RSVS VIEW SOFTWARE USER MANUAL. Version Number. 7.4x. A DICOM Acquisition, Transmission, and Viewing Application Suite Optimized for Teleradiology

Transcription

1 RSVS VIEW SOFTWARE USER MANUAL Version Number 7.4x A DICOM Acquisition, Transmission, and Viewing Application Suite Optimized for Teleradiology B-TM

2 2003 Radiology Information Systems All Rights Reserved RSVS is a trademark of Radiology Information Systems, Inc. All products and company names should be considered registered trademarks or trademarks of their respective companies. The information provided in this manual is subject to change without notice Dulles Corner Park Suite 140 Herndon VA (703) Voice (703) Fax Version 7.4 B-TM Page ii

3 FRONT MATTER Table of Contents FRONT MATTER... iii Table of Contents... iii List of Illustrations... vi Standards & Conventions... viii i. Typographical Conventions... viii ii. Notes, Cautions & Warnings... ix 1. Notes... ix 2. Caution... ix 3. Warning... ix iii. Revision History... ix iv. Errors, Feedback, or Comments... x v. Safety... x Chapter 1: Introduction... 1 A. Welcome... 1 B. New Features... 1 C. System Overview... 1 D. Image Workflow RSVS Functional Elements... 2 a. Acquisition... 2 b. Storage... 3 c. Display Workflow Examples... 3 a. Image Acquisition... 3 b. Image Transfers... 4 i. Scan and Send... 5 ii. Acquire and Send... 5 iii. Query Retrieve... 5 iv. Peer-to-Peer Transfers... 5 E. Specifications Hardware Software... 6 F. Getting Started... 6 Chapter 2: RSVS Configuration... 8 A. Overview RSVS Node Configuration RSVS Communications Basics... 8 B. Hosts file Configuration Windows 95/ Windows Windows XP C. Dial-Up Networking Configuration Windows 95/ a. Dial-Up Networking (DUN) Configuration b. Dial-Up Server (DUS) Windows a. Network Connection b. Incoming Connections (Dial-Up Server) Windows XP Version 7.4 B-TM Page iii

4 a. Network Connection b. Incoming connections (Dial-Up Server) D. Network/Broadband Configuration Windows95/ Windows Windows XP E. RSVS Configuration Launching RSVS Configuration Configuration a. DICOM Nodes i. Node List ii. Local Node iii. Dial-Up Local Node iv. Peer Node v. Image Route Destination b. System Parameters i. DICOM Service Parameters ii. GUI Control Parameters iii. Housekeeping Parameters iv. Image Operation Parameters v. Image Text Overlay Configurations vi. SeriesGroup Operation Parameters Exit Help F. RSVS Data Files rsvs.ini defattr.dat logview.* Chapter 3: RSVS ORIENTATION A. Launching RSVS Automatic Launches Manual Launches B. GUI Operating Environment Standard GUI Features Standard Windows Features C. Closing and Exiting RSVS D. RSVS System Window Familiarization Title Bar Track Menu Hidden Bar a. Work List b. Print c. Network d. House Keeping e. Settings i. CD Drive ii. Housekeep(ing) iii. W/L Presets iv. Exit f. About g. Exit SeriesGroup Hidden Bar Version 7.4 B-TM Page iv

5 5. System Window Icons Chapter 4: DISPLAYING AND MANIPULATING IMAGES A. Overview B. Work List Series List Image List a. Image information in list box b. Thumbnail Images Function Buttons a. Button Set # b. Button Set # C. Study Selection (Work List) Sorting and Locating a. Sort Order b. Sort Strategies Selecting Series a. Single Series Selection b. Multiple (Batch) Series Selections i. Adjacent Studies ii. Non-Adjacent Images c. Individual Image Selection D. Study Selection (Folders) E. RSVS Main Display Window Invoking Display Orientation a. Image Display Window b. Title Bar...59 i. Bar Icon w/ Pull-Down Menu ii. Title Bar w/ Pull-Down Menu iii. Image Information c. Series List d. Image Position Window e. Tool Bar i. Appearance/Orientation Tools ii. Management Tools iii. Quick Access Buttons iv. Reset/Panic button Manipulating Images a. Zoom b. Pan (Roam) Displaying Multiple Studies Displaying Scout Views Chapter 5: TRANSMITTING/RECEIVING IMAGES A. Overview B. Basic Communications Theory C. Echo Function Buttons Remote Node Information Message Area D. Send E. Query F. Events Version 7.4 B-TM Page v

6 G. DICOM Communication Activities Function Buttons Current Operation Messages and Status APPENDIX A: GLOSSARY APPENDIX B: SITE SURVEY WORKSHEET APPENDIX C: RSVS CONFIGURATION FILE READOUTS A. Sample RSVS.INI File B. Sample DEFATTR.DAT File C. Sample Logview.* File APPENDIX D: ERROR CODES List of Illustrations Figure 1-1 RSVS View System Within a System... 1 Figure 1-2 RSVS Functional Elements... 2 Figure 1-3 Typical Workflow... 4 Figure 1-4 RSVS Teleradiology... 4 Figure 1-5 Peer-to-Peer Image Transfer... 5 Figure 2-1 Windows 95/98 Hosts file... 9 Figure 2-2 Make New Connection Icon Figure 2-3 Dial Up Networking Entry Figure 2-4 Drop Down Menu for DUN Entry Figure 2-5 Options Dialog Boxes Figure 2-6 Connections Menu Figure 2-7 Dial-Up Server Configuration Figure 2-8 Server Types Figure 2-9 Network and Dial-up Connections Window Figure 2-10 Network Connection Window Figure 2-11 Phone Number to Dial Figure 2-12 Options Tab Figure 2-13 Networking Tab and Networking Properties Figure 2-14 Network Connection Type Window Figure 2-15 New User Window Figure 2-16 Incoming TCP/IP Properties Figure 2-17 Network Connections Figure 2-18 Network Connection Type Figure 2-19 Network Connection Figure 2-20 Connection Name Figure 2-21 Phone Number to Dial Figure 2-22 Connect Window Figure 2-23 Networking Tab and TCP/IP Properties Figure 2-24 Network Connecttion Type Window Figure 2-25 Devices for Incoming Connections Window Figure 2-26 Add New User Window Figure 2-27 Incoming TCP/IP Properties Figure 2-28 Network Configuration Figure 2-29 TCP/IP Address Configuration Figure 2-30 Local Area Connection Properties Figure 2-31 Internet Protocol (TCP/IP) Properties Figure 2-32 Network Connections Window Version 7.4 B-TM Page vi

7 Figure 2-33 Local Area Network Properties Figure 2-34 Internet Protocol (TCP/IP) Properties Figure 2-35 RSVS Config Icon Figure 2-36 RSVS Configuration Main Screen Figure 2-37 Configuration Selections Figure 2-38 DICOM Node Selections Figure 2-39 DICOM Node List Figure 2-40 DICOM Local Node Parameters Figure 2-41 DICOM Node List Selection Window Figure 2-42 System Parameters Selections Figure 2-43 DICOM Service Parameters Figure 2-44 GUI Control Parameters Figure 2-45 Text Font Size Figure 2-46 Image Layout Mode and Default Display Image Layout Figure 2-47 Mouse Panic Button and The Mouse Reset Button Configuration Figure 2-48 Housekeeping Criteria Figure 2-49 Automatic Image Deletion Warning Figure 2-50 Image Operation Parameters Figure 2-51 Text Overlay Configurations and Layout Figure 2-52 SeriesGroup Operation Parameters Figure 2-53 Exit Selections Figure 2-54 Save Data and Exit Window Figure 2-55 Exit Without Saving Data Window Figure 2-56 About Config Window Figure 3-1 RSVS Splash Screen Figure 3-2 RSVS System Window Figure 3-3 Work List Series based (Left); Study based (Right) Figure 3-4 RSVS Application Icon Figure 3-5 Exit Confirmation Window Figure 3-6 Title Bar Figure 3-7 Track Menu Figure 3-8 Hidden Bar Icons Figure 3-9 Work List Options Figure 3-10 DICOM Network Manager Window Figure 3-11 House Keeping Window Figure 3-12 Setup Window Figure 3-13 CD Drive Window Figure 3-14 House Keep Figure 3-15 Window/Level Window Figure 3-16 SeriesGroup Hidden Bar Figure 3-17 Task Bar Figure 3-18 RSVS System Window Icons Figure 4-1 Work List Windows Figure 4-2 Image List Dialog Boxes Figure 4-3 Work List Function Buttons Figure 4-4 Series Info Window Figure 4-5 Sort By Pop-Up Menu Figure 4-6 Folder Layout Figure 4-7 Work List Button Figure 4-8 Deletion Warning Window Figure 4-9 Sorted Patient Name Columns Figure 4-10 Single Series Selection Version 7.4 B-TM Page vii

8 Figure 4-11 Adjacent Series Selection Figure 4-12 Non-Adjacent Series Selection Figure 4-13 Image Selections Figure 4-14 Folder List Scroll Bar Figure 4-15 RSVS Display Window Figure 4-16 Title Bar Figure 4-17 (Bar Icon) Pull-Down Menu Figure 4-18 Title Bar Pull-Down Menu Figure 4-19 Appearance/Orientation Tools Figure 4-20 Win/Level Button Options Figure 4-21 Orientation Button Options Figure 4-22 Management Tools Area Figure 4-23 Montage Mode Display Figure 4-24 Stack Mode Display Figure 4-25 Layout Button Menu Figure 4-26 Measurement Toolbox Figure 4-27 Measurement Calibration Figure 4-28 Tools Button Menu Figure 4-29 Magnify Glass Figure 4-30 Quick Access Buttons Figure 4-31 Reset Button Figure 4-32 Multiple Studies Displayed Figure 4-33 Scout Image Figure 5-1 DICOM Network Manger Figure 5-2 Communications Monitor Figure 5-3 DICOM Network Manager Echo Figure 5-4 DICOM Network Manager - Send Figure 5-5 DICOM Network Manager Query Figure 5-6 DICOM Query Criteria Figure 5-7 DICOM Query Criteria w/ Entry Fields Figure 5-8 No Records Match Figure 5-9 DICOM Network Manager Events Figure 5-10 DICOM Communication Activities Figure 5-11 DICOM Communication Activities Transfer in progress Standards & Conventions i. Typographical Conventions Various typographical standards exist throughout this manual series to assist readers. These are as follows: Italicized text draws attention to an important point or an item of special interest. Smaller and bold text refers to items appearing on the monitor display, such as screen buttons or menu selection items. When used to indicate a selection string, the individual items are separated by the " " character, as in the File Open string. Monospaced text refers to sequences that must be typed or entered exactly as listed in manual text using keyboards, keypads, touch-screens, or similar entry devices. Bold Monospaced Text refers to file names, directory names, program files, library names, or similar references to programming structures. Version 7.4 B-TM Page viii

9 <RETURN> refers to the entry method used to enter data or indicate the end of a typed line. Various systems alternately refer to this as <NEW LINE> or <ENTER>. These terms are interchangeable. ii. Notes, Cautions & Warnings 1. Notes Notes provide important information to the reader. Notes emphasize or clarify key points. The general format for a Note follows. NOTE This is an example of a note. Note text consists of blocked, indented margins and uses the normal (roman) font. Notes provide important information to the reader. Notes emphasize or clarify key points. 2. Caution Cautions indicate potential hazards associated with equipment use or operations. Failure to observe cautions can result in minor to moderate personnel injury or property damage. The general format for a Caution follows. CAUTION This is an example of a caution. Caution text consists of blocked, indented margins and uses an italic font. Cautions indicate potential hazards associated with equipment use or operations. Failure to observe cautions can result in minor to moderate personnel injury or property damage 3. Warning Warnings indicate that a specific hazard is known to exist with equipment use or operations. Failure to observe warnings will result in severe to fatal personnel injury or substantial property damage. The general format for a Warning follows. WARNING This is an example of a warning. Warning text consists of blocked, indented margins and uses a bold-italic font. Warnings indicate that a specific hazard is known to exist with equipment use or operations. Failure to observe warnings will result in severe to fatal personnel injury or substantial property damage. iii. Revision History Version 7.4 B-TM Page ix

10 Revision Date Reason for Change DRAFT 10 AUG x DRAFT PRELIM 01 JAN 2003 PRELIMINARY RELEASE 0 19 FEB 2003 FINAL RELEASE iv. Errors, Feedback, or Comments Please report any errors or provide feedback or comments to RADinfo Systems at the address given on page ii of this manual. v. Safety Observe appropriate electrical safety precautions whenever using the RSVS Workstation. Never insert or remove connectors with power applied to the workstation. Do not operate the workstation when it is wet. The RSVS Workstation is configured at the factory for optimal performance. Do not load or alter software or drivers without the express permission and authorization of Radiology Information Systems, Inc. Version 7.4 B-TM Page x

