Ge Optima CT 660

GE Healthcare
Optima™ CT660
User Manual
GE Healthcare Japan Corporation does business as GE Healthcare
This product is certified as a Optima™ CT660 CT Scanner.

The MHLW certified number is 222ACBZX00021000.
Optima ™ CT660
Operator Manual, English
5366492-1EN
Revision: 1
© 2010 General Electric Company
All rights reserved.
Optima™ CT660
Revision history
Revision Date Reason for change

1 February 2010 First release for Optima™ CT660 User Manual
5366492-1EN Rev 1 (February 2010) ii

Table of contents
Chapter 1: Read me first 1-1
About this manual 1-2
Safe and proper use notices 1-2
Notices 1-2
Purpose of this manual 1-2
Prerequisite skills 1-3
Pop-up windows 1-3
Mouse controls 1-3
Graphic conventions and legends 1-3
Operator Console applications 1-4
Display/Image monitor 1-5
Feature Status area 1-7
Exam Rx 1-9
ImageWorks 1-10
iLinq 1-11
Scan monitor 1-12
New Patient 1-14
Emergency Patient 1-15
Scan setup 1-16
Patient Schedule 1-17
Protocol Management 1-18
Retro Recon 1-19
Recon Management 1-20
Daily Prep 1-21
Utilities 1-22
User Interface conventions 1-23
Select items from a list 1-23
Cancel 1-23
Button appearance 1-23
Language translations 1-24
System troubleshooting tips 1-26
Chapter 2: Safety 2-27

Introduction 2-28
Warning labels and symbols 2-29
General safety guidelines 2-33
Radiation safety 2-36
Authorized users 2-36
General radiation safety 2-36
Scans acquired at the same tomographic plane 2-37
CTDIvol 2-39
Pediatric and small patient imaging 2-40
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X-ray tubes 2-40

Electrical safety 2-41
Mechanical safety 2-43
General mechanical safety 2-43
Short Footprint Mode 2-43
Patient positioning 2-43
ASiR 2-48
VolumeShuttle™ (Axial) and Volume Helical Shuttle 2-49
Cardiac safety 2-51
Laser safety 2-54
Reconstructed image orientation 2-55
Data safety 2-57
Applications software safety 2-59
Application-specific safety topics 2-60
Helical scanning 2-60
Lung algorithm 2-60
Auto Scan 2-60
SmartStep safety 2-60
Table float 2-61
SmartStep scanning 2-61
Interventional/biopsy scanning 2-61
Treatment planning 2-62
Advanced applications safety 2-62
Measurements 2-63
Segment tools 2-64
Filming and saving images 2-64
Window width and level (W/L) 2-65
Volume Rendering 2-65
Image quality 2-65
Accuracy of measurements 2-66
Measure distance for axial, helical, and cine images 2-66
Measure distance for scout images 2-66
Measure angle 2-67
ROI 2-67
Reformat plane thickness 2-67
Operator console ergonomics 2-68
Posture 2-68
Equipment adjustments 2-68
Accessories 2-70
GE approved accessories 2-70
IV pole safety 2-71
Table tray safety 2-72
Systems with metal-free cradles and accessories 2-72
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Xtream/Enhanced Xtream Injector safety 2-73
Limited access room configuration 2-74
Emergency devices and emergency egress 2-75
Emergency devices 2-75
Emergency Stop 2-75
System Emergency OFF buttons using Main Disconnect Control (For the system with MDC 2-
only) 76
Emergency patient care during X-ray ON 2-76
Emergency egress 2-76
To safely remove the patient 2-77
Maintenance and cleaning 2-78
Cleaning equipment (bio hazard) 2-79
Environmental concerns 2-80
Name and concentration of hazardous substances 2-81
Explanation of Pollution Control label 2-81
Precautions 2-82
Chapter 3: Regulatory information 3-83

Applicable Regulations and Standards 3-83
Intended use of the system 3-84
Indications for use of the system 3-84
3-
Intended purpose and medical effectiveness ( MHLWMinistry of Health, Labour and Welfare)
84
Chapter 4: Pediatrics and small patients 4-85

Radiation exposure 4-86
Radiation exposure sensitivity 4-86
Dose reporting considerations 4-86
Pediatric and small patient scans 4-88
Optimize pediatric protocols for your facility 4-88
Pediatric protocols 4-88
Color Coding for Kids Protocol Selection 4-89
Set up a pediatric or small patient exam 4-91
Minimize pediatric and small patient doses 4-92
Properly center all patients in the gantry 4-92
Lower mA settings for chest and bone imaging 4-92
Scan signal-to-noise 4-92
Consider using in-plane Bismuth shields 4-93
Use pediatric positioning accessories 4-93
Make a kid friendly environment 4-93
Adjust pediatric and small patient scan parameters 4-94
Adjust the parameters by size, age, weight, height, and indications 4-94
Consider decreasing the kVp 4-94
Center the patient properly when using AutomA 4-95
Increase the pitch 4-95
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Use Small SFOV Filters 4-96
Chapter 5: Equipment 5-97

Computer console 5-99
Computer 5-100
Reconstruction Engine 5-100
Monitors 5-101
Operate the SCIM and keyboard 5-102
Film keys - F1 through F4, F12 5-104
Preset W/L keys - F5 through F11 5-104
Page Up/Page Down keys 5-104
W/L control keys 5-105
Operate the mouse controls 5-106
Bright Box (Option) 5-107
Gantry 5-108
Gantry display 5-108
Breath hold lights 5-110
Internal components 5-111
Gantry and Console interfaces 5-111
Use the Gantry controls 5-115
Connect the cardiac trigger monitor 5-119
Table 5-120
Attach the table tray 5-122
Attach the IV pole 5-123
Table X-Y accuracy for the Flat Tabletop workflow 5-124
Verify the table elevation accuracy 5-126
Analyze the table elevation 5-129
Measure the table lateral motion 5-132
Verify the table lateral motion 5-135
Handheld Controller 5-136
Set the W/L with the HHC 5-138
W/L preferences 5-138
W/L preset values 5-138
Hardware components 5-139
Components 5-139
Coverage 5-139
Axial detector signal collection 5-139
Helical pitch, scan mode, and collimation 5-140
Axial detector configuration screen 5-141
Helical detector configuration screen 5-142
Power Distribution Unit 5-143
X-ray tube and generator 5-144
X-ray tube 5-144
High Frequency Generator 5-144
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Chapter 6: Startup and shutdown 6-145
System startup and login 6-146
Login/logout 6-146
Start up the system 6-147
Routine daily startup 6-148
Startup from power off 6-148
System start-up failures 6-148
Shutdown and restart the system 6-149
Energy Saving Mode 6-150
Daily Quality Assurance 6-152
Daily QA workflow 6-152
SmarTube™ Warm-up 6-153
Use Fast Calibrations 6-154
Chapter 7: Patient Schedule 7-155

Add a patient to the schedule 7-156
Edit a patient in the schedule 7-157
Update the patient schedule 7-158
View more patient information on the schedule 7-159
Set patient schedule preferences 7-160
Select a patient from the schedule 7-161
Check a patient's status 7-162
Delete a patient from the schedule 7-163
Chapter 8: Scan 8-164

Exam workflow 8-167
Set up and position the patient 8-168
Set up the patient's information 8-171
Enter patient information with the bar code reader 8-173
Acquire a scout 8-174
Adjust the Graphic Rx 8-176
Enter contrast descriptions 8-178
Enable Priority Recon 8-179
Start the scan 8-180
Repeat a series 8-181
Modify the Patient Information presets 8-182
Stop a scan 8-183
End the exam 8-184
Scan parameters workflow 8-185
Choose the Scan Type 8-186
Set axial and helical scan parameters 8-188
Set cardiac helical scan parameters 8-189
Set the Start and End locations 8-190
Set a specific number of images 8-191
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Choose the Thick Speed options 8-192

Set the Image Interval 8-194
Set the Gantry Tilt 8-195
Set the Scan FOV 8-196
Set the kV 8-197
Set the mA 8-198
Timing parameters workflow 8-199
Set a Prep Group delay time 8-201
Set the Interscan Delay time 8-202
Set a Breath Hold time 8-203
Set a Breathe Time 8-204
Set the Voice/Lights/Timer options 8-205
Change the preset delay 8-206
Recon parameters workflow 8-207
Set the Display FOV 8-209
Set the R/L Center coordinates 8-210
Set the A/P Center coordinates 8-211
Set the Recon Type 8-212
Set the Recon Options 8-213
Film parameters workflow 8-214
Turn on AutoFilm 8-215
Set a Frame Format 8-216
Set an Interval 8-217
Flip images 8-218
Adjust the W/L 8-219
Magnify images 8-220
Rotate images 8-221
Annotate a film series 8-222
Apply filters 8-223
Apply GSE 8-224
Auto Voice workflow 8-225
Set the Auto Voice language 8-226
Record a message 8-227
Delete a message 8-228
Additional scan features 8-229
Add/split/delete a group 8-230
Optimize technical parameters 8-231
Optimize patient dose 8-232
View the Dose Report 8-234
Chapter 9: Scan applications 9-235

ASiR 9-237
Acquire a scan using ASiR 9-237
ASiR 9-239
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Acquire a scan using Dose Reduction Guidance 9-239
Biopsy Mode 9-240
Acquire a scan 9-240
Direct Multi Planar Reformat (DMPR) 9-241
Exam Split 9-244
Split exams with ConnectPro 9-244
SmartPrep 9-245
Set up a scan 9-245
Display images 9-248
SmartScore Pro 9-249
SmartStep 9-252
Prepare for an exam 9-252
Set up the scan 9-253
Display images 9-256
VolumeShuttle (Axial) 9-258
Acquire a VolumeShuttle (Axial) scan 9-258
Volume Helical Shuttle 9-260
Acquire a Volume Helical Shuttle scan 9-260
Xtream Injector/Enhanced Xtream Injector 9-262
Set up the Xtream Injector 9-263
Enhanced Xtream Injector screen 9-264
Injector status buttons 9-267
Contrast report 9-268
Chapter 10: Cardiac 10-269

Cardiac workflow 10-270
Prepare the patient 10-271
Exam prep instructions 10-271
Breathing instructions 10-271
Consent forms 10-271
IV setup and contrast 10-272
Acquire a Scout scan 10-273
Attach the electrodes/leads to patient 10-274
Acquire a heart localizer scan (optional) 10-278
Acquire a manual bolus timing scan 10-279
Acquire a cardiac contrast enhanced scan 10-281
Cardiac scan parameters 10-284
Select a cardiac Scan Type and Recon Mode 10-284
Set the ECG Gating parameters 10-288
Set the Pitch 10-292
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Set the RR Interval and Phase Location 10-293

Override the monitor heart rate 10-294
Display an ECG trace on the scan monitor 10-296
Cardiac Retro Recon 10-298
Reconstruct basic cardiac scans 10-298
Edit the ECG trace retrospectively 10-301
Move a heart cycle's recon window 10-304
Insert, delete, or move a trigger 10-305
Remove heart cycle data 10-306
Display retro recon images 10-308
Chapter 11: Retro reconstruction 11-310

Create new images from scan data 11-311
Graphically prescribe Retro Recon 11-313
Find unreconstructed images 11-314
Pause/resume the Retro Recon queue 11-315
Remove data from the Retro Recon queue 11-316
Reserve/release acquired scan data 11-317
Save anonymous patient scan data 11-318
Save/restore scan data to/from a USB/DVD-RAM 11-319
Chapter 12: View images 12-320

Open Exam Rx 12-322
Open ImageWorks 12-323
Type an Accelerator command 12-324
Annotate an image 12-331
Set annotation preferences 12-332
Use the Bright Box (Option) 12-333
View images in a cine loop 12-335
Compare exams/series/images 12-336
Use MIROI density readings to calculate bolus timing 12-337
Measure a density reading 12-338
Display normal 12-339
Use edge and smoothing filters 12-340
View exam and series text page 12-341
Flip/rotate images 12-342
Set grid preferences 12-344
Add grid 12-345
Apply Gray Scale Enhancement 12-346
Create and view GSPS objects 12-347
Hide, show, or remove graphics 12-348
Magnify or minify the image 12-349
Apply a Matte 12-350
Place a matte 12-350
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Move, resize, or delete a matte 12-350
Measure distance 12-351
Set mouse preferences 12-352
Move images within a viewport 12-353
View patient list in the browser 12-354
Set a primary and secondary viewport 12-355
View a reference image 12-356
Inverse the video display 12-357
Report a cursor 12-358
Screen save 12-359
Set series binding preferences 12-360
Set image display 12-361
Select exam/series/image 12-362
Soft keys in ImageWorks 12-362
List/Select in Exam Rx 12-362
Select images using the keyboard 12-362
Select images using the Accelerator Line 12-362
Set viewport preferences 12-364
Sort by exam/series/images 12-365
Set tick mark preferences 12-366
Set next/prior viewport settings 12-367
Set W/L preset preferences 12-368
Adjust the W/L 12-369
Accelerator Line 12-369
Keyboard 12-369
Function keys 12-369
Mouse 12-370
Cross reference images on a scout 12-371
Chapter 13: Display applications 13-372

Add/Subtract 13-373
Add/subtract images 13-373
Bind series 13-374
Create images with min/max values 13-375
Direct Multi Planar Reformat (DMPR) 13-376
Manually prescribe DMPR batch 13-376
Manipulate DMPR images 13-377
Exam Split 13-379
Split exams when the scan is completed 13-379
Neuro 3D Filter 13-382
Create Neuro 3D images 13-382
Chapter 14: Reformat 14-383

Open Reformat 14-386
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Use the Reformat Image Controls 14-387

Rotate freehand or page images 14-387
Zoom (magnify) images 14-387
Pan (roam) images 14-387
Select objects 14-387
W/L images 14-388
Change the image orientation 14-388
Activate the Oblique mode 14-388
Use the keyboard shortcuts 14-389
Use the right-click functions 14-390
Display 14-392
Modify red annotation 14-392
Review Controller screen 14-394
Annotate an image 14-396
Save preset annotation 14-397
Measure 14-398
Measure distance 14-398
Measure angle 14-398
Measure area 14-398
Measure volume 14-399
Manage color maps 14-400
Add an ROI 14-401
Set ROI preferences 14-402
Reformat view types 14-403
Create a Curved view 14-404
Create an X Section Histogram view 14-405
Create an MPVR (Multi Projection Volume Reformation) view 14-406
Create a Profile view 14-407
Volume Render 14-408
Attach/detach objects 14-409
Cut planes 14-410
Work with colors 14-411
Add colors 14-411
Assign a range of colors 14-411
Change a color 14-411
Autofit 14-412
Create a multi-VR object 14-413
Modify the opacity ramp 14-414
Zoom in/out 14-415
Combine segmented objects 14-416
Paint on slices 14-417
Segment 14-418
Add/Remove anatomy with Auto Select 14-418
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Remove floaters 14-419
Threshold an image 14-420
Batch Film 14-421
Set up a batch oblique 14-421
Batch film images 14-422
Save a curved parallel plane or rotating curve batch 14-424
Chapter 15: Film 15-425

Set the AutoFilm parameters 15-426
Film parameters 15-426
Image parameters 15-426
Automatically film images 15-427
Start AutoFilm 15-427
Pause AutoFilm 15-427
Delete a series from AutoFilm 15-427
Delete an exam from AutoFilm 15-427
Add an image to the AutoFilm composer 15-427
AutoFilm recon troubleshooting tips 15-428
Manually film images 15-429
Exam Rx 15-429
ImageWorks 15-429
ImageWorks or Exam Rx 15-429
Set the Print Series parameters 15-431
Chapter 16: Image Management 16-432

Archive 16-433
Set an archive node 16-433
Select an archive device 16-434
Save images to a remote archive host 16-435
Pause/resume the queue 16-436
Work-arounds 16-437
Remove 16-438
Remove exam/series/images from system 16-438
Network 16-439
Set up a remote host 16-439
Send images 16-440
Retrieve images 16-441
Access the local host and perform a custom search 16-442
Check network history file 16-443
CD/DVD Interchange 16-444
Save images to a CD/DVD 16-444
Restore images from a CD/DVD 16-446
View images on a PC or laptop 16-447
Data Export 16-448
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Compose a report 16-448

Export a report 16-449
View a report on a PC 16-450
Delete items 16-451
Patient Data 16-452
Make a patient anonymous 16-452
Edit patient data 16-453
Install a SMPTE pattern 16-455
Chapter 17: Protocols 17-456

Build or edit a protocol 17-457
Set protocol as default 17-460
Copy and paste a protocol 17-461
Add an ECG Trace to a protocol 17-462
Delete a protocol 17-463
Chapter 18: Data privacy 18-464

Open EA3 18-465
Configure local users 18-467
Add a local user 18-468
Add a local group 18-469
Add an enterprise group 18-471
Add or remove a user from a group 18-472
Change a user's full name 18-473
Change a user's password 18-474
Lock/unlock a user 18-475
Remove a user, group, or membership 18-476
Configure EA3 properties 18-478
Configure the Enterprise tab 18-479
Auto Configuration 18-480
Manual configuration 18-482
Chapter 19: System Management 19-483

Control the Auto Voice volume 19-484
Open a Unix shell 19-485
Turn on/off extended CT numbers 19-486
Collect data with Quick Snap 19-487
Collect data with IQ Snap 19-488
Save an ECG trace 19-489
Restart Show Localizer 19-490
Set the anonymize patient annotation level 19-491
Export protocols 19-492
Set the screensaver timeout 19-493
Use iLinq 19-494
Apply Product Network filters 19-495
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Download software 19-496
Leave a memo for service engineer 19-497
Appendix A: Operator messages Appendix A-1

Glossary Glossary-1
Index Index-1
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Chapter 1: Read me first

Before using your system, familiarize yourself with the purpose and design of this manual and the overview
of the system user interface.
About this manual
Display monitor
Display/Image monitor
Feature Status area
Exam Rx
ImageWorks
iLinq
Scan monitor
Scan setup
New Patient
Protocol Management
Patient Schedule
Recon Management
Retro Recon
Daily Prep
Utilities
UI conventions
Troubleshooting tips
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Optima™ CT660
About this manual

This section explains the purpose and design of this user manual. It is an introduction to the manual,
providing information on the purpose, prerequisite skills, organization, format, and graphic conventions that
identify the visual symbols used throughout the manual.
The manual does not identify components or features that are standard or purchasable options. Therefore,
if a feature or component included in the manual is not on your system, it is either not available on your
system configuration or your site has not purchased the option.
Safe and proper use notices

The following safety notices are used to emphasize certain safety instructions. This manual uses the
international symbol along with the danger, warning, or caution message.
DANGER
Danger is used to identify conditions or actions for which a specific hazard is known to exist that
will cause severe personal injury, death, or substantial property damage if the instructions are
ignored.
WARNING
Warning is used to identify conditions or actions for which a specific hazard is known to exist that
may cause severe personal injury, death, or substantial property damage if the instructions are
ignored.
CAUTION
Caution is used to identify conditions or actions for which a potential hazard may exist that will or
can cause minor personal injury or property damage if the instructions are ignored.
Notices
The following notice symbols are used to emphasize information that is considered important, requires
special notice, or includes helpful troubleshooting tips.
Important indicates information where adherence to procedures is crucial or where your

comprehension is necessary to apply a concept or effectively use the product.
Note provides additional information that is helpful to you. It may emphasize certain information
regarding special tools or techniques, items to check before proceeding, or factors to consider about a
concept or task.
Troubleshooting tips provide information that allow you to investigate the resolution of some type of
problem, locate the difficulty, and make adjustments to solve the problem.
Purpose of this manual

This user manual is written for health care professionals (namely, the technologist) to provide the necessary
information relating to the proper operation of this system. The manual is intended to teach you the system
components and features necessary to use it to its maximum potential. It is not intended to teach imaging or
to make any type of clinical diagnosis.
5366492-1EN Rev 1 (February 2010) 1-2

This user manual should be kept with the equipment at all times. It is important for you to periodically
review the procedures and safety precautions. It is important for you to read and understand the contents
of this manual before attempting to use this product.
This user manual is originally written in English.
Prerequisite skills
The operator profile may be limited to registered CT technologists certified by national registries, state
licenses, or organizational certification, physicians with or without specific training in radiology, physicists,
or other persons adequately trained to operate the equipment.
This manual is not intended to teach imaging. It is necessary for you to have sufficient knowledge to
competently perform the various diagnostic imaging procedures within your modality. This knowledge is
gained through a variety of educational methods including clinical working experience, hospital based
programs, and as part of many college and university programs.
Pop-up windows
Pop-up message window require an acknowledgement typically by clicking OK or Accept. Always respond
to the message.
Mouse controls
For mouse control details, see the Operate the mouse controls procedure.
Graphic conventions and legends

This manual uses special conventions for images and legends to make it easier for you to work with the
information. The table below describes the conventions used when working with menus, buttons, text
fields, and keyboard keys.
Graphic conventions
Example Description
UI conventions Blue text indicates a link to another topic.
Select Select an option in a check box or radial button and selecting a tab.
Press Enter Press a hard key on the keyboard or equipment.
Press and hold Shift Press and hold down a hard key on the keyboard.
Click Viewer A button label or Interface button name that you actively click. If there is a reference
to a button label that is not actively clicked, it is not displayed as bold or italic.
In the Spacing field ... The name of the field in which you can select or type text.
Type supine in the Text you enter into a field.
Patient Position field
Select Sort > Sort by The pathway of selecting options in a pull-down menu.
date
Ctrl X simultaneously Press and hold the Control button on the keyboard and simultaneously press the X
button on the keyboard. Ctrl is the abbreviation used for the Control keyboard button,
and ALT is the abbreviation used for the Alternative keyboard.
"message" A system message prompt is in quotations.
Cancel/Close Cancel/Close typically closes a screen without executing the changes on the screen.
The instructions to Cancel/Close are not included in procedures in this manual.
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Optima™ CT660
Operator Console applications

These applications are not included in this user manual.
Common user interface with Advantage Windows for improved productivity. The OC1 now supports an
expanded list of Advanced Application packages such as Volume Viewer, CT Perfusion 4- Multi-Organ or
Neuro only, Advantage CTC Pro, AutoBone, CardIQ Xpress 2.0 Plus, AVA Xpress, Card EP, and Dentascan.
Volume Viewer is a prerequisite to support CardEP, Advantage CTC Pro, AutoBone, CardIQ Xpress 2.0 Plus,
and AVA Xpress.
1Operator Console
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The display or image monitor desktops can be thought of as work environments. When a desktop is open,
all the functions related to that desktop are placed on the display/image monitor.
The display monitor is divided into three areas.
Area 1 = icon display area and feature status area
Area 2 = Tool Chest screen
Area 3 = application display area
1 = desktop icons, 2 = Tool Chest, 3 = application area
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Optima™ CT660
Desktop icons
Icon Description
Exam Rx
Displays viewports to view images as you scan, automatically film, manual film, and
apply measurements and other features to an image.
ImageWorks
Displays a browser from which you can view other exams, archive, network, remove,
manual film, apply measurements and other features to an image, perform 2D
reformations, and access optional software features.
Learning Solutions
Opens electronic based operator information. Place an operator document in the DVD-
RW drive or the DVD-RAM drive and click Learning Solutions icon to open the document.
iLinq
Opens on-line access to GE Online Center engineers and Answerline Applications
Specialists for the purpose of sending and receiving information related to the scanner.
Service
Used most often by field engineers to save User and/or Auto Voice protocols and to
perform system diagnostics.
Shutdown
Displays the Shutdown Attention screen from which you can restart the system,
shutdown for power cycle of the system, or user log out for Data Privacy.
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Display monitor
Feature Status area
The Feature Status area displays the date, time, available system disk space, and reconstruction, archive,
network, film, and reconstruction status.
It is recommended that you remove images when the image space falls below 1,000 images to ensure
disk space for acquiring and reconstructing images. Do not remove images while scanning, restoring, or
receiving images.
Feature Status area
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Optima™ CT660
Feature status icons and text areas
# Description
1 Current date and time display depending on the selected format.
Displays the available image space:
2 Left side is the number of 512×512 matrix images.
Right side is the number of 256×256 matrix images.
3 The Image Reconstruction icon area displays the status as the percent of images completed
for the exam, series, and image range for both prospective and retrospective reconstruction.
4 The Archive/Restore icon area displays the status of the exam, series, and images currently
being saved or restored and the status of the storage media. The Remove Status simply shows
"Removing" or "Removed." The individual exams, series or images are not listed.
5 The Network icon area displays the status of the exam, series, and images currently being
sent or received.
6 The Film icon area displays the status of the exam, series, and images currently being filmed.
System status message area
Click on the area to see a list of system messages. These messages are not necessarily error
messages but can be any informational message generated by the system.
7 View Log opens the system log for more detailed information about messages and errors.
Clear removes message displayed in the message area.
Close closes the message window.
Memo allows you to Leave a memo for service engineer.
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Display monitor
Exam Rx
Click the Exam Rx icon to open the Exam Rx desktop.

Exam Rx desktop, 1 = Exam Rx display control panel, 2 = Exam Rx viewports for AutoView and Review Layout configurations
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Display monitor
ImageWorks
Click the ImageWorks icon to open the browser. Select an exam/series/images from the patient
list (2) and click an application from the browser list of applications (1).
ImageWorks desktop, 1 = browser list of applications, 2 = browser list of patients, 3 = Browser menu bar
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Display monitor
iLinq
Click the iLinq icon to open the iLinq desktop.

iLinq desktop
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Scan monitor
The scan monitor is divided into three areas.
Area 1 = scan control display area.
Area 2 = operator console message area. Click the raised white bar to view a list of messages.
Area 3 = list of scan function icons that, when launched are displayed in area 1.
1 = scan control area, 2 = console message area, 3 = scan function icons
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Scan function icons
Icon Description
New Patient
Starts a new patient and opens a new patient menu. Once the patient information is
completed and the protocol is selected, scan setup interface displays.
Emergency patient
Starts an Emergency patient and opens the Emergency protocol menu. Patient Name
and Patient ID are assigned automatically. Once a protocol is selected, scan setup
interface displays.
NOTE: Emergency Patient will only be displayed if set to ON in System Reconfig.

Patient Schedule
Opens patient schedule to pre-program patient information or retrieve patient
information from DICOM1 HIS/RIS2.
Protocol Management
Opens Protocol Management, from which you create, edit, and delete scan and Auto
Voice protocols.
Retro Recon
Opens Retro Recon, from which you select an exam and then reprocess scan data to
create new images.
Recon Management
Opens the Recon Management screen, from which you can pause, resume, or delete
reconstruction. Also used to save/restore or reserve/release scan data.
Daily Prep
Opens Daily Prep, from which you perform tube warm-up or fast calibrations.
Scanner Utilities
Opens Utilities for the field engineer to perform phantom calibrations.
1Digital Imaging and COmmunications in Medicine

2Hospital Information System / Radiology Information System
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Optima™ CT660
Scan monitor
New Patient
Click the New Patient icon to launch New Patient. It is divided into multiple areas:
Area 1 = patient information area
Area 2 = protocol selection area
New patient
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Scan monitor
Emergency Patient
Click the Emergency Patient icon to to launch Emergency protocol selection. It is divided into
multiple areas:
Area 1 = patient information area. Patient ID is always Trauma. Patient Name is Year/Month/Day/Time and
CT name. Both areas can be modified.
Area 2 = protocol selection area. These are dedicated protocols.
Emergency Patient
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Optima™ CT660
Scan monitor
Scan setup
The scan setup displays when an exam is in process. It is divided into multiple areas:
Area 1 = Patient Position and Series Level Functions area. The buttons that display in the Series Level
Functions area may vary depending on your system configurations and purchased options.
Area 2 = ViewEdit area. This is the area in which you adjust scan parameters. It also displays the real time
scan progress information.
ViewEdit conventions:
You can edit the fields by row or column. If you edit by column, then the change applies to all rows. If
you edit by row, the change only applies to the selected row.
Click a blue button and a pop-up appears displaying the parameters for that selection.
Text boxes are white. Click in the box, type a value, and press Enter. If you click a button above a
white box, a pop-up appears with a text box.
Area 2a = displays the tabs for Timing, Reconstruction, and Filming parameters. Click a tab and set of
parameters overlays a portion of the ViewEdit area.
Area 3 = displays multiple types of contents. Typically, dose information is displayed in this area. It may also
display Real Time information when the active application requires it.
Scan setup
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Scan monitor
Patient Schedule
Click the Patient Schedule icon to launch the Schedule screen.

Patient schedule
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Optima™ CT660
Scan monitor
Protocol Management
Click the Protocol Management icon and then click Protocol Management to view the
Protocol Management screen or click Auto Voice Record to record a new Auto Voice message.
Protocol management
5366492-1EN Rev 1 (February 2010) 1-18

Scan monitor
Retro Recon
Click the Retro Recon icon to open the Retro Recon List Select screen. Select the desired
exam, series and click Select Series to open Retro Recon.
Retro ViewEdit conventions.
You can edit the fields by row or column. If you edit by column, then the change applies to all rows. If
you edit by row, the change only applies to the selected row.
Click a blue button and a pop-up appears displaying the parameters for that selection.
Text boxes are white - click on the box and type and Enter a value. If you click a button above a white
box, a pop-up appears with a text box.
Retro Recon
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Optima™ CT660
Scan monitor
Recon Management
Click the Recon Management icon to open the Recon Management screen (1). Some selections
open a second area (2).
Recon Management
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Scan monitor
Daily Prep
Click the Daily Prep icon to launch tube warm-up and fast cals.
Daily Preparation
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Optima™ CT660
Scan monitor
Utilities
Click the Utilities icon to view Scanner Utilities screen. Utilities is used primarily by service
representatives for system calibration activities.
Scanner Utilities
5366492-1EN Rev 1 (February 2010) 1-22

User Interface conventions
Select items from a list
Single item
Click the item.
Multiple contiguous items
Click and drag over a list of items.

Click a start point in the list, press Shift, click an end point in the list, and all items between start and
end are selected.
Multiple non-contiguous items

Press Ctrl and simultaneously click each item.
Cancel
The Cancel button closes a screen without executing the actions or implementing parameters described on
a screen.
Button appearance
Buttons that are gray, are currently not available.
Button on left is active or available, button on right is inactive or not available
Buttons that are selected are yellow.

Button on left is the selected Film Set button
Buttons that are sensitive and invalid are red.

