CRv5.6 OnlineHelpTopics EN

DIRECTVIEW CR System Software
Version 5.6 Online Help Topics
PN 9J0298
2012- 01-17
Version 1.0
Table Of Contents
CARESTREAM CR System Online Help ..............................................................1
DIRECTVIEW CR System Software V 5.6 New Features and Enhancements.....1
How to Contact Carestream Health, Inc................................................................5
About Online Help.................................................................................................6
CARESTREAM Radiographer's Help ...................................................................9
Patient Verification Mode ......................................................................................9
Completing an Exam Set-up ...............................................................................11
Setting Up Views for a Procedure .......................................................................13
Setting Up Views for My Procedure ....................................................................15
Accepting the Image ...........................................................................................17
Correcting Image Artifacts ..................................................................................18
Reviewing Images...............................................................................................19
Modifying a Delivered Image ..............................................................................20
Flagging an Image for Review ............................................................................21
Low Contrast Images due to IPL Parameters Failure .........................................22
Rejecting an Image .............................................................................................23
Quick Reference Button Guide ...........................................................................24
Using the Patient Input Screen ...........................................................................27
More Image Data ................................................................................................29
More Information Tab..........................................................................................31
Auto-Associating Information ..............................................................................32
Creating an Additional Study ..............................................................................33
Modifying Information..........................................................................................34
Displaying the Procedures List ...........................................................................35
Find Study Remotely Button ...............................................................................36
Displaying Other Studies for a Patient ................................................................37
Displaying Image Icons.......................................................................................38
How to End a Study ............................................................................................39
Entering Temporary Trauma Patient Data for Performing a Trauma Exam ........40
Entering Additional Exam Information.................................................................41
Resolving Cassette ID Errors..............................................................................43
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DIRECTVIEW System Software Version 5.6 Online Help Topics for CR
Finding Patients ..................................................................................................44

Using the Patient Query/Work List Screen..........................................................45
Improving Search Results...................................................................................47
Using Study Status to Search for an Existing Patient .........................................50
Finding an Image ................................................................................................52
Identifying Work List Colors ................................................................................53
Using the Image List Screen...............................................................................54
Defining a View ...................................................................................................56
Adding a View .....................................................................................................57
Deleting a View ...................................................................................................58
Changing the View Name ...................................................................................59
Patient CD (optional)...........................................................................................61
What are Prior Images? ......................................................................................64
Prior Image Retrieval Functions..........................................................................66
Using Prior Images .............................................................................................67
Creating a Companion Image Automatically .......................................................69
Creating a Companion Image Manually..............................................................71
Tube & Line Visualization Software ....................................................................72
Using the Tube & Line Software Option..............................................................73
Troubleshooting the Tube & Line Visualization Software....................................74
Pneumothorax Visualization Software ................................................................75
What Is Multi-format Printing?.............................................................................76
Multi-Format Functions .......................................................................................78
Creating Multi-Format Prints ...............................................................................82
Best Fit to Print ...................................................................................................85
Scale to Fit ..........................................................................................................86
Creating a True-size Print ...................................................................................87
Selecting an Internal or an External Text Box.....................................................88
Using a Single Image External Text Box.............................................................89
Using a Single Image Internal Text Box..............................................................90
Selecting a Destination .......................................................................................91
Using the Crop Box Adjustment Tab...................................................................92
Using Manual Cropping ......................................................................................94
iv
Table Of Contents
Using Measurement Tools ..................................................................................96

Measurement Tool Sample.................................................................................98
Sending Images to a Different Location ..............................................................99
Distributing the Image .......................................................................................100
Using the Image Viewer Screen........................................................................101
Express Viewer Screen.....................................................................................103
Adjusting Image Parameters Menu...................................................................107
Adjusting Image Quality Controls......................................................................108
How to Use Window/Level ................................................................................110
Increasing Latitude............................................................................................111
Image Processing Failure .................................................................................112
Reprocessing the Image ...................................................................................113
Using the Histogram .........................................................................................114
Using the Image Adjustment Tab......................................................................115
Adjusting for More Detail...................................................................................116
Assigning an Image ..........................................................................................117
Assigning an Image to a Different Patient.........................................................118
How an Image Becomes Unassigned ...............................................................119
Unassigning an Image ......................................................................................120
Automatic Delivery or Manual Delivery .............................................................121
Viewing a Thumbnail Image..............................................................................122
Auto Display in QA Mode..................................................................................123
Pass-through Mode...........................................................................................124
Auto Display in QA Mode..................................................................................125
Storage Commitment Function .........................................................................126
Using the View/Look Adjustment Tab ...............................................................127
Reducing Noise.................................................................................................129
Using Grid Suppression Software .....................................................................130
Magnification Tab..............................................................................................131
Rotating and Flipping the Image .......................................................................132
Reversing the Image.........................................................................................133
Using the Comment Tab ...................................................................................134
Review Needed Status .....................................................................................135
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Brightness, Latitude, and Detail Contrast Definitions ........................................136

Markers Menu ...................................................................................................137
Adding Markers.................................................................................................138
Adding the Text Marker.....................................................................................140
Moving a Marker ...............................................................................................141
Removing a Marker...........................................................................................142
Using the Favorites Markers .............................................................................143
Using the Measures Markers ............................................................................144
Using the Others Marker Group ........................................................................145
Using the Time Markers....................................................................................147
Using the Surround Mask Tab ..........................................................................148
Masking Failure.................................................................................................150
Applying Automatic Surround Mask (optional) ..................................................151
Mask Points Are Off the Screen........................................................................152
Applying Manual Surround Mask (optional) ......................................................153
Reprocessing After Using Edit Mask.................................................................154
Performing the Exam ........................................................................................155
Improving Acquisition Techniques ....................................................................157
Determining the Exposure Index.......................................................................158
CARESTREAM CR System Workflow Help......................................................161
Logging On and Logging Out of the Modality....................................................161
Shutting Down the CR System .........................................................................162
Restarting Versus Rebooting ............................................................................164
Using the Shutdown Button ..............................................................................165
Patient Information Bar .....................................................................................166
Using the Erase Cassette Tab ..........................................................................167
Using the Erase Lamp Status Tab ....................................................................168
Using the Scan Status Screen ..........................................................................169
Using the Scan Status Tab ...............................................................................171
Using the System Recovery Tab.......................................................................172
Local User Interface Main Menu .......................................................................173
Using the Volume Settings Tab.........................................................................176
Main Menu Functions........................................................................................177
vi
Table Of Contents
CR Modality Overview ......................................................................................179

Workflow Configurations ...................................................................................180
Modality Performed Procedure Step (MPPS) ...................................................181
Scheduled Workflow Configurations .................................................................182
Scanning CR Cassettes Menu ..........................................................................183
Using the Touch-Screen ...................................................................................184
High-Resolution Scanning ................................................................................185
Slow System Response ....................................................................................186
CR System Freeze-up ......................................................................................187
Scanning on a Classic/Elite CR System ...........................................................188
Scanning on a CR 825/850 System ..................................................................189
Scanning on a CR 950/975/Max CR System ....................................................190
Purchasing Erase Lamps..................................................................................192
Cassette Jams ..................................................................................................193
Scanner Error....................................................................................................194
Scanning CR Cassettes Menu ..........................................................................195
Resolving Cassette ID Errors............................................................................196
Entering Information with the Bar-Code Scanner..............................................197
Information Does Not Appear ...........................................................................198
Configuring Remote Devices ............................................................................199
Setting Up Remote Access to the CR or DR System........................................201
Remote Workstation Options ............................................................................202
Easy to Use Remote Access Software .............................................................203
ROP Links Configuration ..................................................................................204
Administrative Analysis and Reporting Feature ................................................205
CARESTREAM CR Utilities Help ......................................................................207
Utilities Menu ....................................................................................................207
Viewing the Status of System Communications................................................208
Changing Your Password .................................................................................209
Register Badge .................................................................................................210
Key Operator Software Installation Instructions ................................................211
Key Operator Software Upgrade Instructions ...................................................212
Select USB Destination.....................................................................................214
vii
Image Recovery on the Capture Link System...................................................215

Using the Capture Link Server Status Screen ..................................................217
Viewing the Status of System Communications................................................218
CARESTREAM Key Operator Help ..................................................................219
Key Operator Functions Menu ..........................................................................219
System Configuration Menu..............................................................................220
RIS/PACS Web Page Configuration .................................................................221
2D Bar Code Programming...............................................................................222
Multiple Field Bar Code Formatting...................................................................224
Using the HIBC Tab ..........................................................................................225
Using the Character Delimited Tab ...................................................................227
Fixed Mount Bar Code Programming................................................................229
Programming the Automatic Trigger .................................................................230
Bar-Code Configuration Menu ..........................................................................231
Bar Code Configuration ....................................................................................231
Bar-Code Configuration ....................................................................................232
Bar-Code Programming ....................................................................................234
How to Change the Beeper Mode.....................................................................235
How to Change the Cassette ID format ............................................................236
Changing the Country Code .............................................................................237
Changing the Data Field Size ...........................................................................239
Changing the Prefix and Suffix .........................................................................240
Configuring Reread Delay.................................................................................241
Stripping a Bar-Code Field................................................................................242
Stripping Middle Characters from the Bar-Code ...............................................243
Using the Bar-Code Configuration Screen........................................................244
Bar-Code Programming Samples .....................................................................246
Bar-Code Programming Samples (Page 2) ......................................................248
viii
Table Of Contents
Programming the Keyboard Wedge Bar-Code Reader.....................................257

Programming the Keyboard Wedge Bar-Code Reader and Add Suffix.............259
Programming the PS2 Keyboard Bar-Code Reader .........................................260
Programming the PS2 Keyboard Bar-Code Reader and Add Suffix .................262
Programming the PS2 to USB Keyboard Bar-Code Reader .............................264
Programming the PS2 to USB Keyboard Bar-Code Reader and Add Suffix.....266
Programming the Serial Scanner Bar-Code Reader .........................................267
Programming the USB as Serial Bar-Code Reader ..........................................268
How to Configure for a Polling Query................................................................269
HIS/RIS Options................................................................................................269
HIS/RIS Polling Query ......................................................................................271
Configurable Text Box Menu ............................................................................273
Configuring Text Boxes.....................................................................................274
Editing a Text Box.............................................................................................275
Multi-Format Print Image Text Overlay .............................................................278
Multi-Format Page Footer Layout .....................................................................279
Multi-format Image Internal Text Box ................................................................280
Selecting an Internal or an External Text Box...................................................281
Using a Single Image Internal Text Box............................................................282
Using a Multi-format Image Internal Text Box...................................................283
Using a Multi-format Image External Text Box..................................................284
Selecting a Default Multi-format Text Box.........................................................285
Using a Multi-format Page External Text Box ...................................................286
Using a Single Image External Text Box...........................................................287
Configurable Text Box Options .........................................................................288
What Is a Destination Profile?...........................................................................289
Destination Profile Configuration ......................................................................290
IEC Exposure Index Menu ................................................................................292
IEC Exposure Index ..........................................................................................293
Determining the IEC Beam Technique..............................................................295
IEC Exposure Index Compliance Testing .........................................................299
Changing Image Processing Preferences.........................................................301
What Is a Look? ................................................................................................304
ix
What Is a DICOM GSDF-calibrated Monitor? ...................................................305

Region of Interest (ROI) Tool ............................................................................306
Image Processing Controls...............................................................................308
Using View Before and After.............................................................................309
Changing the Look............................................................................................310
Reprocessing the Image ...................................................................................311
Layout Configuration.........................................................................................312
Image Viewer Editors........................................................................................314
Markers Editor...................................................................................................316
Anatomy Clipping Procedure ............................................................................320
Patient Names Editor ........................................................................................322
Patient Work List Editor ....................................................................................323
Patient Input Editor ...........................................................................................325
RPDES Editor ...................................................................................................327
Prior Image Configuration .................................................................................328
Prior Image Configuration Options Tab.............................................................329
Prior Image Search Tab....................................................................................331
Prior Images PACS Tab....................................................................................332
Statistics Menu..................................................................................................333
Viewing Radiographer's Statistics.....................................................................334
Viewing Destination Summary Statistics...........................................................335
Viewing the Flagged Image List ........................................................................336
Downloading Statistics......................................................................................337
Cassette Statistics ............................................................................................338
Erase Cycles.....................................................................................................339
Exporting Data ..................................................................................................340
Trauma Defaults Configuration .........................................................................342
Entering or Changing Trauma Exam Data ........................................................344
Hiding Trauma Exam Buttons ...........................................................................345
View Configuration............................................................................................346
Automatic View Selection .................................................................................350
Patient Size Indexing ........................................................................................351
Grid Indexing ....................................................................................................352
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Table Of Contents
Importing Custom Tutor Images........................................................................354

Network Configuration ......................................................................................356
Configuring Surround Mask Enlargement .........................................................357
Changing View Configuration Attributes ...........................................................359
Managing View Categories ...............................................................................360
Color Preferences Configuration.......................................................................361
How to Change Field Descriptions....................................................................362
Delivery Preferences Configuration ..................................................................363
Display Configuration........................................................................................365
Harvesting Flagged Images ..............................................................................370
How to Configure for a Polling Query................................................................372
HIS/RIS Options................................................................................................372
Setting the Limits for Image Retention ..............................................................374
List Configuration ..............................................................................................375
Long-Length Imaging Configuration..................................................................376
Procedure Mapping Configuration (optional) ....................................................377
Proximity Badge Configuration .........................................................................379
Regional Configuration .....................................................................................380
Configuring Remote Devices ............................................................................381
Required Fields Configuration ..........................................................................382
Setting the Limits for Image Retention ..............................................................383
Scanner Options ...............................................................................................384
AEC Calibration ................................................................................................386
Backup and Restore Configurations .................................................................387
Manage Patient Exam Records ........................................................................392
Reject Reasons Configuration ..........................................................................394
Register and Activate Options ..........................................................................396
What Is TQT?....................................................................................................398
Performing System Tests..................................................................................399
Testing Cassettes .............................................................................................400
Selecting a Test Phantom.................................................................................401
Positioning a Test Phantom ..............................................................................402
Appending the Session .....................................................................................404
xi
Determining the Exposure ................................................................................405

Collimating for TQT Testing ..............................................................................406
Using the Total Quality Tool Main Page............................................................407
Performing Phantom Tests for General Radiography .......................................409
Performing the Erased Image Test ...................................................................410
Understanding the System Noise Test..............................................................411
Cassette Testing Menu .....................................................................................412
Testing Cassettes with TQT..............................................................................413
Flat-Field Image Test ........................................................................................414
Performing a Flat-Field Image Test...................................................................415
Best Results from Cassette Testing..................................................................416
Viewing Test Result Indicators..........................................................................417
Reported Cassette Test Results .......................................................................418
Using Results (Page 1) .....................................................................................419
Using Results (Page 2) .....................................................................................420
How to Export Data...........................................................................................421
Cassette Inventory and Inspection....................................................................422
Cleaning Cassettes...........................................................................................423
Film-Printer Calibration Test .............................................................................424
Workstation Display Calibration Test ................................................................425
Phantom Image Test Failure.............................................................................426
Flat-field Test Failure ........................................................................................431
System Noise Test Failure................................................................................433
Troubleshooting TQT for General Radiography ................................................434
Monitor Calibration Introduction ........................................................................435
Display Pro for General Radiography ...............................................................436
SMPTE Test Target ..........................................................................................438
Monitor Calibration............................................................................................439
Touch-screen Calibration..................................................................................440
Measuring Luminance for Tracking...................................................................441
Measuring Luminance for Gamma....................................................................442
How to Order a VERILUM CHROMA 5 Photometer .........................................443
CSA Log Viewer................................................................................................444
xii
Table Of Contents
CARESTREAM Capture Link System Help ......................................................445

Joining Devices.................................................................................................445
Capture Link System Workflow .........................................................................446
Capture Link System Range of Operation ........................................................447
Identifying Active Devices in the Capture Link System .....................................451
Identifying Icons ................................................................................................452
Using the Capture Link System ........................................................................454
Standalone Mode..............................................................................................456
Changing Image Processing in the Capture Link System .................................457
Configuring Destination Profiles with the Capture Link System ........................459
Communicating with the HIS/RIS......................................................................461
Image Review with the Capture Link System....................................................462
Multi-format Printing with the Capture Link System ..........................................463
Scanning Long-Length Images (LLI) on the Capture Link System....................464
Image Recovery on the Capture Link System...................................................465
Rejoining the Capture Link System...................................................................467
Redelivering an Image ......................................................................................468
Using Image Recovery to Capture Link ............................................................469
Making Preference Editor Changes in the Capture Link System ......................470
Capture Link Configuration Screen ...................................................................472
Configuring and Connecting a Console or Accessory Device...........................473
Capture Link System Requirements .................................................................474
Restoring Configurations from the Server to a Standalone Machine ................475
Removing a Console from the Capture Link System ........................................476
Troubleshooting the Capture Link System ........................................................477
Capture Link Server Safety and Regulatory......................................................478
Logging On to the Capture Link Server.............................................................479
Using the Capture Link Server Status Screen ..................................................480
Using the Capture Link Server ..........................................................................481
CARESTREAM CR Long Length Imaging Help ................................................483
Long-Length Imaging (LLI) Menu......................................................................483
Performing a Long-Length Exam ......................................................................484
Optimizing a Long-Length Exam.......................................................................485
xiii
Entering Data for an LLI Exam..........................................................................486

Determining the SID..........................................................................................487
LLI Techniques .................................................................................................488
Scanning Long-Length Images (LLI) on the Capture Link System....................489
Assigning and Unassigning Long-Length Images (LLI).....................................490
DIRECTVIEW CR Long-Length Grid ................................................................492
Tips for Optimizing Long-length Image Quality .................................................493
Using the Manual Stitch Editor..........................................................................494
Printing Long-Length Images............................................................................496
Viewing Long-Length Images ...........................................................................497
No Composite Image ........................................................................................498
Images are Stitched Incorrectly ........................................................................499
Distorted Composite Image ..............................................................................500
CARESTREAM Remote Patient Data Entry System Help ................................501
Remote Patient Data Entry System (RPDES)...................................................501
xiv
CARESTREAM CR System Online Help
DIRECTVIEW CR System Software V 5.6 New
Features and Enhancements
Combined Query/Patient Work List screen—Provides quick access to the patient
list, combining patient query and work list functions. Allows searching by filtering
by criteria that is selected by the user. Field focus and ascending or descending
sort order are user selectable.
Multi-format Print Enhancements—

Enhancements include:
 "What you see is what you get" layout and editing
 Sub-image page layout in a possible mix of True size, Scale–to–Fit, or custom
magnifications.
 Pan, zoom, rotate, and modify sub-images independently
 New print layouts, including 2, 3, 6, and 9 up prints, 2 x 1 (60:40 %) and (75:25
%), or 1 up portrait and landscape, on a single film
 Customized page footers
 Virtual cassette auto-cropping to standard cassette/film sizes
 Asymmetric and symmetric multi-format print layouts
 Configured overlays that appear on each image in the layout
Express Viewer Screen—The Express Viewer screen provides a large View

pane and a quick selection of commonly used tools.
If configured, the Express Viewer screen appears whenever the Image Viewer
screen is needed. The complete set of image processing functions still reside on
the Image Viewer screen, which can be can be accessed by pressing the
Advanced Viewer button.
IEC Exposure Index Option—The International Exposure Index standard is now

supported as an option for CR/DR Systems. You can choose CARESTREAM EI
or IEC EI, or both. The IEC Exposure Index option provides for configurable
target values for all views and a system-wide configurable value for deviation
Index warning threshold. This feature does not apply to Mammography images.
Intensive Care Unit software package:

 Consistent rendering of chest images
1
DIRECTVIEW System Software Version 5.6 Online Help Topics
 Grid Indexing—With this feature, the system automatically selects a View with
image processing parameters optimized for exposures made with a grid.
 Pneumothorax Visualization Software—Pneumothorax imaging optimizes the
image processing of a chest image so that it is easier to view a pneumothorax.
Tech Assist Software

o Anatomy Clipping notification—alerts the user that anatomy could be
excluded from an image.
o Contrast Noise Ratio (CNR) notification—alerts the user that the image has a
CNR below the set limit.
Importing Custom Tutor Images—CR/DR System Software Version 5.6 allows

the user to import custom tutor images that are consistent with site preferences.
Images are imported easily from a USB drive, and are selectable for each View.
Key Operator Installation of Software Updates—The Key Operator can upgrade

software by installing software and firmware updates without Service assistance.
Pediatric Support Option—System Software V 5.6 now supports the selection of

pediatric “size” for each View based on user-defined age and weight categories.
Recall Prior Image Software—Lets the user import and view images and
information from the patient’s last exam, including technical information such as
the technique used.
Image Delivery to USB Removable Media—Now you can use a USB flash drive
to carry images to a PACS when the network is down.
Patient Verification Mode—A visual indicator verifies the patient wristband

barcode with the patient information using the 2D bar code reader.
2D Barcode Reader—A new bar code reader scans two dimensional bar codes,
which contain much more information than traditional bar codes. This is used for
patient verification.
Key Operator Editing Capabilities—The Key Operator can edit the AE Title, IP
address and port for their DICOM destinations as well as Copy Log History,
Tech Assist features, Patient Worklist, switch between Imaging Types (GOS,
CSI), and more. See the Key Operator Functions menu for quick access to all
Key Operator functions.
2
Trademark and Copyright Information
CARESTREAM and DIRECTVIEW are trademarks of Carestream Health, Inc.

The Kodak trademark and trade dress are used under license from Kodak.
This document is copyrighted with all rights reserved.

Under the copyright laws, this document may not be copied, in whole or in part,
without the written consent of Carestream Health, Inc.
Under the law, copying includes translating into another language or format.
All names or identities used in this document are fictitious.
Federal law restricts this device to sale to, by, or on order of a physician.
The information contained herein is based on the experience and knowledge

relating to the subject matter gained by Carestream Health, Inc. prior to
publication. No patent license is granted by this information.
Carestream Health reserves the right to change this information without notice
and makes no warranty, express or implied, with respect to this information.
Carestream Health shall not be liable for any loss or damage, including
consequential or special damages, resulting from the use of this information,
even if loss or damage is caused by Carestream Health's negligence or other
fault.
FCC Compliance
This equipment has been tested and found to comply with the limits for a Class
A digital device, pursuant to Part 15 of the FCC Rules.
These limits are designed to provide reasonable protection against harmful
interference when the equipment is operated in a commercial environment. This
equipment generates, uses, and can radiate radio frequency energy and, if not
installed and used in accordance with the instruction manual, may cause
harmful interference to radio communications.
Operation of this equipment in a residential area is likely to cause harmful
interference in which case users will be required to correct the interference at
their own expense.
Notice: This document contains references to software products that were

formerly marketed as Products from Eastman Kodak Company.
3
Carestream Health France

1, rue Galilèe
93192 NOISY-LE-GRANDE CEDEX
FRANCE
2012-01-17
Online Help Version 1.0
PN 9J0298
Carestream Health, Inc.

150 Verona Street
Rochester, N.Y. 14608
4
How to Contact Carestream Health, Inc.

 For technical support in the United States and Canada, contact the Center of
Excellence (COE, formerly TSC) at 1-800-328-2910.
 For regions outside the United States and Canada, contact your local Shared
Service Center (SSC).
 General Customer Support for US and Canada:
CARESTREAM HEALTH, INC.
150 Verona Street
Rochester, NY 14608
1-800-431-7278
Elsewhere in the world, contact Carestream Health, Inc. in your country.
5
About Online Help

CARESTREAM DIRECTVIEW System Software V 5.6
2011-11-30
Online Help gives you specific information on the function of System operations.
For product safety information, refer to Safety and Regulatory Information for
your system.
How do I access and navigate Help?

 Touch the question mark in the upper right corner of the Console screen to
open context-sensitive Help for that screen, as well as the Table of Contents
of the entire Help system.
 Select the Back or Forward arrows at the top of the Help window to navigate
between Help pages.
 Select Hide to hide the Table of Contents.
 Select Index and double-click any text to display the information for that term.
 Select Close to easily close the Online Help window with the touch of a finger.
 Select any blue text to jump to related topics for additional information.
Document Conventions
This help system uses the following messages to emphasize information or
potential risks to personnel or equipment:
Notes provide additional information, such as expanded explanations, hints, or
reminders.
Importants highlight critical policy information that affects how you use
this information and this product.
Cautions point out procedures that you must follow precisely to avoid
injury to yourself, others, damage to the system or any of its components,
loss of data, or corruption of files in software applications.
TIPS are techniques or best practices and recommendation that may improve
your workflow.
The Table of Contents follows the basic workflow of the software and how it is
used. The book icons divide the Help into sections (chapters) that contain all
of the topics for related to the book title. An open book indicates that all topics in
the book are displayed. A closed book means that a number of topics are
available in that book and you must click the book to open it and display them.
Click on any topic to display the information for that topic.
 The CARESTREAM CR Application Workflow section indicates that each
topic is located in the Study Data section of the software, where you will find
specific information for CR equipment and software.
6
 The CARESTREAM Radiographer Help section lists all of the common buttons
used in the software and their definitions, such as patient data entry, existing
patient exams, new patient exams, creating and reviewing studies, searching for
patients, acquiring images, print formatting, image review, manipulating images,.
image quality control, accepting or rejecting images, and printing images.
Radiographer Help covers the DIRECTVIEW System Software Study Data and
Image Review menu choices.
 The CARESTREAM CR Utilities Help section gives all users access to utility
functions such as changing passwords, installing software and firmware, and
image recovery.
 The CARESTREAM Capture Link System Help section provides the user with
information about the Capture Link option, where modalities can be linked
together to share patient information and functionality.
 The CARESTREAM Long-Length Imaging Help section provides step by step
procedures for processing long bone and scoliosis exams on one composite
image.
 The CARESTREAM Key Operator Help section is accessed by users with Key
Operator passwords, and provides information on configuring all of the options
and features of the system, communicating with RIS and PACS, software
updates, IEC Exposure Index, monitor configuration, and remote access
functions, to name a few.
 The CARESTREAM Total Quality Tool Help section provides step by step
instructions on performing image quality testing of receptors used by the facility.
7
CARESTREAM Radiographer's Help
Patient Information
CR System Exams
Patient Verification Mode
Patient Verification Mode provides an icon on the title bar that tells the user
whether or not the information on the patient's wristband matches the
information displayed on the Patient Input screen.
Patient Verification is enabled by the Key Operator. Navigate to Key
Operator>System Configuration>Display Configuration>Patient Input tab.
See Display Configuration.
The patient ID is verified by scanning the patient wristband with the 2D bar code
reader.
An icon in the title bar on the Patient Input screen displays when this feature is
enabled.
To Be Verified
 Waiting for the wristband to be scanned with the 2D bar code reader.
Does Not Match
 Wristband has been scanned with the 2D barcode reader and the Patient IDs do
not match.
 User searches for another patient or enters data for a new patient using the 2D
bar code reader.
Is a Match
 Patient ID on the wristband matches the patient ID in the system. The patient
verification is complete.
 User proceeds with the exam
9
There are two identifiers that the Key Operator can use to configure
Verification:
 Patient ID
 Name and date of birth
10
Completing an Exam Set-up

Setting up Views for My Study:
To complete the setup of an exam without the optional Procedure
Mapping:
1. Select the Add View button.
2. Select a region from the Primary Category Tab.
3. Select a body part from the Secondary Category Tab.
4. Select all of the desired Views for the study.
5. Select Save Changes.
6. Enter information on the More Information and More Image Data Tabs if
needed.
To complete an exam from the HIS/RIS with optional Procedure Mapping:
If your facility has a HIS/RIS and your modality has the optional Procedure
Mapping feature, the Key Operator can associate procedure codes to
automatically populate the necessary views for a study.
The HIS/RIS must populate the procedure code field on the Patient Input
Screen in order for the Views to automatically populate.
1. From the Main Menu, select Study Data.
2. Search for the patient using the Patient Query Screen.
3. Select the patient from the Patient Work List.
The patient information and the Views for the procedure automatically
appear on the Patient Input Screen.
Enter information on the More Information and More Image Data Tabs if
needed.
To complete an exam from optional Procedure Mapping without the
HIS/RIS:
If your facility has purchased the optional Procedure Mapping feature, you can
complete the View selection process as follows:
1. From the Main Menu, select New Patient.
2. Manually enter the patient data and complete all of the highlighted required
fields.
3. Select Procedure Name.
Steps 3-6 are not required if you know the procedure code. Enter the
procedure Code in the Procedure Code field and select Enter. The system
automatically enters the procedure name in the Procedure Name field and
the associated Views automatically appear.
4. Select a region from the Primary Category Tab.
5. Select a body part from the Secondary Category Tab.
11
6. Select a Procedure.
The views for the procedure appear on the Patient Input Screen
automatically.
7. Enter information on the More Information and More Image Data Tabs if
needed.
See also:
Using the More Image Data Tab
Using the More Information Tab
12
Setting Up Views for a Procedure

There are three ways to quickly enter procedure information on the Patient
Input Screen:
Using the Add View Workflow
1. Manually enter required information in highlighted fields with the virtual
keyboard, or use the bar-code scanner. Required fields must be completed
before you proceed with the exam.
2. Enter optional information if available. Optional fields are not highlighted and do
not have to be filled in order to complete the exam. The Key Operator
determines which fields are considered optional.
3. Select the Procedure Name field if this field is not populated from the RIS. After
selecting the field, use the keyboard tab to manually name the procedure. The
procedure then appears on the Work list.
4. Select Add View.
5. Select a region from the Primary Category.
6. Select a body part from the Secondary Category.
7. Select all of the views in the study, and then select Save Changes.
8. Enter information on the More Information and More Image Data tabs if
needed.
Data fields may be configured to accept a certain number of characters,
character types, or a sequence of characters. Some data fields have menu
selections so the data is set for you. See Entering Patient Information.
Using the Procedure Mapping Workflow

If your facility has purchased the Procedure Mapping feature, you can automate
the view selection process as follows:
1. From the Main Menu, select New Patient.
2. Manually enter the patient data in the highlighted required fields.
3. Select Procedure Name.
The views for the procedure appear on the Patient Input Screen automatically.
Using the Procedure Code Workflow
13
If your facility has a HIS/RIS with the Procedure Mapping feature, the Key
Operator can associate hospital codes that represent procedures with the data
entry on the CR System.
When the patient information is selected from the Patient List, the codes are
included in the list. The Views for that procedure appear automatically on the
Patient Input Screen.
2. Search for the patient using the Patient Query Screen. You can type in the first
letter of the name to view the list.
3. Select the patient from the Patient List.
The patient information and the Views for the procedure automatically appear on
the Patient Input Screen.
See also:
Defining a View
Adding a View
Deleting a View
Changing the View Name
14
Setting Up Views for My Procedure

The following workflows let you enter procedure information quickly on the
Patient Input Screen:
Using the Add View Workflow
1. Manually enter required information in highlighted fields with the virtual
keyboard, or use the bar-code scanner. Required fields must be completed
before you proceed with the exam.
2. Enter optional information, if available. Optional fields are not highlighted and
do not have to be filled in order to complete the exam. The Key Operator
determines which fields are considered optional.
3. Select the Procedure Name field if this field is not populated from the RIS. After
selecting the field, use the keyboard tab to manually name the procedure. The
procedure then appears on the Work List.
4. Select Add View.
5. Select a region from the Primary Category; select a body part from the
Secondary Category.
6. Select all of the views in the study.
7. Enter information on the More Information and More Image Data tabs if
needed.
Using the Procedure Name Workflow
If your facility has the optional Procedure Mapping feature, you can automate
the View selection process as follows:
1. Select the Procedure Name field from the Patient Input Screen.
The views for the procedure appear on the Patient Input Screen automatically.
Using the Automated Procedure Code Mapping

Workflow
If your facility has a HIS/RIS with the optional Procedure Mapping feature, the
Key Operator can associate hospital codes that represent procedures with the
data entry on the CR or DR System.
When the patient information is selected from the Patient List, the codes are
included in the list. The Views for that procedure appear automatically on the
Patient Input Screen.
15

2. Search for the patient using the Patient Query Screen. You can type in the first
letter of the name to view the list.
3. Select the patient from the Patient List.
The patient information and the Views for the procedure automatically appear on
the Patient Input Screen.
See also:
Defining a View
Deleting a View
16
Accepting the Image

Select the Accept Image button or the Accept All button when the image is
suitable to be sent to a destination.
Make sure that:
 The patient was still and there is no motion visible in the image.
 You can see the Region of Interest clearly.
 The image is properly oriented for viewing and printing.
 Markers and annotations are properly located.
Accepting the image sends the image to the printer or PACS workstation
configured by the Key Operator.
See also:
Adjusting Image Parameters
Correcting Image Artifacts
Adjusting Image Quality Controls
Flagging an Image
17
Correcting Image Artifacts

How do I prevent black or white lines from recurring in my image?
 Make sure that the phosphor screens and cassettes are clean. Always follow the
manufacturer's instructions when cleaning screens and cassettes.
 Make sure that the CR room and CR System are kept clean and free of dust.
If the lines do not disappear after cleaning, call Service.
What do I do if the cassette stickers appear in the image?
Verify that stickers are on the reverse side of the cassette and that the cassette
is exposed tube-side up.
What do I do if the phosphor screen is damaged?
Replace the phosphor screen.
18
Reviewing Images
Once an image is acquired, you may want to review it in detail and possibly
make changes before accepting it. Changes to images are made on the Image
Viewer Screen.
To review an acquired image:
1. Select the thumbnail image you would like to review from the Patient Input
Screen.
or
From the Main Menu, select Image Review.
The Image List Screen opens.
2. Select the thumbnail image you would like to review.
The Image Viewer Screen opens.
3. In the Image Viewer Screen, select from the palettes of Image Adjustment,
Masking, Markers, Printing, Orientation, Magnification, Look Adjustment,
Crop Box Adjustment, Magnification, and Measurement Tools.
There are Help screens for each of the palettes to explain the Image Viewer
functions. On the Image Viewer Help Screen, select the icon of the function
you wish to use to see information for that function.
See also:
Using the Image Viewer Screen
19
Modifying a Delivered Image

Modifying a delivered image means that you want to change the image
processing, add a marker, or otherwise change the image that has been
accepted and delivered to destinations such as a printer or a PACS workstation.
In order to modify a delivered image, you must first create a copy of the image
and then modify the copy. A delivered image cannot be altered any other way.
1. Search for a delivered image on the Patient Input Screen or Image List
Screen.
2. Select the image.
The Image Viewer Screen appears.
3. Select the Create Copy of Image button.
4. Modify the copy using the tools on the Image Viewer Screen.
5. Select Save & Accept Image.
See also:
Image List Screen
Reprocessing an Image
20
Flagging an Image for Review

If an image requires additional review, you can mark it and save it to a database
for review later.
From the Image Viewer Screen, do the following:
1. Select the Quick Menu in the lower left corner of the screen.
2. Select Flag for Review.
The image is saved for review by the Key Operator or by Service. The Key
Operator views flagged images on the Flagged Image Screen.
See also:
Harvesting Flagged Images
21
Low Contrast Images due to IPL Parameters

Failure
If you see the message IPL Parameters failed, the system displays an
unprocessed image. It may look too dark or too light, and is unusually low in
contrast. You can adjust the image using the Window/Level tools.
Before making adjustments, make sure that the correct View has been selected.
An incorrect View could cause an Image Processing failure. If the View is
correct, proceed with the adjustments.
1. Select Window/Level Mode on the Image Viewer Screen Image Adjustment
Tab.
 Raise the Window slider control to decrease contrast.
 Lower the Window slider control to increase the contrast.
 Raise the Level slider control to increase the brightness.
 Lower the Level slider control to decrease brightness.
2. Select Save Changes and Save & Accept Image when adjustments are
complete.
This correction does not require reprocessing.
See also:
How to Use Window and Level
Image Processing Failure
Brightness, Latitude, and Detail Contrast Definitions
22
Rejecting an Image
If you do not want to accept an image:
1. Select the Reject Image button.
If the system has the optional Administrative Analysis and Reporting
feature installed, you must select a reason for rejection such as Motion or
Clipped Anatomy.
2. Select the reason for rejecting the image.
If you select Other as a Reject reason, you must enter a Reject comment.
The Key Operator determines how the system retains rejected images for further
review.
See also:
Accepting the Image
Remote Workstation Options
23
Quick Reference Button Guide

Select each button name for a description of its function.
In the Modality, a gray button indicates that the function is not active or
available at that time.
Back Cancel Main Menu
Add View Delete View Save Changes
Accept Image Reject Image Re-Deliver Image
Find Study Find Study Clear Fields

Locally Remotely
Reprocess Assign Image Unassign Image
Logon Logout Quick Menu
24
Shutdown Flag for Marker

Review
Images Images Not Select Destination

Failed to Assigned
Deliver
Destination Change Print

Status Destination
Profile
Add Multi- Delete Multi- Change Multi-

format Print format Print format
Configuration
Multi-format Trauma Discontinue/Cancel
Next Page Previous Page New Patient
New Study Begin Study End Study
25
Accept All
Continue
Without
Saving
26
Entering and Deleting Data

Using the Patient Input Screen
The Patient Input Screen has many functions:
Tutor Image icons display when a View or a procedure is requested. Prior

images and/or companion images are indicated as icons inset into the image.
scanned cassette is associated with a patient name. You can:
 Enter Patient information
 Perform Workflows
 Display a patient study
 Edit Patient information with the Editing Button
 Review a selected image in the Image Viewer Screen
 Accept an image and send it to destinations such as workstations or printers
To scan an image on the Patient Input Screen:

1. Create a study or select a View.
The View icon is highlighted.
2. Scan the cassette. The progress of the scan is displayed in the thumbnail
border.
3. The next unavailable View icon is automatically selected. If another View icon
does not exist, the user may create another icon.
Select a blue link from the list below for information about the Patient
Input Screen.
Beginning a Patient Exam
Completing an Exam Set-up
Ending a Study
Automated Procedure Code Mapping
Displaying Image Icons
Deleting Information
Resolving a Cassette ID Error
Using the More Image Data Tab
27
Using the More Information Tab
See also:
Auto-Associating Information
Creating an Additional Study
28
More Image Data

The More Image Data Tab on the Patient Input Screen contains additional
data elements that show how the image was acquired. The Key Operator can
change the layout of this screen in Key Operator Functions > Layout
Configuration > Patient Input
You can change the patient, exam, and image data at any time up until the
image is delivered.
Use the keyboard to enter the following information, if available:
kVp Refers to peak kilo-volts used in the X-ray exposure
mAs Milliampere seconds, derived by multiplying the
milliampere by time. Controls the quantity of x-radiation
produced during an exposure.
Source to Image Distance Enter the distance from the X-ray source to the center
(SID) of the detector or cassette. This exposure information is
needed for Long-Length Imaging and DR Systems.
Source to Patient Distance Enter the distance from the X-ray source to the patient.
Image Comments Enter comments concerning the image, such as
"inspiration" or "10 minute image".
Patient Position Enter the patient location.
The new feature is to let you edit image data after the image has been scanned
and processed.
To edit a processed image:
1. Select Edit Image Data.
After scanning the image(s), the Patient Input Screen appears.
2. Select Edit Image Data.
The button changes to Edit Is On.
3. Select a thumbnail image and then select any of the input tabs on the Patient
Input Screen
You will be in edit mode and can add or change selected fields of
information.
To end the edit mode:

Select the Edit Image Data a second time.
29
See also:
Layout Configuration
Determining the Exposure Index
30
More Information Tab

The More Information tab on the Patient Input Screen contains additional
patient information.
Use the keyboard to enter the following information, if available:
Referring Physician Primary physician who referred patient.
Patient Comments Comments the patient makes concerning his or her exam.
Procedure Step The procedure step used in this study.
Description
Requested Procedure A code the RIS provides to identify a study.
ID
Requested Procedure The name the RIS provides to identify a study.
Description
See also:
31
On the Classic/Elite CR Systems and CR 825/850 Systems, the Key Operator
can configure the machine to automatically associate the Cassette Identity to a
View icon, which eliminates the need to use an external bar-code scanner for
this purpose. The Modality must be operating independently from a Remote
Operations Panel (ROP). If a ROP is defined as an external device to one of the
Modalities, the Auto-Associate button will not be enabled. Conversely, when
Auto-Associate is enabled and a ROP is added, the Auto-Associate button will
be disabled. To turn ON the Auto-Associate feature, go to Key Operator
Functions > System Configuration > Next Page > Scanner Options > and
check the Auto-Associate Enabled check box.
To initiate Auto-Associate from the Patient Input Screen:
1. Select a View.
For an image to be auto-associated with a View, the desired View must be
selected (highlighted)and displayed on the Patient Input Screen at the time
of scanning until the bar-code appears in the View icon.
2. Insert the cassette.
When the cassette is scanned, the image is automatically associated with
the View icon that was selected (highlighted) when the scan began. The
system automatically highlights the next View after the cassette scanning
process has started.
3. Insert the next cassette.
4. Repeat until each View is scanned.
Each cassette will be associated automatically with the View that was
selected when the cassette was inserted.
Make sure that the View you want to scan is selected (highlighted) before
inserting the cassette. If you do not select a View prior to inserting the cassette,
an Unassigned Image will result.
If a cassette is bar-coded accidentally, the information will not be used by the
system if the Auto-Associate feature is enabled. The image file that is sent to
other devices will contain the cassette ID of the cassette that was scanned, not
the cassette ID that was accidentally read using the bar code scanner.
See also:
Scanning on a Classic/Elite CR System
Scanning on a CR 825/850 System
Assigning an Image
32
Creating an Additional Study

Select the New Study button to create an additional study for the patient
currently displayed on the Patient Input Screen.
 The patient information is copied from the current study.
 The Accession Number, Procedure Code, and Patient Location fields,
among others, are left blank.
 Both old and new studies appear in the study list on the right side of the Patient
Input Screen.
See also:
New Study Button
Defining a View
How to End a Study
33
Modifying Information
You can modify the patient, exam, and image data at any time up until the image
is delivered.
To modify information from the Patient Input Screen:
1. Select a field.
2. Select Backspace.
3. Enter the correct information from the keyboard.
To modify information from the Patient Query Screen:
1. Select a field.
2. Select Backspace.
or
Select the Clear All Fields button on the bottom of the screen to delete
information in all the fields.
All fields that have pre-defined values will be reset to the default value when
you select the Clear All Fields button.
See also:
34
Displaying the Procedures List

Both the Procedure Code field and the Procedure Name field contain the 3-
tabbed Procedure Keyboards and the alphabetical keyboard. The Procedure
Name field displays the Procedure Keyboard first.
 To display the Procedure List quickly, select the Procedure Name field.
See also:
35
Find Study Remotely Button

 Immediately sends the query criteria to the HIS/RIS.
 Returns a list of studies that match those criteria to the Work List from the
HIS/RIS and the local Modality database.
 A countdown appears on the screen. If the search takes more than 30 seconds,
the time for the query expires.
 To cancel the query, select any navigational button on the screen as the
countdown progresses.
 You must select filters in order to query from Find Study Remotely.
 An open query with no filters returns too many records and causes system
problems.
See also:
Improving Search Results
Using the Patient Work List Screen
36
Displaying Other Studies for a Patient

If a patient has other studies stored on the system, they are displayed as large
rectangular icons in the lower right quadrant of the Patient Input Screen. Use
the Up and Down arrows, if necessary, to display the full listing. Selecting an
icon enters that study information into the Patient Input Screen.
To display more than 10 images for a patient:
 Use the Up and Down arrows located to the right of the image thumbnails to
scroll the display of image icons when necessary.
The current page number and total number of pages are displayed on the
scroll bar.
See also:
37

Image icons on the Patient Input Screen may be displayed as gold tutor
images, skeletal drawings, or in CR Systems, as cassette icons. The display
configuration depends on the configuration chosen by the Key Operator.
Tutor image CR Cassette non-tube side CR Cassette image back,
(back) tube side (front)
 The CR Cassette non-tube side (back) is displayed when a View is automatically

flipped (such as Chest-PA-Erect).
 The CR Cassette tube side (front) is displayed when a view is not automatically
flipped (such as Chest-AP-Erect).
38
How to End a Study

When all of the images have been acquired and accepted, you should end the
study.
 Select the End Study button on the Patient Input Screen.
If your system is using Modality Performed Procedure Step (MPPS) for
Scheduled Workflow, selecting the End Study button sends a message to the
HIS/RIS Modality Performed Procedure Step Manager that the procedure has
ended, and changes the status of the exam in the Modality.
See also:
39
Entering Temporary Trauma Patient Data for

Performing a Trauma Exam
The Trauma button displays the pre-configured trauma patients that have been
set up by the Key Operator. If your system is configured for the optional Trauma
feature, the required fields on the Patient Input Screen populate quickly in
emergency situations.
To perform a Trauma exam:
1. Select Study Data.
2. Select Trauma from the Patient Query Screen.
3. Select an exam from the Trauma Tab.
The default patient information and the selected exam information fills in
automatically on the Patient Input Screen.
Enter the actual patient information when it becomes available on the Patient
Input Screen. If the image is delivered, you must unassign the image from the
Trauma ID and assign the image to the correct patient information.
See also:
Assigning an Image
Assigning an Image to a Different Patient
40
Entering Additional Exam Information

Additional exam information is information that the Key Operator has decided
not to require in order to proceed with the patient's exam. You can complete the
patient's record with this information omitted.
The fields are configurable by the Key Operator, depending on the need and on
the layout selected by the facility. Enter optional information from the three
tabbed palettes as shown below on the Patient Input Screen. The chart offers
guidance for each category.
Exam Information
Patient Last Name Required
Patient First Name Optional
Patient ID Required
Gender Male, Female, other
Date of Birth Patient's date of birth
Patient Location Room
Department Name Select from user-defined list or enter from keyboard
Referring Physician Select from user-defined list or enter from keyboard
Priority Low, routine, urgent, STAT
Study Date Entered automatically
Procedure Name Select from tabbed palette, Thorax, Contrast Studies, Spine,
Upper Extremity, Cranium, Abdomen, etc.
Procedure Code Enter from keyboard
Accession Number Enter from keyboard or bar-code
Tech ID Read bar-code ID, select from user-defined list or enter from
keyboard
More Information
Patient Comments Enter from keyboard
Contrast Agent Enter from keyboard
Modality Enter from keyboard
41
Procedure Step Enter from keyboard

