ARIA Radiation Therapy Management 16.0 DICOM Import and Export Reference Guide

DICOM Import and Export
Reference Guide
ARIA® Radiation Therapy Management
P1034778-002-B DECEMBER 2019

Legal Information
Publication ID
P1034778-002-B
Publication Title
DICOM Import and Export Reference Guide
Abstract
This publication provides reference information and procedures for using the DICOM Import and Export release version
16.0.
This publication is the English-language original.
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Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the
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CAUTION: US Federal law restricts this device to sale by or on the order of a physician.
2 DICOM Import and Export Reference Guide

WHO
ICD-O codes and terms used by permission of WHO, from:
● International Classification of Diseases for Oncology, Third Edition.
ICD-10 codes and terms used by permission of WHO, from:
● International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10).
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The link to the current EU REACH SVHC disclosure statement can be found at
http://www.varian.com/us/corporate/legal/reach.html
International Organization for Standardization ISO 13485

Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the
requirements specified within the ISO 13485 quality standard.
13485
Medical Device
Basic Unique Device Identification

The Basic Unique Device Identification (Basic UDI-DI) for ARIA Radiation Therapy Management is 089947500200119PV.
Authorized Representative in the EU

Varian Medical Systems Nederland B.V.
Kokermolen 2
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Legal Information 3
Table of Contents
Introduction ................................................................................................................... 6
About DICOM Import and Export Reference Guide .......................................................................... 6
Overview of Import and Export Features ........................................................................................... 6
Support of Unicode ............................................................................................................................ 6
Image Conversion ............................................................................................................................. 7
Abbreviations and Definitions ............................................................................................................ 7
Related Publications .......................................................................................................................... 8
Safety and Emergency ................................................................................................. 9

General Remarks .............................................................................................................................. 9
Care Required ................................................................................................................................... 9
Responsibility .................................................................................................................................... 9
Further Regulations ......................................................................................................................... 10
Getting Started ............................................................................................................ 11

Purpose of the DICOM Import and Export Application .................................................................... 11
User Groups .................................................................................................................................... 11
User Rights and User Administration .............................................................................................. 12
Starting the DICOM Import and Export Application Modes ............................................................. 12
Overview of the Graphical User Interface ....................................................................................... 13
Menu Bar ................................................................................................................................ 13
Toolbar .................................................................................................................................... 16
Navigation Panel .................................................................................................................... 16
Image View Panel, Image Icons ............................................................................................. 17
Filter Selection Panel ............................................................................................................. 17
Import Selection Panel ........................................................................................................... 18
Export Selection Panel ........................................................................................................... 18
Patient Selection Panel .......................................................................................................... 19
Connection Panel ................................................................................................................... 19
Summary Panel ...................................................................................................................... 19
Setup Functions .......................................................................................................... 20

Setting Up the Options .................................................................................................................... 20
Import and Export Filters ................................................................................................................. 20
About Managing Filters .......................................................................................................... 21
Defining the DICOM Media File Import Filter ......................................................................... 25
Defining the DICOM Media File Export Filter ......................................................................... 26
Defining the Bitmap Media Import Filter ................................................................................. 27
Defining the Bitmap Media File Export Filter .......................................................................... 28

About DICOM Query Retrieve and Storage Filter Definitions ................................................ 29
About Defining Service Providers ........................................................................................... 32
Importing and Exporting Objects .............................................................................. 35

Safety Considerations and Limitations ............................................................................................ 35
About the Import Workflow .............................................................................................................. 35
Importing Objects ............................................................................................................................ 36
Choosing the Import Filter ...................................................................................................... 36
Choosing Objects for Import—General .................................................................................. 36
About DICOM Media File Import Objects ............................................................................... 36
About Bitmap/JPEG/TIFF Import Objects .............................................................................. 37
About DICOM Query Retrieve Import Objects ....................................................................... 37
Import RT Records ................................................................................................................. 39
Verifying the Scheduling in Treatment Preparation ................................................................ 39
Choosing the Target Patient of Import Objects ....................................................................... 40
Validating the Import ............................................................................................................... 40
Checking the Import Export Log ............................................................................................. 40
About General Status of Imported Objects ............................................................................. 41
Turning the Volume Generation for Images on or off ............................................................. 41
Assigning the Missing Image Data ......................................................................................... 42
About Reconnecting Plans ..................................................................................................... 43
Finishing the Import ................................................................................................................ 44
Exporting Objects ............................................................................................................................ 44
Choosing the Export Filter ...................................................................................................... 44
Choosing the Objects to Export and the Destination Folder .................................................. 44
Finishing the Export ................................................................................................................ 45
DICOM Fluence Export File ................................................................................................... 45
Exporting Plan Data for Clinical Trials .................................................................................... 45
Export Planning Data for Clinical Trials in DICOM Format ..................................................... 46
DICOM Data Anonymization .................................................................................................. 46
Appendix: Modality Specifics .................................................................................... 48
Index .......................................................................................................................... 49
Table of Contents 5
Introduction
About DICOM Import and Export Reference Guide

This publication contains detailed information on how to use the DICOM Import and Export
application.
Note: You can switch to the stand-alone DICOM Import and Export application from any
Varian application by using the Quicklinks menu. However, some offline applications, for
example Image Browser or Portal Dosimetry, have additional entries in the File menu to open
DICOM Import and Export application in a modal mode for faster access.
Overview of Import and Export Features

● Planar images (all types)
● CT data sets
● RT plans
● Treatment records (incl. RT brachy)
● RT Ion
● RT dose (except for planar dose, which can only be exported from Eclipse)
● RT structures
● Registrations
● Deformable registrations
● Motion management protocols and waveforms
● Networked query/retrieve and storage
● Bitmap/JPEG/TIFF
Support of Unicode
In the past ARIA supported a fixed set of languages (English, German, French, Japanese,
Simplified Chinese, Italian, Spanish, Swedish and Brazilian Portuguese), which includes a User
Interface translated into that particular language. All this was based on the concept of Windows
code pages with the limitation that characters not part of the active code page could not be
entered into the system. For example in an English setup it was not possible to enter the name of
a Russian patient using Cyrillic characters.
With the introduction of a single universal character encoding this is not a problem anymore. This
character encoding is called Unicode and includes all characters of all languages.
Learn more about Unicode on the official homepage: http://www.unicode.org/
Character Encodings in DICOM

In DICOM the attribute Specific Character Set (0008,0005) is used to specify the encoding of
string attributes with value representations SH, LO, ST, PN, LT or UT in the Information Object
Definition (IOD). DICOM supports different character encodings derived from the International
Registration Number as per ISO 2375.

DICOM does not directly support Windows Code Pages and there is no one-to-one mapping to
an ISO character set as used in DICOM for the 932 and 936 code pages. Therefore, in case of
Japanese and Simplified Chinese, Varian does not set the Specific Character Set attribute in the
exported DICOM IOD. According to DICOM standard this would actually mean that strings are
encoded using ISO_IR 6 (ASCII). Decoding of such an IOD encoded in 932 or 936 code pages
along the DICOM specification would lead to garbage. Windows Code Page 1252 is handled
identical to 932 and 936 code pages. To cope with these ARIA legacy behaviors and to be
prepared for 3rd party vendors potentially not compliant to DICOM, diverse configuration options
have been provided in the import or export channels of ARIA RTM Version 13. This should allow
ARIA to handle all DICOM IODs as available in the field.
What is new in DICOM Import and Export application?

For importing or exporting DICOM media files, you can choose the character set in the particular
dialog box, see Defining the DICOM Media File Import Filter on page 25 and Defining the
DICOM Media File Export Filter on page 26.
Image Conversion
The DICOM Import and Export application allows to convert computed radiograph images and
secondary capture images to RT images during import. To convert the images, choose the
particular options in the DICOM media file import filter dialog, see Defining the DICOM Media File
Import Filter on page 25
Abbreviations and Definitions

ARIA RTM ARIA Radiation Therapy Management
CCD Charge-coupled Device
CR Computed Radiograph
CT Computer Tomography
Service A computer service that runs in the background.
DICOM Digital Imaging and Communications in Medicine
DRR Digitally Reconstructed Radiograph
EMR Electronic Medical Record
FFD Focus to Film Distance
FFDL feet first-decubitus left
FFDR feet first-decubitus right
FFP feet first-prone
FFS feet first-supine
GUI Graphical User Interface
HFDL head first-decubitus left
Introduction 7
HFDR head first-decubitus right
HFP head first-prone
HFS head first-supine
MPR Multi-Planar Reconstruction
MRI Magnetic Resonance Imaging
PACS Picture Archiving and Communication System
PET Positron Emission Tomography
Q/R Query and Retrieve
RT Radiation Therapy
SAD Source to Axis Distance
SC Secondary Capture
SCP Service Class Provider
SCU Service Class User
SID Source to Image Distance
SUV Standardized Uptake Value
US Ultrasound
Related Publications
● ARIA Oncology Information System for Radiation Oncology Online Help
● ARIA Oncology Information System for Radiation Oncology Online Help
● Image Browser Reference Guide
● Offline Review Reference Guide
● DICOM RT Mode Reference Guide
● Eclipse Photon and Electron Instructions for Use
● Eclipse Photon and Electron Reference Guide
● Eclipse Proton Instructions for Use
● Eclipse Proton Reference Guide
● BrachyVision Instructions for Use
● BrachyVision Reference Guide
● Treatment Delivery Instructions for Use
● Varian System Server-DICOM Conformence Statement