Red buttons indicated invalid values
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Optima™ CT660
Buttons that are sensitive and the value appearing in the button is updated by the system are orange.
Orange button indicates the system has updated the value
Language translations
When the system is configured in a language other than English the following may be seen:
Messages posted in the Real Time Information window or the Feature Status Area may be in English.
Image annotation is not translated nor is the corresponding user interface text.
Terms that are globally accepted shown in English.
Buttons or menus on User Interface screens may be in English.
When the system is configured in a language other than English, there are several items that are displayed
in English on the protocol selector. The following table shows the items that are displayed in English and the
translation.
5366492-1EN Rev 1 (February 2010) 1-24

User interface translations
User interface English Translation
Head
Orbit
Neck
Upper Extremity
Chest
Abdomen
Spine
Pelvis
Lower Extremity
Miscellaneous
Pediatric
GE
User
Service
Most Recent
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Optima™ CT660
System troubleshooting tips

If you can no longer type in a field, move the cursor to the field and click the middle mouse to restore
functionality. If this does not work, then a system shutdown is required.
Complete all portions of Fast Cal. This assures that the Air calibration and generator calibrations are
up to date on the system.
Scan aborts may occur during Axial or Helical scanning. Always be aware of the scan progress
during an Exam and select Resume as soon as it is posted to continue.
In general, wait for a screen transition to take place before making another selection. Switching
desktops before the user interface is displayed can result in the wrong screen displayed on the
desktop.
If the console becomes unresponsive for 2 minutes or more, click the Shutdown icon to
restart the system. If you cannot select Shutdown, turn off the console power switch, wait 10
seconds, then turn the console power switch back on. The system should come up normally.
A pink warning dialog may appear indicating the system has low disk space due to full system disk
partition. Removing images does not resolve the problem. Contact your service representative to
help resolve the problem. If a message posts to run storelog, select the option to remove the logs.
Pop-up screens and menus may appear on the wrong monitor or may be displayed split between the
two monitors.
Contact your service representative, if you see the message: “Attention – High Speed Disk
Performance Degraded. Scan disk array has encountered a hard drive failure. The system is
functional, but if another hard drive fails you will lose scan data. Please contact GE service to have
the disk array repaired as soon as possible."
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Chapter 2: Safety
Chapter 2: Safety
Introduction
Warning labels and symbols
General safety guidelines
Radiation safety
Electrical safety
Mechanical safety
VolumeShuttle™ (Axial) and Volume Helical Shuttle
Cardiac safety
Laser safety
Reconstructed image orientation
Data safety
Applications software safety
Application-specific safety topics
Accuracy of measurements
Operator console ergonomics
Accessories
Emergency devices and emergency egress
Maintenance and cleaning
Cleaning equipment (bio hazard)
Environmental concerns
Name and concentration of hazardous substances
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Optima™ CT660
Introduction
The Safety chapter provides information about safety precautions and procedures. It is important for you to
read and understand the contents of this chapter so the correct precautions and procedures are followed.
This manual should be kept near the console for easy access.
CAUTION
This system was designed for use by individuals trained in CT system operation by GE Medical
Systems. Study the Safety Chapter of this Manual before you scan the first patient. Use the Index to
find the section and page number of an item of interest. Periodically review the User Manual,
Applications Tips and Workarounds, and the Technical Reference Manual.
If necessary, additional training is available from a GE Applications Specialist. Contact your institution’s GE
sales representative for additional information about further safety and operational training.
The system complies with IEC 60601-1 and UL 60601-1.
WARNING
Modification of any existing patient data on the system must follow the guidelines specified in the
User Manual.
Detailed information concerning Electromagnetic Capability can be found in the Electromagnetic Capability
chapter of the Technical Reference Manual.
United States Federal Regulation 21CFR 801.109
CAUTION
Federal law restricts this device to sale by or on the order of a physician.
CAUTION
Improper system usage could void your warranty. More importantly, you could endanger your
patients and yourself if you do not follow the correct procedures.
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Chapter 2: Safety
Warning labels and symbols

The Safety chapter addresses three safety classifications:
DANGER
The most severe label describes conditions or actions which result in a specific hazard. You will
cause severe or fatal personal injury, or substantial property damage if you ignore these
instructions.
WARNING
This label identifies conditions or actions which result in a specific hazard. You will cause severe
personal injury, or substantial property damage if you ignore these instructions.
CAUTION
This label applies to conditions or actions that have potential hazard. You may cause minor injury
or property damage if you ignore these instructions.
Equipment symbols
The Safety chapter uses the international symbol or icon along with the danger, warning, or caution
message.
IEC/ISO Standards
Symbol IEC Standard
Alternating current
Three-phase Alternating current
Protective earthing point
Power ON/OFF to Stand-by
Input Power
Output Power
Type B Equipment
Functional Earth Ground
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Optima™ CT660
Symbol IEC Standard
Equipotentiality
Warning, Caution - consult accompanying documents
Electrical Shock Hazard
Date of Manufacture
Serial Number
Cataloque Number
The following Warning Labels are used on the equipment:

Warning labels located at the bottom of the gantry cover
CAUTION
LASER RADIATION
DO NOT STARE INTO BEAM
CLASS 2 LASER PRODUCT
Labels located on the front of the gantry
CAUTION
LASER APERTURE
Do not stare into beam
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Chapter 2: Safety
CAUTION
Finger Pinching Can Cause physical injury.
To prevent pinching of fingers, keep fingers away from this area before operating the switch for
Elevation Down and IMS IN.
Warning labels located on the table
CAUTION
Finger Pinching Can Cause physical injury.
To prevent pinching of fingers, keep fingers away from this area before operating the switch for
cradle OUT.
Label on the side of the table
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Optima™ CT660
CAUTION
Do not grasp the side of the cradle.
Label located on the operators console for systems manufactured after June 10, 2006 (Reference 21CFR 1020.30 (j))
WARNING
This X-ray unit may be dangerous to patient and operator unless safe exposure factors, operating
instructions and maintenance schedules are observed. To be used by authorized personnel only.
5366492-1EN Rev 1 (February 2010) 2-32

Chapter 2: Safety
General safety guidelines

This product was designed and manufactured to ensure maximum safety of operation.It should be
operated and maintained in strict compliance with the safety precautions, warnings and operating
instructions contained herein, and in any other documentation specific to the product.
The system has been designed to meet all the safety requirements applicable to medical equipment.
However, anyone attempting to operate the system must be fully aware of potential safety hazards.
The manufacturer or vendor of the equipment makes no representation, however, that the act of
reading this manual renders the reader qualified to operate, test or calibrate the system.
The owner should make certain that only properly trained, fully qualified personnel are authorized to
operate the equipment. A list of authorized operators should be maintained.
This manual should be kept at hand, studied carefully and reviewed periodically by the authorized
operators.
Unauthorized personnel should not be allowed access to the system.
Do not leave the patient unobserved at any time.
Become familiar with the functional hardware so that you can recognize serious problems. Do not
use the system if it appears damaged or if it fails. Wait for qualified personnel to correct the
problem.
Abbreviations used in the operator manuals can be found in this manual.
If the product does not operate properly or if it fails to respond to the controls as described in this
manual, the operator should:
First ensure the safety of the patient.
Next ensure the protection of the equipment.
Evacuate the area as quickly as possible in any potentially unsafe situation.
Follow the safety precautions and procedures as specified in this manual.
Immediately contact the local service office, report the incident, and await further instructions.
The images and calculations provided by this system are intended as tools for the competent user.
They are explicitly not to be regarded as a sole incontrovertible basis for clinical diagnosis. Users
are encouraged to study the literature and reach their own professional conclusions regarding the
clinical utility of the system.
Understand the product specifications, system accuracy, and stability limitations. These limitations
must be considered before making any decision based on quantitative values. In case of doubt,
please consult your sales representative.
Do not block the ventilation ports of the electronic equipment. Always maintain at least 6 inches (15
cm) clearance around the ventilation ports to prevent overheating and damage to the electronic
hardware.
CAUTION
Prior to powering on the system, the room environmental operating conditions found in the System
Specification chapter must be maintained for at least 24 hours. These conditions must be
constantly maintained when the system is energized or in use.
CAUTION
Do not load any non-GE approved software onto the computer.
5366492-1EN Rev 1 (February 2010) 2-33

Optima™ CT660
Watch for the electromagnetic compatibility from other hardware. For more information, refer
to the Electromagnetic Compatibility section in the Technical Reference Manual, under the
General Safety Guidelines.
DANGER
Make sure all covers are in place before you use the equipment. The covers protect you and your
patient from moving parts or electrical shock. The covers also protect the equipment.
Only qualified Service personnel should service the system with the covers off.
DANGER
Information on internal gantry components is provided for user education. The gantry contains
dangerous voltages and moving parts. TO PREVENT ELECTRICAL SHOCK OR CRUSHING INJURIES,
DO NOT REMOVE COVERS OR ENTER THE GANTRY. ONLY TRAINED, QUALIFIED SERVICE PERSONNEL
MAY REMOVE GANTRY OR OTHER EQUIPMENT COVERS.
WARNING
This system is intended for use by healthcare professionals only. This system may cause radio
interference or may disrupt the operation of nearby equipment. It maybe necessary to take
mitigation measures, such as reorienting or relocating the system or shielding the location.
WARNING
Imaging functions may be lost without warning. Emergency procedures should be developed to
prepare for such an occurrence.
Implantable device safety
WARNING
CT Scans may cause interference with implanted or externally worn electronic medical devices
such as pacemakers, defibrillators, neurostimulators and drug infusion pumps. The interference
could cause operational changes or malfunction of the electronic medical device.
Recommendations prior to scanning
If practical, try to move external devices out of the scan range.

Ask patients with neurostimulators to shut off the device temporarily while the scan is performed.
Minimize the X-ray exposure to the electronic medical device.
Use the lowest possible X-ray tube current consistent with obtaining the required image quality.
Do not scan directly over the electronic device for more than a few seconds.
For procedures such as CT Perfusion or CT Interventional scans that require scanning over the
electronic medical device for more than a few seconds, attending staff should be ready to take emergency
measures to treat adverse reactions if they occur.
5366492-1EN Rev 1 (February 2010) 2-34

Chapter 2: Safety
Recommendations after scanning
Have the patient turn the device back on if it had been turned off prior to scanning.
Have the patient check the device for proper functioning, regardless of whether it was turned on or
off.
Advise patients to contact their healthcare provider as soon as possible if they suspect their device
is not functioning properly after a CT scan.
Recommendations from FDA Preliminary Public Health Notification: Possible Malfunction of Electronic
Medical Devices Caused by Computed Tomography (CT) Scanning date July 14, 2008.
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Optima™ CT660
Radiation safety
(Reference 21CFR 1020.30 (h) (1) (i))
WARNING
Improperly used X-ray equipment may cause injury. Read and understand the instructions in this
book before you attempt to operate this equipment. If you fail to follow safe X-ray practices or
ignore the advice presented in the manual, you and your patient risk exposure to hazardous
radiation.
Authorized users
This equipment incorporates a high degree of protection against X-ray radiation outside the useful beam.
But this equipment cannot substitute the essential requirement that every user must take adequate
precautions to prevent the possibility of any person carelessly, unwisely, or unknowingly exposing
themselves or others to radiation.
Everyone having anything to do with X-ray equipment must receive proper training and become fully
acquainted with the recommendations of the NCRP1 and Measurements and the ICRP2. NCRP reports are
available from:
NCRP Publications
7910 Woodmont Avenue
Room 1016
Bethesda, Maryland 20814
WARNING
Everyone having anything to do with X-ray equipment must take adequate steps to insure
protection against injury.
All persons authorized to use the equipment must understand the dangers posed by X-ray exposure so that
they can prevent any injury or damage that may result from such exposure. GE Medical Systems urges you
to use protective materials and devices to prevent any injury or damage from X-ray exposure.
General radiation safety
WARNING
Never scan a patient with unauthorized personnel in the scan room. Warn visitors and patients
about potential for harm if they fail to follow instructions.
WARNING
Never calibrate, test the system, or warm the tube with patients or personnel present in the scan
room without adequate radiation safety precautions being utilized.
1National Council on Radiation Protection

2International Commission on Radiation Protection
5366492-1EN Rev 1 (February 2010) 2-36

Chapter 2: Safety
Stay behind a lead screen or lead glass shield during each X-ray exposure.
Use technique factors prescribed by the radiologist or diagnostician. Use a dose that produces
the best diagnostic results with the least X-ray exposure.
Amber indicator lights on the gantry control panel, and rear of the gantry, illuminate during X-
ray exposure.
CAUTION
Use of controls or adjustments, or performance of procedures other than those specified herein,
may result in hazardous radiation exposure.
Scans acquired at the same tomographic plane

IEC standard 60601-2-44 section 29.105 states that you must be warned when scans are acquired at the
same tomographic plane, i.e., the same scan location. The need for the warning is to make users aware of
the potential dose that can be given to the patient when acquiring scans at the same table location.
When acquiring scans in this mode:
Utilize the dose information displayed on the ViewEdit screen. The dose information displayed is
covered in the next section, CTDIvol.
An optional DICOM1 SR2 Dose Report is saved in Series 997.
Use proper techniques for the application and anatomy you are scanning.
A warning message is posted when Confirm is selected for the following scan types:
SmartStep
SmartPrep Baseline and Monitor scans
Cine scans
Axial scans with zero table increment (interval)
VolumeShuttle (axial)
Volume Helical Shuttle

2Structured Report
5366492-1EN Rev 1 (February 2010) 2-37

Optima™ CT660
Warning Message when scanning on the same tomographic plane: Axial, Cine, and Helical
WARNING
This series contains one or more groups with multiple scans at the same tomographic plane, i.e.
same location. Do you wish to continue?
CAUTION
Prolonged exposure to X-ray in one spot may cause reddening or radiation burns. Users must be
aware of the techniques used and exposure time to ensure safe operation.
Warning message when scanning on the same tomographic plane for Volume Helical Shuttle
5366492-1EN Rev 1 (February 2010) 2-38

Chapter 2: Safety
WARNING
This series contains one or more groups with multiple scans at the same
tomographic plane, i.e. same location.
Temporal interval for some of the images exceeds 3.2 seconds. Use of this data for
processing of CT Perfusion maps may contain errors in the functional information.
Since Volume Helical Shuttle Scan gives repeated scans over the same region,
careful attention should be made when scanning sensitive organs like the lens of the
eyes.
Do you wish to continue?
Warning message when scanning on the same tomographic plane: VolumeShuttle (Axial)
WARNING
This series contains one or more groups with multiple scans at the same tomographic plane, i.e.
same location.
Temporal interval for some of the images exceeds 3.2 seconds. Use of this data for processing of
CT Perfusion maps may contain errors in the functional information.
After reading the message, if you wish to continue with the scan, click Continue.
CTDIvol
As you setup the scan parameters from the ViewEdit screen, the Dose Information area at the upper right
of the scan monitor contains updated dose information. This dose information is based on a measurement
of the CTDI1, which is the current standard for CT dosimetry and performance. By using a measurement
called CTDIvol, a single value is provided to estimate the relative dose for an exam.
1Computed Tomography Dose Index
5366492-1EN Rev 1 (February 2010) 2-39

Optima™ CT660
The CTDIvol is a weighted average measurement in a reference phantom. This dose is expressed in
milliGrays. For additional information on specific CTDIvol doses and their calculations, refer to your
Technical Reference manual.
The DLP1 is the product of the CTDIvol and the scan length for a group of scans. This number can be
summed over the entire exam to give an estimate of the total dose. The value is expressed in milliGray
centimeters.
The Projected Series DLP shows the DLP that would result from scanning the current group or groups.
The Accumulated Exam DLP displays the total exam DLP up to the current point in time. Scout dose is not
included in the DLP totals since standards for reporting scout dose are not yet defined. Scout dose is
generally a very small part of the exam.
The dose information updates when technique values such as kV, mA, scan time, slice thickness, and scan
field of view are changed.
Dose information is saved as a screen save image in Series 999 upon selecting End Exam. Series 997
contains the DICOM Dose Structured Report.
Pediatric and small patient imaging

Adult techniques and protocols should not be used on pediatric patients under two years of age. The
National Cancer Institute and The Society for Pediatric Radiology developed a brochure, (available at:
http://www.cancer.gov/cancertopics/causes/radiation-risks-pediatric-CT) and the FDA issued a Public
Health Notification, (available at: http://www.fda.gov/cdrh/safety/110201-ct.html), that discuss the value of
CT and the importance of minimizing radiation dose, especially in children. More information can also be
obtained at http://www.fda.gov/cdrh/ct/.
CAUTION
Using accessories which are not GE approved accessories might affect dose and image quality.
X-ray tubes
The system uses cooling and reconstruction algorithms specifically designed for GE X-ray tubes.
You risk three dangers when you do not use GE X-ray tubes.
A non-GE tube could cause destructive component failure if the cooling delays do not meet its design
requirements.
The images could exhibit reduced performance or artifacts if your X-ray tube fails to conform with
GE tube performance specifications.
Radiation leakage may exceed GE specifications when a non-GE X-ray tube is installed in the system.
CAUTION
We cannot guarantee performance or safety if you use a non-GE X-ray tube because the cooling
and reconstruction algorithms depend upon the tube design. Radiation leakage may exceed GE
specifications when a non-GE X-ray tube is installed in the system.
1Dose Length Product
5366492-1EN Rev 1 (February 2010) 2-40

Chapter 2: Safety
Electrical safety
DANGER
ELECTRICAL SHOCK HAZARD. Avoid all contact with any electrical conductor. Do not remove or
open system covers or plugs. Internal circuits use high voltage capable of causing serious injury.
An electrical hazard may exist if any light, monitor, or visual indicator stays on after the system is
shut down. To prevent possible injury, turn off the main power supply wall switch, and contact your
service office immediately.
DANGER
NO USER SERVICEABLE PARTS. Refer service to qualified service personnel. Only allow people who
know the proper procedures, and use of the proper tools, to install, adjust, repair, or modify the
equipment.
To guarantee safe, reliable equipment performance, prepare the site according to GE Medical
Systems requirements. If you have any questions about these requirements, contact GE Medical
Systems.
Fuses blown within 36 hours of being replaced may indicate malfunctioning electrical circuits
within the system. Have the system checked by qualified service personnel, and do not attempt to
replace any fuse.
DANGER
ELECTRICAL FIRE. Conductive fluids that seep into the active circuit components of the system may
cause short circuits that can result in electrical fires. Therefore, do not place any liquid or food on
any part of the system.
To avoid electrical shocks or burns caused by the use of the wrong type of fire extinguisher, make
sure that only fire extinguishers approved for use on electrical fires are used.
Surplus lengths of power cords or other cables from mobile accessory units that may be used
during some patient scanning should be stored in safe and isolated areas. For example, excess
cable may be wound in a figure eight and stored at the base of the stationary equipment. This
minimizes signal interference and protects cables from damage due to traffic.
CAUTION
The outlets are not for General Use. Operator Console outlet has a rating for 2.5A at 120VAC.
Gantry outlets have a rating for 3.0A at 120VAC. Accessories should not exceed above rating.
CAUTION
Included power cord is only to be used when connecting GE-approved accessories to the gantry or
operator console.
5366492-1EN Rev 1 (February 2010) 2-41

Optima™ CT660
Regarding LCD, Modem, Video amp, MOD and Media tower, do not connect these devices to a power source
other than CT system (for example, wall outlet, other electrical equipment) with cables that are not provided
by GE. And, do not connect electric devices that are not provided by GE to CT system. It may cause increased
leakage current and there is possibility of electric shock.
If equipment (for example, Ethernet hub), is connected to the CT system by a signal cable and is
powered by a different power source other than the CT system (for example, wall outlet), then a separation
device for the equipment is required except for the device connected to the USB port of the media tower on
OC.
5366492-1EN Rev 1 (February 2010) 2-42

Chapter 2: Safety
Mechanical safety
General mechanical safety

Check for any obstruction around the equipment before attempting to move the table and gantry.
When performing table or gantry motions, always monitor the progress of the motion.
Be especially careful when tilting the gantry, or when moving the table with the cradle extender or
head holder is in place, to avoid driving these accessories into the gantry covers.
The Cradle Unlatch Indicator is illuminated when the cradle is unlocked. An unlocked cradle
could potentially move unexpectedly.
The Interference light illuminates when the cradle has reached a travel limit or encountered
interference.
If the table reaches one of the limits while you are actively pressing the controls, the limit light will
turn off when the controls are released.
Clear an interference by changing the gantry tilt, moving the cradle, or adjusting the table height.
WARNING
Do not use the table base as a foot rest. You could entrap and injure your foot while lowering the
table. Do not place your hands between the table base and the table side panels.
WARNING
Do not place your hands inside the gantry cover when tilting the gantry. The gantry can pinch or
crush your hands!
WARNING
Be sure that the gantry will not touch the patient during Remote Tilt operation. Pinching or crushing
may happen if the gantry touches the patient.
Avoid any patient contact with the gantry during tilt or cradle movement (manually or software
driven).
Short Footprint Mode

If the system is set to Short Footprint mode, scannable range is limited accordingly. This should
be approved by the customer during pre-installation.
Only qualified Service personnel should change the setting of the Small Footprint Mode.
Patient positioning
CAUTION
Keep the patient in view at all times.
5366492-1EN Rev 1 (February 2010) 2-43

Optima™ CT660
Never leave the patient unattended.
CAUTION
If the head is poorly positioned in the head holder and a gantry tilt is used, images with different CT
numbers and intensities may be seen at the edges of two rotational interfaces. Make sure the
patient is properly positioned in the head holder, and not positioned so that the head is at the
junction of the head holder attachment to the cradle. If a repeat scan is needed, make sure the
locations with different intensities are in the middle of the beam collimation. Do not repeat using
exactly the same prescription.
DANGER
450 Pounds (205 kg) Table:
Do not Place a Patient on the Table Weighing More Than the Upper Limit of 450 Pounds (205kg).
This Could Cause the Table to Fail and the Patient Could Fall.
Do not Place a Patient on the Table Weighing More Than the Upper Limit of 500 Pounds (227kg).
This Could Cause the Table to Fail and the Patient Could Fall.
The concentrated weight of short, heavy patients can cause the cradle to make contact with
the gantry.
Make sure you do not drive the cradle into the gantry cover.
Make sure you do not pinch the patient's skin or extremities between the cradle and the
gantry.
CAUTION
When using the external laser alignment light for patient positioning purposes, be aware that the
patient's elevation may be slightly lower with the cradle extended than with the cradle fully
retracted. This is because the cradle may bend slightly under a patient's weight. This difference
should be taken into consideration for applications where patient position information is critical,
such as Treatment Planning. To minimize these effects, after using the external laser alignment
system to position the patient, advance the patient to the CT scan plane. Turn on the CT alignment
lights to determine if they line up with the markers on the patient. If necessary, compensate for the
bend in the cradle by elevating the table. When the CT alignment lights line up with the markers, set
the landmark for the scan using the Internal laser alignment light.
Please refer to Table X-Y accuracy for the Flat Tabletop workflow for Flat Tabletop in the User Manual to
assess the X-Y accuracy of your system.
CAUTION
When using patient positioning accessories, make sure there are no areas, which might cause a
pinch point or interfere with patient tubing or IV.
CAUTION
Check to make sure the power injector has enough IV tubing to allow free movement of the cradle.
Make sure the unit itself does not interfere with table travel.
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Ensure excess tubing length is secured to the table top. DO NOT loop additional IV tubing in the
patient's fingers.
Check the length of all patient health lines (IV tubing, oxygen line, etc.) and make sure they
accommodate cradle travel. Position these lines so they cannot catch on anything within the
patient vicinity or between the table and gantry during cradle travel or gantry tilt.
CAUTION
The patient positioning straps provided with the system do not support the full weight of the
patient. Patient positioning straps should be used to aid in patient positioning and are not meant to
fully restrain the patient.
CAUTION
Care should be taken to ensure the patient positioning straps, patient clothing, or other material
will not be caught during table motion.
Table
CAUTION
If the table is lowered with anything in the red X area as indicated, the table could be damaged
along with the equipment or object under the table.
CAUTION
Physically assist all patients on and off the table and into position on the cradle.
CAUTION
The foot pedals at the base of the table for loading and unloading patients are always active. Care
should be taken not to activate the foot pedals once the patient has been positioned on the cradle
and an exam started.
Return the gantry tilt to the 0-degree upright position, latch the cradle, and adjust the table to
a comfortable height for patient loading and unloading.
Latch the cradle before you load or unload the patient (the Cradle Unlatch indicator illuminates
when the cradle is unlatched).
WARNING
To prevent pinching or crushing of the patient's extremities, keep the patient's hands and feet away
from the edge of the moving table top/cradle and its surrounding equipment, or between table
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base and side panels of the table. Take special care when positioning physically large patients.
WARNING
To prevent pinching or crushing of the patient, watch the patient and equipment carefully at all
times during gantry tilt or table movement. If unwanted motion occurs or motion does not stop,
press the emergency stop switches on the console or gantry.
WARNING
The head holder may crack, possibly injuring the patient's head or neck, if the patient tries to brace
himself or herself on the head holder during positioning. The head holder and cradle extender are
only designed to support 75 pounds (34kg). Ask the patient to move up into the head holder or
manually help the patient into position.
Load Limit Caution
CAUTION
Excessive weight can break accessory and cause injury. Do not load more than 34 kg or 75 pounds.
CAUTION
The patient head holder or table extender should be adequately secured to ensure stability. If they
are not secured properly, degradation of image quality may result due to introduced motion of the
head holder or table extender.
CAUTION
Use of any cradle extension accessories such as the table extension, head holder, coronal head
holder, and phantom holder are not accounted for in the table gantry interference matrix.
Therefore, additional care needs to be taken to closely monitor any table up/down, in/out or gantry
tilt movement to avoid contact of the extended accessory with the gantry.
Accessory caution
CAUTION
Do not hit the accessory against the gantry. Patient injury or equipment damage could result.
Collision sensors are placed under the table surfaces to stop downward motion and minimize the
effects of a collision in most cases. Upward motion is still allowed if a collision sensor has been activated.
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Check the accessory attachment plate fixed to the end of the cradle. Repair or replace if loose or
damaged.
Use the cradle extender to support the patient's head or feet during a scan.
To move the patient out of the gantry in an emergency, the cradle can be manually withdrawn by applying a
minimum of:
500 Pounds (227 kg) Table: 60 lbs (267 N) of force.

450 Pounds (205 kg) Table: 68 lbs (304 N) of force.
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ASiR
This section contains ASiR warnings.
Warning message when turning Off ASiR in protocol
WARNING
ASiR has been disabled. Please adjust the mA and Noise Index values to the appropriate pre-ASiR
values before using Dose Reduction Guidance. Using Dose Reduction Guidance on already dose
reduced scan parameters may cause sub-optimal or non-diagnostic images. Please consult your
operator documentation for additional information.
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VolumeShuttle™ (Axial) and Volume Helical Shuttle

This section contains VolumeShuttle (Axial) and Volume Helical Shuttle warnings.
For Volume Helical Shuttle a message will be posted in the Real Time Information Area and an
Attention pop-up will be posted with the following messages:
“Table travel did not meet expected time for pass(es) during acquisition.”
"Additional information on the errors seen can be found in the GE System Log."
CAUTION
Temporal sampling may be degraded due to changes in timing for the table to move from location
to location if proper positioning methods are not followed. Make sure that the patient is securely
positioned on the table and their arms are not allowed to drag on the table, or allow clothing,
sheets or blankets to get caught causing a table move problem.
WARNING
Temporal interval for images exceeds 3.2 seconds. Use of this data for processing of CT Perfusion
maps may contain errors in the functional information.
Temporal sampling for data acquired for use in CT Perfusion should not exceed 3.2 seconds between data
points for optimal results. As the temporal resolution increases, an error in the statistical accuracy of the
information may be introduced.
This section contains VoumeShuttle (Axial) warnings.
CAUTION
VolumeShuttle (Axial) is intended for the neuro application of CT Perfusion.
CAUTION
VolumeShuttle (Axial) acquisition for head imaging should be performed with the patient positioned
head first into the gantry in the head holder, or with the top of the head positioned 200 mm from
the end of the cradle. Degraded image quality may result if alternate positions are used due to
excessive body mass on an extended table.
CAUTION
VolumeShuttle (Axial) for the acquisition of perfusion data should not be used for patients whose
weight is greater than 400 lbs (181 kgs). The possibility exists of a scan abort due to the system not
being able to move the table within the specified time. Use a Cine or Axial protocol for a single 40
mm location and repeat for a second location if additional coverage is needed.
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This section contains Volume Helical Shuttle warnings.
WARNING
Prospective reconstruction only allows a preview series to be reconstructed at 5 mm thick with a
10 mm interval. All additional reconstructions need to be done in Retro Recon.
At End Exam for exams containing Volume Helical Shuttle
WARNING
Helical Shuttle Scan: Generate Retro Recon images, or reserve scan files immediately.
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Cardiac safety
CAUTION
If, during the scan, the heart rate drops significantly lower than the prescribed heart rate, there is
a potential for gaps in the gated image location. To avoid image location gaps, a non-gated image
is reconstructed for the period where the patient heart rate dropped below the expected or
confirmed heart rate at the start of the exam. A non-gated image may have more motion and may
not be reconstructed at the prescribed phase.
CAUTION
ECG signal clarity and integrity must be confirmed prior to performing ECG-gated acquisitions.
Items which may require adjustments of equipment settings or positioning, or patient set-up
include:
External Interference
A typical Patient ECG (e.g. elevated T-Waves, low ECG amplitude or signal strength)
Suboptimal Patient Connection
ECG lead placement should follow recommended guidelines to optimize results.

If the ECG lead becomes disconnected during the scan, or the heart rate drops below 30 BPM, the
images will be reconstructed as non-gated segment images. This is done to avoid inaccuracy of
the z-location of images where necessary.
CAUTION
Ensure the ECG patches are not past expiration date and that the gel on the pads is still moist for
proper conduction of the ECG signal for successful gating.
It is important to explain to the patient the events that will occur during the acquisition of the
contrast enhanced cardiac data. Make sure to explain the warm feeling that may occur during
the injection of the contrast material.
Use consistent breathing technique for all the series in a cardiac exam. Practice the consistent
breathing instructions with the patient prior to scanning.
During the practice breath hold, make sure to watch the ECG trigger monitor to determine the
average heart rate, minimum heart rate, and ECG pattern during the breath hold.
Position the patient's arms over the patient's head so they are comfortable and will not move
during the acquisition of data.
CAUTION
A patient with any of the conditions listed below may require additional attention. If patients are
scanned with these conditions, the software may not be able to detect the R-peaks and the images
therefore may be produced as ungated segment images.
Patients with multiple pre-contractions or extra systole (e.g. PVC, PAC).

Patients with persistent or extreme arrhythmia.
Patients with bi-ventricular lead (dual chamber) pacemakers.
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CAUTION
Patient motion, respiration, beat-to-beat variability of heart rate, heart motion, or significant
change in heart rate over the scan duration could cause an ECG gated acquisition to have
degraded image quality. It is important to explain to the patient the pattern of breathing
instructions to expect, the warm feeling that can be felt from the contrast injection, and to position
the patient comfortably such that the arms will not move with respect to the body during the scan.
CAUTION
There is a possibility that the ECG signal may not be detected by the system due to improper lead
placements, or a lead falling off during the scan. It is important to place new leads on the patient
before the scan. Make sure the leads are attached properly, and use only GE recommended ECG
leads. It is important to confirm ECG trace clarity before the scan.
CAUTION
Avoid scanning patients with known arrhythmias. If arrhythmias (including pre-ventricular
contractions, or extra systole), are seen when reviewing the ECG trace prior to scanning, attempt to
regulate the heart rhythm (e.g. practice breathing instructions, calm the patient, or follow
procedure established by your institution). It is not advised to scan a patient with arrhythmias as
image quality may be degraded.
CAUTION
If you do not see the RED line on the R-peak, but somewhere else, it is advised to make the
appropriate adjustments to the electrode placement, monitor settings, and equipment to ensure
proper gating on the R-peak.
CAUTION
The heart rate displayed on CT console is a 3-cycle average. You must review the actual waveform
pattern to determine ECG trace clarity, trigger location, and if any cycle-to-cycle variability or
masked arrhythmias may be present in order to adapt set up and conditions prior to proceeding
with the scan acquisition.
CAUTION
Cardiac helical scan modes of SnapShot Segment, Burst, and Burst Plus are optimized for specific
heart rate ranges. Select the appropriate scan mode for each patient's heart rate pattern. If the
incorrect mode is selected, temporal resolution may be insufficient and degraded image quality
could result.
CAUTION
SnapShot Segment Plus is an alternate reconstruction mode which applies a different weighting to
data in the area of cardiac cycle transitions compared to SnapShot Segment reconstruction mode.
Image quality in these transition areas should be reviewed carefully.
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CAUTION
SnapShot Pulse should not be used for studies where function or full multiphase analysis is
needed. Settings may limit the cardiac phases available to one or a few neighboring phases
impacting the ability to analyze heart motion or review cardiac phase locations outside the
prescribed phase.
WARNING
When using SnapShot Pulse scan mode for coronary artery imaging, SnapShot Pulse should only
be used for patients with stable heart rates of 65 beats per minute (BPM) or less. Heart rates that
are unstable or above 65 BPM inherently exhibit higher heart motion and increase the interscan
delay, which could lead to suboptimal image quality. Alternate imaging modes such as cardiac
helical should be considered if the optimal conditions for SnapShot Pulse are not met.
CAUTION
Auto mA and ECG Modulation are not valid with SnapShot Pulse acquisitions due to prospective
control of X-ray over the scan volume. Only Manual mA values can be prescribed.
CAUTION
Manual edits of the ECG gating R-Peak triggers may be performed retrospectively in some ECG-
gated exams as long as scan data exists on the console. Images can be reconstructed with user
modified gating triggers and the original gating information can be retrieved after edits have been
made.
CAUTION
Heart rate information and phase location will be updated to indicate any movement of trigger
locations since heart rate and phase values are calculated based on time between consecutive
triggers and are not diagnostic values.
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Laser safety
A laser alignment light system is available in order to accurately define the patient scan region.
WARNING
THE LASER BEAM CAN CAUSE EYE INJURY.
Tell all patients to close their eyes before you switch ON the alignment lights.
Instruct your patients to keep their eyes closed until you turn OFF the alignment lights.
Closely monitor infants and inform patients, and prevent them from accidentally staring into
the beam.
CAUTION
For patient safety, it is important to always have patients close their eyes anytime the laser
alignment light is on.
CAUTION
The detector and DAS rotate to position the alignment lights over the laser ports.
Keep your hands away from the gantry opening.