Description
Requested Procedure Enter from keyboard
Description
Procedure ID Enter from keyboard
More Image Data

Body Part Enter from keyboard
View Position Enter from keyboard
Patient Position Enter from keyboard
Laterality Enter from keyboard
Image Comments Enter from keyboard
See also:
List Configuration
42
Resolving Cassette ID Errors

If you see the error Cassette ID Bar-code Read Failed, it means that the
internal bar-code scanner cannot read the cassette bar-code label. The cause is
most often a degraded bar-code label, not an issue with the equipment.
 Select cancel from the dialog box to eject the cassette and try to reinsert the
cassette.
or
Select the cassette type/size from the dialog box.
 Contact Service to repair the bar-code label.
If a duplicate Cassette ID is entered:

You will receive a warning message and must choose one of the following:
 Select Cancel New Image Information to use a different cassette for the exam.
 Select Cancel Old Image Information to remove the cassette ID from the
unacquired image in the previous study.
If the Cassette ID field turns red:
 The field turns red if the cassette ID is invalid. A valid cassette ID is a 10 digit
number that begins with the number 9.
See also:
43
Finding Patients
What if no work list is returned?
Searching for an existing patient
Using the Patient Work list Screen
Entering Trauma patient information
Improving search results
Find Study Remotely button
Back button
Main Menu button
44
Searching Techniques
Using the Patient Query/Work List Screen
The Patient Query function has been combined with the Patient work List screen
and will be referred to as the Patient Work List screen from this point forward. It
appears by default when Study Data is selected from the Main Menu. It
provides the list of studies from the combined local and remote databases if
configured to do so.
To find a study quickly:
1. Set up a query from one of the filters at the top of the Work List, such as
Patient Name, Patient ID, Accession Number, Study Status, Time Window, and
so forth. The information will list the studies in ascending or descending order by
selecting the filter again.
2. Select a study from the Work List.
The Patient Input Screen opens with that patient and study data.
Users can find patients by sorting the list, selecting filters to use, located across
the top of the screen. The layout of the filter fields, and the fields with the first
focus are configured by the Key Operator in Key Operator Functions>System
Configuration>Layout Configuration>Patient Worklist Tab.
All of the text boxes on the Work List screen are user input fields. When
selected, the virtual keyboard appears so that the information can be entered
manually if it does not appear automatically.
 Patient Last Name text box
 Patient First Name text box
 Patient ID text box
 Accession Number text box
 Study Status menu selection
 Time Window menu selection
In addition to the status colors, status icons are displayed in the Status
column:
None
New exam
Working
Complete
45
Recent Exam
The Key Operator configures the layout of the Work List screen from Key
Operator Functions>System Configuration>Layout Configuration>Work
List tab. If the Add Patient Location and Recent Exam Filter layout is
chosen this icon appears in the top right corner of the screen to indicate the
number of patients that have been added since the last login.
The studies are listed on the Work List screen according to the filters from the
query. You can resort the list by selecting a different filter.
See also:
Display Configuration
46

Use the Patient Query Screen to locate studies. Enter search criteria to return
a list of all studies that meet those criteria.
For example: Enter the search criteria Today to return a list of all studies
entered in the system today to the Patient Work List Screen.
To perform a search:
1. If you do not enter any criteria, there is no filter and a list of all patients in the
system will be returned. Returning large volumes of data can cause system
slowdowns. For best results, select a narrow time window filter of Yesterday—
Tomorrow.
2. Select Find Study Remotely to search the CR or DR database, and to query
the HIS/RIS immediately.
If no records match the criteria:
1. Check the criteria carefully for errors in spelling, accurate time window, correct
patient ID, etc.
2. Select the Find Study Remotely button to query the HIS/RIS. Newly entered
records from the HIS/RIS may take a few minutes before they can be polled by
the modality.
Select the New Patient button as a last resort to manually enter the patient
information.
3. Select the New Patient button, which will take you to the Patient Input Screen
to enter the information.
If emergency patient information is not available or emergency circumstances do
not allow the time to enter data, immediately proceed to using the Trauma
function.
How do I search for a patient?
1. On the Patient Query Screen, enter the information for the patient you wish to
find in the appropriate field. This is the search criteria. The more specific the
data, the more likely you are to retrieve the specific patient record you seek.
2. Select CR, DX, RT or ALL from the modality field. If you select ALL, patient
records for all modalities are returned.
3. Select a time range:
 Today
 Yesterday to Tomorrow
 Past Week to Tomorrow
 Unrestricted
The Unrestricted option means that time is not used as a selection criteria
when searching for a patient.
47
If more than one record matches information used in the query, the system
presents a work list of all matching records.
4. After entering the search criteria, select the Find Study Locally or Find Study
Remotely button if you want to retrieve the record from the HIS/RIS. Using the
Find Study Locally will only search the System's database.
Large returns of records can cause system slowdowns. For best results, narrow
the search by selecting a narrow time window such as Yesterday to Tomorrow.
How do I search for a patient whose study is

completed?
1. Enter the search criteria for Study Status Completed.
2. Select the Find Study Locally button.
This function returns a list of patients that match the search criteria. If only a
single record is found, that record appears on the Patient Input Screen.
or
Enter the search criteria for a normal search.
3. Select Find Locally button.
Why don't I see a Work List when I select Find Study

Remotely?
Select a different search criteria.
If the Find Study Remotely function does not return a Work List that includes
the individual patient you are searching for, it is usually because the search
criteria is incorrect or too limiting.
 Review the criteria or make it less restrictive and select Find Study Remotely
again.
The Find Study Remotely operation may "time out" if the Work List provider
is not functioning properly. The Work List providing device is part of your
site’s HIS/RIS and is normally supported by the IT group.
Contact the IT group for assistance if this problem occurs repeatedly.
See also:
Identifying Work List Colors
Using the Patient List Screen
Searching for an Existing Patient
Using the Find Study Remotely Button
48
Finding an Image
49
Using Study Status to Search for an Existing

Patient
What are the search criteria?
The Study Status field
Lets you select from the following study states:
 Scheduled
 Arrived
 Started
 Scheduled/Arrived/Started
 Scheduled/Arrived
 Completed
 Failed Update
 Cancelled
 All
The Time field

 Today
 Today to Tomorrow
 Yesterday to Tomorrow
 Past Week to Tomorrow
 Unrestricted
The Unrestricted option

Unrestricted means that time will not be used as a selection criterion when
searching for a patient.
The Modality field

 CR
 DX
 RT
 ALL
If you select ALL, patient records for all Modalities are returned.
50
The Failed Update status

Failed Update Status lets you find patient records whose status has not been
forwarded to the PACS system due to equipment or network problems. Use this
feature if the Scheduled Workflow option is installed on the System.
See also:
Finding an Image
51
Finding an Image
There are at least two options for finding an image you cannot locate quickly.
Both options begin at the Main Menu.
1. At the Main Menu, select Study Data.
2. Select the study from the Patient Work List.
or
At the Main Menu, select Image Review.
3. At the Image List screen, filter the database for the patient's image.
4. Select a status (All, Unassigned, Delivered, and so forth).
See also:
52
Identifying Work List Colors

The Work List is colorful in order to save you time as you view the list searching
for patients. For example, you can quickly assess the Arrived patients because
they will all appear in green. The standard colors have the following meanings.
Scheduled
Started
Arrived
Failed Update
Complete
All colors are subject to change by the Key Operator.
See also:
Finding an Image
53
Using the Image List Screen

The Image List screen allows you to locate images quickly by applying filters to
sort the images on the local database.
How to search with the Image List Screen:
1. Enter patient information at the top of the screen by bar coding or enter
manually using the keyboard.
2. Search the resulting list by patient data such as Patient's Name, Patient ID,
Accession Number, Tech ID, or Acquisition Date. These filters are located
across the top of the list window.
3. Select a filter to search by image status:
 All Studies
This filter generates links to all non-delivered studies with the criteria you
entered, such as Patient Name, Patient ID, Accession Number, Tech ID, or
Acquisition Date.
 Need Approval
This filter generates links to all images that have not been accepted.
 Unassigned Images
This filter generates links to all images that do not have a patient assigned to
them. This filter is linked to the Images Not Assigned button that appears on
the Main Menu.
 Failed Delivery
This filter generates links to all images that have been accepted and sent to
destinations, but failed. You can access this group from a button on the
Main Menu Screen at any time.
 Pending Delivery
This filter generates links to all studies that have been accepted and sent but
the CR/DR has not heard back from the destination-delivery is in progress.
 Need Destination
This filter generates links to all studies that have been accepted but not
assigned a destination.
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 Delivered Images
All images that have been delivered to printers and workstations. A delivered
image cannot be changed or reprocessed unless a copy of the image is
made.
See also:
Finding an Image
55
Views
Defining a View
A View is a pre-set image type that a radiographer can select to represent an
exam. It consists of position, projection, and image processing preferences. It is
the basic element in the CR or DR image chain.
Views are associated with procedures on the Patient Input Screen with the
optional Procedure Mapping.
When the Key Operator creates a view, it appears on the Patient Input Screen.
See also:
Adding a View
Deleting a View
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Adding a View
You can choose from three procedure workflows to add Views to a study. You
can add as many Views as you like.
Setting Up Views for Procedures
In most instances, the View selection is complete once the procedure is
selected.
To add additional Views to the procedure:

1. Select Add View.
2. Select the Primary Category.
3. Select the Secondary Category.
4. Select all of the desired Views for the study.
An image of a cassette represents the image until it is scanned. Some facilities
use a "tutor" image representing the View to provide a reference for the
radiographer. When you scan an image, the reference image changes to a
thumbnail of the actual image.
See also:
Defining a View
Add View Button
Deleting a View
Setting Up Views for Procedures
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Deleting a View
1. Select the tutor image.
A yellow highlight appears around the icon to indicate this image has been
selected.
2. Select the Delete View button on the bottom of the screen.
An image that has been acquired cannot be deleted from the Patient Input
Screen.
See also:
Defining a View
Adding a View
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Before image acquisition, you can change the view name on the Patient Input
Screen.
1. Select the image with the View Name to change.
2. Select the View Name field.
3. Select a View from a different category by selecting the primary or secondary
keyboard tabs on the View keyboard.
After the image is acquired, you can change the View Name on the Image
Viewer Screen.
1. At the Image Viewer Screen, select the Image Processing Options Editor
tab .
2. Select the View Name field.
5. Select a View.
Categories
Primary Category Select an anatomical
region.
Secondary Select a body part.
Category
Views Select a view.
While the image has a new View Name, it retains the image processing of the
former View Name. Select Reprocess to process the image with the new name.
Reprocess the View Name if it is an incorrect match for the image. Do not
reprocess if the image processing is satisfactory.
When you select a view, the Brightness, Latitude, and Detail Contrast
settings are determined automatically and applied for you if reprocessing
an existing image.
See also:
Defining a View
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Reprocessing the Image
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Patient CD
Study Data
Patient CD (optional)
Patient CD is an optional feature that lets you easily create a CD (or DVD) of a
single patient study, or all studies for a single patient. The images recorded on
the CD are in both a DICOM DIR format and JPEG (.jpg) format. The Patient CD
lets you transport images easily and allows viewing by anyone having a
computer with a DICOM Viewer.
You can compose a Patient CD on a Console or a Remote Operations Panel,
but the media is actually created at the Console containing the CD writer. Only
CR Systems having this optional feature will display the Patient CD Queue
Screen or the Write Patient CD menu option in the Quick Menu.
Creating a Patient CD does not interfere with normal CR System operations.
There is no effect on the Graphic User Interface (GUI) and the time it takes to
move from screen to screen.
How to delete a Patient CD job:
1. From the Patient CD Jobs Screen, select the job you would like to delete.
2. Select Remove from List.
You can view images on a personal computer using DICOM Viewer software
(available free at http://medical.nema.org/).
To create a Patient CD:

1. Select a blank, non-formatted CD or DVD. Images cannot be appended to other
sessions.
2. On the Patient Input Screen, create a patient record and acquire images.
3. Select the Quick Menu.
4. Select Write Patient CD.
5. If multiple studies were created, a pop-up message asks you to select one of
the following:
 Write all images in this study to CD; Only save images for the opened
study.
 Write all images from all studies to CD; Save images for all studies for this
patient.
6. Select OK.
The CD request is added to the Patient CD Jobs queue.
7. Either select the Disc icon at the top of the page or select the Quick Menu >
Patient CD Jobs List to enter the Patient CD Jobs Menu (also located in
Main Menu > Utilities > Patient CD Jobs).
8. The PatientCD Jobs Screen appears.
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9. If multiple CD jobs exist, select the desired row from the list and select Write To
CD.
The status for th3e selected job changes from Ready > Burn CD > Burning
CD > Done.
10. Select the Back button to return to the Utilities Menu.
To return to the Patient Input Screen, use the Quick Menu to select the
Patient Record.
Writing images to the Patient CD does not change the delivery status of any
image.
When you are performing a Backup and Restore function, make sure that the
user at the ROP does not initiate a Patient CD.
To automatically create a Patient CD:

1. Select Key Operator Function > System Configuration > Delivery
Preferences > Write Patient CDs Immediately.
2. Select a blank, non-formatted CD or DVD. Images cannot be appended to other
sessions.
3. On the Patient Input Screen, create a patient record and acquire images.
4. Select the Quick Menu.
5. Select Write Patient CD.
If blank media is not loaded, a "Please insert a writable CD" pop-up message
appears.
 Load a blank, non-formatted CD or DVD.
 Select OK.
The Disc icon at the top of the page changes to a burning disc icon.
Writing images to the Patient CD does not change the delivery status of any
image. When you are performing a Backup and Restore function, make sure
that the user at the ROP does not initiate a Patient CD.
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Image Information
63
Recall Prior Images Software

What are Prior Images?
The Prior Image Display feature lets the user temporarily import and view
images and information from patient's exams (recall time frame is configured by
the Key Operator), including technical information such as the technique used.
This enables the user to quickly copy or change the settings before acquiring the
image, using the previous exam as a reference.
This is achieved by requesting the images from the patient’s last exam from the
PACS or locally from the CR or DR system. The images are retrieved and made
available for review. Pertinent data will be extracted from the DICOM header
when it is available.
A new icon is added to the tutor image, indicating the presence of priors
and the number of priors retrieved. Note that if you are in Manual retrieval mode,
this icon may simply indicate that you can click on it to request priors.
The graphic above shows a tutor image with the Priors icon, and a companion
image icon (indicating tube & line or pneumothorax Views), showing that three
prior images have been retrieved.
Prior Image Compatible Systems

 CARESTREAM PACS V10.0 systems
 GE Centricty V3.0 systems
 Agfa Impax V6.5 systems
 Philips iSite V4.1 systems
 McKesson Horizon Medical Imaging V11.6
Types of Images Retrieved

 DX and CR IOD radiographic images
 MG IOD radiographic images
 Grayscale Presentation Information can also be retrieved.
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See also:
Prior Image Retrieval Functions
Using Prior Images
65

When the Prior Image Retrieval feature is enabled, a new icon is added to the
tutor image.
The icon displays one of the following conditions:
Searching—No priors retrieved
This display indicates that the system is actively searching for prior images, but
none have been found yet. The icon is disabled and the animated cursor
indicates that the search is in progress. The icon does not indicate the presence
of priors.
Retrieving—At least one prior retrieved
This display indicates the number of prior images that have been retrieved.
Clicking on this icon opens the Prior Images screen. If additional images are
actively being retrieved, the icon as well as the Prior Images screen will be
updated to reflect the additional images as they are retrieved into the system.
Enabled—for Manual mode
This display indicates that the user can manually request to retrieve priors for
this image,even if the system is in another "fetch" mode.
See Also
Using Prior Images
Prior Image Configuration
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Using Prior Images

Prior retrieval data are used before the image is acquired.
1. Retrieve the prior images. The image(s) will appear as a window on the
Patient Input screen.
2. Select the Priors icon. The Prior Images screen opens.
1. One button is listed on the right side of the screen for each prior image. Click
the button to load a prior image into the preview panel to the left of this list.
2. View the image.
3. Determine whether to use the same techniques that were used to create this
image, or whether to change the technique to improve on these results when
the image is acquired.
Controls:
Rotate the prior image 90 degrees clockwise
Rotate the prior image 90 degrees counter clockwise
Flip the prior image horizontally
Flip the prior image vertically
Copy the technique for the prior image to the Acquisition screen if
desired. (DR only).
On-screen information
 View name
 Date image was taken
 Technique information
 Exposure Index
 Manufacturer's name
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 Manufacturer's model name

The search for prior images must meet certain criteria. For example, the system
will search for the number of images and time limit the Key Operator has
configured as a default, such as two images processed in the past two weeks.
Prior image Views may be configured for certain body parts only. The search for
Priors can be narrowed by Department name or Modality type.
The retrieval method is configured by the Key Operator. One of three retrieval
methods may be configured for your system:
Manually retrieve prior images
 In manual retrieval mode, the software begins to search for Prior images when
the Prior Images icon in the thumbnail is selected. The software searches for the
prior images for that body part when the user selects the icon.
Automatically retrieve prior images when the study is opened
 When this button is selected, the software will automatically search for priors for
the indicated body parts when a study is selected from the Work List.
 Automatically retrieve when the study is added to the work list or view is
created.
 When this third mode is selected, the Retrieve priors for work list items
matching the following criteria checkbox will be enabled. It is not available in
any other fetch mode.
See Also:

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Creating a Companion Image Automatically

Navigate to Key Operator Functions>System Configuration>Display
Configuration > Image Viewer tab.
Select from the following:

Automatically create all companion views on image acquisition radio button
Create companion views when requested by the Tech on the Image Viewer
radio button.
You can choose to have the Companion Image automatically display after the
image is acquired, or create it manually by selecting the button from the Image
Viewer screen.
A companion image is an image that provides the user with a View that is
optimized for certain conditions, such as the tube and picc line procedure, or
pneumothorax diagnosis. Companion images are primarily created for chest and
abdomen Views.
The companion image appears to the user first as an icon on the thumbnail of
the tutor image on the Patient Input screen.

The icon lets the user know that an additional image is available that displays
the optimized processing. The companion image can be used exactly the same
as the standard image for viewing, processing, and delivery.
Using the View Configuration>Linked Views radio button,the Key Operator

enables the companion View by selecting the Views that will have an associated
companion image .
To configure the system to display companion images:

1. Make sure the option is enabled.
2. Navigate to the Key Operator Functions>System Configuration>View
Configuration>View Configuration Details>Linked Views tab.
3. Select the companion View(s) you would like to associate as a companion
image.
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Tube and Picc Line
Pneumothorax
See also:
Creating a Companion Image Manually
70

On the Image Viewer screen and the Express Viewer screen, the option to
toggle between standard, Pneumothorax, and Tube and Picc Line views lets you
apply optimized image processing for those Views, save, and deliver them.
See the Express Viewer screen for details about pneumothorax and Tube and
Picc Line Views.
See also:
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Tube & Line Visualization Software

Tube & Line Visualization Software
This is a feature that uses image processing parameters to increase the contrast
of the image and make it easier to detect the end points of Tube or Picc lines.
When Tube or Picc line detection is requested, a second, or Companion Image
is created. You can verify the position of the tube or picc line with this image.
You can deliver this new image to a PACS workstation or film along with the
standard processed image (any standard X-ray).
You can configure a View to create a Companion Image automatically at image
acquisition time, or request the Companion Image manually for selected Views.
See Also:
Using the Tube & Line Software Option
Troubleshooting the Tube & Line Visualization Software
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Using the Tube & Line Software Option

How can I tell if the Tube & Line View should be selected?
Determine that the study was ordered to verify the placement of a tube or picc
line:
 One-view Chest AP (possibly portable) study
 Study ordered individually
 Ordered as a STAT exam. Breathing tube placement X-rays should be done
within 5 minutes of tube placement
 New patient or that the tube/line is new for this patient
 Physician that placed the tube/line is still with the patient.
 Difficult to see the tip of the tube/line when looking at the Standard processed
image on the Image Viewer
1. Select the icon on the Image Viewer.

 A message "Creating..." appears as the image is processed. All buttons except
the Main Menu and Back are disabled.
 A high-contrast version of the image appears.
 If you apply markers, masking, measurement tool settings, etc. to the original
image, those changes will also be applied to the Companion Image. Any
changes to the Companion Image are also applied to the Standard Processed
Image.
 Changes to image processing, Window/Level sliders or the Noise
Suppression check box affect the displayed image only.
 Any reprocessing changes for one image will not cause a reprocessing of its
companion image.
 Select Accept Image.
 The standard processed Image and the Companion Image are delivered to the
selected destinations.
 The thumbnails for the Standard processed image and the Companion Image
can be viewed on the Patient Input Screen.
See also:
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Troubleshooting the Tube & Line Visualization

Software
Scenario Action
 Virtual Keyboard does not appear Enable Tube & Line Visualization Software.
 Companion View does not change
 Radio buttons on Acquisition mode are
disabled
 Companion View is unchanged Caused by selecting Close button on virtual
keyboard.
 "Turn off" the Companion Image created Select Clear to eliminate a Companion
for a given view–but create it for other Image.
views
 Do not create Companion Images Select Create the view when requested
automatically by the Tech on the Image Viewer. The
Companion Image will only be created on
request. This is the default value.
 Companion Image Button not selectable Change the view to one that supports a
Tube/Line View, then reprocess the image.
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Pneumothorax Visualization Software

Pneumothorax is the presence of air between the two layered membrane that
separates the lungs from the chest wall. This condition generally causes the
lung to collapse. A chest X-ray confirms the diagnosis.
Pneumothorax imaging optimizes the image processing of a chest image so that
it is easier to detect a pneumothorax.
DIRECTVIEW software provides an option to automatically create a companion
image.
1. Select the button on the Image Viewer screen.

 An hourglass and the message "Creating..." appears as the image is processed.
All buttons except the Main Menu and Back are disabled.
 A high-contrast version of the image appears.
 If you apply markers, masking, measurement tool settings, and so forth, to the
original image, those changes will also be applied to the companion image.
 Changes to image processing, Window/Level sliders or the Noise
Suppression check box affect the displayed image only.
 Any reprocessing changes for one image will not cause a reprocessing of its
companion image.
2. Select Accept Image.
3. The standard processed image and the companion image are delivered to
the selected destinations.
 The thumbnails for the standard processed image and the companion image can
be viewed on the Patient Input screen
The pneumothorax View is independent from the “tube and picc line” View, but
behaves the same way. A pneumothorax companion image is created along
with the standard image and is delivered to any destination, such as a multi-
format print, the same as the standard image.
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Printing
What Is Multi-format Printing?
Overview
Multi-Format printing gives you the ability to print up to nine images on one
piece of film. The user can select from the images in a single study or images
from all studies for that patient, combine them into one of many different layouts
on one page, and then print exactly what they see.
On the Multi-format Print Configuration screen, images or tutor images

appear at the right of the screen. The original list of tutor images/thumbnails
contains images from the current study. Selecting the Display All Patient
Images check box will display all images (in all studies) available for that
patient. The scroll bar displays a fraction that indicates the page you are viewing
relative to the total number pages of images that are available, such as one out
of three (1/3).
In addition to the large View panel, there are two tabs:
 The Page Setup tab lets you set the layout of the print.
 The Image Adjustment tab lets you modify each image in the print as desired.
Each image responds independently when image adjustments are applied from
the Image Adjustment tab.
To place an image in a cell on the View panel:
1. Select a format.
One of the cells will be highlighted. The image you select will go into the
highlighted cell. You can touch or click any cell to highlight it.
2. Select the thumbnail of the image you want in that cell.
You can change the location of each image later, if desired.
When you create a multi-format print:

 Image aspect ratio is maintained once a destination is selected.
 Images from any cassette size can be placed together.
 Images are printed crosswise or lengthwise in many different layouts.
 Images are saved and printed with selected image processing parameters,
markers, and orientation.
Multi-format images are only delivered to print destinations.
See also:
Creating Multi-format Prints
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Multi-Format Functions
77
The Multi-Format Print Configuration screen provides the following user
selectable functions:
Add Multi-Format Print button
 Displays 25 multi-format layouts to choose from

 Select one format to use
 Does not retain the previous images–they must be selected again
Delete Multi-Format Print button
 Deletes format
View Panel
 “What You See is What You Get” presentation of images selected for multi-
format printing, displaying the actual layout the user selects.
 Controls all of the display, such as the format, image selection, text box and
location, markers, orientation, image processing, magnification, footer, and so
forth.
Text Overlay radio button
 Displays a text overlay in four corners of the multi-format print
 Configured overlay content, location, and font size (small, medium, and large)
 Contains information from DICOM header associated with that particular
patient’s study
 Not user editable. The radio button chooses between new overlays, traditional
text boxes, or no text. The text is configured separately in Key
Operator>System Configuration>Configurable Text Boxes.
Switch Position button
 Organizes images in the selected format by switching images from one cell to
another.
 Switches the placement of two images when you:
1. Depress the button
2. Select the first image to relocate (highlights green)
3. Select the second image
 The Switch Position function stays active until you select the button again.
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None radio button

 Default position
 No text or overlay displayed on any of the images in the print
Text Box radio button

 Displays an Image Internal text box on individual images in the layout
 Crops the text to the bounding area of the image box
 Select the Edit Location button to change the location and orientation
(horizontal or vertical).
Rotate buttons
 Turns the image clockwise or counterclockwise at 90 degree intervals.

Flip buttons
 When selected, it transposes individual images horizontally or vertically.

Invert button
 Displays the black areas of the image as white and the white areas as black.
Window/level function
 Changes brightness and contrast in an individual image.
 Touch the image and move your finger vertically to change the brightness and
horizontally to change the contrast.
Magnification buttons
 Increase (+) or decrease (-) magnification

Manual Zoom text box
 Manually changes magnification by percentage

 Numeric value input by user
Measurement Scale button
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 Applies a measurement scale to an X and Y axis inside the border of a selected

image on the right and bottom sides of the print.
True Size button
 Displays the image in it's actual size.
 Select an image and then select the True Size button
Scale to Fit button

 Select an image and then select the Scale to Fit button.
 Scales the image to fit to any area.
Justification buttons
 Changes the image of an individual image position to left, center, right. of its cell
 Select the image and then select the appropriate button.
Include Page Footer check box
 Adds a page footer across the bottom of the page
 Requires Key Operator configuration, may contain text and logos
Portrait/Landscape toggle button
 Affects the way the entire multi-format print is printed on the film. It does not
change the orientation of individual sub-images.
Display All Patient Images check box

 Displays all of the images from all of the studies for that patient. Use the adjacent
scroll bar to view them
 Scroll bar indicates the page viewed to total pages, for example, one of two (1/2)
Multi-Format Layouts tab

 Displays a multi-format layout palette from the 25 default layouts.
 Annotating a multi-format print
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Select a point on the image where you want the annotation to appear, and
type your annotation in the free-form text box.
 You can also add an annotation to a multi-format print by adding a text box.
What Is Multi-Format Printing?

Creating Multi-Format Prints
81
Creating Multi-Format Prints

The Multi-Format Print Configuration screen lets the user choose the layout
and modify the images as they will appear on the final film. The result is a
combination of individual images printed on a single piece of film.
1. Acquire the images in the study.
2. Navigate to the Multi-Format Print Configuration screen:
 From the Patient Input screen, select the Change Multi-Format Configuration
button
 From the Image Viewer screen, select the multi-format icon. This Multi-format
icon indicates that the image is currently in a multi-format print.
Otherwise, the button appears as a blue rectangle .

Select the Multi-format icon to access the Multi-Format Configuration screen,
where you can:
 Create a new multi-format print for this study.

 Change an existing multi-format print.
 Print a multi-format print.
3. From the Multi-Format Print Configuration screen, select a format.
4. Select an image from the image list at the right side of the screen.
5. Select the Display All Patient Images button to see all of the images in the
patient's other studies. The border of each selected image changes color as
the image appears in the highlighted cell in the layout.
6. Select the rest of the images to fill in the layout.
7. Select the radio button next to None if you do not want any text boxes or
overlays on the images.
8. Select the radio button next to Text Box to display the default location of the
text boxes for each image.
9. Select the Edit Location button if you want to move or change the
orientation of any text box.
10. Select the Text Overlay check box to display the text overlay. The Key
Operator must configure the overlay to make this function active. The user
cannot change the location of the overlay.
11. Select Include Page Footer check box if desired. The footer will appear
across the bottom of the page, and may contain a company logo in one or
both corners. Page footers are configured by the Key Operator and are not
editable by the user.
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12. Select the Select Destination button to open the Destination Selection
page. This page lists the destination type for each print. You can also print a
page for each individual image by checking the Also print 1-ups for each
image check box.
13. The Key Operator can configure procedures to print in a multi-format
configuration using Procedure Mapping. See Procedure Mapping
Configuration.
To use the Image Adjustment tab:
All of the functions on the Image Adjustment tab are user selectable and apply
to each image independently. For details about each of the following functions,
see Multi-Format Functions.
1. Select an image from the layout.
2. Select from the following:
 Rotate or Flip
 Invert
 Zoom in or out
 True Size or Scale to Fit
 Measurement scale for reference
 Justification (right, left, center)
Add Multi-Format Print if desired.
Delete Multi-Format Print if desired.
Select Destination to deliver the image. Select Print 1-up if you want a
separate print of each image in the layout.
Select Mark all images in the print as delivered if desired.
When images have been acquired, positioned, modified, and oriented, select
Print.
Any quadrants not used will print black.
Multi-format images are only delivered to print destinations.
You can print multi-format images regardless of the printer type and film size.
Reminder—If you want to print the images in a multi-format print as True-size,
you must select the True Size radio button for each individual image before you
create the multi-format print.
See also:
Selecting a Destination
What Is Multi-Format Printing?
83
84
Best Fit to Print

Rotates the image 90 degrees.
Multi-Format Print Layout (Landscape)
Image Orientation on Viewer (Portrait)
Best Fit Shrink to Fit
85
Scale to Fit
On the Multi-Format Print Configuration screen, the Scale to Fit button is
used to fit an image that has been masked with the Black Surround Mask to the
cell in the multi-format print. The image fills the frame according to the mask.
1. Select the masked image in the multi-format.
2. Select the Scale to Fit button.
The image enlarges to fill the frame as though it were not masked.
If no mask was used, there is little difference in the display, because a standard
image fills the frame automatically.
86
Image Review
Creating a True-size Print

True-size produces the same size image you would get if you were using a film-
screen system.
True-size always crops the print slightly. Use the crop box to determine what
part of the image will be printed.
1. At the Image Viewer Screen, select the Crop Box Adjustment Tab .
2. Select the True-size Print radio button.
3. Select the Crop Box Orientation arrows to locate the crop box on the area of
the image to be printed.
5. Select Accept Image to send the image to selected printers and workstations.
True-size printing delivers the image to the destination at 100% +/-2%.
Because variations exist in scanners and printers, use caution when using
these images for exact measurements. Use a known marker at the subject
level when making the exposure and calculating image magnification.
To support True-size printing, a printer must support DICOM Requested
Image Size. See the printer’s DICOM Conformance Statement to determine
if a printer supports Requested Image Size.
See also:
Using the Print Tab
Printing an Image
87
Selecting an Internal or an External Text Box

To select the appropriate Text Box, consider the type of image area that is
displayed. You can make the selection or the Key Operator can select a default
Text Box for any given View.
 Select the Internal Text Box when you want the information to appear within the
image and when you must be able to print to any printer. The Text Box can be
moved to any corner or any inside edge to avoid covering any anatomy.
 Select the External Text Box when you want to position the label outside the
image area. This Text Box shrinks the image and affects True-size printing.
The Key Operator configures a Text Box to automatically fill in with data, such
as Hospital Name, Exposure Index, or View.
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Key Operator Functions > System Configuration > Configurable Text

Boxes
Using a Single Image External Text Box

 The External Text Box positions the information outside the image area;
therefore, it never interferes with anatomy. However, the box takes up space on
the film, and the system crops additional image data compared with printing
without an External Text Box. Thus, an External Text Box affects True-size
printing.
 This text box can be up to 120 characters wide.
 Text boxes appear on the print only. They do not appear when the image is
viewed on a workstation.
See also:
Editing a Text Box
Selecting a Default Multi-format Text Box
Using a Single Image Internal Text Box
Using the Single Image Internal Text Box
Using a Multi-format Page External Text Box
Using a Multi-format Image External Text Box
Using a Multi-format Image Internal Text Box
Configurable Text Box Menu
89

Boxes

 The Internal Text Box displays information about the patient, exam, and image
and is positioned inside the image area on one of the four sides of the image.
 The text box can be up to 160 mm wide. Its content depends on the length of the
data fields and the size of the font.
 You can move the text box to any corner or any inside edge to avoid covering
anatomy.
 You can print an Internal Text Box on any printer. Use an Internal Text Box
when you want to print True-size.
See also:
Editing a Text Box
90
Selecting a Destination
Select Destination lets you automatically deliver your images to specific
printers or PACS workstations. Select Destination is located on the Image
Viewer Screen.
To select a destination:
 Place a check mark next to the destination on the Select Destination Screen.
The destination may be a specific film size or type of image that requires a
specific printer.
To select a different Destination Profile:
 Select Change Destination Profile from the Patient Input Screen.
To print an image:
1. Select the thumbnail to display the image in the Image Viewer Screen.
2. Select Save & Accept Image to send the image to all pre-defined destinations.
See also:
Select USB Destination
Using the Print Tab
Using the Multi-format Configuration Screen
91
Cropping Images
Using the Crop Box Adjustment Tab
The Crop Box Adjustment Tab lets you change the way the image prints.
To use the Crop Box Adjustment Tab:
 Select the check box or button for the appropriate feature and select Save
Changes.
True Size Prints the image True-size.
Manual Crop Lets you adjust how much anatomy is displayed on the film. The
area inside of the crop box determines what is displayed. You can
drag the corners of the crop box to change the size of the box. Use
the arrows to adjust the position of the crop box.
Best Fit Rotates the image 90 degrees counter-clockwise to maximize film
usage.
1 cm Scale Displays and prints reference marks at 1 cm intervals to help you
evaluate image size. The system places the scale on two adjacent
sides of 1-up or a Multi-format print .
Crop Box Changes the crop box from a lengthwise position to a crosswise
Orientation position
Arrows Moves the crop box to another part of the image as you select the
arrows.
92
See also:
Using Manual Cropping
93
Using Manual Cropping

Manual Cropping lets you adjust the amount of anatomy that is displayed on
the film. The area inside the crop box determines the display. The aspect ratio of
the crop box depends on the film size selected. You can enlarge the crop box to
include more anatomy, but it will reduce the magnification.
1. From the Main Menu, select Image Review.
2. Select an image to open the Image Viewer Screen.
3. Select the Crop Box Adjustment Tab.
You can drag the edges of the crop box to change the size of the box, use
the arrows to adjust the position of the crop box.
See also:
Using Manual Cropping on a Multi-format Print 1. Make sure that the image is
included in a multi-format layout. If it is not, the cropping choices for multi-format
will be grayed out.
2. Select one of the following:
True-size
94
Manual Crop
Best Fit
You can mix cropping selections from the 1-up and multi-format menus on the
Crop Box Adjustment tab. For example, you can select True-size for 1-up and
Manual Crop for the multi-format print. Both crop boxes are displayed.
95
Measurement Tools
Using Measurement Tools
This feature provides tools that let you make measurements on the image. It is
accessed from the Image Viewer Screen .The Measurement Tools

calculate angles and distances between specified points at the film plane. The
system does not make adjustments to the measurements based on the relative
positions of the tube, patient and CR cassette. The reported values from the
measurements are directly calculated at the detector plane without any
compensation of geometric magnification.
Three different measurement tools are available. Select the Tool Icon below to
see a sample of the tools.
Tool Function Directions for Use
Measures the 1. Select the Distance icon on the Measurement
distance between Tools Tab.
two points. 2. Select a point to anchor the tool.
3. Select another point on the image to form the line.
Distance  To move the Distance Tool, use the directional
arrows on the Measurement Tool Tab to move
the line.
 To change the Distance Tool, select the points
and select another location on the image.
 To remove the Distance Tool, select the line on
the image and then select the trash can.
96
Measures an 1. Select the Angle icon on the Measurement Tools

angle from three Tab.
selected points on 2. Select the first, second, and third points on the
the image. image to form the drawing of the angle.
Angle  To move the Angle Tool, use the directional
arrows on the Measurement Tool Tab.
 To change the Angle Tool, select the points and
select another location for each point.
 To remove the Angle Tool, select the angle on the
image and then select the trash can.
Measures the 1. Select the Cobb Angle icon on the Measurement
angle of Tools Tab. The Cobb Angle measures curved
intersection shapes such as hips or spines.
between two lines 2. Select a point on the image.
Cobb drawn on the
Angle 3. Select a second point to form a line.
image. Used to
4. Select another point on the image.
determine the
angle of a curve. 5. Select a second point to form a second line. The
Cobb Angle is calculated for the arc between two
lines.
 To move the Cobb Angle Tool, use the directional
arrows on the Measurement Tool Tab.
 To change the Cobb Angle, select the points in
the lines and drag to another location.
 To remove the Cobb Angle, select the angle or
lines on the image and then select the trash can.
See also:
Measurement Tool Sample
97
Measurement Tool Sample
98
Distributing Images
Sending Images to a Different Location
1. At the Image Viewer Screen, select Select Destination.
2. Select a different or additional destination from the screen.
3. Select the check box of the new destination.
5. Select Back.
6. Select Accept to deliver the image to printers and workstations.
You can only configure multiple copies for hard copy (printer) devices.
See also:
Accepting the Image
99
Distributing the Image

Images can be sent to destinations:
 Automatically, configured by the Key Operator based on the Destination
Profile filters (Body Part, Physician, Cassette Size, etc).
 Manually, by selecting the destination using the Select Destination button.
See also:
Automatic Delivery or Manual Delivery
Destination Status Button
Change Destination Profile Button
100
Adjusting Image Quality

On the Image Viewer Screen, any accessed image in the system appears
before modification. Radiographers or Key Operators can perform any of the
functions described on this page before sending an image to its destination. You
can make any of the following changes:
 Review an image and decide to accept or reject it.
 Make adjustments to the image quality before sending the image to destinations.
 Add markers, measurements, or comments to images.
 Quickly review an image each time a thumbnail image is selected from
anywhere in the system.
Image Viewer Palette Tabs

Select an Image Viewer Palette Tab icon below for detailed instructions on
using the Tab.
Image Adjustment Tab (adding brightness, latitude, and detail contrast)
Markers Tab (adding, moving, and deleting markers)
Surround Mask Tab (applying, moving, and removing surround mask)
View/Look Adjustment Tab (changing views, applying grid suppression,

inverting images, applying noise suppression.)
Crop Box Adjustment Tab (printing True-size images, applying 1 cm scale)
Print Tab (adding text boxes, rotating, flipping images)
Magnification Tab (pan and zoom)
101
Comments Tab (adding comments to the image using the keyboard)
Measurement Tools (taking orthopedic measurements of distance, angle, or

Cobb angle)
Shortcut (Quick) Menu (logging out, shutting down, flagging images for
review)
See Express Viewer Screen.

Make sure you select Save Changes before closing the Image Viewer Screen.
See also:
Unassign/Assign Images
When should I accept the image?
Reject Image
Reprocess Image
Select Destination
Additional Topics
102
Express Viewer Screen

The Express Viewer screen provides a large View pane and a quick selection
of commonly used tools. The Key Operator configures the Express Viewer
screen to appear by navigating to the Key Operator Functions>System
Configuration>Display Configuration>Image Viewer tab.
If configured, the Express Viewer screen appears whenever the Image Viewer
screen is needed. The complete set of image processing functions still reside on
the Image Viewer screen, including the functions described here, and can be
accessed by pressing the Advanced Viewer button.
For more image editing tools, select the Advanced Viewer button.
Once you access the Advanced Viewer screen, you cannot toggle back to the
Express Viewer screen.
Standard image view
 Default view.
 Applies standard image processing to the displayed image.
Tube and Line view
 Applies image processing that makes it easier to see the tube and line view in
the displayed image.
 View the image and then select the appropriate button. Depress the button to
activate it.
 A companion image is created if it has not been created automatically.
 The companion image appears as a View on the Patient Input/Image
Acquisition screen.
 The image can be delivered separately from the original, and is treated the same
as any standard image.
Pneumothorax view
103
 Applies image processing that makes it easier to see a patient's pneumothorax

in the displayed image.
 View the image and then select the appropriate button. Depress the button to
activate it.
 A companion image is created if it has not been created automatically.
 The companion image appears as a View on the Patient Input/Image
Acquisition screen.
 The companion image can be delivered separately from the original, and is
treated the same as any standard image.
Histogram
 A graph of the distributions of pixel values in the image. The X-axis is exposure
from low to high. The Y-axis is frequency of occurrence.
 A normal exposure produces an S-shaped curve across the histogram. If image
processing fails, the histogram displays a straight diagonal line and the image
displays very low contrast. This is an indication that no additional image
processing has been applied to the image
 Displays changes in contrast such as changing from standard view, tube and line
view, and pneumothorax view.
Flip buttons
 When selected, they transpose individual images horizontally or vertically.

Rotate buttons
 When selected, an individual image turns clockwise or counterclockwise at 90

degree intervals.
Markers
104
 The markers palette appears with a crosshair target.

 Touch a marker to select it and touch the target to place it precisely on the
image.
 Move the marker to a different location by selecting the marker (highlights in
yellow) and then select a different location within the image.
 Add and Delete markers from an image.
Delete a marker
Touch a marker and touch the recycle bin.
View Name field

 Change the View name for the current image.
Edit Mask check box

 Edit the mask points
Back button
 Select the Back button to return to the Patient Input screen.
Main Menu button

 Select to return to the Main Menu.
Accept and Reject buttons

 Accept or reject the image
105
Reprocess Image button
 Reprocess the current image if the View name or Black Surround Mask has
changed.
 This button is not visible if the system is configured to reprocess images
automatically.
 Select Previous and Next buttons to navigate to other views of the image
Set To Corners
 Used with Black Surround Mask.
Tech Assist Toggle button
If Tech Assist software is enabled, this button lets you toggle back and
forth between the standard view and the CNR/Anatomy Clipping view.
See also:
106
Adjusting Image Parameters Menu

If the image quality is not acceptable, make sure that you selected the correct
View. Make sure you have the best image quality before making a diagnosis.
Increasing Latitude
Using the Histogram
Using the Image Adjustment Tab
Viewing More Detail
See also:
Viewing More Detail
Low Contrast Images
Increasing Latitude
Applying Automatic Masking
Applying Manual Masking
107

To change brightness:
 Select the top arrow to raise the value and increase the brightness.
 Select the bottom arrow to lower the value and decrease the brightness.
To change latitude:
 Select the top arrow to raise the value and increase the latitude.
 Select the bottom arrow to lower the value and decrease the latitude.
To change detail contrast:

 Select the top arrow to increase the value and increase the contrast.
 Select the bottom arrow to lower the value and lower the contrast.
To return to the last saved value of all of the slider controls:

1. Select Reset.
2. Select Save Changes when finished making changes.
3. Select Save & Accept Image to send the image to destinations.
See also:
Viewing More Detail
108

Accept Image Button
109
How to Use Window/Level

Use the Window/Level controls to change the brightness and contrast level
when normal image processing fails or is unsatisfactory.
1. At the Window /Level Screen:
 Raise the Window slider control to decrease contrast.
 Lower the Window slider control to increase the contrast.
 Raise the Level slider control to increase the brightness.

