software for healthcare

INOBITEC DICOM VIEWER

User Manual

Version 1.14
 The information contained in this User Manual belongs to Inobitec LLC (Voronezh, Russia).
The Manual is delivered to the users of Inobitec DICOM Viewer software product exclusively for
the purposes of working with this product. No part of the information herein contained can be
modified, used for any other purpose or delivered to any third party without the prior written
consent of Inobitec LLC (Voronezh, Russia). Inobitec LLC reserves the right to alter this Manual
without prior notice.Screenshots are made in Windows for gray style of the Viewer. Differences
in the appearance of the Viewer interface from the images in the screenshots are allowed.

c Inobitec LLC, Voronezh, Russia, 2009-2019, All rights reserved

2
About this Manual

This User Manual describes the functionality of Inobitec DICOM Viewer (version 1.14) and how
to use this software product.

Contents
The User Manual contains the following sections:
• Contents
• Installing, Uninstalling and Launching the Program
• Chapter 1. Program Window Elements
• Chapter 2. View Flat Images
• Chapter 3. Volume Reconstruction
• Chapter 4. Series Fusion
• Chapter 5. Multiplanar Reconstruction
• Chapter 6. Segmentation
• Chapter 7. Planning of Pedicle Screws Installation
• Chapter 8. Vessels Analysis
• Chapter 9. PET Analysis
• Chapter 10. Virtual Endoscopy
• Chapter 11. View ECG
• Chapter 12. Working with the Network
• Chapter 13. Working with the Storage
• Chapter 14. Disk Creator
• Chapter 15. Viewer Settings
• Chapter 16. Print Images
• Chapter 17. Licensing

3
Contents

• Chapter 18. The Help System and User Assistance

• “Hotkeys”
• Index
• Clossary

Accepted Conventions
Names of program interface elements, key names and important notes are printed in bold.
Image captions are printed in italics.
The numbers of the pages, which contains a detailed description of the subject, are printed
in bold in the Index.

4
Technical Support

Technical support of Inobitec DICOM Viewer users is provided by the Inobitec LLC team. If you
apply for technical support, please include the following information in your message:

• your computer OS name, version and bitness (you can get this information from your
system administrator);
• Viewer version (e.g. 1.9.0.11628). To get your version number, select the About... item
from the main Help menu;
• product code. To find out the product code, select the License... item from the main
Help menu.

To apply for technical support, or if you have any further questions or comments, please email
us at [email protected]

5
About the Product

About the Product

The Inobitec DICOM Viewer software product is intended for viewing, analyzing and printing
medical data obtained from various DICOM equipment (modality). The product is deployed on
diagnostic workstations and integrated with PACS servers. The Viewer propels the capabilities
of diagnostics to a new level that cannot be achieved using films and other hard media, and
makes it possible to detect pathological conditions timely and efficiently, predict their develop-
ment and plan their elimination.
The Inobitec DICOM Viewer software product and installer does not:

• collect and transfer of confidential user information;

• intercept network traffic;
• show ads;
• send spam;
• show messages not related to work;
• automatically update itself without notifying the user.

After uninstalling you do not need to restore operating system and browser settings. Unin-
stalling is free of charge. Uninstalling does not adversely affect the operation of the computer
and installed software. Files not related to the Viewer are not removed and changed after
uninstalling. The Viewer functionality, installing, uninstalling, licensing are fully described in
this User Manual on the website inobitec.com. License Agreement is available from the link
inobitec.com/eng/downloads/eula.php.
The Viewer is available in two editions:

• Lite: contains the sufficient functionality for high-grade work, including storage and trans-
fer of information on a network. This edition does not contain tools for conducting highly
specialized studies. The cost is much lower than the cost of the Pro edition.
• Pro: contains all available functionality. In the User Manual the description of the func-
tionality is marked with the symbol «PRO ».

The edition of the Viewer which is recorded on the disk and the memory card containing
minimal functionality for viewing studies by patients.
Starting from version 1.11.0 specialized modules can additionally be connected to the Pro
edition. Such modules are licensed and paid separately. The main functionality remains available
in the Pro edition. In the User Manual the description of the functionality is marked with the
symbol «ADD ».
If the functionality is not available in the current edition, then a corresponding warning
appears. It indicates in which edition functionality is available.

6
 Viewer Functionality

32-bit and 64-bit builds are available for Windows operating systems. 64-bit builds are
available For Linux and MAC OS. You can install only a 32-bit build of the program on a
computer with a 32-bit operating system, and any build on a computer with 64-bit one, but
it is recommended to install 64-bit, since it uses computer resources more efficiently. The
functionality that requires a large amount of RAM is available only in 64-bit builds.

Viewer Functionality

Available in
Function edition
Lite Pro
View flat images with the following options: X X
rotate, pan, zoom, mirror X X
change window width and level X X
view several images or series simultaneously, and
X X
synchronize scrolling automatically
calibration image size X X
show image scout lines on other series images X X
measure length, angles X X
play series images subsequently as a movie X X
choosing of image resampling filter in the Flat Images X X
View window
add comments, labels and various graphic elements on
X X
images
measure Cobb angles and intensity at some point or in X X
some area
export the model to a graphic file or to a new series of
X X
DICOM images
DSA (Digital Subtraction Angiography) X X
DCE (Dynamic contrast-enhanced MRI and CT View) X X
add markers X X
edit CLUTs X X
browse DICOM image tags X X
Diffusion Tensor Imaging(DTI) support X
calcium scoring X
View three-dimensional tissue reconstruction with the
X X
following options:

7
About the Product

Available in
Function edition
Lite Pro
rotate, pan and zoom the model X X
view scaled-down multiplanar reconstruction of the series
X X
simultaneously (with automatic synchronization)
remove bone tissue X X
cut outside and inside parts of the model X X
MIP (Maximum Intensity Projection) X X
measure length, angles X X
export the model to a graphic file or to a new series of
DICOM images, including export of several images X X
obtained by rotating the model
add markers and line markers X
build the surface by the model X
segmentation X
View multiplanar reconstruction with the following options: X X
view axial, frontal and sagittal sections of tissue X X
rotate cutting planes in space X X
3D view X X
measure length, angles X X
build a section of a spatial model by a random surface X
export sections of any of the planes with a selectable X
increment to a series
add markers and line markers X
segmentation X
mixed RGB colors Fusion X
Virtual endoscopy (viewing the inner surfaces of cavities in
X
tissues) with the following options:
automatic and manual navigation inside a cavity X
build cavity surfaces X
view scaled-down multiplanar reconstruction of the series
X
simultaneously (with automatic synchronization)
Merge series with the following options: X
remove bone tissue for DualScan and DualEnergy studies X

8
 Viewer Functionality

Available in
Function edition
Lite Pro
build three-dimensional models based on multiple series of
X
images of the same tissue in different modes
quick transition to full-scale view of three-dimensional
reconstruction, multiplanar reconstruction and virtual X
endoscopy of the model built by merging series
images stitching X
View electrocardiogram X X
Native OS open\save file dialogs X X
Set up the interface and viewer functionality with a possibility
X X
to export and import the settings configuration
Minimize application window to system tray X X
Integrated help system X X
Creating series display templates for various modalities X X
Write data to CD, DVD and flash cards X X
Integration with PACS servers X X
Store data in a local storage X X
Print images on paper or film using a DICOM printer X X
Work as a PACS server, support C-FIND and C-MOVE X X
Save studies to the folder X X
Edit patient name and study description on the Local Storage X X

Anonymizing of studies and series X X

Planning of Pedicle Screws Installation X
PLY format surface import X
Web access X
Images registration X

Additional modules to the Pro edition, purchased separately:

Name Short Description

Vessel Analysis Virtual endoscopy of vessels. Available in 64-bit builds only

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About the Product

Coronary Arteries Virtual endoscopy of coronary arteries. Available in 64-bit

Analysis builds only
Analysis of the study containing the PET series with the ability
PET Analysis to view the MIP of the PET series, CT and PET fusion, CT and
PET series separately, measuring SUV

10
 New Functions in Version 1.14

New Functions in Version 1.14

Available in
Function Description edition
Lite Pro
Lasso mode for Polygon X X
Smooth line selection
Cut tools
Corner tool for 3D X X
Opening all charts from Charts open in the ECG Viewer X X
dcm files window
[WL]Hot Metal, [WL]Flow, [WL]GE X X
Added new CLUTs
color
Automatic start of the disk editor
Improved disk recording X X
when adding a data
Optimized image
X X
displaying
Font size settings for X X
annotations
Setting custom values for anonymized
Extended anonymization X X
tags
High-pass filter for ECG X
Improved adding and
removing layer in 3D and X
MPR
Watershed segmentation X

Extended PET analysis +

module

11
CONTENTS

Contents

Installing, Uninstalling and Launching the Program 20

System Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Installing and Uninstalling the Program . . . . . . . . . . . . . . . . . . . . . . . . . 21
Launching the Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Service files . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Launching the Web Viewer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

1 Program Window Elements 40

1.1 Main Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
1.1.1 File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
1.1.2 Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
1.1.3 Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
1.1.4 View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
1.1.5 Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
1.1.6 Series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
1.1.7 Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
1.1.8 Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
1.2 Windows Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
1.3 Tab Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
1.3.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
1.3.2 Manage a Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
1.4 Tollbar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
1.5 Select Data Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
1.5.1 Select a CD, DVD or Local Folder as the Data Source . . . . . . . . . . 53
1.5.2 Select a PACS Server or Local Storage as the Data Source . . . . . . . 54
1.6 Save Studies to the folder . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
1.7 Search Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
1.8 Select Server Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
1.9 Study Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
1.9.1 Customize Study Panel . . . . . . . . . . . . . . . . . . . . . . . . . . 57
1.9.2 Sort Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
1.9.3 Edit Patient Name and Description in a Study . . . . . . . . . . . . . . 59
1.10 Series Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
1.11 Studies and Series Import/Export Panels . . . . . . . . . . . . . . . . . . . . 61
1.12 Information Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
1.13 Uncompress series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
1.14 Anonymize studies and series . . . . . . . . . . . . . . . . . . . . . . . . . . 64

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 CONTENTS

2 View Flat Images 66

2.1 Open Series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
2.2 Open Series with Current Settings . . . . . . . . . . . . . . . . . . . . . . . . 67
2.3 Working with Several Monitors and Splited Screen . . . . . . . . . . . . . . . 68
2.4 Resampling filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
2.5 View Images in a Series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
2.6 Switch between Series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
2.7 View Several Studies at a Time . . . . . . . . . . . . . . . . . . . . . . . . . 71
2.8 View Multiple Series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
2.8.1 Auto Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
2.8.2 Stacked Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
2.8.3 Grid Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
2.9 View Multiple Images in the Same Series Simultaneously . . . . . . . . . . . . 74
2.10 Play images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
2.11 Zoom. Pan. Rotate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
2.11.1 Zoom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
2.11.2 Pan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
2.11.3 Rotate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
2.12 Set Window Level and Width . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
2.13 Magnifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
2.14 Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
2.14.1 Ruler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
2.14.2 Polygonal Ruler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
2.14.3 Corner meter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
2.14.4 Cobb angle meter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
2.14.5 Measure Intensity at a Point . . . . . . . . . . . . . . . . . . . . . . . 81
2.14.6 Measure the Intensity Average and Standard Deviation in an Area . . . . 82
2.14.7 Drawing Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
2.14.8 Move Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
2.14.9 Move Measurement Results . . . . . . . . . . . . . . . . . . . . . . . . 83
2.14.10Delete all Annotations and Measurements . . . . . . . . . . . . . . . . 83
2.15 Dynamic contrast-enhanced MRI and CT View Mode . . . . . . . . . . . . . . . 84
2.15.1 Map Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
2.15.2 Detection of tumors using ROI . . . . . . . . . . . . . . . . . . . . . . 85
2.16 Visualize Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
2.16.1 Select CLUT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
2.16.2 Edit CLUTs List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
2.16.3 CLUT Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
2.16.4 Create and Edit CLUT . . . . . . . . . . . . . . . . . . . . . . . . . . 98
2.17 SUV Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
2.18 Calcium Scoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
2.18.1 Selection of measurement areas . . . . . . . . . . . . . . . . . . . . . 102
2.18.2 Actions with measurement areas . . . . . . . . . . . . . . . . . . . . . 104
2.18.3 Measurement results . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
2.19 Scout Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
2.19.1 The Tool Context Menu . . . . . . . . . . . . . . . . . . . . . . . . . . 106
2.19.2 Lines Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
2.20 Set Up Viewer Workspace . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
2.21 Export Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
2.21.1 Export to DICOM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
2.21.2 Export to Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
2.22 DSA Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
2.22.1 Single-image subtraction view . . . . . . . . . . . . . . . . . . . . . . 111

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CONTENTS

2.22.2 Series subtraction view . . . . . . . . . . . . . . . . . . . . . . . . . . 112

2.23 Image Information in the Series Window . . . . . . . . . . . . . . . . . . . . . 112
2.23.1 Orientation Cube . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
2.23.2 Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
2.23.3 Image Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
2.23.4 Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
2.24 View DICOM Tags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
2.25 Graphic Label Tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
2.25.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
2.25.2 Create Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
2.25.3 Actions with Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
2.26 Synchronize Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
2.26.1 Synchronize Series in One Study . . . . . . . . . . . . . . . . . . . . . 117
2.26.2 Synchronize Series in Several Studies . . . . . . . . . . . . . . . . . . 117
2.27 Mirror Image Horizontally/Vertically . . . . . . . . . . . . . . . . . . . . . . . 119
2.28 Calibration sizes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
2.29 Additional Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120

3 Volume Reconstruction 121

3.1 View Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
3.2 Actions with the Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
3.3 Model Positioning Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
3.3.1 Model Shift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
3.3.2 Model Rotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
3.3.3 Model Scaling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
3.4 Cutting Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
3.4.1 Polygon Cut . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
3.4.2 Inverse Polygon Cut . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
3.4.3 Delete Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
3.4.4 Delete All Areas except Selected Area . . . . . . . . . . . . . . . . . . 125
3.4.5 Cutting Tools Parameters . . . . . . . . . . . . . . . . . . . . . . . . . 125
3.4.6 Sphere Cut, Sphere Restore and Restore by Mask Tools . . . . . . . . . 125
3.4.7 Tools for intelligent volume editing . . . . . . . . . . . . . . . . . . . . 127
3.4.8 Remove Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
3.5 Centrate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
3.6 Clipping Box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
3.7 Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
3.7.1 Ruler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
3.7.2 Polygonal Ruler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
3.7.3 Corner 3D Meter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
3.8 Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
3.9 Export Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
3.9.1 Export Rotation to Series . . . . . . . . . . . . . . . . . . . . . . . . . 132
3.9.2 Export Rotation to Images . . . . . . . . . . . . . . . . . . . . . . . . 132
3.10 Render settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
3.11 Reconstruction by Series with Varying Distances between Slices . . . . . . . . 133
3.12 Remove Bone Tissue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
3.12.1 Remove Bone Tissue for DualScan and DualEnergy . . . . . . . . . . . 134
3.12.2 Remove Bone Tissue Manually . . . . . . . . . . . . . . . . . . . . . . 134
3.12.3 Remove Bone Tissue for Fused Series . . . . . . . . . . . . . . . . . . 135

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 CONTENTS

4 Series Fusion 136

4.1 Volume Reconstruction of Cardiac Studies . . . . . . . . . . . . . . . . . . . . 136
4.1.1 Create Series Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
4.1.2 Play a Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
4.2 Merge Series from Different Studies . . . . . . . . . . . . . . . . . . . . . . . 138
4.3 Merge layers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
4.3.1 Merge layers automatically . . . . . . . . . . . . . . . . . . . . . . . . 140
4.3.2 Merge layers manually . . . . . . . . . . . . . . . . . . . . . . . . . . 141
4.3.3 Merge layers by control points . . . . . . . . . . . . . . . . . . . . . . 141
4.4 Image registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
4.4.1 Series registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
4.4.2 Phases registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
4.5 Actions with the fused series . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
4.6 Image stitching mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149

5 Multiplanar Reconstruction (MPR) 151

5.1 Open Study in Multiplanar Reconstruction window . . . . . . . . . . . . . . . . 151
5.2 MPR View Elements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
5.3 View Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
5.4 Working with Orthogonal Planes . . . . . . . . . . . . . . . . . . . . . . . . . 153
5.4.1 View Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
5.4.2 Working with Planes in 3D Cursor Mode . . . . . . . . . . . . . . . . . 153
5.4.3 Working with Planes in the Cutting Plane Mode . . . . . . . . . . . . . 154
5.5 Curvilinear Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
5.5.1 Build Surface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
5.5.2 Curve settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
5.5.3 Actions with a Curve . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
5.5.4 Position of a Curve, Its Nodes and Surface in Space . . . . . . . . . . 157
5.6 Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
5.6.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
5.6.2 Add Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
5.6.3 Add Line Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
5.6.4 Poilygonal Marker line . . . . . . . . . . . . . . . . . . . . . . . . . . 159
5.6.5 Actions with Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
5.6.6 Marker Properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
5.6.7 Position of Markers in Space . . . . . . . . . . . . . . . . . . . . . . . 160
5.7 Reconstruction Modes. Slice Thickness . . . . . . . . . . . . . . . . . . . . . 161
5.7.1 Render Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
5.7.2 Slice Thickness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
5.8 Rotate Image in the Section Plane . . . . . . . . . . . . . . . . . . . . . . . . 162
5.9 Mirror Image Horizontally/Vertically . . . . . . . . . . . . . . . . . . . . . . . 163
5.10 Show labels tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
5.11 Export Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
5.12 Reslice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
5.13 Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
5.14 Annotations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
5.15 Volume Reconstruction window . . . . . . . . . . . . . . . . . . . . . . . . . . 166
5.16 Diffusion Tensor Imaging (DTI) Mode . . . . . . . . . . . . . . . . . . . . . . . 166
5.16.1 Open series in DTI Mode . . . . . . . . . . . . . . . . . . . . . . . . . 167
5.16.2 Select Visible Fibers . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
5.16.3 Fibers Color . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
5.16.4 Scalar Maps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170

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CONTENTS

6 Segmentation 171
6.1 The Segmented Structures Panel . . . . . . . . . . . . . . . . . . . . . . . . . 173
6.2 The Mask . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
6.2.1 Creating a mask . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
6.2.2 Mask editing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
6.2.3 Set Mask Tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
6.3 Creating segmented structure . . . . . . . . . . . . . . . . . . . . . . . . . . 178
6.3.1 Creating a structure by copying . . . . . . . . . . . . . . . . . . . . . 178
6.3.2 Manual structure creation . . . . . . . . . . . . . . . . . . . . . . . . . 179
6.4 Structure editing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
6.4.1 Tools for automatic structure filling . . . . . . . . . . . . . . . . . . . . 180
6.4.2 Brush restore tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
6.4.3 Region growing tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
6.4.4 Vessel tree segmentation tool . . . . . . . . . . . . . . . . . . . . . . 183
6.4.5 Watershed segmentation tool . . . . . . . . . . . . . . . . . . . . . . . 183
6.4.6 Multi-segment growing tool . . . . . . . . . . . . . . . . . . . . . . . . 184
6.5 Building surface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
6.6 Union, subtraction and intersection of the structures . . . . . . . . . . . . . . . 186
6.6.1 Union . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
6.6.2 Subtraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
6.6.3 Intersection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
6.7 Actions with the structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
6.8 Export structure and surface . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
6.9 Import surface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
6.10 Histograms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190

7 Planning of Pedicle Screws Installation 191

7.1 Open Study in Planning of Pedicle Screws Installation window . . . . . . . . . 192
7.2 Planning of Pedicle Screws Installation window View Elements . . . . . . . . . 193
7.3 Planning of Pedicle Screws Installation . . . . . . . . . . . . . . . . . . . . . . 194
7.4 Export images for print . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196

8 Vessels analysis module 197

8.1 Open Studies in Vessels Analysis Module . . . . . . . . . . . . . . . . . . . . 197
8.1.1 Vessels list . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
8.2 Centerline building mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
8.2.1 Building the centerline . . . . . . . . . . . . . . . . . . . . . . . . . . 199
8.3 Vessels Analysis Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
8.3.1 Vessel borders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
8.3.2 Section analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
8.3.3 Curved surface analysis . . . . . . . . . . . . . . . . . . . . . . . . . 204
8.3.4 Export vessel surface mesh . . . . . . . . . . . . . . . . . . . . . . . . 206
8.4 Coronary Arteries Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206

9 PET analysis 207

9.1 Open Studies in PET Analysis window . . . . . . . . . . . . . . . . . . . . . . 207
9.2 PET Analysis View Elements . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
9.3 PET Window settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
9.4 Image Positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
9.5 Visualize Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
9.6 Measurements and Annotations . . . . . . . . . . . . . . . . . . . . . . . . . 211
9.7 Measure the Intensity Average and Standard Deviation in an Space . . . . . . . 212
9.7.1 Create sphere . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213

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 CONTENTS

9.7.2 Sphere location in space . . . . . . . . . . . . . . . . . . . . . . . . . 213

9.7.3 Actions with the sphere . . . . . . . . . . . . . . . . . . . . . . . . . . 214
9.7.4 Drawing Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . 214

10 Virtual Endoscopy 215

10.1 Open Studies in Virtual Endoscopy window . . . . . . . . . . . . . . . . . . . 215
10.2 View Elements. Customize MPR Panel . . . . . . . . . . . . . . . . . . . . . . 216
10.2.1 View Elements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216
10.2.2 Customize MPR Navigation Panel . . . . . . . . . . . . . . . . . . . . . 217
10.3 Move Camera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
10.3.1 Move Camera Automatically . . . . . . . . . . . . . . . . . . . . . . . 218
10.3.2 Manage Camera Manually . . . . . . . . . . . . . . . . . . . . . . . . . 219
10.4 Customize Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
10.5 Measurements and Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
10.6 Multiplanar Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
10.7 Surface Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
10.7.1 Create Surface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
10.7.2 Surface Orientation and Navigation . . . . . . . . . . . . . . . . . . . . 221
10.8 Export . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222

11 ECG Viewer 223

11.1 Select Data Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
11.2 Open Series in ECG View window . . . . . . . . . . . . . . . . . . . . . . . . 223
11.3 View Graphs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224
11.4 Toolbar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224
11.4.1 Select Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
11.4.2 ECG Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
11.4.3 Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226
11.4.4 Length Interval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226
11.4.5 Value Interval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226
11.4.6 Move to a Time Point on the Graph . . . . . . . . . . . . . . . . . . . . 227
11.4.7 Set Up Coordinate Plane . . . . . . . . . . . . . . . . . . . . . . . . . 227
11.5 Frequency Filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
11.6 Export series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229

12 Network 230
12.1 Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
12.1.1 DICOM Service (PACS Server functionality) . . . . . . . . . . . . . . . 230
12.1.2 HIS/HTTP Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
12.1.3 Web Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
12.2 Set Up PACS Server Connection . . . . . . . . . . . . . . . . . . . . . . . . . 232
12.2.1 Add PACS Server . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
12.2.2 Check PACS Server Availability . . . . . . . . . . . . . . . . . . . . . 234
12.2.3 Configuring the connection of two application Inobitec DICOM Viewer . . 235
12.3 Network Operation Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236

13 The Local Storage 240

13.1 View Storage Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
13.2 Verify Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
13.3 Clear Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
13.4 Automatic Local Storage cleaning . . . . . . . . . . . . . . . . . . . . . . . . 241

17
CONTENTS

14 Disk Creator 242

14.1 General information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242
14.2 Add Data to Disk Creator . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
14.2.1 Automatically Add Data to a Disk Image . . . . . . . . . . . . . . . . . 243
14.2.2 Manually Add Data to a Disk Image . . . . . . . . . . . . . . . . . . . 244
14.2.3 Adding the Viewer to the Disk Image . . . . . . . . . . . . . . . . . . . 244
14.3 Burn image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
14.3.1 Write to Disk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
14.3.2 Write to Memory Card or Folder . . . . . . . . . . . . . . . . . . . . . 245
14.4 View studies written on disk . . . . . . . . . . . . . . . . . . . . . . . . . . . 246

15 Viewer Settings 247

15.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
15.2 Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
15.2.1 Set Up a Second Monitor . . . . . . . . . . . . . . . . . . . . . . . . . 249
15.2.2 Split Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
15.3 Skins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
15.4 Modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
15.4.1 Set Up Image Viewer Module . . . . . . . . . . . . . . . . . . . . . . . 251
15.4.2 Set Up Study List Module . . . . . . . . . . . . . . . . . . . . . . . . 252
15.4.3 Set Up 3D Reconstruction Module . . . . . . . . . . . . . . . . . . . . 252
15.4.4 Set Up Network Support Module . . . . . . . . . . . . . . . . . . . . . 253
15.4.5 Set Up Local Storage Module . . . . . . . . . . . . . . . . . . . . . . 253
15.4.6 Set Up PET Analysis Module . . . . . . . . . . . . . . . . . . . . . . . 253
15.5 Set Up “Hotkeys” Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
15.6 Import and Export Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
15.6.1 Export Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
15.6.2 Import Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256

16 Print Images 257

16.1 Working with Print List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
16.1.1 Add/Delete Images in View Flat Images and Fusion windows . . . . . . 258
16.1.2 Add Images in Multiplanar Reconstruction, Volume Reconstruction and
Planning of Pedicle Screws Installation windows . . . . . . . . . . . . . 258
16.1.3 Add Series and Clear Print List . . . . . . . . . . . . . . . . . . . . . 259
16.1.4 Add Images from Different Studies . . . . . . . . . . . . . . . . . . . . 259
16.2 Edit print list in Preview window . . . . . . . . . . . . . . . . . . . . . . . . . 260
16.2.1 Preview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260
16.2.2 Set Up Page Templates . . . . . . . . . . . . . . . . . . . . . . . . . . 262
16.2.3 Cells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
16.2.4 Print Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
16.2.5 Reference image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
16.3 Print Images on Film . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
16.3.1 Set Up DICOM Printers . . . . . . . . . . . . . . . . . . . . . . . . . . 265
16.3.2 Set Up DICOM Printing Parameters . . . . . . . . . . . . . . . . . . . 267
16.3.3 Print . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268
16.4 Print Images on Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268

17 Licensing 269
17.1 Trial period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
17.2 The First Launch and Licensing . . . . . . . . . . . . . . . . . . . . . . . . . . 270
17.2.1 Registration on the License Server Using Internet . . . . . . . . . . . . 270
17.2.2 License Proxy Server for automated corporate licensing . . . . . . . . . 271

18
 CONTENTS

17.2.3 Terminal License Server for corporate licensing . . . . . . . . . . . . . 271

17.3 Purchase of a License . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271

18 The Help System and User Assistance 272

18.1 Help System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
18.1.1 Launch the Help System . . . . . . . . . . . . . . . . . . . . . . . . . 272
18.1.2 Help System Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
18.2 Tooltips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273

“Hotkeys” 274

Index 279

Glossary 279

19
Installing, Uninstalling and Launching the Program

Installing, Uninstalling and Launching the

Program

System Requirements
Minimum System Requirements
Operating system:

• WindowsXP x86;

• Mac OS X version 10.8;

• CentOS 6 x86;

• OpenSuse 13.2 x86, or

• Ubuntu version 10.4;

RAM: 2 Gb;
free space on the disk: 300 Mb;
processor: clock frequency of 1,5 GHz;
video card: without hardware acceleration support;
keyboard: standard;
mouse: two-button with a scroll wheel;
display: resolution 1024x768;
network card.

Optimum System Requirements

Operating system:

• Windows7 x64 and greater;

• Mac OS X version 10.8 and greater;

• CentOS 6 x64;

• OpenSuse 13.2 x64, or

• Ubuntu version 10.4 and greater.

20
 Installing and Uninstalling the Program

RAM: 16 Gb (for full-fledged 3D and 4D reconstruction);

free space on the disk: 500 Mb;
processor: clock frequency of 3 GHz (4 or more cores);
video card: GeForce GTX 500, 600 or 700 with embedded memory of 4 Gb (with CUDA
support);
keyboard: standard;
mouse: two-button with a scroll wheel;
display: two displays, resolution HD 1920x1080;
network card.

Installing and Uninstalling the Program

Installing the Program on Windows
To install the program:

1. Run the installator by double-click.

2. Click Next in the window shown in Fig. 1.

Figure 1: Beginning of the installation

3. Read the License Agreement carefully. Its text is also available from the link ino-
bitec.com/eng/downloads/eula.php. If you agree check the item I accept the license
and click Next (Fig. 2). Otherwise click Cancel and in the confirmation dialog box that
appears click Yes.

21
Installing, Uninstalling and Launching the Program

Figure 2: License Agreement

4. Select for whom you want to install the program (Fig. 3). If you select Anyone who uses
this computer (all users) then the program will be installed to system folder and you
need administrative privileges.

22
 Installing and Uninstalling the Program

Figure 3: Select users

5. If necessary change the Installation Folder (Fig. 4). We recommend leaving the default
value. Click Next.

23
Installing, Uninstalling and Launching the Program

Figure 4: Installation Folder

6. If other version of the program is already installed in the selected folder than the installer
will prompt you to first uninstall the other version (Fig. 5).
To unilstall click Yes. Uninstaller will start (see the next Section).After the uninstall the
installation will continue.
To leave the already installed version of the program and select a new folder to install,
click No and in the window shown in Fig. 4 specify another folder.

Figure 5: Confirm uninstallation

7. If you select installation for all users then you need to specify the Common Directory to
store program service information (Fig. 6). If necessary change the path to the Common
Directory. We recommend leaving the default value. Click Next.

24
 Installing and Uninstalling the Program

Figure 6: Path to the Common Directory

8. If necessary change the path to the Local Storage (Fig. 7). We recommend leaving the
default value. Click Next.

25
Installing, Uninstalling and Launching the Program

Figure 7: Path to the Local Storage

9. If necessary change the enable DICOM Service in the windows shown in the Fig. 8 and
specify computer name and port. This functionality is descrided in Section 12.1.1 and can
be configured later. If this functionality has already been configured in this computer then
the window shown in Fig. 8 will contain the values specified earlier. Parameters specified
earlier for a specific user will not be changed, if you install the program for othe user or
for all users. Click Next.

26
 Installing and Uninstalling the Program

Figure 8: DICOM Service

10. If necessary enable License Proxy Server in the window shown in Fig. 9 and specify IP
address and port. This functionality can be configured later. Click Next.

27
Installing, Uninstalling and Launching the Program

Figure 9: License Proxy Server

11. Select required components by checking the corresponding boxes on the Select Compo-
nents window (Fig. 10). To open/close components list click on the arrow on the left of
the components group name (highlighted in red in Fig. 10):

• the Help group:

– Slideshow tips»: Compact movies for tooltips;

– Assistant (English): English integrated help system;
– Assistant (Russian): Russian integrated help system;
– PDF (English): English user manual in PDF format;
– PDF (Russian): Russian user manual in PDF format.

• the Additional languages group contains available languages.

For detailed information about a component select it with the mouse.

28
 Installing and Uninstalling the Program

Figure 10: Select Components Window

12. If necessary change the folder for the program’s shortcuts in the Start menu (Fig. 11).
We recommend leaving the default value. Click Next.

29
Installing, Uninstalling and Launching the Program

Figure 11: Start Menu Shortcuts

13. In the confirmation window click the Install button (Fig. 12).

30
 Installing and Uninstalling the Program

Figure 12: Confirm installation

14. Wait until the installation process is complete (Fig. 13). Click the Finish button.

31
Installing, Uninstalling and Launching the Program

Figure 13: Installation complete

Silent Installation on Windows

Silent installation allows you to speed up and automate the process of installing the program by
submitting the installation parameters to the installer through the file. Such installation can be
launched automatically on domain computers using Microsoft Active Directory.
To prepare the installer for a silent installation:

1. Unpack the installer to a folder using an archiver (for example, 7-zip).

2. Go to the folder where the installer is unpacked.

3. Edit the following parameters in the autoinstall.qs file:

(a) AllUsers = false to install only for current user (by default) or AllUsers = true to
install for all users;
(b) TargetPathName: path to folder to install the Viewer. If AllUsers = true then
the default value is C:\Program Files\InobitecDICOMViewer<Edition><Version>,
if AllUsers = false then default value is
C:\Users\<CurrentUserName>\InobitecDICOMViewer<Edition><Version>.
If necessary, specify another value.
(c) CommonPath: path to the common folder (only if AllUsers = true). The default
value is C:\ProgramData\InobitecDICOMViewer<Edition><Version>. If neces-
sary, specify another value. All users must have write access to the specified folder.
(d) LocalStoragePath: path to the local storage. The default value is
C:\Users\<username>\InobitecDICOMViewerWorkspace.

32
 Installing and Uninstalling the Program

(e) OptionsFilePath: path to the file with settings exported from an already installed
Viewer. For detailes on how to export settings see Section 15.6. The settings file
should be in the current folder. If the file is not specified, the default settings are
used.
(f) ForceInstall = false to remove the previously installed version of the Viewer in the
folder selected for installation.

If national characters are used save the autoinstall.qs file in utf-8 encoding.

To install the Viewer run the silent_install.bat file. Log is written to file
%temp%\install%DATE%.log, where %temp% and %DATE% are Windows system variables.

Uninstalling the Program on Windows

To uninstall the program:

1. Run uninstaller using one of the following methods:

(a) select Inobitec Dicom Viewer -> Uninstall on the Start menu or
(b) use Programs and Features in the Control Panel.

2. Make sure that the item Remove all components is selected in the window shown in
Fig. 14 and click the Next button.

Figure 14: Beginning of the uninstallation

3. In the confirmation window click the Uninstall button (Fig. 15).

33
Installing, Uninstalling and Launching the Program

Figure 15: Confirm uninstallation

4. In the confirmation window click the Finish button (Fig. 16).

34
 Installing and Uninstalling the Program

Figure 16: Uninstallation complete

Silent Uninstallation on Windows

Silent uninstallation allows you to automate the process of installing of the program similar to
silent installation.
To prepare the installer for a silent uninstallation:
1. Unpack the installer to a folder using an archiver (for example, 7-zip).
2. Go to the folder where the installer is unpacked.
3. Change the <Disk:\Full\Path\To\Installed\DICOMViewer\You\Want\To\Uninstall> text
to th path to the folder with the Viewer to uninstall in the silent_uninstall.bat file.
To uninstall the Viewer run the silent_install.bat file. Log is written to the
%temp%\uninstall%DATE%.log, where %temp% and %DATE% are Windows system vari-
ables.

Installing and Uninstalling the Program on Mac OS

To install the program uncompress the dmg file and drag Viewer.app into the Applications
folder.
To uninstall the program remove the Viewer.app from the Applications folder.

Installing and Uninstalling the Program on Linux

To install the program uncompress the archive to the desired location.

35
Installing, Uninstalling and Launching the Program

The program needs libraries, some of which must be installed in the system, the other part
is supplied in the archive. To install the required libraries, run the following commands (for
Ubuntu):

• sudo apt install libqt5opengl5

• sudo apt install libqt5xml5
• sudo apt install libqt5xmlpatterns5
• sudo apt install qt5-image-formats-plugins
• sudo apt install libqt5printsupport5
• sudo apt install libqt5help5
• sudo apt install libqt5webkit5

To uninstall the program remove the folder with the program.

Launching the Program

Launching with Shortcuts
Each installed in Windows version and edition of the Viewer has their own shortcuts on the
Desktop and Start Menu to ensure the convenience of launching.
To launch the program double-click on the desktop shortcut or click on the shortcut from
the Start menu.

