Welcome to Onyx-RAD - Viztek

USER MANUALTABLE OF CONTENTSWelcome to Onyx-RAD...................................................................................................................................................... 7Welcome to Onyx-RAD ...................................................................................................... 8Easy To Use....................................................................................................................... 9The Study List ..................................................................................................................11The Image Viewer ............................................................................................................ 13Other Features / Options of Professional Workstation..................................................... 15How to Use This Manual .................................................................................................. 16Brief Walkthrough of Professional Workstation............................................................................................ 19Introduction ...................................................................................................................... 20Log On ............................................................................................................................. 21The Study List screen ...................................................................................................... 22The Image Viewer screen ................................................................................................ 24Going Further ...................................................................................................................26The Study List Screen....................................................................................................................................................29An Overview of the Study List Screen.............................................................................. 30Columns in the Study List ................................................................................................ 32Rearrange Study List Columns ........................................................................................ 33Remove Study List Columns............................................................................................ 33Restore Study List Columns............................................................................................. 34The Study List Filter Window ........................................................................................... 35Patient’s Studies window ................................................................................................. 37Select a Study for Viewing ............................................................................................... 37The Image Viewer Screen.......................................................................................................................................... 39An Overview of the Image Viewer Screen ....................................................................... 42The Series Window .......................................................................................................... 43

Onyx-RAD Professional WorkstationUser ManualThe Image window ........................................................................................................... 45The Config Bar (Image Bucket tab and Study tab) .......................................................... 46Image Viewing Tools........................................................................................................ 48Width & Center.................................................................................................................49Zoom ................................................................................................................................ 51Pan................................................................................................................................... 52Magnify............................................................................................................................. 53Invert ................................................................................................................................ 54True Size (1:1) .................................................................................................................55Fit To Window ..................................................................................................................56Unsharp Masking ............................................................................................................. 57Invert Red/Blue ................................................................................................................58Gamma Correction........................................................................................................... 59Contrast............................................................................................................................ 60Annotations : Introduction ................................................................................................ 61Annotation : Line ..............................................................................................................62Annotation : Ellipse .......................................................................................................... 63Annotation : Box...............................................................................................................64Annotation : Arrow............................................................................................................ 65Annotation : Freehand...................................................................................................... 66Annotation : Text ..............................................................................................................67Annotation : Measure ....................................................................................................... 68Annotation : Angle............................................................................................................ 69Annotate : Delete All Annotations .................................................................................... 70Annotations : Editing and Deleting ................................................................................... 71Advanced Viewing Operations................................................................................................................................. 75Key Images : an Overview ............................................................................................... 76DICOM Elements (“Tags”) ............................................................................................... 78Histogram......................................................................................................................... 79Cut-Lines.......................................................................................................................... 81Cine.................................................................................................................................. 84Compare Mode (Compare Series in One Study) ............................................................. 85Comparing Multiple Studies ............................................................................................. 86Printing (Paper and Film) ........................................................................................................................................... 89Printing Overview .............................................................................................................90The Image Bucket ............................................................................................................ 91Drag Individual Images to the Image Bucket ................................................................... 92Drag a Complete Series to the Image Bucket.................................................................. 92Print to Paper ................................................................................................................... 93Page 2

Print to Film ...................................................................................................................... 95Clear the Image Bucket.................................................................................................... 97Adding DICOM Printers.................................................................................................... 98Configuring DICOM Printers ............................................................................................ 99Removing DICOM Printers............................................................................................. 105CD Burning ........................................................................................................................................................................ 107Introduction to Burning CDs ........................................................................................... 108Creating a Patient Disc .................................................................................................. 109CD Burning Configuration .............................................................................................. 112CD Archiving .................................................................................................................. 114Send and Receive Exams........................................................................................................................................... 119Sending Exams : Introduction ........................................................................................ 120Sending Exams: .ONX or DICOM .................................................................................. 121Send (“Push”) an Exam.................................................................................................. 122Monitor the Progress of Pushed Exams......................................................................... 123Requirements to Receive Exams................................................................................... 125Sending Exams via DICOM : Configuration ................................................................... 126Set up AE Titles ............................................................................................................. 126Set up Contact Entries ................................................................................................... 129Automatic Sending (“Routing”)....................................................................................... 132Image Acquisition ....................................................................................................................................................... 135Introduction to Acquiring Images.................................................................................... 136Acquiring Orex Images : Step by Step ........................................................................... 137Acquiring Howtek Images : Step by Step....................................................................... 146Using Modality Worklist.................................................................................................. 153Every Toolbar .................................................................................................................................................................. 155The Toolbars : Overview ................................................................................................ 156Standard toolbar............................................................................................................. 157View Operations toolbar................................................................................................. 158Cut-line Operations toolbar ............................................................................................ 159Cine toolbar.................................................................................................................... 160Image Left-button Operations toolbar ............................................................................ 161Image Layout toolbar ..................................................................................................... 162Annotations toolbar ........................................................................................................ 164Group Control toolbar..................................................................................................... 165Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 3

Onyx-RAD Professional WorkstationUser ManualInstalling Onyx-RAD...................................................................................................................................................... 167Installing ......................................................................................................................... 168Configuration Manager ............................................................................................................................................ 183Start Configuration Manager .......................................................................................... 184AE Node Editor .............................................................................................................. 185Contact Editor ................................................................................................................ 188Exam Routing................................................................................................................. 192General Server Config ................................................................................................... 195Image Server Config ...................................................................................................... 197Windows 2000 Primer................................................................................................................................................201Using the Mouse ............................................................................................................ 202Mouse Click : Left or Right button? ................................................................................ 203Using the Keyboard........................................................................................................ 204Menu bars (“Menus”)...................................................................................................... 205Context Menus ...............................................................................................................205Toolbars ......................................................................................................................... 206Scrollbars ....................................................................................................................... 207Page 4

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1Welcome to Onyx-RADThis chapter officially welcomes you to Onyx-RADProfessional Workstation. The chapter covers mousebutton fundamentals, introduces the two main screens inProfessional Workstation – the Study List and the ImageViewer, and offers a brief look at what else is available inthis and other applications in the Onyx-RAD suite of medicalimaging tools.Chapter ContentsWelcome to Onyx-RAD.................................8Easy To Use .................................................9The Study List...............................................11The Image Viewer.........................................13Other Features/Options ofProfessional Workstation ..............................15How to Use This Manual...............................16Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 7

Onyx-RAD Professional WorkstationUser ManualWelcome to Onyx-RADThe Onyx-RAD suite of Telemedicine PACS applicationswas developed specifically to handle the DICOM protocol,for both transmitting and viewing DICOM images and dataelements. The applications were developed for networkedPCs running Microsoft Windows NT and 2000, and offer aninterface that users find to be quite intuitive after some initiallearning.The Onyx-RAD applications deal with all manner of DICOMimages and modalities, including MR, CT, CR, US, andmany others. These images can be viewed, manipulated,annotated, transmitted to other facilities, printed, animatedand stored using the Onyx-RAD suite.This manual is concerned primarily with the Onyx-RADProfessional Workstation application, though other parts ofthe suite will be explored as necessary (e.g., administratorconfiguration tasks.)Page 8

Easy To UseOnyx-RAD is designed to combine a multitude of powerfultools with an intuitive and configurable interface.With any software package, there is an initial learning curvethat must be surmounted. Trial and error lead tofamiliarization and efficiency. First-time users of MicrosoftWindows often become accustomed to it within a week ortwo of regular use.Onyx-RAD builds on this by using menus, shortcuts, andoperations which are similar to most other Windowsprograms, thus decreasing the learning curve andfamiliarization period. The Onyx-RAD applications makeextensive use of toolbars, context menus, drag-and-dropfunctionality, menus, and shortcut keys to provide evenmore efficiency to your busy schedule.The computer’s mouse has two buttons (some newermodels also have a third, the “middle” button, and/or ascroll-wheel in the center.) The behavior of these twobuttons, referred to as the “left” and “right” buttons,respectively, is consistent throughout Onyx-RAD software.The right mouse button: a single click with this buttonreveals a pop-up menu containing functions and optionspertinent to the area of the software you are currently using.“Dragging” (hold the button down and move the mouse) thisbutton is used primarily for functions like windowing animage while you view it.The left mouse button: Almost all other tasks are performedwith this button. A single click is used extensivelythroughout the software to select an item (e.g., select astudy in the Study Listing, select an image in the ImageViewer, select a recipient on the “Send To” dialog, etc.) oractivate a feature (e.g., clicking the appropriate toolbarbutton to activate the Zoom tool, clicking the “OK” button ona dialog in response to a question, etc.) Dragging with theOnyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 9

Onyx-RAD Professional WorkstationUser Manualleft mouse button is employed for two main functions inOnyx-RAD: dragging an object (e.g., dragging individualimages to the Image Bucket for printing) or using a tool(e.g., after activating the Zoom tool above, dragging the leftmouse button performs the zoom operation.)These behaviors are consistent with most other softwaredesigned to run in Microsoft Windows, so you will find thatyou use the same mouse skills across multiple softwareproducts, and you will very quickly become accustomed tousing the mouse.Please see Appendix C for a Windows 2000 primer if youare unfamiliar with Windows in general.Page 10

The Study ListThe basic functionality of Professional Workstationalternates between finding a study and viewing the images itcontains. Thus, Professional Workstation has been dividedinto two different screens, the Study List (for finding yourstudy) and the Viewer (for viewing and manipulating theimages.)The Study List screenAt the top of this screen are menu options and toolbars,below this are several smaller windows and a main window.This screen is intended to resemble some popular emailapplications, with filtering options on the left (for filtering thenumber and types of studies appearing the list) and the listof the studies in the main (and largest) section.The listing itself is divided into many columns includingStatus, Modality, Patient Name, Study Date, StudyDescription, etc. Studies can be sorted by any of thesecolumns, and many of the column headers actually doubleas search fields. All of these listing options enable you toOnyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 11

Onyx-RAD Professional WorkstationUser Manualquickly find your desired study among the thousands ofexams in your database.The Study List screen also gives you access to otherfeatures of Professional Workstation, such as sendingimages to other doctors, creating Patient CDs, and acquiringimages from film and plate scanners.To view your study, you simply double-click it. This willopen the exam in the Image Viewer screen (explored in thenext topic.)Page 12

The Image ViewerAfter locating your study in the Study List screen, a simpledouble-click will load up the images in the diagnostic-qualityImage Viewer screen.The Image Viewer screenThis screen retains the menus and toolbars found on theStudy List screen (and adds a few menus and toolbarbuttons) and sets up the remainder of the screen to aid indiagnostic viewing. The largest section of the screen isreserved for displaying the images, and be configured todisplay the images in any number of columns / rows (thesample picture above shows 2 column view.)The smaller section on the leftmost side of the screen is theSeries/Stacks window, which holds thumbnail images ofevery series (also referred to as a stack) in the exam.These thumbnails also act as buttons (allowing you toquickly navigate between series) and also indicate yourOnyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 13

Onyx-RAD Professional WorkstationUser Manualposition in the current series via the actual thumbnail picturedisplayed and the progress bar at the top of each thumbnail.The rightmost window seen in the sample picture is theImage Bucket, where individual images of interest aredragged for printing. With one click, the Image Bucket canbe replaced with the Stats Bar which displays summaryexam information like patient name, study date, anddescription, and holds quick buttons like Close Study.The Image Viewer screen provides a vast array of powerfulimage manipulation tools to assist in your diagnosis.Images can be windowed/leveled manually andautomatically, sharpened, flipped, rotated, zoomed, panned,and inverted. You can view “cut-lines” (image intersections,e.g. MRI studies), histograms, Hounsfield Units (for CT),and DICOM elements (“tags”). Additionally, you cananimate (“cine”) entire series, mark individual images as“key images” (for quick reading later) and “Unsharp Mask”CR images. Various annotation tools are available, rangingfrom simple arrows and text boxes to angle and distancemeasurements. Advanced paper printing – including theability to define exactly how the printed page will lookbeforehand – is also included.Page 14

Other Features / Options ofProfessional WorkstationOnyx-RAD Professional Workstation is highly configurableand modular. In its most basic form, ProfessionalWorkstation includes all of the advanced Study Listing andImage Viewing features mentioned above, including CDburning. Available modules add to this functionality byproviding:• Sending and Receiving images over phone line,local area networks, and the Internet. The Onyx-RAD suite features truly impressive teleradiologycapabilities, including DICOM transmission/receive,and a proprietary format for transmissions betweentwo Onyx-RAD machines utilizing compression,encryption, and auto-resume functions.• Acquisition of images. Professional Workstation canbe configured as a QC (quality control) Acquirestation and connected to one of several compatiblescanners, such as the Orex PcCR line of CRscanners, Howtek film digitizers, the VIDARDiagnostic Pro film digitizer, Lumisys Film digitizers,frame-capture devices, and any acquisition devicethat already speaks DICOM.• Film printing. For those instances where film isessential, Professional Workstation providesadvanced capabilities and control over the finalappearance of the printed film, and is compatiblewith virtually all film cameras.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 15

Onyx-RAD Professional WorkstationUser ManualHow to Use This ManualThe next chapter offers a walkthrough for typical usage ofProfessional Workstation, which includes locating a study inthe Study List screen, viewing and basic manipulation of thestudy’s images in the Image Viewer screen, and returning tothe Study List.The rest of the chapters explore individual sections ofProfessional Workstation in greater detail, including theStudy List and Image Viewer screens, advanced imageviewing and manipulation tools / operations, printing topaper and film, creating Patient CDs (“cd burning”), sendingand receiving exams, and acquiring exams from asupported acquisition device.The appendices cover the Onyx-RAD ConfigurationManager program as it relates to Professional Workstationtasks, the Onyx-RAD installation process, and a MicrosoftWindows primer to cover the basic of using Windows as itrelates to the use of Professional Workstation.Page 16

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2Brief Walkthrough ofProfessional WorkstationThis chapter offers a walkthrough for typical usage ofProfessional Workstation. The walkthrough includeslocating a study in the Study List screen, viewing and basicmanipulation of the study’s images in the Image Viewerscreen, and returning to the Study List.Chapter ContentsIntroduction ...................................................20Log On ..........................................................21The Study List screen ...................................22The Image Viewer screen.............................24Going Further................................................26Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 19

Onyx-RAD Professional WorkstationUser ManualIntroductionOnyx-RAD Professional Workstation (a.k.a. “Workstation”for brevity) is a network client application that allows usersto view and manipulate vast amounts of DICOM and patientinformation.There are two basic functions in Workstation: selecting apatient and viewing that patient’s images. As such, theprogram is divided into two interfaces: the Study List screenfor selecting patient studies, and the Diagnostic-QualityImage Viewer screen for viewing and manipulating theimages. As you use Workstation, you will find that youalternate between these two screens quite frequently.In this chapter we will look at a sample user session ofViewer. This session includes the following steps:• Logging In• Study List screen:o Searching for a patient study in the databaseo Selecting a study to view• Image Viewing screen:o Viewing the images of this patient• Returning to Study List screenPage 20

Log On(This dialog may not appear if your Workstation isconfigured to log on automatically.)The first step in a Workstation session is to log on so thatyou may access the database of patient studies. The log ondialogue (shown above) consists of three boxes that mustbe filled in. The first two, username and password, areassigned to you by your database administrator (or similarauthority). Requiring a valid username and password is aneffective security measure for protecting the records of yourpatients.The Database field contains the name of the database inuse at your facility. In most cases it will already contain thecorrect name, and should not be changed. For our examplesession, our database name is “Onyx”.Once you have filled in the three fields, click the OK buttonto enter Onyx-RAD Professional Workstation.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 21

