Moonray User Manual - Rev.34 - 2020/01/22

MOONRAY User Manual - Rev.
34 - 2020/01/22
USER MANUAL
ISO 9001:2015 ISO 13485:2016
A Sago Medica Company

MOONRAY User Manual - Rev.34 - 2020/01/22
SIMAD srl reserves the right to modify both this user manual and the device herein described. Technical
specifications of the device are subect to modification without prior notice. No part of the content of this
“USER MANUAL” can be intended as an offer, a guarantee, a promise or contractual condition. All modifica-
tions will conform to updated norms and regulations that govern production of medical devices.
Images and drawings shown are for information purposes only
© Copyright SIMAD Srl 2020
No part of this publication may be reproduced, transmitted, copied, transcribed or stored in a retrieval sy-
stem and cannot be translated in any form or by any means or converted into a different electronic format
than the original for any purpose, without the written consent of SIMAD.
DOCUMENT code: moexxx_34_20200122
REVISIONS - MODIFICATIONS
rev date note signature
D. Rigotti
23 2011/11/10 Added display cleaning instructions – Page 181
E. Carnevale
Added paragraph “Data Backup” - Page 19
D. Rigotti
24 2011/12/14 Added residual risks notices at pages 46, 124, 125.
E. Carnevale
Added routine check “Check Injector piloting” - Page 179
25 2013/09/26 Updating table values of
tolerances G. Fogliani
26-30 Not edited G. Fogliani
31 2019/10/17 Major Updates G. Fogliani
32 2019/11/27 Update - note “Digital Radiography (optional)” page 58 G. Fogliani
Note added - optional mode in place of boost mode - page 62
33 2020/01/17 G. Fogliani
Update - list of icons - page 189
Note added in “Options - Accessories and Detachable Parts”
34 2020/01/22 Update - notes in “introduction” - “Maintenance” G. Fogliani
Updated label figure in “Labelling”
2 © Copyright SIMAD srl 2020

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 Contents
Contents
1 Overview
1.1 Information regarding this Manual ........................................................................................... 12
1.1.1 Manual Validity . .................................................................................................................................................. 12
1.2 Updates ..................................................................................................................................... 12
1.3 Alerts, Warnings and Information . ........................................................................................... 13
2 Introduction
2.1 The Moonray device and its versions ....................................................................................... 16
2.2 Intended use ............................................................................................................................. 18
2.3 Certifications . ........................................................................................................................... 19
2.4 Authorization of use . ................................................................................................................ 19
2.5 Training ..................................................................................................................................... 19
2.6 Authorization for Maintenance and/or Repairs ....................................................................... 20
2.7 Non-authorized modifications .................................................................................................. 20
2.8 Installation of external devices ............................................................................................... 20
2.9 Data Backup .............................................................................................................................. 20
2.10 Technical Assistance Contacts ................................................................................................. 21
2.11 Technical References . .............................................................................................................. 21
3 Safety
3.1 Electrical Safety . ...................................................................................................................... 25
3.1.1 Equipotential Connection . .................................................................................................................................. 25
3.2 Safe Transporting ...................................................................................................................... 25
3.3 Mechanical Safety .................................................................................................................... 25
3.4 Risk of Explosion ...................................................................................................................... 26
3.5 Fire Safety ................................................................................................................................. 26
3.6 Safety, in the presence of mobile phones and IT products . ..................................................... 26
3.7 Contact Risk of Electronic Parts with Conductive Liquids . ....................................................... 27
3.8 Electromagnetic Compatibility . ................................................................................................ 27
3.9 Risk of Exposure to Ionizing Radiation ..................................................................................... 27
3.9.1 List of personal protective apparatus and accessories . .................................................................................... 28
3.10 Laser Safety . ............................................................................................................................. 29
3.11 Network/Data Coupling and USB port ..................................................................................... 29
3.12 Emergency Shutdown Procedures ............................................................................................ 30
3.12.1 Dual VersionEmergency Shutdown Alternatives ................................................................................................ 30
© Copyright SIMAD srl 2020

Total pages: 218 Contents 3
Contents MOONRAY User Manual - Rev.34 - 2020/01/22
3.12.2 Compact / 500 VersionEmergency Shutdown Alternatives . ............................................................................... 31
4 Using the Moonray

4.1 Safety ........................................................................................................................................ 34
4.2 Transporting . ............................................................................................................................ 35
4.3 Transporting the device and movement of the mobile parts .................................................. 36
4.3.1 Grip Handles ........................................................................................................................................................ 38
4.3.2 Direction of Movement ...................................................................................................................................... 39
4.3.3 C-Arm and Workstation Cart Braking System .................................................................................................... 40
4.3.4 Wig-Wag Movement ........................................................................................................................................... 40
4.3.5 Rotational Movement .......................................................................................................................................... 41
4.3.6 Orbital Movement ............................................................................................................................................... 42
4.3.7 Longitudinal Slide Movement ............................................................................................................................. 42
4.3.8 Vertical Motorized Movement ........................................................................................................................... 43
4.3.9 Workstation Cart Movement .............................................................................................................................. 43
4.4 Start-up/ Shutdown ................................................................................................................. 44
4.4.1 Connecting the various units .............................................................................................................................. 44
4.4.2 Powering up the Device . ...................................................................................................................................... 47
4.4.3 Device Start-up ..................................................................................................................................................... 47
4.4.4 Shutting-Down . ................................................................................................................................................... 48
5 C-Arm Control and Command Console

5.1 Description . .............................................................................................................................. 50
5.1.1 X-Ray Commands . ............................................................................................................................................... 51
5.2 General Settings ........................................................................................................................ 52
5.3 X-Ray selection mode . ............................................................................................................ 61
5.3.1 Fluoroscopy .......................................................................................................................................................... 61
5.3.2 Cine/DSA . ............................................................................................................................................................ 64
5.3.3 Roadmap . ............................................................................................................................................................ 67
5.3.4 Typical Radiographic Values ................................................................................................................................ 68
5.3.5 Maximum Levels of Air Kerma Rate .................................................................................................................... 68
5.4 List of Warnings . ...................................................................................................................... 69
6 Software Guide
6.1 Organizing Information ............................................................................................................. 72
6.1.1 Series/Sequences ................................................................................................................................................ 72
6.1.2 Anonymous Series .............................................................................................................................................. 72
6.1.3 Locked/Unlocked Series ...................................................................................................................................... 73
6.1.4 Work Planning ..................................................................................................................................................... 73
6.1.5 Apply/Remove a Search Filter .............................................................................................................................. 74
6.1.6 Eliminating a Series/Sequence ............................................................................................................................. 74
6.1.7 Recuperating a Series/ Sequence . ...................................................................................................................... 75
4 Contents
Total pages: 218
6.1.8 Sequence Catalogue of an Exam in Progress ..................................................................................................... 75

6.2 Input Peripherals . ..................................................................................................................... 76
6.3 Editing Data in a Field ............................................................................................................... 77
6.4 Organizing Views . ..................................................................................................................... 78
6.4.1 Monitor “A” View ................................................................................................................................................ 79
6.4.2 “Monitor B” View ................................................................................................................................................ 82
6.4.3 View Commands - Image Interaction Commands . ............................................................................................. 83
6.4.4 “Patient Data” View . ........................................................................................................................................... 84
6.4.5 Database - “View” ............................................................................................................................................... 85
6.4.6 Database - “Exams” ............................................................................................................................................ 86
6.4.7 Database - “Scheduled” ...................................................................................................................................... 91
6.4.8 Database – “Recycle bin” .................................................................................................................................... 92
6.4.9 Print Composer . .................................................................................................................................................. 94
6.4.10 “Clipboard” View ................................................................................................................................................. 94
6.5 Sequence Acquisition . .............................................................................................................. 95
6.5.1 Types of Fluoroscopy ........................................................................................................................................... 95
6.5.2 Work Modes ........................................................................................................................................................ 96
6.5.3 Recursive Filter .................................................................................................................................................... 97
6.5.4 Horizontal and Vertical Image Flipping ............................................................................................................... 97
6.5.5 Brightness and Contrast Setting .......................................................................................................................... 98
6.5.6 Black/White Inversion ......................................................................................................................................... 98
6.5.7 Image Clipboard . ................................................................................................................................................ 99
6.5.8 Video Marking ................................................................................................................................................... 100
6.5.9 Measuring Toolkit .............................................................................................................................................. 104
6.5.10 Saving Images .................................................................................................................................................... 109
6.5.11 Angular Position of the camera . ....................................................................................................................... 110
6.5.12 Collimator Position Thumbnail .......................................................................................................................... 110
6.5.13 Digital Subtraction . ........................................................................................................................................... 111
6.5.14 Mask Catalogue ................................................................................................................................................. 112
6.5.15 Subtraction Settings .......................................................................................................................................... 112
6.5.16 Recording Speed . ............................................................................................................................................... 114
6.6 Generating images ................................................................................................................. 115
6.7 Fluoroscopy . ........................................................................................................................... 116
6.8 DSA . ........................................................................................................................................ 117
6.9 Roadmap ................................................................................................................................. 118
6.10 Cine ......................................................................................................................................... 119
6.11 Indicators, Alerts & Error Messages ....................................................................................... 120
6.11.1 Indicators . ......................................................................................................................................................... 120
6.11.2 Alert/Error Messages ........................................................................................................................................ 121
6.12 UPS (Uninterruptible Power Source – Optional) ..................................................................... 123
6.13 Print Composer ....................................................................................................................... 126
6.13.1 Print Composer Description .............................................................................................................................. 126
6.13.2 Print Composer Settings .................................................................................................................................... 127
6.13.3 Print Composer Commands .............................................................................................................................. 128
6.13.4 Impagination . .................................................................................................................................................... 129

6.14 DICOM Print Composer . ......................................................................................................... 130

6.14.1 DICOM Print Composer Description ................................................................................................................. 130
6.14.2 DICOM Print Composer Settings ....................................................................................................................... 131
6.14.3 DICOM Print Composer Commands .................................................................................................................. 132
6.14.4 DICOM Impagination ......................................................................................................................................... 133
6.14.5 Print Composer DICOM Log .............................................................................................................................. 134
6.14.6 DICOM Remote Server Configuration ............................................................................................................... 134
6.15 DICOM Work List . ................................................................................................................... 135
6.15.1 DICOM Worklist Description ............................................................................................................................. 135
6.15.2 DICOM Worklist Search Criteria ........................................................................................................................ 136
6.15.3 DICOM Worklist Interface Commands .............................................................................................................. 137
6.15.4 DICOM Worklist – Import Patient Data . ........................................................................................................... 137
6.15.5 DICOM Worklist Log .......................................................................................................................................... 138
6.15.6 DICOM Worklist – Configuring Remote Servers . ............................................................................................. 138
6.16 Query Retrieve ........................................................................................................................ 138
6.16.1 QR Description . ................................................................................................................................................ 138
6.16.2 QR from Remote Servers . ................................................................................................................................. 140
6.16.3 QR Interface Commands .................................................................................................................................... 141
6.16.4 QR Server Selection Administration .................................................................................................................. 142
6.16.5 QR Remote Server Configuration ....................................................................................................................... 142
6.17 Exporting . .............................................................................................................................. 143
6.17.1 Export Description . ........................................................................................................................................... 143
6.17.2 Selecting Export Format . .................................................................................................................................. 144
6.17.3 Export Destination Selection . .......................................................................................................................... 145
6.17.4 Exporting Commands ........................................................................................................................................ 146
6.17.5 Export Command Settings . ............................................................................................................................... 146
6.17.6 Exporting – Sequence List View ......................................................................................................................... 147
6.17.7 Editing the group of sequences-series to be exported ..................................................................................... 147
6.17.8 Export to a LAN network .................................................................................................................................. 148
6.17.9 Export to DVD or CD .......................................................................................................................................... 148
6.18 Importing ................................................................................................................................ 149
6.18.1 Import Description ............................................................................................................................................ 149
6.18.2 Import Commands . ........................................................................................................................................... 150
6.18.3 Import Command Settings ................................................................................................................................ 151
6.18.4 Importing a Series ............................................................................................................................................. 151
6.19 DAP Report ............................................................................................................................. 153
6.19.1 Printing a DAP Report . ...................................................................................................................................... 154
6.19.2 Saving a DAP Report as an Image ...................................................................................................................... 155
6.19.3 Exporting DAP details ........................................................................................................................................ 156
6.20 Customizing . .......................................................................................................................... 157
6.21 STATLAB data export (plug-in DbExporter) ............................................................................. 158
6.21.1 Description ........................................................................................................................................................ 158
6.21.2 Use ..................................................................................................................................................................... 158
7 Guide to the use of the Accessories
6 Contents
Total pages: 218
7.1 Sterile Drapes . ........................................................................................................................ 160

7.2 Film Cassette Holders . ............................................................................................................ 160
7.3 Infrared Remote Control ......................................................................................................... 161
8 Troubleshooting
8.1 Proposed solutions ................................................................................................................. 164
9 Maintenance
9.1 Introduction ............................................................................................................................ 166
9.2 Scheduled Maintenance ......................................................................................................... 166
9.2.1 Scheduled Maintenance for motorized version . ............................................................................................. 167
9.3 Routine Check by User ............................................................................................................ 167
9.4 Cleaning & Disinfection ........................................................................................................... 169
9.4.1 Cleaning ............................................................................................................................................................. 169
9.4.2 Disinfection . ...................................................................................................................................................... 169
9.5 Cleaning and disinfection the motorization console .............................................................. 170
9.6 Cleaning the motorization console cable ................................................................................ 170
9.6.1 Printer ................................................................................................................................................................. 170
10 Recycling the Device

10.1 Introduction ............................................................................................................................ 172
10.2 Transferring the Device .......................................................................................................... 172
10.3 Recycling ................................................................................................................................. 172
10.4 Batteries .................................................................................................................................. 173
10.4.1 Remote Control .................................................................................................................................................. 173
10.4.2 Laser ................................................................................................................................................................... 173
10.4.3 UPS . .................................................................................................................................................................... 173
11 Technical Data
11.1 Functionality - Ambient Conditions ....................................................................................... 176
11.2 Power Supply .......................................................................................................................... 176
11.3 Generator . .............................................................................................................................. 176
11.4 Maximum Ratings .................................................................................................................. 176
11.5 Radiation Leakage Factors ...................................................................................................... 178
11.6 Grid ......................................................................................................................................... 178
11.7 Options - Accessories and Detachable Parts . ......................................................................... 179
11.8 X-Ray Scattering ...................................................................................................................... 180
11.9 Interventional Reference Point ............................................................................................... 181
11.10 Leakage radiation . .................................................................................................................. 183
11.11 Labeling .................................................................................................................................. 184

11.11.1 Labels position . ................................................................................................................................................. 185
12 List of Icons/Console Commands

12.1 List of icons ............................................................................................................................. 188
13 Motorized Version
13.1 Specific warnings .................................................................................................................... 192
14 THE MOTORIZATION CONSOLE

14.1 Description and connections .................................................................................................. 194
14.2 LCD Display . ............................................................................................................................ 195
14.3 “Menu” Key . ........................................................................................................................... 196
14.4 “Zero” Key ............................................................................................................................... 196
14.5 “Go To” Key ............................................................................................................................. 197
14.6 “Save” Key . ............................................................................................................................. 197
14.7 Numeric keyboard: . ................................................................................................................ 198
14.8 Cursor Keyboard ..................................................................................................................... 198
14.9 Quick Recall Memory Keys . .................................................................................................... 199
14.9.1 Saving a C-Arm position in the Quick Recall Memory Keys ............................................................................. 199
14.9.2 Recalling a position from the Quick Recall Memory Keys . .............................................................................. 199
14.10 Isocentric Function Keys ......................................................................................................... 200
14.11 Joysticks .................................................................................................................................. 201
14.11.1 Using the joysticks ............................................................................................................................................. 201
14.11.2 Movement Commands ...................................................................................................................................... 201
14.12 Arresting movement ............................................................................................................... 202
14.13 Re-Setting the Emergency Stop Button .................................................................................. 202
14.14 Arrest due to overcurrent ....................................................................................................... 202
14.15 Luminous Signal Lights ............................................................................................................ 203
14.15.1 Power . ............................................................................................................................................................... 203
14.15.2 Ongoing Communication . ................................................................................................................................. 203
14.15.3 Error ................................................................................................................................................................... 203
15 MENU ITEMS
15.1 Accessing Menu Items ............................................................................................................ 206
15.2 Save . ....................................................................................................................................... 206
15.3 Memory Recall ........................................................................................................................ 207
15.4 Manual Positioning ................................................................................................................. 207
15.5 Select Language ...................................................................................................................... 208
16 ISOCENTRIC FUNCTION
8 Contents
Total pages: 218
16.1 Definition of the Isocentric Feature ....................................................................................... 210

16.2 The Isocenter Mode ............................................................................................................... 210
16.2.1 Configuration procedure to activate the Isocenter Mode . .............................................................................. 210
16.2.2 Utilizing a previously acquired isocenter configuration ................................................................................... 211
16.3 Important aspects regarding the Isocenter Function of the Moonray Precisio ...................... 212
17 Monitor console touch screen

17.1 Activating the C arm control console ...................................................................................... 214
17.2 Views organization . ................................................................................................................ 215

10 Contents
Total pages: 218
1 Overview
1
A Sago Medica Company MOONRAY User Manual - Rev.34 - 2020/01/22

1 Overview MOONRAY User Manual - Rev.34 - 2020/01/22
1.1 Information regarding this Manual

This manual was written to help users and operators in the safe and effi-
cient use of the device.
Before turning on the device read and scrupulously keep in mind all the
WARNINGS of DANGER, SAFETY and the NOTES enclosed. Pay particular
attention to all the information supplied and the procedures described in
the SAFETY chapter.
1.1.1 Manual Validity

This manual is applicable to the Moonray Systems from 08 series and for
Moonray with digital detector from 20 and 30 series.
1.2 Updates
Changes to the functions of the system are possible after the publication of
this manual, therefore operators must consult the “Updates” chapter found
in the addendum if present. If there are no diverse indications, the functions
of the system must be utilized according to the indications in this manual.
12 Information regarding this Manual

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 1 Overview
1.3 Alerts, Warnings and Information

The following graphic symbols are used in this manual to signal particular
attention to the user:
“WARNING”: If these warnings are not taken into consideration, mortal or

serious injury could be caused to the operator, the patient or other people
or could result in an incorrect diagnosis.
“ATTENTION”: If these indications are not taken into consideration, dama-

ges to the device or to other apparatus or environmental pollution could
be caused. In such cases SIMAD does not guarantee the perfect functiona-
lity of the devise.
Ch.
“NOTE”: Informs the operator to pay special attention to certain conditions
or settings in order to avoid malfunctions and to help avoid problems. 1

Total pages: 218 Alerts, Warnings and Information 13
1 Overview MOONRAY User Manual - Rev.34 - 2020/01/22
14 Alerts, Warnings and Information

Total pages: 218
2 Introduction
2

2 Introduction MOONRAY User Manual - Rev.34 - 2020/01/22
2.1 The Moonray device and its versions

The portable digital fluoroscopy Moonray is an advanced high definition
device for the acquisition, processing, management and evaluation of fluo-
roscopic images.
DUAL Version
Which is composed of a Workstation and a mobile “C” arm unit.
Figure 1: Moonray System examples
16 The Moonray device and its versions

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 2 Introduction
Compact Version
A sole Compact device with an integrated workstation.
Ch.
Figure 2: Moonray System Compact version examples 2
500 Version
Figure 2bis: Moonray System 500 version examples
The different versions available allow to satisfy the particular requests for
diagnostic procedures.

Total pages: 218 The Moonray device and its versions 17
2.2 Intended use

The device is meant to be installed and used only in conformity with the
safety procedures and the instructions of use given in this manual and for
the aims for which it was designed, that is, as a radiological support to cli-
nical and diagnostic procedures. Anything declared in this manual does not
limit the responsibility of the operators regarding clinical judgment or in the
choice of the best clinical procedures.
The device can be used to carry out long-lasting interventional procedures
under radiological monitoring, including those in which there is a risk of skin
dose levels so high as to cause deterministic effects (CEI EN 60601-2-43 -
§6.8.3 a).
The skin dose level indication is obtained by processing data from an ioniza-
tion chamber (CEI EN 60601-1-3 - §5.2.4.3).
18 Intended use

Total pages: 218
2.3 Certifications
SIMAD adheres to national and international laws and norms and to the
EMC standards for these types of devices. These norms and standards
define the admissible electromagnetic levels by the device and the relative
immunity to electromagnetic interference from external sources. For details
and for the declaration of conformity please contact SIMAD.
The Moonray Systems are compliant to IEC 60601-1:2005/A1:2012 and is
classified as a Class I type B (electrical).
The Moonray Systems are compliant to 93/42/CEE directives and subse-
quent modifications and is classified as a Risk Class II b (active device desti-
ned to emit ionizing radiation).
According to the 2007/47 EEC directives, SIMAD guarantees that the devices
is not manufactured utilising tissues of animal and human origin.
Ch.
2
2.4 Authorization of use
The installation and use of these devices are subject to the national laws
of the country in which it is installed and to which the users/operators are
obligated to adhere.
The use of the device for other aims other than those expressly declared by
the manufacturer as well as its wrongful use, can release the manufactu-
rer (or his agent) of all or part of the responsibility due to non-conformity,
damages or injury resulting from improper use. The radiological system
must be exclusively used by qualified personnel for the use of radiological
apparatus, as per the national norms in force.
SIMAD declines responsibility tied to the malfunction of the Moonray
Systems and any possible damages caused to people or things derived from
the use by non-qualified personnel.
2.5 Training
Personnel must receive sufficient training on safety and use before activa-
ting the device as described in this manual. Training requirements for this
type of device vary from country to country. The operators must receive
training in accordance with the laws and norms of binding character.
SIMAD can supply necessary training for the correct use of the device and
can supply the relative informative material upon request.

Total pages: 218 Training 19
2.6 Authorization for Maintenance and/or

Repairs
All maintenance and/or repair must be exclusively carried out by qualified
personnel specialized in maintenance or repair of radiological apparatus, in
accordance with the national norms in force.
SIMAD declines responsibility tied to the malfunction of the device resulting
from the use of non-authorized or non-original spare parts.
2.7 Non-authorized modifications

Modifications of any kind are not permitted on the device unless authori-
zed in writing by SIMAD. In cases of non-authorized modifications, SIMAD
declines responsibility of malfunctions and any possible damages caused to
people or things.
2.8 Installation of external devices

Only external devices exclusively authorized by SIMAD can be installed. Con-
tact SIMAD directly for compatibilities. Changes and/or add-ons must satisfy
all the laws and regulations applicable and in force in the country in which
the device is installed.
In case of non-authorized installations of external devices, SIMAD declines
responsibility of malfunctions and any possible damages caused to people
or things.
Changes and/or add-ons to the device, which are carried out by personnel
without the proper specified training and/or the use of non-authorized
spare parts will result in the suspension of the guarantee.
Pay special attention to the information given in the external device ma-
nuals.
2.9 Data Backup

It’s your responsibility to make a backup of data stored in Moonray in order
to have a security copy external to Moonray itself. In particular, we re-
commend making a copy of the exams procedures data (data, pictures and
videos)
20 Authorization for Maintenance and/or Repairs

Total pages: 218
2.10 Technical Assistance Contacts

In case of malfunction of the device, contact the following telephone or fax
numbers or call our technical assistance service directly.
SIMAD Srl
Tel: + 39 051 686 08 11
Fax: +39 051 686 12 46
2.11 Technical References

Ch.
For all specifications and technical functions not expressly indicated in this
manual contact SIMAD’S technical assistance numbers.
2

Total pages: 218 Technical References 21
22 Technical Assistance Contacts

Total pages: 218
3 Safety
This chapter supplies indications relative to the precautions to adopt in the
course of use, during maintenance and the safety features of the device.
This chapter must be read and understood in order to guarantee knowledge
3
of the risks involved in the use of this device. It is also important to scru-
pulously adhere to the notices of DANGER, WARNING and SAFETY that are
present in this manual in order to guarantee the safety of the patient and
personnel.
You must pay particular attention and read, understand and become fami-
liar with the emergency procedures described in this first section, before
using the device.

3 Safety MOONRAY User Manual - Rev.34 - 2020/01/22
Maintenance & Defects: do not use the Moonray Systems for applications
until the internal auto-check procedure has terminated and the main-
tenance program has been updated. If a part of the device should be
defective or not correctly repaired, do not use it until the repair has been
terminated. Using the device with defects or with repairs that have not
been carried out correctly can expose the operators and the patient to
danger (injuries, death or wrong diagnosis/treatments).
Get to know the safety features: do not use the Moonray Systems until
you have read and understood and become familiar with all the safety
information, safety and emergency procedures contained in this section.
Use, without adequate knowledge can result in injury/death or in incorrect
diagnosis/treatments.
Adequate Training: do not use the Moonray Systems for applications until
you have received adequate and sufficient training relative to the safe and
efficient operation of the device. If you are not sure of your capabilities in
the use of the device DO NOT USE IT. Operating the device without ade-
quate training can result in injury/death or incorrect diagnosis/treatments.
External Connections: Make sure the device is not connected to any type of
information network during use on a patient. Connect to networks only for
post-processing or to execute a backup.
Safety Mechanisms: do not try to remove, edit or exclude the safety me-
chanisms, it can result in injury or death.
Use & Compatibility: do not use the Moonray Systems for other than what
it was intended.
Do not use the Image Intensifier grid as a workbench or as a shelf for
objects or to place anatomical parts of the patient.
Use products recognized as compatible by SIMAD. Operation and uses
other than those intended or with incompatible devices can cause injury/
death or incorrect diagnosis/treatment.
Residual risks
SIMAD has taken the necessary actions to reduce risks tied to the use of the
device; however risks cannot be eliminated totally. Following, you will find
warnings to inform the operators of possible risks.
The accidental activation of the mushroom-head emergency stop button

causes the radiological section to shut down with consequent interruption
of the procedure in progress and the need to switch the C-arm back on.
The homologated version 60601-2-43 has a non-projecting push-button
to avoid this. Restarting the system and its functionality needs Microsoft
Windows Reeboting time
The total shutdown of the device is possible following the accidental acti-
vation of the general switch, in fuse failure, in variations of power or other
abnormalities in the power supply. When rebooting, you must wait for the
operating system to restart and in some cases it might not be possible to
resume the procedure in progress. Consult internal regulations to determi-
ne the necessity of a backup device to use in case of emergencies.

