive or less sensitive.
The default is shown in the graphic.
These rectangles appear on the image in the Image Viewer or the Express Viewer
screens.

Exposure Value Display


Select the desired Exposure Index configuration:
IEC Exposure Index
IEC Exposure Index and Carestream Health Exposure Index
Carestream Health Exposure Index

Exposure Deviation Index System Setting


A target IEC Exposure Index is shown on the View Configuration screen.
The Exposure Deviation Index measures a percentage of standard deviation from the
exposure aim.
The default value is 3.0.
The scale increments by 10 %.
Use the slider controls to set the threshold for all Views in the system.
Fewer warnings indicates that the threshold will be met within a higher range.

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Layout Configuration

Contrast Noise Ratio (CNR)

The Contrast Noise Ratio (CNR) indicator alerts the user when the combination of low
contrast and excessive noise will not produce an optimum image. The analysis occurs
when the image is processed or reprocessed.
The indicator is located in the upper-left quadrant of the Image Viewer and Express
Viewer screens. It can be configured to appear automatically, or to be viewed by
toggling back and forth manually.
The System calculates the Contrast Noise Ratio for chest images only and records the CNR
for inclusion in the image statistics.
The default value is 0.3.
The Key Operator configures the threshold value. For example, if the CNR indicator is
green, but if you are not satisfied with the images, move the slider to change the ratio
higher, which provides a more optimal CNR target. If the indicator is red, then the value
is too high.
Move the slider toward More Warnings to increase the sensitivity of the tool and
improve the image.

How to Enable the Anatomy Clipping Detection Feature

To Enable the Anatomy Clipping Detection Feature:


1. Navigate to Key Operator Functions > System Configuration > Layout
Configuration screen.
2. Select the Tech Assist tab.
3. In the Tech Assist for Chest Anatomy section, select the Enable Tech Assist on
Image Viewer for chest anatomy regions check box.
When checked, the Anatomy Clipping Regions section becomes active.

4. Select a region by selecting a rectangle to highlight it.


5. Use the slider control to set the threshold for sensitivity. You can configure up to 11
sensitivity adjustments for the anatomy clipping detection.
More Warnings means it is more likely that clipping has occurred in that region.
6. Select Save Changes.

You can view the result of the warnings by viewing a (clipped) image on the Image
Viewer or Express Viewer screens. Rectangular outlines display the anatomy clipping
regions on the image. See the image below.

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Layout Configuration

How to Disable the Anatomy Clipping Detection Feature

The Key Operator can disable the anatomy clipping feature by clearing the Enable Tech
Assist on the Image Viewer for chest anatomy regions check box.

Patient Work List Editor


The display of the Work List tab appears exactly the same as the actual Work List screen.
This format helps you configure the default focus field and sort order for the Work List.
Go to Key Operator Functions > System Configuration > Layout Configuration >
Patient Work List tab.
1. To configure the default focus field:
a. Touch or click the field you prefer from the text boxes across the top of the screen.
For example, some sites will search by Accession Number and others will search by
Patient ID.
The field will become highlighted when you select it.
When the user views the Work List screen, this field will be required first.
b. Select Save Changes.
c. Select the Clear Focus Field button to reset the default.
The focus selection appears in text across the bottom of the screen to confirm the
selection: Default Focus Field.
2. To configure the default sort order:
a. Review the default selection criteria used to sort the Work List (sort order).
The default sort order is Patient Name.
b. To see more criteria, select a layout for the sort order from the Select New
Layout tab.
c. Select from the menu choices. The choices may be different depending on the
system you use.
d. To change the sort order from ascending to descending, select the heading from
the layout.
The sort order appears in text across the bottom of the screen: Default Sort
Order.

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Layout Configuration

Patient Input Editor


You can assign a status to each field on the Patient Input screen, including the Exam
Information, More Information, and Image Information tabs. When you assign a
field to be Required to Submit or Required to Deliver to Mandatory Destinations,
an icon appears in the upper-right corner of the text box label, letting the user know the
status at a glance.

How to Assign Patient Data Entry Requirements

Use this procedure to configure required fields.


1. Go to Key Operator Functions > System Configuration > Layout
Configuration > Patient Input tab.
2. Touch or click a text box.
3. From the table below, select a radio button or a label for the patient data entry
requirements that you want the text box to have.
For example, click the Accession Number text box then select a radio button such as
Required to Submit. The associated icon appears next to the label in that text box.

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Layout Configuration

Radio
Button Name Description

Normal Text box This label is assigned by default to all optional text boxes
with no assigned status. This is not required.

Required to Sub- Assign to a text box for which information is required


mit before the user can save changes.

Required to By default, assigned to Patient Last Name and Patient ID


Deliver to Man- text boxes. Assign to any text box that should be required
datory Destina- to be populated before the image can be sent to manda-
tions tory destinations.

Read Only Text box appears as a label. Assign to text boxes that will
display information that the user cannot change. Not edit-
able.

Read Only Label Text box appears as a label. Assign to a text box that hides
the information.

Select New Lay- Choose this button to change the text boxes that appear
out on the Patient Input screen. After making all selections,
select Save Changes.

4. Select Save Changes.

Tube Head Acquisition Screen Editor


This screen lets you set the layout for the Image Acquisition screen that appears on the
secondary screen on the DRX-Revolution tube head.
1. Navigate to Key Operator Functions > System Configuration > Layout
Configuration > Tube Head Acquisition tab.
2. Touch the Select New Layout button and select a different order for
Patient Name
Patient ID
Date of Birth
Accession Number

Note
This information is for DRX-Revolution Mobile X-ray System only.

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Layout Configuration

Work List Editor on the Tube Head Display


The Patient Work List appears on the tube head display as the first screen by default.
The layout is configured by the Key Operator, selected from Select New Layout menu.
The user can sort the Patient Work List by any one of the fields at the top of the list.
The Work List on the tube head display has the same functionality as the Work List on
the primary monitor.
1. To configure the default focus field:
a. Touch or click the field you prefer from the text boxes across the top of the screen.
For example, some sites will search by Accession Number and others will search by
Patient ID.
The field will become highlighted when you select it.
When the user views the Work List screen, this field will be required first.
b. Save Changes.
c. Select the Clear Focus Field button to reset the default.
The focus selection appears in text across the bottom of the screen to confirm the
selection: Default Focus Field.
2. To configure the default sort order:
a. Review the default selection criteria used to sort the Work List (sort order).
The default sort order is Patient Name.
b. To see more criteria, select a layout for the sort order from the Select New
Layout tab.
c. Select from the menu choices. The choices may be different depending on the
system you use.
d. To change the sort order from ascending to descending, select the heading from
the layout.
The sort order appears in text across the bottom of the screen: Default Sort
Order.

Note
This information applies to the DRX-Revolution Mobile X-ray System only.

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Display Configuration Screen

Display Configuration Screen


Navigate to Key Operator Functions > System Configuration > Display
Configuration.
The Display Configuration screen lets you customize the way data displays for Patient
Query, Patient Input, Patient Link, Image Viewer, and Other functions. Each
function has a tab, and when selected, the Key Operator can configure the way all of the
data will display to the Technologist.

Patient Query
Configures the primary search method for finding a patient study by selecting radio
buttons:
Local
Remote
Local then Remote
Select the default status criteria for the technologist to use for a Patient Query.
Select the Status from the panel at the bottom of the screen.
See the topic Patient Search Techniques for more information.

Patient Input
Configures the Procedure Step/Study Configuration that the system uses to organize and
deliver patient information. The Key Operator may choose the following by selecting an
option button:
Create new procedure steps from Patient Input
Create new studies from Patient Input
Configures the application of profiles in the system. The Key Operator may choose the
following configuration for profile application by selecting the option button:
Profile change applies to current study only
Profile change applies to all incomplete steps for this patient
Configures the Tutor Image style by selecting the appropriate option button:
Gold
Silhouette
Configures Patient Input options by selecting the desired check box:
Require confirmation to end a procedure step
After accepting all images in one or more procedure steps or studies, set the status to
Completed
Auto populate Tech ID with logged in user
Auto populate Tech ID from previous study
Display Tutor images

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Display Configuration Screen

Enable wristband Verification Mode on Patient Input screen.


Verify patients by:
Patient ID
Patient ID, name, and date of birth

Patient Link
Displays a list of patients that are listed in the Quick Menu, with the functions such as
Shutdown, Logout, Snapshot Log Files, Image Export List, and so forth. The actual
number of patients allowed is set under Number of Shortcuts. You access the Shortcut
menu by selecting the Quick Menu icon located in the lower-left corner of every screen.
The Key Operator may configure the shortcut menu to display:
Patient Link Enabled check box. Select patient studies that have been done recently
from the Quick Menu for faster access.
Repeat Patients check box. If a patient has more than one study, they will be listed
for each study.
Button Sort Order
Most recently accessed item appears at the top of the list.
Most recently accessed item appears at the bottom of the list.

Image Viewer
Configures the display choices on the Image Viewer screen:
Display ID window on the Image Viewer window. Select to display the ID window
on the Image Viewer screen. You can use this to identify the orientation of the
receptor during the exposure.
Use Express Viewer button, toggling to the Express Viewer for a selection of
simple, common tools.
Automatically Reprocess Image so that the user will not have to press the
Reprocess button after modifications such as masking.
Default Zoom Mode
Fit to ScreenDisplayed image from the receptor fits the Image Viewer window.
Fit to BSMImage from the receptor displays only what is viewable within the
Black Surround Mask, so the image appears larger.
Region of Interest
ROI is the tool that displays the mean, minimum, maximum and standard deviation
values for the code values within the area specified by the user on the image.
DimensionThe size of the area that defines the ROI when the user touches a point on
the image is determined here. You can select from the following using the option
button:
10 %
Custom

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Display Configuration Screen

Customize the size of the area by selecting the ROI Width and Height arrows on the
slider controls, displayed in centimeters.

Other
Audio Volume slider controlCustomize the volume of the sound by selecting the
arrows on the slider controls. You can determine the volume by listening to the sound of
the chime as you move the control.
Blue Tint slider controlUse the slider control to set the amount of blue tint to add to
images displayed on the CR, DR, or ROP.
Keyboard Clicks check boxAllows an audible click when a virtual keyboard is
selected. The level of sound is determined by the default setting in Audio Volume.

How to Configure Fit to Screen or Fit to BSM Display


The Key Operator can configure the system to display images in the Fit to Screen or Fit to
BSM configuration by default, so that the image displayed in the Image Viewer always
appears in the selected configuration. The user can override this configuration if desired,
because the Fit to Screen, Fit to BSM, and Full Screen buttons are always available on
the Image Viewer screen and may be selected at any time.
1. Navigate to Key Operator Functions > System Configuration > Display
Configuration.
2. Select the Image Viewer tab.
3. In the Default Zoom Mode section, select the Fit to Screen or Fit to BSM option
button.
4. Select Save Changes.

Companion Images
A Companion Image is an image that is optimized for certain conditions, such as the Tube
and Picc Line procedure, Pneumothorax, Bone Suppression, or High Detail Visualization
(HDV). A small image appears in the lower-right corner of the thumbnail image on the
Patient Input or Image Acquisition screen. This picture within a picture lets the user
know that a Companion Image is available that is linked to the standard image for that
View. The Companion Image displays processing that is optimized for that condition.
Companion Images are primarily created for chest and abdomen Views.
The Companion Image can only be sent to PACS or printers with a standard image. A
Companion Image can be deleted alone, but if the standard image is deleted, both
images are deleted. Electronic markers and annotations are replicated on the standard
image. Both the standard and companion images are viewable in the PACS, and no
additional workstation is needed for use.

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Display Configuration Screen

When a system is configured to create a Companion View, the user can create one as
needed from the Image Viewer by choosing the correct icon. All of the companion
image icons that were linked by the Key Operator will display.
Standard image
Tube and Picc image
Pneumothorax image
Bone Suppression image
High Detail Visualization image (HDV)
While a Companion View is being generated, a pop-up message Creating... indicates
that the image is processing, and the Image Viewer screen is grayed out.
Once a Companion View is created, the thumbnails displayed on the Image Acquisition
screen will reflect the original image and whichever Companion Views have been
created.

How to Configure the System to Display Companion Images

To configure the system to display Companion Images:


1. Make sure that the Companion View option is enabled.
2. Navigate to the Key Operator Functions > System Configuration > Display
Configuration > Image Viewer tab.
Select Automatically create all companion Views on image acquisition
radio button, which creates a Companion Image every time the View is acquired.
Select Create Companion Views when requested by the Technologist on the
Image Viewer screen.
3. Select Save Changes.

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Display Configuration Screen

4. Navigate to the Key Operator Functions > System Configuration > View
Configuration screen.
5. Select the Raw, Linked Views, Skin Line Detection, Surround Mask, Surround
Mask Enlargement option buttons.
This icon will appear in the Linked Views column on the View Configuration screen
when the Linked Views option button is selected. The user will only see the

Companion Views that are related to the selected View. For example, if the
pneumothorax Companion View is selected for chests, abdomen Views will not
appear.
6. Select the Views for which you would like a particular Companion Image to be linked.
7. Select View Configuration Details from the bottom of the screen.
8. On the View Configuration Details screen, select the Linked Views tab.
9. Select the companion View that you would like to link to from the displayed buttons.
Tube and Picc Line

Pneumothorax

Bone Suppression

High Detail Visualization

None
A list of Views for the selected Companion Image appears at the bottom of the
screen. These Views have been optimized as Companion Images.
10. Select the specific anatomic View for each companion image from the tabbed menu
at the bottom of the screen.
Only chest Views are displayed for chests, and only abdomen Views are displayed for
abdomens.

When the View is selected by the Technologist at acquisition, the companion View will
automatically be created or available for the user to create as needed.

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Display Configuration Screen

How to Create a Companion Image Automatically

The Key Operator configures the system to display Companion Images for
Pneumothorax, Tube and Picc Line, and High Density Visualization Views.
1. Navigate to Key Operator Functions > System Configuration > Display
Configuration > Image Viewer tab.
2. Select from the following:
Automatically create all companion views on image acquisition
Create companion views when requested by the Tech on the Image
Viewer
You can choose to have the Companion Image automatically display after the image
is acquired, or create it manually by selecting the button from the Image Viewer
screen.

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Image Processing Preference Editor

Image Processing Preference Editor


Button Description

Select New View Lets you select a Primary Category, Secondary Category, or an individ-
ual View. When you select an entire Category, the changes you make
affect every View in that category.

Change Look Displays pre-configured examples of Brightness, Latitude, Detail Con-


trast, Sharpness, and Noise to choose from to start building the look
you want.

Deliver Select a workstation or printer to send the image to.

View Before & After Displays the image before adjustment and after.

Zoom Use Zoom to evaluate images. To return to normal view, select Zoom
to clear the check box.When the image is in Zoom mode, you can
change the viewing area by panning or changing the view by selecting
the image area by selecting a point on the image and dragging across
the image area. If you change image processing characteristics save
your changes.

Region of Interest Lets you determine the Exposure Index of any point on the image. The
mean, max, min, and standard deviation of the exposure for the
selected location is displayed in a rectangle around the selected Region
of Interest.

Free Form Text The Free Form Text annotation field brings up a keyboard so that you
can easily identify changes to images on PACS.

Save Changes Completes the action by writing to the local database.

Main Menu Exits the current screen and returns to the Main Menu.

Back/Cancel The Cancel button returns you to the previous function without
changing to another screen.The Cancel button toggles to the Back
button after you have selected Save Changes.

Image Processing Preference Configuration


Prerequisites:
Read this before you make a change in the Preference Editor.

The Image Processing Preference Editor provides controls so that you can change the
look of images from the Primary Category (all images in an anatomical region) to a
Secondary Category (all body parts of that type) or from an individual View. The Image

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Image Processing Preference Editor

Processing Preference Editor lets you determine the Look of the images based on your
preference.
1. Go to Key Operator Functions > System Configuration > Image Processing
Preferences.
2. To use the Editor, click the Select New View button and select a Primary Category.
3. Select a Secondary Category.
4. Select a View.
If you select Close after selecting a Primary or Secondary Category, your changes will
apply to all of the Views in that category.
5. Select Change Look.
Select one of the pre-configured looks first to approximate the desired Look.
6. Adjust the individual slider controls to fine-tune the desired effect.
7. Select View Before and After to compare your changes.
8. Select View After Only to see your selection.
9. Select Deliver to send the image to a destination for evaluation.
10. Select Save Changes.
There is no confirmation on the status of the delivered image.

Considerations Before Changing Preferences


Before making a change in the Preference Editor, check the following:
Is the issue seen at the Capture Device monitor and the destination (PACS /
Printer)?
NOIf the issue is seen at the PACS/Printer but not at the Console, investigate the
destination device for proper calibration and correct settings (Lookup Tables, and
so forth).
YesProceed to the next questions.
Have the following items been checked?
Check that the Radiographers have followed good radiographic practices. The factors
needed to obtain quality radiographic images are the same whether you use a
film/screen cassette or digital imaging. Check to make sure the following are being
applied:Proper beam alignmentExposure techniques

Proper Exposure Indexes
Tube-Part-Receptor alignment
Collimation
Use of grids
Patient positioning
Filtration
Is the issue related to a particular cassette ID (CR only)?

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Image Processing Preference Editor

Are there image processing errors (black/white appearance, raw image


appearance, and so forth)?
Is the correct View Name selected for the body part?
Is the X-ray equipment calibrated for the receptor?
Verify that the calibration of your printers, monitors, and workstations are correct.
Check this especially if noise is the issue See Monitor Configuration, Introduction in
Key Operator's Help.
Have you checked radiographic equipments exposure reproducibility?
Is the image consistently too light or too dark?
Before making a change, verify the consistency of the view from other patient
images. Always use at least five to six images, of different body uses for the same
View, when changing image preferences.
Have Total Quality Tool tests been performed recently?
When all of the above have been verified, proceed to the Preference Editor and make
necessary changes.

How to Make Changes to a View Name


The Radiologist may say that the Adult Chest PA Upright Views are displaying too dark,
so a change should be made in the Preference Editor.

Prerequisites:
You must be logged in as a Key Operator in order to access the Preference Editor
screen.

1. Ask the Radiologist to give you the names of patients for the View Name that needs
adjusting.
2. Go to the Image Review screen and find the image (using the search field at the top
right of the screen).
3. Enter the last name of the patient.
4. Select the Close button (to close the keyboard).
5. Select the Delivered Images button.
6. Make sure that it has been processed with the correct View Name.
To do this, checking the View Name in the Patient Information bar underneath the
image.
7. Select the Preference Editor button at the bottom of the screen.
Accessing the Preference Editor this way will only apply changes to that View Name.

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Image Processing Preference Editor

How to Make Changes to Multiple Views within the Same Category


The Radiologist may say that all of the Adult Chests images (AP, Laterals, and so forth)
are displaying too dark. You can make multiple changes in the Preference Editor.
1. Navigate to Key Operator Functions > System Configuration > Image
Processing Preferences.
2. Select the Select New View button at the bottom-left of the screen.
3. Select a region, body part, and then Close (instead of selecting a View).

Changes made will be applied to all views in Adult Chest.

Troubleshooting Image Quality


Below are some things to consider when troubleshooting an image quality concern. It is
important that all aspects of the imaging chain are considered before making image
processing changes.

Important
Never make IPL changes based on a single image. Be sure to evaluate at least 35 images of the
same body part. After making IPL changes, be sure that you reprocess at least 5 images with the
new parameters. Important to remember: First, do no harm!

Acquisition Technique Exposure


Noise
Exposure in range for the body part imaged
Use of Automatic Exposure Control (AEC)
Anatomy is centered over the Photocell
AEC is calibrated properly
Correct receptor is selected for the exposure
(table/upright, and so forth)
kV vs mAs
Verify Technique that was used
Grid vs non-grid

Factors Affecting Optimal Image Processing Correct positioning


Collimation
Body part/projection selection
Unassigned Image
Multi-exposure processing

Radiographic Equipment Reproducibility of exposures


AEC calibration
Filtration

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Image Processing Preference Editor

Grids Verify that the grid is necessary


Condition of the grid
Produces a uniform image
Grid cut off/misalignment
Aliasing artifact from stationary grid

Artifacts White noiselow exposure


Black noisecassettes being erased/rotated
Proper care and cleaning of phosphor screens

CR/DR Hardware and Software TQT performed recently


All TQT tests were passed

Image Processing Radiologist preference


Recent software upgrade
On the CR System
On the PACS
Unauthorized changes to image processing
slider controls
Correct image identification (unas-
signed/correct View)
Image processing error

Display HardcopyWet Processor or Printer


Softcopy
Monitor calibration
One monitor or all monitors
Display Protocol
PACS set up to use the Modalitys LUT or
Work List
Linearity validation with SMPTE

Miscellaneous Lead markers and masking


True Size print from CR or PACS

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Trauma Defaults

Trauma Defaults
The Key Operator can configure categories for patients who enter the Emergency Room
who do not have complete identification or analysis of their condition. These categories
are default designations, such as gender and approximate age, that will be changed later
when the information is available. The Trauma defaults are selected when the patient is
admitted.

Navigation and Function Buttons on the Trauma Defaults List

Buttons

Name Description

Change Trauma Opens the Patient Data form on the Patient Input screen. Lets you edit
Defaults the default patient data for the selected trauma button. Enter the
required data that represents this default ID.

New Tab Selects the matrix size based on the number of items you will have in
your list. Choose from 4 x 5, 5 x 5, 6 x 5, 7 x 5, and 8 x 5. You can enter
up to five tabs of data per list.

Delete Tab Deletes the tab of information from the list. You will be prompted to
confirm the deletion. There is no recovery from deleting a tab.

Show Button Displays the button in the list in the interface. Toggles to Hide Button.

Hide Button Hides the button display on the interface. Toggles to Show Button.

Save Changes Saves the change to the local database.

Main Menu Exits the current screen and returns to the system Main Menu.

Back Returns to the previous screen.

Tab Controls at bottom of screen

Name Description

Keyboard Activates the keyboard when you touch a button. The button becomes
active for editing. Type the information from the virtual keyboard.

Color Selects the colors of the buttons from over 200 individual colors. Select
the color you desire.

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Trauma Defaults

Name Description

Color Palette Selects from a full color palette of blended hues.

Move Moves the button to another position on the tab. You cannot move the
button to another tab.

How to Locate a Trauma Patient


Prerequisites:
The patient is in an emergency condition and you must enter data quickly. The Key
Operator must configure the Trauma option.

1. Select Trauma.
2. Select a Trauma ID.

Postrequisites:
If you do not see a Trauma button, consult with your Key Operator.

Note
The Trauma button does not appear unless the Key Operator has configured it. On CR Systems,
the Trauma feature is a purchasable option.

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Reject Reasons

Reject Reasons

Reject Reasons Configuration


The Key Operator can build a list of up to ten reject reasons which a radiographer can
choose from when rejecting an image, if the Reject Reasons option is purchased and
enabled. You can create up to nine default reasons; the tenth reason is listed as Other
Reason, and provides a blank field for the radiographer to enter text. The Other Reason
field can be renamed, but not deleted.
The following default reasons may be used or deleted:
Clipped Anatomy
Motion
Positioning Error
Artifact
Technique
Duplicate
Test/Service/Blank
If the Track Rejects button is not selected, no prompt for the reject reason is provided.
Select the Track Rejects check box to enable the Radiographer to select a reject reason.

Note
If the Reject Reasons option is not purchased, the Radiographer will simply select Accept or
Reject without providing a reason.

How to Add a Reject Reason


Go to Key Operator Functions > System Configuration > Reject Reason
Configuration.
1. Select Add Reject Reason.
2. Type the Reject Reason.
3. Select Enter.
4. Select Save Changes.

How to Delete a Reject Reason


1. Go to Key Operator Functions > System Configuration > Reject Reason
Configuration.
2. Select the reject reason.
3. Select Delete Reject Reason.

AC1456 | 2015-03-16 175


Reject Reasons

How to Reject an Image


The Technologist can reject an image based on the quality of the image. When the
Administrative Analysis Reporting Software option is purchased and enabled, each time
an image is rejected, a reason must be selected. This reason is recorded and becomes a
record in Technologist Statistics. The image is evaluated at the Image Viewer screen.
The Key Operator can edit the default list.
An image may be rejected for the following reasons:
Clipped Anatomy
Motion
Positioning Error
Artifact
Technique
Duplicate
Test/Service/Blank
Once the image is evaluated, and you decide it should be rejected, do the following:
1. Select Reject.
2. Choose a reject reason.
3. Select Reject.

The rejected image then appears on the Rejected Image List screen. It may be accessed
by the Key Operator. The Key Operator may configure the system so that the
Technologist can access the screen as well, for further evaluation at another time.

Note
If the Administrative Analysis Reporting Software is not used, the Technologist will answer Yes or
No to a pop-up asking if the image should be rejected, without being prompted for a reason.

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Destination Profile Configuration

Destination Profile Configuration


A Destination Profile is the set of destinations where images are sent. In the CR and DR
System, Image Routing is controlled by profiles.
A Destination Profile has three components:
Name The name or description of the profile.

Criteria Cassette Size, Category (body part, projection), Department, Physi-


cian, Name, or Machine Name.

Destinations Where the data is sent when the criteria matches.

The Criteria fields are prioritized by the order they are listed on the Profile
Configuration screen. You can change the order using the second set of Up and Down
arrows. Default must always be last.
Category
Department Filter
Physician Name
Cassette Size
Machine Name
Output (for Multi-Format Printing)

How Destination Profiles are Assigned to Images


When an exam is routed, the information contained in the Patient Record is compared
to the information contained in the criteria fields of all defined profiles, similar to
performing a query. If the image matches more than one profile, the system assigns the
first profile in the list that matches all criteria to that image.
Profiles can be assigned from Procedure Mapping or manually on the Patient Input
screen or the Image Acquisition screen and Select Destination screen.

Destination Profile Screen

What is a Destination Profile?


A Destination Profile identifies a specific printer, workstation, archive, or other
destination where images are sent. Key Operators create profiles to automate the
process of sending an image to the correct destination.
In the CR and DR Systems, Image Routing is controlled by profiles. A Destination Profile
has three components:
1. NameThe name or description of the profile.
2. FiltersCassette Size, Category (body part, projection), Department, Physician,
Name, Machine Name, and Output (for multi-format prints).
3. DestinationsWhere the data is sent when the criteria matches.

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Destination Profile Configuration

The Filter fields are prioritized by the order they are listed on the Profile Configuration
Screen. You can change the order by using the second set of Up and Down arrows.
Default must be last.
When an exam is routed, the information contained in the patient record is compared to
the information contained in the criteria Filters field of all defined profiles, similar to
performing a query. If the image matches more than one profile, the system assigns the
first profile in the list that matches all criteria to that image.
Profiles can be assigned from Procedure Mapping or manually on the Patient Input
screen, Image Acquisition screen, and Select Destination screen.

What is the Default Profile?


A default profile is defined automatically by the system. It appears in the list of profile
destinations with an (*) asterisk next to the name. You can rename the default profile,
but you cannot change the criteria or delete it.There must be only one default profile. If
the data does not match the criteria for any of the existing profiles, the system uses the
default profile destination.

Why the Default Destination Cannot Be Deleted


You can rename the default profile, but you cannot delete it or edit the filters for it. The
default profile is set by the system and is used to send images to destinations when all
other criteria fail.

Note
There must always be one default profile.

How to Add a New Destination Profile


Go to Key Operator Functions > System Configuration > Destination Profile
Configuration.
1. Select Add.
2. Enter the name of the profile
3. Select the color that will identify this profile.
4. Select the filter (or filters) that will identify this profile. All profiles, except default,
require a filter.
5. Select the destinations (printers and workstations) to send images to automatically.
6. Select the Mandatory check box if desired. (Mandatory destinations are often
archives.)
Mandatory destinations are those that every image must be delivered to.

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Destination Profile Configuration

How Destination Profiles are Assigned to Images


When a study is routed, the information contained in the Patient Record is compared
to the information contained in the criteria fields of all defined profiles, similar to
performing a query. If the image matches more than one profile, the system assigns the
first profile in the list that matches all criteria to that image.
Profiles can be assigned from Procedure Mapping or manually on the Patient Input
screen or the Image Acquisition screen and Select Destination screen.

How to Edit a Destination Profile


Go to Key Operator Functions > System Configuration > Destination Profile
Configuration
1. Go to Key Operator Functions > System Configuration > Destination Profile
Configuration.
2. Select Turn Edit On.
3. Touch the profile name. Enter the name of the profile.
4. Touch the color field and select the color that will identify this profile.
5. Select the filter (or filters) that will identify this profile. Touch clear to clear all filters
for that profile. All profiles, except default, require a filter.
6. Select the destinations (printers and workstations) to send images to automatically.
7. Select the Mandatory check box if the image must reach that destination in order
for the exam to be considered complete. (Mandatory destinations are often archives.)

Note
To prevent Trauma exams from being delivered to Mandatory Destinations, make sure you
leave one of the Required for Delivery fields blank.

AC1456 | 2015-03-16 179


Text Box Editor Screen

Text Box Editor Screen


At the top of each Text Box Editor screen is a template for the text box that you select.
The data fields are represented by question marks: ?????????????
The maximum width and height of the text box are listed in the background next to the
sample box.

Add a Row
If you have the maximum number of rows, the Add Row buttons will not be active.
Delete an unnecessary field to add a row, or select a different text box.

Reset the Text Box


Select Restore Small Default or Restore Large Default to return the text box to the
minimum or maximum configuration.
For Multi-Format Image Internal and Page External Text Box editors, select Restore
Factory Default.

How to Add a Field in a Configurable Text Box


1. Navigate to Key Operator Functions > System Configuration > Configurable
Text Boxes.
2. Select a field to use as a reference point.
The question marks (???????????) should be highlighted.
3. Select New Field Before or New Field After.
A field of one character appears before or after your selection.
4. Select the Field Length box.
5. Enter the desired length of the field from the keyboard.
A multi-format image Internal text box can be up to 160 mm wide.
A multi-format image External text box can be up to 120 characters wide and is
limited to two lines.
6. Select the DICOM Field box.
Use the arrow keys to see all of the fields, or check the Show most common DICOM
fields only check box to narrow the search.
7. Select a DICOM Field Name.
8. Select Assign Field.
9. Select the Text Field Label box.
10. Assign a label that comes before the DICOM value.

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Text Box Editor Screen

How to Edit a Field in a Configurable Text Box


1. Navigate to Key Operator Functions > System Configuration > Configurable
Text Boxes.
2. Select the field you would like to change.
The question marks (???????????) should be highlighted.
Or, select Move Next or Move Prior.
3. To add a row above or below a selected field, click New Row Above or New Row
Below. These fields are not available in single image Internal or multi-format
External text boxes.
If you have the maximum number of rows, the Add Row buttons will not be active.
Delete an unnecessary field to add a row, or select a different text box.
4. Select the DICOM Field box.
Use the arrow keys to see all of the fields, or check the Show most common DICOM
fields only check box to narrow the search.
5. Assign a label that comes before the DICOM value.
6. Select Assign Field.
The new DICOM name and tag are added for you.

Note
If a field is optional and it does not have a value, then the field is removed from the text box. If
all of the fields on a line are optional and blank, then the text box will get shorter. This is useful
if you want to include a field such as Image Comments in the text box when it has a value, but
you do not want to make the text box unnecessarily large; for example, for the time when there
are no comments.

How to Select a Configurable Text Box


There are two main types of configurable text boxes. The Internal Text Box presents
the information within the image. The External Text Box presents the information
outside of the image area.
Multi-Format prints can also include Internal and External Text Boxes.

Note
Text boxes appear on the print only. They do not appear when the image is viewed on a
workstation.
To select the appropriate Text Box, consider the type of image area that is displayed. You
can make the selection or the Key Operator can select a default Text Box for any given
View. The Key Operator can configure a text box to automatically fill in with data, such
as Hospital Name, Exposure Index, or View.
Select the Internal Text Box when you want the information to appear within the image
and when you must be able to print to any printer. The Text Box can be moved to any
corner or any inside edge to avoid covering any anatomy.

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Text Box Editor Screen

Select the External Text Box when you want to position the label outside the image area;
therefore, it never interferes with anatomy. However, the box takes up space on the film,
and the system crops additional image data compared with printing without an External
Text Box. Thus, an External Text Box affects True-Size printing.
The Single Image External text box can be up to 120 characters wide.
At the top of each Text Box Editor screen is a template for the text box that you select.
The data fields are represented by question marks: ?????????????
The maximum width and height of the text box are listed in the background next to the
sample box.

Configure a Multi-Format Image Internal Text Box


The Multi-Format Image Internal Text Box appears inside each image area on a
Multi-Format print. This text box should be selected when you want to label each
individual image and /or want to create True-Size prints.
The text box can hold up to 160 mm wide. Its content depends on length of data fields
and the size of the font selected.
The Multi-Format Image Internal Text Box appears inside each image area on a
multi-format print.

Print it on any printer that supports multi-format printing.


Select this text box when you want to label each individual image and/or want to print
True-size.

Configure a Multi-Format Image Exterior Text Box


The text box can hold up to 120 characters and is limited to one line.
Use this text box when you want the information to fall outside a multi-format image.
Text boxes appear on the print only. They do not appear when the image is viewed on a
workstation

182 AC1456 | 2015-03-16


How to Format a Multi-Format Page Footer

How to Format a Multi-Format Page Footer


Prerequisites:
If you want to add a graphic or logo to the page footer, place the graphic or logo file in
the root directory.

On the Multi-Format Configuration screen, a user can select the Include Page Footer
check box to add a footer across the bottom of the page of any print that is selected for
destinations. The Key Operator can configure the Page Footer using these steps.
1. Go to Key Operator Functions > System Configuration >
Configurable Text Boxes > Multi-Format Page Footer > Page Footer Layout.
2. Footer Fields - Select up to 12 data fields, displayed in 3 columns of 4 rows each.
3. To edit a field, you can do either of the following:
Select the DICOM Fields tab to choose from a list of DICOM fields. Select a field
from one of the three regions in the layout, select a DICOM field, and then select
Assign Field.
Click any footer field and enter free form text from the virtual keyboard
4. Font and Font Size - Select the text box and choose the font and size from the
pop-up menus.
5. To position a field in the Left, Center, or Right column, select the field and in
Selected Region Alignment select a position.
6. To add a graphic or logo to the footer, in Logo/Graphic select the square to display
the root directory from which to select a file. Locate the file and click Select.
7. Click Footer Preview to see the fields and graphics as they will appear in the footer.

AC1456 | 2015-03-16 183


How to Format a Single Image Page Footer

How to Format a Single Image Page Footer


Prerequisites:
If you want to add a graphic or logo to the page footer, place the graphic or logo file in
the root directory.