Launch from the Command Line

Launching the program from the command line allows you to set specific parameters for the
current session of the program, change the settings and get help information about the command
line options. To launch the Viewer, use the following syntax on the command line:
[<path_to_the_program>]< executable_program> [ --help] | [--study-folder <path> [-
-open-series-images | --open-series-mpr | --open-series-volume | --open-series-endoscopy
[--series-uid <uid> | --series-index <index>]]] | [--pacs-aetitle <aetitle> [--patient-id
<patientID>] [--study-uid <studyUID>] [--series-index <seriesIndex> | --series-uid <se-
riesUID>] [--open-series-images] ] | [--aet <aet>]
| [--import-settings <path> [--use-imported-listener-aetitle | --aet <aet>] [--update-scu-
aetitle]] | [--export-settings <path>]

--help: display the help information about the command line options, exit the program.
--study-folder <path>: display the study (studies) contained in the specified folder. If
there are several studies, then the following options are applied to the first study in the
list:
--open-series-images: display the first series in the flat image view window
--open-series-mpr: display the first series in the multiplanar reconstruction window
--open-series-volume: display the first series in the volume reconstruction window
--open-series-endoscopyPRO : display the first series in the virtual endoscopy win-
dow

36
 Launching the Program

Any of these parameters can be used with the following parameters:

--series-uid <seriesUID>: show the series with the specified seriesUID
--series-index <seriesIndex>: show the series with the specified seriesIndex

--pacs-aetitle <aetitle>: attempt to open study list from PACSServer which AETitle
matches the specified aetitle. The following options can be used with whis option in
different combinations:

--patient-id <patientID>: show the study with the specified patientID. Parameter
has higher priority than --study-uid
--study-uid <studyUID>: show the series with the specified studyUID
--series-uid <seriesUID>: select the series with the specified seriesUID. If several
studies are found, the first one in the list is used
--series-index <seriesIndex>: select the series with the specified seriesIndex. If
several studies are found, the first one in the list is used
--open-series-images: display the selected series in the flat image view window. If
series is not selected, the first one of the first study is used

Example: C:\Users\user\DICOMViewerPro1.9.1\viewer.exe --study-folder D:\dicom_data

--open-series-images --series-index 1 shows series with seriesIndex 1 of the first study from
the D:\dicom_data folder in the Flat images view window.
If the option is wrong then the help information about the command line options is displayed
and program exits. If the option value is wrong (e.g. there are not DICOM data in the specified
folder, there are not series with the specified seriesUID or seriesIndex), then this and all
subsequent options are ignored.
Attention! If some AETitles of several PACSServers match than data will be searched
on the first PACSServer in the list. PACSServers are sorted by the Server nickname
field. For detailes on how to set up connection to PACSServer see Section 12.2.
The next options are used to change the settings. After executing any of these commands
the program exits. In case of a successful execution the word Done appears on the command
line.

--aet <aetitle>: parameter AETitle for DICOM Listener is set to <aetitle>

--import-settings <file>: imports settings from <file> except parameter AETitle for
DICOM Listener

--use-imported-listener-aetitle: parameter AETitle for DICOM Listener is set to

value from <file>
if the option --aet <aetitle> is used at the same time then AETitle for DICOM
Listener is set to <aetitle>
--update-scu-aetitle: Client name (SCU) for PACS Servers is set to AETitle for
DICOM Listener specified in <file>
if the option --aet <aetitle> is used at the same time then Client name (SCU)
for PACS Servers is set to <aetitle>

--export-settings <file>: exports settings to <file>.

37
Installing, Uninstalling and Launching the Program

Launch multiple instances of the program

If one instance of editions Pro or Lite is already launched then other instances of editions Pro
or Lite exit and activate the first instance. If other instance is launched from the command line
then command line options are sent to the first instance.
Note that sometimes program can not exit immediately when the main window closes (e.g.
if data is transferring over the network, if the information is writting to disk or flash card). In
this case if you try to launch the program, main window of the launched instance does not open
and you should wait until the launched instance exits and then launch the program again.

Service files
Service files are located in the next folders, depending on the operating system:

C:\Users\<Username>\AppData\Local\Inobitec\<program
Windows
name>
Linux ˜/.local/share/Inobitec/<program name>
Mac OS ˜/Library/Application Support/Inobitec/<program name>

The following files are service ones:

• log files (are located in the subfolder Logs);
• memory dumps, written if the program crashed (are located in the subfolder Dumps).
Only for Windows;
• configuration files (are located in the subfolder Configs);
• 3D image renderer files (are located in the subfolder OpenCL).
E.g. Smith user‘s log files for Inobitec DICOM Viewer Pro version 1.9.1 installed in Windows
are located in C:\Users\Smith\AppData\Local\Inobitec\Inobitec DICOM Viewer Professional
Edition 1.9.1\Logs folder.
Path to log files can be changed (see Section 15.1).

Launching the Web Viewer

Functionality is available in the Pro edition

To use the Web Viewer you should to enable web access (see Section 12.1.3).
To open the Web Viewer:
1. Open the any Web browser.
2. Enter the link to access to the Web Viewer to the address bar. You can see this link on the
services settings dialog (see Section 12.1.3). The link looks like http://youraddress:port,
replace youraddress with the ip address or computer name, on which the Viewer is
installed, and replace port with the web access port specified in the Services dialog.

38
 Launching the Web Viewer

3. Go to the entered link.

4. Enter the user name and user password specified on the services settings dialog.

39
CHAPTER 1. PROGRAM WINDOW ELEMENTS

Chapter 1

Program Window Elements

The main application window looks as follows (Fig. 1.1).

Figure 1.1: Main application window

The Viewer window consists of several elements.

1.1 Main Menu

The Main menu is shown in Fig. 1.2 (highlighted in red) and Fig. 1.3.

40
 1.1. MAIN MENU

Figure 1.2: Location of the main menu in the Viewer window

Figure 1.3: Main menu

The main menu includes several items.

1.1.1 File

Figure 1.4: File menu item

The File menu item contains the following sub-items:

• Study list opens a new tab in the program window;

• Preview opens the image preview tab for printing on paper;
• DICOM preview opens the image preview tab for DICOM printing;
• Print opens the system dialog for printing on paper;
• Page layout opens the settings for printing on paper;
• Exit shuts down the program.

41
CHAPTER 1. PROGRAM WINDOW ELEMENTS

1.1.2 Network

Figure 1.5: Network main menu item

The Network main menu item contains the following sub-items:

• Network status;

• Servers;

• Services;

• DICOM printer setup.

For details on how to work with the network, see Chapter 12.
The DICOM printer settings are described in Chapter 16.

1.1.3 Storage

Figure 1.6: Storage main menu item

The Storage main menu item contains the following sub-items:

• Storage status;

• Check storage;

• Clear storage.

For details on how to work with the storage, see Chapter 13.

42
 1.1. MAIN MENU

1.1.4 View

Figure 1.7: View main menu item

The View main menu item contains the following sub-items:

• Image viewer;

• Volume reconstruction;

• MPR reconstruction;

• Planning of screws installation;

• Virtual endoscopyPRO ;

• Series fusionPRO ;

• PET AnalysisADD ;

• Open pdf document;

• ECG viewer.

If a sub-item name is displayed in grey, it means that the command is unavailable for the
selected study. If all sub-item names are displayed in grey, it means that no study has been
selected from the study panel. Section 1.5 describes how to select studies. Three display
modes are available for each sub-item (Fig. 1.8):

43
CHAPTER 1. PROGRAM WINDOW ELEMENTS

Figure 1.8: View main menu item: options for displaying a tab on the
screen

• Display at monitor 1 opens images in a new tab;

• Display as a window opens images in a separate window;

• Show fullscreen opens images in the full screen mode. To exit the full screen mode,
press Esc or F11 on the keyboard.

If the Viewer is set up for working with two displays and/or if the screen is splited, there
are up to four options for displaying a tab (Fig. 1.1.4). The monitor settings are described in
Section 15.2.

Figure 1.9: Image viewer main menu item: displaying a tab on the screen
with four available options

44
 1.1. MAIN MENU

1.1.5 Studies

Figure 1.10: Studies main menu item

The Studies main menu item contains the following sub-items:

• Open DICOM CD/DVD;

• Scan DICOM folder;

• Search;

• Download selected studies to the local file storage;

• Upload selected studies to the remote server;

• Add selected studies to the Local Storage;

• Remove selected studies from the Local Storage;

• Add the selected studies to the DICOM CD/DVD disk creator;

• Save studies list to the folder;

• Create anonymized copies of the selected studies (see Section 1.14);

• Export study list to CSV (see Section:Study Panel);

• Edit patient name (see Section 1.9.3);

• Edit description (see Section 1.9.3).

For details on how to select data source, see Section 1.5. Sub-items Server search and
Local storage search are available for sub-item Search.
For details on how to work with studies, see Section 1.11.

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CHAPTER 1. PROGRAM WINDOW ELEMENTS

1.1.6 Series

Figure 1.11: Series main menu item

The Series main menu item contains the following sub-items:

• Download selected series to the local file storage;
• Upload selected series to the remote server;
• Add selected series to the Local Storage;
• Remove selected series from the Local Storage;
• Add the selected series to the DICOM CD/DVD disk creator;
• Create uncompressed copy of series (see Section 1.13);
• Create anonymized copy of series (see section 1.14);
• Sort.
Sub-items Sort by description and Sort by time are available for sub-item Sort.
For details on how to work with series, see Section 1.11.

1.1.7 Options

Figure 1.12: Settings main menu item

The Settings main menu item contains the following sub-items:

• Parameters;

46
 1.2. WINDOWS MANAGEMENT

• Export settings;
• Import settings.
The Viewer settings are described in Chapter 15.

1.1.8 Help

Figure 1.13: Help menu item

The Help menu item contains the following sub-items:

• Contents... opens the Help System;
• License... opens a window to enter the license key;
• License from file... opens a window to load a trial version activation key file;
• About... displays a window with the information about the Viewer.
The Help System is described in Chapter 18.

1.2 Windows Management

To the Viewer does not shut down but closed to the system tray, when you close it, check the
box Show system tray icon (see Section 15.1). To restore the main window from the tray,
double-click on the tray icon in the system tray or right-click on the tray icon and select the
Restore item. To shut down the application right-click on the tray icon and select the Exit item
(Fig. 1.14).
To the Viewer minimize to the system tray, check the box Minimize to tray.

Figure 1.14: System tray icon

When you shut down the Viewer, in the dialog box that appears, Click OK to shut down the
Viewer, or Cancel to continue to work with the program. If you want the Viewer to always shut
down without this confirmation, check the box Don‘t show this dialog again and click OK.
If you want the Viewer to show the confirmation dialog, check the box Confirm on exit (see
Section 15.1).

47
CHAPTER 1. PROGRAM WINDOW ELEMENTS

1.3 Tab Panel

1.3.1 General
A tab is a window fixed in the main program window. You can switch from tab to tab using
buttons on the tab panel. The tab panel is highlighted in red in Fig. 1.15.

Figure 1.15: Tab panel location in the Viewer window

Each tab, opened in the Viewer window, corresponds to a button on the panel. To switch to
a particular tab, click the corresponding button (Fig. 1.16). The file path or other information
about the tab content is displayed on the tab button.

Figure 1.16: Multiple tabs. The Image viewer tab is active

1.3.2 Manage a Tab

To manage a tab, use the buttons in its top right part (highlighted in red in Fig. 1.17).

Figure 1.17: Tab management buttons

Tab management buttons:

The Full screen button displays the tab in the full screen mode. The tab
management buttons are unavailable. To exit, press Esc or F11.

The Separate window button displays the tab in a separate window.

The Close window button closes the tab.

To switch to the full screen mode, you may as well press F11, and to go back, you can use

48
 1.3. TAB PANEL

F11 or Esc. If the tab is displayed in a separate window, the Viewer workspace looks as shown
in Fig. 1.18.

Figure 1.18: A tab opened in a separate window

The window management buttons are located in the top right-hand corner of the window
(highlighted in red in Fig. 1.18). Window management buttons:

The Fix window button embeds the window as a tab in the main Viewer window.
The Full screen button displays the window in the full screen mode. The window
management buttons are unavailable. To exit the full screen mode, press Esc or F11.
The Minimize window button reduces the window to an icon located at the bottom of
the screen (highlighted in red in Fig. 1.19). The window title is written on the icon.
The Expand button expands the window to the full screen. Unlike the full screen
mode, the window management buttons will be available.

The Close button closes the window.

The Restore down button restores the initial window size.

49
CHAPTER 1. PROGRAM WINDOW ELEMENTS

Figure 1.19: Window reduced to an icon

To unfold a window from an icon, double-click the left mouse button on the icon.

1.4 Tollbar
The Toolbar is shown in Fig. 1.20 (highlighted in red) and Fig. 1.21.

Figure 1.20: Toolbar location in the Viewer window

50
 1.4. TOLLBAR

Figure 1.21: Toolbar

Data source selection buttons on the toolbar:

The Open DICOM CD/DVD button sets a CD or DVD as the source of DICOM
data and opens the folder selection dialog.

The Scan a folder for DICOM data button sets a local computer folder as the
DICOM data source and opens the folder selection dialog.

The Search data on the remote PACS Server button sets a PACS server as the
DICOM data source and opens the search panel.

The Search data in the Local Storage button sets a local storage as the DICOM
data source and opens the search panel.

For details on how to work with the search panel, see Section 1.7.
The button corresponding to the selected data source is displayed on a light background.
Image view buttons on the toolbar:

The Image viewer button opens images in the flat image view window.

The Volume Reconstruction button opens images in the volume reconstruction

window.

The Multiplanar Reconstruction button opens images in the multiplanar

reconstruction window.

The Screws installation button opens images in the Pedicle Screws Installation
windowPRO .

The Vessels Analysis opens images in the Vessels Analysis windowADD .

The Coronary Arteries Analysis opens images in the Coronary Arteries Analysis
windowADD .

The Virtual Endoscopy button opens images in the virtual endoscopy windowPRO .

The Series fusion button opens images in the series fusion windowPRO .

51
CHAPTER 1. PROGRAM WINDOW ELEMENTS

The PET Analysis button opens images in the PET Analysis windowADD .

The Open pdf document button opens the pdf document contained in the study
in the default pdf viewer.

The ECG Viewer button opens images in the ECG view window.

If the action corresponding to a button is not available, the button is displayed in black and
white and cannot be pressed (inactive).
All buttons in this group consist of two parts (Fig. 1.22).

Figure 1.22: Button with location options

If you click on the arrow (right side of the button highlighted in green), a menu with options
for displaying the information on the screen will pop up (Fig. 1.23):
• display at monitor1 opens images in a new tab;
• display as a window opens images in a separate window;
• full screen opens images in the full screen mode.
To open an image in a new tab, click on the left side of the button (highlighted in red).

Figure 1.23: Display options

The DICOM CD/DVD Creator button opens the creator for disks containing
DICOM data. The disk write is described in Chapter 14.
The Advanced search button opens the advanced search panel at the top of
the tab. To hide the panel, click the button again. If the search panel is open,
the search button will be displayed against a light background. For details on
how to work with the search panel, see the next section.
The Save studies list to the folder button allows you to save the selected
studies to the specified folder. This function is available as well from the
study context menu. For details on how to save studies see Section 1.6
52
 1.5. SELECT DATA SOURCE

1.5 Select Data Source

If the DICOM data contains text in national coding that does not match the coding of the main
data than a meaningless sequence of characters in the names of studies, series, etc may be
displayed. In this case, to display the text correctly you must to select the target encoding in
the settings (see Section 15.1). By default, the encoding of the data source is set. It is one
that is specified in the DICOM files.

1.5.1 Select a CD, DVD or Local Folder as the Data Source

To open studies stored on a CD, DVD or in a local folder:

1. Select a CD or DVD as the data source by clicking the button on the toolbar, or a
local folder by clicking on the button. This commands are available as well from the
Image main menu item.

2. In the window that appears, select the folder containing the images, and click Select. To
cancel the action, click Cancel.

The studies stored at the selected location will be displayed on the study panel.
Attention! If you switch to a different data source and then return to the current
one, the study list will be cleared.

53
CHAPTER 1. PROGRAM WINDOW ELEMENTS

1.5.2 Select a PACS Server or Local Storage as the Data Source

To open studies stored on a PACS server or in a local storage:
1. Select the PACS server as the data source by clicking the Search data at remote PACS
server button on the toolbar, or the local storage by clicking Search data in the
local storage . This commands are available as well from the Study context menu.
2. Search for data using the search panel that opens. For details on how to work with
the search panel, see Section 1.7. The studies that satisfy the search condition will be
displayed on the study panel. The series panel will display the series of the first retrieved
study.
Attention! If you switch to a different data source and then return to the current one,
the study list will be cleared.
To automatically open a Local Storage when you start Viewer, check this option (Sec-
tion 15.4.2) and set up a default search period.
If you open study from the PACS server, it will be downloaded to the Local Storage. When
you close this study the message like 1 series have been downloaded automatically from
server. Would you like to keep them on your local storage? will be displayed. To keep the
study in the Local Storage, click Yes, to remove, click No. If you want to always perform the
selected action, check the box Remember my choice and do not show this dialog again.
For details on how to change your choice, see Section 15.4.2.
For the study, added to the Local Storage at least partially, import date is displayed on the
Study Panel.

1.6 Save Studies to the folder

The Viewer allows you to save one or more studies from the Local Storage, from a local folder,
from a Compact Disk of from a PACS Server to a folder.
Attention! Saving studies from a PACS server in c-move mode is not possible. To do
it connect to PACS Server using c-get mode or first download the studies to the Local
Storage and save them to a folder from the Local Storage. When you try to save studies
from the server in c-move, the error «Unsupported server mode» appears.
If it is impossible to save data from the PACS server, you must first download it to
the Local Storage, connecting to the PACS Server using c-move mode, and then saving
it to the folder from the Local Storage. If it is impossible to save separate series this
does not affect the saving of other series and other studies.
PACS Server connection settings are described in Section 12.2.
If you compress data then the studies are saved to a zip file.
To save studies:
1. Select data source (Local Storage, Local Folder, Compact Disk, PACS Server to which
the Viewer is connected in c-get mode (For details on how to select data source see
Section 1.5)), load studies.
2. Select one or more studies on the Study Panel. For details on how to work with the Study
Panel see Section 1.9.
3. Click the Save studies to the folder button.
4. In the dialog that open set up the following parameters:
• Path to save: path to the folder to save studies;

54
 1.7. SEARCH PANEL

• Folder name (File name): if only one study is selected for saving, this parameter
is editable. Otherwise the Viewer generates folder name (archive file name) and
the Folder name (File name) field is empty. If an archive file with the same name
already exists, the Viewer offers to overwrite it;
• the Compress files check box: if set, the saved data is compressed into a zip
archive;
• if several studies are selected then the Save each study into separate folder (file)
check box appears. It allows to save each study into separate folder (archive file);
• the Anonymize check box allows to anonymize saving data. For details see Sec-
tion 1.14.

5. Click the OK button to save or Cancel to cancel.

The data saved into the folder is supplied for later recording onto a Compact Disk using the
operating system. The Compact Disk opens in the same way as if it were recorded using the
Viewer (without adding the Viewer to the disk image).

1.7 Search Panel

The search panel is shown in Fig. 1.24.
To open or close the panel, click the button on the toolbar.

Figure 1.24: Search panel

The search can be performed by the following parameters:

• patient name (you can enter part of the name, the search can be performed by partial
match);

• patient sex (select from the list);

• patient ID (similar to search by name);

• date of birth (enter the year: YYYY-**-**, year and month: YYYY-MM-**, or the full
date);

• modality;

• body part;

• study date. You can search by exact date, date interval, or select a period from the list.
The study date is entered in the same format as the birth date;

• import date is similar to search by a study date.

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CHAPTER 1. PROGRAM WINDOW ELEMENTS

After filling in the required fields, click the Search button. If the button is inactive, it means
that the selected data source is not available. To clear the search criteria, click Clear filter.
Search for studies on the PACS server for the all time may take a long time and increase
the server load. Therefor, when you click Search button the warning dialog Search for all
time. It may take some time. Would you like to continue? will be displayed. To perform a
search, click Yes, to cancel, click No.

1.8 Select Server Panel

The server selection panel is shown in Fig. 1.25 (highlighted in red).

Figure 1.25: Server selection panel in the Viewer window

The server selection panel specifies the server to search for the data on.

1.9 Study Panel

The study panel is shown in Fig. 1.26 (highlighted in red).

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 1.9. STUDY PANEL

Figure 1.26: Study panel in the Viewer window

The study panel displays the list of studies stored at the selected location (folder, disk, local
storage or PACS server).
To select multiple studies that are contiguous (next to each other):

1. click on one study and then holding Shift click the last study or

2. move the cursor from one study to the last study holding the left mouse button.

To select multiple studies that are anywhere in the study list, click on the each one holding
the Ctrl button.
To save the list of studies displayed in the Study Panel to a CSV file:

1. select the Studies menu and Export studies list to CSV item;

2. in the dialog that opens check columns from which you want to export data and click OK
to confirm or Cancel to cancel;

3. in the dialog that opens choose folder and file name. Click Save to save data or Cancel
to cancel.

1.9.1 Customize Study Panel

The Viewer allows you to customize columns and the font for the list of studies.
To select columns, right-click on the table header, a menu with a list of columns will be
displayed (Fig. 1.27). The displayed columns are marked with check marks. To check/uncheck
a column, left-click on its name in the context menu.

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CHAPTER 1. PROGRAM WINDOW ELEMENTS

Figure 1.27: Context menu

Set up size, family and font style to bold and/or italic (see Section 15.4.2).

1.9.2 Sort Studies

If two or more studies are displayed, they can be sorted by a certain parameter. To do this,
click on the header of the column the parameter is located in. For instance, to sort by date and
time, click on the area highlighted in red in Fig. 1.28.

Figure 1.28: Date and time column header

Next to the column name there is an arrow showing the sorting order (down arrow —
descending , up arrow — ascending ). To change the sorting order, click on the
column header again. Studies can be sorted only by one parameter at a time. The default
sorting order is ascending.

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 1.9. STUDY PANEL

1.9.3 Edit Patient Name and Description in a Study

If a study is loaded to the local storage, the displayed patient name and description for this
study can be edited. The data itself will remain unchanged, and this information will not be
saved on the PACS server. By default editing is disabled. To enable it, check the box Allow
to edit patient name and discription (Section 15.4.2).
To edit the patient name or study description:

1. Right-click on the study at the study panel. The context menu shown in Fig. 1.29 will pop
up.

2. Select one of the menu items Edit Patient Name abd Edit Description. The correspond-
ing field will become available for editing, and the cursor will be located in it.

3. Edit the text.

4. Press Enter or click the mouse in the Viewer window, in any area except the edited text,
to apply the changes.

This commands are available as well from the Study context menu.
Commands from the context menu (Fig. 1.30) are available during editing. To open the
context menu, right-click on the edited text.

Figure 1.29: Study context menu

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CHAPTER 1. PROGRAM WINDOW ELEMENTS

Figure 1.30: Context menu to select the editing action

The following commands are available:

• Undo: undo the changes;

• Redo: redo the last canceled action;

• Cut: delete the selected text and copy it to the exchange buffer;

• Copy: copy the selected text to the exchange buffer;

• Paste: paste the text from the exchange buffer;

• Delete: delete the selected text;

• Select all: select all edited text.

If a command is unavailable, it is displayed in grey in the menu.

1.10 Series Panel

The panel is shown in Fig. 1.31 (highlighted in red). Select the study from the study panel to
see the list of series for it. The first series is highlighted automatically.

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 1.11. STUDIES AND SERIES IMPORT/EXPORT PANELS

Figure 1.31: Series panel in the Viewer window

Selecting of the series is analogous to the studies selecting (see Section 1.9). But if you
want to select multiple series by moving the mouse, start moving when cursor is not on the
series thumbnail.

1.11 Studies and Series Import/Export Panels

The panels are shown in Fig. 1.32 (Studies Import/Export Panel highlighted in green, Series
Import/Export Panel highlighted in red) and Fig. 1.33. These panels are identical except that
the first is designed to work with studies, and the second with series.

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CHAPTER 1. PROGRAM WINDOW ELEMENTS

Figure 1.32: Studies and Series import/export panels in the Viewer

window

Figure 1.33: Import/export panel (the buttons are inactive)

Series import/export panel buttons:

The Download selected series to local file storage button imports the
selected series to the local storage.

The Upload selected series to the remote server button exports the selected
series to the remote PACS server.

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 1.12. INFORMATION PANEL

The Add selected series to the Local Storage button adds the selected
series to the local storage.

The Remove the selected series from the Local Storage button deletes the
selected series from the local storage.
The Add the selected series to the DICOM CD/DVD disc creator button
adds the selected series to the CD/DVD Creator. For details on how to work
with the creator, see Chapter 14.

If the action corresponding to a button cannot be performed, the button will be inactive and
displayed in black and white.
Work with the Studies Import/Export Panel is completely analogous to the Series Im-
port/Export Panel.
These actions are available as well from the context menu and Studies menu item for studies
and from the Series menu item for series. To open it from the context menu, click the right
mouse button on the study.

1.12 Information Panel

The panel is displayed in Fig. 1.34 (highlighted in red) and Fig. 1.35. Its left part displays the
status of the last operation performed. The right part displays the progress bar for the current
action and data transfer/reception indication when working with the PACS server. Fig. 1.35
illustrates data reception from the server.

Figure 1.34: Information panel in the Viewer window

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CHAPTER 1. PROGRAM WINDOW ELEMENTS

Figure 1.35: Information panel. Receiving data from the server

1.13 Uncompress series

The following functionality allows to uncompress data and save it. This makes it possible to
solve the problems with viewing and uploading compressed data on some remote servers.
Uncompressing is possible only for studies in the Local Storage.
To uncompress data:

1. Open study containing compressed data;

2. Select the series that you want to uncompress. For details on how to work with series,
see Section 1.10.
3. Select the Series menu and Uncompress series item. Selected series will be uncom-
pressed and saved to the Local Storage with the mark uncompressed.

1.14 Anonymize studies and series

The following functionality allows to delete of replace the data stored in the following tags:
• PatientName;
• PatientID (patient identificator);
• PatientBirthDate;
• PatientSex;
• InstitutionName (institution where the equipment that produced the composite instances
is located);
• InstitutionAddress (mailing address of the institution where the equipment that produced
the composite instances is located);
• OperatorsName (name(s) of the operator(s) supporting the Series.);
• PerformingPhysicianName (name of the physician(s) administering the Series);
• ReferringPhysicianName (name of the patient’s referring physician).
By default, the date of birth is deleted, the sex is set to undefined and the values of the
other tags are changed to «Anonymous».
Anonymization is possible only for studies in the Local Storage and opened from a folder or
from a CD. To anonymize the study:

1. Select one or more studies in the Local Storage.

2. Select the Studies menu and Create anonymized copies of the selected studies.

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 1.14. ANONYMIZE STUDIES AND SERIES

3. If necessary, change the values that are assigned to tags after anonymization. To restore
default values click the Defaults button.
4. To Anonymize click OK, to cancel click Cancel.

The selected studies will be anonymized and saved to the Local Storage with the patient
name Anonymous.
To anonymize the selected series:

1. Select study in the Local Storage.

2. Select the series that you want to anonymize. For details on how to work with series, see
Section 1.10.
3. Select the Series menu and Create anonymized copy of series.
4. If necessary, change the values that are assigned to tags after anonymization. To restore
default values click the Defaults button.
5. To Anonymize click OK, to cancel click Cancel.

Selected series will be anonymized and saved to the Local Storage with the anonymized
mark.

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CHAPTER 2. VIEW FLAT IMAGES

Chapter 2

View Flat Images

2.1 Open Series

Select a study from the study panel. There are five ways to open a series:

• Click the Image viewer button on the toolbar.

• Double-click the left mouse button on the study title on the toolbar.

• Double-click the left mouse button on the series icon at the series panel.

• Drag the series icon to the study panel holding the left mouse button.

• Right-click the mouse to call the context menu for the series icon, and select one of the
options in the Image viewer item.

The series will open in a new tab.

The series panel will be displayed on the left. To hide/show it select the main menu Image
and the Quick series list item or move the cursor to the panel border so that it would look
like this: and drag the border holding the left mouse button. The series panel is shown in
Fig. 2.1.

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 2.2. OPEN SERIES WITH CURRENT SETTINGS

Figure 2.1: Series panel

The Viewer allows you to open multiple series at a time, or the same series multiple times.
All series are opened in separate windows of the same tab, and their position will depend on
the settings described in Section 2.8.
To open the selected series in Volume Reconstruction or Multiplanar Reconstruction window
click the Volume Reconstruction or MPR Reconstruction button on the toolbar,
respectively.

2.2 Open Series with Current Settings

The Viewer allows you to open series of the opened study with window level and width set for
the previously opened series. To do this:

1. Open any series and set the window level and width.

2. Select the study view windows by clicking the left mouse button the windows header
(marked by the arrow in Fig. 2.2). The windows will be highlighted by a red frame.

3. Open other series of this study. The series will be opened with the parameters of windows
level and width specified earlier.

4. Repeat Steps 2 and 3 if necessary. The settings for the first open series will be used.

5. Change window level and width for the first opened series if necessary.

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CHAPTER 2. VIEW FLAT IMAGES

Figure 2.2: The window header is marked by the arrow

2.3 Working with Several Monitors and Splited Screen

The Viewer allows you to split the screen into two parts, or work with two monitors connected
to the same computer. For details on how to set up your monitor, see Section 15.2.
Let us assume that both displays are used, and each one is splited (Fig. 2.3). In this case,
the Viewer will be running in four autonomous windows. To close the Viewer, just close any of
its windows.

Figure 2.3: Viewer with two splited screens. The right display is the main
one

In the illustration above, the right monitor is the main one, so the Study list tab is open in
its left window. To open this tab in any of the three remaining windows, select the File menu
and Study list item in this window. The series panel on the right side displays the windows
panel (Fig. 2.4).

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 2.3. WORKING WITH SEVERAL MONITORS AND SPLITED SCREEN

Figure 2.4: Windows panel

Each window has a display icon corresponding to it.

• the first icon corresponds to the left window of the main display;

• the second icon corresponds to the right window of the main display;

• the third icon corresponds to the left window of the additional display;

• the fourth icon corresponds to the right window of the additional display.

The OS settings determine which display is the main one. The icon corresponding to the
current window is displayed against a light background. In Fig. 2.5, the Study list tab is open
in each window, and you can see the correspondence between the windows and display icons.
The right display is the main one.

Figure 2.5: Correspondence between open windows and display icons on

series panels

To open a series in a certain window:

1. Load studies in any tab.

2. Select the study from the study panel.

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CHAPTER 2. VIEW FLAT IMAGES

3. Hold the left mouse button and drag the series icon from the series panel to the display
icon corresponding to the window to open the series in.

4. Release the left mouse button. The series will open in the window corresponding to the
display icon.

If the cursor is not located on the display icon, it will look as follows: . This means that
dragging is impossible. As soon as the cursor is over the display icon, it changes to , and
you can drag the icon.

2.4 Resampling filter

To change the Resampling filter open the Image main menu, select the Resampling filter menu
item and in the submenu that opens select a filter. The active filter is marked with a flag
(Fig. 2.6)

Figure 2.6: The Resampling Filter menu

The following filters are available:

• Bilinear;

• B-spline;

• Mitchel;

• Catmull-Rom;

• Lanczos3;

• Lanczos5;

• Lanczos7.

By default the Bilinear filter is active.

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 2.5. VIEW IMAGES IN A SERIES

2.5 View Images in a Series

When a series is opened, its first image is displayed in the series window. There are five ways
to switch to other images:
• Roll the mouse wheel up to switch to the previous image, or down to go to the next one.
One click of the wheel changes the position to one image.
• Use the scrollbar on the right side of the series window to move to the target image. To
change the position by one image, click the left mouse button on the arrow or bar above
or below the scroll.
• Click the left mouse button in the series window. If the current image is the last in the
series, a click will switch you to the first image. Similarly, click the left mouse button
holding the Ctrl key to move to the previous image.
• Use the arrow buttons on the toolbar: , .
• Use the context menu: right-click the mouse on the image, and select Next image or
Previous image.

2.6 Switch between Series

There are two ways to switch between series in the series window:
• Use the arrow buttons on the toolbar: , .
• Use the context menu: right-click on the image and select Next series or Previous
series.

2.7 View Several Studies at a Time

To open several studies simultaneously:
1. Open the study by opening any of its series.
2. Switch to the tab containing the study list.
3. Select another study and drag one of its series to the tab with the opened study (high-
lighted in red in Fig. 2.7).

Figure 2.7: Study view tab button

Series are opened in the same tab, but in different study view windows.

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CHAPTER 2. VIEW FLAT IMAGES

The series panel is displayed on the left, and the series are grouped by study (Fig. 2.8).
The arrows point to series panel stubs. Series panel at the top of the picture is expanded,
and the bottom series panel is folded. To unfold it, just click the left mouse button on the
header (marked by the arrow below). Only one series panel may be unfolded at a time, the rest
will be folded.

Figure 2.8: Series panel for several studies. Study titles are marked by
arrows. The top study is unfolded, and the bottom study is folded

2.8 View Multiple Series

There are several modes for positioning series windows in the study window. The selected
mode is saved when the Viewer is closed.

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 2.8. VIEW MULTIPLE SERIES

2.8.1 Auto Mode

This mode is active by default. If two or more series are open, they will be located in the
window and scaled automatically, occupying the entire window. Three series are displayed in
Fig. 2.9.

Figure 2.9: Automatic displaying of series

To activate this mode, click the button or select the Automatic series arrangement
item from the image context menu.

2.8.2 Stacked Mode

This mode allows you to open only one series in the study window. If you try to open another
series, the current series will be closed. In this case, the Viewer will request confirmation for
closing the current series.
To activate this mode, click the button or select the Stacked series arrangement
item from the image context menu.

2.8.3 Grid Mode

In this mode the study window is splited into parts, and a series window can be opened in each
of them.
If all cells in the grid are filled, you cannot open another series by double-clicking on the
series icon. The Viewer will suggest closing any of the open series. If a series is opened by
dragging the icon to the view window, the program will request confirmation for closing the
current series already opened in this window.
A grid may have from 1 to 100 cells. The maximum number of rows and columns is 10.
Fig. 2.10 illustrates a 2*4 grid with three cells filled.

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CHAPTER 2. VIEW FLAT IMAGES

Figure 2.10: Displaying series in a 2*4 grid

To set up a 1x2, 2x2 or 2x3 grid, use the buttons on the toolbar. These grid
configuration types are available from the image context menu.
To define your own grid configuration, click the button or select the Custom series
arrangement item from the image context menu, and set up the required parameters. This
configuration can be set by default (see Section 15.4.1).
When positioning series on the grid, viewer allows you to move the boundary between cells.
To do this, move the cursor to the panel border so that it would look like or , and drag
the border holding the left mouse button. Setting priority of horizontal or vertical separator is
described in Section 15.4.1.

2.9 View Multiple Images in the Same Series Simultaneously

To select the mode for viewing images of the same study, right-click on the image context menu
to open it, select the Image arrangement... item, and then select one of the displaying modes.
In general, they are similar to the modes for displaying series.
Image displaying modes:
• Stacked. Set by default. A single image is displayed in the window.
• 2 below. Two images are displayed in the window, one above the other. The image
order is downward. The entire screen is scrolled at once (i.e. if Images 1 and 2 of the
same series are initially displayed, Images 3 and 4 will be displayed next) or one Image is
scrolled at once. Selection of the desired mode is described in Section 15.4.1). To apply
a new configuration you should to reopen the Flat Image View Tab.
• 2 near. This mode is similar to the previous one, but the images are positioned horizontally,
and the order is from left to right.

