86500-4A Diamond Operation Instructions Nov 2000 ENG

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November 2000 86500-4A

COPYRIGHT 2000 by Instrumentarium Imaging
Documentation, trademark and the software are copyrighted

with all rights reserved. Under the copyright laws the
documentation may not be copied, photocopied, reproduced,
translated, or reduced to any electronic medium or machine
readable form in whole or part, without the prior written
permission of Instrumentarium Imaging.
This document is the English-language original. In case of

interpretation disputes the English text applies.
Instrumentarium Imaging reserves the right to revise this

publication from time to time and to make changes in the
content of it without obligation to notify any person of such
revisions or changes.
Microsoft, Windows and Windows NT are trademarks of

Microsoft Corporation in the United States of America and other
countries.
MANUFACTURED BY: Instrumentarium Corporation

Imaging Division
P.O. Box 20
FIN-04301 Tuusula
FINLAND
Tel. +358-10-394 6500
Fax. +358-10-394 6501
E-mail: mammo@fi.instrumentarium.com
Internet: http://www.instrumentarium.com/imaging
Diamond Operation Instructions
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3.4.1 Compression paddles............................................................................ 10
3.4.2 Insertion and removal of compression paddles .................................... 12
3.4.3 Cassette holders.................................................................................... 14
3.4.4 Insertion and removal of cassette holders............................................. 15
3.4.5 Insertion and removal of the face shield............................................... 18
3.4.6 Diaphragms .......................................................................................... 18
3.4.7 Additional product accessories............................................................. 19
3.4.8 Connections to the system .................................................................... 19
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5.5.1 Diaphragms .......................................................................................... 29
5.5.2 X-ray field illumination light................................................................ 29
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5.6.1 Paddles.................................................................................................. 30
5.6.2 Compression controls ........................................................................... 31
86500 November 2000

Operation Instructions Diamond
5.6.3 Motorized compression ........................................................................ 32

5.6.4 ECS compression system...................................................................... 34
5.6.5 Positioning data display........................................................................ 34
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5.7.1 ECS movement..................................................................................... 35
5.7.2 Cranio-Caudal (CC) Projection ............................................................ 36
5.7.3 Oblique projection ................................................................................ 39
5.7.4 Medio-Lateral Projection...................................................................... 40
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5.8.1 Installing a cassette............................................................................... 41
5.8.2 Making the exposure ............................................................................ 42
5.8.3 Automatic compression release ............................................................ 42
5.8.4 Removing the cassette .......................................................................... 43
5.8.5 Cooling period ...................................................................................... 44
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5.9.1 Film markers......................................................................................... 44
5.9.2 Alpha ID II Film Identification Camera ............................................... 44
5.9.3 Printed labels ........................................................................................ 45
5.9.4 Printer connection................................................................................. 46
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5.10.1 Magnification studies ........................................................................... 47
5.10.2 Magnification procedure....................................................................... 47
5.10.3 Adjustment of the magnification factor................................................ 48
5.10.4 Spot Magnification ............................................................................... 48
5.10.5 Spot magnification tunnel..................................................................... 49
5.10.6 Implant exposure .................................................................................. 49
5.10.7 Manual biopsy ...................................................................................... 50
5.10.8 Lesion marking ..................................................................................... 52
5.10.9 Spot exposure ....................................................................................... 52
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6.1.1 Automatic compression release (Auto Rel) mode................................ 54
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6.2.1 Automatic release (Auto Rel) mode ..................................................... 55
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6.3.1 Adjustment of the mAs-values in manual mode .................................. 56
November 2000 86500

6.3.2 Automatic compression release (Auto Rel) mode................................ 57

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6.4.1 Testing the AEC ................................................................................... 57
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7.1.1 Pre-Programmed Modes....................................................................... 59
7.1.2 Setup mode ........................................................................................... 59
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13.4.1 3 Ø Constant Potential 50 Hz ............................................................... 77
13.4.2 3 Ø Constant Potential 60 Hz ............................................................... 78
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18.1.1 Insertion ................................................................................................ 95
18.1.2 Removal................................................................................................ 96
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18.2.1 Installing a cassette............................................................................... 97
18.2.2 Removing a cassette ............................................................................. 98
November 2000 86500

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'LDPRQG is a high quality X-ray breast imaging system intended for both
screening and diagnostic examinations. The main features are the Auto Point
Detector, ParkBack tube head, motorized C-arm rotation, ECS-(Easy
Compression System) movement with stereotactic option, digital-ready design,
rotating dual-angle anode tube, ROC grid, Tuned High Frequency (THF)-
generator and easy positioning of the patient.
The height adjustment is motorized, and the motorized C-arm rotation range is
±185° degrees. Motorized compression of the breast is controlled by compression
foot pedals, and the manual compression by manual compression wheels. If
necessary, the compression can be released automatically after exposure. In the
event of power failure the compression is released automatically.
The THF generator is integrated into the unit saving space in the mammography
room. The exposure button is located on the compact control panel. A separate
hand-held exposure switch is available as an option.
All functions of the unit are controlled by a microprocessor, and the operator is
informed of error conditions on the control panel display. The Diamond
incorporates many safety features, for example, exposures without a cassette
installed or double exposure are prevented.
The Diamond is intended only for mammography examinations, no other uses are
permitted. Both film sizes, 18 x 24 and 24 x 30 can be used.
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Instrumentarium accepts no responsibility for safety, reliability or performance

unless:
Assembly, calibration and repairs are performed by an Instrumentarium

Imaging authorized representative according to the corresponding
Diamond manuals.
Any modification, addition or deletion to this system is authorized
specifically by Instrumentarium Imaging, in writing.
Electrical installation complies with the IEC regulations.
The system is used in accordance with the Operating Instructions.
Each Diamond unit has been tested for leakage radiation and the test results are
recorded in the final test protocol.
86500 1 November 2000

This device emits X-ray radiation for medical purposes. The Diamond X-ray tube
has a Molybdenum anode. X-rays are either Molybdenum, Rhodium or Aluminum
filtered. The Minimum HVL is 0.3 mm Al without the compression paddle.
Diamond is CE-marked in accordance with MDD (93/42/EEC) and its design
complies with IEC 60601-1. Diamond fulfills the EMC requirements of IEC
60601-1-2, as a class A equipment.
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As radiation is harmful to human body, the radiation protection regulations of
individual countries must be complied with. The user must have a permission to
use x-ray device for mammography. Radiation protection means should be used.
Prior to examination, it is recommended to make sure that the doctor knows if the
patient is pregnant. If someone has to be close to the patient, protective clothing
must be used.
The optional RADIATION SHIELD must be used, or the unit must be operated
from a shielded control room (significant zone of occupancy is 2 meters). During
the exposure, visual and audible contact should be maintained with the patient.
The free-standing radiation shield can be positioned as required in the X-ray room.
An Instrumentarium Imaging mammography accessory storage unit is available
as an option and may be placed behind the free-standing radiation shield. MGX
2000 with radiation protection in accordance with IEC 601-1-3:1994.
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Fig 1.1 Optional radiation shield (34135)
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The device serial number and the year of manufacture can be found at the back of
the column.
Fig 1.1c Labels at the back of the column
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The manual may have following markings:
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Figure 2.1 The stand
1. X-ray tube
2. Diaphragm/collimator
3. Face shield
4. Position Control Center control buttons (see Figure 2.4)
5. Compression paddle
6. Cassette holder
7. Compression paddle release button
8. Manual compression wheels
9. Cassette holder lock release button
10. Patient hand grip
11. C-arm rotation buttons
12. Vertical movement buttons
13. ParkBack control buttons
14. Pre-programmable C-arm angle buttons
15. Control panel
16. Mains switch (automatic trip switch at the rear)
17. User power On/Off switch
18. Emergency stop buttons, one on each side
19. Tube head stereoangulation buttons
November 2000 4 86500

Figure 2.2 Control panel
20. Ready indicator, green

21 Exposure time display
22. Radiation indicator, yellow
23. kV display
24. kV selection
25. mAs display
26. mAs selection
27. Density display
28. Density selection
30. Average patient dose display
31. Filter indicators, all green
32. Mode selector for Auto-kV, Auto Time and Manual
33. Phototimer mode indicators, all green
34. Auto point indicator, green
35. CANCEL-button for menu operations
36. MENU and SET-button for menu operations
37. LCD display
38. Function key 1 and LED indicator
41. Exposure button
47. Filter selection button
86500 5 November 2000

Figure 2.3 The Positioning Control Center panel
7. Compression paddle release button

8. Manual compression wheel
11. C-arm rotation buttons
12. Vertical movement buttons
45. Compression force control (1-6)
46. Collimator light switch
47. Filter selection button
48. Filter selection display
49. AEC detector selector buttons
50. Auto Point detector button and LED indicator
51. Breast thickness display
52. Compression force display
54. C-arm rotation display
Figure 2.4 Position Control Center controls
November 2000 6 86500

Figure 2.5 Breast thickness display (51), compression force display (52) and
C-arm rotation display (54)
Figure 2.6 Tube head stereo angulation buttons (19)
Figure 2.7 Vertical movement buttons (12) at the compression arm.
Figure 2.8 The tube head cover with C-arm rotation buttons (11), vertical
movement buttons (12) and ParkBack buttons (13).
86500 7 November 2000

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Make sure that siting of the unit allows unobstructed rotation of the C-arm and
that it will not strike any object throughout its full movement range. Please also
take care to ensure that the user does not place her/his self in-between the C-arm
and any nearby object when attempting to rotate the C-arm, as injury could result.
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Make sure that the mains switch (16) is on. Then switch ON the mains power with
the user power ON/OFF switch (17). The following will appear on the on control
panel display screen (with factory defaults dependent upon the final installation
configuration):
Figure 3.1 Diamond default screen
The timer display now shows , kV display 25, mAs display density display
and mGy display . Auto-kV is a factory default setting. Your Instrumentarium
approved service technician can change the default setting if required.
Switching ON and OFF restores the default settings on the control panel. It is
recommended to allow a warm-up period of approximately 3 minutes after the
unit is switched on.
November 2000 8 86500

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The Diamond’s control panel uses an LCD-display (37) and 7-segment LED
displays (21,23,25,27,30) for status information display and has various buttons
to regulate the functions of the X-ray unit. The control panel can be attached to the
radiation shield or to the wall. Exposure can be initiated only from the control
panel.
Use of the function buttons (38-40) depends on the menu display and required
functions. These buttons are used to choose various imaging modes, to select the
Integrated Quality Control (IQC) function and date, time and hospital information
input.
Use the CANCEL-button

(35) to go back one step
in the menu without
selecting an option or to
cancel a selection.
Use the SET- button

(36) to accept selections
and to proceed to the next
step in the menu.
The exposure button

(41) initiates the exposure
signal to the computer but
when released it inhibits
the exposure using
hardware.
The use of the LCD-

display (37) and control
panel interface in service
and setup modes speeds up
the installation and service.
Figure 3.2 Diamond control panel
86500 9 November 2000

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Usual Diamond unit delivery includes:
• Diamond unit
• one compression paddle
• two foot pedals
• Control Panel
• Operating Instructions
The following accessories are available for the unit (more comprehensive
information can be found in the ACCESSORIES CATALOGUE, order code
86503). Choose the necessary accessories relevant to your procedures:
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• 18x24 standard small paddle (81033)
• 24x30 standard large paddle (81032)
• 21x10 (implant or small breast paddle)
• Spot paddle, contact
• Spot paddle, magnification
• Full film magnification paddle
• Biopsy paddles
• 21x24 with ø 9 mm circular openings
• 21x24 with ø 18mm circular openings
• 21x24 with 50x90mm rectangular opening
• Spot compression paddle with ø 9mm circular openings
[FPFRPSUHVVLRQSDGGOH This paddle is used with 18x24cm

film.
Figure 3.3 18x24 cm compression paddle
November 2000 10 86500

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The 21x24 cm compression paddle is the standard paddle used with the 18x24 cm
film format, when using the bucky or cassette tunnel.
Usually, this paddle is used with 18x24 cm film and should not be used with the
24x30 cm film and the corresponding cassette holders, because it does not apply
compression to the whole breast being imaged, especially to the upper quadrant
of the breast in oblique and lateral views. However, it can be used to examine
women who have a long breast to shoulder distance.
[FPFRPSUHVVLRQSDGGOH The 24x30 cm compression paddle

is used with the 24x30cm bucky or
cassette tunnel.
It applies compression to the whole

breast area being imaged.
Figure 3.4 24x30 cm compression paddle
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The 20x21cm compression paddle is narrower than the standard 18x24cm paddle.
Therefore, during positioning it allows a better access to a small breast.
In oblique or lateral views it allows a better compression to the breast if the size
of the axillary muscle does not allow the use of the standard paddle.
It is important to remember, however, that especially in the oblique view the

axillary muscle is of interest because 45% of lesions are in the upper, outer
quadrant of the breast.
86500 11 November 2000

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1) Insert the required paddle into the holes on the compression arm (4) and
push the paddle horizontally until it locks. Insert the paddle so that the
longer pin of the two slides into the right-hand hole.
2) The inserted compression paddle looks like this.
November 2000 12 86500