Safety and Emergency
General Remarks
The following topics provide safety precautions which apply to the general operation of the
DICOM Import and Export application.
The hospital is responsible for establishing proper operation procedures to ensure safe operation.
Where applicable, hardware and software are designed to meet current international
technological and safety standards (for example, IEC) for the protection of operators and patients.
Because hazards can be encountered, and risks cannot be ruled out completely, instructions and
procedures in the manuals must be followed to guarantee safety of operators and patients.
Oncologists, physicists, radiation therapists, and certified medical dosimetrists use this
application to import or export objects of patients from within other Varian applications.
Any use of the system and software which does not comply with the agreed use described in this
manual or other related Varian manuals is prohibited.
No modifications on the software may be made.
Care Required
WARNING: Incorrect use of a radiotherapy linear accelerator can cause serious injury
or death. Only trained personnel under the supervision of a licensed
physician should be authorized by the hospital or owner to operate a
clinical accelerator. The emergency and safety procedures are described in
the related Instructions for Use.
Careless handling or operating can result in unsuccessful treatment or loss of data.
Responsibility
● All persons who handle, use, or operate the system must read and understand the
chapters dealing with safety regulations and emergency procedures.
● Only qualified and trained personnel are permitted to operate and maintain the system
and parts of it.
● The hospital management shall establish emergency and safety procedures before
operating the system and all personnel must be trained in such procedures.
● The system must only be run with its original and unmodified fittings and replacement
parts.
● No modifications to the system, its parts or the software are permitted without prior
review and approval from Varian.
Safety and Emergency 9

Varian cannot be held responsible for personal injury or equipment damage if:
● Changes or repairs are carried out that are not in accordance with the instructions
contained in any Varian manual for the system, or if spare parts, standards and
procedures not authorized in writing by Varian are used.
● Safety devices are removed or changed.
● Updates, modification or repair instructions occasionally issued by Varian are not
complied with.
● The equipment is used for purposes other than those intended.
● The periodic inspection and maintenance instructions are not complied with and records
not kept.
● Operation or maintenance work is performed by unqualified persons.
● The instructions and safety regulations are not complied with by the operators,
maintenance staff, or guests.
● Local laws and regulations have not been complied with.
● Anomalies during operation and maintenance are not reported to Varian immediately.
● Legal and/or government regulations are not complied with.
Further Regulations
These instructions do not render any further hospital and/or local, state or country regulations or
laws invalid. Such regulations must be complied with at any time.

Getting Started
Purpose of the DICOM Import and Export Application

The DICOM Import and Export application is designed to import and export objects of a patient.
The DICOM Import and Export application provides comprehensive, scalable and easy-to-use
DICOM functionality through all of Varian’s product lines. Furthermore, it provides import and
export of non-DICOM image formats, like JPEG, TIFF, and BMP. It supports image acquisition/
import through external devices by scanning or frame grabbing. Connectivity to DICOM compliant
SCU/SCP services are supported. This allows DICOM Query/Retrieve and DICOM Storage
operations to 3rd party devices, like PACS (Picture Archiving and Communicating Systems).
Note: You can switch to the stand-alone DICOM Import and Export application from any
Varian application by using the Quicklinks menu. However, some offline applications, for
example Image Browser or Portal Dosimetry, have additional entries in the File menu to open
DICOM Import and Export application in a modal mode for faster access.
You can use DICOM Import and Export application in various situations, for example:
● Importing images from external DICOM devices such as CT, PET, or MRI scanners.
● Exporting plans and reference images as well as importing treatment records in DICOM
RT mode. For further information, refer to DICOM RT Mode Reference Guide.
● Connecting to another Varian System or, 3rd-party PACS using Network filters:
● DICOM Query/Retrieve (importing image data by connecting for instance to a Varian
DB service).
● DICOM Storage (exporting image data by connecting for instance to a PACS).
User Groups
The DICOM Import and Export application is intended to be used by several user groups.
Table 1 User Groups, Tasks and Responsibilities on page 11 lists the default user groups of the
DICOM Import and Export application. The user rights must be granted, see User Rights and
User Administration on page 12.
Table 1 User Groups, Tasks and Responsibilities
User Group Task and Responsibility

CMD Certified Medical Dosimetrists—trained professional responsible for the
planning support and services.
Oncologist Medical doctors responsible for the patient treatment. They review and
approve patient images.
Physicist Medical physicist trained professionals responsible for the physics sup-
port and services.
RTT Radiation Therapist—Certified Radiation Therapist.
Getting Started 11
Note: CMD and RTT are not pre-defined user groups on the system server. Create these
groups in the user administration.
User Rights and User Administration

User rights management is shared within all Varian applications and carried-out in the Varian
Service Portal. The Varian user right system is a group-based rights management, meaning that
rights are granted to user groups, not to individual users. Each user in this system can be in only
in one user group, for example, Oncologist, Therapist, or Secretary.
The pre-defined user groups have pre-defined rights. For example, the Access DICOM Import
and Export application right is granted to all these groups, except Secretary.
For more information on the management of user rights, refer to the following publication: Varian
Service Portal Administration Reference Guide.
The user rights are grouped into named right groups. DICOM Import and Export uses rights
from the group ARIA DICOM Import and Export.
Starting the DICOM Import and Export Application Modes

There are two modes of the DICOM Import and Export application:
1. Modal mode, i.e. with contextual information
● You start this mode out of other Varian applications, for example Image Browser, by
choosing File > Import or Export. See also About the Import Workflow on page 35.
● Export of single images by using a dedicated context menu in some applications.
2. Standalone mode
● You start this mode using the ARIA Workflow Management, for example, from the
Home Screen or the Quicklinks menu.

Overview of the Graphical User Interface
2 3 4 5 6
Figure 1 User Interface
1. Previous and Next buttons (alternatively, click the panel titles)

2. Menu bar
3. Navigation panel
4. Toolbar
5. Selection panel
6. Image view
Menu Bar
The following menus are available:
● File Menu on page 14
● Edit Menu on page 14
● View Menu on page 14
● Measure Menu on page 16
● Tools Menu on page 16
Getting Started 13
File Menu
Table 2 File Menu Commands
Entry/Icon Description
Close Patient To close the current patient.
Exit To exit the application.
Edit Menu
You can select editing tools in the Edit menu. The table gives an overview of all entries. For
detailed information, refer to the following publication: Image Browser Reference Guide.
Table 3 Edit Menu Commands
Scale Image To define the image scale.
View Menu
You can select view tools in the View menu. The table gives an overview of all entries. For
detailed information, refer to the following publication: Image Browser Reference Guide.
Table 4 View Menu Commands
2-D To select the 2-D view of images.
Note: You can select pre-defined 2-D layouts or customize the

2-D layout by clicking the arrow next to the toolbar icon. A pull-
down menu opens.
3-D To select the 3-D view of images.
Note: You can select pre-defined 3-D layouts or customize the

3-D layout by clicking the arrow next to the toolbar icon. A pull-
down menu opens.
Synchronize Views To synchronize the view of all images, that means if switched on, all im-
ages are zoomed in/out or panned simultaneously.
To adjust the brightness and contrast of the active image. You can use
Window / Level the scroll arrows of the Window/Level slider bar at the right side of the
image. Alternatively, the window/level can be adjusted by pressing the
left mouse button and moving the mouse to the left/right (window) re-
spectively top/bottom (level).

Auto Window/ Level To adjust the brightness and contrast of the active image automatically.
To zoom in on an image by dragging a rectangle.

Zoom In
Note: You can also use the mouse wheel (forward rotation).
Exception: In CT images the mouse wheel scrolls through the
CT slices/planes. Use Ctrl + mouse wheel in this case.
To zoom out of an image step-by-step.

Zoom Out
Note: You can also use the mouse wheel (backward rotation).
To pan the selected image.

Pan
Rotating Volume To rotate rendered 3-D views of images.
Note: You can determine speed and direction of the rotation

with the player bar below the 3-D image.
Rotate Left/Right 90° To rotate (2-D) images 90° to left or right.
Note: You can change the direction of the rotation (left/right)

by clicking the arrow next to the toolbar icon. A pull-down
menu opens.
To reset a temporary modification of the images (for example, zoom or

Reset View pan).
To display/hide the image grid.
Grid
To display/hide the digital graticule.
Digital Graticule
Show Structures To show/hide and select structures and overlays (Structures and
Overlays floating window). Click the drop down arrow next to the
toolbar icon and choose the required structure/overlay from the
Structures and Overlays drop-down window. You can drag the
Structures and Overlays window in the image pane to the location
you want. Click Close.
Note: For volumetric CBCT images: you can also select the
isocenter positions by using the Show/hide structures button.
To show/hide the overlay information of the images.

