SECTION C

Additional Operations

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

CONTENTS

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

ADDITIONAL OPERATIONS IN WORKLIST ............................................................................... 2

ADJUSTING TECHNIQUE SETTINGS ........................................................................................ 5

IMAGE PROCESSING................................................................................................................ 10

ADVANCED APPLICATIONS ..................................................................................................... 20

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Additional Operations in Worklist

When open a study in Local page or Worklist page, the system will go to Exam window
automatically. The Exam window is shown as below.

Figure 1: Exam window

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

 Add a new study

 Add or delete a new view
 Reject the captured image
 Change the order of image acquisition
 Switch between protocols
 Adjust exposure technique
 Exit Exam window

To Add a New Study

1. Click “Add Protocol” button which is located in the upper right corner of
Exam window:

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2. The Add View window displays, as shown below. In this window, you can add
protocols. Details please refer section B.

Figure 2: Add Protocol window

3. Select a Body Part from the left list, the corresponding protocol will be listed in the
upper right area. If select “Often Used” item in the left list, only protocols marked
“often used” display in the upper right area (The often used protocol is defined by
DROC configuration)

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Figure 3: select a body part

4. Click the protocol to load the corresponding views into the lower right area.

Figure 4: add protocols

To save the study information, click the “OK” button. To cancel operation, click the
“Cancel” button. Then system go back to Exam window.

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When the View is added successfully, it will be indicated in the Image Area of Exam
window.

To Add or Delete a View/Image

If you want to exposure a view again, select the view and click Copy View button to copy
the view again. Then you can capture image of the same view.

If you like to delete the reduplicate/unsuitable view, click the “Delete View” button which is
located in the upper right corner of Exam window.

Figure 5: Copy View button and Delete View button

To Change the Order of Image Acquisition

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

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

Figure 6: change the exposure order

Adjusting Technique Settings

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

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Figure 7: Technique Settings panel

From the Technique Settings panel you can:

 Adjust exposure settings manually.

 Adjust exposure settings using AEC (Automatic Exposure Control); this includes
selecting one or more AEC fields, and adjusting default density settings.

 Select a focal spot size.

 Select a patient size setting.

 Reset the status of the Generator & Detector.

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

Selecting the Patient Body Type

To select a body type, click on the icon for the required type—Large, Medium, Small, and
Pediatric. The selected button will be pushed down

Figure 8: Patient Size

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

You can select AEC detector fields in each ion chamber individually or in any combination.
You can vary the density setting between +4 and -4 (0 is neutral).

To change the density setting, click on the Increase Density button or Decrease Density
button located to the right of Density value field, as shown above. For the increases or
decreases amplitude of each time, please refer to the Service Manual of Generator.

Density Setting Percent of mAs

+4 150.0%

+3 137.5%

+2 125.0%

+1 112.5%

0 100%

-1 87.5%

-2 75.0%

-3 62.5%

-4 50.0%

Adjusting Exposure timing using MAS setting

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

To specify the exposure by mAs, ensure the mAs button in the Exposure Control panel is
selected, then click on the Increase mAs button or Decrease mAs button located to the
right of MAS value field to set the desired value. The value changes by one unit each time.
Pressing and holding the button causes the value to increase or decrease automatically until
the button is released. If the value reaches maximum or minimum, the value will remain
unchanged.

Figure 11: MAS Setting

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With the mAs button selected, the TIME controls are dimmed. Since the TIME settings and
MAS setting are dependent to each other.

Adjusting Exposure timing using TIME settings

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

To specify the exposure by Time setting, make sure the Time button in the Exposure
Control panel is selected (shown below), then click on the Increase mA/ms button or
Decrease mA/ms button to set the desired values. The value increases and decreases in
steps of one unit. Pressing and holding the button causes the value to increase or decrease
automatically until the button is released. If the value reaches maximum or minimum, the
value will remain unchanged.

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

Figure 12: TIME Setting

Selecting the Focal Spot Size

To select the focal spot size, click on the corresponding size button. The selected button will be
pushed down.

Figure 13: Focal Setting

If the selected Focal Spot Size is not compatible with the tube and focal spot, the
system inhibits exposure and displays an overload condition. An overload condition

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may exist if the technique selected exceeds the maximum or is below the minimum
allowable X-ray tube focal spot rating. The tube parameters are consistent with the
X-ray tube manufacturer's rating charts.