 Lower the Level slider control to decrease brightness.
110
Increasing Latitude
Latitude controls the number of shades of gray visible in the image. Increasing
the latitude increases the number of gray levels, making blacks and whites less
apparent. You may want to increase the latitude if important anatomical
information appears in the black or white region of the image and it cannot be
visualized clearly.
Increasing latitude:
 Increases the number of gray levels
 Decreases the apparent black and white values
See also:
Brightness, latitude, and detail contrast definitions
111

If image processing "fails" or does not perform on an image, the Modality will
automatically revert to Window/Level Mode instead of the standard Image
Viewer controls, allowing you to modify the contrast and brightness of the
image. The image will appear unusually low in contrast.
See also:
Low Contrast Images due to IPL Parameters Failure
Using the Histogram
112

Reprocessing modifies the image by applying the processing changes you have
selected. It does not matter whether the changes were made through masking
or View selection.
Changing the mask alters the image data used by the image processing
algorithms to do the image processing.
Reprocessing an image resets the contrast, brightness, and latitude value to the
defaults of the current View Name. When you change the View and select
Reprocess Image, the image processing is performed again using the new
image processing parameters for the new View.
Reprocessing is an option that should only be used when you want to change
the look of the image.
Select the Reprocess Image button:
 When you are not satisfied with the current look of the image.
 When increasing or decreasing the size of the mask to the edge of the
collimation.
 When masking out unneeded anatomy, to optimize on the visible anatomy.
 When poor collimation leaves unwanted objects in the image. Edit the Surround
Mask and reprocess to improve image quality.
 When you modify the View Name.
You cannot reprocess an image if the image has been accepted and delivered
across the network. You must create a copy of the image, modify the copy, and
send it to the proper destinations. In addition, an image must be delivered
before you can make a copy of it.
When should I not reprocess an image?
Do not reprocess the image if visible collimation lines are desired.
See also:
113
Using the Histogram

 The histogram is a graph of the distributions of pixel values in the image. The X-
axis is exposure from low to high. The Y -axis is frequency of occurrence.
 A normal exposure produces an S-shaped curve across the histogram. If image
processing fails, the histogram displays a straight diagonal line and the image
displays very low contrast. This is an indication that no additional image
processing has been applied to the image
 In Window/Level Mode, the image is displayed without the additional image
processing and the line on the histogram remains a straight diagonal line. It does
not become an S-shaped curve.
See also:
114

You can make the following adjustments on the Image Adjustment Tab:
 Brightness
 Latitude
 Detail Contrast
 Reset
 Window/Level Mode
See also:
Increasing Latitude
Using the Histogram
Viewing More Detail
115
Adjusting for More Detail

You can adjust the amount of detail visible in an image using the Image Quality
adjustment.
1. On the Image Viewer Screen, select the View/Look Adjustment Tab.
2. Make sure that the selected View is correct for the image you are reviewing.
(Selecting an incorrect View can cause unexpected results from the automatic
image processing).
If the View is correct:
1. Select the Image Adjustment Tab.
2. Carefully adjust the brightness, latitude, and detail contrast slider controls to
achieve the optimal appearance of the image.
If the View is not correct:
1. Select the View Name field on the View/Look Tab.
2. Select a new View Name from the View/Look Tab.
3. Select Reprocess.
See also:
Increasing Latitude
Using the Histogram
Flagging an Image
What are Brightness, Latitude, and Detail Contrast?
116
Assigning and Unassigning Images

Assigning an Image
Assigning a View.
1. At the Main Menu, select the Images Not Assigned button.
2. Select the image from the list to open the Image Viewer Screen.
3. At the Image Viewer Screen, select the Look/Adjustment Tab.
4. Select the View Name field to correctly designate the appropriate body-part
specific algorithm.
5. Select Reprocess Image.
Assigning an image to the Patient
1. Select Assign Image. Assign the image to a patient.
2. At the Patient Query Screen:
Enter the search criteria to search for the correct patient.
or
Select New Patient.
3. Select Add View.
If New Patient was selected, enter the patient information.
The image is assigned. The Patient Input Screen opens.
See also:
How an Image Becomes Unassigned
Unassigning an Image
117

You can move an image from one patient to another by unassigning it from one
patient and reassigning it to another.
1. Open the image to be moved from the Image Viewer Screen.
2. Select the Unassign Image button.
3. Select the Assign Image button.
4. At the Patient Query Screen:
Enter the search criteria to select the correct patient
or
Select New Patient.
5. Select Add View.
6. If New Patient was selected, enter the patient information.
7. Save Changes.
See also:
Assigning an Image
118

Unassigned images occur when:
 The cassette is scanned without first associating the cassette with a patient,
such as in a trauma situation.
 A View icon is not selected when an image is scanned and the auto-associate
feature is enabled.
 The image is manually unassigned from the original patient.
Unassigned images must be assigned to a patient before delivery.
See also:
Assigning an Image
119
To unassign an image from a patient ID or from a trauma ID:
1. Select the image to be unassigned.
The image opens in the Image Viewer Screen.
2. Select Unassign Image.
The patient information is removed from the image. The image information is
retained with the image.
See also:
Assigning an Image
120
Delivering Images
The Key Operator, Applications Consultant, or Service Engineer configures the
Modality for one of the following operating modes:
 Pass-through mode: all images are routed directly to destinations without
inspection.
 QA mode: all images are inspected and approved before sending to
destinations. Within QA mode, you can configure the system to automatically
open an image in the Image Viewer Screen after it has been processed.
 Auto QA by Image mode: the console automatically transfers from image
acquisition to the Image Viewer Screen once the image is captured. You do not
need to select the thumbnail to open the Image Viewer Screen. All images are
inspected and approved before sending to destinations.
 QA by Study: all images in a study (DR Systems only) are manually inspected
and approved before sending to destinations.
 Select Accept Image to send the image to destinations.
See also:
Unusable Image
Viewing a Thumbnail Image
QA by Image Mode
Pass-through Mode
121
Viewing a Thumbnail Image

 Select the study from the Study List on the Patient Input Screen.
The thumbnail images from that study appear across the bottom half of the
screen.
To view an image that appears as a thumbnail:
 Select a thumbnail image to open it automatically in the Image Viewer.
If you make changes to an image that require reprocessing, such as masking,
orientation, or annotation with markers, the thumbnail image always reflects
the saved changes.
See also:
122
Study Data
Auto Display in QA Mode

When you are operating in QA Mode, you can configure the system to
automatically open an image in the Image Viewer Screen after the image is
processed instead of selecting the image manually to inspect it.
For the Key Operator to configure QA by Image Mode:

1. Select Key Operator Functions > System Configuration > Delivery
Preferences.
2. At the Delivery Preferences Screen, select Auto Display in QA Mode.
See also:
Pass-through Mode
123
Pass-through Mode
In Pass-through mode, all images are routed directly to destinations without
inspection.
When Pass-through mode is configured, you can select the Pause the Pass-
through function on the Scan Status Screen to inspect an image.
Select Resume Pass-through to continue scanning and to allow images to go
to destinations without inspection. When the system distributes the image, you
can recall the image for review at that time, if necessary.
In QA mode, the radiographer must view and approve the image before
distributing it across the network.
See also:
QA Mode
124
Auto Display in QA Mode

If your system is configured for QA Mode, you must review and accept the
image before distributing it to the selected destinations. You may choose to
accept images individually following review of each, or all together after
reviewing them all.
Acceptance by Image
To review and accept individual images:
1. After acquisition, a thumbnail image appears on the Patient Input Screen.
2. Select the thumbnail image to display it for review on the Image Viewer
Screen.
3. Select Accept Image to send the image to the appropriate network
destinations.
Acceptance by Study
To review and accept all images in the study:
1. After acquisition, thumbnail images appear on the Patient Input Screen.
2. Select one of the images to open the image on the Image Viewer Screen.
3. View the other thumbnail images using the arrow buttons to on the Patient
Information Bar
4. Select the Patient Information Bar to return to the Patient Input Screen after
reviewing all of the images.
5. Select Accept All to send all the images to the selected destinations.
See also:
Destination Status Button
125
Storage Commitment Function

When you send an image to a destination, there is no guarantee that the image
was stored to the hard drive. Sending the image means that the Modality
transmitted the image to the PACS.
With Storage Commitment enabled, a delivered image is successfully saved
by the PACS and the Modality receives a confirmation that the image has been
received and stored.
The destination must support Storage Commitment for the Modality to use this
feature. This feature is enabled by Service.
126
Image Orientation and Appearance

Using the View/Look Adjustment Tab
The View/Look Adjustment Tab lets you select a new View Name if the
current View Name assigned to the image is producing poor results. Each View
Name carries with it contrast and brightness settings, latitude and noise settings
that determine what the image will look like. If the View Name is not assigned to
the correct View, the results will be unsatisfactory.
To change settings on the View/Look Adjustment Tab:
1. Select the View Name field if the current View is incorrect for the image and
enter a new name.
2. Select the Invert Grayscale check box to display the black areas of the image
as white and the white areas as black.
This may be helpful when identifying line placements.
3. Select the Grid Suppression check box to suppress grid lines from the image.
4. Select the Noise Suppression check box to reduce the appearance of noise in
low exposure areas.
See also:
Reducing Noise
Using Grid Suppression Software
Reversing the Image
127
128
Reducing Noise
Noise is density that appears in low exposure areas of an image. Noise is
generally unwanted and can make it difficult to see important detail in an image.
Noise Suppression Software can reduce or eliminate unwanted noise without
adversely affecting the rest of the image. The Key Operator can configure this
feature.
Use Noise Suppression to reduce the amount of apparent noise in low
exposure areas of the image.
To apply noise suppression:
1. At the Image Viewer Screen, select the View/Look Adjustment Tab .

2. Select the Noise Suppression check box.
 This feature selectively applies a noise suppression algorithm to only those
areas of the image with low exposure.
 When you apply Noise Suppression, the improved low exposure areas
appear clearer and smoother.
See also:
129

Grid Suppression Software is an optional feature that can detect the presence
of a grid and can suppress the visual effects of grid lines. The Key Operator can
configure this feature.
Use this feature to automatically suppress:
 Visible grid artifacts on the monitor when viewing CR/DR images.
 Moiré patterns when the image is minified and reduced line artifacts when the
image is magnified.
To apply Grid Suppression:
1. At the Image Viewer Screen, select the View/Look Adjustment Tab .

2. Select the Grid Suppression check box.
To remove Grid Suppression:

1. Clear the Grid Suppression check box.
See also:
130
Magnification Tab
The Magnification Tab lets you change the level of magnification you see in the
image displayed in the Image Viewer window and move the view by selecting
different points on the screen.
To use the Magnification Tab:
1. Select the zoom level (200%, 100%, 50%, 25%).
2. Move the area of view by selecting the image, the thumbnail, or the arrows, or
by dragging across the image.
3. Increase or decrease the magnification of the image for viewing on the Modality.
4. Select Fit to Screen:
 To exit Pan and Zoom mode.
 To make all areas of the image accessible for viewing.
5. Select Fit to BSM to fit the image to a Black Surround Mask.
Zoom Level is based on normal screen view.
See also:
131
Rotating and Flipping the Image

Rotating and flipping the image lets you change the orientation of an image
before it is sent to destinations.
1. From the Image Viewer Screen, select the Print Tab.
2. To rotate the image clockwise, select the Rotate CW button. To rotate the
image counter clockwise, select the Rotate CCW button.
The image rotates in increments of 90 degrees.
You can see the change in the Image Viewer window.
3. To flip the image, select the Flip Horizontal or Flip Vertical button.
You can see the change in the Image Viewer window.
The change you make to image orientation appears at the destination.
See also:
Using the Print Tab
Printing an Image
132
Reversing the Image

 At the Image Viewer Screen, select the Invert Grayscale check box.
The reversal image provides an alternate view of image detail.
o To print the image, select Save & Accept Image.
o To remove the effect, clear the Invert Grayscale check box.
See also:
133
Using the Comment Tab

The Comment Tab allows the radiographer or Key Operator to create a record
of comments about the image.
In addition, the Comment Tab lets you edit the laterality of an image after it is
acquired. This is important if the image was flipped or rotated in the Image
Viewer or if the laterality had not been noted elsewhere.
1. Select the Image Comments box.
2. Use the Keyboard to enter the comment.
See also:
134
Image Review
Review Needed Status

Occasionally, EVP Plus Software may not fully predict the parameters for an
image. When this happens, it produces a Review Needed status.
To use the Review Needed Status:
 Check the contrast and brightness of the image.
For images with the Review Needed status, you have access to the brightness,
latitude, and detail contrast controls to correct the image in the Image Viewer
Screen.
Review Needed should not be confused with Need Approval, which is a
status of images which have not yet been approved and are waiting for
destinations. Need Approval is located on the Image List Screen.
See also:
Using the Image List Screen
135
Brightness, Latitude, and Detail Contrast

Definitions
The radiographer may adjust three powerful parameters to fine-tune image
quality.
 Brightness makes an image lighter or darker.
 Latitude controls the number of shades of gray visible in the image. Increasing
information is in the black or white region of the image and it cannot be
visualized.
 Detail Contrast controls the local contrast of medium-sized structures such as
joint spaces, vertebral body spacings, and ribs in the image. Increasing detail
contrast makes anatomical features more pronounced.
See also:
Viewing More Detail
Low Contrast Images
Increasing Latitude
Using the Histogram
136
Markers
Markers Menu
Adding Markers
Adding the Text Marker
Moving a Marker
Removing a Marker
Using the Favorites Markers
Using the Measures Markers
Using the Others Markers
Using the Time Markers
137
Adding Markers
You can add an unlimited number of markers to an image. Once a marker is
added to an image, it will be visible when it is sent to a destination.
1. From the Image Viewer Screen, select the Markers Tab.
2. Select the type icon as indicated in the table below.
3. Select the desired location on the image.
Favorites Markers Group
Others Markers Group
Measures Markers Group
Time Markers Group
User-created Markers Group
.
The marker remains in place until you change its position.
When you add a Free-Form Text marker, use the keyboard to enter text in the
Free-form text field. You must select Enter every time the Free-Form text field is
changed.
138
See also:
How do I add a free-form text marker?
Using the Markers Tab
139

The free-form text marker lets you add 32 characters of text to the image.
You can add the text marker to an image or change the marker already in place.
The text marker becomes part of the image and is retained when sent to
destinations.
To add a free-form text marker:
1. From the Image Viewer Screen, select the Markers Tab.
2. Enter the desired information in the Text field from the keyboard for your
system.
3. Select the desired location on the image.
To remove the text marker:
1. Select the Text marker on the image.
2. Select the trash can.
See also:
Markers Menu
Adding Markers
Removing a Marker
140
Moving a Marker
1. Select the marker on the image.
The marker is highlighted when selected.
2. Select a new location.
See also:
Markers Menu
Adding Markers
Removing a Marker
141
Image Review
Removing a Marker
A marker can be removed from an image before or after it is saved to the
Modality database.
1. Select a marker on the image. The marker is highlighted when selected.
2. Select the trash can.
See also:
Markers Menu
Adding Markers
142
Image Review
1. Select Favorites by selecting the icon.

2. Select a position marker such as Left or Right, and select the image to place the
marker.
3. Select the arrow to apply an arrow marker.
4. Select the arrow again to change the direction of the arrow.
 To delete a marker from the image, select the marker on the image and then
select the trash can.
See also:
Markers Menu
Adding Markers
Removing a Marker
143
Image Review

The Measures Markers include markers for different positions, including:
 15°, 30°, 45°, 60°, and 90°
 Semi-supine
 Semi-erect
 L Lat Decub
 R Lat Decub
 Oblique
 MLO
 CC
 Scout
 Post Reduction
To use the Measures Markers:

 To place a marker on the image, select the marker name on the palette and then
select a point on the image to locate it.
144
Image Review
Using the Others Marker Group
1. Select Others by selecting the icon.

2. Select a marker from the markers on the palette.
3. Select a point on the image to locate it.
The Others Markers Group includes:
 Flexion
 Internal
 Inspiration
 Wt Bearing
 Axial
 Stress
 Extension
 External
 Expiration
 Post Contrast
 Prelim
 Erect
145
 To delete a marker from the image, select the marker on the image, then select
the trash can.
See also:
Markers Menu
Adding Markers
Removing a Marker
146
Image Review
1. Select the Time Markers by selecting the icon.

2. Select the Time interval marker and select a point on the image to locate it.
Time intervals include 15 and 30 seconds, 1 minute to 60 minutes, and 2
hours to 24 hours.
See also:
Applying Markers
Adding Markers
Removing a Marker
147
Masking
Using the Surround Mask Tab
Surround Mask causes the unexposed areas around the image to be displayed
black and makes soft tissue and low contrast detail more visible. Mask
placement normally corresponds to the placement of collimator blades.
If two images are exposed on one phosphor screen, they are processed as two
separate images. Image quality is optimized for each exposure field, and the
images are delivered exactly as they appear on the system monitor. A Black
Surround Mask and the Exposure Index are applied to each exposure field
separately.
 Make adjustments as desired.
Show Mask Applies Automatic Surround Mask and makes it visible.

Edit Mask Applies Manual Surround Mask and adjusts the mask. Select
the check box to apply.
Circle or Rectangle Locates where on the image the mask must be applied.
Controls
Arrows Moves the mask shape you created to another area of the
image.
Reset Returns the mask to the last saved Surround Masking position.
Select Set to Places the mask points in the four corners of the image. Use
Corners this feature if there is a Surround Mask failure and you want to
enlarge the mask quickly, or if you move a point off the image
and you cannot get it back.
Treat as Single- Overrides masking when the system interprets a single
Exposure Image exposure as multiple images, or improperly masks multiple
exposures on a single image. This feature can be configured in
View Configuration to treat certain (or all) views always as
single exposures.
148
See also:
Masking Failure
Mask Points Are Off the Screen
Reprocessing After Using a Mask
149
Masking Failure
When Automatic Surround Mask fails, apply Manual Surround Mask.
See also:
150
Applying Automatic Surround Mask (optional)

Surround Mask reduces viewing flare. The mask helps you see soft tissue and
low contrast information. Automatic mask placement normally corresponds to
the placement of collimator blades.
To apply automatic Surround Mask:
 If you have the optional Automatic Surround Mask feature, automatic mask is
ON by default. The Show Mask check box is checked.
See also:
Reducing Noise
151

To find a mask point when it is off the image, you can change the magnification
so you can see the points.
1. At the Image Viewer Screen, select the Magnification Tab .

2. Select 25 % zoom.
3. Select the Surround Tab.
4. Select Edit Mask.
5. Move the circular or rectangular control points on the mask on the smaller
image.
See also:
152
Applying Manual Surround Mask (optional)

Manual Surround Mask is used when Automatic Surround Masking is not
sufficient.
1. From the Image Viewer Screen on the Surround Mask Tab, check the Edit
Mask check box.
2. To change the shape of the mask:
 Select a circle (corner) or rectangle (side) on the mask, then drag it to
another location.
 Select a side and select another location on the image.
 Use the green arrows on the editor to move a selected side or edge.
3. Select Reprocess.
See also:
153
Reprocessing After Using Edit Mask

The Reprocess Image button becomes active when you modify the Surround
Mask with Edit Mask. The Region of Interest (ROI) is redefined based on the
current location of the mask if you select the Reprocess Image button. This
may improve the appearance of the image, but not as much as collimating to the
body part.
See also:
Region of Interest Tool
154
Optimizing the Exam

Performing the Exam
What size cassette should I use?
Use the smallest cassette capable of fully including the anatomy.
What is collimation? Why should I do it?
 Collimation means to manually adjust the size of the X-ray field so that the area
exposed and imaged by the X-ray is just that area necessary for the diagnosis.
 Collimation decreases scatter, increases detail and contrast, and helps optimize
the image processing software by determining the correct area of interest on the
screen.
 Collimation is very important to your initial exposure. Apply as much as is
practically possible.
Why should I use lead behind the patient?

Use lead behind the patient to reduce X-ray scatter.
For example, you can improve Lateral L-Spine images with careful collimation.
Place a strip of lead behind the patient to decrease scatter.
How should I expose for soft tissue?

Use normal technique factors for Images exposed for soft tissue (lateral soft
tissue neck).
Should I put more than one image on a cassette?
Typically, capture only one image per cassette, such as a Posteroanterior (PA)
hand on one cassette, and a Lateral hand on a separate cassette.
When you put more than one exposure on a cassette:
 Leave a small gap of unexposed area between two consecutive images. The
width of the gap should be greater than 0.5 in.(1.27 cm) but smaller than 1.0 in.
(2.54 cm).
 Avoid overlapping the exposure fields.
 Place the exposure fields close to the cassette center.
 Expose all of the images in the same orientation and in similar size.
Large gaps between images and overlapping fields can adversely affect the
image contrast and masking.
Another option is to create a multi-format image. See What Is Multi-format
Printing?
155
How are multi-exposure cassettes processed?

Arrange exposure fields approximately parallel to one another and separated by
an air gap of 1.2 to 5.0 cm (0.5 to 2 inches). While each exposure field is
processed separately, the images are delivered exactly as they appear on the
system monitor.
1. Separate the images using Surround Masking.
2. Process each image separately.
See also:
More Image Data
156
Improving Acquisition Techniques

How can I improve my image quality?
 Choose the appropriate cassette size.
 Choose the appropriate View.
Guidelines for Good Exposures

 Reduce back-scatter radiation.
 Reduce off-focus radiation.
 Make sure collimator blades are working efficiently.
 Use grids when appropriate.
 Use good collimation practices. Be mindful of the cathode/anode orientation and
heel effect.
See also:
Changing Image Processing Preferences
157

What is the Exposure Index (EI)?
 The Exposure Index (EI) is the average code value for the area that the image
processing software determined was the Region of Interest.
 If the system used the incorrect Region of Interest, the EI value may be
inaccurate.
 The EI is affected by exposure, kVp, collimation, the View chosen for processing,
and filtration in the X-ray tube.
 Under standard X-ray beam conditions, 80 kVp with 0.5 mm Cu and 1.0 mm AL
filtration at the tube, the relationship between EI and the cassette incident
exposure level mR is EI = 1000 x log 10 (mR) + 2000.
For example, at 1.0 mR exposure level the EI should be 2000. Every time the
dose is doubled or halved, the Exposure Index will increase or decrease by
300.
Use EI as a guide, not as an absolute value.
What should the EI value be?

Users should define the exposure techniques for acceptable image quality, then
define the EI range guidance for a variety of exam types. Typical EI ranges can
be from 1500 to 1800.
What do I do if the EI is too low?

If the EI is too low make sure these kVp guidelines are used:
 Make sure that the image quality is acceptable for diagnosis. If not, try adjusting
the image quality controls first.
 Use a minimum of 55 kVp on extremities.
 Use 85 - 90 kVp for average sized non-grid portable chests.
 Because the EI is calculated by image processing algorithms, it is possible that
the processing has failed to correctly report the EI.
 A lower EI may mean that the exposure factors were not adequate and the
image will be noisy, grainy, or mottled.
What do I do if the EI is too high?

 Check to see if the image quality is acceptable for diagnosis. If not, try adjusting
 Because the Exposure Index (EI) is calculated by image processing algorithms,
it is possible that the processing has failed to correctly report the EI.
158
 A higher Exposure Index may indicate that a large amount of radiation struck the
cassette. Often this happens when a large cassette is used for an exam such as
a cross-table lateral hip or when collimation is not adequate.
 If an exam is not collimated closely, direct areas of exposure may adversely
affect the image processing and consequently the final image.
Why might my image look light when the exposure is

high?
A light image could be caused by the following:
 An excessive dose could cause image processing to fail.
 Misidentification of the region of interest. The EI is the average code value of the
region of interest if the direct exposure regions have been identified as the
Region of Interest.
Why is the EI so high? I did not overexpose it!

A high EI may be caused by a misidentification of the Region of Interest in the
image processing. Reasons for this may include
 excessive scatter
 poor collimation
See also:
What do I do if the EI is too high?

 Check to see if the image quality is acceptable for diagnosis. If not, try adjusting
 Because the Exposure Index (EI) is calculated by image processing algorithms,
it is possible that the processing has failed to correctly report the EI.
 A higher Exposure Index may indicate that a large amount of radiation struck the
cassette. Often this happens when a large cassette is used for an exam such as
a cross-table lateral hip or when collimation is not adequate.
 If an exam is not collimated closely, direct areas of exposure may adversely
affect the image processing and consequently the final image.
159
CARESTREAM CR System Workflow Help
Logging and Shutdown Procedures
Logging On and Logging Out of the Modality
To logon to the Modality:
1. Select the User Name field and type in your user name.
2. Select the Password field and type in your password.
3. Select Logon.
The Security Administrator determines what your log on information is.
If your system is configured without user names and passwords, select the
Logon Tech button.
If you forgot your password:
 Contact your Security Administrator for logon information.
 Your Security Administrator can reset your password.
Your Security Administrator can configure your system so that user names and
passwords are not required.
To log out of the Modality:
1. Select the Quick Menu button (left most button on the bottom of the screen) to
bring up the menu.
2. Select the Logout button.
See also:
Shutting Down the CR System
Restarting Versus Rebooting
Using the Shutdown Button
161

Select the blue link below to for instructions on how to shut down the CR
825/850/950/975/Max CR System.
CR 825/850/950/975/Max CR System
To turn off the CR System:
1. Select the Quick Menu button , the lower left button on any CR System
screen.
2. Select the Shutdown button.
3. On the Shutdown screen, select the appropriate radio button:
 Restart: restarts the interface without turning off the machine.
 Reboot: turns off and resets the machine.
 Shutdown/Power Off: turns off all power to the machine and the interface.
4. Select OK.
The UPS shuts down up to one minute after the DIRECTVIEW CR Software and
WINDOWS Operating System shut down.
Select the blue link below to for instructions on how to shut down the
Classic/Elite CR System.
Classic/Elite CR System
162
To turn off the CR System:

1. At the Main Menu, select the Quick Start Menu button.
2. Select System Shutdown/Power Off and select OK. The CR computer shuts
down.
3. Turn off the power switch on the side of the Classic/Elite CR System.
163

 To Restart means to turn the software off and on without affecting the System
computer.
 To Reboot the system means to turn off and reinitialize the System.
164
Using the Shutdown Button

The Shutdown button is located in the lower left corner of every screen as part
of the Quick Menu. The Shutdown button displays different options depending
on the logon password used. For example, Service personnel see different
options than radiographers.
1. At the Main Menu, select the Quick Menu button.
2. Select the Shutdown button.
The System Shutdown Menu of radio buttons appears:
 Join Capture Link Server after Restart
 Restart
 Reboot
 Shutdown/Power Off
o For the CR 825/850/950/975/Max CR System, selecting
Shutdown/Power Off turns off all power to the machine and the interface.
o For the Classic/Elite CR System, selecting Shutdown/Power Off shuts
down the CR System computer.
3. Select the appropriate action on the System Shutdown Menu.
4. Select OK.
5. For the Classic/Elite CR System, turn off the power switch on the side of the
machine.
See also:
How to Log On and Log Out
165
CR Scan Status Screen

Patient Information Bar
The Patient Information Bar appears at the bottom of every image in the Image
Viewer Screen.
It provides the current patient information for the displayed image.
 When selected, it opens the patient record on the Patient Input Screen.
The information on the Patient Information Bar includes:

 Patient Name
 Patient ID
 Accession number
 Cassette ID
 Exposure Index
 Date/Time
 Tech ID
 View Name
You can select the previous image or the next image in the study by selecting
the arrows on the Patient Information Bar. The Patient Information Bar changes
color depending on the status of the image. For example, the bar may be green
for an image that is assigned, and orange for an image that is unassigned.
See also:
Using the Scan Status Screen
166
Using the Erase Cassette Tab

1. Select the Erase Cassette Tab on the 825/850/950/975/Max CR
System/Classic CR with Easy View display to place the system into the Erase
Mode. Make sure that you want to erase a cassette! The system cannot scan a
cassette with an image while in Erase Mode.
For the Classic/Elite CR Systems, use the Erase button on the Local User
Interface.
Erasing deletes any image on the phosphor screen.
1. Select the Erase Cassette tab on the Scan Status Screen.
2. Insert the cassette into the CR System.
3. Press the Erase Cassette button.
Note: The mechanical Start button on the front of the CR 950/975 is not active
during Erase mode.
2. Insert the cassette into the CR System.

Select the Erase Cassette button for the 950/975/Max CR.
The phosphor screen is removed from the cassette, and erased from the
screen. The screen is replaced in the cassette for use with another exam.
The mechanical Start button on the front of the CR 950/975 is not active during
Erase Mode.
Use the Erase Cassette function to erase a phosphor screen if the cassette has
not been used within 24 hours or if you suspect it has been exposed to any X-
ray radiation.
Do not insert cassettes containing patient images into the CR 950/975
System while it is erasing cassettes.
See also:
167
Using the Erase Lamp Status Tab

The Erase Lamp Status Tab on the 825/850/950/975/Max CR System/Classic
CR with Easy View display notifies you when one or more pairs of erase lamps
are not functioning.
For Classic/Elite CR Systems without the Easy View display, the Erase Lamp
Status appears only on the Local User Interface.
When two pairs of lamps stop functioning, a warning appears and scanning is
stopped. You must replace the lamps. See the CR Systems Hardware Guide for
instructions on replacing the lamps.
See also:
Purchasing Erase Lamps
168

 Displays the last scanned image
 Erases cassettes
 Resolves cassette transport problems such as cassette jams
 Provides erase lamp status
CR 825/850/950/975/Max/CR Classic with Easy View

display CR Systems
The Scan Status Screen appears with the following Tabs/functions on the CR
825, CR 850, CR 950, CR 975, Max CR, and CR Classic with Easy View display
Systems.
Scan Status Tab Displays the last scanned image. From this tab you
can assign the image, access the Patient Input
Screen and the Image Viewer Screen. The Pause
Pass-through button is active if Pass-through mode
is configured, allowing inspection of images before
delivery.
Erase Cassette Erases cassettes that have become exposed to
Tab ambient radiation. Cassettes that have not been used
in 24 hours should be erased prior to use.
System Recovery Resolves cassette transport problems such as

Tab cassette jams.
Erase Lamp Tab Displays the Erase Lamp Status. System warnings
occur when one or more pairs of erase lamps are not
functioning.
Classic/Elite CR Systems without Easy View display

Only the Scan Status Tab is available on the Console of the Classic/Elite CR
Systems without the Easy View display. The Erase Cassette Tab, System
Recovery Tab, and Erase Lamp Tab functions are available on the Local User
Interface of the Classic/Elite CR Systems.
169
See also:
Local User Interface Main Menu
Using the Scan Status Tab
Using the Erase Cassette Tab
Using the System Recovery Tab
Using the Erase Lamp Status Tab
170

Displays the status of image acquisition.
Progress bar Displays the progress of the scan from start to completion.
Pause Pass- If the Key Operator configures the system for Pass-through
through/Resume Mode, these buttons appear. They allow you to inspect an
Pass-through image before accepting and sending to destinations, and then
functions resume Pass-through Mode.
Image Viewer Screen Opens the Image Viewer Screen to modify the image quality.
Assign Image Opens the Patient Query screen to assign patient information
to the image.
Patient Information Opens the Patient Input Screen to view or change patient
Bar information.
Patient Record Opens the Patient Input Screen to observe or change patient
information.
The Scan Status Tab displays on all CR Systems.
See also:
Assigning an Image
Patient Information Bar
Pass-through Mode
171

To release cassettes that are not transporting properly:
1. Select Clear Cassette Jam to reverse the movement of the transport
mechanism.
2. Select Release Cassette to move the cassette to the home position.
3. If the cassette is released, remove the cassette.
If the problem persists, call your Service Representative.
See also:
172
CR Local User Interface

The Local User Interface is available only with the Classic and Elite CR
Systems. It is accessed through the LCD display on the top of the machine.
The menu is dynamic. The menu choices may appear in the following order, or a
different order depending on the directional arrows you choose.
To use the Local User Interface Menu:
Select the icon on the Classic or Elite System to access the menu selections.
The functions are listed in the table below.
Utilities
Volume Button Click
Alarms
Settings Bar-Code Read
Control the volume of Cassette Loaded
Touch the icon on the the following settings:
Classic or Elite System to
 The response of
access the Utilities menu.
selecting a button
on the remote
interface.
 The sound of
alarms on the CR
System.
 The sound of the
Bar-Code Scanner.
 The sound that
occurs when you
place a cassette in
the cassette feed
slot and it is ready to
scan.
Scanner Scan Count

Laser Hours
Information Erase Lamp Status
 Scan Count is a
consecutive count of
scans on the
machine.
 Laser Hours is a
consecutive count of
the hours the laser
173
has operated.
 Erase Lamp Status
gives a picture of
the current
performance of
each pair of erase
lamps in the
machine.
Display Brightness
Sleep
Settings
 Brightness—Use
the + and - buttons
to control the
brightness of the
display on the
interface.
 Sleep—Select the
interval for the
interface to be
active without being
accessed.
Scan Mode High Speed

Reduced Border
Scan Modes are Standard Speed
unique to the Classic
and Elite CR
Systems. Scan Modes
affect large cassettes
such as 35 x 35 cm
and 35 x 43 cm.
There are three scan

modes you can set
from the Local User
Interface (not the
Console):
Standard Speed
Mode—Standard
Resolution, High
Resolution, Enhanced
174
Resolution.
High Speed Mode—
Standard Resolution,
High Resolution,
Enhanced Resolution.
Reduced Border—
Images on 35 x 35 and
35 x 43 cm cassettes
are captured with pixel
sizes of 171 microns
rather than 168
microns. The scanned
image area increases
slightly, producing
borders smaller than
those produced on
other systems.
Active Console IP address
Provides the name and

IP address of the
Classic or Elite System
currently in
communication with
the Console.
System Release Cassette

Cassette Jam
Recovery
Touch this button to
release a jammed
cassette in the Classic
or Elite System.
Erase Cassettes
Cassette will
be Erased
Insert the cassette.
Erasing begins
automatically.
The phosphor screen
in the cassette is
erased and released.
175
Using the Volume Settings Tab

The CR Classic and Elite Systems have a local user interface built into the top of
the machine.
You can set the volume for the following signals by selecting the symbol:
Button Click Alarms
Bar-Code Read Cassette

Loaded
176
CR System Overviews
Main Menu Functions
The headings throughout the software color-coded for easy reference.
Function Name Description

Study Data  Locate Patient and Exam Data
 Enter New Patient Data
 Create New Studies
 Access Work Lists
Image Review  Search for and View all Stored Images
 Change Image Presentation
 Add Markers, Change Orientation, Reverse Viewing; turn
on/off Grid Suppression and Noise Suppression
 Change Image Quality Controls, Masking
 Reprocess
 Print Images as Single or Multi-Format
Scan Status  Display the Last Scanned Image
 Erase the Cassette
 Display the Erase Lamp Status
 Release Cassette and Phosphor Screen Jams
Key Operator  Set up and Manage System Configurations
Functions
Service Functions  Service the Machine (Qualified Service personnel only)
Utilities  Change Password
 System Status
 Software Updates
 Image Recovery
 Image Recovery Capture Link
 Capture Link Server Status
Security  Generate User Names
Administrator  Manage User Accounts
Functions
 Role Settings
 User Configuration
 Security Log Configuration
 Archive Security Log Entries
New Patient Button  Immediately opens the Patient Input Screen to create a new
patient record.
patient record.'
Quick Menu Button  Provides quick access to logon, logout, and shutdown
menus.
177
Images Not  Displays the number of images on the system that are not
Assigned Button assigned. Pressing the button takes you to the Image
Review Screen where the images are available.
The Key Operator Functions, Service Functions, and Security Administrator

Functions are only accessible by authorized personnel.
See also:
Radiographer's Screen Guide
Key Operator Functions
Utilities Menu
178
CR Modality Overview
The DIRECTVIEW CR (Computed Radiography) product family consists of a
series of medical scanners utilizing phosphor screen technology to produce
diagnostic quality images. The different product members offer a variety of
performances and functional capabilities to meet the demands of a range of
large centralized sites to small clinics.
Each scanner allows the radiographer to input the required data manually or
interface with the site's HIS/RIS to retrieve patient information. Using the
device's User Interface, the radiographer can verify proper image placement and
check for motion prior to routing images to printers or store devices. The
products can communicate with other medical devices, specifically store devices
and printers, that support the DICOM 3 standard.
The products support a number of add-on options that allow extended
functionality, such as advanced image processing, ability to perform long-length
imaging, image reject analysis, and various workflow enhancements. The
products also support the use of the optional Total Quality Tool (TQT) as a
means to verify the integrity of the image acquisition and erase sub-systems and
the individual cassettes.
In addition, the CR System provides a Remote Operations Panel (ROP) that can
be used to interact with the product. This remote workstation allows control of
certain CR System functions from a remote location.
See also:
What is TQT?
179
Scheduled Workflow
Workflow Configurations
A Key Operator configures the System workflow to organize the way images are
foldered at the workstation. To set up this configuration, go to Key Operator
Functions > System Configuration > Display Configuration. Select the
Patient Input Tab. You can select the radio button to configure your system
with one of two ways to identify images:
Image Identifier Result
Select Create new procedure steps from Create new procedure steps from the
Patient Input to keep the same Study Patient Input Screen.
Instance Unique Identifier (SIUID)This
places the images into the same study.
Select Create new Studies from Patient Create new studies from the Patient Input
Input to generate a new Study Instance Screen.
Unique Identifier (SIUID) and a new
Procedure Step.
Scheduled Workflow is an option that may be used with either of the workflow
configurations listed above.
Your system may be configured for either mode for Integrated Healthcare
Enterprise (IHE) compliance.
See also:
MPPS Mode
180
Modality Performed Procedure Step (MPPS)

MPPS is an element of the optional Scheduled Workflow software feature. The
MPPS feature communicates with the Modality Performed Procedure Step
Manager every time a procedure starts, ends, or is discontinued using the
appropriate button on the Patient Input Screen. The Modality Performed
Procedure Step Manager is responsible for updating the PACS system with the
information sent by the CR System.
The Key Operator selects the "Send scheduled workflow MPPS command"
option on the HIS/RIS Polling & Remote Query Screen.
See also:
HIS/RIS Configuration
HIS/RIS Polling Query
181
Scheduled Workflow Configurations

Scheduled Workflow provides automatic notification of exam status to the HIS,
reducing the steps necessary to complete the exam. It provides consistency for
ordering patient images, and defines schedules and imaging acquisition
procedures.
Select the following check boxes to configure your system with one or more of
the following conditions:
Setting the Procedure Steps to Complete
Select the check box to configure Scheduled Workflow so that a study is
automatically set to Complete when all images are accepted.
Display End Procedure Step Confirmation Dialog Box

Select the check box to configure an End Study prompt when all images are
accepted.
182
Scanning Equipment and Procedures

Scanning CR Cassettes Menu
Scanning on the Classic/Elite CR System
Scanning on the CR 825/850 System
Scanning on the CR 950/975/Max CR System
High-Resolution Scanning
Scanner Error
Slow System Response
CR System Freeze-up
183
Using the Touch-Screen

When you are logged on, the Main Menu appears on the touch-screen.
To select a menu choice, select the center of the button. Selecting the edge of
the button may give you unexpected results.
Use only your finger or mouse to select buttons on the screen. Other objects can
damage the surface of the touch-screen.
The touch-screen automatically shuts off or goes to "sleep" if it is not used for a
certain length of time. Select the screen to reactivate it.
The basic Classic CR system is shipped with a flat panel, non-touch screen
monitor. A touch screen monitor is available as an upgrade on a Classic CR
system.
184
 High-Resolution scanning produces diagnostic quality images with 97 micron
spacing between pixels. The bar-code on the cassette tells the CR System that a
GP Plus Cassette is inserted, and the scan rate changes to 97 microns.
 GP Plus Scan Mode, available worldwide, produces high-resolution images with
GP Plus cassettes.
 If the scanner does not recognize the bar-code, manually specify the cassette
type.
What Are Scan Modes?

Scan Modes are unique to the Classic/Elite CR Systems. Scan Modes affect
large cassettes such as 35 x 35 cm and 35 x 43 cm.
You can set three scan modes from the Local User Interface (not from the
Console):
Standard Speed Mode: High Resolution
High Speed Mode: Standard Resolution
This mode scans in the least amount of time.
Reduced Border: Images on 35 x 35 cm and 35 x 43 cm cassettes are
captured with pixel sizes of 171 microns rather than 168 microns. The scanned
image area increases slightly, producing borders smaller than those produced
on other systems.
See also:
Scanning CR Cassettes
What do I do if I receive an error while scanning?
Automatic delivery vs manual delivery
185

Slow System Response means a long wait between screen changes or a long
wait before data appears on the screen. Resolving this may require a system
reboot. The CR System may require a weekly reboot, and in cases of high
cassette throughput, you may need to reboot more often.
See also:
186
CR System Freeze-up
If it is not possible to reboot the CR System using normal Shutdown procedures,
it may be necessary to manually reboot the System.
1. Select and quickly release the computer Power button.
2. Wait 30 seconds.
3. Turn the computer back on.
If the power down sequence still does not initiate:
1. Select and hold the computer Power button.
2. Wait 10 seconds.
3. Reinitiate the UPS system.
Use the computer's Power button to turn the computer back on if there is no
UPS system.
If the Remote Operations Panel (ROP) won't respond:
1. Select the Quick Menu/Shutdown button to reboot the ROP.
2. If the Shutdown button is not available:
3. Turn Off the Power button located under the ROP front panel.
4. Wait 10 seconds and turn the ROP back on.
See also:
How to Logon, Log Out
Using the Shutdown button
187
Loading a Cassette
The cassette feed slot lets you insert a single cassette manually.
1. Hold the cassette with the yellow corner facing up and toward you.
2. Place the cassette in the feed slot with the tube side facing to the right.
3. Push the cassette into the slot. The CR System beeps once when it reads the
cassette bar-code label.
4. Push the cassette all the way to the back until the CR System beeps twice,
signaling that you can let go of the cassette.
After the cassette has been scanned, the CR system releases it, and
displays the Remove Cassette message on the Local User Interface (LUI).
5. Manually remove the cassette.
Make sure that the Tube Side label faces to the right, and the cassette's yellow
corner is always up and towards you.
See also:
188
Loading a Cassette
1. Slide the cassette into the front of the cassette feed slot at the top of the CR
825/850 System.
When you insert the cassette into the CR 825/850 System, the cassette is
pulled into scan position and scanning starts immediately.
After the cassette has been scanned, the system releases it automatically.
2. Remove the cassette from the cassette feed slot.
Make sure that the tube side label faces to the right, and the cassette’s yellow
When the CR System scans the phosphor screen, it erases any residual image
before it places the phosphor screen back into the cassette for re-use.
See also:
CR System Freeze-up
What Is High Resolution Scanning?
Scanner Error
189
Scanning on a CR 950/975/Max CR System
Loading Cassettes
1 Place exposed cassettes on the right side of the
feed slot.
1. Push a cassette all the way into one of the drive belt slots.
2. Set the cassette into the transport mechanism.
3. Make sure the cassette is perpendicular when loaded and pushed all the way to
the back of the slot.
You can load up to eight cassettes of all sizes at one time.
2 Start scanning when the Start button turns green.

1. Press the green Start button to begin scanning.
 The Start button turns orange while scanning.
 When the cassette reaches the feed slot, the phosphor screen is extracted and
scanning starts immediately.
 When scanning is complete, the screen is erased and re-inserted into the
cassette.
 The cassette moves to the left as the next cassette reaches the feed slot.
 You can now remove the cassette and reuse it.
3 Select the Start button to pause the transport.

 When the system is paused, the Start button turns white.
 Remove any completed cassettes from the left so that scanning can continue.
190
Make sure that the tube side label faces to the right, and the cassette’s yellow
When the CR System scans the phosphor screen, it erases any residual image
before it places the phosphor screen back into the cassette for re-use.
Place exposed STAT cassettes in the second slot to the right of the center
process slot. If there is already a cassette in the second slot, remove it first. Do
not load or remove cassettes from Slot 1.
The CR 950/975 has moving parts. Avoid contact with the belt.
See also:
CR System Freeze-up
Scanner Error
191
Purchasing Erase Lamps

Order new erase lamps from Carestream Health, Inc. Customer Support. The
erase lamps are sold in pairs.
Customer Support (US and Canada)
1-866-927-1018
PN 7E9471
The part name to ask for is CR Erase Lamp Bulb.
Elsewhere in the world, contact Carestream Health, Inc. in your country.