Show Overlays
To open a dialog box displaying image properties, ID, technical data
Properties (size), setup data as well as modification history.
Getting Started 15
Measure Menu
You can select measuring tools in the Measure menu. For detailed information, refer to the
following publication: Image Browser Reference Guide.
Table 5 Measure Menu Commands
To measure the HU of a selected pixel in an image.
Pixel Info
To measure the distance between any two points in an image to within
Distance 1/10 mm. This measurement can be performed in any screen view. It is
possible to correct a measurement as well as to place multiple meas-
urements in an image.
To measure the angle between any three points in an image to within
Angle 1/10 degrees. The measurement can be performed in any view.
Displays the Line Profile window.
Profile
Displays the Area Profile window.
Area Profile
Displays the Histogram dialog box.
Histogram
Tools Menu
Table 6 Menu Tools Commands
Options To adjust the DICOM Import and Export settings, see Setting Up the
Options on page 20.
Toolbar
You can select various tools by clicking the icons on the toolbar. For the complete list, see:
● File Menu on page 14
● Edit Menu on page 14
● View Menu on page 14
● Measure Menu on page 16
Navigation Panel
You can select the required objects of a patient in the navigation panel.
● Click and drag the right end to expand or reduce the panels width.

Image View Panel, Image Icons
In the image view panel, you can to view the images which you want to export or import. For
detailed information, refer to the following publication: Image Browser Reference Guide. This
topic gives a short overview of the icons in this panel.
Table 7 Control Buttons on the Title Bar of the Active View
Icon Description
Maximizes the image view to the size of the entire image view panel.
Resets the image view size to the previous size.
Unlocked / Locked images: Unlocked images are temporary and change if

/ other images or groups are selected, whereas locked images are preselected im-
ages which stay in the image view panel. By clicking the icon the image status
toggles (unlocked or locked). This function is only available in 2-D views.
Patient Orientation Indicator:
Indicates the position of the patient when the image was acquired.
● The red nose indicates the front of the patient.
● The red hand indicates the left hand.
● The blue dots indicate the toes.
Filter Selection Panel

There are two views of the Filter Selection panel:
● If you start the import or export function from the DICOM Import and Export application,
then you have two tabs, Import and Export.
● If you start the import or export function from within other Varian applications by choosing
File > Import > From <filter> or File > Export > To <filter>, the Filter Selection panel
is not visible.
● If you start the import or export function from within other Varian applications by choosing
File > Import > From… or File > Export > To…, then you have one tab, Import or
Export.
This panel is used to manage the filters, see About Managing Filters on page 21. You can add,
remove, or edit the filter. Additionally, you can start the import and the export of objects, see
Choosing the Import Filter on page 36 and Choosing the Export Filter on page 44.
Getting Started 17
1 2 3
Figure 2 Filter Selection Panel
1. Import and Export tab.

2. List of filters.
3. Manage button.
Import Selection Panel

The Import Selection panel is where you select the objects to import.
For DICOM Media File Import, do the following:
● Specify the working directory from which to import the objects.
● Select the objects to import in the navigation panel.
For Bitmap Media File Import, do the following:
● Specify the working directory from which to import the objects.
● Specify the image type (BMP, JPEG, TIFF, or ALL).
For DICOM Query Retrieve Import, do the following:
● Apply search criteria, as needed.
Export Selection Panel

The Export Selection panel is where you select the objects to export.
For DICOM Media File Export, do the following:
● Specify the working directory to which to export the objects.
● Select the objects to export in the navigation panel.
For Bitmap Media File Export, do the following:
● Specify the working directory to which to export the objects.
● Specify the image type (BMP or TIFF).
For DICOM Storage Export, you can select the objects you want to export.

Patient Selection Panel
This panel is used to select the patient to whom you want to assign the objects, see Choosing the
Target Patient of Import Objects on page 40. This panel is only shown during the import of
objects. You can choose a patient from the list of patients or start the Patient Explorer
application by clicking New Patient or Browse Patients. For detailed information about the
Patient Explorer application, refer to the ARIA Oncology Information System for Radiation
Oncology Online Help, Patient Explorer.
Note: For Varian DB service import, you cannot start Patient Explorer.
Figure 3 Patient Selection Panel
Connection Panel
The Connection panel is used to validate the import or export.
● Review the import or export, and resolve any open issues.
● As an option for RT plan import, connect objects to courses.
Summary Panel
The Summary panel shows a summary of the import or export. In addition you can do the
following:
● View the import/export log.
● Browse to the export directory.
Getting Started 19
Setup Functions
Setting Up the Options

1. Choose Tools > Options.
2. Select your required options and click OK.
The following table shows the tabs of this dialog and the settings you can define:
Table 8 Options
Option Description
Startup
● Show Window/Level: If selected, this user-specific option enables
window level at the start of the application. As a consequence,
window/level sliders are shown on images by default. This option is
user-specific.
● Rendering: This workstation-specific option defines which graphics
rendering method is used for the application. You can choose:
● Automatic: Automatic use of hardware rendering if hardware capabil-
ities are sufficient (default setting).
● Software: The graphics card hardware is not used for rendering. It is
the slower option but recommended in case of problems.
● Hardware: The graphics card hardware is used for rendering.
General
● Grid Spacing: Use dynamic grid spacing: If selected, this user-
specific option dynamically adjusts the grid when you zoom in on an
image. If cleared, you need to choose the static grid spacing from the
drop down menu.
Note: You can define the grid spacing as dynamic (depending

on the zoom factor) or as fixed to 10 mm, 20 mm or 50 mm.
When grid display is selected, the current interval is displayed
on the lower right corner of the view.
Workstation Show Buttons In Toolbars: You can change the icon size on the toolbar.
Available user-specific settings:
● Normal
● Large
This setting applies to the DICOM Import and Export application only.
Import and Export Filters

Every import or export process is based on filters.

To initiate the import and export of objects, choose a filter which supports the import or export of a
specific object type. You can choose the filter directly at import and export. The filter selection is
available, if you have set up your required filters and settings according to your needs.
Use the Manage Filters dialog box to configure the import and export filters (About Managing
Filters on page 21).
Table 9 Available Import and Export Filter Types
Feature Task and Location

DICOM Media File Import Defining the DICOM Media File Import Filter on page 25
Filter
DICOM Media File Export Defining the DICOM Media File Export Filter on page 26
Filter
Bitmap/JPEG/TIFF Import Defining the Bitmap Media Import Filter on page 27
Filter
Bitmap/TIFF Export Filter Defining the Bitmap Media File Export Filter on page 28
DICOM Query Retrieve Import Defining the DICOM Query Retrieve Import Filter on page 30
Filter
DICOM Storage Export Filter Defining the DICOM Storage Export Filter on page 32
About Managing Filters

The Manage Filters dialog box lists all available import and export filters.
You can add, remove, configure, import, export filters as well as manage the mapping of external
IDs:
● Adding a Filter on page 21
● Removing a Filter on page 22
● Configuring a Filter on page 22
● Exporting Filter Configurations on page 22
● Importing Filters on page 23
● Managing External ID Mapping on page 23
Refer to the following topics for reference information:
● About Settings Available in All Filter Configurations on page 23
● About the Export Options Dialog Box on page 24
Adding a Filter
1. In the Filter Selection panel, click Manage.

The Manage Filters dialog box opens.
2. In the Import or Export section, click Add.
The Select Filter Type dialog box opens.
Setup Functions 21
3. Select the required filter type, and click OK.
4. Enter a filter name according to your needs. It is recommended to use a name describing the
purpose of the filter.
5. Select or clear the option Shared.
6. Enter the filter specific settings and options according to your needs.
7. Click OK.
For more information about general settings, see Table 10 Settings Available in All Filter
Configurations on page 23.
Removing a Filter

2. In the Import or Export section, select a filter, and click Remove.
Configuring a Filter
To change the configuration of existing filters, proceed as follows:

2. In the Import or Export section, select a filter, and click Configure.
3. Optionally, change the filter name.
4. Optionally, change the option Shared.
5. Change the filter specific settings and options according to your needs.
6. To apply the new filter configuration, click OK.
For more information about general settings, see Table 10 Settings Available in All Filter
Configurations on page 23.
Exporting Filter Configurations
You can export filter configurations to pass them over to other users. The configuration file format
is XML.
1. In the Manage Filters dialog box, select a filter and click Export.
2. Navigate to the target directory, enter a file name and click Save.