Bucky location display

Bucky’s location is in one of these locations: Table, Stand, Mobile and Direct.

Figure 14: location of Bucky

Reset Hardware

If there has an error and it cannot auto recover, the error message will remain in message field.
Click the Reset button before performing subsequent exposure.

Figure 15: Reset button

Display the state of generator

DROC can show the state of generator in different procedure (push hand switch,
release hand switch, exposure)

Pressing hand switch:

Exposure is ongoing:

Forbidden exposure:
Figure 16: state of generator

Image Processing

After taking an exposure, the acquired image could be loaded into the Process Window for

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processing.
You can perform the following processes as:

 Verify patient and exposure information.

 Select LUT or Symphony algorithm.
 Adjust the LUT curve.
 Adjust symphony parameters.
 Add markers to the image.
 Add comments to the image.
 Pan or zoom the image
 View the image in full size or fit to window.
 Rotate or flip the image.
 Clip the image.
 Add or delete mark on the image.
 Invert the image.
 Reset to the original image.

Verify the Patient and Exposure Information

In Process window, you can see the patient/study information on the top left of the image,
and the real exposure dose information on the top right of the image.

Figure 17: Patient and Exposure Information

Select LUT or Symphony

The DROC supports both LUT algorithms to adjust the image contrast，and Symphony
algorithms to enhance the image based on the anatomy selected. Click the corresponding
button to use the algorithms.

Figure 18: LUT button, Symphony button

Click the LUT, Symphony button or Custom Symphony, system would use the default
parameters to process the image.

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Adjust the LUT

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

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

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

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

Figure 19: adjust the LUT curve

Adjust symphony parameters

DROC will process the captured image automatically. Generally speaking, using
the default symphony parameters, one can get a very good processed image. If
you want to adjust the image for some certain purpose, you can click Custom

Symphony button to adjust the symphony parameters.

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Figure 20: adjust symphony parameter

Add Markers to the Image

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

Figure 21: Marker buttons

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

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

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Add Comments on the image

By clicking Define Mark button, you can add a customized label which will be displayed
on the image.

Figure 22: Define Mark button

Click Define Mark button, Labe list displays as the following figure. You can add
information into image by clicking an item from the list.

Figure 23: Comment list

To add a customized label

1. If the label information you want to add is in the predefined list, choose the associated
checkboxes. Otherwise, you have to add the customized comment by this way: System
-> DROC Configuration -> System -> Image Comment, input the customized comment
into the text field, and then click New button to save it. Now you could find the new
customized comment in the Image Comment list. You can also delete a current
comment by clicking Delete button after select the comment in Image Comment tab of
DROC Configuration page.
2. Click the new customized comment from the Image Comment list to add the comment.
The Image Comment list closes and the comment display(s) on the image Area of
Process window.

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Figure 24: The image with added comment

Remove Marks and Comments

Clicking Clear All Marks button, all of added marks and comments are removed from the
image.

Figure 25: Clear All Marks button

Pan and zoom the image

You can pan or zoom the image by selecting the pan or zoom button to a better
observation.

Figure 26: Pan and Zoom button

View Full Size Image

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operations, you must return to Fit Window mode by click Fit Window button

Figure 27: Fit Window button and Original Size button

Rotate the Image

The image can be rotated 90°(clockwise) or 90°(anti-clockwise) clockwise as required. It is

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

Figure 28: Image Rotate buttons

Flip the Image

The image can be mirrored by clicking Flip Horizontally button or Flip Vertically button.

Figure 29: Flip Horizontally button and Flip Vertically buttons

Clip an Image

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

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

Figure 30: clip function

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To display the clip lines: click the Recover Clip button .

Figure 31: display the clip lines

The clip line can be operated by use mouse.

To remove the clip line and not clip the image: click the Remove Clip button .

To change clip size: choose one item from the clip size drop-down list which can be

triggered by clicking Define Clip Size button ，the items in the drop down list
represent standard film size with inch being unit.

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Figure 32: Clip Size List of Define Clip Size button

To fix clip line: click Save Clip button , the current clip line set to be the default
clip line.