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 3 Safety
3.1 Electrical Safety
Do not remove cover or wires from the device if not indicated in this
manual. High voltage is present and failure to comply can cause injury or
death. Only qualified and authorized personnel can remove the cover and
wires.
Use the device only in places and areas that satisfy the requirements called
for by laws for this type of device.
Always unplug the device from the power panel when cleaning and disin-
fecting.
3.1.1 Equipotential Connection

The device must be used only in areas that comply with the electrical
Ch.
safety requirements for medical device (IEC 60601).
The device is equipped with an earthing point and earthing wire.
3
3.2 Safe Transporting

When the device is transported or moved, avoid bumping objects or people.
The operator must be familiar with the braking and steering system of the
device.
If the device needs to be transported to a place that is not relatively near,
it should be moved in the most compact position possible: vertical column
down to its travel limit, horizontal arm completely retracted, C-arm in a
vertical position.
Cross ramps, go down stairs or around obstacles as slowly as possible. Pay

particular attention to steep inclines. The device must always have the
brake on when not in movement.
3.3 Mechanical Safety
Only qualified and authorized personnel can remove the protective covers
and all other covers.

Total pages: 218 Mechanical Safety 25
3.4 Risk of Explosion

The use of the device in the presence of inflammable gases (anesthetics
or others) can cause explosions or fire, therefore turn off the device when
using such gases.
Inflammable or potentially explosive disinfectant sprays must not be used

because the residual vapor can catch fire and cause injury/death to people
or damages to the device itself.
3.5 Fire Safety

The use of electrical material, in an area for which it was not designed, can
cause fire or explosion. Fire prevention requirements must be applied, ob-
served and enforced. Fire extinguishers must be supplied both for electrical
and non-electrical fires. All operators must be thoroughly informed and
trained in the use of fire extinguishers and fire fighting materials.
Use only specific extinguishers for electrical equipment. Using water or

other liquids on electrical equipment can cause injury/death.
If liquids must be used, isolate the device beforehand to avoid electrical

shocks.
3.6 Safety, in the presence of mobile

phones and IT products
The Moonray Systems satisfies the EMC standards. Some apparatus (i.e.
mobile phones) exceed in the defined limits of the EMC standards and, in
particular conditions can alter the device’s functions.
Do not allow the use of radio devices in the area allocated for the Moonray
Systems even if they are turned off. If their emissions go above the EMC
standards, malfunctions and in severe cases injury/death or incorrect
diagnosis can occur.
26 Risk of Explosion

Total pages: 218
3.7 Contact Risk of Electronic Parts with

Conductive Liquids
If the electrical or electronic parts should come into contact with conducti-
ve liquids (detergents or similar) short circuits or fire can occur. Avoid using
liquids than could infiltrate inside the device: to clean, use only damp cloths
that do not release liquids. In cases of infiltration of liquids, wait till they
have completely evaporated before applying power to the device.
3.8 Electromagnetic Compatibility

The Moonray Systems satisfies the EMC standards. The electromagnetic Ch.
interference (irradiated or conducted) does not exceed the allowed levels
and the device is also resistant to interferences from other apparatus that
3
remain under these levels.
All surrounding apparatus must adhere to EMC standards. Contrarily, in-

terferences to the correct function of the device can occur and in extreme
cases, can be the source of injury/death and incorrect diagnosis.
3.9 Risk of Exposure to Ionizing Radiation

The Moonray Systems produces Ionizing radiation: adopt the necessary me-
asures included in the norms in force so as to guarantee efficient radiopro-
tection to the people exposed.
The device can be destined for exams in which the skin dose level can
be elevated, in normal use, enough to constitute the risk of deterministic
effects (CEI EN 60601-2-43 - § 6.8.2 aa).
The correct use of the exposure mode allows the reduction of said risk. (CEI
EN 60601-2-43 - § 6.8.2 a).
X rays are potentially dangerous. Precautions must always be taken and
particular attention must be posed in the following cases:
• Protection of embryos or fetuses during exams
• Sensitive parts of the body (eyes, endocrine glands, etc.)
• Acute burns of the skin (patients)
• Continuous radiation exposure (staff).
During use, the skin/focal spot spacer, supplied with the device, must be
mounted. The spacer maintains the minimum distance of 20 centimeters
between the focal spot and the patient’s skin.

Total pages: 218 Risk of Exposure to Ionizing Radiation 27
Increasing the distance between the patient and the II (Image Intensifier)
obtains less visual field, less definition of the images and major skin doses.
Diffused radiation results to be higher as opposed to the correct position
(CEI EN 60601-1-3 9.2).
Higher doses than expected can occur due to objects that are found
between the X-Ray and the patient, for example the operating table. See
device documentation to discover the attenuation equivalent (CEI EN
60601-1-10.2)
Only qualified and authorized personnel can operate this device. Personnel
who operate the device and personnel in the workplace must observe all
the laws and regulations in force in the country in which they are found. If in
doubt do not use the device. Users are invited to follow the current recom-
mendations of the International Commission of Radiology and the United
States National Council on Radiation Protection and Measurements.
Do not alter the safety mechanisms present; in particular, be sure that

when the device is not utilized it is locked and that X-Rays cannot be emit-
ted accidentally.
Utilize only the necessary doses for each treatment or specific exam. Guide-
lines for radiation:
• Produce rays only if necessary and for the least amount of time possible.
• Use the pulsating rays technique and, when possible, use the automatic
exposure control.
• Stay as far away as possible from the X-Ray source and from the subject
it hits.
• Wear personal protective apparatus and a dosimeter to detect the
absorbed values.
• Use the iris collimator (beam reduction)
• Keep the focal point as far away as possible (at least 200 mm) to reduce
the absorbed dose as much as possible.
• Eliminate all objects along the beam and place the source of the X-Rays
under the table to reduce scattering.
3.9.1 List of personal protective apparatus and ac-

cessories
During use of the Moonray system, it is necessary for the operators to pro-
tect themselves by using protective clothing indicated in the national norms
in force for X-Ray protection.
Particularly, we recommend the protection of the body with the use of a le-
aded apron, protection of the thyroid with the use of a leaded thyroid collar
and protection of the eyes with the use of adequate protective glasses.
We furthermore recommend protective leaded gloves for the protection of
the operator’s arms, which find themselves in close proximity of the princi-
pal beam.
We recommend, when possible, the use of protective panels positioned
appropriately. (CEI EN 60601-2-43 - § 6.8.2 dd)
28 Risk of Exposure to Ionizing Radiation

Total pages: 218
3.10 Laser Safety

The SIMAD laser-centering device, if mounted, must only be utilized in the
presence of qualified personnel who are aware of the dangers included in
the use of a laser beam. The user has the responsibility to respect the laws
and norms in force regarding such use. Consult the relative manual of the
installed laser for further information on safety.
3.11 Network/Data Coupling and USB port

The Moonray Systems can be connected to other apparatus through a net-
work outlet. SIMAD cannot guarantee the quality of the connection and its Ch.
response to the norms of the apparatus connected.
3
Do not connect to a LAN network during use of the device on a patient.
Make sure that the information network to which the Moonray will be
connected is safe and FREE OF INFORMATION VIRUSES, contrarily, the
Moonray Systems could lock and the computer configurations and data
contained in the hard disk could be altered.
Connection to other apparatus could cause unforeseen unidentifiable risks
to patients, operators or third parties. Modifications to the network con-
figurations, the connection, disconnection or updates of other connected
apparatus, can introduce new and non-preventable risks.
The person in charge of managing the information network must evaluate
all connections in order to identify, evaluate and check the risks that could
occur.
Any changes to the network (configurations, added devices, disconnection
of devices, updates and upgrades) could introduce new risks.
The USB connection to the computer is reserved for use by technicians for
maintenance purposes.
Do not connect devices to the USB port of the Moonray during use of the
device on patients.

Total pages: 218 Network/Data Coupling and USB port 29
3.12 Emergency Shutdown Procedures
3.12.1 Dual Version

Emergency Shutdown Alternatives
C-Arm Shutdown
Option A Press the red Emergency Stop Button
or:
Option B
Turn the key towards the OFF position
When a part of the device is not shutdown, electrical power is present in parts of the
circuits until total shutdown and until the plug is removed from the power panel. If
a UPS (uninterruptible power source) is present (limited to the Moonray Dual ver-
sion) the Workstation has sufficient power only to guarantee switching off the PC.
Total shutdown
Option C Workstation monitor cart magneto thermal circuit breaker set to 0
or:
Option D Remove plug from the power panel
D
B
60601-2-43
Non-Projecting Version
30 Emergency Shutdown Procedures © Copyright SIMAD srl 2020

Total pages: 218
3.12.2 Compact / 500 Version

Emergency Shutdown Alternatives
C-Arm Shutdown
Option A
Turn the key towards the OFF position
When a part of the device is not shutdown, electrical power is present in

parts of the circuits until total shutdown and until the plug is removed
from the power panel.
Total shutdown
Set to 0 the magneto thermal circuit breaker located on fuses
Ch.
Option B
panel
3
or:
Option C Remove plug from the power panel

Total pages: 218 Emergency Shutdown Procedures 31
32 Emergency Shutdown Procedures © Copyright SIMAD srl 2020

Total pages: 218
4 Using the
Moonray
4
.

4 Using the Moonray MOONRAY User Manual - Rev.34 - 2020/01/22
4.1 Safety
The operator must learn and become familiar with the information and the
emergency procedures indicated in the relative safety chapter.
Safety: do not use the Moonray Systems without having first read and un-
derstood the information on safety and emergency procedures indicated.
Use without having first become familiar with the safety and emergency
procedures can cause injury/death or incorrect diagnosis.
Maintenance: use the Moonray Systems after having carried out the equip-
ment check procedure making sure that maintenance has been completed.
If the user finds defects DO NOT USE the device until it has been repaired.
Using the device in these cases can expose the user and the patient to
radiation and other dangers. For information regarding maintenance see
relative chapter.
Knowledge by the operator: become familiar with the Moonray Systems
before using.
34 Safety © Copyright SIMAD srl 2020

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 4 Using the Moonray
4.2 Transporting
The device has a limited grade of stability. Comply with the indications
relative to transport and movement.
1 Lower the C-Arm completely

through the use of the motori-
zed vertical movement feature.
2 Retract the horizontal support
arm of the C-Arm completely.
3 Bring the C-Arm to a vertical
position with the Image Intensi-
fier on top. Ch.
4 Bring the wig–wag movement
of the C-Arm to the central
4
position.
5 Place the command console in
a central position and retract it
completely.
• Lock the brake levers.
• Unhook the power cable
and the connecting cable
between the C-Arm and the
Workstation if present.
• Turn the device off.
Only if the device has met all
these conditions will it be perfectly stable and ready for transport.
During transport, wheels must be kept in a straight position (steering whe-

el in the central position).
To move, grip the handles B positioned on the sides of the control panel.
To brake or release the base of the C-Arm push the pedal.
Before transporting the workstation cart make sure that the wheels are all
locked in the same direction.

Total pages: 218 Transporting 35
4.3 Transporting the device and

movement of the mobile parts
Following is an illustration of the transport modes of the device and the
movements of the various parts with relative locking commands.
A – Attention Points – C-Arm
Figure A – The areas which present a risk of entrapment are numbered. See
the following paragraphs for detailed description.
Pay particular attention to points number 10 (pedal hook), danger of finger

injury, 11 (swiveling sheathing encasement, danger of finger injury) and 17
(C-Arm cable connector, pinching or crushing danger).
36 Transporting the device and movement of the mobile parts

Total pages: 218
Ch.
4
B – Attention Points – Workstation Cart
Figure B – The areas that present an entrapment risk are numbered. See the
following paragraphs for detailed description.

Total pages: 218 Transporting the device and movement of the mobile parts 37
4.3.1 Grip Handles

To move the C-Arm Base, grip the handles on the sides of the control panel
and move the device where desired. The handles come in either white or
yellow depending on the version of the device.
Figure 3: Grip Handles
Grip the device using only the handles and pay attention to points number
1 and 2 indicated in Figure A so as to avoid harming hands or arms.
To move the Workstation Cart grip the handles on the sides as per the C-
Arm. The handles come in either white or yellow depending on the version
of the device.
Pay attention to the movement of the cart in the presence of uneven

flooring and pay particular attention to steps or uneven areas such as lift
or elevator entrances. Don’t try to pass these uneven areas by pushing or
getting a running start but get help and slightly lift the cart to help it get
over the obstacle.
The weight of the monitors and their positions can make the cart instable
if pushed at a high speed against a step or an uneven area.
Grip the device only using the handles and pay attention to point n. 1 indi-
cated in Figure B to keep hands and arms from getting caught.

Total pages: 218
4.3.2 Direction of Movement

The device is equipped with double front swivel caster wheels. This system
permits the front wheels to orient themselves in the direction the user desi-
res by simply steering it with the back handlebar.
The device is also equipped with a parallel orientation system of the back
wheels. This system is activated with a command placed on the top part of
the C-Arm. Orienting the back wheels, the C-Arm can be moved in a sole
direction and repositioned in the preceding point, which makes it very use-
ful for moving in and out of the operating area. Contrarily, it is not a good
idea to use the handle for longer transports (from one operating theatre to
another).
Ch.
4
Figure 4: Steering wheel
During movement of the C-Arm and the workstation cart, do not pull but
push it forward. Keep feet away from the bottom of the device while it is
moving, see points 4 in Figures A and B.
Warning – Danger of getting hands and wrists caught in the steering wheel
(point 5 in Figure A)

4.3.3 C-Arm and Workstation Cart Braking System

To lock the C-Arm push down the right pedal, push down left pedal to rele-
ase.
Figure 5: Pedal Brake
Warning, do not insert foot between the two pedals when the C-Arm is in a
locked position.
To lock/release the workstation cart, use the brake commands integrated

into two out or four wheels.
4.3.4 Wig-Wag Movement

Release the corresponding brake by turning the command anti-clockwise.
Move the C-Arm to the desired position.
To lock the corresponding brake, turn the command clockwise.
Figure 6: Wig Wag Movement

Total pages: 218
4.3.5 Rotational Movement

Release the corresponding brake turning the command towards the “open
padlock” symbol.
Move the C-Arm to the desired position using the graduated scale found on
the front of the horizontal arm if necessary.
To release the corresponding brake, turn the command towards the “closed
padlock” symbol.
Ch.
4
Figure 7: Rotational Movement Handles
Do not rotate over +/- 360°, going over this limit can cause damages to the
cable and malfunction to the device.
Danger of getting parts of the body caught or crushed while carrying out
the movement. Pay particular attention to fingers, hands, feet, arms and
head. See figure A at points 12 (fingers) and 13 (hands, arms), 14 (arms,
wrists), 15 (body, head), 16 (fingers, hands) and 18 (feet).

4.3.6 Orbital Movement

Release the corresponding brake by turning the command towards the
“open padlock”.
Move the C-Arm to the desired position using the graduated scale found on
the back of the C-arm if necessary.
To lock the corresponding brake, turn the command towards the “closed
padlock” symbol clockwise.
Figure 8: Orbital Movement Handle
the orbital movement. Pay particular attention to fingers, hands, feet,
arms and head. See figure A at points 12 (fingers) and 13 (hands, arms), 14
(arms, wrists), 15 (body, head), 16 (fingers, hands) and 18 (feet).
4.3.7 Longitudinal Slide Movement

Release the corresponding brake turning the command clockwise, towards
the “open padlock”.
Figure 9: Longitudinal Slide Movement Handle
Move the support bracket horizontally to the desired position using the
graduated scale found on the side of the bracket itself if necessary.
To lock the corresponding brake, turn the command towards the “closed
padlock” symbol anti-clockwise.
the longitudinal slide movement. Pay particular attention to fingers, hands
and arms. See figure A at points 7 (hands, wrists) and 8 and 9 (fingers).

Total pages: 218
4.3.8 Vertical Motorized Movement

The vertical movement of the C-Arm is motorized and is activated with the
commands placed on the right and the left sides of the console (can be acti-
vated only if the device is on).
Continue pressing the arrow corresponding to the desired movement until
you reach the desired position, using the graduated scale found on the ver-
tical column supporting the C-Arm, if necessary.
If using the new touch screen console, the vertical movement buttons are
placed on the sides of the console. The buttons are metallic and backlit in
blue while the functionality remains unchanged.
Ch.
4
Figure 10: Vertical Movement Command
the motorized movement. Pay particular attention to arms. See figure A at
point 6.
4.3.9 Workstation Cart Movement

Pay particular attention while moving and positioning the cart and its com-
ponents and accessories (monitor, printer etc.), danger of getting body parts
caught, pinched or crushed.
Danger of getting body parts caught or crushed. See figure B point 2

(fingers, hands, arms) 3, (body, head), 5 (fingers, hands, wrists, arms, feet)
and 8 (danger of getting fingers caught in the cable passage opening).

4.4 Start-up/ Shutdown
4.4.1 Connecting the various units

Before starting up the device, verify that all the X-Ray Mobile Unit connec-
tions are correct.
Dual Version cable connections
Power
supply
C-arm cable.
Model
Serial
number
C-arm to
Workstation
Cart cable.
Detail A
MODEL CODE
Pedal
Detail B
Hand-held
radiography
SERIAL N. command
C-arm connection Model Serial number Main switch
44 Start-up/ Shutdown © Copyright SIMAD srl 2020

Total pages: 218
Connecting the C-Arm to the Workstation

Please note the orientation of the three pins, located vertically on the plug
and align them with the fixed receptacle.
Once seated fully, rotate the ferrule clockwise until you hear an audible
“click”.
Ch.
4
Disconnecting the C-Arm from the Workstation
Rotate the ferrule anticlockwise and extract the connector.
Rewind the cable loosely to avoid damage and place on the reel.

Total pages: 218 Start-up/ Shutdown 45
Compact Version cable connections
C-arm cable
Power
supply
Model
Serial
number
Detail A
Pedal
MODEL CODE
Hand-held
radiography
command
SERIAL N.
Main
switch

Total pages: 218
4.4.2 Powering up the Device

Insert the power cable in an adequate power outlet.
Turn the general magneto thermal switch to ON found

on the back of the Monitor Cart; the white indicator
Dual Version
lamp on the right will light to signal that the device is
now receiving electrical power.
Turn the general magneto thermal switch to ON found
Compact Version
on the same side as the power cable.
If the Moonray Systems is already on, do not turn it off by using the same
switch but carry out the correct shutdown procedure; not doing so can
cause damages or data loss.
4.4.3 Device Start-up Ch.
Before starting up the device, make sure that removable disks (CD or DVD)
4
are not still inserted because they can cause errors to the PC’s booting
procedure.
To turn the X-Ray Mobile Unit and the Digital Imaging

system on, rotate the key switch placed on the right-
Dual Version hand side of the Monitor Cart to the ON position. The
initiation sequence will terminate after about 2 minutes
and the Digital Imaging System’s software will load.
To turn the X-Ray Mobile Unit and the Digital Imaging
system on, rotate the key switch placed on the left side
Compact Version of the C-Arm base to the ON position. The initiation
sequence will terminate after about 2 minutes and the
Digital Imaging System’s software will load.

Total pages: 218 Start-up/ Shutdown 47
4.4.4 Shutting-Down
Dual Version Shutdown

Shutting down the device can be done with various procedures, according
to the section of the system you wish to leave on or turn off.
Shutting down the C-Arm + Workstation Cart
In cases in which the total shutdown is called for, position the C-Arm in its
most compact position and click on the shutdown icon positioned in the
bottom right hand corner of the monitor B.
Once the shutdown has terminated, turn the magneto thermal switch,
found on the back of the Workstation Cart, to the OFF position.
Disconnect main power.
Disconnect the parts by unplugging the C-Arm base from the Workstation
Cart.
Shutting down the C-Arm
In cases in which only the C-Arm is to be turned off, maintaining the Wor-
kstation Cart active, position the C-Arm in its most compact position, turn
the key on the side of the Workstation Cart to the OFF position.
Shutting down the Workstation Cart
In cases in which the Workstation Cart must be turned off and the C-Arm
has already been disconnected, click on the shutdown icon positioned in the
bottom right hand corner of monitor B.
found on the back of the Workstation Cart, to the OFF position.
Compact Version Shutdown

In cases in which total shutdown is called for, position the C-Arm in its most
compact position and click on the shutdown icon positioned in the bottom
right hand corner of the monitor.
found on the same side as the power cable, to the OFF position.

Total pages: 218
5 C-Arm Control
and Command
5
Console

5 C-Arm Control and Command Console MOONRAY User Manual - Rev.34 - 2020/01/22
5.1 Description
The C-Arm control panel/console provides access to X-Ray production nee-
ded to obtain images with the digital imaging system.
Figure 11: Traditional (on the left) and new Touch Screen Consoles (on the right)
For easy access to the control panel, please orient so that it is visible from
each side of the C-Arm. To turn the panel to the other side, just slip it out
towards the back of the mobile unit and turn it in the desired position (the
panel is in a fixed position in the Compact version).
In the following pages you will find descriptions of the icons present on the
control panel and how to select and regulate for various scenarios.
The touch screen console has commands that are activated directly by tap-
ping the command icons on the screen with your finger.
When you try to activate a command that is not permitted, the following
icon will be visualized in the center of the control panel:
Figure 12: “Warning Action not Permitted” Icon
In Moonray 500 models a virtual keyboard is activated on the

touch-screen monitor by clicking on the virtual keyboard icon.
Figure 13: “virtual keyboard” Icon
50 Description
Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 5 C-Arm Control and Command Console
5.1.1 X-Ray Commands

The operator has various commands at his disposal to produce X-Rays:
Exposure in radiography
Hand held mode is accessible
exclusively through
radiography
the hand-held manual
command command located on the
left side of the X-Ray unit:
Figure 13: Hand-Held Radiography Command
In the single pedal

configurations, exposure
Single pedal in fluoroscopy mode is
accessible through the Ch.
pedal.
Figure 14: Single Pedal 5
In the double pedal

configuration, the user
has the option of using
Double Pedal the fluoroscopy mode
(left pedal) and the
fluoroscopy + mode
(right pedal).
Figure 15: Double Pedal
The flouroscopy push

buttons to exposure in
Flouroscopy push fluoroscopy mode are
buttons found on the tips of the
movement handles of the
C-Arm Base.
Figure 16: Manual Fluoroscopy Command
The device is equipped with a warning light that indicates emission of X-

Rays visible to all personnel from all areas of the examination room in which
the device is found. (CEI EN 60601-2-43 - § 6.8.3 aa)
When the device emits X-Rays, the flouroscopy push buttons and the war-
ning light on top of monitor both light. During X-Ray emission an acoustic
signal is audible.
Figure 17: Warning Light
on Dual (A) and Compact (B)
A B

Total pages: 218 Description 51
5.2 General Settings

Following is a description of the icons present on the control panel:
Focal Spot Indicators

The device indicates the focal spot in use with the following icons.
Small focal spot, selects automatically in Fluoroscopy mode
Large focal spot, selects automatically in Radiography mode
Table 1: Focal Spot
The user cannot select the focal spot to use manually.
Preparation to exposure
The icon indicates that the automatic settings of the exposure parameters
are in progress. It will appear off, when the X-Rays are not being emitted
and on, when the values of the exposure have been determined.
Preparation to exposure
X-Ray generator function

This icon indicates that exposure is in progress. It will appear off, when X-
Rays are not being produced and on, when X-Rays are produced.
X-Ray generator status
Anode Rotation Status

The icon indicates the status of the anode: It will appear off when X-Rays are
not being produced and on, when exposure is in progress.
Rotating state
Anode rotation at low speed
Anode rotation at high speed
Table 2: Anode Rotation
52 General Settings

Total pages: 218
Supply voltage status

Indicates if the power network is supplying the correct voltage or not. Based
on the voltage supplied the following icons will appear:
Correct voltage supply
A higher voltage than the maximum level of functionality is

being supplied.
A lower voltage than the minimum level of functionality is

being supplied.
Table 3: Voltage Supply
Ch.
Anode Heating Status
Producing X-Rays causes the consequential heating of the anode. The ther-
5
mal level is indicated in the following icons:
Initial heating level
Low heating level
Medium heating level
High heating level
When maximum heating level is reached, an intermitting acoustic

alarm will be audible.
X-Rays will be emitted for the following duration of time:
• Pulsed mode: max 1 minute
• Pulsed high dose mode: 4 sequences of 12 sec
• Pulsed mode: less than 1 minute then emission will halt, only
when the temperature returns under the limit will emission
be possible again.
Table 4: Heating Level
If possible, try not to reach the maximum heating level.

Repeatedly reaching this level can cause permanent damages to the
Moonray.

Total pages: 218 General Settings 53
Adjustment of the angular position of the camera

The icon indicates if angular rotation of the camera is activated. If the icon is
off, camera rotation is not activated.
In the “radiography” work mode, camera rotation is not possible since it

does not contribute to generating a radiographic image.
To enable camera rotation, press the key relative to the “Camera Rotation”
icon and use the control knob to rotate.
Camera rotation
If using the touch screen console, the two command keys for rotation will
appear next to the icon just selected.
Rotation Keys
To deactivate the camera rotation, press the “Camera Rotation” icon again.
The system will hide the two rotation keys.
If the camera is activated it will always rotate and will stop only when it
reaches its travel limit.
The “Monitor A” will visualize the actual rotation of the camera during its
movement; it could result to be different from the direction indicated by
the icon of the selected command, depending on if it is activated or not
and if the horizontal or vertical flip imagine positioning is being used.
54 General Settings

Total pages: 218
Regulating the iris diaphragm position
Active regulation of iris diaphragm.
To activate position regulation, press relative icon.

