ACR Accreditation Image Upload Instructions

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Rodger Stokes
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ACR Accreditation Image Upload Instructions Contents I. Introduction... 2 II. Your Application... 2 III. Your Testing Package... 3 A. ACRedit Web Client... 4 B. TRIAD Windows Client.

1 ACR Accreditation Image Upload Instructions Contents I. Introduction... 2 II. Your Application... 2 III. Your Testing Package... 3 A. ACRedit Web Client... 4 B. TRIAD Windows Client... 7 Step 1: Select Modality Testing Package... 9 Step 2: Choose image files to submit for your examination... 9 Step 3: Viewing your images using the TRIAD Windows Client Step 4: Upload or delete files that are checked ( ) Step 5: View and Print Image Upload Summary Step 6: Submit Testing Package IV. Installing ClearCanvas Workstation Page 1 of 19

I. Introduction Facilities seeking ACR Accreditation can choose to upload clinical and phantom images to an encrypted, secure server for accreditation review.

2 I. Introduction Facilities seeking ACR Accreditation can choose to upload clinical and phantom images to an encrypted, secure server for accreditation review. There are two choices for uploading your images: 1. Web Client compatible with your Windows PC or MAC no software to install, only needs an internet connection. 2. Windows Client compatible with your Windows PC, allows you to connect directly to your PACS for image retrieval. This document will give you the information on the process and functionality of both Web Client and Windows Client. II. Your Application When you apply for accreditation, in addition to choosing modules and/or examinations for submission (depending on the accreditation program), you also choose the type of submission. For unit based accreditation programs, you may choose the way you submit your images differently for each unit. For facility based accreditation programs such as ultrasound, you will choose one submission type no matter how many units are at that facility. Select submission as Upload from the drop down. Electronic Image Selection in ACRedit Application Page 2 of 19

If you choose upload submission, please be aware that you will be required to upload both clinical and phantom images (if applicable), and any supporting documents required in the online testing

For instance, if you are applying for CT Accreditation, you must submit copies of your written protocols for the examinations on your application, as well as the most recent Annual System

After you finish and submit your application, ACR staff will ensure that everything is received (fees, survey agreement if applicable, etc.) and accept your application.

Your Testing Package Once the testing package is available you may access it by clicking on My Testing Packages.

3 If you choose upload submission, please be aware that you will be required to upload both clinical and phantom images (if applicable), and any supporting documents required in the online testing package for that modality. For instance, if you are applying for CT Accreditation, you must submit copies of your written protocols for the examinations on your application, as well as the most recent Annual System Performance Evaluation, for that unit. These must be uploaded they should not be mailed or faxed. After you finish and submit your application, ACR staff will ensure that everything is received (fees, survey agreement if applicable, etc.) and accept your application. You will then receive an stating that your online testing package is available. III. Your Testing Package Once the testing package is available you may access it by clicking on My Testing Packages. To open your testing package, you will click the Modify link under the Action column. You will see several items on the left hand navigation pane. Each item will have a red X next to it, indicating that section is not completed. As you complete each section, a green check mark will appear. All items must have a green check prior to submitting your testing package. This document will focus exclusively on the item Upload Images. Fields marked X are the incomplete sections. This section of the page is used to upload the images electronically. Fields marked with a green check are the completed sections. Left navigation pane in ACRedit online Testing Package Page 3 of 19

PLEASE REFER TO THE TESTING INSTRUCTIONS SPECIFIC FOR YOUR MODALITY AT https://www.acraccreditation.org/ TO ENSURE YOU ARE UPLOADING ONLY THE IMAGES THAT ARE REQUIRED FOR YOUR TESTING PACKAGE.

On the Upload Images screen, there are two choices for uploading your images, ACRedit Web Client and TRIAD Windows Client. You can switch between these two uploading methods at any time.

