USER MANUAL VP PLANNING

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USER MANUAL VP PLANNING 1.0 Mobile application Android Visible Patient SAS RCS Strasbourg TI 794 458 125 1 place de l'ho pital 67000 Strasbourg, FRANCE Share capital: 58330 Tel.: 33 (0)3 88 11 90 00 Fax: 33 (0)3 88 11 90 99 support@visiblepatient.com Dec 11, 2014 2014 V 1.0

Purpose The purpose of this application is f o r educational use and a general public approach of anatomy. Warning Minimal system requirements: Android 4.1 device (or earlier version) Visible Patient Planning mobile application being a prototype software, it is not certified as a commercial medical device and cannot be used in clinical routine and/or for patient care unlike the Visible Patient Planning computer software. The application is neither FDA approved nor CE marked. You can only use the Visible Patient Planning application as a reviewing, research or teaching software. 2/13

Table of Contents Preface 4 Section 1: Getting Started 4 1.1 Installation 4 Section 2: Menu 5 2.1 Home 5 2.2 Local Data 6 2.3 Online Data 6 2.3.1 Online Data FREE USER 6 2.3.2 Online Data VISIBLE PATIENT CLIENT 7 2.4 Settings 8 2.4.1 Server selection 9 2.4.2 User 9 2.4.3 Enable logging 9 2.5 About 10 Section 3: How to use the 3D model? 10 Section 4: APPENDIX 12 3/13

Preface VP Planning is a 3D visualization mobile application for anatomical and/or pathological modeling from anonymous medical images of patients. The 3D models of patients reconstructed by the Visible Patient online service can be used for the 3D visualization of real pathological anatomical cases for educational purposes. This user manual gives you an easy understanding on how to use the VP planning mobile application. Section 1: Getting Started 1.1 Installation 1. Search for VP Planning in the Google Play Store, follow this link, or flash the QR code. 2. Click INSTALL 3. Accept the agreement agreement window 4. Once the installation is complete, tap on OPEN or tap on the icon 4/13

Section 2: Menu 2.1 Home 1. Launch the app by taping on the icon 2. The software then displays the Home page entitled Visible Patient Planning. 3. Tap on the top left VP icon, you can access the menu. * You can also access the data from the short-cut links on the Home page via Browse local data and Browse online data. Homepage of the application (left) and menu (right) Using this menu, you have access to the following pages: Home Local data Online data Settings About Homepage of the application. Cases stored on your device are available here. Online cases are available here. Login and change the settings here. More information about the application is available here. 5/13

2.2 Local Data 1. To access cases stored in the memory of your device, go to the Local data page from the menu or the link available on the Home page. 2. Select the 3D model of a patient for visualization. * The menu gives you the number of cases stored in your Android device. * You can use keywords to find a specific case in the area at the top right corner. * To remove cases from your Android device, press on the case you want to delete for a few seconds and choose Delete. You can download the case again from the Online data section. Local data page 2.3 Online Data 2.3.1 Online Data FREE USER 1. Be sure to be connected to the Internet * The Visible Patient directory and the VPOD directory (Visible Patient Open Database) are publicly available all the time for reference or educational purposes. * You can find descriptions of all clinical cases available for all users in section 4: APPENDIX, at the end of the document. For more information about the cases in the VPOD folder, follow this link: http://www.visiblepatient.com/gallery/vp-open-db/. 6/13

2. Tap on Online data 3. Tap on the targeted directory 4. Choose the folder which is named by YY/MM 5. Tap on the 3D patient model you want to see, the model will be automatically downloaded onto your Android device. The 3D model will be marked Cached. 6. The 3D view opens automatically at the end of the download. 7. Whenever you want to return to the parent directory or folder, tap at the top left corner. To return to the root directory, tap on the back button of your Android device. 3 1 2 3' DIRECTORY FOLDER (name: YY/MM) 3D MODEL 2.3.2 Online Data VISIBLE PATIENT CLIENT 1. Be sure to be connected to the Internet * The Visible Patient directory and the VPOD directory (Visible Patient Open Database) are publicly available all the time for reference or educational purposes. * If you want to access your personal community database, you need to log in in Settings. These databases correspond to communities you belong to. 7/13

* You can find descriptions of all clinical cases available for all users in section 4: APPENDIX, at the end of the document. For more information about the cases in the VPOD folder, follow this link: http://www.visiblepatient.com/gallery/vp-open-db/ 2. Tap on Online data 3. Tap on your community directory 4. Choose the Patient folder 5. Tap on the 3D patient model you want to see, the model will be automatically downloaded onto your Android device. The 3D model will be marked Cached. 6. The 3D view opens automatically at the end of the download. 7. Whenever you want to return to the parent directory or folder, tap at the top left corner. To return to the root directory, tap on the back button of your Android device. 2.4 Settings 1. Tap on the Settings button and you will see Select server, User, Enable logging. Settings page 8/13