Rotate the Image with any angle

To rotate the image by Rotate Any Angle button, make sure the Rotate Any Angle button
is clicked (shown below), then click the Increase button or Decrease button to set the
desired values. The value increases and decreases in steps of one unit. Pressing and
holding the button causes the value to increase or decrease automatically until the button is
released. If the value reaches maximum or minimum, the value will remain unchanged.

Figure 33: Rotate Any Angle

Add Mask on the image

If you like to see only part of the image, you can add the mask on the image. Click the
Add/Delete Mask button, click several points around your interested region and double
click the end point. The system will add mask on the image except the setting region, like
following figure.

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Figure 34: Add Mask button and Delete Mask button

Invert the image

If you like to see the inverse image, click the Invert button.

Figure 35: Invert button

Reset to initial image

One can restore the image by click Reset to initial image button.

Figure 36: Reset to initial image button.

Accept or Reject the Image

To accept the image, click the Accept button. The Process window closes and a thumbnail

(minimized view) of the image will be displayed in Exam window, as shown below. The

applied exposure parameters will also be found under its thumbnail image.

Figure 37: Accept and Reject button in the Next step bar

If reject an image (for example, if the patient moved during the exposure).The Image
Rejection Reason list displays, as shown below. In this list, you can select a reason of the
rejection. Then system will go back to Exam window for capturing the same view again.

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Figure 38: Reject Reason Window

Advanced Applications

Image Stitching

Stitching module is an advanced option for DROC application. Its workflow will be described
in this part.

1. Register a patient/Study and select one stitch procedure as showed below;

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Figure 39: A ready-to-be-exposed Study

2. Expose and then the thumbnail images of captured images are displayed as below:

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Figure 40: A Study with images being captured

3. Switch to the Stitch window by clicking the Stitch menu item on the Menu Bar, all
the images being captured will be loaded on the Stitch window:

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Figure 41: Stitch window

4. On the Stitch window, you can stitch the images together, the detailed instruction will
be described in the following topic “Image stitching operation”:

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Figure 42: The stitched panorama

5. Save the image and the screen will switch back to Exam window with the thumbnail
image of the stitched panorama.
6. Click Close button to exit stitching and without save.

Dual Energy

Dual Energy module is an advanced option for DROC application.

To start a dual-energy exam, select “Advanced->Dual Energy” during selecting a protocol for
a patient.

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Figure 43: The dual energy protocol

After entering the exam screen, pressing down and holding the hand switch until these two
exposures, one is the low dose and the other is the high dose, are completed. Finally,
DROC will automatically process these two images and created two new processed Dual
Energy images, one is about bones, and the other is about soft tissues.

Figure 44: Dual Energy images

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Health Screening

The system allows importing batch patients with a specified procedure. It is helpful for health

screening. To start import batch patients, go to the Work->Local page as shown in the below

figure, and then click the button .

Click this button

to start import
batch patients

Figure 47: To start import batch patients

Before above import operation, an Excel file is required to be prepared in advance. The

batch patient template for import employs Microsoft Excel file format as below figure. The

Excel file template “Import Template.xsl” is located under the root directory of DROC.

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Figure 488: Import batch patient file example

The format of each field in this table is defined as below：

(1) PID: maximum length is 64 bytes. No uniqueness check.

(2) Patient Name: maximum length 64 bytes ( 32 double byte characters); Its

format must be “FirstName^MiddleName^LastName”, for example,

Murray^W^Andreas

(3) Age: maximum length 4 bytes, 3 are digits and 1 is ASCII character Y, M,

or D (Standing for Year, Month, or Day). The one ASCII character is optional. If the

character Y, M, or D is missing, it is also allowed. For example, 10 or 10Y is for 10

years old. If the birth date field is available, the patient age will be calculated

automatically by DROC no matter the age is provided or not.

(4) DOB (Date of Birth): it is the same as the current format in Windows

operating system. This field could be blank;

(5) Sex: only one byte, M, F, or O, which stands for male, female, or others

correspondingly. If this field is blank, the “O” will be employed.

The Procedure will employ the emergency definition in DROC -> System -> Emergency.

Thus it is not required to be provided in this Excel file.

To change the Excel file template, for example, to add or delete one filed, please change its

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configuration file “conf \ WorklistImportColumnconf.xml” only for advanced users. It is

strongly not recommended to change this file for non-advanced users.

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