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 2.9. VIEW MULTIPLE IMAGES IN THE SAME SERIES SIMULTANEOUSLY

• 2x2. Two columns and two rows of images are displayed in the window. The order is
downward from left to right.

• 2x3, 3x2, 3x3, 4x4. Similar to the previous item.

• Custom arrangement. The number of columns and rows is set manually (from 1 to 10).
This configuration can be set by default (see Section 15.4.1).

Fig. 2.11 illustrates a 3x2 grid.

Figure 2.11: Images in a series displayed in a 3x2 grid

Multiple series may be displayed on the screen simultaneously, and each series window may
contain multiple images. In Fig. 2.12, three series windows are open, the first one displays a
single image, the second contains a 2x2 grid, and the third a 4x4 grid.

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CHAPTER 2. VIEW FLAT IMAGES

Figure 2.12: Displaying multiple series and multiple images in a series

To set default viewing images modes for series of different modalities add settings for these
modalities (see Section 15.4.1). Use only English letters to specify modality. The modality
designation should coincide with the designation on the icon of the series (Fig. 2.13).

Figure 2.13: Series modality designation is marked by the red arrow

2.10 Play images

The Viewer allows you to automatically play back images of the series at a certain speed. To
set up playback:
1. click on the right part of the Play and select the speed (5, 10, 20 or 25 frames per
second). If you want to set a different playback speed, select the item User defined...
and in the dialog that opens set the value from 1 to 100. The selected speed will be
marked with a flag.
2. If you want to play images cyclically, click on the arrow on the right side of the Play
button and select the item Loop. The item will be marked with a flag. To disable cyclic
playback, select this command again. The flag will be removed.

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 2.11. ZOOM. PAN. ROTATE

To play the images click on the left side of the button on the toolbar. To end playback,
click on the left side of the button again.

2.11 Zoom. Pan. Rotate

2.11.1 Zoom
To zoom an image use one of the following methods:

1. Roll the mouse wheel holding the Ctrl key. Roll the wheel up to zoom in, or down to zoom
out.

2. With the Zoom tool. Activate the tool by clicking on the left side of the button
and zoom the image, moving the cursor up and down. To select scale values, call the
drop-down menu clicking on arrow on the right side of the button and select the
value. To set the scale manually, select the Custom zoom... item from the drop-down
menu. This tool is available from the image context menu.

Images are scaled relative to the point the cursor is located at.
This tool is also available from the image context menu and from the Image main menu item.

2.11.2 Pan
To pan an image activate the Pan tool by clicking on the button and drag the image with
the mouse holding the left button.
This tool is also available from the image context menu and from the Image main menu item.

2.11.3 Rotate
To rotate an image by an angle multiple of 90 degrees, click on the arrow on the right side of
the Image rotation button on the toolbar, and select one of the four options:

• 0 degrees;

• 90 degrees clockwise;

• 180 degrees;

• 90 degrees counterclockwise.

To rotate an image by an arbitrary angle, click on the left part of the Image rotation
button, and rotate the model by moving the mouse holding the left button. When you finish,
click the Image rotation button to deactivate the tool.
These commands are available from the image context menu. To open them, right-click on
the image and select the Image rotation item from the context menu.
This tool is also available from the image context menu and from the Image main menu item.

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2.12 Set Window Level and Width

To change the parameters move the mouse in the study window holding the right mouse button
• to increase the window level — up;
• to reduce the window level — down;
• to reduce the window width — left;
• to increase the window width — right.
The window width and window level on digital images are similar to contrast and brightness,
respectively, on your computer.
The current window level and width values are displayed at the top right-hand corner of the
window. If the Adjust W/L tool on the toolbar is active, these changes are made holding
the left mouse button. You may as well activate this mode from the image context menu.
The Viewer contains predefined width and level values for some specific tissues. To select
them, click on the left part of the Custom W/L button. The following modes will be
available in the newly opened window:
• recommended (defined by the Viewer as optimum automatically)
• to view chest tissues;
• to view lung tissues;
• to view headcheck tissues;
• to view brain tissues;
• to view bone tissues;
• to view abdomen tissues;
• custom mode. The values defined by the user can be edited.
You cannot edit the values predefined for specific tissues.
To select one of the modes without the preview option, click on the arrow on the right side
of the button. To return to the original settings, select the Recommended mode.
This tool is also available from the Image main menu item.

2.13 Magnifier
This tool allows you to increase the tissue with a zoom increment of 2 to 32 (Fig. 2.14).
To increase the tissue:
1. Activate the Magnifier tool by clicking the button.
2. Move the cursor to the area you want to make out.
3. The radius and the zoom increment of the tool are set in the context menu of the tool. To
set this parameters, click on the arrow to the right side of the button .
4. To increase the value of zoom increment click the left mouse button, to reduce value click
the right mouse button.

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 2.14. MEASUREMENTS

Figure 2.14: Tool Magnifier

2.14 Measurements
The following tools are used to measure various parameters: Ruler, Polygonal Ruler, Corner
meter, Kobb angle, Point value, ROI rectangle tool, ROI ellipse tool, ROI polygon tool.
To select one of these tools, click on the arrow on the right side of the tool selection button.
The button will look different depending on the selected tool:

Ruler (selected by default)

Polygonal Ruler

Corner meter

Cobb angle measurement

Intensity value at point

ROI rectangle tool

ROI ellipse tool

ROI polygon tool

To activate or deactivate the tool that is currently selected, just click on the left side of the

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CHAPTER 2. VIEW FLAT IMAGES

tool selection button. If some tool is activated, the button is highlighted. The drawn objects will
be displayed in the window while it is open, and you can pan, zoom or rotate them together
with the image.
If the series is open in multiple windows or tabs, the measurements made in any window,
appear in all the others.

2.14.1 Ruler
To measure the distance in an image:
1. Select the Ruler tool on the toolbar or from the image context menu.
2. Click the left mouse button on the image to mark the first point.
3. Move the cursor over the screen. The distance from the first point to the current point will
be displayed next to the line.
4. Click the left mouse button to fix the current point.
5. To cancel an incomplete measurement, press Esc.
This tool is also available from the image context menu and from the Image main menu item.

2.14.2 Polygonal Ruler

To perform plygonal linear measurement:
1. Select the Polygonal ruler tool by clicking the button.
2. Mark the first point on the toolbar by clicking the left mouse button.
3. Drag the cursor over the screen. The distance from the first point to the current point will
be displayed beside the line.
4. To fix the current point, click the left mouse button.
5. Repeat Steps 3 and 4 until the last but one point is fixed.
6. Fix the last point by right-clicking the mouse.
7. To cancel an incomplete measurement, press Esc.
To move the linear measurement point:
1. Activate the Polygonal ruler tool.
2. Locate the cursor on the point to be moved.
3. Drag the point holding the left mouse button.
4. Release the left mouse button.
To delete a point:
1. Activate the Polygonal ruler tool.
2. Locate the cursor on the point to be deleted.

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 2.14. MEASUREMENTS

3. Right-click the mouse and select the Remove point command.

To insert a point:
1. Activate the Polygonal ruler tool.
2. Locate the cursor on the ruler where you want to insert a point.
3. Right-click the mouse and select the Insert point command.
This tool is also available from the image context menu and from the Image main menu item.

2.14.3 Corner meter

To measure an angle:
1. Select the Corner meter tool from the toolbar or from the image context menu.
2. Make two points on the image clicking the left mouse button. The second point is the
angle apex.
3. Move the cursor over the screen to set the other side of the angle.
4. Click the left mouse button to fix the second side of the angle.
5. To cancel an incomplete measurement, press Esc.
The Viewer allows you to build as many angles as you need. To deactivate the tool, click on
the left side of the tool selection button.
This tool is also available from the image context menu and from the Image main menu item.

2.14.4 Cobb angle meter

To measure a Cobb angle:
1. Select the «Cobb angle» tool from the toolbar or from the image context menu.
2. Draw a line that runs along the border of one of the vertebrae. To do this, click the left
mouse button to set points through which the line must pass.
3. Likewise construct a line for the second vertebra.
4. To cancel an incomplete measurement, press Esc.
This tool is also available from the image context menu and from the Image main menu item.

2.14.5 Measure Intensity at a Point

To measure intensity at some point:
1. Select the Intensity value at point tool from the toolbar or from the image context
menu.
2. Click the left mouse button at the target point.
The point will be highlighted at the image, and the intensity value will be displayed next to
it.
This tool is also available from the image context menu and from the Image main menu item.

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2.14.6 Measure the Intensity Average and Standard Deviation in an Area

To measure the average intensity value and standard deviation in a particular area:
1. Select one of the ROI ... tools (rectangle , ellipse , or polygon ) from the
toolbar or from the image context menu.
2. To draw a rectangle, click the left mouse button in its top left-hand and bottom right-hand
corners.
3. To draw an ellipse, just draw the rectangle the ellipse is inscribed in.
4. To draw a polygon, click the left mouse button to mark each apex, and then right-click
the mouse to finish.
5. To cancel an incomplete measurement, press Esc.
This tool is also available from the image context menu and from the Image main menu item.
The following parameters will be displayed next to the highlighted area:
• minimum intensity value;
• maximum intensity value;
• average intensity value;
• standard deviation;
• area perimeter;
• area space.

2.14.7 Drawing Parameters

To set the default drawing parameters for measurement tools:
1. Click on the arrow on the right side of the measurement tool selection button.
2. Select the item Set default ROI render params....
3. In the dialog box that appears set the color by clicking on the color box.
4. Set the line thickness and font size.
5. Set length and area units (millimetres or centimetres).
6. To connect the footnote and the measurement of the dotted line, check the box Footline.
7. To apply the settings, click OK. To cancel the settings, click Cancel.
Drawing parameters are available as well from the image context menu and from the Image
main menu item.
The settings will be applied only to measurements conducted in the flat image view window.
For multiplanar reconstruction similar settings should be saved separately.
To edit the drawing parameters of an existing measurement:
1. Activate the tool that was used to make the measurement.

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2. Locate the cursor on the measurement to highlight the line or point.

3. Right-click the mouse.
4. Select the Set render params item from the context menu.
5. In the dialog box that appears, set the parameters in the same way as the default drawing
parameters.
6. To use this parameters by default check the box Set as default. Set the measurement
name if necessary.

2.14.8 Move Measurements

To move a measurement:
1. Activate the tool that was used to make the measurement.
2. Locate the cursor on the measurement to highlight the line or point or to magnify the
cross, marking the angular point. Do not locate the cursor on angle points.
3. Move the measurement holding the left mouse button.

2.14.9 Move Measurement Results

To move a measurement result:
1. Activate the tool that was used to make the measurement.
2. Locate the cursor on the measurement so that it is highlighted by a dotted frame.
3. Move the measurement result holding the left mouse button.
If the cursor is located on the measurement, corresponding measurement result will be
highlighted, and vice versa.

2.14.10 Delete all Annotations and Measurements

To delete annotations and measurements:
1. Activate the tool that was used to make the measurement.
2. Locate the cursor on the measurement to highlight a line or point.
3. Right-click the mouse.
4. Select the Remove object item from the context menu.
To delete all annotaions and measurements, click the Delete all Annotations and Mea-
surements button on the toolbar, or select the corresponding item from the image context
menu. In the dialog box that appears, Click Yes to delete, or No to cancel. If you want the
Viewer to always delete annotations and measurements without this confirmation, check the box
Don‘t show this dialog again and click Yes. If you want the Viewer to show the confirmation
dialog, check the box Ask for delete all annotations and measurements (see Section 15.4.1).
Please note that all other graphic objects created manually will be deleted as well.
This tool is also available from the image context menu and from the Image main menu item.

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2.15 Dynamic contrast-enhanced MRI and CT View Mode

Functionality is available in the Pro edition

Dynamic contrast-enhanced MRI or CT are imaging methods where images are acquired
dynamically after injection of a contrast agent what allows to view the "wash-in" and "wash-out"
of contrast. To open this mode select the Image main manu and the DCE menu item. The DCE
panel will be shown on the right (Fig. 2.15).
To change the size and the configuration of panel, move its borders (highlighted by red
arrows in Fig. 2.15). To do this, move the cursor to the panel border so that it would look like
this: , and drag the border holding the left mouse button. If you strongly reduce the panel,
it closes.

Figure 2.15: Dynamic contrast-enhanced MRI and CT View Mode. Borders

are highlighted by red arrows

2.15.1 Map Settings

Map Settings panel is located on the bottom part of the DCE Panel (Fig. 2.16).

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Figure 2.16: Map Settings Panel

The following parameters can be set:

• Map Type (None, Time Peak, Slope, Area);
• Config, or CLUT;
• Minimal Signal: the map will be built for the tissue with signal level greater than the
specified;
• Minimal;
• Maximal;
• Transperency.
After you enter numeric values, press the Enter key on the keyboard and the entered values
will be applied. Color card shows how quickly change the concentration of a contrast agent in
the tissue.

2.15.2 Detection of tumors using ROI

Measurements are performed with the ROI tools (point , rectangle , ellipse and
polygon ). The tool buttons are in the top of the DCE Panel. Attention! Since version
1.11.0 similar tools located on the toolbar of the View Flat Images window and in the
Image item of the main menu can not be used to detect tumors!. The tools are described
in Section 2.14.5. Dy default annotations are not displayed.
A graph of the signal average value in ROI is shown at the top of the DCE panel. The graph
color corresponds to the ROI color. To hide the graph, select the Hide value from drop-down
list on the ROI panel, to show the graph, select the Show value.
The values of the Ktrans, Kep and Vp peremeters are shown on the DCE Panel.
To build a signal change graphics for plasma and tissues:

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1. Select the ROI corresponding to plasma and ROI, corresponding to tissue on the ROI
Panel on the bottom of the DCE Panel. At the same time each value can be set for only
one ROI. If the value is already set for another ROI, then for him the value will be changed
to Show.

2. Select the type of graph from the drop-down list (Fig. 2.17):

• Signals (set by default). All graphics except hidden are shown.

• Concentration. Graphics corresponding to Plasma and Tissue are shown. The
solid lines shows the graphics and the dotted line shows the approximation.
• Approximation. This type is analogous to the previous one, the solid line shows the
approximation and the dotted lines shows the graphics.

3. If necessary, set the Begin and End frames by entering the values under the graphics or
moving the border of the graphics manually. To do this, move the cursor to the border so
that it looks like and move the border holding the left mouse button.

4. Set the parameters T10 for tissue and plasma. To do this click the Estimate button to
the DCE panel. In the dialog box that opens, select the value entry mode:

• Manual (Fig. 2.20). Enter the values from the keyboard.

• From table (Fig. 2.21). Select the values from the table.
• Estimate (Fig. 2.22). If the study contains a series made without contrast, this
series is used as a reference. Select it from the drop-down list Series and click
on the Estimate. Below the calculated values are displayed, which can be adjusted
manually.
If the study contains a series without contrast, this series is used as a reference. Se-
lect it from the drop-down list Series and click the Estimate button. The calculated
values will be displayed below. You can adjust its manually.

To build a graph by the present values, click OK, to cancel click Cancel. Graph type
will be changed to Concentration and graphs will be rearranged in accordance with the
preset values.

Figure 2.17: DCE Panel

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Figure 2.18: DCE Panel

Figure 2.19: ROI Panel

Figure 2.20: Manual setting of parameters

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Figure 2.21: Setting of parameters from a table

Figure 2.22: Calculating the parameters by a reference series

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 2.15. DYNAMIC CONTRAST-ENHANCED MRI AND CT VIEW MODE

The two fillowing figures illustrate examples of concentration measurement. The Fig. 2.23
shows the graphs for plasma (red) and healthy tissue (green), and the Fig. 2.24 shows the
graphs for plasma (red) and cancerous tissue (yellow). The map transparency is set to zero.

Figure 2.23: Concentration in healthy tissue

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Figure 2.24: Concentration in cancerous tissue

The following three figures illustrates three map types for this study.

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Figure 2.25: Map Type: Time Peak

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Figure 2.26: Map Type: Slope

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 2.16. VISUALIZE IMAGES

Figure 2.27: Map Type: Area

The vertical yellow line on the graph shown in fig. 2.23 corresponds to the current phase of
the study. To change the phase move the cursor to the line so that it would look like and
drag the line holding the left mouse button.

2.16 Visualize Images

2.16.1 Select CLUT
Select the CLUT (colour look-up table) from the drop-down menu on the rendering setup panel
(Fig. 2.28).

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Figure 2.28: Rendering setup panel

2.16.2 Edit CLUTs List

To edit list, open CLUTs setup tab by clicking the CLUTs button. The tab is shown in
Fig. 2.29.

Figure 2.29: CLUTs setup tab

CLUTs setup panel is located on the right-hand part of the window (Fig. 2.30).

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Figure 2.30: CLUTs setup panel

The CLUTs list edit buttons are located on the top of the panel.

Add a new CLUT as a copy of the current one adds a new CLUT as copy of
the selected one

Add a new group adds a new group of CLUTs

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Remove the selected CLUT/group deletes the selected CLUT or group.

Predefined groups and some CLUTs cannot be deleted
Reset the selected CLUT to its original state sets up default parameters for the
selected CLUT

Edit configuration/group opens the CLUT or group setup dialog

Groups contains several CLUTs (e.g., WL, CT) and are intended for the structuring of the
list. They are marked by the arrow (Fig. 2.31) on the drop-down menu (Fig. 2.28).

Figure 2.31: Group of CLUTs

To add a new group, set up the following parameters on the dialog box (Fig. 2.32):

1. Name: any name of group;

2. Required tags: labels that must contain CLUTs to be included in the group.

Figure 2.32: Group setup dialog box

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2.16.3 CLUT Parameters

To browse the settings for the selected CLUT, click the Rendering transfer function
button. The panel displaying the visualization transfer function graph will appear at the bottom
of the study window (see the example in Fig. 2.33).

Figure 2.33: Rendering transfer function graph

You cannot change the setup parameters for predefined CLUTs.

Intensity will be displayed on the horizontal axis, while the number of points with a particular
intensity will be shown on the vertical axis (blue line). The default scale may not allow you to
see the intensity distribution graph (blue) at once. To change the horizontal axis scale, move
the scroll under the axis, or roll the mouse wheel while the cursor is located on the scrollbar.
The scale value will be displayed on the right of the scrollbar. To change the vertical axis scale,
roll the mouse wheel while the cursor is located on the visualization setup panel, but not on the
scrollbar. Fig. 2.34 shows the same graph as in the previous figure, but with a greater intensity
distribution scale (on the vertical axis).

Figure 2.34: Intensity distribution graph with a greater vertical axis scale

The color/transparency chart (white line) is superimposed on the intensity distribution scale.
The horizontal axis shows the intensity, and the vertical axis shows the transparency of the
color highlighting the points with this intensity. The color is displayed below the graph. The

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horizontal axis scale changes for both graphs simultaneously, while the vertical axis scale for
the color/transparency chart does not change. To move the graph along the horizontal axis,
hold the left mouse button.
To find out what percentage of tissue has a density in a given range, click on the Histogram
percentage button, move the cursor to the beginning of the range and move the cursor
to the end of the range holding the left mouse button. The percentage of tissue that have a
density within the range is indicated in red (fig. 2.35). To edit a range move the cursor to its
border and move the border with the left mouse button pressed. To move a range move the
cursor on it so that the cursor would look as follows , and move the cursor holding the left
mouse button. Multiple ranges can be built at the same time. To remove the built ranges click
the Histogram percentage button again.
To export data on the distribution of densities click on the button, in the dialog that
opens specify the file name and folder, click Save to finish or Cancel for cancel.

Figure 2.35: Histogram percentage

2.16.4 Create and Edit CLUT

To create your own CLUT:

1. Click the CLUTs button to open the CLUT setup panel.

2. Copy one of the existing CLUTs by selecting it from the list and clicking on the Add a
new CLUT as a copy of the current one button.

3. To rename a CLUT, double-click the left mouse button on it, enter the new name and
press the Enter key.

4. Specify the required parameters:

• Color. Select a point on the color/transparency chart. The color settings for this
point will become available. To set up color of the current point for all points of the
chart, click the Apply to all chart points button.
• Density. Sets the position of the point on the horizontal axis. The alternative way to
set this parameter is to move the point along the horizontal axis using the mouse.
• Opacity. Sets the transparency of the color. 1 — maximum, 0 — minimum. The
alternative way to set this parameter is to move the point along the vertical axis using
the mouse.

5. To add a point, locate the cursor on the graph so that it looks like , right-click the
mouse and select the Add point item.

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6. To delete a point, locate the cursor on the point so that it looks like , right-click the
mouse and select the Remove point item.
7. To restore the original settings for this CLUT, click the Reset the selected CLUT to its
original state button.
To delete a CLUT, click the Remove the selected CLUT/group button.
Viewer allows you to add additional color/transparency charts. To add:

1. Click the Add chart button. New chart will appear on the bottom part of the window
and its name will be added to the drop-down chart menu. The opened menu is shown in
Fig. 2.36.
2. To rename the selected chart, click the Edit chart name button, type new name and
press Enter.
3. To delete the selected chart, click the Remove chart button.
4. To move the all charts along the horizontal axis, locate the cursor not on the any chart
and move its holdind the left mouse button.
5. To move any chart, select Auto detection from the drop-down chart menu, locate the
cursor on the some chart and move it holdind the left mouse button.
6. To move a certain chart, select its name from the drop-down chart menu, locate the cursor
on this chart and move it holdind the left mouse button. This mode is useful, if the charts
overlap.

If the chats overlap, the colors are mixed.

Figure 2.36: Drop-down chart menu

2.17 SUV Measurement

Functionality is available in the Pro edition

SUV (Standardized Uptake Value) is a value reflecting the intensity of contrast accumulation
in tissues. To measure the SUV:

1. Open a series suitable for a SUV measuring.

2. Select the Image main menu, select the SUV item and the Show SUV command. If
the selected series is not suitable for a SUV measuring then the Show SUV command
is disabled. If a SUV measuring is already activated then the Show SUV command is
marked by flag.

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3. If necessary change the CLUT to [WL]PET by selecting it from the drop-down list or by
pressing the Shift+F8 key combination on the keyboard. For details see Section 2.16.1.

4. If the data contained in the study is insufficient then the dialog shown in Fig. 2.37 appears.
Specify the following data:

• SUV Type. Choose one of four ways to measure SUV:

– by body weight: SUV Body Weight (SUVbw);

– by body surface area: SUV Body Surface Area (SUVbsa);
– on the body mass index according to the James method: SUV Lean Body Mass
(SUVlbm James);
– on the body mass index according to the Janmahasatian method: SUV Lean
Body Mass (SUVlbm Janmahasatian);

• Patient weight (Kg) (is optional for the method of calculating by body surface
area);

• Patient height (cm);

• Injected dose (MBq);

• Injection date time;

• Acquisition date time;

• Half-life (min);

• Sex (is optional for the method of calculating by body weight and by body surface
area);

• if it is necessary to display the SUV measurement results for ROI tools then check
the Use SUV for ROI tools box.
To measure the SUV click OK, to cancel the operation click Cancel. If there is not
enough data to calculate (for example, the patient’s weight or height is not specified
or is zero), then the OK button is disabled.

5. To change the SUV calculation settings select the Image main menu, select the SUV item
and the Settings... item.

6. When the SUV measurement is activated the value at the point where the cursor is located
appears in the upper corner left of the window. For example: SUVlbm (James): -0.092
g/ml. Move the cursor over the image to measure the SUV. Please note that the Display
information button must be pressed (see Section 2.20).

7. To calculate the SUV in a particular area or point use the ROI tools (see Section 2.14.5).
Please note that the Use SUV for ROI box must be checked in the SUV settings.

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Figure 2.37: SUV Settings

If the time and date of the series creation is more than the time and date of the study then
the message Warning: This series may be post-processed in which date of series creation
unrelated to acquisition appears in the SUV Settings dialog.
To disable the SUV measurement select the SUV in the main menu Image and select Show
SUV command. The density information will be displayed for built ROIs.

2.18 Calcium Scoring

Functionality is available in the Pro edition

The Viewer allows you to measure calcium in the coronary arteries. CT-series with informa-
tion about the slice thickness are suitable for measurement. For all other series tools are not
available.

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The tool selection button will look different depending on the tool that was used last:

Calcium scoring (ellipse) (selected by default)

Calcium scoring (polygon)

To switch between these tools click the arrow on the right side of the tool selection button
and select the desired tool.

2.18.1 Selection of measurement areas

Functionality is available in the Pro edition

To measure calcium:
1. Open a CT series suitable for a calcium scoring.
2. Select image to measure.
3. Activate the Calcium scoring (ellipse) tool or Calcium scoring (polygon).
These tools are similar to ROI ellipse and ROI polygon (see Section 2.14.5). If the study
does not contain information about the age and/or gender of the patient the dialog shown
in Fig. 2.38 appears. Enter missing information and click OK to continue or Cancel to
cancel the measurement. After clicking OK this dialog no longer appears until the Flat
image viewer window is closed. To change the gender and/or age of the patient close
the Flat Images View window and return to 1 step.
4. When the calcium scoring tool is active a window shown in Fig. 2.39 is displayed on the
screen. Move the window if necessary. To do this move the cursor over the window title
(highlighted in red in the figure) and move it holding the left mouse button. In the upper
part of the window there are vessel selection buttons:
• LM — Left main coronary artery
• LAD — Left anterior descending coronary artery
• LCX — Left circumflex coronary artery
• RCA — Right coronary artery
Select an artery for measurement by clicking the corresponding button. The choice of
artery does not affect the measurement result.
5. Build an ellipse or polygon around the affected area. For detailes on how to build see
Section 2.14.5 (the ROI ellipse and ROI polygon tools). A block with the following data
is displayed near the measurement:
• The name of the artery (corresponds to the button pressed while building);
• Area of calcified lesion. If the measurement area contains several lesions then their
total area is displayed;
• Agatston score;

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• Volume score.

Figure 2.38: Patient data entry dialog

Figure 2.39: Calcium scoring

To deactivate the tool click the tool selection button Calcium scoring (ellipse) tool
or Calcium scoring (polygon) or close the Calcium scoring window. All changes made
are saved until the Flat images view window is closed.

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2.18.2 Actions with measurement areas

Functionality is available in the Pro edition

For detailes on how to move measurement areas see Section 2.14.8, how to move measure-
ment results see Section 2.14.9.
To edit the drawing parameters:
1. Activale the calcium scoring tool.
2. Locate the cursor on the measurement or the mesurement results to highlight them.
3. Right-click the mouse and select the Set render params... item from the context menu.
4. In the dialog box that appears enter the measurement name.
5. Set the color by clicking on the color box.
6. Set the line thickness and font size.
7. To connect the block with measurement results and the measurement of the dotted line
the Footnote line box must be checked.
8. To display the block with measurement results the Show labels box must be checked.
9. To use this parameters by default check the box Set as default.
10. To apply the settings click OK. To cancel the settings click Cancel.

2.18.3 Measurement results

Functionality is available in the Pro edition

The measurement results are displayed in the window shown in Fig. 2.39:

1. For each vessel separately and total:

• total lesion area (for all lesions);
• lesions numder (N);
• Agatston score (AS);
• Volume score (VS).
2. Patient gender
3. Age group
4. Percentile

The measurement results are exported in html format and can be inserted into text editors
that support html markup, for example, LibreOffice Writer or Microsoft Word. To do this click
the Export to clipboard button, create a document in a text editor and paste the copied
information into it.

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2.19 Scout Lines

The Show series scout lines tool is used if two or more series are opened for a particular
study. The tool allows you to display the series image scout lines on images from other series
if they are synchronized.

By default current image scoute line is highlighted in green, and boundary scout lines are
highlighted in yellow (Fig. 2.40). If Show all scout lines mode is active, the intermediate scoute
lines are highlighted by a dotted lines, and current and boundary scoute lines are highlighted
by a solid lines (Fig. 2.41).

Figure 2.40: The left image scout line is displayed on right image

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Figure 2.41: The all scout lines of left series images are displayed on right
image

2.19.1 The Tool Context Menu

The tool context menu contains the following items:

1. Mode Show all scout lines shows scout lines of all series images, not just of current
one.

2. Mode Scout lines on selected view shows on current window scout lines of images
opened on other windows.

3. Mode Selected view scout lines shows scout lines of current image on other windows.

4. Line settings opens the dialog to set up scout lines settings (Fig. 2.42).

To activate/deactivate the the mode of the tool, click on the arrow on the right side of the
button and check/uncheck the corresponding item.
The modes are activated independently.
By default the Show series scout lines tool is active and the Selected view scout lines
mode is checked. To activate/deactivate the tool, click the button on the toolbar.

2.19.2 Lines Settings

To set up lines color and width:

1. Click on the arrow on the right side of the button and select the Line settings...
item. A dialog box shown in Fig. 2.42 will be displayed.

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2. Set up line color. To do this, click the color change button (highlighted by red arrow in
Fig. 2.42), select a color on the dialog box and click OK.
3. Set up the line width.
4. Click OK to apply the changes, or Cancel to cancel the actions.

Figure 2.42: Line settings dialod box

2.20 Set Up Viewer Workspace

The Show labels tool allows you to display or hide the information about an image in the series
windows. The settings are applied to all series opened in the current tab. By default the tool is
active. To activate/deactivate the tool, click the Show labels button on the toolbar.
You can adjusts the visibility of:
1. Orientation cube;
2. Orientation letters;
3. Render annotations;
4. Tags values.
To show (hide) the Orientation cube, Orientation letters or Render annatations click the
arrow on the right side of the Show labels and check (uncheck) the corresponding item.
To customize the list of displayed tags click the arrow on the right side of the Show labels
button, select the Select displayed tags... command and in the dialog that opens set the flags
for the required tags. Click OK to apply the changes or Cancel to cancel the actions.

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To customize the Annotations text size click the arrow on the right side of the Show labels
button, select the Set annotations text size... command and in the dialog that opens enter
integer or fractional value. Click OK to apply the changes or Cancel to cancel the actions.

2.21 Export Images

2.21.1 Export to DICOM

Export to DICOM allows you to export images to a series that is available while the current
study is open. To export:

1. Click on the arrow on the right side of the Quick export images button on the
toolbar, and select the Export images... item or press Ctrl+E.

2. Select the Export to DICOM tab. The export window will look as shown in Fig. 2.43.

3. Select the series to export. If no series have been exported yet, only the Create new
series item will be available. If export has been conducted before, you can export the
data to the last created series by selecting the Use exists series option.

4. If you need to load the exported images to the DICOM server immediately, check the
option Upload image to the default server. If the default server is not set in the
Viewer, this option will be inactive.

5. Select the set of images for export. Three options are available:

• Current image;
• Entire series;
• Current phase images (only for multiphase series).

6. Select the capture type. Three options are available:

• View screenshot: the entire view window workspace is captured, including the
image information without conversions performed by the user;
• Image screenshot: only the image visible in the workspace (with conversions per-
formed by the user) is captured;
• Raw image data: only the image is captured, irrespective of scale and without user
conversions.

7. Set the image size if necessary.

8. To initiate export, click OK. To cancel the export, click Cancel.

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Figure 2.43: DICOM export window

To continue exporting images to the DICOM format with the current settings, click on the
left side of the Quick export images button, or press F5.
This tool is also available from the Image main menu item.

2.21.2 Export to Image

Export to image allows you to export the current image to a .png or .jpg file. To export data to
an image:
1. Click on the arrow on the right side of the Quick export images button on the
toolbar, and select the Export images button or press Ctrl+E.
2. Select the Export to image tab. The export window will look as shown in Fig. 2.44.
3. Set the path to the folder for export by entering it to the Path to export field, or click
the button and select the path in the dialog box.
4. Enter the file name.
5. Select the file extension from the drop-down menu.

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6. Select the set of images for export. Three options are available:
• Current image;
• Entire series;
• Current phase images (only for multiphase series).
7. Select the capture type. Three options are available:
• capture view area: the entire view window workspace is captured, including the
image information;
• capture visible image: only the image visible in the workspace is captured (including
the scale);
• all image: only the image is captured, irrespective of scale.
8. Set the image size if necessary.
9. To initiate export, click OK. To cancel the export, click Cancel.

Figure 2.44: Export image to file window

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To continue exporting images to the file with the current settings, click on the left side of the
Quick export images button or press F5. The file names will be specified automatically.
If you attempt to export the same image twice, the Viewer will return a «File with the same
name already exists. Do you want to overwrite it?» warning. To overwrite the image, click
Yes. To cancel, click No.
This tool is also available from the Image main menu item.

2.22 DSA Mode

Using DSA mode you can process a series of frames with different concentration of a contrast
agent, subtracting images in such a way that tissues, containing contrast, are best seen.

2.22.1 Single-image subtraction view

For studies containing a series of frames (images) with a varying concentration of a contrast
agent, one of the images is subtracted from all images in the series. To apply the DSA mode:

1. Open the study in the View Flat Images window.

2. Click on the left side of the button. The first image of the series has been subtracted
from all the images of this series.

3. Scroll through the images by moving the slider or rotating the mouse wheel, hovering the
cursor over the scroll bar on the Frame Scroll Bar (Fig. 2.45).

4. If you want to subtract another image from all the images, select this image using the
scroll bar in the Frame Scroll Bar, click on the arrow on the right side of the button
and select the command Set the current frame as a key frame.

5. If the series pictures are offset relative to each other, then correct it by selecting the
command Auto adjust key image offset on the DSA mode tool menu.

6. To manually correct the offset, select the command Manual Adjustment from the DSA
Mode tool menu and change the location of the images using the buttons that appear in
the image view window (Fig. 2.46) or using the keys.

7. If necessary, change the window width and window level.

Figure 2.45: Frame Scroll Bar

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Figure 2.46: The button for manual adjustment is highlighted in red

2.22.2 Series subtraction view

For studies containing at least two related series of frames (images) with different concentration
of a contrast agent, images of the one series are subtracted from the corresponding images of
another series. To apply the DSA mode:

1. Open the study in the View Flat Images window.

2. Choose a series whose images you want to subtract from the images of the other series.
3. Click on the left side of the button.
4. Click on the arrow on the right side of the button. If the study contains the necessary
data, then the command Set the frame series as key frames is available. Select this
command.
5. Select another series of frames by rotating the mouse wheel or moving the slider on the
right side of the image view window.
6. Scroll through the images by moving the slider or rotating the mouse wheel, hovering the
cursor over the scroll bar on the Frame Scroll Bar (Fig. 2.45).
7. If necessary, change the window width and window level.

This tool is also available from the Image main menu item.

2.23 Image Information in the Series Window

2.23.1 Orientation Cube
The Orientation Cube is located at the bottom right-hand corner (Fig. 2.47). The markers on
the cube show the side the image is viewed from:
A — Anterior
R — Right
L — Left

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P — Posterior

F — Foot

H — Head.

Figure 2.47: Orientation cube

If «F» is written on the cube face, it means that the image is viewed from below; if «R» is
written beside a rib, it means that the patient’s right side is on this side of the image.

2.23.2 Scale
A graduated 10-cm scale is displayed on the right side of the window.

2.23.3 Image Information

The image information is displayed at the bottom left-hand corner. It may include the following
parameters, depending on the study type:

• Image No — current image number in the series/total number of images in the series;

• Image size — image size (pixels);

• FOV (field of vision) — image size (millimeters);

• Location — image location determined by the device;

• Thickness — interval between slices.

2.23.4 Patient Information

The information about the patient is displayed at the top left-hand corner.

