ARCADIS Orbic

Operator Manual

www.siemens.com/healthcare
 Manufacturer’s note:
This product is provided with a
CE marking in accordance with
the regulations stated in
Annex II of Directive 93/42/EEC of
June 14th, 1993 concerning medical
devices.
The CE marking applies only to medical
devices which have been put on the mar-
ket according to the above-mentioned
EC Directive.
Unauthorized changes to this product inval-
idate this declaration.

Original Language: English

Siemens Healthcare Headquarters Legal Manufacturer

Siemens Healthcare GmbH Siemens Healthcare GmbH

Henkestr. 127 Henkestr. 127
91052 Erlangen 91052 Erlangen
Germany Germany
Phone: +49 9131 84-0
siemens.com/healthcare

siemens.com/healthcare

Order No. SPR2-320G.620.30.03.02 | Printed in Germany | © 11.2016, Siemens Healthcare GmbH

Register 1 Introduction

Register 2 Safety

Register 3 System Description

Register 4 Patient data

Register 5 Examination

Register 6 Image Processing

Register 7 3D option

Register 8 Documentation

Register 9 Configuration

Register 10 Technical Data

Register 11 Maintenance

Register 12 Options
 Overall Table of Contents

Register 1 Introduction
Product application ..............................................................................................3
Information about this Operator Manual..............................................................7

Register 2 Safety
General safety information ..................................................................................3
Personal safety ..................................................................................................14
Equipment safety...............................................................................................29

Register 3 System Description

Description of functions.......................................................................................3
Operation .............................................................................................................9

Register 4 Patient data

Introduction Patient Registration .........................................................................3
Emergency registration........................................................................................5
Registering a new patient....................................................................................8
Registering a known patient ..............................................................................12
Configuration of Patient Registration .................................................................18
Introduction Patient Browser .............................................................................24
Searching for and displaying patient data ..........................................................28
Updating and deleting data ................................................................................34
Patient Browser Configuration...........................................................................48

Register 5 Examination
Safety information relating to the examination procedure...................................3
The Examination task card ...................................................................................5
Performing the examination ..............................................................................11
References task card .........................................................................................25
Displaying reference images .............................................................................29
Native task card .................................................................................................33
Displaying native images ...................................................................................34
Reports ..............................................................................................................36

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Overall Table of Contents

Register 6 Image Processing

Introduction..........................................................................................................3
Loading and displaying images ..........................................................................13
Scrolling and selecting images ..........................................................................19
Editing images ...................................................................................................33
2D Evaluation (option)........................................................................................47
Subtraction processing ......................................................................................57
Saving, transferring, documenting, closing images ...........................................61
Viewing configuration ........................................................................................69

Register 7 3D option
General Information .............................................................................................5
Sequence of 3D scans.......................................................................................12
Introduction to 3D Evaluation.............................................................................22
Transferring images to 3D .................................................................................31
Working in 3D ....................................................................................................37
Multiplanar Reconstruction (MPR) .....................................................................99
Surface shaded display (SSD) ..........................................................................108
Volume Rendering Technique (VRT) (option) ...................................................115
3D Image Fusion (option).................................................................................124
Configuration for 3D ........................................................................................158

Register 8 Documentation
Introduction to filming/printing.............................................................................5
Automatic/manual filming ..................................................................................11
Viewing and processing film sheets and images...............................................19
Changing film settings for a film job ..................................................................33
Checking the data transfer.................................................................................43
Configuration for filming/printing .......................................................................51
Introduction to archiving ....................................................................................61
Archiving Data....................................................................................................65
Exporting data....................................................................................................68
Import/export in the file system ........................................................................75
Checking the data transfer.................................................................................81
Configuration for archiving .................................................................................87

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 Overall Table of Contents

Register 9 Configuration
Configuration Examination ...................................................................................3

Register 10 Technical Data

Curves and diagrams ...........................................................................................3
Notes concerning electromagnetic compatibility (EMC)....................................11
Unit data ............................................................................................................16
Labels ................................................................................................................22

Register 11 Maintenance
Functional and Safety Checks..............................................................................3
Service via network connection ...........................................................................8
Cleaning and disinfection...................................................................................16

Register 12 Options
Accessories .........................................................................................................3

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Overall Table of Contents

Operator Manual
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 Register 1 Introduction

Table of Contents

Product application .............................................................................................................. 3

Intended use..................................................................................................................................... 3
Body region ............................................................................................................................ 3
Patient group .................................................................................................................................... 4
Contraindications .............................................................................................................................. 4
Physical functionality......................................................................................................................... 4
User profile ....................................................................................................................................... 4
Training ................................................................................................................................... 5
Conditions of use.............................................................................................................................. 5
Maintenance, cleaning, and disinfection................................................................................. 5
Essential performance characteristics .............................................................................................. 5
Frequently used operating functions ................................................................................................ 6
Operating functions regarding safety................................................................................................ 6

Information about this Operator Manual ............................................................................. 7

Validity .............................................................................................................................................. 7
Names and parameters .................................................................................................................... 7
Values ............................................................................................................................................... 7
Layout conventions........................................................................................................................... 7
Instructions ............................................................................................................................. 7
Conclusion .............................................................................................................................. 8
List.......................................................................................................................................... 8
Cross-reference ...................................................................................................................... 8
General Notes......................................................................................................................... 8
Warnings ................................................................................................................................ 9
Information about correcting errors ........................................................................................ 9

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Introduction

Operator Manual
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 Introduction

Register 1 Introduction

We welcome you as a user of the powerful multifunctional ARCADIS Orbic C-arm

system from Siemens.

Product application 0

Intended use 0

The ARCADIS Orbic system is a mobile X-ray system that we developed for clin-
ical applications such as cholangiography as well as endoscopic, urologic,
pain therapy, orthopedic, neurologic, vascular, cardiac, and trauma procedures.
It supports medical examinations through digital imaging as well as 3D imaging
(optional).

Body region 0

Clinical applications may include, but are not limited to, cholangiography, endo-
scopic, urologic, pain therapy, orthopedic, neurologic, vascular, cardiac, critical
care and emergency room procedures.
The system is suitable for a large variety of clinical visualizations such as
o Visualization of bones
o Visualization of vessels, soft tissues
o Visualization of implants
o Visualization of surgical instruments

Caution
Non-permitted use of the X-ray system outside of its stated intended use pre-
sents a
risk to the patient and operating personnel
u The X-ray system may be used in the aforementioned clinical applications
and procedures only.

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Introduction

Patient group 0

In principle, the ARCADIS Orbic can be used for examining all types of patients
without restriction. When using this system, the relevant applicable country-spe-
cific requirements must be complied with.

Contraindications 0

Prior to the examination, it must be confirmed by a physician that an examination

is permissible and checked whether increased precautions are necessary.

Physical functionality 0

The ARCADIS Orbic is a compact and powerful mobile X-ray image intensifier
system with digital image processing for fluoroscopy and radiography. The sys-
tem is equipped with a footswitch and a hand switch for the release of radiation.
The following modes of operation are available in ARCADIS Orbic for the broad
scope of applications:
Digital radiography, fluoroscopy, pulsed fluoroscopy, subtraction/roadmap

User profile 0

The system can be used properly only by suitably qualified medical personnel.
This requires operating personnel to be familiar with the Operator Manual.
This manual must be studied in detail prior to starting up the system. Pay special
attention to the following sections:
o General safety information
o Personal safety
o Equipment safety
o Maintenance

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 Introduction

It is the responsibility of the system operator to ensure that operating personnel

are professionally and properly instructed.
As the manufacturer of the system, SIEMENS is not responsible for any impact
on its safety, reliability and performance if it is not used in accordance with the
Operator Manual.

Please also read the supplements and addenda to the Operator Manual necessi-
tated by technical developments.

Training 0

It is recommended that operating personnel undergo application training prior to

using the system. This training can be conducted by Siemens employees.

Conditions of use 0

The digital ARCADIS Orbic X-ray system is a mobile system that is designed for
use in the ER, OR, and in radiology and endoscopy departments of hospitals,
clinics, and outpatient practices. Current country-specific requirements must
be complied with.
The system is suited for operation on hospital networks (IEC 60601-1
Chap. 14.13 IT security statement). For more information, see the technical
documentation.

Maintenance, cleaning, and disinfection 0

See › Register 11: Maintenance.

Essential performance characteristics 0

See › Register 10: Technical Data.

ARCADIS Orbic
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Introduction

Frequently used operating functions 0

o System On/Off
o Patient registration
o Selecting the operating mode
o Recording X-ray images
o Processing X-ray images (Post-processing/Adding comments)
o Saving/archiving studies locally or to a PACS

Operating functions regarding safety 0

o Emergency stop function (emergency stop switch)

o Radiation protection (collimator function)
o Moving the C-arm

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 Introduction

Information about this Operator Manual 0

Validity 0

This Operator Manual is valid for the following product:

ARCADIS Orbic/Orbic 3D

Names and parameters 0

All names and data of patients and facilities used as examples in this
Operator Manual are entirely fictional.
Any resemblance to names of real persons and institutions is entirely coinciden-
tal.
All parameters and images shown in this Operator Manual are examples.
Only the parameters displayed by your system are definite.

Values 0

All numbers specified are typical values unless specific tolerances are indicated.

Layout conventions 0

The Operator Manual has several registers. A detailed table of contents listing all
chapters contained in the manual is provided at the beginning.
Certain sections of text are marked with symbols to help you quickly identify the
information content of the text.

Instructions 0

The individual steps contained in procedural instructions guide you in the proper
use of your system.
u Text of this type is identified by a diamond.

ARCADIS Orbic
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Introduction

Conclusion 0

– The result of procedural instructions is identified by a dash.

List 0

o Text of this type is identified by a square.

Cross-reference 0

Cross-references refer you to related topics on other pages or in other chapters.

› Cross-references are identified by thin arrows.

General Notes 0

A note refers to information that is important for safe operation of the system
without the presence of any hazard to health or life.

A note is marked with an exclamation mark "!" and printed in italics.

Additional information contains tips regarding optimal system use and settings as
well as other useful hints.

Additional information is identified by the letter "i" and printed in italics.

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 Introduction

Warnings 0

A Warning indicates a danger which, if not observed, can lead to serious injury or
even death.

Warning
First the source of danger is stated.
Then possible consequences are pointed out!
u Finally, information on how to avoid the danger is provided.

Caution indicates a danger which, if not observed, can lead to minor or moderate
injury.

Caution
First the source of danger is stated.
Then possible consequences are pointed out!
u Finally, information on how to avoid the danger is provided.

Information about correcting errors 0

Information on how to solve problems that might occur when performing operat-
ing steps is given at the end of the relevant instructions.

In these paragraphs, the problem and the potential cause are described.
To solve the problem, perform the operating steps specified here.

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Introduction

Operator Manual
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 Register 2 Safety

Table of Contents

General safety information .................................................................................................. 3

Laws and regulations ........................................................................................................................ 3
Validity .............................................................................................................................................. 3
Software ........................................................................................................................................... 4
Equipotential bonding ....................................................................................................................... 5
Electromagnetic compatibility........................................................................................................... 5
Use in connection with high frequency ............................................................................................ 5
Maintenance and inspection ............................................................................................................. 5
Malfunctions ..................................................................................................................................... 7
Error messages at the C-arm system ..................................................................................... 7
System messages on the monitor.......................................................................................... 8
Saving the log file ................................................................................................................... 9
Electrical faults................................................................................................................................ 10
System failure....................................................................................................................... 10
Switching to emergency power supply ................................................................................ 11
Disconnecting the power plug.............................................................................................. 11
Emergency STOP ........................................................................................................................... 12
Fire protection................................................................................................................................. 12
Explosion protection ....................................................................................................................... 13
Overload protection ........................................................................................................................ 13

Personal safety .................................................................................................................. 14

Open heart and skull examinations................................................................................................. 14
Crushing hazards on the C-arm system .......................................................................................... 14
Crushing hazard on the monitor trolley ........................................................................................... 16
Radiation protection........................................................................................................................ 17
Deterministic radiation effect ............................................................................................... 18
Position and extent of the main operating area .................................................................... 19
Maximum scatter radiation in operating area ....................................................................... 28
Radiation interruption for all operating modes...................................................................... 28

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Safety

Equipment safety .............................................................................................................. 29

Positioning the C-arm ..................................................................................................................... 29
Installation, repair............................................................................................................................ 30
Original accessories ........................................................................................................................ 30
Combinations with other systems .................................................................................................. 31
Attachment of dedicated options ................................................................................................... 31
General safety requirements ................................................................................................ 31
Tilting resistance; mechanical strength; central ray migration .............................................. 31
Attachment........................................................................................................................... 31
Attenuation equivalent.......................................................................................................... 32
Weight counterbalance......................................................................................................... 32
Image quality ........................................................................................................................ 33
Electrical safety .................................................................................................................... 33
Electromagnetic compatibility .............................................................................................. 33
Additional safety information ................................................................................................ 33
Disposal .......................................................................................................................................... 34

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 Safety

Register 2 Safety

General safety information 0

Laws and regulations 0

If legally binding regulations govern the installation and/or operation of the sys-
tem, it is the responsibility of the installer and/or the operator to observe these
regulations.
Regulations required by law and the radiation protection regulations must be ob-
served in all countries. Deviating from this Operator Manual, values may be set
according to country-specific regulations.
This product is provided with a CE marking in accordance with the provisions of
Directive 93/42/EEC of June 14th, 1993 concerning medical devices.
Data related to individual persons are subject to data protection. Ensure compli-
ance with all applicable laws and regulations.
Legally required tests must be performed at the specified intervals. These tests
include, for example,
o Constancy test according to the X-ray ordinance (§16 RöV) in the
Federal Republic of Germany.
o Tests based on DHHS guidelines (Department of Health and Human Services)
where applicable.

Validity 0

This Operator Manual is valid for the following product:

o ARCADIS Orbic/Orbic 3D

Warning
The use of unreleased accessories or system modifications and changes is not
permitted can lead to system malfunctions.
This can result in injury to the patient and/or damage to the equipment!
u Only accessories released by Siemens for use with this product may
be used.

ARCADIS Orbic
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Safety

Software 0

The system and user software used in this product is protected by copyright.

Caution
Impermissible or faulty manipulations/modifications to the software or to the
connection between the ARCADIS Orbic system and the power supply can lead
to malfunctioning of the system.
Unauthorized access and/or virus attacks possible!
u Make sure all necessary precautions are taken (with the existing level of se-
curity) when changing a functionality or factory-set configuration.
u Make sure that the anti-virus protection is up to date
(› Register 11: Maintenance, Page 9).

Caution
Reduced system performance due to overload of the network environment.
Unexpected system behavior!
u Only use the system in a secure and load-adapted network.

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 Safety

Equipotential bonding 0

Products for which equipotential bonding is required may only be operated in

medical facilities where supplementary equipotential bonding has been installed
and tested according to DIN VDE 0107/10.94 section 4 for Germany or the rele-
vant country-specific regulations.

Electromagnetic compatibility 0

This medical device complies with the requirements of the applicable standard
on electromagnetic compatibility (EMC).
(› see "Notes regarding electromagnetic compatibility (EMC)" in the
Operator Manual)
However, we wish to inform you that other mobile electronic devices such as
radio telephones (mobile phones) exceed the radiation limits specified in the
EMC standard and can therefore disturb functions of your medical device.

Use in connection with high frequency 0

The following regulations for use must be observed:

o IEC/TR 1289-1/07.94/
High frequency surgical equipment - Part 1: Operation
High frequency surgical equipment - Part 1: Operation
o IEC/TR 1289-2/08.94/
High frequency surgical equipment - Part 2: Maintenance
High frequency surgical equipment - Part 2: Maintenance

Maintenance and inspection 0

Before using the equipment for examination, the user must ascertain that all
safety-relevant devices function properly and that the system is ready for
operation.

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Safety

Wear and tear The system is subject to mechanical and electrical wear and tear. In the interest
of the safety of patients, operating personnel and third persons, maintenance and
safety checks must be carried out every 12 months to maintain the operational
safety and reliability of the product.

Please follow the relevant instructions in the

(› Register 11: Maintenance).

Caution
Improper use and excessive load on the system can lead to mechanical damage
and damage to the system electrics.
Injury to operating personnel, patients or third parties and damage to
the product!
u If necessary, have the system checked more frequently.
u Ensure that any defects are repaired professionally.

Image quality Maintenance should include checking the image quality. Maintenance at regular
intervals is recommended to always ensure best image quality.

To ensure optimal image quality, have the following functions checked in partic-
ular as part of regular maintenance:
Pixel shift, image rotation, noise reduction, edge enhancement, subtraction,
Roadmapping, multiplanar reconstruction (MPR).

Performing Maintenance work should be performed by trained technical personnel only.

maintenance If you do not have a maintenance contract, please contact Siemens Customer
Service.
If more frequent checking and/or maintenance is required by national laws or reg-
ulations, compliance with these regulations is essential.

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 Safety

Malfunctions 0

In the event of malfunctions of the ARCADIS Orbic system, please call Siemens
Customer Service.

Error messages at the C-arm system 0

When a malfunction is detected, the ARCADIS Orbic system is disabled. An error

message is displayed on the control panel of the C-arm system:

In addition, a malfunction is also displayed on the left monitor.

o All vital system functions are automatically checked each time the
ARCADIS Orbic is switched on.
o During routine operation, the ARCADIS Orbic is continuously monitored.
o Temporary error messages, such as No. 5901, can be canceled by pressing
any button on the C-arm system (except vertical up/down movement but-
tons).
o Non-temporary error messages, such as No. 5015 or 5016, cannot be can-
celed. If these errors occur, radiation release is no longer possible.
Please notify Customer Service immediately.
Error messages 7309 (tube unit iris diaphragm), 7009 (slot diaphragm) and
7409 (TV camera iris) are temporary error messages that can lead to unnecessary
radiation exposure of the user and patient if treatment is continued.
If errors occur repeatedly, switch off the ARCADIS Orbic and notify Customer
Service. Prior to that, save the log file with the recorded system activities
(Menu Options > Save Log, › Page 9). Additionally, write down the following
information:
o Error number and time when error occurred
o Operating mode selected
o Was radiation activated when the error occurred?
o Is the error related to an operating process?

If there are any malfunctions/failure of the radiation indicators, please contact

Siemens Customer Service.

ARCADIS Orbic
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Safety

System messages on the monitor 0

Three different types of system messages can appear on the monitor. The type
of message is identified by a corresponding symbol (top left).
o Example of an error message:

o Example of a warning:

o Example of information:

You must confirm error messages with the OK button or the radiation release
button to be able to resume your work. However, warnings and information do
not disable radiation release.

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 Safety

Saving the log file 0

It is recommended to back up the log file on an external data medium

(CD, USB memory medium) when system error messages occur. You can then
attach the log file to an e-mail and send it to Siemens Service. Siemens Service
can evaluate the recorded system activities and identify the error without the
need of a site visit.
u Insert a CD into the drive of the monitor trolley or connect the USB memory
medium.
u Select Options > Save Log File from the main menu.
– A dialog window is displayed.

u Click this button.

– The log file is saved to the USB memory medium as a compressed zip file.
Or
u Click this button.
– The log file is written to the CD as a compressed zip file.

u Close the dialog box with Close.

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Safety

Electrical faults 0

In the case of danger for patients and operators (e.g. if there is no live image on
the monitor but the radiation indicator is lit) or danger for the product, you must
disconnect the power plug immediately. The ARCADIS Orbic will be shut down
completely and disconnected from the power supply. This will
o switch off radiation
o abort the current system program
o abort and cancel current operating sequences
o delete all image information not saved to a hard disk

Caution
Electrical faults
Risk of injury to the patient and operating personnel.
u Immediately disconnect the power plug from the socket.

Only after the cause of the hazard has been clearly identified and remedied may
the system be reconnected to the power supply. In all other cases, e.g. system
malfunction, contact Siemens Customer Service immediately.

System failure 0

The user must have a replacement unit available if a system failure could predict-
ably cause a critical situation resulting in patient injury during a medical examina-
tion.

Caution
o System component failure during the cardiovascular examination
o The footswitch has been removed and radiation release is no longer possible
Risk of injury to the patient!
u Ensure a replacement unit is available during the examination procedure.

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 Safety

Switching to emergency power supply 0

In the event of a power interruption of longer than 8 ms, the ARCADIS Orbic can
switch off. In this case the ARCADIS Orbic must be switched on again after the
system has switched over to the emergency power supply.
In case of a power failure, a signal sounds (up to 10 min.) when the system
switches to the uninterruptible power supply (UPS).

Disconnecting the power plug 0

After the power plug is disconnected, the uninterruptible power supply (UPS)
supplies voltage to the imaging system and the left-hand monitor until the
ARCADIS Orbic switches off completely.
When the power plug is pulled out, switching to the uninterruptible power supply
causes an acoustic signal to be emitted. The UPS switches off after 10 min. at
the latest.

As soon as the mains supply is restored, the battery of the UPS is recharged.
Please remember that the UPS battery life is limited.

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Safety

Emergency STOP 0

Immediately press the red EMERGENCY STOP button (arrow) on the electronics
unit of the C-arm system at the first sign of any dangerous situation resulting from
motorized movements.

STOP

o Motorized vertical movement is then immediately disabled.

o With the 3D option, automatic travel of the C-arm is stopped immediately.
o All other system functions remain unaffected by this.
Unlock the button only after the danger has clearly been eliminated.
o The button can be unlocked by gently turning it clockwise.

Fire protection 0

Warning
In the event of fire
A fire or smoldering fire can produce toxic gases or fumes!
u Immediately switch off the ARCADIS Orbic.
u Pull the power cable out of the wall outlet.
u Inform all personnel of the correct procedures in case of fire as part of
occupational safety training.

Please inform our Customer Service prior to starting up the ARCADIS Orbic again
as it may require refurbishing due to damage caused by fire.

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 Safety

Explosion protection 0

Warning
Ignitable concentration of anesthetic gases in the examination room.
Explosion hazard!
u The ARCADIS Orbic must not be operated in such an environment.

Overload protection 0

Prolonged continuous radiation at maximum tube load is permissible in fluoros-

copy mode. However, this can cause the X-ray tube assembly to heat up. For this
reason, the X-ray tube assembly has a thermal monitor. If necessary, power is re-
duced in all operating modes, in SUB/Roadmap with the next new scene/mask.

If the temperature rises to ≥ 50 °C,

o the temperature indicator on the control panel of the C-arm system lights up.
o the selected characteristic curve is switched to S1 at the end of radiation in
FLUORO and pulsed FLUORO.
If the temperature rises to ≥ 60 °C,
o the selected characteristic curve is switched to S1 during radiation in
FLUORO and pulsed FLUORO.
If the temperature rises to ≥ 70 °C,
o the temperature indicator on the control console of the C-arm system flashes.
o radiation is aborted and cannot be released again.
If the temperature falls below 50 °C
o the previously deselected characteristic curve is automatically reselected.

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Safety

Personal safety 0

Open heart and skull examinations 0

If an approved system is used alone or with other equipment for open heart or
open skull examinations, a conductive connection must be made between the
system and a potential equalization point, e.g. the tabletop.
(› Register 3: System Description, Page 10)
Only then can the patient be connected to the system.

Crushing hazards on the C-arm system 0

Correct handling of the C-arm system requires that operating personnel and pa-
tients use only the grips provided for this purpose. Where this is not possible,
monitor the points of potential crush injury between movable system parts and
their guide openings.

Warning
Moving and braking the C-arm (see graphic), turning the control console.
Risk of crushing hands!
u Please make sure that your hands are not in the travel path of system parts.

Warning
Maximum lowering of the C-arm (see figure)
Risk of crushing feet!
u Please watch your feet when the C-arm is being lowered fully, since there
may not be sufficient clearance left between the I.I. and the floor.

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 Safety

The system areas marked in the drawing indicate points of crushing or impact
hazards for the patient or the operator.

Potential danger points when moving, braking or fully lowering the C-arm

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Safety

Crushing hazard on the monitor trolley 0

The monitor trolley holds two rotatable monitors. Using the corresponding op-
tion, these can be height-adjusted and folded up for transport. As an option, the
monitor trolley can also be equipped with a printer, which is placed in the provid-
ed bay.

Caution
Risk when positioning or folding up monitors, pulling out or pushing in
the printer.
Risk of crushing hands!
u Carefully watch your hands when carrying out these steps.

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 Safety

Radiation protection 0

The automatic dose rate control feature contributes significantly to reducing the
radiation exposure of patients and operating personnel.
Nevertheless, observe the following important notes in order to keep the dose
absorbed by the patient as low as possible.

For the patient o Keep the radiation field as small as possible.

o Ensure that the patient receives the best possible protection when exposures
are taken in the vicinity of the patient's reproductive organs (use gonadal
shields or lead-lined rubber covers).

For operating o When releasing the exposure, the operator must keep a sufficient safety
personnel distance from the X-ray tube assembly.
o Wear protective clothing in the control area during an examination.
o Wear a radiation monitoring badge or use a pen dosimeter.

For patients and o Keep the fluoroscopic time as short as possible.

operating personnel
o Keep the source-to-skin distance as large as possible.

Additional objects in the beam path may result in increased scattered radiation.
Please be aware that certain materials in the X-ray beam (e.g. parts of an operat-
ing table) may impair the X-ray image due to imaging of contours and inclusions
in these materials. In certain rare cases, this may lead to incorrect diagnosis.
This material may also result in higher radiation exposure.

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Safety

Deterministic radiation effect 0

As per IEC 60601-1-3, 5.2.4.5 (A.2), deterministic radiation injury is possible if

a radiation dose delivered to an organ or tissue exceeds a value of 1 to 3 grays.

With typical applications and proper use of the C-arm, you do not have to take
such injuries from radiation into consideration. It is assumed that the maximum
fluoroscopic time does not exceed 5 to 15 minutes, depending on the application,
and that the point of skin penetration is 30 cm (50 cm maximum) away from the
image intensifier input.

The skin penetration dose for various operating modes and under standard oper-
ating conditions can be estimated using the „Dosimetric information“ table under
the › Register 10: Technical Data register.

Example: An accumulated fluoroscopic time of 15 minutes and a skin penetration

dose of 20 mGy/min yields a dose of 300 mGy.

When changing the distance from the skin penetration point to the focus, please
note that the skin dose decreases with the inverse square of the distance to the
focus. This means that when the distance to the focus is halved, the skin pene-
tration dose rate quadruples.

Operator Manual
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 Safety

Position and extent of the main operating area 0

All examination types may be performed in the illustrated operating area of the
X-ray system.

C-arm vertical, image

intensifier at the top

Focal point

Main operating area

Dimensions in cm

ARCADIS Orbic
SPR2-320G.620.30.03.02 19 of 34
Safety

Scatter radiation in the main operating area according to EN 60601-1-3

Beam direction vertically upwards

Height above Measurement A1 Measurement A2 Measurement B

floor in cm μGy/h μGy/h μGy/h
10 1685 2088 612
20 2052 2916 648
30 2473 3708 648
40 3294 5112 684
50 4050 6552 684
60 4698 8388 720
70 5573 9828 720
80 6545 11124 720
90 7214 12852 684
100 7009 13824 648
110 5497 10404 576
120 4266 6588 540
130 3834 5328 540
140 2970 3348 504
150 1955 1944 504
160 1253 1332 468
170 875 1152 432
180 680 1044 396
190 544 972 360
200 475 900 360

Measurement A1: (operating area A1)

Continuous fluoroscopy 110 kV, 3.0 mA
Measurement A2: (operating area A2)
Continuous fluoroscopy 110 kV, 3.0 mA
Measurement B: (operating area B)
continuous fluoroscopy 110 kV, 3.0 mA

Operator Manual
20 of 34 SPR2-320G.620.30.03.02
 Safety

cm above ground

μGy/h (power air kerma)

ARCADIS Orbic
SPR2-320G.620.30.03.02 21 of 34
Safety

C-arm vertical, image

intensifier down

Focal point

Main operating area

Dimensions in cm

Operator Manual
22 of 34 SPR2-320G.620.30.03.02
 Safety

Scatter radiation in the main operating area according to EN 60601-1-3

Vertical, downward projection

Height above Measurement A1 Measurement A2 Measurement B

floor in cm μGy/h μGy/h μGy/h
10 486 648 360
20 594 648 396
30 734 792 432
40 994 1080 468
50 1631 1548 504
60 2527 2556 540
70 3395 4500 576
80 3852 5688 576
90 5108 9180 612
100 6700 12996 648
110 7160 12816 684
120 6628 11520 720
130 5764 10368 756
140 4849 9180 756
150 4306 6768 720
160 3604 5580 684
170 2700 4212 684
180 2203 3384 684
190 1840 2484 648
200 1541 1836 612

Measurement A1: (operating area A1)

Continuous fluoroscopy 110 kV, 3.0 mA
Measurement A2: (operating area A2)
Continuous fluoroscopy 110 kV, 3.0 mA
Measurement B: (operating area B)
Continuous fluoroscopy 110 kV, 3.0 mA

ARCADIS Orbic
SPR2-320G.620.30.03.02 23 of 34
Safety

cm above ground

μGy/h (power air kerma)

Operator Manual
24 of 34 SPR2-320G.620.30.03.02
 Safety

C-arm vertical, image

intensifier outside

Focal point

Main operating area

Dimensions in cm

ARCADIS Orbic
SPR2-320G.620.30.03.02 25 of 34
Safety

Scatter radiation in the main operating area according to EN 60601-1-3

Beam direction horizontal, X-ray tube near control console

Height above Measurement A Measurement B

floor in cm μGy/h μGy/h
10 680 702
20 842 767
30 1048 853
40 1350 929
50 1739 972
60 2322 1058
70 3229 1112
80 5227 1166
90 8676 1199
100 9126 1210
110 6048 1206
120 4072 1202
130 3175 1112
140 2506 1026
150 1987 950
160 1588 875
170 1274 810
180 990 734
190 778 680
200 659 616

Measurement A: (operating area A)

Continuous fluoroscopy 110 kV, 3.0 mA
Measurement B: (operating area B)
Continuous fluoroscopy 110 kV, 3.0 mA

Operator Manual
26 of 34 SPR2-320G.620.30.03.02
 Safety

cm above ground

μGy/h (power air kerma)

ARCADIS Orbic
SPR2-320G.620.30.03.02 27 of 34
Safety

Maximum scatter radiation in operating area 0

Measuring conditions The values are valid for continuous fluoroscopy 110 kV, 3.0 mA,
water phantom 25 x 25 x 15 cm in the center of the central beam on the image
intensifier.

C-arm vertical, image

intensifier at the top
Height above floor Area Value in mGy/h

90 cm A1 ≤ 7,22
100 cm A2 ≤ 13,9
60 - 70 cm B ≤ 0,72

C-arm vertical, image

intensifier down
Height above floor Area Value in mGy/h

110 cm A1 ≤ 7,16
110 cm A2 ≤ 12,82
130 - 140 cm B ≤ 0,76

C-arm vertical, image

intensifier outside
Height above floor Area Value in mGy/h

100 cm A ≤ 9,13
100 cm B ≤ 1,21

Radiation interruption for all operating modes 0

The hand and footswitches are designed as pushbutton switches. Radiation is

interrupted immediately when releasing the corresponding operating element or,
in other operating modes, after the completion of the stored image.

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28 of 34 SPR2-320G.620.30.03.02
 Safety

Equipment safety 0

Positioning the C-arm 0

In case of improper handling of the ARCADIS Orbic, the mobility of the C-arm
may lead to collisions of the image intensifier and the single-tank with the patient
and the patient table.

Brakes Make sure the brakes are applied after adjusting the C-arm position.

Transport When moving or transporting the C-arm system please take special care that the
system parts do not collide with an obstacle. This could also result in accidental
radiation release or an impairment of image quality under certain circumstances.

ARCADIS Orbic
SPR2-320G.620.30.03.02 29 of 34
Safety

Installation, repair 0

Modifications or upgrades to the system must comply with federal or local regu-
lations as well as generally recognized engineering standards.
As the manufacturer, Siemens cannot accept responsibility for the safety
features and for the reliability and performance of the equipment if:
o the product is used in a manner other than that specified in the
Operator Manual;
o installation, upgrades, readjustments, modifications or repairs are performed
by personnel not authorized by Siemens;
o components affecting safe operation of the product are not replaced by origi-
nal spare parts in the event of a malfunction,
o the electrical wiring in the room containing the system does not meet the
specifications of DIN VDE 0107 or the corresponding local regulations.
If desired, we will provide the technical documentation for the product.
However, this does not imply authorization to undertake repairs.
We cannot be held responsible for repairs made without our express written ap-
proval.
When any work is performed on the product, we would recommend that you ob-
tain a certificate indicating the nature and scope of the work performed. The cer-
tificate should include any changes in rated parameters or operating ranges as
well as the date, the name of the company and a signature.

Original accessories 0

For safety reasons, only approved original accessories or non-Siemens accesso-

ries approved by Siemens AG, Medical Solutions may be used for this product.
The operator is liable for any risks associated with the use of accessories not ap-
proved by Siemens.

Operator Manual
30 of 34 SPR2-320G.620.30.03.02
 Safety

Combinations with other systems 0

To ensure the required operational safety, only products and components ex-
pressly approved by Siemens AG, Medical Solutions may be used in combination
with this product.
For further details regarding the attachment of non-Siemens products to the
image intensifier see
(› Page 31).

Additional components placed into the beam path (e.g. positioning aids) will at-
tenuate radiation and can degrade image quality.

Attachment of dedicated options 0

The attachment of certain (dedicated) options is permitted only if the following

conditions are complied with:

General safety requirements 0

The use of accessories that do not comply with the relevant safety requirements
of this system can result in a reduced safety level of the combined system.
When choosing accessories, the following aspects must be considered
in particular:
o Use of accessories close to the patient.
o Proof that the accessories have been safety tested according to the
applicable IEC 60601-1 guideline and/or the IEC 60601-1-1 harmonized
national standard.

Tilting resistance; mechanical strength; central ray migration 0

To comply with the tilting resistance, mechanical strength and the central ray
migration standards (IEC 60601-1, IEC 60601-2-32, UL 60601-1, 4 times load,
IEC 60601-1-3), the additional weight attached to the image intensifier must not
exceed 4.5 kg (10 lbs).
If these conditions are not fulfilled, the function may be impaired.

Attachment 0

When a dedicated option is used on the image intensifier, it must be ensured that
there is no danger due to insufficient or incorrect attachment of the option.

ARCADIS Orbic
SPR2-320G.620.30.03.02 31 of 34
Safety

Attenuation equivalent 0

According to IEC 60601-1-3, inadequate attenuation of the X-ray beam by mate-

rials between the patient and image receptor (here: I.I.) must be avoided.
Documented proof by the manufacturer is recommended.
Remove any auxiliary devices located in the beam path for calibration or adjust-
ment of the dedicated options before operating the ARCADIS Orbic.

If materials are placed directly in front of the image intensifier, the image quality
can be impaired and the applied dose will be increased by the automatic adjust-
ment. Additional objects in the beam path may result in increased scattered radi-
ation.

Weight counterbalance 0

Attachment of any additional loads on the image intensifier or the tube assembly
side compromises the counterbalance and can lead to unintentional C-arm move-
ment.
Users must be alerted to this by a warning label. The responsibility for affixing the
corresponding warning label lies with the company that attaches the dedicated
option to the C-arm.

Operator Manual
32 of 34 SPR2-320G.620.30.03.02
 Safety

Image quality 0

The attachment of a dedicated option, such as a navigation system, must not

affect image quality (impairment of the diagnosis).
After maintenance or service work, the correct function of the non-Siemens sys-
tem on the image intensifier must be tested.

Electrical safety 0

EN 60601-1, Section 3, “Protection against electric shock hazard” must be com-

plied with.

Electromagnetic compatibility 0

EN 60601-1-2 must be observed in order to comply with the limit values for
electromagnetic compatibility.

Additional safety information 0

o Risk of injury due to sharp edges must be avoided.

o To avoid thermal overloading of components and short circuits, EN 60601-1
Section 7 and, if appropriate, UL 60601-1 must be complied with.
o Connecting external loads to the power supply of the C-arm system is not per-
mitted.
o We recommend that users in the EU have the relevant manufacturer of the
accessory operated by you, e.g. a navigation system, confirm the
CE Declaration of Conformity according to Appendix II, MDD and the
Declaration of Compatibility according to Article 12, MDD. In countries outside
the EU the relevant national regulations must be observed.

Product liability and warranty are restricted or expire if the above listed conditions
and limit values are not complied with when attaching accessories, such as nav-
igation systems.

For non-Siemens options, such as navigation systems, we generally accept

no liability.

ARCADIS Orbic
SPR2-320G.620.30.03.02 33 of 34
Safety

Disposal 0

There may be local regulations governing the disposal of your system.

o If you want to remove the product from service, take into consideration that
public legal directives may contain special regulations regarding disposal of
this equipment. To ensure that these legal regulations are complied with and
to avoid potential environmental hazards which may be caused by the disposal
of your product, we recommend that you consult Siemens Customer Service.
o Batteries and packaging should be disposed of in an ecologically sound man-
ner, as specified in national regulations.
o The sterile single-use covers (I.I., C-arm) must be disposed of in accordance
with national regulations or the rules of the hospital.
o For further information about the disposal of the product, please refer to our
service documents.

Operator Manual
34 of 34 SPR2-320G.620.30.03.02
 Register 3 System Description

Table of Contents

Description of functions ...................................................................................................... 3

System overview .............................................................................................................................. 3
Operating modes.................................................................................................................... 3
Options ................................................................................................................................... 3
C-arm system ................................................................................................................................... 5
Components of the C-arm system ......................................................................................... 5
Control and display panel on the C-arm system ..................................................................... 6
Monitor trolley .................................................................................................................................. 7
Standard monitor trolley ......................................................................................................... 7
Keyboard at the monitor trolley .............................................................................................. 8
UPS display field..................................................................................................................... 8
Operation............................................................................................................................. 9
Startup .............................................................................................................................................. 9
Connecting the C-arm system with the monitor trolley.......................................................... 9
Connecting the footswitch ................................................................................................... 10
Establishing the equipotential bonding connection .............................................................. 10
ARCADIS Orbic Switching on ............................................................................................... 11
C-arm movements .......................................................................................................................... 12
Lifting and lowering the C-arm ............................................................................................. 14
Moving the C-arm horizontally .............................................................................................. 15
Swivelling the C-arm............................................................................................................. 16
Angulating the C-arm ............................................................................................................ 17
Orbital movement of the C-arm............................................................................................ 18
Exposure preparation...................................................................................................................... 19
Protection against contamination and the penetration of fluids ........................................... 19
Positioning the C-arm ........................................................................................................... 19
Setting the semi-transparent slot diaphragm ....................................................................... 20
Manual slot diaphragm calibration ........................................................................................ 20
Setting the iris diaphragm..................................................................................................... 21
Selecting the noise reduction factor ..................................................................................... 22
Selecting the image intensifier format.................................................................................. 22
Setting image reversal .......................................................................................................... 22
Positioning an image for fluoroscopy.................................................................................... 23
Selecting the operating mode .............................................................................................. 24
Setting the X-ray parameters manually................................................................................. 29

ARCADIS Orbic
SPR2-320G.620.30.03.02 1 of 44
System Description

Radiation release ............................................................................................................................ 30

Key switch ............................................................................................................................ 30
Radiation release with the hand switch................................................................................ 31
Radiation release with the footswitch .................................................................................. 33
Shutdown ....................................................................................................................................... 34
Simple shutdown.................................................................................................................. 34
Switching the system off: complete shut down in the main menu...................................... 35
Reactivating the system ....................................................................................................... 36
Transport......................................................................................................................................... 37
Transport and parking position of the C-arm system............................................................ 38
Monitor trolley transport position ......................................................................................... 41
Park position of the monitors with height-adjustable monitor column (option) .................... 41
Moving the monitor trolley ................................................................................................... 42
Locking the monitor trolley ................................................................................................... 43
Setting the direction of the monitor trolley........................................................................... 43

Operator Manual
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 System Description

Register 3 System Description

Description of functions 0

System overview 0

The ARCADIS Orbic consists of a C-arm system and a monitor trolley.

(1) (2)

(1) C-arm system with a 23 cm image intensifier and single-focus tube with
generator
(2) Monitor trolley with keyboard, mouse, USB port, two rotatable TFT displays,
DVD drive and memory for 60,000 images

Operating modes 0

The ARCADIS Orbic has the following operating modes:

o Continuous fluoroscopy (CFC) with 30 f/s
o Pulsed fluoroscopy (PFC) with 8 f/s
o Digital Radiography (DR)

Options 0

The following options are available for the ARCADIS Orbic:

o Additional operation modes Subtraction and Roadmap
o Pulsed Fluoroscopy (PFC) 15 f/s
o Fluoro Loop
o 2 TFT High-contrast black/white displays (alternative to TFT color displays)
o Height-adjustable and foldable (park position) monitors

ARCADIS Orbic
SPR2-320G.620.30.03.02 3 of 44
System Description

o Video splitter live monitor/reference monitor

Output for connecting an external live/reference monitor. Implemented as a
splitter solution for connection with a 15-pin VGA plug (no galvanic isolation).
o Audio package
o Wireless network connection (WLAN)
o DICOM Standard (Send/Receive, Storage Commitment, Print)
o DICOM Query/Retrieve (enhancement of DICOM Standard)
o DICOM Worklist (enhancement of DICOM Standard)
o DICOM MPPS (enhancement of DICOM Standard)
o DICOM Advanced (Send/Receive, Storage Commitment, Print,
Query/Retrieve, Worklist, MPPS)
o 3-dimensional imaging
o NaviLink 2D
Integrated digital navigation interface for lossless transfer of 2D image data to
a navigation system.
o NaviLink 3D
Integrated digital navigation interface for lossless transfer of 2D and 3D image
data to a navigation system.
o 2D measuring function (for measuring angles and distances)
o HIPAA (Health Insurance Portability and Accountability Act)
o Thermal printer SONY UP-970
Economical, light-weight, compact printer for single-color printing on thermal
paper
o Thermal printer SONY UP-990
Economical, light-weight, compact printer for single-color printing on thermal
paper and thermal foil
o Dose measuring chamber for dose area product/air kerma
(valid for IEC 60601-1:2005 only)
o Integrated I.I. laser aimer
o Single-tank laser targeting device
o Horizontal laser light localizer
o Multifunctional footswitch
o DHHS spacer
o Grounding cable
o Sterile covers for the image intensifier, X-ray tube assembly and C-arm
o Set of clamps
o Key switch

Operator Manual
4 of 44 SPR2-320G.620.30.03.02
 System Description

C-arm system 0

Components of the C-arm system 0

(1) ARCADIS electronic unit

(2) Control and display panel
(3) Lifting column
(4) Horizontal support arm
(5) C-arm
(6) Image intensifier with integrated TV camera
(7) Single tank with X-ray tube unit and integrated collimator

ARCADIS Orbic
SPR2-320G.620.30.03.02 5 of 44
System Description

Control and display panel on the C-arm system 0

On the C-arm system you can find the control and display panel with membrane
keys and digital displays for performing your examinations.
The individual keys and displays are grouped by their functions in different areas.

(8) (9) (10) (11) (12)

(6)

(7) (7)

(1) (2) (3) (4) (5)

(1) Operating mode selection

(2) Select image parameters (high-contrast fluoroscopy, image quality,
image display)
(3) Collimator setting
(4) Image postprocessing
(5) Image selection, storing and printing
(6) Radiation indicator, X-ray tube assembly temperature
(7) Lift/lower C-arm
(8) Image rotation
(9) Laser light localizer ON
(10) Automatic dose regulation OFF (ADR Stop)
(11) Selecting and displaying exposure parameters
(12) Display exposure time, reset exposure time (confirm warning tone)

Operator Manual
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 System Description

Monitor trolley 0

Standard monitor trolley 0

(1)

(2)

(8)
(3)
(9)
(4)
(5) (10)

(6)

(11)

(12)

(7)

(1) Radiation indicator

(2) Monitors rotatable by 180°
Optional: folding monitors
(3) Control panel with storage drawers, keyboard and mouse
(4) Grips: for neat cable storage
(5) Drawer for storage of CDs/DVDs, Quick Guide etc.
(6) DVD R/W drive
(7) Wheels with cable deflectors
(8) Monitor column
Optional: Height adjustable
(9) Storage shelf with USB connection; On/Off switch of ARCADIS Orbic
Optional: Connection for MP3 player including loudspeaker on the rear of the
monitor trolley
(10) Printer bay
(11) Charge state of uninterruptible power supply (UPS) (see › Page 8)
(12) Central locking brake

ARCADIS Orbic
SPR2-320G.620.30.03.02 7 of 44
System Description

Keyboard at the monitor trolley 0

The application software for preparing (e.g. entering patient data) and evaluating
examinations is operated via the keyboard at the monitor trolley.

(1) Alphanumeric keypad

(2) Cursor keys
(3) Symbol keypad
(4) Function keys

UPS display field 0

The display field of the UPS at the front of the standard monitor trolley shows the
charge state of the batteries and the operating status.
(1) Bar display of battery charge status

(1) (2) (2) Bar display of utilization ratio

(3) "UPS On" LED (lit during operation)
(4) "Load protected" LED (lit during mains and battery operation)
(5) "Faulty operation" LED (lit additionally during battery operation)
(3)
(6) "Error" LED (lit in case of errors)

(4)
(5)
When the "Error" LED is lit, the ARCADIS Orbic is no longer protected against
(6)
power outages by the UPS. Notify Siemens Service.

Operator Manual
8 of 44 SPR2-320G.620.30.03.02
 System Description

System Description

Operation 0

Startup 0

Connecting the C-arm system with the monitor trolley 0

The C-arm system is connected to the monitor trolley with a cable. This cable
has plug connectors on both ends and therefore can be replaced directly on site,
if necessary.

Before starting the ARCADIS Orbic, please make sure that the cables are straight
(without loops).
Do not lay connection cables parallel to other cables.

(1) Lever
u Plug the central plug into the socket on the left side of the C-arm system.

If the central plug is marked with a green dot, then the green dot must also be
above the connector of the C-arm system so that the C-arm system is correctly
connected.

The monitor trolley may only be connected to the corresponding C-arm system.
If the monitor trolley is connected to the wrong C-arm system, an error message
is displayed during system startup.
u Turn the lever to the right until it audibly clicks into place.
– The monitor trolley is connected to the C-arm system.

ARCADIS Orbic
SPR2-320G.620.30.03.02 9 of 44
System Description

Connecting the footswitch 0

For the release of radiation with the footswitch, it must be connected to the
C-arm system.

u Plug the footswitch cable into the socket labeled with the footswitch symbol
at the C-arm system.
u Open the flap for cabling.
u Place the footswitch cable inside the groove for the cable and close the flap.

Establishing the equipotential bonding connection 0

The ARCADIS Orbic can be connected to a protective ground terminal via the
equipotential connector on the C-arm system. This will ensure that the
ARCADIS Orbic has the same electrical potential as other units connected to the
same protective earth terminal.
When performing cardiac examinations or examinations of the open skull, an ad-
ditional grounding cable according to DIN 57107/VDE107 must be routed in
rooms of Application Group 2.

u Clamp the grounding cable to the front face of the C-arm system (arrow) and
to an equipotential bonding point in the patient vicinity.
– Equipotential bonding is established.

Operator Manual
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 System Description

ARCADIS Orbic Switching on 0

The ARCADIS Orbic is operated via a grounded wall socket. The mains cable is
on the monitor trolley.
u Plug the power plug into the appropriate socket.
– The mains connection is established.
u Position the unit so that it is easy to disconnect from the mains.

Warning
Contact voltage while using the unit.
Electrical shock to operator and patient
u Connect this device only to a power supply network that has been properly
grounded.

u Press the ON button at the monitor trolley.

– The ARCADIS Orbic is switched on.
– The system automatically runs a self-test.
Depending on which shutdown procedure of the ARCADIS Orbic was used be-
forehand, the system will be ready for operation again in less than a minute
(following a simple shutdown) or after 3 min (following a complete shutdown)
(› Page 34).

If the HIPAA Security Package is activated, it can take approx. 90-100 s for the
ARCADIS Orbic to be operational again after a simple shutdown.

If the ARCADIS Orbic is restarted after a simple shutdown and immediately after-
wards large image data amounts (500 MB and more; approx. 250 single images)
are loaded, an error message may be displayed.
u In this case, confirm the error message and repeat loading the data.

ARCADIS Orbic
SPR2-320G.620.30.03.02 11 of 44
System Description

The following functions are set when the ARCADIS Orbic is started:
o Operating mode: The basic setting configured for the body region "All"
(› Register 9: Configuration, Page 5).
o Iris diaphragm in full format (edges visible).
o Semitransparent slot diaphragm in full format.

Before beginning the examination, perform the daily function and safety checks.

C-arm movements 0

The C-arm can be adjusted in height by motor control.

The horizontal movement, swivel movement, angulation and orbital movement of
the C-arm are performed manually. To do this, use the C-arm handle.

Operating the brakes The ARCADIS Orbic is equipped with electromechanical brakes which are con-
trolled via the buttons on the horizontal carriage.
The buttons for releasing and locking the brakes for different directions of move-
ment are marked with different colors. A graduation in the same colors for the
corresponding directions of movement is located on the housing.
Before moving the C-arm, the brake for the relevant direction of movement must
be released.
u To release an electromagnetic brake, press the corresponding brake button.
– When the brake is released, the pilot lamp of the button is switched on.
u To lock an electromagnetic brake again, press the corresponding brake but-
ton.
– When the brake is locked, the pilot lamp of the button is switched off.

Please lock the corresponding electromagnetic brakes on the horizontal carriage

after moving the C-arm system.

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 System Description

Emergency STOP
The horizontal carriage of the C-arm system is provided with a red EMERGENCY
STOP button which you can use to stop motorized lifting movements immediate-
STOP
ly in a hazardous situation.

Warning
Motorized vertical movement of the C-arm.
Risk of crushing!
u In the event of danger immediately push the EMERGENCY STOP button.
u Unlock the EMERGENCY STOP button by turning it counterclockwise only
when the hazardous situation has been eliminated.

ARCADIS Orbic
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System Description

Lifting and lowering the C-arm 0

You can lift and lower the C-arm by motor control using the arrow keys on the
control panel of the C-arm system.

Lifting the C-arm

u Press the Up key on the control panel of the C-arm system.
– The lifting column moves upwards.

The lifting column cannot be moved.

The EMERGENCY STOP button is pressed and must be unlocked.

STOP

u Turn the rotary knob clockwise.

u If the lifting column can still no longer be moved in any direction, please con-
tact Customer Service.

Lowering the C-arm

u Press the Down key on the control panel of the C-arm system.
– The lifting column moves downwards.

Operator Manual
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 System Description

Moving the C-arm horizontally 0

You can move the support arm horizontally by up to 20 cm.

u Press the button marked in green for the horizontal movement brake
(see arrow).
– The brake is released. The pilot lamp of the button lights up.
u Move the support arm while observing the green scale.
u Press the button for the brake again.
– The brake is locked. The pilot lamp of the button goes out.

ARCADIS Orbic
SPR2-320G.620.30.03.02 15 of 44
System Description

Swivelling the C-arm 0

You can swivel the C-arm horizontally ± 10° about the lifting column.

u Press the button marked in orange for the horizontal swivel brake (see arrow).
– The brake is released. The pilot lamp of the button lights up.
u Swivel the C-arm to the required position.
u Press the button for the brake again.
– The brake is locked. The pilot lamp of the button goes out.

Operator Manual
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 System Description

Angulating the C-arm 0

You can rotate the C-arm vertically about the horizontal support arm by ± 190°.

u Press the button marked in yellow for the angulation brake (see arrow).
– The brake is released. The pilot lamp of the button lights up.
u Rotate the C-arm to the required angulated position while observing the yel-
low scale on the support arm joint.
u Press the button for the brake again.
– The brake is locked. The pilot lamp of the button goes out.

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System Description

Orbital movement of the C-arm 0

Starting from the basic position (0°), you can swivel the C-arm by up to ± 95°
(190° in total).

u Press the button marked in blue for the orbital movement brake (see arrow).
– The brake is released. The pilot lamp of the button lights up.
u Swivel the C-arm to the required orbital position while observing the blue
scale.
u Press the button for the brake again.
– The brake is locked. The pilot lamp of the button goes out.

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 System Description

Exposure preparation 0

Protection against contamination and the penetration of fluids 0

If a significant amount of fluid is expected during an examination, there is a risk

of fluids penetrating into the system. It is recommend to cover the relevant areas
appropriately.
The C-arm can be covered completely or partially with a sterile disposable sheet
to protect it against contamination (› Register 12: Options, Page 12).

Positioning the C-arm 0

u Align the ARCADIS Orbic.

u Release the brakes and set the C-arm to the required position.
(› Page 12)

Warning
As long as the brakes are not locked after movement, the C-arm system moves
freely.
Risk of injury to the patient and personnel!
u Lock the brake.

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System Description

Setting the semi-transparent slot diaphragm 0

The semi-transparent slot diaphragm is used for collimation primarily when imag-
ing the extremities.
Collimation enhances image contrast and reduces scatter radiation. Direct radia-
tion that passes the soft tissue laterally is reduced to such an extent that the im-
age can be viewed on the monitor without any disturbing differences in
brightness.
By rotating the slot diaphragm, the collimated field can be quickly oriented to the
direction of the anatomy under examination (e.g. the extremities).
u Press one of the keys.
– The semi-transparent slot diaphragms are rotated to the left/right.

u Press this key.

– The semi-transparent slot diaphragm is closed.

u Press this key.

– The semi-transparent slot diaphragm is opened.

Manual slot diaphragm calibration 0

If it is determined during an intervention that the accuracy of the slot diaphragm

has deteriorated too much, a recalibration of the slot diaphragm can be per-
formed by pressing the buttons OPEN and CLOSE simultaneously and holding
them approx. 3 sec. This process lasts about 20 sec. During this time the kV and
mA indicators will flash. It is not possible to release radiation in this case.

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 System Description

Setting the iris diaphragm 0

The iris diaphragm is a collimator which serves to reduce radiation exposure to

the patient and third parties. Smaller collimation produces less scatter radiation
and therefore better image contrast. When the iris diaphragm is fully opened,
it must be visible in at least 2 places in the fluoro image.

The X iris leaves are set such that at least two leaves are visible.
When switching on the ARCADIS Orbic, the iris diaphragm automatically opens
to the full format.
u Press this key.
– The iris diaphragm is closed.

u Press this key.

– The iris diaphragm is opened.
– The LED lights up.

When you open/close the iris diaphragm or move the semi-transparent slot dia-
phragm without radiation, you can see the position of the collimator on the
LIH image displayed with a superimposed line/circle.
When you release radiation, the diaphragms are in the position shown in
the image.

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System Description

Selecting the noise reduction factor 0

u Press this key.

– A low integration factor is selected (for recording fast-moving objects).
When a low integration factor is selected, the LED lights up.
– If the key is pressed again, the LED goes out. A higher integration factor is
selected (for very slow movements).

Selecting the image intensifier format 0

You can select a zoom format.

u Press this key.
– The LED lights up when this function is selected.

Setting image reversal 0

u Press this key.

– The image is flipped vertically.
– The LED lights up when this function is selected.
u Press this key.
– The image is flipped horizontally.
– The LED lights up when this function is selected.

The image reversal is effective only on the left (live) monitor.

