100 PDF

GE Healthcare
BrightSpeed Series
Learning and Reference Guide
GE Medical Systems does business as GE Healthcare
This Manual Supports the Following Product Names:

BrightSpeed Excel
BrightSpeed Edge
BrightSpeed Elite
BrightSpeed Excel Select
BrightSpeed Edge Select
BrightSpeed Elite Select
0459
BrightSpeed Series
Learning and Reference Guide, English
5141172-100
Revision: 4
2007 General Electric Company
All rights reserved.
Revision History
REV
DATE
REASON FOR CHANGE
06-02
First Release for BrightSpeed Series
06-09
Information update
07-03
Add BrightSpeed Select Series information
07-06
Information update
BrightSpeed Series 5141172-100 Rev. 4 (06/07)

2007 General Electric Company. All rights reserved.
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Table of Contents
Revision History............................................................................................................................. i-1
Chapter 1: About This Guide

Purpose of This Guide................................................................................................................1-1
Prerequisite Skills.........................................................................................................................1-1
Chapter Format............................................................................................................................1-1
Introduction ...........................................................................................................................1-2
What Do I Need to Know About... ................................................................................1-2
How Do I... ...............................................................................................................................1-2
Graphic Conventions and Legend.......................................................................................1-2
Safety Notices ...............................................................................................................................1-5
Chapter 2: Safety
Introduction............................................................................................................................................2-1
What Do I Need to Know About....................................................................................................2-2
Warning Labels and Symbols................................................................................................2-2
General Safety Guidelines .......................................................................................................2-5
Radiation Safety...........................................................................................................................2-7
Authorized Users .................................................................................................................2-7
General Radiation Safety.................................................................................................2-8
Scans Acquired at the Same Tomographic Plane ...............................................2-8
CTDIvol .....................................................................................................................................2-9
X-Ray Tubes........................................................................................................................ 2-10
Electrical Safety ................................................................................................... 2-10
Mechanical Safety.................................................................................................................... 2-11
General Mechanical Safety ......................................................................................... 2-11
Short Footprint Mode ..................................................................................................... 2-12
Patient Positioning........................................................................................................... 2-13
Laser Safety ................................................................................................................................ 2-16
Reconstructed Image Orientation.................................................................................... 2-17
Data Safety.................................................................................................................................. 2-18
Application Specific Safety Topics.................................................................................... 2-18
Cardiac Imaging ............................................................................................................... 2-19
Patient Preparation ......................................................................................................... 2-20
Lung Algorithm.................................................................................................................. 2-21
Autoscan .............................................................................................................................. 2-21
SmartStep/SmartView Safety..................................................................................... 2-21
Interventional / Biopsy Scanning.............................................................................. 2-22
Measure Distance for Axial, Helical, and Cine Images ................................... 2-23
Measure Distance for Scout Images....................................................................... 2-23

TOC-1
Measure Angle................................................................................................................... 2-24

ROI........................................................................................................................................... 2-24
Reformat Plane Thickness............................................................................................ 2-24
Operator Console Ergonomics........................................................................................... 2-24
Posture .................................................................................................................................. 2-24
Equipment Adjustments................................................................................................ 2-25
Accessories.................................................................................................................................. 2-26
GE Approved Cardiac Trigger Monitors ................................................................. 2-26
IV Pole Safety...................................................................................................................... 2-26
Table Tray Safety.............................................................................................................. 2-27
Systems With Metal-Free Cradles and Accessories......................................... 2-27
Emergency Devices and Emergency Egress ............................................................... 2-28
Emergency Devices......................................................................................................... 2-28
Emergency Stop................................................................................................................ 2-28
System Emergency OFF Buttons .............................................................................. 2-29
Emergency Patient Care During X-Ray ON: ......................................................... 2-30
Emergency Egress ........................................................................................................... 2-30
Maintenance and Cleaning.................................................................................................. 2-30
Environmental Concerns ...................................................................................................... 2-31
Name and Concentration of Hazardous Substances ............................................. 2-32
Explanation of Pollution Control Label................................................................... 2-32
Precautions ......................................................................................................................... 2-34
Chapter 3: Getting Started

Introduction............................................................................................................................................3-1
Hardware Components............................................................................................................3-3
Power Distribution Unit (PDU)........................................................................................3-3
Gantry Controls....................................................................................................................3-3
Gantry Display ......................................................................................................................3-6
Internal Gantry Components.........................................................................................3-8
Computer ................................................................................................................................3-9
Table for BrightSpeed Excel, Edge, Elite................................................................. 3-12
Table for BrightSpeed Select Series......................................................................... 3-12
Tape Strips for BrightSpeed Excel, Edge, Elite Table........................................ 3-13
Tape Strips for BrightSpeed Select Series Table................................................ 3-13
Monitors................................................................................................................................ 3-14
Keyboard and Scan Interface module ................................................................... 3-16
Mouse .................................................................................................................................... 3-18
Bright Box (Option)........................................................................................................... 3-19
Power Distribution Unit (PDU) ............................................................................................. 3-21
Users Conventions ................................................................................................................... 3-21
Tool Chest .................................................................................................................................... 3-25
HIPAA.............................................................................................................................................. 3-27

TOC-2
Understanding users and groups............................................................................. 3-28

Understanding groups and privileges.................................................................... 3-28
Product Network Filters - PNF ............................................................................................ 3-28
Software Download................................................................................................................. 3-29
How Do I................................................................................................................................................ 3-30
Chapter 4: Daily Maintenance

Introduction............................................................................................................................................4-1
Performing Tube Warm-Up ....................................................................................................4-2
Performing Daily Calibrations................................................................................................4-2
Performing Full System Calibrations ..................................................................................4-2
How Do I...................................................................................................................................................4-3
Chapter 5: Multi-Detector Information

Introduction............................................................................................................................................5-1
BrightSpeed Excel and BrightSpeed Excel Select .................................................................5-1
Hardware Components............................................................................................................5-2
Detector Configurations...........................................................................................................5-3
Axial Configurations ...................................................................................................................5-5
Axial User Interface ....................................................................................................................5-7
Axial Signal Collection ...............................................................................................................5-7
Axial Interval ..................................................................................................................................5-8
Tilt Correction ................................................................................................................................5-8
Helical Pitch and Scan Mode Definitions..........................................................................5-9
Helical Configurations 2 and 4 Row Mode Interleaved .............................................5-9
Helical Configurations 4 Row Mode Interspaced ...................................................... 5-11
Helical User Interface ............................................................................................................. 5-12
Guidelines For mAs.................................................................................................................. 5-13
Slice Profiles ................................................................................................................................ 5-14
BrightSpeed Edge and BrightSpeed Edge Select............................................................... 5-15
What Do I Need to Know About................................................................................................. 5-16
Hardware Components......................................................................................................... 5-16
Detector Configurations........................................................................................................ 5-17
Axial Configurations ................................................................................................................ 5-20
Axial User Interface ................................................................................................................. 5-22
Axial Signal Collection ............................................................................................................ 5-22
Axial Interval ............................................................................................................................... 5-23
Tilt Correction ............................................................................................................................. 5-23

TOC-3
Helical Pitch and Scan Mode Definitions....................................................................... 5-24

Helical Configurations 2 and 4 Row Mode Interleaved .......................................... 5-25
Helical Configurations 4 Row Mode Interspaced ...................................................... 5-26
Helical Configurations 8 Row Mode................................................................................. 5-27
........................................................................................................................................................... 5-29
Guidelines For mAs.................................................................................................................. 5-29
Slice Profiles ................................................................................................................................ 5-30
Cardiac Helical Slice Profiles....................................................................................... 5-31
BrightSpeed Elite and BrightSpeed Elite Select .................................................................. 5-32
Hardware Components......................................................................................................... 5-33
Axial Configurations ................................................................................................................ 5-34
Axial User Interface ................................................................................................................. 5-38
Axial Signal Collection ............................................................................................................ 5-39
Axial Interval ............................................................................................................................... 5-39
Tilt Correction ............................................................................................................................. 5-40
Helical Pitch and Scan Mode Definitions....................................................................... 5-41
Helical Configurations 8 and 16 Row Modes .............................................................. 5-42
Guidelines For Building Protocols ..................................................................................... 5-45
Slice Profiles ................................................................................................................................ 5-46
Cardiac Helical Slice Profiles....................................................................................... 5-47
Chapter 6: Building Protocols

Introduction............................................................................................................................................6-1
Helical/Axial/Cine ........................................................................................................................6-2
Prospective Multiple Reconstructions (PMR)...................................................................6-3
Full and Plus Recon Modes .....................................................................................................6-3
Building Protocols........................................................................................................................6-5
Using Protocols.............................................................................................................................6-5
Editing Protocols ..........................................................................................................................6-6
Viewing Protocols........................................................................................................................6-6
System Options ............................................................................................................................6-6
Noise Index Values......................................................................................................................6-6
AutomA.............................................................................................................................................6-7
Background ...........................................................................................................................6-7
AutomA Theory.....................................................................................................................6-9
AutomA FAQs ..................................................................................................................... 6-10
AutomA Interface............................................................................................................. 6-13

TOC-4
SmartmA....................................................................................................................................... 6-17
WideView...................................................................................................................................... 6-20
Pediatric Protocols................................................................................................................... 6-21
Protocol Numbers .................................................................................................................... 6-24
Anatomical Selector................................................................................................................ 6-25
ECG Trace (Option) ................................................................................................................... 6-25
How Do I................................................................................................................................................ 6-27
Chapter 7: SmartPrep
Introduction............................................................................................................................................7-1
SmartPrep.......................................................................................................................................7-2
Setting SmartPrep Parameters.............................................................................................7-2
Scanning the Baseline Phase.................................................................................................7-2
Scanning the Monitor Phase..................................................................................................7-2
Scanning the Scan Phase........................................................................................................7-3
How Do I...................................................................................................................................................7-4
Chapter 8: VariSpeed (Option)

Introduction............................................................................................................................................8-1
VariSpeed ........................................................................................................................................8-2
How Do I...................................................................................................................................................8-3
Chapter 9: Prospective Gating (SmartScore)(Option)

Introduction............................................................................................................................................9-1
Prospective Gating (SmartScore) .........................................................................................9-2
R to R interval ................................................................................................................................9-2
ECG (or EKG) Waveform............................................................................................................9-2
How Do I...................................................................................................................................................9-4
Chapter 10: Cardiac Imaging

Introduction......................................................................................................................................... 10-1
Prior to Scanning ...................................................................................................................... 10-3
Cardiac Helical .................................................................................................................. 10-5
SnapShot Segment.......................................................................................................... 10-6
SnapShot Burst.................................................................................................................. 10-6
SnapShot Burst Plus........................................................................................................ 10-6

TOC-5
CardIQ SnapShot Window ........................................................................................... 10-7

ECG (or EKG) Waveform ................................................................................................ 10-8
Auto Detection of Heart Rate .................................................................................. 10-10
Manual Detect Heart Rate ........................................................................................ 10-10
Pitch..................................................................................................................................... 10-10
Phase Location............................................................................................................... 10-10
% R-Peak Value.............................................................................................................. 10-11
SnapShot Mode Usage ............................................................................................... 10-11
ECG Modulated mA ...................................................................................................... 10-11
Scan Preparation................................................................................................................... 10-13
Patient Preparation .............................................................................................................. 10-15
Patient Skin Preparation & Electrode Placement........................................... 10-15
Alternate Electrode Positions for Signal Clarity............................................... 10-17
Scan Parameters Usage .................................................................................................... 10-18
Scout Scan........................................................................................................................ 10-18
Localizer Scan................................................................................................................. 10-18
Timing Bolus Scan......................................................................................................... 10-19
Cardiac Helical Scan.................................................................................................... 10-21
Cardiac Series Retro Reconstruction Numbering .................................................. 10-22
Single Phase Image Set.............................................................................................. 10-22
Multiphase Image Set ................................................................................................. 10-22
Cardiac ECG-gated Images are annotated with either of the following:10-22
How Do I............................................................................................................................................. 10-23
Chapter 11: Direct Visualization Auto Applications (Option)

Introduction......................................................................................................................................... 11-1
Direct3D ........................................................................................................................................ 11-2
Direct3D Curves ........................................................................................................................ 11-2
Direct Multi Planar Reformat (DMPR)............................................................................... 11-2
Session Setup Window .................................................................................................. 11-3
Scanning with DMPR............................................................................................................... 11-5
DMPR Review Controller........................................................................................................ 11-7
DMPR Manual Batch Prescriptions................................................................................ 11-10
How Do I............................................................................................................................................. 11-12
Chapter 12: Performed Procedure Step (PPS) (Option)

Introduction......................................................................................................................................... 12-1
Performed Procedure Step (PPS) (Option)...................................................................... 12-2
How Do I................................................................................................................................................ 12-3

TOC-6
Chapter 13: Exam Split (Option)

Introduction......................................................................................................................................... 13-1
Exam Split .................................................................................................................................... 13-2
Virtual Mode ....................................................................................................................... 13-2
Hard Mode........................................................................................................................... 13-2
How Do I................................................................................................................................................ 13-4
Chapter 14: SmartStep (Option)

Introduction......................................................................................................................................... 14-1
SmartStep .................................................................................................................................... 14-2
Hand Held Controller (HHC) ................................................................................................. 14-3
SmartStep Display.................................................................................................................... 14-7
How Do I................................................................................................................................................ 14-9
Chapter 15: SmartView (Option)

Introduction......................................................................................................................................... 15-1
SmartView.................................................................................................................................... 15-2
Integrated Hand Held Controller (HHC).......................................................................... 15-3
SmartView Display................................................................................................................... 15-7
How Do I................................................................................................................................................ 15-8
Chapter 16: Scheduling Patients

Introduction......................................................................................................................................... 16-1
Patient Schedule....................................................................................................................... 16-2
Connect Pro................................................................................................................................. 16-2
New Records and Completed Records .......................................................................... 16-2
How Do I................................................................................................................................................ 16-3
Chapter 17: Biopsy Mode

Introduction......................................................................................................................................... 17-1
Biopsy Mode................................................................................................................................ 17-2
Biopsy Reference Scans ........................................................................................................ 17-2
How Do I................................................................................................................................................ 17-3
Chapter 18: Recommended Workflow for RT

TOC-7
Introduction......................................................................................................................................... 18-1
Chapter 19: Patient Setup and Scout Scan

Introduction......................................................................................................................................... 19-1
Using Protocols.......................................................................................................................... 19-2
Using Contrast ........................................................................................................................... 19-2
Setting Up a Patient without an ID#................................................................................ 19-2
Emperor Era Birth Year Entry .............................................................................................. 19-3
Preset Descriptions.................................................................................................................. 19-3
How Do I................................................................................................................................................ 19-4
Chapter 20: Scan Series Setup

Introduction......................................................................................................................................... 20-1
Adjusting a Protocol ................................................................................................................ 20-2
Setting Scan Field of View and Display Field of View .............................................. 20-2
Using a Breath Hold Delay................................................................................................... 20-2
Working with the Optimizer................................................................................................. 20-3
Dose Reports .............................................................................................................................. 20-3
How Do I................................................................................................................................................ 20-5
Chapter 21: Automatic Filming

Introduction......................................................................................................................................... 21-1
Automatic Filming .................................................................................................................... 21-2
Autostart....................................................................................................................................... 21-2
Image Filters ............................................................................................................................... 21-2
Gray Scale Enhancement ..................................................................................................... 21-3
How Do I................................................................................................................................................ 21-4
Chapter 22: Manually Filming Images

Introduction......................................................................................................................................... 22-1
Using the F Keys........................................................................................................................ 22-2
Setting Film Series Parameters.......................................................................................... 22-2
Setting Window Width and Level Presets ..................................................................... 22-2
Setting Film Composer Parameters................................................................................. 22-3
Differences Between Auto Film and Manual Film Composers............................ 22-3
How Do I................................................................................................................................................ 22-4

TOC-8
Chapter 23: Managing Images

Introduction......................................................................................................................................... 23-1
Feature Status Area ................................................................................................................ 23-2
Anonymous Patient ................................................................................................................. 23-3
Archive (Option for Bright Speed Excel/Edge/Excel Select/Edge Select) ........ 23-3
Network......................................................................................................................................... 23-3
Networking Terms ........................................................................................................... 23-4
Performed Procedure Step (PPS) ....................................................................................... 23-4
WorkArounds.............................................................................................................................. 23-5
Data Export ................................................................................................................................. 23-6
CD/DVD Interchange ........................................................................................................... 23-10
Media Requirements:................................................................................................... 23-11
Operation Requirements: .......................................................................................... 23-11
How Do I............................................................................................................................................. 23-13
Chapter 24: Viewing Images

Introduction......................................................................................................................................... 24-1
List/Select..................................................................................................................................... 24-2
Paging............................................................................................................................................ 24-2
Viewer and Mini-Viewer......................................................................................................... 24-2
Performed Procedure Step (PPS) ....................................................................................... 24-3
How Do I................................................................................................................................................ 24-4
Chapter 25: Image Display Viewing Area

Introduction......................................................................................................................................... 25-1
Autoview....................................................................................................................................... 25-2
Auto Link....................................................................................................................................... 25-2
Primary Viewport...................................................................................................................... 25-2
Secondary Viewport................................................................................................................ 25-2
Viewport........................................................................................................................................ 25-3
How Do I................................................................................................................................................ 25-4
Chapter 26: Sort Examinations and Images

Introduction......................................................................................................................................... 26-1
Sorting Examinations ............................................................................................................. 26-3
Sort Examinations by Examination Number ....................................................... 26-3

TOC-9
Sort Examinations by Patient Name ....................................................................... 26-3

Sort Examinations by Date .......................................................................................... 26-3
Sort Examinations by Modality .................................................................................. 26-3
Sort Examinations by Archived Status ................................................................... 26-3
Sorting Images........................................................................................................................... 26-3
Sort Images by Image Number ................................................................................. 26-4
Sort Images by Location............................................................................................... 26-4
Sort Images by Echo....................................................................................................... 26-4
Sort Images by Trigger .................................................................................................. 26-4
Sort Images by Scan Time ........................................................................................... 26-4
How Do I................................................................................................................................................ 26-5
Chapter 27: Image Manipulations

Introduction......................................................................................................................................... 27-1
Gray Scale Enhancement ..................................................................................................... 27-2
Using Proview or Image Filters .......................................................................................... 27-2
DICOM Gray Scale Presentation State Object (GSPS) .............................................. 27-2
How Do I................................................................................................................................................ 27-3
How Do I............................................................................................................................................. 27-13
Chapter 28: Image Addition/Subtraction

Introduction......................................................................................................................................... 28-1
Image Addition .......................................................................................................................... 28-2
Image Subtraction ................................................................................................................... 28-2
Maximum Pixel Value Extraction....................................................................................... 28-2
Minimum Pixel Extraction ..................................................................................................... 28-2
Binding Series............................................................................................................................. 28-3
Accept Negative Pixels........................................................................................................... 28-3
The Difference Between "Proc" and "Comb"................................................................ 28-3
Ratio Slider Bar .......................................................................................................................... 28-3
How Do I................................................................................................................................................ 28-4
Chapter 29: Magnifying Images

Introduction......................................................................................................................................... 29-1
Auto Enlarge ............................................................................................................................... 29-2
Auto Minify................................................................................................................................... 29-2
How Do I................................................................................................................................................ 29-3
How Do I................................................................................................................................................ 29-8

TOC-10
Chapter 30: Measuring Structures Within an Image

Introduction......................................................................................................................................... 30-1
ROI ................................................................................................................................................... 30-2
Expanded CT Number Range ............................................................................................. 30-2
MIROI .............................................................................................................................................. 30-2
How Do I................................................................................................................................................ 30-3
How Do I............................................................................................................................................. 30-14
Chapter 31: Graphics, Text Pages and Commands

Introduction......................................................................................................................................... 31-1
Cross-referencing..................................................................................................................... 31-2
Screen Save................................................................................................................................. 31-2
Accelerator Line ........................................................................................................................ 31-2
User Preferences ...................................................................................................................... 31-2
How Do I................................................................................................................................................ 31-3
How Do I............................................................................................................................................. 31-16
How Do I Edit Default Settings in the Image Works Desktop.................................... 31-26
Chapter 32: Managing Scan (Raw) Data

Introduction......................................................................................................................................... 32-1
Scan (Raw) Data........................................................................................................................ 32-2
Suspended Entries ................................................................................................................... 32-2
Saving Scan Data ..................................................................................................................... 32-2
Restoring Scan Data ............................................................................................................... 32-2
Reserving Scan Data............................................................................................................... 32-3
Releasing Scan Data............................................................................................................... 32-3
WorkArounds.............................................................................................................................. 32-3
How Do I................................................................................................................................................ 32-4
Chapter 33: Reformat

Introduction......................................................................................................................................... 33-1
Requirements for Reformat................................................................................................. 33-3
Main Control Panel................................................................................................................... 33-4
Layout Presets ................................................................................................................... 33-5
Tools ....................................................................................................................................... 33-5
Rotate Translation ........................................................................................................... 33-6

TOC-11
Close....................................................................................................................................... 33-7
Review Controller ..................................................................................................................... 33-7
Display Tools............................................................................................................................... 33-9
Reformat Layout.................................................................................................................... 33-10
What are the Cursor Controls? ....................................................................................... 33-11
What is the Plane Orientation Indicator? ................................................................... 33-11
What are View Types?......................................................................................................... 33-11
What are Render Modes?.................................................................................................. 33-12
What is Batch?........................................................................................................................ 33-12
What is the Main On View Menu?.................................................................................. 33-12
WorkArounds........................................................................................................................... 33-14
How Do I............................................................................................................................................. 33-15
Appendix A
Accelerator Line Commands
Introduction............................................................................................................................................A-1
Exam Rx ...........................................................................................................................................A-1
Image Works ..............................................................................................................................A-13
Appendix B
Legacy Precautions
System ..............................................................................................................................................B-1
Tube Warm Up/Fast Cal...........................................................................................................B-3
Tube Warmup and Fast Cal BrightSpeed based systems........................................B-4
Scan ...................................................................................................................................................B-4
Patient Schedule..........................................................................................................................B-7
ConnectPro (Purchased Option) ...........................................................................................B-7
Performed Procedure Step (part of connect pro option) ..........................................B-8
Protocol Management ..............................................................................................................B-8
Reconstruction .............................................................................................................................B-8
Lung Algorithm.....................................................................................................................B-8
3000 Image Series ......................................................................................................................B-9
Display......................................................................................................................................B-9
Archive ..................................................................................................................................B-10
Network ................................................................................................................................B-10
DentaScan/Add/Subtract.............................................................................................B-10
Retro Recon.................................................................................................................................B-10
Recon Management................................................................................................................B-11
Volume Viewer (Option) .........................................................................................................B-12
CT Perfusion 2, 3 or Neuro on OC Purchased Option...........................................B-12
CT Colon (Option) ......................................................................................................................B-12

TOC-12
SmartScore PRO Purchased Option.............................................................................B-13

Advanced Vessel Analysis (Option)...................................................................................B-13
Dentascan....................................................................................................................................B-13
BMD.................................................................................................................................................B-13
CardIQ Snapshot Purchased Option............................................................................B-13
Auto Transfer..............................................................................................................................B-14
Display (Applies to ExamRx Display and Image Works) .........................................B-15
Exam Rx Display........................................................................................................................B-16
Image Works Display..............................................................................................................B-17
Edit Patient Data.......................................................................................................................B-18
FILMING.........................................................................................................................................B-19
Network.........................................................................................................................................B-21
Image management............................................................................................................... B-22
Appendix C
Operator Messages
Introduction........................................................................................................................................... C-1

TOC-13

TOC-14
About This Guide
Chapter 1
About This Guide

This chapter explains the purpose and design of this Learning and Reference Guide. It is an
introduction to the guide, providing information on the purpose, prerequisite skills, guide
organization, chapter format, and graphic conventions that identify the visual symbols used
throughout the guide.
Purpose of This Guide

This guide is written for health care professionals (namely, the technologist) to provide the
necessary information relating to the proper operation of this system. The guide is intended
to teach you the system components and features necessary to use it to its maximum
potential. It is not intended to teach imaging or to make any type of clinical diagnosis.
This guide should be kept with the equipment at all times. It is important for you to
periodically review the procedures and safety precautions. It is important for you to read
and understand the contents of this guide before attempting to use this product.
Prerequisite Skills
This guide is not intended to teach imaging. It is necessary for you to have sufficient
knowledge to competently perform the various diagnostic imaging procedures within your
modality. This knowledge is gained through a variety of educational methods including
clinical working experience, hospital based programs, and as part of many college and
university programs.
Chapter Format
Each chapter contains a consistent format. This consistency provides uniformity for content
delivery and a better learning environment for you. Listed below are the components for
each chapter.

1-1
About This Guide
Introduction
The Introduction provides a short introduction to the chapter and a list of tasks to be
presented.
What Do I Need to Know About...

The What Do I Need to Know About... section lists and explains concepts necessary to
perform the tasks within the chapter.
How Do I...
The How Do I... section provides the detailed steps necessary to complete a given task.
These detailed steps not only provide the steps to complete a task, but also provide
additional information, as needed, related to a step.
Each task also includes a Quick Steps table. This Quick Steps table is intended to be used as
a quick reference by the experienced technologist and provides only the steps necessary to
complete a task. Be sure to read the detailed steps before using this table.
Graphic Conventions and Legend

The format of the page is such that you have room in the outer margin to make notes as
needed, except in the area where the In Brief table is located in the How Do I... section.
Table 1-1 describes the terminology used for the various mouse functions. Table 1-2
describes the conventions used when working with menus, buttons, text boxes and
keyboard keys.
Table 1-1 Conventions for Mouse Actions
Mouse Action
Description
Click
Clicking the left mouse button to select a

button or icon. The button can be pressed
in, not pressed in, or popped in/out.
Right-click
Clicking the right mouse button.
Middle-click
Clicking the middle mouse button.
Click and drag
Clicking and holding the left mouse button

down while dragging the cursor to the
desired location.

1-2
About This Guide

Mouse Action
Description
Right-click and drag
Clicking and holding the right mouse button

down while dragging the cursor to the
desired location.
Middle-click and drag
Clicking and holding the middle mouse

button down while dragging the cursor to
the desired location.
Double-click
Clicking the left mouse button twice in rapid

succession.
Triple-click
Clicking the left mouse button three times in

rapid succession.

1-3
About This Guide

Table 1-2 Conventions for Menus, Buttons, Text Boxes, and Keyboard Keys
Example
Describes
Select
Selecting an option in a check box or radial

button and selecting a tab.
Press Enter
Pressing a hard key on the keyboard.
Press and hold Shift
Pressing and holding down a hard key on

the keyboard.
Click [Viewer]
A button label or Interface button name.
Click
prior)
(Exam
Selecting an icon-based button.
In the Matrix text box,...
The name of text box in which you can

select or type text.
Type supine in the

Patient Position text box
(different font and bold)
Text you enter into a text box.
Select Sort > Sort by date
The pathway of selecting option(s) in a

pull-down menu.

1-4
About This Guide
Safety Notices
The following safety notices are used to emphasize certain safety instructions. This guide
uses the international symbol along with the danger, warning, or caution message. This
section also describes the purpose of a Note.
DANGER:
Danger is used to identify conditions or actions for which a specific hazard is

known to exist which will cause severe personal injury, death, or substantial
property damage if the instructions are ignored.
WARNING: Warning is used to identify conditions or actions for which a specific hazard
is known to exist which may cause severe personal injury, death, or
substantial property damage if the instructions are ignored.
CAUTION:
Caution is used to identify conditions or actions for which a potential hazard

may exist which will or can cause minor personal injury or property damage
if the instructions are ignored.
NOTE: A Note provides additional information that is helpful to you. It may emphasize certain
information regarding special tools or techniques, items to check before proceeding,
or factors to consider about a concept or task.

1-5
About This Guide


1-6
Safety
Chapter 2
Safety
Introduction
This chapter provides information about safety precautions and procedures. It is important
for you to read and understand the contents of this chapter so the correct precautions and
procedures are followed.
This manual should be kept near the console for easy access.
If necessary, additional training is available from a GE Applications Specialist. Contact your
institutions GE sales representative for additional information about further safety and
operational training.
United States Federal Regulation 21CFR 801.109
CAUTION:
Federal law restricts this device to sale by or on the order of a physician.

2-1
Safety
What Do I Need to Know About ...

The Learning and Reference Guide and Technical Reference Manual include information
required for the safe use of the equipment. This chapter summarizes the most important
safety issues. Some of the concepts you need to understand:
Warning Labels and Symbols
General Safety Guidelines
Radiation Safety
Electrical Safety
Mechanical Safety
Laser Safety
Reconstructed Image Orientation
Data Safety
Application Specific Safety Topics

Cardiac Imaging
Accuracy of Measurements
Operator Console Ergonomics
Accessories
Emergency Devices and Emergency Egress
Maintenance and Cleaning
Environmental Concerns
Name and Concentration of Hazardous Substances
Warning Labels and Symbols

This chapter addresses three safety classifications:
DANGER:
The most severe label describes conditions or actions which result in a specific
hazard. You will cause severe or fatal personal injury, or substantial property
damage if you ignore these instructions.
WARNING: This label identifies conditions or actions which result in a specific hazard.
You will cause severe personal injury, or substantial property damage if you
ignore these instructions.

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Safety
CAUTION:
This label applies to conditions or actions that have potential hazard. You may
cause minor injury or property damage if you ignore these instructions.
This chapter uses the international symbol or icon along with the danger, warning or caution
message.
Table 2-1 IEC Standards
Symbol
IEC Standard
Alternating current
Protective earthing point
ON / Power
OFF / Power OFF
Input Power
Output Power
Type B Equipment
Functional Earth Ground
Warning, Caution - consult accompanying documents
Electrical Shock Hazard
The following Warning Labels are used on the equipment:.

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Safety
Figure 2-1 The following warning labels are located at the bottom of the gantry cover
CAUTION:
LASER RADIATION
DO NOT STARE INTO BEAM
CALSS 2 LASER PRODUCT
Figure 2-2 Labels on the front of the gantry warn:
CAUTION:
LASER APERTURE
Do not stare into beam
Figure 2-3 Table Caution Label
CAUTION:
Do not grasp the side of the cradle.
The scan control unit will contain one of the two labels shown below.

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Safety
Figure 2-4 For Systems manufactured after June 10, 2006
Figure 2-5 For systems manufactured before June 10, 2006
WARNING: This x-ray unit may be dangerous to patient and operator unless safe
exposure factors, operating instructions and maintenance schedules are
observed. To be used by authorized personnel only.
General Safety Guidelines
This product was designed and manufactured to ensure maximum safety of operation.
It should be operated and maintained in strict compliance with the safety precautions,
warnings and operating instructions contained herein, and in any other documentation
specific to the product.
The system has been designed to meet all the safety requirements applicable to medical
equipment. However, anyone attempting to operate the system must be fully aware of
potential safety hazards.
The owner should make certain that only properly trained, fully qualified personnel are
authorized to operate the equipment. A list of authorized operators should be
maintained.
This manual should be kept at hand, studied carefully and reviewed periodically by the
authorized operators. The manufacturer or vendor of the equipment makes no

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Safety
representation, however, that the act of reading this manual renders the reader
qualified to operate, test or calibrate the system.
Unauthorized personnel should not be allowed access to the system.
Do not leave the patient unobserved at any time.
Become familiar with the functional hardware so that you can recognize serious
problems. Do not use the scanner if it appears damaged or fails. Wait for qualified
personnel to correct the problem.
If the product does not operate properly or if it fails to respond to the controls as
described in this manual, the operator should:
First ensure the safety of the patient and then the protection of the equipment.
Evacuate the area as quickly as possible in any potentially unsafe situation.
Follow the safety precautions and procedures as specified in this manual.
Immediately contact the local service office, report the incident and await further
instructions.
The images and calculations provided by this system are intended as tools for the
competent user. They are explicitly not to be regarded as a sole incontrovertible basis for
clinical diagnosis. Users are encouraged to study the literature and reach their own
professional conclusions regarding the clinical utility of the system.
Understand the product specifications, system accuracy, and stability limitations. These
limitations must be considered before making any decision based on quantitative
values. In case of doubt, please consult your sales representative.
Make sure all covers are in place before you use the equipment. The covers protect you
and your patient from moving parts or electrical shock. The covers also protect the
equipment.
NOTE: Only qualified Service personnel should service the system with the covers off.
Do not block the ventilation ports of the electronic equipment. Always maintain at least
6 inches (15 cm) clearance around the ventilation ports to prevent overheating and
damage to the electronic hardware.
Use only GE approved equipment with this system.
Do not load any non GE approved software onto the computer.
WARNING: CT Scans may cause interference with implantable devices such as

pacemakers or neuro stimulators and could cause operational changes to the
device. Consult with the Technical Service assistance/Hot line of the
Implantable manufacturer prior to scanning. The Operator Warnings and
instructions from the implantable device manufacturer may provide further
assistance.

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Safety
Radiation Safety
WARNING: Improperly used X-Ray equipment may cause injury. Read and understand
the instructions in this book before you attempt to operate this equipment.
If you fail to follow safe X-Ray practices or ignore the advice presented in the
manual, you and your patient risk exposure to hazardous radiation.
Authorized Users
This equipment incorporates a high degree of protection against X-Ray radiation outside the
useful beam. But this equipment can not substitute the essential requirement that every
user must take adequate precautions to prevent the possibility of any person carelessly,
unwisely, or unknowingly exposing themselves or others to radiation.
Everyone having anything to do with X-Ray equipment must receive proper training and
become fully acquainted with the recommendations of the National Council on Radiation
Protection and Measurements and the International Commission on Radiation Protection.
NCRP reports are available from:
NCRP Publications
7910 Woodmont Avenue
Room 1016
Bethesda, Maryland 20814
WARNING: Everyone having anything to do with X-Ray equipment must take adequate
steps to insure protection against injury.
All persons authorized to use the equipment must understand the dangers posed by X-Ray
exposure so that they can prevent any injury or damage that may result from such
exposure. GE Healthcare urges you to use protective materials and devices to prevent any
injury or damage from X-Ray exposure.

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Safety
General Radiation Safety
WARNING: Never scan a patient with unauthorized personnel in the scan room. Warn
visitors and patients about potential for harm if they fail to follow
instructions.
WARNING: Never calibrate, test the scanner, or warm the tube with patients or personnel
present in the scan room.
Stay behind a lead screen or lead glass shield during each X-Ray exposure.
Use technique factors prescribed by the radiologist or diagnostician. Use a dose that
produces the best diagnostic results with the least X-Ray exposure.
Amber indicator lights on the gantry display panel, and rear of the gantry, illuminate
during X-Ray exposure.
Scans Acquired at the Same Tomographic Plane

IEC standard 60601-2-44 section 29.105 paragraph states that you must be warned when
scans are acquired at the same tomographic plane, i.e. same scan location. The need for the
warning is to make users aware of the potential dose that can be given to the patient when
acquiring scans at the same table location.
When acquiring scans in this mode:
Utilize the dose information displayed on the View Edit screen. The dose information
displayed is covered in the next section, CTDIvol.
Use proper techniques for the application and anatomy you are scanning.
A warning message Figure 2-6 is posted when [Confirm] is selected for the following scan
types:
SmartStep
SmartView
SmartPrep Baseline and Monitor scans
Cine scans
Axial scans with zero table increment (interval)

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Safety
Figure 2-6
WARNING: This series contains one or more groups with multiple scans at the same
tomographic plane, i.e. same location. Do you wish to continue?
After reading the message, if you wish to continue with the scan, click [Continue].
CTDIvol
As you setup the scan parameters from the view/edit screen, the Dose Information area at
the upper right of the scan monitor contains updated dose information. This dose
information is based on a measurement of the CTDI or CT Dose Index, which is the current
standard for CT dosimetry and performance. By using a measurement called CTDIvol, a
single value is provided to estimate the relative dose for an exam.
The CTDIvol is a weighted average measurement in a reference phantom. This dose is
expressed in milliGrays. For additional information on specific CTDIvol doses and their
calculations, refer to your Technical Reference manual.
The DLP or Dose Length Product is the product of the CTDIvol and the scan length for a
group of scans. This number can be summed over the entire exam to give an estimate of the
total dose. The value is expressed in milliGray centimeters.
The Projected Series DLP shows the DLP that would result from scanning the current group
or groups.
The Accumulated Exam DLP displays the total exam DLP up to the current point in time.
Scout dose is not included in the DLP totals since standards for reporting scout dose are not
yet defined. Scout dose is generally a very small part of the exam.

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Safety
The dose information updates when technique values such as kV, mA, scan time, slice
thickness, and scan field of view are changed.
Dose information is saved as screen save image in Series 999 upon End Exam.
CAUTION:
Using accessories which are not GE options might effect dose and image
quality.
X-Ray Tubes
The scanner uses cooling and reconstruction algorithms specifically designed for GE X-Ray
tubes.
You risk three dangers when you do not use GE X-Ray tubes.
A non GE tube could overheat and explode if the cooling delays do not meet its design
requirements.
The images could exhibit artifacts if your X-Ray tube fails to conform with GE tube
performance specifications
Radiation leakage may exceed GE specifications when a non GE X-Ray tube is installed
in the scanner.
CAUTION:
We cannot guarantee performance or safety if you use a non GE X-Ray tube

because the cooling and reconstruction algorithms depend upon the tube
design. Radiation leakage may exceed GE specifications when a non GE X-Ray
tube is installed in the scanner.
Electrical Safety
DANGER:
ELECTRICAL SHOCK HAZARD. Avoid all contact with any electrical conductor.
Do not remove or open system covers or plugs. Internal circuits use high
voltage capable of causing serious injury.
An electrical hazard may exist if any light, monitor or visual indicator stays
on after the system is shut down. To prevent possible injury, turn off the
main power supply wall switch, and contact your service office immediately.

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Safety
DANGER:
Do not touch the live part of the connectors for ECG,Respiratory equipment.
DANGER:
NO USER SERVICEABLE PARTS. Refer service to qualified service personnel.

Only allow people who know the proper procedures, and use of the proper
tools, to install, adjust, repair, or modify the equipment.
To guarantee safe, reliable equipment performance, prepare the site
according to GE Healthcare requirements. If you have any questions about
these requirements, contact GE Healthcare.
Fuses blown within 36 hours of being replaced may indicate malfunctioning
electrical circuits within the system. Have the system checked by qualified
service personnel, and do not attempt to replace any fuse.
DANGER:
ELECTRICAL FIRE. Conductive fluids that seep into the active circuit
components of the system may cause short circuits that can result in
electrical fires. Therefore, do not place any liquid or food on any part of the
system.
To avoid electrical shocks or burns caused by the use of wrong type of fire
extinguisher, make sure that only fire extinguishers approved for use on
electrical fires are used.
Surplus length of power cords or other cables from mobile accessory units that may be
used with some patient scanning should be stored in safe and isolated areas, such as
individually in a figure eight at the base of stationary equipment. This discourages signal
interference and protect cables from damage due to traffic.
Mechanical Safety
General Mechanical Safety
Check for any obstruction around the equipment before attempting to move the table
and gantry. When performing table or gantry motions, always monitor the progress of
the motion.
Be especially careful when tilting the gantry or moving the table when the cradle
extender or head holder is in place to avoid driving these accessories into the gantry
covers.
The (Cradle Unlatch Indicator) is illuminated in green when the cradle is
unlocked. An unlocked cradle could potentially move unexpectedly.

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Safety
The (Interference) light only illuminates when an obstruction is encountered.
NOTE:The interference light only illuminates if an obstruction is detected. The light
will not illuminate when the cradle travel reaches the home position or end of cradle
travel. When obstructions are detected, the light wil go out if you do not release the
button.
Clear interference by changing the gantry tilt, moving the cradle or adjusting the
table height.
WARNING: Do not use the table base as a foot rest. You could entrap and injure your foot
while lowering the table. Do not place your hands between the table base and
the table side panels.
WARNING: Do not place your hands inside the gantry cover when tilting the gantry. The
gantry can pinch or crush your hands!
WARNING: Implosion Hazard - do not subject the system to serious mechanical shock,
as the Cathode Ray Tube (CRT) can fracture if struck or jarred. This may result
in flying pieces of glass and Phosphor coating that can cause serious injury.
Short Footprint Mode
If the system is set to Short Footprint mode, scannable range is limited accordingly. This
should be approved by the customer during pre-installation.
Only qualified Service personnel should change the setting of the Small Footprint Mode.
WARNING: The IN-limit position of cradle Short Footprint Mode should be set in order not
to pinch a patients foot between the cradle edge and the wall of the scan
room.
WARNING: TO PREVENT PINCHING OR CRUSHING OF THE PATIENT, WATCH THE PATIENT

AND EQUIPMENT CAREFULLY AT ALL TIMES DURING TABLE MOVEMENT. IF
UNWANTED MOTION OCCURS OR MOTION DOES NOT STOP, PRESS THE
EMERGENCY STOP SWITCHES ON THE CONSOLE OR GANTRY.

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Safety
Patient Positioning
DANGER:
DO NOT PLACE A PATIENT ON THE TABLE WEIGHING MORE THAN THE UPPER
LIMIT OF 450 POUNDS. THIS COULD CAUSE THE TABLE TO FAIL AND THE
PATIENT COULD FALL.
Table capacity:
For BrightSpeed Series Table:
Up to 400 lb. (180 kg) with .25 mm positional accuracy guaranteed.
400 to 450 lb. (180 to 205 kg) maximum allowed with normal operation and 1mm
positional accuracy.
For BrightSpeed Select Series Table:
Up to 205 kg within 0.5mm positional repeatability guaranteed.
Temporal sampling for data acquired for use in CT Perfusion should not exceed 3.2 seconds
between data points for optimal results. As the temporal resolution increases an error in the
statistical accuracy of the information may be introduced.
CAUTION:
When using the external laser alignment light for patient positioning
purposes, be aware that the patient's elevation may be slightly lower with the
cradle extended than with the cradle fully retracted. This is because the cradle
may bend slightly under a patient's weight. This difference should be taken
into consideration for applications where patient position information is
critical, such as radiation therapy planning. To minimize these effects, after
using the external laser alignment system to position the patient, advance
the patient to the CT scan plane. Turn on the CT alignment lights to determine
if they line up with the markers on the patient. If necessary, compensate for
the bend in the cradle by elevating the table. When the CT alignment lights
line up with the markers, set the landmark for the scan using the Internal laser
alignment light.
Please refer to Recommended Workflow for RT to assess the X-Y table
accuracy of your system.
CAUTION:
When using patient positioning accessories that are not GE options, make
sure there are no areas which might cause a pinch point or interfere with
patient tubing or IV.

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Safety
CAUTION:
When using accessories, make sure all accessories are CT imaging

accessories. Do not use accessories from other modalities.
CAUTION:
None of the accessories support the full weight of a patient. If you sit, stand,
or otherwise apply excessive pressure to these devices, they break or come
off the cradle and may cause an injury. GE cannot guarantee precise location
accuracy at the upper weight limit of 400 to 450 pounds (180 to 205 kg).
WARNING: None of the accessories support the full weight of a patient. If you sit, stand,
or otherwise apply excessive pressure to these devices, they break or come
off the cradle and may cause an injury.
CAUTION:
Check to make sure the power injector has enough IV tubing to allow free
movement of the table. Make sure the unit itself does not interfere with table
travel:
Ensure excess tubing length is secured to the table top. DO NOT loop
additional IV tubing in the patient's hand.
Check the length of all patient health lines (IV tubing, oxygen line, etc.) and make sure
they accommodate cradle travel. Position these lines so they cannot catch on anything
within the patient vicinity or between the table and gantry during cradle travel or gantry
tilt.
The concentrated weight of short, heavy patients can cause the cradle to make contact
with the gantry.
Make sure you do not drive the cradle into the gantry cover.
Make sure you do not pinch the patient's skin or extremities between the cradle and
the gantry.
Avoid any patient contact with the gantry during tilt or cradle movement (manual or
software driven).
Return the gantry tilt to the 0 degree upright position, latch the cradle, and adjust the
table to a comfortable height for patient loading and unloading.
Latch the cradle before you load or unload the patient (the Cradle Unlatch indicator
illuminates when the cradle is unlatched).
Physically assist all patients on and off the table and into position on the cradle.

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Safety
WARNING: TO PREVENT PINCHING OR CRUSHING OF THE PATIENT'S EXTREMITIES, KEEP

THE PATIENT'S HANDS AND FEET AWAY FROM THE EDGE OF THE MOVING TABLE
TOP/CRADLE AND ITS SURROUNDING EQUIPMENT, OR BETWEEN TABLE BASE
AND SIDE PANELS OF THE TABLE. (TAKE SPECIAL CARE WHEN POSITIONING
PHYSICALLY LARGE PATIENTS).
Check the length of all patient health lines (IV tubing, oxygen line, etc.) and make sure
they accommodate cradle travel. Position these lines so they cannot catch on anything
within the patient vicinity or between the table and gantry during cradle travel or gantry
tilt.
WARNING: TO PREVENT PINCHING OR CRUSHING OF THE PATIENT WATCH THE PATIENT

AND EQUIPMENT CAREFULLY AT ALL TIMES DURING GANTRY TILT OR TABLE
MOVEMENT. IF UNWANTED MOTION OCCURS OR MOTION DOES NOT STOP,
PRESS THE EMERGENCY STOP SWITCHES ON THE CONSOLE OR GANTRY.
Check the accessory attachment plate fixed to the end of the cradle. Repair or replace if
loose or damaged.
Use the cradle extender to support the patient's head or feet during a scan.
The scannable range is not indicated by the black mark on the table, scannable range is
indicated by the Tilt and Travel limites button on the Gantry Controls.
WARNING: The head holder may crack, possibly injuring the patient's head or neck, if the
patient tries to brace himself or herself on the head holder during positioning.
The head holder and cradle extender are only designed to support 75 pounds
(34kg). Ask the patient to move up into the head holder or manually help the
patient into position.
To move the patient out of the gantry in an emergency, the cradle can be manually
withdrawn.
WARNING: Patient strap should be used to fix the patient's head and body. This is to
prevent the patient from injury of Gantry.
CAUTION:
The patient head holder or table extender should be adequately secured to

ensure stability. If they not secured properly, degradation of image quality
may result due to introduced motion of the head holder or table extender.

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Safety
CAUTION:
Use of any cradle extension accessories such as the table extension, head
holder, coronal head holder, and phantom holder are not accounted for in the
table gantry interference matrix. Therefore, additional care needs to be taken
to closely monitor any table up/down, in/out or gantry tilt movement to avoid
contact of the extended accessory with the gantry.
Laser Safety
A laser alignment light system is available in order to accurately define the patient scan
region.
WARNING: THE LASER BEAM CAN CAUSE EYE INJURY.

- Tell all patients to close their eyes before you switch ON the alignment
lights.
- Instruct your patients to keep their eyes closed until you turn OFF the
alignment lights.
NOTE: Closely monitor infants and infirm patients, and prevent them from accidentally
staring into the beam.
CAUTION:
THE DETECTOR AND DAS ROTATE TO POSITION THE ALIGNMENT LIGHTS OVER
THE LASER PORTS.
- Keep your hands away from the gantry opening.
- Make sure the gantry side covers are in place.
CAUTION:
Use of controls or adjustments, or performance of procedures other than

those specified herein, may result in hazardous radiation exposure.
The indicator on the gantry display panel lights when you turn ON the alignment lights.
Warning labels regarding laser safety are provided on the gantry, as described in the
Warning Labels and Symbols section.

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Safety
Reconstructed Image Orientation
CAUTION:
GE CT image reconstruction is in an orientation viewing from the patient's

feet. The reconstructed orientation is the orientation the image is installed in
the image data base and is the orientation images are networked with to a
remote viewing station.
Figure 2-7 Patient Orientation

A
P
Head First Supine
R
A
Head First Prone
P
L
L
P
Feet First Supine
R
A
Feet First Prone
The patient position information stored in the image header correctly reflects the orientation
(RAS) information for the patient. Viewing applications will correctly reflect Right (R), Left (L),
Anterior (A) and Posterior (P) of the patient.
The reconstructed image orientation may differ from preferred anatomical viewing
presentation in which the patient's Right is on the viewers Left and patient's Left is on the
viewers Right. For example when the patient is scanned Head First and Prone the patientss
Left is on the viewers Left and the patients Right is on the viewers Right. The image
presentation will need to be modified to display preferred anatomical viewing. Some
viewing stations may not have the capability to flip the image presentation, but if the
capability exists, you must use display tools such as Flip to change the presentation of the
image. Some remote viewing stations may have the capability to set default viewing
protocols, this is another tool that can be used to set an anatomical viewing presentation.

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Safety
Post processing applications such as Direct MPR, Reformat and Volume Viewer
automatically orient images in anatomical viewing orientation. These applications create
axial images in anatomical viewing presentation. Please see Direct Visualization Auto
Applications (Option) for more information. The system also provides the capability to create
Gray Scale Presentation State Objects (GSPS) to flip the image orientation.
Data Safety
To ensure data safety:
Verify and record the patient's identification before starting a scan.
Observe and record the patient's orientation, position and anatomical landmarks
before starting a scan. Ensure that the patient is positioned within the scan
parameters.
Maintain system image quality by performing Daily QA and other maintenance.
Connectivity - Always verify that the data transferred to another system has been correctly
received.
Application Specific Safety Topics
WARNING: Helical scanning has the inherent ability to produce artifacts when scanning
highly sloped anatomy (e.g. pediatric or adult heads). Factors which worsen
this effect are: faster table speeds, thicker image thickness, and gantry tilt.
In some cases these artifacts could be mistaken for a hemorrhage near the
cranium, or a thickening of the skull.
To reduce the occurrence of these artifacts you may prescribe slower table
speeds and/or thinner slices (such as 2.5mm) during helical scans near the
vertex of a pediatric or adult head.
WARNING: For helical scans, the Segment Recon Mode in Retrospective Recon may be
used to assess if there is an artifact or not. If questions still arise, then re-scan
the area with a 2 second Axial scan.

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Safety
WARNING: It has been documented in radiology literature than an artifact may occur in
the chest that bears the double margin of the great vessels, which emulates
a dissection of the vessel during 0.5 - 1.0 second scans. This can occur in axial
or helical scans. If you have scanned axially with a 0.5 - 1.0 second rotation
time and observe this phenomenon, re-scan the area with a 2 second axial
scan to verify if it is artifact or patient pathology. Segment recon mode may
be used in Retro recon to also assess if the areas is artifact or pathology.
Cardiac Imaging
CAUTION:
A patient with the following conditions may be difficult to examine:

- Patients with multiple pre-contractions or extra systole (e.g. PVC, PAC)
- Patients with persistent or extreme arrhythmia
- Patients with bi-ventricular lead pacemakers
If scanned, resulting images may be ungated or have artifact present.
CAUTION:
ECG signal clarity and integrity must be confirmed prior to performing

ECG-gated acquisitions. Items which may require adjustment of equipment
settings or positioning, or patient set-up include:
- External Interference
- Atypical Patient ECG (e.g. elevated T-Waves, low ECG amplitude or signal
strength)
- Suboptimal Patient Connection
ECG lead placement should follow recommended guidelines to optimize
results.
If the ECG lead is disconnected during the scan, or the heart rate drops
below 30 BPM, the images will be reconstructed as non-gated segment
images. This is done to avoid inaccuracy of the z-location of images where
necessary.
CAUTION:
Cardiac helical scan modes of SnapShot Segment, Burst, and Burst Plus are
optimized for specific heart rate ranges. Select the appropriate scan mode
for each patient's heart rate pattern. If the incorrect mode is selected,
temporal resolution may be insufficient and degraded image quality could
result.

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Safety
CAUTION:
An ECG-gated acquisition may have degraded image quality due to patient

motion, respiration, beat-to-beat variability of heart rate or heart motion, or
a significant change in the heart rate over the scan duration. It is important
to explain to the patient the pattern of breathing instructions to expect, the
warm feeling that can be felt from the contrast injection and to position the
patient comfortably such that the arms will not move with respect to the body
during the scan.
Patient Preparation
Practice hyperventilation breathing instructions with the patient.
It is important to explain to the patient the events that will occur during the acquisition
of the contrast enhanced cardiac data. Make sure to explain the warm feeling that may
occur during the injection of the contrast material.
Use hyperventilation technique for all the series in a cardiac exam. Practice the
hyperventilation instructions with the patient prior to scanning.
During the practice breath hold, make sure to watch the ECG trigger monitor to
determine the average heart rate, minimum heart rate, and ECG pattern during the
breath hold.
Position the patient's arm over the patient's head so they are comfortable and will not
move during the acquisition of data.
CAUTION:
If, during the scan, the heart rate drops significantly lower than the prescribed
heart rate, there is a potential for gaps in the gated image location. To avoid
image location gaps, a non-gated image is reconstructed for the period where
the patient heart rate dropped below the expected or confirmed heart rate
at the start of the exam. A non-gated image may have more motion and may
not be reconstructed at the prescribed phase.
CAUTION:
There is a possibility that the ECG signal may not be detected by the scanner
due to improper lead placements, or a lead falling off during the scan. It is
important to place new leads on the patient before the scan. Make sure the
leads are attached properly, and use only GE recommended ECG leads.
It is important to confirm ECG trace clarity before the scan.

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Safety
CAUTION:
The heart rate displayed on the CT console is a 3-cycle average. You must
review the actual waveform pattern to determine ECG trace clarity, trigger
locations, and if any cycle to cycle variability or masked arrhythmias may be
present in order to adapt set up and conditions prior to proceeding with the
scan acquisition.
Lung Algorithm
The Lung algorithm setting provides edge enhancement between structures with large
density differences, such as calcium and air, resulting in a sharper lung field when
compared to Standard algorithm.
For best image quality, prescribe a 5mm scan thickness when you plan to use the Lung
algorithm. If you plan to prescribe a High Resolution Lung study with 3.75, 2.5, or 1.25
mm, use the Bone algorithm.
The Lung setting enhances the contrast of small objects. For best viewing and film
quality, select a window width of 1000 to 1500 and a window level of -500 to -600.
The Lung algorithm setting increases the CT number values at the edge of high contrast
objects. If you plan to take CT number measurements of vessels or nodules in the lung,
please check and compare your results with Standard algorithm images. (ROI and
Histogram functions use CT numbers.)
Remember: The edge enhancement provided by the Lung setting may not be
appropriate in some clinical cases. Please take individual viewing preferences into
account when you choose the Lung setting.
Autoscan
Press and release move to scan from the console to advance the cradle during Auto
Scan.
If you select Auto Scan during one group Rx, it remains ON for every group in that series.
SmartStep/SmartView Safety
The SmartStep/SmartView option adds several components to the scan room. These are the
In-Room Monitor, Hand Held Control for table movement as well as image review, and the
X-Ray Control Foot switch.
Each of the SmartStep/SmartView components is connected to the system by a cable.
When using the system, ensure that the cables cannot catch on anything when the gantry
or table is moved.

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Safety
Table Float
During SmartStep/SmartView the Clinician has the option to float the table between scans.
When the Table Float mode is selected, the table is unlatched and can be moved freely by
anyone at the bedside.
WARNING: UNINTENDED TABLE MOTION COULD CAUSE A SERIOUS INJURY. TABLE MAY BE
BUMPED OR JARRED DURING AN INTERVENTIONAL PROCEDURE. CARE MUST
BE TAKEN WHEN PERFORMING INTERVENTIONAL PROCEDURES IN THE FLOAT
MODE. IT IS THE CLINICIAN'S RESPONSIBILITY TO ENSURE THAT THEY HAVE
CONTROL OF THE TABLE WHEN IN THIS MODE OF OPERATION. TABLE MUST
NOT BE LEFT UNATTENDED WHEN IN THE FLOAT MODE. ENSURE THAT THE
TABLE IS LATCHED BEFORE LEAVING THE TABLE SIDE.
SmartStep/SmartView Scanning
SmartStep/SmartView scanning allows multiple scans at one location for interventional
procedures. The system allows up to 90 seconds of scanning in one place. After 90 seconds,
the operator must prescribe a new scan to continue. The accumulated scan time from a
procedure is displayed in the In-Room Monitor.
CAUTION:
Prolonged exposure to x-ray in one spot may cause reddening or radiation

burns. User must be aware of the techniques used and exposure time to insure
safe operation.
Clinician's working in the scan room should wear appropriate protective clothing. Lead
aprons, groin and thyroid protection, as well as protective eye wear are available through
the GE Accessories Catalog.
Interventional / Biopsy Scanning
WARNING: When scanning for interventional (biopsy) studies the scan mode, image
thickness, number of images per rotation and the display layout used affect
the display of the images. It is recommended to use the Biopsy Mode provided
on the system. If manually prescribing biopsy scans, Axial 1i scan mode or
Helical scan mode with a slice thickness greater than 2.5 mm must be used.
Do not use Cine scan mode for interventional (Biopsy) imaging. Do not use an
Auto view layout with more than one Auto View image viewport.
Refer to Select a Multiple Image Display in the Image Display Viewing Area chapter
of the Learning and Reference Guide for more information on how to set up the
desired viewing options.

2-22
Safety
Choose one of the following for the best auto view layouts
CAUTION:
Accuracy of Measurements
Measure Distance for Axial, Helical, and Cine Images

Measure error using the straight line distance graphic is less than 2 times the image pixel
size.
Measure Distance for Scout Images

Accuracy of measurements for scout images in the "X" direction varies with object thickness
and distance from ISO center in the "Y" direction. Note the orientations of the "X" and "Y" in
the diagram below assume a scout scan plane of 0 degrees. If the scout plane is rotated
then the "X" and "Y" orientation changes respectively.
For measurements of anatomy in the "X" direction that are at ISO center ("Y"):
The measure error using the straight line distance graphic is less than 5% of the
measured distance plus 2mm.
For measurements of anatomy in the "X" direction that are NOT at ISO ("Y"):
The measure error using the straight line distance graphic is less than 5% of the
measured distance plus 2mm plus 3% of measured distance per centimeter from
ISO.
For measurements of anatomy in the "Z" direction:

Measure error using the straight line distance graphic is less than 2 times the image
pixel size.

2-23
Safety
Measure Angle
Measurement accuracy using the angle graphic is equal to the displayed angle value +/- 10
degrees for an angle measured between segments which are five times larger than the
image pixel size. Accuracy improves as the length of the segments increases.
ROI
Area measurement accuracy using a region of interest graphic (rectangle, smooth curve,
ellipse or free draw) is equal to the displayed area +/- the circumference of the region
multiplied by (image pixel size)2/2. Mean and standard deviation values for the intensity of
the pixels in the region are also affected by this accuracy. If the ROI is rotated, the area
measurement can vary up to 5%. Region of interest statistics are based on the pixels INSIDE
the graphic defining the region.
Reformat Plane Thickness

Reformat plane thickness equals 1 pixel.
If each axial pixel represents 0.5mm or anatomy, then the reformat plane thickness
equals 0.5mm.
If pixel size equals 0.9766mm (500mm/512), then the reformat plane represents a slice
of anatomy about one millimeter thick.
Operator Console Ergonomics

To optimally use your CT Scanner and reduce the chance of physical strain and fatigue, the
following steps are recommended regarding how you use your operator console.
Posture
Correct posture is very important. To ensure correct posture while sitting at your operator
console, follow these basic steps:
1. Face the monitors and keyboard without twisting your body.
2. Sit comfortably erect with the small of your back well supported.
3. Position your forearms parallel to the floor, with your wrists straight.
4. Position the screen so that your eyes are nearly level with the top of the screen.
5. Keep both feet flat on the footrest, with your thighs parallel to the floor.
If you cannot comfortably maintain this position while working at your operator console, you
should make the necessary adjustments to your operator console environment.

2-24
Safety
Equipment Adjustments
Chair
Adjusting the fit and height of your chair is very important for comfort. Follow these basic
guidelines:
1. Fit the backrest snugly against your back. People with shorter legs might need a back
cushion.
2. Set your chair height to position your forearms parallel with the floor when your hands
are placed on the keyboard. If your feet dangle, you need a footrest.
Keyboard
Keyboard height is also important. When typing:
Your wrists should be as straight as possible.
Your forearms should be parallel to the floor.
Your hands and fingers should float over the keys or mouse.
Screen
The recommended viewing distance from the screen is 18 - 28 inches (45 - 70

centimeters).
With your head straight, your eyes should be looking directly at the top of the screen.
You should look at the screen straight-on, not at an angle from the side, top or bottom.
Glare from the screen can disrupt your viewing and cause eyestrain. Do not face a
window, and position the screen at right angles to bright light sources.
Comfort
Comfort at your operator console indicates you've set up your work area correctly. However
even a well-designed area needs frequent adjustment, especially for different users. Take
the time when positioning yourself at your operator console to ensure your comfort.
It is also recommended that if you use the operator console for extended periods of use
(several hours at a time), that you take short breaks to get away from your operator console
and perform simple stretching exercises to reduce the chance of fatigue.

2-25
Safety
Other considerations:
Keep the patient in view at all times.
Never leave the patient unattended.
Stay alert to your patient's condition.
Use the speakers and microphones on the table, gantry, and console to stay in
constant communication, even while you sit at the console.
Follow the exam procedures explained in the Chapters 13 and 14 of the Learning and
Reference Manual. Carefully enter patient information and position before
proceeding.
CAUTION:
Incorrect data entries or procedures could result in misinterpretation or

misdiagnosis.
Accessories
Use only GE approved equipment together with this system.
With each use check all accessories for damage and remove them from service if
damaged or cracked.
GE Approved Cardiac Trigger Monitors

IVY 3150,
IVY 3100 with Ethernet,
IVY 3150-A
IVY 3100-A with Ethernet
IVY 3100
InVivo
The placement of the IVY cardiac trigger monitor should be on the monitor stand. The
monitor should not be placed on the CT table or table tray. It should be positioned so that it
is not touching the CT table or gantry when it is in use.
IV Pole Safety
Care should be taken in the amount of weight and ensuring that the pole is tightened prior
to use.

2-26
Safety
CAUTION:
The IV pole may bend when excessive weight is placed on the pole. Ensure no
more than 4.5 kg or 10 lb. is placed on the IV pole.
CAUTION:
Ensure that the IV pole extension collar is tightened prior to use to avoid the
pole height to move on it's own.
Table Tray Safety

Care should be taken in the amount of weight and the objects that are placed on the tray.
CAUTION:
The maximum allowable weight on the table tray is 9kg or 19.8 lbs
CAUTION:
Objects that may be susceptible to tipping should be strapped down with the
Velcro strap provided.
Systems With Metal-Free Cradles and Accessories
CAUTION:
Prevent damage to metal-free accessories! Carefully examine the metal-free

clasp assembly on the accessory and the catch on the cradle before
attempting to attach the accessory for the first time.
To Latch an accessory:
Align the accessory tongue with the pocket at the end of the cradle.
Keep fingers clear of the cradle.
Push the tongue all the way into the pocket until it latches into place.
Rubber shims may have been installed on the head holder or foot extender to give it
a tighter fit. Please take care when latching the accessory to make sure that it is
completely latched. Push the latch forward until you hear a click. Verify that the latch
is fully latched.
To Unlatch an accessory:
Pinch the two L-shaped parts together and pull the accessory out of the cradle.
An alternate method is to apply a light force to the catch in the direction to pull the
accessory out of the cradle.

2-27
Safety
Proper operation:
Keep the accessory "tongue" and cradle pocket clean and free of fluids and debris.
Keep the latch and cradle pocket area clear of sheets, drapes, pads or any item that
could interfere with proper latching and cause damage.
Positioning
Positioning patient anatomy over the area where the head holder or cradle extension
attaches to the cradle may produce images where the contrast be between 2
adjacent rotations is different. Make sure the area of interest especially the head in
properly positioned in the head holder or on the cradle extension.
Limited Access Room Configuration:
CAUTION:
Due to access limitations on the left side of the gantry, some procedures may
be affected when ancillary equipment is used. Assess the placement of the
equipment needed for the procedure before the placement of the patient on
the table. Access around the left side of the gantry may also be affected.
Emergency Devices and Emergency Egress

Emergency Devices
The system has two types of Emergency buttons:
1. Emergency Stop- when pressed, all table and gantry motions are halted, generation of
X-rays is stopped, laser alignment lights are turned off. The system aborts any data
acquisition in progress, and attempts to save all data acquired prior to the abort. Use
the Emergency Stop button for patient related emergencies.
2. System Emergency Off Button- when pressed, the power to all system components is
removed, stopping all table and gantry motion and generation of X-rays. The system
aborts any acquisitions in progress, and data obtained prior to the abort can become
corrupt or lost. Use the System Emergency OFF button for catastrophic emergencies,
such as fire or earthquake.
CAUTION:
If you press the Emergency Stop or Emergency OFF buttons during a scan, the
system will abort the data acquisition.
Emergency Stop
NOTE: Every operator should take a few minutes to locate the Emergency Stops on his or
her system before he or she scans the first patient.

2-28
Safety
The system has five Emergency Stop buttons:
One on each control panel on the front of the gantry (Figure 2-8).
Figure 2-8 Front of gantry Emergency Stop Buttons
Two on the rear cover of the gantry.

One on the Acquisition Control (Figure 2-9).
Figure 2-9 Emergency Stop button on the Keyboard
Press an Emergency Stop button in the event of a patient related emergency or if the cradle,
table or gantry starts to move unexpectedly.
Once an Emergency Stop button is pressed, the Reset gantry key, on the gantry control
panel, flashes about once every two seconds.
Press the Reset gantry key to restore power to the gantry and table.
When Emergency Stop is applied, the moving cradle and tilting gantry may overrun by less
than 10 mm and less than 0.5 degrees respectively.
System Emergency OFF Buttons

In the event of a fire, flood, earthquake, or any other catastrophic emergency, all power to
the system should be turned off. Pressing the System Emergency OFF button immediately
removes all power to the system by removing power to the Main Disconnect Control (MDC).
Because the system has no time to save data, or shutdown in an orderly fashion, pressing
the System Emergency OFF button can corrupt system files or result in loss of patient data.
The facility designer determines the quantity and locations of the Emergency OFF buttons.
GE recommends placing an Emergency OFF button near the doorway of every room in the
system scan suite. Ask your supervisor to show you the location of all the Emergency OFF
buttons in the system suite. Follow facility guidelines to report an emergency.

2-29
Safety
Press the System Emergency OFF button (red, circular button located on the wall) in the
event of a catastrophic emergency, such as fire or earthquake.
Reset the Emergency OFF Button
1. Press the Start button on the Main Disconnect Control.
Power to the Power Distribution Unit (PDU), operator console and system electronics
will be restored.
2. Press the Reset gantry key on the gantry panel.
Power to the gantry drives, X-ray system and table drive will be restored.
Emergency Patient Care During X-Ray ON:
Press STOP SCAN to abort x-ray and stop gantry/table movement.
Press PAUSE SCAN to pause scanning after the current scan completes.
During an exam, the system pauses between scans if you Press any button on the
control panel other than the alignment lights. It stops X-Ray if you Press the same
button(s) during a scan.
Select Resume on the screen to continue the exam.
Emergency Egress
System operation may be stopped due to power failure or a safety event (something coming
into contact with the collision sensors), or the system may be halted by the operator in
response to emergency conditions.
The Cradle unlatch button should only be used in two situations.
1. In Emergency Egress situations.
2. When using the SmartStep/SmartView scan type.
To safely remove the patient:
1. Press the Cradle Release gantry key or the Emergency Stop button (Figure 2-8) to
disengage the clutch.
2. Pull the cradle to its out position, using the Cradle Lip or Cradle Release Handle.
3. Assist the patient off the table.
Maintenance and Cleaning
To guarantee safe, reliable equipment performance, the site must be prepared

according to GE Healthcare requirements, as specified in the Pre-Installation Manual.

2-30
Safety
There are no user serviceable parts in this system. The product should be installed,
maintained and serviced by qualified service personnel according to procedures laid
down in the product service manuals.
The system in whole or in part should not be modified in any way without prior written
approval by GE Healthcare.
Keep the equipment clean. Remove body fluids and/or IV spills to prevent a health risk
and damage to internal parts. Clean the equipment with warm water and soap or a mild
antiseptic.Use dry cleaning for electro components.
Do not clean the connectors on the cables for ECG,Respiratory equipment, etc If you
need to clean up them,cantact GEHC service.
Planned maintenance must be carried out regularly to ensure safe operation of the
equipment.
For user maintenance of the system and performance tests, refer to the maintenance
and calibration information in the Technical Reference Manual.
Environmental Concerns
This symbol indicates that the waste of electrical and electronic equipment
must not be disposed as unsorted municipal waste and must be collected
separately. Please contact an authorized representative of the manufacturer for
information concerning the decommissioning of your equipment.

2-31
Safety
Name and Concentration of Hazardous Substances

Explanation of Pollution Control Label
This symbol indicates the product contains hazardous materials in excess
of the limits established by the Chinese standard SJ/T11363-2006
Requirements for Concentration Limits for Certain Hazardous Substances in
Electronic Information Products. The number in the symbol is the
Environment-friendly Use Period (EFUP), which indicates the period during
which the toxic or hazardous substances or elements contained in
electronic information products will not leak or mutate under normal operating conditions
so that the use of such electronic information products will not result in any severe
environmental pollution, any bodily injury or damage to any assets. The unit of the period is
"Year".
In order to maintain the declared EFUP, the product shall be operated normally according to
the instructions and environmental conditions as defined in the product manual, and
periodic maintenance schedules specified in Product Maintenance Procedures shall be
followed strictly.
Consumables or certain parts may have their own label with an EFUP value less than the
product. Periodic replacement of those consumables or parts to maintain the declared EFUP
shall be done in accordance with the Product Maintenance Procedures.
This product must not be disposed of as unsorted municipal waste, and must be collected
separately and handled properly after decommissioning.
Table 2-2 Table of hazardous substances' name and concentration
Component Name
Hazardous substances' name

(Pb)
(Hg)
(Cd)
(Cr(VI))
(PBB)
(PBDE)
Operator Console
Gantry
LCD Monitor
ECG Cardiac Trigger
Power Distribution Unit
Patient Table

2-32
Safety
Component Name
Hazardous substances' name

(Pb)
(Hg)
(Cd)
(Cr(VI))
(PBB)
(PBDE)
O: Indicates that this toxic or hazardous substance contained in all of the

homogeneous materials for this part is below the limit requirement in SJ/T11363-2006.
X: Indicates that this toxic or hazardous substance contained in at least one of the
homogeneous materials used for this part is above the limit requirement in
SJ/T11363-2006.
Data listed in the table represents best information available at the time of
publication
Applications of hazardous substances in this medical device are required to
achieve its intended clinical uses, and/or to provide better protection to human
beings and/or to environment, due to lack of reasonably (economically or
technically) available substitutes.
This product consists of devices that may contain mercury, which must be recycled or
disposed of in accordance with local, state, or federal laws. (Within this system, the backlight
lamps in the monitor display contain mercury.)
The X-Ray Collimator contains the following potentially hazardous materials:
Lead: Lead salts are toxic and their ingestion may cause serious problems. The
manipulation/ handling of lead is subject to regulations.
WARNING: Do not discard the X-Ray Tube Assembly among industrial waste or domestic
garbage.
WARNING: A damaged X-ray Tube Assembly should not be dispatched through the
national postal service.
The X-Ray Tube Assembly contains the following potentially hazardous materials:
Lead: Lead salts are toxic and their ingestion may cause serious problems. The
manipulation/ handling of lead is subject to regulations.
Oil: Univolt 54 and Crosstrans 206 mineral oil are not toxic, but the prevailing
environmental regulations should be observed for their disposal or recuperation. For
example, it is forbidden to dispose of these oils in the wastewater or sewage system or
in the natural environment.
Your local GEMS field service will advise you on the suitable means of disposal.
The X-Ray Tube Assembly to be discarded should be forwarded to the GEMS Service
network, and it will be disposed of in a GEMS recycling center.

2-33
Safety
Precautions
Take all the necessary precautions for the personnel handling the recovery or destruction of
X-Ray Tube Assemblies, and in particular against the risks due to lead.
These personnel must be informed of the danger involved and of the necessity to observe
the safety measures.

2-34
Getting Started
Chapter 3
Getting Started
Introduction
The Getting Started chapter provides you with information about the hardware components
and users conventions, as well as the shutdown and startup procedures of the system. The
chapter is broken into three parts: hardware components, users conventions, and shutdown
and startup. The purpose of this chapter is to provide the necessary background information
about the system that may be important in understanding other topics presented in
subsequent chapters.
This chapter explains the process of shutting down and starting up the system. It provides
step-by-step instructions to learn how to:
Shut Down and Start Up System
Login and Logout
Configure Users for the System
Enterprise Tab
Local User Management Tab
Group and Permission Mapping
Use QuickSnap
Use IQ Snap
Use Anonymous Patient (Anon Pat. Level)
As stated in the About This Guide chapter, it is necessary for you to have sufficient
knowledge to competently perform the various diagnostic imaging procedures in
computerized tomography. This guide is not intended to teach computerized tomography.

3-1
Getting Started

This section presents the concepts necessary to successfully set up a patient for scanning.
Some of the concepts you need to understand are:
Hardware Components
Power Distribution Unit (PDU)
Gantry Controls
Gantry Display
Internal Gantry Components
Computer
Table for BrightSpeed Excel, Edge, Elite
Table for BrightSpeed Select Series
Monitors
Keyboard and Scan Interface module
Mouse
Bright Box (Option)
Users Conventions
Tool Chest
HIPAA
Understanding users and groups
Understanding groups and privileges
Product Network Filters - PNF
Software Download

3-2
Getting Started
Hardware Components
The Power Distribution Unit or PDU supplies power to the table, gantry, computer, and
monitors. This unit is a separate piece of hardware normally located in the same room as
the table and gantry.
2
1
14
13
12
15
11
5
16
4
6
8
17
7
9
18
10
Gantry Controls
The numbers on the above picture correlate to the numbered explanations below.
1. Prep Delay Timer- Displays the prescribed prep delay before scan starts.
2. Stop Scan- In the event of an emergency situation, pressing (Stop Scan) stops the prep
delays as well as any X-ray exposure in progress.
3.Start Scan - In the event that you want to stand by the gantry and start
the scan, you can press this button after you have confirmed the
prescription and the table has been moved to the start scan location. Start
Scan will flash for 30 seconds before it times out. Press the solid green
Start Scan button again to bring the system back to ready to scan state.
4. Cradle In - Pressing
(Cradle In) moves the cradle in, towards the gantry.

3-3
Getting Started
WARNING: To prevent unnecessity X-ray receiving, customer should use X-ray protection
equipment when using In Room Scan Start button.
5. Table Up - Pressing
(Table Up) moves the table up and towards the gantry. While
moving the table up, with the laser alignment light on, the cradle adjusts horizontally to
maintain the anatomic reference point.
If you step on the up pedal, it raises the table up and move the cradle in.
6. Cradle Out - Pressing
(Cradle Out) moves the cradle out, away from the gantry.
Cradle In or Out can be used to move the patient to the scan location after clicking
confirm. Cradle In or Out LED will flash for 180 seconds before it times out.
7. Table Down - Pressing

(Table Down) moves the table down and away from the
gantry. While moving the table down, with the laser alignment light on, the cradle
adjusts horizontally to maintain the anatomic reference point.
If you step on the down pedal, it moves the cradle out and lower the table down. It
also tilts the gantry back to zero.
8. Fast Speed - Pressing
(Fast Speed) in conjunction with Up/Down or In/Out causes
those functions to operate at a faster speed.
9. Superior Gantry Tilt - Pressing
(Superior Gantry Tilt) tilts the gantry towards the
patients head, regardless of his/her position.
NOTE: Maximum tilt depends on the table height and interaction with interference matrix.
Use the Tilt and Table Travel Limit button to determine limits.
NOTE: The Remote Tilt button on the Scan Control Interface Module can be use to return the
gantry to zero once all prescribed scan for the exam have been acquired.
10. Inferior Gantry Tilt - Pressing
(Inferior Gantry Tilt) tilts the gantry towards the
patients feet, regardless of his/her position.

3-4
Getting Started
11. Breathing Lights Demo- Pressing
allows you to demonstrate to the patient how
to use the breathing lights and countdown timer.
Blinking green breathe light indicates to get ready to hold your breath.
Solid yellow light indicates to hold your breath.
Count down indicator counts down the seconds to breathe tim
Solid green breathe light indicates to breathe.
Breathe Light
Breath
Light
Hold Your
Count Down Indicator

12. Tilt and Table Travel Limits- Pressing
allows you to view the current gantry tilt
range and scannable range, based on table position, on the gantry display panel.
NOTE: The Tilt and Table Travel Limits displayed are calculated based on a limit and collision
matrix that takes into consideration the table height and landmark location on the
cradle when providing the information displayed.
13. Internal Landmark - Pressing
(Internal Landmark) establishes the tables reference
point when positioning the patient, using the internal laser alignment light. This
reference point is normally the anatomic reference point to be used when positioning
the patient. For example, if the patients anatomic reference point is the sternal notch,
then the sternal notch would be centered to the internal laser alignment light, and you
would press
(Internal Landmark). The gantry display would then show a table
location of 0 mm. The reason for the table location of 0 mm is because the CT system
calculates its table location numbers based on the internal laser alignment light. Either
(Internal Landmark) or
(External Landmark) has to be used before you can click
[Confirm].
14. External Landmark - Pressing
(External Landmark) establishes the tables
reference point when positioning the patient, using the external laser alignment light.
This reference point is normally the anatomic reference point to be used when
positioning the patient. For example, if the patients anatomic reference point is the
sternal notch, then the sternal notch would be centered to the external laser alignment

3-5
Getting Started
light, then you would press
(External Landmark). The gantry display would then
show a table location approximately 240 mm, depending on table characterization. The
reason for these location numbers is that the CT system calculates its table location
numbers based on the distance between the external and internal laser alignment
lights. Either
(Internal Landmark) or
(External Landmark) has to be used before
you can click [Confirm].
15. Laser Alignment Light - Pressing
(Laser Alignment Light) turns the laser alignment
on. Pressing it again turns the light off.
CAUTION:
For patient safety, it is important to always have patients close their eyes
anytime the laser alignment light is on.
16. Cradle Lock - Pressing

(Cradle Lock) once unlocks the table cradle, making it "free
floating". This means that the cradle can be moved freely with your hands. This can be
useful to move the patient out of the gantry in an emergency. Pressing
(Cradle
Lock) a second time returns the cradle to the locked position and the landmark
established is maintained.
NOTE: If Cradle Lock is used during a SmartStep acquisition, the cradle must be in the locked
state to make an exposure.
17. Table collision sensor indicator/reset(Reset) is used if (Emergency Stop) has
been pushed,
(Reset) flashes approximately once every two seconds. Pressing
(Reset) re-engages the table and gantry.
NOTE: If the table stops moving, clear the obstruction and continue moving the table.
18. Home - Pressing
(Home) simultaneously moves the cradle out of the gantry and
return the gantry tilt to zero degrees. Once the cradle has been removed from the
gantry, the table begins to lower to its lowest allowable limit.
Gantry Display
1 2 3
The numbers on the above picture correlate to the numbered explanations below.The
Gantry display indicates the table and gantrys current status.

3-6
Getting Started
1. Laser Light Indicator - The
(Laser Light Indicator) is illuminated anytime the
laser alignment light has been turned on. Normally, this light is only on when
positioning a patient.
CAUTION:
For patient safety, it is important to always have patients close their eyes
anytime the laser alignment light is on.
2. Collision Indicator- The

(Collision) light illuminates when there is a possibility that
the table, cradle, and gantry comes in contact with each other. There are tilt/elevation
collision sensors on the front and rear covers at the top of the gantry opening. The
collision sensors are active during table elevation and during tilting of the gantry. The
light also illuminates if there is ten pounds of resistance during cradle motion in/out or
when reaching the travel limits of table, cradle, and gantry motion. In the case of
interference, you may need to raise or lower the table, check the gantry tilt, or
determine if resistance is being caused by any patient restraints, accessories, or by the
patient. If you need to tilt the gantry after a collision has been detected, the gantry only
tilts in 0.5 degree increments. You can also check the Table collision sensor
indicator/reset button on the front of the gantry. The light will go out if you continue to
hold the button.
3. Cradle Unlocked Indicator - The
(Cradle Unlocked Indicator) is illuminated,
indicating the cradle is unlocked. When the cradle is unlocked, it is "free floating".
4. Vertical Height Indicator - The
(Vertical Height Indicator) displays the
vertical height of the table in relation to ISO center.
5. Horizontal Cradle Position - The
(Horizontal Cradle Position)
displayed is the position of the cradle based on the established anatomic reference of
the patient. This reference is established using the internal or external landmarks. The
number is preceded by an S if the position is superior to the reference point or an I if the
position is inferior to the reference point.
6. Gantry Tilt Indicator - The
(Gantry Tilt Indicator) shows one of two
displays. One display, which is the normal display, indicates the current gantry tilt. If the
gantry tilt is superior, the number is preceded with an S. If the gantry tilt is inferior, the
number is preceded with an I.
7. Exposure Indicator - The
exposure is taking place.
(Exposure Indicator) illuminates amber when an actual
8. Heart Indicator - The heart is lit whenever there is an ECG gating signal seen by the
scanner.

3-7
Getting Started
Internal Gantry Components

Gantry left side view
BrightSpeed Excel, Edge, Elite

Gantry front side view
DANGER:
BrightSpeed Select Series

Gantry front side view
Information on internal gantry components is provided for user education.

The gantry contains dangerous voltages and moving parts. TO PREVENT
ELECTRICAL SHOCK OR CRUSHING INJURIES, DO NOT REMOVE COVERS OR
ENTER THE GANTRY. ONLY TRAINED, QUALIFIED SERVICE PERSONEL MAY
REMOVE GANTRY OR OTHER EQUIPMENT COVERS.
1. Tube and Collimator BrightSpeed Excel, Edge, Elite : The anode heat capacity with a Performix tube is 6.3
million heat units (MHU) and the cooling rate is 840,000 heat units per minute
(KHU/min).
BrightSpeed Select Series: The anode heat capacity with a Solarix tube is 3.5 million
heat units (MHU) and the cooling rate is 820,000 heat units per minute (KHU/min).

3-8
Getting Started
2. Detector/Data Acquisition System - The detector is comprised of a solid scintillator
material known as HiLight. HiLight, using a 16 channel 16 X 1.25mm matrix design 4
slice and 8 slice systems provides 99 % dose efficiency. The 16 slice systems have 24
channels for the 16 X 0.625 and 8 X 1.25 modes.
3. Generator Tube Controller Auxiliary - The tube controller regulates the tubes rotor
start and stop time.
4. Generator For BrightSpeed Excel, BrightSpeed Edge and BrightSpeed Elite:
The high frequency generator is composed of the cathode and the anode tanks. Each
tank occupies one cubic foot within the gantry. Together the cathode and the anode
provide 53.2 kilowatts (kW) of power with the Performix tubes.
The BrightSpeed Elite high frequency generator is composed of inverter and high
voltage tanks.
For BrightSpeed Excel Select, BrightSpeed Edge Select and BrightSpeed Elite Select:
The high frequency generator is composed of the cathode and the anode tanks.
Together the cathode and the anode provide maximum 42 kilowatts (kW) of power .
The BrightSpeed Elite Select high frequency generator is composed of inverter and
high voltage tanks.
The BrightSpeed Elite Standard Select high frequency generator is composed of
inverter and high voltage tanks. Together the cathode and the anode provide
maximum 30 kilowatts (kW) of power .
5. ORP The ORP provides the central communication point for the rotating subsystem.
6. TGPU - The TGPU provides the mechanism for input and output exchange to and from
the operator console.
Computer
The numbers on Figure 3-1 correlate to the numbers in Table 3-1.
The computer is located at the base of the console and it contains all the hardware
necessary to operate the system and perform image generation.
Xtream FXTM Technology
The operator console issues a PC based computer system running a Linux based operating
system. The system supports a gigabyte network port. The system includes a 291GB disk
(system, image, scan disks) stores up to 250,000 images (512x512) and 5,400 scan rotation
data files.
GRE Recon
(Option for BrightSpeed Excel/Edge)

3-9
Getting Started
The Global Reconstruction Engine (GRE) hardware provides faster reconstruction times of up
to 3 images per sec. or up to 16 FPS (Option) based on hardware configuration. The faster
times enhance the capabilities of SmartPrep to provide more precise timing in the delivery
of contrast material for a wide variety of examinations.
(Option for BrightSpeed Elite Select)
The Global Reconstruction Engine (GRE) hardware provides faster reconstruction times of up
to 3 images per sec. or up to 6 FPS (Option) based on hardware configuration. The faster
times enhance the capabilities of SmartPrep to provide more precise timing in the delivery
of contrast material for a wide variety of examinations.
Applications on Operator Console (OC)
Common user interface with Advantage Windows for improved productivity. The OC now
supports an expanded list of Advanced Application packages such as Volume Viewer,
Advanced Vessel Analysis, CT Perfusion 3 - Multi-Organ or Neuro only, CT Colonography or
Advantage CTC Plus or Pro, CardIQ Xpress - Plus or Pro, CardEP, Auto Bone, and DentaScan.
CardEP are not available for BrightSpeed Excel Select, BrightSpeed Edge Select and
BrightSpeed Elite Select systems.
Volume Viewer is a prerequisite to support Advanced Vessel Analysis, CT Colonography or
Advantage CTC, CardIQ Xpress, CardEP, and AutoBone.
Located on the top of the console table top is a media tower with two drives.
Table 3-1 Device Descriptions
Device Name
Description
Magnetic Optical
Disk Drive (MOD)
(Option for
BrightSpeed
Excel/Edge/Excel
Select/Edge
Select/Elite
Select)
Located at the top of the media tower is the MOD drive used
for image archiving and restoring. The MOD disks are
erasable and re-writable and 1.2 or 2.3 GB media can be
utilized. The MOD can store 1800 (1.2GB) or 4700 (2.3GB)
lossless JPEG compressed 512 x 512 matrix images per side.
Actual number may vary by stored image type.
NOTE: PC based systems only save images files to MOD, scan

data is saved to DVD RAM for these systems.

3-10
Getting Started
Device Name
Description
Digital Video
Disk-Random
Access Memory
(DVD-RAM)
Located at the bottom of the media tower is the DVD drive

which supports writing to the following media types
DVD-RAM, CD-R and DVD-R.
The DVD drive can be used to access the electronic copies of
the Operator Manual titled "The Learning and Reference
Guide".
The DVD can also be used for saving scan files, protocols, and
service files to DVD-Ram. The CD/DVD option (Interchange) in
the Browser on the Image Works desktop can save images to
CD-R or DVD-R. The CD/DVD option can restore data from
CD-R, and DVD-R. The Data Export option in the Browser on
Image Works desktop can only save information to CD-R.
Connections for
iLinq and service
computer
functions
Located on the front of the computer are connections for

iLinq and service computer functions.
This is intended to be used by trained service personnel only.
Computer power
on/off switch
Located on the front of the computer is the computer power

on/off switch.If power is turned off via this switch and the
Main Disconnect Control (A1), then power cannot be restarted
to the computer unless the on/off switch is turned on after
power to the Main Disconnect Control is restored.
NOTE: In a typical workflow the system would be shutdown
by clicking [Shutdown] on the right monitor prior to
disabling power.
Figure 3-1 Computer Console with single piece desktop
3
4
1
2

3-11
Getting Started
Freedom WorkSpace (FWS) Console Table
Innovative hardware creates a unique convenient ergonomic working environment. It offers
sit/stand and horizontal/vertical monitor flexibility. The monitor arms are designed to be
adjusted quickly and easily. FWS Console Table can also help reduce noise and heat with
remote location of the console compared with the single piece desktop. For how to adjust
FWS Console Table, you can refer to the Installation manual shipped with the system
Figure 3-2 Computer Console with side by side console table (FWS Console Table)
stand
sit
FWS Console Table
Table for BrightSpeed Excel, Edge, Elite

The table has a weight limit of 450 pounds (205 kg) with an incremental accuracy of 1mm.
At 400 pounds (180 kg), incremental accuracy increases to 2.5mm. The vertical range of
the table is 51 to 99 centimeters. The scout view range is 1,600 mm and the scan range is
1,700 mm.
Table for BrightSpeed Select Series

The table has a weight limit of 205 kg. The vertical range of the table is 44 to 99 centimeters.
The scout view range is 1,260 mm and the scan range is 1,346 mm at 140mm below ISO
center with 300mm cradle extender.
Figure 3-3 Table

3-12
Getting Started
NOTE: The maximum scan range depends on table height. The mark which shows the
maximum scan range can not be adjusted, depending on table height. Adjust
patient's position to place the target part within the scannable range with margin.
Figure 3-4 Tape Strips
BrightSpeed Excel, Edge, Elite Table
BrightSpeed Select Series Table
Tape Strips
Tape Strips
Tape Strips for BrightSpeed Excel, Edge, Elite Table

Located underneath the table are the collision sensor strips. These strips are located in
areas where there is potential for the table to come into contact with foreign objects, such
as a wheel chair or a stretcher. If one of the tape strips is touched, the table and gantry
motion stops immediately. Raise the table and clear the obstruction. You can now continue
moving the table down.
Tape Strips for BrightSpeed Select Series Table

Located underneath the table are the collision sensor strips. These strips are located in
areas where there is potential for the table to come into contact with foreign objects, such
as a wheel chair or a stretcher. If one of the tape strips is touched, the table motion stops
immediately. Clear the obstruction. You can now continue moving the table down.
NOTE: The maximum scan range and gantry tilt depends on the table height. The mark on
the cradle for maximum scannable range is based on the table center at isocenter.
Make sure the patient is positioned within the scannable range and use the Tilt and
Table Travel Limit button on the gantry control panel to check limits.
NOTE: LightSpeed 5.X based 4, 8, 16 slice systems, LightSpeed Pro16, and LightSpeed RT tape
switches are only activated when downward motion of the table elevation
encounters an obstruction. They are not activated when touched.
CAUTION:
Use of any cradle extension accessories such as the table extension, head
holder, coronal head holder, and phantom holder are not accounted for in the
table gantry interference matrix. Therefore, additional care needs to be taken
to closely monitor any table up/down, in/out or gantry tilt movement to avoid
contact of the extended accessory with the gantry.

3-13
Getting Started
Monitors
There are two monitors for the system (Figure 3-5). The monitor on the left is the Scan
monitor and the monitor on the right is the Display/Image monitor.
Figure 3-5 Monitors
Std Monitors
NOTE: If the power is turned off to the monitors by either console off or using the power off
button on the monitor, it takes 15 minutes for the monitors to stabilize to their set
brightness and contrast levels. During this warm-up time, do not make any
adjustments to the brightness or contrast levels.
1. Scan Monitor - The Scan monitor contains you interface that controls all aspects of
scanning from entering patient information to ending the patient exam. The interface
also includes scan protocol control, scan data manipulation, and system maintenance,
such as tube warm-up and calibrations.
Top Level Features (from left to right):

New Patient - To start a new patient.
Patient Schedule - To pre-program patient information and to get information
from DICOM HIS/RIS.
Protocol Management - To create, edit, and delete scan and voice protocols.
Retro Recon - To reprocess scan data to create new images.
Recon Mgmt - To pause, resume, or delete reconstruction. Also used to
save/restore or reserve/release scan data.
Daily Prep - To perform tube warm-up or fast calibrations.
Scanner Utilities - For Field Engineer to perform phantom calibrations.
Operator Console Message Area - Located above the buttons, it is a raised white
bar in the middle of the white line. Clicking on this bar gives you a list of various
messages related to the scan monitor.
NOTE: The details about each of the features, except the Operator Console Message Area,
is covered in various chapters in this manual.