Onyx-RAD Professional WorkstationUser ManualThe Study List screenAs stated earlier, Onyx-RAD Professional Workstationconsists of two interfaces (screens), each with a separatefunction. The first interface you will see when enteringWorkstation is the Study List screen. This interface is usedfor searching and selecting patient studies and sendingstudies to other users. The picture below shows thisscreen.At the top of this screen are menu options and toolbars, andbelow these are several smaller windows and a mainwindow. These windows simulate an email application, withthe largest window listing the patients currently in thedatabase along with their many attributes, the way an emailprogram would list emails in an inbox. This listing window isdivided into columns such as Status, Modality, PatientName, etc., with scrollbars (vertical and horizontal) allowingyou to scroll through the many records in the database.Icons on the far left of the screen toggle the display list byALL, UNREAD, READ, and INCOMPLETE studies.Page 22

In our example session, we are interested in a particularpatient whose exam was entered into the database recently,so we will sort the listing by date by clicking the “Date”column heading.The listing is now sorted by Date, but for our example thishasn’t helped us much because there are many studies thatwere entered recently. Our next step is to perform a quicksearch for this patient by name. To search by any field inthis study listing, simply double-click in the white spacedirectly below the column heading, and type in your searchterms. We are looking for a John Doe, so we type that inand click OK:The Patient listing is updated to display only the patientsthat match the search criteria. From this reduced listing wecan see our desired patient. Now to view the images in thisstudy, we double-click the Patient’s listing. The images willbegin to load and the Image Viewer screen will appear,temporarily hiding the Study List screen, which is notneeded for the moment.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 23

Onyx-RAD Professional WorkstationUser ManualThe Image Viewer screenAfter double-clicking the selected study you will be whiskedaway to the Viewer screen. This screen is a DiagnosticQuality image viewer where you will perform all of yourimage viewing and manipulation.Note that the menu bar and toolbars have remained at thetop of the screen, gaining some additional items. Only theworkspace has significantly changed, with a new set ofwindows designed to enhance viewing.Leftmost is the Series Window, which displays thumbnails ofeach series in the study. The largest window in theworkspace is the actual viewing window, where the image(s)are displayed.The images are displayed in columns according to yourselected number of columns. You will find buttons on thetoolbar to change the number of columns used in thewindow.Page 24

The buttons above allow you to use 1, 2, 3, 4, 16, or aspecified number of columns for display.The Viewer screen offers a large number of tools andfunctions for viewing medical images. Please see theappropriate sections of this manual for more discussion ofthe features. You will find that most of the features can beaccessed quickly through a toolbar button or the contextmenus.When viewing is complete, there are two methods of closingthe study to return to the Study List screen. If the Stats Baris displayed (on the right-hand side of the screen), you canclick the “Close Study” button. The other method is to rightclickan image in the main image window (the largestsection of the screen) and select the Close Study option(near the top of the menu.)Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 25

Onyx-RAD Professional WorkstationUser ManualGoing FurtherThis completes our sample session using Onyx-RADProfessional Workstation. We have only looked at the mostbasic functionality of the software: selecting and viewing astudy. Professional Workstation contains many useful andspecialized functions designed to increase efficiency andthe quality of reading. Please review the more advancedsections of the manual to learn about them.Page 26

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3The Study List ScreenThis chapter explores in detail the first of two screens youwill constantly alternate between while using ProfessionalWorkstation. This screen lists all of the exams in thedatabase(s) you are connected to, allowing you to filter andsort the listing as you navigate the list.From this screen you can also change a study’s status,send it to another site, create Patient CDs, and view studyhistories.Chapter ContentsOverview of the Study List screen ................30Columns in the Study List .............................32Rearrange Study List Columns.....................33Remove Study List Columns ........................33Restore Study List Columns .........................34The Study List Filter Window ........................35Filter by Study Status....................................35Filter by Study Modality ................................36Filter by both .................................................36The Personal Button .....................................37Patient’s Studies window ..............................37Select a Study for Viewing............................37Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 29

Onyx-RAD Professional WorkstationUser ManualAn Overview of the Study List ScreenLet’s start by identifying this screen’s distinct parts.Menus andToolbarsStudy List FilterWindowStudy ListPatient’s StudiesDatabase TabThe Menus and Toolbars hold entries and shortcuts tocommon functions of Workstation. Note that most of thetoolbar buttons are “grayed out”, i.e., disabled, because theyhave no relevance on this screen.The Study List Filter Window holds icons representing studystatuses and the various modalities that Workstationsupports. Clicking any one of these icons will update themain study listing to display only the studies whose status ormodality matches the icon clicked.The Study List is the largest and most important part of thisscreen, as it holds the actual listing of studies in yourdatabase. The list is divided into several columns(completely configurable as we’ll see later) to organize all ofthe information available – like Patient Name, age, sex, andbirthdate, the study’s status, number of series and numberPage 30

of images, description, originating institution, etc.The Patient’s Studies window is a handy tool which works inconjunction with the study listing to quickly show you all ofthe studies associated with the selected patient.The Notes Window quickly displays study notes entered bya technologist at the time of QC’ing (qualitycontrol/checking) the images.Finally, the Database Tab (or Tabs) indicate whichdatabase(s) you are currently logged onto. ProfessionalWorkstation allows you to log onto multiple databasessimultaneously and switch between the listings by way ofthese easy one-click tabs.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 31

Onyx-RAD Professional WorkstationUser ManualColumns in the Study ListThe columns available in the Study List are (listed here indefault order):• Status• Modality• Series• Images• Study ID• Patient Name• Patient ID• Description• Study Date• Referring Physician• Gender• Age• Date of Birth• Social Security Number• Accession Number• Institution Name• Owner• GroupThe column header themselves serve double-time asbuttons which you can click to sort the study list by that field.For example, click the Patient Name column header to sortthe list by Patient Name, ascending. Click the header againto reverse the sort (resulting in Patient Name, descendingorder.)After sorting the list you can use the scroll bar on the rightside of the list to scroll through the list and find your desiredstudy.Page 32

Rearrange Study List ColumnsThe column listing on the previous page follows the defaultorder of the columns in the Study List. However, thesecolumns can be rearranged in any order desired. Simply“drag” (left-click and hold, then move the mouse) the columnheader to its new place between two other column headers.As you drag the column header between two other columnheaders, little red arrows will appear to indicate a validplacement for the header. Simply release the mouse buttonto drop the column header into place.All column headers can be moved around in this manner.Remove Study List ColumnsYou may find that you prefer to have certain columns listedin the Study List. This may be because the information isunnecessary or not available (e.g., many institutions do notuse an Accession Number.)To remove a column header, simply “drag” (left-click andhold, then move the mouse) the column header down. Afteryou have dragged the column header below the othercolumn headers, release the mouse button and the columnheader will disappear.You can remove as many column headers as you like.Please see the next topic for information on restoringcolumn headers.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 33

Onyx-RAD Professional WorkstationUser ManualRestore Study List ColumnsBecause it is very easy to remove column headers, it isquite possible that you or another user may remove columnheaders.To see a list of columns that have been removed, click the“worklist Fields” button, seen below:Worklist Fields buttonA “Field Chooser window appears containing all Study Listcolumns that have been removed:To restore a column, “drag” it (left-mouse click and hold,then move the mouse) from the Field Chooser window to itsnew spot on the Study List, between two other columns.(When you drag the column header between two existingcolumns, little red arrows appear indicating that your columncan be inserted here.) Release the mouse button and thecolumn will be inserted.Page 34

The Study List Filter WindowSorting the study list by any column is handy enough, butonce you begin to accumulate hundreds of studies, the listbecomes quite long and more time-consuming to navigateby scrolling through it. Filtering what is displayed in the listbecomes essential.The Study List Filter window contains three horizontalbuttons labeled “Global,” “Personal,” and “Modality.”Filter by Study StatusTo filter by study status, click the “Global” button. Observethe icons available: All, Unread, Read, Incomplete, andDeleted. Click any one of these icons to alter the studiesdisplayed.All :Display studies of any status.Unread : Display only studies marked Unread. Unreadstudies have been validated by a technologist andare awaiting diagnosis.Read : Display only studies marked Read. After readingand diagnosing a study you should mark it Read toindicate this.Incomplete : Display only studies marked Incomplete.These studies are considered “incomplete” becauseeither (a) the images are still coming into the system(from the modality or another sender), or (b) thetechnologist has not yet validated this study (at which timethe study will become “Unread”.)Deleted : Display only deleted studies. Studies markeddeleted remain on the system for a time. If you needto access a study you’ve deleted, click this icon.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 35

Onyx-RAD Professional WorkstationUser ManualFilter by ModalityTo filter by modality, click the “Modality” button. Observethe icons available – one for each modality that Workstationsupports. (Also notice the downward arrow button at thebottom-right of the Filter window, indicating more modalityicons to choose from. Click this arrow to see more modalityicons.)Simply click the desired modality icon to filter the study listappropriately. Click the “ALL” icon to display studies fromall modalities.Filter by bothYou can filter by a combination of status and modality.Simply click your first filter icon (either a modality or statusicon), and then an icon from the other filter list.Note that the gray title bar for the Study Listing will updateas you change the Status or Modality filter type. “All Global”changes to “Unread Global” when you click the “Unread”icon, and you will observe that only studies whose status is“Unread” will be displayed. Note that clicking the “ALL” iconreturns the display to “All Global” and studies of all statusesare again displayed.Filtering by modality will similarly change the title bar. Thesample picture below shows the title bar after clicking“Unread”, and then additionally filtering by MR modality.Page 36

The Personal buttonThe “Personal” button in the Filter window works the sameway as the “Global” button, and displays icons to filter bystudy status. The personal view, however, is intended toprovide a personalized view of the database. Generally, it isrecommended to use the Global button.Patient’s Studies windowWhen you single-click a study in the study list it becomesthe selected study. Workstation will quickly search throughthe study list to find every other study for this selectedpatient, and after a moment displays these studies in thePatient’s Studies window. This enables you to quickly seeall studies for the patient you are interested in. You canalso select the study to view from this window just as you dofrom the main study list window.Select a Study for ViewingWhen you have located your desired study, simply doubleclickit in either the main study list window or the patient’sstudies window.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 37

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4The Image Viewer ScreenThis chapter explores in detail the second of two screensyou will alternate between while using ProfessionalWorkstation. This screen displays the images contained inPatient exams.A wide range of manipulation tools is available to aid in yourreading and diagnosis.Chapter ContentsAn Overview of the Image Viewer Screen ....42The Series Window.......................................43The Image window........................................45The Config Bar..............................................46Image Viewing Tools ....................................48Width & Center .............................................49Zoom.............................................................51Pan ...............................................................52Magnify .........................................................53Invert.............................................................54True Size (1:1) ..............................................55Fit To Window...............................................56Unsharp Masking..........................................57Invert Red/Blue .............................................58Gamma Correction .......................................59Contrast ........................................................60Annotations : Introduction .............................61Annotation : Line...........................................62Annotation : Ellipse .......................................63Annotation : Box ...........................................64Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 39

Onyx-RAD Professional WorkstationUser ManualAnnotation : Arrow ........................................65Annotation : Freehand ..................................66Annotation : Text...........................................67Annotation : Measure....................................68Annotation : Angle ........................................69Annotate : Delete All Annotations .................70Annotations : Editing and Deleting................71Page 40

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Onyx-RAD Professional WorkstationUser ManualAn Overview of the Image ViewerScreenLet’s start by identifying this screen’s distinct parts.Menus andToolbarsSeries windowImage windowImage Bucketwindow☼ Remember thatscreenshots heremay look slightlydifferent from yourworkstation due tocustomization.The Menus and Toolbars are similar to those seen on the StudyListing Screen (explored in the previous chapter), but now includemore menus and functions that are relevant to manipulatingimages.The remaining sections of this screen are described in separatetopics, below.Page 42

The Series Window☼ As part of thecustomizationavailable, the SeriesWindow can beturned on and off atany time. Toaccomplish this, seepage 45.Leftmost on the screen is the Series/Stacks window, inwhich every series (or “stack”) of images is indicated by athumbnail picture of the first image in that stack.At any time, the series which is currently being viewed (inthe Image Viewing area) is noted with a red border aroundit. (On grayscale monitors, a thick white border isobserved.)A patient study may contain many series, all of which areloaded when the study is opened. All series are loaded intothe Series/Stack window as thumbnail images, andgenerally the first image(s) of the first series is displayed inthe Image Viewing area. To view another series, simplymove the mouse cursor over the series thumbnail (in theSeries window) you wish to view, and click the left mousebutton one time.Note that on studies where the technician has entered Studyor Series descriptions, holding the mouse cursor over aseries thumbnail (in the Series/Stack window) for a momentor two will display a “tooltip” hint showing the description.☼ You can also usethis position bar as anavigational tool.Click anywherealong the gray bar tomove to that positionin the series.The series thumbnails update to show the current imagebeing viewed as you move through the study in the mainImage window. Additionally, there is a gray progress bar atthe top of each thumbnail that displays visually your positionin the current series, indicated by the yellow box in the bar.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 43

Onyx-RAD Professional WorkstationUser ManualThough the Series window is perhaps most useful with theseries thumbnails displayed in one column, it is possible tochange the number of columns at any time, by using two ofthe column layout buttons seen below:Stack ViewbuttonFirst, click on the Stack View button to indicate that you wishto change columns for the Series window (otherwise you willaffect the Image window.) Then click the buttonrepresenting the number of columns you desire. Finally, it isa good idea to click the Stack View button again as mostusers expect the column layout buttons to affect the Imagewindow, not the Series window.Page 44

The Image windowThe largest area in the previous screenshot, the centralarea, is the Image window. This is where image viewingand manipulation occurs. In the sample screenshot, theimages are displayed in a two-column format, which can bechanged at any time (as we will see later.)Note that only a limited number of images may be shown inthe viewing area at one time (only so many will fit), thus ascroll bar is provided on the right-hand side of this viewingarea to allow you to scroll down and see more images.☼ See Appendix Cfor details on usingscroll bars inMicrosoft Windows.☼ The ability tomove to anotherseries using theRight and Left arrowkeys can be enabledin the Preferencesdialog.☼ Adjusting thenumber of columns.You can navigate through the images in a study by any ofthese methods:• Use the scroll bar to the immediate right of theImage window• Use the arrow keys on your keyboard• Use the wheel on your mouse (if present)• Click on the position bar in the series thumbnail (inthe Series Window)When using the arrow keys, take note:• Right arrow key moves forward in a series, Leftarrow key moves backward.• Down arrow key moves forward in a series, Up arrowkey moves backward.• Right and Left arrow keys will not advance beyondthe current series.• Up and Down arrow keys will advance beyond thecurrent series.The number of columns displayed in the Image window canbe changed at any time by clicking on one of the columnlayout buttons, as seen here:Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 45

Onyx-RAD Professional WorkstationUser ManualThe Config Bar (Image Bucket tab andStudy tab)☼ As part of thecustomizationavailable, the ConfigBar can be turnedon and off at anytime. To accomplishthis, see page 157.Immediately right of the Image Viewing area is the ConfigBar, which consists of two tabs: Image Bucket and Study.These two tabs are explored below.Tabs such as these allow formultiple sub-windows tooccupy the same space,providing more screen area for other things (most notablythe Image Viewing area.) The tabs work the same way atab in a rolodex would work. Simply click the tab you wishto view and that sub-window will appear in the Config barspace. In this example screen shot, the Image Bucket tab isselected.Config Bar : Image Bucket tabThe Image Bucket is the gateway to printing; all printingoccurs through this handy little window. The window iscomposed of a large white area with several more buttons atthe bottom. This white area is used to hold the images youwill print. The buttons at the bottom perform actions specificto the Image Bucket.Please see the chapter 6: “Printing” for more information onprinting and using the Image Bucket.Page 46

Config Bar : Study tabThis sub-window is handy informational and shortcutwindow when viewing a patient study. The top portion of thewindow lists the Patient ID,Patient Name, Study ID, StudyDate, and Study Description forthe current study.Below these fields are threelarge shortcut buttons:Mark Read : click to change thestudy’s status to “Read.” (unavailableif the study is already“Read”.)Mark Unread : click to changethe study’s status to “Unread”.Close Study: click to close thestudy and return to the StudyListing screen.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 47

