DOC2046828_8_4DView_18_BUM_en-US

4DView
for Software Version 18

Instructions for Use
English (English)
Part number: DOC2046828_en-US
Revision 8
for Software Version 18
© 2023 GE HealthCare
Revision History
Revision Date
Revision 1 November 2017
Revision 2 August 2018
Revision 3 January 2019
Revision 4 September 2019
Revision 5 September 2020
Revision 6 May 2021
Revision 7 May 2022
Revision 8 October 2023
4DView Instructions for Use

i-ii DOC2046828_en-US Revision 8
Table of Contents
Chapter 1 – Introduction
Introduction to 4DView - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-2
About these Instructions for Use - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-4
Conformance Statement - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-5
Safety Regulations - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-6
Symbols - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-9
Chapter 2 – Installation
Installation Requirements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-2
Getting Started - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-3
Installing 4DView - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-4
Uninstalling 4DView - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-7
Chapter 3 – Menu Functions
File Menu - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-2
Edit - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-6
View - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-7
Settings - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-10
Help - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-17
Chapter 4 – Working with Volume Data
Demo Cases - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-2
Rotation and Reference Slices - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-3
Visualization Mode - Render - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-14
Visualization Mode - Multiplanar - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-15
Visualization Mode - TUI - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-26
Volume Analysis Modes - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-29
Render Modes - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-43
Cine Sequences - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-51
Image Settings - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-63
MagiCut - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-68
Annotation - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-72
Chapter 5 – Measurements
Measurements - General Information - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-2
Generic Measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-3
Calculation Measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-10
Measurement Setup - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-21
Chapter 6 – Archive
Current Patient Dialog - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-3
Archive - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-8
Image History - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-17
Exam Review - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-18
Save to Archive - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-23
Worksheet - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-24
Chapter 7 – Connectivity
DICOM Configuration - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-2
DICOM Send - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-7
DICOM Print - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-10
DICOM Transfer Status - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-12

DOC2046828_en-US Revision 8 i-iii
Table of Contents
DICOM Worklist - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-14

DICOM Storage Service Class Provider - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-15
Report Transfer - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-17
VolusonClub.net - Learn. Network. Share. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-18
Samples of Private Network Setups - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-19
Chapter 8 – Troubleshooting
Installation problems - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-2
Performance problems - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-4
Display resolution - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-5
Network problems - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-6
Error Messages - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-8
Chapter 9 – Glossary
Glossary - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-2
Chapter 10 – Appendix
Trademarks - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-2
e-Distribution Portal - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-3
Additional Products - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-4
Chapter 11 – Country-specific Information

i-iv DOC2046828_en-US Revision 8
Chapter 1
Introduction
Introduction to 4DView - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-2

About these Instructions for Use - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-4
Conformance Statement - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-5
Safety Regulations - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-6
Symbols - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-9

DOC2046828_en-US Revision 8 1-1
Introduction
1.1 Introduction to 4DView

Intended use/ Indications for use
Image Display of GE Ultrasound 3D/4D data sets for diagnostic purposes including measurements on
displayed image.
Essential Performance
• Display* of archived ultrasound images
• Measurement* on ultrasound images
Note *Not part of 4DView: The display and the hardware functionality for displaying
archived ultrasound images as well as hardware such as keyboard, mouse,
monitor, PC, etc. required for performing measurements and the handling of
ultrasound data.
Contraindication
No known contraindications.
Clinical benefit
The clinical benefit of diagnostic imaging software is to help healthcare professionals acquire
accurate diagnostic information (visualize human tissue/internal structure and perform
measurements of displayed structures) that enhances the data used for diagnostic purposes.
Primary Operating Functions
• Display and editing of GE Ultrasound 3D/4D data sets
• Measurements on displayed image incl. derived calculations based on medical literature in the
following applications: Abdominal, Obstetrics, Gynecology, Cardiology, Transrectal, Vascular,
Cephalic, Small Parts, Pediatrics, Musko-Skeletal (MSK).
• Data storage (image, measurement and patient data)
• Data transfer to and from remote systems (e.g. via DICOM® )

1
• Adding annotations to acquired image

The 4DView Software can be downloaded from the e-Distribution Portal (see 'e-Distribution Portal'
on page 10-3. Additionally, demo cases in the volume file format can be downloaded from
www.VolusonClub.net.
There are two possibilities for transferring volume files from a Voluson™ Family series ultrasound
machine to a PC with 4DView:
• Sending via a DICOM connection with Storage SCP ( For more information see 'DICOM Storage
Service Class Provider' on page 7-15. ) as DICOM storage server.
• Save the volume file on the Voluson™ Family series machine, then export it via Archive (please
refer to the Instructions for Use ) and import it ( For more information see 'Data Transfer Menu'
on page 6-13. ) on a PC with 4DView. In this case it is important not to mix data from more
than one Voluson™ Family series machines, because volume files and images might be
assigned an erroneous Patient ID.
Note 4DView also supports certain volume data sets derived from LOGIQ™ systems.
Consult your LOGIQ™ system’s Instructions for Use for further information.
The software 4DView is developed and produced by GE Healthcare Austria GmbH & Co OG. For more
Information please contact:
1 DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications relating to digital communications of medical
information.

1-2 DOC2046828_en-US Revision 8
Introduction
GE Healthcare Austria GmbH & Co OG
Tiefenbach 15 Telephone: +43-7682-3800-0
4871 Zipf Fax.: +43-7682-3800-47
Austria Internet: http://www.gehealthcare.com

Introduction
1.2 About these Instructions for Use
The Instructions for Use is only provided electronically. If needed as free hardcopy please contact the
service personnel in e-Distribution.
• Read and understand all instructions in the Instructions for Use before attempting to use the
4DView .
• Keep this Instructions for Use with the product for future reference.
• The availability of some functions or features depends on the probe and ultrasound system
used. Please see the Instructions for Use of your ultrasound device for further reference.
• The screen graphics and illustrations in these Instructions for Use are for illustrative purposes
only and may be different from what is displayed on the screen.
• All references to standards / regulations and their revisions are valid for the time of publication
of these Instructions for Use .
• Paper Copy: The EU Commission Regulation on electronic instructions for use of medical
devices in the European Union demands, that a paper copy of Instructions for Use can be
ordered at no additional charge. You may therefore, send a request to vpsupport@ge.com .
This request will be treated within 7 days.

Introduction
1.3 Conformance Statement

This product conforms to the following standards and regulations:
• REGULATION (EU) 2017/745 concerning medical devices:

the CE label affixed to the product testifies compliance to the Regulation
• IEC62304: Medical device software – Software life cycle processes
• IEC62366: Medical devices – Application of usability engineering to medical devices
• ISO 14971 Medical devices – Application of risk management to medical devices

Regulatory remarks:
Certifications: GE Healthcare Austria GmbH & Co OG is ISO 13485 certified.

The 4DView is a Diagnostic Medical Product belonging to Class IIa according to the MDR -
REGULATION (EU) 2017/745 for use on diagnostic images of human patients.

Introduction
1.4 Safety Regulations

The software package 4DView has been developed for use on a PC with the operating system
Microsoft Windows® 10 64-Bit, Windows® 11 64-Bit. GE HealthCare is not liable for any defects if
4DView is installed on any other operating system than Microsoft Windows® 10 64-Bit, Windows® 11
64-Bit.
Remark ATTENTION!
Under conditions of patient contact, if the data transfer takes place directly
from the ultrasound scanners Voluson™ Family series to the PC, or the PC is
connected to the Voluson™ Family series ultrasound scanner, the following
safety precautions must be considered:
The used hardware (monitor, graphic card, display cable, etc.) can affect the image quality and
compromise the diagnostic quality. The user is responsible to use adequate hardware and choose
relevant settings (display settings, etc.) to ensure that the images displayed in 4DView show
identical quality as observed on the respective ultrasound system. If in doubt, only the image as
displayed on the respective ultrasound system is to be used for diagnostic purposes.
4DView is only to be used by qualified physicians and professional sonographers with basic
ultrasound knowledge.
GE HealthCare is not responsible for data loss if other unauthorized software is installed on the PC.
GE HealthCare is not responsible for proper functionality of the operating system Microsoft
Windows® 10 64-Bit, Windows® 11 64-Bit and PC hardware components.
The Windows® operating system must be kept up to date. Updates must be performed and
configured properly.
4DView is intended to be used as a standard user without administrative rights. The Windows®
User Account Control must be configured accordingly.
A malware detection and protection solution should be installed and kept up to date. In addition,
the system firewall should be configured to block ports that are not required for operation of
4DView, specified in 'Network disclosure' on page 1-7.
Do not leave the PC / 4DView unattended. The PC must be locked using the respective function of
the Windows® operating system.
4DView is not designed and must not be used as a primary long-term storage solution for image,
measurement and patient data.
It is the user’s duty to perform regular backups to minimize damage in case of data loss. GE
HealthCare is not responsible for data loss and will not aid in the recovery of lost data.

Introduction
The archive should be set up in a location accessible only to the 4DView user. Access restrictions
are enforced using the Windows operating system.
The storage location of the archive should be protected utilizing the hard disk or file system level
encryption feature of the operating system.
Using volume, image or video compression methods at higher rates reduces image quality, which
can lead to a false diagnosis.
It is possible that some options or features are NOT available in some countries!
If you are not sure whether these measures have been applied or how to apply them, please ask
your local system administrator for assistance.
For safety instructions concerning measurements see 'Calculation Method and Accuracy' on page 5-
4.
The user (physician or hospital) is responsible for compliance with these safety regulations.
All references to standards / regulations and their revisions are valid for the time of publication of
this Instructions for Use .
The screen graphics and illustrations in the Instructions for Use are for illustrative purposes only and
may be different from what is displayed on the screen or device.
In accordance with other Voluson™ products, a lifetime of 7 years may be expected for the product.
In case a serious incident occurred in relation to 4DView, this should be reported to GE HealthCare
and the competent Authority.
1.4.1 Network disclosure
Purpose and scope

This disclosure is intended to satisfy the requirements of IEC 60601-1 and IEC/ISO 80001-1 for
disclosure of network-related specifications, requirements and residual risks in order to facilitate the
responsible organization's risk management activities (e.g. pursuant to 80001-1) for their networks
incorporating the 4DView .
Purpose of the network connection

The connection options provide a possibility for data transfers from and to the 4DView . This allows
the customer to use a convenient database system for data management and data sharing e.g.
within a hospital or any other relevant organizations.
Network interface technical specifications
Internet Protocol Version: IPv4
Required IT network characteristics

Recommended throughput 100 Mbit/sec
Ports open only to secure LAN closed to Internet:
• 104 – DICOM (default outbound) / 105 - DICOM (default inbound)

Introduction
Note DICOM is the registered trademark of the National Electrical Manufacturers

Association for its standards publications relating to digital communications of
medical information. The DICOM Conformance Statement can be downloaded
from the internet.
Ports open to the Internet or local network depending on the configuration:
• 25, 465 or 587 - SMTP (configurable on the system)
Potential hazardous situations resulting from failures of the IT network

The following general hazardous situations have been identified as potentially arising as a result of
the IT network failing to provide the required characteristics specified above:
• Delayed or impaired access to images or other exam information or patient data.
• Permanent loss of images or other exam information or patient data.
• Corruption of images or other exam information or patient data.

In addition to the hazardous situations identified above, connection of the 4DView to a network that
includes other equipment could result in other unidentified risks to patients, operators or third
parties. The responsible organization should identify, analyze, evaluate and control these risks on an
ongoing basis including after changes to the network such as those listed below, which could
introduce new risks and require additional analysis.
• changes in network configuration
• connection of additional items to the network
• disconnection of items from the network
• update of equipment connected to the network
• upgrade of equipment connected to the network

Introduction
1.5 Symbols
Symbol Meaning Reference
Legal Manufacturer EN ISO 15223-1 and ISO 7000-3082
Date of manufacture EN ISO 15223-1 and ISO 7000-2497
CE sign indicates the conformity with the European REGULATION (EU) European REGULATION (EU)
2017/745 in connection with the number of the notified body. 2017/745
0123: Identification number of the notified body TÜV SÜD Product
Service European REGULATION (EU) 2017/745
Consult Instructions for Use ! EN ISO 15223-1 and ISO 7000-1641
Electronic Instructions for Use To indicate on product or product ISO 7000 - 3500
packaging that relevant information for use of the product is available in
electronic form rather than, or in addition to, printed paper form.
Consult Instructions for Use ! This device is delivered with electronic GE HealthCare crafted symbol
Instructions for Use (eIFU). This electronic IFU can be read with PDF
Reader. The latest version of the Instructions for Use is available on
Internet at: https://voluson-sw.gehealthcare.com/login. A paper copy of
Instructions for Use can be ordered at no additional cost.
United States federal law restricts application to sale by or on the order 21 CFR 801.109 and Alternative to
of a physician. Certain Prescription Device
Labeling Requirements Guidance
to Industry 1/2/2000
U.S. Food&Drug Administration
modified by General Electric for
clarity that this is for the USA
Brand and Model. EN ISO 15223-1 and ISO 7000-2493
Caution, consult accompanying documents. This symbol advises the EN ISO 15223-1 and ISO
reader to consult the accompanying documents for important 7000-0434A
information that cannot be presented on the device itself.
Every system has a unique marking for identification. The UDI marking is ISO 15223-1
part of the product labeling which can be found in the About dialog. Scan FDA 21 CFR 830
or enter the information from these labels into the patient health record
as required by the governing laws.
Batch code EN ISO 15223-1 and ISO 7000-2492
This symbol indicates hints for the user. GE HealthCare crafted symbol

Introduction
Symbol Meaning Reference
This symbol indicates the item is a medical device ISO15223-1
Name and address of the authorised representative’s registered place of Swissmedic

business
Consult accompanying documents. This symbol advises the user to ISO 7010-M002
consult the accompanying documents.
Symbol that is shown on the screen (monitor and/or touch-display) that GE HealthCare crafted symbol
indicates an important information.
Symbol that is shown on the screen (monitor and/or touch-display) that GE HealthCare crafted symbol
indicates a useful information.

Chapter 2
Installation
Installation Requirements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-2

Getting Started - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-3
Installing 4DView - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-4
Uninstalling 4DView - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-7

Installation
2.1 Installation Requirements

In order to be able to install 4DView on a PC correctly, ensure that the requirements listed below are
met:
Component Required Recommended
Processor Intel Core i -series CPU Intel® Core™ i5 or better
RAM 4GB 8GB
Graphics Card Graphic card with 2GB RAM Laptop:

• Nvidia GeForce® GTX 950M
or higher
• Nvidia Quadro M2000M or
higher
• AMD Radeon R9 M280X or
higher
• AMD FirePro W5170M or
higher
Desktop PC:
• Nvidia GeForce® GTX 950 or
higher
• Nvidia Quadro P1000 or
higher
• AMD Radeon RX 460 or
higher
• AMD FirePro W4300 or
higher
Display resolution*) Min. resolution 1280x720 Full HD
Free disk space Min. 20GB Min. 20GB
Operating system Microsoft Windows® 10 64-Bit, Microsoft Windows® 10 64-Bit,

Windows® 11 64-Bit Windows® 11 64-Bit
*) Display resolution: 'Display resolution' on page 8-5.
Optional Components Used for
CD/DVD-Writer Export
External Hard Disk Drive Export

or Flash Drive

Installation
2.2 Getting Started

If a previous version of 4DView is already installed on the system, please uninstall this version before
starting the setup process of the new version. Even if the features of 4DView appear familiar, please
review the chapter about uninstalling (“Section 'Uninstalling 4DView' on page 2-7“) 4DView, as new
features of 4DView have more items which should be removed from the hard disk or can optionally
be preserved for further work.
Note The 4DView setup is digitally signed by GE. Please verify the presence and validity
of the signature before executing the setup.
Note The user needs administrator access or similar rights on the system to install
4DView. Once it is installed the use of 4DView with lower access rights is possible.
Ensure that the system is using a resolution of 1280 x 720 or higher and select “High Color” or “True
Color” display mode in order to get the best results. (True Color is recommended.) Please review the
Microsoft Windows® documentation for details on how to change the resolution of the system. Before
installing 4DView please close all other non-essential Windows® programs.

Installation
2.3 Installing 4DView

If you have bought the full version of 4DView read first 'Start Installation' on page 2-4 and then
'Installation Process' on page 2-4.
For updating an existing 4DView version, access the e-distribution portal here: https://viewpoint-
sw.gehealthcare.com/login. To log in use the credentials provided in 'e-Distribution Portal' on page
10-3. Follow the instructions given there to update 4DView.
2.3.1 Start Installation
Download 4DView from the e-Dristribution Portal (see 'e-Distribution Portal' on page 10-3) and run
the setup file.
Note In case an error message appears see 'Error Messages' on page 8-2 for
instructions.
The following dialog appears:
2.3.2 Installation Process
Please follow the instructions displayed during the 4DView setup process step by step.
If you encounter any problems during installation, please see 'Installation problems' on page 8-2.
Installation Step Required User Input Note
Welcome None -
Customer Correct User Name and -

Information Company must be entered.
Safety Regulations Accept regulations -
Choose Destination Define where to install 4DView -

on your hard disk.
Select Program Define the name of the Program -

Folder folder in the Start menu.
Choose Archive Select where to store images, -

Location volumes and patient data.

Installation
Installation Step Required User Input Note
Select Language Define the preferred language These settings can be changed
for software and help file afterwards. For more
( Instructions for Use information see 'Language
Language). Settings' on page 3-14.
Review Settings Check if all settings are correct, -

then press “Next” to start the
installation.
Finishing 4DView Installation

Start the newly installed 4DView.
The following message appears:
If a dongle was used before a license file has to be generated. Press Generate License File (see below)
to start the process otherwise press Load License File.
Generate License File

1. WhenGenerate License File is pressed the following window appears: Press Start to continue.
2. Enter the Site ID which can be found in the Voluson™ Club registration and press OK.
3. If the Site ID is correct, an account confirmation dialog appears. Press Yes, if the account
information is correct and save the license file.
4. Press OK to close the confirmation dialog and continue with Load License File.
If problems occur the following error messages can appear:
• No or an invalid dongle is connected
• Invalid Site ID
• License file was not saved

Installation
• Dongle already converted
• No connection to license server possible
• Leave the tool without saving the license file
• No account found for entered Site ID
• The account is not a valid 4Dview account.
• Invalid answer from server.
• License information could not be read.
• Invalid server request.
• An unknown error occurred.
Load License File

1. Browse to the license file (.lic) and open it.
When the license file is loaded, the following message appears:
If a wrong license file is loaded a message appears.

2. 4DView starts automatically.
Note If a dialog box appears asking you to restart the system, additional DirectX® 11
components had to be installed. Please reboot your PC before attempting to start
4DView.
2.3.3 4DView Installation on Mac OS
Prerequisites
Boot Camp for Mac
Apple Boot Camp and Parallels v15 or higher (with Windows 10, 64-bit Operating Systems installed)
at a MAC OS.
If Parallels v15 or higher is used to run 4DView, the “Parallels Display Adapter” is selected
automatically in “Settings -> Render devices”. Furthermore it is recommended to set the graphics
configuration for parallels to “Scaled” and to define a resolution of 1920x1200 and a scaling of 100%
in the Windows “Display Settings”.
High performance MacBooks have 2 GPUs, a slow integrated one and a fast dedicated one. Switching
is automatic. To ensure optimal performance this should be switched off in “System Preferences”,
“Energy Saver”, “Automatic graphics switching”.
Note For further information consult the Boot Camp Instructions for Use .

Installation
2.4 Uninstalling 4DView

Note The user needs administrator access or similar rights on the system to uninstall
4DView.
Ensure that 4DView is not running when uninstalling the program.

There are two additional programs associated with 4DView. These applications are Storage SCP and
Transfer. Transfer is used by the DICOM send function of the archiving system. For information on
Storage SCP review the chapter “DICOM Storage Service Class Provider.” in the help file.
The presence of these programs can be detected in the status area of the task bar. The status area is
usually positioned in the lower right corner of the Windows® screen. However, it can also be situated
in the lower left or in the upper right corner.
In this sample the sign of Transfer, an “T” in a square, and the sign of Storage SCP, a colored circle can be
seen.
The colors of
Storage SCP:
For a description of the meaning of the different colors of this circle, review the chapter “DICOM
Storage Service Class Provider” in the help file.
Right-click the icons of these programs and choose exit from the pop-up menu.
Exit both programs and start the un-installation process. Please start setup as described in “Section
'Getting Started' on page 2-3“.
When uninstalling 4DView completely, click the Start Button in your Windows, point to Settings and
click Control Panel. Then double-click “Add/Remove Programs,” select 4DView, click the “Add/
Remove” or “Change /Remove” button and follow the instructions.
At some point during the uninstall process the Uninstall Options dialog appears:
Decide whether to keep
• Archive Images and Reports (with attached data, e.g., volume files, Cine sequences...), which
have been stored with SonoView™ or the Voluson Archive, so that they can be reused after
installation of a newer version of 4DView by checking/unchecking the appropriate check
boxes.
• User-defined Biometry Measurements (e.g., self-defined tables or equations for GA ...). This box
might not be available. Please see “Note” below for details.
• DICOM Configuration
Note If you are uninstalling a 4D Version older than 4.0 (3.0 or 2.1 for example) the
second check box is not available. The reason for this is that it is not possible to
transfer user-defined biometry measurements from an older 4D Version to a
version of 4DView 4.0 and higher. 4DView 4.0 and higher features a completely
new measurement package and requires the self-defined measurements to be
configured again. Patient data and measurement reports will remain available, if
“Images and Reports” is selected.
Note If the archive images are from SonoView™ a dialog is displayed, that explains how
to import the data into the new archiving solution after the installation.
If “Images/Reports” was unchecked, a message appears. It asks whether the user really wants to
delete all the images and reports. Choose “Yes” to continue and delete the images, and “No” to
return to the previous screen. In the latter case, the checkbox “Images/Reports” is checked
automatically.
Continue to click “Next” till the uninstallation process is finished. Exit by pressing the “Finish” button
when it appears.

Installation
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Chapter 3
Menu Functions
File Menu - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-2

Edit - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-6
View - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-7
Settings - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-10
Help - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-17

Menu Functions
3.1 File Menu
3.1.1 Menu items
Using the “File” menu on the menu bar, it is possible to select one of the following functions:
Toolbar Menu item Description

Icon
Open By selecting the Open function, an Open File window will

appear. This enables selection of a directory and opening of
volume files.
The volume file has the format VOL_NAME.VOL.
When selecting a volume file, a preview image in JPEG( For
more information see 'Glossary' on page 9-2. ) format and
detailed information such as date, patient ID and clinic name is
shown at the lower part of the “Open File” window.
Close This menu item closes the current volume data set.
Save Saves a volume file to a given directory. For more information

see 'Save options' on page 3-5.
Patient ID Press this button to open the "Current Patient" dialog.
Archive Archive (For more information see 'Archive' on page 6-8. ) is

initialized, or brought to the foreground if it is already active.
Save to The volume file is stored in the Archive (For more information
Archive see 'Save to Archive' on page 6-23. ) database system.
DICOM Send By selecting the DICOM Send function, the current image is
sent to a DICOM Server , or to another PC which is equipped
with 4DView.
For more information about sending a DICOM image or
volume, review “Sending a DICOM Image” (For more
information see 'DICOM Send' on page 7-7. ).
DICOM Print By selecting the DICOM Print ( For more information see 'DICOM
Print' on page 7-10. ) function, the current image can be
printed on a DICOM printer.
Send Email Press the button to open the Send Email dialog and select the
sending criteria (receiver, options,...).
Store to Press the button to open the Tricefy send dialog. (This button is
Tricefy only visible when Tricefy is activated.)
Share with Press the button to transfer the currently loaded data set to a
Patient via patient email or phone number. (This button is only visible
Tricefy when Tricefy is activated.)
Export 3D A Cine sequence that has been calculated previously, can be

Calc Cine saved for viewing later on. The file is saved as an AVI file, so
Sequences that it can be viewed using a standard Microsoft Windows® 10
64-Bit, Windows® 11 64-Bit player. In order to save the file,
simply specify the directory, filename and save options (see
'Save options' on page 3-5).

Menu Functions

Icon
Export 4D A 4D image sequence can be saved for viewing later on. The file
Image Cine is saved as an AVI file, so that it can be viewed using a standard
Sequences Microsoft Windows® 10 64-Bit, Windows® 11 64-Bit player. In
order to save the file, simply specify the directory, filename
and save options (see 'Save options' on page 3-5).
Export This menu item enables the user to capture the graphic
Graphic window and save its contents as a bitmap file to the disk. For
more information see 'Save options' on page 3-5.
Export Mesh This menu item opens a Save as dialog for exporting mesh
(e.g. for 3D printing). Available file formats include:
• STL File Format (*.stl)
• Stanford Polygon File Format (*.ply)
• Alias Wavefront Object File Format (*.obj)
• Point Cloud File Format (*.xyz)
• 3D manufacturing Format (*.3mf)

Available quality controls include High, Mid and Low.
The following types are available:
• Full mesh - full depth exported volume
• Projected mesh - surface (flat) exported volume
Copy to This menu item copies a screen capture of the current view to
Clipboard clipboard. Alternatively, you can press Ctrl+B.
Annotation Press this item to open the "Annotation" menu.
Clear Press this item to delete all annotations.

Screen
Help Topics Press this item to start the 4DView help.
Print This item enables the user to print the entire graphic output
window of 4DView.
Print Select this to show a preview of how the image will be printed.
Preview
Print Setup This menu item allows configuring of printer settings, such as
paper orientation (portrait or landscape) or paper format, and
enables the selection of different printers.
"Recent The latest closed file can be opened again using this menu
File” item.
Exit When this menu item is chosen, 4DView will exit to Microsoft
Windows® 10 64-Bit, Windows® 11 64-Bit.
3.1.2 Email Send
Press this button to open the Send Email dialog

Menu Functions
To Enter email address.
Options • Request a Read Receipt
• Request a Delivery Receipt
• Send a Copy to me
Subject Enter a subject or edit the previously stored one.
Note The subject line is cleared after every email.
Message Enter a message or edit the previously stored one.
Subject & Message A default subject and message (configured in the email
system setup) can be entered by clicking Default. Clear
deletes the subject and the message input field.
Press Send to send data or Cancel to cancel the process.
Click this button to open the Email Options dialog.
Email send mode Select the desired Email send mode (normal, anonymized,
Password protected zip archive).
Password Choose a Password. (Only available for the Email send mode
"Password protected zip archive".)
Send as JPG format only is selected.
Cine SE/ES Check to send a cine from Start to End and End to Start.
Size Select the desired size. (The second values are for XLScreen
records.)
Quality Select the desired Quality (low, mid, high)

Menu Functions
Press Cancel to leave the menu or OK to apply the changes.
3.1.3 Save options
Volume save options

Save Options:
In the volume file a 3D Calc Cine, a 4D Image Cine or a 4D Volume Cine can be included, if these are
available. Save the volume in 3D Cartesian Volume format, by selecting the appropriate option (only
enabled in Render Visualization Mode).
Wavelet Compression:
The volume files can be compressed using Lossless or Lossy compression. To save the file
uncompressed, select None.
Compression Quality:
If lossy compression is selected, it is possible to choose the compression quality. The higher the
quality number the better is the quality of the compressed file but the smaller is the compression
rate.
Note If a file is loaded that was created using lossy compression, “Wxx” is displayed in
yellow text in the 3D/4D info block, where xx is the compression quality.
Cine save options

Save SE /ES
If the Save SE / ES check box is checked the sequence will be played back from start to end and from
end to start.
Compression
Check the “Compression” check box to compress the avi file.
Note Compressed avi files contain the text “COMP” to indicate lossy compression.
Reduction
Set the “Reduction ” up to a maximum of 1: 2.50 to reduce the size of the calculated movie.
Graphic save options

Save as Type
Select whether to export the image in uncompressed bitmap or JPEG format.
Quality
Select the quality of the JPEG image.

Menu Functions
3.2 Edit
It is possible to select the following items from the “Edit” menu on the menu bar:

Icon
Patient ID Display and edit patient and exam data ( For more information
see 'Current Patient Dialog' on page 6-3. ).
Annotation Open the annotation menu (see For more information see
'Annotation' on page 4-72. ) in order to place text and arrows.
Clear Remove all annotations (text and arrows).

Screen

Menu Functions
3.3 View
In the “View” menu on the menu bar the following items are selectable:
3.3.1 Histogram
Click the menu item “Histogram”, to display a histogram of the ultrasound intensities.
Histogram Display
The calculation is possible in the “3D Image Rendering” display modes and in the “VOCAL II” display
modes. The calculation of a histogram is possible in the “Render” and “VOCAL II” display modes only
for “B”, "Color Flow Mode", "Tissue Doppler", “Power Doppler” and "HD-Flow™" mode volumes. For
an overview of display modes, review “Visualization Types” ( For more information see 'Visualization
Mode - Multiplanar' on page 4-15. ).
3D Image Rendering Display Modes:

The histogram is calculated from the content of the Region of Interest (ROI) ( For more information see
'How to Position the Render Box' on page 4-7. ).
VOCAL II Display Modes:

If a shell ( For more information see ' VOCAL ' on page 4-29. ) is defined, the histogram is calculated
from the content of the shell. If a contour without a shell is defined, the histogram is calculated from
the content of the contour.
Histogram 2D
The Histogram 2D is available for Render, Multiplanar and VOCAL modes (not in single format).
When Histogram 2D is selected, a yellow circle appears. It is possible to move the circle with the
mouse and adjust its size with the radius control. The area defined by the circle is used for
calculating the histogram.
Explanation of displayed values:

MG Mean Gray Value (vertical red line)
VI Vascularization Index
FI Flow Index (vertical red line)
VFI Vascularization Flow Index
Sample display (Power-Doppler/Angio):

Menu Functions
In color histograms it is possible to suppress low speed values by increasing the “Power Threshold”
in the “Image Settings” ( For more information see 'Power Threshold and Power Balance' on page 4-
65. ) dialog.
Formulas
Definitions
g gray-scale value in ultrasound image normalized to 0 -100 low intensity - 1 high intensity - 100
c color value in ultrasound image (ANGIO mode) normalized to 0 - 100 low intensity - 0 high intensity
- 100
hg(x) frequency of gray value x in ultrasound image
hc(x) frequency of color value x in ultrasound image (ANGIO mode)
3.3.2 Threshold Volume
This menu item is only available if a VOCAL II contour is available. It displays the result window of the
Threshold Volume measurement utility.For more information see ' VOCAL ' on page 4-29.
3.3.3 Probe Orientation
This menu item is only available if probe orientation information is available in the data set. For more
details on how to include probe orientation information in the data set please review the Voluson™
Family system’s Instructions for Use .
If this item is selected, the probe orientation menu is displayed.

Menu Functions
Click the “Remove Probe Orientation” button to remove the probe orientation information from the
file.
Attention: Removing the probe orientation information cannot be undone. Be sure to really want to
loose this information before choosing this action.
3.3.4 3D Frame
Check this menu item to show the bounding box and reference line in the 3D image.
3.3.5 DICOM Queue
For more information see 'DICOM Transfer Status' on page 7-12.
3.3.6 Email Queue
The Queue Status window displays all email transfers which have not been sent, are being sent at the
moment or failed. (Successful transfers are deleted from the list).
3.3.7 Toolbar
A toolbar that provides shortcuts to commonly used software features is situated on the left. Toggle
display on or off using this menu item.
3.3.8 Status Bar
A status bar can be displayed in the bottom that provides information about the loading progress of
volume files, or indicates whether the program is busy otherwise. Toggle display on or off using this
menu item.
3.3.9 Contrast Clock
When a 4D/Contrast data set with an activated contrast clock is reloaded, the contrast clock is
displayed (T1 = mm.ss). Running the 4D Auto Cine shows the corresponding contrast clock time.