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 System Description

Positioning an image for fluoroscopy 0

To have the image appear on the monitor in the desired orientation during
fluoroscopy, you must rotate it.

Object display on the monitor depends upon the C-arm system position relative
to the patient.

(1) (2)

(1) Right side of patient

(2) Left side of patient
The rotation angle is displayed on the C-arm system (± 360°). The rotation angle
is displayed on the monitor absolute (proportional to the original position) as well
as relative (proportional to the previous image).
u Press one of the keys.
– The image is rotated in the respective direction.

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System Description

Selecting the operating mode 0

You can select the following operating modes for the ARCADIS Orbic:

Fluoroscopy For fluoroscopy (CFC) you can choose between several exam sets with different
characteristic curves to determine exposure parameters for fluoroscopy (DL).
Every application allows you to choose between different optimized programs.
The standard setting of the ARCADIS Orbic after startup is the basic setting con-
figured for the body region "All", which is typically Continuous fluoroscopy
(› Register 9: Configuration, Page 5).
Exposure factors and system control units including the way in which the auto-
matic setting is controlled:
o 1 k2 matrix; 30 f/s frame rate; image integration (as a function of the k factor
set), i.e. a number of k exposures are integrated into one image by sliding av-
eraging; the k factor can be selected between k = 1 ("OFF" setting) and
k = 32 and can be assigned to an exam set and stored.
Typical clinical procedure:
o Fracture reposition of the distal upper extremity (e.g. distal forearm fracture)
in the plaster room of an emergency outpatient clinic where, under continuous
fluoroscopy, the fracture elements are reduced by extension, fixed temporari-
ly in the best possible position and then fixed permanently by applying a plas-
ter cast.

Pulsed fluoroscopy This operating mode (frame rates up to 15 f/s) allows a reduction in radiation
dose of up to 70% for the patient and operator. The pulse duration is
generally 7 milliseconds. According to the level of noise reduction, many differ-
ent fluoroscopic images can be integrated. For frame rates less than or equalling
2 frames per second a type of intermittent continuous fluoroscopy is used where
the pulse duration varies depending on the noise reduction set.
Exposure factors and system control units including the way in which the auto-
matic setting is controlled:
o 1 k2 matrix; typical frame rate 4-15 f/s; image integration (as a function of the
k factor set), i.e. a number of k exposures are integrated into one image by
sliding averaging; the k factor can be selected between k = 1 ("OFF" setting)
and k = 8 and can be assigned to an exam set and stored.
Typical clinical procedure:
o Fracture reposition of the distal upper extremity (e.g. distal forearm fracture)
in the plaster room of an emergency outpatient clinic where, under continuous
fluoroscopy, the fracture elements are reduced by extension, fixed temporari-
ly in the best possible position and then fixed permanently by applying a plas-
ter cast, with the additional advantage of dose savings for the patient and
medical staff.

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 System Description

Digital radiography Digital radiography (DR) provides an electronic instant image of the patient on the
monitor. It is recommended for final exposures. The exposure time depends on
the noise reduction set.
Exposure factors and system control units including the way in which the auto-
matic setting is controlled:
o 1 k2 matrix; 1 f/s frame rate, with image integration, depending on the setting;
X-ray pulse with 7 ms up to approx. 1400 ms width, depending on the noise
reduction set.
Typical clinical procedure:
o Final follow-up exposure of a fracture reposition of the distal upper extremity
(see above).

Subtraction/Roadmap The subtraction memory option allows you to perform a subtraction angiography
(option) and simultaneously display the unsubtracted angiogram on the second monitor.
Subtraction technique allows hemodynamic display as well as display of the max-
imum vascular filling and Roadmap. The Roadmapping features can also be used
for other procedures.
Exposure factors and system control units including the way in which the auto-
matic setting is controlled:
o 1 k2 matrix; continuous fluoroscopy; storage rate usually 3 to 8 f/s; image in-
tegration (as a function of the k factor set), i.e. number of k exposures are in-
tegrated into one image; the k factor can be set between k = 1 and k = 32 by
an authorized technician.
Typical clinical procedure:
o Display of an arterial vessel for localizing vascular stenoses with injection of a
contrast medium to enable the contrast-enhanced display of the vascular fill-
ing (subtraction of the native image (mask) from the contrast-enhanced im-
age).
o Alternative to native image display, subsequent inversion of the displayed im-
age allows you to display a catheter introduced into the vessel path using the
Roadmap function.

For information on performing an examination with Subtraction or Roadmap

refer to (› Register 5: Examination, Page 21).

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System Description

Selecting an The operating modes can be selected directly at the control panel of the C-arm
operating mode system or in the Examination task card.
The operating modes can also be selected via the corresponding button on the
optional multifunctional footswitch, if used. The switch from one mode to anoth-
er is confirmed with a confirmation tone. You can then release radiation again
right away.
(› Register 12: Options, Page 7)

When an operating mode is selected, the LED of the corresponding key lights up
on the control panel. On the imaging system the operating mode is indicated by
a symbol or text display. The current operating mode is deselected when switch-
ing to another mode.

By repeatedly pressing an operating mode key that is already activated, you can
scroll through the exam sets assigned to the corresponding operating mode.
This is possible only if a patient has been registered.

Continuous
Fluoroscopy (CFC)
u Press this key.
– Fluoroscopy mode is selected.
– The LED lights up.

Upon startup of the ARCADIS Orbic, the basic setting configured for the body re-
gion "All", which is usually Fluoroscopy, is used as the automatic default
(› Register 9: Configuration, Page 5).

Pulsed
Fluoroscopy (PFC)
u Press this key.
– Pulsed Fluoroscopy mode is selected.
– The LED lights up.

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 System Description

Digital Digital radiography (DR) provides an electronic instant image with best image
Radiography (DR) quality. It is recommended for final exposures.
On activation of digital radiography a short radiation pulse is released.
u Press this key.
– Digital Radiography DR mode is selected.
– The LED lights up.

In order to ensure sufficient image quality, images are completely acquired after
the start of acquisition, even if no more radiation is released. The effective acqui-
sition time depends on the preset integration factor and is a maximum
of 1.8 seconds.
After complete image acquisition, radiation is automatically switched off, even if
the radiation release button remains pressed.

High-contrast For high-contrast fluoroscopy, the system switches from the normal to the
fluoroscopy "high contrast" characteristic. This characteristic temporarily enables maximum
(Power Mode) output.

"High contrast" is not possible in the DR, SUB and Roadmap modes.
u Press the key (in CFC or PFC mode).
– High contrast is selected.
– The LED lights up.
u Press this key again to switch "high contrast" off.
– High contrast is deselected.
The maximum radiation time for "high contrast" is 15 s (CFC and PFC). During the
exposure an acoustic warning signal is emitted. At the end of the maximum radi-
ation time, radiation is automatically switched off.

If the X-ray tube overheats, high-contrast fluoroscopy cannot be selected; the

overload protection will switch over the characteristic curve.
(› Register 2: Safety, Page 13)
If you select another operating mode or change the exam set, the selection of
SIREMATIC curves will change. This depends on the corresponding setting of
exam sets.

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System Description

Subtraction (SUB) The subtraction technique enables an isolated display of the vascular system af-
ter injection of the contrast medium by means of background subtraction.
(› Register 5: Examination, Page 21)
u Press this key.
– The Subtraction mode is selected.
– The LED lights up.

Roadmap The Roadmap technique enables the user to position a catheter precisely in a
blood vessel under fluoroscopy.
(› Register 5: Examination, Page 23)
u Press this key.
– The Roadmap mode is selected.
– The LED lights up.

Display of Sometimes the displayed pulse frequency does not correspond to the pulse fre-
pulse frequency quency defined in the examination program. However, a highly improbable com-
bination of settings must have been selected:
o Create user-specific exam set for body region "All" with bones displayed
white, high dose and PFC 10 p/s.
o Now, PFC mode and the exam set stated above will be saved in the basic set-
tings for the "All" body region.
o If the system is switched off and back on, and a patient is newly registered,
8 p/s will now be displayed in "Basic" mode instead of 10 p/s (CFC).
If you now switch to "Extended" mode and register a new patient, 10 p/s will be
correctly displayed. If you then switch back to "Basic" mode, and register a new
patient, 10 p/s is also correctly displayed here.

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 System Description

Setting the X-ray parameters manually 0

The default X-ray parameters can be changed manually with the +/- keys for kV/mA.

Automatic dose rate Using automatic dose rate control (ADR), the mean value of the image gray val-
control ues is kept constant within the dominant largely independently of the object
transparency and position. This ensures optimal image quality for on-screen eval-
uation.
(› Register 10: Technical Data, Page 4)
There are three factory default settings for the dose rate: reduced dose, standard
dose, increased dose (for 23 cm/9" I.I. 0.11/0.185/0.37 μGy/s).

Activating ADR stop When metallic objects (e.g. intermedullary nails) are introduced into the beam
path or when examining objects of varying density (e.g. hip prosthesis) under
fluoroscopy, it is recommended that you set the kV just established with the
Dose rate control Stop key at the start of fluoroscopy.
u Press this key.
– The stop function is switched on, the LED lights up.
– Automatic dose control is disabled.
– The +/- keys for kV/mA are enabled.

Setting the X-ray You can set the kV/mA values manually by activating the Dose rate control Stop
parameters manually key.
u Press the +/- keys briefly.
– The kV/mA values are increased/reduced.
– The set values are displayed.
Or
u Keep the +/- keys pressed for a period of time.
– This results in a continuous increase/decrease of the particular X-ray param-
eters.
Once the upper or lower limit of the setting range is reached, an acoustic signal
is emitted every time you press the key again.

The mA values assigned to the kV values result from the SIREMATIC curves.
(› Register 10: Technical Data, Page 3)
On reaching the end of the curve, the iris diaphragm is opened. The LED flashes.
If the iris diaphragm is opened to maximum, an acoustic signal sounds.

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System Description

Radiation release 0

Radiation can be released with the hand switch or the footswitch.

Complete image integration as a function of the set k factor (up to max. k = 8,
depending on the operating mode) is ensured even for very short exposures
("toe tapping").

k factor: a number of k exposures are integrated into one image; the k factor can
be selected between k = 2 and k = 32 and can be assigned to an exam set and
stored (IEC 60601-2-7:1998 29.1.103 d).

Key switch 0

To ensure that radiation is released by authorized personnel only, the C-arm in-
cludes a key switch.

The key switch is located on the left side of the C-arm (viewed from the direction
of travel).
u Prior to releasing radiation, turn the key switch to the right until it is horizontal.
– Radiation now can be released either with the hand switch or the foot-
switch.
u Return the key switch back to its original position.
– Radiation can no longer be released with either the hand switch or foot-
switch.
– The key can now be removed.

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 System Description

Radiation release with the hand switch 0

The hand switch is used to remote control radiation release and image storage.
The hand switch can be connected on either side of the C-arm system.

(2)

(1)

(1) Key for saving images (hold down key for < 2 seconds) and
scenes (hold down key for > 2 seconds)
(2) Release button

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System Description

Releasing radiation
u Use the button to release the exposure.
– Radiation is released in the selected operation mode.
– The current radiation parameters are displayed on the control panel of the
C-arm system.

During the exposure or after ending the exposure, an acoustic warning signal
sounds (can be configured).

Confirming a After 5 minutes of fluoroscopy time, a warning signal sounds. This can be reset
warning signal at the control panel. If no reset is performed, radiation is automatically disabled
after another 5 minutes (total of 10 minutes after the last reset).

These settings are country-specific and can be changed by Siemens Service in

accordance with the applicable regulations.

u Press the Reset key on the control panel of the C-arm system.
– The acoustic warning signal is deactivated.

Storing images
(during radiation)
u Press this button on the hand switch during radiation.
– The image currently generated and displayed is saved.
(› Register 5: Examination, Page 17)

Storing images
(after radiation)
u Press this button on the hand switch.
– Holding the key for < 2 seconds: saves the image last recorded (LIH).
– Holding the key for > 2 seconds: saves the scene last recorded (LSH).

The ARCADIS Orbic transfers images from monitor A to monitor B and then
stores them in the local database.

Images/scenes can also be stored via the corresponding button on the optional
multifunctional footswitch, if used.
(› Register 12: Options, Page 7)

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 System Description

Radiation release with the footswitch 0

The footswitch is used if both hands need to be free during the exposure.

SIEMENS SIEMENS

Standard footswitch

Standard footswitch

The footswitch is also suitable for applications where fluids may land on the floor.

For operation of the multifunctional footswitch (option) see

(› Register 12: Options, Page 7).

Releasing radiation The right footswitch is always used to activate fluoroscopy (CFC) (standard set-
ting).
The left pedal is used to activate the currently selected operating mode.
Exception: If fluoroscopy (CFC) is selected, the left pedal is assigned the digital
radiography (DR) mode.

The functionality of the two pedals can be reversed by Siemens Service upon re-
quest.
u Keep the foot pedal pressed during radiation release.

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System Description

Shutdown 0

Before disconnecting the ARCADIS Orbic from the mains, you must shut it down.
During the shutdown procedure the imaging system is powered down. There are
two different procedures, each with a different reset time.
The shutdown procedure used depends on how you switch off the
ARCADIS Orbic:

Simple shutdown 0

u Press the OFF switch on the monitor trolley.

– The C-arm system is immediately shut down.
– The imaging system and monitor A switch off after the computer has been
shut down.
The image system is shut down to "hibernate" before it is switched off by using
the OFF button. When the ARCADIS Orbic is switched on again, it will normally
be ready for operation after approx. one minute.

Depending on the configuration, it may take longer than one minute for the
ARCADIS Orbic to be ready for operation again.

It is possible to switch on again in approx. 5 seconds after you used the switch
off button (even during shut down).
Switching off (simple shut down) can be used up to 15 times in a row.
After the 10th shut off using the OFF button, a dialog opens in which you can
select simple or complete shut down. After the 15th switch off using the
OFF button, a complete shut down automatically occurs with appropriate notifi-
cation.

If you want to ensure a very short power-up time of your ARCADIS Orbic system,
we recommend that you initiate a complete shutdown yourself before the maxi-
mum number of 15 simple shutdown procedures is reached. You can do this dur-
ing a break between examinations, for example, and then switch the
ARCADIS Orbic on again in time before the next examination.

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 System Description

Switching the system off: complete shut down in the main

menu 0

Complete shutdown u Select Options > End Software Session in the main menu at the monitor
trolley.
– The System Message dialog box is displayed.

u Click Shutdown.
The imaging system is completely shut down.

u Press the OFF switch on the monitor trolley.

– The C-arm system, the imaging system and the monitors are switched off.

Using the End Software Session menu command (or automatically upon
16th switch off using the OFF button), the imaging system is completely shut
down before it switches off. When the ARCADIS Orbic is switched on again after
a complete shutdown, it may take more than 3 minutes, depending on the con-
figuration and previous use, for it to reach operational readiness.

The Restart button in the System Message dialog box only shuts down the
syngo user interface and the application programs and then restarts them.
This can be used, for example, when installing a virus protection update
(› Register 11: Maintenance, Page 12).

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System Description

Reactivating the system 0

If the imaging system cannot be shut down properly after pressing the
OFF button and does not react any more, you must deactivate the
ARCADIS Orbic system as follows:

u Open the monitor trolley drawer partway and press the Reset button on the
bottom of the key panel.
– All running processes are aborted and the ARCADIS Orbic is shut down.
u Switch the ARCADIS Orbic on again and let it boot up completely.
– Now you can either continue using the ARCADIS Orbic or shut it down.

If the ARCADIS Orbic is not fully operational despite the reset, please notify
Customer Service.

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 System Description

Transport 0

The C-arm system is equipped with 4 wheels for easy steering in any direction.
The C-arm system can be locked in place with the foot brake.

Caution
In general, care should be taken when transporting the C-arm system and the
monitor trolley.
Risk of injury to persons and risk of material damage!
u Always be sure to move the equipment slowly and carefully.

Caution
When transporting the C-arm system and the monitor trolley in the transport
position, the floor inclination must not exceed ± 10°.
The C-arm system can tip over!
u Avoid an inclination angle of more than ± 10°.

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System Description

Transport and parking position of the C-arm system 0

Prior to transport, the C-arm system must be set to the transport position.

Preparing the C-arm

u Release all brakes of the C-arm.

u Set the C-arm to the transport position shown in the drawing.
– Angulation 0°/Orbital position 0°.
u Move the lifting column downwards.
u Move the horizontal carriage all the way back.
Lock all brakes of the C-arm again.

Disconnect the u Switch off the ARCADIS Orbic and wait for it to shut down.
power plug
u Pull the power plug out of the wall outlet.

Pull on the plug, not on the cable!

The ARCADIS Orbic can be switched on again after approx. 5 s.
Please note that after finishing an examination, the ARCADIS Orbic must be shut
down properly before it is disconnected from the power supply.

Disconnect the u Turn the lever counterclockwise for unlocking and remove the plug.
central plug – The central plug is disconnected from the monitor trolley.
u If attached, disconnect the grounding cable from the C-arm system.

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 System Description

Rolling up the
footswitch cable

(1) Footswitch holder

(2) Rolling up the footswitch cable
u Roll up the footswitch cable onto the cleat provided and place the footswitch
into its holder.

When attaching the footswitch, please be careful not to kink the cable.

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System Description

Driving the unit

(1) (2)

(1) Foot brake locked (pedal tilted)

(2) Foot brake released (pedal horizontal)
u Release the foot brake.

(1) (2)

(1) Steering lever shown in the position for forward travel

(2) The steering lever can be locked into position for transverse travel to the right
or left
u Lift the steering lever and turn it in the desired direction.

The steering lever can be locked into 3 different positions. One is for movement
straight ahead, the others for transverse travel to the right or left.
u Move the C-arm system by hand.
– If the steering lever is in a transverse position, the C-arm system moves
parallel to the lever position (the movement is possible even when the sys-
tem is in an unlocked position)

When transporting the C-arm system make sure there are no obstructions on
the floor.

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 System Description

Monitor trolley transport position 0

Prior to transport, the rolled-up power cable and the connection cable for the
C-arm system should be placed on the grips of the monitor trolley.

Depositing the
connection cable

u Place the rolled-up cables on the grips of the monitor trolley.

Park position of the monitors with height-adjustable monitor

column (option) 0

(1)

(2)

(1) Height-adjustable monitors

(2) Toggle switch for height-adjustment of the monitors
The height of the monitors can be adjusted with the black toggle switch.

u Press the arrow symbol for Down on the toggle switch.

– The monitors automatically move downwards.

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System Description

u When the lowest position has been reached, the monitors can be folded.

Moving the monitor trolley 0

u Release the central brake at the front of the monitor trolley (see arrow) to start
moving the trolley.

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 System Description

Locking the monitor trolley 0

u To lock the monitor trolley, push the center brake down with your foot until it
stops/engages.

Warning
As long as the brake at the front is not locked, the monitor trolley can move
freely.
There is a risk of injury to persons and damage to equipment!
u Lock the brake at the front of the monitor trolley.

Setting the direction of the monitor trolley 0

u In order to set the direction of the monitor trolley, push the center brake
upwards with your foot until it stops/engages.

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System Description

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 Register 4 Patient data

Table of Contents

Introduction Patient Registration ......................................................................................... 3

The Patient Registration window...................................................................................................... 4

Emergency registration ....................................................................................................... 5

Emergency Registration window...................................................................................................... 6
Emergency registration in the Patient Registration window............................................................. 7

Registering a new patient.................................................................................................... 8

Opening Patient Registration ............................................................................................................ 8
Entering data..................................................................................................................................... 9
Personal data .......................................................................................................................... 9
Hospital-specific data............................................................................................................ 10
Examination data .................................................................................................................. 10
Institution data ...................................................................................................................... 10
Completing data entry .................................................................................................................... 11
Registering a patient for the examination............................................................................. 11
Preregistering a patient ........................................................................................................ 11

Registering a known patient.............................................................................................. 12

Searching in the Patient Registration window ................................................................................ 13
Starting a search ................................................................................................................... 13
Accepting patient data.......................................................................................................... 14
Patient data not recognized .................................................................................................. 14
Searching in the Patient Browser ................................................................................................... 15
Completing your entries ................................................................................................................. 16
Resuming a commenced study ...................................................................................................... 17
Configuration of Patient Registration................................................................................. 18
Calling up the configuration window............................................................................................... 18
Configuring selection lists............................................................................................................... 19
Configuring Patient Search ............................................................................................................. 21
Introduction Patient Browser............................................................................................. 24
The Patient Browser window ......................................................................................................... 25
Databases and drives...................................................................................................................... 26
Data levels ...................................................................................................................................... 27

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Patient data

Searching for and displaying patient data .......................................................................... 28

Data at the workstation................................................................................................................... 28
Opening a data level ............................................................................................................. 28
Filtering data ......................................................................................................................... 29
Sorting data .......................................................................................................................... 30
Data on external exchange media................................................................................................... 30
Data in the network ........................................................................................................................ 31
Printing a data list ........................................................................................................................... 33

Updating and deleting data................................................................................................ 34

Changing patient or examination data............................................................................................. 34
Safety notes for changing data ............................................................................................. 35
Correcting Data..................................................................................................................... 36
Rearranging data................................................................................................................... 39
History of changes .......................................................................................................................... 40
Changing the work status ............................................................................................................... 41
Performance documentation (MPPS) ............................................................................................. 42
Adding data........................................................................................................................... 43
Sending and concluding a report .......................................................................................... 43
Delete data ..................................................................................................................................... 45
Deleting patient data ............................................................................................................ 45
Protecting data from deletion ............................................................................................... 46
Removing delete protection ................................................................................................. 46
Deleting data in the scheduler .............................................................................................. 47
Patient Browser Configuration .......................................................................................... 48
Calling up the configuration window............................................................................................... 48
General settings.............................................................................................................................. 49
Configuring the tool bar ........................................................................................................ 50
Data preview for external media .......................................................................................... 50
Work status .......................................................................................................................... 51
Delete confirmation .............................................................................................................. 52
Tree view ........................................................................................................................................ 53
Selecting a database and a data level ................................................................................... 54
List entries............................................................................................................................ 55
Hiding data levels ................................................................................................................. 55
Single view ..................................................................................................................................... 56
Selecting a database and a data level ................................................................................... 57
List entries............................................................................................................................ 58
Configuring Patient Search ............................................................................................................. 59

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Register 4 Patient data

Introduction Patient Registration 0

Before you can examine a patient with your system, you must register the pa-
tient.
Registration means that you give your system all the information about a patient
that it requires for an examination.
Depending on how registrations are organized in your hospital and how much
time you have for registration, you can choose between different patient registra-
tion procedures.

Emergency If a patient is admitted who is in an extremely critical condition and must there-
registration fore be examined and treated immediately, call up emergency registration.
This reduces the time before you can begin the examination to a minimum.

Registration for the However, if you want to register a patient for an examination, you first enter the
examination patient's data or call it up from the database and then examine the patient.

Preregistration If you want to prepare the system to examine a patient at a later time, then you
can preregister the patient.
For example, in the morning you can enter the data of all the patients to be ex-
amined during the day. When you want to begin an examination, simply call up
the relevant data and edit them, if necessary. This saves time during the exami-
nation.

HIS/RIS query If your system is connected to a HIS/RIS system (hospital and radiology informa-
tion system), you can query and retrieve data for the patient to be examined for
preregistration or registration.

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Patient data

The Patient Registration window 0

The Patient Registration window is subdivided into four areas into which you
can enter topically coherent data.

(1) Personal data of the patient (PATIENT)

(2) Hospital-specific data (HOSPITAL)
(3) Study-specific data (PROCEDURE)
(4) Institution data (INSTITUTION)

The input fields can be adapted by Siemens Service.

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Emergency registration 0

An emergency registration is performed if a patient must be examined and treat-

ed immediately, without any time to waste entering the patient’s data.
You can register an emergency patient either in the Emergency Registration or
in the Patient Registration window.

If you release radiation without having registered a patient for the examination,
a corresponding dialog box is displayed. After radiation has been released again,
an emergency patient is automatically registered. You can register an emergency
patient by releasing radiation twice with the hand switch or footswitch. Thus en-
tries at the monitor trolley are unnecessary.

Provisional The patient is registered with provisional data as an emergency patient. As soon
patient data as you have more time after the examination, you must complete the patient and
examination data of your emergency patient using the Patient Browser.

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Emergency Registration window 0

u First finish off or interrupt the current examination.

u Press the button in the tool bar of the Patient Browser.
— Or —
u Call up Patient > Emergency in the main menu.
– The Emergency Registration window opens.

u Click the Exam button in the Emergency Registration window.

– The Emergency Registration window is closed.
– The Examination task card is opened.

By clicking Cancel you can stop emergency registration at any time, e.g. if you
have accidentally called up the Emergency Registration window instead of the
Patient Registration window.

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Emergency registration in the Patient Registration

window 0

u First finish off or interrupt the current examination.

u Press the key on the symbol keypad.
– The Patient Registration window is displayed.

u Click the Emergency button in the Patient Registration window.

– The Patient Registration window is closed.
– The Examination task card is opened.

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Patient data

Registering a new patient 0

If a patient has never been examined in your hospital or practice before, no data
about this patient will be stored on your system.
Therefore all the data of this patient must be entered before an examination.

Registering If you register a patient and want to examine this patient immediately afterwards,
enter all the examination-relevant data into the corresponding input fields.

Preregistration If you only want to preregister the patient for later examination, you must fill in at
least the mandatory input fields. These are emphasized by bold letters
(sex, name, patient ID and date of birth).

Opening Patient Registration 0

The data of a new patient are entered into the empty Patient Registration
window.
You can call up patient registration from the Patient menu, via icon buttons on
the Viewing task card as well as from the Patient Browser.
u Press the key on the symbol keypad.

Or
u Click the corresponding button on the Viewing task card/Patient subtask
card or in the tool bar of the Patient Browser.
Or
u Select Patient > Register.
– The Patient Registration window opens.

If you call up patient registration from the Patient Browser make sure that you
have not selected a patient or study there. Otherwise the selected data are trans-
ferred to the Patient Registration window.

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Entering data 0

After you have called up patient registration, the cursor is in the input field for
patient name in the PATIENT area.
The Exam and Preregister buttons remain deactivated until you have entered all
the information required to register or preregister a patient.

Personal data 0

Name, patient ID, age, and sex of the patient are mandatory entry fields.
This information uniquely identifies the patient in your databases.

If you do not enter a Patient ID, your system automatically generates an identifi-
cation code from the date, time, abbreviation for daylight-saving or standard time,
and the identification number of your system (unique worldwide).

Caution
For internal identification of patient data, e.g., studies, series and images, the
system time is used. By resetting the system time duplicate identifiers may be
created.
Data may be assigned to the wrong patient!
u If it is necessary to reset the system time for synchronization, wait until the
new system time is later than before.

u Enter the personal data of the patient (at least the mandatory input fields) in
the PATIENT area.

The valid input format for the Date of birth is displayed in the status line.
Enter the year of birth using four digits.

If you do not know the date of birth you can enter the estimated age. The system
then calculates a date of birth from the current date. In the selection field next to
it you can specify whether the age is in years, months or days (for example for
infants).

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Patient data

Hospital-specific data 0

In the HOSPITAL area, you can enter the referring physician, the preliminary
diagnosis, and the hospital ward where the patient is located.
u Enter the hospital-specific data via the keyboard.
Or
u Select the entries you require from the selection lists.

Examination data 0

In the PROCEDURE area, data from the HIS/RIS system (option), if connected,
are entered automatically.
u Do not enter any data here.

After you have registered the patient, the data for the upcoming examination can
be entered in the Examination task card.

Institution data 0

In the INSTITUTION area, you enter the information about the examining institu-
tion and the personnel performing the examination. This information can be help-
ful if the examination results are passed on to a different organization for
reporting.
u Enter the institution data via the keyboard.
Or
u Select the entries you require from the selection lists.

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Completing data entry 0

After you have entered all the necessary patient data in the Patient Registration
window, you can register the patient for the ensuing examination or preregister
him or her for examination later on.

Registering a patient for the examination 0

If you want to examine the patient directly afterwards, register the patient now.
The ensuing examination is conducted with the data that you have entered.
u Click the Exam button.
– The Examination task card is displayed.
– Now you can start examining the patient.

Preregistering a patient 0

You can preregister the patient with the data entered if you want to perform the
examination later on. You can then access the patient data again when you start
the examination.
(› Page 12)

u Click the Preregister button.

– The patient is included in the scheduler. The input fields of the PATIENT
area in the Patient Registration window are empty again. You can enter
the data of the next patient.

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Patient data

Registering a known patient 0

A patient who is preregistered or has already been examined in your hospital or

practice is known to your system.
You can search for the patient in the databases and transfer the information
stored into the Patient Registration window.

Resuming a If you cancelled a study with "End Examination", you can continue this study later.
commenced study Just select the study from the Patient Browser, load the data into
(e.g. IVP) Patient Registration and then start the examination. Please note that this is only
possible if you have already acquired images in the commenced study. An empty
study cannot be used for registration.

HIS/RIS query If the patient's data have already been entered via a HIS/RIS system, you can que-
ry and retrieve the data from the hospital network and transfer them to the sched-
uler. The patient is then preregistered.

The scheduler is updated via the HIS/RIS system at regular intervals. If the patient
registered for examination does not appear in the scheduler, although he/she has
been entered via the HIS/RIS, update the scheduler manually by double-clicking
the scheduler icon. This is advisable in particular after switching on or restarting
the ARCADIS Orbic.

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Searching in the Patient Registration window 0

You can search for patient data in the databases from the Patient Registration
window and then use the data for registration.

In Registration Configuration you can define which databases (e.g. local

database, local archive) are to be searched.
(› Page 21)

Starting a search 0

u Call up the empty Patient Registration window.

u Enter the data known to you in the Last name and Patient ID fields.

If you know only part of the name or part of the ID of the patient you are looking
for, you can use the asterisk "*" as a wildcard.
It does not matter whether your entries contain upper or lower case letters.
u Click Search.
– The databases of your system are now searched for the patient with the
data entered.
– During the search, the Cancel button is displayed instead of the Search
button. Thus you can cancel long search processes.

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Patient data

Accepting patient data 0

If only one patient was found at the end of the search, this patient's personal data
are automatically transferred to the Patient Registration window.
As soon as a second patient was found, your system displays the Patient Search
window with the hit list.

u Select the patient in the search list and click OK.

Or
u Double-click the required patient.
– The personal data of the selected patient, for preregistered patients all data
entered previously, are placed in the Patient Registration window.

Repeat your search with changed entries and/or extend the search to further
databases.

Patient data not recognized 0

If a patient is already registered in the local database with “Last Name,

First Name”, the data may be saved differently in the systems. This is not visible
to the user, however.
In this case, the patient data are not found and the error message
"Certain identifying characteristics are missing". In order to access the patient
data nevertheless, proceed as follows:
u Delete the patient data from the local database.
u Re-register the patient data.

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Searching in the Patient Browser 0

You can also use the Patient Browser to search for a patient in the scheduler,
a database and in the local archive (inserted data medium). You can then transfer
the data to the Patient Registration window. You can simplify your search by
filtering and sorting the patient data.
(› Page 28)
u First select the database from which you want to transfer the patient data.
u Click the required patient entry in the navigation or content area of the
Patient Browser.
— Or —
u Select the study or studies of the patient that you want to perform or repeat.
u Press the key on the symbol keypad.
— Or —
u Select Patient > Register to open the Patient Registration window.

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Patient data

Completing your entries 0

After you have transferred the patient data you searched for into the Patient
Registration window, check that the data are correct and, if necessary, add any
missing data before registering the patient.
u Click Exam if you want to examine the patient next.
– The patient is registered for examination.
– The examination data are transferred to the Examination task card and
you can begin the examination.
Or
u Click Preregister to preregister the patient.

The Changing Patient Attributes window is displayed.

If you have transferred the patient from the local database and made corrections
to that patient’s personal data, this message box appears.

u Do not forget to correct the patient data in the original record later on.
u Close the message window with Continue.

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Resuming a commenced study 0

You can resume an incomplete study of a patient.

All newly generated images are appended to the existing study as a new series.
u Call up the Patient Browser.
u Select the relevant study.
u Call up the Patient Registration window.

u Click the Exam button.

– The Examination task card is displayed and you can resume the study.

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 Patient data

Patient data

Configuration of Patient Registration 0

You can adapt patient registration flexibly to the individual requirements of your
examination practice.
You can change the following default settings:
o The entries in the selection lists of the Patient Registration window.
o Selection of the databases that you want to be searched when using the
search function as well as the search procedure and display of the search re-
sults.
o Worklist settings, if a HIS/RIS system is connected.

Calling up the configuration window 0

You can call up the configuration window from the syngo Configuration panel.
u Select Options > Configuration in the main menu.
u Double-click on the Patient Registration icon.
– The Registration Configuration window is displayed with the Entering
Data, Searching, and HIS/RIS cards.

The HIS/RIS card is displayed only if your system is connected to a hospital or

radiology information system and configured and licensed accordingly.

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Configuring selection lists 0

In the Entering Data card you can create selection lists. During patient registra-
tion, you can then make use of these entries. In this way you save time during
data entry and avoid typing errors.

Possible selection lists You can change and add to the selection lists for the following input fields if these
fields are shown in the Patient Registration window:
o Referring physician
o Admitting diagnosis
o Ward
o Institution name
o Performing physician
o Operator

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Patient data

Creating entries You can create up to 50 entries for each selection list.

u Under Entering Data, select which selection list you want to edit.
u Enter new entries in the text input field below and correct or delete the exist-
ing entries.

The entries are automatically sorted in alphabetical order.

Defining default For each selection list you can define whether and which entries are preselected
entries in an input field when you call up patient registration.

u Select No default.
– When you call up patient registration, the input field is empty.
Or
u Select Use first element as default.
– When you call up patient registration, the first entry from the selection list
is already in the input field.
Or
u Select Keep selection from previous (pre-)registration as default.
– When you call up patient registration, the entry you selected for the last
patient you (pre-)registered is already in the input field.

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Configuring Patient Search 0

In the Searching tab card you can define which databases are to be searched
during a patient search, after how many hits the search is terminated, and what
information the search list is to contain.

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Patient data

Specifying databases During a patient search the following databases can be searched:
o Scheduler database
(contains all patients preregistered at your system)
o Local database
(contains all patients who were examined at your system in the past and
whose data have not yet been deleted)
o Local archive
(contains all patients that are stored on the data media currently inserted)

u Select the databases that you want to search during the patient search.

It is not possible to exclude the scheduler from the search.

Limiting the number You can have the search stopped once a certain number of patients have been
of patients found found.

u Enter after how many hits you want the patient search to be stopped.

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Defining the display of Here you can select which data items of the patients found will be listed in the
the search list Patient Search window and how the display is to appear.
You can have the following information displayed:
o Personal data
You can have some or all of the information that you have entered in the
PATIENT area displayed in the search list.
o Admission data
Information about the referring physician and ward from the HOSPITAL area.
o Information about the hospital/practice
The name of the hospital/practice that you have entered in the INSTITUTION
area.
o Location
The network node where the data of the patient displayed in the search list
are stored.
u Enter the column of the search list in which the information is to be entered.

u Enter the column width (number of characters).

u Click the information that you want to display.

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 Patient data

Patient data

Introduction Patient Browser 0

The Patient Browser supports you in the administration of the patient and exam-
ination data that are stored in the databases of your system.
With the Patient Browser you can search for data in a fast and uncomplicated
way and then process that data in the browser or in the task cards.

When to use the o To examine a patient who has already been examined once before with your
Patient Browser system and whose data are still saved in the local database
o To view the images of a patient from earlier examinations in order to compare
them with current results
o To comment or postprocess images after an examination
o To correct incorrect information on a patient stored in your system
o To archive patient and examination data or to send them to another location in
your hospital via the network
o To expose images of a patient onto film for reporting or documentation pur-
poses

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The Patient Browser window 0

When you call up the Patient Browser, the Patient Browser window is dis-
played and placed into the foreground.
The window is subdivided into various processing areas and therefore provides
you with access to your data in a clearly laid out manner.

(1) Menu and tool bar

(2) Navigation area
(3) Information box
(4) Content area
(5) Status bar

Tool bar You can edit the data you have selected using the menus or the icon buttons on
the tool bar.

Navigation area The lower data levels for the selected databases, patients, studies and series are
displayed graphically in the navigation area.

Information box In the information box you can see brief information about the patient and study
selected.

Content area The content area contains a list of the studies or procedure steps for the patient
selected in the navigation area. If you select the lower data levels, you can see
which series or procedure steps are stored for a study and which images or ac-
tion items are stored for a series or procedure step.

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Patient data

Databases and drives 0

In the Patient Browser you can access patient and examination data that is
stored in the various databases of your system or on external data media such
as CDs/DVDs.

Local Database
The local database is the area of your system where patient data and results of
current examinations are stored.

If the data volume in the local database increases, access times become longer
and examinations are slowed down. Therefore you should regularly move data
from your local database to archive media.

If patient data are saved only locally, they will no longer be available once they
have been deleted. If follow-up studies need to be performed, the patient must
be registered again.
If you have saved the data in an archive on the network, they will still be available
even after the patient has been deleted from the local database.

Scheduler
The scheduler contains the data of all preregistered patients. This database gives
you an overview of all patients who have been preregistered for examination.
Here you can search for patients you want to register for an examination.
If available, the HIS/RIS worklist is displayed in the scheduler.

The Clear Scheduler function allows you to delete certain scheduler entries in
one step.
(› Page 47)

Connected drives
One or more CD/DVD drives are connected to your system. The icons with the
drive names provide a quick way of accessing these storage media. You can ex-
port the examination data to these locations after completing an examination.
However, this does not replace data backup to (long-term) archives such as
a PACS.

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Data levels 0

In the databases and on the external data media, the patient and examination data
are structured hierarchically. This structure helps you find examination results
quickly.

(1) Database
(2) Patient
(3) Examination
(4) Series
(5) Images

The display of the data levels depends on the configuration.

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Patient data

Searching for and displaying patient data 0

In the Patient Browser window you can view all the patient and examination
data stored in the databases of your system or in the main databases of other net-
work nodes (if connected) and on external archive media.

Calling up the You can call up the Patient Browser window either from the main menu or by
Patient Browser using the symbol keypad.
u Press the Patient Browser key on the symbol keypad.
Or
u Call up the Patient Browser in the main menu by selecting Patient >
Patient Browser.

Data at the workstation 0

You can search for patient data in the Patient Browser by navigating through the
data levels of the window by mouse click or using the keyboard.
You can speed up your search by sorting the data displayed, e.g. alphabetically
by the last name of the patient. You can also filter the data displayed and only
view a certain subset.

Opening a data level 0

To select certain images of a patient for processing, you can open the patient,
study, and series information levels one after the other until the images you re-
quire are listed or displayed in the content area.
u Click on individual data objects in the navigation area to open all the associated
entries of lower data levels.

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Filtering data 0

When filtering your data you can use filter criteria that are offered by default by
your system. These are available to you on the menu bar or with the buttons on
the tool bar.

Using the Patient Browser you can also create your own filter criteria in order to
filter the database according to a combination of target items. You can call up the
Filter Specification window with Options > Filter Settings.

Activating a filter u Select one of the filter criteria in the Filter menu of the Patient Browser.
Or

u Select a standard filter from the tool bar.

In the Browser Configuration dialog you can define which filter icons are dis-
played on the tool bar. To open this dialog box, select Options > Configuration.
(› Page 48)

Deactivating the filter u Call up Filter > Off.

Or
u Click on the icon button to have all the data displayed again (unfiltered).

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Patient data

Sorting data 0

You can sort the data displayed in the Patient Browser by various criteria. This en-
ables you to output the data in a certain sequence and makes it easier to find cer-
tain patient and examination data.
u Select a data level in the navigation area.
u Open the Sort menu.

Depending on the data level displayed in the content area, different sorting crite-
ria will be provided.
u Click on one of the sorting criteria offered.

Data on external exchange media 0

You can import patient and examination data archived or exported onto a data
medium in DICOM format into your system (into the local database) if a drive has
been installed and configured appropriately.

Importing data u Insert the required data medium.

u Click on the icon of a data medium in the navigation area.
u Select the required patient data from the data medium in the navigation area.
u Call up Transfer > Import.
— Or —
u Click the icon button on the tool bar.
u Call up Transfer > Eject from... to remove the data medium.

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Data in the network 0

Patient and examination data stored on other workstations or in a long-term ar-

chive can be accessed via Patient Search. Import the required data into your lo-
cal database via the network so you can process and evaluate them on your
workstation.

Calling up u Call up Patient > Search.

Patient Search
— Or —
u Click the icon button on the tool bar.

If you need further data on a patient stored in your local database, select the pa-
tient in the Patient Browser and call up Patient > Search Selected. The search
window will then already contain the search mask for the relevant patient.

– The Patient Search dialog box is displayed.

(1) Input fields for search criteria (search mask)

(2) List of search details
(3) Display of search results

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Patient data

Starting a search u Enter the known patient data and further search details, if necessary.

Unknown data can be replaced by the wildcard “*”, e.g. T*.

u In the Node field, specify the network node where you want to search for the
data.
u Start the search by clicking the Search button.
– The patients, studies and series found are displayed in the results area of
the Search dialog box.

To display a list of all images of a series selected in the results area, click the
Image List button.

Import data

Caution
Receipt of images of a patient listed under different personal data in the local
data and on the sending network node (e.g. after patient was renamed on the
network node).
Possible loss of data since the images are assigned to the patient with the
original personal data in the local database!
u In this case, search for the imported data with the Patient Browser using
suitable search and filter criteria.
u If necessary, correct the personal data of the patient concerned in your local
database.

u Select the required data in the results area (or in the image list).
u Click the Import button.
– The selected data are copied from the network node to your workstation
and displayed in the navigation and content area of the Patient Browser.

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Printing a data list 0

If a printer is connected, you can print a list of examination data. When printing
data, the information displayed in the content area is processed.

Displaying a u Display the required patient and examination data in the content area.
print preview
u Select Patient > Print Preview.
– A print preview of the data list is displayed.

Printing u Select Patient > Print List.

— Or —
u Click Print in the Print Preview.
– The data list is printed on the default printer.

If you wish to print on another printer, select Patient > Print. You can now
change the print settings in the dialog box displayed.

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Patient data

Updating and deleting data 0

Every now and then it is necessary to add or correct patient data or information
relating to the study of a patient (e.g. emergency patient). You use the Patient
Browser to search for the patient in the database and to edit the corresponding
data.
With the DICOM MPPS option the system automatically generates a perfor-
mance report for each examination which you complete and terminate after the
examination and postprocessing.
Once the examination data have been successfully archived and are no longer
needed, you can delete them from the local database.

Please note that when deleting large amounts of data part of the system resourc-
es will be occupied for a while (up to 30 minutes for deleting all data with com-
pletely filled database). During this time the system performance during
examinations with high image storage rates may be restricted.

To avoid interfering with routine clinical procedures, we recommend that up-

dates, deletion and archiving of data be performed during times when the
mobile C-arm system is not used.

Changing patient or examination data 0

The described functions for changing patient and examination data are used for
correcting the local database.

Possible changes You have the following possibilities of changing data:

o Correcting data in the Correct dialog box.
o Rearranging patient data in the Patient Browser.

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External data If you change a data set that has also been sent to another network node, please
note the following: The changes affect the local database. The corresponding
data set is not automatically updated on other network nodes. This can lead to
inconsistencies between the local data set and the exported data set.
You have two possibilities to avoid these inconsistencies:
o Besides the local data set, you also correct all relevant data sets on other net-
work nodes.
o You delete all relevant data sets on other network nodes and resend the cor-
rected data sets.

Safety notes for changing data 0

When correcting and rearranging examination data, make sure that the images
are assigned correctly and these changes are also made on the other network
nodes.

Caution
Correcting/rearranging objects with references.
References may be lost!
u Rearrange the entire hierarchical group containing all objects with references
in order to maintain the references.

Caution
Rearranging of series/images into another series may lead to wrong image in-
formation, if the selected images/series are not compatible.
Wrong diagnosis due to incorrect image information!
u Correct the attributes which do not correspond, before you rearrange the
series/images.

Please terminate the active study of the patient before correcting examination
data of this patient.

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Correcting Data 0

Patient and examination data can be changed and added to in the Correct dialog
box.

Calling up the dialog u Select the patient, study, series or images that you want to correct in the nav-
window Correct igation or content area of the Patient Browser.
u Call up Edit > Correct.
— Or —
u Click on the icon button on the tool bar.
– The Correct dialog box opens.

(1) Name and number of selected data

(2) Entry form for correction data, divided in data areas
(3) Entry cards for details of the individual data

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Entering data In the input and selection fields of the Correct window you can see the informa-
tion that has been stored for the selected patient or selected study or series
so far.
u Correct or add to the selected data.

Depending on the data level in which you want to correct data, some fields of the
Correct window might be dimmed. Data marked "*" cannot be changed.

When you enter very long comments in the Comment input field, only the first
part of the text is displayed in the Viewing task depending on the selected lay-
out. A third or fourth comment line is not displayed, either.

Signing for changes

u Enter your name under Modifier's name.

Or
u Select your name in the selection list.

If you do not specify a name, the name with which you logged on to the system
is taken as the modifier.

Saving changes
u Click on OK.
– The new data are saved and the changes are included in the history of
changes.

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Merging patient data A patient whose name was spelt incorrectly during an examination or who was
once registered as an emergency patient is stored in the database twice.
As soon as you save the corrected patient name, the dialog box asks you whether
you want to merge the examination data of the two patient entries or not.

Caution
Patient data are merged.
Examination data may be assigned to the wrong patient!
u Before confirming the message, make sure that the patient is one and the
same.

u Click on OK.
– All selected data are stored under the corrected patient name.
Or
u Click Cancel.
– The correction of the data is canceled. No changes are made.

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Rearranging data 0

The study images of a patient are sorted hierarchically by series and studies.
If required, you can change this assignment in the Patient Browser.

Data can be rearranged only within a patient entry.

The following restrictions apply for rearranging data:
o Only images of the same application area that were acquired in the same
patient position can be merged.
o The data hierarchy must be maintained, e.g. a study cannot be subordinated
to a series.
o Delete-protected data or data currently loaded in an application cannot
be edited.

Moving data u Select the study, series or images in the Patient Browser.
u Move the selected data to the required position by drag & drop.
– The Rearrange dialog box for confirming your changes is displayed.

Signing for changes

u Enter your name under Modifier's name.

Or
u Select your name in the selection list.

If you do not specify a name, the name with which you logged on to the system
is taken as the modifier.
u Click on OK.
– The changes are saved and included in the history of changes.

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History of changes 0

The history of changes is a type of logbook of your local database that is created
separately for each data level. Here you can always see what changes and addi-
tions have been made to the data of patient and to the information about the pa-
tient's examinations.

Opening the u Select the patient, study, series or image stored in the local database whose
history of changes history of changes you want to view.
u Call up Edit > History.
Or
u Click the icon button on the tool bar.
– The Correct & Rearrange History window is displayed with a chronologi-
cal list of changes.

Depending on the hierarchy level of the selected data, different information is list-
ed in the Correct & Rearrange History window.

If an object has been moved, the entry is marked with ">" under Attribute in the
Correct & Rearrange History window.

Closing the history

u Click on OK.
– The history display is closed.

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Changing the work status 0

The work status indicates the processing stage of patient and examination data.
This status is indicated as an abbreviation in every list entry in the content area.
With the exception of "read" and "verified", all work statuses are automatically set
by the system.

After storing or transferring data, always check whether the process was carried
out correctly - irrespective of the work status display.

Under Transfer Configuration you can specify that data must have reached a cer-
tain work status before they can be archived and sent.

Entering the status As the user you can set the following entries for studies and series in your local
manually database:
o com/... Completed
o ver/... QA Verified
o rea/... Read
u Select Edit > Set State and select the work status you want to assign.
Or
u Click the appropriate button on the tool bar.
– The work status of the selected data objects is changed correspondingly.

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Performance documentation (MPPS) 0

If the DICOM MPPS option is installed, your system creates a performance report
during patient registration. During examination and post-processing of the exam-
ination results, the report is updated.
Before you conclude your work on the examination by archiving, check and add
missing entries to the performance report.
u Select the patient, the study, or one of the associated series or images from
the Patient Browser.
u Call up Patient > Show MPPS.
Or
u Click the icon button on the tool bar.
– The Modality Performed Procedure Step window is displayed.

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Because of digit overlaps, the display of long radiation times (> 65 s) can be dif-
ficult to read in the Dose card. However, this does not affect the printable radia-
tion report.

Adding data 0

u Enter a comment and a short description in the MPPS area, if necessary.

u Enter all performed actions in the table on the Actions card.
u Click the Billing card in the foreground and enter all action steps, the film con-
sumption and the material into the tables.
u If you want to annotate the applied radiation dose, click the Dose card in the
foreground and enter the text into the lower Comment field.

Sending and concluding a report 0

If all data in the performance report are entered correctly, you can close the report
and therefore also the examination. If further working steps are planned, you can
save the report temporarily and conclude it later.
Depending on operational requirements, you can transfer the report to
the HIS⁄RIS system.

Saving a report
u Click the Save button.
– Your entries are saved to the report and the Modality Performed
Procedure Step window is closed.

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Concluding a report
u Click the Completed button to conclude the report and the examination.
– The report and the examination is concluded.

A message indicating this is sent to the HIS/RIS system, if connected. You can
no longer make changes to the performance report.

Exiting a report as
discontinued
u Click the Discontinued button.
– The examination is no longer continued.

The report is also closed with that. A message indicating this is sent to
the HIS⁄RIS system, if connected.

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Delete data 0

If an examination has been completed and all the examination results and images
have been reviewed and commented, you can archive the data and then delete
it from the database.
(› Register 8: Documentation, Page 61)

Deleting patient data 0

You can delete existing data in the navigation or content area.

Caution
Deleting non-archived images
Data are irretrievably lost!
u Before deleting images, make sure that these were archived correctly.

u Select the data you want to delete.

u Call up Edit > Delete in the main menu of the Patient Browser.
— Or —
u Click on the icon button on the tool bar.
– A dialog box is displayed in which you have to confirm again that you really
want to delete the selected data.

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Protecting data from deletion 0

You can protect patient and examination data from accidental deletion.
u Select the data that you want to protect against deletion in the navigation or
content area.
u Call up Edit > Protect in the main menu of the Patient Browser.
— Or —
u Click on the icon button on the tool bar.
– You can now no longer simply delete the selected data. Delete protection
always includes all lower data levels and the related entries of the higher
data levels. For example, if you protect a study entry you can no longer
delete the individual images of that study nor the patient entry.
– Delete protection can be identified by the mark status "prot".

Data that you have assigned delete protection to, are protected from both moving
and correction.

Removing delete protection 0

If you want to correct, move, or delete data without a message box being dis-
played, you must remove the delete protection again.
u Call up Edit > Remove Protection in the main menu.
— Or —
u Click on the icon button on the tool bar.
– Delete protection is removed.

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Deleting data in the scheduler 0

The Clear Scheduler function allows you to delete certain scheduler entries in
one step.
u Select Edit > Clear Scheduler in the menu bar of the Patient Browser.
– The Clear Scheduler dialog box is displayed.

u Select the entries to be deleted by ticking the relevant check boxes.

u Confirm your selection with OK to save your settings and delete the corre-
sponding procedure steps.

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 Patient data

Patient data

Patient Browser Configuration 0

With the Browser Configuration dialog box you can adapt the Patient Browser
to your method of working.
You can change the following settings:
o General settings such as the layout of the tool bar and the display of the
work status.
o The hierarchical view of the information levels (patient, study, series, instance)
in the navigation and content area.
o The display of the individual information levels (study, series, instance) in the
content area.
o The selection lists in the Patient Search window.

Calling up the configuration window 0

You can call up the configuration window from the syngo Configuration panel.
u Select Options > Configuration in the main menu.
u Double-click on the Patient Browser icon.
– The Browser Configuration window with the tab cards General,
Tree View and Single View is displayed.

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General settings 0

On the General tab card you can configure the tool bar of the Patient Browser,
define which work status is displayed for the examination data, and set the influ-
ence of the work status on delete permission. And finally, here you can establish
the links to network nodes.

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Patient data

Configuring the tool bar 0

You can place buttons for the functions of the Patient Browser that you require
frequently on the tool bar and remove rarely used functions.

u Select an action that you want to place as an icon button on the tool bar from
the Tool Pool.
u Click the Down arrow button.
– The selected button is displayed in the Tool Bar.
u Repeat this step until the Tool Bar contains all the buttons you require.

Deselect the buttons that you do not require using the Arrow up key.

Data preview for external media 0

In addition to the list view, the data of external media can also be shown as a
thumbnail preview. The thumbnails are shown in the content area of the Patient
Browser.

u Click the check box to activate the thumbnail preview.

– A dialog window is displayed which prompts you to confirm the activation
of this function.

Please note that loading media with a large number of images may take a long
time when this option is activated.

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Work status 0

In the middle part of the General tab card you can define which work status of
the examination data is displayed in the content area and in which processing
state data is released for deletion.

Showing work status

u Select the check box for a work status if you want this work status to be dis-
played in the content area of the Patient Browser.

Defining delete
permission

u Select the check box of a work status.

– Data without this status cannot be deleted without explicit confirmation in
a message box.

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Delete confirmation 0

The default setting is to have your system display a confirmation window before
each deletion even if the data concerned have already reached the work status
required for deletion. You can activate and deactivate this confirmation in the con-
figuration.

Caution
Delete confirmation has been deactivated.
Potential loss of data!
u Delete confirmation should always be activated.

u Click the Confirm Deletion check box.

– A confirmation box is displayed every time before data is deleted.

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Tree view 0

On the Tree View tab card you can define what information is listed in the con-
tent area of the Patient Browser in the hierarchy levels (e.g. patient). You can
also hide hierarchy levels in the navigation and content areas and configure the
icon display of series and images.

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Selecting a database and a data level 0

u Select Database.
– The local database view is configured.
Or

u Select Scheduler.
– The display of preregistered patient data is defined in the Patient
Browser.

u Select the data level for which you want to define the entries.

The names and information that appear on the Tree View card for the different
data levels differ depending on the database that you have called up (e.g. Study
in the local database corresponds to Procedure in the scheduler).

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List entries 0

For the "Series" and "Instance" data levels you configure the display of the list and
of the icons.

Selecting list/image
stamp display

u Select the display option for which you want to define the entries.

Making entries u In the Heading Pool select which entries you want to have displayed in the
content area.

Select the entries in the sequence in which you want to have them displayed in
the table.
u Click on the Down arrow to place the entry in the Heading Settings for the
table in the content area.

Using the Modality selection list, you can define the entries depending on the
imaging modality or the data type.

Hiding data levels 0

You can define whether the study, series, or instance hierarchy levels are dis-
played in the navigation and content area.

u Click the Hide check box to hide this data level.

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Single view 0

In the Single View card you can define up to which hierarchy level data are to be
displayed if the navigation area is hidden. Each data entry is displayed in exactly
one line.

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Selecting a database and a data level 0

u Select the database that you want to configure from the selection list.

u With the Display Level radio button you can select the data level that you
want to have displayed when switching from Tree View to Single View in
the content area.

In single view, the content area always shows the same data level.

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List entries 0

You can combine list entries of different information levels by varying the data
level for the pool in the Heading Pool from which you then select the required en-
tries.

