Myrian ®

Quick User Guide

www.intrasense.fr
About Myrian®
Manufacturer:

1231 Avenue du Mondial 98

34000 Montpellier
France
Tel : +33 4 67 130 130Fax : +33 4 67 130 132

Contact : [email protected]

Web site : www.intrasense.fr

0459
The Myrian® suite is software intended to provide information which is used to take decisions with diagnosis or
therapeutic purposes. Myrian® is CE mark as class IIa medical device

Intellectual property:

Intrasense® and Myrian®, all logos, slogans, trade names, and marks appearing in this document, whether
registered or not, are the exclusive property of Intrasense, unless otherwise stated.
The presentation, illustrations and content of this document constitute a work protected by applicable law
concerning intellectual property, of which Intrasense is the sole owner. Any reproduction, diffusion, adaptation,
translation, or modification, partial or whole, is strictly prohibited without explicit prior written permission of
Intrasense.

Copies of this software and/or functionalities bearing the labels “Alpha”, “Alpha-Prime” or “Beta” must under no
circumstances ever be used for diagnostic purposes.

Myrian® is registered trademark of Intrasense®. Copyright © Intrasense 2018 – 1231 avenue du Mondial 98, 34000 Montpellier (France). All rights reserved.

This product uses the OFFIS DICOM Toolkit DCMTK (C) 1993-2006, OFFIS e.V. and the ECP registration technology © ECP-2008, under ECP patent license
agreement.
Myrian® also includes the following open source codes:
- Wml Math - Copyright © 1998-2012, David Eberly, Geometric Tools, LLC
- openSSL - Copyright ©1998-2011, the OpenSSL Project. All rights reserved. This product includes software developed by the OpenSSL Project for use in the
OpenSSL Toolkit (http://www.openssl.org/)"

Microsoft® Windows® and Microsoft® Word® are registered trademarks of Microsoft®.

GeForce™ is registered trademark of nVidia®.
Radeon® is registered trademark of ATI®.
Pentium® is registered trademark of Intel®.
Athlon™ and Opteron™ are registered trademarks of AMD™.
All screenshots/instructions/specifications are non contractual and subject to change without prior notice

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 1

Images included in this manual are for reference only. They do not constitute any contractual obligation
Key to symbols
In this document, you will see the following symbols:

Caution or safety warning related to the use of the software.

Describe Technical or functional aspects of the software.

Tooltips or advanced functions which may help save time.

Throughout this manual the terms ‘click’ and ‘clicking’ without any other indication refer to a single click performed with the
left button of the mouse.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 2

Images included in this manual are for reference only. They do not constitute any contractual obligation
Contents

About Myrian® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Myrian®Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Myrian®Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Warning! Please read carefully before use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Installation guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

1 Importing Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
1.1 From a Hospital PACS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
1.2 From a CD or DVD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
1.3 From external storage devices (USB keys, etc.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

2 The Study List. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

2.1 Filters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
2.2 Profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
2.3 QuickProfiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
2.4 Preview Thumbnails . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
2.5 Modify Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
2.6 Display Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
2.7 QuickProtocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

3 The Workspace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.1 Opening Studies from the Workspace. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.2 Image adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.3 Mouse-button function settings and profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
3.3.1 Factory mouse profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
3.3.2 Modifying a factory mouse profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
3.3.3 Creation and edition of a mouse button profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
3.3.4 Associate any mouse profile to the current protocol. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
3.4 Mouse button double-click . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
3.5 QuickTools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
3.6 Warning box: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

4 Viewing several Series/Studies simultaneously . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

4.1 Study comparison . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
4.2 Setting up synchronization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
4.3 Synchronization modes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
4.4 Synchronizing the Anatomical Centre. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

5 Data Cleanup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
5.1 Clear Series Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
5.2 Clear Patient/Series/Study Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
5.3 Automatic cleanup database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

6 MPR and CPR Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

6.1 Multi Planar Reformatting (MPR) Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
6.2 Oblique View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
6.3 Coordinate system selection for improved volume visualization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 3

Images included in this manual are for reference only. They do not constitute any contractual obligation
 6.4 Create a Path . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
6.5 Curved Planar Reformatting (CPR) Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

7 MIP and MinIP Rendering. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

8 SeriesCreator: Reformat and Create New Series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

9 Stitching (optional add-on): Combine multiple Series to produce a single image or volume . . . . . . . . . . . . . . . . . 64

10 Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

11 ‘QuickPatient’: loading other series and studies of the current patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

11.1 Opening the QuickPatient in the workspace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
11.2 QuickPatient window. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
11.3 Loading series/studies from the QuickPatient into the workspace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
11.3.1 Drag and dropping one single series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
11.3.2 Drag and dropping multiple series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
11.4 Patient case with multiple identities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
11.5 Viewing and importing remote series using the QuickPatient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
11.6 Show all images for CR Like studies in the Quick Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

12 Measurement Annotation Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

13 Regions of Interest (ROI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

13.1 toggle the ROI overlay independently in separate viewports in Myrian . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

14 Placing Key Images in the Scrapbook or PrintComposer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94

14.1 Capture Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
14.2 Selection of multiple images in the Scrapbook. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
14.3 Print images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

15 ReportCreator: create an illustrated Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102

15.1 PDF ReportCreator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104

16 Printing and Exporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

16.1 Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
16.2 Export to JPEG (email, postings, presentations, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
16.3 Export to a third-party application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
16.4 Export to DICOM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
16.5 Export to DICOM RT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
16.6 Selecting the organization and name of the exported folder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114

17 Interactive guides and tutorials. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 4

Images included in this manual are for reference only. They do not constitute any contractual obligation
Myrian®Introduction
About Myrian®
Myrian® is a software suite intended for the visualization, storage, reproduction and exporting of medical images.
Image data may originate from standard DICOM modalities (CT, MR, US, CR, PT, NM, etc.) or digital photography (jpeg, tiff,
bmp).
Myrian® is adapted to 3D imaging. It enables Multi-Planar Reconstruction (MPR) of native images as well as real-time
modification of the thickness of slice reconstruction.
Furthermore, this software supports MIP and MinIP display modes as well as highly detailed volume rendering.
The modular architecture of Myrian® software means it can be expanded to house the optional Expert Modules, a
comprehensive range of specialized add-ons such as the XP-Liver module for the automatic detection of anatomical and
pathological structures of the liver.

Certain functions described in this manual may not be accessible in your version of Myrian®.

Myrian® functional diagram

Myrian® functional diagram

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 5

Images included in this manual are for reference only. They do not constitute any contractual obligation
Myrian®Intended Use
Myrian® is a medical device software for processing, management, advanced visualization and analysis of multimodality
medical images. Myrian® is intended to provide information which is used to take decisions with diagnosis or
therapeutic purposes.
It provides Users with the following features:
- Import and export of DICOM files from/to any DICOM-compliant modality, workstation or PACS.
- Visualization of DICOM images in various standard visualization modes (e.g. MPR, 3D…etc.) with optional
image-alignment feature;
- Creation of Objects Of Interest (“OOI”) for analysis and measurement purposes;
- Generation of medical reports;
- Virtual Cutting surface tool for preoperative evaluation of surgery strategies;
- Longitudinal Follow-up of patient, designed to support the oncological workflow by helping the user to
confirm the absence or presence of lesions, including evaluation, quantification, follow-up and documentation
of such lesions.
Common Users are trained medical professionals, including surgeons, radiologists, clinicians and technicians.
Myrian® is designed to be run:
- On standard Standalone Platform, through the installed operating system. The hardware of such platform
consists in “off-the-shelf’ standard PC computer components and may be purchased independently by the end
user.
- Remotely, through a network connecting a Client Platform (standard desktop or laptop PC, Apple® Mac, etc.) to
the Server Platform on which Myrian® is installed. This mode of usage of the Myrian® application is called
“Remote Execution Mode”.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 6

Images included in this manual are for reference only. They do not constitute any contractual obligation
Warning! Please read carefully before use

Caution: US Federal Law restrict this device to sale by or on the order of a trained medical professional, including
surgeon, radiologist, clinician and technician.

Myrian® must not be used on portable devices such as a mobile phones or tablet computers for diagnostic purposes.

This software is a Medical Device as defined in the European Council Directive 93/42/EEC. Before use, please make sure
that you have thoroughly read and fully understood all the safety and regulatory considerations outlined in this section.

This medical software in no way replaces the competence and judgment of a qualified medical practitioner. It should
only be used by qualified and trained persons who are fully aware of the software potential and limitations in the lesion
detection by scanning method.

Intrasense assumes no liability for any misuse or clinical outcome resulting from the use of the software as an aid to
diagnosis. The software is made available to the User with the understanding that the software is only an aid or adjunct to
processes or decisions that can be made without the use of the software.

The software is designed as a visual aid and as such it is not recommended for use in applications where the image
geometry or the fused image geometry (as displayed by the software application) cannot be confirmed by other means.
The software should not be used as the sole basis for surgical planning, or the preparation, execution or post-operative
assessment of surgical practices.

The User should be aware that Myrian® makes use of certain technologies that interpolate within the data provided. In
cases where the pathology is near to or smaller than the resolution at which the data is acquired by the medical apparatus,
the generated data may sometimes resemble healthy tissue. Occasionally, such interpolated data may equally lead to artifacts
which should be identified and considered as such.The User should always refer to the image analysis performed in native
mode.

The User should be aware of the relative precision and validity of any results arising from the use of Myrian® (displayed,
printed or exported). The quality of the data generated by the software is directly dependent on the original quality of the
data provided and any potential manipulation by the User as well as the quality, nature and configuration of the display (or
print medium) and the need to interpolate data for the purposes of display. As an example, measurement values given by
Myrian® depend entirely on the calibration settings found in the DICOM image’s header.

Although Myrian® software is subjected to very thorough and intensive testing by Intrasense, it is nevertheless possible

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 7

Images included in this manual are for reference only. They do not constitute any contractual obligation
that unforeseen measurement and display errors may arise during use of this software. Users should at all times be aware and
warned of such an eventuality. Should the User notice any dysfunctions or faulty behavior of the software liable to put the
patient at risk, we strongly recommend that the User contacts Intrasense without delay at the following email address:
[email protected]

Myrian® treats image data originating from medical Studies which may potentially contain information that identifies
individual patients both in the local database and through the export of data. Even though this data encryption is disabled by
default, it is the User’s responsibility to prevent unauthorized access.

Prior to performing medical diagnosis on images created by Computed Radiography (CR in DICOM terminology),
please ensure the screen used is CE marked in compliance with Council Directive 93/42/EEC concerning medical devices.

LCD screens and computer projection systems may affect the display of imagery in a way which may alter perception.
The display settings in Windows® should be set via the graphics card driver to the highest resolution available and the area
displayed should be adjusted to preserve height/width aspect ratio (black borders may appear). Please note that such
distortion of the picture quality, known as anamorphosis does not affect the accuracy of any type of measurement made or
displayed in Myrian®.

The accuracy of the measurements displayed in Myrian® depends on the image resolution.

For security reasons, we strongly encourage upgrading to Adobe Reader X (10) where possible to view 3D PDF files. If
you upgrade to the new Adobe Reader, a separate install of Flash Player will be required by the Adobe Reader, rather than
using a built-in system which was previously the case in anterior and current versions and was source of vulnerability
problems. Initially opening a 3D PDF does not show 3D content but it can be enabled by simply setting the menu checkbox
at “Preferences – 3D and multimedia – Enable 3D content”. As Adobe Reader X has a stronger security model, this change is
not required if you upgrade.
Moreover, a warning yellow message bar also appears regarding viewing untrusting documents.
We also recommend you to disable Adobe Reader X automatic updates:
- Open Adobe Reader application and Choose Edit>Preferences
- In the categories on the left, click on Updater and choose ’Do not download or install updates automatically’
- Click OK

This product should only be used with approved hardware and software. Please refer to the Hardware and Software
Configuration section for further details.

If using ATI graphic cards, the User may need to change its Renderer settings into Hardware GPU instead of Software
CPU for better performance in Endoscopy Mode.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 8

Images included in this manual are for reference only. They do not constitute any contractual obligation
 If the LOD (Level of Detail) is activated, the image may be degraded.

It is the responsibility of the User to ensure that the image datasets inputted to the Module are complete and that no
image or information is missing, otherwise results may not be reliable.

Some DICOM image formats include a module called « Real World Value Mapping » (described in DICOM Standard part
3, supplement 103). Myrian® supports commonly used values.
For security reasons, when some of those unsupported values are detected, Myrian® impedes the display of all
measurements/calculations based on image intensities (i.e. “n/a” mention on measurements, parametric map computations,
etc.)

Whenever 32-bit native images are imported in Myrian®, those images are by default converted into 16-bit images
which may result in the information loss in terms of image intensities.