3-14
Getting Started
2. Display/Image Monitor - The Display/Image monitor contains the desktop selection
area and the feature status area at the top left, the function buttons for the currently
selected desktop directly below feature status area, and the image display area to the
right.
This section focuses more attention to the desktop selection area and the feature
status area. These areas are visible on all desktops except Learning Solutions.
The function buttons (Figure 3-6) for the current desktop and the image display area are
covered elsewhere in this manual.
Figure 3-6 Display Desktop
2
3
4
5
6
7
1. Desktops - The desktops can be thought of as a work environment. When a
desktop is open, all the functions related to that desktop are placed on the
display/image monitor. The available desktop selections are:
Exam Rx - To view images as you scan, auto film, manual film, and to apply
measurements and other features to an image.
Image Works - To view other exams, archive, network, remove, manual film, apply
measurements and other features to an image, perform 2D reformations, and
access optional software features.
Learning Solutions - CD-ROM based operator information.

3-15
Getting Started
iLinq - To gain on-line access to GE Online Center engineers and Answerline
Applications Specialists for the purpose of sending and receiving information
related to the scanner. Within this desktop, you also have access to the ten most
frequently asked questions and a searchable database.
Service - Used mostly by field engineers to save scan and/or voice protocols and
to perform system diagnostics.
Shutdown - To restart the system, shutdown for power cycle of the system, or
User log out for HIPAA
2. Feature Status Area - contains the following areas:
3. Date/Time/Image Space - Shows current date, time, and the remaining 512 and 256
matrix image space on the system disk.
4. Reconstruction - Shows the current or most recent exam, series, and image
reconstruction status. This status includes prospective or retrospective reconstruction.
On the Xtream and Xtream FX systems, recon shows the exam, series, image range
and percent complete.
5. Archive - Shows the current or most recent exam, series, and image archive status. This
status includes Save or Restore.
6. Network - Shows the current or most recent exam, series, and image network status.
This status includes Send or Receive.
7. Filming - Shows the current or most recent filming status.
8. Current Message - This area serves two functions. First, when you click on the area, you
can see a list of the system messages. These messages are not necessarily error
messages but can simply be any informational messages generated by the system. The
second purpose is to leave messages about the system for the field engineer by using
[Memo]. When you click [Memo], a pop-up menu appears. Making sure the cursor is in
the menu area, you can then type a message, then click [Save]. The message now is a
part of the log files. The field engineer can look at this message at a later date by
viewing the log file via [View Log]. You can also view the error log through [View Log].
Keyboard and Scan Interface module

The keyboard and scan interface module exist of a typical alphanumeric keys, 10 number
keypad and buttons specific to initiating scan, remote tilt of the gantry and communication
with the patient.

3-16
Getting Started
Figure 3-7 Keyboard
2 10 11 12
9
3 4 5
6 7 8
1. Emergency Stop - In the event of an emergency situation, pressing emergency
stop stops all table and gantry motions, as well as any X-ray exposure in progress.
2. Exposure Indicator - The
exposure is taking place.
(Exposure Indicator) illuminate amber when an actual
3. Start Scan - The

(Start Scan) indicator flashes green once the tube has reached
exposure speed. Simply press the button to start the scan. Start Scan will flash for 30
seconds before timing out. Press the solid green Start Scan button again to bring the
system back to the ready state.
4. Pause Scan - Pressing
(Pause Scan) causes the system to pause scanning, once
the current scan is completed. You can resume the scan by selecting [Resume] from the
view/edit screen.
5. Stop Scan - Pressing
(Stop Scan) aborts the scan immediately. You can resume
the scan by selecting [Resume] from the view/edit screen.
6. Move to Scan - The
(Move to Scan) indicator flashes green indicating that the
system is ready for you to advance the cradle into the starting position. Simply press the
button to advance the cradle. Move to Scan will flash for 180 seconds before timing out.
7. Stop Move - Pressing
(Stop Move) stops cradle motion in/out. You can resume the
scan by selecting [Resume] from the view/edit screen.
8. Remote Tilt - Press
is achieved.
(Remote Tilt) and hold the button down until the prescribe tilt
9. Talk - Pressing
(Talk) and speaking towards the intercom above the
button allows you to communicate with the scan room.
WARNING: Be sure that the Gantry will not touch the patient during Remote Tilt
operation. Pinching or crushing may happen if the Gantry touches the patient.

3-17
Getting Started
10.Volume Control (operator to patient) - The (Volume Control Operator Voice
to Patient) dial is located just below the indicator on the front of the keyboard.
This dial controls the volume of the operators voice to the patient. An upward
adjustment of the dial increases the volume while a downward adjustment of
the dial decreases the volume. The dial does have numbers on it to let you
know what volume level you have set.
11.Volume Control (autovoice to gantry)-The (Volume Control Autovoice to

Gantry) dial is located just below the indicator on the front of the keyboard.
This dial controls the volume of the autovoice to the gantry. An upward
the dial decreases the volume. The dial does have numbers on it to let you
12.Volume Control (patient to operator) - The (Volume Control Patient to

Operator) dial is located just below the indicator on the front of the keyboard.
This dial controls the volume of the patients voice to the operator. An upward
the dial decreases the volume.The dial does have numbers on it to let you
13.Filming Keys - The F1-F4 keys can be used for manual filming with the
Manual film composer. The F3 key in conjunction with Shift, and the F12 key
can be used to place images on the Autofilm composer.
14. Preset Window Width/Window Level Keys - The F5 - F11 keys are preset WW/WL keys.
These presets are equivalent to the presets that are in the Viewer and Mini-viewer in
Image Works.
15. Page Up/Page Down - The Page Up and Page Down keys allow you to review the next
and prior images in a viewport or viewports from the Exam Rx or Image Works desktops.
16. Window Width/Window Level Control Keys - You can use these keys to manually
change the WW/WL settings for images in the Exam Rx and Image Works desktops. The
(Up/Down) keys increase/decrease the window level and the
(Left/Right) keys
decrease/increase the window width.
Mouse
The mouse is used extensively to make selections on the scan and display/image monitors.
It is a standard three button computer mouse that is set up to work with the system.

3-18
Getting Started
Figure 3-8 Mouse
left
right
middle
The three mouse buttons are referred to as the left, middle, and right mouse buttons. In this
manual, the term "click" refers to pressing and releasing the left mouse button. The term
"double click" refers to quickly clicking and releasing twice on the left mouse button. The
term "triple click" refers to quickly clicking and releasing three times on the left mouse
button.
Most of the selections required during the scan and review process require a single click on
the left mouse button. This is the primary button for selection. The middle mouse button is
used primarily for adjusting window width and window level. The right mouse button is used
infrequently for scrolling images, magnification, and for accessing hidden menus.
NOTE: For specific terminology and mouse descriptions used in this text, refer to Table 1-1
in the About This Guide chapter.
Bright Box (Option)

The Bright Box (Figure 3-9) is a separate piece of hardware that can be utilized to review
images without having to fully utilize the mouse or keyboard. Using the Bright Box allows
someone to review an image or images while someone else utilizes the mouse and
keyboard to set up or continue the scan series.
The Bright Box can be used only in the Exam Rx desktop with any "free" viewport. The term
"free" refers to a viewport that is not utilized for autoview or autofilm. It can be used in the
Autolink viewport, although, when the first image of another series is reconstructed, that
image is displayed in the viewport, taking the place of the series you are currently reviewing.
It is recommended to click the review screen, bottom left viewport, as a "free" viewport.
You can only work in one viewport at a time. Before you begin, you should put the desired
viewport in primary focus, with a double click in the viewport, so it does not affect the other
viewports.
NOTE: To get additional information about primary and secondary viewports, refer to the
Image Display Viewing Area chapter.

3-19
Getting Started
Figure 3-9 Bright Box
1. Prior Button - Pressing this button displays the prior image in the set. This button is
inactive while in the paging mode.
2. Next Button - Pressing this button displays the next image in the set. This button is
inactive while in the paging mode.
3. Trackball - The trackball has two functions. The first, while not in the paging mode,
adjusts the window width and window level of the image. Moving the trackball to the left
decreases the window width while moving it to the right increases the window width.
Moving the trackball down decreases the window level while moving it up increases the
window level. While in the paging mode, moving the trackball up pages through the
sequence from beginning to end at a rate dependent on the speed at which you move
the trackball. Moving the trackball down pages through the sequence from end to
beginning at a rate dependent on the speed at which you move the trackball.
4. Paging Button - The paging button is used to page through a sequence of images. Once
the viewport of interest is in primary focus, you can click the paging button twice to
initiate paging. You notice the letter "P" displayed in the lower right of the viewport
indicating the paging mode is active. Once you are in the paging mode, the next/prior
buttons are disabled and the trackball is used for paging through the sequence of
images. While in the paging mode, you can click once on the paging button to switch to
the window width and window level mode. This is designated by a "WL" replacing the "P"
in the lower right of the viewport. The trackball now controls the WW/WL settings.
Clicking the paging button again returns you to the paging mode. To exit the paging
mode, click twice on the paging button. The "P" in the lower right corner of the viewport
disappears indicating you are out of the paging mode.

3-20
Getting Started

The PDU supplies power to various part of the system which includes components in the
gantry, table and operator console. On the front of the PDU are controls to indicate that
power is on to the unit, a push button to turn power on/off to the gantry and table, and an
Emergency Stop button.
Figure 3-10 Front Panel of Power Distribution Unit
Function
Description
1. Power
Indicates power is On/Off to the unit
2. Gantry Enable
Enables/disables power to the gantry and table
3. Emergency Stop
When pressed, all table and gantry motions are halted,

generation of x-ray is stopped, laser alignment lights are
turned off. The system aborts any data collection
acquisition in progress and attempts to save all data
acquired prior to the abort. Use the Emergency Stop for
patient related emergency.
Users Conventions
The following users conventions are used throughout you interface. Most of them apply to
the process of scan set up.

3-21
Getting Started
When pressed, all table and gantry motions are halted, generation of x-ray is stopped, laser
alignment lights are turned off. The system aborts any data collection acquisition in
progress and attempts to save all data acquired prior to the abort. Use the Emergency Stop
for patient related emergency.
Functions that are active are highlighted in yellow.
Functions that are not available because another function is open are gray.
If one function is open and then a second is opened, the first open function is
highlighted with a folded corner, indicating the function is still open and active. The
second open function is the current active function.
Once a new patient exam has been started and you are setting up the scan parameters
from the view/edit screen, the scan parameters are listed in columns. If you click a
column heading, the parameters within that column, including all groups (indicated by

3-22
Getting Started
individual rows), are changed. To change a parameter in a specific group, click the
desired parameter below the column heading.
Parameter selections that have a raised button appearance, when selected, displays a
pop-up menu prompting you to click or type in the desired parameter.
Parameter selections that have a sunken/depressed, light background appearance,

when selected, allows you to type in the desired value.
When a parameter is highlighted orange, this indicates that a parameter has been
adjusted by the system from the original preset value. Changing one parameter may
affect other parameters. In this case, you may have more than one parameter
highlighted orange. (In this example, the scan type was changed from helical to axial.
The ISD changed, as well as something in the recon tab card. You will be able to

3-23
Getting Started
continue, however, you should review parameters to make sure they are as needed for
the clinical protocol.)
When a parameter is highlighted red, you cannot continue scanning until a correction is
made. (In this example, the techniques selected for the exam are too much for the
system to handle, so we need to change a parameter to continue.) Once the correction
is made, you can then continue.
When you input an invalid parameter, the system defaults to the closest value possible
and a brief message explaining this change displays in the scan message area. If you
wish to see the message again, click on the parameter that has been changed. (In this
example, 400mA was input but the system changed the value to 380mA.)

3-24
Getting Started
Tool Chest
The tool chest is located on the right monitor in the upper right corner of the screen on the
Image Works desktop. Many items can be selected from this area.
1
2
3
4
5
6
7
8
9
10
Table 3-2 Tool Chest
Clicking this allows you to set the autovoice volume levels

in the scan room.
1
Autovoice Volume
Check Security
This area is used by your service personnel.
Unix Shell Left
Displays a unix shell on the left screen. This area is used

by your service personnel.
Unix Shell Right
Displays a unix shell on the right screen. This area is used

by your service personnel.
Turn On Extended HU
Clicking this turns on extended Houndsfield Units. For

more information, refer to: Expanded CT Number Range.

3-25
Getting Started
Clicking this take a snapshot of all the parameters you

have prescribed and information for processes touched
by the prescription. Use this when you are having system
issues for Service Personnel to recall the system issues.
6
Quick Snap
CAUTION:
Do not use Quick Snap while you are

acquiring data.
Refer to: Use QuickSnap detailed steps on using the

feature.
Clicking on this after selecting a set of images that have
been made anonymous takes a snapshot of the images
and reserves the scan data file related to the images as
well as recon files for service to review.
7
IQ Snap
CAUTION:
Do not use IQ Snap while you are acquiring

data.
Refer to: Use IQ Snap detailed steps on using the feature.

8
Save ECG Trace
Using a blank CD-ROM placed in the CD drive of the

Operator Console, you can click this button to save the
directory of existing ECG files from specific ECG-gated
scan types directly to the CD-ROM.
Restart Show Loc
Use this feature if the scout or lines do not appear in

Show Localizer. If Restart Show Loc does not resolve the
issue, a reboot of the system will be needed.
Annon Pat. Level
Clicking this determines if the anonymized patient

information is saved with full annotation or partial
annotation. This is a toggle button.The pop-up message
indicates current state and state to transition to.
Refer to: Use Anonymous Patient (Anon Pat. Level)
detailed steps on using the feature.
10

3-26
Getting Started
HIPAA
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was signed by
President Clinton on July 21, 1996 and has the general objectives to:
Guarantee health insurance coverage of employees.
Reduce health care fraud and abuse.
Introduce/implement administrative simplifications in order to augment
effectiveness and efficiency of the health care system in the United States.
Protect the health information of individuals against access without consent or
authorization.
Administration Simplification regulations of HIPAA have been in effect since early
2001.
GE Healthcare has a longstanding reputation of providing customizable, clinical solutions to
protect the privacy and security of your organization's unique clinical workflow, as well as
your patient's confidentiality. Our scanner, software and services already incorporate many
of the core HIPAA requirements. We are committed to working with you, our customer, to
provide additional value to help you meet the continuing HIPAA challenge.
Please recognize the intended use of the product when determining how critical any privacy
risk is, relative to patient care and safety. GE is very concerned with providing the best care
to the patients; and in some cases we have determined that patient care is more important
than the risk to privacy. In these cases we take every precaution to minimize the privacy risk.
Security and Privacy are maintained across a Healthcare system. Any product that is placed
into an uncontrolled environment will not be secure and can not protect privacy. As we
design scanners we design them to be implemented in a "Secure Environment". A secure
environment is based on multiple layers of security, a concept known as defense in depth.
For example: a Best Practice that is gaining much attention places firewalls between
departments, as well as at a DMZ, between all extranets, and the external Internet access
point. In this example a radiology firewall may allow DICOM and HL7 traffic through, but no
other protocols. These DICOM and HL7 protocols would be blocked at the DMZ and again at
the Internet Firewall.
HIPAA requires you to log on to the scanner and log off when you are done scanning for a
period of time. If you do not log off the system will log you off and you will have to log back
on.
HIPAA contains the following permissions. You can have Administrator, GE Service,
Standard User, or Limited User. Standard User can perform scanning functions and modify
protocols. Administrator can set up and delete users. Limited users can perform all
scanning functions. GE Service can do all functions. You must have Administrator
permission to add or delete users.

3-27
Getting Started
When you are adding users for local databases, certain rules apply. You must use the
following parameters.
Users/Groups - Lower case letters and numbers only
Users/Groups - Can not start with a number
Users/Groups - No limit on length
Passwords - Must be at least one character long, no NULL
Passwords - Can contain uppercase letters, numbers, and special characters
Administrator and Limited User permissions have different abilities when logging on. The
Administrator permission can add users. The Standard User permission can scan and
modify protocols. The Limited User can only scan. Emergency User login has Limited User
permission.
NOTE: HIPAA is an option that can be turned on or off by your Field Engineer.
Understanding users and groups

Every person who has permission to use the system is a user. Users are set up by system
administrators. These administrators may be IT personnel in an enterprise environment, or a
site manager or lead tech in stand-alone environments. The administrator adds new users
and assigns the users to a group, which dictates the level of privileges a person will have.
For example, a person named Sue Smith could belong to a group called technologists,
radiologists, administrators, or any combination.
Understanding groups and privileges

The group to which a person belongs has privileges. If you do not have an enterprise system,
the assignment of group privileges will probably be limited to those who have administrator
privileges and those who don't. Additionally permission for protocol edit may be assigned to
groups. If your system is set up for enterprise login, your IT person or administrator will be
using more of the features.
Product Network Filters - PNF

Product Network filters provide the capability to place a personnel firewall in front of the CT
scanner. Filters may be configured to restrict which system services are allowed to be
controlled by other devices trying to access the Operator console such as ftp, telnet and
rlogin and which computers may access the system. This access is determined by
configuring which IP addresses are allowed to access the system. DICOM access to the
system can also be configured.
The system default is for no services enabled, no IP addresses authorized and DICOM port
4006 enabled.
Your Field Engineer can assist you and your IT Department in configuring PNF.

3-28
Getting Started
Software Download
Software Download provides the capability for Broadband connected systems with a
Service Contract to automatically down load software updates to the scanner. These
updates can be configured to Auto Install or Manual install.
A pop up indicating that this capability is installed on the system will be displayed for the
first 3 weeks after a software load from cold at every reboot.
Figure 3-11 Automatic Software Update Window
As updates become available a pop up will be displayed informing you of the update.
Figure 3-12 Automatic Software Update download
A progress bar indicates the progress of the install.

3-29
Getting Started
How Do I...
This section provides the step by step instructions for shutting down and starting up the
system. Specifically, it describes how to:
Login and Logout
Enterprise Tab
Use QuickSnap
Use IQ Snap

3-30
Getting Started

To keep your system operating at optimal performance, you need to shut down and start up
the system every 24 hours.
1. From the desktop selection area, click [Shutdown].
A pop-up attention box appears.
2. From the pop-up attention box, select the option you wish to do if HIPAA is enabled.
Logout User allows enables you to login as a different user.
NOTE: For information on how to Login and Logout, refer to: Login and Logout.
Restart brings the system software all the way down and then automatically reboots
the system.
Shutdown brings the system all the way down to the power off prompt. You can then
turn power off to the system.
3. Click [OK].
4. If you selected Shutdown or Restart a series of menus and messages appear.
If Restart was selected the system automatically restarts the system.

3-31
Getting Started
NOTE: The BrightSpeed system has software that verifies the tube ID at startup. If the tube
ID fails, the following screen appears. You may continue scanning however, you do
need to call your Field Engineer..
If Shutdown was selected, turn off the OC power, if not already off with the power
switch on the front of the console and then turn the power switch on to restart the
system.
Wait two minutes before cycling power on after a power interruption.
5. To power up the system push the power switch on the front of the operator console and
the system will automatically restart.
Quick Steps: Shut Down and Start Up System

1.
2.
3.
4.
5.
From the desktop selection area, click [Shutdown].

From the pop-up attention box, select the option you wish to do if HIPAA is enabled.
Click [OK].
If you selected Shutdown or Restart a series of menus and messages appear.
To power up the system push the power switch on the front of the operator console
and the system will automatically restart.

3-32
Getting Started
Login and Logout

The login feature requires you to login to access the system and can be turned on or off by
your administrator or Field Engineer.
How your site uses this feature depends on if your site has a central user repository to which
the system is connected. Sites with networks are referred to as Enterprise systems, those
without are referred to as stand-alone systems. This feature can be used with either
configuration, although some features are more applicable to enterprise systems.
1. At the login screen, type your assigned login name.
This name is assigned by your system administrator.
NOTE: If you need to log in quickly for emergency purposes only, click [Emergency Login].
NOTE: Logging off does not prohibit other users from logging in. Logout is designed to
protect patient privacy, not stop approved users from logging in. When you or another
user logs back in, the system returns to its last known state.
2. Click in the Password area and type in your password.
3. Click [Login]

3-33
Getting Started
Figure 3-13 Login Window
If you have administrator privileges, when you log in you are asked if you want to
perform administrative tasks or scan.
Do not click the button next to the Enter admin screen if you are ready to scan. Click
[Login] to login to the scanning area.
4. To logout of the system, click [Shutdown].
The Shutdown window appears.
5. Click [Logout User].
6. Click [OK].
The system logs you out and waits for the next login.

3-34
Getting Started
Quick Steps: Login and Logout

1. At the login screen, type your assigned login name.
2. Logging off does not prohibit other users from logging in. Logout is designed to protect
patient privacy, not stop approved users from logging in. When you or another user
logs back in, the system returns to its last known state.
3. Click in the Password area and type in your password.
4. Click [Login]
5. To logout of the system, click [Shutdown].
6. Click [Logout User].
7. Click [OK].

3-35
Getting Started

To add users to the system for use, you must be a user whom has administrative
permissions assigned to your user group in order to complete this procedure. For a brand
new system the root user will be used initially by your field engineer to add users. Normal
users do not have permission for this area. System administrators can perform a number of
tasks that affect what users can do or will see. From this screen, administrators can set up:
How many minutes the system can be inactive before it locks the screen.
If the Emergency button and username prompt will be displayed on the start up
screen. If the emergency prompt is not displayed, users cannot log on unless they
have a valid account.
Coordination with the system network.
1. At the Login window (Figure 3-13), enter your login ID.
For information on how to login to the system, refer to: Login and Logout.
2. Enter your Password.

3-36
Getting Started
3. Click the box next to Enter admin screen.
4. Click [Login].
5. Click the [Configurations] tab.
This brings up the Configuration Screen.

3-37
Getting Started
Figure 3-14 Configuration Tab
6. Select the choices you wish to have selected.

Inactivity Timeout Prompt. - Enter a the number of minutes before automatic
logout will occur next to the Inactivity Timeout Prompt. For example if you enter 10
minutes, the system will display the splash screen after 10 minutes of inactivity (no
keyboard entry or mouse movements), requiring you to log in. When logging back in,
the system is returned to its last know state.
You can enter 0 and the system will never logout automatically.
Display Emergency Button - Click the box next to the Display Emergency Button.
The Emergency Login prompt will be displayed on the splash screen. If this prompt is
not displayed, only those users with a valid account can log onto the system.
Display Emergency Prompt - Click the box next to the Display Emergency Prompt
to require emergency users to enter their name. If you do not turn on Display
Emergency Prompt, this prompt is never displayed.
Cache Enterprise Users - allows all users previously set up on the system the ability
to log in even if the site network is down.
Enable Authorization and Enable Enterprise Authentication are used to verify who
you are and what privileges you have based on the network settings at your site.
7. Click [Apply Configurations].
8. Click [Apply Now].

3-38
Getting Started
Quick Steps: Configure Users for the System

1.
2.
3.
4.
5.
6.
7.
8.
At the Login window (Figure 3-13), enter your login ID.

Enter your Password.
Click the box next to Enter admin screen.
Click [Login].
Click the [Configurations] tab.
Select the choices you wish to have selected.
Click [Apply Configurations].
Click [Apply Now].

3-39
Getting Started
Enterprise Tab
The Enterprise Tab is used by the sites IT (Information Technology) or GE Service personnel.
It provides connectivity to the sites user database. If you do not have a network established
in your hospital or clinic, this tab will not be used.
Things to consider:
Utilize the enterprise capability whenever possible.
Make sure the enterprise groups are granular enough to restrict protocol edit access.
The inactivity timeout should be turned on.
1. At the Login window, enter your login ID.

3-40
Getting Started
4. Click [Login].
This brings up the Configuration Screen.
6. Select Enable Enterprise Authentication.

3-41
Getting Started
Figure 3-15 Configuration Tab
7. Click the [Enterprise] tab.

This displays the Enterprise screen.

3-42
Getting Started
8. Enter the parameters needed.
Your Network Administrator can help with these parameters.
9. Click [Apply Configuration].
10. Click [Exit].
Quick Steps: Enterprise Tab

4. Click [Login].
6. Select Enable Enterprise Authentication.
7. Click the [Enterprise] tab.
8. Enter the parameters needed.
9. Click [Apply Configuration].
10. Click [Exit].

3-43
Getting Started

To add users to the system for use, you must be a user whom has administrative
permissions assigned to your user group in order to complete this procedure. For a brand
new system the root user will be used initially. Normal users do not have permission for this
area.
System administrators can perform a number of tasks that affect what users can do or will
see. From this screen, administrators can set up:
From the Local User Management Tab, you can:
Add a user
Assign users to groups
Assign permissions to groups
Show protected users
Change passwords
Remove users
Figure 3-16 Login screen


3-44
Getting Started
Figure 3-17 Enter Administrator screen
4. Click [Login].
5. Click the [Local User Management] tab.
Figure 3-18 Local User Management Screen.

3-45
Getting Started
Table 3-3 Local User Management
a) Click [Add User].
A second screen is displayed from which you continue adding
information (Figure 3-19).
b) Enter a user name.
Enter a user name.
Add first and last name in lower case.
The first and last name will be shown in the audit log.
c) Enter a password and retype to confirm.
Adding Users
d) Click [Submit].
When you are adding users for local databases, certain rules apply. You
must use the following parameters.
Users/Groups - Lower case letters and numbers only
Users/Groups - Can not start with a number
Users/Groups - No limit on length
Passwords - Must be at least one character long, no NULL
Passwords - Can contain uppercase letters, numbers, and special
characters
All groups set up on your system are displayed on this tab. Here you
assign each user to a group. That user will then have all the privileges
assigned to the group.
Assign Users to
Groups
a) Find the users name along the left side of the tab (Figure 3-18).
b) Click the check box under the group heading.
c) Click [Apply User Settings].
d) At the Apply user settings? prompt, click [Apply now].
a) Click on a username and click [Change Password].
Changing
Passwords
Removing a User
b) In the New password field, enter a new password, and retype in

the Confirm password text field.
c) Click [Submit].
a) Click on a username and click [Remove User].
b) At the Remove User xxxx, prompt, click [Remove now].

3-46
Getting Started
Figure 3-19 Add User Screen
6. Enter the changes you wish to make.

7. Click [Submit].
8. Click [Exit].
This returns you to the login splash screen.
Quick Steps: Local User Management Tab

4. Click [Login].
5. Click the [Local User Management] tab.
7. Click [Submit].
8. Click [Exit].

3-47
Getting Started

Groups, not individuals are assigned privileges. Individuals get their privileges from groups.
From this tab you can:
Give groups permissions
Add a group
Remove a group
Show protected groups
Figure 3-20 Login screen


3-48
Getting Started
Figure 3-21 Enter Administrator screen
4. Click [Login].
5. Click on the [Group and Permission Mapping] tab.
Figure 3-22 Groups and Permission Mapping tab

3-49
Getting Started
Table 3-4 Group and Permission Mapping table
Group and Permission Mapping Tab
Show Protected
Groups
There is a class of users identified as Protected Users.

a) To view this group, click the checkbox next to Show protected
users.
All groups and permission levels set up on your system are displayed
on this tab. Here you assign permissions to a group. That user will then
have all the privileges assigned to the group.
a) Find the group name along the left side of the tab.
b) Click the check box under the permission heading.
Assigning
Permissions to
Groups
c) Click [Apply Group Settings].

d) At the Apply group settings prompt, click [Apply now].
NOTE: In a non-enterprise system (one without a site network), only the
users with Administrator or Standard User permission have
unique privileges. On an enterprise system, other permission
levels can be added. The privileges extended to standard and
limited users are identical in the CT environment. The GE Service
permission is for use by GE service personnel.
a) Click [Add Group].
b) Enter a group name at the Group name to add prompt.
Add a Group
No spaces can be used.

All group names must be lower case letters.
Removing a
Group
c) Click [Submit].
a) Click on a group name.
b) Click [Remove Group].
c) Click [Remove Now] at the Remove Group xxx prompt.

7. Click [Apply Group Settings].
8. Click [Apply now].
9. Click [Exit].
This returns you to the login splash screen.

3-50
Getting Started
Quick Steps: Group and Permission Mapping

4. Click [Login].
5. Click on the [Group and Permission Mapping] tab.
7. Click [Apply Group Settings].
8. Click [Apply now].
9. Click [Exit].

3-51
Getting Started
Use QuickSnap
QuickSnap provides the ability to collect data for trouble shooting system issues. QuickSnap
is found in the Tool Bar on Image Works desktop.
1. Click [QuickSnap].
This is located on the Image Works Desktop Toolbar.
Figure 3-23 Toolbar
Selecting QuickSnap displays a pop-up menu on the right monitor.

Figure 3-24
2. Click [OK].
The pop-up menu goes away when the snap is complete.
3. Make note of the time and date of the QuickSnap for later use in debugging by the
service engineer.

3-52
Getting Started
CAUTION:
Do not initiate a QuickSnap if the system is actively collecting data with x-ray
on.
Quick Steps: Use QuickSnap

1. Click [QuickSnap].
2. Click [OK].
3. Make note of the time and date of the QuickSnap for later use in debugging by the
service engineer.

3-53
Getting Started
Use IQ Snap
IQ Snap provides the ability to reserve the scan data files related to images with IQ issues for
further investigation.
CAUTION:
Do not initiate an IQ Snap while the system is actively scanning or

reconstructing data.
The maximum number of images that can be selected for IQ Snap is 500 images. All the
images need to be in the same series. If there are IQ issues in more than one series, each
series needs to be done separately.
The corresponding scan data files will be reserved for images in the anonymous exam. You
can verify the scan data is reserved by selecting Recon Mgnt; then selecting Release Scan
Data. For Helical, the scan data reserved is for the group or scan the group the images are
related to. For Axial mode, the scan data reserved will be the axial rotation the images are
related to. For Axial mode, you may want to select a group of images on either side of the
image where an IQ issue is seen to make sure enough scan data will be available later.
1. Select the images that you want to reserve the scan data files in the Browser on Image
Works desktop.
2. Make an anonymous series or a set of anonymous images for the series with IQ issues.
If the images selected are not anonymous, a pop-up will appear instructing you to
make the data anonymous.
Figure 3-25
3. Select the anonymous Exam in the Browser.

Selecting by exam or series will only save the first image in the list. In the Anonymous
Exam highlight all the images so they will be available for investigation of the issue.
4. Click [IQ Snap] on the Tool Bar in Image Works.

3-54
Getting Started
Figure 3-26 Toolbar
The IQ Snap pop-up is displayed on left monitor.

Figure 3-27 IQ Snap Pop-Up Window
5. Click [OK].

3-55
Getting Started
Quick Steps: Use IQ Snap

1. Select the images that you want to reserve the scan data files in the Browser on
Image Works desktop.
2. Make an anonymous series or a set of anonymous images for the series with IQ
issues.
3. Select the anonymous Exam in the Browser.
4. Click [IQ Snap] on the Tool Bar in Image Works.
5. Click [OK].

3-56
Getting Started

Selecting Anon Pat. Level provides the ability to change the annotation level to Full or
Partial modes for Anonymous Patient by Exam, Series, or Image in Utilities on the Browser in
the Image Works desktop.
Table 3-5 Full or Partial Modes
Field
Full Mode
Partial Mode
Exam Number
ANON or ANONYMIZED
ANON or ANONYMIZED
Patient ID
ANON or ANONYMIZED
ANON or ANONYMIZED
Patient Name,
ANON or ANONYMIZED
ANON or ANONYMIZED
Exam Description
ANON or ANONYMIZED
Shown
Series Description
ANON or ANONYMIZED
Shown
Birthdate
Removed
Removed
Age
Removed
Removed
Weight
Removed
Removed
Operator Name
Removed
Removed
Site Name
Removed
Shown
Sex
Blank
Blank
Referring Physician
Blank
Blank
Accession Number
Blank
Blank
Full mode is the most HIPAA compliant mode.

Screen Save images such as Exam or Series Text pages or Dose Report text page are not
anonymized.
1. Click [Anon. Pat. Level].
Selecting Anon Pat. Level in the Tool Bar on Image Works will display one of two
messages depending on the current mode the software is set to.

3-57
Getting Started
Figure 3-28 Full mode
2. Click [OK] to change from Full Level to Partial Level.

Click [Cancel] to remain at Full Anonymous Level.
3. Click [OK] to change from Partial Level to Full Level.
Click [Cancel] to remain at Partial Anonymous Level.
Figure 3-29 Partial mode

3-58
Getting Started
Figure 3-30 Image examples
Quick Steps: Use Anonymous Patient (Anon Pat. Level)

1. Click [Anon. Pat. Level].
2. Click [OK] to change from Full Level to Partial Level.
3. Click [OK] to change from Partial Level to Full Level.

3-59
Getting Started

3-60
Daily Maintenance
Chapter 4
Daily Maintenance
Introduction
This chapter explains preparing the system for daily use and calibrations. It contains the
step-by-step instructions to help you learn how to:
Perform Tube Warm-Up
Perform Air Calibrations (Fast Cals)
NOTE: When performing the tube warm-up or calibrations, it is essential that the gantry area
be clear of any objects. Any obstruction in the gantry most likely lead to artifacts in
scanned images.
CAUTION:
No personnel or patients should be in the area of the gantry during warm-up

or calibrations without adequate radiation safety precautions being utilized.
For important information regarding safety, please refer to the Safety chapter.

4-1
Daily Maintenance

This section presents the concepts necessary to successfully prepare the scanner for daily
use. Some of the concepts you need to understand are:
Performing Tube Warm-Up
Performing Daily Calibrations
Performing Full System Calibrations
Performing Tube Warm-Up

The system operates most efficiently within certain parameters. These parameters are
established by warming up the tube using a preset group of exposures. When the operator
performs a tube warm up at least once per 24 hour period and at any system prompt, the
tube warm-up reduces the possibility of artifacts and may aid in prolonging the life of the
tube.
NOTE: GE recommends that you warm up the tube after two hours of non-use. Only the tube
warm-up scans need to be done at this time.
NOTE: If the detectors are cold due to the A1 power being off, turn the system on and wait
two hours before performing a tube warm up. This allows the detectors to return to
their operating temperature.
NOTE: Failure to perform tube warm-ups when requested by the system may result in
serious damage to the tube and system.
Performing Daily Calibrations

The system requires that all kV and mA settings be within specific ranges. These ranges are
established and maintained by performing air calibrations. The air calibrations are done by
the user as part of the daily system preparation following a tube warm-up procedure.
Performing Full System Calibrations

Full system calibrations are normally performed by a qualified engineer following a tube
change or as part of preventative maintenance.

4-2
Daily Maintenance
How Do I...
This section provides the step-by-step instructions for warming-up the tube and performing
air calibrations. Specifically, it describes how to:

4-3
Daily Maintenance

For optimum performance and consistent image quality, perform a tube warm up if your
system has been inactive for two or more hours. The system notifies you at the two hour
time limit with a warning dialog box. It is desirable to perform a tube warm-up procedure
along with fast calibrations once per 24 hours.
1. From the scan monitor, click [Daily Prep].
The screen changes and the system displays blue colored button features for Tube
Warm-Up and Fast Cals (air calibrations) in the upper left corner of the screen.
2. Click [Tube Warm-Up].
The system displays a warning dialog box. This is because the tube cooling
algorithms are established for GE specific tubes. If any other tube is installed, the
user is responsible.
NOTE: Refer to the Safety chapter regarding using non-GE-specific tubes.
3. Click [Accept & Run Tube Warm-up] to proceed.
The system displays a message area detailing each slice concerning kV, mA, slice
thickness and exposure duration.
NOTE: Make sure gantry area is clear of all objects and personnel.
4. Press Start Scan on the top of the keyboard.
The system automatically performs all tube warm-up scans. For BrightSpeed Excel,
BrightSpeed Edge and BrightSpeed Elite systems, this procedure takes approximately
53 to 60 seconds. For BrightSpeed Excel Select, BrightSpeed Edge Select and
BrightSpeed Elite Select systems, this procedure takes approximately 90 seconds..
The system returns to the Daily Prep menu when scans are completed.
5. Click [Quit] or proceed to Fast Calibrations.
Choosing quit ends the Daily Prep screen.

4-4
Daily Maintenance
Quick Steps: Perform Tube Warm-Up

1.
2.
3.
4.
5.
From the scan monitor, click [Daily Prep].

Click [Tube Warm-Up].
Click [Accept & Run Tube Warm-up] to proceed.
Press Start Scan on the top of the keyboard.
Click [Quit] or proceed to Fast Calibrations.

4-5
Daily Maintenance

Air calibrations, also called Fast Cals, must be performed following a tube warm-up
procedure. These calibrations ensure consistent image quality and radiation exposure.
1. After completing the tube warm-up, click [Fast Calibration].
Once Fast calibration is selected, the system performs a Check DAS converter
board/Check collimator cal. This assures that the correct DAS converter board is
installed.
For BrightSpeed Systems, a gantry balance check is automatically run upon selecting
Fast Cal. The balance check takes about 2 minutes. A pink pop-up is displayed
indicating the balance check is in-progress.
The Cold Warm-up Scan list screen appears.
NOTE: No objects can be allowed in gantry during Fast Cals. No phantoms are used during
this procedure.
2. Press Start Scan.
This procedure can take up to 30 -60 minutes to complete.
First, the dirty Mylar Window check is done. The mylar window must be kept clean.
Dirt could corrupt the calibration files.
If a dirty window is detected, a warning message appears and you must clean the
window and click [Clean and Retry].
Click [Continue] if mylar windows are clean and do not need attention.

4-6
Daily Maintenance
Following the dirt Mylar Window check, the system then performs cold warm-up,
warm-up 1 and warm-up 2 scans. (According to the tube temperature at that time,
some of the warm-up scans may not run.)
Every 6 months, after Warm-up II, Auto Z-Slope is done to check the health of the
detector. If this test fails, a warning message appears telling you to call your service
engineer.
Next, Collimator Cal scans are done that rotate through several stations. This is only
run if the last Collimator Cal is more than 24 hours old.
Then a Mini Scan is taken that checks the focal spot position. This ensures the proper
operation of the Z-Axis beam tracking.
The system finishes the Fast Cal procedure by performing the actual Fast Cal scans
from the Fast Cal screen. This includes Clever Gains scans which calibrate the gain of
each detector configuration. The default is to perform the Fast Cal scans for 120 and
140 kVp.
3. Click [Quit].
The system closes the Daily Preparation screen.
Quick Steps: Perform Air Calibrations (Fast Cals)

1. After completing the tube warm-up, click [Fast Calibration].
3. Click [Quit].

4-7
Daily Maintenance

4-8
Multi-Detector Information
Chapter 5
Introduction
The BrightSpeed series has three different detector configurations. It is important for you to
know which detector configuration your system has. Your system should have the name
displayed on the gantry. Select your system from the list of links.
BrightSpeed Excel and BrightSpeed Excel Select
BrightSpeed Edge and BrightSpeed Edge Select
BrightSpeed Elite and BrightSpeed Elite Select ,
BrightSpeed Excel and BrightSpeed

Excel Select
This section explains the multiple detector hardware and detector configurations. The
step-by-step instructions to help you learn how to set these factors is located in Building
Protocols. It is important to understand how the detectors work in order to choose the
correct technical factors for the exam.

5-1

This section presents the concepts necessary to understand multi-detector utilization. The
concepts you need to understand are:
Hardware Components
Detector Configurations
Axial Configurations
Axial User Interface
Axial Signal Collection
Axial Interval
Tilt Correction
Helical Pitch and Scan Mode Definitions
Helical Configurations 2 and 4 Row Mode Interleaved
Helical Configurations 4 Row Mode Interspaced
Helical User Interface
Guidelines For mAs
Slice Profiles
Hardware Components
Changes have been made to several pieces of hardware that make this scanner different
from other scanners you may have used in the past. These changes are:
Collimator
The collimator consists of three independently controlled tungsten cams. The rotation
of the cams provides continuous variable slice thickness and Z-axis position.
Scan Geometry
A shorter scan geometry allows for a 20 % mAs reduction from HSA CT/I single slice
axial scan techniques. The gantry aperture is 70 cm. The Focal Spot to Isocenter
distance is 54 cm. The Focal Spot to Detector distance is 95 cm.
Matrix Detector
There are 16 detector cells in the Z direction. The 16 rows are 1.25mm in Z direction.
Up to four signals are gathered per gantry rotation. Each signal can be collected from
an individual detector row or a combination of two, three or four detectors. Four
signals can be taken from 16 cells (or four slices per rotation of the gantry).
Other Changes
Changes in the DAS, Slip Ring and Scan/Recon Unit have been made. There are also
new reconstruction algorithms for the multi-slice data.

5-2
The Detector Configurations are 4 X 1.25 mm, 4 x 2.5 mm, 4 X 3.75 mm, 4X 5.0 mm, 1 X 1.25
mm, and 2 X 0.625 mm.
4 X 1.25 mm- Four signals (axial) or interleaving or interspaced helices (helical) can be
collected from four 1.25 mm detector rows.
collected from eight 1.25 mm detector rows with two detector rows contributing to each
signal (axial) or interleaving/interspaced helix (helical).

5-3
4 x 3.75 mm- Four signals (axial) or interleaving or interspaced helices (helical) can be
collected from 12- 1.25 mm detector rows with three detector rows contributing to each
collected from 16- 1.25 mm detector rows with four detector rows contributing to each
1 X 1.25 mm - One axial signal can be collected from one - 1.25 mm detector row with
one detector row contributing to the signal.

5-4
2 X 0.625 mm - Two signals (axial) or interleaving helices (helical) can be collected from
two 1.25 mm detector rows with two detector rows contributing half of each signal
(axial) or interleaving helix (helical).
The Axial Configurations are 4 X 1.25 mm, 4 X 2.5 mm, 4 X 3.75 mm, 4 X 5.0 mm, 1 X 1.25
mm, and 2 X 0.625 mm.
4 x 1.25 mm -1.25 mm is the minimum slice thickness. 5 mm of anatomy are covered per
rotation of the gantry.
Four slices at 1.25 mm slice thickness each.

4i mode
Two slices at 2.5 mm slice thickness each.

2i mode
One slice at 5.0 mm slice thickness.

1i mode

5-5

One slice at 10 mm slice thickness.
4 X 3.75 mm -3.75 mm is the minimum slice thickness. 15 mm of anatomy are covered

per rotation of the gantry.
4 X 5.0 mm - 5.0 mm is the minimum slice thickness. 20 mm of anatomy are covered per
1 X 1.25 mm - 1.25 mm is the minimum slice thickness. 1.25 mm of anatomy are covered
2 X 0.625 mm - 0.625 mm is the minimum slice thickness. 1.25 mm of anatomy are

covered per rotation of the gantry.

5-6

The User Interface demonstrates slice thickness choices, number of images per rotation,
and retrospective options. The parameters selected to set the slice thickness and speed
determine the detector configuration.
Axial thickness choices range from 0.625 mm thick to 10.0 mm thick.
Number of images per rotation are 1i, 2i, and 4i.
Retro recon choices are the result of slice thickness and number of images, i.e. selecting
one image at 5 mm thickness allows retro choices of 1.25mm thick, 2.5 mm thick, and
5.0 mm thick. Prospectively, the choices are 10.0 mm at 1i or 5.0 mm at 2i or 4i.
Button colors change to indicate options.

Light yellow- current selections.
Blue with black text- Available parameters.
Light gray with black text- Available parameters (choosing changes other
parameters)
Light gray with gray text- Not available.

Four signals/channels are collected per gantry rotation. Each of the four signals can be
collected from an individual detector or a combination of two, three, or four detectors. Once
a signal from multiple detectors has been combined into a channel, it cannot be separated.
The number of detectors combined per signal/channel affects the minimum slice
thickness.
One, two, or four slices can be generated per slice rotation.
The slice thickness can be changed retrospectively.
The detector configuration at the time of acquisition affects the retrospective choices.
Multislice axial scanning is faster than single slice helical scanners using a 1:1 pitch.

5-7
Axial Interval
The interval is equal to the number of images per rotation x slice thickness, i.e., in the 4 x 2.5
mode- four images are generated, each 2.5 mm thick for a total of 10 mm of coverage per
rotation. The interval per rotation would be 10 mm.
If an interval skip were needed, the above formula would be used plus the gap desired.
Tilt Correction
Tilt correction for the multiple detectors is done automatically when axial or Helical
scanning. In axial scanning the interval changes to keep the inter slice distance equal when
the gantry is tilted. In Helical scanning, table speed increases as part of the tilt correction.
This is to keep the row data lined up for reconstruction. The image annotation reflects the
table speed.This allows the slice thickness to remain the same when measured
perpendicular to the slice edges.

5-8
.

Scan modes for helical are expressed in terms of pitch. Helical pitch is defined as the ratio of
table travel per rotation in millimeters divided by the beam collimation. PreviousBrightSpeed
systems expressed scan modes with names and defined pitch as table travel per rotation in
millimeters divided by the detector row width. In you can compare the old scan mode
names to the new names.
Table 5-1 Scan modes
Old Scan Mode
Name
New Scan Mode Name
HQ 1
1:1
2 Row
HQ 3
0.75:1
4 Row
HS 6
1.5:1
4 Row

The helical configurations are: 2 x 0.625, 4 x 1.25 mm, 4 x 2.5 mm, 4 x 3.75 mm, and 4 x 5.0
mm. In these modes, configurations are acquired at a pitch of either one or three. Table
travel is 1X the detector configuration or a pitch of 1:1 and 3X the detector configuration or

5-9
a pitch of 3:1, (i.e., 3.75 mm speed divided by three equals 1.25 or a 4 X 1.25 mm detector
configuration). This mode allows you to have interleaved helices, that is 1.5 to 3.0 times
faster than single slice helical scans, minimizes helical artifact, and gives the best detail.
2 Row Mode 2 x 0.625 mm.

2 x 0.625 detector configuration.
1.25 mm of table travel per rotation.
1.25 mm beam collimation.
Pitch 1:1.
Fixed 0.625 mm prospective/retrospective slice thickness.
4 Row Mode 4 x 1.25 mm. All images use data from all four helices.
4 x 1.25 mm detector configuration.

5 mm beam collimation.
Pitch 0.75:1.
1.25 and 2.5 prospective/retrospective slice thickness.
4 X 2.5 mm detector configuration.

Pitch 0.75:1.
2.5 mm, 3.75 mm, and 5.0 mm prospective/retrospective slice thickness.
4 Row Mode 4 X 3.75mm. All images use data from all four helices.

Pitch 0.75:1.

5-10
4 Row Mode 4 X 5.0 mm. All images use data from all four helices.

15 mm of table travel per rotation.
Pitch 0.75:1.
5.0 mm, 7.5 mm, and 10.0mm prospective/retrospective slice thickness.

The helical configurations are: 4 x 1.25 mm, 4 x 2.5 mm, 4 x 3.75 mm, and 4 x 5.0 mm. All
configurations are acquired when in 4 row mode at a pitch of six. Table travel is 6x the
detector configuration or a pitch of 6:1, (i.e., 7.5 mm table speed divided by six equals 1.25 or
a 4 X 1.25 mm detector configuration). This mode utilizes interspaced helices and is 2x to 6x
faster than single slice helical scans. Interspaced helices mean more interpolation of data
and increased helical artifact when compared to interleaved mode.
4 X 1.25mm detector configuration.

Pitch 1.5:1.
1.25 mm and 2.5 mm prospective/retrospective slice thickness.

Pitch 1.5:1.

5-11

Pitch 1.5:1.

20 mm beam Collimation.
Pitch 1.5:1

Parameter selections within the thickness/speed areas on the view edit screen determine
the detector configuration. There are three main parameter selections for helical.
Speed- Number of millimeters of table travel per gantry rotation. Speed choices range
from 1.25 mm to 30.0 mm.
Scan Mode- Determines the speed of the table travel per gantry rotation. Scan mode
choices are 2 or 4 row.
Image Thickness- Determines the prospective and retrospective image slice thickness.
Slice thickness choices range from 0.625 mm to 10.0 mm.

5-12
Button Colors- Change to indicate choices.

Yellow- Current selections.
Teal with black text (thickness)- Prospective and retrospective slice thickness choices.
Blue with black text (Scan Mode/Speed)- Available parameters.
parameters).
Guidelines For mAs

Refer to known techniques or technique charts for proper techniques, as adequate
technical factors must be used to ensure image quality. The system is delivered containing
protocols that helps learn adequate technical factors. The system automatically update mA
based on changes made to rotation time, scan type, helical pitch, and slice thickness to
maintain equal image noise.
BrightSpeed Helical.
Interspaced to Interleaved = 30% decrease.

5-13
Slice Profiles
Because the data for a helical image is weighted over more than one rotation, to provide the
best possible image quality the nominal image slice may differ slightly from the user
selection, dependent on table speed, pitch and slice selection. The nominal FWHM slice
widths are given in the following tables.
Table 5-2 Slice Profile Table for Recon Full Mode
Selected Slice
Scan Mode
Table
Speed
(mm/rot)
Axial
N/A
0.85
Helical 1:1
1.25
0.95
3.75
Helical
0.75:1
0.625
mm
1.25 mm
2.5 mm
3.75 mm
5.0mm
7.5 mm
10.0 mm
1.09
2.34
3.59
4.84
7.34
9.84
1.30
2.50
3.75
5.0
3.90
5.0
7.50
5.20
7.50
7.5
2.60
11.25
15.0
7.5
Helical
1.5:1
1.60
15.0
10.0
2.50
3.20
3.75
5.0
22.5
6.40
7.50
30.0
6.40
7.50
10.0
The indicator FWHM stands for Full Width Half Max. It is used to describe the slice thickness
represented by the image on the screen or film.

5-14
BrightSpeed Edge and BrightSpeed

Edge Select

5-15

Hardware Components
Axial Interval
Tilt Correction
Helical Configurations 8 Row Mode
Guidelines For mAs
Slice Profiles
Hardware Components
Collimator
The collimator consists of two independently controlled tungsten cams. The rotation
Scan Geometry
Matrix Detector
There are 16 detector cells in the Z direction. The 16 rows are 1.25mm in Z direction.
Up to eight signals are gathered per gantry rotation. Each signal can be collected
from an individual detector row or a combination of two, three or four detectors.
Eight signals can be taken from 16 cells (or eight slices per rotation of the gantry).
Other Changes

5-16
The Detector Configurations are 4 X 1.25 mm, 4 x 2.5 mm, 4 X 3.75 mm, 4X 5.0 mm, 1 X 1.25
mm, 2 X 0.625 mm, 8 X 1.25 mm, and 8 X 2.5 mm.
collected from four 1.25 mm detector rows.
collected from eight 1.25 mm detector rows with two detector rows contributing to each

5-17
4 x 3.75 mm- Four signals (axial) or interleaving or interspaced helices (helical) can be
collected from 12- 1.25 mm detector rows with three detector rows contributing to each
collected from 16- 1.25 mm detector rows with four detector rows contributing to each
1 X 1.25 mm - One axial signal can be collected from one - 1.25 mm detector row with
one detector row contributing to the signal.

5-18
2 X 0.625 mm - Two signals (axial) or interleaving helices (helical) can be collected from
two 1.25 mm detector rows with two detector rows contributing half of each signal
(axial) or interleaving helix (helical).
8 X 1.25 mm - Eight helices collected from eight 1.25 mm detectors with one detector
contributing to each helix.

5-19
8 X 2.5 mm - Eight helices collected from 16 1.25 mm detectors with two detectors
contributing to each helix.
The Axial Configurations are 4 X 1.25 mm, 4 X 2.5 mm, 4 X 3.75 mm, 4 X 5.0 mm, 1 X 1.25
mm, 2 X 0.625 mm, 8 X 1.25 mm, and 8 X 2.5 mm.

4i mode

2i mode
One slice at 5.0 mm slice thickness.

1i mode

5-20

One slice at 10 mm slice thickness.
4 X 3.75 mm -3.75 mm is the minimum slice thickness. 15 mm of anatomy are covered

4 X 5.0 mm - 5.0 mm is the minimum slice thickness. 20 mm of anatomy are covered per
1 X 1.25 mm - 1.25 mm is the minimum slice thickness. 1.25 mm of anatomy are covered
2 X 0.625 mm - 0.625 mm is the minimum slice thickness. 1.25 mm of anatomy are

covered per rotation of the gantry.

5-21
8 x 1.25 mm - 1.25 is the minimum slice thickness. 10 mm of anatomy are covered per
Eight slices at 1.25 mm slice thickness each.

8i Mode
3 4
5
1 2
8 x 2.5 - 2.5 mm is the minimum slice thickness. 20 mm of anatomy are covered per
Eight slices at 2.5 mm slice thickness each.

8i Mode
3 4
1 2

Number of images per rotation are 1i, 2i, 4i, and 8i.

parameters)

Four or eight signals/channels are collected per gantry rotation. Each of the four or eight
signals can be collected from an individual detector or a combination of two, three, four, or
eight detectors. Once a signal from multiple detectors has been combined into a channel, it
cannot be separated.

5-22
thickness.
One, two, four, or eight slices can be generated per slice rotation.
Axial Interval
The interval is equal to the number of images per rotation x slice thickness, i.e., in the 4 x 2.5
mode- four images are generated, each 2.5 mm thick for a total of 10 mm of coverage per
rotation. The interval per rotation would be 10 mm.
If an interval skip were needed, the above formula would be used plus the gap desired.
Tilt Correction
Tilt correction for the multiple detectors is done automatically when axial or Helical
scanning. In axial scanning the interval changes to keep the inter slice distance equal when
the gantry is tilted. In Helical scanning, table speed increases as part of the tilt correction.
This is to keep the row data lined up for reconstruction. The image annotation reflects the
table speed.This allows the slice thickness to remain the same when measured
perpendicular to the slice edges.

5-23
.

table travel per rotation in millimeters divided by the beam collimation. Previous
BrightSpeed systems expressed scan modes with names and defined pitch as table travel
per rotation in millimeters divided by the detector row width. In you can compare the old
scan mode names to the new names.
Table 5-3 Scan modes
Old Scan Mode
Name
New Scan Mode Name
HQ 1
1:1
2 Row
HQ 3
0.75:1
4 Row
HS 6
1.5:1
4 Row
UQ 5
0.625:1
8 Row
UM 7
0.875:1
8 Row
UF 10.8
1.35:1
8 Row
US 13.4
1.675:1
8 Row

5-24

The helical configurations are: 2 x 0.625, 4 x 1.25 mm, 4 x 2.5 mm, 4 x 3.75 mm, and 4 x 5.0
mm. In these modes, configurations are acquired at a pitch of either one or three. Table
travel is 1X the detector configuration or a pitch of 1:1 and 3X the detector configuration or
a pitch of 3:1, (i.e., 3.75 mm speed divided by three equals 1.25 or a 4 X 1.25 mm detector
configuration). This mode allows you to have interleaved helices, that is 1.5 to 3.0 times
faster than single slice helical scans, minimizes helical artifact, and gives the best detail.
2 Row Mode 2 x 0.625 mm.

2 x 0.625 detector configuration.
1.25 mm beam collimation.
Pitch 1:1.
Fixed 0.625 mm prospective/retrospective slice thickness.

Pitch 0.75:1.
1.25 and 2.5 prospective/retrospective slice thickness.

Pitch 0.75:1.

5-25
4 Row Mode 4 X 3.75mm. All images use data from all four helices.

Pitch 0.75:1.

Pitch 0.75:1.
5.0 mm, 7.5 mm, and 10.0mm prospective/retrospective slice thickness.

The helical configurations are: 4 x 1.25 mm, 4 x 2.5 mm, 4 x 3.75 mm, and 4 x 5.0 mm. All
configurations are acquired when in 4 row mode at a pitch of six. Table travel is 6x the
detector configuration or a pitch of 6:1, (i.e., 7.5 mm table speed divided by six equals 1.25 or
a 4 X 1.25 mm detector configuration). This mode utilizes interspaced helices and is 2x to 6x
faster than single slice helical scans. Interspaced helices mean more interpolation of data
and increased helical artifact when compared to interleaved mode.
4 X 1.25mm detector configuration.

Pitch 1.5:1.

5-26

Pitch 1.5:1.

Pitch 1.5:1.

20 mm beam Collimation.
Pitch 1.5:1
Helical Configurations 8 Row Mode

The helical configurations are: 8 x 1.25 mm and 8 x 2.50 mm. In this mode, configurations
are acquired at a pitch of either 0.625:1, 0.875:1, 1.35:1, or 1.675:1. Table travel is 5x times
faster in the 8 row mode or at a pitch of 0.625:1. The 8 row mode allows you to have
interleaved or interspaced helices, that is 5 to 13.4 times faster than single slice helical
scans.
In one helical scan eight interspaced helices are collected from eight detectors to form a
volumetric data set.
Helical weighting algorithms tailored to each pitch mode allow mAs reduction and reduce
helical artifacts compared to interspaced modes.

5-27
Slice thickness is affected by the detector configuration and the helical reconstruction
algorithm. Slice thickness can be changed retrospectively.
8 Row Mode 8 x 1.25 mm. All images use data from eight helices.

0.625:1 mode 6.25 mm of table travel per rotation.
1.25 mm, 2.5 mm, 3.75 mm, and 5 mm prospective/retrospective slice thickness.
8 Row Mode 8 x 2.5 mm. All images use data from eight helices.

2.5 mm, 3.75 mm, 5 mm, 7.5 mm, and 10 mm prospective/retrospective slice
thickness.

the detector configuration. There are three main parameter selections for helical.
from 1.25 mm to 33.5 mm.
Scan Mode- Determines the speed of the table travel per gantry rotation. Scan mode
choices are 2, 4, or 8 row.
Image Thickness- Determines the prospective and retrospective image slice thickness.
Slice thickness choices range from 0.625 mm to 10.0 mm.

5-28

Light yellow- Current selections.
Blue with black text (thickness)- Prospective and retrospective slice thickness choices.
Blue with black text (Scan Mode/Speed)- Available parameters.
parameters).
Guidelines For mAs

protocols that helps learn adequate technical factors. The system automatically update mA
based on changes made to rotation time, scan type, helical pitch, and slice thickness to
maintain equal image noise.
BrightSpeed Helical.
Interspaced to Interleaved = 30% decrease.

5-29
Slice Profiles
selection, dependent on table speed, pitch and slice selection. The nominal FWHM slice
widths are given in the following tables.
Table 5-4 Slice Profile Table for Recon Full Mode
Selected Slice
Scan Mode
Table
Speed
(mm/rot)
Axial
N/A
0.85
Helical 1:1
1.25
0.95
3.75
Helical
0.75:1
0.625
mm
1.25 mm
2.5 mm
3.75 mm
5.0mm
7.5 mm
10.0 mm
1.09
2.34
3.59
4.84
7.34
9.84
1.30
2.50
3.75
5.0
3.90
5.0
7.50
5.20
7.50
7.5
2.60
11.25
15.0
7.5
Helical
1.5:1
1.60
15.0
10.0
2.50
3.20
3.75
5.0
22.5
6.40
7.50
30.0
6.40
7.50
10.0
Helical
0.625:1
6.25
Helical
0.875:1
8.75
Helical
1.35:1
13.5
Helical
1.675:1
16.75
1.25
12.5
1.25
17.5
1.60
27.0
1.70
33.5

2.50
3.75
5.0
7.5
10.0
2.50
3.75
5.0
7.5
10.0
2.50
3.75
5.0
7.5
10.0
2.50
3.75
5.0
7.5
10.0
2.50
3.75
5.0
7.5
10.0
3.20
3.75
5.0
7.5
10.0
2.50
3.75
5.0
7.5
10.0
3.20
3.75
5.0
7.5
10.0
5-30
Table 5-5 Slice Profile Table for Recon Plus Mode
Selected Slice
Table
Speed
(mm/rot)
1.25 mm
2.5 mm
3.75 mm
5.0mm
7.5 mm
10.0 mm
Helical
0.625:1
6.25
1.50
3.0
4.50
6.0
9.0
12.0
3.0
4.50
6.0
9.0
17.0
Helical
0.875:1
8.75
3.0
4.50
6.0
9.0
12.0
3.0
4.50
6.0
9.0
15.0
Helical
1.350:1
13.5
3.0
4.50
6.0
9.0
12.0
3.0
4.50
6.0
9.0
12.0
Helical
1.675:1
16.75
3.0
4.50
6.0
9.0
12.0
3.0
4.50
6.0
9.0
12.0
Scan Mode
12.5
1.50
17.5
2.0
27.0
2.0
33.5
The indicator FWHM stands for Full Width Half Max. It is used to describe the slice thickness
represented by the image on the screen or film.
Cardiac Helical Slice Profiles

Slice profile measurements for Cardiac helical scans are complicated by the fact that a
variable helical pitch is chosen based on the patients heart rate. For helical pitches greater
than 2.0, the full width half max of a slice collimated at 1.25 is approximately 1.6 mm. The
full width half max of a slice collimated at 2.5 mm is approximately 3.2 mm.
When a pitch value significantly below 2.0 is chosen, the slice profile may vary significantly
from image to image in a single helical scan. The profile will depend on the location of the
prescribed image with respect to the detector locations. The variation in the slice profiles
can be understood by thinking of an axial scan. In an axial scan, an arbitrary image location
is not permitted. However, an attempt to create an image at an intermediate location could
be performed by using data from adjacent detector rows. This would result in an increased
slice profile. As the pitch becomes much less than 2.0, the helical scan data becomes more
and more like axial scan data.
At a pitch of 1.4, for example, which is the prescribed pitch for a Cardiac Segment scan with
a patient heartrate of 60 bpm and gantry period of 0.5 sec, a 35% variation in the nominal
FWHM is possible.

5-31
BrightSpeed Elite and BrightSpeed Elite

Select

5-32

Hardware Components
Axial Interval
Tilt Correction
Helical Configurations 8 and 16 Row Modes
Guidelines For Building Protocols
Slice Profiles
Hardware Components
Collimator
The collimator consists of two independently controlled tungsten cams. The rotation
Scan Geometry
Matrix Detector
There are 24 detector cells in the Z direction. The outside four rows located on each
side of the detector are 1.25 mm in the Z direction. The center 16 rows are 0.625 mm
in the Z direction. Up to sixteen signals are gathered per gantry rotation. Each signal
can be collected from an individual detector row or a combination of detectors.
Sixteen signals can be taken from 24 detector cells (or sixteen slices per rotation of
the gantry).
Other Changes

5-33
The Axial Configurations are 16 X 0.625 mm, 16 X 1.25 mm, 8 X 1.25 mm 8 X 2.5 mm, 4 X 3.75
mm, and 2 X 0.625 mm.
16 X 0.625 mm - 16 signals are collected from sixteen 0.625 mm detectors with 1

detector contributing to each signal.
0.625 mm is the minimum slice thickness. 10 mm of coverage per rotation.
Detector Cells can be combined to form 16 slices at 0.625 mm

16i mode = 1 row. Each detector cell is a slice at 0.625 mm each.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
8 slices at 1.25 mm
8i mode - eight signals from two 0.625 mm detector cells combined is 8 slices at 1.25
mm each.
1 2 3 4 5 6 7 8
4 slices at 2.5 mm
4i mode - four signals from four 0.625 mm detector cells combined is four slices at
2.5 mm each.
2 slices at 5mm
2i mode - two signals from eight 0.625 mm detector cells combined is two slices at
5 mm each.

5-34
1 slice at 10 mm
1i mode - sixteen 0.625 mm detector cells combined is a slice at 10 mm.
16 X 1.25 mm - 8 signals are collected from sixteen 0.625 mm detectors with 2 detectors
contributing to each signal and 8 signals are collected from eight 1.25 mm detectors.
1.25 mm is the minimum slice thickness. 20 mm of coverage per rotation.
16 slices at 1.25 mm each

16i mode = 8 signals from two 0.625 mm detectors combined and 8 signals at
1.25 mm becomes 16 slices at 1.25 mm each.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
8 slice at 2.5 mm
8i mode = 4 signals from four 0.625 mm detectors combined and 4 signals from two
1.25 mm detectors combined becomes 8 slices at 2.5 mm each.
4 slices at 5 mm
4i mode = 2 signals from eight 0.625 mm detectors combined and 2 signals from four
1.25 mm detectors combined becomes 4 slices at 5 mm each.
2 slices at 10 mm
2i mode = 1 signal from 8 detector cells combined from 0.625 mm detector and 4
detector cells combined from 1.25 mm detector plus 1 signal from 8 detector cells

5-35
combined from 0.625 mm detector and 4 detector cells combined from 1.25 mm
detector becomes 2 slices at 10 mm each.
8 X 1.25 mm - 8 signals collected from sixteen 0.625 mm detectors with 2 detectors

contributing to each signal.
1.25 mm is the minimum slice thickness. 10 mm coverage per rotation.
8 slices at 1.25 mm
8i mode - eight signals from two 0.625 mm detector cells combined is 8 slices at 1.25
mm each.
1 2 3 4 5 6 7 8
4 slices at 2.5 mm
4i mode - four signals from four 0.625 mm detector cells combined is four slices at
2.5 mm each.
2 slices at 5mm
2i mode - two signals from eight 0.625 mm detector cells combined is two slices at
5 mm each.
1 slice at 10 mm
1i mode - sixteen 0.625 mm detector cells combined is a slice at 10 mm.

5-36
8 X 2.5 mm - 4 signals from four 0.625 mm detectors combined and 4 signals from two
1.25 mm detectors combined become 8 slices at 2.5 mm each.
8 slice at 2.5 mm
8i mode = 4 signals from four 0.625 mm detectors combined and 4 signals from two
1.25 mm detectors combined becomes 8 slices at 2.5 mm each.
4 slices at 5 mm
4i mode = 2 signals from eight 0.625 mm detectors combined and 2 signals from four
1.25 mm detectors combined becomes 4 slices at 5 mm each.
2 slices at 10 mm
detector becomes 2 slices at 10 mm each.
4 X 3.75 mm - 2 signals are collected from four 1.25 mm detectors along with four 0.625
detectors and 2 signals are collected from twelve 0.625 mm detectors.

5-37
4 slices at 3.75 mm
4i mode = 2 signals from six 0.625 mm detectors combined and 2 signals from two
1.25 mm detectors and two 0.625 mm detectors combined becomes 4 slices at 3.75
mm each.
2 slices at 7.5 mm
detector becomes 2 slices at 7.5 mm each.
2 X 0.625 mm - 2 signals are collected from two 0.625 mm detectors with 1 detector
contributing to each signal.
0.625 mm is the minimum and maximum slice thickness. 1.25 mm coverage per
rotation.
You can get 2 slices at 0.625 mm which is a image from each row or you can
combine the 2 rows and get 1 image at 1.25 mm slice thickness.
This detector configuration is used for Sub mm and HiRes scanning.

Number of images per rotation are 1i, 2i, 4i, 8i, and 16i.

5-38

parameters)

Eight or sixteen signals/channels are collected per gantry rotation. Each of the eight to
sixteen signals can be collected from an individual detector or a combination detectors.
Once a signal from multiple detectors has been combined into a channel, it cannot be
separated.
thickness.
One, two, four, eight, or sixteen slices can be generated per slice rotation.
Axial Interval
The interval is equal to the number of images per rotation x detector thickness, i.e., in the 8 x
1.25 mode - eight images are generated, each 1.25 mm thick for a total of 10 mm of
coverage per rotation. The interval per rotation would be 10 mm.

5-39
Images per Rotation x Detector Thickness = Interval
10 mm
First Rotation
10 mm
Sec. Rotation
10 mm
Third Rotation
10 mm
Fourth Rotation
If an interval skip was needed:

Images per Rotation x Detector Thickness + Gap = Interval with Skip
10 mm
First Rotation
10 mm
Gap
20 mm Interval
Third Rotation
Gap
20 mm Interval
Tilt Correction
Tilt correction for the multiple detectors is done automatically with axial or Helical scanning.
In axial scanning the interval changes to keep the inter slice distance equal when the gantry
is tilted. In Helical scanning, table speed increases as part of the tilt correction. This is to
keep the row data lined up for reconstruction. The image annotation reflects the table
speed.This allows the slice thickness to remain the same when measured perpendicular to
the slice edges.

5-40
.

table travel per rotation in millimeters divided by the beam collimation. Previous
BrightSpeed systems expressed scan modes with names and defined pitch as table travel
per rotation in millimeters divided by the detector row width.
For example: 13.75/10mm = 1.375: 1
Table Speed (13.75) divided by the Beam Collimation (10 mm) equals a Pitch of 1.375
Table 5-6 Beam Collimations
Detector
configuration
Beam
collimation
2 X 0.625
1.25 mm
4 X 3.75
15 mm
8 X 1.25
10 mm
8 X 2.5
20 mm
16 X 0.625
10 mm
16 X 1.25
20 mm

5-41
Helical Configurations 8 and 16 Row Modes

The helical configurations are: 8 X 1.25 mm, 8 X 2.5 mm, 16 X 0.625 mm, and 16 X 1.25 mm.
In the 8X mode the preferred pitches are:
0.625:1 interleaved helices
1.35:1 interspaced helices
In the 16X mode the preferred pitches are:
Interleaved helices minimizes helical artifact, and gives the best detail. Interspaced helices
has more interpolation of data and increased helical artifact when compared to interleaved
mode.
8 Row Mode 8 X 1.25. All images use data from all eight helices.
0.625:1 mode--6.25 mm table travel per rotation5 x detector thickness

0.875:1 mode8.75 mm table travel per rotation--7 x detector thickness
1.35:1 mode--13.5 mm table travel per rotation10.8 x detector thickness
1.675:1 mode16.75 mm table travel per rotation13.4 x detector thickness
The helical algorithm can reconstruct 1.25 mm, 2.5 mm, 3.75 mm, 5.0 mm, 7.5 mm,
and 10 mm slice thickness.

5-42
8 Row Mode 8 X 2.5 mm. All images use data from all eight helices.
0.625:1 mode12.5 mm table travel per rotation5 x detector thickness

0.875:1 mode17.5 mm table travel per rotation--7 x detector thickness
1.35:1 mode--27 mm table travel per rotation10.8 x detector thickness
1.675:1 mode33.5 mm table travel per rotation13.4 x detector thickness
The helical algorithm can reconstruct 2.5 mm, 3.75 mm, 5.0 mm, 7.5 mm, and 10 mm slice
thickness.
16 Row Mode 16 x 0.625 mm. All images use data from all 16 helices.
0.5625:1 mode - 5.625 mm table travel per rotation9 x detector thickness

0.9375:1 mode - 9.375 mm table travel per rotation--15 x detector thickness
The helical algorithm can reconstruct 0.625 mm, 1.25 mm, 2.5 mm, 3.75 mm, and 5.0
mm slice thickness.

5-43
16 Row Mode 16 X 1.25 mm. All images use data from all 16 helices.
0.5625:1 mode - 11.25 mm table travel per rotation9 x detector thickness

1.75:1 mode - 35 mm table travel per rotation--28 x detector thickness
The helical algorithm can reconstruct 1.25 mm, 2.5 mm, 3.75 mm, 5.0 mm, 7.5 mm,
and 10 mm slice thickness.

the detector configuration. There are four main parameter selections for helical.
from 5.625 mm to 35 mm.
Pitch- Determines the speed of the table travel per gantry rotation. There are four pitch
selections each optimized to 8 and 16 row acquisition.
Helical Thickness- Determines the prospective and retrospective image slice thickness.
Slice thickness choices range from .0.625 mm to 10.0 mm.
Detector Rows- You can choose between 8 or 16 rows of detectors.

5-44

Light blue- Current selections.
Teal with black text (thickness)- Prospective and retrospective slice thickness choices.
Teal with black text (Scan Mode/Speed)- Available parameters.
parameters).
Guidelines For Building Protocols

protocols that helps users learn adequate technical factors. The system automatically
updates mA based on changes made to rotation time, scan type, helical pitch, and slice
thickness to maintain equal image noise. There are many considerations for the anatomy
you a scanning. Timing is very important when administering contrast or for long breath
holds. Considerations are the slice thickness, coverage time, how you wish to view the data,
and what artifact can be tolerated. Trade-offs should be made to fit these considerations.
The basic rules are: Interleaved pitches will have less helical artifact especially when slice
thickness is equal to the detector. Interleaved pitches will have better slice profile when
thickness is equal to the detector.
Interspaced to Interleaved = 30% decrease in mAs.
Changing from Full to Plus recon allows a 15-20% decrease in mA.

5-45
Slice Profiles
selection dependent on table speed, pitch, and slice selection. The nominal FWHM slice
widths are given in the following table.
Table 5-7 Slice Thichness- Full Modes
Scan Mode
Table
Helical
Speed
Pitch
(mm/rot)
Axial
0.563:1
0.938:1
1.375:1
1.750:1
0.625:1
0.875:1
1.350:1
1.675:1
N/A
5.625
11.25
9.375
18.75
13.75
27.5
17.5
35.0
6.25
12.5
8.75
17.5
13.5
27.0
16.75
33.5
Image Thickness
0.63mm
1.25mm
2.5mm
3.75mm
5.0mm
7.5mm
10mm
0.60
0.63
1.09
1.25
1.25
1.25
1.60
1.25
1.60
1.25
1.60
1.25
2.34
2.50
2.50
2.50
2.50
2.50
2.50
2.50
2.50
2.50
2.50
2.50
2.50
2.50
3.20
2.50
3.20
3.75
3.75
3.75
3.75
3.75
3.75
3.75
3.75
3.75
3.75
3.75
3.75
3.75
3.75
3.75
3.75
3.75
4.84
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
7.35
9.84
7.50
10.00
7.50
10.00
7.50
10.00
7.50
7.50
7.50
7.50
7.50
7.50
7.50
7.50
7.50
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
10.00
0.85
0.80
0.85
1.25
1.60
1.70
Table 5-8 Slice Thickness- Plus Modes

Scan Mode
Table
Helical
Speed
Pitch
(mm/rot)
Axial
0.563:1
0.938:1
1.375:1
1.750:1
0.625:1
0.875:1
N/A
5.625
11.25
9.375
18.75
13.75
27.5
17.5
35.0
6.25
12.5
8.75
17.5
Selected Slice
0.63mm
1.25mm
2.5mm
3.75mm
5.0mm
7.5mm
10mm
0.60
0.75*
1.09
1.50
1.50
1.50
1.90
1.50
1.90
1.50
1.90
1.50
2.34
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.75
4.50
4.50
4.50
4.50
4.50
4.50
4.50
4.50
4.50
4.50
4.50
4.50
4.84
6.00
6.00
6.00
6.00
6.00
6.00
6.00
6.00
6.00
6.00
6.00
6.00
7.35
9.84
9.00
12.00
9.00
12.00
9.00
12.00
9.00
9.00
9.00
9.00
9.00
12.00
12.00
12.00
12.00
12.00
0.92**
1.0
1.0
1.50

5-46
Scan Mode
Table
Helical
Speed
Pitch
(mm/rot)
1.350:1
1.675:1
Selected Slice
0.63mm
13.5
27.0
16.75
33.5
1.25mm
2.5mm
3.75mm
5.0mm
7.5mm
10mm
2.00
3.00
3.00
3.00
3.00
4.50
4.50
4.50
4.50
6.00
6.00
6.00
6.00
9.00
9.00
9.00
9.00
12.00
12.00
12.00
12.00
2.00
NOTE: * Head SFOV 0.95 mm.

NOTE: ** Head SFOV 1.0 mm.
For more information on Full and Plus Recon, refer to: Full and Plus Recon Modes.
This is used to describe the slice thickness represented by the image on the screen or film.
Cardiac Helical Slice Profiles

Slice profile measurements for Cardiac helical scans are complicated by the fact that a
variable helical pitch is chosen based on the patients heart rate. For helical pitches greater
than 0.125, the full width half max of a slice collimated at 1.25 is approximately 1.6 mm. The
full width half max of a slice collimated at 2.5 mm is approximately 3.2 mm.

5-47

5-48
Building Protocols
Chapter 6
Building Protocols
Introduction
This chapter explains the process of building, viewing, and editing protocols. It contains the
Build or Edit a Protocol
Record a Personalized AutoVoice
Select Default Language for AutoVoice 1, 2, and 3.
Change Pre-Set Delay for AutoVoice
Delete an AutoVoice
Copy and Paste Protocols
Delete a Protocol
Use ECG Trace
NOTE: A protocol must be selected in order to initiate the scanning sequence. Protocols are
used as a basis for routine or established procedures. Once chosen for use, any
protocol may have any factor modified as needed for individual case purposes. While
the individual case is being set up in the New Patient Area, any changes needed may
be made. This changes the protocol for that particular patient only, it does not change
the established protocol. The system comes with several common protocols ready
for you to use. If you wish to change the established protocols, you must follow the
directions outlined in this chapter for editing a protocol.

6-1
Building Protocols

This section presents the concepts necessary to successfully build and use protocols for
scanning. Some of the concepts you need to understand are:
Helical/Axial/Cine
Prospective Multiple Reconstructions (PMR)
Full and Plus Recon Modes
Building Protocols
Using Protocols
Editing Protocols
Viewing Protocols
System Options
Noise Index Values
AutomA
SmartmA
WideView
Pediatric Protocols
Protocol Numbers
Anatomical Selector
Helical/Axial/Cine
Helical or spiral scanning is a method of acquiring images in a continuous data set. The
x-ray tube and Digital Acquisition System (DAS) expose and rotate continuously through 360
degrees while the patient is passed through the area of exposure at a set rate of movement
(pitch). The information gathered is then reconstructed into images of the prescribed slice
thickness and interval.
Axial scanning is the traditional step and shoot method of acquiring data. The x-ray tube
and DAS expose and rotate one 360 degree loop. The table and patient move a preset
distance (interval) and the process is repeated.
Cine is a method of scanning that uses full or partial rotations of the gantry while gathering
input from one location over time. You may set the acquisition in groups expanding the time
to be scanned. This is especially beneficial when determining the function of anatomy and
physiology (i.e., hemangioma).

6-2
Building Protocols
Prospective Multiple Reconstructions (PMR)

The system allows you to have additional reconstructions of your scan groups that uses any
portion of a group to change several of the scan parameters. These parameters include
Display Field of View (DFOV), Algorithms, Image Center, Start and End Locations (each group),
Image Interval, and Slice Thickness. Rather than relying on retrospective reconstruction for
additional data sets, you are able to create these sets prospectively.
For Cardiac Helical acquisitions, PMR parameters include phase % and recon types of
SnapShot Segment, SnapShot Burst, SnapShot Burst Plus and cardiac noise reduction filters
- C1, C2, C3.
Full and Plus Recon Modes

The system provides the ability to manage dose, slice profile, and helical artifact through the
Full and Plus recon modes. Full mode provides a thinner slice profile but requires 10-15%
more milliampere (mA) than Plus mode with equal image noise. Plus mode has up to a 20%
wider slice profile than Full, but requires 15-20% less mA with equal noise. At the same mA,
Plus mode provides reduced image noise. Reduction of helical artifacts can be seen with
Plus mode. Plus mode uses additional views of data to reconstruct an image. When
acquiring images in Plus mode, exposure time increases slightly to assure that enough
views are collected to reconstruct all image locations prescribed. Both modes can be used
prospectively and retrospectively including Prospective Multiple Reconstructions (PMR). Data
acquired in Plus mode can be retrospectively reconstructed in full mode or data acquired in
Full mode can be reconstructed in Plus mode.
In general, every data channel will contribute to at least one image during helical image
reconstruction. Some data channels are not used at the beginning and end of helical scan
due to the physics of multi-slice scanning and helical view weighting algorithms.
NOTE: Plus recon is only available for 8 slice and 16 slice helical scan types.
NOTE: Full mode is disabled for scans with 0.625 mm and 1.25 mm thick from 16 X 0.625
and 16 X 1.25 detectors when the SFOV used is Head or Ped Head.
During helical image reconstructions, some data channels in the middle of the helical scan
are not used if the image interval prescribed is greater than the values listed in Table 6-1
and Table 6-2 below.
For example, all data channels are used for 1.25 mm images, 0.75:1 pitch, if the image
interval is less than or equal to 1.3 mm.

6-3
Building Protocols
Table 6-1 Channel Utilization Table Recon Full Mode
Scan Mode
Helical Pitch
0.563:1
0.938:1
1.375:1
1.750:1
0.625:1
0.875:1
1.350:1
1.675:1
Table Speed
(mm/rot)
Image Thickness in MM
Detector
Row
Collimation
(mm)
5.625
0.625
11.25
1.25
9.375
0.625
18.75
1.25
13.75
0.625
27.5
1.25
17.5
0.625
35.0
1.25
6.25
1.25
12.5
2.5
8.75
1.25
17.5
2.5
13.5
1.25
27.0
2.5
16.75
1.25
33.5
2.5
0.63
0.68
0.62
0.93
1.24
1.24
1.25
2.5
3.75
5.0
7.5
10.0
2.18
4.06
5.92
7.85
1.62
4.48
6.35
8.20 12.08 15.70
2.27
4.24
6.14
8.17
1.87
4.73
6.73
8.59 12.27 16.33
2.57
4.53
6.47
8.48
2.49
5.34
7.32
9.36 13.16 16.96
2.58
4.54
6.44
8.47
2.49
5.34
7.33
9.21 12.88 16.93
1.24
4.45
6.80
5.74
2.49
6.78 11.03 15.70 16.72
4.38
6.94
2.49
6.79 11.04 15.70 16.72
6.24
7.18
4.99
9.47 11.69 14.98 14.02
4.97
6.33
7.81
4.97
9.60
9.43 14.64 13.96
1.24
2.50
2.49
5.74
7.23
8.10 10.60
8.11 10.61
9.60 11.98
9.57 11.92
Table 6-2 Channel Utilization Table Recon Plus Mode

Scan Mode
Helical Pitch
0.563:1
0.938:1
Table Speed
(mm/rot)
Detector
Row
Collimation
(mm)
5.625
0.625
11.25
1.25
9.375
0.625
18.75
1.25

0.63
1.30
1.65
1.25
2.5
3.75
5.0
7.5
10.0
2.66
4.76
7.00
9.28
2.68
5.22
7.48
9.65 14.20 18.57
2.73
4.98
7.36
9.48
3.41
5.60
7.91 10.10 14.71 19.46
6-4
Building Protocols
Scan Mode
Helical Pitch
Table Speed
(mm/rot)
1.375:1
Detector
Row
Collimation
(mm)
13.75
0.625
27.5
1.25
17.5
0.625
35.0
0.63
2.5
3.75
5.0
7.5
10.0
5.34
7.64
3.97
6.20
8.47 10.73 15.34 19.31
3.04
5.28
7.65
1.25
4.02
6.22
8.50 10.71 15.29 20.03
6.25
1.25
2.24
6.17
8.24 10.23 10.79 12.72
12.5
2.5
4.67
8.35 11.47 15.46 18.09
8.75
1.25
4.72
8.47 10.24 10.80 12.73
17.5
2.5
4.84
8.48 11.22 15.95 17.73
13.5
1.25
6.45
9.25 10.61 12.98 13.86
27.0
2.5
7.35
9.99 13.47 15.83 16.60
16.75
1.25
6.42
9.29 10.67 13.04 13.91
33.5
2.5
0.625:1
0.875:1
1.350:1
1.98
1.25
3.07
1.750:1
1.675:1
1.96
2.36
3.87
3.97
9.66
9.76
7.93 10.18 13.28 15.52 16.75
Building Protocols
The protocols are built using the Protocol Management feature. There are four protocol
selections to choose from: User, GE, Service, and Most Recent. The protocols contain all of
the scan parameters. User protocols can be built in either adult or pediatric models. There is
space for 90 protocols in each of the ten anatomical regions for adult protocols and 90
protocols for each color area of the pediatric protocols. There are nine different weight
classifications in each of the seven color areas plus three additional areas for you to build
pediatric protocols in. You have a total of 6,840 available user selected protocols to build.
Using Protocols
After entering the patient information in New Patient, you have several options for choosing
a protocol. There are four protocol selections to choose from: User, GE, Service, and Most
Recent. Once you choose the area you wish to get the protocol from, then you select an
anatomical area and the protocol you wish to use. Once the protocol is chosen, the
scanning sequence is activated. All parameters for scanning a patient can be set up in a
protocol. This saves you time when prescribing scan parameters for each patient.

6-5
Building Protocols
Editing Protocols
Once a protocol is chosen, any factor in the individual exam may be adjusted without
affecting the established protocol. If an established protocol has a factor or factors you wish
to permanently change, this can be done by clicking the [Protocol Management] button,
selecting the user tab and going to the appropriate area, entering or choosing the desired
value changes, and clicking on the [Accept] button. If your system has been configured for
HIPAA Login you must have permission to accept any changes in Protocol Management.
Viewing Protocols
To view a protocol click the [Protocol Management] button, User or GE, then select the
appropriate area or protocol. Every series can then be viewed by using the [Next Series]
button. Values may be changed to see effects on other values or other available options.
When finished, the [Cancel] button cancels any possible changes made and closes the
window. It does not cancel the established protocol. The established protocol remains as it
was built.
System Options
There are several option packages that may be purchased and installed on your system
which include setting up various protocols. You need to have some understanding of their
functions if you are to use them in your protocols. These options include: VariSpeed (not
available for BrightSpeedSelect Series), Prospective Gating, Cardiac Imaging (not available
for BrightSpeedSelect Series), SmartViewTM and Direct Visulation Auto Applications. For
details on these options refer to the specific chapters, VariSpeed (Option), Prospective
Gating (SmartScore)(Option), Cardiac Imaging, SmartStep (Option), SmartView (Option) and
Direct Visualization Auto Applications (Option).
Noise Index Values

The system has three different tables of Noise Index values. Table 1 is configured to deliver
lower noise in the images at a higher mA value. Table 2 is configured to deliver average
noise in the images at a average mA value. Table 3 is configured to deliver higher noise in
the images at a lower mA value. The system defaults to Table 2 but can be modified by your
GE Service Engineer. The default Noise Index values for each table are optimized for the
anatomical area and slice thickness you choose to scan. The higher the Noise Index value,
the lower overall mA is required. These images are noisier with lower mA values. The lower
the Noise Index value, the higher the overall mA is required. These images have less noise.
The Noise Index value table is only used when building a protocol from Create New Series or
when Reset is selected in the Auto mA pop up.

6-6
Building Protocols
AutomA
Background
A significant factor in the quality of a CT image is the amount of x-ray quantum noise
contained in the scan data used to reconstruct the image. Most technologists know how the
choices of x-ray scan technique factors affect image noise. That is, noise decreases with the
inverse square root of the mAs and slice thickness. Noise also decreases approximately
inversely with kVp. For example, increasing the mA from 50 to 400 (a factor of 4) will
decrease quantum noise by a factor of 2 (the square root of 4). Quantum noise also
increases with increasing helical pitch; however, the exact relationship is dependent on the
details of the helical reconstruction process.
The most significant factor that influences the quantum noise in the scan data is the x-ray
attenuation of the patient section being scanned. The x-ray attenuation is related to the size
and tissue composition of the patient section. Figure 6-1 shows a distribution of patient
attenuation area values (PAA) for adult abdominal images that ranges from 19 to about 41
with a mean of 27.6 (for this patient sample set). The patient attenuation area (also called
the Patient Attenuation Indicator, PAI)1 is computed for the patient section as the square
root of the product of the sum of raw pixel attenuation values times the pixel area.
Figure 6-1 Adult abdominal patient distribution in terms of average patient attenuation
1.T Toth, Z.Ge, and M. Daley, "The influence of bowtie filter selection, patient size and patient centering on CT
dose and image quality", Poster SU-FF-I42, 2006 AAPM Conference (MedPhy, Vol 33, No.6, June 2006)

6-7
Building Protocols
Figure 6-2 Example small patient (PAI = 20) with factor of 5 noise increase (simulated)
For a given fixed scan technique, the quantum noise varies by about a factor of 5 from the
smallest to the largest patients attenuation (PAI range of 17 to 41). Figure 6-2 shows an
example of a five times noise increase simulated for a small patient (20 PAI). With a fixed mA
scan protocol, the technologist must select the mA using a qualitative estimate of the
patient attenuation. This is may be accomplished using patients weight, diameter
measurements, body mass index, or just as a qualitative visual classification. Because these
methods provide very rough x-ray attenuation estimates and do not account for
attenuation changes within the patient region being scanned, the technologist must use a
high enough technique margin to avoid the possibility of compromising the diagnostic
quality of the images with too much noise. Since dose is inversely related to the square of
the noise, many patients are likely to be receiving more dose than necessary for the required
diagnostic quality using such manual methods.
Automatic tube current modulation: AutomA is an automatic tube current modulation
feature that can make necessary mA adjustments much more accurately than those
estimated for the patient by you and thereby can obtain a more consistent desired image
noise in spite of the wide range of patients. Since image noise variability is substantially
reduced, a significant overall patient dose reduction is possible with proper scan parameter
selection.
AutomA (Z-axis modulation) adjusts the tube current to maintain a user selected quantum
noise level in the image data. It regulates the noise in the final image to a level desired by
you. AutomA is the CT equivalent of the auto exposure control systems employed for many
years in conventional X-ray systems. The goal of AutomA is to make all images contain
similar x-ray quantum noise independent of patient size and anatomy.
The AutomA tube current modulation is determined from the attenuation and shape of
scout scan projections of the patient just prior to CT exam sequence.