Importing Filters
You can import filter configurations passed over by other users. The configuration file format is
XML.
Note: Filters created in different system versions may fail to import or present changes in their
behavior. After the import, review all filter configuration files that were created using a system
version other than the one currently in use.
1. In the Manage Filters dialog box, click Import.

2. Navigate to the file you want to import and click Open.
Managing External ID Mapping
Some DICOM objects such as RT plans or treatment records are referring to specific machines
and machine add-ons (for example, wedges) by means of IDs. These IDs are site specific.
Therefore, a mapping between the IDs used internally and the ones used externally (at the origin
of the DICOM data to be imported) needs to be established.
1. In the Manage Filters dialog box, select a filter and click Manage Machine IDs.
The Manage Machine IDs dialog box opens, presenting the information in tree view.
2. Do one of the following:
a. To add a new mapping, click Add Machine.
b. To add an add-on, select an external ID, and click Add Addon.
c. To rename a mapping, double click the mapping or click Rename.
d. To delete a mapping, select an external ID, and click Remove.
e. To save your changes, click OK.
About Settings Available in All Filter Configurations
The following settings are commonly available in all filter configurations dialogs.
Table 10 Settings Available in All Filter Configurations
Setting Description
Name Defines the filter name. The name is shown as a submenu option in
the File > Import or File > Export menu of other applications such as
Image Browser, Offline Review; by this, you start the modal mode,
see Starting the DICOM Import and Export Application Modes on
page 12. In the standalone mode, you can choose the filters in the
Filter Selection panel, see Filter Selection Panel on page 17. For in-
formation about how to choose filters, see Choosing the Import Filter
on page 36 and Choosing the Export Filter on page 44.
Note: The filter name must be unique.
Shared Defines whether a filter is available to all users on all workstations, or

only to the current user on all workstations.
Setup Functions 23
About the Export Options Dialog Box
Table 11 Export Options Dialog Box
Setting Description
Include Related Objects
Group RT plan To configure which associated objects to automatically export
when exporting a plan.
Group CT/MR/PET Images To configure which associated objects to automatically export
when exporting CT/MR/PET images.
Group RT Structure Sets To configure which associated objects to automatically export
when exporting structure sets.
Group Spatial Registration To configure which associated objects to automatically export
(rigid and deformable) when exporting spatial registrations.
General Options
Automated Export You can select or clear the Automated Export check box. This
option is only effective when you start the modal mode, see
Starting the DICOM Import and Export Application Modes on
page 12. If this check box is selected, the following happens
when you start an export:
● The export progress window opens immediately.
● Case 1: If you have selected particular objects, for example
in Image Browser, then only the selected objects are ex-
ported.
● Case 2: If nothing is selected, the entire patient is exported.
If the check box is cleared, more export options are available
during the export. In this case you can select or deselect the
objects to be exported in the navigation panel. Additionally, it is
possible to change the Export Destination Folder, see
Choosing the Objects to Export and the Destination Folder on
page 44. For the export procedure, see Choosing the Export
Filter on page 44.
ATC Checks To define whether to check compliance of the DICOM file with
File Set Reader Application DICOM Conformance Statement of
the Advanced Technology QA Consortium.
More information: Exporting Plan Data for Clinical Trials on
page 45
Group Plan If the check box Generate structure outlines on reference
images is selected, structure outlines are generated on refer-
ence images.
If the check box Export Photon applicators as Stereotactic
is selected, photon applicators are exported as stereotactic.

Setting Description
Group Structure Set If the check box Extrapolate to Original Slice Set is selected,
the contour planes in the structure set are extrapolated to
match the planes of the original (non-equally spaced) CT
image. This guarantees that the planes of the contours match
the planes of the image in the exported dataset (IHE-RO com-
pliant).
If the check box Extrapolate to Original Slice Set is unse-
lected, the contour planes in the structure set are exported as
available in the internal model. Therefore the planes of the con-
tours do not match the planes of the CT image.
If the check box Export fluences in compensator sequence
is selected, the fluences are exported in the compensator se-
quence.
Group Dose To configure the dose values, DVH types, and volumen units.
Group Brachy If this check box is selected, the geometry of the radiograph set
is maintained.
Technical Options
Group Transfer Syntax To configure the VR Little Endian transfer syntax.
Anonymization
Enable To enable data anonymization for DICOM media file export and
DICOM storage export.
Group Standard Options To select how data is to be anonymized (DICOM Data Anonym-
ization on page 46).
The confidential attributes list updates according to the se-
lected standard options and shows in detail what type of data is
anonymized and how it is anonymized.
Group Custom Options To enable a user-defined constant for anonymization of clinical
trial information (for example the patient ID or the patient
name).
You can define the constant as free text, or generate it by
means of sub-constants.
Defining the DICOM Media File Import Filter

After adding a filter, configure it in the Configure DICOM Media File Import Filter window.
Table 12 DICOM Media File Import Filter Configuration
Setting Description
Name Name of the filter.
Shared Defines whether the filter is available on all workstations.
Setup Functions 25
Setting Description
Working Directory Defines the default folder where the DICOM object files to be imported
are located. Click ... to navigate to a folder.
Include Defines whether to search subdirectories of the working folder for
Subdirectories DICOM files by default.
Backup Directory Defines the default folder where the backup of the files is saved.
Click ... to navigate to a folder.
Backup Imported Defines whether a backup of the imported files is done.
Files
Use ID Mapping Defines whether the machine ID in the DICOM file is to be mapped
against a machine ID as defined under Manage Machine IDs.
Contour Resolution Defines the resolution with which to import contours.
● Automatic means that the system determines the best resolution
and imports smallest structures with high resolution if necessary.
● High means that all structures except body, bolus and support struc-
tures are imported with high resolution.
● Low means that all structures are imported with standard resolution.
Set User Origin of Defines whether the user origin of CT images is automatically set to the
imported CT images isocenter of imported CT images (represented by the data collection
to the value of Data center attribute).
Collection Center
The z-offset allows specifying the reference plane, that is, the offset of
attribute
the external laser system to the CT isocenter. The z-offset can be be-
tween −10000 and 10000 mm.
DICOM Specific Defines the character encoding to use if the imported DICOM IOD does
Character Set not specify the Specific Character Set (0008,0005) attribute. The de-
fault character encoding settings is US-ASCII.
Override DICOM When selected, the DICOM Specific Character Set is always used to
Specific Character decode the DICOM IOD, independently of the value specified in the
Set Specific Character Set (0008,0005) attribute.
Image Conversion Click to convert secondary capture images or computed radiograph im-
button ages into several formats.
Select the checkbox Convert SC/CR images to following format and
choose the format to convert.
Defining the DICOM Media File Export Filter

After adding a filter, configure it in the Configure DICOM Media File Export Filter window.

Table 13 DICOM Media File Export Filter Configuration
Setting Description
Working Directory Defines the default folder where the DICOM object files are to be ex-
ported. Click ... to navigate to a folder.
File Name Options Defines the method used to generate file names for the DICOM files.
Object UID uses the object UID itself as file name. Patient ID + Object
Suffix uses the patient ID along with a suffix to identify the object type
and to make the filename unique. If needed, the suffix ends with a se-
quence number to avoid file overriding.
RT Image Defines the type of the RT Image label. Choose RT Image Label or
Beam Label/Fraction Nbr.
DICOM Specific Defines the character encoding to use when exporting a DICOM IOD.
Character Set The selected encoding will be specified in the Specific Character Set
(0008,0005) attribute in the exported DICOM IOD except for Windows
Code Pages 932, 936 and 1252 where the Specific Character Set will
be unspecified.
Defining the Bitmap Media Import Filter
CAUTION: Images can be handled differently during the planning process system
depending on what type of image is used. It is important that you check
your images in the process that they will be used to ensure that the scaling
of objects generated from the images is correct.
After adding a filter, configure it in the Bitmap/JPEG/TIFF Import Configuration window.
Table 14 Bitmap Media Import Filter Configuration
Setting Description
Working Directory Defines the default folder where the image files to be imported are lo-
cated. Click ... to navigate to a folder.
Backup Directory Defines the default folder where the backup of the files is saved.
Click ... to navigate to a folder.
Backup Imported Defines whether a backup of the imported files is done.
Files
Setup Functions 27
Setting Description
Type Choose the image type to be assigned to the imported images. The fol-
lowing types are available:
● DRR
● Ultrasound
● Portal
● Print from Digital Radiograph System (1:1)
● X-Ray Film (Includes Magnification)
Note: DRR and Portal should not be used for brachytherapy

imports! If you select Print from Digital Radiograph System
(1:1), BrachyVision assumes that the magnification factor is
1.0 on film, and automatically applies the magnification factor
to the image when an imaging geometry is defined in Brachy-
therapy 2D Entry. For more information, refer to the following
publication: BrachyVision Reference Guide.
SAD (mm) and Specify the geometric setup of image acquisition for the image types
SID/FFD (mm) DRR, Portal, and Print from Digital Radiograph System (1:1): enter
a value for the Source to Axis Distance (SAD) and the Source to Image
Distance (SID). The latter is sometimes also called Focus to Film Dis-
tance (FFD).
Note: Scale to SAD should not be used for brachytherapy im-

ports!
File Search Choose the image file type you import using this filter. The following file
types are possible:
● ALL
● BMP
● JPEG
● TIFF
Defining the Bitmap Media File Export Filter

After adding a filter, configure it in the Bitmap/TIFF Export Configuration window.
Table 15 Bitmap Media File Export Filter Configuration
Setting Description
Type Format of the exported images.