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2.24 View DICOM Tags

To view the DICOM tags of the image:

1. Open the image.

2. Open the image context menu by right-clicking on the image.

3. Select the Show image tags item. The DICOM tags will be displayed in a new tab
(Fig. 2.48).

Figure 2.48: DICOM tag tab

2.25 Graphic Label Tool

2.25.1 General
This tool allows you to create graphic labels (as arrows, ellipses, polygons and text fields) on
an image. The labels will be applied during the entire session of working with the series. Labels
are attached to specific points on the image and paned, scaled or rotated together with the
image.
The button design depends on the selected tool. The default tool is Pointer, and the tool
selection button looks like this: .
To activate/deactivate the selected tool, click on the left side of the graphic label tool
selection button. To select and activate one of the tools, click on the right side of the tool
selection button and select the tool.
This tool is also available from the image context menu and from the Image main menu item.

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2.25.2 Create Labels

To create a label on an image:

1. Activate the Pointer tool. The button will look as follows: .

2. Click the left mouse button at the location the arrow should point to.

3. Click the mouse where the opposite end of the arrow should be. The pointer will be
displayed (Fig. 2.49.

4. To cancel an incomplete creation, press Esc.

Figure 2.49: Pointer

To create a text label on an image:

1. Activate the Text tool. The button will look as follows: .

2. Click the left mouse button where the text should be located.

3. Enter the text in the dialog box and click OK to add it to the image, or Cancel to cancel
the action.

To create a polygon on an image:

1. Activate the Polygon tool. The button will look as follows: .

2. Click the left mouse button where the first point of the polygon should be located.

3. Move the cursor to the location of the next point. The lines connecting the points of the
polygon will be displayed on the screen.

4. Click the left mouse button to save the point.

5. Repeat Steps 3 and 4 until the last but one point is set.

6. Right-click the mouse to create the last point. The polygon is complete (Fig. 2.50).

7. To cancel an incomplete creation, press Esc.

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Figure 2.50: Polygon labels

To create an ellipse on an image:

1. Activate the Ellipse tool. The button will look as follows: .
2. To build an ellipse, just build the rectangle the ellipse is inscribed into. Click the left
mouse button where the first angle of the rectangle should be located.
3. Move the cursor to the location of the opposite angle. The ellipse will be displayed on the
screen.
4. Click the left mouse button to fix the opposite angle. The ellipse is complete (Fig. 2.51).
5. To cancel an incomplete creation, press Esc.

Figure 2.51: Ellipse label

2.25.3 Actions with Labels

To work with a label, activate the tool that was used to create it. The Viewer allows you to
perform the following actions with labels:
• Drag. Locate the cursor on the figure line of text and drag the object holding the left
mouse button.
• Drag a point (an apex for an arrow or polygon, and a rectangle apex for an ellipse).
Locate the cursor on a point and drag the point holding the left mouse button.

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• Delete. Locate the cursor on the label border, right-click the mouse and select the
Remove object item from the context menu.
• Set render params. Locate the cursor on the label border, right-click the mouse and select
the Set render params item from the context menu. In the dialog box that appears, set
the line color and thickness for a figure or font color and size for text. Click OK to apply
the changes, or Cancel to cancel the actions.
• Edit text label. Locate the cursor on the text, right-click the mouse, and select the Edit
text command from the context menu.
To set the default render parameters, click on the right side of the button and select
the command Set default annotation render params.
To delete all objects, click the Delete all Annotations and Measurements button or
select the corresponding item from the image context menu. In the dialog box that appears,
Click Yes to delete, or No to cancel. If you want the Viewer to always delete annotations and
measurements without this confirmation, check the box Don‘t show this dialog again and click
Yes. If you want the Viewer to show the confirmation dialog, check the box Ask for delete
all annotations and measurements (see Section 15.4.1). Attention! All measurements and
other objects created manually will be deleted.

2.26 Synchronize Images

2.26.1 Synchronize Series in One Study
Synchronization is applied if two or more series are opened for the same study. This function
allows you to scroll images in several series synchronously. By default the option is disabled.
To enable synchronization:
1. click on the arrow on the right side of the button Sync series scroll button on the
toolbar.
2. Check the item Sync series (Same study).
3. If this button is not pressed, press it.
The images will be synchronized automatically. Click in the left side of the button Sync
series scroll to disable synchronization.
This tool is also available from the Image main menu item.

2.26.2 Synchronize Series in Several Studies

Synchronization is applied if two or more series of one or more studies are opened at a time.
This function allows you to scroll images in multiple series simultaneously. By default the option
is disabled.
To enable synchronization:
1. click on the arrow on the right side of the button Sync series scroll button on the
toolbar.
2. Check on of the following items:
• synchronize from current positions;
• Sync series with specified distance.

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3. If this button is not pressed, press it.

Click in the left side of the button Sync series scroll to disable synchronization.

Figure 2.52: Synchronization by current position

To set up manual synchronization:

1. Select the item Set distance to sync series... from the Sync series scroll button
menu. A dialog box similar to the one shown in Fig. 2.53 will be displayed.

2. Check the series relative to which the shift should be set.

3. In other series, set the shift (millimeters) relative to the selected series. To do this, click
the left mouse button on the value in the Distance column and enter the new value.

4. To apply the settings, click OK To cancel the actions, click Cancel

During the scrolling the images will be shifted relative to each other by the specified values.

Figure 2.53: Synchronous scrolling shift setup window

This tool is also available from the Image main menu item.

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 2.27. MIRROR IMAGE HORIZONTALLY/VERTICALLY

2.27 Mirror Image Horizontally/Vertically

This tool allows you to mirror images. The button will look different depending on the mode that
was used last ( — horizontal, — vertical). The horizontal mode is used by default.
To activate/deactivate the tool, click on the left side of the button. If several series are
opened in the view window, the mirroring is activated for each series independently.
To change the mirroring mode, click on the arrow on the right side of the button and check
the required mode. Both modes can be activated simultaneously.
This tool is also available from the Image main menu item.

2.28 Calibration sizes

X-ray images sizes are increased as compared with the real size of the tissues (Fig. 2.54).

Figure 2.54: The green arrow shows the actual size of the tissues and red
arrow shows the size of the image

So, the size determined by X-ray modality may be incorrect. If a picture contains the object
whose size is known (e.g., a catheter), it is possible calibration image size. To calibrate the
size:

1. Select the Images main menu and the Calibration tool.

2. Mark the first point on the picture by clicking the left mouse button.

3. Drag the cursor over the screen. The calibration interval and its length will be displayed.

4. To fix the second point, click the left mouse button.

5. In the dialog box that appears, type the real length of the interval constructed (Fig. 2.55).
To calibrate size, click OK, to calcel click Cancel.

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Figure 2.55: Calibration size

If you cancel the calibration, the calibration interval remains in the image.
Calibration accounted for measurements that depend on the linear dimensions. Already
made measurements after calibration are automatically adjusted.
To hide the calibration interval, deactivate the tool by selecting the Images main menu and
the Calibration item. This calibration will remain.
Calibration is maintained until the window containing the current series is open.
This tool is also available from the image context menu.

2.29 Additional Options

The Sync by point tool is used to select a point at one image and highlight it at all images.
When the mouse moves with the left button pressed in one window, the images in other windows
are synchronized in real time. To activate/deactivate the tool, use the image context menu or
click the button on the toolbar. The Add to print list button adds the current image
to the list of images to print. For details on how to print, see Chapter 16.

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Volume Reconstruction

It is recommended to use the render device supporting the CUDA technology (preferable) or
OpenCL technology to build a volume model. The settings are described in Section 15.4.3.

3.1 View Images

To open a study in the volume reconstruction window:

1. Load the studies to the Viewer.

2. Select the study from the study panel.

3. Click the Volume Reconstruction button on the toolbar. To select the tab location
(in the current window, in a separate window, or in the full screen mode), click on the
arrow on the right side of the button. To open the volume reconstruction window in a new
tab in the current window, click on the left side of the button.

Fig. 3.1 illustrates the volume reconstruction window.

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Figure 3.1: Volume reconstruction tab

This process may take some time. The right side of the screen displays the toolbar with the
volume edit tools and the windows for viewing the axial, frontal and sagittal sections. You can
work with the sections in the 3D cursor mode described in Section 5.4.1.
The volume reconstruction of tissues is located on the left side of the screen.

3.2 Actions with the Model

The Viewer allows you to perform the following actions with the model:

• Pan leftward and rightward using the keys.

• Zoom the 3D image by rolling the mouse wheel or using the keys.

• Rotate by moving the mouse holding the wheel or using the Rotate tool (see Sec-
tion 3.3.2). To jump to a different space orientation option, use the buttons on the
left side of the tab (Fig. 3.2)

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Figure 3.2: Space orientation selection buttons

3.3 Model Positioning Tools

3.3.1 Model Shift
To activate/deactivate the tool, click the Model shift keys button on the toolbar or use
the image context menu. By default the tool is disabled. The tool allows you to drag the model
with the mouse holding the left button.
This tool is also available from the image context menu and from the Volume main menu
item.

3.3.2 Model Rotation

To activate/deactivate the tool, click the Model Rotation button on the toolbar. By
default the tool is active. It allows you to rotate the model with the mouse holding the left
button.
Note that the initial point of the cursor does not affect the rotation. If the cursor is moved
vertically, the image is rotated round the horizontal axis. If the cursor is moved horizontally,
the image is rotated round the vertical axis. That is, the image follows the cursor. If the cursor
moves along a slanting line, the image slants the same way.
This tool is also available from the image context menu and from the Volume main menu
item.

3.3.3 Model Scaling

To activate/deactivate the tool, click the Model Scaling button on the toolbar. By default
the tool is disabled. The tool allows you to zoom the model with the mouse holding the left
button. Move the cursor up to zoom in or down to zoom out.
This tool is also available from the image context menu and from the Volume main menu
item.

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3.4 Cutting Tools

There are several cutting tools on the right toolbar.

3.4.1 Polygon Cut

The tool allows you to build a polygon or area with smooth borders that the cut area is projected
on. The tool is enabled/disabled using the button on the toolbar.
To build a polygon

1. Activate the Polygon Cut tool.

2. Click the left mouse button to set the apices of the polygon marking the figure to be cut,
except the last point.

3. Fix the last point by right-clicking the mouse.

4. To cancel an incomplete building, press Esc.

To build an area with smooth borders (Lasso mode):

1. Activate the Polygon Cut tool.

2. Press and hold the Shift key on the keyboard.

3. Circle the area to be cut holding down the left mouse button.

4. To complete the building release the left mouse button or click the right mouse button.

5. To cancel an incomplete building, press Esc.

The part of the model to be projected on the area will be cut.

3.4.2 Inverse Polygon Cut

The tool is similar to the previous one, except that part of the model not to be projected on the
area will be cut. To activate/deactivate the tool, use the button on the toolbar.

3.4.3 Delete Area

The tool allows you to delete an area of a 3D model not associated with its other parts. To
activate/deactivate the tool, use the button on the toolbar.

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3.4.4 Delete All Areas except Selected Area

The tool is similar to the previous one, except that all areas excluding the selected area are
deleted. To activate/deactivate the tool, use the button on the toolbar.

3.4.5 Cutting Tools Parameters

For Delete Area and Delete All Areas except Selected Area tools the following parameters
can be set:

1. Grow from surface (mm). The tissue surrounding deleted area will be deleted too. This
parameter specifies the distance from the surface on which the tissue will be deleted. If
this parameter is set to zero, model surface may look rough, so use a value of zero only
if necessary.

2. Min object thickness (mm). If the value is greater than zero, the tissue with a thickness
less than the set value will be ignored during deletion.

This parameters for each tool are set separately.

To set these parameters, click on the arrow on the right side of the appropriate tool button
and select the Parameters... item and in the dialog box that appears, specify the required
values.

3.4.6 Sphere Cut, Sphere Restore and Restore by Mask Tools

Brush cut, Brush restore and Restore by mask tools allow to remove tissue within the sphere
or cylinder and restore tissue deleted by cutting tools. To select one of these tools (Brush cut,
Brush restore, Restore by mask) and modes (Sphere, Cylinder), click the arrow on the right
side of the tool buttons. The button will look different depending on the tool that was used last:

Brush cut (is selected by default)

Brush restore

Restore by mask

The cursor will look different depending on the mode that is selected. The cursor for Sphere
mode is shown in Fig. 3.3, and the cursor for Cylinder mode is shown in Fig. 3.4.

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Figure 3.3: The cursor for Sphere mode

Figure 3.4: The cursor for Cylinder mode

To activate/deactivate the tool, click on the left side of the tool button. If any tool is
activated, the button is highlighted.
To cut tissue:

1. Activate the Brush cut mode by clicking button.

2. Set the tool diameter, moving the mouse holding the left button and Alt key.

3. For the Cylinder mode set the height if it is necessary. To do it, click the arrow on the
right side of the tool button and select the Cylinder settings... item. In the dialog box
that appears set the cut height.

4. Click the left mouse button in the place where you want to cut tissue. Part of the tissue
will be cut. The green dot indicates where the great circle of the sphere (the base area of
the cylinder) touches the surface of the model. The great circle passes through the center
of the sphere and is parallel to the plane of the screen.

5. Repeat steps 3 and 4, if necessary.

Brush restore tool allows you to perform the reverse process of brush cutting.
Restore by mask tool allows you to restore tissue by mask (this tool is used for
segmentation). It mask is not set, this mode is analogous to the Brush restore mode. For
details how to set mask see section 6.2.3.

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3.4.7 Tools for intelligent volume editing

Functionality is available in the Pro edition

Functionality is available in the Pro edition

The Grow (dilation) Shrink (erosion), Fill and Cut invisible volume tools allow to edit
tissue within the special algorithms. The Multi-segment growing tool allows you to edit
segmented structures. To select one of these tools, click the arrow on the right side of the tool
buttons. The button will look different depending on the tool that was used last:

Grow (dilation) (set by default)

Shrink (erosion)

Remove noise (opening)

Remove holes (closing)

Multi-segment growing

Fill

Cut invisible volume

The Grow (dilation) tool allows you to increase the volume by a certain value from the
surface for 1 iteration. This value is specified in the Settings menu of this tool (parameter
Growing radius). The increase is possible only within the original volume, for example, after
the use of cutting tools. When you use this tool to edit a segmented structure, an increase is
possible only within the mask. The tool is used to fine-tune the structure, if initially the required
volume was not obtained.
The Shrink (erosion) tool performs the opposite action. The reduction value is specified by
the parameter Growing/Shrinking radius.
The Remove noise (opening) tool allows to remove noise from the volume. This tool is
equivalent to consistently applied tools Shrink (erosion) and Grow (dilation).
The Remove holes (closing) tool allows to remove little holes from the volume. This tool is
equivalent to consistently applied tools Grow (dilation) and Shrink (erosion).
The Multi-Segment Growing tool allows you to simultaneously build several structures and
base volume. It is used to edit segmented structures (see Section 6.4.6). If the tool is applied
only to the base volume then it works like the Grow (dilation) tool.
The Fill tool allows you to fill the voids in the volume. If you are working with segmented
structures, the tool is used to improve structures built on a «grainy» mask. Such masks are
typical, for example, for kidneys.

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The Cut invisible volume tool sets the mask according to the visible volume.

3.4.8 Remove Table

The tool allows you to delete areas similar to medical equipment table. To delete, click the
button on the toolbar.
To undo or redo the last action associated with cutting, use the Undo and Redo
buttons.

3.5 Centrate

The tool allows you to set the center point. The model rotates and scales with respect to
this point. This may be necessary if the model is cut off with cutting tools. The tool has two
modes: auto and intaractive (manual). To select mode click on the arrow on the right side of
the Centrate button on the toolbar and select mode. Current mode is marked with check
marks.
To activate the tool click on the left side of the Centrate button. If auto mode is
selected, the centering will be performed immediately after the tool is activated. If interactive
mode is selected, the cursor takes the form of a crosshair. Set the center point by clicking on
it the left mouse button.

3.6 Clipping Box

The clipping box allows you to cut off all tissues outside it. To build a box, click on the left side
of the Clipping Box Redo button on the toolbar.
To build a minimum box not cutting the model, click on the arrow on the right side of the
Clipping Box button and select the Fit to model command.
To build a box by the image borders, click on the arrow on the right side of the Clipping
Box button and select the Reset clipping box command.
To cut off parts of tissues, move the box face so that it intersects the 3D model. To do this,
locate the cursor on the box face so that its borders are highlighted in green (Fig. 3.5).

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Figure 3.5: Editing the Clipping Box. The active face ready for moving is
highlighted in green

Next, move the face using the mouse holding the left button. Only the faces located on the
foreground (highlighted in white) can be moved. Faces unavailable for moving are highlighted
in grey. To be able to work with unavailable faces, rotate the image. The box is rotated
synchronously with the image.
To zoom the box symmetrically, move the mouse holding the left button and Ctrl key.
To pan the box, move the mouse holding the left button and Shift key.
To rotate the box, move the mouse holding the left button and Alt key.
If the Clipping Box tool is deactivated, the sections made using the tool will be saved. To
restore the initial look of the model, use one of the following options:
1. Activate the Clipping Box tool and move the faces to make the model visible.
2. Click on the arrow on the right side of the Clipping Box button and select any of the
building options. If the Clipping Box tool is inactive, the box will not be visualized, but
the section will still be reset.
This tool is also available from the Volume main menu item.

3.7 Measurements
The tool allows you to make linear and polygonal linear measurements of distances in an image.

3.7.1 Ruler
To make linear measurements:
1. Activate the Ruler tool by clicking the button or select the corresponding item from
the image context menu.
2. Mark the first point on the toolbar by clicking the left mouse button.

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3. Drag the cursor over the screen. The distance from the first point to the current point will
be displayed beside the line.
4. To fix the current point, click the left mouse button.
5. To cancel an incomplete measurement, press Esc.
To move the ruler border:
1. Activate the Ruler tool.
2. Locate the cursor on the point to be moved.
3. Drag the point holding the left mouse button.
4. Release the left mouse button.
To delete a ruler:
1. Activate the Ruler tool.
2. Locate the cursor on the line to be deleted.
3. Right-click the mouse and select the Delete all Measurement command.
This tool is also available from the model context menu and from the Volume main menu
item.

3.7.2 Polygonal Ruler

To perform plygonal linear measurement:
1. Select the Polygonal ruler tool by clicking the button on the toolbar.
2. Mark the first point on the toolbar by clicking the left mouse button.
3. Drag the cursor over the screen. The distance from the first point to the current point will
be displayed beside the line.
4. To fix the current point, click the left mouse button.
5. Repeat Steps 3 and 4 until the last but one point is fixed.
6. Fix the last point by right-clicking the mouse.
7. To cancel an incomplete measurement, press Esc.
To move the linear measurement point:
1. Activate the Polygonal ruler tool.
2. Locate the cursor on the point to be moved.
3. Drag the point holding the left mouse button.
4. Release the left mouse button.
To delete a point:
1. Activate the Polygonal ruler tool.

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2. Locate the cursor on the point to be deleted.

3. Right-click the mouse and select the Remove point command.
To insert a point:
1. Activate the Polygonal ruler tool.
2. Locate the cursor on the ruler where you want to insert a point.
3. Right-click the mouse and select the Insert point command.
To resume a completed polygonal linear measurement:
1. Activate the Polygonal ruler tool.
2. Locate the cursor on the point to continue the measurement from, so that it would look as
follows: .
3. Right-click the mouse and select the Resume ruler command.
4. Perform polygonal linear measurement.
This tool is also available from the model context menu and from the Volume main menu
item.

3.7.3 Corner 3D Meter

To measure an angle on the model:
1. Select the Corner 3D meter tool on the toolbar.
2. Make two points on the model clicking the left mouse button. The second point is the
angle apex.
3. Move the cursor over the screen to set the other side of the angle.
4. Click the left mouse button to fix the second side of the angle.
5. To cancel an incomplete measurement, press Esc.
To move the corner 3D meter point:
1. Activate the Corner 3D meter tool.
2. Locate the cursor on the point to be moved.
3. Drag the point holding the left mouse button.
To remove the corner 3D meter:
1. Activate the Corner 3D meter tool.
2. Locate the cursor on the line of the Corner 3D meter to be deleted.
3. Right-click the mouse and select the Remove corner tool command.
This tool is also available from the model context menu and from the Volume main menu
item.

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3.8 Markers

Functionality is available in the Pro edition

Working with markers is mostly similar to the procedure described in Section 5.6. The
differences are as follows:
• To drag a marker, locate the cursor on the circle in the middle of the marker. If the image
scale is relatively small, the circle size may exceed the marker size.
• If the marker is on a surface currently hidden behind other tissues, only the circle in the
middle of the marker will be visible, and the marker itself will be hidden. If you drag the
marker, it will be moved to the model surface that is currently visible. The line marker in
this situation is not visible.

3.9 Export Model

All tabs can not fit in the box, in this case, scroll through the tabs using the left and right
arrows .
The export of a model to DICOM or to an image is similar to image export described in
Section 2.21.

3.9.1 Export Rotation to Series

To export rotation to series:
1. Set the series description.
2. Specify the rotation axis (the default is Y).
3. Set the rotation angle (the default is 90 degrees).
4. Set the rotation step (the default is 5 degrees).
5. If you need to load the exported series to the server at once, check the option Upload
exported series to the default server. If the default server is not specified in the
Viewer, this option will be inactive.
6. Specify the image size if necessary.
7. To export the rotation, click OK. To cancel, click Cancel.

3.9.2 Export Rotation to Images

To export rotation to images:
1. Set the path to the folder for export.
2. Enter the file name.
3. Select the file extension from the drop-down menu. Other parameters are described in
the previous section.
4. To export the rotation, click OK. To cancel, click Cancel.
This tool is also available from the Volume main menu item.

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3.10 Render settings

The tool allows you to set up a quality of the model during the moving and in a static state.
Opacity threshold allows to ignore relatively transparent tissue when performing measure-
ments and creating segments. That is, tissue which transparency level below a predetermined
value, will be visible, but the points of the measuring tools will be projected on the tissue with
a higher level of transparency. Such tissue will not be included in the segment.
To set up quality:
1. Click on the «Render settings» button on the toolbar. The dialog shown in Fig. 3.6
will be displayed.
2. Move the sliders to set up the quality of the model during the moving (Dynamic quality)
and in a static (Static quality). Move the slider to the right for maximum quality.
3. Set the opacity threshold (in percentage) for the measuring tools (the Point projection
parameter) and for segmentation (the Segmentation parameter).
4. Click the Close button.

Figure 3.6: Render settings dialog box

It the quality is high, update image may be delayed because of low computer resources.

3.11 Reconstruction by Series with Varying Distances be-

tween Slices
If a series contains images made with a varying step, volume reconstruction by the standard
algorithm is impossible. There are two solutions to this problem.
1. Missing images are interpolated (recreated). In this case the reconstruction will not be
exact. The Viewer will return a warning like Series slice distance varies too much:
most unique distance: 7.5 mm; min distance: 7.5 mm; max distance: 22.5 mm.
Model may be innacurate.
2. The reconstruction is made by the part of the series where the distances between slices
are the same. In this case the reconstruction will be incomplete. The Viewer will return a
warning like Series slice distance varies too much. Only slices 1-22 of 28 are used.
The first method is used by default. For details on how to specify the preferable reconstruc-
tion method, see Section 15.4.3.

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3.12 Remove Bone Tissue

3.12.1 Remove Bone Tissue for DualScan and DualEnergy
The series in a study should contain the same number of images with identical position, one
made with contrast and the other without it. To remove the bone tissue:

1. Open any series of the study in the series fusion window by clicking the Series fusion
button on the toolbar. The Series fusion tab will open.

2. Go to the study list tab.

3. Drag the other series of images to the Series fusion tab holding the left mouse button
(Fig. 3.7). The Series fusion tab will open again. If both series meet the bone tissue
removal conditions, the Bones removal mode button will appear on the toolbar. If
the series cannot be dragged, the cursor will look like this: .

4. To remove the bone tissue, click the Bones removal mode button.

5. To set up the maximum bone density value, click on the arrow on the right side of the
Bones removal mode button, select the Bones removal options item from the
button menu, and specify the required value in the dialog box that appears.

6. Click the Volume Reconstruction button on the toolbar.

Figure 3.7: Series fusion tab button

3.12.2 Remove Bone Tissue Manually

Functionality is available in the Pro edition

You can remove the bone tissue for any series specifying the required parameters manually.
To remove the bone tissue manually:

1. Open the series containing bone tissue in the volume reconstruction window.

2. Click the Remove bones button on the toolbar. A dialog box will pop up.

3. Set the Min bones density(HU) value in the dialog box. All tissues whose density
exceeds this value will be deleted.

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4. Set the Grow bones (voxels) value. This value allows you to set the thickness of the
soft bone surface layer in voxels. This layer may have the same density as other tissues.
In this case, if you set the minimum bone density value equal to the surface layer density,
some tissues other than bones may be removed as well. To avoid this, the minimum bone
density is skewed upward, and the soft bone surface layer is deleted using the Grow
bones parameter.
5. Set the Grow tissues (voxels) value. This value allows you to restore other tissues (e.g.
vessels inside bones) removed together with the bone tissue. Tissues are restored only in
locations contacting with bone tissue.
All these values should be adjusted experimentally. The default values are not optimum.
To remove bone tissues with a lesser density, click the Remove bones button and
reduce the minimum bone density value. If the value turns out to be too small, undo the last
removal using the Undo button, and increase the minimum bone density value during the
next removal.
This tool is also available from the Volume main menu item.

3.12.3 Remove Bone Tissue for Fused Series

Functionality is available in the Pro edition

This tool is used for angiographic and other studies containing at least one series with
contrast and without one for the same body area.
To remove the bone tissue:
1. Fuse the series with contrast and without one in the Series Fusion window (see Section 4).
2. Open the fused series in the Volume or Multiplanar Reconstruction window.
3. Select the series with contrast. By default the first series is selected.
4. Click the Subtract bones (choose layer to subtruct from first) button on the
toolbar. In the dialog that opens enter the name of the new series. The process may take
some time. Upon completion, a series without bones will appear on the series panel for
this study. Open this series in the desired mode.

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Chapter 4

Series Fusion

4.1 Volume Reconstruction of Cardiac Studies

4.1.1 Create Series Fusion

Functionality is available in the Pro edition

To create a series fusion:

1. Open the Cardiac CT study.

2. Select the series containing the CT data.

3. Click the Series fusion button on the toolbar or select the View menu and Series
fusion item. The selected series can be found on the Slice list panel.

4. Select the series containing the PET data on the Available series panel.

5. Click the Add series as a new fusion layer button. If the series fusion is already
open in the Multiplanar reconstruction or Volume reconstruction window then the series
will be also added in these windows.

6. To delete a slice click the Remove fusion layer button or select the Fusion
menu and the Remove layer item. If the series fusion is already open in the Multiplanar
reconstruction or Volume reconstruction window then the series will be also removed in
these windows.

7. Open the series fusion in the Volume reconstruction, Multiplanar reconstruction or Virtual
endoscopy window by clicking the corresponding button on the toolbar.

The series fusion will appear on the current study series panel and may as well be opened
from there.

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4.1.2 Play a Reconstruction

Functionality is available in the Pro edition

Open the series fusion in the volume reconstruction window.

To start, click the Play button on the view management panel (Fig. 4.1).

Figure 4.1: View management panel

To set the playing speed, click on the arrow on the right side of the Play button and select
the speed from the list or set the value manually by clicking the Set button. To loop the playing,
activate the Repeat button.
To switch to the needed image, move the scroll on the view management panel.
To navigate between images, use the cursor management keys ( or to switch to
the next image, or to go back to the previous image). To do this, click the left
mouse button on the scrollbar first.
If you click the left mouse button on an image, the management keys will perform other
functions:

zoom in;

zoom out;

pan the image to the right;

pan the image to the left.

To open the Slice list panel (Fig. 4.2), click the Select slice button on the toolbar.

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Figure 4.2: Slice list panel

The window level and width parameters are set separately for each slice. To set the
parameters for a specific slice, select the slice from the list.
Other features of the volume reconstruction window are described in Chapter 3.

4.2 Merge Series from Different Studies

Functionality is available in the Pro edition

To merge series from different studies:

1. Select the first study from the study panel.

2. Select one of the series from this study.

3. Click the Series fusion button on the toolbar or select the View menu and the
Fusion item. The Series fusion tab will be opened.

4. Switch to the previous tab.

5. Select another study from the study panel.

6. Select the series to be merged with the selected series from the first study.

7. Drag the series to the Series fusion tab. The second series will be added to the slice list
(Fig. 4.3).

8. To delete a slice click the Remove fusion layer button or select the Fusion menu
and the Remove layer item.

9. Set the visualization mode for the second slice (see Section 2.16.1).

The order of selecting series is important. The first (basic) series of images is located
behind the second series in the flat image view window. The volume model is based on the
first series, and even if the second series covers a larger volume of tissue, only those pictures

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are used in the reconstruction, the location of which is the same in both series, and others are
ignored.

Figure 4.3: Slice list

Merged series can be opened in the Volume Reconstruction, Multiplanar Reconstruction,

Screw Installation and Virtual Endoscopy windows.

4.3 Merge layers

Functionality is available in the Pro edition

Fused layers do not always coincide, particularly in cases when two different studies are
fused (Fig. 4.4). In this case you need to merge layers.
To merge layers:

1. Open the fused series in the Multiplanar Reconstruction window by clicking the MPR
reconstruction button on the toolbar.

2. In the Multiplanar Reconstruction tab open the Layers list panel by clicking the Choose
layer button. There is a Layers Merge Panel at the bottom of the Layers list panel
(Fig. 4.5).

3. Select the layer which must be merged with the base one.

4. Merge layers automatically (see Section 4.3.1), manually (see Section 4.3.2) or by points
(see Section 4.3.3).

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Figure 4.4: Not merged layers

Figure 4.5: Layers Merge Panel

4.3.1 Merge layers automatically

Functionality is available in the Pro edition

To merge layers automatically:

1. Click the Merge layers automatically button on the Layers Merge panel (Fig. 4.5).
This starts the merging process, the Optimizing correlation dialog will open.

2. To cancel merging process click the Cancel button on the Optimizing correlation dialog.

3. When merging process is completed, click the Done button.

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4. Merging quality can bee poor if the tissue density on the merged layers is very different.
In this case check the Gradient correlation box on the Layers Merge panel and repeat
steps 1-3.
5. To change the merge accuracy, move the Accuracy slider on the Layers Merge panel.
Move the slider to the right for maximum quality. High accuracy requires more time to
merge.

4.3.2 Merge layers manually

Functionality is available in the Pro edition

To merge layers manually:

1. Click on the left side of the Manual layer fusion button.
2. Match the images in three projections. To do this:
• drag the selected slice holding the left mouse button or pressing the cursor manage-
ment keys , , and ;
• rotate the selected slice holding the right mouse button;
• zoom the selected slice in and out holding the Ctrl key and the left mouse button.
3. To cancel all transformations, click the Reset layer transformations button.
4. To cancel zoom, click the Reset layer zoom button.
5. To set the displacement step click on the arrow on the right side of the Manual layer
fusion button and select the item Set step... and set the value.
6. When the slices are matched satisfactorily, close the MPR reconstruction tab. The
Series fusion tab will reappear on the screen.
7. Browse the series fusion images to see the result. If the result is unsatisfactory, repeat a
merge proccess.

4.3.3 Merge layers by control points

Functionality is available in the Pro edition

To merge layers by control points:

1. Select the base layer on the Layers list panel.
2. Activate the Fit layers by points tool on the Layers Merge panel.
3. Make all the layers transparent except the base one. To do this, move the slider to the
left of the layer thumbnail down. Transparency slider is highlighted in red in Fig. 4.6.
4. Put at least three control points on the image. Each point has its own colour and number.

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5. Select the layer that you want to fit with the base. Make all the layers transparent except
this one.

6. Put on this layer the same number of control points in the same places, as on the base
layer. Points numbering starts over again. Colours of the corresponding points are same.

7. If necessary, adjust the position of points on all three orthogonal plains. When you locate
the cursor on a point, it is highlighted in all three orthogonal plains.

8. To delete point, locate the cursor on it, right-click the mouse and select the Remove
point item.

9. To switch to slices containing a point, move the cursor to this point, right-click the mouse
and select the Go to point item. A point on the current slice is brighter than others.

10. To delete all points, click on the arrow on the right side of the Fit layers by points button
and select the Remove all points item. In the dialog box that opens, click Yes to confirm
the deletion, or click No to cancel.

11. To change the point properties, click on the arrow on the right side of the Fit layers by
points button and select the Points properties item. In the window that opens, set the
diameter of the points.

12. Click on the arrow on the right side of the Fit layers by points button and select the Fit
layers item. The second layer will be moved in such a way that the corresponding points
were as close to each other.

13. If necessary, adjust the position of the points and repeat the previous step again.

14. If necessary, add the same number of points on the all layers.

Figure 4.6: Control layer slider

Fig. 4.7 illustrates the example of control points location. Red dots (#1) are located on the
tip of the nose, green (#2) on top, blue (#3) on the right eye.

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 4.3. MERGE LAYERS

Figure 4.7: Control points

If the points are set correctly, they match with minor errors. If the points are set inaccurate,
the result looks something like in Fig. 4.8.

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Figure 4.8: Control points are matched with a large error due to location
errors

4.4 Image registration

Functionality is available in the Pro edition

This tools allows you to deform the images so that their coincidence is maximal. If the
inconsistencies of the series are too large (for example, the patient has turned), you must first
merge the layers manually or automatically (see Section 4.3), and then register the images.
If the study contains images with a changing density over time (for example, due to the
introduction of contrast), then registration may not be performed correctly. To do this, exclude
tussue with varying density.

• Set the maximum value of the density for which registration is performed. In this case
tissue with a density higher than the specified value do not participate in the registration
and their deformation is performed according to another algorithm.

• Check the Use image gradient in the Series registration settings dialog. This mode
requires a large amount of video card memory. If the registration failed due to the lack
of memory of the video card, turn off this mode or select a CPU(software) render device
(see Section 15.4.3).

If the images contain air outside the patient’s body then the density of such areas for CT
examinations is usually less than or equal to -1024. It makes no sense to register these sections
of images. So for CT studies the default minimum density value is -1023.
If the registration failed due to a lack of video card memory, select the CPU(Software)
render device (see Section 15.4.3). In this case registration takes more time, but it is performed
regardless of the amount of GPU memory.

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4.4.1 Series registration

Functionality is available in the Pro edition

To register two series:

1. Create a fused series of at least two series.

2. Open the fused series in the Multiplanar Reconstruction window.

3. If the inconsistencies of the series are too large (for example, the patient has turned), you
must first merge the layers manually or automatically (see Section 4.3). More accurate
merging of layers allows faster registration.

4. Open the segmentation panel by clicking the Segmented structure panel button.

5. Select a base layer on the layers panel (fixed layer). Its images will not be changed.

6. Click the Volumes registration button. The dialog shown in Fig. 4.9 appears. If
more than two series are fused, then a list from which you must to select one series is
displayed in the dialog (fig. 4.10).

7. The Output series description field will be automatically filled in based on the name of
the series being registered and will contain the mark (registered). If necessary change
the description.

8. Select desired registration options checking the Affine registration, Non rigid registra-
tion and Use image gradient boxes.

9. Set the minimum size of parts that will affect registration. The default size is 20 voxels.
The smaller the value the more minor details are registered, but the risk of incorrect
registration increases.

10. Set the percentage of voxels that are used during registration. The larger the value, the
higher the accuracy, but the lower the registration rate.

11. If it is necessary to perform registration for a specific range of densities then set the
minimum and/or maximum values. To do this, set the appropriate flag and enter a
numeric value. If the flag is set but the value is not set then the OK button is unavailable.
For CT series the minimum default value is -1023.