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12 Chapter 1: Introduction A. Welcome Welcome to RSVS View TM software from RADinfo Systems TM, a leader in providing DICOMbased solutions. RSVS View software is a modular DICOM viewing application that can either be used in conjunction with a RSVS Scan & View System or within a PACS environment. RSVS facilitates image management and organization and also provides utilities designed to move (export) DICOM images into other software applications. This manual provides users with information necessary to understand and operate the RSVS View Only Software. B. New Features This newest version of RSVS View software offers greater capability in image manipulation in the viewing portion of the software. These functions will be discussed in detail throughout this manual. C. System Overview Because RSVS View software is a small part of an integrated imaging system, examining system workflow provides a good starting point for understanding RSVS functionality. Refer to Figure 1-1. Review Station (Office) Image Archive On-Call (Home) RSVS Workstation Analog Modem 56k/v.90 ISDN or T1 DSL RSVS Workstation Film Digitizer DICOM Gateway Video Image Capture Plain Film Imaging Modality Analog Video Figure 1-1 RSVS View System Within a System Imaging modalities produce three types of outputs: Plain Film, Analog Video, or digital (DICOM) Files. RSVS Scan Manager software directly controls commercially available Film Digitizers to scan, capture and store the images from film. Optional Video Image Capture hardware and software permits RSVS to intercept, convert, capture, and store analog video signals. Direct connections into networks permit RSVS to receive and store digital image files directly from DICOM compliant modalities. All RSVS stored images comply with DICOM standards and contain all mandatory DICOM information fields provided by the originating modality. Version 7.4 B-TM Page 1

13 Regardless of the method of acquisition and transmission, after reaching the RSVS workstation, images are stored in DICOM format. RSVS incorporates worklist management functions to organize images by Series, Study, or Patient ID. RSVS provides a full complement of ACR compliant, DICOM 3.0 image display and manipulation tools. Thus, the images are available for immediate review, using the workstation monitor. In the event the images are needed at remote locations, the RSVS application suite incorporates advanced communication features such as automatic and/or manual image forwarding to as well as Query/Retrieve from compatible DICOM destinations. RSVS provides several connection and transmission options. The most common methods of image transmission include analog modem/telephone line combinations, ISDN, DSL, or other existing data infrastructures such as Ethernet or broadband technologies. Transmitted images are automatically compressed (none, lossless, or lossy) according to configurable parameters. In addition, RSVS incorporates various levels and types of security during image transmission. The destination whether an On-Call review station, a Primary Diagnostic/Review Station, or an image Archive Server receives DICOM images. D. Image Workflow The importance of this section is to give a greater understanding in how the RSVS System fits into your workflow. 1. RSVS Functional Elements This section first describes the functional elements of the RSVS application suite, then describes the workflow between these components. The RSVS application comprises three functional elements. Acquisition. Storage. Display. In addition, various communications interfaces exist throughout the RSVS application suite. Communications interfaces are neither illustrated nor discussed unless absolutely necessary. ACQUISITION STORAGE DISPLAY a. Acquisition Figure 1-2 RSVS Functional Elements RSVS acquires DICOM images from any of three sources. The preferred source is a digital image over a DICOM 3.0 compatible network. In this case, the originating device can be a modality, a QA workstation, a PACS, or an archive. Commercially available Film Digitizers are a secondary source of DICOM images. In this case, the film digitizer directly interfaces with the RSVS Workstation using a dedicated cable. The RSVS is also capable of reading CD-ROMs and locating all DICOM images on the disc. Regardless of how the images are acquired, all RSVS images are digital and conform to DICOM 3.0 standards. Version 7.4 B-TM Page 2

14 NOTE Analog video capture to the RSVS is also possible using optionally available Video Image Capture Server software and hardware. b. Storage Immediately upon acquisition, all RSVS images are stored on the local volume (hard drive) in DICOM 3.0 format. Depending on the method of acquisition, additional services such as decompression might be required prior to storage. Any received image involving potentially lossy data (wavelet compression) is tagged and so identified. Stored images are subject to automated housekeeping routines. Depending on selected criterion, images are identified as candidates for deletion or automatically deleted according to as any or all of the following: Duplicates. Originating Modality. Age. 2. c. Display Images are available for display as soon as they are stored on the local volume. All RSVS workstations include a full compliment of image manipulation tools. The technology used to display the image varies with the basic function of the workstation, as does the size of the attached monitor. Smaller, 15 monitors might be used for digitizing or QA workstations. Medium sized 17 workstations might be used for review workstation. Full sized 1k or 2k monitors might be used for primary diagnostic workstations. Regardless of the monitor used, all workstations are capable of displaying the image at full resolution, per ACR guidelines. Workflow Examples Each hospital environment is unique, though there are many similarities and common elements in all hospital environments. Two examples of integrated workflow will be examined in the following sections. a. Image Acquisition Refer to Figure 1-3 for a basic block diagram indicating a typical RSVS hospital installation. This hospital contains a mixture of DICOM and non-dicom modalities. The two Toshiba 27A Ultrasounds are non-dicom devices. These devices provide inputs to the processor (not shown), which generates film. The film is manually transferred and loaded into the scanner. RSVS accepts keyboard entries used to identify the images, controls the scanner through the digitization process, then stores the resulting DICOM image file. The three cross-sectional DICOM modalities directly capture images and store these as DICOM entities according to normal protocols. Operators send these to the RSVS workstation using the DICOM network. In the unlikely event that the DICOM network is down and images cannot be directly routed to the RSVS Workstation, film is optionally printed and scanned into the RSVS Workstation using the Film Digitizer. Version 7.4 B-TM Page 3

15 GE Horizon Toshiba MR GE High-Speed Film DICOM 3.X NETWORK Film Toshiba 27A Film Toshiba 27A RSVS Workstation Film Digitizer & DICOM Capture Film Figure 1-3 Typical Workflow Regardless of the method of image capture, the DICOM images are available for immediate display using the attached workstation monitor. The RSVS workstation can also be used to send the images to other destinations using the DICOM network, telephone lines, or broadband digital communications interfaces. These images are automatically or manually transferred between these locations. b. Image Transfers Refer to Figure 1-4. Typically, RSVS workstations facilitate after-hours, on-call Teleradiology using commercially available communications lines and technologies. This configuration permits describing several scenarios. The RSVS Workstation located at the Hospital is arbitrarily designated as a Scan and Transmit Station for this example. Similarly, the RSVS Workstation carried by the doctor is designated as the Home Review Station. In this example, the Home Review Station comprises a portable (laptop) computer. HOSPITAL SCAN AND TRANSMIT STATION HOME REVIEW STATION 15 SVGA Monitor LCD Workstation Mouse Laptop #1 Mouse ISDN #1 Analog Line ISDN #1 COMMERCIAL TRANSMISSION LINES Figure 1-4 RSVS Teleradiology Version 7.4 B-TM Page 4

16 i. Scan and Send The most basic application is Scan and Send. As previously described, DICOM images are digitized and stored on the Hospital Scan and Transmit Station. The images are then sent to the Home Review Station using either the analog or the ISDN lines. (Generally, the ISDN line provides faster image transfer and would be the preferred method of image transfer. There is no difference in the quality of the image once it arrives at the destination station.) ii. Acquire and Send Similarly, when connected to a DICOM network and properly configured, the Hospital Scan and Transmit Station becomes an Acquire and Transmit Station. Technologists operating acquisition modalities send DICOM images directly to the workstation via hospital networks. The images are then sent to the Home Review Station using either the analog or the ISDN lines. iii. Query Retrieve Doctors often travel to diverse locations. In these situations, it is more practical for the doctor to initiate communications and retrieve the desired study using a laptop. In this example, the Home Review Station uses the analog line to connect with the Hospital Scan and Transmit Station. The doctor performs a DICOM Query Retrieve and obtains a list of studies stored on the Hospital Scan and Transmit Station. The desired studies are indicated and marked for retrieval. The Hospital Scan and Transmit Station then sends the studies to the Home Review Station. The images appear on the Home Review Station and are available for display. iv. Peer-to-Peer Transfers Refer to Figure 1-5. RSVS permits peer-to-peer image transfer, permitting consultation with specialists or equalization of workload. In the example, Laptop #1 and Laptop #2 use analog phone lines to transmit images between the two stations. Laptop #1 can send images to Laptop #2, or can use Query Retrieve to obtain images from Laptop #2. Laptop #2 is able to perform similar image transfers with Laptop #1. LCD LCD Laptop #1 Laptop #2 Mouse Mouse Analog Line E. Specifications Figure 1-5 Peer-to-Peer Image Transfer RSVS View software complies with DICOM standards and provides user and network security to ensure patient confidentiality. The RSVS System contains hardware (PC Workstation) and software components. Version 7.4 B-TM Page 5

17 1. Hardware Minimum workstation specifications are given in the following list. Item Vendor RSVS Scan & View System OS Microsoft Windows 9.x, Windows 2000, Windows NT, or Windows XP Processor Intel Pentium III Speed MHz 800 Memory Generic 256 MB Hard Disk Seagate or 20 GB Storage Equivalent Case Generic Mid or Tower Media 1 Generic 3 ½ Media 2 Generic 24x CD Video Monitor Generic 15 SVGA Modem 3COM/USR v.90 PCI Winmodem NIC 3COM/USR PCI Bus Ethernet (RJ-45) Keyboard Generic Yes Mouse Generic Yes w/wheel Remote Access Symantec PcANYWHERE 9.x 2. Software Minimum software specifications for a complete RSVS View software are as follows: Microsoft Windows 9.x, Windows NT sp 6, Windows 2000, or Windows XP Remote Session Software (Dial-up Networking, Dial-up Server (or Remote Access Server) TCP/IP Drivers and stacks RSVS Application pcanywhere is optionally required for remote maintenance and diagnostics F. Getting Started In order to use the RSVS View software, the software must be properly configured. This will have been done either by RADinfo Systems prior to installation or by following the installation instructions in Chapter 2. Please verify that system has been properly configured prior to launching RSVS. To Launch RSVS Scan & View: Find RSVS View Icon on the desktop: Double-click RSVS icon. Chapter 3 will give more detailed information about RSVS View software. Version 7.4 B-TM Page 6

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19 Chapter 2: RSVS Configuration A. Overview Prior to receiving images, RSVS must first be properly configured. RSVS strictly adheres to DICOM standards; thus nodes must be exactly configured. Appendix B gives a sample configuration worksheet that is helpful in obtaining all necessary information. Configuring RSVS requires entering site- and network-specific information into three locations: Hosts file. Dial-Up Networking (if using point-to-point communications; i.e. modems). Networking for broadband or LAN (Local Area Network) connectivity. RSVS Configuration Utility. RSVS Data files. RSVS will not operate unless the Configuration Utility correctly creates node data. The data files permit users to customize default DICOM parameters for their location. 1. RSVS Node Configuration When configuring RSVS, each DICOM Node requires setting five variables. For example, a node could have the following values: Host Name: AE Title: Port Number: 104 Description: Use Dial Up Connection: Dial-Up Connection Name: Hidden: risview1 RISVIEW1 Primary View Station Unchecked=Use Local Network to connect Checked=Use Dial-up Networking to connect Necessary to select when using a dial-up connection Blank if using a network connection Unchecked = Displayed in Node Listings Checked = Not displayed in Node Listings 2. NOTE By convention, the Host Name and AE Title are identical strings except that Host Names are in lowercase and AE Titles are in UPPERCASE. RSVS Communications Basics When using a Local Network destination, RSVS attempts to establish communications with the other DICOM Node using TCP/IP Protocols. The Host Name must identically match an entry in the Hosts file. The Operating System cross-references this literal string to obtain valid TCP/IP addresses for both DICOM Nodes. The TCP/IP protocol then uses these addresses when establishing communications between the two nodes. The Port Number indicates a logical port on which the nodes are expected to listen for such Version 7.4 B-TM Page 8

20 communications these must be identical at both nodes. DICOM uses the AE Title (Application Entity Title) to reference the Node after the TCP/IP connection is established. When using a Dial-Up Networking connection, RSVS first uses Dial-Up Networking to establish a connection with the other DICOM node using PPP (Point-to-Point Protocols). This requires the other node to have Dial-Up Server running. After the PPP session is established the process continues as described for a Local Network destination. B. Hosts file Configuration All devices that will connect with each particular unit must have their hosts file configured properly. For each TCP/IP address that is given for a node, that address and associated host name must be included in the hosts file. The following sections will guide you through properly configuring the hosts file for each operation system. 1. Windows 95/98 Locate the MS-DOS prompt by going Start Programs MS-DOS and left-clicking once on MS- DOS. At the command prompt C:\Windows>, type edit hosts. Figure 2-1 shows a typical hosts file. Figure 2-1 Windows 95/98 Hosts file For any new systems that will be implemented, the appropriate TCP/IP addresses must be added to this file, along with the corresponding host name. The host name must be a unique identifier of each IP address. Once all information is placed into the file, save and close this screen. Exit out of command prompt and put proper information into RSVS Configuration. 2. Windows 2000 Configuration of the hosts file is identical to the Windows 95/98 configuration with the exception of the location of the hosts file. Locate the Command Prompt by going to Start Programs Accessories Command Prompt. At the command prompt C:\>, type cd winnt\system32\drivers\etc and hit enter. Type edit hosts. Figure 2-1 displays an open hosts file. For any new systems that will be implemented, the appropriate TCP/IP addresses must be added to this file, along with the corresponding host name. The host name must be a unique identifier of each IP address. Once all information is placed into the file, save and close this screen. Exit out of command prompt and put proper information into RSVS Configuration. Version 7.4 B-TM Page 9

