Philips: MX 4000 Dual MX 6000 Dual

English
Instructions for Use
MX 4000 Dual
MX 6000 Dual
4535 673 83741
PHILIPS
Contents
1 Introduction ..................................................................................... 1-1
1.1 About this guide ...................................................................................1-1

1.2 Intended use .........................................................................................1-3
1.3 Contraindications .................................................................................1-4
1.4 Compatibility .......................................................................................1-4
1.5 Compliance ..........................................................................................1-5
1.6 IEC-60601-1 classification....................................................................1-6
1.7 Training................................................................................................1-7
2 Safety ................................................................................................ 2-1
2.1 Important safety directions ...................................................................2-1

Philips and Neusoft Medical Systems 4535 673 83741
2.2 Emergency procedures ..........................................................................2-4

2.3 Electrical safety and grounding .............................................................2-6
2.4 Mechanical safety..................................................................................2-6
2.5 Explosion safety ....................................................................................2-7
2.6 Implosion hazard ..................................................................................2-7
2.7 Fire safety .............................................................................................2-7
2.8 Mobile telephones & similar products ..................................................2-8
2.9 Radiation safety ....................................................................................2-9
2.10 Oil leaks..............................................................................................2-11
2.11 Laser safety..........................................................................................2-12
2.12 Protection measures ............................................................................2-13
MX 4000 Dual/MX 6000 Dual - Volume 1 Contents i

3 Security of system and data ............................................................. 3-1
3.1 Regulatory controls............................................................................... 3-2

3.2 Security issues and guidelines................................................................ 3-3
4 System description ........................................................................... 4-1
4.1 Operating station.................................................................................. 4-2

4.2 Gantry and patient table ....................................................................... 4-6
4.3 Gantry panels ....................................................................................... 4-7
4.4 Patient table........................................................................................ 4-10
4.5 Patient supports (positioning aids)...................................................... 4-11
4.6 X-Ray and detection systems............................................................... 4-12
4.7 Key technical data............................................................................... 4-13
4.8 System symbols................................................................................... 4-14
4.9 Extended Brilliance Workspace (optional) .......................................... 4-15
5 Navigating the software ................................................................... 5-1
5.1 Overview .............................................................................................. 5-1

5.2 Home window...................................................................................... 5-2
6 Scanner operation ............................................................................ 6-1
6.1 Overview .............................................................................................. 6-1

6.2 Startup.................................................................................................. 6-2
6.3 Tube warm-up...................................................................................... 6-3
6.4 Air calibration....................................................................................... 6-4
6.5 Shut down ............................................................................................ 6-5
6.6 Operating the gantry tilt and table........................................................ 6-6
6.7 Using the scan window ......................................................................... 6-9
ii Contents MX 4000 Dual/MX 6000 Dual - Volume 1

6.8 Using the patient catalog.....................................................................6-15
6.9 Scan procedure....................................................................................6-17
6.10 Plan on surview...................................................................................6-23
7 Service .............................................................................................. 7-1
7.1 Service menu.........................................................................................7-2

8 Scan protocols .................................................................................. 8-1
8.1 Overview ..............................................................................................8-1

8.2 Common parameters ............................................................................8-3
8.3 Surview .................................................................................................8-5
8.4 Scan parameters ....................................................................................8-7
8.5 Reconstruction parameters ..................................................................8-12
8.6 Voice parameters.................................................................................8-16
9 Image reconstruction ....................................................................... 9-1
9.1 Overview ..............................................................................................9-1

9.2 Online recon.........................................................................................9-2
9.3 Offline reconstruction...........................................................................9-3
10 Review mode .................................................................................. 10-1
10.1 Common tools....................................................................................10-2

10.2 2D Viewer mode.................................................................................10-6
10.3 Planar mode........................................................................................10-8
10.4 Volume mode ...................................................................................10-10
10.5 Endo mode .......................................................................................10-13
MX 4000 Dual/MX 6000 Dual - Volume 1 Contents iii

11 Filming ........................................................................................... 11-1
11.1 Overview ............................................................................................ 11-1

11.2 Filming window ................................................................................. 11-2
11.3 Print film.......................................................................................... 11-11
12 Reporting ....................................................................................... 12-1
12.1 Overview ............................................................................................ 12-1

12.2 Report window ................................................................................... 12-2
13 Image performance quality assurance ........................................... 13-1
13.1 Overview ............................................................................................ 13-1

13.2 Head & body system performance phantom....................................... 13-2
13.3 Schedule of quality assurance checks ................................................... 13-8
13.4 Monthly checks ................................................................................ 13-14
13.5 Advanced quality assurance checks.................................................... 13-17
13.6 System maintenance ......................................................................... 13-20
13.7 Dose and imaging information ......................................................... 13-21
iv Contents MX 4000 Dual/MX 6000 Dual - Volume 1

1 Introduction
The MX 4000 Dual and MX 6000 Dual CT systems are advanced

continuous-rotation computed tomography systems suitable for a wide
range of computed tomographic (CT) applications.
1.1 About this guide

This manual is intended to assist users and operators in the safe and
effective operation of the equipment described. It covers the information
needed for your CT scanner.
• The “user” is considered to be the body with authority over the
equipment.
• The “operators” are those persons who actually handle the equipment.
Before attempting to operate the equipment, you must read, note, and
strictly observe all DANGER notices and safety markings on the CT
System.
Before attempting to operate the equipment, you must read this manual
thoroughly, paying particular attention to all Warnings, Cautions and
Notes incorporated in it. You must pay special attention to all the
information given and procedures described in the SAFETY section.
Wa r n i n g Directions, which if not followed, could cause fatal or serious injury to an

operator, patient or any other person, or could lead to a misdiagnosis or
mistreatment.
MX 4000 Dual/MX 6000 Dual Introduction 1- 1

1.1 About this guide
Caution Directions, which if not followed, could cause damage to the equipment
described in this Instructions for Use and/or any other equipment or goods,
and/or cause environmental pollution.
Note Highlight unusual points as an aid to an operator.
Within this Instructions for Use, the most extensive configuration of the
system is described, with the maximum number of options and accessories.
Not every function described may be available on your system.
This volume explains how to use the CT scanning system. It also contains
information about safety, data security, system start-up, software
navigation, scanning protocols, networking, and calibration.
1 -2 Introduction MX 4000 Dual/MX 6000 Dual

Intended use 1.2
1.2 Intended use

The MX 4000 Dual and MX 6000 Dual CT systems are intended to be
used and operated only in accordance with the safety procedures and
operating instructions given in this Instructions for Use for the purpose for
which it was designed. The purpose for which the equipment is intended
are given below. However, nothing stated in this Instructions for Use
reduces user’s and operator’s responsibilities for sound clinical judgement
and best clinical procedure.
These CT systems are intended for use as a diagnostic patient imaging
device that produces images that correspond to tissue density. The quality
of the images depends on the level and amount of X-ray energy delivered to
the tissue. CT imaging displays both high-density tissue, such as bone, and
soft tissue. When interpreted by a trained physician, CT images yield useful
diagnostic information. It is intended for use in the head and whole body.
Use and operation of this equipment is subject to the law in the
jurisdiction(s) in which the equipment is being used. Both users and
operators must only use and operate the equipment in such ways as do not
conflict with applicable laws, or regulations which have the force of law.
Caution In the United States, Federal law restricts this device to sale, distribution,
and use by or on the order of a physician.
Note Equipment described in this manual is designed to be compatible with

PNMS products. It is designed to operate according to recognized and
accepted compatibility standards. The equipment produces images which
may be transferred by the user to other non-PMS workstations by a
network or other means. When doing so, the user or manufacturer of that
workstation has the responsibility to validate that images are correctly
transferred and displayed under all conditions of use. Use of incompatible
equipment may result in the incorrect transfer, display, or other processing
of the data.

1.3 Contraindications
1.3 Contraindications
The MX 4000 Dual and MX 6000 Dual CT systems should not be used if
any of the following contraindications exist or are thought to exist.
• The image performance quality assurance checks listed under the
heading, Maintenance, have not been satisfactorily completed.
• The preventative maintenance program is not up-to-date.
• If any part of the equipment or system is known
(or suspected to be) operating improperly.
1.4 Compatibility
Equipment described in this manual should not be used in combination
with other equipment or components unless such other equipment or
components are recognized as compatible.
Changes and/or additions to the equipment should only be carried out by
Philips and Neusoft Medical Systems or by third parties expressly
authorized by Philips and Neusoft Medical Systems to do so. Such changes
and/or additions must comply with all applicable laws and regulations that
have the force of law within the jurisdiction(s) concerned, and with best
engineering practice.
Changes and/or additions to the equipment that are carried out by persons
without the appropriate training and/or using unapproved spare parts may
lead to the PNMS warranty being voided. As with all complex technical
equipment, maintenance by persons not appropriately qualified and/or
using unapproved spare parts carries serious risks of damage to the
equipment and of personal injury.

Compliance 1.5
1.5 Compliance
The MX 4000 Dual and MX 6000 Dual CT systems comply with relevant
international and national standards and laws. Information on compliance
will be supplied on request by your local PNMS representative, or by:
Philips and Neusoft Medical Systems Co. Ltd.
Hun Nan New District
110719 Shenyang
China
The MX 4000 Dual and MX 6000 Dual CT systems comply with relevant
international and national laws and standards on EMC (electro-magnetic
compatibility) for this type of equipment when used as intended. Such laws
and standards define both the permissible electromagnetic emission levels
from equipment and its required immunity to electromagnetic interference
from external sources.
The Maintenance schedule identifies the procedures and frequency of their

performance, which is necessary to ensure (continued) compliance with the

Federal Performance Standards for Diagnostics X-Ray Equipment, 21
CFR Subchapter J, Radiological Health Section 1020.30 and 1020.33.
This symbol appears on components on your CT scanner system. It

indicates separate collection for electrical and electronic equipment in
compliance with the Waste Electrical and Electronic Equipment (WEEE)
Directive. Please dispose of the system in accordance with your local
regulations.

1.6 IEC-60601-1 classification
1.6 IEC-60601-1 classification
Type of protection against electric shock Class I equipment
Degree of protection against electric shock Type B equipment
Degree of protection against harmful Ordinary equipment

ingress of water
Possible interference with other equipment IEC 60601-1-2 Group 1 Class B

Device for Radiated Emission
Mode of operation Continuous mode with

intermittent loading
1.6.1 Electrical ratings

• 380 VAC normal voltage transformer
• 200/208/220/230/240/380/400/415/440/460/480 VAC
• 50/60 Hz
• <40kVA/56kVA
• three-phase distribution source

Training 1.7
1.7 Training
Operators of the MX 4000 Dual and MX 6000 Dual CT systems must
have received adequate training on its safe and effective use before
attempting to operate the equipment described in this Instructions for Use.
Users must also ensure that operators receive adequate training in
accordance with local laws or regulations which have the force of law.
If you require further information about training in the use of this

equipment, please contact your local Philips and Neusoft Medical Systems
representative. Alternatively, contact:
Philips and Neusoft Medical Systems Co. Ltd.
110179 Shenyang
China

2 Safety
2.1 Important safety directions

Philips and Neusoft Medical Systems products are all designed to meet
stringent safety standards. However, all medical electrical equipment
requires proper operation and maintenance, particularly with regard to
human safety.
It is vital that you read, note, and where applicable, strictly observe all
DANGER notices and safety markings on the CT system.
It is vital that you follow strictly all safety directions under the heading
Safety and all Warnings and Cautions throughout this, Instructions for
Use to help ensure the safety of both patients and operators.
In particular, you must read, understand and know the Emergency

Procedures described in this Safety section before attempting to use the
equipment for any patient examination.
You should also note the following information given in the Introduction
section of this Instructions for Use:
• intended use of the MX 4000 Dual and MX 6000 Dual CT systems
• contraindications
• training for operators of the MX 4000 Dual and MX 6000 Dual CT
systems
Wa r n i n g The X-ray unit may be dangerous to patient and operator unless safe
exposure factors and operating instructions are observed.
MX 4000 Dual/MX 6000 Dual Safety 2- 1

2.1 Important safety directions
Wa r n i n g Do not use the CT system for any application until you are sure that the
Image Performance Quality Assurance has been satisfactorily completed,
and that the Preventative Maintenance Program is up to date. If any part of
the equipment or system is known (or suspected) to be operating
improperly or wrongly-adjusted, DO NOT USE the system until a repair has
been made.
Wa r n i n g Operation of the equipment or system with improperly-operating or

wrongly-adjusted components could expose the operator or the patient
safety hazards. This could lead to fatal or other serious personal injury.
You can find information about the Image Performance Quality Assurance
and the Preventative Maintenance Program in the Maintenance section of
this Instructions for Use.
Wa r n i n g Do not use the CT system for any application until you have read,
understood and know all the safety information, safety procedures and
emergency procedures contained in this SAFETY section. Operation of the
CT system without a proper awareness of how to use it safely could lead to
fatal or other serious personal injury.
Wa r n i n g Do not use the CT system for any application until you have received
adequate and proper training in its safe and effective operation. If you are
unsure of your ability to operate this equipment safely and effectively DO
NOT USE IT. Operation of this equipment without proper and adequate
training could lead to fatal or other serious personal injury. It could also
lead to clinical misdiagnosis.
For information about training, please refer to Training in the Introduction

section of this Instructions for Use.
2 -2 Safety MX 4000 Dual/MX 6000 Dual

Important safety directions 2.1
Wa r n i n g Never attempt to remove, modify, over-ride or forcibly move any safety

device on the equipment. Interfering with safety devices could lead to fatal
or other serious personal injury.
Wa r n i n g Do not use the CT system for any purpose other than those for which it is
intended. Operation of the CT system for unintended purposes, or with
incompatible equipment, could lead to fatal or other serious injury. It could
also lead to clinical misdiagnosis.
Intended use of the CT system is described under the heading Intended

Use in the Introduction section of this Instructions for Use. Compatibility
is discussed under the heading Compatibility in the Introduction section of
this Instructions for Use.

2.2 Emergency procedures
2.2 Emergency procedures
2.2.1 Emergency stop

To bring scanner and Patient table movements and X-ray production to an
immediate halt, press one of the red Stop buttons. One button is located on
the Scan control box, and one on each gantry control panel.
Wa r n i n g After the Stop button is pressed, the table is locked in place for two
seconds. Then it will be free floating with no up/down capabilities. Make
sure that you maintain control of the table so that it does not move.
Wa r n i n g Make sure that the motion of the table is in the direction that will ensure
that the patient can be easily released and will not get pressed against the
gantry covers.
2.2.2 Emergency patient release

If the patient’s head is lying on one side of the gantry opening and the
trunk and legs are lying on the other side of the opening, the patient should
be released in the direction of the legs.
If the head is likely to touch the roof of the gantry opening, lower the head
by removing the head support or the pillow, and turn the head to the side
before moving the patient table.
To release the patient in the event of a power failure or in an emergency
stop situation, use this procedure:
1 Release the clutch to push it outward.
2 Holding the rear handle of the patient table, pull it out of the gantry.