12. Click OK to export the series or Cancel to cancel. Registration can take a long time
depending on the amount of RAM and speed of the computer.

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Figure 4.9: Series registration settings dialog

Figure 4.10: Selection of a series for registration

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 4.4. IMAGE REGISTRATION

4.4.2 Phases registration

Functionality is available in the Pro edition

To register the phases of one series:

1. Open the multiphase series in the Multiplanar or Volume Reconstruction window.

2. Open the segmentation panel by clicking the Segmented structure panel button.

3. Click the Volumes registration button. The dialog shown in Fig. 4.11 appears.

4. The Output series description field will be automatically filled in based on the name of
the series being registered and will contain the mark (registered). If necessary change
the description.

5. Select the base phase that should not be changed (fixed phase).

6. Select desired registration options checking the Affine registration, Non rigid registra-
tion and Use image gradient boxes.

7. Set the minimum size of parts that will affect registration. The default size is 20 voxels.
The smaller the value the more minor details are registered, but the risk of incorrect
registration increases.

8. Set the percentage of voxels that are used during registration. The larger the value, the
higher the accuracy, but the lower the registration rate.

9. If it is necessary to perform registration for a specific range of densities then set the
minimum and/or maximum values. To do this, set the appropriate flag and enter a
numeric value. If the flag is set but the value is not set then the OK button is unavailable.
For CT series the minimum default value is -1023.

10. Click OK to export the series or Cancel to cancel. Registration can take a long time
depending on the amount of RAM and speed of the computer.

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Figure 4.11: Phases registration settings dialog

4.5 Actions with the fused series

Functionality is available in the Pro edition

Action buttons on the toolbar:

The Rotate is described in Section 2.11

The Zoom is described in Section 2.11

The Pan is described in Section 2.11

The Adjust W/L is described in Section 2.12

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 4.6. IMAGE STITCHING MODE

The Ruler is described in Section 2.14

The Corner meter is described in Section 2.14

The Cobb angle is described in Section 2.14

The Point value is described in Section 2.14

The ROI rectangle is described in Section 2.14

The ROI ellipse is described in Section 2.14

The ROI polygon is described in Section 2.14

The Delete all annotations and measurements is described in Section 2.14

The Quick export images is described in Section 2.21

The Add to print list is described in Section 16

4.6 Image stitching mode

Functionality is available in the Pro edition

If the study contains several series that are the results of scanning sections of an extended
area, then such series can be fused into one in the «stitching» mode. The mutual arrangement
of images from different series is determined automatically according to the scanner data.
To «stitch» images:

1. Open the study containing the series that need to be «stitched» in the series fusion
window.

2. Make a series fusion. If the image does not fit in the window, use the image positioning
tools Zoom and Pan (see Section 4.5).

3. Press the Image stitching mode button on the toolbar. The image will change as
shown in Fig. 4.12 (right image is the image after «stitching»).

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Figure 4.12: Changes in the «stitching» mode (right image is the image
after stitching)

In the «stitching» mode the Adjust W/L tool applies to the entire series.

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Chapter 5

Multiplanar Reconstruction (MPR)

5.1 Open Study in Multiplanar Reconstruction window

To open a study in the multiplanar reconstruction window:

1. Load the studies to the Viewer.

2. Select the target study from the study panel.

3. Click the MPR reconstruction button on the toolbar. To select the tab location (in
the current window, in a separate window or in the full screen mode), click on the arrow
on the right side of the button. To open the multiplanar reconstruction window in a new
tab in the current window, click on the left side of the button. The process may take some
time.

Fig. 5.1 illustrates the multiplanar reconstruction window.

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Figure 5.1: Multiplanar reconstruction tab

5.2 MPR View Elements

The tab will display four image view windows. The top left window displays the axial section,
the right window shows the coronal section, the left bottom window contains the sagittal section
.
The Viewer allows you to move the borders between image view windows. To do it locate
the cursor on the border so that it would look like or , and drag the border holding the
left mouse button. You can set up image view windows borders priority (see Section 15.4.1).
For details on how to save image view windows configuration see Section 15.4.3.
The top part displays the toolbar on the left (Fig. 5.2) and the image setup panel on the
right (Fig. 5.3).

Figure 5.2: Toolbar

Figure 5.3: Image setup panel

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5.3 View Images

View images is similar to view flat images. To switch to other image roll the mouse wheel or
use the scrollbar on the rigth side of the window.
To activate/deactivate automatic playback of images in the selected window click on the
Play button on the windows header (marked by an arrow in Fig. 5.4). For details see Sec-
tion 2.10.

Figure 5.4: The Play button

5.4 Working with Orthogonal Planes

5.4.1 View Modes
Click the Switch navigation mode button and select one of the four view modes:
1. 3D cursor mode. Allows you to drag and rotate orthogonal cutting planes using the
mouse. The Switch navigation mode button will look as follows: .
2. On click 3D cursor mode. Allows you to move orthogonal cutting planes similarly to the
3D cursor mode, but the plane lines are visible only during the dragging (while the left
mouse button is pressed). The Switch navigation mode button will look as follows:
.
3. Planes cursor mode. The cutting planes are displayed permanently. Their moving is
described in the next section. Rotation of planes is similar to the 3D cursor mode and
described in Section 5.4.2. The Switch navigation mode button will look as follows:
.
4. Curve mode. This mode is described in Section 5.5. The Switch navigation mode button
will look as follows: .

5.4.2 Working with Planes in 3D Cursor Mode

To move orthogonal planes, click the left mouse button at the point to move the planes to, or
move the mouse holding the left button. When the button is released, the position of the planes
is fixed. To rotate a plane maintaining orthogonality:
1. Locate the cursor on the radial bidirectional arrow on the plane line (see red arrows in
Fig. 5.5). The bidirectional arrow will be highlighted.
2. Move the cursor holding the left mouse button to rotate the plane by the required angle.
The images in the other planes will change.

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3. Release the left mouse button to fix the current position of the plane.

Figure 5.5: Rotate an orthogonal plane

To rotate a plane without maintaining orthogonality follow the steps above holding the Shift
key while performing the 2nd step.
To undo the rotation of all planes, click the Undo rotation button on the toolbar . Note
that all other view changes will be undone as well.

5.4.3 Working with Planes in the Cutting Plane Mode

The Viewer allows you to move planes one by one in the image view modes. To do this:

1. Locate the cursor on the plane line to highlight it.

2. Move the line holding the left mouse button.

Scroll the images in some window to see how the target plane is moving in other windows.
For convenience, zoom the image in and out by rolling the mouse wheel holding the Ctrl key.

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5.5 Curvilinear Reconstruction

5.5.1 Build Surface

Functionality is available in the Pro edition

To build the surface the reconstruction will be based on, switch the Viewer to the curvilinear
reconstruction mode (see Section 5.4.1).
Curvilinear reconstruction is a section of tissues by a curvilinear surface whose configuration
is set by the trajectory passing through the middle of this surface. This trajectory is called a
curve. To build a surface:

1. Select the plane in which it would be convenient to start building a curve.

2. Roll the mouse wheel to select the slice where the first point will be located.

3. Fix the first point on the image by clicking the left mouse button.

4. If necessary, move to another slice by rolling the mouse wheel.

5. Move the mouse to select the location of the next point. Fix the point by clicking the left
mouse button. The point will appear in the current slice.

6. Repeat Steps 4 and 5 until the last but one point is fixed.

7. Fix the last point by right-clicking the mouse. While building the curve, the current section
will be displayed in the bottom right-hand window. The other windows will display the
projections of the curve to the corresponding planes (Fig. 5.6).

8. If necessary, correct the projections of the curve on the two other planes. For details on
how to correct, see the next section.

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Figure 5.6: Reconstruction by a curve

5.5.2 Curve settings

Functionality is available in the Pro edition

To adjust the curve move the cursor to the curve so that it would look like , right-click
the mouse and in the dialog that opens select the Set curve properties... item. You can set
up the following parameters:
• color;
• line width;
• showing the curve in the curvlinear reconstruction window (bottom right-hand window).
If you check the Set as default box then current settings will be used by default.

5.5.3 Actions with a Curve

Functionality is available in the Pro edition

Actions with a curve can be performed only if the curvilinear reconstruction mode is active.
The following actions are available:
• Drag point. Locate the cursor on the point so that it would look like , and drag the
point holding the left mouse button. Then release the left mouse button.

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 5.5. CURVILINEAR RECONSTRUCTION

• Add point. Locate the cursor on the curve where the point should be added, so that the
cursor would look as follows: . Right-click the mouse and select the Add point
item.

• Delete point. Locate the cursor on the point so that it would look like . Right-click
the mouse and select the Remove point item.

• Continue curve. Locate the cursor on one of the border points of the curve, so that the
cursor would look like this: . Right-click the mouse and select the Resume curve
item. Then perform Steps 3 and 4 of the curve building algorithm.

• Delete curve. Locate the cursor on any position on the curve where there is no point, so
that the cursor would look like this: . Right-click the mouse and select the Remove
curve item.

5.5.4 Position of a Curve, Its Nodes and Surface in Space

Functionality is available in the Pro edition

By the color of the curve you can determine which part of the curve is located in front of
the current image in space. This part of the curve is brighter than the part behind the image.
In Fig. 5.7, the central part and the third point are a brighter color. This means they are
located in front of the current section.

Figure 5.7: Reconstruction by a curve

To make it easier to find a node on the curve on all projections, locate the cursor on this
node, so that it looks as follows: . The node will be magnified on all projections.
To rotate the surface relative to the curve, move the cursor to the bottom right-hand window
(Surface by curve) and roll the mouse wheel.

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5.6 Markers

5.6.1 General

Functionality is available in the Pro edition

A marker is a point, line or polygonal line in space associated with the model. The Viewer
allows you to display the length of the marker line and the polygonal marker line and the angles
of the polygonal marker line.
The following tools are used to add markers Marker, Line marker and Polygonal Line
marker. To select one of this tools, click on the arrow on the right side of the tool selection
button. The button will look different depending on the selected tool:

Marker (selected by default)

Line marker

Polygonal Line marker

To activate or deactivate the tool that is currently selected, just click on the left side of the
tool selection button. If some tool is activated, the button is highlighted.
The added markers are located in the displayed slice.

5.6.2 Add Markers

Functionality is available in the Pro edition

To add a marker as a point:

1. Activate the Marker tool by clicking the button on the toolbar.

2. Mark a place on an image by clicking the left mouse button. The marker will appear in all
three windows.

After adding all markers, deactivate the Marker tool.

This tool is also available from the image context menu and from the MPR main menu item.

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5.6.3 Add Line Markers

Functionality is available in the Pro edition

To add a Line marker:

1. Activate the Line marker tool by clicking on the button on the toolbar.

2. Click the left mouse button on the image to mark the first point.

3. Move the cursor over the screen to find the second point.

4. Click the left mouse button to fix the current point. The line marker will appear in all three
windows.

5. To cancel an incomplete adding, press Esc.

After adding all line markers, deactivate the Line marker tool.
This tool is also available from the image context menu and from the MPR main menu item.

5.6.4 Poilygonal Marker line

Functionality is available in the Pro edition

To add a Poilygonal Marker line:

1. Activate the Polygonal Line marker tool by clicking on the button on the toolbar.

2. Mark a point by clicking the left mouse button.

3. Repeat the previous steps until the last but one point is fixed.

4. Fix the last point by right-clicking the mouse.

5. To cancel an incomplete adding, press Esc.

After adding all polygonal line markers, deactivate the Polygonal Line marker tool.
To continue the polygonal marker line, move the cursor to the end point of the line, right-click
and select the Continue line item.
This tool is also available from the image context menu and from the MPR main menu item.

5.6.5 Actions with Markers

Functionality is available in the Pro edition

Actions with markers are performed only if any tool for creating markers is activated. The
following actions are available:

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• Drag point or line and polygonal line marker points. Locate the cursor on the marker or
point, so that it would look like , and drag it holding the left mouse button. The
location of the marker will change accordingly in all windows. The marker will be moved
parallel to the displayed slice.

• Remove. Locate the cursor on the marker, so that it would look like , right-click the
mouse and select the Remove marker item.

• Remove all markers. If you need to delete all markers, locate the cursor on any marker
so that it would look like this: , right-click the mouse and select the Remove all
markers item, or select the corresponding item from the Marker tool menu.

5.6.6 Marker Properties

Functionality is available in the Pro edition

You can set the following properties:

• Text;

• Diameter or Line width;

• Color;

• Show length (for Line Markers);

• Show angle (for Polygonal Line Markers).

To set properties for an already added marker, activate any tool for adding markers, locate
the cursor over the marker, right-click and select the Set marker properties... item.
To set the default marker properties, click the arrow on the right side of the Marker
button and select one of the Set Default Marker Properties..., Set default marker line
properties... or Set default marker polygonal line properties... items.

5.6.7 Position of Markers in Space

Functionality is available in the Pro edition

If the marker is in or near the current slice, it is displayed as a circle, otherwise it is displayed
as a ring with a dot in the center. The further the marker slice is from the current slice, the
darker the marker is.
You can determine how is marker line located relative to the plane of the current image by
the color of the marker line. The line (or its part) located in front of the plane is brighter than
the line (part) behind the plane. In Fig. 5.8 bottom part of the line is located behind the image.

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 5.7. RECONSTRUCTION MODES. SLICE THICKNESS

Figure 5.8: Position of Line Marker in Space

5.7 Reconstruction Modes. Slice Thickness

5.7.1 Render Modes

To switch between modes, the Switch render mode button on the toolbar is used.
Four render modes are available:

1. MPR mode. Sections are available for viewing. Set by default.

2. MIP mode . A slice of a particular thickness is viewed instead of a section. A point with
maximum intensity in the slice is projected to each point on the image. For details on how
to set the thickness, see the next section.

3. mIP mode . Similar to the previous mode, but points with minimum intensity are projected
to the image.

4. AIP mode. Similar to the previous mode, but the intensity of each point equals the average
intensity of points projected to this point on the image.

This tool is also available from the MPR main menu item.

5.7.2 Slice Thickness

In the MIP, mIP and AIP render modes the slice thickness is set using the Thickness
button on the toolbar. Click the button and select predefined values from the list, or click the
User defined button to specify your own value. In the any projection window the slice borders
are marked by lines (the red arrows in Fig. 5.9).
To set the thickness of only the slice which is projected to the single plain move the cursor to
the any line, marked by the arrows in Fig. 5.9, for the corresponding slice and move it holding
the left mouse button.

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Figure 5.9: Slice borders

Setting the thickness is also available from the MPR main menu item.

5.8 Rotate Image in the Section Plane

To rotate an image by an angle multiple of 90 degrees:

1. Activate the window in which the target image is located. To do this, click the left mouse
button on the window area or header (marked by an arrow in Fig. 5.10).

2. Click on the arrow on the right side of the Rotate by 90 degrees clockwise button
and select the angle from the drop-down menu.

3. To restore the initial image position, select the Set 0 degrees rotation angle item.

4. To rotate the image by 90 degrees clockwise, just click on the left side of the Rotate by
90 degrees clockwise button.

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 5.9. MIRROR IMAGE HORIZONTALLY/VERTICALLY

Figure 5.10: Window header

To cancel rotation of all images, click the Reset view orientation button on the toolbar
. Note that all other view conversions will be undone as well.
This tool is also available from the image context menu and from the MPR main menu item.

5.9 Mirror Image Horizontally/Vertically

The tool is described in Section 2.27.

5.10 Show labels tool

The tool is described in Section 2.20.
On the MPR reconstruction tab this tool has 3 items in menu, which can be checked
independently:

• Show orientation cube;

• Show orientation letters;

• Show render annotations.

This tool is also available from the image context menu and from the MPR main menu item.

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5.11 Export Images

The export of a model to DICOM or to an image is similar to image export described in
Section 2.21.

5.12 Reslice

Functionality is available in the Pro edition

The reslice functionality allows you to export the series generated in multiplanar reconstruc-
tion window, setting the area, size, step images and other parameters.
To reslice:

1. Select the plane whose sections should be exported to the series. To do this, click the
left mouse button on the corresponding window.

2. Open the image export window by clicking on the Quick export images button.
The window will look as shown in Fig. 5.11.

3. Enter the series description in the dialog shown in the Fig. 5.12.

4. Set the step to generate images in the series.

5. Set the images number.

6. If you need to load the exported images to the DICOM server at once, check the option
Upload image to the default server. If the default server is not specified in the Viewer,
this option will be inactive.

7. Set the image size if necessary.

8. Image area that is to be exported, highlighted by white frame positioned symmetrically

with respect to the intersection point of cutting planes. To resize the area, drag the white
frame holding the left mouse button.

9. To rotate the reslice area, rotate the cuttings planes. The cutting planes are described in
Section 5.4.2.

10. The other two planes display projections of the exported slices. If necessary, move or
rotate them in the same way.

11. Click OK to export the series or Cancel to cancel.

This tool is also available from the MPR main menu item.

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 5.12. RESLICE

Figure 5.11: Reslice

Figure 5.12: Reslice dialog box

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5.13 Measurements
Measurements are conducted in the same way as for flat images (Section 2.14).
Additionally, the 3D Polygonal ruler tool is available in the MPR window. For details
on how to work with this tool, see Section 3.7.2.

5.14 Annotations
Annotations are descrideb in Section 2.25.

5.15 Volume Reconstruction window

In the Multiplanar Reconstruction window you can view and edit a 3D model. To open it, click
the 3D button on the toolbar. The model will be displayed in the lower right window. The
following tools are available for working with the model:

• Clipping box;

• Centrate;

• Select model point;

• 3D Ruler and Polygonal ruler;

• all tools fot editing the model and creation segmented structuresPRO .

The Volume Reconstruction window is described in Chapter 3.

5.16 Diffusion Tensor Imaging (DTI) Mode

Functionality is available in the Pro edition

The Viewer allows you to show result of the fiber tractography for series of Diffusion MRI.
The Fig. 5.13 shows tracks, which are the result of brain tractography.

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 5.16. DIFFUSION TENSOR IMAGING (DTI) MODE

Figure 5.13: Result of brain tractography

Tracks which are the result of tractography are called fibers in the Viewer interface and in
the User Manual.

5.16.1 Open series in DTI Mode

Functionality is available in the Pro edition

The tractography will be performed automatically for the series made in DTI mode when you
open it in Multiplanar Reconstruction Mode. To display fibers over the images not made in DTI

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mode (for the same study):

1. Open the series not made in DTI mode.

2. Click the DTI button on the toolbar.

3. In the dialog that appears select series made in DTI mode.

4. Click Select to display fibers over the images or Cancel to cancel.

5.16.2 Select Visible Fibers

Functionality is available in the Pro edition

If you want to make visible only some fibers, specify areas through which the fibers pass,
which must be visible or invisible. Use ROI tools from the Fibers panel. Use of this tools is
similar to use ROI from the toolbar at the top of the window (see Section 2.14.5). But you
cannot use ROI tools from the top toolbar to adjust the visibility of the fibers.
To make visible some fibers:

1. Open series made in DTI mode or display fibers over the series not made in DTI mode.

2. Select plane and image in which you want to specify the area through which the target
fibers pass.

3. Open the Segmented Structure panel by clicking the Segmented structure panel
button. The Fibers panel will be located at the bottom.

4. Specify area using the ROI tools (Rectangle , Ellipse , Polygon ) on the
Fibers panel. Similar tools from the toolbar at the top of the window cannot be used to
adjust the visibility of the fibers. After making the ROI only the fibers passing through
the region specified by the ROI will be visible. A new group appears in the Fibers panel.
This group includes the new ROI.

5. To delete ROI select it and click the Remove ROI button on the Fibers panel.

6. To make fibers which pass through the area invisible, check the Inverse box for this ROI
on the Fibers panel.

7. To hide ROI, check the Hide ROI box for this ROI (marked with number «1» in Fig. 5.15).
To hide all ROIs in the group check the Hide ROIs box for this group (marked with
number «2» in Fig. 5.15). To hide all ROIs check the Hide ROIs box in the header of
table (marked with number «3» in Fig. 5.15). The visibility of the ROI does not affect the
visibility of the fibers.

8. Make new ROI until you see only target fibers. Only fibers which pass through all ROIs
are visible (or invisible if you check the Inverse box).

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 5.16. DIFFUSION TENSOR IMAGING (DTI) MODE

Figure 5.14: The Fibers Panel

Figure 5.15: ROIs visibility

When you create the first ROI, a group is automatically created for it. New ROIs are added
to the same group.
The flag on the left of the name of the ROI group and the Base fibers group allows you
to display or hide the respective fibers. If the box is checked, then the fibers are displayed.
This flag does not affect the visibility of fibers, it only allows you to temporarily hide them, for
example, to adjust the visibility of other fiber groups.
To make visible other fibers without changing the visibility of the fibers already made visible:

1. If necessary hide already displayed fibers by unchecking the box on the left of the fibers
group name.

2. Show the base fibers by checking the box on the left of the Base fibers group.

3. Add a new group by clicking the Add ROI group on the Fibers panel.

4. Add a new ROI to make visible only target fibers. To make ROI in the right group this
group must be selected before making ROI.

5. If necessary show other fibers by checking boxes on the left of the other group names.

To show the image containing ROI, select this ROI in the table and click the Find ROI
button on the Fibers panel.

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5.16.3 Fibers Color

Functionality is available in the Pro edition

By default fibers are colored in accordance with the DEC (Direction Encoded Color) scheme.
It means that color of the fiber depends on its direction. You can set color for the group
manually. Color is indicated by the pictogram in the DEC mode and by the single-colored
pictogram if the color is set manually.
To set color manually uncheck the DEC box for the group, double-click the left mouse button
on the color pictogram and in the dialog button that appears select the color or leave the default
color.
To swith to DEC scheme check the DEC box.

5.16.4 Scalar Maps

Functionality is available in the Pro edition

The Viewer allows to display scalar maps for series made in DTI mode. The following types
of maps are available:
• Fractional Anisotropy (FA);
• Mean Diffusivity (MD);
• Axial Diffusivity (AD);
• Radial Diffusivity (RD).
By default maps are not displayed. To display the map, select the target map in the drop-
down list Scalar map type (Fig. 5.16). To hide a map select an empty value from the list.

Figure 5.16: Select scalar map

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Chapter 6

Segmentation

Functionality is available in the Pro edition

Segmentation is the division of an object into its component parts for ease of research and
modeling.
Tasks that segmentation solves:

• the researching of separate tissues parts with definite density range. Usually such parts
have a complicated form and are hidden inside the other tissues, however it is impossible
or difficult to highlight it with the cutting tools. E.g.: teeth and them roots, tumors, bones,
vessels;

• the calculation of the volume of tissue, such as tumors;

• the study of mutual disposition of tissue that can not be visible simultaneously;

• fusion segment and a full model to see its location within the tissue;

• export of the structure surface for further use, such as 3D-printing;

• import of objects that are used in the treatment to simulate their location in the tissues.
E.g.: pedicle screws;

• separation of tissues into separate fragments for convenience of perception.

• cutting tissue by mask created from a segmented structure.

To solve these problems the Viewer allows you to build segmented structures both automat-
ically and manually.
Segmentation of tissues is possible in the Volume Reconstruction window and Multiplanar
Reconstructions window. In both modes you work with the same segmented structure (struc-
tures), thereby for its constraction you can use the advantages of both modes, switching
between them.
Fig. 6.1 illustrates the segmented root of the tooth hightlightes in yellow. Fig. 6.1 illustrates
the segmented kidneys highlighted in red and blue. The base volume highlighted with the CLUT
so that the bones can be seen best and the other organs are not visible.

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Figure 6.1: Segmented root of the tooth

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 6.1. THE SEGMENTED STRUCTURES PANEL

Figure 6.2: The Segmented kidneys

6.1 The Segmented Structures Panel

Functionality is available in the Pro edition

The Segmented Structures Panel for 3D reconstruction window is shown in Fig. 6.3. In the
MPR window the panel looks like.

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Figure 6.3: The Segmented Structures Panel

The panel contains the Control buttons:

The Add a new segmented structure button creates a new structure for a visible
parts of a model.
The Copy the segmented structure button creates a structure from an existing
structure or the base volume.
The Restore segmented structure makes the main volume the same as the
selected segmented structure (only for the Volume Reconstruction window).

The Remove segmented structures button removes the selected structure.

The Export segmented structure button exports the selected structure to a series
of DICOM images.
The Create surface for current segment button creates a surface for the
selected structure or for the base volume.
The Remove surface for current segment button removes a surface for the
selected structure or for the base volume.
The Export mesh button exports the surface of the selected structure to a ply, obj
or stl file formats.
The Import surface button imports the segmented structure from ply, obj or stl file
formats.
The Click and Drag segmentation It creates a structure at the point where the
cursor is located and produces its growth within the mask when the cursor is
removed from the starting point. The algorithm for constructing the structure takes
into account the shape of the mask and performs less intensive growth in those
directions in which the mask could be built wrongly.

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 6.2. THE MASK

Volume and statistics for the density are calculated for each structure (Fig. 6.4).

Figure 6.4: Segment parameters

6.2 The Mask

Functionality is available in the Pro edition

The mask is a pattern beyond which the structure is not visible. A mask can be constructed
in different ways:

• by density: the mask includes voxels from a certain range of densities set manually;

• by color table: the mask includes voxels corresponding to the color table;

• by visible volume: the mask includes only voxels that are currently displayed on the
screen.

The mask is not visible in the volume reconstruction window, and it is displayed in green
in the MPR window. If necessary the mask can be inverted, that the tissue not under the
mask are displayed in green. To invert the mask, set the flag Invert edit mask on MPR (see
Section 15.4.3).
The structure can occupy an arbitrary volume that does not go beyond the base volume,
including being empty.
The mask can be changed at any time. If the mask is reduced and the structure goes beyond
the mask, then this part of the structure becomes invisible and is not taken into account in the
calculations. However, it is not removed and when the mask is increased, it becomes visible
again.

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6.2.1 Creating a mask

Functionality is available in the Pro edition

1. Open the segmantation panel by clicking the Segmented structure panel button.

2. Click the Add a new segmented structure button. The dialog shown in Fig. 6.5
appears. Set up the tissue density values for the mask. You can do it in one of three
ways:

• using the Threshold mode. In this mode the mask is set for tissue whose density
is greater or less than the specified threshold value. To set a mask for tissue with
a density less than the threshold, select the Low intensity setting, and vice versa.
Set the threshold;
• using the Interval mode. In this mode the mask is set for tissue whose density is in
the range from minimum to maximum;
• using color tables. In this mode the mask is set for the tissue displayed for the
selected color table.

3. If nessesary adjust the opacity of the mask in percent.

Figure 6.5: Set mask

6.2.2 Mask editing

Functionality is available in the Pro edition

You can edit the mask in several ways:

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 6.2. THE MASK

1. Using the mask settings dialog (only for the MPR window):

(a) Select the target structure on the panel of segmented structures.

(b) Click the Segmented structure editing button on the volume editing panel.

(c) Click on the arrow on the right side on the Add a new segmented structure
button, select the Segmented density config settings item.

(d) Set up values on the dialog that opens.

2. Using the Adjust W/L tool:

(a) Select the target structure on the panel of segmented structures.

(b) Click the Adjust W/L button on the toolbar.

(c) Change the window width and level for the mask (see Section 2.12). The green mask
changes in real time in the MPR window.

3. Selecting a color table from the dropdown list (see Section 2.16.1) or with the Custom
W/L tool (see Section 2.12).

4. For Volume Reconstruction window only: using the Set mask tool (see Section 6.2.3).

6.2.3 Set Mask Tool

Functionality is available in the Pro edition

By default the base volume is the mask for all segmented structures. To set any structure
as the mask for other structure or base volume:

1. Select a ctructure (base volume) for which you want to change the mask.

2. Click on the Set Mask button. The dialog shown in Fig. 6.6 will be displayed.

3. Select the structure (base volume) which you want to set as mask.

4. Click OK to set mask and Cancel to calcel the action.

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Figure 6.6: Select mask dialog

6.3 Creating segmented structure

6.3.1 Creating a structure by copying

Functionality is available in the Pro edition

When creating a structure by copying, a mask is created based on the visible volume and
the structure is automatically filled using this mask. To create a structure:

1. Open the segmentation panel by clicking the Segmented structure panel button.

2. Choose the base volume or the structure created earlier as the initial volume.

3. Click the Copy the segmented structure button.

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6.3.2 Manual structure creation

Functionality is available in the Pro edition

To create a structure manually:

1. Open the segmentation panel by clicking the Segmented structure panel button.
2. Click the Add a new segmentation structure button. Set up the mask in the dialog
that opens (see Section 6.2.1). An empty structure is created with the given mask.
3. Fill out the structure using volume editing tools (see Section 6.4).

6.4 Structure editing

Functionality is available in the Pro edition

When working with segmented structures pay attention to which structure or volume is
selected. All editing operations are performed with a selected visible structure or volume. If
the Visible flag is currently unchecked for this structure or volume then editing is not possible.
If the volume model is open (see Section 5.15) then the created structure appears simulta-
neously on the model. This causes an additional load on the processor. If you want to reduce
the load, click the arrow on the right side of the Growing Region button and uncheck
the Interactive 3D Update item. After this the structure on the volume model will be updated
after the completion of the next stage of creation of a structure.
To edit the structure use specialized tools (described below) and volume editing tools:

• Polygon Cut (see Section 3.4.1);

• Inverse Polygon Cut (see Section 3.4.2);
• Delete Area (see Section 3.4.3);
• Delete All Areas except Selected Area (see Section 3.4.4);
• Brush Cut (see Section 3.4.6);
• Brush Restore (see Section 3.4.6). The use of the tool is possible only if the part ot the
structure is already created;
• Grow (dilation) (see Section 3.4.7);
• Srink (erosion) (see Section 3.4.7);
• Remove noise (opening) (see Section 3.4.7);
• Remove holes (closing) (see Section 3.4.7);
• Fill (see Section 3.4.7).
• Cut Invisible Volume (see Section 6.6);

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• Vessels Tree Segmentation (see Section 6.4.4).

• Union (see Section 6.6);

• Subtract (see Section 6.6);

• Intersect (see Section 6.6);

6.4.1 Tools for automatic structure filling

Functionality is available in the Pro edition

The Segmentation from point by mask tool allows you to create a structure for a bound
area. It is necessary that the mask for this area does not touch the masks of the neighboring
areas. To create a structure:

1. Activate the Segmentation from point by mask tool.

2. Click on the bound area.

3. If the segment was created for a larger area than required, undo the action by clicking
the Undo button. Change the window width and level so that the mask for this area
is not in contact with the masks of the neighboring areas and create the structure again.

The «Vessel tree segmentation» tool works in the same way, however, the vessel
tree is used as a mask instead of a bound area. Study must be done with contrast.
If it is impossible to get a bound area completely separated from other tissues, then if you
use the tool Segmentation from point by mask, there will be leaks (segmentation beyond
the required area). To quickly and with minimal leaks create a segment, use the tool Region
growing :

1. Activate the Region growing tool. The tool modes are described in Section 6.4.3.

2. Select the point on the mask about the center of the region you want to segment.

3. Move the cursor in any direction holding the left mouse button. The segmented structure
will grow. Growth occurs faster in those directions in which the curvature of the surface
is less (in thin sections growth is slower to avoid leaks). The direction of the cursor move-
ment does not matter, the distance from the starting point of the movement is important.
When the cursor moves in the opposite direction, the structure does not decrease.

4. If the structure is completely created or the faster growth will lead to leaks stop growing
by releasing the left mouse button.

5. If necessary repeat growth for tissue not yet segmented.

6. To undo action click the Undo button, to redo the canceled action click the Redo
. However, keep in mind that the tool will operate at regular intervals, so with a single
click on the Undo button you can only delete that part of the structure that was added
during the next actuation, and not in the whole path of the cursor movement.

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6.4.2 Brush restore tool

Functionality is available in the Pro edition

To fill out the structure using the Brush restore tool:

1. Activate the tool Brush restore .

2. Set up the tool diameter. To do this, move the mouse cursor up and down holding the Alt
key on the keyboard.
3. Move the mouse cursor to the area for which you want to create a structure.
4. Click the left mouse button. Tissues that are under the mask and inside the sphere will be
added to the structure. Color tissue changes to the one set for the structure.
5. To undo the action, click the Undo button, to repeate the canceled action, click on
the Redo button.
6. To add a large area to the structure, move the tool Brush restore holding the left
mouse button. However, keep in mind that the tool will operate at regular intervals, so
with a single click on the Undo button you can only delete that part of the structure that
was added during the next actuation, and not in the whole path of the sphere movement.
7. To remove a part of the tissue from the structure, activate the Brush cut tool. The
tool works in the same way as to the Brush restore tool, but unlike Brush restore tool
removes the tissue from the structure.
8. To disable or enable the mask, click the Segmented structure creation button.

6.4.3 Region growing tool

Functionality is available in the Pro edition

When using the Brush restore tool, there may be leaks (segmentation beyond the required
area). The Region growing tool takes into account the shape and density of the segmented
areas and allows to minimize leaks. The tool has two modes: EDT Method and Level Set
Method. To switch the mode, click the arrow on the right of the button and select the
desired mode. The current mode is marked by the flag.
The EDT Method mode allows you to create a structure in the masked space. To create
structure:
1. Activate the Region growing and select the EDT Method mode if necessary.
2. Select the point on the mask about the center of the region you want to segment.
3. Move the cursor in any direction holding the left mouse button. The segmented structure
will grow. Growth occurs faster in those directions in which the curvature of the surface
is less (in thin sections growth is slower to avoid leaks). The direction of the cursor move-
ment does not matter, the distance from the starting point of the movement is important.
When the cursor moves in the opposite direction, the structure does not decrease.

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4. If the structure is completely created or the faster growth will lead to leaks stop growing
by releasing the left mouse button.

5. If necessary repeat growth for tissue not yet segmented.

6. To undo action click the Undo button, to redo the canceled action click the Redo
. However, keep in mind that the tool will operate at regular intervals, so with a single
click on the Undo button you can only delete that part of the structure that was added
during the next actuation, and not in the whole path of the cursor movement.

If the Level Set Method is selected the tool use its own mask created according to a
special algorithm, so created structure can go beyond the standard mask and when you change
mask boundaries will be visible. To create a structure:

1. Activate the Region growing and select the Level Set Method mode if necessary.

2. Select the point on the mask about the center or the region you want to segment.

3. Press and hold the left mouse button. The own tool blue mask appears in the window
in which you work. If the mask is poorly visible against the background of the standard
mask, reduce the opacity of the standard mask. To do this, click the arrow on the right
side of the Add a new segmented structure button and reduce the Opacity value
in the dialog that opens.

4. Evaluate the coverage of the tissues with a blue mask. Density of tissues that are under
the blue mask depends on the density under the cursor. If the blue mask is not built
correctly, then release the left button, cancel the structure creation by clicking the Undo
button or deleting the structure; move the cursor to the tissue section with the desired
density, and repeat this step.

5. The red circle around the cursor shows the curvature of the areas that will be segmented
(the smaller the diameter of the circle allows to segment the tissue with the greater
curvature, that is, the thinner tissues are segmented). To change the diameter of the
circle, move the cursor up or down pressing the Alt key on the keyboard.

6. Move the cursor in any direction holding the left mouse button. The segmented structure
will grow under the blue mask. If the blue mask goes beyond the standard mask, the
structure can be build beyond the standard mask, but it will be visible only within the
standard mask.

7. If the structure is completely created or the faster growth will lead to leaks stop growing
by releasing the left mouse button.