21 3. Windows XP Configuration of the hosts file is identical to the previous operating systems, with the exception of the location of the hosts file. Locate the Command Prompt by going to Start All Programs Accessories Command Prompt. At the command prompt C:\>, type cd windows\winnt\system32\drivers\etc and hit enter. Type edit hosts. Figure 2-1 displays an open hosts file. For any new systems that will be implemented, the appropriate TCP/IP addresses must be added to this file, along with the corresponding host name. The host name must be a unique identifier of each IP address. Once all information is placed into the file, save and close this screen. Exit out of command prompt and put proper information into RSVS Configuration. C. Dial-Up Networking Configuration In order to receive images through an analog line via the modem, Dial-Up Networking must be properly configured. There are several steps to properly configure the Dial-Up Networking section prior to using RSVS with an analog modem. Dial-Up Networking (DUN) provides dial-out services and is only necessary when using a modem to dial to remote locations. If images will be received in the LAN (Local Area Network) within the hospital or via broadband (cable modem, DSL), then refer to Section D on page 18 for installation instructions. 1. Windows 95/98 There are two main areas that need to be configured: Dial-Up Networking and Dial-Up Server. Dial-Up Server must be configured in order to receive images from the analog phone line. a. Dial-Up Networking (DUN) Configuration Open the DUN folder using the following string Desktop My Computer Dial-Up Networking. The two most significant items are the Make New Connection Icon and the Connections pull-down menu. The Make New Connection Wizard allows users to alter the dialing directory used by Windows to establish remote telephone connections to other machines. In other words, this is the method used to create and edit the phone book used by RSVS when dialing to a remote RSVS Workstation. Figure 2-2 Make New Connection Icon Each dialing destination requires a separate DUN item. Double-clicking the Make New Connection Icon (Figure 2-2) launches a setup wizard designed to simplify the entry process. The user enters pertinent information into appropriate boxes. The end result is a new directory entry that can be used by RSVS. In this case, the new connection was designated as RISTEST1, with a phone number of (703) The new item appears in the DUN Folder, as shown in Figure 2-3. Version 7.4 B-TM Page 10

22 Figure 2-3 Dial Up Networking Entry The default values Windows uses when creating this dialing destination are not optimized for use with RSVS; it is necessary to change these parameters. Locate the appropriate icon and right-click on it. An Options Dialogue box appears, shown in Figure 2-4. Figure 2-4 Drop Down Menu for DUN Entry Highlight and left-click the Properties line entry appearing at the bottom of the list. The Options Dialogue Box disappears and is replaced by the Properties Dialogue Box (see Figure 2-5). This box changes appearance, depending on the tab selected. The General Tab permits entering dialing numbers. The Use Area Code and Dialing Properties checkbox enables options configured in the Telephony Control Panel. The Server Types Tab sets the protocols used for communications. Both boxes shown are properly configured for use with RSVS. Figure 2-5 Options Dialog Boxes Networking information for a dial up connections needs to be put in the TCP/IP Settings button. This networking information must be properly configured in order to send information to a remote node. b. Dial-Up Server (DUS) Dial-Up Server permits your RSVS Workstation to answer incoming modem calls. It is extremely important to have Dial-Up Server properly configured if you want images pushed to you. From the DUN folder, locate and select the Connections Pull Down. Refer to Figure 2-6. The Dial-Up Server item should appear at the bottom of the list. (Contact RADinfo Systems Technical Support if it does not.) Highlight and left-click the Dial-Up Server item appearing at the bottom of the list. Version 7.4 B-TM Page 11

23 Figure 2-6 Connections Menu Refer to Figure 2-7. The DUS Properties Box appears. A properly configured DUS indicates Allow caller access and Monitoring in the Status window. Figure 2-7 Dial-Up Server Configuration Refer to Figure 2-8. Left-clicking the Server Type button opens a different dialogue box. A properly configured dialogue box indicates the PPP protocol stack with Enable software compression checked. Figure 2-8 Server Types Click on the OK button to get out of the Server Types window. Click on the Apply button in the Dial-Up Server window to start the Dial-Up Server. 2. Windows 2000 Setting up Dial-Up Networking in a Windows 2000 environment is slightly different than Windows95/98 environment. The following sections will give you step-by-step instructions on setting up your Windows 2000 system. a. Network Connection From the main Windows 2000 screen, use the following string Start Settings Network and Dialup Connections. Double click on Make New Connection (Figure 2-9). Version 7.4 B-TM Page 12

24 Figure 2-9 Network and Dial-up Connections Window When the Network Connection Window appears, click on Next. Refer to Figure 2-10, select Dial-up to private network and then click Next. Figure 2-10 Network Connection Window Put in the phone number to where you will be dialing and any dialing properties of that phone number on the next screen, shown in Figure Click Next. Figure 2-11 Phone Number to Dial On the next screen select For all Users and then click Next. Type in the name of the dial-up node (e.g. Memorial Hospital) in Connection Name box. Click on Finish. A connection screen will then appear. Click on Properties button. Refer to Figure There are two tabs that need to be properly configured: Options and Networking. Version 7.4 B-TM Page 13

25 Figure 2-12 Options Tab In the Options tab uncheck Prompt for name and password, certificate, etc. Select Networking tab shown in Figure 2-13, making sure that the type of dial-up server you are calling is PPP; Windows 95/98/NT4/2000 Internet. In the Components checked are used by this connection area, highlight Internet Protocol (TCP/IP) and make sure it is checked. Click on Properties. Figure 2-13 Networking Tab and Networking Properties Be sure to click on Use the following IP address and type in correct network IP address. Typically this dial-up network address is different than the Local Area Network address used within the hospital or for broadband connectivity. b. Incoming Connections (Dial-Up Server) Windows 2000 uses the notation Incoming Connections instead of Dial-Up Server, but the functionality is the same. On the Network Connection Type window, select Accept incoming connections (Figure 2-14). Click Next. Version 7.4 B-TM Page 14

26 Figure 2-14 Network Connection Type Window In the Devices for Incoming Connections window, make sure that your modem is checked. Click Next. For the Incoming Virtual Private Connection window, select Do not allow virtual private connections. Click Next. On the next window, Allowed Users, make sure that you have the name of each computer that will dial into you. For example, if the hospital will be calling your computer to push images to you, you will need to have the hospital computer s name listed here. Typically this is called RISSEND or RISSEND1. To include this or any other computer that will call your computer, click on the Add button. Refer to Figure Type in the name of the other computer that will dial your computer from the phone line. Typically, there is no password associated with the other computer. Figure 2-15 New User Window Click OK and, if you are finished adding users that will dial into your computer, then click Next. In the Networking Components window, highlight Internet Protocol (TCP/IP). Click on the Properties button. Refer to Figure 2-16 below, which shows a correctly configured Incoming TCP/IP Properties window. Figure 2-16 Incoming TCP/IP Properties Select Specify TCP/IP address and put your own dial-in IP address in the From field. It is ok to have only 2 IP addresses listed in this area, as long as you have checked Allow calling computer to specify its own IP address. Click OK to save changes and then click Next. Version 7.4 B-TM Page 15

27 Click on the Finish button to complete configuration for Incoming Connections. 3. Windows XP Windows XP is very similar to Windows 2000 with a few exceptions. Configuration of WindowsXP is outlined below. a. Network Connection From the main Windows XP screen, click Start Connect To Show all Connections. Click once on Create a new connection, shown in Figure Figure 2-17 Network Connections When the Network Connection Type window appears, click on Next. Refer to Figure Select Connect to the network at my workplace. Click Next. Figure 2-18 Network Connection Type Refer to Figure When the Network Connection window appears, select Dial-up connection and then click Next. Version 7.4 B-TM Page 16

28 Figure 2-19 Network Connection Refer to Figure When the Connection Name window appears, type the name that you want to call this connection (e.g. Memorial Hospital). Click Next. Figure 2-20 Connection Name Please refer to Figure When the Number to Dial window appears, type in phone number that you want to dial (e.g ) in the box provided. Click Next. When the next window appears, click Next. Click Finish to complete New Connection Wizard. Figure 2-21 Phone Number to Dial When the Connect window appears, as shown in Figure 2-22, click on the Properties button. Version 7.4 B-TM Page 17

29 Figure 2-22 Connect Window When the Properties window opens, there are only two tabs of interest: Options and Networking. Within the Options tab, uncheck Prompt for name and password, certificate, etc. Under the Networking tab, highlight Internet Protocol (TCP/IP) and click on the Properties button. Please refer to Figure Click on Use the following IP address and type in appropriate IP address for this computer. This IP address will be the one that this computer uses to present itself onto the other network. Typically, this dial-in network uses a different IP address than a Local Area Network (LAN) or broadband (cable modem, DSL) connection. Once this is complete, click the OK button to save changes to this configuration. Figure 2-23 Networking Tab and TCP/IP Properties It is a good practice to test the connection once you have complete dial-up configuration. On the next window that appears, click on the Dial button to see if you can get a connection between this computer and the computer that you are dialing into. b. Incoming Connections (Dial-Up Server) Windows XP uses the notation Incoming Connections instead of Dial-Up Server, but the functionality is the same. From the main Windows XP screen, click Start Connect To Show all Connections Command Prompt. Click once on Create a new connection. Click Next. Version 7.4 B-TM Page 18

30 On the Network Connection Type window, click on Set up an advanced connection, as shown in Figure Click Next. Figure 2-24 Network Connection Type Window On the Advanced Connection Options window, select Accept Incoming Connections and then click Next. In the Devices for Incoming Connections window, make sure that your modem is checked, as in Figure Click on Next. Figure 2-25 Devices for Incoming Connections Window On the Incoming Virtual Private Network (VPN) Connection window, select Do not allow virtual private connections. Click Next. For the User Permissions window, make sure that you have the name of each computer that will dial into you. For example, if the hospital will be calling your computer to push images to you, you will need to have the hospital computer s name listed here. Typically this is called RISSEND or RISSEND1. To include this or any other computer that will call your computer, click on the Add button. Refer to Figure Type in the name of the other computer that will dial your computer from the phone line. Typically, there is no password associated with the other computer. Version 7.4 B-TM Page 19

31 Figure 2-26 Add New User Window Click OK to save changes. Click Next, if you are finished adding users to connect to your computer. In the Networking Software window, highlight Internet Protocol (TCP/IP) and click on the Properties button. Refer to Figure 2-27 below, which shows a correctly configured Incoming TCP/IP Properties window. Figure 2-27 Incoming TCP/IP Properties Select Specify TCP/IP address and put your own dial-in IP address in the From field. It is ok to have only 2 IP addresses listed in this area, as long as you have checked Allow calling computer to specify its own IP address. Click OK to save changes and then click Next. Click on Finish to compete the Incoming Connections setup. Your computer is now ready to accept calls from a remote source. D. Network/Broadband Configuration In order to receive images via network or broadband (cable modem, DSL), you must first configure the networking part of your software. The following sections will show how to set up your network configuration based on your operating system. First, make sure that you have a network (Ethernet) card installed prior to configuration. 1. Windows 95/98 Access Network Configuration by using the Start Settings Control Panel entry sequence. Double-click on Network. Refer to Figure Highlight TCP/IP->(Your network card name). Click on the Properties button. Version 7.4 B-TM Page 20

32 Figure 2-28 Network Configuration Under the IP Address tab, select Specify an IP address, demonstrated in Figure Put appropriate IP Address and Subnet Mask information into fields. Figure 2-29 TCP/IP Address Configuration Click OK to save changes. Click OK on the Network screen to save all changes. 2. Windows 2000 To access the networking configuration for Windows 2000, use the following string Start Settings Network and Dial-up Connections. Highlight Local Area Connection and right-click to get drop down menu box. Left-click on Properties. Select Internet Protocol (TCP/IP), as shown in Figure Click on the Properties button. Version 7.4 B-TM Page 21

33 Figure 2-30 Local Area Connection Properties Please refer to Figure Select Use the following IP address. Put in appropriate IP address, Subnet mask, and Default gateway, if appropriate. If your network has a DNS server, place that information in the DNS Server area. Figure 2-31 Internet Protocol (TCP/IP) Properties Click on the OK button to save changes. Click OK once more on the Local Area Connection Properties window. 3. Windows XP Use the following string to get to network configuration in Windows XP Start Connect To Show all Connections, shown in Figure 2-32.Locate your Ethernet connection and right-click on it to reveal a drop down menu box. Click on Properties. Version 7.4 B-TM Page 22

34 Figure 2-32 Network Connections Window Select Internet Protocol (TCP/IP), as shown in Figure Click on the Properties button. Figure 2-33 Local Area Network Properties Please refer to Figure Select Use the following IP address. Put in appropriate IP address, Subnet mask, and Default gateway, if appropriate. If your network has a DNS server, place that information in the DNS Server area. Figure 2-34 Internet Protocol (TCP/IP) Properties Click on the OK button to save changes. Click OK once more on the Local Area Connection Properties window. Version 7.4 B-TM Page 23

35 E. RSVS Configuration After the hosts file and any dial-up networking information have been configured, RSVS needs to be properly configured. RSVS Configuration (Config) provides users with a means setup and edit several data files used by the RSVS application suite. The first step in configuring RSVS is to set up the Node List located within Configuration. 1. Launching RSVS Configuration Refer to Figure Access RSVS Configuration by using the Start Programs RSVS entry sequence. Locate and click once on the RSVS Config icon. Figure 2-35 RSVS Config Icon The Configuration Main Screen appears (Figure 2-36). This screen provides three primary options: Exit. Configuration. Help. 2. Configuration Figure 2-36 RSVS Configuration Main Screen Refer to Figure The Configuration selections permit users to perform the primary functions associated with the RSVS Configuration utility. Upon selection, users see two options: DICOM Nodes System Parameters Figure 2-37 Configuration Selections The DICOM Nodes section is where setup of local and remote computers takes place. In the following sections you will find step-by-step guides to configuring the DICOM nodes. Contained within System Parameters are the tools that control how images are displayed and how the software looks and feels. Version 7.4 B-TM Page 24

