Diagnostic Viewer User Manual

Transcription

1 Diagnostic Viewer User Manual NovaPACS Diagnostic Viewer User Manual March 28, 2013 Version Copyright 2013 Novarad Corporation. All rights reserved. This publication may not be copied, reproduced, or converted to any other electronic or machine-readable format without prior consent of Novarad Corporation. Novarad, NovaPACS, and NovaRIS are registered trademarks of Novarad Corporation. The Lite Viewer is a trademark of Novarad Corporation. Windows XP, Vista, and Windows 7 are registered trademarks of Microsoft Corporation. All other products or name brands are the trademarks of their respective owners. Novarad Corporation USA 752 East 1180 South Suite 200 American Fork, UT Office Fax Toll Free info@novarad.net Copyright Novarad Diagnostic Viewer Manual

2 Intended Use: NovaPACS is intended for the viewing, archiving, analysis, annotation, registration, distribution, editing, fusion, and processing of digital medical images and data acquired from diagnostic imaging devices and all DICOM devices, etc. NovaPACS is intended for use by trained healthcare professionals, including radiologists, physicians, technologists, clinicians, and nurses. NovaPACS allows the end user to display, manipulate, archive, and evaluate images. Digital mammography images must be acquired from an approved Full Field Digital Mammography (FFDM) modality for primary interpretation and diagnosis. NovaPACS used on mobile devices is not intended to be used as, or replace a full diagnostic workstation or system and should not be used for mammography diagnosis. Such viewers are intended for use after primary reading has been performed on dedicated diagnostic workstations. It is the user's responsibility to ensure quality, ambient light conditions, and to confirm image compression ratios are consistent with the generally accepted standards of the clinical application. Installation Instructions: Installation is the responsibility of Novarad Technical Services. The user will be directed by Novarad Technical Services if their assistance is required. NovaPACS is only intended for use with hardware that meets or exceeds minimum performance requirements, satisfies current safety regulations, and is CE marked as required by national or regional regulations. Maintenance/Upgrade Procedures: Maintenance, upgrades, and warranty replacements are the responsibility of Novarad Technical Services and the Original Equipment Manufacturer (OEM). The user will be directed by Novarad Technical Services if their assistance is required. Hardware Disposal: Contact technical support regarding any hardware warranty replacement or disposal issues before taking action. Disposal of hardware should be authorized by technical support and done in accordance with the procedures specified in the original equipment manufacturer s manual. Degree of Accuracy for measuring functions: Measurements done on DICOM images that include pixel scaling data are precise within two pixel lengths. NovaPACS will not return a measurement with more precision than is appropriate for the DICOM data and resolution of the images. Due to the imprecise nature of a computer monitor, a mouse and a person s hand, calibrating measurements by hand can result in inaccurate measurements. Measurement taken after calibration should be treated as rough estimates. Calibration is only valid for the current image. Copyright Novarad Diagnostic Viewer Manual

3 Manufacturing: Authorized Representative: Contact Information: Novarad Corporation 752 E 1180 S, Suite 200 American Fork, UT USA Tel.: Emergo Group / Emergo Europe Molenstraat BH The Hague The Netherlands Tel.: (31) (0) Fax: (31) (0) Technical Support & Regional Distributors info@novarad.net support@novarad.net Copyright Novarad Diagnostic Viewer Manual

4 Table of Contents Chapter 1 Getting Started Introducing the Study Browser and Image Viewer NovaPACS Diagnostic Viewer Systems Accessing the Diagnostic Viewer A. The Managed Viewer B. Launching the Managed Viewer C. The Web Viewer D. Launching the Web Viewer Logging in to the Diagnostic Viewer A. Logging in Automatically B. Logging in to a Data Source Chapter 2 Using the Study Browser Filtered Studies List A. Display B. Search Tab Filtered Studies Toolbar C. Assigned Worklist Filtered Studies Toolbar D. Advanced Worklist Filtered Studies Toolbar Patient History List Series List Hanging Protocol Layouts The Search Tab A. Customizing the Filters Group B. Customizing and Saving Filters C. Selecting a Saved Filter D. Deleting a Saved Filter E. Using the Search Filters The Data Source Filter The Time Frame Filter The Modlity Filter The Radiologist Filter The Referring Physician Filter The Status Filter The Checked Out Filter The Patient Group Filter The Study UID Filter The Patient ID Filter The Last Name, First Name, and Accession # Filters The Assigned To Filter The Assigned Worklist Tab A. Display B. Activating the Assigned Worklist C. Using the Search Filters The Data Source Filter Copyright Novarad Diagnostic Viewer Manual

5 2. The Time Frame Filter The Status Filter The Assigned To Filter The Advanced Worklist Tab A. Creating Advanced Worklists B. Editing Advanced Worklists C. Deleting Advanced Worklists Customizing Study Browser Lists A. Resizing Column Headings B. Resizing List Heights C. Choosing Column Headings D. Sorting Data in a Column E. Changing the Order of Columns Using the Study Browser Menus/Custom Toolbar A. Where to Find Additional Study Browser Menu Information B. Using the Study Browser Custom Toolbar C. Customizing the Study Browser s Custom Toolbar Activating the Study Browser Chapter 3 Using the Study Browser File Menu Open from Directory Open from File Exit the Diagnostic Viewer Chapter 4 Using the Study Browser Worklist Menu Introduction to the Worklist Add to Worklist A. Add to Worklist B. Assign Open Worklist Item Next Worklist Item Remove Worklist Item Clear Worklist Chapter 5 Using the Study Browser Study Menu Copyright Novarad NovaPACS Diagnostic Viewer Manual

6 5-1 Select All Open Close Workspace Close All Workspaces Route Documents Exam Report Manage Report Workflow RIS Information Retrieve Images Patient CD/DVD Assign Password Scan Complete Launch Cardio Reporting Launch Mammo Viewer View Study on Other Workstation Launch Orthopedic Tools Collaboration A. Checkout B. Undo Checkout C. Verified D. Reviewed E. Reset Status to New F. Peer Review G. Utilization Review Chapter 6 Using the Study Browser View Menu Worklist Hanging Protocol Layouts Series List Patient History List Refresh Lists Reset Filters Chapter 7 Using the Study Browser Settings Menu Options A. General Tab B. Keyboard Shortcuts Tab (Hotkeys) C. Mouse Settings Tab D. Image Context Menu Tab E. Auto W/L Tab F. Labels Tab G. Lexicon Tab H. Plug-ins Tab I. Data Sources Tab Copyright Novarad NovaPACS Diagnostic Viewer Manual

7 7-2 W/L Presets A. Customizing the W/L Settings B. Customizing Width and Center for Window/Level Fields and Presets Manage Hanging Protocols A. Add new Hanging Protocol B. Manage Layouts i. Tiled ii. Cine iii. Processed By i. Adding Content Filters ii. Editing Content Filters iii. Deleting Content Filters C. Edit Hanging Protocol D. Remove Hanging Protocol Configure Monitors Preferences A. Reset Preferences B. Import Preferences C. Export Preferences D. Save as Default Preferences Customize Toolbar A. Adding Toolbar Items B. Removing Toolbar Items C. Re-ordering the Menu D. Customizing Toolbar Options Chapter 8 Using the Study Browser Help Menu Instructions Current User Information Contact Support Submit Feedback User Manual What s New About Chapter 9 Using the Image Viewer The Image Viewer Hanging Protocol Drop-down Menu A. Add Study Description to Current Hanging Protocol B. Create New Hanging Protocol for the Open Study s Study Description C. Save Current Layout D. Create New Layout from Current Layout E. Apply Available Hanging Protocols Customizing Image Viewer Toolbars A. Adding Toolbar Items B. Removing Toolbar Items C. Re-ordering the Menu D. Customizing Toolbar Options Copyright Novarad NovaPACS Diagnostic Viewer Manual

8 9-4 Moving Toolbars Locking Toolbars Accessing Menu Options Image Viewer Icon Buttons Dragging and Dropping Images A. Dragging from Image Box B. Dragging from Choose Series Thumbnail C. Dragging Images within a Study D. Dragging Images between Studies E. Resizing Images F. Saving changes Chapter 10 Using the Image Viewer Study Menu Patient History A. Resizing Column Headings B. Choosing Column Headings C. Sorting Data in a Column D. Changing the Order of Columns E. Resizing Lists Select All Series Close Study Close Study and Show Study Browser Close Workspace Close All Workspaces Close All Workspaces and Show Study Browser Mark Reviewed, Close Workspace, and Show Study Browser Manage Hanging Protocols A. Add new Hanging Protocol B. Manage Layouts iv. Tiled v. Cine vi. Processed By vii. Adding Content Filters viii. Editing Content Filters ix. Deleting Content Filters C. Edit Hanging Protocol D. Remove Hanging Protocol Add Split Choose Series Auto Sync Cross Localize Point Cross Localize Set Sync Aggregate Print A. Selecting a Printer B. Printing to the Default Printer Copyright Novarad NovaPACS Diagnostic Viewer Manual

9 10-18 Route Documents Exam Report Manage Reports Workflow RIS Information Dictate Echocardiogram Measurements Launch Cardio Reporting Launch Mammo Viewer View Study on Other Workstation Launch Orthopedic Tools Assign Password Notes Collaboration A. Checkout B. Undo Checkout C. Verified D. Reviewed E. Reset Status to New F. Peer Review G. Utilization Review Research Upload to GlobalRad Save View Settings Show All Series Series Layout Hanging Protocol Layouts Minimize Exit Chapter 11 Using the Image Viewer Series Menu Select All Images Close Views A. Tiled B. Cine C. MPR View D. Image Fusion Copyright Novarad NovaPACS Diagnostic Viewer Manual

10 11-4 Adjust All Split Horizontal Split Vertical Choose Image Layout Calcium Scoring Sort Images Window/Level A. Choosing a W/L Preset B. Setting a W/L Preset Colorize Create New View Subtract Remove Images Ejection Fraction Percent Stenosis Chapter 12 Using the Image Viewer Image Menu Zoom Reload Invert Subtract Clip Frames Calibrate Measurement Details Flip/Rotate Annotate A. Accessing the Annotate Options B. Using Annotations C. Annotation Options Color Font Reset Cursor ROI Pen Polygon Rectangle Circle Ellipse Point Arrow Coordinates Text Spine Labeling Measure Length Measure Path Measure Area Measure Angle Cobb Angle Record Copyright Novarad NovaPACS Diagnostic Viewer Manual

11 21. Play Show Scale Hide All Erase Erase All Undo Redo History D. Editing Annotations Click and Drag Drop-down Menu Move Images Export to File Auto W/L Magnification Undo All Selections Key Image Series Critical Findings A. Add Critical Findings B. Record Findings C. Edit Physician Info Adjust Auto W/L Equalize Histogram Set Win/Level Smooth Sharpen Local Contrast Enhancement Chapter 13 Using the Image Viewer Navigation, Customize Toolbars, and Help Menus, along with descriptions of additional software products available with NovaPACS Navigation Customize Toolbars A. Adding Toolbar Items B. Removing Toolbar Items C. Re-ordering the Menu D. Customizing Toolbar Options Help A. Instructions B. User Manual C. What s New D. About Additional Software Products A. ClinicPACS Ortho B. NovaScan C. NovaPro D. NovaPro Single User E. TraumaCad Ortho Plug-in Copyright Novarad NovaPACS Diagnostic Viewer Manual

12 F. Voxar 3D G. NovaRIS H. NovaVault On-Site, Off-Site, or Off-Line I. NovaMG J. MRS K. MBMS Bill L. Syntermed Chapter 14 Cardiology Features Calcium Scoring Ejection Fraction Percent Stenosis Echocardiogram Measurements Colorize Launch Cardio Reporting Remote Access Copyright Novarad NovaPACS Diagnostic Viewer Manual

13 NovaPACS Diagnostic Viewer Chapter 1 Getting Started NovaPACS Diagnostic Viewer is a world-class product and is one of the original Picture Archiving and Communication Systems (PACS). The NovaPACS Diagnostic Viewer includes many innovations created by Novarad. NovaPACS is known in the industry as a product that leads to radiology efficiency through a mouse-driven viewer, customizable interface, and easy access to advanced features. NovaPACS Diagnostic Viewer also includes web-based functionality, dual monitors, viewers, technology tools, an admin console, and on-site 7 year archives. Novarad understands that workflow and efficiency are highly valued, and all products are built around these concepts. NovaPACS provides your radiology department with the following: The best web-based technology that utilizes high-level streaming, imaging, algorithms, and proprietary methods for distributing large data sets quickly. Images and reports that are available anytime, anywhere accessible via any web browser, PDA, or smartphone. A full Diagnostic Viewer that is accessible from any computer and location, and is feature-rich including advanced hanging protocols, MIP/MPR, and voice annotation. A user-friendly, easy to learn Diagnostic Viewer that has customizable buttons, toolbars, menus, hotkeys, and mouse settings that follow you wherever you go. An Image Viewer that is mouse-driven and allows the radiologist s eyes to focus on the images on the screen rather than on keys or buttons. A Study Browser that displays the entire patient s image history, the number of series for a study, and the number of images in a series, along with many other features. This chapter addresses the following options for using the Diagnostic Viewer: 1-1 Introducing the Study Browser and Image Viewer 1-2 NovaPACS Diagnostic Viewer Systems 1-3 Accessing the Diagnostic Viewer A. The Managed Viewer B. Launching the Managed Viewer C. The Web Viewer D. Launching the Web Viewer 1-4 Logging in to the Diagnostic Viewer A. Logging in Automatically B. Logging in to a Data Source Copyright Novarad Diagnostic Viewer Manual

14 Chapter 1 Getting Started 1-1 Introducing the Study Browser and Image Viewer The Study Browser is essentially the control panel for the Diagnostic Viewer. The Study Browser displays information in branches or lists, and shows details such as the entire patient s image history, the number of series for a study, and the number of images in a series. In addition to these details, the viewable columns can be set to show studies with existing reports and the name of the reviewing radiologist. Note: For more information on the Study Browser, see Chapters 2 through 8. The Image Viewer automatically displays the images you select from the Study Browser. Radiologists can design their workspace with the Image Viewer s flexible display options allowing them to move efficiently through their caseload. Note: For more information on the Image Viewer, see Chapter 9 Using the Image Viewer. You can also find additional details in Chapters 10 through NovaPACS Diagnostic Viewer Systems The following recommendations represent what Novarad prepares and delivers to new customers using this software release with the NovaPACS Diagnostic Viewer (Enterprise and Tech Workstations): Note: To use the NovaPACS Diagnostic Viewer systems at their highest performance, it is best to meet or exceed these recommendations. These system recommendations are subject to change. Tech Workstation Dell OptiPlex 790 Operating System: Windows 7 Professional 64 bit, Service Pack 1 Processor: Intel Core i3 or higher or AMD equivalent Disk Space: 250 GB+ Video Card: 512 MB Video RAM, DirectX 10 compatible discrete graphics card Memory: 4 GB RAM Screen Resolution: 1600x1200 pixels or higher Note: Windows 98, Windows ME, Windows 2000, and Windows Vista are not supported Operating Systems in NovaPACS 8.0 or higher. Enterprise Workstation Note: To use the NovaPACS Diagnostic Viewer systems at their highest performance, it is best to meet or exceed these recommendations. These system recommendations are subject to change. Dell Precision T3500 Operating System: Windows 7 Professional 64 bit, Service Pack 1 Processor: Intel Xeon Quad Core E5000 Series or higher Disk Space: 256 GB Solid State Drive Copyright Novarad NovaPACS Diagnostic Viewer Manual

15 Chapter 1 Getting Started Ethernet: Video Card: Memory: Screen Resolution: 1 Gb 1 GB Video RAM, DirectX 10 compatible discrete graphics card w/capability to support 3 monitors simultaneously 6 GB RAM 1536x2048 pixels or higher * = Higher resolution may be required for larger matrix images (i.e. MG images). Note: Windows 98, Windows ME, Windows 2000, and Windows Vista are not supported Operating Systems in NovaPACS 8.0 or higher. Web Viewer The following requirements and recommendations represent what Novarad prepares and delivers to new customers using this software release with the NovaPACS Web Viewer: Note: To use the NovaPACS Diagnostic Viewer systems at their highest performance, it is best to meet or exceed these recommendations. These system recommendations are subject to change. Dell OptiPlex 790 Operating System: Windows 7 Professional 64 bit, Service Pack 1 Processor: Intel Core i3 or higher or AMD equivalent Disk Space: 250 GB+ Video Card: 512 MB Video RAM, DirectX 10 compatible discrete graphics card Memory: 4 GB RAM (2GB RAM can be used for Secondary Reads) Screen Resolution: 1600x1200 pixels or higher * = Higher resolution may be required for larger matrix images (i.e. MG images). Note: Windows 98, Windows ME, Windows 2000, and Windows Vista are not supported Operating Systems in NovaPACS 8.0 or higher. Software: Windows XP SP3 or Windows 7 Microsoft.NET Framework 4 Client Profile or higher is required to run the NovaPACS Web Viewer* Internet Explorer 7.0 or higher is required when connecting to NovaPACS Web Viewer to run the Diagnostic Viewer.* *=Microsoft.NET Framework 4 Client Profile is not required for the Lite Viewer. Your administrator will configure the Diagnostic Viewer for your site. Part of the configuration is assigning unique user names and passwords for each user on each server that will be used. Copyright Novarad NovaPACS Diagnostic Viewer Manual

16 Chapter 1 Getting Started 1-3 Accessing the Diagnostic Viewer The Diagnostic Viewer functions the same no matter how it is accessed. There are two ways users can access the Diagnostic Viewer: (1) From a computer or workstation referred to as accessing the Managed Viewer. (2) From the Internet referred to as accessing the Web Viewer (unmanaged). A. The Managed Viewer The Managed Viewer is accessed from a computer/workstation that has the Diagnostic Viewer software installed, providing users with direct access to the program and a direct connection to the server. This Viewer is faster and allows images to route directly to the workstation. The Managed Viewer gives users full use of all product functions. B. Launching the Managed Viewer Users will see Novarad s Image Viewer Icon on the computer s desktop after installing the Managed Viewer. Double-click the icon to launch the Diagnostic Viewer. A log-in dialog box will appear. Note: Your administrator can configure the Diagnostic Viewer to use your Windows login as the log-in for the Viewer. If you are using this configuration, you will not see a prompt to log in to the Viewer. C. The Web Viewer The Web Viewer is Novarad s thin-client version that downloads Image Viewer files temporarily and is accessed through a secure server using the Internet. Users will need to download and use Microsoft s.net Framework 4 Client Profile to use the Web Viewer. This Viewer gives users full use of all product functions and can be accessed anytime from any computer through a website and a secure server. Note: Users must have Internet access to use the Web Viewer and its reporting functions. Copyright Novarad NovaPACS Diagnostic Viewer Manual

17 Chapter 1 Getting Started D. Launching the Web Viewer Open Internet Explorer and enter the address for the secure server in the address bar. Press Enter to launch the Web Viewer. The Web Viewer window will open after entering this information. The following options are available with the Web Viewer: Diagnostic Viewer Novarad s Diagnostic Viewer accessed via the web provides access to our DICOM PACS with full product functionality. Radiologists and Radiology departments can use this version to work from an office, clinic, and/or hospital. Note: This requires access to Microsoft.NET Framework 4 Client Profile. Lite Viewer Novarad s Lite Viewer provides quick retrieval and manipulation of patients images and reports. This zero-client version does not require a program or Microsoft s.net Framework 4 Client Profile download. You can use the Lite Viewer on any Internet browser including Internet Explorer, Firefox, Google Chrome, and Safari. The images viewed on the Lite Viewer are in JPEG format and display more rapidly than the traditional DICOM format; however, they are also a lower resolution and are not diagnostic quality. Single Study Access Radiologists can use this option to grant a physician access to a patient s PACS records with the Lite Viewer for a set period of time. Note: The physician receiving access to the records will need Internet access. MPR/3D Plug-in Your system administrator can download this one-time plug-in if you are using the Web Viewer and a fully licensed version of Voxar. This download must be completed by your system administrator before launching the Web Viewer to allow access to MIP/MPR with Voxar. Note: The Diagnostic Viewer provides MIP/MPR support. For more information about using Novarad s MIP/MPR support, see Chapter 11, section 11-3 Views. Cardio Reporting Plug-in Users should download and run this one-time plug-in before using the Web Viewer with EncaptureMD. Copyright Novarad NovaPACS Diagnostic Viewer Manual

18 Chapter 1 Getting Started 1-4 Logging in to the Diagnostic Viewer Click the Diagnostic Viewer option to launch it, and a log-in dialog box will appear. Enter your user name and password and click the OK button. A. Logging in Automatically You can select the Automatically login with this account checkbox in the log-in dialog box. This saves your user name and password for future logins and the Diagnostic Viewer will launch automatically. B. Logging in to a Data Source If your site uses other servers to access images, you will receive a prompt to log in to that data source when the Diagnostic Viewer tries to connect to it. This prompt will also appear when you select another data source within the Diagnostic Viewer. Note: Contact your system administrator if you would like to log in across all data sources using the same user name and password for each additional server. For additional information, see Chapter 7, section 7-1 Options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

19 NovaPACS Diagnostic Viewer Chapter 2 Using the Study Browser The Study Browser functions as the control panel for the Diagnostic Viewer. The Study Browser displays information including patient study information, patient history, the number of series in a study, and the number of images in a series. In addition to these details, the viewable columns can be set to show information such as studies with existing reports and the name of the reviewing radiologist. The Study Browser has filters on the Search tab and other tabs that can be set and customized to find an exact study, select other data sources from which to find studies, and set filters that users employ on a regular basis. The Assigned Worklist tab allows users to see studies that have been assigned. The Advanced Worklists tab allows users to create sets of filters to find specific exams, facilities, etc. Chapter 2 addresses the following options for using the Study Browser functions: 2-1 Filtered Studies List A. Display B. Search Tab Filtered Studies Toolbar C. Assigned Worklist Filtered Studies Toolbar D. Advanced Worklist Filtered Studies Toolbar 2-2 Patient History List 2-3 Series List 2-4 Hanging Protocol Layouts 2-5 The Search Tab A. Customizing the Filters Group B. Customizing and Saving Filters C. Selecting a Saved Filter D. Deleting a Saved Filter E. Using the Search Filters 1. The Data Source Filter 2. The Time Frame Filter 3. The Modality Filter 4. The Radiologist Filter 5. The Referring Physician Filter 6. The Status Filter 7. The Checked Out Filter 8. The Patient Group Filter Copyright Novarad NovaPACS Diagnostic Viewer Manual

20 Chapter 2 Using the Study Browser 9. The Study UID Filter 10. The Patient ID Filter 11. The Last Name, First Name, and Accession # Filters 12. The Assigned To Filter 2-6 The Assigned Worklist Tab A. Display B. Activating the Assigned Worklist C. Using the Search Filters 1. The Data Source Filter 2. The Time Frame Filter 3. The Status Filter 4. The Assigned To Filter 2-7 The Advanced Worklist Tab A. Creating Advanced Worklists B. Editing Advanced Worklists C. Deleting Advanced Worklists 2-8 Customizing Study Browser Lists A. Resizing Column Headings B. Resizing List Heights C. Choosing Column Headings D. Sorting Data in a Column E. Changing the Order of Columns 2-9 Using the Study Browser Menus/Custom Toolbar A. Where to Find Additional Study Browser Menu Information B. Using the Study Browser Custom Toolbar C. Customizing the Study Browser s Custom Toolbar 2-10 Activating the Study Browser 2-1 Filtered Studies List The Filtered Studies list is the top list in the Study Browser window and displays the list of studies that match the information in the search filters. The Filtered Studies list is on all tabs in the Study Browser (i.e., the Search tab, Assigned Worklist tab, and Advanced Worklist tabs). The Filtered Studies list toolbar items and right-click menus vary depending on which tab is being used. The following sections describe the Filtered Studies list in the Study Browser. A. Display Users can set the Filtered Studies list to be a patient-centric or a study-centric display. If the list is set to a patient-centric display, only the most recent exam that matches the Search tab s filters will display. All other exams for the patient will appear in the Patient History section. If the list is set to a study-centric display, the list will show all studies for the patients using the Search tab s filters. Copyright Novarad NovaPACS Diagnostic Viewer Manual

21 Chapter 2 Using the Study Browser Note: For more information on changing the Filtered Studies list to a study-centric display, see Chapter 7, section 7-1 Options. The Filtered Studies list displays information in columns, including (but not limited to): Last name displays the patient s last name First name displays the patient s first name Birth Date displays the patient s date of birth Modality-- displays predefined codes identifying the modality Anatomical Area-- displays the body part examined (modality generated) Patient ID displays the patient identification number Status indicates if the study is new, reviewed, checked out, or verified Accession #--displays the accession number Procedure Status displays the status of the procedure Facility displays the facility where the study was performed Study date displays the date of the study Report indicates if a report is included Note: You can customize the columns that appear in the list by right-clicking on the column heading bar and checking/unchecking the heading labels in the drop-down list. You can also rearrange the order of the columns by clicking and dragging the column headings to the preferred locations. You can auto-fit the column to its contents by double-clicking on the right divider of the column heading. Copyright Novarad NovaPACS Diagnostic Viewer Manual

22 Chapter 2 Using the Study Browser B. Search Tab Filtered Studies Toolbar The Filtered Studies list toolbar on the Search tab allows users to complete the following actions: Select All Selects all the studies in the list for the next action. Add to Worklist Adds the selected study to your worklist. Open Opens the selected study in the Image Viewer. Open + Old Opens the selected study and the most recent, related study. Open in Current Workspace Opens the selected study in the current open workspace in the Image Viewer. Assign Allows users to assign studies to their own worklist or another user s worklist. C. Assigned Worklist Filtered Studies Toolbar The Filtered Studies list toolbar on the Assigned Worklist tab allows users to complete the following actions: Select All Selects all the studies in the list for the next action. Open Opens the selected study in the Image Viewer. Open + Old Opens the selected study and the most recent, related study. Open in Current Workspace Opens the selected study in the current open workspace in the Image Viewer. Assign Allows users to assign studies to their own worklist or another user s worklist. Remove Removes the selected study from the Assigned Worklist. Clear Clears the Assigned Worklist. D. Advanced Worklist Filtered Studies Toolbar The Filtered Studies list toolbar on the Advanced Worklist tab allows users to complete the following actions: Select All Selects all the studies in the list for the next action. Add to Worklist Adds the selected study to your worklist. Open Opens the selected study in the Image Viewer. Open + Old Opens the selected study and the most recent, related study. Open in Current Workspace Opens the selected study in the current open workspace in the Image Viewer. Assign Allows users to assign studies to their own worklist or another user s worklist. Note: Advanced Worklist tabs will not appear on the default display. Copyright Novarad NovaPACS Diagnostic Viewer Manual

23 Chapter 2 Using the Study Browser 2-2 Patient History List The Patient History list displays all completed studies for the selected patient including all time frames and modalities. This list appears on the left side of the Study Browser window, just below the Filtered Studies list. The Patient History list is on all tabs in the Study Browser (i.e., the Search tab, Assigned Worklist tab, and Advanced Worklist tabs). The Patient History list displays information in columns, including (but not limited to): Modality displays predefined codes identifying the modality Study Date displays the date of the study Anatomical Area displays the body part examined (modality generated) Study UID displays the study unique identification number Accession #--displays the accession number of the study Report indicates whether a report exists for this study Notes indicates if the study includes notes Note: You can customize the columns that appear in the list by right-clicking on the column heading bar and checking/unchecking the heading labels in the drop-down list. You can also rearrange the order of the columns by clicking and dragging the column headings to the preferred locations. You can auto-fit the column to its contents by double-clicking on the right divider of the column heading. The Patient History list toolbar allows users to complete the following actions: Report opens the diagnostic report for the currently selected study in a new window. Select All selects all the studies in the list for the next action. Add to Worklist adds the selected study to your worklist. Open opens the selected study in the Image Viewer. Open+ Old opens the selected study and the most recent, related study. Open in Current Workspace opens the selected study in the current open workspace in the Image Viewer. Copyright Novarad NovaPACS Diagnostic Viewer Manual

24 Chapter 2 Using the Study Browser 2-3 Series List The Series list displays all the series that are part of the selected study. The Series list appears below the Filtered Studies list and to the right of the Patient History list in the Study Browser Window. The Series list is on all tabs in the Study Browser (i.e., the Search tab, Assigned Worklist tab, and Advanced Worklist tabs). The Series list displays information in columns, including (but not limited to): Series ID the Series Identification that provides a unique identification for each series within the study ((generated by the modality)). Description displays a description of the images in the series (generated by the modality). Modality displays predefined codes identifying the modality. Image Count displays the number of images in the series. Note: You can customize the columns that appear in the list by right-clicking on the column heading bar and checking/unchecking the heading labels in the drop-down list. You can also rearrange the order of the columns by clicking and dragging the column headings to the preferred locations. You can auto-fit the column to its contents by double-clicking on the right divider of the column heading. The Series list toolbar allows users to complete the following actions: Select All selects all the series in the list for the next action. Open opens the selected series of images in the Image Viewer. Copyright Novarad NovaPACS Diagnostic Viewer Manual

25 Chapter 2 Using the Study Browser The Report tab of the Series list allows users to quickly preview a diagnostic report in the current window without having to open the selected study. The Report toolbar allows users to complete the following actions: Print Report opens a print dialog allowing the user to print the report Print Options opens a print options dialog allowing the user to adjust how the report template will appear when printed. After making selections, click print to open the normal print dialog and print the document. 2-4 Hanging Protocol Layouts The Hanging Protocol Layouts are the saved layouts associated with a specific Hanging Protocol for displaying study images in the Image Viewer. If activated, the Hanging Protocol Layouts section is located at the bottom of the Study Browser window and displays thumbnail images of the layouts defined for the current Hanging Protocol. The title of this section will also list the current Hanging Protocol. This section will appear on all tabs in the Study Browser (i.e., the Search tab, Assigned Worklist tab, and Advanced Worklist tabs). Copyright Novarad NovaPACS Diagnostic Viewer Manual

26 Chapter 2 Using the Study Browser To activate the Hanging Protocol Layouts section in the Study Browser window, click on the View menu on the Study Browser s main toolbar and select Hanging Protocol Layouts. Users can also use the default hotkey setting of F4. Note: The Hanging Protocol Layouts section will only display content in the Study Browser if a study is open in the Image Viewer. To use the Hanging Protocol Layouts options, click on one of the Hanging Protocol images to apply it to the images in the Image Viewer or use the number keys 1-0 at the top of the keyboard (not the side key pad) to quickly apply the associated Layout. Users can Add, Duplicate, and Remove layouts by using the links in the upper right-hand corner of the Hanging Protocol Layouts section. Users can Edit layouts by right clicking on a thumbnail image and selecting Edit Layout from the menu that appears. For detailed instructions on Adding, Duplicating, Removing, and otherwise managing Hanging Protocols, see Chapter 7, section 7-3 Managing Hanging Protocols. Generally, the Hanging Protocol Layouts section will display the Single-study Layouts for the current Hanging Protocol. However, Multi-study Layouts will display in the Layouts section whenever multiple studies are opened concurrently. If multiple studies are opened at the same time with different Hanging Protocols applied (such as when the studies are from separate modalities), the Layouts section will display the Multi-study Layouts for the currently selected study. Simply select another study to view the Layouts associated with it. Whenever there are no Multi-study Layouts available for the current Hanging Protocol, Single-study Layouts will be displayed instead. Note: For more information on managing and applying Hanging Protocol Layouts see Chapter 6, section 6-2 Hanging Protocol Layouts; Chapter 7, section 7-3 Managing Hanging Protocols; Chapter 9, section 9-2 Hanging Protocol Drop-down Menu; Chapter 10, section 10-9 Managing Hanging Protocols; Chapter 10, section 37 Hanging Protocol Layouts; and Chapter 11, sections 11-3 to The Search Tab The default tab on the Study Browser s home window is the Search tab. The Search tab is used with the filters on the page to locate specific information. The following sections explore how to customize filters, save filters, and perform searches using the filters. Note: To the right of the Search tab is an Assigned Worklist tab than can be shown/hidden using the View menu. There is also an Advanced Worklist tab that can be used to create advanced Copyright Novarad NovaPACS Diagnostic Viewer Manual

27 Chapter 2 Using the Study Browser worklists with custom settings. The Assigned Worklist and Advanced Worklist tabs are explained later in this chapter. The following sections describe the available options when using the Search tab. A. Customizing the Filters Group The default settings for the filters vary depending on each user s role. Users can add or remove filter fields by right-clicking on the filter s bar and selecting the appropriate option in the drop-down list. The active filters on the screen will have a checkmark beside them. Note: The Saved Filters and Data Source fields are not optional and will not appear in the optional filters list. B. Customizing and Saving Filters The Saved Filters drop-down list allows users to create and save custom filters for settings used on a regular basis. To save a custom filter, complete the following steps: 1. Select the settings you want to save in all the filter fields by right-clicking the filters and selecting the options you want from the drop-down lists. 2. Select Edit Saved Filters from the Saved Filters drop-down list. 3. Enter a name for the new filter in the Save Current Filters As field. Copyright Novarad NovaPACS Diagnostic Viewer Manual

28 Chapter 2 Using the Study Browser 4. Click the OK button to save the filter. C. Selecting a Saved Filter To select and apply a previously saved filter, complete the following steps: 1. Click on the Saved Filters drop-down list. 2. Select the saved filter you want from the list. Note: All the filters in the filter group will immediately change to the saved filters, and the Filtered Studies list will update to reflect the results for those filters. D. Deleting a Saved Filter To delete a saved filter, complete the following steps: 1. Click on the Saved Filters drop-down list. 2. Select the Edit Saved Filters option from the drop-down list. An Edit Saved Filters dialog box will open. 3. In the Select Saved Filters to Delete box, click to check the box next to the filter you want to delete. 4. Click the OK button to delete the filter. Copyright Novarad NovaPACS Diagnostic Viewer Manual