Onyx-RAD Professional WorkstationUser ManualImage Viewing ToolsOnyx-RAD Professional Workstation features a vast array ofimage manipulation tools to assist in diagnosticinterpretation of medical images.All of the tools described in this chapter have easy, one-clicktoolbar buttons to activate them. They are also availablefrom the Image Context menu (right-click on any image),and additionally can be found by navigating the menus inthe menu bar.Each topic below names an image manipulation tool, liststhe ways to activate it (toolbar button, menu entry, etc.), andexplores its usage.Page 48

Width & Centerthe Width & Center toolbar buttonThis is the most basic and yet most important tool available,as it adjusts the width and center (also known as “windowand level”, or simply brightness and contrast) of an image.Adjusting the width and center of an image allows forviewing different “levels” of an image, e.g., moving frombone to soft tissue.To perform the width & center:1. Place the mouse cursor over the image.2. Hold down the right mouse button.3. Move the mouse horizontally and/or vertically; theimage is adjusted as you do so.4. When satisfied with the image, release the rightmouse button.Horizontal movement of the mouse adjusts “center”; verticalmovement adjusts “width.”This tool can be also be activated with its toolbar button(above). Click the toolbar button to turn this tool on, anduse it by holding down the left mouse button while draggingthe mouse over an image.The width & center tool can also be found in the Imagemenu, or by right-clicking any image and choosing the toolfrom the context menu.Width & Center all images in a seriesNote that if the “Share single frame properties” button isenabled, whatever width & center changes you make to oneimage will also apply to all other images in the same series.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 49

Onyx-RAD Professional WorkstationUser ManualTo enable or disable this behavior, click the “Share singleframe properties” button.Page 50

Zoomthe Zoom toolbar buttonThis tool is used to zoom the entire image “in” (for closerinspection) or “out” (view the whole image at once.)To use this tool, first activate the Zoom tool. This isaccomplished by either clicking the Zoom button on thetoolbar, or by choosing the Zoom entry from the ImageContext menu.The mouse cursor will change to the Zoom tool cursor.To perform the zoom:1. Activate the zoom tool.2. Place the cursor over the image.3. Hold down the left mouse button.4. Move the mouse up to zoom in, down to zoom out.5. Release the left mouse button.Note that as you zoom images in it may no longer bepossible for the entire image to fit in the window, thus thePan tool may be of some assistance in moving the imagearound.Zoom all images in a seriesNote that if the “Share single frame properties” button isenabled, whatever zoom changes you make to one imagewill also apply to all other images in the same series. Toenable or disable this behavior, click the “Share single frameproperties” button.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 51

Onyx-RAD Professional WorkstationUser ManualPanthe Pan toolbar buttonUse this tool to move an image around within its displaywindow.To activate the Pan tool, either click the Pan button on thetoolbar, or choose the Pan entry from the Image Contextmenu.To perform a pan:1. Activate the Pan tool.2. Place the cursor over the image.3. Hold down the left mouse button.4. Move the mouse in any direction; the image willfollow your movements.5. When you are satisfied with the image’s placement,release the left mouse button.Pan all images in a seriesNote that if the “Share single frame properties” button isenabled, panning one image will also pan all other images inthe same series. To enable or disable this behavior, clickthe “Share single frame properties” button.Page 52

Magnifythe Magnify toolbar button☼ The popup window isa 2x magnification. Forgreater magnification,zoom the image in firstwith the Zoom tool, thenuse the Magnify tool.Use this tool to magnify parts of an image, similar to using amagnifying glass. This is in contrast to the Zoom tool, whichwill zoom the whole image. The magnifying tool creates atemporary pop-up window which you can move over theimage as you would a magnifying glass.To activate the Magnify tool, either click the Magnify buttonon the toolbar or click the Magnify entry on the ImageContext menu.To use the Magnify tool:1. Activate the Magnify tool.2. Place the cursor over the image.3. Hold down the left mouse button. Observe the popupmagnifying window.4. Move the mouse around over the image and themagnifying window will follow your movements.5. Release the left mouse button and the magnifyingwindow will disappear.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 53

Onyx-RAD Professional WorkstationUser ManualInvertthe Invert toolbar buttonUse this tool to invert the black and white pixel data, givingthe image a “negative” appearance.To use this tool, simply click the Invert button on the toolbaror click the Invert entry on the Image Context menu. Theselected image will invert. To restore the image, simplyclick the Invert button again.Invert all images in a seriesNote that if the “Share single frame properties” button isenabled, inverting one image will also invert all other imagesin the same series. To enable or disable this behavior, clickthe “Share single frame properties” button.Page 54

True Size (1:1)the True Size toolbar buttonUse this tool to display the image in its true size, i.e., 1-to-1ratio. When in 1:1 mode, you can view every pixel thatmakes up the image.To use the True Size tool, simply click the True Size buttonon the toolbar or click the True Size entry on the ImageContext menu.Note that the image may be too large for the viewingwindow, especially if you are viewing in multiple columns. Inthis case, you may wish to change the number of columns(see 162), use the Zoom tool to zoom the image out, or usethe Fit To Window tool.True Size all images in a seriesNote that if the “Share single frame properties” button isenabled, clicking the True Size tool will affect all images inthe same series. To enable or disable this behavior, clickthe “Share single frame properties” button.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 55

Onyx-RAD Professional WorkstationUser ManualFit To Windowthe Fit To Window toolbar buttonUse this tool to expand or shrink an image so that it fits inthe image viewing window.This tool is of assistance when viewing large images inmultiple columns as it shrinks images to fit in these smallerwindows and allows you to view the whole image at once.To use this tool, simply click the Fit To Window button onthe toolbar, or click the Fit To Window entry on the ImageContext menu.Fit all images in a seriesNote that if the “Share single frame properties” button isenabled, clicking the Fit To Window tool will affect allimages in the same series. To enable or disable thisbehavior, click the “Share single frame properties” button.Page 56

Unsharp MaskingUnsharp Masking is a technique which processes an imageinto a clearer and more defined image. In general, sharpparts of an image are sharpened and less defined areasbecome clearer. It is a better technique than simplesharpening because the results are much less harsh than asimple sharpen would produce.Unsharp Masking is most effective on large, CR images,such as those acquired from an Orex PcCR scanner.To use the Unsharp Masking tool:1. Place mouse cursor over the image.2. Click the right mouse button to bring up the ImageContext menu.3. Click (with left mouse button) the “Unsharp Mask”entry.4. Click (with left mouse button) the percentage youwould like to use. Higher values will unsharp maskthe image more, but may result in a harsh image.5. Wait a moment for the system to process the image.To “undo” the effects of unsharp masking and return theimage to its original state, use the Unsharp Masking toolagain but choose “Reset” from the percentage menu.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 57

Onyx-RAD Professional WorkstationUser ManualInvert Red/Bluethe Invert Red/Blue toolbar buttonThis tool is useful for Ultrasound images and acts like theinvert tool for grayscale images, swapping blue and redvalues.To use this tool, simply click the Invert Red/Blue button orclick the Invert Red/Blue entry on the Image Context menu.Invert all images in a seriesNote that if the “Share single frame properties” button isenabled, using the Invert Red/Blue tool will affect all imagesin the same series. To enable or disable this behavior, clickthe “Share single frame properties” button.Page 58

Gamma Correctionthe Gamma Correction toolbar buttonThis tool uses gamma correction by locating the midpointgray values and softening extremely light and dark tones inan image.To activate the Gamma Correction tool either click theGamma Correction button on the toolbar or click theGamma Correction entry on the Image Context menu.To use this tool:1. Place mouse cursor over the image.2. Activate the Gamma Correction tool.3. Hold down the left mouse button and move themouse up or down to adjust the Gamma Correction.4. When satisfied with the image, release the leftmouse button.Gamma Correct all images in a seriesNote that if the “Share single frame properties” button isenabled, using the Gamma Correction tool will affect allimages in the same series. To enable or disable thisbehavior, click the “Share single frame properties” button.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 59

Onyx-RAD Professional WorkstationUser ManualContrastRight-click on an image and choose “Contrast” for threeContrast operations:Original contrast : click this to reset the width and centervalues present when the exam was opened.Auto contrast : click this to perform an auto width & centeradjustment.Reset contrast : click this to reset the width and centervalues to those present when the exam was validated.Often this value will be the same as the “original contrast”option above.Page 60

Annotations : IntroductionAnnotation buttonsAnnotating in Professional Workstation consists of addingtext and graphical objects to enhance or isolate regions ofinterest within an image.Annotations do not permanently alter the image; rather theyare stored separately from the image data, and are held in atransparent layer atop the image. (Think of a transparencysheet with writing laid over a picture.) Thus it is not possiblefor annotations to damage the original image data, and theycan be hidden at any time to allow full analysis of the image.All of the annotation tools described over the next severalpages have easy, one-click toolbar buttons to activate them.They are also available from the Image Context menu (rightclickon any image, choose “Annotate”), and additionally canbe found by navigating the menus in the menu bar.Each topic below names an image annotation tool, lists theways to activate it (toolbar button, menu entry, etc.), andexplores its usage.Save your Annotations!One of the most important reminders is to save yourannotations.After you have annotated images in a study, be sure tosave those annotations! This is accomplished simplyby clicking the “Save Annotations to Database” buttonshown here. The button is found on the Annotationstoolbar.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 61

Onyx-RAD Professional WorkstationUser ManualAnnotation : Linethe Line tool buttonThis tool creates a straight line on the image.To use this tool, click the Line tool button on the Annotationstoolbar (or choose the tool from the Annotations contextmenu) and:1. (left-)Click on an area of the image to set the line’sfirst endpoint.2. Move the mouse pointer to where the secondendpoint will be (notice that a preview of the line isdrawn while you move the mouse).3. (left-)Click on an area of the image to set the line’ssecond endpoint.The easiest way to quickly remove the annotation is to rightclickthe image (which displays the image context menu)and choosing “Delete All Annotations” from this menu.Page 62

Annotation : Ellipsethe Ellipse tool buttonThis tool creates a (hollow) ellipse on the image. This isoften used to circle an ROI (region of interest).To use this tool, click the Ellipse tool button on theAnnotations toolbar (or choose the tool from the Annotationscontext menu) and:1. (left-)Click on an area of the image to start theellipse.2. Move the mouse pointer and observe the ellipseexpanding. Move the mouse such that the ellipsewill enclose the ROI.3. (left-)Click to set the ellipse in place.Regarding the initial click: it is generally best to click a spotthat is above and left of the ROI, as you will then drag theellipse down and to the right to enclose the ROI. It generallytakes a few practice ellipses to master the technique.The easiest way to quickly remove the annotation is to rightclickthe image (which displays the image context menu)and choosing “Delete All Annotations” from this menu.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 63

Onyx-RAD Professional WorkstationUser ManualAnnotation : Boxthe Box tool buttonThis tool creates a (hollow) box on the image. You cancreate a square or a rectangle of any ratio (tall, long, etc.)and is often used to indicate an ROI (region of interest).To use this tool, click the Box tool button on the Annotationstoolbar (or choose the tool from the Annotations contextmenu) and:1. (left-)Click on an area of the image to start the box.2. Move the mouse pointer and observe the boxexpanding.3. (left-)Click again to set the box.Regarding the box drawing technique: your first click will seta corner of the box in place. Generally, make your first clickabove and left of the ROI. This will set the top left corner ofthe box. You then move the mouse down and right to drawthe box and enclose the ROI.The easiest way to quickly remove the annotation is to rightclickthe image (which displays the image context menu)and choosing “Delete All Annotations” from this menu.Page 64

Annotation : Arrowthe Arrow tool buttonThis tool creates an arrow (or “pointer”) which will point atan area of the image.To use this tool, click the Arrow tool button on theAnnotations toolbar (or choose the tool from the Annotationscontext menu) and:1. (left-)Click the mouse on an area of the image to setthe pointer end of the arrow.2. Move the mouse and observe the trailing end of thearrow following your movements. You can rotate thearrow around and shorten or lengthen the trailingend.3. (left-)Click the mouse to set the other endpoint of thearrow.Regarding the arrow drawing technique: your first click setsthe arrowhead, so you should click on or very near the areathat you wish to point to. The trailing line should be madewhatever length you feel is appropriate and can be rotatedso that the arrow is out of the way of other ROI or otherannotations.The easiest way to quickly remove the annotation is to rightclickthe image (which displays the image context menu)and choosing “Delete All Annotations” from this menu.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 65

Onyx-RAD Professional WorkstationUser ManualAnnotation : Freehandthe Freehand tool buttonThis tool is used to draw freehand on the image. With thetool you are able to draw any shape or figure that youdesire.To use this tool, click the Freehand tool button on theAnnotations toolbar (or choose the tool from the Annotationscontext menu) and:1. Move the mouse over the image to where you wouldlike to start drawing.2. Hold down the left mouse button (the mouse pointerchanges to hand) and drag the mouse. As youmove the mouse, the drawing will mimic yourmovements.3. Continue to draw as necessary.4. Release the left mouse button to end the freehanddrawing.The easiest way to quickly remove the annotation is to rightclickthe image (which displays the image context menu)and choosing “Delete All Annotations” from this menu.Page 66

Annotation : Textthe Text tool buttonThis tool allows you to place typed text on the image. Manydoctors use this in conjunction with other tools, such as thearrow or ellipse, to explain the ROI or indicate opinions /readings.To use this tool, click the Text tool button on the Annotationstoolbar (or choose the tool from the Annotations contextmenu) and:1. (left-)Click on an area of the image to set the upperleft corner of the textbox.2. Move the mouse downward and to the right to setthe size of the textbox.3. (left-)Click to set the textbox’s size.4. The area you have boxed off now turns white and aflashing cursor appears in the top left part of thetextbox. At this point you should type your text withthe keyboard.5. When you are done typing, press the Enter key onthe keyboard.Notes on the text tool: the initial setup of the tool has youcreate a “textbox”, simply a rectangular area in which yourtext will be placed. The borders of this textbox do notappear once you have typed the text.Note that the text will only appear as wide as the textboxyou set up, thus you are effectively setting the size of the“page” on which the text appears. Be sure to create atextbox large enough to hold all that you wish to say.The easiest way to quickly remove the annotation is to rightclickthe image (which displays the image context menu)and choosing “Delete All Annotations” from this menu.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 67

Onyx-RAD Professional WorkstationUser ManualAnnotation : Measurethe Measure tool buttonThis tool is used to measure straight-line distance (inmillimeters) of an area in the image.To use this tool, click the Measure tool button on theAnnotations toolbar (or choose the tool from the Annotationscontext menu) and:1. (left-)Click on the image to set the first end point ofthe ruler.2. Move the mouse and observe that the line beingdraw follows your movement. Move the mouse towhere the end point of the measurement will be.3. (left-)Click to set the end point. Observe themeasurement that appears.4. At this point, you have the option of moving thedrawn line and measurement out of the way. Movethe mouse up or down (for horizontalmeasurements) or side to side (verticalmeasurements) and note that the text will move withyou.5. (left-)Click a final time to set the placement of thetext.Note that the ability to move the position of themeasurement text allows you to leave the measured areauncovered and in full view.The easiest way to quickly remove the annotation is to rightclickthe image (which displays the image context menu)and choosing “Delete All Annotations” from this menu.Page 68