Emergency procedures 2.2
3 Help the patient off of the patient table.

4 Reset the patient table.
Note In the event of a power failure or an emergency stop, it is impossible to
move the elevator of the patient table down. Therefore, it would be
advisable to keep a stool or stepladder on hand.

2.3 Electrical safety and grounding
2.3 Electrical safety and grounding
Wa r n i n g Do not remove covers or cables from this equipment. High electrical

voltages are present within this equipment. Removing covers or cables
could lead to serious or fatal personal injury.
Covers or cables should only be removed by qualified and authorized

service personnel.
Only use this equipment in rooms or areas that comply with all applicable
laws (or regulations have the force of law) concerning electrical safety for
this type of equipment.
The equipment must be grounded to an earth ground by a separate
conductor. The neutral side of the line is not to be considered the earth
ground. On equipment provided with a line cord, the equipment must be
connected to a properly grounded, three-pin receptacle. Do not use a three-
to-two pin adapter.
2.4 Mechanical safety
Wa r n i n g Do not remove covers from this equipment. Removing covers could lead to
serious or fatal personal injury.
Covers should only be removed by qualified and authorized service

personnel.

Explosion safety 2.5
2.5 Explosion safety

This equipment must not be used in the presence of explosive gases or
vapors, such as certain anaesthetic gases. Use of electrical equipment in an
environment for which it was not designed can lead to fire or explosion.
Wa r n i n g Flammable or potentially explosive disinfecting sprays must not be used,

since the resultant vapor could ignite, causing fatal or other serious
personal injury and/or damage to equipment.
2.6 Implosion hazard
Wa r n i n g Do not subject the system to serious mechanical shock, as the cathode ray
tube (CRT) can fracture if struck or jarred. This may result in flying pieces
of glass and phosphor coating that can cause serious injury.
2.7 Fire safety

Use of electrical equipment in an environment for which it was not
designed can lead to fire or explosion.
Conductive fluids that seep into the active circuit components of the
operator’s console may cause short circuits that can result in electrical fires.
Therefore, do not place any liquid or food on any part of the consoles or
other modules of the system.

2.8 Mobile telephones & similar products
Fire regulations for the type of medical area being used should be fully
applied, observed and enforced. Fire extinguishers should be provided for
both electrical and non-electrical fires.
All operators of this medical electrical equipment should be fully aware of
and trained in the use of fire extinguishers and other fire-fighting
equipment, and in local fire procedures.
Wa r n i n g Only use extinguishers on electrical or chemical fires which are specifically

labelled for those purposes. Using water or other liquids on an electrical fire
can lead to fatal or other serious personal injury.
If it is safe to do so, attempt to isolate the equipment from electrical and

other supplies before attempting to fight a fire. This will reduce the risk of
electric shocks.
2.8 Mobile telephones & similar products

The MX 4000 Dual and MX 6000 Dual CT systems comply with the
requirements of applicable EMC standards. Other electronic equipment
exceeding the limits defined in such EMC standards, such as certain mobile
telephones, could affect the operation of the CT system.
Wa r n i n g You should not allow portable radio transmitting devices (such as mobile
telephones) into the examination room - whether switched on or off. Such
devices could exceed EMC radiation standards could interfere with the
proper functioning of the CT system. This could, in extreme cases, lead to
fatal or other serious personal injury or to clinical misdiagnosis.

Radiation safety 2.9
2.9 Radiation safety

X-ray and gamma rays are dangerous to both operator and others in the
vicinity unless established safe exposure procedures are strictly observed.
The useful and scattered beams can produce serious or fatal bodily injuries
to patients and persons in the surrounding area if used by an unskilled
operator. Adequate precautions must always be taken to avoid exposure to
the useful beam, as well as to leakage radiation from within the source
housing or to scattered radiation resulting from passage of radiation
through matter.
Those authorized to operate, participate in or supervise the operation of the
equipment must be thoroughly familiar and comply completely with the
current established safe exposure factors and procedures described in
publications, such as the “Diagnostic X-ray systems and their major
components,” section of subchapter J of Title 21 of the Code of Federal
Regulations, and the National Council on Radiation Protection (NCRP)
No. 102, “Medical X-ray and gamma ray protection for energies up to 10
MEV equipment design and use,” as revised or replaced in the future.

Operators are strongly urged to comply with the current recommendations
of the International Commission on Radiological Protection, or in the
United States, with those of the US National Council for Radiological
Protection.
• ICRP, Pergamon Press, Oxford, New York, Beijing, Frankfurt, Sao Paul,
Sydney, Tokyo, Toronto
• NCRP, Suite 800, 7910 Woodmont Avenue, Bethesda, Maryland
20814, USA
Individuals responsible for the planning of X-ray and gamma ray
equipment installations must be thoroughly familiar and comply
completely with NCRP No. 49, “Structural shielding design and evaluation
for Medical of X-rays and gamma rays of energies up to 10 MEV,” as
revised and replaced in the future.

2.9 Radiation safety
Failure to observe these warnings may cause serious or fatal bodily injuries
to the operator or those in the area.
2.9.1 Radiation warning lamps

The radiation warning lamps on the gantry panels, on the scan control
panel, as well as site radiation warning lamps, must light up if scanning has
been triggered.
If a radiation warning lamp does not light up:
• Shut down the system immediately and contact Customer Service.
• Press the Emergency Stop button if there is danger to you or the
patient.
2.9.2 Installation and environment

Except for installations requiring certification by the manufacturer per
United States Federal Performance Standard, see that a radiation protection
survey is made by a qualified expert in accordance with NCRP 012,
Section 7, as revised or replaced in the future.
Perform a survey after every change in equipment, workload or operating
conditions which might significantly increase the probability of persons
receiving more than the maximum permissible dose equivalent.
2 -1 0 Safety MX 4000 Dual/MX 6000 Dual

Oil leaks 2.10
2.10 Oil leaks

The x-ray tube and high-voltage generator are cooled by oil. This is a
closed-circuit system that is sealed.
Caution If oil leaks are detected, shut down the scanner and immediately contact
the nearest Philips and Neusoft field service office.

2.11 Laser safety
2.11 Laser safety
Wa r n i n g
• Do not stare into the laser beam and instruct the patient not to stare into
the beam.
• The use of optical instruments, such as eyeglasses with large diopter or
mirrors, with this product will increase eye hazard.
• Ensure that, for head examinations, the patient wears protective glasses
when the laser beams are on.
• Refer to the equipment labels for specific compliance and laser safety
information.
2 -1 2 Safety MX 4000 Dual/MX 6000 Dual

Protection measures 2.12
2.12 Protection measures

Take the following protection measures to protect both yourself and the
patient.
Anyone who has to be near the patient during scanning must wear
protective clothing (lead apron), wear a PEN dosimeter and/or film badge,
and stay in the zone shielded by the system (to the side of the gantry or
behind a mobile protective wall).
The physician is responsible for protecting the patient from unnecessary
radiation.
• Always use a gonadal shield, if possible.
• Use the pediatric mode for children.

3 Security of system and data
Philips and Neusoft Medical Systems is dedicated to helping you maintain

the confidentiality, integrity, and availability of electronic protected health
information and the hardware and software products that create and
manage these data.
Maintaining security of Philips and Neusoft Medical Systems’ products
should be an important part of your facility's security-in-depth strategy.
You should implement a comprehensive, multi-layered strategy (including
policies, processes, and technologies) to protect information and systems
from external and internal threats. Your security strategy should follow
industry-standard practices, addressing physical security, personnel security,
procedural security, risk management, security policies, and contingency
planning.
The practical implementation of technical security elements varies by site

and may employ a number of technologies, including firewalls, virus
scanning software, authentication technologies, etc. As with any computer-
based system, protection must be provided such that firewalls and/or other
security devices are in place between the medical system and any externally
accessible systems. These perimeter and network defences are essential to
good security practice.
This chapter provides guidelines to help the operator and owner
understand the possible ways security can be compromised, and then insure
that safeguards are in place to prevent this from happening. For specific
information about security within their institutions, operators and owners
can consult with the following offices at their location:
• Information Systems Security Officer
• Chief Information Officer
• HIPAA Officer (in the U.S.A.)
• Safety Officer
MX 4000 Dual/MX 6000 Dual Security of system and data 3- 1

3.1 Regulatory controls
3.1 Regulatory controls

Protect patient’s health information
One of the most important assets to protect with security measures is the
patient’s health related information.
Many governments require maintaining the confidentiality of this
information. Therefore, strict security measures must be taken to guard this
protected information.
(Users in the U.S.A. may find guidelines at
http://www.hhs.gov/ocr/hipaa/.)
Prevent unauthorized device modification

Philips and Neusoft Medical Systems sells highly complex medical devices
and systems. We are required to follow government-regulated quality
assurance procedures to verify and validate modifications to the operation
of our medical devices.
Operators and owners of this medical equipment must permit only Philips
and Neusoft-authorized changes to be made to these systems, either by
Philips and Neusoft personnel or under Philips and Neusoft explicit
published direction.
Caution Although the MX 4000 Dual and MX 6000 Dual CT systems operate on a
personal computer (PC) platform, the installation of PC software not
specified in the system documentation may adversely affect the operation
and security of the system, as well as the networks to which the system is
connected. These adverse effects may not be immediately apparent to the
user. Users should therefore not install unauthorized software onto their
system.
3 -2 Security of system and data MX 4000 Dual/MX 6000 Dual

Security issues and guidelines 3.2
3.2 Security issues and guidelines

In addition to the patient information and device integrity needs discussed
in the preceding section on regulatory requirements, the following topics,
issues, and guidelines should be understood and addressed by operators and
owners.
Network security
The MX 4000 Dual and MX 6000 Dual CT systems must be placed on a
secure local computer network that has protections against viruses and
other harmful computer system intruders. Make sure the equipment is
connected to a local network that uses appropriate protection, such as a
firewall and virus scanners.
Antivirus Updates
Virus definition files and updated virus scanning engines are included with
the equipment. Updates of virus definition files and/or corrective software

versions are regularly made available by Philips to address known
vulnerabilities (virus and otherwise).
The system’s antivirus scanner is scheduled to activate during off hours,
while system is typically not in use. (Refer to the section “Antivirus
Software” in the System Description chapter of this volume for details.)
Caution Under no circumstances should updated virus definition files (or any type of
software) be installed on the CT system by anyone other than a Philips and
Neusoft Field Service Engineer or an authorized Philips and Neusoft agent.

3.2 Security issues and guidelines
Room access control

Procedures must be put in place to limit physical access to the medical
equipment, to prevent accidental, casual, or deliberate contact by
unauthorized individuals.
Access to the room containing the MX 4000 Dual or MX 6000 Dual CT
should be controlled by policy and procedures that identify who is
authorized to occupy specific areas. Check with your Safety and Security
Office for more information on what measures are in place or how to
implement room access controls.
Positioning of monitors
Unauthorized visual access to protected information can be minimized by
positioning the system’s monitor so it faces a wall, to prevent viewing from
doorways, hallways and other traffic areas.
To help in limiting unauthorized visual access, an unattended CT monitor
automatically goes blank after a set period of time.
User login and logout protections

A consistent user login process (user names and passwords) provides good
security of protected information.
Minimum login standards include:
• Implementing strong passwords. This is the easiest and most effective
method to increase security. Strong passwords consist of at least eight
alphanumeric, mixed case characters, digits and special characters like
‘@’ or ‘*’. Never use words that can be found in the dictionary
• Never post or share user names and passwords
• Change passwords periodically
3 -4 Security of system and data MX 4000 Dual/MX 6000 Dual

Security issues and guidelines 3.2
Removable / portable media

When using removable media (floppy disks, CD-ROMs, and EODs) be
aware of these security issues:
• Inserting removable media can introduce a virus to the medical
device.
• Removing media containing patient data can allow access to the data
by unauthorized individuals.
• If the media is to be discarded it must be destroyed or disabled so that
the data can no longer be accessed.
Caution Whenever media is inserted into the MX 4000 Dual or MX 6000 Dual CT,
be sure that the media has not been exposed to potential viruses, worms
and trojans that infect desktop PCs.
Caution Removable media that contains images and/or other medical information
must be stored in a secure area that is not accessible by unauthorized

individuals.

4 System description
The MX 4000 Dual and MX 6000 Dual CT systems are advanced

continuous-rotation tomographic systems that consist of these
components:
• Operating station
• Scan control box
• Gantry
• Patient table
MX 4000 Dual/MX 6000 Dual System description 4- 1

4.1 Operating station

The operating station is used to operate and monitor the scans being
performed. It consists of the following components:
• Computing system
• Scan control box
• Monitor
• Keyboard and mouse
• Patient intercom
• Data storage devices
• Automatic filming control device
4.1.1 Monitor
A flat screen monitor displays images and operating the system.
An optional flat panel monitor is also available.
The power switch for the monitor is located on the front. The power
indicator LED lights when you turn on the monitor.
Caution To maintain optimal adjustment and correlation with the filmed images, do
not change the settings of the monitor.
4 -2 System description MX 4000 Dual/MX 6000 Dual

Operating station 4.1
4.1.2 Scan control box

Once the scanning process has been initialized via the on-screen scan
toolbox, you can control the remainder of the process using the Scan
control box, which consists of a variety of buttons and LEDs for controlling
and displaying gantry tilt angle and patient table movements:
1
STOP 2 3
6 7
4 5
X 8
9
1 Emergency Stop button stops gantry motions and x-ray generation in

the event of an emergency.
2 Control screen indicates position of gantry and table. The first line is
tilt, the second is vertical and third is horizontal.

3 Tilt button tilts the Gantry in the direction indicated by the arrows
(in relation to the diagram on the button).
4 Table in/out and up/down buttons move the Patient table in the
respective directions.
5 Accelerate button for increasing the speed at which the table moves.
6 Manual scan button for starting a scan.
7 Stop button stops scans. Scan cannot be resumed if this button is
used.
8 Microphone/Microphone on button allow you to speak to the patient.
9 Volume controls set volume for the console and gantry speakers.
Wa r n i n g Observe the condition of the patient when operating the Scan control box.