29 Chapter 2 Using the Study Browser E. Using the Search Filters The filters are a group of search fields just below the Search tab along the top of the Study Browser Window. These filters allow users to select the information to display in the Filtered Studies list. Patient searches can be conducted more quickly and efficiently using the filters in this tab. Users can search for studies using any combination of search filters. The following sections describe the available search filters and how to use them. Note: If all search filters are set to All or blank, the Filtered Studies list will be empty. 1. The Data Source Filter The Data Source Filter allows users to filter a search using the various sources that may contain patient data. To use the Data Sources filter, click on the Data Source drop-down list and select one or more of the data source checkboxes. You can also select the All option to select all available data sources. You will see a Data Source display at the bottom right of the Study Browser window. The indicator light to the left of the Data Source display gives you a visual indicator of the status of that server. A green light indicates the data source connection is active and the status is available; yellow indicates connectivity issues; and red signifies the data source is unavailable or disconnected. Hover the mouse cursor over the Data Source display at the bottom of the Study Browser window to see the connection status and click to see the Edit Data Source dialog box. Users may have DICOM Pass Through enabled in NovaPACS. This allows users to securely view images and data from off-site archives and PACS servers by remotely accessing them through NovaPACS. DICOM Pass Through servers will be set up as a data source that will interact normally with NovaPACS. Users can use the Data Source filter to search for or filter out results from a DICOM Pass Through server the same way they would any other data source. Copyright Novarad NovaPACS Diagnostic Viewer Manual

30 Chapter 2 Using the Study Browser 2. The Time Frame Filter The Time Frame Filter allows users to select specific time periods to filter a search. Users can search all time frames by selecting the All option in the Time Frame Filter. Users can also select from the time frames listed in the drop-down list, or create a custom time frame for this filter. Note: If you deselect the Time Frame filter from the search filter list, the time frame will default to the last 3 hours and only show studies added in that time frame. To create a custom time frame, complete the following steps: a. Click the Time Frame drop-down list. b. Select the Custom option at the bottom of the list. c. Click the arrow for the drop-down calendar to choose a specific date for the Start Time and use the arrows next to the time to set the exact starting time frame. Click the arrow for the drop-down calendar to choose a specific date for the End Time and use the arrows next to the time to set the exact ending time frame. d. Click the OK button to apply the new custom Time Frame Filter. 3. The Modlity Filter The Modality Filter allows users to search for data from a specific modality. Users can select just one modality to search, or select several modalities. Click the Modality Filter drop-down list and click the checkboxes next to the modality options to select or deselect them. Note: The server that is selected as the current data source provides the modalities that are on the Modality Filter drop-down list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

31 Chapter 2 Using the Study Browser 4. The Radiologist Filter The Radiologist Filter allows users to filter studies that are associated with a Radiologist. To use the Radiologist filter, enter the Radiologist s username, last name, or first name. All studies that contain those letters or that last name will be returned in the search list. Note: Users will not be able to search for a radiologist with a first and last name combined. Search for either last name or first name. 5. The Referring Physician Filter The Referring Physician filter allows users to filter studies that are associated with a Referring Physician. To use the Referring Physician filter, enter the Referring Physician s username, last name, or first name. All studies that contain those letters or that last name will be returned in the search list. Note: Users will not be able to search for a Referring Physician with a first and last name combined. Search for either last name or first name. 6. The Status Filter The Status Filter allows users to filter results based on the status of the studies being searched. To use the Status Filter, click the Status Filter drop-down list and choose from All, Checked Out, New, Reviewed, and/or Verified. 7. The Checked Out Filter The Checked Out Filter allows users to filter results based on who has checked out the studies. To use the Checked Out filter, enter a username. All studies that contain that username will be returned in the search list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

32 Chapter 2 Using the Study Browser 8. The Patient Group Filter The Patient Group filter allows users to filter by Patient Group. To use the Patient Group filter, click the Patient Group drop-down list and click the checkboxes next to the patient groups to select or deselect them. 9. The Study UID Filter The Study UID filter allows users to search for studies by their study unique identification (UID). To use the Study UID filter, enter all or part of the Study UID in the search field. All studies that contain those numbers will be returned in the search list. 10. The Patient ID Filter The Patient ID filter allows users to search for studies by the patient identification number (PID). To use the Patient ID filter, enter the first few characters or the complete Patient ID of the desired patient. All studies associated with a Patient ID beginning with the characters entered will be returned in the search list. 11. The Last Name, First Name, and Accession # Filters The Last Name, First Name, and Accession # filters all function in the same manner. By entering the first few letters or numbers of the patient s last name, first name, or accession number, the filters will search and return all results that contain those letters or numbers in the Filtered Studies list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

33 Chapter 2 Using the Study Browser 12. The Assigned To Filter The Assigned To filter allows users to filter studies by user for studies that have been assigned. To use the Assigned To filter, click on the Assigned To drop-down list and select an option from the list. 2-6 The Assigned Worklist Tab The Assigned Worklist tab is located to the right of the Search tab when activated and is used with the filters on the page to locate specific information. The Assigned Worklist is an effective tool for large groups of users that read images at the same time from a Filtered Studies list. The Assigned Worklist shows studies that have been added by the user to view later, or that have been assigned to the user by someone else. Radiologists can move studies into their worklist for review, or assign studies to another user s worklist for specific users or larger groups to review. Note: To the left of the Assigned Worklist tab is the Search tab. There is also an Advanced Worklist tab that can be used to create advanced worklists with custom settings. The following sections describe the Assigned Worklist s display, how to activate the Assigned Worklist, and how to perform searches using the filters. A. Display The Assigned Worklist displays information in the same way information is displayed in the Search tab with a Filtered Studies, Patient History, and Series list. Some menu items are not available on the Assigned Worklist, including the Add to Worklist options. These options are available on the Search tab and the Advanced Worklist tabs. Copyright Novarad NovaPACS Diagnostic Viewer Manual

34 Chapter 2 Using the Study Browser Some functions are available only on the Assigned Worklist tab, however. The Remove and Clear Filtered Studies toolbar buttons are specific to the Assigned Worklist. The Remove Worklist Item and Clear Worklist options on the Worklist menu on the Study Browser s main toolbar are also specific to the Assigned Worklist. B. Activating the Assigned Worklist Users can activate the Assigned Worklist tab by selecting the Worklist option from the Study Browser s View Menu or pressing the default hotkey setting of F2. The Assigned Worklist tab will appear next to the Search tab in the Study Browser. The Advanced Worklist will also appear automatically if a user adds a study to their worklist. C. Using the Search Filters The filters are a group of search fields just below the Search tab along the top of the Study Browser Window. These filters allow users to select the information to display in the Filtered Studies list. Patient searches can be conducted quicker and more efficiently using the filters in this tab. Users can search for studies using any combination of search filters. The following sections describe the available search filters and how to use them. Note: If all search filters are set to All or blank, the Filtered Studies list will be empty. Copyright Novarad NovaPACS Diagnostic Viewer Manual

35 Chapter 2 Using the Study Browser 1. The Data Source Filter The Data Source Filter allows users to filter a search using the various sources that may contain patient data. To use the Data Sources filter, click on the Data Source drop-down list and select one or more of the data source checkboxes. You can also select the All option to select all available data sources. You will see a Data Source display at the bottom right of the Study Browser window. The indicator light to the left of the Data Source display gives you a visual indicator of the status of that server. A green light indicates the data source connection is active and the status is available; yellow indicates connectivity issues; and red signifies the data source is unavailable or disconnected. Hover the mouse cursor over the Data Source display at the bottom of the Study Browser window to see the connection status and click to see the Edit Data Source dialog box. Users may have DICOM Pass Through enabled in NovaPACS. This allows users to securely view images and data from off-site archives and PACS servers by remotely accessing them through NovaPACS. DICOM Pass Through servers will be set up as a data source that will interact normally with NovaPACS. Users can use the Data Source filter to search for or filter out results from a DICOM Pass Through server the same way they would any other data source. 2. The Time Frame Filter The Time Frame Filter allows users to select specific time periods to filter a search. Users can search all time frames by selecting the All option in the Time Frame Filter. Users can also select from the time frames listed in the drop-down list, or create a custom time frame for this filter. Note: If you deselect the Time Frame filter from the search filter list, the time frame will default to the last 3 hours and only show studies added in that time frame. To create a custom time frame, complete the following steps: a. Click the Time Frame drop-down list. b. Select the Custom option at the bottom of the list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

36 Chapter 2 Using the Study Browser c. Click the arrow for the drop-down calendar to choose a specific date for the Start Time and use the arrows next to the time to set the exact starting time frame. Click the arrow for the drop-down calendar to choose a specific date for the End Time and use the arrows next to the time to set the exact ending time frame. d. Click the OK button to apply the new custom Time Frame Filter. 3. The Status Filter The Status Filter allows users to filter results based on the status of the studies being searched. To use the Status Filter, click the Status Filter drop-down list and choose from All, Checked Out, New, Reviewed, and/or Verified. 4. The Assigned To Filter The Assigned To filter allows users to filter studies by user for studies that have been assigned. To use the Assigned To filter, click on the Assigned To drop-down list and select an option from the list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

37 Chapter 2 Using the Study Browser 2-7 The Advanced Worklist Tab Users can create sets of filters for specific conditions such as reading certain types of exams or reading at certain locations. This eliminates the need to change filters on the Search tab constantly. These preferred filters are created using the Advanced Worklist option. The Advanced Worklist tab is located to the right of the Study Browser s Search tab. The tab will either be labeled Advanced Worklist or will be a blank tab. The following sections describe how to create, edit, and delete Advanced Worklists: A. Creating Advanced Worklists To create an Advanced Worklist, complete the following steps: 1. Select the blank or empty tab to the right of the Search tab. 2. Select New and the Advanced Worklist options window will expand. 3. Create a name for the Worklist by typing it into the Worklist Name field. 4. Select the preferred criteria in each search field using the drop-down lists. Note: To set a second set of search criteria, click the + button below the search criteria columns. An additional row of search criteria will appear; set as many rows of search filters as needed. To delete a row of search criteria, click the icon to the left of the row. Copyright Novarad NovaPACS Diagnostic Viewer Manual

38 Chapter 2 Using the Study Browser 5. When you are done setting the search criteria, click the Save button at the bottom of the window. Your Advanced Worklist tab will appear to the right of the Search tab with the name you saved. A new blank worklist tab will appear next to your Advanced Worklist tab in the Study Browser window. 6. To access your Advanced Worklists, click on an Advanced Worklist tab and click the drop-down list next to the Advanced Worklists heading. Select the Advanced Worklist you need. B. Editing Advanced Worklists To edit an existing Advanced Worklist, complete the following steps: 1. Click on the Advanced Worklist tab. 2. Click on the drop-down list next to the Advanced Worklist heading. Select the Advanced Worklist that you want to edit from the list. 3. Select Edit next to the Advanced Worklist heading. 4. The Advanced Worklist window will expand. Edit the search criteria as needed using the drop-down lists. 5. Click the Save button at the bottom of the window. C. Deleting Advanced Worklists To delete an existing Advanced Worklist, complete the following steps: 1. Click on the Advanced Worklist tab. 2. Click on the drop-down list next to the Advanced Worklist heading. Select the Advanced Worklist that you want to delete from the list. 3. Select Delete next to the Advanced Worklist heading. 4. A Delete Advanced Worklist confirmation box will appear to confirm that you want to delete the Advanced Worklist. Click the OK button to delete the worklist. Copyright Novarad NovaPACS Diagnostic Viewer Manual

39 Chapter 2 Using the Study Browser 2-8 Customizing Study Browser Lists Users can customize options in the Study Browser lists, including column options, resizing options, and sorting or changing column orders. The following sections describe the options users have to customize Study Browser lists. A. Resizing Column Headings Users can resize the width of a column heading in any list to better accommodate the information within. To resize the width of a column heading, complete the following steps: 1. Move the mouse cursor over the right divider of the column heading. The cursor will change to a double-ended arrow. 2. Double-click on the right divider of the column heading and the column will auto-fit to its contents. Users can also click the right divider of the column heading and drag it to the right or left until the column is the desired size. B. Resizing List Heights Users can resize the height of the Study Browser lists to display more or less information. To resize the height of a list, complete the following steps: 1. Move the mouse cursor over the divider at the edge of the list you want to resize. The cursor will change to a double-ended arrow. 2. Drag to the preferred height. C. Choosing Column Headings Users can select the column headings that will appear in each of the Study Browser lists by completing the following steps: 1. Right-click on the column heading bar that you want to customize. A drop-down list containing the column heading options will appear. 2. Click to select or deselect the column headings you want to appear in the list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

40 Chapter 2 Using the Study Browser Note: You can auto-fit the column to its contents by double-clicking on the right divider of the column heading. D. Sorting Data in a Column Users can sort the information in the list columns alphabetically/numerically and in ascending/descending order by completing the following steps: 1. Click once on the column heading that you want sorted and it will automatically alphabetize the information (or sort numerically if applicable). It will also automatically list in ascending order. 2. To reverse the sort order to descending, click the column heading a second time. E. Changing the Order of Columns Users can change the order in which the columns appear in the lists. To change the column order, complete the following steps: 1. Left-click and hold the column heading that you want to move. 2. Drag the column heading to the preferred location and release. Note: As you pass the mouse cursor over the other column headings, they will highlight a dark blue representing where the column heading will reside if you release it. 2-9 Using the Study Browser Menus/Custom Toolbar The Study Browser s Menus and Custom Toolbar have many helpful functions. The following sections provide brief information on the Study Browser s Menu and Custom Toolbar. A. Where to Find Additional Study Browser Menu Information The Study Browser Menus contain available actions for the Study Browser and Image Viewer. Copyright Novarad NovaPACS Diagnostic Viewer Manual

41 Chapter 2 Using the Study Browser Refer to the following chapters for additional information about the Study Browser menus: Chapter 3 Using the Study Browser File Menu Chapter 4 Using the Study Browser Worklist Menu Chapter 5 Using the Study Browser Study Menu Chapter 6 Using the Study Browser View Menu Chapter 7 Using the Study Browser Settings Menu Chapter 8 Using the Study Browser Help Menu B. Using the Study Browser Custom Toolbar The Study Browser Toolbar is just below the menu bar at the top of the Study Browser window. The default settings for the Study Browser toolbar vary by role. Click on any button on the toolbar to use that function. C. Customizing the Study Browser s Custom Toolbar Users can customize the Study Browser s Custom Toolbar to their preferences. Users can add or remove toolbar items and change the way the toolbar appears in the window. To customize the Study Browser s Custom Toolbar, complete the following steps: 1. Click on the Settings Menu on the Study Browser s main toolbar, and select Customize Toolbar. Users can also right-click on any toolbar in the Study Browser window and select Customize from the drop-down list. A Custom Toolbars page will open. 2. To add an item to the toolbar, select the item to add from the Available items list on the left of the screen. Click the Add button to add it to the Current toolbar items list on the right of the screen. You can also select items in the Current toolbar items list and click the Remove button. 3. Click the OK button to save and exit. Copyright Novarad NovaPACS Diagnostic Viewer Manual

42 Chapter 2 Using the Study Browser Note: For more detailed instructions on customizing the Study Browser s Custom Toolbar, see Chapter 7, section 7-6 Customize Toolbar. For information on customizing the Image Viewer Toolbars, see Chapter 9, section 9-3 Customizing Image Viewer Toolbars Activating the Study Browser Users can hide the Study Browser window when using the Image Viewer to allow a full image display. Users can activate the hidden Study Browser window by completing one of the following steps: 1. Move the mouse to the right or left edge of the Image Viewer window. 2. Click the Study Browser icon on the Image Viewer toolbar. 3. Click the default hotkey setting of the Spacebar on the keyboard to close all workspaces in the Image Viewer and show the Study Browser. Note: For more information on hotkeys (Keyboard Shortcuts), see Chapter 7, section 7-1 Options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

43 NovaPACS Diagnostic Viewer Chapter 3 Using the Study Browser File Menu One of the main functions of the Diagnostic Viewer s Study Browser is to help users search for and view studies. The File Menu in the Study Browser allows users to open studies to view or to exit the Diagnostic Viewer. The File Menu is on the Study Browser s main toolbar. This chapter addresses the following options for using the Study Browser s File Menu: 3-1 Open from Directory 3-2 Open from File 3-3 Exit the Diagnostic Viewer 3-1 Open from Directory The Open from Directory option allows users to open a group of DICOM image files from a directory that is on a computer or CD-ROM. To use the Open from Directory option, complete the following steps: 1. Click on the File Menu on the Study Browser s main toolbar, and select Open from Directory. A Browse for Folder dialog box will open. 2. Browse for the folder you want to open by expanding the folders in the dialog box and click the OK button when you have located the correct folder. Copyright Novarad NovaPACS Diagnostic Viewer Manual

44 Chapter 3 Using the Study Browser File Menu 3-2 Open from File The Open from File option allows users to open a single DICOM image file from a directory on a computer or a CD-ROM. To use the Open from File option, complete the following steps: 1. Click on the File Menu on the Study Browser s main toolbar, and select Open from File. An Open dialog box will open. 2. Browse for the image file you want to open by expanding the folders in the dialog box and click the Open button when you have located the correct folder. 3-3 Exit the Diagnostic Viewer The Exit option allows users to exit from the Diagnostic Viewer application completely. To use the Exit option, click on the File Menu on the Study Browser s main toolbar and select Exit. If you have selected the option for the Diagnostic Viewer to prompt before closing the application, you will receive a warning prompt asking if you are sure you want to exit the application. Click the Yes button to exit, or the No button to return to the Diagnostic Viewer. Note: For more information on the Prompt before closing the application option, see Chapter 7, section 7-1 Options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

45 NovaPACS Diagnostic Viewer Chapter 4 Using the Study Browser Worklist Menu The Study Browser s Worklist Menu contains Worklist functions that help users organize and manage workflow. The Worklist Menu is located on the Study Browser s main toolbar. The menu items on the Worklist menu are dependent upon which tab is being used. The Search and Advanced Worklist tabs contain fewer worklist menu items than the Assigned Worklist tab. This chapter addresses the following options for using the Study Browser s Worklist Menu: 4-1 Introduction to the Worklist 4-2 Add to Worklist A. Add to Worklist B. Assign 4-3 Open Worklist Item 4-4 Next Worklist Item 4-5 Remove Worklist Item 4-6 Clear Worklist 4-1 Introduction to the Worklist The Assigned Worklist is a tab located to the right of the Search tab when activated and is used with the filters on the page to locate specific information. The Assigned Worklist is an effective tool for large groups of users that read images at the same time from a Filtered Studies list. The Assigned Worklist shows studies that have been added by the user to view later, or that have been assigned to the user by someone else. Radiologists can move studies into their worklist for review, or assign studies to another user s worklist for specific users or larger groups to review. Note: To the left of the Assigned Worklist tab is the Search tab. There is also an Advanced Worklist tab that can be used to create advanced worklists with custom settings. For more information on the Assigned Worklist, see Chapter 2, section 2-6 Assigned Worklist. Copyright Novarad NovaPACS Diagnostic Viewer Manual

46 Chapter 4 Using the Study Browser Worklist Menu 4-2 Add to Worklist Users can add a study to the Worklist to organize and manage workflow. Users can also assign a study to another user s Worklist for them to review. The following sections describe how to add studies to your worklist and assign studies to another user. A. Add to Worklist Users can add studies from the Search tab and the Advanced Worklist tabs to their Assigned Worklist. This allows users to see only specific studies along with studies assigned to them by other users for convenience. To add a study to the Assigned Worklist, complete the following steps: 1. Select a study from the Filtered Studies or Patient History list on the Search tab or an Advanced Worklist tab. To select multiple studies to add, hold the CTRL key while selecting patients. 2. Click the Add to Worklist button on the toolbar. The study will then appear in the Assigned Worklist tab. Note: If the study added does not meet the search criteria in the search filters, it may not appear in the Filtered Studies list on the Assigned Worklist. Review your search filters if a study is not visible on your worklist. Users can also add selected studies to their Assigned Worklist in the following ways: Click on the Worklist menu on the Study Browser s main toolbar, and select the Add to Worklist option. Right-click and select the Add Selected Studies to My Worklist option from the drop-down list. You can customize a hotkey to assign a study to your Worklist. For more information on hotkeys (Keyboard Shortcuts), see Chapter 7, section 7-1 Options. B. Assign Users can assign studies to another user for review. Studies can be assigned to other users from any tab in the Study Browser (Search tab, Assigned Worklist tab, and Advanced Worklist tabs). To assign studies to another user s Assigned Worklist, complete the following steps: 1. Select the study you want to assign from the Filtered Studies list in the Study Browser. To select multiple studies, hold the CTRL button as you click. Copyright Novarad NovaPACS Diagnostic Viewer Manual

47 Chapter 4 Using the Study Browser Worklist Menu 2. Click the Assign button on the Filtered Studies list toolbar. An Assign Studies from dialog box will open. 3. In the Assign Studies from dialog box, select an option from the What role is the assignment to? drop-down list. Note: The Which user to assign to? section will populate with users that have that selected role. 4. Select a user from the Which user to assign to? section and click OK. Note: If you want the Worklist items to no longer have a New status so other users in your Worklist group do not see the patients in the Worklist make sure you click the Checkout button for the item before or right after you move it to your Worklist. For additional information on the Study Browser s Checkout feature, see Chapter 5, section 5-14 Collaboration. Users can also assign selected studies to other users in the following ways: Click on the Worklist menu on the Study Browser s main toolbar, and select the Assign option. Right-click and select the Assign Selected Studies to Another User option from the drop-down list. You can customize a hotkey to assign a study. For more information on hotkeys (Keyboard Shortcuts), see Chapter 7, section 7-1 Options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

48 Chapter 4 Using the Study Browser Worklist Menu 4-3 Open Worklist Item Users can open Worklist studies in the Image Viewer. To view the images in a Worklist entry in the Image Viewer, complete the following steps: 1. Select the Worklist study that you would like to view in the Image Viewer. 2. Click the Open button on one of the toolbars in the Study Browser. (The Filtered Studies, Patient History, and Series lists all have the Open toolbar button). If you want to open the selected study (studies) with prior studies, click the Open + Old button on the Filtered Studies or Patient History toolbar. The study will open in the Image Viewer. Users can also open selected studies in the following ways: Click on the Worklist menu on the Study Browser s main toolbar and select Open Worklist Item. Double-click on a study on the Assigned Worklist tab. Right-click on a study and select Open Selected Studies option from the drop-down list. If you want to open the selected study (studies) with prior studies, select the Open Selected Studies with Older Related Studies option. You can customize a hotkey to open a study. For more information on hotkeys (Keyboard Shortcuts), see Chapter 7, section 7-1 Options. 4-4 Next Worklist Item The Next Worklist Item option allows users to close all currently opened studies and open the next worklist study in the Image Viewer. To use the Next Worklist Item option, click on the Worklist Menu on the Study Browser s main toolbar and select Next Worklist Item. Users can also use the default hotkey of F1. Note: For more information on hotkeys, see Chapter 7, section 7-1 Options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

49 Chapter 4 Using the Study Browser Worklist Menu 4-5 Remove Worklist Item The Remove Worklist Item option allows users to remove a worklist item from the Worklist. To remove an item from your Worklist, complete the following steps: 1. Click on the worklist item that you want to remove. 2. Click the Remove button on the Filtered Studies toolbar on the Assigned Worklist tab. You can also use any of the following steps to delete a selected Worklist item: Click the Worklist Menu on the Study Browser s main toolbar and select Remove Worklist Item. Right-click on the worklist item and select Remove Selected Study from the drop-down list. 4-6 Clear Worklist Users can clear their Assigned Worklist using the Clear option. To clear the Assigned Worklist, complete the following steps: 1. Click on the Assigned Worklist tab if not already on the page. 2. Click the Clear button on the Filtered Studies list toolbar. This will remove all studies from the Assigned Worklist. Note: Users can also clear the Advanced Worklist by clicking on the Worklist menu on the Study Browser s main toolbar and selecting the Clear Worklist option. Copyright Novarad NovaPACS Diagnostic Viewer Manual

50 NovaPACS Diagnostic Viewer Chapter 5 Using the Study Browser Study Menu The Study Menu helps radiologists find additional study information sources and tools and manage caseloads. The Study Menu is located on the Study Browser s main toolbar. This chapter addresses the following options for using the Study Browser s Study Menu: 5-1 Select All 5-2 Open 5-3 Close Workspace 5-4 Close All Workspaces 5-5 Route 5-6 Documents 5-7 Exam Report 5-8 Manage Report Workflow 5-9 RIS Information 5-10 Retrieve Images 5-11 Patient CD/DVD 5-12 Assign Password 5-13 Scan Complete 5-14 Launch Cardio Reporting 5-15 Launch Mammo Viewer 5-16 View Study on Other Workstation 5-17 Launch Orthopedic Tools 5-18 Collaboration A. Checkout B. Undo Checkout C. Verified D. Reviewed E. Reset Status to New F. Peer Review G. Utilization Review Copyright Novarad NovaPACS Diagnostic Viewer Manual

51 Chapter 5 Using the Study Browser Study Menu 5-1 Select All The Select All option allows users to select all of the items on the active list (Filtered Studies, Patient History, or Series List). To use the Select All option, complete the following steps: 1. Click on a list in the Study Browser to make it the active list. 2. Click on the Study Menu on the Study Browser s main toolbar and select the Select All option. The following are alternate ways to use the Select All option: 1. Click on a list to make it the active list, then right-click on the list and choose Select All from the drop-down list. 2. Click on a list to make it the active list, then click on the Select All button on the toolbar for that list. 3. Click on a list to make it the active list and use the default hotkey setting of CTRL + A. For more information on customizing hotkeys, see Chapter 7, section 7-1 Options. Click anywhere on the list to deselect the items after using the Select All function. Copyright Novarad NovaPACS Diagnostic Viewer Manual

52 Chapter 5 Using the Study Browser Study Menu 5-2 Open The Open option allows users to open a selected study, series, or image in the Image Viewer. To use the Open option, click on the study, series, or image you want to open and click on the Study Menu on the Study Browser s main toolbar, and select the Open option. The following are alternate ways to use the Open option: 1. Click on the study, series, or image you want to open from any list in the Study Browser, and click on the Open button on the toolbar for that list. 2. Double-click on the study, series, or image and the Image Viewer will automatically open it. 3. Click on the study, series, or image you want to open and use the default hotkey setting of CTRL + O. For more information on customizing hotkeys, see Chapter 7, Section 7-1 Options. Note: In order to prevent two users from changing a study at the same time, a message will alert the second user that the study/series is currently checked out. This warning also appears when an administrator is editing the study in the Admin Console. Copyright Novarad NovaPACS Diagnostic Viewer Manual

53 Chapter 5 Using the Study Browser Study Menu 5-3 Close Workspace The Close Workspace option closes the current, visible workspace in the Image Viewer while leaving any other workspaces open. To use the Close Workspace option, click on the Study Menu on the Study Browser s main toolbar, and select Close Workspace. Note: There are other ways to use the Close Workspace option. You can set a hotkey or add a button to the Study Browser s Custom Toolbar. For more information on customizing the Study Browser s Custom Toolbar, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. For more information on hotkeys, see Chapter 7, section 7-1 Options. 5-4 Close All Workspaces The Close All Workspaces option closes the current, visible workspace and all other open workspaces in the Image Viewer. To use the Close All Workspaces option, use one of the following steps: 1. Click on the Study Menu on the Study Browser s main toolbar, and select Close All Workspaces. 2. Use the default hotkey setting of CTRL + Shift + F4. For more information on customizing hotkeys, see Chapter 7, section 7-1 Options. Note: For more information on workspaces, see Chapter 10, section 10-5 Close Workspace, 10-6 Close All Workspaces, 10-7 Close all Workspaces and Show Study Browser, and 10-8 Mark Reviewed, Close Workspace, and Show Study Browser. Copyright Novarad NovaPACS Diagnostic Viewer Manual

54 Chapter 5 Using the Study Browser Study Menu 5-5 Route The Route option allows users to share images with another site. Images can be routed manually from a NovaPACS data source to a specified destination. Note: NovaPACS can be set up to automatically route prior studies to workstations based on the RIS schedule for the next day. This allows users to view necessary information without workflow interruptions or delays. Contact customer support to enable this feature. To route images, complete the following steps: 1. Select the study or series that you want to route from any list in the Study Browser. Note: Use the Select All function on the Filtered Studies list to select all studies to route or hold the CTRL button and click to select multiple studies or series to route. 2. Click on the Study Menu on the Study Browser s main toolbar, and select Route. An Add Route Queue Entry dialog box will open. 3. Choose the study, series, and/or image(s) that you want to route by expanding the lists and clicking the corresponding checkboxes next to the items. If the checkbox next to the study is marked without expanding the list, all of the accompanying series and images will automatically be routed. Note: Route rules can be configured in the Admin Console. If one series in a multimodality study matches the route rule, the entire study will be routed (e.g., a mammography study can include images from multiple modalities like MG and US, and also non-image files such as Structured Reports). 4. Choose a destination from the Destination drop-down list. Note: An Administrator must add the Destinations that appear in the drop-down list. If the destination that you need isn t on the list, talk to your Administrator. 5. Set the routing priority for the image routing by clicking the up or down arrows next to the Priority field. Routing priorities range from 1-100, with 1 as the highest priority. The default routing Priority is Click the OK button to route to the specified destination. Note: You can customize a hotkey or add a button to the Study Browser s Custom Toolbar for the Route option. For more information on customizing the Study Browser s Custom Toolbar, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. For more information on hotkeys, see Chapter 7, section 7-1 Options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

55 Chapter 5 Using the Study Browser Study Menu 5-6 Documents The Documents option allows users to see any documents associated with the patient file that were scanned into the RIS. To view Documents, complete the following steps: 1. Select the study from any list in the Study Browser. 2. Click on the Study Menu on the Study Browser s main toolbar and select Documents. Note: For more information on viewing Documents from the Image Viewer, see Chapter 10, section Documents. 5-7 Exam Report The Exam Report option allows users to see the report associated with the patient file if one exists. Exam Reports are only available if the system is integrated with NovaRIS. To view an Exam Report, complete the following steps: 1. Select the study from any list in the Study Browser. Note: You can also use the Select All function on the Filtered Studies list to select all studies or hold the CTRL button and click to select multiple studies or series. 2. Click on the Study Menu on the Study Browser s main toolbar and select Exam Report. Copyright Novarad NovaPACS Diagnostic Viewer Manual

56 Chapter 5 Using the Study Browser Study Menu The following are alternate ways to use the Exam Report option: 1. Select the study from any list in the Study Browser and use the default hotkey setting of CTRL + R. For information on customizing hotkeys, see Chapter 7, section 7-1 Options. 2. Users can add an Exam Report button to the Study Browser s Custom Toolbar. For more information on how to do this, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. 5-8 Manage Report Workflow The Manage Report Workflow option allows users to quickly view their reports and report statuses. The Manage Report Workflow option is particularly useful for Administrators, Transcriptionists, and Radiologists. Users can review and/or sign reports using this option. In the Report Workflow window, users will see four main boxes for Dictated Reports, Unsigned Reports, Signed Reports, and Finalized Reports. In the Other section, users can see reports that have been marked Requires Correction and can look up physicians in the system by using the Physician Lookup box. To access the Report Workflow window, click on the Study Menu on the Study Browser s main toolbar, and select Manage Report Workflow. Note: You can customize a hotkey or add a button to the Study Browser s Custom Toolbar for the Manage Report Workflow option. For more information on customizing the Study Browser s Custom Toolbar, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. For more information on hotkeys, see Chapter 7, section 7-1 Options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

57 Chapter 5 Using the Study Browser Study Menu 5-9 RIS Information The RIS Information option allows users to view the RIS Information dialog box for a study. The information included in the RIS Information box is submitted by the Admin, Receptionist, or Technologist in NovaRIS. RIS Information dialog boxes include patient information, Referring Physician information, order notes, and procedure information about a study. To use the RIS Information option, complete the following steps: 1. Select a study from any list in the Study Browser. 2. Click on the Study Menu on the Study Browser s main toolbar, and select RIS Information. Note: You can customize a hotkey or add a button to the Study Browser s Custom Toolbar for the RIS Information option. For more information on customizing the Study Browser s Custom Toolbar, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. For more information on hotkeys, see Chapter 7, section 7-1 Options Retrieve Images The Retrieve Images option allows users to download all image files in a selected study from an archive server to their computer. The Retrieve Images option operates in the background, allowing users to perform other tasks while waiting. This option is most useful for situations where there is a slow connection between the archive server and the local Diagnostic Viewer installation. To use the Retrieve Images option, click on the Study Menu on the Study Browser s main toolbar, and select Retrieve Images. Note: You can customize a hotkey or add a button to the Study Browser s Custom Toolbar for the Retrieve Images option. For more information on customizing the Study Browser s Custom Toolbar, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. For more information on hotkeys, see Chapter 7, section 7-1 Options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

58 Chapter 5 Using the Study Browser Study Menu 5-11 Patient CD/DVD Users with a CD/DVD burner can use the Patient CD/DVD option to burn a patient s file to a CD or DVD (from the Managed Viewer or Web Viewer). Users can continue using the Diagnostic Viewer while a Patient CD/DVD burns in the background. To create a Patient CD/DVD, complete the following steps: 1. Select the study or series that you want to burn to CD/DVD. 2. Click on the Study Menu on the Study Browser s main toolbar, and select Patient CD/DVD. A Patient CD/DVD dialog box will open. 3. Select the Studies, Series, and Compression options you want for your CD/DVD and click OK. In order to include the exam report on a Patient CD/DVD, the user who burns the CD/DVD must have corresponding permissions in NovaRIS. Users can add a Patient CD/DVD button to the Study Browser s Custom Toolbar. For more information on how to do this, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. You can also customize a hotkey for the Patient CD/DVD option. For more information on hotkeys (Keyboard Shortcuts), see Chapter 7, section 7-1 Options. Note: When the CD/DVD creation process is complete, the CD or DVD slot will open automatically Assign Password The Assign Password option allows users to assign a temporary Single-Study Access Password for a study, giving a person (i.e. a Referring Physician or patient) access to that study through the Web Viewer. The Single-Study Access Password gives the user access to the study s images and RIS reports. Note: For more information on the Web Viewer, see Chapter 1, section 1-3 Accessing the Diagnostic Viewer. Copyright Novarad NovaPACS Diagnostic Viewer Manual