Annotation : Anglethe Angle tool buttonThis tool is used to draw an angle and display themeasurement of that angle.To use this tool, click the Angle tool button on theAnnotations toolbar (or choose the tool from the Annotationscontext menu) and:1. (left-)Click on the image to set the vertex (centerpoint) of the angle.2. Move the mouse and notice the drawn line whichfollows your movements.3. (left-)Click to set the endpoint of the first vector.4. Move the mouse and notice the second drawn linewhich follows your movements.5. (left-)Click to set the end endpoint of the secondvector.6. At this point, the angle’s measurement is displayedand you have the option of moving the text out of theway. Move the mouse and observe themeasurement text moving with you.7. (left-)Click a final time to set the position of the text.Note that the ability to move the position of themeasurement text allows you to leave the measured areauncovered and in full view.The easiest way to quickly remove the annotation is to rightclickthe image (which displays the image context menu)and choosing “Delete All Annotations” from this menu.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 69

Onyx-RAD Professional WorkstationUser ManualAnnotate : Delete All AnnotationsThis is only available from the image context menu (rightclickthe image with annotations you wish to delete.)This tool provides a quick method of removing annotations.It is useful, for example, when you simply want to take aquick measurement and then remove the measurementfrom view.To use the tool, right-click the image with annotations andselect “Delete All Annotations” from the menu.Note about Saved Annotations:Note that if you previously saved the annotations (using theSave Annotations to Database” button), this tool will notremove them from the database, only temporarily removethem from the image. If you close and reopen the study, theannotations will reappear. If you mean to permanentlydelete the annotations, you should click the “SaveAnnotations to Database” button after using this tool.Page 70

Annotations : Editing and DeletingProfessional Workstation includes the ability to edit anddelete previously created annotations. To perform either ofthese operations, you must be in “Annotation Mode,”accomplished by clicking the appropriate toolbar buttonor choosing “Enter Annotation Mode” from the Imagecontext menu.When in “Annotation Mode”, right-clicking an image willresult in the Annotation context menu being displayedinstead of the usual Image context menu.Selecting AnnotationsYou must first select an annotation before you can edit ordelete it.1. Enter Annotation Mode (explained above)2. Move the mouse over an annotation and observethat the mouse pointer changes to a pointing hand.Also observe the annotation will light up.3. (left-)Click the annotation to select it. It will changecolors and several little filled boxes (called “handles”)will appear on the annotation.The annotation is now selected.A shortcut to selecting all of the annotations on the image:right-click and choose “Select All” from the Annotationscontext menu.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 71

Onyx-RAD Professional WorkstationUser ManualEditing AnnotationsTo edit an annotation, you must first select the annotation.See “Selecting Annotations” on page 71 for an explanationof selecting annotations.Once selected, the editing process depends on the type ofannotation.Arrow: Click and drag either endpoint to adjust the positionof the arrow.Line: Click and drag either endpoint to adjust the position ofthe line.Ellipse: Click and drag one of the four “handles” to adjustthe size, shape, and position of the ellipse.Box: Click and drag one of the six “handles” to adjust thesize, shape, and position of the box.Measure (ruler): Click and drag either endpoint to adjust themeasurement. Click and drag the measurement text tomove it out of the way.Angle: Click and drag a “handle” to adjust the vertex or oneof the vectors. Click and drag the measurement text tomove it out of the way.Textbox: Click and drag one of the six “handles” to changethe size, shape, and position of the textbox. Click inside thetextbox to bring up the white editing window and use thekeyboard to edit or add to the text.Page 72

Deleting AnnotationsTo delete an annotation, you must first select theannotation. See “Selecting Annotations” on page 71 for anexplanation of selecting annotations.Once selected, you can simply press the “Delete” key(sometimes labeled “Del”) on your keyboard to delete theannotation. Or, you can right-click the annotation andchoose “Delete” from the Annotations context menu.Note that if you have multiple annotations selected, eachone will be deleted in this single step.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 73

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5Advanced Viewing OperationsThis chapter explores some of the more advanced viewingfeatures found in the Onyx-RAD Professional Workstation.Chapter ContentsKey Images : An Overview ...........................76Marking Key Images .....................................76Reading Key Images ....................................77DICOM Elements (“Tags”) ............................78Histogram .....................................................79Cut-Lines ......................................................81Cine ..............................................................84Compare Mode (Compare Series in One Study)......................................................................85Comparing Multiple Studies..........................86Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 75

Onyx-RAD Professional WorkstationUser ManualKey Images : an Overview☼ Key images aremarked with thisicon in the upper leftcorner of the image:The “Key Images” feature of Onyx-RAD ProfessionalWorkstation is designed to allow the quick identification ofparticularly important images in a study. The doctor readingthe exam marks images as “key” that (s)he feels areprominent in the study. A copy of each of these images isthen placed in a separate series (image stack) so that all ofthe key images in the study can be viewed quickly insequence. Additionally, the image is marked with a specialicon to identify it as a key image.The power of this tool is that the next doctor who reads theexam can concentrate on this new stack of key images andrender a reading very quickly. Another advantage is that,although the key images may reside in many separateseries, the new key image stack brings all of these imagestogether into one stack, providing a more efficient read.Marking Key ImagesMarking images as “key” is simple. Simply select the image(in one column viewing the visible image is automaticallyselected; in multiple column viewing the selected image hasa thicker red border) and press the “K” key on the keyboard.Other methods: click the Key Image button on the toolbar, orclick the Key Image menu entry on the Image Context (popup)Menu.To unmark a key image, (i.e., remove its “key” status),simply key it again and its key status will toggle off.Page 76

Reading Key ImagesImages that have been marked as key images will appear intheir respective series (as normal), but the image will bemarked with a special icon to indicate its “key” status:Additionally, all key images in the study will appear in aseparate series to allow for quick viewing of all key images.This series is always the last one in the Series/Stackswindow, and has a thick border. (On a color monitor theborder is purple.)Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 77

Onyx-RAD Professional WorkstationUser ManualDICOM Elements (“Tags”)To view the DICOM tag data for a particular study or image,simply right-click the study (in the Study Listing screen) orimage (in the Image Viewing screen) and choose “DICOMElements” from the pop-up menu. The DICOM tags aredisplayed in a new window.This tool is provided for those times that you or atechnologist may need access to this data. To exit thiswindow, click the “OK” button in the bottom right corner ofthe window.Page 78

HistogramSometimes it is helpful to have an idea of how the pixelvalues fall for a particular image. Such information may beuseful in calibrating a scanner or troubleshooting the qualityof an image from another institution.To view a three-dimensional histogram for an image in theImage Viewing screen, simply right-click the image andchoose “Histogram” from the pop-up menu.The screenshot above shows a sample histogram.To rotate the 3-D model, click and hold the left mousebutton and drag the model.To pan the model around, right-click the model to bring up amenu, and choose Pan from the menu. Then drag with theleft mouse button to pan the model around.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 79

Onyx-RAD Professional WorkstationUser ManualTo Zoom the model in or out, right-click the model to bringup a menu, and choose Zoom from the menu. Then dragup or down with the left mouse button to zoom in or out,respectively.A two-dimensional graph is also provided (upper portion ofthe window), and the data can be skewed exponentially withthe by dragging the slider bar up or down.Adjust other parameters, such as the X, Y, and Z scales, bydragging the appropriate slider bars up or down.There are also several radio buttons to change the color andappearance of the model.To exit the histogram, click the long “OK” button at thebottom of the window.Page 80

Cut-Lines☼ You may need toclick on anotherimage before cutlinesappear on yourcurrently selectedseries.Cut-Lines are simply red lines (white on grayscale displays)that depict the intersection between images in a study.Note that cut-lines will only appear when the study containsintersecting images.Cut-lines are controlled via buttons found on the Cut-Linestoolbar (also found on the Cut-Lines menu.) Pictured belowis this toolbar and a brief overview of the buttons. The nextfew pages cover the functionality of each button.Enable/Disable Cut-LinesStacks cut single framesSingle frames cut stacksSingle frames cut single framesStacks cut stacksDisplay image numbers next to cut-linesEnable Cut-LinesClick the “Enable/Disable” Cut-Lines button to turn on cutlines.If the study contains cut-line information, it isprocessed for a few moments and then will appear onscreen (depending on which cut-lines you have chosen toappear, see next few topics.)Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 81

Onyx-RAD Professional WorkstationUser ManualControlling the intersectionsThe toolbar and menu contain four different options fordisplaying cut-lines, and they are described below. Notethat all four options may be enabled at once; doing so willresult in a great many red-lines appearing on the screen.You may wish to disable an option or two to limit the numberof cut-lines displayed at one time.Stacks cut single framesWhen this option is enabled, single frames in the Imageviewing window will display a red cut-line when the cuttingimage is selected in the Series Window.Single frames cut stacksWhen this option is enabled, thumbnails in the SeriesWindow will display a red cut-line when the cutting image isselected in the Image Window.Single frames cut single framesWhen this option is enabled, single frames in the Imageviewing window will display a red cut-line when the cuttingimage is selected in the Image viewing window.This is only apparent when viewing images in more thanone column or on multiple screens.Page 82

Stacks cut stacksWhen this option is enabled, thumbnails in the SeriesWindow will display a red cut-line when the cutting image isselected in the Series Window.Display Image Numbers on Cut-linesThis option (“Show/Hide Image numbers on cut-lines”)controls whether the DICOM image slice numbers aredisplayed beside each cut-line. These image numbers canhelp you quickly locate the slice you are interested in.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 83

Onyx-RAD Professional WorkstationUser ManualCine☼ The Cineanimation occurs inthe Series Window,not the main ImageViewer window, sobe sure the SeriesWindow is displayed.You can show/hidethis window with theappropriate toolbarbutton (see page 43for moreinformation.)Cine is the tool used to animate a stack (“series”) of images.Use this tool via the buttons on the Cine Operations toolbar,explored on page 160 and again below:Play cine animation in reverseStop cine animationPause cine animationPlay cine animationRewind to first frameSkip back one frameSkip forward one frameFast-forward to last frameThe actual animation occurs in the Series window, andanimates the currently selected series. Select the desiredseries by clicking on the series thumbnail in the Serieswindow, then use the buttons on the Cine toolbar to animatethe stack.Page 84

Compare Mode (Compare Series inOne Study)Often it is useful to compare two series side-by-side. Whilethis is easily accomplished (and often automatic) on aworkstation with multiple monitors, Compare Mode must beused when only one monitor is present.To enter Compare Mode:1. Click the first series thumbnail in the Series Window.The series should become active (its images willappear in the Image Window) and it will be shownwith a red border, indicating it is active and selected.2. Select the second series by holding the Control(“Ctrl”) key on the keyboard and click the secondseries, then release the Control key. You shouldnotice that both the first and second series have redborders now, indicating that both are selected.3. Enter Compare Mode by clicking either the VerticalCompare Mode or Horizontal Compare Mode toolbarbutton.Vertical Compare ModeHorizontal Compare ModeThe Image Window splits in half with one series on eachside. You can cause both windows to scroll together (i.e.,as you progress through one series the other moves with it)by clicking the “Compare Scroll” button:Compare ScrollOnyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 85

Onyx-RAD Professional WorkstationUser ManualComparing Multiple StudiesOften it is helpful to view multiple studies at once, e.g. tocompare original and follow-up exams. Onyx-RAD featuresmany tools and options for view multiple studies at once.Over the next few pages we will explore how to openmultiple studies, control how the images are laid out acrossthe display(s), compare mode, linked scrolling, and otherfeatures.Multiple Studies – OpeningShow/Hide theWorklist windowTo open multiple studies:1. Open the first study in the normal way, selecting itfrom the Study List.2. Once all of the images for the study have loaded,click the “worklist window” button to show aminiature study list.3. Find the next study in the list and open it by doubleclicking(same way you normally open a study.)4. Continue to open other exams by repeating step 3.5. Finally, to reclaim maximum image viewing space,close the worklist window by clicking the “worklistwindow” button again.Page 86

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6Printing (Paper and Film)This chapter covers printing in Professional Workstation.Topics include using the Image Bucket to select individualimages for printing, the Print window and its options, andprinter selection.Paper and Film printing are covered.Chapter ContentsPrinting Overview..........................................90The Image Bucket.........................................91Drag Individual Images tothe Image Bucket.....................................92Drag a Complete Series tothe Image Bucket.....................................92Print to Paper................................................93Print to Film...................................................93Clear the Image Bucket ................................97Adding DICOM Printers ................................98Configuring DICOM Printers .........................99Removing DICOM Printers ...........................105Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 89

Onyx-RAD Professional WorkstationUser ManualPrinting OverviewOnyx-RAD Professional Workstation offers the ability to printto film as well as paper, specifying the number and layout ofimages printed, overlay printing, and other options.Your printing capabilities depend on the type of printersinstalled at your site. Paper printing can utilize virtually anynormal office printer (though Laser quality is recommended).Film printing, however, is only possible with special printers.The general technique for either kind of printing (paper orfilm) is:1. Drag the desired images (or series) to the ImageBucket.2. Click the appropriate print button.Page 90

The Image BucketThe Image Bucket is a narrow window which resides on theright-hand side of the Image Viewer Screen. Like mostother parts of the Workstation screens, this window can beturned on or off as needed. If the Image Bucket is notcurrently displayed, simply click the Stats Bar (“Config Bar”)icon on the Standard Toolbar.Config Bar buttonThe Image Bucket shares space with the Stats Bar, so youmay need to click the “Image Bucket” tab at the bottom ofthe window to switch between the two.The Image Bucket acts as a space to hold selected imagesfor printing until you are ready to print. You can manipulateimages (window and level, zoom, annotate, etc.) as you likeand then drag the image to the Image Bucket for holdingwhile you work on other images.When you are ready to print, clicking one of the two printbuttons (paper or film) will process only the images in theImage Bucket.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 91

Onyx-RAD Professional WorkstationUser ManualDrag Individual Images to the ImageBucketTo select individual images for printing, you must drag theminto the Image Bucket.You should first perform any desired manipulation (windowand level, zoom, annotate, etc.). To drag the image,ensure that no view tools are selected such as pan or zoom.If one of these tools is selected, your mouse cursor willreflect it – e.g. a magnifying glass for Zoom, or a hand forPan. Turn the tool off to return your mouse cursor to across hair.Now you can drag images. With the left-mouse button, clickthe image and hold the mouse button down while draggingthe image over to the Image Bucket window. Release thebutton and observe that a copy of the image is now in theImage Bucket.Drag a Complete Series to the ImageBucketYou may desire to print an entire series. Rather thandragging the series’ images individually, you may drag thewhole series from the Series/Stack window to the ImageBucket window.Mouse your mouse cursor to the Series/Stacks window andensure that “Span Images” is not enabled. (Your mousecursor will show “span” if this tool is on. Click the SpanImages toolbar button to turn this off.) Drag the seriesthumbnail to the Image Bucket window in the same manneras you drag individual images.Page 92

Print to PaperAt the bottom of the Image Bucket window are the printbuttons:Paper printFilm printClick the “Print” button to bring up the Paper Print window,seen below:This window offers many options for defining the layout ofthe printed page, and a preview of what the printout will looklike. In this window it is possible to control:• Number of columns and rows to print images in• Orientation of the paper (portrait / landscape)Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 93

Onyx-RAD Professional WorkstationUser Manual• Margins• Spacing between images• Width of border around images• Overlay printing• Patient summary• Header and footer text, which can contain anything(common usage is institution information and pagenumbers)To change any of these options, simply locate theappropriate checkbox or button on the window and click.Once the page is set up as desired, click the Print button inthe top right of the window and your images will be sent tothe selected printer.Page 94

Print to FilmAfter selecting the images or series to print (by dragging tothe Image Bucket, see previous section), it’s time to print.Click the DICOM Print button and the DICOM print dialogappears.Select the DICOM printer from the list box at the top of thedialog (the printer that was used last is already selected.)Choose a layout for the printed images by clicking any oneof the layout buttons. The supported layouts includecommon configurations such as “4 X 4”, indicating 4columns by 4 rows.After choosing the layout, check the other options availableon the dialog such as print job priority (higher priority jobsare completed before lower priority jobs), resolution (higherOnyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 95