4.1.3 Patient intercom

The patient intercom is a system which allows you to communicate with
the patient during a scan procedure. The patient portion of this system
consists of a speaker and microphone located in the opening of the gantry.
The user portion of the system consists of a speaker and a microphone on
scan control box.
Recorder microphone
A recorder microphone is located in the scan control box. This microphone
is used to record messages that can be used during the scan process.
4.1.4 Data storage

These options are available for storing data:
• internal hard disk
• internal CD writer
Internal hard disk

The internal hard disk is used to store images, the operating system, raw
files and calibration data. To allow for flexibility, this disk space can be
expanded to suit your needs. Contact your Philips and Neusoft Service
Representative for information on expansion of internal drive space.

Operating station 4.1
Internal CD writer
The internal CD writer is a CDR drive that stores DICOM images along
with the necessary viewing software on a CD. It provides an alternative for
archiving images or transferring patient images to referring physicians.
Note • Always use a blank CD for recording.
• Upon completion of the writing process, verify that all required
information has been written to the CD.
4.1.5 AMC – automatic filming control device (optional)

This is an interface to Laser Imagers and non-DICOM printers. In
conjunction with the Filming function, it enables film rearranging and
automatic printing.

4.2 Gantry and patient table
4.2 Gantry and patient table

The gantry provides the support and means for rotating the X-ray tube,
beam elements, detectors, and front end electronics (FEE). The gantry
panels are used to activate the laser marker, tilt the gantry, and control
patient table movements.
See Volume 1, Chapter 2: Safety for description of emergency procedures.

Gantry panels 4.3
4.3 Gantry panels

The gantry panels (see 1 and 2 below) control and display the gantry tilt
angle, patient table movements, alignment markers and safety system
release. The LEDs for the buttons light when their function is enabled.

4.3 Gantry panels
4.3.1 Gantry control panel

1 Emergency Stop button to bring the scanner and patient table
movements and X-ray generation to an immediate halt. The red Stop
Buttons are located on the gantry control panels.
2 Control screen indicates position of gantry and table. The first line is
tilt, the second is vertical and third is horizontal. The screen includes
the X-ray on indication light.
3 Laser on/off button serves a dual purpose. It turns on and off the laser
markers which are used for positioning the patient in the slice plane. It
also displays the maximum and minimum tilt and patient table
positions.
• Press the button once to turn on the laser. The system displays the
maximum positive tilt position, the maximum table height and the
maximum table in position.
• Press it a second time to turn off the lasers (the lasers turn off after five
seconds). The system displays the current table position.
• Press the button a third time to display the maximum negative tilt
position, the minimum table height, and the maximum table out
position (lasers turn on again).
• Press the button a fourth time to turn off the lasers (the lasers turn off
after five seconds). The system displays the current table position.
Note Lasers automatically turn off after 60 seconds.
4 Zero table button sets the current Z position at zero.

5 Patient release button moves the patient table (out and down) and
gantry (to zero tilt) to positions for easiest patient release at the end of
the scanning procedure. The patient table moves to its maximum
distance from the gantry and lowers to its minimal height. When the

Gantry panels 4.3
button is released before completing the process, all motion stops.

6 Head position elevates the patient table to the head position and moves
it in. If the table is at the head position or higher, the table moves in but
does not elevate.
7 Body position elevates the patient table to the body position and moves
it in. If the table is at the body position or higher, the table moves in but
does not elevate.
8 Zero gantry button moves the gantry to zero tilt.
9 Tilt button tilts the gantry in the direction indicated by the arrows (in
relation to the diagram on the button).
10 Table in, out, up and down buttons move the patient table in the
respective directions. If pressed and held, the out button also lowers the
table.
Wa r n i n g Be sure to observe the condition of the patient when operating the control
panel.

4.4 Patient table
4.4 Patient table

The patient table moves the patient to the scan position through the use of
the gantry control panel. The operator then makes fine adjustments in
preparation for the actual scan, still with the gantry control panel.
Movement of the patient table during the scan procedure is then controlled
either from the gantry control panel or from the Scan control box.
Normal unloading of a patient, after completing the scanning procedure, is
controlled from the gantry control panel.
Wa r n i n g The patient table moves when you initiate a scan.
4 -1 0 System description MX 4000 Dual/MX 6000 Dual

Patient supports (positioning aids) 4.5
4.5 Patient supports (positioning aids)

This section gives an overview of the standard and optional patient
supports (positioning aids). Use the patient supports to position the patient
safely and comfortably to prevent motion artifacts.
NoteNote Patient supports are prone to wear and tear. They must be replaced with
original parts if they are dirty or damaged.
Wa r n i n g s • Do not use any positioning aids not mentioned in this chapter.

• Non-original patient supports may cause danger for the patient through
collisions with the gantry. Image quality may also decrease.
• If a head holder or support is not engaged securely, it can come loose
causing injury to the patient.
• Positioning aids must be used exclusively for their intended purpose. Use
the head holder only for positioning the head.
Head holder
The head holder can be used for most routine child or adult CT head
exams. The angle of the holder positions the head naturally for a routine
brain scan and minimizes the required gantry angle to achieve optimal
results.
Patient pads
This complement of accessories includes head cushions, patient straps for
immobilization, and pads for patient comfort.

4.6 X-Ray and detection systems
4.6 X-Ray and detection systems
4.6.1 X-Ray tubes

The MX 4000 Dual X-ray tube (mounted on the gantry) has a 2.5 MHU
rotating anode with a variable focal spot size of
0.4 x 0.7 mm, and 0.6 x 1.3 mm.
The MX 6000 Dual X-ray tube (mounted on the gantry) has a 4.0 MHU
rotating anode with a variable focal spot size of
0.4 x 0.7 mm, and 0.6 x 1.3 mm.
4.6.2 X-Ray power supply

The X-ray Power Supply consists of the rotor-mounted DC-to-high-
frequency inverters and the high voltage transformers. It is powered from
the power cabinet through low-voltage slip-rings and controlled by the
computerized high voltage control unit.

Key technical data 4.7
4.7 Key technical data

MX 4000 Dual MX 6000 Dual
Maximum tube current Maximum tube current

200 mA for nominal 300 mA for nominal
Large focal spot
voltage 80 kV, 100 kV, voltage 80 kV, 100 kV,
120 kV, 140 kV 120 kV, 140 kV
Maximum tube current Maximum tube current

200 mA for nominal 300 mA for nominal
voltage 80 kV, 100 kV, voltage 80 kV
120 kV, 140 kV
Maximum tube current
260 mA for nominal
voltage 100 kV
Small focal spot
230 mA for nominal
voltage 120 kV

200 mA for nominal
voltage 140 kV
Maximum tube voltage and current

140 kV x 200 mA 140 kV x 300 mA
generated by high voltage generator
24 kW, (at 120 kV, 200 mA 36 kW, (at 120 kV, 300 mA
Nominal output power
and load time of 4s) and load time of 4s)
28 kW, (at 140 kV, 200 mA 42 kW, (at 140 kV, 300 mA
maximum output power
and load time of 54s) and load time of 38s)

4.8 System symbols
4.8 System symbols

These symbols may be included on system labeling:
Attention symbol Radiation warning symbol
Laser Warning symbol Biohazard warning symbol
Magnetism warning symbol Projectile warning symbol
Electrical warning symbol Do not touch
Take care to adhere to all warnings included on product labeling as well as

those included in this manual.
Wa r n i n g Make sure the system and the scan room comply with operational
requirements before initiating the system.

Extended Brilliance Workspace (optional) 4.9
4.9 Extended Brilliance Workspace (optional)

The Extended Brilliance Workspace is an independent diagnostic
workstation that enables the physician to review and process clinical images
without interfering with scanner operation.
The Extended Brilliance Workspace is connected to the CT system through
an Extended Brilliance Workspace high-speed data communication link.

5 Navigating the software
5.1 Overview
This chapter provides a brief description of the features available in the
software as well as instructions on how to access them. Be sure to familiarize
yourself with this information before conducting any scan procedures.
MX 4000 Dual/MX 6000 Dual Navigating the software 5- 1

5.2 Home window
5.2 Home window

The image below shows the Home window which displays when the system
starts up or after the Home workflow button is clicked.
5 -2 Navigating the software MX 4000 Dual/MX 6000 Dual

Home window 5.2
It consists of these areas:

1 Workflow bar
2 Data source tools
3 Data operations tools
4 Reconstruction tools
5 Archive status box
6 Patient list
7 Series lists
8 Data list
9 Sample image
This section details the home window specifications and explains the screen
layout and features as well as the mouse and keyboard operations. These
options are available while in the Home window:
• Select and retrieve images from local and remote storage devices.
• Copy images and files from one device to another.
• Erase data from local devices.
• Format and rescue removable storage media.

• Display the remaining free space on storage devices.

5.2 Home window
5.2.1 Workflow bar

Your scanning process is guided by a simple graphical user interface, called
the Workflow bar, that appears across the top of the window.
The Workflow bar consists of several buttons that become highlighted to

guide you as you work your way through an exam.
As shown in image above, the buttons are color-coded to indicate their
status:
Yellow buttons are selected stages (as in the Scan button above). This
indicates your current stage in the workflow.
Note At any time, only one of the workflow buttons is in the “Selected” state.
Orange buttons are active (as in the all other buttons above). This stage of
the workflow is accessible, if you want to move to it.
Gray buttons are inactive. These functions cannot be accessed at this stage
in the workflow.
The Workflow bar consists of these buttons:
• Home to toggle to the Home window. This window features a directory
of completed studies including a series list, data list and a review
window.
• Schedule to access the patient catalog. This window features options for
scheduling new patients, removing patients from the catalog and a
comprehensive list of all patients previously scanned.

Home window 5.2
• Scan to start a new study or to continue the previous one. The window
varies depending on the current process:
• If you click this button during scan preparation, the current scan
parameters display.
• If you click this button when scan preparation is not in progress, it
displays the patient data window.
This step is active automatically after you log in. This button is always
enabled, except during image acquisition or between acquisitions in
timed scans. It is also enabled automatically after clicking End Study.
Note Once a procedure is selected, the patient details cannot be changed.

• Review to access the image viewer. This window allows you to review
images in 2D, Planar and Volume modes.
• Film to display and arrange the images for filming. It is always enabled.
• Report (purchasable option) to access the report generated from the
exported scan information. This feature is not active when information
has not been sent.

• Service to access daily Service options for the scanner. These options
include Air Calibration, Tube warm-up, and Protocol generation (see
corresponding sections for more information on Service applications).
• Help displays current software version for your system.

5.2 Home window
5.2.2 Data source tools

Device list allows you to select a device from which to access patient data.
To prevent patient list confusion, only one device may be selected at a time
(in this case, the Local drive).
• Click the down-arrow next to the selected device icon to view the
device list. The list offers local and remote locations.
• Click on the device you want to access. If the device is not available, the
system displays a message.
Refresh updates the patient list with newly arrived studies.
Search provides a dialog box where you can enter information to search for
a specific patient.
• Click Search.
• Enter the desired search parameters.
• Click Confirm.
5.2.3 Data operations tools

Combine images allows you to reduce the number of images sent to file
according to your settings.
• Define the number of images to combine. The system displays the
thickness of the resulting image.
• Click Confirm to create the new combined image.
Film images sends selected images to the filming application.
• Click Every to display a list of options from which you can select the
desired number of images to film (for example, every 2nd image or 3rd
image).

Home window 5.2
Lock allows you to toggle the lock on and off. Locked patient data cannot
be removed from the system.
Fix patient data allows you to edit the details of a patient who was
previously entered in the system.
Wa r n i n g • Do not use the Fix patient data to change patient data entered from the
HIS/RIS system. This tool is solely for use with data entered manually
through the patient data form.
• The patient ID cannot be changed using the Fix patient data feature.
Delete allows you to delete the selected patient and their corresponding
data.
Copy To allows you to copy the currently selected items to another device.
A dialog box opens with lists of available Local and Remote archive devices.
Load to Viewer allows you to load the selected images for Review.
5.2.4 Reconstruct tools

Offline recon allows you to access the reconstruction parameters to
reconstruct raw data.
Recon manager allows you to stop, continue or delete the reconstructions
in the queue.

5.2 Home window
5.2.5 Archive status

Local shows the relative free space on the Local disk
CDROM shows the free space on the CD.
USB:N/A means that no USD storage devices are connected to the system.
X-ray tube heat displays the current tube heat of the system. The system
must be above 10% to operate properly.
To exit the CT system or change users, click Logout.

6 Scanner operation
6.1 Overview
This chapter covers these scan operation procedures:
• login and daily checks
• operation of patient table
• use of the scan window
• scanning process
• ancillary functions
Review this information carefully before using the scanner.
MX 4000 Dual/MX 6000 Dual Scanner operation 6- 1

6.2 Startup
6.2 Startup
Before using your system, confirm that the scan room meets the
appropriate conditions:
Temp. of scan room Temp. variation Relative humidity
18° ~ 24° less than 5° per hour 30% ~ 60% (no condensing)
18° ~ 28° less than 5° per hour 20% ~ 80% (no condensing)
Use this procedure to start up your scanner when it has been completely
shut down.
1 Turn ON the wall power (if gantry power is off ).
2 Locate the power switch on the side of the gantry.
3 Turn on the gantry power.
4 Turn on the power to the computer (inside the cabinet), and monitor.
• Computer power-up takes about 1.5 minutes.
5 Double click the Spiral CT icon to activate the software.
6 Type the desired User name and password.
7 Click Login.
Continue to Tube warm-up.
6 -2 Scanner operation MX 4000 Dual/MX 6000 Dual

Tube warm-up 6.3
6.3 Tube warm-up

Tube warm-up is a process which allows you to bring the tube to normal
operating temperature after a pause in system operation of more than two
hours. This process is required at least once daily before any scans can be
performed on patients.
1 Check the scan room to be sure no people are present.
2 Check that the table is up and within 10–20 mm from the out position.
3 Click Service to access the service options.
4 Click Tube WarmUp. The Tube warm-up dialog box opens.
5 Click Start.
The system displays information regarding the progress in the message
box.
Wa r n i n g • Do not perform Tube warm-up when there is a person in the scanning

room.
• During tube warm-up, watch the Message box for error messages. If there
is an emergency condition, press the Stop Scan button immediately.
6 When the warm-up is complete, click Exit to return to the Home

window. Your system is now ready to scan.
Note When the heat capacity is above 20%, the system automatically stops the
tube warm-up.