150 Verona Street
Rochester, N.Y. 14608
192
Cassettes, Troubleshooting, and Error Messages

Local User Interface
Scan Status
Cassette Jams
CR 825/850/950/975/Max/CR Classic with Easy View
display CR Systems
If a cassette jam occurs when you are using the CR 825/850/950/975/Max
CR/Classic CR with Easy View display Systems, open and close the front door
of the CR System. This resets the CR System hardware and clears most
cassette jams.
If the cassette fails to release, do the following:
1. At the Main Menu, select Scan Status.
2. Select System Recovery.
3. Select Clear Cassette Jam to reverse the movement of the transport
mechanism.
4. Select Release Cassette to move the cassette to the "home" position.
5. If the cassette is released, remove the cassette.
6. If the problem persists, call your Service Representative.
Classic/Elite CR Systems without Easy View display

1. Select the Local User Interface Utilities menu.
2. Select System Recovery.
3. Select Cassette Jams.
See also:
193
Scan Status
Scanner Error
If you receive an error on the CR screen while scanning a cassette, make sure
that the cassette is inserted properly and follow the instructions on the screen.
See also:
Cassette Jams
Resolving a Cassette ID Error
194
Scanning CR Cassettes Menu

Scanning on the CR 825/850 System
Scanning on the CR 950/975/Max CR System
Scanner Error
CR System Freeze-up
195
Resolving Cassette ID Errors

If you see the error Cassette ID Bar-code Read Failed, it means that the
internal bar-code scanner cannot read the cassette bar-code label. The cause is
most often a degraded bar-code label, not an issue with the equipment.
 Select cancel from the dialog box to eject the cassette and try to reinsert the
cassette.
or
Select the cassette type/size from the dialog box.
 Contact Service to repair the bar-code label.
If a duplicate Cassette ID is entered:

You will receive a warning message and must choose one of the following:
 Select Cancel New Image Information to use a different cassette for the exam.
 Select Cancel Old Image Information to remove the cassette ID from the
unacquired image in the previous study.
If the Cassette ID field turns red:
 The field turns red if the cassette ID is invalid. A valid cassette ID is a 10 digit
number that begins with the number 9.
See also:
196
Bar-Code Scanner
Entering Information with the Bar-Code Scanner
You can populate ANY field in the Modality using the bar-code scanner. Select a
data field and scan a bar-code to place its value in the field. The system is
capable of recognizing and automatically placing the values. This feature is the
system's ability to automatically recognize certain data fields and enter the
information without selecting that field in advance.
The Modality and the Bar-Code Scanner can:
 Expedite data entry by reading bar-codes for selected fields and place those
values into the fields.
 Automatically place the correct value in the correct field if you read an accession
number or Patient ID and the patient exam is opened automatically.
This includes:
 Accession #
 Patient ID
 Procedure Code
 Cassette ID
 Tech ID
 Automatically executes a local query to retrieve Work List or patient records that
match the value read.
See also:
Information Does Not Appear
Where Can I Use the Bar-Code Scanner?
197
Information Does Not Appear

Why doesn't the information appear when I use the bar-code scanner?
If the bar-code scanner beeps, it has read the bar-code successfully.
If the information does not appear or does not appear properly on the screen,
the bar-code scanner must be re-configured. The Key Operator can configure
the bar-code scanner.
Bar-Code Configuration Menu
If there is no beep, check to see if there is a:
 Hardware problem
 Unreadable bar-code (it if it is due to a blurred bar-code, move the bar-code
scanner closer or farther away from the bar-code label as you scan)
 Invalid bar-code
To determine if the bar-code scanner is functioning:

1. Press the trigger (if in manual trigger mode) while aiming the scanner at a sheet
of paper.
2. Look for the red scanning beam. If you can see the red scanning beam, the
device is working.
198
Remote Devices
Key Operator Functions > System Configuration > Remote Device
Configuration
Configuring Remote Devices

For the Key Operator to configure a Remote Operations Panel (ROP):
At each CR System:
1. Select New Device.
 Key Operator: Enter the IP address of the ROP.
 Key Operator: Select Remote Operations Panel as the device type.
 Key Operator: Repeat these steps for all Remote Operations Panels.
2. Select Edit ROP Links.
3. Enter the IP address of every CR System that will be linked to the ROP.
4. Select Save to All.
This adds all CR links to each ROP that you added in steps 2-4.
5. Select Delete Device to remove a device from the CR System.
At each ROP:
The initial link from the ROP to the CR System must have already been done by
a qualified installer.
1. Select the link to the CR System on which you just made changes.
2. Once the ROP is linked, select Key Operator Functions.
3. Select Fetch ROP Links.
This adds the new links you added in step 3 above.
4. Select the Quick Menu and select ROP Links to display the new links.
This button does not exist at the CR System or the ROP.
Navigational Buttons
Edit ROP Changes the configuration of the existing communication links between
Links ROPs and other devices. Takes you to the ROP Links Configuration
Screen.
Ping Lets you ping selected devices to verify their connection. If the ping is
Devices successful, a green indicator appears in the left corner of the table. If there
is no connection, the indicator turns red.
New Device Lets you add a new IP address.
Delete Lets you delete a device.
Device
Main Menu Exits the current screen and returns you to the system Main Menu.
Back Returns to the previous screen.
199
200

Configuration
Setting Up Remote Access to the CR or DR

System
1. At a Modality, from the Main Menu, select Key Operator Functions > System
Configuration > Remote Device Configuration.
2. Enter the IP address of the remote computer.
3. Select Remote Access Software for the Device Type.
5. Follow the instructions to install Remote Access Software on an appropriate
remote computer.
6. Select INTERNET EXPLORER at the remote computer and enter the IP
address of the Modality.
7. Add: 56333/ to the end of the IP address.
Example: http://192.168.1.1:56333/
8. At the firewall dialog, select Unblock.
At the Logon Screen:
 Log in as a Key Operator to access Remote Key Operator Functions.
 Log on as a Security Administrator to access Remote Security
Administrator Functions.
 Log on as a Technologist to access the Remote Patient Data Entry Screen.
(The Tech Log on button can be used if available.)
You must always enter :56333/ at the end of the IP address when setting up a
remote function.
To locate your System’s IP address, from the Main Menu, select Utilities, and
select the System Status Screen.
See also:
Easy to Use Remote Access Software
201

Configuration

Remote Access Software is a customer-installed software that lets you set up
and perform selected CR functions from a remote computer. These functions
include:
 Remote Key Operator
 Remote Patient Data Entry System (RPDES)
 Remote Security Administrator
To verify the system requirements for Remote Access Software:

The system requirements are:
 MICROSOFT WINDOWS XP Professional Operating System
 INTERNET EXPLORER V 6.0 or higher
 1.4 GHz Pentium M or higher processor
 512 MB Ram (1 GB Recommended)
 32 bit Color Monitor
 1280 x 1024 monitor display
To determine the differences between the remote computer and the CR

System:
When you log in remotely, the Main Menu will look different. The Study Data
menu and the Image Review menu will not be available.
The items you can access, depending on password, are described below:
Remote Key Operator Manage Patient Exam Records (delete records without
images)
Statistics (cannot view rejected images)
System Configuration (reduced features)
Backup & Restore (same as CR System)
Option Registration (same as CR System)
Remote Patient Data Entry Access to the Patient Input Screen to pre-populate the
System Work List.
Remote Security Access to all Security Administrator Functions.
Administrator
See also:
Exporting Data
Setting Up Remote Access
202

Configuration
Easy to Use Remote Access Software

Once you have set up Remote Access Software, you can create a shortcut to
Remote Access Software and place it on your desktop for easy access.
To create the shortcut:
1. Open MICROSOFT INTERNET EXPLORER.
2. With the address displayed, click and drag the MICROSOFT INTERNET
EXPLORER icon to your desktop.
3. Right-click the shortcut to rename it.
4. Double-click the shortcut to launch the remote connection.
See also:
Setting Up Remote Access
203
ROP Links Configuration

ROP Links Configuration lets you enter the IP address of a Remote
Operations Panel and set it up for communication with CR Systems. ROP Links
is accessed from the Remote Device Configuration Screen.
To enter a remote device:
1. Select the New Device button. The virtual keypad appears.
2. Enter the IP address of the remote device.
3. Select Edit ROP Links. The ROP Links Configuration Screen appears.
4. Select Add ROP Link to add the IP address of a CR System. An IP address
must have the format of X.X.X.X where X is a number between 0 and 255.
The CR Systems listed on the ROP Links Configuration Screen appear on
the ROP Links Screen on the Remote Operations Panel.
5. Select Delete ROP Link to remove a CR System from the ROP Links
Configuration Screen and the ROP Links list.
6. Select Save Changes or Save to All.
204
Key Operator Functions > Remote Devices
Administrative Analysis and Reporting Feature

The CR Administrative Reporting Templates workbook replaces all previous
versions. To transfer data from previous versions of the workbook to the new
workbook, do the following:
1. Open new workbook file on your computer.
2. Select Import Data.
3. Navigate to the data contained in the previous workbook.
4. Select Open and proceed with instructions to Overwrite or Append.
The EXCEL workbooks contain report templates for use with the Administrative
Analysis and Reporting Feature of DIRECTVIEW CR Systems. Select the
software option and the appropriate workbook for the data you want to report:
Required Software Workbook Purpose

Option
DIRECTVIEW Software V CR Admin Reporting Analyze and report general
5.1 Templates information about CR
Operations.
DIRECTVIEW Total Quality CR Admin Reporting TQT Analyze and report TQT
Tool (TQT) data.
The CR Admin Reporting TQT workbook contains reports designed for the
structure and content of the Total Quality Tool Software option only. Do not use
this workbook for other reports.
205
CARESTREAM CR Utilities Help
Utilities
Utilities Menu
The Utilities Menu is accessed from the Main Menu. On this Help Screen,
select the blue link in the table below to access the information for the desired
topic.
Quick Reference
Change Password Change Your Password
System Status System Status (Communications)
Software Updates Install Software Updates
Image Recovery Recover Images
Capture Link Status Capture Link Server Status
Scanner Configuration
Change the Scanner Configuration
207
Viewing the Status of System Communications

Use this screen any time your Service Representative requests a report. Status
of System Communications provides easy access to logs about the Modality.
To access the logs:
1. Select the tab that Service requests:
 Summary
 .NET CLR
 Hot Fixes
 Assemblies
 MIM Core
2. Select Snapshot Log Files. This button captures the current logs and dates
them so that when they are retrieved later, they will identify the status of the
system at that time.
To tell if communication to the HIS/RIS is open:
Go to the Summary Tab and check the lights on the Device Column. If the light
is green under HIS/RIS, the Modality is communicating with the HIS/RIS.
To select the Log Files Snapshot button:
Select this button any time there are issues with the Modality performance, and
every time you need to call Service.
To view the status of the prior image retrieval job queue:
Here the user can clear the outstanding requests in the queue.
208
Changing Your Password

You can change your password at any time. Remember to create a password
that conforms to the number and type of characters set for passwords in your
facility by your Security Administrator.
To change your password:
1. At the Main Menu, select Utilities.
2. Select Change Password.
3. Enter your old Password.
4. Enter your new Password.
5. Confirm your new Password by entering it again (exactly the same way).
6. Select the Change Password button.
What if I have forgotten my password?
Contact the Security Administrator. Your Security Administrator can reset your
password so that you can change it if needed.
209
Register Badge
1. Log in to the system.
2. Navigate to Utilities>Register Badge.
3. To log in using your proximity badge for the first time, follow these steps (this
procedure assumes you have already have a user account.):
4. Touch Register Badge.
5. Scan your badge by swiping it across the badge reader.
6. When the system reads your badge you will hear a beep.
7. When asked if you want to associate the badge to your account, touch OK.
8. Follow the on-screen instructions to register your proximity badge.
Once configured, the user can log in by passing the badge across the reader,
.without entering their User Name and Password on the Log on screen.
The user will log out the previous user when using this feature.
See also:
Proximity Badge Configuration
210
Key Operator Software Installation Instructions

Software updates are sent to the modality from a remote location by your
Service Representative. You will know when updates are available and have
been sent for installation when an Updates Available button appears on the
Main Menu. In addition, archived software updates are kept stored on the
Archived Tab.
To install software updates:
1. From the Main Menu, select Utilities.
2. Select Software Updates.
3. At the New Software Updates Screen, check the red or green color bars at
the top of the screen.
4. When the Ready to Install light turns green, select Install Update.
To understand the light code:
 Ready to Install, green light—The prerequisites have been met for this
update.
 Prerequisites Not Met, red light— Further action required before this
installation can begin.
To install software updates from a CD or USB drive:
 If the updates are delivered on a CD or a removable USB drive, insert into the
appropriate drive, select Find on Removable Media, and then select Install
Update.
To meet software installation prerequisites:
1. View the Prerequisites on the lower half of the screen.
2. See which updates were installed.
3. Call Service.
To delete a software update:
 Select the update file name and select the Delete Update button.
To uninstall a software update:

 Select the update file name and select the Uninstall Update button.
You must be logged in as a Key Operator to install software updates.
For information about installing firmware upgrades, see Key Operator Firmware
Upgrade Instructions .
211
Key Operator Software Upgrade Instructions

This upgrade process converts the DIRECTVIEW CR System Software V 5.4
Software to V 5.6 Software, and restores customer configurations. This upgrade
process takes up to 45 minutes.
Notice:
 Read these instructions entirely before starting the upgrade.
 Make sure all images are assigned and delivered, since the upgrade deletes
all patient and image data.
Upgrade Procedure
1. Remove all removable media (DVD, flash drive, and so forth).

2. Log in as a Key Operator.
3. At the Main Menu, insert the supplied DVD.
4. Select Utilities.
5. Select Software Updates.
6. From the Software Updates screen, select the Find Removable Media
button.
If the system fails to find the DVD, remove the DVD, reboot the system, and
begin the upgrade procedure again.
7. Wait until the files are copied from the DVD to the computer, approximately
10 minutes.
8. At the pop-up message “One new update is found,” select OK.
9. If the update is successful, the upgrade executable (.exe) appears on the list.
Select it.
10. Select the Install Update button. Disregard any system settings pop-
up dialog boxes. They are automatically dismissed during the upgrade
process.
Important:The DVD ejects automatically. Remove the DVD from the tray
immediately and select OK.
When the upgrade is complete, the system will restart three times. The V 5.6
Login screen appears when the upgrade is finished.
Troubleshooting
 If the upgrade is unsuccessful, a message appears stating the system will revert
to the V 5.4 software. The system will reboot and return to the V 5.4 logon
screen.
212
 If the upgrade begins to go into a loop, repeating and not continuing, check to
see that the DVD is still in the computer. Remove the DVD and the installation
will continue normally.
Post Installation Procedure

1. Re-calibrate the touch screen monitor. See Calibrating the Touchscreen
Monitor.
2. Activate the System Software V 5.6 using the enclosed instructions.
For information about installing software updates, see Key Operator Software
Installation Instructions.
213
Select USB Destination

This feature lets you register a USB flash drive with the CR or DR system, and
transport an image to a destination such as a PACS by physically carrying the
image. This is useful if the connection to the PACS is down.
A standard USB flash drive is required.
A USB destination must be configured for the USB device in the Select
Destination screen.
Delivering to a USB device will update the status of the image to Delivered.
To register the flash drive

1. Navigate to Utilities>Select USB Destination.
2. Insert a flash drive into a USB port on the CR/DR computer.
The flash drive appears as an available device on the Select USB Destination
screen.
3. Select the row where the device appears.
4. Select the Associate Selected Device button.
This registers the flash drive with the system and allows it to be recognized any
time it is used.
It is not necessary to do this step again unless a new flash drive is used.
The flash drive can now be used to transport images as a selected destination.
The screen provides the following information automatically, assigning it by

reading from the flash drive:
Currently Associated Device:
Device Name
Device Status
Drive Letter
Size
Free Space
Image Storage Estimate
Total Space
Usage
See also:
Destination Profile Configuration
214
Image Recovery on the Capture Link System

When the Modality is configured for the Capture Link System but is not yet
joined, it is in Standalone mode. A console is fully functional in Standalone
mode. You can operate a Modality in Standalone mode if the Capture Link
Server becomes unavailable and the individual Modality remains joined.
If the Modality is no longer joined to the Capture Link Server, you do not lose
access to the images that are located on the hard drive of each Console.
However, the link between the image and its patient/exam data is broken, and
must be restored before the image can be reviewed or delivered.
To restore the link between an image and its patient/exam data when the
machine has switched to Standalone mode:
1. From the Main Menu, select Utilities and Image Recovery.
The following data appears in a row for each image:
 Accession Number
 Patient ID
 Acquisition Date and Time
 View Name
2. Select the row(s) that represent the images you are looking for.
3. Select Recover Checked Images.
The Modality attempts to associate the image to a patient/exam.
If the Modality cannot automatically associate the image to a patient/exam,
the image will be unassigned.
See Assigning an Image
For unassigned images,
1. Re-create the patient/exam image record (Query the local or remote Work List
or enter data manually at the Patient Input Screen).
2. Assign the image to the patient and exam.
3. The data listed above appears in a row for each image.
To restore the association between an image and its patient/exam data
when the machine has returned to Capture Link Mode select Main Menu >
Utilities:
See: Image Recovery to Capture Link
1. Use the filters to select the images in the system: All Studies, Need Approval,
Unassigned Images, Failed Delivery, Pending Delivery, Need Destination, or
Delivered Images.
You can sort by Patient Last Name, Patient ID, Accession Number, Tech ID,
or Acquisition Date.
215
If you are in a Standalone mode and then join the Capture Link System, an
image on your system will not be visible or accessible unless you use the Image
Recovery to Capture Link utility.
The recovered image is retrieved but unassigned to a patient/exam record if
there is no match of the Accession Number and Patient ID.
3. Select a patient record from the RIS or create one manually.
4. Assign the image.
See also:
Rejoining the Capture Link System
Re-delivering an Image
Using Image Recovery to Capture Link List
216
Using the Capture Link Server Status Screen

The Capture Link Server Status Screen quickly lists what machines are
connected to the Capture Link System, or what the network communication
statuses of those systems are. To access it, from the Main Menu, select
Utilities.
To determine which devices are in the Capture Link System:
View the Capture Link Server Status Screen list of the names and IP address
of each machine Console and server configured for the Capture Link System.
Remote Operations Panels and other external devices are not listed.
To determine whether there is a Capture Link connectivity problem:
 Select Ping Devices.
o If there is a good connection, the light appears green.
o If there is a problem with the connection, the light appears red.
To determine which types of connections you can check:

 Network
 Application
 Database
217
Viewing the Status of System Communications

Use this screen any time your Service Representative requests a report. Status
of System Communications provides easy access to logs about the Modality.
To access the logs:
1. Select the tab that Service requests:
 Summary
 .NET CLR
 Hot Fixes
 Assemblies
 MIM Core
2. Select Snapshot Log Files. This button captures the current logs and dates
them so that when they are retrieved later, they will identify the status of the
system at that time.
To tell if communication to the HIS/RIS is open:
Go to the Summary Tab and check the lights on the Device Column. If the light
is green under HIS/RIS, the Modality is communicating with the HIS/RIS.
To select the Log Files Snapshot button:
Select this button any time there are issues with the Modality performance, and
every time you need to call Service.
To view the status of the prior image retrieval job queue:
Here the user can clear the outstanding requests in the queue.
218
CARESTREAM Key Operator Help
Key Operator Functions Menu
Select a blue link below for quick access to these Key Operator Functions.
Managing Patient Exam Records
Statistics
Monitor Configuration
Auto Download
System Configuration
Flagged Image List
Capture Link Configuration
Backup and Restore
Option Registration
Total Quality Tool
CSA Log Viewer
219
System Configuration
System Configuration Menu
Touch a blue link for quick access to System Configuration Help.
 View Configuration  Bar Code Configuration

 Scanner Options  Delivery Preferences
 Image Processing Preferences  HIS/RIS Configuration
 Destination Profile Configuration  Regional Configuration
 Procedure Mapping Configuration  Customizable Field Descriptions
 List Configuration  Long Length Configuration
 Reject Reasons  System Maintenance
 Destination Configuration  Automatic View Selection
 Layout Configuration  Trauma Defaults
 Configurable Text Boxes  Display Configuration
 Remote Device Configuration  Color Preferences
 RIS/PACS Web Page  Proximity Badge Configuration
Configuration
 Import Tutor Images  Prior Images Configuration
 Network Configuration
220
RIS/PACS Web Page Configuration

Navigate to Key Operator Functions>System Configuration>RIS/WEB Page
Configuration.
The Key Operator can configure the System to connect to any Web URL, inside
or outside the facility network.
When connected to a RIS or PACS, the user can do any function remotely that
the server allows.
Add Link button

Select to begin.
Display Name text box

Select and enter a name that will be easily recognizable to the user.
Web Page URL text box

Select and enter a URL.
Remove Link button

Select a link and select the Remove Link button to remove a link from the list.
Save Changes.
Once the link is configured, the Display Name appears on the Quick Menu
(shortcut menu) and remains until the link is removed.
221
2D Bar Code Programming

Navigate to Key Operator>System Configuration>Bar Code
Programming>2D Bar Code Scanner Configuration.
The 2D bar code scanner changes dots and lines on a bar code into meaningful
characters. Bar code programming parses the characters into useful data that is
used by the modality to populate patient information fields.
The 2D bar code scanner reads both 1 dimensional (1D) and two dimensional
(2D) bar codes.
For the Carestream 2D bar code option, 2D bar codes can be read only by the
2D bar code scanner provided by Carestream.
The System software is configured to read Health Industry Bar Codes (HIBC)
and character delimited bar codes. You should know which type of bar code
your facility is supplying before configuring the scanner.
The 2D bar code scanner works wirelessly. The user associates the scanner
with the IP address of a Bluetooth adapter that is inserted into a USB port on the
modality's computer. The user pairs the scanner with the IP address of that
adapter. If the adapter is moved to another modality, the configuration must be
done again.
The 2D bar code scanner is used with the Patient Verification feature.
Procedure to program the 2D bar code scanner:

1. Insert the Bluetooth adapter into a USB port on the System computer.
2. Navigate to Key Operator Functions>System Configuration>Bar Code
Programming>2D Bar Code Programming.
3. You will scan three screens of bar codes to configure the scanner and
associate it with the modality. Scan all of the bar codes on all three screens,
starting with the first bar code in the upper left on the first screen. Scan the
bar codes from left to right and top to bottom, in order, on each screen.
The scanner LED will glow red and beep as each scan takes place, and emit
a green light when it is ready for the next scan. (Some bar codes take longer
to read than others.)
Ambient light and the display settings for the monitor can prevent you from
successfully scanning on-screen bar codes. Increase the brightness and
contrast of the monitor if necessary and point the reader straight at each bar
code.
222
1. RF Factory Reset
2. Clear all stored data
3. Clear prefix and suffix
4. Save settings
5. QR On
6. Do not go to sleep
7. No Store Data
8. Save settings
4. Select Next Page.

The bar codes on the third screen are generated by the modality, and are
specifically associated with the installed Bluetooth adapter.(If the adapter
was not inserted into the USB port, this screen would not appear.)
5. Scan the Bluetooth connection and Save Settings bar codes.
When the connection is successful, the scanner will emit a slowly flashing
blue light.
6. Select the Pair with Scanner button to authorize the connection. The scanner
will beep and flash a green light.
The message Authorization successful appears.
7. Proceed to Multiple Field Bar Code Formatting.
See also:
2D Bar Code Samples
Fixed Mount Bar Code Programming
223
Multiple Field Bar Code Formatting

Navigate to Key Operator Functions>System Configuration>Bar Code
Formatting>Multiple Field Bar Code Formatting.
The Key Operator configures the System software to interpret the data scanned
from a 2D bar code on a patient's wristband. The software formats the bar code
data into information that is used to populate patient information fields on the
Patient Input and Work List screens.
The user needs to know which bar code format the facility uses before
configuring the reader to recognize and populate certain DICOM fields, and
must have configured the scanner to use it with the system.:
See 2D Bar Code Programming for more information about configuring the
scanner..
An HIBC bar code displays a standard list of fields. If your facility is using HIBC
bar codes, you will select the HIBC tab. See Using the HIBC Tab.
A character delimited bar code displays the text with delimiting characters that
separate the data that will appear in each field. It might appear as the following
example, where | is the delimiter:
|Johnson | Robert | 123456 | 23423480 | M | meaning:
| Patient Last Name | Patient First Name | Patient ID | Accession Number |
Gender | and so forth. See Using the Character Delimited Tab.
Using the HIBC Tab

Using the Character Delimited Tab
See also:
224
Using the HIBC Tab

This procedure assumes that you have configured the bar code scanner to work
with the modality. See 2D Bar Code Programming for information about
configuring the scanner.
If the facility creates its bar code using the Health Industry Bar Code (HIBC)
standard, do the following:
1. Navigate to the Key Operator Functions>System Configuration>Bar

Code Configuration>Multiple Field Bar Code Formatting>HIBC tab.
There are two list boxes on the screen. The top list box has three columns:
HIBC Field DICOM Field Test Scan Data
 The HIBC Field column is a standard list of all HIBC fields. It is fixed and
filled in by default. It lists all of the fields in the HIBC bar code in
alphabetical order.
 The DICOM Field column is a list of the data that is used by Carestream to
populate patient demographic fields.
 The Test Scan Data column is the result of an actual scan of the test 2D bar
code.
The second list box, DICOM Field, contains a list of all DICOM fields
Carestream uses in its Patient Input and Work List screens.
The objective is to map the DICOM data with the corresponding fields in the
HIBC column.
Several common fields are mapped for you by default, such as Date of Birth,
Last Name, Middle Name, First Name, and so forth.
Procedure:
1. Scan a patient wristband 2D bar code to create a list of test data. The Test
Scan Data column populates with data from the bar code.
2. Compare the known values in the HIBC column with the corresponding
values in the Test Data column.
 If data in the HIBC field, the DICOM Field, and the Test Data field match, the
configuration is complete.
225
 If the DICOM Field does not match the Test Data field and the HIBC field, select
the correct DICOM field from the bottom DICOM Field list box and select the
Assign Field button to map it correctly.
 Remove a field by highlighting it and selecting the Unassign Field button.
If you want to map an HIBC field with a different DICOM field:

1. Select the HIBC field to highlight it.
2. Select the DICOM field from the DICOM Field list box.
3. Select the Assign Field button.
See also:
226

This procedure assumes that you have configured the bar code scanner to work
with the modality. See 2D Bar Code Programming for information about
configuring the scanner.
Navigate to Key Operator Functions>System Configuration>Bar Code

Configuration>Multiple Field Bar Code Formatting>Character Delimited
tab.
Character delimited bar codes do not appear in a standard format. They can
contain any information, in any order. We can scan these codes and configure
the System so that the data we require displays in the order we need to populate
the Patient Input and Work List screens. To do this, we configure the system
to interpret character delimited bar codes.
Procedure:
1. Viewing the Character Delimited screen, scan a test bar code. The
information appears in the Test Scan Data text box.
2. Identify the delimiter and enter it in the Delimiter Character text box. This
notifies the system that the data is parsed by that character. The default
delimiter is |.
For example, the data may appear |Johnson | Robert | 123456 | 23423480 |
M | meaning:| Patient Last Name | Patient First Name | Patient ID |
Accession Number | Gender |
3. From the DICOM Field list box, select the first field that appears in the test
data string.
In our example, it would be Patient Last Name. Use the right arrow to move
it to the top position in the Configured Fields list box. Patient First Name
would follow in the list.
The order is important. Follow the test data string and map the
corresponding fields in the order that they appear.
If an item in the Test Scan Data string is not used by Carestream, does not
make sense, and/or does not appear in the DICOM Field list, scroll down the list
and select Unmapped Field and move it into the Configured Fields list box.
The unmapped field acts as a placeholder, and when the system parses the
data, that field will be ignored.
227
4. Enter the Gender term that appears in the Test Scan Data text box as
described above.
5. Select Save Changes when done.
6. Confirm your configuration by viewing the format of the data in the Data
parsed from Test Scan text box.
7. Save Changes.
Functions:
DICOM Field list

 Lists all of the data fields used for Carestream patient input data fields.
Configured Field list
 Lists all fields mapped to the character delimited format bar code..
Delimiter Character text box
 Displays the character delimiter that separates the test data fields. (*), (|), and so
forth.
Test Scan Data text box
 Displays the actual code that the 2D bar code reader detects from the test scan.
Data parsed from test scan text box
 Displays the result of your configuration.
 Use the data in this text box to confirm that the data appears as you expected.
Gender Mapping text boxes
 Should display the term used for Gender from the Data parsed from test scan
text box. Any text other than the text used to indicate gender will map to "other."
See also:
Using the HIBC Tab
228

A fixed mount bar code reader is hard-wired to the unit, and is used to read bar
codes on requisition forms. It is used only with Mobile DR systems.
To program a fixed mount bar code reader, simply navigate to Key Operator
Functions>System Configuration>Bar Code Programming>Fixed Mount
Bar Code Programming. Open the screen and touch the appropriate button for
each category.
The default setting you choose will remain in effect until the settings are
changed.
Automatic Trigger
 Auto Trigger
 Always On
Beeper Mode
 Beep Off
 Low Volume Beep
 Medium Volume Beep
 High Volume Beep
 Extremely High Volume Beep
Reread Delay
 None
 Short
 Medium
 Long
 Extra Long
See also:
229
Bar-Code Configuration
Key Operator Functions > System Configuration > Bar-Code Configuration
Programming the Automatic Trigger

The Automatic Trigger lets you program the bar-code scanner to be on all of
the time, or to be on only when you touch the manual trigger.
Scan the bar-code listed for the operational mode you choose.
To program the hand-held bar-code reader to its operational mode:
 Scan the Automatic Trigger bar-code if you want the scanner on all of the time.
 Scan the Manual Trigger bar-code if you want the scanner LEDs off until you
touch the trigger.
See also:
Bar-Code Programming Samples 5
How to Configure a Bar-Code
230
Bar-Code Configuration Menu

Bar Code Configuration
Bar-Code Programming
Multiple Field Bar Code Programming
231
Key Operator Functions > System Configuration > Bar-Code Configuration > Bar-
Code Configuration
1. On the Bar-Code Configuration Screen, enter the Prefix, Data, and Suffix
information.
3. At the Bar-Code Configuration menu, select Bar-Code Programming.
4. Select a category of information that displays sample bar-codes.
5. Scan the appropriate bar-code to configure the bar-code scanner for each
change.
You can configure the bar-code to get the result you desire. The selections you
make on the Bar-Code Configuration Screen add or subtract information that is
read from the Bar-Code.
For example, if the bar-code is a series of characters such as Pid00001-XX and
you need to change it to 01, the following three options are available to you on
the screen:
Field Strip Size Strip Prefix Data Strip Suffix Strip Size
Size
Patient X 3 X 000 2 X - X 2
ID
Patient X 6 2 X 3
ID
Patient X Pid000 2 X -XX
ID
How do I know what will be stripped out?

When you designate Strip, the action is performed from left to right on the Bar-
Code Configuration Screen.
How do I configure for the other fields?
The rules apply the same way for the Accession Number, Tech ID, and
Procedure Code fields.
What if all of the fields have the same number of digits?
If the fields contain the same number of digits (Prefix strip size + Data size +
Suffix strip size), then the first field name appears in the Test Field.
What do I do if the Patient ID is the same length as the Cassette ID?
If there is a conflict with the 10-digit Cassette ID field and a field that is 10
characters in length.
232
1. Go to Main Menu > Key Operator Functions > System Configuration > Bar
Code Configuration > > Bar-Code Configuration.
2. Select: Add # to Cassette IDs to make them 11 digits.
3. Select Save Changes
4. The You must reprogram the bar-code scanner after changing the
Cassette ID Format Must reprogram bar-code scanner Notification pop-up
message appears.
5. Select OK.
6. Return to Bar-Code Programming > Prefix& Suffix and reprogram the bar-
code reader.
See also
How to Strip Middle Characters from a Bar-Code
Changing the Prefix and Suffix
Bar-Code Programming Samples
233
Key Operator Functions > System Configuration > Bar-Code Configuration > Bar-
Code Programming
1. Select the feature you wish to program.
2. Scan the sample bar-code for that feature with the hand-held bar code reader.
See also:
Country Code
Prefix and Suffix
Automatic Trigger
Beeper Mode
Reread Delay
Do not scan the test bar-code more than once. If you scan it twice, it will fail.
If you change the Cassette ID format, the country code, or bar code reader
prefix or suffix characters, then you must program the Bar-Code Scanner.
234
How to Change the Beeper Mode

This screen lets you change the sound that the hand-held bar-code scanner
makes.
1. Select a volume level and scan the appropriate bar-code.
 High (default)
 Low
 Medium
 Off
2. Select a tone and scan the appropriate bar-code.
 Normal Beep (default)
 Short Beep
If the scan is successful, the scanner will emit a tone. If it is not successful, it will
emit a buzzing sound.
See also:
235
How to Change the Cassette ID format

If the Cassette ID bar-code format (normally 10 digits in length) conflicts with
other bar-codes in use, you can change the bar-code format to an 11-digit
format.
1. Select the Add # to Cassette IDs to make them 11 digits check box.
The You must reprogram the bar code scanner after changing the
Cassette ID Format message appears. You must reprogram bar-code
scanner when this notification message appears.
3. Select OK
4. Select Back.
5. Select Bar-Code Programming.
6. Select Prefix & Suffix.
7. Scan all of the bar codes on the Add Prefix and Add Suffix pages.
See also:
236
Changing the Country Code

The Country Code selection changes the language of the headings on the Bar-
Code Programming Screen. A reboot is required to make this setting function
properly.
1. On the Bar-Code Configuration Screen, select the Country Code data box.
2. Select the country where the CR or DR System resides.
4. Select Back, then select Bar-Code Programming.
5. Select Country Code.
6. Use the bar-code scanner to scan the Country Code, the Country, and the
Save bar-codes.
7. Scan the Program Country Code.
Program Country Code

8. Scan the numeric bar-code sample for your country.
Country Code Scan Country Scan
Code
Belgium 1 Italy 5
Denmark 8 Norway 9
Finland 2 Spain 10
France 3 Switzerland 6
Germany/Austria 4 USA (Default) 0
United Kingdom 7
9. Scan Save to program the keyboard for your country.
Save
237
Generally, the following characters are not supported by the scanner for
countries other than the U.S.:
@| $ # { } [ ] = / ' \ < > ~
You can make all of your changes on the Bar-Code Configuration Screen and
then select Save Changes when finished.
See also:
238
Changing the Data Field Size

1. On the Bar-Code Configuration Screen, select the Data Size field.
2. Enter the number of characters that you want the data size to be.
You can make all of your changes on the Bar-Code Configuration Screen and
then select Save Changes when finished.
See also:
239

Prefixes are characters (up to ten digits) preceding data which serve as mapping
keys. Bar-codes read into the system containing these prefix characters will
populate into the designated field on the Patient Input and Patient Query
screens.
For example, configuring the Accession Number on the Bar-Code Configuration
screen via Key Operator Functions > System Configuration > Bar-Code
Configuration as such:
 Strip enabled (checked)
 prefix as "ACN"
 Data size of "6."
When you have configured the bar-code (Bar-Code Configuration Screen) so
that the Prefix or Suffix is not used, or an alternate prefix and suffix are used,
you must program the scanner to use the new configuration instead.
How to enter data on the Bar-Code Configuration Screen:
1. For each field, enter the desired Prefix and Suffix Character formats, if any,
and set the Data Size field.
2. Select a field and use the keyboard to enter the data.
3. Enter the number of characters you want to accept in the Data Size field.
4. Select Strip if you want to remove the field when it is read by the bar-code
scanner.
5. Select Save Changes and then select Back.
6. Select Bar-Code Programming, then select Prefix and Suffix.
7. Scan the Clear all Prefix or Clear all Suffix bar-codes.
How to add a prefix or suffix:
1. Scan all of the bar-codes on the Add Prefix or Add Suffix page.
2. Scan the Save bar-code.
Leave the Data Size field blank if you want to accept any size data.
Test the Cassette ID to ensure that there are no bar-code conflicts.
See also:
240
Configuring Reread Delay

To configure the time delay allowed between reading the same bar-code, select
the following and scan the appropriate bar-code:
 Short (default)
 Medium
 Long
 Extra Long
This feature is only available in Automatic Trigger Mode.
See also:
Trigger Modes
241
Stripping a Bar-Code Field

A bar-code may contain Prefix and Suffix information that must be removed.
For example, the bar-code below may be identified as
(BNM,/?<12345678<()\+).
Prefix Data
See also:
How to Change the Prefix and Suffix
242
Stripping Middle Characters from the Bar-Code

You can configure the bar-code to produce the results you desire.
When you designate Strip, the action is from left to right on the Bar-Code
Configuration Screen.
For example, if the bar-code is a series of characters such as ABC-01752-001

and you need to change it to AC-01752-1, do the following:
Field Strip Size Strip Prefix Data Strip Suffix Strip Size
Size
Accession 1 X B 8 X 00 1
Number
Legend:
Prefix = B
Data = AC-01752-1
Suffix = 00
See also:
Using the Bar-Code Configuration Screen
How to Change the Prefix and Suffix
243
Using the Bar-Code Configuration Screen

The default bar-code that a medical facility uses may not automatically place the
patient data in the correct fields on the Patient Input Screen. You can use the
Bar-Code Configuration Screen to change the way the bar-code scanner
identifies the following:
 Tech ID
 Patient ID
 Procedure Code
1. Select the bar-code device:
USB as Serial PS2 to USB Keyboard Serial Scanner
Keyboard Wedge PS2 Keyboard None
2. Select the serial COM Port:
COM1 COM2 COM3
COM4 COM5 COM6
The CR or DR system supports the following type of bar-codes:

Code 128
This example of a 128 bar-code indicates a Prefix of -+@# and a data set of
1234567801234.
By configuring the bar-code, you can output only the Data portion of the code
1234567801234.
See also:
How to configure a Bar-Code
244
Programming the Serial Bar-Code Reader

Programming PS2 Keyboard Bar-Code Reader
Programming the PS2 Keyboard Bar-Code Reader 2
Programming the PS2 to USB Keyboard Bar-Code Reader
Programming the PS2 to USB Keyboard Bar-Code Reader 2
245
Program Country Code
Clear All Prefix
Clear All Suffix
Test Code
Add Prefix
246
Add Suffix
< Next >
247
Bar-Code Programming Samples (Page 2)
Number 0
Number 1
Number 2
Number 3
Number 4
248
Number 5
< Previous | Next >
249
Number 6
Number 7
Number 8
Number 9
Save
< Previous | Next >
250
Bar-Code A
Bar-Code B
Bar-Code C
Bar-Code D
Bar-Code E
Bar-Code F
251
< Previous | Next >
252
Code 39 Full ASCII On
Automatic Trigger
Beep Tone Normal
Code 39 Full ASCII Off
Manual Trigger
Beep Tone Short
253
< Previous | Next >
254
Reread Delay Short
Reread Delay Medium
Reread Delay Long
Reread Delay Extra Long
< Previous | Next >
255
Beep Volume High
Beep Volume Medium
Beep Volume Low
Beep Volume Off
< Previous >
256
Programming the Keyboard Wedge Bar-Code

Reader
Scan the bar-codes in the following order: left to right and top to bottom.
Standard Product Keyboard
Defaults
Wedge
Add Prefix 9
9 0
4 0
4 0
4 Save
Add Suffix 9
257
9 0
4 0
4 0
4 Save
258
Programming the Keyboard Wedge Bar-Code

Reader and Add Suffix
In addition to Programming the Keyboard Wedge Bar-Code Reader, if the Add #
to Cassette IDs to make them 11 digits check box is checked, scan the
following bar-codes in order (left to right, top to bottom). This only affects
Carestream Health Cassette ID bar-codes, which are Interleaved 2 of 5 bar-
code types.
Add Suffix 6
5 2
3 0
4 0
4 0
4 Save
259
Programming the PS2 Keyboard Bar-Code

Reader
Scan the bar-codes in the following order: left to right, top to bottom.
Standard Product Defaults Emulate Keyboard
Add Prefix 9
9 0
4 0
4 0
4 Save
Add Suffix 9
260
9 0
4 0
4 Save
261
Programming the PS2 Keyboard Bar-Code

In addition to Programming the PS2 Keyboard Bar-Code Reader, if the Add # to
Cassette IDs to make them 11 digits check box is checked, scan the following
bar-codes in order (left to right, top to bottom). This only affects Carestream
Health Cassette ID bar-codes, which are Interleaved 2 of 5 bar-code types.
Add Suffix 6
5 2
3 0
4 0
4 0
4 Save
262
263
Programming the PS2 to USB Keyboard Bar-Code

Reader
Scan the bar-codes in the following order: left to right, top to bottom.
Standard Product Defaults Emulate Keyboard
Add Prefix 9
9 5
B Save
Add Suffix 9
9 5
D Save
264
265
Programming the PS2 to USB Keyboard Bar-Code

In addition to Programming the PS2 to USB Keyboard Bar-Code Reader, if the
Add to Cassette IDs to make them 11 digits check box is checked, scan the
following bar-codes in order (left to right, top to bottom). This only affects
Carestream Health Cassette ID bar-codes, which are Interleaved 2 of 5 bar-
code types.
Add Suffix 6
5 2
3 5
D Save
266
Programming the Serial Scanner Bar-Code

Reader
The Serial Bar-Code Reader must have two connectors: one for the serial port
and one for power (such as a PS2 connector).
1. Scan the following bar-codes left to right, top to bottom.
Standard Product
Defaults
Serial Port
9600 Baud, 7 Data Bits, 1 Stop Bit, Even Parity
2. If the Add # to Cassette IDs to make them 11 digits check box is checked,
scan the following bar code.
Add # Suffix for Interleaved 2 of 5 via Data Formatter
267
Programming the USB as Serial Bar-Code Reader

1. Scan the bar-codes in the following order:
Standard Product Defaults
USB Emulating Serial Port
2. If the Add # to Cassette IDs to make them 11 digits check box is checked,
scan the following bar-code.
Add #Suffix for Interleaved 2 of 5 via Data Formatter
268
HIS/RIS Communications Configuration

Key Operator Functions > System Configuration > HIS/RIS Configuration
How to Configure for a Polling Query

A polling query lets the CR System communicate with the Radiology
Information System (RIS), to display the patient Work List. You can also query
the RIS for individual patients.
To configure a Polling Query:
1. Set up the type of query and interval to the PACS Broker:
2. Modify HIS/RIS Options:
HIS/RIS Options
HIS/RIS Options
At the Key Operator Functions menu, select System Configuration, HIS/RIS
Broker Configuration, and then select HIS/RIS Options.
PACS Common Configuration
HIS/RIS AE Title Broker Name, normally BROKER
HIS/RIS IP Address PACS Broker IP Address
HIS/RIS Port PACS Broker Port, normally 3320
Enter the information for your system and select Save Changes.
Other HIS/RIS Options

1. Select the check box to automatically delete canceled studies from the system
when the status is Cancelled.
2. Select the check box again to clear it if you do not want this action.
3. Select the check box to send the Scheduled Workflow MPPS Command
(optional feature).
The selection for the following list is determined by the Procedure Mapping
configuration of the HIS/RIS Broker. To change selections, the Broker must be
reconfigured.
HIS/RIS Procedure Mapping
DICOM Field Name DICOM Tag Requested Procedure
Code Sequence
Procedure ID (0040, 1001) NA
269
Procedure Code (0032,1064) (0008, 0100)

Scheduled Procedure Step (0040, 0100) (0008, 0100)
Sequence, (0040, 0008)
Performed Protocol Code
Sequence
The purpose of this screen is to select which RIS is used with CR Procedure
Mapping.
If you enable your system for Scheduled Workflow, PerformedProtocol Code is

selected automatically, and is not configurable.
Navigation Buttons
Main Menu Exits the current screen and returns you to the system
Main Menu.
See also:
See also:
270
Key Operator Functions > System Configuration > HIS/RIS Configuration > HIS/RIS
Polling and Remote Query

The Modalities utilize DICOM Work List Management to receive study
information from the hospital’s HIS/RIS.
The Remote Query, Polling, and Options Tabs let you set up your System to
communicate with the HIS/RIS in any combination of the tables in the following
links:
Remote Query
Remote Query Active Select to permit a Query of the HIS/RIS from the CR or DR
System.
Modality Select the modality: CR, DX, RT, All
Filter by Station Name Select either Station Name or AE Title to filter the information.
Only records that contain matching data in these fields appear.
Filter by AE Title Select either Station Name or AE Title to filter the information.
Station Name/AE Title Enter your station names or AE Title.

The system retrieves records that contain only the names
specified.
The system sends an immediate request for records to the hospital's HIS/RIS
system, queried from the Patient Query Screen.
Polling
Poll Model Active Select to activate Polling Configuration.
Modality Select the modality: CR, DX, RT, All
Filter by Station Name Select either Station Name or AE Title to filter the information.
Filter by AE Title Select either Station Name or AE Title to filter the information.
Station Name/AE Title Enter your station names or AE Title.

The system retrieves records that contain only the names
specified.
271
The System requests records at a defined interval, filtered by modality, station

name, A/E title, and date and time. Carestream Health recommends
approximately 100 records per poll.
Polling Interval
 Hours Before Current Time.
 Hours After Current Time.
 Minutes Between Search Updates.
Initial search time: (default is ± 12 hours from the current time, range 1 - 48
hours). Only records that have a date and time that falls in this range appear.
272
Configurable Text Boxes

Boxes
Single Image Internal Text Box

Multi-format Image Internal Text Box
Single Image External Text Box
Multi-Format Image Text Overlay
Multi-format Page Footer
Configurable Text Box Options
273

Boxes
Configuring Text Boxes

Selecting a Text Box
Editing a Text Box
Selecting a Default Multi-Format Text Box
Configurable Text Box
274

Boxes
Editing a Text Box

At the top of each Text Box Editor screen is a template for the text box you have
selected.
 Data fields are represented by question marks: ???????????????
 The maximum width and height of the text box are listed in the background next
to the sample box.
How do I activate the next or prior available field?
Select a field. The question marks (??????????) should be highlighted.
Or, select the Move Next and Move Prior buttons.
How do I edit the fields in the text box?

1. Select a field you would like to change.
The question marks (???????????) should be highlighted.
2. Select the DICOM Field box.
3. Assign a label that comes before the DICOM value.
4. Select Assign Field.
The new DICOM name and tag are added for you.
Optional: If a field is optional and it does not have a value, then the field is
removed from the text box. If all of the fields on a line are optional and blank,
then the text box will get shorter. This is useful if you want to include a field such
as Image Comments in the text box when it has a value, but you do not want to
make the text box unnecessarily large (for example, for the time when there are
no comments).
How do I add a field?

1. Select a field to use as a reference point.
The question marks (???????????) should be highlighted.
2. Select New Field Before or New Field After.
A field of one character appears before or after your selection.
3. Select the Field Length box.
4. Enter the desired length of the field from the keyboard.
5. Select the DICOM Field box.
6. Select a DICOM Field Name.
7. Select Assign Field.
275
8. Select the Text Field Label box.

9. Assign a label that comes before the DICOM value.
How do I add a row if the buttons are gray?
If you have the maximum number of rows, the Add Row buttons will not be
active.
Delete an unnecessary field to add a row, or select a different text box.
Can I reset the text box after I have changed it?

Select Restore Small Default or Restore Large Default to return the text box
to it's minimum or maximum configuration.
For Multi-format Image Internal and Page External Text Box editors, select
Restore Factory Default.
How are dates and times recorded in the system?

The DICOM specification is as follows:
Study Date—DICOM tag (0008,0020): The date the study started.
Study Time—DICOM tag (0008,0030): The time the study started.
Image Date—DICOM tag (0008,0023) Content Date: The date the image pixel
data creation started. Required if the image is part of a series in which the
images are temporally related.
Image Time—DICOM tag (0008,0033): The time the image pixel data creation
started. Required if the image is part of a series in which the images are
temporally related.
The system sets these values to be the date and time the image record was
created in the database.
What are the Text Box Editing Controls?

Optional Designates the selected field as optional.
New Field Before Creates a new field before the current selected field, designated
by question marks: ????????????????
New Field After Creates a new field after the current selected field.
Delete Field Deletes the current selected field.
Move Next Moves the current selected field to the next position.
New Row Above Adds a new row above the selected field. This field is not active in
Single Image Internal or Multi-format Image External Text Box
configuration.
New Row Below Adds a new row below the selected field. This field is not active in
Single Image Internal or Multi-format Image External Text Box
276
configuration.
Move Prior Moves the current selected field to the previous position.
Restore Small Returns the text box to the small default configuration.
Default
Restore Large Returns the text box to the large default configuration.
Default
DICOM Field Select the DICOM Field. From the Keyboard, select Show most
common DICOM fields only to reduce the size of the list. Select
the field. Select the field you want to change and select Assign
Field.
DICOM Tag Displays the DICOM Tag associated with the DICOM Field.
Assign Field After selecting a field in the text box, select a field from the
DICOM field list and select Assign Field. The new field appears
in the text box.
Text Field Label Enter a label for the field with the keyboard.
Field Length Enter the maximum length of the selected field. Keep the font size
in mind.
Font Size Enter the font size for the selected field with the keypad and select
Enter.
Justification Place the text Left, Right, or Center within the selected field.
Restore Factory Return Multi-format Image Internal and Page External text boxes
Default to their original format.
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Multi-Format Print Image Text Overlay

Navigate to Key Operator Functions>System Configuration>Configurable
Text Boxes>Multi-Format Print Image Text Overlay.
 An Image Text Overlay can display information in four corners of the Multi-format
print.
 Overlay content and location are configured, and not editable by the user.
 Contains patient information and study information from free form text or by
choosing information from DICOM fields.
 Font size (small, medium, or large) is configurable.
To create an image overlay:

1. Select a region from the Overlay format section. A selection is highlighted in
green.
2. Select a field.
3. Enter free form text from the virtual keyboard or, select the DICOM fields tab
and select a field from the list.
4. Select the Assign Field button to add the criteria to the selected field in the
form.
5. Use the arrow keys to see all of the fields, or check the Show most
common DICOM fields only check box to narrow the search.
278
Multi-Format Page Footer Layout

Navigate to Key Operator Functions>System Configuration>Configurable
Text Boxes>Multi-Format Page Footer>Page Footer Layout.
On the Multi-Format Configuration screen, the user can select the Include
Page Footer check box and add a footer across the bottom of the page of any
print that is selected for destinations.
The Page Footer Layout screen contains the following features:
Footer fields
 A total of 12 fields of data are available, displayed as three columns of four rows
each.
 Edit by selecting from the DICOM fields list or entering free form text from the
virtual keyboard.
Font and Font Size text boxes

 Select the text box and choose the font and size from the pop-up menus.
Selected Region Alignment radio buttons

 Select a footer field (described above) and align Left, Center, or Right within the
column.
Logo/Graphic selections
 Select the square to display the root directory from which to select a graphic or
logo file.
 Select the graphic and the Select button.
Footer Preview display

 Displays the fields and graphics you selected as they will appear on the footer.
Virtual Keyboard
 Appears when you select a footer field.
DICOM Fields list

 Appears when you select the DICOM Fields tab.
 Displays DICOM fields associated with the Patient and Exam information.
 Select a field from one of the three regions in the layout, select the DICOM field,
and then select the Assign Field button.
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Boxes

data field and the size of the font.
 The Multi-format Image Internal Text Box appears inside each image area on a
multi-format print.
 Print on any printer that supports multi-format printing.
 Select this text box when you want to label each individual image and/or want to
print True-size.
See also:
Editing a Text Box
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Selecting an Internal or an External Text Box

To select the appropriate Text Box, consider the type of image area that is
displayed. You can make the selection or the Key Operator can select a default
Text Box for any given View.
 Select the Internal Text Box when you want the information to appear within the
image and when you must be able to print to any printer. The Text Box can be
moved to any corner or any inside edge to avoid covering any anatomy.
 Select the External Text Box when you want to position the label outside the
image area. This Text Box shrinks the image and affects True-size printing.
The Key Operator configures a Text Box to automatically fill in with data, such
as Hospital Name, Exposure Index, or View.
281

Boxes

 The Internal Text Box displays information about the patient, exam, and image
and is positioned inside the image area on one of the four sides of the image.
data fields and the size of the font.
 You can move the text box to any corner or any inside edge to avoid covering
anatomy.
 You can print an Internal Text Box on any printer. Use an Internal Text Box
when you want to print True-size.
See also:
Editing a Text Box
282

Boxes

 The text box can be up to 160 mm wide. Its content depends on length of data
fields and the size of the font selected.
 The Multi-format Image Internal Text Box appears inside each image area on a
multi-format print.
 Print it on any printer that supports multi-format printing.