Setting Description
File Name Options > Object The exported file is renamed using the DICOM object UID.
UID
File Name Options > Patient The exported file is renamed using the patient ID and the ob-
ID+ ObjectSuffix ject label. The file is saved into a folder named after the Pa-
tient and a sub folder named after the object DICOM modality.
About DICOM Query Retrieve and Storage Filter Definitions

For both the Query Retrieve Import Filter and, the Storage Export Filter two ends of a DICOM
network connection need to be defined:
● The client-end of the DICOM network connection is the workstation running the DICOM
Import and Export application with the filter. This end of the DICOM network connection
is defined as follows:
● AETitle.
You can choose the AETitle on the workstation freely. However, this AETitle needs to
be registered on the 3rd-party PACS (or the Varian DB service). Otherwise the 3rd-
party PACS (or the Varian DB service) will not accept a DICOM connection with the
DICOM Import and Export application. For detailed information, refer to the
manufacturer’s manual of the PACS.
● IP/Hostname of the workstation (which is identified automatically).
This option is available only for the DICOM Query Retrieve Import Filter.
● Port number.
You can choose port numbers on a workstation freely to some degree. However, they
need to be unique, i.e. two concurrently running programs cannot use the same port
number. It is recommended to use port numbers in the range 51000 to 51999.
Contact your network administrator in case of doubt.
This option is available only for the DICOM Query Retrieve Import Filter.
● The server-end of the DICOM network connection is the 3rd-party PACS or, the computer
running the Varian DB service , the so-called service provider. This end of the DICOM
network connection is defined as follows:
● AETitle
● IP/Hostname of the computer running the PACS or the daemon
● Port number
Refer to the manufacturer's manual of the PACS for how to identify this information.
The definitions of the 3rd-party PACSs and the Varian DB services are shared between all
DICOM Query and Retrieve and Storage filters.
Both configuration dialog boxes have a Configure button to open the corresponding dialog box,
see About Defining Service Providers on page 32.
Setup Functions 29
Defining the DICOM Query Retrieve Import Filter
The 3rd-party PACS or Varian DB service needs to be installed and configured to accept DICOM
connections with DICOM Import and Export application, see About DICOM Query Retrieve and
Storage Filter Definitions on page 29.
After adding a filter, configure it in the DICOM Query Retrieve Configuration window.
Table 16 DICOM Query Retrieve Import Filter Configuration
Setting Description
General Name Name of the filter.
Note: Not all 3rd-party PACS support the

sharing feature. Before using this feature, make
sure that the 3rd-party PACS is capable of han-
dling multiple IP addresses per AETitle.
Include instance Defines whether to search subdirectories of the working

creation date in folder for DICOM files. If this check box is selected, the
search criteria creation date can be used to contain search results
during import.
Note: Not all 3rd-party PACS support instance

creation date query.
Use ID Mapping Defines whether the machine ID in the DICOM file is to

be mapped against a machine ID as defined under
Manage Machine IDs.
Set User Origin Defines whether the user origin of CT images is automat-
of imported CT ically set to the isocenter of imported CT images (repre-
images to the sented by the data collection center attribute).
value of Data
Collection
Center attribute
Z-offset [mm] Allows specifying the reference plane, that is, the offset
of the external laser system to the CT isocenter. The z-
offset can be between −10000 and 10000 mm.

Setting Description
Contour Defines the resolution with which to import contours.
Resolution
● Automatic means that the system determines the
best resolution and imports smallest structures with
high resolution if necessary.
● High means that all structures except body, bolus
and support structures are imported with high resolu-
tion.
● Low means that all structures are imported with
standard resolution.
Specific Select Server Select the appropriate server from the list.
Configure Click to add new servers or modify server details.
Server Details Verify Server Click to verify the DICOM connection between client and
server. Unsuccessful verification may be due to incorrect
configuration or network problems
Client Details AETitle1 Enter an AETitle.
The read-only field will show the combination of the AE-
Title and the current workstation hostname, if the
Append hostname checkbox is selected.
Append Select the checkbox to add the current AE Title to the
hostname current workstation hostname.
Network Shows the network address from every available network
Interface interface.
Target Port1 Defines the callback port number in the current worksta-
tion for move operations to be used by the remote SCP.
Perform C- Defines what Q/R level is to be used for C-MOVE. Selec-
● Automatic
MOVE by Q/R tion depends on your remote SCP.
level ● Image only
● Select Automatic (default, recommended) to auto-
● Series only
matically use the optimal transfer level and perform-
ance.
● Select Image only to transfer all objects on image
level. Use this option only if your remote SCP re-
quires this. Performance will be slow.
● Select Series only to transfer all objects on series
level. Use this option only if your remote SCP re-
quires this. Performance will be slow.
1 This field may be required by certain service providers.
Setup Functions 31
Setting Description
DICOM Specific Character Set Select a character set from the drop-down menu.
Character Set
Override DICOM Defines if the encoding in the DICOM IOD being im-
Specific ported (specified by Specific Character Set (0008,0005))
Character Set shall be overridden by the character encoding as se-
lected in above combobox. This means that on import
characters will be encoded in the selected character en-
coding instead of the encoding specified in the DICOM
IOD.
Defining the DICOM Storage Export Filter
The 3rd-party PACS or Varian DB service needs to be installed and configured to accept DICOM
connections with DICOM Import and Export application, see About DICOM Query Retrieve and
After adding a filter, configure it in the DICOM Storage Export Configuration window.
Table 17 DICOM Storage Export Filter Configuration
Setting Description
Select Server Select the appropriate server from the list.
Configure Click to add new servers or modify server details.
Client AETitle Enter an AETitle. The AETitle needs to be registered on the 3rd-party
PACS (or the Varian DB service).
Server Details Enter an AETitle, the IP/Hostname and the Port, if you want to connect
manually to a server.
Verify Server Click to verify the DICOM connection between client and server. Unsuc-
cessful verification may be due to incorrect configuration or network
problems.
DICOM Specific Select a character set from the drop-down menu.
Character Set
Options button Click to open the general Export Options dialog box.
About Defining Service Providers

For conceptual information, see About DICOM Query Retrieve and Storage Filter Definitions on
page 29.
For task information, see:
● Adding a Service Provider on page 33
● Editing a Service Provider on page 34

● Deleting a Service Provider on page 34
Figure 4 Configure Service Providers Dialog Box
Table 18 Service Provider Configuration
Setting Description
AETitle The AETitle of the service provider.
IP/Hostname Defines the IP address or hostname of the service provider.
Port Defines the port number of the service provider.
Q/R Service If this check box is selected, the service provider can be used for Query
Retrieve Import filters.
Storage Service If this check box is selected, the service provider can be used for
Storage Export filters.
Adding a Service Provider
The Configure Service Providers dialog box is open, see About DICOM Query Retrieve and
To add a service provider:
1. In the Configure Service Providers dialog box (see Figure 4 Configure Service Providers
Dialog Box on page 33), click Add New.
2. Enter your required settings, see Table 18 Service Provider Configuration on page 33.
3. Click OK.
Setup Functions 33
Editing a Service Provider
To edit a service provider:
Dialog Box on page 33), select an entry in the list, and click Edit.
2. Enter your required settings, see Table 18 Service Provider Configuration on page 33.
3. Click Update.
Deleting a Service Provider
To delete a service provider:
Dialog Box on page 33), select an entry in the list, and click Remove.
2. Click OK.

Importing and Exporting Objects
Safety Considerations and Limitations

Safety Considerations
NOTICE: It is recommended to use equidistant slices in imaging, and always visually

verify the imported structures. The volume of imported structures may
change or be even completely lost in the conversion to the internal data
model used inside the system. Be especially careful in these cases:
structures defined on non-equidistant slices or outside the image area and
miniscule structures.
Limitations
● Import and export of margins are not supported.