Make sure the gantry side covers are in place.
CAUTION
Use of controls or adjustments, or performance of procedures other than those specified herein,
may result in hazardous radiation exposure.
The indicator on the gantry display panel lights when you turn ON the alignment lights.
Warning labels regarding laser safety are provided on the gantry, as described in the Warning
Labels and Symbols section.
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Chapter 2: Safety
Reconstructed image orientation
CAUTION
If you plan to reconstruct images, you must first use the files that reside on the disk. Either reserve
the scan files you plan to retrospectively reconstruct, or reconstruct unsaved scan files before the
system overwrites the file with new scan data. The system refuses to overwrite reserved scan
files. Remember to release the reserved scan files when you finish retrospective reconstructions.
CAUTION
GE CT image reconstruction is in an orientation viewing from the patient's feet. The reconstructed
orientation is the orientation in which the image is installed in the image data base, and is the
orientation with which images are networked to a remote viewing station.
1=Head first supine, 2=Head first prone, 3=Feet first supine, 4=Feet first prone
1 2
3 4
The patient position information stored in the image header correctly reflects the orientation (RAS1)
information for the patient. Viewing applications will correctly reflect Right (R), Left (L), Anterior (A) and
Posterior (P) of the patient.
The reconstructed image orientation may differ from preferred anatomical viewing presentation in which
the patient's Right is on the viewers Left and patient's Left is on the viewers Right. For example, when the
patient is scanned Head First and Prone the patients’s Left is on the viewer’s Left and the patient’s Right is
on the viewer’s Right. The image presentation will need to be modified to display preferred anatomical
viewing. Some viewing stations may not have the capability to flip the image presentation, but if the
capability exists, you must use display tools such as Flip to change the presentation of the image.
1Right Anterior Superior
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Some remote viewing stations may have the capability to set default viewing protocols. This is another tool
that can be used to set an anatomical viewing presentation.
Post processing applications such as Direct MPR, Reformat and Volume Viewer automatically orient images
in anatomical viewing orientation. These applications create axial images in anatomical viewing
presentation. Please see Display Applications for more information. The system also provides the capability
to create GSPS1 to flip the image orientation.
Flip/Rotate in recon can be used to generate images where right/left or anterior/posterior are flipped or
where both R/L and A/P have been flipped to meet desired image display preference. An Attention pop-up is
displayed at Confirm for series where Flip/Rotate in recon is selected. Attention: This scan prescription
utilizes one of the reconstruction-based image flip or rotate options. Please ensure that this prescribed
image orientation is displayed appropriately on all remote viewing devices.
Flip warning message
CAUTION
The scan prescription utilizes one of the reconstruction based image flip and/or rotate options.
Please ensure the prescribed image orientation is displayed correctly on all remote viewing
devices.
1Gray Scale Presentation State
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Data safety
To ensure data safety:
Verify and record the patient's identification before starting a scan.

Observe and record the patient's orientation, position, and anatomical landmarks before starting a
scan. Ensure that the patient is positioned within the scan parameters.
Maintain system image quality by performing Daily QA and other maintenance.
Connectivity - Always verify that the data transferred to another system has been correctly received.
CAUTION
When comparing GE CT images with other images, consult the DICOM Conformance Statement for
the details on the DICOM Image Position, Frame of Reference UID, and Slice Locations values
stored.
CAUTION
Some annotation values are stored in private DICOM elements. When viewing images on a remote
station, these annotation values may not be visible on the image. Consult the DICOM Conformance
Statement for information on private DICOM data fields.
CAUTION
If you plan to reconstruct images, you must use files that reside in the disk. Either reserve the scan
files you plan to retrospectively reconstruct, or reconstruct unsaved scan files before the system
overwrites the files with new scan data. The system refuse to overwrite reserved scan files.
Remember to release the reserved scan files when you finish retrospective reconstruction.
CAUTION
CT Numbers are NOT absolute; misdiagnosis is possible. System and patient variables may affect
CT Number accuracy. If you rely solely upon CT Numbers without taking variables into
consideration, you could misdiagnose an image.
CAUTION
Incorrect data entries or procedures could result in misinterpretation or misdiagnosis.
CAUTION
When entering Patient ID information, the system may contain multiple instances of the same
Patient ID. Multiple schedule records can be due to multiple procedures being ordered under
separate accession numbers or New and Completed records in the Patient schedule for the same
Patient ID.
When entering the Patient ID, verify that the correct Accession number and Exam Description
selected is what is desired. Scanning with an incorrect accession number may cause problems
reconciling exams on a PACS system. Please see the Schedule Patients chapter for more
information.
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CAUTION
The system posts a warning message when expected disk space required to store scan data from
the prescribed exam is insufficient.
CAUTION
The system posts a warning message when expected image space required to store images from
prescribed reconstruction is insufficient.
CAUTION
The system posts a warning message when data was interpolated to generate images.
CAUTION
The system posts a warning message if there is a failure during the archive of patient data.
CAUTION
The system posts a warning message if there is a failure during the network of patient image data.
CAUTION
The system posts a warning message when a scan is aborted due to a failure in the acquisition
chain.
CAUTION
The system posts a warning message when the system has low disk space. This is due to a partition
on the system disk getting too full. Removing images will not help. Contact service to help with
recovery. If you reboot the system and see the message asking if you want to run storelog, select
the option to remove the logs.
CAUTION
The system posts a warning message if patient orientation has been changed or does not match
after start of exam.
CAUTION
The system posts warning message prior to modifying any existing data set by a software utility.
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Applications software safety
CAUTION
Do not initiate a QuickSnap if the system is actively collecting data with X-ray on.
CAUTION
Do not initiate an IQ Snap while the system is actively scanning or reconstructing data.
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Application-specific safety topics
Helical scanning
WARNING
Helical scanning has the inherent ability to produce artifacts when scanning highly sloped anatomy
(e.g. pediatric or adult heads). Factors which worsen this effect are: faster table speeds, thicker
image thickness, and gantry tilt. In some cases these artifacts could be mistaken for a hemorrhage
near the cranium, or a thickening of the skull.
To reduce the occurrence of these artifacts, you may prescribe slower table speeds or thinner
slices (such as 2.5 mm) during helical scans near the vertex of a pediatric or adult head.
WARNING
It has been documented in radiology literature that an artifact may occur in the chest that bears the
double margin of the great vessels, which emulates a dissection of the vessel during 0. 4 - 1.0
second scans. This can occur in axial or helical scans. If you have scanned axially with a 0. 4 - 1.0
second rotation time and observe this phenomenon, re-scan the area with a 2 second axial scan to
verify if it is artifact or patient pathology. Segment recon mode for helical and cine acquisitions may
be used in Retro Recon to also assess if the area is artifact or pathology.
Lung algorithm
The Lung algorithm setting provides edge enhancement between structures with large density
differences, such as calcium and air, resulting in a sharper lung field when compared to Standard
algorithm.
For best image quality, prescribe a 5 mm scan thickness when you plan to use the Lung algorithm. If
you plan to prescribe a High Resolution Lung study with 3.75, 2.5, or 1.25 mm, use the Bone
algorithm.
The Lung setting enhances the contrast of small objects. For best viewing and film quality, select a
window width of 1,000 to 1,500 and a window level of -500 to -600.
The Lung algorithm setting increases the CT number values at the edge of high contrast objects. If
you plan to take CT number measurements of vessels or nodules in the lung, please check and
compare your results with Standard algorithm images. ROI and Histogram functions use CT
numbers.
Remember: The edge enhancement provided by the Lung setting may not be appropriate in some
clinical cases. Please take individual viewing preferences into account when you choose the Lung
setting.
Auto Scan
Press and release Move to Scan on the console to advance the cradle.
If Auto Scan is disabled, Move to Scan must be pressed for every scan before Start Scan will
become ready.
If you select Auto Scan during one group Rx, it remains ON for every group in that series.
SmartStep safety
The SmartStep option adds several components to the scan room. These are the In-Room Monitor, Hand
Held Control for table movement as well as image review, and the X-ray Control Foot pedal.
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Each of the SmartStep components is connected to the system by a cable. When using the system, ensure
that the cables cannot catch on anything when the gantry or table is moved.
Table float
During the scan, the clinician has the option to float the table between scans. When the Table Float mode is
selected, the table is unlatched and can be moved freely by anyone at the bedside.
WARNING
Unintended table motion may cause a serious injury. Table may be bumped or jarred during an
interventional procedure. Care must be taken when performing interventional procedures in the
float mode. It is the clinician's responsibility to ensure that they have control of the table when in
this mode of operation. Table must not be left unattended when in the float mode. Ensure that the
table is latched before leaving the table side.
SmartStep scanning
SmartStep scanning allows multiple scans at one location for interventional procedures. The system allows
up to 90 seconds of scanning in one place. After 90 seconds, the operator must prescribe a new scan to
continue. The accumulated scan time from a procedure is displayed on the In-Room Monitor.
CAUTION
Exposure time to the patient can be up to 90 seconds per Confirm compared to 60 seconds for all
other scan modes.
CAUTION
Prolonged exposure to X-ray in one spot may cause reddening or radiation burns. User must be
aware of the techniques used and exposure time to ensure safe operation.
CAUTION
The foot pedal is active if the system is in the “Prepped” state. Care should be taken not to step on
the foot pedal and make an unwanted exposure.
Clinicians working in the scan room should wear appropriate protective clothing. Lead aprons, groin and
thyroid protection, as well as protective eye wear are available through the GE Accessories Catalog.
Interventional/biopsy scanning
CAUTION
The continuous AutoView layout format should not be used for display of images during an
interventional study because it does not allow for quick review of images in a free viewport.
WARNING
When scanning for interventional (biopsy) studies, the scan mode, image thickness, number of
images per rotation, and the display layout used affect the display of the images. It is
recommended to use the Biopsy Mode provided on the system. If manually prescribing biopsy
scans, Axial 1i scan mode or Helical scan mode with a slice thickness greater than 2.5 mm must be
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used. Do not use Cine scan mode for interventional (Biopsy) imaging. Do not use an AutoView
layout with more than one AutoView image viewport.
Refer to the Set Image Display procedure in the Viewing images chapter for more information on how to
set up the desired viewing options. Choose one of the following for the best AutoView layouts.
AutoView Layouts
Treatment planning
Potential inaccuracy can occur in the positional display of the system when the manual cradle release is
used inappropriately during Radiation Therapy simulation procedures.
Advanced applications safety
CAUTION
3D or slab reconstructions provide additional supplemental information, complementing diagnosis
that should be based on classical techniques.
WARNING
Non-GE images acquired can be loaded in Volume Viewer but GE does not guarantee the quality or
reliability of any reconstruction, segmentation, or measurements performed on these images.
Non-GE images can easily be identified by the corresponding image annotation.
Follow the DICOM acquisition parameter guidelines listed in each application user guide. Consult
GE-published DICOM conformance statement of Volume Viewer which is available on the GE
Healthcare website at
http://www.gehealthcare.com/usen/interoperability/dicom/products/workstation_dicom.html
WARNING
Before using any segmentation tool (threshold, scalpel, remove & keep object, Auto Select, “floater”
filters…), always make sure that it will not remove pathologies or other essential anatomical
structures.
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WARNING
When using any Segmentation tools (Auto Select, threshold, Paint on slice, Quick Paint…), check
contours to check the reliability of the segmentation. Make sure the contours match the correct
segmentation and volumes. Check that segmented volumes match contours.
Measurements
WARNING
Do not use 3D or slab views only to perform any measurements (distance, angle, Region of
Interest, Report Cursor, Area, Volume…). Always check measurement points' position and refer to
2D baseline views (acquisition images or reformatted images of minimal thickness) to confirm
measurements.
CAUTION
The software calculates and displays measurements with a resolution of one decimal (such as 0.1
mm, 0.1 degree, etc.). You should be aware that the real measurement accuracy is generally less
for a number of different reasons (image resolution, acquisition conditions…).
Distance, angle and area measurements are valid only if all trace segments are longer than the
inter-slice distance.
WARNING
Depending on WW/WL settings, objects may display differently. Check WW/WL before depositing
measurement points.
CAUTION
When filming or saving images for diagnostic purposes, always make sure the patient name and
geometry information is displayed on all views, and that they match information on the reference
view.
CAUTION
When saving images with a new series description, make sure this description matches the saved
images.
WARNING
After post processing and reloading, check the reliability of segmentations and measurements
performed in Saved objects with original datasets.
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Segment tools
WARNING
Before using any segmentation tool (threshold, scalpel, remove & keep object, Auto Select, “floater”
filters…), always make sure that it will not remove pathologies or other essential anatomical
structures.
WARNING
When using any Segmentation tools (Auto Select, threshold, Paint on slice, Quick Paint…), check
contours to check the reliability of the segmentation. Make sure the contours match the correct
segmentation and volumes. Check that the segmented volumes match contours.
Filming and saving images
CAUTION
When filming or saving images for diagnostic purposes, always make sure the patient name and
geometry information is displayed on all views, and that they match information on the reference
view.
CAUTION
When saving images with a new series description, make sure this description matches the saved
images.
CAUTION
After post processing and reloading, check the reliability of segmentations and measurements
performed in Saved objects with original datasets.
Image reliability
CAUTION
3D or slab reconstructions provide additional supplemental information, complementing diagnosis
that should be based on classical techniques.
WARNING
Always correlate any information (cursor position, image orientation, measurements, image
quality…) in any 3D reconstruction (reformatted plane, oblique, MPVR, MIP, Volume Rendering,
Navigator endoluminal views, Curved, segmentations, measurements, tracking, saved images…)
with the original data (acquisition or baseline images).
WARNING
A 3D view is a two-dimensional projection on the screen of the 3D Volume. There is no indication
on a 3D view of how “deep “inside the 3D volume a 3D cursor is. Always check the accuracy and
consistency of 3D coordinates by checking cursor position on original data (acquisition images).
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Window width and level (W/L)
WARNING
The window width and level (W/L) determine how clearly pathologies and other anatomical
structures can be discerned. Incorrect W/L settings may result in pathologies and other essential
anatomical structures not being displayed correctly. As a single W/L cannot display all features
present in an exam, use several different settings, when necessary to explore all exam data.
Volume Rendering
WARNING
When using Volume Rendering, incorrect setting of opacity curve, opacity threshold, transparency
setting when merging VR objects, can result in pathology or essential anatomies not being visible.
Always correlate Volume Rendering images with original images.
Image quality
WARNING
At all times, it remains the responsibility of the physician to determine whether the inter-slice
distance used for a particular exam is acceptable.
WARNING
Loading non-square pixels will result in bad quality image.
WARNING
Default Plaque Color Map preset is provided for information. You must check and adjust Values
and segment names.
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Accuracy of measurements
Measure distance for axial, helical, and cine images
This section includes information on accuracy of measurements used when reviewing images.
CAUTION
Measure error using the straight line distance graphic is less than two times the image pixel size.
CAUTION
Note that the measurements are accurate only if the trace segments are longer than the slice
interval.
Measure distance for scout images

Accuracy of measurements for scout images in the “X” direction varies with object thickness and distance
from ISO center in the “Y” direction. Note the orientations of the “X” and “Y” axes in the figure shown here
assume a scout scan plane of 0°. If the scout plane is rotated, then the “X” and “Y” orientation changes
accordingly.
1 = ISO center, 2 = Y axis, 3 = X axis, 4 = Z axis, 5 = X-ray tube focal spot, 6 = scan plane, 7 = patient table
For measurements of anatomy in the “X” direction that are at ISO center (“Y”):
The measure error using the straight line distance graphic is less than 5% of the measured
distance plus 2 mm.
For measurements of anatomy in the “X” direction that are NOT at ISO (“Y”):
The measure error using the straight line distance graphic is less than 5% of the measured
distance plus 2 mm plus 3% of measured distance per centimeter from ISO.
For measurements of anatomy in the “Z” direction:
Measure error using the straight line distance graphic is less than two times the image pixel size.
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Chapter 2: Safety
Measure angle
CAUTION
Measurement accuracy using the angle graphic is equal to the displayed angle value +/- 10° for an
angle measured between segments that are five times larger than the image pixel size. Accuracy
improves as the length of the segments increases.
ROI
CAUTION
Area measurement accuracy using a region of interest graphic (rectangle, smooth curve, ellipse or
free draw) is equal to the displayed area +/- the circumference of the region multiplied by (image
pixel size) 2/2. Mean and standard deviation values for the intensity of the pixels in the region are
also affected by this accuracy. If the ROI is rotated, the area measurement can vary up to 5%.
Region of interest statistics are based on the pixels INSIDE the graphic defining the region.
Reformat plane thickness

Reformat plane thickness equals 1 pixel.
If each axial pixel represents 0.5 mm of anatomy, then the reformat plane thickness equals 0.5 mm.
If pixel size equals 0.9766 mm (500 mm/512), then the reformat plane represents a slice of anatomy
about one millimeter thick.
CAUTION
CT Numbers are NOT absolute; misdiagnosis is possible. System and patient variables may affect
CT Number accuracy. If you rely solely upon CT numbers without taking the variables into
consideration, you could misdiagnose an image.
CAUTION
The limiting measurement resolution of the cursor is 1 mm, i.e., the distance less than 1 mm but
greater than 0.5 mm is rounded to 1 mm, therefore, the accuracy of this testing is limited by the
cursor measurement capability. This is especially important for a thin slice measurement where
the FWHM is close to 0.625 mm. The results for these thin slice images will not be as accurate as
the thick slice ones. This is the limitation of this testing method.
5366492-1EN Rev 1 (February 2010) 2-67

Optima™ CT660
Operator console ergonomics

To optimally use the system and reduce the chance of physical strain and fatigue, the following steps are
recommended regarding how you use your operator console.
Posture
Correct posture is very important. To ensure correct posture while sitting at your operator console, follow
these basic steps:
1. Face the monitors and keyboard without twisting your body.

2. Sit comfortably erect with the small of your back well supported.
3. Position your forearms parallel to the floor, with your wrists straight.
4. Position the screen so that your eyes are nearly level with the top of the screen.
5. Keep both feet flat on the footrest, with your thighs parallel to the floor.
If you cannot comfortably maintain this position while working at your operator console, you should make
the necessary adjustments to your operator console environment.
Equipment adjustments
Chair
Adjusting the fit and height of your chair is very important for comfort. Follow these basic guidelines:
1. Fit the backrest snugly against your back. People with shorter legs might need a back cushion.
2. Set your chair height to position your forearms parallel with the floor when your hands are placed on
the keyboard. If your feet dangle, you need a footrest.
Keyboard
Keyboard height is also important. When typing:
Your wrists should be as straight as possible.

Your forearms should be parallel to the floor.
Your hands and fingers should float over the keys or mouse.
Screen
The recommended viewing distance from the screen is 18-28 inches (45-70 centimeters).
With your head straight, your eyes should be looking directly at the top of the screen.
You should look at the screen straight-on, not at an angle from the side, top, or bottom.
Glare from the screen can disrupt your viewing and cause eyestrain. Do not face a window, and
position the screen at right angles to bright light sources.
Comfort
Comfort at your operator console indicates you have set up your work area correctly. However, even a well-
designed area needs frequent adjustment, especially for different users. Take the time when positioning
yourself at your operator console to ensure your comfort.
It is also recommended that if you use the operator console for extended periods (several hours at a time),
that you take short breaks to get away from your operator console and perform simple stretching exercises
to reduce the chance of fatigue.
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Chapter 2: Safety
Other considerations
Stay alert to your patient's condition.

Use the speakers and microphones on the table, gantry, and console to stay in constant
communication with the patient, even while you sit at the console.
Follow the exam procedures explained in the User Manual. Carefully enter patient information and
position before proceeding.
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Optima™ CT660
Accessories
WARNING
Do not connect accessories that are not approved as part of the system. Do not use accessories
from other modalities.
WARNING
None of the accessories support the full weight of a patient. If you sit, stand, or otherwise apply
excessive pressure to these devices, they break or come off the cradle and may cause injury. If an
accessory breaks, use caution when picking it up and do not continue to use.
CAUTION
When using patient positioning accessories and straps, make sure there are no areas that might
cause a pinch point or interfere with patient tubing or IV.
WARNING
Accessories like arm boards and catheter bag holders are not secured to the gantry and may
interfere with the gantry if not positioned properly.
WARNING
All non medical equipment connected to the USB port of the media tower on the CT operator
console must comply with IEC/EN/UL60950-1 and should be approved by GEHC.
CAUTION
Do not use the USB or Ethernet port on the front cover of the CT operator console, it is intended for
service use only.
Service USB /Ethernet Port
GE approved accessories
With each use, check all accessories for damage and remove them from service if damaged or cracked.
GE approved accessories types and models
Type Manufacturer/model
IVY 3100 - B with ethernet
Cardiac Monitor
IVY 3150 - B
5366492-1EN Rev 1 (February 2010) 2-70

Chapter 2: Safety
Type Manufacturer/model
Respiratory Monitor Varian 1.7

Partial UPS* Eaton Powerware 9155-10GE
External Hard Drive Seagate FreeAgent
Opticon 6125
Bar Code Reader* Hand Held 3800
Honeywell 3800g
SmartStep Monitor*
(includes LCD monitor, video splitter, and GEHC 5115174-2
mountings)
SmartStep Handheld Control* GEHC 2199947
SmartStep Foot pedal* GEHC 2199945-2
Nemoto Dual Shot Alpha (CiA425 Class I) / GEHC 5328194
Patient contrast injector: Nemoto Dual Shot GX (CiA425 Class IV)
For Xtream Injector option Medrad ISI900 (for Stellant D) (CiA 425 Class IV) / GEHC
5335919
Nemoto Dual Shot Alpha (CiA425 Class IV) / GEHC 5328195
Patient contrast injector: Nemoto Dual Shot GX (CiA425 Class IV)
For Enhanced Xtream Injector option Medrad ISI900 (for Stellant D) (CiA 425 Class IV) / GEHC
5335919
Note: *: CT system component.

The following approved accessories were shipped with the system:
Patient comfort and workflow accessories such as the cradle pad, cradle extender, patient arm
board, catheter bag holder, table tray, and IV pole attached to the cradle.
Patient positioning accessories including Axial and Coronal head holders, positioning straps, and
pads.
System quality assurance accessories including imaging phantoms and phantom holder.
Additional accessories and supplies approved for use with the system are available at
www.GEhealthcare.com.
The placement of the cardiac monitor should be on the monitor stand. The monitor should not be placed on
the table. It should be positioned so that it is not touching the table or gantry when it is in use.
IV pole safety
Care should be taken in the amount of weight placed on pole. Ensure that the pole is tightened prior to use.
CAUTION
The IV pole may bend when excessive weight is placed on the pole. Ensure no more than 4.5 kg or
10 lb. is placed on the IV pole.
5366492-1EN Rev 1 (February 2010) 2-71

Optima™ CT660
CAUTION
Ensure that the IV pole extension collar is tightened prior to use to prevent the pole height from
collapsing.
IV Pole Load Limits
CAUTION
Do not load more than 4,5 kg or 10 pounds. Verify that extension collar is securely tightened before
use.
Table tray safety

Care should be taken in the total weight of objects that are placed on the tray.
Tray Load limits
CAUTION
Do not load more than 9 kg or 20 pounds.
CAUTION
Objects that may be susceptible to tipping should be strapped down with the Velcro™ strap
provided.
Systems with metal-free cradles and accessories
CAUTION
Prevent damage to metal-free accessories! Carefully examine the metal-free clasp assembly on
the accessory and the catch on the cradle before attempting to attach the accessory for the first
time.
5366492-1EN Rev 1 (February 2010) 2-72

Chapter 2: Safety
Accessory Load Limit
CAUTION
Accessory may fall and cause injury if not latched to cradle. Make sure that accessory is latched to
underside of cradle.
To latch an accessory:
Align the accessory tongue with the pocket at the end of the cradle.
Keep fingers clear of the cradle.
Push the tongue all the way into the pocket until it latches into place.
Rubber shims may have been installed on the head holder or foot extender to give it a tighter fit.
Please take care when latching the accessory to make sure that it is completely latched. Push the
latch forward until you hear a click. Verify that the latch is fully latched.
To unlatch an accessory:
Pinch the two L-shaped parts together and pull the accessory out of the cradle.
An alternate method is to apply a light force to the catch in the direction to pull the accessory out of
the cradle.
Proper operation:
Keep the accessory “tongue” and cradle pocket clean and free of fluids and debris.
Keep the latch and cradle pocket area clear of sheets, drapes, pads or any item that could interfere
with proper latching and cause damage.
Positioning:
Positioning patient anatomy over the area where the head holder or cradle extension attaches to
the cradle may produce images where the contrast between two adjacent rotations is different.
Make sure the area of interest, especially the head, is properly positioned in the head holder or on
the cradle extension.
Xtream/Enhanced Xtream Injector safety
CAUTION
The injector and the system are operated independently after the Start Scan button is pressed.
When you want to stop both the system and the injector, use the Stop Scan button on the system
SCIM and the stop injector function on the injector.
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Optima™ CT660
CAUTION
When you use Xtream Injector with SmartPrep, injection doesn't start at the beginning of Baseline
Phase. It starts at Monitor Phase. Going to Scan Phase without Monitor Phase, injection will not
start.
Limited access room configuration
CAUTION
Due to access limitations on the left side of the gantry, some procedures may be affected when
ancillary equipment is used. Assess the placement of the equipment needed for the procedure
before the placement of the patient on the table. Access around the left side of the gantry may also
be affected.
5366492-1EN Rev 1 (February 2010) 2-74

Chapter 2: Safety
Emergency devices and emergency egress

(Reference 21CFR 1020.33 (f)(2)(ii))
Emergency devices
The system has two types of Emergency buttons:
1. Emergency Stop- when pressed, all table and gantry motions are halted, generation of X-rays is
stopped, laser alignment lights are turned off. The system aborts any data acquisition in progress,
and attempts to save all data acquired prior to the abort. Use the Emergency Stop button for patient
related emergencies.
2. System Emergency OFF button- when pressed, the power to all system components is removed,
stopping all table and gantry motion and generation of X-rays. The system aborts any acquisitions in
progress, and data obtained prior to the abort can become corrupt or lost. Use the System
Emergency OFF button for catastrophic emergencies, such as fire or earthquake.
CAUTION
If you press the Emergency Stop or Emergency OFF buttons during a scan, the system will abort
the data acquisition.
Emergency Stop
Every operator should take a few minutes to locate the Emergency Stops on their system before
scanning the first patient.
The system has five Emergency Stop buttons:
One on each control panel on the front of the gantry.

Emergency Stop buttons on gantry cover
One on the Scan Interface Control Module (SCIM).
5366492-1EN Rev 1 (February 2010) 2-75

Optima™ CT660
Emergency Stop button on the SCIM
Press an Emergency Stop button in the event of a patient-related emergency or if the cradle, table or
gantry starts to move unexpectedly.
Once an Emergency Stop button is pressed, the Reset gantry key, on the gantry control panel, flashes
about once every two seconds.
Press the Reset gantry key to restore power to the gantry and table.
When Emergency Stop is applied, the moving cradle and tilting gantry may overrun by less than 10 mm and
less than 0.5° respectively.
System Emergency OFF buttons using Main Disconnect Control (For the system with
MDC only)
In the event of a fire, flood, earthquake, or any other catastrophic emergency, all power to the system
should be turned off. Pressing the System Emergency OFF button immediately removes all power to the
system by removing power to the Main Disconnect Control (MDC). Because the system has no time to save
data, or shutdown in an orderly fashion, pressing the System Emergency OFF button can corrupt system
files or result in loss of patient data.
The facility designer determines the quantity and locations of the Emergency OFF buttons. GE recommends
placing an Emergency OFF button near the doorway of every room in the system scan suite. Ask your
supervisor to show you the location of all the Emergency OFF buttons in the system suite. Follow facility
guidelines to report an emergency.
Press the System Emergency OFF button (red, circular button located on the wall) in the event of a
catastrophic emergency, such as fire or earthquake.
Reset the Emergency OFF button
1. Press the Start button on the Main Disconnect Control.
Power to the Power Distribution Unit (PDU), operator console, and system electronics will be
restored.
2. Press the Reset gantry key on the gantry panel.
Power to the gantry drives, X-ray system, and table drive will be restored.
Emergency patient care during X-ray ON

Press STOP SCAN to abort X-ray and stop gantry/table movement.
Press PAUSE SCAN to pause scanning after the current scan completes.
During an exam, the system pauses between scans if you Press any button on the control panel
other than the alignment lights. It stops X-ray if you press the same buttons during a scan.
Select Resume on the screen to continue the exam.
Emergency egress
System operation may be stopped due to power failure or a safety event (something coming into contact
with the collision sensors), or the system may be halted by the operator in response to emergency
5366492-1EN Rev 1 (February 2010) 2-76

Chapter 2: Safety
conditions.
The Cradle unlatch button should only be used in two situations:
1. In emergency egress situations.

2. When using the SmartStep scan type.
To safely remove the patient

1. Press the Cradle Release gantry key or the Emergency Stop button (1) to disengage the clutch.
2. Pull the cradle to its out position, using the Cradle Lip or Cradle Handle (2).
3. Assist the patient off the table.
1 = Emergency Stop, 2 = cradle handle
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Optima™ CT660
Maintenance and cleaning

To guarantee safe, reliable equipment performance, the site must be prepared according to GE
Medical Systems requirements, as specified in the Pre-Installation Manual.
There are no user serviceable parts in this system. The product should be installed, maintained, and
serviced by qualified service personnel according to procedures laid down in the product service
manuals.
The system in whole or in part should not be modified in any way without prior written approval by
GE Medical Systems.
Keep the equipment clean. Remove body fluids and/or IV spills to prevent a health risk and damage
to internal parts. Clean the equipment with any of the following approved cleaning agents:
Warm water and soap or a mild antiseptic
Common household bleach, diluted 10:1
Sani-cloth HB
Perasafe
Incidin Plus
TriGene
Also, use dry cleaning for electronic components.
Do not clean the connectors on the cables for ECG, respiratory equipment, etc. If you need to clean
them, contact GE Service.
Planned maintenance must be carried out regularly to ensure safe operation of the equipment.
For user maintenance of the system and performance tests, refer to the maintenance and
calibration information in the Technical Reference Manual.
5366492-1EN Rev 1 (February 2010) 2-78

Chapter 2: Safety
Cleaning equipment (bio hazard)
CAUTION
Blood Bourne Pathogens Procedure - Before any equipment is serviced or returned to GE Medical
Systems, the following criteria must be met:
Equipment used in a clinical setting must be cleaned and free of any blood and other
infectious substances.
Customers are responsible for the sanitary condition of the equipment. The suggested
equipment clean-up procedure for cleaning any fluids or matter discovered in accessible
areas or inside under direction of service are as follows:
Wear personal protective equipment.
Wear proper Nitrile gloves.
Before cleanup, take note of sharp corners or objects that could cut the gloves. If gloves
tear, remove, wash hands thoroughly, and re-glove.
Use cloth or paper towels along with cleaner, taking care not to splash.
Sanitize the area using common bleach diluted 10:1 or an approved cleaning agent listed
in the Maintenance and Cleaning section. Clean any tools that come in contact with body
fluid.
Since viruses require moisture to remain active, dry the entire area.
When confident the area is clean and dry, place cleaning materials in a red biohazard bag.
Remove gloves, turning them inside out, and put gloves in the biohazard plastic bag. Seal
and give the bag to appropriate personnel for disposal.
5366492-1EN Rev 1 (February 2010) 2-79

Optima™ CT660
Environmental concerns
This symbol indicates that the waste of electrical and electronic equipment must not be disposed of as
unsorted municipal waste and must be collected separately. Please contact an authorized representative of
the manufacturer for information concerning the decommissioning of your equipment.
5366492-1EN Rev 1 (February 2010) 2-80

Chapter 2: Safety
Name and concentration of hazardous substances
Explanation of Pollution Control label
This symbol indicates the product contains hazardous materials in excess of the limits established by the
Chinese standard SJ/T11363-2006 Requirements for Concentration Limits for Certain Hazardous
Substances in Electronic Information Products. The number in the symbol is the EFUP1, which indicates the
period during which the toxic or hazardous substances or elements contained in electronic information
products will not leak or mutate under normal operating conditions so that the use of such electronic
information products will not result in any severe environmental pollution, any bodily injury or damage to
any assets. The unit of the period is "Year".
In order to maintain the declared EFUP, the product shall be operated normally according to the
instructions and environmental conditions as defined in the product manual, and periodic maintenance
schedules specified in Product Maintenance Procedures shall be followed strictly.
Consumables or certain parts may have their own label with an EFUP value less than the product. Periodic
replacement of those consumables or parts to maintain the declared EFUP shall be done in accordance
with the Product Maintenance Procedures.
This product must not be disposed of as unsorted municipal waste, and must be collected separately and
handled properly after decommissioning.
Table of hazardous substances' name and concentration
Hazardous substances' name

Component name
(Pb) (Hg) (Cd) (Cr(VI)) (PBB) (PBDE)
Operator console X O O X O O
Gantry X O X X X X
LCD monitor O X O O O O
ECG cardiac trigger X O O X X X
Power distribution unit X O X X X X
Patient table X O X X X X
O: Indicates that this toxic or hazardous substance contained in all of the homogeneous materials
for this part is below the limit requirement in SJ/T11363-2006.
X: Indicates that this toxic or hazardous substance contained in at least one of the homogeneous
materials used for this part is above the limit requirement in SJ/T11363-2006.
Data listed in the table represents best information available at the time of publication.
Applications of hazardous substances in this medical device are required to achieve its
intended clinical uses, and/or to provide better protection to human beings and/or to
environment, due to lack of reasonably (economically or technically) available substitutes.
1Environment-Friendly Use Period
5366492-1EN Rev 1 (February 2010) 2-81

Optima™ CT660
This product consists of devices that may contain mercury, which must be recycled or disposed of in
accordance with local, state, or country laws. (Within this system, the backlight lamps in the monitor display
contain mercury.)
The X-ray collimator contains the following potentially hazardous materials:
Lead: Lead salts are toxic and their ingestion may cause serious problems. The
manipulation/handling of lead is subject to regulations.
The X-ray tube assembly contains potentially dangerous materials but does not present any danger as long
as it is neither opened nor disassembled.
WARNING
Do not discard the X-ray Tube Assembly among industrial waste or domestic garbage.
WARNING
A damaged X-ray Tube Assembly should not be dispatched through the national postal service.
The X-ray tube assembly contains the following potentially hazardous materials:
Lead: Lead salts are toxic and their ingestion may cause serious problems. The
manipulation/handling of lead is subject to regulations.
Oil: Univolt 54 and Crosstrans 206 mineral oil are not toxic, but the prevailing environmental
regulations should be observed for their disposal or recuperation. For example, it is forbidden to
dispose of these oils in the wastewater or sewage system or in the natural environment.
Your local GEMS field service will advise you on the suitable means of disposal of equipment.
The X-ray tube assembly to be discarded should be forwarded to the GEMS Service network, and it
will be disposed of in a GEMS recycling center.
Precautions
Take all the necessary precautions for the personnel handling the recovery or destruction of X-ray tube
assemblies, and in particular against the risks due to lead.
These personnel must be informed of the danger involved and of the necessity to observe the safety
measures.
5366492-1EN Rev 1 (February 2010) 2-82

Chapter 3: Regulatory information
Chapter 3: Regulatory information

Applicable Regulations and Standards
In accordance with IEC 60601, the system is classified as a Class I, IPX0 equipment, not suitable for use in
the presence of a flammable anaesthetic mixture with oxygen or nitrous oxide. It is rated for continuous
operation with intermittent loading. No sterilization is applied. The patient table cradle is considered a Type
B applied part.
This product complies with the requirements of the following regulations and standards:
Council Directive 93/42/EEC concerning medical devices when it bears the following CE marking of
conformity:
Authorized representative for Europe/European registered place of business:

GE Medical Systems SCS
Quality Assurance Manager
283 rue de la Minière
78530 BUC France
Tel +33 130704040
Manufacturer and manufacturing site: See Product-Manufacturer Matrix.
Code of Federal Regulations, Title 21, Part 820 -Quality System Regulation
Code of Federal Regulations, Title 21, Sub chapter J -Radiological Health
Federal U.S. law restricts this device for sale by or on the order of a physician.
GE Medical Systems is ISO 9001 and ISO 13485 certified.