 Select this text box when you want to label each individual image and/or want to
print True-size.
See also:
Editing a Text Box
Using the Single Image External Text Box
283

Boxes

 The text box can hold up to 120 characters and is limited to one line.
 Use this text box when you want the information to fall outside a multi-format
image.
See also:
Editing a Text Box
284

Boxes

1. At the Key Operator Functions menu, select System Configuration and
select Configurable Text Boxes.
2. Select Configurable Text Box Options.
3. Select each check box corresponding with the text boxes) you want as a
possible default for multi-format printing.
The radiographer can select other text box formats on the Multi-Format
See also:
Editing a Text Box
285

Boxes

Because certain image-specific data may not be identical for every image on a
multi-format print, these fields should be omitted from the Multi-format Page
External Text Box. When creating a Multi-format Page External Text box,
include only DICOM fields with values that will always be identical for all of the
included images. Failure to do so will result in fields that display a question mark
(?).
 Select the Multi-format Page External Text Box when you want the text label
to:
o Appear outside the image area on a Multi-format print.
o Extend across the page under the images.
 The text box can be up to 120 characters wide and is limited to two lines.
See also:
Editing a Text Box
Editing a Text Box
286

Boxes
Using a Single Image External Text Box

 The External Text Box positions the information outside the image area;
therefore, it never interferes with anatomy. However, the box takes up space on
the film, and the system crops additional image data compared with printing
without an External Text Box. Thus, an External Text Box affects True-size
printing.
 This text box can be up to 120 characters wide.
See also:
Editing a Text Box
Using the Single Image Internal Text Box
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Key Operator Functions > System Configuration > Configurable Text Box
Menu > Configurable Text Box Options
Configurable Text Box Options

Select the check box of each option you want to be available in your system.
You may choose as many formats as you wish.
 Use Transparent background for Internal Text Boxes.
The text appears directly on the background of the image.
 Use the Image Internal Text Box in Multi-format Images.
 Use the Image External Text Box in Multi-format Images.
 Use the Page External Text Box in Multi-Format Images.
 Use Transparent background for Text Markers.
See also:
Using a Multi-Format Image Internal Text Box
Using a Multi-Format Image External Text Box
Using a Multi-Format Page External Text Box
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Destination Configuration
Key Operator Functions > System Configuration > Profile Configuration
What Is a Destination Profile?

A Destination Profile is the set of destinations where images are sent. In the
CR and DR system, Image Routing is controlled by profiles. A destination
profile has three components:
 Name: the name or description of the profile.
 Criteria: Cassette Size, Category (body part, projection), Department, Physician,
Name, or Machine Name.
 Destinations: where the data is sent when the criteria matches.
The criteria fields are prioritized by the order they are listed on the Profile
Configuration Screen. You can change the order by using the second set of
Up and Down arrows. Default must always be last.
 Category
 Department Filter
 Physician Name
 Cassette Size Filter
 Machine Name Filter
 Output (for Multi-format Prints)
When an exam is routed, the information contained in the Patient Record is
compared to the information contained in the criteria fields of all defined
profiles, similar to performing a query. If the image matches more than one
profile, the system assigns the first profile in the list that matches all criteria.
Profiles can be assigned from Procedure Mapping or manually on the Patient
Input Screen and Select Destination Screen.
What Is the Default Profile?
A default profile is defined automatically by the system. It appears in the list of
profile destinations with an (*) asterisk next to the name. You can rename the
default profile, but you cannot change the criteria or delete it.
There must be only one default profile. If the data does not match the criteria for
any of the existing profiles, the system uses the default profile destination.
See also:
Define multiple profiles with criteria so you can assign the data’s destinations.
289
Key Operator Functions > System Configuration > Destination Profile

Configuration

How do I add a new destination profile?
1. Select Add.
2. Enter the name of the profile.
3. Select the color that will identify this profile.
4. Select the filter (or filters) that will identify this profile. All profiles, except default,
require a filter.
5. Select the destinations (printers and workstations) to send images to
automatically.
6. Select the Mandatory check box if the image must reach that destination in
order for the exam to be considered complete. (Mandatory destinations are
often archives.)
How do I edit an existing destination profile?

1. Select Turn Edit On.
2. Touch the profile name. Enter the name of the profile.
3. Touch the color field and select the color that will identify this profile.
4. Select the filter (or filters) that will identify this profile. Touch Clear to clear all
filters for that profile.
5. Select the destinations (printers and workstations) to send images with this
profile to automatically.
6. Select the Mandatory check box if the image must reach that destination in
order for the exam to be considered complete. (Mandatory destinations are
often archives.)
Why can't I delete the default destination profile?

You can rename the default profile, but you cannot delete it or edit the filters for
it. The default profile is set by the system and is used to send images to
destinations when all other criteria fail.
There must always be one default profile.
How do I create a destination profile for images from

a cassette size (CR Only)?
290
1. Select Turn Edit On.

2. Select the Destination Profile Name field and enter a name for the profile.
3. Select Clear for the Category and Department fields.
4. Touch the Cassette field and select the desired cassette size (CR Only).
5. Select the destinations.
Images that meet this criterion (this cassette size) will go to these selected
destinations automatically.
Turn Edit On Edits the profile. Select this button to make changes to filters such as
name, category, department, physician, cassette size.
Save Completes the action by writing changes to the local database.
Changes
See also:
What is a Destination Profile?
Configuring Destination Profiles with the Capture Link System
291
IEC Exposure Index Configuration

IEC Exposure Index Menu
To comply with the International Electrotechnical Commission (IEC)
standards for testing and reporting Exposure Index (EI), Carestream Health
provides a procedure that converts the standard Carestream calibration (80 kVp
with 0.5 mm Cu + 1.0 Al filtration) to comply with the IEC EI standard. The
following topics explain those procedures.
IEC Exposure Index
Part 1–Determining the IEC Beam Technique
Part 2–IEC Exposure Index Compliance Testing
292
IEC Exposure Index

To comply with the International Electrotechnical Commission (IEC)
standards for testing and reporting Exposure Index (EI), Carestream Health
provides a procedure that converts the standard Carestream calibration (80 kVp
with 0.5 mm Cu + 1.0 Al filtration) to comply with the IEC EI standard.
 The Carestream implementation of IEC does not require any changes to the
existing detector calibration procedures for DIRECTVIEW CR/DR systems.
 All detector/system calibrations will continue to be calibrated using Carestream
calibration.
 The current Carestream Health EI values will be calculated and reported with
new IEC EI value if desired.
 To calculate an IEC compliant EI, the system applies an IEC conversion factor to
convert the pixel value from the Carestream space into the IEC space.
 The IEC conversion factor is a constant value (detector technology dependent )
that reflects the detector sensitivity change between the Carestream beam and
the IEC beam.
 All DIRECTVIEW CR systems calibrated with the current procedures will be IEC
compliant when performed with the cassettes used for product calibration. The
use of other cassettes may not result in compliance due to the variability of
individual cassette speed.
 The Online Help provides the verification procedure. Based on the result of this
verification test, the Carestream Health Field Engineer (FE) can adjust the IEC
conversion factor from the Carestream default value to recertify the system to
meet the IEC compliance requirement.
The user gives a flood field exposure to the detector under the IEC beam
setting, and checks the reported IEC EI against the actual exposure reading to
the detector using a dosimeter. If the measurement is within ± 20 %, the system
is IEC compliant. If not, the Carestream Health FE adjusts the IEC conversion
factor, Co, to match the IEC EI with the measured dose.
The data from the detector generates the EI, requiring the user to test each
detector.
Materials needed:
Filter 1—IEC filter set (0.5 Cu + 2 mm Al)
Filter 2—6.8 mm aluminum beam filter block
UNFORS dosimeter (or equivalent model that is not sensitive to beam back
scatter)
Summary of procedure:
1. Set up the beam, Source to Image Receptor distance (SID), field size, Bucky
cover, grid, etc.
293
2. Position the IEC filter set.

3. Input the IEC beam technique (kVp, mAs, etc.).
4. Make the exposure and record the IEC EI value displayed on the screen.
5. Place a dosimeter at a specific location on the detector surface, make the
exposure, and record the dosimeter reading.
If the meter reading agrees with the IEC value within ± 20 %, the system is IEC
compliant. If not, the system may not be IEC compliant.
What if the test fails?
Repeat the test (verify the IEC beam technique) and contact Carestream Health
Technical Support Service if the repeated test proves that the system is not
IEC compliant.
See Also
Determining the IEC Beam Technique
IEC Exposure Index Compliance Testing
294
Determining the IEC Beam Technique

Part 1—Procedure for Determining the IEC Beam
Technique.
Follow this procedure to determine the generator kVp setting for the IEC beam
quality, as described in IEC 62494–1. The user does not need to perform this
procedure again unless there is a change in the system, such as the SID.
The radiation quality of the IEC beam is characterized by:

 A half-value layer of 6.8 ± 0.3 mm aluminum (Al)
 An added filter of either 21 mm aluminum or 0.5 mm copper (Cu) and 2 mm
aluminum (Al)
 An X-ray tube voltage in the range of 66 kV-74 kV
Materials
 Filter 1—IEC filter set (0.5 Cu + 2 mm Al)
 Filter 2—6.8 mm aluminum beam filter block
 UNFORS dosimeter (or equivalent model that is not sensitive to beam back
scatter)
Test Procedure
1. Set the Source to Image Receptor Distance (SID) to 183 cm (72 in.).
For some system components, such as the table detector, 183 cm (72 in.) SID is
not possible. For the table detector, set the system to the maximum SIC value
allowed, and if possible, make sure the table Bucky is fully extended.
2. Place the collimator in Manual mode.
3. Adjust the collimator to create a field size of approximately 12.7 x 12.7 cm (5
x 5 in.).
4. Remove the grid.
5. Place the dosimeter in the center of the X-ray field.
6. Place filter 1 (0.5 Cu + 2.0 mm Al) in the beam path, with the Cu filter facing
the tube.
7. Set the kVp according to Table 1 below.
8. Make exposures and vary the mAs setting to determine the mAs setting that
will produce approximately 1 to 2 mR using the dosimeter. Record the mAs
setting in Table 1 and Table 2 for each kV setting listed in the tables.
9. Using the kV and mAs combination recorded in Table 1, make three
exposures and input the measurements in Table 1 (exposures. 1, 2, and 3).
10. Calculate the average of the three readings and record the result in
the appropriate cell in the table.
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11. Repeat this procedure for all kVp settings listed in Table 1. Record all
of the dosimeter readings and calculated results.
Table 1—Exposures with Cu and Al filter set only
kVp mAs Exposure Exposure Exposure Average
Filter 1 1 2 3 Exposure
(produces
1 to 2 Filter 1 Filter 1 Filter 1
mR)
66
68
70
72
74
12. Add Filter 2 (6.8 mm aluminum beam filter block) to the beam path (level Filter 1
in the beam).
13. Using kV and mAs combination recorded in Table 2, make three exposures and
record the measurements in Table 2. Make three exposures and input the
measurements in Table 2 (exp.4 , 5. 6).
14. Calculate the average of the three readings and record the results in Table 2.
15. Calculate the ratio of the average readings from Table 1 and Table 2 (with and
without the 6.8 mm Al filter) and record results in Table 2 (with 6.8 mm Al filter
divided by the exposure without the filter).
16. Repeat for each kVp setting listed in Table 2.
Table 2—Exposures with Copper and Aluminum (CU + AL) filter set and 6.8
mm Al filter
kVp mAs Exp. 4 Exp. 5 Exp. 6 Avg Ratio
(same as Filter 1 + Filter 1 + Filter 1 + Exp. (average
Table 1) Filter 2 Filter 2 Filter 2 Filter 1 + exp.
Filter 2 Table 2
divided
by
average
exp.
Table 1)
66
68
70
72
74
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17. Using the graph below, establish appropriate and evenly distributed
values on the Y-axis for the exposure ratio.
Note: If possible, include 0.5 on the Y-axis. If 0.5 does not fall within the range of
the ratios, verify the setup for this procedure, and repeat the entire procedure. If
after repeating the procedure, and 0.5 still falls outside the range of ratios, then
the X-ray system may require calibration/adjustment according to manufacturer's
recommended procedure.
18. Plot the ratios from Table 2 for each kVp setting.
19. At the point where the exposure ratio line crosses 0.5, identify the
closest kVp setting and record in Table 3.
20. Set the kVp according to the recorded value in Table 3.
21. Make exposures and vary the mAs setting to determine the mAs
setting that will produce approximately 1 to 2 mR using the dosimeter.
Record the mAs setting in Table 3.
Table 3——IEC Exposure Index Beam Technique.
kVp mAs
Sample Graphs
297
298

Part 2—Procedure for IEC Exposure Index Compliance
Testing.
This procedure is to be implemented on DIRECTVIEW CR/DR systems to test
for IEC compliance of Exposure Index reporting.
Materials
 1 IEC filter set (0.5 mm Cu + 2 mm Al)
 Dose meter qualified to operate under the IEC beam
Test Procedure
1. Set the Source to Image Receptor Distance (SID) to 183 cm (72 in.).
Note: For some system components, such as the table detector, 183 cm (72 in.)
SID is not possible. For the table detector, set the system to the maximum SIC
value allowed, and if possible, make sure the table Bucky is fully extended.
2. Place the collimator in Manual mode.
3. Adjust the collimator to create a field size of approximately 12.7 x 12.7 cm (5
x 5 in.).
4. Remove the grid.
5. Place the dosimeter in the center of the X-ray field.
Set the meter so that measurements are in uGy, or convert accordingly.
6. Place Filter 1 (0.5 Cu + 2.0 mm Al) in the beam path, with the Cu filter facing
the tube.
7. Set the kVp and mAs to the settings recorded in Table 3. See Determining
the IEC Beam Technique.
8. Make an exposure and record exposure measurement in Table 4, Measured
Exposure A.
For the DRX-Evolution Table with fixed 42 cm x 43 cm (17 x 17 in. ) detector,
use the following calculation applied to the meter reading, and then record the
result in Table 4 for Measured Exposure "A." Make sure the units for SID are in
centimeters (cm) when making the calculation.
Use (meter reading (in uGy) x (SID-7)^2) x 0.95.
9. Remove the dosimeter.
10. At the Console, navigate to the Image Acquisition screen and select Pattern
view.
11. Set the kVp and mAs to those settings recorded in Table 3.
12. Make an exposure and record IEC EI displayed on the Console in Table 4,
Calculated Exposure Index B.
13. In Table 4, compare items A and B. If the two readings are within ± 20 % of
each other, the system is IEC compliant.
299
14. If the values are not within ± 20 %, double-check the entire setup and repeat all
of the steps.
15. If after repeating, and the values are still outside the limits, contact Carestream
Health Center of Excellence.
Contact Carestream Health
Table 4—Compliance
Measured Exposure Calculated Exposure Are A and B within 20 %
(uGy) Index ((ABS(A-B))/a*100<20
-A- (from Console)
-B-
See Also:
IEC Exposure Index
300
Image Viewer Editor Configuration

Key Operator Functions > System Configuration > Image Processing
Preferences

The Image Processing Preference Editor provides controls so that you can
change the look of images from the Primary Category (all images in an
anatomical region) to a Secondary Category (all body parts of that type) or
from an individual View. The Image Processing Preference Editor lets you
determine the Look of the images based on your preference.
To use the Editor:
1. Select the Select New View button and select a Primary Category.
2. Select a Secondary Category.
3. Select a View.
Selecting the Close button after selecting a Primary or Secondary Category
will make your changes apply to all of the Views in that category.
4. Select the Change Look button.
Use this to select one of the pre-configured looks first to approximate the
desired Look.
5. Adjust the individual slider controls to fine-tune the desired effect.
6. Select the View Before and After button to compare your changes.
7. Select the View After Only button to see your selection.
8. Select Deliver to send the image to destinations for evaluation.
Never make any changes based on a single image. Always use at least 5 to
6 images (of different body uses for the same View) when changing image
preferences.
Read this Before You Make a Change in the
Preference Editor
Before making a change in the Preference Editor, check the following:
Is the equipment calibrated? Verify that the calibration of your printers, monitors,
and workstations are correct. See Monitor
Configuration, Introduction in Key Operator's
Help.
Is the image consistently too Before making a change, verify the consistency of
light or too dark? the view from other patient images.
Have you saved the changes? Make all of the changes and save them before
exiting the screen.
Changing the Look of a View

301
1. Select the Select New View button.

2. Select Primary and Secondary Category, and View that already exists in the
system (or close the window at the desired level).
3. Select Change Look to select a starting point for correction.
4. Select Accept this Look.
5. Change the image processing values to correct the image by moving the slider
controls.
6. Select View Before and After to compare your changes.
7. Select View After only.
8. Select Deliver to select a printer or a workstation to send the image to for
evaluation..
There is no confirmation on the status of the delivered image.
Select New View Select New View lets you select a Primary Category, Secondary
Category, or an individual view. When you select an entire
Category, the changes you make affect every view in that
category.
For example:
1. Select the Thorax Category.
2. Select the Close button (red X).
3. Change Chest AP Brightness from 3 to 5 (+2), thus changing
Chest Lateral, currently at 6, to 8 (+2).
Since Thorax is the highest level, this selection changes all
images at all levels.
The Viewer is color-coded to indicate the level you have chosen.
Change Look Pre-configured examples of Brightness, Latitude, Detail Contrast,
Sharpness, and Noise to choose from to start building the look
you want.
Deliver Select the workstation or printer to send the image to.
View Before & After Displays the image before adjustment and after.
Zoom Use the Zoom feature to evaluate images. To return to normal
view, select Zoom to clear the check box.
When the image is in Zoom mode, you can change the viewing
area by "panning" or changing the view by selecting the image
area by selecting a point on the image and dragging across the
image area.
 Select the image and drag across.
When the image is in zoom mode you can:
 change image processing characteristics
 save changes
302
Region of Interest Lets you determine the EI of any point on the image. The mean,
max, min, and standard deviation of the exposure for the
selected location is displayed in a rectangle around the selected
point of interest. The size of the Region of Interest is configurable
by the Key Operator in Display Configuration.
Save Changes Completes the action by writing to the local database.
Main Menu Exits the current screen and returns to the Main Menu.
Back/Cancel The Cancel button returns you to the previous function without
changing to another screen.
The Cancel button toggles to the Back button after you have
selected Save Changes.
See also:
Changing the Look
Using View Before and After
303

Preferences
What Is a Look?
Looks are different recipes for processing the images that take into
consideration the degree of brightness, latitude, detail contrast, sharpness and
noise that radiologists like. Every institution chooses its Look from a family of
Looks provided by Carestream Health, Inc. and can then customize exams to its
own taste using the Image Processing Preference Editor.
The Family of Looks
Look Name Description

Premium Processing with noise Default Look from factory. Base models (no
suppression biases) used in clinical study. Noise
suppression consistent with Low Exposure
Optimization.
Fixed Processing with medium contrast, Models which have fixed rendering
detail, and sharpness parameters. Noise suppression same as
above.
Premium Processing with brighter Default Look biased to produce brighter,
processing, more detail, and sharpness sharper, more detailed renderings with
custom noise suppression.
Premium Processing with high contrast Default Look biased to be higher in contrast
and detail (less latitude) and detail with custom noise
suppression.
Premium Processing with more latitude Default Look biased to provide on average
slightly greater latitude and detail than the
CR Premium Look with custom noise
suppression.
Premium Processing with medium Default Look biased to be less digital in
latitude appearance, in line with a medium latitude
analog film Look.
Baseline Image Processing Mimics Non-EVP Plus processing.
Premium 2 Image Processing with noise Now has a DR mimic Look for General
suppression Radiography.
See also:
Changing the Look
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What Is a DICOM GSDF-calibrated Monitor?

Grayscale Standard Display Function (GSDF) is a standard designed for
high-quality output from computer monitors used to view X-ray images. The
calibration procedure is listed in the DICOM standard part 14.
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Preferences
Region of Interest (ROI) Tool

The ROI Tool calculates the statistics about the code values and optical density
of a user-specified area of the CR image. The tool displays the mean, minimum,
maximum and standard deviation values for the code values within the area
specified by the user on the image. The code value measurements are from the
raw, unprocessed image and the optical density measurements are from the
processed image.
The ROI Tool is accessible only to Key Operators. After selecting the location to
be included in the ROI calculations on the CR display by using a finger touch or
mouse-click, the measurement appears.
Select Region of Interest to identify the Exposure Index of any point on the
image.
To access the Region of Interest Tool:

1. Select an image.
2. Open the Image Viewer Screen.
3. At the Key Operator Preference Editor, select the Region of Interest button.
4. Select a point on the image.
The Region of Interest is the mean code value of exposure, indicated in a
square area drawn around the point you selected on the screen.
The display reads:
Mean:1229, 0.49 O.D.
Min:1045, 0.37 O.D.
Max:1384, 0.61 O.D.
St. Dev: 47.2, 0.04 O.D.
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The first value in each row is code data, and the second value is optical
density (OD).
The Key Operator can configure the size of the Region of Interest window in
Display Configuration.
Mean Code Value Usefulness

The mean code value provided in ROI information is useful for determining the
selective exposure in different sections of an anatomic or test image. Medical
physicists may use the ROI Tool for system calibration or QC testing.
Region of Interest Configuration
The Key Operator can configure the size of the selected region of interest to be
from 1 x 1 mm cm to 10 x 10 mm cm on the Display Configuration Screen by
selecting 10% increments or custom size by using the slider controls provided.
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Preferences
Image Processing Controls

 Brightness makes an image lighter or darker. Decreasing brightness can make
low exposure noise more visible.
 Latitude controls the number of shades of gray visible in the image. Increasing
information is in the black or white region of the image and it cannot be
visualized.
Increasing latitude:
o Increases the number of gray levels.
o Decreases the apparent D-max and D-min areas.
 Detail Contrast controls the local contrast of medium sized structures such as
joint spaces, vertebral body spacings, and ribs in the image. Increasing detail
contrast makes anatomical features more pronounced.
 Sharpness controls the visibility of finer structures such as bony trabeculae, lung
markings, and micro calcifications.
 Noise controls the appearance of quantum noise in the image.
o Moving the slider control up decreases the effect of noise suppression.
As a Best Practice, evaluate the changes in Zoom mode before saving.
Detail Contrast, Sharpness, and Noise should be adjusted with careful
inspection.
See also:
What Is a Look?
Changing the Look
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Preferences

The Image Preference Editor Screen lets you compare the look of one image
against another and select the look you prefer.
1. At the Key Operator Functions menu, select System Configuration and then
select Image Processing Preferences.
2. Select an image.
3. Change Image Processing Preferences.
4. Select View Before and After and compare the results.
5. Select the look you prefer.
See also:
Changing the Look
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Preferences
Changing the Look

1. Select Change Look.
2. View the images provided. Use the Up or Down arrows to see all of the sample
Looks. Consider the characteristics described above.
3. Select Accept This Look if the sample image displays the image processing
results you would like to see for images with that View.
Accept This Look Selects the View that is closest to the image processing values
you would like to see for that View. The selected Look appears
in the Image Processing Preference Editor. Additional changes
can be made at this time.
Previous Page/Next Selects the previous page of samples or the next page of
Page sample Views.
Cancel Cancels the selection.
Continue Without Saving.
Zoom Zooms the view to examine the image more closely.
See also:
What Is a Look?
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Reprocessing modifies the image by applying the processing changes you have
selected.
To select the Reprocess button, make sure one of the following conditions is
true:
 The current look of the image is unsatisfactory.
 Surround Mask has been applied.
 The View Name on the Image Viewer Screen has been changed.
You cannot reprocess an image if the image has been accepted and delivered
across the network. You must create a copy of the image, modify the copy, and
send it to the proper destinations. In addition, an image must be delivered before
you can make a copy of it.
See also:
How to Modify a Delivered Image
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Key Operator Functions > System Configuration > Layout Configuration
This screen provides easy access to layout editors. With these editors the Key
Operator can configure what, where, and how the information will display for all
functions on various screens.
Image Viewer Editors Tab

 Lets you order the editors that appear on the tabs on the Image Viewer screen.
 The order of the editing icons and their functions are editable from the Layout
Configuration screen. The most frequently used editors can be accessed
quickly with this organization.
 See Image Viewer Editors.
Markers Editor Tab

 Lets you organize the markers that appear on the Image Viewer and Express
Viewer screens.
 Version 5.6 introduces a new marker: Acquisition Date/Time. You can insert
this marker from the Markers Images tab.
 See Markers Editor
Tech Assist Tab

 If enabled, it provides indicators that appear on the Image Viewer or Express
Viewer screens, or the Patient Information bar.
 These indicators are warnings that a certain threshold has been reached for IEC
Exposure Index, Contrast Noise Ratio, or Anatomy Clipping. The Key Operator
sets the threshold and determines what the sensitivity will be for each of the
warnings.
 See Tech Assist Editor
Patient Names Tab

 Select the radio button for Single Byte Names or Single and Multiple Byte
Names.
 See Patient Names Editor
Patient Work List Tab

 Configure the layout for the Work List and the default focus field.
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See Patient Work List Editor
Patient Input Tab

 Configures the layout of the fields and tabs on the Patient Input screen.
See: Patient Input Editor
RPDES Tab
Configures the layout of the Remote Patient Data Entering System.
See: RPDES Editor
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Image Viewer Editors

To add, remove, or reorder the editors in the panels in the Image Viewer to
reflect your preferences and enhance your workflow.
The Image Viewer Editors Tab is divided into two parts:
Disabled Editors
These editors will not appear on the tabs in the Image Viewer screen
Enabled Editors
These editors will appear on the tabs in the Image Viewer screen in the order
they appear in the list. In other words, the first editor's icon will appear as the
first tab icon on the Image Viewer screen. The second will appear on the
second tab, and so forth.
To change the order of the editors:

1. Select an editor from the Enabled Editors list.
The editor will be highlighted when selected.
2. Select the arrows to the right of the list to move the editor to another position.
The arrows on the far right move the selected editor to the top or bottom of
the list
This selection moves the position of the editor on the Image Viewer Screen.
To remove an editor from the Image Viewer Screen:
1. Select an editor from the Enabled Editors list.
The editor will be highlighted when selected.
2. Select the arrow to the bottom of the list to move the editor to the Disabled
Editors list.
The arrows on the bottom move the selected editor to the left or right of the
list.
This selection moves the editor from the Image Viewer Screen.
The tabs on the Image Viewer screen will reflect the changes immediately.
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The Tab display on the Image Viewer screen will collapse or expand depending
on the size and shape of the monitor.
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Markers Editor
The Markers Editor lets you customize the marker palette on the Image Viewer
Screen.
 Add a marker before the selected column.
 Add a new row above a selected marker.
 Add a new row below a selected marker.
 Add a marker after a selected column.
 Change the order the markers display.
 Select a transparent background for text markers.
To add a marker to an existing Marker group:

1. Select a group icon such as Favorites.
2. Select a marker on the palette.
The marker is highlighted.
3. Select from the control tabs at the right of the palette, such as Add Marker
before Column.
4. Enter the marker label in the Free Form Text field.
5. Save Changes.
6. The new marker appears.
To move a marker to a different position on the palette:

Select a marker on the palette.
Select the Move tab.
Select the directional arrow to change the position of the marker.
If you accidentally deleted a marker, such as the arrow or Right or Left marker,
select the Marker Images Tab and select a replacement.
Selecting the yellow triangle opens a blank palette that you can fill with
markers of your choice. The palette is limited to 5 rows across and 6 rows down.
To reset any palette to its original condition, select Restore Factory Defaults.
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Tech Assist Editor

Tech Assist for Chest Anatomy
Enable Tech Assist on Image Viewer for chest anatomy regions check box
 When checked, Tech Assist for Contrast Noise Ratio and anatomy clipping
warnings are enabled.
 The check box is unchecked by default.
Automatically display Tech Assist overlay when a problem is detected
radio button
 Automatic configuration that displays a status or warning in the form of a Safe
Color or an Alert Color. The Key Operator chooses the colors from the Layout
Configuration screen color palette, which appears when a color square is
selected. An alert color indicates that the threshold has been reached, and the
probability is that clipping has occurred.
 Used as the status and warnings that the threshold has been maintained or
reached for Contrast Noise Ratio (CNR) and anatomy clipping.
 Safe and Alert color warnings are displayed on the Image Viewer or Express
Viewer screen.
Display Tech Assist overlay only when requested
The areas that may be clipped can be only seen by selecting the toggle
button on the patient information bar on the Image Viewer or Express
Viewer screen.
Anatomy Clipping Regions
 Indicates the typical regions of anatomy that may be excluded, or clipped, in an

X-ray.
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 Provides a prediction of the likelihood that a particular area might be clipped is

illustrated by the above graphic. The regions that are likely to be clipped are
designated by rectangles around the chest.
 The likelihood that the region may be clipped is represented numerically, as
sensitivity levels, 0.0–1.0.
 The Key Operator determines how sensitive the warning indicator should be by
selecting a particular rectangle and moving the slider toward More Warnings or
Fewer Warnings.
 The numeric value changes as the area is set to more sensitive or less sensitive.
 The default is shown in the graphic.
 These rectangles appear on the image in the Image Viewer or the Express
Viewer screens.
Exposure Value Display
Select the desired Exposure Index configuration.

 IEC Exposure Index radio button
 IEC Exposure Index and Carestream Health Exposure Index radio button
 Carestream Health Exposure Index radio button
See: IEC Exposure Index.
Tech Assist Sensitivities
Exposure Deviation Index slider control

 A target IEC Exposure Index is shown for each View on the View Configuration
screen.
 The Exposure Deviation Index measures a percentage of standard deviation
from the exposure aim.
 The default value is 3.0.
 The scale increments by 10 %.
 Use the slider controls to set the threshold for each View.
 Fewer warnings indicates that the threshold will be met within a higher range.
Contrast Noise Ratio (CNR)
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 The Contrast Noise Ratio (CNR) indicator alerts the user when the combination
of low contrast and excessive noise will not produce an optimum image. The
analysis occurs when the image is processed or reprocessed.
 The indicator is located in the upper left quadrant of the Image/Express Viewer
screen. It can be configured to appear automatically, or viewed by toggling back
and forth manually.
 The System calculates the Contrast Noise Ratio for chest images only and
records the CNR for inclusion in the image statistics.
 The default value is 0.3.
 The Key Operator configures the threshold value. For example, if the CNR
indicator is green, but you are not satisfied with the images, move the slider to
change the ratio higher until the images are satisfactory. If the indicator is red,
then the value is too high.
 Move the slider toward More Warnings to increase the sensitivity of the tool and
improve the image.
See Also
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Anatomy Clipping Procedure

To enable the Anatomy Clipping detection feature:
1. Navigate to the Key Operator Functions>System Configuration>Layout
Configuration screen.
2. Select the Tech Assist tab.
3. In the Tech Assist for Chest Anatomy section, select the Enable Tech
Assist on Image Viewer for chest anatomy regions check box. When the
check box is checked, the Anatomy Clipping Regions section becomes
active.
4. Select a region by touching a rectangle to highlight it.

5. Use the slider control to set the threshold for sensitivity. You can configure up
to eleven sensitivity adjustments for the anatomy clipping detection. More
Warnings means that the detection is more sensitive and shows more
likelihood that clipping has occurred in that region.
6. Save Changes.
You can view the result of the warnings by viewing a (clipped) image on the
Image/Express Viewer screens. Rectangular outlines display the anatomy
clipping regions on the image. See the graphic below.
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Note: The user can clip critical anatomy by cropping or using a Black Surround
Mask.
The Key Operator can disable the anatomy clipping feature by unchecking the
Enable Tech Assist on the Image Viewer for chest anatomy regions check
box.
See Also:
Tech Assist Editor
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Patient Names Editor

To configure the format that will determine how patient names will display:
1. Select the format you prefer for patient name display by selecting the radio
button located to the left of your choice.
2. Save Changes.
This format will appear on the Patient Work List screen, Image Review screen,
and the patient information bar.
See Also:
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Patient Work List Editor

The Key Operator configures the layout of the Work List screen from Key
Operator Functions>System Configuration>Layout Configuration>Work
List tab.
This view appears exactly the same as the actual Work List screen. This screen
lets you configure the default focus field and the default sort order for the user
viewing the Work List screen.
To configure the default focus field:

1. Touch or click the field you prefer as the focus to from the text boxes across
the top of the screen. The field will highlight when you select it. When the
user views the Work List screen, this field will be required first.
2. Save Changes.
3. Select the Clear Focus Field button to reset the default.

The focus selection appears in text across the bottom of the screen to confirm
the selection: "Default Focus Field."
To configure the default sort order:

A default selection of criteria to sort the Work List by (sort order) is displayed.
For more criteria, select a layout for the sort order from the Select New Layout
tab and select from the menu choices.
This menu may change depending on the system you use.
Select the heading from the layout to change the sort order from ascending to
descending. You can change the layout by selecting the Select New Layout
button.
The sort order appears in text across the bottom of the screen: "Default Sort
Order."
Selections
Clear Focus Field button
 Removes previous focus selection.

 Resets focus field function.
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Select New Layout button
 Opens new filter layout menu.

 Select a new layout according to the menu.
The following fields are user editable and the information can be entered
manually if it does not appear automatically:
Patient Last Name text box
Patient First Name text box
Patient ID text box
Accession Number text box
Study Status menu selection
 When selected, the Study Status menu appears.
 Select the appropriate status of the patient you want to find.
Time Window menu selection
 When selected, the Time Window menu appears.
 Select the appropriate time frame to search for the patient you want to find.
Add Patient Location and Recent Exam Filter

Adds the patient location as a filter, and adds an icon to indicate the number of
patients that have been added since the last login:
Recent Exam
 Selecting the icon displays only those new orders on the Work List screen.
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Patient Input Editor

You can assign a status to each field on the Patient Input screen, including the
Exam Information, More Information, and Image Information tabs. When you
assign a field to be Required to Submit or Required to Deliver to Mandatory
Destinations, an icon appears in the upper right corner of the text box label,
letting the user know the status at a glance.
To assign a status, select the text box and then select the radio button for the
status you want the text box to have.
For example, touch or click a text box such as Accession Number. Select a
radio button such as Required to Submit. The associated icon appears next to
the label in that text box.
Normal Text box radio button

 Not required.
 This label is assigned by default to all text boxes without an assigned status.
 Assign to a text box that is optional.
Required to Submit radio button
Assign to a text box that should be required to have information populated in it

before the user can save changes.
Required to Deliver to Mandatory Destinations radio button
 By default, assigned to Patient Last Name and Patient ID text boxes.

 Assign to any text box that should be required to be populated before the image
can be sent to mandatory destinations.
Read Only radio button

 Not editable.
 Assign to text boxes that will display information that the user cannot change.
Read Only Label

 Text box only appears as a label.
 Assign to a text box that hides the information.
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Select New Layout button
 User selectable, menu tab.

 Choose this button to change the text boxes that appear on the Patient Input
screen.
After making all selections, select Save Changes.
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RPDES Editor
Use the default setting unless your region specifies the need to support Multi-
byte Names.
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The Recall Prior Image feature lets the user import and view images and
information from the patient’s last exam, including positioning, technical
information such as the technique used, and patient specific anatomy
characteristics. This enables the user to quickly copy or change the present
exam using the previous exam as a reference.
To configure the Recall Prior Image feature:

Navigate to the Key Operator Functions>System Configuration menu.
Select Priors Images Configuration.
The following configuration tabs are available:
Options Tab
Search Tab
PACS Tab
Go to Utilities>System Status to view the status of the prior image retrieval job
queue. Here the user can clear the outstanding requests in the queue.
See: Viewing the Status of System Communications.
See Also:
Using Prior Images
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Prior Image Configuration Options Tab

Enable or disable the Prior Images feature by checking or unchecking the
Enable retrieval of prior images check box.
Set the retrieval method:
Manually retrieve prior images radio button

 In manual retrieval mode, the Prior Images icon is always displayed on the View
thumbnails for the indicated body parts.
 The user must select the Priors icon to initiate the retrieval.
 The software searches for the prior images for that body part.
Automatically retrieve prior images when the study is opened radio button
 When this button is selected, the software searches for the prior images when an
exam is selected from the modality Work List.
Automatically retrieve when the study is added to the work list or view is
created radio button
 If additional criteria are needed to further restrict the images for which priors are
retrieved, check the Retrieve priors for work list items matching the
following criteria and enter the Modality Worklist Field value and criteria. When
modality work list matching is used, it means that priors will be automatically
retrieved for the indicated body parts for which the work list data matches. For
indicated body parts in which the work list data does not match, you will still be
able to retrieve priors, but you must do this manually.
1. Select the appropriate radio button to indicate the type of matching that
should occur.
The choices are:
 Exact match only radio button
 Any item starting with the text radio button
 Any item containing the text radio button
2. Select the body parts for which prior images should be retrieved from the list
box on the left. If a body part should be added, then click the Add button and
select the body part from the keyboard. If a body part should be removed,
then click the body part and then click the Remove button.
The Key Operator can specify alternative names for each body part for other
manufacturer's systems, which may use non-standard DICOM values. The list
box on the right allows the user to enter another name for the body part.
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Use the virtual keyboard to enter the name, and select the Add or Remove
button. Multiple alternate names can be used for the same body part.
See Also:
Using Prior Images
Prior Image Options Tab
Prior Image Search Tab
Prior Image PACS Tab
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Prior Image Search Tab

Search Interval text box
 Sets the number of weeks or days in history to search for prior images.
 The default value is 2, entered numerically.
Units text box
 Sets the search interval to either days or weeks.
 The default value is weeks.
Maximum Images to be Retrieved text box
 Indicates the number of images to be retrieved from the PACS.
Date of birth must match check box
 If checked, the patient’s date of birth must match the patient records from the
PACS.
 The Patient ID and Patient Last Name are always used for retrieving priors.
When the Date of birth must match checkbox is selected, then the date of birth
must also match.
 By default, the check box is not checked.
Retrieve prior images from exams performed on the following modalities
list box
 Specifies which modality records to retrieve from the PACS.
 By default, CR, DX, and PR are checked. PR indicates Grayscale Presentation
State.
See Also:
Using Prior Images
Prior Image PACS Tab
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Prior Images PACS Tab

AE Title text box
 Lets the user enter the AE Title of the PACS from which to retrieve prior images.
 Nothing is set by default.
IP Address text box
 Enter the IP Address of the PACS from which to retrieve prior images.
 Nothing is set by default.
PACS Port text box
 Enter the Port of the PACS from which to retrieve prior images.
Local AE Title text box
 Select an AE Title for the PACS to identify the console. It must be different from
the Computer name, or there will be conflicts with Storage Commitment.
Local Port text box
 The default value is 5041 and shouldn’t need to be changed.
Local AE Title and Local Port: These values are also used to configure the
Console at the PACS, since the Console will now be acting as a storage device
for priors.
See Also:
Using Prior Images
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Statistics
Statistics Menu
Technologist Statistics
Destination Summary Statistics
Rejected Image List
Download Statistics
Cassette Statistics
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Key Operator Functions > Statistics > Technologist Statistics
Viewing Radiographer's Statistics

View all radiographer's statistics, based on Tech ID, that are compiled from
the DIRECTVIEW Reject Analysis Software.
Techs View all of the statistics for a particular radiographer.
Views View all of the statistics for all of the views for the selected radiographer.
Image View all of the statistics for all of the images done by the selected
List radiographer with the selected view.
View each of the images for the selected radiographer.
How do I change the order of the list?

Select the header bar of the Tech, Views, or Image List window. You can sort in
any column. A triangle appears over the column that is being sorted and
indicates ascending or descending order.
Where does the image list come from?

The Image List data contains information for the past year. Only those images
that still exist on the System can be viewed. To view the images, select the
magnifying glass.
The images are delivered images.
How do I save the data?

Save all statistics by downloading them to a removable USB drive, hard drive, or
floppy diskette.
See also:
Downloading Statistics
Main Exits the current screen and returns you to the system Main Menu.
Menu
Back Returns you to the previous screen.
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Key Operator Functions > Statistics > Destination Summary Statistics
Viewing Destination Summary Statistics

 Destination Summary Statistics updates the status of the destinations listed
and the status of the devices as you go to the screen.
 Lets you check the status of destinations if you are getting a repeated failed
delivery.
 Identifies problem destinations quickly.
Navigation Buttons
Menu
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Key Operator Functions > Flagged Image List
Viewing the Flagged Image List

The Flagged Image List lets you:
 Locate flagged images quickly.
 Examine images closely.
 Harvest images for with or without private health information (PHI).
 Unflag images.
This action permanently deletes the image.
Navigation Buttons
Clear Removes all data entered in the search fields.
Fields
Main Menu Exits the current screen and returns to the system main menu.
Quick Shutdown lets you safely shut down the machine.
Menu Logout logs you off the system.
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Key Operator Functions > Statistics > Download Statistics
Downloading Statistics
Download Statistics lets you:
 Log in to multiple CR Systems, remove and retrieve all statistics.
 Select a date range and download all statistics to a spreadsheet for data
management.
 Add or delete device IP addresses in the system from which to download
statistics.
To download statistics:
1. Select the Add Device IP Address button.
2. Enter the IP addresses of the devices you want to get statistics for and select
the devices.
3. Enter the from/to date range.
4. Select Retrieve Statistics.
5. Select Save file as. This is the location where the statistics should be saved.
Navigation Buttons
Add Device Adds a computer, designated by the Computer Name Use the
virtual keyboard to populate the text box in the Computer
Name column.
Delete Device Deletes the row that is currently selected.
Select/Unselect All A tool to quickly get statistics from multiple devices.
Save Changes Updates the IP address list so that it is not necessary to type it
again. It does not retrieve statistics.
Main Menu Exits the current screen and returns you to the system Main
Menu.
Ping Machines If the connection is good, the light appears green. If there is a
problem with the connection, the light appears red.
See also:
Exporting Data
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Key Operator Functions > Statistics Cassette Statistics
Cassette Statistics
Cassette Statistics lets you view the performance of a cassette and identify
possible problems with cassettes.
The Cassette ID column identifies the cassette. The screen also shows the
number of scans for each cassette, how many images were accepted or
rejected, and the percent rejected for each cassette ID.
The total of each column appears at the bottom of the screen.
You can use this information to remove a cassette from service if necessary.
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Key Operator Functions > Statistics > Erase Statistics
Erase Cycles
The Erase Cycles Screen tracks the number of scans/erases done with each
pair of lamps.
The Actuation Count displays the total scans on the system.
The Batch Erase Count displays the number of cassettes that have been
erased by going into the Batch Erase Mode (825/850/975 CR System) or
Manual Erase Mode (Classic/Elite CR System). This number is separate from
the actuation count.
You can use this screen to identify a problem with the erase lamp assembly if
the erase lamps are burning out sooner than expected.
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Key Operator Functions > Statistics > Download Statistics
Exporting Data
With the optional Administrative Analysis and Reporting Software, you can
retrieve data from multiple CR or DR Systems, download it to a PC, and analyze
it using pre-configured templates for MICROSOFT EXCEL 2000 or higher. The
interactive reports can be configured, rearranged, analyzed, saved, and
appended as you choose.
To set-up to export data from several machines:
This feature is best operated from an office computer that is connected to the
CR network using the Remote Key Operator function. The following items must
be installed on a computer with access to the network on which the CR
machines are connected:
 Remote Access Software
 Templates CD
 MICROSOFT EXCEL 2000 or higher (not provided)
The CR devices from which data must be obtained must have Administrative
Analysis and Reporting Software activated on the System.
1. At the Remote Key Operator, open MICROSOFT INTERNET EXPLORER.
2. In the address window, enter the IP address of one machine you choose to be
the host machine.
The host will get the data from all other machines (for example:
http://192.168.1.1).
3. To the end of the IP address, add :56333/
For example, a complete entry would look like this: http://192.168.1.1:56333/
4. Log in as a Key Operator at the Remote Key Operator computer.
5. Select Key Operator Functions >Statistics >Download Statistics.
6. At the Download Statistics Screen, select Add Device IP Address.
7. Add the IP address of all of the Consoles from which you want to collect data.
9. Select the check box for the devices you want to get information from.
10. Enter the From Date and To Date to determine the date range.
11. Select Retrieve Statistics.
12. Choose one of the following:
 Stats
 TQT Stats
13. Select View statistics or Save File As.
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14. Select a drive or the WINDOWS desktop.