Menu Functions
3.4 Settings
The “Settings” menu on the menu bar allows the manipulation of various parameters.
3.4.1 HD Rendering
To enable this setting a DirectX® 11-enabled graphics adapter has to be installed on the PC.
HD Rendering enables the following software features:
• Skin Texture + Skin Smooth Render Modes
• Improved Glassbody Rendering
• Color Depth Rendering
• SRI
3.4.2 Render devices
Select one of the available Render devices:
• If two proper VGA Cards are installed, select the desired one.
• If only one VGA Card is installed, select either this one or the Microsoft® Warp Rasterizer.
3.4.3 Worksheet All Pages
Enable this setting to include all pages of the worksheet when DICOM sending, DICOM printing or
saving it to the Archive.
3.4.4 TUI one by one
Checking this menu item causes 4DView to send, print or store every TUI slice as separate image.
Affected functions:
• Saving images to the Archive (not applicable on volume files)
• Printing images
• Sending images via DICOM
3.4.5 Use Tablet for Measurements
Check this item if you are using a graphic tablet instead of a mouse for measuring.
Note It is recommended to use this setting also when running 4DView on a non -
Windows® PC by means of emulation software.
3.4.6 ROI Direction
Select different view directions ( For more information see 'How to Position the Render Box' on page
4-7. ).
3.4.7 Date Format
Select one of three possible date formats by pressing the appropriate button. The selected choice is
used whenever a date is displayed in 4DView.

Menu Functions
Examples:
• YYYY/MM/DD: e.g., 2008/12/06
• MM/DD/YYYY: e.g., 12/06/2008
• DD.MM.YYYY: e.g., 06.12.2008
Note Depending on the selected date format all date fields are prefilled with dd/mm/
yyyy. A message appears when an entered date is out of range (i.e. DOB,...)
3.4.8 Infoblock Settings
Choose to display detailed acquisition information (“Long Format”), basic acquisition information
(“Short Format”) or to switch off (“Off”) acquisition information completely.
Examples:
Long Format Short Format Off
Note Not all information is displayed in all modes. Older volumes, i.e. volumes acquired
with a software version smaller than 3.1.0, do not contain all information.
Therefore, the information displayed is not very detailed for these older cases.

Menu Functions
For more details on the meaning of the displayed information, please refer to the Voluson™ Family
system’s Instructions for Use .
3.4.9 Patient Dialog Settings
On Start Exam
By checking the relevant check boxes you can select several tasks to be performed on pressing the
“Start Exam” Button in the Current Patient Information Dialog ( 'Current Patient Dialog' on page 6-
3 ). “Save to Archive” automatically saves the patient dialog ( 'Save to Archive' on page 6-23 ).
“Send to DICOM Server” sends it to the selected DICOM Server ( 'DICOM Configuration' on page 7-2 )
and “Send to DICOM Printer” adds the patient dialog to the printing queue ( 'DICOM Print' on page 7-
10 ) of the selected DICOM printer ( 'DICOM Configuration' on page 7-2 ).
Exam Table Columns

The two dropdown lists titled Patients & Exams define which informations are displayed in the user-
definable columns of the exam table when the Patients & Exams view is active. Use the lower
dropdown list to define content of the last column in Exam only view. For more information see
'Archive' on page 6-8.
2nd Patient ID
Default setting is “Off”. If regulations in your country demand that you file your patient data with a
national identification number, select it from the dropdown list. If your country’s system is not
explicitly supported use either “Letter and Number” (no special characters allowed) or “Any” (all
characters allowed).
OB dating method
Select the desired OB dating method:
• LMP (default)
• EDD
• DOC
• GA
Other Patient Dialog Settings

Uncheck the “Show all Patients” option if you want to display all patients that are stored in the
archive only after clicking the “Show All” Button in the patient dialog. For more information see
'Search Area' on page 6-8.
Select to calculate the DOC (Date of Conception) from the given GA (Gestational Age). By placing a
checkmark next to “Calculate DOC by GA”.
Select to calculate the Day of Cycle by LMP (last menstrual period). By placing a checkmark next to
“Calculate Day of Cycle by LMP”.
Turn on or off Auto-Capitalization of first letter (in field, after blank, after dash) of the patient names
(first, middle, last) in the Patient Dialog ( 'Current Patient Dialog' on page 6-3 ).
3.4.10 Title Bar Settings
Font Size & Brightness

Adjust size and brightness of the font used for displaying the patient information in the title bar.
Patient Info
At the top of the graphic output window of 4DView there are two lines of patient information
including “Patient Name” and “Patient ID”,....

Menu Functions
Note GA is only shown if the application selected in the “Patient Information” dialog
(For more information see 'Application Area' on page 6-4. ) is “OB”. If the
application is “Gyn” the LMP is shown in this place.
In order to protect the privacy of a patient, the graphic output window can be shown without that
information. Only the output of this information is suppressed. The information is preserved in the
volume file and in the Archive database.
Check or un-check “Patient Info” to show or to hide these two lines of patient information.
Other Title Bar Info

Un-check this menu item to hide other info (e.g. the name of the sonographer, the name of the
hospital etc.) in the title bar.
Date and Time

Un-check this menu item to disable the display of date and time in the title bar.
3.4.11 Annotation Settings
Open the annotation settings dialog ( For more information see 'Annotation Settings' on page 4-73. )
which allows to adjust the following parameters:
Arrow Size: Select one of the three sizes by pressing the appropriate button.
Brightness: Select between “100%”, “90%” and “80%”. Setting applies to text as well as arrows.
Text Font: This button opens the “Font” dialog where font, font size and font style can be selected.
Text Presets: Opens the “Text Preset Settings” dialog.
Cancel: Close dialog without saving changes.
OK: Close dialog and save changes.
Text Preset Settings

Choose an “Application” and select one of the two available pages by pressing the “Page 1” or “Page
2” button. Afterwards simply enter the new preset in one of the empty fields below or edit an existing
preset by editing the according text field.
3.4.12 Measure Setup
For more information see 'Measurement Setup' on page 5-21.
3.4.13 DICOM Configuration
Define DICOM settings ( For more information see 'DICOM Configuration' on page 7-2. ).
3.4.14 Archive Configuration
The settings here influence the way images, cines and volumes are stored in Archive.
Archive location: Choose either to store the archive locally or on a shared location. To define an
external archive type the network path in the text field or select a folder after pressing the Change...
button.
Image Compression: Select the type of compression used when storing images in Archive. If “JPEG”
(For more information see 'Glossary' on page 9-2. ) is selected, the images are saved JPEG-
compressed. If “None” is selected, the images are saved uncompressed.
Image JPEG Quality: This selection is only available if “Image Compression” is set to “JPEG”(For
more information see 'Glossary' on page 9-2. ). It sets the compression quality for images stored in
the Archive. If “Lossless” is selected, lossless compression is used, i.e. the files become smaller, but
no quality is lost. If a lossy compression (High, Mid, Low) is selected, a caution appears. The reason
for that is that the image quality is reduced. The use of lossy JPEG compression is also indicated in

Menu Functions
the saved image. A yellow indicator appears at the top left corner of the saved image (only
ultrasound images, not patient dialog or report). It displays “JPEG” for JPEG compression.
Image Cine Compression: Choose if compression is used for storing cines For more information see
'Glossary' on page 9-2. ) as Multiframe and 4D Img. Cine(For more information see 'Glossary' on
page 9-2. ) as Multiframe). Either select “JPEG”(For more information see 'Glossary' on page 9-2. )
or “None”.
Image Cine JPEG Quality: Set the compression quality for cines. If “Lossless” is selected, lossless
compression is used, i.e. the files become smaller, but no quality is lost. If a lossy compression (High,
Mid, Low) is selected, a caution appears. The reason for that is that the image quality is reduced. The
use of lossy JPEG compression(For more information see 'Glossary' on page 9-2. ) is also indicated in
the saved image. A yellow indicator appears at the top left corner of the saved cine. It displays
“JPEG” for JPEG compression.
Volume Compression: Set the compression quality for Volume files. Select between “None”,
“Lossless” or “Wavelet Lossy”. If “Wavelet Lossy” is selected, a caution appears that this setting can
lead to reduced image quality.
Volume Wavelet Quality: Only available if Volume Compression is set to “Wavelet Lossy”. Select
between “High, “Mid” or “Low”.
Save 3D/4D Cine as: You can select between “Raw” or “Multiframe”. The internal “Raw”-Format
provides full functionality in case of a reload, though the “Multiframe”- Format can be reviewed as
2D-Cine on most DICOM platforms.
Reloaded Image Save Mode: Choose either to overwrite reloaded images, save a copy or display a
dialog every time a reloaded image is about to be saved.
Copy Position: When a reloaded image is saved as a copy, this option defines if the copy will be saved
after the original or at the end of the exam's image list.
The Default button in the lower right corner sets all options to the recommended values
3.4.15 Email Configuration
Enter your Identity, the SMTP Server Settings, a Default Subject / Message and Options as needed.
Emails contain JPEG format for images and MP4 format for cine sequences.
3.4.16 Language Settings
Select the Program language and the Instructions for Use Language (from Language Settings 'Help'
on page 3-17) of 4DView from the dropdown lists.
Note You have to restart 4DView for the program language setting to take effect.

Menu Functions
3.4.17 Select Skin
Select one out of three different skin displays.

1. Press Select Skin. A dialog window appears
2. Select the desired skin display.
3. Restart the program to activate the selected display.
3.4.18 Tricefy™
Tricefy™ is a cloud based image viewer and a platform to archive, collaborate and share images, clips
and reports.
Note For using Tricefy™ it is necessary to have an installed Tricefy™ uplink and a proper
internet connection.
Using Tricefy™
Open Tricefy™ at the Settings menu and enable it. As soon as Tricefy™ is activated, the buttonDICOM /
Tricefy Send appears within the Archive and the button Transfer to Tricefy™ appears at the
Worksheet to send/store data.
With at the toolbar it is possible to store data to Tricefy™.
With at the toolbar it is possible to share data with a patient.
Note Enter the patient's email address or phone number at the Patient Dialog to share
data.
At the Archive it is possible to store or share single/multiple image(s), single/multiple exam(s) or

patients with the DICOM/Tricefy Send button.
For sending a DICOM Structured Report to Tricefy™ use the Transfer to Tricefy button at the
Worksheet.
Note Structured Reports cannot be shared with the patient.
Connection with Tricefy™

Press the Test connection button in the Tricefy™ settings dialog to test the connection to Tricefy™.
• green badge - connection ok
• orange badge - connection failed

The status bar displays the current connection to Tricefy™:
Connected to Tricefy™, ready to store and share.
Disconnected from Tricefy™.
Registration incomplete.
With the Get account info button it is possible to check the current account status.
1. green badge: connection ok:

Menu Functions
2. green badge: connection incomplete:
3. orange badge: connection failed:

Menu Functions
3.5 Help
Press Help and select the desired menu:
• Instructions for Use
• Export System Info
• About 4DView
3.5.1 Instructions for Use
Select Instructions for Use... to open the electronic Instructions for Use file in the selected language.
Note F1 also opens the Instructions for Use .
3.5.2 Export System Info
Select the menu item Export System Info... to create a password-protected file with the information
of your system.
3.5.3 Load License File
Note To sync Voluson™ options with 4DView it is necessary to update and reload the
license file.
Select the menu item Load License File... to import a new license file.
1. Press Load License File... in the Help menu to reload the license file and repeat the steps in
'Installation Process' on page 2-4- Load license file.
2. The following message appears:
3. Press OK and restart 4DView.
3.5.4 About 4DView...
Choose this item in order to display the 4DView About dialog.

Normally, this is used for finding out which version of 4DView is installed on the system. The
corresponding REF, LOT and UDI information is displayed on this dialog. Press the Close button to
close the screen.
For country specific regulatory information please use the drop box to select the corresponding
country.

Menu Functions
Cybersecurity Bill of Materials (CBOM)

Cybersecurity Bill of Materials (CBOM) – a list that includes but is not limited to commercial, open
source, and off-the-shelf software and hardware components that are or could become susceptible
to vulnerabilities.
To display the CBOM information together with third-party software information click onto Third-
party Software within the About dialog.

Chapter 4
Working with Volume Data
Demo Cases - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-2

Rotation and Reference Slices - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-3
Visualization Mode - Render - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-14
Visualization Mode - Multiplanar - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-15
Visualization Mode - TUI - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-26
Volume Analysis Modes - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-29
Render Modes - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-43
Cine Sequences - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-51
Image Settings - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-63
MagiCut - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-68
Annotation - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-72

4.1 Demo Cases

To explore the possibilities of 4DView a set of up-to-date demo cases can be downloaded from
www.volusonclub.net.
4.1.1 How to import downloaded demo cases
Download the demo cases from the “Tools” section on www.volusonclub.net as.zip files. Extract
the .vol files to your hard disk.
Use the “Open” function from the file menu (For more information see 'File Menu' on page 3-2. ) to
view the cases in 4DView.
You may also save them to the archive (For more information see 'Save to Archive' on page 6-23. ) for
easier access.

4.2 Rotation and Reference Slices
4.2.1 Rotation and Translation
The mouse and slider bars are available to rotate the image slices and the 3D/4D image, which makes
it possible to obtain an improved view of the object of interest. The availability of the rotation
function differs with the different display modes.
Mouse Functionality
For rotation around the X-axis, place the cursor on the left or right border of the selected image, keep
the left mouse button pressed and move up and down as soon as a double-pointed vertical arrow
appears.
For rotation around the Y-axis, place the cursor on the top or bottom border of the selected image,
keep the left mouse button pressed and move left or right as soon as a double-pointed horizontal
arrow appears.
For rotation around the Z-axis, place the cursor close to the center of the selected image, keep the
left mouse button pressed and rotate as soon as a circle appears.
In order to move the entire image, place the cursor within the selected image plane, keep the right
mouse button pressed and move the mouse as soon as a hand-shaped icon appears.
Note In the TUI modes ( For more information see 'TUI Standard' on page 4-26. ) only
the reference image (marked with a green star in the upper left corner) can be
manipulated.
Slider Functionality:
The following sliders can be used instead of the mouse.
Using the mouse, simply drag the bar to the left or the right for a rotation in the negative or positive
direction, respectively. The angle of rotation is displayed above the slider, as can be seen in the
example above for the rotation around the Z-axis.
Note In Render Mode, you can adjust the sectional planes only when Fixed ROI is
activated. The rendered image cannot be moved translationally.
4.2.2 Init Functions
All images can be reset to their initial state with the All button.
Press the 3D tilt button in Render mode to tilt the 3D image slightly to get a more perspective view.
Press the button, which is now named 3D frontal, again to get a frontal view of the 3D image.
In Render mode, after accepting the ROI, you can press the Sect Planes button to only align the
images A, B and C to their initial position. The 3D image remains unchanged.

4.2.3 Reference Images
Reference Image A
Selected reference image is sectional plane A

For instructional purposes assume that the following orientation of the region of interest is selected:
For more information about the selection of the view direction review: “Menu
Functions -Settings” ( For more information see 'Settings' on page 3-10. ) and
“Rotation and Reference Slices - How to Position the Render Box” ( For more
information see 'How to Position the Render Box' on page 4-7. ).

With this orientation of the region of interest, plane A is in parallel direction to the displayed 3D
image. Therefore, there is no intersection between plane A and the 3D image. The dots in image A
and in the 3D image are equal in horizontal and vertical position, but different in depth position.
These two dots are situated on the intersection line of plane B and plane C.
Adjust the depth position of plane A:

The depth position of plane A can be changed by using the “Ref Slice” slider.
For more information about reference slices review “Rotation and Reference Slices - Reference Slices”
( For more information see 'Reference Slices' on page 4-11. ).
Reference Image B
Selected reference image is sectional plane B

For more information about the selection of the view direction review: “Menu Functions - Settings”
( For more information see 'Settings' on page 3-10. ) and “Rotation and Reference Slices - How to
Position the Render Box” ( For more information see 'How to Position the Render Box' on page 4-7. ).

With this orientation of the region of interest, plane B is in orthogonal direction in relation to the
displayed 3D image. The vertical green line indicates the position of plane B in the 3D image (see
picture above).
Adjust the position of the green line within the 3D image:

Place the mouse cursor on the green line and press the right mouse button for positioning the line
(parallel movement of image B).
For more information about reference slices see: “Rotation and Reference Slices - Reference Slices”
Reference Image C
Selected reference image is sectional plane C

For more information about the selection of the view direction review: “Menu Functions - Settings”
( For more information see 'Settings' on page 3-10. ) and “Rotation and Reference Slices - How to
Position the Render Box” ( For more information see 'How to Position the Render Box' on page 4-7. ).

With this orientation of the region of interest, plane B is in orthogonal direction in relation to the
displayed 3D image. The vertical green line indicates the position of plane B in the 3D image (see
picture above).
Adjust the position of the green line within the 3D image:

Place the mouse cursor on the green line and press the right mouse button for positioning the line
(parallel movement of image C).
For more information about reference slices see: “Rotation and Reference Slices - Reference Slices”
Display of Image Plane Intersection Point

A yellow dot signifies the intersection point of the three image planes in the rendered image. It is
visible when Fixed ROI is off and the intersection point has been moved in one of the image planes.
4.2.4 How to Position the Render Box
General Info
The render box determines the ROI ( For more information see 'Glossary' on page 9-2. ) for the
3D/4D calculation and determines the direction of view through the volume block. The adjustment of
the render box is done with the help of the three orthogonal planes A, B and C, which cut through the
center of the render box in all three directions.
The direction of view used in the example below is the same as if the highlighted orientation (top
row, center) of the region of interest was selected:
Plane A: The viewing direction is orthogonal to plane A.

Plane B: The viewing direction is from left to right with respect to plane B.
Plane C: The viewing direction is from bottom to top with respect to plane C.
The green line of the render box in the planes B and C symbolizes the direction of view and the
border for starting the analysis.
Display on the monitor (schematic):
Position of the sectional images relative to the ROI ( For more information see 'Glossary' on page 9-
2. ):
If the “VOCAL Contour Mode” is activated the intersection curves between the shell geometry and
the different image planes A, B and C are displayed instead of the volume render box. The rendered
3D image is not shown, only the shell geometry is visualized.
Adjust the Size of the Render Box

Select reference image A, B or C.
Slider controls and mouse controls are assigned to the reference image for the adjustment of the ROI
( For more information see 'Glossary' on page 9-2. ).
Additionally, the size (=3D resolution) of the render boxes can be adjusted with the mouse by
positioning the cursor on one of the edges of the box, keeping the left or right mouse button pressed
and moving the mouse. This can be done in any of the three sectional planes and in the rendered
image itself.
Note The benefit of a smaller box is less calculation time.
If the “VOCAL Contour Mode” is activated, adjustments of the render box are impossible.

Adjust the Curvature of the Render Box

Using the curved render start is an intuitive way of adapting the render box to the anatomical
structures in the data set. The render start can be modified so it becomes a smooth convex or
concave curve. This is used to increase the quality of the rendered image of a 3D or 4D acquisition
and reduce post processing time. Typical applications: First Trimester Scans and detailed studies of
the spine.
View the three images below to understand how the curvature of the render box effects the rendered
image:
Position the mouse over the “x” on the green line, hold the left mouse button pressed and move the
mouse in order to change the curvature of the render start.
Adjust the Contents of the Render Box

The selected images in the planes A, B or C can be positioned relative to the render
box by placing the cursor within the image, keeping the right mouse button
pressed and moving the image (a hand-shaped mouse cursor appears).
Adjust the Magnification of the Rendered Image
The magnification control changes the size of the box"s contents within image A, B, and C relative to
the render box.
Rotate the Contents of the Render Box

The rotation controls rotate the box"s contents relative to the render box. The mouse can also be
used to rotate the images.
Important: The direction of view of the rendered image is selected with the rotation controls.
For rotation, mouse and slider control, see “Rotation and Sliders” ( For more information see 'Rotation
and Translation' on page 4-3. ).
Adjust the View Direction of the Rendered Image

The menu item “Settings - ROI Direction” ( For more information see 'Settings' on page 3-10. ) allows
the definition of six different view directions for the rendered image. The direction of view is
symbolized by a green line in the graphic shown on each slice. The frame around the enabled
direction of view changes from gray to white, as can be seen in the image below. Another example is
given at the beginning of this section.

See also the menu item “Settings - ROI Direction” ( For more information see 'Settings' on page 3-10. ).
Sono Render Live

Use Sono Render Live to automatically adjust the render curve to easily separate solid tissue in front
of the render object. The algorithm looks for the transition from liquids to solid tissue. The Render
Box size transverse to the render direction and the Render Box position will not be changed.
Click the Calc button to calculate the render curve. If no valid render start area can be found a
warning message appears. Re-position the render box and try again. Use the Undo button if
necessary.
Note The availability of some functions or features depends on the probe and
ultrasound system used. Please see the Instructions for Use of your ultrasound
device for further reference.
Note Data sets created before 4DView 16 are displayed with the former name Sono
Render Start and the controls Calc and Undo.
90 Degree Adjustment of the Rendered Image

With this control adjustment of the render image position--left/right or up/down--without changing
between the image planes A, B and C can be made.
If “VOCAL II” is enabled this control is hidden and set to the up position.

Position Up: Position Right:
Position Down: Position Left:
4.2.5 Reference Slices
Using the 4DView software, it is possible to prepare for a parallel translation through a data set in
each plane, by simply rotating the image to the desired angle, and selecting the appropriate
quadrant.
There are two ways in which this parallel translation can be accomplished: Using the Reference Slice
slider or using the mouse.
The Reference Slice slider bar is available in all display modes except “Full-Screen Mode”.
Note The functionality of the reference slider is always with respect to the image shown
on the screen.
A parallel movement through a certain image is defined as:

Image A: Moving from front to back through the volume.
Image B: Moving from left to right through the volume.
Image C: Moving from top to bottom through the volume.
3D Image: Moving from front to back through the volume.
The above slider is the Reference Slice slider for reference image A. By moving the slider with the
mouse, it is possible to move from the front to the back of the entire volume. If another reference
image (B or C) is selected, the text within the slider changes accordingly (Left/Right, Top/Bottom).
When the slider is moved the distance of the currently displayed reference slice to the last reference
slice is displayed in mm.
In “Multiplanar Mode” and “Multiplanar Full-Screen Mode”, it is possible to move through the image
with both slider and mouse functions.

By keeping the left mouse button pressed near the reference point which is located in each of the
three image quadrants, the particular reference point chosen can be moved on the slice by moving
the mouse.
The reference points in the other quadrants will show in which direction movement occurs (not in
“Full-Screen Mode”). The movement in one plane will affect the other planes accordingly.
In order to use the slider, simply activate the desired quadrant with the mouse, and then move the
slider using the mouse.
In “3D/4D ROI Mode” only the slider bar can be used. The images move and the reference points stay
fixed. Because of this, and the fact that the ROI ( For more information see 'Glossary' on page 9-2. )
can still be altered, the rendered image is affected by movements in the image slices. One border line
of the ROI ( For more information see 'Glossary' on page 9-2. ) is green (as can be seen below),
which indicates the direction of view for that quadrant. As the image intersects this line, the view of
the rendered image changes.
As the image moves from right to left, the ROI box cuts through the image.
In “3D/4D Full-Screen Mode” only the slider bar can be used. Moving the slider bar affects the 3D/4D
image in the same way as selecting reference image A and moving the slider bar in “3D/4D ROI Mode”
would.
In “VOCAL II Mode” curves representing the shell geometry are displayed instead of the volume
render box. Instead of the rendered image the shell geometry is visualized.
In “3D/4D Plane Adjustment Mode” both the slider and the mouse functionality are available.
Depending on the ROI direction ( For more information see 'How to Position the Render Box' on page
4-7. ), a green reference line will be active on the rendered image as soon as a quadrant is selected, as
is shown below.
The image above contains a reference line for movement from left to right.
If the “VOCAL Contour Mode” is activated, the 3D/4D image displays a shell contour.
Using either the mouse or the slider, the green reference line can be moved in order to cut through
the 3D/4D image. The selected quadrant displays the parallel movement. The movement can be

achieved by positioning the mouse cursor near the green reference line, keeping right or left mouse
button pressed and moving the mouse in a motion that is perpendicular to the reference line.
The reference points in the other image slice quadrants move accordingly.
By positioning the cursor near the reference point in one of the image slice quadrants and keeping
the right mouse button pressed, the reference points can be moved instead of the green reference
line. The green vertical reference line in the 3D/4D image then represents the plane in which the
reference point is moving (in the above case, the vertical plane).

4.3 Visualization Mode - Render
Select the desired screen layout (4 different layouts available).
4.3.1 Fixed ROI
After selecting the Render button in the main menu, Fixed ROI Mode is active. This mode is used to
adjust the volume render box. The volume render box determines the ROI for the 3D/4D calculation.
It is displayed in the orthogonal planes A, B and C. For more information see 'How to Position the
Render Box' on page 4-7.
After you are done adjusting the render box, press the Fixed ROI button to lock the current state of
the Render Box.
4.3.2 Render Modes
Press this button to select different render modes. For more information see 'Render Modes' on page
4-43.

4.4 Visualization Mode - Multiplanar
The following imaging modes are available:

Multiplanar Mode - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-15
Omni View - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-15
VCI-A - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-18
Niche - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-19
SonoVCAD™labor - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-20
STIC M - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-24
4D-AMM - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-25
4.4.1 Multiplanar Mode
The following display formats are available:
Normal mode
Select the Multiplanar button in the main menu. This mode does not permit changing of the ROI
('Glossary' on page 9-2), and displays no rendered image. It allows viewing and parallel movement
through the image slices. ( 'Reference Slices' on page 4-11 )
Static VCI mode
In VCI mode the VCI algorithm is applied to the image slices. VCI displays a “Pseudo-2D” image which
is created by using a very small render box in order to create a contrast-enhanced image plane. For
more information please review the Voluson™ Family Instructions for Use .
The “Full-Screen View” of a single image slice can be activated by selecting the “Full-Screen” button.
It allows viewing and parallel movement through the slices of a single image. (Review: “Reference
Slices” ('Reference Slices' on page 4-11 )
Note The image can be inverted 180°.
Multiplanar Mode with Volume Orientation
In addition, the orientation help figure can be displayed in the lower right quadrant of the image by
clicking on “Orient. Help”. It shows the current position of the image plane.
4.4.2 Omni View

Omni View is an improved version of VCI-C. With Omni View you can define your own sectional planes
by drawing reference lines of different types in the A image plane. The direction of view is symbolized
by a human head symbol.
Note SingleView data sets are displayed in SingleView mode.
Menu controls
Select the current reference line.
Clear all lines from the volume.
Reload the last state of the current reference line.
Select the type of Omni View line. Changing the type deletes
the current reference line.
Enable Volume Contrast imaging.
Enter the Omni View sub menu.
Display formats
Choose between Quad, Split-Screen and the Full-Screen display format.
In Quad mode the A plane and the Reference Line planes are displayed at once.
In Split-Screen mode the A plane is on the left and on the right is the processed image plane of the
current Reference Line is displayed.
In Full-Screen mode only the processed image plane of the current Reference Line is displayed.
Reference line types

Line - A straight line defined by a start and end point.
Curve - The Curve line is defined by three points. First set start and end point, then the point which
defines the curvature.
PolyLine - The curve form PolyLine consists of at least three user-defined points.
Trace - A Trace reference line automatically aligns itself to structures in the image.
Drawing reference lines

Draw reference lines using the mouse:

Set the points of a line using the left mouse button.

To finish drawing a PolyLine or Trace line, click again after you set the last
point.
Use the right mouse button to cancel drawing a Line or undo the last
point when drawing a Curve, PolyLine or Trace reference line.
Transforming reference lines
Mouse Functionality:
Move the mouse cursor over the current reference line in the A image
plane and it changes its shape to look like the two arrows on the left.
Now press the left mouse key, the yellow arrow disappears and the cursor
looks like the double-pointed arrow on the left. By moving the mouse up
and down while pressing the left mouse key the reference line can be
rotated.
Press the right mouse key, the blue arrow disappears and the cursor
looks like the double-pointed arrow on the left. Move the reference line
with the mouse while pressing the right mouse key.
The crosshair cursor defines points of a line. Press the left mouse button
to define a point.
Menu Functionality:
Move the current reference line horizontally.
Move the current reference line vertically.
Rotate the current reference line.
Omni View + VCI
Press the VCI button to activate Volume Contrast Imaging. The reference line image planes are
visualized in Render Mode and it is possible to define the Slice Thickness for all lines.

Omni View Sub Menu
Omni View Render Method

Choose between Actual and Projection.
Omni View Render Direction
Only available if VCI is enabled. If the render direction is up/down, the VCI slice is above the reference
line. If down/up is selected, the VCI slice is below the reference line.
View Options
Press Line on/off to toggle display of the full line or only its start and end points.
Press Box on/off to toggle display of the colored dashed frame around the current reference line’s
display section.
Press Icon on /off to toggle display of the Omni View icon.
VCI Thickness Mode (only available when VCI is activated)
Choose between symmetric (the slice thickness is added symmetrically to the entered Omni View
line) and asymmetric (the slice thickness is added asymmetrically to the left or right side of the
entered Omni View line; left/right depends on the VCI Render direction).
4.4.3 VCI-A
By setting a small volume sweep angle you scan a limited number of slices with a relatively high
volume rate. The render box is very narrow and so you can visualize the tissue information of a thick
slice. A mixture of surface texture and transparent maximum (or X-ray) rendering modes (70/30) plus
a low setting of surface transparency (20-50) is used. The resulting image shows the average
(integrated) gray values of the tissue contained within the narrow box. Volume Contrast Imaging [VCI]
improves the contrast resolution and the signal / noise ratio and therefore facilitates the detection of
diffuse lesions in organs. The result is an image with no speckle pattern and a highly improved tissue
contrast.
Figure 4-1 VCI-A principle

1 Scan Situation:
small 4D volume sweep
Vol. angle depends on slice thickness
2 Render Box:
Box size automatically derived from Vol. geometry. Box not shown
on screen.
3 Render result:
All single B-frames are rendered to one single VCI image (Thick Slice
Image).
4 Render direction
5 Vol. angle
6 Screen Display
7 Standard Image (center position of Vol. sweep)
8 VCI Image (Thick Slice rendered Image)
It is possible to load following datasets:
• VCI-A
• VCI-A/CFM
• VCI-A/PD
• VCI-A/HDF
VCI-A Menu controls
Volume edit Press the button to close the VCI-A main menu. The
visualization menu appears.
Display format Select between Dual (A-plane and VCI plane) and Single (VCI
plane) format.
Invert When Invert is pressed, a marker appears on the left top at

the VCI slice.
Init all Press the button to reset to the load state.
ROI Thickness Adjusts the VCI slice thickness.
4.4.4 Niche
Select the “Niche” button in the main menu. This mode does not permit changing of the ROI ( For
more information see 'Glossary' on page 9-2. ), and displays no 3D rendered image. (“Full-Screen
Mode” is obtained by selecting the “Full-Screen” button.)

The Niche mode allows the viewing of 3 orthogonal planes in a stereoscopic view. In order to select
different niches (=niche mode) use the Niche symbol buttons shown above and the Ref. Image
buttons.
Note Niche is available for 3D data sets only.
For more information see 'Reference Images' on page 4-4.
4.4.5 SonoVCAD™labor
This feature allows for supervision of labor using specific measurements aided by on-screen
orientation marks.
Operation
Menu item Description
Click this menu item after you aligned the volume.
Click this menu item to automatically align the volume.
Click this menu item to realign the volume.
Click this menu item to toggle display of past

measurements on screen.
Click this menu item to set the skull contour. The

checkbox controls whether or not the contour line is
displayed in the ultrasound image.
Click this menu item to set the head direction. The

checkbox controls whether or not the line is displayed in
the ultrasound image.
Click this menu item to set the midline. The checkbox

controls whether or not the line is displayed in the
ultrasound image.
Click this menu item to measure the progression of the

fetal head. The checkbox controls whether or not the line
is displayed in the ultrasound image.