● Compensator data is only imported if the compensator type attribute is STANDARD.
If the compensator type attribute is missing or if it has one of the following values,
compensator data is not imported (dropped during import):
● TOTAL_ACTUAL
● TOTAL ACTUAL
● OPTIMAL
● Exporting non-equidistant slices of an image series to non-Varian applications does not
automatically generate a 3D image that includes both the original non-equidistant slices
and the interpolated slices.
● After importing an image with non-equidistant slices, create a new 3D image in the
Selection workspace of Eclipse.
About the Import Workflow

For information on how to start DICOM Import and Export application and the available modes,
see Starting the DICOM Import and Export Application Modes on page 12.
The following example describes how to import objects from within the Image Browser
application in modal mode:
1. In the Image Browser application, choose File > Import > [Import Filter]
2. On the Import Selection panel, select the objects and directory for import.
3. On the Patient Selection panel, assign the applicable patient record.
4. On the Connection panel, validate the import.
5. On the Summary panel, revise the import.
6. Click Restart.
Importing and Exporting Objects 35

You return to the Image Browser application automatically.
Importing Objects
Table 19 Import Objects Tasks
Task and Location

Choosing the Import Filter on page 36
Choosing Objects for Import—General on page 36
Choosing the Target Patient of Import Objects on page 40
Validating the Import on page 40
Finishing the Import on page 44
Choosing the Import Filter

Once you have defined the filter, and you have reached the DICOM Import and Export
application via model mode or standalone mode, proceed as follows:
1. In the Filter Selection panel, open the Import tab.
2. Double-click the filter (or select the filter and click Next).
3. Proceed to the Import Selection panel (click the Next button or the panel title).
Choosing Objects for Import—General

Once you have reached the Import Selection panel, proceed as follows:
1. If necessary, change the working directory.
The default directory is the one that was defined while defining the filter.
2. Depending on the import filter type, do one of the following:
a. For DICOM Media File Import, see About DICOM Media File Import Objects on
page 36.
b. For Bitmap/JPEG/TIFF Import, see About Bitmap/JPEG/TIFF Import Objects on
page 37.
c. For DICOM Query Retrieve Import, see About DICOM Query Retrieve Import Objects on
page 37.
3. In the navigation panel, select the objects you intend to import.
4. Proceed to the Patient Selection panel (click the Next button or the panel title).
About DICOM Media File Import Objects

The Selection panel during a DICOM media file import initially lists all DICOM files found in the
working folder (as defined in the filter configuration).

Note: The Selection panel allows selecting directories to be scanned for DICOM files. The
selection which of the corresponding objects to be imported is solely defined by the check
boxes in the Navigation panel.
Table 20 DICOM Media File Import Selection Panel Options
Setting Description
... Button Click to browse for a working folder different from the default one (as
defined in the filter configuration).
Refresh Click to refresh the list of DICOM files in the working folder. This is
needed if additional files have been added to the working folder after
the import has started.
Scan Subdirectories Select to search subdirectories of the working folder for DICOM files.
About Bitmap/JPEG/TIFF Import Objects

The Selection panel during Bitmap/JPEG/TIFF Import initially lists all image files found in the
working folder as defined in the filter configuration.
Note: The Selection panel allows selecting directories to be scanned for image files. The
selection which of the corresponding objects to be imported is solely defined by the check
boxes in the Navigation panel.
Table 21 Bitmap/JPEG/TIFF Import Selection Panel Options
Setting Description
... Button Click to browse for a working folder different from the default one (as
defined in the filter configuration).
Refresh Click to refresh the list of image files in the working folder. This is
needed if additional files have been added to the working folder after
the import has started.
Scan Subdirectories Select to search subdirectories of the working folder for DICOM files.
File Type Choose the image file type to be scanned for.
● ALL
● BMP
● JPEG
● TIFF
About DICOM Query Retrieve Import Objects

The Search Criteria panel during DICOM Query Retrieve Import allows limiting the request for
object information from the 3rd-party PACS or Varian DB service. When you click Search, the
Navigation panel lists all matching patients.

If you use the search criteria Modality or Instance Creation Date, the following objects are
displayed depending on your remote SCP.
● If your remote SCP does not support the search criteria, objects are displayed unfiltered.
● If your remote SCP supports the search criteria, objects are filtered correctly on all levels.
● If your remote SCP supports the search criteria only partially, objects are filtered correctly
only on series level and image level.
Indication of partial support is, for example, if you see a + symbol in the search results,
but no objects are displayed when you click the symbol.
If you receive an error message while searching by Modality or Instance Creation Date,
your remote SCP does not support one or more of the used search criteria and you must
reduce them.
Note: Asterisks (*) can be used as wildcard. For example, First Name “A*” will select all
patients with a first name beginning with “A”. Patient ID “*123” will select all patients IDs ending
with “123”.
Table 22 DICOM Query Retrieve Import Selection Panel Options
Setting Description
First Name The patient's first name.
Last Name The patient's last name.
Patient ID The ID of the patient.
Accession Number Only show studies with the corresponding accession number.
Modality Only show objects of the corresponding modality.
Instance Creation Only shows objects with the corresponding instance creation date.
Date
This search criterion is only active if Include instance creation date in
search criteria is enabled in the configuration of the DICOM Query Re-
trieve Import Filter.

Import RT Records
There are several possibilities to perform actions or generate data in DICOM RT Mode, for
example when the system is upgraded, or when the Varian system database is down.
Note: If the treatment records fail to save to the database following a treatment session, they
are saved locally as a backup on the treatment machine. In this case you have to import
manually these treatment records (and images, if images failed to save back to database).
The following example follows the import of a pelvis treatment plan. Use it as a guide.
Prerequisites:
● Required filters and user rights are defined by the system administrator.
● A treatment plan including Setup Fields has been scheduled.
● The plan was applied in DICOM RT Mode and Images were acquired respectively during
each DICOM RT session.
To import treatment records:
1. Navigate from User Home > Quicklinks > DICOM to the Import Export workspace.
2. Click on the Import tab.
3. On the Filter Selection panel, select the required DICOM Media File Import Filter.
4. On the Import Selection panel, do the following:
a. Browse to the patient folder that holds the DICOM history data in the file storage system
b. In the navigation panel, select all RT Records in the DICOM Tree.
5. Click the Next button, or the Patient Selection panel title.
The incoming DICOM data is validated automatically. The wizard matches up the patient
defined in the DICOM files against the corresponding patient in the Varian system database.
After successful patient matching, patient data is listed on the Patient Selection panel.
Note: Inform the system administrator of any errors or warnings before proceeding!
6. On the Patient Selection panel, do one one of the following:

a. If patient matching was successful, select the patient from the list of existing patients.
b. If the patient matching failed, browse for the patient or add a new patient.
7. Validate and finalize the import.
After the import is completed, you need to verify the import and verify the scheduling in Treatment
Preparation, see Verifying the Scheduling in Treatment Preparation on page 39.
Verifying the Scheduling in Treatment Preparation

After import of treatment records, you will get a message that you need to verify the scheduling in
the Treatment Preparation application.
To verify scheduling after treatment records import:
1. Navigate using Quicklinks to Plan Scheduling workspace.
2. A message is shown that informs about the locked course. Read the message carefully and
acknowledge it.

3. In the Scheduling Overview panel click Edit > Unlock Scheduling.
4. Verify the scheduled number of fractions. Due to manual import of Treatment Records
additional fractions might have been added. Correct as necessary.
Note: For more information refer to the following publication: Treatment Preparation Reference
Guide.
Choosing the Target Patient of Import Objects

Once you have reached the Patient Selection panel, proceed as follows:
1. Do one of the following:
a. Select an existing patient from those listed.
b. Add a new patient
c. Browse for a patient.
2. Proceed to the Connection panel (click the Next button or the panel title).
Validating the Import

Once you have reached the Connection panel, proceed as follows:
1. If there are no error or warning messages, proceed with step 3.
2. If the Import Export Log dialog box opens, check the warnings and errors.
3. In the Connection panel, do the following:
a. Review the general status
b. If required, turn the volume generation for images on or off.
c. Assign the missing image data.
d. If required, reconnect plans to a course.
4. Proceed to the Summary panel (click the Next button or the panel title).
Checking the Import Export Log

If validation encounters issues during import selection, the Import Export Log dialog box
indicates issues that must be resolved (for example, exclude items from import), before you can
proceed. In this case, your only option is to close the dialog box, resolve open issues, and restart
import selection.
If further validation encounters no issues that prevent import, the Import Export Log dialog box
informs you about alerts and warnings during the import of objects.
1. In the dialog box, choose the options as needed.
2. If required, click Save log file.
3. To continue, click Yes.
The dialog box closes and you can proceed to the Connection to store the imported objects.

Table 23 Import Export Log
Setting/Value Description
Group By Object If this check box is selected, the log data is grouped by object
into a tree structure.
Error and Warning Logs You can choose which problems are displayed.
● All: Information messages, errors and warnings are dis-
played.
● Errors: Only errors are displayed.
● Errors and Warnings: Errors and warnings are displayed.
Reading and Connection You can choose which problem types are displayed.
Logs
● All: Reading and connection problems are displayed.
● Reading Logs: Only reading problems are displayed.
● Connection Logs: Only connection problems are dis-
played.
About General Status of Imported Objects

During the connection step, an overview of the imported objects is shown in the Navigation
panel, see Navigation Panel on page 16:
● New and completely defined objects are flagged with a green check mark.
● Objects with missing data (for example, image creation date or patient position) are
flagged with a red clock and a small yellow warning icon.
● Already existing objects are flagged with yellow warning icon. These objects will not be
imported.
● New plans are flagged with a green up-and-down icon as they can be reconnected to
other series.
Turning the Volume Generation for Images on or off

During the connection step, you can set Volume Creation options for volumetric images:
● If selected, volumetric images of imported slices are created.
● The options are only available for object series that do not exist in the database.
● In the following cases you cannot choose the options:
● For object series that are connected to a structure set. In this case, the volume
creation is automatically performed.
● If the current import process does not contain any relevant objects, for example:
● If only RT images are imported.
● If only series objects connected to structure sets are imported.