6.4 Air calibration
6.4 Air calibration

Air calibration is a part of normal system maintenance. In order to ensure
proper operation of the scanner, conduct this procedure at least every other
day. Because this procedure must be done at stable, operating temperature,
perform it midday after a number of patients have been scanned. The air
calibration feature is accessed from the Service menu.
1 Make sure the table is not in the gantry.
2 Click Service to access the service options.
3 Click Air calibration. The Air calibration window displays.
4 If necessary, click ParaSetting to adjust the parameters accordingly.
5 Click Confirm to begin the calibration.
Wa r n i n g Do not perform Air Calibration when there is a person in the scanning

room.

Shut down 6.5
6.5 Shut down

Use this procedure to shutdown the scanner.
1 Click Logout on the Home window.
2 Click Start.
3 Click Shutdown. The system displays the Shutdown Windows dialog
box.
4 Select Shutdown from the dropdown menu.
5 Click OK. The system will turn off.
6 Locate the power switch on the side of the gantry.
7 Turn off the gantry power.
8 Turn off the wall power.

6.6 Operating the gantry tilt and table

Press the appropriate buttons on the gantry panel to move the
patient table, switch the laser marker on or off and tilt the gantry.
Patients weighing up to 200 kg (450 lb) can be positioned on the
table and examined.
• Be especially careful when positioning heavy patients on the table.
• Before you start the examination ensure that the patient is not
endangered either by the movement of the table or by the inclination of
the gantry.
The stability of the patient table is not at risk when scanning very
heavy patients, but the correct functioning of the table (lift,
positioning precision) cannot be guaranteed 100%.
When the patient is lying on the stretcher, with legs towards the
gantry, use the stretcher extension to support the patient’s legs.
Use the axial head-holder for axial head scans and the coronal head
holder for supine coronal head scans.
Caution • Blood and contrast medium are health risks. Take safety precautions
when removing blood or residual contrast medium.
• Use a commercial biocide, approved by your governing authority to clean
the surface of the system including the table, headholders and
accessories.

Operating the gantry tilt and table 6.6
6.6.1 Patient positioning in gantry
Table Up/Down
To vertically position the region to be scanned from the lowered
position (where the patient can sit and then lay down on the patient
table in the gantry opening), use the Up button on the gantry
panel. Use the Up and Down buttons to properly adjust the table
position.
Table In/Out
To bring the patient’s region of interest into the gantry opening, use
the In or Out buttons.
• “Tapping” an In or Out button will move the table 0.5 mm each time it
is tapped.
• When an In or Out button is continuously held down, movement
accelerates after about five seconds. For fine adjustments, press and
release the button accordingly.
Wa r n i n g When bringing an unrestrained child into the gantry opening, be

prepared to prevent the child from reaching out to grab the gantry
panel (especially the gantry panel buttons).

Note • The patient table cannot be moved in when it is below a certain height.
Raise the patient table up to enable moving it in.
• The patient table motion stops within 10 mm upon actuation of an
emergency stop control.
• If the couch is pushed in manually, be sure couch is high enough (above
210) to avoid colliding with the gantry.
6.6.2 Table and gantry movements

1 To move the patient table and tilt the gantry, use the motion controls:
• on one of the gantry control panels
• on the scan control box
Note Movement of the patient table is executed at two speeds. After pressing the
appropriate button, the table moves at a slow speed and after several
seconds, if the button remains pressed, it proceeds to a higher speed.
2 To stop movement, release the pressed button.

You can also move the table by pressing one of the buttons on the side of
the table.
1 Press the button once to release the table.
2 Move the table to the desired position.
3 Press the button again to lock the table in place.
Caution • While moving the table and gantry, take care not to insert your feet
under the table side covers or between the gantry and patient table.
• Avoid inserting your fingers between the stretcher and the table carriage.
• Avoid placement of ancillary equipment (such as wheelchairs, IV pumps
or beds) under the table. The table could collide with these items during
movement.

Using the scan window 6.7
6.7 Using the scan window

The scan procedure is conducted from the scan window. The contents of
the window vary depending on the part of the scan process you are in:
• Patient Data form
• Plan Scan Window
• Plan Surview Window
• Scan Viewer Window

6.7.1 Patient data form
The sample above shows the patient data form which is used to enter
patient data for a new study. These options are available:
• New opens a blank patient form.
• Anonymous fills a preset subset of generalized patient details for
unidentified patients.
• Current brings the details of the current patient (that was last entered)
to the parameter fields.
Note After the scan has finished, you may operate a utility for correcting
Anonymous patient data retroactively in the patient catalog and in archives.
6 -1 0 Scanner operation MX 4000 Dual/MX 6000 Dual

Patient data fields

While the sample does not show all fields, you can customize the window
to display those fields relevant for your site. You must use the mandatory
fields for all studies. These are the options from which you can select:
• Patient I.D. (mandatory field)
• First Name (mandatory field)
• Last Name (mandatory field)
• Gender (mandatory field)
• Date of Birth (mandatory field)
• Age
• Age Group (mandatory field)
• Patient’s weight (select from a range)
• Patient’s height
• Voice Language
• Referring Physician (doctor sending the patient to be scanned)
• Requesting Physician (radiologist reviewing final images)
• Operator Name
• Orientation
• Description
Note • Age Group - You must select the appropriate setting for the age of the
patient. If the patient is a child up to 18 months, the appropriate setting is
Infant.
• Gender - The Other option refers to Anonymous patients whose gender
is anatomically unidentifiable. It may also refer to anything other than a
living creature (for example, minerals and phantoms).
Note Mandatory fields must be completed in order to conduct a scan procedure.

All mandatory fields have a red asterisk.
Note You have the option to configure your system so that, during a manual
patient entry, the first field to be completed when you start a study is either
the Patient ID or Accession number.

6.7.2 Plan Scan window

After selecting a protocol, the Plan scan mode is activated. The Protocols
window closes and the Plan Scan viewer appears.
1 The Workflow bar contains the workflow buttons.

2 The Main area displays the reference images and resulting cuts after a
scan is complete.
3 The Tools area contains options for layout, archiving, filming and
reporting as well as the graphical aids for annotating and measuring
features on the images.
4 The Scan protocol area allows you to select and review the scan and
reconstruction parameters. Only after approving the parameters in the
scan protocol can the scan or the reconstruction be executed.
Note You are required to understand technical and physics parameters and their
effect on each other in order to modify and approve scan procedures.

6.7.3 Plan Surview window

The surview scan is a non-rotational scan that is used for planning the
clinical scans. This scan can be performed either AP (from above—180°) or
Lateral (from the side—90°).
After completing the scan, the system displays a green overlay. The overlay
is the planned scan coverage area.
Should you manipulate the planned area, the system will automatically
update the corresponding protocol.

6.7.4 Scan viewer window

The scan viewer window allows you to see the final results of your scan
before any post-processing is done. Depending on your scan parameters,
the system displays the last image or the last two images of the scan.
You can use this window to ensure the quality of the images, as well as send
specific images to print. Only window and level options operate in this
window. To see all images, you must load the study into the Viewer (see
Review mode for more information).

Using the patient catalog 6.8
6.8 Using the patient catalog

The patient catalog window is used for handling and managing the patient
catalog database and for easy selection of a scanned patient. The default
screen uses the patient Name column to set priority of the list (according to
the alphabetical order of the patients’ family names), although the order in
which the lines display can be arranged according to preference.
1 Click Schedule to access the patient catalog. At the head of each
column is a button that, when clicked, rearranges the order of all the
lines, according to that parameter.
• The All Scanned tab displays those patients who have already been
scanned.
• Scheduled tab displays only those patients who are scheduled to be
scanned.

6.8 Using the patient catalog
Add a patient
1 Click Schedule Patient to add a new patient to the list. The system
displays the patient data form.
2 Enter the patient information.
3 Click Ok to add the patient to the list.
Note Click Schedule Again to create multiple instances of the same patient.
Delete a patient
1 To delete a patient, select the desired name from the patient list.
2 Click Remove patient.
3 Confirm your selection to remove the patient.
Scan from patient log

1 To begin a scan from the patient catalog, select the desired name from
the patient list. You can also use the Search function to help locate the
desired patient.
2 Click Begin. The system displays the protocol window to allow you to
continue the scan procedure with the selected information (see Scan
procedure, on page 6-17).
Note When HIS/RIS is enabled you also have the option of displaying the medical
alerts stored in the database. Usually the Scheduled list is updated by the
HIS/RIS pushing patients into it.
Wa r n i n g The Fix patient name option should not be used with patients entered from
the HIS/RIS system.

Scan procedure 6.9
6.9 Scan procedure

A typical scan procedure consists of these steps:
• enter patient information
• select patient position
• select an exam protocol
• perform scan
You may also choose to add any of these options to your exam procedure:
• Plan on Surview—exam protocols usually include a Surview scan and
automatically launch Plan on Surview upon reconstruction of the
Surview image. See Plan on surview, on page 6-23, for more
information.
• Multi-reconstruction
The scanning process is set-up and initialized from the Scan control panel
and tabs on the screen. Table movement is controlled from the Scan control
box outside of the scan room or the gantry control panels inside of the scan
room. This section provides detailed steps to complete a typical exam
procedure, as well as descriptions of the available options.
Note In addition to the scanning options you also have the option to film and
conduct post-processing analysis.

6.9 Scan procedure
6.9.1 Enter patient information

1 Click Scan. The Patient data form displays:
2 Enter the patient data (mandatory fields are highlighted). You have
several options for entering patient data:
• For a new patient, click New. See Entering a new patient, on
page 6-19 for instructions on filling in patient data.
• For an anonymous patient, click Anonymous, the system fills in the
patient ID and the first name.
• For a current patient, click Current. The system fills the fields with
the information from the last patient entered.
Note You can also begin a scan by selecting a scheduled patient in the schedule
mode.

Scan procedure 6.9
3 Click the arrow in the Position field to display a list of options.

4 Select a patient position by clicking it.
5 When all required information is entered, the arrow in the lower right
corner becomes active. Click the arrow to continue.
Now that you have completed the mandatory fields, continue to

Select a protocol, on page 6-20.
Caution Before proceeding to protocol selection, verify that the patient information
loaded into the patient data fields (from any source) is correct. Failure to do
so could result in scanning a patient with the wrong information thus
requiring another scan on the patient.
Entering a new patient

When entering a new patient, you must enter the mandatory fields which
are highlighted. Use Tab, or the mouse to navigate through fields while
entering a new patient:
1 Click Scan.
2 Based on your system set-up, the Patient ID field automatically
contains a value. If you want to change it, type a new patient ID for the
patient.
3 In the Last Name field, type the last name of the patient.
4 In the First Name field, type the first name of the patient.
5 Click the appropriate Gender for the patient:
• Male
• Female
• Other

6.9 Scan procedure
6 Click appropriate Age group option for the patient:

• Infant
• Child/Youth
• Adult
Note Your system may be configured to make the birthdate mandatory instead of
the age group.
7 Select a scan position.

8 Enter the rest of the patient’s details, if desired (they are optional).
Note • To reach a field from anywhere on the screen, click inside the text box.
After typing the data, press Enter. The cursor jumps to the next field.
<Tab> also jumps between consecutive fields.
• Enter the date in the international format: yyyy mm dd (1969 10 02).
• The value of the Age field can be typed directly. Once the Date Of Birth is
entered, the patient’s age and Age range are automatically entered.
Upon completing the patient data entry, continue to Select a

protocol, on page 6-20.
6.9.2 Select a protocol

The scan procedure requires you to select an exam protocol. In order to
acquire optimal images, it is recommended that you use factory-set exam
protocols.

Scan procedure 6.9
The Protocol window displays exam protocol groups on the left, and the
corresponding protocols on the right:
Note The image above shows the Adult Exam Protocol Groups. When the
Classify protocols feature is active, an infant displays if the infant or Child
Age Group is selected.
1 Click an exam protocol group to select it.

The system displays the exam protocols for that group.
• Tabs along the left side of the window allow you to select additional
single exam protocols (Surview, Axial or Helix).
• Hold the mouse over an exam protocol to display the specific options
included.
2 Click the desired protocols to select them. All selections display in the

6.9 Scan procedure
Selected protocols box at the bottom of the window.

3 Click the right arrow at the bottom of the window. The system displays
the Scan window with the Surview protocol parameters for the first
scan.
4 If necessary, alter the scan series as needed. These options are available:
• Add scan to return to the Protocol window to add scans to the series.
• Add recon to add a second reconstruction of the scan data.
• Duplicate (Dup) to create a second instance of the selected protocol.
• Delete to remove the selected protocol from the series.
• Save to generate a new protocol using the current parameters.
Type desired information or make a selection from the drop-down
menu to alter the parameters.
5 You can also alter other parameters as desired. Click the appropriate tab
to access its options:
• Surview
• Scan
• Contrast
• Voice
• Reconstruct
6 Click Go. The system displays a message when it is ready to scan.
7 Press Manual to begin scanning the patient. Upon completion, the
system displays the images in the viewer window.
8 If your exam protocol includes a Surview, you may now plan on your
Surview scan.
9 If you are finished with the study, you can end it and begin another.
• Click End study.
• If prompted, click yes to close the viewer.

Plan on surview 6.10
6.10 Plan on surview

When the surview scan is complete, the surview image displays with a plan
scan series box which you can move to select the desired scan location.
Three surview images are saved for a study:
• the surview
• the surview with the planned scan box
• the surview with the ES (executed scan) lines
Note After scanning a clinical series, the surview image is saved with the ES
(executed scan) lines.
1 If desired, adjust the planned scan box over the desired area.
• Click and drag the box to move it.
• Click on a point on the box to expand or contract it.
The system adjusts the parameters accordingly.
2 Click Go to execute the planned scan. The system displays the final
image in the Scan viewer window when the scan is complete.
3 Select an option:
• Edit and Rescan deletes the current surview and allows to re-create
the entire plan.
• Rescan deletes the current surview and rescans with the same
parameters.
• Plan allows you to accept the current plan.
4 The scan parameters for the next scan display. Click Go to execute the
next scan.
Note Once you scan the surview, the plan lines turn blue and are locked in place.
You can add scans, but you must start a new scan to create a new surview.

6.10 Plan on surview
General rules for multiple scan series studies:

If the patient moved on the table, click the Stop button.
To ensure accurate planning and execution, do not move the table Up or
Down after the Surview scan.
If the patient’s position requires changing, restart the procedure.
6.10.1 Timed scans

Timed scans allow you to use contrast while conducting a normal scan. Use
this procedure to created a timed scan.
1 Click the Contrast parameter tab.
2 Set the Trigger Type to Timed. The timing bar displays.
3 Set the options for the PID (post injection delay) and SAS (spiral auto
start) as desired. See Chapter 8: Scan protocols for more information
on scan parameters.
4 You can use the timing bar to adjust the scan time:
• Click and drag the bar to extend the scan time (max time is 4
minutes).
• Click on the right edge of the bar and drag to expand the plan area.