Menu item Description
Click this menu item to measure the angle of the

progressing fetal head. The checkbox controls whether or
not the line is displayed in the ultrasound image.
Click this menu item to delete all measurements for the

current volume.
Mark pubis position - manual

Bring the volume in the correct position using rotation, translation and zoom.
Align image plane A to the Pubis Longitude mark and image plane B to the Pubis Transverse mark.
Confirm the correct alignment by clicking the Set Position menu item.
Mark pubis position - Auto Adjust

Auto Adjust is a convenient feature to automatically align the ultrasound image.
Draw a line consisting of an start and end point along the pubic bone either in image plane A, B or
both. The other image planes are aligned automatically. You can tweak the result using rotation,
translation and zoom.
Confirm the correct alignment by clicking the Set Position menu item.
Skull contour
Measurement in image plane A. Trace the position of the fetal head point by point.

Set midline
Measurement in image plane B. Mark the position of the midline with a line of two
points. The measurement result is the calculated angle between the vertical axis
and the midline. As the rotation can be to the left or to the right it is necessary to
start measuring at the occiput to get accurate results.
Set head direction

Measurement in image plane A. Draw a line of two points along the maximum
head diameter. Then mark the most distant point of the head contour. The head
direction is automatically calculated as a line orthogonal to the max diameter
passing through the distal point

Progression distance
Measurement in image plane A. The measurement’s point of origin is vertically
locked to the pubis. Mark the distal point of the fetal head to measure the distance
between the pubis and the head in millimeters.
Head progression angle

Measurement in image plane A. Starting from the center of the pubis, set the end
point that the dashed line is tangent to the fetal head. The resulting measurement
is the dihedral angle between the pubis and the defined line.

4.4.6 STIC M
STIC-M displays an M-Spectrum from a STIC acquisition.
Menu controls
Start drawing a new M Line. The current line will be

deleted.
Adjust the sweep speed from 1.0 to 4.5 seconds.
Move the M line horizontally.
Move the M line vertically.
Rotate the M line.
Operation
• Select image plane A of a volume acquired in STIC mode.
• Click the “New Line” button.
• Draw a line in the ultrasound image by setting start and end point using the mouse.

• The M spectrum appears to the right of image plane A.
• You can optimize the spectrum by adjusting the M line using the menu controls.
4.4.7 4D-AMM
4D-AMM displays an M-Spectrum from a 4D acquisition.
Menu controls
New Line Start drawing a new M Line. The current line will be
deleted.
AMM Speed Adjust the sweep speed from 1.0 to 4.5 seconds.
Line: horizontal Move the M line horizontally.
Line Vertical Move the M line vertically.
Line: rotation Rotate the M line.
Operation
• Select image plane A of a volume acquired.
• Click the “New Line” button.
• Draw a line in the ultrasound image by setting start and end point using the mouse.
• The M spectrum appears to the right of image plane A.
• You can optimize the spectrum by adjusting the M line using the menu controls.

4.5 Visualization Mode - TUI
The following imaging modes are available:
• 'TUI Standard' on page 4-26
• ' SonoVCAD™heart ' on page 4-27
4.5.1 TUI Standard
With TUI (Tomographic Ultrasound Imaging) it is possible to view parallel slices through a volume.
Note TUI is only available if the volume contains measurement information.
Display formats
In Multi TUI display the overview image is situated in the upper left
corner. It displays a plane orthogonal to the parallel slices with the
position of the slices marked with lines. Change the number of TUI slices
on screen with the TUI Format dropdown box.
In split mode the overview image is displayed to the left and the
reference image is displayed to the right.
If Adjust is activated the selected slice is displayed to the right instead of
the reference image.
Use the Prev. and Next buttons to display different slices on the right
side.
In full screen mode no overview image is displayed and the reference

image is displayed full screen.
If Adjust is activated the selected slice is displayed instead of the
reference image.
Use the Prev. and Next buttons to display different slices.
Operation
By pressing the right mouse button in a selected image and moving the mouse it is possible to
position a single slice on its own without effecting the neighboring slices. The distance to the
reference slice (marked with a green star in the upper left corner) is given for each slice in the lower
right corner.
Menu Controls
Press the Adjust button to enter or leave the TUI

Adjust submenu.
In the TUI Adjust submenu additional controls for
adjusting the parallel slices are available. It is
possible to select one of the slice by place the
mouse over that particular slice. A yellow border
indicates the selection and the selected slice is
shown by a yellow line in the overview image.
Use the TUI Format dropdown box to change the

amount of the image rows and columns on
screen.

Use the “Slices” plus and minus buttons to

increase or reduce the number of the available
parallel slices.
Use the “Prev.” and “Next” buttons to move other

available parallel slices into the visible area.
Use the “init All” button to reset all slices to their

initial position.
Use the “VCI” button to enable Volume contrast

imaging.
Use the “Slices Left” or “Slices right” button to

reduce the number of slices to the left or to the
right of the reference image (marked with a green
star in the upper left corner).
Use the “TUI Distance” slider to adjust the

distance between the parallel slices. The currently
selected distance is displayed in the lower right
corner of the overview image.
4.5.2 SonoVCAD™heart
SonoVCAD Mode
SonoVCAD is a technology that automatically generates a number of views of the fetal heart to make
diagnosis easier.
Adjusting the Start Plane

If you can already see the heart template on the monitor you can start adjusting. If you cannot see
the heart template on the monitor, click the Plane Graphic button. The heart template appears.
Note Before a starting plane can be set either Cephalic (displays the Cephalic view
without rotation) or Breech (displays the Breech view with 180° rotation) has to be
selected.

Adjust the US image, using the X-, Y-, Z-rotary sliders and the zoom slider so that it fits the template.
To adjust the center of rotation, see 'Rotation and Translation' on page 4-3
Press Confirm Alignment. The view will switch to TUI mode now.
Selecting different views

There are 8 predefined views available:
• 4CH
• LVOT
• RVOT
• Stomach
• SVC/IVC
• Ductal Arch
• Aortic Arch
• 3VT
Following display formats are available:
• quad format (3x3 TUI view)
• single format
Note When single format is selected, the view name is inserted at the upper left corner.
The annotation is not shown when the display format is changed to quad format.
Toggle between the formats by double clicking the left mouse control.

4.6 Volume Analysis Modes
4.6.1 VOCAL
The following display format combinations are available:
• Edit VOCAL
• 3D ROI Mode
• 3D Full-Screen Display
• 3D Plane Adjustment Mode
• VOCAL II Niche in Quad- or Full-Screen Format
VOCAL - General Information

The “VOCAL II” menu is separated into two different menus:
• the “VOCAL - Define Contour” menu, where the contours of an object, e.g., lesion or tumor are
generated, and
• the “VOCAL- Contour finder" menu, where the contours can be manipulated and a shell can be
generated.
(Screenshot of a shell contour)
VOCAL - Define Contour

Click on the “VOCAL” button in the main menu in order to enter the “Volume Calculation” menu,
given that no (shell) contour has been generated yet.
IIf a shell contour has already been generated, enter “VOCAL- Contour finder" by pressing Fixed Roi.
Attention:
The main contour axis should be positioned at the center of the 3D lesion. (The 3D object should be
centered with respect to the rotation axis.)
A 2D contour is only valid if the rotation axis is crossed exactly twice.

For automated contours, the green arrows mark the two contour points on the main contour axis for
all 2D contours, i.e., all defined contours (in different planes) intersect the main contour axis at the
position of the green arrows.
For manual contours the first 2D contour specifies where the green arrows will be positioned on the
main contour axis.
Selection of a Contour Generation Mode
Manual method
Manual Contour Mode
This contour mode allows the outline of any connected lesion to be drawn. The number of manually
generated contours depends on the rotation step selected.
The mouse is restricted to the selected reference plane. The menu bar appears on the right side, as
shown in the image above.
The next step is to outline the first contour by keeping the left mouse button pressed and moving the
mouse. The two green arrows are automatically positioned accordingly on the main contour axis.
The outlined contour is only valid if the rotation axis is crossed twice.
Select the next image plane by using the forward button >> (arrows right).
The contour is automatically copied to the next image plane and can be redefined by marking a new
contour. Every time a new contour is started, the previous contour in the current image plane is
replaced by the new contour.
Press the “Clear” button in order to delete the contour in the current image plane.
Press the Exit button to cancel the tracing procedure and exit to the Define Contour Menu.
After a contour has been defined in each image plane, the “Done” button is enabled for the first time.
When clicking this button, the result is shown and the “VOCAL - Edit Contour” menu appears.
In order to make changes to the contour in any image plane, use the reverse button << and redefine
the contour by marking a new contour.
In order to leave this mode at any time, click the “Exit” button.
Trace method
Contour Finder - Trace
This mode works very similar to the manual contour mode, but instead of drawing the contour right
where the mouse is, a sophisticated algorithm helps to find the correct contour of the lesion. The
number of contours generated with the help of this algorithm depends on the rotation step selected.
The mouse is restricted to the selected reference plane and a menu bar appears at the corner of the
window.

Move the mouse approximately along the border of the region, the algorithm looks in the
neighborhood of the mouse cursor for the border of the lesion. How large the area used for looking
for this border is, depends on the Sensitivity setting. Use the “Sensitivity” slider in the VOCAL II menu
to adjust this setting.
It is possible to cut away part of the contour by pressing the right mouse button and moving the
mouse, or by starting outside the gray line, pressing the left mouse button and moving the mouse
inside the gray line.
Select the next image plane by using the forward button >> (arrows right).
After a contour has been defined in each image plane, the “Done” button is enabled for the first time.
When clicking this button, the result is shown and the “VOCAL - Edit Contour” menu appears.
In order to make changes to the contour in any image plane, use the reverse button << (arrows left)
and redefine the contour by marking a new contour.
SemiAuto Trace method

Contour Finder - SemiAuto Trace
This mode works very similar to the Contour Finder - Trace mode, but instead having to trace the
outline in all slices, only two orthogonal slices have to be traced. The number of contours
automatically generated afterwards depends on selected the rotation step.
The algorithm can be adapted for certain types of structures by choosing between “Hypo”, “Cystic”
and “Hyper-Iso”.
The mouse is restricted to the selected reference plane and a menu bar appears at the corner of the
window.
Move the mouse approximately along the border of the region, the algorithm looks in the
neighborhood of the mouse cursor for the border of the lesion. How large the area used for looking
for this border is, depends on the Sensitivity setting. Use the “Sensitivity” slider in the VOCAL menu
to adjust this setting.
It is possible to cut away part of the contour by pressing the right mouse button and moving the
mouse, or by starting outside the gray line, pressing the left mouse button and moving the mouse
inside the gray line.
Select the second image plane by using the forward button >> (arrows right).
After a contour has been defined in two image planes, the “Done” button is enabled for the first time.
When clicking this button, the remaining planes are calculated and the “VOCAL - Edit Contour” menu
appears.
Note If no valid contour is found by the algorithm, the system returns to the “VOCAL -
Define Contour” menu.
In order to make changes to the contour in any image plane, use the reverse button << (arrows left)
and redefine the contour by marking a new contour.

Selection of a Rotation Step
The Rotation Step parameter defines the number of contour planes available. (How many contours
are generated.)
Number of contour planes = 180˚ / rotation step. E.g., for a rotation step of 15˚, 12 contour planes
are available (= 180 / 15)
Selection of the Reference Image

The selection of the reference image defines the image plane(s) used for generating the contours.
In order to generate the contours, the reference image is rotated around the
• vertical axis (for reference image A or B),
• horizontal axis (for reference image C).

which is positioned at the center of the image (red dotted line).
The rotation angle of the reference image is defined by the rotation step.
Pressing “Start”
After having chosen between the available methods and having adjusted the settings for the selected
method, press the “START” button.
VOCAL - Edit Contour

This menu is entered by clicking on the “Edit VOCAL” button in the main menu.
In the “VOCAL Edit Contour” menu the generated contours can be manipulated.
The VOCAL Contour Editor
When entering this menu the screen appears as described here:
• The reference image shows the first contour generated, outlined with red dots.
• In the orthogonal slices the intersection curves between the shell geometry and the different
image planes are outlined as a solid yellow contour.

• The shell geometry is visualized in the lower right quadrant.
When moving the mouse, some red dots of the contour line in the reference image change their color
to yellow (green - pole) depending on the position of the mouse cursor. If the mouse is positioned
close to the contour only one dot becomes yellow (green - pole). When the distance is increased,
more dots become yellow. By keeping the left mouse button pressed and simultaneously moving the
mouse, the yellow (green - pole) dots can be adjusted to fit the lesion. Changing the contour
automatically updates all relevant results (shell contour, volume, etc.).
Now select the next image plane by using the arrow buttons in the “Rotation Ref section.
Defining a Shell Contour (Shell Geometry)
By default the generated contours in the "VOCAL - Define Contour" menu define a shell contour,
meaning that
• the outside surface is equal to the generated contours (reference surface geometry), and
• the inside surface is represented by an inner point (inside surface is degenerated).

This state is automatically generated when “Shell off” is selected.

Selections of Other Shell States:
inside
• The outside surface is equal to the reference surface geometry.
• The inside surface is the surface geometry of the inner “parallel” contours with a distance of
“Shell Thickness” in mm.
If one of the inside contours is not valid, the inside surface is represented by an inner point (inside
surface is degenerated). (A contour is valid only if the rotation axis is crossed exactly twice.)
outside
• The outside surface is the surface geometry of the outer “parallel” contours with a distance of
“Shell Thickness” in mm.
• The inside surface is equal to the reference surface geometry.

symmetric
• The outside surface is the surface geometry of the outer “parallel” contours with a distance of
half of “Shell Thickness” in mm.
• The inside surface is the surface geometry of the inner “parallel” contours with a distance of
half of “Shell Thickness” in mm.
If one of the inside contours is not valid, the inside surface is represented by an inner point (inside
surface is degenerated). (A contour is valid only if the rotation axis is crossed exactly twice.)
Of course only valid reference contours generate a valid shell contour.

The thickness of the shell can be adjusted by using the “Shell Thickness” slider.
Displaying the (Shell) Volume
The (shell) volume is defined as the difference between the volume defined by the outer surface (of
the shell geometry) and the volume defined by the inner surface (of the shell geometry). In the

“Volume” field the volume of the reference surface geometry is displayed. If the inner surface (of the
shell geometry) is degenerated, the volume amount is zero. A degenerated surface is symbolized in
the display with *****.
If the reference surface geometry is not valid, all volumes are invalid and displayed with *****.
Accept, New or Clear Contour
Clicking on one of these buttons ends the “VOCAL Edit” menu.

Accept Contour The shell contour is accepted and stored.
New Contour The shell contour is not accepted and the "VOCAL - Define Contour" menu appears,
where a new contour can be defined..
Clear ContourThe shell contour is deleted and the main menu appears.
Changing the Color of the Contour
For more information see 'Contour Color' on page 4-67.
Threshold Volume
Once a VOCAL II has been created, it is possible to choose “Threshold Volume” from the “View” (For
more information see 'View' on page 3-7. ) menu.
The screen changes to look like this:
The Threshold Volume functionality provides the user with a tool to measure the part of a volume
that ranges below a certain threshold, the part of the same volume that ranges above the same
threshold and the complete volume. And compare these measurements.

The pink areas are the areas below the threshold. The gray areas are the areas above the threshold.
The dialog that appears provides the results. You can move the result dialog anywhere on the screen
to avoid that it hides part of the image you want to evaluate.
Move the “Th. Low” slider to change the value of the threshold. The results in the result dialog and
the pink part of the image changes accordingly.
Press the “Close” button to return to the VOCAL menu.
VOCAL Niche in Quad- or Full-Screen Format
The “VOCAL II Niche Mode” can be activated by selecting the VOCALVOCAL II Niche” button shown
here. (“Full-Screen Mode” is obtained by selecting the “Full-Screen” button.)
The niche mode allows the viewing of 3 orthogonal planes in a stereoscopic view bounded by the
VOCAL II contour.
A VOCAL view direction (=niche mode) can be selected with the “Niche Mode” control shown below:
4.6.2 SonoAVC™follicle
Note Per default, 4DView will only act as a viewer for SonoAVC™ exams. To fully enable
SonoAVC™ functionality in 4DView you have to program the 4DView licences file on
the Voluson™ ultrasound system with installed SonoAVC™ option.
Note Render Type Inversion is activated automatically.
The following display format combinations are available:
• Pre Mode
• Main Mode
SonoAVC™ (Sonographic Automated Volume Count) automatically detects low echogenic objects
(eg.follicles) in an organ (e.g. ovary) and analyzes their shape and volume. From the calculated
volume of the object an average diameter will be calculated. All objects detected that way will be
listed according to size.
Pre-Mode
Select the desired follicle measurement method:
• manual
• semi-auto
• auto

Adjust the ROI to get a good view on the low echogenic objects. Select the desired ROI shape:
angular (the box has the shape of a rectangle) or rounded (the box has an elliptic shape with
rounded corners that can be adjusted by moving (rounding the corners) the slider. It is embedded in
a rectangular box). Then either press the Start Left Ovary or the Start Right Ovary button.
Note The ROI shape can be adjusted only when the selected follicle measurement
method is semi-auto or auto.
After a few moments the list of low echogenic objects is displayed.
SonoAVC™ Main Mode
The results are displayed in the top right corner. The objects are listed according to size. All different
objects are color coded i.e. the color surrounding the number of the object also denotes the object
on the image. If the mouse cursor hovers over a specific item of the list the respective item in the

image is highlighted. The color of the object is bound to its position on the list. The biggest object
will always be displayed in red, the second biggest one in blue and so on.
d (V) Diameter, calculated as if the object were a perfect sphere
dx Length of x-axis of the best fitting ellipsoid
dy Length of y-axis of the best fitting ellipsoid
dz Length of z-axis of the best fitting ellipsoid
m-d Average value of the x-axis, y-axis and z-axis
V Volume of the object
New Analysis Press this button to get back to Pre mode.
Parallel Shift While the slider is moved, a "mm" display shows the
difference in mm to the initial slice.
Add follicle manually Press this button to start a manual follicle measurement and
to activate a measure tool selection.
Note Manually added follicles are displayed with

an asterisk within the worksheet and result
list.
Add the list of volumes to the GYN worksheet.
Press this button to get to the Cine Menu.
Press this button to get to the Measurement Main Menu.
Display options
• Press the Filled button to highlight the segments by filling the area of the segment with color.
Press it again to only highlight the boundaries of the segments.
• Press the 3D Full button to switch on fullscreen display of the rendered image.
Edit Mode
Turn the Edit Mode on and select the cut or merge option to edit the generated volumes.

To cut out a part of the volume:

1. Click and hold the right mouse button to draw a path along the area you want to cut out. If the
path is not closed, 4DView will connect the start and end point with a straight line.
2. The area within the path is cut out and inserted as new volume.
To merge volumes:
1. Click and hold the right mouse button to draw a path that encloses or touches the volumes you
want to merge. If the path is not closed, 4DView will connect the start and end point with a
straight line.
2. All volumes along the path now appear as a single segment.
Revert the auto generated volumes to their initial state.
Undo the last Cut/Merge operation.
Redo the last Undo operation.
Image parameters
Growth is controlling a parameter in the segmentation algorithm that defines the final shape of the
objects found. Increasing this parameter will allow the objects to fit tighter to the visible boundary. A

value too large might cause the objects to grow over the boundary and cover areas no longer part of
the objects of interest.
Note Growth is available in auto and semi-auto mode.
Separation is controlling a parameter of the segmentation algorithm that defines an initial threshold
to separate objects. Increasing this parameter will prevent objects from being identified as multiple
objects (e.g. when there is noise within the object), but might prevent small objects from being
found correctly.
For information on Reference Planes, Rotation Controls and Init functions see 'Rotation and
Reference Slices' on page 4-3.
4.6.3 SonoAVC™general
SonoAVC™general is similar to SonoAVC™follicle. The main difference is the semi-manual detection

of low echogenic objects and support for user defined descriptions for these objects.
Semi-Manual Detection
Unlike SonoAVC™follicle, SonoAVC™general does not automatically detect all low echogenic objects
and lists them on start up. Use the mouse to determine the desired objects.
Point the mouse cursor to a low echogenic structure in the ultrasound

image and click the right mouse button to let SonoAVC™ detect it and add
it to the list.
Double click to split an object.
Apart from this, operation is similar to SonoAVC™follicle. For more information see ' SonoAVC™follicle
' on page 4-36.
Custom Descriptions
Custom descriptions are used to denote various lists of objects in the worksheet.
How to define and use custom descriptions
Type the desired name for the current list of

detected objects in the Description dropdown
field or use one of the already saved descriptions.
Press the Save button to add the text in the

dropdown field to the list of saved descriptions.
Press the Add to Report button to add the current

list of detected objects with the currently selected
description to the Report.

Other options
Press the Number button to toggle display of the

object numbers in the ultrasound image on and
off.
Press the Group button to group all detected

objects into one. This can be undone with the
Undo button.
4.6.4 SonoAVC™antral
Note SonoAVC™antral is an option.
"Antral" means "antral follicle count". SonoAVC™antral enables to automatically detect and count
antral follicles within a ROI box in a 3D volume data set.
Pre Menu
Select the desired ROI shape (angular or rounded) and define the rounding angle (only when
rounded is selected).
Press Left Ovary Start and Right Ovary Start to start the measurement.
Main Menu
The result of the measurement is displayed in the SonoAVC™antral result list:
Within the defined group range (configurable in the measure setup) all detected follicles are
displayed. Follicles out of the defined group range are not displayed. Manually added follicles are
marked with an asterisk.
All results listed within the SonoAVC™antral result list are stored in the GYN worksheet as soon as
Add to Report is pressed. The worksheet can be displayed either as group summary or as single list.
New Analysis Press this button to get back to Pre mode.
Parallel Shift While the slider is moved, a "mm" display shows the
difference in mm to the initial slice.

Add follicle manually Press this button to start a manual follicle measurement and
to activate a measure tool selection.
Note Manually added follicles are displayed with

an asterisk within the worksheet and result
list.
Add to Report Add the list of volumes to the GYN worksheet.
Display Select the desired display mode:

• Number (shows the number of the follicles)
• Filled (displays filled or boundary mode)
• 3D Full (displays in 3D Full format)
Cine Calc Press this button to get to the Cine Menu.
Measure Press this button to get to the Measurement Main Menu.
Main Menu Press this button to go back to the previously opened Main
Menu.

4.7 Render Modes
Caution
The yellow triangle indicates that measurements taken from this data sets might not be suited for
diagnostic purposes.
Using Render Mode

1. Perform a 3D scan.
2. Press Render in the 3D menu on the screen.
3. Press Render Mode.
4. The Main Render menu appears on the screen.
5. Select Gray, Color, Glass Body, VOCAL Surface or Inversion.
6. Select a user program preview image.
7. If desired, change settings in the Sub Render menu.
Two modes are always active simultaneously. They can be mixed by using the Mix rotary
control below the touch panel. The last selected mode is fully displayed (100%). Press the Mix
control to use 50% of each mode. Rotate the Mix control to change the percentage.
Perspective Rendering can be adjusted / turned on/off, too.
4.7.1 Gray Render Mode
In “Gray Render Mode” only gray value information of the data set is used, even if a color volume
image is displayed. In case of a data set without color information being present, this mode is
automatically activated.
Select desired render algorithm:

Smooth Surface Mode: The surface is displayed “smoothed” in “texture” mode.
Surface Mode: The surface is displayed in “texture” mode. Texture: The gray values of the surface are
identical with the gray values of the original scan.
Maximum Mode: Only the maximum gray levels of the ROI ( For more information see 'Glossary' on
page 9-2. ) are displayed. Application: Presentation of bony structures.
Minimum Mode: Only the minimum gray levels of the ROI ( For more information see 'Glossary' on
page 9-2. ) are displayed. Application: Presentation of vessels, hollow or cystic structures.
X-Ray Mode: All gray levels (mean level) within the ROI ( For more information see 'Glossary' on page
9-2. ) are displayed. Application: Presentation of a tissue block containing a tumor or similar
structures.
Light Mode: The surface is displayed in “light” mode. Light: Structures closer to the viewer are
displayed brighter, structures more distant to the viewer are darker.
Gradient Light Mode: The surface is displayed in “gradient light” mode. Gradient Light: Structures
with surfaces more oriented towards the viewer are displayed brighter. Structures less oriented
towards the viewer are displayed darker. Application: e.g. fetus in amniotic fluid.
Skin Texture + Skin Smooth Mode (requires HD Rendering): A skin-like texture is applied to the
surface of echogenic structures. Application: Life-like rendering of a fetus.
Surface Enhanced (requires HD Rendering): Surface display is improved by homogenous
smoothing while details are retained in the image.
HDlive™ HDlive™ Surface + HDlive™ Smooth (requires HD Rendering):HDlive™ uses a light source
that can be positioned around the rendered 3D object. By highlighting structures from the side, the

three-dimensional impression is improved and the surface does not appear flat anymore. For more
information see ' HDlive™ ' on page 4-48.
Note Two modes must always be selected. Except for Skin Texture and HDlive™ Mode,
the combination is free of choice.
Mix function
Mixing of the two selected modes can be performed by moving the “Mix” slider, which modes are
selected is denoted at each end of the slider.
4.7.2 Inversion Render Mode
“Inversion” is a Render Mode especially designed for visualization of anechoic structures like fetal
heart, vessels, cysts and other hollow structures. It makes those parts of a data set visible that do no
contain echoes (e.g. fluids).
Select desired render algorithm: 'Gray Render Mode' on page 4-43
4.7.3 Color Render Mode
In “Color Render Mode” only the color information of the color Doppler signal (velocity mode or
power mode) is used for the 3D display. For a data set containing color information, this mode is
automatically activated.

Surface Mode: Surface display of color information of blood flow.
Light Mode: The surface is displayed in “light” mode. Structures closer to the viewer are displayed
brighter, structures more distant to the viewer are darker.
Maximum Mode: The maximum color levels of the ROI ( For more information see 'Glossary' on page
9-2. ) are displayed. Application: Presentation of all vessels within the ROI ( For more information
see 'Glossary' on page 9-2. ). A 3D impression can be generated by rotating the 3D image.
X-Ray Mode: All color levels within the ROI ( For more information see 'Glossary' on page 9-2. ) are
used for calculating the mean color level (impression of an X-Ray image).
A second mode must be selected in addition to the surface mode.
Mix function
Mixing of the two selected modes can be performed by moving the “Mix” slider. Which modes are
selected is denoted next to the two ends of the slider.
Also select the desired Rendering Color Map: CFM or Monochrome.
4.7.4 Glass Body Render Mode
In “Glass Body Render Mode” the color and the gray value information are processed and combined
to a 3D image.

For “Gray Mode”:
Gray Render 1 Select the desired Gray Render 1 mode:

• Surface Enhanced
• Surface Texture
• Surface Smooth
• X-Ray
• Max
• Min
• HDlive Texture & HDlive Studio Texture
Gray Render 2 Select the desired Gray Render 2 mode:

• Surface Smooth
• Light
• Gradient Light
• Max
• Min
• X-Ray
• HDlive Smooth & HDlive Studio Smooth
For “Color Mode”:
Color Render Select the desired Color Render mode:

• HDlive Surface
• HDlive Studio Surface
• Max
• X-Ray
• Surface
• Gradient
Mix function
Mixing of the selected modes can be performed by moving the “Mix” slider, which modes are
selected is denoted at each end of the slider.
Available mix controls:
• Gray Mix
• Gray / Color Mix

Following combinations of render modes can be mixed.
Gray 1 Gray 2 Color
HDlive Texture HDlive Smooth HDlive Surface
HDlive Studio Texture HDlive Studio Smooth HDlive Studio Surface

Gray 1 Gray 2 Color
Surface Enhanced Surface Smooth Max

Light X-Ray
Gradient Light Surface
Max Gradient
Min
X-Ray
Surface Smooth Light Max

Gradient Light X-Ray
Max Surface
Min Gradient
X-Ray
Surface Texture Surface Smooth Max

Light X-Ray
Gradient Light Surface
Max Gradient
Min
X-Ray
X-Ray Surface Smooth Max

Max X-Ray
Min Surface
Gradient
Max Surface Smooth Max

Min X-Ray
X-Ray Surface
Gradient
Min Surface Smooth Max

Max X-Ray
X-Ray Surface
Gradient
Table 4-1 Glassbody render mixed modes
4.7.5 VOCAL Surface Mode
In “Contour Mode” the shell geometry can be visualized using a surface or a wiremesh model.
This mode can only be activated if a shell contour has been generated by using VOCAL II (For more
information see ' VOCAL ' on page 4-29. ).

Select desired contour render algorithm:
Skin Mode: The surface of the shell geometry is displayed with illumination. If the inner surface
geometry is not degenerated, a combined presentation of the inner and outer surface geometry is
displayed. In order to display only one of both surface geometries please follow the “Select desired
contour display” instructions below.
Wiremesh Mode: The wiremesh of the shell geometry is displayed with illumination. If the inner
surface geometry is not degenerated, a combined presentation of the inner and outer surface
geometry is displayed. In order to display only one of both surface geometries please follow the
“Select desired contour display” instructions below.
Select desired contour display:

A shell geometry consists of an inner and outer surface geometry. Select which surface geometries
will be displayed by checking or unchecking the “Outside/Inside” check boxes.
If “Inside” is selected, the inner surface geometry is displayed. If “Outside” is selected, the outer
surface geometry is displayed. If both boxes are selected, a combined presentation of the inner and
the outer surface geometry is displayed.
4.7.6 Threshold Settings
Function of the threshold values and of the transparency settings (Surface Mode only)
If “Surface Mode” is selected, it is necessary to adjust low and high threshold for the border
recognition of the surface. These threshold levels do not apply for the transparent modes!
Threshold Low (Reject)
Normally, the threshold is always adjusted as to generate a good appearance of the 3D surface
image. When changing “Threshold Low”, all echoes below the selected gray level are colored in pink
during adjustment. By raising “Threshold Low”, disturbances in the foreground can be removed.
Application: Noise or low-level echoes are removed with this function, in order to get a “clear view”
from the start border of the render box to the desired surface.

Threshold High
Normally, this threshold does not need to be adjusted and should be set to the maximum value of
255. When changing “Threshold High”, all echoes above the selected gray value level are colored in
green during adjustment.
Application: If the surface render algorithm encounters a gray value higher than the value of
“Threshold High”, then this gray value marks the border of the surface. Therefore, it is possible to
mark the surface border manually using “Threshold High”.
Transparency
Transparency effects the effect of the threshold values. With a low transparency value, sharp surface
boundaries are defined, whereas with a high transparency value the surface defined is more diffuse.
With a very high transparency value the surface is comparable to the transparent modes (X-Ray, Max).
4.7.7 HDlive™
Note It is necessary to program the 4DView license file on theVoluson™ ultrasound

system before you can use HDlive™ rendering.
Once you have activated HDlive™ mode you can change the position of the light sources and the
color tone of the rendered image. Additionally there is a special tuning for vessels, amniotic fluid and
inside structures of 3D/ 4D Volumes.
4.7.7.1 How to Position the light Source

Use a mouse with a mouse wheel to move the light source. The position of the light source is
displayed in the lower right corner of the screen.
4.7.7.2 How to Change the Color of the Rendered Image

HDlive™ uses a special set of pre- and user-defined Gray Chroma Maps.
1. In the Main Menu, click Image Settings.
2. Choose between 10 predefined HDlive™ Gray Chroma Maps, Skin1 - 10, and 3 user-defined
maps.
To define a custom map click the User Defined button. A dialog window appears.

