DirectRay EPEX ER™ system User's Guide Federal (USA) Law restricts this davice to saleby or on the order ofa physician (or properly licensed practions). CAUTION Document No. 080-1072 Revision 001 CcJanuary 2003 The information contained in this manual is confidential and proprietary to Hologic, Inc. This informatian is provided only to authorized representatives of Hologic’s customers solely for the purpose of facilitating the use of Hologic’s products. No information contained herein may be disclosed to any unauthorized person for any purpose whatsoever without the prior written consent of Hologic, inc. ‘The information in this document is subject to change without notice. Copyright 2003 by Hologic, Inc. All rights reserved. Hologic and EPEX ER are trademarks, and Omniflex and the Hologic logo are registered trademarks of Hologic, Inc. DirectRay is a registered trademark of Direct Radiography Corp. Printed in the U.S.A. All trademarks, registered trademarks, and product names used within this document are the property of their respective owners. Hologic, Inc. 35 Crosby Drive Bedford, MA 01730 usA Tel: (781) 999-7300 Fax: (781) 280-0669 Service: (877) 371-4DRC (371-4372) User Support: (877) 371-4DRC (971-4372) Fax: (781) 280-4788 Hologic Europe Horizon Park Leuvensesteenweg 510, BUS 31 1930 Zaventem, Belgium Tel: 32,2.711.4680 Fax: 32.2.725.2087Contents EPEX ER System User's Guide Contents About This Manual Audience .. Indications for Us« Prerequisites.. Conventions Used in This Manual. Chapter 1: Introduction What Is the EPEX ER System? What Is DirectRay?, Indications for Use.. System Functions System Components... DirectRay Detector/Bucky. X-ray Tube and Collimator. 15 DirectRay Console Output Devices Image Acquisitior Safety and Compliance Information. Safety Precautions. General Use Cautions and Warnings. Cleaning Cautions. Symbols, United States Federal and State Regulations. IEC Regulation: Canadian Regulations ..EPEX ER System User's Guide Manufacturer's Responsibility. 114 Positive Beam Limitation 115 Caution Regarding Small-Detail Object Imaging. 1S Restrictions on Use 116 Authorized EU Representatives. 1-16 Chapter 2: Basic Operations Starting Up and Logging On to the System. Step 1: Powering Up the UPS Step 2: Powering Up the X-ray Generator. Step 3: Checking the System Step 4: Powering Up the DirectRay Console CPU. Step 5: Logging In to the CPU's Operating System.. Step 6: Signing In to the DirectRay Console Application. Changing Your DirectRay Console User Application Password Warming Up the X-ray Tube. Capturing Images Overview for Capturing Images .. ‘Step 1: Identifying the Patient and Adding a New Patient Manually. Choosing an Existing Patient or Visit Using the Search Function Choosing a Patient Using the Modality Worklist Query .. Retrieving Patient Records from the ‘Modality Worklist Provider Viewing Patient Entries in “Today's Worklist” . Reordering and Resizing Columns in the Entry List . Opening a Patient/Study in the Entry List Required Fields for Worklist-Ordered Studies Scanning a Bar Code to Identify the Patient/Visit Step 2: Choosing Output Destinations ‘Study Step 3: Adjusting Exposure Settings and the Exposure Sequence 2-29 (Optional). Step 4: Adjusting the Orientation of the Bucky. Positioning the Bucky joning the X-ray Tube and Collimator Contents,EPEX ER System User's Guide Features. . 2-35 Using the Overhead Tube Crane Control Panel to Position the X-ray Tube. 235 Using the Auto Modes to Have the ‘X-ray Tube Track the Bucky 2:39 Auto Mode Option.. . 2:39 Auto On In Wall Mode... 241 . 2-42 Auto On In Table Mode. Positioning the Overhead Tube Crane for Chest Exposures. Positioning the Overhead Tube Crane for Under Table Exposures Adjusting the Collimator . 2-43 Step 6: Exposing Patients Step 7: Accepting or Rejecting an Image .. . 2-48 Changing the ESA Setting or Adjusting the LUT (Optional) Cropping an Image (Optional)... . 248 Selecting the Image Posi Multiformat Sheet (Optional) . 2-48 Adding Comments to an Image (Optional). . 2-49 Selecting ESA or IT (Optional) . 2-50 Selecting Patient Orientation and Image Laterality (Optional) 2-50 Fitting image on Selected Sheet Format (Optional) . . 2-50 ‘Adding Markers to the image (Optional) 251 Rotating or Mirroring the Image (Optional) . 251 Accepting the Image .. . 2-51 . 2-52 . 2-53 . 2-53 . 2-53 Rejecting the Image Step 8: Opening an Additional Procedure (Optional Step 9: Adding a View to a Procedure (Optional). Step 10: Closing the Study, Visit, and Patient Step 11: Signing Out from an Acquisition Session .. ‘Switching User Levels... Powering Down the System Components Recommended Power Down Procedure Overview .. Step 1: Powering Down the DirectRay Console CPU.. Step 2: Powering Down the X-ray Generator... Step 3: Powering Down the DirectRay Console’s UPS..... . 2-55 . 2-56 . 2-56 2-57 - 2-58 2-59 Contents vEPEX ER System User's Guide Chapter 3: Managing the Image Output Queues and Resending Images Overview. ‘Managing the Image Output Queues .. Resending Images to Output Devices. Repreviewing Images . 3-10 Chapter 4: Protecting Patient Records Overview. Reclamation Strategy Procedure for Protecting a Patient Record. Chapter 5: Maintai ig System Components. Overview. Daily Maintenance. Weekly Maintenance Monthly Maintenance. Cleaning the Equipment. Checking the Equipment Integrity System Periodic Maintenance. ‘Omniflex IV Overhead Tube Crane Maintenance. Maintenance... Operational Check Replacing the UPS Battery Reporting Unusual Conditions. Calibrating the DirectRay Detector ‘Chapter 6: Troubleshooting Overview. CPU Problems.. X-ray Generator Problems.. Resetting the X-ray Generator Contents,Contents. EPEX ER System User's Guide Console Alarm Messages. Troubleshooting Image Problems.. Guidelines for Ensuring Good Images. Diagnosing and Correcting Image Problems Miscellaneous Problems Powering the DirectRay Components On and Off. Loss of Electrical Power X-ray Generator Error Codes (CPI)... Appendix A: Specifications Subsystem Specification: DirectRay Image Capture System. DirectRay Console Omniflex IV Overhead Tube Crane. Articulating Arm, X-ray Generator Environment. Transit/Storage Operating Installation Requirements... Flooring.. vilAbout This Manual Audience Indications for Use Prerequisites Scope This manual is intended for users of the Hologic EPEX ER™ System, to acquire medical diagnostic X-ray images. It provides operating instructions for the system. ‘The EPEX ER™ System has application whenever DirectRay® radiographic images are created, and transmission of these images and related text are required from DirectRay® technology to hardcopy, softcopy, or archive. Follow all safety labels on the equipment. The procedures in this manual assume that you know how to do the following operations related to the system's graphical user interface: + Perform mouse and trackball operations, such as click, drag and select + Select from menus + Click buttons + Enter information in text fields + Select options + Select entries from pop-up or drop-down lists, + Use scroll bars This manual contains information about the EPEX ER System and its operational features.Organization EPEX ER System User's Guide ‘This manual is organized into the following chapters and appendices: Chapter 1: Introduction Illustrates and provides a brief overview of the EPEX ER System functions. Chapter 2: Basic Operations Provides basic information about using the EPEX ER System to acquire images and send them to output devices. It also includes procedures for EPEX ER System start-up, shutdown, and X-ray tube warm-up. Chapter 3: Managing the Image Output Queues and Resending Images Describes the procedures for managing the image output queues, resending previously acquired images that are still stored in the system, and repreviewing images that have not been reclaimed. Chapter 4: Protecting Patient Records Explains how to protect patients and their related images from being deleted by the system. Chapter 5: Maintaining System Components Explains how to perform routine maintenance of the EPEX ER System. Chapter 6: Troubleshooting Explains how to perform basic troubleshooting operations. It identifies and explains how to handle common system problems that do not require service intervention, and provides a listing of system alarms along with the required response actions. Appendix A: Specifications Lists the specifications for the EPEX ER System. A glossary follows Appendix A. ‘About This ManualEPEX ER System User's Guide Conventions Used in This Manual This manual uses three types of special messages to emphasize information or point out potential risks to personnel or equipment. Note: Notes provide A sample of a note is shown in the margin to the left. ‘additional information, such ‘as expanded explanations, hits, or reminders Samples of cautions and warnings are shown below. Cautions point out procedures that you must follow precisely to avoid damage to ‘equipment, loss of data, or corruption of files in software applications. Warnings point out procedures that you must follow precisely to avoid injury to yourself or others. a A About This Manual *Chapter 1 Introduction This chapter provides an overview of the EPEX ER System. It includes a general description of the system's functions and descriptions of each component, as well as a description of possible output devices, optional image acquisition workflows, and Safety and Compliance. Contents Subject ‘What Is the EPEX ER System? Whaat Is DirectRay?. Indications for Use. System Functions. ‘System Components Image Acquisition Safety and Compliance Information 1-10 4EPEX ER System User's Guide What Is the EPEX ER System? The EPEX ER System is a complete filmless, computer-controlled radiographic system consisting of: + Overhead tube crane (see Figure 1-1) + X-ray Generator + Articulating arm and Bucky support (see Figure 1-2) + X-ray tube and Collimator + Bucky and DirectRay® Detector + DirectRay Console DirectRay is technology from Hologic that optimizes the X-ray information for the highest quality images, without film. For a complete description, refer to the topic “What Is DirectRay?” on page 1-3. ‘The EPEX ER System has been designed for a full range of exams using a single DirectRay Detector. Figure 1-1. EPEX ER Overhead Tube Grane Components ‘TRANSVERSE CARRIAGE TRANSVERSE BRIDGE“ TELESCOPING ‘TUBE ARM ‘TUBE MOUNT LONGITUDINAL CEILING RAILS 12 IntroductionArticulating Arm EPEX ER System User's Guide What Is DirectRay? Cc The Hologic product, DirectRay, directly captures and converts X-ray energy into digital electrical signals. + The captured signals (14-bit image data) are immediately transmitted into a DirectRay Controller. The 14-bit linear data is converted into 12-bit log data. + AnExam Specific Algorithm (ESA), associated with the user-selected radiographic procedure and position, is used to create a look-up table (LUT) for the image. + The LUT is applied to the 12-bit log data to optimize the image data prior to viewing it on the DirectRay Console monitor. If the user accepts the image, the LUT is sent with the image data to the selected ‘output devices. Indications for Use Introduction ‘The EPEX ER system has applications whenever DirectRay radiographic images are created, and transmission of these images and related text are required from DirectRay technology to hardcopy, softcopy, or archive. Follow all safety labels on the equipment. 13EPEX ER System User's Guide System Functions Table 1-1 indicates where you can find information about specific system functions. Table 1-1. EPEX ER Functions EPEX ER Functions For More Information Operator Input ‘Associate patient data with radiographic images Define the study Select the output destinations Modify output device parameters Save an incomplete procedure Close a procedure ‘Work with multiple open studies Projection Position the X-ray tube to support a wide variety of radiographic projections Image capture and processing Adjust technique settings Capture the required X-ray image Preview, accept, or reject the image Crop images 14 Chapter 2 Chapter 2 Chapter 2 DirectRay Console Administrator's Guide Chapter 2 Chapter 2 DirectRay Console User's Guide Chapter 2 DirectRay Console User's Guide, Chapter 2 Chapter 2 DirectRay Console User's Guide, IntroductionEPEX ER System User's Guide Tal EPEX ER Functions EPEX ER Functions For More Information Administrative Perform a flat field image exposure Chapter 2 Resend images Chapter 3 Repreview images ‘Chapter 3 Protect selected patient/image files from reclamation Chapter 4 Calibrate the DirectRay Detector Chapter § System administration tasks DirectRay Console Administrator's Guide System Components The EPEX ER is composed of the following components: + DirectRay detector + X-ray tube and collimator + Articulating arm and Bucky + Overhead tube crane + DirectRay Console with DirectRay Controller. The following are contained on and within the DirectRay Console cabinet: + CPU (Central Processing Unit) + Monitor + Keyboard + Pointing Device + Bar Code Reader (optional) + WAMI (Wiring Adaptable Machine Interface) + Uninterruptibte Power Supply (UPS) + X-ray Generator Introduction 15EPEX ER System User's Guide DirectRay Detector/Bucky The Bucky includes: + The DirectRay Detector + Grid + ABC (Automatic Exposure Control) You can use the positioning controls and rotation system to position the DirectRay Detector for a full range of patient needs. X-ray Tube and Collimator The EPEX ER system includes: + Rotating anode X-ray tube + Collimator with shutter control Articulating Arm and Bucky X-ray Generator 16 ‘The Bucky support is an articulated structure that is attached to the baseplate assembly for longitudinal travel. You can position the Bucky around the table and patient, thus accommodating a variety of radiographic projections. The support tower is fully counter-balanced with the Bucky installed, permitting the Bucky to be positioned with a minimum of effort. ‘The X-ray Generator has the following features: * Operator control through the DirectRay Console user interface ‘+ Anatomical pre-programmed exposure factors. IntroductionCc EPEX ER System User's Guide Omniflex IV Overhead Tube Crane DirectRay Console Introduction The Omniflex IV overhead tube crane is a ceiling-mounted overhead X-ray tube crane and collimator suspension system. It provides flexibility in X-ray room design since it occupies no floor space and the rail design allows the tube to operate within a large area as defined by the ceiling rails. The telescoping tube arm allows the tube to be lifted up out of the way when not in use. The DirectRay Console is the interface between the operator, the other system components, and the Hospital Information System/Radiology Information Systems (HIS/RIS). The DirectRay Console application allows you to perform the following functions: + Input or retrieve patient and exam data + Control the exposure and image capture subsystems + Acquire and process digital X-ray image data + Output patient and exam data + Administrative tasks The DirectRay Console includes the following hardware components, shown in Figure 1-3: + Computer with monitor, keyboard, pointing device (mouse or trackball), and modem * Uninterruptible power supply (UPS) + DirectRay Controller + Prep/Exposure switch + Bar Code reader, (optional) + Wiring Adaptable Machine Interface (WAMI) 7EPEX ER System User's Guide Figure 1-3. DirectRay Console Components if Bacaie f omy cae Poot ear I i fii Output Devices ‘You can send images acquired with the EPEX ER System to: + Image printers (for hardcopy) + Workstations (for display) + Archive systems (for storage) Note: Oupput clevices are nor The system uses the DICOM (Digital imaging and Communications in ‘a purt of the system. Contact Medicine) protocol to send images and related information to output von Hologie representative devices. DICOM is a standard that defines the characteristics of data for alist of competible output frets communication between medical imaging equipment, The DICOM standard was developed by the National Electrical Manufacturer's Association and the American Council of Radiology. For the latest list of approved DICOM connections, see your Hologic representative. For information about how to operate an output device at your site, refer to the device's documentation. 18 Inireductionc EPEX ER System User's Guide Image Acquisition Introduction Patient data available in the facility's Hospital Information System (HIS) or Radiology Information System (RIS) can be imported into the system using the Modality Worklist function. Such data may also be obtained from the system's own temporary records of recent radiographic examinations, or from keyboard entries provided by the operator. Patients whose records are accessible through the facility's HIS/RIS network are typically provided with a bar-coded bracelet. A bar code reader connected to the DirectRay Console is used to scan the paperwork or requisition form and identify the patient. Key patient data from the facility's data base is then entered into the DICOM files for the current radiographic examination. If the facility is not equipped with a HIS/RIS, the system can be prompted to search its own temporary records and copy relevant patient data if it is available. If such data is not available, the operator is prompted to enter patient data manually. It should be noted that the storage capacity of the system is limited and the records of patients whe were examined some time ago are not likely to still be in the system. 19EPEX ER System User's Guide Safety and Compliance Information Safety Precautions * Do not remove covers from any part of the equipment for any purpose. + Do not defeat or bypass built-in equipment safety features. + Do not attempt any repairs if the equipment fails to operate correctly. Only qualified Hologic Field Service Engineers or Hologic authorized personnel should service the system, + Do not attempt to move equipment, or connect or disconnect any ‘communication cables. Call a person qualified and authorized to alter the equipment installation. + Observe all wamings and cautions in the procedures, + Follow all safety labels on the equipment. + Keep fingers, hands, and tools clear of moving parts. + Route cables properly to eliminate tripping hazards. General Use Cautions and Warnings Federal (USA) law restricts this device to sale by or on the order of a physician (or properly licensed practitioner). CAUTION ‘The EPEX ER System includes no user serviceable parts. For service assistance, contact Hologic. WARNING A The EPEX ER Systom produces ionizing ration, WARNING ‘The DirectRay Detector may only be operated in an area that is located beyond the 20 Gauss limit. WARNING 4-10 IntroductionEPEX ER System User's Guide moisture. i ‘The EPEX ER System and associated cables must not be operated in the presence of WARNING ‘The EPEX ER System is not suitable for operation in the presence of a flammable anesthetic mixture with air, oxygen, or nitrous oxide. WARNING: A Excessive use ofthe keyboard and mouse or trackball may result in repetitive stain injury WARNING Cleaning Cautions Do not spray cleaning solution directly onto the equipment. Moisten 2 cloth with the ‘solution and wipe the equipment. CAUTION A Do not immerse the equipment in qu Co CAUTION A Do not autoctave the equipment CAUTION Introduction 14EPEX ER System User's Guide Symbols O Power Off (used with the DirectRay Console UPS) | Power On (used withthe DirectRay Console UPS) GD Ethernet Connection TP@*d Twisted Pair Ethemet Connection @ Explosive Gas (flammable) A Attention—Read the CAUTION or WARNING statement that follows Non-Anesthetic Proof Universal Interface Connection Identifiers Du) Sound Earphones DirectRay Detector Orientation Identifier (on the Bucky) 142 IntroductionIntroduction Pea EPEX ER System User's Guide Protective Earth Ground Hazardous Voltage Power On Indicator Hard Drive Standby Switch (used with CPU) On Line Indicator (used with X-tay Generator switch at DirectRay Console) Off Line Indicator (used with X-ray Generator switch at DirectRay_ Console) Prep/Exposure Switch Xray Expose Switch Do Not Immerse In Liquid This product contains no field-serviceable parts Special Cleaning Instructions Lifting WaringEPEX ER System User's Guide | One or more of the following regulatory symbols are found on the equipment: us wy UL Classified Device celeb Jus UL Listed Device USTED cWAXus UL Recognized Device @- CSA Listed Device ous GM). = Listed Device United States Federal and State Regulations EPEX ER Systems conform to the United States Code of Federal Regulations, 21 CFR 1020.30 “Diagnostic X-Ray Systems and their major components.” However, additional state regulations may apply for X-ray products. This may require notifying your state regulatory agency about your installation and/or operator training and certification. Itis the responsibility of the user to contact the applicable state radiation control agency to verify that your installation is in compliance with regulations in your state governing installation and use of X-ray equipment. IEC Regulations EPEX ER Systems comply with the requirements of IEC 60160601-1 and with the following IEC standards: IEC 60160601-2-7 IEC 60160601-1-3 IEC 60601-1-1 IEC 60601-1-2 IEC 60601-2-28 IEC 60601-2-32 Introductionc EPEX ER System User's Guide IEC 60825-1 Software used in the EPEX ER System was developed using TEC 60601-1-4 as a guide. Canadian Regulations EPEX ER Systems comply with CSA 22.2 No. 601.1 Manufacturer's Responsibility This equipment is sold with the understanding that Hologic, its agents and representatives, do not accept any responsibility for overexposure of patients or personnel to X-radiation. Furthermore, Hologic does not accept any responsibility for overexposure of patients or personnel to X-radiation generated by this equipment as a result of poor operating techniques or procedures. Also, no responsibility is assumed for any unit that has not been serviced and maintained in accordance with the technical service manual, or which has been modified or tampered with in any way. Positive Beam Limitation Introduction ‘The EPEX ER System is provided with a positive beam limitation (PBL) system that automatically adjusts the X-ray field to the size of the receptor. ‘The PBL. system is operational in the following two positional orientations of the EPEX ER System (these define the normal operating mode of the system): + Standing Chest Mode (Horizontal SID): The PBL system is functional at 40 and 72 in. SIDs when the Bucky is positioned in the Standing Chest orientation. + Under Table Mode (Vertical SID): The PBL system is functional in the Under Table mode. In this mode, the Bucky is positioned under the table top with the plane of the receptor oriented horizontally. + Many other positional orientations of the EPEX ER System are possible and are used for special procedures. Bypass of the PBL system ‘occurs in these special procedure orientations such that the PBL system is not functional and the system reverts to a manual collimation mode of operation.EPEX ER System User's Guide Caution Regarding Smali-Detail Object Imaging Restrictions on Use As with all digital imaging devices, there is the potential that small-detail structures, high-contrast edge structures, and fine-line structures with a repeating pattern could appear differently in the digital image than in an image created with an analog device—such as screen-film system—or with another digital device having smaller individual detector elements. For example, for a sharp-edged object, the edges of that object may appear to have “stair-steps” when in fact the object edge does not have such structure. This is an effect of digital undersampling. For small-detail objects having a size on the same order of magnitude as an individual pixel or smaller, the apparent contrast of that object can vary based on the position relative to the individual detector element locations. For example, the contrast of a single spherical object the same size as a pixel vould have a different appearance if the object were imaged directly overlying a detector element (highest contrast) or placed at the intersection of four detector elements (lowest contrast). Objects inherently smaller than individval pixels will have a lower apparent contrast because of the digital sampling of the analog radiation intensity signal over an area larger than the small object. In each case,a lower apparent signal-to-noise can result in reduced visibility of such objects. The customer is responsible for assuring that accessories used with the EPEX ER System do not degrade the safety of the system. ‘Accessories and interfacing equipment used in conjunction with the EPEX ER System and located outside the patient environment may be ‘exempt from EN60601-1. Such equipment must, however, conform to EN60601-1-1 and therefore to standards applicable to information technology equipment such as EN60950 and to applicable electromagnetic compatibility requirements. Authorized EU Representatives ‘The manufacturers of parts and subsystems used in the EPEX ER System are represented in the European Union by the following: DirectRay Detector, DirectRay Controller, DirectRay Console and Omniflex IV OTC Hologic Europe Horizon Park Leuvensesteenweg 510, BUS 31 1930 Zaventem, Belgium IntroductionIntroduction EPEX ER System User's Guide Bucky MMS Medicor Medical Supplies Henrich Hertz Strasse 6 50170 Kerpen Germany High Voltage Generator CPI International, Inc. German Branch Hohenadistrasse 31 85737 Ismaning, Germany X-ray Tube and Tube Assembly Varian X-Ray Products c/o Emst Mey De Kokermolen 2 3994 DH Houten, The Netherlands Omnifiex IV Overhead Tube Crane Hologic Europe Horizon Park Leuvensesteenweg 510, BUS 312 1930 Zaventem, Belgium X-ray Collimator CE Partner 4U Nijverheidsstraat 5 2624 BA Delft Netherlands 447Chapter 2 Basic Operations ‘This chapter provides basic information about using the DirectRay Console to acquire images and send them to output devices. It also includes procedures for system start up, shut down, and X-ray tube warm-up. Contents Subject Starting Up and Logging On to the System. ‘Warming Up the X-ray Tube. Capturing Images. Powering Down the System Components 24EPEX ER System User's Guide Starting Up and Logging On to the System To start up the system and prepare for acqu g patient images: Step _| Action Power up the uninterruptible power supply (UPS), which in tum powers up the DirectRay Detector and DirectRay Controller. 2 _ | Power up the X-ray Generator. 3. | Check that the other X-ray system components are on and working properly. 4 | Power up the DirectRay Console CPU. 5 | Log in to the CPU's operating system. 6 _ | Log into the DirectRay Console application. ‘The following topics provide instructions for performing each of these steps. ‘The DirectRay Console CPU should be powered down once a day to ensure a ‘complete system reset. if this is not done, system performance deteriorates. ‘The DirectRay Detector should be powered on at least 1 hour before intended use. it is used sooner than 1 hour after being powered on, image quality can be affected. For more information about powering on the DirectRay Detector, refer to the topic “Step 1: Powering Up the UPS” on page 2-3. > i> = Basic OperationsEPEX ER System User's Guide Step 1: Powering Up the UPS Note: [fat least fire mance des not elapse benween Sweps T and 4. you may gera DirecsRaw porverp feature Figure 2-1 UPS Power Switch Basic Operations, To start the DirectRay Detector and Controller, press the UPS power switch on the left side of the DirectRay Console cabinet to the On (\) position, as shown in Figure 2-1 Once the power switch is in the On (1) position, you must wait at least five minutes before powering up the DirectRay Console. Refer to the next topic. 23EPEX ER System User's Guide Step 2: Powering Up the X-ray Generator Figure 2-2. Generator Power Controls Starting the X-ray Generator typically also powers up other X-ray components, such as the X-ray tube, the Collimator, the overhead tube crane to which the X-ray tube is attached, the Bucky, and the radiographic table. To start up the X-ray Generator, press the ON power button at the front left of the DirectRay Console cabinet, as shown in Figure 2-2. ) Xeay Generator ON la Kay Generator OFF LEFT SIDE nes ae sa ie cece @ sa fCae ormzae Step 3: Checking the System 24 Once the X-ray Generator is powered on, perform the following checks: + Remove any patient supports or other objects so they do not interfere with the movement of the X-ray tube’s suspension arm. + Press the Collimator light switch and verify that the light comes on. + Verify that the Collimator display indicates the current SID and the Collimator opening. + Check the releases on the overhead tube crane, the Bucky, and the radiographic table to ensure that the controls are operating properly. ‘You can now power up the DirectRay Console. Basic OperationsEPEX ER System User's Guide Step 4: Powering Up the DirectRay Console CPU Nore: Before von power wn ‘To power up the DirectRay Console CPU, press the power key located at ihe DreciRay Console CPU. the upper-right corner on the CPU keyboard (refer to Figure 2-3). The CPU sae that te DireeiRew powers up and the monitor (which should typically be lefi on but might be Detecir and Directv in “sleep” mode) “wakes up.” If the monitor is not on, press its power Controller have completed their startup sequence (elit button. ar eas five mimues after vow power on the UPS). Figure 2.3. DirectRay Console Power Key Note: The dal input monitor Once the CPU is powered on, the monitor displays messages related to the site togeles between the progress of the CPU's operating system startup. The CPU takes about four DivectRay Console and the minutes to complete this sequence. DirecaRanv Conroe ‘When the operating system is loaded, the Login window displays. Basic Operations 25EPEX ER System User's Guide Step 5: Logging In to the CPU's Operating System Note: Depending on your sqstem configuration, the dusks on your Status window may differ from the ones depicted in the sample shown here 26 ‘When you power on the DirectRay Console, a grey SUN Microsystems banner displays. To log in to the CPU's operating system: step | Action 1 | Enter the appropriate login name at the Please enter your name: prompt: + tech for technologists + mgr for system administrators 2 | Press the Enter key ‘The Please enter your password: prompt displays, 3. | Enter your password, then press the Enter key. (If you do not know ‘your password, sce your System Administrator.) Note: No characters display as you enter your password. Note: Ifyou make a mistake when entering the login name or password, you can click the Start Over button to clear the fields and start again After displaying progress messages, the DirectRta application Status window displays. Console The Status window, shown below, lists the initialization tasks for DirectRay Console functions. Each task is highlighted once it has become active and passed setup. After the status tests are complete, the application Login window displays at the upper-left comer of the screen. Go to the next topic 19 log in to the DirectRay Console application. Basic OperationsEPEX ER System User's Guide Step 6: Signing In to the DirectRay Console Application Note: See vour System Aalannistraror if vou do wot now yor login or password Fle Ede Adios Help msc Wet Lo To sign in to the DirectRay Console application, choose your name from the Identify Yourself pop-up menu, enter your password, and click the OK button. opin tg oakley a gn we he only Tarok The DirectRay Console application window displays, If the X-ray tube has been inactive for a period of time, you must warm it up, as explained in the topic “Warming Up the X-ray Tube” on page 2-9. Otherwise, you can open, patient record and start capturing images. Enter or search for patient ao Hex Horta | | o} | [Patient Patient Query] Totays Worktt! tee ia Srnter | ex | | New! Sih Visit Basic Operations : Toxncneo | arEPEX ER System User's Guide Changing Your DirectRay Console User Application Password To change your DirectRay Console user application session password: Step | Action cs ae 1 From the Edit menu, choose Change User Password. bt Users ‘The Change Password window displays. Charge OS Ruswerd {Change User Password [={ change User Password a A Emer Ceret Passwords [ nar New Reswor [ 2 | Inthe Enter Current Password field, type your current password, then click the OK button. ‘Note: An asterisk (*) character displays for each character you type to protect the privacy of the password. 3 | Type the new password in the Enter New Password field and in the Reenter New Password field. Note: This is required to verify that you are typing the new password correctly, since you cannot see what characters you are oping. 4 | To save the change, click the OK button. To cancel the change, click the Cancel button. 28 Basic Operations,EPEX ER System User's Guide C Warming Up the X-ray Tube Producing X-rays with a cold or improperly warmed tube considerably shortens the life of the X-ray tube. To prolong the life of the X-ray tube, do not acquire images. Basic Operations CALTION ‘without first warming up the tube. The tube should be warmed up at the start of each day, and whenever the tube has been inactive for more than four hours. To perform the tube warm-up: Step 1 2 3 The Action Ensure everyone is out of the X-ray room. Close the Collimator shutter, using the shutter controls. Cover the Collimator or the Bucky with a lead apron or position the X-ray tube so it will not expose the DirectRay Detector to unattenuated dosage. In the DirectRay Console application main window, with no patient ‘chosen, click the Conventional Mode button. A warning dialog box displays. [9 wasn: Ts note tOT fr Dvcty DIGITAL BAGG ACQUETION® re] Click the OK button, The Conventional X-ray Mode window displays. Set the technique settings, as instructed in the Tube Warm-Up panel. Note: Your site's settings might be different from those in the sample window shown on the next page. Take exposures until the heat units count reaches 7 to 9%. When you have completed the exposures, click the End Conventional Mode button and remove the lead apron from the tube. -ctRay Detector is now disabled, but the X-ray tube is enabled. If ‘you wish to use a conventional film cassette or Computed Radiography, refer to the topic “Capturing Images on Film” in Chapter 3 in the DirectRay Console User's Guide. Once the X-ray tube is properly warmed up, you can start capturing images. Go to the next topic.EPEX ER System User's Guide Conventional X-ray Mode Noe tor Dptt Reason i rs 1s 1 200 f 8.200 [t] wy . Soe comin pe tein ab 5 TUBEWARWUP Pa Size | New! {| | } wo” = ii 1 Vii | == a - s a [ss / Study Recommended Tube Warmup Procedure i ecetee | 7st cecquesarameiers forte war ~ — | Sore Sips Da mA = 200, w= Hi AEC» Ot fo soe = ae t 2) Emr ston ne terre ete anche Xoo re = Many lore bth versal and horas color Bde “totic | aise cxponrer seconde pr the oe use £07~ 9% Outputs {9 che End Conertionl Moe wen you ave fhe exponen. | ~ MDirectRay | ae je 240 Basic OperationsEPEX ER System User's Guide Capturing Images Overview for Capturing Images Nore: I'you wish to use a The general workflow for using the DirectRay Console to acquire and send conventional film cassetteor images to the output devices involves the following steps: Computed Radiography, refer imagen Fine Step _| Action Chapter 3 in the DirectRay i Console User's Guide Identifying the patient and visit. 2 | Choosing output destinations. 3 | Optionally, adjusting the exposure technique settings and the exposure sequence, 4 | Adjusting the position and orientation of the table, Bucky, X-ray tube, and the Collimator shutter to accommodate patient orientation. 5 | Exposing the patient. 6 _| Previewing, then accepting or rejecting the image. ‘You then repeat steps 3 to 6 for each image in the procedure. Step | Action 7 | Optionally, opening an additional procedure for this patient's visit. 8 | Optionally, adding a view to the procedure in progress. 9 | Optionally, select the Inverse Topography feature. 10 | Closing the study. 