8. If necessary repeat growth for tissue not yet segmented.

9. To undo action click the Undo button, to redo the canceled action click the Redo
. However, keep in mind that the tool will operate at regular intervals, so with a single
click on the Undo button you can only delete that part of the structure that was added
during the next actuation, and not in the whole path of the cursor movement.

If the volume model is open (see Section 5.15) then the created structure appears simulta-
neously on the model. This causes an additional load on the processor. If you want to reduce
the load, click the arrow on the right side of the Growing Region button and uncheck
the Interactive 3D Update item. After this the structure on the volume model will be updated
after the completion of the next stage of creation of a structure.

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6.4.4 Vessel tree segmentation tool

Functionality is available in the Pro edition

This tool is used for segmentation of vessel trees for studies performed with contrast. To
create segment in Multiplanar Reconstruction window:
1. Set the mask so that only the vessels are under the mask.
2. Activate the Vessel tree segmentation tool. Initialization of the tool takes some
time and depends on the performance of the computer, the selected study and the mask.
3. Click the left mouse button in the arbitrary point of the vessel that you want to segment.
The tree of vessels is segmented. The completeness of the segmentation depends on the
correct selection of the mask and the configuration of the vessel.
4. If the vessel is not completely segmented, click the left mouse button on those areas that
need to be segmented.
5. If necessary change the mask. After that you need to re-activate the tool and wait for it
to initialize.
6. It is recommended to open the volume reconstruction window in the multiplanar recon-
struction window (see Section 5.15) and turn off the visibility of the main volume.
7. The tool can also be used in the preview window of the volume reconstruction. The main
volume should be is visible.
To specify the maximum branch angle of a vessel that can be segmented, click the arrow on
the right side of the Vessel tree segmentation button, select the Options... and in the
dialog that opens set the value in degrees.
In the volume reconstruction window the tool works in the same way.
All editing operations are performed with a selected visible structure or volume. If the
Visible flag is currently unchecked for this structure or volume then editing is not possible.

6.4.5 Watershed segmentation tool

Functionality is available in the Pro edition

The tool is used for segmentation using the watershed method and allows you to split the
volume into several non-overlapping parts.
The tool has two modes (directions for basins filling):
1. low dencity for soft tissues separation surrounded by more dense tissues: organs con-
taining air, the brain. In this case, the filling of the basins occurs from a lower density of
tissues to a greater one. The minimum density of tissues (Min dencity) is the point from
which the filling of the basins begins, and the Max dencity value limits the density of the
tissues to be segmented from above.
2. high dencity for dense tissues surrounded by less dense tissues: bones, contrasted
organs. In this case, the filling of the basins begins with the maximum density (Max
dencity) and occurs in the direction of its reduction. The minimum density of the tissues
to be segmented is limited from below by the Min dencity value.

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To speed up the segmentation process and avoid creating unnecessary segments exclude
unnecessary tissues from the segmented volume using the cutting tools.
To perform Watershed segmentation:

1. Select the volume to be segmented.

2. If necessary, cut tissues that do not need to be segmented.

3. Click the Watershed segmentation button.

4. In the dialog that opens set the following parameters:

• Min dencity;
• Max dencity;
• Min depth: minimum depth of basins which can be combined;
• Max basins: maximum number of created structures (no more than 31);
• Select a mode (Low dencity High dencity);
• To hide the source volume after segmentation check the «Hide source structure»
box.

5. Click OK to perform segmentation or Cancel to cancel action. The process takes some
time.

6.4.6 Multi-segment growing tool

Functionality is available in the Pro edition

This tool is used when it is necessary to increase several segmented structures so that
they do not intersect. It is similar to Grow (dilation) (see Section 3.4.7), but can be applied
simultaneously to an arbitrary number of structures and to the base volume. To use the tool:

1. Build the required number of segmented structures that you want to grow without inter-
section.

2. Activate the Multi-segment growing tool (see Section 3.4.7). The dialog shown in
Fig. 6.7 will be displayed.

3. The currently selected structure (base volume) is marked with a flag in the dialog. Check
all the structures (base volume) with flags that you need to simultaneously increase. If
only one structure (volume) is checked then the tool works similarly to the Grow (dilation)
tool.

4. Set the maximum growing radius in the Growing radius (mm) field.

5. Click OK to apply the tool or Cancel to cancel action. The process takes some time. If
the building structures is incomplete repeat steps 2-4.

6. To undo or redo the action use the Undo and Redo buttons for each structure
you have built up.

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Figure 6.7: Multi-segment growing settings dialog

6.5 Building surface

Functionality is available in the Pro edition

The Viewer allows you to create a surface for segmented structures in Volume Reconstruction
window and in Multiplanar Reconstruction window.
To set the export options, click on the arrow on the right side of the Create surface for
current structure button and select the Set surface creation parameters.... A dialog
box, shown in Fig. 6.8, will be displayed.

• The smoothness of the surface is defined by the Smoothing pass count parameter. At
zero value of the parameter form of a surface as close as possible to the structure. With
an increase in the value the surface roughness disappear.

• The maximum number of polygons is defined by the Max triangles count parameter.
Increase in the number of polygons increases the accuracy of the construction of the sur-
face. If the specified number of polygons is redundant or not sufficient for the construction
of the surface, the Viewer will use the value from the acceptable range that is closest to
a given by user.

• The thickness of the shell is defined by the Shell thickness(mm) parameter. If the value
is greater than zero shell has an inner and an outer surface. The both surfaces will be
exported to file.

• To create the surface only for the largest structure, check the Remove secondary sur-
faces box.

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• If the Use current clipping box is checked, then the surface is built only for that part
of the structure, which is inside the cube. If the Clipping box tool is not active, this
parameter is not used.

To apply the settings, click OK. To cancel the settings, click Cancel.
To create a surface, click on the left side of the button.

Figure 6.8: Surface creation parameters

6.6 Union, subtraction and intersection of the structures

Functionality is available in the Pro edition

This tool allows you to create the unions, intersections and subtractions of the structures.
The button will look different depending on which instrument was last used:

Union segmented structures (selected by default)

Subtract segmented structures

Intersect segmented structures

To use a tool that is already selected, simply click on the left side of the tool buttons. To
select another tool, click on the arrow on the right of the button and select the appropriate item
in the list.

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 6.6. UNION, SUBTRACTION AND INTERSECTION OF THE STRUCTURES

6.6.1 Union

Functionality is available in the Pro edition

Unification of structures is the addition of one structure to another. The added structure
remains unchanged. To unite structures:

1. Select the current structure on the Segmented Structure Panel (e.g., the left lung).

2. Click on the Union segmented structures button. The dialog box, shown in
Fig. 6.9, will be displayed.

3. Select the structure to merge with the current one. (e.g., the right lung). If you want
to make right lung invisible after merge, check the Hide selected segmented structure
box. To make it visible later, check the Visible box for this structure.

4. To merge, click OK, to cancel, click Cancel.

After combining the original structure will consist of the tissues contained in both structures.

Figure 6.9: Union

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6.6.2 Subtraction

Functionality is available in the Pro edition

Subtraction structures is the removal of original tissue structure present in the other struc-
ture. To subtract the structures:
1. Select the current structure on the Segmented Structure Panel (e.g., the lungs).
2. Click on the Subtract segmented structures button. The dialog box, similar to the
one shown in Fig. 6.9, will be displayed.
3. Select the structure you want to subtract from the current one (e.g., the rigth lung). If you
want to make right lung invisible after subtraction, check the Hide selected segmented
structure box. To make it visible later, check the Visible box for this structure.
4. To subtract, click OK, to cancel, click Cancel.
After subtracting the right lung tissue will be removed from the original structure (Lungs).

6.6.3 Intersection

Functionality is available in the Pro edition

Intersection of structures is the removal from the one structure of all tissues, except those
present in both structures. To intersect structures:
1. Select the current structure on the Segmented Structure Panel.
2. Click on the Intersect segmented structures button. The dialog box, similar to the
one shown in Fig. 6.9, will be displayed.
3. Select the structure you want to intersect with the current one. If you want to make
the second structure invisible after intersection, check the Hide selected segmented
structure box. To make it visible later, check the Visible box for this structure.
4. To intersect, click OK, to cancel, click Cancel.
After intersection the current structure will consist of the tissues contained in both structures
simultaneously.

6.7 Actions with the structure

Functionality is available in the Pro edition

The Viewer allows you to perform the following actions with the structures:
• Renaming. To do this, double-click the left mouse button on the name of the structure,
enter a new name and press the Enter key on the keyboard.

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 6.8. EXPORT STRUCTURE AND SURFACE

• Disabling visibility. To make the structure invisible, uncheck the Visible box. This action
is also available for the base volume.

• Color change. To do this:

1. Double-click the left mouse button on the Color line. The color selection dialog will
be displayed.
2. To set the color of the original model, select the Use model color item.
3. To set a specific color, select the Use custom color item and select the color in the
dialog box that appears.
4. To apply the settings, click OK in all the dialog boxes. To cancel the settings, click
Cancel.

6.8 Export structure and surface

Functionality is available in the Pro edition

To export the structure to a series of DICOM images, click the Export segmented structure
button. Series will be stored in the local storage and will be available in the Series Panels
for this study.
To export the surface, click the Export mesh button, in the dialog box, that appears,
select the file type (ply, obj or stl) and save the mesh.
To move the reference point (the point about which the model can be deformed in the Vector
graphics editors) to the geometrical center of the mesh, click the arrow to the right side of the
button, click Export surface parameters... and in the dialog box, that appears, check
the Center mesh box.
To use the patient’s coordinates when exporting, click the arrow on the right side of the
button, click Export surface parameters... and in the dialog box that appears, check the
Use patient coordinates box.

6.9 Import surface

Functionality is available in the Pro edition

To import a surface click the Export segmented structure button , in the dialog box,
that appears, select the file and press Open.
To use the patient’s coordinates, click the arrow on the right side of the button, click
Import surface parameters... and in the dialog box that appears, check the Use patient
coordinates box.
To fit the centers of the imported surface and the model when importing, click the arrow on
the right side of the button, click Surface Import Parameters... and in the dialog that
appears, check the Add to the center box.
To move the imported surface manually, activate the tool Surface positioning and
move the surface in the plane of the screen holding the left mouse button.

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6.10 Histograms

Functionality is available in the Pro edition

Actions with color tables described in Section 2.16.3 are available for segmented structures.
The difference is that in the Flat images view mode the histogram is built for the entire density
range, and for the structure it is built for only for the range of the density that corresponds to
the structure mask.

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Chapter 7

Planning of Pedicle Screws Installation

Functionality is available in the Pro edition

This functionality allows you to plane installation of pedicle screws for spine fusion. When
planning method is used, in which the angles of the screws are determined indirectly by mea-
suring the distance from the spinous process at its top to the axis of the screws.

To do this, set the points of introduction of the screw (labeled as A1 and A2 in Fig. 7.1.)
and the distance between the middle of the spinous process (point O) and screw axis (point
B1and B2).

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Figure 7.1: The scheme of screws installation

7.1 Open Study in Planning of Pedicle Screws Installation

window

Functionality is available in the Pro edition

To open study in the Planning of Pedicle Screws Installation window:

1. Load the studies to the Viewer.

2. Select the target study from the study panel.

3. Click the Screws installation button on the toolbar. To select the tab location (in
the current window, in a separate window or in the full screen mode), click on the arrow
on the right side of the button. To open the multiplanar reconstruction window in a new
tab in the current window, click on the left side of the button. The process may take some
time.

Fig. 7.2 illustrates the Planning of Pedicle Screws Installation window.

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 7.2. PLANNING OF PEDICLE SCREWS INSTALLATION WINDOW VIEW ELEMENTS

Figure 7.2: Planning of Pedicle Screws Installation window

7.2 Planning of Pedicle Screws Installation window View

Elements

Functionality is available in the Pro edition

The top left window displays the coronal section, the top 2nd window shows the sagittal
section , 3rd and 5th windows shows additional sagittal sections at some distance from the
section shown in the 2nd window. The 4th windows shows axial section . In this window you
can plan the installation screws.
The Viewer allows you to move borders between windows. To do this, move the cursor to
the window border so that it would look like this: or , and drag the border holding the
left mouse button.
The bottom window shows 9 axial sections located with distance 2mm. The section with 0
index coincides with a section of the axial plane in the top 4th window, and the positive and
negative indices on the other images indicate the offset respectively up and down.
The top part displays the toolbar on the left (Fig. 7.3) and the image setup panel on the
right (Fig. 7.4).

Figure 7.3: Toolbar

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Figure 7.4: Image Setup Panel

Most of the toolbar tools are described in Chapter Multiplanar Reconstruction (MPR),
starting from Section 5.4.

7.3 Planning of Pedicle Screws Installation

Functionality is available in the Pro edition

To plan pedicle screws installation:

1. Activate the tool Pattern screw installation by clicking on the button on the toolbar.
2. In accordance with the scheme in Fig. 7.1 put the following points on the axial plane C1,
B1 (axis of screw #1), C2, B2 (axis of screw #1). Screws scheme similar to shown in
Fig. 7.5 will be displayed on the axial plane.
3. If necessary, set the properties of the Pattern screw installation tool. The tool proper-
ties are similar to properties of other measurement tool (see Section 2.14.7).
4. Adjust the positions of the points if necessary. To do this, Locate the cursor on the point
to magnify the cross, marking the point, and move it holding the left mouse button.
• Points C1 and C2 must match with the tips of screws if you want to calculate the
length of the screws.
• Points A1 and A2 denote points of screws introduction. The points move only along
the axis of the screws.
• Point O should be placed on the vertebral axis (shown by the dotted line in Fig. 7.1)
on the border of the spinous process.
Adjusted screws installation scheme is shown in Fig. 7.6.
5. If necessary, change the angles of inclination of the axial plane so that it is parallel to
the plane in which the screws must be installed. Working with the planes is described in
Section 5.4.
6. If necessary, move the axial plane so that it coincides with a plane in which the screws
must be installed.
7. If necessary, move the measurements results (see Section 2.14.9). The measurement
results are connected to points of the dashed lines tool follows:
• point C1: the length of the segment A1C1 (the length of the screw #1);
• point C2: the length of the segment A2C2 (the length of the screw #2);
• point A2: the length of the segment A1A2 (the distance between the screws intro-
duction points);

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 7.3. PLANNING OF PEDICLE SCREWS INSTALLATION

• point B1: the length of the segment B1O (the length of the segment connecting the
axis of the screw #1 to the center of the spinous process). Need for deflection of
the drill to the desired angle in the axial plane;

• point B2: the length of the segment OB2 (the length of the segment connecting the
axis of the screw #2 to the center of the spinous process). Need for deflection of
the drill to the desired angle in the axial plane.

Figure 7.5: The original screws installation scheme with letter according to
the scheme (the letters are not available in the program)

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Figure 7.6: The adjusted screws installation scheme

7.4 Export images for print

Functionality is available in the Pro edition

The Viewer allows you to export the image of this window for printing. To do this:
1. If necessary, set the resolution (DPI) of the exported image. To do this, click on the arrow
on the right side of the Report button, select Set resolution (300), ... item, where
the current value is shown in brackets, and change the resolution.
2. Click on the left side of the Report button. The process may take some time.
All images from this window are placed in a new series. Also an image containing all 14
images will be created.
To print the image, open a new series in the flat image view window (see Chapter 2). For
details on how to print, see Chapter 16.

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Chapter 8

Vessels analysis module

Attention! This functionality is not available under the standard Pro license and must
be purchased separately. Functionality is available only in 64-bit build of the program.
The Viewer allows you to open CT, MR and XA modality series in the Vessels analysis
module.
The Viewer contains the Vessels analysis module (universal) and the Coronary arteries anal-
ysis module (adapted for the analysis of coronary arteries). Both of these modules are licensed
separately. Their functionality basically coincides and the differences are based on the location
of the coronary arteries.
This chapter describes the Vessels analysis module. Differences in the Coronary arteries
module are described in section 8.4.

8.1 Open Studies in Vessels Analysis Module

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

To open study:

1. Load studies to the Viewer.

2. Select the angiographic study and the series with contrast.

3. Click the Vessels analysis button on the toolbar. To select the tab location (in the
current window, in a separate window or in the full screen mode), click on the arrow on
the right side of the button. To open the virtual endoscopy window in a new tab in the
current window, click on the left side of the button. The process may take some time.

If you open CT then the Viewer ask you to select a series without contrast to remove bones.
In the dialog that opens select the seris without contrast and click OK to remove bones or
Cancel to cancel deletion.
To open the bone removal dialog manually click the arrow on the right side of the New
vessel button and select the Remove bones item. This process takes some time.
The vessels analysis window is shown in Fig. 8.1.

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Figure 8.1: The Vessels analysis window

The windows displays the axial, section, sagittal sections and 3D View. These windows are
used to build the centerline. Vessel sweep is displayed in the Curved Surface window.

8.1.1 Vessels list

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

The built centerlines can be saved in the list of vessels until the window is closed. To save
the built line select the vessels category from the drop-down list Categories in the panel shown
in Fig. 8.2, next select the vessel below and click the Bind button. The pictogram appears
on the right of the selected vessel in the list. To switch to the previously saved centerline select
the vessel in the list and click the Switch to button. To remove the centerline from the list click
the Unbind button. The pictogram disappears. Attention! If the current centerline is
not bound to any of the vessels in the list then when you built the another line, it will
be lost.

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 8.2. CENTERLINE BUILDING MODE

Figure 8.2: Vessels list

8.2 Centerline building mode

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

For analysis it is necessary to build a centerline, which is automatically located in the

conditional center of the vessel. Only one centerline can be built at a time. To save the built
line and build a new one, bind it to a specific vessel from the list in the left part of the window
(see Section 8.1.1).

8.2.1 Building the centerline

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

You can build the centerline in three methods. To select a method click the arrow on the
right side of the New Vessel button and select the appropriate method. The current
method is marked by flag.

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1. Building by one point. In this mode the line is built in both directions from the starting
point for the maximum distance. If along the way of building the vessel splits, then the
line is built in an arbitrary branch. To build, click the left mouse button at the starting
point.

2. Building by two points. In this mode the line is built from the starting to the end point. To
build click at the start and end points.

3. Automatic building by one point. This mode differs from the first one in that the line is
built in both directions from the starting point to the bifurcation points, i.e. to the points
at which the vessel splits or two vessels converge. To build, click the left mouse button
at the starting point.

If the centerline for the selected points cannot be built then the message Centerline building
is failed appears.
The Viewer adds the number of intermediate points needed to set the centerline. For more
accurate positioning of the line move these points manually with the mouse while holding the
left button.
If the line is not completely built then select the point to which you want to resume the line
and click in it. The line will be built from the nearest existing point.
If the line is not built correctly then start building it again by clicking on the New vessel
button, or delete part of the line. To delete a part of the line, delete a segment. The segment
is deleted along with the shorter part of the line adjacent to the point.
To delete a segment right-click on the first point of the segment and select Remove segment
item. The shorter part of the centerline is removed from one side of the point and the section
between this and the next point from the other side.
To delete a point, move the cursor over this point so that all points are highlighted, right-click
and in the context menu select the Remove point command.
To add a point move the cursor to the place where you want to add a point, right-click and
in the context menu select the Add point command. The centerline will change in such a way
as to pass through a new point.
The initial research data or the volume reconstruction data can be used for building. To
select data source click the arrow on the right side of the New vessel button and select
the appropriate source.
The centerline is shown in Fig. 8.3.

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 8.3. VESSELS ANALYSIS MODE

Figure 8.3: The centerline

8.3 Vessels Analysis Mode

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

After building the necessary centerlines switch to the Vessel analysis mode by clicking on
the Analysis mode button. The window in the Vessel analysis mode is shown in Fig. 8.4.

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Figure 8.4: The vessels analysis mode

The volume reconstruction is shown in the 3D View window, the curved surface is shown in
the Curved surface window. The wessel sweep after the centerline straightening with borders
is shown in the Straightened vessel window. The sections by a plane that is perpendicular to
the centerline are shown in the Section window.
You can not edit the centerline. To do it swith to Centerline building mode by clicking the
Analysis mode button.

8.3.1 Vessel borders

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

The Viewer calculates the inner and outer borders of the vessel and the border of calcifica-
tions inside the vessel (Fig. 8.5). If no calcifications are found, then the corresponding value
remains empty. To see tissues that correspond to density ranges click the Show vessel tissue
button. Tissues with an intensity between the inner border and a calcium border (vessel
lumen) are highlighted in green, with an intensity between the outer and inner border (vessel
wall) are highlighted in brown, with an intensity higher than the calcium border (calcifications)
are highlighted in white. The borders of the vessel are built in accordance with the threshold
values, but due to smoothing they do not exactly correspond to the threshold values. In the
Straightened vessel window the green line indicates the inner border of the vessel, red line
indicates the outer border (fig. 8.6). The central line is shown as a straight line. To edit borders
activate the Edit vessel contours tool, click the left mouse button at an arbitrary place
near the border, the border will pass through the selected point. When you move the mouse
while pressing the left button, the border repeats the path of the cursor.

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 8.3. VESSELS ANALYSIS MODE

To change the threshold values enter the new values in the appropriate fields and click the
Apply button. The border will be rebuilt in accordance with the new values. To return to the
threshold values calculated automatically, click the Restore button.
To undo all changes and return to the initial borders click on the arrow in the right side of
the New Vessel button and select the Rebuild edges command.
At the bottom of the Straightened Vessel window there is a graph showing changes of the
vessel lumen. The areas in which stenosis is possible are highlighted in red on the graph, the
remaining sections are highlighted in green.

Figure 8.5: Threshold values panel

Figure 8.6: Highlighted density thresholds

8.3.2 Section analysis

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

To add a section move the cursor to the centerline in the Curved surface, Straightened
vessel or 3D View window, right-click and select the Add Section command or Add Reference
to add reference section.
To delete a section select the Remove section command in the context menu of the section
or click on the cross in the upper right corner of the current section window (Fig. 8.7).
The position of the cross on the section corresponds to the position of the centerline.
The border is outlined by a green and red lines. When editing borders in the current section
window (Fig. 8.7) the Edit vessel contours tool can be deactivated.

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The yellow line in the current section window shows the cutting plane for the current section
shown in the Straightened vessel window. To rotate the cutting plane move the cursor on it
so that the bidirectional arrow appears, hold the left mouse button and move the mouse.
The following parameters are calculated in the section view windows:
• Lumen
• Short diameter
• Long diameter
If you set one section as reference then the diameter and lumen values for other sections
are relative to the corresponding values for the reference section. If you set two sections as
reference then the values for other sections are relative to the average values for the reference
sections. Reference sections are recommended to be located on both sides of the section of
interest if the vessel narrows. To set the type of the section select it from the drop-down list in
the upper left corner of the section view window (Fig. 8.7).

Figure 8.7: Section view window

8.3.3 Curved surface analysis

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

A vessel sweep is diaplayed in the Curved surface and Straightened vessel windows.
The Straightened vessel window displays the following information:
1. Thiskness

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 8.3. VESSELS ANALYSIS MODE

2. Curve rotation angle

To analyze the vessel interval select this interval in the Straightened vessel window. To
do this move the cursor to the beginning of the interval and move the mouse to the end of the
interval holding down the left mouse button, then release the button. The built interval is shown
in Fig. 8.8. The borders of the interval are diplayed as white sections.

Figure 8.8: Vesse interval

The following parameters are calculated for the interval:

• Length;

• Avg lumen;

• Min lumen.

To move the interval border move the cursor to the corresponding white section in any of the
3D View, Curved surface or Straightened vessel windows and move it with the mouse while
holding down the left button. To delete an interval click the left mouse button in an arbitrary
place in the Straightened vessel window. To build multiple intervals build them holding down
the Ctrl button on the keyboard.

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8.3.4 Export vessel surface mesh

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

To export the vessel surface to a file click on the Export vessel surface mesh button,
in the dialog that opens select the file type (ply, obj or stl) and save the mesh.
To close the ends of the vessel click on the arrow on the right side of the Export vessel
surface mesh button, select the Export parameters... itew and in the dialog that opens
check the Close sides box.

8.4 Coronary Arteries Analysis

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

The Viewer contains the Coronary Arteries Analysis Module to analyze the coronary vessels.
Its functionality is basically the same as that of the Vessels Analysis module.
Attention! This functionality is not available under the standard Pro license and must
be purchased separately. Functionality is available only in 64-bit build of the program.
The advantage of the Coronary Arteries Analysis module is the automatic detection of the
aorta. The central line of the coronary artery is cut off at the entrance to the aorta.
Features of the Coronary Arteries Analysis module are:
1. Only CT series are suitable fo analyze.
2. The module does not contain bone subtraction functionality.
3. Only coronary arteries are available in the vessel list.
To open series in the Coronary Arteries Analysis window click the Coronary Arteries
Analysis button on the toolbar. To select the tab location (in the current window, in a
separate window or in the full screen mode), click on the arrow on the right side of the button.
To open the Coronary Arteries Analysis window in a new tab in the current window, click on
the left side of the button. The process may take some time.

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Chapter 9

PET analysis

Attention! This functionality is not available under the standard Pro license and must
be purchased separately.

9.1 Open Studies in PET Analysis window

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

To open study:

1. Load studies to the Viewer.

2. Select a study containing at least one CT and one PET series.

3. Select one CT and one PET series by clicking the left mouse button while holding down
the Ctrl key on the keyboard.

4. Click the PET analysis button on the toolbar. To select the tab location (in the
current window, in a separate window or in the full screen mode), click on the arrow on
the right side of the button. To open the PET Analysis window in a new tab in the current
window, click on the left side of the button. The process may take some time.

The PET analysis windows is shown in Fig. 9.1.

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CHAPTER 9. PET ANALYSIS

Figure 9.1: PET analysis window

9.2 PET Analysis View Elements

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

In the upper left part of the window is the MIP (maximum intensity projection) view window
for the PET series.
In the upper right part there is a window for viewing flat images of the PET series, in the
lower left one is the window for viewing flat images of the CT series.
In the lower right part is the series fusion view window (CT+PET). The image in this window
is similar to the image in the series fusion window (see Chapter 4).
The left side contains the Quick series list panel which displays all the series of this study.
To open the required series in the PET Analysis window drag it into the corresponding window.
You can drag the PET series only to the MIP window and you can drag PET, CT or the fused
series to the other windows.

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 9.3. PET WINDOW SETTINGS

9.3 PET Window settings

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

To open the settings dialog select main menu Options->Settings...->

Modules->PET analysis and click the Settings button. You can set up the following pa-
rameters in the dialog that opens:
The Common tab:

• Enable SUV mode automatically;

• First layer modality by default for the CT+PET window;

• PET layer CLUT by default for the CT+PET window;

• CT layer opacity (%) by default for the CT+PET window;

• PET layer opacity (%) by default for the CT+PET window;

In the Controllers MIP you can associate tools with mouse wheel and move operations for
the MIP window, in the Controllers 2D you can do it for the CT and PET windows.
The settings are applied the next time you open the PET Analysis window.
To change the PET layer opacity in the CT+PET window move the slider at the top of the
CT+PET window (marked with number «1» in Fig. 9.2).

Figure 9.2: The CT+PET window

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9.4 Image Positioning

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

Use the following tools for image positioning:

The Reset views tool cancels all actions made with the Rotate, Zoom, Pan
tools

The Rotate tool is described in Section 2.11

The Zoom tool is described in Section 2.11. Allows to zoom images. If the
other windows displayes images in the same projection, they are scaled
synchronously
The Pan tool is described in Section 2.11. Allows to pan images. If the other
windows displayes images in the same projection, they are moved
synchronously

The Axial projection tool displays images in the axial plane

The Coronal projection tool displays images in the coronal plane

The Sagittal projection tool displays images in the sagittal plane

The Sync series scroll tool allows you to simultaneously scroll the images in
the PET, CT and CT+PET windows

The Select model point tool displayes in the PET, CT and CT+PET windows
the images corresponding to the point selected in the MIP window

The MIP projection rotates around a vertical axis. To rotate move the cursor right and left
holding the left button, or move the scroll slider.

9.5 Visualize Images

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

Image visualization is described in Section 2.16. To change the CLUT for a specific window,
first select this window with a mouse click. In the CT+PET window you can change the CLUT
for the PET layer only.

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 9.6. MEASUREMENTS AND ANNOTATIONS

The CT+PET window contains the scale of the CLUT for the PET layer (marked with number
«2» in Fig. 9.2). If the SUV mode is disabled the scale borders coincide with the minimum and
maximum window values for the PET layer. If the SUV mode is enabled then the scale borders
coincide with the minimum and maximum values of the SUV in the current image of the PET
layer.
Changing the window width and window level using the Adjust W/L tool is described
in 2.12. To change the window width and window level for CT images in the CT and CT+PET
windows select the CT window with the mouse. To change the values for all PET images, select
any window with the mouse, except for CT.

9.6 Measurements and Annotations

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

Use the following tools to measure:

The Ruler tool is described in Section 2.14

The Corner meter tool is described in Section 2.14

The Cobb angle tool is described in Section 2.14

The Point value tool is described in Section 2.14

The ROI rectangle tool is described in Section 2.14

The ROI ellipse tool is described in Section 2.14

The ROI polygon tool is described in Section 2.14

The VOI Sphere tool is described in Section 9.7

The Delete all annotations and measurements tool is described in

Section 2.14

The Show SUV tool is described in Section 2.17

The Arrow tool is described in Section 2.25

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The Text tool tool is described in Section 2.25

The Polygon tool is described in Section 2.25

The Ellipse tool is described in Section 2.25

To open the SUV settings dialog click the arrow on the right side of the Show SUV
button and select the Settings... item.

To display the SUV value after opening a study in the PET analysis window set the Enable
SUV mode automatically (see Section 15.4.6). If there is not enough data to calculate an
SUV then a dialog for entering parameters is displayed. For details see Section 2.17.

9.7 Measure the Intensity Average and Standard Deviation

in an Space

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

The VOI Sphere tool is similar to the ROI tools described in section 2.14, but measurements
are performed in a space bounded by a sphere.

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 9.7. MEASURE THE INTENSITY AVERAGE AND STANDARD DEVIATION IN AN SPACE

9.7.1 Create sphere

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

To create sphere:

1. Select a series to measure, go to the image in which the center of the sphere should be
located.

2. Activate the VOI sphere tool by clicking the button on the toolbar.

3. Move the cursor to the point where the center of the sphere should be located.

4. Click the left mouse button.

5. Set the desired diameter of the sphere by moving the mouse.

6. To cancel creation, press the Esc button on the keyboard.

7. Click the left mouse button to finish.

The following parameters are displayed near the sphere:

• minimum intensity value;

• maximum intensity value;

• average intensity value;

• standard deviation;

The results only for the corresponding series are displayed in the CT and PET windows, the
results for the both series are displayed in the CT+PET window.

9.7.2 Sphere location in space

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

All spheres are always displayed in the MIP window. The line of intersection of the sphere
with the image plane and the measurement results are displayed in the other windows. With
distance from the center of the sphere, the diameter of this circle decreases. If the sphere does
not intersect with the image plane, the measurement results for the sphere are not displayed in
this window.
If the center of the sphere is on the current image and the VOI Sphere tool is activated,
crosses are displayed in the center of the sphere and on its border.

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9.7.3 Actions with the sphere

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

To edit sphere:

1. Activate the VOI sphere tool by clicking the button on the toolbar.
2. Go to the image that contains the center of the sphere. To do this, slide images until the
crosses appear in the center and on the border of the sphere.
3. To move the sphere, move the cursor over the cross in its center and move the mouse
holding the left button down. When you locate cursor over the cross it increases.
4. To change the radius move the cursor over the cross on the sphere border and move the
mouse holding down the left mouse button. When you locate cursor over the cross it
increases.

To move the block with the measurement results locate the cursor over it and move the
mouse holding the left button. For this it is not necessary that the center of the sphere be on
the current image.
To remove a sphere right-click on the corresponding block with the measurement results
or on the cross in the center or on the border of the sphere and select the Remove object
command.

9.7.4 Drawing Parameters

Functionality is available in the separate module which is activated in the Pro edition for an
extra fee

To change the drawing parameters:

1. Activate the VOI sphere tool by clicking the button on the toolbar.
2. Locate the cursor over the block with the measurement results or on the cross.
3. Right click.
4. Select the item Set render params... in the context menu.
5. In the dialog box that appears set the color by clicking on the color box.
6. Set the object name, line thickness and font size.
7. To connect the block with the measurement results and the sphere of the dotted line,
check the textbfFootnote line box.
8. To use these settings by default check the Set as default box.
9. To apply the settings, click OK. To cancel the settings, click Cancel.

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Chapter 10

Virtual Endoscopy

10.1 Open Studies in Virtual Endoscopy window

Functionality is available in the Pro edition

To open a study in the virtual endoscopy window:

1. Load studies to the Viewer.

2. Select the target study from the study panel.

3. Click the Virtual endoscopy button on the toolbar. To select the tab location (in
the current window, in a separate window or in the full screen mode), click on the arrow
on the right side of the button. To open the virtual endoscopy window in a new tab in the
current window, click on the left side of the button. The process may take some time.

The virtual endoscopy window is shown in Fig. 10.1.

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Figure 10.1: Virtual endoscopy window

If the camera is in dense body tissues, there will be no image on the left side of the screen.
In this case you need to move the camera to a body cavity manually. For details on how to
move the camera, see Section 10.3.

10.2 View Elements. Customize MPR Panel

10.2.1 View Elements

Functionality is available in the Pro edition

The toolbar is displayed at the top left part of the tab (Fig. 10.2).

Figure 10.2: Toolbar

The MPR navigation panel is on the right side of the tab.

The view setup panel is at the top right part of the tab (Fig. 10.3).

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 10.2. VIEW ELEMENTS. CUSTOMIZE MPR PANEL

Figure 10.3: View setup panel

After you start auto moving (see Section 10.3.1) once the cavity surface sweep will appear
in the bottom of the window (Fig. 10.4).

Figure 10.4: Surface Sweep panel

10.2.2 Customize MPR Navigation Panel

Functionality is available in the Pro edition

The MPR (multiplanar reconstruction) panel consists of three parts, each displaying the body
section by one of the three orthogonal planes.
To hide/display the MPR navigation panel, click the MPR navigation button on the
toolbar.
To change the panel size, move its border. To do this, move the cursor to the panel border
so that it would look like this: , and drag the border holding the left mouse button.
To change the size of panel parts displaying the sections by various planes, move the
borders dividing the panel parts (see example in Fig. 10.5).

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CHAPTER 10. VIRTUAL ENDOSCOPY

Figure 10.5: MPR panel configuration

10.3 Move Camera

10.3.1 Move Camera Automatically

Functionality is available in the Pro edition

To move the camera automatically:

1. Drag the camera to a body cavity using the MPR navigation panel. If the left side of the
screen displays the red cavity surface, it means that the camera is in the cavity. If not,
the camera is located in dense tissues. In this case correct its position.

2. Start auto moving by clicking: the Space key, or the Fly-through camera button
on the toolbar.

The camera can be stopped in a similar way.

After you activate automatic movement the central line appears. The camera moves along
the central line. Color of this line is green. The vertical line on the sweep panel corresponds to
the camera position.
To increase the movement speed press + on the keybord, to decrease speed press -.

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 10.4. CUSTOMIZE IMAGE

10.3.2 Manage Camera Manually

Functionality is available in the Pro edition

You can manage the camera manually using the cursor management keys. Key functions:

move the camera forward

move the camera back

rotate the camera anticlockwise

rotate the camera clockwise

To manage the camera using the mouse and the keyboard:

1. To change the camera rotation angle, move the mouse holding the wheel. The camera
turns in the same direction as the cursor. The camera direction vector will be displayed
on the MPR navigation panel.