Defining data entries

for Heading Pool

u Define the data level in the selection list from which you want to take list en-
tries for the content area in the Heading Pool.
– In the Heading Pool all the possible list entries from the selected informa-
tion level are displayed. The currently selected list entries are highlighted.

Making entries
u Click on a list entry in the Heading Pool and move it into the Heading Settings
with the down arrow button.

u Now select another Level, if necessary, to place list entries of another data
level from the Heading Pool into the Heading Settings.

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Configuring Patient Search 0

You can adapt the user interface of the Search dialog window to your method of
working. The dropdown lists of the search criteria Modality and Body Part are
configurable.
u Call up the syngo Configuration Panel by activating
Options > Configuration in the main menu.
u Double-click the Patient Search icon.
– The Patient Search Configuration window appears.

u Select or deselect the desired items by clicking or deselecting the correspond-

ing check box.
u Click the OK button.
– The settings you have made are saved.

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 Register 5 Examination

Table of Contents

Safety information relating to the examination procedure................................................... 3

Before examination........................................................................................................................... 3
During examination ........................................................................................................................... 4

The Examination task card................................................................................................... 5

Layout of the Examination task card................................................................................................. 5
Menu bar .......................................................................................................................................... 6
Status bar.......................................................................................................................................... 6
Control area ...................................................................................................................................... 6
Display modes ........................................................................................................................ 7
Patient Data ............................................................................................................................ 8
Virtual patient anatomy (VPA) ................................................................................................. 8
Selection area for examination settings (Extended display mode only).................................. 8
Radiation data (Extended display mode only) ......................................................................... 9
Image area ...................................................................................................................................... 10

Performing the examination .............................................................................................. 11

Examination settings....................................................................................................................... 11
Basic display mode ......................................................................................................................... 12
Body region .......................................................................................................................... 12
Starting the examination....................................................................................................... 12
Extended display mode .................................................................................................................. 13
Medical application area ....................................................................................................... 13
Body region .......................................................................................................................... 14
Exam set............................................................................................................................... 15
Operating mode.................................................................................................................... 16
Acquisition ...................................................................................................................................... 17
Releasing radiation ............................................................................................................... 17
Saving and displaying images ............................................................................................... 17
Reviewing and storing a scene............................................................................................. 19
Completing the examination ........................................................................................................... 20
Special examinations ...................................................................................................................... 21
Subtraction angiography (SUB) ............................................................................................. 21
Roadmap .............................................................................................................................. 23

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References task card......................................................................................................... 25

Layout of the References task card ................................................................................................ 26
Subtask cards ................................................................................................................................. 27

Displaying reference images ............................................................................................. 29

Operation at the monitor trolley...................................................................................................... 29
Notes .................................................................................................................................... 29
Transferring Images.............................................................................................................. 30
Holding a reference image.................................................................................................... 30
Operation at the C-arm system ...................................................................................................... 31
Transferring images manually............................................................................................... 31
Using the References task card ........................................................................................... 32

Native task card ................................................................................................................. 33

Layout of the Native task card ........................................................................................................ 33

Displaying native images ................................................................................................... 34

Native images during examinations ................................................................................................ 34
Native images from the database ................................................................................................... 35

Reports .............................................................................................................................. 36
Radiation Summary Report............................................................................................................. 37
Opening a report................................................................................................................... 38
Editing a report ..................................................................................................................... 38
Printing a report .................................................................................................................... 39
LithoReport ..................................................................................................................................... 40
Opening a report................................................................................................................... 41
Editing a report ..................................................................................................................... 41
Printing a report .................................................................................................................... 43
Export for statistical evaluations ........................................................................................... 44
Configuration .................................................................................................................................. 46
Calling up the configuration window .................................................................................... 46
Configuring selection lists..................................................................................................... 47
Defining designations for stone locations............................................................................. 48
Defining print settings .......................................................................................................... 49
Configuring the Radiation Summary Report ......................................................................... 51
Entering address details ................................................................................................................. 52
Applying configuration settings ............................................................................................ 53

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Register 5 Examination

Safety information relating to the

examination procedure 0

Before examination 0

Orientation aid for

image orientation

Warning
Incorrect image position displayed on the monitor.
Surgical intervention in the wrong position!
u Use lead letters as orientation aids during the exposure.

Integrated I.I. Depending on the configuration of your ARCADIS Orbic, you can use the
laser aimer integrated I.I. laser aimer for positioning the C-arm.

Warning
Laser radiation
Risk of eye injury!
u Do not view the beam using optical instruments (laser class 1M).

Single-tank laser Depending on the configuration of your ARCADIS Orbic, you can use the integrat-
targeting device ed single-tank laser targeting device for positioning the C-arm.

Warning
Laser radiation
Risk of eye injury!
u Do not look directly into the laser beam (Class 2 laser).

Examination settings Before starting surgery, please make sure that all the set parameters as well as
examination settings in all operation modes are correct.

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Examination

Software failure In case of a software failure, restart the ARCADIS Orbic by switching it off and
then back on using the corresponding keys on the monitor trolley
(› Register 3: System Description, Page 34, › Register 3: System Description,
Page 11).

Storage capacity The hard disk usage is displayed in the status bar of the left monitor. A warning
signal is displayed before the final capacity of the hard disk is reached.
This icon, for instance, indicates that about 10 percent of the disk space is used.

Please make sure that there is sufficient storage capacity before you start the ex-
amination. In addition, please observe the relevant system messages.

Reference images Since permanent network functionality cannot always be guaranteed, reference
from previous images should be loaded from the network archive before starting an examina-
examinations tion.

During examination 0

Prior to the release of radiation, check whether the patient is positioned correctly.
Ensure correct image orientation (accurate to side) on the monitor and/or film.
Before storing images, check to make sure that images and patient data are as-
signed correctly.
Before terminating an examination, check the patient data to make sure every-
thing is correct before starting treatment of the next patient.
The registered patient should be deselected at the end of the examination.
(› Page 20)

If the exam set used is configured such that all images are saved, you must limit
the series length to less than 1000 images.

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The Examination task card 0

The Examination task card is used for setting and displaying examination-related
operating and program parameters. It is also used for acquiring images and dis-
playing current images and examination data.

Layout of the Examination task card 0

The task card is displayed on the left monitor, the so-called live monitor:

(1) Menu bar

(2) Status bar
(3) Control area (shown here with maximum functionality in the Extended dis-
play mode)
(4) Image area

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Examination

Menu bar 0

The user can access various functions using the menu bar. It opens when the
mouse cursor is moved to the upper edge of the monitor.

Status bar 0

System messages indicating the current state of the system or error messages
are displayed in the lower part of the control area.

NaviLink 2D
If the NaviLink 2D option is available in the system and communication between
the navigation system and the C-arm is activated, you can see the NaviLink 2D
icon in the status bar of the Examination task card.
The navigation system sends a message to the C-arm system signaling readiness
for receiving images. The C-arm system receives the message, identifies the
sending navigation system and responds. At this moment, communication be-
tween the two systems is activated and the NaviLink 2D icon appears in the sta-
tus bar of the Examination task card. As soon as the communication connection
is terminated, the NaviLink 2D icon disappears again.

Control area 0

The display of the control area and the availability of functions depends on the
selected display mode.
Depending on the display mode, the following data is displayed within the
control area:
o Information about the current patient
o Examination settings
o The current state of the ARCADIS Orbic

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Display modes 0

The Basic display mode reduces the user interface to the display of basic func-
tions. This mode is recommended for examinations that are to be performed with
the standard exposure parameters of the body region to be examined.
In the Extended display mode, the full functionality of the user interface is
shown. This allows for detailed examination settings, with additional information
displayed.
You can switch between the two display modes at any time with the
Basic ⁄ Extended button.

(1) (2)

(1) Control area in the Basic display mode

(2) Control area in the Extended display mode

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Patient Data 0

The registered patient's last name, first name and date of birth appear in the
upper control area. The data are shown in both display modes.

Virtual patient anatomy (VPA) 0

The upper control area shows a schematic virtual patient anatomy for selecting a
body region (VPA = Virtual Patient Anatomy). The display is available in both dis-
play modes.

Selection area for examination settings (Extended display

mode only) 0

The selection area for examination settings offers several selection lists that can
be opened by using arrow symbols.

(1) Selection list of medical application areas

(2) Selection list of exam sets
(3) Selection list of operating modes

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Radiation data (Extended display mode only) 0

The different dose levels of the selected exam set are displayed in a progress bar.

Here, the entire fluoroscopic time since the start of the examination of a patient
is displayed.

The cumulative area dose product for the current patient is displayed, if the op-
tional dose measurement chamber is installed.
As an alternative: Display of air kerma values. The cumulated air kerma value is
identified by a preceding dot.

The reference location for determining the air kerma strength with the optional
dose measurement chamber is 30 cm in front of the image intensifier input.
The reason for this convention is that in typical applications the object to be ex-
amined is located approximately 30 cm in front of the I.I.

Depending on country-specific regulations, you can have Siemens Service

change the display so that it indicates the air kerma and cumulated air kerma
value instead of the area dose product.

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Image area 0

In the image area the fluoroscopic images are displayed during and after expo-
sure. Additional information may be shown as image text, depending on the con-
figuration (see › Register 6: Image Processing, Page 78).

(1) (2)

(1) Information on kV and mA

(2) Window value and LUT information

Live images As soon as the exposure (i.e. radiation) starts, the current fluoroscopic images
(live images) are displayed in the image area of the Examination task card.

Last Image Hold (LIH) The last fluoro image (Last Image Hold) is displayed in the Examination task card
as soon as the exposure is terminated.

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Performing the examination 0

After you have registered the patient for the examination, the Examination task
card appears automatically. Here you can check the default examination parame-
ters. If necessary, you can change the settings in the control area or at the control
panel of the C-arm system.
Individual exposures are released directly at the C-arm system with the hand
switch or footswitch.

If you X-ray a patient without having registered him/her, this patient will have the
status of an emergency patient in the local database.

Examination settings 0

In the Examination task card, standard exposure parameters for Ortho/Trauma

applications are already preset. If these settings are appropriate for your exami-
nation, you can start the acquisition immediately on the ARCADIS Orbic
(› Page 17).
To examine other body regions, you must first select them in the Examination
task card. You can use the Basic display mode if otherwise the standard expo-
sure parameters for the corresponding body region are to be used (› Page 12).
If, however, you want to optimize the examination settings according to your
medical indication, simply call up the required parameters by using the corre-
sponding selection lists. In this case, switch to the Extended display mode
(› Page 13).

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Examination

Basic display mode 0

In the simple display mode, the user only has to select the body region. The med-
ical application area, the examination program and the operating mode are then
preset automatically.

You can define the presettings for individual body regions in the Basic setting
configuration window (› Register 9: Configuration, Page 5).

Activating the basic

display mode
u Click here to switch from the Extended to the Basic display mode.

Body region 0

Selecting a
body region
u Click on the body region that you want to examine.
– The activated body region is highlighted in a light color.

Deactivating the
selected body region
u Click in the area outside of all body regions.
– The deactivated body region is displayed in the original color.
Or
u Click on another body region that you want to examine.

If no body region is selected, the standard program for general purposes is

activated.

Starting the examination 0

u Start your examination at the C-arm system (› Page 17).

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Extended display mode 0

The different examination settings are divided into different parameters sets that
are structured hierarchically. The sequence of the associated selection fields in
the Examination task card corresponds exactly to this hierarchy.
Therefore, when defining the desired settings, you simply proceed from top to
bottom in the control area:

(1) 1. Selection of the medical application field

(2) 2. Selection of the body region to be examined
3. Selection of the exam set (thereby setting the dose)
4. Selection of the operating mode (thereby loading the parameters settings of
(3)
the associated operating program)
(4)

Activating the
Extended display
mode

u Click here to switch from the Basic to the Extended display mode.

Medical application area 0

First select the intended medical application field.

You can configure which application field is automatically selected after patient
registration.
Each medical application field is assigned a specific standard program. As soon
as the application field is activated, you can perform an X-ray examination right
away.

Selecting the
application field
u Select the required medical application field for your examination in the selec-
tion list.

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Examination

Body region 0

If you want to X-ray a specific body region within an application field, several
exam sets adapted especially to this particular body region are at your disposal.
They can be selected using the VPA (Virtual Patient Anatomy).

Selecting a
body region
u Click on the body region that you want to examine.
– The activated body region is highlighted in a light color.

Deactivating the
selected body region
u Click in the area outside of all body regions.
– The deactivated body region is displayed in the original color.
Or
u Click on another body region that you want to examine.

If no body region is selected, the standard program for the selected application
field is activated.

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Exam set 0

Three different dose programs are available for each selectable body region.
These programs are contained in the operating mode settings.
When a body region is selected, the Standard Dose program is activated by
default:

Modifying the dose Usually a dose rate deviating from the standard setting is reasonable only if you
have to adapt the dose to the particular anatomical conditions of the patient
(e.g. very slim or obese patients).
u Use the selection list to select another exam set (dose program), if necessary.
– With Reduced Dose you set the minimum dose rate, which still provides
satisfactory image quality for the selected body region.

If you change the exam set, the fluoroscopy mode is automatically set.
Even if a different LUT is stored with the new exam set, the display of the current
image (LIH) or of the subtracted image does not change (the current LUT is main-
tained).

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Operating mode 0

The different operating modes are defined in each examination set. They can be
activated at the monitor trolley and at the C-arm system as well as with the
(optional) multifunctional footswitch. The default setting is Fluoroscopy:

Switching the
operating mode
u Use the selection list to select another operating mode, if necessary.
Or
u Press the corresponding icon button at the C-arm system.
(› Register 3: System Description).
– The selected operating mode is displayed as a symbol in the control area.

Standard Symbol Option Symbol

Fluoroscopy Roadmap

Pulsed fluoroscopy Subtraction

Digital radiography

Using the footswitch, the operating mode can be changed temporarily,

depending on the pedal actuated.
(› Register 3: System Description)
With an additional operating element on the (optional) multifunctional footswitch
you can select the operating mode permanently.
(› Register 12: Options, Page 7)
During the exposure, the Examination task card always shows the symbol of the
operating mode in which radiation is released. If no radiation is released, you will
see the symbol of the operating mode currently selected at the control panel of
the C-arm system or in the Examination task card.

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Acquisition 0

All further steps of the examination are performed at the C-arm system.
For detailed information please read (› Register 3: System Description, Page 9).

Releasing radiation 0

u Release radiation with the hand switch or footswitch.

– The current fluoro image is displayed on the left (live) monitor.

Saving and displaying images 0

In the Continuous Fluoroscopy, Pulsed Fluoroscopy, Subtraction and Roadmap

modes, images can be stored during the examination. Images that you later want
to print on a local printer must be saved during the examination.

Frequent activation of the Save button during fluoroscopy can delay the storage
process.

Storing images
(during radiation)
u Press this key on the control panel of the C-arm system.

– Or –
u Press this key on the hand switch.
– The current image (or the subtraction image in Sub/Roadmap mode) is
saved to the local database. All images saved in the course of an examina-
tion are stored as a series.
– The saved image is displayed on the right (reference) monitor (› Page 25).

If the examination program used is configured to save all images automatically,

the Save Image key is inactive.

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Examination

Storing images
(after radiation)
u Press this key on the control panel of the C-arm system.

– Or –
u Press this key on the hand switch.
– Holding the key for < 2 seconds: saves the image last recorded (LIH).
– Holding the key for > 2 seconds: saves the scene last recorded (LSH).
– The saved LIH is displayed on the right (reference) monitor (› Page 25).

Changing the The control panel of the C-arm system provides basic tools for optimizing the
image display image display of the Examination task card.
u Edge enhancement (4 levels).

u Selection of LUT steps on monitor A.

u Enlarging/reducing the image.

During an examination, single frames and scenes can automatically be loaded

into the References card (› Page 31). Changes in edge enhancement only affect
the left monitor (the image is displayed with an enhanced or less enhanced edge).
The reference image on the right monitor is not affected. If the difference be-
tween the images on the left and right monitor is a distraction, it is recommended
not to change the edge enhancement at the control panel of the C-arm system
during the examination.

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Reviewing and storing a scene 0

In the Continuous Fluoroscopy, Pulsed Fluoroscopy, Subtraction and Roadmap

modes, scenes can be reviewed and stored (LSH, Last Scene Hold) during the
examination.

Reviewing a scene As soon as the exposure is finished, buttons for controlling scene review are dis-
played in the control area of the Examination task card.
u Start (review speed matches the storage rate).

u Review at half/double speed.

u Pause.

u Previous/next frame.

If Autoloop is configured in the exam set used, review of the scene is started
automatically at the end of the exposure.

Storing the scene Prerequisite: Scene review has been stopped.

u Select Patient > Save LSH Scene from the main menu.
– Or –
u Press function key F9 on the keyboard.
– The last 120 images are stored in the local database.
– You can load the scene into the Viewing task card at any time and review
it there.

If the exam set used is configured to automatically save all images, manual saving
is not necessary and therefore not possible.

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Examination

Completing the examination 0

After you have completed your exposures, the last acquired image is displayed
on the left monitor. Now you finish the examination of the current patient.
If you want to examine the next patient immediately afterwards, you can register
that patient straight away. In this case the examination of the current patient is
automatically finished.

Finishing an u Select Patient > End Examination in the main menu.

examination
— Or —
u Press function key F4.
– The examination is concluded. Patient and examination data are deleted
from the Examination card.
– If the MPPS option is installed, the Modality Performed Procedure Step
window for performance documentation is now displayed automatically.
(› Register 4: Patient data, Page 42).

Examining the u Select Patient > Register in the main menu and register the next patient for
next patient the examination.
– The examination of the previous patient is completed.
– The data of the new patient are loaded into the Examination card.

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Special examinations 0

The following optional operating modes require special procedures deviating

from the standard examination:
o Subtraction angiography (SUB)
o Roadmap

After incorrect operation, it may be necessary for the user to repeat certain pro-
cedures, e.g. administering of contrast agent.

Subtraction angiography (SUB) 0

During the examination, images without contrast medium (mask) are continuous-
ly subtracted from images with contrast medium and displayed on the monitor.
Depending on the contrast medium flow, they display the relevant vascular seg-
ment without superimposition in real time.

Progression The subtraction angiography is divided into three phases:

o Phase A
Time until the mask is completed (permanently defined)
o Phase B1
Time from the "inject" display on the monitor until the contrast medium has
reached the area to be examined
o Phase B2
Time of the actual exposure of the examination region

If Auto Save is activated in the configuration menu, you should enter the duration
for phase B1 and the storage transfer rate for phases B1 and B2 in that menu.
Thus the image memory is not overloaded with unnecessary images.
(› Register 9: Configuration, Page 18)

Landmark In some cases it is useful to see the anatomy surrounding the contrast-filled
blood vessels. This can be configured gradually prior to the examination using the
Landmark function.
(› Register 9: Configuration, Page 18)

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Examination

Performing Prerequisite: The patient to be examined has been registered.

subtraction
u Make the necessary settings for the examination.
angiography
(› Page 11)
u Set the Subtraction mode in the Examination task card or by pressing the
corresponding key on the control panel.
– The symbol for the current operating mode, Subtraction, is displayed.
– The LED of the Sub key lights up.
u Before starting the exposure, click the Native tab on the right monitor.
– The Native task card is placed in the foreground.
u Release radiation with the hand switch or with the assigned footswitch.
– During the generation of the mask the native image is displayed on the
right monitor.
u Inject the contrast medium as soon as the syringe symbol appears on the
screen.

Keep the radiation release button pressed until the vessel is filled with contrast
medium.

– On the left monitor you can see the continuous filling of the blood vessel
with contrast medium.
– After radiation has been switched off, the left monitor shows a subtraction
image with accumulated contrast medium (maximum fill image). The right
monitor shows the image with the largest fill phase and anatomical back-
ground (native).

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Roadmap 0

In the first step of the Roadmap examination, the max. fill image is created as a
mask from a normal subtraction (phase A and phase B). You can use the existing
subtraction mask if you have already performed a subtraction angiography during
the current examination. In that case, the first step of the Roadmap examination
is not required.

A previously created subtraction mask can also be used if you have switched to
a different operating mode (such as DR). The subtraction mask symbol (display
to show existing subtraction mask) will remain active.
In the second step, the display of the vessel into which the catheter is to be po-
sitioned is superimposed by current fluoroscopic images (phase C).

Generating a If there is no suitable subtraction mask (e.g. from a previous subtraction angiog-
new fill image raphy), you have to generate a new fill image.
Prerequisites: The patient to be examined has been registered.
u Make the necessary settings for the examination.
(› Page 11)
u Set the Roadmap mode in the Examination task card or by pressing the cor-
responding key on the control panel.
– The symbol for the current operating mode, Roadmap, is displayed.
– The LED of the RoadMap key lights up.
u Release radiation with the hand switch or with the assigned footswitch.
– The live image is displayed on the left monitor.
u Inject the contrast medium as soon as the syringe symbol appears on the
screen.

Keep the radiation release button pressed until the vessel is filled with contrast
medium.
u Let go of the radiation release button.
– Radiation is stopped.

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Examination

Using the fill image Prerequisites:

from subtraction
A subtraction angiography (SUB operating mode) was performed at any time dur-
angiography
ing the current examination.
The symbol for an existing subtraction mask is shown in the control area.

u Press the RoadMap key on the control panel once.

– The operating mode is switched to Roadmap.
– If the vessels are easy to recognize, you can now start positioning
the catheter.

If you press the RoadMap key twice, the existing subtraction image is discarded.
You will then have to regenerate the fill image.

Positioning the u Release radiation with the hand switch or with the assigned footswitch.
catheter – The live image is displayed on the left monitor.
u Position the guide wire or the catheter under fluoroscopic control.
– The right monitor shows the fluoroscopic image.
– The left monitor shows the subtracted Roadmap image with catheter.

You can repeat fluoroscopy as often as needed while you insert the catheter.
If you select RoadMap again, you will start a new roadmap scene.

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References task card 0

The imaging system uses two monitors for image display.

o The left monitor is used to display live images as well as preoperative and
postoperative images. It contains the Examination and Viewing task cards.
o The right monitor is used to display reference images and contains the
References, Native (for the Subtraction option), and Filming (option)
task cards.

Reference images The References task card is used to display specific images during an examina-
tion.
Reference images may be:
o preoperative images, incl. images of other modalities (e.g. CT, MR)
o images of current examinations
o images from previous examinations

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Layout of the References task card 0

(1) Menu bar

(2) Image area
(3) Control area with subtask cards

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Subtask cards 0

The function of the individual buttons is the same as in the Viewing task card.
For detailed instructions on how to use the buttons, please refer to
(› Register 6: Image Processing, Page 5).

Using the View, Image and Tools subtask cards, you can easily change the
display of reference images and perform measurements, if necessary.

The Tools subtask card is available if your ARCADIS Orbic includes the
"Measure angles and distances" option.

This button copies the currently displayed image to the Filming task card.
From there you can send it to a connected printer.

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Examination

View subtask card The View subtask card contains buttons for setting the layout.

Division of the screen (Single view,

4:1, 9:1 and 16:1)

Image stripe display (stripe)

Image stack display (stack)

Image subtask card On the Image subtask card you will find tools for image processing.

Reduce image size to half (factor 0.5)

Zoom in to double image size

(factor 2.0)

Zoom and pan

Tools subtask card The Tools subtask card contains buttons for image evaluation.

Angle

Distance

Calibration

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Displaying reference images 0

Besides the live images on the left monitor, selected images, e.g. images that
you may need for comparisons, can be displayed on the right monitor in the
References task card.
If images from previous examinations of a patient are required, these must be
loaded prior to the new examination.
During the examination, you can define suitable live images as references and
manually transfer them to the References task card. Depending on the configu-
ration settings, individual images and scenes can also be loaded automatically.
As long as you do not perform an examination, you work directly at the monitor
trolley in the Viewing and References task cards. During an examination you can
use the control panel of the C-arm system to control the individual functions of
the References task card.

Operation at the monitor trolley 0

You can load images of completed examinations from the Patient Browser into
the Viewing task card, and then into the References task card.
Images from the hospital network (e.g. archive) can also be loaded as reference
images using the Viewing task card. Thus you have the possibility of displaying
images from other modalities (e.g. MR, CT etc.) on the References task card.

Notes 0

Since permanent network functionality cannot always be guaranteed, reference

images should be loaded from the network archive before starting an examina-
tion.

Once a patient has been registered for an examination, only images of the regis-
tered patient can be transferred to the References task card.

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Examination

Transferring Images 0

Selecting images u Load the images of the requested patient into the Viewing task card by using
the Patient Browser.
u Select the reference images in the image area.

You can also select a single frame from a series as reference image
(with Subtraction option).

Loading images
u Click on the icon button of the References subtask card in the control area of
the Viewing task card.
– Or –
u Select Patient > Copy To References in the main menu of the Viewing task
card.
– The images selected in the Viewing task card are loaded into the
References task card.

You can use the View subtask card in the control area of the References task
card to change the display of loaded images.

Holding a reference image 0

The Hold Reference function allows you to select a particular image and then
record it on the right monitor.
u In the Options menu of the Examination or Viewing task card, select
Hold Reference.
– The image is recorded on the right monitor. The menu entry is marked with
a check mark.

If you save a new image, it is displayed on the right monitor and the held refer-
ence image is hidden. Scroll to the held reference image to show it again.
u To deactivate the function, deselect Hold Reference in the Options menu.

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Operation at the C-arm system 0

During an examination the current live images are displayed in the Examination
task card.
Select those live images that are suitable as reference images and transfer them
to the right monitor in the References task card.

Automatic storing and You can set the system to automatically save images and scenes during the ex-
loading amination. For this purpose, the Autostore function must be activated in the op-
erating program of the examination program (see › Register 9: Configuration,
Page 13).
In the Viewer Configuration dialog box you can specify which of these data will
then be automatically transferred to the References task card
(see › Register 6: Image Processing, Page 77).

Transferring images manually 0

As soon as you save an image, it is displayed on the right monitor in the

References task card.

Frequent activation of the Save button during fluoroscopy can delay the storage
process. In this case an image other than the one last saved may be displayed.
If this happens, manually scroll to the last image.

Saving an image
u Press this key on the control panel of the C-arm system.

Or
u Press this key on the hand switch.
– The last acquired image is stored and displayed in the References task
card.
– If you continue with the examination, the last stored image is always dis-
played on the right monitor.

If Hold Reference is activated for a particular image, this image is permanently

available on the right monitor.
(› Page 30)

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Using the References task card 0

Besides transferring images, you can select other important functions of the
References task card from the C-arm system.

Scrolling
u Scrolling to the next reference image.

u Scrolling to the previous reference image.

Changing the
image display
u Toggling between single frame and multiple frame display.

u Selection of LUT steps on monitor B.

Printing
u Printout of one or several reference image(s) on the local printer.
– If single frame display is selected, the image displayed on the right monitor
is printed.
– If multiple frame display is selected, the images selected on the reference
monitor are printed individually.

Printing does not take place immediately. Images are first transferred to the
Filming task card and can be printed out later (provided that Auto Expose
is deactivated).
(› Register 8: Documentation, Page 19)

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Native task card 0

The Native task card is available if your ARCADIS Orbic provides the
Subtraction operating mode (option).
The Native task card allows you to have subtraction images shown on the left
monitor and simultaneously displayed as native (unsubtracted) images on the
right monitor.

Layout of the Native task card 0

(1) Image area for displaying native images

(2) Control area with patient folder and status bar

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Examination

Displaying native images 0

There are basically two cases in which you use the Native card for displaying un-
subtracted images:
o During an examination simultaneously with the display of currently calculated
subtraction images in the Examination card
o Outside of examinations, simultaneously with the display of subtraction imag-
es from the local database in the Viewing card

Native images during examinations 0

If you are working in the Subtraction mode and want to have the subtracted im-
age shown on the left monitor displayed as a native image on the right monitor
at the same time, you must select the Native task card before releasing radiation.

Displaying native u Before starting the exposure, click the Native tab on the right monitor.
images – The Native task card is placed in the foreground.
u Start your exposures with the hand switch or the footswitch on the C-arm sys-
tem.
– Each new exposure is simultaneously displayed as a native image on the
right monitor and as a subtraction image on the left monitor.

Saving an image When an image is saved, it is automatically transferred to the References task
card. The Native task card stays in the foreground.
u Press this key on the control panel of the C-arm system.
– The last acquired image is stored.
u Click the References tab.
– The stored reference image is displayed.
u Click the Native tab.
– The Native task card is placed in the foreground again.
– Each additional exposure is displayed as a native image on the right
monitor.

Deactivating the If you want to deactivate the Native task card, simply select the References task
Native task card card.
u Click the References tab.
– The References task card is placed in the foreground.

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Native images from the database 0

Native images from previous examinations acquired in Subtraction mode

(option) or Roadmap mode (option) are stored in the local database or in your
archive together with the subtraction images. Both image types can be displayed
simultaneously on both monitors.

Loading and u Load the images of the requested patient into the Viewing task card by using
displaying images the Patient Browser.
u Select Sub > Sub/Native Display in the main menu of the Viewing task card.
— Or —
u Click this button in the Sub subtask card.
– In the Viewing task card the subtraction images are displayed on the left
monitor.
– In the Native task card the corresponding native images are displayed on
the right monitor.

Closing the patient After finishing your evaluation of patient images, close the folder of this patient.
Now you can load images of the next patient.
u Select Patient > Close Patient in the main menu of the Viewing task card.
– The images in the Viewing and Native task cards are unloaded. Both task
cards are empty now.

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Examination

Reports 0

Certain examination data can be stored as structured reports (SR).

ARCADIS Orbic offers the following types of reports:
o Radiation Summary Report
o LithoReport

Use The reports serve to document examination and treatment data. They are mostly
generated automatically. You can read, edit and print the reports and export sta-
tistics.

Prerequisite The reports require the examination of a registered patient.

With the LithoReport option, please note that triggering of shots at the lithotripter
is also possible only after the patient has been registered.

Security settings All processes related to reporting are recorded in the audit trail. This applies to
generating, opening and editing a report as well as to printing reports and export-
ing statistics.

Formats Reports are saved in two different formats. This allows them to be opened in dif-
ferent applications.
o Secondary Captures (SC)
Allows loading into Viewing, for example; PACS compatible
o Structured Report (SR)
Data format that is compatible with other DICOM systems; reports are auto-
matically exported in DICOM-SR format

Display in the Reports are identified in the Patient Browser as follows, irrespective of the re-
Patient Browser porting type:

Symbol Comment
Symbol in the navigation area (series level)

Symbol in the content area (instance level)

Format: Secondary Capture (SC)

Symbol in the content area (instance level)

Format: Structured Report (SR)

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Radiation Summary Report 0

The Radiation Summary Report contains the cumulated values for the number of
exposures, examination duration and dose. The generation of this report is a fully
automatic process.

(1) Icon buttons (printing a report)

(2) Generation status
EXAMINATION REPORT: Treatment in process, report is being generated.
POSTPROCESSING REPORT: Treatment is finished, the report has been
completed and stored and can be postprocessed.
(3) Work status and verification status
(4) Content area

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Examination

Opening a report 0

For the current patient u Select Reporting > Open Report in the Viewing task card.
– The report for the current patient is opened.

If several reports exist for the patient loaded in the Viewing task card, a dialog
box is displayed in which you select the required report.

For another patient u Double-click the required report in the content area of the Patient Browser.
Or
u Select the report in the Patient Browser.
u Select Reporting > Open Report or click the relevant button in the tool bar
of the Patient Browser.
– The selected report is opened.

Editing a report 0

Apart from the work and verification status, no changes are required in the
Radiation Summary Report. The other entries can therefore not be edited.

Setting the status The status for the postprocessing report is set according to the work progress.
A report with the "verified" status can be printed out for documentation purposes.
u Select the relevant work status/verification status in the selection lists in the
status area.
u Click Apply.

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Printing a report 0

You can display a print preview of the completed report or send the report to a
connected printer straight away.

Calling up the u Select Reporting > Print Preview in the menu of the Patient Browser.
print preview – The print preview of the report is displayed. Here you can scroll through the
individual pages and check the entries.

Printing u Select Reporting > Print in the menu of the Patient Browser.
— Or —
u Click this button in the report window or in the print preview.
– The Print Report dialog box is opened. Here you can make the necessary
print settings and start the print job.

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Examination

LithoReport 0

The LithoReport is generated for extracorporeal shockwave lithotripsy (ESWL)

provided that the lithotripsy function is enabled on your ARCADIS Orbic system
and the lithotripter is connected to the C-arm system.
Part of the data are automatically recorded during treatment. Any other data can
be added and postprocessed by you at any time.

(1) Icon buttons (printing a report)

(2) Generation status
EXAMINATION REPORT: Treatment in process, report is being generated.
POSTPROCESSING REPORT: Treatment is finished, the report has been
completed and stored and can be postprocessed.
(3) Work status and verification status
(4) Content area

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Opening a report 0

After starting the ESWL treatment, the Report Editor is automatically opened in
editing mode. The relevant report needs to be opened manually only for later
postprocessing.

Opening the report for u Select Reporting > Open Report in the Viewing task card.
the current patient – The report for the current patient is opened.

If several reports exist for the patient loaded in the Viewing task card, a dialog
box is displayed in which you select the required report.

Opening a report for u Double-click the required report in the content area of the Patient Browser.
another patient
Or
u Select the report in the Patient Browser.
u Select Reporting > Open Report or click the relevant button in the tool bar
of the Patient Browser.
– The selected report is opened.

Editing a report 0

The content area of the LithoReport is subdivided into 4 cards in which you can
add any missing information relating to the examination and treatment.

Entering patient and On the Patient/Diagnosis card, you enter data relating to the diagnosis and your
diagnostic data organization.
u Click the Patient/Diagnosis card into the foreground.
– The patient data are automatically transferred from the registration.
u Enter the missing data in the active fields.

u Click Apply.

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Entering treatment On the Therapy card, you enter data in preparation for treatment.
data
u Click the Therapy card into the foreground.
– The shockwave data of the treatment are entered automatically.
u Enter the missing data in the active fields.

u Click Apply.

Adding summary data The Summary card already contains the permanent examination data (in particu-
lar relating to radiation). Here you can enter additional information on the exami-
nation and treatment.
u Click the Summary card into the foreground.
– The patient data are automatically transferred from the registration.
u Enter the missing data in the active fields.

u Click Apply.

Entering follow-up On the Follow up card, you enter the measures to be taken following the exam-
data ination and treatment.
u Click the Follow up card into the foreground.
u Enter the missing data in the active fields.
u Click Apply.

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Setting the status For the postprocessing reports the work and verification statuses are set accord-
ing to the work progress. A report with the "verified" status can be printed out for
documentation purposes.
u Select the relevant work status/verification status in the selection lists in the
status area.

u Click Apply.
Or

u Click OK to accept the changes and close the LithoReport.

The OK button is enabled only if the patient has been closed.

Printing a report 0

You can display a print preview of the completed report or send the report to a
connected printer straight away.

Calling up the u Select Reporting > Print Preview in the menu of the Patient Browser.
print preview – The print preview of the report is displayed. Here you can scroll through the
individual pages and check the entries.

Printing u Select Reporting > Print in the menu of the Patient Browser.
— Or —
u Click this button in the report window or in the print preview.
– The Print Report dialog box is opened. Here you can make the necessary
print settings and start the print job.

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Export for statistical evaluations 0

In the Viewing task card you can have statistical data on a LithoReport compiled
taking into account other LithoReports, and export the data in meta format.
The exported file can be opened and edited with different programs,
e.g. Microsoft Excel.

A report can be exported only if it has reached the status “completed” and
“verified”.

Opening the export In the export dialog you define the criteria for the comparison data. The program
dialog window then searches the local database for all reports meeting these criteria.
u In the Viewing task card, open the LithoReport for which you want to compile
comparison data.
u Select Reporting > Export Statistics To in the main menu.
– The Export Statistics To dialog box is opened.

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Exporting u Define the reporting period, evaluation groups and evaluation parameters as
filter criteria.
u Enter the name of the output file in the Result field.

u Click Export Statistics.

– The data search is started and the file is exported. A progress bar informs
you of the progress of the export process.

u Click Close.
– The dialog box closes. The export process is continued in the background
until it is successfully completed.

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Configuration 0

The generation, printing and exporting of reports is configured in the Structured

Reporting dialog. Depending on the type of report (LithoReport or Radiation
Summary Report), you have different configuration possibilities.

Calling up the configuration window 0

You can call up the configuration window from the syngo Configuration panel.
u Select Options > Configuration from the main menu.

u Double-click the Structured Reporting button.

– The Structured Reporting dialog is displayed.

Configuring the To configure a LithoReport, you perform settings on the following cards:
LithoReport
o General: Here you define the contents of different selection lists.
o Stone locations: Here you define the position indications for nephroliths
(gallstones etc.).
o Options: Here you perform the presettings for printing the report.
o Hospital data: Here you enter the address details of your institution for the
report letter head.

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Configuring selection lists 0

To generate a LithoReport, you define in the General card which entries are to
be shown in the selection lists.
u Click the General card into the foreground.

u In the left list, select the parameter for which you want to configure the selec-
tion list.
– In the right list you can see the currently available selection possibilities for
this parameter.
Using the icon buttons above the list, you can adapt the list to your requirements.

Symbol Comment
Inserts another list entry.

Deletes the active list entry.

Moves the active list entry up one line.

Moves the active list entry down one line.

u If necessary, select the list entry that you want to edit and click on the icon of
the required function.

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Defining designations for stone locations 0

On the Stone locations card, typical body positions for nephroliths are displayed.
Every position is marked by a small square. You can give a name to each of these
locations.
u Click the Stone locations card into the foreground.

u Click on the square of the position to be named.

– If this position has already been named, the name will be displayed in the
entry field.
u Enter a suitable name.
u Proceed in the same way to name the other positions you require.

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Defining print settings 0

On the Options card, you can define print settings for the reports.
u Click the Options card into the foreground.
– The card has three subcards that you can access using the tab at the left-
hand edge.

Defining default u Click the General subcard into the foreground.

print settings

u Select the required printer from the Default printer selection list.
u Select the required paper size from the Default papersize selection list.

The default print settings on the General subcard are valid for the LithoReport
and the Radiation Summary Report.

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Displaying the On the Litho subcard, you can define when a report is to be shown automatically.
LithoReport
u Click the Litho subcard into the foreground.
automatically

u Check the check box after creation if you want the report to be displayed au-
tomatically after it has been generated.
u Check the check box after end examination if you want the report to be dis-
played automatically at the end of the examination.

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Configuring the Radiation Summary Report 0

The Options card is available for the configuration of a Radiation Summary

Report. No settings are made on the other two cards.
u Click the Options card into the foreground.
– The General subcard is opened.

The default print settings on the General subcard are valid for the LithoReport
and the Radiation Summary Report.
(› Page 49)

Printing the Radiation u Click the Radiation subcard into the foreground.
Summary Report
automatically

u Check the check box Print after end examination if you want to print the
Radiation Summary Report automatically at the end of the examination.

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Entering address details 0

In the Hospital data card you enter the address details of your institution.
These data are shown in the report header.
u Click the Hospital data card into the foreground.

u Enter the address data that you want to appear in the reports.

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Applying configuration settings 0

After you have made all the required settings, you apply them to your system.
u Click OK to apply the settings and to close the configuration window.

Or

u Click Apply to apply the settings without closing the configuration window.

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Table of Contents

Introduction ......................................................................................................................... 3
The Viewing task card....................................................................................................................... 4
Image area ........................................................................................................................................ 5
Control area ...................................................................................................................................... 5
Display modes ........................................................................................................................ 5
Patient information ................................................................................................................. 6
Subtask cards ......................................................................................................................... 7

Loading and displaying images.......................................................................................... 13

Calling up the Viewing task card ..................................................................................................... 13
Transferring images from the Patient Browser............................................................................... 14
Displaying images and series ......................................................................................................... 15
Selecting image stripe display .............................................................................................. 15
Selecting image stack display............................................................................................... 15
Subdividing the image area .................................................................................................. 16
Showing and hiding image text ............................................................................................ 17
Displaying and hiding graphic elements ............................................................................... 18

Scrolling and selecting images .......................................................................................... 19

Scrolling .......................................................................................................................................... 19
Scrolling image by image...................................................................................................... 20
Scrolling page by page.......................................................................................................... 21
Scrolling from series to series .............................................................................................. 24
Scrolling from study to study................................................................................................ 24
Sequence for displaying images ........................................................................................... 24
Selecting images ............................................................................................................................ 25
Working in the input focus ................................................................................................... 25
Selecting images explicitly.................................................................................................... 27
Selecting direct image processing........................................................................................ 29
Viewing images in movie mode...................................................................................................... 30
Editing images ................................................................................................................... 33
Windowing images ......................................................................................................................... 34
Assigning fixed window settings (LUTs) .............................................................................. 34
Windowing using the mouse................................................................................................ 35
Windowing with the keyboard.............................................................................................. 36
Restoring window values ..................................................................................................... 36
Edge enhancement .............................................................................................................. 37
Zooming and panning images ......................................................................................................... 38
Zooming images ................................................................................................................... 38
Panning images .................................................................................................................... 41
Enlarging an image section................................................................................................... 42

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Inverting images ............................................................................................................................. 43

Rotating images .............................................................................................................................. 44
Flipping images............................................................................................................................... 45

2D Evaluation (option)........................................................................................................ 47
Calibration ....................................................................................................................................... 47
Measuring distances and angles .................................................................................................... 49
Drawing a distance line, measuring the distance ................................................................. 49
Measuring an angle .............................................................................................................. 50
Hiding/deleting graphic elements ......................................................................................... 52
Setting a shutter ............................................................................................................................. 53
Text in images ................................................................................................................................ 55
Annotating images................................................................................................................ 55

Subtraction processing ...................................................................................................... 57

Loading and displaying images ....................................................................................................... 57
Selecting another mask .................................................................................................................. 58
Adding the anatomical background................................................................................................. 58
Achieving exact covering of image and mask................................................................................. 59

Saving, transferring, documenting, closing images ........................................................... 61

Save images ................................................................................................................................... 61
Restoring image display ....................................................................................................... 63
Archiving, sending or filming images .............................................................................................. 64
Archiving images .................................................................................................................. 64
Sending images (DICOM option) .......................................................................................... 65
Filming Images ..................................................................................................................... 66
Transferring images to the References task card ........................................................................... 67
Closing the patient .......................................................................................................................... 68
Viewing configuration ........................................................................................................ 69
Calling up the configuration window............................................................................................... 69
Concluding configuration ................................................................................................................ 70
Division of the image area .............................................................................................................. 71
Creating annotation texts................................................................................................................ 73
Exporting Sub/Roadmap image data............................................................................................... 75
Layout in the References task card ................................................................................................ 76
Loading reference images during an examination .......................................................................... 77
Configuring image text display ....................................................................................................... 78

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Register 6 Image Processing

Introduction 0

On the Viewing task card, you can view the results of an examination and eval-
uate them. You can also compare image material of different examinations and,
depending on the configuration, of different patients.

Loading and You can load the images from the Patient Browser into the Viewing task card.
displaying images Here you can select one of various ways of arranging the image material and dis-
playing it in the clearest way for your diagnostic problem.

Processing and On the Viewing task card, you can then process and evaluate the images:
evaluating images
o You can change window values, zoom, pan, rotate, and flip images.
o You can add comments to relevant image parts.
o You can measure and evaluate distances and angles in images.
Images that are loaded into the Viewing task card can also be loaded into the
References task card. This also applies for patient images from previous exami-
nations or images that were acquired with other modalities (e.g. MR/CT).

Storing, filming and You can save the images you have processed and evaluated, you can print them
transferring images or expose them on film or send them to other locations in your hospital.

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The Viewing task card 0

As soon as you have loaded images into the Viewing task card, the task card
moves into the foreground. You can, however, switch to other applications at any
time and resume image processing on the Viewing task card later.
The Viewing task card is divided into four areas.

(1) Menu bar with specific entries for viewing and processing images
(2) Status bar for system messages
(3) Control area
(4) Image area

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Image area 0

In the image area, the images that you have loaded into the Viewing task card
are displayed.

Display of the The image area is subdivided into segments. One image is displayed in each seg-
image area ment. Depending on the division of the screen and the number of images loaded,
you can only see some of the images. The remaining images are in the back-
ground. The last loaded image is displayed in the top left segment.
You can choose between the following layouts:
o Small-format layout
An overview of many images at the same time is displayed.
o Large-format layout
Only a few images are displayed on one page in a format large enough to
show all details.

Image, text and In the Viewing task card, medical images can be supplemented with graphic el-
graphic objects ements or texts.

Control area 0

In the control area, you will find the tools you need to select image material,
arrange the screen display and process images.
Here you can also control data exchange with other parts of the program and
access other applications.
The display of the control area and the availability of functions depends on the
selected display mode.

Display modes 0

The Basic display mode is designed for standard post-processing steps.

The control area is limited to the essential functions.
The Extended display mode contains additional functions for detailed evaluations
and post-processing.
You can switch between the two display modes at any time with the
Basic ⁄ Extended button.

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(1) (2)

(1) Control area in the Basic display mode

(2) Control area in the Extended display mode

Patient information 0

In the upper part of the control area, you can see the names of the patients
whose images are currently loaded in the Viewing task card. In the Viewing task
card, you can manage up to three patients.

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Subtask cards 0

The subtask cards contain buttons for accessing editing tools, defining display
modes, transferring image data and switching to other applications.

View subtask card The View subtask card shows keys for setting up the layout (the Basic display
mode only has the first row of keys).

Division of the screen (full screen 1:1, 4:1, 9:1 and 16:1)

Image stripe display (stripe)

Image stack display (stack)

Showing/hiding image text

Showing/hiding graphic elements and comments

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Tools subtask card The Tools subtask card includes keys for image evaluation and commenting (the
Basic display mode only has the first row of keys).

Use a shutter

Magnifier

Insert an annotation into the image

Angle (option)

Distance (option)

Distance calibration (option)

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Image subtask card The Image subtask card shows tool keys for image editing (the Basic display
mode only has the first row of keys).

Switch brightness/contrast characteristic (LUT) to previous (–) and next (+)

Reduce (–) and increase (+) edge enhancement

Inverting gray-scale values

Reduce an image by factor 0.5

Enlarge an image by factor 2.0

Zoom or pan the image

Rotating an image

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Sub subtask card The Sub subtask card is only available with the Subtraction option.
(optional)

Pixelshift

Auto Pixelshift

Change the mask – and +

Dual Channel Mode (Sub/Native Display)

o Subtracted image on monitor A (left)
o Native image on monitor B (right)

Display the anatomical background

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Movie subtask card The Movie subtask card contains control functions to play a scene as a movie.

u Start (review speed matches the storage rate).

u Review at half/double speed.

u Pause/stop.

u Previous/next frame.

u Show previous/next scene.

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Other control The keys in the lower segment of the control area have the following functions:
functions
Copy an image into the References task card

Reset all

Copy to film sheet

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Loading and displaying images 0

In the Viewing task card, you can view and process images that are stored in the
main database of your system, and archive them on different media or in a net-
work.
You can access these data via the Patient Browser. You can search for patients,
studies, series or individual images and load them into the Viewing task card.

Calling up the Viewing task card 0

As soon as you have loaded images into the Viewing task card, the task card
moves into the foreground. You can, however, switch to other applications at any
time and resume image processing on the Viewing task card later.
u Click the Viewing tab on the left-hand edge of the screen.
– The Viewing task card is placed in the foreground.

u Select the desired display mode with the Basic / Extended button.

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Transferring images from the Patient Browser 0

You can search for image data that you have stored in the local database or in the
archive using the Patient Browser and then load the data into the Viewing task
card.
u Select Patient > Patient Browser....
u Search for the required patient(s), study(s), series or one or more images in
the navigation or content area.
u Double-click the entry or entries that you were looking for.
Or
u Click the Load To Viewer button.
Or
u Select Patient > Load To Viewer.
Or
u Drag your selection onto the Viewing task card with the mouse (drag & drop).
– The image data are loaded into the Viewing task card.
– The Loading Progress window is displayed.

If you transfer further images of a patient who is already loaded in the Viewing
task card, the new images are attached to the existing ones.
Images of series or studies that are already in the task card are not loaded a sec-
ond time.
When you load scenes, each scene is displayed as a separate series. If you load
a series consisting of several scenes and normal images, each scene and all nor-
mal images are loaded as a separate series.

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Displaying images and series 0

After you have loaded images into the Viewing task card, you can choose
between different views.

Selecting image stripe display 0

Medical images are always displayed in the image area of the Viewing task card
grouped by studies or series.
Select image stripe display to view the loaded series of a study one after the
other image by image.
u Select View > Image Stripe.
Or
u Click the Image Stripe button in the View subtask card.
– Image stripe display is activated. You see the images of the first loaded
series displayed in the image area from top left to bottom right.

Selecting image stack display 0

If you want to compare the images of various series of one study, you best select
stack display.
u Select View > Series Stack.
Or
u Click the Series Stack button on the View subtask card.
– All images of a series are now arranged in a stack one on top of the other.
You can see the first image of each series.

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Subdividing the image area 0

With the division of the image area, you define the number and size of the seg-
ments in the image area.
Switch to a large format display with just a few images on the screen if you want
to see diagnostic details. Select a small format display to obtain an overview.
u Select a layout in the View menu.
Or
u Select a layout with the buttons on the View subtask card.

– When you select a new layout, the division of the image area is changed,
but the sequence of the images displayed remains the same.

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Showing and hiding image text 0

Patient and study-specific information and image settings can also be displayed
on the image, thus making it easier to identify each image. The image text can
also be filmed/printed.

You can define in the configuration which image text information is to be shown
by default (› Page 78).

Text blocks The information displayed is arranged in blocks around the edge of the image ac-
cording to its content.

(1) Patient and study data

(2) Hospital/system information
(3) Image-specific settings (incl. kV and mA)
(4) Image comment
(5) Window values and edge enhancement
Especially with a small format layout, the images displayed can become cluttered
by image text. You can then decide whether you want to have the image text
shown in the image or not.
u Select View > Hide Text.
Or
u Click the Hide Text button on the View subtask card.

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Displaying and hiding graphic elements 0

Like text information, you can have graphics (e.g. distance lines) and annotations
displayed or hidden.
u Click the Hide Graphics button in the View subtask card.
Or
u Select View > Hide Graphics in the menu bar.
– The graphics and annotations are hidden.

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Scrolling and selecting images 0

You will usually have loaded more images and series of a patient into the
Viewing task card than can be displayed in the image area at once. All those im-
ages that cannot be displayed due to lack of space are placed in the background.

Scrolling 0

The Viewing task card provides you with several alternative ways of scrolling
through loaded images of different patients, studies, or series:
o Scroll menu
o Scroll bar on the left-hand side of the image area (depending on the configu-
ration)
o Buttons on the View subtask card in the control area (depending on the con-
figuration)
o Dog ears in the upper right corner of the images
(in the stack display)
o Keyboard and symbol keypad
Depending on the processing stage and working method you are accustomed to,
you can select your individual way of working.

In the stack display, you can simultaneously browse through several image
stacks in the monitor split settings 4:1, 9:1 and 16:1. When doing this, it may be
possible that you reach the end of one or several stacks while in other stacks
there are more images left (e.g. if the stacks do not consist of the same number
of images). In these cases, black segments are shown in the stacks that are fin-
ished as you continue scrolling. The dog ear indicates that the images are in front
of or behind the black segments in the stack.
If you select several stacks and scroll to the previous or next series, the image
stacks are moved accordingly by segments. The image text displayed will help
you identify the relevant image stacks. This applies in particular if stacks with
black segments have been moved; in this case scroll back to the images first.

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Scrolling image by image 0

Within a study, you can scroll through the loaded images and series image
by image.

Scrolling with image u Select Scroll > Next Image or Scroll > Previous Image.
stripe display
Or
u Scroll with the Image- or Image+ keys of the symbol keypad.
– You scroll backward or forward by one image.

Explicitly selected images remain selected even if the images are moved into the
background.

Scrolling image by u Click on the stack through which you want to scroll with the mouse.
image in a stack
u Scroll from image to image in a stack with Image+ or Image- just like in image
stripe display.
Or
u Click on the outer triangle (1) or on the inner triangle (2).
– You scroll forward or backward by one image.

If you want to scroll through a stack of images very quickly, click on a dog ear and
hold the mouse button down.

Scrolling through u Press the Ctrl key and click on the stacks that you want to scroll through.
several stacks image If you click on a stack again, you deselect it.
by image
u Using the Scroll menu, the buttons or the symbol keypad, scroll
forward (Image+) or backward (Image-) through the selected stacks by one
image at a time.

If you have not selected a stack, you only scroll through the stack which has the
input focus.

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Scrolling page by page 0

A screen page can contain different numbers of segments depending on the lay-
out selected and it may contain only images of one series or images of more than
one series depending on the display mode.
You can use the menu, keyboard, or scroll bar to page through the series of a
study.

Scrolling with the u Select Scroll > Page Up.

menu – You scroll forward by one page.
u Select Scroll > Page Down.
– You scroll back by one page.
u Select Scroll > Last Page.
– You jump to the last page of the current patient folder.
u Select Scroll > First Page to jump back to the first page of the current patient
folder.
– You jump to the first page of the current patient folder.

The first image of the series is displayed in the top left segment of the
image area.

Scrolling page by page u Press the Page Up key.

with the keyboard – You scroll forward by one page.
u Press the Page Down key.
– You scroll backward by one page.
u Press the End key.
– The last screen page of the study is displayed.
u Press the Home key.
– You jump to the first page of the study.

The image area is filled with images. The first image of the series is displayed in
the top left-hand corner of the image area.

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Scrolling with the The third way of scrolling through the images and series of a study is to use the
scroll bar scroll bar.

(1) Scroll arrow for first page

(2) Scroll symbol for previous page
(3) Scroll arrow for previous page
(4) Slider
(5) Scroll arrow for next page
(6) Scroll symbol for next page
(7) Scroll arrow for last page

The position of the slider only refers to the specific series through which you are
currently scrolling and not to all images currently loaded in the Viewing task card.

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u Click the scroll arrow for the next or previous page.

– You jump backward or forward by one page/line within the series.

u Click the scroll arrow for the first or last page.

– You jump to the corresponding screen page of the loaded series.

u Click the scroll symbol for the next or previous page.

– You jump from the beginning/end of the series to the end of the previous
series/beginning of the next series (scrolling across series).
– If you are in the middle of a series, you first jump to the beginning/end of
the current series.

u Drag the slider up or down with the mouse until the page you require is dis-
played. (The page number is also displayed.)

If you click the scroll bar above or below the slider, you scroll backward or forward
by one page.

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Scrolling from series to series 0

In addition to scrolling image by image and page by page, you can also scroll by
entire series if you have loaded more than one series of a study into the Viewing
task card.

It depends on the selected display which images are subsequently displayed in

the image area. In image stripe display, for instance, the first image of the series
to which you have scrolled is displayed in the first image segment. In stack dis-
play, you move the series stacks to the left or right by one position, and up or
down line by line.
u Select Scroll > Next Series or Scroll > Previous Series in the main menu.
Or
u Press the Series- or Series+ key on the symbol keypad.

Or
u Scroll with the image scroll symbols in the scroll bar.

Scrolling from study to study 0

The image area of the Viewing task card contains all the images of the loaded
studies and series, provided they all fit on one screen page.
As soon as you have loaded the images, the images of the first study are dis-
played starting at the top left.
u Select Scroll > Next Series or Scroll > Previous Series in the main menu.
– You scroll forward or backward by one study.
Or
u Scroll to the next or previous study using the Study- or Study+ key.