On the Multi-Format Configuration screen, a user can select the Include Page Footer
check box to add a footer across the bottom of the page of any print that is selected for
destinations. The Key Operator can configure the Page Footer using these steps.
1. Go to Key Operator Functions > System Configuration > Configurable Text
Boxes > Single Image Page Footer.
2. Footer Fields - Select up to 12 data fields, displayed in 3 columns of 4 rows each.
3. To edit a field, you can do either of the following:
Select the DICOM Fields tab to choose from a list of DICOM fields. Select a field
from one of the three regions in the layout, select a DICOM field, and then select
Assign Field.
Click any footer field and enter free form text from the virtual keyboard
4. Font and Font Size - Select the text box and choose the font and size from the
pop-up menus.
5. To position a field in the Left, Center, or Right column, select the field and in
Selected Region Alignment select a position.
6. To add a graphic or logo to the footer, in Logo/Graphic select the square to display
the root directory from which to select a file. Locate the file and click Select.
7. Click Footer Preview to see the fields and graphics as they will appear in the footer.

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Delivery Preferences Configuration

Delivery Preferences Configuration


Delivery Preferences lets you configure the default settings for the following information
delivery selections.
Field Description

Hospital Name The hospital name that you want to associate with the images.

Hospital Address The address of the hospital that you want to associate with the
images.

Operating Mode The default operating mode:


QA Mode
Auto Display
Pass-Through Mode
QA by Study (DR)

Pixel Spacing The pixel spacing for workstations that require the (0018, 1164)
Imager Pixel Spacing or require the (0018, 1164) Pixel Spacing
fields.

Relative X-ray Exposure The Carestream Health Exposure Index or the IEC Exposure Index.
DICOM Tag ID (0018,
1405)

Delivery Tab Options Use uppercase for all DICOM fields on delivery.
Send all images in L/F orientation. This means the workstation
will not rotate the image when it is received. Sends patient
orientation tag (0020:0020).
Remove print destinations from 1-up when creating new
Multi-Format prints.
Scale mark to storage.
Use CR IOD. It means always use the CR DICOM IOD, instead of
DX or MG IOD.
Translate Body Part and Projection.
Allow non-conforming DICOM.
Label Patient CD using LIGHTSCRIBE.
Edit the AE Title IP address and port for their DICOM destina-
tions.

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Delivery Preferences Configuration

Field Description

Image Instance Tab The general image instance number:


Every image is its own Series. Instance Number is always 1.
Every image is its own Series. Instance Number is unique.
Every image is in the same Series. Instance Number is unique.

Note
The Image Instance tab has different configurations to help with
foldering at the PACS. Consult your PACS Administrator to
determine which setting is required for your PACS system.

Patient Media Tab Include Media Viewer on CD.


Include CARESTREAM Image Suite Viewer on CD.
Acquire Solutions Review Application.
Write Patient CD immediately.
Write Dose Report to Patient Media.

Report Tab Configure a list of destinations that support structured Report


storage.

Custom Page Layouts Configure a custom Multi-Format layout from a blank page or
Tab from a copy of a layout.
Customize by cell width and cell height.
Use the arrow keys to move the cell up, down, left, or right.
Add or delete a cell from the layout.
Delete the existing layout.

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Automatic View Selection

Automatic View Selection


To configure a View based on patient size, age, weight, and/or whether a grid is present
during the exposure, navigate to Key Operator Functions > System Configuration >
Automatic View Selection.
If configured, the Patient Size field on the Patient Input screen will automatically
determine the appropriate Pediatric View for Chest and Abdomen exams. The following
is a list of Patient Size categories:
Newborn (1 day to 1 month)
Infant (Greater than 1 month to 2 years)
Child (Greater than 2 years to 11 years)
Preadolescent (Greater than 11 years to 13 years)
Adolescent (Greater than13 years to 21 years)
For Newborns, there are two additional categories, Very Low Birth Weight (1.5 kg (3.3 lb)
or less) and Low Birth Weight (between 1.5 and 2.5 kg) (0.10 and 0.15 lb)
Each of these categories have their own Views so that the image processing can be set
differently by the Key Operator. After the image has been processed, the correct View
will automatically be processed with the corresponding Patient Size category.

Note
On DRX-Revolution Mobile X-ray Systems, Automatic View Selection will also chose supine,
erect, or semi-erect based on the receptors angle.

Detector Angle Indexing


This information applies to the DRX-Revolution Mobile X-ray System only.
Navigate to Key Operator Functions > System Configuration > Automatic View
Selection > Detector Angle Indexing tab.
Detector Angle Indexing allows the Key Operator to define degree range of the angle of
the detector for the View used for an exam.

AC1456 | 2015-03-16 187


Automatic View Selection

Note
For example, if you select the blue indicator as illustrated above, and place it at 30 , Supine is
then defined as any angle from 030
You can configure the angle the detector will be when the View should be supine,
semi-erect, and erect. Select the highest limit and enter it into the appropriate text box.

How to Configure Detector Angle Indexing

Note
This information applies to the DRX-Revolution Mobile X-ray System only.

188 AC1456 | 2015-03-16


Automatic View Selection

For Views with Supine, Semi-Erect, and Erect section:


Touch and hold the round target on the pie-shaped scale and drag it to the maxim point
you want to position the detector.
For Supine and Semi-erect angles less than _degrees text boxes:
The detector angle at any degree below that is used for a Supine or Semi-erect
exam. The color of the values in the text box will match the color of the indicator.
For Views with only Supine and Erect section:
The detector angle at any degree below that point is a Supine exam, and any
point above it is an Erect exam. The color of the value in the text box will match
the color of the indicator.

Note
You can also enter the value in the text box using the virtual keyboard.

How to Configure Patient Size Indexing for Pediatric View Selection


DIRECTVIEW System Software offers a wide range of Views to select for pediatric
patients.
1. Navigate to Key Operator Functions > System Configuration > Automatic
View Selection > Patient Size Indexing tab.
2. If you want the system to Automatically determine Patient Size based on the
age and weight of the patient, select this check box. The patients date of birth
determines the patient size.
If you want the system to Automatically change the View based on the Patient
Size, select this check box.
3. Select the Active check box to select the category you want to make available.
The categories and the default maximum values for each category are displayed:
Very Low Birth Weight
Low Birth Weight
Newborn
Infant
Child
Preadolescent
Adolescent
4. Optionally, you can edit the maximum value for each category and set new defaults
for your system.
a. Select the displayed maximum value.
b. Enter a new value using the virtual keyboard.
5. Select Save Changes.

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Automatic View Selection

Grid Indexing
Navigate to Key Operator Functions > System Configuration > Automatic View
Selection > Grid Indexing tab.
Select the Automatically change View based on the presence of a grid check box
if Grid Indexing is desired.
The image processing for Views that are used with a grid can vary widely. Grid
Indexing optimizes the image processing for Views that use a grid. The Key Operator
can activate the Grid Indexing option by checking the Grid Indexing check box.
Grid Indexing software automatically detects the presence of the CARESTREAM Grid
Alignment electronic grid or a stationary grid. After the image has been processed,
the View will automatically be processed with the correct View (non-grid or grid). It
will change the View name on the thumbnail on the Image Acquisition screen to a
Grid view.
If the Grid Alignment electronic grid is not detected, the image is processed with the
non-grid Views.

Note
This information applies to the DRX-Revolution Mobile X-ray System only.
On the DRX-Revolution system, if the Grid Alignment electronic grid is connected to the
detector, the system selects a Grid View automatically.
If the user is using a non-electronic grid, they can select the Grid check box on the Image
Acquisition screen, and that will be processed as a Grid View. Selecting this check box
changes the exposure techniques for the View before image acquisition
If the Grid check box is not selected, the system will still detect the grid and change to a Grid
View when processing after the acquisition process.
The Key Operator can disable the Tube and Grid Alignment software by clearing the Grid
Indexing check box.
The Key Operator can delete or copy Views on the View Configuration screen without
affecting the optimized grid Views. See View Configuration.

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How to Configure the Network

How to Configure the Network


Prerequisites:
To configure the System to communicate with a hospital network, write down the
information requested from this page. Contact your hospital IT staff for the information.

Navigate to Key Operator Functions > System Configuration > Network


Configuration.
PC Info tab
1. Enter the Computer Name.
If you do not know the name, touch the orange C icon in the left corner of the
title bar on the screen. A pop-up window will display all of the computer
identification information.
2. Enter a Network Speed / Duplex. Auto Detect is the default.
3. Firewall enabled. Recommended, checked by default.
4. Obtain an IP address automatically. If selected, the system will search for an IP
address set by Service.
5. Use the following IP address_______________________________
6. Local IP Address____________________________________________
7. Subnet Mask________________________________________________
8. Default Gateway____________________________________________
9. Obtain DNS Server automatically___________________________
10. Use the following IP address________________________________
11. Preferred DNS server________________________________________
12. Alternate DNS server________________________________________
13. Wireless Configuration______________________________________
14. Firewall Settings_____________________________________________

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How to Configure the Network

15. Save Changes.


IPv4 tab
Obtain an IPv4 address automatically.
Use the following IPv4 address:
Local IP Address ___________________________
Subnet Mask_______________________________
Default Gateway___________________________
Obtain DNS server address automatically.
Use the following DNS server address:
Preferred DNS server________________________
Alternate DNS server________________________
IPv6 Configuration tab
Prevent IPv6 connections
Allow IPv6 connections using the address below
Local IPv6 Address_______________________________

IPv6 Configuration
Internet Protocol version 6 (IPv6) is the latest revision of the Internet Protocol (IP), the
communications protocol that provides an identification and location system for
computers on networks and routes traffic across the Internet. IPv6 was developed by the
Internet Engineering Task Force (IETF) to deal with the long-anticipated problem of IPv4
address exhaustion.
IPv6 adds the option of a new network protocol that allows more flexibility when
configuring the network. If the hospital determines that there is a need for more IP
addresses than are currently available, the option will be enabled and the hospital will
provide the additional address.

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Destination Configuration Overview

Destination Configuration Overview


The Key Operator can configure destinations and view the status of destinations on the
Destination Configuration screen.

Configure Destinations
Destinations can be changed, copied, or deleted on this screen.
The Key Operator can edit the IP address and AE Title fields by clicking in the column and
entering the change.

View the Status of Destinations


This screen serves as a quick reference to see if network paths are clear to PACS, monitors,
printers, workstations, archives, and so forth.
Select DICOM Echo Devices to ping device response and update the status.
Green buttons appear after the DICOM echo, and indicate that the device is online. A red
button indicates that the communication is broken.
USB Delivery Destination is pre-configured.

AC1456 | 2015-03-16 193


RIS/PACS Web Page

RIS/PACS Web Page


From this screen you can access up to six Web URL addresses that are inside or outside the
facilitys network. To access this screen, select Quick Menu in the lower left corner of the
screen. If enabled, the name given to the Web address appears in the Display Name text
box.
The Key Operator configures the URL addresses.

194 AC1456 | 2015-03-16


Recall Prior Image Configuration

Recall Prior Image Configuration


The Recall Prior Image feature lets you import and view previous images and
information from the patients previous exam, including positioning, technical
information such as the technique used, and patient specific anatomy characteristics. This
enables you to quickly retrieve and copy or change the present exam using the previous
exam as a reference.
You can configure one of three retrieval methods:
1. Manually retrieve prior images.
2. Automatically retrieve prior images when the study is opened.
3. Automatically retrieve prior images when the study is added to the Work List or when
a View is created.
The Key Operator can specify multiple alternative names for each body part for other
manufacturer's systems, which may use non-standard DICOM values.
When the Prior Image Retrieval feature is enabled, a new icon is added to the tutor
image, indicating the presence and number of prior images retrieved. Note that if you
are in Manual retrieval mode, this icon may simply indicate that you can click on it to
request priors.
The following configuration tabs are available:
Options tab
Search tab
PACS tab

Priors Image Configuration


The Recall Prior Image feature lets you import and view images and information from
the patients last exam, including positioning, technical information such as the
technique used, and patient specific anatomy characteristics. This enables you to quickly
retrieve and copy or change the present exam using the previous exam as a reference.
You can configure one of three retrieval methods:
1. Manually retrieve prior images
2. Automatically retrieve prior images when the study is opened
3. Automatically retrieve prior images when the study is added to the Work List or when
a View is created
The Key Operator can specify multiple alternative names for each body part for other
manufacturer's systems, which may use non-standard DICOM values.
When the Prior Image Retrieval feature is enabled, a new icon is added to the tutor
image, indicating the presence of priors and the number of priors retrieved. Note that if
you are in Manual retrieval mode, this icon may simply indicate that you can click on it
to request priors.
The following configuration tabs are available:
Options Tab

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Recall Prior Image Configuration

Search Tab
PACS Tab

Prior Image Configuration - Options Tab

1. Navigate to Key Operator Functions > System Configuration > Prior Images
Configuration.
2. To enable or disable the Prior Images feature, check or clear the Enable retrieval of
prior images check box.
3. Select a radio button to set the retrieval method from the following choices:
Manually retrieve prior images
In manual retrieval mode, the Prior Images icon is always displayed on the View
thumbnails for the indicated body parts. The user must select the Prior Images
icon to initiate the retrieval for the prior images for that body part.
Automatically retrieve prior images when the study is opened
When this button is selected, the software searches for the prior images when an
exam is selected from the Modality Work List.
Automatically retrieve when the study is added to the Work List or a
View is created
If additional criteria are needed to further restrict the images for which priors are
retrieved, check the Retrieve priors for Work List items matching the
following criteria option button and enter the Modality Work List Field value
and criteria.
When Modality Work List matching is used, it means that priors will be
automatically retrieved for the indicated body parts for which the Work List data
matches. For indicated body parts in which the Work List data does not match, you
will still be able to retrieve priors, but you must do this manually.
4. If you select the third option in step 2, a check box is enabledRetrieve priors for
Work List items matching the following criteria. Continue with steps 45;
otherwise, you are done.
5. Select a radio button to set the type of matching that should occur from the following
choices:
Exact match only
Any item starting with the text
Any item containing the text
6. From the list box on the left, select the body parts for which prior images should be
retrieved.
To add a body part, click Add and select a body part from the keyboard.
To remove a body part, select the body part and then click Remove.
To specify alternative names for each body part, use the virtual keyboard to enter
another name in the list box on the right and select Add or Remove. Multiple
alternate names can be used for the same body part.

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Recall Prior Image Configuration

Prior Image Configuration - Search Tab

This section allows the user to configure the search criteria for prior image retrieval.

Navigate to Key Operator Functions > System Configuration > Prior Image
Configuration > Search tab.
The search for prior images must meet certain criteria. For example, the system will
search for the number of images within a period of time that the Key Operator has
configured as a default, such as two images processed in the past two weeks. Prior image
Views may be configured for certain body parts only. The search for Priors can be
narrowed by Department name or Modality type.

Provide the following information:


Field Description

Search Interval Sets the number of weeks or days in history to search for prior
images. The default value is 2, entered numerically.

Units Sets the search interval to either days or weeks. The default
value is weeks.

Maximum Images to be Indicates the number of images to be retrieved from the


Retrieved PACS. The default value is 2, entered numerically.

Date of birth must match If checked, the patients date of birth must match the patient
records from the PACS.The Patient ID and Patient Last Name
are always used for retrieving priors. When the date of birth
must match check box is selected, then the date of birth must
also match. By default, the check box is not checked.

Retrieve prior images from Specifies which modality records to retrieve from the PACS. By
exams performed on the fol- default, CR, DX, and PR are checked. PR indicates Grayscale
lowing modalities Presentation State.

Priors Image Configuration - PACS Tab

This section allows the user to configure the PACS from which Priors Images will be
retrieved.

Navigate to Key Operator Functions > System Configuration > Prior Image
Configuration > PACS tab.
Provide the following information:

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Recall Prior Image Configuration

Field Description

AE Title Enter the AE Title of the PACS from which to retrieve prior images.

IP Address Enter the IP Address of the PACS from which to retrieve prior images.

PACS Port Enter the port of the PACS from which to retrieve prior images. The
default value is 2104, entered numerically.

Local AE Title Select an AE Title for the PACS to identify the Console. It must be differ-
ent from the Computer name or there will be conflicts with Storage Com-
mitment. This value is also used to configure the Console at the PACS,
since the Console will now be acting as a storage device for prior images.

Local Port The default value is 5041 and should not need to be changed. This value
is also used to configure the Console at the PACS, since the Console will
now be acting as a storage device for prior images.

How to Clear the Prior Image Queue

1. Go to Utilities > System Status > Priors.


2. Select Clear Requests.

Prior Image Retrieval

When the Prior Image Retrieval feature is enabled, a new icon is added to the tutor
image. The icon displays one of the following conditions:

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Recall Prior Image Configuration

Icon Name Description

SearchingNo pri- This display indicates that the system is actively searching for prior
ors retrieved images, but none have been found yet. The icon is disabled and
the animated cursor indicates that the search is in progress. The
icon does not indicate the presence of priors.

RetrievingAt This display indicates the number of prior images that have been
least one prior retrieved. Clicking on this icon opens the Prior Images screen. If
retrieved additional images are actively being retrieved, the icon as well as
the Prior Images screen will be updated to reflect the additional
images as they are retrieved into the system.

Enabledfor Man- This display indicates that you can manually request to retrieve
ual mode priors for this image, even if the system is in another retrieval
mode.

Systems and Images Compatible with the Prior Image Retrieval Feature

The following systems can be used with Prior Images:


CARESTREAM PACS systems
GE Centricity V3.0 systems
AGFA IMPAX V6.5 systems
PHILIPS iSite V4.1 systems
MCKESSON Horizon Medical Imaging
The following types of images can be retrieved with Prior Images:
DX and CR IOD radiographic images
MG IOD radiographic images
Grayscale Presentation Information can also be retrieved

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HIS/RIS Configuration

HIS/RIS Configuration
The Modalities use DICOM Work List Management to receive study information from
the hospitals HIS/RIS.
The Remote Query, Polling Query, and Optionstabs let you set up your System to
communicate with the HIS/RIS in any combination of the options presented in these tabs.
Using Remote Query, the system sends an immediate request for records to the
hospitals HIS/RIS system, queried from the Work List screen.
Using Polling Query, the System requests records at a defined time interval. A polling
query allows the System to communicate with the Radiology Information System (RIS) to
display the Patient Work List. You can also query the RIS for individual patients.
With either polling choice, there are additional configuration options for the PACS
broker and for Procedure Mapping.

Configure Polling HIS/RIS Query


Go to Key Operator Functions > System Configuration > HIS/RIS Configuration >
HIS/RIS Polling and Remote Query.
1. Select Poll Active to activate Polling Configuration.
2. Select a Modality: CR, DX, RT, or All.
3. Select either Filter by Station Name or Filter by AE Title to filter the information.
Only records that contain matching data in these fields appear.
4. Enter your Station Name(s) or AE Title. The system requests records at a defined
interval, filtered by modality, Station Name, AE Title, and date and time.
5. Select a Polling Interval to the PACS Broker:
Hours Before Current Time
Hours After Current Time
Minutes Between Search Updates
The Initial search time default is 12 hours from the current time, range 148 hours.
Only records that have a date and time that falls in this range appear. Carestream
Health recommends approximately 100 records per poll.

Postrequisites:
Review additional configuration choices in Configure Remote HIS/RIS Query and
Configure HIS/RIS Query Options.

HIS/RIS Remote Query


Go to Key Operator Functions > System Configuration > HIS/RIS Configuration >
HIS/RIS Polling and Remote Query.
The DIRECTVIEW CR and DR Systems utilize DICOM Work List Management to receive
study information from the hospital HIS/RIS.

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HIS/RIS Configuration

The Remote Query, Polling, and Options tabs let you set up your system to
communicate with the HIS/RIS in any combination of the tables in the following links:
Remote Query Active Select to permit a Query of the HIS/RIS from
the CR or DR System.

Modality Select the modality: CR, DX, RT, All

Filter by Station Name Select either Station Name or AE Title to filter


the information. Only records that contain
matching data in these fields appear.

Filter by AE Title Select either Station Name or AE Title to filter


the information. Only records that contain
matching data in these fields appear.

Station Name/AE Title Enter your station names or AE Title.The sys-


tem retrieves records that contain only the
names specified.

Configure HIS/RIS Query Options


1. Navigate to Key Operator Functions > System Configuration > HIS/RIS Broker
Configuration > HIS/RIS Options.
2. In the PACS Common Configuration section, complete the following fields:
a. HIS/RIS AE Titleenter the Broker Name, usually BROKER
b. HIS/RIS IP Addressenter the PACS Broker IP Address
c. HIS/RIS Portenter the PACS Broker Port, usually 3320
3. Select Save Changes.
4. In the Other HIS/RIS Options section:
a. Select the check box to automatically delete canceled studies from the system
when the status is Canceled at the HIS/RIS. Clear the check box if you do not want
this.
b. Select the check box to send the Scheduled Workflow MPPS Command. Clear
the check box if you do not have this optional feature.

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HIS/RIS Configuration

5. In the HIS/RIS Procedure Mapping section, select the DICOM field your RIS uses to
send the Procedure Code.
Requested Procedure
DICOM Field Name DICOM Tag Code Sequence

Procedure ID (0040, 1001) NA

Procedure Code (0032, 1064) (0008, 0100)

Scheduled Procedure Step Sequence (0040, 0100) (0008, 0100)

Performed Protocol Code Sequence* (0040, 0008)

*If you enable your system for Scheduled Workflow, Performed Protocol Code is
selected automatically, and is not configurable.

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How to Use the Bar Code Configuration Screen

How to Use the Bar Code Configuration Screen


These are the general steps used to configure bar codes. For specific examples, see Bar
Code Configuration Examples.

Go to Key Operator Functions > System Configuration > Bar Code Configuration
1. Enter the Prefix, Data Size, and Suffix information for the data that you wish to
configure.
Leave the Data Size field blank if you want to accept any size data.
2. Select Save Changes.
3. At the Bar Code Configuration Menu, select Bar Code Programming.
4. Select the feature that you wish to program or a category of information for which
bar codes are displayed.
5. Scan the sample bar code for that feature with the hand-held bar code reader.

Bar Code Configuration Examples


You can configure the bar code to get the result you desire. The selections you make on
the Bar Code Configuration screen add or subtract information that is read from the bar
code for the following fields: Accession Number, Patient ID, Procedure Code, Cassette ID,
and Tech ID.
The default bar code that a medical facility uses may not automatically place the patient
data in the correct fields. You can use the Bar Code Configuration screen to change the
way the bar code reader identifies the Accession Number, Patient ID, and Tech ID.

Example 1
For example, if the Patient ID bar code is a series of characters such as Pid00001-XX and
you need to change it to 01, the following three options are available to you on the
screen:
Data
Field Strip Size Strip Prefix Size Strip Suffix Strip Size

Patient ID X 3 X 000 2 X - X 2

Patient ID X 6 2 X 3

Patient ID X Pid000 2 X -XX

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How to Use the Bar Code Configuration Screen

Example 2
The following example of a 128 bar code indicates a Prefix of -+@# and a data set of
1234567801234.

By configuring the bar code, you can output only the data portion of the code,
1234567801234.

Additional Notes
When you designate Strip, the removal is performed from left to right on the Bar Code
Configuration screen.
The same configuration rules apply for the Accession Number, Procedure Code, and Tech
ID fields.
If the fields contain the same number of digits (Prefix Strip Size + Data Size + Suffix Strip
Size), then the first field name appears in the Test Field.
If there is a conflict with the 10-digit Cassette ID field and another field that is 10-digits
in length, make the Cassette ID field 11 digits.

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Proximity Badge Configuration Using Auto Detect

Proximity Badge Configuration Using Auto Detect


Prerequisites:
A proximity card reader is required.

Go to Key Operator Functions > System Configuration > Proximity Badge


Configuration.
1. Select the Primary Badge Type or Secondary Badge Type text box and select the
badge type from the pop-up menu.
2. Select Auto Detect to register the badge type with the System.
3. Place a proximity badge on the card reader and select the Scan Badge button.
Wait until the badge type is detected.
A message will appear: Detecting Badge.
If successful, you will see the message Auto Detection Succeeded.
4. Verify the proximity badge configuration.
a. Select the Primary Badge Type or Secondary Badge Type text box.
The Verify button will be gray if no badge type has been configured.
b. If the configuration is successful, select OK. If not, reconfigure the badge type.
5. Select Save Changes.

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System Maintenance

System Maintenance
System Maintenance lets you set the minimum limit for use of disk space, balancing
between performance and image retention. This lets you determine the criteria used by
the system to automatically erase images or delete patient records.

Navigate to Key Operator Functions > System Configuration > System


Maintenance.
Navigate to System Settings > Maintenance > System Maintenance.
1. In the Disk High Water Mark field, enter the percentage of disk space to allow
before automatic clean-up occurs.
The disk manager runs every hour. It deletes the number of images that have gone
over the watermark that hour.
2. In the Maximum Rejected Images Allowed field, enter the maximum number of
rejected images to allow in the system before images are deleted.
The system will not delete rejected images until it reaches the watermark. It will then
delete rejected images until it either reaches the watermark or reduces the number
of rejected images to the Maximum Reject count.
If it is still not under the watermark it will then delete delivered non-rejected images.
3. In the Patient Record Delete Age field, enter the maximum number of rejected
images to allow in the system before images are deleted.
This defines the length of time the system retains an order with no images attached
to it.
4. Select Save Changes.

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How to Configure Regional Preferences

How to Configure Regional Preferences


The Key Operator can configure the display on the modality for your region.

Go to Key Operator Functions > System Configuration > Regional Configuration.

Field Description

Language Select a language for the system to display using the multilingual
international keyboard.

Time Zone Select the time zone that the modality resides in using the interna-
tional time zone keyboard.

Date Format Select a default format for the date (M=Month, D=Day, Y=Year)
MM/DD/YYYY
DD/MM/YYYY
YYYY/MM/DD

Calendar Check to use a Gregorian calendar; clear if not.

Military Time Check to use a 24-hour clock; clear if not.

Decimal Separator Select a symbol to use as a decimal using the alphanumeric keyboard.

Data Separator Select a symbol (such as . / - , ) to separate data using the alphanu-
meric keyboard.

Time Separator Select a symbol (such as : ) to separate time using the alphanumeric
keyboard.

Current Date Enter the current date using the numeric keyboard.

Current Time Enter the current time using the numeric keyboard.

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Customizable Field Description

Customizable Field Description


Follow this procedure to change a dialect or the field descriptions that appear in the CR
or DR user interface.
1. Go to Key Operator Functions > System Configuration > Customizable Field
Description.
2. Select the phrase that appears in the Translation column.
3. Select the Customized Translation column on the right side.
4. Retype the phrase.
5. Select Enter.
6. Select Save Changes.

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How to Import Custom Tutor Images

How to Import Custom Tutor Images


A Key Operator can import tutor images of their own design from Key Operator
Functions > System Configuration > Import Tutor Images.
1. Load custom tutor images onto a USB drive. They must be 100 x 100 cm.
2. Insert the drive into the Console computer.
3. Navigate to the Import Tutor Images screen.
4. Click the Import From field and select the directory that contains the USB drive.
The custom tutor images appear in the left panel.
5. Select the image(s) to import by selecting the check box in front of each image. Select
Check All to select every image. Select Uncheck All to deselect every image. Move
the selected images to the right panel using the Import arrow.
6. To delete an image, select the image and then Select Delete.
Custom Tutor images must be assigned to each View, one at a time, by the Key
Operator in the View Configuration screen.

About Tutor Images


A tutor image is an anatomical representation of a View. In other words, it is an image
that shows the body part and position of the View that is selected for a study. A tutor
image can be a gold member, a silhouette, or even a custom image. The Key Operator
can import the custom tutor images the facility desires. Tutor images are assigned to
Views by the Key Operator on the Techniques Configuration screen. When the
technologist selects a View, the associated tutor image appears on the Patient Input or
Image Acquisition screen. If a pediatric View is selected, the tutor image appears as a
pediatric image rather than an adult image. When an image is acquired, the tutor image
is replaced by an image of the actual X-ray.

Note
Custom tutor image size is limited to no larger than 170 pixels square (170 x 170).

How to Change the Tutor Image from View Configuration


Key Operator Functions > System Configuration > View Configuration
1. Go to the View Configuration screen.
The View Configuration screen appears.
2. Find the View.
3. Select the tutor image for that View.
The Tutor Image panel opens.
4. Select a gold, silhouette, or custom tutor image.
5. Select Show View Details.

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How to Import Custom Tutor Images

6. Optionally, select an Internal Text box if desired.


7. Select Change Tutor Image.
8. Select Back.

The tutor image style is changed for that View.

How to Globally Change the Tutor Image


1. On the View Configuration screen, select the Global Edit check box.
2. Select one of the images in the Tutor Image column.
3. Select a gold or silhouette tutor image from the Tutor Style tab.

The tutor image style changes for all Views automatically.

How to Assign Custom Tutor Images


1. Navigate to Key Operator Functions > System Configuration > View
Configuration.
2. Select the radio button for Color, Body Part, Projection Position, Laterality,
Auto Position, and Tutor Image.
3. Select a View.
4. Select the tutor image for that View.
The Tutor Image Panel opens.
5. Click Custom.
6. Select the tutor image you want to associate with that View.
7. Select View Configuration to assign a text box position, or change the tutor image
if necessary.

How to Select the Default Tutor Image Type


Tutor images display body parts in View positions. Carestream Health provides gold or
white tutor images to display as default tutor images.
1. Select either of these image types from Key Operator Functions > System
Configuration > Display Configuration.
2. Select the Patient Input tab and select the Display Tutor Images check box.
3. Select the radio button for either Gold or Silhouette to set the default.

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How to Import Custom Tutor Images

How to Change the Default Tutor Image


Tutor images display body parts in View positions. Carestream Health provides gold or
white silhouette tutor images to display as default images.
1. Go to Key Operator Functions > System Configuration > Display
Configuration.
2. Select the Patient Input tab.
3. Select the Display Tutor Images check box.
4. Select the radio button for either Gold or Silhouette to set the default.

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How to Configure Color Preferences

How to Configure Color Preferences


The Key Operator can configure your System interface to provide a general, overall color
scheme for buttons and backgrounds; or, colors can be assigned individually by color
group.

Go to Key Operator Functions > System Configuration > Color Preferences.


1. For a quick reference to the palette you are using, select Colors in Use or go to the
Used Colors tab. These palettes will clearly display the colors that are designated
within your system.
2. To automatically select a color-coordinated palette to apply a general, overall color
scheme to the interface, select one of the following at the bottom of the screen:
Apply Gray Theme
Apply Blue Theme
3. Select Reset to reset the color to the factory default.
4. To assign colors individually, select the radio button of the color group at the top of
the screen:
All Colors
Status Colors
General Application Colors
5. From the Description column, select an item that you want to make a different
color.
6. Select the color from the Color tab or full-range Color Palette tab.
7. Continue to make all of the color changes that you want.
8. Select Save Changes when you are finished.

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About the Technique Settings Configuration Screen

About the Technique Settings Configuration Screen


The Technique Settings Configuration screen lets you add new or change existing
techniques for a View. Navigate to Key Operator Functions > System
Configuration > Technique Settings > Technique Settings Configuration.
Techniques are configured by View and patient size on the Technique Settings
Configuration screen. Each View is configured with default techniques that are applied
when the user selects a View for a study. The Key Operator checks the default techniques
to confirm that they meet their site specific and regional regulatory requirements.
A Key Operator can change these techniques from the Image Acquisition screen if
desired, by evaluating and optimizing techniques for a particular View, and making a
new default for this View.

About the Technique Settings Configuration Screen


The Technique Settings Configuration screen lets you add new or change existing
techniques for a View. Navigate to Key Operator Functions > System
Configuration > Technique Settings > Technique Settings Configuration.
Techniques are configured by View and patient size on the Technique Settings
Configuration screen. Each View is configured with default techniques that are applied
when the user selects a View for a study. The Key Operator checks the default techniques
to confirm that they meet their site specific and regional regulatory requirements.
A Key Operator can change these techniques from the Image Acquisition screen if
desired, by evaluating and optimizing techniques for a particular View, and making a
new default for this View.

System Receptor Types


The system supports two receptor types
GOSDRX-1 System detector
CslCesium Iodide detector
The service engineer uses an installation wizard to configure the system for these
detector types when the software is installed
The Key Operator can go to the Equipment Management screen and change the
configuration for the receptor type.
The user does not have to know which receptor type is being used for an exam. There is
a GOS and CsI technique configured for each View and patient size. The system uses the
technique and image processing for the View when the receptor is identified.

About Changing Technique Settings for a Receptor


If a System is configured for Gadolinium Oxysulfide (GOS), Cesium Iodide (CsI), and CR
receptor types, option buttons will appear at the top of the Technique Settings

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About the Technique Settings Configuration Screen

Configuration screen. The Key Operator selects the receptor type when configuring the
techniques for each View and patient size.
A facility may use GOS, CsI, and CR receptors in their system. The Key Operator can
configure the system so that the user can use any of these receptor types when creating
a study.
The System provides techniques for all receptor types for every View and patient size in
the system. For example, when the user selects a GOS detector, the system recognizes the
detector type and automatically selects the appropriate techniques for the GOS or the CsI
type. With Technique Scaling, the differences between the receptors are calculated and
automatically balanced so that the results will be consistent with each receptor type.

How to Save Optimized Techniques and Create a New Default


This is one way to save optimized techniques and change the default. It is intended to
allow the user to change and save a technique while performing an exam. This procedure
can only be done if a Key Operator is logged in.
1. Optimize the technique settings for a View on the Image Acquisition screen.
2. Select Quick Menu in the bottom-left corner of the screen.
3. Select Store Techniques.

This action only saves the default for the optimized View, patient size, and receptor that
are selected when the Store Techniques button is selected.

How to Filter the Views on the Technique Settings Configuration


Screen
Navigate to Key Operator Functions > System Configuration > Technique
Settings.
1. Select Filter On.
This icon lets you filter for the Primary Category, Secondary Category, and View.
2. Select the desired View.
The screen displays the patient information, such as patient size, for that View alone.

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About the Technique Settings Configuration Screen

3. Select Filter Off.


This icon turns off all filters, closes the Category menu, and returns the screen to the
default presentation.

Filter On

Filter Off

How to Use Copy and Paste on the Technique Settings Screen


When you are using the Copy and Paste feature on the Technique Settings screen, the
active controls will turn blue. The selected View row will turn red.
1. Select the check box for any number of Views.
2. Select Copy.
3. Select the corresponding Views you wish to overwrite.
4. Select Paste.
5. The prompt will ask you if you are sure you want to paste the selected technique
settings. Select Yes or No.

Copy

Paste

Note
When the Copy/Paste feature is used, it will copy and paste all patient sizes for the selected View.

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About the Technique Settings Configuration Screen

How to Perform Multiple Edits on the Technique Settings


Configuration Screen
This procedure allows the Key Operator to change techniques for multiple Views in one
step.
1. Select any number of Views by selecting the check box(es) at the left of the screen.
2. Change the active technique settings from the Generator Controls panel at the top of
the screen.