11} When you are done taking exposures, logging out of the current DirectRay Console application session so that another user can log in. Except for adjusting the position and orientation of the table, DirectRay Detector, X-ray tube, and the opening of the Collimator shutter, you perform all of these steps from the DirectRay Console user application's main window. Basic Operations antEPEX ER System User's Guide Step 1: Identifying the Patient and Visit Before capturing images, you must identify with which patient they are to be associated. Proper identification ensures that the image data are associated with the correct patient information. Depending on the system configuration at your site, there are three ways for you to identify the patient and visit for which you want to acquire images, as described below. lll systems allow you to identify patients and visits manually using the DireetRay Console’s local database. Whether you are acquiring images for a new or existing patient, you can identify a patient manually by: + Creating a new patient record in the local database. + Selecting a patient from those previously entered and currently stored in the local database. Unless protected by a key operator, patient records are stored only temporarily in the local database. Since database space is limited, the oldest patient records and their associated images are periodically deleted to reclaim space for new patients. For more information about how to manually specify the patient and visit, refer to the topics “Adding a New Patient Manually” on page 2-13 and “Choosing an Existing Patient or Visit Using the Search Function” on page 2-15. If your system supports Modality Worklist queries, you can retrieve patient information from a Radiology Information System. Refer to the topic “Choosing a Patient Using the Modality Worklist Query” on page 2-21. If your system supports bar code scanning, you can use the bar code scanner to read in the patient ID, visit number, or some other unique identifying number. If the ID is found in the Modality Worklist (if this feature is available) or in the local DirectRay Console patient database, that corresponding patient, visit, and study is opened. If the ID is not found, ‘you must enter that patient manually. 242 Basic Operations.Cc EPEX ER System User's Guide Adding a New Patient Manually ‘Note: Ensure you enter patient names and IDs correctly. Incorrect entries can cause duplicate patient records for the same patient, cor make it more difficult 10 nd the patient in faure ‘search operations. Note: When the CPU's storage space begins to run low, patient records and their corresponding images are deleted to make room for new images (oldest images and patient records firs). For ‘more information about atiest and image reclamation, and how you ‘ean protect a patient record ‘and associated images from being deleted, refer to Chapter 4 Basic Operations To add a new patient when not using a barcode, click the New button in the Patient panel of the main window. ‘The New Patient Entry window displays; a sample is shown below. Note that, for your site, the fields in this window may be different. In the sample, the visit number field is labeled “Admission Number.” Patient Demographic Applicati Last Name: PUBLIC ‘First Name: JOHN *DOBAMMDDYYYY)O3 Oi 11958 *Age of Patent: BY Gender: M Referring Physician: | ae ea) “Admission Number: a "Accession Number. 7867867 ‘Procedure Description: Thorax LICHEST PA + LAT WjOBUQUES |v} "*NOTE Fiolds with an asterisk "* are mandatory and require input. ‘Complete the fields in the window. Fields whose labels include an asterisk (*) are required fields. When specifying the procedure: + From the first drop-down list, choose the exam type. + From the second drop-down list, choose the procedure within that exam type. To save the patient information, click the Accept button. The Creating/Editing Patient Information window closes. To clear the patient information and reenter it, click the Clear button. To cancel entry of the patient information, click the Cancel button.EPEX ER System User's Guide When you finish creating or modifying the patient information, the main window is updated, as shown in the sample screen below. Note that: + The patient name displays in the Patient panel. + The visit number displays in the Visit panel. + The study ID displays in the Study panel. + The chosen procedure name displays in the Study pane! + The series of image views that are to be captured, as defined by the chosen procedure, are displayed. + The exposure technique settings, relative to the chosen procedure, are displayed, After entering and saving patient information, you are ready to choose the output devices to which you want to send the images. Refer to the topic “Step 2: Choosing Output Destinations” on page 2-29. _ Nam incisor button , Technique settings ea Uerononrame PUBLICICHNAG a a mabbeuoune / ASSorm N20 (00 F nL ee ame | g sen Conte wetmmt_e a RES : ‘Study pane! _- Cutout panel 7ADirectRay = f . Thum of Datector Aa Trumenalot ext ier to expose satis scauresimge Se acasted pore! 244 Basic OperationsEPEX ER System User's Guide Choosing an Existing Patient or Visit Using the Search Function Note: You can use the ‘You can choose an existing patient by first clicking the Local DB tab to asterisk (*) character as a search the local database, then wsing the Search function to list patients wildcard character to broaden your search, For example emering Rph To search for an existing patient or visit in the local database: swould return patients named Randolph and Rudolph. If whose name, ID, or visit number match search criteria that you enter. To search by patient name, click the Patient Name tab, enter the name sing the wildcard character in the search field, then click the Search button or press the Enter key. make sure you include at Note the following guidelines when entering names: least one other character phoning + Names are stored in the database as LAST*FIRST*MIDDLE. aterisl) to avoid sting all When specifying two or more parts to a name, you must include the patiens oF visits, which might caret (°) character between the name parts (for example, DOE*J*). take several minutes 10 ae ad + Because names are stored in the format LAST*FIRST/MIDDLE, searching for the first name John requires preceding it with an asterisk (that is, *John). + Search entries are case insensitive; you can enter upper or lower case letters. + To search by patient ID, click the Patient ID tab, enter the ID in the search field, then click the Search button or press the Enter key. + Tosearch by visit number, click the Visit tab, enter the visit number in the search field, then click the Search button or press the Enter key. Basic Operations 215EPEX ER System User's Guide “The list of patients or visits matching the search criteria that you entered displays (for example, refer to the following sample window). i ke | Enter or search for patient 4) ae Ne a ___Sant | Werle, Loe DB] | Patient Pao Nae Pte Va oo ee ‘a ote pac Search Rest New) i. i se 1 2 js oe, Visit 00008, ™ 19490819 2 | j - jeccor F mesxste ~ |i svt sas 5 sro7 I asin " 19750817 248 Basic OperationsBasic Operations EPEX ER System User's Guide To navigate through a list that is too long to be entirely displayed, refer to the following illustration CF «| ___ Te serol to the top of the lst, ick here To scroll up one entry ata time, cick here [Bfen| re sro don one ety at aie, ck ere Be} rr setto neat meta nae To clear the list and start a new scareh, click on one of the other search tabs (for example, Patient ID or Visit). To choose a patient or visit from the list, click on the entry: + Ifthe patient entry that you chase has multiple visits associated with it, the visits are listed afier clicking the patient entry. Click on the visit you want to open. + Uf the visit entry that you chose has multiple studies associated with it, the studies are listed after clicking the visit entry. Click on the study you want to open. The study list includes the status of each study, as shown on the following page. 247EPEX ER System User's Guide tesa Patient Hone BB os aint | ) |Search Resuls:2 entries t New| | on es nassau mers "| | Iviste ia34 2. SKULL 4 VIEWS ROUTINE Seheiiled 7455321 1 ABD COMP WPA CHEST +)0R DECURG Scheduled ee 218 Basic OperationsEPEX ER System User's Guide After making the final selection in the patient/visit/study hierarchy, that selection is opened in the main window, as shown below Fe Fie Adin Help Public‘John*Q. & Patient ~|choose a Stidy: Pane | |Search Results: 2 entries, SU ery nr) | ec] to} oe} ‘Study Posedee ‘Outputs [tes ta sent If multiple procedures are listed under one patient, click on the appropriate procedure(s) and click the Seleet button, To cancel and return to the search sereen, click the Clase button in the patient option box. Unless you want to change the procedure from the default one(s) displayed in the Study panel, go to the topic “Step 2: Choosing Output Destinations” ‘on page 2-28, Ifyou want to change the procedure, refer to the topic “Step 8: Opening an Additional Procedure (Optional)” on page 2-53. Basic Operations 249EPEX ER System User's Guide Alarm inieator buon taeator ba Tectnique setings area erage PUBLICOHN'S & ' t 1 fay Gonerator aot yoo f 0.508 | see 4 Sastre aus” y a / tahespanel mw rae sana Thumtnal of Detector ray Trunbnalot ned waite exposure salts acqured mage be acquved pane ia ta 2-20 Basic OperationsCc EPEX ER System User’s Guide Choosing a Patient Using the Modality Worklist Query Basic Operations, The DirectRay Console application includes an optional feature-—Modality Worklist—that allows you to retrieve patient information from a Radiology Information System (RIS). This feature follows the DICOM Modality Worklist standard, and requires your facility to have a DICOM Modality Worklist provider. If this feature is configured on your system, the Enter or search for Patient window contains an enhanced user interface that includes two tabs: + Worklist tab. This tab includes two subtabs. The Patient Query tab allows you to search for a patient in the Modality Worklist provider using several different search criteria. The Todays Worklist tab allows you to retrieve a daily worklist of patients and visits from the RIS. + Local DB. This tab allows you to manually enter patient information, or search the local database for a patient or visit. This tab functions as described in the topics “Adding a New Patient Manually” on page 2-13 and “Choosing an Existing Patient or Visit Using the Search Function” on page 2-15. 22EPEX ER System User's Guide ‘The enhanced Enter or search for patient window is shown below. : elon agin “Fle Ese Adrin Help | Enter or search for patient cr | Pavone Name ene Vise reer ater Nae to sare oe a | | | { Joe anne 2.22 Basic OperationsNote: The query fields are configurable and are named er the criteria for your ‘specific facility Note: In addition to the specific search criteria you enter, the chosen Date Range criteria always applies o the query. Ensure that the date the patient's exam(s) were ordered is included in the Date range field before Iniiaing a query Basic Operations int Records from the Modality Work EPEX ER System User's Guide it Provider ‘You retrieve patient records from the Modality Worklist provider by using search criteria to query the Modality Worklist provider. In response, the Modality Worklist provider returns the patients that match the search criteria. You then choose the patient and study whose images you want to acquire. The Patient Query is useful when searching for a specific patient or study. The patient search criteria that can be used includes patient name, patient ID, study ID (for example, an accession number), Requested Procedure ID, and/or order date. Any combination of these criteria can be used for any given query. To query the information system for a patient, choose the Worklist tab, then choose the Patient Query tab. Enter the following search criteria, in any combination: + Patient ID. The Patient ID must be an exact match. + Patient Name. You can enter the entire name, or use the asterisk (*) as a wildcard character to specify only a portion of the name. Follow the same text entry guidelines as described previously under “Choosing an Existing Patient or Visit Using the Search Function.” + Study ID (Accession Number in the sample window). The study ID ‘umber must be an exact match. + Requested Procedure ID (not applicable for all installations). This ID must be an exact match. + Date Range. Choose a date range from the Date drop-down list. The within 3 days date range option includes the 3 days prior to and 3 days following today. The other within options behave similarly. Note that when you return to the Patient Query window after completing exams, the Date range always reverts to today. When you are finished entering the search criteria, click the Query button or press the Enter key. The list of patients matching the search criteria displays, as shown in the sample window on the next page. In this example, the search criterion PUB* was entered in the Patient Name field. To navigate through a list that is too long to be entirely displayed, refer to the topic “Choosing an Existing Patient or Visit Using the Search Function” on page 2-15.EPEX ER System User's Guide Hoon He Enter or search for patient ie Sq 0m, Wothst: Loo DB Patient Paene Query Todays Worlds. Pec vettne Asati oe : statue: Bu : ~ a 28 DAVID"PUBLICSQ. Mm Issc0315 rs Ie 308 JANerPURLICn F we00s10 vs 287 JOHN PUBLIC Mi _15e40401 tet Outputs ‘sean Orme] | | ee) eet 2.24 Basic OperationsCc EPEX ER System User's Guide Viewing Patient Entries in “Today's Worklist” Today's Worklist is useful if you prefer choosing patients or studies from a list of scheduled studies for the day. To retrieve all patient studies scheduled for today, choose the Worklist tab, then choose the Todays Worklist tab. The list of patient studies that have been ordered for today’s calendar day displays, as shown in the sample window below. To update the list, if you would like to query the Modality Worklist provider for studies that have been ordered since the last list update, click the Update button. An updated list of patients and studies displays. ‘The DirectRay Console may occasionally perform scheduled queries in the background. To refresh the list to see possible new entries, click the Refresh button. Hage espa —_— Enter or search for patient 6 Iss00515MSSI214 us emo # san | fp) Basic Operations 225EPEX ER System User's Guide Reordering and Resizing Columns in the Entry List You can reorder or resize the columns in the patient entry list in the Worklist tab. To reorder the columns, click and drag the colunn heading cell to the left or right, then release the mouse button when at the desired location. To resize a column, move the pointer over one of the border lines of the column until it turns to a bidirectional handle icon. Click and drag the resize handle, then release the mouse button when at the desired width. Opening a Patient/Study in the Entry List ‘Yo open a patient/study listed in the Worklist tab’s entry on the entry. That patient, visit, and study are opened in the main window, as shown below. Technique setings area lam Inceater bution PUBLICJOHNAQ/ User logon rome — is unin onan ae ron t inn t sempre HOY 108 Stuy aie, ay OEP URES Study panel“ output panei x / \ / Detector aay Thumbnails of exposure staivs ven forthe pane provedure can 2.26 Basic OperationsC EPEX ER System User's Guide Required Fields for Worklist-Ordered Studies SMITHAJOHN*A The DirectRay Console is customized at the time of each site installation to require certain patient and order-related information before acquiring the patient images can proceed. Occasionally, all the required patient and study information is not sent from the Modality Worklist provider to the DirectRay Console as part of the query. In that case, you are presented with an Edit Patient, Visit, or Study window, prompting you to enter the missing information. An example of the Edit Study window is shown below. In the example, a Study ID has been configured as a required value, but no value was received in the patient query from the Modality Worklist provider. at stay Description: Abdomen _|,ABD COMP WIPA CHEST */OR DECUB(S) je Braces Basic Operations Enter the required information, modify the Procedure Description if needed, then click the Accept button to proceed. For more procedures about how to edit patient, visit, or study information in these windows, refer to Chapter 3 in the DirectRay Console User's Guide. 2207EPEX ER System User's Guide Scanning a Bar Code to Identify the Patient/Visit/Study AN ‘Note: Patient records are ‘kept temporarily in a local database, storage space ‘availability permitting, 10 save you from having to reenter information for a patient who was recently A-rayed. Note: If any required patient/ visidstudy information was ‘not included in the information retrieved, the appropriate Edit Patient, Visit, or Study window displays, so that you can ‘enter the missing required information. Refer to Chapter 3 in the DirectRay Console User's Guide for ‘more information about how ‘oedit patient, visit, or study information, 2.28 ‘The bar code scanner is a Class Il laser device. Do not use it in a patient contact area. Laser light is emitted from the bar code scanner aperture. Avoid exposure. Do not stare into the beam. For more information about using the bar code scanner and safety precautions, refer to the bar code scanners original manufacturer documentation. When you scan a bar code to uniquely identify a patient/visit/study: + Ifyour site supports a connection to a Hospital Information System, Radiology Information System, or other remote patient database (for example, using a Modality Worklist provider), the DirectRay Console user application queries that database and the local DirectRay Console patient database for the ID. + Ifyour site does not support such a remote database connection, the DirectRay Console user application searches its local patient database for the ID. Uf the scanned ID is not found, you must manually add the patient/visil study. Refer to the topic “Adding a New Patient Manually” on page 2-13. If the scanned ID is found, the DirectRay Console application “opens” that patient and visit in the application’s main window, as shown on the following page. You are ready to choose to which output devices you want to send the images. Unless you want to change the procedure (that is, the series of images to be captured) from the default one displayed in the Study panel, 20 to the topic “Step 2: Choosing Output Destinations” on page 2-29. If you want to change the procedure, refer to the topic “Opening a New Study” in Chapter 3 in the DirectRay Console User's Guide. Basic OperationsCc EPEX ER System User's Guide Step 2: Choosing Output Destinations Before you acquire patient images, you need to choose the output setup you want to use. To choose an output setup, choose it from the Selection pop-up menu in. the Outputs panel. The pop-up menu lists all of the output setups that have been created for your site. Step 3: Adjusting Exposure Settings and the Exposure Sequence (Optional) At the time the system is installed, default exposure settings and imaging sequences are configured for each view in each available procedure. You can use manual techniques or phototiming techniques to adjust the default exposure settings. Typically, you simply use the default settings. You would only change them for special circumstances, such as a very small person or a missing lung. If you want to adjust the exposure settings, refer to the topic “Adjusting Technique Settings” in Chapter 3 in the DirectRay Console User's Guide. If you want to adjust the exposure sequence, refer to the topic “Working with Procedures in Chapter 3 in the DirectRay Console User's Guide. When you have finished adjusting exposure and sequence settings, you are ready to position the patient and acquire images. Basic Operations 2.29EPEX ER System User's Guide Step 4: Adjusting the Orientation of the Bucky You can now position the radiographic table and Bucky to accommodate the orientation of the patient for the exposure. Positioning the Bucky Use push buttons located on the Bucky handle, arm handle, and tower handis to release the brakes on the various joints of the articulating arm, freeing the Bucky and Bucky tower for repositioning. Also, to assist you in positioning the Bucky into standard positions, mechanical detents are incorporated into the articulating arm joints. NOTE: The orange buttons on the Bucky handle and the tower handle do not control a funetion on the EPEX ER System at this time. Each brake release push button is a momentary switch. Brakes are deactivated for as long as you depress the corresponding release switch. With the articulating arm brakes released, you perform all Bucky ‘movements manually. For complete details on the Bucky controls and procedures, refer to the EPEY ER Articulating Arm User's Guide, ‘You can position the Bucky in the following ways: + Pivot the Bucky between portrait and landscape + Pivot the Bucky between upright and horizontal positions + Raise or lower the Bucky + Move the Bucky longitudinally along the table + Rotate the Bucky around the articulating arm Rotating the Bucky Between Portrait and Landscape Figure 2-4 shows the controls you use to rotate the Bucky between portrait and landscape orientations. Figure 2-4. Portrait/Landscape Release Button ‘To rotete the Bucky between press one of these portrait and landscape release butions on the rientations, sides of the Bucky 2:30 Basic OperationsEPEX ER System User's Guide Pivoting the Bucky Between Upright and Horizontal Figure 2-5 shows the controls you use to pivot the Bucky between upright and horizontal orientations. Figure 2-6. UprightHorizontal Release Button To oa te Bucy berwen ress the yl release aon ‘ota! an up posts Raising or Lowering the Bucky Figure 2-6 shows the controls you use to raise and lower the Bucky. Figure 2-6. Sa Vertical Release Button 1 70 ress this release (or press this release Basic Operations 231EPEX ER System User's Guide Moving the Bucky Longitudinally Figure 2-7 shows the controls you use to move the Bucky longitudinally along the table. Figure 2-7. Optional Longitudinal Release Buttons ae 30" ke (ee) OAS econ GO! oR press this release on the press this release Bice harle nine tower nano 2:32 Basic OperationsEPEX ER System User's Guide Rotating the Articulating Arm @ Figure 2-8 shows the controls you use to rotate the Bucky's articulating arm. Figure 2-8. ‘Arm Rotation Release Co = ‘orotate the articulating arm, press is release ‘onthe tower handle | ete tne Se Co (=o) Basic Operations 2:33EPEX ER System User's Guide Step 5: Positioning the X-ray Tube and Collimator ‘You position the X-ray tube and Collimator by moving the Overhead Tube Crane, from which they are suspended. The Overhead Tube Crane consists of longitudinal rails, a transverse bridge, a transverse carriage and telescoping column, and a control console. Refer to Figure 2-9. Figure 2-9. Omnifiex IV Overhead Tube Crane 2-34 Basic OperationsG Features EPEX ER System User's Guide The features of the Omniflex IV overhead tube crane include: + Digital height readout indicating the focal film distance either to the Bucky, table top, or floor + Digital angulation readout + Easy-Touch dome switches + Clear, unobstructed viewing and access to Collimator controls and indicators + Built-in lateral CABL-TRAC™ for concealed support of high-voltage cables + Rotational tube movement + Full field travel and coverage of tube support allows maximum use of available room space + Positive stops at 0° and 90° to aid in aiming the beam for use with the Bucky Using the Overhead Tube Crane Control Panel to Position the X-ray Tube Basic Operations You position the X-ray tube by pressing one of the release buttons on the overhead tube crane’s control panel, moving the X-ray tube arm to the desired position, then releasing the button to lock the crane into place. Figure 2-10 shows the control panel. The functions of the contral panel are described in Table 2-1 on page 2-37. 2:35EPEX ER System User's Guide Figure 2-10, Omniflex IV Control Console 2:36 Notes: 1. All directions for use of the EPEX-Omniflex tube crane are described from the point of view of a user standing in front of the tube crane. 2, The system's layout may alter the meaning of some directions. For example, in Wall Mode Configurations A and C, the lateral center position for the tube crane is in the tube crane’s transverse direction; in ‘Wall Mode Configuration B, the lateral center position for the tube crane is in the tube crane's longitudinal direction. The meanings of control console soft-keys and LEDs change accordingly. 3. Unless noted otherwise, the LED above the soft-key indicates the lock status: ON = locks active, OFF = locks released. 4, A flashing LED generally indicates a function that needs to be performed to comply with required conditions. Basic OperationsEPEX ER System User's Guide (or 1. Omniflex IV Control Panel Component Descriptions Figure 2-10 Callout. Control Number Component —_—_Description 1 Handles The control panel has three handles—two on either side and one at the center below the panel. Note: Unless noted otherwise, the LED above the sofi-key indicates the lock status: ON = locks active, OFF = locks released. 2 All Locks ‘Squeeze this grip switch, located at the rear of the center handle, to Release Grip _release the lateral, longitudinal, and vertical locks and manually Switch position the tube crane. To lock the tube crane in the current position, release this switch. ‘When squeezed, this switch stops all automatic motions and turns Auto mode off, if it was on. 3 Longitudinal _Pressing either soft-key releases the longitudinal lock, allowing you Lock Soft-Key to manually move the tube crane longitudinally. Cc ‘Note: With Auto Mode engaged, the longitudinal lock is automatically applied when either the lateral center or SID position(s) is reached. This function is dependant upon the Wall Mode position for which the room is configured. Down soft-key This soft-key activates the drive motor and moves the telescopic arm down. While the arm is moving down, its associated LED flashes. To release the vertical lock and move the tube crane up and down manually, press the Down and Up soft-keys simultaneously. Pressing this soft-key while Auto mode is on tums Auto mode off. Up soft-key This soft-key activates the drive motor and moves the telescopic arm up. While the arm is moving up, its associated LED flashes. To release the vertical lock and move the tube crane up and down manually, press the Down and Up soft-keys simultaneously. Pressing this soft-key while Auto mode is on turns Auto mode off. 6 Transverse Lock Pressing either soft-key releases the transverse locks, allowing you Soft-Keys to manually move the tube crane transversely. ‘Note: The transverse lock is automatically applied when either the lateral center or SID position(s) is reached. This function is dependant upon the Wall Mode position for which the room is configured. Basic Operations 237Table Figure 2-10 Callout Number Control Component EPEX ER System User's Guide ‘Omniflex IV Control Panel Component Descriptions Description a ‘AngulationLock Pressing either soft-key releases the angulation lock, allowing you Soft-keys to rotate the X-ray tube about the horizontal axis. Press both angulation soft-Keys simultaneously to release all locks (vertical, angulation, longitudinal and lateral) so that you can manually move the tube crane in all available directions and orientations. However, pressing both soft-keys simultaneously while Auto mode is on, will turn Auto mode off. Not Used ‘Auto Mode soft-key This soft-key toggles between auto and manual mode, as described below. The current setting is shown just above the soft-key in the status display called out by number 16 in Figure 2-10 on page 2-36. Table Mode Use this setting when in Table mode and you want to manually (Auto Off) position the X-ray tube vertically to establish the SID. Table Mode Use this setting when in Table mode and you want the X-ray tube to (Auto On) automatically track the Bucky's vertical motion, maintaining the predetermined SID (a vertical SID of either 40 in. or 44 in. can be set during calibration). Wall Mode Use this setting when in Wall mode and you want to manually (Auto Off) position the X-ray tube vertically to align it with the Bucky. Wall Mode Use this setting when in Wall mode and you want to have the X-ray (Auto On) tube automatically align itself vertically with the Bucky. Using the Auto Modes to Have the X-ray Tube Track the Bucky 2:38 When Auto mode is installed, the tube crane is equipped with a motorized vertical drive. There are two different AUTO modes available and the tube crane can be configured as follows: Auto-wall, Auto-table, both, or neither. The Auto option allows automatic tracking of the tube to the Bucky (Wall Auto) or with the table top (Table Auto). Selection of the desired Auto option is accomplished by pressing the Mode soft-key (callout 10 in Figure 2-10 on page 2-36) so that the Auto indicator is illuminated. The tube must be angulated correctly for the desired Auto option to be active. Angulation of the tube to 90 +15° towards the Bucky with the Bucky in the upright (vertical) position automatically places the tube crane in Auto-wall mode. Ifthe tube is outside the 0 +15° window, the tube crane is in Auto-table mode. Basic OperationsEPEX ER System User's Guide the table top; otherwise, the automatic positioning may drive the tube into the table top or the patient until the safety clutch stops vertical motion (set at 40 fb or A Prior to selecting Wall Auto mode, the Bucky must be positioned to a height above 18.14 kg). CAUTION Auto Mode Option The Omniflex can be configured with or without the Auto Tracking option. The Auto Tracking option allows automatic vertical tracking of the X-ray tube to the Bucky. Refer to the topic “Positioning the Overhead Tube Crane for Chest Exposures” on page 2-42 or “Positioning the Overhead Tube Crane for Under Table Exposures” on page 2-43 for instructions on turning Auto Mode on. Basic Operations, 2:38EPEX ER System User's Guide Auto On In Wall Mode ‘With Auto on in Wall mode, the Omniflex continually drives the tube up or down to maintain alignment of the X-ray field and the Bucky. It is important to remember that the operator moves the Bucky to the desired height, and the X-ray tube follows, not the other way around, In Auto mode, the system suspends automatic vertical tracking for the duration of the occurrence of any of the following conditions: + The X-ray tube is not in Wall mode Sateral center. + The Bucky horizontal centerline has been raised or lowered beyond the tube crane’s limit of travel. + The Bucky is not in the +90° (vertical) position. + The SID is not 40 in. or 72 in. Tracking automatically resumes as soon as all of the above conditions are no longer in effect. The system automatically tums off Auto mode upon the occurrence of any of the following events: * The Lateral Center function is turned off. + The Left or Right soft-key is pressed, releasing the longitudinal lock. + Any manual vertical motion control is activated, whether activating the drive motor or not. + Any manual multi-axis motion control is activated. If Auto mode turns off automatically, the operator must press the Auto Mode soft-key to tur it back on. The following messages display on the Omniflex front panel when operational requirements are not met: + IN MOTION. Indicates that the tub the Bucky. + HORIZ SID? A prompt instructing the operator to position the tube at the selected horizontal SID. + BUCKY? LAT CNTR? Indicates that the Omniflex is not at Wall mode lateral center ot that the Bucky is not vertical. in motion, aligning itself with + READY. Indicates that all positioning requirements are met. 2-40 Basic Operations,EPEX ER System User's Guide Auto On In Table Mode With Auto on in Table mode, the Omniflex drives the telescopic tube-arm vertically to maintain a 40 in.SID with the Bucky in the 0° position (horizontal). It is important to remember that the operator positions the table to the desired height, and the X-ray tube follows, not the other way around. Cc In Auto mode, the system suspends automatic tracking for the duration of the occurrence of any of the following conditions: + The X-ray tube is not in Table mode lateral center. + The Bucky has been raised or lowered to a point such that maintenance of the specified SID would take the tube crane beyond its limit of travel. + The Bucky is not in the 0° (horizontal) position. Tracking automatically resumes as soon as all of the above conditions are ‘no longer in effect. The system automatically turns off the Auto mode upon the occurrence of any of the following events: + The Lateral Center function is turned off. + The Left or Right soft-key is pressed, releasing the longitudinal lock. G + Any manual vertical motion control is activated, whether activating the drive motor or not. + Any manual multi-axis motion control is activated. If Auto mode tums off automatically, the operator must press the Auto Mode sofi-key to turn it back on. The following messages display on the Omniflex front panel when operational requirements are not met: + IN MOTION. Indicates that the tube is in motion and has not stopped at the 40 in, vertical SID position. + BUCKY? LAT CNTR? Indicates that the Omniflex is not at Table mode lateral center or that the Bucky is not horizontal. + READY. Indicates that all positioning requirements are met. Basic Operations 241EPEX ER System User's Guide Positioning the Overhead Tube Crane for Chest Exposures To position the overhead tube crane for chest or other upright exposures: Step | Action Move the Bucky tower all the way to the left. Position the Bucky Stand arm at 135°, Rotate the Bucky to the vertical position (Bucky’s 90° switch ON). Raise the Bucky to the proper height. 2 3 4 5 Ensure that the Bucky is in Portrait or Landscape orientation, not an intermediate orientation. 6 | Rotate the X-ray tube/Collimator to the 90° position, facing the Bucky. Note: The Omniflex automatically enters Wall mode whenever the angulation of the X-ray tube is 90° 15° clockwise (horizontal, X-rays aimed lefi) or counterclockwise (horizontal, X-rays aimed righ). Prior to selecting Auto when in Wall mode, the Bucky must be positioned to a height above the table top; otherwise, the automatic positioning may drive the tube into the CADTION ‘28 top or patient, until motor torque Is exceeded (set at 40 bor 18.14 kg). Step | Action To use the Auto Mode: Note: The Omniflex must be equipped with the Auto Tracking option. 7 | Totum on Auto mode, press the Auto Mode soft-key. 8 | To tum on Lateral Center, press the Lateral Center soft-key. Ifthe message BUCKY? LAT CNTR? flashes on the Omniflex ‘Sfront panel display, move the tube crane te Wall mode lateral center. Ifthe message HORIZ SID? flashes on the Omniflex front panel display, position the X-ray tube at one of the predetermined horizontal SIDs (40 in. or 72 in.) and verify that the SID is displayed on the Omniflex front panel display. Note: In Auto mode, the X-ray tube must reach vertical alignment with the center of the Bucky before exposure is enabled. 