Sequence for displaying images 0

Sometimes the sequence of displaying images changes. However, a highly im-

probable combination of settings must have been selected:
o Images of a patient that were created using the Save button are loaded into
the Viewing task card. Afterward, these are saved as "New series".
After saving these images as a new series, the sequence of the images and also
the continuous numbering in the image text could have changed.

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Selecting images 0

On the Viewing task card, you cannot only view images, but also process and
evaluate them.

Selection possibilities There are two different ways of selecting images for processing:
o explicitly holding the Ctrl key down (explicitly selected images are shown with
a continuous border)
o implicitly by working in the input focus

Working in the input focus 0

The input focus shows the active segment of the image area. It is marked by a
dashed border, i.e. it is selected implicitly.

Default input focus When you load images into the Viewing task card, the input focus is in the de-
fault position in the top left segment of the image area.

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Placing the input focus u Using the left mouse button, click into the segment of the image area on
with the mouse which you want to place the input focus.

An explicitly selected image or an explicitly selected graphic is deselected if you

place the input focus on a segment, even if you only click on the same segment.

Changing the input u Press the arrow key left or right.

focus using the – The input focus is moved to the next column of the image area.
keyboard
Or
u Press the arrow key up or down.
– The input focus is moved to the next row of the image area.

If an image or a graphic is selected explicitly, the arrow keys are not active.

Processing an image As long as you have not selected any images explicitly, your processing steps are
applied to the image in the segment that has the input focus, i.e. the image with
the dashed border.
u Place the input focus on the image that you want to process.

If you cannot see an input focus in the image area, one or more images are
explicitly selected in the background.

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Selecting images explicitly 0

Selecting images explicitly means that you select images or series specifically
and one after the other. Unlike the input focus, the explicit selection is associated
with the content of the segment. Explicitly selected images remain selected even
if you move them into the background.
All explicitly selected images have a continuous border.

Selecting images u Press the Ctrl key and click an image with the left mouse button.
individually – The image is selected explicitly.
u Hold the Ctrl key down and click on further images if you want to extend your
selection.
– Several images are selected explicitly one after the other.

Selecting images u Click on the image that you want to select explicitly holding the Ctrl key down,
explicitly up to the end or set the input focus by clicking on the image.
of series
u Select Edit > Select On Succeeding in the main menu.
– The selected image and all the following images are now selected.

If you have explicitly selected images of different series, the remaining images of
these series are selected starting with those images.

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Selecting a complete u First, select an image of the required series explicitly by clicking on it holding
series explicitly the Ctrl key down, or place the input focus on the image by clicking on it.
u Select Edit > Select Series in the main menu.
– The whole series is now selected explicitly.

Selecting more than u Hold the Ctrl key down and click on individual images of the required series.
one series explicitly
u Select Edit > Select Series in the main menu.
– Several series are selected completely.

Deselecting images If the explicit selection of images does not contain the set of images you require,
you can deselect individual images or all images.
u Place the input focus on an unselected segment manually with the mouse by
clicking on it.
Or
u Select Edit > Deselect All in the main menu.
– All selected images are deselected again.

After that, the standard input focus is set automatically, i.e. the top left segment
is active.

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Selecting direct image processing 0

Direct image processing (implicit selection) with the mouse is automatically ap-
plied to the image segment on which the mouse cursor is located.

Setting the input focus u Place the mouse cursor on an image which is not selected and edit the image,
for example, by windowing.
– The input focus is placed on this segment.

If graphics were previously explicitly selected in the input focus, they remain
explicitly selected.

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Viewing images in movie mode 0

After an examination, you can start movie mode to check the quality of the
scenes you just acquired.

Movie mode is possible only for scenes generated with the ARCADIS Orbic.
You cannot view imported series in film mode. This also applies to imported
scenes in the "JPG lossless" format.

Movie mode is active only in the one image per page layout.
For movie mode a large image segment is used. The images included in a movie
are always from a single series. You can control the movie mode with the Movie
subtask card or the options of the Scroll menu.

Image text and graphic objects are not displayed during movie replay.

Scrolling a In the movie segment, you can scroll through all images of the series.
single image
u Click the Step backward button.
– You scroll backward by one image.

u Click the Step forward button.

– You scroll forward by one image.

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Limiting the The bar display labels the images of the scene with bars. The left and right bor-
playback range ders show the first and last image of the playback range.

u Drag the border bar to the first and last image of the desired playback range.

Starting movie mode In movie mode the images of a series are displayed in a loop. After the last image
of the series, the first image is displayed again etc.

Movie mode cannot be started in the following situation (the button Realtime
Movie does not react): three patients are loaded in Viewing, a fourth patient is
being registered and a scene (multiframe object) is being recorded.
You have the following possibilities to optimize movie display and set the speed
according to your requirements:
o Slowly
o Real time
o Fast

u Select Scroll > Realtime Movie or click the button.

– The movie is started with the original frame rate.

Or
u Select Scroll > Half Speed Movie or click the button.
– The movie is started with half the frame rate.

Or
u Select Scroll > Double Speed Movie or click the button.
– The movie is started with double the frame rate.

The playback speed may be reduced by postprocessing activities, edge enhance-

ment or subtraction.

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Stopping the movie

u Select Scroll > Pause Movie or click the button.
– The running movie is stopped.
– If you continue playback of the movie, it will start from the segment where
you paused.

Stopping movie mode

u Click the Stop button.
– The running movie is stopped.
– If you continue playback of the movie, it will start from the beginning again.

There is no indication where the film was stopped.

Storing the scene Scenes of a currently running examination that have not yet been saved can be
stored using the Last Scene Hold function.
Prerequisite: Scene review has been stopped.
u Select Patient > Save LSH Scene in the main menu.
— Or —
u Press function key F9 on the keyboard.
– The last 120 images are stored in the local database.

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Image Processing

Editing images 0

As soon as you have loaded all the series and/or images that you want to view
and process into the Viewing task card, you can change the display parameters
of individual images. In this way, you can emphasize areas and image contents
for subsequent evaluation or reporting.
You can adapt the window values of the loaded images. You can enlarge seg-
ments and display regions of interest in the center of the screen. You can also
rotate, flip or invert images for certain diagnostic problems.

Extreme window values can impair image quality.

With scenes, the image processing functions are applied to all images of a series.

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Windowing images 0

Imaging methods provide information in the form of gray scale images with up to
several thousand different gray scale values. Windowing means to emphasize
the range of gray scales of the relevant area and tissue type.
The first step in windowing therefore consists in determining the window center,
i.e. the gray value of the tissue type that is central to your diagnostic problem.
The smaller the window center, the brighter the image.
With the window width, you define how many gray scale values above and below
the center value you want to see. The smaller the window width, the higher the
contrast.

Windowing of color images is not possible.

Displaying window You can see the window values set in the bottom right-hand corner of the
values images.

(1) W: Window width – Contrast

(2) C: Window center – Brightness

Assigning fixed window settings (LUTs) 0

Some imaging methods allow you to display images with alternative window set-
tings using LUTs (lookup tables).
The currently selected LUT is displayed at the bottom right of the image (with dis-
play of window values).
u Select the images that are to be assigned a different LUT.
u Click the LUT Previous - or LUT Next + button on the Image subtask card.

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Windowing using the mouse 0

You can assign new window values to images using the mouse.

Pay attention to the scope.

u Click on an image segment with the center mouse button and move the
mouse holding the button down.
– The mouse cursor disappears.
u Drag the mouse up or down.
– The window center (brightness) is changed.
Or
u Move the mouse right/left.
– The window width (contrast) is changed.

Brightness -
(center +)

Contrast + Contrast –
(width –) (width +)

Brightness +
(center -)

– As soon as you release the mouse button, the new window values are also
applied to all the other selected images or the selected scope of action.

The changed window values are displayed immediately in the image (interactive
windowing).

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Windowing with the keyboard 0

For fine adjustment of the window values, you can also use the keys on the
symbol keypad of the keyboard.

Pay attention to the current scope.

Setting the contrast

u Press the Width- or Width+ button.
– The contrast is reduced or increased in small steps.
Or
u Keep the Width- or Width+ button pressed.
– The contrast is reduced or increased in larger steps.

Setting the brightness

u Press the Center- or Center+ button.
– The brightness is reduced or increased in small steps.
Or
u Keep the Center- or Center+ button pressed.
– The brightness is reduced or increased in larger steps.

Restoring window values 0

u Select Image > Reset Window.

– The selected image(s) is/are displayed with their original window values.

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Edge enhancement 0

Blurred images, or images with a high noise level, can be postprocessed with a
filter. Edge enhancement is an adaptive filter that emphasizes existing structures
(edges) in the image.

The enhancement factor can be set within a range of 0% to 100% in 10% incre-
ments.
u Select one or more images or series.
u Click the Edge Filter Next button on the Image subtask card.

— Or —
u Select Image > Edge Filter Next.
– The image is displayed with enhanced structures.

The higher the filter setting, the more structures are enhanced and the less they
are smoothed.
u Click the Edge Filter Previous button on the Image subtask card.

Or
u Select Image > Edge Filter Previous.
– The image is displayed with less enhanced structures.

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Zooming and panning images 0

You can zoom in on sections of images that you are particularly interested in
(zooming). If the enlarged image then no longer fits in the segment, you can pan
it until the relevant area is in the center of the segment again.

Zooming images 0

The Viewing task card provides you with several possibilities of enlarging or
reducing images.

Displaying images in
double size/half size

u Select the images that you want to edit.

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u Click the Zoom Out By 0.5 button.

– The zoom factor of an image is halved.

Or
u Click the Zoom In By 2.0 button.
– The zoom factor of an image is doubled.

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Zooming with the The left mouse key is used to select or deselect images and objects. However,
mouse you can also switch over the function of the left mouse button to perform zoom-
ing and panning.
u Select Image > Zoom/Pan.
Or
u Click the Zoom/Pan button on the Image subtask card.

u Now position the mouse pointer in the outer area of an image.

– The mouse cursor changes shape.
u Drag the mouse cursor up with the left mouse button pressed.
– The image is enlarged.
Or
u Drag the mouse cursor down with the left mouse button pressed.
– The image is reduced.
– As soon as you release the mouse button, the new zoom factor is applied
to all the selected images or the selected scope of action.

When zooming, make sure you do not accidentally click on a graphic element.
Otherwise, you would pan the graphic element and not the content of the image.
u Deselect Image > Zoom/Pan again.
— Or —
u Click the relevant button again.
– The left mouse button is available for selecting images again.

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Panning images 0

After you have zoomed images, parts of the images might extend beyond the
edge of the image segments. Therefore, before saving an image, always pan the
image so that the region of diagnostic interest is in the center of the segment
again.
u Select Image > Zoom/Pan.
— Or —
u Click the Zoom/Pan button on the Image subtask card.
– The function of the left mouse button is now switched from
Select to Zoom/Pan.
u Now place the mouse cursor in the center part of the image.
u To pan the content of the image, press and hold the left mouse button while
dragging the mouse upward, downward, to the left or to the right.
– You can immediately see the result of your mouse movements in the
image on which the mouse cursor is located.

When panning, make sure you do not accidentally click on a graphic element.
Otherwise, you would pan the graphic element and not the content of the image.

Restoring image u Select Image > Reset Zoom & Pan.

display – The original size with which the images were last stored in the database is
restored.

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Enlarging an image section 0

Instead of zooming an image and then panning it so that the relevant section is in
the center of the screen again, you can also quickly select specific image sections
and display them in a segment in maximum size.
u Select the image in which you want to display an enlarged image section.
u Select Tools > Magic Glass.
— Or —
u Click the Magic Glass (Zoom) button on the Tools subtask card.
u Click on the selected image with the left mouse button.
– A rectangular image is displayed with zoom factor 2.0. In this window the
enlarged area of the image around the position of the mouse key is dis-
played.

u Move the mouse key in the segment.

– The content of the magnify window is automatically updated.

Switching off the u Select Tools > Magic Glass again.

zoom function
— Or —
u Click the Magic Glass (Zoom) button on the Tools subtask card.
– The magnify windows are deleted from all segments. The original size with
which the images were last stored in the database is restored.

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Inverting images 0

When an image is inverted, bright areas in grayscale images are displayed dark
and dark areas are displayed bright. The gray scale assignment in the
LUT (look-up table) is inverted.
u Select the images that you want to edit.
u Select Image > Invert Gray Scale.
— Or —
u Click the Invert Gray Scale button on the Image subtask card.

To reset the original view, select Image > Invert Gray Scale again.

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Rotating images 0

u Click on the image that you want to edit.

u Select Image > Rotate.
— Or —
u Click the Rotate button on the Image subtask card.
– The shape of the mouse cursor indicates that you can rotate the image
freely to the left or to the right.

u Place the mouse cursor at the edge of the image and rotate the image to the
required position by using the mouse.
– As long as you keep the left mouse key pressed, the rotation angles are
displayed in the lower control area. The first angle indicates by how many
degrees the image had already been rotated with reference to the original
image. The second angle indicates the current rotation.

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Flipping images 0

The Flip function allows you to easily compare images of series that were ac-
quired in a different patient position or direction of examination.

Flipping images u Select the images that you want to edit.

vertically
u Select Image > Flip Vertically.

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Flipping images u Select the images that you want to edit.

horizontally
u Select Image > Flip Horizontally.

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2D Evaluation (option) 0

The Viewing task card provides you with tools for measuring distances, lengths
and angles.
Using a shutter, you can limit the region of interest to the necessary detail,
excluding all irrelevant areas.
You can annotate images with comments to document your evaluations.

Calibration 0

If you perform evaluations with distance measurements, you must calibrate the
image.

When calibrating, measuring and interpreting values, please note that the ac-
quired images are only a 2-dimensional display of 3-dimensional objects.

Performing a A calibration object with known measurements (e.g. length, diameter, ...) is nec-
calibration essary to define the longitudinal scale.

The calibration object must be perpendicular to the central beam and within the
area of the structure you intend to measure (typically in the center of the measur-
ing field to avoid I.I. distortions).
u Select the required image.
u Select Tools > Calibration.
— Or —
u Click the Calibration button of the Tools subtask card.

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Drawing a u Move the mouse cursor into the image.

distance line – The mouse point changes shape.
u Click on the image to set the starting point and drag a line to the vertex by
using the mouse.
– As soon as you move the mouse, the line is displayed.
u Release the mouse button to finish the line.
– The distance line is displayed.
– The Calibration dialog box is displayed.

u Enter the distance (in cm).

u Confirm by clicking OK.
– Distance calibration is performed and the calibration factor is displayed in
the image.
– Distances already drawn in the image are updated.

Cancelling calibration u Click Cancel.

– The previous calibration factor is maintained.

Deleting the u Select Edit > Remove Calibration.

distance line – The existing distance line is deleted.
– Instead of the current length, "??" is displayed in all measurement graphics.

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Measuring distances and angles 0

You can measure and evaluate distances and angles in images, if the
2D Measurement option is available.

Drawing a distance line, measuring the distance 0

Using a distance line, you can measure the distance between two points in an
image.

When measuring distances near the edge of the image, take into account that the
I.I. distortion will result in measurement errors. These depend on the I.I. format.
With full format the error of measurement is comparatively large whereas it is
considerably smaller with an increasing zoom factor.

Drawing a u Select Tools > Distance.

distance line
— Or —
u Click the Distance button of the Tools subtask card.
– The mouse point changes shape.
u Place the mouse cursor on the starting point of the distance line.
u Hold the left mouse button down and drag out a line.
u Release the mouse button to finish the line.

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Measuring an angle 0

You can define an angle by two lines, the legs of the angle, that you draw on the
image. The system then calculates the angle between the two lines drawn in
clockwise. If the angle is larger than 180°, the program subtracts 180°.

Drawing an angle u Select Tools > Angle.

— Or —
u Click the Angle button on the Tools subtask card.
u Place the mouse cursor on a starting point for the first leg.
– The mouse cursor changes shape.
u Holding the left mouse button pressed, drag a line to the end point of the
first leg.
u Draw the second leg in the same way.
– The two legs of an angle are assigned the same number so you can distin-
guish several angles unambiguously.

As soon as you start drawing the second leg, the angle is calculated and dis-
played.
The two lines between which you want to measure an angle do not have to inter-
sect in the image. The program automatically calculates the point of intersection,
even if you have not drawn it or if it is beyond the edge of the image.

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Changing the angle You can change the legs of an angle independently of one another.
u Move the mouse cursor into the image.
– The shape of the mouse cursor changes at the positions where you can
change a leg of the angle.
u Move the entire line or drag an end point to another location.

Switching the You can also have the complementary angle displayed (difference of 180° - angle
angle direction measured).
u Select the angle.
u Select Other Angle from the context menu (right mouse button).
– The angle is now measured counterclockwise and the new value is dis-
played.

(1) Angle between the legs

(2) Complementary angle

If the angle approximates to 90°, 180°, 270°, it is not clear whether the angle
between the legs or the supplementary angle has been drawn.
Therefore, annotate the angle when you display the supplementary angle.

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Hiding/deleting graphic elements 0

You temporarily hide the graphic elements (distance lines, angles and text) or per-
manently remove them from the image.

Hiding u Select View > Hide Graphics from the menu.

– All drawn graphic elements are hidden.
– The image text with the scale remains visible.
u To unhide the graphic elements, click View > Hide Graphics again.

Delete Graphic elements can be deleted jointly or individually from the image in the
following ways:
u Select one or several (Ctrl key) graphic elements.
Or
u Open Edit > Select All Graphics to delete all graphics.

u Press the Del key on your keyboard.

— Or —
u Select Edit > Delete Graphics.
— Or —
u Select Delete from the context menu (right mouse key).
The selected graphic elements are deleted.

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Setting a shutter 0

You can hide irrelevant areas of the image. To do that, you place a shutter over
the image.
After that, only the area within the shutter is displayed and all the surrounding ar-
eas appear black.

Only one shutter can be set in an image or scene. When setting different shutters
in different frames of a scene, the shutter in the first frame is taken into account.

Setting a shutter u Select Tools > Shutter.

— Or —
u Click the Shutter button on the Tools subtask card.

u Place the mouse cursor in the area of the image that you want displayed.
– The mouse cursor changes shape.
u Hold the left mouse button pressed and drag a rectangle open for the shutter.

By clicking on the border of the image you can select a shutter which you can
then move or resize.
u Release the mouse button.
– The area outside the shutter is displayed black.

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You can transfer images in the current shutter setting to the Filming task card
for printing (menu Patient> Copy to Film Sheet). If the image contains additional
graphic elements, they may not be hidden (menu View > Hide Graphics).
Otherwise, the shutter cannot be transferred to the film sheet, and printing is im-
possible.

Removing the shutter u Click on the border of the shutter.

– The shutter is selected.
u Press the Del key on your keyboard.
– The image is displayed in its original size again.

Images of a scene always have the same shutter. If they are moved or resized,
that change is applied to all images.

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Text in images 0

You can annotate interesting or anomalous areas in an image.

Some modalities also allow you to store comments with an acquisition series.
These comment texts are also displayed in the images and can be altered.

Notes and comments are automatically saved with the image when the examina-
tion is ended or the patient file is closed.

Annotating images 0

You can anchor image text with a special image detail.

u Select Tools > Annotation Arrow.

— Or —
u Click the Annotation Arrow button on the Tools subtask card.
– The mouse cursor changes shape.
u Click into the image where you want to place the annotation and draw
an arrow, keeping the left mouse button pressed.
– The text cursor is at the end of the arrow.

Annotation text

u Enter the desired text.

– The following special characters cannot be used in annotation texts
because they interfere with saving:
#@'"\{(
u Confirm your text entry with the Enter key.
— Or —
u Click into the image outside the text.
– The text is displayed white with shading.

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Using predefined text Frequently used texts can simply be selected from a list once they have been
configured.
(› Page 73)
u Select Tools > Annotation Arrow.
u Using the right mouse button, click on the position in the image where you
want to insert the text.
– A selection list with predefined texts is displayed.
u Select an entry from the list by clicking it once. If necessary, use the scroll bar
to display further texts.
– The text appears immediately.

Positioning text Entered texts can be moved as required.

u Click on the text with the left mouse button.
– The text is marked by small squares.
u Drag the text to the new position.

Editing text Previously entered image annotations can be changed at any time.
u Click on the text with the left mouse button.
– The text is marked by small squares. The text cursor is at the beginning of
the text.
u Now change or add to your text.
u You can finish text editing by clicking into the image outside the text frame or
by pressing the Enter key.

Deleting text Texts can be deleted individually or together with other graphic elements.
u Select one or several (Ctrl key) text elements.
u Select Delete in the context menu (right mouse key) or press the Del on your
keyboard.
– The selected texts are deleted.

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Subtraction processing 0

Unlike bones for example, vessels do not show a considerably greater absorption
of X-rays compared to the surrounding tissue. In X-ray exposures vessels are not
especially highlighted.
When subtraction is performed, two X-ray exposures are acquired of the region
of interest, one with contrast medium and one without contrast medium. After-
wards both exposures are subtracted.
In the subtraction image, areas with the same attenuation and areas with a
(slightly) different attenuation, e.g. vessels that were filled with contrast medium
during the exposure, can be discerned clearly.
When the SUB/Roadmap option is installed, the following functions are available
to optimize subtraction images:
o Anatomical background
o Pixelshift

Loading and displaying images 0

Native images from previous examinations acquired in Subtraction mode (option)

or Roadmap mode (option) are stored in the local database or in your archive to-
gether with the subtraction images. Both image types can be displayed simulta-
neously on both monitors.
u Load the images of the requested patient into the Viewing task card by using
the Patient Browser.
u Select Sub > Sub/Native Display in the main menu of the Viewing task card.
— Or —
u Click this button in the Sub subtask card.
– In the Viewing task card the subtraction images are displayed on the
left monitor.
– In the Native task card the corresponding native images are displayed on
the right monitor.

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Selecting another mask 0

You can select an image without contrast medium (mask), that you want to sub-
tract from a stack of images acquired with contrast medium. To do this, scroll si-
multaneously through the stacks of subtraction images.

Selecting the u Select Sub > Mask Next in the main menu of the Viewing task card.
next mask
— Or —
u Click this button.
– The next mask is selected.

Selecting the u Select Sub > Mask Previous in the main menu of the Viewing task card.
previous mask
— Or —
u Click this button.
– The previous mask is selected.

Adding the anatomical background 0

Normally the anatomical surroundings of vessels of interest are not visible in im-
ages that are displayed subtracted. By adding the mask image, the surrounding
tissue can be highlighted more or less. The initial degree of admixture is defined
in the examination set. This value can be modified.
u Select the required image.
u Using the mouse, drag the slider to the required position.
– The selected image is displayed with anatomical background.

You can set the anatomical background between 0% and 30%.

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Achieving exact covering of image and mask 0

During acquisition of the subtraction series, the patient or the C-arm system may
move. The images that are to be subtracted may not be congruent. The anatom-
ical background, especially in the area of image contrasts, is thus not canceled
out.
Exact covering of image and mask (= image without contrast medium) can be
achieved if you shift the mask by single pixels.
There are two possibilities for pixelshift:
o Manual pixelshift
Shift the mask manually until the best result of the subtraction image is
achieved.
o Automatic pixelshift
Define an area (ROI) for which pixelshift is to be optimized. The ROI can be
defined in one image or in a series of images in a stack. The best result is au-
tomatically calculated for this area.

Manual pixelshift
u Click this button.
– The button is displayed selected.
– The mouse pointer changes shape (arrow).
u Move the mouse cursor in the image keeping the left mouse button pressed
down.
– The mask is shifted simultaneously (by small amounts).

Shift mask up

Shift mask left Shift mask right

Shift mask down

To shift the mask in big steps, move the mouse pointer at the edge of the image.
For fine mask shifting, move the mouse pointer in the center of the image.
u Click this button again.
– The pixelshift function is switched off. The button is displayed deselected.

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Automatic pixelshift

u Click this button.

– The button is displayed selected.
– The mouse cursor changes into a rectangle.
u Move the rectangle to the position in the image where misalignment is most
evident.
u Click this position in the image.
– The mask is moved so that subtraction for the area within the rectangle is
optimized.

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Saving, transferring, documenting, closing

images 0

After image processing, when all the images have been displayed in an optimum
way and have been evaluated, you can save and archive these images or transfer
them to the Filming task card for further evaluation and documentation.
After that, you can close the images of this patient and make space in the
Viewing task card for the images of the next patient.

Please note the following when transferring edited images:

Images that were zoomed in or out, shifted or rotated in the viewer may be ex-
ported or transferred with reduced pixel matrix. Always include the original image
in the transfer. We strongly recommend that you include original images in your
diagnostic considerations, which should not be based solely on edited or modi-
fied images.

Save images 0

Once you have finished processing and evaluating the images, save your results.
You can save your images in one of two ways:
o You can save the processed images in a new series.
o You can add the images to an existing series.

It is impossible for radiation to be released when images are being saved; this ap-
plies particularly to large numbers of images. Wait until the save process is fin-
ished, or save the images after all exposures have been made.

Note that the newly saved data may not immediately be shown in the
Patient Browser. The display should first be updated manually, in particular
after comprehensive storage processes (select View > Refresh in the
Patient Browser).

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Calling up the Save As Only images of the same study can be saved together in one series.
dialog box
u First select the images or series that you want to save.
u Select Patient > Save As.
– The Save As dialog box is displayed.

Saving images as a You can save all selected images in a new series. The old series remains un-
new series changed. You can then easily compare processed and evaluated images with the
original images of the study.
u Click the Save images in new series option in the Save As dialog box.
u Enter a new description for the series in the text input field.
u Confirm by clicking OK.
– The images are saved in a new series.

Appending images to If you do not want to create a new series for your processed and evaluated im-
an existing series ages, you can append them to an existing series.
u Click the Append images to series option in the Save As dialog box.
u Select the series from the selection list using the series number and descrip-
tion.
u For images of a subtraction or Roadmap study, select the image type.
u Confirm by clicking OK.
– The images are saved in the specified series.

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Restoring image display 0

You can reset the image processing parameters that were changed (e.g. window
values, edge filter, zoom/pan) and thus reapply the values that were set when you
last saved the selected image in question. This will also reset any image evalua-
tion steps (e.g. shutter or measurements) that were performed after the relevant
image was last saved.
u Select the images in the image area of the Viewing task card.
u Select Edit > Reset all.
– Or –
u Click this button.
– All selected images are reset to their original state (before they were pro-
cessed).

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Archiving, sending or filming images 0

After an examination or postprocessing, the images are stored in the local data-
base from where they can be accessed for reporting or documentation,
for example.

Archiving images 0

Using the Archive to... function, you can save patient and examination data to an
archive via the network (only DICOM option).

Please note that CDs/DVDs are not archive media. Saving and keeping data on
CD/DVD-R does not comply with archiving requirements.

For images of a subtraction or Roadmap study, you can select whether you want
to send native images or only the subtracted images.
u Select the images that you want to archive.
u Select Transfer > Archive To....
– The Archive To dialog box is displayed.
u Select the required archive destination.
u Click Archive.
– The data are archived to the selected destination.
(› Register 8: Documentation, Page 65)

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Sending images (DICOM option) 0

If your system is connected to a network, you can send patient and examination
data to other workstations via the network using the Send to... function.

For images of a subtraction or Roadmap study, you can select whether you want
to send native images or only the subtracted images.

Send images to node 1 u Select the data that you want to send.
u Select Transfer > Send to Node 1.
– The data are sent to the selected address.

Sending images to a u Select Transfer > Send to....

specific network
address
u Select the required network address(es) in the Send To dialog box.
u Click Send.
– The selected data are sent to the required address(es).

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Filming Images 0

You can also use the Viewing task card to select images and copy them to
Filming (DICOM option).

Make sure the printer is switched on before you send images to print.

Transferring images u Select the images in the image area of the Viewing task card.
to Filming
u Select Patient > Copy to Film Sheet.
– Or –
u Click this button.
– All the selected images are transferred to the "virtual film sheet" (Filming
task card or Film Preview window). There you activate the Auto Expose
option, and the images are exposed on film or printed on paper as soon as
the film sheet has been filled, or they are first collected in a film job.

Exposing images Patient images that you have collected in a film job can be printed or exposed
on film from the Viewing task card. To do that, you do not need to switch to the Filming
task card.
u Select Patient > Expose Film Task.
– All images of the film job are transferred to the camera.

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Transferring images to the References task card 0

In the Viewing task card, you can transfer images to the References task card.
u Select the images or series you want to process in the Viewing task card.
u Select Patient > Copy to Reference Monitor.
– Or –
u Click this button.
– The images are copied to the References task card.
(› Register 5: Examination, Page 29)

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Closing the patient 0

When you have finished image processing and evaluation in the Viewing task
card, you can close the patient. If images of several patients are loaded, you can
close all patients in one step.
If images of a current examination are loaded, the patient will be closed when the
examination is ended. This can also be initiated in the Viewing task card.

Closing the patient u Select Patient > Close Patient.

– The current patient folder is closed.
Or
u Select Patient > Close All.
– All patient folders are closed.
The images are unloaded from the Viewing task card.
You can now load images of another patient for postprocessing.

When closing the patient, the error message “Unloading of patient data failed"
may appear. This happens if more than 320 images of a study are being unloaded.
In this case, a restart must be performed.

Automatic slot diaphragm calibration

When a patient is closed, the slot diaphragm is automatically recalibrated in order
to ensure increased accuracy of the function. This process lasts about 20 sec.
During this time the kV and mA indicators will flash. It is not possible to release
radiation in this case. (The recalibration is carried out only if the slot diaphragm
function was used for the registered patient.)

Finishing an u Select Patient > End Examination.

examination
The images are unloaded from the Viewing task card and the examination
is ended.
You can now register the next patient for examination.

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Image Processing

Viewing configuration 0

In the Viewer Configuration window, you can adapt the user interface and pro-
gram operation of the Viewing task card to your method of working.
You can change and make the following settings:
o Standard layout of the image area of the Viewing task card
o Generation of annotation text
o Presettings for saving Sub/Roadmap image data
o Standard layout of the image area of the References task card
o Behavior of reference images during loading
o Settings for image text display (configuration via image text editor)

Calling up the configuration window 0

You can call up the configuration window from the syngo Configuration panel.
u Select Options > Configuration in the main menu.
u Double-click the Viewer button.
– The Viewer Configuration window appears.
— Or —

u Double-click the Image Text Editor button, if you want to configure image
text display.
– The Image Text Configuration window is displayed.

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Image Processing

Concluding configuration 0

If you have changed the settings in the cards of the configuration window, you
must confirm them. If you have changed parameters by accident, you can reset
these values to default values or reject all your changes.

Applying changes u Confirm by clicking OK.

– All changes are applied.
– The Viewer Configuration dialog window is closed.
Or
u Click Apply.
– The changes of the current card are applied.
– The Viewer Configuration dialog window remains open.
– The changed settings are automatically applied the next time you load data
into the Viewing task card.

Resetting to u Click Reset to Default.

default settings – The values of the current card are reset to standard values.
– The Viewer Configuration dialog window remains open.

Discarding changes u Click Cancel.

– The changes are not applied.
– The Viewer Configuration dialog window is closed.

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Division of the image area 0

On the Layout card, you define the number and size of the segments in the
image area.
The standard layout is 1:1 (full screen). This is the most suitable layout for detect-
ing diagnostic details. For overview purposes you can set a layout with several
images per page (4:1, 9:1 or 16:1).

Changing the size of

the layout

u Click the Layout card into the foreground.

u Select the size of the layout from the selection list.
– After the images have been loaded into the Viewing task card, they are
displayed in the selected layout size.

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Image Processing

Setting the type u Click the Stripe option.

of layout – You can view the loaded series of a study one after the other image by
image.
Or
u Click the Stack option.
– All images of a series are now arranged in a stack one on top of the other.
Or
u Click the Unchanged option.
– All images are displayed in the type of layout that was used last.

Stripe is the default setting for the layout type.

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Creating annotation texts 0

Texts that are often used can be created on the Annotation card. You can also
delete texts or change existing annotations. The texts created must not exceed
one line and 50 characters.

The entered texts are available for selection, if you have enabled the
Tools > Annotate function in the Viewing task card and then click into the
image with the right mouse button.

Creating a new text

u Click the Annotation card into the foreground.

u Click the Paste button.
u Double-click the empty box.
u Enter the new text.
u Click the Paste button or press the Enter key.
– The new annotation text is placed in the top position of the list.

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Image Processing

Changing text u Double-click an existing box.

u Enter the new text.
u Click the Enter button.
– The modified annotation text is displayed.

Deleting an u Select a text in the list of annotation texts.

existing text
u Click the Delete button.
– The selected text is deleted.

Moving texts u Select a text in the list of annotation texts.

u Click the Move up button.
— Or —
u Drag&drop the text to the required position.
– The selected text is moved up one line.
Or
u Click the Move down button.
— Or —
u Drag&drop the text to the required position.
– The selected text is moved down one line.

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Exporting Sub/Roadmap image data 0

In the Exporting card you can define the data of Subtraction/Roadmap examina-
tions that are to be saved during exporting and transfer (Transfer menu).

u Click the Exporting card into the foreground.

u Click one or more of the following options:
– export for Subtraction Review
Subtracted images are saved. These can also be viewed in non-Siemens
systems. Subtraction functions can no longer be performed with these
data.
– export for Native Display Review
Native images are saved. These can also be viewed in non-Siemens sys-
tems.
– export as 'Raw Data'
The original data set is saved. It can be post-processed in other ARCADIS
systems or in systems with subtraction functions.

Native Image Display is the default setting for export.

u Check the corresponding check box, if applicable.

– A dialog box is shown for every transfer of Subtraction/Roadmap images.
This allows you to select data that differ from the default settings.

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Layout in the References task card 0

The Ref. Split card lets you determine how to split the image area in the
References task card when the Monitor split button at the C-arm system is
pressed.

u Click the Ref. Split card into the foreground.

u Select the size of the layout from the selection list.
– Loaded images are displayed in the selected layout size in the References
task card, if the Monitor split button is selected at the C-arm system.

You can set the following layout sizes: 4:1, 9:1, 16:1.
The standard setting for the layout size is 4:1.

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Loading reference images during an examination 0

You can set the system to automatically save images and scenes during the ex-
amination. For this purpose, the Autostore function must be activated in the op-
erating program of the examination program (see › Register 9: Configuration,
Page 13).
The Ref. Loading card lets you determine which data are to be automatically
transferred to the References task card.

u Click the Ref. Loading card into the foreground.

u Click the Single Frame Images check box.
– Automatically saved individual images are always loaded in the References
task card.
u Click the Multi Frame Images check box.
– Automatically saved multiframe images (scenes) are always loaded in the
References task card.

In the default setting, both check boxes are activated.

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Configuring image text display 0

In the Image Text Configuration dialog you can set which image text informa-
tion is to be displayed by default with individual basic formats. The dialog box is
opened by clicking the Image Text Editor button in the syngo Configuration
Panel.

u In the View Name selection list, select the basic format for which your con-
figuration settings apply.
u Select either All Text or No Text.
– By default, all available image texts or no image text are/is displayed.
Or
u Click on the option field Customized Text.
u Select the desired information in the left selection area.
– By default, the selected image texts are displayed.

All entries in the left selection area can be selected or deselected with the button
Select All or Deselect All.

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 Register 7 3D option

Table of Contents

General Information ............................................................................................................. 5

Introduction....................................................................................................................................... 5
Areas of application .......................................................................................................................... 5
Calibration ......................................................................................................................................... 6
NaviLink 3D Option........................................................................................................................... 7
Connection to the navigation system ..................................................................................... 7
System illustration .................................................................................................................. 8
Navigation marker ring (registration unit)................................................................................ 8
Data transfer to the navigation system................................................................................... 8
Safety information .................................................................................................................. 9
Troubleshooting guide ............................................................................................................ 9

Sequence of 3D scans....................................................................................................... 12
Adjustment ..................................................................................................................................... 12
Setting the orientation .................................................................................................................... 13
Manual test run (collision monitoring)............................................................................................. 16
First step of the test run....................................................................................................... 16
Second step of the test run.................................................................................................. 17
3D scan........................................................................................................................................... 18
Starting the automatic 3D scan ............................................................................................ 19
Start of the run ..................................................................................................................... 20
Registration position (only with NaviLink 3D option) ............................................................ 20
Measurement ....................................................................................................................... 21
End of the measurement...................................................................................................... 21
Introduction to 3D Evaluation ............................................................................................ 22
3D evaluation methods ................................................................................................................... 23
3D on two monitors........................................................................................................................ 23
The 3D task card............................................................................................................................. 24
Image area ............................................................................................................................ 25
Control area .......................................................................................................................... 26
Smart Select ......................................................................................................................... 30

Transferring images to 3D ................................................................................................. 31

Starting 3D evaluation..................................................................................................................... 31
Calling up the 3D task card ............................................................................................................. 32
3D Series List ................................................................................................................................. 33
Transferring series to 3D ...................................................................................................... 35
Other series from the 3D Series List.................................................................................... 36

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3D option

Working in 3D.................................................................................................................... 37
The patient coordinate system ....................................................................................................... 38
Orientation aids in the image................................................................................................ 39
Image display in 3D ........................................................................................................................ 41
Image information................................................................................................................. 42
Setting views in the volume data set.............................................................................................. 43
Using the 3D cross hairs ...................................................................................................... 43
Scrolling with the dog ears ................................................................................................... 45
Rotating the volume with the mouse ................................................................................... 46
Rotating about one axis (oblique cut planes) ........................................................................ 46
Rotating about two axes (double-oblique cut planes) ........................................................... 50
Controlling image orientation................................................................................................ 51
Setting standard views ......................................................................................................... 53
Fixing the angle .................................................................................................................... 56
Defining output types ..................................................................................................................... 58
Setting MPR ......................................................................................................................... 58
Setting SSD .......................................................................................................................... 59
Setting VRT........................................................................................................................... 59
3D task card with mixed output types.................................................................................. 60
Free View ............................................................................................................................. 61
Selecting and processing images ................................................................................................... 64
Selecting images .................................................................................................................. 64
Windowing images ............................................................................................................... 64
Zooming and panning images............................................................................................... 65
Generating series from 3D images ................................................................................................. 66
Generating parallel slice images ........................................................................................... 68
Generating radial images ...................................................................................................... 74
Series of radial projections and views .................................................................................. 79
Generating curved ranges .................................................................................................... 81
Generating expanded ranges................................................................................................ 85
Saving 3D series and images.......................................................................................................... 87
Saving images and series quickly ......................................................................................... 87
Saving individual images as a new series............................................................................. 88
Transferring 3D images .................................................................................................................. 91
Filming 3D images................................................................................................................ 91
Transferring images to the Viewing task card ...................................................................... 91
Ending 3D evaluation ...................................................................................................................... 91
Particularities with 3D multi-monitor............................................................................................... 92
Monitor display ..................................................................................................................... 92
Charging performance .......................................................................................................... 94
Loading series in Compare mode ......................................................................................... 95
Working in the Compare mode ............................................................................................ 98

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Multiplanar Reconstruction (MPR)..................................................................................... 99

Transfer as MPR to 3D ................................................................................................................. 101
Changing the slice thickness (MPR Thick).......................................................................... 102
Generating series of images ......................................................................................................... 103
Generating curved cuts................................................................................................................. 104
Drawing curves................................................................................................................... 105
Displaying images............................................................................................................... 106

Surface shaded display (SSD).......................................................................................... 108

Transferring as SSD to 3D ............................................................................................................ 109
SSD reconstruction with changed thresholds .................................................................... 111
Generating a radial range of SSD images ..................................................................................... 114

Volume Rendering Technique (VRT) (option)................................................................... 115

Transferring as VRT to 3D............................................................................................................. 115
Parameter sets ............................................................................................................................. 116
Assigning a parameter set automatically ............................................................................ 117
Assigning a parameter set by hand .................................................................................... 117
Editing parameter sets ....................................................................................................... 118
VRT Thin ....................................................................................................................................... 122
Starting VRT Thin ................................................................................................................ 122
Changing the slice thickness .............................................................................................. 123

3D Image Fusion (option) ................................................................................................ 124

Fusion functions ........................................................................................................................... 125
Calling up Fusion........................................................................................................................... 126
Loading image data sets..................................................................................................... 126
3D card in Fusion mode...................................................................................................... 128
Aligning image series.................................................................................................................... 129
Registration ........................................................................................................................ 131
Aligning images visually...................................................................................................... 133
Aligning images with reference points ............................................................................... 137
Automatic Registration ....................................................................................................... 141
Surface Matching ............................................................................................................... 143
Terminating alignment ........................................................................................................ 147
Displaying overlaid images ........................................................................................................... 148
Side by Side mode.............................................................................................................. 148
Fusion mode....................................................................................................................... 150
Modifying the display ......................................................................................................... 151
Saving result images .......................................................................................................... 155
Results for other applications ............................................................................................. 155

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Configuration for 3D ........................................................................................................ 158

Calling up the configuration window............................................................................................. 158
Configuring image information...................................................................................................... 159
Configuring the processing of ranges ........................................................................................... 160
Configuring storage ............................................................................................................ 160
Configuring filming.............................................................................................................. 161
Configuring the orientation of the reference image............................................................ 161
Configuring resampling....................................................................................................... 161

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Register 7 3D option

General Information 0

Introduction 0

The 3D option essentially consists of motor control of the orbital movement,

which can be switched on optionally, and a task card for 3D image reconstruction
and visualization.
This enables a fixed number of fluoroscopic images to be acquired at fixed angu-
lar distances during automated continuous orbital rotation through 190°. In the
isocenter, a data cube of approximately 11 cm edge length that consists of iso-
tropic submillimeter voxels is calculated from these images.
The 3D information is available directly after the measuring run (3D scan) is
ended and is visualized with the aid of the syngo interface as multiplanar refor-
matting (MPR) or as surface shaded display (SSD).
The conventional, manual use of the ARCADIS Orbic C-arm for generating
2D projections continues to be possible without any restrictions.

Areas of application 0

The 3D option of the ARCADIS Orbic is suitable for intraoperative use for bones
and joints of the lower and upper extremities, the entire spine, the hip and pelvic
region and facial bones.

In case of extremely adipose patients or patients with highly osteoporotic bones,

loss of image quality may occur in the area of the thoracic and lumbar spine.
The positioning of extremely adipose patients and the resulting limited move-
ment range of the C-arm can make an integrative application in the area of the
thoracic and lumbar spine impossible.
Only radiolucent positioning accessories may be used for the application, since
metal parts of the OR table that are in the beam path will cause loss of image in-
formation.

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Calibration 0

During the installation of the 3D option each system is calibrated by Siemens.

It is necessary to check calibration, as soon as one of the following criteria
is fulfilled:
o the last calibration dates back 6 months
o since the last calibration 150 patients have been examined
o since the last calibration 400 3D scans have been performed
Calibration is an important prerequisite for achieving good image quality.
Later changes of the starting values, e.g. due to replacing system components,
require recalibration by a Siemens service engineer.
In connection with the NaviLink 3D option, the calibration of the system should
be checked in shorter time intervals, together with the navigation system.
If necessary, a new calibration should be performed.

Caution
System calibration provides good results only in the angulation range
between ± 20°.
Outside the range the image quality deteriorates. An error message is
displayed!
u It is important to adhere to this range since error messages will otherwise
appear and the image quality will deteriorate.
u If additional weights are attached to the C-arm, a new calibration must be
performed.

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NaviLink 3D Option 0

The NaviLink 3D option of the ARCADIS Orbic is an extension of the 3D software

for this system. It offers an interface for automatic registration of the 3D data set
for different navigation systems. The interface only supports optical systems.
The navigation system has to register the position of the C-arm in the starting po-
sition during a 3D scan. After the scan the 3D image data are directly transferred
to the navigation system.

Connection to the navigation system 0

There must be a network connection to the navigation system, either via the
hospital network or a direct connection to the navigation system.

A direct connection should be preferred. In case of a connection via the hospital

network, faults during the process may occur due to overload of the network.

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System illustration 0

The illustration shows the relation of the C-arm to the acquired 3D data set (cube).
The matrix "Ma" points from the navigation marker ring to the cube and thus de-
termines the exact position and orientation of the cube. This matrix is stored
together with the 3D data set.

Navigation marker ring

Pointer

3D cube

Navigation marker ring (registration unit) 0

o There are registration units which are permanently mounted to the image in-
tensifier. These can only be dismantled by service personnel of the navigation
company.
o There are registration units which are not permanently mounted. These can
be mounted and dismantled by hospital staff.

Data transfer to the navigation system 0

Data are transferred automatically to the navigation system after termination of

the 3D scan.

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Safety information 0

o The material required for navigation must be removed from the beam path for
normal operation.
o Before using the I.I. interface, make sure the interface is clean and not dam-
aged (visual check).
o After a recalibration in 3D mode, a recalibration must also be performed with
the configured navigation systems.
o Prior to performing an operation with a navigation system, the user has to
make sure that the navigation system is sufficiently accurate.
o Please also observe the safety information regarding the attachment of dedi-
cated options (› Register 2: Safety, Page 31).
o For distance and angle measurements in 3D images, a tolerance of ± 2% for
an inner cube of 7 cm x 7 cm x 7 cm applies.

Troubleshooting guide 0

Error message "Communication to navigation system failed.

Check navigation system and network connection."

Possible error cause Troubleshooting possibilities

Error at the Check for an error message from the navigation
navigation system system
No connection Verify there is a connection to the navigation
system
Connection is broken If connected by local area network (LAN):
Check the function of the local network
With direct connection:
Replace the connection cable
Incorrect navigation Verify that the navigation system you have select-
system selected in the ed corresponds to the navigation system in use
orientation dialog

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3D option

Error message: "Registration failed. Check navigation system".

Possible error cause Troubleshooting possibilities

Error at the navigation Check for an error message from the navigation
system system
The navigation camera Check for an error message from the navigation
cannot see the marker ring system
on the I.I.
Correct the camera position

Error: Bad accuracy

Possible error cause Troubleshooting possibilities

Error at the navigation Check whether sufficient accuracy is ensured
system without automatic registration:
If no:
Call navigation service
If yes:
Check the following error causes
The wrong navigation Verify that the marker ring (registration unit) cor-
marker ring is mounted responding to the navigation system in use is
on the I.I. mounted on the I.I.
The navigation marker ring Verify that the marker ring is mounted correctly
is not mounted correctly
at the I.I.
The adapter ring at the I.I. Clean the I.I. and the adapter ring at the
is polluted C-arm system
I.I. is damaged Call Siemens Service
Navigation marker ring is Call Siemens Service
damaged
The C-arm is damaged Call Siemens Service
Bad image quality in 3D Call Siemens Service

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Error: Navigation system cannot be selected

Possible error cause Troubleshooting possibilities

The navigation system is Call Siemens Service for the configuration of the
not configured at the navigation system
Siemens C-arm
Incorrect navigation Verify that the navigation system you have select-
system selected in the ed corresponds to the navigation system in use
orientation dialog

Error message at the navigation system

Possible error cause Troubleshooting possibilities

Error at the navigation Please refer to the users manual of the navigation
system system

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Sequence of 3D scans 0

1. Horizontal adjustment 2. Adjustment -90° vertical 3. Test run +190° manually 4. 3D scan -190° motor
powered

The procedure is described in detail below.

If a 3D scan is performed immediately after the X-ray tube assembly has been
subjected to a considerable long-term load, the maximum allowable X-ray tube
assembly temperature of 70°C could be exceeded (with automatic abortion of the
scan). In these cases, allows the tube unit to cool down for a few minutes during
the scan preparation.

Adjustment 0

Always bring the object to be examined into the isocenter.

There are three methods of adjustment:

1. With the I.I. laser aimer

u Proceed as follows:

1. Horizontal adjustment 2. Adjustment -90° vertical

u Then lock all brakes, because otherwise the system will display an error mes-
sage.

2. With the I.I. laser aimer and the horizontal laser light localizer (option)
In contrast to the first method, it is not necessary to move the C-arm.
Details on the horizontal laser light localizer see › Register 12: Options, Page 19.

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3. With the single-tank laser targeting device

In contrast to the first method, the C-arm must be rotated through 180°.

Setting the orientation 0

Before you can perform a valid test run, you must determine the patient position
relating to the device.
u Press this button in the control area of the Examination task card.
– The Acquisition dialog box is opened. You are requested to select the
body region for the examination.

u Click on the body region to be examined in the image.

– The other body regions are hidden and new operating elements are shown.

Example: left leg

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u Use the arrow keys to set the actual position of the patient on the operation
table.

Example: left leg, turned to the left

u Set the position of the C-arm relating to the patient (device orientation).
– Now the position of the body region to be examined relating to the device
is uniquely defined. The "Start 3D scan" button is active.

u Check the image quality settings and change the option, if necessary.
o High Quality = 100 images/scan (slow scan)
o Standard Quality = 50 images/scan (fast scan)

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Settings for If you work with the navigation system (Option NaviLink 3D), the correct naviga-
3D navigation tion unit must be selected.

u Check the selection of the navigation system and change it, if necessary.

The navigation unit must be ready for operation and ready to receive.
u If the selected navigation system should be the default setting in the selection
list, acivate the checkbox Use the selected system as default.
u Select the option Yes under 3D navigation.

Calling up the test run

u Click Start 3D scan.
– The Collision check window is displayed, prompting you to perform the
first step for the manual test run.

If the C-arm is already in the end position after the adjustment has been carried
out, you are prompted to perform the second step for the test run.
(› Page 17)

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Manual test run (collision monitoring) 0

3. Test run +190° manually

Warning
Released brakes during the manual test run.
Danger of collisions!
u Before performing the test run, make sure that all brakes are locked.

First step of the test run 0

In the first step you determine the end position of the automatic 3D scan.
In doing so, consider the required scan range:
o Full scan (Scan range = 190°)
o Quick scan (120° ≤ Scan range < 190°)

u Release the brake for orbital movement.

u Move the C-arm manually to the end position for the 3D scan.
– If performing a full scan, move to the system end position.
– If performing a quick scan, an orbital end position of at least 120° starting
from the selected end position must be possible.
u Lock the brake for orbital movement.
– If the C-arm is in the system end position, this is automatically accepted as
end position.
u Click Accept position provided the C-arm is not in the system end position.
– The current position is accepted as end position for a quick scan.

Please note that with a limited scan range, the image quality is also limited.

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Second step of the test run 0

If you have set the end position, you are prompted to perform the second step of
the test run:

u Release the brake for orbital movement.

u Move the C-arm manually to the start position for the 3D scan.
u Lock the brake for orbital movement.
– The current position is automatically accepted as start position.
– The test run is complete. The system is ready for the 3D scan.

After the test run, you have a maximum of 4 minutes to carry out the 3D scan.

If you fall short of the minimum scan range of 120°, the following error message
will appear:

u Confirm with OK and repeat the test run with a larger scan range.

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3D scan 0

4. 3D scan - 190° motorized

End position

Warning
Changing the settings of the C-arm or unit before or during the 3D scan.
Danger of collision during the run! Scan becomes useless!
u After the test run, you must not change the position of the C-arm or change
any settings of the entire unit.
u Make sure that all brakes are locked.

Warning
Starting the 3D scan.
Danger of radiation!
u Please observe the radiation protection notes
(› Register 2: Safety, Page 17).

Caution
Patient moves during the scan.
Image quality loss!
u Make sure that the patient does not move during the scan!

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Starting the automatic 3D scan 0

After the test run has been successfully completed you will be prompted to per-
form the 3D scan.

Warning
For the duration of the scan, the orbital movement of the C-arm is motorized.
Risk of crushing!
u Keep a sufficient safety distance.

u Start the 3D scan by actuating the left footswitch.

u Make sure that you press the footswitch during the duration of the scan
(up to 1 minute, depending on the selected image quantity)
(deadman's switch).

If the radiation warning signal sounds before the scan is started (after 5 minutes
of fluoroscopic time), you have to reset it in time at the control console.
Otherwise radiation will be switched off and the scan will be aborted after
another 5 minutes. It is not possible to interrupt the 3D scan and then continue it
for image quality reasons.

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Start of the run 0

As long as you continue to press the footswitch, the C-arm moves to the starting
position. Thereby the following window is displayed:

Registration position (only with NaviLink 3D option) 0

The following screen is displayed during automatic registration of a 3D scan:

If the registration of the relevant system parts causes an error, the communica-
tion with the navigation station is ended and the scan preparation interrupted.
If the system does not confirm registration within about 2 minutes, an error mes-
sage is displayed on the monitor and the scan preparation is cancelled.

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Measurement 0

While the 3D scan is performed, a progress bar is displayed:

End of the measurement 0

The ARCADIS Orbic 3D generates two data sets with a 3D scan, a scene
with 100 or 50 acquisitions and a CT data set with 256 slices (reconstructed
volume). The reconstructed volume is automatically shown in MPR mode in the
3D task card.

Please note that the work status for the CT dataset is not set and thus this infor-
mation cannot be processed.

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3D option

Introduction to 3D Evaluation 0

Tomographic examinations provide consecutive cross-sectional slice images

through an examined volume of the patient's body.
By combining these two-dimensional images, a three-dimensional view of the
examined region is obtained.

(1) (2)

(1) 2D slice images

(2) Volume data set
In this three-dimensional display, you can work just like in a three-dimensional
model. For example, you can generate new images, cut out individual regions and
use a range of evaluation functions for special diagnostic problems.
Your system provides you with a number of alternative procedures for working
with three-dimensional images.
You decide which method you want to begin with as soon as you load images
into the 3D task card.
On the 3D task card, you then prepare your image material by the selected
method, or you start another image processing procedure.

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3D evaluation methods 0

Your system provides you with the following methods for combining two-dimen-
sional images to form three-dimensional views:
o Multiplanar reconstruction (MPR) is used to place slices in other orientations
through the region of interest. The resulting images are two-dimensional.
o The surface shaded display (SSD) method is used, for example, to evaluate
bone studies that you want to display with virtual three-dimensionality.
o The Volume Rendering Technique (VRT), for example, is used for differentiat-
ing organs and tissue structures as well as for the colored 3D display of bones,
tissues and organs.

3D on two monitors 0

For 3D evaluations, more comprehensive information can simultaneously be dis-

played on two monitors with the 3D multi-monitor option.
Each monitor shows a 3D task card. The right monitor, which is the 3D main mon-
itor, shows the loaded data set in standard layout. The second monitor serves as
interaction monitor and, depending on the data set and processing step, shows
the result of a reconstruction in full screen (Blow Up) mode or a second data set
in Compare mode.
For functions and particularities of using the 3D multi-monitor option see
› Page 92.

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The 3D task card 0

You process your three-dimensional images on the 3D task card.

The task card is subdivided into the following areas:

3D task card (no patient loaded)

(1) Image area, subdivided into 4 segments, optionally 1 segment

(2) Control area for easy access to functions
(3) Status block for ongoing actions and error display
(4) Menu bar

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Image area 0

The images that you have loaded into the 3D task card are displayed in the image
area. Depending on the division of the screen and the number of images loaded,
you can only see some of the images. The remaining images are in the back-
ground.

Layout of the The image area is subdivided into segments. Each segment contains one image.
image area
Depending on whether you want to see an overview of the loaded images,
or whether you require a display suitable for reporting, you can choose between
2 layouts:

2x2 1x1

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Control area 0

In the control area, you will find all the tools you need to select image material,
arrange the screen display and process images.
Here you can also control data exchange with other parts of the program and
access other applications.
You can access these functions easily using buttons and thus work much faster
than via the menu bar.