Applicable standards of the International Electrotechnical Commission (IEC), Underwriters Laboratories (UL)
and the Canadian Standards Association (CSA) :
The Optima™ CT660 system complies with IEC 60601-1: 1988, UL 60601-1, and EN 60601-1.
The Optima™ CT660 system complies with IEC 60601-1-1: 2000.
All portions of the Optima™ CT660 system are suitable for use in the patient environment.
The system should be used only with GE approved equipment.
The Optima™ CT660 system complies with IEC 60601-1-2: 2004.

Detailed information concerning Electromagnetic Compatibility can be found in the
Electromagnetic Compatibility chapter of the Technical Reference Manual.
The Optima™ CT660 system complies with the applicable portions of IEC 60601-1-3: 1994.
The Optima™ CT660 system complies with applicable portions of IEC 60601-2-28.
X-ray Source
Performix™ 40 Tube Unit Assembly IEC 60601-2-28 (1993)
Assembly
The Optima™ CT660 system complies with the applicable portions of IEC 60601-2-32.
5366492-1EN Rev 1 (February 2010) 3-83

Optima™ CT660
Associated
Patient Table IEC 60601-2-32: 1994
Equipment
The Optima™ CT660 system complies with IEC 60601-2-44.
CT Scanner... Optima™ CT660 System IEC 60601-2-44: 2001
Intended use of the system

The system is intended to be used for head, whole body Computed Tomography applications.
Indications for use of the system

The system is intended to produce cross-sectional images of the body by computer reconstruction of x-ray
transmission data taken at different angles and planes, including Axial, Cine, Helical (Volumetric), Cardiac,
and Gated acquisitions. These images may be obtained either with or without contrast. This device may
include signal analysis and display equipment, patient and equipment supports, components and
accessories.
This device may include data and image processing to produce images in a variety of trans-axial and
reformatted planes. Further the images can be post processed to produce additional imaging planes or
analysis results.
The system is indicated for head, whole body, cardiac and vascular X-ray Computed Tomography
applications in patients of all ages.
The device output is a valuable medical tool for the diagnosis of disease, trauma, or abnormality and for
planning, guiding, and monitoring therapy.
Intended purpose and medical effectiveness ( MHLW1)

The intended purpose and medical effectiveness is to produce cross-sectional images of the patient by
computer reconstruction of X-ray transmission data taken at different angles for medical examination.
1Ministry of Health, Labour and Welfare
5366492-1EN Rev 1 (February 2010) 3-84

Chapter 4: Pediatrics and small patients

GE Healthcare strongly suggests reducing radiation dose to ALARA1 in all patients, especially pediatric and
small patients, whenever it is determined that a CT scan is necessary. CT is an extremely valuable tool for
diagnosing injury and disease, but its use is not without risk. This chapter discusses the importance of
minimizing the radiation dose in small patients and children consistent with ALARA principles.
Radiation exposure
Minimize pediatric and small patient doses
Pediatric and small patient scans

Set up a pediatric or small patient exam
Adjust pediatric and small patient scan parameters
1As Low As Reasonably Achievable
5366492-1EN Rev 1 (February 2010) 4-85

Optima™ CT660
Radiation exposure
Radiation exposure sensitivity

Radiation exposure is a concern in both adults and children. However, children are more sensitive to
radiation than adults and have a longer life expectancy. Radiation risk is higher in young patients, as they
have more rapidly dividing cells than adults. The younger the patient, the more sensitive they are. Using the
same exposure parameters on a child as used on an adult may result in larger doses to the child. There is
no need for these larger doses to children, and CT settings can be adjusted to reduce dose significantly
while maintaining diagnostic image quality.
The National Cancer Institute and The Society for Pediatric Radiology developed a brochure, Radiation Risks
and Pediatric Computed Tomography: A Guide for Health Care Providers, and the FDA issued a Public
Health Notification, Reducing Radiation Risk from Computed Tomography for Pediatric and Small Adult
Patients dated November 2, 2001, that discuss the value of CT and the importance of minimizing the
radiation dose, especially in children. These documents can be accessed at http://www.fda.gov/cdrh/ct/.
Dose reporting considerations

It is widely understood and accepted that adult techniques should never be applied to small patients or
pediatrics since smaller objects have higher dose at the same technique. The chart below illustrates the
sharp increases in relative dose as the part scanned gets smaller in size using the same technique.
Relationship between dose and phantom size for head and body filters at 120 kV. Similar curves are obtained for the 80, 100, and 140
kVs.
Since it is not possible to characterize dose given to individual patients, the CT dose indices are provided to
help make relative comparisons. These dose index values can be used to compare CT systems and to help
select appropriate operating conditions for scanning. However, it is important to recognize that the dose
reported by these indices is inversely proportional to phantom size (see the above chart). This means that
for the same scan technique, smaller phantoms (patients) will produce a higher absorbed dose than larger
phantom (patients). Therefore, it is critical to remember that the body filter uses the 32 cm CTDI phantom
and the head filter uses the 16 cm CTDI1 phantom for dose reporting purposes (CTDIvol is displayed in the
1Computed Tomography Dose Index
5366492-1EN Rev 1 (February 2010) 4-86

Dose Information area on the ViewEdit screen). The table below indicates the phantom size used for
calculating dose for each SFOV1.
In other words, when looking at the actual absorbed dose to the patient, understand that the dose may be
higher than reported if the part scanned is smaller than the phantom tested. Keep this in mind when
adjusting scan parameters to fit patients who are smaller than the phantoms tested.
CTDI phantom used dose report based on SFOV type
SFOV type CTDI phantom

Ped Head
Ped Body 16 cm phantom
Head
Small Body
Cardiac Small
32 cm phantom
Large Body
Cardiac Large
1Scan Field Of View
5366492-1EN Rev 1 (February 2010) 4-87

Optima™ CT660
Pediatric and small patient scans
Optimize pediatric protocols for your facility

Work with your team of radiologists, medical physicists, and CT technologists to evaluate techniques that
may reduce radiation dose and still provide adequate diagnostic information. In addition to the
recommended protocols installed on your system and suggestions in this manual, these websites offer
excellent sources of additional information on how to optimize scanning protocols:
American College of Radiology (ACR): http://www.acr.org/

Society of Pediatric Radiology (SPR): http://www.pedrad.org/
National Cancer Institute (NCI): http://www.nci.nih.gov/aboutnci
Image Gently: http://www.imagegently.com/
FDA website: http://www.fda.gov/
Pediatric protocols
The Pediatric Protocol area was designed to help facilitate protocol selection for pediatric patients by
providing age based protocol areas for Head, Orbit, and Miscellaneous and color coding system for Neck,
Upper Extremity, Chest, Abdomen, Spine, and Pelvis. It is highly recommended to place and select pediatric
protocols from the pediatric selector based on age, height, and weight. By entering the pediatric patient's
weight in the New Patient screen, the system automatically selects the appropriate color code area for the
anatomical area selected.
Pediatric Selector
5366492-1EN Rev 1 (February 2010) 4-88

Color Coding for Kids Protocol Selection

Based on the Broselow-Luten Pediatric System, the Color Coding for Kids system was developed to help
you select the correct pediatric CT protocol. The system divides the protocols into nine color zones based on
height and weight, and incrementally increases scan technique as the patient’s size increases. This
arrangement of protocols assists you in reducing the variations in pediatric protocol selection. If the patient
weight is unavailable, a Broselow-Luten Tape can also be used to obtain the weight based on the length.
Once the anatomical area is selected, the Pediatric Protocol Category screen displays, which contains the
Color Coding for Kids based on weight selection. Selectors on the color/weight bar are labeled with the
zone ranges for weight and length, with the word of the selected color and with the weight/color zone
number.
Weight-specific protocols are enforced for all anatomical areas except Head, Orbit, and
Miscellaneous. Protocols in the Head and Orbit categories are usually defined based on patient age as
opposed to patient weight/height.
Pediatric Protocol Category screen
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Color codes
Zone number Zone color Zone weight (lb) Zone weight (kg) Zone length (cm)
1 Pink 6.0 to 7.5 13.2 to 16.5 59.5 to 66.5
2 Red 7.5 to 9.5 16.5 to 20.9 66.5 to 74.0
3 Purple 9.5 to 11.5 20.9 to 25.4 74.0 to 84.5
4 Yellow 11.5 to 14.5 25.4 to 32.0 84.5 to 97.5
5 White 14.5 to 18.5 32.0 to 40.8 97.5 to 110.0
6 Blue 18.5 to 22.5 40.8 to 49.6 110.0 to 122.0
7 Orange 22.5 to 31.5 49.6 to 69.5 122.0 to 137.0
8 Green 31.5 to 40.5 69.5 to 89.3 137.0 to 150.0
9 Black 40.5 to 55 89.3 to 121.3 --
Translated text
English Translation
Pink
1 6.0 to 7.5 kg (13.2 to 16.5 lbs)
59.5 to 66.5 cm
Red
2 7.5 to 9.5 kg (16.5 to 20.9 lbs)
66.5 to 74.0 cm
Purple
3 9.5 to 11.5 kg (20.9 to 25.4 lbs)
74.0 to 84.5 cm
Yellow
4 11.5 to 14.5 kg (25.4 to 32.0 lbs)
84.5 to 97.5 cm
White
5 14.5 to 18.5 kg (32.0 to 40.8 lbs)
97.5 to 110.0 cm
Blue
6 18.5 to 22.5 kg (40.8 to 49.6 lbs)
110.0 to 122.0 cm
Orange
7 22.5 to 31.5 kg (49.6 to 69.5 lbs)
122.0 to 137.0 cm
Green
8 31.5 to 40.5 kg (69.5 to 89.3 lbs)
137.0 to 150.0 cm
Black
9
40.5 to 55.0 kg (89.3 to 121.3 lbs)
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Set up a pediatric or small patient exam

Use this procedure each time you start a new patient exam for a pediatric patient. It is recommended that
you complete the patient information setup before you get the patient on the table to reduce patient table
time. The data can also be input by using Patient Schedule or a bar code reader.
The "/" and control characters are not valid for entries in the New Patient screen.
1.
From the scan monitor, click the New Patient icon.
The Patient Information screen displays the new Exam Number.
The maximum Exam Number is 49, 999, which is reset by your Field Engineer.
2. From the Patient Information area, type data into the appropriate fields.
Press Enter to advance to the next field. Alternatively, use the mouse to navigate to each field.
Patient ID is a required field. If the patient does not have an identification number, type ? or the
word trauma.
3. Click Pediatric.
4. From the Pediatric Protocol Selection screen, click an anatomical area.
With the patient's weight entered, the system automatically selects the appropriate pediatric
color code area for the anatomical area selected.
Use the arrows to scroll through the list.
Click a protocol from the list to download the scan parameter values.
5. From the Pediatric Protocol Category screen, select the weight/length category based on the size of
your patient or verify the correct Color category has been selected if you entered a weight.
The protocols in the selected color code are then displayed accordingly.
The default weight/color selector displays the patient weight entered on the Patient Information
screen, or the last weight/color selection (if no patient information was entered).
There is no default protocol for Pediatric areas Neck, Upper Extremity, Chest, Abdomen, Spine,
Pelvis, and Lower Extremity.
If you enter a patient weight on the Patient Information screen and select a color/weight that is
not consistent with the entered information, an error message displays. You must acknowledge
that you have chosen a protocol that does NOT match the patient size.
6. Proceed with the Acquire a Scout scan procedure.
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Optima™ CT660
Minimize pediatric and small patient doses

There are several steps that can be taken to reduce the amount of radiation that pediatrics and small
patients receive from CT examinations. Everyone shares the responsibility of minimizing CT radiation dose.
Use the following suggestions for minimizing unnecessary doses.
Perform only necessary CT examinations

Is CT the most appropriate study? This important communication between the patient's physician and the
radiologist is essential in determining the need for the CT examination. The indications and the appropriate
technique to be used should be reviewed by the radiologist prior to every scan including the patient’s
number of previous scans, reasons for the scan, and consideration of other effective lower dose modalities.
In all circumstances, the expected benefits of the scan must always exceed the overall risk.
Scan only the organ or anatomical region indicated

Limit scan coverage to cover only the organ or anatomical region of the body indicated to avoid
unnecessary exposure.
Minimize multi-phase contrast CT examinations

Scan only one series if possible.
CT studies with and without contrast material are not always needed.
Multiphase imaging may double or triple the dose and may not add diagnostic information to the
study.
If multi-phase studies are needed, use a lower dose technique for the non-contrast series compared
to the contrast series and limit the scan only to the organ or anatomical region indicated.
Properly center all patients in the gantry

Center all patients in the gantry to allow the bow tie filters to deliver dose where it is needed and filter more
where it is not.
This is especially important using automatic exposure control techniques such as AutomA and
SmartmA to further reduce unnecessary radiation exposure.
Patients not properly centered may be under or over exposed to radiation if the table height is set
too high or too low.
Lower mA settings for chest and bone imaging

Consider using a lower mA setting and higher Noise Indexes if AutomA is used for chest and bone imaging.
Higher resolution/dose imaging is typically unnecessary for these types of studies where there is high
inherent contrast between the structures being imaged.
Scan signal-to-noise
Limit the highest quality images requiring the highest radiation dose to very specific indications such as
angiography or visualizing small subtle lesions. Studies with higher noise may be just as diagnostic and
require lower dose.
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Consider using in-plane Bismuth shields

Use in-plane Bismuth shields to reduce the patient dose.
Recent studies have shown dose reductions to sensitive organs, such as breast tissue in females,
the thyroid, and eyes without significantly affecting image quality.
If used with AutomA, they should be put in place after the scout scans are acquired to reduce
technique overcompensation.
Use pediatric positioning accessories

Use papoose boards and neonatal immobilizers, as needed, with certain patients.
These accessories are sometimes helpful to secure the patient and keep the patient still.
Results in less patient motion and therefore, less repeated exams.
Make a kid friendly environment

Help pediatric patients feel less scared.
Put pictures of animals on the wall or ceiling.

Use stuffed animals.
Play games.
Depending on the patient age, explain the procedure so they know what to expect when they enter
the scan room. This will aid in patient cooperation and potentially less repeat studies and dose due
to patient motion.
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Optima™ CT660
Adjust pediatric and small patient scan parameters

Use the following guidelines for adjusting individual exposure parameters by patient.
Adjust the parameters by size, age, weight, height, and indications

Use pediatric protocols based on the age, weight, height, and indications to avoid over exposure.
Recommended pediatric color coded protocols are installed on the system and are arranged in
colors according to height and weight for easy selection.
These protocols should be considered as a baseline. It is strongly encouraged that you work with
your radiologist and medical physicist to determine the lowest possible dose at the image quality
desired.
Consider the diameter of the part being scanned as a final determination before scanning. For
instance, the part may be smaller or larger than what is indicated by the weight of the patient.
Consider decreasing the kVp

Decrease the kilovoltage to 80 or 100 kVp for smaller patients.
A decrease in kVp should not be done without increasing the mA to maintain noise levels and
contrast to noise ratios.
Lower kV selections increase HU 1 values. Therefore, increase the window width for viewing images
to maintain a similar appearance.
Since lower kVp selections lower X-ray penetration, it is important to not use low kV selections on too
large of a patient, which can potentially result in compromised image quality. Work with your
radiologist and medical physicist to establish low kV protocols and patient size limits.
Use the table of kV and mAs adjustment factors as a guide for making adjustments to mAs for
changes in kV in a protocol. Refer to Chapter 12, Quality Assurance in the Technical Reference
Manual.
For example, keeping contrast to noise ratio constant, a technique of 120 kV at 150 mA for adults you
get the following techniques for pediatric patients:
100 kV at 190 mA
80 kV at 250 mA
140 kV at 95 mA
To assure sufficient X-ray penetration, the following chart is intended as a relative guide to the
maximum patient diameter that can be scanned based on a kV and mAs selection. It does not
indicate, a recommended technique factor (that is generally higher) since the technique factor also
depends on the image quality needed for the diagnostic task.
1Hounsfield Unit
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Maximum patient diameter guide for low kV selection (1) and Lateral Patient Diameter in cm (2)
Center the patient properly when using AutomA

Properly center the patient. This is critical with AutomA.
Double check and verify the table height is centered to the patient.
Raise or lower the table as needed before taking the scouts.
After the scouts are taken and prescription is done, verify the mA table calculations before
confirming the scan.
Make sure minimum mA and maximum mA values are set appropriately.
See Set the mA procedure in the Scan chapter.
Increase the pitch

Increase the pitch.
Increasing the pitch decreases the amount of radiation needed to cover the region indicated, usually
without compromising the diagnostic quality of the scan.
Increasing pitch from 1.0 to 1.375:1 decreases dose by a factor of about 27%.
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Optima™ CT660
Pitch table travel and slice thicknesses
Acquisition mode parameters for CTDI100 and CTDIw

Helical mm/rotation per
pitch and acquisition Axial and Cine slice thickness (mm)
mode (mm)
Acquisition ~0.5:1 ~0.9:1 1.375:1 64i 32i 16i 8i 4i 2i 1i
64 × 0.625 20.63 39.38 55.00 *0.625 *1.25 2.50 5.00 10.00 N/A N/A
32 × 0.625 10.63 19.38 27.50 N/A 0.625 1.25 2.50 5.00 10.00 N/A
16 × 0.625 N/A N/A N/A N/A N/A 0.625 1.25 2.50 5.00 10.00
8 × 0.625 N/A N/A N/A N/A N/A N/A N/A 1.25 2.50 5.00
4 × 0.625 N/A N/A N/A N/A N/A N/A N/A N/A 1.25 2.50
2 × 0.625 N/A N/A N/A N/A N/A N/A N/A N/A N/A 1.25
Note: *Only available in Retro Recon.
Use Small SFOV Filters

Use the smallest SFOV whenever possible, depending on the exam and size of the patient.
Matching the appropriate SFOV bowtie filter to the size of the patient ensures the dose is delivered
where it is needed, and filtered where it is not needed.
Small SFOV supports DFOVs up to 32 cm in diameter.
Ped Head SFOV supports DFOVs up to 32 cm in diameter and uses IBO processing to correct for
beam hardening effects. It is particularly useful for infants 18 months or less in age.
Ped Body SFOV supports DFOV’s up to 32 cm in diameter.
Both the Ped Body and Ped Head SFOVs are limited to 30 kW. This limits the maximum mA
possible to 250 at 120 kVp.
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Chapter 5: Equipment
IMPORTANT: Please refer to the Safety section for important safety information regarding the use
of the equipment and software on this system.
This section helps you to become familiar with your CT system, including the system components and
hardware.
Computer console
Operate the SCIM and keyboard
Operate the mouse controls
Monitors
Scan monitor
Bright Box (Option)
Use the Bright Box (Option)
Gantry
Use the Gantry controls
Connect the cardiac trigger monitor
Table
Attach the table tray
Attach the IV pole
Table X-Y accuracy for the Flat Tabletop workflow
Verify the table elevation accuracy
Analyze the table elevation
Verify the table lateral motion
Measure the table lateral motion
Handheld Controller
Set the W/L with the HHC
Xtream Injector/Enhanced Xtream Injector

Set up the Xtream Injector
Enhanced Xtream Injector screen
Injector status buttons
Contrast report
Hardware components
Axial detector configuration screen
Helical detector configuration screen
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Optima™ CT660
Power Distribution Unit
X-ray tube and generator
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Computer console
The operator console is comprised of:
media tower
scan monitor
display monitor
Scan Control Interface Module (SCIM) and keyboard
mouse
Bright Box
Computer
Operator console
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Optima™ CT660
Operator console
No. Description
Digital Video Disk Read/Write (DVD-R/W) drive
The CD/DVD option uses the DVD-R drive to write to or restore from CD-R or DVD-R.
The Data Export option can only save information to CD-R.
1
Use to save ECG traces.
Use to access the electronic copies of the operator documentation.
Use to export protocols.
Digital Video Disk-Random Access Memory (DVD-RAM): Located at the bottom of the media tower.
Use to write to a DVD-RAM.

2
Use to access the electronic copies of the Operator documentation.
Use to save scan files, protocols and service files to 9.4 GB DVD-RAM media.
USB Connection: Located in lower-right corner of the media tower.
3 Supports connecting a USB media storage device to save or restore scan files.
This device should have a minimum size of 4 GB.
Connections for iLinq and service computer functions: Located on the front of the console.
Connection port for iLinq and service computer functions.

4
Connection port for an external USB drive support for saving scan data. Intended use is only
for trained service personnel.
Computer power on/off switch: Located on the front of the console.
5 Use to start up the system.
Use to shut down the system.
Computer
The computer is located at the base of the console and it contains all the hardware necessary to operate the
system and perform image generation.
It uses a PC based computer system running a Linux based operating system.The system includes system,
image and scan data disks and stores up to 250,000 512 images and with 500 giga byte for scan data files.
Reconstruction Engine
The reconstruction engine provides advanced processing capabilities for the reconstruction of
routine imaging modes, and ASiR mode.
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Computer console
Monitors
There are two monitors for the system:
1. Scan monitor
2. Display/Image monitor
System monitors
If the power is turned off to the monitors by either console off or using the power off button on the
monitor, it takes 15 minutes for the monitors to stabilize to their set brightness and contrast levels. During
this warm-up time, do not make any adjustments to the brightness or contrast levels.
If a monitor has experienced burn-in, turn off the monitor and leave it off for the same amount of time
as caused the burn-in to occur.
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Optima™ CT660
Computer console
Operate the SCIM and keyboard
The keyboard and SCIM1 consist of a typical alphanumeric keyboard, 10 number keypad, buttons specific to
initiating scan, remote tilt of the gantry, and communication with the patient. Standard keyboard keys and
SCIM functions include:
Delete or Backspace erases characters

Enter confirms what is typed or selected
Tab moves across the areas on the current screen
For more information on the keyboard and filming, see Automatic film and Manual film.
SCIM and keyboard
1Scan Control Intercom Module
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SCIM buttons
No Icon Function Description
Emergency
1 Stops all table and gantry motions, and X-ray exposure.
Stop
Exposure
2 Illuminates amber when an exposure is taking place.
indicator
Controls the volume of the operator’s voice to the patient indicated by the
Volume
numerical volume level label.
control
3
operator to Upward movement = increases volume
patient
Downward movement = decreases volume
Controls the volume of the Auto Voice to the gantry indicated by the
Volume numerical volume level label.
4 control Auto
Voice Upward movement = increases volume
Controls the volume of the patient’s voice to the operator indicated by the
Volume
numerical volume level label.
control
5
patient to Upward movement = increases volume
operator
Flashes green for 30 seconds once the tube has reached exposure speed.
6 Start Scan Press Start Scan to initiate the scan. If it times out, press Start Scan again
to bring the system back to the ready state.
Pauses scanning, once the current scan is completed. From the Dynaplan
7 Pause Scan
screen, click Resume to restart the scan.
Aborts the scan immediately. From the Dynaplan screen, click Resume to
8 Stop Scan
restart the scan, if it is possible.
Press and hold Prescribed Tilt until the prescribe tilt is achieved.
Press Prescribed Tilt on the Scan Control Interface Module to return the
gantry to zero once all prescribed scans for the exam have been acquired.
Prescribed tilt
9
(Remote tilt) WARNING
Be sure that the Gantry will not touch the patient during Remote
Tilt operation. Pinching or crushing may happen if the Gantry
touches the patient.
Stops cradle motion in/out. Click Resume from the ViewEdit screen to
10 Stop Move
resume the scan.
Flashes green for 180 seconds indicating that the system is ready to
11 Move to Scan advance the cradle to the start position.
Press Move to Scan to advance the cradle to the start location.
Press Talk and speaking towards the intercom to communicate with the
12 Talk
scan room.
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Optima™ CT660
Film keys - F1 through F4, F12

The F1 - F4 function keys can be used for filming to the Manual Film Composer. The F3 function key, in
conjunction with Shift, and the F12 function key can be used for filming to the AutoFilm Composer.
Film function keys
F key Description Translated text

F1 Film Image
F2 Film Screen
F3 Film MID
F4 Print Series
F12 AutoFilm Image
Preset W/L keys - F5 through F11

The F5 - F11 function keys are used to apply preset W/L1 values in the following applications:
ImageWorks Viewer, Mini-Viewer, and Reformat. The W/L values are defined from the Viewer User
Prefs.
Exam Rx - The W/L values are defined by pressing Shift and the function key to which you want to
assign the value.
Preset W/L function keys
F key Description Translated text

F5 Previous
F6 Abdomen
F7 Head
F8 Lung
F9 Mediastinum
F10 Spine
F11 Vertebrae
Page Up/Page Down keys

Page up and down keys
The Page Up and Page Down keys allow you to review the next and prior images in a viewport or viewports
from the Exam Rx or Image Works desktops.
1Window Width and Window Level
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W/L control keys

Arrow keys
You can use these keys to manually change the W/L settings for images in the Exam Rx and ImageWorks
desktops. The Up/Down keys increase/decrease the window level and the Left/Right keys
decrease/increase the window width.
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Optima™ CT660
Computer console
Operate the mouse controls
The three button mouse is used to make selections on the scan and display monitors. It is a hand-operated
device that you maneuver across the surface of a pad. As you move it, the on-screen cursor mimics the
movement of the mouse, allowing you to move among windows and menus. For instance, moving the
mouse to the right causes the on-screen cursor to move to the right. The mouse is used to make selections
by clicking the left, right, and middle buttons.
Left (1), middle (2), and right (3) mouse buttons
Mouse actions
Mouse action Description

Click Click the left mouse button to select a button or icon.
Right-click Click the right mouse button.
Middle-click Click the middle mouse button.
Click and drag Click and hold the left mouse button down while dragging the cursor to the
desired location.
Right-click and Click and hold the right mouse button down while dragging the cursor to the
drag desired location.
Middle-click and Click and hold the middle mouse button down while dragging the cursor to the
drag desired location.
Double-click Click the left mouse button twice in rapid succession.
Triple-click Click the left mouse button three times in rapid succession.
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Computer console
Bright Box (Option)
The Bright Box is a separate piece of hardware that is used to review images without having to use the
system mouse or keyboard. Use the Bright Box to review images while someone else uses the mouse and
keyboard to set up or continue the scan series.
The Bright Box can only be used in the Exam Rx desktop with any free viewport that is not in use for
AutoView or AutoFilm.
It can be used in the Auto Link viewport, although, when the first image of another series is
reconstructed, that image is displayed in the viewport, taking the place of the series you are
currently reviewing. It is recommended to click the review screen, bottom left viewport, as a free
viewport.
You can only work in one viewport at a time. Before you begin, place the desired viewport in primary
focus (double-click the viewport), so it does not affect the other viewports.
Bright Box controls
Bright Box controls
No Description
Prior Button - Press to display the prior image in the set. This button is inactive while in the
1
paging mode.
Next Button - Press to display the next image in the set. This button is inactive while in the
2
paging mode.
3 Trackball - The trackball has two functions: adjusting W/L and image page speed and direction.
Paging Button - Press to launch the paging mode. While the paging mode is active, this button
4
toggles between paging and W/L. "P" is seen for paging and "WL" is seen for WW/WL settings.
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Optima™ CT660
Gantry
Gantry display
The gantry LCD display provides gantry and table status information.
Gantry display
Gantry display components
No. Component Description

The Collision light illuminates when there is a possibility that the table,
cradle, and gantry comes in contact with each other. There are tilt/el-
evation collision sensors on the front and rear covers at the top of the
gantry opening. The collision sensors are active during table elevation
and during tilting of the gantry. The light also illuminates if there is ten
Collision indicator pounds of resistance during cradle motion in/out or when reaching the
travel limits of table, cradle, and gantry motion. In the case of inter-
1.
ference, you may need to raise or lower the table, check the gantry tilt,
or determine if resistance is being caused by any patient restraints,
accessories, or by the patient. If you need to tilt the gantry after a col-
lision has been detected, the gantry only tilts in 0.5 degree increments.
You can also check the Table collision sensor indicator/reset button
on the front of the gantry. The light will go out if you continue to hold the
button.
Cradle unlocked indicator
The Cradle Unlocked Indicator is illuminated, indicating the cradle is
2.
unlocked. When the cradle is unlocked, it is “free floating”.
The Laser Light Indicator is illuminated anytime the laser alignment light
Laser light indicator has been turned on. Normally, this light is only on when positioning a
patient.
3.
CAUTION: For patient safety, it is important to always have

patients close their eyes anytime the laser alignment light is on.
5366492-1EN Rev 1 (February 2010) 5-108


Lung indicator
The lung indicator is lit when there is an respiratory gating signal cap-
4.
tured by system.
Heart indicator
The heart is lit whenever there is an ECG gating signal seen by the sys-
5.
tem.
Vertical height indicator

The Vertical Height Indicator displays the vertical height of the table in
6.
relation to ISO center.
The Horizontal Cradle Position displayed is the position of the cradle

Horizontal Cradle Position based on the established anatomic reference of the patient. This ref-
7. erence is established using the internal or external landmark. The
number is preceded by an S if the position is superior to the reference
point or an I if the position is inferior to the reference point.
The Gantry Tilt Indicator shows one of two displays. One display, which
Gantry tilt indicator is the normal display, indicates the current gantry tilt. If the gantry tilt is
8. superior, the number is preceded with an S. If the gantry tilt is inferior,
the number is preceded with an I. This is enlarged during Prescribed Tilt
button on the Scan Control Interface Module flashes.
Patient Name Patient Name is displayed as input on Patient Information screen. The
9. system automatically display 2 lines when the name is long.
Note : Font size is automatically changed by the number of characters.
Patient ID
Patient ID is displayed as input on Patient Information screen.
10.
Age and Gender Age and Gender are displayed as input on Patient Information screen.
11. The patient below 1year old, 0 is displayed in Age.
Exam Description is displayed as input on Patient Information screen.
NOTE: Patient Information (items above with *) can select Hide/Show
Exam Description during an exam. If you want not to show it during every exam, it can be
12.
set by GE Field Engineers. Contact to GE service to change the
selection.
Default Patient Positioning
buttons
These buttons define the location where the cradle stops with a set
13.
pedal. The location can be set by GE Field Engineers.
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Optima™ CT660

Tools button
14. There are several functions related to the LCD Display setting.
Movie button
There are some movies that help to explain CT examination procedures
15.
to patients.
Breath hold lights

Breath hold lights
Breath hold light components
No. Description
1. Breathe light
2. Hold breath light
3. Elapsed breath hold time in seconds
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Internal components
Gantry internal components
Component Description
The anode heat capacity with a Performix™ 40 tube is 6.3 million heat
units (MHU) and the cooling rate is 840 kilo heat units per minute
Tube and Col- (KHU/min).
limator
Performix™ 40 operates at 48kW or 72kW, depending on configuration.