4 PLEASE REFER TO THE TESTING INSTRUCTIONS SPECIFIC FOR YOUR MODALITY AT TO ENSURE YOU ARE UPLOADING ONLY THE IMAGES THAT ARE REQUIRED FOR YOUR TESTING PACKAGE. IT IS IMPORTANT WHEN UPLOADING IMAGES TO ENSURE THAT ALL IMAGES HAVE BEEN SUCCESSFULLY UPLOADED AND VIEWED PRIOR TO SUBMISSION. On the Upload Images screen, there are two choices for uploading your images, ACRedit Web Client and TRIAD Windows Client. You can switch between these two uploading methods at any time. We will go into more detail of these two choices separately. You will be able to add or delete images until your online testing package is submitted. Once your testing package is fully submitted, you cannot make any changes to the images you have chosen. The Web Client option does not require software installation for uploading your images. You can view the images using the DICOM viewer provided prior to submitting the images and testing package. See Section A for more details. This option (TRIAD Windows Client) requires software installations and allows you to upload images directly from your PACS system or from your computer. You can view the images using ClearCanvas Workstation viewer prior to submitting the testing package. See Section B for more details. A. ACRedit Web Client Upload Images Screen of ACRedit Testing Package The ACRedit Web Client requires no download or installation of any software to your computer or network. An internet connection and access to the images on your computer hard drive, network or CD/DVD/thumb drive are required. Web Client requires the use of an up to date web browser. Here is a list of the supported browsers: Internet Explorer IE 10 or above upload files Google Chrome Chrome 22 or above upload files or folders Safari Safari 5 or above Mozilla Firefox Firefox 27 or above upload files or folders Page 4 of 19

Select View/Upload. Select ACRedit Web Client and the below window appears.

file types for each modality, get further instruction and view/upload images.

This will open a new window allowing you to navigate to the image files for upload.

for each series in a particular examination.

To select all files from a folder, press Ctrl + A.

uploading. You may also remove one file or all files by clicking the Delete button.

5 Select View/Upload. Select ACRedit Web Client and the below window appears. Upload Images Screen with Web Client chosen From this window, you may view supported file types for each modality, get further instruction and view/upload images. To upload images, click File Upload or Folder Upload (if available). This will open a new window allowing you to navigate to the image files for upload. For many examinations, images will be stored in separate folders for each series of images. If that is the case, it is necessary to click File Upload or Folder Upload separately for each series in a particular examination. You may, however, select multiple files from a particular folder with your selection. To select all files from a folder, press Ctrl + A. Please note that a progress bar will appear while your files and/or folders are uploading. You may also remove one file or all files by clicking the Delete button. Once all of the exams have been uploaded, you must view the images by clicking the View button. When you have finished uploading images for that examination, click the Ready for Submission box in the upper right corner of that exam. This will save the uploaded images. Page 5 of 19

It is important to view all the uploaded images prior to submitting the testing package to ensure all required images have been uploaded and can be

When you are finished uploading the images for all examinations, click on Image Upload Summary. A new window will open.

6 It is important to view all the uploaded images prior to submitting the testing package to ensure all required images have been uploaded and can be viewed successfully. At this point, you can log out of the ACRedit database and finish later, or click next to progress. When you are finished uploading the images for all examinations, click on Image Upload Summary. A new window will open. Once all the testing materials have been uploaded and all items are checked with a green check mark on the left navigation menu, you are then able to submit your testing package. Please note that once you finish and submit your testing package you are not able to make any changes to the uploaded documents and images. You will be able to view the images you uploaded and submitted for accreditation by clicking on My Testing Packages and then View images for Submission once the link is available. Page 6 of 19

B. TRIAD Windows Client o Software installation required TRIAD Windows Client application ClearCanvas Workstation You can download both here: https://triad4.acr.

retrieve images from PACS for upload Minimum system requirements for TRIAD Windows Client: Windows 7 (32 or 64 bit) only (Windows 8 and Windows 10 are not currently supported) Intel/AMD CPU / 2.

NET Framework requires administrative privileges on the local computer. You can download.net Framework from: https://www.microsoft.com/en us/download/details.aspx?