6-8
Building Protocols
SmartmA (angular or xy modulation) has a different objective than Z-modulation. It adjusts
the tube current to minimize X-rays over angles that have less importance in reducing the
overall image noise content. In anatomy that is highly asymmetric, such as the shoulders,
x-rays are significantly less attenuated in antero-posterior (AP) direction than in the lateral
direction. Thus, the overwhelming abundance of AP x-rays can be substantially reduced
without a significant effect on overall image noise.
Angular modulation was first introduced on GE single slice scanners in 1994. 1, 2
AutomA Theory
AutomA is an automatic exposure control system that employs Z axis tube current
modulation and is available on all GE LightSpeed scanners. A noise index parameter allows
you to select the amount of X-ray noise that will be present in the reconstructed images.
Using a single patient scout exposure, the CT system computes the required mA to be used
based on the selected noise index setting. The noise index value will approximately equal
the standard deviation in the central region of the image when a uniform phantom (with the
patient's attenuation characteristics) is scanned and reconstructed using the standard
reconstruction algorithm.
Figure 6-3 Example noise variation with fixed mA and mA variation with AutomA with a
Noise Index setting
1. L. Kopka and M. Funke, "Automatically adapted CT tube current: Dose reduction and image quality in phantom
and patient studies," Radiology 197 (P), 292 (1995).
2. D. R. Jacobson, W. D. Foley, S. Metz, and A. L. Peterswen, "Variable milliampere CT: Effect on noise and low contrast detectability," Radiology 210(P), 326 (1996)

6-9
Building Protocols
The system determines the tube current using the patient's scout projection data and a set
of empirically determined noise prediction coefficients for a reference technique. The
reference technique is the selected kVp, and an arbitrary a 2.5 mm slice at 100 mAs for an
axial reconstruction using the standard reconstruction algorithm. The scout projections
contain density, size and shape information about the patient. The total projection
attenuation (projection area) contains the patient density and size information and the
amplitude and width of the projection contains the patient shape information. These patient
characteristics determine how much x-ray will reach the detector for a specified technique
and hence predict the image standard deviation due to x-ray noise for the standard
reconstruction algorithm.
To predict the image noise at a given z position for the reference technique, the projection
area and oval ratio are obtained from the patient's scout. The oval ratio is an estimate of the
patient asymmetry that is determined from the amplitude and width of the projection data.
The expected x-ray noise for the reference technique (reference noise) is then calculated as
a function of the projection area and oval ratio from the scout using polynomial coefficients
that were determined by a least squares fit of the noise measurements from a set of
phantoms representing a clinical range of patient sizes and shapes.
Knowing the reference noise and the difference between the reference technique and the
selected prescribed technique, the mA required to obtain the prescribed noise index is
calculated using well know x-ray physics equations. That is, the noise is inversely related to
the square root of the number of photons and the number of photons is proportional to the
slice thickness, slice acquisition time, and mA. In the GE AutomA design, an adjustment
factor for helical pitches is also incorporated in the calculation to account for noise
differences that scale between helical selections and the axial reference technique.
AutomA FAQs
1. What suggestions do you have for a new AutomA user?
If you are not familiar with the concept of noise index (image noise) you can use the
GE default protocols as a starting point or consult the literature until you find the
highest noise index value that provides acceptable diagnostic quality. Experiment by
scanning some phantoms with different noise index values to gain some confidence.
A 30 cm diameter water phantom or a 35 cm diameter low density polyethylene
phantom have an attenuation similar to the average adult abdominal patient (27.6
PA).
Check the mA table on the scan Rx menu to see what mA is actually being used. If
you see that it is frequently at the max mA range, consider increasing the noise index
or increase the max mA limit if it is not at the maximum limit of the x-ray generator.
Each dose step decrease will increases the Noise Index by 5% and reduces the mA in
the mA table about 10%.
If you normally reconstruct images with thin sections for 3D reformatting and thicker
slices for axial viewing it is important to understand that the first prospective
reconstructed slice thickness is used for calculating AutomA. Generally you would
want to set the noise index for the thicker slice images. For example, you might want

6-10
Building Protocols
a noise index of 10.0 for 5 mm thick images for viewing but you may also want 0.625
mm slices for 3D reformatting. If you prescribe the 0.625 mm slice recon first
followed by the 5 mm recon, AutomA will calculate the mA needed to obtain an
image noise of 10 for the 0.625 mm slices since it is prescribed first. In this case, to
avoid excessively high mA and high dose, you need to readjust the noise index using
the following approximation;
RxNoiseIndexthin = RxNoiseIndexthick
ViewingSliceThickness
FirstRxSliceThickness
Example:
28.3 = 10
5mm
0.625
2. Why is the standard deviation I measure in the image some times different than the
noise index I selected for the scan?
There are many factors that can account for this. But, first consider that the noise
index setting you make only causes the tube current to be adjusted so that the
system projects a similar X-ray intensity through the patient to the detector. Hence it
regulates the X-ray noise or quantum noise in the scan data. The noise in the image
depends on other factors as well. The selection of reconstruction algorithms,
reconstructed slice thickness selection (if different than your prospective selection),
and the use of image space filters will also change the noise in the image. In addition,
it is very difficult to make standard deviation measurements on patient data since
the standard deviation is affected by small CT number variations of the anatomy and
by patient motion or beam hardening artifacts. Even with uniform phantoms,
standard deviation measurements will produce some variability in measured results
because of the inherent nature of quantum statistics.
Another situation that can cause significant differences between the selected noise
index and the image standard deviation is when very large patients provide
insufficient detector signal. In these cases, electronic noise sources can become the
dominant image noise source instead of X-ray noise. In these cases at various
threshold levels, special projection data dependent filters begin to be applied to help
preserve image quality. The highest kVp is recommended when excessively large
patients are to be scanned.
Another factor is how well the patient is centered in the SFOV. Image noise can
increase significantly if the patient is mis-centered. This occurs because the bow ti
filter projects maximum x-rays intensity at isocenter since this is the region of
maximum attenuation if the patient is centered. If the patient is mis-centered, there
are fewer x-rays projected to the thickest part of the patient, and hence image noise
will increase. The optimum strategy is to find the highest noise index sufficient for the
clinical task and let AutomA select the mA without using significant constraints.

6-11
Building Protocols
3. Will I get a dose reduction when I use AutomA?
AutomA will use a dose that depends on the noise index you select and the size of the
patient you are scanning. If, you do not obtain a dose reduction over a population of
patients, you may have selected a lower noise index than you really need and this
results in higher mA values on average than your fixed mA protocols. One strategy to
avoid using more dose is to set the max mA parameter to the same level as your
fixed mA protocols. This will cap the maximum dose to the same level as your fixed
mA protocol. Hence, AutomA will never be allowed to use more dose than you
previously used. However, image noise will increase in regions where the mA is
limited by the max mA selection and the IQ will degrade with increasing patient size.
The optimum strategy is to find the highest noise index sufficient for the clinical task
and let AutomA select the mA without using significant mA limits.
4. Why do my images seem noisier when I use AutomA?
AutomA will produce an x-ray intensity to maintain the noise index you select. Thus,
you may need to use a lower noise index. This may be the case if you find that the
average mA for your population of patients is generally lower than your previous
fixed mA protocols. This situation indicates you are using lowerdose and hence
higher noise levels would be expected.
Certain patient images may also be noisier than your experience suggests. For
example, your experience tells you to expect significantly lower noise in thin patients
than obese patients. Since AutomA makes the image noise approximately the same
for all patients, you may have to re-learn what to expect. What is most important, is
to find the highest noise index that allows you to make a confident diagnosis for the
clinical problem since this results in the lowest patient dose.
If you desire somewhat lower noise in small patients, you may want to create Small,
Nominal, and Large patient protocols. You can use the slightly a slightly lower noise
index for the small patients and a slightly higher noise index for large patients.
A conditional noise limiting strategy you can employ, is to increase the low mA range
parameter. If you find that images are generally not acceptable to you below some
minimum mA value, then you may set this value as the low mA range limit. This will
prevent AutomA from using lower mA values than you desire. Note, however, that this
defeats the purpose of AutomA and causes the image noise to decrease below the
selected noise index and thereby increases the dose.
Yet another possibility for higher noise than you might expect is if you are looking at
multiple reconstructed images that have thinner slices than the prospective scan Rx
slice thickness. AutomA uses prospective slice thickness as a factor when the mA
table is generated. You need to be sure the noise index is set for the the first
prospective image based on image thickness you will use for axial image viewing
(see FAQ 1). This caveat applies equally for fixed mA as well as AutomA scanning.
Higher noise images can also occur when patients are not well centered in the scan
field of view. The bowtie filter attenuation increases with distance away from
isocenter. Hence the thickest part of the patient should be approximately centered in
the scan field of view. Otherwise image noise will increase since the patient thickness

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adds to the bowtie filter thickness. This is especially important for highly asymmetric
anatomy such as through the shoulders. Again, this effect is no different with AutomA
than with fixed mA.
Recognize also that there are some obese patients that exceed the capabilities of the
tube and generator to satisfy the selected noise index. This is also no different than
fixed mA scanning. For such obese patients, one strategy is to select a higher kVp
setting when possible.
5. Why is the mA that is annotated on the image sometimes slightly different than the mA I
see in the mA table?
The mA displayed on the image is determined by measuring the generator mA during
the scan and averaging the measured result over the total number of views used to
reconstruct the image. The number of views used to produce the image may be more
than one gantry rotation for a helical scan. Hence the annotated value is a
combination of the mA table values that depends on how many views from each
rotation were used for the image. In addition, the generator is automatically
adjusting the filament current to account for changing conditions during the scan to
keep the mA within the desired tolerance of the commanded mA table. For example,
this is why you may see an mA value of 41 in the image where the mA table indicated
40.
6. I understand that noise in the image noise changes with reconstruction parameter
selections, but why is the noise sometimes different when I retro reconstruct the same
scan data at a different display field of view?
When you select a reconstruction algorithm, the system may sometimes re-adjust
the actual filter kernel. This readjustment will change the image standard deviation.
This will happen if the display field of view selection exceeds a certain size and is
especially apparent with higher resolution algorithms such as bone and edge. The
change in kernel is required when the DFOV selection makes the pixel size too large
to support the intended spatial resolution. This characteristic is independent of
AutomA.
AutomA Interface
AutomA is selected for a group of scans. When you select AutomA (Figure 6-6), this enables
the feature. The system uses the data collected from the most recent Scout scanned for the
exam.
When possible, the kVp setting for the scout should be taken using the same kVp that the
axial or helical scan is taken.
Function
Reference Noise Index
Description
Default or baseline Noise Index for the given protocol.
Any changes to Dose Steps, Slice Thickness or Noise
index are referenced to this value. This value can only be
prescribed while in protocol management.

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Function
Description
Noise Index
Default or baseline Noise Index for the given protocol.

Any changes to Dose Step or Noise index are referenced
to this value.
Dose Steps
Adjusts Noise Index by steps of 5%. Dose steps can be

increased or decreased + values decrease image noise
thus increasing required mA. Minus values increase
image Noise index, thus decreasing required mA. A Dose
step value of 0 indicates that the prescribed Noise index
is equal to the Reference Noise index for the protocol.
Reset
Resets the Reference Noise Index to the GE Target Noise

Index Default for the anatomical area and slice thickness
chosen in the protocol.
The Noise Index value displayed is updated automatically as you change the Relative Dose.
The Noise Index change is relative to the Default Noise Index. You can prescribe your own
Noise Index value. The mA range area is used for entering a Min and Max mA value. The Max
mA value sets the clipping mA value. This mA value can also determine the focal spot size.
You need to enter the proper mA value for the focal spot size you wish to use.
Table 6-3 Focal Spot Size
Performix
kV
Small Focal Spot

Min mA
Max mA
Solarix 350
Large Focal
Spot
> mA
Small Focal Spot

Min mA
Max mA
Large Focal
Spot
> mA
80
10
300
300
10
200
200
100
10
240
240
10
190
190
120
10
200
200
10
160
160
140
10
170
170
10
130
130
When AutomA is selected, the mA annotation on the view/edit screen is annotated with the
maximum mA in the mA range prescribed for the scan group. See Figure 6-4. You can view
the list of mA values that will be used for each rotation for the acquisition if you select [mA
Table].This is a read-only table showing the mA for each rotation or scan separated by
groups. Refer to Figure 6-5. AutomA is automatically turned off and can not be enabled if the
orientation for the series does not match the orientation for the scouts. The calculation of
the mA table is based on the last scout so the series much match the scout. if there is no
scout, AutomA will also be unavailble.

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Manual mA
The Manual mA mode allows you to scan without enabling the AutomA mode. You can enter
a mA value for each group prescribed. When building protocols, make sure the Manual mA
value field has a reasonable mA entered in it even if the protocol will use AutomA in case
AutomA is turned off.
The Manual mA mode allows you to scan without enabling the AutomA mode. You can enter
a mA value for each group prescribed.
Figure 6-4 mA Annotation
Max mA Selected
Noise Index
Figure 6-5 mA Table

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Figure 6-6 mA Control Window

Default or baseline Noise Index for the given protocol. Any changes to Dose Steps or Noise
index are referenced to this value. This value can only be prescribed or changed while in
protocol management.
Noise Index
The noise level required for the study. As the Noise Index increases the required mA
decreases and image noise increases.
Dose Steps
Adjusts Noise Index by steps of 5%. Dose steps can be increased or decreased. Plus values
decrease image noise thus increasing required mA. Minus values increase Noise index, thus
decreasing required mA. A Dose step value of 0 indicates that the prescribed Noise index is
equal to the Reference Noise index for the protocol.
Reset
Reset returns the Reference Noise Index to the GE Target Noise Index default values for the
anatomical area and slice thickness chosen in the protocol. Reset is available while in
Protocol Management.

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SmartmA
SmartmA is variable mA in the X-Y direction. For each rotation along Z, the system calculates
each X and Y mA value from the ratio of the long and short axis of the patient and is shown
in the SmartmA head and body examples (Figure 6-7).
Figure 6-7 SmartmA Tables
Head Table
Body Table
The low and high mA are calculated from the long and short axis ratio. The SmartmA tables
(Figure 6-7) show examples of low and high mA values per scan.
The noise increase from using SmartmA compared to AutomA is no more than 7 %. The dose
reduction from using SmartmA is approximately 15 %.
Figure 6-8 Dose Tables
AutomA Dose Information

SmartmA Dose Information
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SmartmA modulates four times during a rotation. Because of this the mA varies four times
during each exposure. The mA ramp up time is about 100 milli-seconds.
Figure 6-9 Modulation Example
Quadrant 1
Quadrant 2
Quadrant 4
Quadrant 3
The images are annotated with a tilde sign (~) marking next to the noise index number
indicating SmartmA was used (Figure 6-10).
Figure 6-10 SmartmA Annotation
AutomA Annotation
SmartmA Annotation
NOTE: SmartmA is only available on BrightSpeed Gantries.

You can select SmartmA by clicking on the mA value on the view/edit screen.
NOTE: AutomA must be selected first, then SmartmA is available.
NOTE: AutomA and SmartmA will be disabled if patient orientation does not match the
orientation of the scout (Figure 6-13). Once the orientation for the series matches the
scout, AutomA and SmartmA can be selected.

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Figure 6-11 View/Edit Screen
The mA control window opens and you can click on [SmartmA].

Figure 6-12 SmartmA Control Window
Manual mA
The Manual mA mode allows you to scan without enabling the SmartmA mode. You can
enter a mA value for each group prescribed.

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Default or baseline Noise Index for the given protocol. Any changes to Dose Steps or Noise
index are referenced to this value. The Reference Noise Index value can only be prescribed
while in protocol management.
Noise Index
The noise level required for the study. As the Noise index increases the required mA
decreases and image noise increases.
Dose Steps
Adjusts Noise Index by steps of 5%. Dose steps can be increased or decreased. Plus values
decrease image noise thus increasing required mA. Minus values increase Noise index, thus
decreasing required mA. A Dose step value of 0 indicates that the prescribed Noise index is
equal to the Reference Noise index for the protocol.
Reset
Reset returns the Reference Noise Index to the GE Target Noise Index default values for the
anatomical area and slice thickness chosen in the protocol. Reset is available while in
Protocol Management.
WideView
BrightSpeed 4 slice scanners
The WideView feature is an algorithm that allows a CT image to be reconstructed with a
Display Field of View (DFOV) that is larger than the Scan Field of View (SFOV), defined by the
detector arc. For BrightSpeed, the SFOV is 50 cm and, therefore, the maximum DFOV has
also been 50 cm. With the WideView option, the maximum DFOV can be greater than 50 cm.
NOTE: For 4 slice BrightSpeed systems, WideView is a purchased option. WideView is not
available on 8 or 16 slice systems.
When using graphic Rx the scout image will be automatically minified when the DFOV is 40
cm or greater. This minification will keep the DFOV handles for Graphic Rx visible.
When the WideView option is installed, a DFOV of up to 65 cm may be entered in prospective
or retrospective reconstructions. Although the maximum DFOV will be 65 cm, the default
DFOV shall be 50 cm when Large SFOV is chosen. The algorithm is used when a DFOV of
50.1cm or greater is entered.
Since the image quality in the area beyond the SFOV may not be as good as that within the
SFOV, you are alerted when the WideView algorithm is being used. The DFOV entry becomes
"orange" when a value greater than 50.0 cm is entered and a message in the message box
is displayed informing you that the WideView reconstruction will be used ("WideView
processing enabled").

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If a DFOV value greater than 65 cm is entered, the value will be changed to 65 cm and
highlighted in orange. A message is displayed in the message box informing you that "DFOV
set to maximum value available with WideView processing.
The [Recon Type] field updates with the algorithm you have chosen and it is annotated with
WideView on in the column.
Recon time increases when Wide View mode is selected.
Figure 6-13 Recon Type Choices
NOTE: Edge algorithm is not available with the WideView option.

A goal of the WideView algorithm is to help the radiation therapy planner to accurately
(within a few millimeters) locate the air/skin boundary.
The image quality in the region beyond the Scan FOV is not expected to be as good as that
within the Scan FOV, and is not intended for diagnostic imaging.
Pediatric Protocols
The [Pediatric] button brings up a screen that allows you to select an anatomical area. The
anatomical areas are indicated by text.

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Figure 6-14 Pediatric Selector
Once the anatomic area is selected, a window containing rainbow bars appears. This
indicates you are using weight based protocols designed for pediatrics. Choose the color
category for your patient and the protocol list is displayed accordingly. If there is no
weight-specific protocol associated with the selected anatomical area, the Protocol
Category window appears (Figure 6-16). The default weight/color selector will show the
patient weight entered in the patient information screen, or the last weight/color selection (if
no patient information was entered). If you enter a patient weight on the patient information
screen and select a color/weight selector that is not consistent with the entered information,
an error message appears (Figure 6-15) and you must acknowledge that you have chosen a
protocol that does not match the patient size. Selectors on the color/weight bar are labeled
with the zone ranges for weight and length, with the word of the selected color and with the
weight/color zone number as indicated in Table 6-4. Weight-specific protocols are enforced
for all anatomical areas except head, orbit and miscellaneous. Protocols in the head and
orbit categories are usually defined based on patient age as opposed to patient
weight/height.
Table 6-4 Color Code Table
Zone
Number
Zone
Color
Pink
Zone Weight (kg) Zone Weight (lb)

6 - 7.4

13 - 16.4
Zone Length (cm)

59.5 - 66.5
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Building Protocols
Zone
Number
Zone
Color
Red
7.5 - 9.4
16.5 - 20.4
66.5 - 74
Purple
9.5 -11.4
20.5 - 25.4
74 - 84.5
Yellow
11.5 - 14.4
25.5 - 31.4
84.5 - 97.5
White
14.5 - 18.4
31.5 - 40.4
97.5 - 110
Blue
18.5 - 22.4
40.5 - 49.4
110 - 122
Orange
22.5 - 31.4
49.5 - 69.4
122 - 137
Green
31.5 - 40.4
69.5 - 88.4
137 - 150
Black
40.5 - 55
88.5 - 121
--
Zone Weight (kg) Zone Weight (lb)
Zone Length (cm)
Figure 6-15 Protocol Category Warning

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Figure 6-16 Protocol Category Window
Protocol Numbers
The protocol numbering systems enable you to easily enter a protocol number in the patient
information screen when you are setting up a scan. The first number indicates the protocol
area you are using. The second number indicates what weight zone you are using. This
shows up on pediatric protocols. The third number indicates which protocol you selected
out of that area. If only two numbers are displayed, this means you are using an adult
protocol and the second number indicates which protocol you selected from that area
(Figure 6-17).

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Building Protocols
Figure 6-17 Protocol Numbers
Area Number
Color Weight Zone Number

For pediatric scans only
Protocol Number
GE Area Numbers
Adults
Peds
21-30
31-40
User Area Numbers
Adults
Peds
1-10
11-20
Anatomical Selector
The Anatomical Selector area lets you decide if you want to
use a GE defined, User defined, Service defined, or a Most
Recent protocol. GE defined protocols are a list of protocols
the factory installs on your system. These protocols have been
used by physicians and radiologists on this type of system and
have worked well. User protocols are a list of protocols that you and your radiologist or
physician have built into your system. These protocols are custom protocols that your
radiologist or physician likes to use. Service protocols are used when your GE Service
Engineer needs to perform routine maintenance on your system. The Most Recent protocol
tab is an area where the parameters from the last 90 exams scanned are stored. Protocols
under GE and Most Recent tabs cannot be modified or deleted, but they can be copied into
the user selector in any of the adult or pediatric anatomical areas.
ECG Trace (Option)

ECG Trace provides the capability to display and view the ECG waveform on the operator
console. The ECG waveform is sent from the IVY 3150/IVY 3100 with Ethernet or IVY 3150-A
with Ethernet cardiac to the operator console. When the IVY monitor is set in Ethernet mode
and Ethernet cable connection exists between Ivy Monitor, gantry and Operator console. The
ECG Trace display is defaulted to off for Scout Scans unless enabled on in a protocol. Then
the ECG Trace is displayed in minimized format. Select the ECG Trace button below the
Gating button to enable display of the ECG Trace. The ECG monitor must be set to Ethernet
mode, not floppy mode for the ECG trace to display.
The ECG Trace display can be minimized or expanded (maximized) by clicking the size bar at
the front of the ECG Trace display.
The trigger point on the ECG Trace for each R-R interval will be displayed in red, the point or
percent in the R-R where the images are reconstructed is displayed in white, (Figure 6-18).

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Building Protocols
ECG Traces can be saved to CD-Rom using the Save ECG Trace feature in the Tool Bar on the
Image Works desktop when the IVY monitor is connected to the gantry, set in Ethernet mode
and ECG Trace/Viewer option is installed.
The ECG Trace for the last 500 cardiac gated series is stored on the system.
The ECG traces (waveforms) can be edited using the ECG Viewer in Retro Recon which
provides the capability to modify the R-peak trigger points. This can be useful to make
modifications to the locations of the triggers in the event an irregular heartbeat occurred
during the acquisition.
Figure 6-18 ECG Trace (waveform display)
Re-size Icon

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How Do I...
This section provides the step-by-step instructions for building, viewing, or editing protocols.
Specifically, it describes how to:
Delete an AutoVoice
Delete a Protocol
Use ECG Trace

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Every scan must start by selecting a protocol. Protocols save time by using preset
established factors, allowing you to start the scanning sequence as soon as possible. All
aspects of the exam including scanning, filming, and storing images can be established as
part of your protocols. Use the following instructions to complete new protocols or edit
existing protocols within the system.
1. From the scan monitor, click [Protocol Management].
The AutoVoice and Protocol Management window appears.

2. From the window, click [Protocol Management].
You now see the anatomical selector.

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NOTE: There is space for 90 protocols in each of the Adult anatomical areas. In the Pediatric
anatomical areas, there is space for 90 protocols each in Head, Neck and
Miscellaneous. For the seven color coded Pediatric anatomical areas, there is space
for 90 protocols in each of the nine different weight classifications. You have a total
of 6,840 available user selected protocols to build. If you wish to create, edit, or view
protocols in the pediatric selector, click [PEDIATRIC]. To return to the adult protocols,
click on the adult model.
3. Click [User].
This is used to build custom protocols for your site.
4. Select an anatomical region.
A space for up to 90 protocols opens (there may be existing protocols listed).
You can click the arrow up or down to view a list of 15 protocols at a time.
You can use the scroll bar to move quickly through all 90 protocols.
5. Click [New] or [Edit].
Select [New] if you have not built this protocol before.
Select [Edit] if you are making changes to an existing protocol.
6. Select an open area in the list and enter the name of protocol.
Any name may be used. It is helpful if you choose a name that reflects what the
protocol is meant to be used for (e.g., Routine Head, Trauma Spine, Chest/Abd/Pelvis).
If the protocol being built is to be the default (most commonly used) protocol, click
[Set As Default]. Only one protocol in each list can be set as the default.
NOTE: Default protocols can not be set in the pediatric color coded areas.
7. Select the type of series to be built from the window that appears.
In most cases, a scout series is built first because this allows for more precise
scanning. A scout must be programmed first if it is to be displayed automatically with
Show Localizer.
Auto mA and Smart mA require a scout to be acquired in order to generate a mA
table.
8. Click [OK].

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9. Set the proper patient position.
Place the mouse cursor at the head or feet of the model and click once to change
orientation. Place cursor over the abdomen area and click once to rotate model 90
degrees.
10. Select anatomical reference point.
Click [Anatomical Reference] and a window appears from which you may choose
one of the preset center points, or designate with a two letter abbreviation your
centering or 0 point.
11. Click [AutoStore] and/or [AutoTransfer].
Selecting [Auto Store] automatically transfers the image to a local storage device
such as Magnetic Optical Disk (MOD) media or remote storage device such as PACS,
when [End Exam] is selected.
Selecting [Auto Transfer] automatically sends images to one or up to four
destinations. The transfer can occur by image, by series or by exam
When selecting By Image, the transfer occurs in groups of 10 images. Only
prospective images are transferred when using this mode.
If transfer By Series is selected, the entire series is transferred when [Next Series]
or [End Exam] is clicked.
If transfer By Exam is selected, the entire exam is transferred when [End Exam] is
clicked. The series of images that are contained in the exam are transferred. This
means any Screen Save, Reformat, 3D, Navigator, Dentascan, Retrospective,
DMPR, Direct 3D images created before the exam is ended are transferred. The
Dose Report is automatically sent when Auto Transfer By Exam is selected.
Selecting [Dose Report Auto Transfer] automatically transfers the dose information
to up to four different locations. [Dose Report Auto Transfer] is used to transfer the
dose information when Auto Transfer By Image and By Series are being used
opposed to By Exam.

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NOTE: If you do not want the Dose Text Page auto transferred, select Auto Transfer By
Image or By Series. Do not select Auto Transfer by Exam.
12. Set Scout Parameters.
NOTE: Scout Parameters include Scout Image number, Start and End Locations to set the
length of the scout, technique factors of kV and mA, scout plane, and use of the
AutoVoice feature. Selecting an individual cell under a parameter column allows you
to adjust only the factor in that group. Selecting the parameter column from the top
row highlights all of the factors directly below the selected column and allows you to
adjust that factor in all of the images.
The number of scouts may be added to or deleted by selecting the scout number and
using the [Add Scout] or [Delete Scout] buttons.
Start Loc./ End Loc. are to set the amount of anatomical coverage needed for the
scout. The S designation stands for superior (toward the head) from the center point.
The I designation stands for inferior (toward the feet) from the center point,
regardless if the patient is oriented head first or feet first to the gantry.
Technique Factors for scout images are set low because scouts are normally used for
planning purposes only. 120kV and a low mA are common factors.
Scout Plane designates what type of scout is being acquired. Zero designates an AP
(supine) or PA (prone) scout. Ninety designates a lateral scout.
AutoVoice is used if you want the system to give the patient breathing instructions
while the scouts are acquired.
Click [AutoVoice] and a window appears.
Click the desired pre-recorded message.
Select Pre Set Delay if desired.
NOTE: The Auto Voice language displayed at the time the systems is booted up is the
defaulted language set by your Field Engineer initially.
If the Auto Voice Language is changed to use one of the preset autovoice
multi-language messages, the system will return to the default language once you
have clicked on [End Exam].
Auto Transfer by Series automatically transfers the series to the selected
destination.

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Figure 6-19 Scout Window
13. Click [Create New Series].

A window appears.
In most cases, you do not need another scout series, although this is an option.
14. Click [Axial] and [Create After].
This places the axial (or helical) series to follow the scout series in the protocol.

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15. Set Scan Parameters.
NOTE: The Scan Parameters include Patient Position, Anatomical Reference point,
AutoFilm Setup, AutoStore, AutoTransfer, Show Localizer, and Series Description.
The data acquired for all other series is different than data acquired for scout images.
This means that features such as Patient Position and AutoVoice must be set or
activated again for this series.
Set the proper patient position by placing the cursor at the head or feet of the model
and click to change the head first/feet first orientation. Place the cursor over the
abdominal area of the model and click to rotate the model in 90 degree increments.
Click [Anatomical Reference] and a window appears where you can choose one of
the preset center points or designate with a two letter abbreviation your center or 0
point. This should be set the same as your scout images.
Click [AutoFilm Setup] and a window appears where you may establish how the
filming is going to be set up.
NOTE: refer to the Set the Film Parameters for Automatic Filming task for more details.
Set Auto Store/AutoTransfer. If these features were set for the scout image, they are
automatically set for this series. If they were not selected for the scout series, they
may be activated in this series and the scout image(s) are included in the
storage/transfer. Click [AutoStore] and it automatically sends the image data to the
system storage device. Click [AutoTransfer] and a window appears. Click the IP
address to which the images are to be sent, click [OK].
Click [Show Localizer]. This will display a scout image on the display monitor in a 1 on
1 format with graphic representation of the start and end locations as well as
displaying a line for each image that is reconstructed. This allows for graphically
adjusting the protocol (adding or deleting slices).

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16. Set Technical parameters.
NOTE: Technical Parameters include Scan Type (axial/helical/cine-full/segmented/Cardiac

Option), Start and End Location, Number of Images, Thickness Speed (collimation),
Image Interval, Gantry Tilt, Scan Field of View (SFOV), kV, mA, Total Exposure Time,
Prep Group, interscan delay (ISD), Breath-Hold, Breathe Time, Auto Voice,
Voice/Lights/Timer. Selecting an individual cell under the parameter column allows
you to adjust only the factor for that group. Selecting the parameter column from the
top row highlights and change the parameters in all groups.
The Scan Type can be Axial, Helical, or Cine.
NOTE: If your scanner has CardIQ SnapShot cardiac options installed, the Scan Types will
include SnapShot Segment, SnapShot Burst and SnapShot Burst Plus.
NOTE: If your system has the option VariSpeed installed the rotation times will include , 0.5
seconds, 0.6 seconds, 0.7 seconds, and 0.9 seconds.
Axial scans may be acquired at gantry rotation times of 0.8 second, 1, or 2 seconds.
Typically, axial scans are used for routine head studies using a two second rotation
time. Axial scans may also be done as a sub-millimeter (0.625 mm) slice or with a
single 1.25 mm slice, which is useful for studies such as Hi-Res chests.
Helical scan type is used most frequently for a wide range of exam types.
Cine mode is used when one location needs to be scanned over a period of time such
as for a hemangioma.
Start and End Locations are set in millimeters superior to, and/or inferior from, the
anatomical reference point. The locations designate the points of anatomy to be
scanned. If specific numbers are known, select the correct button (Start or End) and
enter the value. The numbers must be preceded by the correct designation of S for
superior (towards the head) from the centering point, or I for Inferior (towards the
feet). The easiest way to set Start and/or End Locations is to graphically adjust
them. The slices are represented as a group of lines on the scout image. The start
location is demonstrated with a solid square in the middle of a line. The end location
is demonstrated by an open square box in the middle of a line.
To adjust, click and drag the appropriate square to the desired location. When the
mouse is released, the system automatically updates the value to the nearest
0.25 mm in the start or end location, depending on which value was adjusted. If

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the entire group of lines is to be adjusted, click and drag the X annotation in the
center of the lines to move all the lines together.
+ and - may be used as a substitute for S and I. S equals + and I equals -.
The Number of Images is determined by the combination of Start and End Location,
Slice Thickness, and Image Interval and set automatically by the system.
If a specific number of images are needed, select that cell and enter the desired
value. The system automatically adjusts the End Location for you and highlight
the End Location area in orange to let you know a change was made to the
parameters.
To set the slice thickness and speed, click [Thick/Speed] and a window appears.
Choose a slice thickness of 0.625 mm, 1.25 mm, 2.5 mm, 3.75 mm, 5.0 mm, 7.5
mm, or 10 mm. For axial scans, you choose between 1i, 2i, 4i, 8, or 16i depending
on system configuration. For helical, you choose between 2, 4, 8 or 16 Row Modes
depending on system configuration.
NOTE: For details on the different modes, refer to the Multi-Detector Information chapter for
your system.
The Image Interval is for helical scans only and is automatically set to match the
slice thickness by the system. This is known as contiguous (back to back) scans. If an
overlap or spacing (skip) is desired, click the image interval cell and enter the correct
value.
NOTE: If any of the values in Start/End Location, Number of Images, Slice Thickness, or Image
Interval are changed from the original value, the system automatically adjusts any
necessary values to maintain the scan. For example, if the number of images is
decreased, the system automatically adjusts the end location. The system highlights
any adjusted value in orange and changes any necessary graphic representations
on the scout. Refer to the Getting Started chapter for details.
The Gantry Tilt can be set manually or graphically to a maximum of 30 degrees in
half degree increments. The most common way to set the tilt is graphically. On a
lateral scout, you see circular handles on the Start and End locations.
Click and drag the circle to adjust the lines on the scout to the desired tilt. If a
specific tilt is wanted, select the feature button and enter the desired value.
C may be used in the Tilt field. Typing C enters the current gantry tilt in degrees.
NOTE: Maximum degree of tilt depends on the height of the table and interaction with
interference (collision) matrix. Use the Tilt/Table Travel button on the gantry keypad
to observe the min/max values for gantry tilt and table travel for the current
landmark.
The SFOV is set by selecting the SFOV parameter column or cell. A window appears
and the different SFOV values are there. The values are: Pediatric Head, Head, Small,
and Large. The Pediatric Head and Head SFOV are 25 cm in diameter with special
processing, Iterative Beam Operation - IBO noted in image annotation after the
reconstruction algorithm, to correct for beam hardening effects. The Pediatric Head

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SFOV is limited to a technique showed in Table 6-5 . The Large SFOV is 50 cm. Click
the appropriate SFOV or click cancel and the window closes.
Table 6-5 Maximum mA for PedHead
kV
BrightSpeed
BrightSpeed
Excel/Edge/Elite
Excel/Edge/Elite
Select
80
300
200
100
240
190
120
200
160
140
170
130
To set the kV, select [kV] and a window appears. The kV values of 80, 100, 120, and
140 are displayed. Select the desired factor or cancel and the window closes. The
most common kV factor used for routine scanning is 120kV.
To set the mA, click [mA]. Any mA value in increments of 5 starting at 10 and going to
350for 42kW systems, 250 mA for 30 kW systems, 440 for 53kW systems may be
entered in Manual mA. AutomA can be selected to provide consistent image quality.
To use AutomA, enter the AutomA values. Refer to AutomA for more information.
As with any x-ray exposure, mA x time is the mAs value. Appropriate exposure
values must be used to maintain image quality.
Select [SmartmA] if you wish to use this.A scout must exist and the orientation for
the series must match to be able to enable AutomA or SmartmA. For more
information on SmartmA refer to: SmartmA.
The Total Exposure Time is automatically set by the system and is determined by the
number of images and type of scan. This setting can only be changed by resetting
one of the other factors. The Total Exposure Time is useful for determining
breath-hold times, and contrast injection timing. If the scan type is helical, the
displayed Total Exposure Time is exactly what is shown. The Total Exposure Time lists
the x-ray on time only and does not reflect any ISD applied. When calculating
breath-hold times for axial scans, the ISD for each scan must be added to the
Exposure Time displayed to reflect the total amount of time the patient would need
to hold his/her breath.
The Prep Group feature is used to establish how long the system waits before turning
the x-ray on for a given group of scans. This delay can be used during initial contrast
injection, timing of auto voice instructions, or a delay to wait for structures to fill with
contrast.
To set the Prep Group, click the [Prep Group] parameter column or cell and enter
the appropriate value in seconds. The system starts to acquire the images after
the [Start Scan] button is selected and the Prep Group Delay counts down. It is
important to start the injection at the same time as starting the scan to insure
accuracy of when the IV bolus arrives in the appropriate anatomy. The valid

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ranges for Prep Group delays are: 1st group 0-90 seconds, group delay for axial is
1-300 seconds and helical is 5-300 seconds.
When the scan type selected is Axial, the feature ISD (Interscan Delay) is available.
To set the ISD, click the ISD parameter column or cell and enter the appropriate
value in seconds. This feature allows time for the table to move the correct
amount of millimeters set for the Image Interval. It can also be used to help with
tube cooling by increasing the value, extending the time between exposures
allowing the heat units to dissipate. Typically, the ISD is set at 1 second so the
exam is done as fast as possible. The valid range for ISD is 1-300 seconds. If
Helical or Cine scan type are selected, this feature is not available.
Breath-Hold is the setting for how long the patient must hold his/her breath for each
exposure.To set the breath-hold, click the [Breath-Hold] parameter column or cell
and enter the appropriate value in seconds. Breath-Hold and Breathe Time can be
used in conjunction in order to cluster scans within a group. The valid range for
Breath-Hold is N (None) or 0-60 seconds.
The Breathe Time is the setting to allow the patient to breathe normally between
breath holds.
To set the Breathe Time, click the [Breathe Time] parameter column or cell and
enter the appropriate value in seconds. If there is IV contrast being injected, it is
important to consider the appropriate length of this delay and its effect on patient
comfort. Breath-Hold and Breathe Time can be used in conjunction in order to
cluster scans within a group. The valid range for Breathe Time is N (None) or 0-60
seconds.
The Voice/Light/Timer feature is used so that the system will automatically give the
breathing instructions to the patient according to the Breath Hold, Breathe Time, and
Total Exposure Time. If the Total Exposure Time is less than the Breath Hold time, the
system uses only the time needed for the exposure. The Light and Timer features will
be visible on the gantry if these two features are selected for use. For more
information on the Voice/Light/Timer feature, see Set Timing Parameters. If the
Voice/Light/Timer feature was selected for the scout series, it must be selected for the
axial series as well.

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17. Set Recon Parameters.
NOTE: The Recon Parameters include DFOV, Right/Left Center (R/L), Anterior/Posterior
Center (A/P), Recon Type (algorithm), Matrix Size, Recon Mode, and Direct Visulation
Auto Applications.
The DFOV allows you to target a particular piece of anatomy for display on the
screen. The smallest DFOV is 9.6 cm. The maximum DFOV is always the same as the
selected SFOV.
To set the DFOV value, click the [DFOV] parameter column or cell and enter a
specific value. The DFOV may also be set graphically by using the diamond
handles on the Show Localizer Image. Click and drag the diamonds to expand or
contract the DFOV. The system automatically updates the value in the feature
area.
NOTE: With WideView recon option, the maximum DFOV is 65 cm. In GraphicRX as the DFOV
is increased beyond 50cm, the Scout image is minified to allow display of the
prescribed DFOV.
The R/L Center allows you to offset the center of the image for display. This is useful
if the patient is not positioned normally or if an offset structure such as the spine or
kidney is what you want centered.
To set the R/L Center, click the [R/L] parameter column or cell and enter a value in
millimeters starting with the correct designation of R or L. The range of values can
be from 0 to one-half the SFOV. Typically, you would not want the offset to exceed
one-half the DFOV or the resulting image does not show a right or left marker, it
does show markers as R-R or L-L. The R/L Center may also be set graphically by

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using the X annotation on the AP scout image reference lines. Hold down the Shift
key first, then click and drag the X to center over the area of interest.
+ and - may be substituted for R and L. R equals + and L equals -.
The A/P Center works the same way as the Right/Left Center using the lateral scout
image.
+ and - may be substituted for A and P. A equals + and P equals -.
The Recon Type sets the algorithm for reconstruction of the images.
To set the Recon Type, click the [Recon Type] parameter column or cell and a
window appears.
Select the appropriate algorithm. This sets the algorithm for the primary or first
reconstruction. The algorithms going from left to right increase spatial resolution
and decrease low contrast detect ability. The Bone Plus algorithm can be used for
any study that normally used bone algorithm but is very useful in cases where the
Edge algorithm was used. This is because the Bone Plus algorithm has no
reconstruction penalty and is very close in standard deviation to Edge.
NOTE: The system allows you to program up to three reconstructions of data from one
exposure. To set up the other reconstructions and phases (if needed), click [Show
Recon 2] and enter appropriate values in the parameter columns or cells. The [Show
Recon 3] button is now available if needed.
If you want to transfer Recon 2 and Recon 3 to another workstation, you can select
[Series Auto Transfer].
All three recons can be sent to a different place than set in the exam level transfer.
A Host window will pop-up.

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Building Protocols
Up to four locations can be selected.
The Matrix Size is a 512 matrix.

The Recon Options area is where you can select Recon Mode (Full or Plus) for the
acquisition, set the window/level and for Cardiac acquisitions select a Cardiac Filter
level. For more information, refer to Full and Plus Recon Modes covered earlier in this
chapter.
NOTE: Full and Plus recon modes are available only in the 8 and 16 row (detector) helical
modes.
NOTE: This selection is available on all Xtream based systems.

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Recon options window contains, Recon Mode, Window Width and Window Level
settings, and Cardiac Noise reduction filters if scan type is set for Cardiac Helical.
Window Width and Window Level values entered in the Recon Option window is also
added to film Set 1 in the Auto Film Tab Card.
Window/Level can be defined for the different groups on the Recon Tab.
The Recon Options area is where you can select Recon Mode (Full or Plus) for the
acquisition, set the window/level and for Cardiac acquisitions select a Cardiac Filter
level. For more information, refer to Full and Plus Recon Modes covered earlier in this
chapter.
18. Set the filming parameters.
NOTE: The Filming Parameters include AutoFilm (On/Off), Frame Format, Interval, Flip,
Window Width, Window Level, Mag. Factor, Rotate, User Annotation, Filter, and GSE
(Gray Scale Enhancement).
The AutoFilm feature must be turned on if the system is to display and film images in
the AutoFilm Viewport on the Display Monitor. The system defaults to off, so in
building new protocols or editing existing protocols it must be turned on.
To turn AutoFilm on, click [AutoFilm] then click the [AutoFilm] parameter column
or cell, and click [YES].
NOTE: If the selection is left in the Off position, images have to be filmed manually. Refer to
the Manually Filming Images chapter.
The Frame Format sets how many images are placed in each frame of the film
composer. You have the option of choosing 1 on 1, 2 on 1(vertical and horizontal), or 4

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on 1 formatting. Any option chosen is used for the entire film series, there is no option
to change format once the filming starts.
The Interval is used to tell the system which images is to be filmed. For every image
reconstructed to be filmed, enter 1. For every other image, enter 2. For every third
image, enter 3 and so on. The range is 1-5.
The Flip feature allows you to flip images Top/Bottom, Left/Right or both. This is
helpful when a patient is scanned in a prone or hanging head (i.e., supine coronal)
position.
To set Flip, click the [Flip] parameter column or cell and a window appears from
which you can choose the appropriate option.
The Window Width allows you to set the width level for filming. The image appears in
the AutoFilm viewport with this setting. It may be used or adjusted in the filming
viewport.
To set the Window Width, click the [Width 1] parameter column or cell and enter
the value desired. This setting is also stored in the image header for transfer to a
network receiving station. The range is 1 to 4096.
The Window Level allows you to set the window level for filming. The image appears
in the AutoFilm Viewport with this setting. It may be used or adjusted in the filming
viewport.
To set the Window Level, click the [Level 1] parameter column or cell and enter
the desired value. This setting is also stored in the image header for transfer to a
network receiving station. The range is -1024 to 3071.
NOTE: Recon Option is only available on Xtream based systems. The values entered for Film
Set 1 of each Recon is added to the Recon Option Window Width and Window Level
area or the values entered in the Recon Option window of each Recon is added to
Film Set 1 Window Width and Window Level area.
NOTE: For information on expanded CT number range, refer to: Expanded CT Number Range.
The Magnification Factor (Mag. Factor) allows you to establish a preset
magnification for each image for filming. The range is 0.5-2 (in 0.1 increments e.g.
1.1/1.2/1.3).
To set the Mag. Factor, click the [Mag. Factor] parameter column or cell and enter
the desired value.
The Rotate feature allows you to rotate images Right/Right or Right/left. This is
helpful if the patient is scanned in a decubitus position.
To set Rotate, click the [Rotate] parameter column or cell and a window appears
where you can choose the appropriate option.
The User Annotation (User Anno) feature allows you to place annotation(s) on each
image in a film series. This annotation appears in the middle of the cell above the

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Building Protocols
image. This is helpful to denote delayed studies or other unusual film sequences. It is
commonly used on spine studies to denote vertebral levels.
To set User Annotation, click the [User Annotation] parameter column or cell and a
window appears in which you can enter appropriate text.
The Filters feature allows you to use edge enhancement filters (to sharpen images)
or smoothing filters (to soften images) on every image in a film series.
To set Filters, click the [Filters] parameters column or cell and a window appears
where you can choose the appropriate option.
NOTE: For more information on filters and their use, refer to the Image Manipulations
chapter.
The Gray Scale Enhancement [GSE] feature allows you to change the gray scale
curve to enhance areas of low contrast such as the gray/white matter interface in
brain tissue, on every image in a film series.
To set the GSE click [GSE] parameter column or cell and a window appears from
which you can choose the appropriate option.
19. Use Additional Feature Buttons.
NOTE: These features cannot be built as a portion of a protocol. They can be used when
actually scanning a patient.
The Add Group feature allows you to insert another set of images following the prior
group with all of the same factors, except for Start/End location within the same
series. The start location of the new group automatically set contiguous to the end of

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Building Protocols
the prior group. The end location is determined by the number of slices, slice
thickness, and image interval.
To add additional groups, click [Add Group] and the new group is inserted. Every
click inserts another group.
The Split Current Group feature allows you to split a selected group into separate
groups. This is helpful for tube cooling issues or breath-holds.
To split a group, you must first highlight which group you wish to split by clicking
on the first box (with image numbers) at the start of the group. It highlights in a
bright blue color.
Click [Split Current Group] and a window appears from which you may choose to
split between selected slices or by location.
The Delete Selected Group feature allows you to remove an entire group from the
series.
To delete a group, you must first highlight the group to be deleted by clicking on
the first box (with image numbers) at the start of the group. It highlights in a bright
blue color.
Then click [Delete Selected Group] and the highlighted group is deleted.
The Smart Prep feature can be built into a protocol. Smart Prep is an excellent tool
for monitoring the peak enhancement of IV contrast injections. For details on the
SmartPrep option, refer to the SmartPrep chapter.

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Quick Steps: Build or Edit a Protocol

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
From the scan monitor, click [Protocol Management].

From the window, click [Protocol Management].
Click [User].
Select an anatomical region.
Click [New] or [Edit].
Select an open area in the list and enter the name of protocol.
Select the type of series to be built from the window that appears.
Click [OK].
Set the proper patient position.
Select anatomical reference point.
Click [AutoStore] and/or [AutoTransfer].
Set Scout Parameters.
Click [Create New Series].
Click [Axial] and [Create After].
Set Scan Parameters.
Set Technical parameters.
Set Recon Parameters.
Set the filming parameters.
Use Additional Feature Buttons.

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The system has three pre-recorded voice message sets in 9 selectable languages that
cannot be deleted. You may record up to 17 additional messages on your system. This
allows for consistent breathing instructions which assists in more precise timing in the
exam. Your system also comes equipped with microphones at the console and gantry for
communication with the patient.
1. From the Scan Monitor, click [Protocol Management].
A window appears with the choices of AutoVoice and Protocol Management.

2. Click [AutoVoice].
The AutoVoice menu appears with the three pre-recorded voice messages and 17
blank areas.

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3. To record a message, select a blank area, enter a name and press Enter.
Every selection must have a name. You probably want to title it so it is easily
identifiable (i.e., Mary S. Inspiration), that way you know whose voice is being used
and the content of the message, especially if the message entered is in another
language.
4. Click [Record] and begin message.
Click and hold [Record] until you are ready to begin your message. Normally, you are
recording a pre-message first, e.g., Take in a breath and hold it. When you release
the mouse button, the recording starts as indicated by the clock to the right of the
[Record] button. Begin your message right away. Speak clearly toward the
microphone located on the computer keyboard. Click [Stop] as soon as you finish
speaking. The total time of the message is displayed in the clock. If you make a
mistake, simply click [Stop] and then repeat these steps.
NOTE: It is very important to try to start and stop the recording as quickly as possible to
avoid adding time to the beginning or end of a message.
5. Click [Pre-Message].
Select the [Pre-Message] button next to the name you just entered. This highlights
the feature in blue.
6. Click [Save Message].
This enters the message to the system and enters the time in the Pre-Message Area.
7. Click [Record] and begin Post-Message.
Repeat the steps to record a message for post instructions (e.g. Breathe normally).
8. Click [Post- Message].
This highlights the area in blue.
9. Click [Save Message].
This enters the message to the system and enters the time in the Post-Message area.

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NOTE: If you wish to hear any recorded message, click on the selections Pre- or Postmessage to highlight it in blue. Go to the lower right corner of the screen to the
Message Management area and click play.
Quick Steps: Record a Personalized AutoVoice

1.
2.
3.
4.
5.
6.
7.
8.
9.
From the Scan Monitor, click [Protocol Management].

Click [AutoVoice].
To record a message, select a blank area, enter a name and press Enter.
Click [Record] and begin message.
Click [Pre-Message].
Click [Save Message].
Click [Record] and begin Post-Message.
Click [Post- Message].
Click [Save Message].

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The system has three pre-recorded voice message sets in 9 selectable languages that
cannot be deleted. You can select the desired language to use on your scanner.
A window appears with the choices of AutoVoice and Protocol Management.

2. Click [Auto Voice Record].
The AutoVoice menu appears with the three pre-recorded voice messages and 17
blank areas.

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3. Click [English-Male] and select the desired primary language from the AutoVoice
Language Selection window.
You can choose from nine different languages.

English-Male
English-Female
Japanese
French
German
Spanish
Mexican Spanish
Italian
Korean
Chinese
4. Click [Done].
Quick Steps: Select Default Language for AutoVoice 1, 2, and 3.


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Building Protocols
Quick Steps: Select Default Language for AutoVoice 1, 2, and 3.

2. Click [Auto Voice Record].
3. Click [English-Male] and select the desired primary language from the AutoVoice
Language Selection window.
4. Click [Done].

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The Preset delay adds a delay between the completion of the Auto Voice Pre-scan message
and X-ray on. This delay can be set per protocol.
1. To set the preset delay before the auto voice message is played, click the time next to
Preset Delay Time.
2. Click the desired preset delay from the popup window.

3. Click [OK].
Quick Steps: Change Pre-Set Delay for AutoVoice

1. To set the preset delay before the auto voice message is played, click the time
next to Preset Delay Time.
2. Click the desired preset delay from the popup window.
3. Click [OK].

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Delete an AutoVoice
It may be necessary to remove old or unwanted messages from the system as employees
change or as different languages are required.
A window appears with the choices of AutoVoice or Protocol Management.
2. Click [AutoVoice].
The AutoVoice menu appears with three pre-recorded voice messages and any that
have been saved to the system.
NOTE: The three pre-recorded messages cannot be deleted.
3. Select the title of the message to be deleted.
This highlights the selection in blue.
4. Click [Delete Set].
Quick Steps: Delete an AutoVoice

1.
2.
3.
4.

Click [AutoVoice].
Select the title of the message to be deleted.
Click [Delete Set].

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Use this procedure to copy protocols from the GE anatomical selector or Most Recent scans
into the User anatomical selection area. You can also copy a protocol within the User
anatomical selection window. Copy protocol can be used as a template to create different
protocols with minor adjustments.

2. Click [Protocol Management].
3. Select the anatomical selector you wish to copy from.

You can choose between GE, User, or Most Recent.
4. Select the protocol you wish to copy.
5. Click [Copy].

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6. Select the anatomical selector you wish to paste to.
You can only paste to User protocol selector. The [Paste] button is not available for
the GE or Most Recent selectors.
7. Select the area you wish to paste to.
8. Click [Paste].
The protocol is now copied to this area.
You can now use or edit this protocol.
NOTE: If you copy a protocol from the Most Recent area, check features like; Smart Prep,
Show Localizer, and other choices are good choices for the protocol.
9. To change the name of the protocol, click on the protocol to be renamed.
10. Enter the new name.
The protocol is renamed.
11. Click [Done] to exit.

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Building Protocols
Quick Steps: Copy and Paste Protocols

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.

Click [Protocol Management].
Select the anatomical selector you wish to copy from.
Select the protocol you wish to copy.
Click [Copy].
Select the anatomical selector you wish to paste to.
Select the area you wish to paste to.
Click [Paste].
To change the name of the protocol, click on the protocol to be renamed.
Enter the new name.
Click [Done] to exit.

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Delete a Protocol
Use this procedure to delete a protocol from your user defined list. This allows you to keep
your protocol list current by deleting any unnecessary protocols.

2. Click [Protocol Management].
3. Select the anatomical selector you wish to delete from.

You can only delete from the User or Service protocol selectors.
4. Select the protocol you wish to delete.
5. Click [Delete].
The protocol is deleted.
6. Click [Done] to exit.

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Building Protocols
Quick Steps: Delete a Protocol

1.
2.
3.
4.
5.
6.

Click [Protocol Management].
Select the anatomical selector you wish to delete from.
Select the protocol you wish to delete.
Click [Delete].
Click [Done] to exit.

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Use ECG Trace

ECG Trace provides the capability to display and view the ECG waveform on the operator
console. The ECG waveform is sent from the IVY 3150/IVY 3100 with Ethernet or IVY
3150-A/IVY 3100-A with Ethernet cardiac monitor when the IVY monitor is set in Ethernet
mode and Ethernet cable connection exists between Ivy Monitor, gantry and Operator
Console. The ECG Trace display is defaulted to off for Scout Scans unless display is turned on
in the protocol. Select the ECG Trace button below the Gating button to enable display of the
ECG Trace.
The ECG Trace display can be minimized or expanded (maximized) by clicking on the arrow
on the left side of the display.
The trigger point on the ECG Trace for each R-R interval will be displayed in red, the point or
percent in the R-R where the images are reconstructed is displayed in white, (Figure 6-18).
The BPM heart rate shown on the console is updated every 3 heart beats. The BPM heart
rate shown on the IVY 3150/IVY 3100 with Ethernet updated every 10 heart beats and on
the IVY 3150-A/IVY 3100-A with Ethernet every 3 heart beats.
1. From the scout View/Edit page, click [ECG Trace].
This will enable the trace.
2. Click the Minimize/Maximize icon.

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3. Make sure the IVY 3150/IVY 3100 with Ethernet or IVY 3150-A/IVY 3100-A with Ethernet
is to is set to ethernet mode.
If not, cycle power to the monitor after changing from data mode to ethernet mode.
Quick Steps: Use ECG Trace

1. From the scout View/Edit page, click [ECG Trace].
2. Click the Minimize/Maximize icon.
3. Make sure the IVY 3150/IVY 3100 with Ethernet or IVY 3150-A/IVY 3100-A with Ethernet
is to is set to ethernet mode.

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Chapter 7
SmartPrep
Introduction
This chapter explains SmartPrep. It contains the step-by-step instructions to help you learn
how to:
Set the SmartPrep Parameters
Scan the Baseline Phase
Scan the Monitor Phase
Scan the Scan Phase

7-1
SmartPrep

This section presents the concepts necessary to successfully utilize SmartPrep. Some of the
SmartPrep
Setting SmartPrep Parameters
Scanning the Baseline Phase
Scanning the Monitor Phase
Scanning the Scan Phase
SmartPrep
SmartPrep is a purchasable option. It is a feature that allows real-time monitoring of IV
Contrast enhancement in one particular section of anatomy that is in the area of interest.
The contrast flow is monitored by low dose scans until the contrast enhancement reaches
the preferred point and the operator initiates the scan prescription.
If SmartPrep is enabled for a series, the system cancels the AutoView display for any images
in the recon queue when the SmartPrep series is started. These images are selected from
the browser for review once they have been reconstructed. Only images from the series with
SmartPrep and those after the SmartPrep series are displayed in AutoView viewport.
Setting SmartPrep Parameters

When utilizing SmartPrep parameters controlling scan location, time between images,
enhancement values, technique factors and time to start the study must be set. The values
may be set as part of any protocol utilizing SmartPrep, or they may be set for individual
SmartPrep scans. Some values such as matrix and algorithm are not adjustable.
Scanning the Baseline Phase

The first phase is the Baseline Phase. In this phase a single unenhanced image is acquired in
the anatomy where the monitoring occurs and the Region(s) of Interest (ROI) is established.
Scanning the Monitor Phase

The second phase is the Monitor Phase. Using the same location as the Baseline Phase, up
to 40 low dose scans can be taken during the injection of IV Contrast. Using the established
ROI(s), the system displays a graph and the monitoring image to allow you to determine the
peak enhancement value.

7-2
SmartPrep
Scanning the Scan Phase

The third and last phase is the Scan Phase. This is the actual study as set in the scan
prescription. The Scan Phase is initiated by the operator when the IV enhancement,
determined by visual or preset Hounsfield unit, is achieved.

7-3
SmartPrep
How Do I...
This section provides the step-by-step instructions for Utilizing SmartPrep. Specifically, it
describes how to:
Scan the Scan Phase

7-4
SmartPrep

Setting the SmartPrep Parameters does not need to be done each time SmartPrep is used.
The parameters can be included in any protocol using SmartPrep. The system holds the last
values entered if SmartPrep is activated for an individual study. SmartPrep parameters
allow for checking the IV enhancement both visually and graphically.
1. After setting the scan Rx, on the view/edit screen click [SmartPrep Rx].
A pop up window appears with several areas to input ranges.

2. From the pop up window click [Off].
The system toggles to ON and highlight the area in bright blue.

3. Click [Show Localizer].
This puts the scout image for your scan in the display monitor with a single line
annotated on the image.

7-5
SmartPrep
4. Set the Monitor Location.
This may be done graphically by clicking and dragging the red X on the line in the
scout image to the desired location.
The location can also be entered in the Monitor Location area once you have
determined the specific value. The value must have an S or I designation. (refer to
Report the Cursor Location and the Pixel Value on how to get value using cursor).
+ and - may be substituted for S and I. S equals + and I equals -.
NOTE: This location is very important as this is where the monitoring images are scanned
and where the ROI(s) are placed.
5. Enter the mA.
The system defaults to a low mA value.
a) To change the value select the mA area and enter the desired setting. You want to
use low mA to keep heat units to a minimum. The usual range is around 40 mA for
most studies.
6. Enter the Monitoring Delay.
Select the Monitoring Delay area and enter the desired value. This value determines
how long the delivery of IV contrast is allowed to take place prior to the monitoring
images being acquired. This is generally set to start well in advance of the expected
or average time of enhancement (10-15 seconds for arterial studies, 30-45 seconds
for venous/routine exams). The range is 0-60 seconds in 0.1 second increments.
7. Enter the Monitoring ISD (Interscan Delay).
This sets the time between monitor images being acquired. The range is 1-60
seconds in 0.1 second increments. Use less time between images for arterial studies
and more time for venous/routine studies. There are 40 images available for
monitoring images.
8. Enter the Enhancement Threshold.
Measured in Hounsfield units, this is the difference between the desired threshold
value and the pre monitoring threshold ROI. (i.e. pre monitoring ROI in a liver is 30
Hounsfield units and the desired contrast enhancement value is 70 units; the
Enhancement Threshold would be set to 40).
9. Enter the Diagnostic Delay.
This value allows time for the table to move into the Scan Phase Start Location and to
ready the system for the Scan phase. This is generally set to three seconds for arterial
studies and five seconds for venous/routine studies. The range is 3-60 seconds in 0.1
second increments.
The delay time selected needs to include time for the initial breathing instructions to
the patient.

7-6
SmartPrep
NOTE: Once the scan phase is initiated, the operator must give the first breathing instruction
to the patient. The system automatically gives all other instructions if AutoVoice has
been set for the study.
Figure 7-1
The diagnostic delay is updated at confirm to adjust for table movement between
the Monitor location and the Scan Phase Location. If the diagnostic delay is less than
the time required to move the table from the Monitor location to the Scan Phase
location, a dialog is posted at confirm indicating what the Diagnostic Delay will be.
10. Click [Continue] or [Cancel].
Selecting [Accept] confirms any changes to the SmartPrep parameters and returns
you to the view/edit screen.
Selecting [Cancel] returns you to the view/edit screen and closes the pop up window.
It does not cancel SmartPrep Rx.
Quick Steps: Set the SmartPrep Parameters

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
After setting the scan Rx, on the view/edit screen click [SmartPrep Rx].
From the pop up window click [Off].
Click [Show Localizer].
Set the Monitor Location.
Enter the mA.
Enter the Monitoring Delay.
Enter the Monitoring ISD (Interscan Delay).
Enter the Enhancement Threshold.
Enter the Diagnostic Delay.
Click [Continue] or [Cancel].

7-7
SmartPrep

The initial phase for SmartPrep is called the Baseline Phase. This phase is done prior to any
IV contrast injection in order to acquire a single image, that is used to establish the baseline
region of interest (ROI).
1. On the view/edit screen click [Confirm].
2. A warning message displays.
The diagnostic delay is updated at confirm to adjust for table movement between
the Monitor location and the Scan Phase Location. If the diagnostic delay is less than
the time required to move the table from the Monitor location to the Scan Phase
location, a dialog is included in the warning message pop-up at confirm indicating
what the Diagnostic Delay will be.

7-8
SmartPrep
3. Click [Continue].
The system displays the Scan Progress screen. The display shows the dynaplan for all
three phases, Baseline, Monitor, and Scan.
4. On the keyboard press [Move to Scan].
This takes the table to the Monitoring Location.
5. On the keyboard press [Start Scan].
This acquires the baseline image at the monitoring location.
When the image is reconstructed, you see a one on one display of the image on the
display monitor. To the left of the image is six SmartPrep display features available to
use on the image. These features are Zoom (2x), Display Normal, Ellipse ROI, Hide
Graphics (toggle to hide/show graphics), Erase, Explicit Mag (range 0.5-2.0).
6. Place Ellipse ROI in an area of interest.
You can now put up to three ROIs on an area of interest by selecting the Ellipse ROI
feature from the SmartPrep display area. For example, if you are interested in
evaluating the liver parenchyma, put the ROI in the liver so that it is not touching any
vessels. If you are interested in evaluating a vessel, put the ROI on the vessel of
interest.
Quick Steps: Scan the Baseline Phase

1.
2.
3.
4.
5.
6.
On the view/edit screen click [Confirm].

A warning message displays.
Click [Continue].
On the keyboard press [Move to Scan].
On the keyboard press [Start Scan].
Place Ellipse ROI in an area of interest.

7-9
SmartPrep

The Baseline phase acquires one non contrast scan and allows you to establish an area to
monitor contrast enhancement. The Monitor phase acquires images at the monitoring
location during the delivery of intravenous iodinated contrast material and graphically
displays the images, charts the enhancement thresholds and displays a clock with the time
since monitoring began.
1. On the Scan Progress screen click [Monitor Phase].
2. On the keyboard press [Start Scan] and start the injection of IV contrast at the same time.
The system waits the time set in the Monitoring Delay area and then begin acquiring
images at the time set for the inter-scan delay (ISD).
NOTE: There is a maximum of 40 monitoring images available.
3. On the Display Monitor watch the four on one display for the monitoring activities.
The upper left quadrant shows the baseline image with the ROI(s).
The upper right quadrant shows the real time monitoring image as it reconstructs
along with the ROI(s).
The lower left quadrant shows a real time enhancement threshold graph comparing
the ROIs of each monitoring scan versus the time from the start of the monitoring
delay.

7-10
SmartPrep
NOTE: On the graph is a horizontal line denoted by a T. This represents the numeric
enhancement threshold that was entered from the SmartPrep prescription. If an ROI
was not placed on the baseline image this line does not appear.
The lower right quadrant shows, in real time, the time that each monitoring scan was
acquired based on the beginning of the monitoring delay as well as showing the ROI
values for each scan.
The lower right quadrant also displays an elapsed time clock. This displays, in real
time, the time from when Start Scan was selected for the monitor phase until the
Scan Phase icon was selected. This is the inject to scan delay for this series of scans.
4. When the desired enhancement threshold is achieved click [Scan Phase].
The table moves to the scan prescription start location and, based on the Diagnostic
Delay selected, the scan prescription is started.
When the line representing the ROI of interest is close to or on the line denoting the
preset enhancement threshold value, you may click [Scan Phase] to initiate the scan
prescription.
You can also click [Scan Phase] based on your observation of the real time
monitoring images, if those images show adequate contrast in the area of interest.
NOTE: If all forty monitoring scans have been utilized it is necessary to use the Move To Scan
and Start Scan buttons on the keyboard to place the table in position and initiate the
scan prescription.
Quick Steps: Scan the Monitor Phase

1. On the Scan Progress screen click [Monitor Phase].
2. On the keyboard press [Start Scan] and start the injection of IV contrast at the same
time.
3. On the Display Monitor watch the four on one display for the monitoring activities.
4. When the desired enhancement threshold is achieved click [Scan Phase].

7-11
SmartPrep
Scan the Scan Phase

The Scan Phase is the start of the actual Scan Prescription following the Monitor Phase.
1. On the Scan Progress screen click [Scan Phase].
The table moves to the scan prescription start location and, based on the Diagnostic
Delay selected, the scan prescription is started.
The real time updating of information in the quadrants is stopped.
A screen save image of the quadrant is captured by the system for later review if
needed.
NOTE: The system places the baseline image, the monitoring images and the screen save
image with the exam in the browser. These images are denoted as series 200
prospective and screen save images. If an additional baseline image was acquired
these images are in series 201.
NOTE: The initial breathing instructions to the patient for the start of the exam scan
prescription must be delivered by the operator during the Diagnostic Delay. The
system then provides the rest of the breathing instructions if Auto Voice has been
selected.
Quick Steps: Scan the Scan Phase

1. On the Scan Progress screen click [Scan Phase].

7-12
VariSpeed (Option)
Chapter 8
VariSpeed (Option)
Introduction
This chapter explains the choices available in the purchasable option known as VariSpeed
for BrightSpeed Excel, BrightSpeed Edge, and BrightSpeed Elite systems. VariSpeed allows
the system to operate at new sub-second rotation speeds. This chapter contains
Use VariSpeed

8-1
VariSpeed (Option)

This section presents the concept necessary to understand VariSpeed utilization. The
concept you will need to understand is:
VariSpeed
VariSpeed
VariSpeed is a purchasable option that allows the system to operate utilizing various
sub-second rotation times. The rotation times in this package are 0.5 seconds, 0.6 seconds,
0.7 seconds, and 0.9 seconds. The variability of the rotation times gives you the ability to
adjust the parameters for patient size and different applications. For scanning a medium or
average sized patient for an abdominal study, the 0.5 second rotation time provides
adequate mAs for image quality. For a larger patient you may need to use the 0.6 or 0.7
second rotation time. Both studies would be completed using sub-second rotation times
because of the flexibility in having the various rotation times.

8-2
VariSpeed (Option)
How Do I...
This section provides the step-by-step instructions for using VariSpeed. Specifically, it
describes how to:
Use VariSpeed

8-3
VariSpeed (Option)
Use VariSpeed
VariSpeed is a purchasable option that allows the system to operate using various
sub-second rotation times. The rotation times in this package are 0.5 seconds, 0.6 seconds,
0.7 seconds, and 0.9 seconds. The variability of the rotation times gives you the ability to
adjust the parameters for patient size and different applications.
1. From the view/edit screen, click [Scan Type].
A pop up window appears.
2. Select rotation time from options listed.

All times will be available for axial.
The two second, three second, and four second times will be gray text and not
available for both helical and cine.
3. Click [Accept] or [Cancel].
[Accept] will utilize the selected parameters.
[Cancel] closes the pop up window. Any parameters set within the protocol will be
utilized.
Quick Steps: Use VariSpeed

1. From the view/edit screen, click [Scan Type].
2. Select rotation time from options listed.

8-4
Prospective Gating (SmartScore)(Option)
Chapter 9
Prospective Gating
(SmartScore)(Option)
Introduction
This chapter outlines the process for setting up a prospectively gated unenhanced
(non-contrast) acquisition for calciumscoring. It contains the step-by-step instructions to
help you learn how to:
Set the Exam Prescription for Prospective Gating (SmartScore)
The procedure for using Prospective Gating (SmartScore )in conjunction with calcium
scoring includes the following operator and system actions:
Patient and ECG monitor set up
Cardiac exam prescription and confirmation
Automatic system preparation
Scanning initiation
Image transfer to Advantage Windows workstation
SmartScore on Advantage Windows workstation
The exam prescription is described here. Information on patient set up, ECG monitor set up,
image management, and scoring can be found in the separate SmartScore documentation.

9-1

This section presents the concept necessary to understand the use of Prospective Gating
(SmartScore). The concepts you need to understand are:
Prospective Gating (SmartScore)
R to R interval
ECG (or EKG) Waveform
Prospective Gating (SmartScore)

This feature is designed to acquire prospective ECG gating measurements, which provide
information that is valuable for scan timing. Using the measurements, the system
synchronizes the collection of data used for scoring with the cardiac cycle.
Specifically, prospective ECG gating measures the timing between patient heart
contractions in order to trigger scanning at moments of relaxation (diastolic phase of heart
action). Because the gating measurements determine scan timing, they improve the data
acquisition process. The quality of the resulting images is enhanced, and therefore fewer
images are required. Acquiring fewer images means less x-ray exposure for the patient.
Prospective Gating (SmartScore) requires the selection of cine scanning. Prospective Gating
is not compatible with axial or helical scan types. It is limited to patients with a normal
resting heart rate of up to 90 beats per minute for best results with the calcium scoring
application. It also requires the use of an ECG monitor, which is connected to the
BrightSpeed system.
R to R interval
Images used for Prospective Gating (SmartScore) are acquired during the R to R interval. The
R to R interval is the time between maximum patient heart contractions (R wave peaks). For
example, the R to R interval is 660 milliseconds for a resting heart rate of 90 beats per
minute. See below for more information on the cardiac cycle.

The ECG (or EKG) waveform represents the electrical activity of the heart that correlates to
heart motion:
Cardiac contraction is called systole.
Cardiac relaxation is called diastole.
Three waveform elements are critical to cardiac gating:

9-2
P-wave
Represents depolarization of the atria and results in contraction or systole of the
atria.
QRS complex
Represents depolarization of the ventricles and results in contraction or systole of the
ventricles.
R-wave is used for triggering because of its strong electrical signal and correlation
of the muscle activity of the heart.
The R-R interval is the time between the peak of one R-wave and the peak of the
next. Each R-R interval represents the length of one cardiac cycle.
T-Wave
Represents re-polarization of the ventricles and results in relaxation or diastole of the
ventricles.
Figure 9-1 ECG with Triggers
Figure 9-2 ECG without Triggers
Ventricular systole extends from the R-peak to the T-Wave when the heart is contracting
and expelling blood.
Ventricular diastole extends from the T-Wave to the R-peak. During diastole, the
ventricles fill with blood.

9-3
How Do I...
This section provides the step-by-step instructions for using Prospective Gating
(SmartScore). Specifically, it describes how to:
Set the Exam Prescription for Prospective Gating (SmartScore)

9-4
Set the Exam Prescription for Prospective Gating

(SmartScore)
1. Set up the patient and monitor, and place ECG leads in recommended location on the
patient.
For more information refer to: Patient Skin Preparation & Electrode Placement.
NOTE: The GE recommended electrodes are Dyna/Trace1500 by ConMed.
Make sure a good signal is detected on the ECG monitor in the scan room.
Electrodes should be radiolucent with silver/silver chloride gel, with fresh gel adhere
to the patient and be able to maintain good contact during table movement.
Use Dyna/Trace1500 electrodes by ConMed. Information of where to order these
electrodes is found on the top of the IVY monitor.
Use electrodes made for short term monitoring (e.g. exercise monitoring). Do not use
electrodes used for long term monitoring.
2. Enter patient information on the New Patient screen.
3. Prescribe an PA (180 degree) and Lateral (90 degree) scout scan.
4. To verify that the scanner is receiving the ECG signal, click [Gating Off] on the view/edit
screen.
Figure 9-3
If the system detects a valid ECG signal, the patients heart rate in Beats Per Minute
(BPM) is displayed on the Gating button. BPM displayed is a 3 cycle average of the

9-5

patient's heart rate. The ECG waveform for the patient can be displayed by clicking
on [ECG Trace] after a BPM is displayed.
If the system detects no signal from the ECG monitor, the button turns red and no
BPM value is displayed. In this scenario, reevaluate ECG connections to patient and
monitor to gain ECG signal before continuing
5. Perform the scout scan.

NOTE: It is important to give the patient the same breathing instructions for the scout scans
as are given for the Cine Scan Type acquisition. The patient should be requested to
take several breaths in and out before holding breath while the actual scan is
acquired. This helps provide a more consistent heart rate during the acquisition of
the SmartScore images.
6. Prescribe the cine scan parameters.
Scan Type: Cine, Segmented , 0.5 second
Start Location: Level of the carina
End Location: Base of the heart
Thick/Speed: 2.5mm/4i
Interval: 10.0
Cine Duration: System automatically update the value based on the number of
images per R to R and the time between images that is prescribed.
Gantry Tilt: S0
SFOV: Large
kV: 120
mA: Average patient 370, Large patient 390
Breath Hold: Set to No
Prep/Group Delay: 0.0 (only allowed if breath hold is set to No)
ISD (sec): 1.0 second

9-6

7. Click [Gating] to turn on Prospective Gating (SmartScore).
The SmartScore Pro (Prospective Gating (SmartScore)) screen is displayed.
8. On the SmartScore Pro pop up, click [Off] to turn gating on.
9. Review and/or change parameters on the SmartScore Pro pop up screen as necessary.
The R to R interval is displayed in BPM in the R to R Interval field.
The R to R interval is displayed in milliseconds directly below the BPM entry. The
R-to-R interval is updated based on an average over a period of 3 cardiac cycles.
The center R-Peak Delay (%) is defined as a percentage of time between 2
consecutive R-peaks. The default value is 70%, which should be in the diastolic phase
in order to minimize occurrence of cardiac motion. The time, in milliseconds,
displayed directly below the Center R-Peak Delay (%) identifies the amount of time

9-7

after the preceding R-peak that aligns with the Trigger Delay percent for the patient's
displayed heart rate.
Time Between Images is the temporal interval in milliseconds that is prescribed
between images generated at the same image location.
a) Select either [50] or [100] from the pop up menu.
Images per R-to-R Interval defines the number of images reconstructed per image
location for each heart cycle. You have a scan at that location that lasts X duration,
and out of that data you reconstruct images at a time interval of either 50 or 100
milliseconds.
b) Select either [1], [3], or [5] from the pop up menu.
The number of images that can be acquired depended upon the R to R Interval of the
patient.
The middle slice of the group is taken at the point of the Trigger Delay. The remaining
images, if more than one, are reconstructed at either 50ms or 100ms intervals before
and after the middle image.
If the point to begin data acquisition is too short for the hardware to start after the R
to R wave, the system skips one beat and begin in the next R to R wave.
10. Click [Accept] on the SmartScore Pro pop up menu to continue with prospective gating
(SmartScore) or click [Cancel].
NOTE: It is important to give the patient the same breathing instructions for the scout scans
as are given for the Cine Scan Type acquisition. The patient should be asked to take
several breaths in and out before holding breath while the actual scan is acquired.
This helps provide a more consistent heart rate during the acquisition of the
SmartScore images.

9-8
Quick Steps: Set the Exam Prescription for Prospective Gating

(SmartScore)
1. Set up the patient and monitor, and place ECG leads in recommended location on the
patient.
2. Enter patient information on the New Patient screen.
3. Prescribe an PA (180 degree) and Lateral (90 degree) scout scan.
screen.
5. Perform the scout scan.
6. Prescribe the cine scan parameters.
7. Click [Gating] to turn on Prospective Gating (SmartScore).
8. On the SmartScore Pro pop up, click [Off] to turn gating on.
9. Review and/or change parameters on the SmartScore Pro pop up screen as
necessary.
10. Click [Accept] on the SmartScore Pro pop up menu to continue with prospective gating
(SmartScore) or click [Cancel].

9-9

9-10
Cardiac Imaging
Chapter 10
Cardiac Imaging
Introduction
This chapter explains the cardiac imaging (CI) scanning process for BrightSpeed Excel,
BrightSpeed Edge, and BrightSpeed Elite systems. It contains the step-by-step instructions
to help you learn how to:
Set Up a Patient
Scan the Patient

Scout Scans
Localizer Scan
Timing Bolus Scans
Enhanced Cardiac Scan
Reconstruct Cardiac Scans
NOTE: The maximum number of images in a series is 3000 for prospective and retrospective
series. How images are put in different series based on how they are reconstructed.

10-1
Cardiac Imaging

This section presents the concepts necessary to successfully complete the cardiac imaging
process. Specifically you need to understand:
Prior to Scanning
Cardiac Helical
SnapShot Segment
SnapShot Burst
SnapShot Burst Plus
CardIQ SnapShot Window
Auto Detection of Heart Rate
Manual Detect Heart Rate
Pitch
Phase Location
% R-Peak Value
SnapShot Mode Usage
ECG Modulated mA
Scan Preparation
Patient Preparation
Patient Skin Preparation & Electrode Placement
Alternate Electrode Positions for Signal Clarity
Scan Parameters Usage

Scout Scan
Localizer Scan
Timing Bolus Scan
Cardiac Helical Scan
Cardiac Series Retro Reconstruction Numbering

Single Phase Image Set
Multiphase Image Set
Cardiac ECG-gated Images are annotated with either of the following:

10-2
Cardiac Imaging
Prior to Scanning
Before initiating a scan, it is extremely important to check the ECG trace on the scanner
console and ECG trigger monitor to make sure the waveform is clean and ECG-gating is
triggering properly. In cardiac imaging, there is a dependency on the patient specific heart
rate as input to ECG gated exam completion.
ECG-gating is considered correct if the R-peak is pronounced and clearly distinguishable
from the remainder of the waveform (i.e. no other elevated segments) and the red trigger
line is shown on the R-peak of the QRS complex on the ECG waveform.
If these conditions are not met, reposition the electrodes as per recommendations in the
Patient Skin Preparation & Electrode Placement section of this guide.
Figure 10-1 ECG Trace
The figures below demonstrate varying electrocardiograms (ECG) similar to the waveforms
that could be seen from connecting the leads of the cardiac trigger monitor to the patient
for an ECG-gated CT acquisition. These show an expected normal or typical waveform
(Figure 10-2), a suboptimal noisy waveform (Figure 10-3), a suboptimal elevation in T-Wave
amplitude (Figure 10-4), and an irregular spacing between the R-Peaks creating an
arrhythmia (Figure 10-5).

10-3
Cardiac Imaging
Figure 10-2 Normal ECG Trace
Figure 10-3 Noisy ECG Trace
Figure 10-4 ECG Trace with Elevated T-Waves
Figure 10-5 ECG Trace with Arrhythmia

10-4
Cardiac Imaging
If the waveform is noisy as shown in Figure 10-3 below, please refer to Patient Skin
Preparation & Electrode Placement to ensure the optimal conditions are being met.
Additionally, confirm all cables are properly connected and ECG monitor is positioned away
from the table and gantry.
If the waveform has elevated T-waves, as in Figure 1-7, do the following:
Confirm electrode placement, or
Try to place the electrodes more laterally on clavicles or on the arms, or
Use the Alternate Electrode Positions for Signal Clarity in Figure 10-15.
Refer to Patient Skin Preparation & Electrode Placement.
If this does not yield a more normal waveform (Figure 10-2), try changing the measurement
Lead on the ECG monitor from Lead 2 to Lead 1 or Lead 3.
Avoid scanning patients with known arrhythmias. If arrhythmias (including pre-ventricular
contractions, or extra systole), as seen in Figure 10-5, are seen when reviewing the ECG
trace prior to scanning, attempt to regulate the heart rhythm (e.g. practice breathing
instructions, calm the patient, or follow procedure established by your institution). It is not
advised to scan a patient with arrhythmias as image quality may be degraded.
If you do not see the RED line on the R-peak, but somewhere else, it is advised to make the
appropriate adjustments to the electrode placement, monitor settings and equipment to
ensure proper gating on the R-peak. The white area represents the Reconstruction window
of 75 % R to R interval used for the first set of images reconstructed.
Cardiac Helical
Cardiac Helical is a low-pitch ECG-gated helical acquisition mode where the pitch value is
set based on the patient's heart rate. The range of pitch values varies based on both the
gantry speed and the scanner configuration. The patient's heart rate must be within the
range of 30-200 BPM for the system to allow scan confirmation.
NOTE: If Start Scan times out or you need to pause scan and resume, make sure to review
the patient's heart rate before you resume/reconfirm the scan. The heart rate may
have changed from the value you originally confirmed and a different pitch might be
used for the scan. In cardiac scanning, confirm the acquisition only when you are
ready to proceed.
Move to Scan is valid for 180 seconds while Start Scan is only valid for 30 seconds
before it times out.
The pitch selected is based on the patients heart rate on the console at the time that the
"confirm" button is selected on the view/edit screen. Therefore it is very important to be
aware of what the pitch is set to prior to confirming the scan. If you want to use a smaller
pitch other than what the scanner is detecting for the HR, you will need to use the HR
override button located in the gating area.

10-5
Cardiac Imaging
SnapShot Segment
SnapShot Segment is an acquisition and reconstruction method used to generate
retrospectively ECG-gated images using data from one cardiac cycle in a half-scan
reconstruction technique.
The temporal resolution that results depends on the gantry speed used. For SnapShot
Segment single sector reconstruction, the fastest gantry speed available should be used in
order to optimize the temporal resolution.
Images acquired with SnapShot Segment are annotated SSEG.
SnapShot Burst
SnapShot Burst is a reconstruction method used to create retrospectively gated images
from two cardiac cycles within the same phase of the heart cycle. Burst imaging produces
images with improved temporal resolution due to the combining of data from 2 cardiac
cycles.
SnapShot Burst image reconstruction is recommended to be used for patient's whose heart
rate is higher than the SnapShot Segment range listed above. (Please see previous tables for
specific ranges at each scanner configuration.) The temporal resolution will vary depending
on the heart rate and scanner configuration. Please note, SnapShot Burst reconstruction will
optimize temporal resolution across the image set based on the scan acquisition
parameters. Resulting images will be annotated SSB2 indicating that data from 2 cardiac
cycles was used, or SSEG when resulting acquisition parameters yield single sector images.
SnapShot Burst Plus

SnapShot Burst Plus is an acquisition and reconstruction method used to generate
retrospectively ECG-gated images using data from up to 4 consecutive cardiac cycles. Burst
Plus imaging yields improved temporal resolution for patients with high and stable heart
rates.
SnapShot Burst Plus imaging may be useful for patient's with heart rates elevated beyond
the SnapShot Segment and SnapShot Burst heart rate ranges. (Please see charts above for
each scanner configuration.) The gantry rotation speed will be automatically updated based
on the heart rate. For SnapShot Burst Plus imaging it is required to enter a value in the Heart
Rate Override button on the view/edit screen. The heart rate entered should be the lowest
heart rate expected to occur during the scan acquisition.
SnapShot Burst Plus images will be annotated SSB4, SSB3, or SSB2 to indicate the number of
cardiac cycles that contributed to each image. Some images may be annotated SSEG if
parameters varied such that only one cycle was available.

10-6
Cardiac Imaging
NOTE: If the patient HR varies unexpectedly during the scan, and ungated images result,
these images will be annotated 'SEGM' on the axial images. In order to optimize
cardiac helical imaging results, always watch the patient heart rate during the
pre-scans and practice breath hold to ensure cardiac helical acquisition parameters
are optimized to meet the minimum expected heart rate.
CardIQ SnapShot Window

When you click [Gating], the CardIQ SnapShot window opens.
Figure 10-6 CardIQ SnapShot Window
Table 10-1 This table provides a description of each function in the CardIQ window
Function
Descriptions
Heart Rate
Monitoring
This button toggles [On] or [Off]. This button defaults to [On] which allows
the scanner to capture the ECG signal. This needs to be on in order to do a
cardiac scan.
Heart Rate
Override
This button toggles [On] or [Off]. This is defaulted to [Off]. If you click [On],
you can manually enter the patients heart rate which forces the system to
override the detected heart rate and set the pitch to the heart rate you
entered.
NOTE: This is defaulted [On] for SnapShot Burst Plus scanning.
R to R
Interval
This displays the heart rate in beats per minute. This is updated based on
the average of 2 R to R intervals.

10-7
Cardiac Imaging
Function
Descriptions
R-Peak
Delay
This controls the cardiac phase location of a given reconstruction. It refers

to the center of the reconstruction window in terms of a percentage
distance between any two successive R-Peaks given from the ECG.
Heart Rate
Use this to manually enter a patients heart rate for patients whose heart
rates vary during breath holds. You can only enter a value when the Heart
Rate Override button has been toggled [On]. This is a mandatory entry for
SnapShot Burst Plus scanning.
[Accept]
This accepts the parameters that you entered and returns you to the view
edit screen.
[Cancel]
This closes the window without accepting any changes.

The ECG (or EKG) waveform represents the electrical activity of the heart that correlates to
heart motion.
Cardiac contraction is called systole.
Cardiac relaxation is called diastole.
Three waveform elements are critical to cardiac gating.
P-wave
Represents depolarization of the atria and results in contraction or systole of the
atria.
QRS complex
Represents depolarization of the ventricles and results in contraction or systole of the
ventricles.
R-wave is used for triggering because of its strong electrical signal and correlation
of the muscle activity of the heart.
The R to R interval (Figure 10-7) is the time between the peak of one R-wave and
the peak of the next. Each R to R interval represents the length of one cardiac
cycle.
T-Wave
Represents repolarization of the ventricles and results in relaxation or diastole of the
ventricles.

10-8
Cardiac Imaging
Figure 10-7 ECG with Triggers
Figure 10-8 ECG without Triggers
Ventricular systole extends from the R-Peak to the T-Wave when the heart is contracting
and expelling blood.
Ventricular diastole extends from the T-Wave to the next R-Peak. During diastole, the
ventricles fill with blood.
CAUTION:
There is a possibility that the ECG signal may not be detected by the scanner
due to improper lead placements or a lead falling off during the scan. It is
important to place new leads on the patient before the scan. Make sure the
leads are attached properly.
CAUTION:
Ensure the ECG patches are not past expiration date and that the gel on the
pads is still moist for proper conduction of the ECG signal for successful
gating.

10-9
Cardiac Imaging
Auto Detection of Heart Rate

Automatic detection of heart rate can be performed in any ECG-gated scan mode, such as
cardiac helical or gated cine. When performing cardiac imaging, the scanner must be able
to detect the heart rate of the patient. This is accomplished by connecting the ECG monitor
to the scanner and applying ECG electrodes to the patient and enabling Gating on the
view/edit screen. Once the ECG monitor is on and the signal is being read from the patient,
the heart rate will be displayed on the scanner console and scan parameters, such as pitch
for helical will be optimized. The auto detect scanning method is used for patients with a
stable resting heart rate that is maintained during breath hold and contrast injection as
seen from the pre-scans, and is the default parameter for most cardiac exams. Under the
auto detection method, the Heart Rate Monitoring button is [On] and the Heart Rate
Override button is [Off].
Manual Detect Heart Rate

Manual detect Heart Rate is an optional monitoring feature where you can decide to
manually enter (override) the heart rate instead of using the auto detected heart rate. The
heart rate you enter is based on the heart rate observed during practicing of breath holds
and pre-scans. For instance, if the heart rate is at 65 BPM at rest then changes to 55 BPM
while the patient is holding their breath, manual detect would be recommended. To enable
manual detect you must click on [Gating] and then toggle Heart Rate Override [On]. Enter
the desired heart rate in the Heart Rate text box. The default heart rate value for manual
detect is 0 BPM. Heart Rate Override should be used If the heart rate increases or decreases
more than 10 BPM for a breath hold. This entry is compulsory in SnapShot Burst Plus
scanning mode.
The heart rate entered in Heart Rate Override should always be the minimum value in HR
Range for the lowest heart rate expected for the patient which was seen during breath hold
practice, scouts acquisitions, localizer acquisitions, normal breathing or test bolus contrast
injection.
Pitch
Pitch is the ratio of table travel per rotation divided by the detector Z collimation. With
cardiac scans, the movement of the cradle and the x-ray tube needs to be in sync with the
heart rate to avoid any gaps in the image data set. As the patients heart rate increases, the
pitch increases for SnapShot Segment and Burst Mode. If the patients heart rate decreases,
the pitch decreases. This is why it is very important to understand the heart rate of the
patient during a breath hold so the appropriate pitch is selected.
Phase Location
The cardiac phase is defined as a point or period in time in the cardiac cycle. The location of
the cardiac phase is defined in a percentage of how far it is between R-Peaks (% R-Peak
Delay).

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Cardiac Imaging
% R-Peak Value
The percent R-peak parameter controls the cardiac phase location of a given reconstruction
(Figure 10-9). It refers to the center of the reconstruction window in terms of a percentage
distance between any two successive R-Peaks given from the ECG.
Figure 10-9 % R-Peak Value
SnapShot Mode Usage

There are three different scanning modes you can choose from when scanning a cardiac
exam which are: SnapShot Segment, SnapShot Burst or SnapShot Burst Plus.
You should be aware that a patients heart rate may change based on the breathing
instructions. It is important to hyperventilate the patient for all series including the scout and
timing bolus scan. The heart rate is displayed on the ECG monitor and the scanner once you
have clicked on [Gating].
ECG Modulated mA
ECG Modulation is a dose reduction feature that allows the user to specify a minimum and
maximum mA Range which is varied across the patient's cardiac cycle (R-to-R interval. A
phase percent range is specified for the Full mA range. ECG Modulation is only available in
cardiac helical modes (SnapShot Segment, SnapShot Burst and SnapShot Burst Plus).

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Cardiac Imaging
In a stable heart rate this can lead to clinically relevant dose reduction for the patient by
implementing "full mA" for the useful portion of the cardiac cycle where images are to be
reconstructed and a reduced mA for the remainder of the cardiac cycle.
Figure 10-10 Full mA
There are four parameters to set for ECG dose modulation.

Start and End phase for full mA.
Min and Max mA Setting.
Set the start phase for full mA to be delivered in the useful portion of the cardiac cycle for
imaging (example 70%).
Set the End Phase for full mA to be delivered in the useful portion of the cardiac cycle for
imaging (example 80%).
Set the Min mA to be used outside the above phase range (no less than 20% of full mA can
be set, 40% of Max mA is the default).
Set the Max mA to be used within the above phase range.
There will be ramp up time factored in for the Min mA to alter to Max mA & vice versa by the
software.