Plan on surview 6.10
6.10.2 Filming images

The Film icon is available in the common tools area. Use it to send the selected
images, window or series to the Filming application. The images filmed in the
applications are added to the images already in the Filming application.
Use this procedure to film images from an application:
1 Click on the appropriate selection mode. In some applications, only the
displayed image can be filmed.
2 Launch the film option by clicking the Film icon on the toolbar.
3 Rearrange and adjust the images.
4 Print the film pages (see the next sections for more details).

7 Service
There are several customizable features included in the MX 4000 Dual and
MX 6000 Dual software packages. This chapter provides information and
procedures for setting up the system according to your needs. Make sure
you complete the system setup before scanning any patients.
Daily service functions include these items:
• Warm-up (see Scan operation)
• Air Calibration (see Scan operation)
• Protocol
• Setting
• Anti virus
• Log off user
Note When the temperature or humidity in the scanning room changes in a large
scale, ring artifact shadow or central shadow may be generated in the scan
image.
Note Make sure there is no object in the scan hole in the sensitivity calibration
operation.
MX 4000 Dual/MX 6000 Dual Service 7- 1

7.1 Service menu
7.1 Service menu

The Service menu displays when Service is clicked.
7.1.1 Menu buttons

Click a button to assess the corresponding feature.
• Warm-up allows you to bring the tube to normal operating temperature
after a pause in system operation of more than ten hours (see Tube
warm-up, on page 6-3).
• Air Calibration is a part of normal system maintenance that ensures
proper operation of the scanner (see Air calibration, on page 6-4).
• Protocol allows you to create new customized protocols. For a full
procedure see section Generate Protocol.
• Setting allows you to customize a variety of system options to best suit
the needs of your facility.
• AntiVirus automatically runs the built-in antivirus software.
• Log Off User allows you to exit out of the CT system or change users.
7 -2 Service MX 4000 Dual/MX 6000 Dual

Service menu 7.1
Setting
Setting allows you to customize a variety of system options to best suit the
needs of your facility.
• Password modification allows you to create new passwords.
• ID generator allows you to select options for creating the patient ID.
• Record use to add new messages, or edit and delete existing messages
that may be used during the scan process.

7.1 Service menu
Protocol
The protocol service option allows you to create, modify, and delete
protocols for scanning and viewing images. Use this option to configure the
protocols to best suit your needs.
1 Click Protocol to access the protocol edit function. The system displays
this window:
2 Click the desired protocol group. The system displays the

corresponding protocols.
Note Hold the pointer over a protocol to display its parameters.

Service menu 7.1
3 Select the desired option:

• Edit Mode requires you to select a protocol first (the system displays
its features in the Selected protocol box).
• Delete Mode requires you to select a protocol and confirm.
Note The Philips logo displays on factory set protocols. These protocols cannot
be edited or deleted. Use the Save As feature to create a new protocol
containing the changes to default settings.
4 If you selected Edit mode, the system displays the scan parameters.
Adjust the parameters as needed.
5 Click the back arrow in the upper left corner to return to the protocol
edit window.
6 Click Exit to return to the Daily Service menu.
Display edit
The Display edit feature allows you to alter the viewing protocols. You can
set these options:

• Name
• Window width and level
• Dual window
• Threshold
• Layout type
• Shared status
Film template
Allows you to create a new film template (layout). New templates are
selectable for the auto film feature of when you generate a new protocol.
When you scan, your film output automatically displays in the selected
layout.

7.1 Service menu
Antivirus
The system includes built-in Antivirus software. Click this option to run a
virus check on the CT system.
Log off User

Click this option to log off of the system or change users.

8 Scan protocols
8.1 Overview
This chapter covers the protocols used during the scan procedure as well as
the parameters available in each protocol. There are several scan modes:
• Surview scans are radiographic-like scans upon which the study is
planned.
• Axial scans are the CT mode of slice-by-slice scanning while the Patient
Table is motionless. The result is: n slice images (n is the product of the
number of scans, and the number of slices/scan in the specific scanner,
one to forty depending on the selected collimation).
• Helical (spiral) scans are multi-rotational scans while the Patient Table
is incrementing continuously. The result is a series of slice images,
reconstructed with flexible increment.
8.1.1 Scan protocol parameter tabs

The scan series protocol parameters are organized into tabs. Click a tab to
access its corresponding parameters:
• Surview
• Scan
• Contrast (available when Contrast is selected in the scan parameters)
• Voice (available when Auto voice is selected in the scan parameters)
• Reconstruction
MX 4000 Dual/MX 6000 Dual Scan protocols 8- 1

8.1 Overview
8.1.2 Modifying protocols

If the values of the Protocol parameters do not suit the case requirements,
modify them this way:
• Select the desired parameter for modification by either pressing the Tab
key until its field is reached, or by directly clicking in its field with the
left mouse button.
• If an arrow appears to the right of a field, click it to open a drop down
menu of selections (some fields are limited to values listed in the menu).
• To modify the current protocol during the scanning procedure, click on
the Pause/Stop button, then click and change the parameters.
When all the parameters are set as desired, click Go.
The LED for Manual button lights up and system is ready to scan.
Note If the preset parameter values are changed frequently, use the Edit
Protocols function to permanently replace them with frequently used
values.
Caution Make sure that the correct scan parameters are entered to ensure correct
left/right orientations.
8 -2 Scan protocols MX 4000 Dual/MX 6000 Dual

Common parameters 8.2
8.2 Common parameters

The parameters included in this section are part of the Surview, axial and
Helical scans.
Couch Direction
The Couch direction setting determines whether the scan is performed as
the Patient table moves into the gantry or out of the gantry.
Start [mm]
The Start value denotes the patient table position for the first image in the
scan series. The value in this box is copied from the Plan on Surview. If
there is no plan, and a number is typed in the Start field, the patient table is
moved to this planned position during the scan process (while pressing and
holding the Enable button). The Start position can be changed with a
resolution of 0.5 mm. When an asterisk (#) appears, the scan will start from
the current patient table position, which is taken from the patient table
in/out settings when the scanner is in the Ready for Scan state.
Length [mm]
The Length parameter gives the region covered. Usually, the value in this
box is copied from Plan on Surview but you can type any desired value in
the correct resolution and range. If the entered value is out of range (for
example, the time that is needed to execute is less than the scanner
limitation), a message displays.
Current [mA]
This parameter is used to set the X-ray current. Type the desired current in
the range of 10 mA to 230 mA in adult protocol and 30 mA in infant
protocol. You can also select from a list of frequently used values.
Low mA values are generally recommended for the surview scans.

8.2 Common parameters
Voltage [kV]
The Voltage parameter is used to set the voltage according to the absorption
characteristics of the scanned body part.
All Infant scans are only performable with Medium (120 kV) or Low
(80 kV) voltage. Low or Medium voltages improve contrast resolution in
small and medium objects or bodies, and therefore are preferred for
scanning infants and normal size patients respectively. On the other hand, a
High voltage (140 kV) scan provides greater penetration in large objects
and reduces the noise of the images.
Collimation [mm]
Tailored to different applications, several collimation apertures are
available:
• 0.8 (optional)
• 1
• 2.5
• 5
• 7
• 10
The minimum available thickness is always larger than the basic
collimation.

Surview 8.3
8.3 Surview
The image shows the Surview tab, which in addition to the common
parameters (see Common parameters, on page 8-3)includes these options:
Scan type
The Scan type setting determines the rotation of the tube. PA indicates a
180 degree scan angle. Lateral is a 90 degree scan.
FOV [mm] (Field of View)

The FOV parameter denotes the diameter of the reconstructed image. The
FOV value is usually copied from Plan on Surview. where it is interactively
set by the FOV function.
The 250 mm FOV is normally used for head, spine and infant scans. The
350 mm and 500 mm FOV are normally used for body scans.
Window Width/Window
Window Center and Window Width are used to set the gray levels of the
displayed image.
Auto Voice
The Auto voice parameter is used to select a pre-recorded message set:
before the scan (for example, “hold your breath”) and after it (for example,
“you can relax now”).

8.3 Surview
View Angle [degrees]

This parameter is used to set the angle from which the X-ray tube irradiates
the patient during Surview, analogous to conventional radiography. The
available viewing angles are 90° (lateral), 180° (PA).
Thickness [mm]
This parameter indicates that the collimation is set to
4 x 0.625 mm during the Surview scan.
The effective spatial resolution in the direction of the Axial Surview scan is
0.625 mm. It is set to this value and cannot be changed. These are the
available slice thicknesses:
• 2 x 0.8 (optional)
• 2x1
• 2 x 2.5
• 2x5
• 2x7
• 2 x 10

Scan parameters 8.4
8.4 Scan parameters

The images show the Axial and Helical scan tabs, which provide the
following options:
Scan Mode
This parameter allows you to select from the Surview, Axial and Helical
scan modes.
Rot Time [sec]
The Rotation Time [sec] parameter defines the duration of one rotation of
the gantry. The table below shows the relationship between the rotation
time and Resolution.

8.4 Scan parameters
Pitch (CT pitch factor) For Helical Scans only

The Pitch parameter represents the value of the patient table speed (this is a
normalized speed: the motion of the table relative to the total collimation
for one rotation of the gantry-1, 10 12.5, 25 mm or 40 mm).
CT pitch factor = ∆d/T
Where ∆d is the patient table travel in horizontal direction.

T is the collimation (nominal tomographic section thickness)
A larger Pitch enables a longer total coverage for a given scan time but can
sometimes produce a lower quality image, in terms of image noise.
The values in the Pitch field are recommended from an image quality
perspective.
The maximum available pitch is limited by FOV.
Increment [mm] For Axial Scans only
The Increment parameter is used to set the distance between two
consecutive scans in millimeters.
The default value of the Increment is equal to the selected collimation.
Caution Increment of zero is allowed, but then the scanned area will receive an
increased amount of radiation. This mode will be used for biopsies and for
Bolus tests. It is suggested that the dose used in these cases should be as low
as allowed by the specific application.
When the Thickness value is changed, the increment is set automatically to

the sum of the Slice Thickness achieved by one scan, unless it was zero. In
that case, the Increment value remains set at zero-there will be no Table
motion between adjacent scans.

Scan parameters 8.4
Tilt [deg]
The Tilt value (in degrees) denotes the Gantry Tilt angle for the planned
scan on lateral (90 degree) Surview scan. The value in this box is copied
from Plan on Surview, where it is interactively set by the Rotate function.
The Gantry will tilt to the desired tilt angle before the scan start (while the
Enable button is pressed and held). The range for Axial scans is from -30°
to +30° depending on the couch height (see Operating the gantry tilt and
table, on page 6-6).
Note When the Surview scan angle is 180°, the Rotate button is grayed out.
Sample
This parameter is available with values of 512 and 1024.
Scan angle
The Scan Angle parameter is used to set the angle of the data acquisition.
At this time only 360° is available.

8.4 Scan parameters
Trigger
The Trigger is used to generate a timing mechanism. You determine the
desired delay before the start of the scan, counting from the beginning of a
selected event. The initiation of contrast injection then serves as the trigger,
with radiation starting after the desired delay has elapsed.
Note • When using Trigger, always plan from a surview; complete the surview
before entering the desired time delays. The Timing Ruler displays at the
screen bottom while the scan is in progress, allowing the scan progress to
be monitored.
• When using timed sequences, the maximum delay for the first scanned
series is 180 seconds with voice time and the minimum time is 1 second
without voice time. Maximum time between series is 180 seconds with
voice time and the minimum time is 7seconds without voice time.
• There is no longest delay time when the time between series is less than
180s. You can add multiple series if desired.
• Pausing the injector will NOT pause the scanner once the injector delay is
reached.
The Trigger to start the scan can be started manually or automatically. For
Spiral scans the scan can be started with Auto Start or SAS.
• In manual mode operation, you must press the Auto scan button and
the Injection button at the same time.
• In automatic mode, after you press the Auto scan button, the scanner
continues to wait for a triggering signal from the contrast injector.
The countdown of the delay before scanning begins immediately following
the triggering signal from the contrast injector.
Wa r n i n g Keep the patient under continuous observation. Between the series, the
bed will move automatically until completion of the plan.
8 -1 0 Scan protocols MX 4000 Dual/MX 6000 Dual

Scan parameters 8.4
Auto Voice
The Auto voice parameter is used to select a pre-recorded message set:
before the scan (for example, “hold your breath”) and after it (for example,
“you can relax now”).

8.5 Reconstruction parameters

The image shows the Reconstruction tab, which provides the following
options:
Center X [mm], Center Y [mm]

Center X and Center Y set the Horizontal (X) and Vertical (Y)
displacements, in millimeters (with resolution of 1.0 mm) of the
reconstructed image relative to the center of the Gantry opening. They are
used to center the region-of-interest in the image frame.
Usually, the Center X and Center Y values are copied from Plan on Surview
where it is interactively set by the Move function. Values within the range
of ± FOV/2 may also be typed.
FOV [mm] (Field of View)
The FOV parameter denotes the diameter of the reconstructed image. The
FOV value is usually copied from Plan on Surview. where it is interactively
set by the FOV function. The FOV value can be selected from a list or
typed directly in its text box.
The 250 mm FOV is normally used for head, spine and infant scans. The
350 mm and 500 mm FOV are normally used for body scans.

Reconstruction parameters 8.5
Thickness [mm]
Use the Thickness parameter to set the tomographic thickness, which
determines the spatial resolution in the axial direction (perpendicular to the
plane of the slice). Select the desired combination of collimation and
reconstruction from a string in the list:
• 2 x 0.8 (optional)
• 2x1
• 2 x 2.5
• 2x5
• 2x7
• 2 x 10
Increment [mm]
The Increment parameter is used to set the distance between two
consecutive scans in millimeters.
The default value of the Increment is equal to the selected collimation.
Caution Increment of zero is allowed, but then the scanned area will receive an
increased amount of radiation. This mode will be used for biopsies and for
Bolus tests. It is suggested that the dose used in these cases should be as low
as allowed by the specific application.
When the Thickness value is changed, the increment is set automatically to

the sum of the Slice Thickness achieved by one scan, unless it was zero. In
that case, the Increment value remains set at zero-there will be no Table
motion between adjacent scans.