2.42 Basic OperationsStep EPEX ER System User's Guide Action To use the Automatic Collimation mode: Ensure that the angulation of the X-ray tube is 90°+2°, facing the Bucky. Positioning the Overhead Tube Crane for Under Table Exposures To posi Step 1 2 3 Basic Operations, n the overhead tube crane for under table exposures: Action Rotate the Bucky to the horizontal position (Bucky 0° SW is “ON” Position the Bucky Stand’s arm at 0°. Ensure that the Bucky is in Portrait or Landscape orientation, not an intermediate orientation. Rotate the X-ray tube to 0°, Note: The Omniflex automatically enters Table mode whenever the angulation of the X-ray tube is 0° +15° (X-rays aimed vertically downward). To use Auto mode: Note: The Omniflex must be equipped with the Auto option. To tum on Auto mode, press the Auto Mode soft-Key. To turn on Lateral Center, press the Lateral Center soft-key. If the message BUCKY? LAT CNTR? flashes on the Omniflex front ‘panel display, move the tube crane to Table mode lateral center. Verify that the 40 in, SID is displayed on the Omniflex front panel display. ‘To use the Automatic Collimation mode: Ensure that the angulation of the X-ray tube is 0° 42° (vertical). Note: When Auto is off in Table mode, the differential SID between the X-ray tube and Bucky appears on the Omniflex front panel disple 2.43EPEX ER System User's Guide Adjusting the Collimator Use the Collimator shutter to help you aim and size the X-ray exposure area + To ensure that the tube is aimed properly, project a light through the shutter to illuminate a target area on the patient. + Tocontral the area size of the exposure on the patient, adjust the height and width of the shutter opening. For more information on Collimator adjustments, refer to the Linear IY" Collimator Installation, Operation, ancl Maintenance Manual. Step 6: Exposing Patients AN WARNING Figure 2-11 DirectRay Console Prep/Exposure Switch 244 This X-ray unit may be dangerous to the patient and operator unless safe exposure factors and operating instructions are observed. Patient exposure is controlled by a 2-position button switch on the side of the DirectRay Console, as shown in Figure 2-11 repre eosure Suit RIGHT SIDE — ‘When the prep button is pressed half way, you have 30 seconds to complete the exposure. ‘When the prep button is pressed all the way, the exposure is taken within one half second. Basic OperationsNate: Releasing the Prep Expose buiion before the exposure is completed causes pramainre urd inmediare ermination of the exposure This may cause the X-ray Generator Reser button on the DirectRey Console application's main window 10 light. To perform subsequent exposures, click the Reser button Notes Ifthe X-ray tube beat tunity exeved the maximum allowable limit, the X-ray tube anel Generator are disabled until the heat units drop to a safe level. I this condition occurs, a mess displays en am axuetble be sounds Basic Operations EPEX ER System User's Guide The Status indicator on the DirectRay Console application's main window displays a message to indicate when the DirectRay Detector is ready for the next exposure: + A Wait countdown indicates that the DirectRay Detector is refreshing for the next exposure. This countdown occurs only when the DirectRay Detector has been recently powered up, or if an exposure has been aborted. + Ready to expose indicates that the DirectRay Detector is ready to capture an exposure To acquire an ima; ‘Wait until the Status indicator reads DireetRay: Ready (green background), Press the Prep/Expose button half way (to the second position) and hold Give the patient breathing and/or pre-exposure instructions. Press the Prep/Expose button all the way (to the second position) and hold. ‘When the exposure occurs; the Status panel turns grey and a tone sounds, Note: While behind the leaded wall when taking ant exposure. you ‘must maintain verbal communication with the patient and keep the patient within your sight at all times: ‘After the tone stops, release the button, 6 | Give the patient the appropriate breathing instructions. When the exposure is complete, the Image Preview window opens and displays the image. Your customized windows may look different from the windows presented in this manual 2-45Note: The DirectRay Detector goes into "sleep" ‘mode to save energy if it has not been used for a predefined period of time. Opening a patient record or running the rabe warmup “awakens” the DirectRay Detector. If this has happened, you might have 10 wait a few minutes for the DirectRay Detector 10 enter its ready state. EPEX ER System User's Guide Step 7: Accepting or Rejecting an Image 2.46 From the Image Preview window, you can: + Verify the exposure information. + Select ESA or Inverse Topography (if available). + Verify the appropriate ESA information. + Verify Image Laterality. + Verify Patient Orientation. + Verify image fits on selected sheet format using true size. + For an image being sent to a DICOM print or storage device, crop the image or, if auto-cropping has been enabled, modify the cropping. + Ifa multi-image sheet format has been chosen, pick the position of the image on the sheet. + Entera comment that accompanies the image if sent toa DICOM workstation or printer. + Add markers. + Rotate image, if required. + Accept the image as it is. oR + Reject the image. Basic OperationsEPEX ER System User's Guide The following topics explain how to perform these tasks. A sample of the Image Preview window is shown below. an [wire or OBL FR rca fora Basic Operations 247EPEX ER System User's Guide Changing the ESA Setting or Adjusting the LUT (Optional) ‘You can change the current ESA setting by: + Clicking on the pop-up menu in the ESA panel and choosing a different setting. + Adjusting the image's LUT settings manually by using the curve controls in the ESA panel. These adjustments change the minimum and ‘maximum densities used for the image, thus changing the image display. + Adjusting the image’s LUT settings by placing the cursor on the curve, pressing and holding the right mouse button, and dragging the line. * Modifying an image’s LUT by clicking and holding the right mouse button and moving the cursor across the image. ESA setting changes or LUT adjustments are not typically needed. For more information about making LUT adjustments, refer to the topic “Changing the ESA Setting or Adjusting the LUT” in Chapter 3 in the DirectRay Console User's Guide. Cropping an Image (Optional) You can crop an image for output to a printer. The cropping applies only to the image when it is sent to a DICOM print or storage device. For more information, refer to “Cropping an Image” in Chapter 3 in the DirectRay Console User's Guide. Selecting the Image Position on a Multiformat Sheet (Optional) ‘Note: Malt-format film will ‘not automatically print until all the spaces are filled. If exam is finished, and all spaces are not filled the film can be printed by clicking the Close Study bution 2-48 Ifthe image is being printed on a multiformat sheet (that is, more than one image on the sheet), you must choose which position on the sheet to place the image. The Image Preview window includes a Format area that displays rectangles representing the chosen image placement format. A 4-up format is shown in the sample Format area below. Sheet Format Basic OperationsNote: Ifyou choose one of the formans other than 1 mp, use text-on-film instead of ‘annotation boxes for any image-specific text you want printed under each image.. EPEX ER System User's Guide The default placement area on the sheet for the current image is indicated as a white rectangle. If other images have already been captured for the current sheet, their thumbnails are displayed in their chosen areas. To change the format, choose another format from the drop-down list. Depending on the DICOM printer's capabilities, the available formats are: + Lup. Only one image on the sheet. The default setting for output devices that do not support multiformatting. + 2up—1 by 1. Two images are placed side-by-side. + 2up—1 over 1. Two images placed one over the other. + 4up~2.x 2, Four images placed two over two. Adding Comments to an Image (Optional) Basic Operations. ‘You can add text comments to an image at the time of acquisition; the comment is sent to any DICOM devices chosen as an output destination for the image. For more information, refer to the topic “Adding Comments to an Image” under the topic “Working with Acquired Images” in Chapter 3 in the DirectRay Console User's Guide. 249EPEX ER System User's Guide Selecting ESA or IT (Optional) Inverse Topography (IT) isa pre- or post-processing software technique that is user selectable. IT expands the visibility of low-contrast structures such as tissue and vessels while maintaining and enhancing the visibility of high-conteast structures such as bone. , # Standard Exam-Specif Processing loverse Tepearapis For more information, refer to the topic “Selecting ESA or IT” under the topic “Working with Acquired Images” in Chapter 3 in the DirectRay Console User's Guide. Selecting Patient Orientation and Image Laterality (Optional) You can select the image laterality. For more information, refer to the topie “Selecting Patient Orientation and Image Laterality” under the topic “Working with Acquired Images” in Chapter 3 in the DirectRay Console User's Guide. Fitting Image on Selected Sheet Format (Optional) When a sheet format is selected, the true size function calculates whether the image will fit on the specified format and displays crop marks to indicate what area of the image will be sent to the output device. For more information, refer to the topic "Using the True Size Function” under the topic “Working with Acquired Images” in Chapter 3 in the DirectRay Console User's Guide 2-50 Basic Operations~ EPEX ER System User's Guide Adding Markers to the Image (Optional) You can add markers to an image that allow you to give further information about the image (for example, supine, upright, and so on), the markers are sent to any DICOM devices chosen as an output destination for the image. For more information, refer to the topic“ Adding Markers to an Image” under the topic “Working with Acquired Images” in Chapter 3 i the DirectRay Console User's Guide. Rotating or Mirroring the Image (Optional) Accepting the Image Note: Once the imuge is accepted, t cannot be moved to another image placement aah View Sule oe » scquied image Basic Operations ‘You may wish to rotate or mirror the image. For more information, refer to the topic “Rotating or Mirroring the Image” under the topic “Working with. Acquired Images” in Chapter 3 in the DirectRay Console User's Guide. To accept the image, click the Accept button (or press the Spacebar on the keyboard). The Image Preview window closes and a thumbnail (minimized view) of the image displays in the Image Panel of the DirectRay Console application's main screen, as shown below. The exposure settings used to acquire the image are displayed next to its thumbnail. Once accepted, that image is stored in the DirectRay Console and sent to the chosen output device. You are now ready to acquire the next image in the procedure, Seu) CHEST PA + LAT WIDBLIQUES ‘Clase Sealy sr Lass Next view tbe To change the exposure order, ‘aequled by data lek on tha view you want tw acquire next By default, the next view to be exposed is chosen in the image panel. If needed, you can choose a different view and adjust the exposure settings before acquiring the next image. For more information about these procedures, refer to Chapter 3 in the Direc’Ray Console User's Guide 2.51Rejecting the Image Note: Unless auorcleanup of the reject hin hes heen configured. rejected images ampst be manually deleted by tie system adninistranor: the spstem does nor delete rejected images when it reclains disk space. 2-62 EPEX ER System User's Guide You may want to reject an image (for example, if the patient moved during the exposure). To reject the image: Action Step 1 | In the Image Preview window, click the Rejeet button. ‘The Image Rejection Information window displays. as shown, below. In this window, you enter a reason for the rejection, we mane aynet ae Seamoprne| 2 | Choose one or more reasons from the displayed list of default ‘comments, and/or type in a reason, 3 | To save the rejection reason and reject the image, click the Reject button. The Rejection Reason and Image Preview windows close and you can then recapture the image, To dismiss the window and return to the Image Preview window without rejecting the image, click the Return to Preview button. Rejected images are stored in a designated reject bin storage area in the DirectRay Console, and can be discarded or resent to an output device by users with administrative operating privileges. Basic OperationsEPEX ER System User's Guide Step 8: Opening an Additional Procedure (Optional) Fora given study, you may want to open additional procedures, to include their images in the study. For more information refer to the topic “Working with Multiple Open Procedures” under the topic “Working with Procedures” in Chapter 3 in the DirectRay Console User's Guide. Step 9: Adding a View to a Procedure (Optional) Ifthe current procedure does not include all the views you want to capture, you can add views to it. For more information, refer to the topic “Adding a View to a Procedure” under the topic “Working with Procedures” in Chapter 3 in the DirectRay Console User's Guide. Step 10: Closing the Study, Visit, and Patient After acquiring all images for a study, you close the study. You can then ‘open a new study for the same patient, open a new patient, choose another patient or visit, or log out of the session. Note: When all images ina Youcan also close a study even though you have not finished acquiring all study have been acquired. the of the required images (or have not acquired any images). You can reopen Close Study baton displays the study ata later time to complete it. To close a completed study, from the DirectRay Console application's main screen, click the Close Study button. The main window clears, allowing you to add or choose the next patient. Note: The fact tata study is To close an incomplete study, from the DirectRay Console application's incomplee dees notprevent main seren, click the Close Study button. You are prompted whether you the patient record an shi aerate imam being Want to close the study without finishing, as shown below. deleted as part ofthe system's storage space reclamation process, For more information about the reclamation, and how to protect a patient record and ‘associated images from being deleted, refer to Chapler 4 Click the Yes button to continue. The main window clears, allowing you to choose the next patient or visit with which you want to work. To close a visit, click the Close button in the Visit panel. To close a patient, click the Close button in the Patient panel. Basic Operations 253EPEX ER System User's Guide Step 11: Signing Out from an Acquisition Session ~ ‘Note: You can sign out from To sign out from the current DirectRay Console acquisition session, ‘an acquisition session witha from the main window click the Sign Out button. The Login window —— displays. For system security, the workstation display is locked at the procedure opensser Mees! Login window. In this state, a user can only log in to another session, and at ‘ser who signs on oa pashan the same user level (tech or mgr) of the previous user. I you click the Exit button, you must restart the DirectRay Console. This takes 264 Basic Operations,Switching User Levels EPEX ER System User's Guide To be able to sign in at a different user level—that is, switching between tech and mgr—you have to log out of the DirectRay Console application. To switch user level Step 1 Basic Operations, Act From the ‘The Exit from DROC window displays. ile menu, choose Exit. By oyourantes _ Power ff te computer? “Destro computer? © tap eutt oe come? Sian na tert user? te} Nel Choose the Log out of the computer? option and click the Yes button, ‘A dialog box displays asking you to confirm that you wish to log out. Click the Yes button. ‘The DirectRay Console application closes and the grey SUN Microsystems banner displays. Log in at the desired user level using the procedure in the topi “Step 5: Logging In to the CPU's Operating System” on page 2-6. Log in with your name and password using the procedure in the topic “Step 6: Signing In to the DirectRay Console Application” on page 2-7. 2:55EPEX ER System User's Guide Powering Down the System Components Typically, you should leave the system components on. The DirectRay Console CPU, monitor, and DirectRay Detector enter energy-saving “sleep” mode when not used for a period of time. If you have to power down the system, perform the steps outlined in the following topics. Recommended Power Down Procedure Overview To power down the system, it is recommended that you perform the power down tasks in the following sequence: Step | Action 1 Power down the DirectRay Console CPU. 2 | Power down the X-ray Generator. This also typi the other X-ray system components. lly powers down 3 | Power down the DirectRay Console’s UPS, which in turn powers down the DirectRay Detector and DirectRay Controller. The following topics provide instructions for performing each of these steps. ‘The DirectRay Console CPU should be powered down once a day to ensure a complete system reset. If this is not done, system performance deteriorates. Power Off. This does not turn off power to the X-ray tube arm, the Bucky, or the table, and should be used only when directed by a Hologic service representative. CAUTION Ay Inthe Admin menu, the Device Control function has a selection called DirectRay CAUTION 256 Basic Operations,co EPEX ER System User’s Guide Step 1: Powering Down the DirectRay Console CPU To power down the DirectRay Console CPU: CAUTION Basic Operations, Step Action From the File menu, choose Exit. The Exit from DROC window displays. E Bik rom OROC———] By doyourente: Power othe computer? start ha compute? Step eattee computer Sion inase rel ml Choose the Power off the computer? option. To continue with the power down, click the Yes button. ‘The system displays messages as it performs the operating system shutdown procedures. When the shutdown sequence completes, the CPU powers off and the monitor goes blank (the monitor enters an ‘energy-saving “sleep” mode). Wait until the monitar goes blank before proceeding to “Step 2: Powering Down the X-ray Generator” ‘on page 2-58. To cancel from the DirectRay Console application's power down process and redisplay the DirectRay Console application’s Login ‘window, click the No button, ‘Always power down the CPU as described above. Improper power down can cause loss of data. 257EPEX ER System User's Guide Step 2: Powering Down the X-ray Generator Powering down the X-ray Generator also typically powers down the other X-ray system components, such as the X-ray tube, overhead tube crane, Collimator, Bucky, and table. To power down the X-ray Generator, press the X-ray Generator OFF button located at the front left of the DirectRay Console cabinet. Refer to Figure 2-12. Figure 2-12. X-ray Generator Power ‘Switch a6 Basic Operations,EPEX ER System User's Guide _~ Step 3: Powering Down the DirectRay Console’s UPS To power down the DirectRay Console’s U! press the UPS power switeh (o the Off (Q) position. Refer to Figure 2-13. The DirectRay Detector and DirectRay Control! re powered off, Figure 2-13. UPS Power Switch Basic Operations 259Chapter 3 Managing the Image Output Queues and Resending Images This chapter describes the procedures for managing the image output queues, and resending previously acquired images that are stil stored in the system. Contents Managing the Image Output Queves Resending Images to Output Device: Repreviewing Images .. 34Overview Note: Images are not stored indefinitely. To ensure that there is always sufficient room to store newly acquired images, the system deletes the oldest images as needed to reclaim storage space. However, you can protect specific patient images so that they will not be deleted. Refer to Chapter 4 for more information. 32 EPEX ER System User's Guide As images are captured, they are put in queues assigned to the output devices. The images wait in the queues until the DirectRay Console is able to establish communication with the output device, and the output device is ready to accept images. You can view the status of queued images, and remove images from a queue. For more information, refer to the topic “Managing the Image Output Queues” on page 3 ‘You can also resend images to the output destinations (for example, film printers or workstation displays) originally selected at the time of exposure, or to different output destinations. For more information, refer to the topic “Resending Images to Output Devices” on page 3-6. Managing the Image Output Queues and Resending Images.EPEX ER System User's Guide Managing the Image Output Queues When you accept an acquired inrage, itis placed in an output queue controlled by the DirectRay Console application. A queue is used so that the image can be sent in the background, and you can go on acquiring other images On the main windows in the application, in the bottom right-hand corner. is an output queue status. This allows you to monitor whether the output is being processed. Refer to the following screen or rs PUBLIC4JOHN‘Q Patient ET oor Study sats yan) Sr OSES Pho BAT WICRICUE Mew UT a= yl) OR) ae DirectRay aa ous | dots in queue o | Vv Because image files are large, they can sometimes stack up in the output queue. Also, if'an output device is not responding or has a problem, the image cannot be sent and will be held in the queue. The DirectRay Console will retry sending the image, based on a retry count configured for the system. ‘You can examine the status of images in the output queue, and remove images from the queue. Managing the Image Output Queues and Resending ‘mages 33ae [Pconcrmpoater ry angle serv, leon earn poke EPEX ER System User's Guide To examine the status of images in the output queue, from the Admin ‘menu choose Manage Queues. The Queue Management window displays. (ai vamgeQoues | rowatiion | Colbrate Image Maragement | OR Dever Cone | Pee a The spoolers (queues) for the available output devices are listed in the Devices panel. The queued images are listed in the Queued Jobs panel. For queued images, the job status of Sending, Waiting, or Problem displays. hi ute 1 Tange py, je sce Dlem ster ob ipod 1 ea Note: Ifan output queue job is running, it cannot be deleted, To display the jobs in a queue, choose the output device in the Devices list by clicking on it. To remove an image from the queue, choose the image by clicking on it in the Queued Jobs list, then click the Delete from Queue button. To refresh the queue listing, click the Refresh button. To exit, click the Close button. Managing the Image Output Queues and Resending ImagesEPEX ER System User's Guide To resend the images from a stopped job, choose the image by clicking on it in the Queued Jobs list, then click the Resend Stopped Job button. jh 12343678. AVE NE 112345678 _|SKULL 4 VIEWS ROUTINE 'SRULL 4 VEWS ROUTINE 12345678 Dae trom Que] Resend Spedich| Ce Managing the Image Output Queues and Resending Images 35EPEX ER System User's Guide Resending Images to Output Devices Note: Images are not stored indefinitely. To ensure that there is aiways sufficient ‘room to store newly acquired images, the system deletes the oldest images as needed 10 reclaim storage space. However, you can protect specific patient images 50 that they will not be deleted. Refer to Chapter 4 for more information. The Resend function enables you to view thumbnails (small versions) of images previously acquired for a patient and then retransmit the full images to one or more specified output devices. In addition to the images, the original patient information, comments, and text annotations are sent. To resend images from a previous patient exam: Step 1 menu, choose Image Management. ‘The Choose a New Patient window displays. Giese New Raa Managing the Image Output Queues and Resending ImagesEPEX ER System User's Guide Step _ | Action 2 | To search by patient name, click the Patient Name tab, enter the ‘name in the search field, then click the Seareh button or press the Enter key. To search by patient ID, click the Patient 1D tab, enter the ID in the search field, then click the Search button or press the Enter key. The list of patients matching the search criteria that you entered displays (for example, see the following sample window), For Patients who have multiple studies, an entry is listed for each patient/study combination. Note: You can use the asterisk (*) character as a wildcard character to broaden your search. For example entering R*ph would return patients named Randolph and Rudolph. Ifusing the wildeard character, make sure you include at least one other character (that is, don't enter only an asterisk) to avoid creating a large listing of patients (up to the configured limit, the default is 50) which might take several minutes 1o complete. Note: When searching for wames, they are stored in the system as LAST"FIRST*MIDDLE. Therefore, searching for the first name John requires preceding it with an asterisk (that is, *John). Also, search entries are case insensitive; you can enter upper or lower case letters. a ‘Grosse A New Faent ‘Managing the Image Output Queues and Resending Images 37EPEX ER System User's Guide Step Action 3. | Te choose a patient from the list, click on the patient entry. ‘The Image Management window is updated, including the thumbnails (minimized views) of the images, and related patient and image information, as shown below. Arnie Managenent ‘poner $18 ——— Patient Name: PabhoifonnrQ Provecet. Yer [Ne inage seco o 12345678 08 19750017 ciger \ ns] nate] tear ba Seas tpe ed ¢ | fem m0 cy ae aap ced | ia Step Action 4 | Choose the options required. Refer to the table following this procedure. 5 | To transmit the images, click the Resend button, ‘A prompt displays a message that the resend was successful. Click the OK button, When you are done resending images, click the Clase button to close the window. Managing the Image Output Queues and Resending ImagesEPEX ER System User's Guide Option Description Resend all Use this option when you wish to send all images images for from a patient study. patient Resend selected Use this option when you wish to send a single or images for several images from a patient study. patient Select all the required images by clicking on them. The border(s) tums blue. To deselect, click the image again. Setups Use this option to specify the devices to which you ‘want to send the images. Formats Use this option if you are printing multiple images to one sheet. Note: You must be sending the images to a printer 10 use this option. Print True Size Use this option when you are printing to a printer that supports True Size and want to print the image at its true size, Print Ruler Use this option when you want to print a ruler on the sheet. Print Best Fit Use this option when you want the destination printer to adjust the image size to fit within its image area on the shee To resend another patient’s images, click the Choose a New Patient button in the Resend window to redisplay the Choose a Patient window. ‘Then repeat steps 2 to 8 from the previous procedure. ‘Managing the Image Output Queues and Resending Images 39EPEX ER System User's Guide Repreviewing Images [Adnin ange Queues Protect aint: Caters rage Macageneat | [DA Dace Conrad Paice Newel raion [fee Paine Name er wget: The Repreview function is used to manipulate an original image that has already been sent. You can take the original image, perform image enhancement functions such as cropping, image rotation, mirroring, or adding markers, and resend the image to the printer. To repreview an image: Step | Action From the Admin menu, choose Image Management, The Choose a New Patient window displays. Managing the Image Output Queues and Resending ImagesEPEX ER System User's Guide ep | Ac Locate the patient record: + To search by patient name, click the Patient Name tab. enter te name in the search field, then click Search or press the Enter key. + To search by patient 1D, click the Patient 1D tab, enter the 1D in the search field, then click Seareh or press the Enter key. The list of patient records matching the search criteria that you entered displays (for example, see the following sample window). Note: You can use the asterisk (*) character as a wildeardd character 10 broaden your search. For exaniple entering Réph would return patients named Randolph and Rudolph. If using the wildcard character, make sue vou include at least one other character ist Is, don't enter only an asterisk) to avoid creating a large listing of patients (up to the configured limit, the default is 50) which might take several minutes to complete. Note: When searching for nantes, they are stored in the system as LAST'FIRSTP’MIDDLE. Therefore, searching for the first name John requires preceding it with an asterisk (that is, *John). Also, search entries are cave insensitive; you ean enter upper ov lower case keters iu Choose A New Patent Paiene Name Paine D Inter Patene Nan fr wideard Ps [Search Results: entries ~~ soe L . Js oa JruBuicyoHNes 57065, ™ 1976909 PuBucyouNrg er M 19800901 Managing the Image Output Queues and Resending Images ant32 EPEX ER System User's Guide Step | Action 3. | Choose the patient record from the list by clicking on it The images for that patient display as thumbnails in the Image Management window. Pacone None: PubleoerQ Protected) Yer [Nownge sect) i rasera [00% 9750917 | Lopes 4 o Managing the Image Output Queues and Resending ImagesEPEX ER System User's Guide Step | Act 4 | trot already selected, click the Repreview tab. 5 | Click on the image you wish to repreview display in the upper-ri The details pertaining to the SpoalUsienton 51% 7 Coens Membre | Patiene Nome Publi§John’ (leage LEFT LATERAL [Soe taser aay meet ee at tut, SKULL 4 VIEWS ROUTINE aprerie i Managing the Image Output Queues and Resending Images 343Options Ren orgatGine EPEX ER System User's Guide 6 | Click the Repreview button, The preview sereen displays. Prmueawnane 12345673 SEL A OWS Routine — LEFT LATERAL a4 ‘Managing the Image Output Queues and Resending ImagesEPEX ER System User's Guide 10 ul 12 Make the required changes. Refer to the table following procedure. Click the Save button. ‘The image is saved as a new image and the Spool Management window displays. Click the Resend tab. Choose the options you wish to use. Refer to the table following this, procedure. Click the Resend button. To close the resend function, click the Close button. ere Managing the Image Output Queues and Resending Images 345EPEX ER System User's Guide Deseription Resend all Use this option when you wish to send all images images for from a patient study. patient Resend selected Use this option when you wish to send a single or images for several images from a patient study. patient Select all the required images by clicking on them. ‘The border(s) tums blue. To deselect, click the image again. Setups Use this option to specify the devices to which you want to send the images. Formats Use this option if you are printing multiple images to one sheet. Note: You must be sending the images to a printer to use this option. Print True Size Use this option when you are printing to a printer that supports True Size and want to print the image at its true size. Print Ruler Use this option when you want to print a ruler on the sheet. Print Best Fit Use this option when you want the destination printer to adjust the image size to fit within its image area on the sheet. 316 Managing the Image Output Queues and Resending ImagesChapter 4 Protecting Patient Records This chapter explains how to protect patients and their related images from being deleted by the system. Contents owOverview EPEX ER System User's Guide Patient records and images are stored in the DirectRay Console CPU temporarily, until storage space begins to get low. Then, the system deletes the oldest patient records and images to make room for new ones. The amount of storage space depends on the specific storage capacity configured for your DirectRay Console. Your Hologic service representative can tell you approximately how many images can be stored before reclamation begins. ‘You can protect patient records, and the related images, from being deleted as part of this reclamation process. You might want to do this if you will be creating new studies for the patient and want to avoid having to enter the demographic information again. Or, you may want to resend images to output devices. Reclamation Strategy ‘Note: Image reclamation is independent of the patient record reclamation. Deleting images as part of reclamation does not cause the related patient record to be deleted. Patient records fend to stay in storage longer than images. 42 ‘When the available storage capacity drops below a predefined level, patient records and images are deleted on a first-in-first-out basis. When a patient record is due for deletion, the image spool is checked for images associated with the patient record to be reclaimed; then the following rules are applied: + If any of the patient's images are in the image queue, the patient record is not reclaimed. + Ifany of the patient's images are in the reject bin, the patient record is not reclaimed. + If'there are no images in the image queue or reject bin associated with the patient, and a patient's study is not currently open, the patient record and related images are eligible for deletion. Images are deleted on a study basis. That is, once acquired images in a study have been sent to their output devices and the study is closed, the images in that study are eligible for deletion (unless the patient record is protected). This is true even if the study is incomplete (that is, images have not been acquired for all views in the related procedure). Protecting Patient RecordsEPEX ER System User's Guide C Procedure for Protecting a Patient Record Note: tis strongly’ To protect a patient record and the related images: recommended that you do not protect too many paaient records unnecessarily. The system isnot intended to be 1 «an archiving system. Iftoo -many images are provected from removal, you might run Cu of space 0 store new images. Step Protecting Patient Records Action From the Admin menu, choose Protect Patients. [Adrrin Morage Queues Protect Patent Gaivate trogeMaagenent | DR Device Control Te ‘The Protect Patients window lays. Find the patient whose record you want to protect: + To search by patient name, click the Patient Name tab, enter the name in the search field, then click the Search button or press the Enter key. + To search by patient ID, click the Patient ID tab, enter the ID in the search field, then click the Seareh button or press the Enter key. Note: You can use the asterisk (*) character as a wildcard character 10 broaden your search. For example entering R*ph would return patients named Randolph and Rudolph. If using the wildcard character, make sure you include at least one other character (that is, don’t enter only an asterisk) 10 avoid creating a large listing of patients (up to the configured limit, the default is 50) which might take several minutes to complete. Note: When searching for names, they are stored in the system as. LAST*FIRST*MIDDLE. Therefore, searching for the fist name John requires preceding it with an asterisk (that is, *John). Also, search entries are case insensitive; you can enter upper or lower case letters The list of ts matching the search criteria that you entered displays (for example, refer to the following sample window). 43EPEX ER System User's Guide Protectants il Patiene Name. Paton 1D Ener Patient Name (for wildcard | ew Search Search Results: 2 entries ~ a : | __ roa en | cp si Jpuauicyouneg 9587 M__(13580801 yes [ees | | | | \ | | | at | 7 | | aryl | | | frou | Ove Action 3 Choose an unprotected patient record from the list (protected status is “no”) by clicking on the patient name, then click the Protect button. ‘The patient record’s protect status changes to “yes” (protected). 4 To close the window, click the OK button. Note: The burton labet ‘Yo unprotect a patient record, follow the same procedure as above, sayles benween Provect and except choose the protected patient record entry. Then click the UNProtect Unprowet button. The patient record’s protect status changes to “no” (unprotected). 44 Protecting Patient RecordsCc Chapter 5 Maintaining System Components This chapter explains how to: * Perform maintenance for the X-ray equipment + Calibrate the DirectRay Detector Contents Subject Page Overvie Daily Maintenance.. Weekly Maintenance .. 