59 Chapter 5 Using the Study Browser Study Menu To use the Assign Password option, complete the following steps: 1. Click on the Study that you want to assign Single-Study Access to. 2. Click on the Study Menu on the Study Browser s main toolbar, and select Assign Password. 3. An Assign Web Password to Selected Study dialog box will appear. A randomly generated password is assigned automatically. You can generate your own password by clicking on the New Password link. 4. Click on the Expiration Date drop-down list to set the length of time the password is valid, and click OK. Note: See Chapter 10, section Assign Password for information on assigning a password from the Image Viewer. There are other ways to use the Assign Password option. You can set a hotkey or add a button to the Study Browser s Custom Toolbar. For more information on customizing the Study Browser s Custom Toolbar, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. For more information on hotkeys, see Chapter 7, section 7-1 Options Scan Complete The Scan Complete option allows users to change the patient s status to reflect a completed scan, which will reflect on the Patient Workflow in NovaRIS. To use the Scan Complete option, complete the following steps: 1. Select a study from the Filtered Studies list in the Study Browser. 2. Click on the Study Menu on the Study Browser s main toolbar, and select Scan Complete. Note: You can customize a hotkey for the Scan Complete option. For more information on hotkeys (Keyboard Shortcuts), see Chapter 7, section 7-1 Options Launch Cardio Reporting The Launch Cardio Reporting option allows users to launch EncaptureMD a cardio reporting tool used with NovaPACS to create echocardiography reports. Copyright Novarad NovaPACS Diagnostic Viewer Manual

60 Chapter 5 Using the Study Browser Study Menu To use the Launch Cardio Reporting option, complete the following steps: 1. Launch the Diagnostic Viewer and open an appropriate study (i.e., a cardio echo study). 2. Return to the Study Browser by clicking on the Study Browser icon in the top right corner of the Image Viewer window. 3. Click on the Study Menu on the Study Browser s main toolbar, and select Launch Cardio Reporting. The EncaptureMD program will launch. 4. When using EncaptureMD, if users need to re-measure specific measurements, they will return to PACS to re-measure, and then return to EncaptureMD to finalize the report. When finished creating the report in EncaptureMD, the report will be saved as PDF and will be viewable from PACS or RIS. Note: EncaptureMD must be installed and configured on the workstation to use the Launch Cardio Reporting option. If it is not configured, the Launch Cardio Reporting option will not be available on the Study Menu. There are several other ways to launch EncaptureMD. Users can customize a hotkey or add a custom toolbar button to the Image Viewer or Study Browser. Copyright Novarad NovaPACS Diagnostic Viewer Manual

61 Chapter 5 Using the Study Browser Study Menu 5-15 Launch Mammo Viewer The Launch Mammo Viewer option allows users to launch a mammo viewing tool used with NovaPACS for mammography viewing. To use the Launch Mammo Viewer option, complete the following steps: 1. Launch the Diagnostic Viewer and open an appropriate study (i.e., an MG or breast US study). 2. Return to the Study Browser by clicking on the Study Browser icon in the top right corner of the Image Viewer window. 3. Click on the Study Menu on the Study Browser s main toolbar, and select Launch Mammo Viewer The configured mammo viewer will launch in a new window. 4. When finished using the mammo viewer, you can return to the PACS by closing the window. Note: A mammo viewer software must be installed and configured on the workstation to use the Launch Mammo Viewer option. If it is not configured, the Launch Mammo Viewer option will not be available on the Study Menu. Users can customize a hotkey or add a custom toolbar button to the Image Viewer or Study Browser to access this option. Copyright Novarad NovaPACS Diagnostic Viewer Manual

62 Chapter 5 Using the Study Browser Study Menu 5-16 View Study on Other Workstation The View Study on Other Workstation option allows users to send studies from the Diagnostic Viewer to another computer. Contact Novarad s Technical Support for the required configuration for this option. Once configured, studies can be viewed and processed by another computer. This option is useful if users need to view studies on post-processing stations for MIP/MPR or 3D Reconstruction. To use the View Study on Other Workstation option, complete the following steps: 1. Select the study you want to send from a list in the Study Browser. 2. Click on the Study Menu on the Study Browser s main toolbar, and select View Study on Other Workstation. Note: For more information on using the View Study on Other Workstation option from the Image Viewer, see Chapter 10, section View Study on Other Workstation Launch Orthopedic Tools The Launch Orthopedic Tools option allows users to use the orthopedic template 3 rd party software with Novarad s Diagnostic Viewer. This optional software integration allows users to create a complete array of orthopedic pre- and post-surgical planning and mapping tools including (but not limited to) Cobb Angles, templates, overlaying, and surgical repairs. To use the Launch Orthopedic Tools option, complete the following steps: 1. Launch the Diagnostic Viewer and open an appropriate study. 2. Return to the Study Browser by clicking on the Study Browser icon in the top right corner of the Image Viewer window. Copyright Novarad NovaPACS Diagnostic Viewer Manual

63 Chapter 5 Using the Study Browser Study Menu 3. Click on the Study Menu on the Study Browser s main toolbar, and select Launch Orthopedic Tools. The configured orthopedic tool will launch in a new window. 4. When finished using the orthopedic tools, you can return to the PACS by closing the window. Note: The product launched when using the Launch Orthopedic Tools option is dependent upon which software option is configured in the PACS Admin Console. If you do not have an orthopedic software tool configured, the Launch Orthopedic Tools option will not be available on the Study Menu. Users can customize a hotkey or add a custom toolbar button to the Image Viewer or Study Browser to access this option. For more information on creating Orthopedic Templates, see Chapter 13 Additional Software Products Collaboration The Collaboration option allows multiple Radiologists to work simultaneously from the same worklist without having duplicate readings. The Collaboration option also allows users to participate in peer-to-peer reviews of patient studies. Note: For more information on Collaboration options from the Image Viewer, see Chapter 10, section Collaboration. Copyright Novarad NovaPACS Diagnostic Viewer Manual

64 Chapter 5 Using the Study Browser Study Menu To access Collaboration options, complete the following steps: 1. Select a study from a list in the Study Browser. 2. Click on the Study Menu on the Study Browser s main toolbar, and select the Collaboration option. A submenu will drop down with collaboration options. The Collaboration submenu contains the following collaboration options: A. Checkout The Checkout option prevents multiple users from reviewing the same study simultaneously. To use the Checkout option for a study, complete the following steps: 1. Select a study from the Filtered Studies list in the Study Browser. 2. Click on the Study Menu on the Study Browser s main toolbar, select Collaboration, and then select Checkout. The study will now have a Checked Out status in the Status column of the Filtered Studies list. The Current User column will reflect the user name of the person who checked the study out. The Checked Out status for the study will update on all collaborating users lists. Other users may view a Checked Out study, but cannot mark it reviewed or use the Checkout function on it. Note: See Chapter 2, section 2-2 The Study Browser Lists for more information on customizing columns. Copyright Novarad NovaPACS Diagnostic Viewer Manual

65 Chapter 5 Using the Study Browser Study Menu The following are alternate ways to use the Checkout option: 1. Users can set the Study Browser to automatically checkout a study when opened. To set this option, click on the Settings Menu on the Study Browser s main toolbar. Click on Options. Click the checkmark next to the Auto-checkout studies when they are opened option. See Chapter 7, section 7-1 Options for more information. 2. Users can customize a hotkey for the Checkout option. See Chapter 7, section 7-1 Options for more information on hotkeys (Keyboard Shortcuts). 3. Users can add a Checkout button to the Study Browser s Custom Toolbar. See Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar for more information. B. Undo Checkout The Undo Checkout option allows users to undo the checkout process for a study. This option is helpful when a user checks out the wrong study or the user is unable to complete the review of a study after checkout. The study or series will be restored to the status it had before checkout (i.e. New or Verified). The Undo Checkout option cannot restore the status of a study if it has already been marked Reviewed. Users can only change a study with a Reviewed status by using the Reset Status to New option (see section E. Reset Status to New). To use the Undo Checkout option, complete the following steps: 1. Select the checked-out study from the Filtered Studies list in the Study Browser. 2. Click on the Study Menu on the Study Browser s main toolbar, select Collaboration, and then select Undo Checkout. Note: There are other ways to use the Undo Checkout option. You can set a hotkey or add a button to the Study Browser s Custom Toolbar. For more information on customizing the Study Browser s Custom Toolbar, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. For more information on hotkeys, see Chapter 7, section 7-1 Options. C. Verified The Verified option allows users to mark studies as verified, which means that all attached documents, images, etc., are checked and ready for review. To use the Verified option, complete the following steps: Copyright Novarad NovaPACS Diagnostic Viewer Manual

66 Chapter 5 Using the Study Browser Study Menu 1. Select the study to be verified from the Filtered Studies list in the Study Browser. 2. Click on the Study Menu on the Study Browser s main toolbar, select Collaboration, and then select Verified. Note: There are other ways to use the Verified option. You can set a hotkey or add a button to the Study Browser s Custom Toolbar. For more information on customizing the Study Browser s Custom Toolbar, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. For more information on hotkeys, see Chapter 7, section 7-1 Options. The study will now have a Verified status in the Status column of the Filtered Studies list. The Current User column will reflect the user name of the person who verified the study. The Verified status for the study will update on all collaborating users lists. Note: See Chapter 2, section 2-2 The Study Browser Lists for more information on customizing column headings. D. Reviewed The Reviewed option allows users to mark a study as reviewed. To use the Reviewed option, complete the following steps: 1. Select the study that you have reviewed. 2. Click on the Study Menu on the Study Browser s main toolbar, select Collaboration, and then select Reviewed. Note: There are other ways to use the Reviewed option. You can set a hotkey or add a button to the Study Browser s Custom Toolbar. For more information on customizing the Study Browser s Custom Toolbar, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. For more information on hotkeys, see Chapter 7, section 7-1 Options. The study will now have a Reviewed status in the Status column of the Filtered Studies list. The Current User column will reflect the user name of the person who reviewed the study. The Reviewed status for the study will update on all collaborating users lists. Note: The status of a study will reset to its previous New or Verified status if the study is closed out without marking it Reviewed, and the following options are marked in the Settings Menu, under the General tab: Auto-checkout studies when they are opened Auto-review studies when they are closed Prompt before marking a study reviewed Copyright Novarad NovaPACS Diagnostic Viewer Manual

67 Chapter 5 Using the Study Browser Study Menu E. Reset Status to New The Reset Status to New option allows users to restore the status of a reviewed study back to New, so it can be reviewed again. To use the Reset Status to New option, complete the following steps: 1. Select the reviewed study from the Filtered Studies list in the Study Browser. 2. Click on the Study Menu on the Study Browser s main toolbar, select Collaboration, and then select Reset Status to New. Note: There are other ways to use the Reset Status to New option. You can set a hotkey or add a button to the Study Browser s Custom Toolbar. For more information on customizing the Study Browser s Custom Toolbar, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. For more information on hotkeys, see Chapter 7, section 7-1 Options. The study s status will change from Reviewed to New in the Status column of the Filtered Studies list. The user name will no longer appear in the Current User column. Note: The Reset Status to New option must be used within four hours of a study being marked Reviewed. To change the status of a study after four hours, contact your administrator. F. Peer Review The Peer Review option allows radiologists to evaluate each other s reviewed studies, give second opinions, and provide quality assurance. Any radiologist involved in the review process can view a completed Peer Review. To use the Peer Review option, complete the following steps: 1. Select a reviewed study from the Filtered Studies list in the Study Browser. 2. Click on the Study Menu on the Study Browser s main toolbar, select Collaboration, and then select Peer Review. A Peer Review dialog box will appear. 3. Click on an option for the Position field. 4. Enter any comments needed in the Comment field box and click OK. Copyright Novarad NovaPACS Diagnostic Viewer Manual

68 Chapter 5 Using the Study Browser Study Menu Note: Peer Review reports are available to NovaPACS Administrators in the Admin Console. The Administrator can choose to report an average rate of missed diagnoses over a given time period. G. Utilization Review The Utilization Review option allows radiologists to review film to provide quality assurance. To use the Utilization Review option, complete the following steps: 1. Select a reviewed study from the Filtered Studies list in the Study Browser. 2. Click on the Study Menu on the Study Browser s main toolbar, select Collaboration, and then select Utilization Review. A Utilization Information for Reviewed Study dialog box will appear. 3. Select the drop-down list for the Utilization Heading Position field and select the position that applies. 4. Enter any comments needed in the Comment field box and click OK. Copyright Novarad NovaPACS Diagnostic Viewer Manual

69 NovaPACS Diagnostic Viewer Chapter 6 Using the Study Browser View Menu The View Menu contains options for how information is displayed in the Study Browser window, as well as settings for the Hanging Protocols in the Image Viewer. The View Menu is located on the main toolbar in the Study Browser. This chapter addresses the following options for using the Study Browser s View Menu: 6-1 Worklist 6-2 Hanging Protocol Layouts 6-3 Series List 6-4 Patient History List 6-5 Refresh Lists 6-6 Reset Filters 6-1 Worklist The Worklist option displays the Assigned Worklist tab containing studies that have been added by the user to view later, or that have been assigned to the user by another user. Large radiologist groups use this function to improve workflow. The Assigned Worklist tab is not viewable on the Study Browser s window by default. To view the Assigned Worklist tab, complete one of the following steps: 1. Click on the View Menu on the Study Browser s main toolbar, and select Worklist. 2. Use the default hotkey setting of F2. The Assigned Worklist will appear as a tab next to the Search tab on top of the Filtered Studies list. The Assigned Worklist tab looks and functions like the Search tab except there are less search filters to use on the Assigned Worklist because studies are already filtered by assignment. Copyright Novarad NovaPACS Diagnostic Viewer Manual

70 Chapter 6 Using the Study Browser View Menu Note: For more information on using the Worklist, see Chapter 2 Using the Study Browser and Chapter 4 Using the Study Browser Worklist Menu. 6-2 Hanging Protocol Layouts To activate the Hanging Protocol Layouts section in the Study Browser window, click on the View Menu on the Study Browser s main toolbar and select Hanging Protocol Layouts. Users can also use the default hotkey setting of F4. Note: The Hanging Protocol Layouts section will only display content in the Study Browser if a study is open in the Image Viewer. The Hanging Protocol Layouts are the saved layouts associated with a specific Hanging Protocol for displaying study images in the Image Viewer. If activated, the Hanging Protocol Layouts section is located at the bottom of the Study Browser window and displays thumbnail images of the layouts defined for the current Hanging Protocol. The title of this section will list the current Hanging Protocol. This section will appear on all tabs in the Study Browser (i.e., the Search tab, Assigned Worklist tab, and Advanced Worklist tabs). To use the Layouts section, click on one of the Layout images to apply it to the study in the Image Viewer or use the number keys 1-0 at the top of the keyboard (not the side key pad) to quickly apply the associated Layout. Users can Add, Duplicate, and Remove layouts by using the links in the upper right-hand corner of the Hanging Protocol Layouts section. Users can edit layouts by right clicking on a thumbnail image and selecting Edit Layout from the menu that appears. For detailed instructions on Adding, Duplicating, Removing, and otherwise managing Hanging Protocols, see Chapter 7, section 7-3 Managing Hanging Protocols. Generally, the Hanging Protocol Layouts section will display the Single-study Layouts for the current Hanging Protocol. However, Multi-study Layouts will display in the Layouts section whenever multiple studies are opened concurrently. If multiple studies are opened at the same time with different Hanging Protocols applied (such as when the studies are from separate Copyright Novarad NovaPACS Diagnostic Viewer Manual

71 Chapter 6 Using the Study Browser View Menu modalities), the Layouts section will display the Multi-study Layouts for the currently active study. Simply select another study to view the Layouts associated with it. Whenever there are no Multi-study Layouts available for the current Hanging Protocol, Single-study Layouts will be displayed instead. Note: For more information on managing and applying Hanging Protocol Layouts see Chapter 2, section 2-4 Hanging Protocol Layouts; Chapter 7, section 7-3 Managing Hanging Protocols; Chapter 9, section 9-2 Hanging Protocol Drop-down Menu; Chapter 10, section 10-9 Managing Hanging Protocols; Chapter 10, section 37 Hanging Protocol Layouts; and Chapter 11, sections 11-3 to Series List The Series list is part of the default view in the Study Browser. The Series list displays all the series that are part of the selected study. It is below the Filtered Studies list and to the right of the Patient History list in the Study Browser window. Users can choose to have the Series list not available by clicking on the View Menu on the Study Browser s main toolbar, and selecting Series. This option allows the user to have a patient-centric view in the Study Browser. Copyright Novarad NovaPACS Diagnostic Viewer Manual

72 Chapter 6 Using the Study Browser View Menu 6-4 Patient History List The Patient History list displays all completed studies for the selected patient, including all time frames and all modalities. The Patient History list is part of the default view in the Study Browser. It is below the Filtered Studies list and to the left of the Series list in the Study Browser window. Users can choose to have the Patient History list not available by clicking on the View Menu on the Study Browser s main toolbar, and selecting Patient History. This option allows the user to have a study-centric view in the Study Browser. 6-5 Refresh Lists The lists in the Study Browser window can be refreshed to show the most up-to-date information by using the Refresh Lists option. Copyright Novarad NovaPACS Diagnostic Viewer Manual

73 Chapter 6 Using the Study Browser View Menu To use the Refresh Lists option, complete one of the following actions: 1. Click on the View Menu on the Study Browser s main toolbar and select Refresh Lists. 2. Use the default hotkey of F5. Note: If you want the Study Browser lists to automatically update when idle, click on the Settings Menu on the Study Browser s main toolbar and select Options. Mark the check box next to Refresh Study Browser automatically when idle. The lists will then automatically refresh after the user has been idle for one minute. 6-6 Reset Filters Users can reset filters when searching the Filtered Studies list with by using the Reset Filters option. To use the Reset Filters option, complete one of the following steps: 1. Click on the View Menu on the Study Browser s main toolbar, and select Reset Filters. 2. Click the Reset Filters button on the Study Browser s Custom Toolbar (if set up). 3. Use the default hotkey of CTRL + Shift + F5. Copyright Novarad NovaPACS Diagnostic Viewer Manual

74 NovaPACS Diagnostic Viewer Chapter 7 Using the Study Browser Settings Menu The Settings Menu contains options to arrange and setup the Diagnostic Viewer s features, tools, and monitors. The Settings Menu is on the Study Browser s main toolbar. This chapter addresses the following options for using the Study Browser s Settings Menu: 7-1 Options A. General Tab B. Keyboard Shortcuts Tab (Hotkeys) C. Mouse Settings Tab D. Image Context Menu Tab E. Auto W/L Tab F. Labels Tab G. Lexicon Tab H. Plug-ins Tab I. Data Sources Tab 7-2 W/L Presets A. Customizing the W/L Settings B. Customizing Width and Center for Window/Level Fields and Presets 7-3 Manage Hanging Protocols A. Add New Hanging Protocol 1. Select Modality 2. Manage Study Descriptions 3. Select a Display Tool Option 4. Select a Spine Labeling Default B. Manage Layouts 1. Add Layout 2. Edit Layout a. Editing Series Layout b. Using the Image Box (Series) Tab c. Using the Filters Tab C. Remove Layout D. Duplicate Layout 7-4 Configure Monitors Copyright Novarad NovaPACS Diagnostic Viewer Manual

75 Chapter 7 Using the Study Browser Settings Menu 7-5 Preferences A. Reset Preferences B. Import Preferences C. Export Preferences D. Save as Default Preferences 7-6 Customize Toolbar A. Adding Toolbar Items B. Removing Toolbar Items C. Re-ordering the Menu D. Customizing Toolbar Options 7-1 Options The Options page in the Settings Menu allows users to customize options for the Study Browser and the Image Viewer. To open the Options page, click on the Settings Menu on the Study Browser s main toolbar, and select Options. An Options page will open. The Options button can also be set up to be available on the Study Browser s Custom Toolbar. Note: The Options page can also be set as a button on the Study Browser s Custom Toolbar. For more information see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar. The Options page contains the following tabs: A. General Tab B. Keyboard Shortcuts Tab (Hotkeys) C. Mouse Settings Tab D. Image Context Menu Tab E. Auto W/L Tab F. Labels Tab G. Lexicon Tab H. Plug-ins Tab I. Data Sources Tab Copyright Novarad NovaPACS Diagnostic Viewer Manual

76 Chapter 7 Using the Study Browser Settings Menu A. General Tab The General Tab on the Options page allows users to select general options for the Study Browser and Image Viewer. The General Tab options are described in the following sections. 1. Smart Image Layout The Smart Image Layout option utilizes the unused space in a series window. When selected, the Image Viewer will place images into any unused space of a series window so there are no empty windows. 2. Auto-hide Study Browser The Auto-hide Study Browser option hides the Study Browser window from view when the mouse cursor is moved off of the window, and restores it when the mouse cursor is moved to the far left or right edge of the Image Viewer window. Note: If the Auto-hide Study Browser option is not selected, the Study Browser window will not automatically appear when the mouse cursor is moved to the far left or right edge of the Image Viewer window. 3. Auto-subtract Multiframe Angios Some modalities create multi-frame Angio images. The subtract feature lets users take away a frame from the entire multi-frame image and only show the changes between the other frames. The Auto-subtract option performs the subtracting automatically when the multi-frame image is opened. Note: The subtract option is available in the Image Viewer to Cardiologists only. 4. Auto-checkout Studies when they are Opened The Auto-checkout Studies when they are Opened option will set the status of a study to Checked Out when it is opened in the Image Viewer. Note: The study will also drop off your Worklist when opened with this option depending on your Worklist settings. 5. Auto-review Studies when they are Closed The Auto-review Studies when they are Closed option is a sub-option available when the Auto-checkout Studies when they are Opened option is selected. This option will automatically set the status of a study to Reviewed when it is closed. 6. Prompt before Marking a Study Reviewed The Prompt before Marking a Study Reviewed option is a sub-option available when the Auto-checkout Studies when they are Opened and the Auto-review Studies when they are Closed options are both selected. This option will prompt users that the study is about to be marked as Reviewed, asking if the user is sure they want the study marked reviewed. Copyright Novarad NovaPACS Diagnostic Viewer Manual

77 Chapter 7 Using the Study Browser Settings Menu 7. Open a New Workspace for Each Patient The Open a New Workspace for Each Patient option allows users to open multiple studies in separate workspaces. 8. Display Older Related Studies when Opening a Study The Display Older Related Studies when Opening a Study option opens up previous studies along with the selected study in the Image Viewer. Note: The Older Related Studies that are opened are determined by the Anatomical Area field of the image. 9. Prompt for Related Studies when Needed The Prompt for Related Studies when Needed option is a sub-option available when the Display Older Related Studies when Opening a Study option is selected. This option will prompt users when the Diagnostic Viewer cannot determine whether an older study is related or not, based on discrepancies of the Anatomical Area field of the image. 10. Show Patient History when Opening a Study The Show Patient History when Opening a Study option displays a list of other studies available for a patient when their study is opened in the Image Viewer. 11. Show Patient History when Opening with a Barcode The Show Patient History when Opening with a Barcode option displays a list of other studies available for the patient when a study is opened with a barcode scanner. 12. Show Study Notes when Opening a Study The Show Study Notes when Opening a Study option opens a dialog box with any study Notes when a study is opened in the Image Viewer. Note: For more information on Study Notes, see Chapter 10, section Notes. 13. Show Other Users Annotations The Show Other Users Annotations option will show all annotations created for a study, from all users. 14. Reset Filters when Opening the Study Browser The Reset Filters when Opening the Study Browser option will reset the search filters back to default settings every time the Study Browser is opened. 15. Add Study Split when Opening a Second Study for a Patient The Add Study Split when Opening a Second Study for a Patient option will automatically split the Image Viewer window to display multiple studies. If this Copyright Novarad NovaPACS Diagnostic Viewer Manual

78 Chapter 7 Using the Study Browser Settings Menu option is not selected, the second study opened will appear as a tab at the top of the Image Viewer window. 16. Auto-sharpen XAs The Auto-sharpen XAs option will automatically apply edge enhancement to XA images that may need more detail. 17. Auto-Local Contrast Enhance CRs The Auto-Local Contrast Enhance CRs option will apply filters to CR images to enhance details in the image(s). Selecting this option will apply the Local Contrast Enhancement to all CR images when opened in the Image Viewer. 18. Use Multiple Windows to Display RIS Reports The Use Multiple Windows to Display RIS Reports option allows users to view more than one exam report at a time. If this option is not selected, the default setting causes a second opened report to replace the first one. 19. Show Only the Most Recent Study for Each Patient in Filtered Studies The Show Only the Most Recent Study for Each Patient in Filtered Studies option shows only the most recent study for each patient in the Filtered Studies list in the Study Browser window. This is the default setting for users. If this option is deselected, all studies for each patient will appear in the Filtered Studies list. 20. Always Sort Filtered Studies by Priority The Always Sort Filtered Studies by Priority option sorts studies by highest priority in the Filtered Studies list in the Study Browser window. Note: STAT exams will always appear red on the list, regardless of this option. 21. Display Separate Window when Creating a Key Image Series The Display Separate Window when Creating a Key Image Series option will automatically show the Key Image Series in the Image Viewer window when a Key Image is added. If this option is not selected, a Key Image Series is still created, but not automatically displayed in the Image Viewer window. 22. Reset Cursor when Closing a Study The Reset Cursor when Closing a Study option will reset the mouse cursor back to the default settings if a study is closed while annotating. If this option is not selected, the mouse cursor will retain the same settings that it was using when the previous study was closed. 23. Auto-sync Hanging Protocol Image Layout Options There are a few options in the Auto-sync Hanging Protocol Image Layout Options section: Copyright Novarad NovaPACS Diagnostic Viewer Manual

79 Chapter 7 Using the Study Browser Settings Menu a. Always Match Layout The Always Match Layout option displays all series windows using the same image layout, regardless of plane, when one series is adjusted. b. Only Match Layout if Series are Coplanar The Only Match Layout if Series are Coplanar option synchronizes image layouts for all coplanar series. c. Never Match Layout The Never Match Layout option will not automatically synchronize the layout of images. If this option is selected, any adjustments need to be made to each series individually. 24. Mouse Control Options There are a few options in the Mouse Control section for using the mouse in the Image Viewer: a. Mouse Scroll Sensitivity Mouse Scroll Sensitivity determines how large or small movements need to be to move the mouse cursor over a given distance. Increased Mouse Scroll Sensitivity makes the mouse movement faster, while a decreased sensitivity results in a slower mouse. Users can select a Mouse Scroll Sensitivity level using the level bar. b. Minimum Mouse Drag Distance The Minimum Mouse Drag Distance determines how long of a distance the mouse must move to respond. Increased Minimum Mouse Drag Distance increases the distance the mouse must move to respond. Users can select a Mouse Drag Distance from c. Mouse Wheel Sensitivity Mouse Wheel Sensitivity determines how much the mouse wheel needs to be moved before it responds. Increased Mouse Wheel Sensitivity makes the mouse wheel respond faster, while a decreased sensitivity results in a slower response. Users can select a Mouse Wheel Sensitivity level using the level bar. 25. Prompt Before Marking a Study Reviewed if it has not Been Completely Reviewed The Prompt Before Marking a Study Reviewed if it has not Been Completely Reviewed option prompts users with a dialog box stating that all of the images in the study have not been viewed, asking if the user is sure they want the study marked reviewed. Copyright Novarad NovaPACS Diagnostic Viewer Manual

80 Chapter 7 Using the Study Browser Settings Menu 26. Prompt Before Saving Annotations The Prompt Before Saving Annotations option prompts users asking if they want to save their recent annotations to the study permanently. 27. Prompt Before Closing the Application The Prompt Before Closing the Application option prompts users asking if they are sure they want to close the entire Diagnostic Viewer when exiting. This is useful when the wrong exit button is pressed and the user does not want to close the entire Diagnostic Viewer application. 28. Prompt Before Clearing the Worklist The Prompt Before Clearing the Worklist option prompts users asking if they are sure they want to clear the Worklist. 29. Prompt to Allow Cross Localization of Different Frames of Reference The Prompt to Allow Cross Localization of Different Frames of Reference option prompts users asking if they are sure they want to set up a cross localization between images with different frames of reference. 30. Display Spine Label Cross References The Display Spine Label Cross References option will display spine label references at the top of intersecting images. 31. Refresh Study Browser when Idle The Refresh Study Browser when Idle option will automatically refresh the Study Browser lists every 60 seconds when the user is idle. Note: The auto-refresh feature begins after the first minute of user idle time. Contact Novarad s Technical Support to change the length of the idle time before auto-refresh begins in the Study Browser. 32. Show RIS Information when Opening a Study The Show RIS Information when Opening a Study option brings up a RIS Information page in the Image Viewer when a study is opened. 33. Fade Away after This Many Seconds The Fade Away after This Many Seconds is option is a sub-option available when the Show RIS Information when Opening a Study option is selected. This option lets the user select the duration of the RIS Information page being visible when the study is opened. Users can select from seconds. The default fade time is 60 seconds. Copyright Novarad NovaPACS Diagnostic Viewer Manual

81 Chapter 7 Using the Study Browser Settings Menu 34. Magnify Glass Size The Magnify Glass Size option allows users to adjust the size of the magnify glass tool for the Image Viewer with size options in the drop-down list. Autosize is the default setting. When using Autosize, the magnifying glass will auto-adjust according to the available series window and study space. The glass size will also grow or shrink as the magnification increases or decreases. 35. Draw Arrow Annotations Head to Tail The Draw arrow annotations head to tail allows users to switch the way that arrows are drawn when annotating images. When selected, an arrow annotation will be drawn with the pointed end of the arrow planted where the user first clicks and the tail end of the arrow dragged away from the point to the correct length and direction. This feature is turned off by default. Note: Refer to Chapter 12, section12-8 Annotations for more information on drawing arrow annotations. B. Keyboard Shortcuts Tab (Hotkeys) The most commonly used features in the Study Browser and Image Viewer come with default hotkey settings. However, these default settings can be changed and customized. Any of the menu functions can also be assigned a customized hotkey setting using the Keyboard Shortcuts Tab in the Options menu. Hotkey settings for menu functions are listed next to menu function names in the menu drop-down lists. The following sections describe how to assign a hotkey to Study Browser functions: 1. Opening the Keyboard Shortcuts Tab 2. Creating Study Browser Shortcuts 3. Creating Image Viewer Shortcuts 1. Opening the Keyboard Shortcuts Tab To open the Keyboard Shortcuts Tab, click on the Settings Menu on the Study Browser s main toolbar, and select Options. An Options page will open. In the Options dialog box, select the Keyboard Shortcuts tab. The page will have windows for both the Study Browser menu items and the Image Viewer menu items. Copyright Novarad NovaPACS Diagnostic Viewer Manual

82 Chapter 7 Using the Study Browser Settings Menu 2. Creating Study Browser Shortcuts To create a Study Browser Shortcut for a menu function, complete the following steps: a. Open the Keyboard Shortcuts Tab by clicking on the Settings Menu on the Study Browser s main toolbar, and selecting Options. Click on the Keyboard Shortcuts Tab. b. Select the menu function you want to assign a Keyboard Shortcut to by expanding the menu options in the Assign shortcuts to the Study Browser menu items window. c. Select a Keyboard Shortcut option from the drop-down list. Click the Clear button if you need to clear the current setting, and click OK when you have selected the function you want. 3. Creating Image Viewer Shortcuts Copyright Novarad NovaPACS Diagnostic Viewer Manual

83 Chapter 7 Using the Study Browser Settings Menu To create an Image Viewer Shortcut for a menu function, complete the following steps: a. Open the Keyboard Shortcuts Tab by clicking on the Settings Menu on the Study Browser s main toolbar, and selecting Options. Click on the Keyboard Shortcuts Tab. b. Select the menu function you want to assign a Keyboard Shortcut to by expanding the menu options in the Assign shortcuts to the Image Window menu items window. (Image Window menu items are for the Image Viewer.) c. Type a keystroke or keystroke combination in the Image Window Keystroke field to assign the Keyboard Shortcut (any key combination can be used). Click the Clear button if you need to clear the current setting, and click OK when you have typed the selection you want. Note: The Image Window settings do not allow the same Keyboard Shortcut to be assigned for multiple functions and will prompt users if a combination is already in use. However, a Keyboard Shortcut assigned to a Study Browser function can be used for Image Viewer functions also. C. Mouse Settings Tab Most functions in the Image Viewer can be performed with the mouse instead of the keyboard for radiologists convenience. The most commonly used features in the Image Viewer come with default mouse settings. These default settings can be changed and customized. The following sections describe how to assign mouse settings to Image Viewer functions: 1. Viewing Mouse Settings 2. Assigning Functions to Mouse Settings Copyright Novarad NovaPACS Diagnostic Viewer Manual

84 Chapter 7 Using the Study Browser Settings Menu 1. Viewing Mouse Settings Users can change or create mouse settings using the Options menu. To view the mouse settings, click on the Settings Menu on the Study Browser s main toolbar, select Options, and click on the Mouse Settings Tab. There are three categories of mouse settings that users can customize: Assign Click Events to Actions lists the functions available for control by mouse click. Assign Drag Events to Actions lists the functions available for control by dragging the mouse. Assign Wheel Events to Actions lists the functions available for control by the mouse wheel. 2. Assigning Functions to Mouse Settings To change or create the Mouse Settings using the Mouse Settings Tab, complete the following steps: a. Select the function you want to assign or change a Mouse Setting for from one of the three lists (Mouse Click Event, Mouse Drag Event, or Mouse Wheel Event). b. Select a mouse action from the corresponding drop-down list below the window you ve selected from and click OK. Copyright Novarad NovaPACS Diagnostic Viewer Manual