36 a. DICOM Nodes Refer to Figure Selecting the DICOM Nodes item brings up another menu. This menu contains five selection options: Local Node. Dial-Up Local Node. Peer Node. Image Route Destination. Node List. i. Node List Figure 2-38 DICOM Node Selections Refer to Figure Though at the bottom of the selections, the Node List is the first item used during configuration and is the most important part of configuring your RSVS SYSTEM. The completed Node List is used to configure RSVS Local and Peer DICOM nodes. The Node List indicates all of the DICOM nodes configured to communicate with this RSVS Workstation. Unless DICOM node data is properly entered in this list, RSVS cannot establish communications with the remote computer. Figure 2-39 DICOM Node List The Node List Box, shown in Figure 2-39, provides several functional areas. The large rectangle to the left lists the nodes entered into the system. A scroll bar permits viewing fields when column width exceeds display capacity. The four text boxes are for entering configuration information. The checkbox Use Dial-Up Connection designates the connection as either a Dial-Up or a network connection. The Dial-up Connection Name relates to the information that is provided in the Dial-Up Networking Folder and can be associated with a specific node entry. The three function buttons to the lower right allow users to Add, Modify, or Delete entries. If Hidden is checked, the DICOM node entry will not be displayed in the Network Manager window. It is helpful to have this checked, if there are nodes that will send automatically to this workstation, but will never be queried (i.e. CT or MRI). The OK button at the bottom closes this box and opens the Configuration Main Screen. The Version 7.4 B-TM Page 25

37 final checkbox Don t allow the user to select dial-up connection in run-time does not allow a user to change configuration during normal operation. NOTE When adding information, fill in all appropriate fields, and then click the Add Button. As previously indicated, each DICOM Node requires setting six variables. The following is an example of how a node can be properly configured: Host Name: AE Title: Port Number: 104 Description: Use Dial Up Connection: Dial-Up Connection Name: Hidden: risview1 RISVIEW1 Primary View Station Unchecked=Use Local Network to connect Checked=Use Dial-up Networking to connect Necessary to select when using a dial-up connection Blank if using a network connection Unchecked = Displayed in Node Listings Checked = Not displayed in Node Listings ii. Local Node Refer to Figure The Local Node selection designates DICOM parameters for the local workstation. Figure 2-40 DICOM Local Node Parameters If the information in this box is not correct, left-click the Get From Node List Button. The DICOM Node List Box illustrated in Figure 2-41 appears and displays the information entered into the DICOM Node List box (Figure 2-40). Left-click to highlight the desired Version 7.4 B-TM Page 26

38 Host Name. Left-click the OK button to close this box and return to the DICOM Local Node Parameters Box. The Local Node will now indicate the desired node information. iii. Figure 2-41 DICOM Node List Selection Window Dial-Up Local Node Except for the name in the title bar, the Dial-Up Local Node Box is identical to the example of Figure The Dial-Up Local Node selection permits designating which RSVS Workstation will be used to establish the Dial-Up Networking session. That is, this designates the RSVS Workstation whose modem will be used to originate telephone calls. NOTE It is possible to have the local and Dial-up Local Nodes be different, when using a network and analog modem configuration to send and receive images. iv. Peer Node Except for the name in the title bar, the Peer Local Node Box is identical to the example of Figure The Peer Node selection permits designating the default DICOM destination used when sending or retrieving images. This destination automatically appears when RSVS first launches. v. Image Route Destination Except for the name in the title bar, the Image Route Destination Node Box is identical to the example of Figure The Image Route Destination selection permits designating a default DICOM destination when the RSVS Workstation is configured for automatic image forwarding. In other words, the RSVS Workstation automatically routes all images received to the indicated destination. b. System Parameters Refer to Figure Selecting the System Parameters item brings up another selection menu. This menu contains six selection options: DICOM Service Parameters. GUI Control Parameters. Housekeeping Parameters. Image Operation Parameters. Image Text Overlay Configurations. SeriesGroup Operation Parameters. Version 7.4 B-TM Page 27

39 Figure 2-42 System Parameters Selections i. DICOM Service Parameters Refer to Figure The DICOM Service Parameters Box permits configuring defaults used when sending DICOM images. There are fourteen configurable areas within the box. From top-to-bottom, these are: Compression Type RSVS provides three compression algorithms (NONE, JPEG LOSSLESS, WAVELET). The NONE option sends the image in its original, uncompressed format; the file is large, but retains all diagnostic information. This should be used if images will be sent through a network connection. The JPEG LOSSLESS option compresses the image to approximately one-half of its original size; the destination decompresses the image, which retains all diagnostic information. The WAVELET option compresses the image according to a quality index; this produces very small images with degradation of image quality. Compression Quality Index (the smaller the better) The intelligent wavelet compression algorithms used by RSVS produce variable compression rates. The algorithms compress data to a maximum rate without exceeding a Compression Quality Index specified by the user. Smaller quality indexes result in less image degradation. The range of values is from 1 to 60. The default value is 25, which is good for 14X17 films that are to be transmitted over an analog phone line. Direct feed DICOM images, especially from CT or MRI, should be sent over at a lower quality index (typically 10) for better image quality. Intermediate File Temporary Directory This directory location is created during RSVS installation and specifies a temporary file storage location used during image reconstruction (decompression). Figure 2-43 DICOM Service Parameters The Image to be sent uses the window/leveling parameters currently set in the image display window When checked, permits the local RSVS workstation to correct the Version 7.4 B-TM Page 28

40 window and level settings of captured images before transmission. This setting only affects image transfer operations. Transfer defaults to the original window/level values when this box is not checked. The values the user enters during image manipulation are sent to the receiving station when this box is checked. Decompress image data immediately after it is received in a C-STORE operation When not checked, received images are saved in compressed form if they were compressed prior to transmission. Decompression occurs on the fly, prior to displaying the image. This preserves disk space at the expense of performance. When checked, decompression occurs as images are received during transmission. Enable Image Routing When checked, this item enables automatic image forwarding. Any image received by RSVS is automatically forwarded to the DICOM destination indicated in the Image Route Destination Node Box, located within DICOM Nodes. Routing C-Store Compression Type When Image Routing is enabled, this specifies the type of compression applied to the routed image. Perform highlevel image data CRC Check This is used for poor quality phone lines, where there is a great deal of static present. This extra check will try to prevent data loss, due to unusually noisy phone lines. DICOM Network Connection Timeout Now configurable in this version, this is the time it takes to get an error message to appear when a connection is not successful. This should be carefully set because too low of a number may result in data loss. Default is two minutes. DICOM Network Send Timeout The time it takes to get an error message to appear when sending is not successful. Too low of a number may result in data loss. Default is two minutes. DICOM Network Receive Timeout The time it takes to get an error message to appear when there is an error in receiving information. Too low of a number may result in data loss. Default is two minutes. Don t check remote host name of the incoming connection Selecting this option will not check the host name of any incoming connections. Dial-Up Login Password If password is necessary when dialing into a network, this field can automatically be filled in with the default password. Use Local Node AE Title as the default Password -- When it is necessary to use a password to dial into a remote network, checking this box will use the AE title as the default password. ii. GUI Control Parameters Refer to Figure The GUI (Graphic User Interface) Parameters Box sets the Look and Feel of the RSVS application. Version 7.4 B-TM Page 29

41 The box contains eight sections: Image Display. Dialog Color Scheme. Text Font Size. Image Layout Mode. The Mouse Rest Button. Work List Sorting Criteria. Worklist Mode. Image Roam Operation. Figure 2-44 GUI Control Parameters The Image Display section contains six checkboxes and one numeric entry box. Images are displayed in large initial size When checked, images are automatically displayed with a 2x-magnification factor when initially appearing in the RSVS application. Maximum Displayed Image Size xx Bytes This box permits fine-tuning the RSVS application with the installed video display card. The minimum setting is 8,192,000 (8 MB). The setting should be twice the value of RAM installed on the video display card. Use Rectangular Buttons When checked, changes the shape of RSVS function buttons to rectangles. When not checked, the buttons have rounded corners. Open the Hidden Bar in static mode When checked, the RSVS application always displays the Hidden Bar at the left side of the application window. When not checked, the hidden bar only displays when the cursor is to the left of the screen for more than 0.5 seconds. Keeping the Hidden Bar open reduces viewing area. Worklist uses strip colors When checked, the worklist differentiates between viewed/unviewed images using strips of colors. When not checked, the worklist differentiates between these using colored text. Always smooth magnified images When checked, RSVS automatically applies a smoothing algorithm to the magnified image area. This reduces jagged edges. Version 7.4 B-TM Page 30

42 Always smooth displayed images When checked, RSVS automatically applies a smoothing algorithm to the displayed images. The Dialog Color Scheme section has four radio buttons. Only one may be active at a given time. The four options Fresh Colors, Light Grays, Dark Grays, and Deep Dark Background control the background color scheme used by RSVS. The selection is a matter of personal choice. The Deep Dark Background choice is best for providing the greatest contrast between images and background. The Text Font Size area allows for configuration of the worklist and measurement font sizes. As monitors increase in resolution, the sizes of the fonts appear to decrease. For this reason, RSVS allows you to configure the worklist and measurement font sizes accordingly. Please refer to Figure The Worklist font size selections are Small, Large, and Extra Large. Measurement Font size is based on a numeric value. Like other applications, the greater the number the larger the font size. Figure 2-45 Text Font Size The Image Layout Mode allows you to select how image will initially be displayed. The checkbox, Starts with Stack mode, will display images stacked one on top of the other. The Default Image Display Layout drop-down menu allows you to set display by using typical image formats. By clicking on the down arrow, a selection box appears, as shown in Figure 2-46, to allow for default settings. Free Mode will display all images at once on the display monitor. The final checkbox in this section is Optimize Image Layout. Checking this option will utilize the entire monitor size to provide optimal viewing settings. Figure 2-46 Image Layout Mode and Default Display Image Layout The Mouse Rest Button is a rest button located on the main viewing toolbar (Figure 2-47). When double-clicked, the image will return to the original values based on configuration. The three configuration checkboxes are Rest Orientation, Reset Image Layout, Reset Win/Level. Figure 2-47 Mouse Reset Button and The Mouse Reset Button Configuration The Work List Sorting Criteria section contains seven buttons and one checkbox. The seven buttons (By Patient Name, By Study Date/Time, By Accession Number, Patient ID, By Body Part, By Version 7.4 B-TM Page 31

43 Status, Study Description) correspond to columns displayed in the RSVS application. Only one button may be selected at a time. The button indicates the key sorting field used by RSVS when initially displaying image information. The default sort is ascending by patient name. If the Sort Descendingly is checked, the sort order reverses. Worklist Mode has three options: Series based, Study based, Patient based. The default configuration is Study based where the worklist displays based on the study level and displays folders. These folders may be expanded to show one or more series available for the listed patient. When Series based, the worklist displays each series as separate line items. Therefore, your worklist may become very long if your patients have more than one series associated with them. The Patient based worklist, places all studies within one patient folder. Image Roam Operation is used to control images for roaming or panning functionality. There are three choices in this selection: Roam Images within Image Frames Panning is done within the Image Frame rather than the entire frame and image. Reset Image Frame Positions when this Mode is On This selection appears when Roam Images Within Image Frames is selected. Checking this will automatically reset frame positions. Synchronize Roam Operations Over all Images in the Series When this is checked, the roam operations will happen with all images contained within the series. Unchecked, the selected image is the only one that will be affected with any roam operations. iii. Housekeeping Parameters Refer to Figure The Housekeeping Parameters Box sets deletion criteria for received images. Figure 2-48 Housekeeping Criteria The Housekeeping Box contains five configurable/selectable fields. Delete File Criteria The pull-down menu allows four selections: ALL, ARCHIVED, SENT, and VIEWED. The selection permits marking a specific type of image for deletion. The number of days triggering the mark depends on the number set in the Days To Keep Files box. Days To Keep Files The entry box controls the number of days before the images indicated in the Delete File Criteria are marked as candidates for deletion. Delete Any File Which Is At Least XX Days Old When checked, this globally marks all files for deletion according to the value entered in the XX Days Old box. Let the System Automatically Delete Files When checked, RSVS automatically deletes images marked as candidates for deletion. There is neither warning nor request Version 7.4 B-TM Page 32

44 for confirmation to this automated process except for the dialogue screen indicated in Figure When not checked, images marked as candidates for deletion appear on a separate recycle menu and must be manually deleted. Figure 2-49 Automatic Image Deletion Warning Delete data according to Study Date or Delete data according to file creation date These two selections are mutually exclusive of each other. If the Study Date option is selected, data will be deleted based on the actual study date. If the file creation option is selected, deletion will occur based on the date the images were created, no matter what the actual study date is. iv. Image Operation Parameters Refer to Figure Image Operation Parameters selections control image export functions and how images are displayed. There are five areas within this configuration utility: Export Image; Image Quality; Sort Images By; Defualt CD Directory; and lower configuration check boxes. The Export to File and the Export to An Image Utility buttons are mutually exclusive. Marking either choice activates its associated configuration items and deactivates the configuration items of the other choice. Images are either exported directly to a File or via utility program for import into another Windows application. Export to File permits selecting images and directly exporting these to files stored on the local hard drive. Files are stored in either bitmap or DICOM format, depending on the File Format option selected. Images are automatically routed to the Default Image File Directory indicated in the entry box. The syntax for configuring this directory must follow Windows standards (i.e., c:\images\saved images). Export to An Image Utility permits moving an image using features native to the Windows Operating System. The Browse feature permits users to Specify an software that catches the exported image. Once specified, the export functions move the image into the specified application. The specified application can then manipulate the image. Version 7.4 B-TM Page 33