The two command icons seen below will appear. To open the iris collimator,
hold the “open” icon, to close the iris collimator hold the “close” icon. The
system will continue changing the dimension of the aperture of the iris colli-
mator for the amount of time one of the commands is activated.
Open and Close icons
Ch.
For deactivating diaphragm movement icon touch on other part of the
screen . 5
Regulating the opening of the iris collimator is not possible in the “radio-
graphy” mode, due to the fact that it must be completely open.
The maximum and minimum aperture of the iris diaphragm depends on
the “level of the zoom” (input field) activated.
The aperture dimension will never surpass the allowed value for the zoom
level selected.

Regulating the filter compensator position

The icons indicate if the filter compensator position regulator is enabled.
Compensating Filter Aperture/Closure
Enabled Rotation of the Compensating Filter
Table 5: Filter Regulator
To activate position regulation, press the relative icon. When on, the filter
movement is enabled and the following icons will appear.
Aperture/Closure icons
To open or close the filter compensator, select the corresponding icons, the
aperture regulation will last as long as the command is active.
To enable rotation regulation, select and hold the corresponding icon. The
same rotating icons seen before will appear.
For deactivating diaphragm movement icon touch on other part of the
screen.
Regulating the aperture or closure and/or the rotation of the compensa-

ting filters is not possible in the “radiography” mode due to the fact that
they must be completely open.
The direction indicated in “Monitor A” might not correspond to the one
indicated by the icon of the selected command as a consequence of activa-
ting the horizontal or vertical flip imagine command.
56 General Settings

Total pages: 218
Image Flipping
To obtain a specular flip of the image present in monitor A, press the key
next to the icon. Each time you press you obtain a new flip.
Horizontal Flip
Vertical Flip
Table 6: Image Flipping
The flip image commands are visible only in the absence of X-Ray emission.
Ch.
Field of View 5
The on icon indicates which field of view has been selected. Upon start-
up, the device positions itself on the maximum field available. To select a
diverse input field and therefore a different magnifying factor of acquisition,
press on desidered fied of view icon.
Maximum field
Medium field
Small field
Minimum field
Table 7: Version 4 - Input fields
Maximum field
Medium field
Minimum field
Table 8: Version 3 – Input fields
This setting is possible only in the absence of X-Ray emission.

This setting is not possible when using the Hand-Held Command mode be-
cause the II does not contribute to the creation of the radiographic image.

Selecting exposure control

The selected icon indicates which type of exposure control is active. Auto-
matic exposure is activated in default upon start-up.
Automatic Exposure Control
Manual Exposure Control
Manual Exposure Control for Radiography
Table 9: Types of Exposure Control
To activate the manual mode, select desidered icon.

To activate the radiographic mode select and hold for 2.5 sec the desidered
icon.
When the “Radiographic” mode is activated, the system opens the dia-
phragm compensators completely, the iris collimator blocks the comman-
ds that can be activated through the icons on the right hand side of the
screen and “turns off” the icon corresponding to fluoroscopy.
The system also disables the movement commands of the camera, of the
collimator diaphragms, horizontal and vertical image flipping and the II
visual field selection.
Exiting the “Radiographic” mode, all the controls will be reactivated and
the iris diaphragm will be brought back to the position it was in before
entering the radiographic mode.
Digital Radiography (optional)
The Moonray System equipped with a Digital Detector can acquire and
display the image also using a three-point configuration as a radiological
power setting mode. The image will be presented on a monitor with the
typical resolution of fluoroscopy.
58 General Settings

Total pages: 218
Duration of X-Ray emission

The total exposure time, since the last start-up of the device, is visualized
next to the relative icon in a minutes:seconds format.
Exposure time
In all the other working modes except “Radiographic”, the amount indicates
the total duration of X-Ray emission executed, starting from start-up of the
device or from the last reset of this parameter.
In the “Radiographic” work mode, the amount indicates the duration of the
impulse that will be emitted in correspondence to the activating command
of the X-Rays.
To regulate the duration of emission, press the key next to the icon. Modifi-
cations can be made using the following command icons: Ch.
Increase/Decrease icons
5
To disable the modification of these values, press the key on the left of the
icon till it “turns off”. The system will hide the variation keys.
The device is equipped with a double safety feature that works as follows:
Pulsed low energy X-Ray emission: every time the sum of the duration of
emission surpasses 4’:30”, an acoustic warning signal is sounded which can
turned off by touching the time exposure icon for not more than 1 second.
If you do not stopped, the acoustic warning signal will sound every time one
of the X-Ray emission commands is activated.
X-Ray boost emission: Following is a table of the duration of X-Ray emis-
sions, which correspond to the frequency pulsed emission boost:
• Boost 0.5: 240 sec
• Boost 1: 120 sec
• Boost 2: 60 sec
• Boost 4: 30 sec
• Boost 6: 20 sec
• Boost 12: 20 sec
The image on the video shows the duration of the X-Ray emission and not
the duration of the activation of the command.
For example, activating the fluoroscopic command for 10 seconds with a
Boost emission of 12 will produce a 5 second value on the screen.
To reset the chronometer from the total emission value, select and hold the
icon till the system visualizes the value: “0:0”.
To reset the timer to 5 minutes of X-Ray emission, press and hold Exposure
time icon.

Manual setting of exposure voltage (kV)

In the radiographic and manual fluoroscopy work modes, the user must set
the anode-cathode voltage value to generate X-Rays:
Voltage setting visualization
To set voltage:
1 Touch the icon Voltage setting visualization. Two variation icons will appear
on the right of the value.
Increase / Decrease icons
Holding down the “+” and “-“ icons will increase or decrease the value one
unit at a time for the first 1.5 seconds then the system will vary the units
10 at a time.
To disable the value setting, select the icon till it turns off.
Setting current values (mA)
Current setting/visualization and exposure tables
In the radiographic and manual fluoroscopy work modes, you must set the
value of the filament current to generate X-Rays. In the “DSA”, “Cine” or
“Road Mapping” modes you can specify a maximum current table.
To activate the mA value setting:
1 Touch the icon Current setting/visualization and exposure tables. The sy-
stem will visualize the two variation icons on the right of the value.
Increase / Decrease icons
The maximum current value is set for the anode-cathode voltage.
Current setting can be executed only when an X-Ray emission command

has been activated.
Setting the values of the current tables for Boost, DR, DSA, Cine and Road-
map work modes can be done only in the absence of X-Ray emission.
60 General Settings

Total pages: 218
5.3 X-Ray selection mode
5.3.1 Fluoroscopy
Touch the desired icon till it lights and then touch the icon relative to the
desired mode. If the boost or pulsed mode is chosen, the system predispo-
ses for the selected mode and visualizes the increase/decrease keys. The
user can select a diverse mode or accept the current one. To exit selection,
touch the same icon till it turns off. The fluoroscopy manual commands and
pedal command are activated with the left pedal (in the two pedal versions).
Fluoroscopy
X-Rays are emitted in a pulsed mode. The user can manually or automatical-
ly set the current and voltage parameters. The maximum supply current is 3 Ch.
mA.
This emission mode is defined NORMAL FUNCTION MODE (CEI EN 60601-2- 5
43 - § 51.101.4)
The Pulsed fluoroscopy value that generates the highest Air Kerma Rate is
120 kV, 20mA. (CEI EN 60601-2-43)
Fluoroscopy

Total pages: 218 X-Ray selection mode 61
Boost
Pulsed rays are emitted with frequency indicated in the upper part of the lit
icon. The voltage and current values are established automatically. The user
can indicate the full scale current. The initial current value is 6 mA and can
reach up to 10 mA,
The Boost value that generates the highest Air Kerma Rate is 120 kV, 10 mA,
12 impulses/sec (CEI EN 60601-2-43)
12 impulses/sec.
6 impulses/sec.
4 impulses/sec.
2 impulses/sec.
1 impulses/sec.
1 impulse every 2 sec.
Table 10: Boost
The boost mode can be optionally replaced by a mode having the maxi-
mum current values comparable to those of radioscopy. Times and pulse
frequencies remain typical of the boost mode.
DR (Digital Radiography)
A single pulse is emitted. The voltage and current values are established
automatically. The user can indicate the full scale current: the initial setting
is 6 mA and by accessing the mA setting mode 10 mA can be set.
DR (Digital Radiography)
62 X-Ray selection mode

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Pulsed Fluoroscopy
Pulsed X-Rays are emitted and frequency is indicated in the upper part of
the lit icon. The voltage and current values are established automatically.
The maximum current available is 3mA.
The Pulsed Fluoroscopy value that generates the highest Air Kerma Rate is
120 kV, 3 mA, 12 impulses/sec (CEI EN 60601-2-43)
12 impulses/sec.
6 impulses/sec.
4 impulses/sec.
Ch.
5
2 impulses/sec.
1 impulses/sec.
1 impulse every 2 sec.
Table 11: Pulsed Fluoroscopy
To allow the command and control console to visualize the commands

“Boost”, “DR” o “Pulsed”, you must select the “Fluoroscopy” work mode
on the PC.

5.3.2 Cine/DSA
The Cine or DSA modes can be selected only through the PC by clicking on
the desired work mode.
• The Cine work mode is available only in GSE+ and VE version.
• The DSA function is available only in the double pedal and vascular/en-
dovascular software versions. It is not available on the Compact models.
When you select the Cine or DSA modes, the system disables (by hiding
them) the selection icons “Boost”, “DR” and “Pulsed”; the Fluoroscopy
mode icons (described above) disappear on the control panel and the fol-
lowing icons appear:
Fluoroscopy
Pulsed Exposure 25 imp/sec
The operator can set diverse types of reference tables, according to necessi-
ty, through the mA setting procedure. (See Setting current values (mA)).
Pulsed or pulsed exposure tables are available:
• In the 12 imp./sec. version, the only available frequency is 12 impulses
per second;
• In the 25 imp./sec. version, the user can select either 12 or 25 imp./sec.
To set the desired frequency, touch the icon corresponding to the diverse
pulsed frequencies:
Pulsed Exposure 12 imp./sec.
Pulsed Exposure 25 imp./sec.
Table 12: Cine Exposure

Total pages: 218
Fluoroscopy Commands (manual and left pedal command)

The manual fluoroscopy and fluoroscopy commands (left pedal command)
exclusively activate Pulsed fluoroscopy. Emission is effective exclusively and
automatically. The operators can set 4 diverse types of current tables for X-
Ray emission through the mA setting procedure. (See Setting current values
(mA)). Table 13 lists the maximum current in full scale.
When the regulating table n. 3 is selected the emission mode is defined as
NORMAL MODE FUNCTION, when the regulating table n. 1 is selected the
emission mode is defined LOW INTENSITY MODE FUNCTION. (CEI EN 60601-
2-43 - § 51.101.4).
120 kV, 20 mA. (CEI EN 60601-2-43).
Manual and left pedal fluoroscopy commands: Ch.

Value
Full Scale Current Acoustic Alarm after (4)
Max Exposition Type of 5
Duration exposition
1 Max 1 mA LOW INTENSITY

2 Max 2 mA 4’:30” 5’:0”
3 Max 3 mA NORMAL MODE
30
40 Pulsed
50
Max 6 mA 2’:15” 2’:30”
60
70
80
Table 13: Manual Fluoroscopy and Fluoroscopy Command

Fluoroscopy+ Command (right pedal command)

The “Fluoroscopy+ command” activates the set function on the Workstation
(that is the “Cine” or the “DSA”). Emission is executed only automatical-
ly. Through the mA setting procedure, (see Setting current values (mA)),
the operators can set diverse types of current tables for X-Ray emission
according to his needs. Table 14 lists the available tables. For values 1, 2 and
3 emission is Pulsed; for values between 30 and 80 emission is pulsed. In
both cases, the maximum current in full scale varies according to the choice
made as described in Table 14.
Current Visualization/Setting and Exposure Tables
The numerical value on the right of the icon has two diverse meanings, ac-
cording to the activation / deactivation of the X-Ray emission commands:
• Deactivated X-Ray emission command: the numerical value indicates
the current table set for emission with a “fluoroscopy +” command.
• Activated X-Ray emission command: the numerical value indicates the
existing current value of the filament current.
The Fluoroscopy+ Pulsed value that generates the highest Air Kerma Rate is
120 kV, 80 mA, 12 imp/sec (or 25 imp/sec in the versions in which this value
is available). (CEI EN 60601-2-43)
Right Pedal Command (Fluoroscopy +):

Value
Full Scale Current Type of exposure selected
1 Max 1 mA Pulsed
2 Max 2 mA
3 Max 3 mA
30 Max 30 mA
40 Max 40 mA Pulsed 25 imp./sec Pulsed 12 imp./sec
50 Max 50 mA
60 Max 60 mA
70 Max 70 mA
80 Max 80 mA
Table 14: Right Pedal Command

Total pages: 218
5.3.3 Roadmap
Selection of the roadmap mode is activated from the workstation by clicking
on the desired work mode (see Setting current values (mA)). The Roadmap
function is available only in GSE+ and VE version and with vascular and
endovascular software.
When using the Roadmap mode, the command and control console visuali-
zes only the Pulsed Fluoroscopy icon:
Fluoroscopy
Fluoroscopy Command (manual or left pedal command)

Both the manual and left pedal commands exclusively activate Pulsed fluo-
roscopy. Emission is executed only automatically. Through the mA setting
Ch.
procedure, (see Setting current values (mA)), the operators can set diverse
types of current values for X-Ray emission according to his needs (see table
5
below).
When the mA value 3 is selected, the emission is defined NORMAL MODE
FUNCTION, when the mA value 1 is selected the emission is defined LOW
INTENSITY FUNCTION. (CEI EN 60601-2-43 - § 51.101.4)
120 kV, 20 mA, (CEI EN 60601-2-43)
Manual and Left Pedal Fluoroscopy Commands:

Value
Full Scale current Type of exposure
1 Max 1 mA
2 Max 2 mA
Pulsed
3 Max 3 mA
20 Max 20 mA
Table 15: Manual and Left Pedal Fluoroscopy Commands

Fluoroscopy Command + (right pedal command)

The right pedal command (Fluoroscopy +) activates the set function (Road
Mapping). Emission is exclusively Pulsed and automatic. Through the mA
setting procedure, (see Setting current values (mA)), the operators can set
diverse types of current values (tables) for X-Ray emission according to his
needs (see table below).
120 kV, 3 mA, (CEI EN 60601-2-43)
Right Pedal Command (Fluoroscopy +):

Value
Full Scale Current Type of exposure
1 Max 1 mA
2 Max 2 mA Pulsed
3 Max 3 mA
Table 16: Right Pedal Command (Fluoroscopy+)
5.3.4 Typical Radiographic Values

Typical Radiographic values used for different types of exams for which the
device is intended. (CEI EN 60601-2-43 - § 6.8.2 bb)
Exam Exposure Values Type of Exposure

Peripheral Angiography 60 kV – 2 mA Pulsed
Thorax/Abdomen Angiography 80 kV – 3 mA Pulsed
HD Thorax/Abdomen Angiography 80 kV – 30 mA 12/25 impulses/second
5.3.5 Maximum Levels of Air Kerma Rate

Maximum levels of Air Kerma Rate (RATIO) [mGy/s] (CEI EN 60601-2-43 - §
6.8.2 cc):
Fluoroscopy
Fluoroscopy AUTO : 120 kV, 3 mA 0.37
Boost : 120 kV, 10 mA, 12 impulses/sec 0.6
Pulsed Fluoroscopy : 120 kV, 3 mA, 12 impulses/sec 0.26
Cine/DSA
Pulsed Fluoroscopy : 120 kV, 1 (3) [6] mA 0.16 (0.37) [0.6]
120 kV, 30 mA, 12 (25)
Pulsed Fluoroscopy : 0.84 (2)
impulses/sec
120 kV, 80 mA, 12 (25)
Pulsed Fluoroscopy : 1.6 (3.6)
impulses/sec
Maximum levels of AIR KERMA RATE IN Radiography for image:
A specific trial object representing an average patient can be indicated in a
PMMA dummy in a square form that is 20 cm thick and 25 cm. side base (CEI
EN 60601-1-3 - § 5.2.4.2).

Total pages: 218
5.4 List of Warnings

The diagnostic status icons described below are found in the upper part of
the control panel, on the right of the icon relative to the focal point size:
Indicates anode malfunction. Refer to the Troubleshooting section of

Rotating Anode Error
the Appendix.
The CPU card power supply battery is not charged to the optimum
Discharged Battery
level. Call customer service.
The icon is visualized when there is a camera error: the camera

cannot rotate and the various input fields are locked. This icon is also
Camera/Video Error
visualized when the camera doesn’t receive the Frame Sync signal.
X-Ray emission locked.
Ch.
Communication Error
Signals a communication error between the mobile X-Ray unit and
the digital imaging system. 5
The MMT processor has generated an error and the Watchdog
Principal C-Arm Card Error
system has intervened by locking all emissions and functions.
Diaphragm Error The collimator’s control unit has generated an error.
Filament Error The Filament or its control function has generated an error.
Voltage Error The inverter / monobloc system has a breakdown
When overheating is near, an acoustic alarm will be activated. The

device will allow X-Ray emission for the following time periods:
• Pulsed mode: for max 1 minute of actual X-Ray emission
• High Dose Pulsed Mode: 4 sequences of 12 seconds
Anode Overheating
At this point emission will be locked. Only the decrease in temperate
under the allowed limit will permit reactivation of the emissions.
Rebooting the device locks its functions and does not reset this
condition.

Total pages: 218 List of Warnings 69
5 5 MOONRAY User Manual - Rev.34 - 2020/01/22

Total pages: 218
6 Software Guide
6

6 Software Guide MOONRAY User Manual - Rev.34 - 2020/01/22
6.1 Organizing Information

The Moonray system retains two types of information: text and images
(sequences).
• Textual information is collected in order to describe and document the
stored information. This information includes the patient’s personal
data, the doctor whom requested the exam, the doctor whom executed
the exam, the doctor whom read and interpreted the exam, etc. Other
data permits the system to univocally identify the exams carried out.
• The sequences represent the product stored from the images shown on
video during acquisition. The sequences produced are automatically in-
serted in a container called a series, which represents the exam’s “File”.
Every sequence belongs to a series and is characterized by the exposure
data, that is, the parameters used for its production, its name, its univo-
cal identifier number etc. All images are part of a series.
6.1.1 Series/Sequences
Every series is univocally identified with an “ID Series” number and contains
all the textual data relative to the exam.
The identification of a series is independent of the patient’s chart; therefore
a patient can appear in more than one series.
Every acquisition executed by activating one of the commands generates X-
Ray emissions producing images (frames), which are visualized on the video
and recorded in the permanent memory (hard drive) of the machine. These
are denominated sequences.
The sequences can have just one frame, several frames and mask frames,
according to mode set and the X-Ray command used to generate the se-
quence.
6.1.2 Anonymous Series

Upon start-up, the system automatically presents blank series which can
be recognized by the field “ID Series” which is “000000”, in other words
without the patient’s personal data, ready to receive the sequences. The
blank series is also presented every time the user opens a new series using
the “New Series” command, or closes the current series using the “Close
Series” command.
If there are no particular urgencies, we recommend inserting data before
beginning the exam, so as to make recognition of the series that one will
create easier. The user can edit the patient’s personal data at any moment,
both before and after the exam by recalling the series and editing it.
As soon as the patient’s personal data is inserted and confirmed, the series
passes from anonymous to identified.
72 Organizing Information

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MOONRAY User Manual - Rev.34 - 2020/01/22 6 Software Guide
6.1.3 Locked/Unlocked Series

When a series is created, it is always unlocked that is, it can receive sequen-
ces. If a series does not contain sequences, it can be re-opened to insert
new sequences.
A locked series is recognizable by the icon in Figure 20, visible in “Monitor
A”, which notifies the user of the locked X-Rays and therefore the sequences
contained can only be viewed and the system allows to add only sequence
those creation doesn’t require X-Ray emission.
Figure 20: “X-Ray Lock” Icon

Ch.
Closure of a series comes about when the user executes a “Close Series”
command. (See Table 18). 6
6.1.4 Work Planning
A list of exams to be made can be planned ahead of time, creating the seri-
es and filling in the patients’ personal data without inserting the sequences.
The series created this way will be memorized and will remain open and
ready to receive images. On the date of the exam, the operator will select
the series already prepared and will fill it with the exam’s images.
As already mentioned, as soon as a series receives at least a sequence and is
closed, a subsequent re-opening allows only revision of the images and the
system allows to add only sequence those creation doesn’t require X-Ray
emission.

Total pages: 218 Organizing Information 73
6.1.5 Apply/Remove a Search Filter

To carry out precise searches, the system offers the possibility to apply
search filters by utilizing a search form called “Filter Settings”.
To apply a filter:
1 fill in one or more fields with the chosen filter criteria
2 point and left click on the “apply filter” key.
Filling in a field, i.e. “Surname” Doe, the filter will only select the records
that have the name “Doe” inserted in the “Surname” field. If you fill in two
or more fields the number of records visualized on screen can diminish
because more information is given to enhance the search.
For example, the name “Doe” (without quotes) in the “Surname” field and
the name “John” (without quotes) in the “Name” field will produce only
John Doe’s exams (if present).
Apply Filter
Remove Filter
Figure 21: Search Window and Application Filers.
If the user closes the search window after having applied a filter with the
“Set Filter” form and opens it again, the form will show the preceding crite-
ria specified.
The “Remove Filter” command eliminates the filter criteria set.
6.1.6 Eliminating a Series/Sequence

To eliminate a series or a sequence, select the object and activate the
command “Eliminate” (see below). Eliminating a series or a sequence does
not automatically recuperate occupied space in the device’s hard drive. The
eliminated file is moved to the trash where it remains till the user decides to
expressly and permanently eliminate it.
To recuperate occupied space by the file you must first open the trash and
activate the command “Empty Trash” (see paragraph Database – Trash)
When you eliminate a series you also eliminate all its sequences.
74 Organizing Information

Total pages: 218
6.1.7 Recuperating a Series/ Sequence

As explained in the paragraph above “Eliminating a Series/Sequence”, the
files contained in the trash remain in the device’s permanent memory until
the user proceeds to empty the trash.
To visualize a series and/or sequences moved to “trash” you must reactivate
it with the command “Restore”. To do this, activate the trash view (see para-
graph Database – Trash), select the file you want to recover and activate the
command “Restore”.
6.1.8 Sequence Catalogue of an Exam in Progress

The image catalogue of an exam in progress is found on the left side of the
monitor “B” and views a list of the thumbnails of the images and/or of the
sequences present in the correctly selected exam for visualization.
When creating a new series (when you begin a new exam), the image catalo- Ch.
gue is empty and while the exam is in progress it fills with thumbnails of the
sequences generated by the emission of X-Rays and saved (both manually
or automatically) or snapshots are created with the command “capture
6
snapshot”. Normally, the catalogue views only one column of thumbnails
(Column A in Figure 22): if there are a sufficient number of thumbnails in the
series, a vertical scroll bar activates on the right side of the catalogue with
which the user can scroll the images. Three keys are present on the upper
part of the catalogue (enlargements are shown in the lower part of Figure
22), which allow for expansion/reduction: pointing and left clicking on the
central key expands the catalogue to 2 columns, pointing and left clicking on
the key on the right, expands to the maximum amount of columns.
To request an image, the user must find it on the scroll bar and recall it by
positioning the pointer on the thumbnail and left clicking once.
The size of the catalogue is brought back automatically to 1 column if you
select and image to view on the monitor “B” or you activate X-Ray emission.
A B C
1 column 2 columns Expansion to maximum number of columns
Figure 22: Image Catalogue

Total pages: 218 Organizing Information 75
6.2 Input Peripherals

The user can interact with the Workstation software through the keyboard
and the incorporated trackball, which acts like a mouse.
The keyboard allows the user to edit fields and quickly activate several
commands (shortcuts found on the upper row of the keyboard) instead of
having to move a hand onto the trackball, position the pointer on the com-
mand and activate it by left or right clicking on the keys stationed below the
trackball.
Figure 19: “New” Workstation Keyboard
Send to Monitor B (Limited to

Moonray)
Take Snapshot
Activate the following recursive

filter level
Views/Hides Instruments
Decreases/Increases Window
Decreases/Increases Level
Activates the following mode
Go to the beginning
Play / Stop reproduction
Go to the end
Table 17: Keyboard Commands (Shortcuts)
The trackball on the right side of the keyboard allows the user to position
the pointer on the monitor and interact with the objects presented through
pressure on the right and left keys (click).
76 Input Peripherals

Total pages: 218
6.3 Editing Data in a Field

To edit data in a field, position the pointer on the box containing the data
and left-click entering the “edit” mode which is indicated by the change of
the background of the field, as seen in Figure 23.
Figure 23
As soon as the data is modified, the save modification key goes from deacti-
vated to activated. (See Figure 24).
Save (deactivated)
Save (activated)
Ch.
6
Figure 24: Save Key
As can be seen in Figure 23, the characters that have already been typed
are automatically selected and typing any other character will result in the
elimination of the string of characters previously filled in.
• To move the cursor to the right or the left inside the field, use the arrow
keys “right” and “left” (see Figure 25)
• To eliminate characters that precede the cursor hit the “Backspace” key.
• To exit the “Edit” mode, point and left click the “Enter” key or right click
under the pointer in an area that does not contain modifiable fields.
Enter Backspace Left arrow Right arrow
Figure 25
To make modifications permanent, you must use the “Save” command iden-
tified by the “floppy” icon key. (Figure 24)

Total pages: 218 Editing Data in a Field 77
6.4 Organizing Views

The system has been organized with overlapping views.
In the configurations with a double monitor, the left monitor always and
only shows the “Monitor A” view, which views the images coming from
acquisition. The right monitor has a principal view “Monitor B” and a series
of other views selectable with the corresponding tabs (Tab Strip).
To go from one view to the other you must position the pointer and click
on the tab that represents the name of the desired view. Additional forms
can be recalled by positioning the pointer and clicking on the corresponding
icon.
The system can offer other views that allow the user to interact with addi-
tional forms, which can be bought separately. The upper part of the right
monitor shows you the shortcuts to possible additional forms. (See Figure
26): in this case we have 3 additional forms.
Figure 26: Form Example
78 Organizing Views