85 Chapter 7 Using the Study Browser Settings Menu D. Image Context Menu Tab The Image Context Menu allows users to add or remove options in the various modality Image Context menus. The following sections describe how to add or remove options for the Image Context Menus in the Image Viewer: 1. Viewing the Image Context Menu Tab 2. Adding Image Context Functions 3. Removing Image Context Functions 4. Re-ordering the Image Context Functions 1. Viewing the Image Context Menu Tab To open the Image Context Menu Tab, click on the Settings Menu on the Study Browser s main toolbar, and select Options. Click on the Image Context Menu Tab. The Image Context Menu tab has two windows an Available items window and a Current toolbar items window. 2. Adding Image Context Functions To add Image Context Functions to a specific modality s Image Context menu, complete the following steps: a. Click on the Modality selection field at the top of the Image Context Menu Tab page, and select a modality. Note: If you choose all modalities, the option you modify shows up in all Image Context Menus when you right-click. However, if you choose a specific modality, the option you modify shows up in the Image Context Menu for that modality only. b. Select the function you want to change or add from the Available items list. c. Click the Add button to add the function to the Current toolbar items list and click OK so save the changes. (The function will then be available in the Image Context Menu in the Image Viewer when the user right-clicks.) Copyright Novarad NovaPACS Diagnostic Viewer Manual

86 Chapter 7 Using the Study Browser Settings Menu 3. Removing Image Context Functions To remove Image Context Functions from a specific modality s Image Context Menu, complete the following steps: a. Click on the Modality selection field at the top of the Image Context Menu Tab page, and select a modality. b. Select the function you want to remove from the Current toolbar items list. c. Click the Remove button to remove the function from the Image Context Menu, click OK to save the changes. 4. Re-ordering the Image Context Functions Users can customize the order of the Image Context Menu items. Items can be reset to original settings and moved to a different location or hierarchy on the list. To re-order the Image Context Functions, select the item you want to move on the Current toolbar items window list, and click the Reset, Move Up, Move In, Move Out, or Move Down option. Click OK to save the changes. E. Auto W/L Tab Users can view and manage Auto Window/Level Adjustments from the Auto W/L tab of the Options page accessed from the Study Browser s Settings menu. Copyright Novarad NovaPACS Diagnostic Viewer Manual

87 Chapter 7 Using the Study Browser Settings Menu The Options page Adjustments box lists all Auto Window/Level Adjustments saved for the current user. The Filters box lists all filter settings applied across a modality. Users can add, edit, and remove Adjustments and Filters from this tab to ensure that images will always be displayed according to their preferences. Note: There is only one set of Add, Edit, and Remove buttons. These buttons are used to manage both Adjustments and Filters. 1. Adding Adjustments To add an adjustment, click inside the Adjustments box and select the Add button below the filters box at the bottom of the page. A Window Level Adjustment dialog box will open. The Window Level Adjustment dialog box allows users to manual specify the modality and image type the Auto Window/Level Adjustment will apply to, as well as the desired Window/Level values to be applied. In the Modality field, specify the modality to be associated with the new adjustment. In the Low Window, High Window, Low Level, and High Level fields specify the range of intensity values for the images that the new adjustment will apply to. In the New Window and New Level fields, specify the values to be automatically applied to the specified images. Note: When created directly from the Image Viewer these values will be automatically calculated and populated based on the currently selected image and applied Window/Level values. For instructions on creating Auto Copyright Novarad NovaPACS Diagnostic Viewer Manual

88 Chapter 7 Using the Study Browser Settings Menu Window/Level Adjustments from the Image Viewer, see Chapter 12, section Adjust Auto W/L Click OK when finished. The new Window/Level Adjustment will be saved and appear in the Adjustments list. The new Window/Level Adjustment will automatically apply to the appropriate images the next time they are opened. In order to save a new adjustment, all fields must be completed. If fields are not completed appropriately, warning dialog boxes will appear prompting the user to correct the error before saving. 2. Editing Adjustments Users can edit Window/Level Adjustment by selecting the item they wish to edit from the Adjustments list and clicking Edit. An Edit Parameters dialog box will appear, allowing users to specify the images that the adjustment will apply to, as well as the Window/Level values to be applied. Note: Users may not edit the modality of an existing Auto Window/Level Adjustment. In the Low Window, High Window, Low Level, and High Level fields users may edit the range of intensity values for the images that the new adjustment will apply to. In the New Window and New Level fields, Users may specify the values to be automatically applied to the specified images. Click OK when finished. Changes to the Window/Level Adjustment will be saved and appear in the Adjustments list. The new changes will automatically apply to the appropriate images the next time they are opened. In order to save changes to an auto Window/Level Adjustment, all fields must be completed. If fields are not completed appropriately, warning dialog boxes will appear prompting the user to correct the error before saving. 3. Removing Adjustments Users can delete Window/Level Adjustment by selecting the item they wish to delete from the Adjustments list and clicking Remove. The Window/Level Adjustment will be deleted immediately and will no longer automatically apply to images. 4. Adding Filters Copyright Novarad NovaPACS Diagnostic Viewer Manual

89 Chapter 7 Using the Study Browser Settings Menu To add a filter, click inside the Filters box and select the Add button at the bottom of the page. A Window Level Filter dialog box will open. The Window Level Filter dialog box allows users to manually manage filters that will apply across an entire modality. Only one filter may be created per modality. In the Modality field, specify a modality for the new filter. In the Minimum Pixel and Maximum Pixel fields, specify the appropriate values for images in the modality. Select the Use DICOM values checkbox to automatically use the DICOM values supplied by the modality. If the Use DICOM values checkbox is selected, Auto Window/Level Adjustment will not be applied to images within the specified modality that have supplied DICOM values. Click OK when finished. The new filter will be saved, appear in the Filters list, and immediately apply to all images for that modality. In order to save a new filter, all fields must be completed. If fields are not completed appropriately, warning dialog boxes will appear prompting the user to correct the error before saving. 5. Editing Filters Users can edit existing filters by selecting the item they wish to edit from the Filters list and clicking Edit. An Edit Parameters dialog box will appear, allowing users to edit filter values. Note: Users may not edit the modality of an existing Filter. Make any necessary changes and click OK when finished. Changes to the filter will be saved and appear in the Filters list. The new changes will automatically apply to the appropriate Modality. In order to save changes to a filter, all fields must be completed. If fields are not completed appropriately, warning dialog boxes will appear prompting the user to correct the error before saving. 6. Removing Filters Copyright Novarad NovaPACS Diagnostic Viewer Manual

90 Chapter 7 Using the Study Browser Settings Menu Users can delete Filters by selecting the item they wish to delete from the Filters list and clicking Remove. The Filter will be deleted immediately and will no longer apply to images in the modality. F. Labels Tab Users can change and customize the DICOM labels that appear on images in the Image Viewer. These labels provide useful patient, study, and series information. Font sizes and colors can be customized for the labels as well. (Labels automatically adjust according to each monitor s resolution.) The following sections describe Labels options: 1. Viewing the Labels Tab To view the Labels Tab, click on the Settings Menu on the Study Browser s main toolbar, and select Options. Select the Labels Tab. The Labels Tab page opens up with the default DICOM label settings displayed. These default settings are used if a specific modality s labels are not customized. Select a modality from the Modality drop-down list to view that modality s DICOM label settings. Users can create and modify their own custom labels from the Labels Tab. Note: The default color of a label is determined by the level of that label. (I.e. the Patient level has a default color of light teal; the Study level has a default color of dark teal; the Series level has a default color of purple; and the Image level has a default color of gold.) 2. Editing Label Font Size and Color To edit Label Font Size and Colors, complete the following steps: a. Select the modality you want to edit from the Modality drop-down list. b. Click the Size/Color link above the DICOM Fields section. An Edit Default Label Properties dialog box will open. Copyright Novarad NovaPACS Diagnostic Viewer Manual

91 Chapter 7 Using the Study Browser Settings Menu c. Select a label from the Select label level to edit drop-down list. The Size and Color fields will become available once a label is selected. d. Select a size for the font from the Size drop-down list. The default size is Normal. e. To change the font color, click on the colored square next to the Color field. A Color dialog box will open allowing users to select from the Basic Colors options or create a custom color using the Define Custom Colors option. To create a custom color, click on the Define Custom Colors button. Use the colors box cross-point tool and/or the Hue, Sat, Lum, Red, Green, and Blue custom boxes to define the custom color you want. Copyright Novarad NovaPACS Diagnostic Viewer Manual

92 Chapter 7 Using the Study Browser Settings Menu When you have selected your preferred color, click the Add to Custom Colors button. Select that custom color as your font color and click the OK button to save the changes. 3. Adding Labels To add a Label for a specific modality s images, complete the following steps: a. Select the modality you want the label to appear on from the Modality drop-down list. b. Select the DICOM label from the DICOM Fields list to the right of the page. c. Drag the label text onto the black image box on the page to add it to the labels for the modality s images. Note: You cannot drag a label from one section of the black image box to another. If you want to move a label from one section to another, you must first delete the image label by double-clicking it, and then drag the label onto the appropriate section. 4. Removing Labels To remove a Label, select the modality you want to remove a label from, and double-click the label on the black image box to remove it. 5. Creating Labels If there is a Label users need on images that is not available in the DICOM Fields list, labels can be created and added to any specific modality s images. Copyright Novarad NovaPACS Diagnostic Viewer Manual

93 Chapter 7 Using the Study Browser Settings Menu Note: You will need to know the specific group and element numbers located on the image to create a label (found using the Image Details option in the Image Viewer). For more information, see Chapter 12, section 12-6 Details. To create a label, complete the following steps: a. Click the Create Field option located at the bottom of the DICOM Fields list. A Create DICOM Label dialog box will appear. b. Enter the necessary information into the fields in the Create DICOM Label dialog box. The following are descriptions of the needed information: Name Enter the full name of the field. Modality Choose a modality if you want this DICOM field to be available as a label for a specific modality. Display Label Enter a short, abbreviated title for the label (i.e. ACC# for Accession Number). DICOM Tag Fields Specify from what DICOM group and element you want to pull information. Text Display Properties Use the Size drop-down list to select the text size. The default text size is Normal. Select the Color icon and choose a basic color or create a custom color. Copyright Novarad NovaPACS Diagnostic Viewer Manual

94 Chapter 7 Using the Study Browser Settings Menu To create a custom color, click on the Define Custom Colors button. Use the colors box cross-point tool and/or the Hue, Sat, Lum, Red, Green, and Blue custom boxes to define the custom color you want. When you have selected your preferred color, click the Add to Custom Colors button. Select that custom color as your font color and click the OK button to save the changes. 6. Editing DICOM Fields To edit a Label, complete the following steps: a. Select the field you want to edit from the DICOM Fields list and click the Edit Field button. An Edit DICOM Label dialog box will open. b. Make any needed changes to the information fields and click OK to save the changes. (Click Cancel to exit without saving changes.) G. Lexicon Tab A Lexicon value is one or more words commonly used to annotate images in the Image Viewer. Users can add phrases that are used frequently and have the option to select these from a list in the Image Viewer instead of manually typing them. Your administrator creates global Lexicon values available to all users, and customized values can be created by each user available only to them. The following sections describe how to add, edit, or delete Lexicon values: Copyright Novarad NovaPACS Diagnostic Viewer Manual

95 Chapter 7 Using the Study Browser Settings Menu 1. Viewing the Lexicon Tab To open the Lexicon Tab, click on the Settings Menu on the Study Browser s main toolbar, and select Options. Click on the Lexicon Tab. 2. Adding Lexicon Values To add a Lexicon value, complete the following steps: a. On the Lexicon Tab page, click the Add button at the bottom. An Add Lexicon Item dialog box will open. b. Select a modality to add a Lexicon value to from the Modality drop-down list. c. Enter the text you want into the Lexicon Text box and click OK to save the new Lexicon value. 3. Editing Lexicon Values To edit a Lexicon value, complete the following steps: a. Select the Lexicon value that you want to edit from the Lexicon list. b. Click the Edit button at the bottom of the page. An Edit Lexicon Item dialog box will open. c. Make any needed changes to the Lexicon value and click OK to save. 4. Deleting Lexicon Values To delete a Lexicon value, complete the following steps: a. Select the Lexicon value that you want to delete from the Lexicon list. b. Click the Delete button at the bottom of the page to delete the value from the list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

96 Chapter 7 Using the Study Browser Settings Menu H. Plug-ins Tab The NovaPACS Diagnostic Viewer has three Plug-ins options available: Image Rendering Provider options are DirectX and GDI+ Dictation Provider options are Basic, File, Dragon, and CMDLine CD Burning Provider options are Primera, Legacy, and Basic Note: The Dictation Provider and CD Burning Provider options may require additional software. To view and/or change the Plug-ins options, click on the Settings Menu on the Study Browser s main toolbar, and select Options. Select the Plug-ins Tab. Use the drop-down lists next to the Plug-ins options to select new options. Note: In order to edit the Plug-ins options the user s credentials must be verified as the Windows Administrator. I. Data Sources Tab Data Sources are the connections that allow the Diagnostic Viewer to communicate with the Database and Image Servers. Data Sources are the primary locations from which images are downloaded. The following sections describe how to add, edit, delete, or test Data Sources: Note: Users cannot add, edit, or delete Data Sources for DICOM Pass Through servers. For more information on DICOM Pass Through, see the segment on The Data Source Filter in Chapter 2, section 2-5 The Search Tab. 1. Viewing Data Sources To view the Data Sources page, click on the Settings Menu on the Study Browser s main toolbar, and select Options. Select the Data Sources Tab. Copyright Novarad NovaPACS Diagnostic Viewer Manual

97 Chapter 7 Using the Study Browser Settings Menu All of the currently established Data Sources are listed on the Data Sources Tab page. Users can change the Primary Archive and Image Cache options using the corresponding drop-down lists. 2. Adding a Data Source To add a Data Source, complete the following steps: a. On the Data Sources page, click the Add button at the bottom. An Add Data Sources dialog box will open. b. Enter the appropriate Friendly Name and Server Address information. c. Select the NovaPACS or DICOM source type from the Source Type section. d. If you selected the NovaPACS as the source type, select the appropriate options for the Port and Compress Options. Users can select checkboxes to Stream Images, Automatically retrieve images queued for this machine (Client Requested Transfer), and Automatically login. Note: If you select the Automatically Login option, you will be prompted to enter your user name and password and verify a login for each data source. e. If you selected the DICOM source type, enter the appropriate information for the Port and AE Title fields. 3. Editing Data Sources To edit a Data Source, complete the following steps: a. Select the Data Source listing that you want to edit from the Data Sources list. b. Click the Edit button at the bottom of the page. An Edit Data Source dialog box will open. c. Make any needed changes to the Data Source information and click OK to save. 4. Deleting Data Sources To delete a Data Source, complete the following steps: a. Select the Data Source you want to delete from the Data Sources list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

98 Chapter 7 Using the Study Browser Settings Menu b. Click the Remove button at the bottom of the page. The Data Source will be removed from the Diagnostic Viewer s Data Sources options. 5. Testing Data Sources To test a data source for proper functionality, complete the following steps: a. Select the Data Source you want to test from the Data Sources list. b. Click the Test button at the bottom of the page. c. The Diagnostic Viewer will test the Data Source. If the Data Source is functioning properly, users will not get any message; however, if the Data Source is incorrect, users will receive a warning message stating that the Data Source failed. 7-2 W/L Presets The W/L Presets option allows users to specify window/level preset values for each modality when using the Image Viewer. The Image Viewer sets default W/L values for each modality that correspond in number with the F1-F11 keys on the keyboard (i.e. F1 corresponds with the W/L setting set to 1.) Note: Up to 12 W/L Presets may be specified; however, only 11 may be accessed from default hotkeys F1-F11. W/L Preset 12 may only be accessed from the menu or toolbar. The F12 keystroke is the default hotkey for Auto Window/Level Adjustments. See Chapter 12, Section Auto W/L. The following options can be customized when using the W/L Presets option: A. Customizing the W/L Settings Users can customize the W/L values and save them to user preferences. To customize the W/L values, complete the following steps: 1. Click on the Settings Menu on the Study Browser s main toolbar and select W/L Presets. A Configure Window/Level Presets dialog box will appear. 2. Select a modality from the Modality drop-down list. 3. Select the preset value you want to assign to from the W/L Preset drop-down list. The Preset Values fields will populate with the values assigned to that W/L Preset. Copyright Novarad NovaPACS Diagnostic Viewer Manual

99 Chapter 7 Using the Study Browser Settings Menu 4. Change the Menu/Toolbar Name by entering text in the field. The Menu/Toolbar Name appears on the W/L Toolbar in the Image Viewer. 5. The Apply Current Window/Level button allows users to apply the W/L settings being used in the Image Viewer to the W/L Preset being customized. Adjust the window/level settings in the Image Viewer, then click the Apply Current Window/Level button to apply the settings to the W/L Preset. B. Customizing Width and Center for Window/Level Fields and Presets Users can customize the width and center values for the window/level fields and presets. To customize the width and center window/level values, click on the Settings Menu on the Study Browser s main toolbar and select W/L Presets. A Configure Window/Level Presets dialog box will appear. Complete one of the following steps: 1. Click the up or down arrows next to the Window (Width) and/or Level (Center) fields to choose the values. 2. Manually enter the values in the Window (Width) and/or Level (Center) fields. 3. Click the Apply Current Window/Level button to apply the settings being used in the active study in the Image Viewer. 4. To set the W/L Preset in the Image Viewer, close the Configure Window/Level Presets dialog box and go to the Image Viewer. Make any window/level adjustments needed on the image and press CTRL + F (the F key corresponding Copyright Novarad NovaPACS Diagnostic Viewer Manual

100 Chapter 7 Using the Study Browser Settings Menu to the preset you want to change i.e. F6 for preset 6). This will set the adjustments as the W/L Preset for that F key. Note: To view the saved settings in the Configure Window/Level Presets dialog box, go back to the Study Browser, click on the Settings Menu, and select W/L Presets. The Configure Window/Level Presets dialog will open. Select the modality you changed in the Image Viewer. Select the preset number you changed, and the new values will be populated in the Window (Width) and Level (Center) fields. 7-3 Manage Hanging Protocols A Hanging Protocol is a defined set of Layouts associated with a specific modality (and, optionally, study description) for displaying studies in the Image Viewer. Users can define multiple Hanging Protocols for each modality and define multiple Layouts for each Hanging Protocol. Within each Layout, users can filter individual Image Boxes to display only certain types of images. This allows users to easily create, manage, and navigate between the specific views they prefer for individual study types. Users can manage Hanging Protocols and Hanging Protocol Layouts from the Study Browser menu by clicking on the Settings Menu on the Study Browser s main toolbar, and selecting the Manage Hanging Protocols option. Users can also use the default hotkey setting of CTRL + H. A Manage Hanging Protocols editor dialog box will open. Users manage the following options: A. Add New Hanging Protocol 1. Select Modality 2. Manage Study Descriptions 3. Select a Display Tool Option 4. Select a Spine Labeling Default B. Manage Layouts Copyright Novarad NovaPACS Diagnostic Viewer Manual

101 Chapter 7 Using the Study Browser Settings Menu 1. Add Layout 2. Edit Layout a. Editing Series Layout b. Using the Image Box (Series) Tab c. Using the Filters Tab 3. Remove Layout 4. Duplicate Layout C. Edit Hanging Protocol D. Remove Hanging Protocol The following sections provide instructions for managing Hanging Protocols and Hanging Protocol Layouts from the Study Browser menu: A. Add new Hanging Protocol To add a new Hanging Protocol, click the Add New button at the bottom of the Study Types list. The Manage Hanging Protocol editor will now allow you to select options for the new Hanging Protocol. The following sections describe how to configure a new Hanging Protocol using the Manage Hanging Protocol editor. 1. Select Modality First select a modality from the Modality dropdown list. This is the modality that the new Hanging Protocol will be associated with. A modality must be selected in order to save a new Hanging Protocol. A Hanging Protocol can only be applied to a study if they are both associated with the same modality. 2. Manage Study Descriptions Next manage any Study Descriptions you wish to associate with the new Hanging Protocol. A Hanging Protocol will be applied automatically to any study that matches all of its Study Descriptions. Adding Study Descriptions also helps users distinguish what types of studies the Hanging Protocol was set up to display. Users may manually apply a Hanging Protocol to a study that does not match its study description, as long as both are associated with the same modality. To add a Study Description click the Add button to the right of the Study Descriptions list. A small text box will appear inside the Study Descriptions list. Type in an anatomical area you would like associated with the new Hanging Protocol. Repeat for as many Study Descriptions as needed. A unique Study Copyright Novarad NovaPACS Diagnostic Viewer Manual

102 Chapter 7 Using the Study Browser Settings Menu Description (or combination of Study Descriptions) must be added in order to save a new Hanging Protocol for the same modality as an existing Hanging Protocol. To edit an existing Study Description, highlight the description and click the Edit button to the right of the Study Descriptions list. To delete an existing Study Description, highlight the description and click the Remove button to the right of the Study Descriptions list. 3. Select a Display Tool Option Select an option from the Display Tool drop-down list to specify how you would like the Hanging Protocol displayed. 4. Select a Spine Labeling Default Select an option from the Spine Labeling Defaults drop-down list to specify how you would like spine labeling configured for the new Hanging Protocol. Select the Edit Options button to the right of the Spine Labeling Defaults dropdown list to customize the available spine labeling options. The Spine Labeling Options editor allows users to add, edit, and remove spine labeling options. It also allows users to customize font and font color for spine labeling options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

103 Chapter 7 Using the Study Browser Settings Menu B. Manage Layouts Users can add, edit, remove, and duplicate layouts within a Hanging Protocol using the layouts section of the Manage Hanging Protocol editor. To add a new Layout to a Hanging Protocol, click the Add New button at the bottom of the Study Types list. The Manage Hanging Protocol editor will now allow you to select options for the new Hanging Protocol Layout. Each Hanging Protocol has a Single-study and a Multi-study display mode. The Single-study display mode shows the Layouts that will be available when only one study is open. The Multi-study display mode shows the Layouts that will be available when multiple studies are open at the same time. Whenever there are no Multi-study Layouts available for the current Hanging Protocol, Single-study Layouts will be available instead. Multi-study Layouts are managed in the same way as Single-study Layouts. The following sections describe how to configure layouts using the Manage Hanging Protocol editor. 1. Add Layout To add a new layout to a Hanging Protocol, click on the Add layout link to the top right of the layouts section. A new, blank Layout will be added. Copyright Novarad NovaPACS Diagnostic Viewer Manual

104 Chapter 7 Using the Study Browser Settings Menu 2. Edit Layout To edit a layout, double click on the thumbnail image of a layout. The Edit Layout window will open. a. Editing Series Layout There are three primary ways to edit the Series Layout. 1. Click on the box with multiple green lines on it located above the image boxes. A Choose Series Layout box will open. Select the way you want your series to display by moving the mouse vertically and horizontally over the squares and clicking when the layout you want is highlighted gray. 2. OR Click on the Split Window Tools located in the top bar of an image box to edit the image layout within that image box or to split the series horizontally or vertically. Copyright Novarad NovaPACS Diagnostic Viewer Manual

105 Chapter 7 Using the Study Browser Settings Menu 3. OR Click the red X button at the top of an image box to delete that window from the series layout. b. Using the Imagebox (Series) Tab First, Select the Image Box you wish to edit. This will enable the Imagebox (Series) tab and will allow you to select image layout options for the selected portion of the layout. On the Imagebox (Series) tab, users can edit the View, Image Layout, and Clip Playback. The options for editing the View are as follows: i. Tiled ii. Cine iii. Processed By The following sections explain each of these settings. i. Tiled The images in the series can be set to be in a Tiled display. This is the default view that is usually seen. Copyright Novarad NovaPACS Diagnostic Viewer Manual

106 Chapter 7 Using the Study Browser Settings Menu When the Tiled option is selected, users then have the ability to: 1. Use the Choose Image Layout box to select how images will be displayed within the series. Select the way you want the images to display by moving the mouse vertically and horizontally over the squares and clicking when the layout you want is highlighted gray. 2. Zoom To Fit, To Fill, Custom, or No Zoom. 3. Adjust the Frame rate (controls the playback speed). 4. Select the Auto-start and Use Dicom Frame Rate checkboxes. Note: Auto-start begins to play the clip as soon as the image loads. Use Dicom Frame Rate plays the image frame rate at the recorded rate. When not checked, the Image Viewer determines the image frame rate by the Desired Frame Rate count. 5. Select Looping, Sweeping, or Stop for the Playback Sequencing. Note: Looping repeats the playback from the first image to the last, and then begins again with the first image. Sweeping repeats the playback from the first image to the last, and then from the last image to the first. Stop allows users to control image playback by manually advancing or reversing a single image with the forward and back buttons. After going to the final image, the series stops and is displayed in normal Tiled layout. ii. Cine The images in a series can be set to a Cine display. (Cine is typically used for Cardiology images.) When the Cine option is selected, users then have the ability to: 1. Set the Desired Frame Rate (controls the playback speed). Copyright Novarad NovaPACS Diagnostic Viewer Manual

107 Chapter 7 Using the Study Browser Settings Menu 2. Select the Auto-Start checkbox (begins to play the clip as soon as the image loads.) 3. Select the Use Dicom Frame Rate checkbox Note: This plays the image at the rate recorded if selected. If not selected, the Image Viewer determines the image frame rate by the Desired Frame Rate count. 4. Set the Playback Sequencing to Looping, Sweeping, or Stop Note: Looping repeats the playback from the first image to the last, and then begins again with the first image. Sweeping repeats the playback from the first image to the last, and then from the last image to the first. Stop allows users to control image playback by manually advancing or reversing a single image with the forward and back buttons. After going to the final image, the series stops and is displayed in normal Tiled layout. iii. Processed By The images in a series can be set to be processed by either MPR or by Image Fusion. Select the Processed by option from the drop-down list after selecting the Processed View. If you select the Processed by MPR option, the series will automatically display in a Multi-Planar Reconstruction (MPR) view. (This view reconstructs multiple 2D images into a multiplanar 3D view.) Novarad provides MIP/MPR functionality and support with NovaPACS. Note: If you have not used your system with the Diagnostic Viewer s MIP/MPR support, your administrator needs to contact Technical Support to configure each workstation to be able to access MIP/MPR. If you select the Processed by Image Fusion option, two series from different modalities (typically CT and PET) will fuse for a more detailed image. Note: For more information on both the Processed by MPR and Processed by Image Fusion options, see Chapter 10, section 10-9 Edit Hanging Protocols. Copyright Novarad NovaPACS Diagnostic Viewer Manual

108 Chapter 7 Using the Study Browser Settings Menu c. Using the Filters Tab First, Select the Image Box you wish to edit. This will enable the Filters tab and will allow you to select Content Filter options for the selected portion of the layout. Users can edit options in the Filters tab in the Edit Layout window. The Filters tab allows users to Add, Edit, and Remove Content Filters that manage which files are displayed in individual Image Boxes. i. Adding Content Filters To add a new Content Filter to an image box, click the Add button to the right of the Content Filters list. This will enable the Edit Filter box. ii. Editing Content Filters To enable the Edit Filter options add a new filter or select an existing filter from the Content Filters list and click Edit. The Edit Filter options allow users to Filter by Attribute Presence or Filter by Image Plane. 1. To Filter by Attribute Presence select the checkbox next to the option s title. This will enable the rest of the options associated with this filter. Next, select whether you want content included if the attribute is present or absent. Finally select the Attribute you wish to filter by from the drop-down list. The VR value will be entered automatically. Click Apply. The new filter will now appear in the Content Filters list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

109 Chapter 7 Using the Study Browser Settings Menu Note: The Image Details window will display all available attributes and their values for a selected image. Users can refer to this window if they have difficulty setting up filters. Refer to Chapter 12, section 12-6 Details for instructions on using this feature. 2. To Filter by Attribute Value select the Attribute you wish to filter by from the drop-down list. This will enable the rest of the options associated with this filter. The VR value will be entered automatically. Note: Do not select the Filter by Attribute Presence checkbox when filtering by Attribute Value. Next, select the desired Operation from the drop-down list. The operation specifies the relationship between the Attribute and the Value. Next, select the desired Value from the drop-down list (or type it in). Click Apply. The new filter will now appear in the Content Filters list. Note: The Image Details window will display all available attributes and their values for a selected image. Users can refer to this window if they have Copyright Novarad NovaPACS Diagnostic Viewer Manual

110 Chapter 7 Using the Study Browser Settings Menu difficulty setting up filters. Refer to Chapter 12, section 12-6 Details for instructions on using this feature. 3. To Filter by Image Plane select the checkbox next to the option s title. This will enable the rest of the options associated with this filter. Next, select whether you want content included that is a Member of or Not a Member of an image plane by selecting the appropriate value from the Operation drop-down list. Finally select the Image Plane you wish to filter by by selecting the appropriate option from the Value drop-down list. Click Apply. New filters will now appear in the Content Filters list. Note: Not all images are associated with an Image Plane. If an image plane is associated with an image the data will be stored in the image s Series Description. Users can view an image s Series Description from the Series List on the Study Browser. Users can also view an image s Series Description from the Image Details window. Please refer to Chapter 2, section 2-3 Series List and Chapter 12, section 12-6 Details for more information on how to use these options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

111 Chapter 7 Using the Study Browser Settings Menu 4. Users may also select whether or not they would like the rest of a series or other content that is associated with a filtered image, but does not meet filter requirements, to be displayed in the same Image Box. iii. Deleting Content Filters To delete a Content Filter, select an existing Content Filter from the Content Filters list and click Remove. When you are finished editing a layout click OK or Cancel to close the Edit Layout window and return to the Manage Hanging Protocols editor. 3. Remove Layout To delete a layout, select its thumbnail image from the Manage Hanging Protocols editor and click the Remove layout link. The selected layout will be deleted from the current Hanging Protocol. 4. Duplicate Layout To duplicate a layout, select its thumbnail image from the Manage Hanging Protocols editor and click the Duplicate layout link. The selected layout will be duplicated in the current Hanging Protocol. Copyright Novarad NovaPACS Diagnostic Viewer Manual

112 C. Edit Hanging Protocol NovaPACS Diagnostic Viewer Chapter 7 Using the Study Browser Settings Menu To edit an existing Hanging Protocol, click on its description in the Study Types list. The Manage Hanging Protocols editor will allow you to make changes to any options described in the previous sections. D. Remove Hanging Protocol To delete an existing Hanging Protocol, select its description and click the Remove button below the Study Types list. When you are finished managing Hanging Protocols, click Close to exit the Manage Hanging Protocols editor and return to the Study Browser. Note: For more information on managing and applying Hanging Protocol Layouts see Chapter 2, section 2-4 Hanging Protocol Layouts; Chapter 6, section 6-2 Hanging Protocol Layouts; Chapter 9, section 9-2 Hanging Protocol Drop-down Menu; Chapter 10, section 10-9 Managing Hanging Protocols; Chapter 10, section 37 Hanging Protocol Layouts; and Chapter 11, sections 11-3 to Configure Monitors The Configure Monitors option allows users to select monitors for viewing images. Any monitors properly connected to a user s computer will appear in the Configure Monitors window as numbered rectangles. Users can select any monitor or combination of monitors by clicking on the rectangles. To use the Configure Monitors option, click on the Settings Menu on the Study Browser s main toolbar, and select the Configure Monitors option. Users can also use the default hotkey setting of CTRL + M. A Configure Monitors dialog box will open. Users can select a monitor or combination of monitors by clicking on the rectangles. Selected monitors will have a red border around the rectangle. Deselect monitors by clicking on a selected rectangle. Copyright Novarad NovaPACS Diagnostic Viewer Manual

113 Chapter 7 Using the Study Browser Settings Menu Note: On a three-monitor system, where the third monitor is used only for displaying the Study Browser, make sure the third monitor for the Study Browser is not selected for use with images. Users can also determine whether the left monitor displays new studies or old studies by selecting the options at the bottom of the Configure Monitors dialog box. Click OK to save the monitor settings. 7-5 Preferences The Preferences option allows users to select the settings they will use for viewing and organizing images and information in the Diagnostic Viewer. Any changes a user makes to the default preferences settings are stored and automatically recalled each time that user logs into the Diagnostic Viewer. Note: We recommend that you periodically export a copy of your preferences to your desktop, a flash drive, or some other data storage device. To use the Preferences option, click on the Settings Menu on the Study Browser s main toolbar, and select the Preferences drop-down list. The following options are available: A. Reset Preferences The Reset Preferences option allows users to reset all preferences to the site s original default settings. Note: The Diagnostic Viewer will permanently overwrite any settings that have been changed in the Study Browser and the Image Viewer when the Reset Preferences option is selected. Users will receive a warning prompt before resetting. To use the Reset Preferences option, click on the Settings Menu on the Study Browser s main toolbar, and select the Preferences drop-down list. Select Reset Preferences. Click the Yes button on the warning dialog box. B. Import Preferences The Import Preferences option allows users to import preference settings from a saved location. This is helpful when sharing preference settings from one Diagnostic Viewer installation to another. Copyright Novarad NovaPACS Diagnostic Viewer Manual

114 Chapter 7 Using the Study Browser Settings Menu To use the Import Preferences option, click on the Settings Menu on the Study Browser s main toolbar, and select the Preferences drop-down list. Select Import Preferences. Browse to find the preferences file you want to import, and click Open. Note: When exiting the Diagnostic Viewer, if you have imported preferences that are not stored in the database, you will receive a warning prompt before your preferences are overwritten. C. Export Preferences The Export Preferences option allows users to save and export a copy of their user preferences in case they are ever lost or reset. To use the Export Preferences option, complete the following steps: 1. Click on the Settings Menu on the Study Browser s main toolbar, and select the Preferences drop-down list. Select Export Preferences. An Export Preferences to File dialog box will open. 2. Select a destination for the file by using the Save in drop-down list. 3. Name your preferences file in the File Name field. 4. Select a file type in the Files of type field. (It is standard to save preferences as an XML file.) 5. Click OK to export a copy of your user preferences. D. Save as Default Preferences The Save as Default Preferences option allows users to save viewer preferences for all future users on the NovaPACS server. A new profile for CD preferences can also be set for when users burn Patient CDs. Copyright Novarad NovaPACS Diagnostic Viewer Manual