The high frequency generator is composed of an auxiliary box, inverter
High
and high voltage tank. Each tank occupies one cubic foot in the gantry.
Frequency
Together the cathode and the anode provide 72 kilowatts (kW) of the
Generatorr
Performix™ 40 tube.
Detector/Data The detector is comprised of a solid scintillator material known as HiLight.
Acquisition HiLight detectors, provides 99 % dose efficiency. The V-Res™ Detector
System enables Volume CT with a true 64-channel design with 40mm coverage.
Slip Ring provides data communication path from Detector/DAS to the
Slip Ring
Digital Interface Processor from there to the system disk.
Gantry and Console interfaces

If your system has connections for GE approved accessories, the figures and tables below show where and
how to connect the approved accessories (Refer to the GE Approved Accessories list found in the Safety
chapter).
The Cardiac Monitor and the Respiratory Monitor have connections on both the gantry and the
console.
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Gantry back panel: Left plug-in panel (1) and right plug in panel (2)
Right rear plug-in panel

Right rear plug-in panel
Right rear plug-in panel components
No. Description
1. SmartStep Handheld Control Connection
2. SmartStep Foot Pedal Control Connection
3. Respiratory Monitor Power Connection
4. Cardiac Monitor Power Connection
5. Cardiac Monitor Ethernet Connection
6. Cardiac Monitor Gating Connection
7. Respiratory Monitor Gating Connection
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Left rear plug-in panel

Left rear plug-in panel
Left rear plug-in panel components
No. Description
1. SmartStep Handheld Control Connection
2. SmartStep Foot Pedal Connection
3. Respiratory Monitor Power connection
4. Cardiac Monitor Power Connection
Console rear plug-in panel

Console rear plug-in panel
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Optima™ CT660
Console-rear plug in panel components
No. Connection Description

1. J9 Monitor Power Connection
2. J10 Peripheral Media Tower Power Connection
3. J11 Monitor Power Connection
4. J12 In-Room Monitor Connection
5. J13 Respiratory Monitor Power connection
6. J14 Injector/Respiratory Gating Hardware Power Connection
7. CB3 Power Breaker
Media Tower Rear Panel
Description for the Media Tower Rear Panel
No. Description
1. External Hard Disk Drive USB Port
2. DVD-R/CD-R Drive USB Port
3. DVD-RAM Drive USB Port
4. Do not use this Power switch.
5. Do not use this Receptacle.
6. AC Power connection
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Gantry
Use the Gantry controls
Use this information to control the table and gantry functions.
Gantry controls
Gantry controls
Exposure The (Exposure Indicator) illuminates amber when an actual exposure is

1
Indicator taking place.
Prep Delay
2 Displays a preparation delay before scan starts.
Timer
When pressed, stops the prep display and X-ray exposure, turns off the laser
alignment lights, halts all gantry and table motions and returns the QC pin
3 Stop Scan
source to its shielded enclosure, if exposed. The cradle and base also unlatch
and need to be latched before initiating a scan.
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Optima™ CT660

In the event that you want to stand by the gantry and start the scan, you can
press this button after you have confirmed the prescription and the table has
been moved to the start scan location. Start Scan will flash for 30 seconds
before it times out. Press the solid green Start Scan button again to bring the
4 Scan Start system back to ready to scan state. When the Scan Start button on the
gantry is used and the CT portion of the scan is being preformed, there is risk
of being exposed to radiation while in the scanning room.
NOTE: To prevent unnecessity X-ray exposure, customers should use X-ray
protection equipment when using In Room Scan Start button.
5 Cradle In When pressed, the cradle moves in, toward the gantry.
When pressed, the table moves up and towards the gantry. When the table
6 Table Up moves up with the laser alignment lights on, the cradle will adjust
horizontally to maintain the anatomic reference point.
When pressed, the cradle moves out, away from the gantry.
7 Cradle Out Cradle In or Out can be used to move the patient to the scan location
after clicking confirm. Cradle In or Out LED will flash for 180 seconds
before it times out.
When pressed, the table moves down and away from the gantry. When the
8 Table Down table moves down with the laser alignment lights on, the cradle will adjust
horizontally to maintain the anatomic reference point.
When pressed in conjunction with Table Up/Down or Cradle In/Out, causes

9 Fast Speed
those functions to operate at a faster speed.
Pressing this allows you to demonstrate to the patient how to use the
breathing lights and countdown timer.
Breathing
A blinking green breathe light indicates get ready to hold your breath.
10 Lights Demo
A solid yellow light indicates to hold your breath.
Count down indicator counts down the seconds to breathe time.
A solid green breathe light indicates to breathe.
Pressing allows you to view the current gantry tilt range and scannable
range, based on table position, on the gantry display panel.
Tilt and Table
11 NOTE: The Tilt and Table Travel Limits displayed are calculated based on a
Travel Limits
limit and collision matrix that takes into consideration the table height and
landmark location on the cradle when providing the information displayed.
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Press to establish the table’s reference point when positioning the patient.
This reference point is normally the anatomic reference point used when
positioning the patient. For example, if the patient’s anatomic reference
point is the sternal notch, then the sternal notch would be centered to the
laser alignment light.
Internal
For Internal Landmark, the gantry displays a table location of 0 mm.
12 Landmark
This sets the zero point for which S and I scan locations are centered
around.
13 External For External Landmark, the gantry displays a table location
Landmark approximately 240 mm from the internal landmark, depending on
table characterization.
A landmark must be set before you click Confirm.

At End Exam, the landmark is cleared.
For scan setup details, see the Set up and position the patient procedure.
Press to toggle all laser alignment lights on/off and to move the gantry
components from the park or idle position to the alignment lights position.
Alignment lights are used to establish landmark locations. Three alignment
lights are displayed: axial1, sagittal2 and coronal3.
Laser
14 Alignment
CAUTION
Light
For patient safety, always have patients close their eyes anytime the laser
alignment lights are on.
NOTE: The laser alignment light switch is provided as an alternative to beam
attenuators.
Press once to unlock the table cradle, which makes it so you can freely move
the table with your hands. Use it to move the patient out of the gantry in an
emergency.
Cradle
15 Press a second time returns the cradle to the locked position and the
Lock/Release
landmark is maintained.
NOTE: If Cradle Lock is used during a SmartStep acquisition, the cradle must
be in a locked state to make an exposure.
Press to re-engage the table and to restore full communications to the
gantry and console.
Table
Collision Use if Emergency Stop is pushed. Reset flashes approximately once
16 Sensor every two seconds.
Indicator / If the power has been turned off to the gantry, you must press Reset.
Reset
If the table stops moving, clear the obstruction and continue moving
the table.
1divides anatomy into superior and inferior sections

2divides the anatomy into right and left sections
3divides anatomy into anterior and posterior sections
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Optima™ CT660
Press to simultaneously move the cradle out of the gantry and return the
17 Home gantry tilt to zero degrees. Once the cradle has been removed from the
gantry, the table begins to lower to its lowest limit.
Inferior Tilts the gantry towards the patient's feet, regardless of his or her position.
18
Gantry Tilt NOTE: A landmark must be set for patient position to be known.
Tilts the gantry towards the patient's head, regardless of his or her position.
NOTE: A landmark must be set for patient position to be known.
Superior
19 The Remote Tilt button on the Scan Control Interface Module can be use to
Gantry Tilt
return the gantry to zero once all prescribed scan for the exam have been
acquired.
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Gantry
Connect the cardiac trigger monitor
Use this procedure for cardiac gated exams that require the cardiac trigger monitor.
1. Navigate to the gantry right rear plug in panel.

Right rear plug
2. Plug the power connection for the cardiac trigger monitor into electrical connection port (4)
3. Connect the ethernet cable from cardiac trigger monitor to the port labeled Monitor (5).
4. Turn the switch on the back of the monitor to Ethernet mode.
IVY monitors with Ethernet include: 3100-B with Ethernet and 3150-B with Ethernet.
5. Connect the coaxial cable to the connection port above the heart (6).
6. Do NOT loop cable, which may introduce noise in the ECG trace.
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Optima™ CT660
Table

The table has a weight limit of 450 pounds (205 kg) with an incremental accuracy of ± .25 mm. The vertical
range of the table is 44 to 99 centimeters. The scout view range is 1,400 mm and the scan range is 1,530
mm.
The table has a weight limit of 500 pounds (227 kg) with an incremental accuracy of ± 0.25mm. The vertical
range of the table is 43 to 99 centimeters. The scout view range is 1,600 mm and the scan range is 1,730
mm.
Tape strips (collision sensor strips)

Tape strips on table
Located underneath the table are the collision sensor strips (arrows). These strips are located in areas
where there is potential for the table to come into contact with foreign objects, such as a wheel chair or a
stretcher. If one of the tape strips is touched, the table and gantry motion stops immediately. Raise the table
and clear the obstruction. You can now continue moving the table down.
The maximum scan range and gantry tilt depends on the table height. The mark on the cradle for maximum
scannable range is based on the table center at isocenter. Make sure the patient is positioned within the
scannable range and use the Tilt and Table Travel Limit button on the gantry control panel to check limits.
CAUTION
If the table is lowered with anything in the red X area as indicated in illustration below, the table
could be damaged along with the equipment or object under the table.
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CAUTION
Use of any cradle extension accessories such as the table extension, head holder, coronal head
holder, and phantom holder are not accounted for in the table gantry interference matrix.
Therefore, additional care needs to be taken to closely monitor any table up/down, in/out or gantry
tilt movement to avoid contact of the extended accessory with the gantry.
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Optima™ CT660
Table
Attach the table tray
Use this procedure to attach the table tray to the table so that there is space to place objects during an
examination.
1. Fit the legs of the tray support form into holes at the rear of the table.
2. Place the tray on top of the support form.
3. Use the strap to secure objects that might tip to the tray.
4. Do NOT place the cardiac trigger monitor on the table tray and do not place objects that, in total,
weigh more than 9 kg or 19.8 pounds.
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Table
Attach the IV pole
Use this procedure to attach the IV1 pole to the system.
1. Insert the IV pole into the hole at the rear of the table or into the table tray.
The maximum weight that can be attached to the IV Pole is 4.5 kg or 10 lb.
2. Tighten the extension lock so that so that the IV pole does not move down.
1intravenous
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Table
Recommended workflow for treatment planning

Use this workflow to determine X-Y table accuracy when using a Flat Tabletop.
1. Position the patient on the table.
2.
From the gantry controls, press Cradle Out to return to the home position.
3.
Press Internal landmark .
4.
Press Cradle In to between 890 to 850 mm and then press Cradle Out to the
home position.
This centers the cradle.

Each in and out motion of the cradle is one cycle.
The cradle must cycle the number of times as determined in the Lateral Motion Verification
procedure.
Determine the number of extension/retraction cycles needed based on testing.
5. Center a landmark on the flat tabletop using the sagittal room alignment laser line.
6. Use the external room laser light to position patient elevation as desired and draw temporary
alignment marks on the skin.
7. Fasten radio-opaque fiducial markers on the temporary alignment marks.
8.
Press Laser Light .
9.
Press Cradle In until the axial landmark location for imaging placed in step 7 (for example,
sternal notch), aligns with the axial internal laser light.
10. Adjust the patient elevation until the gantry elevation laser matches the patient alignment marks
placed in step 7.
11.
Press Internal landmark .to establish the landmark as the scan reference.
12. Acquire the CT exam with the landmark established in step 7.
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13. Turn on the external room lasers.
14.
Press Cradle Out .

15. Change table elevation to match the patient alignment marks placed in step 7.
16. Review the images and confirm that the radio-opaque markers placed in step 7 align with the image
coordinate isocenter.
17. Determine treatment Isocenter with simulation software such as Advantage Sim.
18. Adjust room lasers as defined by simulation software.
19. Tattoo the patient for therapy.
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Optima™ CT660

Verify the table elevation accuracy
The purpose of this procedure is to allow a clinical end-user to verify that the workflow for CT simulation
with table elevation adjustment between the room and gantry laser system is working. Proper re-
adjustment of table elevation, independent of weight distribution, is verified by generation of post-
elevation-adjustment images with less than 1.0 mm distance between image center and the QA device
feature.
Materials
Medtec CT Simulation Laser QA device phantom or equivalent device, requires 2 IPPS™ Lok-Bars)
MedTec RT phantom
CT orthogonal reformat image of laser QA device (abdomen window level)
Flat tabletop
100 pounds of standard weights (25 pounds plates recommended)
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Elevation adjustment
1. Position the weights and attach the QA1 device to notches near the center of the flat cradle.
Side view of weights and placement relative to the QA device. 1 = table, 2 = weights, 3 = QA device, 4 = flat table, 5 = Notch 1, 6 =
laser line of sight
2. Adjust the table height until the following occurs:
The room sagittal laser light intersects the side horizontal QA device lines. The sagittal laser light
produces the line parallel to the flat tabletop on the side of the device.
Example of laser light on the flat table top
The room coronal laser light intersects the top QA device lines
3. Start an exam.
4. Acquire the scout over the range of the QA device.
5. Use Graphic Rx to define an axial scan that produces between 10 and 20 mm of images at the
thinnest slice width available.
6. From the ViewEdit screen:
a. Set the DFOV so that the image produces isotropic pixels.
For example, with a scanner producing 0.625 mm slices, a 512x512 image with DFOV 32.0 cm
will produce images with 0.6253 pixels.
The formula for pixel size is: Pixel size = DFOV in mm divided by 512.
b. Select Standard CT recon filter.
7. Read and record the table elevation as reported on the gantry.
1Quality Assurance
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Optima™ CT660
Table elevation record
Label Record
Table elevation - QA aligned to room laser (mm)
Table elevation - QA re-aligned to gantry laser (mm)
Room 1 (mm)
Image Center to QA pre-adjustment distance (mm)
Image Center to QA post-adjustment distance (mm)
8. Start the CT scan to image the QA device.
This image set represents the situation prior to elevation adjustment.
9. When the scan is done, re-adjust the elevation of the table such that the gantry sagittal laser lights
align with the sagittal lines on the side of the QA device.
10. Read and record the table elevation in the Table elevation record.
11. Repeat the same CT scan series to produce the alignment-adjusted images.
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Analyze the table elevation
Use this verification analysis procedure for the flat tabletop to analyze the clinical table elevation.
1. Load the non-adjusted axial CT image series into a viewing tool with zoom and distance measuring
capability.
2. Scroll to the image so that the horizontal feature in the QA device is best visualized in the center QA
feature.
3. Magnify the images to the highest possible zoom to show the cross-hairs representing image center
and the horizontal feature.
Sample image prior to elevation adjustment using gantry sagittal laser
4. Use the measurement tool to determine the distance from image center to the center of the QA
feature.
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Sample image following elevation adjustment. Green lines represent line drawn using measurement tool, numerical report out
is shown in red.
5. Record the number in the results as "Pre-adjustment distance".

Label Record
Room 1 (mm)
6. Repeat steps 1 to 4 for the adjusted-elevation image set.

7. Record the measurement under "Post-adjustment distance".
Label Record
Room 1 (mm)
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Results
Post adjustment QA distance represents the accuracy of table vertical position achievable with the
Recommended workflow for treatment planning.
The post-adjustment image center to QA distance should be less than 1.0 mm, verifying that the gantry
lasers (with elevation adjustment) and room lasers both indicate image center, using the QA feature
location in the image as evidence.
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Optima™ CT660

Measure the table lateral motion
Have your site physicist perform this procedure to measure the amount of lateral cradle motion between
the room and gantry laser system. Use the results to determine how to compensate for it in the
Recommended workflow for treatment planning. This procedure need only be executed once.
Materials
One metric ruler (minimum 1.0 mm resolution)
Flat tabletop
100 pounds of standard weights (25 pounds plates recommended)
Set up
1. Install flat top on cradle.
2. If your system is a PET/CT system, move table base to CT position.
3. Set elevation at 150 mm below ISO.
When reading the metric scale, it is important to read to 0.5 mm.
Determine the number of ½ cradle cycles required for cradle to be centered
1.
From the gantry controls, press Cradle Out to return to the home position.
2. Manually slide the front of the cradle to the left or right.
3. Set four 25 pound weights on the flat top without moving the cradle.
4. Place the metric ruler at the H2 location on the flat top.
1 = table, 2 = weights, 3 = ruler
5.
Press Cradle In until the ruler aligns with the overhead room laser.
6. Center the ruler on a whole number.
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This example shows the ruler center at 15 cm
This measurement is labeled "Room 1" in the chart below and equals 0.0 mm.
7. Define a ± coordinate system.

This example shows a piece of paper that defines the left as positive, and right as negative.
8.
Press Laser Light .
9.
Press Cradle In until the internal gantry laser aligns with the long edge of the ruler.
10. Record the laser position on the ruler.
This measurement is labeled "Scan Plane 1" in the chart below.
11.
Press Cradle Out until the ruler aligns with the overhead room laser again.
12. Record the laser position on the ruler.
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Optima™ CT660
This measurement is labeled "Room 2" in the chart below.
13.
Press Cradle Out to return to the home position.

14. Repeat steps 5 to 11, two more times.
Results
Use this table to record the results.
Table measurement record
Label Record
Measurement location
Weight
Room 1 (mm)
Scan Plane 1 (mm)
Room 2 (mm)
Room 3 (mm)
Scan Plane 2 (mm)
Room 4 (mm)
Room 5 (mm)
Scan Plane 3 (mm)
Room 6 (mm)
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Verify the table lateral motion
Sample analysis
The table below is an example of data used in the interpretation of results discussion.
Sample table measurement record
Label Record
Measurement location H2
Weight 100 pounds
Room 1 0.0 mm
Scan Plane 1 -1.5 mm
Room 2 -3.5 mm
Room 3 -3.5 mm
Room 4 -4.5 mm
Room 5 -4.5 mm
Room 6 -5.5 mm
Results
Depending upon the desired level of offset, this method can be used to determine the number of cycles
needed.
From "Room 6", it can be seen that the initial cradle lateral shift was 5.5 mm. Therefore if the cradle
was not cycled prior to scanning, the offset at the scan plane relative to the room lasers could be
this large.
One cycle equals a cradle in and out motion. Some systems may only require one cycle, others may
require three cycles.
In this example, after one cycle (extend between 890 mm to 850 mm, then retract), the offset at the
scan plane improves by 3.5 mm. Therefore the actual offset is 2.0 mm (5.5 to 3.5).
In this example, after 2 cycles, the offset at the scan plane improves by 4.5 mm. Therefore the actual
offset is 1.0 mm (5.5 to 4.5).
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Optima™ CT660
Handheld Controller
During interventional procedures, the clinician makes exposures using the foot switch, and uses the HHC1
to move the cradle in and out, unlatch and latch the cradle, and review images displayed on an in-room
monitor. The HHC also provides a number of system controls that are detailed in the table below. The cradle
may be positioned with the HHC or by unlatching the cradle to manually position the patient.
Handheld Controller
1HandHeld Control
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Handheld Controller buttons
# Button Description
1 Prep Prepares the system for X-ray acquisitions.
Move to start Positions the cradle to the start location that is prescribed from the SmartStep
2
location ViewEdit screen.
3 Cradle move in Moves the cradle towards the gantry or to the last scanned location.
Moves the cradle a pre-defined bump distance towards the gantry. The bump
4 Bump in distance is defined from the SmarStep parameters screen. The default Bump
distance is half the scan thickness.
5 Disabled This button is not used for SmartStep.
Changes the primary focus window between the interventional viewports and
6 Change focus
the free viewport.
7 Prior image Displays the prior image in the sequence.
8 W/L toggle Scrolls through six different window with and level settings.
Alignment
9 Enables the laser positioning lights.
light
Cradle move
10 Moves the cradle away from the gantry.
out
Moves the cradle a pre-defined bump distance away from the gantry. The bump
11 Bump out
distance is defined on the SmarStep parameters screen.
A toggle button that releases the cradle so it can be moved using the cradle
12 Cradle Release
handle. Press the button again to latch the cradle.
13 Next image Displays the next image in the sequence.
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Optima™ CT660
Handheld Controller
Set the W/L with the HHC
W/L preferences
Use this procedure to set-up the W/L preferences for the HHC1.
1. From the Exam Rx Display control panel, click Display Preferences.

2. From the Display Preferences screen, click SmartStep Window Level Presets.
3. From the SmartStep Presets screen, place the cursor in the field and enter a value for each window
width and level.
4. When you are finished entering values for the desired locations, click Save as defaults.
W/L preset values

Use this procedure to select a preset W/L value from the HHC.
From the HHC, press W/L to cycle through preset W/L values.
1HandHeld Control
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Hardware components
Components
Changes have been made to several pieces of hardware that make this scanner different from other
scanners you may have used in the past.
Collimator
The collimator contains two independently controlled tungsten cams. The rotation of the cams provides
continuously variable beam thickness and Z-axis position. The collimator, also, contains three bowtie beam
filters that filter and shape the beam to optimize dose and image quality.
Scan Geometry
A shorter scan geometry allows for a 20% mAs reduction from HSA CT/i single slice axial scan techniques.
The gantry aperture is 70 cm. The Focal Spot to Isocenter distance is 54 cm. The Focal Spot to Detector
distance is 95 cm.
Matrix Detector
There are 64 detector cells in the Z direction. The 64 rows are 0.625 mm in the Z direction. Each signal can
be collected from an individual detector row or a combination of detectors. Up to 64 signals can be taken
from 64 detector cells (or 64 slices per rotation of the gantry).
Other changes
Changes in the DAS, Slip Ring and Scan/Recon Unit have been made. There are also new reconstruction
algorithms for the multi-slice data.
Coverage
The Axial Detector Coverage/Beam Collimation for 64-slice system are 1.25, 2.5, 5, 10, 20, and 40 mm
beam collimation/detector coverage (0.625 mm).
Axial acquisition modes
Scan Mode 1i 2i 4i 8i 16i 32i 64i

2 × 0.625 1.25 N/A N/A N/A N/A N/A N/A
4 × 0.625 2.50 1.25 N/A N/A N/A N/A N/A
8 × 0.625 5.00 2.50 1.25 N/A N/A N/A N/A
16 × 0.625 10.00 5.00 2.50 1.25 0.625 N/A N/A
32 × 0.625 N/A 10.00 5.00 2.50 1.25 0.625 N/A
64 × 0.625 N/A N/A 10.00 5.00 2.50 1.25* 0.625*
Note: *only available in Retro Recon
Axial detector signal collection

Two, four, eight, sixteen, thirty-two, or sixty-four signals/channels are collected per gantry rotation. Each of
2 to 64 signals are collected from an individual detector or combination of detectors.
The number of detectors combined per signal/channel affects the maximum slice thickness.
One, two, four, eight, sixteen, thirty-two, or sixty-four slices can be generated per rotation.
The slice thickness can be changed retrospectively.
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Optima™ CT660
The beam collimation/detector configuration at the time of acquisition affects the retrospective
choices.
Multi-slice axial imaging is faster than single slice helical scanner using a 1:1 pitch.
Helical pitch, scan mode, and collimation

Scan modes for helical are expressed in terms of pitch. Helical pitch is defined as the ratio of table travel
per rotation in millimeters divided by the beam collimation. Previous systems expressed scan modes with
names and defined pitch as table travel per rotation in millimeters divided by the detector row width.
For example: 55/40 mm = 1.375: 1 (Table Speed (55) divided by the Beam Collimation (40 mm) equals a Pitch
of 1.375.
Beam collimation
Detector Beam
System
configuration collimation
32 × 0.625 20.0 mm 64
64 × 0.625 40.0 mm 64
The following pitches are available:
0.5:1 interleaved helices

0.9:1 interleaved helices
1.375:1 interspaced helices
Interleaved helices minimize helical artifact and give the best detail. Interspaced helices have more
interpolated data and increased helical artifact when compared to interleaved mode. Using interspaced
helices compared to interleaved helices will provide lower dose.
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Hardware components
Axial detector configuration screen
The User Interface demonstrates slice thickness choices, number of images per rotation, and retrospective
options. The parameters selected to set the detector configuration determine the slice thickness and speed
determine the detector configuration.
Beam Collimation or detector coverage allows selection of 1.25, 2.5, 5, 10, 20, or 40 mm.
Axial slice thickness choices range from 0.625 to 10 mm thick.
Number of images per rotation are 1i, 2i, 4i,8i, 16i, 32i, or 64i Retro recon choices are the result of
the slice thickness and number of images, i.e. selecting 32 images at 1.25 mm slice thickness allows
retro choices of 0.625, 1.25, 2.5, 5, and 10 mm.
Rotation Speed can be adjusted to optimize acquisition time. Rotation Speeds are 0.4*. 0.5**, 0.6**,
0.7, 0.8, 0.9, 1.0, and 2.0 seconds.
Note * : 0.4 second option (with SFOV of Ped Head and Ped Body)
Note** : 0.5 second option
For VolumeShuttle (axial), the number of passes and Coverage Time need to be completed.
Button colors change to indicate options.
Light yellow color indicates current selections.
Dark blue with black text indicate available parameters.
Light gray with black text indicates available parameters choosing changes other than displayed
parameters.
Light gray with gray text indicate parameters not available.
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Optima™ CT660
Hardware components
Helical detector configuration screen
Parameter selections within the thickness/speed areas on the view edit screen determine the detector
configuration. There are five main parameter selections for helical.
Detector Coverage determines the beam collimation in mm in Z direction.

Helical Thickness determines the prospective and retrospective image slice thickness.
Slice thickness choices range from 0.625 mm to 10 mm.
Pitch / Speed determines the speed of the table per gantry rotation. There are three pitch selections
with associated table speed.
Rotation Time determines the rotation of the gantry.
For Volume Helical Shuttle, the number of passes and Coverage Time need to be completed.
Button colors change to indicate options.
Light yellow color indicates the current selection.
Dark blue with black text indicates the available parameters.
Light gray with black text indicates the available parameters (choosing changes other
parameters).
Light gray with gray text indicates that it is not available.
Image slice thickness of 7.5mm and 10mm are not available in Volume Helical Shuttle.
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The PDU 1 supplies power to various parts of the system which includes components in the gantry, table
and operator console. On the front of the PDU are controls to indicate that power is on to the unit, a push
button to turn power on/off to the gantry and table, and an Emergency Stop button.
PDU controls
PDU controls
No. Function Description

1 Power Indicates power is On/Off to the unit
2 Gantry enable Enables/disables power to the gantry and table
3 Emergency stop When pressed, all table and gantry motions are halted,
generation of X-ray is stopped, laser alignment lights are
turned off. The system aborts any data collection acqui-
sition in progress and attempts to save all data acquired
prior to the abort. Use the Emergency Stop for patient
related emergency. The cradle and base also unlatch and
need to be latched before starting a scan.
1Power Distribution Unit
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X-ray tube and generator
X-ray tube
The anode heat capacity with a Performix™ 40 tube is 6.3 million heat units (MHU).
The cooling rate is 840,000 heat units per minute (KHU/min).
Performix™ 40 operates at 48kW or 72kW, depending on configuration.
High Frequency Generator

The high frequency generator is composed of the cathode and the anode tanks. Each tank occupies one
cubic foot within the gantry.
mA range by kVp, Focal Spot size, and Scan Type
Large Focal Spot

Scan Mode kV Small Focal Spot
48kW System 72kW System
Large Body 80 10 to 300 305 to 400 305 to 400

Cardiac Large 100 10 to 240 245 to 450 245 to 480
Small Body
Cardiac Small 120 10 to 200 205 to 400 205 to 600*
Head 140 10 to 170 175 to 340 175 to 515
80 10 to 300 305 to 375 305 to 375
Ped Body 100 10 to 240 245 to 300 245 to 300

Ped Head 120 10 to 200 205 to 250 205 to 250
140 10 to 170 175 to 210 175 to 210
* 560 - 600mA is available only for SnapShot Pulse mode.
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Chapter 6: Startup and shutdown

This section contains information on how to turn on and off and log into and out of your CT system. It also
includes quality control information to make sure your system is operating before scanning a patient.
System startup and login

Login/logout
Start up the system
Shutdown and restart the system
Energy Saving Mode
Daily Quality Assurance

Daily QA workflow
SmarTube™ Warm-up
Use Fast Calibrations
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Optima™ CT660

Login/logout
If Data Privacy is enabled, use these procedures to log in and out of the system.
Login
1. From the login screen, type your assigned login name.
2. Type your password.
Click Emergency Login only if you do not have a valid account set up. The Emergency Login
screen is launched, which does not require a ID or password.
3. Click Logon.
Logout
1.
From the display monitor, click Shutdown icon.
2. From the Attention Shutdown pop-up screen, click Logout User and OK.
Logging off does not prohibit other users from logging in. Logout is designed to protect patient privacy,
not stop approved users from logging in. When you or another user logs back in, the system returns to its
last known state.
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Start up the system
Wait two minutes after a power interruption, before cycling the power on.
Never reboot the system with a USB device connected.
SmartID verifies the tube ID at start up. If the tube ID verification fails, attention screens display
indicating the X-ray tube installed on the system is not recognized. You can continue scanning; however,
you need to contact your service representative. Some features are disabled when a non-GE tube is
installed.
Tube ID messages
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Optima™ CT660
Routine daily startup

1. From the display monitor, click Shutdown icon.
2. Click Restart.
3. Click OK.
Startup from power off

1. Push the power switch on the front of the operator console and the system automatically restarts.
DVD-R/W drive (1), DVD-RAM drive (2), USB (3), iLinq connections (4), and Power switch (5)
If power was turned off via the computer switch and the Main Disconnect Control A1 Power Panel
(Breaker), then
a. Turn on power to the Main Disconnect Control.

b. Turn on power to the computer.
c. Press Reset on the gantry controls.
See Tube warm-up procedure for potential Attention messages. Click OK and follow the
Attention instructions.
System start-up failures

If the system fails to startup completely, select Unix Shell from the tool chest menu. Place your cursor in the
shell and type startup.
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Shutdown and restart the system
Shut down and start up the system every 24 hours to keep your system running optimally.
DVD-R/W drive (1), DVD-RAM drive (2), USB (3), iLinq connections (4), and Power switch (5)
1. Disconnect any USB devices from the USB drive before performing a reboot or shutdown.
If a save/restore of scan data is in progress, wait for the process to complete, exit Recon
Management,and disconnect the USB device before you reboot or shutdown. If for some reason
the system should shutdown unexpectedly while a USB drive is connected to the system,
disconnect the USB drive before restarting the system.
2.
3. From the Attention Shutdown pop-up screen, click Shutdown or Restart and OK.
4. For system shutdown, when the power off prompt displays, push the power switch on the front of
the operator's console to the off position.
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Optima™ CT660

Energy Saving Mode
Energy Saving mode provides a power-off/on sequence to the gantry after system shutdown. The gantry
will be automatically ready for system startup at a preset startup time/date.
Turn on energy saving

1. Disconnect any USB devices from the USB drive before performing Energy Saving mode.
2.
3. From the Attention Shutdown pop-up screen, click Energy Saving Mode
4. Click OK.
5. From the Energy Saving Mode pop up, click to change the start up date if needed.
6. Click to change the start up hour if needed.
7. Click to change the start up minutes if needed.

8. Click OK to turn on energy saving mode.
9. The power off prompt is displayed. Then depress the power switch on the front of the operator
console to the off position.
When the system is turned on prior to the power saving preset wake up time, scanning is
disabled until the detector has reached proper temperature.
During Energy Saving Mode is on, 3 dots on count down window on gantry panel will blink on
and off every 3 seconds.
Set up a energy saving schedule
1.
2. From the Attention Shutdown pop-up screen, click Energy Saving Mode
3. Click OK.
4. Click Schedule to display the schedule set up screen.
5. Set the working days:
Click Select All to select all days. or
Click each individual day to be desired.
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6. Click to change the start up hour.
7. Click to change the start up minutes.

8. Click Accept to set the schedule.
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Optima™ CT660

Daily QA workflow
Execute this workflow every day before patients are scanned.
1. Select Daily Prep – select and run Tube Warm-up.

2. In Daily Prep menu – select and run FastCal, once Tube Warm-up is complete.
3. Perform QA scan.
4. Reboot the system if it has not been rebooted in the last 24 hours.
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SmarTube™ Warm-up
The system optimizes scanning performance by including an indication of the temperature state of
the tube. Operating the system in the green zone will maximize tube life.
The tube state will be indicated by 3 zones on the scan monitor above the New Patient icon.
Green: Tube is at optimal operating state.
Yellow: Tube warm up should be performed to move the tube to the
optimal operating state. There are no restrictions during scanning while in this zone.
Blue: Tube warm up must be performed. Depending on system type,
mA may be limited until warm up is performed.
An Attention message is posted if the scanner has been inactive for more than two hours: "No
scans have been taken since Date/Time. Tube warm-up must be run."
Determine if a Tube Warm-Up is needed before moving patients into the scan room to avoid delays.
An Attention message is posted if a tube ID verification fails. Follow the message instructions.
Perform a tube warm-up after two hours of non-use, which takes 72 seconds. Scan within 30
minutes of the tube warm-up. Failure to perform the requested tube warm-up may result in serious
tube and system damage and will reduce the maximum mA possible. An Attention message is
posted regarding the reduced mA due to a canceled or skipped tube warm-up. If Tube Warm-Up is
skipped or cancelled when requested, mA will be limited to 440 mA at 120kV and 380 mA at 140kV.
Acceptable mAs can be achieved by changing rotation times as needed.
If the detectors are cold due to an A1 Power Panel (Breaker) being off, turn the system on and wait
two hours before performing a Tube Warm-up. This allows the detectors to return to their operating
temperature.
1. Clear the gantry area of all objects and personnel. Any obstruction in the gantry may lead to
artifacts in scanned images.
2. From the scan monitor, click Daily Prep or click on the blue or yellow
tube state icon.
3. In the upper left corner of the screen, click Tube Warm-Up.
4. Click Accept & Run Tube Warm-up.
Refer to the Safety chapter regarding using non-GE specific tubes.