7 B. TRIAD Windows Client o Software installation required TRIAD Windows Client application ClearCanvas Workstation You can download both here: o o o Ability to connect with Clear Canvas Workstation for viewing full images before submission May choose entire folders for uploading in addition to individual files Can retrieve images from PACS for upload Minimum system requirements for TRIAD Windows Client: Windows 7 (32 or 64 bit) only (Windows 8 and Windows 10 are not currently supported) Intel/AMD CPU / 2.4 GHz or above 2 GB RAM 60 GB Hard Disk space Microsoft.NET Framework Microsoft Visual C x86 Redistributable Microsoft Visual C x86 Redistributable Installing Microsoft.NET Framework requires administrative privileges on the local computer. You can download.net Framework from: us/download/details.aspx?id=42643 Choosing TRIAD Windows Client (from the Upload Images screen of your online testing package) changes the screen to allow you to install, launch or update the TRIAD Windows Client. This link will: Install TRIAD if you have not already installed the software. Launch TRIAD if the software is already installed. This link will take you to a site to download Clear Canvas. See Section IV: Installing Clear Canvas Workstation for further instructions. Upload Images screen with TRIAD Windows Client chosen Page 7 of 19

Administrative privileges to your PC are required to install TRIAD Windows Client and Clear Canvas Workstation viewer.

While the Web Client allows you to upload and view your images prior to submission, it does not allow you to access your PACS system directly to upload your images.

When installing the Clear Canvas Workstation please ensure that you also install the patch. Once TRIAD is installed and you have launched the software, you will see the TRIAD Home screen.

8 Administrative privileges to your PC are required to install TRIAD Windows Client and Clear Canvas Workstation viewer. If you are unable to acquire these privileges or receive assistance from your IT department, you may still upload images with the ACRedit Web Client. While the Web Client allows you to upload and view your images prior to submission, it does not allow you to access your PACS system directly to upload your images. With the TRIAD Windows Client you can view the DICOM images by using Clear Canvas Workstation, a free DICOM viewer (see section IV. Installing Clear Canvas Workstation). When installing the Clear Canvas Workstation please ensure that you also install the patch. Once TRIAD is installed and you have launched the software, you will see the TRIAD Home screen. The pane on the left side of the TRIAD window is the log in screen. You must first select the appropriate Accreditation program before logging in. The username and password are the same as your login for your ACRedit account. Select the Accreditation Program from the domain drop down list. TRIAD Windows Client software log in screen Page 8 of 19

9 Follow the steps that are marked in red below. TRIAD Windows Client steps to submit testing package Step 1: Select Modality Testing Package The upper left pane is where you will choose the Modality Name, Modality Number/Unit Number (for unit based accreditation programs) and Examination Name. Step 2: Choose image files to submit for your examination The upper right pane is used for choosing and viewing images. The lower pane lists the number of images that you have uploaded so far, and this is where you can view and print your summary of the images chosen for upload. Page 9 of 19

between your PACS and TRIAD Windows Client

you may need assistance from your PACS/IT

10 b) Click to choose files from PACS. a) Click here to establish a connection to your PACS and/or only choose files a) Configure PACS You must setup a connection between your PACS and TRIAD Windows Client in order to select files from the PACS and you may need assistance from your PACS/IT team. Click Manage to add Device details and test the connection. Click DICOM Info to get DICOM information to be given at PACS side. Page 10 of 19

On the left side of the window, click Manage. To connect for the first time to your PACS, you will need to fill out the Device Details section completely, and then click Add.

Click Test Connection to check the connection with device. 2a. Displays if the connection is successful. 2b. Displays if the connection fails.

You can now exit the Manage/Test Device window and search your PACS for the images you want to upload for this particular examination.

images to the ACR TRIAD system. Click on the DICOM Info button for the information needed to set the destination.

Consult with your IT department and if more assistance is needed contact TRIAD support at 703 390 9858.

11 On the left side of the window, click Manage. To connect for the first time to your PACS, you will need to fill out the Device Details section completely, and then click Add. The device name will appear in the Select Device section on the left side of this window. 1. Click on Add, enter the device details and save. 2. Click Test Connection to check the connection with device. 2a. Displays if the connection is successful. 2b. Displays if the connection fails. Click on Test Connection, and the system will state that your new Device is up and running. This configuration allows you to pull images from your PACS. You can now exit the Manage/Test Device window and search your PACS for the images you want to upload for this particular examination. If the above configuration does not work you may also try pushing your images from your PACS system to the ACR TRIAD system by adding the destination to your PACS system and exporting the images to the ACR TRIAD system. Click on the DICOM Info button for the information needed to set the destination. If you receive a C Move Response error message it may indicate that your firewall is blocking the transmission. Consult with your IT department and if more assistance is needed contact TRIAD support at b) Retrieving files from PACS After you select Choose Files, the Select Images window will appear. If this is your first time to choose files from PACS, you will need to set up the connection (see Configure PACS section). Use the Search section of the Select Images window. In order to search as quickly as possible, enter as much information as possible about the examination you would like to upload. Your search results will be shown in the Received Images Section of the window. Place a check by the studies you wish to select, and click Select Images. Those images will show up in the upper right pane of TRIAD Windows Client. Page 11 of 19