Patient information

Image control

Subtask cards

Output control

Patient information
The top of the control area displays the name of the patient whose images are
currently loaded in the 3D task card.

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Image control The buttons in the Image control area have the following functions:
Enabling/disabling Free Mode for rotating/setting the image planes
(› Page 45)

Showing/hiding the cross hairs

Showing/hiding orientation control

(› Page 52)

Activating/deactivating rotation mode

(› Page 46)

Activating/deactivating zoom/pan mode

(› Page 65)

Undo all zoom/pan changes to the view

(› Page 65)

Type subtask card The buttons on the Type subtask card have the following functions:
Activating the MPR display mode
(› Page 99)

Activating the MPR Thick display mode

(› Page 102)

Activating the SSD display mode

(› Page 108)

Selecting the Fusion function

(› Page 124)

Activating the VRT display mode

(› Page 115)

Activating the VRT Thin display mode

(› Page 122)

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Orientation The buttons on the Orientation subtask card have the following functions:
subtask card
Setting the standard viewing direction
(› Page 53)

Establishing standard orientation

(› Page 55, › Page 56)

Aligning image planes perpendicular to the reference image

(› Page 57)

Image subtask card The buttons on the Image subtask card have the following functions:
Measuring distances

Activating/deactivating pixel lens

Inserting annotations into images

Selecting Fusion Registration

(› Page 129)

Activating the Side by Side mode for Fusion

(› Page 148)

Subdividing the image area (Fusion)

Assigning stored window values

(› Page 64)

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Settings subtask card The buttons on the Settings subtask card have the following functions:
Generating series of parallel slice images
(› Page 68)

Generating series of radial slice images

(› Page 74)

Generating series of curved sections

(› Page 81)

Generating a curved section

(› Page 104)

Activating Free View

(› Page 61)

Histogram The Histogram subtask card is available in the VRT display mode. The buttons
subtask card have the following functions:
u Opening the VRT Gallery for assigning parameter sets
(› Page 116)

u Setting the light source for the VRT image in the parameter set
(› Page 118)

u Setting the shading for the VRT image in the parameter set
(› Page 118)

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Output control The buttons in the Output control area have the following functions:
Storing the image of the active segment
(› Page 87)

Defining storage settings and storing the image of the active segment
(› Page 88)

Copy images to the film sheet

(› Register 8: Documentation, Page 11)

Sending images to standard network nodes

(› Register 8: Documentation, Page 73)

Transferring images of the active segment to the Viewing task card

(› Page 91)

Closing the patient

(› Page 91)

Smart Select 0

In the 3D task card, a Smart Select feature is implemented which can be used in
a similar way as the standard pop-up menu (right mouse button) to switch over
functions directly in the image segment without calling up the relevant menus.
u Place the mouse cursor in the segment and keep the right mouse button
pressed.
– A graphic menu is displayed.

u Drag the mouse cursor to one of the four options and let go of the mouse
button.
– Now you can use the selected option as usual via the left mouse button.

If you are already familiar with the use of the Smart Select feature, you do not
need to call up the pop-up menu. You can then simply drag the mouse in the
required direction with the right mouse button pressed in order to switch over the
mouse function.

u Drag the mouse cursor across the center frame and release the mouse button
again.
– The frame appears blue and each of the four options is switched off.

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Transferring images to 3D 0

For three-dimensional image processing, you use examination images that are
stored in the local database of your system or in the archive.
If your system is integrated into a hospital network, you can receive image data
from other departments and wards and evaluate them on the 3D task card on
your system.
In the Patient Browser window (Patient > Patient Browser) you have access to
this data. There you can search for patients, studies, series, or individual images
and transfer them to the 3D task card.
You can also transfer images from the Viewing to the 3D task card.

Starting 3D evaluation 0

You call up 3D processing and load a 3D model in three steps:

Selecting images/ First select the images or series that you want to display in three dimensions in
series for processing the Patient Browser or on the Viewing task card.
In this step, you can select more than one series of one patient for 3D processing.

Selecting a 3D display Next, choose a 3D method under Applications > 3D and transfer the selected
method images/series to the 3D task card.

Or

Drag & drop from the Transfer the images selected in the Patient Browser as an MPR by drag & drop
Patient Browser them onto the 3D task card.

When transferring them, the system checks whether the images and series that
you selected are suitable for 3D postprocessing. If necessary, the system dis-
plays a message box pointing out inconsistencies within the series.

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Selected images that are to be displayed in three dimensions must at least fulfill
the following criteria:
o All images must originate from one patient and from one study.
o At least three images must have been loaded into the 3D task card.
o All images must be parallel and be located on one axis.

If you have selected only one series which also fulfills all the above criteria, the
images will be transferred to the 3D task card and you can start processing them
immediately.
If you select several series or an unsuitable series, the 3D Series List is dis-
played.

Displaying a series The last step is to select a series from the 3D Series List and transfer it to the
from the 3D Series List 3D task card.
in three dimensions
On the 3D task card, the selected series is displayed in three dimensions in the
selected method. You can now evaluate the display.

You can only ever process one series at a time on the 3D task card.

Calling up the 3D task card 0

As soon as you have loaded images into the 3D task card you may switch to other
tasks and then return to the 3D task card to continue processing the images.
u Click the card tab to return to the 3D task card.
– The 3D task card is placed in the foreground Its status has remained the
same since you left the card.

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3D Series List 0

If the series you selected is not suitable for 3D display or if you have selected
more than one series for processing, you can see the results of the selection
check in the 3D Series List dialog box.

Opening 3D Series List You can also open the 3D Series List explicitly, for example, to load another se-
ries into the 3D task card.
u Call Patient > Open Series List... in the main menu of the 3D task card.
– The 3D Series List dialog box is displayed. It is divided into the following
fields:

(1) Patient data

(2) Series suitable for 3D display (valid series)
(3) Series unsuitable for 3D display (invalid series)

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Valid series All the series suitable for 3D reconstruction are shown in the top list (Valid
Series). Depending on how many series you have selected, several lists may be
displayed. You can, however, select and transfer only one of these at a time.

Invalid series All the series unsuitable for 3D reconstruction are displayed in the lower list
(Invalid series). Displayed next to the series data you will also see a comment
which gives a more detailed reason for rejection.

Your computer system has limited storage capacity. Thus, the number of images
for 3D display is also limited. In the 3D Series List window, the images which can-
not be loaded are shown in the Invalid Series list.

Hiding invalid series You can hide the Invalid Series list to retain a better overview of the
3D Series List dialog box.

u Click the Show invalid series list check box to remove the checkmark and
deselect the option.
– The screen display is updated immediately, the Valid Series list is displayed
larger. The Invalid Series list is no longer displayed.

If none of the series you selected is suitable for 3D display, i.e. the Valid Series
list is empty, you cannot hide the Invalid Series list.

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Transferring series to 3D 0

If the list of Valid Series contains more than one series suitable for 3D display,
you have to decide which series you want to display and evaluate in three dimen-
sions first.

You can only ever display and process one series at a time on the 3D task card.

Only medical images can be transferred to the 3D task card. Processing of non-
image data like spectroscopic raw data will be possible in a later software version.
u Double-click in the list of Valid Series on the series that you want to process
first.
— Or —
u Select the required series in the list and click the Select button.
– The series is passed on to the 3D task card and the 3D Series List dialog
box is closed.

Closing without Once you have transferred images to the 3D Series List, you can interrupt the
image transfer processing, for example, to process images.

u Click Cancel to close the 3D Series List dialog box.

– You return to the Viewing task card or the Patient Browser.

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3D task card busy If you are processing another series on the 3D task card, the Confirm dialog box
is displayed.

u Confirm with Yes to load the new series onto the 3D task card and close the
old series.
Or
u Click No if you want to continue processing the old series on the 3D task card.
– The new series is not transferred. The 3D Series List dialog box is dis-
played. There you can select a different series, for example.
Or
u To cancel the transfer of the new series, click Cancel.
– You return to the Patient Browser or to the Viewing task card.

Other series from the 3D Series List 0

At any time, you can also access the other series that you selected for processing
in the 3D Series List from the 3D task card.
u Call up the 3D Series List dialog box with Patient > Open Series List ....
u Select another series and transfer it by clicking on the Select button.
– The previously loaded series is closed.

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Working in 3D 0

Your data are present as a volume data set. A large variety of options are available
to you for generating and processing two-dimensional images.
Various orientation aids, e.g., the orientation cube, guide you through the volume.
They relate to a patient coordinate system that shows the viewing direction or the
image orientation.
You can navigate through the volume to find the images relevant to your diagno-
sis. To do this, use the 3D cross hairs, the dog ears, or rotate the image data set
using the mouse.
Once you have generated a reference image, you can reconstruct entire series in
the desired view with the set output types.
You first generate an image in the orientation that you need. This is referred to as
the reference image, since all subsequent steps relate to this image (either the
orientation or the viewing direction). Then you select the output type, i.e. either
MPR, VRT or SSD, or use the type already set.

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The patient coordinate system 0

The image orientation is indicated by a patient-related coordinate system. In each

image, these data tell you the direction from which you are looking at the
patient (3D) and how a slice (2D) is positioned in the region of interest.

Directions Directions are indicated as follows in the patient coordinate system:

(1) F for feet

(2) R for right
(3) A for anterior
(4) H for head
(5) L for left
(6) P for posterior

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Anatomical Viewing directions along an axis of the patient coordinate system are called ana-
standard views tomical standard views. The slices which you look at in such views are designat-
ed as follows:

(1) (2) (3)

(1) Transversal slice

(2) Sagittal slice
(3) Coronal slice

Orientation aids in the image 0

Various aids are displayed for orientation in the image. They indicate from what
direction you are looking at the image.

Orientation
description
A tilt angle is displayed in the image as an orientation description relating to the
standard view.
The orientation description is also filmed and stored.

Orientation cube
The orientation cube is displayed on all images. It indicates the position of the
layer displayed with reference to the patient coordinate system.
(› Page 38)
The cube is also filmed and saved together with the images.

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Orientation labels The orientation labels show you the orientation of the patient in the image.
They correspond to the directions in the patient coordinate system and are not
annotations that you can edit. This text is always displayed in the center at the
top and left edge of the image.
o L, R - left, right
sagittal viewing direction
o A, P - anterior, posterior
coronal viewing direction
o H, F - head, feet
transversal viewing direction

Orientation in 2D images may be difficult in spite of orientation labels.

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Image display in 3D 0

The image area on the 3D task card is divided into four segments.
The first three segments are reference segments, the fourth segment is an out-
put segment.

Reference segments In the three reference segments the images are first shown in the views parallel
and perpendicular to the direction of scanning.
By turning and moving the views you can define the position and orientation of
the plane that is to be used as the reference image for the reconstruction of im-
ages or series.
The reference segments are used to display different views of the volume data
set, while the reference image (the view) is used as a reference for a 3D recon-
struction.

Output segment The images and series generated by various tools on the basis of the reference
image are displayed in the output segment.

(1) (2)

(3) (4)

(1) Reference segment (sagittal view)

(2) Reference segment (coronal view)
(3) Reference segment (transversal view)
(4) Output segment

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Image information 0

Information about the patient, the examination and image data are shown on the
images.
This information always appears in the same place as shown in the figure below:

(1) (2)
(7)

(2)

(6)

(4) (5)
(3)

(1) Patient data

(2) Orientation labels
(› Page 39)
(3) Slice thickness (only MPR, MPR Thick)
(4) Image comment
(› Page 89)
(5) Window values
(6) Orientation cube
(› Page 39)
(7) Orientation description
(› Page 39)
Of the standard text elements, the following elements are not displayed:
o Exposure-specific settings (e.g. gantry tilt)
(normally in the bottom left corner)
o Hospital/System information
(normally in the top right corner)
o Scale (on the right edge)

It depends on the configuration settings whether or not the orientation descrip-

tion is displayed.
(› Page 159)

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Setting views in the volume data set 0

Three-dimensional image processing allows you to create images in any orienta-

tions and positions within the data volume. You "move" through the volume and
can rotate it in any direction. Depending on the method you are using, various
aids are available to you.

Using the 3D cross hairs 0

The continuous lines of the cross hairs (reference lines) indicate the position of
two slice planes that are perpendicular to each other in the standard view
(the lines represent the cut lines). The two planes are displayed in the other two
reference segments.

The arrows indicate the viewing direction from which you view a plane (shown in
the other image segments).
Broken lines indicate planes that are not perpendicular to the view displayed.

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Moving reference lines You can now move through the views of the reference segments in any direction
using the lines.
u Click on a line and move it holding the left mouse button down.
Or
u Click on the intersection of the lines to move both lines at the same time.
As an alternative, you can move the reference lines to a target position in jumps
by mouse click.
u Click a line to select it and then click the target position with the left mouse
button.
The reference line is moved there immediately.

Or
u Select the entire reference image and click the target position with the left
mouse button (no reference line selected).
Both lines are moved in such a way that the intersection is now at the position
you clicked.

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Rotating using the You can change the view in a reference segment by rotating the corresponding
cross hairs line of the cross hairs in one of the other two segments.
To rotate the reference lines, you must activate Free Mode.
u Click the Free Mode button.
– The angles between the reference lines are no longer fixed.

u Rotate the required line about the displayed center of rotation.

In this way, you create oblique planes (only one line is oblique) or double-oblique
planes (both lines are oblique).
Deactivate Free Mode to fix the angles again:
u Click the Free Mode button.

Scrolling with the dog ears 0

When you have set the MPR output type, you will see dog ears in the top right-
hand corner of the reference segments.
Using the dog ears, you can move through the volume forward or backward slice
by slice. The corresponding line of the cross hairs in another segment moves in
parallel.

(2)

(1)

(1) Scroll backwards

(2) Scroll forwards

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Rotating the volume with the mouse 0

You can also create oblique and double-oblique images by rotating the image dis-
play in one of the segments with the mouse.
u Click the button in the upper part of the control area.
u When you position the mouse cursor on the segment, the cursor changes
shape.

u Move the mouse cursor keeping the left mouse button pressed down.
o Moving the mouse up or down tilts the object.
o Moving the mouse left or right rotates the object.
o A diagonal mouse movement results in a combined rotation and tilt move-
ment.

If the Zoom/Pan mode is activated, you have to deactivate it first.

Rotating about one axis (oblique cut planes) 0

For oblique slices, you rotate a slice around one axis of the patient coordinate sys-
tem starting from the standard view.
The orientation is displayed in the image as a combination of two orientation la-
bels. This designation is comparable with the designations used on a compass,
e.g. NW for north-west.
One of the two reference lines in the image is now dotted. The corresponding
plane is therefore oblique in relation to the displayed image.
For each standard view, there are two different directions of rotation (about an
axis), each of which are explained graphically in the following examples.

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Transversal slice You can rotate a transversal slice toward the coronal or sagittal plane:
o Rotation of the transversal slice toward the sagittal slice (left example)
o Rotation of the transversal slice toward the coronal slice (right example)

H
Sag Tra Sag Tra

Cor Cor

L F
L

ARF AFR

RFP RHA

Depending on the direction of rotation, further combinations of orientation labels

are displayed, e.g. RFP, ARF, RHA or AFR.

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Coronal slice You can rotate a coronal slice toward the transversal or sagittal plane:
o Rotation of the coronal slice toward the transversal slice (left example)
o Rotation of the coronal slice toward the sagittal slice (right example)

A A
Sag Tra Sag Tra

R H R H
Cor Cor

HAR HLP

RPF RAH

Depending on the direction of rotation, other combinations of orientation labels

such as RPF, HAR, RAH or HLP can result.

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Sagittal slice You can rotate a sagittal slice toward the transversal or coronal plane:
o Rotation of the sagittal slice toward the transversal slice (left example)
o Rotation of the sagittal slice toward the coronal slice (right example)

A A Tra
Sag Tra Sag

H
Cor Cor
L

RHA HRP

ALF ARF

Depending on the direction of rotation, other combinations of orientation labels

such as ALF, RHA, ARF or HRP can also result.

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Rotating about two axes (double-oblique cut planes) 0

You obtain cut planes in two axes whenever you rotate one slice around two dif-
ferent patient coordinate axes one after the other. The plane is then no longer
perpendicular to either of the coordinate axes. The image orientation is displayed
as a combination of three orientation labels.

A (1) (2) A
Sag Tra Sag Tra

H H

Cor Cor

(3)
HRP

ARF

(1) Rotation of the sagittal slice toward the transversal slice (left example)
(2) Rotation of the sagittal/transversal slice toward coronal (right example)
(3) Resulting view

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Controlling image orientation 0

If you rotate the image in a reference segment, the viewing angle changes.
To make orientation easier for you in such images, orientation markers are dis-
played in the images.
(› Page 39)

Preferred directions The program also uses the following preferred directions for image orientation/
rotation within the selected cut plane:

A
A HH HH

RR AA RR

(1) (2) (3)

(1) In a predominantly transversal view, the front side is at the top (orientation
mark A at the top). The viewing direction is towards the head (orientation
cube shows F, since "feet" are at the front).
(2) In a predominantly sagittal view, the front of the patient is on the left
(orientation label A is on the left) and the head at the top (orientation label H
is at the top).
(3) In a predominantly coronal view the head of the patient is at the top
(orientation label H is at the top) and the right side of the patient is on the left
side in the image (orientation label R is on the left).

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Automatic orientation If you rotate and tip an image from the sagittal plane towards the transversal
control plane, for example, you will eventually find yourself in the transversal view.
The program then rotates the image by another 90° to display it in a preferred
direction again.

ARF

ARF

u Click the Orientation Control button in the upper part of the control area.

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Setting standard views 0

The standard views are used as a starting point for processing images on the
3D task card.
You can set views for individual segments independently. For example, you can
select a different view for each segment or define the same view in all segments.

Transversal view
In the transversal view, you view the slice images of the patient perpendicular to
the patient axis (axis that runs from the head to the feet of the patient).
Your viewing direction is therefore from top to bottom or from bottom to top,
i.e. cranio-caudal or caudo-cranial.

u Call up Orientation > Head to Feet, or click the button on the Orientation
subtask card.
The viewing direction changes to transverse, cranio > caudal, that is, from the
head to the feet.

Or
u Call up Orientation > Feet to Head or click the button on the Orientation
subtask card.
The viewing direction changes to transverse, caudo > cranial, that is, from the
feet to the head.

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Sagittal view
In the sagittal view, you view the patient from the side (from the left or from the
right).

u Call up Orientation > Left to Right or click the button on the Orientation
subtask card.
The viewing direction changes to sagittal, left > right. You are viewing the patient
from the left side.
Or
u Call up Orientation > Right to Left or click the button on the Orientation
subtask card.
The viewing direction changes to sagittal, right > left. You are now viewing the
patient from the right side.

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Coronal view
In the coronal view, you view the patient from the front or the rear.

u Call up Orientation > Front to Back or click the button on the Orientation
subtask card.
The viewing angle changes to coronal, anterior > posterior. You are now viewing
the patient from the front.
Or
u Call up Orientation > Back to Front or click the button on the Orientation
subtask card.
The viewing angle changes to coronal, posterior > anterior. You are viewing the
patient from the rear.

Restoring the The standard views serve as orientation aids. You can return to the standard view
standard orientation from any other view and start processing again.
u Call up Orientation > Reset to restore the view set at the beginning of pro-
cessing (only possible in reference mode).
— Or —
u Click the Default Orientation button on the Orientation subtask card.

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Fixing the angle 0

As soon as you have set the views to a particular viewing angle, you can fix the
angles. After that, it is no longer possible to rotate the reference lines. They can
only be moved.
u Click this button in the upper control area to deactivate Free Mode.
– The angles are fixed.

Setting orthogonal If you want all the images of the three reference segments to be at right angles
views to each other, select the Free Mode option.
u Click the Default button.
– All views are now perpendicular to each other in the standard view.

u Deactivate the Free Mode button to fix the right angles.

– Now the angles between the reference lines remain constant. The refer-
ence lines now show the standard view.

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View perpendicular to Usually, you activate the orthogonal view to display slices along the main axis,
the reference image e.g. of a bone. In order to do this, you first set the viewing direction in the refer-
(Ortho Sync) ence image.
u Call up Orientation > Ortho Sync.
— Or —
u Click this button on the Orientation subtask card (only possible in reference
mode).
– Now the other reference segments show views that are perpendicular to
the reference image, in the example below the top left-hand image.

These images do not necessarily have to be perpendicular to the patient coordi-

nate system.

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Defining output types 0

You can change the output type for any segment at any time, i.e. from multiplanar
reconstruction (MPR) to surface shaded display (SSD).
Depending on your working method, you will first generate a reference image,
e.g. in MPR, in the desired view and then switch to SSD display.
u Click on the segment for which you want to change the output type.

If you want to switch over all segments, you must select these individually and
then switch them over one after the other.

Setting MPR 0

Using multiplanar reconstruction, you can generate slice images in a view and po-
sition that you define in the volume data set.
u Select Type > MPR or click the MPR button on the Type subtask card.
Or
Transfer the images directly from the Patient Browser or the Viewing task card
to MPR mode:
u To do this, select Applications > 3D > MPR.
— Or —
u In the Patient Browser, double-click the MPR button.

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Setting SSD 0

After you have generated a reference image, you can also generate a surface
structure in this view.
u Select Type > SSD or click the SSD button on the Type subtask card.

A surface view is generated in the selected segment. Your system uses

modality-specific default grayscale values as threshold values to extract the
surface.
Or
Transfer the images directly from the Patient Browser or the Viewing task card
to SSD mode:
u To do this, select Applications > 3D > SSD.

You can display complete volume data sets in the SSD display.

Setting VRT 0

Using the Volume Rendering Technique you can create true color images in
which the entire volume data set is shown. The VRT display delivers the most
comprehensive information about the volume data set examined.
u Select Type > VRT or click the VRT button on the Type subtask card.

A three-dimensional is generated in the selected segment. Preset parameter sets

from the VRT Gallery are used for the display.
Or
Transfer the images directly from the Patient Browser or the Viewing task card
to VRT mode:
u To do this, select Applications > 3D > VRT.

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3D task card with mixed output types 0

In each of the three reference segments you can set any output type indepen-
dently.

(1)

(2)

(1) MPR Image

(2) SSD Image

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Free View 0

With Free View you can isolate the volume data set by clip planes and the clip
box and in that way hide the area you do not require. You can switch over be-
tween the VRT and SSD filters.

Calling up Free View

u Select Settings > Free View in the main menu or click this button on the
Settings subtask card.
Or
u Select the images in the Patient Browser and select
Applications > 3D > VRT to load them into the "Free View".
The volume is displayed in "Free View" mode in the bottom right segment.

(1) Reference segments (MPR)

(2) Free view segments (VRT)

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Orientation aid In the Free View segment, auxiliary lines are shown as an orientation aid for your
interactions. The clip box surrounds the entire displayed volume, the clip planes
indicate the position of the defined intersection plane.

(1) Clip box

(2) Clip plane
(3) Clip Plane Slab Mode button

To hide the auxiliary lines, select Edit > Hide Clip Plane Graphics.

Changing the You can rotate, pan and zoom the volume displayed in the Free View segment
volume display using the standard tools.
(› Page 42, › Page 65).

Rotating a slice plane u In the main menu, select Orientation > Rotate Clip Plane or activate this op-
tion via Smart Select.
u Rotate the clip plane in the image with the left mouse button pressed.

Pushing/pulling a u In the main menu, select Orientation > Push/Pull Clip Plane or activate this
clip plane/ option via Smart Select.
combined action
u Move the mouse cursor as follows, keeping the left mouse button pressed:
– Within the clip plane for pushing/pulling the clip plane.
– At the edge of the inner area of the clip plane for rotating the clip plane.
– Outside the clip plane for rotating the object.

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Changing the You can define the thickness of the volume displayed by entering a value for the
clip plane distance distance of the clip planes.
u Select Settings > Clip Plane Definition in the main menu or, using the right
mouse button, click this button on the Settings subtask card.
– The 3D: Clip Plane Definition dialog box is displayed.

u Enter the distance in mm and confirm with OK.

With Set as default you can save the value displayed as a default setting.
This clip plane distance will then be used when a new data set is loaded.

Displaying one/two u Select Settings > Clip Plane to activate or deactivate the clip planes.
clip planes
u Select Settings > Clip Plane Slab Mode to show one or two parallel clip
planes.
— Or —
u Click this icon button in the Free View segment to toggle between one or two
clip planes.

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Selecting and processing images 0

After you have transferred a volume data set to the 3D task card, you can opti-
mize the display of the images in the segments.
You can adapt the window values of the loaded images. You can enlarge seg-
ments and display regions of interest in the center of the screen.

Selecting images 0

You must first select the images or graphics that you want to process.
On the 3D task card, a distinction is made between images that are displayed in
the reference segments and series that are located in the output segment.

Selecting the In a reference segment, you can only ever select one reference image.
reference segment
u Click the image that you want to process with the left mouse button.
– The segment is now displayed with a thick border.

Windowing images 0

For details about windowing also refer to

(› Register 6: Image Processing, Page 34).

Assigning stored In the 3D task card, you can assign stored window values to the images:
values
u Click the Window 1 or Window 2 button on the Image subtask card of the
control area.

Defining the scope In the default setting, all images of the same output type, e.g. MPR, are assigned
of action the same window values.
If you want to assign window values only to individual images, activate the
Single Windowing option.
u Select/deselect Image > Single Windowing to activate/deactivate single
windowing.

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Zooming and panning images 0

u Click on this button in the control area.

– Zoom/pan mode is activated.

Zoom image u Position the mouse pointer near the image edge.
u Drag the mouse up or down to zoom the image, holding the left mouse button
pressed.

Pan image u Place the mouse pointer in the center of the image.
u Drag the image to the required position, holding the left mouse button
pressed.

Reset Reset the view to its original size and position:

u Click this button in the control area.

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Generating series from 3D images 0

In most cases, the result of your 3D evaluation will be the reconstruction of entire
series (ranges) of images. To do that, first select a reference image in the view
that you require. Depending on the output type you are using, the following op-
tions will be available to you:

Parallel ranges With this option you generate slice images that are parallel to one another and
perpendicular to the reference image for the MPR, MPR Thick and VRT Thin
output types.

(1) Volume data set

(2) Reference image
(3) Parallel slice images
(4) Volume used projection (VRT Thin, MPR Thick)
(5) Direction of projection (VRT Thin, MPR Thick)

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Radial ranges For the MPR, MPR Thick and VRT Thin output types you generate a series of slice
images arranged in a star shape. For the SSD and VRT output types you generate
a series of projections and views of the volume each rotated around a
defined angle.

(1) Volume data set

(2) Reference image
(3) Radial slice images

Curved ranges With this option you generate series of parallel curved slice images for the MPR
and MPR Thick output types.

(1) Volume data set

(2) Reference image
(3) Curved slice images

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Expanded ranges With this option you generate slice images that are located in front or behind the
reference image. This option is also available for the MPR, MPR Thick and
VRT Thin output types.

(1) Volume data set

(2) Area in front of the reference image
(3) Reference image
(4) Area behind the reference image

Generating parallel slice images 0

To generate a parallel range, you generate images that are parallel and a defined
distance apart, and perpendicular to the reference image. This is equivalent to a
step-by-step offset of a reference line of the 3D cross hairs.
u Select a continuous reference line to define the position of the reconstructed
images with that line.

The reference line you select represents an image in one of the other two refer-
ence segments. This image must be of the required output type, i.e. MPR.
(› Page 43)
Or
u Select a broken reference line or a reference image to generate a series
whose slice planes are horizontal in the center of the reference image and per-
pendicular to the reference image.
u Select Settings > Parallel Ranges or click the Parallel Ranges button on the
Settings subtask card.

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Graphic display of the In the selected reference segment, the positions of the parallel slice images to
new series be reconstructed are shown graphically. The slice image of the selected refer-
ence line (preview) is displayed in the output segment.
The lines in the output segment show the position of the individual images.
The arrows indicate the viewing direction.

(4)

(4)

(3) (2) (1)

(1) End line

(2) Reference line
(3) Start line (marked by arrows)
(4) Arrows indicate the viewing direction

If the series consists of many images, not all the lines are displayed in the graphic.
Here, the interior lines are displayed darker.

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Parallel Ranges The Parallel Ranges dialog is displayed.

dialog box

Changing a range
numerically
u Enter the slice thickness of the result images and press the Enter key.
Also refer to (› Page 102).

u Enter the distance between the individual images and press the Enter key.

u Enter the number of parallel slice images and press the Enter key.

Generate at least three images.

u If you want to generate a series (range) with horizontal clip planes, click this
button.
Or
u If you want to generate a series (range) with vertical clip planes, click this
button.

u To reverse the image numbering of the series, click this button.

The graphic display of the series on the reference segment changes according to
your settings. A new preview image is reconstructed in the output segment.

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Changing the range You can also increase or reduce the area of a series calculation by moving the
with the mouse start line or end line with the mouse. The image that corresponds to the line you
have just processed is displayed in the output segment.
u Click on the start or end line and move the line while holding the left mouse
button down.
– The number of images changes accordingly (is increased or decreased).
The distance between the slices remains the same.
Or
u Click this button to move the start line or end line with the mouse.
– The distance between the cut images changes accordingly (is increased or
decreased). The number of images remains the same.

The values in the Parallel Ranges dialog box change automatically to reflect the
changes made to the graphical display.
u Move the entire range by moving the rotation point of the reference line with
the mouse.
u Rotate the entire range by moving the reference line around the rotation point
with the mouse.

Starting If all the settings are as you require them, start with the reconstruction:
reconstruction
u Click Start.
– A progress bar shows how many of the planned images are already gener-
ated. Every newly calculated image is shown in the output segment.

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Canceling You can cancel reconstruction at any time.

reconstruction
u Click Cancel in the progress box.
– All the images already reconstructed are displayed in the output segment.

If the Enable auto-save function is activated, all the images already reconstruct-
ed are stored in the case of cancellation.
(› Page 160)

Ending After reconstruction has been completed, the last image of the range (the image
reconstruction of the end line) is displayed in the output segment.

An image number is automatically assigned to each image of the series.

u To view the images of the series, scroll with the dog-ears through the
image stack.
If the new series is as you require it:
u Store the new series.
(› Page 87)

If the Enable auto-save function is active, the series is automatically stored.

(› Page 160)
u Click Close to return to the reference mode.

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If you have not stored the reconstructed series, the following dialog box is
displayed:

u If you want to reject the series, click Yes.

– The Parallel Ranges dialog box is closed.
Or
u If you want to process or store the series, click No.

Postprocessing series If the reconstructed range of the series is not as you require it, you can adapt it
of parallel images either graphically or in the Parallel Ranges dialog box.

If you generate a new series by changing the values, a query appears asking
whether you want to store or reject the old series.

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Generating radial images 0

Radial slice images are generated so that a range can be viewed from different
angles. In this way, you simulate step-by-step rotation of a reference line.
Depending on the angle, a number of slice images are generated from the vol-
ume data set.
u Select a broken reference line or a reference image to generate a series
whose intersection plane covers a quadrant in the reference image and is per-
pendicular to the reference image.
(› Page 41)

The selected reference line represents an image in one of the other two refer-
ence segments. This image must be of the required output type, i.e. MPR.
How to generate series of radial projections (SSD) is described under:
(› Page 79)

Or
u Select a continuous reference line to define the position of the reconstructed
images with the reference line.
u Select Settings > Radial Ranges or click the Radial Ranges button on the
Settings subtask card.

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Graphic display of the The radial slices are displayed as lines in the reference segment. The lines have
radial series a common point of intersection and are arranged with a constant angle between
them (default 22.5°).
The image of the reference line is reconstructed and displayed in the output seg-
ment. The direction of viewing of the resulting images is indicated by the arrows
in the reference segment.

(1)

(2)

(3)
(4) (4)

(1) End line

(2) Reference line
(3) Start line (marked by arrows)
(4) Viewing direction arrow

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Radial Ranges The Radial Ranges dialog box is displayed.

dialog box

The settings you first see are the default settings. You can change them accord-
ing to your requirements.

Changing a range
numerically

u Enter the original slice thickness and press the Enter key.

u Enter the required angle between the images and press the Enter key.
– The position of the start line and end line remains unchanged. If you enter a
new angle between the images, the number of images is changed accord-
ingly.

u Using the spin buttons, set a new number of images to be reconstructed and
press the Enter key.
– The angle between the images changes accordingly.

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Changing the range u Place the mouse cursor on the start line, the center line, or the end line.
with the mouse
u Rotate the selected line around the rotation point while keeping the mouse
button pressed.
– By rotating the center line you also rotate all the other lines around the rota-
tion point. Rotating the start line and end line changes the angle of aper-
ture.

If you rotate the start line over the end line, angle measurement restarts
at 0° again.

Or
u Move the entire range by moving the point of rotation with the mouse button
pressed.
The image that corresponds to the line you have just processed is displayed in
the output segment. The values in the Radial Ranges dialog box change in ac-
cordance with the changes made to the graphic display.

If you change the range by rotating the start or end line, the number of images
remains constant. Only the angle between the images changes.

Starting
reconstruction

u Click Start to start reconstruction of the range.

– A message box shows the progress of reconstruction and allows you to
cancel reconstruction.
– The reconstructed images are displayed as a stack of images in the output
segment. The upper image corresponds to the end line in the graphical dis-
play.
u To view the images of the series, scroll with the dog-ears through the
image stack.

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If the new series is as you require it:

u Store the new series.
(› Page 87)

If the Enable auto-save function is active, the series is automatically stored.

(› Page 160)
u Click Close to return to the reference mode.
If you have not stored the reconstructed series, the following dialog box is dis-
played:

u If you want to reject the series, click Yes.

– The Parallel Ranges dialog box is closed.
Or
u If you want to process or store the series, click No.

Postprocessing a You can rotate the start and end line of a range in order to change the range and
radial range the angle between the result images.

If you generate a new series by changing the values, a query appears asking
whether you want to store or reject the old series.

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Series of radial projections and views 0

For the SSD output type you do not reconstruct slice images, but series of pro-
jections and view.

Defining viewing The future position of the projections/views is displayed graphically by projection
directions arrows on the reference image. The reconstructed images are at right angles to
these arrows. The arrows therefore indicate the direction from which you view
the projection. You can define the orientation of these arrows as follows:
u Select a broken reference line or a reference image.
The projections of the series describe a quadrant (first or second quadrant) within
the reference image.
Or
u Select a continuous reference line in your reference image to define the direc-
tion of viewing graphically.

The reference line you select represents an image in one of the other two refer-
ence segments. This image must be of the required output type, i.e. SSD.
The selected reference line is at right angles to the center projection arrow of the
series graphics. All other projections are obtained by rotating this reference line
clockwise or counterclockwise.

Setting radial You can generate radial projections in radial range mode in the same way as radial
projections and views slice images in the MPR output type. The images of this series simulate
step-by-step rotation of a reference line.
u Select Settings > Radial Ranges or click the Radial Ranges button on the
Settings subtask card.
– The range of the new series is marked in the reference image. The arrows
indicate the direction of the projections.

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(1) Rotation point

(2) Start arrow (double arrow)
(3) End arrow

Radial Ranges The Radial Ranges dialog box is displayed.

dialog box

With the exception of the slice thickness, you now select all other settings for the
radial series in the Radial Ranges dialog box or with the mouse in the reference
image as you do for the reconstruction of radial cuts.
(› Page 74)

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Generating curved ranges 0

In a series of parallel curved slices you generate images that are parallel and a
defined distance apart.
u Select a segment.

The image displayed in the segment must be of the required output type,
i.e. MPR or MPR Thick.
u Select Settings > Curved Ranges or click the Curved Ranges button on the
Settings subtask card.
– The mouse cursor changes shape.
u Draw a reference line by double-clicking the left mouse button and keeping it
pressed.
In the selected reference segment, the positions of the parallel curved slice im-
ages to be reconstructed are shown graphically. The slice image of the selected
reference line (preview) is displayed in the output segment.

Graphic display of the The lines in the output segment show the position of the individual images.
radial series

(1) Start line (identified as number 1)

(2) Reference line
(3) End line
(4) Image numbers in a series
(5) Distance and thickness

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3D: Curved Ranges The 3D: Curved Ranges dialog box is displayed.
dialog box

The settings you first see are the default settings. You can change them accord-
ing to your requirements.

Changing a range
numerically
u Enter the slice thickness of the result images and press the Enter key.
Also refer to (› Page 102)

u Enter the distance between the individual images and press the Enter key.

u Enter the number of parallel slice images and press the Enter key.

Generate at least three images.

u To reverse the image numbering of the series, click this button.

The graphic display of the series on the reference segment changes according to
your settings. A new preview image is reconstructed in the output segment.

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Changing the range You can also increase or reduce the area of a series calculation by moving the
with the mouse start line or end line with the mouse. The image that corresponds to the line you
have just processed is displayed in the output segment.
u Click on the start or end line and move the line while holding the left mouse
button down.
– The number of images changes accordingly (is increased or decreased).
The distance between the slices remains the same.
Or
u Click this button to move the start line or end line with the mouse.
– The distance between the cut images changes accordingly (is increased or
decreased). The number of images remains the same.

The values in the 3D: Curved Ranges dialog box change automatically according
to the changes made to the graphic display.
u Move the entire range by moving the rotation point of the reference line with
the mouse.

Starting If all the settings are as you require them, start with the reconstruction:
reconstruction
u Click Start.
– A progress bar shows how many of the planned images are already gener-
ated. Every newly calculated image is shown in the output segment.

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Canceling You can cancel reconstruction at any time.

reconstruction
u Click Cancel in the progress box.
– All the images already reconstructed are displayed in the output segment.

If the Enable auto-save function is activated, all the images already reconstruct-
ed are stored in the case of cancellation.
(› Page 160)

Ending After reconstruction has been completed, the last image of the range (the image
reconstruction of the end line) is displayed in the output segment.

An image number is automatically assigned to each image of the series.

u To view the images of the series, scroll with the dog-ears through the
image stack.
If the new series is as you require it:
u Store the new series.
(› Page 87)

If the Enable auto-save function is active, the series is automatically stored.

(› Page 160)
u Click Close to return to the reference mode.

Postprocessing series If the reconstructed range of the series is not as you require it, you can adapt it
of curved slices either graphically or in the Curved Ranges dialog box.

If you generate a new series by changing the values, a query appears asking
whether you want to store or reject the old series.

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Generating expanded ranges 0

With the Expanded Ranges option you can generate a series of images that are
located in front of or behind the reference image. This simulates scrolling with the
dog ear.
u First, select a reference image that contains the view of your choice.

The image displayed in the segment must be of the required output type,
i.e. MPR, MPR Thick or VRT Thin.
u Select Settings > Expanded Ranges.
The preview image of the expanded range is shown in the output segment.
The 3D cross hairs in the reference segment are now hidden.

3D: Expand Ranges The 3D: Expand Ranges dialog box is displayed.
dialog box

Changing range

u Enter the slice thickness of the result images (only with MPR Thick and
VRT Thin) and press the Enter key.

u Enter the distance between the individual images and press the Enter key.

u Enter the number of parallel slice images and press the Enter key.
The new reference image is shown in the output segment.

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Starting
reconstruction
u Click Start.
– The images of an expanded series are displayed in the output segment.
They are parallel to the reference image. The last image of the series is
shown.
u Use the dog ears in the top right corner of the reference segment to scroll
within the series.
If you want to change the range, you have to enter new values in the
3D: Expand Ranges dialog box.

Ending If the new series is as you require it:

reconstruction
u Store the new series.
(› Page 87)

If the Enable auto-save function is active, the series is automatically stored.

(› Page 160)
u Click Close to return to the reference mode.

Postprocessing If the range does not yet have the required views, change the range settings in
expanded ranges the 3D: Expand Ranges dialog box and then perform the reconstruction again.

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Saving 3D series and images 0

Once you have generated a new series of parallel or radial slice images or projec-
tions in the 3D task card, you can save them for documentation.
You can either store the images quickly in a series that already exists or store the
images in new series.

In 3D Configuration, you can set whether you also want to store the reference
image of a series or not.
(› Page 160)
In 3D Configuration you can also have reconstructed series stored automatically
as new series.
(› Page 160)

Saving images and series quickly 0

You can add individual images or your new series quickly and without comments
to the existing images of a study.
You save the images under the patient's name in the loaded series.
u Click on the output segment and select an image, several images or an entire
series.
u Select Patient > Save or click the Save button in the bottom part of the
control area.

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Saving individual images as a new series 0

As an alternative, you can also group newly generated images in 3D and save
them with a comment in your main database. This makes it easier to find these
images later.
u Select an image in a reference segment or one or more images in the output
segment.
u Select Patient > Save As... or click the Save As... button.
– The Save As dialog box is displayed.

Image information The following information is displayed in the upper part of the dialog box:
o Patient name
o Imaging method (modality)
o Exam date
o Number of images
o 3D output type (MPR, MPR Thick, MPR Curved, SSD)
This information is saved together with the series.

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Reading physician

u Enter the name of the physician to whom you want to provide the series of a
patient.

Comments You can comment on a series. These comments are then saved together with the
images.

u Enter a comment text.

The input field contains a default comment text which is the comment saved to-
gether with the original images. If various original images had different com-
ments, then there will be no default comment text.

Saving images in If you want to save all the images that you generate from a set of volume data in
a series one series, select the Save all images in one series option.
All the images are now saved in your main database under the same series name,
regardless of the 3D output type they were generated with (MPR, MPR Thick,
MPR Curved or SSD).

u Click the Save all images in one series option.

u Enter a series name or select a name from the selection list.
Every time you generate and save images in 3D from your original data set, they
are appended to the series entered here.

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Grouping images by If you generate images with different output types (MPR, MPR Thick,
output type MPR Curved or SSD) when processing your original data set, you can save these
images in your database sorted by output type.

u Click the Group all images by type option.

u Enter a series name or select a name from the selection list.
All images that you generate from this original data set are now saved under this
series name and output type.

If you generate entire series of images, these will still always be saved with a dif-
ferent series name.

Example You enter "Name" as the series name for your grouped single images. You then
save 1 SSD image, 2 MPR images, 1 MPR Thick image, 1 MPR image, and again
1 SSD image in this sequence.
You thus generate 3 series:

1.

2.

3.

4.

5.

(1) "Name" SSD Collection

(2) "Name" MPR Collection
(3) "Name" MPR Thick Collection
u Save your series by clicking on OK.
Or
u Reject your inputs by clicking on Cancel.

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Transferring 3D images 0

Filming 3D images 0

u To copy the selected image to the film sheet, click this button in the lower part
of the control area.
Depending on the selected film layout, the images are transferred directly to the
camera or to the printer. Or they remain on the Filming task card for processing
until you manually send the images to the camera or printer.
(› Register 8: Documentation)

In 3D Configuration you define whether you want to additionally film the refer-
ence image of a series or not.
(› Page 161)

Transferring images to the Viewing task card 0

u To load the images pertaining to the 3D scan into the Viewing task card, click
this button in the lower part of the control area.

Ending 3D evaluation 0

u Click this button in the bottom part of the control area to close the patient.
– The images of the patient are unloaded from the 3D task card.

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Particularities with 3D multi-monitor 0

The 3D multi-monitor option allows you to use two monitors for image display:
o When you are working with a single data set, the content of the output seg-
ment (in the case of a system with only one monitor, the fourth segment) is
shown in full screen (Blow Up) mode on the second monitor.
o In addition, a special Compare mode allows the display of two aligned data
sets with one data set displayed on each monitor. This allows you to compare
pre- and post-studies or contrast and native images, for example.

For the Fusion option only one monitor is used; no data are displayed on the
second monitor.

Monitor display 0

On the first monitor the 3D task card is shown as described.

(› Page 24)
The second monitor has a widescreen layout, i.e. the function and status area as
well as the patient folder are not shown.

3D Blow Up mode If only one data set was loaded, the first monitor generally shows 3 MPR images.
On the second monitor, a projected volume image (here: Free View) may be
shown.

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Compare mode If data sets of one or two patients from the same modality are loaded at the same
time, the Compare mode is used. Each monitor shows a data set.
The data sets are correlated, i.e. an action performed on one data set affects the
other data set.

Task card in the It may occur that the 3D task card appears in the foreground on one monitor and
background in the background on the second monitor.
u In this case, click the tab of one of the two 3D task cards.
– Both 3D task cards will then be shown in the foreground.

As long as at least one 3D task card is displayed, no 3D dialog (e.g. Series List)
is hidden. If necessary, a 3D dialog box is displayed above the tab of another ap-
plication. In order to exclude any doubts in the assignment, "3D" appears in the
title of all 3D dialogs.

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Charging performance 0

Depending on the selection and the current "fill status" of the 3D task card
(e.g. empty or series already loaded), the 3D display is started in different modes.

A data set The 3D task card is empty. You can select a series in the Patient Browser, in the
Viewing task card or in the 3D Series List as usual.
If you load the images via the 3D MPR button or the MPR, SSD or VRT entries
in the Application > 3D menu, the 3D Blow Up mode is started.

Second series One series has already been loaded into the 3D task card. You now select a sec-
ond series. If you load the images into the Fusion option, the Fusion mode is
started (only on the first monitor).

Two series The 3D task card is empty. You select two data sets from the same modality of
simultaneously one or two patients. If you load the images via the 3D MPR button or the MPR,
SSD or VRT entries in the Application > 3D menu, the Compare mode is start-
ed. In the 3D display the data sets are correlated, i.e. an action performed on one
data set affects the other data set.

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Loading series in Compare mode 0

u Select two suitable data sets from the same modality in the Patient Browser
or the Viewing task card and load them into 3D.
– If two suitable series of a patient were selected, the Compare mode starts
with automatic registration (› Page 96).
– If the two series belong to different patients, a warning message is dis-
played (› Page 96).
– If the data selection is ambiguous, the 3D Series List is displayed.

3D Series list The 3D Series List dialog box shows the data to be loaded.

(1) List of patients

Patient data relating to the loaded series. The currently selected patient is
shown bright.
(2) Series suitable for 3D display (Valid Series). Series of the currently selected
patient are shown bright. The currently selected series is shown dark. Series
that can be loaded into 3D together with the selected series are highlighted
by blue font.
(3) Series unsuitable for 3D display (Invalid Series). Series of the currently select-
ed patient are shown bright.
u Choose two valid series in the 3D Series List and click Select.

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Two patients selected If two data sets of different patients from the same modality were loaded, a
warning message is displayed.

Caution
Unintentional loading of series of different patients in the 3D Compare mode.
Mix-up of patients and incorrect diagnoses possible!
u Check if you have selected the correct data sets before acknowledging the
warning message.

Automatic start As soon as you have loaded two matching image series into the Viewing task
registration card, the Compare mode is started. The younger data set is shown on the first
monitor.
After loading, a first automatic registration takes place, i.e. the series on the sec-
ond monitor is automatically spatially aligned with the series loaded in the first
monitor. If a registration mask already exists, this mask will be used.

Caution
The automatic registration for the comparison layout may be insufficient.
Insufficient basis for diagnosis!
u Check the registration and, if necessary, use manual registration, if the auto-
matic registration is insufficient.

Manual registration Before starting manual registration, display the two data sets such that the inter-
esting anatomical or pathological structure is visible in the first data set (this struc-
ture is, of course, not shown in the pertinent second data set). In the manual
registration you can then adapt the second data set independently of the first
data set such that it shows the same structure.
u Select Image > Compare Mode Registration.

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The 3D: Compare Mode Registration window is displayed.

u Deactivate the automatic registration via this button.

– For the segments the mode for manual alignment is activated.
u Adapt the display of a data set by scrolling and rotating such that the same
relevant anatomical or pathological structure can be seen as on the images of
the other data set.
u Click Register.
u If necessary, save the new matrix under a new name and confirm with OK.
– You have thus created a new registration, which you can now call up
and use.

Changed automatic The manual registration can be overwritten with a new automatic registration.
registration
u Activate the automatic registration via this button in the 3D: Compare Mode
Registration window.
u Select Precise registration for a very precise alignment or Fast registration
for a fast alignment.
u Click Register.

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Working in the Compare mode 0

Following an automatic registration and possible manual corrections, both data

sets are correlated. This means that an action performed on the first data set will
also be performed on the second data set.
The following actions are supported by correlated data sets on both monitors:
o Rotating MPRs
o Zoom/Pan
o Interactive scrolling
o Free View
o Blow Up segment
Two correlated mouse pointers are shown. The two pointers have different col-
ors so that the active pointer (white) and the correlated pointer (yellow) can be
distinguished from one another. With the active pointer you can manipulate the
data set in a segment while the yellow pointer is shown in the associated second
segment.

If you switch modes on one monitor and then select a segment in the second
monitor, the message "Do you want to end the current mode?" is displayed.
This message must be acknowledged.

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3D option

Multiplanar Reconstruction (MPR) 0

With MultiPlanar Reconstruction you can calculate secondary images of any

planes from the volume, for example sagittal, coronal, or any curved views.
You can reconstruct both single images and series of images.

(1) Transversal/axial
(2) Coronal
(3) Paraxial
(4) Sagittal
(5) Paraxial
(6) Sagittal
In MPR, two-dimensional images are reconstructed from the "volume". However,
you can move through the representation quickly using the 3D cross hairs or the
mouse to gain a three-dimensional impression.
The smaller the distance between the slices or the larger the degree of overlap
of the original images, the greater the resolution in the examination direction.

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The minimum slice thickness of an MPR image is one voxel. But you can gener-
ate thicker slices (MPR Thick). The mean grayscale values are calculated for vox-
els located one behind the other.

(1) MPR slice (1 voxel slice thickness)

(2) MPR Thick (slice thickness can be set)
In multiplanar reconstruction you can create parallel or radial ranges, or curved
cuts from a selected view.
The multiplanar reconstruction is first displayed in the views that are parallel and
perpendicular to the direction of scanning.
You can then move through the volume using the functions of the 3D task card
such as the 3D cross hairs or the mouse in order to generate the views which are
important for you.

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Transfer as MPR to 3D 0

You transfer a series of images from the Patient Browser, the Viewing task
card or the Series List dialog box to the 3D task card in MPR mode.
(› Page 58)
The 3D task card is shown in MPR mode.

If you had already loaded images onto the 3D task card and have only temporarily
switched back to another application, switch back to 3D by clicking the tab card.
(› Page 32)

Once you have finished processing your first 3D series and saved it, you can load
the next marked series directly from the 3D Series List (Patient > Open Series
List). If the last patient to have been processed is in 3D, a dialog box appears in
which you can specify whether you wish to continue processing or load the new
series.
(› Page 36)

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Changing the slice thickness (MPR Thick) 0

With MPR for thick slices, you can define the thickness of the original slice from
which the image is to be reconstructed. The program calculates an average from
several grayscale values and uses these averages to reconstruct the image.
u Select Type > MPR Thick or click the MPR Thick button on the Type subtask
card to set the MPR Thick output type.

u Select Type > MPR Thickness.

— Or —
u Click with the right mouse key on the MPR Thick button of the Type subtask
card.

u Enter an image thickness (in mm).

u Confirm your entry with OK.

Or
u Click Default to set the same thickness as for the original images.

The default setting is the slice thickness of the input data set.
u Click this button to store your entry as default setting.

The selected setting is applied to all the following MPR Thick reconstructions.
The new slice thickness is not applied until you reconstruct a new series.

The value for MPR image thickness is displayed in the image and always filmed
and saved together with the image.

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Generating series of images 0

The possibility of generating images at any interval and in any direction allows you
to simulate examinations independently of the scanning direction.
You can save images reconstructed in this way as new series and, for example,
transfer them to the Viewing task card for 2D evaluation.

Parallel slice images In this mode, parallel slice images are generated at a defined distance.
The images are perpendicular to the reference image.
u Generate and process series of parallel slice images as described in the
following chapters:
(› Page 68, › Page 73)

Radial slice images The images are arranged radially and at a defined angle to one another.
They are perpendicular to the reference image.
u Generate and process series of radial slice images as described in the
following chapters:
(› Page 74, › Page 78)

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Generating curved cuts 0

If you want to view subareas that cannot be acquired by planar, i.e. flat images,
you can draw a freehand curved cut line. You can then display this cut as a slice
image in the output segment.

(1)

(2)

(1) Working segment

(2) Output segment

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Drawing curves 0

You have already generated a view which is important to you in reference mode.

You can set any output type, e.g. SSD, in the working segment.
u Select the segment that contains your reference image.
u Select Settings > Curved Mode.
— Or —
u Activate Curved Mode by clicking the Curved Mode button on the Settings
subtask card.

The program is in drawing mode and the cursor changes shape.

Polygon curve You can draw a cut line by entering several vertices.
as cut line
u Click into the working segment (selected segment) with the left mouse button
to define the beginning of the cut line.
u Define further points along the cut line by clicking each position at which you
want the direction to change with the left mouse button.
u Finish off the line by double-clicking with the left mouse button.

Drawing a As an alternative, you can also draw structures freehand.

freehand line
u Draw a curve by moving the mouse cursor across the image with the left
mouse button pressed.
u Finish off the freehand line by double-clicking with the left mouse button.

For some applications, it may be necessary to connect a polygon curve with a

freehand line and vice versa.
As long as you have not double-clicked the end point, you can mix the two meth-
ods, polygon curve and freehand line.

The way the image is reconstructed depends on the direction in which the line is
drawn. For example, if you draw the spinal canal starting from the top and moving
downwards, the image you produce is different to the one you produce when you
draw the spinal canal from the bottom to the top (opposite way round).

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Displaying images 0

After you have completed your cut line, a new image is reconstructed in the out-
put segment. In the reference image (working segment), the starting point of this
image is marked by an arrow.

Long cut lines If you have drawn a very long cut line, it might not be possible to display the entire
image in the output segment. Instead, only the first section of the line is used to
generate a slice image. This part is then highlighted in the working segment.
The starting point of the display is marked by an arrow.

Caution
No orientation aids in the image.
Incorrect interpretations!
u The physician conducting the examination is responsible for the professional
and correct interpretation of the reconstructed image.

Moving the u Move the starting point in the working segment to display further sections of
line section the cut line by moving the arrow along the line with the mouse.
A new image is generated. In this way, you can gradually display the entire course
of the structures.

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Moving the entire line Occasionally you might want to move a curved cut line in the working segment
to a new location.
u Place the mouse cursor on the line.
– The mouse cursor changes shape.
u Move the entire line holding the left mouse button down.
– A new image is displayed in the output segment.

Delete a line by pressing the Del key.

The direction in which you have drawn the curve into the working image is shown
by an arrow on the resulting image.

Moving a curve within You can also move the cut line within the volume data set layer by layer by scroll-
the volume using the ing with the dog ear of the working segment.
dog ear
u Click on the outside field of the dog ear to move forwards.
Or
u Click on the inner field of the dog ear to move backwards.

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Surface shaded display (SSD) 0

u Select Type > SSD to switch to SSD mode.

This method allows you to reconstruct surfaces from the examined volumes.
These volumes consist of voxels (volume pixels) whose grayscales are within a
range defined by two limit values, an upper and a lower grayscale limit.
With Orbic 3D, SSD serves for orientation, but cannot be regarded as
a 1:1 representation of the real bone.