Matrix
The Image Matrix parameter sets the number of pixels that the
reconstructed image will contain. The matrix size is 5122. Understanding
the relationship between FOV, resolution mode and reconstruction will
help you make a matrix choice that produces the best image quality:
Standard resolution, matrix =1.6 x FOV (except filter D)
HR: matrix = 3.2 x FOV
For example, if the scan mode is HR and the FOV is 300 mm, then the
matrix is 3.2 x 300 = 960. The closest available matrix selection is 1024.
Window Width/Window
Window Center and Window Width are used to set the gray levels of the
displayed image.

Reconstruction parameters 8.5
8.5.1 Contrast parameters

The image shows the Contrast tab, which provides the following options:
Trigger Type
Toggles the timed scan on and off. A time bar appears along the bottom of
the window when timed scanning is enabled.
PID(s) (Post injection delay)
The delay from injection to start of the scan.

SAS
For Spiral scans the scan can be started with Auto Start or SAS.
• In automatic mode, after you press the Auto scan button, the scanner
continues to wait for a triggering signal from the contrast injector.
The countdown of the delay before scanning begins immediately following
the triggering signal from the contrast injector.

8.6 Voice parameters
The image shows the Voice tab, which provides the following options:
Language
To select a language for the auto voice option.
Pre-scan
To select a phrase before the scan.
Post-scan
To select a phrase after the scan.
9 Image reconstruction
9.1 Overview
Image reconstruction allows you to perform reconstructions of raw scan
data using one of these methods:
• On-line-reconstruction begins immediately after the scan is complete.
• Off-line-patient files are accessed in the directory and reconstructed.
You also have the option to automatically launch reconstruction results in
corresponding viewers.
MX 4000 Dual/MX 6000 Dual Image reconstruction 9- 1

9.2 Online recon
9.2 Online recon

Online reconstruction of the clinical scan occurs immediately after the scan
is complete. You can adjust the window Center and Width for optimal
viewing of the image, to monitor the proper execution of the scanning
process.
• Zoom in/out to enlarge or reduce the series of images.
• Pan an image to center the series of images or the region of interest.
• Adjust the window setting.
• Click Start to begin the Reconstruction.
9.2.1 Add Recon

You have the option of inserting a reconstruction into the current study.
Using this feature results in a real-time reconstruction.
1 To insert a reconstruction into the current study (available after Surview
is scanned), click Add Recon. The system displays the recon protocol
parameters which are the same as those of the planned scan or the
previous Add Recon.
2 If desired, edit the parameters.
9 -2 Image reconstruction MX 4000 Dual/MX 6000 Dual

Offline reconstruction 9.3
9.3 Offline reconstruction

Use this procedure to reconstruct patient data.
1 Select a patient from the patient list on the Home window.
2 Click the Offline Recon icon. The system loads the information and
displays the scan parameters.
The displayed parameters correspond with the type of scan that was
performed.
Note You have the option of selecting the patient after clicking Offline recon.
MX 4000 Dual/MX 6000 Dual Image reconstruction 9- 3

9.3 Offline reconstruction
3 Change the scan parameters, if desired.

4 When you have entered the settings, select an option:
• Confirm to accept the settings and begin reconstruction.
• Exit to cancel the reconstruction and exit the reconstruction window.
5 If you clicked Confirm, the Reconstruction Manager displays.
6 Select from these options:
• Stop allows you to temporarily stop the reconstruction. Click Y to
confirm. The system displays options to resume or delete
reconstruction.
• Delete to delete the selected reconstruction.
• Resume to continue with current reconstruction
• Delete All to delete all pending reconstructions.
9 -4 Image reconstruction MX 4000 Dual/MX 6000 Dual

10 Review mode
The system is equipped with a variety of viewers for reviewing patient

images.
• 2D - for reviewing original axial images in stack or tile mode.
• Planar - for reviewing 3 orthogonal images (or slab images)
simultaneously in oblique planes.
• Volume - for reviewing full volume images in different rendering
techniques.
• Endo - for reviewing internal cavities in the flythrough mode.
Each viewing mode has its own clinical usages and has specific visualization
tools associated with it. These uses will be further described in this chapter.
MX 4000 Dual/MX 6000 Dual Review mode 10-1

10.1 Common tools
10.1 Common tools

The common tool box contains a variety of general tools that are used with
all of the CT Viewers - 2D, Slab, MPR and Volume. it is located in the
lower left corner of the viewer window.
Save Image to save images to a storage device.
Report to select images for a report.
Film to send selected images to the Filming function.
Image Parameters tool to display the selected image’s scan parameters.
Leaf & select Images for Fast Leafing and also for deselecting the graphics,
zoom, and pan buttons, thus enabling selection of images.
Pan to center the feature of interest in the image frame by dragging the
image in the image window.
Zoom image for magnifying and reducing the selected images.
Line for length measurement
ROI (free hand, elliptical, rectangular,) Regions of interest for measuring

area, mean and standard deviation of the pixel values
Text for annotation on the images
1 0 -2 Review mode MX 4000 Dual/MX 6000 Dual

Common tools 10.1
Cursor for measuring pinpoint pixel values
Angle for measuring angles between features on the image
Arrow for pointing to feature elements
Windowing - allows you to quickly set the Center and Width of the image
windowing. These options are available:
• P.F.
• Brain
• IAC
• Spine
• Bone
• Lung
• Abdomen
• Liver
Using the mouse for Windowing - You can also adjust the window Level
and Width by clicking and dragging the middle mouse button. Vertical
dragging changes windowing Level and horizontal dragging changes
windowing Width.
Titles off - Turn the image titles off and on. If turned off, they come back
on when the image is filmed or saved.
Reset All - For resetting the study’s images to the state they were in upon
loading.
MX 4000 Dual/MX 6000 Dual Review mode 10- 3

10.1 Common tools
10.1.1 Leaf & Select

Use for Fast Leafing (viewing images in the study) and also for deselecting
the graphics, zoom, and pan buttons, thus enabling selection of images.
Click Select to activate Fast Leafing.
• To leaf forward, drag the mouse down.
• To leaf in the reverse direction, drag the mouse up.
• To display the images one-by-one, drag the mouse slowly.
• To go quickly through the images, drag the mouse rapidly.
10.1.2 Film
Use the Film icon to send selected images, a window or series to the
Filming application. Alternatively, filming options are accessible from the
File menu. Filmed images are added to the images already in the Filming
application. Use this procedure to film images:
1 Click on the appropriate selection mode. In some applications, only the
displayed image can be filmed.
2 Launch the film option using one of these methods:
• Click the Film icon on the toolbar.
• Select Film Images from the File menu.
The system sends the selected images to the Film application.
10.1.3 Report
You have the option to send images to the Reporting application for use
during report creation:
1 Select the desired image.
2 Click Report.
Note There is no limit to the number of images sent to the reporting application.

Common tools 10.1
10.1.4 Batch
The Batch set of tools is used to organize a set of images prior to saving,
filming, reporting, or viewing them in the Cine mode. These tools are
available in the 2D, planar and volume modes.
Note Before using the Batch mode, be sure to set up the images the way you
want them using the 2-D tools.
From allows you to define the starting image of the batch. This is the
default when you enter Batch & Cine.
To allows you to define the end image of the batch.
All selects all images for the batch.
Clear eliminates the start and end definitions you have made.
Images to Skip allows you to select every 2nd, 3rd, 4th, 5th image, and so
on, for the batch (2D mode only).
Step Size [mm] - defines the step size in mm between the first and last
locations (Planar mode only).

Number of images - Define the number of images between the first and
last locations (Volume and Planar modes only)
Save opens a dialog box where you can save the batch as DICOM series
(not available in 2D mode).
Report sends the batch to the report scrap book; send the whole display to
the report by clicking on arrow beside report icon and selecting report
display.
Film sends the batch to the Filming application.
Note The step size and image options vary depending on the viewer window.

10.2 2D Viewer mode
10.2 2D Viewer mode

In 2D Viewer mode you can review original axial images as acquired by the
scanner.
Native 2D images can be reviewed side-by-side in tile viewing mode (2x2,
3x3, and 4x4 layout), or in stack viewing mode, by leafing through the data
set.
The fast leafing method in stack view is an efficient way to quickly review
patient images.
Graphic tools like arrows, text, and ROIs are available for annotations and
measuring.

2D Viewer mode 10.2
2D tools
These tools are available in the 2D Viewer.
Compare Series - when you load a series, they display in tiled mode (see
Image Layout below). The series are sorted one after the other.
• Click Compare Series to enter the compare mode. The window
changes so that each view port contains a series. Each series can be
independently manipulated.
• Click a Series Layout button to select a vertical or horizontal layout of
the compared series.
Image Layout tools - Four arrangements are available for displaying images
(except in Compare mode). From left to right, they are 1x1 (which is used
to view images in a stack mode), 2x2, 3x3, and 4x4.
The layout in Compare mode can be 1x2 or 2x1 (the layout icons change
accordingly).
Flip/Rotate tools - The first two tools flip the axial image top-to-bottom
and left-to-right. The third tool rotates the image in 90 degree increments
clockwise.
Selection Mode - Use these tools to select individual images or all images in
order to leaf, zoom, pan, and change the Window or Level.
Note If you to want view images in larger arrangements, use the Film application.

10.3 Planar mode
10.3 Planar mode

Use the Planar mode for simultaneous three-plane orthogonal images. In
this mode, the three shown planes or slabs can be easily correlated. Three
orthogonal cut planes are shown, with three different color markings:
• yellow represents axial
• blue represents coronal
• purple represents sagittal
MPR tools
MPR tools provide methods to alter the view of the images in order to
follow the path of a specific organ. These tools are available:
Show crosshair toggles crosshairs on or off.
Curved MPR icon toggles curve definition on or off.
Show Path displays the path drawn in curve definition mode.
Oblique displays the oblique path across the selected organ.
Thickness (not available in Normal mode) allows two methods to change
the thickness of the displayed slice:
• Type a value in the thickness box, and click Apply.
• Click the up or down arrows beside the box.
Threshold allows you to change maximum and minimum Hounsfield units
for the displayed image.
These options are available for changing the rendering technique.
• Normal (default, renders according to the average value along the ray;
thickness cannot be changed)
• MinP-minimum intensity projection
• AIP-average intensity projection
• MIP-maximum intensity projection

Planar mode 10.3
Curved MPR procedure

3 Click the Curved mode button. The Define Curve function becomes
active.
4 Click on the starting point of the curve.
Note • You may have to increase the slice thickness to view all of the desired
path.
• If the path does not display, click Show Path.
5 Move the mouse in the desired path, clicking as you go along.

6 When done, double click to end the curve and display results in the
lower left viewport.

10.4 Volume mode
10.4 Volume mode

The volume mode is used to display CT scanner data in a full volume
image. It provides basic tools for image editing and generation of movies.
10.4.1 Volume tools

Views alter the position of the selected image.
Show/Hide Protocols - Open a vertical window containing mini images of

all the existing protocols specific for the loaded volume. The window,
shown at right, will cover part of the image.
• Double click on a protocol mini image to apply the protocol to the
volume.
• Click the Show/Hide button again to hide the mini images.
In addition to the protocols, you can also select an alternate rendering
mode:
SSD 3D (shaded surface display 3D) renders and displays a three-
dimensional view of the image.
MIP (maximum intensity projection) renders and displays two-
dimensional projections from sets of CT slices. In MIP, the brightness of a
displayed pixel is determined by the maximum CT number along path
(ray) through patient.
MinP(minimum intensity projection) renders and generates an interactive
window with ray-traced Minimum Intensity Projection slab images. The
program calculates and displays two dimensional projections of the lowest
1 0 -1 0 Review mode MX 4000 Dual/MX 6000 Dual

Volume mode 10.4
intensity pixels in a three dimensional slab. These images can demonstrate

respiratory airways.
AIP (average intensity protection) provides depth windowing of sample
values, in effect accentuating the pixels closer to the eye and darkening the
ones farther away.
10.4.2 Clipping tools

Clipping is the process of excluding bones and other high contrast material.
It is the initial, prerequisite procedure required for optimal viewing of some
anatomies, such as run off, carotid, and circle of Willis.
The Freehand tool allows you to eliminate the undesired tissue to isolate
the volume of interest. You must confirm each change made with the
clipping tool.
Undo - Undo all VOI.
10.4.3 Opacity curve editing

Volume mode includes a feature which allows you to create and edit the
viewing protocols available under Show/Hide protocols.
The viewing protocols are manipulated using an opacity curve. Each
opacity curve consists of a number of points, each of which can be
manipulated separately to define the curve position.
Add protocol allows you to create a new protocol:
1 Click Add protocol. The Add protocol box displays.
2 Click and drag a point on the curve to move it.
3 When you have completed the protocol, click Ok to accept it. The
system closes the Add protocol dialog box and displays a mini image of
the new protocol in the mini image list.

10.4 Volume mode
Edit protocol allows you to edit a protocol:

1 Select a protocol by clicking its mini image.
2 Click Edit protocol. The Edit protocol box displays.
3 Click and drag a point on the curve to move it.
4 When you have completed the protocol, click Ok to accept it. The
system closes the Edit protocol dialog box and displays a mini image of
the new protocol in the mini image list.
Delete protocol allows you to delete a protocol:
1 Select a protocol by clicking its mini image.
2 Click Delete protocol. The system deletes the selected mini image from
the list.

Endo mode 10.5
10.5 Endo mode

The CT Endo viewer is a review function that allows you to
perform a general flythrough of any suitable anatomical structure
that is filled with air or with contrast material, including general
vessels, cardiac vessels, the bronchus, and the colon.
The CT Endo viewer is best understood as a virtual camera system.
With the camera, you can “see” the inside walls of structures.
You can activate a “cine” function while performing the fly-
through, and the application will remember your path. After you
are finished, you can activate the “playback” mode and review your
path in a cine mode.
After you have found an object you want to examine, you can stop
and use the reference viewports to view the object in detail,
zooming and panning as desired. You can also view the anatomy of
interest in oblique MPR planes.

10.5 Endo mode
10.5.1 Endo viewer window
Above is the opening window after the patient image data is loaded into the
CT Endo application.
1 Tool panel contains the CT Endo tools, the Select Series tab, and the
common tool set.
2 Main viewport displays a rendered perspective image of the study. It is
blank until you define the anatomy to be rendered. The protocol is set
to the default for the application, but you can change it.
3 Reference viewports display axial, coronal, and sagittal images, with
yellow markings showing the camera direction and angle in the upper
and lower images, with the view plane in the center image. Green
crosshairs in each reference image indicate the camera’s target.

