Chapter 6 – Patient Study Workflow

The following procedures are discussed in this chapter:

z Patient Study Overview on page 6-2

z DICOM Modality Worklist on page 6-3

z Monitoring Study Progress on page 6-5

z Study Acquisition Protocols on page 6-6

z Scheduling a Patient Study on page 6-7

 Selecting a Protocol From the Protocol Tree on page 6-10

 Using Patient Details from a Previous Study on page 6-11

z Editing Patient and Study Information on page 6-12

z Deleting a Study from the To Do List on page 6-13

z Opening a Study Session on page 6-14

 Reviewing/Updating Scheduled Scans on page 6-15

 Adding a Scan to a Study on page 6-18

 Deleting a Scan on page 6-20

z Completing a Study on page 6-21

z Auto Transfer of Study Data on page 6-22

z Auto-processing of Study Data on page 6-22

z Auto-processing on page 6-23

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Patient Study Overview Patient Study Workflow

Patient Study Overview

A Patient Study is a collection of images which is the result of a single imaging

procedure, consisting of one or more scans.

Before acquiring data for a Patient Study it is necessary to input patient

information and schedule the acquisition protocol required for this study.

Not all scans have to be acquired. The operator can use the
[Study Acq. Completed] button below the To Do list to change the study state
to completed.

Although the study scans are predefined, the operator can add additional scans
at any time. These can be taken from any existing protocol.

Patient Studies can be scheduled in advance and run at a later time or can be
activated immediately.

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Patient Study Workflow DICOM Modality Worklist

DICOM Modality Worklist

A Worklist Provider is a station on the hospital network (HIS/RIS) that is used

to schedule studies for multiple modalities, defining patient demographic details
and the procedure to be carried out. The Worklist Provider implements the
DICOM Service Class Provider (SCP).

Modality Worklist (MWL) is a communication standard used to define the Infinia

To Do list by importing scheduling information from HIS/RIS. In order to match
the Infinia protocol to the HIS/RIS Procedure Description, acquisition protocol
mapping must be performed. Once configured, a simple query to MWL will define
(in the Infinia To Do list) the new study requested from HIS/RIS.

Note When scheduling for the Infinia scanner, the procedure is defined via the
acquisition protocol. The acquisition protocol to be used is determined
automatically by the system by translating the scheduled procedure provided
in the Modality Worklist request to the related Infinia acquisition protocol as
defined in the Modality Worklist Configuration. This is automatically done by the
system once the matched pairs are defined. See Modality Worklist
Configuration on page 13-23.

The To Do list shows all studies scheduled by the HIS/RIS Modality Worklist
Provider. The [Refresh] button, located above the To Do list, is used to query
the Worklist Provider, refreshing the list.

The [Filter] button opens the Modality List Filter Dialog (see Figure 6-1), allowing
the user to select the matching values to be used for the query. Using an asterisk
(*) indicates that any value is acceptable. Typing a value followed by an asterisk
indicates that all items starting with that value are acceptable. However, the
asterisk along with a value or letter is not effective in all fields (i.e A* or 1*). The
asterisk, along with a value or letter, should only be used for queries in the
following fields only:

z Patient Last Name

z Patient First Name

z Starting Date

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DICOM Modality Worklist Patient Study Workflow

Figure 6-1 Modality List Filter Dialog

By default, the Starting date is three days earlier than the current date and NM
is the default Modality. An asterisk appears in all other fields. If * is placed in
the Starting Date field, all days will be queried.

Press [Query] once criteria are selected. Once [Query] is pressed, the query
configuration is saved.

For details on setting up the connection to a DICOM Worklist Provider, refer to

Modality Worklist Configuration on page 13-23.

The values used for the previous query appear when the dialog opens. The
default values are as follows:
Three days earlier than the current
Starting Date
date

Modality NM

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Patient Study Workflow Monitoring Study Progress

Monitoring Study Progress

The To Do list is used to monitor study status. The status information includes
the current status and the number of scans performed out of the total number
of scans scheduled for the study.

The following status values are defined to indicate the progress of the study:

Status Description

Scheduled No scans were performed.

Open Study session is open.

Started At least one scan has been acquired for this study

A study is considered completed when either of the

following conditions is met:
1. All scans have been acquired.
2. [Study Acq Completed] was pressed.
Completed Once completed, the study no longer appears in the To
Do list.

Refer to Completing a Study on page 6-21 for

additional information.

Note If a completed study is opened, its status changes to “open”. Refer to Opening
a Study Session on page 6-14. If additional scans are added, the study status
reverts to “Started”.