Adjust the color with the Hue and Saturation sliders. Click Save to store the color settings as user-
defined map. Click Exit to adjust the color without saving.
4.7.8 HDlive™ Studio
HDlive™ Studio offers three independent light sources with three different light types (directional,
point, spot) and contains a special render function to visualize the amniotic fluid. Fluid effect
visualizes the amniotic fluid so that the fetus "swims" in an opaque fluid of which the strength can be
adjusted. In addition, CFM Silhouette is available in Color mode and Gray Silhouette in Glass Body
mode.
Moving the Light Sources
Select the desired light source (directional , point or spot ) and move it
with the pressed middle mouse button. All moves react on all activated light sources together. Edit
opens the Edit Light sub menu. The lights are numbered according to the Edit menu.
In case of a two-button mouse the middle mouse button can be emulated as follows:
Light source functionality Three-button mouse Two-button mouse
All Lights Direction Middle Mouse Button Left Mouse Button + Shift
Point/Spot Light Distance Middle Mouse Button + Left Ctrl Left Mouse Button + Shift + Left Ctrl
Spot Light Size Middle Mouse Button + Right Ctrl Left Mouse Button + Shift + Right Ctrl
Spot Light Direction Middle Mouse Button + Alt Left Mouse Button + Shift + Alt

Figure 4-3 Edit menu
One light has to be switched on all the time. As soon as more lights are switched on, the
corresponding numbers of the light sources are displayed together with the screen symbols:
In addition Brightness, Light Hue (graphical bar), Distance and Size can be adjusted as desired by
moving the sliders.

4.8 Cine Sequences
4.8.1 Calculated Cine Sequences
In the Main Menu, press the Cine Calc button to enter the Cine Menu. Depending on the Visualization
mode, you can choose between three possible Cine calculation methods:
• 3D Rotation Cine
• Translation Cine
• Slice Cine
Calculate a 3D Rotation Cine

In order to obtain an overall 3D impression of the rendered object a certain number of calculated
views are displayed image by image in a fast sequence. The rendered object is rotating for the
observer. In transparent mode the rotation of the object enables a 3D impression due to movement
of the structures.
Steps to calculating a 3D Rotation Cine ( For more information see 'Glossary' on page 9-2. )
sequence:
1. Activate the 3D Rotation Cine Mode: In the Cine menu click the Rot. Cine button. It is only
available in Render and VOCAL II Visualization mode.
2. Start Calculation of a New 3D Rotation Cine. Various parameters for the 3D Rotation Cine ( For
more information see 'Glossary' on page 9-2. ) calculation can be entered here:
The small images show the start and end images of the Cine calculation.
3. Select Step Raster: The rotation angle and the step raster define the rotation steps of the 3D
Rotation Cine ( For more information see 'Glossary' on page 9-2. ) sequence.

4. Select Rot. Axis:These buttons define whether the Cine sequence should rotate around the
horizontal (X) or vertical (Y) axis.
5. Mix Render Mode
With this slider two render modes which were previously selected in the “Render Mode” ( For
more information see 'Render Modes' on page 4-43. ) dialog area can be mixed. The text at
either end of the slider indicate which render modes are selected.
6. Optional Adjustment of Start and End View of 3D Image: These controls allow a variable and
asymmetric rotation angle (e.g., rotation from -15 deg to 75 deg). By using the sliders, the start
image and end image can be defined.
Calculate a Translation Cine

A render box is moved in a translational movement through a volume.
1. Activate the Translation Cine Mode: In the Cine menu click the Trans. Cine button. It is only
available in Render Visualization mode.
2. Display Format: Choose between Quad and Full Display format. The Display format cannot be
changed after the Cine is calculated.

Quad Display Format Full Display Format
3. Step Size: The Step Size specifies the distance covered by one calculation frame. It therefore
affects the number of frames that have to be calculated.
4. Cine Length: Move the respective Slider to select the Start and End frame of the Translation
Cine. In Quad Display Format, the Start frame is denoted by a blue dashed line and the End
Frame by a red dashed line in the reference plane. In Full Display Format, the Start frame is
shown in the lower left corner and the End frame is shown in the lower right corner of the
render view. “Cine Length” defines the total number of frames.
Calculate a Slice Cine

2D images are moved in a translational movement through a volume.
1. Activate the Slice Cine Mode: In the Cine menu click the Slice Cine button. It is only available in
Multiplanar Visualization mode.
2. Display Format: Choose between Quad and Full Display format. The Display format cannot be
changed after the Cine is calculated.

Quad Display Format Full Display Format
Step Size: The Step Size specifies the distance covered by one calculation frame. It therefore
affects the number of frames that have to be calculated.
3. Ref. Image: Select the Reference Image of the Slice Cine. For more information see 'Reference
Images' on page 4-4.
4. Cine Length: Move the respective Slider to select the Start and End frame of the Translation
Cine. In Quad Display Format, the Start frame is denoted by a blue dashed line and the End
Frame by a red dashed line in the reference image. In Full Display Format, the last manipulated
frame is displayed. “Cine Length” defines the total number of frames.
5. Press the Slice Max button to set the start image and end image as far away from each other as
the size of the image area allows.

4.8.2 Menu commands
After making necessary adjustments click the

START button to start Cine calculation.
Clicking the BREAK button stops the

calculation.The images that have been calculated
before the calculation has been stopped are
displayed as a sequence.
In playback mode, click the MAIN MENU button to

cancel the creation of Cine sequences and return
to Main Menu.
If a Cine of a given type already exists, playback is

started on entering the Cine Menu. Click the
Calculate New 3D Calc Cine button to generate a
new cine of the given type or select an other Cine
calculation method.
After pressing the Calculate New 3D Calc Cine

button, press the Show Previous Calculated Cine
button to get back to Cine playback without
making any changes.
4.8.3 Playback of a Calculated Cine
After calculation, the sequence is automatically displayed. In “Transparent” mode the display will
produce a true 3D effect.
Set Loop Method

Replay back and forth Scan through the image block in both directions: First
image to last image, last image to first image, etc.
Replay from start Scan through the image block in one direction: First image to last image, first
image to last image, etc.
Select Playback Speed

The speed at which the Cine sequence is played can be set between 6 and 400
percent.
Select Magnification
The 3D image"s Zoom Level can be varied by Magn. slider control.

Selection of Single Images
With this control select any single image one at a time. This control is only visible if the animation is
stopped. It disappears as soon as the animation is started.
Mix Calculated Modes
The mixture between two calculated modes that were previously selected in the “Render Mode”
dialog area can be adjusted even while the 3D Calc Cine ( For more information see 'Glossary' on page
9-2. ) sequence is being displayed.
Controlling the Timeline
Use the timeline underneath the display of the Cine, to control the animation. The animation consists
of several still images, which are displayed in a row in order to create the illusion of movement. Each
vertical line in the timeline represents one image.
In the above example there are seven images (five short lines in the middle of the timeline and one at
the beginning and end). The numbers next to timeline indicate how many images there are and
which image is displayed. In the timeline below, there are 5/7, the fifth of seven images is displayed.
As soon as the animation is stopped, a gray marker appears which indicates the image currently
displayed.
Select single images using this gray marker, as if using the “Cine” slider. Move
the mouse over the gray marker until the mouse cursor changes its shape to
look like the sign on the left, press the left mouse key and drag the gray
marker to the desired position, while keeping the left mouse key pressed.
Restart the animation by simply moving the mouse over the timeline until its
cursor changes its shape to look like the “Play” sign on the left, and click the
left mouse button. The animation will start with the image currently
displayed.
The animation can be stopped anytime by simply moving the mouse over the
timeline again until its cursor changes its shape to look like the “Pause” sign
on the left, and click the left mouse button. The animation will stop.
When clicking anywhere else in the image, the mouse cursor changes its
shape to display the “Forbidden” sign on the left. This indicates that clicking
here has no effect whatsoever.

4.8.4 4D Image Cine Sequence
A 4D Image Cine ( For more information see 'Glossary' on page 9-2. ) sequence can be created with a
Voluson™ Family series machine of GE HealthCare in the “RealTime 4D” or in the “Live 3D”
acquisition modes and can be included in a GE HealthCare volume file. With 4DView a 4D Image Cine
( For more information see 'Glossary' on page 9-2. ) sequence can be examined.
Load the data and press the “4D Img. Cine” button. A new set of controls appears.
Set Loop Method
Replay back and forth Scan through the image block in both directions: First image to last image,
last image to first image, etc.
Select Display Speed

The speed at which the Cine sequence is displayed can be set between 6 and 400 percent.
Selection of Single Images
With this control it is possible to select any single image one at a time. This control is only visible if
the animation is stopped. It disappears as soon as the animation is started.

For more information see 'Playback of a Calculated Cine' on page 4-55.
4.8.5 4D Volume Cine
4D Volume Cine - General Information

A 4D Volume Cine ( For more information see 'Glossary' on page 9-2. ) data set contains up to 128
volumes captured in 4D mode. In comparison to a 4D Image Cine ( For more information see
'Glossary' on page 9-2. ), which contains the last volume and only bitmaps of the rest of the
acquisition, every single volume of the entire 4D Volume Cine ( For more information see 'Glossary' on
page 9-2. ) can be examined. For more details on the 4D Volume Cine ( For more information see
'Glossary' on page 9-2. ) concept, please review the Voluson™ Family system’s Instructions for Use .
The 4D Volume Cine Menu

When opening a volume file which contains 4D Volume Cine ( For more information see 'Glossary' on
page 9-2. ) data, the main menu is the same as in static volume modes.
Currently, only one 3D Calc Cine of one volume from the 4D Volume Cine can be computed. As soon
as a new one is computed using a different volume from the 4D Volume Cine ( For more information
see 'Glossary' on page 9-2. ), the last one is deleted. Also, if a 3D Calc Cine is included when saving
a static volume, the stored 3D Calc Cine will be the last one computed, even if the volume saved is
different from the one used as a source for the 3D Calc Cine.

Measure:
Measuring 4D Volume Cines is similar to measuring static Volumes. Please refer to 'Generic
Measurements' on page 5-3 respectively 'Calculation Measurements' on page 5-10 for further
information.
The Auto Cine Mode
Press the Auto Cine button to replace the controls beneath the display area with sliders for
controlling the animation.
Use the "Cine" slider to select any single image one at a time. This control is only visible if the
animation is stopped. It disappears as soon as the animation is started.
In the Auto Cine area, start and stop the animation, control its speed and decide how to connect two
loops of the animation:
Replay back and forth Scan through the image block in both directions: First image to last image,
last image to first image, etc.
By using the “Start” and “End” sliders the start and end volume of the animation can be set. Simply
move the sliders and watch the timeline. The brackets in the timeline include the part that is being
displayed. These sliders are only displayed while the animation is stopped. As soon as the animation
is started, the sliders disappear.
Press the Auto Cine button again to hide the “Auto Cine” controls and return to the 4D Volume Cine
menu.
Using the timeline below the display of the 4D Volume Cine ( For more information see 'Glossary' on
page 9-2. ), the animation can be controlled as with the “Auto Cine” menu. The animation consists
of several volumes, which are displayed in a row in order to create the illusion of movement. Each
mark in the timeline represents one volume.
The above example shows seven volumes (five vertical marks in the middle of the timeline and one
at the beginning and end).
As soon as the animation is stopped, a gray marker appears, which indicates the volume currently
displayed.

Set the start and end volume of the animation by moving the mouse over the
end (right bracket) or beginning of the timeline (left bracket) until the mouse
cursor changes its shape to look like one of the two arrows on the left. Press
and hold the left mouse key and drag the selected bracket to the desired
position.
Select single volumes using this gray marker, as if using the “Cine” slider in
“Auto Cine” mode. Move the mouse over the gray marker until the mouse
cursor changes its shape to look like the sign on the left, press the left mouse
key and drag the gray marker to the desired position, while keeping the left
mouse key pressed.
Start the animation by simply moving the mouse over the timeline until its
cursor changes its shape to look like the “Play” sign on the left, and click the
left mouse button. The animation will start with the volume currently
displayed.
Stop the animation anytime by simply moving the mouse over the timeline
again until its cursor changes its shape to look like the “Pause” sign on the
left, and click the left mouse button. The animation will stop.
If the position of the mouse cursor is not associated with an action and the
mouse key is pressed, the mouse cursor changes its shape to display the
“Forbidden” sign on the left. This indicates that clicking here has no effect
whatsoever.
4D Real Time
A “4D Real Time” 4D Volume Cine ( For more information see 'Glossary' on page 9-2. ) is created
using the “RealTime 4D” feature of the Voluson™ Family. The volumes captured during acquisition
are stored and exported as a 4D Volume Cine ( For more information see 'Glossary' on page 9-2. ). A
“4D Real Time” 4D Volume Cine ( For more information see 'Glossary' on page 9-2. ) contains a series
of 3D volumes, one acquired after the other, and shown as a “movie”. For more information please
review the Voluson™ E8 Instructions for Use .
eSTIC / STIC / eSTIC Color / STIC Color / STIC B-Flow

A “STIC Fetal Cardio” 4D Volume Cine ( For more information see 'Glossary' on page 9-2. ) is created
using the eSTIC or STIC feature of a Voluson™ Family device. Several heart beat cycles of one slow
sweep are reconstructed to an animation of a single heart beat. For more information please review
your Voluson™ Family product’s Instructions for Use .

When an eSTIC or STIC dataset is reloaded, the button Set Cycle Start appears. By pressing this
button the currently displayed image can be selected the first frame of the cine for replay and save.
Any volumes before this defined position are added at the end.
4D Biopsy
A “4D Biopsy” 4D Volume Cine ( For more information see 'Glossary' on page 9-2. ) is created using
the “4D Biopsy” feature of a Voluson™ Family device. This mode aids in observing and controlling the
movement of the needle during a biopsy. There are different “4D Biopsy” modes, depending on the
selected transducer and biopsy guide, which are described below. For more information please
review your Voluson™ Family product’s Instructions for Use .
General Biopsy
With most transducers (Small Parts, Abdomen, Vaginal) there is a choice “Guided” and “Freehand
Biopsy”, depending on whether biopsy guides are used or not. In “Guided” biopsy (using a biopsy
guide), the path of the needle is displayed as a red dotted line. The render box is positioned with the
needle as its center at the beginning. When using the “Freehand” setting (no biopsy guide), the
render box can be positioned.
Guided Biopsy

When opening a “4D Biopsy” 4D Volume Cine ( For more information see 'Glossary' on page 9-2. )
captured in “Guided” mode with 4DView, the visualization mode is set to “Render”. It is not possible
to select a different mode.
Only the “Split-Screen” display format is available. In “Split-Screen” mode the normal A plane is on
the left and on the right is the rendered view.
Use the “ROI Thickness” slider to change the thickness of the render box used for generating the
pseudo-2D image plane. Use the “Box Move” slider to move the render box.
Freehand Biopsy
acquired in “Freehand” mode with 4DView the visualization mode is set to “Render”. It is not possible
to select a different mode.
Only the “Split-Screen” display format is available. In “Split-Screen” mode the normal A plane is on
the left and on the right is the rendered view.
pseudo-2D image plane. Use the “Box Move” slider to move the render box. There is no mouse
functionality in “4D Biopsy” mode, i.e. it is not possible to move or change the render box using the
mouse.
Biopsy - Rectal

Rectal
captured in “Rectal” mode with 4DView the visualization mode can be selected as either “Sectional
Planes” or “Render”.
Choose between the “Quad-Screen” and the “Full-Screen” display format. In “Quad-Screen” mode
note A and B planes, showing the needle, and C plane. The render box is positioned in the B plane
and the rendered image is also displayed. In “Full-Screen” mode, only the rendered image is seen.
pseudo-2D image plane. Use the “Box Move” slider to move the render box. There is no mouse
functionality in “4D Biopsy” mode, i.e., it is not possible to move or change the render box using the
mouse.

4.9 Image Settings
4.9.1 Image Settings - Scope
All image settings work either on the ABC image planes (slice palettes) by selecting the button “2D”
or on the rendered image by selecting the button “3D”.
If a VCI 4D Volume Cine ( For more information see 'Glossary' on page 9-2. ) is opened, an additional
“VCI” button is visible. If this button is selected, the settings are applied to the rendered VCI image
only.
If a the visualization type ( For more information see 'Visualization Mode - Multiplanar' on page 4-15. )
“Static VCI” is selected, an additional “Static VCI” button is visible. If this button is selected, the
settings are applied to the Static VCI image slices.
Different palettes for “gray” data can be chosen with the “Chroma Map” ( 'Gray Chroma Map' on page
4-63 ) buttons. For “color” data the “CFM/PD Map” ( For more information see 'CFM/PD Map' on page
4-67. ) buttons are used.
4.9.2 Gray Chroma Map
“Chroma Mapping” is defined as a colored display of gray value images. Each gray value is assigned a
color value.
Eighteen chroma curves are available.
Blue Dynamic Blue Sepia Standard 2
Candle Ice Soft Sepia Standard 3
Clear Natural Cool Sepia1 Yellow
Cool Blue Neutral Sepia 1 User Defined
Copper Off Standard 1 -
Using chroma maps

1. Select the visualization mode in the main menu
2. Select Image Settings
3. Select the preset of the drop down menu or select User Defined to make your own changes
User defined chroma map (Palette)

A “Palette” is a range of points in this color space. It is displayed as a column of colors on the right of
the dialog area. The “Start Color” is at the bottom of this column, the “End Color” at the top.
In “Gray” and “Angio” the darkest color, i.e., “Start Brightness”, is at the bottom, the brightest color,
i.e., “End Brightness”, is at the top.
In “CFM” the darkest color is in the middle of the column. The bottom and the top are set to “End
Brightness”.
For the definition of the colors the model of a cylinder is used (see image below):
Saturation is the radial distance from the axis of the cylinder in this model. Saturation 0 means that
the color value lies on the axis of the cylinder and is a darker or brighter shade of gray. Saturation 255
means a pure color. In the cylinder model a pure color is situated at the periphery of the cylinder. In
order to make a color more intense increase the saturation.
Brightness is defined by the height position of the color in the cylinder. The bottom of the cylinder is
dark (black), whereas the colors at the top of the cylinder are bright (light colors).
Color is represented by the angular position on the cylinder. “Start Color” and “End Color” are given
in degrees reaching from 0 to 480. Color 0 equals 360˚ which is red.
4.9.3 Gamma Settings
The echo amplitudes are mapped onto gray and color values for image presentation. These values
are presented by image palettes on the screen. For adjusting the palette to the image, a mapping

called “gamma curve” is used. A linear gamma mapping means the palette is shown unmodified.
Changing this curve leads to “harder” or “softer” images.
Gamma curve correction:
The gamma curve can be adapted. Clicking inside the display field resets the gamma curve to “Init”
(linear mapping).
Horizontal axis: Image values from 0 to 255.
Vertical axis: Brightness from black to white.
This slider sets the starting point to a place from where the gamma curve will be changed.
This slider changes the curvature with respect to the starting point.
Note These settings require careful observation of their influence on the images!
With the two buttons shown above, the gamma adjustment can be performed separately for gray
and color values.
4.9.4 Background
Adjust the brightness of the Background in all image planes including 3D.
4.9.5 Power Threshold and Power Balance
If “Color” is selected, the “Background” slider is replaced with two sliders for “Power Threshold” and
“Power Balance”. These sliders control the amount of color displayed over bright gray echoes and
help confine color within the vessel wall. Raising “Balance” displays color on brighter structures. If
color is seen on the vessel wall, “Balance” is probably set too high. Additionally, wall motion artifacts
can be suppressed with a low “Balance” setting.
The two sliders work together in such a way that the left slider provides the left boundary for the
right slider and vice versa.
4.9.6 Color off
The “Color off” button is available if the current volume contains color information and if the
visualization mode is "Multiplanar". If it is pressed the color information is removed from the A, B and
C image slices. If it is pressed again, the color is displayed again.

4.9.7 SRI
Caution
This filter smoothes the final image (structures can be smeared out).
For diagnosis, the Region of Interest must be examined without SRI filter.
The "2D:SRI II" slider can be used to turn on or off the SRI filter for the A, B and C image slices. The
"3D: SRI II" slider bar controls the filter for the 3D image. If turned on, SRI can be set to a value
between 1 and 5 with increasing affect of the filter. To turn SRI off, move the slider completely to the
left.
Note 4DView’s SRI filter may produce lower quality results than that of a Voluson™
ultrasound system. To enable high quality SRI in 4DView you must program the
4DView license file ont the Voluson™ ultrasound system with installed SRI option.
Volume SRI (V-SRI)

V-SRI is a three-dimensional volumetric filter. The volume data is filtered first and then the sectional
planes and the rendered image are created. This improves the visual appearance of the B and C
planes, and smooths out artefacts in the render image.
Use the checkbox to toggle between SRI and VSRI.
Note To activate VSRI select the checkbox. (Only available, when SRI is not active.)
The "2D: VSRI" slider can be used to turn on or off the V-SRI filter for the A, B and C image slices. The
"3D: VSRI" slider controls the filter for the 3D image. Numbers 1, 2, 3 will affect surface rendering,
numbers 4, 5, 6 will affect structure rendering (e.g. bones). To turn V-SRI off, move the slider
completely to the left.
Note This option may not be available at the time of release of the Instructions for Use .
Note To enable V-SRI in 4DView you must program the 4DView license file on the
Voluson™ ultrasound system with installed V-SRI option.
4.9.8 Radiantflow
Note Radiantflow is only available for Voluson™ E10 and Voluson™ E8 CFM, PD and HD-
Flow™ datasets.
If Radiantflow (min, mid, max, off) is adjusted, the edges of the color information and the color bar
get a gradient look. Radiantflow has no function for the render image.
4.9.9 Read Gain
A positive Read Gain setting intensifies the echogenic structures in the sectional image planes. A
negative setting attenuates these areas. These setting directly affects the 3D output.
4.9.10 Depth Color
This setting is only available if ' HD Rendering' on page 3-10 is active. It simulates depth by coloring
structures that are farther away from the viewer in a darker color tone.
Color choice
Choose between “Gray”, “Blue” and “Black” as color for distant structures. “Off” deactivates Depth
Coloring.
Color Trans. Start

This slider bar controls at which distance the color transition starts. Move the slider to the right to
increase the distance and therefore lessen the effect.

Color Trans. Slope

This slider bar controls the smoothness of the transition. The more the slider is moved to the right,
the harsher is the transition into depth color.
4.9.11 CFM/PD Map
Here is a selection of eight different color palettes for “Angio” or “CFM”. The button “U” selects the
user-defined palette created in the “Settings-Palette” ( 'Settings' on page 3-10 ) menu.
Gently Color: “Gently” describes the transition between color and gray scale information. With
“Gently Color” the embedding of the color into B-Mode is performed smoothly producing less
colored splashes. Therefore, color vessels are less spiky with softer borders.
4.9.12 HD-Flow™ Map
You can select between eight different color palettes. The button “U” selects the user-defined palette
created in the “Settings-Palette” ( For more information see 'Settings' on page 3-10. ) menu.
Gently Color: “Gently” describes the transition between color and gray scale information. With
“Gently Color” the embedding of the color into B-Mode is performed smoothly producing less
colored splashes. Therefore, color vessels are less spiky with softer borders.
4.9.13 Contour Color
Select a color for the displayed shell geometry.
The color can be chosen from the “Color Select” box.

This setting can only be activated if a shell contour has been generated with VOCAL II ( For more
information see ' VOCAL ' on page 4-29. ).

4.10 MagiCut
4.10.1 MagiCut - General Information
This application offers the ability to manipulate the images electronically and, thereby, makes it
possible to remove overlaying structures or artifacts using the mouse in any of the slice images, or in
the 3D or 4D rendered image itself.
The left image displayed above, is rendered without editing, whereas the right image has been
edited in order to achieve a clearer view to the object of interest.
“MagiCut” is available in “3D/4D Full-Screen Mode”, in “Quad-Screen Display” and in “Split-Screen
Display”. If the user is in “3D/4D Full-Screen Mode”, the cutting is done on the enlarged image. In
“Quad-Screen Mode” or “Split-Screen Mode” cutting can be performed on any of the image slices or
the 3D/4D image itself. All alterations are applied to the 3D/4D rendered image only.
Select this button from the main menu in order to enable editing or cutting.
It is then possible to manipulate the images electronically.
“MagiCut” distinguishes between two methods for cutting:
1. Full: Cut through the entire volume..

2. Defined: Cut through the volume at a defined depth.
In order to make corrections, select the “Undo” ( For more information see 'Undo Function' on page 4-
70. ) or the “Undo All” button.
Instructions for MagiCut, Cut Depth “Full”

1. Select cut depth “Full”.

2. Rotate the rendered image into an appropriate position, in order to be able to cut away
overlaying structures or artifacts.
3. Select the method of cutting. For more information, view “Cutting Modes” ( For more
information see 'Cut Mode' on page 4-69. ).
4. Keep the right mouse button pressed on one of the quadrants while moving the mouse in
order to create the outline for the cut. Always have the selected cutting mode in mind, while
performing this step.
5. After releasing the right mouse button the region will be cut away (full depth) from the
rendered volume.
Note The orthogonal image slices will not be affected by the cutting.
6. Rotate the rendered image into another position and continue with step 3.
Instructions for MagiCut, Cut Depth “Defined”

1. Select cut depth “Defined”.
2. Rotate the rendered image into an appropriate position, in order to be able cut away unwanted
structures or artifacts.
3. Select the method of cutting. For more information, see “Cutting Modes” ( For more information
see 'Cut Mode' on page 4-69. ).
4. Keep the right mouse button pressed on one of the quadrants while moving the mouse in
order to create the outline for the cut. Always have the selected cutting mode in mind, while
performing this step.
5. After releasing the right mouse button the region is marked. Use the “Cut Depth” slider in order
to select the depth of the cut. Press Done to confirm changes.
Note The orthogonal image slices will not be affected by the cutting.
6. Rotate the rendered image into another position and continue with step 3.
4.10.2 Cut Mode
Six cutting methods are available in the “MagiCut” mode. These different methods can be used in
different cases in order to achieve an unobstructed view to the object of interest.
The following image shows a 3D rendered image before using “MagiCut”, and afterwards. The cutting
was performed by rotating the image until the best view for the task was found and using the
“Contour Inside” method.

The available functions can be chosen from a panel. Simply select the desired method, and edit the
image. For instructions how to cut, see “MagiCut - General Information” ( For more information see
'MagiCut - General Information' on page 4-68. ).
Here is the layout of the panel:
Inside Contour: The part of the image within the contour (drawn freehand) is discarded. If a contour
is left open, the program automatically closes the contour with a straight line from the ending point
to the starting point.
Outside Contour: All parts of the image which lie outside of the contour (drawn freehand) are
discarded. If a contour is left open, the program automatically closes the contour with a straight line
from the ending point to the starting point.
Inside Box: While holding down the right mouse button, move the mouse in a diagonal fashion from
the beginning cut point to the end cut point in order to create a box. The part of the image inside the
box is discarded.
Outside Box: Using the same way of drawing as with “Inside Box”, draw a box. All parts of the image
that lie outside the box are discarded.
Eraser: Hold down the right mouse button and move across the image. Any area touched by the
mouse cursor will be erased. There are two different sizes available for the erasers: small and big.
Any errors can be undone by using the “Undo” ( For more information see 'Undo Function' on page 4-
70. ) function.
4.10.3 Undo Function
When cutting an image, any mistakes made can be removed by using one of three available buttons:
These buttons allow the removal of mistakes one by one (up to 2 previous cuts), or the removal of all
cuts previously performed.
The “Redo” button can reestablish the situation before the “Undo” actions.

4.10.4 Cut Type
When in “Glassbody” Render Mode it is possible to cut away only from the gray or only from the color
part of the image using the Cut Type selection.
When Gray+Color is selected, MagiCut cuts away both gray and color. Gray cuts only gray values,
whereas Color cuts only colorvalues.
4.10.5 MagiCut Save
Modifications made with “MagiCut” ( For more information see 'MagiCut - General Information' on
page 4-68. ) can be saved using the GE HealthCare volume file format, either directly or in the Archive
( For more information see 'Save to Archive' on page 6-23. ) medical data storage system. However,
since “MagiCut” is related to the “3D Plane Adjustment Mode” ( For more information see 'Visualization
Mode - Multiplanar' on page 4-15. ), “MagiCut” modifications are lost as soon as another display
mode is selected.

4.11 Annotation
Switch to “Annotation” menu by pressing this toolbar button or by going to “Edit” ( For more
information see 'Edit' on page 3-6. )-”Annotation”.
Delete all annotations at once by pressing this toolbar button or by going to “Edit” ( For more
information see 'Edit' on page 3-6. )-”Clear Screen”.
4.11.1 Text Annotation
Use this functionality to place text on the ultrasound image. Activate “Text” mode by pressing the
“Text” button in the “Annotation” menu.
Place the text cursor by moving the mouse cursor to the desired location and clicking with the left-
mouse key. The blinking text cursor appears. Simply enter the text using the keyboard. The typed
text appears immediately. The typed text can be deleted using BACKSPACE as long as the cursor is
not positioned elsewhere by clicking at a different location. Open the “Settings”(For more
information see 'Annotation Settings' on page 4-73. ) menu for changing font, font color, font size
and brightness. Press “Return” to leave the “Annotation” menu again. Press “Clear Screen” to delete
all annotations (text and arrows).
Text Presets
The “Text Preset” buttons are only available if the text cursor is positioned on the ultrasound image
by moving the mouse cursor to the desired location and clicking with the left-mouse key. The
blinking text cursor appears.
Choose an application using the drop-down menu, and switch between the two pages using the
“Page1” and “Page2” buttons. Then simply press the text preset button showing the desired word
and the word is inserted at the current cursor position. A space is automatically inserted after the
word. It is possible to mix text presets with manually typed text as long as the cursor is not
positioned elsewhere by clicking at a different location. Text presets can be deleted letter by letter
using the BACKSPACE key.
There are ten applications with two pages each. Each page contains up to twenty presets. For more
information see 'Annotation Settings' on page 3-13.
4.11.2 Arrows
Use this functionality to place arrows on the ultrasound image in order to point out different
structures. Activate “Arrow” mode by pressing the “Arrow” button in the “Annotation” menu.
Move the mouse over the ultrasound image. The direction of the arrow follows the movement of the
mouse. Place the arrow by clicking the left mouse key. Use the “Delete Last” key to delete the last
arrow placed on the screen. This way it is possible to delete up to twenty arrows. Open the “Settings”
( For more information see 'Annotation Settings' on page 4-73. ) menu for changing arrow size and
brightness. Press “Return” to leave the “Annotation” menu again. Press “Clear Screen” to delete all
annotations (text and arrows).
4.11.3 Delete (Box)
Use this functionality to delete annotations. Activate “Delete (Box)” mode by pressing the “Delete
(Box)” button in the “Annotation” menu.
Move the mouse over the annotation which should be deleted. Press the left mouse key, hold it down
and move the mouse. A rectangle appears. When releasing the mouse key all annotations that are
inside the red rectangle are deleted.

4.11.4 Delete (Eraser)
Use this functionality to delete annotations. Activate “Delete (Eraser)” mode by pressing the “Delete
(Eraser)” button in the “Annotation” menu.
Move the mouse over the annotation which should be deleted. Press the left mouse key, hold it down
and move the mouse. All annotations right beneath the red square are deleted. Press “Return” to
leave the “Annotation” menu again. Press “Clear Screen” to delete all annotations (text and arrows).
4.11.5 Annotation Settings
For more information see 'Annotation Settings' on page 3-13.


