:Network enabled medical diagnosis and education in skeletal imaging using X-Rays

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1 Document title Project title Document Ref. : Suggestions for CollabDDS V1.1 Application :Network enabled medical diagnosis and education in skeletal imaging using X-Rays : CSIO/CI/NKN/ /DOC/9 Computational Instrumentation Division Central Scientific Instruments Organisation Sector 30-C, Chandigarh , India October 2012

2 Errors and suggestions for CollabDDS V1.1 Application CollabDDS V1.1 was installed on desktop computers / workstations running 32-bit and 64-bit Window 7 operating system. Random testing was performed using DICOM and TIFF images of different sizes. Certain errors which were encountered during the running of the application have been mentioned below. Certain suggestions are also provided and discussed which may help to improvise the application. Errors 1. Region zooming error CollabDDS application was installed in various systems with 64 bits and 32 bits operating systems. Region zooming function is working very well in some 32 bits operating systems. But some systems with 32 bits and all systems with 64 bits are not showing proper functionality of this function as shown in Figure 1. Figure 1: Improper functionality of region zooming 2. Out of memory error for uploading images Out of memory error encountered while uploading large size images over CollabDDS application. Testing has been done for uploading images over CollabDDS application on standalone mode sent by IITB recently. DICOM images (titled as Mr. Ramchandra - R Chestsize.dcm and size 54 MB) and TIFF image (titled as Mrs. Mabal - L Left Foot.tif and size 45 MB) failed to be uploaded over CollabDDS application. Encountered error is shown in Figure 2 as below. CSIR-CSIO Suggestions for CollabDDS V1.1 Application 1

3 Figure 2: Out of memory error while uploading large size images 3. Size of dialog box Add new user Figure 3 shows a dialog box for adding a new user. Initially this dialog box has less height. So text-box is not visible to the user. There should be some enlargement in dialog box s height. Figure 3: Small height dialog box for new user addition 4. Case Study is not generated Figure 4 shows the stages of patients to create a case study. Different DICOM images have been uploaded correspondingly using Add Files. Only three stages have been used for case study generation. This application does not allow generating case study till blank stages would be deleted. Error encountered as shown in Figure 5, when some stages have been left blank. If small numbers (1-4) of images are available for case study then empty stages should be automatically deleted or function should work by uploading existing images. CSIR-CSIO Suggestions for CollabDDS V1.1 Application 2

4 Figure 4: Generation of Case Study Figure 5: Error Message in case study construction 5. Undo from the window level functionality option Some manipulations were performed on image and window level function was used over it as shown in Figure 6. Now there is no provision to remove the effect of window level function without losing previous manipulation. Figure 6: Window level function over manipulated image CSIR-CSIO Suggestions for CollabDDS V1.1 Application 3

5 6. Parallel effect on all images in screen layout option Some manipulations e.g. negative of image were performed on image after selecting it in 2X2 screen layout option. User is unable to manipulate over only one selected image. If manipulation is performed then effect is shown over all four displayed images as shown in figure 7. Note: Kindly let us know if this provision has been made intentionally. Figure 7: Manipulation over screen layout option 7. Error in complete CBCT data-sets uploading Testing has been done for uploading CBCT data-set (448 CBCT slices; size 195 MB) in a single step. Error encountered while uploading as shown in the figure 8. The application crashes. Figure 8: CBCT data-set uploading error 8. Deletion of files in case study Five cases have been saved in a case study. Now doctor wants to delete any case from serial no. 1-4, not fifth one. This option is disabled and prompt as shown in figure 9. Kindly allow to delete any of the record in between the case study. CSIR-CSIO Suggestions for CollabDDS V1.1 Application 4

6 Figure 9: Restriction for file deletion 9. Capture current view in screen layout mode The functionality of the Capture current view is not working properly when the screen layout is selected. Figure 10(a) shows 1 2 screen layout mode and Figure 10(b) shows the result of capture current mode option. (a) Screen layout mode (b) Capture current view of image (a) Figure 10: Result of Capture Current View 10. Improper functionality of cine mode in screen layout When images were selected in 1 2 screen layout mode and first screen was selected. Then cine mode was working properly. If second screen was selected then also cine mode function was working properly. Now again first screen was selected and tried to check working of cine mode option. But cine mode option does not work properly (only the first image remains on the screen). It is observed that selection of screen is the solution for this improper functionality. The selection of the screen should be as shown in the figure 11. CSIR-CSIO Suggestions for CollabDDS V1.1 Application 5