Onyx-RAD Professional WorkstationUser Manualresolution provides crisp, clear images), and number ofcopies desired.Other options available:Burn in image orientation labels: Select this option to “burnin” the orientation markers (e.g., “L” and “R” markers) intothe images so that they print to film.Burn in annotations: Select this option to “burn in” anyannotations you’ve made (including markers, text, andmeasurements) so that they print to film.Burn in cut-lines: Select this option to “burn in” any cut-lineappearing on the image so that they print to film.Finally, click the Print button to send the print job to theDICOM printer.The “Debug Messages” checkboxA final option on the DICOM print dialog is the DebugMessages checkbox. Click to enable or disable this option.If enabled, every step of the DICOM print job will pause andpresent you with a list of the DICOM elements involved inthat stage of printing. You will see details of the print jobrequest creation, submission, film box creation, andresponses. This is useful for troubleshooting a DICOMprinter, but generally not desirable for everyday operation,as each popup message that occurs must be dismissed(click “OK”) before the print job continues.Page 96

Clear the Image BucketAfter printing (or if you decide to cancel) you should clearthe images from the Image Bucket. Click the “Clear” buttonnear the bottom of the Image Bucket window to remove allimages from the Image Bucket.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 97

Onyx-RAD Professional WorkstationUser ManualAdding DICOM PrintersBefore you can print to a DICOM Printer (“camera”), it mustbe configured in your Onyx-RAD software. Fortunately, thisis a simple task.From the DICOM menu, select Printer Setup. A windowappears with an icon title “Add Printer”, as well as icons forany DICOM printers you may already have access to.To add a printer, double-click the “Add Printer” icon. Thereare many options you can set for the printer, but at the veryleast you must give it a description. See the next topic,“Configuring DICOM Printers”, for details on the availableconfiguration options.When you have finished adding your printer, click OK. Thenclose the DICOM Printers window by clicking its top-right “X”button.Page 98

Configuring DICOM PrintersDICOM Printers come from many manufacturers, andalthough most of them offer standard features, you maydesire to tweak the configuration of your printer to get thebest results.To configure an existing DICOM printer, select “PrinterSetup” from the DICOM menu bar, then double-click thedesired printer from the next window.The configuration dialogs are shown on the next few pages.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 99

Onyx-RAD Professional WorkstationUser ManualThe first configuration screen is shown below:Printer Name: Enter a friendly name for this printer.Host Address: Enter the network address for this printer.Port: Enter the required port number for this printer.Extra Configuration: Enter any other parameters as directedby the printer manufacturer or an Onyx-RAD technician.Calling AE Title: Enter “OnyxServer” (or whatever AE Titlehas been set up for the printer to accept jobs from.)Called AE Title: Enter the printer’s AE Title.Click the “Next” button to proceed to the next configurationdialog.Page 100

The second configuration dialog is shown below:Print Overlays: Enable this checkbox to send overlays (thetags that appear in the corners of images, such as PatientName, Study Date, image number, etc.)Printer Overlay Support: If the printer supports overlays,select the Printer Supports Overlays option.If overlays do not print, it may be that the printer does notsupport overlays. It is thus necessary to “burn in” theoverlays, which you can do by selecting the Burn InOverlays Before Printing option.More Overlay Options: Select either the Printer SupportsOverlays Storage (the most common) or Send Overlay tagsin Image Data option according to your printer’s capabilities.Overlay Magnification Type: Select the appropriatemagnification type for overlay printing. (BILINEAR is mostcommon.)Click the “Next” button to proceed to the next configurationdialog.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 101

Onyx-RAD Professional WorkstationUser ManualThe third configuration dialog is shown below:Print Method: choose this based on your printer’scapabilities. Basic Print is the most common, while Print ByReference will enable further options at the bottom of thewindow (“execute CSTORE” and “do not executeCSTORE”).Print a trim box surrounding each image: Print a whiteborder surrounding each image. This is commonly enabled.Convert signed images to unsigned: This will convert signedpixel data to unsigned pixel data. Some printers requirethis.Convert 16-bit gray to 12-bit gray: required by someprinters. This also often helps to lighten up images.Convert images to 8-bit: required by some printers. Thisalso often helps to lighten up images which are printing toodark.Page 102

Presentation LUT: Some printers support a LUT (lookuptable) that greatly enhances the appearance of printedimages.Border Color: border color surrounding each image (this isindependent of the white Trim box option mentioned earlier.)Empty Image Color: Empty image boxes on the printed filmwill fill with this color.Magnification Type: Select this based on what your printersupports.Smoothing Type: Select this based on what your printersupports.Minimum Density: Select this based on what your printersupports.Maximum Density: Select this based on what your printersupports.Polarity: Select this based on what your printer supports.Send Width and Center tag: If the printer supports theDICOM pixel width and center tags (contrast), select thisoption.Click the “Next” button to proceed to the next configurationdialog.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 103

Onyx-RAD Professional WorkstationUser ManualThe fourth configuration screen is shown below:Medium Type: Select this based on the media you are using(BLUE FILM, CLEAR FILM, etc.)Media Destination: Select this based on the printer.Orientation: Select whether to print the images “portrait”oriented or “landscape”.Click “Next” to proceed.Click “Finish” to complete the DICOM printer setup.Page 104

Removing DICOM PrintersShould you wish to remove a DICOM printer from yoursystem, you must first open the list of available DICOMprinters. From the DICOM menu, click “Printer setup.” Awindow appears listing all of the available printers. Simplyclick the printer you wish to delete, then press the “delete”key (it may be labeled “del”) on your keyboard to delete theprinter.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 105

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7CD BurningThis chapter explores the process of creating Patient CDsusing a CD-Recordable drive (commonly referred to as a “cdburner.” Onyx-RAD Professional Workstation provides thefunctionality of copying exams to CD in standard DICOMformat for compatibility across PACS systems. Thisfunctionality is a standard feature.Chapter ContentsIntroduction to Burning CDs..........................108Creating a Patient Disc .................................109CD Burning Configuration.............................112CD Archiving.................................................114Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 107

Onyx-RAD Professional WorkstationUser ManualIntroduction to Burning CDsImagine leaving the emergency room with a CD of imagesof your broken foot, a CD that you can insert into your homecomputer and view the x-rays at any time. The ability tocopy an exam onto a CD and send the patient (or referringphysician) home with this disc is truly a tool of the future.Onyx-RAD Professional Workstation provides this abilitytoday.CD “Burning” is a standard feature of Onyx-RADProfessional Workstation. All of the images in an exam canbe copied to a recordable compact disc, along with a “Lite”version of the Onyx-RAD Image Viewer. The finished disccan then be viewed in any computer running Windows 98 orbetter. The result is a special, personalized souvenir for thepatient, and a solution more cost-efficient than film for thereferring physician.Images are stored in standard DICOM format, a medicalstandard ensuring that other vendors’ PACS systems will beable to read the images on the disc.Page 108

Creating a Patient Disc(Note that the workstation must have a CD-Recordable driveinstalled and configured. This is handled by Viztektechnicians.)Burning a CD is simple in Professional Workstation. Thetask is performed from the Study List screen. Simply clickthe desired study one time to highlight it. Right-click thestudy and choose “Burn Study to CD” from the menu thatappears, then choose “Make Patient Disc.”A window will appear (sample screenshot below) with alisting of all the studies for this patient, along with “Start” and“Cancel” buttons.This listing allows you to choose the studies that will beburned to the disc. Select studies by clicking the checkboxfor each desired study.Now click the “Start” button to commence the burningprocess. Clicking the “Cancel” button will cancel theOnyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 109

Onyx-RAD Professional WorkstationUser Manualoperation and return you to the Study Selection screen.A progress window appears and keeps you informed of thestatus of the cd burning:There are four progress bars and a status bar at the top.The status bar displays the current operation, e.g. “Writingto disc…”The DICOM Creation progress bar tracks the progress ofimages being saved in standard DICOM format to atemporary folder.The CD Image Creation progress bar tracks the progress ofthe ISO disc image creation.The Data Caching progress bar tracks the progress of thesystem caching the data to be written to disc.Page 110

Finally, the CD Writing Progress bar tracks the progress ofthe actual writing to disc. When this bar fills completely, thestatus bar at the top will display “Closing Disc” and you aregenerally less than one minute away from a Patient CD!When the job completes, a message pops up on the screen.Click the “OK” button on this message and the new PatientDisc is automatically ejected from the cd burner.Please note that CD burning is a system-intensive processand requires all of the computer’s processing to achieve. Itis therefore necessary to wait while until the CD is completebefore continuing to use Professional Workstation. Withcurrent recording technology and speeds, most discs arecomplete within three minutes. Particularly large examsmay take more time to complete.Also note that Patient CDs can only be created one at atime in Professional Workstation.If this is not sufficient for your institution’s needs (perhapsyou need to create large numbers of CDs, or cannot haveyour reading interrupted by the CD burning process), pleaseconsider either purchasing a separate workstation devotedto creating CDs, or purchasing an Onyx-RAD CDR Server toautomate the process. (For more information pleasecontact Viztek, Inc.)Acquire workstations can utilize CD Archiving (explored laterin this chapter) to offload exams from the local machine ontoCDs for long-term storage.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 111

Onyx-RAD Professional WorkstationUser ManualCD Burning ConfigurationAlthough Viztek technicians will install and configure the cdrecordabledrive, there are a few CDR settings that areavailable for you to change. Below is a screenshot of theCDR Configuration window. This window will appear if youstart a CDR job (like creating a Patient Disc) and the CDRsettings have not already been configured.You can also bring up this window from the File menu (clickFile, CDR Setup.Page 112

CDR/CDRW Drive : Choose your burner from this list ofscanned drives. The drives are identified by vendorand model descriptions.☼ CD-Recordablediscs are rated for acertain write speed.You should choose arecording speed thatis compatible withyour discs.Speed : After selecting your drive, this box will be enabledand filled with speeds that your drive is capable of.Choose your desired burning speed from this list.Auto Eject : Click this checkbox to have the burnerautomatically eject discs once the recording processcompletes.Tem porary Storage Directory : This specifies wheretemporary files are stored during the burningprocess. It is recommended that you not changethis value from the default.Include Onyx-RAD Software : Click this checkbox to includea copy of the Onyx-RAD Lite Viewer on the disc.The disc can then be read by any computer withWindows 98 or newer.☼ The institutiondetails are useful formarketing purposes,as this informationwill appearprominently in theLite Viewer when thepatient disc isaccessed in anothercomputer.Institution details – Name: Enter the institution nameexactly as you would like to appear in the LiteViewer.Institution details – Phone: Enter the institution phonenumber as it will appear in the Lite viewer.After setting your CD burning options, click OK to save thesettings.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 113

Onyx-RAD Professional WorkstationUser ManualCD Archiving☼ CD Archiving isonly available onAcquire (Orex andHowtek)workstations.CD Archiving allows you to backup exams to CD-Recordable discs and deleted them from the workstation.This is essential to saving space on an Acquire workstationwhen a PACS is not available to store the exams.To use CD Archiving, right-click any exam in the Study List,choose “Burn to CD…”, and then “Multiple Patients (CDArchiving).”Patients appear in the list on the left with checkboxes.Select the patient by clicking the checkbox. The total size ofthe images is calculated (this may take a moment) and the“CDR Disc Capacity” gauge on the right will begin to fill.Continue to add patients until the gauge is full, then click“Burn CD.”Exams will be burned to CD with the same progress dialogseen above with creating Patient discs, and shown againPage 114

here:There are four progress bars and a status bar at the top.The status bar displays the current operation, e.g. “Writingto disc…”The DICOM Creation progress bar tracks the progress ofimages being saved in standard DICOM format to atemporary folder.The CD Image Creation progress bar tracks the progress ofthe ISO disc image creation.The Data Caching progress bar tracks the progress of thesystem caching the data to be written to disc.Finally, the CD Writing Progress bar tracks the progress ofthe actual writing to disc. When this bar fills completely, thestatus bar at the top will display “Closing Disc” and you areOnyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 115

Onyx-RAD Professional WorkstationUser Manualgenerally about three minutes away from an archive CD!When the job completes, a message pops up on the screen.Click the “OK” button on this message and the new PatientDisc is automatically ejected from the cd burner.Please note that CD burning is a system-intensive processand requires all of the computer’s processing to achieve. Itis therefore necessary to wait while until the CD is completebefore continuing to use Professional Workstation. Withcurrent recording technology and speeds, most discs arecomplete within ten minutes.Page 116

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8Send and Receive ExamsThis chapter examines the process of sending and receivingexams “over the wire” – local area network, phone line,Internet, etc. – to and from other institutions and Onyx-RADworkstations.The process of sending exams is explored thoroughly,including methods of tracking the progress of the studiesbeing transmitted.Receiving exams is also covered, specifically therequirements and configuration necessary and monitoringthe progress of incoming exams.Chapter ContentsSending Exams : Introduction.......................120Sending Exams: .ONX or DICOM.................121Send (“Push”) an Exam ................................122Monitor the Progress of Pushed Exams .......123Requirements to Receive Exams .................125Sending Exams via DICOM : Configuration..126Set up AE Titles ............................................126Set up Contact Entries..................................129Automatic Sending (“Routing”) .....................132Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 119

Onyx-RAD Professional WorkstationUser ManualSending Exams : IntroductionAlthough there is some prior configuration necessary to“push” exams to other doctors, this configuration is handledby Viztek technicians. This means that you, the user, do nothave to worry about setting up the transfer parameters. Yousimply the push the study and keep working.You may, however, wish to set up your own routes fromtime to time, and this is covered near the end of the chapter.Once the exam has been pushed, the transfer processtakes place behind the scenes, and therefore does notinterfere with your work as you continue to read otherexams. It is possible, however, to check on the status of theexam(s) you have pushed and monitor its progress.Page 120

Sending Exams: .ONX or DICOMOnyx-RAD supports two different methods of sendingexams: standard DICOM or a proprietary method we simplycall .ONX.DICOMSending DICOM results in standard DICOM format andstandard DICOM functions (like CSTOR, CMOVE, etc.).Any recipient who claims DICOM compliance can receivesuch exams. The only disadvantages to sending exams inDICOM format are:• Lack of progress monitoring, as the DICOM standarddoes not provide for this• Onyx-RAD does not send DICOM over phone line,due to the standard’s lack of provision for suchfeatures as auto-resume and validity checking• Lack of security (no encryption).ONXTo compensate for the shortcomings in the DICOM standardmentioned above, Viztek developed its own transfer syntax,.ONX, which provides these features:• Progress monitoring• Auto-resume features• Validity checking on each image• Secure encryptionIt is recommended that you utilize the .ONX transfer syntaxwhen sending exams to other Onyx-RAD sites.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 121

Onyx-RAD Professional WorkstationUser ManualSend (“Push”) an ExamOn the Study List screen, simply click the desired study onetime. This will highlight the study to indicate that you haveselected it. Now right-click the study and choose the “SendTo…” option from the pop-up menu.The next screen that appears contains buttons for each ofthe push recipients that are configured in your system.Simply click the appropriate recipient and the screendisappears, with the transfer of the exam initiated in thebackground.At this point you are free to continue reading exams; nofurther interaction is needed on your part. You may alsopush other exams at this time; it is not necessary to wait forone transfer to finish before initiating another.Page 122

Monitor the Progress of PushedExamsWhen you “push” an exam in Onyx-RAD ProfessionalWorkstation, the exam is added to a queue of exams waitingto be sent. The Onyx-RAD Server (or your standaloneacquire workstation) software manages this queue andsends exams out in the order of their arrival in the queue.Pushed exams that are traveling to recipients over anetwork or the Internet are able to transfer simultaneously.Often these exams will reach their recipients not long afterbeing pushed.Exams that are routed over a phone line, however, willtravel one at a time. Thus it may be desirable to check onthe status of the exam(s) you have pushed, and evenelevate the priority of certain exams so that they are sentsooner than other exams waiting in the queue. These tasksare accomplished in the Queue Management window.To bring up the Queue Management window, simply rightclickany exam in the Study List, and choose “QueueManagement…” from the pop-up menu. (It does not matterwhich exam you right-click.) A sample of this window isseen on the next page.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 123