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1) Push on the release button (7) on the either side.
2) Remove the compression paddle by pulling it out horizontally.
86500 13 November 2000

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The following cassette holder types are available for mammography examinations
with Diamond:
• Synchro Bucky 18x24cm (81042)

• Synchro Bucky 24x30cm (81084)
• Contact tunnel 18x24cm (same as bucky but without grid) (81038)
• Contact tunnel 24x30cm (same as bucky but without grid) (81037)
• Multichoice magnification tunnel (one holder for magnification factors 1.6x,
• 1.8x and 2.0x) (81049)
• Spot Magnification tunnel 1.6x (81053)
All cassette holders are adaptable for darkroom and DIN-cassettes (daylight). As
standard, Diamond cassette holders/buckies are configured for daylight cassette
use.
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The bucky is the most often used cassette holder in mammography. It has a
moving grid inside, which is used to reduce the amount of scattered radiation
reaching the film. Primary radiation goes directly through the breast and the grid
and produces the image of the breast on the film.
Scatter radiation has an arbitrary angle and thus produces no image on the film but
only reduces the contrast in the final image.
Separate buckies are available for both 18x24cm and 24x30cm film formats and
for darkroom and daylight cassette types. The bucky and magnification tunnel are
replaced as described in section 3.4.4.
November 2000 14 86500

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All FDVVHWWHKROGHUV (6) mentioned in Chapter 3.4.3 are replaced the following
way:
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Grooves
1) Align the guides of the desired cassette holder with the grooves on the C-
arm.
2) Push the cassette holder forward until it locks securely in place.
86500 15 November 2000

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Pull the cassette holder from both sides and pull it away from the C-arm. Use both
hands when removing the cassette holder.
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When using a bucky, the patient positioning (Chapter 6.5) and exposure
techniques (Chapter 10) are similar to those described in section 6.6. A bucky is
installed in the same way as a cassette holder.
Figure 3.5 18x24cm Bucky
November 2000 16 86500

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The cassette tunnel has as little material as possible between the breast and the
film cassette. All Instrumentarium cassette holders have a carbon fiber cover to
ensure the lowest attenuation of radiation and so keep patient dose to a minimum.
There is a cassette tunnel for both 18x24cm and 24x30cm film formats and for
both normal cassette and daylight cassette cassette types.
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In order to maximize the image quality, the object (breast) to film distance has to
be as short as possible, which reduces blurring and allows use of a low kV-setting
because of the low attenuation in the cassette holder itself.
The cassette tunnel, however, has no means of reducing scattered radiation to the
film and this reduces the contrast considerably. Therefore in many countries the
cassette tunnel is not a recommended option and may even be prohibited from use.
Please ensure you are familiar with your local regulations before use.
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The magnification tunnel produces a magnified image of the breast. This is done
by having a certain distance between the object and the film. Magnification factors
1.6x, 1.8x and 2.0x are possible with the MultiChoice magnification tunnel.
86500 17 November 2000

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The face shield is used to keep the patient’s face or ear lobes out of the X-ray
beam during exposure.
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Install or remove the face shield with a single diagonal movement along the
grooves. Accidental pinching of the patient during the auto release of the
compression paddle is prevented as the face shield moves upwards and away from
the patient.
Figure 3.6 Insertion of the face shield
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Pull the face shield out diagonally until the lock is released. Store the shield safely
in order to avoid scratches and other physical damage.
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Diamond comes with built-in motorized diaphragms that are automatically
adjusted to the required x-ray field size. A separate semicircular spot diaphragm
is also available that is fitted manually.
November 2000 18 86500

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Diamond can be up-graded with the optional 'HOWD GLUHFWGLJLWDO
FDPHUD that can be used for spot, stereotactic, interventional or 3-dimensional
TACT® imaging.
7KH,',,ILOPLGHQWLILFDWLRQFDPHUD exposes the all necessary patient

and examination information on to the film when DIN standard (daylight)
mammography film cassettes are used.
7KH )LOP PDUNHU NLW FKHFN IRU FRGH YDULRXV ODQJXDJHV stores some
information on the patient examination on to the film when using either darkroom
or DIN standard cassettes.
7KH$OSKD6KLHOG is available for additional protection of the user.
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Diamond has WZR56VHULDOSRUWV that can be used to transfer information
from the mammography unit to external devices.
5HOD\FRQWDFWV are provided to enable the connection of room door entry warning
lights. The system also has SURSULHWDU\ FRQQHFWLRQV e.g. for the Delta 32,
stereotactic reader unit.
86500 19 November 2000

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The Auto Point detector is a highly sophisticated mammography automatic
exposure control (AEC) system. The image receptor base holds the Auto Point
Detector. This comprises 8 separate specially shaped Automatic Exposure Control
(AEC) detectors.
18x24 cm Three D-shaped detectors are positioned at

17 cm
the front edge, three oval detectors towards
the back along centerline and two oval
13 cm
detectors either side of the centerline. The
active area of a D-shaped or an oval
detector is within a rectangular area of
4x1.5cm and the oval detector within
4x3cm.
Figure 4.1 Image receptors
The measurement distance range of the Auto Point detectors from front to back
is 13 cm. The maximum width of the area covered by the detectors in the front is
17cm. The detectors at the front edge are 5mm from edge of the film.
The Auto Point Detector has two modes of operation, automatic and manual. In
the automatic mode, the system selects the most appropriate detector to measure
the radiation coming through the breast. In manual mode the user selects the
detector.
The selection between automatic (Auto Point) and manual selection of the AEC
detectors (49) is made at the Control Center. If Auto Point mode is selected, the
Auto Point LED lights up on the Positioning Control Center (50) and on the
Control Panel (34). When the LEDs (34 and 50) are off, the manual mode is
selected. The user can select the required detector from the selection buttons (49).
An LED turns on to indicate the selected detector.
The system recognizes the collimator size (or diaphragm) and the compression
paddle size in use and disables those detectors that are outside of the radiation
field or not under the compressed part of the breast.
Detectors are not moved mechanically, but selected by software.
November 2000 20 86500

Figure 4.2 Positioning Control Center membrane panel
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The selected force is shown on an LED display. The force values are programmed
by your service technician and the maximum value can be from 78N (8kg / 18lbs)
to 245N (25kg / 55lbs). User selection of the compression force limit is made
using the compression force control buttons (45).
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The tube can be motor-driven backwards 19cm (7½") for totally free access to the
breast from above. This is particularly useful in oblique and lateral positioning or
for biopsy procedures. The motorized movement is controlled by buttons (13)
located on both sides of the tube head and also from buttons on top of the tube
head.
Pressing the button drives the tube head until it comes to its end position. If it
meets an object, it will stop. The Park Back button (13) button may be pressed
once or continuously, depending on the country specific regulations for motorized
movements. Pressing any button will stop all movements.
Figure 4.3 X-raytube movement control buttons
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The tube head can be programmed to move back automatically (if country specific
regulations allow this) back in lateral projections after an exposure and/or when
rotating the tube head. Your service technician can also adjust the speed of the
tube head movement.
86500 21 November 2000

If the patient’s head is in the way of the movement, the tube head either stops or
drives back again. If the tube head is in the park position when the exposure
button is pressed, it will automatically drive forwards into its exposure position
first. This happens before X-ray tube ‘Preparation’ (preheat) phase takes place.
The face shield can be in place during movement of the tube head.
Figure 4.4 Control buttons at the top of Diamond
November 2000 22 86500

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All surfaces of Diamond that come into contact with the patient are smooth and
rounded, with no seams or screws. The result is an increase in patient safety and
comfort.
In order to achieve round corners and smooth surfaces in parts of the cassette
holder that come into contact with the patient, the cassette is loaded from either
side from the rear end of the bucky. This means that the front side of the holder
has no openings until about 7cm (with 18x24cm film) back from the front edge
on either side. When the cassette is inserted into either opening, it is automatically
moved forward to the correct position at the front edge of the cassette holder,
ready for exposure.
After an exposure the cassette is automatically moved back again to the opening
ready for removal from either side. The cassette is also moved back automatically
in some error conditions. The motorized cassette movement system allows manual
cassette removal in the event of power failure or system malfunction.
All cassette holders/buckies are adaptable for darkroom and DIN-cassettes

(daylight) use. Daylight cassettes use is standard unless otherwise requested at the
time of order. The ‘Synchro’ Bucky consists of a one-part carbon fiber cover with
rounded corners. Buckies utilise a common motor integrated into the Diamond's
C-arm for both bucky sizes.
For cassette holder insertion and removal instructions, refer to Chapter 3.4.4,
Insertion and replacement of cassette holders. For cassette insertion and removal
instructions, refer to Chapter 5.8, Exposure Procedure.
Figure 4.5 18x24cm Bucky
86500 23 November 2000

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Diamond has a motorized C-arm that has a rotation range of ±185°. The axis of
rotation is close to the film plane so that the image receptor is able to follow the
contour of the breast. This movement, Anatomic C-arm Rotation (ACR)
minimizes the need to adjust the height of the C-arm when rotating between CC
and OBL projections.
Figure 5.1 Anatomic C-arm rotation (ACR)
The C-arm rotation angle is digitally displayed. C-arm movements are inhibited
under compression. The separate patient handles are located on the C-arm.
Figure 5.2 C-arm rotation display
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All motorized movements should stop. Release the emergency stop button, then
repeat the test using the emergency button on the opposite side of the unit.
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Diamond’s Source to Image Distance (SID) is 66 cm (25.98"). Diamond’s
motorized carriage has dual-speed vertical movements that range from 68 cm
(27") to 144 cm (57") above finished floor level in all projections within ±90°
degrees.
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Control buttons for the vertical movement of Diamond's motorized C-arm are
located near the C-arm rotation controls (12), at the Position Control Center and
on top of the tube head.
The cassette holder vertical movement range is 68 cm - 144 cm ( 27" - 57") with
the C-arm in the upright position and 79 cm - 156 cm ( 31" - 61") with C-arm
rotated in to the lateral (90°) position.
86500 25 November 2000

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The C-arm rotates ±185° from the vertical position (0°). Two groups of control
buttons (14) are provided for convenience to drive the rotation movement. These
are located together with vertical movement control buttons in a central membrane
switch panel and on both sides of the C-arm.
Motorized rotation is possible even with maximum ECS (Easy Compression

System) elevation, but during compression, rotational movements are inhibited.
The rotation speed may be adjusted by the service technician. The rotation angle
can be seen on the digital display (54) located on the C-arm. The C-arm rotation
buttons (11) drive the C-arm to any angle within the usable range.
The OBL-buttons (14) drive the C-arm to a predefined default angle that may
afterwards be fine-tuned to the required angle. Pressing the OBL-button on the
opposite side of the unit after the exposure, causes the C-arm to drive
automatically to the same but opposite angle. The LAT-buttons drive the C-arm
to the lateral (90°) position. If the C-arm angle has been adjusted with the fine-
adjustment buttons (11), then after exposure, pressing the opposite OBL-button
causes the C-arm to rotate to the same but opposite angle.
Figure 5.3 Pre-programmable C-arm angle buttons (14)
([DPSOHRIWKHDQJOHVHOHFWLRQ
Without fine-tuning:
1) rotate the C-arm to the required projection angle using the C-arm rotation
buttons (14)
2) compress the breast
3) make an exposure
4) press the opposite OBL-button
5) the C-arm drives to the equivalent angle on the opposite side of the unit
November 2000 26 86500

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With fine-tuning:
1) rotate the C-arm to the required projection angle using the C-arm rotation
button (14)
2) make further adjustments to the projection angle using the C-arm rotation
buttons (11)
3) compress the breast
4) make an exposure
5) press the opposite OBL-button
6) make further adjustments to the projection angle using the C-arm rotation
buttons (11)
7) pressing the CC-button will return the C-arm to the CC-position (0°). In
this case, C-arm movement is allowed without continuously pressing the
button.
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Diamond has three X-ray beam filters: Molybdenum Mo, 0.025mm), Rhodium
(0.025mm) and Aluminum (0.30mm). If required, Diamond can be set to
automatically select the most appropriate X-ray beam filter. All filters are
motorized and the beam filters can be used automatically, if $XWR )LOWHU is
switched on. Molybdenum and Rhodium are used in the kV range of 20 to 35 kV,
whilst the Al-filter is used in the kV range of 36 to 39 kV.
Manual selection of the beam filter is the default setting, but the filter can also be
selected automatically using the filter selection button (47) in Auto-kV and
Auto-Time modes. The selected filter is indicated with a light (48) below
the appropriate filter selection button.For large and dense breasts, the 5KRGLXP
ILOWHU should be used to reduce the exposure time and the patient dose. For kV’s
over 35 kV, $OXPLQXPILOWHU 0867 be used.
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November 2000 28 86500