115 Chapter 7 Using the Study Browser Settings Menu Note: Only an administrator can alter Default User Preferences. It is important to remember that all settings including buttons, hotkeys, and the general layout of the windows that you set are what the users will be able to use. This includes CD burning preferences. To use the Save as Default Preferences option, complete the following steps: 1. Make all of the preference changes needed (i.e. hotkeys, toolbars, image context menus, mouse settings). 2. Click on the Settings Menu on the Study Browser s main toolbar, and select the Preferences drop-down list. Select the Save as Default Preferences option. A Set Default Preferences for Profile dialog box will open. 3. Select the user role you want to save preferences for. If you are saving Patient CD preferences, select the PatientCD option. 4. Click OK to save the current user preferences to that role. Users with that selected role will now have those settings as their default settings, and will revert back to those settings if they use the Reset Preferences option. 7-6 Customize Toolbar The Customize Toolbar option allows users to edit the functions on the Study Browser s Custom Toolbar, add or remove toolbar items, and re-order the menus. The following sections describe what functions users can do with the Study Browser toolbars: Copyright Novarad NovaPACS Diagnostic Viewer Manual

116 Chapter 7 Using the Study Browser Settings Menu A. Adding Toolbar Items To add to the current toolbar items, complete the following steps: 1. Click on the Settings Menu on the Study Browser s main toolbar, and select Customize Toolbar. Users can also right-click on any toolbar in the Study Browser window and select Customize from the drop-down list. A Custom Toolbars page will open. 2. Select the toolbar that you want to add to from the Select Toolbar drop-down list. 3. Select the feature you want to add to the toolbar from the Available Items list on the left side of the page. 4. Click the Add button to add the feature to the Current Toolbar Items list. 5. Click Save to save the change(s) and exit. B. Removing Toolbar Items To remove items from the Study Browser toolbars, complete the following steps: 1. Click on the Settings Menu on the Study Browser s main toolbar, and select Customize Toolbar. Users can also right-click on any toolbar in the Study Browser window and select Customize from the drop-down list. A Custom Toolbars page will open. 2. Select the toolbar you want from the Select Toolbar drop-down list. 3. Select the feature you want to remove from the Current Toolbar Items list. 4. Click the Remove button to remove the feature from the Current Toolbar items list. 5. Click Save to save the change(s) and exit. C. Re-ordering the Menu Users can customize the Study Browser toolbars by resetting the toolbar settings, moving features up or down on the list, or changing their hierarchy level by moving them in or out on the list. To reset or re-order the Study Browser s custom toolbar, complete the following steps: 1. Click on the Settings Menu on the Study Browser s main toolbar, and select Customize Toolbar. Users can also right-click on any toolbar in the Study Browser window and select Customize from the drop-down list. A Custom Toolbars page will open. 2. Select the toolbar you want to re-order from the Select Toolbar drop-down list. 3. Select the feature you want to re-order from the Current toolbar items list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

117 Chapter 7 Using the Study Browser Settings Menu 4. Click the Reset, Move Up, Move In, Move Out, or Move Down options until the feature is located where you want. 5. Click Save to save the change(s) and exit. D. Customizing Toolbar Options To customize Toolbar Options, complete the following steps: 1. Click on the Settings Menu on the Study Browser s main toolbar, and select Customize Toolbar. Users can also right-click on any toolbar in the Study Browser window and select Customize from the drop-down list. A Custom Toolbars page will open. 2. Click on the Toolbar Options tab on the top of the page. 3. Select an option from the Button Layout drop-down list (Text Only, Image Only, and Image and Text). 4. To change the toolbar layout, click on the Auto Toolbar Layout checkbox to deselect it. 5. In the Toolbar Layout field, select an option from the Image Text Relation dropdown list (Overlay, Image Above Text, Text Above Image, Text Before Image, or Image Before Text). 6. To change the image and/or text size, click on the Auto Size checkbox to deselect it. 7. In the Image/Text Size field, select an option from the Image Size drop-down list (Normal or Large) and an option from the Text Size drop-down list (Normal, Medium, or Large). 8. Click OK to save and exit when finished. Note: For more information on customizing Study Browser toolbars, see Chapter 2, section 2-4 Using the Study Browser Menu and Custom Toolbar and Chapter 9, section 9-3 Customizing Image Viewer Toolbars. Copyright Novarad NovaPACS Diagnostic Viewer Manual

118 NovaPACS Diagnostic Viewer Chapter 8 Using the Study Browser Help Menu The Study Browser s Help Menu offers users help with using the Study Browser and Image Viewer functions. The Help Menu contains instructions, current user information, the ability to contact Novarad s customer support, the ability to submit feedback, access to the Diagnostic Viewer User Manual, and access to What s New documents detailing new features in the Diagnostic Viewer. The Help Menu is located on the Study Browser s main toolbar. This chapter addresses the following options for using the Study Browser s Help Menu: 8-1 Instructions 8-2 Current User Information 8-3 Contact Support 8-4 Submit Feedback 8-5 User Manual 8-6 What s New 8-7 About Copyright Novarad NovaPACS Diagnostic Viewer Manual

119 Chapter 8 Using the Study Browser Help Menu 8-1 Instructions The Instructions window offers users basic information about how to open case studies with the Diagnostic Viewer. The Instructions window also offers a Shortcuts section with information on mouse functionality in the Diagnostic Viewer. 8-2 Current User Information The Current User Information option shows users their role in the Diagnostic Viewer, and what features and tools are available for that role. Copyright Novarad NovaPACS Diagnostic Viewer Manual

120 Chapter 8 Using the Study Browser Help Menu 8-3 Contact Support The Contact Support option allows users to submit general questions to Novarad s Technical Support. To use the Contact Support option, complete the following steps: 1. Click the Help Menu on the Study Browser s main toolbar, and select Contact Support. A Contact NovaPACS Technical Support dialog box will open. 2. Enter the following information in the message window: a. Name b. Facility Name and Location c. Contact Phone Number and/or Address d. Complete description of the issue e. Any troubleshooting details you have tried 3. Click the Send button to the message to Novarad s Technical Support. 8-4 Submit Feedback The Submit Feedback option allows users to send product feedback and suggestions to Novarad Corporate. We value your input and recommendations to improve our products. To use the Submit Feedback option, complete the following steps: 1. Click on the Help Menu on the Study Browser s main toolbar, and select Submit Feedback. A Submit Product Feedback dialog box will appear. 2. Enter the following information in the message window: a. Name b. Facility Name and Location c. Contact Phone Number and/or Address d. Complete description of your suggestion/feedback Copyright Novarad NovaPACS Diagnostic Viewer Manual

121 Chapter 8 Using the Study Browser Help Menu 3. Click the Send button to the message to Novarad s Technical Support. 8-5 User Manual The User Manual option allows users to see the Diagnostic Viewer User Manual (in PDF). Users can search for needed information using the Table of Contents, Index, Find (CTRL + F) feature, or the PDF chapter and section bookmarks to the left of the PDF viewer window. Copyright Novarad NovaPACS Diagnostic Viewer Manual

122 Chapter 8 Using the Study Browser Help Menu 8-6 What s New The What s New option allows users to see the NovaPACS What s New document detailing the newest features in that version of the NovaPACS software (in PDF). 8-7 About The About option allows users to view type and version details about their Diagnostic Viewer. Novarad s Technical Support number is also displayed on the About NovaPACS Diagnostic Viewer page. Copyright Novarad NovaPACS Diagnostic Viewer Manual

123 NovaPACS Diagnostic Viewer Chapter 9 Using the Image Viewer When a user opens a study from the Study Browser, the images are opened and displayed using the Diagnostic Viewer s Image Viewer. The Image Viewer screen displays the images along with easy access to features on toolbars, menus, and buttons. Users can review and annotate images, customize the workspace, and complete reports from the Image Viewer. This chapter addresses the following options for using the Image Viewer: 9-1 The Image Viewer 9-2 Hanging Protocol Drop-down Menu A. Add Study Description to Current Hanging Protocol B. Create New Hanging Protocol for the Open Study s Study Description C. Save Current Layout D. Create New Layout from Current Layout E. Apply Available Hanging Protocols 9-3 Customizing Image Viewer Toolbars A. Adding Toolbar Items B. Removing Toolbar Items C. Re-Ordering the Menu D. Customizing Toolbar Options 9-4 Moving Toolbars 9-5 Locking Toolbars 9-6 Accessing Menu Options 9-7 Image Viewer Icon Buttons Copyright Novarad NovaPACS Diagnostic Viewer Manual

124 Chapter 9 Using the Image Viewer 9-8 Dragging and Dropping Images 9-1 The Image Viewer When a user opens a study from the Study Browser, the images are displayed in the Image Viewer. The images, series, and study will display in the Image Viewer window according to the default Hanging Protocols for that modality. Depending on the monitor configuration you are using, the Image Viewer will either display in front of the Study Browser window, or display on a separate monitor so both windows are visible. Note: For more information on Hanging Protocols, see Chapter 2, section 2-2 Favorite HPs; Chapter 6, section 6-2 Favorite Hanging Protocols; Chapter 7, section 7-3 Configure Default HPs; Chapter 9, section 9-2 Default Hanging Protocol Menu; Chapter 10, section 10-9 Edit Hanging Protocols and Favorite HPs. For more information on monitor configuration, see Chapter 7, section 7-4 Configure Monitors. To access the Image Viewer, double-click on a study in the Study Browser window, or select a study and click the Open button on that Study Browser list. Note: For more methods of opening studies, see Chapter 5, section 5-2 Open. To return to the Study Browser at any time from the Image Viewer, click on the Study Browser icon in the top right of the Image Viewer window, move the mouse cursor to the far left or right of the screen, or press the Space bar (the default hotkey). Note: Users must select the Auto-hide Study Browser checkbox in the Study Browser s Options menu (under the Settings Menu) to access the Study Browser window by moving the mouse to the far left/right of the window.. See Chapter 7, section 7-1 Options for more information. Users can access Image Viewer options from menus, toolbars, and hotkey settings. The Image Viewer s main menu is located in the top right corner of the window. Hotkey functions can be assigned to any of these menu functions. Users can access many functions from the Image Viewer s four default toolbars (Main Toolbar, Quick Reference Toolbar, Annotation Toolbar, and Window/Level Toolbar), or customize new toolbars. This chapter will detail how to access Image Viewer options from menus, toolbars, and hotkeys. In addition, users can access Menu items by assigning a hotkey to that function. Many of these hotkeys are available as default hotkeys. For more information on customizing hotkeys, see Chapter 7, section 7-1 Options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

125 Chapter 9 Using the Image Viewer Copyright Novarad NovaPACS Diagnostic Viewer Manual

126 Chapter 9 Using the Image Viewer The following list contains some of the Image Viewer s main elements: Quick Reference Toolbar a toolbar that has options such as Choose Series and Series Layout for quick access. This toolbar is most commonly located to the far left of the Image Viewer window, vertically aligned on the page. However, it can be moved to any other toolbar location in the Image Viewer window. Note: See Chapter 9, section 9-4 Moving Toolbars for more information on moving toolbars. Switch Between Workspaces button drop-down list that displays a list of open studies with a checkmark by the currently open study. Patient Name, Study Date, Time of Study, Anatomical Area window provides study information Close Current Study button closes the current study but keeps the Image Viewer open. Main Toolbar located at the top of the Image Viewer window with drop-down menus (Annotate, Study, Series, Image). Default Hanging Protocol drop-down menu contains options for the Image Viewer s default Hanging Protocol settings. Study Browser icon users can click this button to restore the Study Browser window. Note: For more information on activating the Study Browser, see Chapter 2, section 2-5 Activating the Study Browser. Image Viewer Menu the main menu list in the Image Viewer that contains the Study, Series, Image, Navigation, Customize Toolbars, Tools, and Help menus. Close Application button closes the entire Diagnostic Viewer application. Annotation Toolbar contains annotation features. Usually set to be located at the bottom of the Image Viewer window. Window/Level Toolbar contains Window/Level preset buttons for images. Usually set to be located at the bottom of the Image Viewer window. Users must activate the four Image Viewer toolbars to view them (Main Toolbar, Quick Reference Toolbar, Annotation Toolbar, and Window/Level Toolbar.) Users can add to or edit the Image Viewer toolbars according to preferences. New toolbars can also be created. For more information on customizing the Image Viewer toolbars, see section 9-3 Customizing Image Viewer Toolbars. Copyright Novarad NovaPACS Diagnostic Viewer Manual

127 Chapter 9 Using the Image Viewer 9-2 Hanging Protocol Drop-down Menu The Hanging Protocol Drop-down Menu displays the name of the currently applied Hanging Protocol and offers five options users can choose from: Add study description to current hanging-protocol Create new hanging-protocol for the open study s Study Description Save current Layout Create new layout from current layout Apply available Hanging Protocols associated with this modality. The following sections describe how to use these options. A. Add Study Description to Current Hanging Protocol Using this option will add the Study Description (Anatomical Area) from the current study to the currently applied Hanging Protocol. In the future, the current Hanging Protocol will be applied as the default Hanging Protocol for all studies with the added Study Description. If the user makes changes to the Layout in the Image Viewer prior to adding the Study Description, those changes will be saved to the current Layout when the Study Description is added to the Hanging Protocol. Note: For more information on managing and applying Hanging Protocol Layouts see Chapter 2, section 2-4 Hanging Protocol Layouts; Chapter 6, section 6-2 Hanging Protocol Layouts; Chapter 7, section 7-3 Managing Hanging Protocols; Chapter 10, section 10-9 Managing Hanging Protocols; Chapter 10, section 37 Hanging Protocol Layouts; and Chapter 11, sections 11-3 to B. Create New Hanging Protocol for the Open Study s Study Description Using this option will create a new Hanging Protocol with the Study Description (Anatomical Area) from the current study added. In the future, the new Hanging Protocol will be applied as the default Hanging Protocol for all studies with the added Study Description. The new Hanging Protocol will be based on the Hanging Protocol that was applied when the option was selected, and will contain all of the same Layouts as the original Hanging Protocol. If the user makes changes to the Layout in the Image Viewer prior to selecting this option, those changes will be saved to the current Layout in the new Hanging Protocol (the original Hanging Protocol will not be modified). Copyright Novarad NovaPACS Diagnostic Viewer Manual

128 Chapter 9 Using the Image Viewer C. Save Current Layout To use this option, make any desired changes to the Layout in the Image Viewer and select Save Current Layout from the drop-down menu. All changes will be saved to the current Layout in the current Hanging Protocol. If a user makes changes using the drag and drop images or the resize image box features, those changes will be saved to the layout. However, filters will remain in their original placement. Note: Please refer to Chapter 9, section 9-8 Dragging and Dropping Images for more information on making changes to the Layout in the Image Viewer. D. Create New Layout from Current Layout Using this option allows users to add a new Layout to the current Hanging Protocol directly from the Image Viewer. The new Layout will be based on the Layout that was applied when the option was selected. To use this feature, first select the Create New Layout from Current Layout option. With the new Layout applied, make any desired changes to the new Layout and select the Save Current Layout option. If users make changes to the original Layout in the Image Viewer prior to selecting the Create New Layout from Current Layout option, those changes will be saved to the original Layout as well as the new Layout. E. Apply Available Hanging Protocols After the previous options, all Hanging Protocols available for the open study will be listed on the drop-down menu. Selecting a Hanging Protocol from the list will apply it to the current study. Although Hanging Protocols associated with a study description are generally set up with a particular type of study in mind, users can apply any Hanging Protocol to the current study that is associated with the same modality, regardless of study description. 9-3 Customizing Image Viewer Toolbars Users can edit the functions on each of the Image Viewer s toolbars, add new functions, and create new toolbars. To customize the Image Viewer toolbars, complete the following steps: 1. Right-click on any toolbar in the Image Viewer window, and select Customize from the drop-down list. A Custom Toolbars page will open. 2. Select the toolbar you want to customize from the Select Toolbar drop-down list (Main Toolbar, Quick Reference Buttons, Default Window Level Toolbar, or Default Annotation Toolbar). 3. Choose from the following available options to the right of the Select Toolbar dropdown list: New Toolbar allows users to add a new toolbar Edit Name allows users to edit the toolbar name Remove Toolbar allows users to delete the toolbar Copyright Novarad NovaPACS Diagnostic Viewer Manual

129 Chapter 9 Using the Image Viewer The following sections describe what functions users can do with the Image Viewer toolbars: A. Adding Toolbar Items To add to the current toolbar items, complete the following steps: 1. Select the toolbar that you want to add to from the Select Toolbar drop-down list in the Custom Toolbars page. 2. Select the feature you want to add to the toolbar from the Available Items list on the left side of the page. 3. Click the Add button to add the feature to the Current Toolbar Items list. 4. Click Save to save the change and exit. B. Removing Toolbar Items To remove items from the Image Viewer toolbars, complete the following steps: 1. Select the toolbar you want from the Select Toolbar drop-down list in the Custom Toolbars page. 2. Select the feature you want to remove from the Current Toolbar Items list. 3. Click the Remove button to remove the feature from the Current Toolbar items list. 4. Click Save to save the change and exit. C. Re-ordering the Menu Users can customize the Image Viewer toolbars by resetting the toolbar settings, moving features up or down on the list, or changing their hierarchy level by moving them in or out on the list. To reset or re-order the Image Viewer toolbars, complete the following steps: 1. Select the toolbar you want to re-order from the Select Toolbar drop-down list in the Customize Toolbars page. 2. Select the feature you want to re-order from the Current toolbar items list. 3. Click the Reset, Move Up, Move In, Move Out, or Move Down options until the feature is located where you want. 4. Click Save to save the changes and exit. D. Customizing Toolbar Options To customize Toolbar Options, complete the following steps: 1. Click on the Toolbar Options tab on the Custom Toolbars page. 2. Select an option from the Button Layout drop-down list (Text Only, Image Only, and Image and Text). 3. To change the toolbar layout, click on the Auto Toolbar Layout checkbox to deselect it. 4. In the Toolbar Layout field, select an option from the Image Text Relation dropdown list (Overlay, Image Above Text, Text Above Image, Text Before Image, or Image Before Text). Copyright Novarad NovaPACS Diagnostic Viewer Manual

130 Chapter 9 Using the Image Viewer 5. To change the image and/or text size, click on the Auto Size checkbox to deselect it. 6. In the Image/Text Size field, select an option from the Image Size drop-down list (Normal or Large) and an option from the Text Size drop-down list (Normal, Medium, or Large). 7. Click OK to save and exit when finished. 9-4 Moving Toolbars Users can move each of the four default toolbars, along with any toolbar created, to the top, bottom, or sides of the Image Viewer window. To move a toolbar in the Image Viewer window, complete the following steps: 1. Right-click on any toolbar in the Image Viewer window, and make sure the Lock Toolbars option is not checked in the drop-down list. 2. Drag the toolbar you want to move by clicking on the gray dots to the left of the buttons. 3. Drop the toolbar in the new location. Toolbars can also be hidden from the Image Viewer window by right-clicking any toolbar, and deselecting the toolbar name in the drop-down list. 9-5 Locking Toolbars Users can select the Lock Toolbars option to lock the toolbars so they cannot be dragged and dropped to a new location. The toolbars will remain in their locations unless the user deselects the Lock Toolbars option. To lock the toolbars, right-click anywhere on a toolbar in the Image Viewer window, and select the Lock Toolbars option from the drop-down list. 9-6 Accessing Menu Options The Menu list in the Image Viewer contains the Study, Series, Image, Navigation, Customize Toolbars, Tools, and Help menus. Chapters 10 through 13 offer more details on the Image Viewer s menu functions. Copyright Novarad NovaPACS Diagnostic Viewer Manual

131 Chapter 9 Using the Image Viewer 9-7 Image Viewer Icon Buttons In the Image Viewer window, each image in a series or study will display with icons in the corner that users can access for different functions. The following list describes the icons on images in the Image Viewer: a. Choose Image Layout icon opens the Choose Image Layout dialog box to allow users to choose how images are laid out in a series. b. Split Window Horizontally icon splits the layout window horizontally into separate windows. Each layout window in the Image Viewer can be split horizontally. c. Split Window Vertically icon splits the layout window vertically into separate windows. Each layout window in the Image Viewer can be split vertically. d. Edit HP icon opens the Edit Layout dialog box Note: See Hanging Protocols in Chapters 2, 6, 7, 9, and 10. e. Close Study/Series icon closes only the study or series currently open. f. Maximize/Minimize Window Layout icon maximizes or minimizes only the study or series currently open. g. Close Window Layout icon closes the window layout from view in the Image Viewer window. Copyright Novarad NovaPACS Diagnostic Viewer Manual

132 Chapter 9 Using the Image Viewer 9-8 Dragging and Dropping Images In the image viewer window, users may now drag and drop images into any series space on any monitor. This feature helps to facilitate comparision between images in different studies. Users may also drag a side of an Image Box to resize it. The following sections provide instructions on how to use the drag and drop feature. A. Dragging from Image Box Users can drag and drop images into any series space from the image display box by completing the following steps: 1. Hover the cursor over the top bar of the image display box for the image to be moved (where the Series ID number and Split Window Tools are). 2. Click and hold the mouse button. 3. Drag the cursor over any series space on any monitor. 4. Release the mouse button. The dragged image will then display in the selected image box. B. Dragging from Choose Series Thumbnail Users can drag and drop images into any series space from the Choose Series Thumbnail by completing the following steps: 1. Access the Choose Series thumbnail box from Menu Study Choose Series or by launching it from the quick access toolbar. 2. Hover the cursor over the thumbnail of the image you wish to move. 3. Click and hold the mouse button. 4. Drag the cursor over any series space on any monitor. 5. Release the mouse button. The dragged image will then display in the selected image box. Copyright Novarad NovaPACS Diagnostic Viewer Manual

133 Chapter 9 Using the Image Viewer C. Dragging Images within a Study Images that are dragged and dropped to an empty series space within the same study will be moved to the new display location without any additional labeling or conditions. Only the visible image will be moved, not the entire series. Note: If an image is dragged and dropped to an image box that already contains a series, the entire series will switch display boxes with the other. D. Dragging Images between Studies To drag images to a display box in another study, both studies must be from the same patient. Images that are dragged and dropped to a display box in a different study, will continue to display in their original study. Only the visible image will display in the new study, not the entire series. Images moved from a comparison study to display in a new study will retain all comparison labeling. The moved image will continue to display in the new image box even if its original study is closed. Images moved to display in a new study will not be saved in the new study or deleted from their original study. E. Resizing Images To resize an Image Box, hover the cursor over any side of the Image Box that is adjacent to another Image Box. A white, double-pointed arrow will appear. Click and drag the side of the Image Box to the desired position. Both of the adjacent Image Boxes will be resized. F. Saving changes Changes made in the Image Viewer can be saved to the Layout by using the Hanging Protocol drop-down list option Save Current Layout. All changes that alter image box size or shape will be saved. Although content will move with an image box as it is dragged and dropped during viewing, those changes to content placement cannot be permanently saved as part of the permanent Layout. Content placement will reset when the layout is reapplied. Content Filters cannot be dragged and dropped and will remain in there original placement. To manage content placement in a permanent Layout use the Filters options in the Manage Layout window. Note: For more information on managing Content Filters please refer to Chapter 7, section 7-3 Manage Hanging Protocols or Chapter 10, section 10-9 Manage Hanging Protocols. Copyright Novarad NovaPACS Diagnostic Viewer Manual

134 NovaPACS Diagnostic Viewer Chapter 10 Using the Image Viewer Study Menu The Image Viewer s Study Menu contains many functions to help users as they work with images. The Study Menu is located on the Image Viewer s Menu list. Note: The Image Viewer s toolbars can be customized to contain frequently used functions from any menu to increase efficiency. Users can also add any options or functions to Image Context Menus for quick access in the Image Viewer. For more information on adding items to the Image Viewer toolbars, see Chapter 9, section 9-3 Customizing Image Viewer Toolbars. For more information on adding items to Image Context Menus, see Chapter 7, section 7-1 Options. This chapter addresses the following options for using the Image Viewer s Study Menu: 10-1 Patient History A. Resizing Column Headings B. Choosing Column Headings C. Sorting Data in a Column D. Changing the Order of Columns E. Resizing Lists 10-2 Select All Series 10-3 Close Study 10-4 Close Study and Show Study Browser 10-5 Close Workspace 10-6 Close All Workspaces 10-7 Close All Workspaces and Show Study Browser 10-8 Mark Reviewed, Close Workspace, and Show Study Browser 10-9 Manage Hanging Protocols A. Add New Hanging Protocol 1. Select Modality 2. Manage Study Descriptions 3. Select a Display Tool Option 4. Select a Spine Labeling Default B. Manage Layouts 1. Add Layout 2. Edit Layout a. Editing Series Layout Copyright Novarad NovaPACS Diagnostic Viewer Manual

135 Chapter 10 Using the Image Viewer Study Menu b. Using the Image Box (Series) Tab c. Using the Filters Tab C. Edit Hanging Protocol D. Remove Hanging Protocol Add Split Choose Series Auto Sync Cross Localize Point Cross Localize Set Sync Aggregate Print A. Selecting a Printer B. Printing to the Default Printer Route Documents Exam Report Manage Reports Workflow RIS Information Dictate Echocardiogram Measurements Launch Cardio Reporting Launch Mammo Viewer View Study on Other Workstation Launch Orthopedic Tools Assign Password Notes Collaboration A. Checkout B. Undo Checkout C. Verified D. Reviewed E. Reset Status to New F. Peer Review G. Utilization Review Research Upload to GlobalRad Save View Settings Show All Series Series Layout Hanging Protocol Layouts Minimize Exit Copyright Novarad NovaPACS Diagnostic Viewer Manual

136 Chapter 10 Using the Image Viewer Study Menu 10-1 Patient History The Patient History option in the Image Viewer allows users to see all of the studies administered to that patient from all time periods and modalities in the Studies list. The Series list displays the series within the selected (highlighted) study. Note: The Patient History information is the same patient history information from the Patient History list in the Study Browser. Users can use the toolbar buttons in the Patient History dialog box to Select All, Open, and Open in Current Workspace. Users can also access other features from the Patient History dialog box using the toolbar buttons. The Report button allows users to view the patient s diagnostic report. The RIS Info button allows users to view information pulled from NovaRIS, including the patient s name, accession #, complaint, Referring info, order notes, and procedure info. The Documents button allows users to see NovaRIS patient and order documents. Users can customize the columns in the Patient History dialog box. The column headings can be rearranged, added, removed, and/or sized to fit the information. The following sections describe how to customize the Patient History dialog box columns: A. Resizing Column Headings Users can resize column headings to fit the information better. To resize column headings, complete the following steps: 1. Move the mouse pointer over the end of the column you want to resize. The pointer should change to a double-ended arrow when it is in the right place. Copyright Novarad NovaPACS Diagnostic Viewer Manual

137 Chapter 10 Using the Image Viewer Study Menu 2. Click and drag the column heading to the desired length. OR Double-click on the end of the column heading (when the pointer is a doubleended arrow) and it will automatically resize to fit the content. B. Choosing Column Headings Users can choose the columns they want to display in the Patient History list. To choose the column headings in the Patient History list, complete the following steps: 1. Right-click on the column heading in either the Studies list or the Series list (depending on which column you want to edit). A drop-down list will appear that lists all the available column heading options, with checkmarks next to the column headings that are currently being displayed in the list. 2. Click on column heading options to select or deselect them for display in the Patient History list. C. Sorting Data in a Column Users can sort the information in a column list by clicking the column heading once with the mouse. The column information will be automatically sorted alphabetically or numerically in ascending order. Click the column heading again to reverse the sort order to descending. D. Changing the Order of Columns Users can change the order in which the columns appear in a list. To change the order of the columns in a list, complete the following steps: 1. Click the column heading that you want to move (left-click). 2. Drag the column heading to the new location and release when it is in place. Note: You will see a blue line by the column headings as you drag the column heading. The blue line indicates where the column heading will reside if you release the mouse click. E. Resizing Lists Users can resize the lists in the Patient History dialog box. To resize the lists, complete the following steps: Copyright Novarad NovaPACS Diagnostic Viewer Manual

138 Chapter 10 Using the Image Viewer Study Menu 1. Move the mouse pointer over the dividing line between the lists until the cursor becomes a double-ended arrow. 2. Click and drag the dividing line to your desired height Select All Series The Select All Series option allows users to select all of the series in an active study. This is helpful when wanting to apply changes to multiple series at the same time. To use the Select All Series option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Select All Series option from the list. Each series will now be highlighted in red, showing they are active Close Study The Close Study option allows users to close the active study while leaving the Image Viewer open. To use the Close Study option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Close Study option from the list. Note: Users can also press the red X button next to the study and patient information in the Image Viewer to close the active study while leaving the Image Viewer open Close Study and Show Study Browser The Close Study and Show Study Browser option allows users to close the active study and view the Study Browser window in front of the Image Viewer window. To use the Close Study and Show Study Browser option, click on the Image Viewer s Menu in the top right of the Copyright Novarad NovaPACS Diagnostic Viewer Manual

139 Chapter 10 Using the Image Viewer Study Menu window and select the Study Menu. Select the Close Study and Show Study Browser option from the list. Note: If other studies are open in other workspaces, they will remain open. The Study Browser window will still show in front of the Image Viewer window Close Workspace The Close Workspace option allows users to close the active workspace. To use the Close Workspace option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Close Workspace option from the list. Note: If other workspaces are open in the Image Viewer, they will remain open Close All Workspaces The Close All Workspaces option allows users to close all of the workspaces open in the Image Viewer. To use the Close All Workspaces option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Close All Workspaces option from the list. Users can also use the default hotkey setting of CTRL + Shift + F Close All Workspaces and Show Study Browser The Close All Workspaces and Show Study Browser option allows users to close all open workspaces in the Image Viewer and view the Study Browser window. To use the Close All Workspaces and Show Study Browser option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Close All Workspaces and Show Study Browser option from the list. Users can also use the default hotkey setting of pressing the Space bar Mark Reviewed, Close Workspace, and Show Study Browser The Mark Reviewed, Close Workspace, and Show Study Browser option allows users to mark a study Reviewed when closing it, and view the Study Browser window. Note: If you have the Prompt before marking a study reviewed or Prompt before marking a study reviewed if it has not been completely reviewed option selected, a dialog box will appear asking you if you are sure you want to mark the study Reviewed. If other studies are open in Copyright Novarad NovaPACS Diagnostic Viewer Manual

140 Chapter 10 Using the Image Viewer Study Menu other workspaces, they will remain open. The Study Browser window will appear in front of the Image Viewer window. To use the Mark Reviewed, Close Workspace, and Show Study Browser option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Mark Reviewed, Close Workspace, and Show Study Browser option from the list Manage Hanging Protocols A Hanging Protocol is a defined set of Layouts associated with a specific modality or study description for displaying study images in the Image Viewer. Users can define multiple Hanging Protocols for each modality and define multiple Layouts for each Hanging Protocol. Within each Layout, users can filter individual Image Boxes to display only certain types of images. This allows users to easily create, manage, and navigate between the specific views they prefer for individual study types. Users can manage Hanging Protocols and Hanging Protocol Layouts from the Image Viewer menu by navigating to Menu Study Edit Hanging Protocols. A Manage Hanging Protocols editor dialog box will open. Users manage the following options: A. Add New Hanging Protocol 1. Select Modality 2. Manage Study Descriptions 3. Select a Display Tool Option 4. Select a Spine Labeling Default B. Manage Layouts 1. Add Layout 2. Edit Layout a. Editing Series Layout Copyright Novarad NovaPACS Diagnostic Viewer Manual

141 Chapter 10 Using the Image Viewer Study Menu b. Using the Image Box (Series) Tab c. Using the Filters Tab 3. Remove Layout 4. Duplicate Layout C. Edit Hanging Protocol D. Remove Hanging Protocol The following sections provide instructions for managing Hanging Protocols and Hanging Protocol Layouts from the Image Viewer menu: A. Add new Hanging Protocol To add a new Hanging Protocol, click the Add New button at the bottom of the Study Types list. The Manage Hanging Protocol editor will now allow you to select options for the new Hanging Protocol. The following sections describe how to configure a new Hanging Protocol using the Manage Hanging Protocol editor. 1. Select Modality First select a modality from the Modality dropdown list. This is the modality that the new Hanging Protocol will be associated with. A modality must be selected in order to save a new Hanging Protocol. 2. Manage Study Descriptions Next manage any Study Descriptions you wish to associate with the new Hanging Protocol. A Hanging Protocol will be applied automatically to any study that matches all of its Study Descriptions. Adding Study Descriptions also helps users distinguish what types of studies the Hanging Protocol was set up to display. To add a Study Description click the Add button to the right of the Study Descriptions list. A small text box will appear inside the Study Descriptions list. Type in an anatomical area you would like associated with the new Hanging Protocol. Repeat for as many Study Descriptions as needed. A unique Study Description (or combination of Study Descriptions) must be added in order to save a new Hanging Protocol associated with the same modality as an existing Hanging Protocol. To edit an existing Study Description, highlight the description and click the Edit button to the right of the Study Descriptions list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