Total pages: 218
6.4.1 Monitor “A” View
Moonray
Upon start-up, the multi-monitor system presents two principal views:
• Monitor A (Figure 31)
• Monitor B (Figure 34)
Monitor A, usually found on the left of the console, is intended to visualize
live images, that is, images obtained during acquisition.
Ch.
6
Figure 31: “Monitor A” View
“Monitor A” View:
• views and allows for selection of currently set work modes of the machi-
ne by using the keys present in the “Modality” area of the panel.
• Views the currently set X-Ray mode of the X-Ray console in the “X-Ray
Mode” area of the panel.
In the bottom left hand corner of Monitor A the boxes named “Disk”,
“Temp.” and “Signals” indicate the system status indicating respectively:
• How much space is available in the system’s permanent memory;
• The thermal status in real time of the X-Ray complex;
• Any possible alarm signals.
The central part of “Monitor A” visualizes the images during acquisition.
Initially it will appear black, but as soon as the fluoroscopy command or the
fluoroscopy+ command is activated, the images acquired or about to be
acquired will be viewed.
The upper and lower left sides of the images will be occupied by a series of
fields and their data

Total pages: 218 Organizing Views 79
Figure 32: “Monitor A” View
• In position 1 from top to bottom we can see: the progressive number of

the series, the patient’s data, “Surname”, “Name”, “Date of birth” and
the “Marked” status.
• Position 2 views the progressive number of the sequence.
• Position 3 views the data that characterizes the acquisition: date and
time of the acquisition, current intensity, voltage used for the genera-
tion of the X-Rays, the dose of radiation sustained by the patient during
acquisition of the sequence, the X-Ray mode used during acquisition and
the duration of the acquisition.
• Position 4 views the flip and rotation status currently applied to the
image.
Monitor A hides the tool keys during acquisition to lessen distractions as
much as possible to the user. They will newly be viewed when the fluoro-
scopy/fluoroscopy+ commands are released or when the pointer is brought
to the right or left area of the monitor or by press the key.
80 Organizing Views

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Moonray Compact
Upon start-up the system presents the Monitor A view. To view Monitor B,
select the tab on the upper part of the screen (see Figure 33).
Ch.
6
Figure 33: Moonray Compact “Monitor A”

6.4.2 “Monitor B” View
Figure 34: “Monitor B” View
The “Monitor B” view allows you to leaf through the images (sequences) of
the current exam (series) and to retrieve them onto the screen. Its principal
function is to be a reference monitor, used to confront the image on “Moni-
tor A” with the one on “Monitor B”.
As you can see in Figure 34, the sequence catalogue of the current series
is available on the left hand side of “Monitor B”. During the course of the
exam, the thumbnail of the last acquired sequence will be added to the
catalogue only after saving it (manually or automatically) and only if there is
sufficient free space to contain it.
The user can retrieve and view any sequence on the screen, by scrolling
down the list, locating it clicking on the image miniature.
The images viewed in the catalogue represent the thumbnail of the sequen-
ces and indicate the progressive number of the sequence on the bottom left
hand side and on the right, the icon of the mode used for its generation.
Send to Monitor A
The catalogue can be viewed with 2 or 5 columns, by activating the keys
found on the upper part of the catalogue.
Send to Monitor B
The image currently viewed in Monitor B can be sent to Monitor A and
vice-versa by utilizing the commands “Send to Monitor A” and “Send to
Monitor B”. Eliminate
The currently viewed sequence can be eliminated by activating the com- Figure 35: “Send” and “Elimina-
mand “Eliminate”. te” Commands
82 Organizing Views

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6.4.3 View Commands - Image Interaction

Commands
Following is a list of the commands that can be activated from Monitors A
and B and from the “Clipboard” command, which will be explained, in the
following paragraphs.
Close Current Series Take a Snapshot
Highlight Yes/No Enlarge
Reduce Send to Monitor A
Send to Monitor B Add to print composer
Ch.
6
Horizontal Flip Vertical Flip
Show/Hide - Brightness/
Invert white with black
Contrast
Show/Hide Marking Tool Show/Hide Measurement Tool
Edit Text Annotation Eliminate
Show X-Ray dose recap Send to Clipboard
Shutdown Deactivate X Rays (60601-2-43)
Table 18: Command buttons from “Monitor A”, “Monitor B” and “Clipboard” views
The deactivate X-Rays command is viewed in the bottom right hand corner
of Monitor A, inhibits X-Ray exposure. Point and left click to deactivate
emission, point and left click again to reactivate. (CEI EN 60601-2-43 - §
6.8.2 gg)

6.4.4 “Patient Data” View

This view allows for management of text data relative to the current open
series, which will be transposed onto the images.
The view presents two columns as seen in Figure 36:
• The “Field” column, which lists the name of the fields that contain the
data.
• The “Data” column, which lists the data corresponding to the field.
The dark grey area of some of the view boxes indicates that the user cannot
edit the data in that field, while the user can edit the boxes with a light
background.
The “Complete List of Fields” box views a complete list of the fields.
Figure 36: Complete List of Fields
The exit command is visible on the bottom right and is used by the user to
shutdown the system.
.
84 Organizing Views

Total pages: 218
6.4.5 Database - “View”

This view allows the Database to be consulted. To recall, position the poin-
ter on the “Database” tab and left click.
Ch.
6
Figure 37: Database Window
This view is divided into two parts:

• the upper part contains the sub-views accessible;
• the lower part contains the commands that can be activated in the
selected sub-views.
Each of the three sub-views can be activated with the corresponding tab in
Figure 38.
Figure 38
• The “Exams” sub-view lists the series contained in the system.

• The “Worklist” sub-view lists the series created but not yet filled by at
least one sequence.
• The “Recycle bin” sub-view manages the eliminated series and/or se-
quences.
Every sub-view includes an “Update” command (see Table 19), which upda-
tes the current sub-view by re-reading the internal database.

6.4.6 Database - “Exams”

The upper part of the “Exams” sub-view shows the list of the series that are
presently in the system in a decreasing order in respect to the data of the
“ID Series” field.
Left clicking on the name of the column can change orientation; you will
view the rearranged order according to the data of the specified field. Left
clicking on the same column changes the order in increasing or decreasing
order.
You can scroll the list both horizontally and vertically to see the columns
that are not visible in the series.
Left clicking on a line of the series list, a “Patient Data” box will appear in
which the patient’s data relative to the selected series is present and in the
“Sequence List” box, a list of the sequences that pertain to the selected
series.
You can select a sequence pertaining to the selected series by left clicking
on the desired line from the list of sequences. This action shows the image
thumbnail of the sequence in the “Thumbnail” box.
The commands of the sub-view “Exams” are listed in Table 19.
Open Send to Clipboard
Print Eliminate
Create dose report Open export
Show filter settings Open import
Mark the sequence Update sub-view
Table 19: Exam Commands
86 Organizing Views

Total pages: 218
“Open Series”
allows you to open a series created previously and not yet filled with a
sequence.
How to proceed:
1 Position the pointer on the line corresponding to the series you want to
open.
2 Select by left clicking.
3 Activate the command “Open”. If another series is already open, a message
will ask if you want to confirm closure of the open series by viewing the
message in figure 39.
Ch.
Figure 39 - Confirmation Window

6
If the user confirms the open command, the system unloads the current se-
ries, opens the selected series, switches to the “Monitor B” view and loads
the sequences of the series in the image catalogue.
Please note that if at least one sequence is present in the series that is being
opened the series is locked and cannot receive other acquisitions, allowing
the user to operate only in post-processing mode on sequences already
acquired.
‘Print’
sends the selected sequences to the print composer (see Print Composer).
Select the series that contains the sequences you want to print. In the “Se-
quence List” box, select one or more sequences, position the pointer on the
line that describes the sequence, and right click to select the sequence to
print. To select more than one line, repeat the previous step, and hold the
“CTRL” key on the keyboard to create the list of sequences to print. Position
the pointer on the “Print” command and left click to activate the print com-
poser, which will view the selected images ready to be printed.

‘Create a DAP report’

produces a DAP (Dose Area Product) report of the radiation sustained by
the patient during the exam. Select the series for which you wish to print
a DAP report, position the pointer on the line of the series, select it by left
clicking and activate the command by positioning the pointer on the corre-
sponding icon and left clicking. A window will be viewed which summaries
the data grouped by type of exposure. Confirm printing through the print
key, a document like the one in Figure 40 will be printed. For details see the
dedicated paragraph in “Print DAP Report”.
Figure 40 – Example DAP Report
‘Show filter settings’

the activated window allows you to specify the criteria to use to view the
series in the list of series (See Apply/Remove Filter).
88 Organizing Views

Total pages: 218
‘Earmark the sequence’

allows you to earmark sequences, which are particularly important in order
to be able to find them again easily at a later time.
To earmark a sequence
1 select it by positioning the pointer on the corresponding line in the “Se-
quence List” window,
2 left click activating the command. The content of the field of the selected
line will change and will read: “Highlighted by the user”.
To remove the earmark, repeat the last step on an earmarked line.
To mark a series or a sequence, just select the series or the sequence and
right click.
Ch.
6

‘Send to Clipboard’
allows the user to send the sequence selected to “Clipboard”. Select the se-
ries to which the sequence belongs, select the sequence to send by positio-
ning the pointer on the line, left clicking and activating the command.
‘Eliminate’
allows you to eliminate the series and/or the selected sequence. Before
moving the file or files to the trash, the system asks for confirmation.
To eliminate a series
1 select the series by positioning the pointer on the corresponding line
2 left clicking, activating the elimination.
To eliminate a sequence:
1 select a sequence by positioning the pointer on the corresponding line
2 left clicking, activating the elimination.
‘Update sub-view’
allows the user to refresh the current view with any modifications made in
other views. Activating this command, the system reloads all the data in the
database eliminating any filters set on the view.
‘Open export’
activates an additional form that allows the user to manage data export.
‘Open import’
activates an additional form that allows the user to manage data import.
90 Organizing Views

Total pages: 218
6.4.7 Database - “Scheduled”

This screenshot allows the user to visualize the series that have been crea-
ted but have not yet been filled.
The upper part of the screen is divided into two areas:
• the list of the scheduled series
• the currently selected series and its data
The group of commands that can be activated are shown in Table 20 below.
Open Series Set Filter
Eliminate Series DICOM Worklist
Table 20: Database - Scheduled Commands

Ch.
6
Figure 42: Database - Scheduled Window
“Open Series”
allows the user to open the series previously created and not yet filled with
a sequence.
Instructions:
1 position the pointer on the series to be opened
2 select with a left-click
3 activate the “open” command. If a series is already open when you give
the “open” command, a message will appear to ask if you want to close the
current series to open another.

“Set Filter”
allows the user to filter the elements shown in this screenshot. After acti-
vating this command, the set filter window will appear (See Apply/Remove
Filter).
“Eliminate Series”
allows the user to eliminate a series from the list of the scheduled exams
moving it to the trash. Sometimes an exam scheduled for a certain day can
be cancelled for various reasons making the created series useless.
Instructions:
1 select the series to be eliminated by positioning the pointer on the corre-
sponding line
2 left click once
3 activate the “eliminate” command; a message will appear to ask you to
confirm the elimination of the selected series.
“DICOM Worklist Use”

this command activates the DICOM Worklist on the devices that are equip-
ped with this option.
6.4.8 Database – “Recycle bin”

The sub-view below (See Figure 43) gives the user a view of all the files that
have been cancelled with the “Eliminate” command but that have not been
definitively eliminated from the system’s hard drive.
Restore
Empty Trash
Eliminate
Figure 43: Database Trash Window
This view is similar to the “Exams” sub-view with different commands that Table 21: Database – Trash
can be activated. (See Table 21). Commands
92 Organizing Views

Total pages: 218
“Restore”
is used to move the selected file back to the area which contains the other
files available to the user to be elaborated.
Instructions:
1 Select the series or the sequence to restore from the list by positioning the
pointer on the corresponding line
2 Select by left-clicking
3 Activate the “restore” command, a message will appear to ask you to con-
firm the command.
“Eliminate file”
used to eliminate single sequences of a series or entire series with all its
sequences.
Instructions: Ch.
1 Select the file to be definitely removed by positioning the pointer on the 6
corresponding line
2 Select by left-clicking
3 Activate the “eliminate file” command, a message will ask you to confirm.
After confirming, the space previously occupied by the file in the hard drive
has now been freed.
“Empty Trash”
removes all files found in the trash creating free space previously occupied
in the hard drive.
Instructions:
1 Activate the command by positioning the pointer on the corresponding key
2 Select by left-clicking, a message will appear for confirmation. If you
confirm, the view will be updated showing the list of the empty series and
sequences.

6.4.9 Print Composer

The print composer can be activated in the view showing the command
which allows you to choose a layout and print the images. The print com-
poser can be activated in each of the screenshots that has a thumbnail of
the sequence: “Monitor A”, “Monitor B”, Database – Exams and Database
– Trash. The print composer can be activated only if the thumbnail shows at
least one sequence.
Activating the “Print” command, the print composer window will be viewed.
The print composer can be DICOM compatible in those installations in which
the DICOM PRINT option is present.
Print
Figure 44: Print Icon
Figure 45: Print Composer Window
6.4.10 “Clipboard” View

The Clipboard view acts as a support feature for the other views:
• Monitor A. Where present and enabled, the Monitor A view can use the
Clipboard feature to show the video without acquired subtraction in
fluoroscopy+ mode, both in the DSA and the Roadmap mode.
• Monitor B. The view present in Monitor B can be sent to the Clipboard
view.
• Database View. You can view sequences of an exam in the Clipboard wi-
thout opening it directly, thus allowing you to confront previous exams
with images of the current exam.
The commands available in this view are a sub-group of the commands of
the Monitor B view.
94 Organizing Views

Total pages: 218
6.5 Sequence Acquisition

Acquisition of the sequences is the work phase in which a sequence, that is,
a series of images, is shown on video and possibly recorded in the perma-
nent memory.
6.5.1 Types of Fluoroscopy

To generate sequences, two types of commands are present:
• The “Fluoroscopy” command
• The “Fluoroscopy+” command
Represented in the listed symbols of:
1 Fluoroscopy Ch.
6
2 Fluoroscopy +
Table 22: “Fluoroscopy” Commands
The manual fluoroscopy commands have the same function as the “Fluoro-
scopy” pedal command.

Total pages: 218 Sequence Acquisition 95
6.5.2 Work Modes

Images can be GENERATED in four different work modes:
• “Fluoroscopy”,
• “DSA” (Digital Subtraction Angiography),
• “RM” (Roadmap)
• “CINE”,
The sequence GENERATING work mode currently set in the system can
be identified in the upper right hand corner of Monitor A in the “Mode”
window, this window contains an interactive key represented by an icon.
Position the pointer and left-click on this icon to move from one mode to
the next, i.e. if you are in the Fluoroscopy mode, pointing and left-clicking
will bring you to the DSA mode, then to the RM mode etc.
Description of the principal work

Symbols Available Commands:
modes
1 Fluoroscopy
2 DSA
3 RM
4 Cine
Table 24: Work Mode
96 Sequence Acquisition © Copyright SIMAD srl 2020

Total pages: 218
6.5.3 Recursive Filter

The level of the digital recursive filter, shown in the “Filter” box in Monitor
A, under the “Mode” window in the upper right-hand corner of the screen,
influences the quality of the images shown on video and recorded.
The level of this filter allows you to reduce the noise effects inevitably pre-
sent in radiological images. The higher the level of the recursive filter, the
less the image will appear noisy. Consequently though, the higher the level
of the filter the more there will be a “drifting” effect on the image.
In low current Fluoroscopy (1 - 3 mA) the use of the recursive filter F0 or F1
is recommended only in cases in which a modest low level contrast thre-
shold on details is not determining in the current process, due to the low
dose emitted and therefore the low rapport signal/noise.
Moonray uses the F2 filter by default, for activities in which the use of a
lower filter is necessary; we recommend the use of anodic current superior Ch.
6
to 3mA.
The C-Arm is generally to be considered a supplementary radiological devi-
ce and the images produced are not valid for diagnostic purposes.
As indicated in Table 25, the recursive filter has four available levels.
1 Recursive Filter Level Deactivated
2 Recursive Filter at 50 %
3 Recursive Filter at 75 %
4 Recursive Filter at 87,5%
Table 25: Filters
To pass from one level to the other, point and left-click on the recursive
filter key.
6.5.4 Horizontal and Vertical Image Flipping

1 Horizontal Flipping
2 Vertical Flipping
Table 26: Image Flipping
This feature is found on the left-hand side of the screen in the fourth box
from the top denominated “Effects” in Monitor A and in the top right hand
corner of Monitor B. To activate flipping:
• Point and left-click on the icon number 1 will be flipped horizontally.
• Point and left-click on the icon number 2 will be flipped vertically.
If both types of flipping are applied, the image will appear as if it has been
rotated 180°.

Horizontal and
Without Flipping Horizontal Flipping Vertical Flipping
Vertical Flipping
Figure 46: Flipping Effects
Figure 46 shows the horizontal and vertical flipping effects.
6.5.5 Brightness and Contrast Setting

3 Show/Hide the Brightness /Contrast Window
Both Monitor A and Monitor B can be regulated independently with the

following features:
• brightness,
• contrast,
• image flipping
• negative of the images shown
To regulate brightness and contrast, point and click on the relative icon (key
number 3 above) of either Monitor A or Monitor B, depending which screen
you want to regulate; this action will show/hide the brightness/contrast
window (See Figure 47).
As seen in Figure 47, the window title bar indicates the monitor on which
one is working.
This window allows you to regulate the parameters, both with the sliders, if
you want to regulate quickly, or with the plus and minus keys located under
the sliders, if you want a finer setting.
• The “W” slider (Window) indicates the number of grays available to
visualize the image. Moving the slider upwards, the number of grays will
increase, moving the slider downwards; the number of grays will decrea-
se with a consequential increase in the contrast of the image.
• The “L” slider (Level) allows you to transform the grays of the image into
the grays indicated by the slider, e.g. an image with a range of grays in Figure 47: Brightness and Con-
the center of the gray scale can be made brighter by moving this slider trast Regulating Window
downwards or darker by moving it upwards.
• The “B” lever (Brightness) acts on all the levels of grays present: moving
this slider upwards, the image will be brighter, moving it downwards the
image will be darker.
The slide bars on the far right allow you to move the threshold of white and
black by diminishing the number of tones of gray visible in the image.
The Reset key brings the parameters to the settings specified by the user
while the “Undo” key allows you to restore the parameters previously set.
When regulating these parameters you must keep in mind that the settings
will be used for all the following sequences acquired.
6.5.6 Black/White Inversion

Total pages: 218
4 Black/white Inversion
To invert the grays, point and click on the relative icon (number 4 above) in
either Monitor A or B in the relative “Effects” window, the image will there-
fore be viewed in its negative form.
6.5.7 Image Clipboard

5 Write/Edit Text Annotation
Activating command number 5 by pointing and clicking on the relative win-

dow in both Monitor A and B allows the user to write or edit n Annotation
on each sequence for which the following window will open:
Ch.
6
Figure 48: Clipboard Window
Instructions:
1 Insert a comment
2 Confirm entry by pointing and left clicking on the OK key. The comment will
be saved in the database.
3 To cancel entry, point and left-click on the “Cancel” key.

6.5.8 Video Marking

6 View/Hide the video marking command window (See Figure 49).
With the Marking Tool (See Figure 49) the user can draw directly on the
image to create visual references that will remain visible till they are
explicitly cancelled or hidden.
Various types of markings can be drawn: symbols of various forms (See
Table 27), lines, circles, ellipses, text and numeric references. Symbols and
geometrical forms can be personalized in color and thickness. Text, which
can only be created inside a text box, can be personalized in character color,
character type, character size and background color which can also be
transparent.
The two work modes, create and edit, are recognizable by the form the
pointer takes (See “pointer” column in Table 27).
Command Pointer Description
B1 Edit
B2 Create text box Figure 49: Marking Tools

Figure 50: Marker Type Selector
B3 Create line
B4 Create ellipse
B5 Create Arrow
B6 Create Empty Bullet
B7 Create Solid Bullet
B8 Create Plus Sign
B9 Create Numbered Marker
B10 not assigned Undo Command
B11 not assigned Redo Command
B12 not assigned Eliminate Command
Table 27: Keys and Pointers for Marking

Total pages: 218
Creating a text box

Instructions:
1 Point and left-click on the B2 key as indicated in Table 27 to
activate the command.
2 Choose where you want to place the upper left-hand corner
of the box by pointing and left clicking on the image.
3 Choose the bottom right-hand corner of the box by left
clicking on the image.
4 An insert/edit text window will appear (See Figure 51).
5 Type the desired text and edit the background color, size, Figure 51: Marking Editor for Text Clipboard
font and other parameters if you wish to do so.
6 Confirm by pointing and left clicking on the OK key or cancel with the Cancel
key.
Ch.
All “create” commands will be aborted by a new X-Ray emission.
6
Creating a Marker
instructions
1 Point and left-click B3 to B9) in Table 27 to activate the desired marker.
2 Position the marker in the desired area by left clicking.
3 Complete the creation of the marker by left-clicking a second time (only for
markers B3, B4, B5 e B9).
Suggestion:
• When creating a line, pressing the Shift key on the keyboard will allow
you to create lines oriented at multiple 45° angles.
• When creating an ellipse, pressing the Ctrl key on the keyboard indicates
that the point in which the pointer is positioned will be the center of
the rectangle in which the ellipse will be contained. If the Ctrl key is not
pressed, then the position of the pointer will be a vertex of the rectangle
in which the ellipse will be placed. You can create a circle by pressing
and holding the Shift key.

Editing Markers
instructions
1 Point and left-click the B1 key to activate the command.
2 Select the items you want to edit with a selecting rectangle (position the
pointer, left-click and release in a different position from the original. All
the items whose tops fall inside this rectangle will be selected. The selected
items are recognizable by small black squares with white outlines (called
handles) visible on their upper part).
Editing position
instructions
1 Position the pointer on one of the selected items,
2 Press and hold the left key while moving the pointer till the items selected
have reached the desired position
3 Release the left key
Editing color and thickness.
Editing orientation/dimension
instructions
1 Position the pointer on a “handle”
2 Press and hold the Ctrl key, press and hold the left key
3 Orient and resize by moving the pointer
Editing the text Annotation:
instructions
1 Double click on the text Annotation you wish to edit
2 The interactive box as indicated in Figure 51 will appear to allow editing.
Eliminating Markers
instructions
1 Point and left-click on the B12 key
2 A confirmation message will appear asking you to confirm elimination. Only
the selected markers will be eliminated but if no markers are selected then
all the present markers will be eliminated.
Undo/Redo
instructions
1 Undo the last command by pointing and left clicking on the B10 key (see
Table 27).
2 Redo the last command by pointing and left clicking on the B11 key. Only
the last 8 commands can be manipulated.

Total pages: 218
Hide
In the marker tool window (See Figure 49) point and left-click on this key to
hide the markers, when you activate this key the on-screen key automatical-
ly becomes a “show” key.
Show
In the market tool window (See Figure 49) point and left-click on this key to
show the markers, when you activate this key the on-screen key automati-
cally becomes a “hide” key.
Point and left clicking any marker editing or creating key will make the
markers visible.
Ch.
6

6.5.9 Measuring Toolkit

7 Shows/Hides the Measuring Toolkit Window (See Figure 52)
The Measuring Toolkit (See Figure 52) allows you to draw directly on the
images, to create length measurements, angle measurements and write text
Annotations that will remain visible until they are explicitly cancelled or
hidden. See relative icon on Monitor A or B.
Command Pointer Description
B1 Edit
B2 Create Measurement Text Box
B3 Measure Length
B4 Measure Angle
B5 not assigned Undo last command
B6 not assigned Redo last command Figure 52 – Measuring Toolkit
B7 not assigned Eliminate
Table 28: Measuring Toolkit -- Icons and Pointers
When you open the Measuring Toolkit Feature, a disclaimer box will appear.
(See Figure 53)
Figure 53: Confirm conditions of use of the measuring toolkit
The disclaimer dialog message is viewed with every new series.

If the referral length sample is missing or if it is created and then cancelled,
only Pixel measures will be created.
Up to two length samples can be created; one on a percentage scale and
the other in French (Fr) or millimeters (mm).
Creating a length sample

instructions
1 Point and left-click on the ruler icon, then left click on the “R” key in Figure
52 Measuring Toolkit.
2 Select the sample’s unit of measure
3 Create a length measurement and fill in the corresponding length segment
factor in the on screen “factor” box next to the “R” key.

Total pages: 218
4 Deactivate the “R” key by pointing and clicking as before. The presence of
the length sample is recognizable from the double measurement factors,
one in Pixel and the other in mm or Fr.
After you have created a length sample for the specified unit of measure, it
will be inserted among the units of measure that can be selected for measu-
ring lengths.
The Fr unit of measure is directly tied to the mm unit of measure by a

constant. Therefore, if you save a length sample in mm it will also become
available in the Fr unit of measure and vice-versa.
The creation of the “length sample” for the unit of measure in % implicitly
becomes a value of 100%, which corresponds to the length of the segment
drawn on the screen, regardless of what the user indicates.
It is possible to create a series of length measurements without having a
“sample length”, later identify a “sample length” and change the unit of
measure of the length measures already created.
If a length sample is edited, all the measurements, which refer to that Ch.
sample, will be recalculated.
6
Measuring a segment’s length
instructions
1 Point and click on the B3 key as shown in Table 28 to activate this feature
(the pointer becomes the same shape as the icon in the corresponding
column).
2 Select the unit of measure you want to use for your segment by selecting
from the drop down menu labeled U.M. of the window in Figure 52.
3 Left click on the first extremity to measure. Move the pointer to the end of
the second extremity to measure and left-click to terminate the measure-
ment. The system creates a text measurement box which hosts the factor
of the measured length; this box will be positioned in the middle of the
measured segment and can be moved (see below).