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Diamond has an automatic motorized collimator that allows any rectangular
collimation. For other collimated shapes, corresponding special diaphragms must
be inserted manually.
When you fit a cassette holder on to the unit, Diamond recognizes the cassette size
and selects the correct collimator aperture. The x-ray field size is displayed in
LCD display (37). If special diaphragms are necessary, these are inserted
manually. Diamond’s collimator interlock feature prevents exposures when using
the wrong cassette size. The system can recognize 8 different manually installed
diaphragms and these are displayed in the control panel screen.
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The X-ray field illumination light is switched on automatically when pressing the
GRZQZDUG FRPSUHVVLRQSHGDO or pressing the FROOLPDWRUOLJKWVZLWFK (46).
The light is switched off automatically after about 40 seconds. The light will
switch on again if the collimator light switch is pressed or if an exposure is
initiated.
During normal procedures, the collimator light stays on for 40 seconds. The light
turns off when the exposure button (41) is pressed to start an exposure or
when the collimator light switch is pressed. The light is switched on by pressing
the collimator light switch (46) or compression footswitches.
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86500 29 November 2000

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Good mammographic image quality requires sufficient compression of the breast.
The breast is compressed against the cassette holder with the compression paddle,
which is either manually moved using the PDQXDOFRPSUHVVLRQZKHHO (8) or
motor-driven using the IRRWSHGDOV.
3DGGOHV
A compression paddle consists of an acrylic compression plate and a metal
supporting frame with fixings used to attach the paddle to Diamond’s compression
paddle arm. Graphics indicating the Auto Point AEC detector locations are silk
screen printed onto the acrylic part of each paddle to the extent the size of the
paddle acrylic allows. Paddles are attached with a straight horizontal movement
and removed by first pressing the compression paddle release key (7) and then
pulling the paddle out with a horizontal movement.
Fig. 5.4 Compression paddle release key
The surfaces between the compression paddle/arm and the cassette holder are
smooth to enable safe, comfortable positioning by the radiographer/technologist.
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November 2000 30 86500

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With the Diamond, a manual or motorized compression can be used. Majority of
compressions/positionings are performed motorized. The manual compression
system is then used for fine tuning of the compression, if necessary.
The 3$''/( pedal drives the compression downwards, the &$50 pedal
drives the c-arm (note: not the carriage) in the direction from the image receptor
to the tube head. The (&6 pedal starts the (&6-compression where the image
receptor compresses the breast against the fixed compression paddle. The 5(/
pedal releases the compression.
7KHFRPSUHVVLRQIRUFHSUHVHOHFWLRQNH\V determine the maximum force

that can be applied to the breast. The left key decreases and the right key increases
maximum compression force limit.
Figure 5.4 Compression force pre-selection
The compression force limit is programmable by the service technician from 80N
(18lbs) to a maximum of 200N (45lbs). For safety reasons, motorized
compression may be limited in position 6, for example, to 200N (45lbs),
dependent upon local regulations. As the manual compression wheel allows
considerable compression force to be applied - XSWR1 OEV , care must
be taken QRWWRLQMXUHWKHEUHDVW
Remember, care must be taken in order not to injure the breast. The compressed
breast thickness and the compression force are displayed in the C-arm display
, see Figure 5.7. The compression system also incorporates a
mechanical force limit, which is adjusted to 300 N (67 lbs.) at the factory. The
service technician may readjust this limit.
Manual compression release is also possible without power to the unit using the
manual compression wheels (8).
86500 31 November 2000

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Compression is controlled in two ways: either using foot pedals or manual
compression wheels. In the event of power failure, the compression releases
automatically.
5.6.3.1 Compression Foot Pedals

A compression foot pedal has the following footswitches:
Figure 5.5 Compression foot pedal
3$''/(
When the Paddle foot switch is pressed, only the compression paddle is
driven down. The collimator light is turned on automatically at the same
time. Before the paddle touches the breast the speed of the paddle is high.
Once the breast is reached the speed slows down. Both drive speed and the
threshold where the speed change occurs on contact with the breast are
adjustable by your service technician.
&$50
When the C-arm foot switch is pressed, only the C-arm is driven upwards
at slow speed. The compression paddle does not move.
(&6
When the ECS foot switch is pressed, the C-arm is driven upwards and the
compression paddle is driven downwards, so that the paddle appears to be
stationary in relation to the patient. This means that the cassette holder
(bucky or cassette tunnel) is used to apply the compression to the breast
against the ‘stationary’ paddle.
5(/
When the REL foot switch is pressed, the C-arm is driven downwards to
its rest position and the compression paddle is driven upwards, removing
compression to the breast. As long as the C-arm is not yet in its rest
position, the paddle is driven at the same speed as the C-arm, thus the
paddle appears to be stationary. Once the C-arm movement stops, the
compression paddle is driven upwards at a higher speed.
November 2000 32 86500

There are two compression foot pedals supplied with the Diamond. These are
connected with cables to the back of the column.
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5.6.3.2 Manual compression wheels

The manual compression wheels (8) allow manual decrease or increase of
compression force. The wheels are located on both sides of the compression arm
Position Control Center.
Fig 5.6 Manual compression wheels
86500 33 November 2000

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(&6 (DV\ &RPSUHVVLRQ 6\VWHP adds one more unique movement to
Instrumentarium mammography systems: the independent movement of the C-arm
in relation to the compression paddle. This movement is also independent of the
angle of the C-arm and it is different from the normal up and down movement of
the C-arm carriage. With the ECS movement, the breast is compressed from the
mobile margin (i.e. from below). The movements are controlled using the (&6
foot pedal. After an exposure the auto-release will release the compression.
Diamond may be programmed by your service technician to return the tube
backwards to its ‘park’ position after an exposure.
The (&6 system uses the natural mobility of the breast to increase the clinical
image quality and patient comfort. (&6 makes it easier to elevate the breast and
open the infra-mammary fold, thereby maximizing the amount of breast tissue
visible in the image. In positioning, (&6 does not replace the skill of an
experienced radiographer/technologist but helps her to carry out positioning more
easily.
In clinical use the amount of images that have pectoral muscle visible in CC-
projections has increased from 20% (the amount prior to the use of the (&6
system) to 50%. The ECS compression system can also be used to perform
conventional compression techniques.
(&6 is also excellent in biopsy procedures. If the lesion is close to the chest wall,
applying compression from below ensures that the lesion stays under the
compression paddle. With standard compression the lesion may move away from
the paddle.
3RVLWLRQLQJGDWDGLVSOD\
The positioning data display shows those parameters that the system is able to
measure during patient positioning (the ± symbols are not displayed):
- %UHDVWWKLFNQHVV, range 0 - 20cm, accuracy ±1cm

- &RPSUHVVLRQIRUFH range 0 - 350 Newtons, accuracy ± 20N
- &DUPDQJOH ±185E degrees, accuracy ±2E
These measured items are shown in a display on the compression arm:
Figure 5.7 Positioning data display
November 2000 34 86500

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The C-arm is driven upwards without applying compression, to open the

infra-mammary fold
The breast is compressed VOLJKWO\ with the paddle to hold it in place
Final compression is applied by the bucky or cassette tunnel from below

using the ECS compresion movement
86500 35 November 2000

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1) Select the required film size, load the film into the cassette, and place the
cassette into the cassette holder.
2) Make sure that the C-arm is in the upright position (0º) by pressing the
CC-key as as described in Chapter 5.3. Adjust the image receptor height
the vertical height control so that patient's nipple is in profile, no skin
folds are present under the breast and that the inframammary fold is open.
Refer to Fig. 5.8 and Fig. 5.9.
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Figure 5.8 Correct vertical position
Figure 5.9 Incorrect vertical position
November 2000 36 86500

3) Slightly rotate the patient medially and lean her towards the unit. Refer to
Fig. 5.10. Allow the patient to grip the hand grips, and lean towards the
unit so that the cassette holder under the breast is in contact against the
ribs.
Figure 5.10 Patient positioning at cranio-caudal projection
4) Place the breast on the cassette holder so that it is symmetrical and totally
covers at least one of the automatic exposure control detectors, as
demonstrated by the graphics printed on the clear acrylic of the
compression paddle. Manually select the most appropriate detector or use
the Auto Point feature automatic detector selection feature.
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5) Apply the compression to the breast using the compression foot pedal or
the manual compression controls. Make sure that the nipple is not
inverted. Smooth out any skin wrinkles that may have been caused during
compression.
6) Position a film marker on the image receptor to the side of the lateral
aspect of the breast. Turn the patient’s head away from the X-ray beam.
7) Take note of the compression thickness display to achieve the correct

compression for both breasts. When compressed correctly, the breast
should be firm when palpated. The skin may become blushed, red or pink.
Make sure that the UHDG\ light (20) is on. Select or de-select the
$XWR5HO(automatic compression release) function.
86500 37 November 2000

Figure 5.11 Cranio-caudal projection
8) Make the exposure by pressing the exposure button (41), and keep it
pressed until the radiation indicator light (22) goes out and the
audible exposure indicator stops. Release breast compression (if not
automatic).
9) Change the cassette and make an exposure of the other breast or move on
to another projection.
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,IWKH\DUHVKRUWHUWKDQVHFUHGXFHWKHN9YDOXH
November 2000 38 86500

2EOLTXHSURMHFWLRQ
1) Select the required film size. Load the film into the cassette. Place the
cassette in the cassette holder
2) Rotate the C-arm to the required oblique projection angle (35-60°) using
the OBL-key of the as described in Chapter 5.3. Adjust the image receptor
height using the vertical drive controls. Place the upper edge of the image
receptor so that the axillary tail of the breast will be visualized
3) Ask the patient to hold the arm on the side to be imaged, at a 90° angle and
turn the patient slightly inwards to an oblique position. Rotate the patient
towards the image receptor and place their breast on to the cassette holder
so that it totally covers at least one of the Auto Point AEC detectors
4) Select the most appropriate detector or use the Auto Point automatic AEC
selection function. Make sure that the lateral breast tissue is pulled
forward.
Figure 5.12 Oblique projection
5) Apply compression with the foot pedal or by using the manual controls (8,
12). Make sure that the patient's nipple is in profile and that no skin folds
are present. Check that the 5HDG\ light (20) is on
86500 39 November 2000

6) Make the exposure by pressing the exposure button (41) and keep it
pressed until the radiation indicator light turns off and the audible
exposure indicator stops
0HGLR/DWHUDO3URMHFWLRQ
1) Select the required film size, load the film into the cassette and place the
cassette in to the cassette holder. Rotate the C-arm to the lateral position
(90º) by pressing pre-programmed angle keys as described in Chapter 5.3.
2) Adjust the cassette holder to a suitable height with the vertical drive
controls. The cassette holder should reach the height of the patient's axilla.
The medial portion of the breast needs to be in contact with the image
receptor. Ask the patient to hold the hand grip and to lean towards the
unit.
3) Place the breast on the cassette holder so that the breast totally covers at
least one of the Auto Point AEC detectors. This can be achieved by gently
pulling the breast away from the chest wall.
4) Check that the breast covers the detector. Manually select the most
appropriate AEC detector or use the Auto Point feature. Apply
compression using the foot pedal or the manual controls. Make sure that
the patient's nipple is in profile and no skin folds are present.
Figure 5.13 Medio-lateral projection
November 2000 40 86500

5) Check that the 5HDG\ light (20) is on. Make the exposure by
pressing the exposure button (41) and keep it pressed until the radiation
indicator light turns off and the audible exposure indicator stops.
(;32685(352&('85(
,QVWDOOLQJDFDVVHWWH
1) Load the film into the cassette.
2) Open the lock to insert the cassette into the cassette holder by inserting the
lower left corner of the cassette to the bucky. Push then the cassette
towards the front of the bucky so that the upper left corner slides in.
3) Slide in (do not throw) the cassette until the lock key returns to its normal
position. Take care not to trap your fingers in between the cassette holder
and the cassette.
86500 41 November 2000

Diamond has an automatic cassette loading mechanism that moves the cassette to
correct position at the front edge of the cassette holder, ready for exposure. In case
the cassette is inside, but in the back of the bucky, pulling the cassette latch
towards the front of the bucky takes the cassette into the front for an exposure.
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The 5HDG\Light (20) indicates that the unit is ready for exposure. The
diaphragm, cassette holder and cassette must be in place. If a manual diaphragm
is being used, this must also be in position.
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Make the exposure by pressing the exposure button (41), and keep it pressed
until the X-ray exposure terminates. The X-ray exposure is indicated by the
radiation light (22), the audible exposure indicator, and the accumulating
exposure time (21) on the control panel exposure time display. If the
exposure button is released during the exposure, the exposure is terminated
immediately and an HUURUPHVVDJH is displayed on the LCD screen of the control
panel.
$XWRPDWLFFRPSUHVVLRQUHOHDVH
By default, Diamond releases compression automatically after exposure. The
automatic release can be disabled from the control panel (see Chapter 7,
Automatic Exposure Control). When performing a manual biopsy procedure,
compression may be released with the foot pedals or manual compression wheels
(8) or with vertical movement keys (12). Automatic compression release (Auto
Rel) will automatically switch off when a biopsy paddle is fitted.
November 2000 42 86500

5HPRYLQJWKHFDVVHWWH
Diamond’s automatic cassette loading mechanism returns the cassette immediately
after exposure, ready for removal.
1) If the cassette has not been exposed yet, it is still in the front end of the
bucky. In order to remove it, slide the cassette latch towards the back of
the bucky. This procedure returns the cassette to the rear end of the bucky.
In the event of a power failure or system malfunction, pull the cassette to
the rear end with fingers.
2) Remove the cassette by pushing the cassette lock release key (9) towards
the front end of the bucky. Hold the key in the forward position with your
middle finger and pull the cassette out with your thumb and index finger.
86500 43 November 2000