The modality operator is responsible for the quality of the input data and the correctness of the patient information.
Suboptimal data may induce suboptimal results.

Using CT scans outside the recommended parameters is not recommended and may result in inaccurate results for the
identification of ROIs.

This product has been designed to function on DICOM standard 3.0 complete data sets. There should be no missing
images within the data set and the software should not be used to process interpolated data. If slices from the image data set
are missing then the results are not reliable.

Myrian® considers as low attenuation all regions which density is below -950 HU although this threshold value can be
configured by the User. Prior to use of the CT modality, the User should always make sure that it is properly calibrated to
ensure low attenuation calculation correctness

In your Institution, Data compression may be performed to facilitate transmission and storage. Several methods exist
which may be used with no reduction in clinical diagnostic image quality, including both reversible (“lossless”) and
irreversible (“lossy”) techniques. These methods should be used under the supervision of a qualified physician who should be
responsible for choosing and periodically reviewing the types of compression used to ensure appropriate clinical image
quality.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 9

Images included in this manual are for reference only. They do not constitute any contractual obligation
 If the User opens any image which is in ”lossy” format, the message ‘image with lossy compression’ is displayed on the
corresponding image(s). The compression ratio display is available following the procedure described in the User Manual

We advise you against using DICOM images with lossy compression.

The software operator is responsible for quality control of the images.

The term ‘Matching’ relates to the process enabling to identify and thus pair equivalent anatomical structures from two
(or more) distinct series belonging to the same patient. At no time will the User access deformed anatomical or functional
images.

When a Matching process between series is performed, always check the resulting synchronization validity, particularly
when those series have few anatomical references such as in functional imaging (for example, diffusion series).

The actions of the User may directly affect the accuracy of functions within the software environment.

The image Scrapbook functionality is intended for storing images along with any Annotations to provide a qualitative
overview of data. Under no circumstances should it ever be used as a primary diagnostic means.

Geometric distortion such as unequal magnification, pincushion distortion and parallax errors is known to exist in
conventional radiography, such as CR and RF radiography. In order to minimize errors, it is recommended to calibrate such
imagery as near as possible to image centers and over at least 200 mm.

All series that are compatible with MPR reconstruction can be loaded directly in volume mode, however the filters
applied to the image may affect the image quality whenever the displayed series is subject to one or both conditions
described below:
- Series where the inter-slice gap is greater than 10% of the slice thickness
- Series containing various voxel dimensions (Voxel Anisotropy) where the dimension of the largest voxel is more than 5 times
greater than the dimension of the smallest voxel
In such cases, a warning message appears at the bottom of any of the viewports using these filters indicating that the image
is not suitable for diagnostic purposes.

The segmentation engine performance results may be limited by the following factors:
- The quality of the image data provided as input to the segmentation engine for analysis.
- The training and experience of the clinical users in acquiring image datasets of the colon and applying post-processing

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 10

Images included in this manual are for reference only. They do not constitute any contractual obligation
software application.
- The User’s command of the functionality and application of the segmentation engine.

The User should visually check that the ROI segmentation is correct. If not correct, the User should re-segment the ROI.

Myrian® takes ROI superimposition into account. Any voxels that are shared between several ROI are counted only
once.

Surfacic ROI Mode is not suitable for Diagnostic Purposes.

To prevent any diagnosis errors, please check that the Centerline, the accuracy of the position of the lumen and outer
wall boundary contours, as well as the position of lesions and reference points all match-up to the exact anatomical positions.

Clinical decisions should never be based solely and entirely upon these results. You must correlate the interpretation
with the original 2D images.

The Fusion feature is designed for use as a visualization tool only.Therefore it is the responsibility of the User to
determine if the results of image fusion are satisfactory for visualization.

As a Medical Device, Myrian® is subject to specific requirements regarding the display of measurements. In this regard,
all metric units displayed in Myrian® and belonging to the Metric International System enforce the requirements of the BIPM
(“Bureau International des Poids et Mesures”).

In order to allow measurements to be performed, image data from CR or XA/XRF or DX modalities are automatically
calibrated according to DICOM standards (ftp://medical.nema.org/medical/dicom/final/cp586_ft.pdf). Accordingly,
Myrian® calibrates images in the first place on the basis of the PixelISpacing value retrieved in the DICOM fields, and where
applicable, on the ImagerPixelSpacing attribute. In that case, a message pops up to inform the user.

Measurement performed on the projection images, as is the case for DX, CR, DR, DX, RF and XA imagery, do not reflect
the real size of the object that is measured in the patient’s anatomy.

When using SUV calculation during PET assessment, certain assumptions are made with regard to the reference time
for the acquisition of the data series. Variability in the interpretation of requirements outlined in the DICOM Standard with
regard to determination of the start reference time during acquisition and the time of tracer injection may result in variability

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 11

Images included in this manual are for reference only. They do not constitute any contractual obligation
in the SUV values calculated by different vendors. It is important to note that due to inconsistency of approach throughout
the industry, the acquisition time used in SUV calculation may be any of the acquisition times presented in the DICOM data.

It is equally important to note that SUV is affected by a number of physiological factors which may cause variability.
Taking these two factors into account, SUV can be thought of as a simplified measure of radio-pharmaceutical uptake which
has a complimentary rather than directive role in the assessment, treatment and staging of disease.

The MIP rendering tool can be used on PET studies with FDG [18F] fluoro-2-deoxyglucose and may be suitable for use
with other oncological probes. Some adjustments may be required to optimize performance with other radio-
pharmaceutical products.

The ‘Set ROI’ feature should only be used in 2D planes and not in the 3D Fly through. Placing a seed point on a 3D
volumetric reconstruction cannot give an accurate location.

Automatic Vessel Measurements require Contrast-enhanced CT images. Measurements can only be calculated on
contrast-enhanced lumen.

It may occur that some Measurements do not match-up absolutely to anatomical measurements in the actual patient
volume.

When using Combined Measurements, the User must be aware that errors, inconsistencies or mistakes may arise in
their definition, in particular:
- The unit of measurement may not match that used in the actual formula
- The Combined Measurement Name might not match the corresponding Description
- The Name and/or Description of the Combined Measurement may bear little or no relation to its Formula, or may be
ambiguous
- Existing Formulas may contain errors, such as “operand” or “variable definition” errors
- Accidental match-ups between certain ROI and certain variables may generate Combined Measurement errors
- Combined Measurements are reconfigurable. It may therefore occur that a given factory preset may no longer be
configured according to its original parameters.

Intrasense provides a number of factory Combined Measurement presets which are intended as examples, however
we do not guarantee the exactitude of computed results in a clinical context. Intrasense can only warrant the exactitude of
results obtained from the computation of factory preset formulas using the original factory values of variables.

It is the sole responsibility of the User to create, modify and use any Combined Measurement in the context of
diagnosis.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 12

Images included in this manual are for reference only. They do not constitute any contractual obligation
 Careful checking and counter-verification using other measurement methods should always be performed to validate
results.

It is essential that the radiologist examines all images in the CTC examination, not only the images with segmentation
engine marks. The User should examine the entire colon. A 3D read should examine the colon in both directions.

It is essential that the User check the colon segmentation thoroughly if using a primary 3D reading.

The distance from rectum calculation should not be used for diagnostic purposes as it should only be used as a guide
to locate the ROI in the colon. The distance from rectum measurement should not be used as a guide for Optical
Colonoscopy (OC) examinations.

The computer operator must click on a polyp to launch segmentation.

The PEF has been designed to highlight regions with a diameter in the range 5-20mm.

Failure to comply with scanner specific protocols may result in inaccurate results for the identification, segmentation
and measurement of ROIs. Scans must comply with good practice for CT Colonography.

Segmentation may be suboptimal for pedunculated polyps, polyps arising from folds and flatter regions.

Reproducibility of the PSM output cannot be guaranteed.

It is not recommended that PEF be used with prepless (no colonic cleansing) or poorly insufflated cases as this may
affect the product’s sensitivity. The colon should be well distended. Performance of the PEF may be less than optimal in cases
where faecal or fluid tagging has been used.

It is not recommended that FT be used with prepless (no colonic cleansing) or poorly insufflated cases as this may
affect the product’s sensitivity.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 13

Images included in this manual are for reference only. They do not constitute any contractual obligation
 Users should visually check that the polyp segmentation is correct. If not correct, users should re-segment the polyp.

When calculating the total volume of the Healthy Liver ROI, Myrian® takes into account every existing instance of
“Healthy Liver” ROI, regardless of any modifications to the “Name”. This is also the case for “Kidney” ROI.

To avoid any potential errors, verify the accuracy of all existing “Healthy Liver” ROI as well as that of any ROI volume
calculated relative to the Healthy Liver ROI. The same applies to the “Kidney” ROI.

Whenever the “Healthy Liver” ROI is modified, verify the pertinence of any relative ROI. The same applies to the “Kidney”
ROI.

This device is indicated for mammography only with the proper module XM-MG. This module isn’t marketed on the
American territory.

Lossy compressed images and digitized film screen images must not be used for primary image interpretations.

For true-size (1:1) size printing, please ensure that the DICOM Server used for printing has been properly configured for
1:1 printing to avoid any potential error.

When using 1:1 size printing functionality, please be sure to check carefully that all values which appear on the printed
copy strictly match all those displayed on screen before proceeding with any critical task concerning patient security.

True-size printing may not function properly in cases when the selected the paper format does not match the actual
paper size.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 14

Images included in this manual are for reference only. They do not constitute any contractual obligation
Installation guidelines

Hardware and software configuration

Myrian® is not supported on Windows Vista Operating System, Windows 7 & Windows 8.

The minimum configuration is the minimal required for Myrian® to run according to specifications.

The system might run on computers not matching the minimal system configuration but it will not be supported by
Intrasense.

Myrian® may run on systems with 16 or 24 bit graphics cards, however this configuration does not deliver diagnostic
quality images so it is no longer supported.

The End-user should ensure that the machine on which this software is installed is at all times adequately protected
against virus/worm contamination by installing and periodically updating appropriate anti-virus software.

Upgrading Myrian® from versions of Myrian® which are older than the 1.5 might require hardware upgrades to
maintain the same level of performance.

Any configuration with performances similar or above the recommended configuration should be suitable to run
Myrian®, taking into account notes 2, 3 and 4 below.

For Computed Radiography (CR) Studies, the internal memory (RAM) requirements are: 2 GB (minimum) and 4 GB
(recommended).

Please refer to the latest Myrian® Release Notes included in the ‘Doc’ folder of your installation package for detailed
Configuration Specifications.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 15

Images included in this manual are for reference only. They do not constitute any contractual obligation
Screen Calibration
To set screen resolution parameters:
- Right-click on the Windows® desktop
- Select ‘Properties’ from the resulting context menu
- Select ‘Parameters’
- Modify the ‘Parameters’ section as required

Recommended resolution is 1600 x 1200/32 bits (or at least 1280 x 1024/32 bits), with the exception of certain specific
modalities (MG...).

It may be necessary/mandatory to adjust the brightness and contrast settings of your monitor after installation to
adapt to ambient lighting conditions. A badly adjusted screen may compromise your interpretation and analysis of medical
images.

A screen calibration tool, ‘ISCalibrator’ is integrated in this software. It is launched automatically the first time the software
is run. Until the calibration has been completed, it will continue to be launched every time you run the application. You can
also access ISCalibrator directly via the ‘Preferences/Display’ tab. It is strongly recommended to perform this calibration
(please refer to Myrian® Installation Manual for further details).
Note: For mammography please use IS Calibrator tool in MG mode.

Recommendations concerning your work environment

Working for prolonged periods of time on a computer can cause hazards to your health, including fatigue, impaired vision,
muscular pain, poor blood circulation, strain on certain joints and general physical or mental stress.
Take a moment to consider your daily routine and establish a preventive strategy for such hazards. Modifying the position,
layout or lighting of your desktop and using furniture which is more conducive to a healthy posture will help to improve your
working conditions.

Automatic user log off after inactivity

In order to protect against unauthorized use or disclosure of individual health information in compliance with the HIPAA
(Health Insurance Portability and Accountability Act, in the USA), you are automatically logged off in the following cases:
- Myrian® and the Operating System remain idle for 5 minutes. In that case, a login dialog box appears asking you to
re-enter your password or click “Quit” to close the application. The login cannot be changed.
- When Myrian® and the Operating System remain idle for 6 minutes, the application is closed.
- During the initial login when Myrian® is started, if no valid login is entered for more than 6 minutes, the application is
closed.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 16

Images included in this manual are for reference only. They do not constitute any contractual obligation
1 Importing Studies
1.1 From a Hospital PACS
- Select the “Remote Studies” tab
- Type the patient Name and/or the PPID in the relevant field by clicking on the corresponding part of the bar
underneath the Column Headers

- Filter your search according to Study Type (Modality) or leave the field empty
Whenever you add a modality to the ‘Modality’ column filter field in the Remote Studies tab, the ‘Any’/‘All’ Modalities
filter options appear at the far right hand-side of the search parameters bar at the top of the window.