45 Figure 2-50 Image Operation Parameters Image Quality refers to how images are loaded into the viewer. Review Quality with Better Performance Speed is used with the Telerad server or with low resolution monitors. Diagnostic Quality images should be used when using a high resolution diagnostic monitor. The selections are mutually exclusive of each other, therefore only one can be selected at a time. Sort Images by is used when a modality sorts their images by SOP Instance UID rather than by image number. The default configuration is Image Number. This configuration can be changed in the viewing area, if necessary. Default CD Directory displays where the CD drive is located for loading CD worklists. The default directory is D. The lower configuration checkboxes have 10 choices. Checking the box will select the appropriate configuration selection(s). Enable Version 4 window/leveling interpretation is used for systems that have upgraded recently from Version 4 of RSVS software. Automatically Copy W/L Adjustment to Entire Series will allow any window or level adjustments to automatically apply to the rest of the series. Turn on Win/Level Mode When Image Dialog Is Opened will automatically enable the left mouse button to change window and leveling properties. When this is checked, the left mouse button will always be used for changing window and level and holding both mouse buttons together will pan or roam the image. Default is to have this checked. Enable Left Mouse Button to Select Images changes the default configuration to allow a click of the left mouse button to select images when checked. If this is not checked, a click with the right mouse button will do the selecting. Default is to have this checked. Pop-up Confirm Dialog when Image Display is closed will display a message screen that verifies that you want to close the image(s). Default configuration is to leave this unchecked. Use Modality LUT will take window and leveling properties of the modality and automatically apply them. Images are distinguished with SOP instance UID only Some modalities may produce duplicate SOP Instance UIDs. When this is checked, RSVS will create its own SOP instance UID to be used with the images. Automatically remove duplicated images is extremely useful in getting rid of duplicated images automatically. If this is not checked, duplicated images will stay on the system until housekeeping removes them. Default configuration is to have this checked. Remove the older image when two images are duplicated is useful if images are to be resent to this station. This is especially useful so that only the newest images Version 7.4 B-TM Page 34

46 are displayed when they are resent by a modality. Default configuration is to have this checked. Pop up Message Box when Win/Level is to be auto changed will display a message window that shows the window and level values will default back to linear. This option is only used when using either non-linear or pulse window and level properties. This message box will not appear during normal (linear) window and level adjustments. v. Image Text Overlay Configurations This section allows configuration of the image text that is displayed on the image or in the image frame when viewing. This information is what is gathered by the modality about the study and patient. Included with your software are some existing configurations for certain modalities. In order to change any of this information, you must understand DICOM tags. Please contact RADinfo Systems to make any changes to the default configuration. Figure 2-51 Text Overlay Configurations and Layout When selecting the Text Overlay Configurations, the first screen that appears is the window located on the left in Figure This window has two checkboxes that Display text overlay when images are opened and Text overlay position is fixed within the image display frame. Please refer again to Figure The window on the right shows the configuration of the text overlay for MR images. Font size displayed on your screen can be controlled from this window. For each modality the font size can be changed. Other options include changing how tags are displayed on the screen and whether you want to Display Distance Scale Marks or Display Orientation Marks. vi. SeriesGroup Operation Parameters One of the newest features of RSVS View is the ability to group series together. Once grouped into a folder, these studies are easily accessible for later review. There are several configuration steps that need to be enabled prior to using this feature. Please refer to Figure Version 7.4 B-TM Page 35

47 Figure 2-52 SeriesGroup Operation Parameters Open one SeriesGroup at a time allows only one folder to be opened at once. This setting is extremely useful so as not to use too many resources. Automatically close all Tools when Image Displays are tiled If more than one series is displayed, this will close all the toolbars. This will give a larger viewing area of the images. Automatically set to Stack Mode when Image Displays are tiled Regardless of your configuration in the GUI parameters section, this will stack the images in each series when they are tiled. Automatically group Image Displays into a SeriesGroup when they are opened This selection is the most important selection for initiating folders. None of the other functions will work unless this is checked. When two or more series are selected from the worklist and displayed, they will automatically be grouped into a new folder. When this is checked another option appears A single Image Display will not be grouped into a SeriesGroup. This means that a series that has a single image will not have an individual folder if this is checked. Automatically tile Image Displays when they are initiated as a SeriesGroup Once a SeriesGroup has been established, this will tile two or more series evenly across the screen(s). No Warning on the removal of an empty SerGroup When checked a message will not appear stating that the SeriesGroup is empty. This should always be checked. 3. Exit Refer to Figure Exit selections permits users to exit the RSVS Configuration utility. Upon selection, users see two options: Save Data And Exit. Exit Without Saving Data. Figure 2-53 Exit Selections Refer to Figure Selecting the Save Data And Exit item brings up a confirmation box. If No is selected, Configuration returns to the main screen without changing anything. If Yes is selected, Configuration creates backup of critical configuration files, writes changes to new files, quits, and closes all of its windows. Version 7.4 B-TM Page 36

48 Figure 2-54 Save Data and Exit Window Refer to Figure Selecting the Exit Without Saving Data item brings up a confirmation box. If No is selected, Configuration returns to the main screen without changing anything. If Yes is selected, Config discards all changes, quits, and closes all of its windows. 4. Help Figure 2-55 Exit Without Saving Data Window Refer to Figure The Help option permits accessing the About Config box, which provides version and copyright information of the configuration tool. F. RSVS Data Files Figure 2-56 About Config Window RSVS creates and uses several data files. These files hold configuration information or global parameters. Files of particular interest are: rsvs.ini dafattr.dat logview.* 1. rsvs.ini CAUTION The information provided in this section is for educational purposes. RADinfo Systems does not sanction unauthorized modification to these data files. The rsvs.ini file stores the majority of information entered using the Config utility program. Appendix C provides readout of the default rsvs.ini file. The RSVS application will not operate if this file is missing or corrupted. This file is located at C rsvs param rsvs.ini. Version 7.4 B-TM Page 37

49 2. 3. defattr.dat The attrib.dat file permits users to configure default values used by RSVS when creating DICOM-compliant files. Wherever possible, RSVS creates DICOM headers using information supplied by the originating modality. When required fields are blank, or the data has not been provided, RSVS uses values entered into attrib.dat file. Appendix C provides readout of the default rsvs.ini file. The RSVS application will not operate if this file is missing or corrupted. This file is located at C rsvs dat defattr.dat. logview.* The logview.* files record significant RSVS events. Normally, there are seven files associated with each RSVS installation, one for each day of the week. RSVS automatically creates a new file at midnight, overwriting the file created seven days earlier. The format of each file is identical. Appendix C provides readout of a typical logview.* file. These files are located at C rsvs log logview. *. Version 7.4 B-TM Page 38

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51 Chapter 3: RSVS ORIENTATION A. Launching RSVS RSVS either automatically launches at workstation startup or is manually launched. 1. Automatic Launches Refer to Figure 3-1. The RSVS application is normally configured to automatically launch at workstation startup. The program opens with a splash screen. This screen: Displays the RSVS Logo. Indicates the software revision level. Denotes the functional modules loaded with the application. Provides copyright information. Figure 3-1 RSVS Splash Screen After a slight delay, the RSVS splash screen disappears and is replaced by the RSVS System Window, shown in Figure 3-2. This is the background upon which all RSVS windows appear. Version 7.4 B-TM Page 40

52 Figure 3-2 RSVS System Window Refer to Figure 3-3. Immediately after the System window appears, RSVS opens the Work List: Local window. This displays all DICOM images loaded into the RSVS Workstation. Depending on configuration, this window will display by either series-, study-, or patientbased. If study or patient based is selected, folders will appear that can be opened to view studies or series information for each patient listed. Default configuration is a study based worklist. 2. Manual Launches Figure 3-3 Work List Series based (Left); Study based (Right) It is necessary to manually launch RSVS when the workstation is not configured to automatically launch the application, or when RSVS was inadvertently closed. Refer to Figure 3-4. Manually launching RSVS requires users to double-click the RSVS Application Icon. Depending on system configuration, this can be located on the desktop, or can be accessed from Start Programs RSVS RSVS. Version 7.4 B-TM Page 41

53 B. GUI Operating Environment Figure 3-4 RSVS Application Icon RSVS exists in a Windows Graphical User Interface (GUI) Operating Environment. Thus, RSVS adheres to several GUI standards. Several of the more important features are presented in the following sections Standard GUI Features As with most Graphics User Interfaces (GUIs), the mouse controls the majority of the functions available in RSVS. Invoking most functions requires use of the mouse to position the cursor over an item, followed by a left-click (and release) of the mouse button. The term double-click(ing) refers to clicking the left-mouse button twice, in rapid succession. The upper-right corner of many screens contains an X in a box; this is the Close and Exit icon. At the RSVS System Window level, left-clicking this icon brings a confirmation dialogue box appears to ensure the user wishes to exit the application. If continued, the function closes all RSVS windows and exits the RSVS application. Left-clicking other RSVS windows invokes a close-window command. A small rectangle immediately to the left of the Close and Exit icon invokes the Minimize feature. Left-clicking this icon hides the RSVS application and places an RSVS item in the Windows Desktop taskbar. Left-clicking the RSVS item in the Windows Desktop taskbar restores the RSVS application. Rectangles (or buttons) containing text represent executable commands. Left-clicking within a rectangle invokes the command. One rectangle has additional shadowing; indicating it is the selected command. Pressing the keyboard Enter key invokes this command. Using the keyboard Tab key moves the shadow box to change the selected command. The text and rectangle dim (gray) to indicate the function is not currently available for use. Standard Windows Features The upper portion of all RSVS Worklist screens contain a series of headings. These headings provide a fast way to sort the data or to resize the column. Left-clicking a heading title forces an ascending (a-z) sort; a second click forces a descending (z-a) sort. Subsequent clicks toggle between ascending and descending. A "hot spot" at the right of each heading permits resizing the column. When correctly positioned, the cursor changes to an "I" with thin, horizontal arrows. Left-clicking and dragging with this icon permits widening or narrowing the column. Horizontal and vertical scroll bars appear when the amount of data exceeds the capacity of the display window. Left-clicking the arrows permits scrolling up, down, right, or left, depending on the arrow selected. Left-clicking and moving the sliding bars permits rapid motion through the data. Left-clicking a row selects and highlights that study. Hold the keyboard Shift key then leftclicking on the start and end rows to select multiple adjacent studies. Holding the keyboard Ctrl (Control) key then left-clicking desired rows permits selecting multiple nonadjacent studies. Version 7.4 B-TM Page 42

54 C. Closing and Exiting RSVS Refer to Figure 3-5. After receiving a close and exit command, RSVS displays a confirmation dialogue box. Selecting Yes allows the sequence to continue. Selecting No returns RSVS to active status. Figure 3-5 Exit Confirmation Window There are four ways to generate a close and exit command from the RSVS application. Exit Icon Double click the Exit Icon in the Hidden Bar. Keyboard Sequence Simultaneously pressing the Alt and F4 on the keyboard. X Icon Left-clicking the X Icon appearing in the upper right of the RSVS System Window. --Icon Double-clicking the Bar [ ] Icon at the upper left of the RSVS System Window. D. RSVS System Window Familiarization The System Window provides a backdrop for all RSVS operations. Familiarization with its components and terminology is a necessary prerequisite for effortlessly operating RSVS. 1. Title Bar Refer to Figure 3-6. The Title Bar appears across the top of the RSVS System Window. Figure 3-6 Title Bar The left-most portion of the Title Bar contains the Bar Icon [Close, Exit and Menu Bar]. The program name RSVS appears immediately to the right of the Bar Icon. The right-most portion of the Title Bar contains two icons. The X Icon at the far right provides a Close and Exit function. The icon immediately to the left is a minimize icon. Right-clicking anywhere in the Title Bar except on the icons opens the Track Menu. 2. Track Menu Refer to Figure 3-7. The Track Menu is a pull down menu allowing access to several functions. It opens as a result of right-clicking in the Title Bar, or right-clicking in the System Window. The Track Menu is divided into two sections, separated by a thin vertical line. The upper section controls the layout of the System Window. The lower section determines what is displayed in the System Window. The number and order of icons in the lower section changes to reflect actual RSVS conditions. Version 7.4 B-TM Page 43

55 The upper section contains three selections: Figure 3-7 Track Menu Arrange Icons Snaps minimized System Window Icons to a hidden grid. Tile Equally divides available System Window space between open windows. Cascade Stacks and arranges open windows in available System Window space. The lower section contains at least four selections. The number of additional line items increases with each opened image. SETUP Opens the Setup Window. Work List [Local] Opens a Work List indicating all images/studies located on the local hard drive. DICOM Network Manager Opens the Network Manager Window. DICOM Communication Activities Opens the Communication Activities Window. 3. Hidden Bar The Hidden Bar appears vertically, across the left side of the System Window in two situations: The mouse is held stationary against the left-most edge of the screen for more than one-half second; or, it is configured to always appear using the RSVS Config Utility. Refer to Figure 3-8. The Hidden Bar provides access to seven icons. For the sake of simplicity, these seven icons have been rearranged. a. Work List Figure 3-8 Hidden Bar Icons Left-clicking the Work List Icon opens a selection screen, displayed in Figure 3-9. The two options available on this screen are Local Work List and CD-ROM Work List. Left-clicking either option causes RSVS to search the indicated location for DICOM images, and to display these images in a Work List Window. Figure 3-9 Work List Options Version 7.4 B-TM Page 44