2. To move the camera over the image plane, move the mouse holding the wheel and the
Shift key. The camera turns in the same direction as the cursor.

3. To move the camera at random, use the MPR navigation panel. Click the left mouse button
at the target place in any projection window, or move the mouse holding the left button.
The camera will move in the same direction as the cursor.

4. To move tha camera alogn the central line, move the surface sweep holding the left button.
The vertical line on the sweep panel corresponds to the camera position.

5. To point the camera at the point on the surface, click the right mouse button on this point
on the sweep panel.

10.4 Customize Image

Functionality is available in the Pro edition

To increase of decrease the camera angle, turn the mouse wheel backward or forward
respectively. To change the view configuration, use the visualization setup panel at the top right
part of the tab. For details on how to work with the panel, see Section 5.4.

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10.5 Measurements and Markers

Functionality is available in the Pro edition

The Viewer allows you to place markers on an image and conduct linear measurements. For
details on working with the Marker tool, see Section 3.8. The use of the Ruler and Polygonal
ruler tools is described in Section 2.14 and Section 3.7.2. However, in the virtual endoscopy
window you switch between the Polygonal ruler and Ruler tools using the menu that opens by
clicking on the arrow on the right side of the button (or in polygonal ruler mode).

10.6 Multiplanar Reconstruction

Functionality is available in the Pro edition

To switch to multiplanar reconstruction, click the MPR reconstruction button. Recon-

struction will open in a new tab. Multiplanar reconstruction is described in Chapter 5.
The camera position is synchronized with the cursor position in MPR, and navigation is
performed synchronously. For convenience, you can open MPR in a separate window and
position it next to the virtual endoscopy window.

10.7 Surface Reconstruction

10.7.1 Create Surface

Functionality is available in the Pro edition

For reconstruction, click the Surface reconstruction button on the toolbar.

The process may take some time.
Sample reconstruction is shown in Fig. 10.6.

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 10.7. SURFACE RECONSTRUCTION

Figure 10.6: Surface reconstruction

To display/hide the camera orientation in the surface window, click the Show camera
orientation button. The camera orientation on the surface is synchronized with the virtual
endoscopy tab. For convenience, you can open surface reconstruction in a separate window
and position it next to the virtual endoscopy window.
The camera position is highlighted by the blue marker.
The yellow vector shows the view direction, and the green one points upward from the
camera (Fig. 10.7).

Figure 10.7: Camera orientation view elements

10.7.2 Surface Orientation and Navigation

Functionality is available in the Pro edition

• To rotate the surface, move the mouse holding the wheel. To select one of the predefined
orientations, use the buttons on the orientation panel. (Fig. 10.8).

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Figure 10.8: Surface orientation panel

• To move the camera, activate the camera orientation view and click the left mouse button
on the 3D surface reconstruction. The camera will move to the selected place in the center
of the cavity. If there are overlapping body cavities, the camera will be located in the
cavity nearest to the user.
• To change the camera vector, right-click the mouse at any point on the surface. The
vector will be directed to this point.
• To change the model transparency, move the Model transparency scroll.
• To drag the surface, move the mouse holding the wheel and the Shift key.
• To zoom the surface, move the mouse holding the wheel and the Ctrl key.

10.8 Export

Functionality is available in the Pro edition

The export of images is similar to image export described in Section 2.21, but you can not
export the entire series.

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Chapter 11

ECG Viewer

11.1 Select Data Source

Select the data source. The source selection algorithm is described in Section 1.5.

11.2 Open Series in ECG View window

Load studies to the Viewer and select the target study. There are five ways to open a series:

1. Click the ECG Viewer button on the toolbar. To select the tab location (in the
current window, in a separate window or in the full screen mode), click on the arrow on
the right side of the button. To open the ECG in a new tab in the current window, click
on the left side of the button.

2. Double-click the left mouse button on the study title on the study bar.

3. Double-click the left mouse button on the series icon on the series panel.

4. Drag the series icon to the study panel holding the left mouse button.

5. Right-click the mouse to call the context menu for the series icon and select one of the
items in the ECG Viewer section. The ECG will open in a new tab in the current window
(Fig. 11.1).

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CHAPTER 11. ECG VIEWER

Figure 11.1: ECG view window

11.3 View Graphs

If the graphs do not fit on the screen, then:

• pan them horizontally with the mouse holding the left button;

• pan them vertically by rolling the mouse wheel.

If a series contains several pages a View pages panel appears in the upper right of the
window (fig. 11.2).

Figure 11.2: View pages panel

To view the pages move the cursor over the scroll bar and rotate the mouse wheel or click
the buttons. The panel displays the current page number and the total number of pages.

11.4 Toolbar
The toolbar is at the top of the tab (Fig. 11.3).

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 11.4. TOOLBAR

Figure 11.3: Toolbar

11.4.1 Select Lead

To select the ECG leads to be displayed:

1. Click the button on the toolbar. The window shown in Fig. 11.4 will be displayed.

2. Check the leads to be displayed. By default all leads are displayed.

3. Click OK to apply the settings or Cancel to cancel the actions.

Figure 11.4: Lead selection window

11.4.2 ECG Speed

Two speed values are available: 25 and 50 millimeters per second. The default speed is 50
millimeters per second. The required value is set using a switch (Fig. 11.5).

Figure 11.5: Toolbar (speed setup)

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11.4.3 Scale
Two scale values are available: 10 and 20 millimeters per millivolt. The default scale is 10
millimeters per millivolt. The required value is set using a switch (Fig. 11.6).

Figure 11.6: Toolbar (setting the scale)

11.4.4 Length Interval

To select a length interval:

1. Activate the Length interval tool on the toolbar.

2. Move the mouse along the graph to find the point to start with (it does not matter if the
point is located on the left or on the right).

3. Click any mouse button to fix the point.

4. Move the mouse along the graph to locate the second point. The interval length value will
be displayed against the interval background.

5. Click any mouse button to fix the point.

To move the interval, locate the cursor on it and drag it holding any mouse button.
Only one interval can be built at a time.
To delete the interval, deactivate the Length interval tool.

11.4.5 Value Interval

To select a value interval:

1. Activate the Value Interval tool on the toolbar.

2. Move the mouse over the graph to locate the point to start with (it does not matter if the
point is located at the top or at the bottom).

3. Click any mouse button to fix the point.

4. Move the mouse over the graph to locate the second point. The value matching the interval
will be displayed against the interval background.

5. Click any mouse button to fix the point.

To move the interval, locate the cursor on it and drag it holding any mouse button.
Only one interval can be built at a time.
To delete the interval, deactivate the Value Interval tool.

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 11.4. TOOLBAR

11.4.6 Move to a Time Point on the Graph

To move to a particular time point on the graph, enter the values (minutes, seconds and
milliseconds) into the corresponding areas on the toolbar (Fig. 11.7) and click the Go to button.
The graph will move to display the part starting from the specified time. At any time you can
drag the graph with the mouse.

Figure 11.7: Time input panel

If the entered time value exceeds the study duration, the graph will be out of vision. Enter
a new value or move the graph manually.

If some parameter has a zero value, it does not need to be entered. For instance, to move
to the time point 1 minute 110 milliseconds, enter the values as shown in Fig. 11.8.

Figure 11.8: Go to the time point 1 minute 0 seconds 110 milliseconds

11.4.7 Set Up Coordinate Plane

To display the scale on the coordinate plane, activate the Scale ECG tool on the toolbar
(by default it is inactive). To hide the scale line, click the button again.

To change the color scheme, click the Choose color scheme button on the toolbar.
Two color scheme variants are available: classic (set by default) and green (Fig. 11.9).

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CHAPTER 11. ECG VIEWER

Figure 11.9: Green color scheme

11.5 Frequency Filters

Functionality is available in the Pro edition

If the ECG is recorded with noise and deformations, use filters to correct the graphs.
These filters remove components that frequency is higher than 35 Hz (the Low pass
filter 35 Hz button) or 75 Hz (the Low pass filter 35 Hz button). To apply the filter
click the corresponding button. To cancel filtering click the corresponding button again. Only
one filter can be applied at a time.
To remove power line interference from the ECG signal use the Notch filter. The tool has 2
predefined values (50 Hz and 60 Hz). To select a filter value click on the arrow on the right
side of the Notch filter button. The current value is marked by flag. If you need to set
a different value select the Custom... item in the button menu and set up value in the dialog
that opens. To use filter with the current value click on the left side of the Notch filter
button. To cancel filtering click the button again.
To remove the walks of the baseline of the graph use a High pass filter 1Hz. To apply the
filter click the High pass filter 1Hz button. To cancel filtering click the button again.

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 11.6. EXPORT SERIES

11.6 Export series

Functionality is available in the Pro edition

When exporting the series is saved in filtered form. The series is stored in local storage
in the same study. To open the export dialog click on the arrow on the right side of the
Quick export ECG.
If necessary, change the description of the series.
To upload the series to the default PACS server when exporting check the Upload ECG to
the default server box in the export dialog.
To export the series with the default settings click the on left side of the Quick Export
ECG button.

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CHAPTER 12. NETWORK

Chapter 12

Network

12.1 Services

12.1.1 DICOM Service (PACS Server functionality)

The Viewer can take on the role of a PACS server. For clients are available the data in the
Local Storage. To do this, enable and set up the DICOM Service and add clients to the PACS
Servers list (section 12.2). To set up the DICOM Service:

1. Select the Services... item from the Network menu. The dialog box shown in Fig. 12.1
will pop up.

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 12.1. SERVICES

Figure 12.1: Services dialog box

2. Check the Enable DICOM Listener box.

3. In the AETitle field, enter a user-defined title for the computer that the Viewer is installed
on to identify it on the server.

4. In the Port field, specify any free port of the computer the Viewer is installed on. If you
are not sure what value to specify, use the default value. This information can be obtained
from your system administrator.

5. Click Apply. If the port is busy, the message Dicom Listener can not be run. Error
message: The address is protected will pop up. In this case, select another port and
repeat the previous action.

12.1.2 HIS/HTTP Service

This service is used to manage the Viewer using the http protocol.
To set up the HIS/HTTP Service:

1. Check the Enable HIS/HTTP Service box.

2. In the Port field under the Enable HIS/HTTP Service checkbox specify any free port of
the computer the Viewer is installed on. If you are not sure what value to specify, use the
default value. This information can be obtained from your system administrator.

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CHAPTER 12. NETWORK

12.1.3 Web Access

Functionality is available in the Pro edition

To set up the Web access:

1. Check the Enable web Access box.

2. In the Port field under the Enable web Access checkbox specify any free port of the
computer the Viewer is installed on. If you are not sure what value to specify, use the
default value. For access from other computers add a web access port to your firewall
exceptions. If necessary contact your system administrator.

3. In the User name field enter the user name.

4. In the Password field enter the user password.

5. In the Session timeout (sec.) field enter a timeout after which the session is terminated,
i.e. to continue you need to enter your username and password again.

At the bottom of the dialog there is a link that must be entered into the browser for web
access to the viewer http://youraddress:<port>, where instead of youraddress you need to
substitute the ip address or computer name, on which the Viewer is installed.

12.2 Set Up PACS Server Connection

In this window you can set up the connections with the applications, which can exchange data
with the Viewer using the DICOM protocol. In this case the Viewer can take on the role of
a PACS server and other applications will be clients, and vice versa. Because most of the
applications with which connection can be established can take on the role of a PACS server,
connections with them set in this window, regardless of whether they will be in relation to the
Viewer of the servers or clients.
To open the window to connect to PACS servers, select the Network menu and the Server
list item, or press Ctrl+S. The dialog box shown in Fig. 12.2 will pop up.

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 12.2. SET UP PACS SERVER CONNECTION

Figure 12.2: PACS server connection dialog box

The Viewer allows you to download several series from the PACS server at the same time,
making several parallel connections to the PACS Server. However, not all PACS Servers
support a large number of simultaneous connections and this leads to errors when downloading
data. Setting the maximum number of connections is described in 15.4.4. This setting applies
to all PACS Servers.

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12.2.1 Add PACS Server

To add a new PACS server:

1. Click the button.

2. Enter the server name in the Server nickname field.

3. Enter a comment in the Server description field. This field may be left blank.

4. Select DICOM from the Server type dropdown menu.

5. Select target mode from the Server mode dropdown menu.

6. Select the server charset from the Character set dropdown menu.

7. In the Client name (SCU) field enter the value specified in Section 12.1.1 in the AETitle
field.

8. In the Service name (SCP) field enter the name of the server that the PACS server is
installed on.

9. In the Server host name or IP field enter the server name or IP address.

10. In the Server port field enter the server port to accept connections by the DICOM
protocol.

11. To save the information without closing the window, click OK.

12. To save the information and close the window, click Save.

13. To close the window without saving the changes, click Cancel.
The required information can be obtained from your system administrator. Other PACS
servers are added in a similar way.

If you have several servers on your list, you can assign a server that will be active by default
when starting the Viewer. To do this, check the Default server box in the server connection
settings.
If another default server is already assigned, its box will be unchecked when you assign a
new server.
If this server is also a client in relation to the Viewer, it is necessary to allow it to exchange
data. To do this, check the box Allow C-FIND and C-MOVE. Configure the client application
in accordance with the User Manual of this application. Configuring the connection of two
applications Inobitec DICOM Viewer described in section 12.2.3.
To delete a server from the list, click the button. Attention! After you click this
button, the deletion cannot be undone.

12.2.2 Check PACS Server Availability

To check if the server is available, click the button in the PACS server connection window.
If the server is available, the system will return the following message: Server network status:
Online (Fig. 12.3).

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 12.2. SET UP PACS SERVER CONNECTION

Figure 12.3: Server network status: Online

Otherwise the following message will be returned: Server network status: Offline (Fig. 12.4).
The error details will be displayed below.

Figure 12.4: Server status: Offline

If a message similar to the one shown in Fig. 12.4 appears, it most likely means that the
Server host name or IP or Server port fields are filled in incorrectly, or the target PACS
server is not running.

12.2.3 Configuring the connection of two application Inobitec DICOM

Viewer
Suppose that the Viewer #1 takes on the role of a PACS-server and Viewer #2 takes on the
role of a client.
Parameters of the Viewer #1:
• AETitle: VIEWER-SERVER;
• IP: 192.168.1.101;
• Port: 3001.
Parameters of the Viewer #2:
• AETitle: VIEWER-CLIENT;
• IP: 192.168.1.102;
• Port: 3002.
To configure server:
1. Enable and set up the DICOM service (section 12.1.1), set AETitle as VIEWER-SERVER,
set Port as 3001.

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2. Add the client on the window for Set Up PACS Server Connection (section 12.2.1). Set
the following parameters for the fields:

• for field Server type — DICOM;

• for field Server mode — C-MOVE;
• for field Client name (SCU) — VIEWER-SERVER;
• for field Service name (SCP) — VIEWER-CLIENT;
• for field Server host name or IP — 192.168.1.102;
• for field Server port — 3002;
• check the box Allow C-FIND and C-MOVE.

Now the Viewer #1 is ready to accept incoming connections from the client with the
AETitle = VIEWER-CLIENT, IP = 192.168.1.102 and port=3002.

To set up client:
Add the server on the window for Set Up PACS Server Connection (section 12.2.1). Set
the following parameters for the fields:

• for field Server type — DICOM;

• for field Server mode — C-MOVE;

• for field Client name (SCU) — VIEWER-CLIENT;

• for field Service name (SCP) — VIEWER-SERVER;

• for field Server host name or IP — 192.168.1.101;

• for field Server port — 3001;

Now the Viewer #2 is ready to connect to the server with AETitle = VIEWER-SERVER,
IP = 192.168.0.101 and port=3001.
If you enable and set up the DICOM-service and check the box Allow C-FIND and C-MOVE
for VIEWER-SERVER server on the Viewer #2 settings, the Viewer #2 will be able to take on
the role of server and the Viewer #1 will be able to take on the role of client. Thus the Viewer
can take on the role of a client and a server simultaneously.

12.3 Network Operation Status

Network operations include information transfer and reception between the Viewer and the
PACS servers.
To view the network operation status, select the Network menu and the Network status
item. The window shown in Fig. 12.5 will pop up.

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 12.3. NETWORK OPERATION STATUS

Figure 12.5: Network status

The window contains three tabs: Downloading, Uploading and History. The Downloading
and Uploading tabs display the queues of studies loaded from the PACS server or sent to the
PACS server respectively.

If the queue is empty at the moment, i.e. no studies are being loaded, the window will look
as shown in Fig. 12.6.

If some data is being transferred at the moment, the study queue will be displayed in
the required tab (Fig. 12.6). The studies positioned at the top of the list are the first to be
processed.

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Figure 12.6: Queue of studies sent to the PACS server

To work with the Downloading and Uploading tabs, the same actions are used.
The following actions with a study can be performed (to do this, select the study first):

• change the position in the queue using the and buttons respectively;

• cancel the study processing using the button. In this case, only the information that
is already loaded will remain on the server.

To clear the queue, click the button. In this case, the studies including the one currently
processed are deleted from the list and their processing is interrupted. If a study is already
being processed (In progress status), you cannot change its position in the queue.
The top of the History tab displays the list of studies loaded, sent or canceled. At the
bottom of the tab there is a list of studies whose transfer failed (Fig. 12.7).

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 12.3. NETWORK OPERATION STATUS

Figure 12.7: Network operations history

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CHAPTER 13. THE LOCAL STORAGE

Chapter 13

The Local Storage

The storage is a folder on the computer disk where the DICOM data is stored.

13.1 View Storage Status

To view the storage status, select the Storage menu and the Storage status item. The window
shown in Fig. 13.1 will pop up.

Figure 13.1: Storage info

The following information is displayed in the window: number of studies in the storage; total
number of images in all studies; size of data stored in the storage (megabytes and bytes).

13.2 Verify Storage

To check the storage, select the Storage menu and the Verify storage item. The checking
shows whether all images related to the studies are located in the storage. The checking
progress (percentage of work performed) is displayed on the screen.
If all files are found in the storage, the All files in storage are valid message will be
displayed.
If any of the files are not found in the storage, the message like Found 10 missed files
in the local storage. Please, try again to download studies. will be returned. In this

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 13.3. CLEAR STORAGE

case, you need to reload all studies to the storage to display all images properly. To clear the
storage, perform the actions described in the next section.

13.3 Clear Storage

To clear the storage, select the Storage menu and the Clear storage item. In this case, the All
local studies will be deleted. Do you really want to clean up the local storage? message
will be displayed. Click Yes to clear the storage or No to cancel. After the storage is cleared,
click OK in the clearing progress window.

13.4 Automatic Local Storage cleaning

Automatic cleaning is performed at the following intervals:
• every time;
• once a day;
• once a week;
• once a month.
To activate/deactivate automatic cleaning, check/uncheck the Automatic local storage
cleaning box and select the cleaning period (see section 15.4.5).

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CHAPTER 14. DISK CREATOR

Chapter 14

Disk Creator

14.1 General information

The disk creator allows you to write information to a CDs, DVDs and Memory Cards. To open
the disk creator, click the DICOM CD/DVD Creator button on the toolbar. To select
the tab location (in the current window, in a separate window or in the full screen mode), click
on the arrow on the right side of the button. To open the creator window in a new tab in the
current window, click on the left side of the button.
The disk creator window is shown in Fig. 14.1.

Figure 14.1: Disk creator

To work with the creator should be set up the Work Folder, i.e. the folder to store the
disk image to be written. By default, the Work Folder is located in the temporary folder of the

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 14.2. ADD DATA TO DISK CREATOR

operating system. To change it click on the Select the work folder where DICOM CD/DVD
image will be created button and select the directory in the dialog that opens. If when
opening the creator the Work Folder already contains data then the dialog with question Do
you want to clear Work Folder before inserting new data? is displayed. Click OK to clear
or Cancel to leave the data.
If the disk image is damaged it may become impossible to work with it. If errors occur when
adding or removing data, manually clean the Work Folder.
After writing data in the Work Folder can be saved for later use or can be automatically
deleted. Automatic cleaning of the Work Folder can be enabled before burning the image (see
Section 14.3).
The top part of the creator contains the control buttons:

Select a work folder where DICOM CD/DVD image will be created is used to
change the Work Folder.
Remove series from the DICOM CD/DVD image: to delete the selected series,
click on the left side of the button. To delete the selected study, click on the arrow on
the right side of the button and select the Remove studies command.

Clear DICOM CD/DVD image deletes all studies from the image.

The Include DiskViewer to the DICOM CD/DVD image button described in

Section 14.2.3.

Write created DICOM CD/DVD image to the blank compact disk writes
information from the creator to the disk.

Write created DICOM CD/DVD image to the memory card of folder writes
information from the creator to the memory card (flash card) or folder.

The Size parameter displays the size of the disk image. The same information is duplicated
by the green bar on the graph (Fig. 14.2).

Figure 14.2: Disk Image size

14.2 Add Data to Disk Creator

14.2.1 Automatically Add Data to a Disk Image
Since version 1.14.0 it is possible to automatically add data to a disk image.

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To set up automatic adding of studies select the main menu Options->Settings...->

Modules->DICOM CD/DVD Creator and click the Settings button. In the window that opens
check the Add selected studies at opening DICOM CD/DVD Creator box. By default the
box is checked. Click OK to apply the settings or Cancel to cancel.
To add studies to the disk image automatically:

1. Load studies to the Viewer.

2. Select the required study (several studies, holding down the Shift or Ctrl keys. For more
information see Section 1.9).

3. Click the left side of the DICOM CD/DVD Creator button on the toolbar. If the
creator is closed, it opens and selected studies are added to the image.

If the Work Folder is not set. Choose Work Folder and try again error occurs then
set the Work Folder for the creator (see Section 14.1) or it will be automatically created in the
temporary folder of the operating system the next time you start the Disk Creator.

14.2.2 Manually Add Data to a Disk Image

To add studies or series to the disk image manually:

1. Load studies to the Viewer.

2. Select the required study (or several studies holding down the Shift or Ctrl key. For
more information on how to select several studies see Section 1.9).

3. To add the entire study to the disk image click the Add the selected studies to the
DICOM CD/DVD disk creator button on the Studies Import/Export Panels.

4. To add a series select them on the series panel and click on the left part of the Add
the selected series to the DICOM CD/DVD disk creator button on the Series
Import/Export Panels. The information will be added to the creator. To select several
series hold down the Shift or Ctrl keys. For more information see Section 1.9).

If the Work Folder is not set. Choose Work Folder and try again error occurs then
set the Work Folder for the creator (see Section 14.1) or it will be automatically created in the
temporary folder of the operating system the next time you start the Disk Creator.

14.2.3 Adding the Viewer to the Disk Image

To be able to view recorded on the disk images without having to install special software, add
to the disk image the Compact Disk Viewer Edition, which requires no installation and runs
directly from the disk on Windows and Mac OS.
To add the Compact Disk Viewer Edition to the disk image click the Include DiskViewer to
the DICOM CD/DVD image button. When cleaning the disk image the Compact Disk
Viewer Edition is stored in the disk image.
To remove the Compact Disk Viewer Edition from the disk image click the button. In
the dialog box that opens click Yes to confirm the deletion, or click No to cancel.

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 14.3. BURN IMAGE

14.3 Burn image

14.3.1 Write to Disk
Attention! This functionality is available only for Windows OS family. In Linux and
MAC OS you can write data to a memory card or burn a disk image created in the Work
Folder to disk using the operating system tools.
To write information to the disk:
1. Click the Write created DICOM CD/DVD image to the blank compack disk
button on the Disk Creator toolbar. The window shown in Fig. 14.3 will pop up.
2. If necessary, select the writing device from the dropdown menu.
3. Edit the disk name if necessary.
4. If necessary, check/uncheck the box Automatically clean up the DICOM CD/DVD
image after burning disk.
5. Click OK to write or Cancel to cancel.

Figure 14.3: Writing parameters

If the box Automatically clean up the DICOM CD/DVD image after burning disk is
checked, the information stored in the Work Folder of the creator will be deleted. Otherwise
you will be able to write it again.

14.3.2 Write to Memory Card or Folder

To write information to a memory card (flash card) or folder:
1. Click the Write created DICOM CD/DVD image to the memory card of folder
button on the Disk Creator toolbar.
2. Select a memory card or folder on your hard disk. To do this, enter the path in the Path
to write field or click the button and select the path in the dialog that opens.
3. If necessary, check/uncheck the box Automatically clean up the DICOM CD/DVD
image after writing data.
4. Click OK to write or Cancel to cancel.

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14.4 View studies written on disk

Insert the disk or memory card with DICOM data and the Compact Disk Viewer Edition into
computer. If autorun of disks and cards is enabled on a computer, the Compact Disk Viewer
Edition will start automatically. Otherwise on Windows run the Start_Win file, on Mac OS run
the DICOMViewer file. Both files are located in the root directory of the disk or card.
Written studies are automatically displayed on the Study Panel.

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Chapter 15

Viewer Settings

To change the settings, select the Options menu and the Settings item. The window shown in
Fig. 15.1 will pop up.

Figure 15.1: Viewer setup window. General settings

The setup menu will be displayed on the left side of the window.

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CHAPTER 15. VIEWER SETTINGS

The Defaults button allows you to set the settings for the current window, which are set
upon the very first launch of the Viewer on the computer.

15.1 General
The following parameters are set up in this section:

• Interface language.

• Using of native OS open

save file dialogs.

• Request for confirmation of closing the Viewer.

• Working directory path. This is the local storage location. The path can be entered
manually or selected from the dialog box. To open the dialog box, click the button on the
right of the path input string.

• Log file path. The information about the Viewer operation is saved in the log. The path
can be entered manually or selected from the dialog box. To open the dialog box, click
the button on the right of the path input string. If the parameter is not specified, the log
file will be located in the directory where the Viewer is installed.

• Log file name.

• Viewer log specification. The following specification levels are available:

– Failure: register information about errors that led to the Viewer failure;
– Error: register information about all errors that may lead to incorrect operation of
the Viewer;
– Warning: register all errors, whether or not they might lead to incorrect operation
of the Viewer;
– Info: register all errors as well as standard actions of the Viewer;
– Debug: register all errors and standard Viewer actions with detailed information.

After changing the logging level you do not need to restart the program.

• Display Tooltips (the ToolTips box), Shortcuts and play Slideshows on the Tooltips. If the
ToolTips box is unchecked, the tooltips are not displayed at all.

• Close to tray (the Show system tray icon box) and minimize to tray (the Minimize to
tray box).

• Use License Proxy Server (the Use License Proxy Server box) and its parameters. To
check the availability of the server click the button after you have filled Host and
Port fields. The information will be displayed on the right.

• Use a shared folder to store service information (the Use shared settings (multi-user
support) box) and path to a shared folder.

• Reading character set (character set of DICOM data).

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 15.2. MONITOR

15.2 Monitor

15.2.1 Set Up a Second Monitor

The Viewer makes it possible to show information on two Monitors without having to move
windows manually.
To enable a second display:

1. Select the Options menu and the Settings item.

2. Open the Monitor section. The window similar to the one shown in Fig. 15.2 will pop up.

3. Check the boxes in the Use monitor column to select the monitor(s) to be used.

4. Click OK or Apply to apply the changes, or Cancel to cancel the actions.

5. In the restart confirmation window (Fig. 15.3), click Yes to restart or No to cancel restart
and continue working.

Figure 15.2: Monitor settings

The Viewer needs to restart to apply the changes. The studies currently opened in the
Viewer will not be opened again after restart. The Viewer will request confirmation before
restarting (Fig. 15.3).

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Figure 15.3: Restart confirmation dialog

If you are still working with the opened studies or if the information needs to be saved, click
No to cancel the restart and set up the displays later. To restart the Viewer, click Yes.
If only one display is selected, the Viewer will be opened on this display. If two displays are
checked, the Viewer windows will be displayed on both. To close the Viewer, just close any of
the windows.

15.2.2 Split Screen

The Viewer allows you to split the screen into two parts, displaying two windows during startup.
To place two windows on the screen:

1. Select the Options menu and the Settings item.

2. Open the Displays section. The window similar to the one shown in Fig. 15.2 will pop up.

3. Check the boxes in the Split vertically column to select the display(s) to be splited. If
the splited display is not currently in use, its Use display box is checked automatically.

4. Click OK or Apply to apply the changes, or Cancel to cancel the actions.

5. In the restart confirmation window (Fig. 15.3), click Yes to restart or No to cancel restart
and continue working.

15.3 Skins
The following parameters are set up in this section:

• the Viewer layout (skin):

– system: the Viewer layout is determined by the OS settings;

– grey (used by default);
– black.

• use the Viewer layout for the Help System.

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 15.4. MODULES

15.4 Modules
In this section you can specify the settings for particular modules (Fig. 15.4).

Figure 15.4: Modules

To browse the detailed information about each module, select the module and click the
Module info button. For some modules, special parameters are set. To do this, select the
module from the Installed modules list and click the Settings button.

15.4.1 Set Up Image Viewer Module

Select the Image Viewer module from the Installed modules and click the Settings button.
The View parameter settings window contains four tabs with the following parameters:
1. Image arrangement tab. The following parameters are set up:
• default series arrangement;
• splitter priority;
• default image arrangement;
• the number of images scrolled per click;
• images sorting method.
This parameters can be set for a specific modality. To add a modality click the Add button
and enter the name of the modality in the dialog that appears. To change the settings
for an already added modality select it in the Settings for modality drop-down list. To
delete the selected modality click the Delete button.
2. Tools tab. The following parameters are set up:

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• default tool (the one that activates when opening an image). Options:
– no tool;
– Adjust W/L;
– Ruler;
– Corner meter;
– ROI rectangle tool;
– ROI ellipse tool;
– ROI polygon tool;
– Sync by point;
• default mode. Options:
– no mode selected;
– DSA mode;
• request for confirmation of deletion of all annotations and measurements;
• show TSE values in annotations.
3. Controllers tab. Sets up the actions associated with mouse actions.
4. W/L settings tab. Sets up the default W/L values. If a value is not specified, the default
is 0.
5. W/L settings tab. The following parameters are set up:
• option Use recommended W/L for Series can be checked/unchecked;
• default W/L for DSA mode can be activated/deactivated;

15.4.2 Set Up Study List Module

Select the StudyList module from the Installed modules and click the Settings button. The
following parameters are set up in the Study list config window:
• option Load local storage automatically can be checked/unchecked;
• option Ask to keep on storage autodownloaded series can be checked/unchecked;
• the period for which the data is loaded can be checked/unchecked;
• font options can be set up;
• option Allow to edit patient name and description can be checked/unchecked;
• option Download whole study by double click can be checked/unchecked.

15.4.3 Set Up 3D Reconstruction Module

Select the 3DReconstruction module from the Installed modules and click the Settings but-
ton. The window contains two tabs with the following parameters:
1. Render tab. Sets up the render device. Options:
• Auto;
• CPU (using the software facilities);

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• OpenCL support;
• CUDA support.
2. Segmentation tab. The following parameters are set up:
• option Use model color in 3D can be checked/unchecked;
• option Use alternate color can be checked/unchecked;
• sets up the default structure opacity;
• option Invert edit mask on MPR can be checked/unchecked;
The available options may vary depending on the configuration and equipment settings.
3. Reconstruction tab.
• option Warn about varied slices distance can be checked/unchecked;
• sets up reconstruction by series with varying distances between slices. Options:
– Non uniform slices interpolation;
– Max uniform distance slices range.
4. UI tab. The following parameters are set up:
• Saving MPR view sizes. To change this parameter checks/unchecks option Save
MPR view sizes. By default is unchecked;
• MPR plane line thickness, including Screw Installation window.
• MPR plane line colors, including Screw Installation window.
• Request for confirmation of deletion of all measurements.
5. 3D controllers tab. Sets up the actions associated with mouse actions in the Volume
Reconstruction window.
6. MPR controllers tab. Sets up the actions associated with mouse actions in the MPR,
Planning of Pedicle Screws Installation and Vessels Analysis windows.

15.4.4 Set Up Network Support Module

Select the Network support module from the Installed modules and click the Settings button.
You can specify the maximum count of connections to a PACS Server.

15.4.5 Set Up Local Storage Module

Select the Data storage module from the Installed modules and click the Settings button.
The window contains one tab with the following parameters:
1. the Automatic local storage cleaning option can be checked/unchecked;
2. cleaning period can be set.

15.4.6 Set Up PET Analysis Module

Select the PET Analysis module from the Installed modules and click the Settings button.
You can specify the following parameters:
• the Enable SUV mode automatically option can be checked/unchecked.

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15.5 Set Up “Hotkeys” Module

In this section you can specify “hotkeys” to perform different actions. To set up “hotkeys”:

1. Select the Options menu and the Settings item.

2. Open the Hotkeys section. The window similar to the one shown in Fig. 15.5 will pop up.

3. Select the target action in the table. If necessary, enter action name or “hotkey” on Filter
field to filter the action list. “Hotkeys” specified for the selected action are displayed on
the Key sequence column.

4. To modify or set “hotkeys”:

• change value on the Key sequence field or

• click the Record button, next press key sequence on the keyboard and to finish click
the Stop recording button.

Entered value will be immediately displayed on the Key sequence column of the table.

5. To delete “hotkeys” erase the value on the Key sequence field.

6. If entered “hotkeys” are already used, warning similar to the one shown in Fig. 15.6 will
be displayed, and the value in Key sequence column will be written in red. To see, what
action corresponds to this “hotkeys”, click Show. Do not set the same “hotkeys” for
actions performed in one window. If entered value can not be set, warning similar to the
one shown in Fig. 15.7 will be displayed.

7. To restore the original value of the “hotkeys” for the selected action, click the Reset
button.

8. To restore the original values of the “hotkeys” for all actions, click the Reset all button.

9. Click OK or Apply to apply the changes, or Cancel to cancel the actions.

10. In the restart confirmation window (Fig. 15.3) click Yes to restart or No to cancel restart
and continue working.

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 15.5. SET UP “HOTKEYS” MODULE

Figure 15.5: Hotkeys

Figure 15.6: Warning about key sequence potential conflict

Figure 15.7: Warning about invalid key sequence

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The types of “hotkeys” are described in the following table:

“Hotkey” type Designation

Single key: any key of alphanumeric keyboard or Single key, e.g.: «A» or «F5»
functional key

Group of keys: two keys should be pressed Two single keys coupled by «+»,
simultaneously. The first key is Ctrl, Alt or Shift, e.g.: «Ctrl+S» or «Shift+F5»
the second one is any key of alphanumeric keyboard
or functional key

A sequence of several keys of alphanumeric Single keys or groups of keys,

keyboard or functional keys: keys should be pressed separated by comma, e.g.:
one by one «A,B,C» or «Ctrl+F1,Ctrl+F2»

15.6 Import and Export Settings

15.6.1 Export Settings
The export functionality allows you to save the current Viewer settings in a file. To export
settings:
1. Select the Options menu and the Export settings item. The save file dialog box will pop
up.
2. Select the location to save the settings file to, and enter the file name.
3. Click Save to save the settings file or Cancel to cancel the actions.

15.6.2 Import Settings

The import functionality allows you to apply settings specified earlier and saved in a file. To
import settings:
1. Select the Options menu and the Import settings item. The Viewer will request confir-
mation for this action because all current settings will be lost after import. Click Yes to
continue or No to cancel the import.
2. If you click Yes, the settings file selection dialog box will pop up. Select the needed file.
3. To import the settings, click Open. The Viewer will be restarted, and the settings will be
applied. To cancel the import, click Cancel.