15. Select New Folder.
16. Name the folder.
17. Select Save.
18. Highlight the file in the list.
19. Select the Select button. This returns you to the Download Statistics Screen.
20. Open the CR Admin Reporting Template from the Administrative Analysis
and Reporting Software CD.
21. Save to the desktop of the Remote Key Operator.
22. Open the template.
23. At the prompt, select Enable Macros.
24. Select Import Data from the worksheet.
25. Select the EXCEL spreadsheet saved to a drive or on the desktop.
26. Select Yes to overwrite the existing record.
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Trauma Defaults
Trauma Defaults Configuration
Trauma is configured by the Key Operator to provide a fast source of patient
information to use when:
 Patient information is not available.
 You need to complete an exam rapidly when a patient's identity may not be
known.
To set up and configure trauma defaults:
1. Select New Tab.
2. Select the tab size based on the number of items you want in the list.
3. Select a button and enter the name in edit mode.
4. Select the Color Tab and select a color.
6. Select Change Trauma Defaults.
The Trauma Defaults [Patient Name] displays. See Entering or Changing
Trauma Exam Data
7. Enter the desired information, such as Priority, Gender, Tech ID, etc.
9. Select Back to pre-configure more Trauma buttons.
or
Select Main Menu > Study Data > Trauma to review the newly created
Trauma buttons.
You cannot move a button from one tab to another.
You can enter five tabs of 40 entries, or 200 items per list.
Navigation Buttons
Change Trauma Opens the Patient Data form on the Patient Input Screen. Lets
Defaults you edit the default patient data for the selected trauma button.
Enter the required data that represents this default ID.
New Tab Selects the matrix size based on the number of items you will
have in your list. Choose from 4 x 5, 5 x 5, 6 x 5, 7 x 5, 8 x 5. You
can enter up to five tabs of data per list.
Delete Tab Deletes the tab of information from the list. You will be prompted
to confirm the deletion. There is no recovery from deleting a tab.
Show Button Displays the button in the list in the interface. Toggles to Hide
Button.
Hide Button Hides the button display on the interface. Toggles to Show Button.
Save Changes Saves the change to the local database.
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Main Menu Exits the current screen and returns to the system Main Menu.
Changing Button Colors or Moving Buttons on a Tab

Use the Tab Controls that appear at the bottom of the screen:
Tab Controls
Keyboard Activates the keyboard when you touch a button. The button
becomes active for editing. Type the information from the virtual
keyboard.
Color Selects the colors of the buttons from over 200 individual colors.
Select the color you desire.
Color Palette Selects from a full color palette of blended hues.
Move Moves the button to another position on the tab. "Move" does not let
you move the button to another tab.
See also:
Changing Trauma Defaults
Hiding Trauma Defaults
Procedure Mapping Configuration
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Key Operator Functions > System Configuration > Trauma Defaults
Entering or Changing Trauma Exam Data

The Change Trauma Defaults button associates a default patient record with
the Trauma Default button previously named.
To create or edit the patient record information for the Trauma button:
1. Select the Change Trauma Defaults button.
2. Enter default values for the fields of interest for the selected Trauma exam.
3. Use the Unique Number button to assign a serial number of 1 to 4 digits to
selected fields.
For example:
1. In the Patient Last Name field, enter Doe.
2. Select Unique Number 2 digits.
The result is a series of Trauma Patient names: Doe 01, Doe 02, Doe 03,
etc.
In the Patient ID field
Select Unique Number 4.
The system identifies the patient as 0001, 0002, 0003, etc.
4. Use the Procedure Name field or Procedure Code field to assign a procedure
to the trauma default button if the Procedure Mapping option has been enabled.
To prevent Trauma exams from being delivered to Mandatory Destinations,
make sure you leave one of the Required for Delivery fields blank
Tab Controls
Keyboard The keyboard becomes active when you select a field. The field becomes
active for editing. Type the information from the keyboard.
Unique Lets you assign a unique number to the Patient Name fields, the Patient
Number ID field, or the Accession Number field. This ensures that no matter how
often this Trauma ID is used, the Patient ID will be unique.
See also:
Hiding Trauma Defaults
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Hiding Trauma Exam Buttons

You can configure trauma exam buttons to not show on the Trauma Defaults
list.
To hide a trauma exam Button:
1. From the Trauma Defaults Screen, select a trauma exam button, such as
cranium.
2. Select Hide Button.
To restore a Trauma exam button:
1. From the Trauma Defaults Screen, select a trauma exam button, such as
cranium.
2. Select Show Button.
See also:
Changing Trauma Defaults
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View Configuration
Key Operator Functions > System Configuration > View Configuration
View Configuration
What is a View?
A View is a pre-set image type that a radiographer can select to represent an
exam. It is the basic element in the digital image chain.
Views are associated with procedures on the Patient Input Screen and in
optional Procedure Mapping.
When you create a View, it appears on the Patient Input Screen as soon as
you add it and save it on the View Configuration Screen.
How do I create a View for a radiographer to select

for an exam?
You can create a View by changing one or more of the following configurations:
Color Mask
Body Part Grid Suppression
Projection Noise Suppression
Position Raw
Text Box True Size
View Name Tick Marks
Tutor Image Rotation
Skin Line Detection Crop Type
For every View, there is an associated look and customized changes for each of
the preference editor controls. These can be seen, but not modified in the View
 Brightness
 Latitude
 Sharpness
 Contrast
 Noise
To create a new View:

1. Reduce the number of Views in the list by selecting the Category radio buttons.
2. Select the check box of the View with a similar body part/projection you want to
copy.
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3. Select Copy Checked Views to copy the View settings and create a new View.
4. Select a Primary and Secondary Category to associate with the copy.
5. Select the new View name tabbed keyboard.
6. Select the radio button to display the parameters for the View (column
selection).
7. Select the item that you want to change and enter a new value from the tabbed
keyboard. Repeat for each parameter you want to change.
8. Select Show View Details to edit all configurations of the View at once, or use
the Column Selection radio buttons to control which columns are displayed in
the View list.
9. Select the Global Edit check box to apply the changes you make to every row
of the Category selected.
How do I delete a View?

1. Select the check box next to the View(s) you want to delete.
2. Select Delete Checked Views to delete the selected View(s).
A confirmation dialog shows what Views will be deleted.
Before selecting Delete Checked Views, deselect all Views to make sure
that no additional Views are unexpectedly selected.
Views are erased from the system when you delete them from the View
Configuration.
Deleting Views from View Category Management moves Views to the
Uncategorized category so they can be added back into a category later, if
desired.
How do I change the sort order of the View List?

 Select the heading item in the list.
The list order changes from ascending to descending.
How to assign default attributes to Unassigned

Images
When an image is unassigned, it has no View attributes assigned to it. When
you assign the image, it still does not take on the attributes of the selected View.
For example, the Text Box would not appear, even though the assigned View
has a text box as an attribute.
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In the View Configuration Screen, you can assign attributes so that all
unassigned images are configured. To do this, select the Unassigned Default
radio button and enable the following for an unassigned default:
 Color
 View Name
 Tutor Image
 Look Name
 Grid Suppression
 Noise Suppression
 Raw
 Skin Line Detection
 Internal Text Box
 Cropping Type
 Surround Mask
How to view the Look name

To view the name of the Look that has been selected for the View:
1. Select the Brightness, Latitude, and Detail Contrast radio buttons.
2. View the name of the Look for each View. The Look name is the far right
column on the screen.
How to change the default characteristics of an image

1. On the View Configuration Screen, place a check mark in the Select column
next to the View you want to modify.
2. Select the characteristic you want to modify, such as Rotation.
3. Select the preferred rotation from the pop-up menu.
Show View Details Lets you view the settings such as, Noise Suppression, Detail
Contrast, Latitude, Brightness, and Sharpness. You can
change settings such as, Grid Suppression, Raw, Surround
Mask, the indicator color, True-size, Tick Marks, Skin line
detection, and cropping type.
 Select the tutor image to change the tutor image for the View.
 Select internal Text Box to add a text box configuration to the
View.
 Select the tutor image to place the Text Box.
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 Select the External Text box setting to be at the bottom, left,

or off.
Delete Checked Views Selects the check box of the Views you want to delete and
then select Delete Checked Views.
A confirmation message appears. If the Views are associated
with a procedure, make sure that deleting them will not affect
Procedure Mapping.
Copy Checked Views Selects the check box of the View you want to copy and then
select Copy Checked Views. Rename the View and modify it
if desired. Select a Primary Category and a Secondary
Category where you want to place the View.
View Category Add or delete Primary, Secondary Categories, or Views. Use
Management the far right column arrows to move highlighted items to
arrange how the Regions, Exams, and Views display. The
order of the items in the column will display left to right, top to
bottom at the Patient Input Screen.
Check All Selects all check boxes. One row is always selected.
Uncheck All Removes the check mark from all check boxes.
Save Changes Completes the action by writing changes to the local database.
Menu.
Tab Controls
Keyboard Activates when you select a button. The button becomes
active for editing. Type the information from the keyboard.
Color Allows you to choose the colors of the buttons from over 200
individual colors.
Color Palette Provides a full color palette of blended hues.
Body Part* Provides three tabs containing all body parts in use to create a
View.
Projection* Provides from three tabs containing all projections in use to
create a View.
Position* Provides all positions in use to create a View.
Flip/Rotate Flips or rotates, and lets you select the degree.
Tutor Image Selects the graphic tutor image that represents the View. Both
Gold and silhouette images are available.
* You can use the virtual alphanumeric keyboard to change body part,
projection, or position. After saving, the new item appears in the appropriate
keyboard.
See also:
What Is a SNOMED® Code?
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Automatic View Selection

If configured, selecting the Patient Size field on the Patient Input screen will
automatically determine the appropriate Pediatric View for Chest and Abdomen
exams. The following is a list of Patient Size categories:
 Newborn (1 day to 1 month)
 Infant (1 month to 2 years)
 Child (2 years to 11 years)
 Preadolescent (11 years to 13 years)
 Adolescent (13 years to 21 years)
For Newborns, there are two additional categories, Very Low Birth Weight (1.5
kg or less) and Low Birth Weight (between 1.5 and 2.5 kg).
Each of these categories have their own Views so that the image processing
can be set differently by the Key Operator. After the image has been processed,
the View will automatically be processed with the correct Patient Size category
if the incorrect View was selected.
To configure a View based on patient size, age, weight, and/or whether a grid is
present during the exposure, navigate to Key Operator Functions>System
Configuration>Automatic View Selection.
Patient Size Indexing
Automatically determine Patient Size based on the age and weight of

the patient check box.
 Entering the patient date of birth automatically determines the patient size.
Automatically change View based on the Patient Size check box.
 The patient size determines the View.
Grid Indexing
Select the Automatically change View based on the presence of a grid
check box if this feature is desired.
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Patient Size Indexing

DIRECTVIEW System Software offers a wide range of Views to select for
pediatric patients.
Automatically determine Patient Size based on the age and weight of
the patient check box.
 Entering the patient's date of birth determines the patient size.
Automatically change View based on the Patient Size check box.
 The patient size determines the View.
To configure patient size for View configuration

1. Navigate to Key Operator Functions>System Configuration>Automatic
View Selection and select the Patient Size Indexing tab.
2. Select the Active checkbox to select the category you want to make
available.
Categories:
 Very Low Birth Weight
 Low Birth Weight
 Newborn
 Infant
 Child
 Preadolescent
 Adolescent
The default maximum values for each category are displayed.
To edit the maximum value for each category and set new defaults for your
system
1. Select the displayed maximum value.
2. Input a new value from the virtual keyboard.
See Also
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Grid Indexing
Navigate to Key Operator Functions>System Configuration>Automatic
View Selection.
Select the Automatically change View based on the presence of a grid

check box. if Grid Indexing is desired.
By default, the image processing is the same for Non-grid and Grid Views,
except for the Companion Grid and Non-grid Views.
 Each View is optimized for exposures taken without a grid, as a rule. However,
the image processing can be optimized for Grid Views. The Key Operator can
select the Grid Indexing option. Grid Indexing will automatically detect the
presence of a stationary grid (recommended use 103 lp/in). After the image has
been processed, the View will automatically be processed with the correct View
(Non-grid or Grid). It will change the View name on the thumbnail on the Patient
Input screen.
 If no grid is detected, the image is processed with the non-grid Views.
On mobile DR systems, grid detection occurs before the image is acquired,
calculated by the angle of the X–ray tube as it relates to the detector.
 The Key Operator can disable this feature.
 The software detects the presence of a grid in many Views. The Key Operator
can optimize the Grid Views so that the image processing is different from the
non-grid views. The system will then automatically select optimal image
processing parameters for that image. See Views that have grid
Views associated with them:
Abdomen-AP-Supine-Grid
Abdomen-AP-Upright-Grid
Abdomen-AP-LLD-Grid
Abdomen-PA-LLD-Grid
Abdomen-Lateral-Recumbent-Grid
Abdomen-Lateral-XTable-Grid
Chest-AP-Supine-Grid
Chest-AP-Erect-Grid
Chest-Lateral-Recumbent-Grid
Chest-Lateral-Erect-Grid
Chest-Lateral-XTable-Grid
Portable Chest-AP-Supine-Grid
Portable Chest-AP-Grid
Portable Chest-AP-Upright-Grid
Portable Chest-AP-Semi Erect-Grid
Pelvis-AP-Supine-Grid
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Pelvis Inlet View-AP w/30 degree angle-Supine-Grid

Pelvis Outlet View-AP w/30 degree angle-Supine-Grid
Pelvis-PROSTHESIS-Grid
Hip-AP-Supine-Grid
Hip-Lateral-Frog Leg View-Supine-Grid
Hip-XTable-Supine Axiolateral-Grid
Femur-AP Proximal PROSTHESIS-Grid
Hip-Obl-PROSTHESIS-Grid
Lateral Hip PROSTHESIS-Grid
Facial Bones-AP Waters View-Supine-Grid
Sinuses-XTable-Lateral-Grid
Femur-AP-Supine-Grid
Femur-Lateral-Grid
Femur-Distal PROSTHESIS-Grid
C-Spine-AP-Supine-Grid
C-Spine-Lateral-XTable-Grid
L-Spine-AP-Supine-Grid
L-Spine-Lateral-Recumbent-Grid
L-Spine-XTable-Grid
T-Spine-AP-Supine-Grid
T-Spine-Lateral-Recumbent-Grid
T-Spine-XTable-Grid
Skull-AP-Supine-Grid
Skull-XTable Lateral Supine-Grid
Portable Chest-AP-Pneumothorax-Grid
 The Key Operator can delete or copy Views on the View Configuration screen
without affecting the optimized grid Views. See View Configuration.
 The Key Operator can backup and restore Views with grid indexing. See Backup
and Restore.
See also:
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Importing Custom Tutor Images

How to Import Custom Tutor Images
A Key Operator can import tutor images of their own design from Key Operator
Functions>System Configuration>Import Tutor Images.
1. Load custom tutor images onto a USB drive.
2. Insert the drive into the Console computer.
3. Navigate to the Import Tutor Images screen.
4. Click the Import From field and select the directory that contains the USB
drive.
The custom tutor images appear in the left pane.
5. Select Check All to select every image. Select Uncheck All to deselect
every image. Select individual images and move them to the right panel
using the Import arrow.
6. Select Delete to delete an image from the list.
Custom Tutor images must be assigned to each View, one at a time.
To Assign Tutor Images

1. Navigate to Key Operator Functions>System Configuration>View
Configuration.
2. Select the radio button for Color, Body Part, Projection Position,
Laterality, Auto Position, Tutor Image.
3. Select a View.
4. Select the tutor image for that View.
5. The Tutor Image panel opens.
6. Click Custom.
7. Select the tutor image you want to associate with that View.
8. Select View Configuration to assign a text box position or change the tutor
image, if necessary.
How to Select Default Tutor Images
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Tutor images display body parts in View positions. Carestream Health provides
gold or white silhouette tutor images to display as default images. You can
select either of these image types from Key Operator Functions>System
Configuration>Display Configuration. Select the Patient Input tab and select
the Display Tutor Images checkbox. Select the radio button for either Gold or
Silhouette to set the default.
To change the tutor image

1. With the View selected, select Go to View.
The View Configuration screen appears.
2. The selected View appears at the top of the screen.
3. Select the tutor image for that View. The Tutor Image panel opens.
4. Select a Gold, Silhouette, or Custom tutor image.
3. Select Show View Details.
4. Select an Internal Text box if desired.
5. Select Change Tutor Image.
6. Select Back.
The tutor image is changed for that View.
To globally change the tutor image

1. On the View Configuration screen, select the Global Edit checkbox.
2. Select one of the images in the Tutor Image column.
3. Select the gold or silhouette tutor Image from the Tutor Style tab.
The tutor image style changes for all Views automatically.
See Also:
View Configuration
How to Change View Configuration Details
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Network Configuration
The Key Operator configures the settings that identify the System to a hospital
network.
These settings appear when the user touches the icon in the title bar of the
screen and the information appears on the pop-up screen.
The following information is required if the System is on a hospital network.

Contact your IT representative for details about this information.
Computer Name text box
Network Speed/Duplex text box
Firewall Enabled text box
Obtain an IP address automatically radio button
Use the following IP address radio button
Local IP Address text box
Subnet Mask text box
Default Gateway text box
Obtain DNS server address automatically radio button
Use the following DNS server address radio button
Preferred DNS server text box
Alternate DNS Server text box
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Configuring Surround Mask Enlargement

Surround Mask Enlargement allows the auto mask to pull back off the
collimated area in order to show the actual collimation. The increments are in
centimeters. It is recommended to use 2-3 cm. Using more than this can create
a black border to appear inside the image area.
To apply the Surround Mask Enlargement:
1. From the Main Menu, select Key Operator Functions > System
Configuration > View Configuration.
2. Select the fourth radio button (under Mask).
3. For a specific View, enter the value for the mask enlargement, from 0 to 12 mm.
4. To change all Views, select Global Edit to apply the mask enlargement to all
Views.
This configuration changes the appearance of the mask on all images you
have selected.
Surround Mask Enlargement Appearance

Surround Mask Enlargement allows the auto mask to pull back off the collimated
area in order to show the actual collimation.
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See also:
358
Changing View Configuration Attributes

To change the View Configuration Attributes:
1. Select a View.
2. Select the desired attributes (View Name, Rotation, Tutor Image, and so
forth.)
Select Show View Details to view a summary of the View's attributes.
 Edit the attributes of a single View.
 View the standard naming and encoding convention (SNM3 Codes) for
identifying body part, position, and orientation in the DICOM header.
To view and/or change the following attributes which make up each View: See
the View Configuration Details Screen for a list of items that make up each
View.
When the Global Edit Mode box is checked, any changes apply to all of the
Views for the category selected.
Changing the View name will not change the image processing. The image
processing for the View is determined by the way the View is set up in the Image
Processing Preference Editor.
Navigation Buttons
Menu
See also:
Managing View Categories
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Key Operator Functions > System Configuration > View Configuration >
View Category Management
Managing View Categories

You can Add or Delete Primary Categories, Secondary Categories, or Views.
 Use the far right column arrows to move highlighted items and arrange the way
the Regions, Exams, and Views display.
 The items in the column will display left to right, top to bottom, at the Patient
Input Screen.
1. Select a Primary Category.
The category name highlights so that you can edit it. The associated
Secondary Category and views appear in the second and third columns.
2. Edit the category or select Add to save it and start a new category.
3. Select a color for the Primary Category from the keyboard.
4. Select a Secondary Category and color.
5. Add or delete the views as appropriate.
See also:
What Is a SNOMED® Code
Changing View Configuration Details
View Configuration
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Key Operator Functions > System Configuration > Color Preferences
Color Preferences Configuration

The color groups are divided as follows:
 All Colors
 Status Colors
 General Application Colors
To change the colors of the interface:

1. Select the radio button of the color group at the top of the screen.
2. Make a selection from the Description column that you want to give a different
color to.
3. Select the color from the Color Tab or the full-range Color Palette Tab.
Select all of the color changes and then select Save Changes when you are
finished.
You can view the colors that have already been used by selecting the Used
Colors Tab.
Select Reset to reset the list. Select to reset the color to the factory default.
You can select a general, overall color scheme for buttons and backgrounds to
save time. At the bottom of the screen select either Apply Gray Theme or
Apply Blue Theme in order to automatically select a color-coordinated palette
for common groups of preferences.
For a quick reference to the palette you are using, select Colors in Use. These
palettes will clearly display the colors that are designated within your system.
Save Changes Completes the action by writing the information to the local database.
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Key Operator Functions > System Configuration > Customizable Field

Description
How to Change Field Descriptions

To change the dialect used in the User Interface:
To add or change a dialect or change the field descriptions that appear in the
CR or DR interface:
1. Select the phrase that appears in the Translation column.
2. Select the Customized Translation column on the right side.
3. Retype the phrase.
4. Select Enter.
Navigation Buttons
Menu.
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Key Operator Functions > System Configuration > Delivery Preferences
Delivery Preferences Configuration

Delivery Preferences lets you set the defaults for information delivery.
Hospital Name Determines the Hospital Name that you want to associate with
the images.
Hospital Address Names the address of the hospital that you want to associate with
the images.
Operating Mode Selects the default operating mode:
 QA mode
 Auto Display
 Pass-Through Mode
 QA by Study (DR)
Pixel Spacing Selects pixel spacing for workstations that require the (0018,
1164) Imager Pixel Spacing and require the (0028, 0030) Pixel
Spacing field.
Uppercase for all Selects the DICOM header to appear in all capital letters by
DICOM fields default.
Delivery Mode Determines whether the film delivery will be:
Best Use of Film (allows for a counter-clockwise 90-degree
rotation when placing the image on the film. Best Use of Film
provides a larger image size (maximizing film usage)
Shrink to Fit (does not allow this extra rotation).

Select the Shrink to Fit check box if images are rotated when
printing multiple images on a single film.
Send patient Sends all images in L/F orientation. This means the workstation
orientation DICOM will not rotate the image when it is received.
tag (0020:0020)
using L/F
Use CR IOD Prevents an error when determining if DX or MG is supported. It
means always use the CR DICOM IOD, instead of DX or MG
IOD.
Previous product always sent images in the CR image space. DX
IOD has many extra DICOM tags, but not all workstations can
understand DX. In that case, CR IOD is used by default.
Translate Body Part Provides a choice to translate body part and projection, or leave
and Projection in English.
Delivery Preferences lets you select the general image instance number:
 Every image is its own Series. Instance Number is always 1.
 Every image is its own Series. Instance Number is unique.
 Every image is in the same Series. Instance Number is unique.
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The Image Instance Tab has different configurations to help with hanging
protocols at the PACS. Consult your PACS Administrator to determine which
setting is required for your PACS system.
See also:
Storage Commitment Support
QA Mode
Pass-through Mode
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Navigate to Key Operator Functions > System Configuration > Display
Configuration.
Display Configuration lets you customize the way data displays on the Patient
Query/Work List, Patient Input, Image Viewer, and other screens.
To speed up data entry, select from the following to set the default display on
these screens:
Patient Query Auto Search Mode
Configures the query used to display the default sort order on the Work
List screen.
 Local Only radio button
 Remote Only radio button
 Local Then Remote radio button
The Patient Query tab lets you set the defaults for patient query, the
function used to narrow the search to locate patients.
Study Status Values
 Scheduled
 Arrived
 Started
 Scheduled/Arrived/Started
 Scheduled/Arrived
 Completed
 Failed Update
 Cancelled
 All
Time Window
 Today
 Today-Tomorrow
 Yesterday-Tomorrow
 Past Week-Tomorrow
 Unrestricted
Modality
 CR
 DX
 RT
 All
Procedure Step/ Study Creation
Patient Select the image output based on the workflow you use. In this section
Input you can select the default for study creation on the Patient Input screen.
 Create new Procedure Steps from Patient Input radio button
A Study Instance Unique Identifier (SIUID) and a New Procedure
Step are generated each time you select New Procedure Step for that
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patient.
 Create new studies from Patient Input radio button
Applying Profiles
Select the default function for destination Profiles in the workflow.
 Profile change applies to current step only radio button
 Profile change applies to all incomplete steps for this patient radio
button
Patient Input Options
Select preferences for field functionality on the Patient Input
screen. See also Layout Configuration>Patient Input editor.
 Require confirmation to end a procedure step check box. A pop-up
message will appear if this option is selected.
 After accepting All Images in one or more procedure
steps or studies, set the status to Completed check box
 Auto-populate Tech ID with logged in user check box
 Auto-populate Tech ID from previous study check box
 Display Tutor images check box. A tutor Image will display when a
View is selected.
Enable Wristband Verification Mode on Patient Input Screen check
box
Select the check box to allow patient verification icons to appear on the
title bar of the Patient Input screen and provide Patient Verification
functionality.
Select the criteria for patient verification :
 Patient ID radio button
 Name and Date of Birth radio button
Image Viewer Image Viewer Options
Region of Interest (ROI) is the mean, minimum, maximum and standard
deviation values for the code values within the area specified by the user
on the image.
Dimension
The size of the area that defines the ROI when the user touches a point
on the image is determined here. You can select from the following:
 10% radio button
 Custom radio button
Customize the size of the area by selecting the ROI

Width and Height arrows on the slider controls,
displayed in centimeters.
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 Display ID Window check box.

Select to display the ID window on the Image Viewer screen. You can
use this to identify the orientation of the cassette during the exposure.
 Use Express Viewer check box.
Select to configure the Express Image Viewer to
appear whenever the Image Viewer screen is needed.
 Automatically Reprocess Image check box
Select to eliminate the need to manually reprocess an
image that has been modified or masked on the Image
Viewer screen.
Companion Image Creation

Select to manually or automatically create companion
images..
 Automatically create all companion views on image
acquisition radio button
 Create companion views when requested by the Tech
on the Image Viewer radio button
Other Audio Volume slider control

 Customize the volume of the sound by selecting the arrows on the slider
controls. You can determine the volume by listening to the sound of the
chime as you move the control.
Blue Tint slider control

 Use the slider control to set the amount of blue tint to add to images
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displayed on the CR, DR, or ROP.
Keyboard Clicks check box

 Allows and audible "click" when a virtual keypad is selected.
The level of sound is determined by the default setting in
Audio Volume.
.
Patient Link Patient Link
Displays buttons that link functions such as Shutdown,
Logout, Snapshot Log files, Image Export List, and so
forth, to the Shortcut menu. In addition to these functions,
current patient studies and patients with repeated entries
appear there. Access the Shortcut menu by selecting the
icon located in the lower left corner of every screen.

 Patient Link Enabled check box. This allows you to select patient
studies that are in progress from the Shortcut (Quick) menu for faster
access.
 Repeat Patients check box.
 Number of Shortcuts text box. Enter the number of shortcuts allowed
on the Shortcut menu numerically. The default number is 3.
Shortcut Menu
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Button Sort Order

Orders the patient studies that appear on the Shortcut
menu.
 Most Recently Accessed Appears at the Top of the List
radio button
 Most recently Accessed Appears at the Bottom of the
List radio button
Save Changes.
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Key Operator Functions > Flagged Image
Harvesting Flagged Images

The Flagged Image List provides a quick and easy way to export images from
the system for further evaluation. The Flagged Image List looks very much like
the Image List. You can search the list using the bar-code scanner to input
Patient Name, Patient ID, Accession Number, Tech ID, or Acquisition Date
(or enter manually).
Place checks in the check boxes on the list to indicate which images you want to
harvest.
Flagged Image List Controls

Quick Menu Provides a quick access to functions such as logout,
shutdown, and special interest features.
Select All Selects all available items that are listed after one of the filter
categories have been applied.
Clear Fields Clears all of the criteria that has been entered to locate a
patient.
Harvest Checked Sends a copy of the image to a removable disk for further
Images evaluation.
Unflag Selected Image Removes the status of flagged image from any selected
images.
Main Menu Returns you to the CR Main Menu screen, exiting the Flagged
Image List.
Back Returns you to the previous function or page.
New Folder Creates a new folder to send the harvested images to.
Select Highlights the destination folder and then directs the images.
To harvest images:
1. Filter the list using the search filters:
 All Images
 Flagged Images
 Rejected Images
2. Use the check boxes to the left of each thumbnail to select the image of interest,
or Select All images.
3. Select Harvest all Checked Images.
4. Select a destination directory.
5. Select the Select button.
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A transfer icon appears at the top of the screen to indicate that the transfer is in
progress. The icon disappears when the transfer is complete and a pop-up
message confirms that the harvest was successful.
For any image you can remove all protected health data by selecting the
Remove PHI data (Protected Health Information) check box.
Select the Unflag the Image after Harvesting check box to return the image to
the workflow.
To harvest images to a CD/DVD:
1. Filter the list with the search filters described above.
2. Use the check boxes to the left of each thumbnail to select the image of interest,
or Select All images.
3. Select Harvest all Checked Images.
4. Select a destination directory.
5. Select CD ROM.
6. Select Select.
To change the destination:
When you select Harvest Checked Images, a screen appears for you to select
the destination directory.
1. Select the directory pull-down menu to see available directories. You can select
New Folder and give it a name.
2. Highlight the folder you want and then select Select. The selected images are
copied there.
Why Didn't My Images Transfer?

Images cannot be harvested if enough space is not available on the destination
drive. The total space required and the available space are reported on the
screen. If the images did not transfer, make room on the destination drive and
harvest the files again.
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Key Operator Functions > System Configuration > HIS/RIS Configuration
How to Configure for a Polling Query

A polling query lets the CR System communicate with the Radiology
Information System (RIS), to display the patient Work List. You can also query
the RIS for individual patients.
To configure a Polling Query:
1. Set up the type of query and interval to the PACS Broker:
2. Modify HIS/RIS Options:
HIS/RIS Options
HIS/RIS Options
At the Key Operator Functions menu, select System Configuration, HIS/RIS
Broker Configuration, and then select HIS/RIS Options.
PACS Common Configuration
HIS/RIS AE Title Broker Name, normally BROKER
HIS/RIS IP Address PACS Broker IP Address
HIS/RIS Port PACS Broker Port, normally 3320
Enter the information for your system and select Save Changes.
Other HIS/RIS Options

1. Select the check box to automatically delete canceled studies from the system
when the status is Cancelled.
2. Select the check box again to clear it if you do not want this action.
3. Select the check box to send the Scheduled Workflow MPPS Command
(optional feature).
The selection for the following list is determined by the Procedure Mapping
configuration of the HIS/RIS Broker. To change selections, the Broker must be
reconfigured.
HIS/RIS Procedure Mapping
DICOM Field Name DICOM Tag Requested Procedure
Code Sequence
Procedure ID (0040, 1001) NA
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Procedure Code (0032,1064) (0008, 0100)

Scheduled Procedure Step (0040, 0100) (0008, 0100)
Sequence, (0040, 0008)
Performed Protocol Code
Sequence
The purpose of this screen is to select which RIS is used with CR Procedure
Mapping.
If you enable your system for Scheduled Workflow, PerformedProtocol Code is

selected automatically, and is not configurable.
Navigation Buttons
Main Menu Exits the current screen and returns you to the system
Main Menu.
See also:
See also:
373
Key Operator Functions > System Configuration > System Maintenance
Setting the Limits for Image Retention

The System Maintenance Screen lets you set high and low limits for use of
disk space, balancing between performance and image retention.
This screen lets you determine the criteria used by the system to automatically
erase images or delete patient records.
Disk High Water Mark Disk High Water Mark is set Enter the percentage of disk
for optimum performance at space to allow before
installation. automatic clean-up occurs.
80% is recommended.
Disk Low Water Mark Disk Low Water Mark is set Enter the percentage of disk
for optimum performance at space that you want the
installation. clean-up to reach.
75% is recommended.
Maximum Rejected Retaining rejected images is Enter the maximum number
Images Allowed optional. of rejected images to allow
The number of rejected in the system before
images stored affects the deleting.
total number of available
images in the system.
Patient Record Delete Permits retention of patient Enter the number of days a
Age information without patient patient record can remain
images. on the system before
deleting.
1. At the Key Operator Functions menu, select System Configuration.

2. Select System Maintenance.
3. Enter the value in each field from the keyboard.
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Key Operator Functions > System Configuration > List Configuration
List Configuration
To create a list that the radiographer can pick from when entering data:
1. In Key Operator > System Configuration > List Configuration, select a list
name: Department Name, Referring Physician, or Tech ID.
2. Select New Tab.
3. Select the Tab size based on the number of items you want in the list.
4. Select a button and enter the name in edit mode.
5. Select the Color Tab and select a color.
Make sure that you place the button on the tab you want. You cannot move a
button from one tab to another.
You can enter five tabs of 40 entries, or 200 items per list. You can also change
the title and color of the tab label.
Navigation Buttons
New Tab Select the matrix size based on the number of items you will have in your
list. Choose from 4 x 5, 5 x 5, 6 x 5, 7 x 5, 8 x 5. You can enter up to five
tabs of data per list.
Delete Tab Deletes the tab of information from the list. A prompt asks you if you are
sure. There is no recovery from deleting a tab.
Show Displays the button in the list in the interface. Toggles to Hide Button.
Button
Hide Hides the button display on the interface. Toggles to Show Button.
Button
Main Menu Exits the current screen and Returns to the system Main Menu.
To change button colors or move buttons on a tab:

 Use the Tab Controls that appear at the bottom of the screen:
Keyboard The keyboard becomes active when you select a button. The button
becomes active for editing. Type the information from the keyboard.
Color Lets you select the colors of the buttons from over 200 individual colors.
Select the color you desire.
Color Lets you select from a full color palette of blended hues.
Palette
Move Lets you move the button to another position on the tab. "Move" does not
let you move the button to another tab.
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Key Operator Functions > System Configuration > Long-Length

Configuration
Long-Length Imaging Configuration

Long-Length Configuration for CR Systems lets you enter the Source to Image
Distance for vertical and portable cassettes. You can also select a delivery
method:
 Deliver only the composite image
 Inspect composite images before delivery
 Deliver composite images without inspection
Required Source to Image (SID) values

 For Long-Length Vertical Cassette Holder, a value from 152 cm to 229 cm (60
in. to 90 in.) is recommended.
 For Long-Length Portable Cassette (supine), a value of 59 in. (150 cm) is
recommended.
 For Long-Length Portable Cassette (erect), a value of 59 in. (150 cm) is
recommended.
To configure for Long-length Imaging:
1. Enter the SID value for the cassette(s) you will be using.
2. Select the check box if you want all sub-images automatically marked as
delivered after the composite image is complete. The sub-images are not
actually delivered.
3. Select the radio button for the image processing mode you desire: QA mode or
Pass-Through Mode for the composite image.
QA Mode: Delivers composite images after inspection.
Pass-through Mode: Delivers composite images automatically without
inspection.
Navigation Buttons
Menu.
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Key Operator Functions > System Configuration > Procedure Mapping

Configuration
Procedure Mapping Configuration (optional)

Use Procedure Mapping to save data entry time on the Patient Input Screen
and add consistency to procedure preparation.
 Procedure Mapping lets the Key Operator associate a set of Views with a
particular Procedure Name or code.
 Studies that come from a HIS/RIS select a procedure that matches a code.
 The radiographer can select a procedure manually using the procedure
keyboard.
 The procedures are categorized so that they are easy to locate, even when there
are thousands to choose from.
To set up pre-defined procedures:
1. Choose an existing Region, or Select Add, then enter a Region.
For example, Thorax, Spine, Upper extremity, Lower extremity.
2. Choose an existing exam, or Select Add, then enter an Exam.
For example, Adult Chest, Pediatric Chest, Sternum, Ribs.
3. You can modify an existing Procedure Name (by selecting Turn Edit On) or
select Add, then enter a procedure name.
4. Enter a Procedure Code to match the code sent by the HIS/RIS in the
Procedure Code field on the Patient Input Screen. This will automatically
populate the views when selecting a patient record.
5. You can select a Destination Profile. However, you should leave this field blank
for the CR modality.
6. Save Changes.
7. Select Add in the Views box, then enter the desired Views for the procedure.
You can add Views from different categories. Select Delete to remove
highlighted Views from a procedure.
Use the second column of arrows (located to the right of the Views) to rearrange
the order in which the Views display at the Patient Input Screen. The top View
will display first at the Patient Input Screen.
To delete a procedure:
 Go to Procedure Mapping to delete a procedure.
To define Views to use with Procedure Mapping:

 View Configuration lets you add, delete, and modify views for use in procedure
mapping.
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To Restore Procedure Mapping configurations:

When restoring Procedure Mapping Views, the system will present two
choices:
Delete ALL Procedures and Views

Then Restore Procedures and Views from Backup radio button
 Clears the database by deleting all Procedure Mapping configurations,
both Views and categories, before restoring the new ones.
Keep NEW Procedures and Views
Then restore older Procedures and Views from Backup radio button
 Merges all previous and new procedure codes and Views.
 Does not back up categories—categories become uncategorized.
Select OK.
Navigation Buttons
Change Multi-format Lets you add a multi-format configuration to the
Configuration procedure, such as 2-up lengthwise to 4-up
crosswise.
Change View Configuration Quick access to View Configuration. Lets you add,
delete, and modify views for use in procedure
mapping. Select the Back button in View
Configuration to return to Procedure Mapping.
Turn Edit On Lets you edit the procedure. Select this button to
make changes such as name, category (body part,
position) procedure code, destination, auto position.
Save Changes Completes the action by writing changes to the local
database.
Main Menu Exits the current screen and returns you to the
system Main Menu.
See also:
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Proximity Badge Configuration

Navigate to Key Operator Functions>System Configuration>Proximity
Badge Configuration.
The user registers the proximity badge after logging in, and access the Register
Badge screen from Utilities. To register the badge, swipe the badge across the
Proximity Card reader.
The Proximity Badge Configuration screen has the following features:
Primary and Secondary Badge Type text boxes

 Select the text box and select the badge type from the pop-up menus.
Auto Detect button

 Select to register the badge type with the System.
 Place a proximity badge on the card reader and select the Scan Badge button.
Wait until the badge type is detected.
Verify button
 Select to verify that the badge type is registered.
 Scan the badge across the proximity card reader.
125kHz Proximity Card menu

13.56MHZ Wireless Smart Card menu
Save Changes
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Key Operator Functions > System Configuration > Regional Configuration
Regional Configuration
To customize the display on the modality for your region:
Select: Change: Change using:
Language The language that the system will display Multi-lingual
international
keyboard.
Time The time zone that the modality resides in International Time
Zone Zone keyboard.
Date Default/MM/DD/YYYY;DD/MM/YYYY;YYYY/MM/DD Radio button
Format selection.
Calendar Gregorian Check if yes; clear if
no.
Military Check box Check if yes, clear if
Time no.
Decimal Preferred symbol to separate decimal for your Select from
Separator region alphanumeric
keyboard.
Data Preferred symbol to separate data, such as the Select from
Separator period, forward slash, comma, etc.( . / , ) alphanumeric
keyboard.
Time Preferred symbol to separate time, such as the Select from
Separator colon ( :) alphanumeric
keyboard.
Current Enter the current date Enter from numeric
Date keyboard.
Current Enter the current time Enter from numeric
Time keyboard.
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Configuration

For the Key Operator to configure a Remote Operations Panel (ROP):
At each CR System:
1. Select New Device.
 Key Operator: Enter the IP address of the ROP.
 Key Operator: Select Remote Operations Panel as the device type.
 Key Operator: Repeat these steps for all Remote Operations Panels.
2. Select Edit ROP Links.
3. Enter the IP address of every CR System that will be linked to the ROP.
4. Select Save to All.
This adds all CR links to each ROP that you added in steps 2-4.
5. Select Delete Device to remove a device from the CR System.
At each ROP:
The initial link from the ROP to the CR System must have already been done by
a qualified installer.
1. Select the link to the CR System on which you just made changes.
2. Once the ROP is linked, select Key Operator Functions.
3. Select Fetch ROP Links.
This adds the new links you added in step 3 above.
4. Select the Quick Menu and select ROP Links to display the new links.
This button does not exist at the CR System or the ROP.
Edit ROP Changes the configuration of the existing communication links between
Links ROPs and other devices. Takes you to the ROP Links Configuration
Screen.
Ping Lets you ping selected devices to verify their connection. If the ping is
Devices successful, a green indicator appears in the left corner of the table. If there
is no connection, the indicator turns red.
New Device Lets you add a new IP address.
Delete Lets you delete a device.
Device
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Key Operator Functions > System Configuration > Required Fields
Required Fields Configuration

To make sure that certain radiographers fill in the appropriate fields, you should
configure those fields so the radiographer must fill them in before the exam can
be delivered.
The Required Fields Configuration screen lets you determine which fields
must be filled in on the Patient Input Screen before an exam is submitted or
delivered.
 You can set required fields for delivery to mandatory destinations, such as
archives, or for submitting exam/patient information. For example, you may want
to make Tech ID a required field if you are using Reject Reason logging.
 Making a field Required to Submit guarantees that the radiographer enters all
required Exam/Patient Information at the time the patient record is submitted to
the database.
 Making a field Required to Deliver prevents images that are missing key fields
from going to the Archive (mandatory destination) until those fields are filled in.
This prevents you from sending images that have incomplete patient
demographic information to workstations and printers only, until the
radiographer enters the required information and accepts the image. The
system then forwards the image to the mandatory destination.
1. Select each field check box you want to include from the Field Name list.
2. Select Required for Submission and / or Required for Delivery.
3. Select Editable if you want the radiographer to be able to edit the field.
If you are using Reject Reasons, you may want to make Tech ID a required
field.
Menu
382
Key Operator Functions > System Configuration > System Maintenance
Setting the Limits for Image Retention

The System Maintenance Screen lets you set high and low limits for use of
disk space, balancing between performance and image retention.
This screen lets you determine the criteria used by the system to automatically
erase images or delete patient records.
Disk High Water Mark Disk High Water Mark is set Enter the percentage of disk
for optimum performance at space to allow before
installation. automatic clean-up occurs.
80% is recommended.
Disk Low Water Mark Disk Low Water Mark is set Enter the percentage of disk
for optimum performance at space that you want the
installation. clean-up to reach.
75% is recommended.
Maximum Rejected Retaining rejected images is Enter the maximum number
Images Allowed optional. of rejected images to allow
The number of rejected in the system before
images stored affects the deleting.
total number of available
images in the system.
Patient Record Delete Permits retention of patient Enter the number of days a
Age information without patient patient record can remain
images. on the system before
deleting.
1. At the Key Operator Functions menu, select System Configuration.

2. Select System Maintenance.
3. Enter the value in each field from the keyboard.
383
Key Operator Functions > System Configuration > Scanner Options
Scanner Options
Depending on the scanner you use, the Scanner Options page will show
different configurations for the following
CR 850/950/975/Max CR Systems:
 Reduced Border check box
 Auto Associate check box
 Auto IP radio button
 IP Address radio button
 IP Address radio button
 Connecting button
Classic CR with Local User Interface

 Auto Associate check box
 IP Address radio buttons
Classic CR with Easy View display

 IP Address radio buttons
Reduced Border
Scanner Options lets you select and enable or disable the Reduced Border
Option.
To enable Reduced Border, select the Reduced Border check box on the
screen and select Save Changes.
Images on 35 x 35 cm and 35 x 43 cm cassettes are captured with pixel sizes of
171 microns rather than 168 microns. The scanned image area increases
slightly, producing borders smaller than those produced on other systems.
384
IP Address Section
This section is used to establish connections when there is a
communications problem.
Auto IP Address radio button

 Selected by default.
 When the Auto IP button is selected and the user selects the Connecting
button, the system searches for the IP Address that Service sets.
 Searches and connects to the computer with which the scanner will connect.
IP Address radio buttons
 Let you choose two IP addresses of the computers to which the scanner will
connect.
Users should only change these settings when requested by Service.
385
AEC Calibration
The X-ray energy dependence of Computed Radiography detectors may be
different than that of intensifying screens used to expose film. Adjustment of the
AEC configuration may be necessary to account for the transmission of the
DIRECTVIEW CR Cassette.
If AEC adjustment is required, it is appropriate to adjust AEC photo timers over
the full range of X-ray energies (kVp) that are used. The recommended
exposure level is a general recommendation based on balancing the
requirements for high image quality and minimum patient dose. All adjustments
that affect patient dose should be done under the guidance of a certified medical
physicist to ensure that exposures are in compliance with all applicable
guidelines and local regulations.
A Medical Physicist or, if permitted by applicable regulations, qualified personnel
under direction of a Medical Physicist should:
 Perform the necessary acceptance testing
 Ensure the X-Ray Unit’s Automatic Exposure Control (AEC) is properly
calibrated for use with DIRECTVIEW CR Cassettes and meets applicable
regulations.
 Establish and/or approve the use of an exposure technique control chart.
If required, Carestream Health, Inc. can provide guidance for the AEC
calibration procedure. Contact your Carestream Health representative for more
information.
All AEC adjustments and calibrations must be performed by qualified X-ray
equipment manufacturers or trained service providers.
See Also
Contact Carestream Health, Inc.
386
Key Operator Functions > Backup and Restore
Backup and Restore Configurations

The Backup and Restore feature provides a mechanism to save and preserve
a machine’s configuration settings. You can restore the machine to a prior state
following installation of new software or recover from accidental changes in
settings. Additionally the Backup and Restore feature is a convenient method of
transferring selected configuration information between systems in a
department.
Because of the unique attributes of different DIRECTVIEW systems, there are
some limitations to which configuration information can be transferred between
machines. The software automatically restricts the restoration of the
configurable items as described in Transferring configuration information to
different machines.
Because of the unique attributes of different DIRECTVIEW systems, there are
some limitations to which configuration information can be transferred between
machines.
Feature Backup Prompt

When the Key Operator makes changes to any feature or function in System
Configuration and exits the screen, the system will pop-up a prompt that asks
Do you want to backup your changes? after you have selected Save
Changes and attempt to leave the screen. Answering Yes to this prompt will
send a backup file of the entire section you changed to a specified folder in the
database. This is useful when small changes are made between the times that
the Backup and Restore feature is used, and provides a safeguard in case
there should be an unexpected event that requires re-imaging before Backup
and Restore has been performed.
For example, if you made a change such as changing a language, saved
changes, and answered Yes to the prompt, the entire Regional Configuration
section would be backed up. Selecting No would not affect the change you
made, but the backup file will not be created.
387
Restoring Procedure Mapping configurations

When restoring Procedure Mapping configurations, the system will present two
choices.
To Restore Procedure Mapping configurations:
1. Delete ALL Procedures and Views
Then Restore Procedures and Views from Backup radio button
 Clears the database by deleting all Procedure Mapping configurations,
both Views and categories, before restoring the new ones.
2. Keep NEW Procedures and Views
Then restore older Procedures and Views from Backup radio button
 Combines all previous and new procedure codes and Views.
 Does not back up categories—categories become uncategorized.
Select OK.
Transferring Configuration Information.