3) Pull the cassette out of the cassette holder.
&RROLQJSHULRG
After each exposure, there is a W\SLFDOFRROLQJSHULRG of 10 to 50s depending on
tube loading, but it can also be a longer period. During this time an exposure
cannot be made. If the exposure button is pressed before the cooling time has
elapsed, the timer display will indicate the remaining cooling time.
If the 5HDG\Light (20) does not turn on 50 seconds after an exposure,

refer to Ready light not lit, Chapter 8.2
),/0/$%(/,1*
There are three ways to identify films. 1) using film markers that show the
projection and year on the film. 2) using a film identification camera (Alpha ID
II) that exposes all relevant information directly onto the film. 3) using printed
adhesive paper labels that are attached to the film.
)LOPPDUNHUV
The film markers provided for use with Diamond are positioned close to the film
to prevent scatter. Markers can be moved sufficiently far to extend past the
cassette’s daylight ID marking window and into imaging area of the film.
Each cassette holder has a plate onto which the film marker set is fitted. In this
way, only one marker set is needed. The corners of the marker set have no sharp
edges to ensure patient comfort.
$OSKD,',,)LOP,GHQWLILFDWLRQ&DPHUD
The Alpha ID II digital ID camera exposes information directly onto the
undeveloped film. The Alpha ID II is connected to Diamond’s serial port using a
serial communications cable. Diamond’s serial port is located at the lower rear
cover of the unit. The Alpha ID II camera can only be used with daylight cassettes.
November 2000 44 86500

3ULQWHGODEHOV
The Diamond can output information to a printer. In this way, printed film
identification labels can be produced. One of two printer label sizes can be
selected by your service technician:
36.7 x 101 mm
26.0 x 101 mm
For each of the four rows printed, the last 15 characters of the 40 on each row are
freely programmable. The following is an example of the text produced by
Diamond and printed on to a label:
1234567890123456789012345678901234567890
B Rh 0.02s 28kV 002mAs +0 HOSPITALxNAMEx

6.5cm 200N 180^/R 0.06mGy CODExxxxxxxxxx
15 / 08 / 00 R1 12345 RADIOLOGISTxxx
_________________________ DEPARTMENTxxxx
Explanations:
% %ucky / &assette tunnel / 0agnification

5K 5Kodium / 0Rlybdenum / $Ouminum filter
Density correction
N9 kV
P$V mAs
V Exposure time
FP Breast thickness
1 Compression force
A5 C-arm tilt angle, A= degrees (°), to the 5ight or /eft
P*\ Average patient dose
Date of examination (day/month/year)
5 Site of the detector (L1, L2, C1, C2, C3, C4, R1, R2)
Exposure counter, up till 99999
BBBBBBBBBBBBBBBBBBBB The patient’s name must be handwritten after
printing the label
86500 45 November 2000

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A label printer may be connected to Diamond’s serial port using a serial
communication cable. Diamond’s serial port is located at the lower left of the
unit’s rear cover. To print the information permanently onto film, use of the Alpha
ID II digital ID Camera is necessary.
Diamond ports:
1. COM1
2. ID II film marking or label

printing
3. Paddles
4. Diamond Control Panel
The Film ID Camera and a label printer use the same serial port i.e. only either
one of the devices may be connected at one time.
&$87,21 :KHQFRQQHFWLQJ'LDPRQGWRDSULQWHURUDVLPLODUFRPELQDWLRQPDNHVXUH
WKDWFRQQHFWLRQFRQIRUPVWR,(&7KHOHDNDJHFXUUHQWYDOXHVPXVW
QRWH[FHHGWKHOLPLWV8VHLVRODWLRQWUDQVIRUPHU
November 2000 46 86500

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0DJQLILFDWLRQVWXGLHV
By placing the breast at a distance from the film causes the image to be magnified.
This increases the size of the smallest objects (micro-calcifications) above the
grain size of the film-screen combination thus improving the image quality.
:$51,1* $VVRXUFHWRVNLQGLVWDQFHLVGHFUHDVHGZKHQXVLQJDPDJQLILFDWLRQWXQQHO
DYRLGXQQHFHVVDU\PDJQLILFDWLRQH[DPLQDWLRQVWRNHHSWKHVNLQGRVHDVORZ
DVSRVVLEOH'RQRWSHUIRUPVFUHHQLQJZLWKDPDJQLILFDWLRQWXQQHO
The air gap between the breast table and the cassette reduces scattered radiation
and further improves image contrast. A small focal spot is essential for good
magnification image quality and therefore a true 0.1mm focus is needed. The
Diamond X-ray tube features a 0.1mm focal spot and during magnification studies
this is automatically selected.
Although the object may be visualized well, this is offset by the fact that only a
small area of the breast can be imaged at a time.
For magnification studies the Diamond uses the MultiChoice magnification

tunnel. One tunnel is used for all magnification factors 1.6x, 1.8x and 2.0x. The
factor is a user preference and can be changed by the user. The film format in
magnification studies is always 18x24cm.
Magnification studies can be performed by applying compression to the whole

area of the breast which is all imaged or by applying compression only to a
specific area, called spot compression. In whole field imaging, a larger area can
be studied on one image, for example when it is not known where the area of
interest lies in the breast.
0DJQLILFDWLRQSURFHGXUH
Remove the face shield and install the magnification tunnel. Magnification tunnel
is inserted and removed the same way as the cassette holders in chapter 3.4.4.
Follow the general patient

positioning procedure. The
size of the top of the
magnification tunnel
corresponds to the area which
can be magnified onto the 18
x 24cm film size.
86500 47 November 2000

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The window in the magnification tunnel design displays the current magnification
factor. It can be changed by pushing in the small lever in the back of the tunnel
frame and then lifting up or lowering down the tunnel.
If you are using the spot magnification compression technique, ensure that the
area of interest is in the light field.
The small focus (0.1mm) microfocus is automatically selected for magnification

exposures.
6SRW0DJQLILFDWLRQ
Spot compression also compresses the breast more, thereby allowing the use of
a lower kV-setting, which results in improved image quality. However,
positioning using spot compression is more difficult to achieve.
The spot diaphragm collimates the image area to about 12cm in diameter. This
reduces scattered radiation to the image area, so improving contrast and also
reduces the patient dose. However, the final image may be harder to read on the
viewing box due to the density difference between the exposed area of the film
(the image) and the unexposed areas of the film.
6SRW FRPSUHVVLRQ applies

local compression to a
particular area. There is less
overlapping of tissue
structures, which improves
visualization.
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RQDVPDOOHUEUHDVWH[DPLQDWLRQDUHD
November 2000 48 86500

6SRWPDJQLILFDWLRQWXQQHO
Spot compression can be further

enhanced by using the spot
magnification tunnel. This allows
the same kind of effect in
compression but with the added
dimension of compression also
being applied from below the
breast, not only from the
compression paddle.
The benefits are increased local

compression, enhanced tissue
visualization and improved
contrast, because a lower kV
setting can be used.
,PSODQWH[SRVXUH
The implant paddle allows very good access to the breast during positioning. The
paddle can be best utilized with small breasts, with breasts that have a silicon
implant or with male breasts. It also provides excellent compression in oblique or
lateral projections because it extends to the whole width of the 18x24cm film
format.
In populations where a greater proportion of women have small breasts, the

implant paddle may be used as the standard paddle, together with the 21x24cm
paddle.
127( ,IWKHEUHDVWGRHVQRWFRYHUDWOHDVWRQH$(&GHWHFWRURUWKHEUHDVWLVNQRZQ
WRKDYHDQLPSODQWDPDQXDOO\VHOHFWHGH[SRVXUHWHFKQLTXHPXVWEHXVHG
86500 49 November 2000

0DQXDOELRSV\
There are three types of biopsy paddle available for use with Diamond, each with
different openings. These openings are available as holes with a diameter of
18mm, holes with a diameter of 9mm and as rectangular opening of 50x90mm.
User preference determines, which type of paddle that is used. Biopsy paddles are
used in manual biopsy procedures for Fine Needle Aspiration (FNA) or lesion
marking.
Attach the biopsy compression paddle in the normal way. Diamond recognizes the
paddle in use and chooses the correct collimator format automatically. Diamond
turns the auto compression release off whilst the biopsy paddle is attached. Clean
the biopsy compression paddle and breast area carefully.
The biopsy procedure can be performed at all projection angles, but an angle
should be used that provides the shortest possible distance for the needle from the
skin to the lesion. Rotate the C-arm to the appropriate angle.
A biopsy chair should be used for the patient that provides good support to the
patient’s back and arms. An optional biopsy chair available from Instrumentarium
Imaging for use with Diamond.
127( 0DNHVXUHWKDW&DUPFDQURWDWHIUHHO\DQGWKDWLWLVQRWREVWUXFWHGLQVXFK
DZD\WKDWLWPD\VWULNHDQREMHFWFDXVLQJWKHV\VWHPWRWLOW$OVRHQVXUHWKDW
WKH XVHU GRHV QRW SRVLWLRQ WKHPVHOYHV EHWZHHQ WKH &DUP DQG DQ\
REVWUXFWLRQDVLQMXU\FRXOGUHVXOW,IQHFHVVDU\XVHHPHUJHQF\VWRSEXWWRQV
RUDQ\EXWWRQRQ'LDPRQGXQLWH[FHSWRQWKH&RQWURO3DQHO
0DQXDOELRSV\SURFHGXUH
1) Make the patient comfortable in the sitting position

2) Adjust the compression paddle to a suitable height using the foot pedal or
manual controls (8) or with the vertical movement keys (12)
3) Place the breast on the cassette holder so that the breast totally covers at
least ofe AEC detector
4) Turn the patient’s head to the side. Apply compression using the foot pedal
or manual controls (8) or with the vertical movement keys (12)
Take care that the patient’s nipple is in profile and no skin folds are present. Do
not compress the breast quite as much as in a routine examination, since it must
remain compressed for some time until the X-ray film is developed. However, the
compression must be enough to prevent the breast from moving. Too little
compression allows the breast to move and the biopsy will be inaccurate.
127( 0DNHVXUHWKDWWKHSDWLHQW VKHDGLVRXWRIWKHOLJKWILHOG
5) Make the exposure by pressing the exposure button (41) and keep it
pressed until the radiation indicator light turns off and the audible
exposure indicator stops. Do not release the compression.
November 2000 50 86500

Develop the film. The holes in the compression paddle can be seen on the image,
and localization of the biopsy target can be made. Carry out the biopsy procedure
and when completed, release the breast compression.
6WHUHRWDFWLFRSWLRQ
Diamond’s optional stereotactic feature can be used together with the ECS
compression system in order to perform high-quality biopsies. Diamond is also
'HOWDfor 3-dimensional imaging using TACT®. The TACT® option makes use
of the Delta 32 digital camera.
In the FNA procedure, a sample of the breast tissue is taken for cytological
analysis of the lesion. In lesion marking the lesion is marked for surgical biopsy
either with a steel wire or with dye. The surgeon then follows either the wire or
color trail to remove the correct lesion.
In a procedure the breast is imaged

with a biopsy paddle from one
projection.
The openings from the paddle can

be seen in the image and with their
help the location of the lesion in this
plane can be estimated.
Figure 5.15 FNA paddle
How deep in the breast the lesion is can be estimated from images that have been
taken using a second projection. These can be taken earlier or during the same
procedure.
127( 7KHFROOLPDWRUOLJKWWXUQVRQZKHQWDSSLQJWKHIRRWVZLWFKDQGWXUQVRIIDIWHU
VHFRQGV'RQRWWDSWKHIRRWSHGDOUHSHDWHGO\DVWKLVFDQDOWHUWKHDPRXQW
RI EUHDVW FRPSUHVVLRQ UHVXOWLQJ LQ LPSDLUPHQW RI ELRSV\ DFFXUDF\ )RU
SRVLWLRQLQJVZLWFKWKHFROOLPDWRUOLJKWRQZLWKWKHFROOLPDWRUOLJKWVZLWFK

The biopsy needle is inserted into the breast after careful estimation and another
image is taken to ensure that the correct localization has been achieved.
127( &KHFNWKH&DUPURWDWLRQDQJOH EHIRUHSHUIRUPLQJDELRSV\SURFHGXUH
When localizing using a steel wire, correct localization can be determined after
insertion by producing another image at a second projection angle. If this is done,
the amount of compression applied has to be quite small to ensure that the
localization wire does not move.
86500 51 November 2000