56 b. Print Left-clicking the Print Icon will give a menu to either print selected image or print entire series to paper. This will send image(s) selected to default printer (if configured). NOTE Good image quality requires printers with 600 dpi or greater resolution. c. Network Refer to Figure Left clicking the Network Icon opens the DICOM Network Manager Window. This window initiates DICOM communications with other devices and logs significant events. Available selections include: Echo Invokes the DICOM ECHO operation to validate communications between two DICOM nodes. This should be the first step in checking any DICOM communications. Send Invokes a DICOM C-STORE operation to send selected images/studies to a valid DICOM destination. Query Invokes DICOM QUERY operations to retrieve and create a Work List for another valid DICOM workstation. Events Displays a log list of significant events. Exit Closes the DICOM Network Manager Window. Figure 3-10 DICOM Network Manager Window Note the two icons in the upper-right corner of the window. The icon to the far-right alternately expands and collapses the DICOM Network Manager Window within the RSVS System Window. The icon to the right minimizes the DICOM Network Manager Window and places an icon in the RSVS System Window. d. House Keeping Refer to Figure Left clicking the House Keeping Icon opens the Image House Keeping Board. Images appearing in this window satisfy housekeeping criterion established using RSVS Config. Version 7.4 B-TM Page 45

57 Images can be individually selected and removed using the Delete Button. Similarly, images can be sequentially or non-sequentially selected and marked for deletion. Finally, all images can be removed using the Del All Button. e. Settings Figure 3-11 House Keeping Window Refer to Figure Left clicking the Settings Icon opens the Setup Window. This provides a means to configure several ancillary items. Figure 3-12 Setup Window The three function buttons (CD Drive, Housekeep, and W/L Presets) immediately above the Exit Button change the appearance of the Setup Window. When invoked, these functions fill the main region of the window, as described in the following sections. i. CD Drive Refer to Figure The CD Drive function allows users to: Enable/Disable the Build Work List from CD-ROM function using a check box. Select the default drive designation used to search CD-ROM devices. In addition, error and status messages designed to facilitate troubleshooting appear in the center of the window. Version 7.4 B-TM Page 46

58 ii. Housekeep(ing) Figure 3-13 CD Drive Window Refer to Figure The Housekeep function allows users to further automate the image deletion process. Available selections resemble those provided in the RSVS Config application program. From top-to-bottom, selections include: Delete images which are sent. Delete images which are viewed. Delete images which are archived. Delete images of any above type. The images to be deleted are at least XX days old. Delete all images that are at least XX days old. The first four boxes are logically linked. If any of the first three boxes are checked, the fourth cannot be checked. Similarly, if the fourth box is checked, none of the first three boxes may be checked. The logic permits all of the first three boxes to be simultaneously checked. Figure 3-14 House Keep In addition, in the center of the window are messages that show how much space is used. Version 7.4 B-TM Page 47

59 iii. W/L Presets Refer to Figure The W/L Presets function allows users to establish preset values for Window-Level (Brightness-Contrast) for use when viewing images. Figure 3-15 Window/Level Window The top portion of this window contains a pull down used to display the names of all presets. The defined values associated with the preset appear in the four entry boxes (Preset Name, Message ID, Window, Level) after selection. The four function buttons (Set Values, Add, Update, Delete) at the bottom of the window permit entering, modifying, and deleting presets. iv. Exit The Exit function button will close the Setup Window. f. About Clicking on the About Button displays the RSVS Splash screen illustrated in Figure 3-1. To close this screen, left-click once on the window. 4. g. Exit The Exit Button closes all RSVS windows and exits the application. SeriesGroup Hidden Bar In the bottom left portion of the RSVS screen is a secondary hidden bar that is used for SeriesGroup operation. By holding your cursor for 2 seconds at the lower left portion of the RSVS window, the hidden bar will appear with folders. Please refer to Figure Version 7.4 B-TM Page 48

60 Figure 3-16 SeriesGroup Hidden Bar The top portion of the hidden bar is always Worklist, which gives the ability to immediately go back to the worklist to select the next patient without having to close the presently open series or study. Under the worklist are the patient(s) that have recently been viewed. If the folder is open, that means the series is open in RSVS. When the folder is closed, it means that the images are not presently being displayed. Clicking on a closed folder will open it; alternately clicking on an open folder will close it. If configured, you may only be able to open one folder at a time. Right-clicking on any of the folders will give a menu shown in Figure Left-clicking on Open will open the selected SeriesGroup. Information will display Series Information. Merge into a SeriesGroup will allow you to place the highlighted series into another SeriesGroup in order to compare. Purge will empty the SeriesGroup folder. Purging is an easy way to clean up this secondary hidden bar so that it does not become full of SeriesGroups. Whenever RSVS is closed completely, this secondary menu bar will automatically purge all SeriesGroups. 5. System Window Icons Figure 3-17 Task Bar Refer to Figure The RSVS System Window provides place-keeping icons to keep track of minimized windows. Double-clicking an icon expands it to full size. Figure 3-18 RSVS System Window Icons Version 7.4 B-TM Page 49

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62 Chapter 4: DISPLAYING AND MANIPULATING IMAGES A. Overview Displaying studies in RSVS requires following a simple process. The user opens a Work List, locates and selects the desired study, then invokes the Display Command. Each study appears in a separate window. The studies are now available for manipulation and inspection. B. Work List Refer to Figure 4-1.The RSVS Work List: Local is normally opened or minimized in the background. The Work List Window consists of several sections: Upper Section (Worklist). Lower Section (Image List). Function Buttons. There are two ways to display image in formation within the image list. Figure 6-1 shows two different formats of how image information can be displayed. To switch between thumbnail and image list, right-click in the image list area to get a drop-down menu. Select from this menu the mode that you would like displayed. Worklist with Image Information in List box Figure 4-1 Work List Windows Worklist with thumbnail images listed The lower-left portion of the Image List contains five information boxes associated with the image Series: Total Patient Count Indicates the number of patients in the worklist. Total Series Count Indicated the total number of series in the worklist. Series Count Indicates the number of studies in the worklist. This number must be equal to or greater than the Total Patient Count. When the Series Count is greater than the Patient Count, at least one patient has multiple image series. Image Count The number of images in the currently selected Series. PATIENT, SERIES, STUDY This indicates which worklist type is displayed, based on configuration. Version 7.4 B-TM Page 51

63 1. 2. Series List As the name indicates, the Series List displays all available DICOM image series. The Series List may be sorted or resized as previously described. The display format resembles a tencolumn spreadsheet: Status Either an X or a.. The X indicates the study has not been opened; text on the line is gray. The. indicates the study has been opened; the information on the line is blue. Patient Name Information taken from the DICOM header. Patient ID Information taken from the DICOM header. Accession # Information taken from the DICOM header. Modality Information taken from the DICOM header. Body Part Information taken from the DICOM header. Study Description Information taken from the DICOM header. Series # Information taken from the DICOM header. Image Count Information taken from the DICOM header and verified by RSVS. Study Date Information taken from the DICOM header. Study Time Information taken from the DICOM header. The format follows a 24- hour clock, with Hour-Minute-Seconds (HHMMSS.0.). Left-click to select a study. The line changes color (highlights) to indicate successful selection. After selection, the Image List displays information or thumbnails for all images in the study. Image List As the name indicates, the Image List can either display detailed image information or thumbnails of the images themselves. The following sections will describe how to turn on either of these features. a. b. Image information in list box When the image information is contained in a list, the main portion of this section resembles a seven-column spreadsheet. Unlike the worklist, these entries cannot be sorted. Images are automatically sorted according to the Image Number by default, but can be changed in configuration. Patient Name Information taken from the DICOM header. Patient ID Information taken from the DICOM header. Image Number The sequence in which images were acquired. Rows The number of rows of pixels in the image. Columns The number of columns of pixels in the image. Bits Stored The bit-depth of the stored image (8- or 16-bits). Compression The compression algorithm used, with the compression factor obtained. Thumbnail Images In order to display thumbnails of all the images within a study, use the mouse to position the arrow anywhere within the image list box. Using the right mouse button, click once to get the display box (shown in Figure 4-2). Using the mouse, left-click on List Thumbnail Images. Images will default to small thumbnail images, like what is shown in the second image in Figure 4-1. If larger thumbnail images are desired, right-click in the area again to get the Version 7.4 B-TM Page 52

64 dialog box shown in Figure 4-2. Left-click on List in Large Thumbnail Images and larger thumbnails will be displayed. Image List Dialog Box #1 Image List Dialog Box #2 Figure 4-2 Image List Dialog Boxes To return listing image information, right-click again within the image list area (Figure 5-2). Left-click on List Items in List Box and the worklist will return to the default setting. 3. Function Buttons Refer to Figure 4-3. The bottom portion of the Work List provides six Function Buttons. The appearance of the buttons toggles between two different selections. Left-clicking the button labeled Function toggles between the two selections. Button Set #1 a. Button Set #1 Button Set#2 Figure 4-3 Work List Function Buttons The first set is the default set appearing at application launch. From left-to-right, these selections are: Function Toggles between Button Set #1 and Button Set #2. Display Opens a viewing window for each series/image selected on the Work List. Info Opens an information window and displays key DICOM fields. Refer to Figure 4-4. Version 7.4 B-TM Page 53

65 Figure 4-4 Series Info Window Sort By Refer to Figure 4-5. Opens a pop-up menu to permit Series List field sorts. Figure 4-5 Sort By Pop-Up Menu Folders Toggles the Work List display between Spreadsheet and Folder layouts. Refer to Figure 4-6. The button reads Folder when in Work List/Spreadsheet layout; the button reads Work List when in Folder layout. Figure 4-6 Folder Layout Version 7.4 B-TM Page 54

66 NOTE When RSVS displays studies in the folder layout, text on the Folder Button changes to read Work List, as indicated in Figure 4-7. Figure 4-7 Work List Button Help Invokes the Help file that will provide information on the program. Close Closes the Work List Window. b. Button Set #2 The second button set appears after toggling the Function button. Three of the six buttons remain unchanged. From Left-to-right, the selections are: Function Unchanged. Print Same as the Print Button in the Hidden Bar. This will invoke a print function to the default printer that is set up within your system. Delete Permits deleting selected images directly from the Work List. Invokes a confirmation box prior to image deletion. Refer to Figure 4-8. Folders Unchanged. Close Unchanged. Figure 4-8 Deletion Warning Window NOTE Work List layout permits resizing the Series List and the Image List windows. The cursor icon changes to a vertical line with top-and-bottom arrowheads when directly over the central, horizontal separating bar. Left-clicking and dragging permits changing the relative size of these two windows. C. Study Selection (Work List) The image selection process occurs in the Series List. The list is sorted to facilitate locating the desired series. The desired series is then selected (highlighted). Frequently it will be necessary to select multiple series. 1. Sorting and Locating When first opening the Work List, RSVS automatically sorts the Series List according to the setting into Config. The default is Sort by Patient Name, Ascending. Version 7.4 B-TM Page 55

67 a. Sort Order Refer to Figure 4-9. A representative Patient Name column has been sorted in ascending (left) and descending (right) order. The information originally appeared in ascending order. Left-clicking the Patient Name column heading toggles between the two. Figure 4-9 Sorted Patient Name Columns The sort order differs from what might be expected. RSVS sorts are based on the actual binary (digital) data format of the information in the field. Sorting rules are characterized as follows: Spaces appear before numbers. Numbers appear before letters. Special characters (@, #, %, &) follow complex rules. Sequences require an identical number of characters. Thus, the 1.0T VISTA, PELVIS entry appears before NewTest. Similarly, Test Image12 is between Test Image11 and Test Image2. If this sequence needed to be sorted in ascending order, the names could have been entered as Test Image01, Test Image02, etc. 2. b. a. Sort Strategies Sorting strategies vary with operational needs. The best strategy is to sort using the most significant field based on your requirements. Thus, for on-call situations Study Date or Study Time sorts might be effective, while for clinical situations a Patient Name or Patient ID sort might be a better choice. Selecting Series RSVS permits users to select individual series or groups of studies. In addition, RSVS permits users to select individual images from within a study. Single Series Selection Refer to Figure Selecting a single series consists of left-clicking anywhere within the study line. You may select the entire folder or may expand the folder to select individual series. The line highlights and the Image List indicates data for all images within the series. Figure 4-10 Single Series Selection Version 7.4 B-TM Page 56

68 b. Multiple (Batch) Series Selections There are two scenarios for selecting multiple series. The first involves adjacent line entries. The second involves non-adjacent line entries. The methods are non-exclusive and can be combined to facilitate selecting images for large batch jobs. i. Adjacent Studies Refer to Figure Locate the adjacent line items. Select the first item as you would for a single entry. Hold down the Shift Key. Left-click the top-most and bottom-most adjacent line entries. Release the Shift Key. The Image List box fills with data for the last series selected. To display these adjacent series, left-click the Display function button, located below the image list. ii. Figure 4-11 Adjacent Series Selection Non-Adjacent Images Refer to Figure Locate any desired line item. Select the first item as you would for a single entry. Hold down the Ctrl Key. Left-click all desired line entries. Release the Ctrl Key. The Image List box fills with data for the last series selected. Figure 4-12 Non-Adjacent Series Selection If a series was selected by mistake, hold down the Ctrl Key and left-click the line entry. This toggles the line between selected and not-selected. To display the non-adjacent series, left click the Display function button, located below the image list. c. Individual Image Selection Refer to Figure Select individual images appearing in the Image List by simply clicking on them. When thumbnails are displayed, the selected images will be highlighted in red. To display the individual images for a particular series, left click the Display function button, located below the image list. Version 7.4 B-TM Page 57