Chapter 5
Measurements
Measurements - General Information - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-2

Generic Measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-3
Calculation Measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-10
Measurement Setup - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-21

Measurements
5.1 Measurements - General Information

The 4DView software has been developed to allow application specific generic and application-
specific calculation measurements. By selecting the Measure button situated on the right-hand side
of the main dialog area, the measurement menu is activated.
Measurement Button:
Note When starting the measurement package, there may be a few seconds delay. As
the measurement package has such a wide range of possibilities, it can take some
time to load it from the hard disk into the memory of the PC.
Note Generic and calculation measurements can be performed without entering

patient data. However, in order to produce a patient report/worksheet for a
specific patient as result of measurements, patient data must be entered. Also, if
the basic patient data of “patient ID” and “patient name” is entered, the
measurements are stored in a database and can be retrieved for future reference.
Therefore, before starting measurements, ensure the correctness of the patient
data.
If patient information is not registered, do it using the “Patient and Exam Info” ( For more information
see 'Current Patient Dialog' on page 6-3. ) dialog.
Open this dialog in the “Edit” menu or with the “Person” button in the toolbar.
In the “Patient and Exam Info” ( For more information see 'Current Patient Dialog' on page 6-3. )
dialog select the appropriate application and enter the patient data.
Figure 5-1 Measurement Main Menu

Measurements
5.2 Generic Measurements
5.2.1 Introduction
Select the “Generic” button in the upper right corner of the Measurement Menu to start generic
measurements.
Select the desired “Application”, “Preset” and “Subcategory”. Now select a “Study” by pressing the
according button. Per default there are four predefined studies in the generic measurement menu:
• Generic Dist. ( For more information see 'Distance Measurements (Generic Dist.)' on page 5-5. )
• Generic Area ( For more information see 'Area and Circumference Measurements (Generic Area)'
on page 5-6. )
• Generic Volume ( For more information see 'Volume Measurements (Generic Volume)' on page 5-
7. )
• Generic Angle ( For more information see 'Angle Measurements (Generic Angle)' on page 5-8. )
Studies or measurements can be edited in the Measure Setup Menu ( For more information see
'Measurement Setup' on page 5-21. ).
Now start a measurement by pressing the according button at the bottom of the screen.
Note Additionally, volumes can be measured using VOCAL II ( For more information see '
VOCAL ' on page 4-29. ).
Mouse Buttons:
After selecting a mode of measurement, position the cursor at the initial point of measurement and
press the left mouse button. All measurements are completed with the left mouse button. The right
mouse button is of use only during measurements. Between starting and finishing a measurement,
the position of the cursors may also be changed with the right mouse button.
Worksheet:
The results of the generic measurements are included in the worksheet. View the “Generic” section
of the worksheet by pressing the “Worksheet” button in the lower right corner of the measurement
menu.
5.2.2 Menu Items of Calculation Measurements
Use this dropdown field to change the

Measurement Application.
Use this dropdown field to change

between the three user defined and
the factory preset.
Use this dropdown field to change the

Application’s subcategory.
Press this button to show the

worksheet. For more information see
'Worksheet' on page 6-24.
Clear a measurement that is started

but not yet finished with the Cancel
button.

Measurements
Delete the last measurement.
Clear the actual group of

measurements with the Clear Group
button. All measurement data gets
lost.
Clear all measurements off the screen,

but preserve the measurement data
with the Clear button.
5.2.3 Calculation Method and Accuracy
Measurement Method
All measurements are performed using pixel resolution on the screen. All distances are calculated in
screen coordinates. The accuracy of the method depends on the resolution of the data set and the
“zoom” of the image on the screen. This means that larger, “zoomed” data sets lead to a finer
resolution than smaller, “zoomed” data sets. Therefore, a larger, “zoomed” image on screen leads to
more accurate measurements than a smaller, “zoomed” image.
Accordingly, the overall accuracy depends on the accuracy of the ultrasound, the “zoom” of the
volume data set and the “zoom” of the image on the screen.
For distance and circumference measurements the distance of screen points is calculated and
converted to “mm” ultrasound units ( For more information see 'Glossary' on page 9-2. ).
For area measurements the area of the marked polygon points on the screen is calculated. The
result is converted to “cm2” ultrasound units ( For more information see 'Glossary' on page 9-2. ).
Volume measurements are performed by integration of polygon areas marked in parallel planes.
The method used for the integration of the polygon areas is given by:
N = number of marked polygon areas Ai = polygon area in plane i di,j = distance between plane i and
plane j the sort order of planes 1,..., N is given by d 1,2 £ d 1,3 £... £ d 1,N
The result is converted to “ml” or “cm3” ultrasound units ( For more information see 'Glossary' on
page 9-2. ).
VOCAL II ( For more information see 'Glossary' on page 9-2. ) measurements are performed by
integration of polygon areas generated by rotation around a fixed axis (rotation axis of contours). The
method used for the integration of the polygon areas is given by:
N...number of marked contours TAi ... if i £ N... 1. halfplane polygon in plane i else 2. halfplane
polygon in plane i – N dsi ... distance between center of mass of TAi and rotation axis of contour

Measurements
The result is converted to “ml” or “cm3” ultrasound units ( For more information see 'Glossary' on
page 9-2. ).
5.2.3.1 Accuracy of measurements

Caution
The results achieved in various application specific modes (i.e. SonoAVC™, SonoNT,…) always
depend on the accuracy of the procedure performed. Any clinically relevant decisions based on
ultrasound measurements need to be reconsidered and treated carefully.
The possible accuracy of geometric, flow speed or other measurements with this ultrasound system
is a result of various parameters that shall be equally considered. The used images shall be
optimized and scaled to provide the best view of the examined structures. To ensure this, the correct
choice of the ultrasound probe and imaging mode for a certain clinical application plays an essential
role.
Despite the high theoretical accuracy of the scan geometry and the measuring system of the
Voluson™ ultrasound system, it is important to be aware of increased inaccuracies caused by the
ultrasound beam travelling through the inhomogeneous human tissue. Therefore differences
between operators shall be minimized by standardization of procedures.
For more information see Advanced Acoustic Output References.
For more information see the respective chapter in the Instructions for Use of your device.
5.2.4 Distance Measurements (Generic Dist.)
Several different measurement methods are available. The measurement will be drawn on the
screen identified with a special top left graphic. The corresponding result will be displayed in the
result field located at the bottom left of the screen.
Distance 2 Point Measurement

Begin measuring by placing the mouse cursor at the initial point of measurement in one of the three
orthogonal planes, and click the left mouse button once. Move the mouse cursor to the final point of
measurement, and click the left mouse button once again.
Distance 2 Line Measurement

A horizontal line appears on the screen. Place the line on the initial point of measurement and click
the left mouse button. Rotate the line by moving the mouse. If the line is aligned correctly with the
image click the left mouse button once again. A parallel line appears. Move the mouse to position the
second line. Click the left mouse button to finalize this measurement.
Length Trace
orthogonal planes. Click the left mouse button and move the cursor along the structure that should
be measured. To finish the trace, click the left mouse button again.
Length Point
orthogonal planes. Click the left mouse button and move the cursor to the next point of
measurement. Click the left mouse button to connect the two measurement points. Repeat this
process until the measurement is finished. Click the right mouse button to delete the previous point
of measurement. Finalize the measurement by double-clicking the left mouse button at the last
measurement point.
Stenosis% Distance

Measurements
measurement, and click the left mouse button once again. Repeat this procedure for the second
distance.
Ratio D1/D2
To measure the ratio between two distances:
1. Measure the first distance as described above.
2. Measure the second distance as described above. The ratio is calculated automatically.
5.2.5 Area and Circumference Measurements (Generic Area)
screen identified with a special graphic. The corresponding result will be displayed in the result field
located at the top left of the screen.
Area Trace
orthogonal planes. Click the left mouse button and move the move the mouse along the
circumference of the area of interest. To finish the trace, click the left mouse button again. If an area
trace is not closed completely after finishing the trace, the trace will be automatically completed with
a straight line from the end point to the start point. Circumference and area of the figure are
displayed in the result field.
Ellipse
With one click of the left mouse button fix one diameter of the ellipse, with another click of the left
mouse button fix the other diameter. Move the mouse to expand the ellipse and click the left mouse
button to finish the measurement. Circumference and area of the figure are displayed in the result
field.
Area Point
orthogonal planes. Click the left mouse button and move the cursor to the next point of
measurement. Click the left mouse button to connect the two measurement points. Repeat this
process until the measurement is finished. Finalize the measurement by double-clicking the left
mouse button at the last measurement point. If an area is not closed completely after finishing the
measurement, the first and the last measurement point will be automatically connected with a
straight line. Circumference and area of the figure are displayed in the result field.
Area 2Distance
measurement, and click the left mouse button once again. Repeat this process to draw the second
line. The area and circumference defined by the two lines are displayed on the screen.
Stenosis% Area
With one click of the left mouse button fix one diameter of the ellipse, with another click of the left
mouse button fix the other diameter. Move the mouse to expand the ellipse and click the left mouse
button to finish the measurement. Repeat this process for the second area measurement.
Ratio A1/A2
To calculate the ratio between two areas:
1. Select Ratio A1/A2.
2. Measure the first and second area as described above. The ratio is calculated automatically.

Measurements
5.2.6 Volume Measurements (Generic Volume)
3 Distances
Draw the distances in the same manner as drawing lines described in “Distance Measurements” ( For
more information see 'Distance Measurements (Generic Dist.)' on page 5-5. ). The volume of the
ellipsoid described by three distances is displayed.
Ellipse
Draw an ellipse as described in “Ellipse Measurements” ( For more information see 'Area and
Circumference Measurements (Generic Area)' on page 5-6. ). The volume of the ellipsoid described by
the ellipse is displayed in the result field.
Ellipse 1 Distance
Draw the distances in the same manner as drawing lines described in “Distance Measurements” ( For
more information see 'Distance Measurements (Generic Dist.)' on page 5-5. ). Then draw an ellipse as
described in “Ellipse Measurements” ( For more information see 'Area and Circumference
Measurements (Generic Area)' on page 5-6. ). The volume of the ellipsoid described by the ellipse and
the distance is displayed in the result field.
1 Distance
Draw the distances in the same manner as drawing lines, described in “Distance Measurements” ( For
more information see 'Distance Measurements (Generic Dist.)' on page 5-5. ). The distance is used as
diameter for a sphere and the volume of the sphere is calculated and displayed.
Multiplane
For this measurement method a submenu appears, to perform the definition of a volume:
In this method different areas around the object of interest must be defined in parallel slices. In order
to mark an area review the “Area and Circumference Measurements” ( For more information see 'Area
and Circumference Measurements (Generic Area)' on page 5-6. ) method.
The mouse will be restricted to the selected image plane. The image plane can be selected in the
“Main” menu with the three “Ref Image” buttons.
Marked areas are displayed in green when the image plane is in the same slice. Use the “Ref Slice”
slider to change image slices. By moving forward or backward, the outline of the area changes to
yellow. Using the “Previous” or “Next” button, the area of the nearest marked slice is displayed. Note
that in any single slice only one area can be marked. This means, by marking a new area, the
previous one (if one exists) is replaced by the new area trace. Each marked area is represented in the
orthogonal planes as a point, a line and an arrow in the corresponding location. Use the “Previous”
or “Next” buttons to move to these planes.
The volume is calculated using all marked areas and connecting them in order to form a volume.

Measurements
For best results:

The object of interest should be aligned in its main axis position. If the outline of the area displayed
in yellow does not fit the area structure on the screen, a new area should be marked. A marked area
can always be redrawn when it appears in green. The final result depends on the accuracy of the
marked areas.
Note During this measurement mode, all other measurements on screen will be
temporarily removed, and will reappear when the specific measurement mode is
selected again.
5.2.7 Angle Measurements (Generic Angle)
Angle 3 Point
Start by placing the cursor at the initial measurement point and clicking the left mouse button. Move
the mouse to the second measurement point and click the left mouse button to draw the first line.
Now finalize the measurement by moving the mouse to the third measurement point and clicking
the left mouse button again. The second line is drawn. The angle between these two lines is
displayed in the result area.
Angle 2 Line
To begin measurement, move the cursor to the image where angle calculation will be performed and
draw a line as described in “Distance Measurements” ( For more information see 'Distance
Measurements (Generic Dist.)' on page 5-5. ). Draw a second line in the same way. The angle between
these two lines is displayed in the result area.
5.2.8 Generic Vessel
Vessel Area
To start the measurement move the cursor to the starting point an click the left mouse button. Move
the mouse to the end point and click the left mouse button again. Adjust the width of the ellipse if
necessary and click the left mouse button. The result is displayed in the result area.
Vessel Diam.
To measure the vessel diameter position the starting point with the mouse and click the left mouse
button. Then move the mouse to the end point and click the left mouse button again. The result is
displayed in the result area.
Stenosis Area
Position the first point of the long axis with the mouse and click the left mouse button. Then position
the second point of the long axis and click the left mouse button. Adjust the length of the short axis
with the mouse if necessary. The result is displayed in the result area.
Stenosis Diam.
To measure the diameter position the starting and the end point of the line and click the left mouse
button. The diameter is displayed.
IMT
The IMT is measured by positioning the starting and the end point with the mouse and clicking the
left mouse button.

Measurements
Flow Diam.
To measure the diameter position the starting and the end point with the mouse and click the left
mouse button. The result is displayed.

Measurements
5.3 Calculation Measurements
5.3.1 Calculation Measurements
In order to start calculation measurements click on the “Calc” button at the top of the “Measure”
menu.
The menu now looks similar to the image below:
The “Fetus” control at the bottom of the screen is displayed only if the application is OB and a
number of fetuses greater than 1 has been entered in the “Patient and Exam Info” ( For more
information see 'Current Patient Dialog' on page 6-3. ) dialog.
Select the desired “Application”, “Preset” and “Subcategory”. Now select a “Study” by pressing the
according button.
Studies or measurements can be edited in the Measure Setup Menu ( For more information see
'Measurement Setup' on page 5-21. ).
Now start a measurement by pressing the according button at the bottom of the screen.
5.3.2 OB Calculations
Note The mathematical methods used in 4DView are identical to those used in the
Voluson™ Family series ultrasound scanners. Please refer to your system’s
Advanced Reference Manual for further information about equations and tables
used for calculations.
Biometry
Per default the items of OB - Biometry calculations are briefly divided into “Fetal Biometry”, “Early
Gestation”, “Long Bones”, “Fetal Cranium”, “AFI”, “Uterus”, “Left/Right Ovary”, “Umbilical Vein” “Left/
Right Uterine”, “Fract. Limb Vol.”, "Placenta" and "Cerebellar Vermis".
To switch between left and right ovary use the “Side” control at the bottom of the screen.
For some measurements there are different measure tools available. For example, HC(Hadlock) can
be measured using either the AreaEllipse, 2DAreaTrace or the 2DAreaPoints tool. Simply select the
appropriate tool in the “Tool” dropdown field.
Fetal Biometry per default contains: BPD, OFD, HC, APAD, AC, TAD, FL, CEREB, HL, NF.
Early Gestation per default contains: CRL, GS, YS, BPD, FL, NT, IT.
Long Bones per default contains: FL, HL, RAD, ULNA, TIB, FIB, CLAV.

Measurements
Note If "Use Left/Right for Fetal Long Bones" is selected in the measurement setup, a
Right/Left/Neutral switch is available.
Fetal Cranium per default contains: CEREB, CM, BOD, IOD, NT, Va, Vp, HEM, C.S.P., NF.
AFI per default contains: Q1, Q2, Q3 and Q4.
Uterus per default contains: Length, Height, Width, UT-Trace, Endo Trace, Endo. Thickn and Cervix
Length.
Left/Right Ovary per default contains: Length, Height, Width.
Umbilical Vein per default contains: Diameter.
Left/Right Uterine per default contains: Uterine A. Diameter.
Fract Limb Vol. per default contains: AVol and TVol.
Placenta per default contains: Thick., Width, Height.
Cerebral Vermis per default contains: Sagittal AP, Sagittal CC, VermisC VermisA and Cereb.
Z Score
Per default the items of OB - Z Score calculations are briefly divided into “Long Axis”, “Aortic Arch”,
“Short Axis”, “Obl. Short Axis” and “4 Chamber”.
Long Axis per default contains: AV, Asc Aorta.
Aortic Arch per default contains: AV, Asc Aorta, Desc Aorta, Inf. Vena Cava.
Short Axis per default contains: PV, Main PA, Right PA, Left PA.
Obl. Short Axis per default contains: Art. Duct.
4 Chamber per default contains: TV, RV EDD, RV Inlet, RV Area, MV, LV EDD, LV Inlet, LV Area.
Fetal Echo
Per default the items of OB - Fetal Echo calculations are briefly divided into "Chambers", “Thorax”,
“Venuos”, "Aorta, LVOT" and "Pulmonary, RVOT".
Chambers per default contains: RVW, RVD, RAD, IVS, MV annulus, LVW, LVD, LAD sys, LAD dia, TV
annulus.
Thorax per default contains: Cardiac circumfer., Thoracic circumfer., Heart area, Thorax area,
Cardiac axis.
Venuos per default contains: SVC, IVC.
Aorta, LVOT per default contains: AV annulus, Ao root diam., Ao ascending, Ao isthmus, Ao
descending and LVOT Diam.
Pulmonary, RVOT per default contains: PV annulus, MPA Diam., LPA Diam., Duct. Art. Diam., RVOT
Diam. and RPA Diam.
OB Calculation Measurements
As input for OB calculations distances and circumferences/areas are measured. For most of the items
in the OB calculations a distance is measured (e.g. BPD). The items that use a circumference as input
include "HC", and "AC" for example. In the case of "AFI" four distances are measured.
OB Calculations with Distance

Example: BPD
1. After obtaining the desired image, click the “Measure” button and then in the “Measure” menu
click the “Calculation” button.
2. Select the application “OB”.
3. Select the desired study. In the case of “BPD”, select “Fetal Biometry”.
4. Select the desired item “BPD”.

Measurements
5. Measurements are performed using the mouse. (For details please refer to the section
“Distance Measurements” ( For more information see 'Distance Measurements (Generic Dist.)' on
page 5-5. ))
The results appear in the image area and are included in the worksheet. In order to clear the
measurements of a currently selected study, click the “Clear Group” button.
OB Calculations with Circumference

Example: HC
1. After obtaining the desired image, click the “Measure” button and then in the “Measure” menu
click the “Calculation” button.
3. Select the desired study. In the case of “HC”, select “Fetal Biometry”.
4. Select the desired item “HC”.
5. Measurements are performed using the mouse.(For details please refer to the section “Area
and Circumference Measurement” ( For more information see 'Area and Circumference
Measurements (Generic Area)' on page 5-6. ))
Calculation of AFI
1. After obtaining the desired image, click the “Measure” button and then in the “Measurement”
menu click the “Calculation” button.
3. Select the study “AFI”.
4. Select the desired item.
5. Measurements are performed using the mouse. Four distance measurements can be made and
displayed in the result field. (For details please refer to the section “Distance Measurements”
( For more information see 'Distance Measurements (Generic Dist.)' on page 5-5. ))
Fractional Limb
This measurement is for calculating the volume of fetal limbs. Based on this partial volume-
calculation the fetal weight can be estimated.
Figure: Fractional limb volume. Fractional Arm (AVol) and Thigh (TVol) volumes are based on 50% of
the humeral (A) or femoral (B) diaphysis length. Mid-limb measurements eliminate the need for
tracing soft tissue borders near the ends of the bone shaft, where acoustic shadowing is more likely
to be encountered.
Method

Measurements
The slice positions are determined automatically depending on the reference distance line, the slice
number and the percentage of limb and displayed graphically on screen. The volume is calculated
after the area measurements are done on the slices.
1. 100% Limb length (reference length)
2. Percentage of limb
3. Reference distance line
4. Equidistant Slice positions (start/end

depend on percentage of limb)
Number of slices: fixed to 5Percentage of Limb: fixed to 50%

Operation
1. Activate a Fractional Limb study by selecting the measure group [Fract. Limb] in the Calc.
menu, application OB/Biometry. The Fractional Limb measure items appear on the
touchscreen. Select the corresponding fetus number if necessary.
2. Select the measurement [AVol Leel] or [TVol Lee]. The Fractional Limb edit menu appears on
the the touchscreen.
3. Define the reference line with the mouse. Accept with left or right mouse button.
4. Measure the all areas. When the measurement is done the next line will be highlighted. If the
last area is measured press the Done button.
5. If necessary correct the measurements.
6. Press Done to finish the measurement.
Early Gest. - NT
To calculate NT, the Nuchal Translucency:
• Manual NT: Same as standard distance measurement: 'Distance Measurements (Generic Dist.)'
on page 5-5
• SonoNT: Follow these instructions to carry out an automated NT measurement:
1. Choose the study Early Gestation from the subcategory Biometry in the OB application.
2. Click the NT measure item.
3. Switch to SonoNT by using the Tool dropdown field.
4. Use the mouse to draw a box around the nuchal fold. Press the left mouse button to set the
first corner point of the box. A second cursor appears.
5. Move the second cursor to the second corner point of the box and press the left mouse button
again.
Note To re-adjust the corner points, press the right mouse button. This alternates the
control from one cursor to the other.
6. If the analysis finds a result: The NT measurement will be displayed. The NT position can now
be changed, using the Face up / Face down buttons. If the analysis can not find a result, a
message appears on screen: No valid NT-distance found! Start over with step 4.

Measurements
NT Method Switch between “Manual” or

“Sono” NT.
Face up/down Switch between “Face up” or

“Face down”. Select according
to scanned image.
i-i, i-m NT calculation algorithm

i-i: inner - inner*
i-m: inner - middle**
Key is hidden if not activated
in measure settings:
'Parameters' on page 5-22
*K Nicolaides. The 11-13+6 weeks scan. Fetal Medicine Foundation, London 2004
** FMF Certificate of Competence in the measurement of Nuchal translucency,
http://www.fetalmedicine.com/fmf/training-certification/certificates-of-competence/
11-13-week-scan/nuchal/, 2010
The NT measurement will be displayed in the worksheet as follows:
1.) “1” - inner - inner

2.) “2” - inner - middle
3.)Manual NT
Caution
SonoNT measurement is a suggestion of the system. The user is responsible for all measurements
and images made in SonoNT!
5.3.2.1 SonoIT (Sonography based Intracranial Translucency)

SonoIT (Sonography based Intracranial Translucency) is a system supported measurement for
Intracranial Translucency. Starting from the routinely used midsagittal view of the fetal face,
obtained for assessment of the Nuchal Translucency and nasal bone, the ultrasound system uses a
semi-automated mode to measure the anterior-posterior diameter of the fourth ventricle
recognizable as intracranial translucency.
The workflow is identical with SonoNT.
5.3.2.2 SonoBiometry
SonoBiometry is an alternative to the common fetal biometry measurements. It provides system
suggested measurements for BPD, HC, AC, HL and FL which need to be confirmed by the user or can
be changed manually.
Using SonoBiometry
Preparation
1. Select the Settings menu on the menu bar.
2. Select Measure Setup...
3. Select the tab Application Parameters.
4. Select the measurement package OB.

Measurements
5. Check the desired boxes under SonoBiometry Configuration to enable system suggested
measurements.
Workflow
1. Press Calc on the user interface.
2. Select the measurement package OB.
3. Select the desired measurement item (BPD, HC, AC or FL).
4. The calculation process starts. The result is displayed on the monitor screen. If no result is
found a message appears on the screen and the system switches to manual measurement
mode. If a result is found continue with step 5.
5. Press the left mouse button to store the measurement or press the right mouse button to
continue with manual correction.
Note The measurement mode can be changed from auto to manual by using the left
mouse button. Available measurement methods depend on this selection and on
the measurement item itself.
5.3.3 Abdomen Calculations
The Items of Abdomen Calculations

Per default the items of Abdomen calculations are briefly divided into “Liver”, “Gall Bladder”,
“Pancreas”, “Spleen”, “Left/Right Kidney”, “Left/Right Renal A.”, “Prox/Mid/Dist Aorta”, “Vessel”,
“Portal V.” and "Bladder".
To switch between left and right use the “Side” control at the bottom of the screen. To switch
between prox, mid, dist and no position use the “Pos” control at the bottom of the screen.
Liver per default contains: Length, Height, Width, Portal V. Dia.
Gall Bladder per default contains: Length, Height, Width, Wall, CBD.
Pancreas per default contains: Duct, Head, Body, Tail.
Spleen per default contains: Length, Height, Width, Access.Spleen.
Left/Right Kidney per default contains: Length, Height, Width.
Left/Right Renal Artery, Aorta and Vessel per default contains: Vessel Area, Vessel Diameter,
Stenosis Area, Stenosis Diameter, Flow Diameter.
Port V. per default contains: Flow Diameter.
Bladder per default contains: Length, Height, Width.
Abdomen Calculation Measurements

As input for Abdomen calculations distances and circumferences/areas are measured. For most of
the items in the Abdomen calculations a distance ( For more information see 'Distance Measurements
(Generic Dist.)' on page 5-5. ) is measured (e.g., Length, height, Width). The items that use a
circumference/area ( For more information see 'Area and Circumference Measurements (Generic Area)'
on page 5-6. ) as input include “Vessel Area”, and “Stenosis Area” for example.
5.3.4 Small Parts Calculations
The Items of Small Parts Calculations

Per default the items of Small Parts calculations are briefly divided into “Left/Right Thyroid”, “Left/
Right Testicle”, "Dor.Pen.A" and “Vessel”.
To switch between left and right use the “Side” control at the bottom of the screen.
Left/Right Thyroid and Left/Right Testicle per default contain: Length, Height, Width.
Vessel per default contains: Vessel Area, Vessel Diameter, Stenosis Area, Stenosis Diameter.
Dor.Pen.A per default contains: Vessel Area, Vessel Diameter, Stenosis Area, Stenosis Diameter.

Measurements
Per default the items of Breast calculations are briefly divided into "Lesion #1- 5".
Lesion #1- 5 per default contain: Nipple-Les. Dist., Skin-Les. dist., Length, Width, Height.
Small Parts Calculation Measurements

As input for Small Parts calculations distances and circumferences/areas are measured. For most of
the items in the Small Parts calculations a distance ( For more information see 'Distance
Measurements (Generic Dist.)' on page 5-5. ) is measured (e.g., Length, height, Width). The items that
use a circumference/area ( For more information see 'Area and Circumference Measurements (Generic
Area)' on page 5-6. ) as input include “Vessel Area”, and “Stenosis Area” for example.
5.3.5 Cardio Calculations
The Items of Cardio Calculations

Per default the items of Cardio calculations are briefly divided into "LV Simps.", “Vol A/L”, “LV”, “LV
Mass”, “LVOT”, “RVOT”, “MV”, “TV”, “AV/LA”, and “PV”.
LV Simps. per default contains: A4C Dias., A2C Dias., A4C Syst., A2C Syst.
Vol A/L per default contains: LV Vol Diast., LV Vol Syst.
LV per default contains: IVSd, LVDd, LVPWd, RVDd, IVSs, LVDs, LVPWs, RVDs.
LV Mass per default contains: Epi Area, Endo Area, LV Length.
LVOT per default contains: LVOT Diameter.
RVOT per default contains: RVOT Diameter.
MV per default contains: Dist A, Dist B, Area, PISA..
TV per default contains: TV Diam. , PISA..
AV/LA per default contains: Ao Root Diam., LA Diam., PISA.
PV per default contains: PV Diameter, PISA.
5.3.6 Transrectal Calculations
The Items of Transrectal Calculations

Per default there is only one study for Transrectal calculations: "Prostate".
Prostate per default contains: Length, Height, Width.
Transrectal Calculation Measurements

As input for Transrectal calculations distances and circumferences/areas are measured. For most of
the items in the Transrectal calculations a distance ( For more information see 'Distance
Measurements (Generic Dist.)' on page 5-5. ) is measured (e.g., Length, height, Width). The items that
use a circumference/area ( For more information see 'Area and Circumference Measurements (Generic
Area)' on page 5-6. ) as input include “Vessel Area”, and “Stenosis Area” for example.
5.3.7 Vascular Calculations

Measurements
The subcategories of Vascular Calculations

Per default the items of Vascular calculations are briefly divided into Carotid, UEA (Upper Extremity
Artery), UEV ( Upper Extremity Vein), Renal Artery, LEV (Lower Extremity Vein), LEA (Lower Extremity
Artery) and TCD (Transcranial Doppler).
Carotid per default contains: Subclav. A., CCA, ECA, ICA, Bulb, Vertebral, Vessel.
UEA (Upper Extremity Artery) per default contains: Innom. Art., Subclav. A, Axill. Art., Brach. Art.,
Rad. Art., Ulnar. Art., SupPalm.A, DeepPalm.A and Graft.
UEV ( Upper Extremity Vein) per default contains: Innom. V., Subclav. V., Jugular. V., Axill. V., Ceph.
V., Basilic V., Brach. V, Med. Cub.V., Rad. V., Ulnar. V.
Renal Artery per default contains: Renal Artery, Renal V., Segm. Art., Interlob. Art, Arcuate A.
LEA (Lower Extremity Artery) per default contains: Com.Iliac A, Ext. Iliac A, Int. Iliac A, Com. Fem.
A, Prof.Fem.A., Sup. Fem. A, Popl.Art., Ant. Tib.A, Post. Tib. A, Peron. Art., Dors. Ped. A, Graft.
LEV (Lower Extremity Vein) per default contains: IVC, Com.Iliac V, Ext. Iliac V, Int.Iliac V, Com. Fem.
V, Gr. Saph. V, Sup.Fem.V., Prof.Fem.V, Popl. V., Low Saph. V, Ant. Tib. V, Post. Tib. V, Peron. V.
TCD (Transcranial Doppler) per default contains: MCA, ACA, PCA, A com.A, P com.A, Vertebral,
Basilaris.
Default measure items in all studies include Vessel Area, Vessel Diam., Stenosis Area, Stenosis
Diam., IMT and Flow Diam.
Vascular Calculation Measurements

As input for Vascular calculations distances and circumferences/areas are measured. For most of the
items in the Vascular calculations a distance ( For more information see 'Distance Measurements
5.3.8 GYN Calculations
The Items of Gyn Calculations

Per default the items of Gyn calculations are briefly divided into “Uterus”,”Left/Right Uterine”, “Left/
Right Ovary”, “Left/Right Follicle”, “Fibroid” and “Pelvic Floor”.
Uterus per default contains: Length, Height, Width, UT-Trace, Endo Trace, Endo. Thickness, Cervix
Length.
Left/Right Uterine per default contains: A. Diameter
Left/Right Ovary per default contains: Length, Height, Width. Cyst, Mass
Left/Right Follicle per default contains: Follicle.
Fibroid per default contains: Fibroid.
Pelvic Floor per default contains: Detrusor wall thick., Urethral rotation., Uterine desc. max, Re.
amp. desc. max, Rectocele depth, Bladder neck rest, Bladder neck stress, Bladder desc. max, Levator
hiat. stress and Residual urine.
Adnexal per default contains: Cyst (left/right), Mass (left/right)
Mass per default contains: Cyst, Mass
Bladder per default contains: Length, Height, Width
GYN Calculation Measurements

For all GYN calculations the basis is a measurement of distance ( For more information see 'Distance
Measurements (Generic Dist.)' on page 5-5. ).