5. Press Start Scan.
If you click the Start Scan icon again, it pauses the scan. Therefore, click the Start Scan icon
again to resume the scan.
The Cold Warm-Up Scan List displays while scans are acquired.
6. The system returns to the Daily Prep menu when Tube Warm-up is completed. Proceed to Fast
Calibrations.
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Optima™ CT660

Use Fast Calibrations
Considerations
If the detectors are not at operating temperature, a message will post indicating a time when the
detectors will be at operating temperature.
If there is a large shift in room temperature (+/-10 degrees), perform a FastCal to maintain optimum
IQ. Once the room temperature has stabilized perform another FastCal.
Fast Cal must be run once every 24 hours. It takes approximately 10 to 15 minutes, depending on
options installed.
1. Clear the gantry of any objects or personnel. Any obstruction in the gantry may lead to artifacts in
scanned images.
2. Click Fast Calibration. The system automatically performs:

A gantry balance check (approximately 2 minutes).
3. Press Start Scan. Respond to all messages that appear during the approximate 10 to 15 minute
calibration. Execute any necessary actions indicated in the messages.
If the system detects a dirty mylar window, which may be caused by a beam obstruction, a
message displays. Clean the mylar window and click Retry.
The following automated cal check procedures occur: warm-up, inter-connectivity map scan, and
FastCal air scans. Read the screen messages for calibration status.
4. When FastCal is complete, the system returns to the Daily Prep menu. Click Quit to exit the Daily
Prep screen.
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Chapter 7: Patient Schedule

Use the Patient Schedule feature to pre-program patient information and protocols in advance of the
patient's arrival. At scan time, you can select a patient from the created list, enter the patient ID 1 number,
enter the Accession number or use the optional bar code reader to call up the patient's information. Patient
information can be easily added or deleted from this list.
With the ConnectPro option, you can retrieve critical patient information from your HIS/RIS2 using a
DICOM3 connection and then send this information to your Patient Schedule. Connect Pro requires a
HIS/RIS system and PACS4.
Patient schedule
Add a patient to the schedule
Edit a patient in the schedule
Delete a patient from the schedule
Update the patient schedule
View more patient information on the schedule
Set patient schedule preferences
Select a patient from the schedule
Check a patient's status
1identification
2Hospital Information System / Radiology Information System
4Picture Archiving Communications System
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Optima™ CT660
Add a patient to the schedule
1.
From the scan monitor, click the Patient Schedule icon.
2. From the Schedule screen, click Add Patient.
3. From the Schedule Patient screen, complete all relevant fields.
Entering even weights may be rounded up to the next odd pound because weights are stored as
kilogram units then converted back to pounds.
If adding a patient where Exam Split is going to be used, an exam description must be entered for
those entries to be used with Hard Exam Split.
4. Click Accept to add the patient to the schedule list.
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Edit a patient in the schedule
A patient record cannot be edited if it came from HIS/RIS and Edit Modality Worklist on the
Preferences screen is set to No.
1.
2. From the Schedule screen, select a patient.
3. Click Edit Patient.
4. Change the patient information as needed.
5. Click Accept.
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Optima™ CT660
Update the patient schedule

Use this procedure with the ConnectPro option and Modality Work List to update the Patient Schedule.
1.
2. From the Schedule screen, click Update.
3. From the Update Parameters screen, select one of the following options from the Get Patient List to
populate the schedule from your HIS/RIS.
Select This system to pull the patient schedule for the current scanner.
Select All CT Systems to pull the patient schedule for all of the CT systems on the HIS/RIS
connection.
Select All Systems to pull the patient schedule for all the systems on the HIS/RIS connection.
4. Enter values for the Date Range.

5. Enter a Requested Procedure ID, accession number, patient name or ID to narrow the search. These
are optional fields.
6. Click Continue Update to continue or click Cancel Update to exit and make no changes.
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View more patient information on the schedule

Use this feature with the Connect Pro option to view other valuable information about a patient such as
allergies, pregnancy status, and medical alerts. This information is pulled from the HIS/RIS using a DICOM
connection.
1.
2. From the Schedule screen, select a patient.
3. Click View More Info. The screen is populated from your HIS/RIS.
4. Click Cancel to close the More Information screen.
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Optima™ CT660
Set patient schedule preferences

Use this procedure to set your preferences for the Patient Schedule.
1.
2. From the Schedule screen, click Preferences.
3. From the Preferences screen, complete fields as needed.
Sort by date/time, name or ID sort option.

Set a number of days (0 to 30) to delete exams. Set the value to 0 when the schedule is updated
from a HIS/RIS system so that completed exams are not added to the patient schedule. This
eliminates patient reconciliation issues on a PACS system.
Select a location and date range for Update Default Parameters.
Click Yes or No for the remainder of the selections if you have ConnectPro.
Update the Schedule Automatically: updates the schedule when you click Patient Schedule
based on the parameters selected in Update.
Show Update Parameters: displays the Update screen every time the system starts to
automatically update.
Use Study UID: uses a study instance UID 1 from HIS/RIS.
Edit Modality Worklist: allows you to edit any patient information from HIS/RIS.
4. Click OK.
Close the Preferences screen before switching between Patient Schedule and New Patient.
1Unique Identifier
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Select a patient from the schedule

Use this procedure to select a patient from the Patient Schedule to begin an exam.
1.
2.
Click the Patient Schedule icon.
3. From the Patient schedule list, select the desired patient and click Select Patient.
The Patient Information screen fields are populated.

Multiple records for the same patient can be selected.
Multiple records must be selected in order to use Exam Split.
If more than one record with the same Patient ID is found in the Patient schedule list a dialog
message displays. To avoid having multiple Patient Records with the same Patient ID, set the
Delete Completed Exams preference to zero. This will ensure that only new records are in the
Patient Schedule list.
4. If a protocol is not tied to the patient, select the protocol. The system displays the first series.
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Optima™ CT660
Check a patient's status
1.
2. View the Status column.
N = New Record or Not Completed

C = Completed
3. Click Next or Prior arrows to page through the list.
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Delete a patient from the schedule
1.
2. From the Schedule screen, select patients to be removed.
3. Click Delete Selected.
Alternatively, click Delete All, Delete All Completed, or Delete All New to remove all patients
from the list.
4. Click OK to the confirmation prompt.
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Chapter 8: Scan
Chapter 8: Scan
This section includes the workflow and parameters required for scan. It contains guidelines on the user-
friendly graphic areas and describes the basic features of the scan parameters with instructions to help
you navigate through the required areas.
Scan workflow
Exam workflow
Set up and position the patient
Set up the patient's information
Acquire a scout
Adjust the Graphic Rx
Enter contrast descriptions
Enable Priority Scan
Start the scan
Repeat a series
Modify the Patient Information presets
Stop a scan
End the exam
Scan parameters
Scan parameters workflow
Choose the Scan Type
Set axial and helical scan parameters
Set cardiac helical scan parameters
Set the Start and End locations
Set a specific number of images
Choose the Thick Speed options
Set the Image Interval
Set the Gantry Tilt
Set the Scan FOV
Set the kV
Set the mA
Timing parameters
Timing parameters workflow
Set a Prep Group delay time
Set the Interscan Delay time
Set a Breath Hold time
Set a Breathe Time
Set the Voice/Lights/Timer options
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Optima™ CT660
Recon parameters
Recon parameters workflow
Set the Display FOV
Set the R/L Center coordinates
Set the A/P Center coordinates
Set the Recon Type
Set the Recon Options
Film parameters
Film parameters workflow
Turn on AutoFilm
Set a Frame Format
Set an Interval
Flip images
Adjust the W/L
Magnify images
Rotate images
Annotate a film series
Apply filters
Apply GSE
Auto Voice
Auto Voice workflow
Set the Auto Voice language
Record a message
Change the preset delay
Control the Auto Voice volume
Delete a message
Additional Scan features

Apply additional scan features
Add/split/delete a group
Optimize the technical parameters
Optimize patient dose
View a Dose Report
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Chapter 8: Scan
Considerations
If you encounter a message that you need to remove images to be able to scan the current series,
first remove images to create space for scanning.
In general, if a scan fails and a request to Resume is posted, click Resume to continue. Click Resume
again if the first action fails. If a failure still occurs, reset the scanning hardware through System
Resets from the Service desktop. If scan still fails to restart, shutdown and Restart the system.
Complete these steps if images fail to reconstruct:
1.
Click the Recon Management icon.
2. From the Recon Management screen, click Unsuspend Entries.
3. If images still fails to recon click Restart Queue.
4. If images still fails to recon, shutdown and reboot the system.
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Optima™ CT660
Exam workflow
Use this procedure for an overview of scanning a patient, from patient setup to image management.
1. Set up and position the patient.

2. Set up the patient's information.
3. Acquire a Scout scan.
4. Define the Series setup parameters.
a. Set the Auto Store option.
b. Set the Auto Transfer option.
c. Set the AutoFilm parameters.
5. Acquire the scan data.

a. Set the scan parameters.
b. Adjust the Graphic Rx.
c. Set the timing parameters.
d. Set up Auto Voice.
e. Set the recon parameters.
f. Set the film parameters.
g. Apply any additional scan features.
h. Enter contrast descriptions.
i. Start the scan. Check the following before you Confirm:
start/end locations for each recon

direction of scans
mA table for Auto or SmartmA
j. Repeat a series, if necessary.

6. End the exam.
7. View the images.
8. Manually film the images.
9. Manually archive the images.
10. Manually network the images.
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Chapter 8: Scan
Exam workflow
Set up and position the patient
Prepare the scan room before bringing the patient into the room. Have all the necessary supplies and
accessories at hand. If IV contrast is to be used, set up the injector or syringes of contrast before
performing the localizer (scout) scan.
1. Attach the head holder or foot extender to the end of the cradle towards the gantry.
If the head holder does not attach firmly to the cradle, contact your service representative to
apply patches in kit 2327335 (P9230JV).
2. Press and hold the Unload table foot pedal to adjust the table height in preparation of transferring
the patient onto the table.
The gantry tilt moves to zero and the cradle moves to home and to a minimum height of 43 cm.
3. Transfer the patient to the table.
Make sure to follow the manufacture directions for use of a protective table slicker when
scanning, otherwise artifacts may be seen in images.
Blocked reference channels may cause image artifacts. Make sure that there are no blankets,
clothing, tubing, or straps hanging down below the table when scanning that could cause a
blockage. Keep items wrapped close to the table by using the patient restraint straps.
4. Press and hold the Load table foot pedal.

Or select one of the Default Patient Positioning button on the gantry LCD display. Press and hold the
load table foot pedal.
The table moves up to a height of 210mm and advances cradle into the gantry when the Default
Patient Positioning is not used. When the Default Patient Positioning is used, the values are
preset in the Default Patient Positioning setting screen.
5. Make the patient comfortable and immobilize as needed. Connect body straps to the cradle and
wrap them around the patient.
For head scans, confirm that the patient's head is completely in the head holder. If the patient is
not fully in the head holder, light and dark images may be seen at ends of the beam collimation
between two rotations, especially if the gantry is tilted.
Always use the head holder straps to immobilize the patient's head during head scans.
Make sure items such as blankets and straps are not left hanging off the table or head holder,
allowed to touch, or be dragged through the gantry while scanning otherwise artifacts may be
seen in images.
6. If needed, attach the table tray and IV pole.

7. From the gantry controls, press the following buttons as needed to refine the patient's position.
Table Up Cradle Out
Superior
Table Down
Gantry Tilt
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Optima™ CT660
Inferior
Cradle In
Gantry Tilt
If it is not possible to move the table down:

check to make sure there is nothing blocking the table or gantry path
check the message log for collision sensor errors, which prevent downward movement
resolve any issues and press the table up/down buttons
if the problem persists, contact your service representative for assistance
8.
From the gantry controls, press the laser alignment light button to turn on the two laser
lights: internal and external (axial, sagittal, and coronal). Align the laser lights with the desired
anatomical reference. A poorly positioned and centered patient can impact the mA values calculated
for AutomA/SmartmA.
Do not position the patient with the laser lights in their eyes.
9.
From the gantry controls, press the desired landmark internal landmark: external
landmark: button. Confirm remains gray (unselectable) until the landmark button has been
pressed.
The landmark sets a known anatomical reference for the radiologist to correlate anatomy.
The landmark sets the zero location. When scanning towards the patient’s head, you are
scanning superior to the zero location. When scanning towards the patient’s feet, you are
scanning inferior to the zero location. You should set the zero location to known anatomy. For
example, when scanning a head, the landmark or zero location is typically the orbital meatal line.
A landmark or zero reference point is required before you scan a patient. It can be set before or
after you click New Patient.
When using the external laser alignment light for patient positioning purposes, be aware that the
patient’s elevation may be slightly lower with the cradle extended than with the cradle fully
retracted. This is because the cradle may bend slightly under a patient’s weight. This difference
should be taken into consideration for applications where patient position information is critical,
such as Treatment Planning. To minimize these affects, after using the external laser alignment
system to position the patient, advance the patient to the CT scan plane. Turn on the CT alignment
lights to determine if they line up with the markers on the patient. If necessary, compensate for
the bend in the cradle by elevating the table. When the CT alignment lights line up with the
markers, re-set the landmark for the scan using the Internal laser alignment light.
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Chapter 8: Scan
10.
From the SCIM, set the volumes on the patient-to-operator and operator-to-patient or
Auto Voice communication controls. Press the Talk control and test the
volume levels.
11. Proceed to acquire a scout or a localizer scan.
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Optima™ CT660
Exam workflow
Set up the patient's information
Use this procedure each time you start a new patient exam. It is recommended that you complete the
patient information setup before you get the patient on the table to reduce patient table time. The data can
also be input by using Patient Schedule or a bar code reader.
The "/" and control characters are not valid for entries in the New Patient screen.
If mouse selections fail, press Escape to clear backlogged requests.
The system may not show typed information on the New Patient or ViewEdit screen. The system
updates after a short time.
1.
The Patient Information screen displays the new Exam Number.
The maximum Exam Number is 49, 999, which is reset by your Field Engineer.
* If the information is entered from a RIS system, these areas support up to 64 characters. If the
patient is edited or manually entered then the character limits are described in the table below.
Field name Parameters

Accession Number up to 16 characters
Patient ID* up to 16 characters
Patient Name* up to 32 characters
Sex M )Male or F (Female)
Birthdate Months, Weeks, Days
Years, Months, Weeks,
Age
Days
Weight Kgs or Pounds
Feet, Inches, or Cen-
Height
timeters
Reference Physician* up to 32 characters
Radiologist up to 32 characters
Operator up to 3 characters
History up to 60 characters
Exam Description up to 22 characters
Protocol Number up to 5 characters
Req. Proc. ID up to 16 characters
Exam Date Month, Day,
Date
Year
Time Exam Time Hour, Minute
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Chapter 8: Scan
2. From the Patient Information area, type data into the appropriate fields.
Press Enter to advance to the next text field. Alternatively, use the mouse to navigate to each
field.
The mouse cursor must be within the Patient Information area for the input to be accepted.
Patient ID is a required field. If the patient does not have an identification number, type ? or the
word trauma.
Once an identification number has been assigned to the patient, the exam information may be
edited using Edit Patient after End Exam.
Set Delete Completed Exams to zero when Patient Information is updated from the HIS/RIS. This
assures that Completed Accession numbers are not inadvertently selected for scanning a second
time causing Patient reconciliation issues on the PACS1.
DICOM2 users must enter the patient name in the following manner: last name, first name,
middle name separating each field by ^. For example: Doe^John^M.
Enter the patient date in the following manner: Month: 12, Day: 2, Year: 1987. 2 digit years can be
entered if the birth year is 2000+. Birth dates can only be entered for the past 150 years. The
format for date entry depends on your system settings: MM/DD/YYYY, YYYY/MM/DD,
DD/MM/YYYY.
Patients in Japan may know their birth date only by Emperor reign year. Configure the birth date
fields to yyyy/mm/dd date format and enter the reign year in the year field. For example, enter
S26 , if your patient was born in the 26th year of Showa's reign, which corresponds to 1951. The
Era codes are Heisel (H), Showa (S), Taisho (T), Meiji (M). The system stores the converted birth
year in the birth date field on the New Patient and Patient Schedule screens and in the image
header.
If desired, select an item from any of the Preset Selection screens (Referring Physician,
Radiologist, Operator, Exam Description) and click OK. To modify any of the preset window items,
see Modify patient information presets.
3. When all the desired patient information is entered, select a protocol from the Anatomical Selector
area, using one of the following methods.
Type a protocol number in the Protocol Number field.
From the Protocol Selection screen, click an anatomical area. Use the arrows to scroll through
the list. Click a protocol from the list to download the scan parameter values or click a default
protocol.
4. Proceed to the Acquire a Scout scan procedure.

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Optima™ CT660
Exam workflow
Enter patient information with the bar code reader
The patient information must be in the Patient Schedule list before you use the bar code reader.
Bar Codes fail to read if the HIS/RIS system the bar code is created on has a different language keyboard
than the CT system. For example, if your CT system has a French language keyboard then your HIS/RIS must
have a French language keyboard. If it is not possible to have the same language keyboard on each system,
then manually enter the Accession or Patient ID number or select the desired patient from the Patient
Schedule list to display the patient information on the New Patient screen.
The Exam Description will be truncated to 22 characters when imported from a HIS/RIS system. The
Study description field (0008, 1030) in the DICOM header is mapped to the Exam Description field on the
Schedule Patient and New Patient screens.
1. From the scan monitor, click New Patient.

2. To populate the fields on the Patient Information screen, aim the Reader at either the Accession
number or the Patient ID bar codes on the patient requisition.
3. Select desired protocol and begin the exam.
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Chapter 8: Scan
Exam workflow
Acquire a scout
Use this procedure to acquire a localizer from which you can prescribe the scan locations.
1. Confirm that the orientation of the patient matches the orientation of the patient in the Patient
Position and Series Level Functions area of the Scan desktop.
Click the picture of the patient on the body to change the Head/Feet first orientation.
Click the picture of the patient on the table or above the body to rotate the body at 90°
increments.
2. From the ViewEdit screen, confirm the start/end locations, kV, mA, and Auto Voice (if applicable). To
change a parameter value, click the box and type in the new value.
Click an individual cell under a parameter column to adjust only the factor in that group.
Click the parameter column from the top row to select all of the factors directly below the
selected column and to adjust that factor in all of the images.
Click Add Scout or Delete Scout to change the number of scouts.
Technique factors are set low (120 kV and a low mA are common), since these scans are
normally only used for planning purposes.
3. Set the Scout Plane to designate the type of scout to acquire.
0 = 12 o'clock, 90 = 3 o'clock, 180 = 6 o'clock, or 270 = 9 o'clock
Show Localizer is only available if the scout has been acquired at 0, 90, 180, or 270.
4. Click Scout WW/WL and type desired values in the field and click OK.
5. When performing a gated exam, set up the patient monitor and check the status of the Gating icon
to verify that the system is receiving the ECG1 monitor signal.
If the Gating button is blue, gating is not enabled. Click the button to enable gating.
If the Gating button is yellow, an ECG signal is being received and you can proceed.
If the Gating button is red, no signal has been detected by the system. The system displays a
message to check the connection. Check that all ECG leads are connected to the patient and that
power is on to the monitor. See Cardiac patient prep for more details. Click OK to close the
message.
6. Clear the scan room of any unauthorized personnel.
7.
On the left monitor, click Confirm icon.
8. Press Move to Scan.
The button illuminates on the SCIM1 and flashes green, indicating you need to press the Move to
Scan button.
If you need to stop table movement, press Stop Move.
If you need to stop the scan, press Stop Scan.
If you need to pause the current scan, press Pause Scan.
This finishes the current scan, then pauses the next scan. A Resume button displays on the
screen. Click Resume when you are ready to scan.
1Scan Control Intercom Module
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10. Repeat steps 8 and 9 to acquire the second Scout scan.

11. Proceed to Set the scan parameters procedure to acquire the Scan data.
If you change the Landmark after the scout has been taken, Graphic Rx does not allow this scout to be
used for Graphic Rx. AutomA/SmartmA will be disabled. Acquire a new scout when the landmark is
changed.
Bands and lines may be seen on scout images if there is a tube spit or the reference channel is
blocked during the acquisition.
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Exam workflow
Adjust the Graphic Rx
Use this procedure to adjust the graphic prescription to set up a scan series. If your protocol is set up
correctly, you may not have to make many changes. You will be able to adjust the graphic lines
representing the series and confirm.
Graphic Rx may fail to start. No image will be shown for Show Localizer. Check to see if the Scout
images are in the browser. If the images are in the browser, toggle Show Localizer on and off. Use the
Restart Show Loc button in the Tool Bar on Image Works desktop.
If the Scout image has been reconstructed but does not display in Show Localizer, click Restart Show
Loc on the toolbar to restart Graphic Rx. If the Scout image still does not display, use the crosshair cursor
on the Scout to explicitly define the start/end locations and offsets. This only works if Continuous Report
Cursor is on in the Exam Rx Display preferences.
At any time while you are in Show Localizer, you can press Next or Prior to scroll through the valid
scout images for the landmark within the series.
1. Verify that Show Localizer is on. If it is off, turn it on.

2. Press Shift and simultaneously click and drag the center red X to position the graphic lines over the
anatomy you want to cover.
The slices are represented as a group of lines on the scout image. The start location is
demonstrated with a solid square in the middle of a line. The end location is demonstrated by an
open square box in the middle of a line.
The red X allows you to move the lines up and down on a lateral scout, as well as from side to
side on a AP1 scout.
By moving the lines, you are adjusting the start and end location, and the RAS2 coordinates.
If you change the landmark after scout has been taken, Graphic Rx will not allow you to change
A/P centers on lateral Scout. Since the landmark changed, a new Scout should be acquired so
Graphic Rx can be used and a more accurate calculation of the mA requirements can be
performed for AutomA or SmartmA, if enabled.
Click the red x moves the slices in the slice direction only.
3. Click and drag the solid box to the starting position.
4. Click and drag the empty box to the ending position.
Press Shift and simultaneously click and drag either the solid or empty box to adjust both the
starting and ending locations at the same time.
5. Click and drag the diamond key to set the DFOV3 equally around the center of the DFOV.
Alternatively, press Shift and simultaneously click and drag the diamond key to adjust the DFOV
and the R/I or A/P center on the selected side.
6. Click and drag the circle to adjust the tilt, if needed.
To return the tilt parameter to 0°, press Shift and simultaneously click the circle.
1Anterior/Posterior
3Display Field Of View
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Only applies to axial and cine scans.

7. From the Graphic Rx control panel, choose an option to show or hide the slices.
Click Hide Slices to show a transparent area of coverage with no slice lines displayed.
Click Show Slices to show a line for each image reconned.
8. Review the Graphic Rx values on the ViewEdit screen to make sure they are correct.
9. Proceed to the Set the Scan parameters procedure.
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Chapter 8: Scan
Exam workflow
Enter contrast descriptions
Use this procedure to enter contrast descriptions for the scan if you are using IV1 or GI2 contrast.
When IV contrast is to be used, make sure the injector or syringes of contrast are set up before
performing the localizer (scout) scan. The IV Contrast icon must be selected.
Enter manual descriptions
1.
From the ViewEdit screen, click the IV contrast or GI contrast icon.
2. In the IV or GI text fields, type and Enter a description of the contrast.
The text entered will not be saved as a preset.
Enter preset descriptions

1. On the ViewEdit screen, click Preset List.
2. On the Contrast screen, select an IV or GI preset description.
3. Select a contrast option, if needed.
Click Change to edit the currently selected description.
Click Add to add new descriptions.
Click Delete to remove a description.
Click Sort to order the items on the list 1, 10, 100 to 9, 90, A to Z, or a to z.
4. Click OK.
When contrast is selected, a “+c” annotation displays on the images next to the image number,
indicating that IV contrast was used for that exam.
1intravenous
2Gastro-Intestinal
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Exam workflow
Enable Priority Recon
Use this procedure to enable Priority Recon for the scan if you want to check images of the last portion of
scan.
1.
From the ViewEdit screen, click the Priority Recon icon.
After the system complete the scan, images in the last 20mm in scan range regardless of image
thickness will be prioritized.
After prioritized image reconstruction is completed, the system continues to reconstruct images
in other portion of scan range.
This is not applicable to Cine, Volume Shuttle, Volume Helical Shuttle, Cardiac Helical, SnapShot
Pulse, SmartStep and Direct MPR.
When there are multiple scan groups in a series, images in the last 20mm in the last scan group
will be prioritized.
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Chapter 8: Scan
Exam workflow
Start the scan
Use this procedure to start a scan.
1. Review the following items for every acquisition before confirming to scan:
the start/end locations for each recon
direction of scan
the mA table for Auto or SmartmA
2.
To start a scan, click the Confirm icon
3. Press Move to scan.
4. Deliver breathing and table move instructions, as needed.
Considerations
Press Stop Scan to stop scans between multiple helical groups and do not press Stop Move.
Scan aborts may occur during Axial or Helical scanning. Always be aware of the scan progress
during an Exam and select Resume to continue.
Scan may fail to confirm posting a message that not enough image space exists, even though the
image space shown in the Feature Status Area indicates there is enough space. This is due to the
fact that images are stored on the system disk in more than one partition. Remove consecutive
exams to free up image space for confirm to proceed.
If you encounter the message that you need to delete images to be able to scan the current series,
first remove images to create space for scanning, next if Scouts have not been taken, end the exam and
start a new exam. However, if scouts have been acquired, use Select New Protocol and prescribe the
series again.
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Exam workflow
Repeat a series
Use this procedure to repeat a series that has already been scanned.
1. On the Scan desktop, click Repeat Series.

When more than one series has been scanned, a list of all scanned series displays.
If only one series has been scanned, the series list does not display.
2. On the Series List screen, select which series you want to repeat.
3. Click OK.
The state of Show Localizer is not remembered by the system.
SmartPrep is turned off.
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Exam workflow
Modify the Patient Information presets
Use these procedures to modify the Preset fields on the Patient Information screen. The Presets are saved
across software loads from the saved System State.
From the Patient Information screen, click any of the preset fields to open the Preset screen.
Referring Physician
Radiologist
Operator
Exam Description
Change an item on the list

1. From the Preset fields screen, select the item you want to change.
2. Type the information in the text field.
3. Click Change.
Add an item to the list

1. From the Preset fields screen, enter new information in the text field.
2. Click Add.
100 is the maximum number of entries.
Items are listed with the newest entry at the top of the list.
Delete an item from the list

1. From the Preset fields screen, select the item you want to delete.
The item is displayed in the text field.
2. Click Delete.
Sort items in the list

1. From the Preset fields screen, click Sort.
The list is sorted alphabetically or numerically, e.g., 1, 10, 100 to 9, 90, A to Z, or a to z.
Close the Preset screen

Click OK to accept your changes and close the screen.
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Scan workflow
Stop a scan
Abort a scan in progress

Use this procedure to abort the X-ray and stop the gantry and table movement.
1.
From the SCIM, press Stop Scan .
2. Click Resume from the Scan Progress screen to resume the scan.
Pause a scan in progress

Use this procedure to pause the current scan. This finishes the current scan, and then pauses the next scan.
1.
From the SCIM, press Pause Scan .
2. Click Resume from the Scan Progress screen to resume the scan.
Emergency stop scan, electronics, and x-radiation

Use this procedure in the event of a patient related emergency or if the cradle, table, or gantry starts to
move unexpectedly.
1.
From the SCIM or gantry, press Emergency stop .
All table and gantry motions, and X-ray exposure are stopped.
2. On the gantry, press Reset to clear the Emergency Stop.
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Exam workflow
End the exam
1. When an exam is completed, click End Exam.
End Exam sends any prescribed Recon 2 or Recon 3 for the last series to be reconstructed.
End Exam starts AutoStore for the exam.
End Exam starts AutoTransfer by Exam.
2. If you have the PPS1 ConnectPro option, click one of the following options.
Click Complete if the exam is complete.
Click Discontinue if the exam has been discontinued (the exam cannot use PPS again).
Click Defer to complete the exam at a later date. To complete the exam, select the exam from
the Image Works browser patient list, and select PPS > Complete or Discontinue.
Due to screen stacking issues, if PPS is enabled, the dialog box to complete the PPS state may be
hidden. A system reboot will be required to recover.
1Performed Procedure Step
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Use this procedure to set the scan parameters according to your patient's size and the anatomy you are
scanning. These parameters determine the image quality you achieve. Always make sure you remove any
objects that may cause artifacts. Review the Scout image to view objects that might cause artifacts.
Considerations
If the patient orientation is different from the previous scan, the following message is seen, "Your
patient orientation has changed from the previous series. Please verify or change orientation if
needed".
If the landmark has changed, the following message is seen, "The table landmark has changed. This
changes the location of all scans you have prescribed. Double check all scan location before you
start scanning".
1. From the Scan desktop, click Next Series in the protocol or click Create New Series.
If you are building a protocol, the next series button moves you around in the protocol.
There may be times that you want to skip a series in the protocol. For example, a series involving
a patient that was scanned for contrast only and your current series is built for no contrast.
2. Make sure the orientation of the patient is the same as the Scout.
If necessary, click the picture of the patient to change the patient position.
There may be times that you change the patient’s position from the way that the protocol was
built. In that case, you have to change the patient’s orientation on the screen each time you
advance to the next series.
You can also build the protocol with Copy Patient Orientation and Patient Position, Anatomical
Reference.
3. Choose the Scan Type.
For an axial or helical scan, see Set axial and helical scan parameters.
For a helical cardiac scan, see Set cardiac helical scan parameters.
4. Set the start and end locations.
To graphically set the locations, see the Adjust the Graphic Rx procedure.
To explicitly set the locations, see the Set the Start and End locations procedure.
To set a specific number of images, see the Set a specific number of images procedure.
5. Choose the Thick Speed options.
6. Set the Image Interval.
7. Set the Gantry Tilt.
8. Set the SFOV.
9. Set the kV.
10. Set the mA.
11. Proceed to the Set the timing parameters procedure.
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Chapter 8: Scan

Choose the Scan Type
Use this procedure to choose a Scan Type to specify how the scan data is acquired.
1. On the ViewEdit screen, click Scan Type.
2. From the Scan Type screen, choose the desired Scan Type.
Click Axial for a step and shoot method.
Routine head studies typically use axial scans acquired with a 1 or 2 second rotation time.
Hi-Res chest studies may use axial scans acquired with a sub-millimeter (0.625 mm) slice or
with a single 1.25 mm slice.
Axial can be combined with VolumeShuttle (Axial) mode for an axial acquisition that moves
back and forth (shuttles) between locations. VolumeShuttle (Axial) mode provides wider
coverage for perfusion imaging.
Read the Safety VolumeShuttle (Axial) patient weight restriction note.
An axial scan with 40 mm beam is not recommended for exams in the head for other than
Perfusion. Imaging of the head should be done using 10 or 20 mm beam collimation.
In Axial scan mode, the scan direction may not be maintained when scanning inferior to
superior when a group is added. When adding a group for axial scan mode, be sure to verify
that the scan direction is correct.
The CT number (HU value) for the 1.25 mm 1i mode may not be the same as seen in 20 and 40
mm beam acquisitions.
Click Helical for a continuous table movement method.
A wide range of exam types use helical scans.
Helical can be combined with Volume Helical Shuttle mode for a helical acquisition that
moves back and forth (shuttles) across a scan range for wider coverage for 4D CTA or
perfusion imaging.
When scanning, press Stop Scan to stop scan between multiple helical groups not Stop Move.
Click Cine when one location needs to be scanned over a period of time, such as for
hemangioma studies.
Full is continuous exposure that supports table movement equal to the beam collimation or
no table movement, where the scan is taken at one table position.
Segment is a partial scan with continuous exposure.
If the scan type is changed to SnapShot Cine from another scan type, the mA value
automatically updates. Review it to be sure it is acceptable.
Click Cardiac to help freeze motion of the heart and vascular structures with a helical- or cine-
gated scan.
If your scanner has CardIQ SnapShot and CardIQ Snapshot Cine cardiac options installed, the
Scan Types include SnapShot Segment, SnapShot Burst, SnapShot Burst Plus, and SnapShot
Pulse.
3. Click a Rotation Time.
Axial – 0.4*, 0.5**, 0.6**, 0.7, 0.8, 0.9, 1.0, and 2.0 seconds
Cine – 0.4*, 0.5**, 0.6**, 0.7, 0.8, 0.9, and 1.0 second
Helical – 0.4*, 0.5**, 0.6**, 0.7, 0.8, 0.9, and 1.0 second
VolumeShuttle (Axial) (option) – 0.4*, 0.5** and 0.6** seconds
Volume Helical Shuttle (option) – 0.4*, 0.5**, and 0.6** seconds
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Cardiac (option) with the Sub 0.4 second option – 0.35, 0.37, 0.4, 0.42, 0.45, 0.47 and 0.5 seconds
Cardiac (option) with the 0.4 second option – 0.4, 0.42, 0.45, 0.47 and 0.5 seconds
Note * : 0.4 second option (with SFOV of Ped Head and Ped Body)
Note** : 0.5 second option
4. Click a Rotation Length if acquiring a Cine scan.