Using an existing length segment as a new sample

instructions
1 Select a new length measurement
2 Point and left-click on the “R” key in the Measuring Toolkit, select the length
sample’s unit of measure.
3 Type the corresponding length factor of the measurement segment in the
“Value” box.
4 Deactivate the “R” key by pointing and left clicking. All the length measu-
rements in the units of measure of the sample already present are then
recalculated according to the new length sample.
Measuring an Angle
instructions
1 Point and left-click on the B4 icon as seen in Table 28 (the pointer becomes
the same shape as the corresponding column). To identify the angle you
want to measure, you must identify 2 segments (each identified with 2 dif-
ferent points). The measurement of the angle is carried out on the intersec-
tion of the rays where the two segments lie.
2 Bring the pointer in correspondence to the first point of the first segment
and left-click. Move the pointer onto the endpoint of the first segment and
left-click. You will note that during positioning a line will be drawn from the
first point to the second.
3 Position the pointer in correspondence to the first point of the second
segment and left-click. Move the pointer onto the endpoint of the second
segment and left-click.
4 The system will draw an intersection of the rays containing the two seg-
ments, number the vertex of the triangle with the letters Ai, Oi, Bi (where
i is substituted by a unique number) and inserts a tag with the highlighted
angle’s measurement and its complementary angle.
Angles can only be measured in degrees.

Total pages: 218
Editing a measurement
instructions
1 Point and click on the B1 icon as shown in Table 28 to activate this feature
2 select the objects to edit with a selection rectangle by positioning the poin-
ter
3 left-clicking and releasing in a different position from the first. All the
objects whose vertex falls within this rectangle will be selected. The selec-
ted items are recognizable by small black squares with white outlines (called
handles) visible on their upper part).
Editing position
instructions
1 Position the pointer on one of the selected items,
2 Press and hold the left key while moving the pointer till the items selected
have reached the desired position Ch.
3 Release the left key 6
Editing color
instructions
1 Position the pointer on the color box
2 left-click to open the drop-down menu,
3 click to select color (See Figure 52 – Marking Tools.)
Editing orientation/dimension:
instructions
1 Position the pointer on a “handle”
2 Press and hold the Ctrl key, press and hold the left key
3 Orient and resize by moving the pointer, if you resize a length measurement
then its corresponding value will be varied. If you resize an angle measure-
ment then the corresponding angle measure will be varied.
Editing the position of the text measurement box
instructions
1 Point on the rectangle of the text measurement box
2 press and hold the Ctrl key
3 press and hold the left key under the trackball
4 move the pointer to change position of the box.
5 Release the left key when the box has reached the desired position.
Editing the text Annotation:
instructions
Point and double click on the text Annotation you wish to edit, the edit box
will open as seen in Figure 51

Eliminate Measurements
instructions
1 Point and click on the B7 icon as shown in Table 28.
2 A confirmation of the command is requested. Only the selected measure-
ments will be eliminated. If none of the measurements are selected then all
the measurements will be eliminated.
Undo/Redo
Point and click on the B5 icon as shown in Table 28 to undo the last com-
mand. Point and click on the B6 icon to redo the last command. Only the
last 8 commands can be manipulated.
Hide
In the marker tool window (See Figure 49) point and left-click on this key to
hide the markers, when you activate this key the on-screen key automatical-
ly becomes a “show” key.
Show
In the market tool window (See Figure 49) point and left-click on this key to
show the markers, when you activate this key the on-screen key automati-
cally becomes a “hide” key.
If you have hidden any of the marking objects, left-clicking on any of the
editing buttons will show the previously created objects.

Total pages: 218
6.5.10 Saving Images

To select the “save” option according to the work mode you are using, left
click on the corresponding icon which identifies the type of work mode you
are using. (See Figure 54).
Save Options for Fluoroscopy
Save Options for Fluoroscopy +
Figure 54: Saving Options
The following options are available:
Symbol Saving Description Fluoroscopy Fluoroscopy+ Ch.
1 Saving Deactivated Yes Yes 6

2 Manual Yes Yes
3 Save only the last image Yes Yes
4 Save the entire sequence No Yes
5 Saving is impossible due to insufficient space Yes Yes
Table 29: Saving Option Commands
When the user selects to save manually (Icon 2), the sequence will be saved
in any case and at the end of the acquisition, the “Image” window in Moni-
tor A will view one of the two icons in Figure 55.
Save the last image Save the entire sequence
Figure 55: Save Commands
The last image acquired will be saved in the current series when clicking on
one of the two icons above. This acquisition will be lost if the machine is
turned off or if one of the two Fluoroscopy commands is activated before
clicking on one of the two “save” icons in Figure 55.
Icon number 5 in table 29 can signal insufficient available space and therefo-
re the impossibility to save.
Each time you save, the system creates a thumbnail of the image inside
the catalogue. This operation will slowly diminish the system’s resources
and will diminish its performance. To keep the system’s performance at its
best, we suggest you do not exceed 600 images. Once you reach the limit
of 1000 images the system will lock X-Ray emission.

6.5.11 Angular Position of the camera

The acquisition camera can rotate about 360° in order to correctly orient
the radiological images. A mechanical stopper prevents rotations above
360°.
“Monitor A” will show a small circle in the corner in which the camera is po-
sitioned and a rectangle where the rotation’s mechanical stopper is found.
(See – Figure 56 A).
The rotating activating command is found on the C-Arm Console (see §4
Using the Moonray). By activating this command, the angle of the camera
can now be manipulated with the knob located on the console itself.
• If the user activates the rotation command without emitting X-Rays, the
screen will visualize the angular position of the camera with an arrow
(See Figure 56 – B). To orient the camera, the arrow must be aligned with
the vertical axis of the image below. The arrow disappears about 150 ms
after the rotation arrest (See Figure 56 – C). When X-Rays are emitted,
the system brings the angular position indicator to the “twelve o’clock”
position to indicate that what is shown on the screen is the “top” of the
image. (See Figure 56 – D).
• If the user activates the camera rotation command while he is emitting
X-Rays, he will see the images produced by the camera rotate in real
time.
A – Position Markers B – Position Search C – Camera position D – Camera position after

before acquisition acquisition
Figure 56: Position Markers
6.5.12 Collimator Position Thumbnail

In the models in which this feature is available and activated, a thumbnail of
the position of the compensator filters and the iris diaphragm can be seen
without X-Ray emission. During collimator movement, a thumbnail of the
final position will appear onscreen (see below); the thumbnail will disappear
1 second after movement has arrested or after X-Ray emission has begun.
Thumbnail of the iris Position after X-Ray Thumbnail of the position Position after X-Ray
diaphragm position during emission of the compensator filters emission
movement during movement

Total pages: 218
The camera’s rotation does not cause the collimators to change their posi-
tion in respect to the anatomical part but will surely change their previous
position on screen. To see their new position, move them slightly and bring
them back to the desired position.
6.5.13 Digital Subtraction

When generating sequences in digital subtraction, a particular frame called
“mask” is first acquired and then subtracted from the images produced
during acquisition, so as to highlight those particular areas that differ from
the image of the mask itself (See Figure 57).
Ch.
6
M - Mask F - Frame Difference M - F
Figure 57
The mask frame, once acquired, will become visible by activating the “Mask
Catalogue” (See Figure 58) window with the key number 1 indicated in Table
30.
The mask frame is associated with every sequence produced in the digital
subtraction mode.
1 Shows/Hides the mask catalogue
2 Shows/Hides the subtraction settings
3 Adds the current frame to the mask catalogue
4 Activate/Deactivate subtraction
5 Activate/Deactivate the max opacity feature
Table 30: Digital Subtraction Commands
The digital subtraction settings can be edited through the “Subtraction

Settings” window which will appear when you point and click on number 2
of Table 30.
The mask to be used for digital subtraction can also be changed by adding a
new frame to the mask catalogue and using it in the place of the one gene-
rated automatically.
During viewing you can momentarily deactivate and later reactivate digital
subtraction by pointing and clicking key number 4 in Table 30.
The number 5 key in Table 30 allows you to select the max opacity function
of every pixel point of a sequence.

6.5.14 Mask Catalogue

The mask catalogue (See Figure 58) groups up to four masks pertai-
ning to the same sequence and allows the user to select a different
subtraction mask from the original.
As can be seen in Figure 58, the window views four different icons,
which correspond to the four functions listed in Table 31.
1 Eliminate the current mask
2 Eliminate all masks
3 Add mask from Clipboard

Figure 58
4 Send copy of mask to Clipboard
Table 31: Mask Catalogue Commands
• Key number 1 allows the user to remove the selected mask from the
catalogue; this command cannot be used on the original mask but only
on those created in post processing.
• Key number 2 eliminates all the masks present in the catalogue aside
from the original mask.
• Key number 3 is used when an image is present in “Clipboard” and
allows this image to be copied in the mask catalogue to be used as a
subtraction mask.
• Key number 4 allows you to send the currently selected mask to “Clipbo-
ard”.
6.5.15 Subtraction Settings

The digital subtraction settings can be varied with the options present in the
“Subtractions Settings” window below (See Figure 59).
Figure 59: Subtractions Settings Window
The window is subdivided as follows:

Total pages: 218
• The “Enhancement Type” window allows the user to choose an algori-

thm used to reinforce the effects of the digital subtraction specifying the
value in the “Enhancement Level” feature. A low reinforcement value
will produce a low contrast of the grays in the frame resulting from the
subtraction. The linear enhancement increases the contrast points of the
frame based on a linear law, while the type of logarithm enhancement
(where present and enabled) uses a logarithmic law which better enhan-
ces the grey values closer among themselves.
• The “Auto Sub” feature (where present and activated) can be used in the
DSA and Roadmap modes and automatically reactivates digital subtrac-
tion when the Fluoroscopy+ pedal is activated, regardless of the subtrac-
tion settings. If Auto Sub is not activated, acquisitions of sequences in
Fluoroscopy+ will be without digital subtraction.
• The “Video in Clipboard” box in Monitor B allows the user to view both
the images, without subtraction, coming from the camera and from
the Monitor A view simultaneously. This mode is deactivated when the
user confirms deactivation of this function after sending an image to the Ch.
Clipboard box from Monitor B or from the “Archive” view.
• The “transparency” feature allows you to mix the subtraction result
6
with the frame that has been subtracted (Land Marking). A 0% value will
show only the subtraction result frame on screen, a 100% value shows
only the frame without the mask subtraction; values in between increa-
se/decrease the influence of the two frames in the final result.
• The “shift” parameter allows you to shift the value of the grays of every
pixel in the subtraction frame so that the values that are nearly black will
be remapped to the applied shift.
• The box containing the X and Y coordinates (See Figure 59) allows the
user to edit the alignment of the mask used in the subtraction by using
the arrow buttons places horizontally and vertically (Pixel Shift). To clear
the alignment point and left click in the middle of the box.
• The “Reset” key brings the settings back to the default values of the
current work mode.
• The “ON/OFF” button exits the window.

6.5.16 Recording Speed

The Recording Speed of the frames/second can be chosen to diminish space
occupied by the sequence in the hard drive. The options are listed in Table
32.
1 25 Images/sec.
2 12 Images/sec.
3 8 Images/sec.
4 6 Images/sec.
5 4 Images/sec.
6 2 Images/sec.
7 1 Images/sec.
8 0,5 Images/sec
Table 32: Recording Speed
The default parameter can be personalized.

Total pages: 218
6.6 Generating images

Images are generated with X-Ray emission, when the user activates one of
the Fluoroscopy or Fluoroscopy+ commands (See Types of Fluoroscopy).
Figure 60 X-Ray Emission in Progress
Figure 61 Acquisition Preparation
Figure 62 X-Rays Locked
Figure 63 Limited Time Fluoroscopy Ch.

6
Figure 64 Cooling Pause
Figure 65 Reset
During X-Ray generation, the icon (X-Ray Emission in Progress – Figure 60)
will appear in Monitor A, which indicates emission of X-Rays.
An hourglass symbol will appear in the center of Monitor A during the first
few seconds while the preparation phase is in progress: when the prepara-
tion phase is complete, the symbol disappears and the fluoroscopic image
will appear (See Figure 61). If the user releases the Fluoroscopy or Fluoro-
scopy+ command before the preparation phase is complete, the radiological
image will not be visible.
If the icon in Figure 62 appears on Monitor A, the system locks any X-Ray
emission command.
When the user executes a high current Fluoroscopy+ emission, the icon
in Figure 63 appears and is “filled” to show the residual time available of
Fluoroscopy+ X-Rays.
The “Cooling Pause” icon in Figure 64 appears at the end of the high current
Fluoroscopy+ command to signal the impossibility to emit X-Rays till the
cooling pause has been completed.
The “Reset” icon in Figure 65 indicates that a reset command from the
C-Arm console of the X-Ray time limit has been activated because the time
limit of use of the C-Arm has been reached.

Total pages: 218 Generating images 115
6.7 Fluoroscopy
In the “Fluoroscopy” mode, the acquired sequences are shown on video and
only the last frame is saved.
To save the fluoroscopic images, take the following steps:
1 Select the “Fluoroscopy” mode.
2 Regulate the filter level, if necessary, by pointing and left-clicking on the
“Filter” window in Monitor A (See Recursive Filter).
3 Specify, if necessary, the image save mode (See Saving Images).
4 Place the device aimed on the anatomical part of interest until you reach
the desired position.
5 Activate the Fluoroscopy command until the image appears on Monitor A.
6 Regulate brightness and/or contrast of the image if necessary (See Regula-
ting Brightness/Contrast).
116 Fluoroscopy
Total pages: 218
6.8 DSA
In the DSA mode, Fluoroscopy produces sequences of fluoroscopic images
and, according to the settings, can only save the last frame of each sequen-
ce.
To save a sequence in digital subtraction you must activate the Fluoro-
scopy+ command and keep it activated.
To save a sequence in the DSA mode, take the following steps:
1 Select “DSA” mode.
2 Regulate the filter level, if necessary, by pointing and left clicking on the
3 Specify, if necessary, the image save mode (See Saving Images).
4 Center the anatomical part of interest and use the Fluoroscopy command to Ch.
verify the correct position.
5 Regulate brightness and/or contrast of the image if necessary (See Regula- 6
6 Begin digital subtraction by using the Fluoroscopy+ command. The following
is a step-by-step account of the procedure:
• automatic acquisition of the frame to subtract from the other frames
(mask frame)
• digital subtraction phase, signaled by the icon “Injection of Contrast
Liquid Possible” (See Figure 74). Injection of the contrast liquid.
• to obtain an adequate result the Fluoroscopy+ command must be held
active the entire time.
Contrast Liquid Injection with Injector (Figure 74) and without (Figure 75)
Figure 74 Figure 75
7 terminate digital subtraction by deactivating the Fluoroscopy+ command.

Acquisition terminates when the Fluoroscopy+ command is released, the
icon “X-Rays Locked” will appear for a few seconds on Monitor A (See Figure
62) which indicates an elaboration in progress of the system.
Between one Fluoroscopy+ command and another, digital subtraction can
be deactivated/reactivated. (See Digital Subtraction).
The activation of the injector is subordinated to the manual injection

approval command managed by the injector itself. In case of failure, an
accidental injector piloting or a failed injector piloting may occur.

Total pages: 218 DSA 117
6.9 Roadmap
This is a digital subtraction mode. The substantial difference between this
mode and DSA is that contrast liquid injection is necessary during the mask
creation phase. Both Fluoroscopy and Fluoroscopy+ commands can be
activated in this mode. The Fluoroscopy command produces sequences of
fluoroscopic images and, according to the settings used, can save only the
last frame of every sequence; furthermore, you can “reset” to reacquire the
digital subtraction mask.
The Fluoroscopy+ command activates the Roadmap function.
To save images in this mode take the following steps:
1 Select the “Roadmap” mode.
2 Regulate the filter level, if necessary, by pointing and left clicking on the
3 Specify, if necessary, the image save mode (See Saving Images) for both the
fluoroscopy commands.
4 Center the anatomical part of interest and use the Fluoroscopy command to
verify the correct position.
5 Regulate brightness and/or contrast of the image if necessary (See Regula-
6 Begin the mask frame formation phase by using the Fluoroscopy+ com-
mand. The following is a step-by-step account of the procedure:
• automatic acquisition of the frame to subtract from the other frames
(mask frame)
• digital subtraction phase, signaled by the icon “Injection of Contrast
Liquid Possible” (See Figure 74).
• Injection of the contrast liquid.
• Begin the subtraction phase by activating the “Fluoroscopy+” command.
The created mask will be used.
7 Terminate digital subtraction by deactivating the Fluoroscopy+ command
All the “Fluoroscopy+” commands activated after the mask subtraction ac-
quisition phase use the subtraction mask and subtract it from the acquired
frames.
Every time the “Fluoroscopy+” command is deactivated, digital subtraction
can also be deactivated with the command mode (See Digital Subtraction).
The use of the “Fluoroscopy” command brings the system back into a new
mask creation phase.
The activation of the injector is subordinated to the manual injection

approval command managed by the injector itself. In case of failure, an
accidental injector piloting or a failed injector piloting may occur.
118 Roadmap
Total pages: 218
6.10 Cine
This work mode is used to record fluoroscopic sequences and the “Fluoro-
scopy” command is used to record single frames while the “Fluoroscopy+”
command is used to record complete sequences.
To record images in the “Cine” work mode, take the following
steps:
1 Select the “Cine” mode.
2 Regulate the filter level, if necessary, by pointing and left-clicking on the
“Filter” window in Monitor A (See. Recursive Filter).
3 Specify, if necessary, the image saving mode (See Saving Images) for both
the fluoroscopy commands.
4 Center the anatomical part of interest and use the Fluoroscopy command to
verify the correct position Ch.
5 Begin acquisition by activating the “Fluoroscopy+” command. 6
6 Terminate acquisition by deactivating the “Fluoroscopy+” command.

Total pages: 218 Cine 119
6.11 Indicators, Alerts & Error Messages
6.11.1 Indicators
Figure 66: Hard Disk Space and Temperature Indicators
Hard Disk Space - Vertical Bar Indicator: The bar indicates the percentage of
available space for the images in the hard disk.
When the available space reaches the limit of 0%, the acquired images will
still be visualized on the Monitor A, but will not be saved, that is, they will
not be available for visualization at a later time. The user must always keep
a “reasonable” percentage of hard disk space available, which coincides
with his style of working and the use of the device. To free space on the
hard disk, take the following steps:
• To save a copy of the data, follow the procedure indicated in “Export
Data” and then proceed with the cancelation of the file from the Databa-
se and the Trash.
• If a copy of the data is not necessary, then proceed with cancelation
from the Database and the Trash.
Temperature – Vertical Bar Indicator: The bar indicates the monobloc tem-
perature.
During X-Ray emission, the monobloc’s temperature increases towards a
thermal saturation limit, when reached, X-Ray emission is disabled.
120 Indicators, Alerts & Error Messages

Total pages: 218
6.11.2 Alert/Error Messages

Monitor “A” interacts directly with the X-Ray generator and views a series of
icons which signal various alert/error conditions. The icons are listed below:
A1 Failed Dosimeter Calibration
A2 Temperature Limit Reached (limited to the Moonray 1K version)
A3 Dosimeter Malfunction
A4 Communication Time-Out
Ch.
A5 C-Arm Disconnected or Off
6
A6 C-Arm Continuous Use Time Limit Reached
A7 No mains power, the computer is powered by the UPS.
A8 The UPS batteries are low.
A9 The UPS batteries are not charging or are out of order.
A10 The UPS software control is deactivated.
Table 33: Monitor A - Alert/Error Messages
The alert message in Figure 67 informs the user that the examination in
progress has already reached 600 images and is therefore long. The messa-
ge does not implicate any variations to the machine operation but recom-
mends that the user end the current exam due to the elevated number of
images that have been stored in the exam.
To hide the message, left-click on the “OK” button or press the “Enter” key
on the keyboard.
Figure 67 – Elevated Number of Images Alert Message

Total pages: 218 Indicators, Alerts & Error Messages 121
The alert message in Figure 68 informs the user that X-Ray emission has
been locked because the system has reached the image limit of 1000 ima-
ges/sequence.
Figure 68 – X-Ray Emission Locked – Image per Sequence Limit Reached
122 Indicators, Alerts & Error Messages

Total pages: 218
6.12 UPS (Uninterruptible Power Source –

Optional)
The system is equipped with a UPS (generator) which disposes of a battery-
run autonomous electrical power system that can guarantee continuous
power to the computer and safeguard the data and the operating system
from accidental or voltage dip shutdowns.
This autonomous system does not allow the user to continue X-Ray emis-
sion but, in cases of voltage dips, the internal computer activates an auto-
shutdown procedure that protects data and images contained in the system
from possible damages.
When power is newly available to the system, the user must re-boot by
turning the startup key (this operation is possible only if the system hasn’t
begun the auto-shutdown procedure).
Ch.
When the UPS batteries are fully charged and efficient, the automatic shut- 6
down procedure will take about 3 minutes (can be configured differently).
When the UPS batteries are NOT fully charged and efficient, the automatic
shutdown procedure will take a relatively short period of time, about 10
seconds (can be configured differently).
Indicator lamps on the UPS:

• green lamp: power available
• yellow lamp: low batteries
• orange lamp: batteries charged
If the batteries are not fully charged and do not recharge in a reasonable
amount of time, the computer will signal the need for service to the user
but will nevertheless allow normal X-Ray emission.
Since low batteries do not guarantee ad adequate autonomy, in cases of
voltage dips, the internal computer software can suffer damages which
would then call for a new software installation.
Icon List:
No power supply: the computer is functioning on its own batteries.
The UPS batteries are not completely recharged. They might have lost power during a preceding black-
out or due to a long period of inactivity. They should be recharged after about 10 hours of use.
The UPS control system is deactivated. In case of power loss or battery malfunction the computer will
take no action, in other words, there will be no automatic shutdown.
Service request for the UPS system, the batteries are probably low and do not recharge.
Table 34: UPS Status Messages

Total pages: 218 UPS (Uninterruptible Power Source – Optional) 123
If the UPS is installed and activated, the icons in Table 34 will interact with
the user. See Figure 71 for on-screen location.
Figure 71: UPS Alert Icon Location
In case of power failure, a message will alert the user of the beginning of the
automatic shutdown procedures of the system (See Figure 72: Power Failure
Alert)
Figure 72: Power Failure Alert
124 UPS (Uninterruptible Power Source – Optional)

Total pages: 218
To deactivate the system’s shutdown procedure, point on any point of the

on-screen alert message and left-click. A confirmation message box will
appear to abort the automatic shutdown procedure (See Figure 73).
Ch.
6
Figure 73: Abort UPS Automatic Shutdown Box
If power supply does not return or if power returns but the device does not
startup after having turned the startup key, the computer will consume the
battery power completely and will potentially shutdown abnormally, dama-
ging the data and the installed software.
UPS Parameters in Software Settings:
Parameter Description
Enabled Activates the UPS status check function
COM port Selects the serial port which checks the UPS status
Delay before start service (sec) Indicates the delay, in seconds, before the UPS status is checked.
Check battery signal Checks/Ignores the low battery signal (DTR pin 4 com port)
Check power failure signal Checks/Ignores the power failure signal (DTR pin 7 com port).
Enables service request in case of low battery alert (See Table 34). The request
Ask assistance if Battery is Low
assistance icon never appears.
Delay before shutdown (sec) Indicates how many seconds the countdown will last.
The countdown will be shorter and will begin from this setting due to low
Short delay before shutdown (sec)
batteries.
Table 35: Configuration Parameters for the UPS Manager

Total pages: 218 UPS (Uninterruptible Power Source – Optional) 125
6.13 Print Composer

Every time the user sends an image print request currently shown on scre-
en, the print composer server is activated.
This feature has been designed to facilitate the collection and the availabi-
lity of the images the user needs, allowing him to print the images simulta-
neously to the exam execution. The images to be printed can be composed
by selecting them from almost every view.
6.13.1 Print Composer Description

The print composer window can be automatically hidden (not closed) by
pointing anywhere outside the window itself and left clicking. To reactivate
point and left-click on the shortcut key in the upper right-hand corner of
Monitor B or give another print command of an image.
Figure 76: “Print Server” Window
The print composer window contains the following:

• Print setting options in the left column.
• Thumbnail of the image to be printed in the center of the
page.
• Commands to leaf through the images ready for printing
• Page currently viewed indicator.
Images can be sent to the printer only if the print composer is
open.
Figure 77: “Print Composer” Window
126 Print Composer

Total pages: 218
6.13.2 Print Composer Settings

Print parameters can be set by utilizing the commands seen in Table 36.
Select printer
Select paper orientation
Set the number of cells of the image grid.
Text spacing setting

Ch.
Table 36: Print Setting Commands 6

Printer box -- specify which printer to use.
Orientation box – specify vertical or horizontal orientation (See Figure 78).
Vertical Horizontal
Figure 78: Print Orientation
Row x Column box – specify the grid to use for image impagination. If the
number of rows and columns is 1, one image per page will be printed, or 2
rows and 1 column, two images per page will be printed, or 3 rows and 1
column, 3 images will be printed or 2 rows and 2 columns, 4 images will be
printed. (See Figure 79).
Figure 79: Print Layout

Total pages: 218 Print Composer 127
6.13.3 Print Composer Commands

The print composer commands are shown in Table 37 below.
Print
User Preferences
Previous Page
Next Page
Exit
Table 37: Print Composer Commands
Print: Send pages to the printer

User Preferences: Activates the User Preference Window used to set advan-
ced printer settings. (See Figure 80).
Figure 80: User Preferences Window
• Heading box: if checked, places the desired heading on each page, i.e.
the name of the hospital and activates the character size option, see
Customizing in §6.24.
• Show image data box: if checked, prints the parameters used to Without filling Filling empty
acquire the sequence and activates the character size option. empty space space
• Show image Annotation: if checked, text Clipboard attached to

the image will be printed.
• Fill empty space printing: if checked the grid cells that do not con-
tain images are completely filled in black (see Figure 81) in order
to better evaluate images.
• Footnotes: when checked, footnotes can be entered in the input
field below that will be viewed at the bottom of every page. Figure 81: Fill Empty Space Printing
128 Print Composer

Total pages: 218
6.13.4 Impagination
Composing images
Once the print composer has been enabled with a “Print” command, further
images can be sent for printing before confirming from any of the following
views with another “Print command: Monitor A or B, Archives – Exams,
Archives – Recycle bin.
Setting the impagination grid

To increase the number of images present in every page, use the “Rows x
Columns” feature to edit the number of rows and/or columns of the grid in
which the images are aligned.
Repositioning an image Ch.