Measurements
When “Left/Right Follicle” or “Fibroid” are chosen as study, the follicles can be measured. After
measuring the diameter, the follicle volume is automatically calculated by using the formula for a
sphere.
5.3.8.1 Additional Measurements
Stress / rest sequence

To measure the stress sequence:
1. Select the measurement. The cursor appears.
2. Position the horizontal reference line and press Set.
3. Position the endpoint of the first distance measurement (BSD-s). The start point is positioned
automatically. The set endpoint is the start point of the first angle measurement.
4. Position the endpoint of the first (UTA-s) and second angle measurement (RVA-s).
5. Position the endpoint of the second distance measurement (BD max). The start point is
positioned automatically.
6. Position the endpoint of the third (UD max) and fourth distance measurement (RAD max). The
start point is positioned automatically on the reference line.
Note The following measurements are displayed as negative numbers when they are
performed from the reference line in direction to the probe surface and as positive
numbers when they are performed starting from the reference line leading away
from the probe surface:
• BSD-s
• BD max
• UD max
• RAD max
Note If BD, UD and RAD are part of the sequence depends on the selection in the
measure setup.
To measure the rest sequence:

2. Position the horizontal reference line and press Set.
3. Position the endpoint of the distance measurement (BSD-r). The start point is positioned
automatically. The set endpoint is the start point of the first angle measurement.
4. Position the second (UTA-r) and third point (RVA_r) of the angle measurement.
5. Position the end-point of the 2nd (BD max.), 3rd (UD max) and 4th (RAD max) distance
measurement . The start-point is positioned on the reference line automatically.
Note The following measurement is displayed as negative numbers when it is

performed from the reference line in direction to the probe surface and as positive
numbers when it is performed starting from the reference line leading away from
the probe surface:
• BSD-r
Note If BD, UD and RAD are part of the sequence depends on the selection in the
measure setup.
Pelvic Floor
To measure the Levator Hiatus:

Measurements
2. Position the cursor and press Set Area to fix the start point of the Levator Hiatus measurement.
3. Draw the trace with the trackball. Press Undo to remove the last part of the trace or Edit Area
to change the trace if needed.
4. Press Set Area to finish the measurement.
5. Position the cursor and press Set AP to fix the start point of the LH AP Diam measurement,
then position the cursor and press Set AP to fix the end point of the LH AP Diam measurement.
Press Change to switch the focus of the start and end point or press Edit Area to edit the
Levator Hiatus measurement.
6. Position the cursor and press Set Lat to fix the start point of the LH Lat Diam measurement,
then position the cursor and press Accept to fix the end point of the LH Lat Diam measurement
or press Edit Area to edit the Levator Hiatus measurement and afterwards Edit AP to edit the
LH AP Diam measurement
2D Angle Distance
To measure the 2D Angle Distance:
2. Position point 1 with the trackball and press Set.
3. Position point 2 with the trackball and press Set. Line 1 is displayed/refreshed while
positioning point 2.
4. Position point 3 with the trackball and press Set. Line 2 is displayed/refreshed while
positioning point 3.
5.3.9 Ped Calculations
The Items of Ped Calculations

Per default the items of Pediatric Calculations are briefly divided into: “Left/Right HIP” and
"Perical.A".
Left/Right HIP per default contains: Hip Joint.
Perical.A per default contains: Vessel Area, Vessel Diam., Stenosis Area, Stenosis Diam., Intima,
Flow Diam.
Ped Calculation Measurements

The basis for the Hip Joint calculation are three lines. The angles between these lines are calculated
and displayed on screen.
5.3.10 Cephalic Calculations
The Items of Cephalic Calculations

Per default the items of Cephalic calculations are briefly divided into “Left/Right Prox/Mid/Dist CCA”,
“Left/Right Prox/Mid/Dist ICA”, “Left/Right ACA”, “Left/Right Vertebral”, “Left/Right MCA”, “Left/Right
PCA”, “Basilar”, “A Com A”, “Left/Right P Com A”, and “Vessel”.
Left/Right Prox/Mid/Dist CCA per default contains: Vessel Area, Vessel Diameter, Stenosis Area,
Stenosis Diameter, Flow Diameter, IMT.
Left/Right Prox/Mid/Dist ACA per default contains: Vessel Area, Vessel Diameter, Stenosis Area,
Left/Right Prox/Mid/Dist ICA per default contains: Vessel Area, Vessel Diameter, Stenosis Area,

Measurements
Left/Right Prox/Mid/Dist MCA per default contains: Vessel Area, Vessel Diameter, Stenosis Area,
Left/Right Prox/Mid/Dist PCA per default contains: Vessel Area, Vessel Diameter, Stenosis Area,
Left/Right Vertebral per default contains: Vessel Area, Vessel Diameter, Stenosis Area, Stenosis
Diameter, Flow Diameter, IMT.
Basilar per default contains: Vessel Area, Vessel Diameter, Stenosis Area, Stenosis Diameter, Flow
Diameter, IMT.
A Com A. per default contains: Vessel Area, Vessel Diameter, Stenosis Area, Stenosis Diameter, Flow
Diameter, IMT.
Left/Right P Com A. per default contains: Vessel Area, Vessel Diameter, Stenosis Area, Stenosis
Diameter, Flow Diameter, IMT.
Vessel per default contains: Vessel Area, Vessel Diameter, Stenosis Area, Stenosis Diameter, Flow
Diameter, IMT.
Cephalic Calculation Measurements

As input for Cephalic calculations distances and circumferences/areas are measured. For most of the
items in the Cephalic calculations a distance ( For more information see 'Distance Measurements
5.3.11 MSK Calculations
The Items of MSK Calculations

Per default there are no items and studies in MSK calculations.

Measurements
5.4 Measurement Setup

Via the “Settings” menu ( For more information see 'Settings' on page 3-10. ) enter the measurement
setup area by selecting “Measure Setup”.
Note When the measurement setup is started and measurements have not been used
previously in the current working session with 4DView, there can be a delay of a
few seconds. As the measurement package does have a wide range of possibilities
it takes some time to load from the hard disk into the memory of the PC.
5.4.1 Measure & Calc
This tab is used to select which measurements will be available in the Generic Measurement Menu
( For more information see 'Generic Measurements' on page 5-3. ) and in the Calculation Measurement
Menu ( For more information see 'Calculation Measurements' on page 5-10. ). In addition it is possible
to add new measurements and tables, edit existing measurements and tables and define auto
sequences.
For more details on how to work with the functionality of this tab please refer to a Voluson™ Family
Instructions for Use Measurement Setup Section.

Measurements
5.4.2 Parameters
Figure 5-2 Parameters
1. Select the desired Parameter (i.e. Global Parameters, Abdomen, Small Parts, Obstetrics,...)
and click onto the + next to it to open the menu. The corresponding configuration menu is
displayed on the right side.
2. Select and adjust the desired settings as you prefer by choosing the desired options from drop
down menus or by enabling/disabling them with the checkboxes available (i.e. enable an
automatic change of the measure application according to the selected probe application by
checking Measurement linked to imaging application, sort the 2D follicle measurements as
desired, define the desired number of Pregnancy Days or select the generic measurements to
be displayed in the Calc menu).
Note When reloading an older worksheet from a previous system, also the old
parameter settings are displayed and not the newly defined ones.
Note It is possible to define the desired values for the Quad graph default
configuration. If " " is selected, no default value is used.
5.4.3 Report
The contents and design of the Report can be configured in the Setup and Designer tabs. One factory
setting and three user defined settings are available. The factory settings cannot be changed.

Measurements
Figure 5-3 Report
Setup
• Individual settings can be configured for each application.
• List items can be checked or unchecked and sorted.
Application 1. Choose an application from the drop down list.

2. Select which Exam Details should be included in the Report.
They are grouped together in blocks. The blocks are related
to the Patient Information Screen.
3. Select which measurements should be displayed and set their
order of appearance.
4. You may check Show only mean values of measurements to
display only the mean values of measurements.
5. In application OB you may check Use Compact Format to
configure a customized Report. Press Configure to define the
output of the Compact Format. For more information see
'Compact Format' on page 5-24.
6. The Report Order button is only available in application OB. It
defines in which order the OB measurements are listed.
General settings The following general report settings are available:
Patient Details
1. Select which Patient Details should be displayed.
2. Set their order of appearance.
Number of images in a row
Show report title
Combine OB & GYN Report
Show signature block
Print: Header, Footer
Repeat header on each page
Print Preview Displays a print preview of the Report.

Measurements
Export Template Opens a window to save the current settings as a template.

1. Select a directory.
2. File name and type (*.rtp) are assigned by the system.
3. Select which settings should be exported (Factory, User 1,
User 2, User 3).
4. Click Export.
5. If the Export was successful, the message "Export
completed!" is displayed. If the Export was not successful, the
message "Export failed" is displayed.
Import Template Opens a window where you can select a template that should be
imported.
1. Select a directory.
2. Select a file (*.rtp).
3. Select the settings (User 1, User 2, User 3) that the template
should be imported to.
4. Select where (Factory, User 1, User 2, User 3) the settings
should be imported from.
5. Click Import.
Copy Opens a window to copy settings from one destination to the

other.
1. Select Copy from.
2. Select Copy to.
3. Select Settings to copy.
4. Select Application.
5. Click OK.
Save Saves the current settings.
Exit Closes the Measure Setup.
Compact Format
Note Compact Format is only available in application OB.
1. Select the Use Compact Format check box.

2. Press Configure.
3. The Compact Report Configuration window opens.
Format A contains 4 graphs and is shown on the left side of the window. Format B contains 1
graph and 3 images with measurements. Format B is shown on the right side of the window.
4. Select Format A or Format B or both to define what should be displayed on the printout.
5. Select the page on which Format A and Format B should be printed.
6. In Format A select from the drop down menus which measurement graphs should be
displayed.
7. If all fetuses should be displayed in Format A, check the box All fetuses.
8. In Format B select from the drop down menu which measurement graph should be displayed.
9. In Format B select from the drop down menus which measurements and images should be
displayed.
10. Press OK.

Measurements
Designer
The style of the Report can be individually designed.
Figure 5-4 Report Designer
Header • Press the + symbol to insert a logo or image
• Press the x symbol to delete a logo or image
• Enter text in the text box
• Insert predefined content such as date or time from Quick

Parts.
• Format the font as desired
Footer Enter text in the text box. It provides the same functions as the
header text box.
Margins Set individual margins for left, right, top and bottom.
Quick Parts Choose predefined items such as date, time or application from
the drop down list.
Images in the Worksheet

Images can be added to the Worksheet.For more information see 'Images in the Worksheet' on page
6-21.

Measurements
5.4.4 SonoAVC™
Figure 5-5 SonoAVC™
Controls
Result Columns Check the parameters, which should be displayed.
Note If Save is pressed and no column is checked,

the system automatically checks the column
V and a default message appears.
Graph Configures the two lines displayed in the graph.
Cut-off Follicles Enter cut-off values to configure the range of values that are
displayed in the result list and graph. All follicles below and
above the defined values are displayed in white color in the
SonoAVC™ list. They are not displayed in the graph in the
worksheet.
Data Transfer Select the desired format:

• Voluson Format (Default)
• DICOM SR Format
• Transfer all values (Default: On; Transfers all follicles)
Defaults Select the desired:

• Method: Auto (Default), Semi-Auto, Manual
• Man. Meas. Tool: 2Dist.(Default), Ellipse
Copy Copies settings from Factory to User.
Group Configuration • Select the desired group.
• Enter the group range values (min, max)
• Select the group color configuration

Default settings: Group 1 (5-8 mm, color red), Group 2 (2-5
mm, color blue)
Save Saves all the changes.
Exit Press Exit to leave the menu.

Chapter 6
Archive
Current Patient Dialog - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-3

Archive - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-8
Image History - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-17
Exam Review - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-18
Save to Archive - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-23
Worksheet - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-24

Archive
The following functions are available:
Current patient dialog: the patient dialog allows you to

enter patient data, For more information see 'Current
Patient Dialog' on page 6-3.
Patient archive: the patient archive is the database, in

which you search for a particular exam of a particular
patient, For more information see 'Archive' on page 6-8.
Image history: image history gives you access to all the us

pictures of all exams of one particular patient, For more
information see 'Image History' on page 6-17.
Exam review: exam review allows you to view one exam of

a particular patient on screen, For more information see
'Exam Review' on page 6-18.
Save to Archive: save images, volumes and cines to the

archive. See 'Save to Archive' on page 6-23 for more
information.

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6.1 Current Patient Dialog

Click this button on the toolbar to access the Current Patient Dialog.
The Current Patient Dialog consists of 5 parts:

1. 'Patient Data Area' on page 6-3
2. 'Application Area' on page 6-4
3. 'Additional Study Information' on page 6-6
4. 'Exam Display' on page 6-6
5. 'Current Patient Menu' on page 6-6
6.1.1 Patient Data Area
In the “Name” fields, the name of the patient can be entered (Last Name, First Name, Middle Name).
If “Capitalize Letter in Patient Names” is activated in the “Patient Dialog settings” menu ( For more
information see 'Patient Dialog Settings' on page 3-12. ), the first letter, the first letter after a space
and the first letter after a dash are capitalized automatically.
If “Second Patient ID” is enabled in the patient dialog settings (For more information see 'Patient
Dialog Settings' on page 3-12. ) you can enter it in the corresponding text field.
When entering a “DOB” (date of birth) for the patient in the date format selected from the menu bar
in “Settings” - “Date Format” ( For more information see 'Date Format' on page 3-10. ), the “Age” of the
patient, at the time the ultrasound image was captured (the volume file was saved), is calculated
automatically. Also select the “Sex” of the patient from the drop-down list.
Area Description max. Characters
Patient ID: ID number 32
2nd Patient ID: Additional ID number (only available if 64, depends on system
checkbox is activated in the System Setup) settings
Last Name: patient’s last name 62 (all fields together)
First Name: patient’s first name
Middle Name: patient’s middle name
DOB (Day of Birth) patient day of birth -
Age patient age -
Sex ----, female, male (selection in pull down -

menu)

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6.1.2 Application Area
Choose between the following applications by clicking on the according tab: “Abd”(omen), “OB”
(stetrics), “Gyn”(ecology), “Cardio”(logy), "TR(ansrectal)", “Vas”(cular), "CEPH(alic)", “SM(all), P”
(arts), “Ped”(iatrics) and “MSK”(Musko-skeletal) by clicking on the appropriate button.
Depending on the application chosen, different data entry fields appear in this part of the dialog box.
Abdomen
Different units of measurement for the patient"s Height and Weight can be selected. The conversion
is adapted automatically.
Obstetrics
LMP means “Last Menstrual Period”.
Note The first day of the last period must be entered. GA and EDD are calculated
automatically after entering the LMP date. The labels next to those fields read
GA(LMP) and EDD(LMP) afterwards.
Note LMP dates are only displayed when the calculated EDD is not older than 43 weeks.
DOC means “Date of Conception”. GA and EDD are calculated automatically after entering the DOC.
The labels next to those fields read GA(DOC) and EDD(DOC) afterwards.
EDD means “Estimated Date of Delivery”. If EDD is entered GA is calculated automatically. The label
next to this field reads GA(EDD) afterwards.
GA means “Gestational Age” in weeks and days. If GA is entered EDD is calculated automatically. DOC
is calculated automatically if Calculate DOC by GA is activated in the “Patient Dialog Settings” ( For
more information see 'Patient Dialog Settings' on page 3-12. ). The label next to these fields reads
EDD(GA) and DOC(GA). The label next to the GA field reads GA(Clin) to indicate that the GA was
entered manually.
Gravida, Para, Aborta, Ectopic: Enter the patient"s history of pregnancies.
Fetus #: Select the number of gestations (e.g., for twins, “2”).
Note The date format for entering the dates can be changed from the menu bar in
Settings - “Date Format” (For more information see 'Date Format' on page 3-10. ).

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Gynecology
LMP Enter the first day of the last menstrual period using the date format selected from the menu
bar in Settings - Date Format ( For more information see 'Date Format' on page 3-10. ).
Note The first day of the last period must be entered.
Exp. Ovul.: Date of expected ovulation using the date format selected from the menu bar in Settings
- Date Format ( For more information see 'Date Format' on page 3-10. ).
Day of Cycles: Enter the current day of the patient"s cycle.
Day of Stim. Applies to IVF: the first day of ovarian stimulation.
Gravida, Para, Aborta, Ectopic: Enter the patient"s history of pregnancies.
Cardiology
Height Enter the patient"s height in one of the specified units (cm, ft., inch).
Weight Enter the patient"s weight in one of the specified units (kg, lb., oz.).
BSA Body surface area (calculation value, no input).
HR Heart rate.
Select different units of measurement for the patient"s Height and Weight. The conversion is
adapted automatically.
Note The BSA value is calculated automatically, after entering Height and Weight.
Calculation formula for BSA:

WT[kg] HT[cm] BSA[m 2]
Transrectal
PSA Enter the PSA value.

PPSA Coefficient 1 Enter the first PPSA coefficient.
PPSA Coefficient 2 Enter the second PPSA coefficient.
Vascular, Cephalic, Small Parts, Pediatrics, MSK (Musko-skeletal): No special input fields.

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Before leaving the menu a dialog appears asking whether to save any changes. Select Yes, No or
Cancel.
6.1.3 Additional Study Information
In the remaining fields of this dialog box enter additional exam data. It is especially useful to
characterize an exam in the field “Exam Type” because the “Exam Type” can be seen in the “Exams
Table” ( For more information see 'Exams' on page 6-10. ) of Archive.
Enter the optional “Accession Number” to additionally characterize an exam.
When entries are made in the fields “Diagnostic Physician”, “Referring Physician”, “Performing
Physician”, “Sonographer” and “Exam Type”, they are stored in the memory and on hard disk. By
selecting the pull-down menu to the right of the entry field, these entries can be seen in new or
existing patient files.
6.1.4 Exam Display
The Exam Display area displays previous exams of the selected patient. These exams can be
organized according to Exam Date, Exam Time, Exam Type, Mode, Number of Images, Exam
Comment or one of the customer adjustable fields simply by clicking the caption of the respective
field.
6.1.5 Current Patient Menu
Worklist Changes to Worklist Dialog 'DICOM

Worklist' on page 7-14
This button is only active, if no exam has
been selected and a worklist server is
defined.
Details Allows you to view the Exam Details, see

'Exam Details' on page 6-20. Only active
if an exam has been selected.
Clear Entries Clears personal information of the

patient and also the information shown
on the worksheets. Saved exams will not
be cleared.
Worksheet Press the Worksheet button if you want

to enter or review data and comments
into the worksheet of the currently
selected exams, 'Worksheet' on page 6-
24
This button is only active if an exam has
been selected.
Hide Patient Hides the Patient Information in the

Info header to ensure a maximum of privacy.
Past Exam Opens the Past Exam dialog. Only

available if the application is OB. Only
active, if a Patient ID has been entered.
Worksheet
Press the Worksheet button if you want to enter or review data and comments into the worksheet of
the currently selected exams.
After completing the worksheet, click the OK button to save the content, or click the Cancel button.

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See 'Worksheet' on page 6-24 for more information about the worksheet.
6.1.6 Exam Menu
Start Exam Returns to View Mode and starts a new

(alternatively) exam with the currently selected
Patient. Only active if no exam has been
started yet.
Continue Returns to View Mode and continues the

Exam exam with the currently selected
(alternatively) patient. Only active if an exam has been
started.
Add Exam Ends the current exam, instantly starts a

new one and returns to View Mode with
the currently selected patient. Only
active if an exam has been started.
End Exam Ends current exam. Only active if an

exam has been started.

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6.2 Archive
Click this button in the toolbar to access the patient archive.
The Archive Screen consists of five parts:

1. 'Search Area' on page 6-8
2. 'Patients' on page 6-10
3. 'Exams' on page 6-10
4. 'Images' on page 6-11
5. Menu see 'Archive Menu' on page 6-12.
Using the radio button below you can change the display format. You can choose to display Patients
and exams or the exam list only.
6.2.1 Search Area
How to search for locally stored exams

In the search area you can either display the patients and exams according to your criteria
or show all patients and exams.
1. Select the source, where you want to search.
2. Select a search criterion from the list and enter its value in the neighboring field.
Note The percent sign (%) can be used as a a wildcard character to substitute for any
character(s) in the search string.
3. If you want to narrow down your search even more, add another search criterion by choosing a
connector (and/or). Then, select the second criterion from the list and enter its value in the
neighboring field.
4. Finally press the [Search] button or the Enter key to perform the search using the entered
criteria.

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How to search for exams stored in the Anonymized Archive

The Anonymize Archive function allows to anonymize patients, exams and/or images in an own
archive. To search in the Anonymized Archive, select Anonymized Archive as source from the
dropdown list.
Using the Anonymized Archive:
1. Right click on the selected patient/exam and select Anonymize. A dialog appears. If more than
one patient is selected from the local archive for copy to the Anonymize Archive, the dialog
appears that often. If more than one exam from different patients is selected from the local
archive for copy to the Anonymized Archive, the dialog appears only once. All exams are
included in one patient ID.
2. It is possible to add anonymized data for:
• Last name
• Middle name
• First name
• Date of birth/Age
• Sex
• Exam Comment
• Exam type
How to search for exams stored on a DICOM server

To search for exams on a DICOM server select “DICOM server” as source from the dropdown list.
If DICOM server is not listed as an option,

there is no QUERY RETRIEVE server defined
(see 'Adding or Editing a Query Retrieve
Server' on page 7-5) or active (see
'DICOM Configuration' on page 7-2).
After defining search criteria click the

Query Patients button to display all
matching patient data. Alternatively, you
can list all patients stored on the server
without defining any search options.
Select a patient from the table (For more

information see 'Patients' on page 6-10. )
and click Query Exams to display
associated exams.
Select an exam from the table (For more

information see 'Exams' on page 6-10. )
and click the Retrieve Images button. A
dialog box showing the status of the
transfer appears. The process may take a
few seconds, depending on the connection
speed and file size of the image.
The retrieved images are now displayed in the Image area (For more information see 'Images' on page
6-11. ).

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6.2.2 Patients
The Patient table shows all the patients that fulfil your search criteria.
If you mark a patient, his or her exams will be displayed in the exam table.
• Sort these patients according to Patient ID, Patient Name, Birthdate, Number of Exams, Sex,
Date of Last Exam simply by clicking the caption of the respective column.
6.2.3 Exams
The Exam table displays all the exams of a particular patient.
• Sort these exams according to Exam Date, Exam Time, Exam Type, Mode, Number of Images,
Exam Comment or one of the customer adjustable fields simply by clicking the caption of the
respective column.
• If you select an exam, all its images will be displayed in the Exam Image area.
• Double-click on an exam to see its first image in Exam Review mode.
6.2.3.1 Lock or unlock selected exams
How to lock or unlock exams

1. Select one or more exams from the list.
2. To lock exams, press the lock button. To unlock exams, press the unlock button.
3. A lock or unlock icon is shown before the entry.
Icon Description
Lock button
Unlock button
Exam locked
Exam locked, backup exists
Exam not locked, backup exists

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How to sort exams

Press the B icon in the first column repeatedly to sort exams in the following sequence:
• All backuped exams
• All backuped and locked exams
• All locked exams
• All other exams
Messages
If patient(s), exam(s) or image(s) are selected to be deleted, the following messages may appear if
locked exams are involved:
Message Description
Your selection contains

Exams that are locked and
cannot be deleted!
Your selection contains

Exams that are locked and
cannot be deleted! Do you
want to delete the unlocked
Exams?
The selected image(s)

belongs to a locked Exam
and cannot be deleted!
6.2.4 Images

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• Use the arrow buttons on the right-side margin or the right and left arrow keys on your
keyboard to skim through the images.
• Click the left mouse button to mark an image. You can mark more than one image.
• Double-click an image with the left mouse button to view it in Single Screen Mode.
• Double-click an image with the right mouse button to reload the exam.
Once you have found the exam you were looking for, you can manipulate it or its saved data in the
following Menus.
The menu items are context-sensitive. That means they change accordingly to the area of the archive
you are currently working in.
6.2.5 Archive Menu
Picture Key Action
Use as Current Uses the currently selected patient

as the current patient and changes
back to the Current Patient menu.
Details Allows you to view the Exam

Details, 'Exam Details' on page 6-
20
Edit Data Opens the Edit Data menu and

allows you to edit the data of the
selected patient.
Worksheet Press the Worksheet button if you

want to enter or review data and
comments into the worksheet of
the currently selected exam,
'Worksheet' on page 6-24
Delete Deletes the currently selected

Patient.
Use as Current
Pressing the [Use as current] key, uses the selected patient as the current patient.
This action is also performed, if a patient is double-clicked.
Note The [Use as current] key is greyed out and cannot be used while there is an exam
running. Please end the running exam and then select your patient.
Edit Data
For easy navigation the Edit Data menu has been designed to look just like the Current Patient
screen.
Use the Filing Card tabs to navigate between the application areas, see 'Application Area' on page 6-
4.
To exit the Edit Data Menu press either:
1. Save&Return to save the modified data and return to previous operating mode.
2. or Cancel&Return to discard the modified data and return to previous operating mode.

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Delete
After selecting the patient(s), exam(s) or image(s) by using the left mouse button, click the Delete
button. A dialog pops up, summarizing all items to be deleted. Press Delete Images Only to preserve
patient and exam data. Press Delete All Data to delet all selected patient(s), exam(s) or image(s).
Press [Cancel] to abort the operation.
Image Details
Image Properties: Allows you to view the Image Properties. Click the buttons of the upcoming
window to view image details, study details, Series details, Equipment details, Regional Calculation
details, Patient details and File details.
6.2.6 Data Transfer Menu
Export

Archive
After selecting the exam(s) to be exported using the mouse and the right mouse button Set, click the
Export button.
This enables the export of images, cines, volumes and data sets (files including
both images and patient data) in the following formats:
Image file formats Movie file formats Volume file formats Data set formats
• BMP • AVI • Volume Files • Voluson format

(.vol) (compressed /
• JPG • BMP-sequence
(compressed)
• MP4 • Cartesian uncompressed /
encrypted)
Volume Files
• TIFF
• CSV • DICOM file
• DICOM file with

DICOMDIR
Combined images and Cines can be exported in PC format (JPG & AVI/MP4) or MAC format (JPG &
MP4).
1. Assign the desired “Drive” from the pull-down menu “Save in:”.
2. Navigate to the desired save location.
3. Enter a “File name”. If multiple items have been selected, the filename applies to all and is
automatically extended by “_x”. Whereby “x” is a variable for the number of the file.
4. Select the appropriate “File Format”. Depending on the file format, the (image) size, quality
and AVI-codec can be adjusted. For more information see 'Save options' on page 3-5. If an
encrypted 4DV file is selected, a password prompt appears. The entering of a wrong password
causes an error message.
Note The “Anonymize” function only works with US images. i.e.: It does not work with
archive - screenshots.
Note The Estimated File Size and Free Disk Space are indicated below the File Format
dropdown menu. The Estimated File Size can only be calculated for uncompressed
Voluson format files.
Export options
Create Patient and Exam folders: The given file name will be omitted and instead a directory
structure with the patient name as directory name will be created in the export location.
Anonymize: Patient data (name, ID number, 2nd patient ID, date of birth) and clinic data (clinic
name, sonographer) as well as time and date will be anonymized in the exported image/cine.
Screen captures cannot be anonymized.
Include Report Data: Check this item to export report data in “.txt” file format.
Use DICOM Setting from Alias: If you are exporting to DICOM format, a dropdown field lists all
Aliases which settings can be used as export settings.
Include SR: If you are exporting to DICOM format, check this item to export structured
reporting data.
Combine OB & GYN: Check this item to send structured reporting data from applications OB
and GYN in a single file.
5. Click the OK button to export all the images of the exam(s) to the selected storage medium.
Attention: Apply JPG-compression with a quality setting less than 100% to an image only once.
Images that were saved to Archive using lossy (less than 100%) JPG compression are clearly marked with a
yellow J (e.g., JPEG = compression factor 80%).

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Note It is possible to export an open, uncompressed 4dv archive to an export location

without importing the 4dv archive first into the local archive. A compressed 4dv
archive cannot be exported directly, it has to be imported into the local archive
first.
Import
Choose where to import your image from, type in a filename, or select your file from the displayed
ones in your selected folder.
You can also limit the display to one file format: Voluson format (*.4dv), V730 format (730.mdb) or
Voluson Backup (*.bkp).
Note Only Voluson Backup files from software version 7.x or higher are compatible with
4DView.
Confirm with Open. Another dialog appears.
This dialog has a checkbox to prevent it from showing up in the future.

After the data has been loaded into archive, you can select exams or single images to import onto
your harddisk.
Press Import again and the selected exams, patients and images will be copied onto the harddisk.
Print
After selecting the items to be printed, click the [Print] button. All selected images of the exam(s) will
be printed at the selected printer, be it a local or DICOM printer.

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1. Firstly select the printer from the pull-down menu

2. Then choose the format (Portrait/Landscape) by selecting the correct radio button.
Note Watch Layout Preview for the effects of your selections.
3. Set the Include Image Comments checkbox to include image comments.

4. Set the Include Page Numbers checkbox to include page numbers.
5. Set the Include Header checkbox to include a header.
6. Set the White background checkbox to save ink or toner. The black frame around the sector of
the US image, which contains information, will be set to white.
7. Set the Invert color for non-US images checkbox to invert the color.
8. Press Print to print the selected image(s).
Printer properties
Press the Properties button to access your printer’s settings dialog. Please refer to your printer’s
Instructions for Use for further information.
If a DICOM printer is selected, the DICOM Config button is displayed instead of the Properties button.
For more information see 'DICOM Configuration' on page 7-2.
DICOM Send
After selecting the exam(s), image(s) or patient(s) to be sent using the left mouse button, click the
DICOM Send button.
The selected items will be sent to the selected DICOM storage destination.

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6.3 Image History

Image History allows you to skim through all the pictures in all the exams of a single patient.
Picture Key Action
Exam Buttons Used to select an exam and

indicate the selected exam
(button pressed). Displays the
Exam Date and Time and the
string “Current Exam” to mark the
current Exam.
Left/Right Used to scroll through the

Arrows individual images.
Up/Down Used to scroll through the

Arrows individual exams.

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6.4 Exam Review

In the "Current Patient", “Archive” or “Image History” Mode select an exam and press Exam Review
to switch to the “Exam Review Mode”.
Picture Key Action
Details Opens the Exam Details

dialog, see 'Exam Details' on
page 6-20.
Exam Comment Opens the Exam Comment

dialog, see 'Exam Comment'
on page 6-20.
Worksheet Opens the Worksheet, For

more information see
'Worksheet' on page 6-24.
Delete Deletes the currently

selected Patient.
Add to Worksheet Adding an image from the

Archive to the Worksheet. For
more information see 'Images
in the Worksheet' on page 6-
21.
Data Transfer See 'Data Transfer Menu' on

Menu page 6-13
Exit Close the Exam Review

dialog and return to the
running exam.
Layout Use the drop-down menu to

select how many images of
the selected exam you wish
to view, see 'Layouts' on
page 6-21
Double-Click on Display the image, that was

Image double-clicked, as Full
Screen.
Select All Click this button to select all

images in the current exam.
Deselect All Click this button to deselect

all images in the current
exam.
Previous Pat. Display exams of the

previous patient in the
patient table.
Previous Exam Display the previous exam of

the current patient.
Next Exam Display the next exam of the

current patient.

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Picture Key Action
Next Pat. Display exams of the next

patient in the patient table.
Arrow Keys Use the arrow keys (2 and 3)

to navigate through the
image pages, or use the
upper (1) and the lower (4)
arrow key to go to the first
respectively the last image.
Reload Reload the according data

set into the system. This
button only works with
3D/4D data and raw data, see
'Reload' on page 6-20
Full Data The preview images in 2x2

and 3x3 Exam Review layouts
are only low resolution
versions. Click this button to
display the full image details
and cine sequences.
Images with a higher version
number than the installed
software version cannot be
loaded. The following
message will appear on the
screen: "Image data has a
higher version number than
this System Software. Data
cannot be displayed.".
Image Properties Opens the Image Properties

dialog of the according
image.
Image Comment Adds an image comment to

the according image. Button
looks differently, if an image
comment already exists for
the according image, see
'Image Comment' on page 6-
20.
Acquisition Type Displays the acquisition type

of the according image and
changes it, see'Player
Controls' on page 6-21.
Play Buttons Start/Stop/Step used to

navigate through cines , see
'Player Controls' on page 6-
21

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6.4.1 Exam Details
The Exam Details dialog displays general information such as patient name and ID, exam date and
number of acquired images as well as administrative information such as the exam’s size and backup
status.
6.4.2 Reload
It is not possible to reload 2D Data. Only 3D/4D Data can be reloaded into 4DView.
When the Reload button is pressed, the selected file is reloaded into the viewer.
This also means that the exam that the file belongs to is reopened.
The range of possible actions is determined by the file type.
6.4.3 Exam Comment
Press the Exam Comment key.
The following window pops up, asking for an exam comment:
This is the same comment as in the comment field in the current patient dialog.
If an exam comment already exists, the dialog displays the current exam comment, which can then
be edited or deleted (max. 40 characters).
Press OK to save and exit.
Press Cancel to exit without saving.
6.4.4 Image Comment
Press the Abc key.
A window pops up, asking for an image comment:

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The image comment is different from the exam comment in that it can differ for each image.
If an image comment already exists, the dialog displays the current image comment, which can then
be edited or deleted (max. 40 characters).
Press OK to save and exit.
Press Cancel to exit without saving.
6.4.5 Layouts
The following display layouts are available in Exam Review Mode and can be selected in the System
Setup page:
1x1
2x2
3x3
A double click on an image that is not already in Full Screen Mode, causes the image to be displayed
in Full Screen Mode. A second double click returns the image to the previous format.
6.4.6 Player Controls
1. Cine Mode: The Cine Mode button displays the acquisition type of the stored image; or if there
are more than one US pictures in one image then it displays more than one type of acquisition
(2D, 3D, 4D).
2. Play: If cines have been stored in Raw Format the [Play]key plays the cine continuously.
For details about Raw Format and Multiframe review: 'Archive Configuration' on page 3-13.
3. One Image Back
4. One Image Forward
5. Display: Displays image numbers according to the following format (current Image number/
total number of images)
6. Images timeline: The vertical bar shows the position of the currently displayed frame in the
cine. Move around the vertical bar in the timeline to skim through the cine.
One selected image from any layout can be displayed in full-screen size.
To use Full Screen View, move the cursor to the desired image and double-click. To return to
normal viewing, double-click again.
6.4.7 Images in the Worksheet
Configuring a P-Button to save images to the Worksheet:

1. Select System Setup .
2. Select Connectivity.
3. Select the Button Configuration tab.
4. Choose a P-Button and check Save to Worksheet with P.
5. Save and exit.
A symbol is displayed on the monitor next to the corresponding P-Button.
Adding an image from the Clipboard to the Worksheet:
1. Select the button Images on the .
A check mark icon is displayed next to each image. If checked the image will be added to the
Worksheet.
2. Move the mouse over an image in the clipboard and use the small trackball buttons Add/
Remove to add or remove images to/from the Worksheet. Or check or uncheck the icon next to
the image displayed on the monitor by pressing the trackball button Set.