Important
Not all technique parameters can be changed this way. Grid, filter, and field size can be changed.
mAs, AEC, kV, or time cannot be changed.
3. Select Save Changes.

How to Export Techniques on the Technique Settings Configuration


Screen
Techniques can be exported. When the Export Techniques button is used, all
techniques for all imaging system types will be exported for the Key Operators records
or review.
Export the file to a USB drive. The file can not be opened at the Console. The resulting
file is a .csv file which will open in MICROSOFT Excel on any computer with Excel installed.

How to Configure Generator Technique Settings


This applies to the Quantum Generator only, on the DRX-Evolution Standard Q
Configuration and DRX-1 Ascend Systems.

To make changes to the generator technique settings:


1. Find the region of interest on the left-most panel, such as Thorax.
2. Expand the tree by clicking on the plus (+) sign in front of the region of interest.
3. Find the procedure desired and expand the tree by clicking the plus (+) sign to see the
Views.
The techniques then populate the fields on the right.

Note
The arrows allow the user to change the exposure factors for Small, Medium, and Large.
The Q-Rad and DRX-Rad systems include an online positioning guide.
4. Select the Edit button in the Positioning Guide box and select the corresponding
study.
5. Select Save Changes.

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About the Technique Settings Configuration Screen

About Technique Scaling


This information applies to the DRX-Evolution and DRX-Revolution Mobile X-ray Systems
only.
The Technique Scaling Tool lets the Key Operator take an optimized set of techniques for
a type of receptor and increase or decrease them automatically to create techniques for
another type of receptor. The tool can be used to create CsI, GOS, or CR techniques from
the existing techniques file.
For example, if a user has techniques established for a GOS type detector, and would like
to use a CsI detector, it is very time consuming to manually modify the techniques for the
new detector so that the results will be the same regardless of the receptor used. The user
can scale the techniques for CsI and/or CR by using the GOS technique file.
Extended Exposure Mode (EEM) techniques will not be scaled. The Key Operator will
have to convert them manually.
Technique Scaling will always maintain:
kV
Exposure Mode
Focal Spot
Grid
Filtration
Where possible, mAs/ms should be the only factor scaled.

Note
Technique scaling may not be accessed by the Technologist.

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Long-Length Imaging Configuration

Long-Length Imaging Configuration


Long-Length Imaging Configuration lets you enter the Source to Image Distance for CR
cassettes. You can also select a delivery method:
Deliver only the composite image
Inspect composite images before delivery
Deliver composite images without inspection
Set component images to Delivered when the stitched image is successfully delivered

Required Source to Image Distance Values


For Long-Length Vertical Cassette Holder, a value from 152 cm to 229 cm (60 in. to 90
in.) is recommended.
For Long-Length Vertical Cassette Holder, a value from 152 cm to 229 cm (60 in. to 90
in.) is recommended.
For Long-Length Portable Cassette (erect), a value of 150 cm (59 in.) is recommended.
For DR LLI, the SID is 183 cm (72 in.) unless you are using a grid that requires a
different SID.

Long-Length Imaging Configuration


Long-Length Imaging Configuration lets you enter the Source to Image Distance for CR
cassettes. You can also select a delivery method:
Deliver only the composite image
Inspect composite images before delivery
Deliver composite images without inspection
Set component images to Delivered when the stitched image is successfully delivered

Required Source to Image Distance Values


For Long-Length Vertical Cassette Holder, a value from 152 cm to 229 cm (60 in. to 90
in.) is recommended.
For Long-Length Vertical Cassette Holder, a value from 152 cm to 229 cm (60 in. to 90
in.) is recommended.
For Long-Length Portable Cassette (erect), a value of 150 cm (59 in.) is recommended.
For DR LLI, the SID is 183 cm (72 in.) unless you are using a grid that requires a
different SID.

How to Configure for Long-Length Imaging


Prerequisites:
The system must be able to achieve the recommended Source to Image Distance (SID).
Default source to wall mounted cassette holder Erect (SID) (cm) 203

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Long-Length Imaging Configuration

Default source to portable cassette Supine (SID) (cm) 150


Default source to portable cassette Erect (SID) (cm) 150

To configure for Long-Length Imaging: (CR Only)


1. Enter the SID value for the cassette(s) you will be using.
2. Select the check box if you want update the status of all sub-images to Delivery Not
Required after delivery of a composite image.
3. Select the option button for the image processing mode you desire:
Pass-Through Mode for Long-Length Composite Images. Stitched images are
automatically delivered when sub-images are acquired.
QA Mode for Long-Length Composite Images
4. Select Save Changes.

Note
QA Mode: Delivers composite images after inspection.
Pass-through Mode: Delivers composite images automatically without inspection.

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Grid Type Configuration

Grid Type Configuration


Follow these steps to define a grid and its parameters.
1. Go to Key Operator Functions > System Configuration > Grid Type
Configuration.
2. Select the parameter to change and enter the new number with the keypad. The
number is provided to you on the grid.

Grid Configuration
When you configure a grid, fields that can be edited include:
Grid Classification (focused, fixed, parallel, crossed)
Absorbing Material
Spacing Material
Focal Distance
Aspect Ratio
Thickness
Pitch

The information configured here will be included in the DICOM header and sent to the
PACS.

How to Define the Parameters of a Grid


1. Go to Key Operator Functions > System Configuration > Grid Type
Configuration.
2. Select the parameter to change and enter the new value with the keypad. The
information is provided to you on the grid.
Parameters that can be changed include:
Grid classification
Absorbing material
Spacing material
Focal distance
Aspect ratio
Thickness
Pitch
3. Save Changes.

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Auto Position Configuration

Auto Position Configuration


This information applies to the DRX-Evolution System only.

The Wall Stand is required for the Auto Position option. Auto Position configuration lets
you pre-set equipment locations for exams. The number of positions depends on the
equipment you are using. You can associate an unlimited number of procedures with
these exams.
To configure the DRX-Evolution System for Auto Position:
1. Navigate to Key Operator Functions > System Configuration > Auto Position
Configuration.
2. Select the Enable Auto Position check box.
3. Select a detector by touching the Detector box and selecting Wall Stand, Table, or
none.
4. Touch a position button. The name changes to an editable format.
5. Touch Clear Position to remove the name.
6. Type a new name.
7. Touch Procedure Associations.
8. Select a procedure from the Associate Procedures menu to associate with this
position, or select Clear Associations to create new associations.
9. Select Save Changes.

AC1456 | 2015-03-16 221


Detector Settings Screen

Detector Settings Screen


Navigate to Key Operator Functions > Detector Settings screen.

Detector Sleep
Inactivity Timeout text box
Enter numeric value, in minutes, using the virtual keyboard.
Disable check box
Disables Sleep mode. Detector is always active.

Enterprise Wireless
Credential Expiration Warning Threshold text box
Enter numeric value, in days, using the virtual keyboard.
Determines the number of days left to update the certificate authentication.
Allow Tech to Disable Enterprise Wireless check box
The technologist will be able to disable the connection to the hospital network server
when this check box is checked.
When communications with a hospital network break and disable the DRX-1
detector, the technologist can disable network connections and proceed with the
exam using the detector locally. After the network issue is passed, the technologist
can rejoin the hospital network.

222 AC1456 | 2015-03-16


How to Create a Text Overlay for a Multi-Format Print

How to Create a Text Overlay for a Multi-Format Print


1. Navigate to Key Operator Functions > System Configuration > Configurable
Text Boxes > Multi-Format Print Text Overlay.
2. Select a region from the Overlay format section. A selection is highlighted in green.
3. Select a field.
4. Enter free form text from the virtual keyboard or, select the DICOM fields tab and
select a field from the list.
5. Select the Assign Field button to add the criteria to the selected field in the form.
6. Use the arrow keys to see all of the fields, or check Show most common DICOM
fields only check box to narrow the search.

AC1456 | 2015-03-16 223


Configurable Text Box Options

Configurable Text Box Options


1. Navigate to Key Operator Functions > System Configuration > Configurable
Text Box Menu > Configurable Text Box Options.
2. Select the check box for each of the following options that you want to be available
in your system. You may choose as many options as you want.
Use Transparent Background for Internal Text Boxes.
The text will appear directly on the background of the image.
Use the Image Internal Text Box in Multi-Format Images.
Use the Image External Text Box in Multi-Format Images.
Use the Page External Text Box in Multi-Format Images.

Note
The radiographer can select other text box formats on the Multi-Format Configuration screen.

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How to Configure Remote Devices

How to Configure Remote Devices


Go to Key Operator Functions > System Configuration > Remote Device
Configuration.
At each CR System:
1. Select New Device.
2. Enter the IP address of the Remote Operations Panel (ROP).
3. Select Remote Operations Panel as the device type.
4. Repeat these steps for all ROPs.
5. Enter the IP address of every CR System that will be linked to the ROP.
6. Select Save to All.
This adds all ROP links to each CR that you added in the previous steps.
7. Select Delete Device to remove a device from the CR System.

At each ROP:
1. Select the link to the CR System on which you just made changes.
2. Once the ROP is linked, select Key Operator Functions.
3. Select Fetch ROP Links to add the new links you created in step 6 above.
4. Select Quick Menu and ROP Links to display the new links.

How to Create a Shortcut to the Remote Access Software


Once you have set up Remote Access Software, you can create a shortcut to the software
and place it on your desktop for easy access.

Prerequisites:
Remote Access Software must be set up on the Key Operators computer.

1. Open MICROSOFT INTERNET EXPLORER.


2. With the address displayed, click and drag the MICROSOFT INTERNET EXPLORER icon
to your desktop.
3. Right-click the shortcut to rename it.
4. Double-click the shortcut to launch the remote connection.

AC1456 | 2015-03-16 225


X-ray Radiation Dose Reporting Overview

X-ray Radiation Dose Reporting Overview


The system creates, sends, and stores the data needed to create a structured report. This
data is the radiation dose a patient receives during the study after the Technologist
selects End Study on the Patient Input or Image Acquisition screen.
The structured report option must be enabled on the system in order to use the feature.

DAP Value
The key information needed to calculate X-ray radiation dose is the DAP value.
This information is collected when a digital system is integrated with the generator, as
with the DRX-Evolution. Alternatively, the DAP and/or OEM generator can be integrated
with the CARESTREAM DIRECTVIEW Console via an X-ray Generator Integrator box, or
the dose related data can be manually entered by the user.
Parameters related to exposure such as kVp, mA, and others are included with the Dose
Report and provide useful information for interpreting dose information. If these
parameters are not automatically communicated to the Console, they should be
manually entered.

Destination Configuration
The Key Operator configures the properties for each destination and destination type on
the Key Operator Functions > System Configuration > Destination
Configuration screen. All of the destinations on the system are listed at the top of the
page. The properties for the selected destinations are listed at the bottom of the page.
The Key Operator configures the destination to support Structured Report Storage by
setting the property to True.

Delivery Preferences
The Key Operator configures the system to send data to certain destinations on the Key
Operator Functions > System Configuration > Delivery Preferences screen. A tab
called Reports lists only the destinations that are configured to support structured
report data storage. A structured report is created from this data by a Radiation Exposure
Monitoring (REM) PACS or a third-party destination.
In addition, on the existing Patient Media tab, a check box is available to select Write
Dose Reports to Patient Media.

Patient Work List


The Patient Work List screen is used for viewing the Patient Work List. From here you
can view the status of the Dose Report delivery. The Study Status column on the left side
of the screen shows an icon for failed report delivery.
A Report List button displays a failure icon if any data collection for a Dose Report in
the system has failed delivery, whether the study appears in the Work List or not.
Selecting Report List opens the Report List screen.

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X-ray Radiation Dose Reporting Overview

Report List Screen


The Report List screen contains a list of all patient procedure steps in the system. The
Report Status icon represents the combinations of all of the structured reports that were
sent for each procedure step. There are options at the top of the screen for filtering the
list, and by default all failed reports are shown. You can also resend reports that are
failed or canceled. Selecting a procedure step opens the Report Destination Status
screen.

Report Destination Status Screen


The patient information for the selected procedure step is listed at the top of the screen.
The bottom of the screen shows a list of all destinations that the structured report was
sent to along with the current status of that report. It also contains the destinations that
support structured report storage, but were not configured to receive the report when
the procedure step was ended. There are buttons for each destination that allow for
sending, resending, or canceling the delivery of the report to that destination.

Report List Screen


The Report List screen lets the user review the delivery status for structured Dose Report
data for an associated patient study. The screen is opened by selecting a patient record
and then selecting Report List from the bottom of the Patient Work List screen.
The Report List screen is similar to the Patient Work List screen in that it can be filtered
by:
Patient Status
Patient Last Name
Patient First Name
Patient ID
Accession Number
Time Window
The user can filter the list to narrow the criteria to display in the list. A Report Status
icon appears in the Report Status column at the far left of the screen. It indicates whether
a data set has the criteria you selected: Delivered, Pending, Canceled, or Failed for the
patient selected in the list.

Note
If the report data doesnt meet the criteria, the study will not display.
Selecting a study opens the Report Destination Status screen for the report data
associated with the selected study.
The user can resend all failed Dose Report data by selecting Resend All Failed from the
bottom of the screen.

AC1456 | 2015-03-16 227


X-ray Radiation Dose Reporting Overview

Report Destination Status Screen


The Report Destination Status screen opens when a report is selected from the Dose
Report List, which is accessed by selecting Report List from the bottom of the Patient
Work List screen. The Report Destination Status screen displays the following:
Destination
Destination Type
Status
Delivery Time
Error Code

Report Delivery
Resending the dataThe user can repeat the attempt to deliver a Dose Report whether
the delivery is successful or unsuccessful.
Canceling a reportThe user can cancel a report if the delivery is pending.

How to Configure DICOM Destinations for Dose Reporting


Prerequisites:
The DICOM device(s) are configured to receive data, and communications are installed
and enabled.
The Dose Reporting option is enabled in the destination supports Structured Reports.

The purpose of this procedure is to configure the DICOM destination(s) that will receive
the Dose Report data.
1. Navigate to Key Operator Functions > System Configuration > Destination
Configuration.
2. In the Destination Type column, select Store.
3. Enter the required network information, such as AE Title, Port Number, and so
forth, for each DICOM destination to be configured for Dose Reporting.
4. Set the property setting DICOMSupports DICOM Structured Support Storage
to True.
This indicates that the destination supports receiving structured reports.
5. To configure DICOM Communication Properties:
a. Continue from step 4. Set the property setting DICOMSupports DICOM
Structured Support Storage to True.
b. Enter information for communication settings such as Maximum Retries,
Response Timeout, and so forth.

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X-ray Radiation Dose Reporting Overview

6. To configure Storage Commitment:


a. Continue from step 4. Set property setting DICOMSupports Storage
Commitment for Structured Reports to True.
b. Enter information for storage commitment properties such as Storage
CommitmentCommunication settings, Storage CommitmentUse
Separate Association, and so forth.
7. Select Save Changes.

The configuration settings for the DICOM device(s) are saved successfully for Dose
Reporting.

What Happens When You End A Study


When all of the images have been acquired and accepted, you should end the study by
selecting End Study on the Patient Input or Image Acquisition screen.
If your system is using Modality Performed Procedure Step (MPPS) for Scheduled
Workflow, selecting End Study sends a message to the HIS/RIS Modality Performed
Procedure Step Manager that the procedure has ended, and changes the status of the
exam in the Modality is Completed.
The system creates, sends, and stores a structured report of the dose of irradiation a
patient receives when the Technologist selects End Study on the Patient Input or
Image Acquisition screen after a study is complete.
The structured report option must be enabled on the system in order to use the feature.

AC1456 | 2015-03-16 229


How to Create an Image Copy

How to Create an Image Copy


An image copy is used to modify a delivered image. This means that you can change the
image processing, add a marker, or otherwise change the image that has been accepted
and delivered to destinations, such as a printer or a PACS workstation. In order to modify
a delivered image, you must first create a copy of the image and then modify the copy.
A delivered image cannot be altered any other way.
1. Search for a delivered image on the Image Acquisition screen, or the Image
Review screen.
2. Select the image.
The Image Viewer screen appears.
3. Select Create Copy of Image.
4. Modify the copy using the tools on the Image Viewer screen.
5. Select Save & Accept Image.

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View Category Management

View Category Management


On the View Category Management screen, the Key Operator can add, edit, and
delete the display of Primary Categories, Secondary Categories, and Views on the
Patient Input and Image Acquisition screens.
The operator can also use this screen to arrange the order of Regions, Exams, and
Views.
Deleting a View from Category Management deletes the View from the System.

How to Edit Regions, Exams, and Views


Go to Key Operator Functions > System Configuration > View Configuration >
View Category Management.
1. Select a Primary Category.
The category name becomes highlighted so that you can edit it. The associated
Secondary Category and Views appear in the second and third columns.
2. Edit the category or select Add to save it and start a new category.
3. Select a color for the Primary Category from the keyboard.
4. Select a Secondary Category and color.
5. Add or delete the Views as appropriate.
6. Use the far right column arrows to move highlighted items and arrange the way the
Regions, Exams, and Views display.
The items in the column will display left to right, top to bottom, at the Patient Input
and the Image Acquisition screens.
7. Select Save Changes.

AC1456 | 2015-03-16 231


Firmware Updates

Firmware Updates
The system can determine whether or not the active DRX-1 detector has current firmware
installed. If it does, the detector can be used normally. If it does not have current
firmware, then the firmware must be updated before you can use the detector.
The Key Operator can install firmware updates without contacting Service. After
updating software using the Software Update screen, the Install Firmware Updates
screen appears if a firmware update is necessary.

How to Install Firmware Updates


1. Navigate to the Firmware Update screen.
2. Select the receptor to be updated.
3. Select Yes to the firmware update message.
4. Follow the on-screen instructions.
The firmware update process is indicated by a progress bar.

Note
The receptor must be tethered during a firmware update.

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Scheduled Workflow Configuration

Scheduled Workflow Configuration

Scheduled Workflow Configuration


Scheduled Workflow provides automatic notification of exam status to the HIS/RIS,
reducing the steps necessary to complete the exam. It provides consistency for ordering
patient images, and defines schedules and imaging acquisition procedures.
1. Navigate to Key Operator Functions > System Configuration > Scheduled
Workflow Configuration.
2. Select Setting the Procedure Steps to Complete to configure Scheduled
Workflow so that a study is automatically set to Complete when all images are
accepted.
3. Select Display End Procedure Step Confirmation Dialog Box to configure an
End Study prompt when all images are accepted.

Scheduled Workflow Alternatives


A Key Operator configures the system workflow to organize the way images are
accounted for. Your system is configured one of these two ways:

Procedure Step-Based Workflow


In this case, the system keeps the Study Instance UID when you select New Procedure
Step. Destinations such as workstations recognize that the images are from the same
study.
The Begin Procedure Step button appears when you select New Patient.

Study Based-Workflow
When the system is configured for Study-based Workflow, the user generates both a
Study Instance Unique Identifier (SIUID) and a new Procedure Step each time New Study
is selected for that patient.
When the user scans a cassette and selects Save Changes, the New Study button
appears. To set the study to completed, select End Study.
Configuration Image Identifier

Procedure Step-based Workflow Selecting New Procedure Step keeps the


same Study Instance UID; therefore destina-
tions keep the same images in the same
study.

Study-based Workflow Selecting New Study generates both a SIUID


and a new Procedure Step.

AC1456 | 2015-03-16 233


Scheduled Workflow Configuration

Select Scheduled Workflow


A Key Operator configures the System Workflow to organize the way images are
accounted for. Your system is configured one of these two ways:
Configuration Image Identifier

Procedure Step-based Workflow Selecting New Procedure Step keeps the


same Study Instance UID; therefore destina-
tions keep the images in the same study.

Study-based Workflow Selecting New Study or selecting a study


from the Work List generates both a Study
Instance Unique Identifier (SIUID) and a
new Procedure Step.

Scheduled Workflow Option


Scheduled Workflow is an option that may be used with either of the workflow
configurations listed above. Your system may be configured for either Procedure
Step-based Workflow or Study-based Workflow for IHE Compliance. The Key
Operator can configure Study-based Workflow or Procedure Step-based Workflow
even if Scheduled Workflow is not enabled.

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Storage Commitment Function

Storage Commitment Function


When you send an image to a destination, there is no guarantee that the image was
stored to the hard drive. Sending the image means that the Modality transmitted the
image to the PACS.
With Storage Commitment enabled, a delivered image is successfully saved by the PACS
and the Modality receives a confirmation that the image has been received and stored.

Note
The destination must support Storage Commitment for the Modality to use this feature, and the
feature must be enabled by Service.

AC1456 | 2015-03-16 235


How to Configure Auto Display in QA Mode

How to Configure Auto Display in QA Mode


When you are operating in QA Mode, you can do the following to configure the system
to automatically open an image in the Image Viewer screen after the image is
processed, instead of selecting the image manually to inspect it.
1. Go to Key Operator Functions > System Configuration >
Delivery Preferences.
2. At the Delivery Preferences screen, select Auto Display in QA Mode.
3. Select Save Changes.

Pass-through Mode
In Pass-through mode, all images are routed directly to destinations without inspection.
When Pass-through mode is configured, you can select the Pause the Pass-through
function on the Scan Status screen to inspect an image. When you are done inspecting
the image, select Resume Pass-through to continue scanning and to allow images to
go to destinations without inspections.
In QA mode, the radiographer must view and approve the image before distributing it
across the network.

About Displaying in QA Mode


If your system is configured for QA Mode, you must review and accept the image before
distributing it to the selected destinations. You may choose to accept images individually
following review of each, or all together after reviewing them all.

How to Accept All Images in QA Mode


Prerequisites:
Your system must be configured for QA Mode.

1. After acquisition, thumbnail images appear on the Patient Input screen.


2. Select one of the images to open on the Image Viewer screen.
3. View the other thumbnail images using the arrow buttons on the Patient Information
bar.
4. Select the Patient Information bar to return to the Patient Input screen after
reviewing all the images.
5. Select Accept All to send all the images to the selected destinations.

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How to Configure Auto Display in QA Mode

How to Accept Individual Images in QA Mode


Prerequisites:
Your system must be configured for QA Mode.

1. After acquisition, a thumbnail image appears on the Patient Input screen.


2. Select the thumbnail image to display it for review on the Image Viewer screen.
3. Select Accept Image to send the image to the appropriate network destinations.

AC1456 | 2015-03-16 237


How to Configure the Edges of a Surround Mask

How to Configure the Edges of a Surround Mask


The Key Operator can configure your System to provide a white outline of a Surround
Mask, which verifies masks placement on any image. The Key Operator can configure
any range of outline from 0 to 12 mm on any view or on all views.

Go to Key Operator Functions > System Configuration > View Configuration.


1. Select the fourth radio button, for Mask.
2. For a specific view, enter the value for the mask outline, from 0 to 12 mm.
3. To change all views, select Global Edit to apply the mask outline to all views.

238 AC1456 | 2015-03-16


Scheduled Workflow Configuration

Scheduled Workflow Configuration


Scheduled Workflow provides automatic notification of exam status to the HIS/RIS,
reducing the steps necessary to complete the exam. It provides consistency for ordering
patient images, and defines schedules and imaging acquisition procedures.
1. Navigate to Key Operator Functions > System Configuration > Scheduled
Workflow Configuration.
2. Select Setting the Procedure Steps to Complete to configure Scheduled
Workflow so that a study is automatically set to Complete when all images are
accepted.
3. Select Display End Procedure Step Confirmation Dialog Box to configure an
End Study prompt when all images are accepted.

AC1456 | 2015-03-16 239


Firmware Updates

Firmware Updates
The system can determine whether or not the active DRX-1 detector has current firmware
installed. If it does, the detector can be used normally. If it does not have current
firmware, then the firmware must be updated before you can use the detector.
The Key Operator can install firmware updates without contacting Service. After
updating software using the Software Update screen, the Install Firmware Updates
screen appears if a firmware update is necessary.

240 AC1456 | 2015-03-16


Snapshot Log Files

Snapshot Log Files


If the System presents a non-catastrophic problem or other error, the technologist can
make a quick snapshot of the system. The Key Operator can then access the files and
e-mail them to the Service engineer. The Service engineer can later access and use the
snapshot to diagnose the system problem.

How to Capture a System Snapshot Log


Occasionally, the Key Operator will be asked to capture logs and send them to a Service
Representative. This is so that Service can examine the logs and be better prepared to
solve the problem when they arrive at the facility.
1. From any screen, touch or click the Quick Menu button in the bottom left corner of
the screen.
2. Touch or click the Snapshot Log Files button.

As a user or Key Operator, selecting this button completes the task. A snapshot of the
System Log will be generated, which can then later be accessed by Service to diagnose
system problems.
The Key Operator can copy the logs in the Key Operator Functions menu under Copy
Log History.

AC1456 | 2015-03-16 241


Scanner Options Screen

Scanner Options Screen


Go to Key Operator Functions > System Configuration > Scanner Options.
Depending on the reader you use, the Scanner Options screen will show different
configurations for the following:
CR 850/950/975/Max CR Systems
Reduced Border check box
Auto Associate check box
Auto IP option button
IP Address option button
Connecting button
Classic CR with Local User Interface
Auto Associate check box
Auto IP option button
IP Address option button
Connecting button
Classic CR with Easy View display
Auto IP option button
IP Address option button
Connecting button

242 AC1456 | 2015-03-16


Pediatric Support Option

Pediatric Support Option


DIRECTVIEW System Software offers a wide range of pediatric sizes for chest and
abdomen imaging. The View selection allows the Key Operator to set adjustable
techniques for newborns, infants, toddlers, preadolescents, and adolescents. Carestream
offers a range of patient sizes for chest and abdomen Views.

Pediatric Imaging
Minimizing the pediatric dose is especially important, as this segment of the population
is most sensitive to X-ray radiation. The choice of acquisition parameter settings has a
strong impact on the delivered dose and image quality.
For example, increasing the mAs setting (the milliamperes x seconds product, that is,
number of X-rays) will proportionally increase the dose to the patient. Similarly,
decreasing the source-to-patient distance will also increase the dose to the patient.
Adjustment of the kVp setting (that is, peak energy of the X-rays) results in more complex
dose and image quality dependence and trade-offs, which in turn depends significantly
on patient size.
For example, decreasing the kVp improves contrast, but increases entrance dose,
especially in larger patients that require more X-rays to achieve a sufficient signal at the
detector. As a result, we suggest that smaller pediatric patients (newborns and infants)
be imaged at lower kVp (< 65 kVp) to maximize contrast and detail. Note that in this case,
the mAs should be adjusted accordingly. We also suggest that larger and obese pediatric
patients be imaged at a higher kVp to decrease noise.

Pediatric Sub-Populations
DIRECTVIEW System Software offers a range of chest and abdomen Views to select for
pediatric patients. Pediatric patient size is categorized in sub-populations:
Very Low Birth WeightLess than 1.5 kg (3.3 lb)
Low Birth WeightGreater than 1.5 kg (3.3 lb) and less than 2.5 kg (5.5 lb)
NewbornBirth to 1 month
InfantGreater than 1 month to 2 years
ChildGreater than 2 years to 11 years
PreadolescentGreater than 11 years to 13 years
AdolescentGreater than 13 years to 21 years

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Pediatric Support Option

How to Configure Patient Size for View Configuration


To configure patient size for View configuration:
1. Navigate to Key Operator Functions > System Configuration > Automatic
View Selection and select the Patient Size Indexing tab.
2. Select the Active check box to select the sub-population category you want to make
available.

Note
To edit the maximum value for each category and set new defaults, select the displayed maximum
value and input a new value from the virtual keyboard.

Patient Size Icons


Patient Size icons have expanded the choices for patient size for techniques on the
Technique Settings and Image Acquisition screens.

Icon 1 Icon 2 Icon 3 Icon 4

Very Low Birthweight Child Small Adult All

Low Birthweight Preadolescent Medium Adult

Newborn Adolescent Large Adult

Infant

Note
When a Pediatric View is selected on the Patient Input screen, the tutor image displays as a
pediatric patient rather than an adult patient.

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What is a View

What is a View
A View is a pre-set image type that a radiographer can select to represent an exam. It is
the basic element in the digital image chain.
Views are associated with procedures on the Patient Input screen or Image
Acquisition screen and in optional Procedure Mapping.
When you create a View, it appears on the Patient Input screen or Image Acquisition
screen as soon as you add it and save it on the View Configuration screen.
For every View, there is an associated look and customized changes for each of the
preference editor controls. These can be seen, but not modified, in the View
Configuration screen.

How to Create a View


1. Navigate to Key Operator Functions > System Configuration > View
Configuration.
2. Reduce the number of Views in the list by selecting the Category radio buttons.
3. Select the check box of the View with a similar body part and projection that you
want to copy.
4. Select Copy Checked Views to copy the View settings and create a new View.
5. Select a Primary and Secondary Category to associate with the copy.
6. Select the new View name from the tabbed keyboard.
7. Select the radio button to display the parameters for the View (column selection).
8. Select the item that you want to change and enter a new value from the tabbed
keyboard. Repeat for each parameter you want to change.
You can change one of the following configurations:
Color Mask

Body Part Grid Suppression

Projection Noise Suppression

Position Raw

Text Box True Size

View Name Tick Marks

Tutor Image Rotation

Skin Line Detection Crop Type

AC1456 | 2015-03-16 245


What is a View

9. Select Show View Details to edit all configurations of the View at once, or use the
Column Selection radio buttons to control which columns are displayed in the View
list.
10. Select Save Changes.

How to Delete a View

Note
If the Views are associated with a procedure, make sure that deleting them will not affect
Procedure Mapping.
1. Navigate to Key Operator Functions > System Configuration > View
Configuration.
2. Deselect all Views to make sure that no additional Views are unexpectedly selected.
3. Select the check box of the View with a similar body part and projection that you
want to delete.
4. Select Delete Checked Views to delete the selected View(s).
A confirmation dialog shows what Views will be deleted.

Note
Views are erased from the system when you delete them from the View Configuration. Deleting
Views from View Category Management moves Views to the Uncategorized category so they
can be added back into a category later, if desired.

How to Find a Look Name


For every View, there is an associated look with customized settings for each of the
preference editor controls: Brightness, Latitude, Sharpness, Contrast, and Noise. These
can be seen, but not modified, in the View Configuration screen.
1. Navigate to Key Operator Functions > System Configuration > View
Configuration.
2. View the name of the Look for each View. The Look name is at the far right column
on the screen.

How to Change the Default Characteristics of an Image?

Note
If the Views are associated with a procedure, make sure that changing them will not affect
Procedure Mapping.
1. Navigate to Key Operator Functions > System Configuration > View
Configuration.
2. Deselect all Views to make sure that no additional Views are unexpectedly selected.

246 AC1456 | 2015-03-16


What is a View

3. Place a check mark in the Select column of the View that you want to change.
4. Select the characteristic that you want to change, such as Rotation.
5. Select the preferred setting from the pop-up menu.
6. Select Save Changes.

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Delivery Preferences Configuration

Delivery Preferences Configuration


Delivery Preferences lets you configure the default settings for the following information
delivery selections.
Field Description

Hospital Name The hospital name that you want to associate with the images.

Hospital Address The address of the hospital that you want to associate with the
images.

Operating Mode The default operating mode:


QA Mode
Auto Display
Pass-Through Mode
QA by Study (DR)

Pixel Spacing The pixel spacing for workstations that require the (0018, 1164)
Imager Pixel Spacing or require the (0018, 1164) Pixel Spacing
fields.

Relative X-ray Exposure The Carestream Health Exposure Index or the IEC Exposure Index.
DICOM Tag ID (0018,
1405)

Delivery Tab Options Use uppercase for all DICOM fields on delivery.
Send all images in L/F orientation. This means the workstation
will not rotate the image when it is received. Sends patient
orientation tag (0020:0020).
Remove print destinations from 1-up when creating new
Multi-Format prints.
Scale mark to storage.
Use CR IOD. It means always use the CR DICOM IOD, instead of
DX or MG IOD.
Translate Body Part and Projection.
Allow non-conforming DICOM.
Label Patient CD using LIGHTSCRIBE.
Edit the AE Title IP address and port for their DICOM destina-
tions.

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Delivery Preferences Configuration

Field Description

Image Instance Tab The general image instance number:


Every image is its own Series. Instance Number is always 1.
Every image is its own Series. Instance Number is unique.
Every image is in the same Series. Instance Number is unique.

Note
The Image Instance tab has different configurations to help with
foldering at the PACS. Consult your PACS Administrator to
determine which setting is required for your PACS system.

Patient Media Tab Include Media Viewer on CD.


Include CARESTREAM Image Suite Viewer on CD.
Acquire Solutions Review Application.
Write Patient CD immediately.
Write Dose Report to Patient Media.

Report Tab Configure a list of destinations that support structured Report


storage.

Custom Page Layouts Configure a custom Multi-Format layout from a blank page or
Tab from a copy of a layout.
Customize by cell width and cell height.
Use the arrow keys to move the cell up, down, left, or right.
Add or delete a cell from the layout.
Delete the existing layout.

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DICOM Specification for Dates and Times Recorded in the System

DICOM Specification for Dates and Times Recorded in


the System
The system sets these values to be the date and time the image record was created in the
database.
Field DICOM Tag Description

Study DateDICOM tag (0008,0020) The date the study started.

Study TimeDICOM tag (0008,0030) The time the study started.

Image DateDICOM tag (0008,0023) Content Date The date the image pixel data
creation started. Required if the
image is part of a series in which
the images are temporally
related.

Image TimeDICOM tag (0008,0033) The time the image pixel data
creation started. Required if the
image is part of a series in which
the images are temporally
related.

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How to Configure Before and After Views

How to Configure Before and After Views


The Image Preference Editor screen lets you compare the look of one image against
another and select the look you prefer.
1. Navigate to Key Operator Functions > System Configuration > Image
Processing Preferences.
2. Select an image.
3. Change the image processing preferences.
4. Select View Before and After and compare the results.
5. Select the look you prefer.

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Image Processing

Image Processing

Adjusting Image Quality Controls In Preference Editor


Making image processing adjustments may optimize the image quality for better
presentation of the image. These image controls are available in Preference Editor to the
Key Operator for DIRECTVIEW products.
Brightness makes an image lighter or darker.
Latitude controls the number of shades of gray levels, making blacks and whites
more or less apparent. You may want to increase the latitude if important anatomical
information is in the black or white region of the image and it cannot be visualized.
Detail Contrast controls the local contrast of medium-sized structures such as joint
spaces, vertebral body spacings, and ribs in the image. Increasing detail contrast
makes anatomical features more pronounced.
Sharpness controls the definition of edges within the image. This feature selectively
applies a sharpness algorithm to only those areas of the image with low exposure.
When you apply sharpness, it enhances the smaller edges like lung markings and
bony trabecula.
Noise is an undesirable mottle that appears in low exposure areas of the image.
When you apply noise suppression, the improved low exposure areas appear clearer
and smoother. The Key Operator can configure this feature.