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Cardiac Imaging
Figure 10-11 mA Control Window
NOTE: For Heart Rates < 65 BPM, we recommend full mA range from 70 % to 80 %. For heart
rates > 65, we recommend full mA range from 40-80 %.
Scan Preparation
For single barrel injector's: Load with 80-100cc of contrast. (Please note: the total
volume and strength of contrast used is the site's discretion).
For dual barrel injector's: Load contrast syringe with 70-90cc of 300 to 350 strength
contrast media. (Please note: the total volume and strength of contrast used is the
site's discretion). Also load saline syringe with 50cc Saline.
Explain test to patient and have them sign a consent form if required at your site.
Have the patient lie supine on the table feet first.
Start IV line; make sure to explain the effects of the contrast to the patient. Even if the
patient has had a contrast injection before, reinforce how they will feel during the
scan. This step is CRITICAL as this will help minimize the patient's anxiety during the

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Cardiac Imaging
injection of the contrast. Reassure them that what they will feel during the injection is
normal and they should try to remain relaxed during the scan.
Turn on the ECG machine, and ensure good connection to gantry and leads. To
confirm a good connection, check the upper right display area of the monitor, Figure
10-12.
Check that the Heart icon is illuminated on the gantry display.
Figure 10-12 ECG Machine showing connection to Gantry
ECG monitor showing valid

connection to the gantry on the
left and no connection on the right
If you do not have a good connection, check to make sure that the cable connecting
the ECG machine to the backside of the Gantry is plugged in properly, and the same
cable is connected to the ECG Machine. In case of low signal, please check electrode
placement and chose alternate position if needed. If there is "noise" within the ECG
wave, it is recommended that you DO NOT SCAN, until this condition is corrected.
Make sure excess IV tubing and excess ECG cable length is properly placed and
secured. Movement of the lead wires during scanning can degrade the gating signal.
To ensure patient safety and avoid disruption of the gating signal, any IV tubing and
the ECG cable length need to be secured properly.
Prior to the scan, have the patient practice the breathing instructions that will be
given during the exam. The scan time for the contrast enhanced cardiac gated
acquisition should be around 5-8 seconds to cover the entire heart. Recommended
breathing instructions include having the patient take a couple of breaths in and out
before holding their breath in order to increase their oxygen levels. Typical procedure
is to instruct the patient to take in one breath, blow it out, then take in another
breath, blow it out, then take in one more breath and hold their breath don't breathe.
Have the patient hold their breath for 10-15 seconds and then inform the patient to
breathe normally. Make sure to watch the ECG monitor during the breathing

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Cardiac Imaging
instructions and take note of the patient's heart rate while they are holding their
breath. A patient's heart rate usually stabilizes a few seconds after they begin
holding their breath. Monitoring the heart rate during the breathing instructions
provides information of how long it takes to become stable and allows you to adjust
breathing instructions for the contrast enhanced acquisition to achieve as stable of
heart rate as possible during the contrast enhanced cardiac gated scan.
If the patient has difficulty holding their breath, you may place the patient on 2-4
liters of oxygen via nasal cannula (per a physician's orders, and the site's discretion).
Placing the patient on oxygen will also help to lower their heart rate.
It is recommended to have a cardiac voice programmed in the scanner to give
CONSISTENT breathing. When building this voice make sure to breathe your patient
SLOWLY. The breathing instructions should be no shorter than 10 seconds. When
recording the instructions, after you say take a breath in and hold it, make sure to
wait for 3-5 sec. (of silence) prior to clicking on the stop recording button. This will
give the patient enough time to hold their breath before the scan starts and for their
heart rate to stabilize before the scan, otherwise the patient may still be breathing in
during the first several slices which could lead to motion on your images.
The Preset Delay in Auto Voice can be used to program 1-7 seconds additional time
prior to x-ray on as needed for each patient to ensure the patient is holding their
breath.
Patient Preparation
Patient preparation is extremely important step in the production of gated cardiac images
due to the dependency on the patient's heart rate input via ECG monitor during the
acquisition of data. The procedure should be explained completely before the exam is
started. Inform the patient of the breathing instructions that you are giving and practice the
breathing instructions before the scan. Review the potential effects the patient may
experience as the contrast is being injected. Inform the patient of the four phases in the
exam and explain what will happen in each phase. This helps the patient understand what
to expect, what is expected of them and remain calm throughout the exam.
This keeps the heart rate at a normal rhythm if the patient is comfortable with what is
happening. If the heart rate changes drastically during the scan, the image quality is
compromised.
The key to success in cardiac imaging is a stable heart rate, ideally the heart rate variation
should be within 5 bpm during a scan. Patients with heart rate variations of 10 BPM or
greater should not be scanned.
Patient Skin Preparation & Electrode Placement

It is recommended that the electrodes/pads NOT be placed over muscle, scar tissue (from
surgery such as bypass etc.), or hair. Proper placement of the electrode is over the clavicles
after the arms have been raised over the patient's head with the arms positioned on an

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Cardiac Imaging
elevated surface, such as pillows or support sponge. The patient's arms should NOT be
placed flat on the table or placed on the gantry due possible vessel flow limitations or
arm/shoulder motion that can result from these positions.
It is very important to have good skin contact. If patient has used any lotion or oils prior to
the study, you may have to scrub the area until slightly pink with a 4 x 4 gauze pad to ensure
good contact.
1. If placed over muscle, the ECG can pick up the electrical activity of the muscle due to the
patient holding their arm over their head. Whenever possible let the patient relax their
arms, so their shoulder muscles do not get fatigued.
2. Scar tissue is denser and will be more difficult to get a good signal. If the patient has
scar tissue in shoulder area, place the electrode out onto the patients arm. In the chest
area, place the electrode in an area with no scar tissue.
3. Placing the electrodes over a very hairy area will not allow good contact to the skin. If
necessary shave the area where the electrode is to be positioned.
Follow Figure 10-13 for proper Lead Placement using the IVY ECG Monitor: First raise the
patient's arms above their head, and then place the leads on the patient as shown. (If the
leads are placed with the patient's arms down, the leads may move position when you have
them raise their arms above their head for the scan. This can cause a low/weak signal to the
ECG machine, which could cause cardiac gating issues.)
Place the two upper leads directly on the mid portion of the patient's clavicle. The electrodes
can be moved lateral if needed to provide better signal. Refer to Figure 10-13 and Figure
10-14.
Figure 10-13 Invivo Lead Placement diagram

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Cardiac Imaging
Figure 10-14 IVY Monitor Recommended 3 Lead Placement
NOTE: Lead placement on the clavicles needs to be done with the arms over the head in
position to be used for scanning.
Alternate Electrode Positions for Signal Clarity

In case of low signal amplitude, undefined R-Peaks, or elevated P- or T-Waves indicating the
QRS peak is not noticeably stronger than the surrounding ECG waveform segments, these
alternate positions shown below may improve the ECG signal triggering.
Figure 10-15 Alternate Electrode Positions
Electrodes may be placed farther out on the arms or in this alternate position.
Check to Ensure the Electrodes are Not the Wrong Type, Expired or Old
The electrodes need to be radiotranslucent with a fresh gel pad (not dried out) to maintain
good electrical contact with the skin surface during table movement. Do not use patient
monitoring electrodes that may be available from other departments in your facility as
these are not suitable for short term ECG triggering. Patient Monitoring electrodes are not
suitable for ECG triggering. Recommended electrodes are listed below.

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Cardiac Imaging
If a different type of electrode is used, there is a risk of errors in gating which could lead to
difficulties in gaining effective diagnosis from the cardiac exams or could even lead to
non-diagnostic results.
Scan Parameters Usage

Before scanning a patient, a cardiac protocol should be created. This saves time setting up a
patient for the cardiac scan. Once patient preparation is complete, there are four steps to
acquire data for CI.
1. Scout scan
2. Localizer scan
3. Timing bolus scan
4. Cardiac Helical scan
Scout Scan
First, you acquire two scouts with the patient in the feet first supine position at 0 and 90
degrees. Refer to Table 10-2 for the parameters.
Table 10-2 Scout Parameters
Action
Parameters
Gating Check
On
Start Location
S60
End Location
I300
mA
40
kV
120
Auto Voice
Hyperventilation (You must record this before the

scan.) Have the patient take slow breaths in and
out and one final breath in and hold it. This is
known as hyperventilation.
Localizer Scan
Second, a series needs to be done to localize the heart to identify the level where the
coronary arteries originate and the base of the heart. (A Smart Score - coronary artery
calcium scoring - series can be done in place of the localizer scan.)

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Cardiac Imaging
Table 10-3 Localizer Parameters
Action
Parameters
Gating
On
Scan Type
Helical
Rotation Time
0.5
Rotation Length
Full
Start Location
One inch below carina
End Location
Apex of heart
Number of images
40
Thickness/Speed
3.75 mm/17.5
Pitch
1.75:1
Interval
Gantry Tilt
SFOV
Large
kV
120
mA
150 (200 for large patient)
Prep Delay
5 seconds
ISD
1.2 seconds
Breath Hold
Single Breath Hold
Breathe Time
Voice Lights Timer
Hyperventilation (You must record this before

the scan.)
DFOV
25
Timing Bolus Scan

Third, a series has to be done to determine the optimum prep delay for the contrast
injection. This is often referred to as a Timing Bolus injection. Refer to Table 10-4 for the
parameters.
Timing Bolus is the recommended method for determining patient specific contrast flow for
cardiac scanning due to the high degree of confidence needed to capture the arterial phase
imaging at the ideal point in the contrast injection duration. Timing Bolus should be used for
each cardiac exam in order to calculate the contrast arrival time for each individual patient.
GE does not recommend use of SmartPrep for routine use with clinical patient cardiac
scanning.

10-19
Cardiac Imaging
Table 10-4 Timing Bolus Parameters
Action
Parameters
Gating
On
Scan Type
Axial
Rotation Time
0.8
Rotation Length
Full
Start and End Location
Aortic root near Left Main Artery Ostium
Number of images
12-15
5 mm in 1i mode for BrightSpeed Excel systems
Thickness/Speed
10 mm in 1i mode for BrightSpeed Edge and

BrightSpeed Elite systems
Interval
Gantry Tilt
SFOV
Large
kV
120
mA
80
Prep Delay
5 seconds
ISD
1.2 seconds
Breath Hold
Single Breath Hold
Breathe Time
Voice Lights Timer
Hyperventilation (You must record this before

the scan.)
DFOV
25
Injection Rate
15-20 cc at 4 cc per second

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Cardiac Imaging
Cardiac Helical Scan

In the last step, the main cardiac scan is acquired. Use one of the Cardiac scan modes
depending on heart rate and focus of the study. Refer to Table 10-5 for the parameters.
Table 10-5 Cardiac Helical Scan Parameters
SnapShot Segment
Helical Parameters
SnapShot Burst
SnapShot Burst Plus
Helical Parameters Helical Parameters
Gating
On
On
On
Scan Type
Cardiac
Cardiac
Cardiac
Rotation Time
0.5
0.5
0.5 - 0.6 Heart rate

dependant
Start Location
One inch below

carina and adjust
the scan time to
cover heart
One inch below

carina and adjust
the scan time to
cover heart
One inch below

carina and adjust
the scan time to
cover heart
End Location
End at the apex of

the heart
End at the apex of

the heart
End at the apex of

the heart
Thickness/Speed
0.625 / 1.25
0.625 / 1.25
0.625 / 1.25
Pitch
This is automatically
selected by the
scanner based on
the heart rate.
Fixed Pitch 0.3:1
Fixed Pitch 0.275:1
Interval
0.625 / 1.25
0.625 / 1.25
0.625 / 1.25
Gantry Tilt
SFOV
Large
Large
Large
kV
120
120
120
mA
300 / 370
300 / 370
300 / 370
Prep Delay
20 seconds
This changes when
you set up the scan
after doing the
timing bolus and get
actual peak time
based on MIROI
calculations.
20 seconds
This changes when
you set up the scan
after doing the
timing bolus and
get actual peak
time based on
MIROI calculations.
20 seconds
This changes when
you set up the scan
after doing the
timing bolus and
get actual peak
time based on
MIROI calculations.
Breath Hold
Single breath hold

approximately
20-40 seconds
depending on
coverage
Single breath hold

approximately
20-40 seconds
depending on
coverage
Single breath hold

approximately
20-40 seconds
depending on
coverage
Action

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Cardiac Imaging
Action (Continued)
SnapShot Segment
Helical Parameters
SnapShot Burst
SnapShot Burst Plus
Helical Parameters Helical Parameters
Voice Lights Timer
Hyperventilation
(You must record
this before the
scan.)
Hyperventilation
(You must record
this before the
scan.)
Hyperventilation
(You must record
this before the
scan.)
DFOV
25 cm adjustable
25 cm adjustable
25 cm adjustable
Algorithm
Stnd
Stnd
Stnd
Injection Rate
100-150 cc at 4 cc
per second
100-150 cc at 4 cc
per second
100-150 cc at 4 cc
per second
Cardiac Series Retro Reconstruction Numbering

Upon reviewing cardiac image series, or as routine processing, additional image sets may
be desired. These image sets can be generated from the existing cardiac scan file using the
Retro Recon option from the left monitor. In Retro Recon, you may adjust items such as the
cardiac phase location, recon location, slice thickness, recon kernel, recon filter, or recon
mode as applicable for the various acquisition types.
Single Phase Image Set
Retro SnapShot Segment Series 104 (100 + original series #)
Retro SnapShot Burst-2 Series 124 (120 + original series #)
Retro Snapshot Burst Plus (3 or 4) - Series 144 (140 + original series #)
When retro reconstructing a multi phase (MP) data set to the acquired slice thickness the
series numbers are as follows if the original series number is 4.
Multiphase Image Set
Retro SnapShot Segment Series 504 (500 + original series #)
Retro SnapShot Burst-2 Series 524 (520 + original series #)
Retro Snapshot Burst Plus (3 or 4) - Series 544 (540 + original series #)
If images are Retro Reconstructed with a thicker slice, the series number has an additional
50 added on.
Cardiac ECG-gated Images are annotated with either of the following:
SSEG (SnapShot Segment single sector image)
SSB2 (SnapShot Burst two sector image)
SSB3, or SSB4 (Snapshot Burst Plus - up to three or four sector image)
SEGM (Ungated segmented image reconstruction)

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Cardiac Imaging
How Do I...
This section provides the step-by-step instructions for cardiac imaging acquisitions.
Set Up a Patient
Scan the Patient

Scout Scans
Localizer Scan
Timing Bolus Scans


10-23
Cardiac Imaging
Set Up a Patient
Before bringing the patient in the scan room, make sure that you have everything ready. The
ECG monitor should be plugged in and connected to the gantry with the leads plugged into
the monitor. Have a supply of fresh unexpired ECG electrodes available. Make sure that the
cardiac protocol is built and ready to use. Have the injector loaded with contrast.
NOTE: Use electrodes made with silver/silver chloride (Ag/AgCl) gel on the pad. Do not use
other additional gels. We recommend using the electrodes that are shipped with the
system.
It is recommended to have the patient fast for ~4 hours prior to their appointment
due to the introduction of contrast media in this examination.
In addition the patient should be advised not to consume any caffeine containing
substances for 12 hours prior to the examination. These could raise the heart rate.
Examples are coffee & Mountain Dew.
In order to keep the heart rate as low as possible the patient should also be advised
not to engage in any cardiovascular exercise prior to the examination.
Administration of Beta Blockers and/or Sublingual Nitroglycerin Spray can be used at
the sites discretion.
The key to cardiac imaging is a Stable Heart Rate, ideally less than 5 BPM variation,
but no more than 10 BPM variation for the most successful exams.
1. Load the injector.
For single barrel injector's: Load with 80-100cc of contrast.
NOTE: The total volume and strength of contrast used is the site's discretion.
For dual barrel injector's: Load contrast syringe with 70-90cc of 300 to 350 strength
contrast media.
The total volume and strength of contrast used is the site's discretion. Also load saline
syringe with 50cc Saline.Explain the exam to the patient.
2. Position the patient supine feet first on the cradle.
3. Start an IV line for the contrast injection.
4. Prepare the patient for lead placement.
a) Place arms above patients head.
b) Gently scrub the location with cotton gauze until the skin is a healthy pink.
Do not use alcohol.
c) If necessary, shave a four-square-inch area.

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Cardiac Imaging
5. Apply the ECG electrodes and leads to the patient.
Use new ECG electrodes for the cardiac exam. Do not use existing electrodes on the
patient.
Attach the electrodes no more than 5-10 minutes before the scan.
Do not use dry or expired electrodes. They do not properly conduct the signal which
may cause intermittent triggering.
To apply the leads, place them according to Figure 10-17. Try to keep the leads away
from the scan field of view.
Once the leads are connected to the patient, make sure you have a valid ECG wave
and the heart rate is between 30-200 BPM.
Figure 10-16 InVivo Lead placement diagram
Figure 10-17 IVY Monitor Recommended 3 Lead Placement
Alternate Electrode Positions for Signal Clarity for Ivy Monitors

In case of low signal or where QRS Peak is not noticeably stronger than the other ECG Wave
Segments, these alternate positions may improve ECG signal and detection.

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Cardiac Imaging
Figure 10-18 Alternate Electrode Positions
Electrodes may be placed farther out on the arms or in this alternate position.
Check to ensure the electrodes are not the wrong type, expired or old
The electrodes need to be radiolucent and have fresh gel (not dried out). They should be
sticky enough to maintain good electrical contact with the skin surface during table motion.
Do not use Patient Monitoring electrodes that may be available from other departments in
your facility. Patient Monitoring electrodes are not suitable for ECG triggering.
Recommended electrodes are listed below.
NOTE: The GE recommended electrodes are Dyna/Trace1500 by ConMed
If a different type of electrode is used, there is a risk of errors in gating which could lead to
difficulties in gaining effective diagnosis from the cardiac exams or could even lead to
non-diagnostic results.
6. Turn on the ECG machine. Make sure there is good connection from the patient to the
ECG monitor and to the gantry and console.
To confirm good gantry connection, check the upper right display area of the monitor
to make sure it indicates Connected.

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Cardiac Imaging
Figure 10-19 Monitor indicates it is connected
If you do not have a good connection, check to make sure that the cable
connecting the ECG machine to the backside of the Gantry is plugged in properly,
and the same cable is connected to the ECG Machine. In case of low signal, please
check electrode placement and chose alternate position if needed. If there is
"noise" within the ECG wave, it is recommended that you DO NOT SCAN, until this
condition is corrected.
7. Practice hyperventilation breathing instructions with the patient.
A hyperventilation technique is used on all scans prior and during the cardiac scan.
During the practice breath hold, make sure to watch the ECG monitor to determine
the average heart rate during the breath hold.
NOTE: If the patient can not hold has difficulty holding their breath for 30 secs (BrightSpeed
Excel) or 20 sec (BrightSpeed Edge & BrightSpeed Elite ), it may be useful to put the
patient on two liters of oxygen at the physician's discretion. Prior to the Cardiac Helical
scan, have them take in a couple breaths and then perform the hyperventilation
breathing for the scan. Oxygen may also help lower the heart rate.
NOTE: It is recommended to have a cardiac voice programmed in the scanner to give
CONSISTENT breathing. When building this voice make sure to breathe your patient
SLOWLY. The breathing instructions should be no shorter than 17 seconds. When
recording the instructions, after you say take a breath in, let it out, take a breath in,
let it out, take a breath in and hold it, make sure to wait for 3-5 seconds (of silence)
prior to clicking on the stop recording button. This will give the patient enough time
to hold their breath before the scan starts and for their heart rate to stabilize before
the scan, otherwise the patient may still be breathing in during the first several slices
which could lead to motion on your images. The Preset Delay in Auto Voice can be
used to add 1-7 seconds additional time prior to x-ray on as need for each patient to
make sure the patient is holding their breath. Typically the patient's heart rate
stabilizes in 3 to 5 seconds.
8. Explain the contrast injection.
Explain to the patient that during the cardiac helical scan, they will be receiving an
injection of contrast material which may make them feel very warm. This warm
feeling is a normal response during the injection.

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Cardiac Imaging
NOTE: If patient are unaware that during the contrast injection they may feel very warm,
they may become anxious, causing the heart rate to increase beyond the ranges you
have prescribed the scan for.
The injector should only be used by trained personnel.
NOTE: Watch the ECG waveform for irregular heart beat patterns prior to acquiring the scan.
Irregular heart beat patterns can be the cause of degrade image quality.
Quick Steps: Set Up a Patient

1. Load the injector.
2. Position the patient supine feet first on the cradle.
3. Start an IV line for the contrast injection.
4. Prepare the patient for lead placement.
5. Apply the ECG electrodes and leads to the patient.
6. Turn on the ECG machine. Make sure there is good connection from the patient to the
ECG monitor and to the gantry and console.
7. Practice hyperventilation breathing instructions with the patient.
8. Explain the contrast injection.

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Cardiac Imaging
Scan the Patient

The following steps assume you have previously built a cardiac protocol. The parameters
were discussed earlier in the chapter. There are four scans series to do.
NOTE: The most accurate display of the heart rate is on the Operators Console.
Scout Scans
This series is scanned to localize the area that you need for scanning the cardiac series. This
description assumes you have selected the appropriate protocol based on the heart rate for
SnapShot Segment, SnapShot Burst, or SnapShot Burst Plus.
1. Landmark the patient at the sternal notch.
2. Click [New Patient] and enter the patient information.
3. Select the Cardiac protocol and accept it.
screen.
If the system detects a valid ECG signal, the patients heart rate average in Beats Per
Minute (BPM) is displayed on the Gating button. On the Console, the BPM is a 3 cycle
average of the R-R interval. On the ECG Monitor, the BPM value displayed is a 3 cycle
average for the IVY 3150-A or 3100-A with Ethernet. The BPM value for the IVY 3150
and 3100 with Ethernet is a 10 cycle average.

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Cardiac Imaging
5. To view the ECG waveform, click [ECG Trace].
If the system detects no signal from the ECG monitor, the button turns red and no
BPM value is displayed.
NOTE: Do not attempt to scan without a valid ECG trace.

6. [Confirm] the scout views, hyperventilate the patient.
NOTE: Watch the heart rate during the scan and note the lowest average heart rate.
It is important to give the patient the same breathing instruction for each series. The
patient should be requested to take two breaths in and out (hyperventilate) and to
hold the third breath before the actual scan is acquired. This helps provide a constant
heart rate during the cardiac scan.
Quick Steps: Scan the Patient-Scout Scans

1.
2.
3.
4.
Landmark the patient at the sternal notch.

Click [New Patient] and enter the patient information.
Select the Cardiac protocol and accept it.
To verify that the scanner is receiving the ECG signal, click [Gating Off] on the view/edit
screen.
5. To view the ECG waveform, click [ECG Trace].
6. [Confirm] the scout views, hyperventilate the patient.

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Cardiac Imaging
Scan the Patient
Localizer Scan
This series is used to find your starting and ending locations for the heart.
1. Click [Next Series] from the protocol.
2. Click [Show Localizer] and position the scans so you scan from approximately one inch
below the carina to the apex of the heart.
NOTE: Pay close attention to where the position of the scan is taken. It should cover the
complete heart.
3. Set up Low-Dose helical scan parameters.
120kV, 0.5 sec, 150 mA (200mA for large patients) 1.75:1 pitch 17.5 table speed.
4. Click [Accept].
5. Click [Confirm].
6. Give the patient the same breathing instruction that you have practiced with.
7. Press Move to scan.
8. Press Start Scan .
Quick Steps: Localizer Scan

3. Set up Low-Dose helical scan parameters.
4. Click [Accept].
5. Click [Confirm].
8. Press Start Scan .

10-31
Cardiac Imaging
Scan the Patient
Timing Bolus Scans

This scan series is scanned to figure out the contrast peak enhancement time.
1. Click [Next Series].
2. Place your localizer one centimeter below the carina and just above the base of the
heart.
3. Connect the injector to the patient and arm it.

NOTE: Make sure the injector is set to deliver 15-20 cc of contrast at a rate of 5 cc per second.
The injector should only be used by trained personnel.
4. [Confirm] the timing bolus scans, hyperventilate the patient.
5. Start the injector and press Start Scan at the same time.
NOTE: Watch the heart rate during the scan and note the lowest average heart rate.
When hyperventilating the patient for the timing bolus, it is recommended to instruct
the patient to breath in and out twice. Do not hyperventilate the patient too quickly
or this could raise the heart rate.
Press Start Scan and start the injector at the same time, and then have the patient
take a breath in and hold it.
6. Review the images and using MIROI find out where the peak enhancement occurred.
For more information on how to use MIROI, refer to the Measure Density Readings on
Multiple Images task.
Add 3-5 seconds to the peak enhancement to calculate the prep delay. Once you
have the time to peak enhancement value, add an additional 4 seconds to allow
filling of the distal coronary vessels. This number will be the Prep Delay for the
contrast enhanced cardiac scan.

10-32
Cardiac Imaging
Figure 10-20 MIROI graph
Quick Steps: Timing Bolus Scans

1. Click [Next Series].
2. Place your localizer one centimeter below the carina and just above the base of the
heart.
3. Connect the injector to the patient and arm it.
4. [Confirm] the timing bolus scans, hyperventilate the patient.
5. Start the injector and press Start Scan at the same time.
6. Review the images and using MIROI find out where the peak enhancement occurred.

10-33
Cardiac Imaging
Scan the Patient

This is the final scan before transferring the images to the Advantage Windows Workstation.
When the scan is complete, you may want to reserve the scan data until the images are
reconstructed and transferred to the workstation. For more information on how to reserve
scan data, refer to the Reserve/Release Scan Data task.
NOTE: Confirm the ECG trace is strong and there are no arrhythmias.
NOTE: Pay close attention to where the position of the scan is taken. It should cover the
complete heart. Be careful not to overscan the area.
3. Click [Gating] and the CardIQ window opens.

10-34
Cardiac Imaging
Figure 10-21 Card IQ Window
The auto detect mode is the default pitch selection method for SnapShot Segment
and SnapShot Burst and automatically set the pitch based on the patient's heart rate
when the scan is confirmed. If you have found that the heart rate is different during
the breath holds, you should enable Heart Rate Override and manually enter a heart
rate value to the minimum hear rate for the HR Range that contains the observed
value.
NOTE: For information on which SnapShot mode to use, refer to SnapShot Mode Usage.
4. If you are going to manually enter the heart rate in SnapShot Segment mode, click [On]
in the Heart Rate Override box.
5. For Cardiac Helical Modes, click in the Heart Rate box and type in the heart rate that you
want to use.
This is defaulted [On] in SnapShot Burst Plus mode.
6. If desired, click [Recon 2] and [Recon 3] to enter parameters for a second and third
prospective reconstruction for Cardiac Helical acquisitions.
7. Click the syringe icon and enter the contrast description and amount.
8. Click [Accept].
9. Enter the prep delay that you determined from the MIROI timing bolus scan.
10. Arm the injector with 4 cc per second for 100-150 cc.

10-35
Cardiac Imaging
11. Click [Confirm].
14. Start the injector and press Scan at the same time.
Quick Steps: Scan the Patient-Enhanced Cardiac Scan

3. Click [Gating] and the CardIQ window opens.
4. If you are going to manually enter the heart rate in SnapShot Segment mode, click
[On] in the Heart Rate Override box.
5. For Cardiac Helical Modes, click in the Heart Rate box and type in the heart rate that
you want to use.
6. If desired, click [Recon 2] and [Recon 3] to enter parameters for a second and third
prospective reconstruction for Cardiac Helical acquisitions.
7. Click the syringe icon and enter the contrast description and amount.
8. Click [Accept].
9. Enter the prep delay that you determined from the MIROI timing bolus scan.
10. Arm the injector with 4 cc per second for 100-150 cc.
14. Start the injector and press Scan at the same time.

10-36
Cardiac Imaging

A cardiac scan is acquired throughout a patients R to R interval. This gives you the ability to
reconstruct the cardiac images at any phase of the R to R interval. If you would like to
reconstruct an image at different phase than what the image was acquired in, use the
following steps. To learn how to use Retro Recon, refer to the Managing Scan (Raw) Data
chapter.
1. Enter all the parameters for Retro Recon.
2. Click [Phase].
The phase window opens.

Figure 10-22 SnapShot Segment, SnapShot Burst, and SnapShot Burst Plus Phase Percent
Phase Entry allows you to change the percentage of R-to-R interval by entering in a
start and end phase and the phase increment. The recommended reconstruction

10-37
Cardiac Imaging
phases are 70 and 80% (with a 5% increment), but you can change the phase from 0
to 99%.
NOTE: If you are doing a functional imaging exam to acquire the ejection fraction and wall
motion, you should prescribe phases from 5 to 95 in phase increments of 10%.
NOTE: If you are doing a functional study for wall motion or ejection fraction, you may want
to reconstruct the data as 1.25 mm thick images.
3. Check window level settings and filter settings in the Recon Options field.
For more information, refer to: Set Display Factors.
4. Click [Accept].
NOTE: Cardiac images are going to be produced routinely at 75% of the R to R interval. This
location displays the cardiac anatomy and vessels well. You might feel the right
coronary artery has too much motion at 75% and would like to reproduce the images
at end of systole (around 40% - 55% with 5% increments).
Quick Steps: Reconstruct Cardiac Scans

1.
2.
3.
4.
Enter all the parameters for Retro Recon.

Click [Phase].
Check window level settings and filter settings in the Recon Options field.
Click [Accept].

10-38
Direct Visualization Auto Applications (Option)
Chapter 11
Direct Visualization Auto

Applications (Option)
Introduction
This chapter explains how to perform some basic tasks for the Direct3D and DirectMPR. Your
system may have one or both of these options. It contains the step-by-step instructions to
Set the Direct3D Parameters in the Scan Prescription
Select Preset Curves for Direct3D
Select Rendering Control Selections on the Direct3D Setup Screen
View Direct3D in the Review Mode
Set the Direct MPR Parameters in the Scan Prescription

11-1

This section presents concepts necessary to understand ways to perform Direct3D, Direct
MPR and/or VariViewer. Some of the concepts you need to understand are:
Direct3D
Direct3D Curves
Direct Multi Planar Reformat (DMPR)
Scanning with DMPR
DMPR Review Controller
DMPR Manual Batch Prescriptions
Direct3D
The Direct3D feature automatically renders a 3D volume as it is being acquired. Direct3D
provides the ability to build protocols where a 3D volume can be automatically built using
pre-selected volume rendering curves which specify what information is extracted from the
volume. To implement this feature, you set Direct3D parameters along with the other scan
parameters in the scan prescription.
After scanning, the Direct3D images display in Exam Rx Autoview and Auto Review the same
way as 2D images. Display parameters, screen saves, networking, storing, and filming
options can be used with the images.
Direct3D Curves
Direct3D curves are settings for opacity and color intensity values which are applied to the
image set when building a Direct3D. The opacity level may be varied within a curve to shift
the center of the curve along the CT number scale. A maximum of five curves may be
selected for each Direct 3D session. The more curves that are selected initially, the more
flexibility you have when reviewing the Direct3D model.
Direct Multi Planar Reformat (DMPR)

Direct Multi-Planar Reformat provides capability to move from the usual 2D image review
mode to a prospective 3D image review mode in the axial, sagittal, coronal, and oblique
planes. DMPR provides opportunity to automatically create batch reformats using
predefined reformat protocols and network reformatted images to selected reading
location reducing total exam time and increasing technologist and radiologist productivity.
DMPR displays images in Anatomical orientation where A is at the top, P is at the bottom, R is
on the left and L is on the right. For example, if you have a data set where the patient was
scanned prone, the image display will be automatically flipped to this orientation.

11-2

Direct Multi Planar Reformat (DMPR) allows reformat protocols to be prescribed
prospectively in a scan protocol. Productivity is improved by providing real time auto view
display of Oblique, Sagittal, and Coronal images in addition to the axial images. DMPR will be
beneficial for fast review of scan prescription. It can also be used with auto view for trauma
imaging and automated multiplanar reformat protocols. DMPR can be done on each group
separately or the groups can be combined into one DMPR session. To combine groups many
parameters must be identical within each group including:
slice thickness
interval
SFOV
DFOV
scan type
rotation speed
image center
algorithm
Each group must also be contiguous. DMPR sessions are limited to 2000 images. Additional
protocols can be added using Reformat application on the ImageWorks desktop.
NOTE: Any scans acquired after scanning has completed on the original scan group using
Add group or One More Scan will not be added to the DMPR session, Please remember
to include all of the desired coverage area in the original scan prescription.
Session Setup Window

The Session Setup window is where you can set up the protocols you wish to use and the
parameters for filming. You can also turn Auto Batch, Auto Store, and Auto Transfer on or
off.
Table 11-1 Session Window Parameters
Function
Icon
Description
Start New
Click this to start a new DMPR session.
Combine
Current
Combines the next group with the prior group. Parameters

for the groups to be combined are locked to the current
group prescription.
Off
Turns DMPR off for the series/group.

11-3

Function
Batch Protocol
List
Icon
Description
This area is where reformat protocols to be used in DMPR
are selected from list of available reformat protocols.
Up to 5 reformat protocols can be selected.
Use Next/Prior arrow buttons to move through the list of
available protocols.
Highlight protocol names and click OK to return to DMPR
Setup.
To remove a protocol from the DMPR Batch Protocol List,
highlight the protocol and then select [Remove Protocol].
NOTE: Remove Protocol only removes a protocol from the
Batch Protocol List, not from the system. Protocols
found in the Batch Protocol List can be modified
permanently in Reformat on Image Works.
NOTE: The protocol name is used as the Series Description
name for any Batch and Auto Batch DMPR series
created.
This allows you to define camera, formats, and start
options for filming reformatted images to the Direct film
Composer.
Filming Setup
Auto Batch
Automatically creates reformatted images based on the

Batch Protocol List once reconstruction is complete. In
Auto Batch, a special edge detection algorithm is used.
This edge detection algorithm detects the outer edge of
the anatomical structures and sets the reformat range
based on the object size and the window width (WW) and
window level (WL) of the images.
Set an appropriate WW and WL value for the image set.
Too narrow of a WW and WL may clip data and too wide
of a WW and WL may create blank images.
NOTE: You will not have the ability to set the localizer lines
on the reference image.

11-4

Function
Icon
Description
Allows you to set up a protocol so the system will
automatically archive reformatted images to the default
archive device selected for the system after they are
created.
Auto Store
Select [On] to enable this feature or [Off] to disable the

feature.
Allows you to set up a protocol so the system will network

the formatted images to desired network location. Up to
four remote hosts can be selected. Use [Apply All] to copy
selected list of host to all the protocols prescribed.
Auto Transfer
Scanning with DMPR

Once DMPR setup is complete and confirm is selected, the DMPR session button will be
displayed in the display control area and the DMPR AutoView layout will become active after
4 images have been reconstructed. The DMPR layout will replace the currently selected
AutoView layout. The upper left viewport is used to display an Oblique image or the Auto
Film viewport accessed via the page turner (Figure 11-1).
In the DMPR AutoView layout display, an oblique image is displayed in the upper left
viewport, axial in the upper right viewport, sagittal in lower left viewport and coronal in the
lower left viewport.
During acquire mode for DMPR, you can interact with the oblique, sagittal and coronal
viewports by using the crosshair cursor. Click and drag in the viewport or use the review
controller.

11-5

NOTE: You will not be able switch to another auto view layout until reconstruction for the
DMPR session is complete. To review images for another exam while images are being
reconstructed, go tot the Image Works desktop and use the Viewer.
Figure 11-1 DMPR Viewer
Page Turner

11-6

To switch displays, click on Auto View or Review layout button, to switch back to DMPR click
on DMPR Icon.
AutoView
Review Layout
Buttons
DMPR Icon
DMPR Review Controller

The DMPR Review Controller provides means to interact with the DMPR model. The review
controller supports review and paging of the images, measurements and roam/zoom
capabilities. See Figure 11-2 for a description of all the icons.

11-7

Figure 11-2 Review Controller
2 3 4
6 7 8
10 11
12
Table 11-2 Review Controller Description

Function
1
Icon
Minimize
Zoom
Description
Clicking on this icon to minimize the review
controller around the image viewport.
This allows you to fit your images in the
viewport by making the images larger or
smaller as needed. Once you have made an
image larger or smaller, all of the images in the
series are displayed in the same adjusted size.
NOTE: This is a right mouse key function.
Pan/Roam
This allows you to pan/roam your images in the

viewport by clicking and dragging. Once you
have made an pan/roam an image, all of the
images in the series are displayed in the same
place.
NOTE: This is a right mouse key function.

11-8

Function
Icon
Description
Display Normal
Clicking display normal icon to return the

image to the original scan parameters.
Render Mode
Clicking on the pull down menu. You can select

between Average, MIP, and Min IP render
modes.
The default rendering mode is Average,
meaning it provides the average density
values of the slice taken along lines
perpendicular to it.
If you click MIP, meaning maximum intensity
projection, the image changes to display the
maximum density value of the slice taken
along lines perpendicular to it.
If you click Min IP, meaning minimum
intensity projection, the image changes to
display the minimum density value of the
slice taken along the lines perpendicular to it.
Measurements
Clicking on the pull down menu to select from

multiple tools in order to place measurements
on an image.
Screen Save
Screen Lock
Cine Paging Speed
This allows the user to select the speed and

direction at which the images cine page.
Loop
Clicking Loop as the images play through the

cine loop they will start at the first image and
go to last image and continues to repeat in this
order until stopped.
Rock
Clicking Rock as the images play through the

cine loop. The images start at the first image
and scroll through to last image and then from
the last image back to the first image. This
repeats back and forth until stopped.
10
11

11-9

Function
12
Icon
Scroll Images
Description
Clicking and dragging up and down on the
middle of the slider. The images will scroll within
the series.
Click and drag on the outside bar of the slider
to change the slice thickness of the images
being displayed.
DMPR Manual Batch Prescriptions

Manual prescription of batch protocols can be done by not selecting auto batch. Once the
images have completed reconstruction click [Start Direct MPR Review] button at the
bottom of the left margin of the right monitor.
Figure 11-3 Enter DMPR Review
NOTE: Slider bar underneath represents the status of Auto Batch.

To toggle back to autoview, click on Autoview Layouts icon.
Figure 11-4 Autoview Layout Icon
NOTE: The right screen display can toggle between DMPR and 2D display. The focus outline
around the DMPR or Layout buttons will indicate the display which is currently active.
To toggle back to DMPR, click on [Continue Direct MPR Review].
Figure 11-5 Continue Direct MPR Review

11-10

Figure 11-6 Direct MPR BatchRx window
Protocol- preselected protocols from DMPR
setup in scan protocol will be listed here. *
Mode - Whether you have a cube on the oblique
viewport to move Oblique image or a Rotation
line on the axial, sagittal, and coronal images to
rotate the oblique image.
Thickness - The slice thickness of the manual
batch protocol.
Spacing between views - The interval of the
manual batch protocol.
FOV - The field of view for the manual batch
protocol. The axial FOV is based off the DFOV
and the sagittal and coronal is based off the
Z-axis length.
Number of Views - The number of images
that will be created in the manual batch
protocol.
Render mode:
Average - average intensity pixel
Min-IP - minimum intensity pixel
MIP - maximum intensity pixel
Preview - Ability to preview the images that
will be created in the manual batch protocol.
Save - Ability to save the images that will be
created in the manual batch protocol to the
system disk
Film - Ability to auto film that images that will
be created in the manual batch protocol.
Store - Auto stores batch to MOD.
Transfer - Auto Transfer images to Host
defined in DMPR set up.
Show - Shows reference image of batch
building.
Apply - Will initialize the preview, save, film of
the manual batch protocol.
Pause - Will pause the preview of the batch
images.
Stop - Stop the preview of the batch images.
NOTE: * The protocol name is used as the Series Description for any Batch and Auto Batch
DMPR series created.

11-11
How Do I...
This section provides the step-by-step instructions for performing Direct Visualizations.
Select Rendering Control Selections on the Direct3D Setup Screen

11-12

The Direct3D feature allows automatic display of volume rendered images from the 2D
images obtained from an axial or helical series. To implement this feature, Direct3D
parameters are set along with the other scan parameters in the scan prescription.
If your scan prescription contains multiple groups, Direct3D can be done on each group
separately or the groups can be combined into one Direct3D session. To combine groups
many parameters must be identical within each group including the slice thickness, interval,
SFOV, DFOV, scan type, rotation speed, image center and algorithm. Each group must also
be consecutive. The maximum number of images per Direct3D session is 1200.
1. To set up Direct3D in the scan prescription, click the Recon tab on the view/edit screen,
then click [Off] under DirectVis.

11-13

2. If you have the VariViewer option installed on your system, a second pop up window
appears with Session Type choices. Click [Direct 3D], and [OK].
This turns Direct3D ON and opens a pop up window.
This selection must be made for each group of images in the scan prescription.
For each group, you may choose to start a new session or combine it to the previous
session.
After selecting Start New or Combine Current, the Preset Curve selection must be
made before continuing on to the next group.
3. Click [Start New] to start a new Direct3D session.
Select this for the first group in a scan prescription.

11-14

4. For subsequent groups, you may choose [Combine Current] to add another group to
the current Direct3D session, or you may choose [Start New] again to start another new
Direct3D session.
You may choose to start another new session to have two separate Direct3D
sessions within one study (i.e., a dual phase study, that way you can have a separate
Direct3D of each phase).
5. To turn Direct3D off, click [Off].
NOTE: Direct3D can be turned ON and built into a protocol using Protocol Management.
Quick Steps: Set the Direct3D Parameters in the Scan Prescription

1. To set up Direct3D in the scan prescription, click the Recon tab on the view/edit screen,
then click [Off] under DirectVis.
2. If you have the VariViewer option installed on your system, a second pop up window
appears with Session Type choices. Click [Direct 3D], and [OK].
3. Click [Start New] to start a new Direct3D session.
4. For subsequent groups, you may choose [Combine Current] to add another group to
the current Direct3D session, or you may choose [Start New] again to start another
new Direct3D session.
5. To turn Direct3D off, click [Off].

11-15

To perform Direct3D, volume rendering curves needs to be set prior to scanning. These
curves set opacity and color intensity values for rendering and there are specific curves that
can be used for each exam type or body part. The more curves that are selected initially, the
more flexibility you have when reviewing the Direct3D model.
1. On the Direct3D Setup screen, after selecting Start New or Combine Current, select one
of the Preset Curves or click [Unused].
Selecting [Unused] brings up the Direct3D Curves Selection screen.

11-16

2. On the Direct3D Curves Selection screen, click the curve(s) desired for the current exam.
The name of the curve(s) you select transfers to the Preset Curves list on the setup
screen.
Up to five curves may be selected.

You may select curves that are designed for a specific anatomical area and each
area can have up to 14 different curves that can be applied to the volume.
3. If you wish to remove a curve you have selected, click on the Direct3D Setup screen. The
Curve Selection window opens, and click [Remove Curve].
4. Under the Default column heading, click the default box to the left of the curve on the
Direct 3D Setup screen that you would like to be the default curve.
The default curve is used for the initial render display in Direct3D Autoview.
5. Opacity Index allows you to shift the center of the Direct3D curve along the CT number
scale. To set the opacity index, click the box next to the name of the curve desired and
type in a value.
The valid range is -20 to 20. Least opaque is -20, which is used for viewing more soft
tissue structures.
The most opaque is 20, which is used for viewing high-density structures.

11-17
Quick Steps: Select Preset Curves for Direct3D

1. On the Direct3D Setup screen, after selecting Start New or Combine Current, select
one of the Preset Curves or click [Unused].
2. On the Direct3D Curves Selection screen, click the curve(s) desired for the current
exam.
3. If you wish to remove a curve you have selected, click on the Direct3D Setup screen.
The Curve Selection window opens, and click [Remove Curve].
4. Under the Default column heading, click the default box to the left of the curve on the
Direct 3D Setup screen that you would like to be the default curve.
5. Opacity Index allows you to shift the center of the Direct3D curve along the CT number
scale. To set the opacity index, click the box next to the name of the curve desired and
type in a value.

11-18
Select Rendering Control Selections on the Direct3D

Setup Screen
There are several rendering control selections (image display factors) which can be set for
Direct3D.
1. To set a Zoom Factor, click the box next to Zoom Factor and type in a value.
This factor allows you to preset the magnification level for display of the Direct3D
volume.
The range is 0.1 to 4.0 in steps of 0.1. Selecting 0.8 allows the entire volume to be
seen in the Direct3D viewport.
If FOV Auto Scale is set to Yes, Zoom Factor is disabled and cannot be set.
2. To set the Horizontal View Angle, click the box next to Horizontal View Angle and type
in a value.
This lets you specify the horizontal angle in degrees for display of the Direct3D
volume.
The valid range is -45 to 45.
A positive value views the volume from the right as it builds.
This view angle shifts the volume around the Y axis of the scanner.
3. To set the Vertical View Angle, click the box next to Vertical View Angle and type in a
value.
This lets you specify the vertical angle in degrees for display of the Direct3D volume.
The valid range is -45 to 45.
A positive value views the volume from above as it builds.
This view angle shifts the volume around the X axis of the scanner.

11-19

4. To set the Resolution, click the button below the Resolution heading. The button is a
toggle between Enhanced or Standard.
Enhanced renders the volume in a 512 matrix.
Standard renders the volume in a 256 matrix.
NOTE: Enhanced Resolution needs to be used for data sets of 256-500 images.
5. To set FOV Auto Scale, click the button below the heading to toggle between Yes and
No.
This feature implements automatic scaling of the Direct3D volume field of view,
based on the volume geometry and view angle to fit the display viewport.
If this feature is active, Zoom Factor cannot be set.
6. To set the Bounding Box, click the button below the heading to toggle between Yes and
No.
This feature displays a box to assist in visualizing the extent of the volume.
If on, the box is included in any filmed or screen saved image.
7. To set the User Annotation Level, click [Full], [Partial] or [None].
This setting controls only the annotation level for the display or filming of the
Direct3D images from the Direct3D viewport. It does not affect the screen or film
annotation of the other ExamRx viewports.
8. When you are ready to leave the Direct3D Setup screen, click [OK] to register your
selections or [Cancel] to exit without changes.
Quick Steps: Select Rendering Control Selections on the Direct3D

Setup Screen
1. To set a Zoom Factor, click the box next to Zoom Factor and type in a value.
2. To set the Horizontal View Angle, click the box next to Horizontal View Angle and type
in a value.
3. To set the Vertical View Angle, click the box next to Vertical View Angle and type in a
value.
4. To set the Resolution, click the button below the Resolution heading. The button is a
toggle between Enhanced or Standard.
5. To set FOV Auto Scale, click the button below the heading to toggle between Yes and
No.
6. To set the Bounding Box, click the button below the heading to toggle between Yes
and No.
7. To set the User Annotation Level, click [Full], [Partial] or [None].
8. When you are ready to leave the Direct3D Setup screen, click [OK] to register your
selections or [Cancel] to exit without changes.

11-20

Direct3D builds a volume rendered session as the 2D images that make up the Direct3D
volume are reconstructed. In ExamRx Autoview, you can view the Direct3D volume after at
least four slices from the scan have been reconstructed.
1. Click the page turner icon that is in the lower right corner of the upper right viewport.
This toggles between the Autoview image and the Direct3D image.
You may view your Direct3D volume at this time.
2. On the bottom of the ExamRx display screen, click [Start Direct3D Review].
Selecting Start Direct3D Review brings up the Interactive Review screen and stops
the Direct3D volume from building.

11-21
The Interactive Review screen allows you to manipulate the Direct3D volume
currently displayed.
3. Change any desired parameters from the Interactive Review screen.

VR Curves lists the curves selected from the Direct3D Setup screen. This feature is
unavailable if MIP is selected.
The Opacity slider allows you to change the range of CT numbers being used for
rendering. This feature is unavailable if MIP is selected.

11-22

a) Moving the slider to the right enhances the display of bone and enhanced structures.
b) Moving the slider to the left enhances the display of soft tissue structures such as
liver, spleen and bowel.
Reset W/L resets the window/level to values defined in the curve.
VR (Volume Render) selects the volume rendering mode and applies the curve
selected in the VR Curves pull down menu.
MIP (Maximum Intensity Projection) applies a maximum intensity projection
algorithm to the volume.
Home Position returns the volume rendering to its start or home position.
S,I,A,P,R,L selects the viewing direction (Superior, Inferior, Anterior, Posterior, Right or
Left) of the 3D volume rendering.
Rotational Arrows allows rotation around the vertical or horizontal axis of the
volume rendering by the incremental value defined in the center of the arrows.
Roam sets the right mouse button to scroll the volume within the Direct3D viewport.
Zoom sets the right mouse button to magnify the volume.
Clipping Sliders displays a screen to define volume clip planes in the R-L, A-P and S-I
direction.
Resize Viewport changes the viewport layout back and forth from four viewports to
a single viewport.
Screen Save saves what is currently displayed in the Direct3D viewport to the system
disc as a screen saved image into series number 400 plus the source series number
(i.e., if a screen save was created from series 3, the screen save images would be in
series 403).
Save State creates a file with the curve information in it to send to an Advantage
Windows 4.1 (or higher) Workstation. This allows rendering of the data on the AWW in
Volume Analysis using the same curve used on the scanner. Saved State images are
saved to series number 300 plus the source series number.
Auto Review provides five predefined batch protocols to generate a batch of screen
saved images of the model.
Back returns to the ExamRx Display Control Panel without ending the Direct3D
session.
Options displays a screen to select annotation level, brightness and lighting of the
volume, view volume with bounding box and resolution.
OK returns to the interactive screen.
Quit stops and exits the Direct3D session, but first a pop up appears to confirm that
you really want to quit the session.

11-23

NOTE: Once a session is quit, it cannot be restarted. Once the current session is ended, if
there is another Direct3D session in the queue it begins to build automatically.
Direct3D sessions remain in the queue until the session is Quit.
Status Bar indicates the status of the rendering being built.
4. Selecting [Complete Model] from the Interactive Review screen returns the model to the
acquire mode and adds images to the model that have been reconstructed since the
interactive review session was started.
This is only available if the entire model is complete.
Quick Steps: View Direct3D in the Review Mode

1.
2.
3.
4.
Click the page turner icon that is in the lower right corner of the upper right viewport.
On the bottom of the ExamRx display screen, click [Start Direct3D Review].
Change any desired parameters from the Interactive Review screen.
Selecting [Complete Model] from the Interactive Review screen returns the model to
the acquire mode and adds images to the model that have been reconstructed since
the interactive review session was started.

11-24

The DirectMPR (DMPR) feature allows automatic display of the images from a helical or axial
series in a 3D autoview format instead of a 2D autoview format. In DMPR, user can select a
set of reformat protocols to automatically or manually create reformatted images once
reconstruction is complete for the series.
If your scan prescription contains multiple groups, Direct MPR can be done on each group
separately or the groups can be combined into one DirectMPR session. To combine groups
many parameters must be identical within each group including the slice thickness, interval,
SFOV, DFOV, scan type, rotation speed, pitch, image center and algorithm. The maximum
number of images per DirectMPR session is 2000.
NOTE: Any scans acquired after scanning has completed on the original scan group using
Add group or One More Scan will not be added to the DMPR session, Please remember
to include all of the desired coverage area in the original scan prescription.
1. Click on the Display Tab.
The display parameters are shown in the light blue rectangle.
2. Click [Off] in the Direct Vis column.
Figure 11-7 Direct Vis

11-25

If you have the Direct3D option installed on your system, a session pop up window
appears with the Session Type choices.
3. Click [DMPR].
This turns DirectMPR ON and opens a pop up session parameter selection screen.
This selection must be made for each group of images in the scan prescription.
For each group, you may choose to start a new session or combine it to the previous
session.
After selecting Start New or Combine Current, the preset protocols must be made
before continuing on to the next group.
4. Click [OK].
Figure 11-8 DMPR Window
5. Click [Start New] to start a new DirectMPR session.

Select this for the first group for the first group in the scan prescription.
For subsequent groups, you may choose [Combine Current] to add another group to
the current DirectMPR session, or you may choose [Start New] again to start another
new DirectMPR session.
You may chose to start another new session to two separate DirectMPR sessions
within one study (i.e. a dual phase study, that way you can a separate DirectMPR for
each phase).

11-26

Figure 11-9 DMPR Protocol Window
6. Click [Unused].
The Batch Protocol List pop up window appears.
7. Click Next and Prior arrows to review all protocols in the list.
The list includes GE predefined reformat protocols and user created reformat
protocols. GE predefined protocols begin with CT.
User defined protocols are created in Reformat on the Image Works desktop (Figure
11-10).
Figure 11-10 Direct MPR Batch Protocol list

11-27

8. Click on the reformat protocols you wish to select.
Up to five protocols can be selected.
For Combined sessions, the same protocols are used the all the groups.
9. Click [OK].
The selected protocols are added to Batch Protocol in the order they are selected.
10. Click [Setup] to select the film composer format for filming.
The camera selection defaults to the same camera and format currently selected for
AutoFilm.
Select the Format, Destination, and number of Copies you wish to use.
11. Click [OK].
12. Click [Off] under Filming.
This button will toggle filming on or off for the protocol.
13. Click [Off] under Auto Batch.
This button will toggle Auto Batch on or off for the protocol.
Auto Batch automatically creates the reformat images once reconstruction is
complete.
System automatically applies an edge detection algorithm to limit the reformat
range n the sagittal and coronal planes to the size of the object.
Auto Batch images are displayed in an insert in the lower right corner of the
DirectMPR viewports.
To stop Auto Batch mode, click in the Auto Batch viewport and select [Cancel].
14. Click [Off] under Auto Store.
This button will toggle Auto Store on or off for the protocol.
The same Archive device is used as selected for Archive on the Image Works desktop.
15. Click [Off] under Auto Transfer.
Up to four network hosts can be selected for each protocol.
16. Click [OK].

11-28
Quick Steps: Set the Direct MPR Parameters in the Scan Prescription
1. Click on the Display Tab.
2. Click [Off] in the Direct Vis column.
3. Click [DMPR].
4. Click [OK].
5. Click [Start New] to start a new DirectMPR session.
6. Click [Unused].
7. Click Next and Prior arrows to review all protocols in the list.
8. Click on the reformat protocols you wish to select.
9. Click [OK].
10. Click [Setup] to select the film composer format for filming.
11. Click [OK].
12. Click [Off] under Filming.
13. Click [Off] under Auto Batch.
14. Click [Off] under Auto Store.
15. Click [Off] under Auto Transfer.
16. Click [OK].

11-29

11-30
Performed Procedure Step (PPS) (Option)
Chapter 12
Performed Procedure Step (PPS)

(Option)
Introduction
This chapter explains how to use the Performed Procedure Step (PPS) option. It contains the
Use Performed Procedure Step (PPS)

12-1

This section presents the concept necessary to understand Performed Procedure Step (PPS).
The concept you need to understand is:

Performed Procedure Step is an OPTION. To use it you need a HIS/RIS system and PACS with
the Connect Pro option. It communicates to PACS and HIS/RIS that you have completed a
procedure. It improves transfer of data because it can provide a complete message when all
data has been transferred. The browser has a PPS column that lists the PPS status of each
exam. There are three states of exam status: COMP which means the exam is complete;
DISC which means the exam is discontinued and it cannot use PPS again; or INPR, which
means that the exam is still in progress.

12-2
How Do I...
This section provides the step-by-step instructions for utilizing the Performed Procedure
Step (PPS) feature. Specifically, it describes how to:

12-3

procedure. It improves transfer of data to PACS because it can provide a complete message
when all data has been transferred. The browser in Image Works has a PPS column that lists
the PPS status of each exam. There are three states of exam status: COMP, meaning the
exam is complete; DISC, meaning the exam is discontinued and it cannot use PPS again; or
INPR, which means that the exam is still in progress.
1. When an exam is completed, click [End Exam].
2. Click [Complete], [Discontinue], or [Defer].

If you click Complete, a message is sent to PACS and HIS/RIS indicating that the
exam is complete and all images have been acquired.
If you click Discontinue, the request to PACS and HIS/RIS is cancelled and that exam
cannot use PPS again.
If you click Defer, you are saying that the exam is not completed. Once the exam is
complete, follow step #3 below.
3. If you chose to [Defer] the exam and the exam is completed, select the [Image Works]
desktop, select the exam from the browser list, then click [PPS] from the top of the
browser, and click [Complete] or [Discontinue] from the pop up window.
On the patient browser, there is a PPS column that lists the PPS status for each exam.
Three status designations are possible:
Complete-Annotates as COMP and indicates that the procedure is complete.
Discontinue- Annotates as DISC and indicates that the procedure has been
discontinued.
Defer-Annotates as INPR and indicates that the procedure is incomplete; (i.e., still
in progress).

12-4
Quick Steps: Use Performed Procedure Step (PPS)

1. When an exam is completed, click [End Exam].
2. Click [Complete], [Discontinue], or [Defer].
3. If you chose to [Defer] the exam and the exam is completed, select the [Image Works]
desktop, select the exam from the browser list, then click [PPS] from the top of the
browser, and click [Complete] or [Discontinue] from the pop up window.

12-5


12-6
Exam Split (Option)
Chapter 13
Exam Split (Option)

Introduction
This chapter explains how to use the Exam Split (Option). It contains the step-by-step
instructions to help you learn how to:
Perform an Exam Split After a Scan is Completed
Using ConnectPro with Exam Split

13-1
Exam Split (Option)

This section presents the concept necessary to understand Exam Split (Option). The concept
you need to understand is:
Exam Split
Virtual Mode
Hard Mode
Exam Split
Provides you with the capability to "split" a series of patient images into separate groups.
These new smaller image groups can be networked to desired reading stations for multiple
"reads" and multiple billings on select patient exams.
Using the Exam Split option will allow for split images from a single acquisition and assign
them to a Requested Procedure ID or accession number retrospectively. On the ImageWorks
desktop using Exam Split, all the images of the scan will be loaded. Using left mouse key to
select the first image and shift, left mouse key simultaneously to choose the last image to
be sent to a specific exam procedure.
At scan time all Patient records that you wish to have available to split to must be selected
from the Patient Schedule when selecting New Patient. Your system will be configured in
one of two modes for Exam Split. The mode configured is dependent on the capabilities of
the system you are sending images to review.
Exam Split requires that the Connect Pro option be installed.
Virtual Mode
Your remote station must support Performed Procedure Step (PPS) and Gray Scale
Presentation State (GSPS). Images will be Auto Transferred to the Remote station. In Exam
Split ranges of images will be assigned to each accession number or procedure code and a
Gray Scale Presentation State (GSPS) object will be created and transferred when selected.
Hard Mode
Hard Exam Split will create a new series of images for each accession number or procedure
code ranges of images are assigned to. For this reason images will not be Auto Transferred
to the Remote Station.
Your GE Field Engineer will configure your site for the mode of Exam Split based on input
from your sites IT and PACS administration.

13-2
Exam Split (Option)

Figure 13-1 Exam Split window
Screen Format choices
See bottom blue square

Window/Level choices
Add or Delete Series
Select or Configure host
Comment Area
Hilight a range of images and click [Add], [Delete],

or [Delete All].
These layout buttons define how you want your
primary port displayed.
Procedure code list
Send or Click Browser to cancel and return to

Image Works
List of Requested Procedure ID or Accession Numbers

selected for the patient.

13-3
Exam Split (Option)
How Do I...
This section provides the step-by-step instructions for utilizing the Exam Split (Option).

13-4
Exam Split (Option)

Exam Split provides users with the capability to "split" a series of patient images into
separate groups and assign the groups of images to Requested Procedure ID or Accession
Numbers. These smaller groups of images can be used for multiple reads and multiple billing
for certain types of exams such as a Chest, Abdomen and Pelvis where there are multiple
procedures where multiple doctors will read a portion of the data.
1. Complete an exam with multiple Requested Procedure ID or Accession Numbers have
been selected.
2. Select the ImageWorks desktop.
3. Click on the exam you wish to split.
4. Select the series to split.
5. Click [Exam Split] from the side of the Browser.
The Exam Split menu will appear with the selected images displayed in the upper
viewports. The system may display every image or skip some images depending on
the total number of images selected.
If the exam you selected does not have Multiple Procedures, a dialog will be posted
and Exam Split will exit.
You must select all procedures you wish to split up front when scanning is done. You
cannot add them after the fact.

13-5
Exam Split (Option)

6. Select the images to be grouped together for a procedure.
Click to select first image and shift and click on the last image for the desired range
of images per procedure code.
7. Select desired Requested Procedure ID or Accession Number from the available list
which reflects the procedures selected from Patient Schedule for New Patient.
This is from the list of exams registered to this patient from ConnectPro.

13-6
Exam Split (Option)

8. Select the receiving host from the Host Config pull down.
Host Selection will show GSPS if configured in VES mode and HES if configured in HES
mode.
VES Mode
HES Mode
9. Adjust the Window Level if needed.
Set the window/level for the images using the mouse or W/L preference buttons.
10. Click [Add].
The images will be added to the procedure list.
11. Hilight the procedure or procedures you wish to send and click [Send].
Repeat until you have sent all procedures you have images added to.
The images are transferred to the desired host.
If the system is configured for VES, a GSPS object is sent to the remote station. If HES
mode is configured, a new series of images will be sent to the remote hosts.
You can select more than one procedure if you are sending them to the same
destination.
You can select the Browser to exit Exam Split before the images have completed
transferring.

13-7
Exam Split (Option)
Quick Steps: Perform an Exam Split After a Scan is Completed

1. Complete an exam with multiple Requested Procedure ID or Accession Numbers have
been selected.
2. Select the ImageWorks desktop.
3. Click on the exam you wish to split.
4. Select the series to split.
5. Click [Exam Split] from the side of the Browser.
6. Select the images to be grouped together for a procedure.
7. Select desired Requested Procedure ID or Accession Number from the available list
which reflects the procedures selected from Patient Schedule for New Patient.
8. Select the receiving host from the Host Config pull down.
9. Adjust the Window Level if needed.
10. Click [Add].
11. Hilight the procedure or procedures you wish to send and click [Send].

13-8
Exam Split (Option)

Using the ConnectPro option will allow for split images from a single acquisition and assign
them to a Requested Procedure ID or accession number retrospectively.
NOTE: When multiple accession numbers are selected, the last accession number will be
displayed on the image.
1. Select [New Patient].
This is located at the bottom of the left monitor.
2. Click [Patient Schedule].
The patient schedule list is displayed.

13-9
Exam Split (Option)

3. Select all of the patient exams.
You can do this by holding the ctrl key down while clicking on the different exams.
This will supply the accession numbers that is used for Exam Split after the images
have been reconstructed.
The last Patient record selected is the Exam Description displayed on the New Patient
Screen.
Up to 15 procedures can be selected.
4. Click [Select Patient].
Quick Steps: Using ConnectPro with Exam Split

1. Select [New Patient].
3. Select all of the patient exams.

13-10
SmartStep (Option)
Chapter 14
SmartStep (Option)
Introduction
SmartStep is a mode of scanning designed for interventional procedures. The Radiologist or
Physician usually inserts a needle or catheters into a patient and then need to see images
showing the position of the catheter or needle.
This chapter explains the SmartStep imaging process. It contains the step-by-step
Prepare for SmartStep
Set Up SmartStep Mode
Scan with SmartStep
Display SmartStep Images
Set Window/Level Presets for the HHC

14-1
SmartStep (Option)

This section presents the concepts necessary to successfully complete the Interventional
Imaging process. Specifically you need to understand:
SmartStep
Hand Held Controller (HHC)
SmartStep Display
SmartStep
SmartStep is a mode of scanning designed to be use by the Radiologist or Physician during
interventional procedures. The SmartStep is accomplished by using the integrated Hand
Held Controller (HHC) and foot switch.
The available slice thicknesses of SmartStep are: 1.25 mm (on BrightSpeed Elite, BrightSpeed
Elite Select and BrightSpeed Elite Select Standard), 2.5 mm, 5 mm, and 7.5 mm. These are
created from using a 4X detector configuration. Detector rows one and two create image
one. Detector rows two and three create image two. Detector rows three and four create
image three. The configuration for 2.5 mm slice thickness is the 4 x 1.25 detector
configuration. The configuration for 5 mm slice thickness is the 4 x 2.5 detector
configuration. The configuration for 7.5 mm slice thickness is the 4 x 3.75 detector
configuration.
Only the 0.8 second and 1 second full rotation scan times are available for SmartStep on
BrightSpeed Elite, BrightSpeed Elite Select and BrightSpeed Elite Select Standard, All
algorithms are available for reconstructions.

14-2
SmartStep (Option)
NOTE: Other desktops are unavailable during SmartStep.
Hand Held Controller (HHC)

During needle biopsies, the Radiologist or Physician controls radiation with the foot switch,
and uses HHC to view images on an in-room monitor. The HHC also provides alignment
light, move-to-scan and cradle micro positioning controls. The Radiologist or Physician also
has the option to release HHC control of the cradle, and use the cradle handle to manually
position the patient in the scan field of view.

14-3
SmartStep (Option)
Figure 14-1 Hand Held Controller
Alignment Light
Prep
Move to Start Location

Cradle Move Out
Cradle Move In
Bump In
Bump Out
Disabled
Cradle Release
Change Focus
Next Image
Prior Image
W/L Toggle
Table 14-1 Hand Held Controller Button Descriptions

Button Name
Prep
Button
Description
Prepares the system for x-ray acquisitions.

14-4
SmartStep (Option)
Button Name
Alignment Light
Move to Start
Location
Button
Description (Continued)
This button Enables the laser positioning lights.
This button positions the cradle to the start

location prescribed by you in the SmartStep
View/Edit screen.
Cradle Move In
The Cradle Move In button moves the cradle in

towards the gantry.
Cradle Move Out
The Cradle Move Out button moves the cradle

away from the gantry.
Bump In
Bump Out
Disabled
This moves the cradle a pre-defined bump

distance towards the gantry. The bump distance is
pre-defined on the View/Edit screen.
distance away from the gantry. The bump
distance is pre-defined on the View/Edit screen.
This button is disabled. It is not used for

SmartStep.
Cradle Release
This is a toggle button. It releases the cradle so it

can be moved using the cradle handle. Pressing
the button again latches the cradle.
Change Focus
This changes the primary focus window between

the interventional viewports and the free viewport.
Next Image
This displays the next image in the sequence of

images.

14-5
SmartStep (Option)
Button Name
Button
Prior Image
This displays the prior image in the sequence of

images.
W/L Toggle
This toggles between six different window level

settings.

14-6
SmartStep (Option)
SmartStep Display
SmartStep display provides three viewports for interventional images on the top of the
display window with a free viewport at the bottom of the display window. The free viewport
allows you to choose any image to be displayed by clicking on [List/Select]. The three
interventional viewports automatically update each time an exposure is made with the foot
pedal.
Figure 14-2 SmartStep window
First Image
Second Image
Third Image
Free Viewport
NOTE: Images in the interventional viewport are displayed superior to inferior in location.
NOTE: For Xtream console with GRE recon, SmartStep images are displayed in
approximately 1.5 seconds after x-ray is turned off.
NOTE: If images are not available after a step, the viewport will be blank. Use Prior image
on the Hand Held Control and then press Next image to display the missing images.
The Remaining time indicates how much time you have left in this series before you have to
go back to the View/Edit screen and click [Confirm] again. The Accumulative time indicates
how much time the patient has been exposed to radiation. This time will keep updating as
long as you stay in the same exam. Once you end the exam, the accumulative time resets to
zero.
NOTE: The total accumulated exposure time for all SmartStep scan groups and Series will
be displayed on the Dose Text page.

14-7
SmartStep (Option)
CAUTION:
You can only expose the patient 90 seconds per confirm.

14-8
SmartStep (Option)
How Do I...
This section provides the step-by-step instructions for using the SmartStep scan mode.
Scan with SmartStep

14-9
SmartStep (Option)

This section explains how to prepare for a SmartStep procedure. You must connect the foot
pedal and the Hand Held Control (HHC) devices to the gantry. These devices are used by the
Radiologist or Physician to prepare the system for exposures, make exposures, view images,
and to move the cradle.
Use this procedure to plug the HHC and foot pedal to the gantry in preparation for
SmartStep.
1. Locate on each side of the gantry the rear access plates to plug the switches into.
Foot Switch Outlet Hand Switch Outlet

2. Plug the foot switch into the foot switch outlet.
This is located on either side of the gantrys rear base plate.
3. Plug the HHC into the hand switch outlet.
NOTE: It is best to plug the switches in on the same side of the patient where the Radiologist
or Physician will be doing the procedure from.
4. Position the in room display monitor so the doctors can view the images.
This display monitor is suspended from the ceiling and can be moved to either side of
the cradle.
5. Prepare the patient and supplies for the procedure.
Have your biopsy tray and other supplies ready for the Physician or Radiologist.
Prepare the patient for the procedure by creating a sterile area and explaining the
breathing instructions.

14-10
SmartStep (Option)
Quick Steps: Prepare for SmartStep

1.
2.
3.
4.
5.
Locate on each side of the gantry the rear access plates to plug the switches into.
Plug the foot switch into the foot switch outlet.
Plug the HHC into the hand switch outlet.
Position the in room display monitor so the doctors can view the images.
Prepare the patient and supplies for the procedure.

14-11
SmartStep (Option)

Once the patient has been prepared and set up for the interventional procedure, you can
proceed with setting up for image acquisition in the SmartStep mode.
1. Select SmartStep from the Dynaplan screen or by clicking [Create New Series].
This following windows appears.
2. Click [SmartStep].
3. Click [Scan Type] and select [0.8 sec] or [1.0 sec].
You can choose between the 0.8 second full rotation or the 1.0 second full rotation.
4. Click [Start Location] and enter the initial image location where you want to start.

14-12
SmartStep (Option)
5. Click [Slice Thickness] and select the desired slice thickness.
For 4, and 8 slice scanners, 2.5 mm, 5 mm and 7.5 mm slice thicknesses are available.
For 16 slice scanners, 1.25 mm, 2.5 mm, 5mm and 7.5 mm slice thicknesses are
available.
6. Click [Gantry Tilt] and enter the desired tilt.

7. Click [SFOV] and enter the desired scan field of view.
8. Click [kV] and select the desired kV.
9. Click [mA] and select or enter the desired mA.
10. Click [Exposure Time] and enter the maximum exposure time.
This is a time that is entered before you have to reset the timer.
11. Click [Bump Distance] and enter the distance you want the cradle to bump in or out.
The default Bump Distance is half of the selected slice thickness.
12. Enter the display parameters for DFOV, R/L Center, A/P Center, and Recon Type.
All algorithms are available. If Edge is selected, the time to display the interventional
images will be increased.

14-13
SmartStep (Option)
A warning message appears.

The SmartStep dynaplan screen appears.
Quick Steps: Set Up SmartStep Mode

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Select SmartStep from the Dynaplan screen or by clicking [Create New Series].
Click [SmartStep].
Click [Scan Type] and select [0.8 sec] or [1.0 sec].
Click [Start Location] and enter the initial image location where you want to start.
Click [Slice Thickness] and select the desired slice thickness.
Click [Gantry Tilt] and enter the desired tilt.
Click [SFOV] and enter the desired scan field of view.
Click [kV] and select the desired kV.
Click [mA] and select or enter the desired mA.
Click [Exposure Time] and enter the maximum exposure time.
Click [Bump Distance] and enter the distance you want the cradle to bump in or out.
Enter the display parameters for DFOV, R/L Center, A/P Center, and Recon Type.
Click [Confirm].
Click [Continue].

14-14
SmartStep (Option)
Scan with SmartStep

This task explains the process of scanning with SmartStep. You must have the foot switch
and the hand held control devices plugged into the gantry.
NOTE: During SmartStep mode, filming, archive, and networking are not available.
SmartStep recon has the highest priority. Previously acquired recon queued images
are paused until SmartStep is complete.
1. Press the Prep button on the Hand Held Control (HHC) or click [Prep] on the dynaplan
screen.
The message area of the screen will indicate PRESS PREP.
Once the Prep button has been pressed or clicked, the screen will update to PREP IN
PROGRESS.
2. The system is ready for scans when the READY TO SCAN message indicator appears.

14-15
SmartStep (Option)
3. Step on the foot pedal to make an exposure in the SmartStep scanning mode.
The XRAY ON message indicator appears.
4. Release the foot pedal when the exposure is finished.

If you keep your foot on the exposure pedal, the message below is displayed.
SmartStep is a single rotation for each time the foot pedal is pressed.
NOTE: After each rotation, you must release foot peddle before you scan again.
5. Repeat steps 1-4 as many times as necessary while scanning in the SmartStep mode.

14-16
SmartStep (Option)
Quick Steps: Scan with SmartStep

screen.
3. Step on the foot pedal to make an exposure in the SmartStep scanning mode.
5. Repeat steps 1-4 as many times as necessary while scanning in the SmartStep mode.

14-17
SmartStep (Option)

There are a few basic image review functions available in the SmartStep mode. For more
information on how to use these display functions, refer to Measuring Structures Within an
Image, Magnifying Images and Graphics, Text Pages and Commands.
WARNING: When scanning for interventional procedures using helical, axial, cine, or
Biopsy Mode with or without the boom in the room option, you should take
care when selecting the display format for Auto View of the images. A multi
image Auto View display such as the 4 on 1 or 2 on 1 Auto View layouts should
not be used for this type of study. These layouts do not display images in the
order the data was acquired and may cause confusion in determining the
relationship of the Superior to Inferior direction of the anatomy. Use a single
image Auto View display and review the images in a single image viewport
for interventional studies.
Refer to Select a Multiple Image Display for more information on how to set up the
Figure 14-3 Viewing options that should not be used
4 on 1
2 on 1
1. Change the primary focus to the free viewport.

Click on the free viewport
OR, using the HHC press the Change Focus button to activate the free viewport.
2. Click [List/Select] to display an image in the free viewport.
This opens a Browser for you to select an Exam, Series, and an Image.
3. Click [Accept].
This displays the selected image.

14-18
SmartStep (Option)
4. Perform the display functions as needed.
Click [Roam] or [Zoom] to set the right mouse button function.
Using the Right mouse key with [Roam] selected moves the image around the
screen.
Using the Right mouse key with [Zoom] selected makes the image bigger or
smaller
Click [Explicit Magnify] to enter a specific magnification factor.
Click [Flip/Rotate] to change the image orientation.
Click [Measure Angle] to measure the angle between structures.
Click [Measure Distance] to measure from point to point.
Click [Display Normal] to return the image to its original state.
Click [User Annotation] to enter text on the screen.
Click [Erase] to remove any added text from the screen.
Click [Maintain] to maintain graphics from image to image.
Click [Grid On/Off] to display a grid or to turn the grid off. This is a toggle button.
Click [Screen Save] to capture the image with graphics added.
NOTE: Screen Saved images will not be added to the data base until the current SmartStep
series is ended. The images will not be listed in List/Select until you exit SmartStep.
Click [Forward 1] to advance the image viewports by one image.
Click [Backwards 1] to reverse the images displayed by one image.
Click [Last Image] to display the last exposed image.

14-19
SmartStep (Option)
Figure 14-4 Display Functions
Quick Steps: Display SmartStep Images

1.
2.
3.
4.
Change the primary focus to the free viewport.

Click [List/Select] to display an image in the free viewport.
Click [Accept].
Perform the display functions as needed.

14-20
SmartStep (Option)

The Hand Held Control device has a window/level button that toggles between six different
window/level presets. To set the presets to your desired levels you must follow the following
steps.
1. Click [Display Prefs] from the Exam RX display screen.
This opens the display preferences screen.
2. Click [SmartStep].
The SmartStep window level preset window appears.
3. Enter the desired window width and level for all six locations.
NOTE: Keep the mouse inside the text box while typing the parameter.
4. Click [Save as defaults] to save the values entered.

14-21
SmartStep (Option)
Quick Steps: Set Window/Level Presets for the HHC

1.
2.
3.
4.
Click [Display Prefs] from the Exam RX display screen.

Click [SmartStep].
Enter the desired window width and level for all six locations.
Click [Save as defaults] to save the values entered.

14-22
SmartView (Option)
Chapter 15
SmartView (Option)
Introduction
SmartView is a mode of scanning designed for interventional procedures. The Radiologist or
Physician usually inserts a needle or catheters into a patient and then need to see images
showing the position of the catheter or needle.
This chapter explains the SmartView imaging process for BrightSpeed Excel, BrightSpeed
Edge, and BrightSpeed Elite systems. It contains the step-by-step instructions to help you
learn how to:
Prepare for SmartView
Set Up SmartView Mode
Scan with SmartView
Display SmartView Images
Set SmartView Layout Preference
Create New Images from SmartView Scan Data

15-1
SmartView (Option)

This section presents the concepts necessary to successfully complete the Interventional
Imaging process. Specifically you need to understand:
SmartView
Integrated Hand Held Controller (HHC)
SmartView Display
SmartView
SmartView is a real-time mode of scanning designed to be used by the Radiologist or
Physician during interventional procedures. The SmartView is accomplished by using the
integrated Hand Held Controller (HHC) and foot switch. SmartView is only available on
BrightSpeed based 4 slice, 8 slice, or 16 slice systems. These systems are designated as a
BSD gantry system in the configuration of the system.
You can make exposures in continuous (fluoro) mode or in step mode.
In continuous mode, images can be acquired in 1i mode with the image display at 12 frames
per second or in 3i mode with the image display at 8 frames per second per viewport or 24
images per second. Tap mode is a single rotation mode which displays 1 or 3 images
(depending on the layout you have selected) when pressing and releasing the foot switch.
The available slice thicknesses for SmartView are:
1.25 mm for BrightSpeed Elite.
2.5 mm, 5 mm, 7.5 mm, and 10 mm for BrightSpeed Excel, BrightSpeed Edge.
These are created from using a 4X detector configuration. In 1i mode all four rows are
combined to create a single image. In 3i mode, detector rows one and two create image
one. Detector rows two and three create image two. Detector rows three and four create
image three. The detector configurations are:
BrightSpeed Elite
4 X 0.625 1.25mm/3i
4 X 0.625 2.5mm/1i
BrightSpeed Excel, BrightSpeed Edge

4 X 1.25 2.5mm/3i
4 X 1.25 5mm/1i
4 X 2.5 5mm/3i
4 X 2.5 10mm/1i
4 X 3.75 7.5mm/3i

15-2
SmartView (Option)
Prospectively Soft and Standard algorithm are allowed with Segment Recon mode and
reconstruction in a 340 image matrix. Retrospectively all algorithms are available when the
Full recon mode is utilized. Retrospective recon is in a 512 image matrix. Rotation times of
0.5, 0.8 second and 1 second are available for SmartView.
SmartView scans can be built in a scan protocol as a new series. Most Recent protocols
containing SmartView series can be saved, copied and pasted as new protocols.
Other desktops are unavailable during SmartView.
Integrated Hand Held Controller (HHC)

During needle biopsies, the Radiologist or Physician controls radiation with the foot switch,
and uses HHC to view images on an in-room monitor. The HHC also provides alignment
light, move-to-scan, cradle micro positioning controls, and table automove controls. The
Radiologist or Physician also has the option to release HHC control of the cradle, and use the
cradle handle to manually position the patient in the scan field of view.

15-3
SmartView (Option)
Figure 15-1 Integrated Hand Held Controller
Alignment Light
Prep
Move to Start Location

Cradle Move Out
Cradle Move In
Bump In
Bump Out
Automove
Cradle Release
Change Focus
Next Image
Prior Image
W/L Toggle
Table 15-1 Hand Held Controller Button Descriptions

Button Name
Prep
Button
Description
Prepares the system for x-ray acquisitions.

15-4
SmartView (Option)
Button Name
Alignment Light
Move to Start
Location
Button
This button Enables the laser positioning lights.
This button positions the cradle to the start

location prescribed by you in the SmartView
View/Edit screen.
Cradle Move In
The Cradle Move In button moves the cradle in

towards the gantry.
Cradle Move Out
The Cradle Move Out button moves the cradle

away from the gantry.
Bump In

distance towards the gantry. The bump distance is
pre-defined on the View/Edit screen.
Bump Out

distance away from the gantry. The bump
distance is pre-defined on the View/Edit screen.
Automove
This places the table in Auto Move mode. While

auto move is enabled the table moves
automatically as the foot switch is pressed and the
direction of movement is selected.
Cradle Release
This is a toggle button. It releases the cradle so it

can be moved using the cradle handle. Pressing
the button again latches the cradle.
Change Focus
This changes the primary focus window between

the interventional viewports and the free viewport.
Next Image
This displays the next image in the sequence of

images.

15-5
SmartView (Option)
Button Name
Button
Prior Image
This displays the prior image in the sequence of

images.
W/L Toggle
This toggles between six different window level

settings.

15-6
SmartView (Option)
SmartView Display
SmartView display provides single or multiple image displays for interventional images with
a free viewport on the side of the display window. The free viewport allows you to choose
any image to be displayed by clicking on [List/Select]. The interventional viewports
automatically update each time an exposure is made with the foot pedal.
Figure 15-2 SmartView window
Free Viewport
Interventional Viewport
The Remaining time indicates how much time you have left in this series before you have to
go back to the View/Edit screen and click [Confirm] again. The Accumulative time indicates
how much time the patient has been exposed to radiation. This time will keep updating as
long as you stay in the same exam. Once you end the exam, the accumulative time resets to
zero.
NOTE: The total accumulated exposure time for all SmartView scan groups and Series will
be displayed on the Dose Text page.
CAUTION:
You can only expose the patient 90 seconds per session.

15-7
SmartView (Option)
How Do I...
This section provides the step-by-step instructions for using the SmartView scan mode.
Scan with SmartView

15-8
SmartView (Option)

This section explains how to prepare for a SmartView procedure. You must connect the foot
pedal and the Hand Held Control (HHC) devices to the gantry. These devices are used by the
Radiologist or Physician to prepare the system for exposures, make exposures, view images,
and to move the cradle.
Use this procedure to plug the HHC and foot pedal to the gantry in preparation for
SmartView.
1. Locate on each side of the gantry the rear access plates to plug the switches into.
Foot Switch Outlet Hand Switch Outlet

2. Plug the foot switch into the foot switch outlet.
3. Plug the HHC into the hand switch outlet.
NOTE: It is best to plug the switches in on the same side of the patient where the Radiologist
or Physician will be doing the procedure from.
4. Position the in room display monitor so the doctors can view the images.
This display monitor is suspended from the ceiling and can be moved to either side of
the cradle.
5. Prepare the patient and supplies for the procedure.
Have your biopsy tray and other supplies ready for the Physician or Radiologist.
Prepare the patient for the procedure by creating a sterile area and explaining the
breathing instructions.

15-9
SmartView (Option)
Quick Steps: Prepare for SmartView

1.
2.
3.
4.
5.
Locate on each side of the gantry the rear access plates to plug the switches into.
Plug the foot switch into the foot switch outlet.
Plug the HHC into the hand switch outlet.
Position the in room display monitor so the doctors can view the images.
Prepare the patient and supplies for the procedure.

15-10
SmartView (Option)

Once the patient has been prepared and set up for the interventional procedure, you can
proceed with setting up for image acquisition in the SmartView mode.
1. Select SmartView.
SmartView can be selected from the following:
from the Dynaplan screen.
[Next Series] if you are using a preset protocol.
Clicking [Create New Series].
This following windows appears.
2. Click [Scan Type] and select, [0.5] ( not available in BSD Select Series), [0.8 sec], or [1.0
sec].
Figure 15-3 .
+ and - may be subsituted for S and I. S equals + and I equals -.

15-11
SmartView (Option)
For 4, and 8 slice scanners you can select from the following:
2.5 mm 3i
5 mm 3i
7.5 mm 3i
5.0 mm 1i
10 mm 1i
For 16 slice scanners you can select from the following:
1.25 mm 3i
2.5 mm 3i
5mm 3i
7.5 mm 3i
2.5 mm 1i
5.0 mm 1i
10 mm 1i
This is a time that is entered before you have to reset the timer.
The default Bump Distance is half of the selected slice thickness.
Soft and Standard algorithm are available prospectively and all algorithms are
available retrospectively if you have the Full recon mode selected.
+ and - may be subsituted for A, P, and L. A equals + and P equals -. R equals + and L
equals -.

15-12
SmartView (Option)
A warning message appears.

The SmartView dynaplan screen appears.

15-13
SmartView (Option)
Quick Steps: Set Up SmartView Mode

1. Select SmartView.
2. Click [Scan Type] and select, [0.5] ( not available in BSD Select Series), [0.8 sec], or [1.0
sec].

15-14
SmartView (Option)
Scan with SmartView

This task explains the process of scanning with SmartView. You must have the foot switch
and the hand held control devices plugged into the gantry.
NOTE: During SmartView mode, filming, archive, and networking are not available.
SmartView recon has the highest priority. Previously acquired recon queued images
are paused until SmartView is complete.
screen.
The message area of the screen will indicate PRESS PREP.
Once the Prep button has been pressed or clicked, the screen will update to PREP IN
PROGRESS.

15-15
SmartView (Option)
3. Step on the foot pedal to make an exposure in the SmartView scanning mode.
The XRAY ON message indicator appears.

As long as the foot pedal is pressed a continuous exposure will be made.
If you want single rotation or tap/quick check press and release the pedal.
5. Repeat steps 1-4 as many times as necessary while scanning in the SmartView mode.
If you use Repeat Series in SmartView, the Exposure time of the SmartView scan
group is the sum of all SmartView scans. This may be less than the 90 seconds
initially chosen.
Repeat SmartView always sets the exposure time to 90 seconds.

15-16
SmartView (Option)
Quick Steps: Scan with SmartView

screen.
3. Step on the foot pedal to make an exposure in the SmartView scanning mode.
5. Repeat steps 1-4 as many times as necessary while scanning in the SmartView mode.

15-17
SmartView (Option)

There are a few basic image review functions available in the SmartView mode. For more
information on how to use these display functions, refer to Measuring Structures Within an
Image, Magnifying Images and Graphics, Text Pages and Commands.
WARNING: When scanning for interventional procedures using helical, axial, cine, or
Biopsy Mode with or without the boom in the room option, you should take
care when selecting the display format for Auto View of the images. A multi
image Auto View display such as the 4 on 1 or 2 on 1 Auto View layouts should
not be used for this type of study. These layouts do not display images in the
order the data was acquired and may cause confusion in determining the
relationship of the Superior to Inferior direction of the anatomy. Use a single
image Auto View display and review the images in a single image viewport
for interventional studies.
4 on 1
2 on 1
1. Change the primary focus to the free viewport.

Click on the free viewport
OR, using the HHC press the Change Focus button to activate the free viewport.
2. Click [List/Select] to display an image in the free viewport.
This opens a Browser for you to select an Exam, Series, and an Image.
3. Click [Accept].
This displays the selected image.

15-18
SmartView (Option)
4. Perform the display functions as needed.
Click [Roam] or [Zoom] to set the right mouse button function.
Using the Right mouse key with [Roam] selected moves the image around the
screen.
Using the Right mouse key with [Zoom] selected makes the image bigger or
smaller
Click [Explicit Magnify] to enter a specific magnification factor.
Click [Flip/Rotate] to change the image orientation.
Click [Measure Angle] to measure the angle between structures.
Click [Measure Distance] to measure from point to point.
Click [Display Normal] to return the image to its original state.
Click [User Annotation] to enter text on the screen.
Click [Erase] to remove any added text from the screen.
Click [Maintain] to maintain graphics from image to image.
Click [Grid On/Off] to display a grid or to turn the grid off. This is a toggle button.
Click [Screen Save] to capture the image with graphics added.
Screen Saved images will not be added to the data base until the current
SmartView series is ended. The images will not be listed in List/Select until you
exit SmartView.
Click [Forward 1] to advance by one image.
Click [Backwards 1] to advance by one image.
Click [Page Forward] to initiate a forward paging loop.
Click [Page Backward] to initiate a backward paging loop.
Click [Last Image] to display the last exposed image.
Click [N/P Each VP] to shift the multi image display to one viewport to shift the multi
image display one viewport with each forward 1 image or backward 1 image..
N/P Each VP provides the ability to move the superior or inferior image to the
center large viewport.

15-19
SmartView (Option)
Figure 15-5 Display Functions
Quick Steps: Display SmartView Images

1.
2.
3.
4.
Change the primary focus to the free viewport.

Click [List/Select] to display an image in the free viewport.
Click [Accept].
Perform the display functions as needed.

15-20
SmartView (Option)

The display layout used during SmartView scanning is determined by the slice thickness
mode, 1i or 3i and the layout preference set in SmartView Preferences.
1. Click [Display Prefs] located on the Exam Rx desktop.
This opens the display preferences window.
2. Click [SmartView].
The SmartView preset window appears.
3. Select the desired format.
You can select the single or multiple viewport display.
4. Click [Save as Default].
This saves the selection that you made.

15-21
SmartView (Option)
Quick Steps: Set SmartView Layout Preference

1. Click [Display Prefs] located on the Exam Rx desktop.
3. Select the desired format.
4. Click [Save as Default].

15-22
SmartView (Option)

The Hand Held Control device has a window/level button that toggles between six different
window/level presets. To set the presets to your desired levels you must follow the following
steps.
1. Click [Display Prefs] from the Exam RX display screen.
This opens the display preferences screen.
The SmartView window level preset window appears.
3. Enter the desired window width and level for all six locations.
NOTE: Keep the mouse inside the text box while typing the parameter.
4. Click [Save as defaults] to save the values entered.

15-23
SmartView (Option)
Quick Steps: Set Window/Level Presets for the HHC

1.
2.
3.
4.
Click [Display Prefs] from the Exam RX display screen.

Click [SmartView].
Enter the desired window width and level for all six locations.
Click [Save as defaults] to save the values entered.

15-24
SmartView (Option)

The SmartView scan data contains all of the information gathered from each exposure. This
makes it possible to create images of the same anatomy presented in a different manner.
SmartView scan data may be reconstructed into a 512 matrix image and any recon
algorithm with Full recon mode. Image reconstruction is time based. A start and end time
must be specified. If 3i mode was used prospectively, Retro Recon will reconstruct the
images in 1i or 2i mode.
For more information on how to reconstruct images, refer to Create New Images From Scan
Data.
1. From the scan monitor, click [Retro Recon].
The Retro Recon list select screen appears. All images with available scan data are
listed.
2. From the Retro Recon list select screen, select the appropriate SmartView Exam.
3. Click [Select Series].
4. Click [Retro] for all groups or click [Y] for an individual group.
If you select [Retro], a pop up window appears. Choose [Yes] or [No]. You may also
click on the individual group and toggle between [Y] and [N].
The system assumes all available data is to be reconstructed. If there are multiple
groups, you must determine which group(s) has data you wish to reconstruct.
5. Select [Time].
The time range window appears.
6. Enter the desired Start and End times.

15-25
SmartView (Option)
7. Click [Recon Options].
The recon options screen appears.
8. Click [Full] from the Recon mode area.

9. Enter the desired Window Width and Level.
10. Click [OK].
11. As needed, click [Recon Type].
A pop up window appears with all of the available algorithms from which you can
choose the appropriate algorithm.
Soft and Standard are only available if Segment recon mode is selected.
Soft, Standard, Detail, Lung, Bone, Bone Plus and Edge are available if Full recon
mode is selected.
12. Click [Confirm] to generate images.

15-26
SmartView (Option)
Quick Steps: Create New Images from SmartView Scan Data

2. From the Retro Recon list select screen, select the appropriate SmartView Exam.
5. Select [Time].
6. Enter the desired Start and End times.
7. Click [Recon Options].
8. Click [Full] from the Recon mode area.
9. Enter the desired Window Width and Level.
10. Click [OK].