7 Point 1 Point 2 Figure 11: Cine mode functionality in screen layout option If the screen is selected through point 1, function works proper for both the screens but if the screen is selected through the region of point 2, the function does not work properly for first screen. But is works properly for second screen. It is suggested that selection of the screen should be unique or whatever the selection of screen the function should work proper for both the screens. 11. Log and dialog box error while dds file opening in case study A dds file has been saved over hard disk using CollabDDS application. This dds file is uploaded in case study and case study was saved. Now the saved dds file was opened and got error dialog as shown in Figure 12 and log error as shown in Figure 13. While dds file was successfully opened in CollabDDS application as expected. Figure 12: Error shown in dds file opening CSIR-CSIO Suggestions for CollabDDS V1.1 Application 6

8 Figure 13: Log error in dds file opening Suggestions 1. Confirmation of Connection successful CollabDDS application should prompt a confirmation message after establishment of connection between two nodes. 2. Scroll Bar for contrast, brightness There should be a scroll bar to increase or decrease brightness / contrast of an image as shown in Figure 14. Figure 14: Scroll bar to change contrast/brightness (image is taken from Microsoft word) 3. Display Hounsfield (HU) value on cursor position There should be a display of HU value according to the dynamic cursor movement over CT/CBCT slices. Figure 15 shows HU value of a certain location and changes as cursor moves. CSIR-CSIO Suggestions for CollabDDS V1.1 Application 7

9 Figure 15: Display of HU value 4. Sharing of CT/CBCT slices In network mode, when two doctors are connected over CollabDDS application, there may be a need of multiple CT slice sharing. At present this application is allowing single slice sharing at a time. If doctor 1 wants to share CT slices to doctor 2 then he has to share every slice separately. So there should be a provision to share complete workspace of opened CT slices in a single step. 5. Icon size Display icons in CollabDDS application are good but a bit smaller size of icons may give a better look for CollabDDS application. 6. Uploading new image(s) along with the image(s) available in workspace There may be a requirement to analyse two different sets of CT images at a time or a specialist may feel to upload other data-set over the application while accessing current data-sets. These conditions may require introducing new workspace tabs to have old data-sets and new data-sets simultaneously. Figure 16 shows a data-set in series No: 1; now doctor is unable to upload another data-set keeping old dataset in workspace. There should be a provision to upload new dataset named as series no: 2. Note: May be it is already implemented in this application but we are unable to find it. Kindly provide the guidelines to use it. CSIR-CSIO Suggestions for CollabDDS V1.1 Application 8

10 Provision should be there to open a new tab name as Series No. 2 Figure 16: uploading images in new tab 7. Control over frame rate of Cine mode CollabDDS application in cine mode changes frames at a default rate. There should be a provision to control the frame rate. So that doctor may control frame rate of CT slices as their applicability. 8. Linear and Angular Measurements There should be a provision to measure distances between two points and angle between two lines. Option is available in CollabDDS application (Image Measurement Line/Angle/Ellipse/Rectangle). But presently it is not working. However this option should include Cobb Angle function as shown in Figure 17 for Radiant Viewer. Sometimes this function may useful to measure deformity angle in medical imaging. Other functions like measure distance, angle determination and ellipse calculation should be interactive as shown in Figure 17. Information tag may be display on image as shown in figure, but tag should be movable by mouse. CSIR-CSIO Suggestions for CollabDDS V1.1 Application 9

11 Distance between two points Angle between two lines Ellipse Calculations Cobb Angle Figure 17: Display of linear and angular measurements in Radiant Viewer 9. Pan Measurement area Presently, this function is available in CollabDDS application for displaying an image. This function should also be implemented for measurement area. It may be required to analyse a fixed area of an image. Area over the image may be made fix (as in this image 5.2 cm 2 ) by ellipse or rectangle and change of minimum & maximum value, mean and SD may be analysed. So there shall be a need to implement a function of Pan Measurement area. Figure 18 shows pan operation performed over image as well as on ellipse area. CSIR-CSIO Suggestions for CollabDDS V1.1 Application 10

12 Figure 18: Shows changes by using "Pan" options 10. Display connectivity references among other CT slices Figure 19 shows some references of CT slices such as Anterior, posterior, left and right. These references may also be display in CollabDDS application for better understanding of radiograph. Display of connectivity references Figure 19: Display connectivity references among other slices CSIR-CSIO Suggestions for CollabDDS V1.1 Application 11

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