Machine to Machine Settings are restored only to the same
machine from which they were backed up.
Bar-Code Device Type & Select the link to view the list of these
Configuration Com Port configuration categories.
388
Machine Model to Same Model items restored to the same model of

machine. (For example, information that is
Machine Model transferred from one CR Elite System can
only be restored to other CR Elite Systems.)
Layout Image
Configuration Viewer Select the link to see a listing of these
Editors configuration categories.
Markers
Editor
Patient
Input
Patient
Names
RPDES
Machines Within Same Configuration information transferred in this

category can be transferred from one CR to
Product Family another CR or from one DR to another DR
machine.
Image All Fields Select the link to view this list of these
Processing configuration categories.
Preference
Editor
Universal You can copy the following items among all

CR and DR machines.
View All (except fields
Configuration that are
configured from
the Image
Processing
Preference
Editor)
Procedure All Fields
Mapping
Configuration
Profile All Fields
Configuration
List All Fields
Configuration
Reject Reasons All Fields
Trauma Defaults All Fields
Display All Fields
Configuration
Bar-Code All except Device
Configuration Type and Com
Port
Display All
Configuration
Delivery All
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Preferences
HIS/RIS Poling All Fields
and Remote
Query
Regional All Fields
Configuration
Long-Length All
Configurations
System All
Maintenance
Remote Device All Fields
Configuration
Security All User
Administrator Configurations
Security All Security
Security All Roles
The description identifies the conditions under which selected items can be
transferred between machines.
Backed-up settings can always be restored to the machine from which they
were created. You can back up configurations to a particular drive and restore
them to this or another machine.
You can back up information to either the machine hard drive or to the
removable media suitable to the machine computer (may include CD, DVD,
USB, or floppy disk devices).
Backing Up Configurations
To back up a configuration:
1. Insert or connect the media to receive the backup file.
2. Select the check boxes of the categories of configuration information that you
want to back up, or Select All.
3. Select the Backup/Restore directory to select a Drive to save the backup to.
4. To create a folder for the backup file, select New Folder and enter the folder
name.
5. Highlight the folder name and press Select.
6. Select Backup.
7. When the progress bar indicates the transfer is complete, select OK.
Restoring Configurations
390
To restore a configuration:
1. Insert or connect the media to receive the backup file.
2. Select the check boxes of the categories of configuration information that you
want to backup, or Select All.
3. Select the Backup/Restore directory to select a Drive to restore the Backup
from.
4. Select the folder name of the backup file (if applicable).
6. Select Restore.
7. When the progress bar indicates the transfer is complete, select OK.
To see all of the configurations listed, select the arrows at the right side of the
screen.
Select Selects the highlighted directory for backup/restore process.
Select All Selects every configuration for backup or restore process.
Deselect All Clears the check box for every selection. No configurations are selected.
Backup Writes the selected configurations and hidden parameters to the selected
backup directory.
Restore Loads the selected configurations, or all configurations if you Select All.
New Folder Creates a folder on the selected drive to contain the configurations.
Cancel Aborts the backup or restore process.
Save Saves the New Folder name.
Main Menu Exits the current screen and Returns to the system Main Menu.
391
Key Operator Functions > Manage Patient Exam Records
Manage Patient Exam Records

To delete a patient record:
1. Enter the search criteria such as Accession Number, Patient ID, Patient Last
Name, Patient First Name.
2. Select Find Study.
3. Select the Delete box next to the record to be deleted.
4. Select the Delete Patients button at the bottom of the screen to remove the
patient records from the system.
To delete all patient records:
 Select Delete All Patients from the Manage Patient Exam Records query
page to delete all patients from the system.
There is no recovery from this command. It deletes even records that have
been Protected.
To prevent selected patient records from being erased when the hard drive
fills up:
1. Enter the search criteria such as Accession Number, Patient ID, Patient Last
Name, Patient First Name.
2. Select Find Study.
3. For the selected study, check the box labeled Protected.
4. After marking all the patients to be protected, select the Protect Patients
button at the bottom of the screen.
5. These studies are protected from removal when the hard drive fills up. These
studies are not protected from the Delete All Studies action.
Names and exams that have an Available, Pending Delivery, or Failed
Delivery status cannot be deleted until they are corrected.
Protected prevents the study from being deleted by the Disk Manager when
the hard disk fills up. These studies are not protected from the Delete All
Studies action.
Navigational Controls
Clear All Fields Removes all the information entered in the search criteria fields.
Delete All Deletes all patient information on the system.
Patients
Delete Deletes all images that have no database references. A pop-up
Unassociated appears warning the user that images acquired while the system was
Images in the Capture Link system (clustered) will be deleted and will not be
available when re-joining the cluster.
392
Find Study Locates the study that matches the criteria entered.
Main Menu Exits the current screen and returns to the system Main Menu.
393
Key Operator Functions > System Configuration > Reject Reason

Configuration
Reject Reasons Configuration

This option lets you build a total list of 10 Reject Reasons that a radiographer
can choose from when rejecting an image.
To create a list of Reject Reasons:
1. From Key Operator Functions > System Configuration > Reject Reasons.
2. Select Add Reject Reason.
3. Type the Reject Reason and select Enter.
4. Repeat steps 2 and 3 for each Reject Reason.
To create the maximum number of Reject Reasons:
You can create up to nine Reject Reasons. The 10th reason is listed as Other
Reason, which can be renamed but not deleted.
The following default reasons may be used or deleted:
 Clipped Anatomy
 Motion
 Positioning Error
 Artifact
 Technique
 Duplicate
 Test/Service/Blank
To delete a Reject Reason:

Select the reject reason, and then select Delete Reject Reason.
To create statistics of Reject Reasons:
If the Track Rejects button is not selected, no prompt for the reject reason is
provided.
 Select the Track Rejects check box to enable the radiographer to select a reject
reason.
Navigation Buttons
Save Completes the action and writes the data to the system database.
Changes
Cancel Returns you to the previous function without changing to another screen.
The Cancel button toggles to the Back button after you have selected
Save Changes.
394
The Cancel button displays the Confirm changes confirmation dialog. It

does not immediately leave the screen.
395
Key Operator Functions > Option Activation
Register and Activate Options

The Key Operator can add or remove purchased options from the Key Operator
Functions > Option Registration Screen.
Activating an Option
You will need a set of Activation Codes from Carestream Health, Inc.
1. Go to Key Operator Functions > Option Registration Screen.
This screen displays all of the available options for that system.
2. Enter all Activation Codes one at a time into the text box from the keyboard or
by using a bar-code reader. If the code is entered manually, then the Add Code
button adds the code to the list of Codes to the right. If you use the bar-code
reader, the code is automatically added to the list.
When an option code is entered and activated from this list, the features and
benefits of that option become temporarily available on the system. The
options stay active for several days.
4. Insert any USB drive into the System.
5. Select the Export Request button.
6. Select the USB drive as the destination directory for the Activation file. The file
named OptionActivationRequest.xml is saved to the USB drive.
7. From a personal computer, e-mail the OptionActivationRequest.xml file to
activation@carestreamhealth.com.
An Activation File is automatically e-mailed back to the sender. This file is a
key that matches the hardware and software that identifies your system. The
file cannot be used with any other device.
8. Place the Activation File on the USB drive.
9. Insert the USB drive into the System.
10. From the Key Operator > Option Registration Screen, select the Import
Activation file.
11. Select the source directory for the Activation File (USB drive).
The Activation File is copied to the local hard drive.
The system verifies the signature and activates the options as specified in
the Activation File.
Sending the Incorrect Code

If you type an Activation Code incorrectly, the system will recognize the error.
The text box will not clear and an error message will be displayed.
This prevents you from sending incorrectly entered Activation Codes.
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No E-mail Available
If there is no access to e-mail or the network is down, the options stay active for
several days to give you time to send the Option Activation Request and
retrieve the Activation File from a remote computer.
Activate Makes the selected option immediately available in the system.
Option
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CR Total Quality Tool

What Is TQT?
The Total Quality Tool (TQT) is a comprehensive, quality assurance system
that evaluates various aspects of image quality on CR Systems and CR
Cassettes. With a few quick steps, you can verify that the system is functioning
within its normal operating specifications.
TQT is an optional feature for DIRECTVIEW CR Systems. If the TQT option is
not activated, contact Carestream Health for purchase information.
Carestream Health recommends the use of the Total Quality Tool as part of a
quality control program for CR Systems. Additional quality control tests should
be incorporated into the quality control program as required by local regulations.
The Total Quality Tool does not directly evaluate or provide a quality
control capability for the X-ray equipment used or output destination
devices (such as workstation monitors or film printers) connected with the
CR System. Quality control procedures for other components in the
imaging chain must be followed at the recommended intervals according
to the manufacturer's instructions.
The CR System must be calibrated at the recommended intervals
according to instructions from Carestream Health, Inc. All components in
the imaging chain (such as the X-ray equipment, workstation monitors, or
film printers) must be calibrated at the recommended intervals according
to the manufacturer's instructions.
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Performing System Tests

Cassette Test Frequency
Test all cassettes used in your system twice per year using the Total Quality
Tool cassette testing feature.
System Image Quality Test Frequency
Perform CR System Image Quality Tests monthly on a dedicated cassette to
assure that the test results obtained accurately reflect the CR System’s
operating condition.
If dedicated cassettes are not available, choose a cassette of each size, then
verify the quality of these cassettes using the CR Total Quality Tool cassette
testing feature. Make sure to use the same cassettes each time you test.
You can test more than once per month. However, the Test Results Graphs
show a maximum of 13 results, representing the recommended testing for one
year (12 monthly and one yearly test). If you test more frequently, the last 13
results that are displayed will represent less than one year’s data.
CR System Tests That May be Performed:
Recommended Test Quality Control Test Comment
Interval
Daily Erase Cassettes-Refer to For cassettes that are used
Erase Cassette information infrequently or if
in the CR System Hardware unintended X-ray exposure
Guide is suspected
Once per week or as CR System-Workstation
recommended by Display Calibration
manufacturer CR System-Printer/Film
Calibration
Once per month, every 200 CR Cassette/Screen
exposures, or as necessary inventory, Inspection, and
Cleaning
See also:
What is TQT?
Testing Cassettes
Appending the Session
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Testing Cassettes
Test all of your cassettes at least twice a year using the Total Quality Tool for
General Radiography. You can test all your cassettes at once or extend the
tests over a period of time.
Tests on multiple machines can be accumulated, consolidated, and reported
over an indefinite period of time. This feature lets you perform long-term trend
analysis.
Test your CR Cassettes to verify that the cassette quality is within acceptable
limits.
To begin test procedures:
1. Obtain a complete list of cassette IDs for all cassettes in your inventory.
2. Answer the following questions:
 Has someone already started a cassette test?
 Which cassettes have not been tested?
 Should test results for the cassettes you want to test be appended to the
previous session or should you start a new session?
This information will help you decide whether a cassette needs to be tested
and if your test results should be part of the previous testing session or the
start of a new session.
See also:
What is TQT?
400
Selecting a Test Phantom

Select the phantom that matches the size and type of cassette you are testing.
Phantoms for use with CR Total Quality Tool for General Radiography come
with a molded plastic tray to test the following DIRECTVIEW CR Cassettes:
 35 x 43 cm
 24 x 30 cm
 18 x 24 cm
 35 x 35 cm
 15 x 30 cm
Phantom Tray
See also:
What is TQT?
401
Positioning a Test Phantom

Test phantoms must be positioned specifically for the size and type of the
phantom. A guide has been developed to position the phantoms accurately and
repeatedly during testing based on the size and type of cassette being tested.
The molded plastic phantom tray contains three overlapping recessed areas, so
you can fit different size cassettes securely in the tray before placing the Test
Phantom inside the tray.
Positioning Tray and Phantoms
 35 x 43 cm, 24 x 30 cm, or 18 x 24 cm cassettes fit squarely in specially

designed slots and do not require special orientation.
 35 x 35 cm and 15 x 30 cm cassettes must be positioned so that the center
targets on the test phantom are exposed.
 When the cassette and Test Phantom are positioned properly, the test images
will be oriented as shown:
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See also:
What is TQT?
403
Total Quality Tool

When you start a new TQT testing session, all previous data becomes
inaccessible. If you want all of the cassettes in your inventory to be tested and
organized under one session, check and verify that every cassette has been
tested at least once.
1. Check the cassette IDs on your inventory against the IDs displayed on the
Cassette Screen Test Results page.
The Cassette Screen Test Results page displays the date, time, cassette
ID, size and type of each cassette tested as well as individual subtest results.
You can see those cassettes that have already been tested and those that
still need to be tested.
2. Look at the Total # Cassettes Tested field on the Cassette Screen Test Page
3.
This counter includes each tested cassette only once; multiple tests on a
cassette are excluded from its total. When the Total Number of Cassettes
Tested equals the total number of cassettes in your inventory, you have
tested all cassettes at least once and can end the session.
Before running a cassette test, decide whether the results should be part of a
new session or appended to the previous session. To append to a previous
session, select the Append to Previous Session check box.
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Exposure
Determining the Exposure
It is not necessary to determine the exposure setting each time an image test is
performed, but remember that exposure settings are only valid for the particular
X-ray source for which they are determined.
Once you have determined the exposure setting, you can use it for all Total
Quality Tool image tests on that specific unit until the X-ray equipment is
serviced or recalibrated. Those settings will no longer be valid and will have to
be established again.
To determine the exposure for TQT for General Radiography:
Use this technique to expose General Radiography cassettes for TQT testing.
1. Turn on the X-ray equipment and the collimator light on the X-ray tube.
2. Attach 0.5 mm Copper and 1 mm Aluminum filtration to the bottom of the X-ray
tube. Tape the filters if necessary.
3. Two filters are provided (and can be stored) in the Test Phantom’s protective
case.
4. Collimate the beam so that the edges of the tray are within the beam of light,
fully exposing the dosimeter.
5. Place a lead sheet or a lead apron between the floor and the phantom tray.
Place a dosimeter calibrated for (80 kV) centered on top of the tray.
6. Use the following specifications for the initial setup of the X-ray equipment:
 80 kVp
 40 mAs
80 kVp (±1) is mandatory. You can adjust the mAs to produce the correct
exposure level.
The dosimeter should show an exposure level of 0.0 mR ± 0.2.
 If the mR reading is lower than the specification, increase the mAs setting on
the X-ray equipment.
 If the mR reading is higher than the specification, decrease the mAs setting
on the X-ray equipment.
 If the dosimeter displays a reading of 10.0 mR ± 0.2, record the reading.
7. Expose the dosimeter three more times to verify consistency.
All three readings should be within 0.5 mR.
See also:
What Is TQT?
405
Collimating for TQT Testing

The field of exposure must completely cover the cassette's surface area for
proper collimation for General Radiography.
Position of the dosimeter:
See also:
What Is TQT?
406
System Testing
Using the Total Quality Tool Main Page
When you open the Total Quality Tool (TQT) and run a test, you begin a new
session.
To use the Total Quality Tool Main Page:
 Select and run image tests and view test results.
 Discard results of the last test performed in the current session.
 Start a new session or append to the last session.
 Access a summary of prior test results.
 Access another page for testing individual cassettes.
Tests
Phantom Image Test Tests the image quality of the system. The calculated exposure
of appropriate Test Phantom is required. (Use a cassette
exposed with a standard dose phantom.)
Insert the cassette when prompted to Load Cassette.
Flat Field Image Test Tests Field Uniformity, Streaks, and Speed Deviation.
Once the Phantom Image Test is complete, TQT automatically
prompts you to Load Cassette for the Flat Field Image Test.
Use the same exposure settings as the Phantom Image Test,
but do not use a Test Phantom.
Erased Image Test Automatically prompts to Load Cassette for Erased Image Test.
The Erase Image test is performed using erased cassettes only
and does not require an X-ray exposure.
System Noise Test Automatically prompts to Load Cassette. System Noise tests
are performed using erased cassettes only and do not require
an X-ray exposure.
Discard Test Discards the results of the last test performed in the current
session.
Cassette Test Opens Cassette Screen Test page for Flat Field Image Test.
Window/Level Identifies artifacts in the image. TQT images can be transferred
to the CR System and viewed on the image viewer.
Results View Results Page 1
 Phantom Image Test
View Results Page 2
 Flat Field Test
 Erased Image Test
 System Noise Test
Cassette Size Lets you use the keyboard to select the size and type of the
cassette you are testing.
Main Menu Select the Main Menu button to close the Total Quality Tool,
end the current session, and return to the CR System Main
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Menu.
Back Select Back to return to the previous page within the current
session.
See also:
What Is TQT?
Testing Cassettes
408
Performing Phantom Tests for General

Radiography
To create a Phantom Image Test:
1. Erase all cassettes to be tested.
2. Turn on the X-ray equipment and the collimator light on the X-ray tube.
3. Place the cassette tube-side-up in the phantom tray on the floor.
4. Make sure that the cassette labels are positioned exactly as shown in How to
Orient a Test Phantom (for TQT for General Radiography).
5. Move the X-ray tube to 180 cm (72.0 in.) above a clear area of the floor.
6. Center the tray edges within the collimator light.
7. Attach 0.5 mm Copper and 1 mm Aluminum filtration (supplied) to the bottom of
the X-ray tube. Use tape to secure the filters, if necessary.
8. Position the copper filter next to the tube.

Use the exposure information as prepared in Determining the Exposure.
9. Position the test phantom on the tray. See Positioning a Test Phantom.
10. Expose the cassette. See Determining the Exposure.
11. Wait 5 minutes before scanning the cassette to ensure a constant Exposure
Index.
12. Start the Total Quality Tool. See Using the Total Quality Tool Main Page.
13. Select the Phantom Image Test button.
14. When you see the Load cassette message, load the cassette you exposed for
the selected test.
All cassettes to be tested must be erased first.
Do not use a Bucky or grid during this procedure.
See also:
Determining the Exposure
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Performing the Erased Image Test

 Correct operation of the CR system requires that the stimulated light signal be
proportional to the X-ray exposure. Light measured from an exposed CR
cassette must not be influenced by previous exposures or by extraneous light
sources in the CR System.
 Stray light can result from inadequate filtration of the laser light or from light leaks
in the CR system cabinet. This test should be done with the highest level of
ambient lighting that will be used in normal operation of the CR system. In this
test, the signal from a fully erased CR cassette is used to verify adequate
erasure and the absence of stray light sources.
 For this test, the same cassette that was used for the uniformity test is re-
scanned. Because exposure level dependent erasure is the final step of the
reading process, the cassette should be fully erased when reading is completed.
Code values read from the cassette are spatially filtered to eliminate outliers due
to small dust particles. The maximum code value in the resulting data is found.
To perform the Erased Image Test:
 Rescan the cassette from the Flat Field Test.
The Erased Residual results are reported in the Total Quality Tool as the
average code value for the erased cassette.
Corrective Action
 Verify that the screen was erased.
 Verify that there are no bright light sources near the CR System.
 Repeat the test.
 If failure condition persists, call Service.
See also:
Flat-Field Image Tests
What Is TQT?
410
Understanding the System Noise Test

 System Noise is measured only with the Total Quality Tool because the CR
System operates in a special hardware mode in which the signal associated with
system electronic noise is amplified and measured. The erased cassette is
scanned a second time with the CR System in this hardware configuration.
 The full 2-D noise power spectrum is computed for the resulting image and the
1-D spectra parallel to the fast- and slow-scan directions are estimated. Median
methods are used to estimate the average of each of the 1-D noise power
spectrum over spatial frequency. This technique is insensitive to noise spikes.
The global maximum of the full 2-D noise power spectrum is then estimated.
To perform the System Noise Test:
 Rescan the cassette from the Erased Image Test.
The System Noise Test Results are reported in the Total Quality Tool.
o Fast-Scan System Noise
o Slow-Scan System Noise
o Overall System Noise
See also:
What Is TQT?
411
TQT Cassette Testing

Cassette Testing Menu
Testing Cassettes with TQT
Performing a Flat-Field Image Test
Best Results from Cassette Testing
Viewing Test Result Indicators
Reported Cassette Test Results
How to Export Data
412

1. At the Key Operator Functions menu, select Total Quality Tool.
2. Select Cassette Test to open the Cassette Screen Test page.
3. Make sure each cassette has a Flat-field image.
4. Test one size and type of cassette at a time.
The results will be grouped according to cassette size and type, making it
easier to view and find results for a particular cassette.
5. If the cassette test fails, set the cassette aside and retest it after you have tested
the remaining cassettes in a session.
Retesting all failed cassettes at once isolates duplicate tests at the end of
your session results, rather than having them dispersed throughout your
session.
See also:
Performing a Flat-Field Test
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Flat-Field Image Test

Computed Radiography requires that the code value at each pixel accurately
reflects the X-ray exposure at each location. Flat-field exposures should result in
a uniform response from the CR System, and they provide the most stringent
test for many common image artifacts that can occur in CR Systems.
Flat-field exposures are used for the following tests of uniformity and artifacts:
Field Uniformity Maximum code value difference between sub-images.
Corrective Action: Verify that the cassette is properly exposed and
not under-collimated. If heel effect is satisfactory and a FAIL
condition persists, call Service.
Line Position A code value representing the RMS pixel variations associated with
Noise wobble in the galvonometer mirror.
Corrective Action:
1. Verify that the cassette is properly exposed and not under-
collimated.
2. Verify that the exposure conditions are correct.
3. Repeat the test.
4. Record values.
5. Call Service.
Exposure Conditions:
 0.5 mm Cu + 1 mm Al filtration
 80 kVp
 10 mR +/- 0.2
Banding Caused by periodic fluctuations in the slow scan direction. Reported
as the code value representing the magnitude of pixel variations
with reference to slow scan velocity.
Corrective Action: Call Service.
Chatter May result from inadequate lubrication of the lead screw. This
results in fluctuations in the slow-scan direction that are not related
to the pitch of the slow scan. Reported as a code value representing
pixel variations associated with chatter in the slow scan assembly.
Corrective Action: Call Service.
Streaks Both the location (pixel or line number) and code value are
calculated to analyze deviations from the background (slow-scan
streaks and fast-scan streaks).
Corrective Action:
1. Check for streaks or lines on the cassette.
2. Clean the screen. Look for scratches.
3. Call Service.
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To create a Flat-Field Test Image:
1. Make sure the cassette is erased.
2. Turn on the X-ray equipment.
3. Collimate the beam of light so that the edges of the light fall on the outer edges
of the cassette.
4. Expose the cassette using the same positioning, filter, and exposure values
used to create the Phantom Test Image, but do not use the test phantom. See
Performing a Phantom Image Test.
5. Make sure the cassette contains a Flat-field image. See Flat-Field Image Tests.
6. At the Cassette Screen Test page, select Flat-field Image Test.
7. When you see the message Load Cassette, load the cassette with the Flat-
field exposure into the CR System.
8. At the Processing Complete message, check the result for each listed subtest.
9. Repeat steps 5-8 until all cassettes are tested.
See also:
Flat Field Test Failure
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To make the most of your cassette testing, follow these suggestions.
 Make sure each cassette contains a flat-field image.
 Test one size and type of cassette at a time. The results will be grouped
according to cassette size and type, making it easier to view and find results for
a particular cassette.
 Retest all failed cassettes at once to isolate duplicate tests at the end of your
session.
Do not load a cassette until AFTER you have initiated the testing process by
selecting Flat-Field Image Test. Wait for the system message "Load Cassette"
and then load the cassette.
See also:
Cassette Testing Menu
416

Indicator Status Indicator Color Results Recommendations
Ready Gray Normal Ready to accept

cassette.
Pass Green Normal Ready to accept
cassette.
Pass Amber Passed but See
approaching the Troubleshooting.
specification limit
Fail Red Outside of the See

specification limit Troubleshooting.
NA Purple Invalid result due to  Check for proper

invalid cassette, orientation of
invalid test image, Phantom.
or incorrect  Check for proper
exposure exposure level.
 Check for proper
filtration at the
tube.
 Check the field of
exposure.
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For each cassette scanned, the following results are reported:
Cassette ID Listed for each cassette measured.
Speed Deviation Reported as a code value.
Field Uniformity Error Reported as the maximum code value difference
between the sub-images.
Slow-Scan Streaks The largest amplitude streak is reported as a code
value.
Fast-Scan Streaks The largest amplitude streak is reported as a code
value.
Corrective Action  Inspect the screen for damage.
If the CR System has passed all  Clean the screen using the cleaning instructions
four image tests, any cassettes provided in the CR Cassette Instruction Sheet.
that fail one or more of the  Repeat the test.
cassette tests should be set aside.
 If the cassette still fails, it should be removed from
use.
See also:
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TQT Test Results

Using Results (Page 1)
Troubleshooting TQT Test Results
Phantom Image Test Failure
419
Using Results (Page 2)

Flat Field Test Failure
System Noise Test Failure
See also:
Troubleshooting TQT for General Radiography
420
How to Export Data

Cassette test results are organized into sessions so that data can be easily
maintained, viewed, and exported. You can save test results in one session by
appending test results until all your cassettes have been tested, or you can test
your cassette inventory over multiple sessions. When a session is complete, you
can export the results and then start a new session.
1. Select the Export button in the bottom left corner of the screen.
2. Select the destination drive to save your data.
3. Select OK.
See also:
Exporting Data Using Administrative Analysis and Reporting Software
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Additional TQT Tests

Cassette Inventory and Inspection
Cassette inventory and inspection should be the first task on your list when
performing a series of Total Quality Tool tests.
Do the following:
 Inventory and inspect the equipment you are going to test.
 Make sure that the inventory includes everything on the itemized list of
components, accessories, options and user manuals purchased.
 Check that the CR System and accessories are properly installed. Make sure
that you have the correct number of cassettes of each type and size.
 Inventory and inspect all cassettes and screens.
 Examine each cassette visually for external defects.
 For screens, see the instruction sheet that comes with the CR Cassette for
instructions on inspecting, handling, and cleaning phosphor screens.
During acceptance testing, select several cassettes and set aside for
subsequent quality control testing.
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Cleaning Cassettes
 Storage phosphor screens are not subject to physical contact in normal use and
consequently do not require a routine procedure surface cleaning.
 Clean storage phosphor screens when you have identified a specific artifact
associated with screen surface contamination (such as persistent dust or
fingerprint artifacts).
 Clean storage phosphor screens according to the manufacturer's instructions
(available separately).
 Open each cassette and extract the screen to inspect for dust or scratches.
 Record all the cassette numbers, the corresponding phosphor screen
identification numbers, and any notes on their condition. Note surface defects
and scratches on the cassette inventory record.
 Carefully close and latch each cassette.
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Film-Printer Calibration Test

1. Verify the printer and CR System combination.
2. Calibrate each printer using the procedures provided by the manufacturer.
Optical density measurements require a calibrated densitometer.
3. Perform printer calibration/CR System verification:
 Periodically per the printer manufacturer’s recommendations as part of a
quality control program.
 Whenever CR System components or printer are serviced or replaced,
including software upgrades.
 Whenever you observe an unexpected change in image quality.
To verify the CR System and Printer Calibration:

1. See Key Operator Functions > Monitor Calibration for a sample of the SMPTE
pattern.
2. Acquire and label the printed film.
3. Measure and record the optical density for each test patch.
Two patches are labeled 50%.
Results
 Make sure that the plot of density versus percentage is linear and the range of
density (the maximum density minus the minimum) is between 2.5 and 3.1.
 Compute the least-squares fit of density with respect to the fractional of full
response shown on the SMPTE pattern (i.e., treat the 10% patch as 0.10).
 Make the slope of this line between 2.5 and 3.1 with no point deviating by more
than 0.3 log density from the line.
 Examine the image of the entire SMPTE pattern for printer artifacts, such as
lines, banding or density non-uniformities.
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Workstation Display Calibration Test

1. Verify the display calibration and combination CR System—Workstation Display
Calibration for all workstations that you use.
2. Calibrate the workstations by following the recommendations provided by the
manufacturer.
 Verify the gray scale calibration of the CR System—workstation display
combination.
 Use a Society of Motion Picture and Television Engineers (SMPTE)
pattern RP-133 as seen in Key Operator Functions > Monitor Calibration.
Display luminance measurements require a calibrated photometer.
3. Perform the Display Calibration—CR System Verification:
 Periodically per the display device manufacturer’s recommendations as part
of a quality control program.
 Whenever components of the CR System or workstations are serviced or
replaced, including software upgrades.
 Whenever you observe an unexpected change in image quality.
To verify grayscale calibration:

1. See the CR System Online Help for information on generating and sending the
SMPTE pattern to the workstation.
2. Display, magnify, and position the SMPTE pattern’s image to fill the center of
the image display area with each of the 14 SMPTE test patches labeled with a
percentage value (0%, 10%, etc.).
3. Measure and record the luminance for each test patch.
Two patches are labeled 50%, although only one is used.
Results
 Make sure that the plot of logarithm (base 10) of the luminance versus
percentage is linear and the range of log luminance (the maximum log luminance
minus the minimum) is between 2.5 and 3.1.
 Compute the least-squares fit of log luminance with respect to the fractional of
full response shown on the SMPTE pattern (i.e., treat the 10% patch as 0.10).
 Make the slope of this line between 2.5 and 3.1 with no point deviating by more
than 0.3 log luminance from the line.
 Examine the image of the entire SMPTE pattern for monitor artifacts, such as
lines, banding, or density non-uniformities.
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Troubleshooting TQT Testing

Phantom Image Test Failure
Select the test name from the list below to view a description of the problem and
suggested corrective action.
Pixel Size Test
Pixel Size is the average center-to-center distance between pixels.
Image segmentation methods are used to automatically detect the location of
the edges of the apertures along the top, bottom, right, and left of the phantom
test image.
For each side of the image, a linear "least-squares" fit of the detected locations
is made to the known relative locations of the edges. The average slope that you
calculated for the top and bottom rows of apertures measures the average fast-
scan pixel size, and the average slope calculated for the left and right columns
of apertures measures the average slow-scan pixel spacing.
Pixel Size is reported as a percentage deviation in Pixel Size Error Fast and
Pixel Size Error Slow.
Corrective Action
 Note whether Pixel Size Error is Fast or Slow.
 Verify that the phantom is properly exposed and not under-collimated.
 Repeat the test and record any failed values.
Aspect Ratio Test

The pixel Aspect Ratio is calculated for the left side, the middle, and the right
side of scan lines in the fast-scan direction.
The local fast-scan pixel size is measured by the center-to-center distances
between apertures in the Test Phantom.
Left Side Use the first and third apertures.
Center Use apertures on either side of the center.
Right Side Use first and third apertures from the end of the scan line.
The Aspect Ratio is then computed as the ratio of the average slow-scan pixel
size to the local fast-scan pixel size.
The Aspect Ratio Error is the percentage deviation from the designed aspect
ratio (unity) for the left, middle and right sides of the image.
The Average Aspect Ratio Error is computed as the ratio of the Average
Slow-Scan Pixel Size to the Average Fast-Scan Pixel Size.
426
Aspect Ratio is reported as the Aspect Ratio Error Left, Aspect Ratio Error
Middle, Aspect Ratio Error Right, and Aspect Ratio Error Average each
expressed as a percentage of the designed aspect ratio.
Corrective Action
 Note if the Aspect Ratio Error is Left, Middle, Right, or Average.
Scan Linearity
Scan Linearity is the measurement of the deviation of the aperture locations
from their expected locations, based on the linear least-squares fit of the
measured locations used to compute the Pixel Size. From these
measurements, the variation in scan speed with position is calculated for each
direction.
The deviation from Scan Linearity is calculated as the maximum deviation of
scan speed from the average speed. The Fast-scan Speed Error and the
Slow-scan Speed Error are expressed as a percentage of the average speed.
This measure of Scan Linearity represents the maximum possible percentage
error in length measurements that could be made by using mean pixel spacing
values.
Scan Linearity is reported as the peak-to-peak Fast-Scan Speed Error and
Slow-Scan Speed Error expressed as a percentage of the average scan speed
in the respective direction.
Corrective Action
 Note if the Scan Linearity is Fast Scan or Slow Scan.
Exposure Response
Computed Radiography requires that the code value at each pixel accurately
reflects the X-ray exposure at that location. KODAK DIRECTVIEW CR Systems
produce raw code values that are linearly related to the logarithm of X-ray
exposure. One of the most important steps in quality control testing is to verify
the large-area exposure response linearity, since all other tests will be done in
terms of these code values.
The average response of three uniform areas of the phantom test image is
computed. Image segmentation methods are used to identify three areas of the
image. The large square area in the center of the phantom test plate has
minimal attenuation. The smaller square area directly below the central square
has uniformly high attenuation. Areas to the left and right of the central square
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have a middle value of attenuation. In each of these areas, the average of the
code values in a square 2.0 x 2.0 cm is computed. The expected attenuation of
the phantom test plate is used to predict the exposure response for these three
levels of attenuation under the specified X-ray beam conditions.
The Exposure Response Test results are reported in the Total Quality Tool.
The error in the average code value (CV) for each of the three levels of
attenuation is reported in the Total Quality Tool as: Low-Exposure Response
Error (CV), Mid-Exposure Response Error (CV), and High-Exposure Response
Error (CV). These are compared with the expected code values based on the
predicted attenuation of the test phantom.
Corrective Action
 Verify that the exposure conditions are correct:
o 0.5 mm Cu + 1 mm Al filtration
o 80 kVp
o 10 mR ± 0.2 (0.0876 mGy ± 0.00175 mGy)
 If high-exposure result is PASS and mid- or low-exposure results are FAIL,
check kVp.
 If high-, mid- and/or low-exposure results are FAIL, check mR (mGy).
 Inspect the screen. If the screen has discolored, repeat the test with a second
cassette.
 Verify that the phantom is oriented properly on the cassette.
 Repeat the test and record failed values.
 Call Service.
Noise
Image Noise depends on factors such as:
 Exposure Technique
 Performance of the CR System
 Image Processing
 Display
Evaluate noise under well-defined exposure conditions and in a way that is
independent of arbitrary image processing and display choices. Because noise
measurements are very sensitive to image artifacts, they normally require
specially prepared materials and laboratory conditions. The Total Quality Tool
uses algorithms that distinguish between artifacts and the underlying noise.
The Noise test results are reported in the Total Quality Tool.
The noise results are reported as the estimated mean pixel deviation for each of
the three exposure levels used for the Exposure Response test.
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Corrective Action
o 80 kVp
o 10 mR ± 0.2 (0.0876 mGy ± 0.00175 mGy)
 If high-exposure result is PASS and mid- or low-exposure results are FAIL,
check kVp.
 If high-, mid- and/or low-exposure results are FAIL, check mR (mGy).
 Inspect the screen. If the screen has discolored, repeat the test with a second
cassette.
 Call Service.
MTF
The best predictor of CR system sharpness is obtained from measurements of
spatial frequency response. This measurement is also called the Modulation
Transfer Function or MTF. Total Quality Tool measures MTF automatically. To
be a useful measure of the CR system, it is important to minimize the influences
of other components of the image chain, such as the exposing equipment and
the display devices.
Pre-sampling MTF measurements are obtained from the edges of the slightly
slanted square in the middle of the Test Phantom image.
Image segmentation methods are used to automatically determine the edge
locations. The centers of the transition for a series of adjacent lines are
estimated and fit to a straight line. The pixels on each line are then displaced
accordingly, and a sub-pixel representation of the Line Spread Function (LSF) is
obtained. The pre-sampled MTF is computed from the fourier transform of the
sub-pixel LSF.
The MTF test results are reported in the Total Quality Tool.
MTF is reported at two frequencies for each of the two scan directions. These
frequencies depend on pixel size. The results reported by the Total Quality Tool
include:
 the Fast-scan MTF @ 95% of Nyquist
 the Fast-scan MTF @ 50% of Nyquist
 the Slow-scan MTF @ 95% of Nyquist
 the Slow-scan MTF @ 50% of Nyquist
Corrective Action
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 Inspect the phantom for damage such as kinks or creases.
 Call Service.
Pixel Position
Flat-Field (Uniform) exposures provide the most stringent subjective test for
many common image artifacts that occasionally occur in CR Systems. However,
there are some artifacts that cannot be detected with flat-field exposures.
Because CR images are read with a scanning laser beam, the relative timing of
data acquisition for each line of data is critical if the pixels are to be aligned in
adjacent lines. Normally this alignment is maintained to a very small fraction of a
pixel. You can detect sub-pixel shifts in pixel position between adjacent lines
before these effects become large enough to affect image quality in clinical
images.
The linear features that are used for MTF measurements are also used to
assess the line-to-line fluctuation in pixel placement. Image segmentation
methods are used to determine locations of the edges of the central square in
the test phantom image. The centers of the transition for a series of adjacent
lines are then estimated from the code values along each line. These locations
are fit to a straight line and the deviations from linearity are computed. The RMS
error of the transition centers from the fitted line is used as a measure of the
line-to-line pixel placement error.
The Pixel Position RMS test results are reported in the Total Quality Tool.
 Pixel Position RMS is reported as the RMS error in the line-to-line pixel
placement as a fraction of the Pixel Size.
Corrective Action
 Record results.
 Call Service.
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Flat-field Test Failure

Select the name of the test from the list below to view a description of the
problem and suggested corrective action.
Field Uniformity
Field Uniformity is computed by partitioning the image into an array of 5 x 5
sub-images. The mean code value of each sub-image is computed.
The Field Uniformity Error is reported as the maximum code value difference
between the sub-images. Pass-fail criteria is based on mean code value
deviation of the sub images for the appropriate cassette size.
Corrective Action
 X-ray heel effect can affect the test results. Verify that the X-ray heel effect is not
significant.
 Verify that the cassette is properly exposed and not under-collimated.
 If heel effect is satisfactory and a FAIL condition persists, call Service.
Line Position Noise

During the CR reading process, randomly distributed variations from line to line
occur in the image. This artifact is most easily observed at the beginning of fast
scan lines. It is measured in terms of uncorrelated variations in the average
code values at the beginning of each line.
Line Position Noise is reported as a code value representing the RMS pixel
variations associated with wobble in the galvonometer mirror.
Corrective Action
 Verify that the cassette is properly exposed and not under-collimated.
o 80 kVp
o 10 mR ± 0.2 (0.0876 mGy ± 0.00175 mGy)
 Record values.
 Call Service.
Banding
 Banding is caused by periodic fluctuations in the slow-scan direction.
 Slow-Scan Banding is reported as a code value representing the magnitude of
pixel variations with reference to slow-scan velocity.
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Corrective Action
 Call Service.
Chatter
Chatter may result from inadequate lubrication of the lead screw. This results in
quasi-periodic fluctuations in the slow-scan direction that are not correlated with
the pitch of the slow-scan.
Slow-Scan Chatter is reported as a code value representing the magnitude of
pixel variations associated with chatter in the motion of the slow-scan assembly.
Corrective Action
 Call Service.
Streaks
Streaks may result from a number of possible causes. Isolated deviations from
the background are analyzed for correlations in the slow-scan and fast-scan
directions. Both the location (pixel or line number) and amplitude (code value) of
these are calculated.
The largest magnitude Slow-Scan Streaks and Fast-Scan Streaks are
reported as code values.
Corrective Action
 Check for streaks or lines on the cassette.
 Clean the screen and look for scratches.
 Call Service.
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System Noise Test Failure

To correct a System Noise Test Failure:
1. Verify that the screen was erased.
2. Verify that there are no bright light sources near the CR System.
3. Repeat the test.
4. If a failure condition persists, call Service.
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Total Quality Tool
Troubleshooting TQT for General Radiography

To resolve a condition that results in a Warning or a Failure:
 Study the graphs.
The graphs provided for each subtest make it easy to see if the results are a
gradual trend or a sudden shift in performance.
 Repeat the tests.
Warnings and Failures could be the result of procedural errors, and should
be verified by repeating the tests.
 Determine the general cause.
Determine whether the Warning or Failure is caused by the CR System or
the cassette.
 Take corrective action as appropriate.
Keep running, based on independent evaluation of image quality.
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Key Operator Functions > Monitor Calibration
Monitor Calibration Introduction

Monitor Calibration checks the D-Max and color values and calibrates the
monitor to provide a consistent viewing standard so that images display the
same way throughout your system.
 Perform only the following two tests:
o Luminance Tracking: This test computes an index for each video display
and tells how well the video system matches a specific luminance response
model. Tracking checks a computed index, the white level, the black level,
and luminance values for red, green, and blue primaries.
o Luminance Gamma Correction: Corrects in conformance with the DICOM
Part 14 Grayscale Standard Display Function or other gamma models for
your system.
 Required equipment:
o All Monitors for CR or DR Systems, and Remote Operations Panels
o The VERILUM CHROMA Photometer
 Perform these tests with a low level of ambient light.
 Perform these tests at the following intervals:
o Measure the Luminance for Tracking every 2 to 4 weeks
o Measure the Luminance for Gamma every 3 months
Why Can't I Start the Test?

The test targets may be grayed out.
On the bottom of the VERILUM Main Menu, the message "cannot open pod or
determine pod type" may appear. The pod must be plugged into a USB port
before you start the application.
 Return to the Key Operator System Configuration menu, plug in the pod, and
select Monitor Configuration again.
See also:
How Do I Order a VERILUM CHROMA 5 Pod?
How Do I Calibrate the Monitor?
How Do I Measure the Luminance for Gamma?
How Do I Measure the Luminance for Tracking?
How to Calibrate the Touch-screen
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Key Operator Functions > Monitor Configuration
Display Pro for General Radiography

The Display Pro test target provides a visual check for monitor calibration.
To use the test target:
1. View the top row of density patches on your monitor.
You should be able to distinguish the rectangles along the top row of
wedges.
Do not use this Help screen to evaluate your monitor.
2. View the targets in the row labeled Contrast Targets for Visual Evaluation.
If you can see contrast between the light and dark circular half-moon
patterns within all of the patches on the top row, the monitor is calibrated as
expected. If you cannot see circular patterns in all of the patches, calibrate
the monitor.
The lower set of patches labeled Density Steps for Measurement and
Objective Evaluation are used for evaluation by your Service Representative.
You can send the Display Pro image to evaluate the calibration of a PACS
workstation or to evaluate the performance of a printer. The printed Display Pro
image represents the same measurement of visual confirmation as it does when
viewed on the monitor.
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SMPTE Test Target

Check the SMPTE test pattern on the Monitor Configuration Screen before
and after testing Luminance for Tracking and Luminance for Gamma.
You should see a 5% contrast difference in the two squares shown below with a
red outline on the SMPTE test pattern.
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Monitor Calibration
1. Adjust the room lighting to a low level of ambient light.
2. Plug in the VERILUM CHROMA 5 Photometer.
3. Place the pod face down on a dark, opaque surface for a few seconds.
4. At the Monitor Configuration Screen, select Photometer Calibration.
See How to Measure Luminance Response for Gamma.
See How to Measure Luminance Response for Tracking.
Why Can't I Start the Test?

The pod must be plugged into a USB port before you start the application.
 Return to the Key Operator System Configuration menu, plug in the pod, and
select Monitor Configuration again.
See also:
Monitor Configuration Screen
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Key Operator Functions > Monitor Configuration > Touch-Screen

Calibration
Touch-screen Calibration
Once calibrated properly, a monitor's touch-screen should not need to be
recalibrated for the remaining life of the monitor.
1. From a position directly viewing the monitor, with your finger, select and release
each of the three red targets as they appear on the screen.
2. Select and drag your finger across the screen to check the cursor's response.
3. Select OK if the cursor follows your finger, or select Return to repeat the
calibration process.
4. When the calibration is complete, select OK to return to the interface.
Caution! Selecting the screen in areas other than the red targets may
cause the screen to behave in an unpredictable manner.
If the calibration times out, and no changes are made, the system remains at the
current calibration.
Why Can't I Get to the Calibration Screen?