15-27
SmartView (Option)

15-28
Scheduling Patients
Chapter 16
Scheduling Patients
Introduction
This chapter explains how to schedule patients. It contains the step-by-step instructions to
Use the Bar Code Reader
Update the Patient Schedule List
Add a Patient to the Schedule
Delete a Patient From the Schedule
Set Up Preferences in the Schedule
Edit a Patient Schedule
Select a Patient from the Schedule
Check the Status of a Patient
View More Information About the Patient

16-1
Scheduling Patients

This section presents concepts necessary to understand ways to use Patient Schedule.
Patient Schedule
Connect Pro
New Records and Completed Records
Patient Schedule
Patient Schedule is a feature which allows patient information and exam protocols to be
pre-programmed in advance of patient arrival. At scan time, you can either select from the
created list, enter the patient ID number, enter the Accession number or use the optional Bar
Code Reader to call up patient information. Patient information can be easily added or
deleted from this list.
Connect Pro
Connect Pro is a purchasable option which retrieves critical patient information from your
HIS/RIS using a DICOM connection and sends it to your scanner. Connect Pro pulls
information from HIS/RIS and put it into Patient Schedule.
Connect Pro can also be customized to fit your departments needs by using "filters" to pull
only the information in which you are interested.
Connect Pro can collect more than just the standard demographic information about your
patients. It can also collect other information, such as allergies, pregnancy status, medical
alerts, or any other information about your patient.
New Records and Completed Records

In the patient schedule there is a column labeled Status. In the status column, an "N" or a "C"
is listed next to each patient entry. "N" stands for Not completed or New record. These are
exams that are scheduled in Patient Schedule, but are not yet completed. "C" stands for
Completed record. These exams were scheduled and have now been completed.
NOTE: If obtaining your patient using Connect Pro it is best to only have New Records in your
schedule list. Having Completed Records may cause inadvertent scanning of a
patients with the wrong accession number. Set Delete Completed Exams to 0 days in
the Connect Pro preferences. This setting assures that Completed Records are not
added to the Schedule List.

16-2
Scheduling Patients
How Do I...
This section provides the step-by-step instructions to utilize the Schedule Patient feature.

16-3
Scheduling Patients

The Bar Code Reader, which is used with the Connect Pro option, is a simple way to get
patient information. The patient information must be in the Patient Schedule list before
using this feature.
1. Click [New Patient].
2. Aim the Bar Code Reader at the bar code for either Accession number or Patient ID on
the patient requisition.
The patient information is pulled from the Patient Schedule list and automatically fill
into the fields on the Patient Information screen.
Table 16-1 Patient Information
Field Name
Parameters
Accession Number
Up to 16 characters
Patient ID
Up to 16 characters
Patient Name
Up to 32 characters
Sex
M (Male) or F (Female)
Birthdate
Months, Weeks, Days
Age
Years, Months, Weeks, Days
Weight
Kgs or Pounds
Reference Physician
Up to 32 characters
Radiologist
Up to 32 characters
Operator
Up to 3 characters
History
Up to 60 characters
Exam Description
Up to 22 characters
Protocol Number
Up to 5 characters
Req. Proc. ID
Up to 16 characters
Date
Exam Date Month, Day, Year
Time
Exam Time Hour, Minute
3. Select desired protocol and begin exam.

16-4
Scheduling Patients
NOTE: The Exam Description will be truncated to 22 characters when imported from a
HIS/RIS system. The Study description field (0008, 1030) in the DICOM header is
mapped to the Exam Description field on the Schedule Patient and New Patient
screens.
NOTE: When entering the Patient ID, if more than one record with the same Patient ID is
found in the Patient schedule list a dialog displays notifying you of this. Be sure when
selecting the patient record that you have selected the correct entry for the scan
being performed. To avoid having multiple Patient Records with the same Patient ID
make sure to set the Delete Completed Exams preference to zero. This will assure that
only new records are in the Patient Schedule list.
Quick Steps: Use the Bar Code Reader

2. Aim the Bar Code Reader at the bar code for either Accession number or Patient ID on
the patient requisition.
3. Select desired protocol and begin exam.

16-5
Scheduling Patients

Update allows you to update your Patient Schedule list with information from HIS/RIS. The
Get Patient List For: section allows you to choose the system or systems you wish to pull
from the HIS/RIS schedule of patients. The With A Date Range: section allows you to pull
from certain dates.
2. Click [Update].
3. Under Get Patient List For:, click [This System], [All CT Systems], or [All Systems].
This System pulls the patient schedule for the current scanner you are on.
All CT Systems pulls the patient schedule for all of the CT systems on the HIS/RIS
connection.
All Systems pulls the patient schedule for all the systems on the HIS/RIS connection.
4. Select a Date Range.
Type in a From and To date. Be sure to follow the correct month/day/year format.

16-6
Scheduling Patients
5. If desired, type the Requested Proc. ID or Accession Number information into the
correct fields.
This is an additional way to pull patient information.
6. If desired, type the patients name information into the correct field.
This is a quick way to search for a patients name.
7. If desired, type the patients ID information into the correct field.
8. Click [Continue Update] to continue or [Cancel Update] to cancel without saving any
new selections.
Quick Steps: Update the Patient Schedule List

1.
2.
3.
4.
5.
Click [Patient Schedule].

Click [Update].
Under Get Patient List For:, click [This System], [All CT Systems], or [All Systems].
Select a Date Range.
If desired, type the Requested Proc. ID or Accession Number information into the
correct fields.
6. If desired, type the patients name information into the correct field.
7. If desired, type the patients ID information into the correct field.
8. Click [Continue Update] to continue or [Cancel Update] to cancel without saving any
new selections.

16-7
Scheduling Patients

Patient information can easily be added manually to the Patient Schedule list.
2. Click [Add Patient].
The Patient Schedule information screen appears (it looks similar to the New Patient
screen).
3. Enter the patient information.

a) If desired, add the number of the specific protocol under Protocol Number.
b) If desired, type in the date and time in the appropriate fields.

16-8
Scheduling Patients
- Accession Number : (up to 16 characters)
- Patient ID : (up to 16 characters)
- Patient Name : (up to 32 characters)
- Sex : M (Male) or F (Female)
- Birthdate : Month, Day, Year
- Age : Years, Months, Weeks, Days
- Weight : Kgs or Pounds
- Reference Physician : (up to 32 characters)
- Radiologist : (up to 32 characters)
- Operator : (up to 3 characters)
- History : (up to 60 characters)
- Exam Description : (up to 22 characters)
- Protocol Number : (up to 5 characters)
- Req. Proc. ID: (up to 16 characters)
- Date : Exam date, Month, Day, Year
- Time : Exam time, Hour, Minute
4. Click [Accept] to save changes and add patient information to the schedule list.
5. Click [Cancel] to return to the main Patient Schedule screen.
Quick Steps: Add a Patient to the Schedule

1.
2.
3.
4.
5.

Click [Add Patient].
Enter the patient information.
Click [Accept] to save changes and add patient information to the schedule list.
Click [Cancel] to return to the main Patient Schedule screen.

16-9
Scheduling Patients

Patients can be deleted from the Patient Schedule list selectively or all at once.
2. Select the patient(s) to be removed.

a) For a single patient, click on patient name with left mouse.
b) For multiple patients in a row, use left mouse and click and drag to select patient
names.
c) For a more defined selection, press Control and click with left mouse on selected
patient names.
3. Click [Delete Selected] to delete the selected patient(s).
4. Click [Delete All] to delete all patients on the list.
Quick Steps: Delete a Patient From the Schedule

1.
2.
3.
4.

Select the patient(s) to be removed.
Click [Delete Selected] to delete the selected patient(s).
Click [Delete All] to delete all patients on the list.

16-10
Scheduling Patients

The Preferences feature allows the sort order to be set along with the delete time for entries
in the Patient Schedule list.
There are also several choices for use if you have the Connect Pro option.
2. Click [Preferences].
3. To sort exams, click [Date/Time], [Name], or [ID] to sort by.

16-11
Scheduling Patients
4. Set the number of days to delete exams.
Type in the number of days after which you would like the scanner to delete the
completed exams.
The number must be between 0-30.
A completed record is not added to the Patient Schedule list if number of days is set
to 0.
The system default is 3.
NOTE: It is important to set the Delete Completed Exams to zero when Patient Information
is updated from the HIS/RIS. This assures that Completed Accession numbers are
not inadvertently selected for scanning a second time causing Patient reconciliation
issues on the PACS system.
5. With the Connect Pro option, click [Yes] or [No] to Update Schedule Automatically.
Selecting Yes updates the schedule when you click Patient Schedule.
It updates based on the parameters selected in Update.
6. With the Connect Pro option, click [Yes] or [No] to Show Update Parameters.
Selecting Yes shows the Update screen every time the system starts to automatically
update.
This allows you to edit the Update parameters, if desired.
7. With the Connect Pro option, click [Yes] or [No] for Use Study UID?
Selecting Yes uses a study instance UID (Unique Identifier) from HIS/RIS.
By selecting No, the scanner assigns the study instance UID (Unique Identifier) to the
exam.
8. With the Connect Pro option, click [Yes] or [No] for Edit Modality Worklist?
Selecting [No] prevents you from editing any patient information from HIS/RIS.
Selecting [Yes] allows you to edit any patient information from HIS/RIS.
9. Click [OK] to accept entries, or [Cancel] to cancel out without accepting entries.

16-12
Scheduling Patients
NOTE: Preferences are not maintained between system software loads. Please update the
preferences after a software load has occurred.
Quick Steps: Set Up Preferences in the Schedule

1.
2.
3.
4.
5.
6.
7.
8.
9.

Click [Preferences].
To sort exams, click [Date/Time], [Name], or [ID] to sort by.
Set the number of days to delete exams.
With the Connect Pro option, click [Yes] or [No] to Update Schedule Automatically.
With the Connect Pro option, click [Yes] or [No] to Show Update Parameters.
With the Connect Pro option, click [Yes] or [No] for Use Study UID?
With the Connect Pro option, click [Yes] or [No] for Edit Modality Worklist?
Click [OK] to accept entries, or [Cancel] to cancel out without accepting entries.

16-13
Scheduling Patients

Patient information may be edited if entered incorrectly in the Patient Schedule list.
The Patient Schedule appears.
2. Select the desired patient from the list.

3. Click [Edit Patient].
4. Change patient information as needed.

The patient record cannot be edited if it came from HIS/RIS and Edit Modality
Worklist is set to [No].
5. Click [Accept].

16-14
Scheduling Patients
Quick Steps: Edit a Patient Schedule

1.
2.
3.
4.
5.

Select the desired patient from the list.
Click [Edit Patient].
Change patient information as needed.
Click [Accept].

16-15
Scheduling Patients

Patient Schedule allows patients to be easily selected at scan time.
3. Select the desired patient from the list.

All patient information fills into the New Patient screen.

5. Select the desired protocol to continue.
If a protocol was not previously chosen or if a different protocol is desired.

16-16
Scheduling Patients
6. Click [Enter] to begin.
NOTE: From the New Patient screen, you can also type in the patient ID, Accession number
or use the optional Bar Code Reader to select a patient. Make sure you have the
correct field selected for your entry.
Quick Steps: Select a Patient from the Schedule

1.
2.
3.
4.
5.
6.
Click [New Patient].

Select the desired patient from the list.
Click [Select Patient].
Select the desired protocol to continue.
Click [Enter] to begin.

16-17
Scheduling Patients

Patients listed in the Patient Schedule has an "N" in the status column if the exam is NOT
completed indicating it is a New Record. A "C" in the status column indicates the exam IS
completed.
The schedule list appears and the far right column is labeled Status.
N stands for an exam which is a New Record or is Not Completed.

C stands for an exam that is Completed.
2. Use the [Next] or [Prior] buttons in the lower right of the screen to scroll from page to
page.
Quick Steps: Check the Status of a Patient

2. Use the [Next] or [Prior] buttons in the lower right of the screen to scroll from page to
page.

16-18
Scheduling Patients

Use this feature with the Connect Pro option to view other valuable information about a
patient such as allergies, pregnancy status, and medical alerts. This information is pulled
from the HIS/RIS using a DICOM connection.
2. Select a patient from the list.

16-19
Scheduling Patients
3. Click [View More Info].
A screen appears with additional patient information.
4. Click [Cancel] to exit this screen.
Quick Steps: View More Information About the Patient

1.
2.
3.
4.

Select a patient from the list.
Click [View More Info].
Click [Cancel] to exit this screen.

16-20
Scheduling Patients

16-21
Scheduling Patients

16-22
Biopsy Mode
Chapter 17
Biopsy Mode
Introduction
This chapter explains how to use the biopsy mode. The biopsy mode improves the efficiency
of setting up and acquiring slices during a biopsy.
This chapter contains the step-by-step instructions to help you learn how to:
Use the Biopsy Mode

17-1
Biopsy Mode

This section presents the concepts necessary to successfully use the Biopsy Mode. The
Biopsy Mode
Biopsy Reference Scans
Biopsy Mode
The Biopsy Mode or Biopsy Rx improves the efficiency of setting up and acquiring slices
during a biopsy. All of the parameters required are available on one menu. You are able to
choose which direction the scanner acquires images from a centering point as well as how
many images to acquire. You can change slice thickness and/or interval. You can enter a
specific location for a slice and a gantry tilt, if required.
NOTE: AutomA is turned off when Biopsy Mode is entered. Review the Manual mA value
prescribed.
Biopsy Reference Scans

When you click [Biopsy Rx], you need to choose how the system scans based on the biopsy
location.
If you choose [Superior], the system makes the biopsy reference location the first scan, with
subsequent images acquired superiorly from that location.
If you choose [Centered], the system makes the biopsy reference location the center slice,
with the other images acquired above and below that location.
If you choose [Inferior], the system makes the biopsy reference location the first scan, with
subsequent images acquired inferiorly from that location.

17-2
Biopsy Mode
How Do I...
This section provides the step-by-step instructions for using the biopsy mode. Specifically, it
describes how to:
Use the Biopsy Mode

17-3
Biopsy Mode
Use the Biopsy Mode

The Biopsy Mode is a very useful function for routine biopsies. Prior to using the biopsy
mode, the scan type must be set. This determines the mode (Axial or Helical) for the biopsy
sequence.
WARNING: When scanning for interventional (biopsy) studies the scan mode, image
thickness, number of images per rotation and the display layout used affect
the display of the images. It is recommended to use the Biopsy Mode provided
on the system. If manually prescribing biopsy scans, Axial 1i scan mode or
Helical scan mode with a slice thickness greater than 2.5 mm must be used.
Do not use Cine scan mode for interventional (Biopsy) imaging. Do not use an
Auto view layout with more than one Auto View image viewport.
4 on 1
2 on 1
NOTE: Technical factors such as scan type, kV, mA and rotation time used is determined
based on the last group scanned. If the AutoVoice feature was used in the prior group,
it is still on for the biopsy scans.

17-4
Biopsy Mode
1. From the view/edit screen, click [Biopsy Rx].
A pop up window appears containing all of the Biopsy Rx Parameters.
2. Set the Biopsy Reference.

The Biopsy Reference tells the system how to acquire images based on the Biopsy
Location. Selecting [Superior] means all images are acquired from the Biopsy
Location, superiorly. Selecting [Centered] means the system acquires images above,
at, and below the Biopsy Location. Selecting [Inferior] means the images are
acquired from the Biopsy Location, inferiorly.
NOTE: When using Centered, it is easier to program odd numbers of slices, i.e. 3,5,7, etc. This
allows the system to place even numbers above and below the reference location. If
you choose to use even numbers of slices, the system places the extra image in the
superior portion.
3. Enter Biopsy Location or click [Get Alignment Light Location].
If you have a specific location chosen from the localizer scans, you may enter that
location in the biopsy location field. Your other option is to move the table and center
the needle under the External or Internal laser light and then select the appropriate
designation in the Set Alignment Light selection depending on the laser used for
centering. This way is especially helpful once the needle or tube is placed.
4. Enter the Number of Images to be acquired for each pass.
You may enter any value.
5. Enter Gantry Tilt, if necessary.

17-5
Biopsy Mode
6. Click [Thickness].
This sets the slice thickness for each image. Choose from 1.25 mm, 2.5 mm, 3.75 mm,
5.0 mm, 7.5 mm or 10 mm for the helical scans.
Axial thickness choices are 5/1i and 10/1i. This restriction for axial scans, is so that
the location on the gantry is the location of a slice.
7. Enter the Image Interval.
Image Interval is for helical scans only.This sets the distance between images.
Commonly for a biopsy, the interval is set to the same value as the slice thickness or
with minimal overlap.
8. Click [Confirm Biopsy Rx] or [Cancel].
Confirm Biopsy Rx activates the scan sequence to acquire images. Cancel cancels
the Biopsy Rx window and does not acquire images.
NOTE: The Biopsy Rx button is also available from the dynaplan screen. All of the steps
remain the same. It is very useful to utilize this button, especially if a series of biopsy
images have been acquired previously. This is because the biopsy images remains in
the same series number and there is no need to return to the view/edit screen.
NOTE: Biopsy Images are not AutoFilmed. If a previous scan group had AutoFilm on, it is now
turned off. Any subsequent scans done has to turn AutoFilm back on.
NOTE: Check the mA prescribed. AutomA is automatically turned off in Biospy Mode. Review
the mA value to ensure it is appropriate for the type of scan being performed. Return
to the view/edit screen and adjust mA as needed.
Quick Steps: Use the Biopsy Mode

1.
2.
3.
4.
5.
6.
7.
8.
From the view/edit screen, click [Biopsy Rx].

Set the Biopsy Reference.
Enter Biopsy Location or click [Get Alignment Light Location].
Enter the Number of Images to be acquired for each pass.
Enter Gantry Tilt, if necessary.
Click [Thickness].
Enter the Image Interval.
Click [Confirm Biopsy Rx] or [Cancel].

17-6
Recommended Workflow for RT
Chapter 18

Introduction
This chapter contains the step-by-step instructions to help you learn how to:
Recommended workflow for RT
Radiotherapy Planning 5141172-100 Rev. 4 (06/07)

18-1
Recommended workflow for RT

1. Position patient on the table.
2. Cradle should be at the home position.
3. Select Internal landmark on the gantry controls.
4. After the patient is positioned on the table, drive the cradle between 890 mm to 850 mm
into the gantry bore and then back to the full-retracted position using the gantry
controls.
This centers the cradle.
Each in and out motion of the cradle is one cycle.
The cradle must cycle the number of times as determined in the Lateral Motion
Verification procedure.
NOTE: Determine the number of extension/retraction cycles needed based on testing.
5. Center a landmark on the RT tabletop using the sagittal room alignment laser line.
6. Using external room lasers position patient elevation as desired and place temporary
patient alignment marks on the skin.
7. Place radio-opaque fiducial markers on the temporary alignment marks.
8. Turn on CT gantry laser lights.
9. Move patient into the gantry such that the axial landmark location for imaging (For
example: sternal notch, .) placed in step 7 aligns with the axial internal gantry laser.
10. With the gantry lasers on, adjust the patient elevation until the gantry elevation laser
matches the patient alignment marks placed in step 7.
11. Establish the landmark as the scan reference with the gantry internal landmark button.
12. Conduct the CT exam with the landmark established in step 7.
13. Turn on the external room lasers.
14. Retract the patient and change elevation of table to match the patient alignment marks
placed in step7.
15. Review the resulting images and confirm that the radio-opaque markers placed in step
7 align with the image coordinate iso-center.
16. Determine treatment Iso-center with simulation software such as Advantage Sim.
17. Shift room lasers as defined by simulation software.
18. Tattoo the patient for therapy.

18-2
Quick Steps: Recommended workflow for RT

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
Position patient on the table.

Cradle should be at the home position.
Select Internal landmark on the gantry controls.
After the patient is positioned on the table, drive the cradle between 890 mm to 850
mm into the gantry bore and then back to the full-retracted position using the gantry
controls.
Center a landmark on the RT tabletop using the sagittal room alignment laser line.
Using external room lasers position patient elevation as desired and place temporary
patient alignment marks on the skin.
Place radio-opaque fiducial markers on the temporary alignment marks.
Turn on CT gantry laser lights.
Move patient into the gantry such that the axial landmark location for imaging (For
example: sternal notch, .) placed in step 7 aligns with the axial internal gantry laser.
With the gantry lasers on, adjust the patient elevation until the gantry elevation laser
matches the patient alignment marks placed in step 7.
Establish the landmark as the scan reference with the gantry internal landmark
button.
Conduct the CT exam with the landmark established in step 7.
Turn on the external room lasers.
Retract the patient and change elevation of table to match the patient alignment
marks placed in step7.
Review the resulting images and confirm that the radio-opaque markers placed in
step 7 align with the image coordinate iso-center.
Determine treatment Iso-center with simulation software such as Advantage Sim.
Shift room lasers as defined by simulation software.
Tattoo the patient for therapy.

18-3


18-4
Patient Setup and Scout Scan
Chapter 19

Introduction
This chapter explains setting up the patient and completing a localizer (Scout) scan. It
contains the step-by-step instructions to help you learn how to:
Set Up Patient Information
Position the Patient
Selecting a Protocol
Adjust the Localizer (Scout)
Confirm the Localizer (Scout)

19-1

This section presents the concepts necessary to successfully set up a patient for scanning.
Using Protocols
Using Contrast
Setting Up a Patient without an ID#
Emperor Era Birth Year Entry
Using Protocols
All parameters for scanning a patient can be set up in a protocol. This saves the technologist
time when prescribing scan parameters for each patient. When a new patient is to be
scanned, the technologist types in the patient information and chooses a protocol. The
protocol may be adjusted on a per patient basis without permanently altering the original
set of parameters. Once the parameters are set and the prescription is confirmed, scanning
can begin.
NOTE: For information on building protocols, refer to the Building Protocols chapter.
Using Contrast
When IV contrast is to be used, make sure the injector or syringes of contrast are set up
before performing the localizer (scout) scan. The contrast (syringe) icon on the lower right
corner of the view/edit screen must be selected. When the icon is selected, there is a +C
annotation on the images next to the image number, indicating that IV contrast was used
for that exam.
Setting Up a Patient without an ID#

The patient ID# is the minimum amount of information required by the scanner to perform a
patient scan. If the patient does not have an ID#, a "?" or the word "trauma" may be typed
into the ID# field. Once an ID# is assigned to the patient, the exam information may be
edited using the Edit Patient feature.
NOTE: For information on performing Edit Patient Information, refer to Managing Images.

19-2
Emperor Era Birth Year Entry

Emperor year entry is available on your system when it is configured in the yyyy/mm/dd
date format. The Era codes are Heisel (H), Showa (S), Taisho (T), Meiji (M). This information is
entered in the birth date field on the New Patient screen. For example, if your patient were
born in the 26th year of Showa's reign you would enter S26 for the year. This corresponds to
a western year of 1951. The system will store the converted birth year in the birth date field
on the New Patient and Patient Schedule screens and in the image header.
Preset Descriptions
The New Patient Screen has 3 different Preset selection that you can choose from. These
areas allow you to enter frequently used Physician, Radiologist ,and Operator names and
initials. This is a feature to expedite data entry.
You can Add, Delete and change the information in this area

19-3
How Do I...
This section provides the step-by-step instructions for Setting Up A Patient And Completing
A Localizer (Scout) Scan. Specifically, it describes how to:

19-4

Use this procedure each time you start a new patient exam. It is best to setup the patient
information before you get the patient on the table. This reduces the amount of time the
patient has to be on the table, possibly in a difficult position. When entering the patient
information, the only field required for scanning is the patient ID. This task describes the
manual input of the data. The data can also be input by using Patient Schedule or a bar code
reader.
NOTE: For more information on Patient Schedule or a Bar code reader refer to Scheduling
Patients.
1. From the scan monitor, click [New Patient].
The Patient Information screen appears automatically displaying the new Exam
Number.
NOTE: The system assigns the exam number automatically. The maximum Exam number
for patient scanning is 49,999. The exam number will need to be reset by your Field
Engineer when the system reaches the maximum number.
Table 19-1 Patient Information
Field Name
Parameters
Accession Number
Up to 16 characters
Patient ID
Up to 16 characters
Patient Name
Up to 32 characters
Sex
M (Male) or F (Female)
Birthdate
Months, Weeks, Days
Age
Years, Months, Weeks, Days
Weight
Kgs or Pounds
Reference Physician
Up to 32 characters
Radiologist
Up to 32 characters
Operator
Up to 3 characters
History
Up to 60 characters
Exam Description
Up to 22 characters
Protocol Number
Up to 5 characters
Req. Proc. ID
Up to 16 characters

19-5

Field Name
Parameters
Date
Exam Date Month, Day, Year
Time
Exam Time Hour, Minute
2. From the Patient Information area, enter data into the appropriate fields.
You must enter the Patient ID to continue. The Protocol Selection area does not
become active until the Patient ID is entered.
When you are typing the patients name, for DICOM users, you have to type the last
name, first name, and middle initial with a "^" between names and initials.
NOTE: The Exam Description will be truncated to 22 characters when imported from a
HIS/RIS system. The Study description field (0008, 1030) in the DICOM header is
mapped to the Exam Description field on the Schedule Patient and New Patient
screens.
NOTE: If you have a network set up to transfer images and the protocol using the DICOM
language then you need to type in the information as described above.
CAUTION:
When entering Patient ID information the system may contain multiple

instances of the same Patient ID. Multiple schedule records can be due to
multiple procedures being ordered under separate accession numbers or
New and Completed records in the Patient schedule for the same Patient ID.
When entering the Patient ID verify that the correct Accession number and
Exam Description selected is what is desired. Scanning with an incorrect
accession number may cause problems reconciling exams on a PACS system.
Please see the Schedule Patients chapter for more information.
Make sure that you keep the mouse over the New Patient screen when typing.
Once you have entered data into a field, you can press Enter to go to the next text
box or you can click in the text box you wish to input data.
3. Click the preset buttons and select the desired information. Or, click on the field and
enter desired information.
If you click Referring Physician, Radiologist, or Operator, a preset menu will appear
allowing you to select which preset you wish to use.
To change a name from the list, click Referring Physician, Radiologist, or Operator,
select the name, enter new information, and click [Change].
To add a name to the list, click Referring Physician, Radiologist, or Operator, type
the name and click [Add].
To delete a name from the list, click Referring Physician, Radiologist, or Operator,
select the name and click [Delete].

19-6

NOTE: These Presets are saved across software loads from Save System State.
4. When all of the desired patient information is completed, select the desired protocol
from the Anatomical Selector area.
You can select a protocol by either selecting a default protocol or by choosing a
specific body part, then selecting the protocol.
If you know the number of the protocol, you can type the number in at the bottom of
the patient information screen.
The protocol area is broken down into 10 adult protocols and 10 infant protocols.
Protocols 1-10 are adult protocol areas and 11-20 are infant protocol areas. In each
protocol area, you can have up to 90 different protocols for that area.
NOTE: It is important to set the Delete Completed Exams to zero when Patient Information
is updated from the HIS/RIS. This will assure that Completed Accession numbers are
not inadvertently selected for scanning a second time causing Patient reconciliation
issues on the PACS system.
NOTE: For more information on protocols, refer to Building Protocols.
Quick Steps: Set Up Patient Information

1. From the scan monitor, click [New Patient].
2. From the Patient Information area, enter data into the appropriate fields.
3. Click the preset buttons and select the desired information. Or, click on the field and
enter desired information.
4. When all of the desired patient information is completed, select the desired protocol
from the Anatomical Selector area.

19-7

It is best to prepare the scan room before bringing the patient into the room. Make sure that
you have all the necessary supplies and accessories.
1. Attach the head holder or foot extender to the end of the cradle towards the gantry.
2. Lay the patient on the table.
Always use the head holder straps with the head holder to immobilize the patients
head to prevent motion. When doing body scans, make sure that you have the body
straps connected to the cradle and wrapped around the patient.
CAUTION:
The patient positioning straps provided with the system do not support the
full weight of the patient. Patient positioning straps should be used to aid in
patient positioning and are not meant to fully restrain the patient.
3. Press the buttons on the gantry to raise the table up and in.
Always make sure that nothing is close to the table that may interfere with table
movement.
4. Position the laser lights so that they are lined up with the desired anatomical reference
and centered to the desired anatomy.
CAUTION:
Make sure that you instruct the patient to look away from the laser lights. The
laser beam used for positioning can cause eye injury.
Do not position the patient with the laser lights in their eyes.
NOTE: Landmark setting for Patient Position Sensitive Study Types. When using the external
laser alignment light for patient positioning purposes, be aware that the patients
elevation may be slightly lower with the cradle extended than with the cradle fully
retracted. This is because the cradle may bend slightly under a patients weight.
NOTE: This difference should be taken into consideration for applications where patient
position information is critical, such as radiation therapy planning. To minimize these
affects, after using the external laser alignment system to position the patient,
advance the patient to the CT scan plane. Turn on the CT alignment lights to
determine if they line up with the markers on the patient. If necessary, compensate
for the bend in the cradle by elevating the table. When the CT alignment lights line
up with the markers, re-set the landmark for the scan using the Internal laser
alignment light.

19-8

5. Press the desired landmark button (Required).
If you do not press the landmark button, confirm remains gray (unselectable) until the
landmark button has been pressed.
Quick Steps: Position the Patient

1.
2.
3.
4.
Attach the head holder or foot extender to the end of the cradle towards the gantry.
Lay the patient on the table.
Press the buttons on the gantry to raise the table up and in.
Position the laser lights so that they are lined up with the desired anatomical reference
and centered to the desired anatomy.
5. Press the desired landmark button (Required).

19-9
Selecting a protocol saves you a lot of time while maintaining a quality exam. It keeps exams
consistent because the exam is done the same way each time.
1. On the left monitor, place the mouse over the area that you want to scan and click on it.
A list of all the protocols that you built in this area of the protocol manager appears.
2. From the list, select the protocol that you want to use by clicking on it.
Figure 19-1 Protocol Selector

19-10
Quick Steps: Selecting a Protocol

1. On the left monitor, place the mouse over the area that you want to scan and click on
it.
2. From the list, select the protocol that you want to use by clicking on it.

19-11

Setting a landmark is very important. The landmark sets a known anatomical reference for
the radiologist which he/she correlate the anatomy. The landmark sets the zero location.
When scanning towards the patients head, you are scanning superior to the zero location.
When scanning towards the patients feet, you are scanning inferior to the zero location.
You should set the zero location to known anatomy. For example, when scanning a head,
the landmark or zero location is typically the orbital meatal line.
1. The orientation of the patient at the top of the screen should be the same as the
orientation of the patient that you are scanning.
Click on the body at the head or feet to change Head/Feet first orientation.
Click on the table or above the body to rotate the body at 90 degree increments.
2. Check the start/end locations, kV, mA and autovoice (if applicable).
Click on the box that you want to make changes to and type in the new parameter.
3. For systems with Smart Score Pro and Prospective Gating, when performing a Smart
Score exam, click [Gating].
The gating check button verifies that the scanner is receiving the ECG monitor signal.
Before this is possible you must set up the patient monitor.
If the button is red that means no signal has been detected by the system. The
system pops up a message instructing you to check the connection. Check to make
sure all of the ECG leads are connected to the patient and that power is on to the
monitor. Click [OK] to close the message box when you have checked everything. If
the gating check button is light blue you can proceed.
NOTE: For more information about gating and instructions on prescribing an exam that
includes gating measurements, refer to Prospective Gating (SmartScore)(Option) or
Cardiac Imaging chapter.

19-12
Quick Steps: Adjust the Localizer (Scout)

1. The orientation of the patient at the top of the screen should be the same as the
orientation of the patient that you are scanning.
2. Check the start/end locations, kV, mA and autovoice (if applicable).
3. For systems with Smart Score Pro and Prospective Gating, when performing a Smart
Score exam, click [Gating].

19-13

Now you are ready to scan the patient. Before you press the start scan button make sure
that no one is in the room.
1. On the left monitor, click [Confirm].
2. On the top of the keyboard, press [Move to Scan].
The button is flashing green.
If you need to stop the table movement, press [Stop Move].
3. Press [Start Scan].
The button is flashing green.
If you need to stop the scan, press [Stop Scan].
If you need to pause the current scan, press [Pause Scan]. This finishes the current
scan, then pause the next scan.
If you pause the scan a resume key pops up on the screen. Click [Resume] when you
are ready to scan.
4. Repeat steps 2 and 3 to take the second scout.
Quick Steps: Confirm the Localizer (Scout)

1.
2.
3.
4.
On the left monitor, click [Confirm].

On the top of the keyboard, press [Move to Scan].
Press [Start Scan].
Repeat steps 2 and 3 to take the second scout.

19-14
Scan Series Setup
Chapter 20
Scan Series Setup

Introduction
This chapter explains how to setup for the scan series. It contains the step-by-step
Set Scan Parameters
Adjusting Graphic Rx
Set Timing Parameters
Set Display Factors
Repeat a Series

20-1
Scan Series Setup

This section presents the concepts necessary to successfully set up the scan series.
Concepts you need to understand are:
Adjusting a Protocol
Setting Scan Field of View and Display Field of View
Using a Breath Hold Delay
Working with the Optimizer
Dose Reports
Adjusting a Protocol
Once a specific protocol is selected from the protocol manager, any of the parameters may
be modified on a per patient basis. This can be done without permanently altering the
original protocol.
Setting Scan Field of View and Display Field of View

Scan Field of View (SFOV) is the parameter that determines how much anatomy is scanned.
The SFOV should always be larger than the circumference of the patient, regardless of what
part is being imaged.
Display Field of View (DFOV) is the parameter that determines how much of the SFOV is
reconstructed into an image. DFOV can be less than or equal to the SFOV but cannot be
more than the SFOV. Within the DFOV a image center must be set. The center determines
upon which anatomy the DFOV is centered. The center is set using two parameters, R-L
center and A-P center. The R-L value centers the DFOV on the right and left axes of the
patient. The A-P value centers the DFOV on the anterior and posterior axes of the patient.
Entering a value other than zero off centers the image. This is most often referred to as
targeting the image. Off centering is used most on spine studies or for minor adjustments to
imperfections in centering the patient on the table. If large adjustments are needed, then
you should consider re-positioning the patient on the table.
Using a Breath Hold Delay

The Breath Hold parameter is the amount of time in seconds that your patient can hold their
breath. For better registration of the patients anatomy on the scan, use a longer Breath
Hold time. It is important that you practice with your patient to determine how long they can
hold their breath. Breath Hold, along with another parameter, Breathe Time, automatically
divides all of your prescribed scans into Breath Hold scanning clusters.

20-2
Scan Series Setup

Breathe Time is the amount of time, in seconds, you allow your patient to breathe in
between breath hold clusters. Typical Breath Hold and Breathe Times are 12 seconds and 12
seconds or 10 seconds and 10 seconds. But, again, practice with your patient.
Working with the Optimizer

If the system cannot complete the entire scan prescription with the technical parameters
that you have selected, the Optimize icon is highlighted in red. At this point, you can select
the Optimize icon to open the technique optimize screen.
The optimize screen calculates and displays in real time up to three factors that can be
changed to allow the system to continue.
One factor that can be changed is the up front delay, which can be changed by the amount
shown in the up front delay column. Remember, the up front delay is the time before you can
proceed with scanning. The start scan button does not light up until the up front delay
expires. The second factor is a change in the mA to what is displayed in the mA column. If
you choose this reduction, you may be reducing image quality. Make sure that you always
use enough mA to get the best image quality. The third potential change is to the group
delay. Again the valid parameter is shown in the group delay column. You need only to
select one of the parameters to continue. The selection is made by simply selecting the
parameter that you feel is best for that prescription.
If multiple groups are prescribed, the optimize screen updates for each group, allowing you
to make choices for each group.
Once you have made the choices which satisfy the system, without compromising image
quality, you then get a message that tube cooling is no longer needed and the Optimize in
Progress icon is highlighted in blue. You can select the icon to leave the technique optimize
screen and continue.
Dose Reports
CCTDIvol, DLP (Dose Length Product), and Dose Efficiency is displayed during scan
prescription and provides patient dose information to you. The CTDIvol, DLP and Phantom
size used to calculated dose is automatically saved once you select End Exam. It is saved as
Series 999. It can be filmed, archived, and networked after the scan is completed.
SmartStep accumulated exposure time is displayed on the Dose Text Page.
Figure 20-1 Dose Information

20-3
Scan Series Setup

20-4
Scan Series Setup
How Do I...
This section provides the step-by-step instructions for setting up the scan series.
Set Scan Parameters
Set Display Factors
Repeat a Series

20-5
Scan Series Setup
Set Scan Parameters

Setting the scan parameters is a very important part of the scan. The screen on which you
input all of these parameters is called the View Edit screen. Remember that you have to
adjust the parameters according to the patients size and the anatomy that you are
scanning. These parameters determines the Image Quality that you achieve. Always make
sure that you remove any objects that might cause artifacts. The scout is a good place to
view objects that might cause artifacts.
1. From the scan monitor, click [Next Series].
This is located at the bottom of the scan monitor screen.
The screen on which you input all of these parameters is called the View Edit screen.
Next and prior series moves you around in the protocol. There may be times that you
want to skip a series in the protocol. For example, a series involving a patient that
was scanned for contrast only and your current series is built for no contrast.
2. The orientation of the patient at the top of the monitor should be the same as the scout.
If not, click on the picture of the patient.
There may be times that you change the patients position from the way that the
protocol was built. In that case, you have to change the patients orientation on the
screen each time you click [Next Series].
3. To set the scan parameters, start at the left side of the screen and work your way to the
right.
This enables you to check all of the parameters without skipping any.
4. Select the [Scan type] and choose Axial, Helical, Cardiac, or Cine scan mode.
There are three scan types on the system.
Axial is a step and shoot method.
Helical (sometimes called spiral) is continuous table movement while exposing the
patient. When scanning in the interleaved mode 3,480 to 4,740 views are
reconstructed.
The interleaved mode gets the best image quality. When scanning in the
interspaced mode 2,584 to 4,008 views are reconstructed.
Cine Full is continuous exposure which supports table moves equal to the beam
collimation or no table move where the scans are taken at one table position.
Cine Segment is continuous exposure which suports table movement. There are five
Rotation Times on the system.
The times are: 0.8, 1.0, 2.0, 3.0, 4.0.
(* only for BrightSpeed Excel Select, BrightSpeed Edge Select, and BrightSpeed Elite Select
(Standard) systems)

20-6
Scan Series Setup

NOTE: If you have the VariSpeed option, the times will be 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 2.0, 3.0, 4.0.
There are two Rotation Lengths on the system.
The Rotation Lengths are Segment and Full.
Full Rotation is used most often.
Segment rotation is good for Cardiac scans.
NOTE: For more information on these scan types, rotation, and lengths, refer to Building
Protocols.
5. Click [Thick Speed] and choose the thickness and images per rotation that you want.
This contains selections for thickness, images per rotation, and high resolution mode.
It also lists the slice thickness that is available for reconstructions.
The system comes with .63 mm, 1.25 mm, 2.5 mm, 3.75 mm, 5 mm, 7.5 mm, and 10
mm selections.
In the axial mode the number of images per rotation can be 1, 2, 4, 8, or 16. The
choice for one determines the choices for the other. Some combinations are not
allowed. The choices you make for thickness and images per rotation determine the
available reconstruction thicknesses.
In the axial mode the High Resolution mode is available with 1.25 mm thickness with
one image per rotation and .63 mm thickness with two images per rotation. No other
thickness can be reconstructed prospectively or retrospectively.
In the helical mode, the pitches are 1:1, 0.75:1, 1.5:1, 0.625:1, 0.875:1, 1.35:1, or
1.675:1. The pitch is the table travel in millimeters per rotation divided by the beam
collimation.
NOTE: BrightSpeed Elite helical pitches are, 0.563:1, 0.938:1, 1.375:1, 1.750:1, 0.625:1,
0.875:1, 1.350:1, and 1.675:1.
2 Row is good for thin slice work. It uses the small focal spot only.
4 Row Interleaved provides a 40 % mAs reduction, and is 1.5 to 3 times faster than
single slice helical and has minimal helical artifacts, but interleaved pitch 0.75:1
provides only half the coverage compared to interspaced mode.
4 Row Interspaced provides data acquisition 2 to 6 times faster than single slice
helical, but requires more interpolation, more helical artifact, and only a 20 % mAs
reduction.
NOTE: For more information on 2, 4, 8, 16, 32, or 64 row modes and multi detectors, refer to:
Multi-Detector Information.
The smaller the slice thickness, the more technique you need to use.
Thinner slice thickness gives you better detail.
For more information on multi detectors, refer to Multi-Detector Information.

20-7
Scan Series Setup

6. Click [Interval mm] and type in the interval that you want.
In the Helical mode, the table moves in mm., while exposing the patient.
In the Axial mode the interval or spacing defaults to equal the number of images per
rotations multiplied by the slice thickness. The interval for axial scanning can be zero,
equal to, or greater than the width of the detector configuration. Typical intervals
used are 10, 20, or 30 mm. With no gantry tilt, the Z axis increment is equal to the
slice thickness. With a gantry tilt, the z axis increment is greater than the slice
thickness because the distance between slice centers is elongated.
Axial interval with skip refers to a gap between scan groups. This can be useful, for
example, when performing a survey exam, such as a high resolution chest exam.
NOTE: For more information on axial interval with skip, refer to Multi-Detector Information.
In the Cine mode, for an interval greater than zero, scans is created at several
locations, and the end location changes. For an interval of zero, all images is taken at
the same location. For the single slice High Resolution Chest Mode, the minimum
scanning interval between slices is 5 mm. The usual interval is 10, 20, or 30 mm. You
can change the interval when setting up prospective multiple recons.
In Helical, the image interval defaults to equal the slice thickness. The interval
maximum is twice the slice thickness.
The Gantry Tilt can be set manually to a maximum of 30 degrees in half degree
increments.
Type C' to enter the "current degree" in tilt field on the view edit table instead typing
the value of current degree.
NOTE: You may adjust the gantry to the desired tilt and type C in the gantry tilt field. This
updates the tilt with the current gantry tilt. This is useful when scanning head studies
without taking a scout scan.
8. Click [SFOV] and choose which field of view that you want.
The system comes with four scan field of views.
a) [Ped Head] is a field of view that is particularly useful for infants 18 months or less in
age. It allows you to enter up to a 25 cm field of view.
b) The [Head] scan field of view is for adult head scanning.
c) The [Small] scan field of view is particularly useful for extremities and the QA
phantom.
NOTE: If the scan type is Cardiac Helical dose is calculated from a 32 cm phantom. Retro
recon allows up to 35 cm DFOV.
d) The [Large] scan field of view is particularly useful for all body work. If you measure
the anatomy that you are scanning and it measures over 25 cm, you need to use the
large scan field of view. It allows you to enter up to a 50 cm display field of view.

20-8
Scan Series Setup

9. Click [kV] and choose which kV station that you want to use.
The system comes with four different kV stations.
These are examples for you to go by.
a) The 80kV station is particularly useful for Bone Mineral Densitomery and Perfusion
imaging in the brain.
b) The 100kV station is particularly useful for pediatric imaging.
c) The 120kV station is particularly useful for routine imaging of the chest, abdomen,
and pelvis areas.
d) The 140kV station is particularly useful for Posterior Fossa area, thick areas, and
heavy patients.
10. Click [mA] and type in the mA selection that you want to use.
The system allows you to type in increments of 10mA up to:
440 mA for Performix tubes
350 mA for Solarix 350 tubes (250 mA for BrightSpeed Elite Select Standard syetem.
Quick Steps: Set Scan Parameters

1. From the scan monitor, click [Next Series].
2. The orientation of the patient at the top of the monitor should be the same as the
scout. If not, click on the picture of the patient.
3. To set the scan parameters, start at the left side of the screen and work your way to
the right.
4. Select the [Scan type] and choose Axial, Helical, Cardiac, or Cine scan mode.
5. Click [Thick Speed] and choose the thickness and images per rotation that you want.
6. Click [Interval mm] and type in the interval that you want.
8. Click [SFOV] and choose which field of view that you want.
9. Click [kV] and choose which kV station that you want to use.
10. Click [mA] and type in the mA selection that you want to use.

20-9
Scan Series Setup
Adjusting the scan series graphically is the fastest way to set up for a scan series. If your
protocol is set up correctly, you do not have to make many changes; just adjust the lines
representing the series and confirm.
This shows the scout with the graphic lines for you to adjust.
2. While holding the shift key down, click and drag the center red X to position the lines
over the anatomy you wish to cover.
This allows you to move the lines up and down on a lateral scout, as well as from side
to side on a AP scout. By moving the lines, you are adjusting the start and end
location, and the RAS (Right, Anterior, and Superior) coordinates.
3. Click and drag the solid box to the starting position.
This changes the starting point.
4. Click and drag the empty box to the ending position.
This changes the ending point.
If you hold the shift key down and drag either the solid or empty box, it adjusts both
the starting and ending locations at the same time.
5. Click and drag the diamond key to set the display field of view.
If you hold the shift key down and drag on the diamond key, it adjusts both sides of
the lines.
6. Click and drag the circle to adjust the tilt if needed.
If you tilt and change your mind, hold the shift key down and click on the circle. This
returns the tilt parameter to 0 degrees.
7. Select [Show] or [Hide] from the control panel.
If Hide Slices is visible then graphic mode is to show a a line for each image
reconned.
Hide Slices is the default at system boot up. Once you change the mode, it will
remain through all exams until a system restart or shutdown is performed.
If Show Slices visible then graphic mode is to show a transparent area of coverage,
no lines displayed for slices.

20-10
Scan Series Setup

Figure 20-2 Graphic Options
Quick Steps: Adjusting Graphic Rx

2. While holding the shift key down, click and drag the center red X to position the lines
over the anatomy you wish to cover.
3. Click and drag the solid box to the starting position.
4. Click and drag the empty box to the ending position.
5. Click and drag the diamond key to set the display field of view.
6. Click and drag the circle to adjust the tilt if needed.
7. Select [Show] or [Hide] from the control panel.

20-11
Scan Series Setup

Timing is a very important part of setting up the scan. The patients condition has a large
effect on timing. Make sure that you know how long the patient can hold his/her breath. This
helps when working with the Auto Voice.
It is very important to utilize injection delays. You can only inject once and you must get it
right the first time. Different anatomy enhances at different times. Check with your
radiologist for the right injection delays.
1. If the (Timing) card is not showing on top, select it. This is the card that looks like a stop
watch.
2. Click [Prep Group] and type in a injection delay if needed.

This can be used for giving contrast with a timed delay.
This can change to accommodate auto voice.
Valid ranges are:
Group 1 can be from 0 to 90 seconds.
Group 2 throughout the scan can be from 1 to 600 seconds, depending on scan
modes. Helical requires a 5 second delay and Cine requires a 1 second delay.
If you are using the Smart Prep option, this field is replaced with SP.
For more information on Smart Prep, refer to Smart Prep.
3. If scanning in the axial mode, click [ISD] (interscan delay) and type in a scan delay
between each axial scan.
This is the amount of time that you want to wait between each scan.
This can be useful when the optimizer is red. You can increase the ISD to allow for
more tube cooling.
4. Click [Breath Hold] and type in how long you want the patient to hold his/her breath.
Try to make this time as long as you can to avoid misregistration of anatomy.
5. Click [Breathe Time] and type in how long you want to give the patient to breathe in
between groups of scans.
Make sure that the patient can breathe but do not make the time gap between
breaths too long otherwise you loses the IV contrast.

20-12
Scan Series Setup

6. Click [Voice Lights Timer] and select which commands you want to use for breathing
instructions.
Three pre recorded voices are available in 9 languages. Which are user selectable.
Figure 20-3
NOTE: The Auto Voice language displayed at the time the systems is booted up is the
defaulted language set by your Field Engineer initially.
If the Auto Voice language is changed for the current exam, the system will return to
the default language once you have clicked End Exam.
NOTE: The Auto Voice language setting is a global setting and not protocol specific. Once
changed the language will be maintained across exams until changed. After a system
reboot the language selection defaults to the language setting in reconfig.
You can record an additional 17 voice instructions. For more information on Auto
Voice, refer to the Record a Personalized AutoVoice section of this guide.
You can choose to select AutoVoice preset delay. For more information refer to:
Change Pre-Set Delay for AutoVoice.
You can choose to select Breathing lights and/or a timer.

20-13
Scan Series Setup

Figure 20-4 .
A pale yellow color window with a "N" indicates the breathing lights are selected only.
No auto voice is selected.
A pale yellow color window with a "T" in it indicates that the breathing lights are
selected with a countdown timer.
A pale yellow color window with a number and a "T" indicates that auto voice,
breathing lights, and the countdown timer are selected.
Figure 20-5
A blue color window with a number indicates that auto voice only is selected. No
breathing lights or delays will come on.

20-14
Scan Series Setup

7. Click [Preview].
The preview function allows you to view graphically how the combination of breath
hold and breathe time affects your system.
Here is an example of the preview screen. In the beginning, you can see that there is
a 45 second prep delay, followed by a axial cluster of six scans. At the end of the axial
cluster, there is a 10 second breathe time and the helical clusters begin.
If your exams preview graph exceeds the width of the screen, you can use the scroll
keys at the bottom of the screen.
Preview also displays a summary of all your scan groups.
8. To get out of the preview mode and start scanning, click Confirm.
If you want to go back to view edit and make changes, click [View Edit].

20-15
Scan Series Setup
Quick Steps: Set Timing Parameters

1. If the (Timing) card is not showing on top, select it. This is the card that looks like a stop
watch.
2. Click [Prep Group] and type in a injection delay if needed.
3. If scanning in the axial mode, click [ISD] (interscan delay) and type in a scan delay
between each axial scan.
4. Click [Breath Hold] and type in how long you want the patient to hold his/her breath.
5. Click [Breathe Time] and type in how long you want to give the patient to breathe in
between groups of scans.
6. Click [Voice Lights Timer] and select which commands you want to use for breathing
instructions.
7. Click [Preview].
8. To get out of the preview mode and start scanning, click Confirm.

20-16
Scan Series Setup
Set Display Factors

Most of these parameters are already set from the protocol, and from the adjustments that
you make with the graphic lines on the scouts.
When setting the display factors, it is important to know why you are scanning the patient
and what you are looking for. If you are looking for fractures, you might want to use certain
parameters instead, if you were looking for a mass, you would want to use a different set of
parameters.
You can reconstruct images three different ways and film images nine different ways.
NOTE: For more information on filming, refer to: Automatic Filming
1. Select the Display card.
This is the card that has a image of a chest on it.

This shows all of the display parameters.
2. Click [DFOV] and type in the patients measurements.
This can also be adjusted by utilizing the diamond keys on each side of the graphic
lines on the scout.
If you want to type in a measurement, measure the patient at the widest point and
add 2 cm. This shows all the anatomy and the soft tissue around the anatomy.
3. Click [R/L Center] and type the R/L (right/left) coordinates.
This can be adjusted on the scout by dragging the diamond keys in or out on an AP
scout.
This can also be found by placing the mouse over the image and looking at the R or L
read out at the bottom of the image.
NOTE: + may be used for R values and - may be used for L values for faster data entry using
the ten key pad.
4. Click [A/P Center] and type the A/P (anterior/posterior) coordinates.
This can be adjusted by dragging the diamond keys up and down on an lateral scout.
This can be found by placing the mouse over the image and looking at the A or P read
out at the bottom of the image.
NOTE: + may be uses for A values and - may be used for P values for faster data entry using
the ten key pad.

20-17
Scan Series Setup

5. Click [Recon Type] and then select which algorithm you want to use.
The system comes with seven different algorithms.
a) Soft is particularly useful for tissues with similar densities, but not useful for
un-enhanced scans.
b) Std, short for standard, is particularly useful for routine exams like chest, abdomens,
and pelvis scans.
c) Lung is particularly useful for interstitial lung pathology.
d) Detail is particularly useful for post myelograms, where hybrid tissue detail and bone
edges are important.
e) Bone is particularly useful for High resolution exams and sharp bone detail.
f) Edge is particularly useful for small bone work in the head, as well as high resolution
scans.
g) Chest is particulary useful for when medium and lung detail are desired.
6. The [Matrix Size] for BrightSpeed CT images is always 512 matrix.
The 512 matrix size gives the best image resolution.
7. Click [Recon Option].
If the scan type is Helical, the Recon Mode options are [Full] or [Plus]. For all other
scan modes, the Recon Mode is set to [Full] with no other options.
NOTE: Full and Plus modes are only on 8 and 16 slice systems.
Window Width and Window Levels entered here is also added to Film Set 1.
If you are in the Cardiac Helical scan mode, the Cardiac Filters are available. Select
the filter you wish to use.

20-18
Scan Series Setup

NOTE: For Head and Ped Head only Plus mode is allowed prospectively for 0.625 and 1.25mm
slice thickness.
8. If you want a second reconstruction, click [Show Recon 2], click [Recon Enabled] and
click [Yes].
You are able to change your start and end locations as long as they do not exceed
Recon 1.
You can also change the slice thickness, interval, DFOV, R/L, A/P, and Recon Type to a
different value than Recon 1.
If you want a different Series Description than Recon 1 enter the desired description
in the Series description field. If the description is blank, it will use the same
description as Recon 1 and add Recon 2 or Recon 3 to the beginning of the
description.

20-19
Scan Series Setup

9. If you want a third reconstruction, click [Show Recon 3], click [Recon Enabled] and click
[Yes].
You are able to change your start and end locations as long as they do not exceed
Recon 1.
You can also change the slice thickness, interval, DFOV, R/L, A/P and Recon Type to a
different value than Recon 1 and turn it on.
10. Click [Series Auto Transfer] if you want to transfer Recon 2 and Recon 3 to another
workstation.
A Host window will pop-up.

20-20
Scan Series Setup
Up to four locations can be selected.
11. Select which Host you wish to network Recon 2 and Recon 3 to.
12. Click [OK].
The button will update to show the first host name.

20-21
Scan Series Setup
Quick Steps: Set Display Factors

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Select the Display card.

Click [DFOV] and type in the patients measurements.
Click [R/L Center] and type the R/L (right/left) coordinates.
Click [A/P Center] and type the A/P (anterior/posterior) coordinates.
Click [Recon Type] and then select which algorithm you want to use.
The [Matrix Size] for BrightSpeed CT images is always 512 matrix.
Click [Recon Option].
If you want a second reconstruction, click [Show Recon 2], click [Recon Enabled] and
click [Yes].
If you want a third reconstruction, click [Show Recon 3], click [Recon Enabled] and click
[Yes].
Click [Series Auto Transfer] if you want to transfer Recon 2 and Recon 3 to another
workstation.
Select which Host you wish to network Recon 2 and Recon 3 to.
Click [OK].

20-22
Scan Series Setup
Repeat a Series
Repeat Series now allows you to choose any series that has been scanned. When more than
one series has been scanned, a list of all scanned series will be displayed. Click on the series
that you wish to repeat. If only one series has been scanned, Repeat Series will not display
the Repeat Series pop-up. The state of Show Localizer on or off is remembered by the
system. If Show localizer state is on, it will be automatically displayed when you return to the
ViewEdit screen.
1. Click [Repeat Series].
This is located at the bottom of the View Edit screen.
The Series List window appears.
2. Select which series you want to repeat from the Series List.
3. Click [OK].

20-23
Scan Series Setup
Quick Steps: Repeat a Series

1. Click [Repeat Series].
2. Select which series you want to repeat from the Series List.
3. Click [OK].

20-24
Scan Series Setup
Enter Contrast Descriptions

If you are using IV or GI contrast, you can enter the descriptions or select from a list of preset
descriptions.
When IV contrast is to be used, make sure the injector or syringes of contrast are set up
before performing the localizer (scout) scan. The contrast (syringe) icon on the lower right
corner of the view/edit screen must be selected. When the icon is selected, there is a +C
annotation on the images next to the image number, indicating that IV contrast was used
for that exam.
1. Click the Syringe or GI icon.
The IV contrast window appears.

2. Select the desire contrast selection or enter your own.
3. Click [Change], [Add], or [Delete].

Change allows you to edit the current selected description.
Add allows you to add new descriptions.
Delete removes the selected description.
4. If you desire to enter a description that is not a preset description, click the text box area
and type the desired contrast description.
The text entered into this description area will not be saved as a preset.
5. Click [OK].

20-25
Scan Series Setup
Quick Steps: Enter Contrast Descriptions

1. Click the Syringe or GI icon.
2. Select the desire contrast selection or enter your own.
3. Click [Change], [Add], or [Delete].
4. If you desire to enter a description that is not a preset description, click the text
box area and type the desired contrast description.
5. Click [OK].

20-26
Automatic Filming
Chapter 21
Automatic Filming
Introduction
This chapter explains how to perform some basic tasks for auto filming. It contains the
Set the Film Parameters for Automatic Filming
Set the Image Parameters for Automatic Filming
Use the Filming Buttons on the Autofilm Viewport
Manually Add an Image to the AutoFilm Composer

21-1
Automatic Filming

This section presents concepts necessary to understand ways to autofilm images. Some of
the concepts you need to understand are:
Automatic Filming
Autostart
Image Filters
Gray Scale Enhancement
Automatic Filming
Automatic filming is a feature in which the scanner automatically films an exam. Values for
filming like format, number of copies, W/L, etc., can be set up ahead of time, in a protocol.
The system can be set up to start filming once images are taken and reconstructed or when
prompted by the user.
Autostart
Autostart is a feature used in automatic filming where the filming can be set to start as soon
as images are taken and reconstructed. This is selected in autofilm setup and can be turned
on or off for each film set. The choices of No Autostart, Autostart New Sheet, and
Autostart Same Sheet are available. No Autostart tells the system not to auto start the
filming of the film set. Autostart New Sheet tells the system to auto start the film set using
a new sheet of film. Autostart Same Sheet tells the system to auto start the film set using
the existing sheet of film. If Autofilm is turned ON and No Autostart is selected, then
AutoFilm has to be started manually by the user from the AutoFilm viewport. Having
Autostart ON adds to maximum AutoFilm efficiency.
Image Filters
There are several different display enhancement filters available on the system. The Edge
Enhancement filters are useful for filming bone windows, as they sharpens the image. There
are six levels of Edge Enhancement, E1, E21, E2, E22, E23, and E3. E1 applies the least
amount of enhancement and E3 applies the most. When these filters are used, the image is
annotated with E1, E2, E21, E22, E23, or E3.
The Lung Enhancement filter is designed specifically to use when filming lung windows.
When the Lung enhancement filter is applied, the image is annotated with the word Lung.

21-2
Automatic Filming
There are also five Smoothing filters, S1,S11, S2, S22 and S3, which are used when filming
soft tissue windows to decrease the appearance of noise in an image or enhance low
contrast areas. S1 applies the least amount of smoothing and S3 applies the most. When
these filters are used, the images is annotated with S1, S11, S2, S22 or S3.

Gray Scale Enhancement (GSE) is a display feature that changes the slope and gamma
curve of an image. It can be used in head studies to improve the bone/brain interface which
helps with gray/white matter differentiation. There are three levels of Gray Scale
Enhancement, G1, G2 and G3. G1 applies the least amount of enhancement and G3 applies
the most. When a filter is applied, the images is annotated with G1, G2, or G3 just above the
vertical tick mark scale on the right side of the image.

21-3
Automatic Filming
How Do I...
This section provides the step-by-step instructions for using autofilming. Specifically, it
describes how to:

21-4
Automatic Filming
Referen
ce)
Automatic filming is a feature in which the scanner automatically films an exam. Values for
filming like format, number of copies, W/L, etc., can be set up ahead of time in a protocol by
using the AutoFilm Setup button from the view/edit screen.
1. Click [AutoFilm Setup].
2. Select the desired camera or printer.

a) Under Destination, select the up and down arrow buttons to make your selection.
If only one camera is installed, there are not any additional entries.

21-5
Automatic Filming
3. Select the desired film format from the choices listed.
Your choice in the protocol determines the format of the AutoFilm composer.
The formats available are determined by the camera configured with the system.
4. Set the expose direction for the images.
Click the arrow under Film Direction to toggle the arrow up or down.
Images can be filmed top to bottom or bottom to top.

Top to bottom is standard. Bottom to top is useful if the patient is being scanned
inferior to superior, and you would like the images filmed in superior to inferior
order.

21-6
Automatic Filming
5. Set the size of the image frame on film.
Click [Normal] or [Slide].
Normal is the default setting. Slide size (35mm) is useful for teaching files and
presentations.
6. Set the number of film copies.
Click the up or down arrows under Copies to increase or decrease the number of
copies desired, or click in the numeric box and type in the desired value.
The number of copies that can be printed range from 1 to 99.

7. Set the autostart parameters.
Click [Auto Start].
From the Auto Start Film Sets window, click [No Autostart], [Autostart New Sheet]
or [Autostart Same Sheet] for each film set, then click [Accept] or [Cancel].

21-7
Automatic Filming
NOTE: For more information on autostart please refer to the Autostart concept section of
this chapter.
8. Set the auto print parameters.
Auto print automatically prints a page when it is full.
Auto print automatically prints a sheet of film once the exam is done filming, whether
or not the page is full.
Under Auto Print, click the button to toggle Auto Print to [Yes] or [No].
9. Set the display for the film composer.
You may choose to have the AutoFilm Composer display either the image being
filmed, or the annotation of the exam, series and image number being currently
filmed.
Under Auto Film Composer, click

or
21-8
Automatic Filming
10. Set parameters to place scoutview image on film.
A scout can be set to automatically film at the end of a study.
Under Scout, click the [Yes] or [No] toggle button.
Click [Yes] if you would like to autofilm a scout.

Fill in the Scout Series Number, the Scout Number, the Magnification Factor, and
the desired WW/WL for the scout.
Click [Accept].

21-9
Automatic Filming
11. Set parameters to place scoutview image with reference lines on film.
A scout with cross reference lines may also be chosen to automatically film at the
end of a study.
Under X-Ref Scout, click the [Yes] or [No] toggle button.
Click [Yes] or [No].

Fill in the Scout Series Number, the Scout Number, the Magnification Factor, and
the desired WW/WL for the scout to be filmed.
Click the Image Range, either [All] or [First/Last].
Click [Accept].
12. Set parameters to place exam and/or series information on film.
The exam page is used to film the exam text information and the series page is used
to film the series text information for the current exam.
Selecting either of these allows them to be autofilmed at the end of an exam.
Under Exam Page or Series Page, click the appropriate button to toggle from [No]
to [Yes].

21-10
Automatic Filming
13. Set parameters to film the grayscale.
Turning this feature on allows a gray scale to be filmed next to each image.
This can only be used on systems configured with an Analog DASM interface. The
button is insensitive if your system does not meet this requirement.
Under Show Grayscale, click the button to toggle the [No] to [Yes].
14. Set parameters to film the dose report information.

Turning this feature on allows a dose report to be filmed at the end of each series.
Under Dose Report, click the appropriate button to toggle from [No] to [Yes].
NOTE: The Dose Report will not automatically film. Start New Sheet or Continue Same Sheet
must be selected in order for the Dose Text Page to be auto filmed.
15. When done with all parameters, click [OK] or [Cancel] on the bottom of the AutoFilm
Setup window.
Selecting [OK] accepts all parameters youve chosen.
Selecting [Cancel] cancels out of the AutoFilm Setup screen without selecting the
parameters youve chosen.

21-11
Automatic Filming
Quick Steps: Set the Film Parameters for Automatic Filming

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Click [AutoFilm Setup].

Select the desired camera or printer.
Select the desired film format from the choices listed.
Set the expose direction for the images.
Set the size of the image frame on film.
Set the number of film copies.
Set the autostart parameters.
Set the auto print parameters.
Set the display for the film composer.
Set parameters to place scoutview image on film.
Set parameters to place scoutview image with reference lines on film.
Set parameters to place exam and/or series information on film.
Set parameters to film the grayscale.
When done with all parameters, click [OK] or [Cancel] on the bottom of the AutoFilm
Setup window.

21-12
Automatic Filming

To use the AutoFilm feature, parameters must be set in AutoFilm Setup and then filming
must be turned on. This is done on the AutoFilm tab card, from the view/edit screen. If
AutoFilming is not turned on, autofilming does not occur.
1. On the view/edit screen, click the AutoFilm tab card.
2. Turn autofilming ON.

Click the [AutoFilm] column heading, and click the [Yes] or [No] toggle to turn
autofilming to Yes for the entire exam, or you may select only a specific series.
Autofilming does not occur if the toggle is not set to Yes.
3. Set the frame format for each film space.
This feature designates the number of images that are placed on each frame of the
film.
The available selections are 1 on 1, 2 on 1 horizontal, 2 on 1 vertical and 4 on 1.
Click the [Frame Format] column heading.
A pop up window appears listing the four format choices.
Click the desired format. You may do this for the entire exam, or click the format icon
buttons below the [Frame Format] column heading to select a specific series.

21-13
Automatic Filming
4. Set the interval of the images to be filmed.
Use this feature to select which images are to be filmed. Setting the interval to 1 films
every image. Setting the interval to 2 selects every other image. Setting the interval
to 3 films every third image and so on.
Click the [Interval] column heading.
Type the desired interval.

5. Set parameters to flip image on film.
Click the [Flip] column heading.
A pop up window appears listing the flip choices.
You may choose from [FTB] flip top to bottom, [FTB/FLR] flip top to bottom and
left to right, [FLR] flip left to right or [None] for no flip.
Select the desired flip. You may do this for the entire exam, or click the icon buttons
below the [Flip] column heading to select a specific series.
For example, you may choose to automatically flip an image [FTB] if your protocol
is for prone coronal sinuses.
6. Set parameters for window width and level.
Window widths and window levels can be defined in the Recon Tab.
The last entry whether it was entered in the Recon tab or the Filming tab is applied to
the images during reconstruction.

21-14
Automatic Filming
7. Set parameters to magnify images to be filmed.
Click the [Mag Factor] column heading.
Type in the desired magnification factor. The valid range is .5 to 2. Typing it here mags
the images for the entire exam, or click the buttons below the [Mag Factor] column
heading to type in a mag factor for a specific group of images.
8. Set parameters to rotate images on film.
Click the [Rotate] column heading.
A pop up window appears with four choices.
The choices are rotate left 90 degrees, rotate right 90 degrees, rotate right 180
degrees or none.
Click the desired rotation. Selecting it here rotates the images for the entire exam, or
click the buttons below the [Rotate] column heading to select rotation for a specific
group of images.
9. Add annotation to images to be filmed.
Click the [User Anno] column heading.
A pop up window with a large box appears.
With your mouse cursor over the large box, type the annotation that you would like
to appear on all of the images.
The annotation appears in the center of the frame above the image.
If you want annotation only for a specific group of images, click the buttons below
the [User Annot] column heading.

21-15
Automatic Filming
10. Add image filters to images to be filmed.
Click the [Filter] column heading.
A pop up window appears with the filter choices.
For an explanation of the filters, refer to the Image Filters concept section of this
chapter.
Click the desired filter. Selecting it here applies the filter to the entire exam, or click
the buttons below the [Filter] column heading to select filters for specific group of
images.
11. Add grayscale enhancement to images to be filmed.
Click the [GSE] column heading.
A pop up window appears with the grayscale enhancement choices.
For an explanation of grayscale enhancement, refer to the Gray Scale

Enhancement concept section of this chapter.
Click the desired enhancement. Selecting it here applies it to the entire exam, or click
the buttons below the [GSE] column heading to select enhancement for specific
group of images.

21-16
Automatic Filming
Quick Steps: Set the Image Parameters for Automatic Filming

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
On the view/edit screen, click the AutoFilm tab card.

Turn autofilming ON.
Set the frame format for each film space.
Set the interval of the images to be filmed.
Set parameters to flip image on film.
Set parameters for window width and level.
Set parameters to magnify images to be filmed.
Set parameters to rotate images on film.
Add annotation to images to be filmed.
Add image filters to images to be filmed.
Add grayscale enhancement to images to be filmed.

21-17
Automatic Filming

There are several buttons you may need to use for autofilming which are located on the
AutoFilm viewport once scanning begins. These buttons allow you to further customize
autofilming.
When the first reconstructed image appears in the AutoFilm viewport, adjust the WW/WL as
needed.
1. Click [Start New Sheet] (if no autostart was selected in AutoFilm setup).
If AutoFilm is turned on for the series, but No Autostart was selected from AutoFilm
Setup, Start New Sheet must be used to start autofilming with a new sheet of film
and to apply the settings prescribed in AutoFilm Setup. Filming uses the format which
was selected from AutoFilm Setup.
2. To pause filming during AutoFilm, click [Pause Filming].
This temporarily pauses autofilming, which allows you to adjust the WW/WL or
perform display features such as ROI and measure distance.

21-18
Automatic Filming
3. To restart autofilming after using [Pause Filming], click [Continue Same Sheet].
This continues filming where you left off, on the same sheet of film.
You can also use Continue Same Sheet to start AutoFilm initially, instead of using
Start New Sheet. The only difference is that filming continues on the same sheet of
film that is already on the film composer, instead of using a new one.
Also, this keeps all of the settings used in the previous exam for autofilming.
4. Click [Cancel Film Series] to delete a series from filming.
This would be useful if there was a lot of patient motion and you did not want the
current series to be filmed.
5. Click [Cancel Film Exam] to delete an entire exam from filming.
Quick Steps: Use the Filming Buttons on the Autofilm Viewport

1.
2.
3.
4.
5.
Click [Start New Sheet] (if no autostart was selected in AutoFilm setup).
To pause filming during AutoFilm, click [Pause Filming].
To restart autofilming after using [Pause Filming], click [Continue Same Sheet].
Click [Cancel Film Series] to delete a series from filming.
Click [Cancel Film Exam] to delete an entire exam from filming.

21-19
Automatic Filming

There are times when you may want to manually add images to the AutoFilm composer. For
example, if you wanted to add an image with special graphics or a particular WW/WL, or if
you wanted to add a multiple image display (MID).
1. When AutoFilm is either paused or finished, place the mouse cursor on the image or MID
to be filmed.
2. Press F12 on the keyboard to place a single image onto the AutoFilm composer.
3. Press Shift F3 to place an MID onto the AutoFilm composer.
4. Repeat as necessary.
Quick Steps: Manually Add an Image to the AutoFilm Composer

1. When AutoFilm is either paused or finished, place the mouse cursor on the image or
MID to be filmed.
2. Press F12 on the keyboard to place a single image onto the AutoFilm composer.
3. Press Shift F3 to place an MID onto the AutoFilm composer.
4. Repeat as necessary.

21-20
Manually Filming Images
Chapter 22

Introduction
This chapter explains Manually Filming Images. It contains the step-by-step instructions to
Set Window Width and Window Level Preset Keys
Set Manual Film Composer Parameters
Place Images in the Manual Film Composer
Set Print Series Parameters
NOTE: In this chapter the feature that is utilized for filming is called a Film Composer and
has the designation of Auto or Manual Film Composer. These features are set as icons
on the display monitor. The icons do not need to be selected for the feature to operate.
It is beneficial in the early use of your system to select these icons and see how they
look when in operation.

22-1

This section presents the concepts necessary to successfully manually film images. Some of
the concepts you need to understand are:
Using the F Keys
Setting Film Series Parameters
Setting Window Width and Level Presets
Setting Film Composer Parameters
Differences Between Auto Film and Manual Film Composers
Using the F Keys

The top row of the computer keyboard is composed of keys labeled F1-F12. The system has
preset functions built for filming images in the F1-F4 keys. The F1 key allows you to place a
single image in the manual film composer. The F2 key allows you to have the composer
automatically adjust to whatever format you are viewing images in and film those images
as a page. The F3 key allows you to film multiple images in a single cell of the composer. The
F4 allows you to film all the images in any one series. All of the images must be filmed in the
same window width and level when using this key. The F5-F11 keys are used for adjusting
the appearance of images by changing window widths and window levels (gray scale and
contrast). The F12 key is utilized with the auto film composer for transferring an image. Use
of the F Keys helps save time for the person doing manual filming.
Setting Film Series Parameters

When utilizing the F4/Film Series function you are able to film any or all of the designated
series by setting parameters in a pop up window that appears.
Setting Window Width and Level Presets

The F5-F11 keys may each be programmed for a different window width and window level
setting. This gives the system a wide variety of appearances for specific image types. The
system comes with settings for each key already set. However, these may be easily adjusted
and programmed into the system according to your facilitys preferences. This allows you to
use a single key to adjust window widths and levels. The widths and levels may be
programmed to follow a template on the keyboard or set to any image type you choose.

22-2
Setting Film Composer Parameters

There are several options available in the film composer including, but not limited to, format
and number of copies. When you select these options they are set in the system but may be
adjusted at any time.
Differences Between Auto Film and Manual Film Composers

The main differences in the two composers are that the F1, F2 and F4 keys work only with
the Manual Film Composer, and Manual Filming can be done from any viewport in Exam Rx
or Image Works. The F3 key works for both composers, but you must use the shift key when
utilizing for the Auto Film composer. Auto Filming is generally done from the Auto Film
Viewport in Exam Rx. Using the F12 key or the drag and drop method it is possible to
manually add images to the auto film composer in Exam Rx and by using the F12 key in
Viewer/ Image works.The most obvious physical difference in the composers (especially
when opened side by side) is that all of the format and options buttons are shown on the
Manual Film Composer and these buttons are not shown on the Auto Film Composer. All of
the options for Auto Film can be adjusted from the Auto Film Setup portion of the View Edit
Screen (refer to Set the Film Parameters for Automatic Filming for auto film setup details).

22-3
How Do I...
This section provides the step-by-step instructions for manually filming images. Specifically,
it describes how to:

22-4

The F5-F11 keys along the top of the computer keyboard are used to adjust window width
and level settings by simply touching the appropriate key. These window widths and levels
represent different gray scale and contrast values to better demonstrate the different types
of anatomy in a scan. These keys are set with values that may be adjusted as needed for
your facility.
1. On the display monitor, double click one of the lower viewports.
You see that viewport outlined in a blue border. This viewport is where an image is
placed to view and adjust window width and level settings.
NOTE: If the scanner is very busy, it is better to use the lower left viewport to display and
film images as the lower right is linked to any exam in progress. You may manually
film while the scanner is autofilming.
2. From the display monitor, click [List Select].

3. From the pop up window select an exam and an image.
Any image works. This image is used to view window width and level settings.
4. Enter the window width setting in the Accelerator Command Bar (gray bar in the lower
left corner of display screen, i.e. WW 400).
You notice the image with the blue border changes to a window width of 400. This is
annotated on the image in the lower left corner of the viewport.

22-5

5. Enter the window level setting in the Accelerator Command Bar (i.e. WL 35).
You notice the image with the blue border changes to a window level of 35. This is
annotated on the image in the lower left corner of the viewport next to the window
width annotation.
6. Hold down [Shift] and press any F5-F11 key.
This sets the window width and window level in the system to whichever key you
choose.
7. Repeat Steps 4, 5 and 6 to set any of the F5-F11 key settings.
Quick Steps: Set Window Width and Window Level Preset Keys
1.
2.
3.
4.
On the display monitor, double click one of the lower viewports.

From the display monitor, click [List Select].
From the pop up window select an exam and an image.
Enter the window width setting in the Accelerator Command Bar (gray bar in the lower
left corner of display screen, i.e. WW 400).
5. Enter the window level setting in the Accelerator Command Bar (i.e. WL 35).
6. Hold down [Shift] and press any F5-F11 key.
7. Repeat Steps 4, 5 and 6 to set any of the F5-F11 key settings.

22-6

Several settings are available on the Manual Film Composer and must be set by the user.
Once these settings are established the system retains them until changed by the user and
then the new settings are in the system. Any of the settings may be changed prior to the
actual printing of the images in the composer.
1. Click [Film Composer].,
2. Select Format.
On the left side of the composer are the formats and options supported by your
camera. Choose from 1 on 1 up to 24 on 1 for your format choice.
NOTE: Not all formats are supported by all cameras. The left side of the composer shows
the valid formats.

22-7

3. Click [Options].
A pop up window appears with all available options.

If your camera supports making slide images (for presentations, teaching slides, etc.),
this option has a drop down menu when you select it for Off or On.
If your camera supports the Grey scale feature this option has a drop down menu for
Off or On. Only systems where the camera interface is an analog DASM, the grey
scale be shown.
Auto Printing, when selected, has a drop down menu for Off or On. When turned on
this automatically send the images to print only when the composer cells are filled.
Auto Clear Page, when selected, has a drop down menu for Off or On. When turned
on, this automatically clears the composer cells of all images when the images are
sent to print, whether by Auto Print or manually.
Icon Labels, when selected, has a drop down menu of Image or ESI. When Image is
selected a picture of the image being filmed is displayed in the composer cell. There
are no annotations indicating exam, series or image number displayed although they
are on the filmed image. When ESI is selected each cell of the composer on the
monitor lists the exam, series, and image number being filmed. Most users find it
easier to follow and/or replace images in the composer when the ESI label is used.
Expose Order, when selected, has a drop down menu of Left/Right Top/Bottom and
Right/Left Bottom/Top. The system is defaulted to Left/Right Top/Bottom. This means
the composer is filming the images starting in the upper left corner of the film, going
to the right, and continuing in this pattern to the bottom of the sheet of film. This is
the most widely-used pattern for filming. The other option films images starting in
the lower right corner of the sheet, going to the left, and continuing this pattern
towards the top of the sheet of film. This is helpful if a patient is scanned from the
bottom up but you wish to film top to bottom.

22-8

4. Select No. of Copies.
You may enter any value from 1-99 in the gray box or use the arrow keys next to the
box to set the number of copies up or down.
NOTE: When more than one copy is selected, that number appears in parenthesis next to
the word print in the print button on the film composer.
5. Click [Done].
Quick Steps: Set Manual Film Composer Parameters

1.
2.
3.
4.
5.
Click [Film Composer].,

Select Format.
Click [Options].
Select No. of Copies.
Click [Done].

22-9

All images to be filmed must be placed in a composer for transfer to the camera. This may
be done automatically or manually. This section deals with the Manual Film Composer.
Images may be placed in the composer individually or in series. See the note at the end of
this section for using the F2 key.
1. On the display monitor, double click in one of the lower viewports.
If the exam you wish to film has an image in one of the lower viewports, click in that
viewport and skip steps 2 and 3.
You notice a blue border around the viewport. This indicates in which viewport
selected images is displayed.

3. From the pop up window, select an Exam, Series and Image.
You generally start with the first image of an axial series but you may choose any
series or image from the menu. This image appears in the blue highlighted viewport
previously selected.

22-10

5. Click [Film Composer].
This is located in the lower left corner of the display monitor. Check format.
In Image works, if you are using Viewer or Mini Viewer, the Manual Film Composer is
accessed by clicking on the film composer button located in the upper left corner of
the tools area.
6. Place cursor in the image to be filmed.
7. Click and drag the image or use F1 key.
Click and drag allows you to take a single image and place it in any available cell on
the composer (you do not see the image move, only the cursor moving).
F1 key places a single image in the next available cell in the composer. When using
F1key leave cursor in the image and use the Page Up/Page Down keys on the
keyboard to advance images.
NOTE: When in Image Works after you select a format for viewing images, using the F2 key
allows you to film that format as a page of images. An example would be to set the
viewing format to 12 on 1, place the cursor in an image and select the F2 key. All 12
images would be transferred to the manual film composer and sent to print. The
composer automatically adjusts to the view format.
Quick Steps: Place Images in the Manual Film Composer

1.
2.
3.
4.
5.
6.
7.
On the display monitor, double click in one of the lower viewports.

From the pop up window, select an Exam, Series and Image.
Click [Accept] or [Cancel].
Click [Film Composer].
Place cursor in the image to be filmed.
Click and drag the image or use F1 key.

22-11

Any portion of a series may be filmed using the Print Series (F4) key. This is a great time
saving feature if, for example, films are lost, duplicate copies are needed, or if auto filming
was not utilized. All images need to be filmed in the same window width and level. If multiple
window widths and levels are needed (i.e. soft tissue and bone) the Print Series can be used
for each window width and level.
1. On the display monitor, click in one of the lower viewports.
If the series to be filmed is already displayed in the viewport, select that one and skip
Steps 2 and 3.
You notice a blue border around the viewport. This indicates where the images is
displayed.

3. Select an Exam, Series and Image.

22-12

4. Click Manual Film Composer icon.
Check or select desired format. This is an important step and should be done every
time Print Series is used.
5. Place the cursor in the image/series to be used for Print Series.
6. Press the F4 (Print Series) key.
7. Set Print Series Parameters.
The system defaults to Use Film Composer. This is why it is important to open and
check the Manual Film Composer prior to selecting Print Series. If you are using
Viewer in Image works and are using the format you want to film (i.e. 12 on 1), you
may select Viewer Format and the system automatically changes the format of the
film composer to 12 on 1. The Image Selection defaults to all images in the series. If
you wish to modify the selection range, click and drag the arrows at the beginning or
end of the selection area to the correct image number.
The Interval allows you to film every image in a series, every other image in a series
(1/2), or every third image in a series (1/3). The most common selection is for every

22-13

image to be filmed. If you have done an exam with 50% or more overlap in the image
interval you may consider filming every other or every third image.
The Current Print Job feature is unavailable when you first select Print Series (F4), as
no images have been programmed. It becomes available after you select Print Series.
The Print Last Sheet feature toggles between Yes and No. With Yes selected, the
system automatically sends the images to print when the last image selected is
placed in the composer regardless if the composer is filled. With No selected, the
system places the last image in the composer and wait for you to send the images to
print by selecting Print on the composer. This gives you the opportunity to place
additional images on the same sheet of film (such as measurements) or to discard
images (if there is only one image on a sheet of film) as necessary.
8. Click [Print Series].
This initiates the Print Series sequence. The system automatically closes the pop up
window.
9. To cancel a Print Series request, Press the F4 key and [Cancel] from Current Print Job.
You must use this feature to cancel Print Series if you need to stop for any reason.
Place your cursor in the image it was in when you started and press the F4 key again.
The pop up window appears and Current Print Job has a button for Cancel All. Click
this button and Print Series is cancelled.
NOTE: The Cancel button at the bottom of the menu closes the pop up window with no
filming being queued.
Quick Steps: Set Print Series Parameters

1.
2.
3.
4.
5.
6.
7.
8.
9.
On the display monitor, click in one of the lower viewports.

Select an Exam, Series and Image.
Click Manual Film Composer icon.
Place the cursor in the image/series to be used for Print Series.
Press the F4 (Print Series) key.
Set Print Series Parameters.
Click [Print Series].
To cancel a Print Series request, Press the F4 key and [Cancel] from Current Print Job.

22-14
Managing Images
Chapter 23
Managing Images
Introduction
This chapter explains the process of managing Images. It provides step-by-step instructions
to learn how to:
Set up a Remote Host
Select an Archive Node
Set an Access to a Local Host and Set Up a Custom Search
Select an Archive Device (Option for BrightSpeed Excel/Edge)
Prepare a New Storage Media for Use
Save Exam/Series/Images to a Storage Media (Option for BrightSpeed Excel/Edge)
Retrieve Exams/Series/Images From a Storage Media
Save Exam/Series/Images using CD/DVD Interchange Option
Transfer Exams/Series/Images to Another Computer
Retrieve Exams/Series/Images From Another Computer
Check Network History File
Edit Patient Information
Remove Patient Information From an Exam
Delete Exams/Series/Images From the System
Compose a Report in Data Export
Save a Report to CD-R
FTP a Report
View a Report on a PC

23-1
Managing Images

This section presents the concepts necessary to successfully complete the process of
managing image data. Specifically you need to understand:
Feature Status Area
Anonymous Patient
Archive (Option for Bright Speed Excel/Edge/Excel Select/Edge Select)
Network
WorkArounds
Data Export
CD/DVD Interchange
Feature Status Area

The Feature Status Area displays the date, time and available system disk space. System
disk space availability is always on your console in the Feature Status Area. It reports how
many 256 x 256 matrix and 512 x 512 matrix images it can hold.
NOTE: It is recommended that you delete images when the image space falls below 200
images. This will ensure there is room on the system disk to confirm scans and to
install reconstructed images.
In the middle of the Feature Status Area is a row of icons. From top to bottom, the icons are
for image reconstruction, archive, network, and filming functions. To the right of these icons
is the current status.
Image Reconstruction Status

Text to the right of this icon indicates the percent completed for the exam, series, and
image range being reconstructed.
Archive Status
Text to the right of this icon indicates status of the images being archived.

23-2
Managing Images
Network Status
Text to the right of this icon indicates the status of the systems networking functions.
Filming Status
Text to the right of this icon indicates filming status of the images being filmed
Anonymous Patient
There may be times when you would want the name of a patient to be kept confidential. This
is when you want to create an Anonymous Patient. An Anonymous Patient can be created
by exam, series, or even a single image.
A few good reasons for using Anonymous patient would be:
Your radiologist wants to take the films to a conference.
You have scanned a test patient or volunteer and do not want the name displayed.
Anytime you do not want the patients name on films. For example, films that are in a
display or would be put in a show.
Anytime you send images to GE.
Anonymous Patient changes Patient Name, Patient ID, Exam Number, Exam Description,
and Series Description.
Archive (Option for Bright Speed Excel/Edge/Excel Select/Edge

Select)
Archive is an off-line filing system for images. The archive feature allows you to save and
restore images to and from a media storage device or remote host. The archive system uses
a Magnetic Optical Disk (MOD) for storage. Images stored on an MOD are "off-line" meaning
that in order to display the images you must first restore them to the system disk. The MOD
is considered a local archive device. Communication from your system to the MOD is in a
DICOM format, so that the MOD listed in the archive window as a DICOM_MOD.
The archive function can read from and write to Maxoptix archive media. This is the
standard drive.
In addition to the Maxoptix MOD, images can be archived to a remote network host
providing the host is a Storage Commitment Class Provider.
Archive verifies the integrity of the data by performing a hardware check in the media drive.
Network
Networks link image acquisition systems and workstations together. By connecting these
compatible devices, you have the ability to transfer images between your scanner and
workstations and/or other image acquisition systems, quickly and easily.

23-3
Managing Images
Common situations for networking are:
To take advanced image manipulations such as 3D and reformatting images offline.
To provide a quick way for a radiologist to view films.
In order to understand the networking process, a few key terms are explained below.
Networking Terms
In the chart below you will find some terms that are associated with the process of
networking.
Term
Definition
Remote Host
Image acquisition system or workstation connected to the

network. Each host has its own network address.
Transfer
Moving of imaging data between stations.
Transmit/Send
Sending images from one station to another.
Transmit/Receive
Retrieving images from another station.
Auto Transfer by Exam
Automatic image transfer of a newly completed exam.
Auto Transfer by Series
Automatic image transfer of a newly completed series. The

series must be ended before the transfer begins.
Auto Transfer by Image
Automatic image transfer of images queued in groups of 50

images.

Performed Procedure Step is part of ConnectPro OPTION. To use it you need a HIS/RIS
system and PACS with the Connect Pro option. It sends communication back to PACS and
HIS/RIS that you have completed a procedure. It improves transfer of data because it can
provide a complete message when all data has been transferred. The browser will have a
PPS column that will list the PPS status of each exam. There are three states of exam status:
COMP, meaning the exam is complete; DISC, meaning the exam is discontinued and it
cannot use PPS again; or INPR, meaning that the exam is still in progress.

23-4
Managing Images
WorkArounds
Images archived on an Advantage Windows 4.0 or 4.1 system may fail to restore on
the BrightSpeed system. Use Network to transfer images from the Advantage
Windows to the scanner.
Even though the Sony MOD drive states that it is a 5.3 gb drive. The archive software
only supports a maximum size of 2.3 gb. 2.3 gb 512 bytes per sector is the preferred
archive media size to utilize on the system.
Archive may fail and slow the system when more than 200 images are queued by
image. To avoid this, try to archive by series if possible.
The system may report that the media is full even though the media has just been
labeled when Save by image is selected. To avoid this, Try selecting a smaller
range of images.
The feature status area or the browser may report an Exam has saved even though
all images have not been saved to MOD. Scroll through the images in the image
window. Highlight the images listed as Archive N and re-save them.
Restoring Exam, Series or images that already exist on the system disk will not post a
message that the images are restored or that they already exist. If you have restored
images, but get no message that they have been restored, verify that they don't
already exist on the system disk.
When the archive media gets close to being full, the system will always look to see if
the exam, series or image can fit on the MOD, if it is desired to have exams
sequentially on a MOD, place a new MOD in the drive when first notified the disk may
be full.
If Label is selected in Archive, finish the Label process; don't select cancel on the
Label pop up. Archive will be non functional, a system reboot will be necessary to
recover.
It's best to resolve any paused queue entry as soon as possible.
To minimize corruption of MODs, it is extremely important the MOD media be
detached and removed from the MOD drive before doing a shutdown or recycling
power to the system.
When restoring from a MOD, it is recommended to write protect the media before
placing it in the drive. If the system is unable to read the media, remove the write
protect and see if the system is able to perform a recovery of the media to access the
data.
If the MOD can not be detached or will not eject from the drive, do a shutdown and
eject the MOD once the message "Hit any key to start the system" is seen. Do not use
the screw to eject the disk.
If you get a time-out message when trying to access the MOD, the MOD drive may no
longer recognized by the system. Perform a shutdown to re-establish
communication between the system and the MOD drive.

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Managing Images
Data Export
Data Export allows you to either store or FTP CT images as JPEG, PNG, AVI, MPEG or MOV
formats. The files can only be burned to a CD-R and only one report can be burned at a time.
Once a CD-R has been burned, you cannot add more reports at a later time. It is not a
rewritable process.
The model for the DVD/CD-R drive in the media tower must be Matshita Model: DVD-RAM
SW-9572 Rev. F100 Type: CD-ROM or equivalent. Your service representative will check
system configuration to determine if the drive will support Data Export.
The JPEG, PNG, AVI, MPEG or MOV images can be viewed from a PC or laptop with a Windows 2000
or XP operating system using Internet Explorer 5.5 or later.
There are two tabs on the Data Export window:
Compose tab allows you to define the compression factor, annotation level, W/L, Zoom,
scroll, and output format for the series you want to export.
Export tab allows you to view a list of all the examinations and series you have in the
Data Export program.
You can compose a series and then export it to either a CD or FTP site at a later date.
Examinations and series stay in the Export program until they are actively deleted.
Figure 23-1 Data Export Window

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Managing Images
Figure 23-2 Compose Tab
8
2
11
10
5
7
4
Table 23-1 Compose Tab Descriptions
Selection
Description
Selection
Displays patient name, examination and series number, number of images in the series,
file size of the images with current compression selection, and matrix size.
Conversion
Format
Allows you to select the image format for the currently selected data set. Format
choices include: JPEG, PNG, AVI, MPEG, and MOV. AVI, MPEG, and MOV are all movie type
formats. Choose the format that is compatible with the movie player on your PC or
laptop.
Compression Only applies to JPEG and MPEGs. The lower the number, the less compression, the
higher the image quality but the larger the file. Image/Sec. is movie play back speed
Factor
and therefore it is only applicable for MPEG, AVI or MOV files.
Frame per
Second
Allow you to set how many frame to play per second. This option is only available when
you have selected a MPEG, AVI or MOV conversion format.
Image Range
Selection
Allows you to select the images you want to place in the designated folder. For example,
if you have a multi-phase series selected and all you want is the first phase in the MPEG,
then select the range of images representing phase 1 of your data set. The ability to
select a subset of images from the selected series is particularly important if you are
plan to FTP the files rather than burn a CD.
You can enter a interval to create a movie file of a specific interval of images. The valid
range for the interval is one minus the maximum number of images in the series.
Annotation
Allows you to set the level of annotation for the images: none, full, partial (a subset of
the full annotation) or custom which activates the [Customize] button that allows
specific annotation options.