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RQWKHORFDOL]DWLRQSDGGOH
The lesion is marked with a steel wire or with dye for surgical biopsy. If using a
control wire, fix it to the breast with tape. The location of the wire end is checked
with an exposure. If required, the location of the wire is altered and checked with
another exposure.
In a marking procedure, the breast is imaged with a biopsy paddle from on

eprojection. The openings from the paddle can be seen on the image and with their
help, the location of the lesion in this plane can be estimated.
6SRWH[SRVXUH
The spot compression paddle is used in clinical studies with the 18x24cm bucky
or cassette tunnel. It applies local compression to a specific area of the breast. This
moves the different tissue structures from overlying each other giving improved
visualization of those structures. The breast tissue at the compressed area is also
thinner allowing the use of a lower kV setting, which improves image contrast.
Normally the whole film is exposed to make it

easier to read on the light box, but on desire, the
X-ray field can be collimated to a smaller area.
This reduces the patient dose because only a part
of the breast gets radiation.
Image contrast is also improved because the amount of scattered radiation is
reduced. However, films exposed in this way are more difficult to read because
of the large unexposed area on the resulting film.
Insert the cassette, the separate spot diaphragm and compression paddle. Diamond
will recognize the cassette and use the correct collimation. Rotate the C-arm to the
required angle for the projection to be performed. Adjust the cassette holder to a
suitable height with the vertical adjustment button.
Select the most appropriate AEC detector for the examination ensuring that it is
totally covered by the breast when under the compression paddle. After selecting
the detector, the AEC system operates only within the defined area. Diamond
prevents the selection of an AEC detector that is not within the area of (not under)
the compression paddle in use.
Apply compression using the foot pedal or manual controls. Smooth out any skin
wrinkles that may have occurred during compression. Ensure the patient’s head is
out of the collimator light field.
November 2000 52 86500

Make the exposure by pressing the exposure button (41), and keep it pressed
until the radiation display indicator light turns off and the audible exposure
indicator stops.
:$51,1* &DUHPXVWEHWDNHQQRWWRRYHUFRPSUHVVWKHEUHDVWDQGULVNLQMXU\WRWKH
SDWLHQW
Normally the whole film is exposed to make it easier to read on the light box, but
if required, the X-ray field can be collimated to a smaller area using a manually
inserted diaphragm. This reduces the patient dose because only a part of the breast
is exposed to radiation.
86500 53 November 2000

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Diamond’s Automatic Exposure Control (AEC) system has three modes of
operation:
Auto kV exposure mode
Auto Time exposure mode
Manual exposure mode
Select the mode with the MODE select button (32). The light at left of the
burtfrom the button indicates the mode mode that is currently selected. An
automatic exposure monitor will terminate the exposure in just 50ms if it
calculates that a suitably exposed image cannot be achieved within the back-up
time. Each AEC mode has 15 steps for density adjustment, where one step
corresponds to a 10% decrease or increase.
:$51,1* 2QO\DXWKRUL]HGSHUVRQQHOPD\SHUIRUP$(&SURJUDPPLQJ
23(5$7,21,1$872.9(;32685(02'(
In the $XWRN9mode there are two sub-modes: Auto Filter and Auto-kV. The
required mode is chosen in the menu selection. A LED light indicates the selected
option.
Figure 6.1 The mode display in Auto-kV Exposure mode
Figure 6.2 The control panel in the Auto-kV Exposure mode
$XWRPDWLFFRPSUHVVLRQUHOHDVH $XWR5HO PRGH

Automatic Compression Release is the default setting on Diamond and will
release the compression paddle after each exposure or in the event of a power
failure. Decide whether you wish your Diamond to release compression
automatically after compression or not. Switch the ‘Auto Rel’ mode off prior to
a biopsy procedure. If a power failure occurs while ‘Auto Rel’ is switched off, the
C-arm remains compressed. compression paddle will not auto-release.
November 2000 54 86500

23(5$7,21,1$8727,0((;32685(02'(
Select the required kV with the kV selection buttons (24). The

exposure control system will select the correct exposure time when you make the
exposure. A LED light indicates that the Auto Time mode has been selected.
Change the selected filter if required with the filter selection button (47).
Figure 6.3 The mode display in Auto Time Exposure mode
Figure 6.4 The control panel screen in the Auto Time Exposure mode
$XWRPDWLFUHOHDVH $XWR5HO PRGH

Automatic Release is the default setting and will release the compression paddle
after exposure or in the event of a power failure. Decide whether you wish your
Diamond to release compression automatically after each exposure or not. Switch
‘Auto Rel’ mode off prior to a biopsy procedure. If a power failure occurs while
‘Auto Rel’ is switched off, the compression paddle will not auto-release.
86500 55 November 2000

23(5$7,21,10$18$/02'(
Select the required kV with the kV selection buttons (24) and
the mAs with selection buttons (26). The system will select the
correct exposure time (which dependent on the selected mAs value). Change the
filter selection if required with the filter selection button (47).
Figure 6.5 The mode display in Manual Exposure mode
Figure 6.6. The control panel screen in Manual Exposure mode
$GMXVWPHQWRIWKHP$VYDOXHVLQPDQXDOPRGH
Select the P$V setting with mAs (26). Pressing the P$V+
button increases the mAs value and pressing P$V- button decreases the mAs
value. The following mAs values may be selected.
4 6 12 16 20
25 32 40 50 63
80 100 125 150 175
200 250 300 350* 400*
450* 500* 550** 600**
Table 6.1 Selection of P$V values

*, ** not allowed in N.Y., ** only allowed in G.B
127( ,IDFRUUHFWRSWLFDOGHQVLW\FRXOGQRWEHUHDFKHGHYHQLIPD[LPXPH[SRVXUH
WLPHZDVXVHGWKH([SRVXUHPRQLWRUZLOOWHUPLQDWHWKHH[SRVXUHLQPV
,IWKLVRFFXUVFKDQJHWKHILOPFDVVHWWHDQGUHSHDWWKHSURFHGXUHVHOHFWLQJD
KLJKHUN9
November 2000 56 86500

$XWRPDWLFFRPSUHVVLRQUHOHDVH $XWR5HO PRGH

Automatic Release is the default setting on your Diamond and will release the
compression after each exposure or in the event of a power failure. Decide
whether you wish your Diamond to release compression after each exposure or
not. Switch ‘Auto Rel’ mode off prior to a biopsy procedure. If a power failure
occurs while ‘Auto Rel’ is switched off, compression will not auto-release.
$(&'(7(&7256
Diamond incorporates software or manually selectable detectors. Diamond's
software control system can automatically select the most appropriate AEC
detector location for you at each exposure and depending upon the individual
breast being examined. Each detector can also be selected manually by the user
by simply pressing the relevant membrane button on the 'HWHFWRU /RFDWLRQ
'LVSOD\ that represents each detectors. The semicircle and oval graphics
printed on the Diamond's compression paddle indicate the size and location of
each detector.
7HVWLQJWKH$(&
1) Expose at 28 kV and 40mm acrylic
2) Develop the film
3) Measure the O.D. from the step wedge
6(/(&7,212)0$69$/8(
During the exposure, the highest possible mA is automatically selected (within the
range described in the table 6.1) and this enables the minimum exposure time to
be used. The $(& system terminates the exposure when the correct amount of
radiation has reached the film. The exposure time range is from 0.04 sec. to 5 sec.
when using the large focus (bucky or cassette tunnel exposures), and from 0.04
sec. to 10 sec. when using the small focus (magnification exposures).
In manual exposure mode, the kV range is 20-39kV, with the bucky 23-39kV and
with the magnification tunnel 25-39 kV. With AEC, kVs up until 35 kV can be
used.
86500 57 November 2000

0$;,080P$VP$9$/8(6
The maximum mAs-value is, however, limited by the selected kV and the
maximum permitted time. The PD[LPXPP$VP$ values are shown in the table
6.2. Automatic mAs-selections are curtailed according to this table.
MGX MGX MGX

0.3 focus N.Y. 0.1 focus
0.3 focus
N9 P$VP$ P$VP$ P$VP$

15 250/53 250/53 175/18
16 250/59 250/59 200/20
17 300/64 300/64 200/22
18 300/69 300/69 200/23
19 350/74 300/74 200/24
20 350/75 300/75 250/25
21 400/80 300/80 250/26
22 400/85 300/85 250/28
23 450/90 300/90 300/30
24 450/95 300/95 250/29
25 500/100 300/100 250/28
26 450/95 300/95 250/27
27 450/90 300/90 250/26
28 400/85 300/85 250/25
29 400/85 300/85 200/24
30 400/80 300/80 200/23
31 400/80 300/80 200/22
32 400/80 300/80 200/21
33 350/75 300/75 200/21
34 350/75 300/75 200/20
35 350/70 300/70 200/20
36 250/50 250/50 175/19
37 250/50 250/50 175/19
38 250/50 250/50 175/18
39 250/50 250/50 175/18
Table 6.2. Maximum mAs/mA values depending on kV, focus size and
country code.
November 2000 58 86500

0(18237,216
Enter the control panel MENU screen by pressing the MENU&SET-button

(36). The MENU screen displays SETUP, where system features are set.
Pressing of the right-hand button (40) enters the SETUP mode.
27+(502'(6
3UH3URJUDPPHG0RGHV
Service technician can program up to 4 pre-programmed modes for the user.
These modes user-defined parameters for easy recall.
6HWXSPRGH
This mode enables feature programming.
Choose SETUP from menu screen:
Following screen appears:
Scrolling the list you find options 'DWH7LPHDQG'LVSOD\.
In the 'DWH7LPH screen, the system date and time are set using ‘Down’, ‘Next’
and ‘Up’ keys:
86500 59 November 2000

In the 'LVSOD\ screen, the brightness and contrast of the LCD-display may be
adjusted using ‘Down’, ‘Next’ and ‘Up’ keys:
The control panel display screen brightness and contrast can each be set in the
range from 0 to 5.
After completing the set-up, the system asks you to confirm the changes:
Accept the changes by pressing the SET-key , or cancel the changes using the
CANCEL-key .
November 2000 60 86500

7528%/(6+227,1*
1232:(5,1',&$7,21
a) Check that the power cord and control panel cable are connected.
b) Check that the mains switch is switched on.
c) Check the fuses or the circuit breaker
d) If the problems still persists, call your approved service center.
5($'</,*+7'2(6127,//80,1$7(
Press the exposure button (41), and note the message text shown in the /&'
display and refer to the "Check code guide" on the next page.
*5,'/,1(6
If the grid light on the control panel does not light up, check that the Bucky is
properly attached on the cassette holder base.
The exposure time is too short (shorter than 0.2 sec.). Reduce the kV to increase
the exposure time.
&2035(66,213$''/(678&.,1833(5326,7,21
The compression paddle has driven to its upper position at high speed after power
failure. Release the compression paddle by turning the manual compression
control handwheel counter-clockwise. In some circumstances, this may require
some force to be exerted on the control wheel.
(5525&21',7,216
The 5HDG\ light (20) indicates that every part of the unit is ready for
exposure. If the light is not on within 50 seconds after the previous exposure or
the ready light is blinking, an error condition has been detected.
Error conditions are indicated by a code on the LCD display (37).
(UURUFRGHV are displayed on the LCD screen.

Most error codes require a call to your service technician. If the error code
includes an OK-text, press the function key (39) and then follow procedures
suggested by Diamond.
All possible conditions and the remedial action required are listed in table 8.1.
86500 61 November 2000

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(UURUFRGHLQ
WLPHUGLVSOD\ 5HDVRQIRUHUURU &RUUHFWLYHDFWLRQ
(U RAM failure Call service
(U Program check sum error (flash) Call service
(U Program check sum error Check exp button

(BattRAM)
(U * Code reserved for later use. *
(U Exposure button is pressed at Check exp button

start up
(U Could not find c-arm calibration

data in BattRAM. Predefined
angles inhibited until CC
projection found
(U Fatal calibration error; Call service

Collimator, filter
(U AEC calibration error
(U ’Motor stop’ pressed Release emergency button
(U Tube Park safety clutch acts - Clear and try again
tube obstacled
(U Tube movement back up time

reached
(U Filter movement back up time

reached
(U Collimator plate movement back

up time reached
(U Unidentified collimator plate Insert correct collimation plate

inserted
(U External collimator plate inserted
(U C-home1 or C-home2 Call service

optocoupler not functional
(U Compression paddle missing

when trying to drive compression
arm down (below face shield
limit)
November 2000 62 86500

(U Unidentified compression paddle

attached. Full auto kV not
allowed
(U Incorrect compresion paddle

attached
(U Compression motor back up time

reached
(U Compression thickness

measurement error.
Acknowledgement required when
trying to expose in auto kV mode
(U Compression force measurement Compress manually

failure. Inhibit compression down
(U Face shield limits the movement
(U Compression thickness

calibration error
(U Overflow in Auto Time-mode kV too low
(U Overflow in Auto kV-mode Use higher kVs
(U Underflow in Auto Time-mode kV too high
(U Underflow in Auto kV-mode Check detector
(U AEC detector failure. Inhibit Call service

exposure with that detector. Show
at startup
(U AEC detector failure Debug error.
(U Cassette tray back up time Call service

reached
(U Cassette not changed Change cassette
(U Cassette lock failure
(U Grid cannot find home position Check Bucky
(U Grid error during/prior to Check grid

exposure. Display after exposure
if exposure started
(U Cassette holder not attached when

trying to expose. Inhibit exposure
(U Unidentified cassette holder Check cassette holder

attached. Inhibit exposure
86500 63 November 2000

(U General motor back up time

reached
(U Stereo not in 0 degrees when Drive the stereo arm

exposing
(U Stereo movement not allowed if Stereo requires digital camera

proper cassette holder is not
installed
(U Vertical movement motor back

up time reached
(U Movement inhibited while Release compression

compressing
(U ECS motor back up time reached Call service
(U Some limit reached Change direction
(U C-arm rotation request while

compressing
(U C-arm rotation back up time

reached
(U Rotation stopped by user (from

any button)
(U C-arm rotation stopped because

of a mechanical limit
(U C-arm angle measurement failure.