The ‘Any’/‘All’ Modalities option is used for multiple modality query/retrieve operations when you are searching
for specific Studies such as dynamic CT/PT Fusion Studies

If you select ‘Any’ in the Modalities Filter Options, your query will retrieve all Studies containing at least one Series of at
least one of the selected Modalities
If you select ‘All’ in the Modalities Filter Options, all Studies containing at least one Series of each of the selected
modalities will be retrieve.
- Filter the Study List according to the ‘New’ or ‘Opened’ status via the Status Column Filter Window by clicking
on the ‘Advanced’ Option in the Status Column Menu

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 17

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - Filter your choice by selecting Study Dates

- Or more specific Dates by clicking on ‘<Advanced>’ and selecting your choice of Dates in the resulting Menu

You can also click on “Remote Studies” in Context Menu by right-clicking on your desired Study to automatically
launch a Query/Retrieve on your Main PACS according to the corresponding PatientID

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 18

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - Click on
- Click on the desired Patient line to select the whole study, or
- Click on the folder icon itself to expand the list and select your choice of Series

- To finish, click on to import the Series to your Local Study Database

You can double-click on a Series/Subseries to import it directly

When you are in the Study List tab, simply type a letter or number on the keyboard to automatically select the first
study in the list with a Patient Name starting with that letter or number

Select a Study in the Local Study List then click on ‘Remote Studies’ to automatically launch a Query/Retrieve on
your Main PACS according to the selected PatientID. The results will then be displayed in the Remote Studies tab

Importing is done “in the background” which enables other tasks to be carried out at the same time in the

interface. You can check the import status by clicking on the ‘Background Jobs’ button (butterfly icon ) located at
bottom-right of the screen

1.2 From a CD or DVD

- Select the ‘Local Studies’ tab

- Click on in the Tools menu at the top of the Local Studies Screen

- Then
The following screen appears in which you can select any Series, multiple Series or all Series:

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 19

Images included in this manual are for reference only. They do not constitute any contractual obligation
 Use CTRL/Shift+click to make multiple
selections in the list

- Click on to import the Study to your Local Database

If you browse for a new location clicking on , Myrian® first looks for a DICOMDIR file and reads it if
it exists: this process is really time-saving. If none, the application starts scanning the disk.

If you click on , the same process takes place: Myrian® first looks for a DICOMDIR file and reads it if
it exists. If none, the application starts scanning the disk.

Click on a Series thumbnail to open the Preview Screen before import

>

- Navigate through the slices by turning the mouse-wheel (or click-and-drag the mouse over the thumbnail)
- Double-click on the image to import the Series

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 20

Images included in this manual are for reference only. They do not constitute any contractual obligation
 Whenever a Myrian® session is open, inserting a CD or DVD into the PC’s CD/DVD player opens a dialog box
displaying the contents of the disk.

When the “Reconcile Patient’ checkbox at the bottom-left of the Import window is activated, the Patient Reconciliation
window opens automatically as soon as you click the ‘Import’ button

Activate the Export to PACS checkbox to launch an automatic Export to PACS process of the selected Studies

If you activate the ‘Use Patient Data from Imported Series’ radio button, the Patient Reconciliation process will be
overridden and the Patient Information from the Imported Series alone will be used.

If you activate the ‘Reconciliation from PACS’ radio button, Myrian® will automatically launch a query for all Studies
stored on the PACS bearing the same Patient Name.

- Press to launch Reconciliation

The Reconcile Patient feature is not available for Follow-ups.

The Reconcile Patient feature changes Patient Info of Series only.

1.3 From external storage devices (USB keys, etc.)

- Click on the Local Studies button

- Click on in the toolbar at the top of the Local Studies Tab

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 21

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - Click on in the resulting screen

- Use the Windows browser to locate and select the desired folder then click OK

- In the resulting window, select one or more Studies/Series (using Ctrl/Shift button + mouse-click for multiple
selections)

Use CTRL/Shift+click to make

multiple selections in the list

- Then

Click on a thumbnail to preview a Series before importing

Note : In the settings, in the system tab and in module space, using the checkbox you can select which DLL
Myrian should load or not. Removing some unused DLL will speed up Myrian startup.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 22

Images included in this manual are for reference only. They do not constitute any contractual obligation
 Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 23
Images included in this manual are for reference only. They do not constitute any contractual obligation
2 The Study List
2.1 Filters

1 Click on the Study List tab

2 Type a name in the ‘Name’ field or select a Study in the Local Study List

The Local Study List can be filtered using Name, Study Type (Modality) or any other criteria by clicking on the line
immediately beneath the desired criterion and typing-in your filter condition

You can also use the drop-down menus below the column title fields

Press to deactivate all column filters. Note that this button appears at the top-right
of the Study List Tab only if a filter is activated

2.2 Profiles

You can click on the “Capture or Modify current Profile” button (floppy disc icon) in the Column Configuration

Profiles toolbar above the Local Study List to save or configure your filter
settings
- To select a Profile, use the Column Profiles drop-down list

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 24

Images included in this manual are for reference only. They do not constitute any contractual obligation
 To delete a Profile you must first select it in the drop-down list, then click on “<Remove>” at the top of the same
drop-down list

You can also create or modify Column Configuration Profiles by clicking on in the same toolbar, or use to
restore the user set Default Column Configuration

2.3 QuickProfiles
You can use the “QuickProfiles” function to create quick access buttons at the top of the Study List for your favourite
Study List Profiles. You can define in your QuickProfiles which Protocols or QuickProtocols will appear in the Study List
configuration, as well as column and filter settings.
- At any point when you are satisfied with your column and filtering configuration, click on the “Capture or

Modify current Profile” button to open the Current Profile modification window

- To create a new Profile, enter a name in the “New Profile” field under the QuickProfiles list

- To create a new QuickProfile, double-click on a desired Profile in the “Profiles” box at top-left of the window or

select it and use the “Add selected Profile to QuickProfiles” button at the right of the QuickProfiles list

Tick the checkbox at the bottom-left of the Profiles window to automatically add any
selected new Profile to the QuickProfiles list

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 25

Images included in this manual are for reference only. They do not constitute any contractual obligation
 This will also automatically create a new QuickProfile button at the top of the Study List and activates it as the

current Profile

- To delete a QuickProfile, select it in the QuickProfiles list and use the “Remove selected QuickProfiles” button

at the right of the QuickProfiles list

2.4 Preview Thumbnails

1 Click on the study folder icon to expand the list of Series contained in a Study

Thumbnail scrollbar

Diskspace gauge

A Thumbnail of each Series/Subseries you select is displayed at left of the Study List (use the scrollbar at left to
view any hidden thumbnail).

Click on a thumbnail to open a preview screen in which you can preselect the specific range of slices you wish to
open

At any time, you can check the available disk space of Myrian® database system at the bottom-left of the main
screen.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 26

Images included in this manual are for reference only. They do not constitute any contractual obligation
 You can double-click on thumbnails to open Studies directly

Slice scrollbar

You can modify the size of Study List icons and lines in the Preferences>Display>Miscellaneous menu

2 Select one or more Series then click on the ‘Open Series’ button at far left of the toolbar

You can switch between Local Study Lists in Myrian® by changing the Database directory in the ‘Files’ section of
the Preferences>System Tab. This can be particularly useful if you are working on several different Study Lists such as, for
example, a research database and an everyday clinical database

Changing Local Database is done ‘on the fly’ and does not require a software reboot

2.5 Modify Patient Information

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 27

Images included in this manual are for reference only. They do not constitute any contractual obligation
1 Right-click on the Study of your choice and select ‘Modify’ from the context menu

2 Select ‘Patient Info in the ensuing sub-menu

3 Click on to open the Local Study Database Reconciliation Window and select a Study
of your choice

4 Press to open the Patient Reconciliation Window and select a Study of your choice

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 28

Images included in this manual are for reference only. They do not constitute any contractual obligation
 from the PACS

It is possible to modify Patient Information of Patients that have one or more Follow-ups in progress

This operation changes the Patient Information of all Series for the Patient concerned simultaneously.

If the Patient being modified has one or more Follow-ups in progress, the Patient Information is updated to the
new values in each Follow-up.

Patient Info modifications in Reports created prior to the modifications are not updated.

It is not possible to reconcile Series that belong to a Follow-up

2.6 Display Protocols

1 Select a Study or Series and click on the “Open Series” button

Use the CTRL/SHIFT key + click to select multiple Series or Studies

This action opens the Protocols tab

2 Double-click on your choice to launch the Series
3 in the settings, by checking the opening by double click you can open this way an exam in the study list by
clicking directly on the study

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 29

Images included in this manual are for reference only. They do not constitute any contractual obligation
2.7 QuickProtocols
QuickProtocols are user-defined Protocols which you can configure to appear at the bottom of the Study List for quick
access.

1 Click on the “Configure QuickProtocols” button (cogwheel icon) at the bottom-right of the Study List
2 In the QuickProtocols Configuration Window, select a Protocol in the QuickProtocols Box at left and modify
its properties via the fields at right.
3 You can specify or modify:
- The "Protocol", to define what type of Display Protocol you wish to use,
- The "Application Protocol” and/or the associated Protocol step when available, to define what specific
Tools and Toolbars, etc. will be available,
- Which "Viewport Layouts” will appear in the given Protocol,
- The Name of the QuickProtocol button (you can rename any Protocol freely).
4 You can also associate the double-click to a given protocol associated to the requested modality(ies).
In that case, double-clicking on the desired series will automatically open it using the assigned protocol.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 30

Images included in this manual are for reference only. They do not constitute any contractual obligation
When a double-click has been allocated to a given protocol, the related protocol thumbnail displays the following

mouse icon

You can select any QuickProtocol and modify it freely

5 Use the Move Up/Down buttons / to modify the order the QuickProtocols appear in

6 Click on under the QuickProtocol list to create a New QuickProtocol

By default, all new QuickProtocols are set to “Native Images”. Once selected, they can be modified in the ways
described above

7 To remove a QuickProtocol, first select it then click on to the right of the Create New
QuickProtocol button

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 31

Images included in this manual are for reference only. They do not constitute any contractual obligation
Click on to restore Factory Settings for QuickProtocols

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 32

Images included in this manual are for reference only. They do not constitute any contractual obligation
3 The Workspace
3.1 Opening Studies from the Workspace
The “Open Next Study” function enables you to load and review your entire Local Study List, Study by Study, directly in
the Workspace without having to return to the Study List. This mode takes into account any active filtering (Name,
Modality, Gender, etc.) you have applied to the List (i.e. if you have filtered your Study List to display only “CR”-type
images created on a specific date, this feature will load only those types of Studies).

This option enables you to close all open Series and open the next Study in the Study List directly from the ‘Series
Layout’ Toolbar in the Workspace by clicking on the ‘Open Next Study’ button

- Click on the ’Local Studies’ button

- Open a Study/Series using the desired Protocol

- When you find yourself in the Main Workspace, click on the ‘Open Next Study’ button to launch the next
Study in your Local Study List automatically closing the current Series

The Study List is reviewed taking into account any active filtering or sorting

If a Study is opened via a QuickProtocol, the next Study will be opened with the same Protocol.

If a Study is opened via a Protocol selected by the user in the Protocols tab, when the next Study is opened, the
Protocol selection screen will be opened again.

3.2 Image adjustment

Once the Series is loaded, you are ready to view the Images

Some Tools are hidden by default in various Protocols. To bring all your activated tools back into view, right-click
on the Toolchest and select ‘All’ from the context menu

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 33

Images included in this manual are for reference only. They do not constitute any contractual obligation
 You can hide all toolbars and the bottom information panel if you wish to toggle the image display to full screen
mode: press CTRL + I
To restore overall layout mode back to normal, simply press CTRL + I again.

- Press to activate the Windowing tool and modify Windowing settings manually,
or,
- Use the Presets (Bones, Lungs, etc.) from the drop-down menu:

- Click on “Customize” to modify the Windowing Presets to your own needs

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 34

Images included in this manual are for reference only. They do not constitute any contractual obligation
- Customize the list of Presets available for each Modality

- To sharpen the definition of any image, click on the Edge Enhancement button at the bottom-right of the
corresponding Viewport and choose the desired setting from the menu:

- Click on the Grid Filter ‘On’ button to remove artefacts caused by Anti-Scattering grids used on CR
Modalities.