53 Monthly Maintenance System Periodic Maintenance... ‘Omniflex IV Overhead Tube Crane Maintenance Replacing the UPS Batter Reporting Unusual Conditions.. Calibrating the DirectRay Detecto 56 otEPEX ER System User's Guide Overview ~ System components require little special care. Normal care in handling and ‘operating the equipment should ensure continuing satisfactory performance. Some considerations for daily, weekly, and monthly maintenance of the equipment are provided here to prevent possible equipment damage or failure. Also, this chapter describes how to calibrate the DirectRay Detector. Daily Maintenance The DirectRay Console should be powered down once a day to ensure a complete system reset. For detailed instructions, refer to “Step 1: Powering Down the DirectRay Console CPU” in Chapter 2. It is also recommended that you power down the DirectRay Console if you are not going to use it for an extended period (for example, overnight). Weekly Maintenance The DirectRay Detector should be calibrated once a week. For detailed instructions, refer to the topic “Calibrating the DirectRay Detector” on page 5-6. > 52 Maintaining System ComponentsEPEX ER System User's Guide Monthly Maintenance A ‘CAUTION Perform the following general preventive maintenance procedures on a ‘monthly basis. The equipment must be maintained in good operating order at all times to provide safe conditions for operating personnel and patients. Do not attempt mechanical or electrical repair of the equipment. Contact your Hologic service representative if any unit does not perform to your satisfaction. Cleaning the Equipment Note: Follow your hospital's cleaning and decontamination policies and A CAUTION A CAUTION A CAUTION A CAUTION The exterior of the equipment can be cleaned with common hospital decontamination solutions that are acceptable for use with plastics or enameled metal. To apply the cleaning solution, power down the system and disconnect the pawer source. Then moisten a cloth with the solution and wipe down the equipment. Do not use isopropyl alcohol on the Bucky as it may damage (remove) the silk screening. Do not spray cleaning solution directly onto any part of the equipment. Instead, ‘moisten a cloth with the solution and wipe it clean. Do not immerse the equipment in liquid. Do not autociave the equipment. Maintaining System Components 53EPEX ER System User's Guide Checking the Equipment Integrity ‘You should perform the following checks to ensure that the equipment is functioning and operating safely: + Ensure fastening hardware is tight, and that there are no missing or defective parts. + Ensure buttons and switches which are supposed to light, do. * Check that indicators and lights are working properly. + Ensure all switches operate smoothly. + Check all exterior painted or plated surfaces for evidence of deterioration. Ensure all name plates, legal labels, and warning labels are legible and secure. + Ensure electrical cables, cords, connectors, and fittings are secure. Check all cables for abrasions and damage; pay particular attention to locations where cables are draped and subject to stress due to tube positioning. System Periodic Maintenance ‘The recommended schedule of required tests should be performed at the required intervals by either the X-ray equipment dealer or an authorized service technician. To ensure continuing compliance with the U.S. Department of Health and Human Services Regulations, these tests may be performed more frequently than the indicated intervals. The service technician must conduct the tests pursuant to the requirements of 21 CFR 1020.30. Refer to recommended maintenance schedules for the certified components. The recommended maintenance schedule for the Radiographic Table, DirectRay Detector, and X-ray tube is: + First servicin; 10 days after installation + Subsequent servicing: every six months 54 Maintaining System ComponentsEPEX ER System User's Guide Cc Omniflex IV Overhead Tube Crane Maintenance C Maintenance Operational Check Maintenance should be performed on the Omniflex IV Overhead Tube Crane to prevent failure of the system. The operator and maintenance technician must be aware of and identify problems before catastrophic failure occurs. The operator should observe the operation of the Overhead Tube Crane. If there is any abnormal operation (that is, stiffness, grinding, noise, and so on), authorized service personnel must be notified immediately. The surfaces of the Overhead Tube Crane should be cleaned as necessary. Every 6 months the following maintenance should be performed: + Inspect the spring balancer cables ‘+ Inspect the main support cables + Inspect the safety mechanism + Perform the operational check on the safety mechanism The Operational Check Form is provided to keep a record of the semi-annual maintenance results. Make a copy of the form and record the results by crossing out or circling pass or fail. The Operational Check Form is to be copied, filled in, and stored with the Overhead Tube Crane documentation. The Operational Check Form will be provided in a later version of this ‘manual. Maintaining System Components 55EPEX ER System User's Guide Replacing the UPS Battery The battery inside the uninterruptible power supply (UPS) must be replaced periodically. The information provided in the UPS manual about battery replacement is for reference only. Contact your Hologic service representative for UPS service and battery replacement. battery contains lead and poses a hazard to the environment and human healt disposed of properly. ay ‘The UPS battery must be replaced by an authorized Hologic representative, The UPS Reporting Unusual Conditions Report any unusual equipment condition that occurs between periodic servicing to your Hologic service representative. Report any unusual noise, difficulty of motion, squeaks, malfunctions, or other problems with the equipment at your earliest convenience. Ifa failure occurs, it could speed repair if you can supply specific information to the service representative. Make a note of any unusual events prior to the failure. Also note the type of procedure in progress, as well as specific failure information. Calibrating the DirectRay Detector ‘You must calibrate the DirectRay Detector once a week. Note: Calibration must be To calibrate the DirectRay Detector: performed at least one hour ‘fier system startup or power up from the sleep mode. pie |nceen 1 | Ensure everyone is out of the X-ray room. 2 | Inthe DirectRay Console application's main window, close any open study and ensure that no patient is selected. 3 | From the Admin menu, choose C: rate, The Calibration Test panel displays. This panel includes instructions for how to set the technique settings and take exposures for the calibration. The sample on the next page shows an example of the instructions. Note: The instructions for your site may be different from what is shown in the sample window. 56 Maintaining System Components:File Ee Aun Help Patient EPEX ER System User's Guide CALIBRATION MODE ann it cuu j a \¥ we - CALIBRATE PA SIZE2 fl fl fl hen | i | ae om ae ‘Study | Calibration Precsane [Realersan saul be pertarmed Wi Fat brn a Tas one month shee the be slbration, - Suara forfehere are any concerns about unormey 1) possbl,gendy remove dhe ped 2) Maral. apen the cotir™ fy uri pot ty pl emt ry th msi 30) ) Set cecsque partners lr bration expose: PPS eip = 90, nt = 200, As = 8, AEC = OFF. focal spac © eno | 5) Enare tas nothg it he ear path (Remove any ead markers) | J} Expo ehe pe when rx cannson Sinn | _tescavanosauce "PROG ready MDirectRay = step | Action 4 | Change the technique settings, as defined in your Calibration Test panel. 5 _| Remove the grid Maintaining System Components 57Step EPEX ER System User's Guide Action Take an exposure. ‘The Calibration window with the flat field image displays. the Accept or Reject button, Ifyou accept the image, calibration uns. The progeess of the calibration displays in the calibration panel in the message bar at the bottom of the window. Af you reject the image, the Calibration Test panel displays. Comect the problem and return to step 6, Note: You would reject an image if it exhibits any edlge cut-off due 10 collimation or misalignment or if there are any artifacts from debris or obstructions. ‘Wait until the status bar turns green and the message in the panel says “Calibration.” If the calibration is successful, «| displays in the calibration panel. Goto step 9, Uf the calibration is not successful, adjust the technique settings and take another exposure. Maintaining System ComponentsEPEX ER System User's Guide a — - sion % CALIBRATION MODE Co i Mettr Pane apart I Sui 1 nt “2a8 . an if i a . CALIBRATE PA SIZE2 x a Jt) 2] a Uy study | Calibration ee [Enibeaion as bea cee completed —— } ner fenayron pce ona ope, | ‘Outputs | | Seuewn eau I | HOIOGIC. [paste | Step Action 9 | Click the Accumulate Calibration button. 10 | Repeat steps 6 through 9 until you have accumulated four calibrations, When you are finished with the calibration sequence, click the End Calibration Seq) Ifyou want to discard the acum’ rations and start over, click the Restart Calibration Sequence button, Maintaining System Components 59Chapter 6 Troubleshooting This chapter explains how to performs basic troubleshooting operations. It identifies and explains how to handle common system problems that do not require service intervention, and provides a listing of system alarms and error codes. Contents Subject Page X-ray Generator Problems.. Troubleshooting Image Problems. Miscellaneous Problems .. Powering the DirectRay Components On and Off. Loss of Electrical Power 6-10 ol X-ray Generator Error Codes (CPI) 61Overview 62 EPEX ER System User's Guide This chapter lists the error codes, error conditions, and alarms that the system components can produce. This includes: + DirectRay Console component problems, related to starting up the DirectRay Console or problems with system peripherals such as the keyboard or bar code scanner, and so on. + How to determine the status and reset the X-ray Generator + DirectRay Console alarms function, related to the DirectRay Console application, the DirectRay Detector, and remote devices on the network such as printers and view workstations. + Loss of power, causing the Uninterruptible Power Supply (UPS) to provide backup power. + X-ray Generator error codes, Refer to the following topics for a complete listing and recommended actions. ‘The error messages whose source is a problem with either the DirectRay Console application, the DirectRay Controller, or the DirectRay Detector ‘typically include an explanation of the problem and suggested corrective action. These error messages are not included in this chapter. Also, for a listing of the error messages related to the X-ray tube, tube suspension arm, or Collimator, refer to the accompanying user guide for those components. TroubleshootingEPEX ER System User's Guide CPU Problems This topic explains simple corrective steps you can take to troubleshoot common CPU problems that might occur in the course of daily operations. Table 6-1 lists each problem and the appropriate corrective actions. Table 6-1. CPU Problems If this happens: Do this: The CPU does not startup after pressing the power key on the keyboard. During startup, one of the tasks in the Startup window fails. ‘The CPU powers up successfully, but reports a blocking error. ‘The CPU powers up successfully, but the DirectRay Console application does not start. The keyboard is not responding. Mouse/trackball is not responding. You cannot logon. ‘The CPU user interface is locked. The system cannot read a scanned bar code. Contact Hologic service. Power down the CPU (refer to “Step 1: Powering Down the DirectRay Console CPU” in Chapter 2), and power up the unit again. Ifit still fails, contact Hologic service. Power down the CPU (refer to “Step 1: Powering, Down the DirectRay Console CPU” in Chapter 2), and power up the CPU again. If the blocking error occurs again, contact Hologic service. Contact Hologic service. Contact Hologic service. Contact Hologic service Ensure you are using the correct login and password. Note that passwords are case sensitive, If you are still having a problem logging on, contact Hologic service. Contact Hologic service. Contact Hologic servic Troubleshooting 63EPEX ER System User's Guide X-ray Generator Problems The Techniques portion of the DirectRay Console application's main window includes an X-ray Generator Status field, shown below. After an exposure or other Generator event, the most current status displays here. If there is more than one message, click on the up or down arrow buttons that appear to scroll through the messages. | CHEST ow. sizez Status field To reset the generator, - lick here X-ray Generator error messages are also displayed here. For a list of Generator error codes, refer to the topic “X-ray Generator Error Codes (CPI)” on page 6-11. The error message is cleared automatically by the Generator when the error condition is corrected or when you click the Reset button. For more information about resetting the Generator, refer to the next topic. Resetting the X-ray Generator Note: The need to repeatedly reset the system can indicate a serious problem. If his ‘occurs, contact Hologic ‘You may need to reset the X-ray Generator after a fault is detected. When the X-ray Generator detects a fault, the Reset button in the Control panel (shown above) is enabled and further exposures are prevented. Click the Reset button to clear the displayed error message and return the system to normal operation. TroubleshootingEPEX ER System User's Guide _» Console Alarm Messages The Alarms bution at the upper-left comer of the DirectRay Console user application's main window notifies you of DitectRay Console and DirectRay Detector alarms, as well as alarms from networked components such as printers or view workstations. When one or more alarm conditions exist, the label of the Alarms button lights yellow and the number of pending alarms displays in it. Once you have opened and closed the Alarms window, the label turns back to black. To view alarms, click the Alarms button on the main screen. Fie Ede Admia Help Ataris | A list of current alarms displays. The Status column indicates whether an alarm has been viewed before: a status of “New indicates that it has not onsite ~ Teatiere a i fae fs ciclo DIMER ARES WO Su st = ews ure ge CACO fae aang 1 ea cde Seed Troubleshooting 65Note: Some alarms camnot be ‘erased by a user, but are cleared by the device reporting the error once the error condition has been corrected. EPEX ER System User's Guide To view information about an alarm, choose the alarm entry in the list; the source, time, and other information about the alarm displays. To scroll through the list of alarms, use the navigation buttons next to the list. To erase an alarm, choose it, then click the Erase button. To close the Alarms window, click the OK button. Troubleshooting Image Problems The following topics explain how to maximize the image quality, and diagnose and correct image problems. Guidelines for Ensuring Good Images Following are some guidelines for ensuring that the images you capture are of the highest quality possible: + Ensure the correct Patient Size setting is used, especially when the patient is very large. This will allow the system to use correct exposure parameters and avoid using back-up timing. + Unlike a standard X-ray system, the DirectRay system applies a ‘mathematical algorithm to present the image on the monitor. If the presentation does not appear to be yielding the desired results, the ‘exam-specific algorithm (ESA) may need to be adjusted. + Ifthe densities on the film are not as they appear on the monitor, an adjustment or reconfiguration may be required by a Hologic representative. TroubleshootingEPEX ER System User's Guide Diagnosing and Correcting Image Problems Refer to Table 6-2 for information about how to correct image problems. Table 6-2. Image Problems If this happens: Do this: Image on film has a line drop-out. Contact Hologic service. A line drop-out looks like a clear scratch, usually going through the middle of the image. The image is very dark or very light. Check to see if the appropriate ESA was selected in the Preview Image window. If not, choose an appropriate ESA from the drop-down list. You might also try manually adjusting the minimum and maximum densities (refer to Chapter 3 in the DirectRay Console User's Guide for more information). However, if the dose is simply too low, there will, not be enough digital information to create an acceptable image. X-ray the patient again, using a ‘more appropriate mAs setting. There is noise in the image. In general, image noise will appear different than screen-film because the image data is digital. While noise can be affected by dose (as in standard X-rays), it can also be affected by the exam-specific processing. Note any cases of excessive noise, and contact Hologic service about the problem. Image on film has speckles or “snow”. Contact Hologic service. ‘Troubleshooting 67EPEX ER System User's Guide Miscellaneous Problems Table 6-3 lists miscellaneous problems that can occur when using the system, and suggested responses. Table 6-3. Miscellaneous Problems If this happens UPS power switch does not turn the DirectRay Detector and DirectRay Controller on. X-ray equipment power switch at the DirectRay Console does not turn the X-ray Generator on. ‘The technique settings in the DirectRay Console main window display dashes instead of setting numbers. ‘The Bucky will not rotate to the other orientation position. The Collimator does not operate. If the image does not transfer to a selected output device and the DirectRay Console does not display a related alarm, Do thi Contact Hologic service. Ensure that power is being supplied to the Generator. If there is still a problem, contact Hologic service. There is a problem in connection between the X-ray Generator and the DireetRay Console. Contact Hologic service. Contact Hologic service. Contact Hologic service. There is either a problem in the connection between the DirectRay Console and the output device, or there is a problem with the output device. Contact Hologic service and/or the manufacturer of the output devies ‘TroubleshootingEPEX ER System User’s Guide Powering the DirectRay Components On and Off Using the Device Control funetion, you can power the DirectRay components (that is, the DirectRay Controller and DirectRay Detector) on and off. Typically, you should not power the DirectRay components off; you would only do this at the direction of a Hologic service representative. To power the DirectRay components off: Step | Action 1 | Finish or close the open study. 2 | From the Admin menu, choose Device Control. The DirectRay Device Control window displays. [= oretay Davee Contd] ‘ ee put cten ‘notay Ten Frtom 3 | Choose the DirectRay Power Off setting. 4 | Totum off power to the DirectRay components and close the window, click the OK button. To power the DirectRay components back on, redisplay the DirectRay Device Control window, choose the DirectRay Power On setting, then click the OK button. Troubleshooting 69EPEX ER System User's Guide Loss of Electrical Power In the event of a loss of electrical power to the DirectRay Console’s Uninterruptible Power Supply (UPS), the UPS automatically provides about 10 to 15 minutes of backup power to the CPU, DirectRay Controller (in the cabinet), and DirectRay Detector. While backup power is being used, the UPS sounds a high-pitched alarm, If the UPS backup power is activated, the DirectRay Console begins a 5-minute counter. If normal power is restored within five minutes, the irectRay Console automatically switches back to normal power. If normal power is not restored within five minutes, the DirectRay Console ‘commences an orderly shutdown. You cannot interrupt this shutdown. Determine the cause of the power loss and resolve the problem before attempting to start up the system again. For details about restarting the system, refer to the topic “Starting Up and Logging On to the System” in Chapter 2. 610 ‘TroubleshootingEPEX ER System User's Guide X-ray Generator Error Codes (CPI) Note: The need to repeatedly reset the system can indicate ‘serious problem. If this occurs, contact your Hologic service representative. Note: An* indicates that an error is not recoverable, Troubleshooting Table 6-4. CPI Error Code Descriptions Generator Error Code Description E001 Generator CPU EPROM checksum error’ E002 Generator CPU EEPROM data checksum error* E003, Generator CPU NVRAM error* “E004 Generator CPU Reat Time Clock error E005 Main Contactor ervor* E006 Rotor Fault E007 Filament Fault E008 Beam Fault “E009 Power Supply Not Ready E010 No KV during exposure EON TA during exposure too high . E012 mA during exposure too low E013 ‘Operator released exposure switch during exposure E014 ‘AEC exposure exceeded allowed back up time EOS ‘AEC exposure exceeded allowed back up mAs E016 Tomo Back-up Timer—Exposure Terminated E017 Uncalibrated Exposure Parameter “BOIS —___ Preparation Time-out Error “BOI9__ Selected parameters will cause X-ray tube to exceed its programmed anode heat limit E020 “Thermal Switch Interlock #1 Error ent612 EPEX ER System User's Guide Table 6-4, CPI Error Code Descriptions Generator Error Code Description E021 ‘Thermal Switch Interlock #2 Error E022 Door to X-ray room is open 023 Collimator error—not ready E024 ‘Cassette Interlock Error E025 Safety Interlock Error E026 Spare Input Interloc Esror £027 Receptor Time-out Error—Receptor did not respond within time-out E028 Prep Input active during Initialization Phase* ‘X-ray Input active during Initializ E030 Fluoro Input active during Initialization Phase* E031 ‘Communication Error Remote Fluoro 032 ‘Communication Error Console E033 Lithium Battery Low Voltage Error E034 +12 Vde Error E035 “12 Vde Error E036 +15 Vde Error E037 -15 Vde Error E038 Calibration Data Corrupt Error E039 ‘AEC Data Corrupt Error E040 Fluoro Data Corrupt Error E041 Receptor Data Corrupt Error 5042 Tube Data Corrupt Error 043 High Voltage Error—kV detected in non X-ray state 044 Invalid Communication Message E045 ‘Communication Message Not Supported E046 E047 Fluoro Timer Limit Error TroubleshootingTroubleshooting EPEX ER System User's Guide Table 6-4. CPI Error Code Descriptions Generator Error Code Description £048 Focus Mismatch Error £049 Not Enabled Error "E050 Generator Limit Data Corrupt Eror E0SI Generator has detected no feedback signal from AEC device E052 High Small Focus Filament Current Error in Standby 053 High Large Focus Filament Current Error in Standby E054 ‘AEC Reference is out of range E055 No Fields Selected in AEC mode E056 ‘No Tube Programmed E057 ‘AEC Stop signal in wrong state E058 ‘Console Back-Up Timer E059 Housing Heat Limit Exceeded E060 High kV Error 061 Low kV Error EXP_SW signal active in standby state £063 Factory Defaults Enabled E064 ‘No Exposure Release E065 Tomo Device Error 7 E066 No Syne Pulse Input E067 Power Supply Duty Cycle Limited E100 Calibration Error—Maximum mA Exceeded E101 Calibration Error—Calibration Data Table Exceeded E102 Calibration Error—Maximum Filament Current Exceeded E103 Calibration Error—Manually Terminated, E104 Calibration Error—No mA E105 Calibration Error—Minimum mA not calibrated E200 Anode Warning Level Exceeded 613614 EPEX ER System User's Guide Table 6-4. CPI Error Code Descriptions Generator Error Code Description E201 Fluoro Timer Warning Level Exceeded E21 Calibration Limit, Selected parameter not Calibrated E212 Generator AEC Density Limit E213 Invalid Communication Parameter E214 ‘Hoousing Heat Waring E215 CT Termination Input Wrong State E216 Deselect Tomo Table E217 Select Tomo Angle E218 Invalid Tomo Angle E219 ‘Generator PPS Limit E220 Generator Power Supply Duty Cycle Warning TroubleshootingEPEX ER System User's Guide Troubleshooting 615Appendix A Specifications This appendix provides: + System specifications + Environmental and installation requirements Contents Subject ‘Subsystem Specifications Environment... Installation RequirementsEPEX ER System User's Guide Subsystem Specifications ‘This topic contains specifications for the following subsystems: DirectRay Image Capture system (DirectRay Detector and DirectRay Controller) DirectRay Console Ceiling mounted tube suspension X-ray Generator Articulating arm Mobile radiographic table DirectRay Image Capture System A2 Weight DirectRay Detector 8.6 kg (19 Ib) DirectRay Controller 7.3 kg (16.3 Ib) Dimensions DirectRay Detector Width: 46.7 em (18.4 in.) Height: 46.7 cm (18.4 in.) Depth: 4.3 cm (1.7 in.) DirectRay Controller Width: 49.5 em (19.5 in.) Height: 37.8 cm (14.9 in.) Depth: 9.4 cm (3.7 in.) Image Area Full field 35 x43 cm (14 x 17 in.) nominal active image area DetectorPixel 139 um. 129 um x 129 jm active element size 2560 x 3072 detector element matrix 89% geometric fill factor Presampling 98% at 1.0 cycles/mm MTF 89% at 2.0 cycles/mm 70% at 3.0 cycles/mm Static Load 18 kg (39 Ib) applied to the front surface over a nominal 10 x 10 em (4x 4 in.) area ‘SpecificationsEPEX ER System User's Guide DirectRay Console Weight 159 kg (350 Ib) Base Width: 71 em (28 in.) Depth: 49 cm (19 in.) Height: 100 cm (39 in.) without monitor 150 cm (59 in.) with monitor Top Surface ‘Width: 84 cm (33 in.) Depth: 56 cm (22 in.) Clearance 30cm (12 in.) minimum on both sides 75 em (30 in.) minimum in front Weight 125 kg (275 Ib) without monitor 156 kg (350 Ib) with monitor Electrical US: 115 Vac, 50/60 Hz, 5 A Europe: 220 Vac, 50/60 Hz, 3 A Omniflex IV Overhead Tube Crane Weights Longitudinal Rails (length used is site-dependent): 14 (4.27 m) 154 Ibs (69.7 kg) per set of 2 16 ft (4.87 m) 177 Ibs (80.1 kg) per set of 2 18 (5.48 m) 200 Ibs (90.6 kg) per set of 2 20 ft (6.09 m) 225 Ibs (102 kg) per set of 2 ‘Transverse Bridge (length used is site-dependent): 89 (2.44 m) 175 Ib (80 kg) 10 ft (3.05 m) 200 Ib (90.6 kg) 12 (3.65 m) 225 Ib (102 kg) 14 ft (4.27 m) 250 Ib (114 kg) 16 ft (4.88 m) 275 Ib (125 kg) Tube/Collimator: 75 Ib (33.9 kg) Specifications ABEPEX ER System User's Guide Cable & Transverse 300 Ib (136 kg) Carriage/ Telescoping Tube Crane: Omniflex 1V Overhead Tube Crane Specifications (cont.) Tube Rotation +110° Output Power 400 BTU/hr (421 kI/hr) Articulating Arm Bucky Travel _86 cm (34 in.) longitudinal travel 132 cm (52 in.) vertical travel Rotation Vertical tower rotation +180° Vertical Bucky rotation +180° Vertical arm rotation +120° Portrait and transverse DirectRay Detector orientation Electrical Input voltage: 115/230 VAC nominal Input current: 9.6/4.8 A nominal Input frequency: 47 Hz to 63 Hz Config: Single-phase, grounded or isolated Aa SpecificationsCc X-ray Generator Specifications EPEX ER System User's Guide Cabinet Weight Cabinet Dimensions Output Line Voltage Range High Voltage Ripple Other Features 227 kg (500 Ib) Width: 71 cm (28 in.) Depth: 110 em (43 in.) 80 kV high frequency 100 mA @ 80 kVp 800 mA @ 100 kVp 500 mA @ 150 kVp 40 to 150 kVp 0.5 to 1000 mA £10% 4 kVp @ 100 kVp (typical) Dual speed starter AEC programmable by operator Two and three point manual techniques Manual APR/AEC override 380/440/480 Vac, 3 phase ASEPEX ER System User's Guide Environment Transit/Storage Temperature: -20° to +45°C (-4° to +113°F), assuming the DirectRay Detector is shipped in a Hologic insulated shipping container Maximum gradient: 15°C (27°F) per hour, assuming the unit is stored in a shipping container approved by Hologic. Relative humidity: 30 to 80% non-condensing Maximum gradient: 10% per hour Pressure: 1.6 to 23.2 psia (600 to 1200 hPa) Shock: Drop Test per IEC601-1 Operating Temperature: 10° to 35°C (50° to 90°F) Maximum gradient: 5°C (9°F) per hour Relative humidity: 10 to 75%, non-condensing Maximum gradient: 10% per hour Maximum altitude: 3,000 m (10,000 #t) Maximum vibration: 0.5 G RMS Pressure: 13.5 to 20.5 psia (700 to 1060 hPa) Installation Requirements Flooring Leveling: Flat and level within 3 mm (0.12 i over the entire equipment area, Load-Bearing: Capable of supporting the operating weight of the ‘equipment. For more information, refer to the specification tables for each subsystem presented earlier in this appendix. ) in both directions Ceiling Suggested Height: 290 cm (114 in.) AS SpecificationsAccession Number AEC Antiscatter Grid AP Artifact Autoclave Automatic Exposure Control (AEC) Bucky Collimator CPU Detent Diagnostic X-ray System DICOM Digital Imaging and Communications in Medicine (DICOM) Glossary Im DICOM, a term to uniquely identify a visit to a site by a patient. The meaning and use of accession numbers is not consistent in medical information. The DirectRay System uses the DICOM definition of the term. Automatic Exposure Control. Device used to prevent the radiation scattered within the patient from reaching the DirectRay Detector and fogging it. Anterior/Posterior view position for X-ray exposure. Changes to an image due to outside influences such as defective pixels or DirectRay Detector scan lines. The process of disinfecting articles by heating them with pressurized steam. Ton chamber within the Bucky. Used to terminate X-ray when image density is achieved by measuring the amount of dosage occurring at the DirectRay Detector and providing feedback to the X-ray Generator to stop the exposure. ‘The component that houses the DirectRay Detector, AEC, moving grid, and related components. In the DirectRay System, the bucky contains the DirectRay Detector instead of the conventional film cassette. ‘The Collimator regulates the size and shape of the X-ray beam to accurately localize the area of interest on the patient, while reducing overall patient irradiation exposure. Central Processing Unit of the DirectRay Console. A device for positioning and holding an articulated mechanism in relation to another so that the device can be released by force applied to one of the parts. An X-ray system designed for irradiation of any part of the human body for the purpose of diagnosis of visualization. Digital Imaging and Communications in Medicine An industry standard specification for interconnection of medical imaging equipment. G4DirectRay (DR) DirectRay Console DirectRay Controller DirectRay Detector Direct Radiography (DR) DR ESA Exam Specific Algorithm Focal Distance Generator HIS Hospital Information ‘System (HIS) Image Artifact kVp Lateral Look-Up Table (LUT) LUT mA mAs Oblique Operating System (OS) EPEX ER System User's Guide Trade name for the Direct Radiography Corp. DirectRay Detector and DirectRay Controller. ‘The DirectRay System component that houses the CPU (where the user interface runs), the DirectRay Controller, and the uninterruptible power supply (UPS). It also stores the DirectRay Console Application, the user-interface for the system. The interface between the DirectRay Detector and the DirectRay Console controls. ‘The DirectRay Detector isa flat panel that receives the X-ray image and converts it to digital information. The DirectRay Detector replaces conventional X-ray film and cassettes. ‘A term used to distinguish the use of a photoconductor-based method as ‘opposed to the X-ray capture and conversion method used in a scintillator or phosphor-based detector. Direct Radiography/DirectRay Exam Specific Algorithm. Algorithm used to optimize raw image data for a particular type of exam. The distance from the source of the X-rays to the patient. Device that supplies power to and controls the X-ray tube. Hospital Information System In a hospital, the computer system that tracks patient demographic information, visit information, and other patient records. Non-desirable qualities on a printed image. Peak kilo-volts. The highest energy of X-rays emitted by an X-ray tube (equal to the peak applied tube voltage). Possible view position for X-ray exposure. A table of values used to convert raw image data to output data fora specific ESA setting. Look-Up Table. Milliamperes. Miilliampere-seconds. Combined with kVp, it indicates the dose of X-rays. Possible view position for X-ray exposure. The basic software control system of the CPU. GlossaryPA PBL Positive Beam Limitation (PBL) Procedure RIS. sID Source to Image Distance (SID) Study Technique Factor View Visit Glossary EPEX ER System User's Guide Posterior/Anterior view position for X-ray exposure. Positive Beam Limitation This function automatically adjusts the X-ray field to the size of the receptor. A predefined collection of images (views) for X-ray exposure. Radiology Information System. Source to Image Distance. The distance from the source of the X-rays to the detector. A specific instance of a procedure consisting of a set of X-ray images. ‘Any of the parameters describing the properties of an X-ray beam, including beam energy (kVp), beam intensity (mA), exposure (mAs), duration (seconds), and, at times, the Source to Image Distance (SID). Prescription for the technique factors and geometric arrangement of the X-ray source, patient, and image sensor that yields and image of organs of interest seen on a specific orientation. A set of studies identified in a locally unique manner and performed on a particular patient at a particular site for a particular reason. A visit is normally identified by an accession number or a Visit ID and is associated with a diagnosis. GL3DirectRay Console User's Guide ~~ Federal (USA) Law restricts this device to sale by or on the order of a physician (or ( properly licensed practitioner). CAUTION Document No. 080-1093 Revision 001 CcJanuary 2003 The information contained in this manual is confidential and proprietary to Hologic, Inc. This information is provided only to authorized representatives of Hologic’s customers solely for the Purpose of facilitating the use of Hologic’s products. No information contained herein may be disclosed to any unauthorized person for any purpose whatsoever without the prior written consent of Hologic, Inc. The information in this document is subject to change without notice. Copyright 2003 by Hologic, Inc. All rights reserved. The Hologic logo is a registered trademark of Hologic, Inc. Printed in the U.S.A. All trademarks, registered trademarks, and product names used within this document are the property of their respective owners. Hologic, Inc. 35 Crosby Drive Bedford, MA 01730 USA Tel: (781) 999-7300 Fax: (781) 280-0669 Service: (877) 371-4DRC (371-4372) User Support: (877) 371-4DRC (371-4372) Fax: (781) 280-4788 Hologic Europe Horizon Park Leuvensesteenweg 510, BUS 31 1930 Zaventem, Belgium Tel: 32.2.711.4680 Fax: 32.2.725.2087Contents. DirectfRay Console User’s Guide Contents About This Manual Audiene: Indications for Use. Prerequisites... Scope. Organization.. Conventions Used in This Manual. Chapter 1: Introduction Introduction to the DirectRay Console... New Features in the v1.6 Release Operations Performed at the DirectRay Console. Image Acquisition Workflow. ‘Tracking a Series of Images by a Study ID Optional Workflow Operations. ‘Safety and Compliance Information... Safety Precautions.. General Use Cautions and Warnings .. Cleaning Cautions.. Symbols .. United States Federal and State Regulations .. TEC Regulations. Canadian Regulations Manufacturer’s Responsibility Caution Regarding Small-Detail Object Imaging.. Restrictions on Use Authorized EU Representatives.DirectRay Console User's Guide Chapter 2: Basic Operations ‘Starting Up and Logging On to the System ‘Step 1: Powering Up the UPS Step 2: Powering Up the X-ray Generator. ‘Step 3: Checking the System ‘Step 4: Powering Up the DirectRay Console CPU, ‘Step 5: Logging In to the CPU’s Operating System... Step 6: Signing in to the DirectRay Console Application Changing Your DirectRay Console User Application Password. Warming Up the X-ray Tube . Capturing Images Overview for Capturing Images Step 1: Identifying the Patient and Visit. Adding a New Patient Manually. Choosing an Existing Patient or Visit Using the Search Function Choosing a Patient Using the Modality Worklist Query Retrieving Patient Records from the Modality Worklist Provider. 2.22 ‘Viewing Patient Entries in “Today's Worklist”, Reordering and Resizing Columns in the Entry List Opening a PatientStudy in the Entry List Required Fields for Worklist-Ordered Studies. ‘Scanning a Bar Code to Identify the Patienv/Visit/Study Step 2: Choosing Output Destinations. Step 3: Adjusting Exposure Settings and the Exposure Sequence (Optional). Step 4: Adjusting the Orientation of the X-ray Tube and Bucky. Step 5: Exposing Patients. ‘Two-Stage Image Preview .. Contents.Contents. DirectRay Console User's Guide Step 6: Accepting or Rejecting an Image .. Rotating or Mirroring the Image (Optional) ‘Verifying and Correcting Image Laterality and Patient Orientation Settings (Optional). Using True Size Helper (Optional Masking an Image (Optional) Adding Markers to the Image (Optional) Selecting ESA or IT (Optional) Changing the Appearance of the Image (Optional) ‘Adding Comments to an Image (Optional). Accepting the Image Rejecting the Image Step 7: Opening an Additional Procedure (Optional ‘Step 8: Adding a View to a Procedure (Optional) ‘Step 9: Closing the Study, Visit, and Patient. ‘Step 10: Signing Out from an Acquisition Session ‘Switching User Levels. Powering Down the System Components Recommended Power Down Procedure Overview Step 1: Powering Down the DirectRay Console CPU.. Step 2: Powering Down the X-ray Generator. Step 3: Powering Down the DirectRay Console’s UPS. Chapter 3: Additional Operations Overvie, Editing Patient Information Working with Visits Opening a New Visit. Editing Visit Information. ‘Working with Studie: Opening a New Stud} Editing Smdy InformationDirectRay Console User's Guide Working with Procedures.. Changing the Order of Image Acquisitio Adding a View to a Procedure ‘Working with Multiple Open Procedures 3-10 Cancelling a Procedure 3-10 Adjusting Technique Settings .. 3-1 Adjusting kVp. 3.12 Manual Timing Using the mA Station and Exposure Time Settings.. 3-12 Manual Timing Using the mAs Setting 313 Changing AEC Settings. 3-14 Selecting the Focal Spot Size. 315 Selecting the Patient Size 316 Heat Units Status. 3-16 Working with Acquired Images. 3.17 ‘The DirectRay Digital Marker. 318 Rotating the Image. 319 Mirroring the Image. 319 ‘Verifying and Correcting the Image Laterality and Patient Orientation Settings Image Laterality Patient Orientation Labels Cropping an Image.. 3-21 Selecting the Sheet Format 3.25 Using the True Size Helper. Sheet Formats and Auto-Cropping with True Size. Using a Mask to Outline the Image .. 3-29 ‘Masking with Auto-Cropping 3-30 Undoing Rotating, Mirroring, Cropping, and Masking... 331 Adding Markers to an Image 3-32 Selecting ESA vs. IT Image Processing .. 3-35 Adjusting the LUT... Adjusting the LUT by Anatomical Region. Adding Comments to an Image 3.37 3-38 ContentsDirectRay Console User's Guide Viewing Accepted Images at High Resolution with the DCM View ‘ool Adjusting the Image Appearance. Changing the Zoom Factor . Changing the Size of the Image Window .. ‘Viewing the Images's DICOM Information . Closing the DCM View Tool Capturing Images on Film .. . 3-39 . 3-45 . 3-47 . 3-47 Chapter 4: ‘Managing the Image Output Queues and Resending Images Overview.. ‘Managing the Image Output Queues Resending Images to Output Devices. Repreviewing Images 410 Chapter 5: Protecting Patient Records Overview. Reclamation Strategy .. Procedure for Protecting a Patient Record. Chapter 6: Maintaining the DirectRay Console Overview. Daily Maintenance.. Weekly Maintenance. ‘Monthly Maintenance 63 Replacing the UPS Battery Reporting Unusual Condition: Calibrating the DirectRay Detector...vil DirectRay Console User's Guide Chapter 7: Troubleshooting Overview. CPU Problems... X-ray Generator Problem: Resetting the X-ray Generator Console Alarm Messag: ‘Troubleshooting Image Problem: Guidelines for Ensuring Good Images. Diagnosing and Correcting Image Problem: Miscellaneous Problems... Powering the DirectRay Components On and Off. Loss of Electrical Power. X-ray Generator Error Codes (CPI). Appendix A: User Interface Basic Operations Basic Window Elements. Using the Pointing Device and Pointer to Select Window Elements Working with Text Fields. Subsystem Specifications DirectRay Image Capture System. DirectRay Console. Environment. ‘Transit/Storage Operating, Installation Requirements Floorin; Ceiling Glossaryc About This Manual Audience Indications for Use Prerequisites Scope This manual is intended for users of the DirectRay® Console, to acquire medical diagnostic X-ray images. It provides operating instructions for the DirectRay Console. The DirectRay Console has application whenever DirectRay radiographic images are created, and cransmission of these images and related text are required from DirectRay technology to hardcopy, softcopy, or archive. Follow all safety labels on the equipment. The procedures in this manual assume that you know how to do the following operations related to the system's graphical user interface: + Perform mouse and trackball operations, such as click, drag and select + Select from menus * Click buttons * Enter information in text fields + Select options ‘+ Select entries from pop-up or drop-down lists + Use scroll bars This manual contains information about the DirectRay Console and its operational features. From the DirectRay Console, you can acquire and transfer images to hardcopy, softeopy, and archive devices on the same network.Organization DirectRay Console User's Manual This manual is organized into the following chapters and appendices: Chapter 1: Introduetion Illustrates and provides a brief overview of the DirectRay Console functions. Chapter 2: Basic Operations Provides basic information about using the DirectRay Console to acquire images and send them to output devices. It also includes procedures for DirectRay Console start-up, shutdown, and X-ray tube warm-up. Chapter 3: Additional Operations Describes additional image acquisition operations that were not covered in Chapter 2, such as changing visit and study numbers, changing image settings, and adjusting technique settings. Chapter 4: Managing the Image Output Queues and Resending Images Describes the procedures for managing the image output queues, resending previously acquired images that are still stored in the system, and repreviewing images that have not been reclaimed. Chapter 5: Protecting Patient Records Explains how to protect patients and their related images from being deleted by the system. Chapter 6: Maintaining the DirectRay Console Explains how to perform maintenance of the DirectRay Console. Chapter 7: Troubleshooting Explains how to perform basic troubleshooting operations. It identifies and explains how to handle common DirectRay Console problems that do not require service intervention, and provides a listing of system alarms along with the required response actions. Appendix A: User Interface Basic Operations Describes how to execute basic operations in the DirectRay Console graphical user interface. Appendix B: Specifications Lists the specifications for the DirectRay Console. A glossary follows Appendix B. ‘About This ManualDirectRay Console User's Manual Conventions Used in This Manual This manual uses three types of special messages to emphasize information r point out potential risks to personnel or equipment. Note: Notes provide A sample of a note is shown in the margin to the left. additional information, such as expanded explanations, hints, or reminders. ‘Samples of cautions and warnings are shown below. Cautions point out procedures that you must follow precisely to avoid damage to ‘equipment, loss of data, or corruption of files in software applications. Warnings point out procedures that you must follow precisely to avoid injury to yourself or others. WARNING ‘About This Manual xiChapter 1 Introduction ‘This chapter provides an overview of the DirectRay Console system. An introduction to the DirectRay Console is provided including an overview of the operations performed at the DirectRay Console and the image acquisition workflow. Contents Subject Introduction to the DirectRay Console. Operations Performed at the DirectRay Console. Image Acquisition Workflow.. Safety and Compliance Information .. oTDirectRay Console User's Guide Introduction to the DirectRay Console The DirectRay Console is the user interface component of the DirectRay System, All operator functions—except adjusting the position of the DirectRay Detector Bucky and operator control of the Collimator shutters—are accomplished at the DirectRay Console. The DirectRay Console also provides the control functions responsible for synchronizing the ready states of the DirectRay Detector and the X-ray equipment. The DirectRay Console includes the following hardware components: + CPU with monitor, keyboard, pointing device (mouse or trackball), and modem + UPS (Uninterruptible Power Supply) + DirectRay Controller + Prep/Exposure switch ‘+ Bar Code Reader, optional; supports a Hospital Information Systern/ Radiology Information System (HIS/RIS) interface ‘+ WAMI (Wiring Adaptable Machine Interface) New Features in the v1.6 Release The following features have been added to the Image Preview function for the V1.6 release: + Two-stage image preview. A captured image is displayed in two stages, so that the image is displayed faster: a low-resolution image is displayed first, so that you can begin cropping operations; then a high- resolution will display a few seconds later, enabling all of the Image Preview window functions. + “Blinds” are included around non-image areas in the Image Preview window. Cropped areas of the image are covered by “shutters,” to better hide those portions of the displayed image that will not be part of the actual image being sent to output destinations. + DirectRay digital marker added to images. A digital marker—the DirectRay logo—that corresponds to the marker at the upper left corner of the bucky (in portrait mode) is automatically added to the appropriate comer of the captured image. This marker helps users recognize the proper image orientation. a2 IntroductionDirectRay Console User's Guide + Image masking. A masking tool has been added to the the Image Preview window, allowing you to draw an irregular mask around the image. The area outside of the defined mask is converted to black. An auto-crop feature can also be used with the mask, automatically cropping the image to the perimeter of the mask. + Revamped minimum and maximum densities, contrast, and brightness adjustment tool. The LUT curve adjustment tools in the Image Preview window has been redesigned to enhance adjustments to the image appearance. * DXIOD help screen. A DX IOD help screen has been added, accessible by clicking on the Image Laterality/Patient Orientation button in the Image Preview window. The help screen includes sample patient positioning in front of the bucky, accompanied by a sample corresponding X-ray image, for common views. + The DCM (DICOM) Image Tool has been added. Users can use the new DCM Tool to view an image at high resolution and make image appearance adjustments. This tool can be used, for example, if the PACS is down but radiologists need immediate access to images for diagnostic purposes. ‘+ Create a new pixel map for the DirectRay Detector. During the calibration sequence, a mgr-level user has the option of creating a new pixel map for the DirectRay Detector. The pixel map indicates which pixels in the Detector’s array might not be reading X-ray densities correctly and so should be ignored when the image is acquired. + Setting the site name. A mgr-level user can now set the name for the site. The site name is displayed in the title bar of the main window, and can be included as a label on printed sheets. Introduction 13DirectRay Console User's Guide Operations Performed at the DirectRay Console Table 1-1 lists the operations that you can perform at the DirectRay Console, and where to find more information about each. Table 1-1. DirectRay Console System Functions For More From the DirectRay Console, you can Information ‘Add a new patient to the system, and enter Refer to Chapter 2 information about the patient and physician that will be associated with the radiographic images. Edit existing patient information. Refer to Chapter 2 Pick from a selection of procedures, which Refer to Chapter 2 defines the series of images to be taken. Associate a unique ID number for the current visit Refer to Chapter 2 by the patient (e.g., a visit or accession number). Select the output destinations for the images (e.g., Refer to Chapter 2 remote film printers or viewing workstations). Capture the required X-ray image. Refer to Chapter 2 Preview the image, accept or reject it, then attach Refer to Chapter 2 comments or rejection reasons to the image. (Accepted images are sent to the selected output destinations.) Save an incomplete procedure, for which the rest Refer to Chapter 2 of the exposures will be made at a later time. Close a procedure when all images have been _Refer to Chapter 2 captured. Entering patient data from a remote location. Refer to Chapter 3 Adjust technique settings. Refer to Chapter 3 ‘Working with acquired images. Refer to Chapter 3 Resend images. Refer to Chapter 4 Repreview images. Refer to Chapter 4 Protect patient records from being deleted by the Refer to Chapter 5 system (as part of the system's storage space reclamation). 14 IntroductionDirectRay Console User's Guide @ Image Acquisition Workflow Introduction ‘The start of the workflow depends on whether your site is using a bar code reader to scan in patient or visit IDs (at many sites, a visit ID is referred to as an accession ID). If your site is using patient or visit ID bar codes, each patient's image acquisition session starts when you scan a patient ID or visit ID bar code. Then: * If your site supports a connection to a Hospital Information System, Radiology Information System, or other remote patient database, the DirectRay Console application queries that database for the ID. * If your site does not support such a remote database connection, the DirectRay Console application searches its local database for the patient or visit ID. (Patients and related patient/visit information are Kept temporarily, storage space availability permitting, to save you from having to reenter information for a patient who was recently X-rayed.) Ifit finds the ID, the DirectRay Console application “opens” that patient in the application’s main window. If your site is not using bar codes, each patient's image acquisition starts + Searching for and selecting an existing patient who has recently been X-rayed, if that patient's record is still stored in the application’s local database. + Ifthe patient is not in the local database, specifying the patient and related patient/visit information. Once the patient information has been entered, you: + Select an acquisition procedure. The procedure defines the number and types of patient views to be captured. In the DirectRay Console application, a procedure is also referred to as a study. ‘+ Select the output device destinations for the images. ‘+ Capture an image. Before capturing an image, you can change the technique settings for the exposure. * After taking an exposure, preview the image on the DirectRay Console monitor and accept or reject it. 1DirectRay Console User's Guide When you accept a preview of the image, the image is sent to the selected output destinations. All of this image identification information—patient >) name/ID, visit number, and study ID—is sent with the image to the specified output devices. It can then be printed on the film, displayed at an image viewing workstation that supports displaying such information, or stored with the image on an archiving system. Tracking a Series of Images by a Study ID The DirectRay Console application tracks the series of images being captured (that is, the procedure) by a study ID. The study ID provides a ‘way of relating a series of images being taken for a given diagnostic procedure, Optional Workflow Operations In addition to the standard workflow described previously, the DirectRay Console provides the following optional workflow operations: * You can open multiple procedures (studies) within a visit. To help you understand the patient/visit/procedure (study) hierarchy, refer to Figure 1-1. + Because images and patient information is temporarily stored on the ~ system until storage space needs to be recovered, you can search by either patient ID or visit ID to: © Open a new visit for an existing patient + Recall an open study, to continue acqui 1g images for that study + Resend images that were previously acquired Figure 1-1. Hierarchy of Patient/ Patient Visit/Procedure (Study)/ Images. Vist vest Vist Procedure Procedure Procedure (Study) (Study) (Study) Image ‘mage mage 16 IntroductionCc Cc DirectRay Console User's Guide Safety and Compliance Information Safety Precautions + Do not remove covers from any part of the equipment for any purpose. + Do not defeat or bypass built-in equipment safety features. ‘+ Do not attempt any repairs if the equipment fails to operate correctly. Only qualified Hologic Field Service Engineers or Hologic authorized personnel should service the system. + Do not attempt to move equipment, or connect or disconnect any communication cables. Call a person qualified and authorized to alter the equipment installation, + Observe all warnings and cautions in the procedures. ‘+ Follow all safety labels on the equipment. * Keep fingers, hands, and tools clear of moving parts. + Route cables properly to eliminate tripping hazards. General Use Cautions and Warnings Introduction A CAUTION A WARNING A WARNING A WARNING Federal (USA) law restricts this device to sale by or on the order of a physician (or property licensed practitioner). ‘The DireetRay Console system includes no user serviceable parts. For service assistance, contact Hologic. ‘The DirectRay Console system produces ionizing radiation. ‘The DirectRay Detector may only be operated in an area that is located beyond the 20 Gauss limit. 17A WARNING. A WARNING. A WARNING Cleaning Cautions A CAUTION A CAUTION A ‘CAUTION Symbols O <> Ted +8 DirectRay Console User's Guide ‘The DirectRay Console system and associated cables must not be operated in the presence of moisture. ‘The DirectRay Console system is not suitable for operation in the presence of a flammable anesthetic mixture with air, oxygen, of nitrous oxide. Excessive use of the keyboard and mouse or trackball may result in repetitive strain injury. Do not spray cleaning solution directly onto the equipment. Moisten a cloth with the solution and wipe the equipment. Do not immerse the equipment in liquid. Do not autoclave the equipment. Power Off (used with the DirectRay Console UPS) Power On (used with the DirectRay Console UPS) Ethernet Connection Twisted Pair Ethernet Connection Explosive Gas (flammable) IntroductionIntroduction DirectRay Console User's Guide Attention—Read the CAUTION or WARNING statement that follows Non-Anesthetic Proof Universal Interface Connection Identifiers Sound Earphones DirectRay Detector Orientation Identifier (on the Bucky) Protective Earth Ground Hazardous Voltage Power On Indicator Hard Drive Standby Switch (used with CPU) On Line Indicator (used with X-ray Generator switch at DirectRay Console) 19DirectRay Console User's Guide Off Line Indicator (used with X-ray Generator switch at DirectRay O Console) © Prep/Exposure Switch [ha X-ray Expose Switch Do Not Immerse In Liquid This product contains no field-serviceable parts, Special Cleaning Instructions [> EB Lifting Waring One or more of the following regulatory symbols are found on the equipment: ot ys UL Classified Device eGd)us UL Listed Device cWAKus UL Recognized Device @- CSA Listed Device ous @. ETL Listed Device 1-10 Introductionc DirectRay Console User's Guide United States Federal and State Regulations IEC Regulations DirectRay Console systems conform to the United States Code of Federal Regulations, 21 CFR 1020.30 “Diagnostic X-Ray Systems and their major components.” However, additional state regulations may apply for X-ray products. This may require notifying your state regulatory agency about your installation and/or operator training and certification. tis the responsibility of the user to contact the applicable state radiation control agency to verify that your installation is in compliance with regulations in your state governing installation and use of X-ray equipment. DirectRay Console systems comply with the requirements of, TEC 60601-1. DirectRay Console systems comply with the following IEC standards: TEC 60601-2-7 TEC 60601-1-3 TEC 60601-1-1 TEC 60601-1-2 TEC 60601-2-28 TEC 60601-2-32 TEC 60825-1 Software used in the DirectRay Console system was developed using IEC 60601-1-4 as a guide. Canadian Regulations Introduction DirectRay Console systems comply with CSA 22.2 No. 601.1 ttDirectRay Console User's Guide Manufacturer's Responsibility This equipment is sold with the understanding that Hologic, its agents and representatives, do not accept any responsibility for overexposure of patients or personnel to X-radiation. Furthermore, Hologic does not accept any responsibility for overexposure of patients or personnel to X-radiation generated by this equipment as a result of poor operating techniques or procedures. Also, no responsibility is assumed for any unit that has not been serviced and maintained in accordance with the technical service manual, or Which has been modified or tampered with in any way. ‘Caution Regarding Small-Detail Object Imaging As with all digital imaging devices, there is the potential that small-detail structures, high-contrast edge structures, and fine-line structures with a repeating pattern could appear differently in the digital image than in an image created with an analog device—such as screen-film system—or with another digital device having smaller individual detector elements. For example, for a sharp-edged object, the edges of that object may appear to have “stair-steps” when in fact the object edge does not have such structure. This is an effect of digital undersampling. For small-detail objects having a size on the same order of magnitude as an individual pixel or smaller, the apparent contrast of that object can vary based on the position relative to the individual detector element locations. For example, the contrast of a single spherical object the same size as a pixel would have a different appearance if the object were imaged directly overlying a detector element (highest contrast) or placed at the intersection of four detector elements (lowest contrast). Objects inherently smaller than individual pixels will have a lower apparent contrast because of the digital sampling of the analog radiation intensity signal over an area larger than the small object. In each case, a lower apparent signal-to-noise can result in 112 IntroductionRestrictions on Use Cc DirectRay Console User's Guide ‘The customer is responsible for assuring that accessories used with the DirectRay Console system do not degrade the safety of the system. ‘Accessories and interfacing equipment used in conjunction with the DirectRay Console system and located outside the patient environment may be exempt from EN60601-1. Such equipment must, however, conform to EN60601-1-1 and therefore to standards applicable to information technology equipment such as EN60950 and to applicable electromagnetic compatibility requirements. Authorized EU Representatives Introduction ‘The manufacturers of parts and subsystems used in the DirectRay Console system are represented in the European Union by the following: DirectRay Console, DirectRay Detector and DirectRay Controller Hologic Europe Horizon Park Leuvensesteenweg 510, BUS 31 1930 Zaventem, Belgium Bucky MMS Medicor Medical Supplies Henrich Hertz Strasse 6 50170 Kerpen GermanyChapter 2 Basic Operations This chapter provides basic information about using the DirectRay Console to acquire images and send them to output devices. It also includes procedures for system start up, shut down, and X-ray tube warm-up. Contents Subject Starting Up and Logging On to the System Warming Up the X-ray Tube Capturing Image: Powering Down the System Components 24DirectRay Console User's Guide Starting Up and Logging On to the System ‘To start up the system and prepare for acquiring patient images: Step | Action 1 | Power up the uninterruptible power supply (UPS), which in turn powers up the DirectRay Detector and DirectRay Controller. 2 | Power up the X-ray Generator. 3 | Check that the other X-ray system components are on and working properly. 4 | Power up the DirectRay Console CPU. 5 | Login to the CPU’s operating system. 6 _ | Login to the DirectRay Console application. ‘The following topics provide instructions for performing each of these steps. ‘The DirectRay Console CPU should be powered down once a day to ensure a ‘complete system reset. If this is not done, system performance deteriorates. CAUTION ‘The Directftay Detector should be powered on at least 1 hour before intended use. itis used sooner than 1 hour after being powered on, image quality can be affected. CAUTION Fo" more information about powering on the DirectRay Detector, refer to the topic IN “Step 1: Powering Up the UPS” on page 2-3, ae Basic OperationsDirectRRay Console User's Guide Step 1: Powering Up the UPS Note: Ifat least five minutes does not elapse between Steps 1 and 4, you may get a DirectRay power up failure. Figure 2-1. UPS Power Switch Basic Operations To start the DirectRay Detector and DirectRay Controller, press the UPS power switch on the left side of the DirectRay Console cabinet to the On (I) position, as shown in Figure 2-1 Once the power switch is in the On (I) position, you must wait at least five minutes before powering up the DirectRay Console. Refer to the next topic. 28DirectRay Console User's Guide Step 2: Powering Up the X-ray Generator Figure 2-2. Generator Power Controls Starting the X-ray Generator typically also powers up other X-ray components, such as the X-ray tube, the Collimator, the arm to which the X-ray tube is attached, the Bucky, and the table (if one is present). To start up the X-ray Generator, press the ON power button at the front left of the DirectRay Console cabinet, as shown in Figure 2-2. Xray Generator ON Xray Generator OFF LEFT SIDE WARIONG Tis ay a ab ngs pa ad pe es ‘al pus at and apa its ae ober ret i decease ce ne et aap. Step 3: Checking the System 24 Once the X-ray Generator is powered on, perform the following checks: + Remove any patient supports or other objects so they do not interfere with the movement of the X-ray tube’s suspension arm. + Press the Collimator light switch and verify that the light comes on. ‘+ Verify that the Collimator display indicates the current SID and the Collimator opening. * Check the releases, if applicable, on the X-ray tube’s suspension arm, the Bucky, and the table to ensure that the controls are operating Properly. You can now power up the DirectRay Console. Basic OperationsDirectRay Console User's Guide ie Step 4: Powering Up the DirectRay Console CPU Note: Before you power on To power up the DirectRay Console CPU, press the power key located at the Diree’Rey Console CPU, the upper-right corner on the CPU keyboard (refer to Figure 2-3). The CPU ensure that the DirectRay powers up and the monitor (which should typically be left on but might be Detector and DirectRay een” * i eee hve compre a in “sleep” mode) “wakes up.” If the monitor is not on, press its power button. their startup sequence {wait at least five mines after you power on the UPS), Figure 2-3. DirectRay Console Power Key, 4 = Note: The dual input monitor Once the CPU is powered on, the monitor displays messages related to the switch toggles berween the progress of the CPU's operating system startup. The CPU takes about four DireeiRay Console and the minutes to complete this sequence. DirectRay Controller. When the operating system is loaded, the Login window displays. Basic Operations 25DireotRay Console User's Guide Step 5: Logging In to the CPU’s Operating System Note: Depending on your systent configuration, the tasks an your Status window ‘may differ from the ones depicted in the sample shown here. 26 When you power on the DirectRay Console, a grey SUN Microsystems log in banner displays. ‘To log in to the CPU’s operating system: Step | Action 1] Emter the appropriate login name at the Please enter your name: prompt + tech for technologists + mgr for system administrators 2 | Press the Enter key. ‘The Please enter your password: prompt displays. 3 | Enter your password, then press the Enter key. (If you do not know ‘your password, see your System Administrator.) Note: No characters display as you enter your password, Note: If you make a mistake when enrering ihe login name or password, you can elick the Start Over button 10 clear the fields and start again, After displaying progress messages, the DirectRay Console application Status window displays The Status window, shown below, lists the initialization tasks for DirectRay Console functions, Each task is highlighted once it has become active and passed setup. After the status tests are complete, the application Login window displays at the upper-left corner of the screen. Go to the next topic to log in to the DirectRay Console application, sae Basic Operations.DirectRay Console User's Guide Step 6: Signing in to the DirectRay Console Application Note: See your System To sign in to the DirectRay Console application, choose your name from Administrator ifyou dono the Identify Yourself pop-up menu, enter your password, and click the OK now your login or password. utton, ‘in ia ato |B tmeteatoc enwyYeoseh pox) fet Pear The DirectRay Console application window displays. If the X-ray tube has been inactive for a period of time, you must warm it up, as explained in the topic “Warming Up the X-ray Tube” on page 2-9. Otherwise, you can open a patient record and start capturing images. Fae Fie £6 Ain tip 5% Need Enter or search for patient @ = re ato Pen oe Te ie | lees | ase} Il Lbs ey ===> iano Basic Operations, a7DirectRay Console User's Guide Changing Your DirectRay Console User Application Password ee Oupwe ' Change Ue ssn faves “chs Peon 28 ‘To change your DirectRay Console user application session passwor Step Action From the Edit menu, choose Change User Password. ‘The Change Password window displays. Grape User aes Usarpr | Gat Caran sword | frerNewtisment | | BeanerNew sie In the Enter Current Password field, type your current password, then click the OK button. Note: An asterisk (*) character displays for each character you type 10 protect the privacy of the password. “Type the new password in the Enter New Password field and in the Reenter New Password field, Note: This is required to verify that you are typing the new password correctly, since you cannot see what characters you are typing. To save the change, click the OK button. To cancel the change, click the Cancel button. Basic OperationsDirectRay Console User's Guide c@ Warming Up the X-ray Tube Producing X-rays with a cold or improperly warmed tube considerably shortens the life of the X-ray tube. To prolong the life of the X-ray tube, do not acquire images CAUTION Wiheut first warming up the tube. ‘The tube should be warmed up at the start of each day, and whenever the tube has ‘been inactive for more than four hours. ‘To perform the tube warm-up: Step _| Action 1 | Ensure everyone is out of the X-ray room. 2 | Close the Collimator shutter, using the shutter controls. 3 | Cover the Collimator or the Bucky with a lead apron or position the ‘X-ray tube so it will not expose the DirectRay Detector to tunattenuated dosage. 4 | Inthe DirectRay Console application main window, with no patient chosen, click the Conventional Mode button. ‘A waming dialog box displays. a eT ae {@ | WAINNG: Tots NOT recta IGT MAGING ACQUETIONT i 5 | Click the OK button. ‘The Conventional X-ray Mode window displays. 6 _| Set the technique settings, as instructed in the Tube Warm-Up panel. 7 | Take exposures until the heat units count reaches 7 to 9%. 8 | When you have completed the exposures, click the End ‘Conventional Mode button and remove the lead apron from the tube. The DirectRay Detector is now disabled, but the X-ray tabe is enabled. If you wish to use a conventional film cassette or Computed Radiography, refer to the topic “Capturing Images on Film” in Chapter 3. ‘Once the X-ray tube is properly warmed up, you can start capturing, images. Go to the next topic. Basic Operations aDirectAay Console User's Guide Conventional X-ray Mode Mote Di Acuson ial nun fl! x uw aw fiverz u Sts ma fall) eco es lal == =| Recommended Tube Warmup Procedure [T'S tednipe prams ere varmone [= Rp 75, mA= 200, ms = 40, AEC = OF, fr spo = ge Dy Ensure that the detector lacked fremsthe XoRay beam |= Manwaly hoes beth vetal and heron colirmter Be. | Use lead apron or srezno block the Bea 3) Moke exposes 3 seconds apa unl the heat uns ese to 7 ~ 9% ) Cato Comers Mok hes jou ove hed th expe 210 Basic OperationsDirectRay Console User's Guide Capturing Images Overview for Capturing Images Note: Ifyou wish to use a ‘The general workflow for using the DirectRay Console to acquire and send conventional film cassette or images to the output devices involves the following steps: Computed Radiography, refer to the topic “Capturing Images on Film” in Step | Action Chapter 3, 1 | Identifying the patient and 2 | Choosing output destinations. 3 | Optionally, adjusting the exposure technique settings and the exposure sequence. 4 | Adjusting the position and orientation of the DirectRay Detector, X-ray tube, and the Collimator shutter to accommodate patient orientation. 5 | Exposing the patient, 6 _| Previewing, then accepting or rejecting the image. ‘You then repeat steps 3 10 6 for each image in the procedure. Step | Action 7 | Optionally, opening an additional procedure for this patient’ visit. 8 | Optionally, adding a view to the procedure in progress. 9 | Optionally, select the Inverse Topography feature. 10 | Closing the study. 11 | When you are done taking exposures, logging out of the current DirectRay Console application session so that another user can log Except for adjusting the position and orientation of the DirectRay Detector, X-ray tube, and the opening of the Collimator shutter, you perform all of these steps from the DirectRay Console user application's main window. Basic Operations 2atDirectRay Console User's Guide Step 1: Identifying the Patient and Visit Before capturing images, you must identify with which patient they are to be associated. Proper identification ensures that the image data are associated with the correct patient information. Depending on the system configuration at your site, there are three ways for you to identify the patient and visit for which you want to acquire images, as described below. lll systems allow you to identify patients and visits manually using the DirectRay Console’s local database. Whether you are acquiring images for a new or existing patient, you can identify a patient manually by: ‘* Creating a new patient record in the local database. + Selecting a patient from those previously entered and currently stored in the local database. Unless protected by a key operator, patient records are stored only temporarily in the local database. Since database space is limited, the oldest patient records and their associated images are periodically deleted to reclaim space for new patients. For more information about how to manually specify the patient and visit, refer to the topics “Adding a New Patient Manually” on page 2-13 and “Choosing an Existing Patient or Visit Using the Search Function” on page 2-15. If your system supports Modality Worklist queries, you can retrieve patient information from a Radiology Information System. Refer to the topic “Choosing a Patient Using the Modality Worklist Query” on page 2-20. If your system supports bar code scanning, you can use the bar code scanner to read in the patient ID, visit number, or some other unique identifying number. If the ID is found in the Modality Worklist (if this feature is available) or in the local DirectRay Console patient database, that corresponding patient, visit, and study is opened. If the ID is not found, ‘you must enter that patient manually. 242 Basic Operations,DirectRay Console User's Guide ye~ Adding a New Patient Manually Note: Ensure you enter patient names and IDs correctly: Incorrect entries can cause duplicate patient records for the same patient, or make it more difficult to fina the patient in future search operations. Note: When the CPU's storage space begins to run ow, patient records and their corresponding images are deleted to make room for new images (oldest images and patient records fist). For >more information about patient and image reclamation, and how youcan protect a patient record and ‘associated images from being deleted, refer to Chapter 5. Basic Operations To add a new patient when not using a barcode, click the New button in the Patient panel of the main window. Patient lame, a8, iD ‘The New Patient Entry window displays: a sample is shown below. Note that, for your site, the fields in this window may be different. In the sample, the visit number field is labeled “Admission Number.” Patient Demographic | Application stat Name: PUBLIC | *FiseNane; JOHN | ide Name: | Srrcene 1D: BRT | osmmpornnos_ | Aga of Patient *Gendor. Referring Physi | Padone Loeacion: ‘Admission Number: 778678 *Aceassion Number: 7667857 ‘Procedure Description: Thorax CHEST PA +LAT W/OBLIQUES ||: “NOTE: Fields with an asterisk are mandacory and require input. 1 H ‘Complete the fields in the window. Fields whose labels include an asterisk (®) are required fields. ‘When specifying the procedure: + From the first drop-down list, choose the exam type. + From the second drop-down list, choose the procedure within that exam type. To save the patient information, click the Accept button. The Creating/Editing Patient information window closes, To clear the patient information and reenter it, click the Clear button, To cancel entry of the patient information, click the Caneel button,User lagon name Patient ranel Vist sanet bs Alarm incicatortuton A= for: A Dl / Saw FT amo” sara | | ° | DirectRay Console User's Guide When you finish creating or modifying the patient information, the main window is updated, as shown in the sample screen below. Note that: + The patient name displays in the Patient panel. + The visit number displays in the Visit panel, + The study ID displays in the Study panel. + The chosen procedure name displays in the Study panel. + The series of image views that are to be captured, as defined by the chosen procedure, are displayed. + The exposure technique settings, relative to the chosen procedure, are displayed. After entering and saving patient information, you are ready to choose the output devices to which you want to send the images. Refer to the topic “Step 2: Choosing Output Destinations” on page 2 “Teeique setings area Tecraue sting ————e umuienoune / @ 193 959 9.500 8) xem | ‘208 a Xray Generator hurt ctor Ar Thanonaiiot onto exjeaue sais aecuredimags — Recqurag fare Basic OperationsDirectRay Console User's Guide Choosing an Existing Patient or Visit Using the Search Function Note: You can use the asterisk (*) character as a wildcard character to broaden your search. For example entering Réph would return patients named Randolph and Rudolph. if using the wildcard character, make sure you include at least one other character (that is, don't center only an asterisk) to ‘void listing all patients or visits, which might take several minutes to complete. Basic Operations ‘You can choose an existing patient by first clicking the Local DB tab to search the local database, then using the Search function to list patients whose name, ID, or visit number match search criteria that you enter. ‘To search for an existing patient or visit in the local database: + To search by patient name, click the Patient Name tab, enter the name in the search field, then click the Search button or press the Enter key. Note the following guidelines when entering names: + Names are stored in the database as LAST/FIRST*MIDDLE. ‘When specifying two or more parts to a name, you must include the caret (*) character between the name parts (for example, DOEAJ*).. ‘+ Because names are stored in the format LAST*FIRST*MIDDLE, searching for the first name John requires preceding it with an asterisk (that is, *John). ‘+ Search entries are case insensitive; you can enter upper or lower case letters. * To search by patient 1D, click the Patient ID tab, enter the ID in the search field, then click the Search button or press the Enter key. + To search by visit number, click the Visit tab, enter the visit number in the search field, then click the Search button or press the Enter key. The list of patients or visits matching the search criteria that you entered displays (for example, refer to the following sample window). 