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Chapter 16

Print Images

The Viewer allows you to print images on paper or film using DICOM printers.
You must add images to the print list, then open the list in the preview window and print
images.

16.1 Working with Print List

To print images, you should add them to the print list first. You can do this in the following
windows:

• View Flat Images window;

• Multiplanar Reconstruction window;

• Volume Reconstruction window;

• Planning of Pedicle Screws Installation window;

• Vessel Analysis window;

• Coronary Arteries analysis window;

• PET Analysis window;

• Series Fusion window.

Depending on the way the image is captured, you can change the window level and width
in the print preview window (in this case, the labels on the screen are not captured) or cannot
change the window level and width (in this case the image is captured with all labels and
annotations). For detailes see the next Sections.
If the Add to print list button is inactive, click the left button on the header of the window
with the image to be printed or removed.
The print list is saved until the program is closed.

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16.1.1 Add/Delete Images in View Flat Images and Fusion windows

To add the current image to the print list, click on the left side of the Add to print list
button. The button will look as follows: . When browsing images, the button will look like
this if the current image is not on print list and like this if it is. If there are several
images views opened in the tab, note which view window is active (highlighted by a red frame).
To remove the current image from the print list, click on the left side of the Add to print
list button that should look like this: . The image will be removed, and the button will
change to . Also you can remove images in the Preview window (see Section 16.2).
In View Flat Images and Fusion windows there are two capturing images modes for printing:

• View screenshot: the entire image including the labels, annotations is captured. There
is no possibility to change the window width and level in the Preview window.

• Image capture: only the image of tissues is captured. There is possibility to change the
window width and level in the Preview window.

When you click on the left side of the Add to print list button the previously selected
capture mode is used. To switch capture mode click the arrow on the right of the Add to Print
List button and select the target mode. The selected mode is marked with a flag and
saved as the default capture mode for the View Flat Images and Series Fusion windows.
If the image was captured in the Series Fusion window then changing the window width and
level in the Preview Window is possible only for the first layer.

16.1.2 Add Images in Multiplanar Reconstruction, Volume Reconstruc-

tion and Planning of Pedicle Screws Installation windows
To add the current image to the print list, click on the left side of the Add to print list
button.
In Multiplanar Reconstruction, Volume Reconstruction and Planning of Pedicle Screws Instal-
lation windows there are three capturing images modes for printing:

• View screenshot: the entire image including the labels, annotations is captured. There
is no possibility to change the window width and level in the Preview window.

• Image screenshot: only the image of tissues is captured. There is no possibility to

change the window width and level in the Preview window.

• Entire image: only the image of tissues is captured. There is possibility to change the
window width and level in the Preview window (except images captured in the Volume
Reconstruction window).

When you click on the left side of the Add to print list button the previously selected
capture mode is used. To switch capture mode click the arrow on the right of the Add to Print
List button and select the target mode. The selected mode is marked with a flag and
saved as the default capture mode for the Multiplanar Reconstruction, Volume Reconstruction
and Planning of Pedicle Screws Installation windows.
If the fused image was captured in Entire image Mode in the Multiplanar Reconstruction
Window then changing the window width and level in the Preview Window is possible only for
the first layer.
Deletion of images captured in these modes is available in Preview window (see Sec-
tion 16.2.3).

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16.1.3 Add Series and Clear Print List

To add the entire series to the print list, click on the arrow on the right side of the Add to
print list button and select the Add entire series. Images will be added with default mode
menu item. This functionality is available only for View Flat Images and Fusion windows.

To clear the print list, click on the arrow on the right side of the Add to print list button
and select the Clear print list item.

16.1.4 Add Images from Different Studies

If the print list is not empty and you are trying to add an image from another study, the Viewer
will return a warning as shown in Fig. 16.1.

Figure 16.1: Warning: adding an image from another study

To add the image, click Yes. To clear the print list and add the current image, click Rewrite.
To cancel the addition and leave the current print list as it is, click No.

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16.2 Edit print list in Preview window

16.2.1 Preview
The Preview windows are intended to control printing and final editing of the print list. The
Preview window is used to view printing on paper and save images to a pdf file, the DICOM
preview is used for printing on film. To open the target window select the File menu and the
Preview item or DICOM preview item. Settings made in one window do not affect the settings
in the other one except deleting images. The print list is common for both windows, so images
deleted in one of the windows are deleted from the print list and disappear in the other window.
To update the print list in the Preview window after deleting or adding images, click the
Update button.
The DICOM preview tab is shown in Fig. 16.2.

Figure 16.2: DICOM preview window

The toolbar is located at the top (Fig. 16.3), and the bottom part shows what the printed
images will look like (preview page).

Figure 16.3: Toolbar

The toolbar contains the following elements:

The Update button refreshes the preview page after the print list has
been changed
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 16.2. EDIT PRINT LIST IN PREVIEW WINDOW

The Fit width button adjusts the preview page size to the screen
width

The Fit page button adjusts the preview page size to the tab size

Page scale field. The scale is entered from the keyboard manually or
selected from the dropdown menu. To open the dropdown menu,
click on the arrow on the right side of the panel
The Zoom in button zooms in the page. The current scale is
displayed in the Page scale field

The Zoom out button zooms out the page. The current scale is
displayed in the Page scale field

The Portrait button sets the portrait layout for the page

The Landscape button sets the landscape layout for the page

The First page button is used to jump to the first page if the images
do not fit into a single page

The Previous page button is used to jump to the previous page if the
images do not fit into a single page

Page indicator. Shows the current page and the total number of
pages
The Next page button is used to jump to the next page if the images
do not fit into a single page

The Last page button is used to jump to the Last page if the images
do not fit into a single page
Page templates drop-down list. Allows to select predefined page
template (see Section 16.2.2)
The Edit page template button opens Page Template Settings dialog
(see Section 16.2.2)
The Resolution (DPI) drop-down list (only for the Preview window).
The list allows to set the print resolution (clarity)
The Printer dropdown menu (only for the DICOM Preview window).
Specifies the DICOM printer

The Zoom tool allows to zoom selected images

The Shift image tool allows to shift selected images inside the cells

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CHAPTER 16. PRINT IMAGES

The Reset transformation tool allows to reset all transformation

made using the Zoom and Shift image tools

The W/L tool allows to change window width ana level

The Arrow tool allows to make graphic labels such as arrows. For
detailes on how to do it see Section 2.25

The Text tool allows to make text labels. For detailes on how to do
it see Section 2.25

The Ellipse tool allows to make graphic labels such as ellipse. For
detailes on how to do it see Section 2.25

The Rectangle tool allows to make graphic labels such as rectangle.

For detailes on how to do it see Section 2.25

The Polygon tool allows to make graphic labels such as polygon. For
detailes on how to do it see Section 2.25

The Show labels tool allows to show the information about image.
For detailes on how to do it see Section 16.2.4

The Show reference image tool allows to display reference image.

For detailes on how to do it see Section 16.2.5

The Remove selected images button allows to remove the selected

images from the print list (see Section 16.2.3)

The Page setup (only for the Preview window) opens the print
settings dialog

The Print button opens the print dialog

The Clear print list command removes all images from the print list.
To use it click the arrow on the right side of the Print button and
select the Clear print list item

The Export to PDF tool (only for the Preview window) saves images
to pdf file

16.2.2 Set Up Page Templates

Page templates allows you to arrange pictures in arbitrary order. To open page template
editing dialog press the Edit page template button. The dialog, shown in Fig. 16.4, will
be displayed.

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 16.2. EDIT PRINT LIST IN PREVIEW WINDOW

Figure 16.4: Page template settings dialog

Select template from the drop-down list. To add a new template press the Add page
template button, to delete a template press the Remove page template button.
Attention! Deleting a template can not be undone.
To change a template name enter a new name to the Name field.
To change row and column count enter values to Row count and Column count fields.
If columns and/or row count is greater than 1 you can merge arbitrary number of cells.
Merged cells must form a rectangle. For example, set Row count to 3 and Column count to 4.
Next select cells 7, 8, 11, 12. To do it move the cursor from cell 7 to cell 12 holding the left
mouse button. Next press Merge. Four selected cells will be merged.
To cancell the merging select the merged cell and press Unmerge.
To split any cell into an arbitrary number of rows and columns, select this cell, enter values
to the rows and columns fields and press the Split button. Cells made by splitting can only be
merged with each other.
To save changes press OK or Apply, to cancel press Cancel.

16.2.3 Cells
If the page template contains several cells then to apply the Zoom, Shift image, W/L tools to
several images on page or to delete image (images) you need to select corresponding cells. To
select click the left mouse button on the cell. To remove a selection click on the image again.
To select multiple cells:
• To select multiple cells that are contiguous (next to each other): click on the first cell and
click on the last one holding the Shift key on the keyboard.
• To select multiple cells that are anywhere in the page: click on the each one the left
mouse button holding the Ctrl key on the keyboard.

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CHAPTER 16. PRINT IMAGES

• To remove a selection click on the any selected cell again.

Warning! If any of the graphic labels tools, Zoom, Shift image, W/L tool is active,
selection and removing of the selection is impossible.
To remove the images in the selected cells click the Remove selected images button.
To swap images in cells, drag the image to the target cell holding the left mouse button.
Images will be swaped.

16.2.4 Print Labels

If image is captured without labels you can add them in the Prview Window. To do it click the
Show labels button. The tags that should be displayed are marked by flags. To display
or hide label click the arrow on the right side on the Show labels button and select the
target item.
To set the font size select the Show annotation text size... item in the button menu.
To select the DICOM tags that should be displayed in the left bottom side select the Set
visible tags... item in the button menu and in the dialog that appears mark the target tags by
flags.
If one or more cells are selected, the settings will be applied only to these cells.

16.2.5 Reference image

To add reference image:

1. Add images to print list.

2. Open another series of the same study, select the image you want to make reference.

3. Click the arrow on the right side of the Add to print list button and select the Add
as reference image item.

4. Open Preview or DICOM Preview window. If the window is already opened click the
Refresh button. A reduced reference image is displayed in the corner of each
image.

5. To show/hide reference image click on the left side of the Show reference image
button.

6. To adjust the display of reference image click the arrow on the right side of the Show
reference image button and select the Property... item. You can set up the
following properties:

• image alingment;
• dimention ration;
• project line width (mm).

If there are selected images, the changes are applied only to them.

If you add images from different studies to print list then you can set individual reference
image for them.

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 16.3. PRINT IMAGES ON FILM

16.3 Print Images on Film

16.3.1 Set Up DICOM Printers
To set up the DICOM printing parameters, select the Network menu and the DICOM printer
setup... item. The window shown in Fig. 16.5 will be displayed.

Figure 16.5: DICOM printing settings window

The window displays the toolbar (Fig. 16.6), list of printers (Fig. 16.7) and printing setup
panel (Fig. 16.8).

Figure 16.6: DICOM printing settings window

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Figure 16.7: Printer list

Figure 16.8: Printing setup panel

To add a DICOM printer to the list:

1. Click the Add printer button on the toolbar. The printer setup dialog box shown in
Fig. 16.9 will be displayed.
2. Enter a user-defined printer name into the Name field.
3. In the SCU AE header field, enter the name of the client allowed to access the printer
(this parameter is defined in the printer settings).
4. In the SCP AE header enter the printer name (this parameter is defined in the printer
settings).
5. Enter the printer network address in the Host field.
6. Enter the printer port in the Port field.
7. Check the Default box if the printer should be used by default.
8. Click OK to apply the changes or Cancel to cancel them.

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 16.3. PRINT IMAGES ON FILM

Figure 16.9: DICOM printer setup dialog box

All the added printers will appear on the printer list. The default printer can be assigned
directly from the list by checking the box next to the printer.
To delete a printer from the list, select it and click the Remove printer button. Click
OK in the confirmation dialog to delete the printer, or Cancel to cancel the deletion.
To edit the printer settings, select the printer and click the Edit printer button.
To check whether a printer is available, select it and click the Info printer button. If
the printer is available, the printer list will display the Online status for the printer. If not, the
Offline status will be displayed (Fig. 16.7). If the status has not been checked, its value will be
Unknown (Fig. 16.6).

16.3.2 Set Up DICOM Printing Parameters

To set up the DICOM printing parameters, select the Network menu and the DICOM Printer
setup... item. The window shown in Fig. 16.6 will pop up. Set up the required parameters on
the printing setup panel (Fig. 16.8):

1. Set the film source (Unit or Processor).

2. Set the film cutting.

3. Set the magnification type. If you need to print the images with the original resolution,
select No. If you need to fit the images to the film size, select one of the magnification
types (Bilinear, Cubic or Replicated). In this case, the printer will change the image
resolution according to the selected algorithm to maximize the image size on the page and
retain its proportions.

4. Select the resolution to print the images (Standard or High).

5. Since version 1.11 you can not deactivate the Print as one image option.

6. If necessary, enable the printing of labels.

7. For color printing check the Color print box.

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16.3.3 Print
You can print images on a DICOM printer from the DICOM preview window (see Section 16.2).
To open it select the File menu and the DICOM Preview item. To print images on a DICOM
printer, click the DICOM print button on the toolbar. The window shown in Fig. 16.10 will
be displayed.

Figure 16.10: DICOM print

The parameters in the window correspond to the default parameters specified during the
printing setup. Change these parameters if necessary and click the Print button to initiate the
printing, or Cancel to cancel.
If the printer is not available the message like Pinter «PrinterName» is not available will
be displayed.

16.4 Print Images on Paper

For this purpose, a printer for printing on paper should be connected to your computer and set
up. The Viewer does not have the functionality to set up such a printer.
Printing on paper is possible from the preview window (see Section 16.2). To open it, select
the File menu and the Preview item. The Preview tab will be displayed.
The preview window is similar to the DICOM printer preview window, except the Print setup
button on the toolbar opening the printing system settings. The printing is carried out by
the OS facilities. If necessary, consult the printer manual and the OS help reference.

268
Chapter 17

Licensing

In accordance with item 3.1 of License Agreement to make sure that the Software is rightfully
used the Owner reserves the right to use applicable tools to check whether the User has a
licensed copy of the Software. To do this the Viewer license must be regularly activated on the
license server using Internet. At the same time no personal data of the User is transmitted to
the license server.

17.1 Trial period

Demo mode allows the users to try to work with the Viewer, using it without limitation functional
for 30 days. The only requirement is the need to connect your computer to the Internet. After
30 days of using Viewer it becomes impossible. To continue, you must purchase a license. The
trial period for each edition is calculated separately.
You can activate the Viewer versions released within a year from the moment of purchase
of the key. Versions released after a year are not activated, but the trial period is available for
them. To extend the activation period of new versions for another year, purchase a subscription
to updates.
Beginning with version 1.9.0 after the release of the product with the changed second
number in the product version (the so-called minor version), you can re-activate the trial period.
For example, a user who activated Lite edition version 1.9.0, but after a month did not acquire
a license, will be able to activate the trial Lite edition version 1.10.0 again to research its
functionality. Similarly for the Pro edition.
Starting from version 1.11.0 specialized modules can additionally be connected to the Pro
edition. Such modules are licensed and paid separately. The main functionality remains available
in the Pro edition.

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CHAPTER 17. LICENSING

17.2 The First Launch and Licensing

17.2.1 Registration on the License Server Using Internet
When you first start Viewer after installing, it attempts to register itself on the license server.
During registration Viewer does not transmit any personal data. If the connection fails, a dialog
box similar to the one shown in Fig. 17.1 will be displayed.

Figure 17.1: The connection to the license server failed

If you have a license key, click the License and select the Enter key... item. In the dialog
box that opens (Fig. 17.2), enter the license key and click OK to confirm or Cancel to cancel
the input. If the license key is not valid, the activation fails.

Figure 17.2: License key input dialog box

To try to connect to the license server again, click Repeat.

To continue working with the Viewer after 30 seconds without entering the license key and
the connection to the license server, click on the Continue to work after 30 sec. In this case,
the dialog shown in Fig. 17.1, closes after 30 seconds and after some time appears again.
To close the Viewer, click Exit.
The Lite and Pro editions are registered separately.
If the license key does not support the activation of Additional Modules and you need to
replace it with a new one click on the Enter New Key button and enter the new key.

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 17.3. PURCHASE OF A LICENSE

17.2.2 License Proxy Server for automated corporate licensing

To automatize the licensing of a large number of copies of the program in the organization a
License Proxy Server is used. The License Proxy Server must have a permanent connection
to the License Server. It is installed on the computer located in the local network of the
organization, it loads the set of keys necessary for licensing all copies of the program. At
the first start, the program accesses the License Proxy Server and asks for the key. It saves
users from sending product codes to developer, and then entering the received license keys. If
necessary, additional keys can be loaded into the License Proxy Server.

17.2.3 Terminal License Server for corporate licensing

Terminal License Server allows you to run a certain number of copies of the program on the
local network of the organization. The terminal server must have a permanent connection to
the License Server. For the Terminal License Server you need either a license key, similar to
the key for the Viewer, or the Guardant electronic key. It does not matter which computers the
program is installed on. If the maximum number of copies of the program is already running on
the organization’s network, then when the new copy can not be launched.

17.3 Purchase of a License

After 30 days from the date of activation of the trial version a dialog box similar to the one
shown in Fig. 17.2 will be displayed after starting the Viewer. Further work without the license
key input will be impossible.
To purchase a license, call +7 (920) 405-67-43 or send a request to the address mar-
[email protected].
If you purchased a license for the Lite edition, then you can update it to the Pro, paying
the difference in price. In this case the license for the Lite edition will be revoked.

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CHAPTER 18. THE HELP SYSTEM AND USER ASSISTANCE

Chapter 18

The Help System and User Assistance

18.1 Help System

The Help System is available from the Viewer interface. To use the Help System, you need
to check the box Help->Assistant for the required languages during the installation of the
program.
The Help System language is the same as has been set in the Viewer previously. If the
help files for selected language are missing or the Help System is not installed, dialog with an
appropriate message appears at the Help System startup time. In this case reinstall the Viewer
and check the box Help->Assistant for the required languages during the installation of the
program.
The Help System interface language coincides with the language has been set in the oper-
ating system.

18.1.1 Launch the Help System

The Help System is context-sensitive, it allows to open sections describing the interface ele-
ments, features that are currently in use. There are three ways to launch the Help System:
1. From the main menu. Open the Help menu and select the Contents... item. The Help
System will open on a page containing information about the active tab.
2. From a tooltip. Place your cursor on a button to display a tooltip. If this button corre-
sponds to a page of the help system, then there is a Help link in the tooltip. Click this
link to open the Help System page. Tooltips are described in section 18.2.
3. Using the hotkey. Place your cursor on the required interface object (button, panel, dialog
window, etc) and press the hotkey to open the Help System. If this object corresponds to
the interface page, the Help System will be opened on this page.
If the Help System is already running, then it opens the appropriate page.
If the selected interface object does not correspond to any page, the Help System will be
opened on the last viewed page.

18.1.2 Help System Settings

The default Help System skin coincides with the Viewer skin. To disable the use of the Viewer
skin, uncheck the Use the selected style for Help System box (see Section 15.3).

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 18.2. TOOLTIPS

18.2 Tooltips
Tooltips appear while hovering the cursor over a button or other interface element. It contains
information about this item.
The tooltip for the button contains the following information:
• button name;
• hotkey (if specified);
• a link to a page in the Help System (if specified);
• a slideshow with a brief demonstration of the capabilities of the instrument, or view mode
(if specified).
Slideshow appears in 3 seconds after the appearance of the tooltip and is played back
cyclically. After that to close a tooltip click a mouse button or rotate a mouse wheel. If there is
a slideshow for this button, a countdown appears in the form of points in the lower right part
of the tooltip. To display a slideshow, check the box Slideshow Tips during the installation of
the Viewer.
The Viewer allows you to disable the display of hotkeys, slideshow, or completely disable
the tooltips (see Section 15.1).

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“HOTKEYS”

“Hotkeys”

The most part of the “hotkeys” can be changed (Chapter 15.5).

Accepted Abbreviations
LMB — left mouse button;

RMB — right mouse button;

MMB — middle mouse button;

MW — mouse wheel;

Left — left arrow;

Right — right arrow;

Forward — forward arrow;

Back — back arrow.

Key Combinations Used in All Windows

F1 — open the help System;

Ctrl+S — PACS server list management window;

Ctrl+N — network message queue management window;

Ctrl+Q — quit the program;

F11 — switch to the full screen mode and exit from it;

Esc — exit from the full screen mode;

Ctrl+P — print on paper;

Ctrl+Z — undo;

Ctrl+Y — redo;

274
Key Combinations Used in Image View Window
[ — switch to previous image;
] — switch to next image;
F — play images;
H — mirror image horizontally;
V — mirror image vertically;
K — activate the tool Marker;
N — activate the tool Line marker;
I — activate the tool Image rotation;
Z — activate the tool Image scaling;
M — activate the tool Image shift;
W — activate the tool Adjust W/L;
A — activate the tool Arrow tool;
T — activate the tool Text tool;
O — activate the tool Polygon tool;
E — activate the tool Ellipse tool;
R — activate the tool Ruler;
C — activate the tool Corner meter;
B — activate the tool Kobb angle;
P — activate the tool Point value;
L — activate the tool ROI rectangle;
Q — activate the tool ROI ellipse;
G — activate the tool ROI plygon;
Y — activate the tool DSA;
Delete — delete markers and measurements;
MW — switch from slice to slice;
LMB — browse images (forward);
Ctrl+LMB — browse images (back);
move the mouse holding RMB — edit W/L;
move the mouse holding LMB — drag the image;
Ctrl+MW — zoom;

275
“HOTKEYS”

RMB — call the context menu;

Ctrl+E — call the image export setup dialog;
F5 — export the image with the latest settings.

Key Combinations Used in 3D Reconstruction Window

MW, Ctrl+MMB — zoom;
Shift+MMB — drag the model;
MMB — rotate the model;
I — activate the tool Model rotation;
Z — activate the tool Model scaling;
M — activate the tool Model shift;
C — activate the tool Polygon cut;
T — activate the tool Remove table;
X — remove bones;
W — activate the tool Adjust W/L;
B — activate the tool Clipping box;
L — activate the tool Ruler;
K — activate the tool Marker;
N — activate the tool Line marker;
P — activate the tool Select model point;
Ctrl+E — call the image export setup dialog;
F5 — export the image with the latest settings.

Key Combinations Used in DICOM Tag View Window

Ctrl+F — open the search panel;
Esc — close the search panel;
Ctrl+C — copy the selected cell.

Key Combinations Used in Curvilinear Reconstruction Mode

Ctrl+LMB on a curve — jump to the surface the point is located on;
Shift+drag the mouse holding LMB — drag the curve;
RMB on a curve — context menu.

276
Key Combinations Used in Multiplanar Reconstruction Win-
dow
Ctrl+MW — zoom;
Ctrl+LMB — move the inclined plane;
Shift+MMB — drag the image;
MW — switch from slice to slice;
Left, Right, Forward, Back — move planes;
Ctrl+E — call the image export setup dialog;
F5 — export the image with the latest settings;
Z — activate the tool Model scaling;
M — activate the tool Model shift;
K — activate the tool Marker;
N — activate the tool Line marker;
R — activate the tool Ruler;
O — activate the tool Polygonal ruler;
C — activate the tool Corner meter;
B — activate the tool Kobb angle;
P — activate the tool Point value;
L — activate the tool ROI rectangle;
Q — activate the tool ROI ellipse;
G — activate the tool ROI plygon.

Key Combinations Used in Virtual Endoscopy Window

LMB in the navigation menu — set the camera position;
MMB — rotate the camera;
Shift+MMB — drag the camera;
MW — zoom;
RMB — context menu;
Left, Right — rotate the object relative to the camera axis;
Forward, Back — move the object along the camera axis;
R — activate the tool Ruler;

277
“HOTKEYS”

K — activate the tool Marker;

N — activate the tool Line marker;

278
 INDEX

Index

3D Reconstruction . . . . . . . . . . . . . see Volume custom . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

Reconstruction grid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
4D Reconstruction . . . . . . . . . . . . . . . . . . . . . 136 stacked. . . . . . . . . . . . . . . . . . . . . . . . . . .73
DSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
A DTI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
AIP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 Dynamic contrast-enhanced MRI and CT . 84
Anonymize . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Arrangement E
of Images . . . . . . . . . . . . . . . . . . . . . . . . . 251 ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Axial section . . . . . . . . . . . . . . . . 122, 152, 193 ECG Viewer . . . . . . . . . . . . . . . . . . . . . . . 52, 223
Edit
B Patient Name . . . . . . . . . . . . . . . . . . . . . . . 59
Brightness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Study Description. . . . . . . . . . . . . . . . . . .59
Erosion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127
C Export Structure. . . . . . . . . . . . . . . . . . . . . . .189
Camera Orientation . . . . . . . . . . . . . . . . . . . . 221 Export surface . . . . . . . . . . . . . . . . . . . . . . . . 189
Clipping Box . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Closing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127 F
CLUTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Fill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Command Line Keys . . . . . . . . . . . . . . . . . . . . 20 Frequency Filters . . . . . . . . . . . . . . . . . . . . . . 228
Command Line Options . . . . . . . . . . . . . . . . . 36 Frontal section . . . . . . . . . . . . . . . . . . . . . . . . 122
Contrast. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78 Full Screen Mode . . . . . . . . . . 44, 48, 49, 274
Coronal section . . . . . . . . . . . . . . . . . . 152, 193 Fusion . . . . . . . . . . . . . . . . . . . . . . . 51, 134, 136
Curved MPR . . . . . . . . . . . . . . . . . . . . . . . . . . 155 Cardiac . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Cut invisible volume. . . . . . . . . . . . . . . . . . . .127
G
D Grow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
DCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Grow bones . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
DICOM Printer . . . . . . . . . . . . . . . . . . . . . . . . 265 Grow tissues . . . . . . . . . . . . . . . . . . . . . . . . . . 135
DICOM Service. . . . . . . . . . . . . . . . . . . . . . . .230
DICOM Tags. . . . . . . . . . . . . . . . . . . . . . . . . . .114 H
Diffusion Tensor Imaging . . . . . . . . . . . . . . . 166 Help System . . . . . . . . . . . . . . . . . . . . . . . . . . 272
Digital Subtraction Angiography . . . . . . . . 111 Hotkeys. . . . . . . . . . . . . . . . . . . . . . . . . .254, 274
Dilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
I
Disk Creator . . . . . . . . . . . . . . . . . . 52, 63, 242
Image registration . . . . . . . . . . . . . . . . . . . . . 144
Adding viewer to image . . . . . . . . . . . . 244
Import surface. . . . . . . . . . . . . . . . . . . . . . . . .189
Write to Disk . . . . . . . . . . . . . . . . . . . . . . 245
Installing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Write to Memoky card . . . . . . . . . . . . . 245
Display mode J
of images jpg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109
custom . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
grid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 L
stacked . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Label. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117
of series Launching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
auto . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Launching the Program . . . . . . . . . . . . . . . . . 36

279
INDEX

Launching the Web Viewer . . . . . . . . . . . . . . 38 on Paper . . . . . . . . . . . . . . . . . . . . . . . . . . 268

Leads. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .225 Page template . . . . . . . . . . . . . . . . . . . . . 262
License . . . . . . . . . . . . . . . . . . . . . . . . . . 270, 271 Print images
Local Storage . . . 51, 54, 62, 240, 248, 252 Reference Image . . . . . . . . . . . . . . . . . . . 264
Product Registration . . . . . . . . . . . . . . . . . . . 270
M
Maximum Intensity Projection. . . . . . . . . . .161 R
Merge layers . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Region Growing . . . . . . . . . . . . . . . . . . . . . . . 181
automatically . . . . . . . . . . . . . . . . . . . . . . 140 Remove holes. . . . . . . . . . . . . . . . . . . . . . . . . .127
by point . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Remove noise. . . . . . . . . . . . . . . . . . . . . . . . . .127
manually . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Rendering transfer function. . . . . . . . . . . . . .97
Minimum Intensity Projection . . . . . . . . . . . 161 ROI
MIP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 ellipse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
mIP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 polygon . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
MPR . . . . . . . . see Multiplanar Reconstruction rectangle . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Multi-monitor Window Design . . . . . . . . . . 249
Multi-segment Growing . . . . . . . . . . . 127, 184 S
Multiplanar Reconstruction . . 136, 139, 151, Sagittal section. . . . . . . . . . . . . .122, 152, 193
220, 277 Scout lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
3D Cursor Mode . . . . . . . . . . . . . . . . . . . 153 Screw installation. . . . . . . . . . . . . . . . . .51, 191
Build Surface . . . . . . . . . . . . . . . . . . . . . . 155 Screws. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .191
Curvilinear Reconstruction . . . . . . . . . . 155 Search . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Cutting Plane Mode . . . . . . . . . . . . . . . . 154 Segmentation . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Export . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Intersection of structures. . . . . . . . . . .188
Line Markers . . . . . . . . . . . . . . . . . . . . . . 159 Mask . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . 158 Subtraction structures . . . . . . . . . . . . . 188
Mirror Image Horizontally and Vertically Unification of structures . . . . . . . . . . . . 187
163 Setting
Orthogonal Planes . . . . . . . . . . . . . . . . . 153 CLUTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Polygonal Line Markers . . . . . . . . . . . . 159 Render settings . . . . . . . . . . . . . . . . . . . . 133
Reslice . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Scout lines . . . . . . . . . . . . . . . . . . . . . . . . 106
Rotate Image . . . . . . . . . . . . . . . . . . . . . . 162 Synchronization . . . . . . . . . . . . . . . . . . . . 118
Rotate Planes. . . . . . . . . . . . . . . . . . . . . .153 Visualization . . . . . . . . . . . . . . . . . . . . . . . . 93
Slice Thickness . . . . . . . . . . . . . . . . . . . . 161 Workspace . . . . . . . . . . . . . . . . . . . . . . . . 107
Multiplanar reconstruction . . . . . . . . . . . . . . . 51 Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .247
Export . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
N Import . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Network . . . . . . . . . . . . . . . . . . . . . . . . . 230, 236 Modules . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
O Shortcuts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
obj. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .189, 206 Shrink. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127
Opening. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127 Skins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Orientation Cube . . . . . . . . . . . . . . . . . . . . . . 112 Sort studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Spinal Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . 191
P Spine Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . 191
PACS Server. . . . . . . . . . . . . . . . . . . . . .56, 232 Splited Screen . . . . . . . . . . . . . . . . . . . . . . . . . 68
pdf . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Stitching Mode . . . . . . . . . . . . . . . . . . . . . . . . 149
PET . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 stl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189, 206
PET analysis . . . . . . . . . . . . . . . . . . . . . . . . . . 207 Storage . . . . . . . . . 51, 54, 62, 240, 248, 252
Play a Reconstruction . . . . . . . . . . . . . . . . . . 136 Surface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
ply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189, 206 SUV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
png . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Switch between Series . . . . . . . . . . . . . . . . . . 71
Print Images . . . . . . . . . . . . . . . . 120, 196, 257 Synchronize Images. . . . . . . . . . . . . . . . . . . .117
on Films . . . . . . . . . . . . . . . . . . . . . . . . . . . 267 Synchronize images . . . . . . . . . . . . . . . . . . . . 117

280
 INDEX

System Requirements . . . . . . . . . . . . . . . . . . . 20 Visualization

CPU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
T CUDA. . . . . . . . . . . . . . . . . . . . . . . .121, 253
Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 OpenCL . . . . . . . . . . . . . . . . . . . . . . 121, 253
Tab display mode . . . . . . . . . . . . . . . 43, 49, 52 Volume Reconstruction. . . . . . .121, 136, 276
Technical Support . . . . . . . . . . . . . . . . . . . . . . . 5 Centrate. . . . . . . . . . . . . . . . . . . . . . . . . . .128
Tooltips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273 Corner 3D Meter . . . . . . . . . . . . . . . . . . . 131
Delete All Areas except Selected Area
U 125
Uncompress series . . . . . . . . . . . . . . . . . . . . . 64 Delete Area . . . . . . . . . . . . . . . . . . . . . . . 124
Uninstalling. . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 Delete Table . . . . . . . . . . . . . . . . . . . . . . . 128
Export Rotation to Series . . . . . . . . . . 132
V Inverse Polygon Cut. . . . . . . . . . . . . . . .124
Vessel Tree Segmentation. . . . . . . . . . . . . .183 Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Vessels analysis . . . . . . . . . . . . . . . . . . . . . . . 197 Polygon Cut . . . . . . . . . . . . . . . . . . . . . . . 124
Vessles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 Polygonal Ruler . . . . . . . . . . . . . . . . . . . . 130
View Flat Images . . . . . . . . . . . . . . . . . . 66, 275 Remove Bone Tissue . . . . . . . . . . . . . . . 134
Calibration Sizes . . . . . . . . . . . . . . . . . . . 119 DualEnergy . . . . . . . . . . . . . . . . . . . . . . 134
Export . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 DualScan . . . . . . . . . . . . . . . . . . . . . . . . 134
Graphic Label Tool . . . . . . . . . . . . . . . . .114 Manually. . . . . . . . . . . . . . . . . . . . . . . . .134
Mirror Image Horizontally and Vertically Rotation . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
119 Ruler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Sync by point. . . . . . . . . . . . . . . . . . . . . .120 Scaling . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
View flat images Shift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Cobb angle meter . . . . . . . . . . . . . . . . . . . 81 Sphere Cut . . . . . . . . . . . . . . . . . . . . . . . . 125
Corner meter . . . . . . . . . . . . . . . . . . . . . . . 81 Sphere Restore . . . . . . . . . . . . . . . . . . . . 125
Delete Measurements . . . . . . . . . . . . . . . 83 Volume reconstruction . . . . . . . . . . . . . . . . . . 51
Drawing Parameters . . . . . . . . . . . . . . . . 82
Intensity at a Point . . . . . . . . . . . . . . . . . . 81 W
Intensity Average . . . . . . . . . . . . . . . . . . . 81 Window Level . . . . . . . . . . . . . . . . . . . . . . . . . . 78
magnifier . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Window Width. . . . . . . . . . . . . . . . . . . . . . . . . .78
Move Measurements . . . . . . . . . . . . . . . . 83
Move Measurements Results. . . . . . . . .83
pan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
play . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Polygonal Ruler . . . . . . . . . . . . . . . . . . . . . 80
rotate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Ruler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Standard Deviation in an Area . . . . . . . 81
zoom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
View Several
Images at a Time . . . . . . . . . . . . . . . . . . . 74
Series at a Time . . . . . . . . . . . . . . . . . . . . 72
Studies at a Time . . . . . . . . . . . . . . . . . . . 71
Virtual Endoscopy . . . . . . . . . . . 136, 215, 277
Camera Fly . . . . . . . . . . . . . . . . . . . . . . . . 218
Customize MPR Navigation Panel . . . 217
Export . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222
Measurements and Markers . . . . . . . . 220
Move Camera
Automatically . . . . . . . . . . . . . . . . . . . . 218
Manually. . . . . . . . . . . . . . . . . . . . . . . . .219
Surface Reconstruction . . . . . . . . . . . . 220
Virtual endoscopy . . . . . . . . . . . . . . . . . . . . . . 51

281
Glossary

Glossary

multiphase series — series contained more then one phase. 108, 110, 147

phase — image group with different location. If the study contains images of the same body
part taken at intervals (for example, contrast studies), then images with different locations
are grouped into phases and sorted according to the time taken to create the image. 108,
110, 147

voxel — element of a 3D image containing the value of a raster element in 3D space. 135

282
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stantly working to improve it. We will be grateful for any feedback,
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ity, user-friendliness and visualization quality.

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