Drive to predefined angles not
allowed
(U C-arm movement not calibrated Drive to 0 degrees

at start up
(U Communication error with Call service

internal electronics, Supervisor
bus cable broken (Board not
answering)
(U Communication error with Check control panel

control panel
(U Communication error with RS323
(U kV missing Call service
(U mA missing Call service
(U Anode start failure Refer to Operation Instructions.
(U Anode run failure Call service
(U Exposure button released during

exposure
(U Preheat cannot be calibrated Check waveforms
November 2000 64 86500

(U Incorrect reading in generator

monitoring
(U Line voltage low
(U Cassette missing Insert new cassette
(U Exposure time too long
(U Movement button or switch

pressed during movement, the
function not allowed
(U Device not ready for exposure
(U Delta PC refused to receive

exposure.
(U Delta PC connection timeout
(U Error in stereo motor pulse

measuring
(U Heat unit exceeded, wait for

cooling
(U Side collimator failed Call service
(U Internal communication error. Call service

AEC Board not answering. Cable
broken

Compression Board not
answering

Stereo Board not answering

Collimator Board not answering

Control Panel not answering

Power Board parallel line broken
or detached
(U Stereo movement back up time Call service

reached
Table 8.1 Diamond error code guide
86500 65 November 2000

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Mo, Rh, Al
),/0.2'$.0LQ56&5((1.2'$.0LQ5DQG0LQ5
),/0)8-,$'0 6&5((1)8-,$'0DPPR)LQH
),/0$*)$+'5DQG+'5& 6&5((1$*)$+'DQG+'6
&RPSUHVVHGEUHDVW 7HFKQLTXH
WKLFNQHVV N9S )LOWHU 'HQVLW\
< 3 cm 23 Mo 0
4 - 5 cm 24 - 26 Mo 0
6 - 7 cm 27 - 29 Mo or Rh* 0
> 8 cm 30 - 32 Mo or Rh* 0
0DQXDO7HFKQLTXHV P$V N9S

Small breasts 16 - 40 23 - 25
Implants 80 - 175 26 - 29
Specimens (non-mag and mag) 4 - 16 20 - 23
Note: Implant displaced views and specimens may be phototimed if sufficient breast
tissue covers the photocell closest to the chest wall.
Table 9.1 Diamond technique guide
&200(176
1. Maintain exposure times between 0.5 and 2.5 seconds. Decrease kVp if
times are less than 0.5 seconds and increase if they are more than 2.5
seconds.
2. If exposure times are within indicated times, use + or - density settings to
achieve optimal film density.
3. Your technique may vary from those indicated above depending on film
density preferences, processor or film irregularity, or different film/screen
combinations.
4. 5KRGLXP - use for very dense breasts, 6 cm or greater. No need to
increase kV.
5. 0DJQLILFDWLRQYLHZV - increase technique by 2 - 3 kVp, if exposure time
exceeds 5 seconds.
November 2000 66 86500

63(&,),&$7,216
6<67(063(&,),&$7,21602'(/0*;
0$18)$&785(5 Instrumentarium Corporation

Imaging Division
P.O. Box 20
04301 TUUSULA
FINLAND
Manufacturer’s
quality system ISO9001
General Medical electrical equipment
Model MGX 2000
Power supply Mains plug connection, 1-phase
Apparent resistance of
supply mains
Rated voltage 230Vac ±10%, single phase, 50/60 Hz

16 A slow blow fuse in power outlet
Rated current 20 A Momentary (during exposure)

300mA long term (otherwise)
Rated input power 4.6 kVA
IEC safety class I
IEC applied part type B
Enclosure IP 20
Weight 350 kg (771 lbs.)
Height 1.9 m (6.23 ft)
Operation mode Continuous operation with intermittent loading
Radiation intensity typical range 1000-1200mR/100mA at 28kV
(19,5210(17$/63(&,),&$7,216
Operating conditions +10°C...+40°C

Non condensing (maximum humidity 90%)
Storage and transportation in dry cool place
86500 67 November 2000

*(1(5$725
Manufacturer Instrumentarium Imaging
Type B
Frequency 40 - 100 kHz
Power Max. 2.6 kW
kV range 15 - 39 kV, in 1 kV increments, in testing 49 kV
accuracy ± 1.5 kV (internal acceptance limit ±1 kV)
kV ripple < 5%
mA range focus 0.3mm 70 - 100 mA

focus 0.1mm 20 - 30 mA
maximum mA output focus 0.3mm 45mA

focus 0.1mm 150mA
mAs range focus 0.3mm 4 - 500 mAs

(600 max in U.K.)
tolerance: mAs # 40: ± 4 mAs
mAs > 40: ±10%
focus 0.1mm 4 - 300 mAs

tolerance mAs # 40: ± 4 mAs
mAs > 40: ±10%
time range focus 0.3mm 0.05 - 6 s

focus 0.1mm 0.05 - 10 s tolerance ± 0.10 +
instrument inaccuracy - tube
current reduced with small breast
thickness
$8720$7,&(;32685(&21752/ $(&
Solid state 15 step density selector
Operating range: for large focus 23 - 35 kV
for small focus 25 - 35 kV
November 2000 68 86500

;5$<78%( Varian M113SP in B112 housing
Anode type rotating dual-angle anode

Anode heat capacity 300,000 HU
Target material Molybdenum, niobium doped
Anode rotation speed 3000rpm(50Hz)/3600rpm(60Hz)
Focal spot sizes M113SP 0.1, 0.3 (IEC60336)
Port material beryllium
Reference axis 42 mm (M113SP) from chest wall edge (tube
angle 4°)
1) Focal spot is marked in the

front part of the tube head
assembly.
2) The collimator label is at

the front end of the tube
head assembly.
),/75$7,21
DIAMOND 0.025 mm Molybdenum
0.025 mm Rhodium
0.30 mm Aluminum
326,7,21,1*
movement rotation ±185°
vertical 760 mm (30")
6,' 660 mm (26")
&2035(66,21 motorized (max 200N) and manual (max

270N±20N)
Foot pedal protection
classification IPX1
5(&25',1*6<67(06
Contact for 18 x 24 and 24 x 30cm film
Bucky for 18 x 24 and 24 x 30cm film
Magnification for 18 x 24cm film 1.6, 1.8 & 2.0
exposed size 10 x 24
Stereotactic device for 18 x 24cm film or digital ccd-camera
&255(6321'(1&(%(7:((1
;5$<),(/'$1',0$*(5(&(37,21$5($
Chest wall 0...+3 mm
Other walls +1...+5 mm
Correspondence between collimator light field and X-ray field PPDQ\ZDOO
86500 69 November 2000

&2//,0$725
Type MGB 600
Filtration 0mm Al
Electrical input 34Vac (for half-step motors)
9-14Vdc (for 12Vdc lamp)
Lamp type HLX (halogen), 12V, 50W
5$',$7,21),(/'
Maximum radiation field 24x30cm
$77(18$7,21(48,9$/(17
Bucky, cassette tunnel
or magnification tunnel 0.25 mm Al (Total of all layers)
$17,6&$77(5*5,'
Line pairs 36 lp/mm

Grid ratio 5:1
52&*5,'
Line pairs 36 lp/mm

Grid ratio equal to 6:1
',63/$<$&&85$&<
Compression force ± 20N

Compression thickness ± 1cm
C-arm angle ± 2°
mGy display ± 30%
For mGy display accuracy, refer to:
“Spectral Dependence of Glandular Tissue dose in Screen-Film Mammography”

Wu Xizeng, Wu X, Barnes Gary T, Tucker Douglas M, Radiology 1991; 179:143-
148
and
“Normalized Average Glandular dose in Molybdenum Target- Rhodium Filter and

Rhodium Target –Rhodium filter Mammography” Wu Xizeng, Wu X, Gingold
Eric L, Barnes Gary T, Tucker Douglas M, Radiology 1994; 193:83-89
November 2000 70 86500

0($685(0(17&5,7(5,$)25(;32685(7,0(
([SRVXUHWLPH Consists of beginning and ending points as

measured by a calibrated x-ray monitor at 70% of
the peak radiation waveform
N9 The high voltage mean value received after

measurement with a calibrated x-ray monitor
P$V The resistance value divided by voltage. A

calibrated x-ray monitor measures the voltage over
feedback resistor and provides a mAs value.
The QRPLQDO[UD\YROWDJH 39kV is obtained at highest tube current 50mA.
The QRPLQDOWXEHFXUUHQW50mA is obtained at the highest tube voltage 39kV.
The KLJKHVWHOHWULFSRZHU is obtained both at 32kV tube voltage and 80mA tube
current and at 25kV tube voltage and 100mA tube current.
The QRPLQDOHOHFWULFSRZHU of 185kW is obtained, when loading time is 0.1s and

nominal x-ray tube voltage 39kV is used.
)86(6
Power Board 85020
F1,2 FUSE 5x20mm 4AT, IEC 127-2/3

F3 FUSE 6.3x32mm, 12.5AT 440V
F4 FUSE 5x20mm 0.8AT, IEC127-2/3
F5 FUSE 13/32" 20AF 600VAC (Bussmann KTK-20)
AMD 32305
F1 FUSE 6.3x32mm 10AT 250V
',$021')86(686('%<'(/7$
On PCB located in the bottom part plate of the c-arm. Fuse Board 33615
F5 FUSE 1 pcs, 6x32mm 1,25AT 250V UL

F3 FUSE 1 pc, 6x32mm 0,8AT 250V UL
F1,2,4 FUSE 3 pcs, 6x32mm 0,5AT 250V UL
In the carriage next to the transformers: D32 Fuse Plate 82685
F1,2 FUSE 2 pcs, 6X32mm 0,3AD 250 UL 248-14
86500 71 November 2000

86(5 667$7(0(172)02'(/',$021'
Radiation Leakage Technique Factors:
The maximum-rated peak tube potential is 39 kVp and the maximum rated
continuous tube current is 4.0 mA (Duty cycle 1:12) for the maximum rated peak
tube potential at large focal spot. The maximum-rated peak tube potential is 35
kVp and the maximum rated continuous tube current is 4.5 mA (Duty cycle 1:3)
for the maximum rated peak tube potential at small focal spot.
Beam Limiting Device/Tube Housing Assembly Compatibility:
The tube housing assembly is compatible with the interchangeable plate

collimator assembly, which is an integral part of the tube head and can only be
used with the tube housing assembly.
Equipment Statement for Tube Housing Assembly:
Maximum operating voltage: 35 kVp effective focal spot 0.3 mm for large spot
0.1 mm for small focal spot.
X-ray tube: Varian M113SP 0.3/0.1. For additional information see tube
specification sheets.
23(5$7,1*3$5$0(7(56
Maximum Deviation of Peak Tube Potential from Indicated Value:
" 1.5 kV + instrumentation inaccuracies (1.5% of the reading + 600 V) as

measured by a calibrated Dynalyzer
Maximum Deviation of Tube Current-Exposure time from Indicated Value:
" 4 mAs for mAs values less than or equal to 40 mAs, " 10% for mAs values
greater than 40 mAs
Maximum Deviation of Timer from Indicated Value:
" 0.1 second + instrumentation inaccuracies (0.5% of the reading + 0.25 msec.)
as measured by a calibrated Dynalyzer.
Power Supply Requirements:
Line voltage 230 VAC +/- 10%, 50/60 Hz, single phase. Operating Voltage Range
207-253 VAC.
Automatic regulation for all voltages within Operating Voltage Range
November 2000 72 86500

Maximum Line Current:
Maximum line current during exposure is 30A at technique factors 25 kVp and
100 mA. The system line circuit breaker is 15A because the maximum line current
of 30 A is only during short peaks during the exposure.
127( $VPHDVXUHGE\DFDOLEUDWHGPRYLQJLURQLQVWUXPHQW
General Output Rating and Duty Cycle:
At 230 VAC nominal:

Large Focal Spot 100 mA at 25 kV
70 mA at 35 kV
Small Focal Spot 30 mA at 23 kV

20 mA at 35 kV
Exposures are automatically limited if the tube or housing heat capacity counter
is activated.
Tube protection counter:
$QRGH
Heating = kV x mAs = Joule (increased only during exposures)

Cooling = 30 Joule / sec (decreased continuously)
+RXVLQJ
Heating = kV x mAs = Joule (increased only during exposures)

Cooling = refer to diagram in Chapter 13.2 (decreased continuously)
86500 73 November 2000

78%(/2$',1*&+$57)2506378%(
N9 063 063
P$ 6) P$ /)
15 18 53
16 20 59
17 22 64
18 23 69
19 24 74
20 25 75
21 26 80
22 28 85
23 30 90
24 29 95
25 28 100
26 27 95
27 26 90
28 25 85
29 24 85
30 23 80
31 22 80
32 21 80
33 21 75
34 20 75
35 20 70
36 19 50
37 19 50
38 18 50
39 18 50
SF = Small focus, LF = large focus
Time range with loading factors shown above:

Focus 0.3 0.05 - 5.0 sec. (6.0 sec. in UK)
Focus 0.1 0.05 - 10.0 sec.
November 2000 74 86500

063;5$<78%('$7$6+((76
Various tube charts and markings are included in the latest revision of 5708,
M113SP Rotating Anode Tube by Varian Medical Systems.
063),/$0(17(0,66,21&+$576
)XOO:DYH
86500 75 November 2000

$12'(+($7,1*$1'&22/,1*&859(6
+286,1*+($7,1*$1'&22/,1*&859(6
November 2000 76 86500

6,1*/(/2$'5$7,1*6
&RQVWDQW3RWHQWLDO+]
86500 77 November 2000

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November 2000 78 86500

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The M113SP rotating anode X-ray tube is a 39 kVp VARIAN insert tube with 0.1
mm and 0.3 mm focal spot combination and 77 mm diameter bi-angular (10E/16E)
Molybdenum anode disc, cathode grounded.
The M113SP metal center section X-ray tube is for use in Mammography systems.
The use of a metal center section tube eliminates arcing due to metal deposition
on glass and allows use of a beryllium window in the insert for minimum inherent
filtration.
*(1(5$/'$7$
Maximum Peak Voltage: 39 kV (Anode to Ground)
Nominal Focal Spot Size:
Small 0.1 mm (See General Information

Section for Focal Spot
Measurement Method).
Large 0.3 mm
Maximum Anode Load: 3-phase, 180Hz, 0.1 second
Small Focal Spot 1320 W
Large Focal Spot 2.6 kW
Anode Disc Construction: Molybdenum Alloy
Anode Disc Diameter: 77 mm
Anode Disc Target Angle:

- M113SP (LF/SF) 16/10
Anode Heat Storage: 300 kHU
Maximum Anode
Cooling Rate: 60,000 HU/minute
Inherent Filtration: 0.0 mm Alum. Equiv.