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Adding an image from the Archive to the Worksheet:

1. Press A on the left menu bar to open the Archive.
2. Press Exam Review on the right side of the open window.
3. Select individual images by checking the icon next to an image or press Select all images and
then press Add to Worksheet.

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6.5 Save to Archive
Use this button to save volumes, images and Cine sequences into the Archive database system.
When storing data into the Archive certain information is needed for the database entry. If this
information is missing, the dialog box asking for “Patient ID and Exam Info” ( For more information see
'Current Patient Dialog' on page 6-3. ) is automatically opened.
Otherwise the dialog box “Save to Archive” appears.
In this dialog area select options for saving data into Archive ( For more information see 'Save to
Archive' on page 6-23. ).
Choose whether to save a single image with “Save 2D”, or an additional GE HealthCare volume file
with “Save 3D”. 2D images will be JPEG ( For more information see 'Glossary' on page 9-2. )
compressed if this is configured in the “Archive Configuration” dialog ( For more information see
'Archive Configuration' on page 3-13. ).
Save Options:
In the volume file a 3D Calc Cine ( For more information see 'Glossary' on page 9-2. ), 4D Image Cine
( For more information see 'Glossary' on page 9-2. ) or 4D Volume Cine ( For more information see
'Glossary' on page 9-2. ) sequence can be included, if these are available. They will be saved in the
format, configured in the “Archive Configuration” dialog ( For more information see 'DICOM
Configuration' on page 7-2. ). Save a “3D Cartesian Volume” by simply selecting the option “3D
Cart. Vol.”.
Note How many files are generated depends on the “Archive Configuration” ( For more
information see 'Archive Configuration' on page 3-13. ). If “Raw” format is used,
“3D Calc Cine”, (For more information see 'Glossary' on page 9-2. ) “4D Image
Cine” (For more information see 'Glossary' on page 9-2. ) and “4D Volume Cine”
(For more information see 'Glossary' on page 9-2. ) will be included in one file.
However, if “Multiframe” is used, a separate file has to be generated for each
Multiframe object. So if for example, “3D Calc Cine”, (For more information see
'Glossary' on page 9-2. ) and “4D Image Cine” (For more information see
'Glossary' on page 9-2. ) are stored as multiframe together with a “4D Volume
Cine” (For more information see 'Glossary' on page 9-2. ). Three files are
generated, one for each of the two multiframe objects and one for the “4D Volume
Cine” (For more information see 'Glossary' on page 9-2. ).
Click on the Exam Info button and a new dialog box appears to edit patient and exam data ( For more
information see 'Current Patient Dialog' on page 6-3. ).

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6.6 Worksheet
6.6.1 View the Worksheet
To open the worksheet simply click the “Worksheet” button in the “Measurement” menu.
In order to exit the worksheet select the “Close” button in the worksheet window.
The worksheet data will be removed from memory in the following events:
• Closing of the current file.
• Opening of a new volume file.
• Exiting of 4DView.
In these events, if a “Patient ID” and a “Patient Name” have already been entered, the worksheet
data is stored in the database.
The range column gives the range of the measured value in a population.
A variety of calculation equations and tables is available for selection in order to find those that fit
best for a particular population.
Choose tables and equations using Measure Setup - Measure & Calc(For more information see
'Measure & Calc' on page 5-21. ) from Settings in the menu bar.
The references of the tables and equations including the sources can be found in the Advanced
Reference Manual of your Voluson™ Family ultrasound scanner.
Edit a measurement by simply clicking into the field that contains the measurement to be edited.
Type the corrected value and press [Enter]. The edited values are marked with an asterisk “*”.
In the Method field select the value that should be displayed: average (all values + or - or average for
+ and - values mixed), minimum, maximum, last or no value (off).
6.6.2 The Worksheet Menu
On the right side of the worksheet the worksheet menu can be found:

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Graphic App. Decription
Application: Select the desired application

from the drop down menu.
All Calc: Display results of calculation

measurements.
All Generic: Display results of generic

measurements. Place checkmark next to
this button or press the “Include in Report”
button to include this page in the printed
report.
All Scan Assistant: If Scan Assistant data is

available, it is displayed on this worklist
page. It is not possible to edit Scan
Assistant data.
All Comment: Display the “Comment” ( For

more information see 'Comment' on page
6-30. ) page.
All Clear All: Clears all measurements from

the worksheet. All measure data will be
lost.
All Save to Archive: Save a screenshot of the

currently displayed worksheet page to
Archive.
All DICOM Send: Send a screenshot of the

currently displayed worksheet page to the
currently selected DICOM Servers.
All DICOM Print: Print a screenshot of the

currently displayed worksheet page on the
currently selected DICOM Printer.
All Transfer Data: Transfer ( For more

information see 'Report Transfer' on page
7-17. ) the worksheet data to a remote
station.
All Print Preview: View a preview ( For more

information see 'Print Preview' on page 6-
31. ) of what will be printed to the printer.
All Print Report:

Print the worksheet data.
All Page: Step through the pages of the

worksheet page by page.
All Close:
Close the current worksheet.
Gynec SonoAVC™ (Sonographic Automated

ology Volume Count) automatically detects low
echogenic objects (eg.follicles) in an organ
(e.g. ovary) and analyzes their shape and
volume. From the calculated volume of the
object an average diameter will be
calculated. All objects detected that way
will be listed according to size.

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Graphic App. Decription
Obstet Fetal Anatomy: Display “Fetal Anatomy”

rics page. On this page enter details on the fetal
anatomy. Place checkmark next to this
button or press the “Include in Report”
report.
Obstet Graph: Display “Graph” ( For more

rics information see 'Graph Display' on page 6-
29. ) page. Place checkmark next to this
button or press the “Include in Report”
report.
Obstet Fetus Compare: Only available if more

rics than one fetus is selected in the “Current
Patient Dialog” ( For more information see
'Current Patient Dialog' on page 6-3. ).
Display “Fetus Compare” page. On this
page the results of the calculation
measurements of each fetus are presented
next to each other to simplify comparison.
Place checkmark next to this button or
press the “Include in Report” button to
include this page in the printed report.
Small BI-RADS: Enter a BI-RADS category and

Parts check several items of a breast exam.
Switch pages to display and enter data for
the left and right breast.
Vascul Vessel Summay: This feature makes it

ar possible to select custom Doppler values
for calculating the ICA/CCA value.
Fetus: Only available if application is “OB” and more than one fetus is selected in the “Current Patient
Dialog” ( For more information see 'Current Patient Dialog' on page 6-3. ). Switch between the results
of the different fetuses. The current fetus is displayed in the worksheet at the upper left side of the
page.
6.6.3 Fetal Anatomy

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Note The content of Fetal Anatomy depends on the selected Presets. 'Parameters' on
page 5-22
Note When opening a worksheet of a previous exam, which contains Fetal Anatomy
data, the previous Fetal Anatomy pages are displayed.
Note When the worksheet gets printed, the results are displayed in 2 columns.
Controls
Controls Description
Header Buttons e.g. Press to open additional dialog for further

items.
Header Buttons:
• Head/ Neck
• Face
• Heart
• Abdomen
• Spine
• Extremities/ Skeleton
• Placenta
• General
Set all to Sets all items of this group (e.g.Head/

Neck, Face,...) to the desired status.
Note The status can be selected for each item.
Note An additional status drop down text field is available for comments and
descriptions.
Fetal Anatomy Details

1. Press either the Header Buttons (e.g. Head/Neck, Face, ...) or select details to open additional
Fetal Anatomy items.
2. Select the desired status in the Fetal Anatomy Details.
3. Press Close to close the Fetal Anatomy Details.

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Biophysical Profile and Cardiovascular Profile Score (CVP Score)
Items
Biophysical Profile Displays information of the Fetus:

• Nonstress Test
• Fetal Movements
• Fetal Breathing Movements
• Fetal Tone
• Amniotic Fluid Volume
Cardiovascular Profile Score (CVP Score) CVP Score consists of the following items:
• Hydrops
• Heart size
• Cardiac function
• Venous Doppler
• Arterial Doppler
Score Values [0 - 2] Enter the score values accordingly: 0, 1, 2

(0... worst case, 2... best case)
Total The total number of all scores.

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6.6.4 Graph Display
In order to enter this window click the Graph button in the worksheet menu.
In the “Graph” window the results of measurements can be compared in the obstetrics report to the
normal range in a particular population using curve or bar graphs. The curve graphs show an upper
and a lower limit for a biometric value at a given gestational age.
Note If the measurement result is outside the visible range of a graph, an arrow
indicates that the "x" is off the charts.
If an LMP was entered in the “Current Patient Dialog” ( For more information see 'Current Patient
Dialog' on page 6-3. ) dialog box, a marker is seen in the graph, which indicates the measured value
of the fetus. There are different markers for up to four fetuses.
On the left side, graphs can be selected for printing by checking the relevant box.
The format in which the graphs are printed can be selected by pressing the “Format” button and
selecting the desired format.
Select either: GA(LMP) or GA(AUA) in the GA Reference dropdown field.
Select to show the trend or only current values by default with the “Plot” setting.
Use these three buttons in the worksheet menu to switch between “Single Display”, “Quad Display”
and “Bar Graph Display”.

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6.6.5 Comment
Enter a comment into the “Comment” field by simply clicking into the field and typing the desired
text.
Use these buttons in the worksheet menu to store comment text into presets, invoke those presets
and clear the comment field.
Store Comment Preset: Type some text into the comment field. Then press the “Save” button and
the button of the preset, i.e. “A”, “B” or “C”. The text in the comment field is now stored in the select
preset button, i.e. “A”, “B” or “C”.
Invoke Comment Preset: Simply press “A”, “B” or “C”. The comment stored in the according preset
button is now added to the comment field.
Clear: Press the “Clear” button to remove all text from the comment field.
6.6.6 Special Worksheet pages
SonoVCAD™labor
The SonoVCAD™labor section of the CALC worksheet consists of automatically calculated values and
form fields for manual input. Everytime a measurement is acquired with SonoVCAD™labor a new line
will be added to the worksheet page. Press the Clear button to delete the measurement history.
For more information see ' SonoVCAD™labor ' on page 4-20.

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6.6.7 Print Preview
In order to view the above dialog click the Print Preview button in the worksheet menu.
This dialog displays a representation of what will be printed to the printer if the Print button is
pressed. Use Next Page and Previous Page to navigate through the different pages of the worksheet.
Use Zoom In and Zoom Out to zoom the page and Cancel to close the dialog without printing the
report.

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Chapter 7
Connectivity
DICOM Configuration - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-2

DICOM Send - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-7
DICOM Print - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-10
DICOM Transfer Status - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-12
DICOM Worklist - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-14
DICOM Storage Service Class Provider - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-15
Report Transfer - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-17
VolusonClub.net - Learn. Network. Share. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-18
Samples of Private Network Setups - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-19

Connectivity
7.1 DICOM Configuration

This dialog box is invoked through the “Settings” menu ( For more information see 'Settings' on page
3-10. ).
The entries in the upper part of the “DICOM Configuration” dialog are the properties of the home
station. The single lines in the lower part refer to connected stations. Such a station can be a DICOM
viewer, a DICOM printer, another PC with 4DView installed, a worklist server or a server designed to
receive measure reports in a special format. The checkbox left to the “Services” column has to be set,
if you want to use the service.
To display Tricefy™ entries, check Show Tricefy entries. The services (Store, Patient Share, SR and
QR) are visible and can be edited (excluding the Alias, AE Title, IP address and port, TLS and SC
server).
Transport Layer Security (TLS) is a cryptographic protocol designed to provide communications
security over a computer network. Settings and activation (green check icon) can be configured with
the TLS button in:
• Store
• Print
• MPPS
• Storage Commit
• STR. Report
• Query Retrieve
• Worklist
• Report
By pressing TLS a window appears which allows to adjust the settings (Use TLS encrypted
connection, Use Certificate, Verify Server, Import Certificates, Delete Certificates) as desired.
Import Certificates:
1. A window appears. Select a drive and a file and press Open. Enter the password if the
certificate is protected by a password.
2. Press either OK to save your changes or Cancel to close the dialog without saving any changes.
Note If the certificate is not trusted by a certification authority a Windows® Security

message can appear. Decide whether to install (Yes) the certificate or not (No).
Delete Certificates:
1. Select the certificate to delete. A window appears.
2. Press Yes to finally delete the certificate or No to keep it.
7.1.1 Setting the Properties of the Home DICOM Station
AE (Application Entity) Title: The name that is used to identify the 4DView DICOM application in
other DICOM applications. For setting the AE-Title correctly please contact the designated DICOM
network administrator.
Station Name: The name of the home institute or organization (optional).
Retry Count: The number of times the viewer should retry to establish a DICOM connection in case
an attempt fails.
Retry Count Seq.: The number of times the viewer should retry to establish a DICOM connection in
case an attempt to sequentially send images fails.
Retry Interval: The amount of time in minutes the viewer pauses between two attempts to establish
a DICOM connection.
Timeout: The amount of time in seconds the viewer waits for a response from the DICOM device.

Connectivity
Note You must be logged in as administrator to be able to change the Timeout.
Sound notification: Check this item to enable an acoustic signal everytime a transfer has been
carried out properly.
Default (button): Click this button to restore the default values fot Retry Count, Retry Interval and
Timeout.
7.1.2 Testing the Connection
Test the connection of the home system to another DICOM station. First choose the station to test
from the list by clicking on its line with the left mouse key, then click the Test Connection button. If
the TCP/IP connection to the remote station is active, the entry OK appears in the Ping line. If the
DICOM server on the remote station is active, the entry OK also appears in the Verify line.
This connection test may take up to 30 seconds.
If one of the tests fails please refer to 'Network problems' on page 8-6.
7.1.3 Setting the Connection Properties of the Remote DICOM Stations for Connection
In order to add a new destination (DICOM device to send data) or source (DICOM device from where
data is retrieved) click the “Add” button and enter all available information.
In order to edit the configuration of an existing DICOM device, mark the line containing this device
and click the “Edit” button.
To delete an entry, select the appropriate line by clicking on it with the left mouse key and click on
the “Delete” button.
Types of services:
STORE The service provided by DICOM servers or other PCs with 4DView.
STORE3D The service provided by DICOM servers or other PCs with 4DView. Used to set up a server
which shall only receive 3D data.
PRINT The service provided by DICOM Printers.
MPPS The service provided by a DICOM server to receive images with transfer information.
ST.COMMIT The service provided by a DICOM server to receive images with an additional layer of
security.
STR. REPORT The service provided by a DICOM server to receive the Patient report data via network
or serial port.
QUERY RETRIEVE The service provided by a DICOM server to receive the Patient report data via
network or serial port.
WORKLIST The service provided by a DICOM worklist server.
REPORT The service provided by a server designed to receive measure reports in a special format.
Report is limited to one entry, i.e., this service can only be provided by one device. On the other
hand, there can be several “Storage”, “Storage 3D” and “Worklist” entries in the list. However, only
one of each type can be activated at a time by selecting it with a checkmark in the first column at a
time. Something similar applies for “Print” entries. Several printers can be in the list, but only one
can be selected at a time.
Properties for all types of services: (Ask the designated DICOM administrator for the information.)
Alias: A unique nickname for each DICOM station. Use any name, but do not insert space characters.
AE Title: “Application Entity Title” of the remote DICOM application.
IP Address: The IP address or host name of the remote DICOM station.
Port: The number of the port at the remote DICOM station used to establish a DICOM connection
(normally 104).

Connectivity
7.1.4 Adding or Editing a DICOM Store / Store 3D Server
When configuring a “STORE” or a “STORE3D” server following settings are possible:

Send seq.: Check this item to send only one file (image, cine,...) at a time to this DICOM station. This
prevents the files from arriving in incorrect order.
St. Commit: Select one of the defined Storage Commitment servers from the dropdown field.
Color: Images can be sent in “Color” (RGB) or in “Grayscale” (Monochrome) or in “Automatic” mode
(Color or Grayscale depending on image mode).
Image Size: Select the size of the images sent to this DICOM server. The two options are “Original”
and “640x480”. The latter should be selected when sending to a DICOM server that expects an image
size of 640x480.
2D Compression: Select the type of compression used when sending images to this DICOM server. If
“JPEG” ( For more information see 'Glossary' on page 9-2. ) is selected, the images are sent JPEG
compressed ( For more information see 'Glossary' on page 9-2. ). If “None” is selected, the images
are sent uncompressed.
2D JPEG Quality: This selection is only available if “2D Compression” is set to “JPEG” ( For more
information see 'Glossary' on page 9-2. ). It sets the compression quality for images sent to this
DICOM server. If lossless compression is used the files become smaller, but no quality is lost. If High,
Mid or Low is selected, a caution appears. The reason for this is that now lossy compression is used,
which means that the image quality is reduced. The use of lossy JPEG compression ( For more
information see 'Glossary' on page 9-2. ) is also indicated in the sent image. A small, yellow
indicator appears at the top left corner of the sent image (only ultrasound images, not patient dialog
or report). It displays a J for JPEG compression ( For more information see 'Glossary' on page 9-2. )
and the compression quality.
Cine Compression: Choose which type of compression is used for sending cines (2D Cine, 3D Rot.
Cine ( For more information see 'Glossary' on page 9-2. ) as Multiframe and 4D Img. Cine ( For more
information see 'Glossary' on page 9-2. ) as Multiframe).
Cine JPEG Quality: This selection is only available if “Cine Compression” is set to “JPEG” ( For more
information see 'Glossary' on page 9-2. ). Set the compression quality for cines sent to this DICOM
server. If lossless compression is used the files become smaller, but no quality is lost. If High, Mid or
Low is selected, a caution appears. The reason for this is that now lossy compression is used, which
means that the image quality is reduced. The use of lossy JPEG compression ( For more information
see 'Glossary' on page 9-2. ) is also indicated in the sent image. A small, yellow indicator appears at
the top left corner of the cine sent. It displays a J for JPEG compression ( For more information see
'Glossary' on page 9-2. ) and the compression quality.
Volume Compression: Set the compression quality for Volume files. Select between None, Lossless
or Lossy. If Lossy is selected, a caution appears that this setting can lead to reduced image quality.
Volume Compression Quality: Only available if Volume Compression is set to Wavelet Lossy. Select
between High, Mid or Low.
Send Image as: Select between Image (sends a Screenshot) and Raw Data.
Send 2D Cine as: Select between Raw Data, Multiframe and Image.
Send 3D Volume as: Select between Image (sends a Screenshot), Raw Dat and DICOM Volume.
Send 4D Cine as: You can select between “Raw”, “Multiframe” , “Image” or “DICOM Volume”. The
internal “Raw”-Format provides full functionality in case of a reload, however the “Multiframe”-
Format can be reviewed as 2D-Cine on most DICOM platforms. Selecting “Image” causes 4DView to
send the start frame of the Cine only.
DICOM Image Type: Select “secondary capture” in order to send all 2D images as DICOM secondary
capture.
Multiframe FPS Limit: Choose between 50, 40, 30, 20.
Send Measurements as: Choose between one of the defined Structured Reporting Services and
Internal Format (4DView).
Include Scan Assistant Data: Select whether to include Scan Assistant Data or not.
There are also three buttons available. “4DView default” adjusts all settings to the values
recommended (AE Title: 4DVIEWSCP, Port 105) when sending to a different PC with 4DView installed.
“DICOM Station default” adjusts all settings to the values recommended for sending to a DICOM

Connectivity
Server. “Viewpoint default” adjusts all settings to the values recommended for sending to a
ViewPoint Server.
7.1.5 Adding or Editing a DICOM Printer
When configuring a DICOM Printer there are several additional choices to be made. The most
important field in this dialog is the one named “Copies”. Here set the number of times the data
should be printed. Another important item is “Print Format” which determines how many images are
printed on a page. Here set how many images are printed in each row, i.e., how many columns there
are, and how many rows shall be printed on one page. In the above example, “2x3” means that 2
images will be printed in each of the 3 rows per page, i.e., that 6 images fit on one page. Most of the
time all other fields can be left unchanged.
7.1.6 Adding or Editing an MPPS Server
The following settings can be adjusted:

Store Server Select a STORE / STORE 3D server from the dropdown field.
SR Server Select a STR. REPORT server from the dropdown field.
7.1.7 Adding or Editing a Storage Commitment Server
No special settings.
7.1.8 Adding or Editing a Structured Reporting Server

Send seq. Check this item to send only one file (image, cine,...) at a time to this DICOM station. This
prevents the files from arriving in incorrect order.
Combine OB & GYN Check this item to send structured reporting data from applications OB and GYN
in a single file.
ST.COMMIT Select a Storage Commitment Server from the dropdown field.
Note Data that will be transferred: OB, GYN, Vascular and Cardio
7.1.9 Adding or Editing a Query Retrieve Server

Default Appl. Select the application that will be applied to queried exams.
7.1.10 Adding or Editing a DICOM Worklist Server
When configuring a DICOM Worklist Server additional parameters can be set.

Private Tags: Checking this item ensures that all patient data fields from a Voluson™ system are
transferred to a ViewPoint™ system.
Modality: A filter (mask) can be selected, that chooses only patient data marked with
“ULTRASOUND”.
Add local data: This option determines if data from a worklist server should be merged with locally
stored patient data. Set this option to Yes to allow merging of worklist data or to No to discard
worklist data. The Ask setting causes a dialog box to pop up whenever patient data from a worklist
server is going to be merged with locally stored data.
7.1.11 Adding or Editing a Report Server
When configuring a report server, the first choice to be made is whether to use a network or the serial
port. Use the “Transfer” pull-down menu for this selection.

Connectivity
If Serial is selected the dialog is changed to look like in the image below:
COM port: Select the number of the COM port the data will be sent to.
Flow control: Select between “None” (default) and “Hardware”.
Bits per second: Select the appropriate number of bits per seconds to be sent (baud rate).

Connectivity
7.2 DICOM Send
With a click on this button in the toolbar begin sending volumes and images over a DICOM
connection.
If certain information is missing the Current Patient Dialog (For more information see 'Current Patient
Dialog' on page 6-3. ) is popping up before you get to the actual DICOM Send Dialog.
Choose the destination where to send the volumes and images to in the “DICOM Configuration” ( For
more information see 'DICOM Configuration' on page 7-2. ) dialog box, which is invoked through the
“Settings” menu ( For more information see 'Settings' on page 3-10. ), or by clicking on the “Alias”
button, which displays the alias name of the currently selected remote DICOM device (e.g., labeled
“2D: 4DView 2D; 3D: 4DView 3D” in the dialog shown below). The designated device to send data to
must provide a “STORE” or a “STORE3D” service, e.g. the Storage SCP ( For more information see
'DICOM Storage Service Class Provider' on page 7-15. ) of the 4DView. Therefore, only destinations in
the “DICOM Configuration” dialog can be selected that display “STORE” or “STORE3D” in the
“Services” column.
In order to select a destination, place a checkmark on the corresponding line in the “DICOM
Configuration” dialog.
7.2.1 Queue Status
Click the “Queue Status” button and the status of the DICOM transfer queue ( For more information
see 'DICOM Transfer Status' on page 7-12. ) is displayed.
7.2.2 3D Options
Select one of the three “3D Option” for sending volumes over a DICOM connection. In the volume file
a “3D Calc Cine”, ( For more information see 'Glossary' on page 9-2. ) “4D Image Cine” ( For more
information see 'Glossary' on page 9-2. ) or “4D Volume Cine” ( For more information see 'Glossary'
on page 9-2. ) sequence can be included, if these are available. Also, the volume can be sent in
“Cartesian” format.

Connectivity
Note How many files are generated depends on the settings of the “Store” and
“Store3D” server. (See “DICOM Configuration” ( For more information see 'DICOM
Configuration' on page 7-2. )). If “V730” format is used, “3D Calc Cine”, (For more
information see 'Glossary' on page 9-2. ) “4D Image Cine” (For more information
see 'Glossary' on page 9-2. ) and “4D Volume Cine” (For more information see
'Glossary' on page 9-2. ) will be included in one file. However, if “Multiframe” is
used, a separate file has to be generated for each Multiframe object. So if for
example, “3D Calc Cine”, (For more information see 'Glossary' on page 9-2. )
and “4D Image Cine” (For more information see 'Glossary' on page 9-2. ) are
sent as multiframe together with a “4D Volume Cine” (For more information see
'Glossary' on page 9-2. ). Three files are generated, one for each of the two
multiframe objects and one for the “4D Volume Cine” (For more information see
'Glossary' on page 9-2. ).
7.2.3 Select a DICOM Destination
Send to (Alias) (general case):

Here the alias name of the 2D and 3D DICOM destination is displayed, if one has been specified in the
“DICOM Configuration” ( For more information see 'DICOM Configuration' on page 7-2. ) dialog box. If
no DICOM destination is specified, the “Send 2D” and “Send 3D” buttons are disabled and the “Send
to [Alias]” button displays: “2D: not defined; 3D: not defined.” In order to select a DICOM destination
in the “DICOM Configuration” ( For more information see 'DICOM Configuration' on page 7-2. ) dialog,
click on the first (Alias) button and the “DICOM Configuration” dialog opens. Select one of the devices
marked with “STORE” or “STORE3D” by placing a checkmark in the appropriate line. If no device
fitting this description is available add one by pressing the “Add” button and entering the
appropriate information.
If only a “STORE” server is selected in the DICOM configuration dialog, both “Send 2D” and “Send 3D”
are enabled and the Send to [Alias] button reads: “2D: [Alias]; 3D: not defined.” Both 2D and 3D data
are sent to the specified “STORE” server.
If only a “STORE3D” server is selected in the DICOM configuration dialog, “Send 2D” is disabled,
“Send3D” is enabled and the Send to [Alias] button reads: “2D: not defined; 3D: [Alias].” 3D data is
sent to the specified “STORE3D” server.
If both, a “STORE” and a “STORE3D” server are selected in the DICOM configuration dialog, both
“Send 2D” and “Send 3D” are enabled and the Send to [Alias] button reads: “2D: [Alias]; 3D: [Alias].”
2D data is sent to the specified “STORE” server and 3D data is sent to the specified “STORE3D” server.
For more information on sending the image/volume to the DICOM destination chosen, see “Send 2D /
Send 3D” ( For more information see 'Send 2D / Send 3D' on page 7-9. ).
VolusonClub.net
If registered as a member at www.VolusonClub.net, personal volumes or images can be sent directly
to this website.
When using this service the first time, enter the “AE-Title” acquired during membership registration.
For entering the “AE-Title” please click the “www.VolusonClub.net” button again and enter the
registered AE-Title.
For more information on sending the image/volume to this specific homepage see “Send 2D / Send
3D” ( For more information see 'Send 2D / Send 3D' on page 7-9. ).
The volume/image is stored automatically in one's personal homepage and in the volume/image
library at www.VolusonClub.net.
Attention
In order to ensure the privacy of patient data, patient names are removed in the transfer process. By
sending volumes/images to www.VolusonClub.net, the data will be compressed (volumes up to 1:40,
images with JPEG) automatically in order to speed up the internet transfer!
It is not allowed to use these data sets for diagnostic purposes - this is prohibited by law.

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7.2.4 Send 2D / Send 3D
Choose whether to send only an image by choosing “Send 2D”, or an additional GE HealthCare
volume file, by using “Send 3D”.
If the “Send 2D” and “Send 3D” buttons appear disabled, a DICOM destination must be selected in
the “DICOM Configuration” ( For more information see 'DICOM Configuration' on page 7-2. ) dialog box
first.
7.2.5 Adding a Comment
A comment can be added by simply typing a message in the “Comment” field of the dialog box.

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7.3 DICOM Print
Click on this button in the toolbar to print images on a DICOM printer.

Choose the destination where to print the images in the “DICOM Configuration” ( For more
information see 'DICOM Configuration' on page 7-2. ) dialog box, which is invoked through the
“Settings” menu ( For more information see 'Settings' on page 3-10. ), or by clicking on the “DICOM
Config” button (in the “DICOM Print” dialog shown below). The designated device must provide a
“PRINT” service. Therefore, only devices in the “DICOM Configuration” dialog which display “PRINT”
in the “Services” column can be selected.
In order to select a printer, place a checkmark on the corresponding line in the “DICOM
Configuration” dialog. If no device providing a “PRINT” service is available, add one by pressing the
“Add” button and entering the appropriate information.
By clicking the “Store” button, store as many images as desired.

The following information will be provided:
Print Format: 2x3 (depending on “Printer Setup”)
Stored Images: 3/6 (3 images are currently stored, and 6 per page are possible with the selected
“Print Format”)
Pages: 1 (Number of pages which will be printed. E.g., to print 12 images, and 6 are placed on one
page, 2 pages will be printed.)
For information on changing the “Print Format” please review: “DICOM Configuration” ( For more
information see 'DICOM Configuration' on page 7-2. ).
If desired, delete either “All” or just the “Last” stored image.
When storing images is completed, print them to the DICOM printer by clicking on the “Print” button.
Remark:
If the current exam is ended before printing all the stored images on the DICOM printer, the following
message appears:

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Choose either to print the remaining stored images or to discard the remaining stored images.
Queue status
Click the Queue Status button to display the status of the DICOM transfer queue ( For more
information see 'DICOM Transfer Status' on page 7-12. ).

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7.4 DICOM Transfer Status

Enter the “DICOM Transfer Status” window by clicking the Queue Status button in the “DICOM Send”
( For more information see 'DICOM Send' on page 7-7. ) or the “DICOM Print” ( For more information see
'DICOM Print' on page 7-10. ) dialog box.
In this window the status of all DICOM messages can be viewed that have not yet been successfully
transferred yet.
7.4.1 Status messages
When a DICOM transfer is in progress its status is TRANS.

When a DICOM transfer has been successfully finished, the entry for this transfer disappears from the
window.
A reminder occurs only for the transfers which have not yet been completed. They have the
indication FAIL.
7.4.2 DICOM Queue Operation
Press the Hold Queue button to pause queue processing.
Press the Retry button to try again sending the currently

highlighted job.
Press the Delete button to delete the currently highlighted job.
Press the Retry all button to try again sending all jobs in the
DICOM queue.

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Press the Delete all button to delete all jobs in the DICOM
queue.
Press the Show Information button to show the following info

about the currently highlighted job:
• Patient ID, Date and Time of Akquisition
• Alias, IP Adress, Port number and AE Title of the DICOM

server
• Job status and the time this status was set
If the image is stored in the Archive you can view it using the Go
to Archive button.
Press the Close button to close the DICOM Queue dialog.
Press Restart Transfer to restart the transfer service. If the

service is not started, the button is highlighted with two gray
bars.