Onyx-RAD Professional WorkstationUser Manualthe Queue Management windowThe bottom half of the screen holds a list of all pendingtransfers in the queue, complete with progress bars. Theupper half of the screen displays details on the currentlyselected exam.Check the status of a pushed exam by checking its progressbar to see how far along the transfer is.To elevate the priority of a queued exam:Click the desired study (this will highlight it.)Click the “Stat” button.This exam is now “next in line” to be transferred, and willbegin transmitting as soon as the transfer medium (network,phone line, etc.) is available.It is also possible to cancel the transfer of an exam:Click the desired study (it will highlight.)Click the “Delete” button.The study will be deleted from the queue and will not betransmitted. If the exam was already being transferred, thetransfer will cancel and the study will be deleted from thequeue.Page 124

Requirements to Receive ExamsReceiving exams from other Onyx-RAD sites requires:• Onyx-RAD Listener Agent software• A connection medium between you and the sender(phone line, network, Internet, etc.)All configuration is handled by Viztek technicians.For the connection medium:• If a phone line is used, 56k modems arerecommended.• If a local area network (LAN) is available, a100Mbps connection is recommended, and a staticIP address is required.• If the Internet is to be used, a static IP address isrequired, as well as a constant connection. A digitalsubscriber line (DSL) is recommended.Receiving DICOM exams from any sender requires:• Onyx-RAD DICOM Gateway (also commonlyreferred to as “CStore Server”)• A connection medium between you and the sender(network, Internet, etc.)Viztek technicians will handle the configuration on your (thereceiving) side, and provide the sender with the necessaryinformation – your host address, AE Title, port number, etc.– to send you DICOM exams.Please contact Viztek, Inc. to add receiving capability toyour Onyx-RAD workstation.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 125

Onyx-RAD Professional WorkstationUser ManualSending Exams via DICOM :ConfigurationThe next few topics explore how to set up a “push” entry foreach DICOM recipient you wish to send exams to. Sendingexams via DICOM requires more setup than the .ONXformat, including the configuration of AE Titles andmanual/automatic sending.Set up AE TitlesThe DICOM standard dictates that senders and receiversmust define for themselves (and answer to) an AE(Application Entity) Title. To send DICOM exams to yourintended recipient you will need some basic information:• Recipient’s AE Title• Recipient’s network (IP) address or hostname• Recipient’s port number(As for your own workstation’s AE Title, you should checkwith the receiver and agree on an AE Title to use. Usuallythe receiving software will only allow connections from AETitles that have been configured at the other site.)First, start Onyx-RAD Configuration Manager. Click Start,then Programs, then Onyx-RAD, then ConfigurationManager. (If this is not in the menu, open a commandprompt [Start, Run, “cmd”, click OK], then enter thefollowing:cd \onyx-rad\bincfgmgrConfiguration Manager will require you to log on to yourdatabase; the username and password are the same valuesyou use to log on to the Viewer.Page 126

The Configuration Manager should resemble the picturebelow:Double Click the AE Node Editor icon to start the AENode Editor. A sample screenshot appears below:Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 127

Onyx-RAD Professional WorkstationUser ManualClick “New AE Node” and set up the AE Node asfollows:• Destination / Calling AE Title : enter the AE Titleof your intended recipient• Source / Called AE Title : enter your AE Titlehere (you may use “ONYXRAD”, for example.)• Host IP/Address : enter the network address ofyour recipient.• Port : enter the port number on which therecipient will listen for DICOM transmissions• Image Server : select “Default Image Server”• Archive Server : select “Default Archive Server”• Group : select “Users”• The options grid at the bottom (contains the“Auto Validate” option, for example) is notrelevant to this outgoing entry.Click “Save.” If all required fields have values, your new AENode will appear in the listing. Click “Exit.”Page 128

Set up Contact EntriesYou must set up a Contact Entry (“Push Entry”) for eachperson/site you wish to send exams to. Push Entriesappear as individual buttons when you perform a right-click,Send To… on the Study List, and also appear in a list whenyou are setting up automatic routes. Note that in order toset up a DICOM push entry, you must set up the AE Titlesfirst (previous topic).In Configuration Manager, double-click the Contact Editoricon. The Onyx-RAD Contact Editor screen should besimilar to this:Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 129

Onyx-RAD Professional WorkstationUser ManualTo set up an .ONX format entry (for sending to otherOnyx-RAD sites):1. Click “New Entry”2. For User, choose your desired user (default is theuser “ONYX”)3. Contact Type : Choose Network or Dialup, asappropriate.4. (Network) Host Name/IP : Enter network address ofrecipient.(Dialup) Phone Number : Enter the full phonenumber (including 1 + area code if necessary) of therecipient.5. Description: The text you enter here will appear onthe button that you see in the “Send To…” dialog. Itis also the text you will see in the RoutingConfiguration dialog (explored later in this chapter.)6. (Dialup) Enter the dialup user name and passwordon the right side of this dialog.7. After sending study, set status to: The most commonvalues for this are “NONE” (don’t change the exam’sstatus) or “DELETED” (set the exam to be deletedafter it sends successfully.)8. Scheduling: “now” is the most common value, or youcan set a specific date and time.9. Click “Save”.Your new contact will appear in the list. Click Exit.Page 130

To set up a DICOM format entry (for sending to anyDICOM-compliant software):1. Click “New Entry”2. For User, choose your desired user (default is theuser “ONYX”)3. Contact Type : Choose CSTORE.4. Dest AE Node: Choose the AE Title from the dropdownlist. This list comes from the AE Titles createdin the AE Node Editor tool.5. Description: The text you enter here will appear onthe button that you see in the “Send To…” dialog. Itis also the text you will see in the RoutingConfiguration dialog (explored later in this chapter.)6. After sending study, set status to: The most commonvalues for this are “NONE” (don’t change the exam’sstatus) or “DELETED” (set the exam to be deletedafter it sends successfully.)7. Scheduling: “now” is the most common value, or youcan set a specific date and time.8. Click “Save”.Your new contact will appear in the list. Click Exit.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 131

Onyx-RAD Professional WorkstationUser ManualAutomatic Sending (“Routing”)Normally you must actively push an exam in order to send it(right-click and choose “Send To…” from the Study List.)However, Onyx-RAD can be configured to automaticallysend exams once they are validated. This is especiallyuseful for Acquire workstations.You must first enter AE Titles (if sending DICOM) in the AENode Editor and a Contact Entry in the Contact Editor (seethe previous topic.) After these steps have been taken careof, you can create a route.In Configuration Manager, double-click the “Exam Routing”icon. The Routing Configuration window will appear after afew moments:Click the node to add a default route from, in most casesyou will click the entry titled “DEFAULT.” Click the “AddNew Route” button.On the right side of the window, select a Push Entry fromthe drop down box. This box lists all the entries you havepreviously set up using the “Contact Editor” utility inConfiguration Manager. (If you have not set up any entries,Page 132

exit from this window and set up an entry first.)The next two boxes will fill with the values stored in thecontact entry (e.g., network address and port), and thescheduling box will be empty. For a temporary route, entera specific date and time. Otherwise, enter “now” (withoutquotes) in the box.Finally, click “Save Changes”.You can verify configured routes by expanding the list onthe left side of the window (click the little plus box next to anAE Title to view routes.)Click “Exit” to exit the Routing Configuration tool.When routes are set up, exams are automatically added tothe push queue (according to the routes) once they arevalidated.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 133

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9Image AcquisitionOnyx-RAD Professional Workstation can be configured asan acquire workstation and combined with an Orex PcCRscanner or a Howtek film scanner.Chapter ContentsIntroduction to Acquiring Images ..................136Acquiring Orex Images : Step by Step..........137Acquiring Howtek Images : Step by Step .................146Using Modality Worklist ................................153Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 135

Onyx-RAD Professional WorkstationUser ManualIntroduction to Acquiring ImagesOnyx-RAD Professional Workstation, when attached to anOrex PcCR scanner or Howtek film scanner, becomes apowerful acquire workstation where exams are acquired,checked for quality control (“QC’ed”), diagnosed, stored,and transmitted – all on one workstation.An attached Orex scanner scans raw image data fromphosphor plates (housed inside the cassette on PcCR 1417models). The Onyx-RAD software then converts this data toDICOM compliant format and compresses the data in JPEGLossless mode and stores the resulting study on theworkstation.If a Howtek film scanner is installed, the software performssimilar features, converting film into digital DICOM exams.Page 136

Acquiring Orex Images : Step by StepStep 1 : Ensure Scanner is turned onEnsure the Orex CR scanner is turned on. If it is not, pleaseturn it on. (The power switch is located on the back of thescanner, and powering up may take from 20 seconds to 60seconds. Some Orex CR scanners, especially the newer“auto cassette” models, may take a few seconds before theyrespond to the power switch being flipped on, so please bepatient. This delay is due to the scanner running internaldiagnostic tests.)Step 2 : Start Workstation (if not alreadyrunning)If the Onyx-RAD Orex QC Workstation application is notalready running, start it by double-clicking (with the leftmouse button) the icon titled “Onyx-RAD Orex QCWorkstation.”Step 3 : Log On (optional)(optional) If your Workstation has not been set up toautomatically log you in to the database for securityreasons, you will need to do so manually. To do so, click onthe “File” menu and choose “Log On” (or you can click thelightning bolt icon.) Enter your user name and password inthe dialog box that appears, and choose your database fromthe drop-down list.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 137

Onyx-RAD Professional WorkstationUser ManualStep 4 : “Study Listing” screenOnce you are logged in, you will see a screen similar to thescreenshot below.As seen in the Overview on page 30, this screen is the“Study Listing” screen. All of the studies in your databaseare listed here and can be sorted by any of the fields,although the “Patient Name” and “Study Date” fields areperhaps most useful.Page 138

Step 5 : New Patient / New Study / NewSeriesNow its time to add an entry for the image(s) you will scan.You must decide whether to add a new patient, study,series, or image.New Patient: If the patient is not listed in your StudyList, you must add a new patient.1. Click the New Patient button (the red “P”).New Study: If the patient is already listed in the StudyList, and this is a new exam (e.g., a follow-up examination),you should add a new study for this patient.1. Find the patient in your Study List (see the previouschapter for a brief introduction to the Study Listscreen, including sorting and searching the StudyList).2. Click the line containing the existing patient so thatthe line lights up (highlights.)3. Click the New Study button (the red “S”).New Series. If you are adding multiple images to onestudy, it is suggested that you create a new series for eachimage.1. Find the patient in your Study List (see the previouschapter for a brief introduction to the Study Listscreen, including sorting and searching the StudyList).2. Click the line containing the existing patient so thatthe line lights up (highlights.)3. Click the New Series button (the red “E”).Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 139

Onyx-RAD Professional WorkstationUser ManualNew Image. If you are adding multiple images to onestudy, and you wish to group images under the same study(e.g., perhaps you have two images of a lateral chest andone chest AP, and you desire to have the two lats in oneseries, with the AP in second series), you should use theNew Image button to add images to the current series.(Viztek recommends that you put each image in a newseries [use the New Series button] as it simplifies laterviewing.)1. Find the patient in your Study List (see the previouschapter for a brief introduction to the Study List screen,including sorting and searching the Study List).2. Click the line containing the existing patient so thatthe line lights up (highlights.)3. Click the New Image button (the icon is of a spooland film).Test Scan. This button is for diagnostic testing of theOrex PcCR unit. You should not need to use this buttonunless you are instructed to do so by a Viztek technician.Images are not saved when running a test scan.Page 140

Step 6 : Enter Patient / Study / Series detailsAfter clicking one of the buttons described in Step 5, you arepresented with a dialog asking for relevant details.If you are adding a New Study, Series, or Image, the dialogwill be partially completed for you, using data from theexisting patient record (e.g., Patient ID and Name willalready be filled in.) You will be unable to change thesefields.To enter data into a field, simply click the white box next tothe field and start typing. Although there are many fields onthe dialog, the only required fields are marked with anasterisk, are listed here:• Patient ID : This must be unique for every patient. ItOnyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 141

Onyx-RAD Professional WorkstationUser Manualis suggested social security numbers be used for thisfield, or any other uniquely identifying tag. (This fieldcan be letters, numbers, or a mix of both.)• Gender• Patient Name : Last Name : Only the last is required,but it is suggested that both last and first name beentered.• Patient Birth Date : This must be entered in MM-DD-YYYY format. Please ensure that you use a fourdigityear.Enter values for at least the required fields and click“Accept” to open the Orex CR scanner interface.Page 142

Step 7 : Orex Scanner InterfacePatient OutlineSelect the correctanatomic region byclicking this figure.The Orex scanner interface screen will now appear. The leftside of this dialog has a patient outline. Click on the portionof the body of which you are scanning, and choose thecorrect anatomic location from the menu that appears.This is an important step in ensuring quality images. Just asit is necessary to increase technique when shooting denserparts of the patient’s body, the Orex scanner must similarlyadjust its sensitivity when reading plates that have moreexposure. Choosing the correct body part from the PatientOutline (seen above) will ensure that the Orex scannerproperly scans the shot.Step 8 : Insert the CassetteInsert the cassette into the Orex scanner, and push gentlyuntil it locks into place with an audible “click.” The scannerwill quickly load the plate from the cassette and display amessage similar to “14x17 plate ready” near the bottom ofthe screen.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 143

Onyx-RAD Professional WorkstationUser ManualStep 9 : Start scanningYou are now ready to scan. To start the process, click the“Start Scanning” button found at the bottom left portion ofthe Orex screen.Start ScanningScanning may take up to two minutes, depending on thesize of the plate. During the scan you can observe theprogress window as it shows, in real-time, what has beenscanned thus far. Additionally, a timer in the bottom-rightcorner of the window keeps track of the remaining scantime.Step 10 : When the scan completes…When the scan has completed, please wait a few momentsfor the communication between the computer and the CRscanner to complete. (You will see a small dialog windowindicating “Processing Image…” during this time.) While theOnyx-RAD software processes and imports the image, theOrex scanner will begin erasing the plate. The Orex erasingprocess can last up to a minute, and the Onyx-RAD importprocess should only last between ten and thirty seconds.When the Orex scanner has finished erasing the plate, anaudible “click” will indicate that the cassette may beremoved.When Onyx-RAD finishes importing the image, the“Processing Image…” dialog will disappear. If this scan wasa new patient, you will notice the patient’s entry on yourlisting screen (you may need to scroll down if your listing isvery long.)If this scan was an additional series/image to an existingstudy, you will notice the number of series/images for thestudy has been updated.Page 144

Step 11 : “QC” the image(s)When you have completed the scanning and have no moreimages to add to the study, it’s time to perform some qualitycontrol. The study is currently marked “INCOMPLETE,”indicating that the technologist has not yet verified and/orprepared the images.At this time you should open the study (double-click thestudy; see the previous chapter for a brief introduction to theStudy Listing screen and the Image Viewing screen.)View the images and optionally prepare them for the doctorby adjusting the contrast or zooming, etc.When you are satisfied with the images, close the study(right-click on an image, then choose “Close Study”).Back at the Study Listing screen now, you should validatethe study (which changes its status from INCOMPLETE toUNREAD) with the following procedure:1. Click the study one time to select (highlight) it.2. Click the “OK” button to validate the study. Thisbutton is found to the left of the New Patient / Study /Series buttons, and is pictured below.If you wish to delete the study (perhaps the images werereally off, or the wrong body part was scanned?), use thisprocedure:1. Click the study one time to select (highlight) it.2. Click the delete button to validate the study. Thisbutton is found to the left of the New Patient / Study /Series buttons, and is pictured below. (It is a pictureof an eraser.)ValidateDeleteOnyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 145