How to Reset Image Processing Controls


To return to the last saved value of all of the slider controls for brightness, latitude, and
detail contrast at the Image Viewer:
1. Select Reset.
2. Select Save Changes when finished making changes.
3. Select Save & Accept Image to send the image to a destination.

Adjust Image Quality


1. To change brightness:
Select the top arrow to raise the value and increase the brightness.
Select the bottom arrow to lower the value and decrease the brightness.
2. To change latitude:
Select the top arrow to raise the value and increase the latitude.
Select the bottom arrow to lower the value and decrease the latitude.
3. To change detail contrast:
Select the top arrow to raise the value and increase the contrast.
Select the bottom arrow to lower the value and decrease the contrast.

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How to Configure Trauma Exam Buttons

How to Configure Trauma Exam Buttons


This task describes how to set up and configure defaults for trauma exam buttons.
1. Navigate to Key Operator Functions > System Configuration > Trauma
Defaults.
2. Select New Tab.
3. Select the tab size based on the number of items you want in the list. You can enter
up to 5 tabs of 40 entries or 200 items per list. Buttons cannot be moved from one tab
to another tab.
4. Select a button and enter the name in edit mode.
5. Select the Color tab and select a color.
6. Select Save Changes.
7. Select Change Trauma Defaults.
The Trauma Defaults [Patient Name] displays.
8. Enter the required information, such as Priority, Gender, Procedure, and so forth.
9. Select Save Changes.
10. Select one of the following:
Select Back to pre-configure more Trauma buttons.
Select Main Menu > Study Data > Trauma to review the newly created Trauma
buttons.

How to Move a Trauma Exam Button


1. Navigate to Key Operator Functions > System Configuration > Trauma
Defaults.
2. Select a trauma exam button, such as John Doe.
3. Select the Move button.
4. Use the arrows to rearrange the location of the trauma exam button.
5. Select Save Changes.

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Region of Interest (ROI) Tool

Region of Interest (ROI) Tool


The Region of Interest (ROI) Tool defines the area in which the code values and optical
density are measured and calculated. The tool displays the mean, minimum, maximum
and standard deviation values for the code values within the area specified by the user
on the image. The optical density measurements are from the code value.
Medical physicists may use the ROI Tool for system calibration or QC testing. The mean
code value provided in ROI information is useful for determining the selective exposure
in different sections of an anatomic or test image.
After selecting the location to be included in the ROI calculations on the display by using
a finger touch or mouse-click, the measurement appears. The Key Operator can configure
the size of the selected region of interest to be from 1 x 1 mm cm to 10 x 10 mm cm on
the Display Configuration screen.
Select ROI to identify the Exposure Index of any point on the image.

Region of Interest Tool


The Region of Interest (ROI) Tool is accessible only to Key Operators. After selecting the
location to be included in the ROI calculations on the display by using a finger touch or
mouse-click, the measurement appears. The Key Operator can configure the size of the
selected region of interest to be from 1 x 1 mm cm to 10 x 10 mm cm on the Display
Configuration screen.
Select ROI to identify the Exposure Index of any point on the image.

How to Access the Region of Interest Tool


1. Navigate to Key Operator Functions > System Configuration > Image
Processing Preferences.
2. Select an image.
3. Open the Image Viewer screen.
4. Select the Region of Interest tab.
5. Select the Show Region of Interest box.
A red square will appear in the image.

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Region of Interest (ROI) Tool

6. Click another location in the image to move the Region of Interest box.
The Region of Interest is the mean code value of exposure, indicated in a square area
drawn around the point you selected on the screen.
The display reads:
Mean:1229.00, 0.49 O.D.
Min:1045.00, 0.37 O.D.
Max:1384.00, 0.61 O.D.
St. Dev: 47.20, 0.04 O.D.
The first value in each row is Pixel Location and the second value is optical density
(OD).

Note
The Key Operator can configure the size of the Region of Interest window in Display
Configuration.

Configure the Region of Interest Tool


1. Navigate to Key Operator Functions > System Configuration > Display
Configuration.
2. Click the Image Viewer tab.
3. Choose from 10 % or Custom.
If you choose Custom, use the sliders to adjust the ROI width and ROI height.

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How to Hide or Restore Buttons on Trauma Defaults List

How to Hide or Restore Buttons on Trauma Defaults


List
1. From the Trauma Defaults screen, select a trauma exam button, such as John Doe.
2. Select Hide Button or Show Button.
3. Select Save Changes.

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V4343 Detector Reports

V4343 Detector Reports


The Service Engineer accesses this screen to determine multiple detector parameters such
as detector sensitivity.

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Beam Detect

Beam Detect
Beam Detect is a feature that allows the detector to be active when it detects an X-ray
beam. Typically, a fixed detector is cabled from the Console to the generator, along with
another cable from the generator to the detector. A wireless detector such as the DRX-1
System detector makes an exposure when the user presses the Prep/Expose switch,
signaling the detector and the generator at the same time.
With the Beam Detect feature, the technologist signals the generator directly from the
exposure switch at the Console, and the detector activates when it senses the X-ray beam.
The detector will continuously make short duration acquisitions, once activated by the
X-ray beam, depending on the duration of the X-ray.
A system can be configured either for the Beam Detect feature or not. It cannot be
configured for both, and Beam Detect is designed to be used with CARESTREAM
DIRECTVIEW System Software V5.7D and higher. Beam Detect cannot be used for
long-length imaging studies.
There is no interface between the workstation and the generator. The wireless detector
makes an exposure when the technologist presses the prep/expose switch connected to
the generator and the detector is signaled by the presence of the X-ray beam.
The DRX-1, DRX-1C, DRX 2530C, TDR, and DRX 2530-01 detectors are not supported for
the Beam Detect feature. The serial number of the detector is checked by the system.
Only the DRX Plus and PRO detectors support the Beam Detect feature at this time.

Note
Only the DRX Plus and PRO detectors support the Beam Detect feature at this time.

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Configure a System for Beam Detect Timeout

Configure a System for Beam Detect Timeout


1. Navigate to the Key Operator Functions > Detector Settings screen.
2. Select one of the following:
Timeout EnabledOnce activated, the detector will remain activated for a
period of 120 seconds. After 120 seconds, the user must reactivate the detector. A
green progression circle will appear to represent the time lapsed, and will switch
to red as a warning when the time is nearly elapsed.
Timeout DisabledOnce the detector is activated, it will remain activated until
an exposure is made, (in which case the Status has changed), the user exits, or ends
the study.
3. Select Save Changes.

Note
Only the DRX Plus and PRO detectors support the Beam Detect feature at this time.

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How to Use Beam Detect

How to Use Beam Detect


The Beam Detect feature must be enabled on your system before you can use it.
1. Select a study.
2. Position the patient.
3. If the system has more than one detector, select a detector.
The selected detector begins the activation process, and the system Status changes to
reflect this process.
4. The system Status changes to Ready, assuming all other factors are normal.
When operating in Beam Detect Mode, the optimal kVp range is 40150 kVp. The
exposure time should not be less than 2 msec or greater than 3.6 sec.

Note
If the Power Saver option is enabled, a green circle will display to show progress as the time
elapses. You have 2 minutes to make an exposure.
The Deactivate button replaces the Activate button on the screen.
5. Acquire the first image.
The detector moves to an Idle state, and stay idle until the full resolution image
transfers to the Console.
The detector then transitions from Idle to Activated, and the system Status displays
Ready, assuming all other factors are normal.
The detector is ready for the next exposure.

Note
Only the DRX Plus and PRO detectors support the Beam Detect feature.

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About Linear Tomography

About Linear Tomography


This information applies to the DRX-Evolution only.
Linear Tomography is a method of imaging areas of the anatomy that would otherwise
be obstructed from view by other anatomy, such as bone, muscle, tissue, or organs.
Tomograms are X-rays that focus only on the anatomy of interest. The extraneous image
information that appears above and below the selected area is softened and blurred.
Tomograms are created when the DRX-Evolution Overhead Tube Crane (OTC) and the
DRX Detector travel in opposite directions as the exposure is made, blurring the
overlaying anatomic structures.
The area of interest is calculated to be exposed at a fixed point located at a selected level
of the anatomy. The result is an X-ray of only one layer of the body part. A subsequent
View can be taken at each level, so that a section of the body part at any level can be
imaged
The thickness of the layer and the angle of the tube are determined by the Sweep Angle
and Layer Height settings that you input at the Console from the Patient Information >
More Patient Data screen. These settings are changed manually for each View before
you begin taking exposures
The Sweep Angle setting determines the thickness of the layer. (The larger the number,
the longer the angle, and the thinner the slice.)
The Layer Height setting determines the location of the slice of the body part in relation
to the table top
The prerequisites for Linear Tomography from Carestream are:
Linear Tomography Feature, enabled
A motorized DRX-Evolution system with Linear Tomography equipment installed
0.5 Copper (Cu) and 1.0 Aluminum (Al) filters
A table set up to achieve a SID of 110 cm (43 in.)

How to Use Linear Tomography


The following information applies to the DRX-Evolution only.
1. At the Console, select a patient from the Work List or create a new patient record.
2. Select Add View if one is needed.
3. Select the first tomography View.
The More Patient Data screen displays.
4. Put the patient on the table.
5. Make sure that the Bucky is in the center of the Bucky travel area.
6. Verify that the detector is in the Bucky.
7. Lower the table so that Auto Center can set a SID of 110 cm (43 in.).
8. UseAuto Center to align the tube and detector.

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About Linear Tomography

9. Position the patient.


10. Collimate the X-ray beam tightly to the anatomy of interest.
11. Insert the Cu and Al filters into the collimator.
12. Select the Sweep Angle field and choose the Sweep Angle from the five sizes (8,
10, 20, 30, or 40 degrees) provided in the menu on the More Patient Data screen.
13. Select the Layer Height from the keyboard.
14. Select Save Changes.
15. Select the first Linear Tomography View from the Image Acquisition screen.
16. Press the Prep/Expose switch halfway down.
The tube and Bucky move into position. When the switch is pressed all the way down,
the tomographic motion begins and the exposure occurs

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The Detector EnvironmentPRO Detectors

The Detector EnvironmentPRO Detectors


You can use the detector in a Bucky. You can also use the detector to capture images on
a tabletop, similar to a cassette.
Refer to the PRO 3543/3543C Detectors Safety and Regulatory Information with
Hardware User's Guide for product safety information.

How to Activate a Detector


1. From the Console, access the Image Acquisition screen.
2. Select the detector that you want to activate and use for the exam.
3. View the Status bar. When a status of Ready appears, you can use the detector to
capture images.
4. Proceed with image acquisition tasks.
Status Description

The Console is connecting to the detector over the net-


work.

Active You have selected the detector for an exam.


The Console is connected to the detector to receive image
data over the network.

(yellow border)

Inactive The detector is not selected. You cannot use the Console
and the detector for image acquisition.

(gray background)

Note
If you want to take exposures using a cassette, you must deactivate the detector and select the
Generator icon.

Using the Detector


Look at the Status bar in the middle of the screen for information about the detector
state.
1. In the exam room, look at the detector surface for an identification label.
2. Hold the detector with the identification label toward you.

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The Detector EnvironmentPRO Detectors

3. Put the detector in a Bucky or position the detector for a tabletop exam.
4. At the Console, access the Image Acquisition screen.
5. If not previously activated, touch the Status Control that matches the identification
label.
6. Add or modify exam information.
7. Add or delete views.
8. On the prep/exposure switch, press and hold the button halfway down to the prep
position.
9. When the generator is prepped, press the button completely to take the exposure.

Note
You can press the button completely without holding in the prep position. However, the
generator must delay firing until the generator and the detector finish their preparation processes.

How to add a DetectorPRO Detectors


1. Go to Utilities > Equipment Management > Detector.
2. Select the Add Detector button.
3. At the If you have the detector registration DVD screen.
If you have the detector registration DVD, insert the DVD and select Yes.
Continue with the next step.
If you do not have the detector registration DVD, select No and enter the detector
serial number.
4. At the next screen.
a. Type a name for the new detector.
b. Select the icon that matches the sticker on the detector.
c. Select OK.
5. At the Detector Successfully Configured screen, select OK.
6. At the Equipment configuration successfully updated screen, select OK.
7. At the Changes you have made require the system to be rebooted, Please
reboot now screen, select OK.
The system reboots.

How to Remove a DetectorPRO Detector


1. Go to Utilities > Equipment Management > Detector.
2. Select the Remove Detector button.
3. At the Detector Successfully Configured screen, select OK.
4. At the Equipment configuration successfully updated screen, select OK.

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The Detector EnvironmentPRO Detectors

Detector IdentificationPRO Detector

Detector Icon

This icon identifies a detector that is registered for use in the system. The icon
corresponds to a unique identification label on the physical detector. The detector icon
is applied during the detector registration process.

Benefits of Knowing the Identity of a PRO Detector


Each Console supports up to 2 PRO Detectors per exam room.
When multiple detectors are available, it is important for you to correctly identify each
detector. Knowing how to locate the identity of each detector helps you to:
Choose and activate the correct detector for the image study
Verify that you are performing calibrations on the correct detector

Tasks that Use the PRO Detector Icon


During daily operation, you will view the Detector Icon most often from the
Image Acquisition screen.
There are several other menus and functions which use the detector icon. Your operation
rights, permission, or privileges will determine which menus you can access.
From Main Menu > Utilities > Equipment Management: You can add and
remove a detector.
From Main Menu > Utilities > Detector Calibration: You can run a Daily Dark or
X-ray calibration on a detector.

Detector RulesPRO Detector


The same rules for using a single detector apply to using multiple detectors.

Detector Identity
You must select and activate a specific detector on the Console prior to taking an
exposure.
Always verify the identity of the detector you are using for an exam prior to taking
an exposure.
Each detector must have a complete identity, which includes an identification label
and a detector icon.

Detector Calibration
You must calibrate each detector daily.

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The Detector EnvironmentPRO Detectors

If the Key Operator does not configure the system to calibrate automatically, it will
have to be calibrated manually.
You must calibrate the detector when requested by the software.

Calibration Types, Frequency, and Duration


DRX Plus Detector
Family Calibration Type Frequency Duration

Dark Calibration Daily Less than 1 minute

X-ray Full Annually 10 minutes

X-ray Express As needed 5 minutes

DRX-1 Detector Family Calibration Type Frequency Duration

Dark Calibration Daily Less than 5 minutes

X-ray Full Every 6 months 10 or more minutes

PRO Detector Family Calibration Type Frequency Duration

Dark Calibration Daily Less than 5 minutes

X-ray Full Every 6 months 20 or more minutes

Note
Perform detector calibration if the system prompts you to do so. If the detector is dropped, a new
calibration will be needed at that time.

Note
The Dark calibration must be performed if the Key Operator for the site has disabled the
automatic daily dark feature, or if automatic Dark calibration fails for a specific period of time:
DRX Plus Detector Family: after the calibration fails for 10 weeks
DRX-1 Detector Family: after the calibration fails for 10 days.
PRO Detector Family: after the calibration fails for 10 days.

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How to Set Up for an X-ray CalibrationPRO Detector

Important
The X-ray calibration must be performed every six months or after a significant shock to the
detector.
The user must activate the exposure button for 32 exposures.
The dark calibration must be completed successfully before performing the X-ray calibration.
1. Set the SID to 183 cm (72 in.) and remove the grid.
2. Ensure that nothing is in the beam path.
3. Do the steps in the How to Calibrate the Detector procedure.

Run the Dark Calibrations


The Dark Calibration needs to be performed manually only if the Key Operator has
disabled the automatic daily dark feature which requires no user interaction, or if the
automatic daily dark fails for ten days.
1. Go to Utilities > Detector Calibration.
2. Select and activate the detector you want to calibrate.
3. Select Calibration Type.
4. In the virtual keyboard, select the Dark Calibration radio button.
5. Select Begin Calibration.
The calibrations run automatically. View the progress on the Calibration Progress Bar.
6. When the message, Calibration Successful appears, select OK.
7. If necessary, repeat the calibration steps to:
Run another calibration type on the same detector
Run calibrations on another detector

Run X-ray CalibrationsPRO Detector


1. Place the detector in the calibration tray.
2. Set the SID to 183 cm (72 in.).
3. Verify that the collimator blades are completely open.
4. Ensure that nothing is in the beam path.
5. From the Console, navigate to Utilities > Detector Calibration.
6. Select and activate the detector you want to calibrate.
7. Select Calibration Type.
8. In the virtual keyboard, select X-ray.

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The Detector EnvironmentPRO Detectors

9. Select Begin Calibration to access the Calibration Progress Bar and the Status Bar
with a Ready status.
A message will prompt you to take the exposure.
10. Use the pre/exposure button to take the exposure.
11. Follow the prompts until all the necessary exposures are completed.
12. When the message, Calibration Successful appears, select OK.

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The Detector EnvironmentPRO Detectors

Wireless Operation
Icon Description

Wireless Operation
This symbol indicates that the detector and Console are successfully
communicating wirelessly.

Signal Strength
The strength of the wireless signal affects how quickly the detector
can transfer images to the Console.

No signal. Check the access point connection.

Poor signal. Check for obstructions to the antenna on the detector.

Adequate signal. A stronger signal may improve the rate at which


the detector transfers image data to the Console and eliminate the
possibility of a lost connection.

Good signal.

Excellent signal.

Wireless Icons for Mobile Systems


The following icons appear only on Mobile Systems.
Icon Description

No connection between the mobile Console and the hospital


network is established.

A wired connection between the mobile Console and the hospi-


tal network is established.

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The Detector EnvironmentPRO Detectors

Icon Description

A wireless connection between the mobile Console and the hos-


pital network is established.

Both wired and wireless connections between the mobile Con-


sole and the hospital network are established.

Requirements for Wireless Operation


1. Select an active, registered detector on the Console.
2. Operate the detector in a room not exceeding 9.14 m (30.00 ft) in length or width.
3. Comply with the recommended separation distance between RF communications
equipment and the system.
For more information, refer to your systems user guide.

Overview for Adding or Removing a DetectorPRO Detector

Note
The yellow buttons in the image appear if the user logs in as Service only.
Navigate to Utilities > Equipment Management > Detector.
Use the information in the following table to complete the fields on this screen.
Field Description

Status Group Allows you to remove a detector from the available detector list.
Click on any item in the row to select a detector.

Status A green dot with a white check mark indicates that the detector is
added for use on this console.

Icon Identifies each detector in the system by number and color of the
icons assigned label which are selected by the Key Operator and
affixed to the detector.

Description Displays the location/name of each detector in the system.

Detector Details Displays the following information about the selected detector:
Serial number
Model
Sensitivity

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The Detector EnvironmentPRO Detectors

Detector Battery Charge SymbolsPRO Detector


The battery is the power source for the detector.

Important
Use the Console to monitor the level of charge in the battery. The battery charge icons on the
detector help you determine whether the detector has adequate power to capture images.

Icon Name Description

Battery Power Status Indicates the amount of charge remaining in the


battery. A fully charged battery can capture
approximately 90 images. The symbol helps you
know when to change the battery.

Battery Empty Battery charge is depleted. You cannot take an


exposure.You must immediately replace the bat-
tery or use another detector which has a battery
with adequate charge.

25 % charged

50 % charged

75 % charged

100 % charged

Unknown The current state of the battery is unknown.

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Troubleshooting Detectors: Checklist


The checklist below offers basic corrective actions for common error situations. Refer to
the corresponding Troubleshooting topic(s) for corrective action.

Note
The checklist is not a substitute for preventative maintenance, repair, or troubleshooting for the
equipment by qualified service personnel. For critical repairs or situations outside the scope of
basic troubleshooting, please contact Service for assistance.

Symptom See Troubleshooting Topics

You are unable to take an exposure. Communication Errors


Inadequate Power
Incorrect Detector Identity

Calibration failure message appears Calibration Failure


during calibration. Sub-Optimal Image Quality
The image quality is not optimal.
Frequent reminders to calibrate appear on
the Console.
The image quality is not optimal. Overdue Calibration
Frequent reminders to calibrate appear on Sub-Optimal Image Quality
the Console.

The image quality is not optimal. Incorrect Detector Position


Sub-Optimal Image Quality

The acquired image is blank. Incorrect Detector Identity

Inadequate Power

Communication Errors or Battery Power

The status bar shows a message: Not Communication Errors


Ready: Detector Unavailable.

The Image Acquisition screen does not Incomplete Registration


show a new detector.

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Troubleshooting Detectors: Calibration FailurePRO Detector


SYMPTOMS: A message on the Console indicates that the calibration failed. The image
quality is not optimal.
RECOMMENDED CORRECTIVE ACTIONS:
1. Verify that a battery is inserted into the detector.
2. Verify the identity of the detector.
3. Do not touch Abort Calibration during calibration.
4. Do not navigate to another menu or screen until the calibration is complete and
successful.
5. Use the Calibration Progress Bar to track the exposures completed out of the total
number of required exposures. Complete all of the exposures.
6. For Dark Calibration, keep the detector away from potential noise sources.
7. Protect the detector from X-ray exposures during any calibration.

REQUIREMENTS:
Make sure the beam path is clear.
Make sure a battery is inserted into the detector.
Make sure the virtual keyboard settings are enabled.
Do not move the detector during the calibration process.
Use the correct SID.
Use the correct technique.
Make sure collimation is beyond detector edges.
Place the detector away from noise sources.

Note
If the calibration procedure continues to fail, contact the Center of Excellence (COE) for
assistance.

Troubleshooting Detectors: Communication ErrorsPRO Detector


SYMPTOMS: The status bar shows a Not Ready: Detector Unavailable message.
RECOMMENDED CORRECTIVE ACTIONS:
1. Verify that the detector is in the room.
2. Replace the battery with a fully charged battery.
3. Reboot the Console.

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

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Troubleshooting Detectors: Inactive Detector


SYMPTOMS: The detector is not selected. The detector is inactive.

The generator is selected. This option deactivates the detector and allows you to use
cassettes to capture an image.

RECOMMENDED ACTIONS:
1. Select the detector icon on the console.

The detector is active when the yellow border appears.

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The Detector EnvironmentPRO Detectors

2. After you activate the detector, use the Status bar to see the status of the detector.
The detector must be in the Ready (green) state.

Status Color Description

Ready Green The detector is active and available to


capture an image.

Detector Preparing for Yellow The detector is warming up. Press and
Exposure hold the button on the prep/exposure
switch in the prep position.

Detector Completed Pre- Yellow The detector is ready. Press the button
paring on the prep/exposure switch to the
exposure position.

Exposing Blue The generator initiates the exposure


and the detector receives the X-ray
image.

Acquiring Image Blue The exposure is complete and the gen-


erator shuts off. The detector sends the
image to the console.

Not Ready: Exposures Dis- Grey The exposures for the requested view
abled are complete. You can add a view, or
continue to the next view
and exposure.

Not Ready: Detector Grey The detector cannot capture an image.


Unavailable

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

Troubleshooting Detectors: Inadequate PowerPRO Detector


SYMPTOMS: You are unable to take an exposure. You see the following symbol:

RECOMMENDED CORRECTIVE ACTIONS:


1. Provide power to the detector with a fully charged battery.
2. Do one of the following:

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The Detector EnvironmentPRO Detectors

Replace the low or depleted battery with a fully charged battery.


If multiple detectors are registered on your system, check the battery status for
another detector. If another detector has adequate power, select and use that
detector for your exam.

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

Troubleshooting Detectors: Detector Not AvailablePRO Detector


SYMPTOM: The Image Acquisition screen does not show a new detector.
RECOMMENDED CORRECTIVE ACTIONS:
1. Verify that a battery is inserted in the detector.
A detector requires a battery. Without a battery, the detector is turned off. Verify
that a charged battery is inserted into the physical detector.
2. Verify that the detector is added for the system you are using.
3. Determine whether the system has reached the maximum limit of 2 PRO Detectors.
4. Perform a reboot on the Console.
The changes from the registration process do not take effect until after you reboot
the Console system.

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

Troubleshooting Detectors: Line Artifacts - PRO Detectors


SYMPTOMS: The acquired image is not optimal. An artifact of randomly spaced
horizontal lines or rows, which may or may not traverse the full width of the image when
viewed in portrait mode.
RECOMMENDED CORRECTIVE ACTIONS FOR BUCKY USE:

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Rotate the detector 180 .

Note
If the detector is rotated the image will also rotate, the key operator can change image rotation
underKey Operator > System Configuration > View Configuration.

RECOMMENDED CORRECTIVE ACTIONS FOR TABLETOP USE:


Place the detector on one end of the table and move the Bucky to the other end of the
table.

Note
Other factors that can contribute to line artifacts:
Grids
Calibration
Position
Technique
Orientation

Note
If the problem persists, call the Center of Excellence (COE) for assistance.

Troubleshooting Detectors: Detector Not AvailablePRO Detector


SYMPTOM: The Image Acquisition screen does not show a new detector.
RECOMMENDED CORRECTIVE ACTIONS:
1. Verify that a battery is inserted in the detector.
A detector requires a battery. Without a battery, the detector is turned off. Verify
that a charged battery is inserted into the physical detector.
2. Verify that the detector is added for the system you are using.
3. Determine whether the system has reached the maximum limit of 2 PRO Detectors.
4. Perform a reboot on the Console.
The changes from the registration process do not take effect until after you reboot
the Console system.

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

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Troubleshooting Detectors: White ImagePRO Detector


SYMPTOMS: You requested an exposure. The acquired image is white.
RECOMMENDED CORRECTIVE ACTIONS:
1. Was a CR Cassette used to acquire an image?
You must select the Generator Only button before an exposure is made on a
cassette. If this button is not selected the detector will acquire a blank image.
2. Did you take the image with the detector in the X-ray beam path?
If yes: Was the correct detector icon selected on the screen?
If no: Select the correct detector and restore the image.
If the problem persists, call Service.
3. Is the X-ray tube pointing to the correct detector?
4. Is the door to the room completely closed?
The generator can sense that the room is not secure and will not fire. A blank
image will result on the detector.
5. Does the tutor image icon have a red background and say Failed Acquisition?
If yes: Wait two minutes after the exposure before removing the battery to
reboot the detector. When the battery is replaced and the detector boots, the
image can be found as Unassigned in the Image Review list or it can be
recovered from the Image Recovery list.
6. Is the system operating in Beam Detect mode?
If yes: position the detector before pressing the Activate button on the Console
in order to minimize detector movement.

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

Troubleshooting Detectors: Overdue Calibration


SYMPTOMS: Image quality is not optimal. A message on the console indicates that the
calibration is overdue.
RECOMMENDED CORRECTIVE ACTIONS:
1. Go to Utilities > Detector Calibration.
2. Select and activate a specific detector.
3. Select Calibration Type to access the virtual keyboard.
4. Select a specific calibration type.

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5. Look at the Date/Time Last Calibrated for each calibration type.


6. Run calibrations as necessary.

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

Troubleshooting Detectors: Sub-Optimal Image Quality


SYMPTOM: The image quality is less than optimal.

RECOMMENDED CORRECTIVE ACTIONS:


Verify that each of the following were performed correctly.
1. Settings and Tasks
a. Acquisition
b. Technique
c. Positioning
d. Collimation
e. Body Part and Position Selections
2. Radiographic Equipment
a. Grid
b. AEC/Photometers
c. Tube Calibration
3. Detector
a. Detector Orientation
b. Detector Calibration

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

Equipment Management ScreenPRO Detectors


From the main Menu, select Utilities > Equipment Management.

The Equipment Management screen is used by the technologist or a Key Operator to


add or remove a detector from the system.

Equipment ManagementPRO Detector


From the Main Menu, select Utilities > Equipment Management.
The Equipment Management screen is used by the technologist or a Key Operator to
add or remove a detector from the system.

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For additional information see Adding and Registering a Detector.

Access Point Tab


The Access Point acts as a wireless hub for connectivity to a secure hospital network.
The technologist can view the network setting for the Access Point.
The Key Operator can change the Access Point configuration, based on the rules set by
the customer. The customer site will provide the IP address, Server, and determine the
access allowed by Carestream.

Equipment Management Screen


From the main Menu, select Utilities > Equipment Management.

The Equipment Management screen is used by the technologist to enable or disable a


detector in the System. It allows the Key Operator to add or remove a detector from the
system.

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Detector OverviewDRX Detectors


Each enabled DRX detector is represented in the Image Acquisition screen by an
instance of the DRX detector Status Control.

DRX Detector Status Control


The color of the border and the background color of the DRX Detector Status Control
indicate the status of the detector as it pertains to the next image acquisition.
Status Description

InactiveThe detector is not selected. You can-


not use it to acquire images.

ConnectingThe DRX System software is con-


necting to the detector over the network. The
gears icon will temporarily replace the detector
identifier icon while the connection is being
established. Once the communication attempt
has completed, the detector icon will be dis-
played.

Active Standard ExposureYou have


selected the detector and it can be used to
acquire images. The grey background indicates
an exposure of up to 800ms can be performed.

Active Extended ExposureYou have


selected the detector and it can be used to
acquire images. The dark blue background indi-
cates an exposure of up to 3 seconds can be
performed.

The DRX Detector Status Control also provides you with other important information
about:
Detector orientation
Detector identity
Battery life
Detector awake or asleep
Wireless or wired communications
Wireless signal strength

Note
This information does not apply to the PRO detectors. See Detector OverviewPRO for
information on the PRO detectors.

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How to Activate a Detector


1. From the Console, access the Image Acquisition screen.
2. Select the detector that you want to activate and use for the exam.
3. View the Status bar. When a status of Ready appears, you can use the detector to
capture images.
4. Proceed with image acquisition tasks.
Status Description

The Console is connecting to the detector over the net-


work.

Active You have selected the detector for an exam.


The Console is connected to the detector to receive image
data over the network.

(yellow border)

Inactive The detector is not selected. You cannot use the Console
and the detector for image acquisition.

(gray background)

Note
If you want to take exposures using a cassette, you must deactivate the detector and select the
Generator icon.

The Detector EnvironmentDRX Detectors


The DRX-1 System includes a cassette-size digital radiography detector. No modifications
to the Bucky or generator are required to use the detector in existing analog rooms.
You can use the DRX detector in a Bucky. You can also use the detector to capture images
on a tabletop, similar to a cassette. Wireless operation is the default mode.
The Wall Bucky may accommodate the DRX-1 System Tether Interface. When you place a
DRX detector in a Bucky and connect the detector to the tether interface, the tether
interface provides power and data.
If you disconnect the tether interface, the DRX-1 System automatically defaults to
wireless operation.
Refer to CARESTREAM DRX-1 System User's Guide for product safety information.

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Using the Detector


Look at the Status bar in the middle of the screen for information about the detector
state.
1. In the exam room, look at the detector surface for an identification label.
2. Hold the detector with the identification label toward you.
3. Put the detector in a Bucky or position the detector for a tabletop exam.
4. At the Console, access the Image Acquisition screen.
5. If not previously activated, touch the Status Control that matches the identification
label.
6. Add or modify exam information.
7. Add or delete views.
8. On the prep/exposure switch, press and hold the button halfway down to the prep
position.
9. When the generator is prepped, press the button completely to take the exposure.

Note
You can press the button completely without holding in the prep position. However, the
generator must delay firing until the generator and the detector finish their preparation processes.

Detector IdentificationDRX Detectors

Detector Icon

This icon identifies a detector that is registered for use in the system. The icon
corresponds to a unique identification label on the physical detector. The Detector Icon
is applied during the detector registration process.

Note
Only enabled detectors will appear on the Image Acquisition or Detector Calibration screens.
If you dont see the icon of the detector you want to use, follow the Detector Migration process.
See Detector Migration for details.

Benefits of Knowing the Identity of a Detector


Each Console supports up to eight detectors per exam room, three of which may be
available for use at one time.
When multiple detectors are available, it is important for you to correctly identify each
detector. Knowing how to locate the identity of each detector helps you to:

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Choose and activate the correct detector for the image study
Register or enable a new detector for use on the system
Disable or remove a detector for use on a system
Verify that you are performing calibrations on the correct detector

Tasks that Use the Detector Icon


During daily operation, you will view the Detector Icon most often from the
Image Acquisition screen.
There are several other menus and functions which use the Detector Icon. Your operation
rights, permission, or privileges will determine which menus you can access.
From Main Menu > Utilities > Equipment Management: You can add, remove,
enable, or disable a detector.
From Main Menu > Utilities > Detector Calibration: You can run a Daily Dark or
X-ray calibration on a detector.

How to Position the DetectorDRX Detectors


For optimal image results when performing an exam, you must use the detector in the
proper position and orientation inside the Bucky. The System includes portrait/landscape
labels for each Bucky.
1. Locate the portrait/landscape label on the wall stand or table Bucky.
2. Locate the identification label on the detector.
3. Adjust the position of the detector until the position of the identification label
matches the portrait/landscape label on the Bucky.
The portrait/landscape labels show the correct orientation of the detector inside the
Bucky for portrait and landscape exams.

Note
This information does not apply to the PRO detectors.

Auto Detector Orientation


DRX detectors are designed to send information about how they are oriented during an
exam. In this way, the System software will automatically apply any necessary image
rotation, so that it is presented in the Console user interface properly.
Detector Orientation icons report up to four positions:

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Icon Display Orientation

Portrait

Landscape

Unknown. The Detector is probably slightly rotated or


skewed in such a way that the System cannot sense
actual orientation.

Flat/Other. Detector is laid flat on a table or other flat


surface.

Fast PreviewDRX Detectors


The Fast Preview function allows the System to generate and display a preview image
in a short period of time (< 5 seconds).
The Key Operator can enable the Fast Preview function.

Note
The Fast Preview image uses alternative image processing and may have a different appearance
than the image provided with the standard preview.

Note
The PRO detectors run in Fast Preview automatically. This feature is not configurable with the PRO
detectors.

How to Enable or Disable Fast PreviewDRX Detectors


1. Go to Main Menu > Key Operator Functions > System Configuration > Display
Configuration.
2. Select the DRX Display Settings tab.
3. Choose one of the following:
To enable Fast Preview, select the Fast Preview check box.
To disable Fast Preview, clear the Fast Preview check box.
4. Select Save Changes.

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DRX Detector RulesDRX Detectors


The same rules for using a single detector apply to using multiple detectors.

Detector Identity
You must select and activate a specific detector on the Console prior to taking an
exposure.
Always verify the identity of the detector you are using for an exam prior to taking
an exposure.
Each detector must have a complete identity, which includes an identification label
and a Detector Icon.

Detector Registration
You must register each detector on a DRX-1 System. Each Console supports up to
eight registered detectors, with three active at any one time.
You cannot exceed the eight-detector limit on one Console.
Assign a purpose and location for each detector.
For example, one detector is always in the wall stand Bucky, one detector is always in
the table Bucky, and one detector is always mobile and used for tabletop exams or
placed on the patient.
Detectors do not need to be powered on to be registered.

