SECTION C

Additional Operations

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

CONTENTS

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

W ORKING WITH THE CURRENT STUDIES ........................................................................................ 2

ADJUSTING TECHNIQUE SETTINGS ................................................................................................ 8
ADDITIONAL OPERATIONS IN PROCESS W INDOW ......................................................................... 13

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Working with the Current Studies

The Exam window with the selected study/studies is showed as below.

Figure 1: Exam window

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

To Add a New Study

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

Figure 2: Add Protocol button

2. The Add View window displays, as shown below.

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Figure 3: Add Protocol window

3. To save the study information, click the “OK” button.

To cancel operation, click the “Cancel” button.

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

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Figure 4: Exam window with added view icon

To Delete a View/Image

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

Figure 5: Delete View button

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After confirm the delete operation, the reduplicate/unsuitable view will disappear from

Exam window.

To Roll Up/Down Page

When there are many view(s) or/and captured image(s) which cannot be displayed in one
page, click the “Page Up” or “Page Down” button to see the view or image on other page.

Figure 6: Page Up button and Page Down button

To Change the Order of Image Acquisition

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

Figure 7: thumbnail of acquired image and view

By default, the views to be acquired are arranged sequentially from left to right as images

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are acquired. However, you can change the exposure order just by clicking on the view
icon that you want to take next.

Figure 8: change the exposure order

To Save the Technique Settings

Before capturing image, you can adjust the exposure technique parameters (Detail is
introduced in next topic). The modified settings will be saved automatically.

Figure 9: Save Parameter button

To Quit Exam Window

You can quit Exam window by clicking other available items (Worklist or Output) on the
Menu bar. For study with all the images being captured, the quit operation will change the
status of this study into COMPLETED, and return to Worklist window. The completed
study will exit in the worklist page for a certain period, and you can add view to the study
by retrieving the study from worklist page.For study with not all the images being captured,
the Studies’ status confirmation dialog like below figure will pop up.

Figure 10: Studies’ status confirm dialog

 Choose Suspend button, the closing operation will change the status of unfinished
study into IN PROGRESS, and return to Work window.

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 Choose Finish button, the closing operation will change the status of unfinished
study into COMPLETED, and return to Work window.
 Choose Cancel button, stay in Exam window.

Whatever the study’s status is, you can proceed to taking exposures by retrieving the
study from Worklist page.

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Adjusting Technique Settings

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

Figure 11: Technique Settings panel

From the Technique Settings panel you can:

 Adjust exposure settings manually.

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

 Select a focal spot size.

 Select a patient size setting.

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 Check the status of the Generator & Detector.

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

Selecting the Patient Body Type

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

Figure 12: Patient Size

Adjusting kV

The range of kV is confined by the generator.

Figure 13: kV setting

To adjust the kV value, click on the Increase KV button and Decrease KV button
located to the right of the kV value field. The kV value increases and decreases in steps of
1 kV. Pressing and holding the button causes displayed kV value to increase or decrease
automatically until the button is released. If the kV value reaches maximum or minimum,
the value will remain unchanged.

Changing AEC Settings

The Automatic Exposure Control (AEC) system monitors X-radiation dosage which is
passing through ion chambers and automatically terminates the exposure after the
X-radiation dosage reaches a predetermined amount of radiation.

NOTE: The default density (0) is calibrated for normal contrast and density levels. Larger,
heavily muscled patients will require an increase in density. Smaller, lightly muscled
patients will require a decrease in density. However, only use this density adjustment if
the image is grainy. If an image is too dark or light, adjust the ESA settings (refer to the

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followed topic "Changing the ESA Settings of an Acquired Image"); do not adjust AEC.

Typically you use the AEC and detector field default settings. You can override them under
special circumstances (for example, the patient has only one lung).

Figure 14: AEC Settings

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

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

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

Adjusting Exposure timing using MAS setting

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

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

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the button is released. If the value reaches maximum or minimum, the value will remain
unchanged.

Figure 15: MAS Setting

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

Adjusting Exposure timing using TIME settings

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

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

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

Figure 16: TIME Setting

Selecting the Focal Spot Size

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

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Figure 17: Focal Setting

NOTE: If the selected Focal Spot Size is not compatible with the tube and focal spot, the
system inhibits exposure and displays an overload condition. An overload condition
may exist if the technique selected exceeds the maximum or is below the minimum
allowable X-ray tube focal spot rating. The tube parameters are consistent with the
X-ray tube manufacturer's rating charts.

Hardware Status

The status of hardware is displayed in the Common Message area, as shown below.

Figure 18: Hardware Status：OK/ Warning/ Error

Reset Hardware

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

Figure 19: Reset button

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Additional Operations in Process Window

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

Figure 20: Process window

You can perform the following processes as:

 Verify patient and exposure information.

 Selecting LUT or IT.
 Clipping the image.
 Changing the look-up table (LUT) of the image.
 Adding comments to the image.
 Adding markers to the image.
 Rotating or mirroring the image.
 View the image in full size.

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Checking the Patient and Exposure Information

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

Figure 21: Patient and Exposure Information

Add Markers to an Image

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

Figure 22: Marker buttons

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

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

Work with Comments

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

Figure 23: Define Mark button

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

Figure 24: Label list

To add a customized label

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

Figure 25: The image with added label

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Remove Marks and Comments

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

Figure 26: Clear All Marks button

View Full Size Image

Click the Original Size button; you can view the image in full size by holding the left mouse
key pressed and moving mouse to desired direction. In Original Size mode you can only
view the image, cannot permitted to clip, rotate and do other operations. To enable such
operations, you must return to Fit Window mode by click Fit Window button

Figure 27: Fit Window button and Original Size button

Rotating the Image

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

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

Figure 28: Image Rotate buttons

Mirror the Image

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

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Figure 29: Flip Horizontally button and Flip Vertically buttons

Clip an Image

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

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

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

Figure 30: Recover Clip button

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

Figure 31: Remove Clip button

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

Figure 32：Save Clip button

To change clip size: choose one item from the clip size drop-down list which can be
triggered by clicking Define Clip Size button，the items in the drop down list represent
standard film size with inch being unit.

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Figure 33: Clip Size List of Define Clip Size button

Rotate the Image with any angle

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

Figure 34: Rotate Any Angle

Add Mask on the image

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

Figure 35: Add Mask button and Delete Mask button

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Figure 36: Image with mask

Show the image with inversed phase chromatography

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

Figure 37: Invert button

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Figure 38: Inversed image

Select LUT or Symphony

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

Figure 39: LUT button, Symphony button, Custom Symphony button

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

Adjust the LUT

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

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

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

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

Figure 40: LUT

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