The touch-screen calibration program guides you through a careful calibration
process so the cursor will respond precisely to a precise selection on the
interface.
If you cannot get to the monitor calibration screen or select the test targets, try
accessing the screen with the mouse. If the touch-screen cannot be accessed
because it has been put far out of calibration, call Service.
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Key Operator Functions > Monitor configuration
Measuring Luminance for Tracking

1. Place the VERILUM CHROMA 5 Photometer in the center of the square
target.
2. Select Continue.
3. Hold the pod gently in place until the test progress reaches 17. A graph signifies
the end of the test.
4. Select Close.
Always hold the pod gently in the center of the target.
Do not press too hard!
Do not save the information to a MACBETH Color Chart. Luminance for
Tracking is a black-and-white test.
See also:
Measuring Luminance for Gamma
Monitor Calibration
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Measuring Luminance for Gamma

1. Place the VERILUM CHROMA 5 Photometer in the center of the square
target.
2. Select Continue.
3. Hold the pod firmly in place until the test progress indicator reaches 33.
4. Select Close.
Always hold the pod gently in the center of the target.
Do not press too hard!
See also:
Measuring Luminance for Tracking
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How to Order a VERILUM CHROMA 5 Photometer

To obtain a VERILUM CHROMA 5 Photometer (required), go to the Web site:
http://www.image-smiths.com.
The product is VERILUM V5.2 Software with CHROMA 5 Pod. You do not need
to install the software on the Modality in order to use the photometer.
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Key Operator Functions > System Configuration > CSA Log Viewer
CSA Log Viewer

The CISCO Security Agent (CSA) feature is a tool that permits the Key
Operator to review the event log file created on the modality. The CSA Log
Viewer is displayed only in English.
 The Cisco Security Agent provides protection against malware attacks. CSA
intercepts and prevents system activities not specifically authorized by the
System Software.
 CSA prevents new intrusions by understanding the rules of inappropriate or
unacceptable behavior for all applications.
 When an application attempts an operation, the CSA checks the operation
against the application's security policy and determines if the application should
continue and if the request should be logged.
 Because protection is based on blocking malicious behavior, the default policies
stop both known and unknown attacks without needing updates.
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CARESTREAM Capture Link System Help
Basic information
Joining Devices
To join a Console to the Capture Link System:
1. Deliver all undelivered images that were scanned in Standalone mode.
2. At the Capture Link Configuration Screen, enter the IP address of the
Capture Link Server.
3. Select Connect to a Capture Link Server.
4. Select Save Changes and reboot.
5. When you get the message "Do you want to connect?" select Yes.
Once a machine joins the Capture Link System, it is no longer in Standalone
mode. Patient and exam data created in Standalone mode and images captured
on the machine in Standalone mode are not accessible in Capture Link mode
(although they all remain on the hard drive). Make sure to deliver all images
captured in Standalone mode before joining to the Capture Link System. When
joining to the Capture Link System, a message reminds you to deliver all
images.
See also:
Introducing the Capture Link System
Capture Link System Workflow
Capture Link System Range of Operation
Identifying Active Devices
Identifying Icons
Standalone Mode
445

In a Capture Link System, all patient records and all patient images from any
device joined to the Capture Link System are available for review and use on
any device joined to the Capture Link System.
When thumbnail images are displayed, the name of the machine of origin
appears in the border of the image after it leaves the Capture Link System. The
name appears on the Image List at the Capture Link Server and any Modality
joined to the Capture Link System.
An example of a Capture Link System workflow:
1. Start a study that includes multiple cassettes or exams.
2. Initiate the study at any Console or Remote Operations Panel (ROP).
3. Perform any of the following activities at any Console or ROP:
 Edit Patient/Exam data.
 Read the cassette bar-code.
 Scan CR cassettes at any CR Console.
 Review images, adjust Image Processing, add markers.
 Add views or exams.
Images are grouped, stored, and labeled for all destinations.
See also:
Identifying Icons
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Application of Configuration Attributes to DIRECTVIEW Capture Link CR
Systems
When setting system configurations for a machine that is part of a Capture Link
group the extent of use for these parameters varies. The levels of use (scope)
are:
 All CR Systems on the Capture Link System
 All CR Systems of the Same Model on the Capture Link System
 Unique for each CR System
 Unique for each system on the Capture Link System, CR, Remote Operating
Panels (ROP) and Remote Access Software (RAS)
For ROP and RAS applications, their configuration is derived from the CR to
which they are attached.
Every configurable item in the System is assigned a scoping level, or range of
use. This level determines if changing an item at one device will cause the same
change at a different device within a Capture Link environment.
There are 5 different levels of scoping:
These configuration items are
identical on every machine that
is a member of the Capture
Link System: The Capture Link
Universal Server, the CR/DR consoles,
and ROP/RAS devices.
View All (except fields
Configuration that are
configured from Example: The HIS/RIS Server
the Image information is the same for
Processing every machine.
Preference
Editor)
Procedure All Fields
Mapping
Configuration
Profile All Fields
Configuration
List All Fields
Configuration
Reject Reasons All Fields
Layout Marker Editors
Configuration
Trauma All Fields
Defaults
Display Patient Query
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Configuration Tab
Patient Input
Tab (Including
Auto Populate
Tech ID) Patient
Link Tab
Other Tab
(Except key
clicks and
volume)
Bar-Code All except
Configuration Device Type &
Com Port
Delivery Remove Print
Preferences from 1-up on MF
Print
Upper Case on
Delivery
Translate Body
Part and
Projection
HIS/RIS Polling All Fields
and Remote
Query
Regional All Fields
Configuration
Customizable All Fields
Field
Descriptions
Long-Length Auto update
Configurations sub-images to
delivered
System All
Maintenance
Configurable Marker
Text Boxes Transparency
Remote Device All Fields
Configuration
Security All User
Security All Security
Security All Roles
Single Device Only These configuration items can

be different for everything, even
Display Other> Key ROP & RAS devices.
Example: Key click volume
448
Configuration Clicks and might need to be louder for a

Volume ROP that is in a loud room, but
quiet in a different room.
Bar Code Device Type and
Configuration COM Port
Long-Length SID Values
Configurations
Network All Fields
Settings
Single Machine Only These configuration items can

be different for every CR/DR
Image All Fields device in a cluster. ROP/RAS
Processing devices will use the
Preference configuration of the machine
Editor that they are currently
connected to.
Required All Fields
Fields
Example: Preventative
Layout Patient Input Maintenance reminders are
Configuration Layout machine-based because the
Remote Patient last service time for each
Data Entry machine can be different.
System
Delivery Hospital Name
Preferences and Address
Operating Mode
Long-Length QA Mode for
Configuration Long-Length
Imaging
SID Values
Configurable Text Box Layout
Text Boxes Text Box
Transparency
Security All Fields
Configuration
Preventative All Fields
Maintenance
Configuration
MIM All Fields
Destinations
Same Product Family When using CR/DR integration

on a Capture Link System –
Layout Image Viewer These configuration items are
Configuration Editors the same within a Product
Patient Names Family (all CR devices, all DR
devices, or the Capture Link
Color All Fields Server within the same family)
Preferences but can be different for different
Product Families.
Delivery Delivery Mode
449
Preferences Upper Case on ROP/RAS devices will use the

Delivery configuration of the machine
Translate Body that they are currently
Part and connected to.
Projection
Example: You may want to use
CR IOD on CR devices, but DX
IOD for DR devices.
Same Machine Model These configuration items are

the same for every device that
Layout Image Viewer has the same model name (CR
Configuration Editors 850, CR 950, DR 7500) in the
Capture Link System.
ROP/RAS devices will use the
configuration of the machine
that they are currently
connected to.
Example: The tabs displayed
on the Image Viewer Screen
may vary within different
applications based on the
capabilities of that specific
model.
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Identifying Active Devices in the Capture Link

System
The Status of the Capture Link System is seen in Utilities in Capture Link
Server Status.
The name of each machine in the Capture Link System is listed.
The active devices appear with a green dot to indicate good communication
or a red dot to indicate a communications problem.
See also:
Using the Capture Link Server
Troubleshooting the Capture Link System
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Identifying Icons
Once you configure a Console for the Capture Link System and communicate
with the Server, a Capture Link icon appears in the upper right corner of the
title bar on the Console or device screen. When communication is active and
intact, the icon is green.
If the network becomes disconnected from the device and is unable to
automatically reconnect within 10 minutes, the icon turns red.
When you see this It means What you should do
icon
Always shown on Capture Link Use the Capture Link
Server or Mini-Capture Link System.
Server.
Able to communicate with the Remain in Standalone

Capture Link Server, but the Mode until the icon
Capture Link Server is down. changes showing that you
can communicate with the
Capture Link Server.
Deliver all images and
finish working on the
current exam before
rejoining the Capture Link
System.
Able to communicate with the Use the Capture Link
Capture Link Server and the System.
Capture Link Server is up and
running.
Not able to communicate with You are not connected to
the Capture Link Server and the the Capture Link Server.
Capture Link Server is down. The Server is down. Do not
reconnect.
Not able to communicate with You are not connected to
the Capture Link Server, but the the Capture Link Server.
Capture Link Server is up and The Server is running but
running. you cannot reconnect.
What do I do if the Capture Link icon turns red?

1. When the light turns red, allow five minutes for the communications problem to
clear.
2. Reset the Capture Link System connection by restarting in Standalone mode
and reconnecting.
What if I see a red icon on the first attempt to connect?
1. Check to see if the server IP address is typed correctly.
2. Check to see if the server is accessible on the network.
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See also:
Removing a Console from the Capture Link System
453
Using the Capture Link System

How does the Capture Link System work?
The Capture Link System automatically finds the correct patient data, no matter
where the image is acquired. You can link multiple devices to the system. Once
linked, the various devices share patient and exam data from a single database
on the Capture Link Server.
You can enter all patient and exam data at the various consoles and external
devices, and it is immediately available for use at each device on the Capture
Link System. All images in the System may be viewed at any device in the
System, although the actual image file remains on the CR or DR system that
produced it.
After beginning an exam, you can perform the following functions from any point
on the network:
 Add a View
 Edit patient and exam information
 Review images
 Approve images
 Check for quality
 Manipulate images
 Reject images
 Deliver to destinations
What can I link to a Capture Link System?

 You can link up to five CR or DR Consoles and up to 20 external devices (such
as an ROP or RPDES) to a Capture Link System at one time.
 Remote Operations Panels (ROPs) communicate with all CR Consoles in the
 Remote Data Entry Stations, RIG/RDET or a combination of these communicate
with the all CR Consoles in the Capture Link System.
 You can connect up to five System Consoles.
What happens if I am not connected to the Capture Link System?

When the CR Console is configured for the Capture Link System but not
connected to a Capture Link System, it is in Standalone mode. A console is
fully functional in Standalone mode. Standalone mode lets you continue using
the CR System if access to the Capture Link Server is disrupted.
What systems are compatible with a Capture Link System?
 CR Systems that are running DIRECTVIEW CR System Software V 5.1 and
higher.
 DR Systems that are running DIRECTVIEW System Software V 5.0 and higher.
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See also:
Joining Devices
Identifying Icons
Standalone Mode
455
Standalone Mode
When the Console is configured for the Capture Link System, but is not yet
connected, it is in Standalone mode. A console is fully functional in Standalone
mode. Standalone mode lets you continue using your System if Network
problems or other causes disable access to the Capture Link Server.
Standalone mode is useful for correcting error conditions, such as
communication errors that display the red icon.
When should I enter Standalone mode?
 Enter Standalone mode whenever it is necessary to operate the System and the
Capture Link network is unavailable.
If the network to which the System is connected becomes unavailable, it will
be possible to enter patients and scan images, but it will not be possible to
deliver images to destinations.
 Enter Standalone mode to intentionally remove your machine from the Capture
Link network.
To enter Standalone mode:
1. Select Shutdown.
2. Deselect Join Capture Link Server after Restart.
3. Select Reboot and OK.
See also:
Identifying Devices
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Basic Capture Link System Operations

Changing Image Processing in the Capture Link
System
How can the Key Operator make Global Changes to default Image
Processing values?
The Key Operator has the same ability to change IP configurations in Capture
Link mode as in Standalone mode. See How to Configure a View.
For example, the Key Operator can use the Image Processing Preference
Editor to change all of the images in an image Category or the images in a
specific View. These changes become the defaults for the CR device in the
Capture Link System. When you leave the Capture Link System, make sure to
restore the parameters to the individual Systems. See Capture Link System
Range of Operation.
 Use a Console in the Capture Link System to configure image processing
preferences across the Capture Link System.
 Back up parameters and restore them to each local machine to ensure proper
behavior when working off-line.
1. The Key Operator logs in.
2. From the Key Operator Functions menu, select System Configuration,
then select Image Processing Preferences.
3. Select a Category (primary or secondary) or specific View to adjust.
What routine changes can the technologist make to the Image Processing
for each view?
You can apply the following Image Processing settings and features to any
image at any Console or CR ROP such as:
 A Look (if EVP Plus is enabled)
 Brightness, latitude, and detail contrast
 Noise Suppression
What happens to my Image Processing Values when I join and leave the
Capture Link System?
While you are joined to the Capture Link System, the Image Processing
Preference configurations are specific to each CR device.
When in Standalone mode, each machine uses the Image Processing
parameters that were stored on the local machine.
How can I make sure the Image Processing parameters in Standalone
mode are the same as those used with the Capture Link System?
Each machine uses its own locally saved configuration settings when it operates
in Standalone mode. Back up the configuration settings from the Capture Link
457
server and restore them to each individual machine to insure they are identical.
Make sure to repeat this process whenever the settings change in the Capture
Link System.
See also:
Backup and Restore

Restoring Configurations from the Server to a Standalone Machine
Adjusting Image Parameters Menu
What Is Standalone Mode?
Configuring Destination Profiles
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Configuring Destination Profiles with the Capture

Link System
You can set destination profiles so that images acquired on a certain CR or
DR system will always be delivered to a certain destination. There is one set of
profiles for the entire Capture Link System. You can add as many as you like for
different filter conditions.
Profiles in the Capture Link System can include the Modality name, where
profiles in Standalone mode do not.
Does configuring the destination profile make all the machines in the
Capture Link System deliver to the same destination?
Yes, if the images meet the profile filter criteria.
For example, if you set up a profile so that cassette size 18 x 24 prints to printer
ABC, all cassettes of size 18 x 24 that are scanned anywhere on the Capture
Link System will be printed to printer ABC.
If this is not what you want, then you can create a machine profile:
1. Go to the Key Operator Functions, System Configuration, and select the
Destination Profiles Configuration Screen.
2. Create a profile that specifies a destination and a machine name filter such as:
Profile Filters Result
Machine A images print to All images scanned on Machine A print to printer XYZ
printer XYZ
Machine B images print to All images scanned on Machine B print to printer ABC
printer ABC
With this profile set, any images scanned on Machine B will not go to printer
XYZ.
Does setting up a new profile override the others in the Capture Link
System?
The Capture Link Server selects the profile with the highest priority set by the
user. Each image is distributed in accordance with the first profile it matches.
The profiles are listed by priority on the interface. You can change the priority by
moving profiles up and down the list.
The Default Destination Profile will always appear at the bottom of the
Destination Profile Name list.
For example:
The first profile: 18 x 24 Machine A images print to printer XYZ.
The second profile: 24 x 30 images print to printer ABC.
If an 18 x 24 cassette is scanned on Machine A, the first profile is selected, and
it delivers to printer XYZ.
459
If a 24 x 30 cassette is scanned on Machine A, the first profile does not match,

so the software moves to the next, and the image is delivered to printer ABC.
Destination Profiles are included in the configuration settings that may differ
between Capture Link mode and Standalone mode. To duplicate the settings
between modes, back them up from the Capture Link server and restore them to
each machine in Standalone mode.
See also:
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Communicating with the HIS/RIS

 The Capture Link server connects the Capture Link System to the HIS/RIS.
Information from the HIS/RIS is available to all Consoles and ROPs on the
 Patient and exam queries from any Console or ROP are directed to the Capture
Link Server and then to the HIS/RIS as necessary. Information returned from the
Query is stored on the Server and is available to all other Consoles and ROPs.
 The Capture Link Server polls the Work List for new data.
 For best overall performance, configure exact queries of the DICOM Work List
(queries by patient name, patient ID, or accession number) whenever possible.
See also:
Entering Data with the Capture Link System
Image Review with the Capture Link System
Multi-format Printing with the Capture Link System
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Image Review with the Capture Link System

You can review all images for an exam at any Console or ROP regardless of
where they were acquired.
1. Make sure that the Key Operator has enabled the Console with the Capture
Link System option and connected the System to the Capture Link System.
2. Acquire a single patient exam from any CR/DR systems within the Capture Link
System.
3. Query the patient, and select the patient from the Patient Work List Screen.
All thumbnail images display properly, regardless of where they were
acquired. The name of the system where the image resides does not appear
on the thumbnail of the Image List until after the Modality leaves the Capture
Link System. At that time the name appears on the Image list at the Capture
Link server and any modality joined to the Capture Link System.
Although the view of the image is shared, the actual image file resides in the
local database on the hard drive local database of the CR or DR Console where
it was acquired.
What should I do if I can't see the image?
If the System cannot connect with the machine that has the image file (the
machine is down or network issues prevent a connection), an icon indicates that
the image is inaccessible. Make sure that the machine with the image file is
available on the network. Make sure that the Capture Link server is available on
the network.
How can I tell which machine has the image?
The name of the system where the image resides does not appear on the
thumbnail of the Image List until after the Modality leaves the Capture Link
System. Then the name appears on the Image List at the Capture Link Server
and any Modality joined to the Capture Link System.
How long does it take to retrieve the images with Capture Link?
Depending on network performance, the image retrieval time may be slower
than retrieving an image from Standalone mode.
See also:
Changing Image Processing
462
Multi-format Printing with the Capture Link

System
You can create a multi-format print for an exam where the images have been
acquired from multiple Systems.
1. Make sure that the Key Operator has enabled the Console with the Capture
Link System option and connected the System to the Capture Link System.
2. Acquire a single patient exam on different CR/DR systems within the Capture
Link System.
3. Query the patient, and select from the Patient Work List screen the patient that
has images acquired on multiple CR/DR systems.
All thumbnail images are displayed properly (images retrieved from the
different systems from where they were acquired). Each thumbnail indicates
where the image is located.
4. Select the Multi-format Print icon.
5. At the Multi-format Configuration Screen, add images from multiple Systems
to create a multi-format print.
How long does it take to print a multi-format print from the Capture Link
System?
It only takes a few seconds; not much longer than printing from Standalone
mode.
Why can't I see the image?
If the System cannot reach the machine where the image was acquired
(machine down or network issues), an icon indicates that the image cannot be
viewed.
When you attempt to deliver the print, a delivery error appears if the image
cannot be retrieved from the remote machine.
See also:
463
Scanning Long-Length Images (LLI) on the

Capture Link System
You can scan multiple CR Cassettes on multiple systems to reduce scanning
time, and process the individual cassettes by stitching them together
automatically. This workflow reduces the time to stitch the Long-Length image
for review and delivery.
Make sure that the Key Operator enables the Capture Link System option at the
CR Systems.
1. Scan the cassette bar-codes.
2. Perform the exam.
3. Scan the cassettes on one or more machines in the Capture Link System.
When the last image is acquired, stitching occurs at the machine where the first
long-length cassette in the study was scanned. The image is stitched as soon as
the last image is scanned, and is available for review at any Console or ROP on
the Capture Link System.
How long does it take to create a stitched image with Capture Link?
Stitching starts as soon as the last cassette is scanned. For best workflow, scan
all cassettes in parallel on various machines.
See also:
464
Capture Link System Communications

When the Modality is configured for the Capture Link System but is not yet
joined, it is in Standalone mode. A console is fully functional in Standalone
mode. You can operate a Modality in Standalone mode if the Capture Link
Server becomes unavailable and the individual Modality remains joined.
If the Modality is no longer joined to the Capture Link Server, you do not lose
access to the images that are located on the hard drive of each Console.
However, the link between the image and its patient/exam data is broken, and
must be restored before the image can be reviewed or delivered.
To restore the link between an image and its patient/exam data when the
machine has switched to Standalone mode:
1. From the Main Menu, select Utilities and Image Recovery.
The following data appears in a row for each image:
 Patient ID
 View Name
2. Select the row(s) that represent the images you are looking for.
3. Select Recover Checked Images.
The Modality attempts to associate the image to a patient/exam.
If the Modality cannot automatically associate the image to a patient/exam,
the image will be unassigned.
See Assigning an Image
For unassigned images,
1. Re-create the patient/exam image record (Query the local or remote Work List
or enter data manually at the Patient Input Screen).
3. The data listed above appears in a row for each image.
To restore the association between an image and its patient/exam data
when the machine has returned to Capture Link Mode select Main Menu >
Utilities:
See: Image Recovery to Capture Link
1. Use the filters to select the images in the system: All Studies, Need Approval,
Unassigned Images, Failed Delivery, Pending Delivery, Need Destination, or
Delivered Images.
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You can sort by Patient Last Name, Patient ID, Accession Number, Tech ID,
or Acquisition Date.
If you are in a Standalone mode and then join the Capture Link System, an
image on your system will not be visible or accessible unless you use the Image
Recovery to Capture Link utility.
The recovered image is retrieved but unassigned to a patient/exam record if
there is no match of the Accession Number and Patient ID.
3. Select a patient record from the RIS or create one manually.
4. Assign the image.
See also:
Re-delivering an Image
466

If you left the Capture Link System and wish to rejoin:
1. Select the Quick menu in the lower left corner of the screen.
2. Select Shutdown.
3. Select Join Capture Link Server after Restart.
4. Select Reboot.
The system will restart and reconnect to the Capture Link Server.
See also:
467
Redelivering an Image
When a machine joins the Capture Link System, it cannot access the patient
records that were previously captured while in Standalone mode. To avoid this,
deliver all images acquired in Standalone mode before connecting to the
Capture Link System. A message reminds you to do this before you connect.
If a Standalone mode image must be redelivered after reconnection to the
Capture Link System, two methods are available.
Method 1—Redeliver in Standalone Mode
1. Return the machine to Standalone mode.
2. Select the image(s) from the Image Review list.
3. Redeliver as needed.
Method 2—Image Restoration in Capture Link Mode
1. At the Main Menu, select Utilities.
2. Select Image Recovery to Capture Link.
3. Select the row that represents the image you are looking for.
4. Select the image to recover. The image is retrieved but unassigned to a
patient/exam record if there is no match of the Accession Number and Patient
ID.
5. Recreate a patient exam record for the image. (You may do this with a Query to
the local or remote Work List or a manual entry at the Patient Input screen.)
7. Review the now-assigned image and proceed in the usual manner.
The following data appears in a row for each image stored on the machine’s
hard drive:
 Patient ID
 View Name
 Cassette ID (CR only)
What happens in Image Recovery?

If you acquired an image while in Capture Link mode, and now operate in
Standalone mode (or acquired the image in Standalone mode and are now in
Capture Link mode), you are no longer connected to the CR/DR System that
owns the image. Image Recovery lets you access the image on the hard drive
of the machine that scanned the image.
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Using Image Recovery to Capture Link

 Use the following filters to select the images in the system:
o All Studies (all that need to be completed)
o Need Approval (studies that are not accepted)
o Unassigned Images (images not assigned to a patient)
o Failed Delivery (images that were not delivered)
o Pending Delivery
o Need Destination (no destination defined)
o Delivered Images (all images that have been delivered)
 You can sort by Accession Number, Tech ID, or Acquisition Date.
If you are in a Standalone mode and then join the Capture Link System, images
acquired while not part of the Capture Link System will not be visible or
accessible unless you use the Image Recovery to Capture Link Utility.
 If a study exists with the same Patient ID and Accession number, it associates
the image with that study. If not, the image is an unassigned image, and the
Patient ID and Accession number are placed in the Image Comments field.
See also:
How do I assign an image?
469
Capture Link Configuration

Capture Link
Making Preference Editor Changes in the Capture

Link System
When using the Capture Link System, you may want to change Preference
Editor settings while the Modality is joined to the Capture Link Server. The
Preference Editor settings for each Modality are recorded by the Server when
they are joined.
If Image Processing Preference changes were made at the CR 975A in the
example below, the changes would be seen there, but the changes would
actually exist on the Server. The Server records each Modality's Preference
Editor separately. The CR 975B does not see the Preference Editor changes
made on the CR 975A. Any images processed on the CR 975B will be
processed with the original Preference Editor settings.
To transfer the settings from CR 975A to CR
975B:
1. Back up the optional Procedure Mapping and Views component at the CR
975A.
2. Restore the Procedure Mapping settings and Views component at the CR
975B.
The Server records the new CR 975B Preference Editor settings.
Restore the optional Procedure Mapping settings and Views from the back up
and use the Local Database Only check box to transfer the Preference Editor
settings onto each Modality for when the CR is in Standalone Mode. You can do
this while still joined to the Server.
470
See also:
Backup and Restore Configurations
471
Capture Link Configuration Screen

The Capture Link Configuration Screen lets you do the following by selecting a
radio button on the screen:
 Disconnect from a Capture Link Server
 Connect to a Capture Link Server
 Become a Capture Link Mini Custer Server
A Capture Link Mini Cluster Server is a Capture Link System consisting of two
modalities, where one of the modalities acts as a Server.
See also:
Joining Devices
472
Configuring and Connecting a Console or

Accessory Device
1. At the Key Operator Functions menu, select Capture Link Configuration.
2. To configure the Console to connect to the Capture Link System, select
Connect to a Capture Link Server.
3. Enter the IP address of the Capture Link Server.
5. At the Quick Menu in the lower left corner of the screen, select Shutdown.
6. Check Join the Capture Link System after rebooting.
7. Select Reboot.
 Capture Link Icons in the application title bar show that the Capture Link
System is configured, but the machine is not connected. This is Standalone
mode.
 The application restarts and is connected to the Capture Link System. The
Capture Link Icons in the application title bar turn green to show that the
device is connected to the Capture Link System.
 The Capture Link Server Status Screen updates to include a new
identifying data row for the machine you added.
To view the Capture Link Server Status Screen, from the Main Menu, select
Utilities.
To configure the Console to disconnect from the Capture Link System, select
Disconnect from a Capture Link Server.
See also:
Capture Link System Requirements
Removing a Console from the Capture Link System
473
Capture Link System Requirements

All machines that are linked to a Capture Link System must meet the following
requirements:
 Install KODAK DIRECTVIEW CR Software Version 5.1 or higher in all CR
Systems.
 Install KODAK DIRECTVIEW DR Software Version 5.0 or higher in all DR
Systems.
 Install KODAK DIRECTVIEW System Software Version 5.2 or higher in all
systems if joining CR and DR Systems.
 Connect Computed Radiography (CR) and Digital Radiography (DR)
Systems via a Local Area Network (LAN).
 No common software options are required. A Console can join the Capture Link
System at any time.
Machines that run in Standalone mode, adjacent to a Capture Link System, do
not have to meet these requirements.
See also:
Backup and Restore
474
Restoring Configurations from the Server to a

Standalone Machine
The Key Operator can back up the configurations from the Capture Link System
and restore them to a CR or DR System for when the machine is in Standalone
mode. The machine in Standalone mode will be configured identically to the
1. At the Key Operator Functions menu, select Backup Restore.
2. Select the Backup/Restore Directory to select a drive to save the Backup to.
4. Select the items you would like to back up.
5. Select the Backup button.
6. Select Local Database Only and select Restore to save the configurations
from the Capture Link System to the local machine.
The selected Capture Link System configurations are now available to the
machine when it is in Standalone mode.
What configurations are restored?
See also:
What Is Standalone Mode?
475
Removing a Console from the Capture Link

System
To remove a CR or DR Console from the Capture Link System:
1. At the Key Operator Functions menu, select Capture Link Network
Configuration.
2. Select Disconnect.
The system auto-restarts and resumes operation in Standalone mode.
476
Troubleshooting the Capture Link System

Why can't I enter an IP address in the Capture Link Configuration Screen?
Capture Link is an option that must be purchased and enabled on the Option
Registration Screen. If the option is not enabled, you will not be able to enter
an IP address or change the mode to connect to a Capture Link Server.
Why can't I see my images now that I am connected to the Capture Link
System?
The images you seek were captured when you were in Standalone mode.
Images that were captured in Standalone mode are unavailable when you are
connected to the Capture Link System. If the Capture Link System cannot
connect with the machine that has the image file (the machine is down or
network issues prevent a connection), an icon indicates that the image cannot
be viewed, and you will need to check for communication issues.
The System checks to see if there are any non-delivered images the local
system when you attempt to connect to the Capture Link System, but you must
deliver them before you join or those images will not be accessible until you
leave Capture Link.
See Image Recovery.
Identifying the Capture Link Icons
The Capture Link Icons may indicate action on your part, or simply a status.
See Identifying Icons.
How can I tell which machine has the image?
The name of the system where the image resides does not appear on the
thumbnail of the Image List until after the Modality leaves the Capture Link
System. At that time the name appears on the Image List at the Capture Link
Server and any Modality joined to the Capture Link.
What happens if the Capture Link Server is unavailable on the hospital network?
If your system is configured for and connected to Capture Link and you
encounter data network problems, you can switch to Standalone mode.
The system will repeatedly attempt to overcome the network problems unless
you switch to Standalone mode. Choose an action:
 Go into Standalone mode and run independently.
 Do not restart in Standalone mode. Wait for the network problems to be
resolved, and then reconnect to the Server.
477
Capture Link Server Help

Capture Link Server Safety and Regulatory
EMC
Europe
EN 55022:1998+A1:2000 (Class B) Emissions
EN 55022:1998+A1:2000 (Class B) Immunity
EN 61000-3-2:2000 Harmonics
EN 61000-3-3:1995+A1:2001 Flicker
U.S. and Canada
CFR 47 part 15 sub B (Class B) Emissions
Safety
Standards for Safety of Information Technology Equipment
UL 60950
EN 60950:2000
IEC 60950:1999
478
Logging On to the Capture Link Server

Log on to the Capture Link server the same way you would log in to any System
Console.
See also:
Capture Link Server Safety and Regulatory
479

The Capture Link Server Status Screen quickly lists what machines are
connected to the Capture Link System, or what the network communication
statuses of those systems are. To access it, from the Main Menu, select
Utilities.
To determine which devices are in the Capture Link System:
View the Capture Link Server Status Screen list of the names and IP address
of each machine Console and server configured for the Capture Link System.
Remote Operations Panels and other external devices are not listed.
To determine whether there is a Capture Link connectivity problem:
o If there is a good connection, the light appears green.
o If there is a problem with the connection, the light appears red.
To determine which types of connections you can check:

 Network
 Application
 Database
480
Capture Link System

Log into the Capture Link Server the same way you would log onto a Console.
The appearance of the Server Software is similar to an ROP. If the System
cannot connect with the machine that has the image file (the machine is down,
or network issues prevent a connection) an icon appears that indicates the
image cannot be viewed.
What can I use the Capture Link Server for?
Besides providing a master database for CR and DR Systems, you can:
 You can use the Capture Link Server as another very-capable ROP to review
and manage images and patients.
 Use the Capture Link Server for patient and image review.
 Query images and patients.
 Perform QA functions.
 Create and update patient information.
How fast is the Server response for viewing patient and image data?
The performance time of image display should be similar to that of an ROP.
See also:
How to Use the Capture Link Server Status Screen
How to Recover Images from Capture Link
How do I enter data in Capture Link?
How do I connect?
481
CARESTREAM CR Long Length Imaging Help
Long-Length Imaging (LLI) Menu
Acquiring Images
Performing a Long-Length Exam
Optimizing a Long-Length Exam
Entering Data for an LLI Exam
Determining the SID
LLI Techniques
Scanning LLI Images on Capture Link System
Assigning and Unassigning LLI Images
CR Long-Length Grid Ratio
Tips for Optimizing LLI Image Quality
Composite Images
Printing Long-Length Images
Viewing Long-Length Images
No Composite Image
Images are Stitched Incorrectly
Distorted Composite Image
483
Acquiring Images
Long-Length Imaging

1. Enter Patient data into the CR Modality the same way you would for a standard
study.
2. Select a View or a Procedure.
3. Bar-code one of the cassettes used in the study.
5. Select the number of Long-length Cassettes used.
6. Bar-code the remaining cassettes.
You can override the default SID setting before processing the cassettes in
the CR System by selecting one of the thumbnails and then the More Image
Data Tab. There may be a distortion at the seam line of the composite image
if the SID used is not within plus or minus 1 cm of the actual SID used.
When all of the cassettes have been processed in the CR System, the
composite image will automatically begin to process.
Five image icons always appear for each long-length vertical exposure
regardless of the number of cassettes used. If there are three icons representing
cassettes 2, 3, and 4, the last is the composite image. The fifth cassette icon
remains as a placeholder if it is not used.
Three image icons always appear for each portable long-length exposure. For
example, three icons would represent images 1, 2, and the stitched image.
The composite image is represented by the fifth image placeholder for the
Vertical Cassettes and the third image placeholder for the Portable Cassette.
The number of the cassettes used in the exposure appears on this image.
The SID for the Portable Long-Length Cassette is determined automatically by
the Position field selection on the Patient Input Screen (Supine or Erect). The
defaults for these positions are set by the Key Operator. The radiographer can
override this setting for the combined image body part and projection as desired
from the More Image Data button on the Patient Input Screen.
To use your CR System for long-length imaging, a Carestream Health
Representative must install DIRECTVIEW CR System Software Version 5.1 or
higher.
See also:
Determining the SID
484
Long-Length Imaging

What kind of grid should I use?
Use the optional DIRECTVIEW CR Long-Length Grid (103 lp/in 8:1).
Carestream Health has not tested other grids.
If you use another grid, make sure that you evaluate the best conditions
for image quality.
You can order extra front panels for mounting standard long-length grids.
What kind of collimation is best?
Use vertical collimation for long-length imaging exams. The image stitching
algorithm uses the non-image area at the sides of the phosphor screen to
correctly align the image information.
For best results, collimate approximately 1 in. (2.5 cm) inside the image target
on the Front Panel or Grid.
How many cassettes will I need?
Use the minimum number of cassettes required to capture the desired image.
Large unexposed areas can degrade image quality.
What kind of filtration is required?
Use an intensity profile compensation filter (wedge filter) to pre-attenuate
images.
485

1. Enter Patient data into the CR System the same way you would for a standard
study.
2. If the Procedure Mapping option is enabled, enter the procedure codes for the
long-length image on the Patient Input Screen.
3. Scan a CR long-length cassette bar code, always starting with 9105 for Long-
length Vertical Cassettes and 9112 for Portable Cassettes.
4. Enter the number of long-length imaging cassettes used for the exposure.
Make sure you select cassettes that have consecutive numbers, such as 1,
2, and 3. The software will not let you select cassettes that would leave a
gap in the combined image, such as 1 and 3 or 1 and 4.
5. Enter the exam data
To change the number of cassettes selected:
You cannot change this selection, however you can select Delete View and
start again.
If you are processing a Long-Length Portable Cassette, a dialog box appears
with the message: Choose a patient position for this long-length exam,
Erect or Supine.
How many icons should I see?
Five image icons always appear for each long-length Vertical Cassette
exposure, regardless of the number of cassettes used. The composite image is
represented by the fifth image placeholder for the Vertical Cassette.
Three image icons always appear for each Portable long-length exposure. In
this example, three icons represent images 1, 2, and the stitched image. The
composite image is represented as the third image placeholder for the Portable
Cassette.
The number of the cassettes used in the exposure series appears on the
composite image.
See also:
Determining the SID
LLI Techniques
486
Determining the SID

The Source to Image Distance (SID) for the Portable Long-length Cassette is
determined automatically when you select the Position field on the Patient Input
Screen (Supine or Erect). You can override this setting for the View as desired
from the More Image Data button on the Patient Input Screen.
To enter the correct SID:
Vertical Cassette Holder—Enter a value from 102 cm to 183 cm (40 to 72 in.) ±
1 cm.
Portable Cassette and Grid—Enter a value from 102 cm to 183 cm (40 to 72
in. ) ± 1 cm.
The SID is one of the measurements used for pixel size calculations. If the
calculated pixel size is not the actual pixel size, angular measurements made
from the image display may not be accurate.
It is imperative that measured SID is within +/- 1 cm of the value assigned
in the system.
See also:
Long-Length Imaging Configuration
487
LLI Techniques
The software looks for sharp edges in each of the sub-images to combine when
applying the stitching algorithm. Therefore, if you collimate closely when
performing a long-length exam, your results will improve.
See also:
Assigning and Unassigning Long-Length Images
CR Long-Length Grid Ratio
488
Scanning Long-Length Images (LLI) on the

Capture Link System
You can scan multiple CR Cassettes on multiple systems to reduce scanning
time, and process the individual cassettes by stitching them together
automatically. This workflow reduces the time to stitch the Long-Length image
for review and delivery.
Make sure that the Key Operator enables the Capture Link System option at the
CR Systems.
1. Scan the cassette bar-codes.
2. Perform the exam.
3. Scan the cassettes on one or more machines in the Capture Link System.
When the last image is acquired, stitching occurs at the machine where the first
long-length cassette in the study was scanned. The image is stitched as soon as
the last image is scanned, and is available for review at any Console or ROP on
the Capture Link System.
How long does it take to create a stitched image with Capture Link?
Stitching starts as soon as the last cassette is scanned. For best workflow, scan
all cassettes in parallel on various machines.
See also:
489
Assigning and Unassigning Long-Length Images

(LLI)
The process for assigning and unassigning long-length images is slightly
different than the process we use for general radiography images. Follow the
procedure carefully.
Never delete the composite view icon or composite image while the sub-images
are attached to the composite's patient record. Doing so will delete all of the
images for that LLI exam.
Unassigning Long-Length Images
1. Select one of the sub-images.
2. Select the Unassign Image button at the bottom of the screen.
3. Repeat steps 1 and 2 for the remaining sub-images until all of the sub-images
are unassigned.
4. Delete the composite image when all of the sub-images have been unassigned.
Assigning Long-Length Images
1. Locate the correct patient record for the LLI exam and assign it an appropriate
View icon.
2. Enter the cassette ID of one of the unassigned LLI sub-images into the Cassette
ID field. The cassette ID can be found in the image's information bar in Image
Review.
The 5th position in the cassette ID corresponds to the cassette's position in the
LLI Study.
3. After the cassette ID has been entered, select the number of cassettes used in
the LLI Study. You do not need to enter the remaining cassette IDs.
4. Select the Unassigned Image button on the Main Menu screen to locate the
unassigned LLI sub-images.
5. Select one of the unassigned LLI sub-images.
6. Select the Assign Image button.
7. Locate the patient record.
8. Select the existing view icon that corresponds to the position of the unassigned
image.
Remember that the 5th position in the cassette ID corresponds to the cassette's
position in the LLI study. The software will not let you put the unassigned image
into the wrong existing LLI view icon.
9. Repeat these steps until all of the LLI sub-images have been assigned into the
correct patient record. The composite image will automatically stitch once all of
the sub-images have been assigned.
490
See also:
How do I enter data for a long-length image?
How do I print long-length images?
Why are the images stitched incorrectly?
Why is the composite image distorted?
What do I do when there is no composite image?
How do I determine the SID?
491
DIRECTVIEW CR Long-Length Grid

DIRECTVIEW Long-Length Grid for Vertical Cassette Holder
DIRECTVIEW Portable Grid
Performance for LLI image quality is optimized. If you choose another grid,
make sure to evaluate the best conditions for image quality:
 Grid Ratio: 8:1
 103 LP
Handle the Grid with care. Dropping or bumping the Grid causes serious
internal damage that produces permanent, unacceptable imaging artifacts.
Carestream Health has not tested other grids.
492
Long-Length Imaging
Tips for Optimizing Long-length Image Quality

There are several ways you can optimize the image quality of long-length
images.
 Measure Source to Image Distance (SID) accurately:
SID is one of the measurements used for pixel size calculations. If the calculated
pixel size is not the actual pixel size, angular measurements made from the
image display may be inaccurate.
Therefore, it is imperative that measured SID is within +/- 1 cm of the value
assigned in the system.
The DIRECTVIEW CR Long-Length Vertical Cassette Holder has a
recommended SID of 183 cm (72 in.). You can set the default SID value from
150 cm to 229 cm (60 to 90 in.), depending on site and grid requirements. You
must enter SID values in centimeters (cm).
The DIRECTVIEW CR Long-length Portable Cassette has a recommended
SID of 150 cm (60 in.). You can set the default SID value from 101 cm to 183 cm
(40 to 72 in.), depending on site and grid requirements. You must enter SID
values in centimeters (cm).
Your staff radiographers can move the tube from the default position for an
exam, but must override the default distance and enter the measured SID when
entering exam information. The actual SID must be within +/- 1 cm of the value
assigned in the system.
493
Composite Images
Using the Manual Stitch Editor
The Manual Stitch Editor is a tool that allows you to adjust the stitching of a
composite image if the results of the automatic stitching need optimization.
To access the Manual Stitch Editor, touch the composite image that appears
after a Long-Length exam.
The Image Viewer screen opens with the composite image in the Viewer
window.
Making Adjustments with the Manual Stitch Editor

1. While viewing the stitched image, select the Edit Stitched Image checkbox.
2. You can now adjust the image stitching three ways:
 Use the cursor to drag-and-drop the image in place, either on the main viewer
screen or the small viewer panel at the right of the screen.
 Use the arrow keys to move the image to make fine adjustments. One touch of
the arrow key moves the image one pixel. Pressing the Control key and
touching the arrow moves the image five pixels.
 Select the Use Fiducials check box. This removes automatic stitching
and lets you manually re-stitch the composite.
494
Be sure to pan and zoom the image before selecting Use Fiducials, because
once selected, the cursor changes to a crosshair, and it is not possible to pan
the image without unintentionally selecting a reference point. Only the small
image panel will allow panning once Use Fiducials is checked.
To Use Fiducials
1. Select a point in the overlap area (such as a point on the ruler) and click
once.
2. Select a point in the second image and click again. The image aligns to those
two reference points.
3. Select Reset to follow these steps again if your first attempt is not
satisfactory.
TIP If a radiopaque ruler is used in the image, selecting identical points is
simple. Use the arrow keys adjusts the image pixel-by-pixel if necessary.
4. Select Save Changes when the image stitching is complete.
5. Select Save & Accept to deliver the image.
495
Printing Long-Length Images

The composite image is printed on a single piece of film. Use True-size printing
to print the individual images at the same size they were acquired then fasten
them together if desired.
True-size printing significantly crops a composite image and is not normally
used.
To use True-size imaging:
1. At the Patient Input Screen, select one of the sub-images.
2. At the Image Viewer screen, select the Crop Box Adjustment Tab.
3. Select True-size Print.
4. Select Save & Accept Image.
5. Repeat these steps for the remaining sub-images.
See also:
How do I make a True-size print?
Why are the images stitched incorrectly?
Why is the composite image distorted?
What do I do when there is no composite image?
How do I determine the SID?
How do I enter data for a long-length image?
What techniques can I use with long-length imaging?
How do I unassign and assign long-length images?
496

There are always five image icons that appear when a long-length series is
created, even if only three or four will be used in the final image.
To view long-length images:
 View each image segment acquired.
 View the processed composite image, which appears in a resolution to fit the
screen.
 With long-length imaging enabled, you can activate QA Mode just for the
composite image. Doing so does not affect the QA Mode for standard images or
long-length image segments.
There is no exposure index calculated for the composite image. To evaluate the
technique, use the exposure index for one of the image segments.
See also:
Viewing Modes
497
No Composite Image
If no composite image forms:
 Make sure the Long-length option is enabled.
 Print the individual segments True-size and tape them together.
 Unassign the sub-images and reassign them to produce a composite image.
See also:
498

To review images stitched in the wrong order:
 The phosphor screen is in the wrong cassette.
 The bar-code label on the cassette is incorrect.
Place the image plate into the correct cassette or place the correct bar-code
label on the cassette before further use.
When one or more images are missing:
 There were fewer images in the long-length exposure specified than were
actually used.
Unassign images and reassign or handle individually, then print.
To resolve stitching that is misaligned:
 The Cassette Holder door could be ajar.
Check that door is tightly closed.
 Incorrect Source to Image Distance.
Enter proper Source to Image Distance (SID).
 Software problem.
Call Service.
See also:
Assigning and Unassigning LLI Images
499

The composite image can become distorted when the incorrect Source to
Image Distance (SID) is entered. Use the correct SID values;
 Vertical Cassette Holder—Enter a value from 102 cm to 183 cm (40 to 72 in.)
+/-1 cm.
 Portable Cassette and Grid—Enter a value from 102 cm to 183 cm (40 to 72
in.) +/-1 cm.
See also:
No Composite Image
500
CARESTREAM Remote Patient Data Entry System
Help
Remote Patient Data Entry System (RPDES)
Remote Patient Data Entry Software is a software option for entering patient
data at a workstation. It is installed on the CR System and allows
communication between a customer-supplied computer workstation and the CR
System.
If the Remote Patient Data Entry option has been enabled, the Remote Access
Software lets you access the Patient Input Screen to pre-populate the Work
List. A radiographer-level password is required when logging into the CR from
the customer PC.
A RPDES must have a fixed IP address. If the PC is configured to use DHCP
(dynamic IP address assignment on boot),or the link with the CR System may
be lost when the PC is rebooted.
Setting up the RPDES at the CR
1. Load the Remote Access Software onto the customer's computer (see
Remote Workstation Options section).
2. Follow the steps in Setting Up Remote Access to the CR or DR System.
Entering Patient Information using the RPDES:
The Remote Patient Data Entry System saves time by letting you input patient
information from a remote location.
1. Log on into the CR remotely.
2. Select the Remote Patient Data Entry menu bar.
3. Enter the patient information.
This clears all the fields and lets you enter the next patient record.
You can retrieve the patient information at the CR System.
501

150 Verona Street
Rochester, NY 14608
United States
CARESTREAM and DIRECTVIEW are trademarks of Carestream Health, Inc.

© Carestream Health, Inc. 2011
Printed in the USA

Version 1.0
502

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DIRECTVIEW CR System Software

Version 5.6 Online Help Topics

Finding Patients ..................................................................................................44

Using Measurement Tools ..................................................................................96

Brightness, Latitude, and Detail Contrast Definitions ........................................136

CR Modality Overview ......................................................................................179

Image Recovery on the Capture Link System...................................................215

Programming the Keyboard Wedge Bar-Code Reader.....................................257

What Is a DICOM GSDF-calibrated Monitor? ...................................................305

Importing Custom Tutor Images........................................................................354

Determining the Exposure ................................................................................405

CARESTREAM Capture Link System Help ......................................................445

Entering Data for an LLI Exam..........................................................................486

Multi-format Print Enhancements—

Express Viewer Screen—The Express Viewer screen provides a large View

IEC Exposure Index Option—The International Exposure Index standard is now

Intensive Care Unit software package:

Tech Assist Software

Importing Custom Tutor Images—CR/DR System Software Version 5.6 allows

Key Operator Installation of Software Updates—The Key Operator can upgrade

Pediatric Support Option—System Software V 5.6 now supports the selection of

Patient Verification Mode—A visual indicator verifies the patient wristband

Trademark and Copyright Information

CARESTREAM and DIRECTVIEW are trademarks of Carestream Health, Inc.

This document is copyrighted with all rights reserved.

The information contained herein is based on the experience and knowledge

Notice: This document contains references to software products that were

Carestream Health France

Carestream Health, Inc.

How to Contact Carestream Health, Inc.

Elsewhere in the world, contact Carestream Health, Inc. in your country.

About Online Help

How do I access and navigate Help?

Completing an Exam Set-up

Setting Up Views for a Procedure

Using the Procedure Mapping Workflow

Using the Procedure Code Workflow

Setting Up Views for My Procedure

Using the Automated Procedure Code Mapping

1. From the Main Menu, select Study Data.

Accepting the Image

Correcting Image Artifacts

Modifying a Delivered Image

Flagging an Image for Review

Low Contrast Images due to IPL Parameters

Quick Reference Button Guide

Back Cancel Main Menu

Add View Delete View Save Changes

Accept Image Reject Image Re-Deliver Image

Find Study Find Study Clear Fields

Reprocess Assign Image Unassign Image

Logon Logout Quick Menu

Shutdown Flag for Marker

Images Images Not Select Destination

Destination Change Print

Add Multi- Delete Multi- Change Multi-

Multi-format Trauma Discontinue/Cancel

Next Page Previous Page New Patient

New Study Begin Study End Study

Entering and Deleting Data

Tutor Image icons display when a View or a procedure is requested. Prior

To scan an image on the Patient Input Screen: