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Synapse Mobility 5.3 Web Quick Start Guide Synapse Mobility is FDA 510(k) cleared for primary diagnostic use on all modalities except mammography. Synapse Mobility Web is not to be used for diagnostic review of mammography images. Login: https://mobility.penrad.org VERSION PREREQUISITES: First option or Traditional Viewer Requires Adobe Flash Second option or NEW HTML Client Requires Internet Explorer 11, Safari, or Chrome that support HTML5. **Each interface is slightly different but have the same features. Extensive Help Menu in each client Available in the upper RT corner of the application Traditional Viewer Question icon New HTML Client book icon TOOL MENUS (Traditional Viewer) Right click to launch Tools menu (NEW HTML Client) Primary Tools on Top of Image Window To Access Advanced tools (Click Lower left Image Window) CHOOSE VERSION: TO FIND A PATIENT: From first login, 1search for a patient by entering a partial patient name and clicking Search Alternately click Advanced Search to use a range of multiple criteria TO SELECT A STUDY FROM THE STUDY BROWSER: Double click on the study. The study opens in a new window or tab Use the check boxes to select multiple studies, then click Load Data *Images Launch in 2D Viewer Mode by Default.

TO SCROLL THROUGH SLICES: 1. To coarse scroll through images, hold down the left mouse button and drag up or down 2. To fine scroll through images, use the mouse wheel to navigate up or down 3. Use expand at right upper corner to enlarge an image to full screen 4. To navigate among image stacks in a series, press the Down arrow key to view the next stack and the Up arrow key to view the previous stack TO ZOOM AND PAN: 1. Depress Shift key and left mouse (click/hold) to pan 2. Use (+) or (-) keys to zoom or minify TO MANUALLY ADJUST WINDOW AND LEVEL: Press and hold down the right mouse button and move the mouse TO ADJUST WINDOW USING PRESETS: 1. Open the menu and select Presets 2. Click on the down arrow key 3. Select a preset from the drop down list TO MEASURE: 1. Open the menu and select Measure for Linear, ROI, Point and Angle Measure 2. For linear measurement, click on a starting point in the image and drag to the end point TO INVERT THE IMAGE: Click (I) on the keyboard to invert image, toggle on or off TO USE THE MAGNIFY GLASS: Click (O) on the keyboard to toggle on or off TO RESET THE ENTIRE VIEW, DELETE ANNOTATIONS, OR RESET IMAGE TO ITS ORIGINAL STATE: To manually adjust window and level: Press and hold down the right mouse button and move the mouse TO CHANGE DISPLAY LAYOUTS: 1. Click on the layout icons in the lower left pane, or 2. Right click in the image area and select View Mode. Layout selections are displayed TO LINK SERIES IN THE SAME STUDY: 1. Select 2D view for a study with multiple series 2. Select a 2x1, 1x2, or 2x2 layout 3. Drag and drop series into the layout 4. Select the Link Views icon in the lower left pane 5. Navigate using the mouse or image slider to the right side of the images. Yellow reference lines will be displayed, showing the frame of reference GO BACK TO THE STUDY LIST: Press the Study Browser button in the upper left MIP / MPR Viewer / 3D Traditional Viewer 1. Right click to launch menu 2. Select MIP / MPR NEW HTML CLIENT (Click lower left Image Window) To reveal additional Tool Menu TO SWAP ANATOMICAL PLANE: 1. Drag and drop the Coronal or Sagittal thumbnail from the left pane into the main view 2. Plane now fills main view

NAVIGATE OR ROTATE MPR VIEWS: 1. Place cursor over the colored positional lines and move up or down, right or left 2. Place cursor over dotted lines at end to rotate positional lines TO RESET THE ENTIRE VIEW, DELETE ANNOTATIONS, OR RESET IMAGE TO ITS ORIGINAL STATE: 3-D VIEWER TO NAVIGATE: Click and hold left mouse, move mouse to rotate image TO MAGNIFY: 1. Middle mouse wheel up or down 2. Press (+) or ( ) keys TO USE LENS TOOL: 1. Right click the menu 2. Launch Lens TO RESET THE ENTIRE VIEW, Delete Annotations, OR Reset Image to Its Original State: TO OBTAIN INTERACTIVE GUIDE, REMOVE METADATA, OR SHOW STATUS BAR: Menu: Options o Hotkeys for Interaction Help Guide o Display Metadata check box (toggle off to remove display of on-screen demographics) To Display Status Bar check box (toggle on to display status bar) COLLABORATION TO INVITE ANOTHER USER TO A COLLABORATION SESSION: 1. Click the Show Collaboration Dialog icon in the upper right hand corner 2. Click Email Invite to create a message in your default email client 3. Enter recipient s email address in To: field 4. Send the message To copy the session link to send an invitation via other means than email, click Copy to Clipboard in the collaboration panel. Chrome users must use this method to send invitations. To grant or revoke a participant s ability to interact with the session: Fill or clear the Interact check box TO SHOW OR HIDE THE HOST S OR PARTICIPANT S CURSOR: Fill or clear the Cursor check box TO JOIN A COLLABORATION SESSION: 1. Click or tap the link in the invitation email or otherwise provided by the session s host 2. Enter your name and email address to identify yourself to the host TO END A COLLABORATION SESSION: Click End Session TO SHOW OR HIDE CONFIDENTIAL PATIENT INFORMATION: Fill in or clear the Show confidential patient information check box CONFIGURATION ADOBE FLASH Synapse Mobility version 5.3 has two web client applications that are available to the user at the time of login. There is the new option to launch an HTML client that requires no browser plug-ins, as long as the browser is a current version of IE 11, Safari, or Chrome that supports HTML5. The option for the Flex client, is the traditional Mobility web client that uses Adobe Flash to render medical images. Any browser that supports Flash content may be used. For best performance Adobe Flash Player 10.1 or higher is recommended. Mobility uses to determine if Flash is installed. To check whether the browser is able to display Flash content, launch the following URL: http://www.adobe.com/software/flash/ab out/ If there are problems running Flash content, launch the following URL to install or update Adobe Flash: http://get.adobe.com/flashplayer/

BROWSER SETTINGS In the general use case, Synapse Mobility will work with default browser settings. If there are issues running Synapse Mobility, ensure that the browser settings are configured as defined in the following sections. Internet Explorer Tools...Manage Add-ons o Shockwave Flash Object...Enabled Tools > Internet Options > Security tab > Custom Level o Scripting...Active Scripting...Enable Run ActiveX controls and plug-ins...enable Script ActiveX controls marked safe for scripting...enable Downloads...File download...enable (If Flash is not already installed) If IE still doesn't work, read this KB article: http://forums.adobe.com/message/3432049# 3432049 Firefox - PC Tools...Options o Enable Tools...Add-ons...Plug-ins o Shockwave Flash Enabled Firefox Mac Firefox...Preferences Content o Enable Tools...Add-ons o Shockwave Flash Enabled Safari Mac Safari Edit...Preferences Security o Enable Enable plug-ins Google Chrome Settings Under the Hood Privacy...Content Settings o Javascript...Allow all sites to run Plug-ins...Run automatically Click on Disable individual plug-ins and ensure that Flash plug-in is Enabled LANGUAGE SETTINGS Synapse Mobility provides language support for English, French, Italian, German, Spanish, Portuguese (Brazilian), Korean, Japanese, simplified Chinese, and traditional Chinese. Users should configure their web browser to achieve the applicable date and time, language, and regional formatting settings. The Synapse Mobility Server shall be configured to provide the user manual and regional settings appropriate for the installation locale. TROUBLESHOOTING TIPS: BASIC PREREQUISITES The system administrator must provide a valid URL for the Synapse Mobility server, along with a user name and password for each user. The Synapse Mobility study browser should automatically launch when the URL is accessed from a supported internet browser: Apple Safari Google Chrome Microsoft Internet Explorer Mozilla Firefox Synapse Mobility Web is a web-based application that requires no installation of client software. All that is required on the PC / Mac Browser of the valid URL for the Synapse Mobility server. PERFORMANCE FOR IMAGE DOWNLOAD Workstation performance will be limited by the type of network access, especially for home users with cable modem and DSL. Synapse Mobility performance will be affected by shared internet connections where other users are in the process of downloading large music or video files. More bandwidth means better performance. There are several free internet speed tools that can be used to test the bandwidth of home and office internet connections. Will ADOBE FLASH IS NOT INSTALLED Computers that are managed by the healthcare enterprise may be controlled by security policies that prevent end users from downloading code. Contact the system administrator if errors are encountered related to Adobe Flash not being installed. Local network and / or computer firewall settings may be configured to block traffic over certain ports. Synapse Mobility uses ports 8080 and 443 for standard and secure network access. Check whether the computer firewall settings are blocking communication over these ports. If the computer settings appear correct, and the problem persists, contact the network administrator for help. Pop-up blockers may prevent code downloads, so check for warning messages in the browser that indicate Adobe Flash install is being blocked. Incorrect URL for Synapse Mobility Contact the system administrator to confirm the Synapse Mobility URL if either of these error messages occurs: This webpage is not available Unable to contact server please check that Wi-Fi or 3G is enabled and server settings are correct SSL CERTIFICATE NOT TRUSTED OR EXPIRED Users that access Synapse Mobility through secure connections (SSL) will encounter an error if the certificate is not trusted or expired. Contact the system administrator to resolve this problem.