23-7
Managing Images
#
Selection
Description
Propagate
Allows you to apply the image manipulations (W/L, zoom, scroll) you have performed on
all images forward from the currently displayed image.
Play/Stop
Click the [Play] button to preview the MPEG, AVI, or MOV file. Click the [Stop] button to
quit playing the movie.
Quit
Image Area
Closes the Data Export window.

Displays the current images by scrolling through them in a cine loop. Use the keyboard
Page Up and Page Down keys to move through the images manually.
NOTE: You must click on the image window and put it in focus before next/prior
will function.
Appears at the top of the report once you execute the data export. It also appears in the
Report Name Export data list. Typically the patients name and type of file are entered as the Report
Name. There can be no spaces or characters other than AlphaNumeric.
10
Folder Name
The name of the folder to which you want to file the Report Name. From the Export tab,
you can view the data listed within each folder. The data within a folder is sorted by file
type. For example, if you added 10 JPEGs from the T1 series and 20 JPEGs from the T2
series you will see a list of 30 JPEGs in that folder. If you want these JPEGs separated,
you must place them in separate folders.
Anonymous
The images added to the report will have the patients name replaced with Anonymous
and the examination number.
Save State
Add to
Report
11
+/- Series
Saves the image orientation, w/l values, roam and zoom values of a range of
images that you select.
Adds the current data set to the report from which you can either burn the information
to a CD-R or FTP it to an IP address. A Data Conversion progress window appears once
you click the [Add to Report] button. Click the [Cancel] button if you want to stop the
data conversion.
This navigates through the series.

23-8
Managing Images
Figure 23-3 Export Tab
Table 23-2 Export Tab Descriptions
Selection
Description
Report Name
List
Lists all the report names in the data base.
Delete Icon
Select an item in any of the list displays (Report, Folder, or Type) and click the Delete icon
to remove the item from the list. Items remain on the list after you Quit Data Export until
they have been deleted through this method.
Folder Name
List
Lists all the folders associated with the report name. Note the file size to make sure you
can FTP the file or store it on a single CD-R.
Move to
Allows you to move the currently highlighted item to a destination of your choice. For
example, you can highlight an item in the Type list and add it to a particular folder in the
Folder list. The size of the data that comprises each folder is listed.
Type Name
List
Lists the item types. If, for example, you added 20 T1 JPEG images to Folder 1 and then
added another 20 T2 JPEG images to Folder 1, the number of JPEGs in folder 1 is 40. The
quantity and size of each data type is listed.
Quit
Closes the Data Export window.
Report Name
The name of the report that you are going to export. Select the report from the menu.
Comment
Allows you to type in a comment that appears on the report. Do not apply a carriage
return when typing. The text wraps automatically when appropriate for the finished
report.
Conversion
Formats
Select one of the radio buttons to determine the file type. Typically select HTML.

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Managing Images
#
Selection
Description
10
[Create CD]
Click [Create CD] to start burning the report to the CD-R that is currently in your systems
CD/DVD drive. The following message appears once the system is ready to write to the
CD-R: CD writing operation cannot be cancelled after start,
Start CD Write Continue?
Click [OK] to continue. Once the write process is active the following prompt appears:
CDWriting is going on ...
When the system has successfully written the CD, the following prompt
appears: CD Writing successfully completed.
[Send FTP]
Click [Send FTP] to open the FTP window. Enter the information for all the text boxes. The
User Name, Password, and IP Address are for the FTP destination site. Selecting Save the
Settings only saves the Target Directory information. There must be a target directory at
the IP address to successfully transfer files.
CD/DVD Interchange
The Interchange option is used to write data to CD-R and DVD-R; or recall images from CD-R
or DVD-R in a Dicom format. CD/DVD cannot be selected as the default archive device.
Exam, series, or images will not be marked as archived. A DICOM viewer is stored on the
media so the images can be viewed on a PC. The media is write once and all selections must
be queued at the same time. Approximately 7000 images can be stored to a 4.7 gb DVD-R.
NOTE: If your FE is trying to load this option, it is listed in the options list as Copy Composer.
NOTE: CD/DVD Interchange feature is available for recording DICOM images onto below
media, but so far CD/DVD Interchange is not be considered as a way for long-term
images storage.
NOTE: Please pay attention to the following declarations about Media requirements and
Operation requirements when you use the CD/DVD Interchange function.

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Managing Images
Media Requirements:
Only support single layered CD-R and DVD-R media. No other media types are
supported, including but not limited to DVD-RW.
Also, dual layered CD-R and DVD-R media are not supported.
Only support 650MB single layer CD-R media
Only support 4.7GB single layer DVD-R media
GEHC recommends using the following media brands have been qualified by GEHC
FCT:
Verbatim 4.7GB 4X commercial DVD-R media
Maxell 4.7GB 1X-4X Compatible DVD-R
SONY 650M CD-R
SONY 1X-4X Compatible 4.G media
TDK 4.7GB commercial DVD-R media
Other high quality CD-R and DVD-R media may also work but GEHC FCT has only
qualified the media types listed above.
Operation Requirements:
DVD-R only support single-session write mode, not support multi-session mode, cant
append write data on DVD-R have been burned.
DVD Interchange are NOT INTENDED for archive or backup purposes! These features
make only "temporary copies" for interchange purposes. GEHC requires cartridge
media for archive like MOD or future solutions. GEHC will not "recover" any
interchange media (it should just be burned again if necessary using patient data
restored from authorized/provided archive media).
Advise customer not to write DVD/CD during scan operations.

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Managing Images
Figure 23-4 CD/DVD Interchange Window
Table 23-3 Interchange Descriptions

Description
Button Number
1
Add Exam - Add Exam adds all exams selected.
Add Series - Add Series adds all series selected.
Copy - moves the files to the cd or DVD disk.
Eject - opens the DVD or CD tray.
Stop - quits the current process.
Option - opens the options window.
Restore - moves files from the DVD or CD to the local disk.
Quit - closes the CD/DVD interchange window.
List - Give a list of exams, series, and images to store or restore.
10
Clear - deletes the selected selection.

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Managing Images
How Do I...
This section provides the step-by-step instructions for Managing Images. Specifically, it
describes how to:
Set an Access to a Local Host and Set Up a Custom Search
Select an Archive Device (Option for BrightSpeed Excel/Edge)
Save Exam/Series/Images to a Storage Media (Option for BrightSpeed Excel/Edge)
Restore Exam/Series/Images using CD/DVD Interchange Option
Save Exam/Series/Images using CD/DVD Interchange Option
FTP a Report

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Managing Images

Your Field Engineer will usually have this set up for you. If you need to add additional remote
hosts to your system, you will need to have the network IP address provided by your sites
network administrator.
1. Click Network > Select Remote Host.
A pop up window will appear.
2. Click [Add].
The Remote Host Parameters table will appear.
3. Enter the Host name.

The Host name to be entered is the name of the device. If the device is DICOM, the
name must match exactly to the name given to the device.
4. Enter the Network Address.
You can get this information from you sites Network Administrator.
5. Select the Network Protocol.
The Network protocol consists of two choices: Advantage NET or DICOM. If the
BrightSpeed is sending to this device, the device must be able to receive DICOM
images and the DICOM network protocol must be selected.
NOTE: PC based systems only allow DICOM network protocol.

23-14
Managing Images
6. Enter the Port number.
For the HiSpeed CT/i, ZX/i, LX/i, FX/i, DX/i, Advantage Windows, and BrightSpeed
systems the port number is 4006.
If you are adding a 3rd party workstation or PACS system, your sites Network
Administrator can provide you with the port number.
A port number is only required when using a DICOM protocol.
7. Enter the AE Title.
The AE Title is unique to the device. If the device is an Advantage Windows
workstation or another GE Healthcare system, the AE Title is the same as the Host
name.
8. Enter Comments.
The comment field allows you to input a comment.
Quick Steps: Set up a Remote Host

1.
2.
3.
4.
5.
6.
7.
8.
Click Network > Select Remote Host.

Click [Add].
Enter the Host name.
Enter the Network Address.
Select the Network Protocol.
Enter the Port number.
Enter the AE Title.
Enter Comments.

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Managing Images

You will have to select if your current remote host is an archive node.
1. From Image Works, click Network > Select Remote Host.
A pop up window will appear.
2. Under Archive Node click [Auto], [Yes], or [No].

If [Auto] is selected, the system will automatically check if the device is a Storage
Commitment Provider.
If [Yes] is selected, the device is responsible for archiving the images. When the
device has received and saved the images, a notification message is displayed on
the scanner console and the Archive status for the exam is "A" for archived.
If [No] is selected, the device will not be responsible for archiving.
NOTE: At system start up a check is done to assure that devices designated as Storage
Commitment devices are sending a storage commitment response. If no response is
received the Archive node setting will be disabled.
Quick Steps: Select an Archive Node

1. From Image Works, click Network > Select Remote Host.
2. Under Archive Node click [Auto], [Yes], or [No].

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Managing Images
Set an Access to a Local Host and Set Up a Custom

Search
With this function you can lock out other systems so that they cannot send, query, or receive
images from your system.
1. Under Access to local host, click [Yes] or [No].
Click Yes if you want the device to be able to send to and/or query and receive
images from the scanner.
2. Select from the custom search window [On] or [Off].

This allows you to customize your patient listing on any remote browser to make it
easier when searching for specific patient types. When this feature is on and you
access the remote browser, the custom search entry box will initially display to allow
you to perform a custom search. This will eliminate the need of having to go into
Custom Search every time you manually network. This feature will default to off.
3. Click [Save] or [Cancel].
Do this when you are done entering all of the parameters on the remote host table.
[Save] will save the parameters and [Cancel] will close out this function.
Quick Steps: Set an Access to a Local Host and Set Up a Custom

Search
1. Under Access to local host, click [Yes] or [No].
2. Select from the custom search window [On] or [Off].
3. Click [Save] or [Cancel].

23-17
Managing Images
Select an Archive Device (Option for BrightSpeed

Excel/Edge)
Before saving or restoring image data, the archive device needs to be selected. To save
images, the archive device can be the local MaxOptics MOD or a DICOM networked remote
device. To restore images the selected archive device must be a local device, such as the
MaxOptics MOD.
1. Click [Archive].
Archive can be accessed from the Image Works browser.
2. Click [Selected Archive Device].

This will open the Archive Device Selection window.

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Managing Images
3. Select the Archive Destination.
Select from the list which device you want to use.
To select the default device, simply select the desired host/device, then click [Set
Default Device]. You will then see the default label in parenthesis next to that device.
4. Select Local or Remote.
This will show a list of local or remote devices.
5. Click [OK].
This will enable your selection.
Click [Cancel] to close the pop up window and disregard any changes made.
Quick Steps: Select an Archive Device (Option for BrightSpeed

Excel/Edge)
1.
2.
3.
4.
5.
Click [Archive].
Click [Selected Archive Device].
Select the Archive Destination.
Select Local or Remote.
Click [OK].

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Managing Images

Brand new MODs must be labeled before they are able to store image data. Also, use this
procedure to re-label a MOD that contains data that is no longer needed. When an MOD is
re-labeled, all existing data on it is permanently lost.
1. Insert the MOD into the MOD drive.
2. Select the [Image Works] desktop.
This is located in the upper left corner of the display monitor.
3. Click [Archive].
4. From the Archive menu, click [Label].

A window titled, "Format Window" pops up.
The archive device name is shown in the upper left corner of the Format Window.
The name reflects the MaxOptics MOD drive. This is set up during installation and
requires no intervention from you.
5. Enter media ID number by clicking on the text field and entering a value.
This value is the MOD label.

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Managing Images
6. Click on the Comment field and enter comments from the keyboard.
Typically, information about the type of images, MOD side, or pertinent information is
entered.
The text in this field will appear at the bottom of the Archive Browser and the
Image Works browser.
The maximum number of characters allowed in this field is 160.
7. Click [Label].
This begins the labeling process.
A confirmation window pops up and asks you to "Please refer to the Operator Manual
for limitations regarding archive media exchange between GE Products".
8. Click [OK].
This will acknowledge the message.
Selecting [Cancel] in the Format Window will abort the labeling process.
Quick Steps: Prepare a New Storage Media for Use

1.
2.
3.
4.
5.
6.
7.
8.
Insert the MOD into the MOD drive.

Select the [Image Works] desktop.
Click [Archive].
From the Archive menu, click [Label].
Enter media ID number by clicking on the text field and entering a value.
Click on the Comment field and enter comments from the keyboard.
Click [Label].
Click [OK].

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Managing Images
Save Exam/Series/Images to a Storage Media (Option for

BrightSpeed Excel/Edge)
The archiving feature allows you to save large amounts of image data onto the local MOD or
remote archiving hosts. When saving/writing to archive media, the system makes a copy of
the image data and does not remove the image data from the main system disk. The ability
to save images depends on the archive device type and the initial source of the images.
1. With the desired MOD in the drive, select the [Image Works] desktop.
2. Select the exam(s), series, or image(s) to be saved to the disk.
To aid in this, Sort and Selection menu on the browser can be used.
3. Click [Archive].
4. Click [Save Examination], [Save Series], or [Save Images].
All items selected on the browser for saving are written onto the media in the
selected archive device.
Items being saved cannot be deleted from the system disk until the save process is
complete. This is indicated by the gray Remove menu title on the browser whenever
items being saved are selected.
5. Click [Detach].
To eject the MaxOptics MOD from the MOD drive, it must first be "detached" via
[Detach] in the Archive menu on the browser.
NOTE: If the MaxOptics MOD fails to detach and cannot be ejected, Click on [Shutdown] in
the upper right corner of the right monitor. When you see "OK to power off the system"
message, press the eject button on the MOD drive. The MOD will now eject.

23-22
Managing Images
Quick Steps: Save Exam/Series/Images to a Storage Media (Option

for BrightSpeed Excel/Edge)
1.
2.
3.
4.
5.
With the desired MOD in the drive, select the [Image Works] desktop.
Select the exam(s), series, or image(s) to be saved to the disk.
Click [Archive].
Click [Save Examination], [Save Series], or [Save Images].
Click [Detach].

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Managing Images

When restoring/reading from archive media, the system makes a copy of the image data
and does not remove the image data from the archive media. Images must be restored to
be viewed. You cannot view images directly from archive media.
1. Insert the MOD into the MOD drive.
Determine which side of the MOD contains the images to be restored (side A or side
B) and insert into the MOD drive accordingly.
NOTE: You may refer to your GE logbook or other list to determine which side of the MOD
contains the images.
2. Click [Archive].
Verify that the selected archive device is the device needed for restoring.
NOTE: For additional information about selecting the device, refer to the "Selecting the
Archive Device" section earlier in this chapter.
3. Click [Restore].
An Archive browser appears on the screen. It displays the exams, series, and images
on the media of the selected device.
4. Select the exam(s), series, or image(s) to be restored from the disk.

To aid in this, Sort and Selection menu on the Archive browser can be used.
5. Click [Restore examination], [Restore series], or [Restore images].
The selection choice depends on what is to be restored.
6. Click [OK].
This will start the restoring process.
7. Click [Application].
This opens a pull down menu.
8. Click [Quit].
This will quit the Archive browser window.

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Managing Images
NOTE: You do not have to wait for the restore to be complete before quitting the Archive
browser window.
NOTE: Remember to [Detach] and replace the storage media when you are done restoring
a patients images.
Quick Steps: Retrieve Exams/Series/Images From a Storage Media

1.
2.
3.
4.
5.
6.
7.
8.
Insert the MOD into the MOD drive.

Click [Archive].
Click [Restore].
Select the exam(s), series, or image(s) to be restored from the disk.
Click [Restore examination], [Restore series], or [Restore images].
Click [OK].
Click [Application].
Click [Quit].

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Managing Images
Restore Exam/Series/Images using CD/DVD Interchange

Option
This is used to write or recall images from a CD-R or DVD-R in a Dicom format. CD/DVD
cannot be selected as the default archive device. Exam, series, or images will not be marked
as archived. A DICOM viewer is stored on the media so the images can be viewed on a PC.
The media is write once and all selections must be queued at the same time. Approximately
7000 images can be stored to a 4.7 gb DVD-R.
Only CD -R or DVD -R media can be used for CD/DVD Interchange. For CD -R write speed
should be at least 4X and storage size of 700 mb.
1. With the desired CD/DVD in the drive, select the [Image Works] desktop.
2. Click [CD/DVD].
The CD/DVD composer window appears.
3. Click [Restore].
The Restore window appears.
Figure 23-5 CD/DVD Restore Window
4. Select the exam(s), series, and images you wish to restored to the disk.

23-26
Managing Images
5. Click [Local Disk]
This copies the images onto your systems disk.
6. Click [Quit].
This closes the restore window.
7. Click [Eject].
To eject the CD/DVD from the CD/DVD drive.
Quick Steps: Restore Exam/Series/Images using CD/DVD

Interchange Option
1.
2.
3.
4.
5.
6.
7.
With the desired CD/DVD in the drive, select the [Image Works] desktop.
Click [CD/DVD].
Click [Restore].
Select the exam(s), series, and images you wish to restored to the disk.
Click [Local Disk]
Click [Quit].
Click [Eject].

23-27
Managing Images
Save Exam/Series/Images using CD/DVD Interchange

Option
This is used to write or recall images from a CD-R or DVD-R in a Dicom format. CD/DVD
cannot be selected as the default archive device. Exam, series, or images will not be marked
as archived. A DICOM viewer is stored on the media so the images can be viewed on a PC.
The media is write once and all selections must be queued at the same time. Approximately
7000 images can be stored to a 4.7 gb DVD-R.
Only CD -R or DVD -R media can be used for CD/DVD Interchange. For CD -R write speed
should be at least 4X and storage size of 700 mb.
1. With the desired CD/DVD in the drive, select the [Image Works] desktop.
2. Select the exam(s), series, or image(s) to be saved to the disk.
To aid in this, Sort and Selection menu on the browser can be used.
To save an individual series, hilight the series you wish to save and click [Add Series].
3. If the whole exam is desired, then click [Add Exam].
4. Click [CD/DVD].
The CD/DVD composer window appears.
Select the exams, series, and images you wish to copy to the disk.

23-28
Managing Images
5. Click [Add Exam], [Add Series], or [Clear].
[Add Exams] adds all of the exams that are selected.

[Add Series] adds all of the series that are selected.
[Clear] deletes all selections.

6. Click [Copy] or [Restore].
[Copy] burns the images into the disk.
[Restore] copies the images from the disk onto the systems disk.
7. Click [Yes] on the copy or restore confirmation window.

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Managing Images
8. The Interchange Media Browser appears.
This shows the selections and progress of storage.
A window appears stating Restore or Copy completed successfully.

9. Click [Ok].
10. Click [Eject].
To eject the CD/DVD from the CD/DVD drive.
Quick Steps: Save Exam/Series/Images using CD/DVD Interchange

Option
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
With the desired CD/DVD in the drive, select the [Image Works] desktop.
Select the exam(s), series, or image(s) to be saved to the disk.
If the whole exam is desired, then click [Add Exam].
Click [CD/DVD].
Click [Add Exam], [Add Series], or [Clear].
Click [Copy] or [Restore].
Click [Yes] on the copy or restore confirmation window.
The Interchange Media Browser appears.
Click [Ok].
Click [Eject].

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Managing Images

This is the way you can send exams/series/images to another computer. This is known as
sending images from one viewing station to another.
2. Select the exams/series/images from the browser that you wish to send.
To select individual exams, series, or images you must hold down the Ctrl key on your
keyboard as you select the images with left mouse.
3. Click [Network].
A list of choices will appear.
4. Click [Select remote host:].

This will pop-up a list of hosts to which the system can send images. Select the host
to which you want to send the images.
You will have to do this every time you start the system.
5. Click [OK].
Now that you have selected the remote host, you have the ability to ping the DICOM
host. This only functions when using the DICOM protocol. This can be done to make
sure your remote host and scanner can communicate. A box will pop up and if the
host you have selected is connecting with your system you will see a message that
says the host is "alive". If you get a message that there is a "connection error" it

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Managing Images
means that your system cannot communicate with the selected remote host. To ping
the DICOM host, Click Network > Ping DICOM Host.
6. Click [Network].
You will have to select this again.
7. Click [Send examination], [Send series], or [Send image].
This depends on what is to be sent.
Quick Steps: Transfer Exams/Series/Images to Another Computer

1.
2.
3.
4.
5.
6.
7.

Select the exams/series/images from the browser that you wish to send.
Click [Network].
Click [Select remote host:].
Click [OK].
Click [Network].
Click [Send examination], [Send series], or [Send image].

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Managing Images

In this section you will learn to get selected images from another system. This is known as
receiving images to your system.
2. Click [Network].
3. Click [Select remote host:].
This will bring up a list of all the host connected to your system.
4. Select the host from which you want to receive images.
From the list select the host from which you want to receive images.
5. Click [OK].
This will return you to the browser.
6. Click [Network].
7. Click [Receive].
A remote browser will pop-up showing you what is on the system disk of the station
from which you want to receive exams/series/images.

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Managing Images
8. Click Search > Change Search Parameters.
This feature allows you to apply a filter in order to narrow down your patient list. You
may search by patient name, ID number, exam number, accession number, or exam
date.
9. Select exams/series/images from the browser that you wish to get.

To select individual exams, series or images, you must hold down the Ctrl key on your
keyboard as you select the images with left mouse.
10. Click [Get].
This will give you choices.
11. Click [Get examination], [Get series], or [Get images].
This will tell the system to go to that computer and get the selected images and copy
them to your disk. It will not remove the images from that disk.

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Managing Images
Quick Steps: Retrieve Exams/Series/Images From Another Computer

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.

Click [Network].
Click [Select remote host:].
Select the host from which you want to receive images.
Click [OK].
Click [Network].
Click [Receive].
Click Search > Change Search Parameters.
Select exams/series/images from the browser that you wish to get.
Click [Get].
Click [Get examination], [Get series], or [Get images].

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Managing Images

The network history feature provides a listing of successful DICOM image transfers to
network hosts. The listing may be sorted by Exam, Date, or Host Name.
2. Click [Network].
3. Select [Network History].
A window displays a list of entries of network transfers. Entries are listed how the job
was queued for transfer. If by Exam then only the exam number is listed. If by Series
the exam and series are listed. If by Image the exam, series, and image are listed
4. If you want check for a specific transfer, enter the Exam, Exam and Series or Exam Series
Image in the search field.
Entries are added to the list at the level they were queued for transfer.

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Managing Images
5. A results window is displayed.
6. Click [End Search] to go back to the first screen.
Quick Steps: Check Network History File

2. Click [Network].
3. Select [Network History].
4. If you want check for a specific transfer, enter the Exam, Exam and Series or
Exam Series Image in the search field.
5. A results window is displayed.
6. Click [End Search] to go back to the first screen.

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Managing Images

Edit Patient is a function that allows you to edit certain patient information once the exam
has been completed. There are some things to keep in mind regarding Edit Patient. You can
only edit exams that were created on your system. You cannot edit contrast or weight. It
takes about one minute and 45 seconds to update a 100 image exam. Exams can be edited
multiple times.
NOTE: Make sure that you do any retrospective reconstructions before editing and do any
archiving, networking, and filming after editing the patient information.
There are some things that Edit Patient will not do. These things are:
Update scan data files
Update completed patient information
Edit contrast
Edit weight
You also need to remember that you cannot access Edit Patient if the exam you want to edit
is currently in use. An exam is currently in use if New Patient, Network Send, Archive Save,
3D, Reformat, Denta Scan, Navigator, Viewer, or Mini Viewer is active. Also, you cannot use
Edit Patient if the exam displayed is in a free or Autofilm viewport in the Exam RX desktop. If
you try to use Edit Patient when an exam is currently in use, which means the exam is on the
archive, film or network queue, the following message will appear.
About 3D and Edit Patient, there are a couple of things to remember. If you edit an exam
that has a saved 3D model, the 3D model are deleted from the exam. Also, if you want to edit
an exam, but you have the 3D model selected when you choose Edit Patient, you will not be
able to edit the exam.
1. Click [Image Works].
2. Select the exam number.
From the Image Works browser, highlight the exam to update.

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Managing Images
3. Click [Edit Patient].
This is located on the right side of the browser.
4. Click [Edit Patient Data].

When the menu pops up, you can click [View Edit Log] or click [Edit Patient Images].

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Managing Images
5. Click [Accept].
This is a warning message to remind you of all the things that will happen.
If any of the things are of concern, click on [Cancel] and resolve the concern before
proceeding.
6. Click [Accept].
This is an additional reminders warning, letting you cancel if you need to.
7. Enter the patient information.

You may now edit any of the fields.

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Managing Images
NOTE: You must enter at least three characters in the Edited By field to continue.
If you changed a field but wish to change it back to its original value, highlight the
field and click [Reset Selected Value].
If you have edited multiple fields but wish to change them back to their original
values, click [Reset All Original Values].
Click [Cancel] will cancel Edit Patient.

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Managing Images
8. Click [Accept].
The following menu will appear.
9. Click [Accept].
The old exam will now be removed and the new edited exam is created.
As the old exam is being removed and the new exam is being created, a percentage
countdown menu will appear. The closing Application portion of the countdown is
when the Edit Patient feature is being closed and the Patient Information Edit Log is
being updated.
NOTE: After the editing is complete, the new edited exam is listed on the browser. You can
distinguish edited exams from originals by looking at the description area on the
browser. Edited exams will show the letter "e" plus a number identifying how many
times the exam has been edited. "e+1" means the exam has been edited once. Also,
with edited exams, any description for that exam is pushed to the right on the browser
list to make room for the editing information.
Quick Steps: Edit Patient Information

1.
2.
3.
4.
5.
6.
7.
8.
9.
Click [Image Works].

Select the exam number.
Click [Edit Patient].
Click [Edit Patient Data].
Click [Accept].
Click [Accept].
Enter the patient information.
Click [Accept].
Click [Accept].

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Managing Images

You are able to change the patient name to Anonymous by exam, series, or image. The level
of annotation for Anonymous Patient is controlled by Anonymous Patient Level in the Tool
Bar on Image Works desktop. This is done after the patient has been scanned, thus you
must enter a name when you start a [New Patient].
2. From the browser, select the patient you want to be anonymous.
If you want only specific series or images to be anonymous, carefully select only
those series or images desired.
3. Click [Utilities].
A pull down menu will appear. This pull down menu will list three ways for creating an
anonymous patient, by exam, series, or image.
4. Click [Create anonymous patient by exam], [Create anonymous patient by series], or

[Create anonymous patient by image].
This will tell the machine which way you want to create the anonymous patient.
5. Click [OK] to start the create process.
Selecting [Cancel] will stop the process.
Quick Steps: Remove Patient Information From an Exam

1.
2.
3.
4.

From the browser, select the patient you want to be anonymous.
Click [Utilities].
Click [Create anonymous patient by exam], [Create anonymous patient by series], or
[Create anonymous patient by image].
5. Click [OK] to start the create process.

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Managing Images

Eventually, you will want to remove an image, series, or entire exam from the system image
disk to make room for others.
2. Select the exams/series/images from the browser that you wish to remove.
To select individual exams, series or images you must hold down the [Ctrl] key on
your keyboard as you select them with the left mouse.
3. Click [Remove].
It is important to confirm that examinations to be removed have been archived by
checking the status in the browser. Check under the examination area which should
have a "Y" in the archived column by the patients name meaning that the exam has
been Archived.
This will give you three choices.
4. Click [Remove examination], [Remove series], or [Remove image].
This depends on what is to be removed.
5. Click [OK].
This will cause a pop-up window to come up and ask you Are you sure?
6. Click [Yes].
NOTE: It is recommended that you delete images when image space falls below 10,000
images. This will ensure there is room on the system disk to confirm scans and to
install reconstructed images.

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Managing Images
Quick Steps: Delete Exams/Series/Images From the System

1.
2.
3.
4.
5.
6.

Select the exams/series/images from the browser that you wish to remove.
Click [Remove].
Click [Remove examination], [Remove series], or [Remove image].
Click [OK].
Click [Yes].

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Managing Images

1. From the Browser, select the exam you wish to export.
All series in the exam will be loaded into Data Export.
Only one series can be exported at a time.
2. Click [Data Export] from the Browser.
3. Select the Compose tab if that tab is not already selected.
See Figure 23-2 for more information.
4. Review the images in the Compose viewport.
Middle-click and drag to adjust W/L
Right-click and drag to adjust zoom factor.
Click and drag to scroll.
Click on the image to put in focus, then press the Page Up or Page Down keys on the
keyboard to navigate through the images.
Click [Play] to view the images in a cine loop.
Select the +/- Series buttons to navigate through all the series.
5. Once you are satisfied with the image appearance, display the first image in the series
and click Propagate Image Operations box.
6. Select the conversion format from the pull-down menu.
Selections include JPEG, PNG, AVI, MPEG, and MOV.
7. Select the desired image range.
If you want a subset of the images, click the Custom radio button and type the range
in the text box.
8. Select a compression factor.
The smaller the number, the higher the image quality and the larger the file size.
9. Select an Annotation option.
If you want the patient name to be displayed as Anonymous with the examination
number, click the Anonymous radio button.
10. Enter a name for both the report and the folder.
Use no spaces or characters other than alphanumeric.
11. Click [Add to Report].
If you change your mind and decide not to add the data to the report, click [Cancel]
from the progress bar window.

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Managing Images
12. Click [Quit] to exit the Data Export application.
Quick Steps: Compose a Report in Data Export

1. From the Browser, select the exam you wish to export.
3. Select the Compose tab if that tab is not already selected.
4. Review the images in the Compose viewport.
5. Once you are satisfied with the image appearance, display the first image in the series
and click Propagate Image Operations box.
6. Select the conversion format from the pull-down menu.
7. Select the desired image range.
8. Select a compression factor.
9. Select an Annotation option.
10. Enter a name for both the report and the folder.
11. Click [Add to Report].
12. Click [Quit] to exit the Data Export application.

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Managing Images

2. Click the Export tab.
3. Select the desired report from the Export Report Name pull-down menu.
4. Select the desired data set from the Type Name list.
5. Optional: type a message in the Comment text box. Do not press carriage return while
entering your text, the system adjusts the text for the final report.
6. Select a Conversion format, typically html.
7. To burn the report to a CD, place a CD-R in the system CD/DVD drive.
NOTE: The only compatible media for Data Export is CD -R 700 mb with at least 4X write
speed. DVD-R is not supported. If DVD -R is placed in the drive, the system will write
to this media, but the integrity of the data cannot be guaranteed and the time for the
system to recognize the media will be excessive.
NOTE: Care must be taken when placing the CD media in the drive. Place the media squarely
in the drive. Wait until the drive has sensed the media and the drive light goes off
before clicking Create CD. If you click Create CD too quickly after placing the media
in the drive you will get a message no media in the drive.
8. Click [Create CD].
9. Click [Ok] to start the writing process.
A message displays while the CD is written.
When the CD writing step is complete, the CD ejects from the drive.
10. Click [Ok] to the CD Written Successful prompt.
11. Click [Quit] to exit Data Export.

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Managing Images
Quick Steps: Save a Report to CD-R

7. To burn the report to a CD, place a CD-R in the system CD/DVD drive.
8. Click [Create CD].
9. Click [Ok] to start the writing process.
10. Click [Ok] to the CD Written Successful prompt.

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Managing Images
FTP a Report
1. Click [Data Export] from the Browser list.
7. Click [Send FTP] to send the data to an IP address.
8. Complete all the text boxes on the FTP window and click [OK].
9. Click [OK] to the Successful File transfer prompt.
Quick Steps: FTP a Report

1. Click [Data Export] from the Browser list.
7. Click [Send FTP] to send the data to an IP address.
8. Complete all the text boxes on the FTP window and click [OK].
9. Click [OK] to the Successful File transfer prompt.

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Managing Images
1. Place the CDROM in the CD drive of a PC or laptop running Windows 2000 or XP.
The CD launches automatically. If it does automatically start, open the CD by clicking
on your My Computer icon and open your CD drive. Click INDEX to open the file.
The report is opened and displayed from an Internet Browser.
2. Place the cursor over an image and click to magnify the image.
3. Click the Back arrow on your Internet Browser menu bar to return to the report.
4. When finished viewing the report, close your Internet Browser by clicking File > Close
from the menu bar.
5. Remove the CD-ROM from the CD drive and store it.
Quick Steps: View a Report on a PC

1. Place the CDROM in the CD drive of a PC or laptop running Windows 2000 or XP.
2. Place the cursor over an image and click to magnify the image.
3. Click the Back arrow on your Internet Browser menu bar to return to the report.
4. When finished viewing the report, close your Internet Browser by clicking File > Close
from the menu bar.
5. Remove the CD-ROM from the CD drive and store it.

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Managing Images

23-52
Viewing Images
Chapter 24
Viewing Images
Introduction
This chapter explains how to view images. It contains the step-by-step instructions to help
you learn how to:
View a List of Scanned Patients
View a Patients Scan
Advance One Exam/Series/Image At a Time in Image Works
Scroll Through A Set of Images
View Images in a Cine Loop
Compare Exams/Series/Images
View a Reference Image

24-1
Viewing Images

This section presents the concepts necessary to successfully set up images for viewing.
Some of the concepts you need to understand:
List/Select
Paging
Viewer and Mini-Viewer
List/Select
The List/Select function is located in the Exam RX desktop. Selecting this function gives you a
listing of exams and other information about the exams. This list is known as the Browser.
The Browser is broken down into examinations, series, and images. The exam listing
includes the exam number, patient name, date, description of the exam, modality image
format, pps information, and the archive status by exam. The series area lists the series that
comprise the exam. The series number is listed here as well as the scan type, number of
images for that scan type, a description, what modality the images came from, pps
information, and the manufacturer of the system. The image list box contains all the
information related to images that comprise the highlighted series. In the list box, the
images numbers, table location, thickness and spacing, gantry tilt, RAS coordinates, Scan
field of view, Display field of view, Resolution, Matrix size, Mid scan time in seconds, and
Archive status are listed. This function provides a list of all the exams on the system disk for
viewing.
Paging
Paging allows you to rapidly view images at up to 60 frames per second. This function is
good for viewing scans taken at the same location with contrast to track flow or with motion
such as flexing a Elbow. There are two viewing choices in Paging. Temporal displays the
images in a loop from start to end location all the time as paging continues. Spatial goes
from the starting location to the ending location, then from the ending location to the
starting location, and continues the sequence.
Viewer and Mini-Viewer

The Viewer and Mini-Viewer are located on the Image Works desktop. This is the place from
which you can view images. All of the routine display functions are located here. The
difference between the Viewer and Mini-Viewer is a few functions. The Viewer has all the
same functions as the Mini-viewer. The Viewer, however, has the following additional
features: Compare, Film Series, Save Screen, and User Preferences.

24-2
Viewing Images

procedure. It improves transfer of data because it can provide a complete message when all
data has been transferred. The browser has a PPS column that lists the PPS status of each
exam. There are three states of exam status: COMP, meaning the exam is complete; DISC,
meaning the exam is discontinued, and it cannot use PPS again; or, INPR, meaning that the
exam is still in progress.

24-3
Viewing Images
How Do I...
This section provides the step-by-step instructions for Viewing Images. Specifically, it
describes how to:
Advance One Exam/Series/Image At a Time in Image Works

24-4
Viewing Images

Use this procedure to update your log book and to keep track of all the patients that have
been scanned on the system.
1. From the Display monitor, click [Exam RX].
This button is located in the upper left corner of the Display monitor.
2. From the left side of the screen, click [List/Select].
This brings up a list of all the patients that are on the system disk.
NOTE: You can sort the way the list is displayed. For more information on sort, refer to: Sort
Examinations and Images.
Quick Steps: View a List of Scanned Patients

1. From the Display monitor, click [Exam RX].

24-5
Viewing Images

The List/Select button is used for displaying a patient and manipulating the images for
image review or filming.
1. From the Display Monitor, click [Exam RX].
This button is located in the upper left corner of the Display monitor.
This brings up a list of all the patients that is on the system disk.
3. Select the patient name that you want to view.
The names are listed in the order by which they are sorted.
4. Select the series that you want to view.
There may be several series. You can click on the first one that you want to view.
The first series is automatically highlighted. If that is the one you want, you do not
have to select it again.
5. Select the image that you want to view.
The first image is highlighted already. If that is the series you would like to view, you
do not have to select it again.
There may be several images. You can click on the first one that you want to view.

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Viewing Images
6. Click [Accept].
a loading pop up box displays the percentage until completion.
A prompt may be displayed that all of the images in the series have not been loaded.
You may:
a)Select Continue and only display the images currently indicated.
b)Select Try again later and reselect the series from the browser.
c)Wait until the images loaded match the total number of images in the Series
before selecting Continue.
Quick Steps: View a Patients Scan

1.
2.
3.
4.
5.
6.
From the Display Monitor, click [Exam RX].

From the left side of the screen, click [List/Select].
Select the patient name that you want to view.
Select the series that you want to view.
Select the image that you want to view.
Click [Accept].

24-7
Viewing Images
Advance One Exam/Series/Image At a Time in Image

Works
There are a lot of different ways in which you can move from one exam, series, or image to
another.
The Accelerator Bar can be used to move from one exam, series, or image to another.
For more information on the Accelerator Line Commands, refer to the Appendix of this
manual.
In the [Image Works] desktop, the Page Up and Page Down keys work, but the Bright Box
does not. It is designed only for the Exam RX desktop.
1. Select from the Browser the Exam, Series and Image that you want to page through.
You do not have to select all of the images, just the first one is good.
2. Click [Viewer] or [Mini Viewer].
3. In [Image Works] you can move from one exam to another by selecting Exam [+] or [-].
This moves you up or down the patient list, displaying each exam.
4. You can move from one Series to another by selecting Series [+] or [-].
If [Next/Prior] Series is on you automatically advance from one series to the next
while in the same exam.
5. You can move from one image to another by selecting Image [+] or [-], or Clicking and
Dragging the scroll bar.
This moves you through the images one at a time, just as the Page Up and Page
Down keys do.
You can also Click on the number and type the new image number in.
NOTE: For more information on Next/Prior Series refer to: Image Display Viewing Area.
Quick Steps: Advance One Exam/Series/Image At a Time in Image

Works
1.
2.
3.
4.
5.
Select from the Browser the Exam, Series and Image that you want to page through.
Click [Viewer] or [Mini Viewer].
In [Image Works] you can move from one exam to another by selecting Exam [+] or [-].
You can move from one Series to another by selecting Series [+] or [-].
You can move from one image to another by selecting Image [+] or [-], or Clicking and
Dragging the scroll bar.

24-8
Viewing Images

The Bright Box is a white box that can be moved around anywhere on the console. It has a
trackball in the middle of it, page up and page down button on each side, and a paging
button at the top of the trackball. This is a great way for the radiologist to view the images
on the screen. It is fast and requires little work for him/her. This feature only works in the
Exam RX desktop.
1. Double Click on the desired image for paging.
Place you mouse over the image that you want to page through and double click.
2. Using the Bright Box, Double Click on the top button.
This puts the blue frame into a manual paging mode and move the blue frame to
another viewport.
This mode puts a Blue P in the bottom right of the image.
3. Roll the Trackball up and down to scroll through the images.
Rolling the trackball up, moves through the next images and rolling the trackball
down moves through the prior images.
4. Click on the top button and change the window level by moving the trackball.
This changes the Blue P to a Blue WL.
Roll the trackball side to side to change the window width and up and down to
change the window level.
5. Click on the top button and change back to paging mode.
This changes the Blue WL to a Blue P.

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Viewing Images
6. To get out of this mode, Double Click on the top button.
The P disappears.
You have to Click with the mouse, on the viewport to make it in primary focus.

24-10
Viewing Images
Quick Steps: Scroll Through A Set of Images

1.
2.
3.
4.
5.
6.
Double Click on the desired image for paging.

Using the Bright Box, Double Click on the top button.
Roll the Trackball up and down to scroll through the images.
Click on the top button and change the window level by moving the trackball.
Click on the top button and change back to paging mode.
To get out of this mode, Double Click on the top button.

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Viewing Images

This function allows you to view images up to 60 frames per second. This function is good for
viewing scans taken at the same location with contrast to track flow or with motion such as
flexing a elbow. This feature is found in the Image Works desktop.
1. Select from the Browser the Exam, Series and Image that you want to page through.
You do not have to select all of the images, just the first one is sufficient.
3. Click on the viewport that you want to use for paging.
This makes the frame the primary focus.
4. Click [Paging].
5. Click and Drag the scroll bar by Start and change the starting image number.
You can also delete the existing number and type in the new number that you want
to start with.
6. Click and Drag the scroll bar by End and change the ending image number.
You can also delete the existing number and type in the new number that you want
to end with.

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Viewing Images
7. Click and Drag the scroll bar by FPS (Frames Per Second) and change the FPS number.
You can also delete the existing number and type in the new number to set the speed
for the image loop.
8. Select Temporal or Spatial.

There are two viewing choices in Paging. Temporal displays the images in a loop from
starting to ending location all the time as paging continues. Spatial goes from the
starting location to the ending location, then from the ending location to the starting
location, and continues the sequence.
9. Click [Go].
This starts the paging loop.
10. Click [Stop].
This stops the paging loop.
11. If you want to page a new series, and you are in the viewer, click [Select Series].
A pop up message appears stating "On the browser, select the examination, series,
and images which you wish to load into the selected viewport. Select the Viewer".
You can click [Viewer] or click on the [Cancel Series Selection] button.
On the Browser, select another series, then click on [Viewer], and click [Go].
12. Click [Cancel].
This cancels you out of the paging feature.

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Viewing Images
Quick Steps: View Images in a Cine Loop

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Select from the Browser the Exam, Series and Image that you want to page through.
Click [Viewer] or [Mini Viewer].
Click on the viewport that you want to use for paging.
Click [Paging].
Click and Drag the scroll bar by Start and change the starting image number.
Click and Drag the scroll bar by End and change the ending image number.
Click and Drag the scroll bar by FPS (Frames Per Second) and change the FPS number.
Select Temporal or Spatial.
Click [Go].
Click [Stop].
If you want to page a new series, and you are in the viewer, click [Select Series].
Click [Cancel].

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Viewing Images
The compare function allows you to compare images from the same series or a different
series from the current exam, or compare another exam to the current one displayed. This
feature is only available in the image works viewer.
1. Select the first Exam, Series, and Image that you want to compare on the screen.
Highlight the Exam/Series/Image that you want to compare
2. Click [Viewer].
This s displays the first exam.
3. Click [Compare].
The Browser appears with the following message, describing how to use Compare.
4. From the Browser, select the second Exam/Series/Image.

This is the other Exam/Series/Image that you want to be able to compare with the
first set of images.

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Viewing Images
5. Click [Viewer].
The Display screen is now divided into a four on one format, with the original exam
on the left half of the viewer, and the new Exam/Series/Images on the right side.
The monitor is divided into two viewers. If you want to make changes to the first
exam, click on that side to make that image the primary viewport. Make your
changes, then click on the other side to make it the primary viewport and make the
changes to that side.
In the compare mode, the system always default to a four on one format, regardless
of the format that you have chosen.
6. Select the Left Series or Right Series Up and Down arrows to move through the image
set.
If you want to move both series at the same time, use the Page Up or Page Down
keys.

24-16
Viewing Images
7. When you are finished comparing the Exams/Series/Images, click [Cancel Compare].
This cancels Compare and revert back to viewing the first exam/series/image that
you had selected as the primary before canceling.
Quick Steps: Compare Exams/Series/Images

1.
2.
3.
4.
5.
6.
Select the first Exam, Series, and Image that you want to compare on the screen.
Click [Viewer].
Click [Compare].
From the Browser, select the second Exam/Series/Image.
Click [Viewer].
Select the Left Series or Right Series Up and Down arrows to move through the image
set.
7. When you are finished comparing the Exams/Series/Images, click [Cancel Compare].

24-17
Viewing Images

Selecting the reference image button in image works only, allows you to place a reference
image on a selected viewport or all viewports. The reference image is displayed in the lower
right of the viewport or viewports. For the reference image to be displayed, the viewport
display must be 5122 x 5122 or larger.
1. Select from the Browser the Exam, Series and Image that you want to display a
reference image on.
You do not have to select all of the images, just the first one is sufficent.
3. Click on the Viewport that you want to use for a reference image.
This makes the frame the primary focus.
4. Click [Reference Image].
Once you select the reference image button, a listing of four choices appear.
5. Click All On, All Off, Selected On, or Selected Off.

One option is to select All Onto have the reference image displayed on all viewports.
Another option is to select All Off to remove the reference image from all the
viewport or viewports. A third option is to select Selected On to have the reference
image displayed only in the active viewport. The fourth option is to select Selected
OFF to remove the reference image only from the active viewport.
NOTE: When using Print Series with Reference image on, make sure you have All selected
so all the images are filmed with reference image on.
NOTE: If a screen save is done with Reference image on, the Reference image will be saved
with the same WW and WL as the main image, regardless of the WW and WL
displayed on the Reference Image.

24-18
Viewing Images
Quick Steps: View a Reference Image

1. Select from the Browser the Exam, Series and Image that you want to display a
reference image on.
3. Click on the Viewport that you want to use for a reference image.
5. Click All On, All Off, Selected On, or Selected Off.

24-19
Viewing Images

24-20
Image Display Viewing Area
Chapter 25

Introduction
This chapter explains Setting up the Viewing Area for Image Display. It contains the
Select a Single Image Display
Select a Multiple Image Display
Set Viewports for Images to Come Up in Order
Set Viewports for Automatic Display of the Next Series
Set a Primary Viewport
Set a Secondary Viewport

25-1

This section presents the concepts necessary to successfully set up a viewing area for
image display. Some of the concepts you need to understand:
Autoview
Auto Link
Primary Viewport
Secondary Viewport
Viewport
Autoview
Auto View is used to automatically display the images on the screen as the images are
reconstructed by the computer. You have a choice between 8 Autoview layouts.
NOTE: If you are in the one on one layout or any of the multiple viewport layouts, you notice
a folded corner, in the top right corner. This allows you to see what is auto filming. It
toggles the screen each time you click on the folded corner. The folded corner is not
available on the autoview layouts that defaults to filming.
Auto Link
While reconstruction is active, and if you have a autoview port selected with auto link, the
lower right viewport automatically displays the first image of the series being currently
reconstructed. The viewport is annotated with "AL" at the bottom right corner of the image
to indicate that Auto Link is active. All display features and next/prior can be used with Auto
Link.
Primary Viewport
A viewport becomes active or receives primary focus by clicking on it. At that point, the
border around the image turns blue. When a viewport has received the primary focus, you
can choose List/Select and choose which exam you want to view. Also, you can window
level, magnify, and preform other image manipulation functions without effecting other
images currently displayed on the screen.
Secondary Viewport
When you click on another viewport and the border turns blue, the viewport that was
previously in focus receives secondary focus and has a yellow box around it. In effect, these
two viewports are linked together. A change in one of the viewports is reflected in the other

25-2

viewport. For example, changing the window width and window level in the primary image
also changes the window width and window level in the secondary focused image. To return
a single viewport in focus, double click on the viewport of interest, or to put all the images in
focus, triple click on a viewport.
Viewport
The screen can be divided into many different viewing areas. These viewing areas are called
Viewports.

25-3
How Do I...
This section provides the step-by-step instructions for Setting up a Viewing Area for Image
Display. Specifically, it describes how to:

25-4

You can choose between two one on one displays. The first one is a 1024 x 1024 matrix.
Keep in mind, if you select this layout, the entire screen is filled with the image. You notice
the image is annotated with a magnification factor of 2.0. This annotation is a result of the
change going from a 5122 matrix to a 10242 matrix. When the image is filmed, it is filmed in
a 512 matrix and no magnification factor is shown.
The second one on one display is a 768 x 768 matrix. The image covers 768 x 768 of the
entire display screen, but in effect, the entire screen is used.
Both of these formats can be chosen in either the Autoview Layout and/or the Review
Layout.
1. Click the [Exam RX Desktop].
This is located in the upper left corner of the Display Monitor.
2. Click [Autoview Layout] or [Review Layout] to switch between desktops.
This is done by clicking on the switch located above the Autoview and Review layout
icons.
3. Click the [Autoview Layout] or [Review Layout] icon to change the screen format.
This is done by clicking on the icon that looks like multiple images.
4. Click the one on one choice that you want to display.
This is done by clicking on the image layout that looks like what you want your
display layout to look like.

25-5
Quick Steps: Select a Single Image Display

1.
2.
3.
4.
Click the [Exam RX Desktop].

Click [Autoview Layout] or [Review Layout] to switch between desktops.
Click the [Autoview Layout] or [Review Layout] icon to change the screen format.
Click the one on one choice that you want to display.

25-6

There are six choices in Autoview Layout to choose from.
The first Layout allows you to display the scout with the cross reference of the current
autoviewed image in the upper left viewport. In the upper right viewport is the autoviewed
image and then there are two open viewports at the bottom. In the open viewports, you may
choose to view the current exam or other exams that are on the system disk. While
reconstruction is active, the lower right viewport automatically displays the first image of
the series being currently reconstructed. The viewport is annotated with "AL" to indicate
that Autolink is on.
The next Layout selection has the autofilm viewport in the upper left viewport, the
autoviewed image in the upper right viewport and two open viewports at the bottom. While
reconstruction is active, the lower right viewport automatically displays the first image of
the series being currently reconstructed. The viewport is annotated with "AL" to indicate
that Autolink is on.
The next Autoview Layout selection has the scout with the crossed reference of the current
autoviewed image in the upper left viewport, the autoviewed image in the upper and lower
right viewports, and an open viewport in the lower left viewport.

25-7

The next Autoview Layout selection displays the autoviewed images in the top two
viewports, the scout with the cross reference of the current autoviewed image in the bottom
right viewport and an open viewport in the bottom left viewport.
The next Autoview Layout selection displays the last four autoviewed images with the most
current in the upper left and the oldest in the lower right viewport. There are no open
viewports with this selection.
CAUTION:
This format should not be used for display of images during an interventional
study because it does not allow for quick review of images in a free viewport.
The final Autoview Layout selection displays two autoviewed images in the upper two
viewports and two open viewports in the bottom viewports to display the current exam or
other exams that are on the system disk.
CAUTION:
This format should not be used for display of images during an interventional
study because it does not allow for quick review of images in a free viewport.

25-8

There are three choices in Review Layout to choose from.
The first choice displays the four on one selection. This allows you to view an exam in a four
on one layout or view a different exam in each viewport.
The next Review Layout choice displays a two on one horizontal display. This allows you to
view an exam in a two on one layout or to view a different exam in each viewport.
The final Review Layout choice displays a two on one vertical layout which allows you to
view a different exam in a two on one format or view an exam in each viewport.
1. Click the [Exam RX Desktop].

This is located in the upper left corner of the Display Monitor.
2. Click [Autoview Layout] or [Review Layout] to switch between desktops.
This is done by clicking on the switch located above the Autoview and Review layout
icons.

25-9

3. Click [Autoview Layout] or [Review Layout] icon.
This is done by clicking on the icon that looks like multiple images.
4. Click the Layout choice.
This is done by clicking on the image layout that looks like what you want your
display layout to look like.
Quick Steps: Select a Multiple Image Display

1.
2.
3.
4.
Click the [Exam RX Desktop].

Click [Autoview Layout] or [Review Layout] to switch between desktops.
Click [Autoview Layout] or [Review Layout] icon.
Click the Layout choice.

25-10

The Next/Prior Each Viewport function is used in conjunction with a multiple image display.
This function determines how the images are sequenced when the Page up or Page down
buttons are used. For example with a 4 on 1 MID display, if the Next/Prior Each Viewport is
selected, each viewport advances one image. With this function off, the next 4 images
displays.
The function default is off.
1. Click the [Exam RX] Desktop.
2. Click [Display Preferences].
This opens up another menu.
3. Click [Next/Prior Each Viewport].

This is a toggle switch. If it is a dark blue, it is not selected; if it is a light blue color, it is
selected which means the feature is on.
4. Click [Back].
This returns you to the Exam RX screen.

25-11
Quick Steps: Set Viewports for Images to Come Up in Order

1.
2.
3.
4.
Click the [Exam RX] Desktop.

Click [Display Preferences].
Click [Next/Prior Each Viewport].
Click [Back].

25-12

The Next/Prior Series Binding function is on, it takes you to first image of the next series or
prior series within an exam, if you reach the end of a series using the next or prior image
functions. With the Next/Prior Series Binding function off, when you reach the end of a
series, selecting the next image returns you to the first image of that series.
This opens up another menu.
3. Click [Next/Prior Series Binding].

This is a toggle switch. If it is a dark blue, it is not selected; if it is a light blue color, it is
selected which means the feature is on.
4. Click [Back].
This returns you to the Exam RX screen.

25-13
Quick Steps: Set Viewports for Automatic Display of the Next Series
1.
2.
3.
4.
Click the [Exam RX] Desktop.

Click [Next/Prior Series Binding].
Click [Back].

25-14

When a viewport has received primary focus, you can choose List/Select and choose which
exam you want to view. Also, you can window level, magnify, and perform other image
manipulation functions without affecting other images currently displayed on the screen.
2. Double Click on the image that you want in primary focus.
This is done by placing the mouse pointer over the image that you want in primary
focus and clicking twice quickly.
Quick Steps: Set a Primary Viewport

2. Double Click on the image that you want in primary focus.

25-15

The secondary viewport has a yellow frame around it. In effect, the blue and yellow
viewports are linked together. A change in one of the viewports is reflected in the other
viewport. For example, changing the window width and window level in the primary image
also changes the window width and window level in the secondary focused image.
2. Double Click on the image that you want in secondary focus.
The frame is blue, indicating primary focus, but turns yellow after completing the
next step.
3. Single Click on the image that you want to link to.
This image now has primary focus and the previously selected image has secondary
focus.
Quick Steps: Set a Secondary Viewport

2. Double Click on the image that you want in secondary focus.
3. Single Click on the image that you want to link to.

25-16
Sort Examinations and Images
Chapter 26

Introduction
When working with a list of examinations or images, it can be helpful to sort the list by a
particular criteria, such as the scan date or a number. This chapter explains the process of
sorting examinations and images. It contains the step-by-step instructions to help you learn
how to:
Sort Examinations by:

Number
Patient name
Scan date
Modality
Archived status
Sort Images by:

Image number
Table location
Echo (MR images)
Trigger (MR images)
Scan time (MR images)

26-1

This section presents the concepts necessary to successfully sort examinations and images.
The concepts you need to understand are:
Sorting Examinations
Sorting Images

26-2
Sorting Examinations
When you look at the patient list on the browser, you want to know what examinations have
been completed. If you spend time looking for a patient to view, you may want to organize
your list to help you find examinations quickly. The list can be organized in many different
ways. The most common method is to sort the examinations by date.
Sort Examinations by Examination Number

This option sorts the examinations by number. The oldest exam is listed at the top and the
most recent exam is listed at the bottom of the Examination window.
Sort Examinations by Patient Name

This option sorts the examinations by patient name. The patients are listed in alphabetical
order, starting with A at the top of the list.
Sort Examinations by Date

This option sorts the examinations by the date and time on which they were scanned. This
method is used most often since it always lists the most recent patient scanned at the top of
the list. All of the other patients are listed in the order in which they were scanned.
Sort Examinations by Modality

This option sorts the list by modality. It arranges the examinations in alphabetical order by
the modality in which they were scanned.
Sort Examinations by Archived Status

This option sorts the examinations by the archived status. It may be useful to arrange the
patient list so that all of the archived examinations are at the top of the list and the
unarchived examinations are at the bottom of the list.
Sort Examinations by PPS Status

This option sorts the examinations by the PPS status.
Sorting Images
Image organization is very important to the doctor when reviewing the exam. It may be
helpful to find out the order in which each doctor wants to view the images. The most
common method is to sort the images by their number, so the images are displayed in order
that they were acquired.

26-3
Sort Images by Image Number

This option sorts the images by image number and is used most often. The image list places
the lowest number at the top of the list and the highest number at the bottom of the list.
Sort Images by Location

This option sorts the images by the table location. This is a good method to use when you
scan out of order and you want to sort the images by the location that was scanned.
Sort Images by Echo

This method is used for MR images that have more than one echo.
Sort Images by Trigger

This method sorts the MR images by trigger delay.
Sort Images by Scan Time

This option sorts the MR images in a series by the scan time. The most recent scan time is at
the top of the list.

26-4
How Do I...
Anchor
This section provides the step-by-step instructions for sorting examinations and sorting
images. Specifically, it describes how to:
Sort Examinations by:

Number
Patient name
Scan date
Modality
Archived status
Sort Images by:

Image number
Table location
Echo (MR images)
Trigger (MR images)
Scan time (MR images)

26-5
Sort Examinations
Use this procedure when you want to change the order in which the examinations are listed
on your system.
1. Select Sort from the display monitor.
This is located at the top of the browser on both Exam Rx and Image Works.
2. Select the desired sort option from the Sort list.
Sort examinations by exam number
Sort examinations by patient name
Sort examinations by date
Sort examinations by modality
Sort examinations by archived status
Sort examinations by PPS status
Quick Steps: Sort Examinations


26-6
Sort Images
Use this procedure when you want to change the order in which the images are listed on
your system.
This is located at the top of the browser on both Exam Rx and Image Works.
Sort images by image number
Sort images by location
Sort images by echo
This applies to MR images only.
Sort images by trigger
Sort images by scan time
Quick Steps: Sort Images


26-7

26-8
Image Manipulations
Chapter 27
Image Manipulations
Introduction
This chapter explains how to manipulate image data. The chapter is divided into two parts.
The first part lists how to perform all applicable functions from the Exam Rx desktop. The
second part lists how to perform all applicable functions from the Image Works desktop. It
contains the step-by-step instructions to help you learn how to:
In the Exam Rx desktop:
Change the Orientation of an Image
Make Images Sharper or Smoother
Improve the Brain/Bone Interface
Restore an Image to its Original State
Reverse the Video
Apply Mattes to an Image
In the Image Works desktop:
Create a Gray Scale Presentation State Object (GSPS)
View a Gray Scale Presentation State Object (GSPS)

27-1
Image Manipulations

This section presents concepts necessary to understand ways to manipulate images. Some
of the concepts you need to understand are:
Using Proview or Image Filters
DICOM Gray Scale Presentation State Object (GSPS)

Gray Scale Enhancement is a display feature which changes the slope and gamma curve of
an image. It can be used in head studies to improve the bone/brain interface which helps
with gray/white matter differentiation. There are three levels of Gray Scale Enhancement,
G1, G2 and G3. G1 applies the least amount of enhancement and G3 applies the most.
When a filter is applied, the images are annotated with G1, G2, or G3 just above the vertical
tick mark scale on the right side of the image.
Using Proview or Image Filters

There are several different display enhancement filters (called Proview in the Exam Rx
desktop or Image Filters in the Image Works desktop) available on the system. The Edge
Enhancement filters are useful for filming bone windows, as they sharpen the image. There
are six levels of Edge Enhancement, E1, E2, E21, E22, E23, and E3. E1 applies the least
amount of enhancement and E3 applies the most. When these filters are used, the image is
annotated with E1, E2, E21, E22, E23, or E3.
The Lung Enhancement filter is designed specifically to use when filming lung windows.
When the Lung enhancement filter is applied, the image is annotated with the word Lung.
There are also five Smoothing filters, S1, S11, S2, S22, and S3, which are used when filming
soft tissue windows to decrease the appearance of noise in an image or enhance low
contrast areas. S1 applies the least amount of smoothing and S3 applies the most. When
these filters are used, the images is annotated with S1, S11, S2, S22, or S3.
DICOM Gray Scale Presentation State Object (GSPS)

DICOM Gray Scale Presentation State (GSPS) is a DICOM object which saves a range of
images, WW, WL, roam, zoom, image flip, and graphic annotations such as image
annotation and measurement graphics. This object is then sent to a review station along
with the source images. When the object is viewed, images are presented in the form that
was displayed on the scanner. GSPS object can only be viewed on systems that support
DICOM GSPS objects.

27-2
Image Manipulations
How Do I...
This section provides the step-by-step instructions for manipulating images in the Exam RX
desktop. Specifically, it describes how to:
Reverse the Video
NOTE: All of these features are also available from the Accelerator Line Commands refer to
Appendix A.

27-3
Image Manipulations

Use this procedure to flip an image left to right, top to bottom, or both at the same time. You
can also rotate to the right or to the left 90 degrees.
The flip or rotate selected is applied to all images in the series.
1. Put the image of interest in primary focus.
2. Click [Routine Display].
3. Click [Flip/Rotate].
4. Click [FLR] to flip image left to right, click [FTB] to flip image top to bottom or click
[FTB/FLR] to flip image both top to bottom and left to right.
Flip left to right is useful when the patient is lying prone on the table for the exam.
5. Click [RR] to rotate image to the right (clockwise) or click [RL] to rotate image to the left
(counter-clockwise).
The rotate feature is useful if the patient is lying on their side on the table, as in a
biopsy procedure.
6. Click [Cancel] to cancel out of flip/rotate pop up window.

27-4
Image Manipulations
7. Click [Display Normal] to return images to their original orientation.
Quick Steps: Change the Orientation of an Image

1.
2.
3.
4.
Put the image of interest in primary focus.

Click [Routine Display].
Click [Flip/Rotate].
Click [FLR] to flip image left to right, click [FTB] to flip image top to bottom or click
[FTB/FLR] to flip image both top to bottom and left to right.
5. Click [RR] to rotate image to the right (clockwise) or click [RL] to rotate image to the left
(counter-clockwise).
6. Click [Cancel] to cancel out of flip/rotate pop up window.

27-5
Image Manipulations

Using Proview is a great way to enhance anatomical structures without adding additional
reconstruction time.
The Edge Enhancement filters sharpen the image. There are seven levels of Edge
Enhancement, E1, E2, E21, E22, E23, E3 and Lung. E1 applies the least amount of
enhancement and E3 and Lung apply the most.
There are also five Smoothing filters, S1, S11, S2, S22, and S3, which are used when filming
soft tissue windows to decrease the appearance of noisy images or enhance low contrast
areas. S1 applies the least amount of smoothing and S3 applies the most. When these filters
are used, the images is annotated with S1, S11, S2, S22, or S3.
The Proview filter selected is applied to all images in the series when next and prior image
are used from the keyboard.
3. Click [Proview].

27-6
Image Manipulations
4. Click [E1, E2, E21, E22, E23, or E3] for edge enhancement.
Edge enhancement is useful when filming bone windows.
5. Click [Lung] for lung enhancement.
This is designed specifically to use when filming lung windows.
6. Click [S1,S11, S2, S21, or S3] for smoothing.
The smooth enhancements are used for filming soft tissue windows when there is a
need to decrease the appearance of noise in an image.
Enhances low contrast areas.
This feature is useful when scanning larger patients whose images have a grainy
appearance.
Also may be useful when there are bone artifact streaks on an image such as in the
hip and shoulder areas.
7. Click [Off] to turn enhancement off.
8. Click [Cancel] to cancel out of Proview pop up window.
Quick Steps: Make Images Sharper or Smoother

1.
2.
3.
4.
5.
6.
7.
8.

Click [Proview].
Click [E1, E2, E21, E22, E23, or E3] for edge enhancement.
Click [Lung] for lung enhancement.
Click [S1,S11, S2, S21, or S3] for smoothing.
Click [Off] to turn enhancement off.
Click [Cancel] to cancel out of Proview pop up window.

27-7
Image Manipulations

Using Gray Scale Enhancement (GSE) is a great display tool to improve the brain/bone
interface which helps with gray/white matter differentiation without adding additional
reconstruction time.There are three levels of Gray Scale Enhancement, G1, G2 and G3. G1
applies the least amount of enhancement and G3 applies the most.
The GSE filter selected is applied to all images in the series when the next or prior image is
selected.
3. Click [GSE].
4. Click [G1, G2 or G3].

Start with G1. If you want more enhancement, try G2 or G3.
There should be a noticeable difference between the gray and white matter of the
brain.
5. Click [Off] to turn enhancement off.
6. Click [Cancel] to cancel out of GSE pop up window.

27-8
Image Manipulations
Quick Steps: Improve the Brain/Bone Interface

1.
2.
3.
4.
5.
6.

Click [GSE].
Click [G1, G2 or G3].
Click [Off] to turn enhancement off.
Click [Cancel] to cancel out of GSE pop up window.

27-9
Image Manipulations

Display Normal can be used to reset the image display to its original size and orientation.
This feature removes all filters, magnification factors, flip/rotate and graphics such as User
Annotation from selected images.
3. Click [Display Normal].
Quick Steps: Restore an Image to its Original State


27-10
Image Manipulations
Reverse the Video

Inverse Video changes the blacks to white, creating a negative image.
This is applied to all viewports.
3. Click [Inverse Video].
Inverse video changes the bone and contrast to black and air to white.
4. Click [Inverse Video] again to turn feature off.
Quick Steps: Reverse the Video

1.
2.
3.
4.

Click [Inverse Video].
Click [Inverse Video] again to turn feature off.

27-11
Image Manipulations

The Matte function eliminates unwanted information on or around an image. There are two
types of matte, rectangular and elliptical. The size can be easily adjusted.
In Exam Rx, this feature can only be accessed from the Accelerator Line.
2. On the Accelerator Line, type ematte for an elliptical matte or rmatte for a rectangular
matte and click Enter.
An elliptical or rectangular matte appears on the image in primary focus.
Quick Steps: Apply Mattes to an Image

2. On the Accelerator Line, type ematte for an elliptical matte or rmatte for a rectangular
matte and click Enter.

27-12
Image Manipulations
How Do I...
This section provides the step-by-step instructions for manipulating images in the Image
Works Desktop. Specifically, it describes how to:
NOTE: These features can be accessed from either the Viewer or Mini Viewer in the Image
Works desktop, or the Accelerator Line Commands refer to Appendix A.

27-13
Image Manipulations

Use this procedure to flip an image left to right, top to bottom, or both at the same time. You
can also rotate to the right or to the left 90 degrees.
The flip or rotate selected is applied to all images in the series.
1. While in the viewer or mini-viewer, put the image of interest in primary focus.
A pop up window appears with four choices.
3. Select the first set of arrows to flip image left to right, select the second set of arrows to
flip image top to bottom.
Flip left to right is useful when the patient is lying prone on the table for the exam.
4. Select the third arrow to rotate image counter-clockwise or select the bottom arrow to
rotate image clockwise.
The rotate feature is useful if the patient is lying on their side on the table, as in a
biopsy procedure.

27-14
Image Manipulations
Quick Steps: Change the Orientation of an Image

3. Select the first set of arrows to flip image left to right, select the second set of arrows
to flip image top to bottom.
4. Select the third arrow to rotate image counter-clockwise or select the bottom arrow to
rotate image clockwise.

27-15
Image Manipulations

Using the Image Filters feature is a great way to enhance anatomical structures without
adding additional reconstruction time.
The Edge Enhancement filters sharpen the image. There are four levels of Edge
Enhancement, E1, E2, E3 and Lung. E1 applies the least amount of enhancement and E3 and
Lung apply the most.
There are also three Smoothing filters, S1, S2 and S3, which are used when filming soft
tissue windows to decrease the appearance of noisy images or enhance low contrast areas.
S1 applies the least amount of smoothing and S3 applies the most. When these filters are
used, the images is annotated with S1, S2 or S3.
The filter selected is applied to all images in the series when next and prior image are used
from the keyboard.
2. Click [Image Enhance].
A pop up menu appears with all of your enhancement choices.
3. Under Filters, click [E1, E2 or E3] for edge enhancement.

Edge enhancement is useful when filming bone windows.
4. Under Filters, click [Lu] for lung enhancement.
This is designed specifically to use when filming lung windows.

27-16
Image Manipulations
5. Under Filters, click [S1, S2 or S3] for smoothing.
The smooth enhancements are used for filming soft tissue windows when there is a
need to decrease the appearance of noise in an image.
It also may be useful when there are bone artifact streaks on an image such as in the
hip and shoulder areas.
Enhance low contrast areas.
6. Click [Display Normal] to turn enhancement off.
Quick Steps: Make Images Sharper or Smoother

1.
2.
3.
4.
5.
6.
While in the viewer or mini-viewer, put the image of interest in primary focus.
Click [Image Enhance].
Under Filters, click [E1, E2 or E3] for edge enhancement.
Under Filters, click [Lu] for lung enhancement.
Under Filters, click [S1, S2 or S3] for smoothing.
Click [Display Normal] to turn enhancement off.

27-17
Image Manipulations

Using Gray Scale Enhancement (GSE) is a great display tool to improve the brain/bone
interface which helps with gray/white matter differentiation without adding additional
reconstruction time.There are three levels of Gray Scale Enhancement, G1, G2 and G3. G1
applies the least amount of enhancement and G3 applies the most.
The GSE filter selected is applied to all images in the series.
2. Click [Image Enhance].
A pop up menu appears with all of your enhancement choices.
3. Under Gray Scale Enhancements, click [G1, G2 or G3].

Start with G1. If you want more enhancement, try G2 or G3.
There should be a noticeable difference between the gray and white matter of the
brain.
4. Click [Display Normal] to turn enhancement off.

27-18
Image Manipulations
Quick Steps: Improve the Brain/Bone Interface

1.
2.
3.
4.
Click [Image Enhance].
Under Gray Scale Enhancements, click [G1, G2 or G3].
Click [Display Normal] to turn enhancement off.

27-19
Image Manipulations

Display Normal can be used to reset the display to the normal or original size and
orientation.
Quick Steps: Restore an Image to its Original State


27-20
Image Manipulations

The Matte function eliminates unwanted information on or around an image. There are two
types of matte, rectangular and elliptical. The size can be easily adjusted.
2. Click [Rect. Matte].
A rectangular matte appears on your image.

3. Click and drag on the blue crosshair in the upper left corner of the matte to resize it.
4. Click and drag anywhere outside of the matte to re-position it.
Type Prop A on the Accelerator Line to place the matte on all images in the current
series.
5. Click [Erase All] to remove the matte.
NOTE: Using the accelerator line, you may type the command ematte and press Enter to
use an elliptical matte instead of rectangular.
Quick Steps: Apply Mattes to an Image

1.
2.
3.
4.
5.
Click [Rect. Matte].
Click and drag on the blue crosshair in the upper left corner of the matte to resize it.
Click and drag anywhere outside of the matte to re-position it.
Click [Erase All] to remove the matte.

27-21
Image Manipulations

GSPS saves image range, WW, WL, Roam, Zoom, rotate, Image Flip and Image graphics such
as Measure distance, ROI, Image Annotation. The GSPS object can then be networked to a
remote host that supports DICOM GSPS. GSPS Objects can also be displayed on the CT
scanner. GSPS object can only be created and viewed in the Image Works desktop.
This feature can only be accessed from the Accelerator Line.
2. Adjust the image to the desired presentation.
a) Set WW and WL
b) Image Roam
c) Image Zoom
d) Image Flip
e) Set rotate
f) Add graphics such as ROI, Measure distance and Image annotation
3. On the Accelerator Line, type ss and click Enter.
This saves the presentation of the image.
A GSPS object is now stored to the Image data base.
The GSPS series is 10,000 plus the original series.
Figure 27-1

27-22
Image Manipulations
Quick Steps: Create a Gray Scale Presentation State Object (GSPS)

2. Adjust the image to the desired presentation.
a) Set WW and WL
b) Image Roam
c) Image Zoom
d) Image Flip
e) Set rotate
f) Add graphics such as ROI, Measure distance and Image annotation
3. On the Accelerator Line, type ss and click Enter.

27-23
Image Manipulations

1. Hilight the GSPS object in the Browser
2. Select [Viewer].
a) The CPI (Consistent Presentation of Images) viewer is displayed.
b) Use page up and down to page through the images.
c) No further manipulations can be done on the GSPS object.

3. Use the pull down to change the viewer format.
4. Select the CPI object buttons to view additional GSPS objects in the series.
A new GSPS object will be created for each different rotation.
Quick Steps: View a Gray Scale Presentation State Object (GSPS)

1. Hilight the GSPS object in the Browser
2. Select [Viewer].
3. Use the pull down to change the viewer format.
4. Select the CPI object buttons to view additional GSPS objects in the series.

27-24
Image Addition/Subtraction
Chapter 28
Introduction
This chapter explains how to set up image addition and subtraction. It contains the
Add Images Together to Create a New Image
Subtract Images to Create a New Image
Combine Images from Different Series to Create a New Series
Use Existing Images to Create a New Image Using Only the Maximum CT Number
Use Existing Images to Create a New Image Using Only the Minimum CT Number

28-1

This section presents the concepts necessary to successfully complete image addition and
subtraction. Some of the concepts you need to understand are:
Image Addition
Image Subtraction
Maximum Pixel Value Extraction
Minimum Pixel Extraction
Binding Series
Accept Negative Pixels
The Difference Between "Proc" and "Comb"
Ratio Slider Bar
Image Addition
Image Addition is an operation that consists of adding image intensity values pixel by pixel.
This would be useful for adding thin slices together to get a thicker slice.
Image Subtraction
Image Subtraction is an operation that consists of subtracting image intensity values pixel
by pixel. This could be useful to evaluate contrasted vessels. Remember, patient movement
and breathing between the images can affect the quality of the subtraction.
Maximum Pixel Value Extraction

Maximum Pixel Value Extraction is an operation that consists of finding maximum image
intensity values pixel by pixel. This could be useful for contrasted vessels or calcifications.
Minimum Pixel Extraction

Minimum Pixel Value Extraction is an operation that consists of finding minimum image
intensity values pixel by pixel. This could be useful to evaluate soft tissue.

28-2
Binding Series
Binding Series is a new series that can be created which consists of copies of selected
images from one or more existing series. This could be useful if you had images in two
separate series and wanted to have them in one series to perform 3D or Reformat.
NOTE: Save State information is not maintained in the new series generated with Binding
Series.
Accept Negative Pixels

The Accept Negative Pixels function is available for either type of subtraction. This function,
when enabled, allows negative pixel values in the resulting image. If this function is not
enabled, all negative pixel values are set to zero.
The Difference Between "Proc" and "Comb"

The series resulting from operations in the Image Combination command window are
distinguished from other series in the browser via one of the following two indications in the
browser series list type column:
"Proc" appears in the browser series list type column if the images in the series are the
result of processing pairs of images have identical locations in the patients body.
"Comb" appears in the browser series list type column if the images in the series are the
result of a combination of images have different locations in the patients body.
NOTE: Since "Proc" series contains images resulting from processing pairs of images having
identical locations in the patients body, such series can be used like any other series
of acquisition images, i.e., geometrical measurements, reformatting, 3D
reconstructions, etc.
NOTE: Since "Comb" series contains images resulting from a combination of images having
different locations in the patients body, the absolute anatomical coordinates
accompanying these series (shown both in the browser and on the displayed images)
are not accurate. Only relative geometrical measurements (i.e., distance, angle, or
area) made within a resulting image are accurate.
Ratio Slider Bar

The Ratio Slider Bar is available during addition and subtraction when both of the Select Set
buttons are used. Dragging the slider bar to the left increases the pixel weighting of the
image or images on the left Select Set button. Dragging the slider bar to the right increases
the pixel weighting of the image or images on the right Select Set button. The Slider Bar
defaults to the middle to apply equal weighting.

28-3
How Do I...
This section provides the step-by-step instructions for image addition and subtraction.
Combine Images from Different Series to Create a New Series
Use Existing Images to Create a New Image Using Only the Maximum CT Number
Use Existing Images to Create a New Image Using Only the Minimum CT Number
NOTE: The Add/Sub feature can be accessed through the Image Works desktop from the
browser or from [Image Analysis] in the Viewer or Mini Viewer. The detailed steps in
this chapter assume that [Add/Sub] is accessed from the browser.

28-4

These steps assume you are using the browser in Image Works. This also assumes that you
are using both Select Set buttons.
If only one set is selected, each operation performed produces ONE resulting image.
If two sets are selected, images in the two sets are paired according to physical location in
the patients body. Unpaired images in either set are ignored. Each operation performed
produces ONE resulting image PER PAIR.
The images resulting from each operation are generated in the exam defined by the left
Select Set button.
1. From the display monitor, click [Image Works].
2. On the right side of the browser, click [Add/Sub].
This opens the Image Combination menu.
3. From the browser, select the image or images you want to use.
You can do this by clicking and dragging over a range of images for multiple images
or just clicking on one image for a single image.

28-5
4. Select from the Image Combination menu, [Select Set] on the left.
The [Select Set] button changes to annotate the exam/series/image or images that
you selected.
To clear the selection and make changes, use [Clear Selection].
5. Again, from the browser, select the image or images you want to use.
6. Click [Select Set] on the right.
you selected.

7. Click [+].
This tells the program that you want to add the series or images together.
8. In the Save Series Box, type in the new series number.
Place your mouse in the area and type the new number.
You can also just click [New Save Series] and the number increases by one each
time.
Make sure you do this before you click the equal sign.
9. Click [=].
This performs the function.
The new series is located on the browser.

28-6
Quick Steps: Add Images Together to Create a New Image

1.
2.
3.
4.
5.
6.
7.
8.
9.
From the display monitor, click [Image Works].

On the right side of the browser, click [Add/Sub].
From the browser, select the image or images you want to use.
Select from the Image Combination menu, [Select Set] on the left.
Again, from the browser, select the image or images you want to use.
Click [Select Set] on the right.
Click [+].
In the Save Series Box, type in the new series number.
Click [=].

28-7

These steps assume you are using the browser in Image Works. This also assumes you are
using both Select Set buttons.
If only one set is selected, each operation performed produces ONE resulting image.
If two sets are selected, images in the two sets are paired according to physical location in
the patients body. Unpaired images in either set are ignored. Each operation performed
produces ONE resulting image PER PAIR.
The images resulting from each operation are generated in the exam defined by the left
Select Set button.

3. From the browser, select the image or images you want to use.
You can do this by clicking and dragging over a range of images for multiple images
or just clicking on one image for a single image.

28-8
you selected.
5. Again, from the browser, select the image or images you want to use.
you selected.

7. Click [-].
This tells the program you want to subtract the images.
8. Click [Accept Negative Pixels].
This function, when enabled, allows negative pixel values in the resulting image. If
this function is not enabled, all negative pixel values are set to zero.
time.

28-9
10. Click [=].
Quick Steps: Subtract Images to Create a New Image

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

From the browser, select the image or images you want to use.
Again, from the browser, select the image or images you want to use.
Click [-].
Click [Accept Negative Pixels].
Click [=].

28-10
Combine Images from Different Series to Create a New

Series
3. From the browser, select the series you want to use.

you selected.
5. Again, from the browser, select the second series you want to use.

28-11
you selected.

7. Click [Bind].
This tells the program you want to combine the series.
time.
9. Click [=].

28-12
Quick Steps: Combine Images from Different Series to Create a New

Series
1.
2.
3.
4.
5.
6.
7.
8.
9.

From the browser, select the series you want to use.
Again, from the browser, select the second series you want to use.
Click [Bind].
Click [=].

28-13
Use Existing Images to Create a New Image Using Only

the Maximum CT Number
3. From the browser, select the images you want to use.

28-14
you selected.

5. Click [Max].
This is an operation that consist of finding maximum image intensity pixel by pixel.
This could be useful for contrasted vessels or calcifications.
time.
7. Click [=].

28-15
Quick Steps: Use Existing Images to Create a New Image Using Only
the Maximum CT Number
1.
2.
3.
4.
5.
6.
7.

From the browser, select the images you want to use.
Click [Max].
Click [=].

28-16
Use Existing Images to Create a New Image Using Only

the Minimum CT Number
3. From the browser, select the images you want to use.

28-17
4. Click from the Image Combination menu, [Select Set] on the left.
you selected.

5. Click [Min].
This operation consists of finding minimum image intensity pixel by pixel.
This could be useful to evaluate soft tissue.
time.
7. Click [=].

28-18
Quick Steps: Use Existing Images to Create a New Image Using Only
the Minimum CT Number
1.
2.
3.
4.
5.
6.
7.

From the browser, select the images you want to use.
Click from the Image Combination menu, [Select Set] on the left.
Click [Min].
Click [=].

28-19

28-20
Magnifying Images
Chapter 29
Magnifying Images
Introduction
This chapter explains Magnifying Images. It contains the step-by-step instructions to help
you learn how to:
Move the Image Around on the Screen in Exam Rx
Make the Image Smaller or Larger Real Time in Exam Rx
Specify a Zoom Factor in Exam Rx
Auto Enlarge and Auto Minify
Move the Image Around the Screen in Image Works
Make the Image Smaller or Larger Real Time in Image Works
NOTE: Because the features Roam, Zoom and Mag Factor are located in Exam Rx and
Images works. This chapter details their use in each area separately beginning with
Exam Rx.

29-1
Magnifying Images

This section presents the concepts necessary to successfully change the image size in a
viewport using magnify. Some of the concepts you need to understand are:
Auto Enlarge
Auto Minify
Auto Enlarge
Auto Enlarge is always on and cannot be turned off. This allows the system to automatically
display an image acquired in a 256 matrix the same size as one acquired in a 512 matrix.
The reconned matrix size of an image specifies the number of pixels, which represent the
image. Images can be reconstructed in a 256 or 512 matrix, but the image can be displayed
in a variety of viewport sizes. When the image recon matrix size is different than the
viewport matrix size the image is automatically minified or enlarged to fit the image to the
viewport.
Auto Minify
Auto Minify is always on and cannot be turned off. This allows the system to automatically
size images being used in a multiple image display to fit in the selected format. Viewport
size determines the number of pixels utilized to display the image. The system has a variety
of viewport matrix sizes 1024, 768, 512, 256 and 128. If the viewport size differs from the
images recon matrix size the system automatically minifies the image to fit the viewport.

29-2
Magnifying Images
How Do I...
This section provides the step-by-step instructions for magnifying images in Exam Rx.
Specifically, it describes:

29-3
Magnifying Images

Your system has a feature which allows you to keep images centered in a viewport for
filming or viewing purposes. This means that if a patient has an anatomical variance i.e.
scoliosis, has moved slightly, or if offset values were incorrectly entered, you are able to
move the image within the viewport. Once an image is moved, all the images in the series is
displayed in the same adjusted position. You must set the right mouse key for this function
to work.
1. On the display monitor, click on the viewport where the image is located.
You see that viewport outlined in a blue border.
2. On the display monitor, click [Routine Display].

3. From the pop up window, click [Roam].
This changes the right mouse key function to Roam.

4. Click and drag on the image with the right mouse and place the image in the desired
location.
NOTE: If the Roam button is already highlighted in blue, the right mouse key is set for Roam
and you do not need to reselect it.
Quick Steps: Move the Image Around on the Screen in Exam Rx

1.
2.
3.
4.
On the display monitor, click on the viewport where the image is located.
On the display monitor, click [Routine Display].
From the pop up window, click [Roam].
Click and drag on the image with the right mouse and place the image in the desired
location.

29-4
Magnifying Images

Your system has a feature that allows you to fit your images in the viewport by making the
images larger or smaller as needed. Once you have made an image larger or smaller, all of
the images in the series are displayed in the same adjusted size. You must set the right
mouse key for this function to work.
1. On the display monitor, click on the viewport where the image is located.
You see that viewport outlined in a blue border.
2. On the display monitor, click [Routine Display].

3. From the pop up window, click [Zoom].
This changes the right mouse key function to Zoom.

4. Click and drag the right mouse in the image to set the desired size. The magnification
factor is annotated on each image in the upper right side with the initials MF (Mag
Factor) and the value from 0.5 up to 8.0.
NOTE: If the Zoom button is already highlighted in blue, the right mouse key is set for Zoom
and you do not need to reselect it. Once you have made the image larger or smaller,
you can click on Roam and re-center the image if needed.
Quick Steps: Make the Image Smaller or Larger Real Time in Exam Rx
1.
2.
3.
4.
On the display monitor, click on the viewport where the image is located.
On the display monitor, click [Routine Display].
From the pop up window, click [Zoom].
Click and drag the right mouse in the image to set the desired size. The magnification
factor is annotated on each image in the upper right side with the initials MF (Mag
Factor) and the value from 0.5 up to 8.0.

29-5
Magnifying Images

Any image can be magnified after it has been reconstructed. In addition to using the Zoom
button, you can enter a specific magnification value to be applied to your image(s). Once a
magnification has been applied, all of the images in the series retains that magnification.
1. On the display monitor, click in the viewport with the image to be magnified.
You see that viewport outlined with a blue border.
2. From the display monitor, click [Routine Display].

3. From the pop up window, click [Explicit Magnify].
A pop up window appears with preset magnification factors and an area where a
factor can be entered.
4. From the pop up window, select or enter the desired magnification factor.
The system displays magnification factors of 0.5, 1.0, 1.5, and 2.0. There is also a
space where any value within the range of 0.5 up to 8.0 may be entered in 0.1
increments. The image is annotated in the upper right corner with MF (Mag Factor)
and the value used, i.e., MF1.5.
Quick Steps: Specify a Zoom Factor in Exam Rx

1.
2.
3.
4.
On the display monitor, click in the viewport with the image to be magnified.
From the display monitor, click [Routine Display].
From the pop up window, click [Explicit Magnify].
From the pop up window, select or enter the desired magnification factor.

29-6
Magnifying Images

The Auto Enlarge and Auto Minify features are always on and cannot be turned off. You can
see the Auto Enlarge and Auto Minify buttons to verify their active status.
1. On the display monitor, click [Display Preferences].
A pop up window appears with the Auto Enlarge and Auto Minify buttons highlighted
in blue.
NOTE: The functionality (On/Off) of these buttons is not implemented on the system. The
functions of Auto Enlarge and Auto Minify are implemented in the system. refer to the
What Do I Need to Know About... section of this chapter.
Quick Steps: Auto Enlarge and Auto Minify

1. On the display monitor, click [Display Preferences].

29-7
Magnifying Images
How Do I...
This section provides the step-by-step instructions for magnifying images in Image Works.
Specifically, it describes:
Make the Image Smaller or Larger Real Time in Image Works

29-8
Magnifying Images

Your system has a feature which allows you to keep images centered in a viewport for
filming or viewing purposes. This means that if a patient has an anatomical variance i.e.
scoliosis, has moved slightly, or if offset values were incorrectly entered, you are able to
move the image within the viewport. Once an image is moved, all the following images are
displayed in the same adjusted position. You must set the right mouse key for this function
to work.
1. On the display monitor, click [Image Works].
This opens the browser menu unless the Viewer or Mini Viewer has been used
previously and not closed. If the Viewer or Mini Viewer is open, skip to step 3.
2. Next to the Browser Menu, click [Viewer] or [Mini Viewer].
The Viewer or Mini Viewer opens. There is a tools area along the left hand side of the
screen.
3. From the tools, select the button with the moving hand symbol.
This changes the right mouse key function to Roam.

4. Click and drag the right mouse in the image and place it in the desired location.
NOTE: If the button is already depressed, the right mouse key is already set for Roam and
you do not need to reselect it.
Quick Steps: Move the Image Around the Screen in Image Works
1.
2.
3.
4.
On the display monitor, click [Image Works].

Next to the Browser Menu, click [Viewer] or [Mini Viewer].
From the tools, select the button with the moving hand symbol.
Click and drag the right mouse in the image and place it in the desired location.

29-9
Magnifying Images
Make the Image Smaller or Larger Real Time in Image

Works
Your system has a feature which allows you to fit your images in the viewport by making the
images larger or smaller as needed. Once you have made an image larger or smaller, all of
the following images are displayed in the same adjusted size.
1. On the display monitor, click [Image Works].
This opens the browser menu unless the Viewer or Mini Viewer has been used
previously and not closed. If the Viewer or Mini Viewer is open skip to step 3.
2. Next to the Browser Menu, click [Viewer] or [Mini Viewer].
The Viewer or Mini Viewer opens. There is a tools area along the left hand side of the
screen.
3. Click in the viewport with the image to be magnified.
You see the viewport highlighted in blue.
4. Choose from three options for magnification of images. Enter value, click and drag the
slide bar, or click on the arrowheads on either side of the bar.
The range for magnification is 0.5 up to 8.0 in 0.1 increments. The image is annotated
in the upper right corner with MF (Mag Factor) and the value used i.e. MF1.5.
Quick Steps: Make the Image Smaller or Larger Real Time in Image
Works
1.
2.
3.
4.
On the display monitor, click [Image Works].

Next to the Browser Menu, click [Viewer] or [Mini Viewer].
Click in the viewport with the image to be magnified.
Choose from three options for magnification of images. Enter value, click and drag the
slide bar, or click on the arrowheads on either side of the bar.

29-10
Measuring Structures Within an Image
Chapter 30
Measuring Structures Within an

Image
Introduction
This chapter explains how to measure structures within an image. It contains the
In Exam Rx:
Get Density Readings
Measure From Point to Point
Overlay a Grid
Report the Cursor Location and the Pixel Value
Measure Density Readings on Multiple Images
In Image Works:
Overlay a Grid
Extended CT Number Range

Enable Extended CT Number Range
Disable Extended CT Number Range
NOTE: Most of the features listed here are available for use in the Exam Rx and the Image
works desktops. Because of this, the chapter is divided into two parts. The first part
lists how to perform all applicable functions from the Exam Rx desktop. The second
part lists how to perform all applicable functions from the Image Works desktop.

30-1

This section presents concepts necessary to understand ways to manipulate images. Some
of the concepts you need to understand:
ROI
Expanded CT Number Range
MIROI
ROI
ROI stands for Region of Interest. It is a measuring tool that allows you to measure
Hounsfield units (HU) and report a mean and standard deviation. This measurement is an
average of all pixels in the defined area. The area (size) of the ROI is also reported. The size of
the ROI can be adjusted, as well as the location.
The images has a minimum CT number of -1024 HU and a maximum CT number of +3071
HU.
Expanded CT Number Range

The expanded range could allow, for example, a physician to choose a window level to
better image/view the structures near metal implants of post surgical patients. A more
accurate rendering of the CT number value may improve dose calculations in area where
metal is present for radiation treatment planning.
The maximum pixel values for Extended CT Number Range is +/- 31,743.
NOTE: This feature can be enabled or disabled. For information on how to do this refer to:
Enable Extended CT Number Range or Disable Extended CT Number Range.
MIROI
MIROI stands for Multiple Image Region of Interest. It is a tool that allows you to graphically
represent density changes in a single area over time. This tool is useful for graphing a
change in contrast enhancement over time through a designated area.
MIROI requires multiple images from a single series with the same location, gantry tilt, pixel
size, and DFOV center. Once these scans are taken, the MIROI feature can be used.

30-2
How Do I...
This section provides the step-by-step instructions for measuring structures within an image
in Exam RX desktop. Specifically, it describes how to:
Overlay a Grid
NOTE: Some of these features are also available from the Accelerator Line Commands.