0.76 mm Beryllium
U/L Approved Yes
86500 79 November 2000

%+286,1*
Class I
Type B
Maximum Peak Voltage 52 kV

Anode to Ground 52 kV
Cathode to Ground 0 kV
Housing Heat Storage Capacity 370 KJ (500 kHU)
Housing Cooling Rate 100 Watts (135HU/sec)
Weight 10.2 kg (22.5 lbs)

Length 33 cm (13")
Diameter 13.8 cm (5.44")
Focal Spot - Port Spacing Small 47.0mm +/- 1mm

Large 41.4 +/- 1mm
High Voltage Cable, Special Design

(Non-Federal Standard) 55 kV Rating
Acoustic noise 50dB Max. (A-weighted) at 30 cm
Leakage Technique Factor M113SP 52 kV, 2mA
Leakage Technique Factor B112 55 kV, 4mA
Minimum Ambient temperature

for storage & transportation: -9°C (16°F)
Maximum Operation Temperature: +40°C (+104°F)
/RZ9ROWDJH&DEOH
3LQ )XQFWLRQ
3RVLWLRQ
1 Phase Shift
2 Phase
3 Common
4 Housing Ground
5 Grid
6 Not used
7 Small Filament
8 Filament Common
9 Large Filament
November 2000 80 86500

),/$0(176
)2&$/6327 92/76 $03(5(6
0.1 3.8 - 7.3 3.0 - 4.8
0.3 6.0 - 10.5 3.6 - 5.2
67$725+=
67$57,1* 9 9
Amperes 4 8
Seconds to 1 0.5
Start
Duty Intermittent Intermittent
5811,1* 9 9

Amperes 1.4 - 2.0 1.4 - 2.0
Duty Continuous Continuous
PHASE SHIFT CAPACITOR 30 Microfarad
6DIHW\ 7KHUPDO 6ZLWFK &RQQHFWHG LQ VHULHV ZLWK VWDWRU FRPPRQ

ZLUH2SHQVDW°&°& °)°) FORVHVDW°&
°& °)°)
,1+(5(17),/75$7,21
Inherent filtration of the insert is 0 mm Aluminum equivalent. For operation of the
X-ray tube to 39 kV, a minimum of 0.5mm Aluminum equivalent must be added
to the X-ray beam.
5$<3522),1*
Stray radiation complies with the requirements of HEW 21 CFR, Subchapter J for
medical diagnostic-type protective X-ray tube housings.
86500 81 November 2000

)2&$/63270($685(0(170(7+2'
063VPDOOIRFXV
Measured at 25kV, 20mA with one degree star pattern or a slit focal.
Maximum focal spot size = 0.15W x 0.15L (mm).
063ODUJHIRFXV
Measured at 25kV, 80mA with one degree star pattern or a slit focal.
Maximum focal spot size = 0.45W x 0.58L (mm).
Specification of the maximum focal spot size limits must be performed at the
techniques listed above.
November 2000 82 86500

&21',7,2162)385&+$6(2)63$5(3$576,186$
MINIMUM ORDER
Part purchases will be a minimum of $50.00, unless otherwise authorized.
PARTS WARRANTY
Parts carry a 90-day warranty on defects in material and workmanship. The

warranty does not cover operation outside defused product specification and
operating instructions. These instances are assumed to be the result of customer
negligence. 3DUWV LQVWDOOHG E\ DQ\RQH RWKHU WKDQ ,QVWUXPHQWDULXP
DXWKRUL]HGUHSUHVHQWDWLYHVDUHQRWZDUUDQWHGLQDQ\ZD\
SHIPPING
Parts are sold FOB Milwaukee. You will be invoiced for freight and insurance
charges. Counter to counter shipments carry a $75.00 service fee, in addition to
actual shipping charges. ,163(&77+(0(5&+$1',6(83215(&(,37 The
merchandise was carefully packed and thoroughly inspected before leaving our
warehouse. Responsibility for it is a safe delivery was assumed by the carrier
upon acceptance of the shipment. Claims for loss or damage sustained in transit
must be made upon the carrier as follows: External evidence of loss or damage
must be reported to the carrier upon receipt of the merchandise. Concealed loss
or damage must be reported to the carrier within fifteen days of delivery date.
Such loss or damage is the carrier’s responsibility.
3$5765(7851352&('85(
All parts returning to Instrumentarium Imaging, Inc. must have a RETURN

MATERIALS AUTHORIZATION number. If you did not receive RMA
paperwork with your shipment, call our office and a number will be issued for the
following returns: (You are responsible for any freight charges incurred to return
parts to Instrumentarium unless specified on the Return Materials Authorization
form.)
'HIHFWLYH5HFHLYHG
Report the receipt of the defective part within 15 days of shipment. Parts received
defective will be replaced under warranty, FOB destination.
:URQJ3DUW5HFHLYHG
Report the error within 15 days of shipment. Parts shipped incorrectly will be
replaced, FOB destination.
:URQJ3DUW2UGHUHG
If you wish to exchange the part, request the exchange within 15 days of shipment.
Parts ordered incorrectly can be exchanged subject to a $50.00 restocking charge.
86500 83 November 2000

5HWXUQIRU&UHGLW
If you wish to return a part for credit, request the return within 30 days of the
original shipment of the part. Requests after 30 days will require special
authorization, and maynot be returnable.
5(672&.,1*&+$5*(
$50.00 (does not apply to parts returned as defective or wrong part received.)
,167580(17$5,800$002*5$3+<6<67(0:$55$17<
,186$
Instrumentarium Imaging, Inc. ("Instrumentarium") warrants to the original
purchaser that each Instrumentarium product sold by it shall be free from defects
in material or workmanship under normal use and service for a period expiring
twelve (12) months from the completion of installation, unless documented
otherwise on your signed quotation. Concerning products manufactured by
persons other than Instrumentarium or its affiliates: 1) those products which
Instrumentarium considers added on to the system shall be warranted as above;
2) those products which Instrumentarium does not consider added to the system
are not warranted by Instrumentarium, and Purchaser’s sole source of warranty,
therefore, if any, is the original manufacturer’s warranty. If service work is
required and is deemed by Instrumentarium to be caused by equipment and/or
product(s) other than the Instrumentarium product or product(s) Instrumentarium
considers added on, that service work is not covered under warranty (i.e.
processor-related, film screen changes, etc.) and is billable at Instrumentarium’s
standard rates.
If a failure occurs within the warranty period and there is no evidence of misuse,
abuse, neglect or unauthorized alteration or repair, Instrumentarium will repair,
at its option, the defective item without charge for parts. Instrumentarium is the
only authority on what constitutes misuse, abuse, neglect or unauthorized
alternation or repair, under the terms of this warranty.
This warranty is made on condition that prompt notice of any defects is given
within the warranty period and that the company inspection does not disclose an
invalid claim. Obligation of Instrumentarium under this warranty is limited to the
repair or replacement, at its option, of the defective part. Repairs or replacement
deliveries shall not interrupt nor prolong the term of the warranty. This warranty
does not apply to perishable or consumable material, except as specifically stated
in writing, The X-ray tube is warranted for twelve (12) months, non-prorated,
unless otherwise documented on your signed quotation.
WARRANTY PARTS CHARGES
Instrumentarium reserves the right to charge the purchaser for any parts shipped
for warranty repair, if said parts are not returned to Instrumentarium within 15
days of repair. Charges will be billed at suggested list price and will be payable
upon receipt of invoice.
November 2000 84 86500

This warranty is not transferable and is effective only with respect to the original
purchaser of Instrumentarium equipment, where installation has been performed
by certified personnel or Instrumentarium.
Instrumentarium reserves the right to make changes in design and/or

improvements to its products without any obligation to include these changes in
any product previously manufactured. Correction of defects by repair or
replacement shall constitute fulfillment of all warranty obligations on the part of
Instrumentarium.
/,0,7$7,212)/,$%,/,7<
Instrumentarium shall not be liable for any loss of use, revenue or anticipated
profits, nor for any indirect or consequential damages arising out of or in
connection with the sale or use of the products. No agent, distributor or any other
party is authorized to make any warranty on behalf of Instrumentarium, or to
assume for Instrumentarium, any other liability with respect to its product.
Instrumentarium shall not be liable for any loss of use due to natural disaster (i.e.,
weather phenomenon).
INSTRUMENTARIUM IMAGING, INC., MAKES NO WARRANTY OTHER

THAN THE ONE SET FORTH HEREIN. THIS WARRANTY IS IN LIEU OF
ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED, INCLUDING
WARRANTIES OR MERCHANTABILITY OR FITNESS FOR PARTICULAR
PURPOSE, AND IS THE SOLE AND EXCLUSIVE REMEDY FOR ANY
CLAIM OF DAMAGES ARISING FROM ANY DEFECT IN THE
INSTRUMENTARIUM PRODUCT.
86500 85 November 2000

6<67(00$,17(1$1&(
&/($1,1*2)7+(',$021'81,7
:$51,1* %HIRUHFOHDQLQJDQGGLVLQIHFWLQJUHPRYHSRZHUIURPWKHHTXLSPHQW
:$51,1* 'RQRWDOORZOLTXLGVHQWHULQWRWKHXQLW
ALL parts of the unit that come in contact with the patient must be cleaned and
disinfected prior to each examination. Cleaning of the unit is especially important
after biopsy procedures (refer to biopsy device user manual for cleaning
procedure).
The standard hospital regimen for desinfection should be followed, with the
following qualifications:
DO NOT clean surfaces on parts, which come into contact with the patient (i.e.,
face shield, cassette holders, bucky devices, compression paddles) with solvent-
based cleaners (containing benzene, alcohol, or stain removers).
DO NOT use extra-strength or abrasive cleaners, polishes, or waxes on parts that

come into contact with the patient.
Proprietary disinfectant solutions meeting the above limitations are suitable,

provided that the manufacturer’s instructions are stringently followed.
As a general rule, disinfectant sprays may not be used directly. The mist generated
by spraying may penetrate into the unit, and this may damage electronic
components. To use a disinfectant agent in spray form, first apply the agent to a
clean cloth or pad, and then use the pad to apply the agent to the surface requiring
disinfectant.
For general cleaning, use a non-lint cloth dampened with water, or a lukewarm,
diluted aqueous solution of household dishwashing liquid.
&$5(
Handle the plastic accessories carefully, and inspect them frequently. If they
begin to crack, discontinue their use and replace them.
November 2000 86 86500

23(5$72560$,17(1$1&(6&+('8/(
For safe and proper operation of the unit, the following inspections must be
performed monthly (or daily or weekly if so indicated) by the operator of the
equipment.
9LVXDO([SRVXUH,QGLFDWRU
Confirm that the exposure indicator light stays on for the length of the
exposure.
$XGLEOH([SRVXUH,QGLFDWRU
Confirm that the buzzer stays on for the length of the exposure.
([SRVXUH6ZLWFK
Confirm that the exposure switch requires continuous pressing to maintain
the exposure and that releasing of the switch terminates the exposure and
that the timer display indicates "Rel".
:DUQLQJDQG,QGLFDWRU/DEHOV
Inspect and confirm that all warning labels and embossed, painted or other
wearable labels have not been defaced or worn and that they are legible.
$XWRPDWLF([SRVXUH&RQWURO $(&
Confirm that the autoexp light illuminates when AEC is selected. A daily
QA check is recommended. Software monitors the status of each detector
and prevents an exposure with a faulty detector.
9HUWLFDO0RYHPHQW
Check that the carriage moves smoothly and in both directions.
&RPSUHVVLRQIRUFH
Check that the compression force has not changed.
&RPSUHVVLRQUHOHDVHZKHQSRZHUIDLOXUH
Check that the compression paddle drives up for approximately 5 seconds
when the mains voltage is disconnected
5RWDWLRQDO0RYHPHQWDQGDQJOHGLVSOD\
Check that the C-arm moves smoothly in all positions. Check that the
displayed angle corresponds to the selected angle. Also check that +/- 15°
motorized stereo angulation movement is functioning correctly.
&RQWURO3DQHO
Check that all buttons on the control panel are functioning and check that
all lights and display segments function immediately after turning the
main power on.
86500 87 November 2000