2416DirectRay Console User's Guide Hopi espia as Enter or search for patient | wee oc 08) Facet Nae Pst © Wil et Pa Nae (tn seh 246 Basic OperationsDirectRay Console User's Guide ‘To navigate through a list that is too long to be entirely displayed, refer to the following illustration. *l| — ‘To scroll to the top of thelist, cick here [BH Pe rttur one entyat atime, ik here ‘To scroll down one entry at atime, cick here —— To sero! t0 the Bottom of the list, lick here To clear the list and start a new search, click on one of the other search tabs (for example, Patient ID or Visit). ‘To choose a patient or visit from the list, click on the entry: + If the patient entry that you chose has multiple visits associated with it, the visits are listed after clicking the patient entry. Click on the visit you want to open. + Ifthe visit entry that you chose has multiple studies associated with it, the studies are listed after clicking the visit entry. Click on the study you want to open. The study list includes the status of each study, as Shown on the following page. Basic Operations 217| Fle cit Admin Help DirectRay Console User's Guide Hologic Hospi PublicAJohn4Q. GC) Weis Lee D8 |cnoose a Vise [Search Results? entries x | i234 (2 SKULL 4 VIEWS ROUTNE ‘Scheduled [« i fensent a Cone wpa cHEST oR DECURG) | | | | Jerence] 248 After making the final selection in the patient/visit/study hierarchy, that selection is opened in the main window, as shown on the next page. Basic Operations.DirectRay Console User's Guide one! [Patient ine ableyoig loos eens lo tow New) ‘a: coe | == earch Resultss2 entries ee eres c | | visi | pw ery fe | } Se) om] ] t | Study ae sor a |$ ly Z} rer | S C — eel Basic Operations If multiple procedures are listed under one patient, click on the appropriate procedure(s) and click the Select button. To cancel and return to the search screen, click the Close button in the patient option box. Unless you want to change the procedure from the default one(s) displayed in the Study panel, go to “Step 2: Choosing Output Destinations” on page 2-28, If you want to change the procedure, refer to the topic “Step 7: Opening an Additional Procedure (Optional)” on page 2-38.DirectRay Console User's Guide ‘sem incicatr buton _Tecrique setings area PUBLICJOHN*Q, UST ANLAT ROS / H20® too # oso Userlogon name Heer Yoray Ganerstor es mescages rater pene! ee splayed nee Xray Gonerstor | / sets panel | _-* lage pane! Joos in queue Bi | a Detector Anay Thumb exposure stats anqured image pane! Choosing a Patient Using the Modality Worklist Query ‘The DirectRay Console application includes an optional feature—Modality Worklist—that allows you to retrieve patient information from a Radiology Information System (RIS). This feature follows the DICOM Modality Worklist standard, and requires your facility to have a DICOM Modality Worklist provider. If this feature is configured on your system, the Enter or search for patient window contains an enhanced user interface that includes two tabs: + Worklist tab. This tab includes two subtabs. The Patient Query tab allows you to search for a patient in the Modality Worklist provider using several different search criteria. The Todays Worklist tab allows you to retrieve a daily worklist of patients and visits from the RIS. + Local DB. This tab allows you to manually enter patient information, or search the local database for a patient or visit. This tab functions as cescribed in the topics “Adding a New Patient Manually” on page 2-13 and “Choosing an Existing Patient or Visit Using the Search Function” on page 2-15 2-20 Basic OperationsDirectRay Console User's Guide ‘The enhanced Enter or search for patient window is shown below. Basic Operations 221DirectRay Console User's Guide Retrieving Patient Records from the Modality Worklist Provider ‘Note: The query fields are configurable and are named er the criteria for your specific facility. ‘Note: In addition to the specific search criteria you enter, the chosen Date Range criteria always applies to the ‘query. Ensure that the date the patient's exam(s) were ordered is included inthe Date range feld before Initiating a query. 2-22 ‘You retrieve patient records from the Modality Worklist provider by using search criteria to query the Modality Worklist provider. In response, the Modality Worklist provider returns the patients that match the search criteria. You then choose the patient and study whose images you want to acquire. The Patient Query is useful when searching for a specific patient or study. ‘The patient search criteria that can be used includes patient name, patient ID, study ID (for example, an accession number), Requested Procedure ID, and/or order date. Any combination of these criteria can be used for any given query. ‘To query the information system for a patient, choose the Worklist tab, then choose the Patient Query tab. Enter the following search criteria, in any combination: + Patient ID. The Patient ID must be an exact match. + Patient Name. You can enter the entire name, or use the asterisk (*) as a wildcard character to specify only a portion of the name. Follow the ‘same text entry guidelines as described previously under “Choosing an Existing Patient or Visit Using the Search Function.” + Study ID (Accession Number in the sample window). The study ID number must be an exact match. + Requested Procedure ID (not applicable for all installations). This ID must be an exact match. + Date Range. Choose a date range from the Date drop-down list. The within 3 days date range option includes the 3 days prior to and 3 days following today. The other within options behave similarly. Note that, when you return to the Patient Query window after completing exams, the Date range always reverts to today. ‘When you are finished entering the search criteria, click the Query button or press the Enter key. The list of patients matching the search criteria displays, as shown in the sample window on the next page. In this example, the search criterion PUB* was entered in the Patient Name field. To navigate through a list that is too long to be entirely displayed, refer to the topic “Choosing an Existing Patient or Visit Using the Search Function” on page 2-15. Basic OperationsDirectRiay Console User's Guide Enter or search for patient oe Wort tact) Pert Qu sys Wert | | | (se A AL js ‘ert Rien et ‘eco amber te jes —— Te ee 4 oe | sues Sa Sts ——~ Visit fie DAVENUBLICN w~*d | ve pee. pipe, aot tr her JOHNPURLIC"S - |} Basic Operations 2:28DirectRay Console User's Guide Viewing Patient Entries in “Today’s Worklist” Today's Worklist is useful if you prefer choosing patients or studies from a list of scheduled studies for the day. To retrieve all patient studies scheduled for today, choose the Worklist tab, then choose the Todays Worklist tab. The list of patient studies that have been ordered for today’s calendar day displays, as shown in the sample window below. ‘To update the list, if you would like to query the Modality Worklist, provider for studies that have been ordered since the last list update, click the Update button. An updated list of patients and studies displays. The DirectRay Console may occasionally perform scheduled queries in the background, To refresh the list to see possible new entries, click the Refresh button. Hetogic Host Enter or search for patient Lan aes rn Werk ss "Patient | Patient Quary| Txhys Workts| (oe css i a PS oe | ‘ote {nal pe : | Se series Ss } DAVID-PUBLICQ 1 30015 SSSI JANEPUBLICQ us. e010 F JOHN-FUBLICN, teh Ws6i0001 5551212 fF T rnc 2:04 Basic OperationsDirectRay Console User's Guide Reordering and Resizing Columns in the Entry List You can reorder or resize the columns in the patient entry list in the Worklist tab. ‘To reorder the columns, click and drag the column heading cell to the left or right, then release the mouse button when at the desired location. To resize a column, move the pointer over one of the border lines of the column until it turns to a bidirectional handle icon. Click and drag the resize handle, then release the mouse button when at the desired width. Opening a Patient/Study in the Entry List To open a patient/study listed in the Worklist tab’s entry list, click on the entry. That patient, visit, and study are opened in the main window, as shown below. Rise inieator buon “Technique sotings area PUBLICAJOHN*Q // = -/ ooo | Bl ray Generator O50 | 8.500 4), ease arena 4 septa Qo = | Xray Generator ay i : ‘Thumbnai of Detector Arey ‘Thumonaot est view'o expeeure sats acquiedimage Ge aequred panel Basic Operations. 2.25DirectRay Console User's Guide Required Fields for Worklist-Ordered Studies The DirectRay Console is customized at the time of each site installation to require certain patient and order-related information before acquiring the ‘patient images can proceed. Occasionally, all the required patient and study formation is not sent from the Modality Worklist provider to the DirectRay Console as part of the query. In that case, you are presented with an Edit Patient, Visit, or Study window, prompting you to enter the missing information. An example of the Edit Study window is shown below. In the example, a Study ID has been configured as a required value, but no value was received in the patient query from the Modality Worklist provider. 2 say \ SHITHOHNA | ("Procedure Description: Abdomen “ABD COMP W/PA CHEST +/OR DECUB(S) | *Accassion if: 8302000-0001 | | sore ts ne ano! ov : | cin | Bese 2.28 Enter the required information, modify the Procedure Description if needed, then click the Aecept button to proceed. For more procedures about how to édit patient, visit, or study information in these windows, refer to Chapter 3, Basic OperationsA WARNING. Note: Patient records are kept temporarily in a local database, storage space ‘availabilty permitting, 10 save you from having to reenter information for a Patient who was recently X-rayed. Note: If any required patient visit/study information was not included in the information retrieved, the appropriate Edit Patient, Wisi, or Study window displays, so that you can center the missing required information. Refer to Chapter 3 for more information about how to edit patient visit, or study information. Basic Operations DirectRay Console User's Guide g a Bar Code to Identify the Patient/Visit/Study ‘The bar code scanner is a Class Il laser device, Do not use it in a patient contact area. Laser light is emitted from the bar code scanner aperture. Avoid exposure. Do not ‘stare into the beam, For more information about using the bar code scanner and safety precautions, refer to the bar code scanner’s original manufacturer documentation, ‘When you scan a bar code to uniquely identify a patient/visit/study: ‘+ Iyour site supports a connection to a Hospital Information System, Radiology Information System, or other remote patient database (for example, using a Modality Worklist provider), the DirectRay Console user application queries that database and the local DirectRay Console patient database for the ID. + Ifyour site does not support such a remote database connection, the DirectRay Console user application searches its local patient database for the ID. If the scanned ID is not found, you must manually add the patient/visit’ study, Refer to the topic “Adding a New Patient Manually” on page 2-13. If the scanned ID is found, the DirectRay Console application “opens” that patient and visit in the application's main window, as shown on the following page. ‘You are ready to choose to which output devices you want to send the images. Unless you want to change the procedure (that is, the series of images to be captured) from the default one displayed in the Study panel, 4g0 to the topic “Step 2: Choosing Output Destinations” on page 2-28. If ‘you want to change the procedure, refer to the topic “Opening a New Study” in Chapter 3. 227DirectRay Console User's Guide Mar incites tutor ‘Technique setings area £ PUBLICNOHN'Q / Tian Bonen al 190) 950 |) 0500 7 xugee i spayed nee — Xray Generator SF) as _> mage panel / N urna of tector ra Tromenact ——_pestowts Srpaaie ee dauadinage — boscgues a Step 2: Choosing Output Destinations Before you acquire patient images, you need to choose the output setup you ‘want f0 use, Outputs Seater: Dyer ce | tae To choose an output setup, choose it from the Selection pop-up menu in the Outputs panel. The pop-up menu lists all of the output setups that have been created for your site. 2:28 Basic OperationsDirectRay Console User's Guide Cc Step 3: Adjusting Exposure Settings and the Exposure Sequence (Optional) At the time the system is installed, default exposure settings and imaging sequences are configured for each view in each available procedure. You can use manual techniques or phototiming techniques to adjust the default exposure settings. ‘Typically, you simply use the default settings. You would only change them for special circumstances, such as a very small person or a missing lung. If you want to adjust the exposure settings, refer to the topic “Adjusting ‘Technique Settings” in Chapter 3. If you want to adjust the exposure sequence, refer to the topic “Working with Procedures” in Chapter 3. When you have finished adjusting exposure and sequence settings, you are ready to position the patient and acquire images. Step 4: Adjusting the Orientation of the X-ray Tube and Bucky Basic Operations ‘You can now position the patient, the X-ray tube, and the Bucky. For information on how to do this, refer to your system user's guide. 2.29A WARNING Figure 2-4. DirectRay Console Prep/Exposure Switch 230 DirectRay Console User's Guide Exposing Patients ‘This X-ray unit may be dangerous to the patient and operator unless safe exposure factors and operating instructions are observed. Patient exposure is controlled by a 2-position button switch on the side of the DirectRay Console, as shown in Figure 2-4. Prepiexposure Switch RIGHT SIDE ‘When the prep button is pressed half way, you have 30 seconds to complete the exposure, When the prep button is pressed all the way, the exposure is taken within, one half second. The Status indicator on the DireetRay Console application's main window displays a message to indicate when the DirectRay Detector is ready for the next exposure: + A Wait countdown indicates that the DirectRay Detector is refreshing for the next exposure. This countdown occurs only when the DirectRay Detector has been recently powered up, or if an exposure has been aborted. + Ready to expose indicates that the DirectRay Detector is ready to capture an exposure. Basic OperationsNote: Releasing she Prep Expose burton before the exwosure is completed causes premature and inmediate termination of the exposure. This may cause the X-ray Generator Reset button on the DirectRay Console application's main window 10 light. To perform subsequent exposures, click the Reset button. Note: The DirectRtay Detector goes ino “seep” ‘mode to save energy iit has rr been used for a predefined period of time Opening a patient record or running the tube warm-up “awakens” the DirectRay Detector. If his has happened, you might have 10 wala few minwesfor the DirectRtay Detector to enter its ready state Note: Ifthe X-ray tube heat units exceed the maximum allowable limit, the X-ray tube and Generator are disabled uni the hee units drop to a safe level. If this condition occurs, a message displays and an audible beep sounds. Basic Operations DirectRay Console User's Guide To acquire an image: Step 6 Pross the Prep/Expose button half way (to the second position) and hold, Give the patient breathing and/or pre-exposure instructions. Press the Prep/Expose button all the way (to the second position) and hold, ‘When the exposure occurs; the Status panel turns grey and a tone sounds. Note: While behind the leaded wall when taking an exposure, you must maintain verbal communication with the patient and keep the patien? within your sight at all times. Afier the tone stops, release the button. Gi fe the patient the appropriate breathing instructions. San donee. nein i ‘Wher the exposure is complete, the Image Preview window opens and displays the image. Your customized windows may look different from the windows presented in this manual. 231DirectRay Console User's Two-Stage Image Preview ‘Once the Preview Image window opens, the image displays in two stages to allow you to start reviewing and working with * Initially, a low-resolution version of the image displays. The message “Loading image” indicates that the high-resolution image is still being processed. With the low-resolution image displayed, you can perform any of the functions in the Image Preview window except changing the image appearance or accepting the image. This stage allows you enough time to determine whether the patient positioning is satisfactory and, if not, reject the image without having to wait until the high-resolution version is ready to display. + After several seconds, the high-resolution version of the image displays. With this version displayed, all functions in the Image Preview window are enabled. Step 6: Accepting or Rejecting an image 2-82 From the Image Preview window, you can perform the following tasks: ‘+ Rotating or mirroring the image. + Verifying the assigned image laterality and patient orientation, and correcting them if necessary. * Cropping the image. + Selecting the sheet format and specifing the image cell on the sheet for the current image. * Using the True Size helper to ensure that the image can print at its actual size. + Using a mask to outline the image and make the area outside the mask black. + Adding markers to the image. + Selecting the ESA or IT image processing method. + Changing the look-up table (LUT) curve of the image to change its appearance. + Adding a comment to an image, which is sent with the image to DICOM workstations. Basic Operations,DirectRay Console User's Guide + Accept the image as OR + Reject the image. The following topics explain how to perform these tasks. A sample of the Image Preview window is shown on the following page. (Sie) (] een aE = Ineo gon amo | age vl oe te ‘ : ba meen OrinstonRow [tL] Reject] Accept! | Rotating or Mirroring the Image (Optional) If required, you can rotate or mirror the image. For more information, refer to “Rotating the Image” on page 3-19 and “Mirroring the Image” on page 3-19. Basic Operations, 233DirectRay Console User's Guide ‘When an image is captured, itis assigned image laterality and patient orientation settings that are predefined for the selected view. You can change these settings from the default ones assigned. For more information, refer to “Verifying and Correcting the Image Laterality and Patient Orientation Settings” on page 3-20. Cropping an Image (Optional) ‘You can crop an image for output to a printer. The cropping applies only to the image when it is sent to a DICOM print or storage device. For more information, refer to “Cropping an Image” on page 3-23. Selecting the Image Position on a Multiformat Sheet (Optional) ‘Note: Multi-format film will not automatically print untit all the spaces are filled. If exam is finished, and all spaces are not filed, the film ‘can be printed by clicking the (Close Study button. Note: Ifyou choose one ofthe formats other than I up, use text-onfilm instead of annotation boxes for any image-specifc text you want printed under each image. 2:34 If the image is being printed on a multiformat sheet (that is, more than one image on the sheet), you must choose which position on the sheet to place the image. The Image Preview window includes a Format area that displays rectangles representing the chosen image placement format. A 4-up format is shown in the sample Format area below. ‘The default placement area on the sheet for the current image is indicated as a white rectangle. If other images have already been captured for the current sheet, their thumbnails are displayed in their chosen areas. ‘To change the format, choose another format from the drop-down list. Depending on the DICOM printer’s capabilities, the available formats are: + Lup. Only one image on the sheet. The default setting for output devices that do not support multiformatting. + 2up~—1 by 1. Two images are placed side-by-side. + 2up-1 over 1. Two images placed one over the other. + 4up-2.x2, Four images placed two over two. Basic OperationsDirectRay Console User's Guide Note that, if you change formats and your system has been set up with eG auto-cropping and the selected output device has the True Size option on, the image is automatically cropped so that it fits in its cell on the sheet. For ‘more information, refer to “Selecting the Sheet Format” on page 3-25. Using True Size Helper (Optional) ‘When a sheet format is selected and the True Size option has been set for a destination printer, the True Size function calculates whether the image will fit on the specified format and displays crop marks to indicate what area of the image will be sent to the output device. For more information, refer to “Using the True Size Helper” on page 3-26. Masking an Image (Optional) ‘You can draw an irregular mask around the image. The area outside of the defined mask is converted to black. An auto-crop feature can also be used with the mask, automatically cropping the image to the perimeter of the mask, Masking and cropping apply only to the image when it is sent to a DICOM print or storage device. For more information, refer to “Using a Mask to Outline the Image” on page 3-29. G Adding Markers to the Image (Optional) ‘You can add markers to an image that allow you to give further information about the image (for example, supine, upright, and so on), the markers are sent to any DICOM devices chosen as an output destination for the image. For more information, refer to “Adding Markers to an Image” on page 3-32. Selecting ESA or IT (Optional) ‘The DirectRay Console supports both Exam-Specific Algorithm (ESA) and Inverse Topography (IT). For more information, refer to “Selecting ESA vs. IT Image Processing” on page 3-35. Basic Operations 2:35DirectRay Console User's Guide Changing the Appearance of the Image (Optional) ‘You can change the appearance of the image by: + Adjusting the image's LUT settings manually by using the curve controls in the image processing panel. These adjustments effectively change the minimum density, maximum density, contrast, and brightness used for the image, thus changing the image appearance. * Adjusting the image’s LUT settings by placing the cursor on the LUT curve’s handles, pressing and holding the right mouse button, and dragging the handle. * Modifying an image's LUT by clicking and holding the right mouse button and moving the pointer over the image. * Clicking on the pop-up menu in the image processing panel to change the anatomy-related LUT being used. ‘When the image is accepted, the image is saved as currently displayed. It is this version of the image that is sent to the output destinations. Note that, typically, LUT adjustments are not needed. For more information about making these appearance adjustments, refer to “Adjusting the LUT” on page 3-36. Adding Comments to an Image (Optional) You can add text comments to an image at the time of acquisition; the ‘comment is sent to any DICOM devices chosen as an output destination for the image. For more information, refer to “Adding Comments to an Image” on page 3-38. 2:96 Basic Operations~ DirectRay Console User's Guide Accepting the Image Note: Once the inage is ‘accepted, t cannot be moved wo another image placement area. ‘dd View! ule CHE Pa Wp ‘To accept the image, click the Aecept bution (or press the Spacebar on the keyboard). The Image Preview window closes and a thumbnail (minimized view) of the image replaces the view figure in the Image Panel of the DirectRay Console application's main screen, as shown below. The exposure settings used to acquire the image are displayed next to its thumbnail Once accepted, that image is stored in the DirectRay Console and sent to the chosen output devices. You are now ready to acquire the next image in the procedure Seudy: CHEST PA + LAT WIOBLIQUES Clese Sandy war Le Rao. me n A z \ \emwon \ . oo ire a lrt vow tobe Fo change the exposure order, ponuied image acquited (oy cetaut) ek on ho vow you vant eacquve nest Basic Operations. By default, the next view to be exposed is chosen in the image panel. If needed, you can choose a different view and adjust the exposure settings before acquiring the next image. For more information about these procedures, refer to Chapter 3. 2.37Rejecting the Image DirectRay Console User's Guide ‘You may want to reject an image (for example, if the patient moved during the exposure). Note: Unless auto-cleanup of the reject bin has been configured, rejected images ‘must be manually deleted by Step the system administrator: the 1 -sysiem does nor delete rejected images when it reclaims disk space. 3 To reject the image: Action In the Image Preview window, click the Reject button. ‘The Image Rejection Information window displays, as shown below. In this window, you enter a reason for the rejection. Choose one or more reasons from the displayed list of default comments, and/or type in a reason, To save the rejection reason and reject the image, click the Reject button, ‘The Rejection Reason and Image Preview windows close and you can then recapture the image, To dismiss the window and return to the Image Preview window without rejecting the image, click the Return to Preview button. Rejected images are stored in a designated reject bin storage area in the DirectRay Console, and can be discarded or resent to an output device by users with administrative operating privileges. Step 7: Opening an Additional Procedure (Optional) Fora given study, you may want to open additional procedures, to include their images in the study. For more information refer to the topic “Working with Multiple Open Procedures” under the topic "Working with Procedures” in Chapter 3. 2:38 Basic OperationsDirectRay Console User's Guide Step 8: Adding a View to a Procedure (Optional) If the current procedure does not include all the views you want to capture, you can add views to it. For more information, refer to “Adding a View to a Procedure” under the topic "Working with Procedures” in Chapter 3. Step 9: Closing the Study, Visit, and Patient After acquiring all images for a study, you close the study. You can then ‘open a new study for the same patient, open a new patient, choose another patient or visit, or log out of the session. ‘Note: When all images ina ‘You can also close a study even though you have not finished acquiring all study have been acquired, the of the required images (or have not acquired any images). You can reopen Hee ‘Study button displays the study at a later time to complete it. To close a completed study, from the DirectRay Console application's main screen, click the Close Study button. The main window clears, allowing you to add or choose the next patient. ‘Note: The fact that a study is. To close an incomplete study, from the DirectRay Console application's incomplete does not prevent _rnain screen, click the Close Study button. You are prompted whether you the patient record and ‘want to close the study without finishing, as shown below. associated images from being deleted as part ofthe system's TO storage space reclamation —s = eee = @ Doyou are to cove ts ureihed study process. For more information about the reclamation, and how to No protect a patient record and ‘isocited images fm being beens deleted, refer to Chapter 5. Click the Yes button to continue. The main window clears, allowing you to choose the next patient or visit with which you want to work. To close a visit, click the Close button in the Visit panel. To close a patient, click the Close button in the Patient panel. Basic Operations 299DirectRay Console User's Guide Step 10: Signing Out from an Acquisition Session ‘Note: You can sign outfrom To Sign out from the current DirectRay Console acquisition session, ‘an acquisition session witha from the main window click the Sign Out button. The Login window procedure open. The displays. For system security, the workstation display is locked at the procedure opens for the next gn window. In this state, a user can only log in to another session, and at user who signs on 10 a ae the same user level (tech or mgr) of the previous user. it you click the Exit button, you must restart the DirectRay Console. This takes approximately five minutes. CAUTION Switching User Levels To be able to sign in at a different user level—that is, switching between tech and mgr—you have to log out of the DirectRay Console application. ‘To switch user levels: 1 | From the File menu, choose Exit. ‘The Exit from DirectRay Console window displays. Brynn: 1) Fewer ofthe computer? _S esa th computa? ag oat of computor? ‘steel a atfarnt wor? Ye] Nel ona 2-40 Basic OperationsBasic Operations irectRay Console User's Guide Action Choose the Log out of the computer? option and click the Yes button. ‘A dialog box displays asking you to confirm that you wish to log out. Click the Yes button. ‘The DirectRay Console application closes and the grey ‘SUN Microsystems log in banner dispiays. Log in at the desired user jevel using the procedure in the topi “Step 5: Logging in to the CPU's Operating System” on page 2-6. Log in with your name and password using the procedure in the topic “Step 6: Signing in o the DirectRay Console Application” on page 2-7. 241DirectRay Console User's Guide Powering Down the System Components ‘Typically, you should leave the system components on. The DirectRay Console CPU, monitor, and DirectRay Detector enter energy-saving “sleep” mode when not used for a period of time. If you have to power down the system, perform the steps outlined in the following topics. Recommended Power Down Procedure Overview ‘To power down the system, it is recommended that you perform the power down tasks in the following sequence: Step Action 1 Power down the DirectRay Console CPU. 2 | Power down the X-ray Generator. This also typically powers down the other X-ray system components. 3 | Power down the DirectRay Console’s UPS, which in turn powers down the DirectRay Detector and DireetRay Controller. ‘The following topics provide instructions for performing each of these steps. ‘The DirectRay Console CPU should be powered down once a day o ensure @ complete syetem reset. If this is not done, system performance deteriorates. ‘CAUTION A In the Admin menu, the Device Control function has a selection called DirectRay Power Off. Tis does not tum off power to the X-ray tube arm, the Bucky, or the table, CAUTION. 2 should be used only when directed by a Hologic service representative. 242 Basic OperationsDirectRay Console User’s Guide C Step 1: Powering Down the DirectRay Console CPU ‘To power down the DirectRay Console CPU: A CAUTION Basic Operations, Step 1 Action From the File menu, choose Exit. ‘The Exit from DirectRay Console window displays. 2 ee > fasta the comput? 1 tes atet tie computer sion inasa erent we? ys) 5) Choose the Power off the computer? option. To continue with the power down, click the Yes button. ‘The system displays messages as it performs the operating system shutdown procedures. When the shutdown sequence completes, the CPU powers off and the monitor goes blank (the monitor enters an energy-saving “sleep” mode). Wait until the monitor goes blank before proceediag to “Step 2: Powering Down the X-ray Generator” ‘on page 2-44. To cancel from the DirectRay Console application's power down process and redisplay the DirectRay Console application's Login ‘window, click the No buttor ‘Always power down the CPU as described above. Improper power down can cause loss of data. 2-43DirectRay Console User's Guide Step 2: Powering Down the X-ray Generator Figure 2-5. X-ray Generator Power 244 ‘Switch Powering down the X-ray Generator also typically powers down the other ‘X-ray system components, such as the X-ray tube, tube suspension arm, Collimator, Bucky, and table (if applicable). ‘To power down the X-ray Generator, press the X-ray Generator OFF button located at the front left of the DirectRay Console cabinet. Refer to Figure 2-5. ; —— I —— LEFT SIDE ‘te ape tr peg cna ce eel WaT ay a ea pe Az aaa Basic OperationsDirectRay Console User's Guide e~ Step 3: Powering Down the DirectRay Console’s UPS ‘To power down the DirectRay Console’s UPS, press the UPS power switch to the Off (0) position, Refer to Figure 2-6. The DirectRay Detector and DirectRay Coniroller are powered off. Figure 2-6. UPS Power Switch Basie Operations 245Chapter 3 Additional Operations This chapter describes additional DirectRay Console operations that were not described in Chapter 2. Contents Working with Visits Working with Studies.. Adjusting Technique Setting: Working with Acquired Images... ‘Viewing Accepted Images at High Resolution with the DCM View Tool. Capturing Images on Fil atOverview DirectRay Console User's Guide ‘The basic procedure for acquiring and sending images to their output devices is covered in Chapter 2. This chapter includes some additional operations that can be performed during image acquisition. For convenience, the following sample DirectRay Console application's main window, with a patient selected and a study opened, is provided. It is intended to help you identify the areas of the window that are discussed in this chapter. Man nde bton Technique settngs ares Usertgon name Patient panel / [was Visit panel “lowe mom ‘Thur of Detector Array “Thumbnaiot nowt vite ‘exposure satus aequredimage be acquied pane 32 ‘Additional OperationsDirectRay Console User's Guide c@ Editing Patient Information CAUTION Note: The entries for some fields may be dimmed, indicating tha this information cannot be modified. Note: Ensure you enter patient names and IDs correctly. Incorrect entries can cause duplicate patient records for the same patient (or dificult in finding the patient in future search ‘operations. ‘Additional Operations Edit the patient information before image acquisition to insure the images go to the correct file. Editing this information after image acquisition does not change image headers and therefore cannot be resent to store. ‘You edit a patient's information in the Edit Patient window under one of the following conditions: + You want to edit incorrect information, or add missing information. Click the Edit button in the Patient panel to display the Edit Patient window. + Having picked a patient/visit/study from a Modality Worklist, required patient information is missing. In this case, the Edit Patient window displays automatically. ‘A sample of the Edit Patient window is shown below. For your site, the field labels in this window may be different. i | | } | | ‘y= #Patient ID: [12345678 17 w ‘DOB: gepomrmer 4 i975 Gender: ‘M_— | When you finish adding or modifying the patient information, click the Accept button. 33DirectPay Console User's Guide Working with Visits From the Visit panel, you can + Open a new visit for the patient. + Edit some of the information selated to the currently open visit. If a visit has already been selected, the visit number is displayed in the panel. Opening a New Visit ‘To open a new visit, choose the patient, then click the New button in the Visit Pane], The New Visit window displays, as shown below. In addition to entering the new visit number, you can enter visit information and choose a procedure. ‘The labels used in this window are configurable for each site. The sample shown below refers to the Visit number as the “Admission Number.” PUBLICJOHN'Q Referring Physician: Patio Locatio | Admission Number: 7786789 | | “Accession Number: 7867898 | *Procedure Deseripson: Thorax _ARIBS W/PA LAT CHEST eee To clear the fields of data, To exit the window To save your changes, cick here without saving changes, ioe here cick here If another visit was already open, after clicking the Accept button to open the new visit you are prompted with the message “Creating a new visit umber will close the currently open visit. Continue?” Click the Yes button to continue, or click the No button to cancel creating the new visit number, If an incomplete study was open, you are also prompted to save that study. 