- Click on the Grid Filter ‘Off’ button to remove the Grid Filtering

Filtering settings are persistent. Filters are active from session to session until they are removed

- Use to zoom in and out on any specific point in an image

- Move the image using the Pan tool

- Click on to navigate through the image slices

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 35

Images included in this manual are for reference only. They do not constitute any contractual obligation
 While navigating in the active series, a red progress bar located at the bottom of the viewport appears to visually
indicate real-time the images that have been/not been displayed yet (in red). When skipping slices, the following
message pops up to notify you: ’Slices might have been skipped while scrollling’ as illustrated hereunder:

If navigation seems too slow, uncheck the ‘Image per Image navigation is default’ option in the Preferences>
Display>Miscellaneous menu

- Use the Grid Mode button to display the Native Images in the Series

The Movie Mode and Magnifying Glass can be effective presentation tools during Medical Staff Meetings,
Case Reviews, Seminars, Grand Rounds, etc.

Press the ‘M’ key shortcut to switch to MPR (if both the ‘ObliqueNavigator’ and ‘MPRNavigator’ options have been
activated in your version of the software)

Click on the desired Layout in the Viewport Layout Toolbar to instantly change the Display Protocol

- Double-click anywhere in the image while in Navigation Mode to move the Anatomic Centre to that
location
- If you are in Oblique mode, press the ALT key to place the Anatomic Centre automatically to the mouse

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 36

Images included in this manual are for reference only. They do not constitute any contractual obligation
 position
- While holding down the ALT key, click-and-drag the mouse within the Oblique Viewport to swivel the view
around the Anatomic Centre
Projected images can be flipped horizontal/vertical or rotated 90° to the right/left using the Flip/Rotate buttons

which appear at the bottom-right of CR, DR, DX, RF and XA images

For all other modalities, use the Flip/Rotate menu which appears when you click on the orientation square
at bottom-right of each Viewport

3.3 Mouse-button function settings and profiles

3.3.1 Factory mouse profiles
By default, the applied mouse button profile is the default configuration

- If you wish to switch from the mouse default configuration to another mouse factory profile, click on and
select a mouse button profile among those listed.

3.3.2 Modifying a factory mouse profile

You can modify any factory mouse profile as you wish.
- Assign any tool to any of the mouse-buttons by simply clicking with the desired mouse-button on the tool you
wish to assign it to, or
- Click with the corresponding mouse button on the Mouse illustration at the bottom of the Toolchest to select
(with the left mouse button) your choice from a tool contextual menu

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 37

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - To save it, click on then select ’Save’ from the resulting contextual menu.

This customized profile becomes the default configuration profile and is automatically:
- Updated with the new added tools when opening a view in the workspace
- Named ’Copy of (factory name)’

You can rename this ’Copy of (factory name)’ profile via the ’Configuration...’ button

To switch from the customized mouse profile to one of the existing factory mouse profiles, click on ’More’ to
display the mouse profile list

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 38

Images included in this manual are for reference only. They do not constitute any contractual obligation
3.3.3 Creation and edition of a mouse button profile
- Click on ’Configuration...’ from the mouse profile contextual menu to open the Mouse Profile Editor.
The following configuration window opens:

Factory mouse profiles (represented by the padlock icon ) cannot be edited nor deleted.

Only user-defined mouse profiles can be removed clicking on

A user-defined mouse profile can be identified by its user icon (in the above illustration, it is displayed beside
the Copy of Default Configuration profile) instead a padlock. Additionally, a checkmark is displayed over the user
icon whenever it is the current default configuration.

- Click on
- Rename this new mouse profile in the Name field

Rename Profile

- Assign the mouse buttons to the tools of your choice, selecting the default assigned tool then clicking on
’Tool...’ (or simply double-clicking on the default assigned tool) to open the ’Tool’ contextual menu.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 39

Images included in this manual are for reference only. They do not constitute any contractual obligation
 To prevent any modification of the assigned button in a given mouse button profile, you can lock any of those
tools clicking on the padlock icon

- Define the following profile properties:

- Press OK to validate and close the mouse configuration window.

New tools can still be assigned to a given mouse profile at any time (but they won’t be saved unless clicking on

the Save button ).

Right-clicking on the ’Select a mouse profile’ button will reset the tools on each button to the ones saved in the
profile.

3.3.4 Associate any mouse profile to the current protocol

- Click on ’Link with protocol’ from the disk icon contextual menu

Each time a series will be opened with this protocol, the associated mouse button profile will be the default
configuration

- To cancel this preselection, click again on and select ’Unlink with protocol’ from the contextual menu.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 40

Images included in this manual are for reference only. They do not constitute any contractual obligation
 If a factory profile is linked to a protocol, a copy of it is automatically created and becomes the default profile.

3.4 Mouse button double-click

Irrespective of previous mouse button settings, double-clicking with the mouse button on a viewport displayed on the
main Workspace enables you to perform the following actions:
- Double-clicking with the right-mouse button enables to locate the anatomical center under the mouse cursor.
- Double-clicking with the left-mouse button enables to reframe the viewport in full screen mode

Double-clicking again on the enlarged viewport will restore the workspace layout

3.5 QuickTools

This feature requires a 5-button Mouse

The QuickTools function enables you to configure sets of Favourite Tools. You can customize your own palettes which
you can then call up at any time during a Series review on a floating Toolbox.
- When a Series is open in the Main Workspace, press the “Q” shortcut key to open the QuickTools Toolbox

If you have used any tools before calling up the QuickTools Toolbox, a ‘Recent’ palette displays the most recently
used tools (up to 3 maximum)

- Use the “forward” and “back” arrows at the top of the QuickTools Toolbox to cycle through the various
existing palettes

By default, there are 3 available QuickTools palettes: 1 Image Control and 2 Measurement palettes

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 41

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - Click on the “Create New Palette” button ‘+’ at the top-right of the Palette to open the Palette Configuration
Window

The QuickTools Palette Editor enables you to create up to 5 different palettes, each of which is represented by a separate
tab. Tabs are numbered 1 to 5

- Click on the ‘Add Tool’ button at the bottom-left of the Editor to open the Mouse Tool Context Menu and
choose items from this menu

You can remove elements from the palettes using the ‘Remove Selected Tool’ button beside the Add Tool

button, or rearrange them by using the ‘Move Left/Right’ buttons to the right of the Add/Remove buttons

For each set, you can define a list of modalities for which the set is designed by clicking on the Browse button at
right of the ‘Modalities’ field (at the top-right of the QuickTools Editor). The modalities can be further edited directly in
the ‘Modalities’ field.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 42

Images included in this manual are for reference only. They do not constitute any contractual obligation
 QuickTools ‘Modality’ settings default to that of the active view

You can use the mouse wheel to cycle through the sets

Click on to restore factory settings

3.6 Warning box:

Warning messages are displayed in a dedicated warning box from the workspace. This information bar will be visible
from main windows and from workspace.

- A click on the warning icon allows to display/hide the Warning box

- The warning icon flashes when a warning message is received by the warning box
- The addition of new messages is indicated by an animation.
- The icon's colour is representative of the highest level of message displayed in the toolbox (black for
information messages, orange for warnings, or red for regulatory messages).

Myrian messages in three categories:

- Information messages: an information message is displayed in blue at the bottom right of the screen
- Warning messages WITHOUT patient risk: warning message without patient risk does not block the user. This
message is displayed in orange at the bottom right of the screen
- Warning messages WITH patient risk: warning message with patient risk blocks the user. We need to be sure
that the user has seen the message. This message is displayed in a blocking message box

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 43

Images included in this manual are for reference only. They do not constitute any contractual obligation
All displayed messages are listed in the toolbox, composed of three columns:
- The first column is a checkbox that is associated to each message to allow the user to acknowledge the
messages.
The second column is the message type; two different type of message can be displayed: information and warnings.
- The third column is the message itself.

Information messages are displayed in black and Warning messages are displayed in orange.

This toolbox is kept during an entire user session. The content of this window can be cleared manually by clicking on
‘Clear’ button. It also be cleared when the application is closed and relaunched.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 44

Images included in this manual are for reference only. They do not constitute any contractual obligation
4 Viewing several Series/Studies
simultaneously
This function is designed to aid in the analysis of multiphase contrast-enhanced Studies or in Patient Follow-up

4.1 Study comparison

- Click on the ’Local Studies’ button

- Select from the Local Study List several Studies/Series belonging to the same patient you wish to compare (using
CTRL/Shift + click to select multiple items)

- Click on the ’Open Series’ button

By default, the software does not allow you to open Series belonging to different Patients (*) with the same Workspace.
If you attempt to open Series of different Patients simultaneously from the Study List, the following warning message will
appear.

(*) e.g. due to discrepancies in the Name, date of birth or PatientID

If you open a Study belonging to one Patient whilst the Study of another Patient is already open, the Software will
automatically close the Study which is currently open

- If however you do really wish to open multiple Patient Studies simultaneously, you must activate the ‘Multiple
Patients in Workspace’ option in the Miscellaneous list of the Preferences>Display tab

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 45

Images included in this manual are for reference only. They do not constitute any contractual obligation
 You will still be prompted by a warning message when you attempt to open Series of more than one Patient. Click on
‘No’ in the warning window to proceed with opening multiple Patient Series.

The ’Layout’ menu proposes a set of Page Layouts

4.2 Setting up synchronization

- Click on in the Series Layout toolbox to open the Series Synchronization window:
- Select the Options to synchronize (for example, activate the ‘All Series of the same Group’ option) and check the
Actions to synchronize (Navigation, Zoom, etc)

- Click on the ‘Add Series’ button

Current Group numbered color menu

Add Series/Remove Series buttons

By default, the current synchronization group is displayed. You can choose to define another group via the drop-down menu.
A distinctive color and number are automatically allocated to each Group.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 46

Images included in this manual are for reference only. They do not constitute any contractual obligation
 Selection of the Options to synchronize

Activation of the Actions to synchronize

All Series that can potentially be linked together with the active Series are automatically highlighted

- Click successively on an image of a Series you wish to compare in Synchronized Mode with another Series

A frame corresponding to the color of the predefined group is displayed around the icon on each selected image,
indicating you that synchronization is now activated.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 47

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - If you wish, repeat this procedure to create multiple synchronized Groups.

You can also click on at right of the Groups zone in the Synchronization Window to automatically
define all the Synchronized Groups of Series that can potentially be created

- To remove any or all Series from any group, first select the Group in the drop-down Menu, then click on the “Remove

Series” button and click directly on the image of the Series you wish to desynchronize from the Current Group

You can desynchronize the Series directly by simply clicking on the Synchronization button located in the Layout
Options at the top right-hand side of each view

- To resynchronize Series, click on the Sync button again

4.3 Synchronization modes

The Sync button gives you access to several synchronization modes.

- Click on it to display the following contextual menu with the three following options:

- Synchronize: Reactivate synchronization between views (as initially configured, see Section 4.2)
- Capture Offsets & Synchronize: Maintain all offsets between views and reactivate Synchronization (in the case
you have navigated through one of the image slices and that they are no longer aligned but you still wish to
synchronize those series keeping those offsets constant)
- Clear Offsets & Synchronize: Reset all previously captured offsets between views and turn on again
Synchronization
You can synchronize images in any 2D frame (Axial, Sagittal, Coronal and Oblique)

4.4 Synchronizing the Anatomical Centre

- Navigate through the slices to place them at the same location using anatomical landmarks
- Place the Anatomic Centre (red dot) on a recognizable anatomic structure which is common to all the Series you
wish to synchronize, such as the Carina Trachea. All images which are synchronized with the Anatomic centre are
refreshed allowing you to easily locate an anatomical structure of interest in each plane of view simultaneously.

- Click on then to force Native Mode

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 48

Images included in this manual are for reference only. They do not constitute any contractual obligation
 If you cannot see the Anatomic Centre, select the Navigation tool and double-click anywhere in the image

Multiple Series of the Same Patient can be synchronized in Native Mode or even between MPR and Native Mode as
long as they have the same Frame Of Reference UID. The Anatomic Centre is then visible in all synchronized series and
refreshes during navigation

If you activate the “Centre on Anatomic Centre” option and then zoom-in on a specific point in an image, the
image remains centred on the Anatomic Centre; this option can be found in the Display Options at top-right each Series
window

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 49

Images included in this manual are for reference only. They do not constitute any contractual obligation
5 Data Cleanup
5.1 Clear Series Data
The Clear Series Data tool enables you to clear one series upon loading from all information such as:
- ROIs
- Text annotations, Arrows, Measurements…
- Visual Masks
- Etc.
- To launch this basic tool, first select one study in your Local Study list from which you wish to remove all data then
press SHIFT + DEL + ENTER simultaneously.
The following dialog box pops up:

- Click ‘Yes’ to confirm

The series is cleared from all previous sensitive traces of data and ready to be loaded again in its original and initial state.

5.2 Clear Patient/Series/Study Data

This alternative tool can also be performed from your Local Study list but opens up a dialog box displaying the following
elaborate cleanup data options:
- Clear all Data – removes completely the unwanted study/series
Referring to (according to selection):
- Clear Series Data – enables to clear all objects related to the selected series or,
- Clear Study Data – enables to clear all objects related to the selected study or,
- Clear Patient Data – enables to clear all objects of all studies of the selected patient.
- Delete only ROI, Annotations and Visual Mask’ (see Section 5.1) - shared option by all types of selection.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 50

Images included in this manual are for reference only. They do not constitute any contractual obligation
 Right-clicking on the selected series/studies then selecting from the popup menu or clicking on the ‘Delete

Selection’ icon at the top of the Local Study list tab also enables you to access the ‘Delete’ dialog box the same way.

or

The displayed options in the ‘Delete’ dialog box depend on whether you have selected one or several studies/series
from your Local Study list

To perform a ‘Clear Series data’ on all the studies belonging to a same patient, select them in the study list (holding
down the CTRL key) and click on the ‘Delete’ button from your keyboard.

Series cannot be deleted if a Study status has been set to either ‘Locked’ or ‘To be reviewed’. To prevent a Study from
being unintentionally deleted, select “Lock” from the ‘Locking’ Sub-menu of the Study List Context Menu

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 51

Images included in this manual are for reference only. They do not constitute any contractual obligation
Method of use:
- Select the desired series/studies from the Study list:

- Check the radio button related to the type of data you wish to remove
- Confirm clicking ‘Yes’

5.3 Automatic cleanup database

The database cleaning process is administered within ServiceManager and performed according to
preconfigured cleanup settings. By default, automatic database clean-up is configured to delete studies older than 30 days
(including studies which are ‘Not Read’) taking into account disk drive occupation rate.

However, you can still manually launch an automatic cleanup database clicking on the ’Cleanup Database’ tool
particularly if the disk gauge located at the bottom-left of the main screen indicates that your disk space is full.
When the process is required, the following message is displayed:

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 52

Images included in this manual are for reference only. They do not constitute any contractual obligation
6 MPR and CPR Reconstruction
6.1 Multi Planar Reformatting (MPR) Mode

- Click on in the ‘Visualization’ toolbar to open the following menu

- Select your choice of Volume reconstruction (MPR+Oblique/Whole Volume/Endoscopy)

- Click on Page Layout in the ‘Display Options’ (top-right in the Titlebar)

- and select your preferred layout setting from the following menu

Immediately to the right of the Page Layout button in the Display Options is the ‘Reference Lines’ button

- Use this button to display the desired set of Reference Lines:

- None

- Only Oblique

- Only Orthogonal

- All
You can navigate to any point in the image volume by any of the following:
- Dragging the Anatomic Centre to this point
- Double-clicking on the point
- Manipulating each reference line so that it intersects the point
The Menu at top-left of every Viewport enables:
- Choice of Plane of View

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 53

Images included in this manual are for reference only. They do not constitute any contractual obligation
- ‘Recenter’ to refresh to orientation (Oblique or 3D Views)

- Choice of Rendering Modes

- Increase/Decrease Slice Thickness via ‘+’ or ‘-‘ buttons or by entering a numeric value directly

- Tissue Coloration/Surfacic Rendering’ presets in 3D Modes

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 54

Images included in this manual are for reference only. They do not constitute any contractual obligation
 The Windowing tool can be used on 3D Volume Rendering views to highlight structures of interest

6.2 Oblique View

You can manipulate the Oblique View using the handles of the Orientation Cube -> or the
‘Oblique’ Reference Line

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 55

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - Use the ‘White’ handle to manipulate the ‘Simple-oblique’ view (other 2D views refresh orthogonally to
the view as soon as it is manipulated)

- Use the ‘Blue’ handle to manipulate the ‘Double-oblique’ view (other views maintain their current
orientation)

6.3 Coordinate system selection for improved volume visualization

This function enables you to set the MPR either to the patient canonical planes or to the acquisition canonical planes
when the Native image orientation is significantly “tilted”. The coordinate system can also be rotated manually to any
arbitrary orientation.
Specifying your own coordinate system is a good option to get the best reconstruction plane to use for diagnosis, saving
time and memory, and avoiding the creation of an infinite number of slices.

In order to reset the initial layout (windowing, MPR Basis, frame size…) you can use this button :

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 56

Images included in this manual are for reference only. They do not constitute any contractual obligation
In the Viewport orientation menu, the following coordinate systems are available:
- Acquisition Plane or Patient Plane

- If you wish to set manually a custom coordinate system:

- Use the most dotted end of the Axial/Sagittal/Coronal reference line in any viewport (the mouse cursor will
change shape) as you would use an oblique rotation handle
- Drag a reference line and the corresponding plane will rotate as if it was an oblique viewport. The other
MPR plane will also be rotated so as to maintain orthogonality.
- Release the reference line, the coordinate system is recomputed and applied to the reconstructed images.
Axial/sagittal and coronal viewports will be displayed as new references.

Acquisition Plane is the default coordinate system.

6.4 Create a Path

Example of use: to locate a bronchial tumor in the airways or a colic tumor in relation to the anal margin or to measure
the distance from a stenosis to a vascular bifurcation

Quantification of the extent of stenosis is directly dependent upon the results of the calculation of the Centerline.
Centerline alignment errors may cause stenosis calculation errors.

- Click on the ‘Create Path’ tool to open the Path Creation floating menu

- If it is not already done by default, click on to activate the ‘Path Creation’ drawing tool and trace a Path in
any View by placing articulation points

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 57

Images included in this manual are for reference only. They do not constitute any contractual obligation
To resume the creation of Path that has been interrupted:

- Click , then
- Click on the Point you wish to continue on from
- Place more points as desired
If a new Path Point is added while the Path Origin is selected, the newly created Path Point becomes the new Path Origin

Click on in the Display Options Toolbar to toggle display of the Path on/off

- Use to delete a Point or to delete the entire Path

- To lock the navigation of the “camera” to a Path, select ‘Constrain to a Path’ and the desired Path from the sub-
menu

This will enable you to navigate in any plane of view along a Path of your choice
Some ROI creation engines automatically create Paths. These Paths are associated to the ROI created by their
corresponding segmentation engine.

If you delete a ROI which is associated to a Path, the corresponding Path is also deleted

6.5 Curved Planar Reformatting (CPR) Mode

The CPR Mode function enables you to view entire vessels in one single 2D Plane of View. You need to create a Path
before using the CPR function.
- Right-click on a Point to view the following menu

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 58

Images included in this manual are for reference only. They do not constitute any contractual obligation
- Select ‘CPR’, then your desired Path in the resulting menu to launch curvilinear reconstruction of the anatomy
surrounding your Path

The orientation of the CPR Viewport auto adjusts to best-fit the size and shape of the active Viewport

Select ‘None’ to return to the original orientation of the Viewport

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 59

Images included in this manual are for reference only. They do not constitute any contractual obligation
7 MIP and MinIP Rendering

The MIP rendering tool can be used on PET studies with FDG [18F] fluoro-2-deoxyglucose and may be suitable for
use with other oncological probes. Some adjustments may be required to optimize performance with other
radiopharmaceutical products.

- Ensure you are in MPR Mode (MIP and MinIP cannot be accessed in Native Mode)
- Select the Windowing filter that is best adapted to your current diagnostic requirements

- Click on “Average” in the overlaid menu (top-left of the Image frame) to access the Intensity Rendering Menu
The three available Rendering modes are Average, MIP or MinIP:

Axial, Coronal, Sagittal and Oblique images as well as Volume of Interest images can be rendered using Average,
MIP, or MinIP modes; in Whole Volume images, only Average and MIP modes are available

- Increase the slice thickness to view the effect of MIP or MinIP modes, e.g. click on "Thickness" and enter a
numeric value directly:

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 60

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - or use to increment/decrement one unit at a time

' MIP' (Maximum Intensity Projection) mode: useful for Visualizing structures of high intensity such as bones or
injected vessels

’MinIP' (Minimum Intensity Projection) mode: useful for Visualizing structures of low intensity such as airways in
lungs or bile ducts.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 61

Images included in this manual are for reference only. They do not constitute any contractual obligation
8 SeriesCreator: Reformat and Create New
Series

Reformatting planes only apply if the MPR mode is activated (i.e. the reformatting plane tools cannot be used in a
Native viewport) and the selected series shows a coherent volume. By default, this functionality is included in the
Standard and Advanced CT protocols.

- From the ’Create New Series’ toolbox available in the Toolchest, select the appropriate reformating plane tool
(rake) among those displayed according to the loaded series:

- Place the Reformatting Rake as desired on the image

The Reformatting Rake appears in 2 Planes of View. The position, orientation, spacing and size of Rake can be modified
by hand.
Simultaneously, a preview window pops up in the right-part of the workspace displaying the generated images. The
preview window reflects in real-time any changes performed on the rake.

By default, the generated images are displayed in the Preview area as thumbnails. However you can opt for full
size or column preview mode clicking on the corresponding icon above the Preview Area.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 62

Images included in this manual are for reference only. They do not constitute any contractual obligation
The ‘Full Size’ Preview allows you to see a close-up of the results of your Reformatting. All standard Image Control Tools
(Panning, Windowing, Zoom, Navigation and Magnifying Glass) can be used on the preview images although zooming
actually changes the size of the rake.

In Preview Mode, while mouse is over the image (Thumbnails, Full size or Column), it highlights in red the corresponding
slice on the rake.

From the ’Reformat’ toolbox, a number of parameters can be modified and tuned including additional ones:
- Total number of Images created,
- Spacing (between Images),
- Length,
- Thickness,
- Rendering (Average, MIP/MinIP)
- Number of Scout images created.

User-defined rake settings can be saved for subsequent Series Creation by renaming and saving the newly-created rake

profile (by default, <default selection>).

- Click on to create the new Series and visualize it automatically on the screen.

The new Series is automatically saved as a new DICOM series in the Local Study List and displayed on screen
beside the active Series

- Click on Print to send the images to the PrintComposer. In that case, no new series is created.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 63

Images included in this manual are for reference only. They do not constitute any contractual obligation
9 Stitching (optional add-on): Combine
multiple Series to produce a single image
or volume
Method of use:

- Select the Series you wish to stitch together in the Study List

CTRL/Shift +click to make

multiple choice in the list

- Click on the ’Open Series’ button

- Double-click on the Stitching Protocol of your choice

- Hold the ‘CTRL+SHIFT’ keys down and drag the mouse to realign the Series Left/Right or Up/Down (the mouse

cursor then becomes a double-arrow cross)

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 64

Images included in this manual are for reference only. They do not constitute any contractual obligation
 CTRL+SHIFT and drag to
realign Left/Right/Up/Down

Click on at left of the Series to Move the Series Left/Right/Up/Down one unit at a time

- Click on at left of each Series to navigate to and realign the Series Back/Forward one slice at a time

Activate MIP Mode and increase the slice thickness using the ‘+’ and ‘-‘ in the Thickness Menu at top-left of the
Stitching Viewport (or click on ‘Thickness’ and enter a value directly in the thickness value field) to improve visibility

- Adjust the Overlap by dragging the blue-colored Stitching Seam at left Seam up or down

- Switch Viewport Layout in the Display Mode Toolbar to open a Volume of Interest Viewport to make fine

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 65

Images included in this manual are for reference only. They do not constitute any contractual obligation
 adjustments to Series Alignment

- When satisfied with your alignment settings, click on the ‘Create a New Series’ button at bottom-right of
the Stitching Viewport to save your work.
A progress bar will appear to chart the progress of the Construction of the New Series

When the process is complete, the New Series will open alongside any other open Viewport in Native Mode (default
setting) and will be automatically added to the Study.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 66

Images included in this manual are for reference only. They do not constitute any contractual obligation
10 Fusion
The “Fusion” option enables 2 Series to be superimposed and blended.
You can merge the following pairs of modalities:
- CT / CT
- MR/MR
- NM/CT
- CT/PET
To activate the Fusion tool:
- Click on the title bar of one of the Series to be merged
- Drag and drop this Series onto the other Series
- Select "Fusion" from the drop-down menu

At the opening of the series in the PET/CT protocol, the Fusion View contains 2 Viewports:
- The Anatomical Series viewport (with each series corresponding to a phase) on the left part of the workspace which
contains a grayscale Windowing Slider (the Slider is hidden by default and only appears when you hover over the
left side of the Viewport with the mouse).
- The Fusion Viewport at right which contains an auto-hide hover-over Color Lookup Table (CLUT) Slider at the
bottom of the Viewport

The Fusion Toolbar contains a Manual Alignment tool for the Series as well as various Color Look Up Table (CLUT)
presets in a drop-down list.

You can Fuse Series in any plane of orientation

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 67

Images included in this manual are for reference only. They do not constitute any contractual obligation
At opening, the overlay opacity is by default set at 100% in the fusion viewport (only the functional image is displayed, the CT
image cannot be visualized at all). Additionally, the overlay series is initially displayed in inverted black & white (i.e. the CLUT is
deactivated) and the fusion mode is automatically set to Blending mode.

Overlay mode
Blending mode

Reducing opacity
100% overlay opacity level

- Use the Fusion slider located on the left side of the Fusion Viewport to adjust the mixing levels between the CT and
PET Series.
When you move down the transparency slider (under 100%), the blending mode automatically switches to Overlay mode,
the CLUT is activated (the Black & White reverse mode is deactivated) and the Anatomical series appears.

CLUT presets can be customized freely using the CLUT slider (in Gray levels by default) which appears when you mouse-over
the bottom of the Fusion Viewport.

- Click on the pin button to dock the CLUT slider.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 68

Images included in this manual are for reference only. They do not constitute any contractual obligation
The Viewport Layout Toolbar at left of the Image Zone displays a range of various different possible layouts and orientations
for the Series.

When a PET study is loaded that can be converted to SUV, this is automatically done.
The signal for PET Series is normalized using the Patient Weight SUV Normalization formula (default method) and SUV
computation performed according to the QIBA guidelines which required parameters are:
- Patient Weight (in Kg)
- Injected Dose (MBq)
- Decay Time
- Half-Life

When selecting a Study to load in order to perform a SUV Calculation, you must be careful to select attenuation
compensated and decay corrected PET Series with a valid acquisition start time according to the following prerequisites.
- Attenuation compensation: DICOM Corrected Image tag (0x0028, 0x0051) is set to “ATTN” and “DECY”;
- Decay correction: DICOM Decay Correction tag (0x0054, 0x1102) is set to “START”.
- The DICOM Pixel Value Units tag (0x0054, 0x1001) that is supported by Myrian®. Compatible DICOM Pixel Value Units are as
follow
- Counts per second (only for Philips modalities)
- Becquerels/milliliter

The SUV Parameters window appears automatically at the Series load-up stage if any information is missing.

The SUV Parameters window which you can also access by clicking on in the Toolbox Toolbar, enables you to
manually enter or edit the Standardized Uptake parameter values for PET Series.

According to your calculation preferences, you can also choose from the corresponding drop-down menu, your preferred
transformation method among the three available.
- Fill-in the missing information

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 69

Images included in this manual are for reference only. They do not constitute any contractual obligation
 The ’Default’ button sets back all values to those detected in the DICOM series

According to the selected transformation method, if all prerequisites are not fulfilled, the SUV computation cannot be
performed.

SUV information can be displayed as follows:

- Press <ALT> while hovering the mouse pointer on the PET image to display the SUV value

Any data modified in the SUV Parameters Window will affect the overall SUV results, displayed in the Mouse-over
information bar at bottom-right of the Main Workspace

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 70

Images included in this manual are for reference only. They do not constitute any contractual obligation
11 ‘QuickPatient’: loading other series and
studies of the current patient
11.1 Opening the QuickPatient in the workspace

The QuickPatient window is a preview window enabling you to access and open any or all Series or Studies
belonging to the current Patient directly from the Workspace without having to return to the Study List. Those can be of
different modalities and will be loaded in the workspace using the appropriate default protocol.

- With your series already open in the Workspace, click on in the Series Layout toolbar (or press the ’S’
keyboard shortcut) to open the QuickPatient window and access the complete list of Series/Studies
recognized as belonging to the current Patient (same Name, DOB, PID, gender, etc.) available from the Study
list.

If you wish to have a permanent access to the QuickPatient, check the ‘Open list of series automatically’ option in
the Preferences>Display>Miscellaneous menu.
Whenever you open a series from one patient, the QuickPatient window listing all series belonging to that same patient
is automatically displayed in the Workspace.

By default, the QuickPatient opens docked horizontally at the top of the workspace although it can be set at the
bottom or vertically on the left or on the right side of the workspace, as preferred.
- Click in the intermediate area highlighted in yellow as illustrated hereafter to select the QuickPatient window.
- While pressing down the mouse left button, start dragging and moving the mouse cursor until reaching the
wanted location.
A phantom of the new position is visible depending on the cursor position.

- Drop it

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 71

Images included in this manual are for reference only. They do not constitute any contractual obligation
The QuickPatient can also be used as a floating dialog box. When undocking the QuickPatient window clicking on the
pin button , it switches to a floating resizable dialog box as illustrated hereunder:

- Click on the pin button again in the undocked dialog box to dock it back in its previous position.
According to your needs, you can then either move the QuickPatient dialog box in the workspace or switch from one
docking position to another.

- To hide or show the QuickPatient window according to your convenience, click on

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 72

Images included in this manual are for reference only. They do not constitute any contractual obligation
11.2 QuickPatient window
The QuickPatient window is defined according to the three following hierarchical levels:
- Folder
- Study
- Series (or sub-series)
All available study folders for the current patient are displayed on a chronological Timeline (from the most recent on
the left to the oldest on the right) and the series/subseries within the available folders as thumbnails. The Timeline
displays one tab for every existing folder.
From the QuickPatient window, you have access to:
- The Patient data:
- Study name
- Patient birth date
- Age
- Gender
- Patient Identity number (PID)
- The Timeline composed of all study folders belonging to the current patient and corresponding to the selected
or default modality
The folder to which the open series in the workspace belongs to, is highlighted in orange in the Timeline and its
content displayed by default.

The visualization of the Timeline is associated to the QuickPatient. Since they come together, they are always
both visible or hidden.

The study and date to which belong the loaded series from the Study list are outlined in orange.

Default Other available study Current study folder

Modality filter folder from the Study list opened from the Study
list

Opens existing
reports for this
folder

Open the folder Show/hide Show/hide

document list subseries localizers

or
One click on the ’Show/hide localizers’ button or the ’Show/hide subseries’ button enables to select the detail level in
the preview window switching from the Mode On to the Mode Off:

- Exclusion selector: Mode On (default) and Mode Off

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 73

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - Subseries display: Mode On and Mode Off (default)

Description of the study in the timeline displayed in the tool type

When existing reports have been identified, the icon shows the number of available reports

Tooltips are available simply hovering the mouse pointer over any icon of the QuickPatient window.

Clicking on opens the Patient report window from which you can select a report and open it in your default word
processor.

Clicking on the little white arrow located in the top-left corner of the folder enables to expand or minimize the
folder as illustrated hereafter.
In ’Folded’ mode, the folder displays the following information:
- Modality(ies) of the series included in the folder
- Folder date
- Folder age
- Number of studies belonging to this folder

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 74

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - Double-click on the name of the study or click on the arrow to
expand the folder and visualize its whole content or minimize it
- To load the whole study, click on the study name then drag and
drop it in the workspace
- To load one single series from the study folder, select the desired
series from the expanded folder then drag and drop it in the
workspace

The little orange square shows the initially opened folder from the study list. By default, the contents of the other study
folders available from the Timeline are hidden:
- To visualize its contents, click on the relevant ’Folder’ tab as hereafter:

Clicking again will mask the contents of the selected folder.

Each ’Folder’ tab in the Timeline is a toggle display button enabling you to hide and/or display its contents as wanted.

A ’Close’ button on the far right corner of the Timeline allows closing all the views simultaneously in the
workspace.

By default, you cannot select more than 10 folders in the Timeline.

The rules when a new folder is selected are the following:

- If the maximum count is not reached, the folder is selected
- If the maximum count is reached, the folder is selected, but another folder is unselected.

The rules to unselect a folder are the following:

- If the current folder is selected, the other one is unselected
- If the current folder is not selected, the older one is unselected.

A scrollbar appears when all folders cannot be fully displayed in the Timeline enabling you to visualize the whole folder
list.
In the same way, if the focus is on the folder content and the size of the folder window doesn’t allow to display all
thumbnails, you can scroll the window content using the mouse wheel or using the slider that appears when the mouse
cursor is hovered at the bottom of the preview window.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 75

Images included in this manual are for reference only. They do not constitute any contractual obligation
The ’Modality’ button allows filtering study folders by modality.
Other ’Folder’ tabs correspond to the folders that satisfy to the modality filter.
By default, the automatic filtering is applied: only the modalities corresponding to the open study are used.
You can then modify or remove the filter to modify the list of the displayed folders.

When clicking on this button, the usual modality list is displayed:

- If no modality is selected, all studies are displayed.
- Otherwise, only the ones corresponding to the selected modalities are kept.
Each time the modality filter is modified, the content of the QuickPatient is refreshed to display only the folders
containing studies belonging to the relevant modality(ies).

A new display mode allows showing all images of a CR Like study in the series preview.
CR Like studies belong to the modalities: CR, DR, DX, RF, XA, and MG.
When this mode is active, one thumbnail is created for every image in the study, instead of creating one thumbnail for
every series or subseries.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 76

Images included in this manual are for reference only. They do not constitute any contractual obligation
 When a filter is active, the corresponding modalities are displayed on the ’Filter’ button.

The specific <Radiology X-Ray> option selects the following modalities: CR+DX+RF.

11.3 Loading series/studies from the QuickPatient into the

workspace
According to the modalities of the series that are dragged and dropped in the workspace, the series are loaded using the
following predefined protocols:
- CT series > Standard CT protocol
- MRI series > Standard MRI protocol
- CR, DX or RF series > Standard CR protocol
- NM, PET or all other modalities > Native protocol
- CT and PET series included > CT/PET Fusion protocol (see Section 11.3.2)
- CT and NM series included > NM/CT Fusion protocol (see Section 11.3.2)

Click once on a thumbnail to open the preview screen or click and hold to drag and drop

Use the right-mouse click to open a series directly alongside the currently open Series

Distance measurements and quantification shape annotations performed on dropped series are preserved upon
closing the series.

11.3.1 Drag and dropping one single series

When dragging one single series, you can drop it in the workspace as follow:
- Above a single view: the series is loaded in a single view at the view location using a standard protocol and the
target view is first closed.
- Drag and drop the desired Series belonging to the study folder of your choice directly from the
QuickPatient window onto the desired spot of the image zone of the Workspace to open the selected series
- Repeat the same operation to load another series from the study
By dragging thumbnails of the Series near to or over the edges of an open Series window, a shaded zone containing
arrow markers appears indicating the way in which the Workspace will be divided when dropping the thumbnail. For

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 77

Images included in this manual are for reference only. They do not constitute any contractual obligation
example:

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 78

Images included in this manual are for reference only. They do not constitute any contractual obligation
Dropping here,

Results in the following:

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 79

Images included in this manual are for reference only. They do not constitute any contractual obligation
While dropping here,

Results in the following:

- Above a free location: the series is loaded in a single view at this location using a standard protocol
corresponding to its modality.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 80

Images included in this manual are for reference only. They do not constitute any contractual obligation
 If the series is dropped while pressing down the <Ctrl> key, the target series is not closed. The view is added in
the workspace at the first free location. A free location can added if needed, according to the current view layout mode.

- Above a multiphase view: the series is added inside the view when compatible (please refer to User Manual, in
the section dedicated to the QuickPatient for detailed information)

The added series is automatically displayed in the workspace as if it was a regular phase initially loaded in the view and
registered in the ’Phase’ menu as the last phase of the view.

11.3.2 Drag and dropping multiple series

Dragging and dropping multiple series or subseries simultaneously using the CTRL shortcut key is not
supported by the QuickPatient feature

When dropping a study that includes several series (i.e. a folder), a single view is opened for each series using the
standard default protocol corresponding to each series modality.
If the study is dropped above a view, the target view is first closed, except if the <Ctrl> key is pressed down.
- Pass the mouse cursor over the folder name which highlights in orange then drag and drop it into the
workspace.

- Drag it into the workspace over the existing view,

To each study folder is allocated a default color to help you distinguish series from one another folder.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 81

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - and drop it

Otherwise, all the series are added on a free location, creating one or more if needed.

11.4 Patient case with multiple identities

When launching the QuickPatient while a study belonging to a patient with an identity conflict is open in the workspace,
a warning icon appears instantly next to the patient name in the patient data area.

A Patient Security Alert window pops up indicating the various identities found for the given patient.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 82

Images included in this manual are for reference only. They do not constitute any contractual obligation
The study list displays the list of all the studies found for the corresponding patient ID including the patient details
(name, gender, birth date) for each one.
The ’Show all patient identities’ checkbox allows to display or not the whole study list in the Timeline of all patient
identities and Quick Patient window. If not checked, only the studies with patient details identical to the opened study
will be displayed.

11.5 Viewing and importing remote series using the QuickPatient

The Timeline and the QuickPatient can also display studies and series that are not in the local Study list but on a
PACS as if performing a search in the Remote Studies screen.

Populating the Timeline with PACS studies is enabled by default in the Preference>Display>Miscelleanous menu.

If you don’t want those available remote studies displayed in the workspace, you need to disable this option.

In the Timeline, studies that are not yet in the local Study list appear with a hatched background. When clicking on
the title bar of such a study in the Timeline, the QuickPatient displays the corresponding series.

The remote series thumbnails are a simple hatched background with simply the modality displayed over it as
those series are not local yet and so, image of the series cannot be displayed as real thumbnail.

By default, only studies that are less than 12 month old are displayed. If you want to change that setting, you can do so
using the “Show studies on the PACS” menu in the Timeline.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 83

Images included in this manual are for reference only. They do not constitute any contractual obligation
You can display this menu by clicking the button next to the “Close” button, on the right of
the Timeline.
From this menu, you can also select the PACS and the study age for those to import.

This menu can also be used to do a manual search on any of the available PACS.

Only the Main PACS (if defined) is queried or the first PACS in the list (if any PACS is defined).

Drag and dropping any one of those remote series inside the workspace launches the whole study downloading
from the PACS.
During the series download, you can visualize the import progress directly inside the QuickPatient window for each
study:
- A red progress bar for remote series that are not in the local study list
- Or a green progress bar for imported series.
Once the series is imported in the workspace, the real thumbnail representing the series can be visualized.

You can also visualize the series download using the background jobs dialog . and inside the background job
dialog, cancel any pending transfer.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 84

Images included in this manual are for reference only. They do not constitute any contractual obligation
In the case where series from different studies are dropped in the workspace, a default color is allocated to each study
folder in order to better distinguish the dropped series from one another. In the same way, the study date of the view
title bar is framed accordingly.

The coloration of the study date in the view title bar can be disabled from the Preferences>Display>Miscellaneous
menu

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 85

Images included in this manual are for reference only. They do not constitute any contractual obligation
11.6 Show all images for CR Like studies in the Quick Patient
For every study visible in the Quick Patient, if the following conditions are fulfilled:
- all series in the study are CR Like
- the total image count in the study is less than 10 (value modifiable with a new QP setting)

Then the series preview for this study will show all images in the study. Otherwise it will show one
thumbnail for every series/sub-series.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 86

Images included in this manual are for reference only. They do not constitute any contractual obligation
12 Measurement Annotation Tools
Distance Measurement

- Use to draw a straight Line.

- Select the Line by clicking on it to modify its position and use the handles on either end to adjust its length.

Complex AOI (Optional Add-ons)

- Use the AOI tools in the Toolbox to calculate complex angle measurements such as:
- Cardiothoracic ratio (CTR)
- Non Secant Angle
- 3-Point Angle,
- Right HKA Angle Measurement (only available for RF, CR and DX modalities)
- Left HKA Angle Measurement (only available for RF, CR and DX modalities)
- Cobb’s Angle
- Neonatal Pelvis
- Coxometry, Anteroposterior View
- Coxometry, Lateral View
- Hip Tilt
- Biometric Angles of both Right and Left Knees
- Prosthesis Wear
- Caliper I (One shot)
- Caliper II (Step by Step)
- Collapsed Vertebra
- Orthogonal Diameters
- Pelvic Incidence
- Hip dysplasia
- TT-TG
Furthermore, a set of Assisted Orthopaedic Tools enables the calculation of Prosthetic Angle measurements of both
right and left knees

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 87

Images included in this manual are for reference only. They do not constitute any contractual obligation
 Click on the icon (top-right of the Main Workspace) to toggle display of Angles on/off)

Density
The density value of any pixel being hovered over by the Mouse is displayed at all times in the Mouse-Over tab at
bottom-right of the Main Workspace

Alternatively, you can hold the ALT key down to force display of Pixel Density to appear beside the Pointer

Quantification Tools

- Measure Surface and Density of any area using Shapes/Outlines .

Choices are:
- Free shape
- Rectangle
- Ellipse
- Ellipsoid
- IsoContour
- Threshold
- ROI Contour

Once you have created a measure in one series, you have the possibility to duplicate it in a different viewport of the
same image or in another image of the same series as many times as you wish.
Method of use of the Copy/Paste quantification shape tool:
- First copy the annotation to the clipboard:
- Select the annotation and press CTRL + C or right-click on the annotation and select 'Copy to Clipboard'
from the context menu.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 88

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - Paste the annotation from the clipboard:
- Select the destination viewport/image from the same Series
- Put the mouse over the destination viewport and/or navigate to the destination image
- Press CTRL +V
- Use the drag & drop method to move the copied quantification shape to the relevant spot.

Display of
calculated values

- To access the detailed 'free shape measurement' window related to each quantification shape, select one and
click on 'Measurements…' from the right-click context menu.

Pasting to a different series is possible although the cloned quantification shape will be dropped in the center of
the current image in the viewport right under the mouse cursor

Pixel Calibration

- Use the Calibration tool to manually scale images that have not yet been calibrated (if the Series has
already been calibrated, access to this Tool is denied)

Arrow and Text Annotations

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 89

Images included in this manual are for reference only. They do not constitute any contractual obligation
You can add Arrow or Text annotations freely

At any time, you may consult the List of Annotations pressing

Note :
- For all AOIs, when you hold down the SHIFT key, the line draws that trace perfectly horizontal or vertical way.
- When two AOI intersect, a measurement angle is automatically displayed

All the Measurements and Annotations described above are automatically saved

Click on the Annotations button in the Display Option at top-right of the views to display/hide all annotations
on the Images which could obstruct your vision of the images. To display/hide annotations on one selected viewport,

click on located in the concerned viewport (the annotation display is activated by default on all viewports).

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 90

Images included in this manual are for reference only. They do not constitute any contractual obligation
13 Regions of Interest (ROI)
Volume Measurements can be obtained instantly (in cm3) on any tissue or structure captured using CT or MRI
modalities.
- Activate the Region of Interest (ROI) Coloring function

If the colors do not appear, check that ROI coloring has been activated

Check that the MPR feature is activated

- Click on the ‘+’ in the Regions of Interest tab

The list of available ROI segmentation engines appears

- Select "Generic ROI"

- Click on

- Click on the ‘Assign to a ROI’ button in the Editing Regions of Interest tab
- Click on the zone in the image which corresponds to the relevant anatomical structure to launch the engine.
- Right-click on “Generic” in the Regions of Interest tab

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 91

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - Select “Parameters” and modify the Name, Body Part, Color, etc. as desired

Repeat these steps to create other ROIs

- Click on then to draw the outlines of a volume.

You can draw outlines in any plane of view (Axial, Coronal, and Sagittal)

Be sure to start and finish on the outermost slices (superior and inferior, proximal or distal) of the volume you wish
to “Extrude”. You should trace selection outlines only on slices where the shape changes noticeably, for example on 1
slice out of 4.

- When you have drawn a sufficient number of outlines, click on . The colored shape then appears in all
planes of view including the 3D frame.

- Double-click on of the ‘Transparent’ ROI in the ROI list to toggle on/off the
display of all pixels which are not included in the other ROIs For all other ROIs (e.g.

), click on to toggle on or off the display of ROI pixels and color

- Click on to display/hide only the color of the ROI

- To display advanced measurements for a given ROI, right-click on its name in the list (see above) and select
“Measurements”
A list of advanced measurements then appears, including Volume, Density, Area, Inertia Axis, Density Histogram,
Standard Deviation, etc.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 92

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - Right-click on the Density Histogram box to customize column parameters or to copy them to the clipboard

13.1 toggle the ROI overlay independently in separate viewports in

Myrian
You can manage the coloration of the ROI overlay independently in separate viewports, so it can
also be used on an active viewport.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 93

Images included in this manual are for reference only. They do not constitute any contractual obligation
14 Placing Key Images in the Scrapbook or
PrintComposer
14.1 Capture Images

The Capture Image function at the bottom-right of all viewports opens a menu from which you can:

- Export individual or combined screenshots of the Workspace to the Scrapbook or PrintComposer

- Save image in various formats with a customizable selection of parameters
- Capture a View to the Clipboard
- Capture the current Workspace layout and settings to a Protocol

Both the Scrapbook and PrintComposer enable you to capture any Annotations or Viewing Settings such as Text,
Pointers, Measurements, or Zooming, Windowing, Panning, etc. Such Images can subsequently be used for Patient
Reports, Medical Staff Meetings, Case Reviews, Conferences, Presentations, emails, etc.

You can capture a full 3D rotation of the Whole Volume, Volume Rendering and Volume of Interest Viewports by
right-clicking on the capture icon in the corresponding Viewport.

By default, this feature automatically exports 20 images, each at 18 degrees of rotation from the next.

- Choose whether to capture your image to the Scrapbook or PrintComposer

In the corresponding submenu choose whether to capture:
- The Selected Image (shortcut: press the letter ‘P’)
- All images in view (as individual images)
- All images in view (as a combined image)
- All visible Images for Current Study
- The Whole Study
- An RGB screen capture of the entire image zone (active screen)

To include the colored zones (ROI) with your image(s), hold the ‘CTRL’ key down while you click on your choice in
the "Add to..." menu

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 94

Images included in this manual are for reference only. They do not constitute any contractual obligation
 The content of the Image Scrapbook is automatically displayed as thumbnails in the tab at bottom-center of the
screen.

- To open the Scrapbook and visualize its contents, click on the Printcomposer/Scrapbook button

14.2 Selection of multiple images in the Scrapbook

You can select or deselect each image added to the Scrapbook or PrintComposer from the dedicated tab

- To select an image, click anywhere on the image. The square at the bottom right of the image turns from black
to green.
- To deselect an image, click anywhere on the selected image.

You can also select all images at once by clicking on in the “Image Selection” area of the Scrapbook/
PrintComposer tabs.

- To deselect all images at once, click on at left in the “Image Selection” area.

To select a range of images, you must:

- Click on the first image you wish to select (the image becomes active and is outlined with a grey border), then
- Press the ‘SHIFT’ key and click on the last image you wish to select
- Follow the same process to deselect a range of images.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 95

Images included in this manual are for reference only. They do not constitute any contractual obligation
It is possible to open one scrapbook for two studies.

The Scrapbook and PrintComposer display the print output aspect ratio, i.e. the shape of the film or paper preview
windows represent the aspect ratio of the selected output media such as, for example, A4 paper or 36 x 43 cm film, as
well as the page layout which can be either portrait and landscape.

The Scrapbook and PrintComposer film or paper layout aspect ratio (number of images, size of the images, form
factor of each image, etc.) represents on the screen what will appear on the printed hard copy.

Any annotations displayed in the Scrapbook or PrintComposer, including the font size for DICOM annotations as
well as user annotations (measures, text, arrows, etc.) are also represented as they will be printed out on film or paper

14.3 Print images

Selecting a predefined layout

In both the Scrapbook and PrintComposer tabs, you can select your print layout clicking on at left
of the Page Setup field.
A Layout editor window opens enabling you to select your preferred layout among predefined ones (either Standard
grid or Asymmetric) or to create a customized one.
Different print layouts can be selected for each page.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 96

Images included in this manual are for reference only. They do not constitute any contractual obligation
 Layouts are ordered by image count.

Asymmetric layouts are supported both for Windows and DICOM printing

Predefined layouts can combine factory and user-defined layouts. They can be distinguished by their color (black
gridlines for factory layouts against blue gridlines for user-defined ones).

When right-clicking on the newly defined layout, the following menu pops up:

An existing grid can only be edited.

The paper size drop down menu enables you to select the page format of your choice

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 97

Images included in this manual are for reference only. They do not constitute any contractual obligation
 Check the relevant checkbox to make the selected
paper size become the default paper size

Check the relevant checkbox to make the selected

paper orientation become the default orientation size

A Landscape/Portrait option is also available for you to select preferred paper orientation. Predefined layouts will then
match the selected orientation.
Page orientation and Text size are now "per page". To force page orientation or text size to all pages, keep the CTRL key
pressed while setting page orientation or text size.

The ’Fit’ button on the right of the menu field automatically selects the most economical grid layout for printing
in terms of paper.

The thumbnail layout at right automatically adjusts to display the layout of the selected media and selected
paper or film size.

In the top part of the dialog box, an image spin button allows you to filter those layouts according to the image count.

1. Select your number of images

2. Click on the ’+’ button to define a

new layout

3. Specify if the new layout should

become the default layout

4. Determine whether the selected

layout should apply to the active page
or to all pages

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 98

Images included in this manual are for reference only. They do not constitute any contractual obligation
 - To choose a given layout, select the corresponding icon then click on the OK button, or double click on the
preferred layout icon.
- To apply the selected layout to all the pages of the Scrapbook/PrintComposer, check the ’Apply to all pages’
checkbox
- To create and add a new layout, click on the “+” button in the corresponding grid layout section.

By default, whether you have checked the ’Apply to all pages’ checkbox or not, the last choice is preserved
whatever the exam you open

Creating new Layouts

Clicking on the “+” button in the standard grid layout section opens the following grid selector.