(1) Voxels in the SSD image

(2) Foremost surface voxel in the volume data set
The foremost voxel of the volume range that is within a defined grayscale range
is displayed in the SSD image.
You can change the viewing direction in real time with the mouse or 3D cross
hairs. You can also generate series of views from different viewing angles.
You can, for example, cut out any structures to expose areas of special interest.
The grayscales that are shown in the display no longer correspond to the mea-
sured values. They are only intended to create a three-dimensional impression.
A fine distinction in the density of the tissue is no longer possible.
Your system stores commonly used modality-specific defaults as threshold val-
ues for surface extraction in SSD.

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If these defaults are not appropriate for your diagnostic problem, you can adapt
them individually. In this way, you can display the structures of interest to you in
an optimum way.
Analogously to multiplanar reconstruction (MPR), you can generate new radial
ranges on the basis of SSD views and save these images for further processing.

Transferring as SSD to 3D 0

You transfer a series of images from the Patient Browser, the Viewing task
card or the Series List dialog box to the 3D task card in SSD mode.
(› Page 59)
The 3D task card is shown in SSD mode.

If you had already loaded images onto the 3D task card and have only temporarily
switched back to another application, switch back to 3D by clicking the tab card.
(› Page 32)

If you have finished processing your first 3D series and saved it, you can load the
next marked series directly from the 3D Series List (Patient > Open Series
List). If the last patient to have been processed is in 3D, a dialog box appears in
which you can specify whether you wish to continue processing or load the new
series.
(› Page 36)

SSD images only have one window value.

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Once reconstruction has been completed, all segments contain an SSD view in
the set viewing direction.
In each of the three reference segments, an SSD display is shown in the standard
view.

(3)

(1)

(2)

(1) Sagittal view

(2) Transversal view
(3) Coronal view

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SSD reconstruction with changed thresholds 0

If the SSD reconstruction based on the default threshold values in the system is
not appropriate for your diagnostic problem, you can adapt these values. You can
then reconstruct your surface image again.
u Select Type > SSD Definition... to switch to threshold mode.
In all three reference segments, MPR images are displayed. In these images the
ranges lying within the thresholds are highlighted.
The output segment contains an SSD image which is based on the set threshold
values.

(1)

(2)

(1) Highlighted pixels

(2) SSD image

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The SSD Definition dialog box is displayed.

In the SSD Definition dialog box, the preset or last used threshold values are dis-
played for SSD extraction.

u Enter new threshold values in the input fields and confirm with the Enter key.
Or

u Set the required threshold values with the mouse by changing the width
(left⁄right handle) and position (center handle) of the slider.
The threshold values entered are applied to the displays in the reference seg-
ments.

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Light source You can set a light source to obtain a better display of the surface condition of
anatomical structures.
Click this button.
– The Light Source Definition - SSD dialog box is opened.
– An arrow is shown in the selected segment which indicates the direction of
the light source.

u Move the arrow with the mouse to change the direction of the light source.
u Use the sliders to set the required ambient light, diffuse reflection, specular
reflection, and shininess.

u Click this check box to set a double-sided light source.

The 2 light sources are identical in all parameters except that they shine from op-
posite directions.
u If you want to restore the original direction of the arrow, click this button.

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The direction of the light source does not change when the image is rotated or
shifted.

u Click OK to apply the settings and close the Light Source Definition - SSD
dialog box.

Returning to If the new surface display is as you require it, close the SSD Definition dialog
reference mode box and return to reference mode.
u Click Close.
In reference mode, all reference segments are shown as they were last saved
before you started threshold mode.
Now select SSD as the output type for one of these reference segments.
You can see a surface shaded image based on your new threshold values.

Generating a radial range of SSD images 0

Using radial projections, you can generate views of your surface structure from
different angles.

Generating You will find a description of how to generate radial series from SSD projections
radial series in the following chapters:
(› Page 79)

Parallel slice images Based on the SSD display, you can also generate parallel images and curved cuts.
and curved cuts However, the results are always displayed as MPR images. The generation of
parallel series and curved cuts is described in the following chapters:
(› Page 68, › Page 104)

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Volume Rendering Technique (VRT) (option) 0

u Call up Type > VRT to get into VRT mode.

The Volume Rendering Technique (VRT) is a method for generating color images
in which a 3-dimensional effect can be achieved with effects such as opacity,
shading and color.
The entire volume data set is included in the image. Areas of interest, such as
bones and blood vessels, can be highlighted interactively by assigning color and
opacity values.
The VRT method is based on the fact that the voxels of the volume data set are
assigned defined display characteristics (color, brightness, contrast and opacity)
in the VRT image depending on the pixel input value (e.g. HU value or MR signal
value). In practice, ranges of pixel input values are assigned to certain tissue
classes.
Common default settings are stored in your system's VRT Gallery as display pa-
rameters for the VRT view.
If the defaults are not appropriate for your diagnostic problem, you can adapt
them individually. In this way, you can display the structures of interest to you in
an optimum way.

Transferring as VRT to 3D 0

You transfer a series of images from the Patient Browser, the Viewing task
card or the Series List dialog box to the 3D task card in VRT mode.
(› Page 59)

If you had already loaded images onto the 3D task card and have only temporarily
switched back to another application, switch back to 3D by clicking the tab card.
(› Page 32)

If you have finished processing your first 3D series and saved it, you can load the
next marked series directly from the 3D Series List (Patient > Open Series
List). If the last patient to have been processed is in 3D, a dialog box appears in
which you can specify whether you wish to continue processing or load the new
series.
(› Page 36)

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The 3D task card is shown in VRT mode.

(1) Sagittal view (MPR)

(2) Coronal view (MPR)
(3) Transversal view (MPR)
(4) Free view (VRT)

Parameter sets 0

In Volume Rendering Technique, the display of a volume data set is defined by

color, opacity and transparency. The color defines the light emitted by the object
Via the transparency you define how the object absorbs and reflects light.
The way in which an object absorbs, emits or reflects light depends on the char-
acteristics of the data set. These can vary within the three-dimensional space.
Information on color and light is not contained in the original data sets. Therefore,
the CT value or MR signal value must be assigned to the characteristics used in
VRT mode.
The image display is defined by means of parameter sets stored in the
VRT Gallery. These parameter sets are assigned to the original data set automat-
ically or manually in VRT mode.

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Assigning a parameter set automatically 0

Each parameter set has a name. As soon as you load images into the VRT mode,
the system searches the VRT Gallery for a parameter set by the same name
(e.g. Kidney). If a parameter set is found, the preset tissue classes are transferred
to the image.

If there is no matching parameter set in the VRT Gallery, the VRT image is dis-
played with the last selected parameter set from the VRT Gallery.

Assigning a parameter set by hand 0

If the VRT display with the automatically assigned parameter set does not meet
your expectations, select a different parameter set from the VRT Gallery.
u Select Type > VRT Gallery to display the VRT Gallery dialog box.
— Or —
u Click the VRT Gallery button on the Histogram subtask card.
– The 3D: VRT Gallery dialog is displayed.

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In the 3D: VRT Gallery the parameter data sets are listed in alphabetical order
from the top left to the bottom right.

u Click the required parameter set and confirm with OK.

– The predefined tissue class is transferred to the current VRT display.

Editing parameter sets 0

You can change the parameter sets in the VRT Gallery by setting the following
characteristics:
o Opacity
o Color
Depending on the required details of the settings, you can change the
VRT parameters in beginner or expert mode.

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Beginner mode When you apply the VRT filter to the image data for the first time, the Histogram
subtask card will be displayed in beginner mode.

(1) Histogram control with one curve and two window points (no curves or
points can be added or deleted)
(2) Color control with color distribution (no interaction possible)
(3) Zoom control for histogram control
(4) VRT Gallery button for opening the VRT Gallery
(5) Shading button
(6) Light source button

u Click the trapeze in the histogram control and move it or change its shape with
the left mouse button pressed.
– The transparency is changed.

u Click the Shaded icon to generate a shaded display.

– The VRT display is processed with a shading algorithm whereby a simu-
lated light source generates shading in the image. In this way a better
three-dimensional impression of the display is obtained.

u Click the light source icon (only with activated shading).

– The Light Source Definition - VRT dialog box is displayed.
u Set the light source as required, analogously to the light source definition for
the SSD display mode.
(› Page 113)

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Expert mode For the expert mode use the VRT Definition dialog. In this dialog you can set the
VRT parameters individually for each tissue type.
u Select Type > VRT Definition or double-click into the background of the his-
togram control on the Histogram subtask card.
– The 3D: VRT Definition dialog box opens.

(1) Selection list of the currently stored parameter sets

(2) Histogram control for graphic setting of the VRT parameters - display of the
grayscale histogram of the currently loaded data set and possibility to set the
transparency
(3) Color control bar - display of the current color distribution and possibility to
change it
(4) Slide control for zooming the histogram area in and out
(5) Buttons for shading and light source

u Zoom or pan the histogram area with the slide control.

– By limiting the display to the pixel range to be edited, graphic editing of the
parameter sets with the trapezes shown becomes easier.

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u Change the transparency by editing the transparency curve.

– Change the curve by panning it and/or changing its shape with the mouse.
– Remove curve points with the Remove Point item in the pop-up menu
(right mouse button) of the relevant point.
– Show/hide curve sections with the Hide Curve or Unhide Curve menu
items in the pop-up menu (right mouse button) of the relevant curve lines
(between two points).
– Add curve elements with the Insert Point, Add Left Ramp, Add Right
Ramp, Add Trapeze menu items in the pop-up menu (right mouse button)
of the histogram.
u Change the color display of the VRT display by editing the color assignment to
the individual points.
– Select the Color Bar Linked check box to link the points of the transpar-
ency curve with the color bar.
– Change the color assignment (only if Color Bar Linked is activated): Select
Change Color in the pop-up menu (right mouse button) of a point and
select a color from the color palette shown. The color gradient to the neigh-
boring points changes accordingly.

Alternatively to the assignment of colors in the transparency curve you can also
perform the color distribution by linking gray values with colors. To do so, dese-
lect Color Bar Linked, insert color points at the required gray value positions in
the color control bar (Insert Point in the pop-up menu of the color control bar) and
select the desired color in the color palette shown.

u Set the shading and light source with the relevant icon buttons.

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VRT Thin 0

For VRT display the entire volume of the data set is normally used. Sometimes,
however, you may want to use only part of the volume for the projection. The par-
tial area is defined by 2 parallel clip planes ("separation plane"), which are at a dis-
tance to each other that corresponds to the slice thickness to be defined.
Thus you can avoid cutting out interfering structures, for example.

Starting VRT Thin 0

u Change the display of the image in the reference segment until it meets your
requirements.
u Select Type > VRT Thin or click this button on the Type subtask card.
– A VRT Thin display with the standard settings is shown in the selected seg-
ment.

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Changing the slice thickness 0

u Select Type > VRT Thickness to display the 3D: VRT Thin dialog for select-
ing the slice thickness.

u Enter the thickness to be used for the projection in mm and confirm with OK.
– The selected setting is applied to all VRT Thin reconstructions.

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3D Image Fusion (option) 0

The Fusion function allows you to combine the results of different acquisition
techniques or images acquired at different times by superimposing them.
For this, two image series are loaded into 3D and aligned spatially and superim-
posed with Fusion. The original data sets are merged to a new data set. In this
new data set, matching image pairs of the two loaded series are superimposed
and can then be displayed for diagnostic purposes like two slides, one on top of
the other.

Options The following functions are optional:

o Aligning images with reference points
o Automatic Registration
o Surface Matching

Caution
Using fused images for diagnosis.
Incorrect diagnosis!
u Do not use fused images for diagnosis if the history of manipulations is not
well known.

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Fusion functions 0

To perform an evaluation with Fusion, you need to execute the following

three steps:
o Load two different image series of a patient
o Align the two image series
o Edit the image data sets

Loading In the first step you load two volume data sets into 3D one reference series and
one model series.
The reference series serves as an anchor for the subsequent superimposition of
the two image data sets.
The model series is aligned spatially with the reference series.

Aligning In the alignment step, the data of the model series are aligned spatially to the ref-
erence series.
You can align the two image series automatically (automatic registration), by se-
lecting threshold values (surface matching), by assigning points (landmarks) or by
shifting the model series visually (visual alignment).

Editing the Once you have successfully aligned the image data sets, they can be edited for
Fusion image data set a better display. You can window individual image series and the color display of
the fusion images. You can then apply the whole range of 3D functions to the
merged image data set.
(› Page 58)

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Calling up Fusion 0

For the Fusion function you need two volume data sets, the reference series and
the model series.
Both image series should cover approximately the same examination range.

If you select a data set that has already been processed with Fusion, it is loaded
in 3D together with the previously stored alignment parameters. The overlaid se-
ries then do not need to be realigned.

Loading image data sets 0

You will usually select the two image series for Fusion evaluation in the
Patient Browser and then transfer them to the 3D task card one after the other.
If you have already edited the reference series in 3D with another function
(e.g. Editor), you can load the missing model series subsequently from the
Patient Browser.

If you load image series of different patients, you have to confirm a corresponding
message. The resulting images are identified in the image text.

Caution
Unintentional loading of image data sets of different patients
Mix-up of patients and incorrect diagnoses possible!
u When loading reference and model series, make sure you select the correct
patient data.

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Loading new series u Open the Patient Browser (Patient > Patient Browser).
u Select the series whose images you want to use as reference images in the
navigation or content area.
u Select Applications > 3D > MPR in the main menu or click the 3D MPR but-
ton in the tool bar of the Patient Browser.

If you have activated Close after Loading, the Patient Browser is closed as
soon as the images have been loaded.
u Select the series you want to use as model images in the navigation or
content area of the Patient Browser.
u Select Applications > 3D > Fusion in the main menu or click the Fusion but-
ton in the tool bar of the Patient Browser.

Loading the model You have already loaded an image data set into the 3D task card and want to
series subsequently superimpose this data set with another image data set.
u Open the Patient Browser (Patient > Patient Browser).
u Select the series whose images you want to use as model images in the nav-
igation or content area of the Patient Browser.
u Select Applications > 3D > Fusion in the main menu or click the Fusion but-
ton in the tool bar of the Patient Browser.

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3D card in Fusion mode 0

The images of the loaded reference and model series are displayed overlaid in the
first three segments.
In the fourth segment, a dialog box is displayed in which you can set the align-
ment of the images in the reference and model series.

(1) Image area

Three orthogonal views of the loaded images.
(2) Fusion Registration dialog
Control elements for superimposing images.
(3) Settings subtask card
Buttons for image overlay and image display.

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Aligning image series 0

As soon as you have loaded image series for processing with Fusion, you can
align them in orientation and rotation. To perform these steps, call up the
Fusion Registration dialog box.
u Select Fusion > Fusion Registration in the main menu or click the
Fusion Registration button on the Image subtask card.

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The Fusion Registration dialog box contains the following functions:

o Registration Matrix
Lists all available matrices (user defined, initial and default matrix). Enter a
name, save the current registration as a new matrix, or delete it.

o Landmarks
The two loaded image series are made to match using suitable reference
points.
o Visual Alignment
The two loaded image series are (manually) made to match visually.

o Automatic Registration
The two loaded series are automatically made to match.

o Surface Matching
The two loaded image series are made to match on the basis of preset
threshold values specific of the tissue structure.

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Registration 0

You can save intermediate steps or the final result of a Fusion registration by sav-
ing the corresponding registration matrix. You can also assign the initial or the de-
fault matrix.
The matrix is saved to the local database. You can find it in the "3D Application
Data" series of the reference series as a non-image object.
When you register a series for the first time (no matrix has been defined), only
the "Initial" and "Default" matrixes are shown.

Initial If the last alignment that you saved is unsuitable, you can return to the initial po-
sition.
u Select Initial from the list or matrices.

Default If you are working with a combination scanner (e.g. CT-PET scanner), you have
an additional option: Calling up a default alignment stored in the system and ap-
plying it to the alignment of a reference and model series.
u Select Default from the list of matrices.

User Defined After aligning the series (which modifies the matrix) and clicking the
Save Registration button, a matrix with the name "User Defined“ is stored for
this registration (you can change the name of the matrix).
Later you can save further versions or update existing ones.

Re-using matrices The next time the two series are loaded, the matrix last used is automatically as-
signed. You can change this matrix and save it under a different name.

It is possible to re-use a matrix for a registered series together with another se-
ries, if these series are geometrically compatible.

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Saving a In the Fusion Registration dialog box you can enter a new name in the
registration matrix Registration field, overwrite an existing name or keep the current name to save
as an updated version.

It is not possible to overwrite the "Default" and "Initial" matrices. If you overwrite
the name, the matrix is stored with the generated name "User Defined" instead.
u Click the Save Registration button.

Deleting a u Select the name of the matrix to be deleted from the list.
stored matrix
u Click the Delete Matrix icon button.
The selected matrix is deleted from the list and from the local database.

It is not possible to delete the "Default" and "Initial" matrices.

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Aligning images visually 0

With Visual Alignment you make the reference and the model series match by
aligning the model images in the three segments successively with the reference
images.
u Click the Visual Alignment button in the Fusion Registration dialog box to
display the functions of Visual Alignment.

(1) Double direction arrow

for large image movements
(2) Single direction arrow
for small image movements
(3) Double rotation arrow
for large image rotations
(4) Single rotation arrow
for small image rotations

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The two image series are displayed overlaid. In three segments of the image area
you can see the reference and model images in three orthogonal views. To help
you distinguish between them, they are displayed in different colors.

Processing images Using zoom/pan and rotate object you can find the most suitable position to
start the alignment of the two series.
u Select zoom/pan via Smart Select.

— Or —

u Click the zoom/pan icon button in the upper part of the control area.

u Zoom or pan the image.

u Select rotate object via Smart Select.

— Or —
u Click the corresponding button in the upper part of the control area.

u Rotate the image.

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Moving a model series u Activate the align model option via Smart Select, if necessary.
u Drag the model series from the center of the segment into the desired direc-
tion while keeping the left mouse button pressed.
Or
u Click on a single direction arrow in the overview drawing of the
Visual Alignment function.
– The model series moves by 1 mm in the selected direction.
Or
u Click on a double direction arrow.
– The model series moves by 10 mm in the selected direction.

Rotating a u Activate the align model option via Smart Select, if necessary.
model series
u Move the mouse pointer along the edge of the segment to rotate the model
series in the plane while keeping the left mouse button pressed.
Or
u Click on a single rotation arrow in the overview drawing of the
Visual Alignment function window.
– The model series turns in the selected direction in steps of 1°.
Or
u Click on a double rotation arrow.
– The model series turns in the selected direction in steps of 10°.

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Saving alignment You can immediately save any promising alignments you have performed.
images
You can access these versions whenever you need them by selecting the corre-
sponding matrix from the registration matrix list.

Whenever you achieve an improvement by rotating and moving the images, you
should save the new alignment to the database. You can then return to a previous
result if the two series start to drift apart again.

u Click the Save button to save the current alignment matrix.

You can save the alignment as often as you want. The previous result is then
overwritten by the new one.

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Aligning images with reference points 0

You align image series with reference points, if you have detected distinctive
structures in both data sets.
u Click the Landmarks button in the Fusion Registration dialog box to display
the functions of Landmarks.

(1) Buttons
For setting and editing reference points.
(2) List of reference points
With deviation from the current alignment
(when there are at least three defined reference point pairs).

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The reference series is displayed in the two left segments and the model series
in the right segments of the image area. You can address all the image segments
separately.

(1) Reference images

Sagittal view above, axial view below
(2) Model images
Sagittal view above, axial view below
(3) Reference lines with cross hairs
In all images

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Defining First you define a reference point at a distinctive place in the volume. The you set
reference points the associated second reference point at a relevant position in the other series.
Thus you obtain a reference point pair which is used as a basis for aligning the
model series to the reference series.
u In the reference segments, set a view in which you can clearly see the posi-
tion for the reference point.
u Keeping the left mouse button pressed, move the cross hairs in one of the ref-
erence segments to the desired reference point position.
u In the other reference segment, check whether the cross hairs are positioned
correctly and move them, if necessary.
u Now proceed in the same way to define the associated reference point on the
model side.
u Click the Add button to apply the reference point pair.
The new reference point is numbered and entered in the list of reference points.
Your system now "anchors" the model series with the reference series at the de-
fined reference points.

The more points you define, the more precise the overlaying of the two image
series will be. You must define at least three reference points to determine the
spatial alignment of the series. You can define up to 100 landmarks.

Displaying a u Click on the entry in the list that refers to the reference point.
reference point

u Click the Goto button.

— Or —
u Double-click the relevant entry.
The cross hairs jump to the position of the selected reference point.
The displayed reference point is marked in the table with a blue background.

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Defining a u Display one of the reference points.

reference point
u Keeping the left mouse button pressed, move the cross hairs in both series
to the required position.
u Click the Update button.

Deleting a u Display one of the reference points.

reference point
u Click the Remove button.
The selected reference point is deleted.

Deleting all
reference points
u Click the Remove All button if you want to delete all defined reference points.
A dialog box is displayed in which you must confirm the deletion of all reference
points.

Saving alignment
images
u Click the Save button to save the current alignment matrix.
(› Page 136)

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Automatic Registration 0

With Automatic Registration the model series is automatically aligned with the
reference series. This procedure is used mainly for image series of different mo-
dalities from the same patient.
u Click the Automatic Registration button in the Fusion Registration dialog
box to display the functions of Automatic Registration.

It is important to roughly align the model series in the segments with the
reference series.
(› Page 135)
u Select Precise registration for a precise superimposition or
Fast registration for a fast superimposition.
u Click the Register button.
The two image series are now made to match and successively aligned with each
other. You can observe the progress of the superimposition in the image area in
the 3 orthogonal views.

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The dialog display shows the progress of the alignment operation.

u Click the Stop button if you are satisfied with the results and do not want to
wait until the operation has been completed.
The alignment obtained so far is retained.

Saving alignment
images
u Click the Save button to save the current alignment matrix.
(› Page 136)

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Surface Matching 0

With Surface Matching you align the model images with the reference images
on the basis of threshold values corresponding to a specific tissue structure.
This procedure is used in follow-up examinations to compare different data sets
of the same patient.
u Click the Surface Matching button in the Fusion Registration dialog box to
display the functions of Surface Matching.

(1) (2)

(1) Threshold values of the reference series (here: Modality MR)

(2) Threshold values of the model series (here: Modality MR)

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The reference series is displayed in the two left segments and the model series
in the right segments of the image area.

(1) Reference images

Axiale view (MPR) above, coronal view (SSD) below
(2) Model images
Axial view (MPR) above, coronal view (SSD) below

Entering threshold u Select a tissue structure for which you want to make the two image series
values match (e.g. bone, skin).
u Set modality-specific threshold values corresponding to this tissue structure
for the reference series.
u Select the corresponding threshold values for the model series.
The image areas inside the value range are highlighted in color in the correspond-
ing segments.

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Starting overlaying
u Click the Register button in the Fusion Registration dialog box.
The two image series are now made to match and successively aligned with each
other. You can observe the progress of the superimposition in the image area in
the 3 orthogonal views.

A progress bar shows the progress of the alignment process.

u Click the Stop button if you are satisfied with the results and do not want to
wait until the operation has been completed.
The alignment obtained so far is retained.

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Changing As soon as you have started the superimposition, the Registration button chang-
threshold values es to Define.
With Define you have the possibility to repeat the superimposition with other
threshold values.

u Click Define.
The images of the reference and model series are now displayed side by side
again and the threshold values can be changed.

Saving alignment
images
u Click the Save button to save the current alignment matrix.
(› Page 136)

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Terminating alignment 0

If you have aligned the model series and reference series with sufficient preci-
sion, you can store the superimposition in the local database.

Applying alignment
u Click OK in order to keep your alignment defined so far.

Canceling alignment
u Click Cancel if you want to dismiss alignment of the images.

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3D option

Displaying overlaid images 0

Once you have aligned the image data sets and confirmed the alignment, you can
display the image data sets either next to each other (side by side) or
overlaid (Fusion).

Side by Side mode 0

In Side by Side mode, the two image data sets are arranged side by side (in sep-
arate segments).
u Select Fusion > Fusion: Side by Side in the main menu or click the
Side by Side button on the Image subtask card to active side-by-side display.

The left image area is used to display the reference images and the right one is
used for the model images. For easier spatial assignment, two coupled mouse
pointers are displayed that move across both data sets simultaneously.
The coupled mouse pointer is colored.

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Changing the view In Side by Side mode you move through the image stacks in the reference seg-
ment. The corresponding segment is automatically displayed on the model seg-
ment. You can change the view of the fused image data set using one of the
following methods:
o Scrolling
(› Page 45)
o Rotating the volume with the mouse
(› Page 46)
o Setting standard views
(› Page 53)
o Using cross hairs
(› Page 43)

Setting the In Side by Side mode, the following display modes are possible:
display mode
o MPR Thick

o Fused MPR

o SSD

u Click the corresponding button on the Type subtask card.

Terminating
Side by Side mode
u Click the Side by Side button to close the Side by Side view.

The fused data set is now displayed in Fusion mode.

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Fusion mode 0

In Fusion mode, the two image data sets are displayed one on top of the other
like two slides.
u Select Fusion > Fused MPR in the main menu or click the Fused MPR button
on the Typ subtask card to switch the selected image into Fusion mode.

To help you distinguish between the two image data sets, they are displayed in
different colors. As with Visual Alignment, the superimposed image data set is
displayed in three orthogonal views in three segments.

Changing the view In Fusion mode you move through the image stacks in each segment. You can
change the view of the fused image data set using one of the following methods:
o Scrolling
(› Page 45)
o Rotating the volume with the mouse
(› Page 46)
o Setting standard views
(› Page 53)
o Using cross hairs
(› Page 43)

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Modifying the display 0

Once you have successfully overlaid your images, you can optimize the window
values, the mixing ratio and color display of the images so that you can recognize
the structures of individual image data sets more easily.
u Select Fusion > Fusion Definition in the main menu or click the Fused MPR
button with the right mouse button.
The Fusion Definition dialog box is displayed.

Windowing in a u Starting in the left half of a segment, drag the mouse to change the window
segment center (brightness) and window width (contrast) of the reference series using
the middle mouse button.
Or
u Drag the mouse starting in the right half of a segment to change the window
center (brightness) and window width (contrast) of the model series using the
middle mouse button.
(› Register 6: Image Processing, Page 35)

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Windowing in the
dialog box

u Move the slider for the relevant data set to change the window center (bright-
ness).
u Move the right or left edge of the slider to change the window width (con-
trast).
Or
u Enter numeric window values in the input fields and confirm with the
Enter key.

With nuclear medical images the slider determining the width of the windowed
area can also be moved beyond the limits of the range displayed in the dialog box.

SUV (Standard Uptake The SUV (Standard Uptake Value) check box is displayed for PET images only.
Value)
u Check this box to use the value for SUV activity in tissue rather than the
default percentage values.

Caution
SUV calculation is based on the data with the earliest acquisition date and time
within the selected and loaded data set and the first image (with the earliest ac-
quisition date and time) is not within the selection.
Incorrect SUV calculation!
u Make sure that you have selected the first image of the data set so that the
calculation is performed correctly.

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Mixing Ratio To emphasize certain information of one of the two image data sets, increase its
relative importance in the fused image.

u Using the left mouse button, pull the slider in the direction of the data set
whose intensity you want to increase.

Display To delimit the reference and model series more precisely, you can change the
coloring of the image data sets.

u Select the required color representation (LUT, lookup table) in the selection
list for the reference and model data set.

Options The Fusion Definition dialog box provides an advanced masking section for hid-
ing pixel ranges in the fused display.
u To to this, click the Advanced >> button.
The Fusion Definition dialog box is enlarged so you can define which pixel rang-
es are masked out.

If you want to hide the numerical setting area, simply click the Advanced << but-
ton again.

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Masking With the Masking function you can define individual visibility thresholds for the
reference and model series. Only grayscale values that are within the thresholds
are used for alpha-blending.

u Resize the slider with the left or right side handle to change the covered range
of pixels.
Or
u Enter the value into the corresponding L(ow) or H(igh) fields.
Or
u Drag the slider to move the complete range to another position.
The displayed blended segments immediately reflect the change. All pixels out-
side the threshold interval are ignored. They are not blended with the other se-
ries.

The masking thresholds are also stored with the registration matrix, together with
all the other blending parameters.

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Saving result images 0

You can save the fusion images to the local database, send them to a
DICOM node or copy them to the Filming task card.
The images are saved as they are currently displayed.

Fusion mode When you save a selected image in the Fusion display mode, the stored image
will be of the DICOM Secondary Capture type (modality "SC").

Side by Side mode When you save images in the Side by Side display mode, the currently displayed
type is used (e.g. MPR).

If fusion results originate from two series of different patients, this is indicated in
the image text.

Results for other applications 0

Fusion results can be saved for other common applications such as

syngo Viewing or MagicView. These viewers are used to compare the original im-
ages with the fused images.
You have to save two or three different image series with the correct position,
thickness and orientation.
o The first series is a 3D range of the reference series.
o The second series is a 3D range of the model series.
o The third series is a 3D range of images that have been fused from the two
series (option).

There are two possibilities of generating these different series:

o Resampling data
o Generating series

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Resampling data u Select Fusion > Resample in the main menu if you want the data to be
resampled.
Depending on the configuration, three new series with the position, thickness,
orientation and resolution of the reference series are generated and stored in the
local database together with the registration matrix:
o the resampled data set of the model series: "Resampled<Modality><#>"
o the resampled data set of the fused images:
"Resampled<Modality of Reference><Modality of Model><#>"
o registration matrix: "ResampledRegistration<#>"

"#" starts from 1 and is incremented with each recalculation.

For further details on the configuration see

(› Page 161).

During resampling, the result images will not be displayed. The 3D: Resample
Data in Progress dialog shows the progress of the calculation.

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Generating series u Select Settings > Parallel Ranges from the main menu.
A range is calculated with alpha-blended images and the Parallel Ranges dialog
box is displayed.

u Select the modality of the reference series (e.g. MR) from the Output Type
selection list.

The Output Type list is visible only if a second data set is loaded and
Parallel Ranges or Expand Ranges is active.
u Enter the desired range parameters and click Start.
u Save the reconstructed range.
u Repeat the last two steps.

It is important that you do not change the range parameters or range graphics
when performing these steps.
u Select the first modality of the model series, e.g. PET, reconstruct the range
and save it.
u Then select MR_PET, for example, for the reconstruction of a range of fused
images.

If both data sets have the same modality, "pre" and "post" is added. “<MOD>pre“
or "<MOD>post“, e.g. "PTpre“.
The resolution of the calculated range of the output type "from model" depends
on the configuration.
(› Page 161)

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3D option

Configuration for 3D 0

You can adapt several settings in the 3D Configuration:

o Displaying the orientation description
o Saving images with reference lines
o Automatic storage of ranges
o Saving ranges with the reference image
o Filming ranges with the reference image
o Using the stored orientation for the reference image
o Resampling data (Fusion)

Calling up the configuration window 0

You can call up the configuration window from the syngo Configuration panel.
u Select Options > Configuration in the main menu.
u Double-click the icon for the 3D configuration window.
– The Configure 3D window with the Segment Information and Ranges
tabs appears.

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Configuring image information 0

In the images, various image texts and orientation aids are displayed, the follow-
ing of which you can configure:
u Move the Segment Information card into the foreground.

u Activate this check box, if you want to display the orientation description.

u Activate this checkbox, if you want to store the reference lines together with
the transferred images into the Viewing or Filming task card.

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Configuring the processing of ranges 0

On the Ranges card, you can define the settings for storing and filming series.
In addition, you can configure the orientation of the reference image for generat-
ing parallel and radial ranges.
u Click the Ranges subtask card into the foreground.

Configuring storage 0

You can store reconstructed series (ranges) fully automatically with or without
the reference image.

u Activate this check box if you want all reconstructed series to be stored auto-
matically.

With auto-store, you can produce large volumes of data very quickly and thus fill
up the capacity of your hard disk. Check the data stored on your hard disk at reg-
ular intervals. Archive any data that you still require and delete any data that you
no longer require.
(› Register 8: Documentation, Page 65)

u Activate this check box if you want to store the reference image together with
the series.

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Configuring filming 0

You can film reconstructed ranges with or without the reference image.

u Activate this check box if you want to film the reference image together with
the series.

Configuring the orientation of the reference image 0

When generating parallel ranges using the stored defaults, you have the option
of having the preset reference image orientation used automatically.

u Activate this check box, if you want to use the stored orientation for the ref-
erence image.

Configuring resampling 0

For resampling you can either use the original resolution or fused series.

u Click this check box if you want the resolution of the resampled series to be
the same as the resolution of the reference series.
This also applies for generating the model series.

u Click this check box if you want to resample the fused series.

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Table of Contents

Introduction to filming/printing ............................................................................................ 5

Filming and printing .......................................................................................................................... 6
Layouts and settings......................................................................................................................... 8
The Filming task card........................................................................................................................ 9
The Film Preview window .............................................................................................................. 10

Automatic/manual filming.................................................................................................. 11
Transferring images to the virtual film sheet .................................................................................. 11
At the C-arm system ............................................................................................................ 11
At the monitor trolley............................................................................................................ 12
Virtual film sheet full ....................................................................................................................... 13
Sending images to the camera/printer............................................................................................ 15
Automatic exposure ............................................................................................................. 15
Transferring images manually............................................................................................... 17
Correcting the film size......................................................................................................... 18

Viewing and processing film sheets and images .............................................................. 19

Film preview ................................................................................................................................... 20
Calling up the Film preview .................................................................................................. 20
Basic functions ..................................................................................................................... 21
Changing default settings ..................................................................................................... 24
Processing a film sheet ........................................................................................................ 25
Processing film jobs and film sheets .............................................................................................. 26
Calling up the Filming task card............................................................................................ 26
Selecting a film job ............................................................................................................... 27
Selecting film sheets and images......................................................................................... 28
Reorganizing film sheets ...................................................................................................... 31
Editing images ...................................................................................................................... 32

Changing film settings for a film job.................................................................................. 33

Selecting a camera and printer ....................................................................................................... 34
Changing the layout of the film sheet............................................................................................. 35
Image, text and graphic display ...................................................................................................... 37

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Checking the data transfer ................................................................................................ 43

Viewing and manipulating film jobs ................................................................................................ 44
Calling up the Film Task Status dialog .................................................................................. 44
Manipulating film jobs .......................................................................................................... 46
Configuration for filming/printing ....................................................................................... 51
Calling up the configuration window............................................................................................... 51
Configuring film layouts .................................................................................................................. 52
Selecting a layout ................................................................................................................. 52
Configuring film job settings................................................................................................. 54
Configuring film sheets......................................................................................................... 56
Linking layouts to a study or series................................................................................................. 58
Assigning film layout............................................................................................................. 59
Canceling a film layout assignment ...................................................................................... 60
Deleting a layout ................................................................................................................... 60
Introduction to archiving .................................................................................................... 61
Transfer options.............................................................................................................................. 62
Selecting data for transfer .............................................................................................................. 63
Calling up transfer functions ........................................................................................................... 64

Archiving Data ................................................................................................................... 65

General safety information.............................................................................................................. 65
Archiving in the network (option) .................................................................................................... 67

Exporting data.................................................................................................................... 68
General safety information.............................................................................................................. 68
Backup on local data media ............................................................................................................ 69
Media for saving data ........................................................................................................... 69
Inserting and ejecting media................................................................................................. 70
Storing on multi-session media ............................................................................................ 71
Sending patient data in the network (option) .................................................................................. 73
Sending data to a standard address ..................................................................................... 73
Sending data to other addresses in the network.................................................................. 74

Import/export in the file system ........................................................................................ 75

Exporting images to the file system ............................................................................................... 76
Importing images from the file system........................................................................................... 78
Writing off-line files to CD/DVD ...................................................................................................... 80

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Checking the data transfer ................................................................................................ 81

Viewing jobs ................................................................................................................................... 82
Calling up local jobs .............................................................................................................. 82
Calling up network jobs ........................................................................................................ 83
Manipulating job performance ........................................................................................................ 84
Configuration for archiving................................................................................................. 87
Calling up the configuration window............................................................................................... 87
Automatic transfer .......................................................................................................................... 88
Creating and editing rules ..................................................................................................... 89
Infinite loops ......................................................................................................................... 91
Deleting rules ....................................................................................................................... 91
Local Devices.................................................................................................................................. 92
Defining the use of storage capacity .................................................................................... 93
Setting data compression for storing ................................................................................... 94
Defining the work status for storing ..................................................................................... 95
Network node (option) .................................................................................................................... 96
Setting data compression for sending .................................................................................. 97
Setting retries ....................................................................................................................... 97
Defining the work status for sending ................................................................................... 98

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Register 8 Documentation

Introduction to filming/printing 0

You can expose the images of an examination on film or print them on paper for
documentation and reporting.

Filming and printing are the same process except that they use different output
devices. If in the following only the term "filming" is used (e.g. with software ele-
ments), the description is also applicable for printing.

Film job Selected images, series and studies that you have sent for filming are managed
and executed by the system as film jobs.

Multiple film job In general, images of different patients are processed in different film jobs.
However, you can permit images of different patients to be grouped together as
a multiple film job.

Film task status You can also obtain information about the extent to which film jobs in the
camera⁄printer queue have been executed in the Film Task Status dialog box
and intervene in the sequence of execution.

Film preview Images in film jobs are not immediately printed or exposed on film, but are first
transferred to a virtual film sheet. In the Film Preview window, you can see how
the images will later be arranged on the exposed film or printout.

Filming task card In addition to the Film Preview window, the Filming task card is also available
to you as a virtual film sheet. Besides the basic functions of the Film Preview
window, the Filming task card provides a number of additional functions and
configuration possibilities that enable you to adapt the filming and printing pro-
cess to your specific requirements.

Please remember that not all transfer options may be available on your system.
The devices and network nodes available depend on the individual configuration
of your system and the options installed.

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Filming and printing 0

Image material is filmed/printed in two steps:

o First, specify on one of the task cards or in the Patient Browser which images
or series you want to print or expose on film. Then transfer the selected im-
ages to the virtual film sheet.
o From the virtual film sheet, you can either send your selected images directly
to a camera/printer, or you can perform additional processing steps first.

If a local printer is connected, you can print individual images on paper or

X-ray film directly in the OR.
(› Page 11)

Scenes (multiframe objects) with more than 1023 images cannot be sent to a
DICOM camera.
Image material can be printed or exposed on film either automatically or
manually.

Manual filming You transfer images to the virtual film sheet. After that, you manually initiate the
transfer to the camera or printer. In doing so, you can select the images that you
want to expose on film or print.

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Automatic filming You transfer images to the virtual film sheet. As soon as a film sheet is filled, the
images are automatically output on camera or printer (Automatic Exposure
function).

We recommend keeping Automatic Exposure always switched off. This way,

radiation release will not be impeded by images being printed out during the ex-
amination. Instead, the images to be printed will first be collected in the virtual
film sheet. They can be edited after the examination and manually sent to the
printer.

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Layouts and settings 0

All film settings such as the layout of the film sheet or the selected camera/printer
are defined in so-called film layouts.

Standard layout Provided that you do not make any changes to the default film settings, you al-
ways work with the general default layout defined by Siemens Service during in-
stallation of your system.

Changing film settings If you are not satisfied with the default film settings (default layout), you can
change individual film settings using the virtual film sheet. The current film job is
then processed with your new settings. For the next film job, the system will use
the default settings again.

Study-specific layouts In the Configuration of the Filming task card, you can define special film set-
tings for individual studies and series. Whenever you film or print images of a
study or series of the same type, the system automatically uses this study-spe-
cific layout.

Print modes The regular page mode is the default print mode. The scalable page mode pro-
vides images with reduced quality and does not support original size.

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The Filming task card 0

If you want to change individual film sheets of the jobs in the queue or if you want
to process the images again before filming, switch to the Filming task card.
The Filming task card is divided in four main areas.

(1) Menu bar with menu entries for filming

(2) Control area allowing easy access to processing functions
(3) Display of the film sheets (virtual film sheet)
(4) Status bar for system messages

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The Film Preview window 0

If you want to obtain a quick overview of the film jobs in the queue that have not
yet been sent to the camera or printer, you can use the Film Preview window.

(1) Maximize to Filming task card

(2) Film jobs
(3) Display of film sheets
(4) Spin box for selecting the number of copies
(5) Buttons for film control and delete button

The Film Preview window can be opened only from the Patient Browser
by selecting Patient > Film Preview.

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Automatic/manual filming 0

The filming and printing of examination images is performed in two steps:

o Transfer of images to the virtual film sheet.
o Transfer of these images from the virtual film sheet to a camera or printer
where they are exposed on film or printed on paper.

Make sure the printer is switched on before you send images to print.

Configured Siemens Service or your system administrator has configured one or several
printers⁄cameras printers/cameras for your ARCADIS Orbic system. At the same time, the names
of output devices that you can choose from selection lists as well as the specified
paper/film size were set up.

Note that you can only print on the paper/film size that was configured for the
respective output device.

Transferring images to the virtual film sheet 0

Images can be transferred for printing from different applications via the control
panel on the C-arm system or at the monitor trolley.

At the C-arm system 0

If a local printer is connected, you can print individual images on paper or

X-ray film directly in the OR.

Initiating local printing

u Press the Print key on the control panel of the C-arm system.
– The currently selected image is copied to the virtual film sheet.
– Depending on the setting for exposure on film, the image is transferred
directly to the specified (local) printer and printed there.

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At the monitor trolley 0

You have the possibility of selecting and filming/printing single images or all im-
ages of a series, a study or a patient.

Selecting images You decide on the Viewing task card or in the Patient Browser window which
images you want to transfer to the virtual film sheet. You can use the large format
layout when selecting images in the Viewing task card.
u Select Patient > Patient Browser.
– The Patient Browser opens.
u Select the images for filming in the navigation or content area.
Or
u Load the series or study containing the images that you want to film into the
Viewing task card.
(› Register 6: Image Processing, Page 13)
u Select the images for filming in the image area.

Transferring Images u Select Patient > Copy to Film Sheet.

Or
u Click the Copy to Film Sheet button.

Or
u Press the Copy to Film Sheet key on the symbol keypad.
– All the selected objects are transferred to the virtual film sheet.

You cannot transfer scenes from the Patient Browser to the Filming task card.
If one of the images selected for transfer is a scene, you will receive a corre-
sponding message.

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Virtual film sheet full 0

In general, every time you transfer images of a series or whole studies of a pa-
tient to the virtual film sheet, a film job is created.
No more than three film jobs at a time can be managed in the virtual film sheet.
If a fourth film job is transferred to the film sheet, the No More Film Jobs
Available dialog box appears.

This situation can usually only occur if the Automatic Exposure option is deacti-
vated for the film jobs as recommended. The film jobs then remain in the virtual
film sheet until you send them to filming manually and thus complete them.
You must first expose/print or delete one of the film jobs in the queue before a
new film job can be accepted.

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Exposing the selected u Select one of the film jobs listed.

film job
u Click Expose.
– The selected job is filmed and the new job is placed in its position in the
virtual film sheet.

Deleting a selected
film job
u Click Delete.
– The selected job is deleted and the new job is placed in its position.

Merging film jobs

u Click Merge.
– The images of the new film job are appended to the end of this old film job.

The film job remains in the virtual film sheet as a multiple film job until you trans-
fer it to the camera or printer.
(› Page 5)

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Sending images to the camera/printer 0

Images can be transferred to the camera or printer via the same menu entries in
the different task cards or in the Patient Browser.

You should not release radiation while the ARCADIS Orbic is processing film jobs,
because system performance may be restricted during this time. It is advisable
to wait until after the examination to send off film jobs.

Automatic exposure 0

After a film job has been transferred completely to the virtual film sheet, it can
immediately and automatically be transferred to the camera/printer.

Caution
The "printed" flag is set as soon as the images are successfully transferred to
the printer driver. Not all printers (e.g., paper printers) can solve printing prob-
lems themselves.
The image printout may be lost!
u Verify that the printouts are available before you delete images.

We recommend keeping Automatic Exposure always switched off. This way,

radiation release will not be impeded by images being printed out during the ex-
amination. Instead, the images to be printed will first be collected in the virtual
film sheet. They can be edited after the examination and manually sent to the
printer.

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Auto Expose on This function may accelerate the workflow associated with evaluation.
However, it is recommended to switch it off prior to the next examination.
u Select Options > Auto Expose on the right monitor.
Or
u Click the Auto Expose button.
– A film sheet that is completely filled is automatically printed or exposed as
soon as an image for the next (empty) film sheet is transferred.

If the last film sheet is only partially filled, then the configuration settings deter-
mine when it is sent to be filmed.
(› Page 54)

Auto Expose off u Deselect Options > Auto Expose.

Or
u Click the active Auto Expose button.

Aborting Auto Expose

If errors occur during automatic filming, or you notice that defective images have
been filmed/printed, you can abort automatic exposure at any time.
u Deselect Options > Auto Expose on the right monitor.
u Eliminate the fault.
— Or —
u Delete the faulty images from the virtual film sheet.
u Activate Auto Expose again.
— Or —
u Transfer the remaining sheets to the camera/printer manually.

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Transferring images manually 0

If the Auto Expose option is deactivated, all images to be filmed are collected in
the virtual film sheet as film jobs. You decide which jobs are filmed or printed at
what time.

Caution
The "printed" flag is set as soon as the images are successfully transferred to
the printer driver. Not all printers (e.g., paper printers) can solve printing prob-
lems themselves.
The image printout may be lost!
u Verify that the printouts are available before you delete images.

Exposing the current u Call up Film > Expose Film Task.

film task – All images of this film job are transferred to the camera or printer.
Or
u Click the Expose Film Task button.
– All images of the film job are transferred to the camera.

If you only want to expose a single film sheet instead of a whole film job, then
select the desired sheet in the Filming task card or in the Film Preview window
and expose it from there.
(› Page 19)

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Selecting a film job If you have loaded several patients into the Filming task card, you can select the
task you want to expose from the list displayed in the Select Film Job dialog.
u Select Patient > Expose Film Task.
– The Select Film Job dialog box is opened.

u Select a job.

u Click Expose.

Correcting the film size 0

If the film size set for the film sheet waiting to be exposed/printed is not support-
ed by the selected camera, the Incorrect Film Size dialog box is displayed.

Selecting a different u Select the film size configured for the camera/printer from the selection list.
size
u Confirm by clicking OK.
– Filming/printing is resumed.

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Viewing and processing film sheets and

images 0

Once you have deactivated the Automatic Exposure option during manual film-
ing, you can view and process the film sheets again before finally printing them
or exposing them on film.

Film preview If you want to obtain a quick overview of the film jobs in the queue that have not
yet been sent to the camera or printer, you can use the Film Preview window.

Filming task card If you want to organize individual film sheets of the jobs in the queue more effi-
ciently and clearly or if you want to process the images again before filming,
switch to the Filming task card.

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Film preview 0

In the Film Preview window, you can also access some basic functions for film-
ing without having to switch to the Filming task card.

Calling up the Film preview 0

u Select Patient > Film Preview in the Patient Browser.

– The Film Preview window is displayed.

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Basic functions 0

After you have called up Film Preview, the window will appear in front of the ap-
plication you are currently working with.

Viewing film jobs

u Click on a film job.
– The film job is opened.

Scrolling through the Using the dog ears in the top right hand corner, you can page through all the film
display area sheets of the film job.
u Click once on the outer triangle.
– The film sheet is paged forward.
Or
u Click once on the inner triangle (dog ear).
– The film sheet is paged backward.

Film task status

u Click the Film Task Status button.
Or
u Select Patient > Film Task Status.
– The Film Task Status dialog box is displayed.

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Auto Expose on This function may accelerate the workflow associated with evaluation. However,
it is recommended to switch it off prior to the next examination.
u Click the Auto Expose button.
Or
u Select Options > Auto Expose.
– The opened film job is automatically exposed.

Exposing a film job

Caution
Using paper printouts for diagnosing AX, CT and MR images.
Wrong diagnosis possible!
u Only use film material and cameras/printers suitable for diagnostic purposes.

u Click the Expose Film Task button.

Or
u Select Patient > Expose Film Task.
– The opened film job is transferred to a camera/printer.

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Exposing/printing a Instead of a whole film job you can also transfer single film sheets to the camera
film sheet or printer.
u Select a film sheet.
u Call up Film > Expose Film Sheet.
– Only the selected film sheet is processed.

Incorrect film size

If the film size set for the film sheet waiting to be exposed/printed is not support-
ed by the selected camera, the Incorrect Film Size dialog box is displayed.

u Select the film size configured for the camera/printer from the selection list.
u Confirm by clicking OK.
– Filming is resumed.

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Changing default settings 0

By default a layout has already been defined for every film job in the virtual film
sheet and a camera or printer has been selected.
You can change these default settings in the Film Preview dialog box or in the
Filming task card itself.

Selecting a camera or u Select Film > Change Camera....

printer – A dialog box is opened in which you can select a new camera/printer.

Note that you can only print on the paper/film size that was configured for the
respective output device.

Changing film settings u Click in a segment or on the border of the film sheet.
— Or —
u Select the film job.
u Select Film > Properties....
– The Film Properties dialog box is opened in which you can change a num-
ber of layout settings for filming.
Or
u Right-click in a segment or on the border of the film sheet.
u Select Properties from the context menu.
– The Film Properties dialog box is opened in which you can change a num-
ber of layout settings for filming.

The No text option should not be used since otherwise image text and the pa-
tient name will not be visible on the film sheet. This can easily lead to confusions.

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Processing a film sheet 0

The Film Preview dialog offers a number of functions for reorganizing film
sheets.

Deleting images
u Click the delete button in the control area.
– The selected image is deleted. The following images move up so that no
empty segments remain.
Or
u Select Film > Clear Document(s).
– The image is deleted. The following images do not move up.
u Enter Film > Repack.
– Your film material is now used more efficiently.

Adding images If you have opened the Film Preview from the Patient Browser window,
you can add further images to a film job.
u Select Film > New Film Sheet.
– An empty film sheet is added to the end of the film job.
u Select Patient > Copy to Film Sheet.
– These images are also appended to the end of the film job.

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Processing film jobs and film sheets 0

In addition to the simple processing steps in the Film Preview dialog, you can
also make complex and extensive changes to film jobs in the Filming card.

Calling up the Filming task card 0

The Filming task card is in the stack of task cards on the right-hand monitor.

u Click the Filming tab.

Or
u Maximize the Film Preview window.
– The Filming task card is placed in the foreground.

As soon as you transfer images to the virtual film sheet (Print button at the C-arm
control panel or menu option Copy to Film Sheet at the monitor trolley,
the Filming task card is automatically moved to the foreground.

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Selecting a film job 0

By the patient folders in the upper part of the control area you can see which film
jobs are currently waiting to be transferred to a camera/printer.

Designations These jobs have one of the following designations:

o Patient name
A film job that contains the images of a patient.
o Multiple
A film job that contains the images of several patients.

If there is no film job on the virtual film sheet, a patient folder with the designation
New is displayed.

Opening a film job

u Click on a film job.
– The film job is opened.

The patient folder opens up and the color of the folder remains unchanged.

Selecting an entire u Click again on the opened film job.

film job – All the film sheets with all images of this job are selected.

The folder icon is now highlighted (blue), and all the images of this job are shown
in the film sheet display with a clear border and are therefore selected.

Setting multiple
printout

u Select the number of copies with the spin buttons.

Or
u Enter the required number of copies using the keyboard.

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Selecting film sheets and images 0

After you have opened a film job, its images are displayed in the left-hand part of
the Filming task card.

Paging through u Page through the film sheets using the dog ears.
several film sheets
Or
u Double-click on the number of the current film sheet.
– The display field becomes an input field.

u Overwrite the number displayed with the number of the sheet that you want
to go to.
u Press the Enter key.
– The film sheet you have entered is displayed.

Selecting a film sheet u Click on the border of the film sheet.

– All the segments of the film sheet are now shown with a clear border.

Deselecting a u Click outside the film sheet with the left mouse button.
film sheet
Or
u Select a single image, another film sheet or another film job.
– Your selection is canceled.

Selecting multiple You can also select more than one film sheet at once.
selection
u Click on the border of the first film sheet of your choice holding the Ctrl key
down.
u Page to another film sheet.
u Hold the Ctrl key pressed to extend your selection by a single film sheet.
Or
u Hold the Shift key pressed to select all the film sheets between the two film
sheets including all their images.

When you have selected a film sheet, all images have a line border.

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Selecting segments You cannot only select whole film sheets, but also individual images of a film job.

The Input Focus shows the active segment of the image area. It is marked by a
dashed border and shows you which image is currently being processed.

u Click on another image with the left mouse button to place the input focus on
another segment.
Or
u Move the input focus using the arrow keys on the keyboard.

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Selecting one or more u Click into a segment holding the Ctrl key down.
images explicitly – The segment is marked with a line border.

Selecting images u Click on the image that you want to select explicitly holding the Ctrl key down
explicitly up to the end or use the input focus.
of a series
u Select Edit > Select On Succeeding.
– The selected image and all the following images are now selected.

Selecting a complete u Click on the image of the series that you want to select holding the Ctrl key
series explicitly down or use the input focus.
u Select Edit > Select series.
– The whole series is now selected explicitly.

Deselecting images u Hold the Ctrl button pressed.

u Click on an explicitly selected image again.
Or
u Select Edit > Deselect All.
– All selected images are deselected.
– After that, the default input focus is set automatically, i.e. the top left seg-
ment is the destination of the next action.

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Reorganizing film sheets 0

Using the Filming task card, you can reorganize film jobs in such a way that only
those images are exposed or printed that you require.

Deleting images or u Select one or more images or film sheets or use the input focus.
film sheets
u Select Edit > Delete.
Or
u Delete the images/film sheets with this button.
Or
u Select Film > Clear Document(s).
– The images are deleted, the segments in the film job remain empty.

Filling empty u Select Film > Repack.

segments – The gaps are filled.

Copying images or u First select the images/film sheets that you want to copy.
film sheets
u Select Edit > Copy.
u Select the image in front of which you want to insert the copies.
u Select Edit > Paste from the main menu.
– All the copied images are inserted in front of the selected segment.
The image of this segment is moved back in the film job.

Moving images or u Select the image or the images that you want to move.
film sheets
u Select Edit > Cut.
u Select the segment in front of which you want to place the cut-out images.
u Select Edit > Paste from the main menu.

Appending a new u Select Film > New Film Sheet at any point in the film job.
film sheet – A new (empty) film sheet is appended to the end of the film job.
u Then insert the copied or cut images into this sheet.

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Editing images 0

In addition to arranging film sheets, you can also change the display parameters
of the images in the Filming task card to obtain an optimum output result.
(› Register 6: Image Processing, Page 33)

In the Filming task card, images are loaded with the window values with which
they were last saved. If you have transferred images from the Viewing task card,
the images are displayed with the window values last used in the Viewing card.

Windowing images Using the Window 1 and Window 2 buttons, you can assign those window val-
ues that were permanently stored with the image data (e.g. with imported imag-
es). The images acquired at the system do not support different window values,
the buttons are then inactive (dimmed).
u Select one or more images, or work in the input focus.
u Click Window 1 or Window 2.
– The windows are assigned the values of the first or second stored window.

Zooming and panning

images
u Click the Zoom/Pan button.
Or
u Select Image > Zoom/Pan.
– The function of the left mouse button is now switched from Select to
Zoom&Pan. Now you can zoom and pan the image.

Image > Zoom Factor allows for zooming with a defined factor.

Restoring the u Select Image > Home Zoom & Pan.

zoom factor/pan
Or
u Click the Home Zoom/Pan button.
– The images are assigned the pan and zoom factor with which they were
last stored in the database.