Endo mode 10.5
10.5.2 Create an Endo view

Use this procedure to create an endoscopic view of the desired anatomy.
1 Load the desired patient study.
2 Scroll through the viewports until the desired anatomy displays.
3 Click on the anatomy. The system displays the Threshold and
Tolerance for the area in the Segmentation box.
4 Click Ok. The system displays a volume rendered view of the area.
5 Click Start point in the View box to set the desired start point.
6 Click a starting point on the Volume image.
7 Click End point in the View box to set the desired end point.
8 Click an ending point on the Volume image.
9 Use the Flythrough procedures to activate the cine view.

10.5 Endo mode
10.5.3 Flythrough procedures

Once you have succeeded in placing the camera inside the
structure, you are ready to perform the manual flythrough.
Step-by-step flythrough
The two middle buttons of the flythrough tool bar are for the step
forward and step back buttons. They allow you to go through the
structure one image at a time.
1 Use the combo box to change the Step size (between 1 and
20 mm per step).
2 Click either the step back or step forward button. The selected
button becomes active.
3 Position the mouse pointer on the main image onto the center
of the location you want to step toward.
4 Click the mouse. The image updates to your new camera
location.
5 Continue stepping as desired.
Note You can pass through a wall and leave the structure if you point at a wall.
6 When finished, cancel the step-by-step flythrough mode by

clicking the Stop button.
Controlled flythrough
The two outer buttons are for moving through the structure in
automatic mode.
Note If you want to record your path, click the Record button before beginning.

Endo mode 10.5
1 Set the desired Step (from 1 to 50) and Step size parameters to
suit the structure you are viewing.
2 Click either the forward or backward button. The images will
begin updating automatically, advancing or receding according
to the speed and incremental distance you selected.
3 To stop the flythrough, click the left mouse button. To re-start,
click the left mouse button again.
4 When you are finished:
•stop the flythrough with the mouse button
•if you were recording the path, click the Record button off
•click the Stop button
Playback function
Note • If you want to save (record) the path of a flythrough, click the Record
button before you begin.
• Only one path will be saved in the Endo viewer’s memory. If you record a
second path, the previous one will be erased.
• If you close the Endo application, the path will be erased.
1 Click the Play forward or Play back button.

-- or --
2 Click the Step forward or Step back button. Each click on a
Step button will move you one step along the recorded path
In the play forward or play back mode, the recorded path will
begin playing, from front to back or back to front, as selected,
and will repeat until stopped.
3 Stop the playback by clicking the Stop button.

11 Filming
11.1 Overview
The Filming application is used for viewing, rearranging, windowing and
zooming images prior to sending them to be printed.
These are some of the advantages provided by the Filming application:
• Better organization and economy of films can be achieved by filming in
the Multiformat mode.
• Measurements and annotations (done with graphic elements) can be
added or deleted from the images.
Wa r n i n g Measurements on 3D images are in the screen plane and not on the three-
dimensional curved surfaces.
MX 4000 Dual/MX 6000 Dual Filming 11-1

11.2 Filming window
11.2 Filming window

The illustration below shows the Filming window:
1 Workflow bar
2 Layout tools for printing and graphical notation and measurement.
3 Common tools
4 Menu bar includes additional filming options.
5 Main area displays the images and information selected for print.
6 Tabs allow you to toggle between the selected films.
1 1 -2 Filming MX 4000 Dual/MX 6000 Dual

Filming window 11.2
11.2.1 Menu bar

The Menu bar consists of several menu options which, when selected,
display a list of operations that can be performed:
• File (Includes printer which allows you to select from several printers or
imagers, if they are connected, and other printing operations. If there
are any imager problems, use the Print Auto Clear).
• Edit options for copying and deleting images.
• View (includes the ability to set the film format, select specific images
or include pilot or plan lines on the image).
• Windowing allows you to select from inverse, automatic, or the
standard windowing presets. You must select inverse a second time to
turn it off.
• Graphics allows you to select from the standard graphics that can be
used on an image (such as line measurement or define ROI).
• Operations allows you to select from the standard operations that can
be performed on an image (such as zoom, pan, rotate, flip or send to
report).
• Options allows you to turn titles on or off.
MX 4000 Dual/MX 6000 Dual Filming 11- 3

11.2 Filming window
11.2.2 Layout tools

The top of the film tools box contains various icons for layout.
Standard1×1
Standard4×5
Standard5×7
Define film format
Two horizontal windows (multiformat option)
Two vertical windows (multiformat option)
Three windows (multiformat option)
Four windows (multiformat option)
Six windows (multiformat option)
Undo multiformat setting
Toggle Multiformat mode
Display Surview image includes a mini image of the Surview in each

frame.
Location line form displays the first, last and a selected line. Alternately,
all lines display on the image.
Display Surview lines toggles on and off the Surview lines.

Filming window 11.2
Reverse series displays images in reverse order of current view.
Sort series allows you to restore images in the selected series to their
original order after they have been moved.
Film direction
Film can be printed in Landscape or Portrait format.
Flip/Rotate tools
The first two tools flip the axial image top-to-bottom and left-to-right. The
third tool rotates the image in 90 degree increments clockwise.
Selection modes
Image(s) to select one or several frames. These options allow you to make
changes to for a single frame, multiple frames or all frames.

11.2 Filming window
11.2.3 Common tools

The common tool box contains a variety of general tools that are used with
the Filming application
Report to select images for a report.
Pan to center the feature of interest in the image frame by dragging the
image in the image window.
Zoom image for magnifying and reducing the selected images.
Delete image to delete the selected images.
ROI (free hand, elliptical, rectangular,) Regions of interest for measuring

area, mean and standard deviation of the pixel values
Line for length measurement
Text for annotation on the images
Gray bar to display a gray scale along the side of the image
Scale to display a graphical scale along the side of the image
Cursor for measuring pinpoint pixel values
Angle for measuring angles between features on the image
Arrow for pointing to feature elements

Filming window 11.2
Windowing - allows you to quickly set the Center and Width of the image
windowing. These options are available:
• P.F.
• Brain
• IAC
• Spine
• Bone
• Lung
• Abdomen
• Liver
Using the mouse for Windowing - You can also adjust the window Level
and Width by clicking and dragging the middle mouse button. Vertical
dragging changes windowing Level and horizontal dragging changes
windowing Width.
Titles off - Turn the image titles off and on. If turned off, they come back
on when the image is filmed or saved.
Reset All - For resetting the study’s images to the state they were in upon
loading.

11.2 Filming window
11.2.4 Selecting images

Use this procedure to open a study series in the Film viewer:
1 From the Home window, select the desired series.
2 Click Film on the workflow bar.
3 The system displays the Film images box.
4 Set the parameters as desired.

5 Click Confirm. The selected images display in the Filming
application.

Filming window 11.2
11.2.5 Film format

Use this procedure to change the film format.
1 Access the Film format dialog box using one of these methods:
• Click the Film Format icon on the toolbar.
• Select Film Format from the View menu.
The dialog box opens.
2 Click on the desired format.

3 Click Ok.

11.2 Filming window
11.2.6 Multiformat
In addition to standard format options, you have the option to combine
groups of images within a single film frame. Use the multiformat tools to
adjust the film view accordingly.
1 Turn on multiformat mode by clicking the Multiformat icon.
2 Hold Ctrl while clicking on the desired images.
3 Click a Multiformat icon. The system displays the new image frame in
the location of the first selected image.
1 1 -1 0 Filming MX 4000 Dual/MX 6000 Dual

Print film 11.3
11.3 Print film

To send images from the Review modes, use one of the Filming methods
described in Film, on page 10-4.
1 When desired, you have two options to send the images from the
Filming application to the printer or imager:
• Click the DICOM Print icon (or select DICOM print from the file
menu).
• Click the Print icon.
2 From the dialog box, you can print the current (or all) film pages and
either automatically delete the images, or print without deleting the

images.
• If desired, change the number of images printed by selecting Number
of copies from the Options menu.

12 Reporting
12.1 Overview
The Reporting package allows you to create customized reports using pre-
formatted templates. A template is a specially designed formatting
document that places the analytical information and images that you send
from an application into an organized report which can be printed and
saved.
Note Additional templates can be created. Contact your Philips representative
for more information on Report templates.
MX 4000 Dual/MX 6000 Dual Reporting 12-1

12.2 Report window
12.2 Report window

To access the report window, click Report on the Workflow bar.
The system displays a new report with patient information from the current
patient. You can customize the report using the tools and options in the
tool panel.
1 Menu bar 2 Report tools
3 Image gallery 4 Template tools
5 Common tools 6 Report
1 2 -2 Reporting MX 4000 Dual/MX 6000 Dual

Report window 12.2
New Report opens a new blank report in the default template format.
Open report allows you to select a previously saved report.
Add template allows you to modify the Select Report template list.
Image gallery
The Image gallery displays the images you’ve loaded to the reporting
application (see Report, on page 10-4 for more information on loading
images into the image gallery).
The Image gallery holds all loaded images until you remove them. Use this
procedure to remove images from the Image gallery:
1 Click on the desired image. A yellow box indentifies the selected image.
2 Press Delete on the keyboard to remove the image.
Wa r n i n g When you have completed a report, make sure you delete the images from
the image gallery.
Menu bar
The Menu bar includes these options:
File includes options for opening, printing and saving files.
Processing includes options for displaying the images.
View includes options for viewing the image and titles.
Windowing allows you to quickly set the Center and Width of the image
windowing using the standard windowing options.
MX 4000 Dual/MX 6000 Dual Reporting 12- 3

12.2 Report window
12.2.1 Report options

To open a new blank report, click New report. The system displays a new
report based on the default template.
• To change to an alternate template, select the desired name from the
Select template list.
• You can fill in the details of the report by clicking the text tool.
To open a saved report, click Open report.
• Select the desired report.
• Click Ok. The system loads the selected report.
To add a new template to the Select template list, click Add Template. The
system displays a list of previously created templates.
• Select the desired template. Click ok to add it to the list.
To add image(s) into the body of your report, double click the image in the
Image Gallery.
• You can use the flip/rotate tools to alter the position of the image.
• You can add ROIs and notations on the image:
• After selecting the desired image for your report, click the desired
ROI tool.
• Drag over the desired area. The system displays the corresponding
ROI information.
• You can also use the line and text tools to add notations to the image.
Note The number of images in a report is limited by the report template.

Contact your Philips representative for assistance with creating new
templates.
Wa r n i n g Make sure that you have the correct patient information for the image you
have placed in your report.
1 2 -4 Reporting MX 4000 Dual/MX 6000 Dual

13 Image performance quality assurance
13.1 Overview
Imaging performance of the scanner is checked by scanning head and body
system phantoms.
When testing image quality, the system should be properly calibrated.
This chapter covers information on these areas:
• Head and body phantom.
• Quality assurance checks-daily and monthly.
Read this section carefully and follow all instructions regarding scheduling
and performance of quality assurance checks.
Note These instructions represent the manufacturer’s required QA performance

checks. If additional testing is required by your national or local authorities,
please contact your Philips and Neusoft Service representative.
MX 4000 Dual/MX 6000 Dual Image performance quality assurance 13-1

13.2 Head & body system performance phantom

The phantom consists of two portions which cover the aspects of head and
body scans. This section covers the specifications of both the head and
body portions of the phantom. Familiarize yourself with this information
before you scan either portion. The illustration below shows the entire
phantom.
Item Description
1 Head Phantom
2 Body Phantom
3 Physics Layer
4 Water Layer
5 Multi-Pin Layer
6 Copper wire
7 45 degree angle
1 3 -2 Image performance quality assurance MX 4000 Dual/MX 6000 Dual

Head & body system performance phantom 13.2
13.2.1 Head phantom

The head phantom is a PVC shell filled with water. It is 200 mm in
diameter and consists of three layers:
• physics layer for impulse response and tomographic section thickness
(slice width) measurements
• water layer for measuring noise
• multi-pin layer for checking contrast scale
13.2.2 Body phantom

The body phantom is a nylon cylinder 300 mm in diameter. It has an
absorption of 100 ± 10 CT and includes these features:
• Teflon pin-absorption 890 ± 50 CT
• water hole-absorption 0 ± 10 CT
MX 4000 Dual/MX 6000 Dual Image performance quality assurance 13- 3

13.2.3 Phantom composition

Item Description
1 Physics Layer
2 Aluminum strips embedded at 45 degrees
3 0.18 mm copper wire for impulse response measurement
4 Water Layer
5 Multi-pin layer
6 Nylon (Aculon) body with six smaller Lexan pins of 3 mm,
7 Lexan
8 Perspex
9 Perspex with seven rows of holes of different diameters. each
Row 1 1.00 mm holes, 2.00 mm apart

10 Teflon
11 Polyethylene
12 Body layer
13 Water hole
14 Teflon pin

13.2.4 Representative quality assurance images
Multi-pin layer using Head Std (B) protocol Water layer using Head Std (B) protocol
Body layer using Body Std (B) protocol

Physics layer Impulse response

(5 mm slice width/Head Std (B) protocol) (modified—80 FOV, Head Std (B) protocol)

13.3 Schedule of quality assurance checks

Daily checks
Daily checks should be done to ensure the best possible image quality from
your scanner. The procedures for daily checks cover these areas:
• Noise - on head phantom, water layer.
• Noise and artifacts - on body phantom.
Monthly checks
Use your facility’s recommended schedule for monthly checks. These
procedures must be conducted at least once each month.
• Contrast scale and artifacts - on head phantom, multi-pin layer.
Advanced checks
Advanced checks are intended for use as advanced applications for
Physicists and your Philips and Neusoft Service Specialist.
• Impulse Response - on head phantom, physics layer.
• Slice thickness - on head phantom, physics layer for all slice
thicknesses.

Schedule of quality assurance checks 13.3
13.3.1 Daily checks

You will use the water layer of the phantom for the daily checks.
Head scan
1 Position the water layer of the head phantom in the center of the scan
circle.
2 Perform a scan using the Head Std (B) protocol with scan and
reconstruction parameter values in the following tables:
MX 4000 Dual Scan parameters
Scan Type Axial Length (mm) 210.0
Voltage (kV) 120 Tilt 0
Current (mA) 150 Couch Direction In
Rot Time (s) 2.0 Sample 1024

Collimation (mm) 2*7 Scan angle (deg) 360
Increment (mm) 14 Trigger Clinical Scan
Rot. Number 1 Auto Voice Off
Start (mm) 2.0

Start (mm) 2.0
Reconstruction parameters
Recon Scheme Head Std (B) Rec Matrix 512
Center X (mm) 0 Display Mode Head1
Center Y (mm) 0 WW 100
FOV (mm) 250 WL 0
Thickness 14
3 Check the four resulting images to ensure they are free of artifacts.
Note If the images display with artifacts, check that the water phantom is the
only item contained within the scan field, and repeat the procedure.
If there is still a problem, contact your Philips and Neusoft Service
Specialist.
4 From these images, select one.