Enable the Detector

Caution
Before enabling a detector, ensure no other detectors are being enabled or disabled at the same
time as this can cause communication issues.
You must enable each detector on the DRX-1 System it will be actively used on.
A detector can only be enabled on one DRX-1 System at one time, but may be
registered on multiple Consoles.

Detector Calibration
You must calibrate each detector daily.
If the Key Operator does not configure the system to calibrate automatically, it will
have to be calibrated manually.
You must calibrate the detector when requested by the software.

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Calibration Types, Frequency, and Duration


DRX Plus Detector
Family Calibration Type Frequency Duration

Dark Calibration Daily Less than 1 minute

X-ray Full Annually 10 minutes

X-ray Express As needed 5 minutes

DRX-1 Detector Family Calibration Type Frequency Duration

Dark Calibration Daily Less than 5 minutes

X-ray Full Every 6 months 10 or more minutes

PRO Detector Family Calibration Type Frequency Duration

Dark Calibration Daily Less than 5 minutes

X-ray Full Every 6 months 20 or more minutes

Note
Perform detector calibration if the system prompts you to do so. If the detector is dropped, a new
calibration will be needed at that time.

Note
The Dark calibration must be performed if the Key Operator for the site has disabled the
automatic daily dark feature, or if automatic Dark calibration fails for a specific period of time:
DRX Plus Detector Family: after the calibration fails for 10 weeks
DRX-1 Detector Family: after the calibration fails for 10 days.
PRO Detector Family: after the calibration fails for 10 days.

Run the Dark Calibrations


The Dark Calibration needs to be performed manually only if the Key Operator has
disabled the automatic daily dark feature which requires no user interaction, or if the
automatic daily dark fails for ten days.
1. Go to Utilities > Detector Calibration.
2. Select and activate the detector you want to calibrate.
3. Select Calibration Type.
4. In the virtual keyboard, select the Dark Calibration radio button.

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5. Select Begin Calibration.


The calibrations run automatically. View the progress on the Calibration Progress Bar.
6. When the message, Calibration Successful appears, select OK.
7. If necessary, repeat the calibration steps to:
Run another calibration type on the same detector
Run calibrations on another detector

Run X-ray CalibrationsDRX Detectors


1. Place the DRX Detector in the calibration tray.
2. Set the SID to 182 cm (72 in.).
3. Verify that the collimator blades are completely open.
4. Insert the 0.5 mm copper / 1 mm aluminum filter onto the collimator, with the copper
side facing the tube.
5. Ensure that nothing is in the beam path.
6. From the Console, navigate to Utilities > Detector Calibration.
7. Select and activate the detector you want to calibrate.
8. Select Calibration Type.
9. In the virtual keyboard, select X-ray.
10. Select Begin Calibration to access the Calibration Progress Bar and the Status Bar
with a Ready status.
A message will prompt you to take the exposure.
11. Use the pre/exposure button to take the exposure.
12. Follow the prompts until all the necessary exposures are completed.
13. When the message, Calibration Successful appears, select OK.

Postrequisites:
Flat Field Analysis is started automatically as part of X-ray calibration.
See Flat Field Analysis for details.

How to Perform X-ray Express Calibration


The X-ray Express calibration is a short calibration for the DRX Plus detector and can
reduce the time it takes to perform calibration. X-ray Express calibration takes
approximately five minutes to perform.

Note
When major shock has happened to the detector, only Full X-ray calibration is allowed.
Verify that Set Beam Output has been done before you do X-ray Express calibration.

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Set Beam Output is a Key Operator function and can be done only by Service or a Key
Operator.
1. Navigate to Utilities > DRX Detector Calibration.
2. From the menu in the Calibration Type tab, select X-ray Express calibration.
3. Follow the on-screen instructions to set up the detector.
4. Enter the technique settings shown on the screen into the generator.

Note
For non-Beam Detect mode, use the interface on the Console.
For Beam Detect mode, use the generator switch.
5. Make eight exposures as directed in the on-screen instructions.

Note
X-ray Express calibration does not take the place of Full Calibration. DRX Plus detectors are
calibrated annually.

Tether Interface
The DRX Evolution Wall and Table Buckys automatically tether the detector when the
detector is inserted in portrait orientation. When tethered, the tether interface provides
power and data transfer. Wireless operation does not occur when the detector is
connected to the tether. The detector battery is charging when in this orientation.
If you disconnect the tether interface, the DRX detector automatically defaults to
wireless operation.
Icon Description

Tether Interface
The detector is presently connected to the tether interface
at a Bucky location. The detector transfers image data and
receives power through the tether interface.

Tether Interface Communication Trouble


The detector is not communicating with the software. Be
sure the detector is inserted with the tether connector fac-
ing toward the back of the Bucky. Be sure the Bucky is
pushed in completely.

Charging
The tether interface cable is charging the battery inside the
detector.

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Note
A battery must be inserted in the detector for correct operation. When you use the tether
interface, the power supplied through the tether also charges the battery.
If the tether interface cable is damaged, you can order a separate replacement cable.

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Wireless Operation
Icon Description

Wireless Operation
This symbol indicates that the detector and Console are successfully
communicating wirelessly.

Signal Strength
The strength of the wireless signal affects how quickly the detector
can transfer images to the Console.

No signal. Check the access point connection.

Poor signal. Check for obstructions to the antenna on the detector.

Adequate signal. A stronger signal may improve the rate at which


the detector transfers image data to the Console and eliminate the
possibility of a lost connection.

Good signal.

Excellent signal.

Wireless Icons for Mobile Systems

The following icons appear only on Mobile Systems.


Icon Description

No connection between the mobile Console and the hospital


network is established.

A wired connection between the mobile Console and the hospi-


tal network is established.

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Icon Description

A wireless connection between the mobile Console and the hos-


pital network is established.

Both wired and wireless connections between the mobile Con-


sole and the hospital network are established.

Requirements for Wireless Operation

1. Select an active, registered detector on the Console.


2. Operate the detector in a room not exceeding 9.14 m (30.00 ft) in length or width.
3. Comply with the recommended separation distance between RF communications
equipment and the system.
For more information, refer to your systems user guide.

How to Use a Wireless Console and Detector

1. Verify the detector identity.


2. From the Console, verify that there is sufficient charge on the battery in the detector.
3. From the Console, verify that the detector has a signal strength of Adequate, Good,
or Excellent.
4. If not previously activated, touch the detector's status control to select it as the active
detector.
5. Proceed with image acquisition tasks.
You can monitor the strength of the wireless signal and amount of battery charge
available to the detector from the Console.

Important
Monitor the battery power carefully. The only power source for the detector is the battery.
6. If you have acquired an image and the wireless communication encounters an error,
Refer to Troubleshooting Detectors: Communication Errors.

Enterprise Wireless DRX Plus Detector

Image information is transmitted wirelessly from a DRX Plus detector to the Console. To
ensure security for a wireless exchange, Carestream Health provides certificate-based

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authentication between devices. The certificate is an electronic document that identifies


a user and confirms the identity of that user to another party.
The hospital installs a standalone application that creates an Enterprise Wireless
Deployment file. This file is downloaded to a DRX detector, and qualifies a detector for
authentication with a hospital Remote Authentication Dial In User Service (RADIUS)
server.
After successful authentication, detector to Console communication is established using
hospital access point(s).
Enterprise Wireless uses authentication protocols between the DRX detector, the
hospital Access Point, and a hospital RADIUS server. If a facility purchases Enterprise
Wireless, all DRX detectors used in the facility must be configured for Enterprise Wireless.
To achieve Enterprise Wireless, the following must take place:
1. the hospital information technology (IT) staff creates and Enterprise Wireless
Deployment file for each detector.
2. The Service representative configures the detector for communication with the
hospital wireless.

Note
If a detector is configured with a certificate and is moved to a Console that does not expect it, the
detector will not work.

What is Remote Authentication Dial In User Service (RADIUS)?

A RADIUS server is a networking protocol that provides certified authentication,


authorization, and accounting management for computers to connect and use a network
service.
The RADIUS server provides the following functions:
Authenticates users or devices before granting them access to a network
Authorizes those users of devices for certain network services
Accounts for usage of those services

Access Point

The access point provides wireless connectivity to a detector.


The technologist can view the network setting and configuration for the access point.
The Key Operator can change the settings and configuration for the access point based
on the rules set by the customer site.
The customer site provides the IP address, server, and access allowed for service and
support.

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Change Battery
You can change the detector battery without causing the detector to reboot or lose
wireless connection.
Remove the battery and replace it within 15 seconds and the detector will continue to
run. If the battery is removed for more than 15 seconds, the detector will shut down.

Note
If left undisturbed, the detector will remain active until the battery runs out.

How to Add or Remove a DetectorDRX Detectors

Note
The yellow buttons in the image appear if the user logs in as Service only.
Navigate to Utilities > Equipment Management > DRX-1 tab.
Use the information in the following table to complete the fields on this screen.
Field Description

DRX-1 Status Group Allows you to add or remove a detector from the avail-
able detector list. Click on any item in the row to select
a detector. Use the scroll bar arrows to display more
detectors.

Status A green dot with a white check mark indicates that


the detector is enabled for use on this console.
A red dot with a minus sign indicates that the
detector is registered for use but not enabled.

Icon Identifies each detector in the system, by number and


color of the icons assigned label, selected by the Key
Operator and affixed to the detector.

Description Displays the location/name of each detector in the sys-


tem.

Detector Details Displays the following information about the selected


detector:
Serial number
Model
Installation Date (a pop-up message appears when
the certificate is going to expire)
Sensitivity
Credential Expiration Date (displays the expiration
date if Enterprise Security is enabled at the Access
Point.)

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Detector Battery Charge SymbolsDRX Detectors


The battery is the power source for the DRX Detector.

Important
Use the Console to monitor the level of charge in the battery. The battery charge icons on the
detector help you determine whether the detector has adequate power to capture images.

Icon Name Description

Charging The DRX Tether Interface cable is charging the


battery inside the detector.

Battery Power Status Indicates the amount of charge remaining in the


battery. A fully charged battery can capture
approximately 90 images. The symbol helps you
know when to change the battery.

Battery Empty Battery charge is depleted. You cannot take an


exposure.You must immediately replace the bat-
tery or use another detector which has a battery
with adequate charge.

25 % charged

50 % charged

75 % charged

100 % charged

Unknown The current state of the battery is unknown.

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What is Detector Migration?


Detector Migration allows users to enable and disable combinations of up to three
previously registered detectors on any given console. Up to eight detectors may be
registered on a single console, depending on the System.
Detector Migration is an effective workflow aid and time saver, as it allows a User in a
busy area to quickly move Detectors to other consoles without having to perform
registration and related configuration and reboot procedures.

How to Wake Up the Detector

DRX-1 Detectors Remove the detector battery, wait 10


seconds, and reinsert the battery.
Shake the detector.
Connect a tether.

DRX Plus Detectors Press and release the Reset button


on the side of the detector.

PRO Detectors Does not apply to PRO detectors. They do


not have Sleep mode.

How to Enable or Disable a Registered Detector


Use this task to enable or disable combinations of up to three previously-registered
detectors on a Console. This task is also known as Detector Migration.

Prerequisites:
If enabling a detector, insert the battery into the detector before starting these steps.

1. From the Console Main Menu, select Utilities > Equipment Management.
You will be presented with the list of the detectors currently registered on the system.
Icon Detector status

The detector is enabled and available for use with the console.

The detector is registered but disabled for use with the console.

2. To change a detector's availability with the console, first select that detector's row.

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3. Select either the Enable Detector or Disable Detector button.


Various status messages will be displayed during the process. A dialog message will
be displayed confirming the success or failure of the operation.

Postrequisites:
When disabling a detector, once the process completes you should remove the detector
battery.

Troubleshooting Detectors

Troubleshooting Detectors: Checklist

The checklist below offers basic corrective actions for common error situations. Refer to
the corresponding Troubleshooting topic(s) for corrective action.

Note
The checklist is not a substitute for preventative maintenance, repair, or troubleshooting for the
equipment by qualified service personnel. For critical repairs or situations outside the scope of
basic troubleshooting, please contact Service for assistance.

Symptom See Troubleshooting Topics

You are unable to take an exposure. Communication Errors


Inadequate Power
Incorrect Detector Identity

Calibration failure message appears Calibration Failure


during calibration. Sub-Optimal Image Quality
The image quality is not optimal.
Frequent reminders to calibrate appear on
the Console.
The image quality is not optimal. Overdue Calibration
Frequent reminders to calibrate appear on Sub-Optimal Image Quality
the Console.

The image quality is not optimal. Incorrect Detector Position


Sub-Optimal Image Quality

The acquired image is blank. Incorrect Detector Identity

Inadequate Power

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Symptom See Troubleshooting Topics

Communication Errors or Battery Power

The status bar shows a message: Not Communication Errors


Ready: Detector Unavailable.

The Image Acquisition screen does not Incomplete Registration


show a new detector.

Troubleshooting Detectors: Calibration Failure

SYMPTOMS: A message on the Console indicates that the calibration failed. The Image
Quality is not optimal.
RECOMMENDED CORRECTIVE ACTIONS:
1. Calibrate the detector.
2. Verify that a battery is inserted into the detector.
3. Verify the identity of the detector.
4. Do not touch Abort Calibration during calibration.
5. Do not navigate to another menu or screen until the calibration is complete and
successful.
6. Use the Calibration Progress Bar to track the exposures completed out of the total
number of required exposures. Complete all of the exposures.
7. For Daily Dark Calibration, keep the detector away from potential noise sources.
8. Protect the detector from X-ray exposures during the calibration.

REQUIREMENTS:
A battery is inserted into the detector.
Virtual keyboard settings are enabled.
0.5 mm copper / 1 mm aluminum filter is used for X-ray calibration.
Do not move the detector during the calibration process.
Use the correct SID.
Use the correct technique.

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Make sure collimation is beyond detector edges.


Place the detector away from noise sources.

Note
If the calibration procedure continues to fail, contact the Center of Excellence for assistance.

Troubleshooting Detectors: Communication ErrorsDRX Detectors

SYMPTOMS: The Status bar shows a Not Ready: Detector Unavailable message.
You see one of the following symbols:

RECOMMENDED CORRECTIVE ACTIONS:


1. Verify that the detector is in the room.
2. Replace the battery with a fully charged battery.

Note
For DRX Plus detectors, press and release the Reset button.
3. Wake up the detector.
4. Connect the tether (if purchased).
If you are using the DRX detector in the wireless mode to acquire images and lose
communication after the image is acquired, you can use the DRX System Tether
Interface to retrieve the acquired image.
To use the tether interface to retrieve image data on the detector:
a. Place the detector in the Bucky.
b. From the Bucky, connect the tether interface cable head to the detector.
c. From the Console, confirm that the tether connection is successful.

The tether symbol indicates a successful tether connection.


d. From the Console, use the Image Acquisition screen and Image Review screen
to preview, view, and accept the image.
5. Reboot the Console.

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

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Detector OverviewDRX Detectors

Troubleshooting Detectors: Inactive Detector

SYMPTOMS: The detector is not selected. The detector is inactive.

The generator is selected. This option deactivates the detector and allows you to use
cassettes to capture an image.

RECOMMENDED ACTIONS:
1. Select the detector icon on the console.

The detector is active when the yellow border appears.

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Detector OverviewDRX Detectors

2. After you activate the detector, use the Status bar to see the status of the detector.
The detector must be in the Ready (green) state.

Status Color Description

Ready Green The detector is active and available to


capture an image.

Detector Preparing for Yellow The detector is warming up. Press and
Exposure hold the button on the prep/exposure
switch in the prep position.

Detector Completed Pre- Yellow The detector is ready. Press the button
paring on the prep/exposure switch to the
exposure position.

Exposing Blue The generator initiates the exposure


and the detector receives the X-ray
image.

Acquiring Image Blue The exposure is complete and the gen-


erator shuts off. The detector sends the
image to the console.

Not Ready: Exposures Dis- Grey The exposures for the requested view
abled are complete. You can add a view, or
continue to the next view
and exposure.

Not Ready: Detector Grey The detector cannot capture an image.


Unavailable

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

Troubleshooting Detectors: Inadequate Power

SYMPTOMS: You are unable to take an exposure. You see the following symbol:

DRX-1The green LED on the detector flashes in a pattern of five rapid pulses.
DRX PlusThe Power LED will light magenta.
RECOMMENDED CORRECTIVE ACTIONS:
1. Provide power to the detector with a fully charged battery.
2. Do one of the following:
Replace the low or depleted battery with a fully charged battery.

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Detector OverviewDRX Detectors

If multiple detectors are registered on your System, check the battery status for
another detector. If another detector has adequate power, select and use that
detector for your exam.
Use the detector in a Bucky in the Portrait orientation so it can be charged.

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

Troubleshooting Detectors: Detector Not AvailableDRX Detectors

SYMPTOM: The Image Acquisition screen does not show a new detector.
RECOMMENDED CORRECTIVE ACTIONS:
1. Verify that a battery is inserted in the detector.
A detector requires a battery. Without a battery, the detector is turned off. Verify
that a charged battery is inserted into the physical detector.
2. Verify that the detector is registered for the System you are using.
Registration for one detector does not automatically transfer across multiple DRX
System Consoles in one location.
a. You must manually register the detector on the specific DRX System that you plan
to use for the exam.
b. The detector is registered if the identification mark on the detector corresponds
to the detector identity shown on the Console.
c. You can register up to eight detectors on one Console.
3. Determine whether the system has reached the maximum limit for detectors.
You can register a maximum of eight detectors concurrently to one Console.
a. View the number of existing detectors.
b. If eight detectors are already registered on the Console, remove an existing
detector.
c. Register the new detector.
4. Verify that the detector has been enabled for use on the Console.
Does the detector show this icon next to it in the Equipment Management
screen.
If no, refer to the topic Detector Migration.
If yes, continue to the last step.
5. Perform a reboot on the Console.
The changes from the registration process do not take effect until after you reboot
the Console system.

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

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Detector OverviewDRX Detectors

Troubleshooting Detectors: White ImageDRX Detector

SYMPTOMS: You requested an exposure. The acquired image is white.


RECOMMENDED CORRECTIVE ACTIONS:
1. Was a CR Cassette used to acquire an image?
If yes, the Generator Only button was not pressed before the exposure was
made on the cassette and the detector acquired a non-committal image.
2. Did you take the image with the detector in the X-ray beam path?
If yes: Was the correct detector Icon selected on the screen?
If no: Select the correct detector and restore the image.
If the problem persists, call Service.
3. Is the Bucky drawer seated properly?
If no, the generator will not fire and a blank image will result on the detector.
Make sure the Bucky drawer is seated properly before making an exposure.
4. Is the door to the room completely closed?
If no, the generator will sense that the room is not secure and will not fire the
generator. A blank image will result on the detector.
5. Does the tutor image icon have a red background and say Failed Acquisition?
If yes: Wait two minutes after the exposure before removing the battery to
reboot the detector. When the battery is replaced and the detector boots, the
image can be found as Unassigned in the Image Review list or it can be
recovered from the Image Recovery list.
If the image is retained in Beam Detect mode, the image will transfer to the
Console as an unassigned image when the detector reboots.
6. Is the system operating in Beam Detect mode?
If yes, position the detector before pressing the Activate button on the Console
in order to minimize detector movement.

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

Troubleshooting Detectors: Line Artifacts

SYMPTOMS: The acquired image is not optimal. An artifact of randomly spaced


horizontal lines or rows, which may or may not traverse the full width of the image when
viewed in portrait mode.
RECOMMENDED CORRECTIVE ACTIONS FOR BUCKY USE:
1. Verify that the detector is positioned in the correct orientation inside the Bucky.
When the detector is positioned correctly, the orientation of identification label on
the detector will match the orientation portrait/landscape label on the Bucky.

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Detector OverviewDRX Detectors

2. If the detector is not in the correct position:


a. Locate the portrait/landscape label on the wall stand or table Bucky.
b. Locate the identification label on the detector.
c. Adjust the position of the detector until the position of the identification label
matches the portrait/landscape label on the Bucky.

RECOMMENDED CORRECTIVE ACTIONS FOR TABLETOP USE:


Place the detector on one end of the table and move the Bucky to the other end of the
table.

Note
Other factors that can contribute to line artifacts:
Grids
Calibration
Position
Technique
Orientation

Note
If the problem persists, call the Center of Excellence (COE) for assistance.

Troubleshooting Detectors: Overdue Calibration

SYMPTOMS: Image quality is not optimal. A message on the console indicates that the
calibration is overdue.
RECOMMENDED CORRECTIVE ACTIONS:
1. Go to Utilities > Detector Calibration.
2. Select and activate a specific detector.
3. Select Calibration Type to access the virtual keyboard.
4. Select a specific calibration type.
5. Look at the Date/Time Last Calibrated for each calibration type.
6. Run calibrations as necessary.

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

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Detector OverviewDRX Detectors

Troubleshooting Detectors: Sub-Optimal Image Quality

SYMPTOM: The image quality is less than optimal.

RECOMMENDED CORRECTIVE ACTIONS:


Verify that each of the following were performed correctly.
1. Settings and Tasks
a. Acquisition
b. Technique
c. Positioning
d. Collimation
e. Body Part and Position Selections
2. Radiographic Equipment
a. Grid
b. AEC/Photometers
c. Tube Calibration
3. Detector
a. Detector Orientation
b. Detector Calibration

Note
If the problem persists, contact the Center of Excellence (COE) for assistance.

TroubleshootingInactive Detector with Beam Detect Mode

SYMPTOM: The detector is selected, but the image is not captured.


Is the system operating in Beam Detect mode?
If Yes, verify that the Console Status Bar indicates the detector is Ready before pressing
the Prep/Expose button.

About Sleep ModeDRX Detectors


In order to maximize detector battery life, the detector can be configured to enter a
"Sleep" mode after a certain period of time. When the detector enters Sleep mode, an
icon will appear in the User Interface (UI). See figure below:

Depending on your workflow needs, Sleep mode can be enabled and disabled, and the
duration time before entering Sleep mode can be configured.

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Detector OverviewDRX Detectors

Note
DRX-1 and DRX Plus detectors have Sleep mode. PRO detectors do not have the Sleep mode
feature.

How to Enable or Disable Sleep ModeDRX Detectors

Prerequisites:
You must be logged in as a Key Operator.

1. Go to Key Operator Functions > DRX Detector Settings.


2. To enable Sleep mode, uncheck the Disable check box.
3. To disable Sleep mode, check the Disable check box.
The detector will NOT enter Sleep mode if the user is within any of the following
screens:
Image Acquisition
Detector Diagnosis
Image List

Note
DRX-1 and DRX Plus detectors have Sleep mode. PRO detectors do not have the Sleep mode
feature.

How to Configure the Duration Time Before Entering Sleep ModeDRX


Detectors

1. Go to Key Operator Functions > DRX Detector Settings.


2. Make sure the Sleep Mode check box is checked.
3. To configure a custom inactivity period, enter a value between 10 and 20 (minutes)
in the text box.
Minimum duration time = 10 minutes. Maximum duration time = 120 minutes.
Default value = 30 minutes.

Note
DRX-1 and DRX Plus detectors have Sleep mode. PRO detectors do not have the Sleep mode
feature.

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DR Total Quality Tool Overview

DR Total Quality Tool Overview


The DR Total Quality Tool (TQT) software analyzes the performance of your DR detector
for three important characteristics: Flat Field, Dark Noise, and Phantom image test
performance. Test results are provided automatically with historical trending. You can
export this data for independent analysis.

What is DR TQT?
DR TQT is a DR imaging system quality performance monitoring tool. It supplies support
for features such as:
Beam output
Image capture
Image export
Image import
Data export
Data trend charting
DR TQT analyzes signal, noise, and resolution characteristics for DR detectors.

What Does the Tool Test?


The tool performs tests and reports the results for image tests in three major categories:
Flat FieldFour exposures at pre-set mAs with no object in front of the detector.
PhantomA single exposure at a pre-set mAs with the DR TQT Phantom in front of
the detector.
Dark NoiseTests are performed automatically on CARESTREAM detectors. They do
not require an X-ray exposure.

How are the Test Results Presented?


After test exposures are complete, the DR TQT Results page appears, displaying the
results of each test in each category.
Green buttons indicate a successful test that is within specifications.
Red buttons indicate that a test has failed, and the results are outside the parameters
for image quality.
You can export test results to a selected drive. This file is integrated into the
Administrative Analysis and Reporting Software to record and track test results.

DR TQT - What Should I do if a TQT Test Fails?


1. Check the setup and make sure it meets the specifications for testing.
2. Retest and verify the results.
3. Calibrate the detector.
4. Call Service.

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DR Total Quality Tool Overview

DR TQT - Flat Field Analysis


Prerequisites:
Flat Field Analysis is started automatically as part of X-ray calibration.

Following X-ray Calibrations, Flat Field Analysis occurs with 4 exposures at 4 techniques.
Calibration with X-ray should be performed monthly. It takes approximately 30 minutes
and requires approximately 16 exposures.
1. Set the SID to 182 cm (72 in.) for Wall Stand and 132 cm (52 in.) for Table (fixed
detector).
2. Remove the grid.
3. Verify that the collimator blades are completely open.
4. Insert the 0.5 mm copper / 1.0 mm aluminum filter onto the collimator, with the
copper side facing the tube.
5. Ensure that nothing is in the beam path.
6. Select Begin Calibration to access the Calibration Progress Bar and the Status Bar
with a Ready status.
A message will prompt you to take the exposure.
7. Do not move the detector.
8. Use the pre/exposure button to take the exposure.
9. Follow the prompts until all the necessary exposures are completed.
10. When the message, Calibration Successful appears, select OK.
11. Remove the filter.

DR TQT - Configuration Workflow


Access this sequence of screens to configure the system and perform TQT Analysis:

DR Detector Configuration
1. Set Beam Output
2. Calibration Technique Setting for CsI Detectors
3. Calibration Technique Setting for GOS Detectors
4. TQT Configuration
Technique Configuration
DR Acquisition Technique Configuration
5. Tolerance Configuration

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DR Total Quality Tool Overview

DR TQT Analysis
1. DR TQT Analysis
Flat Field Image Acquisition
Phantom TQT Image Acquisition
2. Data Results Review
DR TQT Results
3. Import/Export Test Results

DR TQT - Calibration Techniques Configuration


The Calibration Techniques Configuration screen lets the user configure the system
for TQT Analysis. Configuration of calibration techniques must be performed before TQT
Analysis can begin.
Each section must be completed in sequence before selecting Next to proceed.
Configuration of calibration techniques is required by the TQT Analysis to calculate
sensitivity and correctly calculate the actual mAs value for each exposure that is set in the
Calibration Techniques Configuration screen.

DR TQT - How to Configure Calibration Techniques

Go to Calibration Techniques Configuration > Technique Identification.


The Technique Identification screen displays generator controls for DR Systems that
use generators. The mAs control is active.
1. Use the generator control to achieve an actual mAs value closest to the Aim mAs
value.
2. Enter the actual value in the corresponding Actual mAs field.
3. Save Changes.

DR TQT - Configuration Parameters


The Configuration Parameters screen displays the tolerance parameters and
specifications used by the DR TQT Analysis for each type of analysis. You cannot edit this
screen.
Three tabs provide for the following analyses:
Flat Field (also shows detector specification parameters)
Dark Noise
Phantom
Each tab lists the available detector types, which you can select to display the parameters
that apply to that detector.

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DR Total Quality Tool Overview

DR TQT - Acquisition Technique Configuration


The Acquisition Technique Configuration screen is used for systems that have an
interface to the generator. This screen is used during installation to establish the
achievable generator settings at which the DR TQT Analysis images will be exposed.
The recommended target mAs values are calculated based on the beam output
calculated on the Set Beam Output screen, which must be completed first. The screen
lets you interact with the generator to find the closest achievable mAs. These values are
then used during image acquisition for the selected analysis. The Acquisition
Technique Configuration screen must be completed for each detector type.
Follow the on-screen instructions including:
DetectorSelect a receptor type.
Flat FieldChange the generator settings to achieve a value closest to the target
mAs that was determined when setting the beam output.
PhantomChange the generator settings to achieve a value closest to the target
mAs that was determined when setting the beam output.
kVpSet on the Calibration Techniques Configuration screen.
SIDSet on the Calibration Techniques Configuration screen.

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How to Use the Prep/Expose Switch

How to Use the Prep/Expose Switch


Prerequisites:
When taking an exposure, employ the use of appropriate radiation protection and safety
measures for you and your patient.

Wait until the status bar is green and reads Ready.


1. Give the patient the appropriate breathing instructions.
2. Press and hold the prep/exposure switch halfway down to the prep position.
You can hold the prep state for up to 15 seconds.
3. After the status bar indicates the detector is Ready, press the button completely down
to take the exposure.
The Expose status turns yellow. The system automatically takes the exposure within
0.5 seconds after you press the button.
4. When the audible tone stops, release the Prep/Exposure switch. The status bar turns
blue. Give the appropriate breathing instructions.

Note
The status bar turns from green, to yellow, to blue to signal the ready, prep, and acquisition
stages. For details, see Understanding the Status Bar.

Approximately three seconds after the exposure is completed, the Image Viewer screen
appears.

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Detector Calibration

Detector Calibration

How Often Should I Calibrate the Detector


Perform detector calibration every six months or if the system prompts you to do a
calibration. If you are using a DRX Plus detector, the calibration is required annually. If
the detector is dropped, a new calibration will be needed at that time.

What Calibration Type Should be Performed?


There are two types of calibration:
Detector Calibration Type Frequency Duration X-ray needed

DRX Family Daily Dark Daily < 1 minute No

X-ray Every 6 months 30 minutes Yes

PRO Family Daily Dark Daily < 1 minute No

X-ray Every 6 months 30 minutes Yes

DRX Plus Daily Dark Weekly ?? < 1 minute No

X-ray Annually 30 minutes ?? Yes

Note
The daily dark calibration must be performed if the Key Operator for the site has disabled the
automatic daily dark feature or if automatic daily dark fails for 10 days.

How to Calibrate the Detector


This information applies to the DRX-Evolution, DRX-Revolution Mobile X-ray System, and
the DRX-Ascend Systems.

Important

You must keep the detector away from other electronic devices during calibrations.
Only an authorized Service Representative can adjust the settings on the upper-half of the
Detector Calibration Screen.
1. At the main menu, select Utilities > Detector Calibration.
2. Select the detector type: Wall Stand Bucky or Table Bucky.
3. Select the Calibration Type check box.

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Detector Calibration

4. Follow the instructions on the screen to calibrate the detector.


5. Select Begin Calibration.

How to Set Up for an X-ray CalibrationDRX Detectors

Important
The X-ray calibration must be performed every six months or after a significant shock to the
detector.
The user must activate the exposure button for approximately 15 exposures.
The dark calibration must be completed successfully before performing the X-ray calibration.
1. Set the SID to 183 cm (72 in.) and remove the grid.
2. Check that the collimator blades are open to expose the filter.
3. Insert the 0.5 mm copper and the 1.0 mm aluminum filter onto the collimator, with
the copper side facing the tube.
4. Ensure that nothing is in the beam path.
5. Do the steps in the How to Calibrate the Detector procedure.
6. When the calibration is complete, remove the filters from the collimator.

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Detector Selection on the Acquisition Screen

Detector Selection on the Acquisition Screen


The detector can be installed over the table, under the table, or upright on a Wall Stand.
The Acquisition screen displays the 3 installations for detectors as icons.
Icon Description

Detector installed in a table Bucky.

Detector installed in a Wall Stand.

Detector installed on a table top outside of the table Bucky.

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DR Long-Length Imaging

DR Long-Length Imaging
Long-Length Imaging(LLI) is used to measure angles and bone length. It is a system that
creates a composite image from a series of component images for scoliosis, full spine, or
leg-length procedures.

Caution
The DR Long-Length Imaging Software Module relies on the end user to specify individual fiducial
markers on each component image that is used to build the composite stitched image. If these
points are not properly located, the resulting composite image may not accurately represent the
actual patient anatomy.
The radiographer creates component images manually, or with automatic equipment
depending on the procedure and the system.
Console software for LLI aligns, orders, and stitches component images to form the
composite image, regardless of the equipment being used. Once the system acquires
two or more component images, the software begins to stitch the images together.
Carestream Health only supports alpha rotation (tube angles) rather than Z
translation (linear tube movement from head to toe) for optimal LLI imaging.
An image overlap to include 32.40 mm (1.27 in.) of common anatomy between
component images is required for optimal stitching.
The use of a reference object (such as a radiopaque ruler with lead markings) in the
component images may be necessary when stitching with fiducials.

Caution
The ruler should never be used for distance measurements in the image.
Patient motion must be minimized during the two-to-five exposures needed to create an
LLI exam.
The Manual Stitch Editor allows manual adjustments to composite images if desired.
When manually adjusting stitched results, the user should zoom to an appropriate magnification
for visual assessment.
The user should begin with reference points (external fiducial markers such as a ruler) in the
overlap region. Final adjustments should be made based upon the alignment of the anatomy.

DR Long-Length Imaging Indications for Use


The softwares intended use is to allow post-capture positioning and joining of individual
images to produce an additional composite image. The software is sold only for use on

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DR Long-Length Imaging

Carestream Health system solutions and is available as an integrated feature within the
DIRECTVIEW software.

Caution
Federal law restricts this device to sale by or on the order of a physician.

Figure 1: Stitched image from three component images.

Optional Equipment Used to Perform DR Long-Length Imaging Exams

Exposure Overlap Guides for Patient Stand

Exposure Overlap Guides are used in DR manual upright exams to place the detector
properly at the top, middle, and bottom of a long-length exam. These guides ensure that
there is adequate image overlap for stitching the composite image.

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How to Use the Overlap Guide for DR Long-Length Imaging Exams

The overlap guide has three triangles and three color strips to use as detector positioning
guides.
The points of the triangles indicate the position of the center of the detector for each
exposure. The color strips indicate the amount of overlap between each exposure.
1. Center the red laser over the region of interest (ROI).
2. Line up the point of the middle triangle on the overlap guide with the red laser and
affix the guide to the patient stand.
3. For the first exposure, center the detector on the point of the upper triangle.
4. Take the first exposure.
5. Center the detector on the point of the middle triangle.
6. Take the second exposure.
7. Center the detector on the point of the bottom triangle.
8. Take the third exposure.

Patient Stand

The performance of the DR Long-Length Imaging system is optimized with the use of a
patient stand. If you choose another patient stand, be sure to evaluate the best
conditions for image quality.
The patient stand is constructed so that you can position the patient in front of the Wall
Stand detector for upright exams. A center line is marked on the back of the stand so that
you can align the center of the Bucky with the center of the stand.
The stand is on wheels for easy movement. To lock the stand in place, press one of the
red foot pedals, and all four wheels will lock at once.