69 D. Study Selection (Folders) Figure 4-13 Image Selections The Folder layout does not provide sorting and selecting options, as does the Work List (Spreadsheet) layout. The Folder layout more closely resembles the functionality provided by a traditional film cart, where film jackets (folders) are removed as complete units. Recall Figure 4-6. When in Folder layout, each study is identified by a separate tab. Leftclicking the tab displays Series and image data in the window. Horizontal and vertical scroll bars assist in moving through the displayed data. Folders are automatically sorted (left-to-right) by Patient Name in an ascending order. Refer to Figure When RSVS contains 12 or more studies, the number of folder tabs exceeds the number of available display pixels. Some of the folder tabs will not be immediately available. A Folder List Scroll Bar (at the upper right of the window) permits rapidly moving through the folder tabs. E. RSVS Main Display Window Figure 4-14 Folder List Scroll Bar The RSVS Main Display Window displays selected images and provides all graphics manipulation and navigation tools necessary to examine radiographic studies Invoking Display After selecting studies (images), there are three methods to invoke the RSVS Main Display Window: Display Button Left-click the Display Button. Double-click Double-click a highlighted line entry. Right-click and Drag Right-click a highlighted line entry. Hold down the mouse button. The cursor icon changes to indicate image selection. Drag the cursor to the RIS RSVS title bar and release. Orientation Refer to Figure The RSVS Main Display Window comprises eight elements: Image Display Window. Title Bar. Series List. Image Position Window. Tool Bar. Pull Down Menu. Hidden Menu Bar. Hidden SeriesGroup Bar. Version 7.4 B-TM Page 58

70 Descriptions of each of these elements are provided in the following sections. The general sequence of descriptions follows the display layout, starting at the center of the monitor, then spiraling from the top, in a clockwise direction. a. Image Display Window The Image Display Window comprises the majority of the RSVS Main Display Window. This is the area in which images are mapped, moved, manipulated, and studied. RSVS is optimized to fully use available display screen area. If you close all other sub-windows, the Image Display Window occupies the entire screen. b. Title Bar Figure 4-15 RSVS Display Window Refer to Figure The Title Bar appears across the top of the Image Display Window. From right-to-left, the Title Bar provides: Bar Icon w/ Pull-Down Menu. Title bar w/ Pull-Down Menu. Image Information. Minimize Icon. Expand/Contract Icon. Figure 4-16 Title Bar i. Bar Icon w/ Pull-Down Menu Refer to Figure Left clicking the Bar Icon summons a selection menu. The choices available on this menu configure the look-and-feel of the RSVS Main Display Window. Version 7.4 B-TM Page 59

71 Figure 4-17 (Bar Icon) Pull-Down Menu Available selections include: Open All Tools Opens all display tools. Close All Tools Closes all display tools. Close Series List / Series List Toggles the Series List open or closed. Close Image Position Box / Indicate Image Position Toggles the Image Position Window open or closed. Close Tool Bar / Tool Bar Toggles the Tool Bar open or closed. Ruler Bar/ Close Ruler Bar Toggles Ruler Bar open or closed. The Ruler Bar appears at the lower left of the Image Window and provides a basis for comparing size based on the number of pixels. Stack Series / Montague Series Toggles images between Stack or Montage layouts. Study Information Opens the Study Information Window. Close Closes the Main Display Window. ii. Title Bar w/ Pull-Down Menu By right-clicking anywhere on the title bar, beyond the Bar Icon, another drop-down menu will appear. Please refer to Figure 418. The choices on the menu help with displaying the image(s). The selections available are identical to the main tool bar. This tool bar is helpful when the main toolbar is closed in order to give a larger viewing area. iii. Figure 4-18 Title Bar Pull-Down Menu Image Information The Title Bar displays information that uniquely identifies the study. From left-to-right, this information is: Study Name From DICOM header. Version 7.4 B-TM Page 60

72 Modality From DICOM header. Compression degradation notice Present whenever any image in the displayed series used a compression algorithm that degraded image quality (lossy data). c. d. e. Series List The Series List occupies the far-right portion of the Main Display Window. All images in this study appear in a vertical stack. The first image is at the top of the stack and the last image is at the bottom of the stack. A scroll bar to the right permits rapid paging through the stack. Each image is numbered (outer left corner). Identical numbers indicate the individual image has been duplicated, most likely the result of retaining compressed and non-compressed versions of the same study, or receiving duplicate studies. One image is outlined. This indicates the active image in the Image Display window. The active image may be manually selected with a left mouse click. Alternately, the Page Up and Page Down keys move through the list. Image Position Window The Image Position Window occupies the lower right corner of the Main Display Window. This indicates the currently displayed portion of the image relative to the entire image. A thumbnail of the entire image fills the Image Position Window. A colored rectangle indicates the displayed portion of the image relative to the entire image. This tool facilitates image identification and navigation during certain situations. For instance: A CT study is printed to a chest-sized film in a 3x4 format. The Image Area has been zoomed so that a single slice fills the entire viewable area. The Image Position Window indicates that individual slice s location relative to the entire sheet. Tool Bar The Tool Bar occupies the far-left portion of the Main Display Window. This area contains four regions of interest. From top-to-bottom, these are: Appearance/Orientation Tools. Management Tools. Quick Access Buttons. Reset/Panic Button. The screen will not simultaneously show all of these controls if the display resolution is set below 1024 x 768 pixels. In this situation, the entire Tool Bar can be moved up or down by left-clicking and dragging. i. Appearance/Orientation Tools Refer to Figure Appearance tools change Window/Level (Brightness/Contrast) settings and provide image smoothing. Version 7.4 B-TM Page 61

73 Figure 4-19 Appearance/Orientation Tools There are four areas located within the Appearance/Orientation Tools area of the main tool bar: Window/Level (W/L) Mapping An area indicating the window value (the pixel values) to the level value (the video intensity value, or the display intensity values). Leftclicking and dragging while the cursor is over this area permits changing the relationship between the pixel and the display values. Dragging the mouse up or down changes the window values; dragging the mouse left or right changes the level values. NOTE For 12-bit grayscale images, pixel values are numbers representing shades of gray, from white (0) to black (4096). Video intensities are numbers representing the number of brightness increments the video monitor produces pixel values are mapped to 256 video intensity values to display a digital image on the monitor; a single video intensity value on the monitor represents multiple gray pixel values. To optimize the display, use the mouse to select a range (or window) of pixel values from the 4096 shades of gray to set the pixel value for the center of this range. Win/Level button Located within the Win/Level button are options for further manipulating displayed image. Please refer to Figure Figure 4-20 Win/Level Button Options Mapping Algorithm Selection RSVS provides three different mapping algorithms: Linear, Non-Linear, and Pulse. Left-clicking the button rotates between these selections. Version 7.4 B-TM Page 62

74 Reset Resets window and level of selected (highlighted) image to original values. Reset All Resets all images within the displayed series. Inverse Toggles between positive and negative presentations of the image. Invert All Inverts all images within the displayed series. Preset Opens a pull-down menu allowing access to preset W/L values set in Config. Left-clicking an entry selects those values for the highlighted image. Win/Level Optimized in a specified area Use the cursor to scroll over this option, two selections are displayed: Circle and Rectangle. Left-clicking to select one of these options will bring a different cursor (+) to the image display window. Left-click and hold to expand the circle or rectangle in a specific area of the highlighted image. The optimal window and level values based on that area will be applied to that image. To stop this window/level control, go back into the Win/Level button, place cursor over Win/Level Optimized in a specified area, and select Stop Best-Fit Mode. Apply to Series Sets all series images to the appearance settings (W/L, Mapping, and Inverse) currently indicated. Automatically Apply Win/Level Adjustment to Entire Series Clicking on this option will turn this on. Every time a window/level adjustment is made, it will automatically apply to the entire series, without having to click Apply. This feature is also configurable to be always turned on in RSVS Configuration utility. Orientation button Located within this button is another drop-down menu that will give you the option to change the orientation of the displayed image(s). Please refer to Figure Figure 4-21 Orientation Button Options Horizontal Flip Selecting the Horizontal Flip Button flips the highlighted image horizontally (to produce an image mirrored around the vertical axis). Vertical Flip Selecting the Vertical Flip Button flips the highlighted image vertically (to produce an image mirrored around the horizontal axis). Rotate Selecting the Rotate Button rolls the highlighted image in 90-degree clockwise increments. This is particularly useful when scanning 14 x 17 film that needs to be displayed in a landscape orientation. Apply to Series Sets all series images to the orientation settings (Horizontal, Vertical, and Rotate) currently indicated. Apply Button Applies any changes (window/level or orientation) to entire displayed series. ii. Management Tools Management Tools provide additional image display or utility routines. Located in the Management area are three buttons: Layout, Measure, and Tools. Each will be described below. Version 7.4 B-TM Page 63

75 Figure 4-22 Management Tools Area Layout Button Within the Layout button are several options for how images are displayed on your screen(s). Clicking once on the Layout button opens a menu like the one displayed in Figure RSVS supports two image display modes: Montage and Stack. If configured, when a series first opens, the images appear in Montage Mode. The border around Image #1 is highlighted in the Image Area and in the Series List. A border appearing around each image indicates the level of compression lossy (rust red), or lossless (green) associated with the image. All default tools are open. The Montage mode displays the maximum number of images, in order, by image sequence number, beginning at the upper-left and continuing to the lower-right. See Figure The Series Display window indicates which image is highlighted. Figure 4-23 Montage Mode Display The Stack mode displays only one image at a time even if there is more than one image in the study. You can select the image you wish to display by rightclicking the thumbnail in the Image Series window. The Series Display window indicates which image you are viewing in the series. Figure 4-24 Stack Mode Display When in the Montage mode, you have the ability to choose how the images are displayed on your monitor(s). The following options are available: 1x1; 2x1; Version 7.4 B-TM Page 64

76 2x2; 3x2; 3x3; 4x3; Free. Free displays all the images for the series in the image display area. Figure 4-25 Layout Button Menu Reset Image Positions Will bring the image(s) back to the center of the screen. Roam in Image View Frames Selecting this option will move the image within the frame that surrounds it, rather than moving the whole image and frame together. If this option is check another option appears to Synchronize Roam Operation Over all Images. Selecting this will do the same movement over every image within the displayed series. Sort Images Highlighting this will give the option to change how images are sorted: By SOP Instance UID or By Image Number. Measure Button Opens the Measurement Toolbox, displayed in Figure The Measurement Toolbox gives the ability to make distance, angular, area, density, and histogram measurements while viewing images. These measurements are not permanently saved. Figure 4-26 Measurement Toolbox Distance Point-to-point measurement. This is the default mode when the toolbox is opened. To measure distance, left-click on the first point and hold the left mouse button, while dragging to the second point. The measurement is displayed. Angle Angular measurement. To make and angular measurement, left-click on the first point, while holding the left mouse button drag to second point. Follow the same steps to make the second part of the angle. The angle measurement is displayed. Area Area measurement. To measure an area, left-click on beginning spot. Hold left mouse button while dragging over the area to be measured. Release the mouse button to see area measurement. Density Provides the ability to do density measurement within a Circle, Rectangle, or Along a line. To do a density measurement, left-click, hold and drag mouse in area to be measured. Version 7.4 B-TM Page 65

77 Histogram Provides a histogram of the area defined. This can be done either in a Circle or Rectangle. Font Size The font size of the measurement can be changed by using the A buttons. Clicking on the larger A incrementally increases the font size, while clicking on the smaller A decreases the font size. Erase All Erases all measurements from an image. Unit: CM Clicking on this button will change the units of measure between cm, mm, and inches. This must be changed prior to making a measurement. Erase Last One Erases last measurement made. Calibrate Opens the calibration screen, as shown in Figure Calibration must be done prior to measurement for any images that were digitized. DICOM direct images do not require calibration. Figure 4-27 Measurement Calibration Tools button There are several options contained within the Tools button that allows for further image manipulation. Left-clicking on the Tools button opens the menu displayed in Figure Figure 4-28 Tools Button Menu Smooth (Precise) -- Smoothes an image using linear averaging algorithms so that the human eye more readily interprets the image. Smoothing applies only to the highlighted image. Additional image manipulation removes smoothing; the smoothed image is overwritten by the original image. Magnify Glass Permits viewing a selected area of a digital image from 1X magnification to 16X magnification. The Image display supports the Magnify Glass in either the Stack or DMontage mode, using all mapping algorithms. Opening the Tools menu and left-clicking on Magnify Glass toggles the function ON or OFF. Refer to Figure The Magnify Glass creates a second window within the Image Display area. This window exists independently of the Image Display window. However, both of these windows respond to mouse commands in similar manners and use image manipulation features available in the Tool bar and with mouse controls. Version 7.4 B-TM Page 66