To move an image on the grid, position the pointer on the image to move,
press and hold the left key (the pointer’s form changes) and drag the image 6
to the desired position, release the left key. The images will exchange posi-
tions. (See Figure 82).
Repositioning an image Eliminating an image
Figure 82
Eliminating an image
To eliminate an image from a print composition, position the pointer on the
image to be eliminated, right-click on the image to open the context menu
and select the “Eliminate” command, confirm removal. (See Figure 82).

Total pages: 218 Print Composer 129
6.14 DICOM Print Composer

This is an optional feature that might not be present on the system you are
using.
Every time the user sends a print request to the system, the print composer
server is activated. If the DICOM server option is available, the available
print composer will appear equipped with the selecting functions on the
remote DICOM server printer and on the local printer. Activating the DICOM
print composer will automatically deactivate the standard print composer.
This feature has been designed to facilitate the collection and the availabi-
lity of the images the user needs, allowing him to print the images simulta-
neously to the exam execution.
The images to be printed can be composed by selecting them from almost
every view.
6.14.1 DICOM Print Composer Description

The print server is viewed in a window overlapping the current view.
The print composer window can be automatically hidden (not closed) by
pointing anywhere outside the window itself and left-clicking. To reactivate
point and left-click on the shortcut key in the upper right-hand corner of
Monitor B.
The print composer window contains the following:
• Print setting options in the left column.
• Thumbnail of the image to be printed in
the center of the page.
• Commands to leaf through the images
ready for printing
• Page currently viewed indicator.
Images can be sent to the printer only if the
print composer is open.
Figure 83: DICOM Print Composer Window
130 DICOM Print Composer

Total pages: 218
6.14.2 DICOM Print Composer Settings

Print parameters can be set by utilizing the commands seen in Table 38.
Select printer or print server
Select paper orientation and type of

algorithm to manipulate the image
Select film size and paper type
Row/Column settings on the image grid.
Number of copies
Ch.
Profile 6
Table 38: DICOM Print Composer Settings
Printer Name box -- specify which printer to use.

Magnification box – type of algorithm for image manipulation.
Film size box – select paper size.
Medium type – select type of paper.
Orientation box – specify vertical or horizontal orientation (See Table 39).
Vertical/portrait Horizontal/landscape
Table 39
Row x Column box – specify the grid to use for image impagination. If the
number of rows and columns is 1, one image per page will be printed, or 2
rows and 1 column, two images per page will be printed, or 3 rows and 1
column, 3 images will be printed or 2 rows and 2 columns, 4 images will be
printed. (See Figure 84).
Figure 84: Print Layout

Total pages: 218 DICOM Print Composer 131
6.14.3 DICOM Print Composer Commands

The DICOM print composer commands are shown in Table 40.
Print
Network Connection Test
Selected Server Connection Test
Previous Page
Next Page
Exit
Table 40: DICOM Print Composer Commands
“Print” – sends pages to the printer.

“Network test” executes a “ping” to the server that hosts the selected
DICOM node.
“DICOM test” executes an echo command in the selected DICOM node.
“Next page” moves the composer to the next page.
“Prev page” moves the composer to the previous page.

Total pages: 218
6.14.4 DICOM Impagination
Composing images
Once the print composer has been enabled with a “Print” command, further
images can be sent for printing before confirming from any of the following
views with another “Print command: Monitor A or B, Archives – Exams,
Archives – Recycle bin.
Setting the impagination grid

To increase the number of images present in every page, use the “Rows x
Columns” feature to edit the number of rows and/or columns of the grid in
which the images are aligned.
Repositioning an image Ch.
1
To move an image on the grid
position the pointer on the image to move
6
2 press and hold the left key (the pointer’s form changes) and drag the image
to the desired position
3 release the left key. The images will exchange positions. (See Figure 85).
Repositioning an image Eliminating an image
Figure 85
Eliminating an image
To eliminate an image from a print composition
1 position the pointer on the image to be eliminated
2 right-click on the image to open the context menu
3 select the “Eliminate” command
4 confirm removal. (See Figure 85).

Total pages: 218 DICOM Print Composer 133
6.14.5 Print Composer DICOM Log

The “DICOM Log message” box, lists error messages and operations execu-
ted.
Figure 86: DICOM Log Message Box
6.14.6 DICOM Remote Server Configuration

To add and administer remote servers, please request assistance and con-
sult the configuration documentation.

Total pages: 218
6.15 DICOM Work List

This is an optional interface, which might not be present in the system you
are using. The DICOM worklist gives you access to patients’ personal data
and other information relative to the exams to be carried out by simply con-
sulting the DICOM server and the work lists connected in a LAN network.
This feature was designed to facilitate patient data processing and other
important data normally processed by patient management personnel.
6.15.1 DICOM Worklist Description

The DICOM worklist is activated with the DICOM worklist icon found in the
ARCHIVE view under the “Planned” exams tab.
Ch.
Figure 87: DICOM Worklist Icon 6
Figure 88
Figure 89: “Worklist” Window
The DICOM worklist application is viewed in a window overlapping the

current view .
This box can be automatically hidden (not closed) by pointing anywhere
outside the window itself and left-clicking. To reactivate point and left-click
on the shortcut key in the upper right-hand corner of Monitor B. (See Figure
90) first icon on the left.

Total pages: 218 DICOM Work List 135
Figure 90: Shortcut Keys
The box contains the following commands:

• Select which DICOM worklist server to interrogate.
• Select the DICOM worklist server search criteria.
• Test remote server connection.
• Import data selected.
Data will not be imported in the local archive until the box is closed proper-
ly.
6.15.2 DICOM Worklist Search Criteria

The user proceeds by typing the search criteria in the input fields of the
DICOM worklist interface boxes. (See Table 41).
Select the period of time in which

the exam was performed
Select the patient’s name
Select patient ID
Select patient sex
Select the patient’s date of birth
Select the name of the local

workstation
Select mode
Select the scheduled performing

physician
Select the Requested Procedure ID
Select the requested procedure

description
Select the Accession number
Table 41: DICOM Search Criteria
136 DICOM Work List

Total pages: 218
6.15.3 DICOM Worklist Interface Commands

The commands are listed in Table 42.
Executes a data request that satisfies the

criteria indicated.
Done – Closes the current window
Views results of the search
Table 42: Worklist Interface Commands
“Worklist Query” - Executes a data request that satisfies the criteria indica-
ted.
“Done” Closes the current window.
Ch.
“View Result” Views results of the search.
6
6.15.4 DICOM Worklist – Import Patient Data
Activating the worklist interface

The DICOM worklist interface is activated with the DICOM worklist icon
found in the ARCHIVE view under the “Planned” exams tab.
Viewing remote data

Select the server which contains the data requested, input the selection
criteria so as to reduce the resulting list as much as possible. Point and left-
click on the “Worklist Query” command to view the list of data which satisfy
the criteria indicated. The data will be listed in the window which appears
above the “Worklist Query” key (See Table 42). If the window is not active,
point and left-click on the “View Result” icon (See Table 42).
The data will be listed in a window which appears above the Worklist Query
icon.
Importing the remote data on the local archive

Select the lines from the list that contain the data requested, point and
left-click on the “done” icon. (See Table 42). The box will disappear after a
few seconds and the data requested will be listed in the Archive>Scheduled.
If the data is not immediately visible point and left click on the “Worklist
Query” key again.
Figure 94

Total pages: 218 DICOM Work List 137
6.15.5 DICOM Worklist Log

The “DICOM Log Message” box, lists error messages and operations execu-
ted. Check to verify the operations executed and the errors found during
the data import phase.
To access the log use the dedicated keys.
6.15.6 DICOM Worklist – Configuring Remote Servers

6.16 Query Retrieve
The DICOM image viewer used in this mode is a free shareware version
and since the program’s traceability cannot be guaranteed, it cannot be
used to carry out diagnosis but simply as a search and consult feature of
existing studies.
6.16.1 QR Description
This interface is optional and might not be present in the system you are
using.
The Query Retrieve feature is useful to consult the DICOM image archives.
The Query Retrieve interface allows you to interrogate remote servers and
obtain lists of studies or exams already carried out. The list of exams can be
filtered according to diverse parameters:
• Patient’s Name
• Patient’s Surname
• Mode
• Executing Date
• Patient ID
• Etc.
Images that are located in remote servers can be selected, copied and retri-
eved into the local Moonray computer. The imported images can be viewed
with a DICOM image viewer which is a free shareware version and since the
program’s traceability cannot be guaranteed it cannot be used to carry out
diagnosis but simply as a search and consult feature of existing studies.
The query retrieve option is activated from the relative icon found in the
upper right-hand corner of the Moonray Digital Memory Interface.
Figure 96 Query Retrieve Icon
The user interface to access remote servers is seen in Figure 97).
138 Query Retrieve

Total pages: 218
Figure 97 QR Interface
Once the Query Retrieve interface is activated, the DICOM viewer becomes Ch.
available to view the imported exams. (See Figure 98).
6
Figure 98 DICOM Viewer

Total pages: 218 Query Retrieve 139
6.16.2 QR from Remote Servers

You can execute a Query Retrieve from a remote server as fol-
lows:
1 Select the DICOM server in the upper right-hand combo box of the DICOM
interface window (See Figure 97). If servers do not appear in the list, con-
tact the network administrator and input the data following the DICOM for
Moonray configuration procedures (See Table of Contents of this manual).
Once selected the desired server, input search criteria to pinpoint the list of
resulting exams.
Figure 99 Remote Server Selection
2 Point and left-click on the “Find” button to search the remote server.(See
Figure 100).
Figure 100 Remote Server Search
3 Select the desired images from the resulting list (See Figure 101).
Figure 101 List of results
4 Activate image import onto your local server by pointing and left-clicking
on the “retrieve” key. (See Figure 102 – Import Locally). The transfer feature
will be activated (See Figure 103 – Move Images) to copy the images from
the remote server to your local computer.
Figure 102 Import Locally
140 Query Retrieve

Total pages: 218
Figure 103 Move Images

Ch.
5 Point and left-click on the “move” button. When the process executes or if
there are errors, they will all be listed in the “DICOM log message” box. (See 6
Figure 103).
6 Once the copy has been transferred, point and left-click on the “Close”
button (Figure 103) If no other images need to be imported, close the QR
Interface (Figure 97) which will activate the DICOM image viewer (Figure
98). The studies can be consulted by pointing and left-clicking on the “next
study” and “previous study” buttons found on the upper corners of the
viewer (see Figure 104).
Figure 104
6.16.3 QR Interface Commands

Views the window containing data
information or error messages during
connection to remote servers.
Views the window containing the search
results from the remote servers.
Locally imports the selected images.
Deletes selected images. Only applicable to

locally saved images.

Total pages: 218 Query Retrieve 141
6.16.4 QR Server Selection Administration

Activates the QR on the local server installed
in the Moonray.
Activates the QR interface for the remote
server which can be selected from the drop-
down menu (See Figure 97).
6.16.5 QR Remote Server Configuration

142 Query Retrieve

Total pages: 218
6.17 Exporting
Export images and videos without being compressed and/or resized for
diagnostic purposes. Any image or video that is compressed or resized will
be labeled as such.
If the user wants to export images created during work sessions onto per-
manent or removable recording media he must close the series, access the
“Archive>Exams view and point and left click the “export” button. This key
activates a sequence export server.
The server views a list of the selected sequences from which you can specify
where and with which format the sequences are to be exported.
This feature was designed to facilitate collection and export of sequences.
Ch.
6.17.1 Export Description 6
The export server is viewed in a window overlapping the current view.
outside the window itself and left-clicking. To reactivate point and left-click
on the shortcut key in the upper right-hand corner of Monitor B. (See Figure
90) first icon on the left, or by sending another image to be exported.
Figure 105: Backup Server

Total pages: 218 Exporting 143
6.17.2 Selecting Export Format

The user can select one of the available export formats (See Table 43 – Ex-
port Formats). To use some of these formats an access key is necessary.
Select the “AVI” format
Select the “BITMAPPED” format
Select the “DICOM” format
Select the “SIMAD Property” format
Table 43: Export Formats
“AVI”
The AVI format is preferable when creating presentations and moving image
productions for demonstrative purposes.
“BMP”
It is useful for viewing and saving images composed of a single element,
therefore static images. It is preferable when creating presentations and
image production for demonstrative purposes. Images saved in this format
can easily be modified with retouching photographic programs.
“DICOM”
DICOM has the aim of regulating transfer formats of medical images and
data relative to patients and their clinical exams, a notably important aspect
when keeping in mind the PACS (Picture Archiving and Communication
System) and hospital information systems currently defused. The DICOM
format is preferable to exchange images, patient data for medical purposes.
The DICOM format is indicated for image exchange in the medical field, the
patient’s data and exposure data accompany the image and can be viewed
with an appropriate Workstation or PC which is equipped with dedicated
software to view said format.
“SIMAD”
The “SIMAD” proprietary format is used to save sequences created, preser-
ving the integrity of the information. Use this format when making copies
of work carried out so as to assure the possibility of reloading the saved
work onto the Workstation’s Digital Memory. The saved sequences cannot
be read with standard information instruments and the Digital Memory
Software must be utilized.
144 Exporting © Copyright SIMAD srl 2020

Total pages: 218
6.17.3 Export Destination Selection

The user can select the destination of the sequences exported contained in
the list below. The destination can be a DICOM server, a shared file in the lo-
cal network (if there is one) a removable media or a CD ROM (See Table 44).
CD ROM Select a CD ROM burner as a final export destination
DVD Select a DVD burner as a final export destination
DVD 2L Select a DVD dual layer burner as a final export destination
Removable Media Select a removable media as a final export destination
LAN Network Select a shared file in the LAN network as a final export destination
Ch.
DICOM Server Select a DICOM server as a final export destination 6

DICOM Server printer Select a DICOM server printer as a final export destination
Search LAN network Opens a window to search for a network destination
Table 44: Export Destination

6.17.4 Exporting Commands

The user activates or interrupts the export procedures with the commands
at his disposal in the user interface (See Table 45).
Begin export procedure activates export selected by the user
Interrupt export procedure interrupts export procedure activated by the user
used for setting parameters that influence the user interface presentation
and the characteristics of the output formats selected. Groups the
configuration parameters of the system subdivided in categories. (See Figure
User preferences 106). The categories are represented by tabs in the tab strip. The groups are
indicated in a single gray row which separates them from the preceding row.
The parameters are represented in two columns: the left column represents
the name of the parameter and the right column its value.
Exit exits the application and clears the export list
Table 45: Export Commands
6.17.5 Export Command Settings

Save Changes Saves changes.
applies the new settings to the views. Not all

Apply Changes settings can be reset without rebooting. It is
advisable to reboot the system.
resets parameters as they were set when the
Factory Settings machine was delivered. After activating, save
changes.
Exit Exits the setting window.
Table 46: Export Command Settings

Total pages: 218
6.17.6 Exporting – Sequence List View

The list of series and sequences selected by the user can be viewed
in a tree view denominated “Series” (See Figure 107). The root re-
presents the destination of the selected series (CD ROM : G:\).
The series are represented by yellow folders: pointing and left-
clicking on the parent node connected to the folder will make the
folder open showing a list of selected sequences by the user for that
series.
Next to the series you will find a progressive identification number
which is normally seen in the “Archive>Exams” view. Following you
will find the patient’s name, surname and date of birth.
The sequences are represented by small light blue symbols which Figure 107
identify the type of sequence generated; next to the symbol is a
progressive number of the sequence (inside parenthesis) and then the name
of the file containing the sequence. (See Figure 108). Ch.
Preview
6
Pointing and left-clicking on a sequence activates a preview of the sequence
in the preview window.
Viewing a Sequence
Select a sequence by pointing and left-clicking on the light blue icon which
represents the sequence to be viewed. Right-click to activate the drop
down menu containing the edit/view commands of the sequence. (See Figu-
re 108). If the sequences contains more than one frame, point and left-click
on the view key. The sequence will be viewed in the thumbnail window.
Enabling Digital Subtraction of a sequence

Select a sequence by pointing and left-clicking on the light blue icon which
represents the sequence to be viewed. Right-click to activate the drop down
menu containing the edit/view commands of the sequence. (See Figure
108). If the sequences contain more than one frame and a mask which can
be utilized to effect a digital subtraction, point and left-click on the enable
Figure 108
digital subtraction key.
Digital Subtraction
The sequence will be viewed in the thumbnail window or exported with the
enabled/disabled digital subtraction according to the user’s preference.
6.17.7 Editing the group of sequences-series to be

exported
Eliminate a sequence
Select a sequence to eliminate by pointing and left-clicking on the light blue
icon which represents the gsequence. Right-click to activate the drop down
menu containing the edit/view commands of the sequence. (See Figure
108). Point and left-click on the “remove” key.

Eliminate a series
Select a sequence to eliminate by pointing and left-clicking on the folder
which represents the sequence. Right-click to activate the command box
(See Figure 109) Point and left-click on the “remove” key.
6.17.8 Export to a LAN network

Connect Moonray to the LAN network only when post processing and not
during exposure sessions on a patient.
To export images utilizing the local network point and left-click on the
destination key “Export to Local Network”. (See Table 47).
Export to CD Figure 109
Export to DVD
Export to Double Layer DVD
Export to a DICOM printer
Export to Local Network
Export to Removable Media
Export to a DICOM Server
Table 47: Export Options
The configuration of the destination selection keys can vary as shown in

Figure 110.
Figure 110
Point and left-click on the “Search LAN Network (See Table 44) and select
the appropriate path. Point and left-click on the “Begin Export Process” key.
6.17.9 Export to DVD or CD

Where present, the system uses an advanced burning interface which inte-
grates perfectly with the export form (See Figure 105). In this case, the user
can see the progress of the export procedure directly in the message box
located in the bottom left-hand corner of the window.

Total pages: 218
6.18 Importing
To import sequences saved on a permanent device from another worksta-
tion which uses the Digital Memory software, access the “Archive>Exams”
view, point and left-click on the import key.
The key activates a search and import sequence server. The server views a
grid which will expose a list of available series for import, select the desired
series to transfer a copy of the series including the patients’ data, exposures
and sequences of the series.
6.18.1 Import Description

The export server is viewed in a window overlapping the current view.
outside the window itself and left-clicking. To reactivate, point and left-click Ch.
on the shortcut key in the upper right-hand corner of Monitor B. first icon
on the left or by sending another image to be exported. 6
Figure 113

Total pages: 218 Importing 149
6.18.2 Import Commands

The user activates or interrupts the import procedures with the commands
at his disposal in the user interface (See Table 48).
Begin
activates import selected by the user
Process
Abort
interrupts import procedure activated
Import
by the user
Process
Import begins the import procedure from the
Series remote source.
exits the application and clears the

Exit
import list
used for setting parameters
that influence the user interface
presentation and the characteristics of Figure 114
the output formats selected. Groups
the configuration parameters of the
system subdivided in categories.
(See Figure 114). The categories are
User
represented by tabs in the tab strip.
Preferences
The groups are indicated in a single
gray row which separates them from
the preceding row. The parameters
are represented in two columns: the
left column represents the name of
the parameter and the right column its
value.
Table 48: Import Commands
150 Importing
Total pages: 218
6.18.3 Import Command Settings

Save Changes Saves changes.
applies the new settings to the views. Not all

Apply Changes settings can be reset without rebooting. It is
advisable to reboot the system.
resets parameters as they were set when the
Factory Settings machine was delivered. After activating, save
changes.
Exit Exits the setting window.
Table 49: Import Command Settings
6.18.4 Importing a Series Ch.
“Searching a series to import”: 6

1 Activate the import server from the “Archive>Series” view,
point and left click on the “Import Series” key.
2 Activate the search with the “Begin Process” key (See Table
48).
3 Select the path in the directory from which the search is to
begin. (See Figure 115).
4 Point and left-click on the “OK” key and wait for the system to
terminate searching the sub-directories.
5 Once the search is finished the series found will be listed and
available for import. (See Figure 116).
Figure 115
Figure 116

Total pages: 218 Importing 151
“Importing series”
1 Select the series to import by checking the box on the left of the patient’s
surname. (See Figure 117).
Figure 117: Selecting a Series to Import
2 Point and left-click on the “ON/OFF” button in the bottom right-hand corner.
3 Point and left click on the “Import Series”
Each imported series, even if partia, is marked with an internal identifica-

tion number. Two series with the same identification number cannot be
found in the same archive.
152 Importing
Total pages: 218
6.19 DAP Report

The DAP report form (See Figure 118) can be activated by pointing and left-
clicking on the icon key found in the Monitor B and Archive views.
Ch.
6
Figure 118 - DAP Report Window
Previous Report
Next Report
Save report as an image
Print
Proceed exporting details
Exit
Table 50 DAP Report Commands

Total pages: 218 DAP Report 153
6.19.1 Printing a DAP Report

Select one or more patients, point and left-click on the reports to print by
utilizing the “Previous or Next Report” keys.
Point and left-click on the “Print” key and select a printer. (See Figure 119)
When you select a list of series, a dialog message will appear to ask if you
want to print only the current report or all the reports of the series.
Figure 119 Sample DAP Report
154 DAP Report

Total pages: 218
6.19.2 Saving a DAP Report as an Image

Select one or more patients, point and left-click on the reports to print by
utilizing the “Previous or Next Report” keys. Left-click on the “Save as Ima-
ge” key and a dialog window will open to ask for confirmation. (See Figure
120).
Figure 120 - Dialog window to confirm saving a DAP report as an image
Confirm by left-clicking on the “Yes” key to create an image of a DAP report,

an image like the one below (Figure 121) will be created inside the selected
series. Ch.
6
Figure 121 - DAP Report saved as an Image inside a series
When you select a list of series, a dialog message will appear to ask if you
want to create an image of the current DAP report or of all the reports of
the series selected.

Total pages: 218 DAP Report 155
6.19.3 Exporting DAP details

This function allows you to save a summary of the details of the doses emit-
ted for every series, including every single image onto a hard disk, a flash
drive, or an external resource connected to the Moonray. (See §3.12).
Select the export detail mode. (See Figure 122).
Figure 122 – Select Export Detail Mode
The two types of formats to export DAP details are:

• Structured Text
• Microsoft Access
Point and left-click on the “Enter” key and a dialog box will ask you to cho-
ose the path in the directory or sub-directory and the name of the file in
which the data is to be saved.
The data can then be saved or elaborated with scientific applications.
156 DAP Report

Total pages: 218
6.20 Customizing
The “Settings” view groups all the configuration parameters of the system subdivi-
ded into categories.
The categories are represented by tabs in the tab strip. The groups are indicated
in a single gray row which separates them from the preceding row. The parame-
ters are represented in two columns: the left column represents the name of the
parameter and the right column its value.
Ch.
6
Figure 123: Customizing Window
Factory Settings
resets parameters as they were set when the machine was delivered. After activa-
ting, save changes.
Apply Changes
applies the new settings to the views. Not all settings can be reset without reboo-
ting. It is advisable to reboot the system.

Total pages: 218 Customizing 157
6.21 STATLAB data export (plug-in

DbExporter)
The STATLAB software carries out statistical-mathematical elaborations of
the data collected by Moonray during execution. The DbExporter program
extracts the data requested by STATLAB directly to a CD/DVD.
For optimal functionality, the device must have at least one CD or DVD bur-
ner. If more than one burner is present it will automatically select the first
one available.
6.21.1 Description
When this program is installed and active, the shortcut key will appear in
the upper right hand corner of the monitor B.
through which the user interface can be accessed from a window that
opens overlapping the current view:
Left-click anywhere on the screen outside the open window to automatical-

ly hide (not close) it, the window can be reactivated by left-clicking on the
shortcut key.
6.21.2 Use
To export, simply insert a blank CD, point and left-click on the “Export”
button. A DVD can also be used but is not necessary, due to the reduced
dimension of the file that will be created.
If the CD or DVD is Re-writable and not blank before burning, it will be auto-
matically erased after asking the user to confirm.
During export execution, progress messages and error messages are viewed
in the window in the center of the interface form and the progress bar
indicates the status of its completion. After export, the disk is ejected from
the burner and the DbExporter plugin window can be closed by clicking on
the “Exit” button.
To download the STATLAB data, open the import menu in STATLAB, select
the desired file and initiate import (see the STATLAB software manual).
STATLAB data can be uploaded to another PC with statlab software instal-

led, use the same CD
158 STATLAB data export (plug-in DbExporter) © Copyright SIMAD srl 2020

Total pages: 218
7 Guide to the
use of the
7
Accessories

7 Guide to the use of the Accessories MOONRAY User Manual - Rev.34 - 2020/01/22
7.1 Sterile Drapes

Refer to the illustrated leaflet inside the SIMAD disposable sterile cover
packages.
7.2 Film Cassette Holders

Only for the 9’ (23 cm) Image Intensi-
fier.
To obtain Radiographic Film while using
the Moonray system, you must mount
the appropriate X-Ray cassette holder 9’ (23 cm)
in front of the image intensifier. Image
Intensifier
As indicated in Figure 124 align the
three fixing pins on the cassette holder
in the “UNLOCKED” position with the
receptive anchoring holes on the exter-
nal crown of the II.
Insert the pins in their seats and lock
the cassette holder support by rotating
the cam lock in the “LOCKED” position.
To avoid accidental damages to

the patient, assure correct casset-
te holder mounting.
Figure 124: Mounting the Cassette Holder
160 Sterile Drapes © Copyright SIMAD srl 2020

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 7 Guide to the use of the Accessories
7.3 Infrared Remote Control

The infrared remote control consents activation from a distance of some of
the functions of the system.
Following is a description of the infrared remote control keyboard and the
functions associated to each key.
Not active
Not active
Not active
Ch.
Transfer images from monitor A to monitor B

7
Move the cursor upwards in the icon bar
Select the icon highlighted by the cursor
Move the cursor downwards in the icon bar
Not active
SUB Not active
Save the image on Monitor A in the database
Decrease/Increase Contrast Window
Decrease/Increase Contrast Level
F Cyclically select the recursive filter values
Enter
F1 Not active
F2 Not active
F3 Not active
F4 Not active
Table 51: Remote Control Commands

Total pages: 218 Infrared Remote Control 161
7 Guide to the use of the Accessories MOONRAY User Manual - Rev.34 - 2020/01/22
162 Infrared Remote Control

Total pages: 218
8 Troubleshooting
Possible malfunctions and proposed solutions for the system. Refer to the
technical manual for anything not specified in this manual.
8
For any type of malfunction, it is always a good idea to contact the autho-
rized SIMAD Service Department. SIMAD declines any responsibility due to
repairs carried out on the system unless authorized in writing by SIMAD.