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How to Use the Patient Stand for DR Long-Length Imaging Exam

Use the scale on the Patient Stand handle to determine the object to image distance
(OID)the distance from the midline of the anatomy of interest to the detector.
An accurate OID is important for stitching precision.
1. Position the patient and measure the distance to the detector.
2. Input the measurement in the More Image Data tab on the Patient Input screen.

Note
The CARESTREAM DR Long-Length Patient Stand base can be lifted so that the patient can stand
on the floor if necessary

Using the Manual Stitch Editor


The Manual Stitch Editor is a tool that allows you to adjust the stitching of a composite
image if the results of the automatic stitching need optimization.
To access the Manual Stitch Editor, touch the composite image that appears after a
long-length exam.

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The Image Viewer screen opens with the composite image in the Viewer window.

Make Adjustments with the Manual Stitch Editor

1. While viewing the stitched image, select the Edit Stitched Image check box.
2. You can now adjust the image stitching three ways:
Use the cursor to drag-and-drop the image in place, either on the main viewer screen or
the small viewer panel at the right of the screen.
Use the arrow keys to move the image to make fine adjustments. One touch of the arrow
key moves the image one pixel. Pressing the Control (Ctrl) key and touching the arrow
moves the image five pixels.

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DR Long-Length Imaging

Select the Use Fiducials check box. This removes automatic stitching and lets you
manually re-stitch the composite.

Be sure to pan and zoom the image before selecting Use Fiducials, because once selected,
the cursor changes to a crosshair, and it is not possible to pan the image without
unintentionally selecting a reference point. Only the small image panel will allow
panning once Use Fiducials is checked.

How to Use Fiducials

1. Select a point in the overlap area (such as a point on the ruler) and click once.
2. Select a point in the second image and click again.
The image aligns to those two reference points.

Note
If a radiopaque ruler is used in the image, selecting identical points is simple. Use the arrow keys
to adjust the image pixel-by-pixel if necessary.
3. Select Save Changes when the image stitching is complete.
4. Select Save & Accept to deliver the image.

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DR Long-Length Imaging

Important
The ruler should never be used for distance measurements in the image.

About Cancelling an Automatic DR Long-Length Exam


Releasing the prep/expose switch stops the exam.

When Cancel is pressed


The automated sequence is stopped.
If two or more images have been acquired, stitching can be manually initiated by
selecting the Quick Menu.

When Set is pressed


Manual changes to the automatic positioning equipment aborts the exam
Manual movement invalidates the calculations of the anatomy to be exposed and
causes an automatic reset on the OTC
All disabled buttons are enabled, and you will have to start over.

When any brake release other than Alpha is pressed


The LLI exam or anatomy definition is canceled.
The system supports alpha rotation (tube angles) for optimal LLI.

How to Perform a DR Long-Length Exam for the DRX-Evolution System


1. Set the Source to Image Distance (SID).

Note
Use the longest SID within the focal range of the grid being used.

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DR Long-Length Imaging

2. Define the anatomy to be imaged.


a. Use the laser line from the collimator to point at the uppermost part of the
anatomy to be exposed
b. Adjust the collimator width to the desired setting.
c. Press the LLI Upper Limit button on the OTC display. The button turns green.

d. Use the laser line from the collimator to point on the lowermost part of the
anatomy to be exposed.
e. Press the LLI Lower Limit button on the OTC. The button turns green.

f. Use the arrow buttons to select the Object to Image Distance (OID) on the OTC.
g. Press the Set button.

The OTC and detector move into position to take the first exposure.

Important
All desired technique changes for any of the component images must be made before pressing
the prep/expose switch and initiating the acquisition series.
3. Press and hold the prep/expose switch until all images are acquired.
The system automatically exposes and moves to the next position until all images are
acquired.

Important
If images are acquired in the wrong order, you must unassign the image(s) and then assign them
in the correct order.

When a DR Long-Length Exam is Cancelled


When the prep/expose switch is released the exams stops.
When Cancel is selected:

The automated sequence is stopped.


If two or more images have been acquired, stitching is manually initiated by selecting
the Quick Menu.
After Set is selected, manual changes to the automatic positioning equipment aborts the
exam.

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Manual movements to the equipment invalidate the calculations of the anatomy to be


exposed and cause an automatic reset on the OTC. All disabled buttons are enabled, and
you must start over.
If any brake release, other than Alpha, is pressed after an automated LLI exam is started,
or after the anatomy definition is started, the exam will be canceled. The system only
supports alpha rotation (tube angles) for optimal LLI.

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DR Long-Length Imaging

Overhead Tube Crane (OTC) Long-Length Icons for Automatic DR LLI


Decrease the Object to Image Distance (OID)
Touch this button to decrease the OID value.
Must be entered before pressing Set on the OTC.

Increase the Object to Image Distance (OID)


Touch this button to increase the OID value.
Must be entered before pressing Set on the OTC.

Reset
Touch this button to reset the values on the OTC.
The Reset button is enabled and available when the anatomy to be
imaged is defined during automatic acquisition.
The Reset button is disabled after the first image is acquired.

LLI Lower Limit, LLI Lower Limit Set


Touch the Lower Limit selection before turning the OTC laser to
the lower limit.
Touch Lower Limit Set when the OTC laser is in position for the
lower limit.
The button turns green when the limit is set
..

LLI Upper Limit, LLI Upper Limit Set


Touch the Upper Limit selection before turning the OTC laser to
the upper limit.
Touch the Upper Limit Set when the OTC laser is in position for the
upper limit.
The button turns green when the limit is set.

Set Active
After the upper and lower limits have been set, the Set button
becomes active.

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DR Long-Length Imaging

Set Button
After the Set button is pressed, any manual changes in the acqui-
sition hardware positions will abort the exam. You will have to
start over.
The Set button remains disabled until the upper and lower limit
selections are made.
Do not make any adjustments to the collimation or to the position
of the tube/detector at this time.

Toggle
Touch this icon to toggle from DR Long-Length Imaging Mode to
General Radiography Mode.

Understanding SID and SOD for a Long-Length Exam


You must enter an accurate OID (and SID for retrofit systems) for each patient study to
allow for accurate interpretation at the workstation and more precise stitching.

SIDSource to Image Distance


SID is the distance from the detector to the X-ray source. Set the SID before identifying
the region of interest. Use the longest SID within the focal range of the grid being used.
Move the tube to the correct Source to Image Distance (SID).

SODSource to Object Distance


The Source to Object Distance is the distance from the patient to the X-ray source. The
value is calculated from the SID and OID (SOD = SID - OID).
Magnification is determined by dividing the SID value by the SOD value. Both the SID and
the SOD are included in the DICOM header on the image.

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DR Long-Length Imaging

Configure the System to Print Long-Length Images


You can configure the system to print long-length images two ways:
Print each component image in addition to the composite image automatically.
Print the composite image alone.

Long-Length Imaging Views


Long-Length Imaging procedures are associated with LLI Views. Selecting LLI Views
automatically enables the LLI mode.

LLI Views include:


Full Spine
Scoliosis AP
Scoliosis PA
Scoliosis Lateral
Leg Length

DRX-Evolution System DR Long-Length Imaging Menu

DRX-Evolution Automatic DR Upright Exam


Prerequisites:
The Key Operator must configure the Long-Length Imaging (LLI) procedures and
associate LLI Views before you can use the DR Long-Length feature.

DRX-Evolution Automatic LLI:


Optimizes technique for each exposure
Automates system movement between exposures
Reduces the risk of patient movement

Note
Immobilize the patient to reduce patient motion with an LLI exam.
1. Select an LLI procedure at the Console.
2. Use Auto Center to center the tube to the Wall Stand. Use the longest SID within the
focal range of the grid being used.
3. Position the patient stand in front of the Wall Stand.
4. Select an LLI View.
5. Position the patient on the patient stand.

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6. Adjust handles, straps, and ruler as desired.


7. Angle the tube until the red laser points to the upper point of the area of interest.
The system only supports using alpha rotation (tube angles) for optimal LLI stitching.
8. Press the Upper Limit icon on the tube controls.
9. Angle the tube until the red laser points to the bottom of the area of interest.
10. Press the Lower Limit icon on the tube controls.
11. Enter the OID at the tube.
12. Adjust the collimation width.
13. Press Set.
14. Return to the Console.
15. Adjust technique for all thumbnails in that procedure if desired.
16. Instruct the patient to hold still for a leg-length exam (hold breath or maintain
shallow breathing for Scoliosis exam).
17. Press and hold the Prep/Expose switch until all component images have been
acquired (approximately 1820 seconds for a three-image exam).
18. When the component images have been acquired, instruct the patient to relax and
breathe.
The images automatically stitch to form the composite image.
19. Select the thumbnail of the composite image to view it on the Image Viewer screen.
20. If necessary, manipulate the image stitching using the Manual Stitch Editor.
You can also add angle measurements, Cobb angles, and rulers to the image using
Measurement Tools.

Note
To facilitate manual stitching, adjust the ruler so that it is in front or behind the patient, so that
the ruler can be seen in the image without affecting the view of the anatomy. However, if the
ruler is needed for determining patient size, insert the ruler mid-line, or include an object of
known size for reference.

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DR Long-Length Imaging

DRX-Evolution DR Manual Exam Using a Motorized Wall Stand


Prerequisites:
The Key Operator must configure Long-Length Imaging (LLI) procedures and associate LLI
Views before you can use the DR Long-Length feature.
To perform manual LLI exams, the X-ray tube must be centered to the patient. The
overlap area between exposures must be at least 6.5 cm (2.5 in.).

Note
Immobilize the patient to reduce patient motion with an LLI exam.

Manual LLI exams:


Let you optimize the technique for each of the (25) exposures.
Use motorized or non-motorized Wall Stands and X-ray tubes.
Require care to minimize patient movement while changing equipment positions.
May require the use of a patient stabilization belt.

Note
The detector remains in portrait orientation for scoliosis exams. For leg-length exams, insert the
LLI grid and rotate the Bucky to landscape orientation.
1. Select an LLI procedure at the Console.
2. Set up the DRX-Evolution System.
3. If you are using a DRX detector, insert it in portrait orientation so that it is tethered.
4. Insert the appropriate grid. If the Bucky is in landscape orientation, the LLI grid is
necessary.
5. Manually center the X-ray tube to the Wall Stand. Use the longest SID within the focal
range of the grid being used.
6. Position the patient stand in front of the Wall Stand by aligning the midline on the
Bucky with the midline on the patient stand.
7. Press the red foot pedal on the patient stand to lock all four wheels in place.
8. Position the patient.
If you are performing a scoliosis exam with a patient of average height, have them
step on the stand.
If you are performing a scoliosis exam with a tall patient, raise the floor of the
stand back and ask the patient to stand on the floor so that the Bucky can image
the top of the spine.
If you are performing a leg-length exam, attach the removable step stool so that
the patient is raised and the Bucky can image the ankle.
9. Using the overlap guide, determine the number of images you will need to complete
the LLI exam.

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10. Position the overlap guide on the patient stand in the correct location and line the
Bucky up with the overlap guide.
11. Adjust the handles, straps, and ruler as desired.
12. Determine the center of the region of interest using the overlap guide and position
the X-ray tube pointing straight at that point
13. Angle the tube so that it aligns with the first location on the overlap guide.
Carestream Health only supports using alpha rotation (tube angles) for optimal LLI
stitching.
14. Adjust the collimation width.
15. Adjust the technique for all thumbnails if desired
16. Instruct the patient to hold still for a leg-length exam (hold breath or maintain
shallow breathing for a scoliosis exam).
17. Acquire the first image.
18. Angle the tube and center to the second position on the overlap guide.
19. Press Auto Center to move the Wall Stand into the correct position.
20. Acquire the second image.
21. Angle the tube and center to the third position on the overlap guide.
22. Press the Auto Center to move the Wall Stand into the correct position.
23. Acquire the third image.
24. Instruct the patient to relax and breathe.
25. The images automatically stitch to form the composite image.
26. Select the thumbnail of the composite image to view it on the Image Viewer screen.
27. If necessary, manipulate the image stitching using the Manual Stitch Editor. You
can also add angle measurement, cobb angles, and rulers to the image using
Measurement Tools.

Note
To facilitate manual stitching, adjust the ruler so that it is in front or behind the patient, so that
the ruler can be seen in the image without affecting the view of the anatomy. However, if the
ruler is needed for determining patient size, insert the ruler mid-line, or include an object of
known size for reference.

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DR Long-Length Imaging

How to Configure DRX-Evolution DR Supine Exams


Prerequisites:
The Key Operator must configure Long-Length (LLI) procedures and associate LLI Views
before you use the DR Long-Length feature.
DRX-Evolution Supine Long-Length Imaging (LLI) is an exam that is done automatically.
Typically, you position the patient on a table and make two exposures that are stitched
together.

The DRX-Evolution Supine exam is limited by:


Maximum width of the detector.
70.0 cm (27.5 in.) maximum imaging length.
132 cm (52 in.) maximum SID value.
Upper and lower limits within which the detector can travel.

Note
Immobilize the patient to reduce patient motion with an LLI exam.
1. Select an LLI procedure on the system Console.
2. Select an LLI View.
3. Click the thumbnail to open the Image Acquisition screen.
4. Select the Table detector.
5. Move the table to the lowest position.
6. Set the SID to 132 cm (52 in.) at the tube controls. Carestream recommends the
longest SID possible for best results, within a range of 100250 cm (39 x 98 in.).
The SID may be set manually or by applying Auto Position.
7. Insert the DRX detector into the table Bucky to the most superior position.
8. Position the patient.
9. Angle the tube so that the red laser points to the uppermost limit of the region of
interest.
10. Press the Upper limit icon.
11. Angle the tube so that the red laser points to the lowermost limit of the region of
interest.
12. Press the Lower Limit icon.
13. Press Set.
14. Press and hold down the Prep/Exposure switch until all exposures are made.
The images stitch to form the composite image.

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15. Select the thumbnail of the composite image to view it on the Image Viewer screen.
16. If necessary, manipulate the image stitching using the Manual Stitch Editor. You
can also add angle measurements, Cobb angles, and rulers to the image using
Measurement Tools.

Long-Length Imaging for the DRX-1 System


The Key Operator configures Long-Length Imaging (LLI) procedures and associates LLI
Views before you use the Long-Length feature.
The X-ray tube must be centered to the patient, angled, and marked at the uppermost
and lower-most points of the region of interest.
The overlap area between exposures must be at least 13 cm (5 in.)

Note
Immobilize the patient to reduce patient motion with an LLI Exam.
1. Set up the DR System.
2. Insert the detector in the appropriate orientation for the exam.
3. Manually center the X-ray tube to the center of the region of interest.
4. Position the patient stand in front of the Bucky with the detector and align the
midline on the Bucky with the midline on the patient or the patient stand.
5. If the patient stand is used, press the red foot pedal on the patient stand to lock all
four wheels in place.
6. Position the patient.
a. If you are performing a scoliosis exam with a patient of average height, have them
step on the stand.
b. If you are performing a scoliosis exam with a tall patient, raise the floor of the
stand back and ask the patient to stand on the floor so that the Bucky can image
the top of the spine.
c. If you are performing a leg-length exam, attach the removable step stool so that
the patient is raised and the Bucky can image the ankle.
7. Adjust the handles, straps, and ruler as desired.
8. Position the overlap guide on the patient stand in the correct location and line the
Bucky up with the overlap guide.
9. Using the overlap guide, determine the number of images you will need to complete
the LLI exam.
The overlap guide will remain in this position throughout the exam.

Note
To facilitate manual stitching, adjust the ruler so that it is in front or behind the patient, so that
the ruler can be seen in the image without affecting the view of the anatomy. However, if the

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DR Long-Length Imaging

ruler is needed for determining patient size, insert the ruler mid-line, or include an object of
known size for reference in the plane of the anatomy.
For more information on stitching adjustment, see Manual Stitch Editor in the
CARESTREAM DIRECTVIEW Online Help.

Stitching Software for the DRX-Revolution System


The Key Operator configures procedures and associates Stitching Views before you use
the Stitching feature.
The detector overlap between exposures must be at least 7.6 cm (3.0 in.)
1. Create a new patient, and make sure that you select one of the designated
Stitching Views:
Full Spine Stitch AP
Full Spine Stitch Lateral
Extremity Stitch AP
Extremity Stitch Lateral
2. Select the number of component images for the exam. You can choose two or three
images. Click each component thumbnail to ensure that the techniques are
appropriate, and then verify that the first component image is selected.
3. Position the detector under the patient.
A grid is recommended when possible; grid lines should run parallel with the length
of the patient.

Important
The detector must be placed on a flat, rigid surface.
4. Position the tube over the patient, centered to the area of interest. Carestream
Health recommends a 183 cm (72 in.) SID, or the maximum SID you can achieve within
the range of your grid.
5. Using only the rotational buttons on the tube, angle the tube so that it is centered
over the detector.
6. Open the collimator blades to expose the full detector.
7. Complete the first exposure, and reposition the detector for the second exposure.

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DR Long-Length Imaging

8. Using the rotational buttons, angle the tube and ensure that it is centered over the
detector.

Make sure that the collimator buttons are open to expose the full detector.

Important
It is crucial that the detector is not rotated between exposures, because the stitching software
does not correct for any difference caused by rotation of the detector.
9. Complete the second exposure.
If you are doing a two-image study, you are finished. If you are doing a three-image
study, reposition the detector and the tube for the third image and complete the
third exposure.
After all the images are acquired, the stitching software will combine the images to
form a single stitched image. Use the Manual Stitch Editor to adjust the image
stitching in either the left and right or the up and down direction.
For more information on stitching adjustment, see Manual Stitch Editor in the
CARESTREAM DIRECTVIEW Online Help.

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Tube Head Software

Tube Head Software


This information applies to the DRX-Revolution Mobile X-ray System only.

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Tube Head Login Screen

Tube Head Login Screen


The log on screen is located on the tube head monitor of the DRX-Revolution System. It
gives instruction for the user to log on by swiping their badge, or by entering their User
Name and password on the primary monitor.

Note
You cannot enter data using the tube head screens; you can select icons to perform functions.

Note
This information applies to the DRX-Revolution Mobile X-ray System only.

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Icons on the Tube Head Display

Icons on the Tube Head Display


Note
This information applies to the DRX-Revolution System only.

Icon Description Icon Description

Log on Service login

Log off Hide the privacy screen

Display the Patient Work List Tube head rotation

Wireless is asleep Signal strength

Cart is in drive-only mode Utilities

New patient on the Patient Emergency stop is active


Work List

Version data Grid alignment

Cart battery status 50 % Detector angle

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Icons on the Tube Head Display

Icon Description Icon Description

Detector battery status 25 % Reboot

Grid holder status 50 % Calibrate touch screen

Network is down, partial con- Network is down, no connec-


nection tion

Network is up, excellent con- Network is down, pending


nection connection

Network is unknown Driver code setup

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Cart Driving Access

Cart Driving Access


Note
This information applies to the DRX-Revolution Mobile X-ray System only.

The cart in the graphic above is in the docked position and the column is collapsed.
When the cart is in drive mode, no images can be taken.
The cart may be driven under three conditions:
Allow driving only when logged into the system.
Allow driving without logging on by touching the Drive icon, which will activate the
drive system.
Allow driving without logging on by touching the Drive icon, and entering the drive
code.

How to Configure Cart Driving Access


1. To configure driving access permission for your system, the Key Operator navigates to
Utilities > Driver Code Setup.
2. Select one of the following:
No Unauthorized Driver Access
Drive Cart Option, then enter the access code.
The access code can be up to 23 characters.
3. Select OK.

Note
This information applies to the DRX-Revolution Mobile X-ray System only.

Tube Head Privacy Screen

Note
This information applies to the DRX-Revolution Mobile X-ray System only.

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Cart Driving Access

The Privacy screen may appear when you log on. It is an interactive screen that shows
the status of batteries in the DRX-Revolution system, communications, and access to all
of the tube head functional buttons.

Note
You cannot enter data using the tube head screens; you can select icons to perform functions.

Tube Head Patient Work List Screen


The Patient Work List screen is used to locate, identify, and notify the user of the status
of every patient and study in the local system database. The HIS/RIS or patient
information used by selecting the Patient Work List screen and displayed there as well.
Each column on the Patient Work List screen has a different function. Each function is
a criteria that can be selected to filter the list. The more specific the search criteria, the
easier it is to find the patient record you seek. If more than one record matches the
information used in the query, the system will present a list of all matching records.

See Use the Patient Work List Screen.

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Cart Driving Access

Tube Head Image Acquisition Screen

Note
This information applies to the DRX-Revolution Mobile X-ray System only.
The Image Acquisition screen is located on the tube head display and it performs the
same function on the primary display. It appears when the user prepares to take an X-ray.
It contains all of the controls needed to set up an exam and acquire an image.

See About the Image Acquisition Screen.

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Cart Driving Access

Tube Head Image Acquisition Screen Display

This information applies to the DRX-Revolution Mobile X-ray System only.


Icon/Area Description

Detector status
Selected detector
Detector battery status
Wireless status
Detector name

Required patient information, as determined


by the Key Operator

Tube head rotation in degrees

Detector angle as determined by the grid


alignment system

Battery and communications


Detector battery status
Cart battery status
Wireless access
Communications status

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Cart Driving Access

Icon/Area Description

Focal spot

Patient size

View thumbnail

Patient Work List

Log on

Log out

Privacy Screen (on)

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Cart Driving Access

Icon/Area Description

Detector bin lock

Utilities

Tube Head Image Review Screen


The Tube Head Image Review screen allows you to view, accept and reject images.
The layout is similar to the Image List screen that displays on the primary monitor.
See Image List Screen.

Tube Head Image Utilities Screen


This information applies to the DRX-Revolution Mobile X-ray System, only.

Changes made to screens in the Utilities section will become effective after you select
the Back button.

Tube Head Image Utilities Screen Display

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Cart Driving Access

Icon Description Icon Description

Preferences Version Data

Calibrate Touchscreen Setup

Service Login Reboot

Drive Code Setup Back

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Generator Controls

Generator Controls

The generator controls are active if the detector selection is Generator Only.
The user sets the kVp and mAs values.
See How to Adjust the kVp and mAs.

How to Adjust the kVp and mAs

1. At the Image Acquisition screen, touch the arrows to raise (up) or lower (down) the
kVp values. The blue arrows change the value by one unit. Gray arrows are not
selectable.
The kVp adjustment ranges from 40 to 150 kVp. Maximum power must never exceed
80 KW. Exposures near the 80 kW power level may also be limited to less than the
maximum exposure time.
2. Select the radio button to control mAs and use the arrows to change the value.
The mAs adjustment ranges from 0.1 to 320.0 mAs. Maximum power must never
exceed 80 kW. Exposures near the 80 kW power level may also be limited to less than
the maximum exposure time.

Note
You can adjust the mAs value or the exposure time.

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Generator Controls

With mAs selected, the mAs value remains constant and the exposure is terminated
when the pre-selected value is reached.
With Time selected, the exposure is terminated when the time value is reached. This
mode is used when a specific time must be achieved, such as in a breathing study or
for stop motion.

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Tube and Grid Alignment System (Option)

Tube and Grid Alignment System (Option)


The following information applies to the DRX-Revolution Mobile X-ray System only.
The Tube and Grid Alignment System is an optional feature that provides a tool to
assist you to efficiently align the X-ray source to the grid/receptor for centering and
perpendicularity at the correct focal distance.
The Tube and Grid Alignment System option:
Displays the tube head and detector angles relative to gravity, along with the current
Source to Grid distance (SGD).
Provides guidance for positioning the tube head assembly with three alignment
indicators (vertical, horizontal, in/out) to achieve proper alignment at a selected SGD
(107127 cm (4050 in.)).
Optimizes tube and grid alignment for use with beds that have non-metallic top deck
platforms in the section that is behind the patient chest region.

Caution
The Tube and Grid Alignment System accuracy can be adversely affected by interference from
nearby metal objects. For example, alignments for Supine exams on ED trauma stretchers can
sometimes exhibit excessive interference from the metal bed structure beneath the mattress pad.
A warning is displayed on the Grid Alignment screen if significant interference is detected when
aligning under these conditions.
Carestream Health recommends that the grid holder always be used on top of a mattress that has
a minimum thickness of 7.6 cm (3.0 in.)
Two Grid Alignment systems within 6 m (20 ft) of each other may cause grid alignment
interference.

How to Align the Tube and Grid


Prerequisites:
This procedure requires using the Tube and Grid Alignment System, an optional feature
on the DRX-Revolution Mobile X-ray System.

1. Insert the DRX detector into the grid frame.


2. Position the grid frame on top of the mattress, behind the patient anatomy.
3. Enter the Grid Alignment screen on the remote display by touching the Grid
Alignment button.

4. Select the target Source to Grid Distance (SGD), such as 102.0, 112.0, or 127.0 cm
(40.2, 44.1, or 50 in.).

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Tube and Grid Alignment System (Option)

5. Select the bed type on the screen, either ED for a trauma gurney, or ICU for an
intensive care bed.
6. Use the buttons on the back and front sides of the collimator handles to release the
brakes and position the X-ray tube as you would for any exam. The tube angle and
detector angle indicators and the collimator light can be used as guides for
positioning.

7. Position the grid frame a minimum of 61 cm (24 in.) away from the cart and any other
metal objects of similar size or larger, and at least 15 cm (6 in.) away from any edge
of the mattress while in use.

8. Use the buttons on the back side of the collimator handles to release the brakes for
the boom, column, and turntable. There are three positioning indicators that will aid
in getting the X-ray tube aligned to the grid frame at the target SGD.
Up/Down
Left/Right
In/Out
All indicators are relative to you as you are holding the collimator handles in front of
you.
9. Move the tube head position as required to center each of the three indicators. The
arrows on each position will light up to provide guidance to help you move the tube
so that the white bar stays in the center of each box. The boxes turn green when good
alignment is achieved.
10. Use the buttons on the front side of the collimator handles to release the rotation
brakes so that you can point the tube in the correct direction.

Note
Do not press the back side buttons. Doing so will cause the system to lose alignment.
11. Point the collimator at the patient anatomy using the light, and collimate the beam
down as you normally would for any exam.

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Patient Information Bar

Patient Information Bar


The Patient Information Bar appears at the bottom of every image in the Image
Viewer screen and provides the current patient information for the displayed image.
When the Patient Information bar is selected, it opens the patient record on the
Patient Input screen.
The information on the Patient Information bar includes:
Patient Name
Patient ID
Accession Number
Cassette ID
Exposure Index
Date/Time
View Name
You can select the previous image or the next image in the study by selecting the arrows
on the Patient Information bar.
The Patient Information bar changes color depending on the status of the image. For
example, the bar may be green for an image that is assigned and orange for an image
that is unassigned.

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Auto-Associate Feature

Auto-Associate Feature
This information applies to CR Systems, only.
The Key Operator can configure a Classic/Elite CR System or a CR 825/850 System to
automatically associate the Cassette ID to a View thumbnail, which eliminates the need
to use an external bar code reader for this purpose.

Note
The Modality must be operating independently from a Remote Operations Panel (ROP). When a
ROP is defined as an external device to one of the Modalities, the Auto-Associate button is
disabled.
To enable the Auto-Associate feature, go to Key Operator Functions >
System Configuration > Next Page > Scanner Options and select the
Auto-Associate Enabled check box.

How to Initiate Auto-Associate from the Patient Input Screen


This information applies to CR Systems only.
To initiate Auto-Associate a Cassette ID to a View thumbnail from the Patient Input
screen:
1. Select a View.
For an image to be auto-associated with a View, the desired View must be selected
(highlighted) and displayed on the Patient Input screen at the time of the scanning
until the bar code appears in the View thumbnail.

Note
If you do not select a View prior to inserting the cassette, the image will be unassigned.
2. Insert the cassette.
When the cassette is scanned, the image is automatically associated with the View
thumbnail that was selected (highlighted) when the scan began. The system
automatically highlights the next View after the cassette scanning process has
started.
3. Insert the next cassette.
4. Repeat until each View is scanned.

Note
When the Auto-Associate feature is enabled, if a cassette bar code gets accidentally scanned, the
accidental information will not be used by the system. The image file sent to other devices will
contain only the Cassette ID of the scanned cassette, not the ID of the cassette that was
accidentally scanned.

Each cassette is automatically associated with the View that was selected when the
cassette is inserted.

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Scan Status Screen Overview

Scan Status Screen Overview


The Scan Status screen appears with the following tabs on CR Systems.
Icon Tab Name Description

Scan Status Displays the last scanned image. From this tab
you can assign the image, access the Patient
Input screen and the Image Viewer screen.

Erase Cassette Erases cassettes that have become exposed to


ambient radiation. Cassettes that have not been
used in 24 hours should be erased prior to use.

System Recovery Resolves cassette transport problems such as


cassette jams.

Erase Lamp Displays the Erase Lamp status. System warnings


occur when one or more pairs of erase lamps are
not functioning.

Note
Only the Scan Status tab is available on the console of the Classic/Elite CR Systems without the
Easy View display. The Erase Cassette tab, System Recovery tab, and Erase Lamp tab
functions are available on the Local User Interface (LUI) of the Classic/Elite CR Systems.

Scan Status Tab


The Scan Status tab displays the status of image acquisition on all CR Systems.
Name Description

Progress Bar Displays the progress of the scan from the start to com-
pletion.

Pause Pass-through/Resume These buttons appear if the Key Operator has configured
Pass-through Functions the system for Pass-through Mode. These buttons allow
you to inspect an image before accepting and sending to
destinations, and then resume Pass-through Mode.

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Scan Status Screen Overview

Name Description

Image Viewer Screen Opens the Image Viewer screen to modify the image
quality.

Assign Image Opens the Patient Query screen to assign patient infor-
mation to the image.

Patient Information Bar Opens the Patient Input screen to view or change
patient information.

Patient Record Opens the Patient Input screen to observe or change


patient information.

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How to Use the Erase Cassette Tab

How to Use the Erase Cassette Tab


The following information applies to CR Systems only.
Use the Erase Cassette function to erase a phosphor screen if the cassette has not been
used within 24 hours or if you suspect it has been exposed to any X-ray radiation.
Select the Erase Cassette tab on CR 975, Max CR, and Classic CR Systems with Easy View
display to place the system into the Erase Mode.
For the Classic/Elite CR Systems, select Erase on the Local User Interface.

Important
Make sure that you want to erase a cassette. Erasing deletes any image on the phosphor screen.
The system cannot scan a cassette with an image while in Erase Mode.
1. Select the Erase Cassette tab on the Scan Status screen.
2. Insert the cassette into the CR System.
3. Select Erase Cassette.
The mechanical Start button on the front of the CR 975 or Max CR Systems is not
active during the Erase Mode.

Important
Do not insert cassettes containing patient images into the CR 975 or Max CR Systems while they
are erasing cassettes.

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About the Local User Interface (LUI)

About the Local User Interface (LUI)


The Local User Interface (LUI) is available only with the Classic and Elite CR Systems. The
LUI is accessed through the LCD display on the top of the machine. The menu order is
dynamic and changes depending on the directional arrows you choose.

Local User Interface (LUI) Main Menu


The following information applies to CR Systems with the Local User Interface.

Utilities

Menu Selection Description

Volume Settings Controls the volume of the following:


The response of selecting a button on the
remote interface.
The sound of alarms on the CR System.
The sound of the bar code scanner.
The sound that occurs when you place a
cassette in the cassette feed slot and it is
ready to scan.

Scanner Information Scan Count is a consecutive count of


scans on the machine.
Laser Hours is a cumulative count of the
hours the laser has operated.
Erase Lamp Status gives a picture of the
current performance of each pair of erase
lamps in the machine.

Display Settings BrightnessUse the + and - buttons to


control the brightness of the display on
the interface.
SleepSelect the interval for the inter-
face to be active without being accessed.

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About the Local User Interface (LUI)

Menu Selection Description

Scan Mode Scan Modes affect large cassettes such as


35 x 35 cm and 35 x 43 cm and are unique
to the Classic/Elite CR Systems.
You can set the following three scan modes
from the LUI (not the Console):
Standard Speed ModeStandard Reso-
lution, High Resolution, Enhanced Resolu-
tion.
High Speed ModeStandard Resolu-
tion, High Resolution, Enhanced Resolu-
tion.
Reduced BorderImages on 35 x 35 cm
and 35 x 43 cm cassettes are captured
with pixel sizes of 171 microns rather than
168 microns which slightly increases the
scanned image area, producing borders
smaller than those produced on other
systems.

Active Console Provides the name and IP address of the Clas-


sic or Elite CR System currently in communi-
cation with the console.

System Recovery Touch this button to release a jammed cas-


sette in the Classic or Elite CR Systems.

Erase Cassettes

Menu Selection Description

Cassette will be Erased Insert the cassette and the erasing of the
phosphor screen in the cassette begins imme-
diately and then released.

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About the Local User Interface (LUI)

How to Use the Volume Settings Tab


The local user interface (LUI) on the top of the Classic/Elite CR Systems permits you to
adjust the volume or sound settings of button clicks, alarms, bar code reads, and cassette
loadings.
To adjust the volume or sound settings for the following signals, select the icon and
follow the screen prompts.

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About High Resolution Scanning

About High Resolution Scanning


The following information applies to CR Systems only.
High resolution scanning produces diagnostic quality images with 97 micron spacing
between pixels.
GP Plus Scan Mode, available worldwide, produces high resolution images with GP Plus
cassettes. The bar code on the cassette tells the CR System that a GP Plus cassette is
inserted, and the scan rate changes to 97 microns. If the scanner does not recognize the
bar code, manually specify the cassette type.

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How to Load Cassettes on the Classic/Elite Systems

How to Load Cassettes on the Classic/Elite Systems


The following information applies to CR Systems only.
The cassette feed slot lets you insert a single cassette manually.
1. Hold the cassette with the yellow corner facing up and toward you.
2. Place the cassette in the feed slot with the tube side label facing to the right.
3. Push the cassette into the slot.
The CR System beeps once when it reads the cassette bar code label.
4. Push the cassette all the way to the back until the CR System beeps twice, signaling
that you can let go of the cassette.
After the cassette has been scanned, the CR System releases it and displays the
Remove Cassette message on the Local User Interface (LUI).
5. Manually remove the cassette.

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How to Shut Down the Classic/Elite CR System

How to Shut Down the Classic/Elite CR System


To shut down the Classic/Elite CR System, follow these steps:
1. At the Main Menu, select Quick Menu .

2. Select System Shutdown/Power Off and select OK. The CR computer shuts down.
3. Turn off the power switch on the side of the Classic/Elite CR System.

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How to Load Cassettes on the CR 975 and Max CR Systems

How to Load Cassettes on the CR 975 and Max CR


Systems
Place exposed cassettes on the right side of the feed slot and make sure that the tube side
label faces to the right, and that the cassettes yellow corner is always up and towards
you.