30-3

Use this feature to get a CT number reading. The reading, along with an area measurement,
reports out on the bottom right corner of the image.
Once the ROI is selected, it is applied to the image in primary focus.
Any number of measurements can be made and displayed on the image, but only the last
three results are displayed on the screen in the lower right corner. If you wish to see
information for all measurements, display the Text Page ROI by typing TPR on the
Accelerator Line.
2. Click [Measurements].
3. Click [Box ROI], [Ellipse ROI], or [Trace ROI].
The selected ROI appears on the primary image.

Box ROI is a square, Ellipse ROI is a circular shape, and Trace ROI allows you to trace
the exact shape you want.
The ROI that appears is blue, meaning that it is active. If another ROI is selected, the
cursor that appears is active and the first cursor turns white. Selecting the white
cursor makes it active again.
4. For Box ROI or Ellipse ROI, skip to Step 5. For Trace ROI, move the solid blue box to the
point you would like to start the trace. Press and hold Shift and then click and drag with
the left mouse key to define the area for the trace.
5. To change the size of the ROI, click and drag on the small box in the upper right corner of
the ROI. You may also click in the center of the ROI and drag it to a different location.
The mean, standard deviation and area of the ROI is reported in the lower right
corner of the image.

30-4

6. Click [Erase] to erase the active (blue) ROI.
If there is more than one ROI on the image, continue selecting Erase.
NOTE: Ellipse ROI may also be selected from Routine Display.
Quick Steps: Get Density Readings

1.
2.
3.
4.

Click [Measurements].
Click [Box ROI], [Ellipse ROI], or [Trace ROI].
For Box ROI or Ellipse ROI, skip to Step 5. For Trace ROI, move the solid blue box to the
point you would like to start the trace. Press and hold Shift and then click and drag
with the left mouse key to define the area for the trace.
5. To change the size of the ROI, click and drag on the small box in the upper right corner
of the ROI. You may also click in the center of the ROI and drag it to a different location.
6. Click [Erase] to erase the active (blue) ROI.

30-5

Measure Distance calculates the linear distance between two points on an image. It is used
to measure any anatomy or pathology on an image, and it also lists the angle of the line
from vertical.
three results is displayed on the screen in the lower right corner. If you wish to see
Accelerator Line.
2. Click [Routine Display] or [Measurements].
Measure Distance can be selected from either Routine Display or Measurements.

3. Click [Measure Distance].
A blue line with two small boxes on each end appears on the image in primary focus.
The line is blue, meaning that it is active. If Measure Distance is selected again, the
line that appears is active and the first line turns white. Selecting the white line
makes it active again.
4. Click and drag with the left mouse key on either of the small boxes and move them to
the desired start and end points.
Once the start and end points are set, there is a real time readout of the distance and
angle in the lower right corner of the image.

30-6

5. Click [Erase] to erase the active (blue) Measure Distance line.
If more than one line is on the image, continue selecting erase.
Quick Steps: Measure From Point to Point

1.
2.
3.
4.

Click [Routine Display] or [Measurements].
Click [Measure Distance].
Click and drag with the left mouse key on either of the small boxes and move them to
5. Click [Erase] to erase the active (blue) Measure Distance line.

30-7
Overlay a Grid
When the Grid function is selected, a grid is displayed. It can be used to measure anatomy or
pathology on an image. it can also be used to check the patients relationship to isocenter
which is useful for BMD studies. The grid measurements are in centimeters and the size of
the grid changes with the display field of view.
2. Click [Routine Display] or [Measurements].
3. Click [Grid On/Off].
A grid appears on the primary image.

4. To move the grid, click and drag from the center point.
5. To remove the grid, click [Grid On/Off] again or [Erase].
Quick Steps: Overlay a Grid

1.
2.
3.
4.
5.

Click [Routine Display] or [Measurements].
Click [Grid On/Off].
To move the grid, click and drag from the center point.
To remove the grid, click [Grid On/Off] again or [Erase].

30-8

When Continuous Report Cursor is turned on, your mouse crosshair cursor continuously
reports specific values from the image in real time. It reports the Right/Left and
Anterior/Posterior locations of the cursor as well as the Superior/Inferior location and the
Value (Hounsfield Unit) of the one exact pixel underneath the cursor.
3. Click [Continuous Report Cursor].
As the mouse cursor is moved around the image, the values for that cursor is
reported on the image.
You see an R or L for the Right/Left location, an A or P for the Anterior/Posterior
location, an S or I for the Superior/Inferior location, and a V for the value of the
Hounsfield Unit at the cursor location.
S-I is reported differently for tilted and non-tilted images.
Non-tilted images report S-I at isocenter, which is the same location reported on the
image.
For tilted images, S-I is reported as the center of the image which changes based on
where the cursor is located on the image. S-I only is equal to the image annotation if
the cursor is at isocenter.
This cannot be filmed.
4. To turn off, click [Continuous Report Cursor] a second time.

30-9
Quick Steps: Report the Cursor Location and the Pixel Value
1.
2.
3.
4.

Click [Continuous Report Cursor].
To turn off, click [Continuous Report Cursor] a second time.

30-10

MIROI stands for Multiple Image Region of Interest. It is a tool that allows you to graphically
represent density changes in a single area over time. This tool is useful for graphing a
change in contrast enhancement over time through a designated area.
MIROI requires multiple images from a single series with the same location, gantry tilt, pixel
size, and DFOV center. Once these scans are taken, the MIROI feature can be used.
1. Perform the test scans at one location with a small bolus of contrast.
20cc of contrast is an average dose. Also use a mini- prep delay of 5-10 seconds.
2. Click [Measurements].
3. Click [MIROI].
4. For "Image Range" click [All], or type in the range of images desired for monitoring.

30-11

5. For "Scale for HU", click [Absolute] or [Relative].
Selecting Absolute gives you an actual Hounsfield Unit # for each ROI plotted on the
graph.
For Relative, the ROI measured for the first image is set to zero and then the change
from zero is plotted for the rest of the images.
6. For "Define Region," select the type of ROI you would like to use (box, ellipse or trace).
Place the selected ROI over region of interest on image.
7. Click [OK].
A graph appears and shows a peak where the maximum contrast enhancement took
place.
8. To determine the prep delay needed for the actual exam, look at the peak on the graph.
You need to count the number of images it took get to that peak, the inter-scan delay
between each image, and the mini-prep delay used. Add those three things together to
determine the actual prep delay needed to produce images with maximum
enhancement.
9. Now set up images for the exam as needed, using the prep delay from the MIROI test.
The injection rate used for the exam should be the same as the one used for the
small test bolus.

30-12
Quick Steps: Measure Density Readings on Multiple Images

1.
2.
3.
4.
5.
6.
Perform the test scans at one location with a small bolus of contrast.
Click [Measurements].
Click [MIROI].
For "Image Range" click [All], or type in the range of images desired for monitoring.
For "Scale for HU", click [Absolute] or [Relative].
For "Define Region," select the type of ROI you would like to use (box, ellipse or trace).
Place the selected ROI over region of interest on image.
7. Click [OK].
8. To determine the prep delay needed for the actual exam, look at the peak on the
graph. You need to count the number of images it took get to that peak, the inter-scan
delay between each image, and the mini-prep delay used. Add those three things
together to determine the actual prep delay needed to produce images with
maximum enhancement.
9. Now set up images for the exam as needed, using the prep delay from the MIROI test.

30-13
How Do I...
This section provides the step-by-step instructions for measuring structures within an image
in the Image Works desktop. Specifically, it describes how to:
Overlay a Grid
NOTE: Some of these features are also available from the Accelerator Line Commands.
NOTE: These features can be accessed from either the Viewer or Mini Viewer in the Image
Works desktop.

30-14

Use this feature to get a CT number reading. The reading, along with an area measurement,
reports out on the bottom right corner of the image.
Once the ROI is selected, it is applied to the image in primary focus.
Accelerator Line.
2. Click [Measure].
3. Click [Box ROI] which is the square, [Ellipse ROI] which is the circle, or [Trace ROI] which
is either one of the half circles.
The selected ROI appears on the primary image.
Box ROI is a square, Ellipse ROI is a circular shape, and Trace ROI allows you to trace
the exact shape you want.
The ROI that appears is blue, meaning that it is active. If another ROI is selected, the
cursor that appears is active and the first cursor turns white. Selecting the white
cursor makes it active again.
point you would like to start the trace. Press and hold Shift and then click and drag with
the left mouse key to define the area for the trace.

30-15

5. To change the size of the ROI, click and drag on the small box in the upper right corner of
the ROI. You may also click in the center of the ROI and drag it to a different location.
The mean, standard deviation and area of the ROI is reported in the lower right
corner of the image.
6. Click [Erase All] to erase all annotation.
Quick Steps: Get Density Readings

2. Click [Measure].
3. Click [Box ROI] which is the square, [Ellipse ROI] which is the circle, or [Trace ROI] which
is either one of the half circles.
point you would like to start the trace. Press and hold Shift and then click and drag
with the left mouse key to define the area for the trace.
5. To change the size of the ROI, click and drag on the small box in the upper right corner
of the ROI. You may also click in the center of the ROI and drag it to a different location.

30-16

Measure Distance calculates the linear distance between two points on an image. It is used
to measure any anatomy or pathology on an image, and it also lists the angle of the line
from vertical.
Accelerator Line.
2. Click [Measure].
3. Select the line with the boxes on either end.

A blue line with two small boxes on each end appears on the image in primary focus.
The line is blue, meaning that it is active. If Measure is selected again, the line that
appears is active and the first line turns white. Selecting the white line makes it active
again.
4. Click and drag with the left mouse key on either of the small boxes and move them to
Once the start and end points are set, there is a real time readout of the distance and
angle in the lower right corner of the image.
The system displays up to three measurement results at a time.

30-17

Quick Steps: Measure From Point to Point

1.
2.
3.
4.

Click [Measure].
Select the line with the boxes on either end.
Click and drag with the left mouse key on either of the small boxes and move them to

30-18
Overlay a Grid
When the Grid function is selected, a grid is displayed. It can be used to measure anatomy or
pathology on an image. It can also be used to check the patients relationship to isocenter,
which is useful for BMD studies. The grid measurements are in centimeters and the size of
the grid changes with the display field of view.
2. Click
(Grid).
A grid appears on the primary image.

3. To move the grid, click and drag from the center point.
4. To remove the grid, click
(Grid) again.
Quick Steps: Overlay a Grid

1.
2.
3.
4.

Click (Grid).
To move the grid, click and drag from the center point.
To remove the grid, click (Grid) again.

30-19
Enable Extended CT Number Range

Use this feature to turn the expanded CT number range on.
NOTE: Extended CT Number Range should not be used for CT Perfusion studies unless your
version is CT Perfusion is 2.6.6.
NOTE: Extended CT number range should not be used for BMD studies.
1. From the Image Works desktop, click [Turn On Extend HU] located on the Tool Chest.
2. Click [OK] on the Attention pop-up window.
NOTE: The system will automatically shutdown and restart after you click [OK].
Quick Steps: Enable Extended CT Number Range

1. From the Image Works desktop, click [Turn On Extend HU] located on the Tool Chest.

30-20
Disable Extended CT Number Range

Use this feature to turn the expanded CT number range off.
1. From the Image Works desktop, click [Turn Off Extend HU] located on the Tool Chest.
NOTE: The system will automatically shutdown and restart after you click [OK].
Quick Steps: Disable Extended CT Number Range

1. From the Image Works desktop, click [Turn Off Extend HU] located on the Tool Chest.

30-21


30-22
Graphics, Text Pages and Commands
Chapter 31
Graphics, Text Pages and

Commands
Introduction
This chapter explains how to perform some basic tasks using graphics, text pages and other
commands. It contains the step-by-step instructions to help you learn how to:
Annotate the Scout With Scan Lines
Type Text on the Image
Display the Exam Information
Display the Parameters of a Scan Mode
Hide or Show Graphics
Remove Graphics From the Image
Save an Image Screen
Type in Specific Accelerator Line Commands
NOTE: Most of the features listed here are available for use in the Exam Rx and the Image
Works desktops. Because of this, the chapter is divided into two parts. The first part
lists how to perform all applicable functions from the Exam Rx desktop. The second
part lists how to perform all applicable functions from the Image Works desktop.

31-1

This section presents some of the concepts necessary to understand ways to use graphics,
text pages and commands. Some of the concepts you need to understand are:
Cross-referencing
Screen Save
Accelerator Line
User Preferences
Cross-referencing
Cross-referencing is a feature which is used to correlate scanned locations on the scout.
You may select a scoutview and then choose to display lines on it which represent
previously scanned locations. This is useful to see which anatomy was covered in a
particular exam.
Screen Save
Screen Save is an electronic photograph of an image. Screen Save saves everything that is
on the image in primary focus. This includes any zoom, cursors, measurements, flip, or
annotation. You can use Screen Save to save images when anatomy or pathology has been
measured. The screen saved images are listed on the patient list browser as series number
99, and called SSave for the series type. When a screen saved image is displayed, the
window width and window level can be changed, but information cannot be removed.
Accelerator Line
The Accelerator Line, also known as the Command Line, allows commands to be typed
which can perform certain display functions. Typing these commands can act as a shortcut
to opening additional menus to access a function.
User Preferences
User Preferences is available for use in the Image Works desktop only. It allows you to
choose customized settings for annotation, tick marks, grid, right mouse button use, series
binding, square viewports and window/level presets. You may choose to apply your
selection for the present exam only, or you may choose to save your selection as a default.

31-2
How Do I...
This section provides the step-by-step instructions for using graphics, text pages and
commands in the Exam RX desktop. Specifically, it describes how to:
NOTE: These features can also be accessed from the accelerator line. For more information,
refer to: Accelerator Line Commands.

31-3

Cross-referencing is a feature which is used to correlate scanned locations on the scout.
You may select a scoutview and then choose to display lines on it which represent
previously scanned locations. This is useful to see which anatomy was covered in a
particular exam.
1. Put the scoutview image of interest in primary focus.
3. Click [Cross Reference].
A pop up window appears which is titled Post Reference Lines.
4. On the pop up window, select which series to post on the scout by typing in the series
number.

31-4

5. Select which images to post.
Type in a range (i.e. 1-10). To use a range, you must deselect [All] and [First/Last].
Click [All] for all images in a series.
Click [First/Last] for the first and last images in a series.
6. Next, type in the increment of the lines to be displayed if you selected a range of images
or [All] above.
Typing in 1 displays every line, 2 displays every other line, 3 displays every third line,
and so on.
Leaving the increment blank defaults to every line.
7. When all the fields are completed, click [OK] or [Cancel].
8. To erase the cross reference lines, click [Erase].
Quick Steps: Annotate the Scout With Scan Lines

1.
2.
3.
4.
5.
6.
7.
8.
Put the scoutview image of interest in primary focus.

Click [Cross Reference].
On the pop up window, select which series to post on the scout by typing in the series
number.
Select which images to post.
Next, type in the increment of the lines to be displayed if you selected a range of
images or [All] above.
When all the fields are completed, click [OK] or [Cancel].
To erase the cross reference lines, click [Erase].

31-5

The User Annotation feature allows you to type annotation on an image. This is useful for
typing things such as contrast type, needle gauge and injection rate.
1. Put the image that you want to type annotation on into primary focus.
3. Click [User Annotation].
A blue box with an arrow attached to it appears on the primary image.

4. Place mouse cursor over the image you are typing text onto.
5. Type the desired text and it appears in the blue box.
The box expands to fit text.
Pressing Enter allows an additional line for text.
6.
Adjust the box and attached arrow as needed.

You may click on the blue box and drag it to a different location. You may also click
on the arrow head and drag it to point to a specific structure, or you can drag it into
the box to make it disappear.
7. Click [User Annotation] again to add additional annotation.

8. Click [Erase] to erase the primary (blue) annotation.

31-6
Quick Steps: Type Text on the Image

1.
2.
3.
4.
5.
6.
7.
8.
Put the image that you want to type annotation on into primary focus.
Click [User Annotation].
Place mouse cursor over the image you are typing text onto.
Type the desired text and it appears in the blue box.
Adjust the box and attached arrow as needed.
Click [User Annotation] again to add additional annotation.
Click [Erase] to erase the primary (blue) annotation.

31-7

This feature is used to bring up a text page with exam information on it. This text page can
be filmed.
2. Click [Exam Page].
A text page box appears.
3. Click [Manual Film] or [Auto Film] to select the film composer you would like the exam
page to go to.

31-8

4. Click [Quit].
Quick Steps: Display the Exam Information

3. Click [Manual Film] or [Auto Film] to select the film composer you would like the exam
page to go to.
4. Click [Quit].

31-9

This feature brings up a text page with series information. This can be filmed.
2. Click [Series Page].
A text page box appears.
If there is more than one page, click the Up or Down arrows to display the next page.
3. Click [Manual Film] or [Auto Film] to select the film composer you would like the series
page to go to.

31-10

4. Click [Quit].
Quick Steps: Display the Parameters of a Scan Mode

3. Click [Manual Film] or [Auto Film] to select the film composer you would like the series
page to go to.
4. Click [Quit].

31-11

This feature allows you to temporarily hide graphics without erasing them. This applies to
graphics that you put on the image yourself, such as ROIs, user annotation, etc.
1. With added graphics on the image, click [Routine Display].
2. Click [Hide Graphics].
The added graphics are temporarily hidden.

When this button is selected, it toggles to become [Show Graphics].
3. Click [Show Graphics] to show the hidden graphics.
NOTE: Hide/Show Graphics can also be found under [Measurements].
Quick Steps: Hide or Show Graphics

1. With added graphics on the image, click [Routine Display].
2. Click [Hide Graphics].
3. Click [Show Graphics] to show the hidden graphics.

31-12

This feature allows you to selectively erase annotations or graphics. When annotation is
initially selected it is active (blue). When a second annotation is selected, the newly selected
annotation is active and the first one becomes inactive (white).
2. Click [Erase].
This erases only the active (blue) annotation.

Keep selecting this button to erase all added annotation.
NOTE: Erase can also be found under [Measurements].
Quick Steps: Remove Graphics From the Image

2. Click [Erase].

31-13

Turning
Graphics On
and Off (Hide)
2. Click [Screen Save].
NOTE: Screen Save can also be found under [Measurements].
Quick Steps: Save an Image Screen


31-14

to open additional menus to access a function. When a command is typed, it is applied to all
of the viewports in focus.
1. To see a list of applicable commands, refer to Appendix A or type ? on the Command
Line and click Enter.
When a ? is typed on the Command Line, the Help Command Line menu is displayed
listing available commands.
2. Once you have decided on a command, type the command on the Accelerator Line and
press Enter.
Quick Steps: Type in Specific Accelerator Line Commands

2. Once you have decided on a command, type the command on the Accelerator Line
and press Enter.

31-15
How Do I...
commands in the Image Works desktop. Specifically, it describes how to:
Type in Specific Accelerator Command Lines
NOTE: These features can also be accessed from the accelerator line. For more information,
refer to: Accelerator Line Commands.
NOTE: All of these features can be accessed from the Viewer in the Image Works desktop.

31-16

The User Annotation feature allows you to type annotation on an image. This is useful for
typing things such as contrast type, needle gauge and injection rate. This feature can also
be accessed from the Mini-Viewer.
1. Put the image that you want to type annotation on into primary focus.
2. Click
(Annotation).
A blue box with an arrow attached to it appears on the primary image.

3. Place the mouse cursor over the active viewport.
4. Type the desired text and it appears in the blue box.
5. Once the text is typed, you may click on the blue box and drag it to a different location.
You may also click on the arrow head and drag it to point to a specific structure, or you
can drag it into the box to make it disappear.
6. Click
(Annotation) again to add additional annotation.
7. Click
(Erase Annotation) to erase the primary (blue) annotation.
Quick Steps: Type Text on the Image

1.
2.
3.
4.
5.
Put the image that you want to type annotation on into primary focus.
Click (Annotation).
Place the mouse cursor over the active viewport.
Type the desired text and it appears in the blue box.
Once the text is typed, you may click on the blue box and drag it to a different location.
You may also click on the arrow head and drag it to point to a specific structure, or you
can drag it into the box to make it disappear.
6. Click (Annotation) again to add additional annotation.
7. Click (Erase Annotation) to erase the primary (blue) annotation.

31-17

This feature brings up a text page with exam information on it. This can be filmed and/or
saved. This page can also be accessed from the Mini-Viewer.
1. Click [Text Page].
A pull down window appears.

The exam page appears on the screen.

31-18

3. Click [Manual Film] or [Screen Save].
Click [Manual Film] to place exam page on the manual film composer.
Click [Screen Save] to save this as a image so you can network and/or archive this
information.
4. Click [Quit]
This closes the window.
Quick Steps: Display the Exam Information

1.
2.
3.
4.
Click [Text Page].

Click [Exam Page].
Click [Manual Film] or [Screen Save].
Click [Quit]

31-19

This feature brings up a text page with series information. This can be filmed. This page can
also be accessed from the Mini-Viewer.
A pull down window appears.

The series page appears on the screen.
3. Click [Manual Film] to place series page on the manual film composer, or click [Quit].

31-20
Quick Steps: Display the Parameters of a Scan Mode

3. Click [Manual Film] to place series page on the manual film composer, or click [Quit].

31-21

This feature allows you to temporarily hide graphics without erasing them. This applies to
graphics that you put on the image yourself, such as ROIs, user annotation, etc. This can also
be accessed from the Mini-Viewer.
1. With added graphics on the image, click [Hide].
The added graphics are temporarily hidden.

When this button is selected, it toggles to become [Show].
2. Click [Show] to show the hidden graphics.
Quick Steps: Hide or Show Graphics

1. With added graphics on the image, click [Hide].
2. Click [Show] to show the hidden graphics.

31-22

This feature allows you to selectively erase annotations or graphics. When annotation is
initially selected it is active (blue). When a second annotation is selected, the newly selected
annotation is active and the first one becomes inactive (white). To activate the inactive
(white) annotation, just click on it. the Erase All feature can also be accessed from the
Mini-Viewer.
1. Click [Erase All].
This erases all annotation.
Quick Steps: Remove Graphics From the Image

1. Click [Erase All].

31-23

Quick Steps: Save an Image Screen


31-24
Type in Specific Accelerator Command Lines

to open additional menus to access a function. When a command is typed, it is applied to all
of the viewports in focus. The Accelerator Line can also be accessed from the Mini-Viewer.
When a ? is typed on the Command Line, the Help Command Line menu is displayed
listing available commands.
2. Once you have decided on a command, type the command on the Accelerator Line or
click the command from the Help Command Line menu.
Quick Steps: Type in Specific Accelerator Command Lines

2. Once you have decided on a command, type the command on the Accelerator Line or
click the command from the Help Command Line menu.

31-25
How Do I Edit Default Settings in the

Image Works Desktop
commands in the Image Works desktop. Specifically, it describes how to: edit the default
setting for all the graphics on the image.
Edit Default Settings for Annotation
Edit Default Settings for Grid Preferences
Edit Default Settings for W/L Presets
Edit Default Settings for Right Mouse Button
Edit Default Settings for Tick Marks
Edit Default Settings for Series Binding
Edit Default Settings for Square Viewports

31-26
Edit Default Settings for Annotation

The Annotation Level feature allows you to decide which annotation are included on your
image. There are 4 levels of annotation to choose from. This can be set separately for the
screen and for the film.
1. Click [User Prefs].
2. Click [No Annotation].

This takes ALL annotation off of the image.
3. Or click [Partial Annotation].
Selecting this displays ONLY patient name, exam date, exam/series/image numbers,
center coordinates, and window/level.

31-27

4. Or click [Custom Annotation].
Use this to customize which annotation to take off the image.
5. When you select custom, you must also click [Customize...].
A list appears with all available annotation groups.
6. Select which specific information you would like.
A bright blue box indicates that the information is included on the image.

31-28

7. Click [Customize Large Font] if you wish to change the font size.
For Patient ID greater than 41 characters with Customize Large Font selected, no
Patient ID will be displayed on the screen.
For Patient Name greater than 46 characters with Customize Large Font selected,
no Patient Name will be displayed on the screen.
8. Select the desired selections.

9. When done with your selection, click [OK].
10. On the main User Prefs screen, click [Apply] or [Save as defaults].
Selecting Apply applies selected annotation to the current exam. Selecting Save as
defaults sets the selected annotation as a default in this desktop and in Exam Rx as
well.
Quick Steps: Edit Default Settings for Annotation

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Click [User Prefs].

Click [No Annotation].
Or click [Partial Annotation].
Or click [Custom Annotation].
When you select custom, you must also click [Customize...].
Select which specific information you would like.
Click [Customize Large Font] if you wish to change the font size.
Select the desired selections.
When done with your selection, click [OK].
On the main User Prefs screen, click [Apply] or [Save as defaults].

31-29
Edit Default Settings for Grid Preferences

Use this feature to customize the size and spacing of a grid.

31-30

2. Under Grid Prefs, click [Customize....].
A pop up window, called Grid Preferences appears.
3. For Matrix Lines, click [ON] or [OFF].

ON shows the matrix lines throughout the grid. OFF shows just the two center rulers
of the grid.
4. For Line Style, click [Dotted] or [Solid].
5. Type in the numeric value for grid spacing (in mm).
6. Type in the numeric value for tick spacing (in mm).
This is the space between each tick mark.
7. Type in the numeric value for tick length (in mm).
This is the length of each tick mark.
8. Click [OK] to make changes, or [Cancel] to cancel.
9. On the main User Prefs screen, click [Apply] or [Save as defaults].
Selecting Apply applies grid preferences to the current exam. Selecting Save as
defaults sets the grid preferences as a default in this desktop and in the Exam Rx
desktop as well.

31-31
Quick Steps: Edit Default Settings for Grid Preferences

1.
2.
3.
4.
5.
6.
7.
8.
9.
Click [User Prefs].

Under Grid Prefs, click [Customize....].
For Matrix Lines, click [ON] or [OFF].
For Line Style, click [Dotted] or [Solid].
Type in the numeric value for grid spacing (in mm).
Type in the numeric value for tick spacing (in mm).
Type in the numeric value for tick length (in mm).
Click [OK] to make changes, or [Cancel] to cancel.
On the main User Prefs screen, click [Apply] or [Save as defaults].

31-32
Edit Default Settings for W/L Presets

Preset W/L settings can be selected for CT and MR images. These presets can be used from
the Viewer or Mini-Viewer.

31-33

2. Click either [CT] or [MR].
The modality selection is a toggle switch. If the modality you would like is not
showing, just select the modality that is there and it switches.
3. To change the title of a preset, type in the space for that title and type new title.
4. To change a value for w/width or w/level, type in the new value(s).
5. Click [Set current] to change the settings you just selected.
6. Click [Save as defaults].
Selecting Save as defaults sets the selected W/L settings as a default in this desktop
and in Exam Rx as well.
NOTE: To Save Window Level presets for the Function Keys, refer to: Set Window Width and
Window Level Preset Keys
Quick Steps: Edit Default Settings for W/L Presets

1.
2.
3.
4.
5.
6.
Click [User Prefs].

Click either [CT] or [MR].
To change the title of a preset, type in the space for that title and type new title.
To change a value for w/width or w/level, type in the new value(s).
Click [Set current] to change the settings you just selected.
Click [Save as defaults].

31-34
Edit Default Settings for Right Mouse Button

Use the Right Mouse Button feature to change the functionality of the right mouse button.
2. Click [Scrolling] to set the right mouse button to scroll.

31-35

3. Click [Magnify glass] to set the right mouse button to give you a magnified area at a set
factor when that button is pressed.
4. Click [Apply] or [Save as defaults].
Selecting Apply applies your choice for the current exam. Selecting Save as defaults
sets your choice as a default in this desktop and in Exam Rx as well.
Quick Steps: Edit Default Settings for Right Mouse Button

2. Click [Scrolling] to set the right mouse button to scroll.
3. Click [Magnify glass] to set the right mouse button to give you a magnified area at a
set factor when that button is pressed.

31-36
Edit Default Settings for Tick Marks

Use this feature to show or hide both horizontal and vertical tick marks on an image.
Editing
Default
Settings in the
Image Works
Desktop (User
Preferences)
for Tick Marks
2. Click Vertical to show the side tick marks.

31-37

3. Click Horizontal to show the bottom tick marks.
4. Deselect Vertical and/or Horizontal to hide the tick marks.
NOTE: Another way to set individual tick marks is to use the Accelerator Line and type TMV
ON or TMV OFF to turn the vertical tick mark ONLY on or off, or type TMH ON or TMH
OFF to turn the horizontal tick mark ONLY on or off.
Quick Steps: Edit Default Settings for Tick Marks

1.
2.
3.
4.
5.
Click [User Prefs].

Click Vertical to show the side tick marks.
Click Horizontal to show the bottom tick marks.
Deselect Vertical and/or Horizontal to hide the tick marks.
Click [Apply] or [Save as defaults].

31-38
Edit Default Settings for Series Binding

Use Series binding to customize the way you page through images in an exam.
2. Click [Series binding ON] to page through ALL series in an exam.

31-39

3. Click [Series binding OFF] to page through ONLY the current series in an exam.
Quick Steps: Edit Default Settings for Series Binding

1.
2.
3.
4.
Click [User Prefs].

Click [Series binding ON] to page through ALL series in an exam.
Click [Series binding OFF] to page through ONLY the current series in an exam.

31-40
Edit Default Settings for Square Viewports

Square viewports is used to visualize a magnified image on film. With this feature turned on,
what you see in the viewport is what you get when the image is filmed.

31-41

2. Click [Square viewports ON] to see the entire magnified image on film.
With this feature turned on, what you see in the viewport is what you get when the
image is filmed.
3. Click [Square viewports OFF] and the magnified image is only be partially seen on film.
With this feature turned off, the image does not film as you see it in the viewport.
Quick Steps: Edit Default Settings for Square Viewports

1.
2.
3.
4.
Click [User Prefs].

Click [Square viewports ON] to see the entire magnified image on film.
Click [Square viewports OFF] and the magnified image is only be partially seen on film.

31-42
Managing Scan (Raw) Data
Chapter 32

Introduction
This chapter explains how to manage your scan data. It contains the step-by-step
Create New Images From Scan Data
Look for Images that are not Reconstructed
Pause Images From Reconstructing
Resume Image Reconstruction
Remove Images From the Reconstruction List
Update the Reconstruction List
Save/Restore Scan Data to/from a Disk
Complete an Anonymous Scan Data Save
Reserve/Release Scan Data

32-1

This section presents the concepts necessary to manage scan data. Some of the concepts
you need to understand are:
Scan (Raw) Data
Suspended Entries
Saving Scan Data
Restoring Scan Data
Reserving Scan Data
Releasing Scan Data
WorkArounds
Scan (Raw) Data

With each rotation of the gantry, x-rays are emitted that pass through a portion of anatomy
and strike the detectors. The signal from the detector is converted by the DAS to an analog
signal that is then part of the scan file. This information is known as the scan or raw data. It
contains all of the information gathered during an exposure.
Suspended Entries
Sometimes the system for a variety of reasons may not be able to complete the
reconstruction of a particular image. This data is then automatically placed in a queue,
where you can attempt to reconstruct it again or delete it.
Saving Scan Data

It may be necessary on occasion to retain the scan data for reconstruction at a later time or
for a diagnostic inspection of the system components. This is usually done if the scan data
must be kept for an indefinite period of time or if the scan data is being sent elsewhere for
diagnostic review.
Restoring Scan Data

Scan data that has been stored on a MOD or DVD-RAM media can be placed back onto the
system disk. Once on the system disk, the scan data can be reconstructed using any of the
scan parameters, i.e., image interval (if acquired helically), DFOV, A/P and R/L centers, or
algorithm.

32-2
Reserving Scan Data

The system temporarily saves the scan data in an electronic queue. These entries are
written over in order, with the earliest scans being written over first. Prior to this occurring,
you can have the system place a lock on a given scan file. The system then goes to the next
unlocked scan file to write over. It is important to note that when the scan data files are
reserved, the remaining files are reduced by the number of files saved.
Releasing Scan Data

Scan data files that have been reserved may replaced in the system by releasing the lock set
by reserving scan data. Releasing the files increases the available scan data files
accordingly. The scan data files are written over in the usual manner.
WorkArounds
Scan File save is not complete even though the Saved File message has been posted.
It takes time to transfer the file from the system to the DVD and unmount the DVD. It
can take up to an hour for the file to completely transfer. Do not try to eject the DVD
or MOD until the light has gone out on the DVD or MOD drive.
Scan files from BrightSpeed 4/8 or 16 slice system cannot be restored on LightSpeed
Pro32/VCT Select or LightSpeed VCT/VCT XT systems.

32-3
How Do I...
This section provides the step-by-step instructions for managing scan data. Specifically, it
describes how to:

32-4

The scan data contains all of the information gathered from each exposure, making it
possible to create images of the same anatomy presented in a different manner. Changes in
scan parameters and possibly reducing artifact due to motion are possible. These changes
take place after the original data is reconstructed and are known as retro recons.
The Retro Recon list select screen appears. All images with available scan data are
listed.
2. From the Retro Recon list select screen, select the appropriate patient, exam, and series.
The most recently scanned examination are at the top of the list.
The Retro Recon view/edit page appears, showing all of the scan parameters
available for retro reconstruction.
Figure 32-1 Retro Recon Screen

4. Type a new series description in the Series Description area if desired.
If you select [Retro], a pop up window appears. Choose [Yes] or [No]. You may also
click on the individual group and toggle between [Y] and [N].
The system assumes all available data is to be reconstructed. If there are multiple
groups, you must determine which group (s) has data you wish to reconstruct.

32-5

6. As needed, enter Retro Start and Retro End locations.
The locations must fall within the range of the selected group and must have S or I
designation.
Cine scans use the time range for the start and end locations and do not require the
S or I designations.
7. As needed, click [Image Thickness].
If you select [Image Thickness], a pop up window appears where you can then enter
the thickness. This changes the thickness in all groups. If there is only one group in
which you wish to change the thickness, or only one of multiple groups, you may
select the thickness area for that group.
The original detector configuration at which the patient was scanned affects how
you can change the slice thickness. The thickness in black is available for
reconstruction.
NOTE: For more information on detector configurations, refer to Multi-Detector Information
chapter.
8. As needed, click [Image Interval].
If you select [Image Interval], a pop up window appears where you can then enter
the interval. This changes the interval in all groups. If there is only one group in which
you wish to change the interval, or only one of multiple groups, you may select the
interval area for that group.
Interval is dependent on scan type of the group. Helical is image interval and Cine is
time interval. Axial does not apply and is insensitive.
9. As needed, click [DFOV].
System defaults to the DFOV used in the original prescription.
Select top button to change all groups or select an individual group.
Enter desired value.
10. As needed, click [R/L Center].
Select top button to change all groups or select an individual group.
You are setting the value for Right/Left offset of the image. Right or left value can be
determined by placing the real time cursor in image and the value are displayed in
upper left corner of the image. You may also choose List/Select to highlight the
correct exam and series. All of the values for that series are displayed in the browser
menu.
11. As needed, click [A/P Center].
Same as above step. You are setting the value for anterior or posterior centering.

32-6

A pop up window appears with all of the available algorithms from which you can
choose the appropriate algorithm.
For more information on Recon Options, refer to: Set Display Factors.
13. The [Matrix] is shown here for informational purposes only. You cannot change the
matrix size.
14. As needed, click [Recon Mode].
System defaults either full or segment based on the prescription.
NOTE: Segmenting uses 225 degrees of data from different times within the rotation. This is
useful in segmenting out Aortic dissection artifact caused by the pulsation of the
vessel. Cine scans using 225 degrees of data creates images with a shorter temporal
resolution. This is useful in following contrast through a tumor.
Quick Steps: Create New Images From Scan Data

2. From the Retro Recon list select screen, select the appropriate patient, exam, and
series.
4. Type a new series description in the Series Description area if desired.
6. As needed, enter Retro Start and Retro End locations.
7. As needed, click [Image Thickness].
8. As needed, click [Image Interval].
9. As needed, click [DFOV].
10. As needed, click [R/L Center].
11. As needed, click [A/P Center].
13. The [Matrix] is shown here for informational purposes only. You cannot change the
matrix size.
14. As needed, click [Recon Mode].

32-7

Occasionally for a variety of reasons, the system may fail to complete the reconstruction of
an image. The data is not lost, and you may have the system retry the reconstruction of the
image.
1. From the scan monitor, click [Recon Management].
The recon management page opens. If there is an unreconstructed image, it are
listed in the Suspended Entries window.
2. Select the suspended image(s).
The image(s) is listed by Patient ID, Exam, Series and Image number.
The system highlights selection(s).
3. Click [Delete Suspended Entries] or [Unsuspend Entries].
[Delete Suspended Entries] deletes the image(s) without attempting to reconstruct
the data. Use this if you do not wish the image(s) to be reconstructed.
[Unsuspend Entries] retries the reconstruction of the data. If successful, the system
places the image(s) in the correct exam and series.
a) The [Delete Suspended Entries] button has a pop up window to confirm or cancel
deletion. From the Attention Box, click [OK] to delete the selected entry. Click [Cancel]
to close the pop up window only; this does not cancel entry.
4. Click [Update List].
This allows the system to add any additional suspended entries that may have
occurred while using this feature.

32-8
Quick Steps: Look for Images that are not Reconstructed

1.
2.
3.
4.
From the scan monitor, click [Recon Management].

Select the suspended image(s).
Click [Delete Suspended Entries] or [Unsuspend Entries].
Click [Update List].

32-9

Images being prospectively reconstructed cannot be paused. Images being produced
retrospectively can be paused.
1. From the scan monitor click [Recon Management].
The recon management page opens.
2. Click [Pause Queue].
Button is highlighted in blue.

Images in queue are listed in the window next to the pause button.
Images are listed by Patient ID, Exam, Series and Image numbers.
All image reconstruction are paused, prospective and retrospective. However, several
images from the series may have already completed reconstruction. This is indicated
by the images appearing on the display monitor in the autoview viewport.
Quick Steps: Pause Images From Reconstructing

1. From the scan monitor click [Recon Management].

32-10

It is very important to restart the image queue if it has been paused for any reason. When
the queue is restarted, the images automatically begins reconstruction and be displayed on
the display monitor.
2. Click [Restart Queue].
The system automatically starts reconstruction of any images in the reconstruction

queue.
Quick Steps: Resume Image Reconstruction


32-11

If any of the parameters selected for retro reconstruction of data are incorrect or if the
images are not needed, they may be paused and then deleted from being reconstructed.
This stops the reconstruction of data. Some images may have completed
reconstruction.
3. Click [Delete Retro Entries].
At the bottom of the list, several options buttons are available.
4. Select entries to be removed.
You may select individual images by clicking on them or clicking and dragging over
more than on image to highlight groups of images.
Selection(s) are highlighted.
5. Click [Delete Retro Entries].
At the bottom of the list, several options buttons are available.
6. Click [Delete Selected] or [Delete All].
Use the [Delete Selected] if you want only the images highlighted to be deleted from
the list.
Use the [Delete All] if you want all of the images in the list deleted.

32-12

This automatically starts any remaining images to reconstruct.
If there are no images in retro recon this allows images being scanned to reconstruct
and be displayed.
Quick Steps: Remove Images From the Reconstruction List

1.
2.
3.
4.
5.
6.
7.

Click [Pause Queue].
Click [Delete Retro Entries].
Select entries to be removed.
Click [Delete Retro Entries].
Click [Delete Selected] or [Delete All].
Click [Restart Queue].

32-13

If you wish to see any images that may have been added to the reconstruction queue while
utilizing this function, it is necessary to update the reconstruction list.
The system updates the reconstruction list.

NOTE: If you exit the recon management screens and return, the list is updated
automatically.
Quick Steps: Update the Reconstruction List


32-14

Occasionally, it may be necessary for diagnostic analysis to place all of the information
contained in the scan data onto a DVD-Ram or MOD. You may also wish to place special or
difficult studies on a disk to allow reconstruction of the images in different formats at a later
time. If you have placed scans on a disk and wish to restore them to the system disk, the
steps are exactly the same as saving except you use the restore buttons.
NOTE: If saving scanfiles for troubleshooting, always select Save Selected Anonymous Data
to remove patient identification to comply with HIPAA regulations.
Place DVD-Ram or MOD media in the drive.
2. Click [Save Scan Data].
The Save Scan Data screen appears with all the currently available scan files listed
with the first scanfile in the list highlighted.
Use the up/down arrows to move up/down through the pages of available scan files.
The data is listed in three parts: exam, series, and scans.
Available exams are shown in upper left window, series and scans for the selected
exam (s) in the lower left window and selected scanfiles in the window on the right.
3. Select the exam you wish to save in the Exam window.
Make sure no scanfiles are initially highlighted. Select only the exam you want to
save.
NOTE: Depending on the size of the scan data file, only one scan file may be saved per side
of the DVD-RAM or MOD. Select only the files you want to save and save them one at
a time.
4. Select the individual scanfiles for the series you wish to save in the series window.
Select individual series if you wish to save data from a specific series.
5. Click [Select All Scanfiles Listed] or select individual scan(s).
Click [Select All scanfiles Listed] if you want all listed files saved
Select individual scans if you want specific scan(s) saved.

32-15

6. Click [Save Selected Scanfiles].
All selected exam(s), series or scan(s) is saved to the disk.
NOTE: Make sure the selected scanfiles does not exceed the space available on the
DVD-RAM. For LightSpeed Pro32/VCT Select and LightSpeed VCT/VCT XT only one
helical scanfile will fit on one side of the DVD-RAM, most CINE full scan types can not
be saved to DVD-RAM, for Axial scan types 12 scanfiles will fit on one side of a
DVD-RAM.
NOTE: It is very important to note that you cannot scan once you have selected [Save
Selected Scanfiles]. The system only allows scanning when the save is complete. If
you accept and then choose cancel the system only cancels when the current scan
save is finished. A scan could be a 60 second helical acquisition and could take up to
30 minutes to complete the save process.
NOTE: Make sure to wait till the light is no longer illuminated on the media drive before trying
to eject the media.
7. Click [Quit] to exit.
Quick Steps: Save/Restore Scan Data to/from a Disk

1.
2.
3.
4.
5.
6.
7.

Click [Save Scan Data].
Select the exam you wish to save in the Exam window.
Select the individual scanfiles for the series you wish to save in the series window.
Click [Select All Scanfiles Listed] or select individual scan(s).
Click [Save Selected Scanfiles].
Click [Quit] to exit.

32-16

The system has the ability to save scan data with patient identifying information removed.
This has been added to address HIPAA concerns. Raw data saved anonymously and then
restored will reconstruct with patient identifying information removed. The Patient Name
and ID will be anonymized.
1. Place media in the drive, MOD for Octane based systems and DVD-RAM for PC based
systems. Click [Recon Management].
The Save Scan Data screen appears with all the currently available scan files listed
with the first scanfile in the list highlighted.
Use the up/down arrows to move up/down through the pages of available scan files.
The data is listed in three parts: exam, series, and scans.
Available exams are shown in upper left window, series and scans for the selected
exam (s) in the lower left window and selected scanfiles in the window on the right.

32-17

3. Click [Save Selected Annon. Data].
The Recon Management Save Scanfiles Window appears.
Quick Steps: Complete an Anonymous Scan Data Save

1. Place media in the drive, MOD for Octane based systems and DVD-RAM for PC based
systems. Click [Recon Management].
3. Click [Save Selected Annon. Data].

32-18

You may have the system protect selected scan files from being reused. Essentially, you
place a lock, or reserve, around the scan file that the system then bypasses and uses the
next unlocked or released scan file. When the scans are no longer needed, they may be
unlocked, or released, to the system for use. The steps to release are exactly the same as
reserving, except you use the release buttons.
2. Click [Reserve Scan Data].
The Reserve Scan Data screen appears with all currently available scans listed.
The data is listed in three parts: exam, series and scans.
3. Click [Reserve All Scanfiles], [Select All Exams Listed] or select individual exam(s).
Click [Reserve All Scanfiles] if you wish to reserve all of the data from all of the scans.
Click [Select All Exams Listed] if you wish to see a listing of the different series in
each exam and choose specific series to be reserved.
Select individual exam(s) if you wish to reserve data from specific exam(s) and series.
NOTE: If you wish to reserve by exam(s), click [Reserve Selected Scanfiles] and skip to step
7. If you wish to save by series or image(s), proceed to next step.
4. Click [Select All Series Listed] or select individual series.
Click [Select All Series Listed] if you wish to reserve all of the listed series.
Select individual series if you wish to reserve data from a specific series.
NOTE: If you wish to reserve by series, click [Reserve Selected Scanfiles] and skip to step 7.
If you wish to reserve individual scan(s), proceed to next step.
5. Click [Select All Scanfiles Listed] or select individual scan(s).
Click [Select All Scanfiles Listed] if you want all listed files reserved.
Select individual scans if you want specific scan(s) reserved.
6. Click [Reserve Selected Scanfiles].
All selected exam(s), series, or scan(s) is reserved to the system disc.
7. Click [Quit] to exit.

32-19
Quick Steps: Reserve/Release Scan Data

1.
2.
3.
4.
5.
6.
7.

Click [Reserve Scan Data].
Click [Reserve All Scanfiles], [Select All Exams Listed] or select individual exam(s).
Click [Select All Series Listed] or select individual series.
Click [Select All Scanfiles Listed] or select individual scan(s).
Click [Reserve Selected Scanfiles].
Click [Quit] to exit.

32-20
Reformat
Chapter 33
Reformat
Introduction
The Reformat software is located in the Image Works desktop. It generates reconstructed
cut planes on CT images.
This chapter explains the process of using reformat. It provides step-by-step instructions to
learn how to:
Select and Build an Image Set
Using Layout Presets

Create a Layout Preset
Modify or Delete Layout Presets
Move the Orthogonal View Locations
Adjust the Oblique View Angle
Edit with the Active Annotation
Adjust the Cross-Reference Image
Use the Main On-View Menu Features
Create Measurements
Measure Distance
Create Measurements
Measure an Area

33-1
Reformat
Adjust Display Preferences

Show Annotations
Trace
Choose Ruler Styles
Identify Slices
3D Cursor
Reference Image
Paging Mode
Set Up Film Options
Set Up a Batch Protocol

Use a Protocol
Delete a Protocol
Create and Save a Movie Protocol

Set Up a Manual Prescription Using Steps
Apply the Movie Prescription
Create Different View Types

Create a Curved View Type
Create a Profile View Type
Create a Histogram View Type
Create an X Section View Type
Prescribe a Multi Projection Volume Reformation (MPVR)

33-2
Reformat

This section presents the concepts necessary to successfully complete the process of
creating and managing image sets for reformat. Specifically you need to understand:
Requirements for Reformat
Main Control Panel

Layout Presets
Tools
Rotate Translation
Close
Review Controller
Reformat Layout
What are the Cursor Controls?
What is the Plane Orientation Indicator?
What are View Types?
What are Render Modes?
What is Batch?
What is the Main On View Menu?
WorkArounds
Requirements for Reformat

Certain requirements need to be met to have a valid image set in order to perform reformat.
They are as follows:
Matrix Size
Display Center
Orientation
(The above requirements need to be the same for all images in the set.)
There must be at least four images selected before selecting reformat.
Tilt acquisitions are not supported for right and left decubitus patient orientation.
You cannot have two images with identical locations.
Spacing must be less than 10 millimeters and the set should include only axial, sagittal
or coronal images.
Different Display Field Of Views (DFOV) and Gantry Tilts can be loaded however you have to
select between different sources of images to view them. The source annotation is located
in the upper left corner of the image (Figure 33-1). You can change between sources by
clicking on the red annotation.

33-3
Reformat
Figure 33-1 source Annotation
Main Control Panel

The principal controls in the Main Control Panel (Figure 33-2) are:
Figure 33-2 Main Control Panel
Layout
Presets
Tools
Rotation
Translation
Display
Tools
Filming Tools
Close Icon

33-4
Reformat
Layout Presets
You are able to store a specific layout context, allowing you to recreate it without having to
independently set each of the parameters again.
The following settings can be saved in the Layout Presets:
Screen / Image layout (axial, coronal, sagittal...)
Field of View (FOV) settings
Window Width and Window Level (W/L)
Slice Thickness Display Algorithm (MIP, MinIP...)
Motion lock
Orientation
Tools
Tilt Rotate Mode
In the Tilt/ Rotate mode, as soon as you move the mouse pointer onto the
oblique view, a red "cube" symbol with "handles" in the corners and on the sides
appears on the view.
You can use two different methods to rotate the oblique plane. To rotate and tilt the oblique
plane in any direction:
Click on one of the corners of the cube. If the view wasn't selected before, it is now
selected.
Click and drag the mouse around. The oblique plane will start to rotate with mouse
movement. Keep holding down the mouse button until the oblique plane has rotated to
the new position. When the desired orientation is reached, release the mouse button.
To constrain the rotation of the oblique plane to an axis parallel to one of the edges of the
cube:
Click and drag the rotation marker in the middle of the edge of the cube parallel to the
axis around which you want to rotate the oblique plane. If the view wasn't selected
before, it is now selected.
Still holding the mouse button down, drag the mouse around. The oblique plane will
start to rotate with mouse movement, but it will rotate only around the axis parallel to
the selected edge. Keep holding down the mouse button until the oblique plane has
rotated to the new position. When the desired orientation is reached, release the mouse
button.
Oblique Mode
The oblique view is aligned so as to be perpendicular to the primary view. A
solid line on the primary view indicates the intersection with the oblique view.
Thin dotted lines indicate the intersection with the baseline views.

33-5
Reformat
You can now rotate the oblique plane around the 3D cursor (i.e., around an axis
perpendicular to the baseline view) by clicking and dragging the solid line on the primary
view. The oblique view is updated at the same time.
NOTE: The software rotates the oblique view so it is as close as possible to one of the baseline
orientations. This means that the view may jump when it is halfway between two
orientations.
In oblique mode, you cannot perform two or more successive rotations in different
planes by first selecting one baseline view, then another. As soon as you select
another baseline view in oblique mode, the oblique plane is realigned to be
perpendicular to that baseline view, and you lose your previous settings.
If you want to perform rotations in different planes, you can either use Oblique mode for the
first alignment and then switch to Tilt/ Rotate mode, or create a second oblique view.
Rotate Translation
You can use Rotate/Translate to change the orientation of
the oblique plane or move the 3D cursor in precise steps. You
can also return the oblique plane to one of the baseline
orientations.
Select the oblique view by clicking on the red border. To rotate
the oblique plane in steps, select [Rotate/Translate] > [By deg] (Figure 33-3). In the
numerical entry field, enter the required angle step in degrees. Click on the arrow button
corresponding to the desired direction of rotation. To move the 3D cursor in steps, select
[Rotate/Translate] > [By mm]. In the numerical entry field, enter the required distance step
in millimeters. Click on the arrow button corresponding to the desired direction of
translation. If after repeated rotations you want to rapidly return the oblique view to a
known baseline orientation, use the [S] [I] [A] [P] [L] [R] buttons on the main control panel.
Figure 33-3 Rotate Translate
NOTE: To return the 3D cursor to the initial position at the center of the image, select [Reset
pointer] in the on view menu.

33-6
Reformat
Close
The [Close] button allows you to close the Reformat application and return to the Image
Works Browser.
NOTE: When you close the application, any work in progress that has not yet been filmed or
saved will be lost.
Review Controller
One of the new features of Reformat is the existence of a Review Controller (Figure 33-4),
which allows you an on-view operation of the main controls provided for the software. Table
33-1 describes the functions of each of these controls.
Figure 33-4 Review Controller
Using the Review Controller is the easiest way to view

images. All the viewing tools are in the margins for
easy access.
11
NOTE: These tools are available if you have the

viewport selected or if your cursor is over the
view.

4 5
10
12
6 7 8 9
13
33-7
Reformat
Table 33-1 Review Controller Description
Number
Icon
Name
Description
Job Shuttle
Job Shuttle starts paging at selected speeds in a selected

direction. This is useful with Auto Loop and Auto Rock.
Auto Loop
Auto Loop allows you to have the views appear in a continuous

forward mode, in a loop movement. When the system reaches
the last view, it starts up again with the first one. Click to start
and stop.
Auto Rock
Auto Rock allows you to have the views appear in a continuous

forward to backward movement. When the system reaches the
last view in a forward movement, it starts up again backwards
and vice versa. Click to start and stop.
Report Pixel
Report Pixel gives you the houndsfield measurements for one

pixel value.
5
6
Distance
Tool
Create
Annotation
Scalpel
Enlarge/
Split Views
Selecting Enlarge makes the current view take up the entire

viewing area. The icon then becomes Split Views for returning
the view to its normal size.
10
Hide
Controller
Hides the controller.
11
Scroll to
Select Image
12
Scroll to
Next
Bookmark
Selecting Distance Tool opens a panel that allows you to

execute distance measures for straight or curved lines.
Selecting Annotation Tool opens a panel that allows you to use
predefined annotations on the views. You can also create new
annotations here.
Selecting Scalpel opens up a panel that allows you to define
any kind of cut of the view you may need.
Image location slider: The slider is used to review images. Click

and drag the Location Slider to move within the different slices.
Clicking once on the center bar of slider, or pressing the Control
keyboard key, will link the Location Slider to the mouse cursor.
You can then move within the slices just by moving the mouse
up and down. Clicking again on the Location Slider, or releasing
the Control keyboard key, then unlinks the Location Slider from
the mouse cursor.
Slice Thickness: Click and drag the outer bars to change the
slice thickness of the images within the active viewport.
Shows the next bookmarked image. A bookmark leaves a red
annotation on the image.

33-8
Reformat
Number
Icon
Name
Scroll to
Prior
Bookmark
13
Description
Shows the previous bookmarked image.A bookmark leaves a
red annotation on the image.
Display Tools
The Display Tools menu (Figure 33-5) is where all the tools are located for measuring and
manipulating the images. Table 33-2 describes the functions located in the menu.
Figure 33-5 Display Tools
Table 33-2 Display Tools

Icon
Name
Description
View Color
Use this to apply colors to a structure.
Report Cursor
This reports where the cursor is.

33-9
Reformat
Icon
Name
Description
Annotate
Use this to add annotation to an image. You can

choose from the different styles listed.
Preset Annotation
These are preset annotations that are used often. You

can create new annotations here.
Measure Distance
Use this to measure the distance between two points.
Measure Angle
Use this to measure the angle of a structure.
Measure Area
Use this to measure the area of a structure.
Measure Volume
Use this to measure the volume of a structure.
Preferences
Use this to set up display preferences.
Reformat Layout
Once the model is built, a 4-on-1 display appears with the main control panel on the left side
of the images. The images always display an oblique image in the upper left quadrant, an
axial in the upper right quadrant, a sagittal in the lower left quadrant, and a coronal in the
lower right quadrant. If you would like to change the default layout, you can use the
[Display Tools] and [View Layout] buttons near the bottom of the Main Control Panel. On
the display tools you can place your mouse over any button and a message about that
button appears.
NOTE: There may be a small delay before the message comes up.

33-10
Reformat
What are the Cursor Controls?

Reformat uses the 3D cursor, trackball cursor, and tilt cursor. The 3D cursor appears as a red
crosshair and identifies the same point on each view. If the 3D cursor is repositioned on one
view, the other connected views update based on the change. The trackball cursor appears
on the oblique view when the Tilt/Rotate icon is selected. The trackball cursor can be used
to rotate the oblique view by clicking and dragging the four corner or side handles. A solid
line cursor appears on the primary view when the oblique mode icon is selected. On the
orthogonal views the line cursor can be centered and angled adjusting the oblique views.
What is the Plane Orientation Indicator?

Reformat provides a plane orientation indicator in the lower right corner of each view. The
indicator cross-references the reformatted plane to the original (acquisition) plane image.
What are View Types?

There are several different view types in Reformat. They are No View, Axial, Sagittal, Coronal,
Oblique, Curved, Profile, Histogram, and X Section.
Selecting No View simply blanks out the corresponding viewport. This could be useful if
you only want to view specific view types.
An axial is an image representing a cross-sectional slice of anatomy.
A sagittal is a lengthwise plane dividing the body into left and right portions.
A coronal is a lengthwise plane through the body, dividing it into anterior and posterior
portions.
An oblique plane is a coronal or sagittal plane that has been tilted through the body
rather than following the long axis. It can look like a axial image.
A Curved image allows the definition of a complex, curved view. The curved view does
not need to lie along a single orthogonal or oblique plane but can follow anatomical
lines.
Profile is a graph showing the CT number intensity across a location.
The Volume Histogram view provides a variety of information, including the ability to
display a histogram showing the percentage of occurrence of each voxel intensity value
in an object. It also provides numerical statistics about the voxel intensity values in a
object plus the total object volume. Also, it automatically determines boundaries around
a class of similar voxel intensities and can hilight pixel values. This function is typically
used when you have 3D data; otherwise, the volume statistics are not valid.
An X Section view displays a histogram showing the percentage of occurrence of each

pixel intensity value in a user-defined surface area on a reformatted slice. It also
provides numerical statistics about the pixel intensity values in this same surface area
plus the calculations of this area. It automatically determines boundaries around the
class of similar pixel intensity values in this area.

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What are Render Modes?

Render modes consist of Surface, HD MIP, MIP, Min IP, Ray Sum, and Integral (Table 33-3).
Table 33-3 Reformat Render Modes
Mode
Surface
HD MIP
MIP
Min IP
Ray Sum
Integral
Description
Exists only if the model was built using volume or surface mode and is used to
display the surface of a model.
Displays the model using the High Definition Maximum Intensity Projection mode.
The mode is identical to the MIP mode as described below, except that image
definition is greater but the system speed is slower.
Displays the model using the Maximum Intensity Projection mode. In this mode,
the density of each point on the screen is the maximum density along a line
perpendicular to the screen.
Displays the model using the Minimum Intensity Pixel mode. In this mode, the
density of each point on the screen in the minimum density along a line
perpendicular to the screen.
Displays the model by summing the models intensity along lines perpendicular to
the screen. This mode simulates conventional radiography images.
Displays only the surface of the model, but the density of each surface point is
equal to the sum of densities along a shallow depth below the displayed surface
point.
What is Batch?
The Batch command allows you to set up filming prescriptions or a movie loop on
reformatted images.
What is the Main On View Menu?

This menu is accessed by pressing and holding the right mouse button anywhere on a view
except on the red trackball control points, the 3D cursor or any of the red annotations. The
contents on this menu depends on the view type and whether traces are present on the
view. The options on this menu are: Save Image, Show Less Annotation, Hide Annotations,
Hide reference image, Create trace, Enlarge, and Reset pointer. Lock orientation, Center
on FOV, Center on Object, and Center on cursor only exists on oblique views. Save Image
allows you to save the view for future display. Show Less Annotation removes all the
information about the image except the patients name. Show All Annotation is available if
you have previously selected Show Less Annotation or Hide Annotation. This displays all of
the hidden or removed annotation. Hide Annotations removes all annotation from the
screen. Clear last point exists only if a trace is present and allows you to clear the last point
entered on the trace. Clear trace exists only if a trace is present and allows you to clear all
points from the trace, enabling you to restart trace entry. Enlarge allows you to zoom in by a

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factor of two. This option then becomes Reset size for returning to the normal view. This
does not exist on Profile, Histogram, or X Section views. Hide reference image removes the
cross-reference image from the quadrant. Lock orientation allows you to lock an oblique
view orientation, i.e., to prevent rotation. This option then becomes Unlock orientation for
restoring rotation ability. Reset pointer allows you to center the 3D cursor in the reformat
field of view. This does not exist on Profile, Histogram, or X Section views.

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WorkArounds
Reformat may hang the system and then crash when selecting a camera in Film
Save Options if more than 12 cameras are installed on the system. Install less than 12
cameras to avoid this situation.
Sagittal images created from prone direct coronal position are distorted
Reformat will only allow filming in Batch to the first 30 cameras in the list. If another
camera is desired save the batch images to disk and use Print Series to film the
images.
Images saved from batch mode may appear to have jagged edges or not have
optimal Image Quality. Manually save the images to improve image quality.

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Reformat
How Do I...
This section provides the step-by-step instructions for creating Reformatted images.

Create Measurements
Measure Distance
Create Measurements
Measure an Area

Show Annotations
Trace
Choose Ruler Styles
Identify Slices
3D Cursor
Reference Image
Paging Mode
Set Up Film Options

Use a Protocol
Delete a Protocol


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When Selecting an Image Set, keep in mind that you have to have a valid image set.
From the Browser, check all of the parameters to make sure that you have a valid
image set.
2. Select the Exam/Series/Images that you want to reformat.
You can select an exam and series. All the images are included if you do not select
any images.
If you want a selected range of images, you have to select the first image that you
want to include. Then find the last image in the range and, while holding down Shift,
select the last image. You could also click on the first image and drag through the
range of images.
To select specific images, you must hold down Ctrl on your keyboard as you click the
desired images.
You have to select at least four images for Reformat to work.
3. Click [Reformat].
The series selected is automatically displayed.
Quick Steps: Select and Build an Image Set

2. Select the Exam/Series/Images that you want to reformat.

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Layout Presets
The Layout Preset panel always contains a Layout Preset, which has the name of the
protocol initially used at software startup. This preset cannot be modified or deleted.

This allows you to reverse to the parameters of the original protocol after having modified
some of them or applied a different Layout Preset, without having to leave the software or
to restore them manually.
1. Click on the name of the Layout Preset you want to apply to the currently displayed
exam.
If the name of the layout you want to apply does not appear in the Layout Presets
window of the Control Panel, click the [Options/More] button to open up a pull-down
menu containing a list of all the created layouts.
By clicking on the preset name in the list layout you wish to use, it is automatically
applied to the displayed images.

1. Click [Option/More] on the Layout Presets panel.
A pull-down menu opens up on the right of the panel.
2. Click [Save Layout].
The Save new layout preset panel is displayed on the bottom left viewport.
3. Enter the name of the Preset.
Naming the type of exam generally works.
Parameters can be set for each of the four views.
4. Click on the view you wish to modify.
5. Select all of the choices you desire.
6. Click on [Save] or [Cancel].
Select [Save] to save the layout.
Select [Cancel] to close the panel.
The new Layout Preset is created on the window of the Layout Preset panel.

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Quick Steps: Layout Presets

1. Click on the name of the Layout Preset you want to apply to the currently displayed
exam.
2.
3.
4.
5.
6.
7.
Click [Option/More] on the Layout Presets panel.

Click [Save Layout].
Enter the name of the Preset.
Click on the view you wish to modify.
Select all of the choices you desire.
Click on [Save] or [Cancel].

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Layout Presets

1. Click the [Option/More] button of the Layout Preset panel.
A pull-down menu opens up on the right of the panel.
2. Click [Click for Details] image to access to the Current Settings panel.
You can select or deselect the layout details you want to store in this particular
layout, by selecting the corresponding box. This can be done for each of the four
views.
3. Click on the view you wish to modify.
4. Click [Close] to close the sub-panel when you are finished.
5. Click [Rename] if you want to rename a layout.
A dialog window pops up allowing you to modify the name of the selected layout.
6. Click [Delete] if you want to remove a layout.
A message window pops up asking you to confirm if you want to delete the selected
layout.
7. Click [Close] to close the panel.
Quick Steps: Layout Presets-Modify or Delete Layout Presets

1.
2.
3.
4.
5.
6.
7.
Click the [Option/More] button of the Layout Preset panel.

Click [Click for Details] image to access to the Current Settings panel.
Click on the view you wish to modify.
Click [Close] to close the sub-panel when you are finished.
Click [Rename] if you want to rename a layout.
Click [Delete] if you want to remove a layout.
Click [Close] to close the panel.

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Once you have selected Reformat, the model builds. Once it is built, a 4-on-1 display
appears. The images usually display with a oblique image in the upper left quadrant, an
axial image in the upper right quadrant, a sagittal image in the lower left quadrant, and a
coronal image in the lower right quadrant. When the images are displayed, the oblique
image is in primary focus. Primary focus in Reformat is red. The other images are linked by
green.
The Orthogonal View Locations can be adjusted several ways:
1. Place the mouse cursor over the area desired and press Shift.
The 3D cursor (a red dot, arrow, or X) is deposited at the mouse cursor location.
2. Click and drag the 3D cursor to where you want to place it.
This updates all of the views that are linked in green frames.
3. Click [Rotate/Translate].

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4. Click [By mm] and enter an increment value in the mm text box and click the arrows
around the text box.
This moves the appropriate green frame to the new location.
The red 3D cursor in the red frame always moves.
5. Position the mouse cursor on the red slice location annotation.

Click to increment one slice location in one direction.
Right-click to increment one slice location in the other direction.
Middle-click and drag right or left to page through the image set.
Quick Steps: Move the Orthogonal View Locations

1.
2.
3.
4.
Place the mouse cursor over the area desired and press Shift.
Click and drag the 3D cursor to where you want to place it.
Click [Rotate/Translate].
Click [By mm] and enter an increment value in the mm text box and click the arrows
around the text box.
5. Position the mouse cursor on the red slice location annotation.

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Reformat

The oblique mode button can be used to move and rotate planes of reformatted views on all
views except oblique, curved, histogram, X Section, and profile. The [Tilt/Rotate] button is
the default for Reformat.
1. Click the [Oblique Mode] button.
You must have an axial, sagittal, or coronal image in the primary frame.
2. Click and drag the 3D cursor to the desired location.
This moves the dotted lines, which represents the location.
You can also move the mouse cursor to the desired location and press shift.
3. Click and drag the solid yellow line to the desired angle.
The oblique view updates automatically.
4. Click on the [Tilt/Rotate] button to exit the oblique mode.
The [Tilt/Rotate] button can be use to rotate the image. You can move in any
direction by clicking and dragging on the corner or sides of the red Tilt/Rotate box.
Quick Steps: Adjust the Oblique View Angle

1.
2.
3.
4.
Click the [Oblique Mode] button.

Click and drag the 3D cursor to the desired location.
Click and drag the solid yellow line to the desired angle.
Click on the [Tilt/Rotate] button to exit the oblique mode.

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Any of the red annotated areas can be changed. If you place the mouse over a red
annotated area, a description of the button flashes.The following explains the function of all
of the red annotations.
1. Edit the image number.
On the axial image, place your mouse over the red image number, type in the image
number, and press Enter.
As you type, the number is displayed in a pop-up box. You must press Enter before
the computer accepts the new number.
Click over the red image number to increase the image number.
Right-click over the red image number to decrease the image number.
Middle-click and drag right over the red image number to increase and left to
decrease the image number.
2. Edit the Display Field of View (DFOV) number.
On the axial, sagittal, oblique and coronal images, place your mouse over the red
DFOV number type in the DFOV number, and press Enter.
This magnifies or minifies the image.
Click the red DFOV number to decrease the DFOV.
Right-click the red DFOV number to increase the DFOV.
Middle-click and drag right the red DFOV number to increase and left to decrease the
DFOV.
NOTE: You cannot increase more than the original DFOV. Changing the magnification only
affects the quadrant that you are in.
3. Roam the image.
On the sagittal, oblique, and coronal images, place your mouse over any red Right
Anterior Superior (RAS) coordinates, then click and drag to roam the image.
When you release the mouse button, the image is deposited at that point.
The other planes that are linked in green frames updates to the deposited point.
NOTE: Roam is not available on the original DFOV scanned axial image. It is available on a
magnified axial image or a scan that is longer in millimeters than the DFOV.

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4. Hide or show the patients name.
On any view, place your mouse over the red patients name, click and hold the right
button, and click [Hide] to hide the patients name.
To show the patient name again, click and hold the right button over the red asterisks
and click [Show] to show the patients name.
This affects all quadrants.
5. Edit the Window Width or Window Level numbers.
On any view, place your mouse over the red Window Width or Window Level
numbers. Type the new number and press Enter.
If you click on the Window Width or Window Level numbers a list of presets appears.
Select the one you desire.
Middle-click the red Window Width or Window Level numbers and drag right to
increase and left to decrease the Window Width or Level.
NOTE: Remember you can always use the middle mouse button to change the window width
and level.
Middle-click and drag from side to side to change the window width.
Middle-click and drag up and down to change the window level.
6. Click on the red annotation of the view type to change to a different view type.
The slice thickness and rendering mode red annotations are covered in Prescribe a Multi
Projection Volume Reformation (MPVR).
Quick Steps: Edit with the Active Annotation

1.
2.
3.
4.
5.
6.
Edit the image number.

Edit the Display Field of View (DFOV) number.
Roam the image.
Hide or show the patients name.
Edit the Window Width or Window Level numbers.
Click on the red annotation of the view type to change to a different view type.

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The cross-reference area defaults to an axial image. To change to another orientation, you
have to change the cross-reference image. If the cross-referenced image is over the
anatomy of interest, you can relocate it.
1. Place the mouse cursor over the cross-reference image, right-click and select the plane
of interest.
You can choose Axial, Sagittal, or Coronal.
2. Place the mouse cursor over the cross-reference image, right-click and select the
location of interest.
North East would move the image to the upper right corner of the screen.
South West would move the image to the lower left corner of the screen.
North West would move the image to the upper left corner of the screen.
South East would become available only if the cross-reference image was moved
from its original location.
3. Place the mouse cursor over the cross-reference image, right-click and select [Reset
Focal Point] to change the reference image to the location of the 3D cursor.

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Quick Steps: Adjust the Cross-Reference Image

plane of interest.
location of interest.
3. Place the mouse cursor over the cross-reference image, right-click and select [Reset
Focal Point] to change the reference image to the location of the 3D cursor.

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Reformat

If you click and hold the right button (right-click) anywhere on the quadrant, except the red
annotations points, the Main On-View menu displays. You can drag the mouse to the desired
function and release the button. This task defines how to use each of these features.
1. Right-click anywhere on the quadrant, except the red annotation points, and select the
desired feature.
Save Image
If you select Save Image, the view is saved on the hard disk for future display. It is
placed on the Browser for the exam under a Reformat Type. If you recall the
image from the Browser, the cross-reference image and 3D cursor is not on the
image. If the oblique image is screen saved, the rotation box is not on the image.
Save Image As
If you select Save Image As, the system will prompt you to name the image and
then the view is saved on the hard disk for future display. It is placed on the
Browser for the exam under a Reformat Type. If you recall the image from the
Browser, the cross-reference image and 3D cursor is not on the image. If the
oblique image is screen saved, the rotation box is not on the image.
Screen Save
Selecting this allows you to screen save the current image as a secondary
captured image. The image is installed in the image database with a series
number 100 + the prospective series number. The current Window Width/Level

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Reformat
setting is used to create the screen save image. No graphic functions can be
performed on this type of image.
Show Less Annotation
Selecting this removes all the information about the image except the patients
name.
Show All Annotation
This is available if you have previously selected Show Less Annotation or Hide
Annotation.
This displays all of the hidden or removed annotation.
Hide Annotations
This removes all annotation from the screen.
Reference image
This allows you to select a cross-referenced image.
Create trace
Selecting this allows you to draw a trace line.
Clear last point
This option appears only if you have created a trace and if the trace is active.
Clear last point clears the last deposited point on the trace.
You can keep selecting Clear last point to keep removing points.
Clear trace
This option appears only if you have created a trace.
Clear trace erases the entire trace.
Enlarge
If you click Enlarge, the image enlarges to the full viewing area. The option then
becomes Reset size to return to the normal view.
NOTE: This function does not exist on Profile, Histogram, or X Section views.
Hide reference images
This removes the cross-reference image from the quadrant. The option then
becomes Reference images to restore the reference image to the quadrant.
Lock orientation
Lock orientation is only available on the oblique view. When selected, the image is
locked in its current rotation. The rotation box disappears and the manual rotation

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button does not function. This option becomes Unlock orientation to return the
rotation capabilities.
This is a good tool if you have it rotated correctly and you do not want it to
change.
Reset pointer
Reset pointer returns the 3D cursor to the center of the viewport on all viewports.
This function does not exist on Profile, Histogram, or X Section views.
Quick Steps: Use the Main On-View Menu Features

1. Right-click anywhere on the quadrant, except the red annotation points, and select
the desired feature.

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Create Measurements
When you click on Display Tools, the measuring options are displayed. Please note that
when any of the display functions are selected, the measurement is applied to the viewport
in primary focus.
CAUTION:
Note that the measurements are accurate only if the trace segments are
longer than the slice interval.
Measure Distance
1. Click Display Tools > Measure Distance.
A pop up menu appears.
2. Place your mouse cursor at the starting point of the measurement and click.
This deposits a point.
3. Place your mouse cursor at the ending point of the measurement and click.
NOTE: The distance readout appears in red annotation automatically. You can move this
annotation around by clicking and dragging the annotation to a new location.

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4. Click [Close].
Quick Steps: Create Measurements-Measure Distance

1.
2.
3.
4.
Click Display Tools > Measure Distance.

Place your mouse cursor at the starting point of the measurement and click.
Place your mouse cursor at the ending point of the measurement and click.
Click [Close].

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Create Measurements
Measure an Angle
1. Click Display Tools > Measure Angle.
3. Place your mouse cursor at the middle point of the measurement and click.
4. Place your mouse cursor at the ending point of the measurement and click.
NOTE: The distance readout appears in red annotation automatically. You can move this

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Quick Steps: Create Measurements-Create Measurements

1.
2.
3.
4.
Click Display Tools > Measure Angle.

Place your mouse cursor at the middle point of the measurement and click.
Place your mouse cursor at the ending point of the measurement and click.

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Create Measurements
Measure an Area
1. Click Display Tools > Measure Area.
3. Place your mouse cursor at the next point of the measurement and click.
4. Continue until the area is closed.
5. Place your mouse cursor at the ending point of the measurement and right click.
This deposits a ending point.
NOTE: The area readout appears in red annotation automatically. You can move this
6. Click [Close].

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Quick Steps: Create Measurements-Measure an Area

1.
2.
3.
4.
5.
6.
Click Display Tools > Measure Area.

Place your mouse cursor at the next point of the measurement and click.
Continue until the area is closed.
Place your mouse cursor at the ending point of the measurement and right click.
Click [Close].

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Reformat

The Preferences button allows you to change display preferences while in Reformat. When
you click Display Tools > Preferences, the Display Preferences menu appears.
Show Annotations
1. Click Display Tools > Preferences.
When you click [Preferences], a window appears.

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2. Select Show Annotations.
Select to display all of the annotation on the selected views.

Deselect to remove all of the annotation on the selected views.
3. Click [Close].
Trace
The Trace function determines how you can create the trace.
2. Select the Trace mode you wish to use.
Click on the image to deposit each point of the trace.

Click on the image and free hand draw the trace
Click each point on the image to develop a smooth trace.
3. Click [Close].
Choose Ruler Styles

The Ruler Style function allows you to choose from a grid or tick ruler.
2. Click Ruler style > None or Grid or Tick.
If you click Grid, a grid ruler appears on all active views. You can change the spacing
by clicking in the spacing box, back spacing through the value, and type in the new
value. Press Enter.
If you click Tick, a tick ruler appears on all active views. You can change the spacing
and range by clicking in the box, back spacing through the value, and typing in the
new value. Press Enter.
3. Click [Close].

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Quick Steps: Adjust Display Preferences

Show Annotations
2. Select Show Annotations.
3. Click [Close].
Trace
2. Select the Trace mode you wish to use.
3. Click [Close].
Choose Ruler Styles
2. Click Ruler style > None or Grid or Tick.
3. Click [Close].

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Identify Slices
2. Click [Identify slices].
This button allows you to turn slice cross-reference markings on or off the primary
focus except the axial viewport.
3. Click [Close].
3D Cursor
2. Select which 3D cursor you wish to use.
This is the cursor you move around and deposit.

3. Click [Close].
Reference Image
This displays a cross-referenced image.

3. Click [Close].
Paging Mode
2. Click [Paging Mode].

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3. Select Continuous or Contiguous.
The default is Continuous, which means that the images are displayed in a continual
loop from the first image to the last.
If Contiguous is selected, the images are displayed from the first to the last image,
then from the last to the first image, and continue in a back and forth mode.
4. Click [Close].
Quick Steps: Adjust Display Preferences

Identify Slices
2. Click [Identify slices].
3. Click [Close].
3D Cursor
2. Select which 3D cursor you wish to use.
3. Click [Close].
Reference Image
3. Click [Close].
Paging Mode
1.
2.
3.
4.
Click Display Tools > Preferences.

Click [Paging Mode].
Select Continuous or Contiguous.
Click [Close].

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Set Up Film Options

The button allows you to set up where you want your images to be filmed and how you want
to save your images in the Batch mode.
1. Click [Filming Tools].
2. Click the [Film/Save Options].
3. Click [Printer] and select the name of the camera you want to use.
A listing of all the printers that are connected or networks to your machine appears.
Verify which printer you have selected each time you use reformat batch filming.
4. Click [Hide Cursor on Copies].
If this button is selected, the cursor is invisible on the filmed images.
5. Click [Color Save].
If this button is selected, the colors all be saved when you save the image.
6. Click [Image Type for Reformat].
Select the format you wish for the saved images.
Use Save to store the images on the system disk. It resides on the Browser under a
new series. If it is a Screen Save Image, nothing can be changed. If it is a Reformat
Type Save, you can do all of the graphic measurements and annotations.
7. Click [Name Batch Series].
If this button is selected you will be prompted when you save you batch protocols to
name them.

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Figure 33-6 Series window
NOTE: The following characters should not be used in protocol names:

parenthesis ( )
quotes "
forward or backslash / \
NOTE:
8. Click [Close].
Once [Close] is selected the Batch prescription starts
Quick Steps: Set Up Film Options

1.
2.
3.
4.
5.
6.
7.
8.
Click [Filming Tools].

Click the [Film/Save Options].
Click [Printer] and select the name of the camera you want to use.
Click [Hide Cursor on Copies].
Click [Color Save].
Click [Image Type for Reformat].
Click [Name Batch Series].
Click [Close].

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Batch is used to set up a series of reformatted images. This can be used for cine rotations of
reformatted images or a rapid way to save or film a series of reformatted images.
1. Click on the reformatted image to make it the primary view.
This puts a red frame around the image.
2. Click Filming Tools > Batch Film.
This opens the Modify Batch window.

Figure 33-7 Modify Batch Window
3. Click on the center red box and drag the green lines over the anatomy of interest.

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4. Click and drag the red box on either end line to adjust the tilt.
5. Click an drag the red arrows to adjust the number of slices.

6. Click [Accept].
Quick Steps: Set Up a Batch Protocol

1.
2.
3.
4.
5.
6.
Click on the reformatted image to make it the primary view.

Click Filming Tools > Batch Film.
Click on the center red box and drag the green lines over the anatomy of interest.
Click and drag the red box on either end line to adjust the tilt.
Click an drag the red arrows to adjust the number of slices.
Click [Accept].

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Set Up an Oblique Prescription

1. Click on the reference image to make it the primary view.
This puts a red frame around the image.
2. From the Modify Batch window, click [Oblique] (Figure 33-7).
You see a display of green lines appear on the image.
3. Click on the center red box and drag the green lines over the anatomy of interest.
4. Click and drag the red box on either end line to adjust the tilt.
On the command window, you can manually input the number of slices.
5. Click and drag the red arrows to adjust the number of slices.
6. Click in the Number of Views field, backspace to delete the current value, type in the
new value and press the Enter key.
When you make any changes to any of the numerical fields and press Enter, all of the
other fields update.
7. Click in the Spacing Between Views field, back space to delete the current value, type in
the new value and press the Enter key.
This is used to set the spacing between slices.
8. Click in the FOV field, backspace to delete the current value, type in the new value and
press the Enter key.
This is used to set the desired field of view for the batch being prescribed.
Remember, the smaller the number, the greater the magnification to the reformatted
image.
9. Click in the Slice Thickness field, backspace to delete the current value, type in the new
value and press the Enter key.
10. Click [Render Mode] and select Average, MIP, Min or VR.
The default rendering mode is Average, meaning it provides the average density
values of the slice taken along lines perpendicular to it.
If you click MIP, meaning maximum intensity pixel, the image changes to display the
maximum density value of the slice taken along lines perpendicular to it.
If you click Min IP, meaning minimum intensity pixel, the image changes to display the
minimum density value of the slice taken along the lines perpendicular to it.
This render mode is applied to the batch images.
NOTE: This is only active if you select a slice thickness of two or more voxels.

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Quick Steps: Set Up a Batch Protocol-Set Up an Oblique Prescription

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Click on the reference image to make it the primary view.

From the Modify Batch window, click [Oblique] (Figure 33-7).
Click on the center red box and drag the green lines over the anatomy of interest.
Click and drag the red box on either end line to adjust the tilt.
Click and drag the red arrows to adjust the number of slices.
Click in the Number of Views field, backspace to delete the current value, type in the
new value and press the Enter key.
Click in the Spacing Between Views field, back space to delete the current value, type
in the new value and press the Enter key.
Click in the FOV field, backspace to delete the current value, type in the new value and
press the Enter key.
Click in the Slice Thickness field, backspace to delete the current value, type in the new
value and press the Enter key.
Click [Render Mode] and select Average, MIP, Min or VR.

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Reformat
Select the Output Device

This function allows you to preview the batch sequence and to save and/or print the images.
1. From the Modify Batch window, click [Preview] or [Output] (Figure 33-7).
Use Preview to view the batch sequence on the monitor.
Use Output to choose where to send the images.
Use Save to store the batch on the system disk. It resides on the Browser under a
new series. The way the image is saved depends on the filming setup under Display
Preferences. If it is a Screen Save Image, nothing can be changed. If it is a Reformat
Type Save, you can do all of the graphic measurements and annotations.
If you click [Film] the images are sent to the printer to be filmed.
If you click both [Film] and [Save] the images are filmed and saved to the system
disk.
2. Click [Format] to change the filming format. Click on the desired format.
When you choose the printer as the output mode, the [Format] button becomes
available, and the Number of copies text box appears.
The first number is the vertical layout and the second number is for the horizontal
layout.
3. Click [Accept] button to save and/or print the images.
Quick Steps: Set Up a Batch Protocol-Select the Output Device

1. From the Modify Batch window, click [Preview] or [Output] (Figure 33-7).
2. Click [Format] to change the filming format. Click on the desired format.
3. Click [Accept] button to save and/or print the images.

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Reformat
Save a Protocol
1. From the Modify Batch window, click [Protocol] (Figure 33-7).
Selecting Save Protocol allows you to save the current graphic Rx batch parameters
for future use.
This opens the Save Filming Protocol window.
2. Click in the field and type in the name of the protocol.
3. Select how the current protocol is to be used.
With current loading protocol will add the protocol to the protocol list for future use.
As new loading protocol will add the protocol to the Volume Analysis List or the
Volume Viewer.
4. Click [Save].
Use a Protocol
1. From the Modify Batch window, click [Protocol].
This allows you to pick from a list of saved protocols.
2. Select the protocol of interest.
3. Click [Open].
You can double click on the protocol name to use it.
The parameters appears on the image.

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Reformat
Delete a Protocol
Use this only if you want to get rid of a protocol.
A list displays listing the protocols available to delete.
2. Click to highlight the protocol you wish to delete.
3. Click [Delete].
A message stating "Do you really want to delete this protocol?" appears.
4. Click [Yes] or [No].
Select Yes to get rid of the protocol.
Select No to return to the batch window. This does not delete the protocol.
Quick Steps: Delete a Protocol

Save a Protocol
1. From the Modify Batch window, click [Protocol] (Figure 33-7).
2. Click in the field and type in the name of the protocol.
3. Select how the current protocol is to be used.
4. Click [Save].
Use a Protocol
2. Select the protocol of interest.
3. Click [Open].
Delete a Protocol
1.
2.
3.
4.
From the Modify Batch window, click [Protocol].

Click to highlight the protocol you wish to delete.
Click [Delete].
Click [Yes] or [No].

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Reformat

Selecting the [Add a step] icon allows you to set up a manual rotation for a batch
prescription or movie loop.
1. Click Filming Tools > Movie.
Figure 33-8 Movie Window
Add a new step

Modify a step
Delete a step
Preview current step
2. Move and/or rotate the view or place the 3D cursor in the desired position.
Make sure the view you want is in primary focus.
3. Click [Add a step].
4. Move and/or rotate the view or place the 3D cursor in the desired position.
5. Click [Add a step].
Move and/or rotate the view or place the 3D cursor in the desired position.
Continue this process until all of you desired steps are entered.
6. Enter the State duration.
7. Click [Export] to send the images to the selected output device.

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Reformat
Quick Steps: Create and Save a Movie Protocol-Set Up a Manual

Prescription Using Steps
1.
2.
3.
4.
5.
6.
7.
Click Filming Tools > Movie.

Click [Add a step].
Click [Add a step].
Enter the State duration.
Click [Export] to send the images to the selected output device.

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Reformat

This function applies all of the parameters you have defined in the batch protocol.
Figure 33-9 Movie Viewer
Stop
Pause
Step
Toggle from Loop to Rock
1. Click [Preview] to see the images you have prescribed (Figure 33-8).
This starts the movie definition.
The batch is sent to the selected output mode.
A window appears.

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Reformat
2. Select Loop.
The default is Loop, which means that the images are displayed in a continual loop
from the first image to the last.
If Rock is selected, the images are displayed from the first to the last image, then
from the last to the first image, and continue in a back and forth mode.
3. Adjust the display speed.
Click and drag the display speed slider to the desired location.
You can change the display speed from 1 to 20 images per second.
The default is 10 images per second.
4. To manually change the image index, click [Pause] and [Step].
When [Pause] is selected, it changes to [Restart].
The Image index area is used to visualize or adjust what images are being viewed.
You can click and drag the image index slider or click [Step] to go to the next image.
5. To restart the movie loop, click [Restart].
6. Click [Stop].
This stops the movie loop and return to the Movie Definition window.
7. Click [Close].
This returns you to reformat.
Quick Steps: Create and Save a Movie Protocol-Apply the Movie

Prescription
1.
2.
3.
4.
5.
6.
7.
Click [Preview] to see the images you have prescribed (Figure 33-8).
Select Loop.
Adjust the display speed.
To manually change the image index, click [Pause] and [Step].
To restart the movie loop, click [Restart].
Click [Stop].
Click [Close].

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Reformat

When you click Reformat, an oblique, axial, sagittal and Coronal image are displayed in a
4-on-1 format. This section is going to explain the other view types including: curved, profile,
histogram, and X Section.

The curved function is very useful for displaying a reformat of curved or tortuous vessels or
organs. The first thing you need to do is display the anatomy on which you wish to trace in
one of the other viewports.
image set.
2. Select the [Exam/Series/Images] that you want to reformat.
You can select an exam and series, and all the images are included if you do not
select any images.
want to include, then find the last image in the range, and while holding down the
Shift key, select the last image. You could also click on the first image and drag
through the range of images.
To select specific images, you must hold down the Ctrl key on your keyboard as you
select the images with the left mouse.
You have to select at least four images for reformat to work.
4. Select the Curved Reformat Layout preset if available.
The images will load into a curved format.
This changes the viewport to a blue color (Figure 33-10).

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Reformat
Figure 33-10 Curved Reformat Viewport
5. If the curved image does not display then click the red annotation in the upper left
corner of the viewport and select [Curved].
6. Start tracing along the anatomy of interest.
You can trace on an axial, sagittal, or coronal image.
To create a trace, place the mouse cursor at the starting point, press and hold the
Shift key as you deposit points along the anatomy.
As you are tracing, the curved image updates automatically.
You can change the location of the reference images by clicking on the image
number or image location and continuing your trace on the next image.
7. To exit, click [Close].
A pop-up message asks you if you are sure you want to quit.
8. Click [Yes].
This takes you back to the Browser.

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Reformat
Quick Steps: Create Different View Types-Create a Curved View Type

1.
2.
3.
4.
5.

Select the [Exam/Series/Images] that you want to reformat.
Click [Reformat].
Select the Curved Reformat Layout preset if available.
If the curved image does not display then click the red annotation in the upper left
corner of the viewport and select [Curved].
6. Start tracing along the anatomy of interest.
8. Click [Yes].

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Reformat

Profile provides a grayscale graph along a trace. First create a trace on an axial, sagittal,
coronal or oblique view, then select Profile from the view type buttons.
1. From the display monitor click [Image Works].
image set.
You can select an exam and series, all the images are included if you do not select
any images.
want to include then find the last image in the range and while holding the Shift key
down select the last image. You could also click on the first image and drag through
the range of images.
To select specific images you must hold down the Ctrl key on your keyboard as you
You have to select at least four images for reformat to work.
4. Select the Profile Layout preset if available.
5. If the Profile image does not display then click the red annotation in the upper left corner
of the viewport and select [Profile].
6. Trace the anatomy of interest.
Create a trace on an axial, sagittal, coronal, or oblique view.
You now see the Profile view (Figure 33-11). It gives the intensities of the pixels along
the trace that you created. The horizontal axis of the profile view is the position in

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Reformat
millimeters along the trace and the vertical axis is the pixel intensity value as a
function of that position.
You can move your mouse over the Profile View and press Shift. Notice the pixel
intensity reference line on the graph. This line gives you the pixel intensity from the
location of the 3D cursor.
You can also move the line by clicking and dragging the line itself.
The value for the pixel intensity reference line can be seen at the bottom right of the
white line.
At the bottom of the profile view are the pixel statistics of the trace. These values
represent the mean and standard deviation.
8. Click [Yes].
This takes you back to the Browser.
Figure 33-11 Profile View

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Reformat
Quick Steps: Create Different View Types-Create a Profile View Type

1.
2.
3.
4.
5.
From the display monitor click [Image Works].

Click [Reformat].
Select the Profile Layout preset if available.
If the Profile image does not display then click the red annotation in the upper left
corner of the viewport and select [Profile].
6. Trace the anatomy of interest.
8. Click [Yes].

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Reformat

The Volume Histogram View provides a variety of information. This information includes the
ability to display a histogram showing the percentage of occurrence of each voxel intensity
value in an object. It also provides numerical statistics about the voxel intensity value in an
object plus the total object of an object. Also, it automatically determines boundaries
around the class of similar voxel intensities. This function is typically used when you have
3D data. Otherwise, the volume statistics are not valid. Please keep this in mind on the
following descriptions of volume and class volume. Please note that the tolerance for error
in the total volume measurements is directly proportional to the surface area of the object.
image set.
any images.
4. Select the Histogram Layout preset if available.

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Reformat
5. If the histogram image does not display then click the red annotation in the upper left
corner of the viewport and select [Histogram].
The Volume Histogram then appears giving the statistics of the object in primary
focus (Figure 33-12).
The Vertical Axis displays the percentage of occurrence of the pixel values that are on
the horizontal axis. The horizontal axis displays the pixel value range of the object in
the viewport.
The statistics at the bottom of the histogram are referring to the voxel in the primary
view. The statistics in the upper right are referring to the class of voxel in a specific
area of the object defined by the two dotted green lines on the graph. These lines are
referred to as the voxel class boundary lines. The solid white line corresponds to the
intensity of the voxel at the 3D cursor location in the object.
Remember, the voxel reference line references the voxel intensity at the 3D cursor.
The voxel class boundary lines reference the minimum and maximum intensities
around the 3D cursor.
6. If you place the mouse cursor on the voxel reference line and either click and hold the
left key or hold the Shift key, the image displays green enhancement.
This represents the range between the voxel class boundary lines. You can change
the range by clicking and dragging one or both of the boundary lines to display the
desired range. If the voxel reference line is not visible, simply place the mouse cursor
anywhere along the horizontal axis and press the Shift key.
The smoothing value is used to calculate the percentage of occurrence in relation to
the voxel intensity values. The default is 10, which means a range of plus or minus 10
is taken around each voxel intensity point on the horizontal axis. The greater the
smoothing value, the greater the smoothing effect on the histogram curve.
8. Click [Yes].
Figure 33-12 Histogram View

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Reformat
Quick Steps: Create Different View Types-Create a Histogram View

Type
1.
2.
3.
4.
5.