Full Rotation is used most often.
Segment Rotation is used for coronary artery calcium scoring.
5. For Shuttle Mode, click On if desired.
Shuttle Mode is only compatible with Axial and Helical scan types.
If your scanner has the VolumeShuttle (Axial) or the Volume Helical Shuttle option installed, the
Scan Types include Shuttle mode.
Read the Safety section pertaining to the VolumeShuttle (Axial) and Volume Helical Shuttle
scanning.
6. Click OK.
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Use the following tables as a guide when prescribing an axial or helical scan. Because the data for a helical
image is weighted over more than one rotation, to provide the best possible image quality the nominal
image slice may differ slightly from your selection dependent on table speed, pitch, and slice selection.
Nominal Slice Thickness: Axial Scan Modes (FWHM in mm)
Selected Slice Thickness

Aperature
0.625 1.25 2.50 5.00 10.00
40.00 0.742 0.980 2.350 5.373 9.560
20.00 0.669 1.028 2.323 5.226 9.450
10.00 0.513 1.113 2.404 4.836 9.730
5.00 N/A 1.102 2.387 4.805 N/A
2.50 N/A 1.092 2.388 N/A N/A
1.25 N/A 1.085 N/A N/A N/A
Nominal Slice Thickness - Helical Scan Modes (FWHM in mm)
Pitch 0.5:1 "Full Mode" Pitch 0.9:1 "Full Mode"

Aperature
(mm) 0.625 1.25 2.50 3.75 5.00 7.50 10.00 0.625 1.25 2.50 3.75 5.00 7.50 10.00
40.00 0.66 1.09 2.22 3.53 4.84 7.23 9.68 N/A 1.10 2.34 3.93 5.08 7.37 9.82
20.00 0.68 1.12 2.23 3.57 5.03 7.28 9.71 N/A 1.12 2.34 3.80 5.00 7.34 9.82
Pitch 1.3:1 "Full Mode"

Aperature
(mm) 0.625 1.25 2.50 3.75 5.00 7.50 10.00
40.00 N/A 1.16 2.32 3.81 5.26 7.33 9.80

20.00 N/A 1.14 2.35 3.85 5.08 7.37 9.79
Aperature Pitch 0.5:1 "Plus Mode" Pitch 0.5:1 "Plus Mode"

(mm) 0.625 1.25 2.50 3.75 5.00 7.50 10.00 0.625 1.25 2.50 3.75 5.00 7.50 10.00
40.00 1.00 1.37 2.74 4.09 5.70 7.51 10.00 0.96 1.38 2.98 4.62 5.89 7.51 9.99
20.00 1.02 1.40 2.76 4.23 6.00 7.52 10.00 0.98 1.39 2.95 4.51 6.01 7.54 10.03
Aperature Pitch 1.3:1 "Plus Mode"

(mm) 0.625 1.25 2.50 3.75 5.00 7.50 10.00
40.00 1.00 1.44 2.76 4.53 6.11 7.50 10.00
20.00 0.99 1.44 2.80 4.53 5.92 7.51 9.99
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Use the following table as a guide when prescribing a cardiac helical scan. Slice profile measurements for
Cardiac helical scans are complicated by the fact that a variable helical pitch is chosen based on the
patient’s heart rate. For helical pitches greater than 0.125, the full width half max of a slice collimated at
1.25 is approximately 1.6 mm. The full width half max of a slice collimated at 2.5 mm is approximately 3.2
mm.
Nominal Slice Thickness: Cardiac Scan Modes (FWHM in mm)
Aperature Selected Slice Thickness: Heart Rate 60 BPM

(mm) 0.625 1.25 2.50
40.00 0.84 1.08 2.28
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Chapter 8: Scan

Set the Start and End locations
Start and End Locations are set in millimeters superior to, and/or inferior from, the anatomical reference
point. The locations designate the points of anatomy to be scanned. The easiest way to set the Start and
End locations for a scan is to turn on Show Localizer and adjust the scan range graphically. If specific
locations are known, use this procedure designate the beginning and end points of the anatomy to be
scanned.
1. On the ViewEdit screen, click Start Location.

2. Type a beginning point location.
The numbers must be preceded by the correct designation of “S” for superior (towards the head)
from the centering point, or “I” for Inferior (towards the feet).
Plus (+) can be used for superior and minus (-) for inferior.
The Start location from a the previous scanned series is copied if D or d was enabled in Protocol
Management.
3. Click End Location.
4. Type a end point location.
The numbers must be preceded by the correct designation of “S” for superior (towards the head)
from the centering point, or “I” for Inferior (towards the feet).
Plus (+) can be used for superior and minus (-) for inferior.
The End location from a the previous scanned series is copied if D or d was enabled in Protocol
Management.
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Set a specific number of images
The Number of Images, which set automatically by the system, is determined by the combination of Start
and End Location, Slice Thickness, and Image Interval. Use this procedure if you require a specific number of
images for the scan prescription.
1. On the ViewEdit screen, click No. of Images.

2. Type the desired value.
The system automatically adjusts the End Location.
3. For shuttle acquisitions, the number of images is determined in the Thick/Speed pop-up for the
values entered in the Number of Passes or Coverage Time.
See the Acquire a VolumeShuttle (Axial) scan procedure.
See the Acquire a Volume Helical Shuttle scan procedure.
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Chapter 8: Scan

Choose the Thick Speed options
Use this procedure to set the Thick Speed options for image slice thickness and speed.
1. On the ViewEdit screen, click Thick Speed.

2. On the Image Thickness screen, choose the slice thickness for the detector coverage.
For VolumeShuttle (Axial) and Volume Helical Shuttle, the number of passes or coverage time will
need to be entered. The number of passes determines the total duration or coverage time for the
scan and vise versa.
3. Choose the slice thickness.
In the Axial mode, the 1i mode, the High Resolution Chest mode is available with 1.25 mm
thickness with one image per rotation. No other thickness can be reconstructed prospectively or
retrospectively.
In the Helical mode, choose between 20 mm detector coverage (32 row), or 40 mm detector
coverage (64 row).
Beam collimation:
There is a 5 to 7 HU 1 value difference when scanning the same anatomy with a 20 mm beam
and a 40 mm beam. It is recommended to use the same beam collimation through the entire
acquisition when scanning the head.
CT HU for the 1.25 mm 1i mode may not be the same as in 20 and 40 mm beam acquisitions.
In the Cine mode, the Cine Time Between Images is the time between each image that can
created in a Cine acquisition. Cine Time Between Images is dependent on rotation time selected.
The smaller the slice thickness, the more technique you need to use. The thinner the slice
thickness, the higher the noise will be in the slice. Adjust protocol factors to provide desired
image quality and noise level for the acquisition.
Thinner slice thickness gives you better detail. However, contrast resolution will be decreased.
4. Choose the pitch and speed for the Helical mode.
The pitch is the table travel in millimeters per rotation divided by the beam collimation.
4 Row Interleaved provides a 40% mAs reduction, and is 1.5 to 3 times faster than single slice
helical and has minimal helical artifacts, but interleaved pitch 0.5:1 provides only one third of
the coverage compared to interspaced mode.
4 Row Interspaced provides data acquisition 2 to 6 times faster than single slice helical, but
requires more interpolation, more helical artifact, and only a 20% mAs reduction.
In the helical mode, the helical pitches include 0.531:1, 0.516:1, 0.969:1, 0.984:1, and 1.375:1.
5. Choose the images per rotation for Axial and Cine modes.
In Axial mode, the number of images per rotation can be 1, 2, 4, 8, 16, or 32.
In Cine mode, only 20 and 40 mm beam coverage is allowed.
The choice for one determines the choices for the other. Some combinations are not allowed.
The choice for number of images determines the beam collimation and slice thickness. Some
combinations are not allowed.
The choices you make for thickness and images per rotation determine the available
reconstruction thicknesses.
1Hounsfield Unit
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6. Note the coverage time and coverage speed.

7. Click OK.
The coverage time shown in the Thickness/Speed window does not account for breath hold and
breathe times that have been prescribed in the protocol.
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Chapter 8: Scan

Set the Image Interval
The Image Interval is for helical scans only and is automatically set to match the slice thickness by the
system. This is known as contiguous (back to back) scans. Use this procedure to set an Image Interval if you
want a contiguous, overlapped, or spacing (skip) in the scan prescription.
1. On the ViewEdit screen, click Interval.

2. Type an interval value in mm.
Type D or d in the Image Interval field to copy the locations from the previously scanned series.
In the Helical mode, the table moves in mm per rotation, while exposing the patient.
The image interval defaults to equal the slice thickness.
The maximum interval is twice the slice thickness.
The interval can be less than or greater than the slice thickness.
For Volume Helical Shuttle, the interval is set to 10 mm and cannot be changed, except in
Retro Recon.
The interval of 7.5mm and 10.0mm thickness is available to only integral multiple of 2.5mm.
In the Axial mode, the interval or spacing defaults to the equal number of images per rotations
multiplied by the slice thickness.
The interval for axial scanning can be zero, equal to, or greater than the width of the detector
configuration. Typical intervals used are 10, 20, or 40 mm.
Axial interval with skip refers to a gap between scan groups. This can be useful, for example,
when performing a survey exam, such as a high resolution chest exam.
For the single slice High Resolution Chest Mode, the minimum scanning interval between
slices is 5 mm.
For VolumeShuttle (Axial), the interval is set to 40 mm.
In the Cine mode, for an interval greater than zero, scans are created at several locations and
the end location changes.
The usual interval is 20 or 40 mm.
You can change the interval when setting up prospective multiple recons.
IQ Enhance is compatible with 0.625 mm and 1.25 mm slice thicknesses. Interval for acquisitions
with IQ Enhance must be equal to the slice thickness (0.625 mm or 1.25 mm) or an overlap of
50% (0.312 mm or 0.625 mm).
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Set the Gantry Tilt
The Gantry Tilt can be set manually or graphically to a maximum of 30° in half degree increments. The most
common way to set the tilt is graphically. The maximum degree of tilt depends on the height of the table,
landmark setting, and interaction with interference (collision) matrix.
Graphically set the Gantry Tilt

1. View a lateral Scout image.
2. Click and drag the circular handles on the Start and End locations to adjust the lines on the Scout to
the desired tilt.
Explicitly set the Gantry Tilt

If a specific tilt is wanted, use this procedure to set the gantry tilt.
1. On the ViewEdit screen, click Gantry Tilt.

2. In the Gantry Tilt field, type an S or I prefix and the desired value.
Manually set the Gantry Tilt

1. Adjust the gantry to the desired tilt.
2. In the Gantry Tilt field, type C to enter the current degree of tilt.
This is useful when scanning head studies without taking a Scout scan.
In the Gantry Tilt field, type D or d to copy the tilt value from the previously scanned series.
Click Tilt/Table Travel Limits on the gantry keypad to observe the min/max values for gantry tilt and
table travel for the current landmark.
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Chapter 8: Scan

Set the Scan FOV
The SFOV1 determines how much anatomy is scanned. Use this procedure to select a SFOV that covers the
anatomy of interest. The SFOV should always be larger than the circumference of the patient, regardless of
what part is being imaged.
1. On the ViewEdit screen, click SFOV.

2. Choose an SFOV.
Click Ped Head to image infants 18 months or less in age. It allows you to enter up to a 32 cm
DFOV and is limited to 30 kW. It has a special processing to correct for beam hardening effects.
Click Ped Body to image to image infants 18 months or less in age. It allows you to enter up to a
32 cm DFOV and is limited to 30 kW.
Click Head to image adult heads up to 32 cm. It has a special processing to correct for beam
hardening effects.
Click Small Body to image small bodies, extremities that are centered middle of the gantry and
the QA phantom. It allows you to enter up to a 32 cm DFOV.
Click Large Body to image most adult body work. If you measure the anatomy that you are
scanning and it measures over 30 cm, you need to use the large SFOV. It allows you to enter up
to a 50 cm DFOV.
Click Cardiac Smallor Cardiac Large for cardiac studies.
There is a 5 to 7 CT number (HU value) difference when scanning the same anatomy with a 20 mm
beam and a 40 mm beam. It is recommended to use the same beam collimation through the entire
acquisition when scanning the head.
1Scan Field Of View
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Set the kV
Use this procedure to set the kVp for the imaging study.
1. On the ViewEdit screen, click kV.

2. Choose the desired factor.
Click 80 kV for Bone Mineral Densitomery and Perfusion imaging in the brain.
Click 100 kV for pediatric and small patient imaging.
Click 120 kV for routine imaging of the chest, abdomen, and pelvis areas.
Click 140 kV for imaging the posterior fossa, thick areas, and heavy patients.
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Set the mA
Considerations
AutomA and SmartmA are disabled if the patient orientation does not match the Scout orientation.
Once the patient orientation matches the Scout, AutomA/SmartmA can be enabled.
Use this procedure to set the mA for the scan prescription.
1. On the ViewEdit screen, click mA.

2. On the mA Control screen, choose an mA value.
Click Manual mA and type an mA value.
Type a value, in increments of 5, from 10 mA up to 560 mA depending on the kVp selected
with the Performix™ 40 X-ray tube. Note: for the value of max mA, see High Frequency
Generator in X-ray tube and Generator.
Click AutomA to enable mA modulation in the Z-direction.
Type a Noise Index value that provides acceptable diagnostic quality. As the Noise Index
increases the required mA decreases and image noise increases. The optimum strategy is to
find the highest noise index sufficient for the clinical task and let AutomA select the mA
without using significant constraints. Use a slightly lower noise index for the small patients
and a slightly higher noise index for large patients.
Type a Min and Max value, which constrains the mA range used during the scan.
Select SmartmA to enable mA modulation in the XY-direction.
For cardiac scans, see ECG modulate mA guidelines.
3. Click OK.
4. Review: From the Scan desktop, click the mA Table to view the calculated Z or X and Y values. This
can only be done at the time of scan set up and not in Protocol Management.
Example of a head mA table indicating low and high mA values
The Optimize mA screen displays on top of the ECG Trace. Therefore, make sure to close the Optimize
mA screen once the mA has been set.
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Use this procedure to set up the timing parameters in the scan prescription. The patient’s condition has a
large effect on timing. Make sure that you know how long the patient can hold his/her breath. This helps
when working with Auto Voice.
It is very important to utilize injection delays. You can only inject once and you must get it right the first time.
Different anatomy enhances at different times. Check with your radiologist for the right injection delays.
1.
From the ViewEdit screen, click the Timing Parameters icon.
2. On the Timing Parameters tab, if an injection delay is needed, set a Prep Group time.
The valid range is 0 to 300 seconds.
Auto Voice automatically sets Prep Group time based on message length and Preset Delay Time
set for the Voice, Lights, Timer selection.
3. If scanning in the axial mode, set an Interscan Delay time (ISD 1).
4. For breath hold scans, set a Breath Hold time and set a Breathe Time, as needed.
5. Set the Voice/Lights/Timer options.
Multi-language selection in 9 languages are available for selection for Auto Voice messages 1, 2,
or 3.
Preset Delay Time, sets a delay from the time message ends until the X-ray turns on. This is
helpful for patients who need a longer time to follow breathing instructions.
If you are prescribing a Cine scan, the system automatically updates the Cine Duration value
based on the number of images per R-to-R cardiac cycle and the time set between the neighboring
images.
6. Click Preview.
The preview function allows you to view graphically how the combination of breath hold and
breathe time affects your system.
Preview screen
If your exam's preview graph exceeds the width of the screen, use the arrows at the bottom of
the screen to navigate.
Preview also displays summary of all your scan groups.
1Inter-scan Delay
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7.
To close Preview mode and start the scan, click the Confirm icon.
To view the parameters or make changes, click the return to ViewEdit icon.
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Set a Prep Group delay time
The Prep Group establishes how long the system waits before turning the X-ray on for a given group of
scans. Use this procedure to set a Prep Group delay time for giving contrast with a timed delay or timing of
Auto Voice instructions.
1.
2. On the Timing tab, click Prep Group.
3. Type a scan delay time in seconds.
Valid ranges:
Group 1: 0 to 300 seconds
Group 2: 1 to 600 seconds, depending on scan modes. Helical requires a minimum 5 second
delay and Cine requires a 1 second delay.
The delay time can change to accommodate Auto Voice.
If you are using the SmartPrep option, this field is replaced with SP and the time for the
Diagnostic Delay.
The system starts to acquire the scan after you press Start Scan and the Prep Group delay time
counts down to zero.
Start the injection at the same time as starting the scan to insure accuracy of when the IV1 bolus
arrives in the appropriate anatomy.
The Prep delay will be set to zero upon Resume after Stop Scan or Pause is selected during the Prep
Delay countdown.
1intravenous
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Set the Interscan Delay time
When the scan type selected is Axial, the ISD 1 becomes available. ISD allows time for the table to move the
correct amount of millimeters set for the Image Interval. It can also be used to help with tube cooling by
increasing the value, extending the time between exposures allowing the heat units to dissipate. Use this
procedure to set an Interscan Delay time for an axial scan prescription.
1.
2. On the Timing tab, click ISD.
3. Type a scan delay time, in seconds, between each axial scan.
This is the amount of time that you want to wait between each scan.
This can be useful when the optimizer is red. You can increase the ISD to allow for more tube
cooling.
Typically, the ISD is set at 1 to 1.7 seconds so the exam is done as fast as possible.
The valid range is 1 to 300 seconds.
ISD is not available with Helical or Cine scan types.
1Inter-scan Delay
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Set a Breath Hold time
The Breath Hold parameter is the amount of time, in seconds, that your patient can hold his or her breath.
Breath Hold, along the Breathe Time parameter, automatically divides all of your prescribed scans into
Breath Hold scanning clusters. Use this procedure to set a Breath Hold time for how long the patient must
hold his/her breath for each exposure.
1.
2. On the Timing tab, click Breath Hold.
3. Type a value, in seconds, for how long you want the patient to hold his or her breath.
Breath Hold and Breathe Time can be used in conjunction in order to cluster scans within a
group.
The valid range is N (None) or 1 to 120 seconds.
For better registration of the patient’s anatomy on the scan, use a longer Breath Hold time.
It is important that you practice with your patient to determine how long they can hold their
breath.
Typical Breath Hold times are 10 to 12 seconds.
The coverage time shown in the Thickness/Speed pop-up does not account for breath hold times that
have been prescribed in the protocol.
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Set a Breathe Time
Breathe Time is the amount of time, in seconds, you allow your patient to breathe in between breath hold
clusters. Use this procedure to set a Breathe Time to allow the patient to breathe normally between breath
holds.
1.
2. On the Timing tab, click Breathe Time.
3. Type a value, in seconds, for how long you want to give the patient to breathe between groups of
scans.
Breath Hold and Breathe Time can be used in conjunction in order to cluster scans within a
group.
The valid range is N (None) or 1 to 60 seconds.
It is important that you practice with your patient to determine how long they can hold their
breath.
Typical Breathe Times are 10 to 12 seconds.
If there is IV contrast being injected, it is important to consider the appropriate length of this
delay and its effect on patient comfort. Make sure that the patient can breathe, but do not make
the time gap between breaths too long otherwise you lose the IV contrast.
The coverage time shown in the Thickness/Speed pop-up does not account for breath hold times that
have been prescribed in the protocol.
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Set the Voice/Lights/Timer options
Use this procedure to set the Voice/Light/Timer settings so that the system will automatically give the
breathing instructions to the patient according to the Breath Hold, Breathe Time, and Total Exposure Time. If
the Total Exposure Time is less than the Breath Hold time, the system uses only the time needed for the
exposure. The Light and Timer features are visible on the gantry if these features are selected for use.
If the Voice/Light/Timer feature was selected for the scout series, it must be selected for the axial
series as well.
1.
2. On the Timing tab, click Voice Lights Timer.
3. Select the commands you want to use for breathing instructions.
Three pre-recorded voices are available in 9 languages.
You can record an additional 17 voice instructions. See Record an Auto Voice message.
You can set an Auto Voice preset delay. See Change Auto Voice preset delay.
You can choose breathing lights and/or a timer.
If Auto Voice pre-recorded message 1, 2, or 3 is selected, the following languages can be
selected: English –Male, English-Female, Japanese, French, German, Spanish, Mexican Spanish,
Italian, Korean, and Chinese.
4. Select Lights, Timer, or both.
5. View the color indicator to review your selections.
A pale yellow box with a "N" indicates only the breathing lights are selected (no Auto Voice).
A pale yellow box with a "T" indicates the breathing lights are selected with a countdown timer.
A pale yellow box with a number and a "T" indicates that Auto Voice, breathing lights, and the
countdown timer are selected.
A blue box with a number indicates only Auto Voice is selected. The breathing lights and delays
are not active.
6. Click OK.
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Change the preset delay
The Preset Delay adds a delay between the completion of the Pre-scan message and X-ray on. This delay
can be set per protocol. Use this procedure to set the preset delay before the Auto Voice message is
played.
1.
3. On the Auto Voice screen, click the time next to Preset Delay Time.
4. On the Preset Delay screen, click the desired delay time.
5. Click OK.
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Most of the recon parameters are already set from the protocol and from the adjustments that you made
with the graphic lines on the scouts. When setting the recon factors, it is important to know why you are
scanning the patient and what you are looking for. If you are looking for fractures, you would want to use a
different set of parameters than if you were looking for a mass. You can reconstruct images three different
ways.
Considerations
Non-contiguous groups may be created when add group and Recon 2 or 3 is on. Prior to confirming
the scan, check that the interval between the end location of group 1 and start location of group 2 for
Recon 2 and 3 is equal to the selected slice thickness.
1.
From the ViewEdit screen, click the Recon Parameters icon.
2. On the Recon Parameters tab, set the DFOV.
3. Set the Right/Left Center coordinates.
4. Set the Anterior/Posterior Center coordinates.
If D was selected in Protocol Management, DFOV, A/P Center, R/L Center for reconstruction is
updated automatically to the values used in the previously scanned series. Recon 2 and/or Recon 3
values are copied from Recon 1.
5. Set the Recon Type.

6. The Matrix Size is set at 512 for best image resolution.
7. Set the Recon Option.
8. For a second reconstruction, set Recon 2.
a. Click Show Recon 2.
You can change your start and end locations as long as they do not exceed Recon 1.
You can change the slice thickness, interval, DFOV, R/L, A/P, and Recon Type to a different
value than Recon 1.
If you want a different Series Description than Recon 1, type the desired description in the
Series description field. If the description is blank, it will use the same description as Recon 1
and add Recon 2 or Recon 3 to the beginning of the description.
b. Click Recon Enabled.
c. Click Yes.
If it is not already selected in the protocol.
When Yes is selected, the Start/End Locations, Interval, DFOV, R/L Center, and A/P Center
parameters are copied from Recon 1.
If Duplicate has been enabled, do not selected Yes as this will clear Duplicate mode.
d. If Duplicate is not enabled in the protocol and you want to enable it, type D in the fields (Start/End
Locations, Interval, DFOV, R/L Center, and A/P Center) you want to duplicate.
e. Repeat steps with Recon 3 if a third reconstruction is desired.
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f. To transfer Recon 1, Recon 2, and Recon 3 to another workstation or PACS, click Series Auto
Transfer.
g. Select the host to which you want to network Recon 2 and Recon 3 and click OK.
Up to three reconstructions of data and Cardiac phases from one exposure can be programmed. To
set up the other reconstructions and phases, click Show Recon 2 or Show Recon 3 and enter appropriate
values in the parameter columns or cells, as needed.
To transfer Recon 2 and Recon 3 to another workstation, click Series Auto Tranfser. All three recons
can be sent to a different place than set in the Exam Transfer Level.
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Set the Display FOV
Use this procedure to enter a DFOV that covers the anatomy of interest. This allows you to target a
particular piece of anatomy for display and determines how much of the SFOV is reconstructed into an
image. Within the DFOV, an image center must be set with the R/L Center and A/P Center.
1.
On the ViewEdit screen, click the Recon Parameters icon.
2. On the Display Parameters tab, click DFOV.
3. In the field, type and Enter the value of the patient's measurements.
Measure the patient at the widest point and add 2 cm. This shows all the anatomy and the soft
tissue around the anatomy.
If an R, L or A, P value is more than half of the DFOV, then the R/L, A/P image annotation does not
display on the images. For example if the DFOV is 10 cm and the R value is 56 mm then the image
annotation displays R R. Use a R-L or A-P value that is less than half of the DFOV in mm to avoid
this.
If D was enabled for Recon 1 in Protocol Management, the DFOV will be copied from the
previously scanned series.
The minimum DFOV is 9.6 cm.
The maximum DFOV depends on the selected SFOV.
Alternatively, set the DFOV graphically. On the Show Localizer image, click and drag the diamond
handles to increase or decrease the DFOV. The system automatically updates the value in the feature area.
In certain situations when the signal-to-noise for an acquisition is low and depending on resolution for
the image, faint rings may be seen in axial and cine images. If the DFOV and slice thickness are increased,
the rings may be diminished.
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Set the R/L Center coordinates
Use this procedure to set the R/L Center parameter, which allows you to define the DFOV center of the
image in the Right/Left directions relative to iso-center of the SFOV. This is useful for minor adjustments to
imperfections in centering the patient on the table or if an offset structure such as the spine or kidney is
what you want centered. If large adjustments are needed, then you should consider re-positioning the
patient on the table.
1.
2. On the Recon Parameters tab, click R/L Center.
3. To find the coordinates, place the mouse over the Show Localizer AP1 scout image and look at the R2
and L3 readout at the bottom of the image.
Continuous Report Cursor in Exam Rx Display Preferences must be turned on.
4. In the field, type and Enter an R or L prefix and the R/L center coordinates, in millimeters.
The range of values can be from 0 to one-half the SFOV (e.g., Head SFOV is 32 cm so the
maximum offset R/L is 16 cm or 160 mm). Typically, you would not want the offset to exceed one-
half the DFOV or the resulting image does not show a right or left marker, it does show markers
as R-R or L-L.
Entering a value other than zero off centers the image in the right and left axes of the patient.
Plus (+) can be used for R values and Minus (-) for L values for faster data entry using the ten key
pad.
If D was enabled for Recon 1 in Protocol Management, the R/L Center will be copied from the
Alternatively, the R/L Center may be set graphically by using the X annotation on the AP scout image
reference lines. Press and hold Shift, and then click and drag the X to center over the area of interest.
1Anterior/Posterior
2Right
3Left
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Set the A/P Center coordinates
Use this procedure to set the A/P Center parameter, which allows you to define the DFOV center of the
image in the Anterior/Posterior directions relative to the SFOV. This is useful for minor adjustments to
imperfections in centering the patient on the table or if an offset structure such as the spine or kidney is
what you want centered. If large adjustments are needed, then you should consider re-positioning the
patient on the table.
1.
2. On the Recon Parameters tab, click A/P Center.
3. To find the coordinates, place the mouse over the Show Localizer lateral scout image and look at the
A1 or P2 readout at the bottom of the image.
Continuous Report Cursor in Exam Rx Display Preferences must be turned on.
4. In the field, type and Enter A or P prefix and the A/P Center coordinates, in millimeters.
The maximum offset for A/P Center is one half the SFOV from isocenter selected (e.g., Head SFOV
is 32 cm so the maximum offset A/P is 16 cm or 160 mm).
Entering a value other than zero off centers the image in the anterior and posterior axes of the
patient.
Plus (+) can be used for A values and Minus (-) for P values for faster data entry using the ten key
pad.
If D was enabled for Recon 1 in Protocol Management, the A/P Center will be copied from the
Alternatively, the A/P Center may be set graphically by using the X annotation on the lateral scout
image reference lines. Press and hold Shift, and then click and drag the X to center over the area of interest.
1Anterior
2Posterior
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Set the Recon Type
Use this procedure to set the Recon Type to designate the algorithm used for reconstruction of the images.
1.
2. On the Recon Parameters tab, click Recon Type.
3. Select the appropriate algorithm for the primary of first reconstruction.
The algorithms going from top to bottom increase spatial resolution and decrease low contrast
detectability.
Click Soft for tissues with similar densities, but not useful for un-enhanced scans.
Click Stnd for routine exams, e.g., chest, abdomens, and pelvis scans.
Click Lung for interstitial lung pathology.
Click Chest for mediastinum and lung detail studies. It provides soft tissue resolution and
contrast when viewing the images in a soft tissue/mediastinal W/L1 and high resolution of the
lung tissue when viewing the images in a lung W/L.
Click Detail for post myelograms, where hybrid tissue detail and bone edges are important.
Click Bone for High resolution exams and sharp bone detail.
Click Bone Plus for sub mm detailed head work. It can be used for any study that normally used
the bone algorithm, but is very useful in cases where the Edge algorithm was used. This is
because the Bone Plus algorithm has no reconstruction penalty and is very close in standard
deviation to Edge.
Click Edge for small bone work in the head, as well as high resolution scans.
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Set the Recon Options
Use this procedure to set the Recon Option for the reconstructed images.
1.
2. On the Recon Parameters tab, click Recon Options.
3. On the Recon Option screen, select the desired options.
If the scan type is Helical, click Full or Plus. For Axial, the Recon Mode is set to Full.
Full and Plus mode is only available 0.625 mm slice thickness with Helical 0.5X:1 pitch for
0.625 mm. For all other pitches only Plus mode is available at 0.625 mm.
If the scan type is Cine, click Full or Segment.
If the scan type is cardiac helical, click SnapShot Segment, SnapShot Burst-2, or SnapShot
Burst-4.
Click IQ Enhance to minimize helical artifacts seen in helical thin slice images.
Image Enhance is compatible with 0.625 and 1.25 mm slice thickness.
Intervals must be set equal to the slice thickness (0.625 or 1.25) or half the slice thickness
(0.312 or 0.625).
An "E" is added to the Recon Mode option display to indicate IQ Enhance is enabled.
IQ Enhance annotation is added to the left side of the image.
Type Window Width and Window Level values. These values are also added to Film Set 1.
To enable ASiR, click Slice mode and select the desired ASiR percent of noise reduction.
If the scan mode is Cardiac, select a Cardiac Filter.
Cardiac Filter is not compatible with ASiR.
To flip or rotate the image in recon so the image will be reconstructed in the orientation desired
for viewing, click FLR (flip left to right) , FTB (flip top to bottom), or FTB/FRL (flip both top to bottom
and left to right).
The Flip/Rotate option is turned off when software is delivered. A service representative can
enable Flip/Rotate once you are sure that remote viewing stations display the flipped and
rotated images correctly.
Images are annotated with FI:LR, FI:TB and FI:Rotate 180 on the left side of the image when
prescribed in recon.
If Flip/Rotate in Recon and Continuous Cursor are enabled on a system, the RAS1 coordinates
displayed on the left side of the image have the Flip/Rotate annotation intermixed with the RAS
information. If Flip/Rotate was not applied to the image, there is a blank space in between the RAS
information.
Plus Recon mode is not annotated on the Series Text Page.
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Use this procedure to set the film parameters in a protocol or scan prescription. These parameters apply to
filming a series and the settings are applied to all images in the series. You only need to complete the steps
that apply to your scan.
1. Set the Film parameters in the Series Level Function area.
2.
From the ViewEdit screen, click the Film Parameters icon.
3. On the Film Parameters tab, turn AutoFilm on.
4. Set a frame format.
5. Set an image interval.
6. Flip images.
7. Adjust the Window Width and Window Level.
8. Adjust the magnification factor.
9. Rotate images.
10. Place annotation on the images.
11. Apply filters.
12. Apply GSE.
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Turn on AutoFilm
Use this procedure to turn on AutoFilm if the system is to display and film images in the AutoFilm viewport
on the display monitor. The system defaults to off, so in building new protocols or editing existing protocols
it must be turned on. See also Set the film parameters for automatic filming.
1.
2. On the Film Parameters tab, click AutoFilm.
3. Click On.
If the selection is off, images have to be filmed manually.
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Set a Frame Format
Use this procedure to set how many images are placed in each frame of the film composer.
1.
2. On the Film Parameters tab, click FrameFormat.
3. Choose a format option.
1-on-1
2-on-1 (vertical and horizontal)
4-on-1
Any option chosen is used for the entire film series, there is no option to change format once the
filming starts.
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Set an Interval
Use this procedure to tell the system which images are to be filmed in a film series.
1.
2. On the Film Parameters tab, click Interval.
3. Type and Enter an interval number for the images reconstructed to be filmed.
Type 1 for every image, 2 for every other image, 3 for every third image, etc.
The interval range is from 1 to 10.
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Flip images
Use this procedure to flip images for the film output on every image in a film series. This is helpful when a
patient is scanned in a prone or “hanging head” (i.e., supine coronal) position.
1.
2. On the Film Parameters tab, click Flip.
3. Choose a flip option.
FTP = Flip Top/Bottom
FLR= Flip Left/Right
FTB/FLR = Flip Top/Bottom and Left/Right
None
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Adjust the W/L
Window Width
Use this procedure to set the width level for filming. The image appears in the AutoFilm viewport with this
setting. It may be used or adjusted in the filming viewport.
1.
2. On the Film Parameters tab, click Width 1.
3. Type and Enter a value in the range of 1 to 4,096.
This setting is also stored in the image header for transfer to a network receiving station.
Window Level
Use this procedure to set the window level for filming. The image appears in the AutoFilm viewport with this
setting. It may be used or adjusted in the filming viewport.
1.
2. On the Film Parameters tab, click Level 1.
3. Type and Enter a value in the range of -1,024 to 3,072.
This setting is also stored in the image header for transfer to a network receiving station.
The system image display supports pixels with a range of -32,767 to 32,767.
For information on expanded CT number range, see Enable Extended CT Number Range or Disable
Extended CT Number Range.
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Magnify images
Use this procedure to establish a preset magnification factor for each image filmed.
1.
2. On the Film Parameters tab, click Mag. Factor.
3. Type a magnification value in the range of 0.5 to 2 (in 0.1 increments e.g., 1.1/1.2/1.3).
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Rotate images
Use this procedure to rotate images for the filmed output. This is helpful if the patient is scanned in a
decubitus position.
1.
2. On the Film Parameters tab, click Rotate.
3. Choose the desired rotate option.
Click the first arrow icon to rotate image counter-clockwise 90°.
Click the second arrow to rotate image clockwise 90°.
Click the third arrow to rotate the image clockwise 180°.