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7.5 DICOM Worklist

With the “DICOM Worklist” function of 4DView, data of patients can be retrieved from a DICOM
worklist server.
Note If more worklists are configured, it is possible to check multiple worklist servers in
a box. With button "search" all checked servers are used as source.
Enter the “DICOM Worklist” window via the “Current Patient Dialog” ( For more information see
'Current Patient Dialog' on page 6-3. ) dialog box by clicking the “Worklist” button situated in the
menu area (For more information see 'Current Patient Menu' on page 6-6. ) of the dialog box.
Note If the button is greyed out, check the DICOM Configuration dialog if a device with a
WORKLIST service defined and selected. For more information see 'Setting the
Connection Properties of the Remote DICOM Stations for Connection' on page 7-
3.
7.5.1 Retrieving patient data
Search for Exams

Using the entry fields in the upper part of the dialog box, the search can be narrowed. For example,
enter a “Patient Name”, a “Start Date”, and an “End Date”. When this information is entered, only data
of patients with that particular name between the two given dates will be displayed in the list below.
If a “Modality” of “ULTRASOUND” is selected in the “DICOM Configuration” ( For more information see
'DICOM Configuration' on page 7-2. ) dialog, only data marked with “ULTRASOUND” will be retrieved
from the server.
Access
The button “Show locally stored data” is available if old worklist data from a previous request exists.
The date and time in the “Last updated”: field gives the date and time the currently used worklist
data was retrieved.
To retrieve new worklist data press the “Search” key, to use the old worklist data from the hard disk
press “Show locally stored data”.
The list of scheduled exams can be sorted by clicking the caption of the respective column.
The data to retrieve can be selected in two ways. Either select an exam from the list with the left
mouse key and then click the “Select” button, or, select the exam by double-clicking.
After selecting an exam, the data of this exam will be copied into the corresponding fields of the
“Patient” ( For more information see 'Current Patient Dialog' on page 6-3. ) dialog box.

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7.6 DICOM Storage Service Class Provider

With the “DICOM Storage Service Class Provider” (Storage SCP), the PC can receive DICOM volumes
from another PC with 4DView or from a GE HealthCare Voluson™ Family series ultrasound scanner.
If the “Storage SCP” is running and shows its activity by displaying a green circle in the status area
of the task bar of Microsoft Windows® 10 64-Bit, Windows® 11 64-Bit but obviously does not store
data, i.e., the sent images do not appear in the “Exam Table” ( For more information see 'Exams' on
page 6-10. ) of Archive, check if there is enough free disc space available. In order to work properly
with the Storage SCP, about 200 MB of free disc space is required.
7.6.1 Starting the DICOM Storage SCP
The Storage SCP is an application which can be used independently from 4DView, therefore it is
initialized from the Microsoft Windows® 10 64-Bit, Windows® 11 64-Bit Start Menu. Click the Start
button at the lower left corner of the Microsoft Windows® 10 64-Bit, Windows® 11 64-Bit screen. In the
lower part of the Start menu is the menu item Programs. Move the mouse cursor over this menu
item and look for the program group “4DView”. From this program group start the Storage SCP.
The Storage SCP shows its activity by a colored circle in the status area of the task bar, which is
normally situated at the lower right corner of the screen.
7.6.2 The Colors and Status of the Storage SCP
7.6.3 Controlling of the Storage SCP
When the Storage SCP is running control it by clicking on its icon with the right mouse button. A
small menu appears to choose to stop or to exit the program.
7.6.4 Settings of the Storage SCP
Only when the program is stopped and the circle is red, can the “Settings” menu of the Storage SCP
be entered. (This has nothing to do with the “Settings” menu of 4DView.)
In the “Settings” part of the Storage SCP there is one page for “General Settings” and one page for
“DICOM Settings”.

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DICOM Settings
Here, the DICOM specific settings of the Storage SCP can be changed.
AE-Title is the “Application Entity Title” of the Storage SCP. The Port Number is the number of the
PC"s communication port at which the Storage SCP communicates with the DICOM sender.

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7.7 Report Transfer

Worksheet data can be sent from 4DView to a server designed to receive measure reports in a special
format. The data can be sent over the network or via the computer"s serial port.
Technical detail: Using a network the data is sent using low-level DICOM.
7.7.1 Preparing Worksheet Data
• Enter the patient"s data in the “Patient” ( For more information see 'Current Patient Dialog' on
page 6-3. ) dialog. Invoke this dialog through the “Edit” menu ( For more information see 'Edit'
on page 3-6. ), or with the “Person” button in the toolbar ( For more information see 'Toolbar' on
page 3-9. ).
• An exam must be started with at least one calculation measurement completed, or a

previously saved worksheet must be restored.
• A connection for a report transfer must be registered in the “DICOM Configuration” ( For more
information see 'DICOM Configuration' on page 7-2. ) dialog. The designated device must
provide a “REPORT” service. Therefore, only devices in the “DICOM Configuration” ( For more
information see 'DICOM Configuration' on page 7-2. ) dialog can be selected that display
“REPORT” in the “Services” column.
7.7.2 Sending Worksheet Data
When there is worksheet data available, the button Transfer Data is visible at the bottom of the
worksheet menu.
The status and result of the transfer can be seen in the “DICOM Transfer Status” ( For more information
see 'DICOM Transfer Status' on page 7-12. ) window, entered through the “DICOM Send” ( For more
information see 'DICOM Send' on page 7-7. ) dialog box.

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7.8 VolusonClub.net - Learn. Network. Share.
The Voluson Club is a global network exclusively for Voluson™ ultrasound users. It lets you share with
other specialists from around the world at special events like new product launch meetings, VIP
lounges at congresses and trade fairs, and annual Voluson user days in your region. As a member,
you will also receive regular news-letters, information about the latest in Voluson ultrasound practice
and technology, as well as special offers and opportunities announced on the club website
www.VolusonClub.net.
Membership Benefits.
• Invitation to Voluson Club events such as annual Voluson User Days
• Free access to Voluson Club VIP Lounges offered on several congresses world-wide
• Selection of different Voluson Club offers (White Papers, Education DVDs, GE Ultrasound Post,
Voluson Tutorial CDs, …) exclusively for members
• Unlimited access to all services offered on the Voluson Club website at www.VolusonClub.net
• Personalized mailings and newsletters

At www.VolusonClub.net you can download a series of 4DView Demo Cases for a first evaluation of
the possibilities of 4DView.
All this and much more awaits you - including special offers available only in your region. Become a
member and sign up now for your exclusive membership at www.VolusonClub.net - membership is
free of charge and for Voluson™ ultrasound users only. After registration you will receive your
personal access codes for the club website as well as your personal Voluson Club member card to
access your club benefits.

Connectivity
7.9 Samples of Private Network Setups

Note This section describes the process of setting up a network using the example of a
Voluson™ series machine and PCs running on Windows® 10 64-Bit, Windows® 11
64-Bit. It is only meant as a guideline. If you require assistance on this matter
please contact your system administrator or qualified service technician.
Note For users of a Loqiq system: Please refer to the respective Instructions for Use for
information on how to connect to a Loqiq console.
7.9.1 Connecting Voluson™ to PC
Connecting the Voluson™ and the PC Using a Network Cable

1. Connect the two devices using a RJ-45 network cable.
Note Such a cable should be available in a local computer shop. The designated system
administrator might also be able to provide such a cable.
2. Plug one end of the cable in the appropriate connector of the PC"s network card.
3. Then plug the other end into the “Network-DICOM input/output” slot of the ultrasound
scanner"s “Connector Panel,” which is situated on the rear side of the machine.
For details, please review the “Connections” chapter of the Voluson™ Instructions for Use . Do not
plug the cable into one of the LAN slots located elsewhere on the machine.
The described process is identical for all Voluson™ systems.
Configuring TCP/IP on the PC

After having connected the two devices, TCP/IP protocol must be configured on the Microsoft
Windows® 10 64-Bit PC, Windows® 11 64-Bit.
1. Press Start and choose Control Panel.
2. Select Network and Sharing Center
3. Press Local Area Connection
4. Click Properties
5. Select Internet Protocol Version 4 (TCP/IPv4) and press Properties.

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6. Check Use the following IP address.

7. For a small private network consisting of one PC and the Voluson™ series ultrasound scanner
any "IP adress" can be entered.
8. Set the "subnet mask" to “255.255.255.0.”

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9. Press OK and thereby close the TCP/IP settings dialog.

10. Close all other currently open windows.
Configuring TCP/IP on the Voluson™ Series Ultrasound Scanner

The next step is to configure TCP/IP protocol on the Voluson™ series machine. In order to do this
enter the “System Setup.” For more details please review the “System Setup” chapter of the
Voluson™ Instructions for Use .
1. In the System Setup Connectivitychoose Device Setup and press the TCP/ IP Configuration
button.
2. Select Yes

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3. Select Use the following IP address and enter the “IP address” of this machine.
Info The IP address is different from the PC's address.
4. The “subnet mask” is the same as before – “255.255.255.0”.

5. Press OK and return to the System Setup page.
Starting and Configuring Storage SCP on the PC

1. Click "Start" button of the Windows® operating system
2. Select "All Programs" and click on 4DView
3. Click on Storage SCP

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Info A colored circle appears in the status areas of the Windows® task bar. The circle
changes after a few seconds from yellow to green, which indicates that the
program is active.
4. Stop SSCP by right-clicking on the green circle and chose Stop from the menu.
5. Right-click on the red circle and select Settings.
6. Edit the AE Title or choose the default "4DViewSCP". Leave the Port No:. with its default value
"105" in the DICOM settings. Adjust the TLS Settings as desired.
7. In the "General" tab select the Interval, which default value is "2 seconds".

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8. In the "Start" tab check one of the following Autostart options:
• Autostart with 4DView: SSCP is automatically started, when 4DView is started.
• Autostart with Windows®: SSCP is automatically started, when Windows® is started.
9. Restart Storage SCP by right-clicking the red cicle and choosing Start.
Info The circle changes to green
Adjusting the DICOM Settings on the Voluson™ Series Machine

1. In the System Setup Connectivity select Device Setup and press DICOM Configuration
2. In the "DICOM Configuration" dialog press Add
3. Enter the following Alias, AE Title, IP Address and Port.

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Note Make sure that IP Address, AE Title and Port are the same as you have chosen for
the PC. In the lower half of the dialog set the format used for sending images and
cines. For more details on this settings, see the chapter “Connectivity” in the
4DView Instructions for Use . For now, simply press “4DView default”, to adjust the
settings to the values recommended for sending to 4DView.
4. Press Save and return to the DICOM Configuration

5. The newly added DICOM server appears in the list.
6. Select the PC, which was addend and pressTest Connection to check whether the connection
works or not.
Note After a few seconds the “Ping” as well as the “Verify” field should contain the string
“OK.” If one of the fields displays “Failed,” check all settings on the PC as well as on
the Voluson™ series machine, and the connection itself for errors. (Review:
'Network problems' on page 8-6)
Note Check if Storage SCP is running on the PC!
When no mistakes have been made and the connection works, the images can be sent now.
Note When connecting more than one PC and Voluson™ series machines repeat the
steps above, but enter a different “AE Title” in the “DICOM” tab of the SSCP
settings.
Sending Images from the Voluson™ Series Machine to the PC

For information on how to send images via DICOM from the Voluson™ series machine, please review
the appropriate chapters of the Voluson™ Instructions for Use .
One possibility is to open the archiving application, to select an exam and to choose “Send.” When
asked for a destination, choose “4DView.”
What type of dialog is displayed depends on the method used for sending the images. For more
details please review the appropriate chapters of the Voluson™ Instructions for Use .

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Check whether the transfer was successful by opening the “Transfer Status” window. (Review the
Voluson™ Instructions for Use for details.)
Sending Images from One PC to the Other PC

Since there are two PCs connected to the network, images can be sent from one PC to the other. This
is done by starting 4DView, and opening the data to send.
Press the “DICOM Send” button from the 4DView toolbar. Please review
also the 4DView Instructions for Use .
The “DICOM Send” dialog appears.
By pressing the “Alias” button named “not defined” twice, enter the “DICOM Configuration” dialog.
Here information about this PC and about the DICOM server on the second PC must be entered. This
dialog is similar to the “System Setup” of the Voluson™ series machine.
First enter the “AE Title” which in the example is “PC,” the “Station Name” “Kretz” and set the “Retry
Count“ to “2” and the “Retry Interval“ to “1” minute, for example.

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Now press the “Add” button beneath the list and enter the information on the remote PC. (Review
also “Adjusting the DICOM Settings on the Voluson™ Series Machine” above.)
Choose “STORE” from the “Services” drop-down menu and enter “4DView_2” in the “Alias” field, for
example. The “AE Title” is set to be “PC2,” the “IP-Address” is “10.17.2.3” and the “Port” “104.”
In the lower half of the dialog set the format used for sending images and cines. For more details on
this settings, see the chapter “Connectivity” in the 4DView Instructions for Use . For now, simply
press “4DView default”, to adjust the settings to the values recommended for sending to 4DView.
After pressing “Save,” either test the connection by selecting the appropriate line in the DICOM server
list and pressing “Test Connection,” or return to the “DICOM Send” dialog after having marked the
newly added destination in the list by placing a checkmark in the appropriate check box, by clicking
“OK.”
In the “DICOM Send” menu, send the images by pressing either “Send 2D” or “Send 3D.”
Follow the same steps to transfer data from the second PC to the first one.
For more details on the process please review the chapter “DICOM” in the 4DView Instructions for
Use .
Viewing the Transferred Images on the PC

When the transfer was completed successfully, open the data on the PC. Open the archiving
application with the toolbar button from the 4DView toolbar. (For more details, please review the
4DView Instructions for Use .)
The transferred data appears in the “Exam List” and can be opened from there.

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Chapter 8
Troubleshooting
Installation problems - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-2

Performance problems - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-4
Display resolution - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-5
Network problems - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-6
Error Messages - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-8

Troubleshooting
8.1 Installation problems
8.1.1 Error Messages
An error message is a gray message window, displaying a red circle

with a white “x,” and some text.
There are also messages which can indicate an error. Such a message
is a gray message window, displaying a triangle with a black
exclamation mark in it, and some text.
When an error message is displayed during work with 4DView, it might be that some important
component is missing, or that some other data, which is crucial to the process, is missing or
corrupted. In most cases providing that data is the best and only possibility of solving the problem.
4DView Operating System

Note that 4DView only runs with Windows® 10 64-Bit or a higher operating system. If an unsupported
operating system exists and the installation process is started, the setup process is canceled and a
message appears.
4DView Already Installed – Uninstallation
This message appears, if 4DView uninstallation is started by a user different from the user who
installed 4DView on the system. If uninstallation is continued, other users might encounter problems.
4DView should be uninstalled by the user who installed it on the system.
Click “Yes” to continue with the uninstallation process and “No” to abort 4DView uninstallation.
If no user has installed 4DView, something might have gone wrong during a previous deinstallation
process. In this case try uninstalling 4DView via the Windows Uninstall program function and install
4DView again
Program is not Properly Installed
In case this message appears, make sure no other user has installed 4DView on the system. Contact
all other users of the sytem. Only the user who installed 4DView on the system can use it. If another
user wants to work with 4DView, it has to be uninstalled first by the user who first installed it.
If no user has installed 4DView, something might have gone wrong during installation. Try
uninstalling and reinstalling 4DView via the Windows Uninstall program function.

Troubleshooting
“Locked File Detected” During Deinstallation
If this message appears during the uninstall process, close the “Transfer” program and “Storage SCP”
and click “Retry.” For more details please review “Section 'Uninstalling 4DView' on page 2-7“.

Troubleshooting
8.2 Performance problems

If parts of the application take too long to load or are not running smooth please check the following:
• If there are other programs running on your PC taking too much resources close them.
• If your system does not meet the Installation Requirements specified in the Installation
Instructions for Use ask your system administrator to provide more powerful hardware.
8.2.1 Measurement startup too slow
The time interval between starting Measurement and a reaction of the system can be up to 60
seconds. If Measurement takes too long to load the first time, the reason might be an activated anti-
virus program. Try deactivating the anti-virus program and activating Measurement again.
8.2.2 Opening of datasets too slow
When the delay between opening an image and the image being displayed on the screen takes over
several seconds the system may not be equipped with enough memory (RAM). For more information
see 'Performance problems' on page 8-4.
If a dataset is huge, this problem can occur too. If this is the case, there is nothing to be done about
it. Consider the size of the dataset when capturing data.
8.2.3 Testing the connection takes too long
The process of testing a connection can take up to 30 seconds. Please be patient.

Troubleshooting
8.3 Display resolution

Windows® 10 / Windows® 11
1. Right click on your desktop
2. Select Display settings
3. Chose Customize your display to change text size, apps and other items: 225% - 250%
(Advanced Display Settings: Resolution: 3840 x 2160)

Troubleshooting
8.4 Network problems

When you have troubles sending or receiving data from a DICOM Server or a DICOM Printer on the
network, the first thing to do is testing the connections. This is done by entering the DICOM
Configuration dialog, by choosing Settings - DICOM Configuration from the programs top menu. For
more information see 'DICOM Configuration' on page 3-13. In this dialog, select the connection to be
tested, by clicking on the appropriate line in the DICOM server list, and press the Test Connection
button.
If the string Failed is displayed in either one or both of the fields there are problems with the
connection.
8.4.1 Ping Failed but Verify Succeeded
If the Ping test fails, but Verify succeeds, the connection is working properly. The remote server just
does not know the Ping command which is not demanded.
8.4.2 Ping and Verify Failed
If the Ping and Verify tests failed the system encountered a problem while trying to connect to the
remote server. Reasons for this can be either a problem with the physical network connection
(cables, connectors or network cards) or with the network settings (IP-addresses).
When using more than just a small private network, i.e., the system is connected to a larger network,
please ask the designated network administrator for help.
When using just a small private network, configured similar to the examples given in the Installation
Instructions for Use , check the connection:
• Check the network settings. Make sure that the correct IP-addresses were entered on the
Voluson™ Family system as well as on the DICOM server system (e.g. the PC running Storage
SCP).
• Check the network setup. Make sure all connections are made correctly. Refer to the
Installation Instructions for Use for further information.
• Check the network cables. Make sure all network cables are plugged into the correct slots.Try
using a different network cable to ensure that no defect is the causing problems.
• Check the network cards. Make sure that the network cards function properly and the correct
drivers are installed. (Enter the Windows®Device Manager by right-clicking on My Computer on
the desktop and choosing Properties from the appearing menu. A new dialog appears. Select
the Hardware tab and press the Device Manager button. Another window appears. When
clicking on the + sign next to the item Network Adapters, the name of the network card is
displayed. If there is a caution sign next to this name contact your system administrator.
• Make sure the correct network cable is used. A CROSS-OVER cable must be used in a small
private network without a hub and NORMAL cables are required in a small private network
when using a hub.
• If you are using a hub make sure it is working. Please read the hub"s Instructions for Use for
more information.

Troubleshooting
When all of the above has been checked, and the connection still does not work properly, try taking
the measures suggested in the next section 'Verify Failed' on page 8-7. It could be that the
connection can be established properly but the remote server does not react on Ping and that just
the verification does not succeed.
8.4.3 Verify Failed
If the Ping test was successful, but the Verify test failed nevertheless, it indicates that the system can
connect to the remote server, but does not get an appropriate response from there. Check if the
correct settings for the remote device have been entered, by opening the DICOM Configuration dialog
(For more information see 'DICOM Configuration' on page 7-2. ) selecting the desired device from the
list of available DICOM servers by clicking on the appropriate line, and pressing the Edit button.
Check the settings in the appearing dialog.
Make sure the correct AE Title, IP-Address and Port have been entered and that the correct service has
been chosen from the Services list. Note that the AE Title is case sensitive. Close the window by
pressing OK and test the connection again if any changes have been made.
Make sure the correct settings are also entered at the remote device, e.g. in the Settings dialog of the
Storage SCP of the remote computer. (Right-click on the colored (green) circle in the status area of
the Windows® task bar and choose Stop from the appearing menu. The circle becomes red. Right-
click again and this time select Settings. Check the settings and start the Storage SCP again, by right-
clicking the colored circle and choosing Start).
Check if the DICOM service is running on the remote device, e.g. make sure, that the Storage SCP is
running (green circle in the status area of the Windows® task bar) on the remote computer. If not,
start the service, e.g. Storage SCP, and try again.
8.4.4 Connection is OK - Transfer Does Not Work
If the Ping as well as the Verify test have been OK and the sending process seems to have been
successful but you are still encounting problems like:
• No images arrive at the remote device.
• Data is not available at the remote device
• The exam does not appear in the Exam List of the archiving application.
Make sure there is enough free disk space at the remote device. Storage SCP for examples needs
about 200MB of free disc space to work properly.
Free some disk space and try again.

Troubleshooting
8.5 Error Messages
8.5.1 File Is Corrupted
This message says that the specified file can not be opened, because it is corrupted. If a backup of
the file is available, try restoring the file and opening the restored file. If the file was sent to the
computer via DICOM, try sending the file again. Hardware problems can also be the reason for this
message. If the problem occurs more often, check the RAM and the hard disc for malfunctions. If
none of these solutions is applicable, make a new picture, if the data is important.
8.5.2 Dataset has been Modified
This message appears when a dataset has been modified and 4DView is saving the dataset. A
modification happens as soon as the appearance of the dataset is changed. Even a simple rotation or
any other small interaction can cause a modification. Choose Yes to exit without saving the changes,
choose No to return to 4DView and save the dataset there. When choosing No the dataset must be
saved by choosing Save from the File menu or pressing the Save toolbar button.
8.5.3 File type unknown
This message appears when opening a file which 4DView can not interpret. When opening a file make
sure that the field Files of type is set to Volume Files (*.v*,*.dcm)" so that only files with the correct
extension can be opened.

Troubleshooting
8.5.4 HD Rendering not supported
This message appears when you try to activate HD Rendering and your hardware configuration does
not support it. A DirectX® 11-enabled graphics adapter has to be installed on the PC.
If your graphics adapter does not support DirectX® 11, you have to upgrade your hardware in order to
use HD Rendering features or use the default software rendering.
8.5.5 Low Color Depth
This message appears when your system's color setting is below 32 bit. Please refer to the Microsoft
Windows® help for further information.

Troubleshooting
8.5.6 System Font Too Large
This message appears when your system's DPI scaling is higher than 96 DPI. Please refer to the
Microsoft Windows® help for further information.

Chapter 9
Glossary

Glossary
9.1 Glossary
3D Calc Cine: A 3D Calc Cine is an animated sequence of the rendering of a static 3D volume. There
are three Cine types: Rotation Cine, Translation Cine and Slice Cine. They differ from each other in
their animation method.
4D Image Cine: A 4D Image Cine consists of a number of images and one volume. The images
document a 4D acquisition process and the volume is the last volume acquired during this process.
The volume can be edited just as any other static 3D volume. The images can not be edited after
acquisition. 4D Image Cines can be generated in Realtime 4D mode using a Voluson™ Family
ultrasound scanner.
4D Volume Cine: A 4D Volume Cine consists of up to 128 volumes acquired with a Voluson™ Family
ultrasound scanner in Realtime 4D, Fetal Cardio, VCI A or C, or 4D Biopsy mode. Each volume can be
edited as any static 3D Volume. A 4D Volume Cine contains all the data acquired during acquisition.
JPEG: JPEG is an acronym for the Joint Photographic Experts Group. It is referred to as a “joint”
group because this committee is sanctioned by the CCITT and the ISO, two prominent international
standards groups. JPEG refers both to the committee and their work in progress - a compression
standard that will define a method for compressing photographic images. Images compressed with
the JPEG algorithm undergo a “lossy” compression. The amount of compression can be varied, with
a resulting loss or gain in resolution. JPEG compression can achieve impressive compression ratios,
reducing the memory required by images to less than 10% of the size of the original with only very
slight loss of resolution. By sacrificing more resolution images can be compressed by 95% or more
using JPEG.
Region of Interest (ROI): ROI designates Region Of Interest. A synonym for ROI is “render box”.
Voluson Club: www.VolusonClub.net provides a platform for physicians, ultrasound specialists and
any other interested person in medical ultrasound. Its objective is to support the communication and
knowledge exchange of ultrasound experts world-wide. For more information see 'VolusonClub.net -
Learn. Network. Share.' on page 7-18.
Ultrasound Units: Units calculated with a velocity of sound of 1540 m/s in beam direction.
VOCAL II is an acronym for Virtual Organ Computer-aided Analysis
The diagnosis and therapy of cancer is one of the most important issues in medical care. The new
VOCAL - Imaging program is an extension of the 4DView software, integrated in GE HealthCare's
Voluson™ Family series sonography systems and also available for the PC. It opens up completely
new possibilities in cancer diagnosis, therapy planning and follow-up therapy control. VOCAL offers
different functions:
• Construction of a virtual shell around the contour of the lesion. The thickness of the shell can
be defined. The shell can be imagined as a layer of tissue around the lesion, where the tumor-
vascularization takes place.
• Automatic calculation of the vascularization within the shell by 3D color-histogram, comparing

the number of color voxels to the number of gray-scale voxels.
The follow-up control of tumor volume and vascularization delivers information on the proper dose
of medication or radiation and therefore a measure for the success of treatment.
After definition of a contour in 3D space a wide range of functionality is given:
• Definition of a shell contour.
• Visualization of a (shell) contour as a surface or wire mesh.
• Volume calculation of a (shell) contour.
• Histogram calculation of ultrasound tissue inside a (shell) contour.
• Visualization of ultrasound tissue inside a (shell) contour as a rendered image.
• Niche presentation of contour and slices.
• Shell map presentation of ultrasound tissue inside a (shell) contour.

Voxel: A voxel is the smallest unit of a given 3D data set. In comparison, the smallest unit of a digital
2D picture is a pixel.

Chapter 10
Appendix

Appendix
10.1 Trademarks
Voluson™ , SonoVCAD™, SonoAVC™, B-Flow™, HDlive™, HD-Flow™ and LOGIQ™ are registered
trademarks of the General Electric Company.
Microsoft Windows®, Windows® 10 64-Bit, Windows® 11 64-Bit and Microsoft® DirectX® 11 are
registered trademarks of the Microsoft® Corporation.
PC® is a registered trademark of IBM Corporation, USA.
Adobe® Acrobat® Reader is a registered trademark of Adobe Systems Incorporated, San Jose,
California 95110-2704, USA.
Pentium™ is a trademark of the Intel Corporation.
GE is a trademark of General Electric Company used under trademark license.

Appendix
10.2 e-Distribution Portal
Access the e-Distribution portal (https://viewpoint-sw.gehealthcare.com ) for downloading current

and updated versions of 4DView. Use your credentials (site ID) provided in the email received after
first purchase.

Appendix
10.3 Additional Products

The term "ViewPoint™ system" used in the Instructions for Use describes ViewPoint, ViewPoint 6 and
future products if applicable.

Chapter 11
Country-specific Information
Description of country-specific information.

Turkey
This information is only valid for Turkey.
Türkiye İthalatçısı / GE Medical Systems Türkiye Ltd. Şti.

Turkish Importer Esentepe Mah. Harman Sok. No: 8
34394 Şişli İstanbul Türkiye
Brazil
This information is only valid for Brazil.
Detentor da Notificação: GE HEALTHCARE DO BRASIL COMÉRCIO E SERVIÇOS PARA EQUIPAMENTOS

MEDICOS-HOSPITALARES LTDA.
Endereço: Av. Magalhães de Castro, 4800 – Andar 10 Conj. 101 e 102, Torre 3 - Cidade Jardim -
CEP: 05676-120 - São Paulo/SP – Brasil
CNPJ: 00.029.372/0001-40
Telefone: 3004 2525 (Capitais e Regiões Metropolitanas)

08000 165 799 (Demais Localidades)
ANVISA N°: 80071260320
Kazakhstan - Authorized representative in Kazakhstan

This information is only valid for Kazakhstan.
English Kazakh Russian
General Electric Kazakhstan LLP «Дженерал Электрик Қазақстан» ЖШС ТОО «Дженерал Электрик Казахстан»
26/41, Zenkova Street, Medeu District, Қазақстан, Алматы қаласы, Медеу Казахстан, город Алматы, Медеуский
Almaty, 050010, Kazakhstan ауданы, көшесі ЗЕНКОВ, үй 26/41, район, улица Зенкова, дом 26/41,
T +7 727 3560020 пошталық индексі 050010 почтовый индекс 050010
T +7 727 3560020 T +7 727 3560020
Thailand
This information is only valid for Thailand.
GE Medical Systems (Thailand) Co., Ltd.

32nd Floor, Thanapoom Tower
1550 New Petchburi Road
Makkasan, Ratthewi, Bangkok 10400, Thailand
Tel: (+66) 2 624 8488
Ukraine
This information is only valid for the Ukraine.
Ультразвукова система Voluson E6

Знак відповідності технічним регламентам


Tiefenbach 15, 4871 Zipf, Austria
ДЖИІ Хеалскеа Австрія ГмбХ & Ко ОГ
Тіефенбах 15, 4871 Ціпф, Австрія
Уповноважений представник в Україні:

ТОВ «ДЖИІ ХЕЛСКЕР УКРАЇНА»
02000, Україна, місто Київ, проспект Павла Тичини, будинок 1В, офіс 408
Тeл.: +38 (044) 390 06 08
Дата останнього перегляду інструкції з використання є датою останньої редакції та

вказана у інструкції з використання.
Belarus
This information is only valid for Belarus.
Уполномоченный представитель производителя для получения претензий в Республике
Беларусь
ООО «ДжиИ Хэлскеа»

123112 Российская Федерация, Москва, вн.тер.г. муниципальный округ Пресненский,
Пресненская набережная, д. 10, помещение I, этаж 14, ком.30.
Тел. сервисной службы: 8 800 333 6967
Тел. офиса: + 7 495 739 6931, Факс + 7 495 739 6932
88003336967@ge.com
http://www.gehealthcare.ru/


Tiefenbach 15
4871 Zipf
Austria
www.gehealthcare.com

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Revision 1 November 2017

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Revision 3 January 2019

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Revision 6 May 2021

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Revision 8 October 2023

4DView Instructions for Use

4DView Instructions for Use

DICOM Worklist - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-14

4DView Instructions for Use

Introduction to 4DView - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-2

4DView Instructions for Use

1.1 Introduction to 4DView

• Display* of archived ultrasound images

• Measurement* on ultrasound images

Primary Operating Functions

• Display and editing of GE Ultrasound 3D/4D data sets

• Data storage (image, measurement and patient data)

• Data transfer to and from remote systems (e.g. via DICOM® )

• Adding annotations to acquired image

4DView Instructions for Use

GE Healthcare Austria GmbH & Co OG

Tiefenbach 15 Telephone: +43-7682-3800-0

4871 Zipf Fax.: +43-7682-3800-47

Austria Internet: http://www.gehealthcare.com

4DView Instructions for Use

1.2 About these Instructions for Use

4DView Instructions for Use

1.3 Conformance Statement

• REGULATION (EU) 2017/745 concerning medical devices:

• IEC62304: Medical device software – Software life cycle processes

• IEC62366: Medical devices – Application of usability engineering to medical devices

• ISO 14971 Medical devices – Application of risk management to medical devices

Certifications: GE Healthcare Austria GmbH & Co OG is ISO 13485 certified.

4DView Instructions for Use

1.4 Safety Regulations

4DView Instructions for Use

1.4.1 Network disclosure

Purpose and scope

Purpose of the network connection

Network interface technical specifications

Internet Protocol Version: IPv4

Required IT network characteristics

• 104 – DICOM (default outbound) / 105 - DICOM (default inbound)

4DView Instructions for Use

Note DICOM is the registered trademark of the National Electrical Manufacturers

• 25, 465 or 587 - SMTP (configurable on the system)

Potential hazardous situations resulting from failures of the IT network

• Delayed or impaired access to images or other exam information or patient data.

• Permanent loss of images or other exam information or patient data.

• Corruption of images or other exam information or patient data.

• changes in network configuration

• connection of additional items to the network

• disconnection of items from the network

• update of equipment connected to the network

• upgrade of equipment connected to the network

4DView Instructions for Use

Symbol Meaning Reference