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Changing film settings for a film job 0

When your system is configured, a standard film layout is defined. This layout
contains all the settings required for filming.
If these presettings are not suitable, you can change the following on the Filming
task card or in the Film Preview dialog:
o Select another camera or printer
o Change the number of copies
o Change the layout of the film sheets
o Change the image, text and graphic display

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Selecting a camera and printer 0

If you do not want to expose or print your current film job with the default camera,
then select another camera/printer for this job.

u Click the Camera subtask card on the Filming task card into the foreground.
— Or —
u Select Film > Change Camera....
– The Change Camera and Film Size dialog box is displayed.

u Select a camera or printer from the list.

u Under Film Size, select the film size configured for the camera/printer.

The newly selected camera or printer will then become the default camera or
printer. These default devices will be used as long as you have not selected an-
other camera or printer.
In the Status display, you can see whether the selected camera/printer is
switched on and available.

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Changing the layout of the film sheet 0

With the layout of the film sheet, you can define the size of each image.

Selecting images and The film sheet layout is set for selected images of a film job.
film sheets
u Select an entire film job.
– The layout is changed for all sheets of this job.
Or
u Select a film sheet.
– The layout is changed for this single sheet only.
Or
u Select individual images, or work in the input focus.
– The format for the relevant images is changed.

Changing the layout

u Click the Layout subtask card on the Filming task card into the foreground.
u Click the button for a film layout.
– The selected images are displayed in this format.

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Or
u Select Film > Properties... in the main menu or Properties in the context
menu (right mouse button).
– The Film Properties dialog box is opened.

u Select a division in the Division selection list.

If the film sheet division is different for the selected images or film sheets, the
Division selection list is empty.

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Image, text and graphic display 0

The layout of the film sheet defines the number and size of the segments on a
film sheet. In the Film Preview window and the Filming task card, you can
change the aspect ratio of individual images in your segments and define wheth-
er and how text and graphics are to be printed or exposed on film.

u Click the Images subtask card into the foreground.

— Or —
u Call up the Film Properties dialog box.
– The settings of the currently selected images are displayed.
– The dots in the radio buttons are displayed gray if the settings of the
images are different.

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Changing the size of u Select one image, several images, or the entire film job.
the segment
u Click the Fit to segment button.
Or
u Select Fit to segment in the Film Properties dialog box.
– The images are displayed as large as possible in the segment without any
parts of the image being cut off.

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Changing the
image section
u Click the Clip document button.
Or
u Select Clip document in the Film Properties dialog box.
– Rectangular images can be increased so that the shorter side of the image
fills the segment. Parts of the longer side of the image are cut off (upper
and lower edge of the image or the sides of the image).

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Setting the
original image
u Click the Original Image button.
Or
u Select the Original Image option in the Film Properties dialog box.
– The images are displayed in the segment in their original size (max. 1% tol-
erance), the dimensions on the screen and on the printout are the original
ones.

If it is not possible to display images in the Original Image aspect ratio

(1:1 scale), a message is displayed and the Fit to segment option is selected in-
stead.

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Showing/hiding text In the film settings, you can select whether you want to have text information
about the images printed/exposed.

Image texts and patient names should not be hidden. Otherwise, printed images
can easily be mixed up.
u Click the All text button.
— Or —
u Select the All text option in the Filming Properties dialog box.
– All text information about the images is displayed in the segments and later
filmed or printed together with the images.
u Click the No text button.
— Or —
u Select the No text option in the Film Properties dialog box.
– All text information in the segments is hidden.
u Click the Customized text button.
— Or —
u Select the Customized text option in the Film Properties dialog box.
– Only part of the text information is displayed and exposed on film or
printed.

In the Film Properties dialog box, you can now select which text information is
to be displayed if the Customized text option is selected.

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Displaying/hiding You can have graphics (e.g. ROIs) and annotations displayed or hidden.
graphics and
annotations
u Click the Show Graphics button.
— Or —
u Select the Show option in the Film Properties dialog box.
– The graphics (e.g. ROIs) and annotations are displayed.
u Click the Hide Graphics button.
— Or —
u Select the Hide option in the Film Properties dialog box.
– The graphics (e.g. ROIs) and annotations are hidden.

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Checking the data transfer 0

From the virtual film sheet the film jobs are transferred to the camera/printer.
A queue of jobs waiting to be executed will be formed.

Display in the During the filming process, the status bar displays icons that tell you whether
status bar errors have occurred during filming.

Action Symbol
Camera in operation

Film exposure interrupted

Output of warning messages

The status of the printer is not shown on the status bar.

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Viewing and manipulating film jobs 0

The Film Task Status dialog box contains detailed information about the filming
process. You can stop the entire queue, trigger it again and repeat or delete indi-
vidual film jobs.

Calling up the Film Task Status dialog 0

u Select Patient > Film Task Status.

Or
u Click the Film Task Status button.
Or
u Click an icon for local data transfer in the status bar.
– The Film Task Status dialog box is displayed.

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Displaying the queue

for a camera

u Click one of the camera icons.

– The queue of a camera is displayed.

The camera whose queue is being displayed is highlighted in a different color.

Displaying the queue

of a printer

u Click on one of the printer icons.

– The print job control box is displayed. Here you can manipulate the print
jobs for the selected printer by using the menu entries of the Windows XP
operating system.

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Manipulating film jobs 0

The status of a job determines how you can influence its execution and therefore
what buttons are active.

In the Film Task Status dialog box you can only edit those film jobs for which
you have initiated exposure (manually via Expose Film Task or with
Auto Expose).
Film jobs that have been completely transferred to the output device from the
queue can no longer be interrupted or deleted.

Stopping jobs You can stop jobs with the "Queued" or "Printing" status at any time, for example
to insert a new film.
u Select one or more jobs having the "Queued" status.
u Click Stop.
– All film jobs of this queue are stopped ("Stopped" status). In the job being
filmed, a sheet that has been started will still be completed. All the follow-
ing film sheets will not be processed.

Resuming jobs Once your camera is ready again, you can resume execution of the queue.
u Select one or more jobs with the "Stopped" status.
u Click Continue.
– All the jobs in the queue return to their original status. Film exposure is
resumed. The job that was being exposed when you clicked Stop is
resumed at the point at which you stopped the camera.

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Repeating jobs Film jobs that have been exposed and are therefore completed can be repeated
while they are still in the queue.
u Select the required film job that has already been exposed on film and has the
"Printed" status.
u Click Repeat.
– The job is assigned the "Queued" status and is copied to the end of the
queue.

Deleting jobs You can delete film jobs that are listed in a queue regardless of their status.
u Select one or more jobs.
— Or —
u Click Select All.

u Click Delete.
– The selected jobs are deleted.

If you delete a job that is being exposed, the sheet that has been started will still
be completed, but none of the following sheets will be exposed on film.

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Deleting the priority of Film jobs that you want to process first can be classified as "urgent".
film jobs
u Select one or more jobs with the "Queued" status.
u Click Urgent.
– This job moves to the first position of all jobs with the "Queued" status.

If several jobs are classified as "urgent", they will be processed in the order listed.

Selecting another You can select a new camera for one or more film jobs.
camera
u Select one or more film jobs.
u Click the Change Camera button.
– The Change Camera dialog window is opened.

u Select a new camera from the selection list.

You cannot redirect film jobs with the "Printing" status, i.e. jobs that are being pro-
cessed, to another camera.
Redirecting film jobs from a camera to a printer is not possible.

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Redirecting jobs from You can redirect the queue or even individual film jobs for a camera that is defec-
an inaccessible tive or switched off to another camera.
camera

u Click the camera icon.

– The queue of the camera is displayed.
u Click the Change Camera button.
– The Change Camera dialog window is opened.
u Select a substitute camera from the selection list.
u Close the Change Camera dialog box.
– The queue of the camera is redirected to the substitute camera. The redi-
rected queue is marked with the note "redirect" in the header of the dialog
box.

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Canceling camera
redirection

u Click the camera icon with the note "redirect".

– The redirected queue is displayed.
u Click Change Camera.
– The Change Camera dialog window is opened.
u Click Default.
– The queue is now assigned to the original camera again. The original device
designation is again displayed in the header of the Film Task Status dialog
box.

If you shut down the system before all the film jobs in a queue have been exe-
cuted, they will remain in the queue. After rebooting the system, the film jobs are
displayed in their old status again. Exception: Active film jobs for the local printer
will be stopped and deleted and must be re-created later.

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Configuration for filming/printing 0

You can adapt the filming and printing of images to your requirements in a flexible
and individual way.
For this purpose two configuration windows for setting up the film function are
available:
o In the Filming Layout configuration window, you can adapt the standard
layout and create new layouts that are tailored to individual studies.
o In the Filming Study Layout configuration window, you can assign specific
layouts to individual studies.

Calling up the configuration window 0

You can call up the configuration windows from the syngo Configuration panel.
u Select Options > Configuration in the main menu.
u Double-click the icon of the Filming Layout window.
– The Filming Layout window is displayed.

Or
u Double-click the icon of the Filming Study Layout window.
– The Filming Study Layout window is displayed.

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Configuring film layouts 0

You can change and create film layouts using the Film Task and the Series tab
cards in the Filming Layout window.

Selecting a layout 0

In the Filming Layout configuration window, you can define the study-specific
layouts.
In the Layout name selection list, you can specify which layout you want to
change.

Defining a During installation of your system, some study-specific layouts are also installed
study-specific layout and assigned to individual studies or series.
This has the advantage that a suitable film layout is always used for these images.
You can adapt the default settings to your requirements by creating a new study-
specific layout and assigning it to a study or changing an existing layout.

u Select the layout that you want to change.

Or
u Enter a new name.
– A new layout is generated.

Your system can manage up to 100 layouts. If you attempt to create

a 101st layout, an error message is displayed. You will then need to delete
an existing layout.
(› Page 60)

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Changing the standard When creating a new layout, you can base it on the settings of the standard layout
layout in the Film Task or Series tab cards and change it to meet your requirements.
u Click the General Default button.
– The standard settings are entered in gray in the radio buttons and check
boxes of the corresponding tab cards. Settings that you have changed are
shown in black so that you can distinguish them from the default settings.

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Configuring film job settings 0

On the Film Task tab card, you can define all the settings that determine the
structure and execution of a film job.

Determining a film job u Select the New film job by patient option.
– A film job contains only the images of one patient.
Or
u Deselect the New film job by patient option.
– Multiple film jobs are allowed.

Selecting a new film u Select the New film sheet by option.

sheet – Empty rows in film sheets are permitted.
u Select an option, e.g. Study.
– A new film sheet is started for each study.

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Selecting a new row in u Select New row of images by.

the film sheet – Empty fields in film sheets are permitted.
u Select an option, e.g. Series.
– A new row is started in the film sheet for each series.

Filming a partial u Use the spin buttons to set whether every n-th image or all images (n = 1)
selection of a film job are to be copied in the virtual film sheet and therefore
exposed⁄printed.

Selecting the number u Define the number of copies.

of copies

Selecting a film size u In the Film size selection list, select the film size configured for the
camera⁄printer.

The entries offered depend on the cameras and printers.

Selecting segment u Select the Segment lines option.

lines – The images on the film sheets are separated by lines.

Printing page numbers u Select Page number on print out.

– Page numbers are added to the printout.

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Configuring film sheets 0

On the Series tab card, you define the settings used for exposing or printing a
film sheet.

Select the film sheet u In the Layout divisions selection list, you define the required number of
division columns and rows for a film sheet.
– The division is shown in a diagram in the display window.

Selecting the u Select portrait for exposing on film/printing on paper.

orientation
Or
u Select landscape for exposing on film/printing on paper.

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Selecting the image u Activate the vertical option.

arrangement – The images are arranged on the film sheet one after the other from top to
bottom.
Or
u Activate the horizontal option.
– The images are arranged one after the other from left to right.

Creating series with When transferring a series to the virtual film sheet, you can have a copy generat-
copy on film sheet ed automatically and then process the copy before filming or printing.
u Click the Copy series option.
– Copies of the series are generated.
u Activate the Interleaved option.
– The copied series is inserted.
Or
u Activate the Appended option.
– The copied series is appended to the end.

Selecting the display u Activate the Keep visible part option.

– The image is displayed in the segment with maximum size, without being
cropped. This is the default.
Or
u Activate the Original Image option.
– The image is displayed in its original size. Depending on the original size,
the image might be cropped or displayed too small in the segment.
Or
u Activate the Clip document option.
– The image is enlarged so that it fills the entire segment. The overlapping
edges are cropped accordingly.

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Linking layouts to a study or series 0

In the Filming Study Layout window, you can assign a specific layout to a study
or series. This can either be a layout that you have created yourself or a layout
that was created by Siemens Service during the configuration of your system.

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Assigning film layout 0

You can assign a layout by selecting a study or series stored in your system and
the layout required and then linking the two.

u Select the required film layout.

u Click the + symbol in front of a study.

– The associated series are displayed.
u Click a series or study.
u Click the down arrow button.
– The layout is assigned to the selected study or series.

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Canceling a film layout assignment 0

If you want to assign a different study-specific film layout to a study or series, you
must first cancel the old layout assignment.
u Select the relevant study or series in the Studies/Series linked to selected
layout list.
u Click the up arrow button.
– The study/series is now assigned the standard layout again.

Deleting a layout 0

Since your system can store and manage up to 100 layouts, you should regularly
delete those film layouts that you no longer require for the sake of clarity.
u Select a layout that you no longer require from the Film layouts selection list.
u Click the Delete Layout button.
– The entry is deleted from the list.

You cannot delete the Standard layout.

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Introduction to archiving 0

After an examination or postprocessing, the images are stored in the local data-
base.
This section explains how to save images and patient data from the local data-
base and send them within the network, and how to export them to data media
or through the network.

The hard disk of your image system (local database) is not suitable for long-term
archiving of image and patient data.

Archiving data Using the Archive to... function, you can save patient and examination data to an
archive via the network.

You should archive patient and examination data as a routine at regular intervals.

Exporting data The Export To... function allows you to write data to a removable storage medi-
um (CD/DVD-R) for short-term storage or transfer.
If your system is connected to a network, you can send patient and examination
data to other workstations via the network using the Send to.... function.

Importing data from If you need archived data again at a later date, you can reimport them with the
archive media Patient Browser.

Automatic transfer To make your working routine more effective, you can also have your patient and
examination data automatically written to data media that you have defined, or
sent to specific addresses in the network.
You can define the rules by and time at which automatic data transmission is to
take place.

Import/export in the If you want to process or otherwise use images with other programs, you can ex-
file system/USB port them to a specific directory on the system hard disk or to a USB drive in sev-
eral image formats (DICOM, bitmap) (Export to Off-line).
In the same way, you can import images in DICOM format to your application
(Import from Off-line).

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Transfer options 0

The figure below shows the data backup and transfer options available to you.

Hard disk

Monitor trolley

Archive

Another workstation

CD-R
DVD-R

(1) Storing to the archive (Archive to...)

(2) Exporting on CD/DVD-R (Export To...)
(3) Importing from CD/DVD-R or from archive
(4) Sending to other workstations (Send to...)
(5) Receiving from other workstations
(6) Exporting to a directory on the local hard disk/USB drive (Export to Off-line)
(7) Importing from a directory on the local hard disk/USB drive (Import from
Off-line)

Please remember that not all transfer options may be available on your system.
The devices and network nodes available depend on the individual configuration
of your system and the options installed.

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Selecting data for transfer 0

Before you start transfer, select the relevant data objects.

You can only archive, export, or send objects that are stored in the local database.
If data are to be transferred from one data medium to another, they must first be
imported into the main database.

Scenes (multiframe objects) with more than 1023 images cannot be written
to CD, exported to an offline directory, or sent to a DICOM network node.

Patient Browser If you want to archive or transfer patient or examination data, you usually select
them from the local database of the Patient Browser.

Task cards You can also select individual objects on the task cards to start transfer.
o Viewing task card

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Calling up transfer functions 0

You can call up archiving, data transfer within the network, and export and import
either from a menu or from icon buttons.

Transfer menu You can start archiving and transmission of data from the Transfer menu on the
Viewing task card and in the Patient Browser window.

Names such as CD/DVD-R and Network/PACS are only examples of drive and
network names. The names actually used depend on the configuration of your
system.

Buttons Depending on your configuration, you will find different buttons for starting trans-
fer quickly and easily in the control area of your task cards.
You will also find a series of icon buttons in the tool bar of the Patient Browser
with which you can start transfers.

(1) Import data

(2) Storing data to a specified default CD/DVD-R
(3) Storing data to a selectable local data medium (CD/DVD-R)
(4) Sending data to the first default network destination
(5) Sending data to the second default network destination
(6) Sending data to a selectable network destination

Key
You can also start transfer to the first default network destination with the
Send to default Node 1 key on the symbol keypad.

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Archiving Data 0

The menu item Archive To... is used to copy selected patient and examination
data to archive media. For this, an archive server may be set up via the network.
You can import archived data back to your local database whenever you need
them.

The hard disk of your image system (local database) is not suitable for long-term
archiving of image and patient data.

General safety information 0

When archiving or sending data, an acknowledgement of receipt is sent from

the destination address back to your computer ("Storage Commitment").
In the Patient Browser, this status is shown by flags for the relevant data objects.
The following "Storage Commitment" flags are used:
o AC
Archived and committed
o SC
Sent and committed
However, the flags do not confirm successful long-term archiving on the receiver
side.

Caution
Misleading/misinterpretation of the AC/SC flags. The AC/SC flags indicate re-
ceipt and storage of data on hard disk on the receiver side.
Loss of data within the required period for retention!
u Observe the regulatory requirements regarding the archiving procedure.

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Caution
CD/DVD-R media used for data storage can be damaged or rendered unread-
able.
Loss of data!
u Local media should be configured and used as archive media only if the
manufacturer has approved the media for archiving purposes.
u Check whether the data are legible before deleting them from the
local database.

There are (statutory) regulations governing the archiving period, data availability,
and data security (data integrity, incorruptibility), and recommendations concern-
ing fire protection or water damage for the archiving of image data. The operator
of the archive is responsible for observing these regulations.

Due to constant technical advancements, it may not be possible to implement

storage and access for the required archiving period with a single storage tech-
nology and type of medium. Hence, migration of data may be necessary under
the responsibility of the operator of the digital archive.

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Archiving in the network (option) 0

If your system is connected to a central archive, use this to archive your patient
and examination data (only with DICOM option).
The following information is of relevance for archive nodes:
o Destination
Name of the archive.
o Compression
Method by which data are compressed.
o Quality Factor
Quality factor with which data are compressed.
u Select the data that you want to archive.
u Select Transfer > Archive To....
– The Archive To dialog box is displayed. The available archive nodes and
drives are displayed.

u Select the required archive from the list.

u Click Archive to transfer the data to the selected archive.

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Exporting data 0

Unlike the archiving function, the export function does not check for previous ar-
chiving processes, flags or the work status. In addition, data are not marked as
archived, but only as exported.

General safety information 0

Caution
When you read data from a device and simultaneously export data to the same
device, one job or both jobs can fail (depending on the timing).
Loss of data!
u When exporting or storing data to a local device (CD, DVD, MOD,
DVD-RAM), do not try to read from the same device in parallel, since this
may stop the current export job and even damage the export medium. If you
have stored data on the export medium in multi-session mode, these data
may also become unreadable.

To minimize the risk of data loss, use only CD/DVD-Rs approved by Siemens.
CD⁄DVD-Rs are available through your Siemens representative.

Never shut down the ARCADIS Orbic or disconnect the monitor trolley from the
C-arm system while data is being written to CD/DVD-R.

As a rule, you cannot release radiation during the CD/DVD-R write process.
In exceptional cases (emergencies), you can release radiation in fluoroscopy
mode. However, radiation may be disrupted.
Moreover, the export process of subtracted images to CD/DVD-R is interrupted
during radiation release and other compute-intensive processes (e.g., play LSH).
Images are in those cases stored as raw data.
You are therefore urgently advised to start write processes outside of examina-
tion hours (e.g. at the end of the office day).

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Backup on local data media 0

Media for saving data 0

Depending on the routine you use, one or several drives for external data media
(CD/DVD-R) will be connected to your system.

In Transfer Configuration you can define how the data of a patient are to be
written to a medium (memory utilization and compression).

Data media ARCADIS Orbic supports the following media types for saving data:
o DVD-R (minus R) and
o CD
If other media is accidentally used, e.g., DVD+R or DVD-RW, this may impair
functionality.

Data are archived to a central archive via the network. The archive can use other
data media.

Handling of Please pay attention to the instructions of the manufacturer for handling and
data media storage of CD/DVD-Rs.

Drives Your system comes with a CD/DVD writer for data storage.

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Inserting and ejecting media 0

To export data, you must insert a suitable CD/DVD-R in the correct drive.

Inserting the medium CDs/DVDs can be written to on one side only.

u Select Transfer > Eject from CD/DVD.
– The drawer slides out.
u Place the CD/DVD in the drawer with the label facing up.
u Press the eject button on the drive.
– The drawer with the CD/DVD is retracted.

Ejecting medium from If there is a CD/DVD in the drive, the drive slot cannot be opened using the button
the drive on the actual slot.
u Always remove the CD/DVD from the drive using only in the
Transfer > Eject from CD/DVD menu.
– Or –
u Click the relevant button.

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Storing on multi-session media 0

As your system is configured for multi-session, you can store your data to new,
unrecorded CD/DVD-Rs, or CD/DVD-Rs that have already been written to.
The other data on the CD/DVD-R is not lost, the new data is simply added.

DICOM Viewer In the first session, a DICOM viewer is written to the CD/DVD together with the
image data. This allows you to view the images stored on the medium on any
computer. The DICOM viewer is launched directly from the medium (automati-
cally after the CD/DVD is inserted, or manually by double-clicking
\SYNGO_FV\SYNGO_FV.EXE). No installation of files takes place on the
computer in question.

The DICOM viewer also allows you to store imported image information in the
AVI, Bitmap and JPEG file formats. It is currently not possible to display com-
pressed data on the DICOM viewer.

Selecting data Usually you export the data to CD/DVD-R from the Patient Browser, where you
can simply select the required data objects.

Caution
Write error during the recording of additional sessions on the medium in
multi-session mode.
Previously stored data and data of the current session can no longer
be read!
u Do not delete the data stored on a medium from the local database until you
have successfully finalized the medium and verified the legibility of the data.
u Please note that CD/DVD-Rs are not suitable for long-term archiving.

u Make sure that the correct CD/DVD-R is in the drive.

u Open the Patient Browser.
u Select the patient, study, series or images that you want to store on
CD⁄DVD-R in the navigation or content area.

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Writing data to a u Select Transfer > Export to... in the menu.

CD⁄DVD-R
– Or –
u Click this button.
– The selected data are written to CD/DVD-R.
– The CD/DVD is automatically labeled with the date and time.

If the patient data are not yet complete, a corresponding message is displayed.
Enter the missing data in the Correct dialog box.

Insufficient memory available

If the storage capacity of the CD/DVD-R is not sufficient, the message
Not enough space on CD/DVD is displayed.
u If you want to change the CD/DVD-R (for example, to insert a new,
unrecorded CD/DVD-R), click Eject.

Finalizing the medium Once all desired data have been written to the CD/DVD, it is best to finalize the
medium. This prevents the data on the medium from becoming illegible in the
case of a write error during future write processes.
u Select Transfer > Eject Finalized from CD/DVD-R.

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Sending patient data in the network (option) 0

If your system is connected to and configured in a network, you can select patient
and examination data from your local database and send them to other users in
your DICOM network whenever necessary.

Sending data to a standard address 0

During installation, Siemens Service can configure various network nodes

(e.g. Node 1 and Node 2) as standard addresses in the network.
u Select the data that you want to send.
u Press the Send to Node 1 key on the symbol keypad.

Or
u Call up Transfer > Send to Node 1 or Transfer > Send to Node 2.
— Or —
u Click the relevant button.
– The data are sent to the selected address.

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Sending data to other addresses in the network 0

If you want to send data to addresses other than the standard addresses or to
more than one user in the network simultaneously, select the network node(s)
from a list.
u First select the data that you want to send.
u Select Transfer > Send to....
— Or —
u Click this button.
– The Send To dialog box is displayed with a list of all available network
addresses.

(1) Network Node

– Name of the network node (receiver name).
(2) Compression
– Compression method by which the data are prepared for faster transfer.
(3) Quality Factor
– The quality factor states the image quality of the compressed data com-
pared with the original data.
u Select one or more network nodes.
u Click Send.
– The selected data are sent to the required address(es).

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Import/export in the file system 0

If you want to use and process images on other devices, too, you can copy them
from the local database to a directory on your hard disk, on a network computer
or a USB drive (external hard drive, USB stick), and import them from there.

Please note that the DICOM Viewer will not be saved in the file system during
exports.

If you save data to a USB storage medium, please take care that it is not un-
plugged during the storage process. Danger of data loss!

Image formats The following formats are supported for exporting:

o DICOM format (*.ima)
o Windows Bitmap (*.bmp)

Importing images is only possible in DICOM format, not in Windows bitmap or

AVI format.

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Exporting images to the file system 0

Calling up the u Select the required images.

Export dialog
u Select Transfer > Export to Off-line.
– The Export to Off-line dialog box is displayed.

Selecting the path u Select the required drive and directory from the Path selection list.
– Select drive F:\ to select an inserted USB stick.
u Extend the path, if necessary.

To select or create a subdirectory, add the subdirectory path to the prompted

path separated by "\" (up to 8 subdirectory levels are possible from the root direc-
tory).
You can also select a directory on another computer in the network. In this case,
you must enter the path as "\\computer_name\directory".

Please make sure that the names of new directories and subdirectories do not
contain blanks.
Do not use any of the following characters: ^ = \

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Selecting an u Select the required image format from the Select format selection list.
image format

Depending on the image type in question, images are exported with

8 bit⁄256 gray scales or 24 bit/RGB.
If you have selected a multiframe image in the Patient Browser, only the repre-
sentative image in bitmap format is exported. In the Viewing task card you can
select the individual images explicitly.
Be aware that files of the C:\Temp\CDR_OFFLINE directory exceeding the
CD⁄DVD-R’s capacity are deleted when the Record Off-line Files function has
been successfully performed.

Selecting image text/

graphic
u Check the corresponding check boxes.
– The image text and the graphic are "burnt into" the image and exported
with it.

If you have selected DICOM format, the image text and the graphic is also export-
ed as it is included in DICOM format, i.e. Export functions in the dialog window
are disabled.

Export anonymously u Click the anonymously check box.

u Enter the name under which to store the data in the Dummy Name field.

Starting export
u Confirm by clicking OK.
– The selected image data is stored as individual files.
– File names follow the following scheme:
Last name of the patient.modality.study description.serial number.
image number.timestamp.internal number.image format
– The timestamp follows the following format:
yyyy.MM.DD.hh.mm.ss.dddddd

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Importing images from the file system 0

You can import individual images from specific released directories of the system
hard disk or USB drives or import them into your local database across the net-
work.

Calling up the u Select Transfer > Import from Off-line.

Import dialog – The Import from Off-line dialog box is displayed.

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Selecting files

u Select the required drive and directory from the Path selection list.
– Select drive F:\ to select an inserted USB stick.
— Or —
u If necessary, navigate through the directory tree by double-clicking on a folder
and using the "higher-level folder" button.

All directories starting with the configured root directory are accessible.
u Enter a file name.

You can specify several files at once using the wildcard "*".
Or
u Select the file(s) in question from the directory.

You can select several files at once with the left mouse button using Shift
and Ctrl.
u Confirm by clicking OK.
Or
u Double-click the relevant file.
– The selected image files are imported into your local database.

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Writing off-line files to CD/DVD 0

All images in bitmap format exported previously to a specific directory, can be re-
corded automatically on CD/DVD-R. The path of this directory can be configured
in service mode. The default setting for this path is
C:\ASPIA\temp\CDR_OFFLINE.

As a rule, you cannot release radiation during the CD/DVD-R write process.
You are urgently advised to start this process outside of examination hours
(e.g. at the end of the office day).
In exceptional cases (emergencies), you can release radiation in the Fluoroscopy
operating mode. However, radiation may be disrupted.

Recording files u Select Transfer > Record Off-line Files in the main menu.
– Recording is started in single session mode.

Note that the CD/DVD-R and the Local Job Status clipboard must be empty.
Recording can be started only after all jobs have been deleted from the clipboard.

During the recording process it is not possible to copy files to the source
directory.

Deleting files u All recorded files will be deleted from this directory after recording on CD-R is
completed.

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Checking the data transfer 0

All the jobs for archiving, sending or exporting data are executed one after the
other ("Queued").
You can classify one network job as urgent, stop jobs, repeat jobs or delete jobs
to influence how the queue is executed.

Display in the During data transfer, icons are displayed in the status bar which tell you what op-
status bar eration is currently being executed or whether an error has occurred in at least
one job.

Action Not active Active Errors

Storing/Exporting/ No icon
Importing on data
medium
Sending/Archiving/ No icon
Receiving in the
network

If an error occurs during data transfer, an error message appears on the status
bar together with the appropriate icon.

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Viewing jobs 0

The Local Job Status dialog box informs you about storage jobs and the export
and import of data to or from your CD/DVD drives.
In the Network Job Status dialog box, you can obtain information about jobs for
data exchange through the network.

If your system is closed down during an archiving job, the number of remaining
images displayed in the Job Status dialog boxes may be incorrect when you re-
start the system.
Jobs with the status "Error", "Receiving" (or active import jobs), or "Spooling" are
no longer displayed after a restart.

Calling up local jobs 0

u Select Transfer > Local Job Status.

Or
u Click an icon for local data transfer in the status bar.
– The Local Job Status dialog box is displayed.

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Calling up network jobs 0

u Select Transfer > Network Job Status.

Or
u Click the status bar on an icon for remote data transfer.
– The Network Job Status dialog box is displayed.

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Manipulating job performance 0

The steps that you can perform in the Local Job Status... and Network Job
Status... dialog windows and therefore the buttons that are active depend on the
status of a job.

Stopping jobs Jobs with the status "Active", "Retry" and "Queued" can be stopped at any time,
for example, if you want to change the CD/DVD-R before processing the jobs.
u Select one or more jobs having the "Queued" status.
u Click Stop.
– The selected jobs and all other queued jobs with the same destination
address are now no longer started automatically.

Resuming jobs Jobs with "Stopped" or "Failed" status can be resumed at the point at which they
were stopped (only for archive and import processes listed in the Local Job
Status window).
u Select one or more jobs with "Stopped" or "Failed" status.
u Click Continue.
– Jobs with the same destination address as the selected jobs are also
resumed.

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Restarting jobs If you have stopped jobs or if errors occurred in jobs, you can start them again
from the beginning. You can also repeat a job that has already been completed.
u Select one or more jobs with "Stopping", "Stopped", "Failed" or "Completed"
status.
u Click Restart.
– The jobs are restarted, their status is now "Active" or "Queued".

Deleting jobs You can delete jobs that are listed in the job status windows, provided they do
not have the status "Receiving", "Recording" or "Spooling".
u Select one or more jobs.
u Click Delete.
– These jobs will no longer be executed and they will be removed from the
job list.

For technical reasons, large jobs will remain in the job list for a while with
"Deleting" status even after they have been deleted. Do not restart or continue
such a job.

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Changing priority Send jobs that are to be processed first are classified as "urgent" in the Network
Job Status dialog box (no more than one job per destination address).
u Select one send job that is to be executed first.
u Click Urgent.
– The send job in the queue is then started immediately after the active jobs.

Clearing a job list Entries having the status "Completed", "Received", or "Error" can be removed from
the job list.
u Click Clear.
– The jobs are removed from the job list.

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Configuration for archiving 0

In the Transfer Configuration window, you can define how store, export and
send jobs are executed by your system.
Here you can make or change the following settings:
o Automatic storing and sending of examination data
o Compression of data during storing, export and sending
o Work status required for storing data and storage capacity on data media

Calling up the configuration window 0

You can call up the configuration window from the syngo Configuration panel.
u Select Options > Configuration in the main menu.
u Double-click on the icon of the Transfer configuration window.
– The Transfer Configuration window is displayed with the Auto Transfer,
Local Devices and Network Nodes tab cards.

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Automatic transfer 0

On the Auto Transfer tab card, you can define whether and by what rules patient
and examination data are automatically stored or sent in the network.

(1) Active
A checkmark in the column indicates that this rule is currently being applied.
(2) Workstate
The data selected for transfer that have reached the work status specified
here are automatically stored or sent in the network.
(3) Processing Status
Data that have reached the status stated here are automatically stored or
sent via the network.
(4) Objects
Here you can see to what kind of data the rules refer (i.e. images, series ...).
(5) Destination
In this column, you can see to which drive or to which network address the
data are automatically transferred.
(6) Marked
A checkmark in this column indicates that only marked data are automatically
transferred.
(7) Printed
A checkmark in this column indicates that only printed data are automatically
transferred.

When emergency registration is performed, automatic data transfer is deactivat-

ed (indicated in the status bar). After normal registration automatic data transfer
is reactivated.

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Creating and editing rules 0

Underneath the list with existing rules for automatic data transfer, you will find
input fields for editing the rules or creating new rules. You can create up to
ten rules.

Selecting rules

u Select a rule for editing from the list.

Or
u Click New to create a new rule.

Creating rules You can create a rule for automatic data transfer by combining attributes from the
selection lists in the lower segment of the dialog window.

The selection lists contain the following special entries:

Selecting None in these selection lists means that an auto transfer route is valid
if the according attribute is empty.
Selecting Ignore means that the status is not relevant to the rule and changes
will not be considered.
Selecting * means that any change to the corresponding attribute will initiate an
automatic transfer.

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u Select the editing and processing status to be reached.

– Automatic data transfer will only be started if both attributes have the indi-
cated status.

Please note that you can also assign the "completed" status manually in the
Patient Browser and thus initiate automatic data transfer, if necessary.

u Select the data type and the target.

Automatic data transfer should always be configured at instance level.

u Click this check box if you want to limit the data transfer to marked and/or
filmed/printed images.
– Other images will not be transferred automatically even if the transfer rules
have been met.

Activating rules

u Click on the Activate transfer rule check box.

– The selected rule is active and used for starting automatic data transfer
jobs.

Shut down the ARCADIS Orbic and restart it after activating new transfer rules.
Otherwise, the status display for data transfer may not be updated (display will
be set to "Waiting" although an auto transfer was successfully completed).

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Infinite loops 0

Avoid infinite loops when creating rules!

Example of an unfortunate configuration with an endless loop:

(1) Computer 1 sends data to computer 2.

(2) Rule on computer 2: Send all data received to computer 3.
(3) Rule on computer 3: Send all data received to computer 2.
As soon as computer 2 receives data for the first time, these data are sent back
and forth in a loop between computers 2 and 3.

Deleting rules 0

Rules that will not be needed again for automatic data transfer can be deleted in-
stead of just deactivating them.

u Select the rule that you want to delete from the list.
u Click Delete.
– The rule is removed from the list.

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Local Devices 0

On the Local Devices tab card, you define the default settings for storing and ex-
porting data on the data media.

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Defining the use of storage capacity 0

If you require more than one data medium for storing or exporting, you can define
whether the data of one patient can be distributed over two data media or not
(if possible).

u Click on the option field Keep all objects....

– The data of one patient are always stored contiguously on one data
medium.
Or
u Click on the radio button Maximize media usage.
– The examination data of one patient are distributed over two or more data
media. This will make optimum use of the storage capacity of the data
media.

Keep all objects for one patient on one medium only ever applies to one job.

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Setting data compression for storing 0

Patient and examination data can be stored or exported compressed or uncom-

pressed.
Data that were compressed before transfer will use up less storage space and
are transferred more quickly. When reimporting data into your local database,
compressed data are automatically decompressed.

Images stored in your database by lossy compression can only be stored with the
same quality factor.

Caution
The compression method is set to irreversible compression (Lossy JPEG).
Information of medical relevance may be lost.
u Do not use images stored by lossy compression for primary diagnosis, since
their image quality may not be sufficient.

u Select a drive for which you want to define data compression.

u Select under Compression type whether and how the data is to be com-
pressed.

u State under Quality Factor (1-100%) the remaining image quality in % as

compared with the original material.

The quality factor can be specified only in the Lossy JPEG setting. Which quality
factor is acceptable to you will depend on your requirements.
JPEG compression is indicated in the image segment (it is not indicated if
No Text is selected).

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Defining the work status for storing 0

Here you can select the work status that patient and examination data must have
reached before storing. If this work status is not reached, a warning will be dis-
played before data transfer starts.

u Use the radio buttons to define the work status required as a prerequisite for
storing.

The Verified and Read options apply to the study and series levels only.
If you select the Unspecific option, you can store data of any work status without
confirmation.
u Click on the Filmed check box, if necessary.
– Images must have been printed/filmed at least once before they are
stored.

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Network nodes (option) 0

On the Network Nodes task card, you can define the default settings for sending
data in the network. For each network address you can specify the compression
type and quality factor, if necessary, as well as rules for repeated send attempts
and the work status.

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Setting data compression for sending 0

Similar to storing or exporting data on external data media, you can activate data
compression for sending patient and examination data through the network
(depending on the configuration of your system).

Caution
The compression method is set to "irreversible compression" (Lossy JPEG).
Information of medical relevance may be lost.
u Do not use images stored by lossy compression for primary diagnosis, since
their image quality may not be sufficient.

u Specify the individual network addresses, the compression type and quality
factor.
(› Page 94)

Setting retries 0

If errors occur during data transmission in the network, they can often be reme-
died by a repeated attempt. You can set how many times and at what interval
attempts are to be repeated.

u Enter the number of retries or click on the arrows. (Possible values: 0 to 5;

default: 0)
u Enter the time interval between retries. (Possible values: 5 to 60 min;
default: 10 min)
– The number of new attempts is displayed in the window Network Job
Status.

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Defining the work status for sending 0

Here you can select the work status that patient and examination data must have
reached before they can be sent. If this work status is not reached, a warning is
displayed before sending.

u With the radio buttons, specify the work status desired for sending.
(› Page 95)

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Table of Contents

Configuration Examination................................................................................................... 3
Calling up/closing a configuration window........................................................................................ 4
Basic settings ................................................................................................................................... 5
Managing examination sets .............................................................................................................. 6
Displaying a list of examination sets....................................................................................... 6
Available/active examination sets ........................................................................................... 8
Setting defaults ...................................................................................................................... 9
User-defined examination sets ............................................................................................. 10
Configuring the operating programs ............................................................................................... 13
The Common tab card .......................................................................................................... 14
The Fluoroscopy tab card ..................................................................................................... 15
The Digital Radiography tab card .......................................................................................... 17
The Subtraction tab card....................................................................................................... 18
The Roadmap tab card.......................................................................................................... 20
The LUT Data tab card.......................................................................................................... 21
The Edge Filters tab card...................................................................................................... 23

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Register 9 Configuration

Configuration Examination 0

It is generally not necessary to set examination parameters and thus configure

exam sets, since the default standard programs delivered with the system al-
ready cover a large spectrum of dedicated applications.
If you wish to configure your own examination sets nevertheless, you can make
the parameter settings in the Examination Set Configuration dialog window.
The following configuration options are available:
o Basic settings for examinations in the Basic display mode of the Examination
task card. These default settings are used for the examinations of body re-
gions.
o Administration (activating, deactivating, creating and deleting) of exam sets.
This determines which examination sets are available for the examination.
In the display mode Extended of the Examination task card, these entries
are shown in the selection lists of the control area.
The administration of examination sets is done in the Examination Set
Configuration dialog box.
o Modifying system-specific parameter of operating programs (= parameter
sets for operating modes). Thus you can define in detail the acquisition param-
eters of the exam set to which the relevant operating program belongs.
These settings are made in special tab cards that can be called up for the cor-
responding exam set from the Examination Set Configuration dialog.

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Configuration

Calling up/closing a configuration window 0

You can call up the configuration window from the syngo Configuration panel.
u Select Options > Configuration in the main menu.
u Double-click this button.
– The Examination Set Configuration window appears.

(1) Medical application area

(2) Virtual patient anatomy (VPA)
(3) Area of available examination sets
(4) Area of active examination sets
(5) Operating programs with the parameter settings specific to the examination
set in the individual operating modes

Applying changes Once you have changed the settings of the examination sets, you must confirm
your entries.
u Click this button.
– Your changes are applied to the ARCADIS Orbic system.
– The configuration dialog remains open for further entries.
Or
u Click this button.
– Your changes are applied to the ARCADIS Orbic system.
– The configuration dialog is closed.
– The changes you made in the examination settings are automatically
applied to the next examination.

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Basic settings 0

In the case of examinations you perform in the Basic display mode of the
Examination task card, you only have to select the body region. The medical ap-
plication area, the examination program and the operating mode are then preset
automatically. You can define the presettings for individual body regions in the
Basic Mode Configuration window.

Calling up the
dialog window
u Click this button in the Examination Set Configuration window.
– The Basic Mode Configuration window appears.
– Every line contains the current default settings for a body region.

Changing default u Select the application area, examination set and operating mode for each body
settings region from the corresponding selection lists.

Only application areas relevant to the corresponding body region are displayed.
When the application area is changed, another matching examination set and
operating mode is automatically set as a default. This selection may also be mod-
ified.
u Click this button.
– Your changes will be saved; the dialog box closes.

Note that your changes will only become active when you close the Examination
Set Configuration window with OK.

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Configuration

Managing examination sets 0

The examination sets are assigned to medical application fields. Within each ap-
plication they are also assigned to special body regions. You will find the same
assignment pattern on the Examination task card in the Extended display
mode.

Medical application fields can additionally be licensed by options. The medical ap-
plication area 'Vascular', for instance, is tied to the 'SUB/Roadmap' option. If the
option is not activated, the Examination Set Configuration will not contain a
configuration card for this option, and the application area cannot be selected in
the Examination task card.

Displaying a list of examination sets 0

To edit examination sets, first select the medical application field and then the
body region. All valid examination sets for this combination are shown.

Medical application Each medical application field is represented by a tab card in the Examination
area Set Configuration dialog window.
u Click on the tab of the required medical application field.
– The selected tab card is placed in the foreground.

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Body region Within a medical application field, the following body regions (and only these) can
be selected: "Head", "Body trunk" (thorax, ventral region, cervical spine, thoracic
spine), "Pelvis" (pelvis, lumbar spine, hip), "Upper extremities",
"Lower extremities" as well as "All" (for general purposes).
u Click the required body region in the "Virtual patient anatomy".
– The activated body region is highlighted.
– In the lower area of the Examination Set Configuration dialog window,
the examination sets which are especially designated for this body region
are displayed.
Or
u Click next to the "virtual patient anatomy" to select the body region "All".
– None of the body regions is highlighted.

A medical application area does not necessarily contain examination sets for all
indicated body regions. The assignment of body regions depends on the medical
application area.

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Available/active examination sets 0

The examination sets are listed in the Examination Set Pool and
Active Examination Sets areas.

Examination Set Pool The area of available examination sets consists of all programmed examination
sets that are stored in the ARCADIS Orbic, but have not necessarily been
activated.

Active examination The area of active examination sets consists of all programmed examination sets
sets stored in the ARCADIS Orbic that have been activated. These are now available
for examinations. In the display mode Extended of the Examination task card,
these entries are shown in the selection lists of the control area.

Activating exam sets You can activate further examination sets by moving them from the selection
pool to the active pool.
u Click an examination set in the Examination Set Pool area.
u Click this button.
Or
u Drag the examination set into the Active Examination Sets list using the
mouse.
– The examination set is available for examinations in the selected applica-
tion area for the corresponding body region.

Changing the The sequence of examination sets in this list of active programs defines the se-
sequence quence in which they appear in the selection list of the Examination task card.
Therefore the most important and most frequently used programs should be at
the top of the list.
u Drag the examination sets individually to the required position within the
active pool.

A horizontal line represents the examination set that is currently being moved.

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Deactivating exam You can deactivate individual examination sets by moving them from the active
sets to the selection pool.
u Click an examination set in the Active Examination Sets area.
u Click this button.
Or
u Drag the examination set into the Examination Set Pool list using the
mouse.

At least one examination set must remain in the list of active examination sets.
You cannot deactivate all examination sets.

Setting defaults 0

In the case of examinations you perform in the Extended display mode of the
Examination task card, you initially select the medical application area and the
body region. A certain examination set is then selected automatically as a default
for this combination. The default examination sets can be defined in the
Examination Set Configuration dialog window.

u Click on the desired examination set in the Active Examination Sets area.
– The line is shown with a blue background.
u Click this button.
– The examination set is set as the default for the displayed combination of
application area and body region.
– This examination set is now shown in bold print in the list.

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User-defined examination sets 0

In the Examination Set Configuration dialog window, you can create your own
examination sets with self-defined settings. In the Examination task card you
can access these user-defined examination sets in the same way as the default
standard examination sets, shown in italics.
User-defined examination sets are created on the basis of an existing examina-
tion set. You can adapt the system-specific parameters to your requirements by
editing the individual operating programs assigned to the examination set.
(› Page 13)

Creating exam sets u Select the set you want to use as a template from the active or selectable
examination sets.
u Click this button.
— Or —
u Select Copy As in the context menu of the name entry for the examination
set.
– The Copy As dialog box is opened.

u In the center area, select another medical application area and/or another body
region if applicable.
– The default settings are the same data as those of the template.
u Enter a unique name for the new examination set in the lower segment.

u Click this button.

– The new examination set is created within the current medical application
field and the selected body region and is added to the Examination Set
Pool. If an active examination set was selected as a template, the newly
created examination set is also included in the list of active examination
sets.

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Renaming exam sets u Double-click the name entry of the examination set you want to rename.
— Or —
u Select Rename in the context menu of the name entry.
– A dialog window is displayed in which you can enter the text.
u Enter a suitable name for your examination set.
u Confirm with the Enter (Return) key of your keyboard.
– The new name is accepted and is displayed in the examination set lists.

The standard examination sets delivered with the system cannot be renamed
(shown in cursive print).

Deleting exam sets u Select the examination set that you want to delete.
u Click this button.
— Or —
u Select Delete in the context menu of the name entry for the examination set.
– A dialog window is displayed which prompts you to confirm deletion.
u Click this button.
– The examination set is deleted from the examination set lists.

The standard examination sets delivered with the system cannot be deleted
(shown in cursive print).

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Configuration

Editing exam sets Examination parameters are changed by editing the corresponding operating pro-
grams. Operation program settings can be defined on separate tab cards which
you can call up from the Examination Set Configuration window after selecting
the examination set.

Changes to the parameters of an examination set should only be performed by

experienced medical staff.
If the examination or operating parameters have been modified, a test pattern
should be generated. In this way the new parameters can be verified.
u Select the examination set whose operating parameters you want to change.
u Click this button.
— Or —
u Select Edit in the context menu of the name entry for the examination set.
– The Operating Program Configuration window appears. Here you can
define all the parameter settings for the different operating programs of the
selected examination set.
(› Page 13)

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Configuring the operating programs 0

An examination set consists of a set of operating programs. Each of these pro-

grams defines the settings for X-ray generation and image acquisition for one sin-
gle operating mode.
The operating programs are configured in the Operating Program
Configuration dialog, which you have called up from the Examination Set
Configuration dialog.
The Operating Program Configuration dialog contains a tab card (labeled corre-
spondingly) for each supported operating mode. In the tab cards you can specify
the parameters of the operating program in the respective operating mode.
In addition, some parameters may be common to several operating modes of an
examination set. They are available on other tab cards that are independent of the
operating mode.

The parameters for the fluoroscopy, pulsed fluoroscopy and digital radiography
modes are configured for every examination set. For the Subtraction option the
parameters for the Subtraction and Roadmap modes are configured additionally.
The parameters are individually adapted to each examination set.

There is a Default button on every tab card. With this button you can reset the
parameters back to the original state (parameter settings of the underlying
operating program).

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Configuration

The Common tab card 0

On this tab card you define the parameters that apply to all operating programs
in each examination set.

Parameter settings You can change the following parameters on the tab card:

Parameter Additional info

Black Offset Native possible values: -200 to 900
Black Offset Native Metal possible values: -200 to 900
Auto Dose Adjustment
Auto Dose Adjustment Metal

Changing parameters u Select the required new parameters from the selection lists.
u Click this button.
– Your changes are applied to the ARCADIS Orbic system.
– The configuration dialog remains open for further entries.
u Continue configuring the next operating mode on the corresponding tab card.
— Or —
u Click this button.
– The dialog box closes.

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The Fluoroscopy tab card 0

The operating programs for continuous fluoro and pulsed fluoro are configured on
the same tab card. There are some parameters that are specific to each of these
operating programs (CONTINUOUS and PULSED areas), and some that are
identical for both (COMMON area).

Parameter settings You can change the following parameters on the tab card of the individual area:

Parameter Additional info

Noise Reduction Parameter sets for noise reduction
and or motion detection are possible
Noise Reduction Low Noise Reduction Low is always less or
equal to noise reduction
Noise Reduction LIH Special noise reduction factor for
LIH image to guarantee appropriate
image quality even with short-time
release
off (no noise reduction)
k = 2, k = 4, k = 8 (noise reduction on
with selected k factor); with PFC for
pulse rates > 2 P/s only

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Configuration

Parameter Additional info

Noise Reduction LIH Low Special noise reduction factor for
LIH image to guarantee appropriate
image quality even with short-time
release
off (no noise reduction)
k = 2, k = 4, k = 8 (noise reduction on
with selected k factor); with PFC for
pulse rates > 2 P/s only
Autostore off (no automatic storage)
last (last image is stored)
all (all images are stored)
Storage Rate f/s Only if Autostore = all
Setting in frames/s
Autoloop Check box for activating automatic
playback of a sequence of images at
the end of the exposure
Pulsed - p/s Pulse rate; possible values for storage
rate depend on the set value
Dose Level Possible values: low, medium, high
Characteristic Curve Entries can be defined using the
service user interface
Bone Display Possible values: white, black

Changing parameters u Select the required new parameters from the selection lists.
u Click this button.
– Your changes are applied to the ARCADIS Orbic system.
– The configuration dialog remains open for further entries.
u Continue configuring the next operating mode on the corresponding tab card.
— Or —
u Click this button.
– The dialog box closes.

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The Digital Radiography tab card 0

Parameter settings You can change the following parameters on the tab card:

Parameter Additional info

Dose Level Possible values: medium, high
Noise Reduction Parameter sets for noise reduction
and or motion detection are possible
Noise Reduction Low Noise Reduction Low is always less or
equal to noise reduction
Bone Display Possible values: white, black
Autostore Check box for activating/deactivating
automatic storage of images

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Configuration

Changing parameters u Select the required new parameters from the selection lists.
u Click this button.
– Your changes are applied to the ARCADIS Orbic system.
– The configuration dialog remains open for further entries.
u Continue configuring the next operating mode on the corresponding tab card.
— Or —
u Click this button.
– The dialog box closes.

The Subtraction tab card 0

This tab card is available only with the Subtraction option.

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Parameter settings You can change the following parameters on the tab card:

Parameter Additional info

Opacification Possible values: min, max
Dose Level Possible values: medium, high
Landmark with the slider: 0 to 30%, in steps of 5%
Bone Display Possible values: white, black
Autostore off (no automatic storage)
Phase B1, phase B2 (saves only images
of the respective phase)
all (all images are stored)
Duration Phase B1 Disabled if Autostore = ’off’, otherwise
enabled
Storage Rate Phase B1 f/s Enabled if Autostore = ’all’ and a
duration phase B1 > 0 is set
Storage Rate (Phase B2) f/s Enabled if Autostore = ‘all’
Autoloop Check box for activating automatic
playback of a sequence of images at the
end of the exposure

Changing parameters u Select the required new parameters from the selection lists.
u Click this button.
– Your changes are applied to the ARCADIS Orbic system.
– The configuration dialog remains open for further entries.
u Continue configuring the next operating mode on the corresponding tab card.
— Or —
u Click this button.
– The dialog box closes.

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Configuration

The Roadmap tab card 0

This tab card is available only with the Subtraction option.

Parameter settings You can change the following parameters on the tab card:

Parameter Additional info

Opacification Possible values: min, max
Dose Level Possible values: medium, high
Landmark With the slider: 0 to 30%, in steps of 5%
Bone Display Possible values: white, black
Autostore off (no automatic storage)
all (all images are stored)
Storage Rate f/s only if Autostore = all
Setting in frames/s
Autoloop Check box for activating automatic
playback of a sequence of images at the
end of the exposure
Parameter Set Default parameter set for automatic
vessel contour detection

You have to select the setting "black" for the Bone Display parameter. Other-
wise, the system will apply incorrect image brightness values and automatic ves-
sel contour detection fails.

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Changing parameters u Select the required new parameters from the selection lists.
u Click this button.
– Your changes are applied to the ARCADIS Orbic system.
– The configuration dialog remains open for further entries.
u Continue configuring the next operating mode on the corresponding tab card.
— Or —
u Click this button.
– The dialog box closes.

The LUT Data tab card 0

The specified lookup tables (LUTs) are valid for those operating modes of the cur-
rent examination set that generate/display native images.
If the SUB/Roadmap option is enabled, additional LUTs (lookup tables) can be
selected for those operating modes of the current examination set that
generate⁄display subtracted images.

Up to 4 LUT values can be activated. You can switch between them using the
LUT keys for monitor A and monitor B on the C-arm system.

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Configuration

Activating LUTs u In the left column (LUT pool), select the LUT that you want to activate.
(look-up tables)
u Click this button.
– The LUT is moved into the column of active LUTs and is thus available via
the respective keys.

Deactivating LUTs u Select the LUT that you want to deactivate in the right column (LUT pool).
u Click this button.
– The LUT is moved to the LUT pool. Thus it is inactive.

Defining the LUT The first LUT value in the Active list is set as default. Use the Default buttons to
default settings define a different LUT value as default value.
u Select the value you want as default in the right column (active LUTs).
u Click this button.
– The default LUT value is displayed in bold in the list.

Saving parameters
u Click this button.
– Your changes are applied to the ARCADIS Orbic system.
– The configuration dialog remains open for further entries.
u Configure further parameters on the corresponding tab card.
— Or —
u Click this button.
– The dialog box closes.

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The Edge Filters tab card 0

The edge enhancement values displayed are valid for those operating modes of
the current examination set that generate/display native images.
If the SUB/Roadmap option is enabled, additional edge enhancement values can
be selected for those operating modes of the current examination set that
generate/display subtracted images.

Parameter settings The entries in the lists of available or active edge enhancement values are defined
as follows:

Entry Additional info

off without edge enhancement
mm%_n_Default mm: Edge enhancement in percent
n: Kernel type

Up to 4 edge enhancement values can be activated (including "off"). You can

switch between them using the edge enhancement key on the C-arm system.

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Configuration

Activating edge u Select the value that you want to activate in the left column (edge enhance-
enhancement values ment pool).
u Click this button.
– The edge enhancement value is moved into the column of active values
and is thus available via the respective key.

Deactivating edge u Select the value that you want to deactivate in the right column (active edge
enhancement values enhancement value).
u Click this button.
– The edge enhancement value is moved to the edge enhancement pool.
Thus it is inactive.

Saving parameters
u Click this button.
– Your changes are applied to the ARCADIS Orbic system.
– The dialog box closes.