142 Chapter 10 Using the Image Viewer Study Menu To delete an existing Study Description, highlight the description and click the Remove button to the right of the Study Descriptions list. 3. Select a Display Tool Option Select an option from the Display Tool drop-down list to specify how you would like the Hanging Protocol displayed. 4. Select a Spine Labeling Default Select an option from the Spine Labeling Defaults drop-down list to specify how you would like spine labeling configured for the new Hanging Protocol. Select the Edit Options button to the right of the Spine Labeling Defaults dropdown list to customize the available spine labeling options. The Spine Labeling Options editor allows users to add, edit, and remove spine labeling options. It also allows users to customize font and font color for spine labeling options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

143 B. Manage Layouts NovaPACS Diagnostic Viewer Chapter 10 Using the Image Viewer Study Menu Users can add, edit, remove, and duplicate layouts within a Hanging Protocol using the layouts section of the Manage Hanging Protocol editor. To add a new Layout to a Hanging Protocol, click the Add New button at the bottom of the Study Types list. The Manage Hanging Protocol editor will now allow you to select options for the new Hanging Protocol Layout. Each Hanging Protocol has a Single-study and a Multi-study display mode. The Single-study display mode shows the Layouts that will be available when only one study is open. The Multi-study display mode shows the Layouts that will be available when multiple studies are open at the same time. Whenever there are no Multi-study Layouts available for the current Hanging Protocol, Single-study Layouts will be available instead. Multi-study Layouts are managed in the same way as Single-study Layouts. The following sections describe how to configure a new layouts using the Manage Hanging Protocol editor. 1. Add Layout To add a new layout to a Hanging Protocol, click on the Add layout link to the top right of the layouts section. A new, blank Layout will be added. 2. Edit Layout To edit a layout, double click on the thumbnail image of a layout. The Edit Layout window will open. Copyright Novarad NovaPACS Diagnostic Viewer Manual

144 Chapter 10 Using the Image Viewer Study Menu a. Editing Series Layout There are three primary ways to edit the Series Layout. 4. Click on the box with multiple green lines on it located above the image boxes. A Choose Series Layout box will open. Select the way you want your series to display by moving the mouse vertically and horizontally over the squares and clicking when the layout you want is highlighted gray. 5. OR Click on the Split Window Tools located in the top bar of an image box to edit the image layout within that image box or to split the series horizontally or vertically. Copyright Novarad NovaPACS Diagnostic Viewer Manual

145 Chapter 10 Using the Image Viewer Study Menu 6. OR Click the red X button at the top of an image box to delete that window from the series layout. b. Using the Imagebox (Series) Tab First, Select the Image Box you wish to edit. This will enable the Imagebox (Series) tab and will allow you to select image layout options for the selected portion of the layout. On the Imagebox (Series) tab, users can edit the View, Image Layout, and Clip Playback. The options for editing the View are as follows: iv. Tiled v. Cine vi. Processed By The following sections explain each of these settings. iv. Tiled The images in the series can be set to be in a Tiled display. This is the default view that is usually seen. Copyright Novarad NovaPACS Diagnostic Viewer Manual

146 Chapter 10 Using the Image Viewer Study Menu When the Tiled option is selected, users then have the ability to: 1. Use the Choose Image Layout box to select how images will be displayed within the series. Select the way you want the images to display by moving the mouse vertically and horizontally over the squares and clicking when the layout you want is highlighted gray. 2. Zoom To Fit, To Fill, Custom, or No Zoom. 3. Adjust the Frame rate (controls the playback speed). 4. Select the Auto-start and Use Dicom Frame Rate checkboxes. Note: Auto-start begins to play the clip as soon as the image loads. Use Dicom Frame Rate plays the image frame rate at the recorded rate. When not checked, the Image Viewer determines the image frame rate by the Desired Frame Rate count. 5. Select Looping, Sweeping, or Stop for the Playback Sequencing. Note: Looping repeats the playback from the first image to the last, and then begins again with the first image. Sweeping repeats the playback from the first image to the last, and then from the last image to the first. Stop allows users to control image playback by manually advancing or reversing a single image with the forward and back buttons. After going to the final image, the series stops and is displayed in normal Tiled layout. v. Cine The images in a series can be set to a Cine display. (Cine is typically used for Cardiology images.) When the Cine option is selected, users then have the ability to: 1. Set the Desired Frame Rate (controls the playback speed). Copyright Novarad NovaPACS Diagnostic Viewer Manual

147 Chapter 10 Using the Image Viewer Study Menu 2. Select the Auto-Start checkbox (begins to play the clip as soon as the image loads.) 3. Select the Use Dicom Frame Rate checkbox Note: This plays the image at the rate recorded if selected. If not selected, the Image Viewer determines the image frame rate by the Desired Frame Rate count. 4. Set the Playback Sequencing to Looping, Sweeping, or Stop Note: Looping repeats the playback from the first image to the last, and then begins again with the first image. Sweeping repeats the playback from the first image to the last, and then from the last image to the first. Stop allows users to control image playback by manually advancing or reversing a single image with the forward and back buttons. After going to the final image, the series stops and is displayed in normal Tiled layout. vi. Processed By The images in a series can be set to be processed by either MPR or by Image Fusion. Select the Processed by option from the drop-down list after selecting the Processed View. If you select the Processed by MPR option, the series will automatically display in a Multi-Planar Reconstruction (MPR) view. (This view reconstructs multiple 2D images into a multiplanar 3D view.) Novarad provides MIP/MPR functionality and support with NovaPACS. Note: If you have not used your system with the Diagnostic Viewer s MIP/MPR support, your administrator needs to contact Technical Support to configure each workstation to be able to access MIP/MPR. If you select the Processed by Image Fusion option, two series from different modalities (typically CT and PET) will fuse for a more detailed image. Note: For more information on both the Processed by MPR and Processed by Image Fusion options, see Chapter 10, section 10-9 Edit Hanging Protocols. Copyright Novarad NovaPACS Diagnostic Viewer Manual

148 Chapter 10 Using the Image Viewer Study Menu c. Using the Filters Tab First, Select the Image Box you wish to edit. This will enable the Filters tab and will allow you to select Content Filter options for the selected portion of the layout. Users can edit options in the Filters tab in the Edit Layout window. The Filters tab allows users to Add, Edit, and Remove Content Filters that manage which files are displayed in individual Image Boxes. vii. Adding Content Filters To add a new Content Filter to an image box, click the Add button to the right of the Content Filters list. This will enable the Edit Filter box. viii. Editing Content Filters To enable the Edit Filter options add a new filter or select an existing filter from the Content Filters list and click Edit. The Edit Filter options allow users to Filter by Attribute Presence or Filter by Image Plane. 1. To Filter by Attribute Presence select the checkbox next to the option s title. This will enable the rest of the options associated with this filter. Next, select whether you want content included if the attribute is present or absent. Finally select the Attribute you wish to filter by from the drop-down list. The VR value will be entered automatically. Click Apply. New filters will now appear in the Content Filters list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

149 Chapter 10 Using the Image Viewer Study Menu Note: The Image Details window will display all available attributes and their values for a selected image. Users can refer to this window if they have difficulty setting up filters. Refer to Chapter 12, section 12-6 Details for instructions on using this feature. 2. To Filter by Attribute Value select the Attribute you wish to filter by from the drop-down list. This will enable the rest of the options associated with this filter. The VR value will be entered automatically. Note: Do not select the Filter by Attribute Presence checkbox when filtering by Attribute Value. Next, select the desired Operation from the drop-down list. The operation specifies the relationship between the Attribute and the Value. Next, select the desired Value from the drop-down list (or type it in). Click Apply. The new filter will now appear in the Content Filters list. Note: The Image Details window will display all available attributes and their values for a selected image. Users can refer to this window if they have difficulty setting up filters. Refer to Chapter 12, section 12-6 Details for instructions on using this feature. Copyright Novarad NovaPACS Diagnostic Viewer Manual

150 Chapter 10 Using the Image Viewer Study Menu 3. To Filter by Image Plane select the checkbox next to the option s title. This will enable the rest of the options associated with this filter. Next, select whether you want content included that is a Member of or Not a Member of an image plane by selecting the appropriate value from the Operation drop-down list. Finally select the Image Plane you wish to filter by by selecting the appropriate option from the Value drop-down list. Click Apply. New filters will now appear in the Content Filters list. Note: Not all images are associated with an Image Plane. If an image plane is associated with an image the data will be stored in the image s Series Description. Users can view an image s Series Description from the Series List on the Study Browser. Users can also view an image s Series Description from the Image Details window. Please refer to Chapter 2, section 2-3 Series List and Chapter 12, section 12-6 Details for more information on how to use these options. 4. Users may also select whether or not they would like the rest of a series or other content that is associated with a filtered image, but does not meet filter requirements, to be displayed in the same Image Box. Copyright Novarad NovaPACS Diagnostic Viewer Manual

151 Chapter 10 Using the Image Viewer Study Menu ix. Deleting Content Filters To delete a Content Filter, select an existing Content Filter from the Content Filters list and click Remove. When you are finished editing a layout click OK or Cancel to close the Edit Layout window and return to the Manage Hanging Protocols editor. 3. Remove Layout To delete a layout, select its thumbnail image from the Manage Hanging Protocols editor and click the Remove layout link. The selected layout will be deleted from the current Hanging Protocol. 4. Duplicate Layout To duplicate a layout, select its thumbnail image from the Manage Hanging Protocols editor and click the Duplicate layout link. The selected layout will be duplicated in the current Hanging Protocol. C. Edit Hanging Protocol To edit an existing Hanging Protocol, click on its description in the Study Types list. The Manage Hanging Protocols editor will allow you to make changes to any options described in the previous sections. Copyright Novarad NovaPACS Diagnostic Viewer Manual

152 D. Remove Hanging Protocol NovaPACS Diagnostic Viewer Chapter 10 Using the Image Viewer Study Menu To delete an existing Hanging Protocol, select its description and click the Remove button below the Study Types list. When you are finished managing Hanging Protocols, click Close to exit the Manage Hanging Protocols editor and return to the Image Viewer. Note: For more information on managing and applying Hanging Protocol Layouts see Chapter 2, section 2-4 Hanging Protocol Layouts; Chapter 6, section 6-2 Hanging Protocol Layouts; Chapter 7, section 7-3 Managing Hanging Protocols; Chapter 9, section 9-2 Hanging Protocol Drop-down Menu; Chapter 10, section 37 Hanging Protocol Layouts; and Chapter 11, sections 11-3 to Add Split The Add Split option allows users to split the Image Viewer s viewing area in half. The new viewing space will open to the right of the current study open. If the user has more than one study open from a patient (open in tabs at the top of the Image Viewer window), the new viewing space will automatically populate with the second study. If a second study for a patient is not open, the new space will remain empty. Users can also click and drag an open image into the new window created. To use the Add Split option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Add Split option from the list Choose Series The Choose Series option allows users to see all the series in the current study in a thumbnail view list. Users can select other series to view from this list. To use the Choose Series option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Choose Series option from the list. The Choose Series list will disappear from view after interacting with the Image Viewer unless the Stay Visible checkbox is selected at the top of the list. The Choose Series list can be moved anywhere in the viewing area by clicking and dragging it to a new location. Users can resize the Choose Series list box by placing the mouse pointer in the corner of the box until the cursor becomes a double-ended arrow, and clicking and dragging to the desired size. To open a new series using the Choose Series list, complete one of the following steps: 1. Drag the thumbnail image from the Choose Series list into the series window. Copyright Novarad NovaPACS Diagnostic Viewer Manual

153 Chapter 10 Using the Image Viewer Study Menu 2. Select an image window in the viewing area. (It will highlight red around the edges.) Double-click on the thumbnail image from the Choose Series list and it will open in that selected image window Auto Sync The Auto Sync option allows users to set images to synchronize as they are scrolled (in coplanar series). If the Auto Sync option is selected, it will remain on for all subsequent studies until deselected. To use the Auto Sync option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Auto Sync option from the list. Users can also use the default hotkey setting of the letter S. To scroll through synchronized images, complete one of the following steps: 1. Left-click on an image and drag the cursor up or down on the image. 2. Press the left or right arrow keys on the keyboard. The synchronized images in the other windows will scroll in sync with the image you are scrolling Cross Localize The Cross Localize option allows users to view a line of intersection between two orthogonal images. A linear reference marker will appear in all open series windows that correlate to the selected image. Images will still be cross-localized as the user scrolls through them. To cross localize two images, complete the following steps: 1. Select an image that you want to Cross Localize. (More than one series needs to be viewable in the Image Viewer window.) 2. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Cross Localize option from the list. Users can also use the default hotkey setting of the letter X. The linear reference marker will appear in all visible series that correlate to the selected image Point Cross Localize The Point Cross Localize option allows users to select a point on an image, and the Image Viewer will find the intersecting images in all orthogonal series. The Auto Sync option must be activated to use the Point Cross Localize option. Copyright Novarad NovaPACS Diagnostic Viewer Manual

154 Chapter 10 Using the Image Viewer Study Menu To use the Point Cross Localize option, complete the following steps: 1. Select an image that you want to use the Point Cross Localize option with. 2. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Point Cross Localize option from the list. 3. Right-click on the point you want in the selected image. A bulls-eye image will appear on that point; the same point will be located in the other images in the Image Viewer window Set Sync The Set Sync option allows users to link series from different studies to a frame reference of choice. If the user wants to compare two separate studies side-by-side, they can choose the specific image in a series that they want to start synchronization from using the Set Sync option. The Set Sync option will enable the Auto Sync option when selected. After the Set Sync option is set, the Image Viewer will synchronize the image slices as the user scrolls. Note: The Set Sync option affects how the two series synchronize with each other; the Auto Sync within each series will remain the same. To use the Set Sync option, complete the following steps: 1. Open the comparative studies so the Image Viewer displays both. 2. Scroll through the images in each series until the images to synchronize are both visible and selected (highlighted red). 3. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu Aggregate The Aggregate option allows users to select images from various studies or series and display them in a single series window. The Aggregate series created is temporary and will not exist after the window is closed. To use the Aggregate option, complete the following steps: 1. Open images from one or more series in the Image Viewer window. 2. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Aggregate option from the list. An empty Aggregate window will open. 3. Click on the top bar of the series (where the Series ID number and Split Window Tools are). Hold the CTRL key while dragging and dropping the series into the Aggregate series window. Users can select any number of series to drop into the Aggregate series. Copyright Novarad NovaPACS Diagnostic Viewer Manual

155 Chapter 10 Using the Image Viewer Study Menu Note: For more information on moving images, see Chapter 12, section 12-9 Move Images. If you want to create a custom series of images to save, see Chapter 12, section Key Image Series Print The Print option allows users to print images. Users can choose to print to a default printer or select another printer. This allows users to print to paper or film. The following sections describe how to use the Print option: A. Selecting a Printer To print using a printer that is not the default printer, complete the following steps: 1. (If you are printing all of the open images in the active study or series, you do not need to select images before selecting the Print option.) Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Print option from the list. A Print Wizard dialog box will open. Note: If you are printing selected images, select the images before selecting the Print option (it will highlight in red when selected). 2. Select the Print using a DICOM printer I will select option. 3. Select an option under the Which images will be printed? section. Users can choose from options to print all open images in the active series or study, or to print selected images in the active series or study. 4. Select an option for printing clips. Users can select to print only the active frame or all frames. 5. If you want each series to start printing on a new page, select the Start each series on a new page checkbox. 6. Click the Next button when finished making selections. A Printer Options dialog box will appear. 7. Select a printer from the Printer drop-down list. Note: If the printer you need is not on the Printer drop-down list, contact your Administrator. Printers and their printing formats are configured by the Administrator, Novarad s Technical Support, and the printer s vendor. Copyright Novarad NovaPACS Diagnostic Viewer Manual

156 Chapter 10 Using the Image Viewer Study Menu 8. Click on the black Image Format window to select the format for the image. 9. Select printing format options from the drop-down lists and checkboxes. Note: The printer s abilities and the vendor settings determine the printing formats. 10. If you do not want image labels or overlays (annotations) printed on the images, deselect the checkboxes for these options. They are selected by default. 11. Click the Next button. A final page will open telling the user to Click Finish to start printing. Users can click the Back button if they need to make any changes, or click the Finish button to print. B. Printing to the Default Printer To print to the computer s default (paper) printer, complete the following steps: 1. (If you are printing all of the open images in the active study or series, you do not need to select images before selecting the Print option.) Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Print option from the list. A Print Wizard dialog box will open. If you are printing selected images, select the images before selecting the Print option (it will highlight in red when selected). 2. Select the Print using my computer s default printer option. 3. Select an option under the Which images will be printed? section. Users can choose from options to print all open images in the active series or study, or to print selected images in the active series or study. 4. Select an option for printing clips. Users can select to print only the active frame or all frames. 5. If you want each series to start printing on a new page, select the Start each series on a new page checkbox. 6. Click the Next button when finished making selections. A Printer Options dialog box will appear. Copyright Novarad NovaPACS Diagnostic Viewer Manual

157 Chapter 10 Using the Image Viewer Study Menu 7. Click on the black Page Layout window to select the layout for the printing. 8. Complete the Company Information section if you want this information printed at the top of each printed page. 9. If you do not want image labels or overlays (annotations) printed on the images, deselect the checkboxes for these options. They are selected by default. 10. Select a Zoom option (Fit or Fill). 11. Click the Next button. A final page will open telling the user to Click Finish to start printing. Users can click the Back button if they need to make any changes, or click the Finish button to print Route The Route option allows users to share images with other sites or locations. Images can be routed manually from a NovaPACS data source to a specified destination. To route a study, series, or image, complete the following steps: 1. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Route option from the list. An Add Route Queue for dialog box will open. 2. Choose the study, series, and/or image(s) that you want to route by expanding the lists and clicking the corresponding checkboxes next to the items. If the checkbox next to the Copyright Novarad NovaPACS Diagnostic Viewer Manual

158 Chapter 10 Using the Image Viewer Study Menu study is marked without expanding the list, all of the accompanying series and images will automatically be routed. Note: Route rules can be configured in the Admin Console. If one series in a multimodality study matches the route rule, the entire study will be routed (e.g., a mammography study can include images from multiple modalities like MG and US, and also non-image files such as Structured Reports). 3. Choose a destination from the Destination drop-down list. Note: An Administrator must add the Destinations that appear in the drop-down list. If the destination that you need isn t on the list, talk to your Administrator. 4. Set the routing priority for the image routing by clicking the up or down arrows next to the Priority field. Routing priorities range from 1-100, with 1 as the highest priority. The default routing Priority is Click the OK button to route to the specified destination. Note: For more information on routing, see Chapter 5, section 5-5 Route Documents The Documents option allows users to see any documents associated with the patient file that were scanned into the RIS. To view Documents, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Documents option from the list. Note: For more information on viewing Documents from the Study Browser, see Chapter 5, section 5-6 Documents Exam Report The Exam Report option allows users to see the report associated with the patient file if one exists. Exam Reports are only available if the system is integrated with NovaRIS. To view the Exam Report, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Exam Report option from the list. Note: PDF reports can be viewed but not edited. HTML reports can be edited if the user is authorized. Copyright Novarad NovaPACS Diagnostic Viewer Manual

159 Chapter 10 Using the Image Viewer Study Menu Manage Reports Workflow The Manage Reports Workflow option allows users to see a list of reports and their statuses. This option is particularly useful for Radiologists, Administrators, and Transcriptionists. In the Report Workflow window, users will see four main boxes for Dictated Reports, Unsigned Reports, Signed Reports, and Finalized Reports. In the Other section, users can see reports that have been marked Requires Correction and can look up physicians in the system by using the Physician Lookup box. To use the Manage Reports Workflow option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Manage Reports Workflow option. Note: For more information on using the Manage Reports Workflow option from the Study Browser, see Chapter 5, section 5-8 Manage Reports Workflow RIS Information The RIS Information option allows users to view the RIS Information dialog box for a study. The information included in the RIS Information box is submitted by the Admin, Receptionist, or Technologist in NovaRIS. RIS Information dialog boxes include patient information, referring physician information, order notes, and procedure information about a study. To view the RIS Information dialog box, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the RIS Information option. Copyright Novarad NovaPACS Diagnostic Viewer Manual

160 Chapter 10 Using the Image Viewer Study Menu Dictate The Dictate option allows users to dictate a report for the selected study. The Dictate settings are setup by Novarad in user preferences. The options available are: Basic, File, Dragon, and CMDLine (found on the Plug-Ins Tab of the Options page, under the Study Browser s Settings Menu). To use the Dictate option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Dictate option from the list. Users can also use the default hotkey setting of the letter D. Note: If a prior study is made active and dictation is launched, users will receive a warning dialog box asking them if they are sure they want to dictate the study. A dialog box will alert users if there are existing dictations for the study. Users can select an option to provide an Addendum dictation. The Diagnostic Viewer will check the default microphone settings before starting dictation and notify the user if the microphone is muted or the recording volume is too low. Users should make any needed adjustments before beginning dictation. Note: The Diagnostic Viewer will only check the microphone settings once per application session, not each time dictation launches. When using Dragon dictation, user can insert a RIS Standard Report at any point in the current dictation Echocardiogram Measurements The Echocardiogram Measurements option allows users to create and analyze measurement annotations for an echocardiogram report. To use the Echocardiogram Measurements option, complete the following steps: 1. Open an echo cardio study. 2. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Echocardiogram Measurements option from the list. An Echocardiogram Measurements dialog box will open. Copyright Novarad NovaPACS Diagnostic Viewer Manual

161 Chapter 10 Using the Image Viewer Study Menu 3. Click the C button next to any measurement you want to make. The mouse cursor will change to an annotation cursor. 4. Move the mouse cursor to the image in the Image Viewer window and right-click to measure. Perform the measurement and release the mouse click to complete the measurement. Note: These measurements are not saved in the PACS or RIS after the study is closed and will no longer display on the image(s). You can dictate or enter the results in a report if applicable Launch Cardio Reporting The Launch Cardio Reporting option allows users to launch EncaptureMD a cardio reporting tool used with NovaPACS to create echocardiography reports. To use the Launch Cardio Reporting option, complete the following steps: 1. Launch the Diagnostic Viewer and open an appropriate study (i.e., a cardio echo study). 2. Click on the Menu at the top of the Image Viewer screen, select Study, then select Launch Cardio Reporting. The EncaptureMD program will launch. Copyright Novarad NovaPACS Diagnostic Viewer Manual

162 Chapter 10 Using the Image Viewer Study Menu 3. When using EncaptureMD, if users need to remeasure specific measurements, they will return to PACS to remeasure, and then return to EncaptureMD to finalize the report. When finished creating the report in EncaptureMD, the report will be saved as PDF and will be viewable from PACS or RIS. Note: EncaptureMD must be installed and configured on the workstation to use the Launch Cardio Reporting option. There are several other ways to launch EncaptureMD. Users can customize a hotkey or add a custom toolbar button to the Image Viewer or Study Browser. Users can also click the Launch Cardio Reporting option in the Study Browser s Study Menu Launch Mammo Viewer The Launch Mammo Viewer option allows users to launch a mammo viewing tool used with NovaPACS for mammography viewing. To use the Launch Mammo Viewer option, complete the following steps: 1. Launch the Diagnostic Viewer and open an appropriate study (i.e., an MG or breast US study). 2. Click on the Menu at the top of the Image Viewer screen, select Study, then select Launch Mammo Viewer. The configured mammo viewer will launch in a new window. 3. When finished using the mammo viewer, you can return to the PACS by closing the window. Copyright Novarad NovaPACS Diagnostic Viewer Manual

163 Chapter 10 Using the Image Viewer Study Menu Note: A mammo viewer software must be installed and configured on the workstation to use the Launch Mammo Viewer option. If it is not configured, the Launch Mammo Viewer option will not be available on the Study Menu. Users can customize a hotkey or add a custom toolbar button to the Image Viewer or Study Browser to access this option View Study on Other Workstation The View Study on Other Workstation option allows users to send studies from the Diagnostic Viewer to another computer. Contact Technical Support for the required configuration for this option. Once configured, studies can be viewed and processed by another computer. This option is useful if you need to view studies on post-processing stations for MIP/MPR or 3D Reconstruction. To use the View Study on Other Workstation option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the View Study on Other Workstation option from the list. Note: For more information on this option, see Chapter 5, section 5-14 View Study on Other Workstation Launch Orthopedic Tools The Launch Orthopedic Tools option allows users to use the orthopedic template 3 rd party software with Novarad s Diagnostic Viewer. This optional software integration allows users to create a complete array of orthopedic pre- and post-surgical planning and mapping tools including (but not limited to) Cobb Angles, templates, overlaying, and surgical repairs. Copyright Novarad NovaPACS Diagnostic Viewer Manual

164 Chapter 10 Using the Image Viewer Study Menu To use the Launch Orthopedic Tools option, complete the following steps: 1. Launch the Diagnostic Viewer and open an appropriate study. 2. Click on the Menu at the top of the Image Viewer screen, select Study, then select Launch Orthopedic Tools. The configured orthopedic tool will launch in a new window. 3. When finished using the orthopedic tools, you can return to the PACS by closing the window. Note: The product launched when using the Launch Orthopedic Tools option is dependent upon which software option is configured in the PACS Admin Console. If you do not have an orthopedic software tool configured, the Launch Orthopedic Tools option will not be available on the Study Menu. Users can customize a hotkey or add a custom toolbar button to the Image Viewer or Study Browser to access this option. For more information on creating Orthopedic Templates, see Chapter 13 Additional Software Products Assign Password The Assign Password option allows users to assign a temporary Single-Study Access Password for a study, allowing a person (i.e. a Referring Physician or patient) to access that study through the Internet. Note: For more information on this option, see Chapter 5, section 5-12 Assign Password. To assign a Single-Study Access Password, complete the following steps: 1. Click on the Study that you want to assign Single-Study Access to. 2. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Assign Password option from the list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

165 Chapter 10 Using the Image Viewer Study Menu 3. An Assign Web Password to Selected Study dialog box will appear. A randomly generated password is assigned automatically. You can generate your own password by clicking on the New Password link. 4. Click on the drop-down list next to the Expiration Date to set the length of time the password is valid, and click OK Notes The Notes option allows users to view and edit any notes that have been made for the selected study. The Notes option allows various Diagnostic Viewer users (technologists, radiologists, etc.) to communicate with each other about the study. The Notes option is not part of the patient s medical record, will not print, and does not burn to a patient CD/DVD. To view/edit the Notes for the selected study, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Notes option from the list. Users can also use the default hotkey setting of the letter N Collaboration The Collaboration option allows multiple radiologists to work simultaneously from the same worklist without having duplicate readings. The Collaboration option also allows users to participate in peer-to-peer reviews of patient studies. The Collaboration menu options are described in the following sections: A. Checkout The Checkout option prevents multiple users from reviewing the same study simultaneously. To use the Checkout option for a study, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Collaboration menu, and select the Checkout option from the drop-down list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

166 Chapter 10 Using the Image Viewer Study Menu The study will now have a Checked Out status in the Status column of the Filtered Studies list in the Study Browser. The Current User column will reflect the user name of the person who checked the study out. The Checked Out status for the study will update on all collaborating users lists. Other users may view a Checked Out study, but cannot mark it reviewed or use the Checkout function on it. B. Undo Checkout The Undo Checkout option allows users to undo the checkout process for a study. This function is helpful when a user checks out the wrong study or the user is unable to complete the review of a study after checkout. The Undo Checkout function cannot restore the status of a study if it has already been marked Reviewed. Users can only change a study with a Reviewed status by using the Reset Status to New function (see section E. Reset Status to New). To use the Undo Checkout option for a study, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Collaboration menu, and select the Undo Checkout option from the drop-down list. The study or series will be restored to the status it had before checkout (i.e. New or Verified). C. Verified The Verified option allows users to mark studies as verified, which means that all attached documents, images, etc., are checked and ready for review. To use the Verified option for a study, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Collaboration menu, and select the Verified option from the drop-down list. The study will now have a Verified status in the Status column of the Filtered Studies list (see Chapter 2, section 2-2 The Study Browser Lists for more information on customizing column headings). The Current User column will reflect the user name of the person who verified the study. The Verified status for the study will update on all collaborating users lists. Copyright Novarad NovaPACS Diagnostic Viewer Manual

167 Chapter 10 Using the Image Viewer Study Menu D. Reviewed The Reviewed option allows users to mark a study as reviewed. To use the Reviewed option for a study, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Collaboration menu, and select the Reviewed option from the drop-down list. The study will now have a Reviewed status in the Status column of the Filtered Studies list in the Study Browser. The Current User column will reflect the user name of the person who reviewed the study. The Reviewed status for the study will update on all collaborating users lists. Note: The status of a study will reset to its previous New or Verified status if the study is closed out without marking it Reviewed, and the following options are marked in the Study Browser s Settings Menu, under the General tab: Auto-checkout studies when they are opened Auto-review studies when they are closed Prompt before marking a study reviewed E. Reset Status to New The Reset Status to New option allows users to restore the status of a reviewed study back to New, so it can be reviewed again. To use the Reset Status to New option for a study, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Collaboration menu, and select the Reset Status to New option from the drop-down list. The study s status will change from Reviewed to New in the Status column of the Filtered Studies list in the Study Browser. The user name will no longer appear in the Current User column. Note: The Reset Status to New function must be used within four hours of a study being marked Reviewed. To change the status of a study after four hours, contact your Novarad s Technical Support. Copyright Novarad NovaPACS Diagnostic Viewer Manual

168 Chapter 10 Using the Image Viewer Study Menu F. Peer Review The Peer Review option allows Radiologists to evaluate each other s reviewed studies, give second opinions, and provide quality assurance. Any Radiologist involved in the review process can view a completed Peer Review. To use the Peer Review option for a study, complete the following steps: 1. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Collaboration menu, and select the Peer Review option from the drop-down list. A Peer Review dialog box will appear. 2. Click on an option for the Position field. 3. Enter any comments needed in the Comment field box and click OK. Note: Peer Review reports are available to NovaPACS Administrators in the Admin Console. The Administrator can choose to report an average rate of missed diagnoses over a given time period. G. Utilization Review The Utilization Review option allows Radiologists to review film to provide quality assurance. To use the Utilization Review option, complete the following steps: 1. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Collaboration menu, and select the Utilization Review option from the drop-down list. A Utilization Information for Reviewed Study dialog box will appear. Copyright Novarad NovaPACS Diagnostic Viewer Manual

169 Chapter 10 Using the Image Viewer Study Menu 2. Select the drop-down list for the Utilization Heading Position field and select the position that applies. 3. Enter any comments needed in the Comment field box and click OK Research The Research option allows users to look in the GlobalRad database for cases that have similar anatomical/pathological findings. This can help with more accurate diagnoses and more efficient research. Once activated, the Research option launches GlobalRad a database of studies from around the world that have been made anonymous, complete with clinical findings, diagnoses, etc. Novarad users can sign up for a GlobalRad account and can then submit studies using the Upload to GlobalRad option. GlobalRad preserves anonymity of patient information as it is submitted. For any assistance in this process, please contact Novarad s Technical Support. To use the Research option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Research option from the list Upload to GlobalRad The Upload to GlobalRad option allows users to upload all selected images in the active study to GlobalRad a database of studies that have been made anonymous for research purposes. To use the Upload to GlobalRad option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Upload to GlobalRad option from the list Save View Settings The Save View Settings option allows users to save the view-related changes (W/L, Zoom, Pan, etc.) that have been made while viewing the active study/series. If the user does not select the Save View Settings option, the Diagnostic Viewer will not save any view-related changes that have been made to the study. To use the Save View Settings option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Save View Settings option from the list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

170 Chapter 10 Using the Image Viewer Study Menu Show All Series The Show All Series option allows users to view all of the series for the current patient in the Image Viewer window. To use the Show All Series option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Show All Series option from the list Series Layout The Series Layout option allows users to alter the series layout for the active series using a Choose Series Layout window. To use the Series Layout option, complete the following steps: 1. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Series Layout option from the list. 2. Select the way you want your series to display by moving the mouse vertically and horizontally over the squares and clicking when the layout you want is highlighted gray Hanging Protocol Layouts Hanging Protocol Layouts can be applied to a study from the Image Viewer in a number of ways. The Apply Next Layout option allows users to iterate to the next available Layout for the current Hanging Protocol. To access the Apply Next Layout option, navigate to Menu Study Apply Next Layout. Users may also set up a Hotkey for this option to be able to iterate quickly through the available layouts. Using the Apply Next Layout will allow users to iterate sequentially through Layouts until they reach the last available Layout for the current Hanging Protocol. This option will not allow users to cycle back to the beginning. Note: See Chapter 7, section 7-1 Options for more information on setting up Hotkeys The Apply Previous Layout option allows users to iterate to the previous Layout for the current Hanging Protocol. To access the Apply Previous Layout option, navigate to Menu Study Apply Previous Layout. Users may also set up a Hotkey for this option to be able to iterate quickly through the available layouts. Using the Apply Previous Layout will allow users to iterate backwards through Layouts until they reach the first available Layout for the current Hanging Protocol. This option will not allow users to cycle back to the end. Note: See Chapter 7, section 7-1 Options for more information on setting up Hotkeys Copyright Novarad NovaPACS Diagnostic Viewer Manual

171 Chapter 10 Using the Image Viewer Study Menu The Hanging Protocol Layouts option allows users to apply a preset Hanging Protocol Layouts layout to the active study/series. It also allows users to open the Hanging Protocol Layouts window to preview the set Hanging Protocol Layouts for that modality before choosing to apply one. To use the Hanging Protocol Layouts option, complete the following steps: 1. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Hanging Protocol Layouts option from the list. A drop-down list will open. 2. Select the View Hanging Protocol Layouts option to preview the existing Hanging Protocol Layouts for the modality, and select the thumbnail image you want to apply to the active study. OR 3. Select a Hanging Protocol Layout from the drop-down list to apply it to the active study. These numbered HPs correspond with the available Layouts in the current Hanging Protocol as well as the number keys on the keyboard (i.e. HP 1 corresponds with the first available Layout in the current Hanging Protocol as well as the number 1 on the keyboard, not side keypad.) Press a number key on the keyboard to quickly apply its associated layout. Note: These numbers are configurable in the Study Browser s Options, under the Keyboard Shortcuts tab. See Chapter 7, section 7-1 Options for more information on customizing Keyboard Shortcuts. For more information on Favorite HPs using the Study Browser, see Chapter 6, section 6-2 Favorite Hanging Protocols. Note: For more information on managing and applying Hanging Protocol Layouts see Chapter 2, section 2-4 Hanging Protocol Layouts; Chapter 6, section 6-2 Hanging Protocol Layouts; Chapter 7, section 7-3 Managing Hanging Protocols; Chapter 9, section 9-2 Hanging Protocol Drop-down Menu; Chapter 10, section 10-9 Managing Hanging Protocols; and Chapter 11, sections 11-3 to Minimize The Minimize option allows users to minimize the Image Viewer window. To use the Minimize option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Minimize option from the list Exit The Exit option allows users to exit and close the entire Diagnostic Viewer. If users have selected the Prompt before closing the application option from the Study Browser s Options list, a prompt will appear when selecting the Exit option. Copyright Novarad NovaPACS Diagnostic Viewer Manual