Caution
The CR 950/975 has moving parts. Avoid contact with the belt.
1. Push a cassette all the way into one of the drive belt slots.
2. Set the cassette into the transport mechanism.
3. Make sure the cassette is perpendicular when loaded and pushed all the way to the
back of the slot.
You can load up to eight cassettes of all sizes at one time.

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How to Configure Remote Devices

How to Configure Remote Devices


Go to Key Operator Functions > System Configuration > Remote Device
Configuration.
At each CR System:
1. Select New Device.
2. Enter the IP address of the Remote Operations Panel (ROP).
3. Select Remote Operations Panel as the device type.
4. Repeat these steps for all ROPs.
5. Enter the IP address of every CR System that will be linked to the ROP.
6. Select Save to All.
This adds all ROP links to each CR that you added in the previous steps.
7. Select Delete Device to remove a device from the CR System.

At each ROP:
1. Select the link to the CR System on which you just made changes.
2. Once the ROP is linked, select Key Operator Functions.
3. Select Fetch ROP Links to add the new links you created in step 6 above.
4. Select Quick Menu and ROP Links to display the new links.

How to Create a Shortcut to the Remote Access Software


Once you have set up Remote Access Software, you can create a shortcut to the software
and place it on your desktop for easy access.

Prerequisites:
Remote Access Software must be set up on the Key Operators computer.

1. Open MICROSOFT INTERNET EXPLORER.


2. With the address displayed, click and drag the MICROSOFT INTERNET EXPLORER icon
to your desktop.
3. Right-click the shortcut to rename it.
4. Double-click the shortcut to launch the remote connection.

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How to Configure ROP Links

How to Configure ROP Links


The following information applies to CR Systems only. ROP Links Configuration lets you
enter the IP address of a Remote Operations Panel and set it up for communication with
CR Systems. ROP Links is accessed from the Remote Device Configuration Screen.

To access the Remote Device Configuration screen, go to Key Operator Functions >
System Configuration > Remote Device Configuration.
1. To enter a remote device, select New Device.
The virtual keypad appears.
2. Enter the IP address of the remote device.
3. Select Edit ROP Links.
The ROP Links Configuration screen appears.
4. Select Add ROP Link to add the IP address of a CR System. An IP address must have
the format of X.X.X.X where X is a number between 0 and 255.
The CR Systems listed on the ROP Links Configuration screen appear on the ROP
Links screen on the Remote Operations Panel.
5. Select Delete ROP Link to remove a CR System from the ROP Links Configuration
screen and the ROP Links list.
6. Select Save Changes or Save to All.

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About the Remote Patient Data Entry System

About the Remote Patient Data Entry System


The following information applies to CR Systems only.
Remote Patient Data Entry System is a software option for entering patient data at a
workstation. It allows communication between a customer-supplied computer
workstation and the CR System.
If the Remote Patient Data Entry option has been enabled, the Remote Access Software
lets you access the Patient Input screen to pre-populate the Work List.

Note
A password is required when logging into the CR from the customer computer. A RPDES system
must have a fixed IP address or the link with the CR System may be lost if the customer computer
is rebooted.

How to Enter Patient Data Using RPDES


The following information applies to CR Systems only.
The Remote Patient Data Entry System saves time by letting you input patient
information from a remote location.
1. Log on into the CR remotely.
2. Select the Remote Patient Data Entry menu bar.
3. Enter the patient information.
4. Select Save Changes.
This clears all the fields and lets you enter the next patient record.

You can retrieve the patient information at the CR System.

How to Complete a Study from the Remote Patient Data Entry System
The following information applies to CR Systems only.
When the System is connected to the Remote Patient Data Entry System (RPDES), the
connection lets you access the Patient Input screen and pre-populates the Work List.
Enter the information for all required fields.

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CR Long-Length Imaging Online Help

CR Long-Length Imaging Online Help

About CR LLI Exam Optimization

Grid
Two grids have been optimized for LLI image quality:
DIRECTVIEW Long-Length Grid for Vertical Cassette Holder
DIRECTVIEW Portable Grid
Carestream Health has not tested other grids; so if you use another grid, make sure to
evaluate the best conditions for image quality:
Grid ratio8:1
103 LP
You can order extra front panels for mounting standard long-length grids.

Caution
Handle the grid with care. Dropping or bumping the grid causes serious internal damage that
produces permanent, unacceptable imaging artifacts.

Collimation
Use vertical collimation for long-length imaging exams. The image stitching algorithm
uses the non-image area at the sides of the phosphor screen to correctly align the image
information.
The software looks for sharp edges in each of the sub-images to combine when applying
the stitching algorithm. Therefore, if you collimate closely when performing a
long-length exam, your results will improve.

Cassettes
Use the minimum number of cassettes required to capture the desired image. Large
unexposed areas can degrade image quality.

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CR Long-Length Imaging Online Help

Filtration
Use an intensity profile compensation filter (wedge filter) to pre-attenuate images.

How to Enter Data for CR LLI Exams


Prerequisites:
DIRECTVIEW CR System Software Version 5.1 or higher must be installed.

1. Enter Patient data into the CR Modality the same way you do for a standard study.
2. Select a View or a Procedure.
If the Procedure Mapping option is enabled, enter the procedure codes for the
long-length image on the Patient Input screen.
3. Scan a CR long-length cassette bar code that begins with 9105 for long-length
vertical cassettes and 9112 for portable cassettes.
If you are processing a long-length portable cassette, a dialog box appears with the
message: Choose a patient position for this long-length exam, Erect
or Supine.
4. Enter the number of long-length imaging cassettes used for the exposure.
Make sure you select cassettes that have consecutive numbers, such as 1, 2, and 3. The
software will not let you select cassettes that would leave a gap in the combined
image, such as 1 and 3 or 1 and 4.
5. Bar code the remaining cassettes.
6. Enter the exam data.
7. Select Save Changes.
You cannot change the number of cassettes selected; however you can select
Delete View and start again.

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CR Long-Length Imaging Online Help

About Determining the SID for LLI Exams

Automatic
The SID for the portable long-length cassette is determined when you place the X-ray
tube a specific distance from the Bucky/cassette.

Override
You can override this setting for the View as desired from the More Image Data button
on the Patient Input screen.

SID Ranges
Enter the correct SID values:
DIRECTVIEW CR Long-Length Vertical Cassette HolderHas a recommended SID of
183 cm (72 in.). You can set the default SID value from 150 to 229 cm (60 to 90 in.)
1 cm, depending on site and grid requirements. You must enter SID values in
centimeters (cm).
DIRECTVIEW CR Long-Length Portable CassetteHas a recommended SID of 150 cm
(60 in.). You can set the default SID value from 101 to 183 cm (40 to 72 in.) 1 cm,
depending on site and grid requirements. You must enter SID values in
centimeters (cm).

Note
Your staff radiographers can move the tube from the default position for an exam, but must
override the default distance and enter the measured SID when entering exam information. The
composite LLI image can become distorted when the incorrect SID is entered. Therefore, it is
imperative for optimum image quality that the SID be measured accurately within 1 cm of the
correct SID values.

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CR Total Quality Tool

CR Total Quality Tool

What is CR TQT?
The following information applies only to CR Systems.
The Total Quality Tool (TQT) is a comprehensive, quality assurance system that
evaluates various aspects of image quality on CR Systems and CR cassettes. With a few
quick steps, you can verify that the system is functioning within its normal operating
specifications.
TQT is an optional feature for CR Systems. If the TQT option is not activated, contact
Carestream Health for purchase information.
Carestream Health recommends the use of the Total Quality Tool as part of a quality
control program for CR Systems. Additional quality control tests should be incorporated
into the quality control program as required by local regulations.
The Total Quality Tool does not directly evaluate or provide a quality control capability
for the X-ray equipment used or output destination devices (such as workstation
monitors) connected with the CR System. Quality control procedures for other
components in the imaging chain must be followed at the recommended intervals
according to the manufacturer's instructions.
The CR System must be calibrated at the recommended intervals according to instructions
from Carestream Health, Inc. All components in the imaging chain (such as the X-ray
equipment, workstation monitors, or film printers) must be calibrated at the
recommended intervals according to the manufacturer's instructions.

CR TQT - Determine the Exposure


Use this technique to expose General Radiography cassettes for TQT testing.
1. Turn on the X-ray equipment and the collimator light on the X-ray tube.
2. Attach 0.5 mm copper and 1 mm aluminum filtration to the bottom of the X-ray tube.
Tape the filters if necessary.
Two filters are provided and can be stored in the test phantoms protective case.
3. Collimate the beam so that the edges of the tray are within the beam of light, fully
exposing the dosimeter.
4. Place a lead sheet or a lead apron between the floor and the phantom tray. Place a
dosimeter calibrated for 80 kV centered on top of the tray.
5. Use the following specifications for the initial setup of the X-ray equipment:
80 kVp
40 mAs

Note
80 kVp ( 1) is mandatory. You can adjust the mAs to produce the correct exposure level.
The dosimeter should show an exposure level of 10.0 mR 0.2.

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CR Total Quality Tool

6. Choose one of the following options:


If the mR reading is lower than the specification, increase the mAs setting on the
X-ray equipment.
If the mR reading is higher than the specification, decrease the mAs setting on the
X-ray equipment.
If the dosimeter displays a reading of 10.0 mR 0.2, record the reading.
7. Expose the dosimeter three more times to verify consistency.

All three readings should be within 0.5 mR.

CR TQT - Collimation

The field of exposure must completely cover the cassette's surface area for proper
collimation for General Radiography.
Position of the dosimeter:

CR TQT - System Test Overview


When you open the CR Total Quality Tool (TQT) and run a test, you begin a new session.
You have the following options:
Select and run image tests and view test results.
Discard results of the last test performed in the current session.
Start a new session or append to the last session.
Access a summary of prior test results.
Access another page for testing individual cassettes.

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CR Total Quality Tool

Test or Function Description

Phantom Image Test Tests the image quality of the system. The calculated
exposure of appropriate test phantom is required.

Flat Field Image Test Tests Field Uniformity, Streaks, and Speed Deviation.

Erased Image Test The Erase Image test is performed using erased cas-
settes only and does not require an X-ray exposure.

System Noise Test The System Noise test is performed using erased cas-
(Classic CR only) settes only and does not require an X-ray exposure.

Discard Test Discards the results of the last test performed in the
current session.

Cassette Test Opens Cassette Screen Test page for Flat Field Image
Test.

Window/Level Identifies artifacts in the image. TQT images can be


transferred to the CR System and viewed on the
image viewer.

Results View Results Page 1


Phantom Image Test
View Results Page 2
Flat Field Test
Erased Image Test
System Noise Test

Cassette Size Use the keyboard to select the size and type of the
cassette you are testing.

Main Menu Select the Main Menu button to close the Total
Quality Tool, end the current session, and return to
the CR System Main Menu.

Back Select Back to return to the previous page within the


current session.

CR TQT - System Test Frequency

Cassette Test Frequency


Test all cassettes used in your system twice per year using the Total Quality Tool cassette
testing feature.

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CR Total Quality Tool

CR System Tests that May be Performed

Quality Control Test Recommended Test Interval Comment

Erase CassettesRefer to Erase Daily For cassettes that are used


Cassette information in the CR System infrequently or if
Hardware Guide unintended X-ray
exposure is suspected

CR SystemWorkstation Display Once per week or as recom-


Calibration CR SystemPrinter/Film Cal- mended by manufacturer
ibration

CR Cassette/Screen inventory, Once per month, every 200


Inspection, and Cleaning exposures, or as necessary

System Image Quality Test Frequency


Perform CR System Image Quality Tests monthly on a dedicated cassette to assure that
the test results obtained accurately reflect the CR Systems operating condition.
If dedicated cassettes are not available, choose a cassette of each size, then verify the
quality of these cassettes using the CR Total Quality Tool cassette testing feature. Make
sure to use the same cassettes each time you test.

CR TQT - About the Total Quality Tool Main Page

When you open the CR Total Quality Tool (TQT) and run a test, you begin a new session.
You can use the TQT Main Page to:
Select and run image tests and view test results.
Discard results of the last test performed in the current session.
Start a new session or append to the last session.
Access a summary of prior test results.
Access another page for testing individual cassettes.

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CR TQT - Main Page Options

Option Description

Phantom Image Test Tests the image quality of the system. The calculated exposure
of appropriate test phantom is required, so use a cassette
exposed with a standard dose phantom. Insert the cassette
when prompted.

Flat Field Image Test Tests the field uniformity, streaks, and speed deviation. Once the
Phantom Image Test is complete, TQT automatically prompts
you to load the cassette for the Flat Field Image Test. Use the
same exposure settings as the Phantom Image Test, but do not
use a test phantom.

Erased Image Test Automatically prompts you to load the cassette for the Erased
Image Test. The Erase Image test is performed using erased cas-
settes only and does not require an X-ray exposure.

System Noise Test Automatically prompts you to load the cassette. System Noise
tests are performed using erased cassettes only and do not
require an X-ray exposure.

Discard Test Discards the results of the last test performed in the current ses-
sion.

Cassette Test Opens the Cassette Screen Test page for the Flat Field Image
Test.

Window/Level Identifies artifacts in the image. TQT images can be transferred


to the CR System and viewed on the image viewer.

Results View Results Page 1


Phantom Image Test

View Results Page 2


Flat Field Test
Erased Image Test
System Noise Test

Cassette Size Lets you use the keyboard to select the size and type of the cas-
sette you are testing.

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Option Description

Main Menu Select the Main Menu button to close the Total Quality Tool,
end the current session, and return to the CR System Main
Menu.

Back Select Back to return to the previous page within the current
session.

CR TQT - System Noise Test

System Noise is measured only with the CR Total Quality Tool because the CR System
operates in a special hardware mode in which the signal associated with system
electronic noise is amplified and measured. The erased cassette is scanned a second
time with the CR System in this hardware configuration.
The full 2-D noise power spectrum is computed for the resulting image and the 1-D
spectra parallel to the fast- and slow-scan directions are estimated. Median methods
are used to estimate the average of each of the 1-D noise power spectrum over spatial
frequency. This technique is insensitive to noise spikes. The global maximum of the
full 2-D noise power spectrum is then estimated.

CR TQT - Cassette Test Prerequisites


This information will help you decide whether a cassette needs to be tested and if your
test results should be part of the previous testing session or the start of a new session.

Test your CR cassettes to verify that the cassette quality is within acceptable limits.
Tests that are done on multiple machines can be accumulated, consolidated, and
reported over an indefinite period of time. This feature lets you perform long-term trend
analysis.
1. Obtain a complete list of cassette IDs for all cassettes in your inventory.
2. Answer the following questions:
a. Has someone already started a cassette test?
b. Which cassettes have not been tested?
c. Should test results for the cassettes you want to test be appended to the previous
session or should you start a new session?

CR TQT - How to Test Cassettes

1. At the Key Operator Functions menu, select Total Quality Tool.


2. Select Cassette Test to open the Cassette Screen Test page.
3. Make sure each cassette has a flat field image.

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4. Test one size and type of cassette at a time.


By testing one size and type of cassette at a time, the results will be grouped
according to cassette size and type, making it easier to view and find results for a
particular cassette.
5. If the cassette test fails, set the cassette aside and retest it after you have tested the
remaining cassettes in a session.
Retesting all failed cassettes at once isolates duplicate tests at the end of your session
results, rather than having them dispersed throughout your session.

CR TQT - How to Verify Cassettes Were Tested

When you want all of the cassettes in your inventory to be tested and organized under
one session, you need to check and verify that every cassette has been tested at least
once.
1. Go to the Cassette Screen Test Results page to see those cassettes that have
already been tested and those that still need to be tested.
The Cassette Screen Test Results page displays the date, time, cassette ID, size, and
type of each cassette tested as well as individual subtest results.
2. Check the cassette IDs on your inventory against the IDs displayed on the
Cassette Screen Test Results page.
Use the Total # Cassettes Tested field on the Cassette Screen Test Page 3 which
includes each tested cassette only once; multiple tests of a cassette are excluded from
the total.
3. When the Total Number of Cassettes Tested equals the total number of cassettes
in your inventory, you have tested all cassettes at least once and can end the session.

CR TQT - Get the Best Results from Cassette Testing

Make sure each cassette contains a flat field image.


Test one size and type of cassette at a time. The results will be grouped according to
cassette size and type, making it easier to view and find results for a particular cassette.
Retest all failed cassettes at once to isolate duplicate tests at the end of your session.

Note
Do not load a cassette until AFTER you have initiated the testing process by selecting Flat Field
Image Test. Wait for the system message Load Cassette and then load the cassette.

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CR TQT - How to Read Cassette Test Results

For each cassette scanned, the following results are reported.


Result Description

Cassette ID Listed for each cassette measured.

Speed Deviation Reported as a code value.

Field Uniformity Error Reported as the maximum code value difference between
the sub-images.

Slow-Scan Streaks The largest amplitude streak is reported as a code value.

Fast-Scan Streaks The largest amplitude streak is reported as a code value.

Corrective Action
If the CR System has passed all four image tests, any cassettes that fail one or more of the
cassette tests should be set aside.
1. Inspect the screen for damage.
2. Clean the screen using the cleaning instructions.
3. Repeat the test.
4. If the cassette still fails, remove it from use.

CR TQT - Cassette Test Results

Result Description

Cassette ID Listed for each cassette measured.

Speed Deviation Reported as a code value.

Field Uniformity Error Reported as the maximum code value difference between the
sub-images.

Slow-Scan Streaks The largest amplitude streak is reported as a code value.

Fast-Scan Streaks The largest amplitude streak is reported as a code value.

CR TQT - How to Create a Flat Field Exposure


1. Make sure that the cassette has been erased.
2. Turn on the X-ray equipment.

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CR Total Quality Tool

3. Collimate the beam of light so that the edges of the light fall on the outer edges of
the cassette.
4. Expose the cassette using the same positioning, filter, and exposure values used to
create the Phantom Test Image, but do not use the test phantom.

CR TQT - How to Create a Flat Field Exposure


1. Make sure that the cassette has been erased.
2. Turn on the X-ray equipment.
3. Collimate the beam of light so that the edges of the light fall on the outer edges of
the cassette.
4. Expose the cassette using the same positioning, filter, and exposure values used to
create the Phantom Test Image, but do not use the test phantom.

CR TQT - TQT Position a Test Phantom


Test phantoms must be positioned specifically for the size and type of the phantom. A
guide has been developed to position the phantoms accurately and repeatedly during
testing based on the size and type of cassette being tested.
The molded plastic phantom tray contains three overlapping recessed areas, so you can
fit different size cassettes securely in the tray before placing the Test Phantom inside the
tray.

CR TQT Perform Phantom Image Test


Prerequisites:
All cassettes to be tested must be erased first. Do not use a Bucky or grid during this
procedure.

1. Erase all cassettes to be tested.


2. Turn on the X-ray equipment and the collimator light on the X-ray tube.
3. Place the cassette with the tube side up in the phantom tray on the floor.
Make sure that the cassette labels are positioned correctly.
4. Move the X-ray tube to 180 cm (72 in.) above a clear area of the floor.
5. Center the tray edges within the collimator light.
6. Attach 0.5 mm copper and 1 mm aluminum filtration (supplied) to the bottom of the
X-ray tube. Use tape to secure the filters, if necessary.

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CR Total Quality Tool

7. Position the copper filter next to the tube.

Key to the drawing:


1. Aluminum filter
2. Copper filter
3. Tape
8. Use the exposure information as prepared in Determine Exposure.
9. Position the test phantom on the tray. See Position a Test Phantom.
10. Expose the cassette. See Determine Exposure.
11. Wait 5 minutes before scanning the cassette to ensure a constant Exposure Index.
12. Start the Total Quality Tool.
13. Select the Phantom Image Test button.
14. When you see the Load cassette message, load the cassette you exposed for the
selected test.

Postrequisites:
Once the Phantom Image Test is complete, TQT automatically prompts you to Load
Cassette for the Flat Field Image Test. Use the same exposure settings as the
Phantom Image Test, but do not use a test phantom.

CR TQT - Erased Image Test


Correct operation of the CR System requires that the stimulated light signal be
proportional to the X-ray exposure. Light measured from an exposed CR cassette must
not be influenced by previous exposures or by extraneous light sources in the CR System.
Stray light can result from inadequate filtration of the laser light or from light leaks in
the CR System cabinet. This test should be done with the highest level of ambient lighting
that will be used in normal operation of the CR System. In this test, the signal from a fully

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erased CR cassette is used to verify adequate erasure and the absence of stray light
sources.
For this test, the same cassette that was used for the uniformity test is re-scanned.
Because exposure level dependent erasure is the final step of the reading process, the
cassette should be fully erased when reading is completed. Code values read from the
cassette are spatially filtered to eliminate outliers due to small dust particles. The
maximum code value in the resulting data is found.

CR TQT - Perform Erased Image Test


1. Rescan the cassette from the Flat Field Test.
The Erased Residual results are reported in the Total Quality Tool as the average
code value for the erased cassette.
2. If necessary, take corrective action.
Verify that the screen was erased.
Verify that there are no bright light sources near the CR System.
Repeat the test.
If the failure condition persists, call Service.

CR TQT - When to Append the TQT Session


When you start a new TQT testing session, all previous data becomes inaccessible.
Before running a cassette test, decide whether the results should be part of a new session
or appended to the previous session.

Note
When you decide to append to a previous session, you select the Append to Previous Session
check box on the Cassette Screen Test Results page.

CR TQT - Pixel Size Test


Pixel Size is the average center-to-center distance between pixels. Image segmentation
methods are used to automatically detect the location of the edges of the apertures
along the top, bottom, right, and left of the phantom test image.
The average slope that you calculated for the top and bottom rows of apertures
measures the average fast-scan pixel size, and the average slope calculated for the left
and right columns of apertures measures the average slow-scan pixel spacing.
Pixel Size is reported as a percentage deviation in Pixel Size Error Fast and Pixel Size Error
Slow.

CR TQT - Pixel Size Test

Pixel Size is the average center-to-center distance between pixels. Image segmentation
methods are used to automatically detect the location of the edges of the apertures

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along the top, bottom, right, and left of the phantom test image. For each side of the
image, a linear least-squares fit of the detected locations is made to the known relative
locations of the edges. The average slope that you calculated for the top and bottom
rows of apertures measures the average fast-scan pixel size, and the average slope
calculated for the left and right columns of apertures measures the average slow-scan
pixel spacing. Pixel Size is reported as a percentage deviation in Pixel Size Error Fast and
Pixel Size Error Slow.

Corrective Action
1. Note whether the Pixel Size error is Fast or Slow
2. Verify that the phantom is properly exposed and not under-collimated.
3. Repeat the test and record any failed values.

CR TQT - Scan Linearity Test


Scan Linearity is the measurement of the deviation of the aperture locations from their
expected locations, based on the linear least-squares fit of the measured locations used
to compute the Pixel Size. From these measurements, the variation in scan speed with
position is calculated for each direction.
The deviation from Scan Linearity is calculated as the maximum deviation of scan speed
from the average speed. The Fast-scan Speed Error and the Slow-scan Speed Error are
expressed as a percentage of the average speed.
This measure of Scan Linearity represents the maximum possible percentage error in
length measurements that could be made by using mean pixel spacing values.
Scan Linearity is reported as the peak-to-peak Fast-Scan Speed Error and Slow-Scan Speed
Error expressed as a percentage of the average scan speed in the respective direction.

Corrective Action
1. Note if the Scan Linearity is Fast Scan or Slow Scan.
2. Verify that the phantom is properly exposed and not under-collimated.
3. Repeat the test and record any failed values.

CR TQT - MTF Test


The best predictor of CR System sharpness is obtained from measurements of spatial
frequency response. This measurement is also called the Modulation Transfer Function or
MTF. Total Quality Tool measures MTF automatically. To be a useful measure of the CR
System, it is important to minimize the influences of other components of the image
chain, such as the exposing equipment and the display devices.
Pre-sampling MTF measurements are obtained from the edges of the slightly slanted
square in the middle of the test phantom image.
Image segmentation methods are used to automatically determine the edge locations.
The centers of the transition for a series of adjacent lines are estimated and fit to a
straight line. The pixels on each line are then displaced accordingly, and a sub-pixel

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representation of the Line Spread Function (LSF) is obtained. The pre-sampled MTF is
computed from the Fourier transform of the sub-pixel LSF.
The MTF test results are reported in the Total Quality Tool.
MTF is reported at two frequencies for each of the two scan directions. These frequencies
depend on pixel size. The results include:
Fast-scan MTF @ 95 % of Nyquist
Fast-scan MTF @ 50 % of Nyquist
Slow-scan MTF @ 95 % of Nyquist
Slow-scan MTF @ 50 % of Nyquist

CR TQT - Pixel Position Test


Flat Field (uniform) exposures provide the most stringent subjective test for many
common image artifacts that occasionally occur in CR Systems. However, there are some
artifacts that cannot be detected with Flat Field exposures.
Because CR images are read with a scanning laser beam, the relative timing of data
acquisition for each line of data is critical if the pixels are to be aligned in adjacent lines.
Normally this alignment is maintained to a very small fraction of a pixel. You can detect
sub-pixel shifts in pixel position between adjacent lines before these effects become
large enough to affect image quality in clinical images.
The linear features that are used for MTF measurements are also used to assess the
line-to-line fluctuation in pixel placement. Image segmentation methods are used to
determine locations of the edges of the central square in the test phantom image. The
centers of the transition for a series of adjacent lines are then estimated from the code
values along each line. These locations are fit to a straight line and the deviations from
linearity are computed. The RMS error of the transition centers from the fitted line is
used as a measure of the line-to-line pixel placement error.
The Pixel Position RMS test results are reported in the Total Quality Tool.
Pixel Position RMS is reported as the RMS error in the line-to-line pixel placement as a
fraction of the Pixel Size.

Corrective Action
1. Record results.
2. Call Service.

CR TQT - Exposure Response Test


Computed Radiography requires that the code value at each pixel accurately reflects the
X-ray exposure at that location. CR Systems produce raw code values that are linearly
related to the logarithm of X-ray exposure. One of the most important steps in quality
control testing is to verify the large-area exposure response linearity, since all other tests
will be done in terms of these code values.
The average response of three uniform areas of the phantom test image is computed.
Image segmentation methods are used to identify three areas of the image. The large

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square area in the center of the phantom test plate has minimal attenuation. The smaller
square area directly below the central square has uniformly high attenuation. Areas to
the left and right of the central square have a middle value of attenuation. In each of
these areas, the average of the code values in a square 2 x 2 cm is computed. The
expected attenuation of the phantom test plate is used to predict the exposure response
for these three levels of attenuation under the specified X-ray beam conditions.
The Exposure Response Test results are reported in the Total Quality Tool.
The error in the average code value (CV) for each of the three levels of attenuation is
reported in the Total Quality Tool as: Low-Exposure Response Error (CV), Mid-Exposure
Response Error (CV), and High-Exposure Response Error (CV). These are compared with
the expected code values based on the predicted attenuation of the test phantom.

Corrective Action
1. Verify that the phantom is properly exposed and not under-collimated.
2. Verify that the exposure conditions are correct:
0.5 mm Cu + 1 mm Al filtration
80 kVp
10.0 mR 0.2 (0.08760 mGy 0.00175 mGy)
3. If high-exposure result is PASS and mid- or low-exposure results are FAIL, check kVp.
4. If high-, mid- and/or low-exposure results are FAIL, check mR (mGy).
5. Inspect the screen. If the screen has discolored, repeat the test with a second cassette.
6. Verify that the phantom is oriented properly on the cassette.
7. Repeat the test and record failed values.
8. Call Service.

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CR TQT - Test Result Indicators


Indicator Sta- Indicator
tus Color Results Recommendations

Ready Gray Normal Ready to accept cassette.

Pass Green Normal Ready to accept cassette.

Pass Amber Passed by approaching See topics in Troubleshooting.


the specification limit.

Fail Red Outside of the specifi- See topics in Troubleshooting.


cation limit.

NA Purple Invalid result due to Check for proper orientation of


invalid cassette, invalid the test phantom.
test image, or incor- Check for proper exposure level.
rect exposure.
Check for proper filtration at the
tube.
Check the field of exposure.
Repeat the test.

CR TQT - Phantom Image Test Failure


The Phantom Image Test failure can be a result of the failure of any of the following:
Pixel Size Test
Aspect Ratio Test
Scan Linearity Test
Exposure Response Test
Noise Test
MTF
Pixel Position

CR TQT - Pixel Size Test Failure

1. Note whether the Pixel Size error is Fast or Slow.


2. Verify that the phantom is properly exposed and not under-collimated.
3. Repeat the test and record any failed values.

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CR TQT - Aspect Ratio Test

The pixel Aspect Ratio is calculated for the left side, center, and right side of scan lines in
the fast-scan direction.
The local fast-scan pixel size is measured by the center-to-center distances between
apertures in the test phantom.
Left Side: Use the first and third apertures.
Center: Use apertures on either side of the center.
Right Side: Use first and third apertures from the end of the scan line.
The Aspect Ratio is then computed as the ratio of the average slow-scan pixel size to the
local fast-scan pixel size.
The Aspect Ratio Error is the percentage deviation from the designed aspect ratio (unity)
for the left, center, and right sides of the image.
The Average Aspect Ratio Error is computed as the ratio of the Average Slow-Scan Pixel
Size to the Average Fast-Scan Pixel Size.
Aspect Ratio is reported as the Aspect Ratio Error Left, Aspect Ratio Error Middle, Aspect
Ratio Error Right, and Aspect Ratio Error Average; each is expressed as a percentage of
the designed aspect ratio.

Corrective Action
1. Note if the Aspect Ratio Error is Left, Middle, Right, or Average.
2. Verify that the phantom is properly exposed and not under-collimated.
3. Repeat the test and record any failed values.

CR TQT - Scan Linearity Test Failure

1. Note whether the Scan Linearity is Fast-Scan or Slow-Scan.


2. Verify that the phantom is properly exposed and not under-collimated.
3. Repeat the test and record any failed values.

CR TQT - Noise Test Failure

1. Verify that the phantom is properly exposed and not under-collimated.


2. Verify that the exposure conditions are correct:
a. 0.5 mm Cu + 1 mm Al filtration
b. 80 kVp
c. 10.0 mR 0.2 (0.08760 mGy 0.00175 mGy)
3. If the high-exposure result is PASS and the mid- or low-exposure results are FAIL,
check kVp.
4. If the high-, mid-, and/or low-exposure results are FAIL, check mR (mGy).

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5. Inspect the screen. If the screen has discolored, repeat the test with a second cassette.
6. Verify that the phantom is oriented properly on the cassette.
7. Repeat the test and record the failed values.
8. Call Service.

CR TQT - MTF Test Failure

1. Verify that the phantom is oriented properly on the cassette.


2. Inspect the phantom for damage such as kinks or creases.
3. Repeat the test and record failed values.
4. Call Service.

TQT Exposure Response Test Failure

1. Verify that the phantom is properly exposed and not under-collimated.


2. Verify that the exposure conditions are correct:
a. 0.5 mm Cu + 1 mm Al filtration
b. 80 kVp
c. 10.0 mR 0.2 (0.08760 mGy 0.00175 mGy)
3. If the high-exposure result is PASS and the mid- or low-exposure results are FAIL,
check kVp.
4. If high-, mid-, and/or low-exposure results are FAIL, check the mR (mGy).
5. Inspect the screen. If the screen has discolored, repeat the test with a second cassette.
6. Verify that the phantom is oriented properly on the cassette.
7. Repeat the test and record the failed values.
8. Call Service.

CR TQT - Pixel Position Test Failure

1. Record results.
2. Call Service.

CR TQT - How to Evaluate Flat Field Image Tests


Computed Radiography requires that the code value at each pixel accurately reflects the
X-ray exposure at each location. Flat Field exposures should result in a uniform response
from the CR System, and they provide the most stringent test for many common image
artifacts that can occur in CR Systems.
Flat-field exposures are used for the following tests of uniformity and artifacts:

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Field UniformityField Uniformity is computed by partitioning the image into an


array of 5 x 5 sub-images. The mean code value of each sub-image is computed. The
Field Uniformity Error is reported as the maximum code value difference between the
sub-images. Pass-fail criteria is based on mean code value deviation of the sub-images
for the appropriate cassette size.
Line Position NoiseDuring the CR reading process, randomly distributed variations
from line to line occur in the image. This artifact is most easily observed at the
beginning of fast scan lines. It is measured in terms of uncorrelated variations in the
average code values at the beginning of each line. Line Position Noise is reported as
a code value representing the RMS pixel variations associated with wobble in the
galvanometer mirror.
BandingBanding is caused by periodic fluctuations in the slow-scan direction.
Slow-Scan Banding is reported as a code value representing the magnitude of pixel
variations with reference to slow-scan velocity.
ChatterChatter may result from inadequate lubrication of the lead screw. This
results in quasi-periodic fluctuations in the slow-scan direction that are not correlated
with the pitch of the slow-scan. Slow-Scan Chatter is reported as a code value
representing the magnitude of pixel variations associated with chatter in the motion
of the slow-scan assembly.
StreaksStreaks may result from a number of possible causes. Isolated deviations
from the background are analyzed for correlations in the slow-scan and fast-scan
directions. Both the location (pixel or line number) and amplitude (code value) of
these are calculated. The largest magnitude Slow-Scan Streaks and Fast-Scan Streaks
are reported as code values.

CR TQT - Flat Field Test Failure

Area of Flat Field Test


Failed Corrective Action

Field Uniformity 1. The X-ray heel effect can affect the test results. Verify that the X-ray heel
effect is not significant.
2. Verify that the cassette is properly exposed and not under-collimated.
3. If the heel effect is satisfactory and a FAIL condition persists, call Service.

Line Position Noise 1. Verify that the cassette is properly exposed and not under-collimated.
2. Verify that the exposure conditions are correct:
0.5 mm Cu + 1 mm Al filtration
80 kVp
10.0 mR 0.2 (0.08760 mGy 0.00175 mGy)
3. Repeat the test.
4. Record the values.
5. Call Service.

Banding Call Service.

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Area of Flat Field Test


Failed Corrective Action

Chatter Call Service.

Streaks 1. Check for streaks or lines on the cassette.


2. Clean the screen and look for scratches.
3. Call Service.

TQT Troubleshooting
To resolve a condition that results in a Warning or a Failure:
1. Study the graphs.
The graphs provided for each subtest make it easy to see if the results are a gradual
trend or a sudden shift in performance.
2. Repeat the tests.
Warnings and Failures could be the result of procedural errors, and they should be
verified by repeating the tests.
3. Determine the general cause.
Determine whether the Warning or Failure is caused by the CR System or the cassette.
4. Take corrective action as appropriate.

Note
Keep running production, based on the independent evaluation of image quality results.