2.4.1 Server selection This first option allows you to change the server used to download the 3D model. The default server is the Visible Patient server and it is the only one available, so you do not need to change anything in this option. 2.4.2 User This section is only for Visible Patient Online Service customers; you can setup your account by inserting your user name and password provided by Visible Patient. You have to be connected to the internet in order to log in. * This personalization process allows you to download all the 3D models requested by your community members on your mobile devices. * For more information about the Visible Patient online service, please go to our official website: http://www.visiblepatient.com/ 1. Tap on the User name and fill in your email account. 2. Tap on the Password and fill in your password. 3. Tap Ok for successful login. * This identification needs to be done only once and remains active during your subsequent uses of the application. 4. To log out, tap on the Log out button below your login. 2.4.3 Enable logging The last setting option is only useful if you encounter difficulties using the application and is disabled by default. In case of problems, our support team may ask you to enable login. In normal usage, ensure that this option is disabled because it will slow down the application. 9/13

2.5 About In this section you can learn more about the application and the Visible Patient Company. If you encounter any issue with the application, or if you have suggestions to improve the mobile experience of the Visible Patient Planning application, do not hesitate to contact us at following address: support@visiblepatient.com. Section 3: How to use the 3D model? 1. Select your 3D patient model in the Local data (Section 2.2). 2. Once you have selected your patient, the 3D image will appear on your screen (it may take a while to complete the loading depending on your device). 3. Every time you load a 3D model, following icons will show up and guide you on how to use the 3D model. Double tap on the organ you want to focus on, all the other remaining organs will be hidden. The name of the focused organ will appear. To erase a selected organ, tap once. Pressing on the screen for a few seconds will make all organs appear again. To move the view around the 3D model, swipe your finger up, down, left or right. To move the position of your 3D model, scroll two fingers on the screen to the desired location for the optimal view. To rotate the 3D model, rotate two fingers on the screen. 10/13

To zoom in and zoom out of your 3D model, zoom or pinch your fingers on the screen. Tap on this icon in the top left corner to show axial, sagittal and frontal view icons. Tap this gear icon in the top right corner to use organ manager, camera, and help. Tap on the first icon to open the organ manager and change the visibility of organs. organ manager Every modeled organ is listed on this organ manager, tap on the name of the organ and you can hide/show the organ in the view. Tap in the dark circle to change transparency of the selected organ. Four transparency levels are available. You can also show/hide all organs by taping Show all / Hide all buttons. Tap on the camera icon to take a snapshot of your 3D model. This picture will be stored on your device. Tap on this icon to show the help menu. 11/13

Section 4: APPENDIX Description of clinical cases available for all users Visible Patient directory vpatient01-body: 3D modeling from a thoraco-abdomino-pelvian CT-scan of a female patient without visible pathology. All main visible organs have been modeled: bones, lungs, heart, liver, kidneys, spleen, pancreas, trachea, esophagus, stomach, bowel, colon, adrenal glands, gallbladder, bladder, ureter and urethra, arteries and veins. vpatient02-liver: 3D modeling from an arterial phase abdominal CT-scan of a patient with a focal nodular hyperplasia in the liver. Main visible organs have been modeled: bones, lungs, heart, liver, kidneys, spleen, pancreas, stomach, colon, gallbladder, bladder, arteries and veins. vpatient03-neck: 3D modeling from a neck CT-scan of a female patient with two parathyroid tumors (P1 and P4). Main visible organs have been modeled: bones, lungs, thyroid gland, parathyroid tumors, ganglions, trachea, esophagus, arteries and veins. vpatient04-heart: 3D modeling from a thoracic CT-scan of a child without visible pathology. Main visible thoracic organs have been modeled: bones, lungs, heart and its internal structures (right and left atrium and ventricles), arteries and veins. vpatient05-pelvis: 3D modeling from an abdomino-pelvian CT-scan of a female patient with vaginal tumor. Main visible organs have been modeled: bones, kidneys, sigmoid colon, rectum, vagina, bladder, ureter and urethra, arteries and veins. vpatient06-thorax: 3D modeling from a thoracic CT-scan of a patient with hiatal hernia. Main visible organs have been modeled: bones, lungs, heart, liver, kidneys, spleen, diaphragm, esophagus, stomach, arteries and veins. vpatient07-pancreas: 3D modeling from an abdominal CT-scan of a patient with one hepatic hepato-carcinoma and one pancreatic tumor. Main visible organs have been modeled: bones, liver, kidneys, spleen, pancreas, stomach, adrenal glands, arteries and veins. vpatient08-sleeve: 3D modeling from a thoraco-abdominal CT-scan of a patient with right and left adrenal tumors and a past sleeve surgery. Main visible organs have been modeled: bones, lungs, heart, liver, kidneys, spleen, pancreas, trachea, esophagus, stomach (+ duodenum), adrenal glands, arteries and veins vpatient09-lung: 3D modeling from a thoracic CT-scan of a patient with several left lung tumors. Main visible organs have been modeled: bones, lungs, trachea, bronchus system, heart, arteries and veins. 12/13

vpatient10-pancreas: 3D modeling from an abdominal CT-scan of a patient with a big pancreatic cyst and an important anatomical variation of the spleen drainage. Main visible organs have been modeled: bones, liver, kidneys, spleen, pancreas, stomach and duodenum, arteries and veins. 13/13