Note: For 4D CT data sets, select the checkbox Generate 4D Images for generating 4D image
information. If you do not select the checkbox, CT images of a 4D CT are imported as separate
3D volumes.
After the import is complete, a 4D image object containing the information of a 4D imaging
study appears in the Scope Window. The 3D images automatically created in the study are
grouped together and sorted to form a 4D image set. Each imported image contains an image
series comment containing information on the phases of the respiratory cycle.
Note: If a patient has been scanned during the same session with two different image
modalities (for example, CT and PET), the acquisition device typically describes the geometry
of all images in a common coordinate system (Frame of Reference). In this case, the
application considers all 3D images and all resulting 4D image sets as registered. These
images cannot be unregistered.
Assigning the Missing Image Data

During the connection step, mandatory data for new imported RT and US images have to be
defined. The images requiring your settings are indicated by a red status icon in the navigation
panel. The status is called Image Creation Date and Patient Position have to be assigned. You
have to assign at least two different settings:
● Creation date of the images
● Patient position
If you have assigned the settings, the status changes to Image Creation Date and Patient
Position assigned. The status is indicated by a green icon in the navigation panel.
To assign the missing image data:
1. In the Navigation panel choose the image.
2. Assign the required settings.
3. Repeat step 1 and step 2 for all images.

Table 24 Options of RT and US Image Data
Option Description
Image Creation Date and
● Creation date:
Patient Position have to be
assigned There are two ways to define the creation date.
● In the Treatment Session Date list, choose an entry.
● Select the New Date check box, open the calendar function,
click the drop-down arrow and select the date, and then
enter the time (hh:mm:ss) in the collapsed date time control.
● Patient Position:
There are two ways to define the patient position.
● In the Field list, choose an entry. Available entries are
Course ID, Plan Setup ID, and Field ID.
● In Patient Position, click the drop-down arrow and select
an entry in the drop-down menu. The following options ac-
cording to the DICOM Conformance Statement can be se-
lected: HFP (head first-prone); HFS (head first-supine);
HFDR (head first-decubitus right); HFDL (head first-
decubitus left); FFDR (feet first-decubitus right); FFDL (feet
first-decubitus left); FFP (feet first-prone); FFS (feet first-
supine).
Note: If these values are defined during import, these

fields are read-only.
Gantry / Source Rtn Optional setting, to define the angle of the gantry rotation
during image acquisition.
Note: If this value is defined during import, this field is

read-only. You cannot set this value for US images.
Couch Rtn Optional setting, to define the angle of the couch rotation during
image acquisition.
Note: If this value is defined during import, this field is

read-only. You cannot set this value for US images.
About Reconnecting Plans

During connection step, RT plans can optionally be reconnected to courses.
1. To create a new course, click at the bottom left.

2. Enter the Course Id.
3. Drag and drop plan objects to reconnect them.

Finishing the Import
Once you have reached the Summary panel, proceed as follows:
1. Review the import statistics.
2. Optionally, review the detailed log.
3. Click the Restart button.
● In modal mode, the application closes and you switch automatically back to the previous
application.
● In standalone mode, the Filter Selection panel opens and you can start a new import or
export.
Exporting Objects
Table 25 Export Objects Tasks
Task and Location

Choosing the Export Filter on page 44
Choosing the Objects to Export and the Destination Folder on page 44
Finishing the Export on page 45
DICOM Fluence Export File on page 45
Exporting Plan Data for Clinical Trials on page 45
Export Planning Data for Clinical Trials in DICOM Format on page 46
Choosing the Export Filter

Once you have defined the filter, and you have reached the DICOM Import and Export
application via model mode or standalone mode, proceed as follows:
Note: If you have started the DICOM Import and Export application via modal mode and
selected a Automated Export filter, the following does not apply. Instead, you are taken directly
to a dialog box similar to the Summary panel and export is finished.
1. In the Filter Selection panel, open the Export tab.

2. Double-click the filter (or select the filter and click Next).
3. If prompted, select the applicable patient from the Patient Explorer application that opens.
4. Proceed to the Export Selection panel (click the Next button or the panel title).
Choosing the Objects to Export and the Destination Folder

Once you have reached the Export Selection panel, proceed as follows:
1. If necessary, change the working directory.
The default directory is the one that was defined while defining the filter.
2. In the navigation panel, select the objects you intend to export.

3. For Bitmap/TIFF export, optionally override export options.
Export options which cannot be overridden are displayed as read-only.
4. Proceed to the Summary panel (click the Next button or the panel title).
Finishing the Export

Once you have reached the Summary panel, proceed as follows:
1. Review the export statistics.
2. Optionally, review the detailed log.
3. Click the Restart button.
● In modal mode, the application closes and you switch automatically back to the previous
application.
● In standalone mode, the Filter Selection panel opens and you can start a new import or
export.
DICOM Fluence Export File

For all fields included in the exported plan, the following information is included in the DICOM
export file:
● Optimal fluences
● Actual fluence
● DMLC parameters (both DMLC and conformal arc treatments), collimator jaw settings,
collimator rotation, and gantry rotation
● Portal dose prediction
● Dynamic tolerance information
Note: When exporting fluences, note that:

● Plan-specific volume optimization objectives are not included in the DICOM export file.
● The fluence data is exported using the DICOM Compensator definition with an
extension to the Compensator Type attribute.
● Carriage group information is not included in the export file.
Exporting Plan Data for Clinical Trials

The ATC (Advanced Technology Consortium), a multi-institutional cooperative organization for
cancer research, collects treatment histories to be used as the basis of analyses and reports from
the members.
You can export RT data (image and plan data) from the application to participate in the ATC
studies. To be able to complete the export, you need the ITC DICOMpiler application (3rd party
software). The export is done in the DICOM format, and the data is then modified for the ATC in
DICOMpiler, which creates the DICOM file set required. To transfer the DICOM file set, the data
must be copied to a transfer medium (CD or FTP server).

For more information on the ITC DICOMpiler application, refer to Varian Installation Instructions,
ITC DICOMpiler Software Installation Guide and ITC DICOMpiler Quick Start Guide. The ITC
DICOMpiler documentation is available at the ITC website (http://itc.wustl.edu). For an FTP
account, contact the ITC at ict@castor.wustl.edu or go to the ATC website or the ITC website.
The ATC sets the following restrictions for plans and images exported for ATC studies:
● Image orientation must be HFS (head-first-supine).
● Contours must be closed. Point contours or open-ended line contours are not supported.
● Plans must contain a primary reference point with a location, the volumetric dose must be
calculated, at least one valid dose prescription and valid plan treatment percentage must
be found in the plans.
If these restrictions are not fulfilled in the plan and images to be exported, the Export wizard
shows warnings concerning the unacceptable parts.
● Brachytherapy sources in plans must be point sources.
● Brachytherapy seeds in plans must use sources with equal dosimetric properties
(radioactive source model, source strength and source calibration date).
Note: Ultrasound images or Boolean structures cannot be exported for the ATC.
Export Planning Data for Clinical Trials in DICOM Format

Make sure that your export filter has the Check compliance during export selected.
Make sure that you have the DICOMpiler program installed and that it is running. If DICOMpiler is
not running, start it by double-clicking ITC_DICOMpiler.exe. In the ITC DICOMpiler window, start
the Receiver by clicking Run DICOM Receiver.
1. Select the object filter and export objects as usual.
2. Select the plan, field and dose information to be included in the export.
3. Select the DVH information to be included in the export.
4. Review any remarks about the export.
For a brachytherapy plan, it is normal that in the ATC export warnings the applicators are
reported as unclosed structures, and you may be informed that the primary reference point
has not been set.
5. Check the items to be exported.
6. Transfer your files to the ATC via an internet-based transfer, such as FTP.
DICOM Data Anonymization
Conformance
In connection with DICOM media file export and DICOM storage export, you can anonymize data
conformant to a subset of DICOM Attribute Confidentiality Profiles, as specified in PS3.15:
DICOM Security and System Management Profiles (available free at http://medical.nema.org/).
Supported profiles and options are the following:

● E.1. Application Level Confidentiality Profiles
● E.2. Basic Application Level Confidentiality Profile
● E.3.5. Clean Descriptors Option (Retain Descriptors option)
● E.3.6. Retain Longitudinal Temporal Information Options (Retain Dates option)
● E.3.7. Retain Patient Characteristics Option (Retain Patient Characteristics option)
● E.3.8. Retain Device Identity Option (Retain Device Identity option)
● E.3.10. Retain Safe Private Option (Retain Safe Private Tags option)
Note: For more information on the above options please consult the
DICOM Standard Part 15 E.3 - Basic Application Level Confidentiality Options.
Limitations and Deviations

● De-identification of identifying information that is burned in to the image pixel data
(attribute 7FE0,0010) is not supported.
● The patient's ID (attribute 0010,0020) is replaced with a non-zero length value (default) or
a user-defined constant.
● The patient's name (attribute 0010,0010) is replaced with a non-zero length value.
● If multiple objects relate to one patient, the patient's ID and name and all unique
identifiers (UID) are anonymized in a way that preserves the relationship between the
exported objects.
● Always select the option Retain Safe Private Tags if you want to treat patients on
Halcyon after exporting an anonymized plan.
Note: Local regulations may apply with regard to anonymization. In addition, data populated
and received in DICOM objects may vary or contain unexpected content. For example, private
tags unknown to Varian may contain identifying information. Therefore, qualified personnel shall
assess that the level of anonymization is appropriate for the intended use.