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 Register 10 Technical Data

Table of Contents

Curves and diagrams ........................................................................................................... 3

SIREPHOS 2000 ............................................................................................................................... 3
Tube cooling curve ................................................................................................................. 3
SIREMATIC curves ........................................................................................................................... 4
kV/mA curves for Fluoroscopy and Pulsed Fluoroscopy (0.5 to 2 frames/s) .......................... 4
kV/mA curves for Pulsed Fluoroscopy (> 2 frames/s) ............................................................ 6
kV/mA curves for Digital Radiography (DR) ...................................................................................... 7
Dose rate at the image intensifier input............................................................................................ 8
Deviation of the dose rate value from the set values at the image intensifier input .............. 8
Dosimetric information ..................................................................................................................... 9
Typical air kerma strength ...................................................................................................... 9
Maximum air kerma strength ............................................................................................... 10

Notes concerning electromagnetic compatibility (EMC).................................................... 11

Guidelines and manufacturer's declaration – Electromagnetic emissions ...................................... 12
Guidelines and manufacturer's declaration – Electromagnetic interference immunity................... 13
Guidelines and manufacturer's declaration – Electromagnetic interference immunity................... 14
Recommended protective distances between portable and
mobile RF telecommunication devices and the system ................................................................. 15

Unit data ............................................................................................................................ 16

Complete system ........................................................................................................................... 16
Generation of radiation ................................................................................................................... 17
Generator.............................................................................................................................. 17
X-ray tube unit* .................................................................................................................... 18
Max. output and focuses in operating modes ...................................................................... 18
System components....................................................................................................................... 19
C-arm .................................................................................................................................... 19
Image intensifier ................................................................................................................... 19
Scattered radiation grid at I.I. input....................................................................................... 19
Collimator system................................................................................................................. 19
Imaging chain........................................................................................................................ 20
Monitors ............................................................................................................................... 20
Equipment options.......................................................................................................................... 20
Dose measuring chamber (DAP meter)................................................................................ 20
Integrated I.I. laser aimer ...................................................................................................... 21
Single-tank laser targeting device ......................................................................................... 21
Horizontal laser light localizer................................................................................................ 21

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Technical Data

Labels ................................................................................................................................ 22
C-arm system ................................................................................................................................. 22
(1) I.I. unit.............................................................................................................................. 23
(2) Image intensifier .............................................................................................................. 24
(3) I.I. grid.............................................................................................................................. 25
(4) SIREPHOS X-ray tube housing ........................................................................................ 25
(5) X-ray system (control) ...................................................................................................... 26
(6) Tube shutter .................................................................................................................... 27
(7) Single-tank laser targeting device (option) ....................................................................... 28
(8) Support arm..................................................................................................................... 29
(9) Control console................................................................................................................ 30
(10) System-integrated I.I. laser aimer .................................................................................. 30
(11) Horizontal laser light localizer......................................................................................... 31
Monitor trolley with TFT monitors .................................................................................................. 32
Labels for 3D option ....................................................................................................................... 34

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 Technical Data

Register 10 Technical Data

Curves and diagrams 0

SIREPHOS 2000 0

Tube cooling curve 0

Heat Unit
Heat Unit(HU)
(HU)

1 200 000

1 000 000

800 000

500 000
min
30 60 90 120 min

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Technical Data

SIREMATIC curves 0

kV/mA curves for Fluoroscopy and Pulsed Fluoroscopy

(0.5 to 2 frames/s) 0

(1) LD 330 W
SIREMATIC LD Low Dose
standard mode max. 3.0 mA
in Power Mode 600 W max. 5.5 mA
(2) S1 330 W
SIREMATIC S Standard
standard mode max. 3.0 mA
in Power Mode 600 W max. 5.5 mA
(3) S2 550 W
SIREMATIC S Standard
standard mode max. 5.0 mA
in Power Mode 1000 W max. 9.1 mA
(4) HC1 330 W
SIREMATIC HC High Contrast
standard mode max. 4.7 mA
in Power Mode 600 W max. 8.6 mA
(5) HC2 550 W
SIREMATIC HC High Contrast
standard mode max. 7.9 mA
in Power Mode 1000 W max. 14.3 mA

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 Technical Data

(6) IOD 550 W

SIREMATIC IOD Iodine-contrast optimized
standard mode max. 8.3 mA
in Power Mode 1000 W max. 15.2 mA

SIREMATIC curves Fluoroscopy/Pulsed Fluoroscopy

S-1 Antiisowatt curve with max. 3 mA
S-2 Antiisowatt curve with max. 5 mA
LD Low dose curve with high kV values: i.e. low radia-
tion exposure for the patient, especially well-suited
for pediatrics.
The characteristically high kV values result in lower
image contrast.
HC-1 High-contrast curve with max. 4.7 mA
HC-2 High-contrast curve for applications requiring high-
er mA values (max. 7.9 mA) e.g. spinal column, hip,
skull
IOD IODINE curve
For special applications using iodine contrast agent

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Technical Data

kV/mA curves for Pulsed Fluoroscopy (> 2 frames/s) 0

(1) LD 330 W
SIREMATIC LD Low Dose
standard mode max. 21.6 mA
in Power Mode 600 W max. 22.8 mA
(2) S1 330 W
SIREMATIC S Standard
standard mode max. 22.4 mA
in Power Mode 600 W max. 23.0 mA
(3) S2 550 W
SIREMATIC S Standard
standard mode max. 23.0 mA
in Power Mode 1000 W max. 23.0 mA
(4) HC1 330 W
SIREMATIC HC High Contrast
standard mode max. 23.0 mA
in Power Mode 600 W max. 23.0 mA
(5) HC2 550 W
SIREMATIC HC High Contrast
standard mode max. 23.0 mA
in Power Mode 1000 W max. 23.0 mA
(6) IOD 550 W
SIREMATIC IOD Iodine-contrast optimized
standard mode max. 23.0 mA
in Power Mode 1000 W max. 23.0 mA

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 Technical Data

kV/mA curves for Digital Radiography (DR) 0

(1) DR 1000 W (3D option)

N > 1: with noise reduction factor
max. 14.3 mA
(2) DR 1000 W
N = 1: without noise reduction factor
max. 23.0 mA

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Technical Data

Dose rate at the image intensifier input 0

The dose rate is factory-set between 0.11 μGy/s and 0.44 μGy/s depending on
the I.I. format, measured behind the scattered radiation grid at the I.I. input.
Using a test phantom, the dose rate was set in a kV range between 70 kV
and 80 kV. The iris diaphragm is maximally opened for this.

Deviation of the dose rate value from the set values at the
image intensifier input 0

Depending on the examined object, different fluoroscopy data (kV, mA) are set.
The sensitivity of the image intensifier is influenced by beam quality (kV). As a
consequence, different dose rates may result at the I.I. input screen for the same
luminance at the I.I. output screen.
When examining a patient in fluoroscopy mode, additional scatter radiation val-
ues are produced in comparison to the phantom values, affecting the dose rate
at the image intensifier input.

Deviation calculation Using K as a correction value, (refer to diagram), the approximate deviation value
from the set dose rate can be calculated.

K
2,5

1,4

1,0
50 60 70 80 90 100 110 120 130 kV

Calculation example: With 70 kV the correction value is 1.4.

That is, if the set dose rate value is 0.22 μGy/s, the actual value is
approx. 0.22 μGy/s x 1.4 = 0.308 μGy/s.

Setting the dose rate If desired, the preferential position for the dose rate can be reprogrammed.
value

Operator Manual
8 of 34 SPR2-320G.620.30.03.02
 Technical Data

Dosimetric information 0

Typical air kerma strength 0

The skin dose values were measured at a distance of 48.5 cm (patient entry
reference point with isocentric C-arm) from the focal point input with a
20 cm PMMA phantom (equivalent to a typical patient) pursuant to
IEC 60601-2-54:2009, 203.5.2.4.5.101.

Program* Curve I.I. field size Dose Level kV/mA Air kerma reference
strength
CFC HC2 21.4 cm medium 68/4.2 17 mGy/min
medium push 68/4.9 20 mGy/min

Standard
CFC IOD 21.4 cm low 66/2.7 11 mGy/min
Standard
medium 66/4.5 17 mGy/min
high 68/8.1 33 mGy/min
CFC S2 21.4 cm high push 79/3.3 21 mGy/min
Standard

Program* Curve I.I. field size Noise kV/mA Air kerma reference
Reduction
DR DR 1000 21.4 cm k=4 110/9.1 0.3 mGy/f (image)
k=8 110/9.1 0.6 mGy/f (image)
k = 16 110/9.1 1.1 mGy/f (image)
k = 32 110/9.1 2.3 mGy/f (image)
*) standard examination program provided

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Technical Data

Maximum air kerma strength 0

The skin dose values were measured at maximum generator power at a distance
of 48.5 cm from the image intensifier input pursuant to IEC 60601-2-54:2009,
203.5.2.4.5.101.

Program** Curve kV/mA*** Reference air kerma

strength
CFC HC2 110 kV/5 mA 108 mGy/min
Standard HC1 110 kV/3 mA 67 mGy/min
* Patient entrance reference point with isocentric C-arm

** Standard examination program provided

*** In ADR stop mode, the maximum kV value is set

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10 of 34 SPR2-320G.620.30.03.02
 Technical Data

Notes concerning electromagnetic

compatibility (EMC) 0

Medical electrical equipment is subject to special precautions regarding EMC.

These systems must be installed and put into service according to the
EMC information provided in the accompanying documents.
Portable and mobile RF communications equipment can affect medical electrical
equipment.

Fixed equipment or system cabling that cannot be removed by the user is not list-
ed. This cabling is part of the system and was considered in all EMC measure-
ments. Without this cabling the equipment or system would not function.

The use of accessories, transducers and cables other than those specified, with
the exception of transducers and cables sold by the manufacturer of the equip-
ment or system as replacement parts for internal components, may result in in-
creased emission or decreased immunity of the equipment or system.

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Technical Data

Guidelines and manufacturer's declaration –

Electromagnetic emissions 0

The system is intended for use in an electromagnetic environment as specified

below. The customer or the user of the system should ensure that it is operated
in such an environment.

Emissions test Compliance Electromagnetic environment - guidance

RF emissions Group 1 The system uses RF energy exclusively for its internal func-
tion. Therefore, its RF emissions are very low and not likely to
according to CISPR 11
cause any interference in nearby electronic equipment.
RF emissions Class A The system is not suitable for use in domestic establishments
and establishments directly connected to a public power sup-
according to CISPR 11
ply network which supplies buildings used for domestic pur-
poses.

Harmonic emissions Not applicable The system is a professionally used unit with a total rated
power larger than 1 kW. There are no limit values for this rated
according to
power.
IEC 61000-3-2

Voltage fluctuations/ Complies with the

flicker emissions specified regulation
according to
IEC 61000-3-3

The device or system should not be operated standing next to or on/under other
devices. If adjacent or stacked use is necessary, the equipment or system should
be observed to verify normal operation in the configuration in which it will be
used.

Operator Manual
12 of 34 SPR2-320G.620.30.03.02
 Technical Data

Guidelines and manufacturer's declaration –

Electromagnetic interference immunity 0

The system is intended for use in an electromagnetic environment as specified

below. The customer or the user of the system should ensure that it is operated
in such an environment.

Interference immunity IEC 60601 Compliance level Electromagnetic environment - guidance

tests test level
Electrostatic discharge ± 6 kV contact dis- ± 6 kV contact dis- Floors should be made of wood, concrete or ce-
(ESD) charge charge ramic tiles. If the floor is covered with synthetic
materials, the relative humidity must be at
IEC 61000-4-2 ± 8 kV air dis- ± 8 kV air dis- least 30%.
charge charge
Electrical fast transient ± 2 kV for power ± 2 kV for power Mains power quality should be that of a typical
disturbances/bursts supply lines supply lines commercial or hospital environment.
according to ± 1 kV for input/ ± 1 kV for input/
IEC 61000-4-4 output lines output lines
Surge ± 1 kV differential- ± 1 kV differential- Mains power quality should be that of a typical
mode voltage mode voltage commercial or hospital environment.
according to
IEC 61000-4-5 ± 2 kV common- ± 2 kV common-
mode voltage mode voltage
Voltage dips, short inter- < 5% UT * Not tested As the product has a > 1 kVA power consump-
ruptions and voltage varia- (> 95% dip in UT) tion, these tests are not required.
tions on power supply for 0.5 cycles
input lines
40% UT
according to (60% dip in UT)
IEC 61000-4-11 for 5 cycles
70% UT
(30% dip in UT)
for 25 cycles

Voltage dips, short inter- < 5% UT < 5% UT Mains power quality should be that of a typical
ruptions and voltage varia- (> 95% dip in UT) (> 95% dip in UT) commercial or hospital environment. If the user
tions on power supply for 5 seconds for 5 seconds of the system requires continued operation dur-
input lines ing power mains interruptions, it is recommend-
ed that the system be powered from an
according to
uninterruptible power supply.
IEC 61000-4-11
Power frequency 3 A/m 3 A/m Power frequency magnetic fields should be at
magnetic field levels characteristic of a typical commercial or
hospital environment.
(50/60 Hz)
according to
IEC 61000-4-8
Remark: UT is the AC mains voltage before application of the test level.

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Technical Data

Guidelines and manufacturer's declaration –

Electromagnetic interference immunity 0

The system is intended for use in an electromagnetic environment as specified

below. The customer or the user of the system should ensure that it is operated
in such an environment.

Interference IEC 60601 Compliance Electromagnetic environment - guidance

immunity tests test level level
Portable and mobile RF telecommunications equipment
should be used no closer to any part of the system (in-
cluding cables) than the recommended separation dis-
tance calculated from the equation applicable to the
frequency of the transmitter.
Recommended separation distance
Conducted RF 3 Vrms 3 Vrms d = 1.2 P
disturbances 150 kHz to 80 MHz
according to
IEC 61000-4-6
Radiated RF 3 V/m 3 V/m d = 1.2 P for 80 MHz to 800 MHz
disturbances 80 MHz to 2.5 GHz
according to
IEC 61000-4-3
d = 2.3 P for 800 MHz to 2.5 GHz

Where P is the maximum output power rating of the

transmitter in watts (W) according to the transmitter
manufacturer and d is the recommended separation dis-
tance in meters (m).
Field strengths from fixed RF transmitters, as deter-
mined by electromagnetic site surveya, should be less
than the compliance level in each frequency range.b
Interference may occur in the vicinity of equipment
marked with the following symbol:

Remark 1: At 80 MHz and 800 MHz, the higher frequency range applies.
Remark 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption
and reflection from structures, objects and people.
a
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile
radios, amateur radios, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy.
To assess the electromagnetic environment due to the fixed RF transmitters, an electromagnetic site survey should
be considered. If the measured field strength in the location in which the device or system is used exceeds the appli-
cable RF compliance level above, the device or system should be observed to verify normal operation. Should unusual
performance features be observed, additional measures (such as change in orientation or change of site of the system)
may be necessary.
b
Over the frequency range of 150 kHz to 80 MHz the field strength should be less than 3 V/m.

Operator Manual
14 of 34 SPR2-320G.620.30.03.02
 Technical Data

Recommended protective distances between

portable and mobile RF telecommunication devices
and the system 0

The system is intended for use in an electromagnetic environment in which radi-

ated RF disturbances are controlled. The customer or the user of the system can
help prevent electromagnetic interference by maintaining a minimum distance
between portable and mobile RF communications equipment (transmitters) and
the system as recommended below, according to the maximum output power of
the communications equipment.

Rated maximum output power Safe distance according to frequency of transmitter [m]
of transmitter [W]
150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2.5 GHz
d = 1.2 P d = 1.2 P d = 2.3 P
0.01 0.12 0.12 0.23
0.1 0.38 0.38 0.73
1 1.2 1.2 2.3
10 3.8 3.8 7.3
100 12 12 23
For transmitters rated at a maximum output power not listed above, the recommended separation distance d in
meters (m) can be determined using the equation applicable to the frequency of the transmitter, where P is the maxi-
mum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.
Remark 1: At 80 MHz and 800 MHz, the higher frequency range applies.
Remark 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption
and reflection from structures, objects and people.

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Technical Data

Unit data 0

Complete system 0

General data

Power requirements 100 V, 110 V, 120 V, 127 V, 200 V, 230 V, 240 V ± 10%; 50/60 Hz ± 1 Hz
An on-site 16 A/characteristic C overcurrent release (trip breaker) is recom-
mended by DIN VDE 0100-710 for supply network voltages of 230 V/240 V.
Country-specific requirements apply for the fuse values to be used for other
supply network voltages.
Nominal rating 20 A to 127 V∼, 15 A from 200 V∼ corresponds to nominal value of the
slow-blow fuse in the power input of the product
Internal line resistance Ri < 0.3 ohms at 100 - 127 V∼
Ri < 0.8 ohms at 200 - 240 V∼
Power consumption max. 2.5 kVA
Weight C-arm system approx. 348 kg
Monitor trolley with 2 monitors, approx. 190 kg (with PC and UPS)
Environmental conditions Temperature range: +15 °C to +35 °C
for operation
Rel. humidity: 15% to 75%, non-condensing
Barometric pressure: 700 hPa to 1060 hPa
Environmental conditions Temperature range: -20 °C to +37 °C
for transport
Rel. humidity: 10% to 95%, non-condensing
Barometric pressure: 700 hPa to 1060 hPa

For environmental conditions that fall within the specified values, no wait time is
required for radiation operation.
For environmental conditions that fall outside the specified values, a wait time
of 1 to 12 hours must be factored in for radiation operation, depending on the lo-
cation of the system.

Classification

Protection against Class 1, no applied part acc. to IEC 60601-1

electrical shock

Protection against IPXO (not protected) acc. to IEC 60529

ingress of fluids

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16 of 34 SPR2-320G.620.30.03.02
 Technical Data

Operating mode Continuous operation

Current/voltage values

Voltage Long-term current consumption Short-term current consumption

100 V 17 A 29 A
110 V 16 A 26 A
120 V 15 A 24 A
127 V 14 A 23 A
200 V 9A 15 A
230 V 8A 13 A
240 V 8A 12 A

Generation of radiation 0

Generator 0

Pulsed Fluoroscopy Min. pulse width 7 ms

Pulse rate 15 f/s/23 mA
Max. pulsed output 2.3 kW
Fluoroscopy 40 kV to 110 kV/0.2 mA to 15.2 mA (max. 1000 W)
Max. 8.3 mA/66 kV
Max. 15.5 mA/69 kV (in Push Mode at max. 15 sec)
Max. 110 kV/5 mA
Max. 110 kV/9 mA (in Push Mode at max. 15 sec)
Digital Radiography 40 kV to 110 kV/0.2 mA to 23 mA (max. 1000 W)
Max. 14.3 mA/70 kV
Max. 110 kV/9.1 mA
Tolerances kV ± 10% (measured using spectrometric kV method)
mA ± 8% ± 0.1 mA (measured in rectified high-voltage circuit)
Fluoroscopic time 1 digit (6 s) ± 5%
Max. power 1 kW (100 kV/9.9 mA) DR
1 kW (70 kV/14.3 mA) CFC
Accuracy of radiation Variation coefficient < 0.05
output for DR
Accuracy of automatic ± 20%
dose rate control

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Technical Data

X-ray tube unit* 0

SIREPHOS single-tank Inverter frequency 15 kHz up to 26 kHz

high-frequency generator
Inherent filtration 3 mm Al eq. + 0.1 mm Cu
X-ray tube Stationary anode, focal spot nominal value 0.6
*The X-ray tube and image receptor are geometrically aligned such that the emitted radiation cone
(radiation axis) is always perpendicular to the plane of the image intensifier.

Max. output and focuses in operating modes 0

CFC/SUB/ PFC (> 2 f/s) DR (k = 1) DR (k > 1)

ROADMAP/PFC
(≤ 2 f/s)
Tube voltage 40 – 110 kV 40 – 110 kV 40 – 110 kV 40 – 110 kV
Tube current 0.2 – 15.2 mA 1 – 23 mA 1 – 23 mA 0.2 – 14.3 mA
Exposure time n.a. 7 – 24 ms 7 – 42 ms n.a.
Pulsed output n.a. max. 2.3 kW max. 1.8 kW n.a.
Mean power max. 550 W max. 550 W n.a. n.a.
max. 1000 W for max. 1000 W for
CFC and PFC PFC high contrast
high contrast

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18 of 34 SPR2-320G.620.30.03.02
 Technical Data

System components 0

C-arm 0

C-arm orbital movement 190° ± 95°

C-arm angulation ± 190°
C-arm horizontal 20 cm
movement
C-arm immersion depth 73 cm
C-arm swivel range ± 10°
C-arm vertical movement 40 cm, motorized
SID 98 cm
Tube-image receptor 78 cm
distance

Image intensifier 0

SIRECON 23-2int. 1k Nominal diameter 23 cm (9")

Format switch-over 23 cm/15 cm (9"/6")
Size of I.I. input field 21.5 cm
Detective quantum ≥ 61% according to IEC 61262
efficiency (DQE)

Scattered radiation grid at I.I. input 0

Round grid 17/70 fo100

System attenuation factor m = 1.5

Collimator system 0

Collimator system Iris diaphragm for concentric collimation and semi-transparent slot diaphragm
for collimation with unlimited rotation

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Technical Data

Imaging chain 0

Camera with CCD Sensor 1024 (H) x 1024 (V)

Aspia imaging system Features, e.g. digital image rotation +360 °

Monitors 0

TFT color displays Resolution 1280 x 1024 (pixels)

Screen diagonal 48 cm (19")
Luminance Typically 180 cd/m2/max. 250 cd/m2

s/w displays Resolution 1280 x 1024 (pixels)

Screen diagonal 48 cm (19")
Luminance Typically 400 cd/m2/max. 600 cd/m2

Equipment options 0

Dose measuring chamber (DAP meter) 0

Technology Ionization chamber

Active area Diameter 90 mm, area 63.2 cm2
DAP resolution 0.01 μGym2/s equivalent to cGycm2/s
Maximum 3000.00 μGym2/s equivalent to cGycm2/s
measurable DAP
Measuring inaccuracy < 1% under constant pressure and temperature
Energy range 40 - 125 kV ± 6%
Attenuation equivalent < 0.5 mm Al equivalent
(Inherent filtration)
Dose rate linearity Better than ± 2%
Measuring readiness 10 seconds after power on
Accuracy of dose display/ < 25%
deviation of displayed
from measured dose
area product
Work environment Temperature range: +10 °C to +70 °C
Rel. humidity: 15% to 75% (without condensation)
Barometric pressure: 700 hPa to 1060 hPa

Operator Manual
20 of 34 SPR2-320G.620.30.03.02
 Technical Data

Integrated I.I. laser aimer 0

Laser class 1M (IEC 60825-1:2007)

Laser type Semiconductor laser (laser diode)
Wave length 635 Nm
Color Red
Effective power ≤ 0.2 mW

Single-tank laser targeting device 0

Laser class Class 2 pursuant to IEC 60825-1:2007

Laser type Semiconductor laser (laser diode)
Wave length 655 nm
Color Visible red
Power output < 1 mW

Horizontal laser light localizer 0

Laser class Class 2 pursuant to IEC 60825-1:2007

Optical setup Line generating optics
Beam angle 20° to 25°
Wave length 540 - 700 nm
Output power on 0.5 mW
the module
Voltage supply 1.5 volt battery operation
Current consumption 80 mA
Battery type 1 round cell R6 (AA)
Alternatively primary cells R6/LR6 (1.5 V) or
NiCd or NiMH batteries
Service life At least 20 hours of continuous operation
Aut. time limitation 1 min. (typical)
Case material Aluminum
Weight Approx. 1.6 kg
Temperature range Up to 37.5°C

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Technical Data

Labels 0

C-arm system 0

The labels shown below are attached permanently to the following sub-assem-
blies.

3
10 8

11

4,6, 7

SIEME NS
SIEMENS SIEMENS

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22 of 34 SPR2-320G.620.30.03.02
 Technical Data

(1) I.I. unit

(2) Image intensifier
(3) Grid
(4) SIREPHOS X-ray tube housing
(5) X-ray system (control); system identification label
(6) Tube assembly collimator
(7) Single-tank laser targeting device (option)
(8) Support arm
(9) Control console
(10) System-integrated I.I. laser aimer
(11) Horizontal laser light localizer

Equipotential bonding

Read Operator Manual

(1) I.I. unit 0

(1) Manufacturer's identification label

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Technical Data

(2) Image intensifier 0

(1) Manufacturer's identification label

(2) Approval label

(3) Approval label

(4) Approval label

(5) Label for I.I. tube

Operator Manual
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 Technical Data

(3) I.I. grid 0

(1)
(1) Identification label GRID

(4) SIREPHOS X-ray tube housing 0

(1) Special label with beam entry

(2) Approval label

(3) Tube ID label

(4) Revision status label

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Technical Data

(5) Supplementary label

(5) X-ray system (control) 0

(1) System identification:

Manufacturer's identification label

(2) Approval label

kg

(3) Weight label on C-arm basic unit

(4) Approval label

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 Technical Data

(5) Approval label

(6) Revision status label

(7) Label for Brazil only

(6) Tube shutter 0

(1) - (3)

(1) Manufacturer's identification label

(2) Approval label

(3) Supplementary label

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Technical Data

(7) Single-tank laser targeting device (option) 0

(1)

(1) For USA/Canada/Great Britain

Warning label

(2) (7)

(2) Manufacturer's identification label

(3) Supplementary label

(4) For USA/Canada

Approval label

(5) For USA/Canada

Warning label

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28 of 34 SPR2-320G.620.30.03.02
 Technical Data

2007
635 nm

(6) Countries other than USA/Canada

Warning label

(7) Countries other than USA/Canada

Warning label

(8) Support arm 0

(4) (1) For Canada only

Warning label

(2) Affixed for Germany/Austria only

Warning label

(3) For China only (Warning label)

(4) Danger of tipping during transport (Warning label)

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Technical Data

(9) Control console 0

(1) For Canada and USA only

Warning label

(10) System-integrated I.I. laser aimer 0

(1) - (3)

(1) Manufacturer's identification label

(2) For USA/Canada

Warning label

(3) For USA/Canada/Great Britain

Warning label

Operator Manual
30 of 34 SPR2-320G.620.30.03.02
 Technical Data

(11) Horizontal laser light localizer 0

(1) Manufacturer's identification label

(1) (2)

(2) Approval label

(3), (4) (5), (6)

2007
635 Nm

(3) Warning label

German or acc. to country-specific language

(4) For USA/Canada

Warning label

(5) Countries other than USA/Canada

Warning label

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Technical Data

(6) For USA/Canada

Warning label

Monitor trolley with TFT monitors 0

(1)

(2)
(8) (1) For USA/Canada
(3)
(4) - (7) Warning label

(2) For USA/Canada

Warning label

kg

(3a) Weight label on monitor trolley

29

23
15
13

(4) Optional label country-specific connection data

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 Technical Data

(5) Identification label of the manufacturer (Monitor trolley)

(6) Approval label

(7) Approval label

(8) Manufacturer's revision level label

(9) Read Operator Manual

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Technical Data

Labels for 3D option 0

(1)

Warning label

Warning
For the duration of the scan, the orbital movement of the C-arm is motorized.
Risk of crushing!
u Keep a sufficient safety distance.

(1) Manufacturer's identification label

Operator Manual
34 of 34 SPR2-320G.620.30.03.02
 Register 11 Maintenance

Table of Contents

Functional and Safety Checks ............................................................................................. 3

Daily checks ...................................................................................................................................... 3
Prior to the examination.......................................................................................................... 3
Monthly checks ................................................................................................................................ 4
Checking the dose rate control function................................................................................. 4
Checking the EMERGENCY STOP function for motor-driven system movements................ 4
Maintenance plan for checking the system............................................................................ 5
Checks prior to special examinations (e.g. of the open heart and skull) ........................................... 6
Dose and consistency test ............................................................................................................... 6
Preparation ............................................................................................................................. 6
Dose measurement ................................................................................................................ 7
Calculation .............................................................................................................................. 7

Service via network connection........................................................................................... 8

Updating virus protection.................................................................................................................. 9
Remote service access................................................................................................................... 13
Service access ...................................................................................................................... 13

Cleaning and disinfection................................................................................................... 16

Cleaning .......................................................................................................................................... 16
Disinfection..................................................................................................................................... 17
Monitor trolley ................................................................................................................................ 18
Screen surfaces/TFT displays ............................................................................................... 18

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Maintenance

Operator Manual
2 of 18 SPR2-320G.620.30.03.02
 Maintenance

Register 11 Maintenance

Functional and Safety Checks 0

To ensure that the ARCADIS Orbic is ready for operation and all safety features
are functioning properly, you must perform regular functional and safety checks.

Daily checks 0

Prior to the examination 0

u Check the power plug. If the power plug is damaged, the ARCADIS Orbic
must not be used.
u Check the power cable. If the power cable is damaged, the ARCADIS Orbic
must not be used.
u Check the function of the foot brakes of the C-arm system and the monitor
trolley as well as the steering of the C-arm system.
u Check the C-arm counterbalance after releasing the brakes.
u Check the function of all radiation indicators.
u Inspect the housing of the I.I. and the single tank for mechanical damage.

ARCADIS Orbic
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Maintenance

Monthly checks 0

Checking the dose rate control function 0

This following simple procedure allows you to check the automatic dose rate con-
trol function without an object in the beam path. A kV value of ≤ 45 kV must sta-
bilize:
u Open the iris and slot diaphragms to maximum aperture.
u Press the Dose rate control Stop (ADR Stop) key.
u Select 110 kV with the +/- keys.
u Press the ADR Stop key again.
– The stop function is canceled; automatic dose rate control is switched on
again.
u Release radiation in the fluoroscopy mode.
– The tube voltage is reduced to a value ≤ 45 kV.
– The monitor image is not overexposed.

Checking the EMERGENCY STOP function for motor-driven

system movements 0

u Switch the ARCADIS Orbic on.

u Move the lifting column and press the EMERGENCY STOP button at the
same time.
– The lifting movement is stopped.
– A message is displayed on the monitor indicating that EMERGENCY STOP
has been actuated.
u Unlock the EMERGENCY STOP button again.
u Press one of the keys for moving the lifting column.
– The lifting movement is enabled again.

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 Maintenance

Maintenance plan for checking the system 0

The tests and inspections required by national laws or regulations, such as

DHHS regulations or RöV (constancy tests), are not part of the activities listed in
this maintenance plan.
If more frequent checking and/or maintenance is required by national laws or reg-
ulations, compliance with these regulations is essential.
Maintenance work should be performed by trained technical personnel only.
To keep the system in an optimum condition, we recommend that you conclude
a maintenance contract. In the case of questions relating to maintenance/mainte-
nance contract please contact our Siemens Customer Service.

Please observe the relevant information in

(› Register 2: Safety, Page 5).

Checking the system

Procedures to be Function Interval

performed
Mechanical safety Damage to the housing, system movements and options 12 months
(e.g. laser light localizer)
Electrical safety Ground conductor, grounding strap on the C-arm system, 12 months
cables and plugs
Function check Emergency stop and lifting column 12 months
Image quality Image display and image processing 12 months
Calibration with 3D option Display of 3D scans 6 months

The stated functions are minimum requirements.

ARCADIS Orbic
SPR2-320G.620.30.03.02 5 of 18
Maintenance

Checks prior to special examinations (e.g. of the open

heart and skull) 0

u Make sure that there is an additional conductive connection between the

C-arm system and a point of potential equalization, e.g. the patient table.

Dose and consistency test 0

Carry out dose area product testing after performing the following procedure:

Preparation 0

u Open the collimator completely (full format).

u Select the "fluoroscopy" operating mode.
u Place the lead ruler centrally on the image intensifier.
u Release radiation, setting the iris diaphragm to approx. 15 cm diameter.
u Keep the diameter (shown on the lead ruler) constant.

The iris diaphragm may no longer be adjusted.

u Remove the lead ruler.

u Place a small (1 cm3) measurement chamber in the center of the image inten-
sifier (see figure 1).

(1) Measurement
chamber

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 Maintenance

Dose measurement 0

u Release radiation for a short period and then actuate the kV stop button and
set to 70 kV.
u Note the dose area product - value "A" (cGycm2) - shown on the monitor.
u Set the measured dose area product to "0" on the measuring device.
u Release radiation for approx. 10 s and note the measured dose (cGy).
u Note the dose area product - value "B" - shown on the monitor.
u Subtract value "A" from value "B".

Calculation 0

Measured dose area product = measured dose (cGy) x diameter x 0.892

Compare the measured value with the dose area product displayed on
the monitor.

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Maintenance

Service via network connection 0

The ARCADIS Orbic must be connected to a network (DSL ≥ 1 Mbit/s) for the ser-
vice measures described below.

Updating virus With the "Virus Protection Service" option you can import and install the latest
protection virus protection files via the network connection. It is urgently recommended to
do so regularly.

The ARCADIS Orbic should only be operated within a virus-protected hospital

network.

Remote service access Siemens Customer Service has the possibility of accessing the ARCADIS Orbic
via an active network connection (DSL or ISDN).

With full access, the image area of the left monitor is superimposed by a full
screen message. When this message is displayed, radiation can still be released.

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8 of 18 SPR2-320G.620.30.03.02
 Maintenance

Updating virus protection 0

Virus protection should be updated every 2-3 days to make sure the
ARCADIS Orbic has the latest virus definitions installed. The update process
takes a few minutes and should be performed during a break or outside of exam-
ination hours.

Calling up the dialog To update the virus protection, open the SoftwareDistribution dialog window in
window the Local Service window.
u Select Options > Customer Service > Local Service in the main menu of the
task card.
– The Service Software dialog box is displayed.

u Delete the default code in the left window of the entry area Please enter
password and click OK.
– The start window for service settings is displayed.

u Click SoftwareDistribution.
– The SoftwareDistribution window appears.

ARCADIS Orbic
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Maintenance

Selecting an update

u If necessary, click Overview in the left window area.

– An overview of updates is displayed.
u Click on Update Catalog at the lower right bottom of the window if
applicable.
– The list of updates is updated.
u Find the most recent virus definition (virus pattern) in the Software Package
column by looking at the version information in the packet name and the Date
column.
– In this example, it would be "CS_Virus-Pattern_4.627.00" of August 7, 2007.
u Click Download in the left window area.
– The Download area is displayed.

u In the Action column, click on the corresponding Software Package.

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 Maintenance

Downloading an
update
u Click on Download at the lower right bottom of the window.
– The update is downloaded from the network.
– The Progress column shows the download status.
– A message window is shown when the process is successfully completed.

u Close the window with OK.

Installing an update in The latest version of the virus protection files is now stored locally in your
the system ARCADIS Orbic. You have to install them in the system to use them.
u Click Install in the left window area.
– The list of installable updates is shown.

u In the Action column of the corresponding update, click Install.

– The update is installed.
– A message window is shown when the process is successfully completed.

u Close the window with OK.

u Close the SoftwareDistribution and Service Software windows with the
Close window button.

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Maintenance

Installing an update As a last step, the update of the virus protection files must be installed and acti-
in syngo vated in the syngo user interface.
It is recommended to complete this step immediately to finish the update pro-
cess. For this purpose, the syngo user interface must be restarted. The Software
Distribution / Installation dialog box is automatically displayed to complete the
installation for syngo.

You can also open the Software Distribution / Installation window later (man-
ually, without restarting). For this purpose, click the yellow exclamation mark on
the status bar. This symbol will appear approx. 15 min after installing the virus up-
date in the system.
u Call up Options > End Software Session in the main menu.
– The System Message dialog box is displayed.
u Click Restart.
– The syngo user interface and the application programs are shut down and
then started again.
– After the start-up of syngo, the Software Distribution / Installation dialog
box is shown.

u Click Install.
– The virus protection update is installed and activated in syngo.
– The Software Distribution / Installation dialog box is closed.

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 Maintenance

Remote service access 0

The Remote Service Access Control window allows you to grant Service per-
sonnel access rights so that they can perform remote maintenance.

If the Remote Service Access Control option is activated, remote service can
only be performed from "trusted systems" (systems that have exchanged
"proved certificates" with your syngo system).

Service access 0

u Open Options > Customer Service > Remote Service to start a remote ser-
vice session.
– The Remote Service Access Control window is displayed.

u Wait for a response from the remote location before you grant access to your
workstation.

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Maintenance

Granting access u Depending on the required service activities, you will assign the service engi-
neer full or limited access to your workstation:
o Full access
Allows the service technician to take control of your workstation (which dis-
ables it to you).
o Limited access
This mode provides access to all service functions that do not interfere with
regular patient operations.
o No access
o Allow patient data access
The service engineer will only have access to patient data if you give your
explicit permission upon his specific request.

Limiting access rights As long as you have assigned full access rights to service, i.e. maintenance is in
progress, you cannot continue working with your ARCADIS Orbic.

Warning
Aborting remote service without consultation with service engineers.
Aborting remote service cancels all service procedures and causes the
ARCADIS Orbic to malfunction!
u Always consult with a service engineer before aborting remote service.

u Select Limited access or No access and confirm with OK or Apply to

continue working.

For further information, please contact Siemens Service or your system adminis-
trator.

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14 of 18 SPR2-320G.620.30.03.02
 Maintenance

Terminating the If you end a remote service session while the service engineer is still working,
service session all currently active service programs will be terminated. This may cause the
ARCADIS Orbic to be inconsistent or inoperable.

The service engineer is only notified that the session is going to be ended by you.
u Check with the service engineer before you end the session.

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SPR2-320G.620.30.03.02 15 of 18
Maintenance

Cleaning and disinfection 0

Before cleaning or disinfecting the ARCADIS Orbic, the system must be discon-
nected from the power supply and switched off.

Cleaning 0

Before each examination, clean all parts which come into contact with the patient
to prevent contamination of the ARCADIS Orbic.

Caution
Cleaning agents or fluids penetrating into the equipment.
This can cause danger or damage to the ARCADIS Orbic!
u Never spray the ARCADIS Orbic.

u Clean the parts with a damp cloth.

u For cleaning, use water or a lukewarm diluted solution of water and a com-
mercially available cleaning agent.
u Do not use abrasive cleaning agents or organic solvents or solvent-based
cleaning agents such as benzine, alcohol, spot removers, etc., due to potential
material incompatibility.

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 Maintenance

Disinfection 0

For the disinfection of surfaces we recommend liquid solutions of common sur-

face disinfectants based on aldehyde and/or amphoteric surfactants,
e.g. Tensodur 103, Kohrsolin, Cidex.
Substituted phenol-based or chlorine-releasing disinfectants can weaken materi-
als and are therefore not recommended. The same restrictions apply to undiluted
solutions with a high alcohol content, e.g. for disinfecting hands.

Caution
The spray mist of disinfectant sprays may penetrate into the equipment.
Sprays can cause damage to electronic components or the formation of
flammable mixtures of air/vapor!
u Disinfectant sprays should generally not be used.

u Please also observe the operator manual of the disinfectant.

As is commonly known, some substances in disinfectants are hazardous to

health. Their concentration in the air must not exceed the legally defined limit.
We recommend that you follow the manufacturer’s instructions for the use of
these products.

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SPR2-320G.620.30.03.02 17 of 18
Maintenance

Monitor trolley 0

Screen surfaces/TFT displays 0

Monitors should be cleaned at least every two months.

Caution
Acids or alkaline solutions on the monitor screen.
This may damage the monitor screen!
u Monitors with anti-glare, non-reflective surfaces should only be cleaned with
a soft cloth.

u Clean the monitor screen with a cotton cloth dampened with water.
u Remove stubborn stains with a mixture of 2/3 water and 1/3 alcohol.
u Immediately dry off the monitor screen with a soft cotton cloth.
u Wipe off any contrast agent spots as quickly as possible.

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 Register 12 Options

Table of Contents

Accessories ......................................................................................................................... 3
Spacer............................................................................................................................................... 4
Grounding cable................................................................................................................................ 4
Wireless WLAN network connection (option)................................................................................... 5
Activating WLAN .................................................................................................................... 5
Operation via Ethernet cable .................................................................................................. 7
Multi-function footswitch (option)..................................................................................................... 7
Selecting the operating mode ................................................................................................ 8
Releasing radiation ................................................................................................................. 8
Storing images (during radiation) ............................................................................................ 8
Storing images (after radiation)............................................................................................... 8
Stowage for transport............................................................................................................. 9
Text-based entry keys..................................................................................................................... 10
Control panel, English text (option)....................................................................................... 10
syngo keypad, English text (option) ...................................................................................... 11
Sterile cover on the C-arm .............................................................................................................. 12
Clamps to keep covers in place ...................................................................................................... 15
Sterile cover for 3D option .............................................................................................................. 16
Integrated I.I. laser aimer ................................................................................................................ 18
Protective measures............................................................................................................. 18
Single-tank laser targeting device (option) ...................................................................................... 18
Protective measures............................................................................................................. 18
Horizontal laser light localizer.......................................................................................................... 19
Protective measures............................................................................................................. 19
Product description............................................................................................................... 19
Operation.............................................................................................................................. 21
Use of batteries and accumulators ....................................................................................... 22
Notes on maintenance and care ........................................................................................... 23
Dose measuring chamber (DAP meter) .......................................................................................... 24

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Options

Operator Manual
2 of 24 SPR2-320G.620.30.03.02
 Options

Register 12 Options

Accessories 0

Anyone who connects additional equipment to the medical device configures the
system and is therefore responsible for ensuring that the system configuration in
its current version complies with the relevant standards (e.g. system standard
IEC/EN 60601-1-1 and/or other applicable standards). In the case of queries
please contact your local contact person.

If one of the listed accessory parts requires special operating conditions

(e.g. temperature, air pressure, humidity), appropriate attention will be drawn to
such in the description. Please follow the Operator Manual provided by the man-
ufacturer.

The following accessories have been approved for use with the ARCADIS Orbic:

Accessories Part Number Manufacturer

I.I. laser aimer 3099988 Z-Laser Optoelektronik
GmbH
Integrated I.I. laser aimer 8079563 Z-Laser Optoelektronik
GmbH
Horizontal laser light localizer 7139897 Siemens AG
Dose measuring chamber 10047654 IBA Dosimetry GmbH
Grounding cable 2171767 Nicolay Services GmbH
DHHS cap 5643502 MED CO IDB
Wireless network connection 8082005 Siemens AG
WLAN
Multifunctional footswitch 10252058 Steute
Fabric cover 2829096 Karl Dieckhoff GmbH
Set of clamps 5646307 NPW Schubert GmbH &
Co.KG
Disposable cover 8609005 Microtek Medical B.V.,
ARCADIS Orbic cpl. (16 pcs.) NL
Disposable cover 8609013 Microtek Medical B.V.,
ARCADIS Orbic I.I. (32 pcs.) NL
NaviLink 3D 8081452 Siemens AG
Audio package 10143418 Visaton

ARCADIS Orbic
SPR2-320G.620.30.03.02 3 of 24
Options

Spacer 0

The distance between the source and tube assembly cover (shortest possible
source-skin distance) is ≥ 200 mm with the standard system (acc. to IEC 601-1-3).
Country-specific regulations may require a larger source-skin distance
(≥ 300 mm acc. to DHHS 21CFR). This is achieved by attaching an additional
spacer to the C-arm system.

(1)

(1) Knurled screws

u If this source-skin distance is too large for special examinations, the spacer
can be removed by taking off the knurled screws.
– The spacer must be reattached after this type of examination to ensure the
reduction in skin dose resulting from a greater source-skin distance.

Grounding cable 0

An optional grounding cable is available for equipotential bonding in accordance

with DIN 57107/VDE 0107 for rooms of Application Group 2E (cardiac catheter-
ization).

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 Options

Wireless WLAN network connection (option) 0

The WLAN option enables a wireless connection between the ARCADIS Orbic
and a (hospital) network. The dedicated WLAN unit is integrated into the monitor
trolley housing and completely set up. Its ON/OFF switch is found on the side of
the monitor trolley.

Activating WLAN 0

To activate WLAN, use the switch on the side of the monitor trolley.

Once the WLAN unit is switched on, it takes less than a minute for the
WLAN connection to be functional.

WLAN ON/OFF switch

Warning
The operation of WLAN may lead to disruptions of other electrical systems.
This may endanger the function of life-support systems!
u Maintain a minimum distance of 1m between the WLAN unit and any other
devices when WLAN is in operation. If this is unfeasible at times (e.g. in the
operating room), then switch off the WLAN for as long as necessary.

ARCADIS Orbic
SPR2-320G.620.30.03.02 5 of 24
Options

The coexistence of wireless sources operated in the same environment may

affect the quality of data transfer.
The transmission speed is reduced if additional WLAN clients are operated simul-
taneously in the same environment.

For reasons of data security, it is recommended to encrypt the data in the WLAN
according to WPA or WPA2.

In case the wireless connected is interrupted, impaired or overloaded, it is rec-

ommended to keep an Ethernet cable on hand, provided there are connection op-
tions nearby.
The position of the RF beam of the activated WLAN is shown in a warning label.

(1)

(2)

(1) Warning label: Non-ionizing electromagnetic field

(2) Warning: Read Operator Manual

If WLAN is activated, this warning label must not be covered up, and no devices
sensitive to high frequencies should be placed on top of the unit. Otherwise,
damage to such devices or impairment to WLAN functionality could result.

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 Options

Operation via Ethernet cable 0

In case of operation of the ARCADIS system via Ethernet cable, the WLAN at the
monitor trolley needs to be deactivated prior to switching on the system.

Simultaneous operation via Ethernet cable and WLAN is not possible and should
be avoided by all means.

After inadvertent simultaneous operation or after a change between both op-

tions, the system must be switched off and on again.

Multi-function footswitch (option) 0

MODE

Caution
If the C-arm is lowered all the way and the bracket is folded up, there may be
contact between the multifunctional footswitch and image intensifier or tube
assembly housing.
Damage to the multifunctional footswitch and image intensifier or
tube assembly housing!
u Please make sure that the footswitch is not located underneath the I.I.

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Options

Selecting the operating mode 0

The operating mode button of the multifunctional footswitch allows you to select
one of the operating modes, i.e. DR, PFC, SUB, ROADMAP (depending on the
configuration level).
u If necessary, press this button on the multifunctional footswitch several
MODE times.
– The selected operating mode is indicated in the Examination task card and
on the control panel of the C-arm system.
– A confirmation sound acknowledges the successful switch of operating
modes. You can then release radiation again right away.

Releasing radiation 0

The right footswitch is always used to activate fluoroscopy (CFC) (standard set-
ting).
The left pedal is used to activate the currently selected operating mode.
Exception: If fluoroscopy (CFC) is selected, the left pedal is assigned the digital
radiography (DR) mode.

The functionality of the pedals can optionally be changed.

u Keep the foot pedal pressed during radiation release.

Storing images (during radiation) 0

u Press this button on the multifunctional footswitch during radiation.

– The image currently generated and displayed is saved in the local database.

Storing images (after radiation) 0

u Press this button on the multifunctional footswitch.

– Holding the key for < 2 seconds: saves the image last recorded (LIH).
– Holding the key for > 2 seconds: saves the scene last recorded (LSH).

The ARCADIS Orbic transfers images from monitor A to monitor B and then
stores them in the local database.

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 Options

Stowage for transport 0

Before transporting the unit, place the multifunctional footswitch into its holder
on the side facing away from the C-arm. The cleat to hold the rolled-up cable is
on the C-arm side, as is the case with the standard footswitch.

Footswitch holder

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Options

Text-based entry keys 0

Control panel, English text (option) 0

Most of the keys on the C-arm system control panel are labelled with text rather
than symbols.

(8) (9) (10) (11) (12)

(6)

(7) (7)

(1) (2) (3) (4) (5)

(1) Operating mode selection

(2) Select image parameters (high-contrast fluoroscopy, image quality,
image display)
(3) Collimator setting
(4) Image postprocessing
(5) Image selection, storing and printing
(6) Radiation indicator, X-ray tube assembly temperature
(7) Lift/lower C-arm
(8) Image rotation
(9) Laser light localizer ON
(10) Automatic dose regulation OFF (ADR Stop)
(11) Selecting and displaying exposure parameters
(12) Display exposure time, reset exposure time (confirm warning tone)

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 Options

syngo keypad, English text (option) 0

The numeric keypad on the monitor trolley for selecting syngo functions is
labeled with the relevant text.

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Options

Sterile cover on the C-arm 0

To protect against contamination, the C-arm including the image intensifier and
the X-ray tube assembly is completely covered with a two-part sterile cover.
The cover is attached with sterile clamps.

C-arm completely covered

Caution
Insufficient attachment of the sterile cover.
The patient can be injured if the cover falls down!
u When attaching the sterile cover with the clamps, make sure the cover is fas-
tened properly.

u Slip the cover over the image intensifier.

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 Options

u Attach the image intensifier cover.

u Fold the cover for the C-arm and the X-ray tube.

Slipping the cover over becomes easier if you fold it first. Make sure that the out-
side of the cover does not come into contact with the C-arm.

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Options

u Slip the cover over the X-ray tube and cover the C-arm.

u Attach the cover close to the X-ray tube with clamps.

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 Options

u Let the C-arm cover overlap the image intensifier cover and secure the C-arm
cover with a clamp.

u Tie down the cover of the X-ray tube.

The C-arm is now covered completely.

Clamps to keep covers in place 0

The clamps keep the sterile C-arm cover in place.

They can be sterilized.

Please make sure that the clamps are properly fastened. Otherwise there is a
danger of injury.

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Options

Sterile cover for 3D option 0

During the 190° orbital rotation for 3D data acquisition, part of the C-arm will trav-
el from underneath the OR table to above the OR table. This requires special
measures to maintain sterile conditions.
Surgeons are currently applying two different methods for this:

1. A sterile tunnel is created with sterile drapes (see picture). Only the floor re-
mains unsterile. The C-arm, which is covered with a sterile drape, rotates
through this sterile tunnel.

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 Options

2. The patient is covered with two additional overlapping sterile drapes before
the scan is started. After the scan, these two (possibly contaminated) drapes
can be rolled down with sterile towel clips (see below).

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SPR2-320G.620.30.03.02 17 of 24
Options

Integrated I.I. laser aimer 0

To project the target crosshairs, two Class 1M lasers are used whose exit win-
dows are arranged offset by 90° in the holding ring for the I.I. grid.

Protective measures 0

Warning
Laser radiation
Danger of eye injury!
u Do not view the beam using optical instruments (laser class 1M).

Single-tank laser targeting device (option) 0

Short-term exposure (looking into the laser beam for no longer than 0.25 s) to
laser beams of Class 2 is not hazardous to the eye.
The aversion response and the blinking reflex will usually protect the eye.
In Germany, the operator is responsible for ensuring that the user has been in-
structed in the use of the laser. Outside Germany, the relevant laws and regula-
tions regarding the use of Class 2 lasers must be complied with.

Protective measures 0

Warning
Laser radiation
Danger of eye injury!
u Do not look directly into the laser beam.

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 Options

Horizontal laser light localizer 0

Short-term exposure (looking into the laser beam for no longer than 0.25 s) to
laser beams of Class 2 is not hazardous to the eye.
The aversion response and the blinking reflex will usually protect the eye.
In Germany, the operator is responsible for ensuring that the user has been in-
structed in the use of the laser. Outside Germany, the relevant laws and regula-
tions regarding the use of Class 2 lasers must be complied with.

Protective measures 0

Warning
Laser radiation
Danger of eye injury!
u Do not look directly into the laser beam.

Product description 0

The horizontal laser light localizer is mounted to the C-arm ready for use and con-
nected by the service engineer.

Horizontal laser light localizer on the C-arm

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Options

Use In connection with the I.I. laser aimer, the horizontal laser light localizer allows
easier and faster positioning of the X-ray system relative to the patient.
On ARCADIS Orbic in connection with the I.I. laser aimer, it allows the X-ray sys-
tem to be adjusted without orbital movement of the C-arm and without radiation.

Intended use Proper use of the horizontal laser light localizer presupposes the following:
o the laser light localizer is firmly attached to the C-arm housing
o only batteries of the prescribed types are used
If an increased brightness of the beam is observed, the light localizer should im-
mediately be serviced.
The lasers can be switched off at any time by pressing the on/off button.

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 Options

Operation 0

Operating elements

(1)
(2)
(3)

(4)

(1) On/off button

Button for switching on and off.
Automatic switch-off occurs after approx. 1 minute
(2) Laser module
A semiconductor laser with line generating optics
(3) Laser aperture
(4) Battery compartment
The batteries can be accessed by opening the lid

Startup u Flip the cover of the horizontal laser light localizer open to the side.

(1)

(1) Cover of horizontal laser light localizer

u Press the on/off button.

– The laser light localizer is activated.
u To deactivate it, press the on/off button again or wait approx. 1 min. until it
switches off automatically.

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Options

Use of batteries and accumulators 0

Charging status o The horizontal laser light localizer has an early warning function for low battery
charge:
If the battery voltage falls below a certain value, the lasers will operate inter-
mittently, i.e. radiation is briefly interrupted at an interval of approx. 1 second.
In this operating condition you can continue to work with the equipment for at
least 1 hour. The exact duration of this operating reserve, however, strongly
depends on the battery type used.
o Rechargeable accumulators will suffer permanent damage if discharged ex-
cessively. Therefore an additional low voltage disconnect is installed which
disconnects the lasers if the battery voltage is too low, thus preventing dam-
age to the batteries. Under normal circumstances, this condition should never
be reached if the batteries are changed during the reserve period (intermittent
operation).

Battery change The batteries can be changed easily and without tools.
u Open the lid of the battery compartment with the help of a coin.
– The batteries are now accessible and can be replaced.

When inserting the new batteries, be sure to observe the correct polarity as
marked in the battery compartment!
o The horizontal laser light localizer comes equipped with 4 R6 (AA) batteries.
The most efficient alternative is the use of rechargeable NiCd batteries of the
same size for which the electronic control of the horizontal laser light localizer
is optimized. In principle, any other battery system of the same type with a
cell voltage of 1.2 V to 1.5 V can be used. In this case, however, the operating
times achieved may deviate considerably from the specified times.
o The use of LR6 type (alkali-manganese system) batteries is advantageous
whenever it is important that the system operates reliably after extended pe-
riods of no operation, since these cells have a considerably lower self-dis-
charge rate than NiCd batteries. However, the energy of the LR6 cells cannot
be fully utilized due to the low voltage disconnect being adapted to
NiCd batteries.
o In general, only high-quality battery types should be used in order to ensure
high availability of the horizontal laser light localizer and safe protection against
leakage of liquid electrolyte. Discharged batteries should always immediately
be removed from the battery compartment.

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Notes on maintenance and care 0

To ensure a long and fault-free life of the horizontal laser light localizer, observe
the following notes:
o Use only high-quality battery systems of the approved types.
o Replace used batteries immediately.
o Protect the optical parts from contamination and scratches.
o Clean the surfaces with a soft, lint-free cloth which may be moistened with a
mild, non-abrasive cleaning liquid.
o Prevent liquids from seeping into the battery compartment.
o In case of a fault, have the equipment serviced by an authorized person.

Make sure the horizontal laser light localizer is serviced regularly!

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Dose measuring chamber (DAP meter) 0

If available, this option is integrated in the single-tank of the ARCADIS Orbic.

The DAP meter determines the dose area product (DAP) and air kerma values,
using an ionization chamber and an electron counter. The cumulative patient data
is displayed on the monitor trolley during the examination
(› Register 5: Examination, Page 9).

Dose measuring chamber (DAP meter), integrated in the single-tank

Operator Manual
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