Onyx-RAD Professional WorkstationUser ManualAcquiring Howtek Images : Step byStepStep 1 : Ensure Scanner is turned onEnsure the Howtek film scanner is turned on. If it is not, youwill need to turn it on and reboot the computer (because thescanner is a SCSI device which requires this.)Step 2 : Start Workstation (if not alreadyrunning)If the Onyx-RAD Professional Workstation application is notalready running, start it by double-clicking (with the leftmouse button) the icon titled “Onyx-RAD ProfessionalWorkstation.”Step 3 : Log On (optional)(optional) If your Workstation has not been set up toautomatically log you in to the database for securityreasons, you will need to do so manually. To do so, click onthe “File” menu and choose “Log On” (or you can click thelightning bolt icon.) Enter your user name and password inthe dialog box that appears, and choose your database fromthe drop-down list.Page 146

Step 4 : “Study Listing” screenOnce you are logged in, you will see a screen similar to thescreenshot below.As seen in the Overview on page 30, this screen is the“Study Listing” screen. All of the studies in your databaseare listed here and can be sorted by any of the fields,although the “Patient Name” and “Study Date” fields areperhaps most useful.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 147

Onyx-RAD Professional WorkstationUser ManualStep 5 : New Patient / New Study / NewSeriesNow its time to add an entry for the image(s) you will scan.You must decide whether to add a new patient, study,series, or image.New Patient: If the patient is not listed in your StudyList, you must add a new patient.1. Click the New Patient button (the red “P”).New Study: If the patient is already listed in the StudyList, and this is a new exam (e.g., a follow-up examination),you should add a new study for this patient.4. Find the patient in your Study List (see the previouschapter for a brief introduction to the Study Listscreen, including sorting and searching the StudyList).5. Click the line containing the existing patient so thatthe line lights up (highlights.)6. Click the New Study button (the red “S”).New Series. If you are adding multiple images to onestudy, it is suggested that you create a new series for eachimage.4. Find the patient in your Study List (see the previouschapter for a brief introduction to the Study Listscreen, including sorting and searching the StudyList).5. Click the line containing the existing patient so thatthe line lights up (highlights.)6. Click the New Series button (the red “E”).Page 148

New Image. If you are adding multiple images to onestudy, and you wish to group images under the same study(e.g., perhaps you have two images of a lateral chest andone chest AP, and you desire to have the two lats in oneseries, with the AP in second series), you should use theNew Image button to add images to the current series.(Viztek recommends that you put each image in a newseries [use the New Series button] as it simplifies laterviewing.)1. Find the patient in your Study List (see the previouschapter for a brief introduction to the Study List screen,including sorting and searching the Study List).4. Click the line containing the existing patient so thatthe line lights up (highlights.)5. Click the New Image button (the icon is of a spooland film).Test Scan. This button is for diagnostic testing of theHowtek unit. You should not need to use this button unlessyou are instructed to do so by a Viztek technician. Imagesare not saved when running a test scan.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 149

Onyx-RAD Professional WorkstationUser ManualStep 6 : Enter Patient / Study / Series detailsAfter clicking one of the buttons described in Step 5, you arepresented with the “New Patient/Study” dialog, shownbelow:the Howtek “New Patient/Study” dialogIf you are adding a New Study, Series, or Image, the dialogwill be partially completed for you, using data from theexisting patient record (e.g., Patient ID and Name willalready be filled in.) You will be unable to change thesefields.To enter data into a field, simply click the white box next toPage 150

the field and start typing. Although there are many fields onthe dialog, the only required fields are marked with anasterisk, are listed here:• Patient ID : This must be unique for every patient. Itis suggested social security numbers be used for thisfield, or any other uniquely identifying tag. (This fieldcan be letters, numbers, or a mix of both.)• Gender• Patient Name : Last Name : Only the last is required,but it is suggested that both last and first name beentered.• Patient Birth Date : This must be entered in MM-DD-YYYY format. Please ensure that you use a fourdigityear.Enter values for at least the required fields and click“Accept” to open the Howtek scanner interface.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 151

Onyx-RAD Professional WorkstationUser ManualStep 7 : Howtek InterfaceScanner will already be selected from previous uses.Click either “Scan Single Image” or “Scan Multiple Images”to scan in film. Images will appear in the black box in themiddle of dialog. Click each image you wish to import andclick “Accept” to import the images into your database.The “Auto-accept all images” checkbox will cause all imagesto be imported without requiring any further actions on yourpart.Click “Done” (upper right corner) when finished.Page 152

Using Modality WorklistModality Worklist is an optional component that integratesyour Onyx-RAD Acquire workstation with a 3 rd party RISsystem. The component is designed to save time andreduce data entry errors by taking the patient informationdirectly from the RIS and entering into Onyx-RAD.A sample Modality Worklist is shown below:To use the Modality Worklist, select and expand (click theplus box next to) the patient or exam you wish to addimages to. Then simply click the “New Series” or “NewImage” button.From here, image acquisition works the same as the “NewSeries” and “New Image” topics covered earlier in thischapter.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 153

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10Every ToolbarOnyx-RAD contains many toolbars and menus, designed toallow quick access to the features of the software. Becauseeach individual will only use a subset of all the toolsavailable, the vast number of options may seem daunting.This chapter explores every toolbar found in ProfessionalWorkstation, and describes the usage of each functionfound therein.Chapter ContentsThe Toolbars : Overview...............................156Standard toolbar ...........................................157View Operations toolbar ...............................158Cut-line Operations toolbar...........................159Cine toolbar ..................................................160Image Left-button Operations toolbar ...........161Image Layout toolbar ....................................162Annotations toolbar.......................................164Group Control toolbar ...................................165Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 155

Onyx-RAD Professional WorkstationUser ManualThe Toolbars : OverviewMany software applications make use of toolbars to providethe user with shortcut buttons to common functions. Thesebuttons are quicker than expanding a menu from the menubar and selecting the entry. (One click compared tomultiple.) Toolbars are simply a grouping of such one-clickbuttons.Onyx-RAD Professional Workstation makes great use oftoolbars. Almost every function available through themenus has an associated button on the toolbar.It is important to remember that while toolbars increase auser’s efficiency by providing easy one-click access tocommon features, there are so many buttons on the Onyx-RAD toolbar that initially it may seem less efficient. Likeanything else, practice and experience will lead to efficientusage of these shortcuts. With time the toolbars willbecome second nature, and your speed will increasedramatically.Professional Workstation contains the following toolbars:• Standard (log on/off, show/hide windows)• View Operations (rotate, flip, invert, etc.)• Cut-Line Operations (cut-lines)• Cine• Image Left-button Operations (window & level,magnify, zoom, etc.)• Image Layout (number of columns, link frames, etc.)• Annotations (arrow, circle, measure, etc.)• Group Control (prev/next series, sort, etc.)Each toolbar is pictured and explored over the next severalpages.Page 156

Standard toolbarThese buttons are shortcuts to the entries found in the Fileand View menus.Open a DICOM or .ONX image fileLog on to the databaseLog off of the databaseImport a DICOMDIR formatted exam“Export CD” – copy a study to a CD-Recordable discShow/Hide the Series windowShow/Hide the Worklist windowShow/Hide the Config bar windowShow/Hide the 3-D Slices windowChange the status of the study (unread, read,etc.) – only available on the Study List screen.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 157

Onyx-RAD Professional WorkstationUser ManualView Operations toolbarThis toolbar contains buttons that are shortcut to entriesfound on the Image menu.☼ Remember thatthese imagemanipulations(except for KeyImage) will affect allimages in thecurrent series if the“Share Single FrameProperties withGroup” option isenabled. See page163.Flip image horizontallyFlip image verticallyRotate image 90 degrees counter-clockwiseRotate image 90 degrees clockwiseTrue Size (expand/shrink image to true size)Fit to Window (expand/shrink image to fit in window)Invert black and white pixelsInvert red and blue colors (ultrasound)Reset all aspects of the selected image to its originalstateShow/Hide image overlaysInvert image overlay text colorMark image as a key imagePage 158

Cut-line Operations toolbar☼ For detailed usageof cut-lines, pleasesee the sectionentitled “Cut-Lines”on page 81.This toolbar contains buttons that are shortcuts to entriesfound on the Cut-Lines menu.Enable/Disable Cut-LinesStacks cut single framesSingle frames cut stacksSingle frames cut single framesStacks cut stacksDisplay image numbers next to cut-linesOnyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 159

Onyx-RAD Professional WorkstationUser ManualCine toolbarThis toolbar contains buttons that are shortcuts to entriesfound on the Cine menu.☼ For detailed usageof Cine, please seethe section entitled“Cine” on page 84.Play cine animation in reverseStop cine animationPause cine animationPlay cine animationRewind to first frameSkip back one frameSkip forward one frameFast-forward to last framePage 160

Image Left-button Operations toolbar☼ Remember thatthese imagemanipulations willaffect all images inthe current series ifthe “Share SingleFrame Propertieswith Group” optionis enabled. See page163.This toolbar contains buttons that are shortcuts to theentries found on the image context menu. Click any one ofthese buttons to activate the tool; click again to revert to notool.changes mouse cursor to default pointerIt is a good idea to use this after using one of theother tools to “turn off” the selected tool.changes mouse cursor to Width & Center toolSee “Width & Center”, page 49changes mouse cursor to Gamma Correction toolallows “spanning” in the Series/Stack windowchanges mouse cursor to the Magnify toolSee “Magnify”, page 53changes mouse cursor to the Pan toolSee “Pan”, page 52changes mouse cursor to the Zoom toolSee “Zoom”, page 51enters Annotation modeWhen in Annotation mode, right-clicking an image inthe Image Window results in a special Annotationpopup menu from which you can select and deleteannotations. Click this button again to exitAnnotation mode.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 161

Onyx-RAD Professional WorkstationUser ManualImage Layout toolbarThis toolbar contains buttons that are shortcuts to theentries found on the Layout menu.toggles whether the column buttons affect theSeries/Stacks window or the Image Viewing window☼ You can changecolumn layouts asoften as necessary.displays images in one columndisplays images in two columnsdisplays images in three columnsdisplays images in four columnsdisplays images in sixteen columnsdefine the number of columns to display imageschoose a fixed row and column display size forimagesactivates vertical compare mode (see page 85)activates horizontal compare mode (see page 85)activates compare scroll (see page 85)activates group scrollmanual synchronize seriesauto synchronize seriesWhen enabled, certain series (like a T1 and T2 ofthe same sequence) will scroll togetherautomatically.Page 162

share single-frame properties with groupA very important button, when enabled this causesany image manipulation performed on one image(like zoom, pan, width & center, etc.) to beperformed on all images in the same series.load across multiple monitorsOnly available with multiple monitors, this causes allseries to load on the left-most monitor, while imageswill be displayed across all the monitors. This givesthe effect of looking at one big piece of film.load multiple studies on separate monitorsOnly available with multiple monitors, this loadsseparate studies onto separate monitors whenviewing more than one study at once. When thisbutton is turned off, each study loads a copy oneach monitor.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 163

Onyx-RAD Professional WorkstationUser ManualAnnotations toolbarThis toolbar contains buttons that are shortcuts to entriesfound in the Annotate menu.enters annotation modeWhen in Annotation mode, right-clicking an image inthe Image Window results in a special Annotationpopup menu from which you can select and deleteannotations. Click this button again to exitAnnotation mode.changes mouse cursor to straight line tool(see page 62)changes mouse cursor to ellipse tool (see page 63)changes mouse cursor to box tool (see page 64)changes mouse cursor to arrow tool (see page 65)changes mouse cursor to freehand drawing tool(see page 66)changes mouse cursor to textbox tool (see page 67)changes mouse cursor to ruler tool (see page 68)changes mouse cursor to measure angle tool(see page 69)Loads annotations from the databaseSaves (new and changes to existing) annotations to thedatabase.Page 164

Group Control toolbarThis toolbar contains button that are shortcuts to entriesfound in the Group menu.move to the next seriesmove to the previous seriesmoves selected series right one monitormoves selected series left one monitorsorts images in by slice locationsorts images by image number (usually desired)Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 165

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AInstalling Onyx-RADOnyx-RAD installation is designed to be easy. Use thischapter to quickly walk through a typical installation.Chapter ContentsInstalling........................................................168Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 167

Onyx-RAD Professional WorkstationUser ManualInstallingYou should begin by installing your protection dongle. If it isa USB key, a “Found New Hardware” dialog will most likelyappear after a few moments. Simply click the “Cancel”button if this occurs.Your Onyx-RAD CD should contain a file named“OnyxRADWorkstationSetup”. Run this program to begininstalling Onyx-RAD. (On many Windows computers, thisprogram will start automatically a few moments afterinserting the disc.)The installation process will present you with severaldialogs, for most of which you will simply click “Next”.The first dialog is a copyright notice and standard Windowswarnings about closing other programs before continuingthe installation process.Click Next.Page 168

The next dialog is titled “Choose Destination Location”.The default location of “C:\Onyx-RAD” is already selected,but you can change this by following the directions on thedialog.Click “Next” to continue.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 169

Onyx-RAD Professional WorkstationUser ManualThe next dialog is titled “Backup Replaced Files”. Here youcan choose whether to make backup copies of all filesreplaced during the installation. This is generally a goodidea, so the “Yes” option is already selected. You can alsochange the location of the backup folder.Click “Next” to continue.Page 170

The next dialog is titled “Select Components”. This is animportant dialog because it allows you to choose whatOnyx-RAD components will be installed. Depending on theversion you have purchased, the component list may beslightly different than what you see here. Commoncomponents are described below.☼ Keep in mind thatultimately it is theprotection donglewhich decides whichcomponents will run.If you need to addcapabilities to yourworkstation, pleasecontact Viztek, Inc.Local Database: This should be enabled unless an Onyx-RAD Server is present. With a local database, all imagesare stored on the workstation.Sample Studies: This will install a large selection of sampleexams, including MRI, CT, US, and CR images.DICOM Send: Includes components necessary for sendingDICOM exams to a 3 rd party.Howtek Scanner Interface: indicates that this will be aHowtek Acquire workstation, and includes the necessarycomponents.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 171

Onyx-RAD Professional WorkstationUser ManualCD Archiving: includes components necessary to create CDarchives. These components will only work for Acquireworkstations (Howtek and Orex.)OpenGL Runtime: Some video card drivers do not includeOpenGL support, which is needed for the 3D Slices feature.This component will include the OpenGL drivers. Generallyit is not needed.Click “Next” to continue.Page 172

The next dialog is titled “Select Program Manager Group.”This dialog allows you to define a different Group for theOnyx-RAD software to be installed into. The default (Onyx-RAD, which will create a new Group) is the best choice.Click “Next” to continue.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 173

Onyx-RAD Professional WorkstationUser ManualThe next dialog indicates that you are ready to begininstalling Onyx-RAD Workstation. When you click “Next” onthis dialog, the process of copying and installing files to yourcomputer will begin.Click “Next” to begin the file copy and installation process.Page 174

The “Installing” dialog keeps you informed of the installationprogress.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 175

Onyx-RAD Professional WorkstationUser ManualAbout one-third through the file copying, the WIBU-KEYSetup dialog will appear:☼ You must installthe WIBU-KEYdrivers in order torun Onyx-RADsoftware.Click “Next” to continue, and “Next” on the next dialog aswell. Files will copy and the “Next” button will light up again.When it does, click “Next”. A final WIBU-KEY dialog informsyou that setup is complete. Uncheck the checkbox next to“Yes, I want to view the readme file now”, and click “Finish.”A message will pop up indicating the WIBU-KEY driver hasbeen installed; click “OK”.Onyx-RAD installation will continue.Page 176

Near the end of file copying, the Interbase 6 ODBC setupwill begin:After several moments a new setup window will appear toguide you through the Interbase 6 ODBC driver setup. (Youmay need to check for it on the task bar at the bottom of thescreen, and click on it to make it appear.)☼ You must installthe Interbase ODBCdriver if you selectedthe “Local Database”component.Click “Next” to continue.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 177