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Study Acquisition Protocols Patient Study Workflow

Study Acquisition Protocols

Acquisition protocols define all operations for a single patient study. This
includes:

z One or more scans to be acquired. Scans may be of different types.

The user does not have to perform all the scans included in the protocol
since certain scans may not be relevant for some patients. Scans can
be acquired in a different order (if relevant) and can be added at any
time (Refer to Adding a Scan to a Study on page 6-18).

z Initial Review of the acquired images to confirm data quality.

z Auto Transfer of the study data to one or more destinations.

z Processing application to be automatically started on the Xeleris P&R

workstation after the study data has been transferred.

All of the available acquisition protocols are arranged in a tree structure. The
protocol tree comprises three main categories: Favorite, User, and Factory
(see Figure A-4).

The factory protocols are organized by clinical categories. When selecting a

protocol, a list of scans included within that protocol appears. For a list of factory
protocols, refer to Appendix F.

User protocols are organized into user defined categories. For additional
information on creating user protocols, refer to Protocol Definition on
page 13-49.

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Patient Study Workflow Scheduling a Patient Study

Scheduling a Patient Study

Usage:

z To schedule a patient study in advance

z To immediately start a patient study.

Scheduling a patient study is performed via the To Do list. The To Do list shows
the list of planned patient studies and their current status (refer to Monitoring
Study Progress).

Before starting to schedule a patient study, verify that there is enough disk
Important
space. The amount of space available appears at the top of the To Do list.

Note Scheduling will not fail even if disk space shows as 100% full.

For information on sorting the To Do list, refer to Defaults for the To Do List on
page 13-40.

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Scheduling a Patient Study Patient Study Workflow

Global Navigation

To Do list Opens the To Do list dialog (see Figure A-1

button on page A-2)

To Do list

[New Study] Opens the New Study dialog (see

button Figure A-2 on page A-5)

New Study
Dialog

Type relevant patient information, including

First Name, Last Name, ID., Birth Date or
Age are optional.

Age is automatically calculated once the

Birth Date is filled in. If the patient’s age is
typed in before the date of birth, the year of
Patient
birth is automatically calculated and the day
Information
and month of birth will be 01 until modified.
fields
Weight (in kilograms) and Height (in cm)
can also be filled in if desired.

To use patient details from a previous study,

see Using Patient Details from a Previous
Study on page 6-11.

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Patient Study Workflow Scheduling a Patient Study

The list of Favorite Protocols appears.

Favorite
Select a protocol from the Favorite
Protocol
protocols list.
drop-down
Alternate:
or
To select a protocol that is not in the
Favorite protocols list, select
Select Study
[Select Study Protocol]. For more
Protocol Tree
information refer to Selecting a Protocol
From the Protocol Tree.

Opens the Extended New Study Dialog (see

Figure A-5 on page A-8).

Under Study Information details on

Optional:
Admitting diagnosis, Auto-processing,
[More]
Accession Number, Admitting Diagnoses,
Referring and Reviewing physician and
other Notes relevant to the whole study can
be added.

Acquire This saves the new study in the To Do list

Study and allows the user to start acquiring.
or
Alternate:
Save & Exit Press [Save & Exit] if you do not want to
Buttons begin acquiring,

Note To designate a protocol as a Favorite see Protocol Definition on page 13-49.

Note To close the To Do list, click on the [X] in the upper right corner of the window.

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Scheduling a Patient Study Patient Study Workflow

Selecting a Protocol From the Protocol Tree

Usage:

To select a protocol that does not appear in the Favorite Protocol drop-down.

New Study Dialog

Select
Study The full protocol tree appears (see
Protocol Figure A-4 on page A-7).
Button

Protocol Selection Tree Dialog

Favorite/
Factory/ Select appropriate category
User

Clinical
Select the appropriate clinical category
Category

Protocol
Select desired protocol and click [OK].
Entry

Protocol
View scans defined for this protocol
Entry Tree

OK

Note In the current version, only a full protocol may be selected.

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Patient Study Workflow Scheduling a Patient Study
Using Patient Details from a Previous Study

Using Patient Details from a Previous Study

Usage:

To use patient details from a previous study.

New Study Dialog

Patient Type partial patient information (e.g.

Information ID only) for the patient or leave
Text Box empty.

The list of patients that match the

Find Patient
partial information appears (see
button
Figure A-3 on page A-6).

Find Patient Screen

Select the appropriate patient and

verify that the displayed information
Patient Entry
corresponds to the patient being
scheduled.

If the information is correct, click

[OK]
[OK].

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Editing Patient and Study Information Patient Study Workflow

Editing Patient and Study Information

Usage:

z To add patient demographics to a scheduled study (weight, height, etc.)

z To verify or update a study protocol, auto-processing application.

z To add study-related information, referring physician name, or notes.

z To edit Patient Study information for a scheduled study that is currently

open on the screen.

To Do List

Study Entry Select study entry

Opens the Patient & Study

[Edit Study]
information dialog (see Figure A-5)

Patient & Study Info Dialog

Add patient weight, height and

gender under Patient Info.

Under Study Information details on

Patient & Admitting diagnosis,
Study Fields Auto-processing, Accession
Number, Admitting Diagnoses,
Referring and Reviewing physician
and other Notes relevant to the
whole study can be added.

To Save changes.
Apply
Changes Alternate:
[Cancel Changes] or [Quit]

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Patient Study Workflow Deleting a Study from the To Do List

Note The Patient & Study information are accessible from within an open study

session (via the Patient Study Info button— next to the patient name—

see Figure A-6 on page A-9), although some of the study fields are not editable.

To save changes, click [Apply Changes].

To close the patient information dialog within a session and return to the
acquisition parameters, click on the Patient Study Info button again.

Note Pharmaceutical information may be added to each scan in the Admin.

Parameter Category. For additional information refer to Admin Parameters on
page D-56.

Deleting a Study from the To Do List

Usage:

To cancel a study that is scheduled in the To Do list.

To Do List Screen

Study Entry Select the desired study

Delete Study The Delete Verification dialog

button appears.

Delete Studies Screen

Reselect if relevant.

Delete button Click [Delete] or [Cancel]

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Opening a Study Session Patient Study Workflow

Note If data was acquired, it is not possible to delete the item from the To Do list. A
message informs the operator that the study cannot be deleted.

Opening a Study Session

Usage:

z To begin acquisition

z To review scan(s) already acquired

z To add scans in addition to those already scheduled via the protocol.

To Do List Screen

Double click on the desired

scheduled study from the To Do list.

Alternate:
Click on the desired scheduled
study from the To Do list and press
[Acquire Study].
Study Entry
The scan list for the selected
protocol is shown with the first
unacquired scan selected and its
Key Parameters shown. Refer to
Appendix D – Acquisition
Parameters for additional
information.

To review data acquired refer to

Review Tab
Chapter 14 – Image Viewer

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Patient Study Workflow Opening a Study Session
Reviewing Scheduled Scans

Important Notes:

1. It is possible to switch between open sessions via the drop-down alongside

the patient name in the upper left corner of the currently open session.

2. Studies can be accessed at any time, even when another study is open or
a scan is being acquired.

3. It is possible to re-open studies which were completed by clicking

[View Study] in Data Management. In this case the session is opened
directly in the Review tab. Refer to Opening a Completed Study on
page 8-6

Reviewing/Updating Scheduled Scans

Usage:

z To check what scans have been acquired

z To check which scan is in persistence

z To check which scan is acquiring

z To check parameters of a scan

Acquire Tab

Check whether the scan is in

Scan list persistence/acquiring. Refer to
Table 6-1.

Click on a scan name within the

Scan entry
scan on the Acquire Tab

Parameters Review the values predefined for

area each parameter

Parameter Update the parameters as

fields necessary

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Opening a Study Session Patient Study Workflow
Reviewing Scheduled Scans

Figure 6-2 Study Session Window

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Patient Study Workflow Opening a Study Session
Reviewing Scheduled Scans

An icon alongside the scan name identifies the scan phase as shown in the
table below. The scan icons are used in the scan progress indicator within the
header.

Table 6-1 Scan Phase Icons

Icon Scan Phase

Setup

Persistence

Acquiring

Completed

Interrupted CT/AC
scan

Note Scan parameters can be changed at any time, even while another scan is being
acquired. Changes are saved even if the user selects another scan or closes
the study.

Modifications are applied to the Persistence view by pressing [Apply].

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Opening a Study Session Patient Study Workflow
Adding a Scan to a Study

Adding a Scan to a Study

Adding a Scan

Scan List

[Add...] The Add Scan dialog appears.

Select a scan from within any of the

Add Scan
protocols. Generic scans are
Dialog
provided in the Basic category.

[OK] The Add Scan dialog closes.

Duplicating a Scan From the Current Protocol

Scan List

Scan Name Select the desired scan

Copy The Copy Scan dialog appears.

Copy Scan Dialog

Confirm or update the suggested

scan name (scan names must be
unique and can only include
alpha-numeric characters and a
hyphen (-)).
The suggested name is identical to
the copied scan name with the
addition of a numeric suffix.

Scan List

Scan Name Select the newly added scan.

Opens Manage Remaining Scans

[Edit...]
dialog.

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Patient Study Workflow Opening a Study Session
Adding a Scan to a Study

New name Update the name in the New name

field field (see Figure 6-3)

[Rename]
Saves the new name.
button

The Manage Remaining Scans

[OK]
dialog closes.

Figure 6-3 Manage Remaining Scans Dialog

Note If a scan is in persistence or is acquiring, its name will not appear in the list.

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Opening a Study Session Patient Study Workflow
Deleting a Scan

Deleting a Scan

Global Navigation Screen

Opens Manage Remaining Scans

[Edit...]
dialog.

Select the desired scan. Name of

Scan Name
scan appears in New Name field.

Delete button Scan is deleted

The Manage Remaining Scans

[OK]
dialog closes.

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Patient Study Workflow Completing a Study

Completing a Study

Usage:

When acquisition has been completed for this study.

Session Screen

[Close If all scans were acquired the study

Session] will no longer appear in the
button Schedule.

To Do List

Study Entry Select Study from the To Do list.

[Study Acq. If not all scans are to be acquired

Completed] for this patient.

Note Completed studies can be reopened via Data Management (see Chapter 8).
For information on opening a completed study, refer to Opening a Completed
Study on page 8-6.

Note A study cannot be closed if acquisition is in process. To close the study, stop
the acquisition (refer to Manually Stopping an Acquisition on page 7-82).

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Auto Transfer of Study Data Patient Study Workflow

Auto Transfer of Study Data

Auto-transfer of the acquired data can be requested via the system setup to one
or more destinations.

The transfer is done per scan when the acquisition of the scan ends.

Manual transfer can be initiated via Data Management (refer to Chapter 8 –

Data Management).

Auto-processing of Study Data

The protocol Auto-processing parameter defines the list of Xeleris applications

to be applied to the study once study acquisition has been completed (refer to
Completing a Study). This is available only if a Xeleris station is defined for both
auto-transfer and auto-processing (refer to Network Configuration on
page 13-9).

Once all the data has arrived at the Xeleris workstation, tasks for processing
the data are added to the Infinia queue within the Physician’s In-box. If the
Xeleris workstation is configured for auto launch of auto-processing applications,
the first application is started. If more than one application is requested, they
are each launched, in turn, when the previous application is closed. Otherwise,
the applications can be started manually from the In-box (for additional
information refer to the Xeleris Operator Manual--Physician In-box).

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Patient Study Workflow Auto-processing
Auto-processing in Factory Protocols

Auto-processing

Auto-processing in Factory Protocols

The following table shows examples of Auto-processing currently defined for

the factory acquisition protocols.

Clinical Acquisition Xeleris

Notes
Application Protocol Application

Cardiac Rest/ One Day Myovation Protocol includes Rest, Gated

Stress (MIBI) Stress, Stress and a Spot

Cardiac Rest/ One Day HWK Myovation Protocol includes Rest, Gated
Stress (MIBI) Stress, Stress and a Spot.

Primary reconstruction uses FBP.

Comparison Review of IRAC vs.
IRNC

Bone Whole Whole Body WB & Spots

Body Bone Bone Review

Three Phase Three Phase WB & Spots

Bone Bone Bone Review

Onc. SPECT Ga67 Tomo Oncology

SPECT

Onc. SPECT Prostascint Volumetrix for Includes IR reconstruction with

with Hawkeye HWK (In111) Hawkeye comparison of corrected vs. non-
(Indium) Oncology corrected

Brain SPECT Brain FB Tc99m, Brain SPECT

with/without Brain Tc99m
Hawkeye HWK
(Tc99m)

WB Oncology In111 WB Tomo, Whole Body IR with attenuation correction.

SPECT with/ IN111 WB HWK Slicing for Fused review not yet supported.
without Infinia
Hawkeye
(In111)

For additional information on Factory Protocols, refer to Appendix F.

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Auto-processing Patient Study Workflow
Auto-processing in User Protocols

Auto-processing in User Protocols

The user may add Auto-processing to user acquisition protocols using one of
the above Xeleris applications. In addition Auto-processing is supported for all
Xeleris user applications, as well as the Workspace (Processing Card), which
is especially useful for post-acquisition image display. Additional applications
are supported for auto-processing, as shown in Figure 6-4.

Figure 6-4 Auto-processing Applications

For additional information on adding Auto-processing to a user protocol, refer

to Defining the Auto-Processing Application on page 13-64.

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