Enter information then press Search Images Step 3: Viewing your images using the TRIAD Windows Client Whether you imported your images from PACS or from your computer/network, you

If you have not downloaded ClearCanvas, then see section IV: Installing ClearCanvas Workstation.

12 Enter information then press Search Images Step 3: Viewing your images using the TRIAD Windows Client Whether you imported your images from PACS or from your computer/network, you will view the images the same way. In the top right corner of TRIAD, you will see the DICOM viewer to use when viewing your images. If you have not downloaded ClearCanvas, then see section IV: Installing ClearCanvas Workstation. The images appear in the upper right pane of TRIAD, double click on the image icon to open images at study level in ClearCanvas. Click the + next to the study. The study will open into folders for each series. Click the folder icon in the Image column. This will open the images for that series with ClearCanvas. Page 12 of 19

13 Step 4: Upload or delete files that are checked ( ) After you have viewed your images, the next step is to upload them. Mark the images you want to upload or delete by checking the box just left of the study ID. Please note that if you chose images from other formats, they will be listed separately, and you may need to use the scroll bar on the right side of the pane if they do not all fit in the window. Step 5: View and Print Image Upload Summary You may view and print a summary of the images that you have uploaded by clicking on the Image Upload Summary button. Step 6: Submit Testing Package After all of your images have been successfully uploaded, Select Submit Testing Package in the lower pane of TRIAD. You will not be able to submit the images until all items have been completed in the testing package. If all items have not been completed, then you will be redirected to your testing package in ACRedit. Once all the testing materials have been uploaded, you are then able to submit your testing package. Please note that once you finish and submit your testing package you will not be able to make any changes to the uploaded documents and images. You will however be able to view the images you uploaded and submitted for accreditation by clicking on My Testing Packages and then View images for Submission once the link is available (see illustrations on the bottom of page 7 top of page 8) IV. Installing ClearCanvas Workstation In order to view the DICOM images using the TRIAD Windows Client in a testing packet, you must download and install the free DICOM viewer ClearCanvas. This requires administrative privileges on the PC. If you are attempting to install ClearCanvas on your work PC, you may need help from your IT department. Follow the instructions below to download and install ClearCanvas. When you open DICOM images in TRIAD Windows Client, the ClearCanvas viewer will open. Download the ClearCanvas DICOM Viewer 13.2 (32bit or 64bit) from the link below to your local drive: Page 13 of 19

Download and install ClearCanvas from this

This software version is tested and supported

Please consult with your IT department to

14 Download and install ClearCanvas from this website only. This software version is tested and supported with TRIAD Windows Client. Please consult with your IT department to determine whether to download the 32 or 64 bit version. Steps for installing ClearCanvas Workstation: 1. Download the ClearCanvas Viewer. 2. Right Click and extract the files from the folder Page 14 of 19

15 3. Open the Clean Canvas folder and double Click on ClearCanvasViewer.exe 4. Select No for the following message. 5. Now ClearCanvas will display the below dialog. Click Next to continue. Page 15 of 19

16 6. Click OK to review the End user license agreement and then I Agree. Page 16 of 19

17 7. Click Next (leave the default path. Please do NOT modify.) 8. Please change the AE Title to CCSERVER and Port to 200 to avoid conflicts as port 104 is the most commonly used port among other applications. Page 17 of 19

18 9. Click on Install 10. Click Finish to launch the application. Page 18 of 19

19 11. Close ClearCanvas and double click on Patch.exe 12. Click on Ok 13. Click on Close Page 19 of 19

ACR Accreditation User Instructions for Electronic Submission of Images

ACR Accreditation User Instructions for Electronic Submission of Images Page 1 of 25 Contents I. Introduction... 3 II. Your Application... 3 III. Your Testing Package... 5 A. ACRedit Web Client... 7 B.