8 Troubleshooting MOONRAY User Manual - Rev.34 - 2020/01/22
8.1 Proposed solutions

PROBLEM Solution
The white light on the side of the workstation

(monitor cart) does not light, after having plugged Check the fuses F2 and F3 found in
in the system to a power supply and having Solution 1 the Fuse Panel on the back of the
switched the magneto thermal circuit breaker to workstation (monitor cart)
the ON position,
Verify that the device is correctly

supplied with power, that the magneto
thermal circuit breaker is in the ON
Solution 1
position and that the yellow light on the
Neither the digital imaging system nor the mobile side of the workstation (monitor cart)
X-Ray unit turn on after having turned the start key is on.
to the I position.
Check the fuses F2 and F3 found in
Solution 2 the Fuse Panel on the back of the
workstation (monitor cart).
The mobile X-Ray unit turns on after having turned Check the F1 fuse found in the Fuse
the start key to the I position, but the digital Solution 1 Panel on the back of the workstation
imaging system does not. (monitor cart).
The monitor power supply indicator lamp turns on Check the F4 fuse found on the Fuse
after having turned the start key to the I position Solution 1 Panel on the back of the workstation
but no images appear. (monitor cart).
Check the F1 fuse found in the Fuse

Solution 1
The digital imaging system turns on after having Panel in the mobile X-Ray unit.
turned the start key to the I position but the mobile
X-Ray unit does not. Check that both units are connected
Solution 2
correctly.
After start-up procedures, the control panel of the

Check the F4 fuse found in the Fuse
mobile X-Ray unit is backlit, but the function icons Solution 1
Panel in the mobile X-Ray unit.
are not visible.
The icon seen on the right

appears on the control panel Check the F2 fuse found on the fuse
of the mobile X-Ray unit and Solution 1 panel on the side of the mobile X-Ray
the system does not produce unit.
X-Rays.
The icon seen on the right

appears on the control panel Check the F3 fuse found on the fuse
of the mobile X-Ray unit and Solution 1 panel on the side of the of the mobile
the system does not produce X-Ray unit.
X-Rays.
164 Proposed solutions

Total pages: 218
9 Maintenance
9

9 Maintenance MOONRAY User Manual - Rev.34 - 2020/01/22
9.1 Introduction
The Moonray Systems must be used correctly and maintenance procedures
must be scheduled and carried out as indicated.
It is recommended not to carry out any type of maintenance on the device

in the presence of a patient. In particular, maintenance and / or repair
activities that generally concern the device settings where it is necessary
to emit an X-ray beam are prohibited, and specifically, it refers to technical
interventions on the X-ray generator and on the detector image.
Do not carry out repairs on any part of the device’s electrical system in the
presence of a patient.
Do not perform mechanical repair on the device in the presence of a

patient.
9.2 Scheduled Maintenance

The scheduled maintenance can be carried out only by qualified and autho-
rized technicians.
The user must ascertain that the scheduled maintenance has been carried
out before utilizing the device.
Object Inspection Frequency
Earth Leakage Check for Earth Leakage

Annually
Alerts & Error
Visual and acoustic Check
Indicators Annually
UPS Check for correct function

Annually
Labeling Check legibility

Annually
“ATTENTION”: in case of prolonged inactivity (from two to four weeks) we

recommend proceeding with a preparation of the radiological parts (see
below) before executing any clinical procedure, to avoid transient pheno-
mena that could reduce efficiency and duration.
Follow the procedure described below:
1 -RADIOGRAPHY /FLUOROSCOPY: 70 kV, 3 mA FOR 5 MINUTES + 5 MINU-
TES PAUSE. REPEAT 5 TIMES
2 -RADIOGRAPHY: 70 kV, 20 mA, FOR 0.5 SECONDS + 30 MINUTES PAUSE.
INCREASE BY 5 kV UP TO kV MAX
SIMAD declines responsibility tied to disregard of this warning.
166 Introduction
Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 9 Maintenance
9.2.1 Scheduled Maintenance for motorized version

The motorized parts of the C-Arm must be serviced by a Simad
authorized service center every 12 months .
The user must keep a record of the maintenance and service carried out and
must make sure that they are executed regularly.
9.3 Routine Check by User

Routine Check to be carried out by the user:
Object Inspection Frequency

Ch.
Accessories Availability and Integrity
Daily 9
Cable Protection device for
Check aspect and/or damages
wheels Daily
Brake, Wheels and Handlebar Check for correct function

Daily
Wiring Check cable for any knots or breakage

Daily
X-Ray Lamp Check for correct light and sound function

Every Start-up
Connectors Check for damages and correct connections

Daily
Start-up Check monitor for possible error messages

Daily
Check for correct function – check lamp and buzzer
X ray
Check iris setting and position Daily
C-Arm Base Check for correct console function

Daily
Hand-Held Radiography
Check for correct function
Command Daily
Pedal / Double Pedal Check for correct function

Daily
Vertical Movement Check for correct function

Daily
Check for correct monitor and keyboard functions -
Workstation Check for available disk space (we recommend keeping the
Daily
maximum amount of disk space free)
Remote Control Check for correct function

Daily
Laser Check alignment and function

Daily
Printer Check for function and availability of paper / film

Daily

Total pages: 218 Routine Check by User 167
X-Ray Check
Carry out the following daily check with no obstacles to the
X-Ray beam.
1 Select automatic fluoroscopy
2 Press the X-Ray emission and check images on the monitors
Check iris collimator

Check the following daily without obstacles to the X-Ray beam:
1 Select the iris collimator icon on the C-Arm console
2 Press the the X-Ray key
3 Open and close the iris collimator
4 Verify correct function of the workstation monitor
Check Laser Pointer

Instructions
1 Turn the laser pointer on.
2 Verify the presence of the laser’s red cross.
Lamp Check
Verify lighting and the acoustic indicator by pressing the X-Ray key on the
workstation and the C-Arm.
Check Emergency Stop Button
Before every use of the device, make sure the emergency button is functio-
ning by verifying shutdown and lock of the motorized riser movement.
168 Routine Check by User

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 9 Maintenance
9.4 Cleaning & Disinfection

The Moonray Systems must be cleaned and disinfected regularly.
Disconnect the device from the power supply before cleaning and disinfec-
ting. This will avoid short-circuiting.
Keep all liquids from entering the device because they could cause short-
circuits and corrosion.
Cleaning and disinfection must be executed according to sanitary laws and

norms.
9.4.1 Cleaning
The aluminum surfaces can be cleaned with a damp cloth and a neutral cle-
aner, and then dried with a dry wool cloth. Do not use corrosive detergents,
Ch.
solvents or abrasive cleaners. 9
To conserve varnish use an anti-abrasive wax.
9.4.2 Disinfection
Every part of the device, including accessories and the connecting cables,
can be disinfected by cleaning them with a damp cloth and a disinfectant.
NEVER use phenol based disinfectants, corrosive agents or solvents. If
you’re not sure of the disinfectant’s properties, please do not use it.
Do not use inflammable or potentially explosive sprays.
Before start-up, make sure there are no traces of vapors.

To disinfect, we recommend the use of a product similar to MadaCide-FD,
which is a specific product for hospital use, registered with the EPA. Effec-
tive against Type A Influenza, HIV, Hepatitis B and C, TB, MRSA, VRE, SARS,
fungi. It is non-corrosive. (CEI EN 60601-2-43)

Total pages: 218 Cleaning & Disinfection 169
9.5 Cleaning and disinfection the

motorization console
Disconnect the console from its connecting cable with the C-Arm before
cleaning and/or disinfecting.
To clean use a damp cloth, dampened with water and neutral detergents; do
not use corrosive or abrasive solvents.
To disinfect proceed as with normal cleaning but use a disinfecting product
that is not corrosive or abrasive.
Do not immerse the console in liquids.
Dry carefully with a soft cloth before using.
9.6 Cleaning the motorization console

cable
To clean the cable, disconnect both connectors from the base of the C.Arm
and the console and proceed as described above for the console with pro-
ducts used for cleaning and disinfection that are not corrosive or abrasive
and do not contain solvents.
Do not immerse the cable in liquids.
Dry carefully with a soft cloth before using.
9.6.1 Printer
See the relative user manual for cleaning procedures.
170 Cleaning and disinfection the motorization console

Total pages: 218
10 Recycling the
Device
10

10 Recycling the Device MOONRAY User Manual - Rev.34 - 2020/01/22
10.1 Introduction
The device contains material that can be polluting for the environment
therefore pay particular attention when disposing of all or part of the device
after its use has been terminated.
10.2 Transferring the Device

If the device should be ceded to third parties, its documentation must be
consigned and the new owner must become familiar with this manual. Fur-
thermore, the new owner must be communicated to the manufacturer and
written records of the new location of the device must be kept to guarantee
tracing of the device as indicated by law.
10.3 Recycling
IMPORTANT ENVIRONMENTAL INFORMATION

The symbol above means that the product requires correct disposal at the
end of its life-cycle and according to the current standards; it cannot be
considered as normal waste, product disposal must conform to the environ-
mental requirements of directives 2002/95/EC, 2002/96/EC, 2003/108/EC
which are relative to the reduction of dangerous materials in electrical and
electronic devices.
The user can consign the device to specialized companies who recycle and
reuse electrical or electronic parts or return it to the seller in exchange of a
newly purchased product on a one-to-one basis.
Adequate disposal of the device at the end of its life-cycle and recycling of
its parts and components contributes in avoiding a negative impact on the
environment.
172 Introduction
Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 10 Recycling the Device
10.4 Batteries
10.4.1 Remote Control

The infra-red remote control is equipped with a battery. For optimum
results substitute batteries at regular intervals. Dispose of used batteries in
appropriate containers where no damages to the environment are caused.
10.4.2 Laser
The laser pointer is equipped with a battery. For optimum results substitute
batteries at regular intervals. Dispose of used batteries in appropriate con-
tainers where no damages to the environment are caused.
10.4.3 UPS Ch.
To protect the PC from power supply interruptions which could damage the 10
software, the workstation is equipped with a UPS (uninterruptable power
source). The UPS is equipped with rechargeable gel batteries which do not
need maintenance. Dispose of the used batteries in appropriate containers
where no damages to the environment are caused.

Total pages: 218 Batteries 173
10 Recycling the Device MOONRAY User Manual - Rev.34 - 2020/01/22
174 Introduction
Total pages: 218
11 Technical Data
11

11 Technical Data MOONRAY User Manual - Rev.34 - 2020/01/22
11.1 Functionality - Ambient Conditions

SIMAD guarantees correct functionality of the Moonray systems in the following ambient
conditions:
Condition: Values:
+10° to + 40 °C (maximum)
Normal
+10° to + 20 °C (optimum)
Relative Humidity in use 10% - 75% (in absence of condensation)
Storage -20°C / +40°C
Relative Humidity in storage 5% - 95%
Pressure 700/1066 hPa
Vibrations 10 – 150 Hz, 0.35 mm peak
11.2 Power Supply

DEFINITION SPECIFICATIONS
Voltage 230/115 V
Max Voltage Deviation ± 10 %
Configuration Mono-phase (Phase, Neutral, Earth)
Frequency 50/60Hz
Before connecting the system to the power supply, the user must make sure that the system
socket is homologated with the current and voltage requirements necessary for the opera-
tion of the device. The electrical socket must be equipped with an earth connection accor-
ding to laws and norms in force.
In case of non-conformity, consult qualified personnel and SIMAD’s technical assistance.
11.3 Generator
Definition Data
Type High Frequency
kV range 40-120kV (40-110kV)
Typical X-ray power
mA range 0,2-100mA
11.4 Maximum Ratings

Fluoroscopy Radiography
Nominal X-Ray Tube Voltage 120 (110) kV 120 (110) kV
Max X-Ray Tube Current 20 mA 100 mA (@ 80 kV)
Max electrical power absorbed 600 W 3500 W
176 Functionality - Ambient Conditions

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 11 Technical Data
Acceptable tolerances in various measurements

The device falls into the following functional tolerances, as verified in the
trials included in the Test Report that accompanies each new device.
TUBE VOLTAGE
Tube Voltage [kV] ± 10 %
Tube Current [mA] ± 10 %
Exposure duration [s] ± 1 % se ≥ 0.1 [s]
MAS [mAs] ± 10 %
TOTAL FILTERING
Inherent Filtration @ 80 kV ≥ 1.8
Total Filtration @ 80 kV Measured [mm] ≥3
Half Value Layer @ 80 kV ≥ 2.8
X-RAY BEAM LIMITATIONS & INDICATIONS
Difference A+C and B+D 3 % SID
Difference A+B+C+D 4 % SID
Center to Center Difference 1 % SID
Radiography
Horizontal X-Ray Beam Span 300 +3/-20
9” 13” Ch.
Vertical X-Ray Beam Span
Difference A+C and B+D

Difference A+B+C+D [mm]
240 +3/-20
3 % SID
4 % SID
300 +3/-20
11
Difference Center to Center 1 % SID
Diameter X-Ray Beam Field 13” 300 +3/-20
Fluoroscopy
9” 13”
Diameter X-Ray Beam Field 7”
160 +2/-20 160 +10/-20
RADIATION SCATTERING
Scattering during radiography@ 1 m [mGy/h] ≤ 1.0
Scattering without radiography@ 5 cm [µGy/h] ≤ 20
LINEARITY & REPRODUCIBILIY OF TRANSMISSION KERMA
Typical Values (Tolerance ± 10 %)
Air Kerma
Minimum Maximum
80 [kV] – 0.1 [s] – 25/100 [mA] 7 35
80 [kV] – 25 [mA] – 0.02-3 [s] [nGy] 1 380
80 [kV] – 7.5 [mAs] – (25-75 [mA] – 0.1-0.3[s]) 22 38
RESOLUTION
≥ 8 Field 13”
≥ 10 Field 9”
Coupled visible lines– Manual Fluoroscopy @ 40 [kV] – 0.5 [mA] [lp/cm]
≥ 14 Field 7”
≥ 20 Field 4”
9 “/ FD22 or 13” / FD30 focused in medium field of view, in
automatic modality, placing 1 cm of Al with 1 mm of Cu onto
Dosimetric value
the x-rays output the dosimetric value measured have a range
between 160/260 µGy/s
DAP
DAP measured ± 20 % error
DAP calculated < 35% error
TOTAL FILTRATION
Inherent filtration @ 80 kV ≥ 1.8
Total filtration @ 80 kV Measured [mm] ≥3
Half Value Layer @ 80 kV ≥ 2.8

Total pages: 218 Maximum Ratings 177
11.5 Radiation Leakage Factors

TRIAL CONDITIONS VALUE
Fluoroscopy 120kV 3mA @ 1m ≤ 1 [mGy/h]
Machine on without X-Ray emission @ 5cm ≤ 20 [µGy/h]
11.6 Grid
DEFINITION SPECIFICATIONS
Type Circular or square
Material Carbon Fiber
Ratio h/D (ccd 1k x 1k) 17
Ratio h/D (ccd 576 x 782) 12
Lines/cm (ccd 1k x 1k) 70
Lines/cm (ccd 576 x 782) 40
178 Radiation Leakage Factors

Total pages: 218
11.7 Options - Accessories and Detachable

Parts
For information regarding new accessories and their availability please con-
tact SIMAD’S customer service.
List of accessories and removable parts:

DESCRIPTION CODE
Hand-Held Radiography Command ON DEMAND
Single Fluoroscopy Pedal – Double Fluoroscopy/Cine ON DEMAND
Focal Spot-skin Spacer 1k ON DEMAND
Cable C-Arm-workstation ON DEMAND
Ch.
Optionals List: 11
DESCRIPTION CODE
Infra-Red Remote Control ON DEMAND
UPS ON DEMAND
Laser Centering Device 9” / 13” ON DEMAND
Cassette holder 9” / 13” ON DEMAND
Firewall ON DEMAND
Hand Rest ON DEMAND
Printer ON DEMAND
Kit Sterile Drapes for ventilated monobloc / Ortho ON DEMAND
All detachable parts are provided with special identification label showing
the manufacturer’s name and model.
All accessories come with a special identification label showing the name
of the manufacturer, model and serial number and date of manufacture.

Total pages: 218 Options - Accessories and Detachable Parts 179
11.8 X-Ray Scattering
180 X-Ray Scattering

Total pages: 218
11.9 Interventional Reference Point

For INTERVENTIONAL X-RAY EQUIPMENT, specified point on the REFERENCE
AXIS used as a reference location for the indication of PATIENT-incident.
AIR KERMA and AIR KERMA RATE. Since the Moonray device is equipped
with an isocenter, the IRP is located along the central ray of the X-Ray beam
at a distance of 15 cm from the isocenter in the direction of the focal spot,
therefore the distance of the focal spot results as being 50,3 cm.
The IRP is utilized as a reference point for patient incident Air Kerma and Air
Kerma Rate indication (CEI EN 60601-2-43 - par. 6.8.2 ff)
Ch.
11
medium (air) and the Air Kerma:

Total pages: 218 Interventional Reference Point 181
Air Kerma strength

Automatic
modality kV mA pulse/s Pulse width [ms] Air Kerma Strength [mGy/s]
mode
X DSA 79 2,3 Pulsed -- 0,08
X DSA Ingrand 1 88 2,4 Pulsed -- 0,09
X DSA Ingrand 2 105 2,5 Pulsed -- 0,09
X DSA HQ 77 34 25 14 0,6
X DSA HQ Ingrand 1 78 35 25 14 0,6
X DSA HQ Ingrand 2 80 35 25 14 0,6
X Fluro 79 2,3 Pulsed -- 0,08
X Fluro Boost 87 5,9 12 14 0,17
X Fluro Pulsed 91 2,9 12 14 0,13
Calculated values
Automatic Pulse width Air Kerma
modality kV mA pulse/s Ratio Note
mode [ms] Strength [mGy/s]
DSA and
X DSA HQ Ingrand 1 79 36,2 25 14 0,61 1
CINE
X Fluoro Pulsed 103 3,2 12 14 0,147 1
X Fluoro Pulsed 93 2,9 6 14 0,09 0,5
X Fluoro Pulsed 93 2,9 4 14 0,05 0,34
X Fluoro Pulsed 93 2,9 2 14 0,03
X Fluoro Pulsed 93 2,9 1 14 0,015
X Fluoro Pulsed 93 2,9 0,5 14 N.M.
X Fluro Boost 92 5,9 12 14 0,20 1
X Fluro Boost 92 5,9 6 14 0,10 0,5
X Fluro Boost 92 5,9 4 14 0,07 0,34
X Fluro Boost 2 14 N.M.
X Fluro Boost 1 14 N.M.
X Fluro Boost 0,5 14 N.M.
Maximum AirKerma strength in fluoroscopy mode

Air Kerma Strength
Automatic mode modality kV mA pulse/s Pulse width [ms]
[mGy/s]
Pulse width [ms] Air Kerma Strength mGy/s 79 35,2 25 24 1
X SCOPY 120 3 --- --- 1,3
Maximum AirKerma strength in radiography mode
Manual mode Modality kV mA pulse [ms] Air Kerma Strength [mGy/s]

X Radiografia 120 66 100 1,13
182 Interventional Reference Point

Total pages: 218
11.10 Leakage radiation

Manual mode 70Kv-3mA continuos; 100Kv3mA
Attenuation Body: PMMA 25x20x20 cm
cm
200
21 cm
150
Ch.
100 11
100 cm 50
0
0 500 1000 1500 2000 2500 3000
µSv/h
one hour Air Kerma @ 3mAs

60x60 cm
1 70Kv with x-ray PPE 0,5mm Pb eq.
2 100Kv with x-ray PPE 0,5mm Pb eq.
3 70Kv without x-ray PPE
4 100Kv without x-ray PPE
45
cm

Total pages: 218 Leakage radiation 183
11.11 Labeling
Explanation of Symbols used:
CE Marking ensures conformity with

Special Waste.
safety EC directives
The device presents an applied Type

Indicates Manufacturer
B part
General Warning. Consult

Manufacturing Year
instructions before using
Consult instructions for use
184 Labeling
Total pages: 218
11.11.1 Labels position

F
D
E
H A
Ch.
B
11
G
D
E
A Serial number and model

B Serial number
C Rx tube and monobloc serial number
D Laser model and serial number (if applied)
E Detector serial number
F Monitor model and serial number

Total pages: 218 Labeling 185

Total pages: 218
12 List of Icons/
Console
12
Commands

12 List of Icons/Console Commands MOONRAY User Manual - Rev.34 - 2020/01/22
12.1 List of icons
1 Warning – Action Not Permitted 18 Iris Diaphragm Regulation
Small Focal Spot selected

2 automatically in Fluoroscopy Compensating filter aperture/
19
Mode. Closure
Large Focal Spot selected
3 automatically in Radiographic 20 Compensating filter Rotation
Mode
4 Exposure Preparation 21 Horizontal Flip
5 X-Ray Generator Status 22 Vertical Flip
6 Anode Rotating State 23 Maximum Radiation Field
7 Low Speed Anode Rotation. 24 Medium Radiation Field
8 High Speed Anode Rotation. 25 Small Radiation Field
9 Correct Power Supply 26 Minimum Radiation Field
Power Supply Voltage higher than

10 27 Automatic Control
the functional limit.
Power Supply Voltage lower than

11 28 Manual Control
the functional limit.
12 Anode - Initial Heat Level 29 Radiography Manual Control
13 Anode - Low Heat Level 30 Exposure Time
14 Anode - Medium Heat Level 31 Voltage Regulation
15 Anode - High Heat Level Elec. Current Reg./View

32
Exposure Types
Overheating Anode/ Autonomy

16 33 12 impulses/second
Limit
17 Camera Rotation 34 6 impulses/second
188 List of icons

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 12 List of Icons/Console Commands
35 4 impulses/second 52 Video chain Error
36 2 impulses/second 53 Communication Error
Example icon of optional mode

37 54 C-Arm Card Error
instead of boost mode
38 1 impulses/second 55 Collimator Error
Ch.
12
39 1 impulse every 2 seconds 56 Filament Error
40 DR (Digital Radiography) 57 Voltage Error
41 Fluoroscopy
Consolle touch screen
42 12 impulses/second
58 Maintenance menu
59 Increase value
60 Decrease value
61 Iris Aperture
46 1 impulse/second
62 Iris closure
47 1 impulse every 2 seconds Semitransparent Collimator

63
Aperture
48 Pulsed Exposure 25 imp/sec Semitransparent Collimator

64
Closure
49 Pulsed Exposure 12 imp./sec Clockwise Rotation of the Camera

65
or the Collimator
Counter-Clockwise Rotation of the

50 Error rotating anode 66
Camera or the Collimator
51 Low Battery

Total pages: 218 List of icons 189
12 List of Icons/Console Commands MOONRAY User Manual - Rev.34 - 2020/01/22
190 List of icons

Total pages: 218
13 Motorized
Version
13

13 Motorized Version MOONRAY User Manual - Rev.34 - 2020/01/22
13.1 Specific warnings

Moonray Precisio includes a radiological device with all its functions, and a
mechanically articulated motorized device of the Moonray itself.
Please refer to the other sections for all aspects that do not pertain to the
motorized movement (for example general information and warnings, ra-
diological functions, software, cleaning, accessories, etc.)
During the execution of a motorized movement, the operator must always
be vigil and must observe the part of the arm in movement, in order to
avoid colliding with surrounding objects and/or people.
The Moonray Precisio system is equipped with a safety feature to automa-
tically arrest the movement of the arm should it come into contact with
people or things, however operators are not exempt from keeping a vigil
eye during automatic movements of the arm and from acting quickly by
releasing the movement command and pressing the emergency stop button
in cases in which there is a risk of collision or unexpected conditions arise.
To activate the emergency stop button, press the red emergency button
present at the base of the arm: all movement will be instantly arrested.
Pressure on the emergency button immediately interrupts movement of
the arm and shuts down the movement system. The radiological part of the
Moonray Precisio remains active and its functions are not limited or altered
in any way.
It is always possible to arrest the movement(s) in course by pressing the
emergency button; this button can also be pressed by another person,
whom is not operating the arm directly.
To arrest a movement or combination of movements, just release the
pressure from the button placed on the extremity of the joystick, in cases
in which the commands are governed by a joystick, or release the “Zero”
button or the “Go To” button according to which is being pressed.
Do not reactivate motorization by unlocking the emergency button in cases
in which the arrest became necessary due to a malfunction of the C-arm’s
motorization device and contact customer service for technical assistance.
Under emergency conditions and for brief periods, the C-Arm can be moved
manually except for the up/down movements.
Do not subject the motorization console cable to pressure or pulling.
Extract the console cable by pulling on the connector at the base of the C-
arm and not by pulling directly on the cable.
192 Specific warnings © Copyright SIMAD srl 2020

Total pages: 218
14 THE
MOTORIZATION
14
CONSOLE

14 THE MOTORIZATION CONSOLE MOONRAY User Manual - Rev.34 - 2020/01/22
14.1 Description and connections

The motorization control console is housed on the C-Arm base, from which
it receives power through the dedicated cable. It is therefore inoperable if
disconnected from this cable.
The connecting cable between the console and the C-Arm is separable at
both ends by means of the polarized connector, it is therefore sufficient to
grip the body of the connector and pull it to separate the console from the
cable or the cable from the C-Arm base.
To reconnect the cable to the C-Arm base or to the consosle, insert the
connector respecting the position of the red circle visible both on the cable
connector and the panel connectors mounted both on the console and the
C-arm base.
194 Description and connections

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 14 THE MOTORIZATION CONSOLE
14.2 LCD Display
A backlit four-lined display is found in the centre of the console; the four
coordinates (positions) are always visible for the four motion directions on
the initial screen view
Is the coordinate of the horizontal translation motion of the C-Arm,
X
expressed in mm Ch.
Z Is the coordinate of the up/down motion of the C-Arm, expressed in mm
Is the coordinate of the rotation of the “C” of the arm, also known as 14
R the “rotational motion” or simply “rotational”, expressed in sexagesimal
degrees.
Is the coordinate of the sliding motion of the “C” of the arm upwards
O and downwards, also known as the “orbital motion” or simply “orbital”,
expressed in sexagesimal degrees.
When the end of travel is reached in any one of the above directions, an
acoustic signal is emitted and the message “Warning – Run Limit Reached”
Range” appears on the display, which is then removed automatically or can
be removed by pressing the “OK” key.
During motorized motion the coordinate values for each direction will chan-
ge and be visible on the display.
The movements that can be executed simultaneously are the following:
• Horizontal translation combined with the up/down motion of the C-Arm,
the “X” e “Z” values will simultaneously vary.
• Rotation and orbital motion of the “C”: The “R” and “O” values will
simultaneously vary.
• Reaching the “Zero” position: all the coordinates will simultaneously
vary in cases in which they are all different from the “zero” value.
During a combined movement, if one end of travel position is reached, the
motion continues along the remaining direction with the acoustic signal
being emitted and the “Warning – Run Limit Reached” message on the
display.
The display can view the menu items, the submenu items, the alert messa-
ges and the guide during articulated procedures like pre-set, isocenter and
position memory management positions
The display language can be changed at any time through the dedicated
menu item. .