5 Place around the center of the phantom image, a ROI with an area of
7000 ± 2000 mm2.
1 3 -1 0 Image performance quality assurance MX 4000 Dual/MX 6000 Dual

6 Check these items:
AV (Average Value) 0 ± 4.0 HU
SD (Standard Deviation) < 0.6%
13.3.2 Body scans

1 Position the body phantom in the center of the scan circle.
2 Perform a scan using the Body Std (B) protocol (under Abdomen) with
scan and reconstruction parameter values in the following tables:

Start (mm) 2.0

Start (mm) 2.0
Recon Scheme Body Std (B) Rec Matrix 512
Center X (mm) 0 Display Mode Abdomen
FOV (mm) 350 WL 40
Thickness 7
3 Check the four resulting images to ensure they are free of artifacts.
Note If the images display with artifacts, check that the body phantom is the only
item contained within the scan field, and repeat the procedure.
Specialist.

4 From these images, select one to conduct the remainder of the checks.
5 Check the absorption reading for the Teflon pin. It should be as
follows:
Teflon pin 890 ± 50 HU
Wa r n i n g All measurements should be made by positioning a small ROI well within

each of the checked pins and regions. Because the phantom is comprised of
a variety of materials, you may need to refer to the phantom label for
specific values.
6 Place around the center of the phantom, a ROI with an area of

14000 ±1000 mm2. The ROI should not touch the Teflon pin or water
hole.
7 Check these items:
AV (average) 100 ± 15 HU (or the CT value on

the phantom label ±15 HU)
SD (Standard Deviation) < 1.15%

13.4 Monthly checks
13.4 Monthly checks

Use the multi-pin layer of your phantom for month checks.
Note If the images display with artifacts, check that the phantom is the only item
contained within the scan field, and repeat the procedure.
Specialist.
Head scan
1 Position the multi-pin layer of the head phantom in the center of the
scan circle.
2 Perform a scan using the Head Std (B) protocol with scan and
reconstruction parameter values in the following tables:
Start (mm) 2.0

Monthly checks 13.4
Start (mm) 2.0
Recon Scheme Head Std (B) Rec Matrix 512

Center X (mm) 0 Display Mode Head1
FOV (mm) 250 WL 0
Thickness 14
Image quality
Check the quality of one image according to the following criteria:
• Check with the LINE tool that the diameter of the large Perspex pin is
50 ±1.75 mm.
• All resolution holes (seven rows) in the Perspex pin should be visible.
• Five of the six low contrast pins in the Aculon body should be
detectable.
Note As the phantom ages, the low contrast pin is more difficult to visualize.

13.4 Monthly checks
Absorption readings
The readings for the absorption of the different pins must be as follows
(values in CT numbers):
Water 0±4
Nylon +100 ± 15
Polyethylene -75 ± 15
Teflon +950 ± 50
Perspex +120 ± 15
Polycarbonate +110 ± 15
Wa r n i n g All measurements should be made by positioning a small ROI well within

each of the checked pins and regions. Because the phantom is comprised of
a variety of materials, you may need to refer to the phantom label for
specific values.

Advanced quality assurance checks 13.5
13.5 Advanced quality assurance checks

These procedures can be useful for resolving problems revealed by
the daily checks. They are intended for use as advanced applications
for Physicists and your Philips and Neusoft Service Specialist.
13.5.1 Impulse response measurements

1 Position the physics layer of the head phantom in the center of the scan
circle, taking care to make sure the 0.18 mm copper wire (in the center
of the layer) is perpendicular to the scan direction.
2 Perform a scan using the Head Std (B) protocol, with the parameter
values listed in the Daily Checks section.
3 Click Service.
4 Select Advanced.
5 Click CT Scan Evaluation. The system displays a window.

6 Select MTF.
7 Scroll through the images to access the copper wire.
8 Click Evaluate to display the MTF.
9 Check to ensure that the MTF value is not less than 3.05 circle/cm at
10%.

13.5 Advanced quality assurance checks
13.5.2 Tomographic section thickness (slice width) measurements

This function is used to check the Slice Thickness (width) of the scanner
during monthly tests. Available protocols depend on your scanner type.
1 Install the system phantom used for slice width measurements.
2 Perform a lateral scan.
3 Plan an axial slice on the image as shown in the example below:
• You may have to adjust the gantry tilt so that the phantom axis is
perpendicular to the rotation plane.
4 Adjust In/Out position of phantom to obtain better precision.
5 Perform a scan using the Body bone HR (B) protocol, with the
parameter values listed in the Daily Checks section, except FOV
(in mm) = 250.
6 Click Service.
7 Select Advanced.
8 Click CT Scan Evaluation. The system displays a window.
9 Select FWHM.
10 Set the appropriate line number and FOV.

Advanced quality assurance checks 13.5
11 Click and drag across the image to display the plan lines.
12 Adjust the lines to the desired angle and position.
13 Click Evaluate to measure the thickness.
14 Repeat the procedure for these slice thicknesses and tolerances:
Slice thickness FWHM value
0.8 mm 0.8 mm ± 0.5 mm
1.0 mm 1.0 mm ± 0.5 mm
2.5 mm 2.5 mm ± 0.5 mm
7.0 mm 7.0 mm ± 1.0 mm
10.0 mm 10.0 mm ± 1.0 mm


13.6 System maintenance
13.6 System maintenance

Routine preventive maintenance for the whole CT system is scheduled
every six months and should be performed by qualified Philips and Neusoft
personnel. As part of routine maintenance, the Service Engineer will use a
diagnostic program to check these items:
• Anode voltage
• Cathode voltage
• Emission current
• Exposure time
13.6.1 Cleaning the system

Use a commercial biocide, approved by your governing authority to clean
the surface of the system including the table, headholders and accessories.
Alternatively, you can also use a solution of bleach and water mixed
according to EPA guidelines:
• standard cleaning requires 500-615 ppm available chlorine
• cleaning large amounts of body fluid requires 5,000-6,150 ppm
available chlorine
Caution When cleaning the buttons and the inside of the Gantry opening, take care
to avoid leaking liquid inside.
Blood and contrast medium are health risks. Take appropriate health and
safety precautions when removing blood or residual contrast medium.
Caution Do not use detergents or organic solvents to clean the system. Strong
detergents, alcohol and organic cleaners may damage the finish and also
cause structural weakening.

Dose and imaging information 13.7
13.7 Dose and imaging information
13.7.1 Phantoms and measurement methods

• The phantom is solid acrylic.

• The diameter of head phantom is 16 cm.
• The diameter of body phantom is 32 cm.
• The distance between the centers of B1 and B4 is 10 cm below the
surface of the phantom at 90° intervals.

13.7.2 CTDI and dose analysis information for MX 4000 Dual

The table below displays sample parameters for dosage testing on the
MX 4000 Dual.
Voltage 120 kV
Slice Thickness 7 mm
Scan Time 1.5 s
mA 160 mA
View 250 mm
50mm
D 〈 z〉-
CTDI100 = ∫ ------------ dz
– 50mm N ×T
CTDIW = 1--- CTDI100 (center) + 2--- CTDI100 (peripheral)

3 3
The maximum deviation of the following CTDI value is ±20%.

The following tables show dosage value (CTDI) of the phantom in
different positions (120 kV, 160 mA, 1.5 S, 7 mm) under typical parameter
conditions. All measurements are in mGy.
CTDI100 B1 B2 B3 B4 B5 CTDIw
Head (FOV250) 31.344 28.32 28.784 28.54 26.63 28.38
Body (FOV350) 22.94 15.58 17.22 16.69 8.93 15.10
CTDI Normalization Head (FOV250) Body (FOV350)
10 mm 1.05 1.05
7 mm 1 1
1 mm 1.85 1.78
0.8 mm 1.62 1.62

3s 1.8 2.0
1.5 s 1 1
1s 0.75 0.53
0.8 s 0.73 0.51
200 mA 1.23 1.27
160 mA 1 1
30 mA 0.18 0.2
80 kV 0.25 0.27
120 kV 1 1
140 kV 1.50 1.52
Note Only one parameter can be modified each time. The configuration of other
parameters is typical value.

13.7.3 CTDI and dose analysis information for MX 6000 Dual

The table below displays sample parameters for dose testing on the
MX 6000 Dual.
Voltage 120 kV
Slice Thickness 7 mm
Scan Time 1.0 s
MA 240 mA
View 250 mm
The following tables show dosage value (CTDI) of the phantom in

different positions under typical parameter conditions (120 kV, 240 mA,
1.0s, 7 mm). All measurements are in mGy.
CTDI100 B1 B2 B3 B4 B5 CTDIw
Head (FOV250) 31.36 28.35 28.78 28.55 26.70 28.41
Body (FOV350) 22.97 15.58 17.23 16.96 8.94 15.10
10 mm 1.05 1.05
7 mm 1 1
1 mm 1.85 1.78
0.8 mm 1.62 1.62

3s 3.5 3.5
2s 2.1 2.3
1s 1 1
0.8 s 0.9 0.8
300 mA 1.23 1.2
240 mA 1 1
10 mA 0.04 0.05
80 kV 0.27 0.28
120 kV 1 1
140 kV 1.51 1.53
Note Only one parameter can be modified each time. The configuration of other
parameters is typical value.

13.7.4 Dose and sensitivity curves

10mm Slice

7mm Slice

0.8 mm Slice

13.7.5 Modulation transfer function (MTF)

(Same conditions as the noise testing)
If the MTF is 100% or 1.0, it means there is no signal loss. If the MTF is
0.0, it means there is no signal.
Actually, when MTF is between 0.05 and 0.02, objects with high contrast
and small aperture cannot be distinguished.
MX 4000 Dual MX 6000 Dual

13.7.6 Radiation protection

Only qualified personnel can evaluate shielding in the scan room. These
factors must be considered:
• device position
• scan workload
• materials of walls, floor, ceiling, doors and windows
The image below describes the radiation level in the process of scanning a
320 mm (Body Part) polyethylene phantom in the scanning room.
Scan Condition: 140 kV, 2*10mm, 600 mAs

Proportional Scale: 0.5m each lattice
Dosage Unit: uGy/600mAs

Philips Medical Systems is part of © Koninklijke Philips Electronics 2006
All rights are reserved. Reproduction or transmission in whole
Royal Philips Electronics or in part, in any form or by any means electronic, mechanical or
otherwise, is prohibited without the prior written consent of the
copyright owner.
www.medical.philips.com
medical@philips.com X197
This Medical Device meets the provisions of the transposition of
the Medical Device Directive 93/42/EEC within the country of
the origin of the Notified Body concerned with the device.
Manufacturing address
Philips and Neusoft Medical Systems Co. Ltd. 4535 673 83741 * 06/2006
110719 Shenyang
China
European representative address

Director of PMS Quality & Regulatory Affairs
Philips Medical Systems, Best NL
Building QM-056
Veenpluis 4-6
5680 DA Best
The Netherlands
Copyright address
Philips Medical Systems Nederland B.V.
Veenpluis 4-6
5684 PC Best
The Netherlands
Digitally signed by Rebecca Nemenz

DN: cn=Rebecca Nemenz, c=US, o=Philips
Medical Systems, ou=CT
Reason: I am approving this document
Date: 2006.07.06 11:17:18 -04'00'

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Instructions for Use

1 Introduction ..................................................................................... 1-1

1.1 About this guide ...................................................................................1-1

2.1 Important safety directions ...................................................................2-1

2.2 Emergency procedures ..........................................................................2-4

MX 4000 Dual/MX 6000 Dual - Volume 1 Contents i

3.1 Regulatory controls............................................................................... 3-2

4.1 Operating station.................................................................................. 4-2

5.1 Overview .............................................................................................. 5-1

6.1 Overview .............................................................................................. 6-1

ii Contents MX 4000 Dual/MX 6000 Dual - Volume 1

7.1 Service menu.........................................................................................7-2

8.1 Overview ..............................................................................................8-1

9 Image reconstruction ....................................................................... 9-1

9.1 Overview ..............................................................................................9-1

10.1 Common tools....................................................................................10-2

MX 4000 Dual/MX 6000 Dual - Volume 1 Contents iii

11.1 Overview ............................................................................................ 11-1

12.1 Overview ............................................................................................ 12-1

13.1 Overview ............................................................................................ 13-1

iv Contents MX 4000 Dual/MX 6000 Dual - Volume 1

The MX 4000 Dual and MX 6000 Dual CT systems are advanced

1.1 About this guide

Wa r n i n g Directions, which if not followed, could cause fatal or serious injury to an

MX 4000 Dual/MX 6000 Dual Introduction 1- 1

Note Highlight unusual points as an aid to an operator.

1 -2 Introduction MX 4000 Dual/MX 6000 Dual

1.2 Intended use

Note Equipment described in this manual is designed to be compatible with

MX 4000 Dual/MX 6000 Dual Introduction 1- 3

1 -4 Introduction MX 4000 Dual/MX 6000 Dual

The Maintenance schedule identifies the procedures and frequency of their

performance, which is necessary to ensure (continued) compliance with the

This symbol appears on components on your CT scanner system. It

MX 4000 Dual/MX 6000 Dual Introduction 1- 5

1.6 IEC-60601-1 classification

Type of protection against electric shock Class I equipment

Degree of protection against electric shock Type B equipment

Degree of protection against harmful Ordinary equipment

Possible interference with other equipment IEC 60601-1-2 Group 1 Class B

Mode of operation Continuous mode with

1.6.1 Electrical ratings

1 -6 Introduction MX 4000 Dual/MX 6000 Dual

If you require further information about training in the use of this

MX 4000 Dual/MX 6000 Dual Introduction 1- 7

2.1 Important safety directions

In particular, you must read, understand and know the Emergency

MX 4000 Dual/MX 6000 Dual Safety 2- 1

Wa r n i n g Operation of the equipment or system with improperly-operating or

For information about training, please refer to Training in the Introduction

2 -2 Safety MX 4000 Dual/MX 6000 Dual

Wa r n i n g Never attempt to remove, modify, over-ride or forcibly move any safety

Intended use of the CT system is described under the heading Intended

MX 4000 Dual/MX 6000 Dual Safety 2- 3

2.2 Emergency procedures

2.2.1 Emergency stop

2.2.2 Emergency patient release