How to Export TQT Data


Cassette test results are organized into sessions so that data can be easily maintained,
viewed, and exported. You can save test results in one session by appending test results
until all your cassettes have been tested, or you can test your cassette inventory over
multiple sessions. When a session is complete, you can export the results and then start a
new session.
1. Select Export in the bottom left corner of the screen.
2. Select the destination drive to save your data.
3. Select OK.

Film-Printer Calibration Test Procedure


Perform printer calibration and system verification periodically per the printer
manufacturers recommendations, as part of a quality control program, whenever the

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printer or system is serviced or upgraded, and whenever you observe unexpected


changes in image quality.
1. Verify the printer and system combination.
2. Calibrate each printer using the procedure provided by the manufacturer.
Optical density measurements require a calibrated densitometer.

How to Verify the System-Printer Calibration

1. Go to Key Operator Functions > Monitor Calibration to obtain a SMPTE pattern.


2. Acquire and label the printed film.
3. Measure and record the optical density for each test patch.
Pay attention to the following details:
Optical density measurements require a calibrated densitometer.
Two patches are labeled 50 %.
Make sure that the plot of density versus percentage is linear and the range of
densitythe maximum density minus the minimumis between 2.5 and 3.1.
Compute the least-squares fit of density with respect to the fractional of full
response shown on the SMPTE patternthat is, treat the 10 % patch as 0.10.
Make the slope of this line between 2.5 and 3.1 with no point deviating by more
than 0.3 log density from the line.
Examine the image of the entire SMPTE pattern for printer artifacts, such as lines,
banding, or density non-uniformities.

Workstation Display Calibration Test Procedure


Perform the display calibration and system verification test periodically per the
manufacturers recommendations, as part of a quality control program, following service
or upgrades, and whenever you observe unexpected changes in image quality.
1. Verify the display monitor-system combination.
2. Go to Key Operator Functions > Monitor Calibration and obtain SMPTE pattern
RP-133.

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3. Perform the grayscale calibration.


a. Generate and send the SMPTE pattern to the workstation.
b. Display, magnify, and position the SMPTE pattern image to fill the center of the
image display area with each of the 14 SMPTE test patches labeled with a
percentage value (0 %, 10 %, and so forth).
c. Measure and record the luminance for each test patch.
Display luminance measurements require a calibrated photometer.
Two patches are labeled 50 %, although only one is used.
Make sure that the plot of logarithm (base 10) of the luminance versus
percentage is linear and the range of log luminancethe maximum log
luminance minus the minimumis between 2.5 and 3.1.
Compute the least-squares fit of log luminance with respect to the fractional
of full response shown on the SMPTE patternthat is, treat the 10 % patch as
0.10.
Make the slope of this line between 2.5 and 3.1 with no point deviating by
more than 0.3 log luminance from the line.
Examine the image of the entire SMPTE pattern for monitor artifacts, such as
lines, banding, or density non-uniformities.

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Bar Codes

How to Reset the Bar Code Reader to Factory Defaults


1. Go to Key Operator Functions > System Configuration > Bar Code
Configuration > Bar Code Programming.
2. Scan the Standard Product Defaults bar code with the hand-held bar code reader.
3. Scan the Clear All Prefixes and Suffixes bar code to clear and reset the bar code
reader.

Postrequisites:
Once the bar code reader has been reset, you must reprogram it.

Bar Code Programming

How to Change the Bar Code Data Field Size


1. Go to Key Operator Functions > System Configuration > Bar Code
Configuration.
2. Select the Data Size field.
3. Enter the number of characters that you want to display.
4. Select Save Changes.

Note
You can make all of your changes on the Bar Code Configuration screen and then select Save
Changes when finished.

Program Hand-Held Bar Code Reader Preferences


1. Go to Key Operator Functions > System Configuration > Bar Code
Configuration.
2. Scan the appropriate bar code to select a volume level for the reader:
High (default)
Medium
Low
Off
3. Scan the appropriate bar code to select a tone for the reader:
Normal Beep (default)

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Short Beep

Note
If the scan is successful, the reader will emit a tone. If it is not successful, it will emit a buzzing
sound.
4. Scan the appropriate bar code to select an operational mode for the reader:
Automatic TriggerScan this bar code if you want the reader on all of the time.
Manual TriggerScan this bar code if you want the reader LEDS turned off until
you touch the trigger.
5. If you use Automatic Trigger Mode, scan the appropriate bar code to select the time
delay between reading the same bar code:
Short (default)
Medium
Long
Extra Long

Program the PS2 Keyboard Bar Code Reader


Scan the bar codes in the following order: from left to right and top to bottom.

Standard Product Defaults Emulate Keyboard

Add Prefix 9

9 0

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4 0

4 0

4 Save

Add Suffix 9

9 0

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4 0

4 Save

Program the PS2 Keyboard Bar Code Reader and Add Suffix
In addition to Programming the PS2 Keyboard Bar Code Reader, if the Add # to Cassette
IDs to make them 11 digits check box is selected, scan the bar codes in the following
order: from left to right and top to bottom. This affects Carestream Health Cassette ID
bar codes only, which are interleaved 2 of 5 bar code types.

Add Suffix 6

5 2

3 0.

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4 0.

4 0

4 Save

Program the PS2 to USB Keyboard Bar Code Reader


Scan the bar codes in the following order: from left to right and top to bottom.

Standard Product Defaults Emulate Keyboard

Add Prefix 9

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9 5

B Save

Add Suffix 9

9 5

D Save

Program the PS2 to USB Keyboard Bar Code Reader and Add Suffix
In addition to Programming the PS2 to USB Keyboard Bar Code Reader, if the Add # to
Cassette IDs to make them 11 digits check box is selected, scan the bar codes in the

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following order: from left to right and top to bottom. This affects Carestream Health
Cassette ID bar codes only, which are interleaved 2 of 5 bar code types.

Add Suffix 6

5 2

3 5

D Save

Program the Keyboard Wedge Bar Code Reader and Add Suffix
In addition to Programming the Keyboard Wedge Bar Code Reader, if the Add # to
Cassette IDs to make them 11 digits check box is selected, scan the bar codes in the

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following order: from left to right and top to bottom. This affects Carestream Health
Cassette ID bar codes only, which are interleaved 2 of 5 bar code types.

Add Suffix 6

5 2

3 0

4 0

4 0

4 Save

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Program the Keyboard Wedge Bar Code Reader


Scan the bar codes in the following order: from left to right and top to bottom.

Standard Product Defaults Emulate PC Wedge

Add Prefix 9

9 0

4 0

4 0

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4 Save

Add Suffix 9

9 0

4 0

4 0

4 Save

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Program the USB as Serial Bar Code Reader


The Serial Bar Code Reader must have two connectors: one for the serial port and one for
power (such as a PS2 connector).
Scan the bar codes in the following order: from left to right and top to bottom.
Standard Product Defaults

USB Port Emulating Serial

If the Add # to Cassette ID to make them 11 digits check box is checked, scan the
following bar code:
Add Suffix Via Data Formatter

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Program the Serial Bar Code Reader


The Serial Bar Code Reader must have two connectors: one for the serial port and one for
power (such as a PS2 connector).
Scan the bar codes in the following order: from left to right and top to bottom.
Standard Product Defaults

Serial

9600 Baud 7 Data Bits 1 Stop Bit Even

If the Add # to Cassette IDs to make them 11 digits check box is checked, scan the
following bar code:
Add Suffix Via Data Formatter

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How to Find a Bar Code


You can find the location of the bar code that you need in this list:
1. Bar Code Programming Samples 1
Country Code
Clear All Prefix
Clear All Suffix
Test Bar Code
Add Prefix
Add Suffix
2. Bar Code Programming Samples 2
Numbers 05
3. Bar Code Programming Samples 3
Numbers 69
Save
4. Bar Code Programming Samples 4
Letters AF
5. Bar Code Programming Samples 5
Code 39 Full ASCII On
Code 39 Full ASCII Off
Automatic Trigger
Manual Trigger
Beep Tone Normal
Beep Tone Short
6. Bar Code Programming Samples 6
Reread Delay Short
Reread Delay Medium
Reread Delay Long
Reread Delay Extra Long
7. Bar Code Programming Samples 7
Beep Volume High
Beep Volume Medium
Beep Volume Low
Beep Volume Off

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Bar Code Programming Samples 1

Country Code

Clear All Prefix

Test

Add Prefix

Add Suffix

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Bar Code Programming SamplesNumbers 05

Number 0

Number 1

Number 2

Number 3

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Number 4

Number 5

Bar Code Programming SamplesNumbers 69

Number 6

Number 7

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Number 8

Number 9

Save

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Bar Code Programming SamplesLetters AF

Letter A

Letter B

Letter C

Letter D

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Letter E

Letter F

Bar Code Programming Samples 5

Full ASCII On

Auto Trigger

Beeper Tone Normal

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Full ASCII Off

Manual Trigger

Beeper Tone Short

Bar Code Programming SamplesReread Delay

Reread Short

Reread Medium

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Reread Long

Reread Extra Long

Bar Code Programming Samples 7

Beeper Volume High

Beeper Volume Medium

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Beeper Volume Low

Beeper Volume Off

Troubleshooting the Hand-Held Bar Code Reader


If the information does not appear or does not appear properly on the screen, the bar
code reader must be reconfigured by the Key Operator.
1. If there is no beep, check the sound level for the reader. Has the sound been turned
off?
2. Is there a bar code problem?
Is the bar code unreadable? If the bar code is blurred, move the reader closer or
farther away from the bar code label as you scan.
Is the bar code invalid?
3. If the bar codes are read incorrectly or if there are no results from the bar code reader,
it may be necessary to reset the bar code reader to factory defaults.
4. Check to see if there is a hardware problem. If the reader is in manual trigger mode,
press the trigger while aiming the reader at a sheet of paper. Look for the red
scanning beam. If you can see the beam, the device is working.

Note
If the scan is successful, the reader will emit a tone. If it is not successful, it will emit a buzzing
sound.

HIBC Bar Codes


If your facility creates its bar codes using the Health Industry Bar Code (HIBC) standard,
you can scan these codes and configure the System so that the data required displays in
the order needed to populate the Patient Input and Work List screens. To do this,
configure the system to interpret HIBC bar codes using the HIBC tab.
There are two list boxes on the HIBC screen.
The top list box has three columns:

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HIBC Field DICOM Field Test Scan Data

1. The HIBC Field column is a standard list of all HIBC fields. It is fixed and filled in by
default. It lists all of the fields in the HIBC bar code in alphabetical order.
2. The DICOM Field column is a list of the data that is used by Carestream to populate
patient demographic fields.
3. The Test Scan Data column is the result of an actual scan of the test 2D bar code.
The lower list box, DICOM Field, contains a list of all DICOM fields Carestream uses in its
Patient Input and Work List screens.
The objective is to map the DICOM data with the corresponding fields in the HIBC
column.

Character Delimited Bar Codes


If your facility creates its bar codes using character delimited, you can scan these codes
and configure the System so that the data displays in the order needed to populate the
Patient Input and Work List screens. To do this, configure the system to interpret
character delimited bar codes using the Character Delimited tab.
Character delimited bar codes do not appear in a standard format. They can contain any
information, in order.
The delimiter notifies the system that the data is parsed by that character. The default
delimiter is the character |.
For example, the data may appear |Johnson | Robert | 123456 | 23423480 | M | meaning:|
Patient Last Name | Patient First Name | Patient ID | Accession Number | Gender |

Configure the System to Read Character Delimited Bar Codes


Prerequisites:
This procedure assumes that you have configured the bar code reader to work with the
Modality.

1. Go to Key Operator Functions > System Configuration > Bar Code


Configuration > Multiple Field Bar Code Formatting > Character Delimited
tab.
2. Viewing the Character Delimited screen, scan a test bar code.
The information appears in the Test Scan Data text box.

Note
Do not scan the test bar code more than once. If you scan it twice, it will fail.

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3. Identify the delimiter and enter it in the Delimiter Character text box. This notifies
the system that the data is parsed by that character. The default delimiter is |.
For example, the data may appear |Johnson | Robert | 123456 | 23423480 |
M |meaning: | Patient Last Name | Patient First Name | Patient ID | Accession Number
| Gender |
4. From the DICOM Field list box, select the first field that appears in the test data
string.
In the example above, it would be Patient Last Name. Use the right arrow to move
it to the top position in the Configured Fields list box. Patient First Name would
follow in the list.

Note
The order is important. Follow the test data string and map the corresponding fields in the order
that they appear.
If an item in the Test Scan Data string is not used by Carestream, does not make sense, and/or
does not appear in the DICOM Field list, scroll down the list and select Unmapped Field and
move it into the Configured Fields list box. The unmapped field acts as a placeholder, and when
the system parses the data, that field will be ignored.
5. Enter the Gender term that appears in the Test Scan Data text box as described
above.
6. Select Save Changes when done.
7. Confirm your configuration by viewing the format of the data in the Data Parsed
from Test Scan text box.
8. Select Save Changes.

Configure the System to Read HIBC Bar Codes


Prerequisites:
This procedure assumes that you have configured the bar code reader to work with the
Modality.

1. Go to Key Operator Functions > System Configuration > Bar Code


Configuration > Multiple Field Bar Code Formatting > HIBC tab.
2. Scan a patient wristband 2D bar code to create a list of test data.
The information appears in the Test Scan Data text box.

Note
Do not scan the test bar code more than once. If you scan it twice, it will fail.

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3. Compare the known values in the HIBC column with the corresponding values in the
Test Data column.
a. If data in the HIBC field, the DICOM field, and the Test Data field match, the
configuration is complete.
b. If the DICOM field does not match the Test Data field and the HIBC field, select
the correct DICOM field from the bottom DICOM Field list box and select the
Assign Field button to map it correctly.
c. Remove a field by highlighting it and selecting the Unassign Field button.

Note
The order is important. Follow the test data string and map the corresponding fields in the order
that they appear.
If an item in the Test Scan Data string is not used by Carestream, does not make sense, and/or
does not appear in the DICOM Field list, scroll down the list and select Unmapped Field and
move it into the Configured Fields list box. The unmapped field acts as a placeholder, and when
the system parses the data, that field will be ignored.

4. If you want to map an HIBC field with a different DICOM field:


a. Select the HIBC field to highlight it.
b. Select the DICOM field from the DICOM Field list box.
c. Select the Assign Field button.
5. Select Save Changes when done.
6. Confirm your configuration by viewing the format of the data in the Data Parsed
from Test Scan text box.
7. Select Save Changes.

ExampleStrip Middle Characters from Bar Code


Select Strip to remove the field when it is read by the bar code reader. The action is
performed from left to right on the Bar Code Configuration screen.
For example, if the bar code is a series of characters such as ABC-01752-001 and you need
to change it to AC-01752-1, do the following:
Data
Field Strip Size Strip Prefix Size Strip Suffix Strip Size

Acces- 1 X B 8 X 00 1
sion
Number

Legend:
Prefix = B
Data = AC-01752-1
Suffix = 0

412 AC1456 | 2015-03-16


Bar Codes

Data Entry with the Bar Code Reader


Select a data field and scan a bar code to place its value in the field. The system is capable
of recognizing and automatically placing the values. This feature is the system's ability to
automatically recognize certain data fields and enter the information without selecting
that field in advance.
The Modality and the bar code reader can:
Expedite data entry by reading bar codes for selected fields and place those values
into the fields.
Automatically execute a local query to retrieve Work List or patient records that
match the value read.
Automatically place the correct value in the correct field if you read an accession
number or patient ID and the patient exam is opened automatically.
This includes the following fields:
Accession Number
Patient ID
Procedure Code
Cassette ID
Tech ID

2D Bar Code Programming


The 2D bar code reader allows the user to read both one dimensional (1D) and two
dimensional (2D) bar codes. 2D bar codes contain much more information than
traditional 1D bar codes.
The 2D bar code reader works wirelessly. The user associates the reader with the IP
address of an accompanying adapter that is installed in the modality's computer. The
reader is associated with the IP address of the adapter only. That way, the reader can only
be used with the adapter installed in a particular modality.
The 2D bar code reader is an option that is used in patient verification. For example, the
Key Operator can configure the software to interpret the data that is scanned from a 2D
bar code on a patients wristband. The software then formats the bar code data into
information that is used on the patient Input and Work List screens.
The user needs to know which format the bar code is in before configuring the reader to
recognize and populate certain DICOM fields. The software interprets 2D bar codes in
two formats:
Health Industry Bar Code (HIBC)
Character Delimited Bar Code

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Bar Codes

Program the 2D Bar Code Reader


First, you must pair or associate the reader with the IP address on the adapter that is
packaged with the reader. Until this connection is made, the 2D bar code reader will not
work with your System.

Prerequisites:
Insert the BLUETOOTH adapter into a USB port on the System computer.

1. Go to Key Operator Functions > System Configuration > Bar Code


Programming > 2D Bar Code Programming.
2. The screen displays four 2D bar codes that are used to clear any data from the bar
code reader, reset it to factory defaults, and save those changes:
RF Factory Reset
Clear all stored data
Clear prefix and suffix
Save settings
3. Scan the bar codes with the 2D bar code reader in order, from left to right, top to
bottom. The reader LED will glow red and beep as each scan takes place, and emit a
green light when it is ready for the next scan. (Some bar codes take longer to read
than others.)
4. Select Next Page. Scan the following:
QR On
CR/LF Suffix
Do not go to sleep
No store data
Save settings
5. Select Next Page.
6. Scan the MAC Address:--:--:--:--:--:--
This is the IP address of the adapter. When the scan is successful, a blue light on the
reader will flash repeatedly.

Note
Ambient light and the display settings for the monitor can prevent you from successfully scanning
on-screen bar codes. Increase the brightness and contrast of the monitor if necessary and point
the reader straight at the bar code.
7. Select Pair with Reader to authorize the connection.
8. Scan the Save Settings bar code.

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Bar Codes

ASCII 39 Mode
The American Standard Code for Information Interchange (ASCII) codes represent text in
computers, communications equipment, and other devices that use text. Most modern
character-encoding schemes are based on ASCII, though they support many additional
characters.
For example, to configure the bar code to contain lowercase letters, or some other
symbols that are not available in Full ASCII Off, Full ASCII On has to be turned on.
Code 39 is restricted to 43 characters. In Full ASCII Code 39 Symbols 09, AZ, , and
-are the same as their representations in Code 39. Lowercase letters, additional
punctuation characters and control characters are represented by sequences of two
characters of Code 39.
1. To turn the ASCII Code 39 on, scan the Code 39 ASCII On bar code.

2. To turn the ASCII Code 39 off, scan the Code 39 ASCII Off bar code.

How to Add a Prefix or Suffix Bar Code


Go to Key Operator Functions > System Configuration > Bar Code Configuration.
1. Scan all of the bar codes on the Add Prefix or Add Suffix page.
2. Scan the Save bar code.

How to Change the Prefix and Suffix Bar Codes

Prefixes are characters (up to ten digits) preceding data which serve as mapping keys. Bar
codes that are read into the system and contain prefix characters will populate the

AC1456 | 2015-03-16 415


Bar Codes

designated fields on the Patient Input, Image Acquisition, and Patient Work List
screens.
For example, you might configure the Prefix for the Accession Number via Key Operator
Functions > System Configuration > Bar Code Configuration as such:
Strip enabled (checked)
Prefix as ACN
Data size of 6
When you have configured a bar code so that the Prefix or Suffix is not used, or an
alternate prefix and suffix are used, you must program the reader to use the new
configuration.

Fixed Mount Bar Code Programming


A fixed mount bar code reader is hardwired to the unit, and is used to read bar codes on
requisition forms.

How to Program a Fixed Mount Bar Code Reader

Go to Key Operator Functions > System Configuration > Bar Code


Programming > Fixed Mount Bar Code Programming.
Select the appropriate setting for each field. The default setting you choose will remain
in effect until the settings are changed.

Field Settings

Automatic Trigger Auto Trigger


Always On

Beeper Mode Beep Off


Low Volume Beep
Medium Volume Beep
High Volume Beep
Extremely High Volume Beep

Reread Delay None


Short
Medium
Long
Extra Long

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Bar Codes

Automatic Trigger Mode


The Automatic Trigger lets you program the bar code reader to be on all of the time, or
to be on only when you touch the manual trigger.
To program the hand-held bar-code reader to its operational mode:

Scan the Automatic Trigger bar code if you want the scanner on all of the time.
Scan the Manual Trigger bar-code if you want the scanner LEDs off until you touch
the trigger.

Reread Delay Configuration

Go to Key Operator Functions > System Configuration > Bar Code Configuration.
To configure the time delay allowed between reading the same bar code, select from the
following and scan the appropriate bar code:
Short (default)
Medium
Long
Extra Long

Note
This feature is only available in Automatic Trigger mode.

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Bar Codes

Fixed Mount Bar Code Programming


A fixed mount bar code reader is hardwired to the unit, and is used to read bar codes on
requisition forms.

How to Program a Fixed Mount Bar Code Reader

Go to Key Operator Functions > System Configuration > Bar Code


Programming > Fixed Mount Bar Code Programming.
Select the appropriate setting for each field. The default setting you choose will remain
in effect until the settings are changed.

Field Settings

Automatic Trigger Auto Trigger


Always On

Beeper Mode Beep Off


Low Volume Beep
Medium Volume Beep
High Volume Beep
Extremely High Volume Beep

Reread Delay None


Short
Medium
Long
Extra Long

418 AC1456 | 2015-03-16


Carestream and IEC Exposure Indicators Overview

Carestream and IEC Exposure Indicators Overview


The radiographer may use either the International Electrotechnical Commission (IEC)
Exposure Index or the Carestream Exposure Index (EI) to match the exposure to the
desired speed class of operation. The speed class is determined by consulting with an
interpreting radiologist. The radiologist's feedback on sample images helps determine
the level of image noise he or she can accept. It is important to note that as speed class
increases the amount of image noise will increase. Once an acceptable noise level is
established, a radiographer can identify the speed class of operation for the imaging
system and the corresponding technique charts. It is the responsibility of the
radiographer to select a technique that provides enough exposure to reduce the amount
of noise while adhering to As Low As Reasonably Achievable (ALARA) standards.
The EI is inversely related to the speed class of operation. If you are using the Carestream
Exposure Index values, for every 300 EI increase, the dose is doubled and the speed class
is reduced by half. In other words, if the EI increases from 1400 to 1700, the dose is
doubled and the speed class is reduced from a 400 speed class to a 200 speed class. If you
are using the IEC Exposure Index values, when the Deviation Index (DI) reaches +3, the
dose is doubled and the speed class is reduced by half. Regardless of which exposure
indicators are selected, as the EI increases, the dose to the patient increases and the speed
class is reduced.

Exposure Indicators
The Carestream Exposure Index allows the radiographer to match the exposure to the
desired speed class of operation. The speed class is set in a given department by
consulting with an interpreting radiologist. The radiologists feedback on sample images
helps determine the level of image noise he or she can accept. It is important to note,
that as speed class increases, the amount of image noise will increase. Once an acceptable
noise level is established, a radiographer can identify the speed class of operation for the
imaging system and the corresponding technique charts. It is the responsibility of the
radiographer to select a technique that provides enough exposure to reduce the amount
of noise while adhering to ALARA standards.
The exposure index is indirectly proportional to the speed class of operation. If you are
using the Carestream Exposure Index values, for every 300 exposure index increase,
the speed class is reduced by half. In other words, if the exposure index increases from
1400 to 1700, the speed class is reduced from a 400 speed class to a 200 speed class. If you
are using the Internal Electrotechnical Commission (IEC) Exposure Index values,
when the deviation index reaches +3, the speed class is reduced by half. Regardless of
which exposure indicators are selected, as the exposure index increases, the dose to the
patient increases.
The Exposure Index charts are designed to provide the radiographer with a guide to
determine the proper Carestream Exposure Index or IEC Exposure Index based on
the speed class of operation selected for your department, or particular procedures.

Carestream Exposure Index


The Carestream Exposure Index (EI) is not necessarily unique to the receptor type.
However, Computed Radiography (CR) systems typically operate at a lower speed class

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Carestream and IEC Exposure Indicators Overview

than Digital Radiography (DR) systems. Therefore, your facility may choose to operate
your CR at a different speed class than the DR.
Once an acceptable noise level is determined by the radiologist, the corresponding speed
class may be identified for each range of kVp exams needed (for example, infant skull
may be exposed with 65 kVp). The chart for the Carestream Exposure Index will then
indicate a target range for that exam based on kVp and speed class. For example, if 400
speed class of operation is selected for the infant skull, the target EI should be between
1290 and 1390.
DRX 2530C Exposure Index Target Ranges

Speed Class 5055 kVp 5262 kVp Exams 6375 kVp 76100 kVp
Exams Exams Exams

100 16001660 18201940 18802000 19402060

200 13001360 15201640 15901710 16401760

300 11601200 13601480 14301550 14901610

400 10001060 12301330 12901390 13501450

500 900980 11301220 12001280 12601340

600 820890 10701120 11401190 12001250

700 760810 10101060 10801130 11401190

800 700750 9601000 10301070 10801120

900 650690 910950 9801020 10301070

1000 600640 860900 9801020 9801020

420 AC1456 | 2015-03-16


Carestream and IEC Exposure Indicators Overview

CARESTREAM Exposure Index for DRX and PRO 3543/3543C CsI


Detectors
Table 1: Carestream Exposure Index vs. Speed Class of Operation
for DRX-1C and PRO 3543/3543C CsI Detectors

65-80 kVp 81-100 kVp


Speed Extremities exams exams Adult Chest

100 1820-1940 1880-2000 1940-2060 1970-2090

200 1520-1640 1590-1710 1640-1760 1670-1790

300 1360-1480 1430-1550 1490-1610 1520-1640

400 1230-1330 1290-1390 1350-1450 1380-1480

500 1130-1220 1200-1280 1260-1340 1290-1370

600 1070-1120 1140-1190 1200-1250 1230-1280

700 1010-1060 1080-1130 1140-1190 1170-1220

800 960-1000 1030-1070 1080-1120 1120-1160

900 910-950 980-1020 1030-1070 1080-1110

1000 860-900 930-970 980-1020 1020-1060

Notes and Conditions: On average, images captured on the DRX-1 (CsI) from several U.S.
sites were acquired with speeds in the Bold regions. These charts do not pertain to data
acquired outside the U.S. due to differing beam conditions.

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Carestream and IEC Exposure Indicators Overview

CARESTREAM Exposure Index for DRX and PRO 3543/3543C GOS


Detectors
Table 2: Carestream Exposure Index vs. Speed Class of Operation
for DRX and PRO 3543/3543C GOS Detectors

6580 kVp 81100 kVp


Speed Extremities exams exams Adult Chest

100 1810-1930 1870-1990 1950-2070 1980-2100

200 1510-1630 1570-1690 1650-1770 1680-1800

300 1370-1470 1420-1540 1500-1620 1530-1650

400 1220-1320 1280-1380 1360-1460 1390-1490

500 1120-1210 1180-1270 1260-1350 1290-1380

600 1060-1110 1120-1170 1210-1260 1240-1290

700 1000-1050 1060-1110 1150-1200 1180-1230

800 950-990 1010-1050 1100-1140 1130-1170

900 900-940 960-1000 1050-1090 1080-1120

1000 860-890 920-950 1010-1040 1040-1070

Notes and Conditions: On average, images captured on the DRX (GOS) from several U.S.
sites were acquired with speeds in the Bold regions. These charts do not pertain to data
acquired outside the U.S. due to differing beam conditions.

422 AC1456 | 2015-03-16


Carestream and IEC Exposure Indicators Overview

IEC Exposure Index for DRX and PRO 3543/3543C CsI Detectors
Table 3: IEC Exposure Index vs. Speed Class of Operation
for DRX and PRO 3543/3543C CsI Detectors

6580 kVp 81100 kVp


Speed Extremities exams exams Adult Chest

100 620 723 824 883

200 307 358 409 439

300 203 237 271 291

400 150 175 201 216

500 117 138 158 170

600 97 115 132 142

700 80 95 109 118

800 71 84 96 104

900 62 74 85 92

1000 55 65 75 81

Notes and Conditions: On average, images captured on the DRX (CsI) from several U.S.
sites were acquired with speeds in the Bold regions. These charts do not pertain to data
acquired outside the U.S. due to differing beam conditions.

AC1456 | 2015-03-16 423


Carestream and IEC Exposure Indicators Overview

IEC Exposure Index for DRX and PRO 3543/3543C GOS Detectors
Table 4: IEC Exposure Index vs. Speed Class of Operation
for DRX and PRO 3543/3543C GOS Detectors

65-80 kVp 81-100 kVp


Speed Extremities exams exams Adult Chest

100 594 679 831 889

200 294 336 413 442

300 194 222 274 293

400 143 164 203 217

500 112 129 159 171

600 93 107 133 143

700 77 89 110 119

800 68 78 98 105

900 59 69 86 93

1000 52 61 76 82

Notes and Conditions: On average, images captured on the DRX-1 (GOS) from several U.S.
sites were acquired with speeds in the Bold regions. These charts do not pertain to data
acquired outside the U.S. due to differing beam conditions.

IEC Exposure Index


The International Electrotechnical Commission (IEC) exposure index is unique to the
receptor type being used and to the exam performed. Three default target Exposure
Index (EI) values are preloaded into the system. The three values represent the default
target EI for bucky, non-bucky, and pediatric exams.
Once a determination of speed class of operation is made, the Key Operator will need to
adjust the Target EIs to correspond to the EI/speed charts for that particular receptor
type. When an exposure is made, the IEC EI will be displayed followed by the deviation
index (DI) in parentheses. For example: EI: 360.25 (1.2). The deviation index quantifies
the difference between the actual EI and the Target EI. The DI allows the radiographer
to track and adjust their exposures with this feedback. When the actual EI is equal to the
target EI, the DI will equal 0. A positive or negative DI indicates the amount of exposure
greater or lesser than the target EI. It does not necessarily mean that an image needs to
be repeated. If the deviation is greater than +3, the exposure index will be highlighted
in red to indicate a high/low exposure that may need further review.
The Deviation Index chart outlines how to use the deviation index. In the example above,
the DI was calculated as 1.2. If we look at the DI chart, we see that a DI of 1 means the

424 AC1456 | 2015-03-16


Carestream and IEC Exposure Indicators Overview

resulting exposure was ~26 % higher than the target EI. Our DI was 1.2 so we can
estimate that we are slightly higher, perhaps closer to 30 %. Although it is a good image,
it is merely an indicator to the radiographer that he or she may be able to reduce their
exposure factors the next time they perform that particular exam and still acquire an
acceptable image and reduce the dose to the patient.

Deviation Index Chart


Deviation Index Percent Off Target

3 ~100 % too high

2 ~58 % too high

1 ~26 % too high

0 Correct

-1 ~21 % too low

-2 ~37 % too low

-3 ~50 % too low

About Exposure Index Calibration

IEC 62494-1 Exposure Index


Exposure Index (EI) related to Value of Interest as follows: c0 = 100 Gy-1, where g(V)
is Inverse Calibration Function (Image Receptor Air Kerma/Detector Entrance Exposure
for Value of Interest, V).

Carestream Health Implementation of IEC Exposure Index


Decision not to change Calibration Conditions to those of IEC.
IEC 62494-1 Calibration CSH Calibration

70 kVp 4 kVp 80 kVp

Filter: 21 mm Al or 0.5 mm Cu + 2 mm Al Filter: +0.5 mm Cu, +1 mm Al

Half-Value Layer: 6.8 0.3 mm

AC1456 | 2015-03-16 425


System Workflow

System Workflow
System Workflow refers to the way images are communicated and displayed to Hospital
Information Systems after actions such as Start Study and End Study.Scheduled Workflow
and Scheduled Workflow Alternatives are set by the Key Operator.

Modality Performed Procedure Step (MPPS)


MPPS is an element of the optional Scheduled Workflow software feature. The MPPS
feature communicates with the Modality Performed Procedure Step Manager every time
a procedure starts, ends, or is discontinued using the appropriate button on the Patient
Input Screen. The Modality Performed Procedure Step Manager is responsible for
updating the PACS system with the information sent by the System.
The Key Operator selects the Send scheduled workflow MPPS command option on
the HIS/RIS Polling and Remote Query screens.

Scheduled Workflow

Scheduled Workflow is configured by the Key Operator to let the System communicate
with the HIS/RIS every time a procedure starts, ends, or is discontinued.
When your system uses Scheduled Workflow, it reduces the steps necessary for you to
complete an exam.
Scheduled Workflow allows the user to communicate directly with the RIS without
going to a separate computer, and defines schedules and imaging acquisition
procedures.

Scheduled Workflow Alternatives

A Key Operator configures the System workflow to organize the way images are
accounted for. Your system is configured one of these two ways:

Procedure Step-Based Workflow


The system keeps the Study Instance UID when you select New Procedure Step and
destinations such as workstations recognize that the images are from the same study.
A new UID is created for studies coming from the Work List, also.
The Begin Procedure Step button appears when you start a new study.

Study-Based Workflow
You generate a Study Instance Unique Identifier (SIUID) and a New Procedure
Step each time you select New Study for that patient.
When you scan a cassette and select Save Changes, the New Study button appears.
Select End Study to set the study to completed.

426 AC1456 | 2015-03-16


System Workflow

Select Scheduled Workflow

A Key Operator configures the System Workflow to organize the way images are
accounted for. Your system is configured one of these two ways:
Configuration Image Identifier

Procedure Step-based Workflow Selecting New Procedure Step keeps the


same Study Instance UID; therefore destina-
tions keep the images in the same study.

Study-based Workflow Selecting New Study or selecting a study


from the Work List generates both a Study
Instance Unique Identifier (SIUID) and a
new Procedure Step.

Scheduled Workflow Option


Scheduled Workflow is an option that may be used with either of the workflow
configurations listed above. Your system may be configured for either Procedure
Step-based Workflow or Study-based Workflow for IHE Compliance. The Key
Operator can configure Study-based Workflow or Procedure Step-based Workflow
even if Scheduled Workflow is not enabled.

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Remote Monitoring Services (RMS)

Remote Monitoring Services (RMS)


RMS configuration allows the system to automatically send information to Carestream
Health when system performance issues arise. The option is enabled/disabled on the
System Status screen when the user selects the Start RMS Monitoring or Stop RMS
Monitoring buttons.
Navigate to Service > Remote Monitoring Services.
The screen opens with three tabs.
Tab Description

Status Status of Remote Monitoring and Remote


(Alert Link) Access Services, such as
Active
Inactive
Not configured

Network Information needed if there is no Internet


access.

Identification Department Name


Device Location

428 AC1456 | 2015-03-16


Carestream Health, Inc.
150 Verona Street
Rochester, NY 14608
United States
Carestream Health, Inc., 2015
Printed in the United States.
CARESTREAM and DRX-1 are trademarks of Carestream Health.

Pub. No. AC1456


Rev. A