34 ‘Additional OperationsDirectRay Console User's Guide Editing Visit Information A CAUTION ‘Additional Operations correct file. Editing this information after image acquist headers and therefore cannot be resent to store. n does not change image ‘You can edit visit information in the Edit Visit window, under one of the following conditions: + You want to edit incorrect information, or add missing information. Click the Edit button in the Visit panel to display the Edit Visit window. + Having picked a patient/visit/study from a Modality Worklist, required visit information is missing. In this case, the Edit Visit window displays automatically. A sample of the Edit Visit window is shown below. Note that, for your site, the field labels in this window may be different. For example, in this sample window, the visit number field is labeled “Admission Number.” rAdmission Number. 34567890 NOTE fatanneav endive ee) ee Toclear the fields Toexit the window To save your of data, click here ithout saving changes, click here ‘changes, click here 0.07708 35DirectRay Console User's Guide Working with Studies From the Study panel, you can: + Open a new study for the patient/visit. + Change the currently open study's ID. Study Procedure sway # a) Opening a New Study To open a new study, in the Study panel click the New button. The New Study window displays, as shown below. In addition to entering a new study, you can choose a different procedure, ‘The labels used in this window are configurable for each site. Accession Number: 7867880. ‘Procedure Description: Thorax RIBS W)PALAT CHEST | | | car it Racer \| To clear the fields of data, To exit the window To save your changes, cick hore without saving changes, cick here cick here If another study was already open, after clicking the Accept button to save the new study, you are prompted with the message “Creating a new study will close the currently open study. Continue?” Click the Yes button to continue, or click the No button to cancel opening the new study. If an incomplete study was open, you are also prompted to confirm that you want to save that study. Adcitional Operations,DirectRay Console User's Guide Cc Editing Study Information correct file. Editing this information after image acquisition does not change image A Edit the study information before image acquisition to insure the images goto the headers and therefore cannot be resent io store CAUTION ‘You edit study information in the Edit Study window, under one of the following conditions: + You want to edit some incorrect information, or add missing information. Click the Edit button in the Study panel to display the Edit Study window. + Having picked a patient/visit/study from a Modality Worklist, required study information is missing. In this case, the Edit Study window displays automatically. Note: The entries or some A sample of the Edit Study window is shown below. For your site, the field Jields may be dimmed, labels in this window may be different. indicating that this information cannot be genre eee hee *Seudy td: 98707 lire Description: CHEST PA + LAT NOTE ae wacarter ot aun cans SMITHOHN'A | To.clearthe fields ‘Tocxit the window ‘Tosave your ‘of data, click here, ‘without saving ‘changes, ick here ‘changes, click here com ore Additional Operations 37DirectRay Console User's Guide Working with Procedures You can do the following tasks related to procedures: + Change the order of how the views are acquired, from the default left-to-right sequential order + Add a view to a procedure + Have more than one procedure open at a time + Cancel a procedure Changing the Order of Image Acquisition Study: CHEST PA + LAT W/OBLIQUES With a patient and procedure selected, the Image Panel displays the views to be acquired and thumbnails (minimized views) of any images already acquired, as shown below. By default, the views to be acquired are filled in sequentially érom left to right as images are acquired. However, you ean change the exposure order by clicking on the view you want to take next. If you click a view out of order, after filling that view the subsequent capture, by default, fills the leftmost empty view. Ade View| St CHE Close ey \ [ 2 | 4 - LD : il B : _ uired Image Next view to be ‘To change the exposure order, ‘Acquired image acquired (by defaut) click on the view you want 38 fo acquire next Additional OperationsDirectRay Console User's Guide Adding a View to a Procedure ‘Note: You can only add a If the patient is large or you require a second image of an area for which second view of an area after you have already captured an image, use this procedure. the first view as been a. ‘acquired and accepted. You ‘Toad a view to the current procedure: ‘may not add a view that isnot already included in the study Step_—_| Action ‘procedure. — s 1 | Click the Add View button in the Procedure Views panel. ‘The Add View dialog box is displayed. ‘ave 2 | Choose the view to add from the pop-up menu, then click the OK button. ‘The empty view is added to the procedure, 3. _| Choose this new view to acquire an image for it. Additional Operations 38DirectRay Console User's Guide Working with Multiple Open Procedures ‘You can have multiple procedures open at a time for the current visit, When ‘more than one procedure is open, tabs are added to the Procedure View panel. To open a new procedure within the current visit, in the Study panel click the Add button. The Add Study window is displayed. Enter a study ID, choose the desired procedure, then click the Accept button. A new procedure is opened, assigned to its own tab in the Procedure View panel, as shown below. Te switch to another procedure, ‘click on the tab coo sot To switch to the views of another procedure, click on that procedure’s tab. Cancelling a Procedure ‘You can cancel a procedure for which you have already captured images. Simply close the study (refer to the topic “Step 9: Closing the Study” in Chapter 2). The study is closed in an incomplete state, and is cleared when the patient is deleted (either by the system administrator or storage space reclamation). 340 Additional OperationsDirectRay Console User's Guide Adjusting Technique Settings ‘The technique settings portion of the main window is shown below. t2o%) ico oso & oso tee GHESTOBL OED EI al i | | {| Es | | |! \ | From the techniques settings area you can: + Adjust exposure settings using manual timing + Adjust exposure settings using phototiming (Automatic Exposure Control); this includes selecting one or more detector fields, and adjusting default density settings + Select a focal spot size + Select a patient size setting + Check the % Heat status Each of these controls are described in detail in the following topics. ‘Additional Operations, attAdjusting kVp DirectRay Console User's Guide ‘The range of kVp adjustment is from 40 to 150 kVp. ‘To adjust the kVp, click on the arrow buttons located to the right of the KVp display. The kVp increases and decreases in steps of 1 kVp. Pressing and holding the button causes the kVp display to increase or decrease automatically and with increasing speed, until the button is released. Manual Timing Using the mA Station and Exposure Time Settings 312 You can manually specify exposure timing by setting the mA station and the exposure time. When using the mA/Time settings (shown below), the exposure is terminated when the selected time value is reached. This mode is used when a specific time must be achieved, as in a breathing study or for stop motion. oT (f + ‘To specify the exposure by mA station/exposure time, ensure the Time option button in the Control panel is selected (shown below), then click on the arrow buttons in the mA and Time panels to set the desire values. The values in the panels change by one unit each time you click on an up or down arrow. Pressing and holding the button causes the value to increase or decrease automatically and with increasing speed, until the button is released. [CHEST oxi size2 ‘To toggle between the mAs and Time Setting, click on these buttons. osso.ort et With the Time option button selected, the mAs controls are dimmed. Since the mA station/time settings and mAs setting are dependent to each other, changing mA/Time settings changes the mAs setting, ‘Additional Operations.Cc DirectRay Console User's Guide Manual Timing Using the mAs Setting ‘Additional Operations, You can manually specify exposure timing by setting the mAs (shown below). With mAs selected, the mAs remains constant and the exposure is terminated when the preselected mAs value is reached. - 008.5 : + ‘To specify the exposure by mAs, ensure the mAs option button in the Control panel is selected, then click on the arrow buttons in the mAs panel to set the desire value. The value in the panel changes by one unit each time you click on an up or down arrow. Pressing and holding the button causes the value to increase or decrease automatically and with increasing speed, until the button is released. ‘With the mAs option button selected, the mA station and Time controls are dimmed. Since the mA station/time settings and mAs setting are dependent to each other, changing mAs changes the values of the mA and Time settings. 313DirectRay Console User's Guide Changing AEC Settings Note: When wsing the AEC Jeature, the patient must be positioned aver the enabled detectors and the radiation field must be larger than the ‘detector. In cases where the roferred radiation field is ‘smaller than the detector size, manual techniques are recommended. Note: The default density (0) is calibrated for normal contrast and density levels Larger, heavily muscled patients require an increase in density, Smiter, lightly ‘muscled patients require a decrease in density. However, only use this density adjustment ifthe image is grainy. [fan image is too dark or light, You can adjust the LUT of the ESA, or change the ESA (refer to “Adjusting the LUT" on page 3-36); do not adjust AEC. ‘The Automatic Exposure Control (AEC) system monitors X-radiation passing through ion chambers and automatically terminates the exposure after detecting a predetermined amount of radiation. ‘The ABC is enabled/disabled, and detector fields are selected, based on the selected procedure. While you typically use the default state and settings, you can override them under special circumstances (for example, the patient has only one lung). ‘You control the AEC settings from the AEC panel, as shown below. pinnae ‘To'solect detector fields in an jon chamber, cc one of these (to deselect, cick again) ‘To enable AEC, click here lodisable, click again) To increase or decrease the density, click one of these Indicates when detector elds inan ion chamber are selecled You can select AEC detector fields in each ion chamber individually or in any combination, You can vary the density setting between +5 and -5 (0 is neutral). ‘To change the density setting, click on the up or down arrow button in the AEC Density panel, as shown above, Each change in the density setting from 0 increases or decreases the density by 12.5%, as indicated in Table 3-1 on page 3-15. Additional Operations> CAUTION Directftay Console User's Guide Table 3-1. Density Settings, As Percent of mAs Density Setting Percent of mAs +5 162.5% 4 150.0% 3 137.5% +2 125.0% +1 112.5% 0 100% -l 87.5% 2 75.0% 3 62.5% 4 50.0% 5 315% If the AEC system attempts to exceed the backup mAs limit setting, the exposure is ‘terminated and the message AEC BACKUP MAS is displayed in the X-ray Generator status panel of the main screen. Selecting the Focal Spot Size Note: Ifa technique is selected that is not ‘compatible with the tube and ‘focal spot, the system inhibits ‘exposure and displays an overload condition. An overload condition may exist ifthe technique selected exceeds the maximum or is below the minimum allowable X-ray tube focal spot rating. The tube parameters are ‘consistent with the X-ray tube ‘manufacturer's rating charts Additional Operations ‘To select a focal spot, click on the corresponding button. The selected button lights and the size indicator (small or large) is displayed. Frearsto =e 3415DirectRay Console User's Guide Selecting the Patient Size To select a patient size, click on the icon for the required size—Small, Medium, and Large (shown below). The selected button is highlighted by a white border. | a Se aie Heat Units Status Note: ifheat units exceed the ‘The current heat units (HU) percentage is displayed in the Technique panel, recommendation of the X-ray _ as shown below. ‘ube manufacturer. a warning ‘message displays and an 1 pa aaa SE” my ich arene, CTT ‘you ofthis condition. You will = aEH inot be able to take more sures until the tube cools 1 Heat units % ee ose 346 Additional OperationsDirectRay Console User's Guide @ Working with Acquired Images ‘Additional Operations You can do the following tasks related to an acquired image being displayed in the Image Preview window: + Rotating or mirroring the image, * Verifying the assigned image laterality and patient orientation, and correcting them if necessary. * Cropping the image. + Selecting the sheet format. + Using the True Size helper. * Using a mask to outline the image. * Adding markers to the image. * Selecting the ESA or IT image processing method. * Changing the look-up table (LUT) curve of the image to change its appearance. * Adding a comment to an image, which is sent with the image to DICOM workstations. 347DirectRay Console User's Guide The DirectRay Digital Marker fF] A DirectRay logo is printed on each bucky, to indicate the upper left comer fi “of the bucky in portrait mode. During acquisition, a digital DirectRay a marker is added to the corresponding corner of the image. This is done to assist you with relating the bucky and image orientations. In this way, if the image is rotated or mirrored, you can tell what the original orientation was. The following examples show how the DirectRay marker (circled) moves with the image when rotated or mirrored, Also, if an image is cropped or masked, the marker is automatically moved to ensure that it will remain in, the printable/viewable area of the image. Image Retated Image Cropped 318 ‘Additional Operations) DirectRay Console User’s Guide Rotating the Image ‘You can rotate the image in 90° increments clockwise or counterclockwise, using the two Rotate buttons in the Options pane, as shown below. To rotate 90° counterclockwise, lick here To rotate 90° clockwise, ick here ore | t It is recommended that, ifthe image is rotated, you use markers to designate either left or right rotation. For information on how to add markers, refer to “Adding Markers to an Image” on page 3-32. Mirroring the Image ‘You can mirror an image (that is, flip it on its vertical axis), using the Mirror button in the Options pane, as shown below. ‘To mirror the image, click here 520 ona If you mirror an image, you are required to use a marker—you will not be able to accept the image unless a marker is added. For information on how to add markers, refer to “Adding Markers to an Image” on page 3-32. Note that during system configuration, a view can be configured so that when a corresponding image is captured, it is automatically mirrored. If this is the case, the message “Image Mirrored during Acquisition” displays in the Options panel. ‘Additional Operations 319DirectFtay Console User's Guide Verifying and Correcting the Image Laterality and Patient Orientation Settings Image Laterality 3-20 As an image is captured and displayed in the Image Preview window, itis assigned an image laterality and a patient orientation label, according to the DICOM standard. This assignment is based on the view you selected in the main window before taking the exposure. ‘You must always make sure that the assigned image laterality and patient orientation labels are correct. If they are not, you can change them using Pop-up menus in the Image Preview window. For patient orientation, you ccan also add a second label to the row and column labels displayed to the right and bottom of the image. In the DICOM standard, image laterality indicates the side of the body to which the anatomy in the image pertains. You can change the laterality setting using the pop-up menu at the bottom of the Image Preview window. impiety Ul ‘The following table lists the available settings. Table 3-2. Image Laterality Settings Setting Description R Image is of the right member of a bilateral anatomical structure (for example, the right hand). L Image is of the left member of a bilateral anatomical structure (for example, the left foot). B Image is of both members of a bilateral anatomical structure (for example, the lungs). u Image is of an anatomical structure that does not have a pair (for example, the spine). ‘Additional OperationsDirectRay Console User's Guide Patient Orientation Labels The DICOM patient orientation labels are intended to indicate the orientation of the patient for the exposure. The patient orientation labels can be printed as text on the printed sheet or displayed with the image at a view workstation. The DICOM standard defines the patient orientation label positions as row and column. In the Image Preview window, the row patient orientation label is displayed at the tight. The column patient orientation label is, displayed below the image, Column labet eo. s0808 | ‘Additional Operations 921DirectRay Console User's Guide From the Patient Orientation panel in the Image Preview window, shown below, you can: Change the current patient orientation labels using the two left pop-up menus. ‘Add a second row or column label using the two right pop-up menus. + Display a helper screen that shows figures to help you determine the patient orientation, ‘Select label from these ‘Select optional second label pop-up a ‘from these pop-up menus an SE These two column AR} —— aatigs etn is label below the image orientation helper screen, lick here: feet onaor 0. 0heer The following table lists the available orientation label settings. ‘Table 3-3. Patient Orientation Settings Setting Label A “Anterior = Posterior R Right L Left H Head F Feet ‘The names of the patient orientation pop-up menus are actually on a button. Click this button (called out in the previous illustration) to display the orientation helper screen. The helper screen is shown on the next page. ‘Additional Operations.DirectRay Console User's Guide Cropping an Image When an image has been exposed and is displayed in the Image Preview window, you can cop the image for output to a DICOM print or storage device. Also, your site may have the auto-cropping function enabled. When this, function is enabled, the system automatically applies cropping to the image, based on sharp density changes in the image. When you accept the image, the full image, along with any cropping information, is stored in the DirectRay Console. Also, the image displayed in the View pane] of the DirectRay Console main window is not shown. cropped. The cropping is performed at the DICOM output device. ‘Additional Operations 3:23DirectRay Console User's Guide To display the crop lines (if not already displayed), click the Crop button in the Options panel of the Image Preview window. il feser_| a Comments | roto semen sl ogee ena 1 | [3] [| come omc -_ or ‘Two pairs of vertical and horizontal crop lines display in the image area, as shown below. The cropped image is defined by the rectangle formed by the intersection of the four crop lines, The area that is cropped out of the image is covered by “blinds,” as shown on the sample on the next page. ‘To move a crop line, using the left mouse button, click and drag it to the desired position. ‘To remove the crop lines and not crop the image, click the Crop button again to toggle the cropping off. ‘You can also use auto-cropping with the mask function, for which cropping is automatically set to the outside dimensions of the mask. For more information, refer to “Using a Mask to Outline the Image” on page 3-29. "Blinds" covering ‘cropped area To change the cropping, <—~ es Fa click on and dag the erop fines css. 3:24 Additional OperationsCc DirectRay Console User’s Guide Selecting the Sheet Format Note: Ifyou choose one of the Sormats other than I up, image-related text is not printed on the sheet. ‘Additional Operations If one of the output devices included in the selected output setup supports printing multiple images on one sheet, the Sheet Format controls display in the Image Preview window. When you have selected a sheet format, the application automatically changes the True Size helper to indicate whether the image conforms to the size requirements of the format you have selected. Sheet Format CCick on the cel in which you. = ‘want to place the current image. ‘The selected position is shown in whit. Images already captured for the sheet are displayed ‘as thumbnails in their cell. Stetina sheet emt 4 from this pop-up list ‘To change the sheet format, choose another format from the pop-up list. Depending on the DICOM printer's capabilities, the available formats are: + Lup. Only one image on the sheet. The default setting for output devices that do not support multiformatting. + 2up-1 by 1. Two images are placed side-by-side. ‘+ 2up—1 over 1. Two images placed one over the other. + 4up-2x 2. Four images placed two over two.DirectRay Console User’s Guide Using the True Size Helper If you are sending the image to a printer that supports True Size, the True Size helper will display at the bottom of the Image Preview window. You can use the True Size helper to ensure that the image will print at its actual size on the output device. ‘The following table defines the different states of the True Size helper. ‘True Size Indicator _ Definition "Tree" ‘The image is the correct size for the sheet v format selected. ‘The image is oversized in both directions for the sheet format selected. The image is oversized in the horizontal direction for the sheet format selected. ‘The image is over sized in the vertical direction for the sheet format selected. 3:26 ‘Additional OperationsirectRay Console User's Guide The following screen shows an image that is oversized in both Gereew te [mio da SoM | paesouwemtn 61) 14 fees) Age This uncropped image is oversize in both directions Additional Operations. 327DirectRay Console User’s Guide The following screen shows an image that will print at True Size properly. Cropped portion of image {0 be printed or displayed ‘al the DICOM device canes oom “This image conforms to the requirements of the ‘output device 820,101.08 Sheet Formats and Auto-Cropping with True Size If auto-cropping hes been enabled and you have selected an output setup that includes a printer with True Size enabled, selecting a multi-image sheet format will cause the image to be cropped automatically. This ensures that the image will fit in the allotted image area on the printed sheet. You can change the cropping if you want. As you change the cropping, the ‘True Size helper will indicate whether the newly cropped image will fit in the area allotted to the image on the sheet. 3-28 ‘Additional OperationsDirectPlay Console User's Guide Using a Mask to Outline the Image Figure 3-1. Mask Outline Additional Operations, ‘The Mask function allows you to draw a four-sided polygon outline around ‘an area of interest in the image, then create a mask that blacks out all other portions of the image. To enable the Mask function, click on the Mask button as shown below. To enable the Mask function, click here co. sence With the Mask function enabled, the cursor changes to a cross hair. Using the left mouse button, click (not click-and-drag) at the four corners of the area you are masking. As you click the points, the lines of the outline display, as shown in Figure 3-1. Potygon outline of mask 3.29DirectRay Console User's Guide Once you click the fourth comer, the polygon outline completes and the mask is applied. All of the image area outside the mask changes to black, as shown in Figure 3-2. Figure 3-2. Masked Image Masking with Auto-Cropping 3-80 You can also use auto-cropping with the Mask function, for which cropping is automatically set to the outside dimensions of the mask. To enable the Mask with Auto-Crop function, click on the Mask/Auto-Crop button as shown below. Reset_| ‘To enable tho MasiW/Auto Crop function, cick here 0.808 With Mask with Auto-Crop function enabled, when you create the mask, the image is also automatically cropped to the outside dimensions of the mask. Figure 3-3 shows the image in Figure 3-2, but as it would look with the Mask with Auto-Crop function enabled. Additional OperationsDireciRay Console User's Guide Figure 3-3. aa Masked Image with ‘Auto-Cropping ye Undoing Rotating, Mirroring, Cropping, and Masking ‘To undo any rotating, mirroring, cropping, or masking you performed on the image, click the Reset button in the Options panel. The image is returned to state it was in when originally opened in the Image Preview window. To undo rotating, mirroring, cropping, and masking, click here Hf Conments| ‘Additional Operations 301DirectRay Console User's Guide Adding Markers to an Image You can add digital markers to the image to indicate its orientation, the urgency of the patient's condition, or for other reasons. Up to ten markers can be configured and up to three can be used on each image. The initials of the technologist who captured the image, taken from the technologists login account, are shown on the left side of the marker. Options || Reset f Senses) A lf;Lar [Foe | [evar [fuPrT Ss rs ‘To clear the markers a ‘on the image, lik here AE Tn Ea | ‘To add a marker to the image, click on the marker. The marker moves to the margin of the image and the marker icon in the Options panel is dimmed, as shown on the next page. 332 Additional OperationsDirectRlay Console User's Guide RTC EWEN T= Click on the marker, hold the left mouse button down, and drag the marker to where you want it placed on the image. The illustration on the next page shows two placed markers, Note that, if you attempt to place the marker in an area of the image that will not be printed, the marker is not placed and an error message displays. ‘To clear markers, click the Clear All Marks button. All the markers are Cleared from the image Additional Operations 3-33Ree Sarat ran oiiwa sear Gee NSP A DirectRay Console User's Guide eam | oem | cremate [eld “ Vem | paoentnenenon Cove F | |_| Tin beet | 334 Additional OperationsDirectRay Console User's Guide Selecting ESA vs. IT Image Processing Note: The IT function is ‘The DirectRay Console supports both Exam-Specific Algorithm (ESA) and ceptional and may not be Inverse Topography (IT) image processing methods to enhance the image installed a your location. based on the anatomy selected. During system configuration, a view's default image processing method is configured. You can change the method by clicking on the ESA or IT bution in the Image Processing panel, shown below. ESA and IT buttons: ‘currently selected one is shown depressed yy Click the Resend tab. 10 _ | Choose the Resend options you want to use. For a description of the options, refer to the table that follows this procedure, u Click the Resend button. 12 To close the resend function, click the Close button. Option Description Resend all Use this option when you wish to send all images. images for from a patient study. patient Resend selected Use this option when you wish to send a single or images for several images from a patient study. Patient Select all the required images by clicking on them. The border(s) turns blue. To deselect, click the image again. Setups Use this option to specify the devices to which you ‘want to send the images. Formats Use this option if you are printing multiple images to one sheet. Note: You must be sending the images to a printer to use this option. Print True Size Use this option when you are printing to a printer that supports True Size and want to print the image atts true size. 414 Managing the Image Output Queues and Resending ImagesirectRay Console User's Guide Option Description Print Ruler Use this of sheet, yn when you want to print a ruler on the Print Optimize Use this option when you want the destination Orientation hardcopy output device to adjust the image size and orientation to fit within its image area on the sheet at the largest size possible. Managing the Image Output Queues and Resending Images 415Chapter 5 Protecting Patient Records This chapter explains how to protect patients and their related images from being deleted by the system. Contents Subject Overview... Reclamation Strategy Procedure for Protecting a Patient Recor BtOverview DirectRay Console User's Guide Patient records and images are stored in the DirectRay Console CPU temporarily, until storage space begins to get low. Then, the system deletes the oldest patient records and images to make room for new ones. ‘The amount of storage space depends on the specific storage capacity configured for your DirectRay Console. Your Hologic service representative can tell you approximately how many images can be stored before reclamation begins. ‘You can protect patient records, and the related images, from being deleted as part of this reclamation process. You might want to do this if you will be creating new studies for the patient and want to avoid having to enter the demographic information again. Or, you may want to resend images to output devices. Reclamation Strategy Note: Image reclamation is independent of the patient record reclamation. Deleting images as part of reclamation does not cause the related patient record tobe deleted. Patient records tend to stay in storage longer than images. 52 ‘When the available storage capacity drops below a predefined level, patient records and images are deleted on a first-in-first-out basis. ‘When a patient record is due for deletion, the image spool is checked for images associated with the patient record to be reclaimed; then the following rules are applied: * Hany of the patient's images are in the image queue, the patient record is not reclaimed. + Ifany of the patient's images are in the reject bin, the patient record is not reclaimed. ‘+ If there are no images in the image queue or reject bin associated with the patient, and a patient’s study is not currently open, the patient record and related images are eligible for deletion. Images are deleted on a study basis. That is, once acquired images in a study have been sent to their output devices and the study is closed, the images in that study are eligible for deletion (unless the patient record is protected). This is true even if the study is incomplete (that is, images have not been acquired for all views in the related procedure). Protecting Patient RecordsCc jirectRay Console User's Guide Procedure for Protecting a Patient Record Note: Itis strongly To protect a patient record and the related images: recommended that you do not protect too many patient 5 records unnecessarily. The oe Tac system is nat intended to be 1 From the Admin menu, choose Protect Patients. «an archiving system. If 100 many images are protected from removal, you might run ‘out of space to store new images. ‘The Protect Patients window displays. 2. | Find the patient whose record you want to protect: + To search by patient name, click the Patient Name tab, enter the name in the search field, then click the Search button or press the Enter key. + To search by patient ID, click the Patient ID tab, enter the ID in the search field, then click the Search button or press the Enter key. Note: You can use the asterisk (*) character as a wildcard character 10 broaden your search. For example entering R*ph would return patients named Randolph and Rudolph. If using the wildcard ‘character, make sure you include at least one other character (that is, don't enter only an asterisk) t0 avoid creating a large listing of atients (up to the configured limit, the default is 50) which might take several minutes to complete. Note: When searching for names, they are stored in the system as LAST*FIRST’MIDDLE. Therefore, searching for the first name John requires preceding it with an asterisk (that is, *John). Also, search entries are case insensitive: you can enter upper or lower case letters. ‘The list of patients matching the search criteria that you entered displays (for example, refer to the following sample window). Protecting Patient Records 53DirectRay Console User's Guide a Piet Pens Pate Name Pao] Enter Patient Name (far wildcard __ por [Search Results: 2 entries i Tite a [PUBLICOHNNQ ‘3697 IM_—_(13800801 froet_| Che Step | Action 3 | Choose an unprotected patient record from the list (protected status. is “no”) by clicking on the patient name, then click the Protect button, ‘The patient record’s protect status changes to "yes" (protected). 4 | To.close the window, click the OK button Note: The buon label ‘To unprotect a patient record, follow the same procedure as above, toggles between Protect and except choose the protected patient record entry. Then click the UNProtect Unprotect. button. The patient record’s protect status changes to “no” (unprotected). 