Onyx-RAD Professional WorkstationUser ManualThe next dialog is a license agreement dialog:Click “Yes” to continue.Next is a release notes dialog, click “Next” to continue.Page 178

A “User Details” dialog appears:You should enter “Viztek” (without quotes) for both the“Name” and “Company” fields. The serial number is alreadyentered.Click “Next” to continue.The next dialog is a “Choose Destination Location” dialog.You should keep the default location and simply click “Next”to continue.A final dialog will indicate that Interbase 6 ODBC installationis complete. Click “Finish” on this dialog to return to Onyx-RAD installation.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 179

Onyx-RAD Professional WorkstationUser ManualAt this point, the installation will perform some setup tasks inthe background, so please be patient. Eventually an“Installation Complete” dialog will appear:Click “Finish” to complete the installation.When asked to reboot, please do so.Page 180

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BConfiguration ManagerOnyx-RAD Configuration Manager contains many tools tohelp you quickly configure your Onyx-RAD software. Thischapter explores these tools.Chapter ContentsStart Configuration Manager.........................184AE Node Editor .............................................185Contact Editor ...............................................188Exam Routing ...............................................192General Server Config ..................................195Image Server Config.....................................197Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 183

Onyx-RAD Professional WorkstationUser ManualStart Configuration ManagerClick the “Start” button found at the very bottom-left cornerof the screen:Choose Programs, choose Onyx-RAD, chooseConfiguration Manager.☼ YourConfigurationManager may notcontain all of thetools shown here.You must log on using the same username and passwordthat you use to log on with Professional Workstation.(Often, the user name and password are both “onyx”.)The Configuration Manager window appears:Each of the remaining topics in this chapter explores thetools found in Configuration Manager.Page 184

AE Node EditorThis tool is for adding and managing AE Titles. AE Nodescreated here are used in the Contact Editor and the ExamRouting tools.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 185

Onyx-RAD Professional WorkstationUser ManualTo add a new AE Title:Click “New AE Node” and set up the new AE Node asfollows:• Destination / Calling AE Title : enter the AE Titleof your intended recipient• Source / Called AE Title : enter your AE Titlehere (you may use “ONYXRAD”, for example.)• Host IP/Address : enter the network address ofyour recipient.• Port : enter the port number on which therecipient will listen for DICOM transmissions• Image Server : select “Default Image Server”• Archive Server : select “Default Archive Server”• Group : select “Users”The Options grid at the bottom of the dialog currentlycontains only “Auto Validate”, which is only relevant forincoming exams. If you turn this option on for the“DEFAULT” node, DICOM exams that are received will beautomatically validated (i.e., marked “UNREAD”) after tenminutes.Click “Save.” If all required fields have values, your new AENode will appear in the listing. Click “Exit.”To edit an existing AE Node:Click the node in the listing and the boxes above will displaythe node’s information. Click in any of the boxes andchange the information as necessary. When finished, click“Save Changes”.Note that you cannot change certain fields for the“DEFAULT” node.Page 186

To delete an AE Node:Click the node in the list and the boxes above will displaythe node’s information. Click the “Delete” button to removethe Node.Note that you cannot remove the “DEFAULT” node, as it isnecessary for Onyx-RAD to function.To exit AE Node Editor:Click the “Exit” button to return to the main ConfigurationManager window.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 187

Onyx-RAD Professional WorkstationUser ManualContact EditorContact Editor is the tool used to create and manageContact Entries, also known as Push Entries. These entriesappear on the “Send To” dialog when you are pushingstudies.Page 188

To set up an .ONX format entry (for sending to otherOnyx-RAD sites):10. Click “New Entry”11. For User, choose your desired user (default is theuser “ONYX”)12. Contact Type : Choose Network or Dialup, asappropriate.13. (Network) Host Name/IP : Enter network address ofrecipient.(Dialup) Phone Number : Enter the full phonenumber (including 1 + area code if necessary) of therecipient.14. Description: The text you enter here will appear onthe button that you see in the “Send To…” dialog. Itis also the text you will see in the RoutingConfiguration dialog (explored later in this chapter.)15. (Dialup) Enter the dialup user name and passwordon the right side of this dialog.16. After sending study, set status to: The most commonvalues for this are “NONE” (don’t change the exam’sstatus) or “DELETED” (set the exam to be deletedafter it sends successfully.)17. Scheduling: “now” is the most common value, or youcan set a specific date and time.18. Click “Save”.Your new contact will appear in the list. Click Exit.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 189

Onyx-RAD Professional WorkstationUser ManualTo set up a DICOM format entry (for sending to anyDICOM-compliant software):9. Click “New Entry”10. For User, choose your desired user (default is theuser “ONYX”)11. Contact Type : Choose CSTORE.12. Dest AE Node: Choose the AE Title from the dropdownlist. This list comes from the AE Titles createdin the AE Node Editor tool.13. Description: The text you enter here will appear onthe button that you see in the “Send To…” dialog. Itis also the text you will see in the RoutingConfiguration dialog (explored later in this chapter.)14. After sending study, set status to: The most commonvalues for this are “NONE” (don’t change the exam’sstatus) or “DELETED” (set the exam to be deletedafter it sends successfully.)15. Scheduling: “now” is the most common value, or youcan set a specific date and time.16. Click “Save”.Your new contact will appear in the list. Click Exit.Page 190

To edit an existing Contact Entry:Click the entry in the listing and the boxes above will displaythe entry’s information. Click in any of the boxes andchange the information as necessary. When finished, click“Save Changes”.To delete a Contact Entry:Click the entry in the list and the boxes above will displaythe entry’s information. Click the “Delete” button to removethe entry.To exit Contact Editor:Click the “Exit” button to return to the main ConfigurationManager window.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 191

Onyx-RAD Professional WorkstationUser ManualExam RoutingUse the Exam Routing tool to create and manage autotransfer routes for exams. When exams are validated (i.e.,marked “Unread”) they will automatically be added to thepush queue according to the routing rules defined here.This is especially useful for Acquire workstations that willsend to a 3 rd party PACS after acquiring images.You must first enter AE Titles (if sending DICOM) in the AENode Editor and a Contact Entry in the Contact Editor (seethe previous topic.) After these steps have been taken careof, you can create a route.Page 192

To add a route:Click the node to add a default route from, in most casesyou will click the entry titled “DEFAULT.” Click the “AddNew Route” button.☼ Keep in mind thatyou must havealready created aContact Entry (usingContact Editor).On the right side of the window, select a Push Entry fromthe drop down box. This box lists all the entries you havepreviously set up using the “Contact Editor” utility inConfiguration Manager. (If you have not set up any entries,exit from this window and set up an entry first.)The next two boxes will fill with the values stored in thecontact entry (e.g., network address and port), and thescheduling box will be empty. For a temporary route, entera specific date and time. Otherwise, enter “now” (withoutquotes) in the box.Finally, click “Save Changes”.You can verify configured routes by expanding the list onthe left side of the window (click the little plus box next to anAE Title to view routes.)Click “Exit” to exit the Routing Configuration tool.When routes are set up, exams are automatically added tothe push queue (according to the routes) once they arevalidated.To edit a route:Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 193

Onyx-RAD Professional WorkstationUser ManualClick the route in the list that you wish to edit. Its details willappear in the boxes to the right. Note that you can onlychange two things: the Contact Entry (from the drop-downlist) and the scheduling. If you wish to make changes to theContact Entry itself, such as the network address and port,you must use Contact Editor.To delete a route:Click the route in the list that you wish to edit. Its details willappear in the boxes to the right. Click the “delete” button todelete the route.To exit the Exam Routing tool:Click the “Exit” button to return to the main ConfigurationManager window.Page 194

General Server ConfigUse the General Server Config tool to configure basicparameters of your Onyx-RAD software. Though the tool isintended for Onyx-RAD Server software (as the nameimplies), it is also often helpful when configuring Acquireworkstations.Server Host Address SettingsEnter the server’s IP address here.TeleRAD PullServer Port and Client PortEnter the appropriate port numbers here.SMTP Server SettingsUsed for emailing studies (the Contact Entry type “Email”).Administrator SettingsThese settings are for administrator access.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 195

Onyx-RAD Professional WorkstationUser ManualServer OptionsSet timeout limits for Receiving, Sending, and ARTIMoperations. Also set whether to archive images (requires anOnyx-RAD Archive Server), Replace old image whenduplicates are received, and manage storage space(requires Onyx-RAD Space Management Server.)Dial-Up SettingsEnter dialup settings for this server. The preferred way todo this is through windows dial-up networking.To save changes:Click the “Save Changes” button.To exit:Click the “Exit” button.Page 196

Image Server ConfigUse this tool to add and manage Image Servers. This isgenerally only relevant where an Onyx-RAD Server ispresent.To add an image server:Click “New Entry” and enter data for each field, includingName, Description, Network address and port number.Click “Save” when finished. The new image server willappear in the list at the bottom of the window.☼ You cannot editthe Name property ofthe default imageand archive serverentries.To edit an image server:Click the appropriate entry in the list of image servers. Thefields will display the selected image server’s settings.Make changes as necessary and click “Save Changes” tomake them permanent.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 197

Onyx-RAD Professional WorkstationUser ManualTo delete an image server:☼ You cannot deletethe default imageand archive serverentries.Click the appropriate entry in the list of image servers. Thefields will display the selected image server’s settings. Clickthe “Delete” button to remove the entry.To exit the Image Server Configuration tool:Click the “Exit” button.Page 198

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CWindows 2000 PrimerOnyx-RAD software is designed to run like many otherMicrosoft Windows programs, in order to facilitate its use. Ifyou are unfamiliar with Windows in general, please use thischapter to get an understanding of basic concepts inWindows.Chapter ContentsUsing the Mouse...........................................202Mouse Click : Left or Right button?...............203Using the Keyboard ......................................204Menu bars (“Menus”) ....................................205Context Menus..............................................205Toolbars........................................................206Scrollbars......................................................207Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 201

Onyx-RAD Professional WorkstationUser ManualUsing the MouseThe mouse is your basic interface with the computer. It hastwo large buttons on top (sometimes three, sometimes amouse wheel in the center) and a ball on the bottom thatdetects movement. (Go ahead, pick the mouse up and lookat the bottom side to see the ball!) The two large buttonsare called the “left mouse button” and the “right mousebutton,” respective of their placement on the mouse.The intended method of using the mouse is to rest yourhand on the top of the mouse, with your index fingerpositioned over the left mouse button, and your middlefinger positioned over the right mouse button.If you look at the computer screen you should notice a smallwhite arrow. This is called the “mouse pointer.” With yourhand resting on the mouse as described above, move themouse over the desk (or mouse pad) and observe that themouse pointer will mimic your movements. Move themouse up, down, left, and right, in a circle, etc. and observethe mouse pointer. Practice trying to place the mousepointer on a certain area of the screen, perhaps one of theicons you see on the screen.The buttons are operated but simply pushing down andreleasing the button. For example, to operate the leftmouse button (with your hand resting on the mouse asdescribed earlier) you simply push the button down withyour index finger, then release. This is called “clicking” themouse, named for the little click noise this action produces.Thus, to “click” the mouse means to push one of thebuttons. Note there are two buttons, so “left-click” means toclick the left mouse button, and “right-click” means to clickthe right mouse button.Generally one will only say to “click” something, implying theleft mouse button. Indeed the left mouse button is thebutton used for most every task in Windows, so if you areasked to “click” something you should assume the leftPage 202

mouse button is intended. If the right mouse button isintended it will always be indicated, as “right-click” or “clickthe right mouse button.”This manual uses the common notation:Click : implies clicking the left mouse button one timeRight-Click implies clicking the right mouse button one timeThe other “clicking” term you hear about is to “double-click.”This means to click the left mouse button twice in quicksuccession. This is often a difficult technique to master for abeginning computer user, so practice makes perfect.Thankfully, Onyx-RAD Professional Workstation only makesuse of the double-click in one place (selecting a study toview from the Study Listing.)Mouse Click : Left or Right button?The vast majority of mouse click operations in any Windowsprogram are performed the left mouse button. Thus,whenever you are directed to “click” something, it is impliedthat you click with the left mouse button.Double-click refers to rapidly clicking the mouse buttontwice, and also implies the left mouse button.Right-click means to click the right-mouse button. The rightmouse button is generally not used as frequently as the left,and is generally used to call up “context menus” (pop-upmenus that appear when right-clicking in certain areas orcontexts.)Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 203

Onyx-RAD Professional WorkstationUser ManualUsing the KeyboardWhile most tasks utilize the mouse, there are operationsrequiring the keyboard. Typing in search terms, forexample, or typing annotation text.The keyboard is laid out much like a typewriter. If you arefamiliar with a typewriter you will feel right at home on thekeyboard in a short time.A notable addition on a computer’s keyboard is the set ofarrow keys. These are four keys, grouped together on theright side of the keyboard (between the main letter keys andthe numerical keypad) which are labeled with arrowspointing up, down, left, and right.The arrow keys can be used to move the cursor aroundwhile typing in text. Onyx-RAD Professional Workstationmakes use of these keys as shortcut keys to scroll throughseries of images. Pecking the right-arrow key will take youto the next image, the left-arrow key will take you to theprevious image.Immediately above the arrow keys is a grouping of six keysalso used as shortcut keys. The delete key (sometimeslabeled “del” for short) can be used to delete annotations.The Home and End keys are used in navigating a series ofimages; Home will take you to first image, End to the finalimage. The Page Up and Page Down (sometimes labeled“PgDn and PgUp”) will take you to the previous series ornext series, respectively.Page 204

Menu bars (“Menus”)Menu bars are found along the top of most Windowsprogram, and are useful for concealing large menus whilenot in use.Common menus seen in Windows programs are “File”,“Edit”, and “Help.” To pull down a menu from the menu bar,simply click the menu title. (For example, click “File”.) Amenu drops down with entries. To activate an entry, justclick it. To hide/close a menu until you need it again, simplyclick the menu name again (e.g., click “File” again.)Context MenusContext menus are pop-up menus that appear when youright-click in certain areas. For example, in Onyx-RADProfessional Workstation, if you right-click on an image inthe Image Window, the Image Context Menu appears.Context menus are designed to provide quick access tofunctions or operations that are relevant to that part of theprogram.To cancel a context menu, simply move the mouse cursoroff of the context menu and click the left mouse button onetime.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 205

Onyx-RAD Professional WorkstationUser ManualToolbarsToolbars are collections of shortcut buttons that generallyappear near the top of a program window, usually under themenu bar. These buttons are designed to give quick oneclickaccess to functions and operations in the program. Forexample, many Windows programs have toolbar buttons forCut, Copy, and Paste, operations that people use quitefrequently.In Onyx-RAD Professional Workstation, many toolbarbuttons also serve as an indicator regarding whether certaintools or options are enabled. For example, below arepictures of the “Magnify” toolbar button. The image on theleft shows this button when the “Magnify” tool is notselected; the one on the right indicates the “Magnify” tool isselected.(Notice that the button on the right appears “lit up” and“pushed in”.)Page 206

ScrollbarsUse of a scrollbar is quite simple, and there are a fewdifferent methods of using one:Use the endcap arrow buttons.To scroll down, click the down arrow button at the verybottom of the scrollbar.To scroll up, click the up arrow button at the very top ofthe scrollbar.Move the slider up or down by dragging it:Position the mouse cursor (arrow) over the smaller graybar contained inside the scrollbar. Holding the leftmouse button down, move the mouse up or down tomove the slider accordingly.Click in the empty area of the scrollbar (in an area wherethe inner gray slider is not located) above or below the innergray slider to move the bar up or down accordingly. This issimilar to the operation of the “Page Up” and “Page Down”keys on the keyboard.Onyx-RAD is a registered trademark of Viztek, Inc. © 1995-2002 Page 207