172 Chapter 10 Using the Image Viewer Study Menu Note: Closing the Diagnostic Viewer using the Exit option closes studies properly and saves all changes to patient images. Users are recommended to use this exit option or the Study Browser s exit application option to ensure proper closing and saving of studies. For more information on exiting the Diagnostic Viewer, see Chapter 3, section 3-3 Exit the Diagnostic Viewer. To use the Exit option, click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Exit option from the list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

173 NovaPACS Diagnostic Viewer Chapter 11 Using the Image Viewer Series Menu The Image Viewer s Series Menu contains many functions to help users as they examine and mark findings in series. The Series Menu is located on the Image Viewer s Menu list. Note: The Image Viewer s toolbars can be customized to contain frequently used functions from any menu to increase efficiency. Users can also add any options or functions to Image Context Menus for quick access in the Image Viewer. For more information on adding items to the Image Viewer toolbars, see Chapter 9, section 9-3, Customizing Image Viewer Toolbars. For more information on adding items to Image Context Menus, see Chapter 7, section 7-1 Options. This chapter addresses the following options for using the Image Viewer s Series Menu: 11-1 Select All Images 11-2 Close 11-3 Views A. Tiled View B. Cine View C. Processed by MPR View D. Processed by Image Fusion View 11-4 Adjust All 11-5 Split Horizontal 11-6 Split Vertical 11-7 Choose Image Layout 11-8 Calcium Scoring 11-9 Sort Images Copyright Novarad NovaPACS Diagnostic Viewer Manual

174 11-10 Window/Level A. Choosing a W/L Preset B. Setting a W/L Preset Colorize Create New View Subtract Remove Images Ejection Fraction Percent Stenosis NovaPACS Diagnostic Viewer Chapter 11 Using the Image Viewer Series Menu 11-1 Select All Images The Select All Images option allows users to select all images in the active series. This option is helpful if the users want to make changes to all the images in a series at the same time. To use the Select All Images option, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Select All Images option from the list. Users can also use the default hotkey setting of CTRL + A Close The Close option allows users to close the active series. All other open series will remain open. To use the Close option, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Close option from the list Views The Views option allows users to change the way the active study is viewed. The following sections describe the Views options: A. Tiled The Tiled view is the default view that presents the series with the images and clips in a tiled format. The clips in the Tiled view each have their own controllers and play independently of each other. Note: Users can pause and/or scroll through the frames of a Cine clip in a Tiled Layout. To select the Tiled view, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Views drop-down list, and select the Tiled option. Copyright Novarad NovaPACS Diagnostic Viewer Manual

175 Chapter 11 Using the Image Viewer Series Menu B. Cine The Cine view is used to display all of the images in a series in a played format. The Cine view displays the first frame in each image. Note: If clips are opened using a Cine view, users will be prompted with a message stating that the Cine view is used to cine a series of images and that the Tiled view can play clips. Users will be prompted to switch to a Tiled view. To select the Cine view, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Views drop-down list, and select the Cine option. To adjust the Cine or Clip Frame Rate, complete the following steps: 1. Click on the frame rate number found on the cine or clip controller bar. A slider bar will appear when you click the numbers. 2. Use the slider bar to adjust the frame rate. Moving the slider down decreases the frame rate. Moving the slider up increases the frame rate. C. MPR View The MPR (Multi-Planar Reconstruction) view reconstructs an axial plane into sagittal and coronal planes to provide more comprehensive views of images. Note: Novarad provides MIP/MPR integration and support. If your system has not been setup to use the Diagnostic Viewer with MIP/MPR, your administrator should contact Novarad s Technical Support to configure each workstation that will access MIP/MPR. (MIP is Maximum Intensity Projection.) To select the Processed by MPR view, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Views drop-down list, and select the MPR option. Copyright Novarad NovaPACS Diagnostic Viewer Manual

176 Chapter 11 Using the Image Viewer Series Menu There are four MPR views. Three of the views display a specific orientation (axial, coronal, or sagittal). The fourth view has several buttons that, when used, modifies the view or the functionality of the left mouse button. You can quickly change/reset the fourth MPR view by clicking on an orientation button (axial, sagittal, or coronal). The following list contains a few of the MIP/MPR options: Rapid scroll through the series by left-clicking and dragging the mouse. Change the slice (slab) thickness by scrolling the mouse wheel. Change Window/Level by dragging the right-mouse button. Zoom by pressing and holding both the left-mouse and right-mouse buttons and dragging. Right-click to bring up an MPR Image Context Menu. The Capture Series option allows users to set the parameters for the capture. The capture starts at the green line and ends at the red. Drag those lines around the image for a more precise capture. Users can also change the desired slice spacing. D. Image Fusion The Image Fusion view displays CT and PET images together, along with a row of images with fused (overlaid) CT and PET images together. Note: Image Fusion requires a separate download that your administrator should run before launching the Diagnostic Viewer. This is a one-time download per computer. To use the Image Fusion view, complete the following steps: 1. Open a study with more than one series 2. Click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Views drop-down list, and select the Image Fusion option. A Select Series for Fusion dialog box will appear. 3. Select the two series you want to fuse with Image Fusion. Both series selected need to have the same number of images. In the Image Viewer, the fused PET/CT series will show in three rows. The first two rows will display the PET and CT series, and the third row will display the fused series. Copyright Novarad NovaPACS Diagnostic Viewer Manual

177 Chapter 11 Using the Image Viewer Series Menu To see more options using Image Fusion, right-click and an Image Context Menu will appear with options including Colorize, Measure Line, and Capture Image. Note: You can individually customize the W/L values of the images in each row. If you modify the W/L values of the fused images, the Diagnostic Viewer revises both the CT version in the first row and the PET version in middle row. If you alter W/L values of just the second row of the PET version of the images, the fused images on the bottom row only adjusts the PET portion Adjust All The Adjust All option allows users to apply the adjustments made to one image in a series to all the images in the series (i.e. W/L, magnification). Users can see if the Adjust All option is on by looking at the Adjust All icon on the Series Menu. If the Adjust All option is turned on, the icon will be highlighted. To use the Adjust All option, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Adjust All option from the list Split Horizontal The Split Horizontal option allows users to split the active window in the Image Viewer horizontally. The next series in succession will appear in the new window when it is split. Copyright Novarad NovaPACS Diagnostic Viewer Manual

178 Chapter 11 Using the Image Viewer Series Menu To use the Split Horizontal option, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Split Horizontal option from the list. Users can also click the Split Horizontal button in the upper right corner of each active window Split Vertical The Split Vertical option allows users to split the active window in the Image Viewer vertically. The next series in succession will appear in the new window when it is split. To use the Split Vertical option, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Split Vertical option from the list. Users can also click the Split Vertical button in the upper right corner of each active window Choose Image Layout The Choose Image Layout option allows users to choose how the images in a series are arranged. Copyright Novarad NovaPACS Diagnostic Viewer Manual

179 Chapter 11 Using the Image Viewer Series Menu To use the Choose Image Layout option, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Choose Image Layout option from the list. Users can also click the Choose Image Layout button in the upper right corner of each active window. A Choose Image Layout dialog box will open. Select the way you want your images to display by moving the mouse vertically and horizontally over the squares and clicking when the layout you want is highlighted gray Calcium Scoring The Calcium Scoring option allows users to examine CT studies for calcium buildup in the coronary arteries. Normally, the coronary arteries do not contain calcium. Calcium in the coronary arteries is a sign of Coronary Artery Disease (CAD). Cardiac Calcium Scoring, or coronary artery calcium scoring, uses CT studies to check for the buildup of calcium in the coronary arteries to detect early stages and severity of heart disease. To use the Calcium Scoring option, complete the following steps: 1. Open a CT study in the Image Viewer. 2. Click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Calcium Scoring option from the list. A Calcium Scoring dialog box will appear. Copyright Novarad NovaPACS Diagnostic Viewer Manual

180 Chapter 11 Using the Image Viewer Series Menu 3. Select an Artery Button in the Calcium Scoring dialog box. The following are the descriptions for the buttons: LM: Left Main LCX: Left Circumflex LAD: Left Anterior Descending DIAG: Diagonal RCA: Right Coronary PDA: Posterior Descending Other: Other 4. Complete the Calcium Scoring annotation on the image for each artery you want to measure. 5. When the Calcium Scoring annotation is complete, click the Create Report button on the Calcium Scoring dialog box to create a web page report. Note: This web page report does not save in the Diagnostic Viewer or NovaRIS Sort Images The Sort Images option allows users to change the sort order of the images in a series. The default sort order is sort By Image Number Ascending. To use the Sort Images option, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Sort Images drop-down list, and select one of the following sort options: By Image Number Ascending sorts the images numerically starting from the first image. By Image Number Descending sorts the images numerically starting from the last image. Copyright Novarad NovaPACS Diagnostic Viewer Manual

181 Chapter 11 Using the Image Viewer Series Menu By Slice Location Ascending sorts the images by slice location starting from the last slice taken. By Slice Location Descending sorts the images by slice location starting from the first slice taken Window/Level The Window/Level option allows users to choose a preset W/L value and to assign different values to W/L Presets. The following sections describe the Window/Level options: A. Choosing a W/L Preset Users can choose a Window/Level Preset by completing one of the following steps: 1. In the Image Viewer window, press the F keys on the top row of the keyboard. Each F key corresponds to a Window/Level Preset. 2. Click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Window/Level drop-down list, and select one of the window/level options. 3. If the Default Window Level Toolbar is activated in the Image Viewer window, click a Window/Level Preset on the toolbar. Note: To activate the Default Window Level Toolbar, right-click on any toolbar and select the Default Window Level Toolbar option from the drop-down list. B. Setting a W/L Preset Users can set a Window/Level Preset by completing one of the following steps: 1. Adjust the window/level settings on the image you want, and press CTRL + F (the F key you want to assign for that preset). This will apply the window/level settings as the Window/Level Preset that will activate when that F key is pressed. 2. Adjust the window/level settings on the image you want, and click on the Image Viewer s Menu in the top right of the window. Select the Series Menu and select the Window/Level drop-down list. Select one of the Set W/L Preset options to set the active image s window/level settings as that preset. Note: For more information on W/L Presets, see Chapter 7, section 7-2 W/L Presets. Copyright Novarad NovaPACS Diagnostic Viewer Manual

182 Chapter 11 Using the Image Viewer Series Menu Colorize The Colorize option allows users to identify areas of interest in radiology images using colorization. This helps radiologists to spot or validate areas of interest in images by converting grey scale intensity to colors. To use the Colorize option, complete the following steps: 1. Open a study in the Image Viewer. (Colorization works best on studies that contain a lot of detail.) 2. Click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Colorize drop-down list and select a color from the list Create New View The Create New View option allows users to open a second view of the active series in a new series window. This option is useful when comparing different images within a series or comparing the same image with different window/level values. To use the Create New View option, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Create New View option from the list. To see the new view, scroll to the next image or use the Split Window tools to split the series window horizontally or vertically to see the image and the new view together Subtract The Subtract option allows users to subtract the pixels of the selected image from all other images in the series. When subtracting is complete, the series shows the pixels from all other images in the series. Copyright Novarad NovaPACS Diagnostic Viewer Manual

183 Chapter 11 Using the Image Viewer Series Menu Cardiologists can subtract an angio study (XA) and see the contrast through the veins once the image with bones and soft tissue is subtracted from the series. Note: The Subtract option is available to Cardiologists and Administrators only. To use the Subtract option, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Subtract option from the list Remove Images The Remove Images option allows users to remove selected images from a Key Image series or Aggregate series. This option will not remove images from a regular study. To use the Remove Images option, click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Remove Images option from the list. Note: For more information on Key Image Series, see Chapter 12, section Key Image Series. For more information on Aggregate Series, see Chapter 10, section Aggregate Ejection Fraction The Ejection Fraction option allows users to measure the capacity at which the heart is pumping. Ejection Fraction is the percentage of blood that pumps out of a filled ventricle with each heartbeat. The Ejection Fraction option is usually measured in the left ventricle (LV) the heart s main pumping chamber. A normal Ejection Fraction percentage is 55 to 70 percent. Note: This feature is only for Cardiologists. To use the Ejection Fraction option, complete the following steps: 1. Open an image in the Image Viewer (typically MR) that shows the ventricles of the heart. Copyright Novarad NovaPACS Diagnostic Viewer Manual

184 Chapter 11 Using the Image Viewer Series Menu 2. Navigate through the images in the active series until you find an image of the left ventricle in the Systolic Phase. 3. Click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Ejection Fraction option. A Calculate Ejection Fraction dialog box will appear. 4. Use the Next Frame and/or Previous Frame buttons to find an image of the left ventricle in the Systolic Phase. 5. To measure, right-click and drag the mouse on the image. Outline or draw a circle around the left ventricle in the Systolic Phase to measure the ventricle at its smallest size. 6. Click the Next button when done. Use the Next Frame and/or Previous Frame buttons to find an image of the left ventricle in the Diastolic Phase. 7. To measure, right-click and drag the mouse on the image. Outline or draw a circle around the left ventricle in the Diastolic Phase to measure the ventricle at its largest size. 8. Click the Next button to see an Ejection Fraction Report. 9. Click Save to save the Ejection Fraction Report Percent Stenosis The Percent Stenosis option allows users to check for the presence of a stenosis (abnormal narrowing) in a blood vessel. Calculating the Percent Stenosis tells a Radiologist how narrow the blood vessel is compared to a normal section of the blood vessel. Note: This feature is only for Cardiologists. To use the Percent Stenosis option, complete the following steps: 1. Open an Angio study (XA). Copyright Novarad NovaPACS Diagnostic Viewer Manual

185 Chapter 11 Using the Image Viewer Series Menu Note: An image without any pixel spacing will need to be calibrated before an accurate Percent Stenosis can be calculated. 2. Navigate through the images in the active series until you find an image showing the normal width of the blood vessel. 3. Click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Percent Stenosis option. A Calculate Percent Stenosis dialog box will appear. 4. To measure the vessel at its widest point, right-click and drag the mouse on the image. The cursor will begin in the Measure Length mode. 5. Draw a line extending from one border to the next, from lumen wall to lumen wall, on the fully patent or open lumen. Click the Next button when finished. 6. To measure the vessel at its most narrow point, right-click and drag the mouse on the image. This is to mark the distance of the obstruction. 7. To measure the lesion length, right-click and drag the mouse on the lesion in the image. 8. Click the Next button to see the Percent Stenosis report. 9. Click Save to save the Percent Stenosis report. Copyright Novarad NovaPACS Diagnostic Viewer Manual

186 NovaPACS Diagnostic Viewer Chapter 12 Using the Image Viewer Image Menu The Image Viewer s Image Menu contains many functions to help users as they view images. Users can select from many annotation options and identify critical findings. The Image Menu is located on the Image Viewer s Menu list. If set up, the Image Menu can also be found on the Image Viewer s Main Toolbar. Note: The Image Viewer s toolbars can be customized to contain frequently used functions from any menu to increase efficiency. Users can also add any options or functions to Image Context Menus for quick access in the Image Viewer. For more information on adding items to the Image Viewer toolbars, see Chapter 9, section 9-3, Customizing Image Viewer Toolbars. For more information on adding items to Image Context Menus, see Chapter 7, section 7-1 Options. This chapter addresses the following options for using the Image Viewer s Image Menu: 12-1 Zoom 12-2 Reload 12-3 Invert 12-4 Subtract Clip Frames 12-5 Calibrate Measurement 12-6 Details 12-7 Flip/Rotate 12-8 Annotate A. Accessing Annotate Options B. Using Annotations C. Annotation Options 1. Color Copyright Novarad NovaPACS Diagnostic Viewer Manual

187 Chapter 12 Using the Image Viewer Image Menu 2. Font 3. Reset Cursor 2. ROI 3. Pen 4. Polygon 5. Rectangle 6. Circle 7. Ellipse 8. Point 9. Arrow 10. Coordinates 11. Text 12. Spine Labeling 13. Measure Length 14. Measure Path 15. Measure Area 16. Measure Angle 17. Cobb Angle 18. Record 19. Play 20. Show Scale 21. Hide All 22. Erase 23. Erase All 24. Undo 25. Redo 26. History D. Editing Annotations 1. Click and Drag 2. Drop-down Menu 12-9 Move Images Export to File Auto W/L Magnification Undo All Selections Key Image Series Critical Findings a. Add Critical Findings b. Record Findings c. Edit Physician Info Adjust Auto W/L Equalize Histogram Set Win/Level Smooth Sharpen Local Contrast Enhancement Copyright Novarad NovaPACS Diagnostic Viewer Manual

188 Chapter 12 Using the Image Viewer Image Menu 12-1 Zoom The Zoom option allows users to change the zoom or magnification of an image. Users have the choice of three different Zoom options: No Zoom displays the image in its original size from the modality. Images aren t as large as zoomed images, but appear as visually clear as possible. To Fit displays the image at its maximum size without cutting off any of the image on either the X-axis or Y-axis. To Fill displays the image filled in the screen. Depending on the configuration of the monitors, hanging protocol, and the image/series being displayed, one of the axes may be cut off as the image fills the screen. (The default hotkey setting for this option is Z.) Note: Undo the Zoom option changes by clicking both the left and right mouse buttons and dragging the mouse downward. The entire image will then show. To select the Zoom option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Zoom drop-down list, and select one of the options from the list Reload The Reload option allows users to reload the image file, removing any changes in orientation, magnification, filtering, or pixel inversion. To use the Reload option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Reload option from the list. Users can also use the default hotkey setting of the Backspace key Invert The Invert option allows users to invert the grey scale shades in an image to the colors of a negative image where the black and white colors switch. The Invert option aids in visualization of angiography and other vessel/lumen exams and runoffs. To use the Invert option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Invert option from the list. Users can also use the default hotkey setting of pressing the letter I key. Copyright Novarad NovaPACS Diagnostic Viewer Manual

189 Chapter 12 Using the Image Viewer Image Menu 12-4 Subtract Clip Frames The Subtract Clip Frames option allows users to subtract the active frame of a clip from the other frames in the clip. The Diagnostic Viewer will create a new clip containing the subtracted frames and add it to the series. To use the Subtract Clip Frames option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Subtract Clip Frames option from the list Calibrate Measurement The Calibrate Measurement option allows users to calibrate and measure studies that do not come with pixel spacing as part of their DICOM value. To use the Calibrate Measurement option, complete the following steps: 1. Click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Calibrate Measurement option from the list. 2. A Warning dialog box will appear, warning users of the possible inaccuracies of calibrating measurements by hand. This warning dialog box will appear each time you use the Calibrate Measurement option unless you mark the Don t show this again checkbox. Click OK if you want to continue with the Calibrate Measurement option. 3. Right-click on the image and drag the mouse to draw a line of measurement. 4. In the Measurement Calibration dialog box, choose the measurement value you want you can choose from Use Milimeters or Use French (1/3 mm) value. Select or enter the measurement value for the option you chose. 5. Click OK to save the calibration setting. The cursor will now be ready for measuring the image. Note: This calibration is only valid for the current image. Copyright Novarad NovaPACS Diagnostic Viewer Manual

190 Chapter 12 Using the Image Viewer Image Menu 12-6 Details The Details option allows users to view the list of DICOM fields that the modality transmitted when sending the study to NovaPACS. To use the Details option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Details option from the list. A Dicom Viewer dialog box will open Flip/Rotate The Flip/Rotate option allows users to change flip or rotate an image or images. Users have the choice of four different Flip/Rotate options: Flip Horizontal Flip Vertical Rotate Right Rotate Left To select the Flip/Rotate option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Flip/Rotate drop-down list, and select one of the options from the list. Note: You can flip/rotate an entire series by choosing the Select All Images option from the Image Viewer s Series Menu before using the Flip/Rotate option Annotate The Annotate options allow users to perform functions like annotating, marking, highlighting, and marking regions of interest on images. There are many annotation options in the Annotate list. The following sections will describe how to access and use the Annotate options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

191 Chapter 12 Using the Image Viewer Image Menu Note: Admin users that do not also have a Radiologist or Cardiologist role can annotate, but the annotations will not be saved. A. Accessing the Annotate Options To access the Annotate options, complete one of the following steps: 1. Click on the Image Viewer s Menu in the top right of the window, and select the Image Menu. Select the Annotate option to open the drop-down list. 2. If the Image Viewer s Main Toolbar is activated, click on the Image Menu on the toolbar, and select the Annotate option to open the drop-down list. 3. Right-click on an image in the Image Viewer. The Image Context Menu will appear containing many annotation options by default. For more information on customizing the Image Context Menu option, see Chapter 7 Image Context Menu. 4. Activate the Default Annotation Toolbar by right-clicking on any toolbar in the Image Viewer and selecting the Default Annotation Toolbar option. B. Using Annotations Most annotation options are used in a similar way. The following steps outline the basics of performing annotations: 1. Select an annotation tool from the Annotate drop-down list or toolbar. 2. The mouse cursor will change to reflect the annotation option selected. Activate the annotation by right-clicking on the image and moving the mouse to begin annotating. 3. Perform the action specific to the annotation option. 4. Reset the cursor when finished by selecting the Reset Cursor option from the Annotate drop-down list or toolbar. Users can also reset the cursor by pressing the default hotkey of the Esc key. C. Annotation Options Users have many annotation options to choose from when working with images. Annotations can be added to any image, even in Cine view. The following sections describe the annotation options in the order they appear on the drop-down list: 1. Color The Color annotation option allows users to select a color for annotation marks from a color palette. 2. Font The Font annotation option allows users to select the font, size, and style for any text annotations. Copyright Novarad NovaPACS Diagnostic Viewer Manual

192 Chapter 12 Using the Image Viewer Image Menu 3. Reset Cursor The Reset Cursor option allows users to turn off any selected annotation mode and restores the mouse cursor to the default setting. The default hotkey setting for this option is the Escape key. 4. ROI The ROI (Region of Interest) annotation tool measures Hounsfield values (or the density of a particular area on the image) of the average and deviation values to aid in diagnosis. The ROI annotation is helpful in tumor diagnosis and identifying abnormalities in the anatomy. To use the ROI annotation, select the Annotate drop-down list, select the ROI drop-down list, and choose one of the following options from the drop-down list: ROI Polygon ROI Rectangle ROI Circle (default hotkey is R) ROI Ellipse ROI Point 5. Pen The Pen annotation tool allows users to make annotations using a freehand drawing tool. The default hotkey setting is the letter W. 6. Polygon The Polygon annotation tool allows users to create a freehand polygon shape. Any side left undrawn will be auto-completed. This allows users to highlight an area on an image. 7. Rectangle The Rectangle annotation tool allows users to draw a rectangle shape to highlight an area on an image. 8. Circle The Circle annotation tool allows users to draw a circle shape to highlight an area on an image. Copyright Novarad NovaPACS Diagnostic Viewer Manual

193 Chapter 12 Using the Image Viewer Image Menu 9. Ellipse The Ellipse annotation tool allows users to draw an oval shape to highlight an area on an image. 10. Point The Point annotation option allows users to draw small dot shapes to highlight areas on an image. 11. Arrow The Arrow annotation tool allows users to create arrows for pointing out specific features on images. The default hotkey setting is the letter A. With the arrow annotation selected, right-click and drag to draw the arrow. By default arrows will be drawn tail to head, meaning that the tail end of the arrow will be planted where the user first clicks and the pointed end of the arrow will be dragged to the desired position before releasing the mouse button. Users can reverse the way arrow annotations are drawn in the Study Browser s Option menu. Please refer to Chapter 7, Section 7-1 Options for more information on configuring the arrow annotation. 12. Coordinates The Coordinates annotation tool allows users to determine and annotate the coordinates of a specific point on an image. This tool is useful when counting and comparing vertebrae from one plane to another. To use the Coordinates tool, click the Annotate drop-down list and select the Coordinates option. Right-click on the precise point where you want to establish coordinates. Repeat these steps on any other images that you want to compare to, to verify that the coordinates or anatomy are of equal position. 13. Text The Text annotation tool allows users to add text annotations to images. To use the Text annotation tool, complete the following steps: a. Select the Annotate drop-down list and select the Text option. Users can also use the default hotkey setting of the letter T. b. Right-click on the image in the location you want the text to begin. An Insert Text dialog box will open. c. Enter new text for your annotation, or select pre-existing text from the lexicon. d. If you want the new text added to the lexicon, select the checkbox for the Add this annotation to the lexicon option. e. Users can edit the existing lexicon text and/or add new lexicon items by clicking the Edit Lexicon option. f. Click the OK button to add the text annotation to the image. Copyright Novarad NovaPACS Diagnostic Viewer Manual

194 Chapter 12 Using the Image Viewer Image Menu 14. Spine Labeling The Spine Labeling option allows users to annotate vertebral body and disc mapping. To use the Spine Labeling annotation tool, complete the following steps: a. Select the Annotate drop-down list and select the Spine Labeling option. A Spine Labeling dialog box will appear. b. Select the Vertebral Body or Disc tab to identify the type of label. c. Select the starting point for the annotation (i.e. C3). d. Select the Up or Down option for the direction of labeling. (This will mark the spine labels from either superior to inferior, or inferior to superior.) e. Right-click on the image to mark the starting point or right-click and drag to draw a line on the border of the area. If you drew a line on the border, draw a second line and the Diagnostic Viewer will automatically connect the ends of the lines to form a four-sided polygon; the label text will be automatically centered in the polygon. f. Continue marking the vertebrae in the image. Do not close the menu until the labeling is complete. To use the Spine Label Cross Reference, complete the following steps: a. Click on the Settings Menu on the Study Browser s main toolbar, and select Options. b. On the General Tab, select the Display spine label cross references option. Spine label cross references will show at the top of intersecting images. An intersecting image is any orthogonal in the study (with the same frame of reference) that intersects a spine label in another image. If it is a simple label, it will intersect the label text. If it is a polygon label, it will intersect any part of the polygon (i.e. if a sagittal image of the spine is labeled, any axial images that intersect a spine label displays the label at the top of the axial image for reference). 15. Measure Length The Measure Length annotation tool allows users to measure lengths on images. To use the Measure Length annotation tool, complete the following steps: a. Select the Annotate drop-down list and select the Measure Length option. Users can also use the default hotkey setting of the letter M. b. Right-click on the image in the location you want to start measuring. Copyright Novarad NovaPACS Diagnostic Viewer Manual

195 Chapter 12 Using the Image Viewer Image Menu c. Drag the cursor the length of the area you want to measure, and release at the end point of your measurement. A line will appear with the measurement in millimeters. Note: The Image Viewer can only calculate measurements for images with pixel spacing information. If no pixel information exists, you will need to use the Calibrate Measurements option before measuring. 16. Measure Path The Measure Path annotation tool allows users to measure a freehand line. This tool gives a more accurate measurement of non-linear objects or anatomy. To use the Measure Path tool, click the Annotate drop-down list and select the Measure Path option. On the image, right-click and drag the cursor along the path you want to measure. The measurement will display in millimeters when the path is complete. 17. Measure Area The Measure Area annotation tool allows users to trace around anatomical areas on an image to calculate the area and circumference of the area. The area and circumference values will display on the image in millimeters. 18. Measure Angle The Measure Angle tool allows users to measure the angles of structures and other elements in an image. This is a useful tool for scoliosis and fracture angles. To use the Measure Angle tool, complete the following steps: a. Select the Annotate drop-down list and select the Measure Angle tool. Users can also use the default hotkey setting of CTRL + M. b. Right-click and drag to draw the first line. c. Move the mouse cursor to the fulcrum or hinge point of the angle and right-click and drag to draw another line. An arc will fill in between the two lines established and the degree of the angle will be displayed at the fulcrum point. Users also complete the following Measure Angle options: Cross two lines in the middle Draw two lines that do not touch, but would intersect if they were to extend further Draw two parallel lines Note: Angle measurements can be undone one line at a time by using the Undo annotation tool. Copyright Novarad NovaPACS Diagnostic Viewer Manual

196 Chapter 12 Using the Image Viewer Image Menu 19. Cobb Angle The Cobb Angle annotation tool allows users to perform complex angle measurements for spinal curvature and scoliosis studies along with other angle measurements for Orthopedics diagnosis and reading. To use the Cobb Angle annotation tool, complete the following steps: a. Select the Annotate drop-down list and select the Cobb Angle tool. b. Right-click on the image and drag the mouse to begin using the Cobb Angle annotation tool. c. Right-click and drag the mouse to draw as many lines as you need and the angles between the lines will be measured and displayed in degrees. 20. Record The Record annotation tool is a powerful feature that allows users to record or dictate a voice annotation in conjunction with other annotation marking tools. The Image Viewer records mouse movements over the image along with the voice recording, allowing users to point out and mark relevant pathology on the screen while describing it. To use the Record annotation tool, complete the following steps: a. Select the Annotate drop-down list and select the Record annotation tool. A Voice Annotation Player dialog box will appear, and the recording will begin immediately. Users will need a microphone to use this tool. b. Dictate the information for the image. The mouse movements on your screen will also be recorded. c. Click Save to end the recording session and save the recording. The recorded annotation will be saved to the image. A Voice label will appear in the corner of the image once recorded. 21. Play The Play option allows users to play back information that was recorded with the Record annotation tool. The recording will play back in the Image Viewer when opened. 22. Show Scale The Show Scale option allows users to display a scale on images to help judge sizes. The scale displays to the right and the bottom of the image. The scale is in cm units and will change to mm units if the image is zoomed in a certain amount. Note: The Show Scale option will not save to the image, but it will print with the image when displayed. Copyright Novarad NovaPACS Diagnostic Viewer Manual

197 Chapter 12 Using the Image Viewer Image Menu 23. Hide All The Hide All annotation option allows users to hide all computer-generated and user-generated annotations and labels on the selected image. This option will remain on or off unless selected. 24. Erase The Erase option allows users to erase the user-created annotations from the selected image. Note: This option only erases annotations created by the current user during the current viewing session in the Image Viewer. To erase saved annotations, see the History annotation option. 25. Erase All The Erase All option allows users to delete all of the user-created annotations from the selected image. Note: This option only erases annotations created by the current user during the current viewing session in the Image Viewer. To erase saved annotations, see the History annotation option. 26. Undo The Undo option allows users to remove the last annotation made to the selected image. 27. Redo The Redo option allows users to reinstate the last annotation removed. 28. History The History option allows users to open a history of all the annotations created for the selected image. An Annotation History dialog box will open. The four columns in the dialog box are as follows: Annotation Type, Creation Time, Created By, and Can Delete. If the Can Delete column says Yes for an annotation, users can select the annotation and click the Delete button to delete it. D. Editing Annotations Users may quickly and easily edit annotations for images without having to delete or undo the original annotation. Annotations may be edited only during the current viewing session. Once an annotation has been saved it cannot be edited. A small padlock symbol will appear next to the cursor if an annotation cannot be edited. Users may edit annotations by clicking and dragging, or by using the Edit Annotations drop-down list. 1. Click and Drag Users can click and drag annotations in the Image Viewer to move an existing annotation, move text independently from an existing annotation, or to resize or Copyright Novarad NovaPACS Diagnostic Viewer Manual

198 Chapter 12 Using the Image Viewer Image Menu reshape an existing annotation. The following sections describe each of these three features. a. Moving Annotations To move an existing annotation, hover the cursor over the annotation until a hand-shaped cursor appears. Click and hold the left mouse button. Drag the annotation to the desired location and release the mouse button. If an annotation makes calculations based on location, the calculations will automatically update once the annotation is moved. b. Moving Text If an annotation includes associated text, the text box can be moved independently from the main annotation. Hover the cursor over the text until a hand-shaped cursor appears. Click and hold the left mouse button. Drag the text to the desired location and release the mouse button. The main annotation will remain in place while the associated text is moved. If the main annotation is moved, the associated text will move with it. Users cannot edit text in an existing annotation; however text based on calculations will update to reflect changes to the annotation. c. Resizing or Reshaping Annotations Some annotations can be resized or reshaped. Typically, if an annotation has multiple lines or figures, each item can be resized/reshaped individually. To resize or reshape an annotation, hover the cursor over an existing annotation until a hand-shaped cursor appears. Follow the line of the annotation with your mouse until a small, white circle appears next to your cursor (usually at the ends or corners of an annotation). Click and hold the left mouse button. Drag the cursor to resize or reshape the annotation as desired. Release the mouse button. The edited annotation will remain at the selected size or shape. Any calculations based on the size, shape, or positioning of the annotation will be updated to reflect changes. Note: Annotations that are drawn free-hand or that only represent one point cannot be resized or reshaped. 2. Drop-down Menu Users can right click an existing annotation to access a drop down list that will allow them to delete the annotation, change the color of the annotation, or change the font of text used in an annotation. The following sections describe how to use each of the features available on this drop down list. Copyright Novarad NovaPACS Diagnostic Viewer Manual