54 Protecting Patient RecordsChapter 6 Maintaining the DirectRay Console This chapter explains how to perform maintenance for the DirectRay Console. Contents Subject Overview... Daily Maintenane ‘Weekly Maintenanc Monthly Maintenance. Replacing the UPS Battery Reporting Unusual Condition: Calibrating the DirectRay DetectorOverview DirectRay Console User's Guide ‘System components require little special care. Normal care in handling and operating the equipment should ensure continuing satisfactory performance. ‘Some considerations for daily, weekly, and monthly maintenance of the equipment are provided here to prevent possible equipment damage or failure. Aso, this chapter describes how to calibrate the DirectRay Detector. Daily Maintenance ‘The DirectRay Console should be powered down once a day to ensure a complete system reset. For detailed instructions, refer to “Step 1: Powering Down the DirectRay Console CPU” in Chapter 2. tis also recommended that you power down the DirectRay Console if you are not going to use it for an extended period (for example, overnight). Weekly Maintenance 62 The DirectRay Detector should be calibrated once a week. For detailed instructions, refer to the topic “Calibrating the DirectRay Detector” on page 6-5. Maintaining the DirectRay ConsoleDirectRay Console User's Guide Monthly Maintenance A CAUTION Perform the following general preventive maintenance procedures on a monthly basis. The DirectRay Console must be maintained in good ‘operating order at all times to provide safe conditions for operating personnel and patients. Do not attempt mechanical or electrical repair of the DirectRlay Console equi Contact your Hologic service representative if any unit does not perform to your ‘satisfaction. Cleaning the Equipment Note: Follow your hospital's cleaning and decontamination policies and A CAUTION A CAUTION A CAUTION The exterior of the equipment can be cleaned with common hospital decontamination solutions that are acceptable for use with plastics or enameled metal. To apply the cleaning solution, power down the system and disconnect the power source. Then moisten a cloth with the solution and wipe down the equipment. Do not spray cleaning solution directly onto any part of the equipment. Instead, moisten a cloth with the solution and wipe it clean, Do not immerse the equipment in liquid, Do not autoclave the equipment. Maintaining the DirectRay Console 63DirectRay Console User's Guide Checking the Equipment Integrity ‘You should perform the following checks to ensure that the equipment is functioning and operating safely: + Ensure fastening hardware is tight, and that there are no missing or defective parts. + Ensure buttons and switches which are supposed to light, do. * Check that indicators and lights are working properly. + Ensure all switches operate smoothly. + Check all exterior painted or plated surfaces for evidence of deterioration. Ensure all name plates, legal labels, and warning labels, are legible and secure. + Ensure electrical cables, cords, connectors, and fittings are secure. Check all cables for abrasions and damage. Replacing the UPS Battery A WARNING ‘The battery inside the uninterruptible power supply (UPS) must be repiaced periodically. The information provided in the UPS manual about battery replacement is for reference only. Contact your Hologic service representative for UPS service and battery replacement. ‘The UPS battery must be replaced by an authorized Hologic representative, The UPS. battery contains lead and poses a hazard tothe environment and human health ifnot disposed of property. Maintaining the DirectRay Console\irectRay Console User's Guide Reporting Unusual Conditions Report any unusual equipment condition that occurs between periodic servicing to your Hologic service representative. Report any unusual noise, difficulty of motion, squeaks, malfunctions, or other problems with the equipment at your earliest convenience. Ifa failure occurs, it could speed repair if you can supply specific information to the service representative. Make a note of any unusual events prior to the failure. Also note the type of procedure in progress, as well as specific failure information. Calibrating the DirectRay Detector ‘You must calibrate the DirectRay Detector once a week. ‘To calibrate the DirectRay Detector: Note: Calibration must be performed at least one hour | _cSexeagesDateerime> ‘Text Une2: _erayNumelWptmastma> — | _ | _ > | Save) Cancel a Step | Action 6 | Configure the options you want, then click the Save button, ‘The Edit Outputs window displays again, Note: Changes 10 the configuration for an output device are reflected in all output setups using this output device, Ifyou wish to have a different device listed with different settings, contact Hologic service, 19DirectRay Console Administrator Guide Table 1. Configuration Settings for Printers Configuration Recommended Setting Setting Description Min/Max ‘Min = 20 ‘You can set the minimum and maximum density values to be Density 00 used for the hard copy. Use the arrow buttons to increase or decrease the displayed value. Magnification ‘The magnification factor at which you want the images to print. Note: Do not change this setting from its default unless directed to do so by an authorized Hologic service representative. Image Text ‘You can configure up to 3 image level annotations as one line Parameters of text at the bottom of the image. This works for all imagers, regardless of the number of annotation boxes supported. Copies ‘You can specify how many copies of the image sheet you want printed. Either type the number in the field, or use the arrow buttons to increase or decrease the displayed count. Text Lines For printers that support annotated text lines to be included on the sheet, you can use this set of pop-up menus to choose what you want to appear in the text lines. Note: When printing to a multiformat sheet other than 1 up, the text lines will only print on the sheet if they apply to all the images (for example, patient name or ID). If the text line applies to a single image (for example, kVp or ESA), it will not be printed.DirectRay Console Administrator Guide Maintaining Default Image and Rejection Comments ‘Note: fan image is being sent 10 a multi-format shee, the image comment is not printed on the sheet unless it is chosen as an “Image Text Parameter.” amage Queues Protect Paints Set Patent Comment Defaults Catbrate Reject Maragement Delete Pasients Set Specal Parameters Spool Management DR Device Control Ifa user rejects an acquired image, the user can enter text comments to explain the rejection. Users can also enter comments about the image currently displayed in the Image Preview window. Image comments are added to the patient record. They are sent with the image data to any DICOM devices that have been selected as an output destination, To save the user from having to enter frequently-used comments, and to ensure some consistency with those comments, you can enter and save several default rejection and image comments. These default comments are then available to users in the Image Rejection Information window, and in the Image Comment Entry window. To set up default comments, open the Admin menu and select Set Patient Comment Defaults. The Rejection/Image Comments window displays. As shown on the next page, this window has two tabs: one for setting the rejection comments, and the other for setting the image comments. The comments on your windows will be different. In the Reject window, the user is also given the option of entering a reason in a free text box. This free text box is not shown when setting up the default comments. Type the default comments in the available fields. When you are finished entering comments, click the Aecept button to save them and close the window. aDirectRay Console Administrator Guide falcon Care naga Coen] Rejection Comments 2 Reems ae EY ‘ssn Care ate Cor “Image Comments DR i {bg 1S aDirectRey Console Administrator Guide Resending Accepted Images to Output Devices Note: Images are not stored indefinitely. To ensure that there is absays sufficient room to store newly acquired images, the system deletes the oldest images as needed 10 reclaim storage space. However, you can protect specific pation images s0 that they will not be deleted, Refer to Chapter § of the DirectRay Console User's Guide for more information. [Aare rage Queues Protec Fatens Sa Pant Comment Dette Cattvte eject Maragerent Delete Patent SetSpecel Franeters Spool Management DR Davie Cont ‘The Resend function enables you to view thumbnails (small versions) of images previously accepted for a patient and then resend the images to one or more specified output devices. In addition to the images, the original patient information, comments, and text annotations are sent To resend accepted images: Step Action 1 | Open the Admin menu and select Spool Management. ‘The Choose a New Patient window displays 23.DirectRay Console Administrator Guide Step | Action 2 | Toseareh by patient name, click the Patient Name tab, enter the tame in the search field, then click the Search button or press the Enter key. To search by patient 1D, click the Patient ID tab, enter the ID in the search field, then click the Search button or press the Enter key. The list of paticnts matching the search criteria that you entered displays (for example, see the following sample window). For patients who have multiple studies, an entry is listed for each patient/study combination, Note: You can use the asterisk (*) character as a wildcard character to broaden your search. For example entering Rph would return pationis named Randolph and Rudolph. If using the wildcard character, make sure you include at least one other character (that is, don’t enter only an asterisk) to avoid creating a large listing of patients (up to the configured limit, the default is 50) which might take several minutes to complete. Note: When searching for names, they are stored in the system as LAST*FIRST"MIDDLE. Therefore, searching for the first name John requires preceding it with an asterisk (that is, *John). Also, search entries are case insensitive; you can enter upper or lower case letters Choose A New Patt Pir Nae Paani] emer Fane Nae for wd aera roe i oe ot JpuBLicyoRNA. 764s Mipte%90% puBLicyoHn'g sr HM 3s80901 24DirectRay Console Administrator Guide Step | Action 3. | To choose a patient from the list, click on the patient entry. ‘The Spool Management window is displayed, including the thumbnails (minimized views) of the images, and related patient and image information, as shown below. Speak Wanagent Yor mse users Sealnson 139% heats A Nee Pee | JPacene Name: PUBLICOHNQ inege PA | [Proceczad: No. Capeure: 20021114 ae 142987 . 3867 ‘Tech person [Don 19580801 Accepted As ESA Imges 7 Comments: Vie: 7786788 Sede CHEST. EWS PALAT Step | Action 4 | If not already displayed, click the Resend tab at the lower right panel of the window. 25DirectRay Console Administrator Guide Step 5 10 Action To send specific images, click on the image thumbnails to choose them, then click on the Resend selected image(s) checkbox option. Note: To unselect an image, click on it again. To send all images for the patient, click on the Resend for patient checkbox option. images Choose an output setup from the Setups drop-down list to specify the devices to which you want to send the images. ‘Ifyou are printing multiple images to one sheet, choose the sheet format from the Formats drop-down list. Note: You must be sending the images to a printer to use this option. ‘Choose the other print options you want to use. Refer to Table 2. Click the Resend button to transmit the images. ‘When you are done resending images, click the Close button to close the window. Table 2. Resend Options Description Print True Size Use this option when you are printing to a printer that supports True Size and want to print the image at its true size. Print Ruler Use this option when you want to print a ruler on the sheet. Print Optimize Use this option when you want the destination Orientation hardcopy output device to adjust the image size and orientation to fit within its image area on the sheet at the largest size possible. To resend another patient’s images, click the Choose a New Patient button in the Spool Management window to redisplay the Choose a Patient window. Then start at step 2 of the previous procedure. 26DirectRay Console Administrator Guide Repreviewing Accepted Images ‘You can use the Repreview function to view and adjust the appearance of an image that has already been accepted, in preparation to resending the image to output devices. You can perform all of the image enhancement — functions available in the Image Preview window wher an image is Adon originally acquired, including cropping, image rotation, mirroring, and rage Goes adding markers. Prec Pi Set Pint Comment Daal: ‘To repreview an image: Cave Reject Paemgenent Step | Action Ode nen — 5 Sassen | 1 | Open the Admin menu and select Spoot Management Spool Management ‘The Choose a New Patient window displays. OR Davie Contre peers Pen: Name lent Nae (fr wear [search Results ami] 2DirectRay Console Administrator Guide Fase Ne PD] Enter Patient Name (for wierd): es or Rete ets JucyouNea rusucyounng 2 | Locate the patient record: + To search by patient name, click the Patient Name tab, enter the ‘name in the search field, then click Search or press the Enter key. + To search by patient ID, click the Patient ID tab, enter the ID in the search field, then click Search or press the Enter key ‘The list of patient records matching the search criteria that you centered displays (for example, see the following sample window). Note: You can use the asterisk (*) character as a wildeard character 10 broaden your search. For example entering Rph would return patients named Randolph and Rudolph. If using the wildcard character, make sure you include at least one other character (that is, don’t enter only an asterisk) 10 avoid creating a large listing of patients (upto the configured limit, the default is 50) which might take several minutes 10 complete. Note: When searching for names, they are stored in the system as LAST*FIRST*MIDDLE. Therefore, searching for the first name Jolin requires preceding it with an asterisk (that is, *John). Also, search entries are case insensitive; you can enter upper or lower case letters Ghaoes A New Patent 785 mM 19760509 807 ™ 19500901 28Step DirectRay Console Administrator Guide 3 Action Choose the patient record from the list by clicking on it. The images for that patient display as thumbnails in the Spool Management window. not already selected, click the Repreview tab. Click on the image you want to repreview. | Ghent Anemia Potlene Name:PUBLICNOHNAQ Protected No 1: 687 9590901, 7 77a87e6 ‘CHEST 2 VIEWS PAJLAT ‘anager ‘peslUsiaten 13% ‘The details pertaining to the image display in the upper-right panel. image ®A | pure: 2000114 ae 142857 | eek person | Accepted Aa ESA | Commence \ 29DirectRay Console Administrator Guide Step | Action 6 | Click the Repreview button ‘The Repreview window displays. The image is displayed with the options (rotate, mirror, cropping, masking, markers, image laterality, patient orientation) and image processing settings as they were set when the image was accepted. Gee bel | iva te Pay cons + | | Soues ae Ae EI} of ‘Feet Pestenor | | afer iT iain ud | | jE hea) Soc ei aa | Ip Toate Ose ES | 30DirectRay Console Administrator Guide Step Action ‘Make any changes that you want to the image. The changes that you make are applied to the original raw image data, just as they were when the image was first acquired. The functions in this window are the same as in the Image Preview window. For more information on them, refer to Chapter 3 of the DirectRay Console User's Guide. To save your changes, click the Save button. ‘The image is saved as a new image and added to the list of images in the Spool Management window. From this point, you can select the image and send it to output devices, as described in “Resending Accepted Images to Output Devices” on page 23. Deleting Accepted Images Note: Ifthe reject bin fills up anda user rejects an image, a window will be displayed at the DirectRay Console interface telling the user that images in the reject bin must be deleted. Admin: Manage Queues rote iene Set ent Comin Deus Caibate ‘Rejetbamgsne Dales sens SetSpacl rameters Speck Mangement DR Devs Contr od If the system has not been configured to automatically delete accepted images, you should periodically check the spooled image bin capacity. If the capacity is starting to get close to full, you should delete some images. ‘The Spool Management window has a Spool Utilization indicator that displays a percentage of how full the spool bin is. If the capacity is starting to get close to full, you should delete some of the rejected images. To delete accepted images: Step 1 Action Open the Admin menu and select Spoo! Management. The Choose a New Patient window displays. 31DirectRay Console Administrator Guide Fevers Reman er Pee Nae (fr wider rch Resse 32DirectRay Console Administrator Guide Step | Action 2 | Locate the patient record: + Tosearch by patient name, click the Patient Name tab, enter the name in the search field, then click Search or press the Enter key. + To search by patient 1D, click the Patient UD tab, enter the ID in the search field, then click Seareh or press the Enter key. The list of patient records matching the search eriteria that you entered displays (for example, see the following sample window). Note: You can use the asterisk (*) character as a wildcard character 10 broaden your search. For example entering Rph would return patients named Randolph and Rudolph. if using the wildcard character, make sure you include at least one other character (that is, don't enter only an asterisk) to avoid creating a large listing of patients (up t0 the configured limit, the default is 50) which might take several minutes to complete. Note: When searching for names, they are stored in the system as LAST*FIRST’MIDDLE. Therefore, searching for the first name John requires preceding it with an asterisk (that is, "John). Also, search entries are case insensitive; you can enter upper or lower case letters. Prien Nome Fale ner Pacer Nar (or mideard): [scar Resulr 2 enres ee patos ee 7 PoRucHORNA ‘sus cc) AoHNe sr 4 esem1 33DirectRay Console Administrator Guide Step | Action 3 | Choose the patient record from the list by clicking on it. ‘The images for that patient display as thumbnails in the Spool ‘Management window. 4 | Ifnot already selected, click the Delete tab. —Seinsrmaionnperaes ee 13% ——— choo Ae [Fre nanerUELeyoHNG Proceed” No Capare 2000111436 12987 b er Seti prsnt [poe 19se001 accepted Ae SA ead eonenent Va 706786 | [seu CHEST2 views PayLATDirectRay Console Administrator Guide Action To delete selected images from the current patient record, click on the image thumbnails to choose them, then click the Deleted Selected button in the Delete tab. Note: To unselect an image, click on it again. To delete all images for the current patient record, click the Delete All for Patient button in the Delete tab. ‘When you are done deleting rejected images, click the OK button to close the window.DirectRay Console Administrator Guide Performing Reject Image Management ~ This function allows you to manage the reject image bin. You can: + Send rejected images to output devices + Delete images ‘You can view images of patient. The function includes: + A search tool to help you find the patient + Navigation buttons to allow you to scroll through the patient’s images in the reject bin ‘The images are identified by a thumbnail (minimized view) of the image, and by the following patient parameters: + Patient Name * Patient ID + Patient birth date + Visit number or study ID + Time and date of acquisition There is a configurable auto-cleanup of rejected images based on the length of time the images have been in the reject bin. This function is configured ta.) by a Hologic service representative. Checking How Full the Reject Bin Is Note: fhe reject bin fills yp If the system has not been configured to automatically delete rejected ‘and a user rejects an image, a images, you should periodically check the reject bin capacity. If the window will be displayed at ard i Rp oe capacity is starting to get close to full, you should delete some images. imerface telling he user that The Reject Management window has a Reject Bin Utilization indicator that images in the reject bin must displays a percentage of how full the reject bin is. be deleted. If the capacity is starting to get close to full, you should delete some of the rejected images. For information about how to delete rejected images, refer to “Deleting Rejected Images” on page 47. Selecting Rejected Images You can select which rejected images to view in two ways: + By patient * By tech-level user With the desired rejected images displayed, you can then send them to output devices or delete them. fan)~ DirectRay Console Administrator Guide Selecting Rejected Images by Patient Aden Manage Queves Protect aban ‘Set Paient Comment Dees calibrate | Raye Maagaraat Diet Pinte Set SpecalParametare Spook Management i Devies Const To display all of the rejected images related to a particular patient: Step | Action 1 | Open the Admin menu and select Reject Management. The Reject Bin Management window displays. Rect in ar agen Aejer Bo Uitnton 53% [TT ty neat ia | [Ne image selected | one Dette Seta | Dele alr Pe i | | S| Tre | 37DirectRay Console Administrator Guide Step Action Click the Choose a New Patient button. ‘The Choose a New Patient window displays. ‘Choose A New Pave Pace Na ar] re Puen Nam wird)Paes Nave Pil rer aire Name fr ward F rch Resi anion [PusticryoHNNg DirectRay Console Administrator Guide Action To search by putient name, click the Patient Name tab, enter the name in the search field, then click Seareh or press the Enter key. To search by patient 1D, click the Patient ID tab, enter the ID in the search field, then click Search or press the Enter key. ‘The list of patients matching the search criteria that you entered displays (for example, see the following sample window). Note: You can use the asterisk (*) character as a wildcard characier to broaden your search. For example entering Rph would return patients named Randolph and Rudolph. if using the wildcard character, make sure you include at least one other character (that is, don't enter only an asterisk) to avoid creating a large listing of patients (up to the conyigured limit, the default is $0) which might take several minutes to complete Note: When searching for names, they are stored in the system as LAST*FIRST*MIDDLE. Therefore, searching for the first name John requires preceding it with an asterisk (that is, *John). Also, search entries are case insensitive; vou can enter upper or lower case letters. Choose A New Patent fe 19687 | a {9580901 39)DirectRay Console Administrator Guide Step 4 Action To choose a patient, click on the entry. ‘The Choose a Patient window closes, snd the Reject Bin ‘Management window opens. displaying the thumbnails (minimized views) of the images, and related patient and image information. zee Racin Heapement Shoot ANewfaiom | _RaectedleageRaport | _Dubte AtRejected Iagez RepattinUilnton $38 = —DirectRay Console Administrator Guide _=~ _ Selecting Rejected Images by tech-Level User To display rejected images, listed by tech-level users who rejected them: Step | Action anage Queues 1 | Open the Admin menu and select Reject Management, Protest atians Getfebent Comment ebauts The Reject Bin Management window displays. cbrate | RefectMamagement TaRITT ARETE Delete vente pe SetSpedil Parameters ReeBouimion Si SpoclMirogement | Rejcesiage Report | _ Oe tReet ager | DR Dies Control INo image selected] r ore | Canwsined| Oaverterrna| — | - 4aDirectRay Console Administrator Guide Step | Action 2 | Click the Rejected Image Report button ‘The Choose a New Patient window displays, prompting for an operator login name. Step | Action 3 | Enter the login name of the tech want to view. logist whose rejected images you Note: You can use the asterisk (*) character as a wildcard character instead of typing the full name. If using the wildeard character, make sure you include enough characters (that is, do not enter only an asterisk) to avoid creating a large listing of technologists (up 10 the configured limit, the default is 50) which might take several minutes to complete 4 | Click the Search button, ‘The system searches for and displays all rejected images for the specified technologist 42DirectRay Console Administrator Guide = Choose A New Patient ‘jecced images] leneer operator name (for wileard) Pp - faaiowa tenia ie a. ue L sea 91244 2638 lina ‘ese ‘133821 Step Action S| Youhave three choices: + Click on the row to display the rejected images from a study. ‘The rejected images display in the Reject Bin Management window, shown on the next page. + Choose another tech-level user in the Choose a New Patient window by entering the login name in the Enter operator name field and clicking the Seareh button. + Close the Choose a New Patient window by clicking the Close button. 43.DirectRay Console Administrator Guide RayetBe Lenten 53% [TT Chocse ANwateat | _AdeceinageRepor | Delete AL Reece Inge | lame INQ noma:DirectRay Console Administrator Guide ie Sending Rejected Images to Output Devices To senda Step I rejected image to output devie Action Display the desired rejected images, using the procedure in either “Selecting Rejected Images by Patient” on page 37 or “Selecting Rejected Images by tech-Level User” on page 41 ‘The Reject Bin Management window displays. If not already displayed, click the Resend tab at the lower right panel of the Reject Bin Management window. “Rojec Gin Management Fagen 5% -———— |) Cheote Aw uGant | _Raecad mageReport | _ Dene Reece mages | Patient Name: PUBLICNOHN"Q ~ [image LAO Preeeaed No Copare 200211 158003 © fr eth person Doe Tsse01 petepeed Re unknown frmges: 9 Cmmen Prematoreexpoueremiaten vee Frasit - [sete Rasa ar crest scomis | | | see one il ret | forms up 4) Lh as sa mDirectRay Console Administrator Guide Step | Action 3 | Tosend specific images, click on the image thumbnails to choose them, then click on the Resend selected image(s) checkbox option. Note: To unselect an image, click on it again. To send all images for the patient, click on the Resend all images {for patient checkbox option. 4 | Choose an output setup ftom the Setups drop-down list to specity the devices to which you want to send the images. 5 | Ifyou are printing multiple images to one sheet, choose the sheet format from the Formats drop-down list. ‘Note: You must be sending the images to a printer to use this option. 6 | Choose the options you want to use. Refer to Table 2. 7 | Click the Resend button to transmit the images. 8 | When you are done resending images, click the Close button to close the window. Table 2. Resend Options Option Description Print True Size Use this option when you are printing to a printer that supports True Size and want to print the image at its true size, Print Ruler Use this option when you want to print a ruler on the sheet. Print Optimize _Use this option when you want the destination Orientation hardcopy output device to adjust the image size and orientation to fit within its image area on the sheet at the largest size possible.DirectRay Console Administrator Guide ~~ Deleting Rejected Images You can delete a rejected image, as long as the image is not related to a protected patient. To delete a rejected image: Step | Action 1] Display the desired rejected images, using the procedure in either “Selecting Rejected Images by Patient” on page 37 or “Selecting Rejected Images by tech-Level User” on page 41 The Reject Bin Management window displays. If not already displayed, click the Delete tab at the lower right panel of the Reject Bin Management window zi Rect Bin Management gern tewen 5385 ————— let Report | _Oeioe AERepected men | {Padeie Name:PUBLICHOHN' INo mage seezted} Preeected: No ©: 8687 Cc Dos, 19580501 wage ae a Daescuct) Doverserneer| | 47DirectRay Console Administrator Guide Step 3 Action To delete all of the images in the Reject Bin, click the Delete All Rejected Images button at the top of the window. This will empty the entire Reject Bin of all images forall patients. The Reject Bin Usilization indicator should now read 0%. To delete selected images from the current patient record, click on the image thumbnails to choose them, then click the Deleted Selected bution in the Delete tab. Note: To unselect an image, click on it again. To delete all images for the current patient record, click the Delete All for Patient button in the Delete tab. ‘When you are done deleting rejected images, click the OK button to close the window. Deleting Patient Records You can choose to delete patient records and their images before the reclamation process does. Note: Under normal use, you should not need to delete patients as reclaim will do it ‘automatically. To delete a patient record and related images: Step Action [Rareia erage Queues Protect sents Set Patient Comment Dette Colbrate Reger tirmgement | Dede Paverts Set Spec Prameterr Soot Maragement OR Denes Cantal 48 1 ‘Open the Admin menu and select Delete Patients ‘The Delete Patient window displays. atc aT feces areDirectRay Console Administrator Guide Step 2 Action Locate the patient record: + To search by patient name, click the Patient Nametab, enter the name in the search field, then click Seareh or press the Enter key. + To search by patient ID, click the Patient ED tab, enter the ID in the search field, then click Seareh or press the Enter key. ‘The list of patient records matching the search criteria that you entered displays (for example, see the following sample window). Note: You can use the asterisk (*) character as a wildcard character to broaden your search. For example entering R*ph would return patients named Randolph and Rudolph. If using the wildcard character, make sure you include at least one other character (that is, don’t enter only an asterisk) to avoid creating a large listing of patients (up to the configured limit, the default is $0) which might take several minutes to complete. Note: When searching for names, they are stored in the system as LAST*FIRST*MIDDLE. Therefore, searching for the first name John requires preceding it with an asterisk (tat is, John), Also, search entries are case insensitive; you can enter upper or lower case lesrers 49DirectRay Console Administrator Guide Step 3 Action ‘Choose the patient record from the list, then click the Delete button. ‘The system prompts you to confirm the deletion, as shown below. Bae Fane’ saelinaes @ Areyousure you want to delete gatent Dowt ane” A.? Ye No aoc To delete the patient record, click the Yes button, To cancel deleting the patient record, click the No button. ‘When you are finished deleting patient records and want to dismiss the Delete Patients iow, click the OK button.DirectRay Console Administrator Guide c@ Entering Patient Data to the DirectRay Console ' from a Remote PC Users can enter patient and exam data to a DirectRay Console application's database from a remote PC using a web browser, if the PC is properly configured. This allows users at the site to populate the database with patient records. The following topics explain how to configure the remote PC to support this function. What Is Required on the PC The PC must have the following: + Minimum system configuration: Pentium 166 processor or higher; 64MB of RAM. + Windows 95/98 or NT 4.0 wiservice patches + Aweb browser: Netscape Communicator 4.7. The PC must be configured to support TCP/IP communications, as follows: + Direct connection to the same TCP/IP-Ethemnet subnetwork that the co DirectRay Console is on (which requires an Ethernet card and the necessary TCP/IP software). + The IP address and host file name of the DirectRay Console CPU must be defined in the local PC's hosts file. The format of this file is: [P address] [host alias) Also, the DirectRay Console application must be running to enter data. Checking Whether the Distributed Name Server Is Used If Distributed Name Server (DNS) és used at your site, or the remote PC to be used is connected to a network with a DNS server, you must contact the local IS agent with the host name of the DirectRay Console CPU to which you want to connect. ‘You also have to disable DNS on the remote PC before creating a host file for the remote PC, Go to “Disabling the Distributed Name Server” on page 52. IfDNS is not used, you must create a hosts file and save it on the remote PC. Go to the topic “Creating a Host File for the Remote PC” on page 53. stDirectRay Console Administrator Guide Disabling the Distributed Name Server To disable DNS: Step _| Action 1 | Open the Start menu and select Settings>Control Panel. ‘The Control Panel window displays. 2 | Double-click the Network icon. ‘The Network low displays. 3 | Inthe network components list, choose the TCP/IP component used by the PC, then click the Properties button. ‘The TCP/IP Properties window displays. 4 | Choose the DNS Configuration tab. 5 | Record the following information (as you will have to restore it after the patient entry sessior + Host + Domain + DNS Server Search Order + Domain Suffix Search Order 6 | Choose the Disable DNS option, then click the OK button. ‘The window closes. 7 | Click the OK button to close the Network window. 8 | Restart the PC. ‘Now go to the next topic to create a host file for the remote PC.DirectRay Console Administrator Guide Creating a Host File for the Remote PC. To create a host file for the remote PC: Step dl 2 | Enter the DirectRay Console CPU's IP address, a tab character, then the host alias for the CPU. For example: 192.160.1.2 drocts 3. _ | Save the file in the appropriate directory on the C: drive for the version of Windows running on the PC (refer to the appropriate ‘Windows documentation), using the name hosts. If you need help with this, contact the site's network administrator. 4 | Restart the PC. Users can now run the remote patient entry session on the PC. Running a Remote Patient Toruna Step 1 2 Entry Session patient entry session from a remote PC: Action Start the web browser on the PC. Point your browser to the URL of the remote DirctRay Console, followed by 8080; for example: 192.168. +8080 ‘After your session connection completes, a logon dialog box displays. Log on with the username dbentry and the appropriate password. ‘The Patient Demographic window displays at the PC. ‘Note: Depending on the PC's system configuration, it can take from 510 15 minutes to load the session application. Enter the patient dataDirectRay Console Administrator Guide Step | Action 4 | Click on the Edit Procedures link: ‘The Software Configuration page displays. 5 | To choose the procedure whose view ames you wish to edit, click. on the procedure pop-up menu and select the procedure, ‘Ano conan cas HORDECUS) ‘ARDONENTRLAT- URUOHTORDERES ‘ASDONITO cOSTRUCTON 2 jsnoweisnote EW oD Netscape! Adrt pee eee Sree SO re. WLATERAL HS ‘Administration Tools = eee HOLO Gia sen cmon ee con — ae Yen itet ie mo i te SUE HORT. Shisaea ee a Sas er anaicer — “Repoopures evs me Sromsionne.cocmieiay erates Smart cove Wal son Somer romaine i -L0t spe momcc? newsDirectRay Console Administrator Guide Step | Action 6 | Click the Edit This Procedure button. roc Scher Cenigesi ‘hig ttn eons 5 i a ee 8IQ0E Mane Fee Pacuest iin [jee xa |e oH) wo uy cg eden | an pescosndena ead Step | Action 7 | Make the desired changes in the name fields. ‘The views for that procedure display.DirectRay Console Administrator Guide Action Step ‘When you have made the changes, click the Update Changes button. ‘The updates are saved and the Software Configuration page display’s the changes. [Af Diode noe fig TREY tron gen 7] “Ein Z Sonne dene 2 Yeon Pees Dorcas “eons Administration Tools | HOLOGIC Configuration proc | samare angen ining headers Nate: Youstleeo igo aloe aga at he GS he ange eta tet UpteDS | Scepter ee de We en B09 208 | e2uQUe Nae: | | | AavCoMP uPA EST RET sons ‘augue Step | Action 9 | Exit Netscape. 10 | Log out of the operating system. 11 | Log in to the operating system. ‘The changes are reflected in the procedures the next time a user runs the DirectRay Console user application 58DirectRay Console Administrator Guide ~~ Changing the Admin Password To change the Admin password: Step Ac Launch your Netscape browser. The Netscape browser opens. Enter the URL of the DirectRay Console followed by 8080; for example: 192,168.1.2:8080 Log in as admin with the appropriate password. ‘The Administration Tools page displays. 4e8 3 ston Ieee Dre Aarts AL 5960 DirectRay Console Administrator Guide Step Action Click on the Change Password link. ‘The Change Password page displays. HOLOGIC ‘The password must be alphanumeric only and atleast 4 charactersin length. Action Enter the new password and press the Tab key. Note: An asterisk (*) character displays for each character you ‘enter to protect the privacy of the password. Enter the new password again, Note: This is required, since you cannot see what characters you are typing, to verify that you are entering the password correctly. Click the Submit Information button. ‘The password is changed and you must use the new password the next time you log in to the Netscape browser as admin.DirectRay Console Administrator Guide - Creating the Rejected Images Report ‘To change the manager password: Step Action Launch your Netscape browser ‘The Netscape browser opens. Enter the URL of the DirectRay Console followed by 8080, for example: 192.168.1.2:8000 Log in as admin with the appropriate password. The Administra Tools page displays. eDirectRay Console Administrator Guide Step Action Click on the Reject Bin link. ‘The Image Rejection Report page displays. bs a neat Ee ieee eBlog bnrewes pFALente GT Prete Zio hae ngs tort 5 en Dee Thee Pete vee Peon, | pane aha a6 ARDSMEWEACHEST URINE, ans ‘Action From the File menu, choose Print or click the Printer icon on the top menu bar. ‘Select the printer and any other options required and click the OK button. The Rejected Images Report is printed.DirectRay Console Adi ( Creating a New Pixel Map ” During the calibration function, described in Chapter 6 of the DirectRay Console User’s'Guide, mgr-level users have the option of creating a new pixel map of the DirectRay Detector. The pixel map indicates which pixels in the Detector’s array might not be reading X-ray densities correctly and so should be ignored when the image is acquired. This is similar to a bad spot map for a computer's hard disk. A new pixel map should be created when an excessive amount of pixel dropout is occurring repeatedly on images displayed in the Image Preview window. Do not create a new pixel map unless the DirectRay Detector and Controller have been on for at least 3 hours. CAUTION po not create a new pixel map if Temp 4 or Temp 2 exceed 33°C. You can check these temperature readings by opening the Admin menu and selecting DR Device Control. If either temperature exceéds 33°C, contact Hologic service. To create a new pixel map: Action Ensure everyone is out of the X-ray room. 2 | Inthe DirectRay Console application's main window, close any ‘open study and ensure that no patient is selected. 3 | Remove the grid from the bucky. 4 | Place the X-ray tube and bucky in the Chest scanning position [183 em (72 in.) or greater], and in Portrait orientation. 5 | Open the collimator to ensure full coverage of the bucky, and make sure there are no lead markers or other items in the beam path. 6 | From the Admin menu, choose Calibrate. The Calibration Test panel displays. 7 | Setthe technique settings as described in the instructions displayed in the Calibration Test panel. 8 | Click the Create New Pixel Map button. You are prompted to confirm that you really want to create a new ixel map.DirectRay Console Administrator Guide Step 10 n 2 Action Click Yes to confirm the pixel map creation. ‘The Calibration panel displays, but now its title is “Calibration— New Pixel Map”: There are two buttons: Begin Calibration ‘Sequence and End Calibration. Take an exposure. ‘The Calibration window with the flat field image displays. Make sure that the image is a continuous tone with no anomalies. + Ifthere is a problem with the image, reject it and take another ‘exposure + If the image is acceptable, the Accept button. The new pixel mapping process begins. Its status is indicated in the ‘Status bar at the bottom of the main window (for example, “DRAC is creating a new. pixel map ...”). The process takes about 20 minutes. ‘When the process is complete, a message indicating the status of the new pixel mapping is displayed. Also, there are two buttons: Back to Calibration and End Pixel Map. Click the End Pixel Map button, restart the DirectRay Detector and Controller (refer to Chapter 2 of the DirectRay Console User's Guide), and then run a normal calibration. Note: If an error is reported during the pixel mapping Process, restart the system and contact Hologic service.bala satiny aE ynat © pei