&RPSUHVVLRQWKLFNQHVVGLVSOD\FKHFN
Place a 60 mm acrylic block on the cassette holder. Drive the compression
paddle down against the acrylic blocks. Check that the thickness display
indicates 6.0 cm. If not, call for service.
;UD\ILHOGOLJKWFKHFN
Switch on the x-ray field illumination light (46) and check that it covers
the imaging area.
&RPSUHVVLRQSDGGOHV
Once a week, check all compression paddles for any cracks or broken
surfaces.
6WUDQJHVRXQGV
Pay attention to any strange sounds that your unit may make inform your
service technician about these immediately. if you have any doubts about
the correct safe operation of the unit, switch it off and do not use it until
you can it checked by an Instrumentarium approved Service Technician.
(PHUJHQF\EXWWRQV
Check that the emergency stop buttons function correctly. Rotate the C-
arm or move the compression paddle using a foot pedal and press one of
the emergency stop buttons (18). All motorized movements should stop.
Release the emergency stop button, switch on the unit once again and then
repeat the test using the emergency stop button on the opposite side of the
unit.
Fig 16.1 Emergency stop button
&$87,21 ,I\RXVXVSHFWDQ\HOHFWURPDJQHWLFDOLQWHUIHUHQFHDIIHFWLQJRUFDXVHGE\WKH
XQLWFDOOVHUYLFH
November 2000 88 86500

35(9(17,9(0$,17(1$1&(6&+('8/(
The following inspections must be scheduled by the user. Only authorized and
trained service technicians are allowed to carry out the maintenance on this
equipment. Manufacturer can supply at request necessary documents to
Instrumentarium Imaging approved service technician for repair of such parts that
the manufacturer has indicated to be repairable.
21&($<($5 ,167$//$7,21,16758&7,216
kV/mAs/preheat tests Perform tests 2.12.7, 2.12.8 and 2.14.8.

X-ray and light fields Perform tests 2.14.10 and 2.14.11.
AEC adjustment Perform test 2.14.14.
Safety ground Verify that the metal parts of the unit are connected
to protective ground.
Oil leaks Check that the high voltage unit and the tube
housing do not leak oil.
Anode run voltage Perform test 2.12.6.
Compression force Perform test 2.14.5, 2.14.7 and 2.14.8.
Interlock system Check that exposures are inhibited if the diaphragm,
cassette holder or the cassette is not installed.
Check the error codes.
Clean the High Voltage Connections and grease with clean grease for
example DowCorning #4.
Lubricate the counterweight wires with a light coat of "STP" or "CRC".
Do not apply degreasers or cleaners. Replace if broken strands are found.
Recommended wire replacement interval is 5 years.
Tighten ground connections. Inspect crimps, connections and cables for
wear or breakage.
Check for the operation of the C-arm gear. Lubricate, if necessary.
Check the collimator and filter mechanism and movement.
Inspect the floor fixing points to ensure the secure and safe fixing of the
support base plate of the unit.
Check the stereo drive mechanism.
Check Tube Park alignment.
Update the tube efficiency software parameters.
Remove debris from the cassette loading mechanism and lubricate it.
86500 89 November 2000

48$/,7<&21752/&+(&.
If the performance of the unit has changed, please contact your local distributor.
Distributor:
Contact person: Tel:
DIAMOND serial number *): Installation date:
Last maintenance performed:
Exposure counter number:
Last maintenance performed:
Exposure counter number:
*) The serial number is printed on a label attached to the rear cover of the unit.
7(67 )5(48(1&< 722/ 6 3(5)250('%<

Film Processor Daily Thermometer Radiographer/
Densitometer Technologist
Sensitometer
Image Quality Weekly RMI 156D Phantom Radiographer/
Technologist
Physician
Phototimer Monthly Acrylic phantom Radiographer/
Reproducibility Technologist
Physician
Film/Screen Contact Semi-annually Contact test tool Physicist or Service
Technician
kVp Semi-annually Dynalyzer Physicist
Dose/Patient Exposure Semi-annually Ion Chamber Physicist
Half-Value Layer (HVL) Semi-annually Aluminum HVL set Physicist
with Ion Camber
mAs (mA) Semi-annually Dynalyzer (mAs meter) Physicist or Service
Technician
mAs Linearity Semi-annually Ion Chamber (Digital) Physicist or Service
Technician
Compression Semi-annually Scale Radiographer/
Technologist
Exposure Reproducibility Annually Ion Chamber Physicist or Service
(mR/mAs) Technician
Focal Spot Annually Star Pattern Physicist
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November 2000 90 86500

If the unit does not meet the manufacturer´s specifications, despite of proper
maintenance and repair, the operating life of the unit has come to an end. As the
used X-ray tube and oil, high voltage unit, all electronic boards and parts of lead
in collimator and under the AEC detectors are toxic waste, refer to country-
specific disposal instructions.
5(3/$&(0(172)7+(/,*+7),(/'%8/%
1) Turn the unit off and leave it for a while to allow the bulb to cool.
2) Slide the lamp support plate open.
3) When you see the old bulb lamp, pull it out.
86500 91 November 2000

4) Insert a new bulb. Avoid touching the bulb with your fingers. Use
protective plastic bag (around the bulb, dependent on the bulb
manufacturer) or cotton gloves.
5) Slide the lamp support plate back to normal position.
November 2000 92 86500

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Radiographic control
Collimator light
Compression force (regulation)
Compression force (display)
Tube head rotation keys (stereotactic movement)
Tube head rotation keys (at the top)
C-arm angle display
Vertical movement keys
Compression thickness display
86500 93 November 2000

Filter selection button
Tube park keys
CE-marked (Medical Device Directive 93/42/EEC)
AEC-mode selection key
Earth (ground)
Protective earth (ground)
Type B equipment
Dangerous voltage
ON (Power)
OFF (Power)
Attention, physical danger possible. Refer to Chapter 1.2

and Ch 5 for issues related to radiation, c-arm rotation and
compression.
November 2000 94 86500

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,16(57,215(029$/$1'5(3/$&(0(172)&2035(66,21
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1) Insert the desired paddle into the locating holes in the compression arm (4)
and push the paddle horizontally until it locks. Insert the paddle so that the
longer pin of the two slides into the right-hand hole.
2) The inserted compression paddle looks like this.
86500 95 November 2000

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1) Push the release button (7) and pull the paddle out horizontally.
2) After pressing the lock release button (7), pull out the compression paddle.
5HSODFHPHQW
1) Remove the compression paddle from the C-arm.

2) Insert another paddle following the insertion instructions above.
November 2000 96 86500

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,QVWDOOLQJDFDVVHWWH
1) Load the film into the cassette.
2) Open the lock to insert the cassette into the cassette holder by inserting the
lower left corner of the cassette to the bucky. Push then the cassette
towards the front of the bucky so that the upper left corner slides in.
3) Slide in (do not throw) the cassette until the lock key returns to its normal
position. Take care not to trap your fingers in between the cassette holder
and the cassette.
86500 97 November 2000

5HPRYLQJDFDVVHWWH
1) If the cassette has not been exposed yet, it is still in the front end of the
bucky. In order to remove it, slide the cassette latch towards the back of
the bucky. This procedure returns the cassette to the rear end of the bucky.
2) Remove the cassette by pushing the cassette lock release key (9) towards
the front end of the bucky. Hold the key in the forward position with your
middle finger and pull the cassette out with your thumb and index finger.
3) Pull the cassette out of the cassette holder.
November 2000 98 86500

0$18)$&785(5
,QVWUXPHQWDULXP,PDJLQJ
P.O.Box 20, FIN-04301 Tuusula, Finland
Tel. + 358 10 394 6500 • Fax + 358 10 394 6501
info@fi.instrumentarium.com • www.instrumentarium.com/imaging
,167580(17$5,80,0$*,1*2)),&(62876,'(2)),1/$1'
,QVWUXPHQWDULXP,PDJLQJ,QF
300 West Edgerton Avenue, Milwaukee, Wisconsin 53207, USA
Tel. +1 800 558 6120 • Fax +1 414 481 8665
info@usa.instrumentarium.com • usa.instrumentarium.com
,QVWUXPHQWDULXP,PDJLQJ)UDQFH
4, Avenue des Roses, 94386 Bonneuil Sur Marne Cedex, France
Tel. +33 1 43 39 51 51 • Fax +33 1 43 39 75 75
instrumentarium.imaging@wanadoo.fr
,QVWUXPHQWDULXP,PDJLQJ,WDOLDVUO
20041 Agrate Brianza (MI) Centro Direzionale Colleoni,
Viale Colleoni, 11, Interno 3, Italia
Tel. +39 039 689 0408 • Fax +39 039 609 1299
instrumentarium@it.instrumentarium.com • www.instrumentarium.it
,QVWUXPHQWDULXP,PDJLQJ'HQWDO*PE+
P.O.Box 2044, 77680 KEHL AM RHEIN, Germany
Tel. +49 7851 932 90 • Fax +49 7851 932 930
kontakt@instrumentarium-imaging.de
,QVWUXPHQWDULXP,PDJLQJ=,(+0*PE+
Isarstrasse 40, D-90451 Nuremberg, Germany
Tel. +49 911 642 070 • Fax +49 911 642 0739
info@ziehm-eu.com • www.ziehm-eu.com
=,(+0,QWHUQDWLRQDO0HGLFDO6\VWHPV
4181 Latham Street Riverside, CA 92501, (USA)
Tel. + 1 909 781 6660 • Fax +1 909 781 6457
imsca@aol.com. • www.ziehm.com

86500-4A Diamond Operation Instructions Nov 2000 ENG

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2SHUDWLRQ,QVWUXFWLRQV

November 2000 86500-4A

Documentation, trademark and the software are copyrighted

This document is the English-language original. In case of

Instrumentarium Imaging reserves the right to revise this

Microsoft, Windows and Windows NT are trademarks of

MANUFACTURED BY: Instrumentarium Corporation

86500 November 2000

5.6.3 Motorized compression ........................................................................ 32

November 2000 86500

6.3.2 Automatic compression release (Auto Rel) mode................................ 57

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86500 November 2000

November 2000 86500

Instrumentarium accepts no responsibility for safety, reliability or performance

 Assembly, calibration and repairs are performed by an Instrumentarium

86500 1 November 2000

Fig 1.1 Optional radiation shield (34135)

November 2000 2 86500

Fig 1.1c Labels at the back of the column

86500 3 November 2000

Figure 2.1 The stand

November 2000 4 86500

Figure 2.2 Control panel

20. Ready indicator, green

86500 5 November 2000

Figure 2.3 The Positioning Control Center panel

7. Compression paddle release button

Figure 2.4 Position Control Center controls

November 2000 6 86500

Figure 2.6 Tube head stereo angulation buttons (19)

Figure 2.7 Vertical movement buttons (12) at the compression arm.

86500 7 November 2000

Figure 3.1 Diamond default screen

November 2000 8 86500

Use the CANCEL-button

Use the SET- button

The exposure button

The use of the LCD-

Figure 3.2 Diamond control panel

86500 9 November 2000

[FPFRPSUHVVLRQSDGGOH  This paddle is used with 18x24cm

Figure 3.3 18x24 cm compression paddle

November 2000 10 86500

[FPFRPSUHVVLRQSDGGOH  The 24x30 cm compression paddle

It applies compression to the whole

Figure 3.4 24x30 cm compression paddle

It is important to remember, however, that especially in the oblique view the

86500 11 November 2000

2) The inserted compression paddle looks like this.

November 2000 12 86500

1) Push on the release button (7) on the either side.

2) Remove the compression paddle by pulling it out horizontally.

86500 13 November 2000

• Synchro Bucky 18x24cm (81042)

November 2000 14 86500

2) Push the cassette holder forward until it locks securely in place.

86500 15 November 2000

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Assembly, calibration and repairs are performed by an Instrumentarium

[FPFRPSUHVVLRQSDGGOH This paddle is used with 18x24cm

[FPFRPSUHVVLRQSDGGOH The 24x30 cm compression paddle

7KH,',,ILOPLGHQWLILFDWLRQFDPHUD exposes the all necessary patient

7KH$OSKD6KLHOG is available for additional protection of the user.

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7KHFRPSUHVVLRQIRUFHSUHVHOHFWLRQNH\V determine the maximum force

The C-arm is driven upwards without applying compression, to open the

The breast is compressed VOLJKWO\ with the paddle to hold it in place

Final compression is applied by the bucky or cassette tunnel from below

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