199 Chapter 12 Using the Image Viewer Image Menu a. Changing Color To change the color of an annotation, hover the cursor over the annotation until a hand-shaped cursor appears. Right click the annotation. A drop down menu will appear. Select Color. A Color dialog box will appear. Select the desired color and click OK. The color of the annotation will automatically update in the Viewer. b. Changing Font To change the font of a text annotation, hover the cursor over the text until a hand-shaped cursor appears. Right click the annotation. A drop down menu will appear. Select Font. A Font dialog box will appear. Select the desired font and click OK. The annotation font will automatically update in the Viewer. c. Delete Annotations User may now delete annotations by right clicking on the annotation and selecting Delete Annotation from the drop-down menu. The selected annotation will be deleted from the image in the Viewer. Only annotations from the current viewing session may be deleted using this option Move Images The Move Images option allows users to transfer images in and out of Aggregate and/or Key Image Series. To use the Move Images option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Move Images option from the list. Right-click and drag to move selected images in or out of Aggregate and Key Image series. Note: For more information on Key Image Series see Chapter 12, section Key Image Series. For more information on Aggregate Series, see Chapter 10, section Aggregate. Copyright Novarad NovaPACS Diagnostic Viewer Manual

200 Chapter 12 Using the Image Viewer Image Menu Export to File The Export to File option allows users to save an image to a file for export or other uses (i.e. exporting images to PowerPoint or sending fetal ultrasound images with a patient). The Export to File option supports DICOM, BMP, GIF, TIFF, and JPEG file formats. To use the Export to File option, complete the following steps: 1. Select an image from an open study to export. 2. Click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Export to File option from the list. A Save As dialog box will open. 3. Browse for the export location by expanding the folders in the Save in drop-down list. 4. When the correct location is selected, click the Save button to export the image. Note: The Diagnostic Viewer only exports image files Auto W/L To manually apply an Auto Window/Level Adjustment, users can select Menu Image Auto W/L or use the default hotkey setting of F12. This will reapply the Auto Window/Level Preset to the current image. Note: For more information on adding and editing Auto W/L values, see Chapter 7, section 7-1 Options and Chapter 12, section Adjust Auto W/L Magnification The Magnification option allows users to use the Magnify Glass feature. Users have the choice of four different Magnification options: Magnify Glass turns the magnifying glass on or off. The default hotkey setting is G. Magnify Glass Size increases or decreases the size of the magnifying glass window. The default hotkey setting is Shift + G. Copyright Novarad NovaPACS Diagnostic Viewer Manual

201 Chapter 12 Using the Image Viewer Image Menu Magnify Up increases the size of the magnifying glass window. Magnify Down decreases the size of the magnifying glass window. To use the Magnification option, click on the Image Viewer s Menu in the top right of the window and select the Magnification drop-down list. Select a Magnification option from the list Undo All Selections The Undo All Selections option allows users to deselect any selected images in the Image Viewer. To use the Undo All Selections option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Undo All Selections option from the list Key Image Series A Key Image Series is a series that contains certain key images that the user wants to group together. When a Key Image Series is created by a user, the Diagnostic Viewer saves this series for future viewing. The Key Image Series option allows users to select the following options for any images that are added to a Key Image Series: Key Images shows or hides the Key Image Series in the Image Viewer window. Add to Key Images adds the selected image to the Key Image Series. Remove from Key Images removes the selected Key Image from the Key Image Series. To view the Key Image Series, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Key Image Series drop-down list and select the Key Images option. Users can also use the default hotkey setting of the letter K. To add to the Key Image Series, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Key Image Series drop-down list and select the Add to Key Images option. Users can also click the key icon at the top of each image in the Image Viewer. To remove an image from a Key Image Series, select the key image in the series that you want to remove, and click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Key Image Series drop-down list and select the Remove from Key Images option. Copyright Novarad NovaPACS Diagnostic Viewer Manual

202 Chapter 12 Using the Image Viewer Image Menu Critical Findings The Critical Findings option allows radiologists to mark images, series, and/or studies that contain a critical finding to mark or value to report. Critical findings can contain up to ten diagnoses. The Critical Findings option allows users to complete the following actions: A. Add Critical Findings To Add Critical Findings, complete the following steps: 1. Select an image that you want to mark. 2. Click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Critical Findings drop-down list and select the Add Critical Findings option. Users can also click the critical findings triangle icon at the top of each image in the Image Viewer. An Add Critical Findings dialog box will open. 3. Select from the list of available Critical Findings. 4. After selecting an available Critical Finding, click the Save button and yellow text labeling the Critical Finding will appear in the top-right corner of the image in the Image Viewer. Note: If the user is both a radiologist and an admin, an Add a New Critical Finding Value link will appear. After selecting this option, an Add New Critical Finding dialog box will appear. Enter text for the Critical Finding and click OK. The new value will appear in the available critical findings list and may now be selected. Click the Save button to add the finding to the image. In the Add Critical Findings dialog box, users can also choose from the following options: Add image to the Key Image Series adds the selected image to a Key Image Series. Record Findings opens a Findings Record Editor dialog box where users can record the critical findings and mark any physician notification attempts. B. Record Findings To Record Findings, complete the following steps: 1. Click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Critical Findings drop-down list, and select Record Findings. A Findings Record Editor dialog box will open. 2. Click the Add button to add a finding. A Physician Notification Editor dialog box will open. 3. Mark any notification attempts and click the Add button to add it. 4. Click the Save button to save the recorded finding. The following are alternate ways to use the Record Findings option: Copyright Novarad NovaPACS Diagnostic Viewer Manual

203 Chapter 12 Using the Image Viewer Image Menu Open the Critical Findings option from the Image Viewer s Image Menu. Click on the Record Findings button on the bottom of the Add Critical Findings dialog box. Click on the triangle Critical Findings symbol on an image in the Image Viewer. Click on the Record Findings button on the bottom of the Add Critical Findings dialog box. C. Edit Physician Info When using the Record Findings option, if the Physician field is blank or the Physician you need is not on the list, users can search for and edit Physician info. To Edit Physician Info, complete the following steps: 1. Click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Critical Findings drop-down list, and select Record Findings. A Findings Record Editor dialog box will open. 2. Click the Add button to add a finding. A Physician Notification Editor dialog box will open. 3. In the Physician Notification Editor dialog box, click the magnifying glass icon next to the Physician drop-down list. A Physician Search dialog box will open. 4. Enter the Physician s information in the search fields and click the Search button. 5. When the Physician you are looking for appears in the Physicians list, select it and click the OK button. The Physician s information will populate in the Physician Notification Editor dialog box. To revise physician notification information before selecting Store and permanently recording the information complete the following steps: 1. Click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Critical Findings drop-down list, and select Record Findings. A Findings Record Editor dialog box will open. 2. Click the Add button to add a finding. A Physician Notification Editor dialog box will open. 3. In the Findings Record Editor dialog box, select the name of the physician in the Physicians Notifications field by highlighting it with the mouse, and then select Edit. A Physicians Notification Editor dialog box will open. 4. Make any needed changes and click the Add button. 5. Select Store. A Warning dialog box will appear to warn you what the critical findings and the physician notification will become a permanent record. Click the Yes button to save. To delete the physician notification information before selecting Store and permanently recording the information complete the following steps: 1. Click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Critical Findings drop-down list, and select Record Findings. A Findings Record Editor dialog box will open. Copyright Novarad NovaPACS Diagnostic Viewer Manual

204 Chapter 12 Using the Image Viewer Image Menu 2. Click the Add button to add a finding. A Physician Notification Editor dialog box will open. 3. In the Findings Record Editor dialog box, select the name of the physician in the Physicians Notifications field by highlighting it with the mouse. Click Remove. The name of the Physician will be deleted. 4. Select Store. A Warning dialog box will appear to warn you what the critical findings and the physician notification will become a permanent record. Click the Yes button to save Adjust Auto W/L The Adjust Auto W/L option allows users to save the current window/level settings from the selected image to the Auto W/L settings. To use this feature, open a study and set an image to the desired Window/Level values. Then, select Menu Image Adjust Auto W/L or use the default hotkey setting of Ctrl + F12. This saves the current Window/Level values as an Auto Window/Level Adjustment for the current image definition. A dialog box will appear notifying the user that the adjustment has been saved. Users may view and manage saved Auto Window/Level Adjustments from the Study Browser. If a Window/Level Adjustment already exists for the current image definition, it will be replaced by the new adjustment. Once a Window/Level Adjustment has been saved, any images that fall within the same definition will have the saved Window/Level Adjustment values applied automatically when opened. Note: The image definition for Auto Window/Level Presets is mathematically calculated and automatically set to ensure that presets only apply to images within the same modality that have intensity values similar to the original image. For more information on adjusting the Auto W/L settings, see Chapter 7, section 7-2 W/L Presets Equalize Histogram The Equalize Histogram option allows users to enhance the contrast of an image by equalizing the image s histogram. This option is helpful when viewing images of the lungs. Use the Equalize Histogram option on a PA. The lung apices and angles will be easily visible, the lung markings will be clear, and the mediastinum will not be over- or underexposed. Copyright Novarad NovaPACS Diagnostic Viewer Manual

205 Chapter 12 Using the Image Viewer Image Menu Note: It is important to note when a bucky takes an image. A bucky has a grid that improves the image quality. Portable chest x-ray studies only have one view, therefore a PA and those images do not have a grid. To use the Equalize Histogram option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Equalize Histogram option from the list Set Win/Level The Set Win/Level option allows users to manually enter a window/level value for a selected image. To use the Set Win/Level option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Set Win/Level option from the list. A Set Window/Level dialog box will open. Manually enter the level numbers in the fields for the window/level settings Smooth The Smooth option allows users soften the edge enhancement applied to the selected image(s). The Smooth option can be applied multiple times until the desired effect is created. To use the Smooth option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Smooth option from the list. Note: The Smooth and Sharpen options work in direct opposition to each other. Users can use these two options to correct each other Sharpen The Sharpen option allows users to sharpen the detail or edge enhancement applied to the selected image(s). The Sharpen option can be applied multiple times until the desired effect is created. To use the Sharpen option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Sharpen option from the list. Note: The Smooth and Sharpen options work in direct opposition to each other. Users can use these two options to correct each other. Copyright Novarad NovaPACS Diagnostic Viewer Manual

206 Chapter 12 Using the Image Viewer Image Menu Local Contrast Enhancement The Local Contrast Enhancement option allows users to enhance details in CR images, specifically the bone in the images. To use the Local Contrast Enhancement option, click on the Image Viewer s Menu in the top right of the window and select the Image Menu. Select the Local Contrast Enhancement option from the list. Users can also use the default hotkey setting of Shift + E. Note: Users can also set the option to apply the Local Contrast Enhancement automatically when CR images are opened. For more information on the Auto-Local Contrast Enhance CRs option, see Chapter 7, section 7-1 Options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

207 NovaPACS Diagnostic Viewer Chapter 13 Using the Image Viewer Navigation, Customize Toolbars, and Help Menus, along with descriptions of additional software products available with NovaPACS The Image Viewer s Navigation, Customize Toolbars, and Help Menus contain many functions to help users as they view images. Users can navigate through images, series, and studies, customize the various Image Viewer toolbars, and explore help topics. The Navigation, Customize Toolbars, and Help Menus are located on the Image Viewer s Menu list. If set up, these menus can also be found on the Image Viewer s Main Toolbar. Note: The Image Viewer s toolbars can be customized to contain frequently used functions from any menu to increase efficiency. Users can also add any options or functions to Image Context Menus for quick access in the Image Viewer. For more information on adding items to the Image Viewer toolbars, see Chapter 9, section 9-3 Customizing Image Viewer Toolbars. For more information on adding items to Image Context Menus, see Chapter 7, section 7-1 Options. This chapter also contains information about additional software products available in conjunction with NovaPACS. This chapter addresses the following information about the Image Viewer s Navigation, Customize Toolbars, and Help Menus, and additional available software: 13-1 Navigation 13-2 Customize Toolbars a. Adding Toolbar Items b. Removing Toolbar Items c. Re-Ordering the Menu d. Customizing Toolbar Options 13-3 Help A. Instructions B. User Manual C. What s New D. About the Diagnostic Viewer Copyright Novarad NovaPACS Diagnostic Viewer Manual

208 NovaPACS Diagnostic Viewer Chapter 13 Using the Image Viewer Navigation, Customize Toolbars, Help Menu, and Additional Software 13-4 Additional Software A. ClinicPACS Ortho B. NovaScan C. NovaPro D. NovaPro Single User E. TraumaCAD Ortho Plug-in F. Voxar 3D G. NovaRIS H. NovaVault Onsite, Offsite, or Online I. NovaMG J. MRS K. MBMS Bill L. Syntermed 13-1 Navigation The Navigation Menu contains a convenient list of options to help users navigate to the Study Browser and among images in the Image Viewer. The Navigation Menu is located on the Image Viewer s Menu list. If set up, this menu can also be found on the Image Viewer s Main Toolbar. To access this menu, click on the Image Viewer s Menu in the top right of the window, and select the Navigation Menu. Navigate between worklist items, workspaces, studies, series, and images using the Navigation Menu options. Note: Any of the Navigation Menu options can be assigned a hotkey. For more information, see Chapter 7, section 7-1 Options. The following sections describe the Navigation Menu options: A. Study Browser launches the Study Browser window. B. Next Worklist Item closes the current workspace and opens the next worklist study. The name of the worklist being used will appear in parentheses next to this menu item. C. Mark Reviewed, Close, and Open Next Worklist Item marks the current study as Reviewed and closes it. It will then open the next worklist item from the worklist being used. The name of the worklist being used will appear in parentheses next to this menu item. D. Previous Workspace changes the view to the study located on the previous workspace. E. Next Workspace changes the view to the study located on the next workspace. F. Previous Study closes the current study and changes the view to the previous study on your worklist. Note: You can choose to have the current study close and launch the new study in a new workspace or you can have the old study auto close. For more information, see Chapter 7, section 7-1 Options. Copyright Novarad NovaPACS Diagnostic Viewer Manual

209 NovaPACS Diagnostic Viewer Chapter 13 Using the Image Viewer Navigation, Customize Toolbars, Help Menu, and Additional Software G. Next Study closes the current study and changes the view to the next study on your worklist. H. Previous Series changes the view to the previous series in the study. The default hotkey is the up arrow. I. Next Series changes the view to the next series in the study. The default hotkey is the down arrow. J. Previous Page changes the view to the previous page of images in the current series. The default hotkey is the Page Up key. K. Next Page changes the view to the next page of images in the current series. The default hotkey is the Page Down key. L. Previous Image changes the view to the previous image in the current series. The default hotkey is the left arrow. M. Next Image changes the view to the next image in the current series. The default hotkey is the right arrow. N. First Image changes the view to the first image in the current series. The default hotkey is the Home key. O. Last Image changes the view to the last image in the current series. The default hotkey is the End key Customize Toolbars The Customize Toolbars option on the Image Viewer s Menu allows users to customize any toolbar in the Image Viewer. The Customize Toolbars option is located on the Image Viewer s Menu list. Note: For more information on customizing toolbars, see Chapter 9, section 9-3 Customizing Image Viewer Toolbars. To use the Customize Toolbars option, complete the following steps: 1. Click on the Image Viewer s Menu in the top right of the window, and select the Customize Toolbars option. A Custom Toolbars page will open. 2. Select the toolbar you would like to customize from the Select Toolbar drop-down list (Main Toolbar, Quick Reference Buttons, Default Window Level Toolbar, or Default Annotation Toolbar). 3. Choose from the following available options to the right of the Select Toolbar dropdown list: a. New Toolbar allows users to add a new toolbar b. Edit Name allows users to edit the toolbar name c. Remove Toolbar allows users to delete the toolbar The following sections describe what functions users can do with the Image Viewer toolbars: A. Adding Toolbar Items To add to the current Image Viewer toolbar items, complete the following steps: Copyright Novarad NovaPACS Diagnostic Viewer Manual

210 NovaPACS Diagnostic Viewer Chapter 13 Using the Image Viewer Navigation, Customize Toolbars, Help Menu, and Additional Software 1. Select the toolbar that you want to add to from the Select Toolbar drop-down list in the Custom Toolbars page. 2. Select the feature you want to add to the toolbar from the Available Items list on the left side of the page. 3. Click the Add button to add the feature to the Current Toolbar Items list. 4. Click Save to save the change and exit. B. Removing Toolbar Items To remove items from the Image Viewer toolbars, complete the following steps: 1. Select the toolbar you want from the Select Toolbar drop-down list in the Custom Toolbars page. 2. Select the feature you want to remove from the Current Toolbar Items list. 3. Click the Remove button to remove the feature from the Current Toolbar items list. 4. Click Save to save the change and exit. C. Re-ordering the Menu Users can customize the Image Viewer toolbars by resetting the toolbar settings, moving features up or down on the list, or changing their hierarchy level by moving them in or out on the list. To reset or re-order the Image Viewer toolbars, complete the following steps: 1. Select the toolbar you want to re-order from the Select Toolbar drop-down list in the Customize Toolbars page. 2. Select the feature you want to re-order from the Current toolbar items list. 3. Click the Reset, Move Up, Move In, Move Out, or Move Down options until the feature is located where you want. 4. Click Save to save the changes and exit. D. Customizing Toolbar Options To customize Toolbar Options, complete the following steps: 1. Click on the Toolbar Options tab on the Custom Toolbars page. 2. Select an option from the Button Layout drop-down list (Text Only, Image Only, and Image and Text). 3. To change the toolbar layout, click on the Auto Toolbar Layout checkbox to deselect it. 4. In the Toolbar Layout field, select an option from the Image Text Relation dropdown list (Overlay, Image Above Text, Text Above Image, Text Before Image, or Image Before Text). 5. To change the image and/or text size, click on the Auto Size checkbox to deselect it. Copyright Novarad NovaPACS Diagnostic Viewer Manual

211 NovaPACS Diagnostic Viewer Chapter 13 Using the Image Viewer Navigation, Customize Toolbars, Help Menu, and Additional Software 6. In the Image/Text Size field, select an option from the Image Size drop-down list (Normal or Large) and an option from the Text Size drop-down list (Normal, Medium, or Large). Click OK to save and exit when finished Help The Help Menu offers users resources and information relating to the Diagnostic Viewer and its newest features. The Help Menu is located on the Image Viewer s Menu list. To access this menu, click on the Image Viewer s Menu in the top right of the window, and select the Help Menu. The following sections describe the Help Menu options: A. Instructions The Instructions option provides users with basic information about opening studies with the Diagnostic Viewer. It also provides a Shortcuts section with information on mouse functionality in the Diagnostic Viewer. B. User Manual The User Manual option provides users with access to the NovaPACS Diagnostic Viewer User Manual in PDF form. The User Manual will open in a separate window. Users can navigate the User Manual using the Table of Contents, Index, or Find options. C. What s New The What s New option provides users with a list of new features for their current version of the NovaPACS Diagnostic Viewer. The What s New document will open in a separate window. D. About The About option provides users with basic facts about the type and version of NovaPACS Diagnostic Viewer they are using. Novarad s Technical Support number is also provided Additional Software Products There are additional software products that can be used in conjunction with the NovaPACS Diagnostic Viewer. Users can contact Novarad s Technical Support for more information on the following software: Copyright Novarad NovaPACS Diagnostic Viewer Manual

212 NovaPACS Diagnostic Viewer Chapter 13 Using the Image Viewer Navigation, Customize Toolbars, Help Menu, and Additional Software A. ClinicPACS Ortho Web-based Orthopedic PACS for image and information management that includes the following: Fast and accurate desktop CR with cart workstation and 3 year warranty and maintenance 70 films per hour Crisp, clear images, with cassettes Web-based orthopedic PACS for image and information management Ortho Trauma templates and pre-op planning tools VoyantFlow image-to-room and patient management system On-site archive and redundant archive for imaging storage On-site training and installation B. NovaScan This software tool allows users to create a DICOM file from images produced by non- DICOM equipment. NovaScan software accepts image data from intermediary imaging equipment like film digitizers and video capture cards. NovaScan generates files that contain image pixel data and patient/study information that you send to a DICOM server for review by DICOM viewers. C. NovaPro NovaPro provides any Radiologist or Radiology group the ability to receive DICOM images from unlimited, unaffiliated imaging producing practices with no fear of intermingling of images and/or information. Distributes the resulting reports automatically via , fax, both, or through direct HL7 messaging into the customer s own HIS, RIS, and or EMR/EHR. The system automatically scrubs images from the archive when reaching the pre-determined image storage limit. NovaPro provides this functionality without needing to store or maintain the image files. The provider can configure the system to be a complete PACS solution allowing them to store and maintain images and reports. D. NovaPro Single User This product comes ready and fully functional to tie into a group s workflow with no added expense. E. TraumaCad Ortho Plug-in TraumaCad allows your doctors to use digital images on-screen. You can perform measurements, fix prostheses, simulate osteotomies, and visualize fracture reductions. Procedure-specific measurements tools and semi-automatic wizards guide the measurement process step-by-step. TraumaCad allows you to replicate every action you currently perform by tracing on x-ray films, only more conveniently and much faster. TraumaCad has the largest digital template library with over 90,000 template images available. There are 10 planning modules including Auto-Hip, Knee, and Upper Limb. Copyright Novarad NovaPACS Diagnostic Viewer Manual

213 NovaPACS Diagnostic Viewer Chapter 13 Using the Image Viewer Navigation, Customize Toolbars, Help Menu, and Additional Software View current product information at: F. Voxar 3D Voxar 3D offers a suite of visualization and analysis software tools when reading CT, MR, and PET, along with MIP/MPR. Voxar 3D integrates with NovaPACS, allowing users to access these software tools. G. NovaRIS Streamlines your workflow, providing timestamps, tracking, and reports for every aspect of your process. Completely web-based and runs on your existing workstation hardware. Provides your radiology department with the following features: Drag-and-drop, web-based scheduling, workflow tracking, order entry, interfaces, reports, dictation, and voice recognition Referring physician exam requests and orders entered from their offices go directly into NovaRIS Alert pop-ups for billing and insurance preauthorization requirements, contraindications by patient, prep instructions, and exam orders. Transcription module includes foot pedal control, playback, dictation, and editing within NovaRIS Patient reminder letters, e-sign, auto-refresh of technology screen for easy patient tracking, and many other user-friendly features H. NovaVault On-Site, Off-Site, or Off-Line Archive, backup, and storage solution service designed to provide on-site and off-site storage and off-line disaster recovery of data. There are three versions of NovaVault. These products help you with your long-term access to critical clinical information, managed services, and disaster recovery services. I. NovaMG A dedicated full mammography-reading viewer with a complete tool set. When combined with NovaPACS, it creates an all-in-one reading station for every modality in your department. Features include: Complete CAD and mammography viewing tool sets Mammo driven hanging protocols Individual user customized one click workflow Auto alignment and scaling Launch and view from the enterprise viewer, using the same hardware as PACS Half the price of other industry leading mammography viewers Complete integration with NovaPACS and NovaRIS for a complete department solution Copyright Novarad NovaPACS Diagnostic Viewer Manual

214 NovaPACS Diagnostic Viewer Chapter 13 Using the Image Viewer Navigation, Customize Toolbars, Help Menu, and Additional Software J. MRS Mammography Reporting System Inc. (MRS) is a mammography tracking and reporting data system, or patient communication package. View current product information at: K. MBMS Bill MBMS Bill is a comprehensive, fully automated billing service, powered by MBMS. The NovaRIS and MBMS partnership delivers reliable, timely billing and predictable cash collections. Specific offerings include: Part B global billing Automatic Coding One per day ACHS into their account Completely transparent/anytime web access to view billing status in detail L. Syntermed NovaPACS now integrates with Syntermed Nuclear Studies viewer. This allows users to streamline their workflow by launching nuclear medicine studies directly from the NovaPACS Study Browser. Copyright Novarad NovaPACS Diagnostic Viewer Manual

215 NovaPACS Diagnostic Viewer Chapter 14 Cardiology Features Novarad provides many features for Cardiologists, from a Cardio reporting system to cardiology-specific measuring tools like Ejection Fraction and Percent Stenosis. This chapter presents the following Cardiology features: 14-1 Calcium Scoring 14-2 Ejection Fraction 14-3 Percent Stenosis 14-4 Echocardiogram Measurements 14-5 Colorization 14-6 Launch Cardio Reporting 14-7 Remote Access Note: Most of these features are discussed in previous chapters in this NovaPACS Diagnostic Viewer Manual. Chapter references will be listed after repeated sections for cross-referencing. Copyright Novarad NovaPACS Diagnostic Viewer Manual

216 NovaPACS Diagnostic Viewer Chapter 14 Cardiology Features 14-1 Calcium Scoring The Calcium Scoring option allows users to examine CT studies for calcium buildup in the coronary arteries. Normally, the coronary arteries do not contain calcium. Calcium in the coronary arteries is a sign of Coronary Artery Disease (CAD). Cardiac Calcium Scoring, or coronary artery calcium scoring, uses CT studies to check for the buildup of calcium in the coronary arteries to detect early stages and severity of heart disease. Note: This section is also found in Chapter 11, section 11-8 Calcium Scoring. To use the Calcium Scoring option, complete the following steps: 1. Open a CT study in the Image Viewer. 2. Click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Calcium Scoring option from the list. A Calcium Scoring dialog box will appear. 3. Select an Artery Button in the Calcium Scoring dialog box. The following are the descriptions for the buttons: LM: Left Main LCX: Left Circumflex LAD: Left Anterior Descending DIAG: Diagonal RCA: Right Coronary PDA: Posterior Descending Other: Other 4. Complete the Calcium Scoring annotation on the image for each artery you want to measure. 5. When the Calcium Scoring annotation is complete, click the Create Report button on the Calcium Scoring dialog box to create a web page report. Note: This web page report does not save in the Diagnostic Viewer or NovaRIS. Copyright Novarad NovaPACS Diagnostic Viewer Manual

217 NovaPACS Diagnostic Viewer Chapter 14 Cardiology Features 14-2 Ejection Fraction The Ejection Fraction option allows users to measure the capacity at which the heart is pumping. Ejection Fraction is the percentage of blood that pumps out of a filled ventricle with each heartbeat. The Ejection Fraction option is usually measured in the left ventricle (LV) the heart s main pumping chamber. A normal Ejection Fraction percentage is 55 to 70 percent. This feature is specific to Cardiology. Note: This section is also found in Chapter 11, section Ejection Fraction. To use the Ejection Fraction option, complete the following steps: 1. Open an image in the Image Viewer (typically MR) that shows the ventricles of the heart. 2. Navigate through the images in the active series until you find an image of the left ventricle in the Systolic Phase. 3. Click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Ejection Fraction option. A Calculate Ejection Fraction dialog box will appear. 4. Use the Next Frame and/or Previous Frame buttons to find an image of the left ventricle in the Systolic Phase. 5. To measure, right-click and drag the mouse on the image. Outline or draw a circle around the left ventricle in the Systolic Phase to measure the ventricle at its smallest size. 6. Click the Next button when done. Use the Next Frame and/or Previous Frame buttons to find an image of the left ventricle in the Diastolic Phase. 7. To measure, right-click and drag the mouse on the image. Outline or draw a circle around the left ventricle in the Diastolic Phase to measure the ventricle at its largest size. 8. Click the Next button to see an Ejection Fraction Report. 9. Click Save to save the Ejection Fraction Report. Copyright Novarad NovaPACS Diagnostic Viewer Manual

218 NovaPACS Diagnostic Viewer Chapter 14 Cardiology Features 14-3 Percent Stenosis The Percent Stenosis option allows users to check for the presence of a stenosis (abnormal narrowing) in a blood vessel. Calculating the Percent Stenosis tells a Radiologist how narrow the blood vessel is compared to a normal section of the blood vessel. This feature is specific to Cardiology. Note: This section is also found in Chapter 11, section Percent Stenosis. To use the Percent Stenosis option, complete the following steps: 1. Open an Angio study (XA). Note: An image without any pixel spacing will need to be calibrated before an accurate Percent Stenosis can be calculated. 2. Navigate through the images in the active series until you find an image showing the normal width of the blood vessel. 3. Click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Percent Stenosis option. A Calculate Percent Stenosis dialog box will appear. 4. Use the Next Frame and/or Previous Frame buttons to find the image you want to measure. 5. To measure the vessel at its widest point, right-click and drag the mouse on the image. The cursor will begin in the Measure Length mode. 6. Draw a line extending from one border to the next, from lumen wall to lumen wall, on the fully patent or open lumen. Click the Next button when finished. 7. To measure the vessel at its most narrow point, right-click and drag the mouse on the image. This is to mark the distance of the obstruction. 8. To measure the lesion length, right-click and drag the mouse on the lesion in the image. 9. Click the Next button to see the Percent Stenosis report. 10. Click Save to save the Percent Stenosis report. Copyright Novarad NovaPACS Diagnostic Viewer Manual

219 NovaPACS Diagnostic Viewer Chapter 14 Cardiology Features 14-4 Echocardiogram Measurements The Echocardiogram Measurements option allows users to create and analyze measurement annotations for an echocardiogram report. This feature is specific to Cardiology. Note: This section can also be found in Chapter 10, section Echocardiogram Measurements. To use the Echocardiogram Measurements option, complete the following steps: 1. Open an echo cardio study. 2. Click on the Image Viewer s Menu in the top right of the window and select the Study Menu. Select the Echocardiogram Measurements option from the list. An Echocardiogram Measurements dialog box will open. 3. Click the C button next to any measurement you want to make. The mouse cursor will change to an annotation cursor. 4. Move the mouse cursor to the image in the Image Viewer window and right-click to measure. Perform the measurement and release the mouse click to complete the measurement. You can dictate or enter the results in a report if applicable Colorize The Colorize option allows users to identify areas of interest in radiology images using colorization. This helps Cardiologists to spot or validate areas of interest in images by converting grey scale intensity to colors. Note: This section can also be found in Chapter 11, section Colorize. To use the Colorize option, complete the following steps: 1. Open a study in the Image Viewer. (Colorization works best on studies that contain a lot of detail.) Copyright Novarad NovaPACS Diagnostic Viewer Manual

220 NovaPACS Diagnostic Viewer Chapter 14 Cardiology Features 2. Click on the Image Viewer s Menu in the top right of the window and select the Series Menu. Select the Colorize drop-down list and select a color from the list Launch Cardio Reporting The Launch Cardio Reporting option allows users to launch EncaptureMD a cardio reporting tool used with NovaPACS to create echocardiography reports. Note: This section can also be found in Chapter 10, section Launch Cardio Reporting. To use the Launch Cardio Reporting option, complete the following steps: 1. Launch the Diagnostic Viewer and open an appropriate study (i.e. a cardio echo study). 2. To create a report, click on the Menu at the top of the Image Viewer screen, select Study, then select Launch Cardio Reporting. The EncaptureMD program will launch. Copyright Novarad NovaPACS Diagnostic Viewer Manual

221 NovaPACS Diagnostic Viewer Chapter 14 Cardiology Features Note: There are several other ways to launch EncaptureMD. Users can customize a hotkey or add a custom toolbar button to the Image Viewer or Study Browser. Users can also click the Launch Cardio Reporting option in the Study Browser s Study Menu. 3. Log in with your EncaptureMD username and password. 4. If the patient does not already exist in the EncaptureMD system, you will be prompted to add them as a new patient. Click YES to add the patient. 5. A Create New Patient page will appear. Enter the patient s demographic, contact, physician, and insurance information as needed and click OK. 6. The report will open in EncaptureMD with the patient and study information. If there is a DICOM Structured Report (SR) associated with the study, the Image Viewer will send it to EncaptureMD, and the Encapture report will populate with the measurements from the SR. Copyright Novarad NovaPACS Diagnostic Viewer Manual

222 NovaPACS Diagnostic Viewer Chapter 14 Cardiology Features 14-7 Remote Access NovaCardio can be accessed remotely via the Novaweb Diagnostic Viewer. The Novaweb Diagnostic Viewer downloads Image Viewer files temporarily and is accessed through a secure server using the Internet. Users will need to download and use Microsoft s.net Framework 4 Client Profile to use the Novaweb Diagnostic Viewer. This Viewer gives users full use of all product functions and can be accessed anytime from any computer through a website and a secure server. Note: Users must have Internet access to use the Novaweb Diagnostic Viewer and its reporting functions. Cardiologists can use the Novaweb Diagnostic Viewer in conjunction with EncaptureMD a cardio reporting tool from Flexible Informatics. There is a one-time plug-in on the Novaweb page that users must download and run before using the Novaweb Diagnostic Viewer with EncaptureMD. Copyright Novarad NovaPACS Diagnostic Viewer Manual

223 NovaPACS Diagnostic Viewer Chapter 14 Cardiology Features Note: Users must use Internet Explorer 9 for best results with EncaptureMD s reports. The following options are available with the Novaweb Diagnostic Viewer: Diagnostic Viewer Novarad s Diagnostic Viewer accessed via the web provides access to our DICOM PACS with full product functionality. Cardiologists can use this version to have remote access to NovaCardio from an office, clinic, and/or hospital. Note: This requires access to Microsoft.NET Framework 4 Client Profile. MPR/3D Plug-in Your system administrator can download this one-time plug-in if you are using the Web Viewer and a fully licensed version of Voxar. This download must be completed by your system administrator before launching the Web Viewer to allow access to MIP/MPR with Voxar. Note: The Diagnostic Viewer provides MIP/MPR support. For more information about using Novarad s MIP/MPR support, see Chapter 11, section 11-3 Views Cardio Reporting Plug-in Users should download and run this one-time plug-in before using the Web Viewer with EncaptureMD. Note: NovaCardio is not used with the Lite Viewer or Single-Study Access options on the Web Viewer page. To access the Novaweb Diagnostic Viewer, complete the following steps: 1. Open Internet Explorer and enter the address for the secure server in the address bar and press Enter. The Web Viewer window will open. 2. Click on the Launch Cardio Reporting Installer link to download and run this onetime plug-in. Note: Only do this step if you have not previously installed the Cardio Reporting Plug-in. 3. Click on the Diagnostic Viewer link to launch the Novaweb Diagnostic Viewer. Copyright Novarad NovaPACS Diagnostic Viewer Manual