Click [Reformat].
Select the Histogram Layout preset if available.
If the histogram image does not display then click the red annotation in the upper left
corner of the viewport and select [Histogram].
6. If you place the mouse cursor on the voxel reference line and either click and hold the
left key or hold the Shift key, the image displays green enhancement.
8. Click [Yes].

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Reformat

The Cross-section Histogram View provides a variety of information, including the
percentage of occurrence of each pixel intensity value in a user-defined surface area on a
reformatted slice. It also provides numerical statistics about the pixel intensity values in the
same surface area plus the calculation of this area. Also, it automatically determines
boundaries around a class of similar pixel intensity values in these areas. The tolerance for
error in the total area measurement is directly proportional to the perimeter of the object.
1. From the display monitor click, [Image Works].
image set.
any images.
4. Select the X Section Layout preset if available.
If the X Section image does not display then click the red annotation in the upper left
corner of the viewport and select [X Section].

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Reformat
5. Create a closed trace around the area of interest.
To create a trace, place the mouse cursor at the starting point and press and hold the
Shift key as you deposit points along the anatomy.
You need to define at least three points.
Make sure that the view is in primary focus.
The Cross Section View appears.
The vertical axis displays the percentage of occurrence of each pixel intensity value
in the traced area. The horizontal axis displays the intensity values in the traced area.
The statistics at the bottom reference the entire defined area. The pixel class
statistics at the upper right reference a specified area within the defined area.
The pixel class boundary lines (the green dotted lines) represent the minimum and
maximum pixel intensity values that are part of the pixel class statistics.
The pixel reference line (the white line) corresponds to the intensity of the pixel at the
3D cursor location. The numeric value for this line can be seen to the right of the line
just above the horizontal axis. The pixel reference line can be moved by placing the
mouse cursor on the line, then clicking and dragging, or by placing the mouse cursor
on the graph and pressing the Shift key. If you move the 3D cursor on the image, this
moves the pixel reference line also.
The smoothing value is used to calculate the percentage of occurrence in relation to
the pixel intensity values. The default is 10, which means a range of plus or minus 10
is taken around each pixel intensity point on the horizontal axis. The greater the
smoothing value, the greater the smoothing effect on the cross-section curve.
7. Click [Yes].
Figure 33-13 X Section View

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Reformat
Quick Steps: Create Different View Types-Create an X Section View

Type
1.
2.
3.
4.
5.
6.
7.
From the display monitor click, [Image Works].

Click [Reformat].
Select the X Section Layout preset if available.
Create a closed trace around the area of interest.
To exit, click [Close].
Click [Yes].

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Reformat

Multi Projection Volume Reformation can be defined as a thick slab reformatted image. You
can change the rendering mode to Average, Mip or Min IP. You can also change the
thickness of the slab that you want to display. MPVR can be used to see vessels in CTA scans.
1. From the Browser, select the exam, series and images that you want to include in your
model.
3. Select the MPVR Layout preset if available.
If the MPVR image does not display then click the red annotation in the upper right
corner of the viewport and select [3D] or [MIP].
4. Click [Oblique Mode].
5. Select the axial, sagittal, or coronal image and rotate the yellow line by clicking and
dragging it into the desired position.
6. Change the slice thickness in the oblique viewport to the desire thickness.
Place the mouse cursor over the red thickness annotation and type in the desired
thickness and press Enter.
7. Change the rendering mode.
Place the mouse over the red annotation word MIP and while holding down the right
mouse button, select which mode you desire.
MIP is used most often in CTA models to demonstrate all the voxels that have the
most intensity like calcium.
8. To quit, click [Close].
A pop-up window appears, click [Yes].

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Quick Steps: Create Different View Types-Prescribe a Multi Projection

Volume Reformation (MPVR)
1. From the Browser, select the exam, series and images that you want to include in your
model.
3. Select the MPVR Layout preset if available.
4. Click [Oblique Mode].
5. Select the axial, sagittal, or coronal image and rotate the yellow line by clicking and
dragging it into the desired position.
6. Change the slice thickness in the oblique viewport to the desire thickness.
7. Change the rendering mode.
8. To quit, click [Close].

33-68
Appendix A
Accelerator Line Commands

Introduction
The Accelerator Line will allow commands to be typed which can perform certain functions.
The accelerator line appears as a rectangular text box at the bottom of different desktops. A
flashing I- beam cursor will appear when the mouse cursor is placed in this area. Typing
commands can act as a shortcut to opening additional menus to access a function. When a
command is typed, and Enter is selected from the keyboard, that command will be applied
to all viewports in focus. As next and prior images are selected, the command will be applied
to all those images as well.
These commands are listed in two sections. First there is a list for commands that are valid
in Exam Rx. Next, there is a list of commands that are valid in Image Works.
For each command, the command name is listed first, under that is what should be typed
on the Accelerator line, and under that is an explanation, if needed.
Exam Rx
angle
ang
Creates an angle type measurement cursor by explicitly describing the end points of the
lines that make up the cursor.

A-1
annotation custom
ac
Applies custom annotation to the image displayed as defined by Display Preferences
settings.
annotation full
af
Restores full annotation to the image displayed.
annotation groups
agp <on/off> <N> -where N is a group number
With this feature, you can selectively turn off or on specific image annotations on the
screen. The N number corresponds to the annotation in the customize setting for annotation
in User Preferences. For example, to turn off right marker, type agp off 10. You can type more
than one number at a time.
annotation none
an
Removes all annotation from the image displayed.
annotation partial
ap
Applies partial annotation to the image displayed as defined by Display Preferences
dialogue box on Exam Rx screen.
blank viewport
blank
Removes image from the selected viewport, similar to a user text page.
cross reference
xr <series number> <image set>: <interval>
series number: an appropriate series number to be cross referenced.

A-2
image set: a consecutive group of image numbers within the series.

interval: the interval of images to be filmed: 2 equals every other image, 3 equals
every third image, etc.
(i.e. xr s2 1-40:3)
Display cross referenced scan plane lines on a scout image. This command allows explicit
description of lines to be posted and their interval. The above examples will post every third
slice line between images one and forty in series two, beginning with image one.
cross reference append

xra <series number> <image set>: <interval>
Used to add additional cross referenced groups or series to a scout which already has a
cross reference on it.

interval: the interval of scan plane lines to be displayed: 2 equals every other
image, 3 equals every third image, etc.
cross references off

noxr
Removes cross reference lines from the image display.
display normal or normal

no
Restores the image display to normal orientation and zoom.
distance
dist
A measure distance line will appear on the screen.
ellipse
el
Creates an ellipse type measurement cursor.

A-3
elliptical image matte

ematte
Displays an elliptical black matte or mask around the image. Size is adjustable with the
mouse by a left click and drag on the blue crosshair. Position is adjustable by a click and
drag on the edge of the matte.
erase all graphics

eag
Removes all graphics from the selected image.
erase graphics
eg
Removes selected graphics from the selected image.
exam
e <examination number>
examination number: the desired exam number as indicated on the system

disk.
(i.e. e 4578)
Displays the first image of the specified exam (4578) in the selected viewport.
exam series image

e <exam number> s <series number> i <image number>
<exam number> <series number> <image number>
exam, series and image numbers: As per system disk image numbering system.
(i.e. e 34 s2 i47
or 34 2 47)
Displays the image explicitly requested in the selected viewport. The first example displays
exam 34, series 2, image 47 in the selected viewport. The display command may be entered
without typing the e s i characters. By entering the numeric data, separated by spaces, in
the specified order, the image specified will display in the selected viewport. In the second
syntax example above, the same image will be displayed as in the first example.

A-4
film annotation custom

fac
Applies custom annotation to the images filmed as defined by Display Preferences dialogue
box on Exam Rx screen.
film annotation full

faf
Restores full annotation to the images being filmed.
film annotation groups

fagp <on/off> <N> -where N is a group number
With this feature, you can selectively turn off or on specific image annotations for filming.
The N number corresponds to the annotation in the customize setting for annotation in User
Preferences. For example, to turn off right marker, type agp off 10. You can type more than
one number at a time.
film annotation none

fan
Removes all annotation from the images being filmed.
film annotation partial

fap
Applies partial annotation to the images being filmed as defined by Display Preferences
filter
fi <filter name>
filter names: e1; e2; e21; e22; e23; e3; lung; (for edge enhancement) s1; s11;
s2; s21; s3; (for smoothing filters) and off.

A-5
(i.e. fi e1, fi e2, fi e3, fi lung, fi s1, fi s2, fi s3, fi off)

Apply/remove edge enhancement and smoothing filters on selected image(s). Edge
enhancement filter names are, from least sharpening to most: e1, e2, e3, lung; smoothing
filters are named s1, s2, s3. Entering the command fi e1 applies the least image
sharpening,; entering fi lung applies the most.
flip left right

flr
Flips the image horizontally.
flip top bottom

ftb
Flips the image vertically.
gray scale enhancement

gse <filter name>
filter names: g1; g2; g3; off

(i.e. gse g1, gse g2, gse g3, gse off)
Gray scale enhancement increases the apparent contrast of the image without changing
the window/ level settings. Useful for enhancing low contrast structures.
grid
grid <on> or <off>
(i.e. grid on, grid off)
Displays or removes a ruled grid on the image.
hide graphics
hg
Hides all graphics on the selected image. The undo function is show graphics.

A-6
image
i <image number>
image number: the desired image number from within the displayed series.
(i.e. i 27 or 27)
Displays the specified image (27) of the current series in the selected viewport.
invert video
inv
Reverses the blacks and whites on the image.
mouse mode roam

mmr
Turns the right mouse button drag action into scrolling (pan, roam) of the image.
mouse mode zoom

mmz
Turns the right mouse button drag action into zooming (magnification) of the image.
next exam
ne
Displays the first image of the next exam in the selected viewport, next determined by the
sort function applied to the List Select browser.
next series
ns
Displays the first image of the next series from the displayed exam in the selected viewport.
previous exam
pe
Displays the first image of the previous exam in the selected viewport, previous determined
by the sort function applied to the List Select browser.

A-7
previous series
ps
Displays first image of the previous series of the displayed exam in the selected viewport.
print series
prs
Opens the print series dialogue box for the selected viewport, which is in turn satisfied by
mouse commands. By specifying options in the print series box, a sequence of images may
be sent automatically to the printer, or current print jobs may be cancelled by the operator.
Desired image parameters must be set before calling the print series command - zoom,
window level, annotations etc. cannot be altered after the print series dialogue box is
opened.
propagate
prop <range>
range: a= all images in series; s = series; i = image range (1-15)

(i.e prop a
or prop i 1-15)
Displays selected graphics on the specified images. The i is lower case sensitive. In the first
example, the graphic will display on all images called into the viewport until cleared by
another command (such as erase graphics) or a different series is displayed in the viewport.
In the second example the graphic will be applied only to images 1 through 15 in the current
series.
rectangular image matte

rmatte
Displays a rectangular black matte or mask around the image. Size is adjustable with the
mouse by a left click and drag on the blue crosshair. Position is adjustable by a left click and
rectangle
rect
Creates an rectangle type measurement cursor. Used for ROI.

A-8
report pixel
rp
Opens a Report Pixels dialogue box, and displays an ROI box cursor on the image that is
positioned on the area of interest by a left click and drag of the mouse. Size is not adjustable.
Once in position, clicking OK in the dialogue box creates a pixel report consisting of density
values for individual pixels within the area delineated by the box cursor.
rotate left
rl
Rotates the image ninety degrees counter-clockwise.
rotate right
rr
Rotates the image ninety degrees clockwise.
screen save
scnsave
Captures the selected image exactly as it is displayed, and creates a new image with a
series number of 99 on the system disk that includes all graphics and display factors applied
to the image and/or viewport at the time of capture.
series
s <series number>
series number: the desired series number from within the displayed exam.
(i.e. s 2)
Displays the first image of the specified series (2) of the current exam in the
selected viewport.

A-9
series binding
sb <on> <off>
Turns series binding on or off. With series binding on, the next image is defined as the next
image in the entire exam; at the end of any particular series, the next image is the first
image of the next series. At the end of the exam, a next command will loop back to the first
image of the exam. With series binding off, at the end of a particular series, a next
command will loop back to the first image of the current series.
set initial windowing

siw
Applies default window width and level setting to the display.
show graphics
sg
Shows, or re-displays all graphics on the selected image which were hidden with the hide
graphics command.
text page exam

te
Displays text page for the exam in the primary viewport.
text page region of interest

tpr
Displays a text page for the image in the primary viewport which lists all the ROI cursors and
their statistics.
text page series

ts
Displays text page for the exam/series in the primary viewport.

A-10
tick marks
tm <on> or <off>
(i.e. tm on, tm off)
Displays or removes both horizontal and vertical tick marks (rulers) along the border of the
image.
tick marks horizontal

tmh <on> or <off>
(i.e. tmh on, tmh off)
Displays or removes horizontal tick marks (rulers) only, along the border of the image.
tick marks vertical

tmv <on> or <off>
(i.e. tmv on, tmv off)
Displays or removes vertical tick marks (rulers) only along the border of the image.
user annotation
ua
Displays specified text in a user annotation text box on the image.
user text page

utp
Removes image from the selected viewport, creating a blank viewport for user annotation
or graphics.
window level
wl <desired level>
(i.e. wl 65)
Applies specified window level setting to the display.

A-11
window width
ww <desired width>
(i.e. ww 350)
Applies specified window width setting to the display.
zoom
zo <factor>
factor: magnification factor

(i.e. zo 1.5)
Magnifies the image by the factor specified. In the above example the image is displayed
one and one half times as large as its display normal size, or 150% larger in appearance.

A-12
Image Works
angle
ang
Creates an angle type measurement cursor by explicitly describing the end points of the
lines that make up the cursor.
annotation custom
ac
Applies custom annotation to the image displayed as defined by Display Preferences
dialogue
annotation full
af
Restores full annotation to the image displayed.
annotation groups
agp <on/off> <N> -where N is a group number
With this feature, you can selectively turn off or on specific image annotations on the
screen. The N number corresponds to the annotation in the customize setting for annotation
in User Preferences. For example, to turn off right marker, type agp off 10. You can type more
than one number at a time.
annotation none
an
Removes all annotation from the image displayed.
annotation partial
ap
Applies partial annotation to the image displayed as defined by Display Preferences

A-13
arrow
arrow <on> or <off>
(i.e. arrow on)
Displays or removes an arrow cursor from a text annotation box for user annotation.
cross reference
xr <series number> <image set>: <interval>

interval: the interval of images to be filmed: 2 equals every other image, 3 equals
every third image, etc.
(i.e. xr s2 1-40:3)
Display cross referenced scan plane lines on a scout image. This command allows explicit
description of lines to be posted and their interval. The above examples will post every third
slice line between images one and forty in series two, beginning with image one.
cross reference append

xra <series number> <image set>: <interval>
Used to add additional cross referenced groups or series to a scout which already has a
cross reference on it.

interval: the interval of scan plane lines to be displayed: 2 equals every other
image, 3 equals every third image, etc.
cross references off

noxr
Removes cross reference lines from the image display.
display normal or normal

no
Restores the image display to display normal mode: removes all zoom, filter, pan,
annotations etc. applied to the viewport. Displays the image from the disk as created.

A-14
distance
dist
A measure distance line will appear on the screen.
ellipse
el
Creates an ellipse type measurement cursor.
elliptical image matte

ematte
Displays an elliptical black matte or mask around the image. Size is adjustable with the
erase all graphics

eag
Removes all graphics from the selected image.
erase graphics
eg
Removes selected graphics from the selected image.
exam
e <examination number>
examination number: the desired exam number as indicated on the system disk.
(i.e. e 4578)
Displays the first image of the specified exam (4578) in the selected viewport.
exam series image

e <exam number> s <series number> i <image number>
<exam number> <series number> <image number>

A-15
exam, series and image numbers: As per system disk image numbering system.
(i.e. e 34 s2 i47
or 34 2 47)
Displays the image explicitly requested in the selected viewport. The first example displays
exam 34, series 2, image 47 in the selected viewport. The display command may be entered
without typing the e s i characters. By entering the numeric data, separated by spaces, in
the specified order, the image specified will display in the selected viewport. In the second
syntax example above, the same image will be displayed as in the first example.
film annotation custom

fac
Applies custom annotation to the images filmed as defined by Display Preferences dialogue
box on Exam Rx screen.
film annotation full

faf
Restores full annotation to the images being filmed.
film annotation groups

fagp <on/off> <N> -where N is a group number
With this feature, you can selectively turn off or on specific image annotations for filming.
The N number corresponds to the annotation in the customize setting for annotation in User
Preferences. For example, to turn off right marker, type agp off 10. You can type more than
one number at a time.
film annotation none

fan
Removes all annotation from the images being filmed.
film annotation partial

fap
Applies partial annotation to the images being filmed as defined by Display Preferences

A-16
filter
fi <filter name>
filter names: e1; e2; e3; lung; (for edge enhancement) s1; s2; s3; (for smoothing filters) and off.
(i.e. fi e1, fi e2, fi e3, fi lung, fi s1, fi s2, fi s3, fi off)
Apply/remove edge enhancement and smoothing filters on selected image(s). Edge
enhancement filter names are, from least sharpening to most: e1, e2, e3, lung; smoothing
filters are named s1, s2, s3. Entering the command fi e1 applies the least image
sharpening,; entering fi lung applies the most.
flip left right

flr
Flips the image horizontally.
flip top bottom

ftb
Flips the image vertically.
format
fo <rows>< columns>
rows, columns: rows across and columns down the display screen.
(i.e. fo 4 3)
Format the display screen as specified by rows and columns. The above example displays
images across the screen in 4 rows and 3 columns, or common twelve-on-one.
freehand
freehand
Displays a small solid blue box that can be used to draw a freehand trace for an ROI. You
must click and drag the box to where you would like to start the trace. Then select the blue
box while holding Shift on the keyboard and move the mouse cursor around the screen to
draw the trace.

A-17
gray scale enhancement

gse <filter name>
filter names: g1; g2; g3; off

(i.e. gse g1, gse g2, gse g3, gse off)
Gray scale enhancement increases the apparent contrast of the image without changing
the window/ level settings. Useful for enhancing low contrast structures.
grid
grid <on> or <off>
(i.e. grid on, grid off)
Displays or removes a ruled grid on the image.
hide graphics
hg
Hides graphics on the selected image. The undo function is show graphics.
image
i <image number>
image number: the desired image number from within the displayed series.
(i.e. i 27 or 27)
Displays the specified image (27) of the current series in the selected viewport.
invert video
inv
Reverses the black and white on the image.
mouse mode magglass

mmg
Turns the right mouse button drag action into zooming (magnification) of the image.

A-18
mouse mode roam

mmr
Turns the right mouse button drag action into scrolling (pan, roam) of the image.
next exam
ne
Displays the first image of the next exam in the selected viewport, next determined by the
sort function applied to the List Select browser.
next series
ns
Displays the first image of the next series from the displayed exam in the selected viewport.
paging
pa [<start> <end>] [<rate>]
Activates cine paging. For the start and end values, enter the first and last images you want
to page thru. For rate, enter the number of images per second to page through, with the
maximum being 60.
paging interval
pi <interval>
Allows you to set the interval for paging. The pa command must be used prior to setting
paging interval.
paging interval all

pia <interval>
Allows you to set the interval for paging. The pa command must be used prior to setting
paging interval.

A-19
paging mode
pm <spatial/temporal>
Allows you to change the mode for paging. Selecting temporal will display the imagesin a
loop mode. Spatial will display images in a back and forth mode.
previous exam
pe
Displays the first image of the previous exam in the selected viewport, previous determined
by the sort function applied to the List Select browser.
previous series
ps
Displays first image of the previous series of the displayed exam in the selected viewport.
print page
pp
Sends the entire current display screen to the film composer and sets the film composer
format to that of the current display format.
print series
prs
Opens the print series dialogue box for the selected viewport, which is in turn satisfied by
mouse commands. By specifying options in the print series box, a sequence of images may
be sent automatically to the printer, or current print jobs may be cancelled by the operator.
Desired image parameters must be set before calling the print series command - zoom,
window level, annotations etc. cannot be altered after the print series dialogue box is
opened.
propagate
prop <range>
range: a= all images in series; s = series; i = image range (1-15)

(i.e prop a

A-20
or prop i 1-15)
Displays selected graphics on the specified images. The i is lower case sensitive. In the first
example, the graphic will display on all images called into the viewport until cleared by
another command (such as erase graphics) or a different series is displayed in the viewport.
In the second example the graphic will be applied only to images 1 through 15 in the current
series.
quit
quit
Close the Viewer application and return to the Image Works browser.
rectangular image matte

rmatte
Displays a rectangular black matte or mask around the image. Size is adjustable with the
rectangle
rect
Creates an rectangle type measurement cursor. Used for ROI.
reference image
ri
Puts a reference image on the selected image.
reference image all

ria
Puts a reference image on all images.
reference image all off

noria
Takes reference image OFF all images

A-21
reference image off

nori
Takes reference image OFF of selected image.
report cursor
rc
Displays (reports) current mouse cursor location in pixel coordinates, and a single pixel ROI
reading.
report pixel
rp
Opens a Report Pixels dialogue box, and displays an ROI box cursor on the image that is
positioned on the area of interest by a left click and drag of the mouse. Size is not adjustable.
Once in position, clicking OK in the dialogue box creates a pixel report consisting of density
values for individual pixels within the area delineated by the box cursor.
reset
rs
Reset image to initial display parameters.
rotate left
rl
Rotates the image ninety degrees counter-clockwise.
rotate right
rr
Rotates the image ninety degrees clockwise.
save state
ss [<first image> <last image>]
Saves the image orientation, w/l values, graphics, and filter and gse values of a range of
images that you can set. Typing ss by itself will save settings for the entire series.

A-22
A Gray Scale Presentation State Object is also created and saved to the Data base.
Filters and GSE are not saved to the GSPS object.
screen save
scnsave
Captures the selected image exactly as it is displayed, and creates a new image with series
number of 99 on the system disk that includes all graphics and display factors applied to the
image and/or viewport at the time of capture.
series
s <series number>
series number: the desired series number from within the displayed exam.
(i.e. s 2)
Displays the first image of the specified series (2) of the current exam in the selected
viewport.
series binding
sb <on> <off>
Turns series binding on or off. With series binding on, the next image is defined as the next
image in the entire exam; at the end of any particular series, the next image is the first
image of the next series. At the end of the exam, a next command will loop back to the first
image of the exam. With series binding off, at the end of a particular series, a next
command will loop back to the first image of the current series.
set initial windowing

siw
Applies default window width and level setting to the display.
show graphics
sg
Shows, or re-displays graphics on the selected image which were hidden with the hide
graphics command.

A-23
spline
spline
Deposits a small open blue box for creating a trace. Deposit blue box where you want the
trace to start. Then hold down the Shift key on the keyboard and click with the left mouse to
deposit points. All the points will connect to create a trace.
text page exam

te
Displays text page for the exam in the primary viewport.
text page region of interest

tpr
Displays a text page for the image in the primary viewport which lists all the ROI cursors and
their statistics.
text page series

ts
Displays text page for the exam/series in the primary viewport.
tick marks
tm <on> or <off>
(i.e. tm on, tm off)
Displays or removes both horizontal and vertical tick marks (rulers) along the border of the
image.
tick marks horizontal

tmh <on> or <off>
(i.e. tmh on, tmh off)
Displays or removes horizontal tick marks (rulers) only, along the border of the image.

A-24
tick marks vertical

tmv <on> or <off>
(i.e. tmv on, tmv off)
Displays or removes vertical tick marks (rulers) only along the border of the image.
user annotation
ua
Displays a user annotation text box. Place mouse cursor over the box and type desired
annotation.
user preferences
up
Brings up the user preferences pop up window.
user text page

utp
Removes image from the selected viewport, creating a blank viewport for user annotation
or graphics.
window level
wl <desired level>
(i.e. wl 65)
Applies specified window level setting to the display.
window width
ww <desired width>
(i.e. ww 350)
Applies specified window width setting to the display.

A-25
zoom
zo <factor>
factor: magnification factor

(i.e. zo 1.5)
Magnifies the image by the factor specified. In the above example the image is displayed
one and one half times as large as its display normal size, or 150% larger in appearance.

A-26
Appendix B
Legacy Precautions
System
Run Shutdown and Restart daily.
The system may fail to start if system disk space needs to be recovered from unused
system files.
The following message will be posted in the Disk Management shell window:
The purpose of storelog is to recover system disk space by archiving and then removing core,
log, and data files that have been saved for their system troubleshooting diagnostic value.
Now they may be taking up too much space for the system to run properly. Removing these
system log files does not add image space, but should allow the application to start.
You are then directed to answer the following questions (be patient for the messages
to display):
Place the mouse cursor inside the black Disk Management window
1. Do you want to save system log files to removable media?
Type n and press the enter key
2. Do you want to remove the system log files?
Type y and press the enter key.

B-1
You will then see a message Please be patient, the system is now removing unwanted files.
The system then starts normally.
If the system fails to startup completely, select [Unix Shell] from the tool chest menu
in the upper right of the Scan Monitor place your cursor in the blue shell and type st.
If mouse selections fail, press the Escape key to clear backlogged requests.
The system may not show typed information on the New Patient or Viewedit screen.
The system will update after a short time.
The system may be slow to respond to keyboard entry and mouse clicks. If the
system fails to respond stop and let the events catch up.
The dynaplan screen may fail to update if Priority Recon is selected during scanning.
If you can no longer type in a field, move the cursor to the field and try clicking the
middle mouse to restore functionality. If this does not work, then a system shutdown
will be required.
The cursor may not move between the left and right screen. Wait a few seconds
without moving the cursor and try again.
Pressing the Space Bar after selecting all fields in New Patient, locks the patient
information fields and all the patient information fields become insensitive. Only the
delete and backspace key will be active.
Press the delete key to recover from this situation.
Entering \ and pressing the Enter key in the New Patient can cause the fields to
become insensitive.
Under heavy system operation, the message Unable to install image in the database
may be seen. Recon for the series will take longer due to unsuccessful install of
images to the database.
To install a SMPTE pattern, BRH or Quality assurance images for viewing, select the
following. Once installed the images will be available for viewing from the Image Works
browser or List Select in Exam RX. Both will be listed as Exam 1000, the patient name will
reflect if it is a QA image or a SMPTE pattern.
1. Click Service Desktop.
2. Click [Diagnostics].
3. Click [Display Processing].
4. Select [Install SMPTE Image].
In general, wait for a screen transition to take place before making another selection.
If the console becomes unresponsive for 2 minutes or more, shutdown the system
using the pink shutdown button and restart the system. If you cannot select the pink

B-2
shutdown button, turn off the console power switch, wait 10 seconds, then turn the
console power switch back on. The system should come up normally.
The system will lock up if the mouse becomes hung on the left monitor. The only
known recovery is to cycle power to the console.
You may see a pink warning dialog posted indicating the system has low disk space.
This is due to a partition on the system disk getting too full. This can be caused by
archive, network or film queues containing too many entries. Make sure that the
entries are processed. If the queue is paused, resume it or delete entries as needed.
Protocol Management may not be selectable. Check that retro recon is selectable. If it
is not then the system will need to be rebooted.
Pop-up screens and menus may appear on the wrong monitor or may be displayed
split between the two monitors.
Windows such as the Film Composer that normally are restrained to the right or left
monitor can be dragged to the other monitor. Be careful not to get a Film Composer
hidden behind some screen if you move it to the other monitor.
If a blank viewport is seen where image annotation is displayed and W/L is
interactive but no image is seen, shutdown the system, recycle power and reboot the
system to clear this display issue.
If corrupted images are seen after applying an image filter such as enhance, smooth,
lung or gray scale, try rebooting the system and see if the image can be displayed
correctly. If not contact your GE service representative.
Tube Warm Up/Fast Cal

Run Tube Warm up after 2 hours of non-use. It is best to warm the tube as close as
possible to the time the next patient will be scanned. Dont warm the x-ray tube and
then wait 30 minutes without scanning.
Always check that the beam is clear when doing Fast Cal. In Fast Cal, the system
checks cleanliness of the Mylar Window. If the system suspects the Mylar Window
may be dirty to the point that it may cause a beam obstruction, a pop-up message
will be displayed. The operator will be instructed to clean the Mylar Window and
select [Retry].
Fast Cal must be run once every 24 hours.
Complete all portions of Fast Cal, Warm Up I, Warm Up 2, Gen Cal, Clever Gain, and
Fast Cal. This assures that the Air calibration and generator calibrations are up to
date on the system. Scan aborts may occur during Axial or Helical scanning. Always
be aware of the scan progress during an Exam and select Resume as soon as it is
posted to continue.

B-3
Tube Warmup and Fast Cal BrightSpeed based systems

Gantry balance may fail to update if Fast Cal is exited without taking a scan.
Complete Fast Cal scans before quitting out of the Daily Prep menu.
The pause button on the Tube warmup screen does not function. Use the stop scan
button on the SCIM.
Scan
Scan aborts may occur during Axial or Helical scanning. Always be aware of the scan
progress during an Exam and select Resume as soon as it is posted to continue.
Scan may fail to confirm posting a message that not enough image space exists,
even though the image space shown in the Feature Status Area indicates there is
enough space. This is due to the fact that images are stored on the system disk in
more than one partition. Remove consecutive exams to free up image space for
confirm to proceed.
The system does not verify that the Pediatric protocol number typed in the Protocol
number field matches the Patient weight entered on New Patient. When typing in the
protocol number always verify that you are entering the correct protocol for the
weight category desired.
If Direct3D or VariViewer are enabled in DirectVIS under the Recon tab, Add Group will
display some fields as insensitive as it will be combined with the current Direct3D or
VariViewer session. Turn Direct3D or VariViewer off for the added group if you no
longer wanted it to be included as part of the Direct3D or VariViewer session. This will
allow changes to any of the acquisition parameters.
Auto mA should not be used with Gating and Cine acquisitions even though it can be
selected. This includes scans that are done for Cardiac Scoring using Cine Segment.
The gating button may turn red when the patient experiences a big jump in heart
rate such as in a PVC. The system usually will recover and read the signal. Sometimes
you may have to toggle the gating button Off/On to get the heart rate signal synched
again. Care should be taken in starting the scan if the patient continues to have
PVCs.
When using the IVY monitor the heart rate posted may jump to over 200 after
confirming a scan and moving the table into the gantry. This may be caused by the
cables from the ECG monitor touching the gantry cover.
Always try to position cables for the ECG monitor away from the gantry.
To terminate an Insite connection on your system. Select [New Patient] a message
will be posted informing you that the scan hardware resource is not available. Wait 3
minutes and select [New Patient] again to begin scanning
In general, if a scan fails and a [Resume] is posted, click [Resume] to continue. Try
[Resume] again if the first [Resume] fails. If a failure still occurs, reset the scanning

B-4
hardware through System Resets in the Service desktop. If scan still fails to restart,
shutdown and Restart the system.
Auto Voice may fail to function, especially during system simultaneity. Make sure that
you can hear the Auto Voice to recognize if Auto Voice has quit, manually breathe the
patient when this occurs.
The Show Localizer scout image may fail to display or images may fail to recon and
may become suspended if scanning is started while remove images is in progress. To
avoid this dont remove images while an exam is in progress or scanning is active.
Remove images when the system is idle.
The Dynaplan screen may report incorrect status (i.e. a scan is removed before it is
actually scanned) when stop scan is selected. The screen will reset correctly after
Resume or back to view edit is selected.
Scan groups will not be contiguous if you switch from 2 or more Helical scan groups
column or row edit and the scan type is changed to Axial. If this change is made, then
verify the Start and End locations of each of your scan groups and adjust if needed.
The Cine time between images may change when other parameters are modified
within a protocol. Check the Cine time between images prior to confirming the scan
to verify it is the value you wish.
Tilt handles will not be visible on the screen if the DFOV is larger than 48. Use a DFOV
smaller than 48 to assure that the tilt handles are visible.
Show Localizer may fail to display the scout image if the Next Series is selected
before the scout images are reconstructed. Wait until the scout images are
reconstructed before selecting Next Series. If Next Series has already been selected,
toggle Show Localizer off and then on again.
Quickly changing desktops when Show Localizer has been selected for the next
series can cause a partial display of the scout in the Graphic Rx window to occur.
If Page Up or Page Down fails to change the displayed Show Localizer.
Try the following in order:
1.Turn Show Localizer button off then on.
2.Move the cursor off the image window and back on to the image to refresh
the screen if both of these fail then verify that you have a valid scout for
Show Localizer.
If an R, L or A, P value is more than half of the Display Field of View in mm. The image
annotation will not annotate R and L or A and P on the images. For example if the
DFOV is 10cm and the R value is 56mm then the image annotation will show R R. Use
a R-L or A-P value which is less than half of the DFOV in mm to avoid this.
A protocol may fail to display. The following message will be posted to the message
line on the lower center of the scan monitor Cant read selected protocol, please

B-5
choose another protocol. If this occurs the protocol is corrupt and will need to be
rebuilt. Delete the protocol and rebuild it.
The patient history field may be missing the last 9 characters when all 60 characters
have been entered and the patient record is either selected as a completed exam or
the Patient ID is entered and the system matches a completed exam.
Even weights entered in Patient Schedule may be rounded up to the next odd pound.
This occurs because weights are stored as kilogram units then converted back to
pounds.
During the acquisition of large data sets (1000-1500), there may be Auto film and
reconstruction performance issues. If either stops, check the queues and restart to
continue.
When selecting the Auto Voice field, the selected Auto Voice will be deselected. You
must reselect the desired Auto Voice message before exiting the Auto Voice screen.
When entering birth dates on the New Patient or Schedule Patient screens the
following rules apply:
2 digit years can only be entered if the birth year is in the current century for the
21st century - for the year 2000 forward.
Birth dates from any other century must be entered as 4 digits for example for the
year 1899 1999 all four digits must be entered.
Birth dates can only be entered for 150 years (Current year minus 150 years).
If InSite is running the Remote Safety test, New Patient will not open. New Patient
can be made available by either:
1.Calling InSite and request they abort the test.
2.Going to the Service Desktop and selecting |CleanUp| option to cancel the
test in progress.
PMR images may fail to recon if disk space is low. To recon the images, remove
images and restart the recon queue in Recon Management.
You may get the message Duplicate Scan Key, if a Scout Scan is aborted within the
first 20 to 75 mm of table travel or if a the prescribed length of the Scout is less than
75 mm. In order to proceed, an End Exam must be done and new exam started.
It may be possible to prescribe a recon range that is outside the recon 1 boundary.
This may occur is the start location is dragged below the recon end location in recon
2 or 3.
If a large number of scan files are reserved and there is a large recon queue, you may
see the message: Duplicate Scan Key unable to allocate scan file. There will be a

B-6
Resume at Start Scan. Either wait a few minutes for the recon queue to decrease or
release some of the reserved scan files.
Bands and lines may be seen in scout images if there is a tube spit or the reference
channel is blocked during the acquisition of a scout scan.
A zero interval axial series, if paused, will add another group equal to the remaining
number of images. Make sure to return to the View/Edit screen to delete this group to
avoid acquiring additional images.
Biopsy is not valid for a Thin Twin helical acquisition mode. If Biopsy is selected, the
Biopsy window does not open; however a group is added to the series at an
inadvertent location. Do not select Biopsy mode with Thin Twin helical scan mode.
If the message Can not read Cal Database, select [End Exam] and re-enter patient
information.
The table will take 10 mm to stop if the table is running at 100 mm/sec. when a patient
weighing 450 lbs is on the table.
Patient Schedule
Close the preferences screen before switching between Patient Schedule and New
Patient.
The Patient Name, Patient ID, Accession Number and Requested Procedure ID can
only be edited if Allow to Edit MWL is set to yes in the Preference window.
The Patient Schedule button may not display the Work List from the HIS/RIS server if
the network is slow. Try again.
ConnectPro (Purchased Option)

Bar Codes will fail to be read by the Bar Code reader if the HIS/RIS system the bar
code was created on has a different language keyboard than the CT system. For
example, if your CT system has a French language keyboard then your HIS/RIS must
have a French language keyboard. If it is not possible to have the same language
keyboard on each system, then manually enter the Accession or Patient ID number
or select the desired patient from the Patient Schedule list to display the patient
information on the New Patient screen.
Patients selected from Modality Work List will be displayed with ^ (carets) to define
different DICOM fields. The carets are not displayed on the images.

B-7
Performed Procedure Step (part of connect pro option)

PPS will post the message Failed to Start if the remote server is down.
Screen Save images created in ExamRx or in the Viewer on the Image Works desktop
are not PPS aware in this release of software. Also, images created in Reformat, 3D,
and Navigator are not PPS aware. For these image types, INPR will be posted in the
PPS column in the Browser even though PPS is not enabled.
Complete PPS status for series in the order the series were created. PPS update will
fail if done in a different order.
The PPS server may stop and fail to send the request. You may have to select
Complete multiple times to get the series to update to the complete state.
Add Sub does not update images for PPS correctly
Protocol Management
Protocols, which contained a SmartStep series, cannot be selected or copied from
the Most Recent selector.
There is no default protocol for Pediatric areas Neck, Upper Extremity, Chest,
Abdomen, Spine, Pelvis, and Lower Extremity.
If the weight of a child is at the cross over point of a weight category, due to rounding
errors the correct weight category might not be selected. Please check the weight
based category selected against the label and the patients weight.
Reconstruction
If images fail to recon the following should be used in order:
Select [Recon Management], [Unsuspend Queue].
If the image still fails to recon
Select [Recon Management], [Restart Queue]
If this still fails Shutdown and reboot the system.
Lung Algorithm
Provides edge enhancement between structures with large density differences, such
as calcium and air.
Enhances the contrast of small objects. For best viewing and film quality, select a
window width of 1000 to 1500 and a window level of -500 to -600.
Increases CT number values at the edge of high contrast objects. When planning to
take CT number measurements of vessels or nodules in the lung, please check and

B-8
compare your results with Standard algorithm images. (ROI and Histogram functions
use CT numbers.)
The edge enhancement provided by Lung Algorithm may not be appropriate in some
clinical cases. Please take individual viewing preferences into account when you
choose Lung algorithm.
Image recon may fail and then shutdown.
If images fail to recon the following should be used in order:
Select [Recon Management], [Unsuspend Queue].
If the image still fails to recon
Select [Recon Management], [Restart Queue].
If this still fails Shutdown and reboot the system.
The dynaplan screen may fail to update if Priority Recon is selected during scanning
Retro recon may not be able to get the same image locations as prospective recon.
This is due to rounding in the start and end location. To avoid this mismatch prescribe
start and end locations that are even numbers.
Retro recon may show more images when using PMR than that recond during
prospective recon if Recon 2 or 3 with a slice thickness greater than Recon 1 is used.
This is due to the extra data acquired for recon of the thicker slices.
Retro recon list service exams from Fast Cal. Do not attempt to recon this data, the
SRU will shut down. These exams are listed with exams numbers that begin with
50,000.
SmartStep series are listed in Retro Recon but cannot be selected.
3000 Image Series

Display
Paging and image review with next prior may slow when reviewing large series.

B-9
Archive
An image series of 3,000 images can only fit on one side of a 2.3 gb MOD.
Auto Store will not save the exam if the media size attached is 1.2 gb.
If a 1.2 gb media is used for image archive and the image series is greater than 1,500
images archive will need to be queued by image. Select a range of images 1,500 or
less when archiving to 1.2 gb media.
If greater than 2,000 images are queued to save by image you may see the browser
disappear and reappear. While this is occurring it will be impossible to access the
browser. To avoid this queue less images at a time when saving by image.
Images may fail to save if saving large groups of images. Verify that all desired
images are saved before deleting them from the system disk.
Network
The network queue list will be slow to access. This is typically seen when 200 or more entries
exist.
DentaScan/Add/Subtract
These applications can only load 1,000 images. Hi-light the desired image range of 1,000
images by selecting the first image desired, hold the shift key down and hi-light the last
image desired then select the desired range.
Retro Recon
Two decimal points cannot be entered, i.e. 3.75 for image interval if column edit is
used. Edit each scan group (row) if an interval with 2 decimals is required.
If a 1 rotation 4i or 2i axial scan is prescribed using add group in ViewEdit with a
Superior to Inferior scan direction is retro reconned, the resulting images will be

B-10
reconned Inferior to Superior. The image locations are correct, but the image
numbers will not match the prospective images.
If you delete queued Retro images the image space reserved for those retro recons is
not given back. You will not get the space back until you reboot the system.
Only start Retro Recon when scanning is complete. Do not delete queued retros while
scanning is active, scanning could stop.
If maximum A-P or R-L offset is selected in Retro Recon, one image may fail to
reconstruct. Select an offset that is 0.5mm less than the maximum value allowed.
The start/end locations of a retro reconstruction may be different from Recon 1 and 2
and 3 when a PMR with a thicker slice than Recon 1 is prescribed for the series.
Retro Recon may hang and core. If the Retro recon screen fails to display or queue
retrospective images, retro recon has cored. Reboot the system to recover.
If an R, L or A, P value is more than half of the Display Field of View in mm. The image
annotation will not annotate R and L or A and P on the images. For example if the
DFOV is 10cm and the R value is 56 mm then the image annotation will show R R. Use
a R-L or A-P value which is less than half of the DFOV in mm to avoid this.
It may be possible to confirm a retro recon prescription with an invalid recon start
and end location that results in a recon suspend. To avoid this change image
thickness before changing image locations.
Recon Management
Scout queue entries can be selected in Delete Retro queue entries. Only select Scout
queue entries to delete if you are sure you do not need the scout image
reconstructed.
Before saving or restoring scan data make sure the system is idle and no Archive,
Network or Filming is active. No other features should be accessed until the save or
restore is complete.
Recon Management may hang while trying to display the menu. Finish the current
exam if scanning and shutdown and restart the system to correct the problem.
If you wish to cancel a Save or Restore scan data, the cancel button will cancel only
after the current scan file is saved or restored. A helical scan file contains a large
amount of data even though it is one scan file, that file can take up to 30 minutes or
more to save. You are unable to scan patients while saving or restoring Scan Data.
Make sure that you have ample time to complete the save or restore before
beginning.
Scan data save or restore is active when the dialog message indicating saving or
restoring scan file is displayed.
If saving scan data, after the save is complete select Restore Scan Files to verify the
data is stored.

B-11
Volume Viewer (Option)

Volume Viewer may not display on the ExamRx desktop. This will occur if you switch
back to the ExamRx desktop quickly after launching Volume Viewer
Volume Viewer may get hung up. This occurs due to a error dialog that is hidden. To
avoid this dont switch desktops until you start to see the model build in Volume
Viewer.
A 3D model may be missing data when it is initially displayed. Slightly rotate the
model to re-display all of the 3D data.
CT Perfusion 2, 3 or Neuro on OC Purchased Option

Saving TIFF files of the graph and images is not supported because there is no floppy
drive hardware available on the OC.
The CT Perfusion Control Panel may be displayed on the current desktop if CT
Perfusion is launched from the Browser and the desktop is changed before CT
Perfusion screens are completely displayed.
Do not use data acquired with Expanded CT HU ON on a Advantage Windows
Workstation. The results will be lower than expected. Turn the Extended CT HU range
to OFF for all studies that will be used for processing CT Perfusion studies.
ROI number increments by 2 for ROIs saved and reloaded to the exam
When filming from a split screen viewport, the image being filmed will be shown
briefly in a full viewport. This is done to preserve the resolution of the image for
filming.
If ROIs are saved as part of the exam and then the exam is edited, the ROIs will not be
valid to be loaded into the exam.
Saving TIFF files of the graph and images is not supported because there is no floppy
drive hardware available on the OC.
Set the color ramp to gray scale for screen saves images if you are going to network
the images to another station such as PACS to improve quality of the screen save.
CT Colon (Option)
Rotate and translate is missing in the CTC and Virtual Dissection protocols

B-12
SmartScore PRO Purchased Option

For BrightSpeed Excel, BrightSpeed Edge and BrightSpeed Elite systems, only 0.8 and
0.5 second rotation speeds are valid for Prospective Gating.
For BrightSpeed Excel Select, BrightSpeed Edge Select, and BrightSpeed Elite Select
systems, only 0.8 second rotation speeds are valid for Prospective Gating.
A back slash ( / ) in the Patient ID for SmartScore exams will cause the patient report
to fail to print or be stored to floppy.
If the Confirm button is not available, select the Gating button and turn gating off and
click on Accept. Select Gating button, again, and turn gating on and click on Accept.
The Confirm button should now be available. Contact your local service
representative if you experience this issue for further investigation.
Advanced Vessel Analysis (Option)

AVA defaults to inferior view instead of Anterior after processing AVA. Use the
anatomical buttons to change the view to Anterior
AVA lumen view may show wavy lines while rotating. When the rotation is stopped
the display will update.
Dentascan
Do not use Extended CT Number range for images that will be processed in Dentascan. This
application does not support Extended CT Number range.
BMD
Do not use Extended CT Number range for images that will be processed in BMD on an
Advantage Windows or Mindways system. These applications do not support Extended CT
Number range.
CardIQ Snapshot Purchased Option

If a lead falls off during acquisition, the heart rate annotation will be inaccurate for
the portion of the acquisition after the lead falls off. Images reconstructed for the
complete acquisition using Snapshot Segment will initially display correct BPM for the
period of time the leads were connected, and then ungated images will be displayed

B-13
followed by images annotated with abnormally high heart rate where the leads have
fallen off.
If the Gating button is displayed in red and heart rate is seen, this is most likely due to
loose connection of the cable at the connection to the ECG monitor or the scanner.
Make sure you see a heart rate before you begin the scout scan.
CardIQ Snapshot Segment annotation is not displayed on the images displayed on
the Advantage Windows workstation. The average heart rate and the percent of R-R
interval will not be seen. The Cardiac Helical scan type will be annotated as Axial.
Snapshot Segment images can be networked to a PACS system, however due to an
error in the DICOM header, they can be retrieved from the GE PathSpeed PACS system
but the image annotation is wrong.
Multiphase protocols of Vessel Analysis and Heart MP do not load the images
correctly. Load the images first using the Tree MP protocol and then select new
protocol and change to the desired protocol.
The Lumen view may display Hit space bar to display high resolution view This will
be needed with views 15mm or less.
WW and Wl of screen saved MIP views may not have correct contrast. Adjust the WW
and WL to improve the image.
Batch film will not film images in the Cardiac Short Axis protocol. The images will
need to be manually filmed.
Layout protocols must be created with single phase cardiac data sets. Once saved
they can be used with multiphase cardiac data sets.
Auto Transfer
A series may fail to Auto Transfer if [Next Series] then [Create New Series] is selected after a
scout scan is prescribed, but not scanned, i.e.; pause and return to view edit is selected.

B-14
Display (Applies to ExamRx Display and Image Works)

The Exam Rx List Select and Image Works browsers may in some cases not list an
exam, series or image. This may be seen after an interruption of power to the system
or the database may be updating slowly. The patient does not need to be rescanned.
Verify the following:
Type the Exam, Series, Image on the accelerator line to display the image,
Select another exam in the browser this will cause the browser to update,
The browser may update after a slight delay,
Reboot the system,
A second reboot may be needed if a power fail has occurred.
The browser may update slowly to reflect Screen Save images created in an exam. If
the Screen Save images is not listed in the browser wait for them to appear. The time
to appear may be up to 15 minutes if the Automatic Database check and recovery is
in progress when the Screen Save images are created.
In general, wait for a display action to complete before entering in another
command.
With the system configured in French or German language, if a comma is entered in
explicit magnify, i.e. 2,3 the comma will not be interpreted as a decimal. The
magnification factor is applied without the decimal. In the example shown, 2,3 the
image would only be magnified 2X not 2.3X. Always enter a period to designate a
decimal and have the correct magnification applied.
Cross Reference lines will post incorrectly if sort by image location is selected. Make
sure that sort by number is selected before posting Cross Reference lines.
Cross Reference lines may not post with some combinations of DFOV and RAS center.
RAS centers at the edge of the DFOV and small DFOVs will exhibit the problem. Retro
reconstruct the images to a larger DFOV if posting of the cutlines is desired.
Image annotation may overlap or not be fully shown if a 32 character patient name
is entered for 3D, Navigator, Reformat, MID formats, DentaScan images.
Text and Series pages only display 24 characters for Patient Name.
Text pages will not show foreign characters entered using the ALT GR key.
ROI and STD deviation numbers may be reported as zero after a Zoom is applied to
an image with a ROI posted. This is due to partial pixel contained in the ROI. Adjust
the size of the ROI to include full pixels and recalculate the ROI.
No text will be entered in the accelerator line if the mouse cursor is over the film
composer.
Some combinations or E/S/I will fail to display an image, if cap locks are on. To select
an exam series and image from the accelerator line use the following format when

B-15
cap locks is on: For example to select Exam 576 Series 2 image 3 type E576 2 3 on
the accelerator line.
Selection of an exam series or image may fail a second time after an exam series or
image is displayed. If the desired exam series or image does not display then select
the desired images from the browser.
Image location seen on the scanner may differ from that seen on an AW 3.1 system
for tilted images. BrightSpeed reports the image location as iso-center of the image.
AW 3.1 reports image location as the image center for the image. With tilted images
there will be a difference in the location numbers proportional to the off center
distance times the sin of the tilt angle. The image location can be reported as image
center on BrightSpeed by using the Report Cursor function.
Plus recon mode is not annotated on the Series Text Page. Refer to the image
annotation for the Plus recon mode annotation.
An active user annotation graphic will not film the box or arrow that is displayed on
the screen.
Exam Rx Display
Display may reset its self after a software problem. You may see display stop or not
accept your mouse input. Wait for a few seconds and display will automatically
reset. You will have to re-display the images you wish to work on.
The MIROI pop up may display but will not function. This will occur if an Auto View or
Cross reference viewport is in primary focus (blue border) MIROI is not in these
viewport types. Place a Free or Auto Link viewport in primary focus and reselect the
MIROI button to continue.
Any Report Pixel or MIROI chart that is not screen saved, but is filmed will show the
Exam Series and Image as 1000/1/1 on the film composer icon if E/S/I is selected.

B-16
This is the exam/series/image number the system assigns to this chart display The
patients exam number is listed correctly on the filmed image.
Image selection from the accelerator line will not function if the primary viewport
contains a MIROI plot or Report Pixels chart. Use List Select to display a new image.
Any accelerator commands entered for Series Binding, Annotation levels for display
or filming will be saved as defaults
ExamRx Display may hang. In some cases switching to the Image Works desktop and
back to Exam Rx display may clear the problem. If this doesnt work then perform a
system shutdown and reboot the system.
Display may post the Print Series dialog and hang when switching layouts and using
the trackball. This may lock the cursor. A system power cycle will be needed to
recover.
The Trackball may fail to initialize properly at system reboot. Try rebooting the
system again to recover.
Images recond with Priority recon are not available in the Auto Link viewport.
Re-display the series to access these images.
MIROI may fail to produce a graph if next prior is selected while doing MIROI.
Re-display the series and begin again.
With paging active (P in the lower left corner of the image) the trackball may adjust
window width and window level in other viewports, verify the image has the correct
window level before filming the image.
The right mouse may fail to roam even when the state is set to roam. A system
shutdown may be required to clear this problem.
Display may crash when selecting a 3D object from the list select browser. When a 3D
object is selected, 3D should be selected from the browser.
Images may not be displayed after a switch between Auto View or Image Review
layouts. This is due to a restart in the display process. Re-display the desired images
in the viewport to continue.
Image Works Display

WW and WL adjustments will only be maintained on individually selected images if
the middle mouse button is used. If the accelerator line or Presets are used all images
will update regardless of primary or secondary focus of the images.
Any accelerator commands entered for Series Binding, Annotation levels for display
or filming will be applied and not held if the viewer is closed. Use User Preferences in
the viewer to save the settings as a default if desired.
Reference Image may select the wrong scout series, i.e. not the scout series the
images were prescribed from, if one or more scout series exists. If the wrong scout is

B-17
selected place the Reference Image viewport in primary focus and enter the scout
series number desired on the accelerator line.
Window/Level does not display stored value set in the Viewer when +/- series is used.
The W/L used is the same as the last series displayed.
Images created in Add/Sub are displayed with value of WW 4098 and WL 1024.
If paging is selected while the system is in Compare Mode, the upper left viewport is
left blank. Return to the Browser and select the desired series for paging and restart
the Viewer.
Accelerator Command Line entries for E/S/I do not act properly. The first image in the
series is always displayed instead of the requested image within the series.
Cross Reference line numbering along the top of a sagittal scout may be listed in
offset manor.
The new features in User Preferences on the Image Works desktop are not
translated.
The primary focus may change if the space bar is selected multiple times when
entering accelerator line commands. Verify that primary focus is on the image
desired.
Edit Patient Data

The system may hang if Edit Patient is started while the following operations are in
progress:
Network Receive
Prospective or Retrospective reconstruction is active
Archive Restore
To avoid this, confirm Edit Patient during idle times in network receive, active recon or
archive restore.
Patient age may be seen as zero in Edit Patient Data even though a birth date is
entered. Enter the birth date again and patient age will be calculated.
If duplicate accession numbers exist, Edit Patient Data will not allow the exam to be
modified.
If there is a space at beginning or end of the hospital, Edit Patient Data will fail.
Contact your field engineer to update the hospital name correctly in the system
reconfiguration.

B-18
FILMING
Images or Auto Film control buttons may fail to display in the AutoFilm viewport. This
may occur after a switch between desktops. To display the images change to a
different AutoView layout, then switch back to your desired layout.
Dont let the auto film viewport back up with images to be filmed. Start Auto Film as
soon as possible to keep caught up on filming.
Any of the Auto Film control buttons may be activated when the cursor is over the
button and the space bar is selected. Place the cursor in the Auto Film viewport only
when needed to avoid this problem.
Auto Film may fail to film. This may occur when the Auto Film viewport selection
shows active and the Auto Film status shows paused. Toggle the [Pause] button in
the Auto Film viewport and select [Start New Sheet] or [Continue Same Sheet] to
restart filming.
Image settings such as WW WL and flip rotate, zoom, roam are not maintained
across all images when imitating F4 print series from a MID Viewport format. Use a
512 size viewport to initiate F4 Print Series.
Auto Film may stop and the Continue Same Sheet button will be displayed. The
Continue Same Sheet button will be active, but when selected will not restart filming.
Use Manual Film to complete filming the exam and reboot the system before starting
the next exam
If the F1 key is used to film the Text Page ROI, Exam Text Page and Series Text Page,
the text pages will be filmed to the film composer last selected in the pop-up for text
page. Use the filming selections in the text page screens to film the information
displayed.
The message Film formatting in progress. Please retry. May be seen when filming to
the Manual Film composer when the system is busy with other simultaneous
operations such as recon, network, auto film and scanning. Retry manual filming
when the system is less busy. A system reboot may be required to recover.
Auto Film may fail to display images if recon is having trouble reconstructing the
image or if images have failed to install in the database. This may also occur if a large
exam has not reconstructed all images and scanning is started on a new exam. The
following dialog will be posted if Auto Film cannot display images:
Exam 100
Series 2
Cannot find 10 images
Skip Missing imagesContinueCancel Film Series
You are presented with 3 choices:
1.Skip Missing images will skip the images that Auto Film cannot find. For
example if Auto Film had filmed images 1-10 and you then got the

B-19
message that 10 images were missing and selected Skip Missing Images,
Auto Film would then start filming again with image 21.
2.Continue will look for the images again, if they are not found then the
dialog will be posted again. Before selecting continue verify that recon is
active, that the images have been reconstructed, the missing images are
not suspended or paused in the Recon Queue and the images are able to
be displayed. If the images are suspended or paused in the recon queue,
then unsuspend or restart recon to reconstruct the images before
selecting Continue.
3.Cancel Film Series will cancel Auto Film for the series currently being Auto
Filmed. The images will then need to be manually filmed.
If you get this dialog because you have begun an exam while the previous exam still
has images to reconstruct, then Select Continue and select Pause Auto Film, resume
Auto Film when the Exam Series and Images from the previous exam have
reconstructed.
When prescribing Mag factor for auto film, scout images if the scout is longer than
500 mm then use a magnification factor less than 1 to display the entire scout.
The manual film composer may display when confirm is selected for scanning if the
composer had been closed by selecting iconify in the upper right corner of the
composer.
Its best to run Print Series from only one desktop at a time.
Its best to resolve any paused queue entry as soon as possible.
Print Series may pause automatically under heavy system load.
If Anonymous Patient is selected for an exam where Auto Film is in progress, the
system may fail to cross reference the slices on the scout. If Anonymous Patient is
required for series that are still active in Auto Film, wait till Auto Film is complete for
the series before proceeding with Anonymous Patient.
To install a SMPTE pattern select the following. Once installed the images will be
available for viewing from the Image Works browser or List Select in Exam RX. And
will be listed as Exam 1000. The patient Name will be listed as SMPTE.
Click Service Desktop.
Click [Diagnostics].
Click [Display Processing].
Click [Install SMPTE Image].
Full Annotation instead of partial annotation will be filmed when using F3 (Film MID)
in the Image Works desk top when full annotation is selected.
The format built in a protocol may be changed when the protocol is used with a
message that the format was changed due to an invalid format, even though the

B-20
format is valid. Verify in Auto Film set up is the format you desire before confirming
scan.
For Multi-Image Display (MID) in AutoFilm, filters, gray scale and orientation
selections are applied only to the image in the upper left viewport. If there are an odd
number of images in the series, the filters, gray scale and image orientation is
applied to the first group only.
Network
BrightSpeed images will not transfer if Advantage Net protocols is used. Always use
DICOM protocol to send BrightSpeed images.
BrightSpeed images cannot be sent to a HiLight Advantage, HiSpeed Advantage or
CT Independent console. These systems do not support DICOM receive.
Some 3rd party workstations may fail to receive BrightSpeed scout images. This is
due to the matrix size of the scout image. These stations do not support receiving
matrix sizes greater than 512. Some BrightSpeed scouts images have matrix sizes
greater than 512. If it is desired to have the scout image on the workstation, Screen
Save the scout and then transfer the screen save image to the workstation.
If you query a BrightSpeed system from a CT/I or Advantage Windows system in
Advantage Net, only Advantage format image exams will be displayed, No
BrightSpeed exams will be shown. Always query a BrightSpeed system using DICOM
protocol.
Lateral scouts displayed on an AW 3.1 system will initially display with zero rotation;
they should display with a 270-degree rotation. Rotate the image in the left direction
using the rl command on the command line to display the scout in the desired
format.
Images networked to a Advantage Windows 3.1 workstation running software
versions prior to 3.1_07 will display a DFOV less than what is displayed on the

B-21
scanner. This is due to the AW not taking in account the pixels under the focus border
of the viewport.
Images networked to a AW 3.1 will have the following annotation missing:
Accession number,
Date of Birth,
4i, 2i or 1i recon mode on Axial, Retro Axial or Axial Reformatted images,
Series type on Retro images,
Table Speed on Helical images,
Images are annotated +C when Oral Contrast is used. View the Series Text Page to
see if IV contrast was used.
CardIQ annotation for BPM and percent of R-R interval and scan type will
displayed as Axial.
The number of images indicated in a series may be incorrect on the remote browser
when a query is made from an AW or CT/I station.
Series types may be listed differently when images are networked to an Advantage
Windows 1.2, 2.0 or 3.1 system than that shown on the BrightSpeed system
Exams with Swedish, German or French characters in any Patient Info field will not be
transferred to an Advantage Windows.
When using DICOM protocol, the entered host name must match in spelling and case
sensitive, otherwise a connection error message will be displayed.
Its best to resolve any paused queue entry as soon as possible.
Image management
Remove images when scanning is idle. This will assure that all images are
reconstructed, displayed and installed into the database.
Exams that contain SmartStep may fail to remove. Reboot the system to remove the
lock on the SmartStep series.

B-22
Appendix C
Operator Messages
Introduction
This appendix lists user messages that are posted to the user interface. These message are
displayed in one or more of the following areas
Figure C-1 Attention pop up dialog

C-1
Figure C-2 Real Time information area of the scan progress screen on the left monitor
Real Time
Information
Area
Figure C-3 OC message bar on the View Edit screen of the left monitor
OC Message Bar

C-2
Figure C-4 Message area of the Feature Status Area on the right monitor
Message Area
The following table list the messages.

Table C-1 Warning Messages
Operator Message
Translation
Your patient orientation has changed from the

previous series. Please verify or change the
orientation if needed.
Tube Warm-up has been cancelled or skipped.
Maximum mA allowed will be limited for this
exam.
Small focal spot will be limited to 250 mA.
Large focal spot will be limited to 500 mA.
Select End Exam and run Tube Warm-up from
Daily Prep to enable the full mA range capability.
The table landmark has been changed. This
changes the location of all scans you have
prescribed. Double check all scans locations
before you start scanning.
WARNING: This series contains one or more

WARNING:
groups with multiple scans at the
same tomographic plane, i.e. same
location. Minimum diagnostic delay is
seconds the time of a monitor scan.
Do you wish to continue?

C-3
Operator Message
Translation
WARNING: This series contains one or more

WARNING:
groups with multiple scans at the
same tomographic plane, i.e. same
location. Temporal interval for
images exceeds 3 seconds. Use of this
data for processing of CT Perfusion
maps may contain errors in the
functional information.
Do you wish to continue?
Biopsy has disabled automA. Please verify or
change the mA as needed.
The dose for the new scan is greater than the
maximal possible value. Do you wish to continue?
Unrecognized tube in use - Dose may vary. The
reported dose information is calculated based on
empirical observations of systems with GE
Medical Systems tubes.
GE cannot assure the accuracy of reported dose
information for any configurations that include
tubes other than GE Medical Systems tubes.
The detector is not at the proper temperature
please allow approximately minutes for the
detector to come to temperature.
If you wish to proceed with this scan select the
"OK" button, however IQ maybe degraded
including image artifacts.
AutoMa has been disabled. It can be enabled
again once patient orientation matches with that
of the last scout series.
The prescribed mAs for Group % is greater than
mAs limit for this tube, decrease mA to mA.
The scan database is corrupted.
If you continue to use the system you might
propagate the corruption.
Please shutdown and restart the system in order
to automatically recover the database.
Please confirm that there is no beam obstruction.

C-4
Operator Message
Translation
The Daily Image Quality Check Test has detected

a condition that may result in an image with
unacceptable image quality.
Please call GE Service and request a more
thorough evaluation of your system's condition.
Multiple patient entries are found. Please select
the appropriate patient from the Select Schedule
Patient screen.
Failed to Acquire Scan Hardware.
This is probably because:
New Patient is started in the ExamRx screen, or
Some other tool is already scanning, or
The application firmware is not downloaded to
SBC, or
Some other problem with the scan hardware.
Please correct the problem and try again.
Held Control Communication Failure:
There has been some communication error
detected for the Hand Held Control Unit. Please
Check the Connection and reconfirm Rx.
Firmware reset occurred. Please wait until reset is
completed.
To continue, you may have to reset the landmark.
However, the new landmark could be different
from the previously set landmark.
Firmware reset occurred during scanning. The
current exam cannot be completed. You may
obtain information on completed scans by
returning to view/edit.
Please select end-exam when ready. New-patient
button will be available when the firmware reset
is complete.
Recon Self Test detected reconstruction errors.
You will not be able to scan because no
calibration information is available.
Try pressing |End Exam| followed by |New Patient|.
This will cause ScanRx to attempt to read the
calibration database again.
Cardiac hardware is malfunctioning and has
been disabled.
Please check the connections and re-enable
gating on the View/Edit screen.

C-5
Operator Message
Translation
Can't perform cardiac gated scan.

Cardiac hardware is malfunctioning and has
been disabled.
Please check the connections and re-enable
gating on the View/Edit screen.
WARNING: Please remove any obstruction in the WARNING:

path of the beam.
WARNING: Converter boards have changed.

Please first run DAS Gain Cal before
running Collimator Cal.
WARNING:
WARNING: Collimator Cal failed but scanning can WARNING:

be done with the pre-existing valid
calibration.
If this error repeats over several days
call service. Fast Cal continues
WARNING: Clever Gain Air Calibration failed to WARNING:

get tracking Statistics. Tracking may
have been turned off.
Exit Fastcal and try again. If this
problem persist, call service.
WARNING: Fastcal may not have been performed WARNING:

within the last 24 hours.
Image generation has been delayed! SmartPrep
cannot continue.
Monitor phase scanning has been paused.
Please proceed to the scan phase by selecting
the "Scan Phase" button at your discretion.
The SmartPrep clock continues to show the
elapsed time since the contrast injection began.
Use this clock to determine when to proceed to
the scan phase.

C-6
Operator Message
Translation
The Mylar Window check has detected that the

window is not clean.
A dirty mylar window may affect the calibration
and cause Image Artifacts. Please clean the mylar
window.
Hit Continue to go on with FastCal without
repeating the check or hit Retry to repeat the
check and confirm that the mylar window is
clean.
The DAS Gain Calibration has not been run since
the DAS Converter boards were changed.
Please call the FE or GE Cares center for more
information and help.
It has been over 96 hours since the fastcal was
done.
Zslope calibration fails robustness test. Please
call service.
Unable to determine if need to run auto mode
Zslope Calibration due to access to the
FastCal.cfg has failed.
Press the [OK] button to continue the Fastcal.
Please call service for Fastcal configure file
problem.
WARNING: Scan Manager Configuration Has

Non-Patient Scanning Options
Enabled!
WARNING:
WARNING: Scan Manager Configuration Has

WARNING:
Beam Tracking Disabled! Scanner Is In
High Dose Mode.

C-7
Operator Message
WARNING: Gantry Balance Check must be

performed.
Translation
WARNING:
Pressing OK will cause 2 automatic

gantry rotations with 1 minute
separations.
Make sure Gantry is clear of all
obstructions and click OK.
The Gantry Balance check process
will take about 4 minutes.
Gantry Balance Check is executing. This process
will take about 1 or 2 minutes.
Gantry Imbalance Condition Detected.
Image Quality May Be Compromised.
Perform Gantry Balance or Call GE Service
Gantry is out of Balance.
Calibration is Aborted.
Call Service.
Software has detected an invalid DAS
configuration. Please reconfig to correct. If
condition persists after Reconfig call GE Cares.
Reconstruction process has stopped.
Scanning is possible but no images will be made.
Restart the system.
Please contact GE service.
Reconstruction times will be slower.
Scanning can continue.
None of the Image Generation nodes are
functioning. The system is still operational.
However, recon performance may be degraded.
All of the images from a scan that is currently
being reconstructed are suspended.
The Scanning Hardware is not available; please
wait for the hardware reset successful status
posted in the feature status area on the right
monitor.
If the hardware reset fails, then reset the scan
hardware from the Service Desktop System
Resets button.

C-8
Operator Message
Translation
A scan disk array failure was detected.

Please call GE Service to schedule repair of the
scan disk array.
To continue scanner operation now, you may
rebuild the scan disk array with less storage
capacity.
If you rebuild the scan disk array, all scan data on
the current disk array will be lost.
Are you sure you want to rebuild the scan disk
array?
Unable to verify system functionality on startup.
Please power cycle the console.
If the system fails to startup after the power
cycle, then please call GE Service.
Protocol file is corrupted. Please correct using
method below or contact your GE Service
Representative.
Restore protocols - this will replace all
protocols in "User"
Using the most up to date copy of the Protocol
DVD disk or System State disk
From Service Desktop select "Utilities" then
"System State"
Now select "Protocols" and then "Restore".
An unrecognized X-Ray tube has been installed
on the system.
GE Medical Systems cannot assure that the
system performance will conform to
specifications.
Advisory messages will be posted to the
operator about an unrecognized tube during
tube warm-up, during Fast Calibration, and in
the dose report.

C-9
Operator Message
Translation
The system has been configured to recognize a

GE Medical Systems Tube. A %s-day period from
the date of tube installation has been granted to
allow time to manually verify the tube identity.
Please call GE Medical Systems to dispatch a
Field Service Engineer (FSE) to verify the tube
configuration. Please allow a minimum of 10 days
for the FSE to schedule verification. Verification
should take no more than 30 minutes. If a GE
Medical Systems FSE does not verify the tube
identity within %s days, the system will revert to
an "unrecognized tube" status, resulting in the
following:
GE Medical Systems cannot assure that the
system performance will conform to
specifications.
Advisory messages will be posted to the
operator about an unrecognized tube during
system startup, during tube warm-up, during
Fast Calibration, and in the dose report.
Scan disk array performance is degraded by one
or more hard drive failures. Your scan data
storage is reduced because of this.
Please contact GE service to have the disk array
repaired as soon as possible.

C-10
Operator Message
Translation
New software updates are available and ready to

be installed on your scanner. These software
updates provide system enhancements and
corrections to ensure optimal system
performance and security. All updates have been
developed and validated specifically for your
hardware and software configuration. By
downloading these software updates, you agree
to and are bound by the Terms and Conditions of
Sale for GE Medical Systems Products. The
updates are expected to take approximately to
install. For additional information regarding the
updates: Contact your Customer Service Center
or choose "Install Later" (you will be prompted on
subsequent re-boots with this dialog), go to iLinq,
Under Software Updates review data for updates.
If you have questions or concerns, please contact
your local Service Engineer or Customer Service
Center. Do you want to install software updates
now?
The following patch(es): require a system reboot
after install. The reboot will occur in 10 seconds.
2005 General Electric Company
Installing Software Updates...
Please wait while the system updates are
installed... Estimated time required to install
updates is approximately
The software update installation started at __.
Update Installation Failed!
The following updates failed to install.
Please restart your system and initiate software
update again, or notify the GEHC On-Line Center
that the install failed.
Revert back to the original configuration, skip
installation and notify GEHC On-Line Center that
the install failed and create dispatch for FE
follow-up.

C-11
Operator Message
Translation
Automatic Software Download & Install

Capability Exists for your scanner! This GE
exclusive capability leverages the power of your
Insite Broadband connection to deliver the latest
software updates to your system as soon as they
are released. The updates are downloaded
automatically and the option to automatically
install them is provided during system start-up.
Only GEHC developed and validated updates are
distributed via this tool. For an overview of this
capability, Please review the Software Download
Topic on iLinq.
Automatic Software Updates
Continue (time out after 20 seconds)
Try Again
Skip Install
please wait ....
The detector is not at the proper temperature. If
you wish to proceed with this scan select the "OK"
button, however IQ maybe degraded including
image artifacts.
Please contact GE Service.
The detector is too hot.
No scanning allowed.
Please contact GE Service
A system communication failure has occurred
which will prevent scanning.
Please contact GE Service.
System has detected that firmware is down.
This will prevent scanning.
ScanRx could not be started because it could not
communicate with scan database. The system
has to be shut down and restarted.
Patient placements in series are different.
The landmark is not set.
Patient orientation now differs from when last
scanned.
A localizer(s) is invalid for this prescription.

C-12
Operator Message
Translation
Unable to locate existing Patient Information.

Failed to enable Hand Held Control Unit. Please
Check connections.
Exposure Time was changed to System Maximum
Allowable value.
Exposure Time was changed to Tube Cooling
Maximum Allowable value
Tube has reached the highest allowable
temperature, Tube Cooling Optimization is
required.
Table height has changed - No timing graph will
be displayed in SmartPrep.
The SmartPrep timing graph will not display due
to a mismatch between the system and
reconstruction engine clocks. After the exam is
complete, contact service to synchronize the
clocks.
System rounded Patient Weight in pounds to the
closest value in kilograms.
System adjusted patient weight to be within
allowable weight range.
Scan Request is not possible due to tube cooling.
No up front delay is possible.
The system will apply an up front delay prior to
scanning.
Scan Request is not possible due to tube cooling.
Lower mA or kV to enable scan.
Start/End location(s) were changed due to
landmark position.
More than 2 hours have elapsed since the last
scan. Tube needs warming.
The Smart Prep Baseline image failed. Please try
again.
Can not start Monitor Phase while interacting
with the Baseline image.
Unable to set Alignment location. Landmark not
set or table needs to be referenced.

C-13
Operator Message
Translation
Dose information database is uninitialized. Please

see Error Log for Details.
Detector Temperature Is High. Image quality may
be affected.
Detector Temperature Is Low. Image quality may
be affected.
WARNING: Backup Timer stopped scan. X-ray

stayed on longer than prescribed.
WARNING:
kV out of range. Potential for degraded image

quality.
AutoVoice Malfunction:
AutoVoice is disabled
until scanning is stopped.
Gantry Controls Horizontal In button is
non-functional.
Unlatch cradle to position patient.
Gantry Controls Horizontal Out button is
non-functional.
Unlatch cradle to position patient.
Gantry Controls Internal Landmark button is
non-functional.
Use the External Landmark button.
Gantry Controls External Landmark button is
non-functional.
Use the Internal Landmark button.
Gantry Controls Landmark buttons are
non-functional.
Scanning cannot continue.
Gantry Controls Stop Scan button is
non-functional.
Use the Console Stop Scan button.
Gantry Controls Start Scan button is
non-functional.
Use the Console Start Scan button.
AutoVoice and Breathing lights are disabled due
to operator intervention until scanning is
stopped.
Cradle is released.

C-14
Operator Message
Translation
Gantry Controls Cradle Release button is

non-functional.
Prep Delay: __ Seconds Remaining
Interscan Delay: __ Seconds Remaining
Tube Cooling Delay: Seconds Remaining
Operator Paused Scan
Operator Stopped Scan
Scanner Hardware Paused Scan
Scanner Hardware Stopped Scan
X-ray off scan is in progress. Press [Stop Scan] to
stop scanning
Prep Delay after [Start Scan] will be __ Seconds
Cradle is released. Latch the cradle to scan.
Table is below the scanning minimum.
Raise the table to scan.
Remote Tilt is Disabled due to Touch Sensor
Collision.
Scan position prescribed is no longer valid. Please
re-prescribe.
Cradle is released.
Cannot bring tube rotor up for __ seconds.

C-15

C-16
Numerics
3D Option 33-1
A
Accelerator Line 31-2
Accelerator Line Commands 31-15
Accept Negative Pixels 28-3
Active Annotation 33-24
Add Images Together 28-5
Addition 28-2
Adjust Graphic Rx 20-10
Adjust the Localizer 19-12
Adjusting a Protocol 20-2
Adjusting the Cross-Reference Image 33-26
AE Title 23-15
Anatomical Selector 6-25
Annotate Image 31-6
Annotate the Scout With Scan Lines 31-4
Anonymous Patient 23-3
Archive 23-2, 23-3
Archive Device 23-18
Archive Exams/Series/Images 23-22, 23-26,
23-28
Archive Node 23-16

Auto 23-4
Auto Detect 10-10
Auto Enlarge 29-2
Auto Film 22-3
Auto Link 25-2
Auto mA 6-7
Auto Minify 29-2
Auto Print 21-8
Auto Start 21-7
Auto Transfer by Series 23-4
Auto Voice 20-13
AutoFilm Setup 21-5
Automatic Filming 21-2
Autostart 21-2
Autoview 25-2
Axial 6-2
Axial Detector Configurations 5-5, 5-20, 5-34
Axial Interval 5-8, 5-23, 5-39
Axial Signal Collection 5-7, 5-22, 5-39

B
Backwards 1 14-19, 15-19
Bar Code Reader 16-4
Batch 33-12
Batch Protocol 33-49
Bind Series 28-3
Biopsy Location 17-5
Biopsy Mode 17-2
Biopsy Reference 17-5
Biopsy Reference Scans 17-2
Biopsy Rx 17-2, 17-5
Blue Frame 25-15
Brain/Bone Interface 27-8
Brain/Bone Interface in Image Works 27-18
Breath Hold 20-12
Breath Hold Delay 20-2
Breathe Time 20-12
Bright box 3-19
Build or Edit a Protocol 6-28
Building an Image Set 33-17
Building Protocol 6-5
C
Calibrations 4-2
Cancel Compare 24-17
Cancel Film Exam 21-19
Cancel Film Series 21-19
Cancel Series Selection 24-13
Cardiac Helical 10-5
Cardiac Helical Scan 10-21
CardIQ SnapShot 10-18
Channel Utilization Table - Plus Modes 5-46
Check Network History 23-36
Cine 6-2, 24-12
Cine Loop 24-12
Clear Last Point 33-12
Clear Trace 33-12
Comb 28-3
Comments 23-15
Compare
Exams/Series/Images 24-15
Complete an Anonymous Scan Data Save 32-17
Completed Records 16-2
Index-1
Confirm Biopsy Rx 17-6

Confirm the Localizer (Scout) 19-14
Connect Pro 16-2
Continue Same Sheet 21-19
Contrast 19-2
Copies 21-7
Copy and Paste Protocols 6-54
Copy Protocols 6-54
Create 23-43
Create a New Image
Using Only the Maximum CT Number 28-14
Using Only the Minimum CT Number 28-17
Create Anonymous Patient 23-43
Create New Images from Scan Data 32-5
Cross Reference 31-2
CT Safety 2-5
CTDIw 2-9
Cursor Controls 33-11
Curved View Type 33-55
Custom Search 23-17
D
Delete a Protocol 6-57
Delete an AutoVoice 6-53
23-44
Deleting
A Protocol 33-50
Density readings (See also ROI) 30-4
Destination 21-5
Detector Configurations 5-3, 5-17
DFOV 20-17
Differences between Auto Film and Manual
Film 22-3
Direct Visualization 11-1
Direct3D 11-2
Curves definition 11-2
Curves selection 11-16
Display factors 11-19
Review mode 11-21
Selecting curves 11-16
Set parameters 11-13
Setup 11-13

Display
Exam Information 31-8
Parameters of a Scan Mode 31-10
Display Factors 20-17
Display Field of View 20-17
Display Normal 27-10
Display Normal in Image Works 27-20
Display Preferences 25-11, 25-13
Dose 2-9
Accumulated Exam DLP 2-9
Dose Length Product 2-9
Projected Series DLP 2-9
E
ECG 10-8
ECG Waveform 9-2
Edit 23-39
Edit a Patient Schedule 16-14
Edit Patient Information 23-38
Edited by Field 23-41
Editing Protocols 6-6
EKG 10-8
EKG Waveform 9-2
Enlarge 33-12, 33-29
Era Year Entry 19-3
Exam Prescription for Prospective Gating 9-5
Exam Rx 3-15
F
F Keys 22-2
Fast Cals 4-6
Feature Status Area 23-2
Feature status area 3-16
Film Composer Parameters 22-3
Film Direction 21-6
Film Series Parameters 22-2
Filming 23-3
First/Last View 33-51
Flip 21-14
Flip/Rotate 27-4
Flip/Rotate in Image Works 27-14
FLR 21-14
Forward 1 14-19, 15-19
Index-2
Frame Format 21-13

Free Hand Trace 33-38
FTB 21-14
FTB/FLR 21-14
Full System Calibrations 4-2
G
Gantry controls 3-3
Gantry display 3-6
Gating Check 19-12
Get 23-34
Get Alignment Light Location 17-5
Get Examination 23-34
Get Images 23-34
Get Series 23-34
Graphic conventions 1-2
Graphic Rx 20-10
Gray Scale Enhancement 21-3, 27-2
Grid 30-8, 33-38
GSE 21-16
Guidelines For mAs 5-13, 5-29, 5-45
H
Hand Held Controller (HHC) 14-3, 15-3
Hand Held Controller Button Descriptions 14-4,
15-4
Hardware Components 5-2, 5-16, 5-33

HD MIP Render Mode 33-12
Head SFOV 20-8
Helical 6-2
Helical Configurations
2 and 4 Row Mode Interleaved 5-9, 5-25,
5-42
4 Row Mode Interspaced 5-11, 5-26

8 Row Mode 5-27
Helical Pitch and Scan Mode Definitions 5-9,
5-24, 5-41
HHC 14-3, 15-3
Hide or Show Graphics 31-12
Host 23-14
How to 3D Images 33-15

I
iLinq 3-16
Image 23-2
Addition 28-2
Matte 27-12
Sharp 27-6
Smooth 27-6
Subtraction 28-2
Image Filters 21-2, 27-2
Image in Image Works
Matte 27-21
Sharp 27-16
Smooth 27-16
Image Magnification 29-6
Image Orientation 27-4
Image Orientation in Image Works 27-14
Image Works 3-15
Auto Enlarge and Auto Minify 29-7
Density Readings 30-15
Grid 30-19
Make the image smaller or larger 29-10
Measure from Point to Point 30-17
Mesure Distance 30-17
Move the image around the screen 29-9
Overlay a Grid 30-19
ROI 30-15
Scroll 29-9
Zoom 29-10
Integral Render Mode 33-12
Interscan Delay (ISD) 20-12
Interval 21-14
Interventional / Biopsy Scanning 2-22
Inverse Video 27-11
K
kV 20-9
L
Label an MOD 23-20
Large SFOV 20-8
Laser alignment light 3-6
Lateral Motion Verification 18-2
Left Series 24-16
Index-3
Limited Access Room Configuration

2-28
List/Select 24-5
Localizer 19-12
Lock Orientation 33-13
Look for Images that are not Reconstructed 32-8
Loop 33-54
M
mA 20-9
Main on View Features 33-28
Main On View Menu 33-12
Managing Images 23-1
Manual Detect 10-10
Manual Film Composer 22-3
Manual Film Composer Parameters 22-7
Manually Add an Image to the AutoFilm Composer 21-20
Matrix Size 6-40
Matte
ematte 27-12, 27-21
rmatte 27-12, 27-21
Maximum Pixel Value Extraction 28-2
30-11
Measure Distance 30-6

Measure from Point to Point 30-6
Measuring an Area 33-35
Measuring Distance 33-31
Min IP Render Mode 33-12
Minimum Pixel Extraction 28-2
Mini-Viewer 24-2
MIP Render Mode 33-12
MIROI 30-2, 30-11
Modality 26-6
Monitors 3-14
Mouse 3-18
Moving the Orthogonal View Locations 33-21
Multiple Image Display 25-7
N
Negative Pixels 28-3
Network 23-3, 23-14, 23-31, 23-32, 23-33, 23-36

Network History 23-36

Networking Terms 23-4
New Records 16-2
Next/Prior
Each Viewport 25-11
Series Binding 25-13
No Autostart 21-18
Normal 21-7
O
Optimizer 20-3
Overlay a Grid 30-8
P
Page Down 24-8
Page Up 24-8
Paging 24-2
Patient Information 19-5
Patient Schedule 16-2
Add a Patient to the Schedule 16-8
Check the Status of a Patient 16-18
Delete a Patient From the Schedule 16-10
Edit a Patient Schedule 16-14
Select a Patient from the Schedule 16-16
Set Up Preferences in the Schedule 16-11
Update Patient Schedule 16-6
16-19
Filming 21-18
Pause
Pause Images from Reconstructing 32-10
Ped SFOV 20-8
Pediatric Protocols 6-21
Perform Air Calibrations 4-6
Perform Tube Warm-Up 4-4
Performed Procedure Step 12-2, 23-4, 24-3
Performed Procedure Step (PPS) 12-1, 13-1
Phase Location 10-10
Ping 23-32
Pitch 10-10
Pixel Value 30-9
22-10
Plane Orientation Indicator 33-11
Index-4
PMR 6-3
Port Number 23-15
Position the Patient 19-8
Power Distribution Unit 3-3
PPS 12-2, 23-4
Prep Delay 20-12
Prepare a storage media for use 23-20
Prerequisite Skills 1-1
Preset Window Width and Window Level Keys
22-5
Primary Viewport 25-15

Print Series 22-12
Printer Selected 33-42
Proc 28-3
Prospective Gating 9-1, 9-2
Concepts 9-2
Setup exam prescription 9-5
Prospective Multiple Reconstructions 6-3
Protect/Unprotect Scan Data 32-19
Protocol Management 6-28, 6-54, 6-57
Protocols 19-2
R
R to R interval 9-2
Ratio Slider Bar 28-3
Raw Data 32-2
Ray Sum Render Mode 33-12
Recommended workflow for RT 18-2
Reference Image 24-18
Reference Images 33-29
Reformat
Creating a Histogram View Type 33-61
Creating an X Section View Type 33-64
Creating Measurements 33-31
Releasing Scan Data 32-3
Remote 23-4
Remove Graphics From the Image 31-13
Remove Images from the Reconstruction List
32-12
Remove Patient Information from an Exam

23-43
Render Modes 33-12

Repeat a Series 20-23

Report Pixel Value 30-9

Reserving Scan Data 32-3
Reset 23-41
Reset Pointer 33-13
Reset Size 33-13, 33-29
Restore 23-24
Restoring Raw Data 32-2
Restoring Scan Data 32-2
Resume Image Reconstruction 32-11
Retrieve Exams/Series/Images 23-24
Retrieve Exams/Series/Images from Another
Computer 23-33
Retro Recon 15-25, 32-5
Right Series 24-16
Rock 33-54
ROI 30-2
Rotate 21-15
R-Peak Value 10-11
S
Safety 2-1
Safety Notices 1-5
Save an Image Screen 31-14
Save/Restore Scan Data 32-15
Saving Raw Data 32-2
Saving Scan Data 32-2
Scan
Baseline Phase 7-8
Monitor Phase 7-10
Scan Phase 7-12
Scan Data 32-2
Scan Parameters 10-18, 20-6
Scan Type 20-6
Scout 19-12
Screen Save 31-2, 33-12
Scroll Through A Set of Images 24-9
Secondary Viewport 25-16
Select a Protocol 19-10
Select an Archive Device 23-18
Selecting an Image Set 33-17
Selecting the Output Device 33-47
Send
Exam, Series, Image 23-32
Index-5
Send images to the Manual Film Composer

22-10
Series Binding 28-11

Set an Access to a Local Host 23-17
Set Batch/Movie Loop 33-44
Set the Direct3D Parameters in the Scan Prescription 11-13
Set up a Remote Host 23-14
Set Viewports
Automatic display of next series 25-13
Images to display in order 25-11
Set Window/Level Presets for the HHC 14-21,
15-23
Setting Scan Field of View and Display Field of

View 20-2
Setting Up a Patient without an ID# 19-2
Setup Patient Information 19-5
SFOV 20-8
Show Annotations 33-38
Show Graphics 33-37
Show Localizer 20-10
Show Recon 3 20-20
Shutdown 3-31
Slice Profiles 5-14, 5-30, 5-46
Slide 21-7
Small SFOV 20-8
SmartPrep 7-2
Baseline Phase 7-2
Monitor Phase 7-2
Scan Phase 7-3
SmartPrep Parameters 7-2, 7-5
SmartStep 14-1, 15-1
Backwards 1 14-19, 15-19
Display 14-7, 15-7
Display SmartStep Images 14-18, 15-18
Forward 1 14-19, 15-19
Hand Held Controller (HHC) 14-3, 15-3
Hand Held Controller Button Descriptions
14-4, 15-4
Last Image 14-19, 15-19
Prepare for SmartStep 14-10, 15-9
Scan with SmartStep 14-15, 15-15

14-21, 15-23
SmartStep 14-2, 15-2
SnapShot Segment 10-6
Sort 26-6, 26-7
Sort Examinations 26-6
Archived Status 26-6
Date 26-6
Exam number 26-6
Patient Name 26-6
Sorting 26-3
Spatial 24-13
Specify a Zoom Factor 29-6
Start New Sheet 21-18
Startup 3-31
Subtract Images 28-8
Subtraction 28-2
Surface Render Mode 33-12
Suspended Entries 32-2
System Options 6-6
T
Temporal 24-13
Tick 33-38
Tilt Correction 5-8, 5-23, 5-40
Timing Bolus Scan for cardiac scanning 10-19
Timing Parameters 20-12
Transfer 23-4
Transfer Exams/Series/Images 23-31
Transmit 23-4
Tube and collimator 3-8
Tube Warm-Up 4-2
Type Text on the Image 31-6
U
Unlock Orientation 33-13, 33-30
Update the Reconstruction List 32-14
Use Performed Procedure Step 12-4, 13-5
Use VariSpeed 8-4
User Interface
Axial 5-7, 5-22, 5-38
Helical 5-12, 5-28, 5-44
User Preferences 31-2
Users conventions 3-21
Index-6
V
VariSpeed 8-2
Video Reverse 27-11
View Edit 20-6
View Types 33-11
Viewer 24-2
Viewing Protocols 6-6
W
Window Level 24-9
Window Width and Level Presets 22-2
X
X-Ref Scout 21-10
Y
Yellow Frame 25-16
Z
Zoom 29-5

Index-7

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GE Healthcare

This Manual Supports the Following Product Names:

REASON FOR CHANGE

First Release for BrightSpeed Series

Add BrightSpeed Select Series information

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

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BrightSpeed Series 5141172-100 Rev. 4 (06/07)

Chapter 1: About This Guide

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

Measure Angle................................................................................................................... 2-24

Chapter 3: Getting Started

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

Understanding users and groups............................................................................. 3-28

Chapter 4: Daily Maintenance

Chapter 5: Multi-Detector Information

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

Helical Pitch and Scan Mode Definitions....................................................................... 5-24

Chapter 6: Building Protocols

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

Chapter 8: VariSpeed (Option)

Chapter 9: Prospective Gating (SmartScore)(Option)

Chapter 10: Cardiac Imaging

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

CardIQ SnapShot Window ........................................................................................... 10-7

Chapter 11: Direct Visualization Auto Applications (Option)

Chapter 12: Performed Procedure Step (PPS) (Option)

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

Chapter 13: Exam Split (Option)

Chapter 14: SmartStep (Option)

Chapter 15: SmartView (Option)

Chapter 16: Scheduling Patients

Chapter 17: Biopsy Mode

Chapter 18: Recommended Workflow for RT

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

Chapter 19: Patient Setup and Scout Scan

Chapter 20: Scan Series Setup

Chapter 21: Automatic Filming

Chapter 22: Manually Filming Images

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

Chapter 23: Managing Images

Chapter 24: Viewing Images

Chapter 25: Image Display Viewing Area

Chapter 26: Sort Examinations and Images

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

Sort Examinations by Patient Name ....................................................................... 26-3

Chapter 27: Image Manipulations

Chapter 28: Image Addition/Subtraction

Chapter 29: Magnifying Images

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

Chapter 30: Measuring Structures Within an Image

Chapter 31: Graphics, Text Pages and Commands

Chapter 32: Managing Scan (Raw) Data

Chapter 33: Reformat

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

SmartScore PRO Purchased Option.............................................................................B-13

BrightSpeed Series 5141172-100 Rev. 4 (06/07)

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BrightSpeed Series 5141172-100 Rev. 4 (06/07)

About This Guide

About This Guide