78 Figure 4-29 Magnify Glass For the purpose of adjusting Window or Level, the image appearing in the Magnify window and the image appearing in the Image Display are independent of each other. The presence of a small rectangle in the upper left portion of the window/level map indicates Tool Bar functions apply to the Magnify Glass. The absence of this rectangle indicates the Tool Bar functions apply to the Image Display window. A mouse click in the desired window toggles between the two. Similarly, the mapping algorithms used for both windows are completely independent of each other. Thus it is possible to display one window using the linear mode while the other window uses the non-linear mode. Though nominally independent of each other, the image appearing in the Magnify window and the image appearing in the Image Display must be identically oriented to preserve diagnostic integrity. Thus, using the Orientation button to rotate or flip one image causes an identical result in the other window. Using both mouse buttons moves or resizes the Magnify window. Clicking inside of the window while holding down both buttons permits repositioning (panning) the window within the Image Display area. Clicking on the border of the window while holding down the left button permits resizing the Magnify Glass. The mouse cursor changes to indicate the window can be resized. During resizing, the center point of the window remains fixed while the sides shrink or grow in response to mouse motion. Note that the Magnify window symmetrically resizes both sides of the window. In addition, selecting the corners of this window permit simultaneous horizontal and vertical resizing. The right mouse button varies the level of magnification within the window. Clicking inside of the window while holding down the right button permits altering the magnification ratio. Moving the mouse down and right increases magnification; up and left decreases magnification. When used in conjunction with the Information Text Overlay (Simple), a digital indication of magnification factor appears in the upper left corner of the magnify window. Magnification ratio is adjustable in increments as little as Send Images (DICOM C-STORE) Opens the Network Manager window in order to send images to another configured location. Export Image Permits the exporting of displayed, highlighted image to files or other Windows applications, according to settings create in RSVS Config. These exported images can then be used in PowerPoint or other applications. Print Gives the option to print image(s) to a default paper printer. Left-clicking the Print Icon will give a menu to either print selected image or print entire series to paper. This will send image(s) selected to default printer (if configured). Cine -- Displays a series of images in cinematic mode. Left-clicking on Cine activates the function. Tapping the Enter key on you keyboard deactivates the function. Mouse position controls the speed and direction of the cinematic mode in the image display window. Cinematic scrolling is faster as Version 7.4 B-TM Page 67

79 the cursor moves toward the right or left edge. The images move forward (that is, from the image at the top of the series list to the one at the bottom) with the mouse in the left half of the window. Images move backward with the mouse in the right half of the window. Information Text Overlay (Simple) -- Superimposes Patient Information from the DICOM header over the image. Information appears in three areas. The upper left corner of the Image Window provides Patient Name, Sex, Date of Birth, Patient ID, Study ID, Accession #, Series #, Body Part, Modality, Study Date, Study Time, and Image Count. The lower left corner of the image indicates the actual Image Number within the study. When used with the Magnify Glass function, indicates the actual magnification factor. Information Text Overlay Superimposes Patient Information from the DICOM header over the image. This is more detailed than Information Text Overlay (Simple) and the amount and location of the information displayed is controlled by the settings in RSVS Configuration. High Pas Filter Applies a more detailed algorithm for image manipulation. Short Range Line Enhancement Filter Applies a more detailed algorithm for image manipulation. No Image Filter Default configuration where no further image enhancement is done. Close Button Closes the displayed series or study. iii. Quick Access Buttons The three Quick Access buttons, shown in Figure 4-30, allows for fast access to the most commonly used tools. When they are lit (green) they are activated. Figure 4-30 Quick Access Buttons Win/Lvl Makes the left-mouse button the controller of window and leveling changes. If this button is not activated, holding the two mouse buttons controls window and level within the image(s). Measure Opens the Measurement Toolbox. Smooth Turns on the Smooth function for the displayed image(s). This will apply a linear averaging algorithm so the human eye can more readily interpret the image. iv. Reset/Panic button The Reset/Panic button gives an easy way to reset the image to original parameters. How the image is reset during display is controlled within the RSVS Configuration utility. The default reset parameters are Orientation, Image Layout, and Win/Level. To get back to original parameters, double click on the mouse button on the main toolbar. See Figure Version 7.4 B-TM Page 68

80 3. 4. Manipulating Images a. Zoom b. Figure 4-31 Reset Button As described earlier, RSVS supports two image display modes: Montage and Stack. How the images are displayed when first opened is dependent on what is configured. Regardless of Display Mode selected, images can be Zoomed or Panned. The right mouse button invokes the Zoom command. Place the cursor at the point of interest (the point you want to look at) in the image. This is the anchor point it sets a reference point for zooming. This anchor point remains in the screen display while you are zooming. Hold the right mouse button down while moving the mouse. Moving the mouse up or left zooms out (makes the image smaller) and moving it down or right zooms in (makes the image larger). While zooming in or out, the anchor point will remain stationary. Pan (Roam) Holding the two mouse buttons simultaneously invokes the Pan (Roam) command. Place the cursor at the point of interest (the point you want to look at) in the image. Hold the two mouse buttons down while moving the mouse. The images will follow the movement of the mouse. Displaying Multiple Studies RSVS allow users to simultaneously display multiple studies. Select the studies that you want displayed and click on the Display button in the lower portion of the Worklist window. Depending on your configuration of SeriesGroup operation, the studies will automatically tile. See Figure Figure 4-32 Multiple Studies Displayed Version 7.4 B-TM Page 69

81 Notice that when more than one series is displayed, no tools are visible. This is controlled in RSVS Configuration under SeriesGroup operation. If you have a mouse with a wheel, moving your cursor of any of the displayed series and scrolling the wheel, will move up or down through the series list. If you would like to open the toolbars, click on the bar (-) icon in the top left corner of the series and click on Open All Tools. Or you may open only individual toolbars that are important. The number of studies that the RSVS can simultaneously display depends on your workstation's hardware configuration. However, performance degrades as the number of open series increases. To close an open series, click on the bar (-) icon on the upper left portion of the series and then click on Close. You may alternately close the entire study by going to the SeriesGroup hidden bar and clicking on the open folder to close it. 5. Displaying Scout Image RSVS now gives the ability to display scout images and allows you to select easily the Region of Interest. Once a series that contains a scout image is loaded, located within the Tools button is an option for Scout Image. Clicking on Scout Image will load the image in the lower right corner of your viewing screen, as shown in Figure Right-clicking anywhere on the scout image will load the corresponding slice. Alternately, scrolling with a wheeled mouse will scroll through the images and display on the scout view, where associated slice is located. Figure 4-33 Scout Image Version 7.4 B-TM Page 70

82 Chapter 5: TRANSMITTING/RECEIVING IMAGES A. Overview For images received, as long as the DICOM information is correctly configured in RSVS Config, images will continually be received in the background.refer to Figure 5-1. All outgoing transmissions pass through the DICOM Network Manager. Activate this window using any of three methods: The Network Button on the Hidden Bar. The DICOM Network Manager selection from the Track Menu pull-down. Send Images (DICOM C-STORE) located within the Tools button on the main toolbar. When first opened, the main portion of the window is blank. Figure 5-1 DICOM Network Manger Refer to Figure 5-2. Because RSVS can receive transmissions as a background process, the lower right corner of the Main Window provides visual indication of communications activities. When expanded by moving the cursor to the lower edge of the main window the window provides a running total of bytes sent and received, as well as green SEND and RECV rectangles indicating data activity. When contracted, enough of the window appears in the lower right hand corner of the display monitor to show the green rectangles during data transmissions. B. Basic Communications Theory Figure 5-2 Communications Monitor The RSVS Workstation follows a logical sequence when attempting to establish DICOM communications with peer nodes. A very simplified description of this process follows. Validate DICOM node information. Identify the peer node using Host Name and AE Title. Look up the TCP/IP address using the Host Name. Return an error if validation fails. Version 7.4 B-TM Page 71

83 Establish a TCP/IP session. Use the existing TCP/IP session if it is to the correct peer node. Break the connection if it is to the wrong peer node. Make a connection to the correct peer node. Determine the need for Dial-Up Networking services. ECHO. SEND. QUERY. End the session. Initiate outward dialing. Wait for a valid connection message. Return an error message if the connection attempt is not successful. Return a validation message to indicate a successful Dial-Up connection. Establish a TCP/IP session using the indicated Port. Return an error message if the connection attempt is not successful. Return a validation message to indicate a successful TCP/IP connection. Perform DICOM validations. Perform the indicated task(s). The majority of these tasks are performed by the Windows Operating System. RSVS coordinates these activities and provides indication of returned error codes. C. Echo NOTE RSVS communication is always one-to-one; you can only communicate with one peer workstation. You cannot broadcast a transmission to the DICOM network. Refer to Figure 5-3. RSVS implements the DICOM ECHO function. This creates, sends, and receives a DICOM package. ECHO tests and validates configuration settings and basic network connectivity. Successful ECHO returns indicate that image transfers will probably be successful. The Echo window contains function buttons, a Remote Node Information area, and a message area (Echo Status). Figure 5-3 DICOM Network Manager Echo Version 7.4 B-TM Page 72

84 Function Buttons Echo provides two functions: Echo Invokes the DICOM ECHO command, which sends a DICOM header to a peer node and waits for a validated response from that node. Status messages indicate progress. Cancel Closes the DICOM Network Manager Window. Remote Node Information The Remote Node Information section reads node data entered into the rsvs.ini file. The pull-down icon at the upper right provides a drop down menu used to read and select the DICOM destination. Node entries appear in the sequence in which they were originally entered; they are not automatically sorted. The four display entries correspond to the four entry fields used in the Config utility. RSVS opens indicating the Peer Node selected in Config. While it remains open, RSVS remembers and returns to the last Peer Node selected. The Dial-Up section reads phone numbers entered into the Dial-Up Server. The pull-down icon at the right provides a drop down menu used to read and select these dialing destinations. Dial-Up entries appear in the order in which they were entered. Message Area The Message Area displays status of the current DICOM event. For Echo, this sequence should be: Please Click Echo button to prompt Echo Invoking Echo Echo OK! D. Send It may be necessary that you may send images to another station. Refer to Figure 5-4. RSVS uses a DICOM C-STORE operation to implement Send. Send transmits all studies and individual images currently selected in the RSVS Main Display Window. This process establishes a connection, compresses images, sends images, monitors status, and provides confirmation of DICOM image transfers. Figure 5-4 DICOM Network Manager - Send Version 7.4 B-TM Page 73

85 For the most part, Send operations resemble those of Echo. The most notable differences are messages indicated and compression selection fields. The Send window does not directly indicate message status; it indicates Please see DICOM Communications Activities Dialogue for status. Send provides a means to change transmission compression schemes. Two mutually exclusive checkmarks permit selecting one-of-three compression methods: None, JPEG Lossless Compression, Wavelet Compression at rate xx, where xx is the Quality Index from The window opens indicating the compression values selected in Config. While it remains open, RSVS remembers and returns to the last settings selected. The entry box permits operators to manually enter a different quality index for the indicated transmission. It is recommended to not use any compression when sending through a network or broadband connection. E. Query Refer to Figure 5-5. Query indicates all studies currently available at a remote DICOM node. RSVS uses DICOM C-GET and C-STORE operations to implement Query. This process establishes a connection, generates a Work List [Remote], marks images for retrieval, and sends this list to the peer node. During the image transfer process, your RSVS Workstation monitors status. The peer node marks selected images for transfer, compresses images, sends images, and monitors status; it does not provide confirmation of DICOM image transfers. Figure 5-5 DICOM Network Manager Query Refer to Figure 5-6. RSVS displays another series of windows before initiating the Query process. The background displays a blank Work List, entitled Remote Work List [AE Title]. The DICOM Query Criteria dialogue box is superimposed over the blank work list. Version 7.4 B-TM Page 74

86 Figure 5-6 DICOM Query Criteria The DICOM Query Criteria permits users to filter the Remote Worklist. The filters minimize the number of study headers transmitted across the network, to speed the data transfer process. Available filters include: No Restriction. Patient Name. Patient ID. Modality. Study Date Range. Refer to Figure 5-7. Checking any box except No Restrictions immediately opens additional entry fields in the DICOM Query Criteria dialogue box. This permits entering alphanumeric sort criteria. Figure 5-7 DICOM Query Criteria w/ Entry Fields Left-clicking the Query Button initiates communications with the peer node. A message indicating Query series information from xxx appears. After a brief delay, the Remote Worklist indicates all studies meeting indicated criteria. Refer to Figure 5-8. If no records match the query criteria, a blank Remote Worklist Window appears. Version 7.4 B-TM Page 75

87 Figure 5-8 No Records Match The Remote Worklist functions in a similar manner as the Local Worklist. The only exception is the Retrieve Button. After marking images for retrieval, clicking the Retrieve Button initiates image transfer. F. Events Refer to Figure 5-9. The Events window provides a record of significant events from DICOM Service Provider Objects for troubleshooting and administrative purposes. The log clears each time RSVS restarts. G. DICOM Communication Activities Figure 5-9 DICOM Network Manager Events Refer to Figure The DICOM Communication Activities windows provide details of image transfer status. The screen comprises three sections. The upper left section indicates status for the current image transfer operation. The upper right portion section provides three function buttons. The lower section contains messages and status. Version 7.4 B-TM Page 76

88 Sending Images Figure 5-10 DICOM Communication Activities Retrieving Images Function Buttons There are three function buttons: Cancel Cancel attempts to terminate the current send operation. The success relates to the percentage of study sent and the amount of time remaining to complete the study. Remove Remove permits deleting a batch-send image from the pending queue. Remove has no impact on the current send operation. Close Closes the window. Even with the DICOM Communication Activities window closed, background sending operations continue until the send queue empties. Window condition does not impact receive operations. All entries in the log section purge each time this window closes. Current Operation Refer to Figure The Current Operation section provides status of the image send operation in progress. This area consists of two portions. The upper portion contains text and displays messages. The lower portion provides visual indication of transfers in progress. Figure 5-11 DICOM Communication Activities Transfer in progress Version 7.4 B-TM Page 77