If you create a grid that already exists, the existing layout is automatically selected. No new layout is then created.

Clicking the “+” button in the asymmetric layout section will open the layout editor. The layout editor is initialized with
the currently selected layout in the layout selection dialog box. When no layout is selected, a 1x1 grid is displayed.
This Layout Editor box displays layout icons using the page orientation selected in the scrapbook window (portrait or
landscape).
Clicking on one selected cell belonging to the currently selected layout opens the following contextual menu from
which you can:
- Resize any cell
- Divide an existing cell in one or more columns
- Divide an existing cell in one or more rows
- Rotate the layout
- Flip the layout horizontally or vertically

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 99

Images included in this manual are for reference only. They do not constitute any contractual obligation
All these features can be activated using left and right mouse buttons or keyboard shortcuts.
The newly defined layout is automatically added to the preexisting (standard or asymmetric) layout list and preserved
upon closing Myrian® and whatever study is open.

Every action is undoable and redoable using respectively Ctrl+Z and Ctrl+A.

If you create a layout that already exists, the existing layout is automatically selected. No new layout is created.

New page Layout

An image context-sensitive menu is available right-clicking on an image or on an empty cell/page. This menu enables
you to perform several actions including quick access to a layout contextual menu.

You can among other, move images across pages either to previous page (only if you are not on the first page) or to next
page.

If you are on the last page and move an image to the next page, a new page is created using the same layout as
the current page.
If you are on the last page and move an image to the previous page, then if the last page becomes empty, it is deleted.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 100
Images included in this manual are for reference only. They do not constitute any contractual obligation
Using this menu, you can add columns or rows to the layout of the current page.

You can also rotate the layout, flip it vertically or horizontally, or reset it to a 1x1 grid. Only the current page is affected.

To resize any cell directly on the page, simply place your mouse cursor in-between two cells or at the crossing of
multiple cells and start dragging.

DICOM information

- Click on the ’DICOM overlay...’ button to edit the DICOM information displayed on images

In the Display Option Command Button Toolbar at top-right of the Workspace:

- Click on to toggle display of overlaid DICOM information on/off, or

- Right-click on to modify display settings of overlaid DICOM information

Automatic Export
- Tick the ‘Auto Export to PACS’ checkbox to automatically export all the images contained in the Scrapbook
whenever a Study is closed. The entire Study’s scrapbook content will be automatically exported in the form of
a DICOM Series to your system’s Main PACS (by default) or to the first available PACS listed in the
Preferences>DICOM tab.

At any subsequent opening or closing of the Study, only those images which have been added to the Scrapbook
since the last Automatic Export will be exported.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 101
Images included in this manual are for reference only. They do not constitute any contractual obligation
15 ReportCreator: create an illustrated
Report
- Click on in the tab
The Report Creation window appears:

1 In this screen, type-in:

- Your name
- Your Institution and address
2 Select the format

Be sure to select the appropriate template (Model)

- Click on to generate the Report.

It will then launch in your default word processor

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 102
Images included in this manual are for reference only. They do not constitute any contractual obligation
The Key Images that have been placed in the Scrapbook are automatically added to the Report and all ROI Volumes you
have measured are displayed in a table. You can add any extra comments or remarks in the corresponding fields.
- Save the Report and Exit

- Click on to open the Reports List (see below)

The Report files are not deleted when their corresponding studies are removed.
You should keep a record of these documents elsewhere, e.g. CD, DVD or USB memory stick

You can DiCO Mize Reports by selecting a Report in the Reports tab and clicking on the “DICOMize” button in
the toolbar at top.

DICOMized Reports are automatically added to the Local

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 103
Images included in this manual are for reference only. They do not constitute any contractual obligation
List in the corresponding Studies

You can send a DICOMized Report to the PACS

15.1 PDF ReportCreator

Generates interactive 3D PDF Reports. 3D Images are converted and embedded as 3D Objects which can be
viewed and manipulated within a standard PDF.

Typical use can be to illustrate various Liver Resection scenarios.

All Measurement Data is exported with the 3D View.

- Set any compatible View to 3D Mode

- Click on ‘Create Report’ button in the Scrapbook/Reports Toolbar

- Click on to launch Report Creation

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 104
Images included in this manual are for reference only. They do not constitute any contractual obligation
 Report Creation status is charted by the Image Processing Progress Bar in the "Information Toolbar" at bottom-

right of the Myrian® Workspace

Patient ID appears at the top of the Report

All Measurements and Combined Measurements for every ROI (e.g. Volume, Ratio, etc.) are exported to the 3D
PDF Report

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 105
Images included in this manual are for reference only. They do not constitute any contractual obligation
Default ROI Set is exported with all the defined ROI Groups if it is sole ROI Set.

Default ROI Set is NOT exported if more than 1 ROI Set exists

If no ROI Group exists, all ROI are exported

To generate 3D PDF Reports, Myrian® 3D Navigator and 3D Graphics Card compatibility are not required.

Adobe Reader 7 or above is recommended to view 3D PDF Reports

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 106
Images included in this manual are for reference only. They do not constitute any contractual obligation
16 Printing and Exporting
- Use the ‘Image Selection’ an ‘Print/Export’ tools to adjust settings before printing or exporting
- Use the buttons at top of the Image Selection area to:
- Select All/None of the key image captures
- Delete any of the ‘checked’ images
- Clear the entire content of the Scrapbook or PrintComposer pages
- Configure the display of DICOM Overlays present on the original images

- Use the Image Adjustment buttons at the bottom of the Image Selection area to adjust the Windowing

the Zoom or the Panning parameters of any of the Key Images

Click on to restore Factory Default settings

- Click on the ’Move Image’ button and drag any of the thumbnails to the desired position in the grid to
change the order of the Key Images

16.1 Printing
- Print images directly from both the Scrapbook or the PrintComposer tabs
- Print to DICOM printers or standard Windows-compatible printers
- Use the Print/Export area at bottom-left of the Scrapbook and PrintComposer tabs to set your Printing and
exporting preferences

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 107
Images included in this manual are for reference only. They do not constitute any contractual obligation
 - Select your desired media at the top of the Print/Export section

The thumbnail layout at right adjusts automatically to display the layout of the selected media and selected paper
or film size

1 Click on the print button at bottom-right

2 Modify your printer parameters in the resulting Print settings page

3 Click .at the bottom-right to launch printing

You can modify the size of the font of all the annotations/overlaid DICOM information on the image by adjusting

each respective “Text size” slider at bottom-left of the Scrapbook/PrintComposer

window. Hover the mouse pointer over the cursor to display tooltips.

You can use the large cross-shaped button at the bottom-right of the Print/export area to exit the
Scrapbook and PrintComposer tabs

16.2 Export to JPEG (email, postings, presentations, etc.)

1 Open the Image Scrapbook via the button at bottom-centre of the Workspace

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 108
Images included in this manual are for reference only. They do not constitute any contractual obligation
2 Press at right of the Page Setup field (top-left of the Scrapbook) to apply the best fit
display for all the images contained in current module or select preferred layout clicking on the ’Layout..’
button.

3 Click on the ‘Export’ button to launch export process.

4 Select/Modify the Destination Media and Export Format in the resulting window

5 Select desired level of Anonymizing

6 Enter the Alias of your choice

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 109
Images included in this manual are for reference only. They do not constitute any contractual obligation
Context: Clinical Research, Training, Education, etc.

If you activate the ‘Auto Export to PACS’ function in the Scrapbook Screen, when a Study is closed, all the
images contained in the Scrapbook are automatically exported as a DICOM Series to the Main PACS or to the first
available PACS listed in the Preferences>DICOM tab. At any subsequent opening/closing of the Study, only new images
which have been added since the last batch export will be exported.

16.3 Export to a third-party application

If you are running simultaneously Myrian® and a third-party application supporting image files (Word, Paint, Outlook,

Explorer, etc.), you may wish to drop images in that application. This action can be performed by Drag & Drop .

- In your workspace, click on in the Toolbox

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 110
Images included in this manual are for reference only. They do not constitute any contractual obligation
You now have two options available to click on:
- Either you can choose to drag & drop one viewport only (either 2D or 3D).
Or
- You choose to drag & drop the full view content. In this case, the image is equivalent to the one
generated with the Capture View tool (all viewports combined in one big image).
Whenever selected, use the drag & drop functionality as follow:
- Click on any viewport and start dragging toward the desired application, keeping the left mouse button
down.
During the drag, if the mouse flies over an application which accept dropping image files, the standard cursor is

displayed , otherwise, the cursor indicates that no drop is available

- Release the left mouse button when the mouse is over the target application

All files created during drags & drops are stored in the \Users\Username\Documents\Intrasense\Capture. An
exception is when dropping an image in the Windows Explorer. In this case, the image is copied in the destination folder
and removed from the source folder. If the user wants to keep a copy (in fact the original image) in the Capture folder, he

can keep the <CTRL> key down during the drag. The cursor shows a copy operation will occur

The filename is generated automatically as follows:

- Drop a viewport: Filename = patientName-se number-se desc-orientation-elevation-yymmdd-hhmmss.jpg
(no elevation for 3D viewport)
- Drop a view: Filename = patientName-se number-se desc-yymmdd-hhmmss.jpg
The default file format is JPEG (.jpg) but can be changed in the user preference settings.

16.4 Export to DICOM

1 Click on the Local Studies button

2 Select one or more Studies. [CTRL]/[SHIFT]+Click to select multiple choices

3 Right-click on a Study
4 Select “Export Studies”
5 Select your format from the submenu: JPEG, GIF, DICOM, etc.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 111
Images included in this manual are for reference only. They do not constitute any contractual obligation
The following screen appears:

6 Choose the Export Destination

then
7 Create a CD/DVD by selecting CD or DVD in the ‘Media’ menu

The CD/DVD writing process is a background task. The Export screen disappears as soon as the Export command
is launched.

Click on Myrian® Butterfly icon at the bottom-right of the screen to view the progress status of the Patient
CD writing process

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 112
Images included in this manual are for reference only. They do not constitute any contractual obligation
 Tick the ‘Simulate’ checkbox to simulate the disc writing process to check that all parameters are correctly
configured

“DICOM (*.dcm)” should appear in the Format box

8 Choose level of Anonymizing

9 Use the Spacing section to Export 1 image out of 2, 3, etc

If the ‘Auto Export to PACS’ checkbox in the Scrapbook Window is ticked, whenever a Study is closed, all the
images contained in the Scrapbook are automatically exported as a DICOM Series to your Main PACS.

16.5 Export to DICOM RT

You can export any visible ROI to DICOM RT format by right-clicking on the desired ROI in the ROI List and selecting
“Export to DICOM RT format” from the resulting context menu

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 113
Images included in this manual are for reference only. They do not constitute any contractual obligation
 The “Visibility Level” of the ROI you wish to export must be set to any number greater than ‘0’ to be able to be

exported. This is achieved by right-clicking on the light bulb icon at left of the listed ROI and selecting the desired
visibility level from the resulting slider

This function automatically generates a new Series in DICOM RT format which will be added to the corresponding
Study and visible in the Local Study List

The new Series can be exported to a PACS, external drive, etc. via the right-click menu on the corresponding Series

16.6 Selecting the organization and name of the exported folder

When exporting to any format except DICOM server, DICOMDIR, DICOMDIR with viewer or CD Patient, you can choose to
select the folder organization: Compact or Detailed. You can also Add Timestamp.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 114
Images included in this manual are for reference only. They do not constitute any contractual obligation
In Export Series, once you have selected your destination media, choose the Organization preferred to allocate to the
folder:
- If you select Compact, your folder will be structured as follow: Patient Id/Study date/series number –
modality
- If you select Detailed, your folder will be structured as follow: Patient Name - Patient ID / Modality – Study
Date – Desc / Studies Number
You can choose to add exportation date in the export folder name by ticking the box Add Timestamp.

Please note that flying over Compact, Detailed and Add Timestamp will automatically display the information
specific to that item.

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 115
Images included in this manual are for reference only. They do not constitute any contractual obligation
17 Interactive guides and tutorials
- Click on at the bottom-left of the screen to open a list of Clinical Guides and Wizards
- Click on the tutorial of your choice in the left-hand column

- Click on
The corresponding Step-By-Step guide will then appear:

- Follow each step (displayed on the left)

A tooltip on the right gives further explanation to the step

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 116
Images included in this manual are for reference only. They do not constitute any contractual obligation
Each corresponding tool icon in the application itself will start to flash until you have moved on to the next step

Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 117
Images included in this manual are for reference only. They do not constitute any contractual obligation
BUREAUX :
Montpellier
www.intrasense.fr
Shanghai
Myrian® 2.9 - Quick User Guide - 2021-02-19 - Copyright© Intrasense 2021 118
Images included in this manual are for reference only. They do not constitute any contractual obligation