Total pages: 218 LCD Display 195
14.3 “Menu” Key
Pressing the “Menu” key takes you from the main screen view to the list of
functions with direct access to:
• Save
• Recall Position
• Manual Position
• Select Language
The cursor key allows you to move from one menu item to the next pressing
“OK” selects the item and accesses the submenu.
14.4 “Zero” Key
When the C-Arm is not in use or during transport and transfer from one pla-
ce to another, it must be placed in the rest position which includes the mi-
nimum height and the horizontal translation completely retracted towards
the command side of the arm (the side with the handlebar), the rotational
position of the “C” in the zero position with the “C” centered along its an-
choring point. In this position all the coordinates are viewed as 0 mm or 0°.
To obtain this position the operator must press and hold the “Zero” key: all
the parts of the C-Arm that are not in the zero position will simultaneously
move to reach it.
When the positioning is terminated an intermittent acoustic signal will
sound until the “Zero” key is released.
If an obstruction should impede movement, the operator must release the
“Zero” key and the C-Arm will arrest the movement in course.
196 “Menu” Key

Total pages: 218
14.5 “Go To” Key
Press and hold this key to carry out the following:

• Recall a memorized position.
• Bring the rotational position to zero before beginning to move the arm
in the isocenter mode.
If the key is pressed without first selecting a memorized position to recall or
outside the iscocenter mode of preparation, the alert message “No Memory
Selected” appears on the display and an intermittent acoustic signal will
sound until the key is released. The message will automatically be cleared or
it can be cleared by pressing the “OK” key. Ch.
If an obstruction should impede movement, the operator must release the
“Go To” key and the C-Arm will arrest the movement in course.
14
14.6 “Save” Key
To Save a determined position of the C-Arm, press the “Save” key after ha-
ving selected one of the quick recall memory functions, M1, M2, M3..

Total pages: 218 “Save” Key 197
14.7 Numeric keyboard:
The numeric keyboard is used for the following functions:

• Input the memory number from 1 to 13 in which one wishes to save a
determined position of the C-Arm.
• Input the memory number from 1 to 13 one wishes to recall.
• In the “Manual Positioning” function a numeric value of the various
coordinates that one wishes to reach can be input; translation motion of
the C-Arm, the up/down column movement, the rotation or the orbiting
of the “C”.
Correctness of the numeric value inserted is checked by the system: in
cases in which the number does not correspond to variation intervals or the
coordinates or numbers in the memory, the message “value-out-of-range
– insert value” will appear on the display; this message will automatically
clear or it can be cleared by pressing on the “OK” key
14.8 Cursor Keyboard
The four arrows surrounding the “OK” key form the Cursor Keyboard. It is
utilized to scroll the menu and to move the cursor when imputing a numeri-
cal value, to delete or add the “+” or “-“ sign.
If the cursor movement or input of one of the above mentioned signs is not
a feasible operation, pressing the keys will not produce any change in the
display view.
198 Numeric keyboard

Total pages: 218
14.9 Quick Recall Memory Keys
Up to three positions of the mobile parts of the C-Arm can be saved and
recalled quickly with the “Save”, “M1”, ”M2” and “M3”keys:
Ch.
Saving a C-Arm position in the Quick Recall
14.9.1
Memory Keys 14
1 Position the C-Arm as desired.
2 Press one of the three Memory keys (M1, M2, M3), the dot to the left of the
chosen key will light.
3 Press “Save” and the message “Memory M1 (or M2 or M3) Saved” will ap-
pear on the display, a short acoustic signal will sound and the dot to the left
of the key will turn off.
14.9.2 Recalling a position from the Quick Recall Me-

mory Keys
1 Press one of the three Memory keys (M1, M2, or M3) the dot to the left of
the chosen key will light.
2 Press and hold the “Go To” key until the desired position has been reached,
an acoustic signal will sound and the dot to the left of the chosen key will
turn off when the position is reached.
If a position has previously been saved in any of the three quick memory
keys (M1, M2 or M3) and a new position is saved in the same key, the pre-
ceding position will be deleted without a request of confirmation.
If no position has ever been saved in any one of the three keys and a recall
from memory procedure is carried out, the message “Memory not set – no
memory selected” will appear on the display. .

Total pages: 218 Quick Recall Memory Keys 199
14.10 Isocentric Function Keys
In order to utilize this function, or mode, two previous positions need to

have been acquired, these positions are called ISO1 and ISO2 with which the
desired isocentric point and the distance from the Image Intensifier is defi-
ned. This distance will be kept automatically during the “orbital” movement
of the “C” of the arm.
Three different luminous colours are associated to the three ISO keys. ISO,
ISO1 and ISO2.
By pressing the ISO key the acquisition procedure for the ISO1 and ISO2
positions begin and the isocentric mode is entered; the white signal light
distinguishes the difference between these two situations:
• Fixed white luminous signal lit: the isocentric mode is activated, therefo-
re if the orbital movement is activated, the up/down, horizontal transla-
tion motions are also activated as a consequence keeping the isocentric
point and the distance from the Image Intensifier fixed in the frame. The
only active command on the joystick is the orbital movement.
• Flashing white signal light: the acquisition of one or more positions is re-
quired to determine the isocentric point therefore the orbital, up/down,
horizontal translation motions are all activated; the previously acquired
positions ISO1 and ISO2 can also be utilized.
The signal lights under the keys “ISO1” and “ISO2” indicate the following:
• Flashing green signal light under the “ISO1”:
Acquiring the ISO1 position is necessary to calculate the isocenter.
• Fixed green signal light under the “ISO1” key:
ISO1 position already in memory.
• Flashing yellow signal light under the “ISO2”:
Acquiring the ISO2 position is necessary to calculate the isocenter.
• Fixed yellow signal light under the “ISO2” key:
ISO2 position already in memory, therefore isocenter already calculated
200 Isocentric Function Keys

Total pages: 218
14.11 Joysticks
The console is equipped with two joysticks that command the four moto-
rized movements. The inclination of the handle (lever) varies the speed of
the motorized movement and is directly proportional: the more the lever is
inclined the higher the speed of the C-Arm movement.
14.11.1 Using the joysticks

In order for the command to reach the C-arm the joystick lever must be
inclined and the button found on the uppermost tip of the lever must simul-
taneously be pressed. Tilting the lever without pressing the button will not
activate the desired movement.
Only one joystick can be used at a time therefore only a maximum of two
motorized movements can be carried out simultaneously.
Ch.
For a smooth start, press the button on the tip of the lever and incline the
lever slowly to avoid sudden jolts 14
14.11.2 Movement Commands
The joystick on the left
The joystick on the left (standing in front of the console) commands

the following:
• The orbital movement, if the handle is inclined towards the top
and towards the bottom.
• The rotational movement if the handle is inclined towards right
or left.
Inclining the handle towards the intermediate corners of the four
quadrants of the circle results in simultaneous orbital and rotational
movement, meaning the “C” slides while rotating.
The joystick on the right
The joystick on the right (standing in front of the console) commands

the following:
• The up/down movement, if the handle is inclined towards the
top and towards the bottom.
• The horizontal translation movement if the handle is inclined
towards right or left.
Inclining the handle towards the intermediate corners of the four

quadrants of the circle results in simultaneous up/down movement
of the arm while it slides outwards or towards the handlebar.

Total pages: 218 Joysticks 201
14.12 Arresting movement

Any motorized movement can be arrested be it single, composed or com-
manded with the joystick as follows:
• Releasing the button on the tip of the joystick one is using to command
movement or
• Bringing the joystick that is being used in the central position with no
deviation in any direction
If the movement is commanded by means of the “Go To” or “Zero”, move-
ment is arrested by releasing either the “Go To” or the “Zero” keys, accor-
ding to the command that is being used on the console.
In all cases, both the operator who is using the console or any other person
present can arrest movement by pressing the red emergency stop button.
14.13 Re-Setting the Emergency Stop Button

After an emergency stop, the motorized part of the C-Arm can be reactiva-
ted only by releasing the emergency stop button. To do so, rotate the red
button in the direction indicated by the arrow: it will release and lift and
when the control unit starts up two short acoustic sounds will be heard.
If the emergency stop was activated due to a malfunction of the motorized
part, do not re-activate and call Technical Assistance (See Chapter 10).
14.14 Arrest due to overcurrent

If, during the motorized movement, a part of the C-Arm meets and obstacle
with which it collides, the movement will come to a stop when the overcur-
rent limit is reached. The display will read an error message and a conti-
nuous acoustic alarm will sound and only by pressing “OK” or “Esc” will the
sound stop.
Always check the surrounding area when operating the C-Arm with a moto-
rized movement and arrest the movement in the proximity of an obstacle.
202 Arresting movement

Total pages: 218
14.15 Luminous Signal Lights

Standing in front of the console, three luminous signal lights are found on
the lower right hand side; they indicate the state of the console and its com-
munication with the motorization control unit.
14.15.1 Power
When the console’s cable is connected to the base of the
C-arm, the C-Arm is on and the emergency button is not
inserted, then the console is powered and the green signal
light next to the letters PWR will be lit.
14.15.2 Ongoing Communication Ch.
When the console communicates with the control unit the 14

blue signal light will flash next to the three curved lines that
represent transmission waves.
14.15.3 Error
The red signal light next to the letters ERR will light when
there is an error in communication with the control unit.

Total pages: 218 Luminous Signal Lights 203
204 Luminous Signal Lights

Total pages: 218
15 MENU ITEMS
15

15 MENU ITEMS MOONRAY User Manual - Rev.34 - 2020/01/22
15.1 Accessing Menu Items

Pressing the “Menu” key (found in the top left-hand corner of the numeric
keyboard) a list of possible functions is accessed as follows:
• Save
• Select Language
• Recall Memory
• Manual Positioning
These functions can be scrolled with the up/down arrows and can be selec-
ted and confirmed with the “OK” key.
To exit the menu press “Esc”.
15.2 Save
Aside from the three “recall memory” keys (see paragraph 3.9 in Chapter 3).
other ten different positions can be saved numbered from 4 to 13.
HOW TO PROCEED:
1 Position the C-Arm as desired.
2 Access the menu by pressing the “Menu” key in the upper left-hand corner
of the numeric keyboard and select “Memorize Position”.
3 Press the “Ok” key.
4 Input the number you wish to assign this position in the numeric keyboard.
• An error message will appear if you attempt to input a number that is
higher than 14 and the operation will be cancelled.
5 Once the position is memorized a confirmation message will appear “Me-
mory “x” Saved”.
• If another position had previously been saved in the position selected
(from 1 to 13) then that position will be cancelled and the new one will
overwrite the previous.
206 Accessing Menu Items

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 15 MENU ITEMS
15.3 Memory Recall

To recall a position previously saved with numbers from 4 to 13 proceed as
follows:
1 Press the “Menu” key (found in the top left-hand corner of the numeric
keyboard) access the Memory Recall item listed.
2 Confirm selection by pressing on the “Ok” key.
3 Type the memory number you wish to recall in the numeric keyboard.
If no position has previously been saved and a recall from memory proce-
dure is carried out, the message “Memory not initiated” will appear on the
display.
4 Press and hold the “GO TO” key and the C-Arm will automatically reach the
desired saved position or press “Esc” to cancel the selection.
Ch.
5 An acoustical sound will confirm having reached the desired position.
If the “Go To” key is released before the arm reaches the desired position, 15
the movement will be arrested and the operation will be cancelled.
15.4 Manual Positioning

This function can be accessed from the main menu (found in the top left-
hand corner of the numeric keyboard) and allows you to set the desired po-
sition for each of the four movements of the C-Arm using four coordinates:
1. Long.X (mm)
2. Highlow.Z (mm)
3. Orb.ang.(°)
4. Rot.ang.(°)
With the cursor keyboard, select the desired coordinate and press “OK” to
confirm.
Set the numeric value of the desired coordinate using the numeric keybo-
ard: if you attempt to set a value that does not fall into the consented range,
an error message will appear and you will be brought back to the coordinate
selection menu. If you set the coordinate range correctly a message inviting
you to press the “Go To” key will appear in order to carry out the positioning
requested or “Esc” can be pressed to exit the procedure.
If you wish to set only one coordinate press and hold the “Go To” key until
you reach the desired position which will be audible with an acoustic signal
and the value of the set coordinate visible on the display next to the chosen
movement coordinate.
If you wish to set other coordinates and execute a combined movement
wait until the message on the display disappears “keep Go TO pressed, Esc
to Exit” and select another coordinate whose value you wish to set.
If you wish to insert a new coordinate and execute a combined movement,
wait till the message on the display disappears and select another coordina-
te.

Total pages: 218 Manual Positioning 207
15 MENU ITEMS MOONRAY User Manual - Rev.34 - 2020/01/22
When you finish setting all the desired coordinates, press and hold the “Go
To” key, the C-Arm will carry out the combined movements to reach the
coordinates set. No movement will be carried out for those parts whose
coordinate has not been set.
• The horizontal translation movement: only has positive values; 0 mm
corresponds to the end of travel position in which the arm is totally
retracted towards the handlebar.
• The up/down movement: only has positive values; 0 mm corresponds to
the end of travel position in which the arm is at its lowest height.
• The rotational movement: of the “C” has values that go from -360° to
+360°; the “C” can, in fact rotate completely clockwise and counter-
clockwise. The positive angles correspond to the counter-clockwise
rotation, looking at the arm from the handlebar side. To set a negative
value, press the right arrow key in the cursor keyboard, to go back to the
“+” sign, press the right arrow key again.
• The orbital movement: of the “C” has values that go from -87°to +45°; to
set a negative value, press the right arrow key in the cursor keyboards,
to go back to the “+” sign, press the right arrow key again.
15.5 Select Language

The language of the messages that will appear on the display can be selec-
ted as follows:
1 After having pressed the “Menu” key in the upper left-hand corner of the
numeric keyboard move the “*” indicator up or down with the use of the
up/down arrow keys of the cursor keyboard until you reach the desired
language.
2 Select the desired language confirming with the “OK” key.
You will automatically be brought back to the main menu, which will appear
in the new language selected.
208 Select Language © Copyright SIMAD srl 2020

Total pages: 218
16 ISOCENTRIC
FUNCTION
16

16 ISOCENTRIC FUNCTION MOONRAY User Manual - Rev.34 - 2020/01/22
16.1 Definition of the Isocentric Feature

The possibility of moving the “C” of the arm while keeping a specific point
in space centered, so as to guarantee that the central axis of the beam
directed in that spot, no matter the inclination of the beam itself, continues
to center it. (This point is known as the ISOCENTER).
A device that is able to radiate towards this point from various angles is
called an isocentric machine.
The isocenter can be selected by the utilizer as requested.
16.2 The Isocenter Mode

In order to operate in this mode it is necessary to carry out two (2) acquisi-
tions called “ISO 1” and “ISO 2”, with positions that are diverse from the “C”
in the orbital direction.
16.2.1 Configuration procedure to activate the Iso-

center Mode
PROCEDURE:
1 Press the “ISO” key: the signal light under the key will begin to flash.
2 Press and hold the Go To key till the rotational movement moves to 0° and
an acoustic signal is heard
3 The messages “Select M.ISO 1 and M.ISO 2” will appear on the display.
4 To acquire the first position press the “ISO 1” key: the signal light under the
key will begin to flash.
5 Move the C-Arm so as to frame the point you want to use as the isocenter:
during this phase the rotational movement command is disabled while the
orbital, up/down and horizontal translational movement are active.
6 once found the desired point press the “ISO 1” key to confirm the acquisi-
tion, the signal light under the “ISO 1” key will now stop flashing and stay lit.
• If the “Esc” key should be pressed instead of the “ISO 1” key to confirm
the acquisition, the preceeding isocentric “ISO 1” point already saved, if
present, will be retained valid; entering the isocentric mode will not be
possible until an acquisition for the “ISO 1” position is confirmed.
7 once the “ISO 1” point is confirmed, press the “ISO 2” key, the signal light
under the key will begin to flash to indicate that the second acquisition is
required: during this phase, as with the ISO 1 position, the rotational move-
ment command is disabled.
8 Move the C-Arm so as to frame the same point as with the “ISO 1” position
put with a different orbital angle. To frame this point you must modify the
“C” position with the orbital, the up/down and the horizontal translational
movements.
9 To confirm the second acquisition press the “ISO 2” key. The signal light
under the key will stop flashing and the isocentric point will be calculated in
three dimensions.
210 Definition of the Isocentric Feature

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 16 ISOCENTRIC FUNCTION
10 Press the “ISO” key and the signal light under the key will stop flashing and
remain lit to indicate that movement in the isocentric mode is possible.
11 At this point, all three signal lights under the keys “ISO”, “ISO 1” and “ISO 2”
are lit: the only enabled joystick command is the orbital movement. With
every orbital movement the up/down and horizontal translational move-
ments will compensate the position so as to keep the isocenter and keep
the same distance between the isocenter point and the image intensifier.
During movement of the arm in the isocentric mode, the isocenter will
always be at the center of the frame and the distance between the framed
point and the image intensifier will be kept constant and equal to the ac-
quired frame with “ISO 2”. If you wish to keep the isocenter point but want
to change the distance from the Image Intensifier just re-acquire the “ISO
2” position.
To re-acquire the “ISO 2” position press the “ISO 2” key and repeat the pro- Ch.
cedure for this position only; if you press “ISO 1” then both the acquisitions
need to be re-acquired. 16
12 To exit the isocentric mode, press the “Esc” key or press the “ISO” key again.
16.2.2 Utilizing a previously acquired isocenter confi-

guration
A previously acquired isocenter configuration can be considered valid. In
this case pressing the “ISO” key will result in the signal lights under both the
“ISO 1” and “ISO 2” keys to remain lit to indicate that both positions have
previously been acquired and can be used
If the “ISO 1” and “ISO 2” positions have NOT previously been acquired
the signal light under the “ISO” key will begin flashing and the isocentric
function cannot be used. The configuration procedure must be carried out
as explained in paragraph 5.2.1 above.
How to Proceed:
1 Press the “ISO” key to activate the Isocentric mode.
2 Press and hold the “GO TO” key to align the rotational movement if it is not
already in the 0° position.
3 Press the “ISO” key again and the signal lights under the keys “ISO 1” and
“ISO 2” will remain lit if the positions have previously been acquired.
4 The orbital movement can be carried out with the joystick and the C-arm
will automatically act on the up/down and translational motion to keep the
isocenter point framed.
5 To exit the isocenter mode press “Esc or press the “ISO” key again.

Total pages: 218 The Isocenter Mode 211
16 ISOCENTRIC FUNCTION MOONRAY User Manual - Rev.34 - 2020/01/22
16.3 Important aspects regarding the

Isocenter Function of the Moonray
Precisio
If the isocenter is not kept due to the excessive speed requested of the up/
down and horizontal translation to keep up with the “C” orbital movement,
just release the joystick handle and press only the button of the joystick
itself comanding the rotational/orbital movement until the up/down and
horizontal translation movements stop; the isocenter movement can now
resume.
If the up/down or horizontal translational movements reach their end of

travel points and the isocenter cannot be kept for the desired isocenter
point, the display will show an error message “Attention – Compensation
Error” and an acustic signal will be heard during movement attempts. .
When the C-arm is shut down, the “ISO 1” and “ISO 2” positions already
set are deleted.
If you try to acquire an invalid isocenter point (for example if you try to
use the same position of the arm for both the “ISO 1” and the “ISO 2”
positions, the machine does not begin positioning in the isocentric mode
(when you confirm the “ISO 2” position the signal light under the “ISO 2”
key remains flashing).
212 Important aspects regarding the Isocenter Function of the Moonray Precisio
Total pages: 218
17 Monitor
console touch
17
screen

17 Monitor console touch screen MOONRAY User Manual - Rev.34 - 2020/01/22
The Monitor-console touch screen is provided only on certain models of the

series Moonray and is not an option.
When present, all of the Moonray system software functions are managed
via this interface.
17.1 Activating the C arm control console

To activate the C arm control console in the Moonray Systems series equip-
ped with Touch Screen Monitor console is necessary to click the icon availa-
ble in the view monitor A, circled in the figure A. The C arm control console
will appear as in Figure B
Fig. A Fig. B
214 Activating the C arm control console

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22 17 Monitor console touch screen
Activates the various functions of the C arm control console by tapping on

the corresponding icons displayed on the Touch Screen.
To hide the the C arm control console, simply tap in an area of the touch
screen not covered by it.
For all the functions of the C arm control console see chapter 5.
17.2 Views organization

In the Moonray Systems series equipped with Touch Screen Monitor-Conso-
le all the software views will be present on it and accessible by tapping on it.
The software views present are:
- Monitor A Ch.
- Patient data 17
- Monitor B
- Archive
- Notes
- Settings
- ?
To operate the software, see chapter 6.
In systems with Monitor-Console Touch screen: the touch screen console,

the monitor positioned on C-arm device (if present) and the left monitor
of the monitor trolley (if present) are synchronized and show the same
picture.
The right monitor on the monitor trolley (if present) always shows the
“Monitor B” view.
The monitor on the C-arm device and the monitor trolley are not present in
all models available with Monitor-Touch Screen Console.

Total pages: 218 Views organization 215

Total pages: 218
MOONRAY User Manual - Rev.34 - 2020/01/22
user manual
SIMAD SRL reserves the right to make

changes without notice for continuous
improvement of all its products.
ISO 9001:2015 ISO 13485:2016
A Sago Medica Company
CONCEIVED
DESIGNED and
www.simad.net MANUFACTURED
IN ITALY
info@simad.net
SIMAD s.r.l. Via Benedetto Zallone 25 PEC: simad@legalmail.it C.F./P.I./Reg.Imp.di Bologna

40066 Pieve di Cento, info@simad.net 01854280367
Società Unipersonale Bologna www.simad.net REA di Bologna 433497
Direzione e coordinamento Italy Iscr. RAEE
di Sago Medica s.r.l. Tel: +39 051 686 08 11 IT09110000006357
Fax: +39 051 686 12 46 Cap. Soc. € 76.500,00 I.V.

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ISO 9001:2015 ISO 13485:2016

A Sago Medica Company

DOCUMENT code: moexxx_34_20200122

2 © Copyright SIMAD srl 2020

© Copyright SIMAD srl 2020

3.12.2 Compact / 500 VersionEmergency Shutdown Alternatives . ............................................................................... 31

4 Using the Moonray

5 C-Arm Control and Command Console

6.1.8 Sequence Catalogue of an Exam in Progress ..................................................................................................... 75

© Copyright SIMAD srl 2020

6.14 DICOM Print Composer . ......................................................................................................... 130

7 Guide to the use of the Accessories

7.1 Sterile Drapes . ........................................................................................................................ 160

10 Recycling the Device

© Copyright SIMAD srl 2020

11.11.1 Labels position . ................................................................................................................................................. 185

12 List of Icons/Console Commands

14 THE MOTORIZATION CONSOLE

16.1 Definition of the Isocentric Feature ....................................................................................... 210

17 Monitor console touch screen

© Copyright SIMAD srl 2020

A Sago Medica Company MOONRAY User Manual - Rev.34 - 2020/01/22

1.1 Information regarding this Manual

1.1.1 Manual Validity

12 Information regarding this Manual

1.3 Alerts, Warnings and Information

“WARNING”: If these warnings are not taken into consideration, mortal or

“ATTENTION”: If these indications are not taken into consideration, dama-

© Copyright SIMAD srl 2020

14 Alerts, Warnings and Information

A Sago Medica Company MOONRAY User Manual - Rev.34 - 2020/01/22

2.1 The Moonray device and its versions

Figure 1: Moonray System examples

16 The Moonray device and its versions

Figure 2bis: Moonray System 500 version examples

© Copyright SIMAD srl 2020

2.2 Intended use

18 Intended use

© Copyright SIMAD srl 2020

2.6 Authorization for Maintenance and/or

2.7 Non-authorized modifications

2.8 Installation of external devices

2.9 Data Backup

20 Authorization for Maintenance and/or Repairs

2.10 Technical Assistance Contacts

2.11 Technical References

© Copyright SIMAD srl 2020

22 Technical Assistance Contacts

A Sago Medica Company MOONRAY User Manual - Rev.34 - 2020/01/22

The accidental activation of the mushroom-head emergency stop button

24 ﻿ © Copyright SIMAD srl 2020

3.1 Electrical Safety

3.1.1 Equipotential Connection

3.2 Safe Transporting

Cross ramps, go down stairs or around obstacles as slowly as possible. Pay

3.3 Mechanical Safety

© Copyright SIMAD srl 2020

3.4 Risk of Explosion

Inflammable or potentially explosive disinfectant sprays must not be used

3.5 Fire Safety

Use only specific extinguishers for electrical equipment. Using water or

If liquids must be used, isolate the device beforehand to avoid electrical

24 © Copyright SIMAD srl 2020