Appendix: Modality Specifics
Dose Rates
Table 26 Modality Specific Information
Modality Description
Plan Import Some non-Varian planning systems do not specify dose rates in plans.
In this case, no dose rate is applied on import. The user needs to man-
ually add the dose rate to these plans after import or to configure their
non-Varian application to export a dose rate set.

Index
A connection panel 19
connection review 40
abbreviations 7
administration
user 12 D
all filter configurations
definitions 7
settings 23
DICOM
anonymization 46
fluence export file 45
assign missing data 42
DICOM device
automated export 44
external 11
DICOM fluence export file 45
B DICOM Import and Export application
modal mode 12
Bitmap/JPEG/TIFF Import Filter purpose 11
define 27 standalone mode 12
Bitmap/JPEG/TIFF Import Objects user groups 11
about 37 user interface 13
Bitmap/TIFF Export Filter workflow 35
define 28 DICOM Media File Export Filter
define 26
DICOM Media File Import Filter
C
define 25
care required 9 DICOM Media File Import Objects
Certified Medical Dosimetrists (CMD) 11 about 36
check DICOM Query Retrieve and Storage Filter
alerts 40 Definitions
Import Export Log 40 about 29
warnings 40 DICOM Query Retrieve Import Filter
choose define 30
export filter 44 DICOM Query Retrieve Import Objects
export objects 44 about 37
export working directory 44 DICOM RT mode 11
import filter 36 DICOM Storage Export Filter
import objects 36 define 32
import working directory 36 dose rates 48
source patient 44
target patient 40
clinical trials
E
exporting data in DICOM 46 edit menu 14
exporting plan data 45 emergency 9
close current patient 14 export
CMD (Certified Medical Dosimetrists) 11 choose filter 44
Compensator data 35 DICOM fluence export file 45
configure finish 45
filter 22 fluence export file 45
Configure Service Providers dialog box 32–34
Index 49
objects 44 I
select objects 44
summary 45 image
working directory 44 locked 17
export features 6 maximize 17
export filters 20 unlocked 17
export objects view size reset 17
choose 44 image conversion 7
Export Options dialog box 24 Image Icons 17
export selection 18, 44 image view panel 17
exporting import
data to clinical trials in DICOM 46 finish 44
plan data for clinical trials 45 objects 36
Exporting non-equidistant slices 35 patient selection 40
external RT treatment record 39
DICOM device 11 select objects 36
non-DICOM device 11 summary 44
external ID mapping validate 40
manage 23 volumetric image 41
working directory 36
Import Export Log 40
F import features 6
import filter
file menu 14
choose 36
filter
import filters 20
add 21
import objects
configure 22
choose 36
import 23
import selection 18, 36
name 23
import/export log 40
remove 22
imported objects
filter configuration
about 41
export 22
general status 41
filter selection
import filter 36, 44
filter selection panel 17 L
filters
manage 21 limitations 35
finish locked image 17
export 45
import 44
M
fluence
DICOM export file 45 machine ID
further regulations 10 manage 23
manage
external ID mapping 23
G
machine ID 23
generate volume images 41 Manage Filters 20, 21, 23
export 22
import 23

managing planning system
users 12 non-Varian 48
maximize image 17 plans
measure menu 16 reconnecting 43
menu bar 13 purpose of Reference Guide 6
modal mode
choose export filter 44
choose import filter 36 Q
DICOM Import and Export application 12 Q/R service 33
modality
plan import 48
specific information 48 R
Radiation Therapist (RTT) 11
N reconnecting plans
about 43
navigation panel 16 related publications 8
network filter 11 reset image view size 17
non-DICOM device responsibility 9
external 11 rights
non-Varian user 12
planning system 48 RT Administration workspace 48
RT images
O assign missing data 42
RT records import 39
objects RTT (Radiation Therapist) 11
export 44
import 36
Oncologist 11 S
operating limits 48 safety 9
Options 20 safety considerations 35
SCP 11
P SCU 11
selection panel
PACS 11 object export 18
patient object import 18
select 40 server details
Patient Explorer application 19 AE title 33
patient orientation indicator icon 17 service details
patient selection 40 host name 33
export 44 IP address 33
import 40 port 33
patient selection panel 19 service provider
Physicist 11 add 33
Picture Archiving and Communicating System AETitle 33
11 delete 34
plan import edit 34
modality specific information 48 host name 33
plan with missing dose rates IP address 33
import 48 port 33
Index 51
service providers
about defining 32
standalone mode
choose export filter 44
choose import filter 36
DICOM Import and Export application 12
storage service 33
summary
export 45
import 44
summary panel 19
T
target patient 40
toolbar 16
Tools 20
tools menu 16
U
unicode 6
unlocked image 17
US images
assign missing data 42
user
administration 12
group 12
rights 12
user groups 11
V
Varian Service Portal 12
verify scheduling 39
view menu 14
volume images
generate 41
volumetric image import 41
W
working directory
export 44
import 36

ARIA Radiation Therapy Management 16.0 DICOM Import and Export Reference Guide

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DICOM Import and Export

ARIA® Radiation Therapy Management

P1034778-002-B DECEMBER 2019

FDA 21 CFR 820 Quality System Regulations (cGMPs)

2 DICOM Import and Export Reference Guide

EU REACH SVHC Disclosure

International Organization for Standardization ISO 13485

Basic Unique Device Identification

Authorized Representative in the EU

Safety and Emergency ................................................................................................. 9

Getting Started ............................................................................................................ 11

Setup Functions .......................................................................................................... 20

4 DICOM Import and Export Reference Guide

Importing and Exporting Objects .............................................................................. 35

Appendix: Modality Specifics .................................................................................... 48

About DICOM Import and Export Reference Guide

Overview of Import and Export Features

Character Encodings in DICOM

6 DICOM Import and Export Reference Guide

What is new in DICOM Import and Export application?

Abbreviations and Definitions

8 DICOM Import and Export Reference Guide

Careless handling or operating can result in unsuccessful treatment or loss of data.

Safety and Emergency 9

10 DICOM Import and Export Reference Guide

Purpose of the DICOM Import and Export Application

Table 1 User Groups, Tasks and Responsibilities

User Group Task and Responsibility

User Rights and User Administration

Starting the DICOM Import and Export Application Modes

12 DICOM Import and Export Reference Guide

Figure 1 User Interface

1. Previous and Next buttons (alternatively, click the panel titles)

Table 2 File Menu Commands

Table 3 Edit Menu Commands

Table 4 View Menu Commands

Note: You can select pre-defined 2-D layouts or customize the

3-D To select the 3-D view of images.

Note: You can select pre-defined 3-D layouts or customize the

14 DICOM Import and Export Reference Guide

To zoom in on an image by dragging a rectangle.

To zoom out of an image step-by-step.

To pan the selected image.

Note: You can determine speed and direction of the rotation

Rotate Left/Right 90° To rotate (2-D) images 90° to left or right.

Note: You can change the direction of the rotation (left/right)

To reset a temporary modification of the images (for example, zoom or

To show/hide the overlay information of the images.

Table 5 Measure Menu Commands

Table 6 Menu Tools Commands

16 DICOM Import and Export Reference Guide

Table 7 Control Buttons on the Title Bar of the Active View

Resets the image view size to the previous size.

Unlocked / Locked images: Unlocked images are temporary and change if

Filter Selection Panel

Figure 2 Filter Selection Panel

1. Import and Export tab.

Import Selection Panel

Export Selection Panel

18 DICOM Import and Export Reference Guide

Figure 3 Patient Selection Panel

Setting Up the Options

Note: You can define the grid spacing as dynamic (depending

Import and Export Filters