None does not rotate the image.
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Annotate a film series
Use this procedure to place user annotation on each image in a filmed series. The annotation appears in
the middle of the cell above the image. This is helpful to denote delayed studies or other unusual film
sequences. It is commonly used on spine studies to denote vertebral levels.
1.
2. On the Film Parameters tab, click User Anno.
3. Type and Enter the text you want annotated on the images.
Annotation displays in the AutoFilm viewport under the RAS coordinate at the top of the viewport.
Click the annotation to make it active and move it.
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Apply filters
Use this procedure to use edge enhancement filters (to sharpen images) or smoothing filters (to soften
images) on every image in a film series.
1.
2. On the Film Parameters tab, click Filters.
3. Choose a filter option.
Select an Edge Enhancement filter for filming bone windows, as they sharpen the image. E1
applies the least amount of enhancement and E3 applies the most.
Select Lung Enhancement when filming lung windows.
Select a Smoothing filter for filming soft tissue windows to decrease the appearance of noise in
an image or enhance low contrast areas. S1 applies the least amount of smoothing and S3
applies the most.
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Apply GSE
Use this procedure to set the gray scale curve to enhance areas of low contrast such as the gray/white
matter interface in brain tissue on every image in a film series.
1.
2. On the Film Parameters tab, click GSE.
3. Choose an GSE1 level.
Select G1 for the least amount of enhancement.
Select G2 for medium level of enhancement.
Select G3 for the most amount of enhancement.
1Gray Scale Enhancement
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Auto Voice workflow

Use the Auto Voice feature to provide your patient with automated breathing instructions.
1. Set the default language, if necessary.

2. Record an Auto Voice message.
3. Change Auto Voice preset delay.
4. Control the Auto Voice volume.
5. Delete an Auto Voice message, if necessary.
Considerations
Auto Voice messages brought onto a your console from other GE CT systems may not transfer correctly due
to system hardware differences. Review messages before using them with patients. Any messages that are
incorrect need to be recorded again on the your console.
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Auto Voice workflow

Set the Auto Voice language
Use this procedure to set the language for Auto Voice 1, 2, and 3.
1.
3. On the Auto Voice screen, click English Language-Male.
You can choose from nine different languages: English-Male, English-Female, Japanese, French,
German, Spanish, Mexican Spanish, Italian, Korean, or Chinese.
4. On the Auto Voice Language Selection screen, select the desired language.
When using the multi-language options for Auto Voice 1, 2, and 3, any of the 9 available
languages can be selected for the exam. Once an exam is completed, the system will reset the
Auto Voice language back to the default language set in Reconfig.
The Auto Voice language displayed at the time the system is booted up is the default language
set by your Field Engineer in Reconfig.
5. Click Done.
You will no longer be able to click Play or select a voice message in Message Management if the Auto
Voice language is changed while a voice message is playing. If this occurs, click Record, and then Stop to
enable selection of a voice message, and then click Play.
The Prep Group delay will not update to the minimum delay for the Pre message voice to play when
the Auto Voice Language is changed. Update the prep group delay manually prior to confirming the scan.
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Optima™ CT660
Auto Voice workflow

Record a message
The system has three pre-recorded voice message sets in nine selectable languages that cannot be
deleted. Use this procedure to record up to 17 additional Auto Voice messages on your system.
1.
From the scan monitor, click the Protocol Management icon.
2. Click Auto Voice.
3. To record a message, type a name and press Enter.
Every selection must have a name.
Title the name it so it is easily identifiable (i.e., Mary S. Inspiration), that way you know whose
voice is being used and the content of the message, especially if the message entered is in
another language.
4. Click Record and begin message.
Click and hold Record until you are ready to begin your message. Normally, you are recording a
pre-message first, e.g., “Take in a breath and hold it.” When you release the mouse button, the
recording starts as indicated by the clock to the right of the button.
Begin your message right away.
Speak clearly toward the microphone located on the computer SCIM.
5. Click Stop as soon as you finish speaking.
The total time of the message is displayed in the clock.
If you make a mistake, simply click Stop and then repeat these steps.
The length of a recorded Auto Voice message may be shorter after it is recorded and saved then
during the recording of the message.
Try to start and stop the recording as quickly as possible to avoid adding time to the beginning or
end of a message.
6. Click Pre-Message next to the name you just entered.
7. Click Save Message.
8. Click Record and begin your Post-Message.
Repeat the steps to record a message for post instructions (e.g., Breathe normally).
9. Click Post-Message.
10. Click Save Message.
11. To hear a recorded message, click the selection's Pre- or Post- message and then click Play in the
Message Management area.
The length of a recorded Auto Voice message may be shorter after it is recorded and saved in
comparison to when it was recorded.
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Chapter 8: Scan
Auto Voice workflow

Delete a message
It may be necessary to remove old or unwanted messages from the system as employees change or as
different languages are required. Use this procedure to delete an Auto Voice message.
1.
2. Click Auto Voice.
3. On the Auto Voice screen, select the title of the message you want to delete.
The three pre-recorded messages cannot be deleted.
4. Click Delete Set.
5. Click Done.
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Optima™ CT660
Additional scan features

Use the following additional scan features as needed. They can be used during a patient scan.
ViewEdit screen: Additional Features area
1. Add Group
2. Split Current Group
3. Delete Selected Group
4. Biopsy Rx
5. SmartPrep Rx
6. Preview
7. Optimize
8. Gating
9. ECG Trace
10. mA Table
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Chapter 8: Scan

Add/split/delete a group
The following procedures can only be used during a scan.
Add a group
Use this procedure to insert another set of images following the prior group with all of the same factors,
except for the Start and End locations within the same series.
1. From the ViewEdit screen, click Add Group.

Each time the button is clicked, a new group is added.
The start location of the new group automatically set contiguous to the end of the prior group.
The end location is determined by the number of slices, slice thickness, and image interval.
If any of the Direct Vis applications under Auto App is enabled under the Recon tab, Add Group
displays some fields as insensitive as it is combined with the current DMPR session. Turn DMPR off for the
added group if you no longer want it to be included as part of the DMPR session. This allows changes to any
of the acquisition parameters.
Split the current group

Use this procedure to split a selected group into separate groups. This is helpful for tube cooling issues or
breath hold scans.
1. Click the first box (with image numbers) at the start of the group of the group you want to split.
2. Click Split Current Group.
3. Choose to split the group by image number or location.
Delete the selected group

Use this procedure to remove an entire group from a series.
1. Click the first box (with image numbers) at the start of the group of the group you want to delete.
2. Click Delete Selected Group.
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Optima™ CT660

Optimize technical parameters
If the system cannot complete the entire scan prescription with the technical parameters that you have
selected, the Optimize icon displays in red. At this point, you can select the Optimize icon to open the
Technique Optimize screen and adjust your technique.
1. From the ViewEdit screen, click the red Optimize icon.

The Optimize screen calculates and displays in real time up to three factors that can be changed
to allow the system to continue.
2. On the Technique Optimize screen, select a parameter that you feel is best for your prescription.
Only one parameter (Up Front Delay, mA, or Group Delay) has to change for the scan to continue.
Up Front Delay is the time before you can proceed with scanning.
This parameter can be changed by the amount shown in the Up Front Delay column.
The Start Scan button is not active until the Up Front Delay time expires.
The mA parameter can be changed to what displays in the mA column.
If you choose to reduce mA, you may be reducing image quality.
Make sure that you always use enough mA to get the best image quality.
The Group Delay parameter can be changed to what displays in the Group Delay column.
If multiple groups are prescribed, the Optimize screen updates for each group, allowing you to
make choices for each group.
Once you have made choices that satisfy the system without compromising image quality, a
message displays that tube cooling is no longer needed and the Optimize in Progress icon is
highlighted in blue.
3. Click the blue Optimize in Progress icon.
4.
Click the Confirm icon to start the scan.
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Chapter 8: Scan

Optimize patient dose
For years GE has followed the ALARA1 principle in helping our customers optimize dose. GE has provided
many tools to help the clinician minimize dose while achieving clinically diagnostic image quality.
GE CT is a proven leader in delivering dose efficiency in every scanner category. GE has achieved this
position through a "total system" approach. The following features are some of the features that contribute
to our "total system" approach and affect patient dose. Not all features are available on each system.
To learn much more about this subject, please ask for our comprehensive brochure, Dose in Computed
Tomography: Basics, Challenges, Solutions (01-7192) located on our web site at:
http://www.gemedicalsystems.com/rad/ct/optidose.html.
Pediatric Protocols
The pediatric protocols are based upon a child's size, age, and weight and tailor the dose or treatment to
the size of the patient.
The Head and Orbit categories are aged based. The rest of the categories are height and weight based
protocols.
AutomA/SmartmA
AutomA/SmartmA modulates X-ray tube mA to account for specific patient anatomy – based upon data
gathered from the scout image. The system predicts the optimal setting for the exam and adjusts mA to
these settings. This maintains the best image quality at the lowest dose.
ECG Modulated mA
ECG modulated mA provides flexible prospective control of mA values over the cardiac cycle for ECG-gated
helical exams. This enables you to maintain optimal image quality for vascular analysis coupled with dose
savings for the remaining portions of each cardiac cycle.
SmartHelical
SmartHelical is integrated into all GE CT systems. It decreases image noise and increases image quality or
allows a 20 to 35% decrease in mAs (with the same/original image quality).
Automated Reviewer for Faster R&D

This specialized reading tool automatically has reviewed millions of images to help GE engineers optimize
algorithms and pitch settings and is still in use today.
Presented as RSNA Paper 2001
Advanced Artifact Reduction (AAR)

A low-signal magnification tool that allows low-dose protocols to be used in highly attenuating regions. AAR
is automatically enabled as needed.
Advanced Noise Reduction (ANR)

A low-signal correction algorithm that allows low-dose protocols to be used in highly attenuating regions.
ANR is automatically enabled as needed.
HiLight Matrix Detector

The HiLight Matrix Detector material was developed by GE specifically for CT scanning, offering a 99%
absorption efficiency. It also offers the capability of more slices without increasing dose.
1As Low As Reasonably Achievable
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Optima™ CT660
Tracking Collimator
Developed originally for the LightSpeed systems, the tracking collimator keeps the beam focused only on
the active detector cells, and makes sub-millimeter scanning possible with high dose efficiency.
Protocol Wizard
Automatically adjusts affected parameters to keep image noise constant, dose optimized and within
specifications of the scanner.
Prospective ECG Gating

Reduces dose in cardiac ECG-gated scanning for cardiac calcium scoring and contrast enhanced cardiac
angiography applications by triggering the X-ray tube on only during a specified cardiac phase or phase
range for each cardiac cycles throughout the acquisition.
Neuro3D Filters
Noise reduction filters for thin slice acquisitions for applications where data will be manipulated in 3D
modes such as reformat or maximum intensity projections for neuro applications.
Adaptive Statistical Iterative Recon (ASiR)

ASiR is a noise reduction reconstruction mode that can remove unwanted noise from images allowing for
reduction in dose and improvement in image quality.
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Chapter 8: Scan

View the Dose Report
Use this information regarding patient dose.
CTDIvol, DLP1, and Dose Efficiency is displayed during scan prescription to provide patient dose
information.
Considerations
The Dose Text page displays a message for non-GE tubes that the dose information may not be correct
because the calculations are based on known GE tube response.
Prerequisite
Before DICOM Structured Dose Report is turned on, confirm that your PACS or receiving station you want it
sent to supports structured reports.
End exam
1. Contact your service representative to enable DICOM SR Dose Report.
For more information, refer to section 9.5 in the DICOM Conformance Statement available for
this release of software.
2. Click End Exam.
The CTDIvol, DLP, and Phantom size used to calculated dose is automatically saved.
A DICOM Structured Dose Report generates a CT Dose Report which can enable tracking of dose
for the patient by the hospital radiation tracking system/RIS/HIS.
DICOM SR Dose Report is saved as part of the patient's exam in Series 997. It can be configured
to either a Radiation Dose SR SOP or an Enhanced SR SOP.
The DICOM SR Dose Report cannot currently be opened on the scanner. It can be reviewed and
printed using Reporting Tool on the Advantage Windows workstation or any station that can read
a DICOM Structured Report format. It cannot be saved to DVD or CD on the AW2 system (4.4 or
lower).
SmartStep accumulated exposure time is displayed on the Dose Text Page and the DICOM
Structured Dose Report.
The phantom size for dose calculation for SmartPrep Monitor scans is not shown. The same size
phantom used to calculate dose for the series is used for the SmartPrep images.
The Dose Report is saved as a secondary captured image in series 999. It can be filmed,
archived, and networked after the scan is completed.
3. If desired, film the report.
AutoFilm: select the Dose Report option box on the AutoFilm Setup screen.
Manual film: launch ImageWorks and film the secondary image capture.
You may need to adjust the W/L for the Dose Report saved series to make the information visible
when transferred to a PACS or workstation.
1Dose Length Product

2Advantage Workstation
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Chapter 9: Scan applications
The following applications can be applied in Scan. If an application is not available, it may not be included in
your systems options.
ASiR
Acquire a scan using ASiR
Acquire a scan using Dose Reduction Guidance
Biopsy Mode
Acquire a scan
Direct Multi Planar Reformat (DMPR)

Acquire a scan
Manually prescribe DMPR batch
Manipulate DMPR images
Exam Split
Split exams with ConnectPro
Split exams when the scan is completed
SmartPrep
Set up a scan
Acquire a scan
Display images
SmartScore Pro
Acquire a scan
SmartStep
Prepare for an exam
Set up the scan
Acquire a scan
Display images
VolumeShuttle (Axial)
Acquire a VolumeShuttle (Axial) scan

Acquire a Volume Helical Shuttle scan
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Optima™ CT660

Contrast report
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ASiR
Acquire a scan using ASiR
ASiR™ is licensed for use with a GE X-ray tube. Use of a third party X-ray tube will require the
purchase of an additional license for this feature.
Use this procedure to acquire data where ASiR1 noise reduction reconstruction will be used. ASiR is a
reconstruction technique designed to reduce noise in clinical images while preserving the structure details
in the image. The ASiR noise reduction technique may allow for the reduction in X-ray dose, up to 50% in
some studies while maintaining image noise levels or be selected to improve images with an unacceptable
level of noise. ASiR reconstruction is available in Slice Mode. ASiR is prescribe in 10% steps for 10 to 100.
Slice Mode is annotated SS xx.
Keep the following in mind when selecting an ASiR recon mode:
ASiR is not compatible with Cardiac Noise Reduction Filters (C1, C2, C3) or Neuro 3D Filters (N1,
N2, N3).
ASiR is not compatible with any of the real time interactive image modes such as SmartPrep,
Biopsy mode, or SmartStep.
A warning is posted when ASiR is set to None reminding the user to check the mA and Noise Index prior to
scanning without ASiR enabled.
Scan with ASiR

1. Prescribe a scan.
2. Click Recon Options and from the Recon Options screen, select an ASiR mode (Slice) and an ASiR %
value. As the percentage value increases, the noise reduction increases.
If you want to use ASiR to maintain image quality but reduce dose, from the mA Control screen,
reduce mA or increase noise index value.
3. Proceed to scan.
ASiR reconstruction
Prospective reconstruction
2. From the ViewEdit screen, click Recon Tab.
3. From the Recon tab, click Recon 2 or 3.
4. Confirm that the following scan parameters are identical between the two series:
Start/End Location, Number of Images, Slice Thickness , Interval, DFOV, RL and AP Centers, Recon
Type, and from Recon Options screen, the recon Mode.
5. From the Recon Option screen, select an ASiR mode: Slice and an ASiR % value. Click OK.
6. Continue with your prescription and proceed to scan.
1Adaptive Statistical Iterative Reconstruction
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Optima™ CT660
Retrospective reconstruction
1. From the Scan desktop, click Retro Recon icon.

2. From the Retro Recon screen, select exam and series and click Select Series.
3. From the Retro Recon Setup screen, click New Series Number.
4. Confirm that the following scan parameters match the original series:
Start/End Location, Number of images, Slice Thickness, Interval, DFOV, RL and AP Centers, Recon
Type, and from Recon Options screen, the recon Mode.
5. Click Recon Options.
6. From the Recon Option screen, select an ASiR mode: Slice and an ASiR % value. Click OK.
7. Click Confirm.
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ASiR
Acquire a scan using Dose Reduction Guidance
Use this procedure to have the system automatically select the ASiR level by selecting a dose reduction
percentage.
Keep the following in mind when using Dose Reduction Guidance:
Dose Reduction is not selectable if ASiR is enabled in Recon Options.

Actual mA used is a percentage of the Reference mA and is calculated by the system.
ASiR level selected is optimized based on Standard algorithm and the DFOV prescribed.
The maximum Dose reduction percentage is 50%. If more than a 50% dose reduction is desired,
set Dose Reduction to 0% and follow the Scan with ASiR procedure.
A warning is posted when ASiR is set to None reminding the user to check the mA and Noise
Index prior to using Dose Reduction Guidance.
Scan with Dose Reduction Guidance

2. From the ViewEdit screen, click mA.
3. From the mA, control screen click % Dose Reduction in either manual mA or Auto mA.
4. Enter the desired dose reduction percentage.
5. From the mA control screen in Manual mA click Reference mA.
6. Enter the desired mA value.
7. From the mA control screen, click OK.
8. Continue with your prescription and proceed to scan.
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Optima™ CT660
Biopsy Mode
Acquire a scan
Use this procedure to improve setup and acquisition efficiency during a biopsy. Prior to using the Biopsy
Mode™, the scan type must be set.
Scan technical factors such as kV, mA, and rotation time are based on the last group scanned. The
scan type is always Axial, regardless of the last group's scan type. If AutomA/SmartmA was used in the prior
group, it is turned off and manual mA is used. It is important to review the manual mA value prior to
confirming the scan. If ASiR was used in the prior group, it is turned off. If Auto Voice was used in the prior
group, it is still on for the biopsy scans.
1. From the ViewEdit screen or the Dynaplan screen, click Biopsy Rx.
The images remain in the same series.
2. From the Biopsy Rx screen, complete the following selections:
a. Select a Biopsy Reference.

Click Superior to make the biopsy reference location the first scan, with subsequent images
acquired superiorly from that location.
Click Centered to make the biopsy reference location the center slice, with the other images
acquired above and below that location. Typically, select an odd number for Centered to split
the images evenly above and below the location.
Click Inferior to make the biopsy reference location the first scan, with subsequent images
acquired inferiorly from that location.
b. Select a biopsy location.
Type a specific table location in the Biopsy Location field.

Get Alignment Light Location requires that you move the table to center the alignment light
over the needle and then click Internal or External depending on which light you aligned the
needle with.
c. Type the number of images for each pass in the Number of Images field.
d. If a gantry tilt is needed, type a degree of tilt in the Gantry Tilt field.
e. Select a slice thickness. Axial mode only allows 2.5, 5.0, or 10.00 mm.
3. Click Confirm Biopsy Rx to activate the biopsy scan.

4. Optional: manually film the biopsy images.
5. When the biopsy scan is finished, re-activate AutoFilm and AutomA. Both are turned off with Biopsy
Mode.
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Acquire a scan
Direct MPR (DMPR) provides a prospective auto multi planar image review mode in the axial, sagittal,
coronal, and oblique planes.
Considerations
DMPR displays image anatomical orientation within a viewport as follows: A is at the top, P is at the
bottom, R is on the left and L is on the right. If you have a data set where the patient was scanned
prone, the image display is flipped to this orientation.
DMPR sessions are limited to 2,000 images.
Reformat protocols used in DMPR must be built in Reformat and they must be single step.
For AutoBatch, the reformat protocol cannot use the Oblique viewport.
During scan considerations

If DMPR is enabled under the Recon tab, Add Group displays some insensitive fields because it is
combined with the current DMPR session. Turn DMPR off for the added group if you no longer want it
to be included as part of the DMPR session. This allows changes to any of the acquisition
parameters.
The W/L of the axial source images affect the edge detection of the auto batch. If the W/L is too
narrow, then anatomy is cut off from the auto batch. If the W/L is too wide, then undesired anatomy
is included in the auto batch.
If you prescribed auto batch protocols and then quit DMPR before the auto edge detection starts, the
reformatted images are not completed.
To page/scroll through images during DMPR reconstruction, use the Oblique view for paging. Once
the reconstruction is complete, the image may change DFOV to accommodate all the data in 3D.
If a scan stops before all DMPR images for a session are acquired, it may not be possible to activate
the interactive mode because all the images are not yet available. Quit the DMPR session to return
to 2D display and generate any reformatted images you want in Reformat from ImageWorks
desktop.
DFOV for AutoBatch axial images defaults to the DFOV of the scan range instead of the DFOV in the
protocol.
When multiple sessions of MPR are stacked, you cannot get to the next one until you finish the
previous one by first clicking on Start Direct MPR Review button to get to the Interactive display
screen and select Quit. If you do not want to quit the current DMPR session, you can still see the next
DMPR session by clicking Auto Link and viewing the images in the viewport.
You are not able switch to another AutoView layout until reconstruction for the DMPR session is
complete. To review images for another exam while images are being reconstructed, go to the
Image Works desktop and use the Viewer.
Do not quit until auto batch is started, as indicated by the auto batch in the reference image or until
auto edge detection is done, which is indicated by the black line directly under the Start Direct MPR
Review button.
Start MPR Review
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Optima™ CT660
Be sure to include complete coverage in the original scan prescription. Any scans acquired after
scanning has completed on the original scan group using Add Group or One More Scan are not be added to
the DMPR session.
2.
Click the Recon tab.
3. From the Recon tab, click Off for group under the Auto Apps column.
4. From the Session Selection screen, click Direct MPR and then click OK.
5. From the Session Setup screen in Session Selection, click Start New to setup a DMPR session.
You can combine groups or set each group as a new session. To combine groups the following
parameters must be the same: slice thickness, interval, SFOV, DFOV, scan type, rotation speed,
image center, and algorithm. The groups must be contiguous. If you want to change parameters
between groups, click Start New instead of Combine Current.
6. To select reformat protocols to be used in the DMPR session, click Unused under Batch Protocol to
open the list of available protocols.
Reformat Protocols built in Reformat or the General category in Volume Viewer are displayed in
the Batch Protocol List.
Multi-step reformat protocols do not appear in the list.
7. Select up to five protocols from the Batch Protocol List, and click OK.
Use the Next and Prior arrows to move through the list of GE default reformat protocols and user
define reformat protocols.
The order you select the protocols is the order they are listed for Batch Protocol and the order
Auto Batch applies them.
8. Prescribe Filming, Auto Batch, Auto Store, and Auto Transfer as needed for each protocol.
a. Click Setup to select filming destination, film format, number of copies and film selection for Start
New or Continue Same Sheet.
b. Click Filming Off, to turn on automatic filming for the Batch Reformat.
c. Click Auto Batch Off to turn on Batch Reformats to be created automatically once all the images
for the DMPR series have been reconstructed.
If Auto Batch is enabled, an automatic edge detection algorithm detects the outer edges of the
object and sets the range for Batch Reformats.
Auto Batch is not available if the reformat protocol was created in the Oblique viewport.
d. Click Auto Store Off to automatically have Batch Reformats archived to designated archive
device.
e. Click Auto Transfer Off to select up to 4 host to automatically transfer the DMPR Batch Reformats
by series.
9. Click OK to close DMPR Session Setup screen.

10. Click Confirm.
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The Start Direct MPR Review button displays in the Exam Rx control panel.
Start Direct MPR Review
After four images have been reconstructed, the currently selected AutoView layout is replaced
with the DMPR AutoView layout. In this layout, the following image types are displayed in specific
viewports:
upper left = oblique (or AutoFilm accessed by clicking on the page turn icon)
upper right = axial
lower left = sagittal
lower right = coronal
13. From the upper left viewport, use the crosshair cursors, click and drag, or use the review controller
to interact with the displayed images during acquisition.
14. If you would like to keep the DMPR session available but not in Interactive Review, change the focus
from Direct MPR Review. Click AutoView Layouts or Review Layouts to access viewports to review
images. Click Continue Direct MPR Review to continue reviewing DMPR data.
Continue Direct MPR Review
15. Once all tasks are finished, including all Batch Reformats, click Quit.
16. Manually prescribe DMPR batch.
17. For details on manipulating the DMPR image, see Manipulate DMPR images.
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Optima™ CT660
Exam Split
Use the Exam Split option to split images from a single acquisition and assign them to a Requested
Procedure ID or accession number retrospectively. The smaller image groups can be accessed at reading
stations for multiple reads and multiple billings on select patient exams.
Use ConnectPro option to select multiple Requested Procedure IDs or Accession numbers from the Modality
Work List for images from a single acquisition and then assign them to a Requested Procedure ID or
accession number.
1.
2.
Click the Patient Schedule icon.
3. From the Patient Schedule screen, select the desired patient exams to which you want to apply Exam
Split once the images are reconstructed.
A maximum of 15 procedures can be selected.
4. Click Select Patient.
If multiple accession numbers are selected, the last accession number selected is listed in the images
header. The accession number is stored in a different DICOM1 field (0040,0275) when multiple records are
selected. Use Exam Split to send images to the PACS2 with the associated accession number for a particular
procedure.

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SmartPrep
Set up a scan
Use the following procedures to scan with SmartPrep™, which allows intermittent monitoring of IV1
contrast enhancement in an area of interest. The contrast flow is monitored by Low-Dose scans until the
contrast enhancement reaches the preferred point and then you initiate the scan prescription.
Use this procedure to set up a SmartPrep series to acquire contrast-enhanced images with a bolus tracking
technique.
Scan prescription
1. From the ViewEdit screen, click SmartPrepRx.
2. Click On, if SmartPrep is Off.
3. From the SmartPrep screen, click Show Localizer.
4. From the scout localizer on the display monitor, click and drag the red X on the slice line to define
the Monitor location. Alternatively, type in the S/I location in the Monitor Location text field, for
example, S110.
5. From the SmartPrep screen, enter the following values:
mA (range 10 to 100 in 10 mA increments), typically enter 40 mA for most studies.

Monitoring Delay (0 to 60 seconds in 1 second increments) sets the time before monitoring
scans begin.
Monitoring ISD (1 to 60 seconds in 1 second increments) sets the time between monitoring
scans.
Enhancement Threshold (0 to 1,000 in steps of 1) sets the bar on the graph to monitor threshold
enhancement.
Diagnostic Delay, (range 3 to 60 in 0.1 second increments) typically set to the minimum value
(automatic) for arterial studies and 10 seconds or longer for venous studies.
Allow enough time to deliver breathing instructions when not using Auto Voice.
The minimum time may vary if Auto Voice is turned on and depending on the monitor location
relative to the start location.
If Scan Location is changed after the SmartPrep screen is closed, to accommodate the new
table location, the Diagnostic Delay time is automatically updated to the minimum time
possible when Auto Minimum Delay is on. Respond to the confirmation prompts that indicate
a Diagnostic Delay change.
The Diagnostic Delay time is displayed in Prep Group for Group1 on the Timing Tab, for
example SP11.2.
Auto Voice Pre-message is available if Auto Voice is prescribed in the Voice Lights Timer in
Timing parameters.
Auto Minimum Delay sets the Diagnostic Delay to the most minimum value possible, taking into
consideration location of the monitor phase, start phase location, and Auto Voice Pre-message
length.
6. From the SmartPrep screen, click Accept.

7. Proceed to Scan SmartPrep.
1intravenous
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Optima™ CT660
SmartPrep
Acquire a scan
Use these steps to acquire contrast-enhanced images with a bolus tracking technique.
Baseline phase
The Baseline phase acquires one non contrast scan and allows you to establish an area to monitor contrast
enhancement.
1.
From the ViewEdit screen click the Confirm icon to proceed to scan.
2. Review and respond to the warning message.
3. Review the values on the DynaPlan screen for all three phases: baseline, monitor, and phase.
4. Press Move to Scan to advance the table to the Monitoring location.
6. From the reconstructed image on the display monitor, click Ellipse ROI and place a maximum of
three ROIs over areas of interest. For example, if scanning a liver, place an ROI in liver parenchyma
away from vessels, if evaluating a vessel place the ROI over the vessel.
Use, as needed, the zoom, roam, display normal, hide/show graphics, erase, or explicit mag
(factor range: 0.5 to 2.0) from the SmartPrep display control panel.
If the space bar and the Alt key are depressed during SmartPrep baseline scan, Dynaplan disappears.
Open and close Retro Recon to redisplay the Dynaplan screen.
Monitor phase
The Monitor phase acquires images at the monitoring location during the delivery of intravenous iodinated
contrast material and graphically displays the images, charts the enhancement thresholds, and displays a
clock with the time since monitoring began.
During SmartPrep, if the ROIs set on the baseline image fail to display during the monitoring phase, use the
ROI statistics to monitor elapsed time and visually determine transition point to Scan Phase. If ROIs fail to
display, they will not be on the screen saved SmartPrep image.
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1. From the Scan Progress screen, click Monitor Phase.

2. Simultaneously press Start Scan and start the IV contrast injection. A maximum of 40 monitoring
images are available.
If all 40 monitoring scans have been used, you must press Move To Scan to move the table to the
start location and press Start Scan to initiate the scan prescription.
The system waits the time set in the Monitoring Delay area and then begins acquiring images at
the time set for the ISD 1.
3. View the display monitor and track the IV contrast graph.
Four viewports display from top left to bottom right: baseline image, real time images, graph,
time stamp for each real time image.
A horizontal line indicating the enhancement threshold only appears on the graph.
The tick marks on the SmartPrep graph may not show equal spacing, which is due to time
between acquisition rounding issues. The SmartPrep scans are acquired at the correct timing
interval, as prescribed.
Scan phase
The Scan Phase is the start of the actual Scan Prescription following the Monitor Phase.
1. When the desired enhancement threshold is achieved, from the Scan Progress screen, click Scan
Phase. Deliver the first breath hold instructions if Auto Voice Pre-Message is not turned on.
The table moves to the scan prescription start location and, based on the Diagnostic Delay
selected, the scan starts.
The real time updating in the quadrants stops.
A screen save image of the four SmartPrep viewport display is automatically captured and saved
in series 99 for the exam.
If an Auto Voice Pre-Message is not enabled, the initial breathing instructions to the patient for the
start of the exam scan prescription must be delivered by the operator during the Diagnostic Delay. The
system then provides the rest of the breathing instructions if Auto Voice has been selected.
1Inter-scan Delay
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Optima™ CT660
SmartPrep
Display images
The system places the baseline image, the monitoring images and the screen save image with the exam in
the browser. These images are denoted as series 200 prospective and screen save images. If an additional
baseline image was acquired these images are in series 201.
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SmartScore Pro
Acquire a scan
Use this procedure to acquire prospectively gated non-contrast images for calcium scoring with
SmartScore Pro™. The system uses the measurements to synchronize the scoring data with the cardiac
cycle.
SmartScore Pro is not compatible with axial or helical scan types. It is limited to patients with a normal
resting heart rate of up to 90 beats per minute for best results with the calcium scoring application. It also
requires the use of an ECG monitor, which is connected to the system.
Considerations
Do not apply ASiR to the scan when acquiring data for coronary artery calcification scoring.
Heart rate information is not displayed on SmartScore prospectively gated non-contrast images.
1. Prepare the patient.

The GE recommended electrodes are Dyna/Trace1500 by ConMed.
Electrodes should be radiolucent with silver/silver chloride gel, with fresh gel adhere to the
patient and be able to maintain good contact during table movement.
Use electrodes made for short term monitoring (e.g., exercise monitoring). Do not use electrodes
used for long term monitoring.
2. Prepare the ECG monitor.
3. Verify that a good signal is detected on the ECG monitor in the scan room.
4. Enter patient information on the New Patient screen.
5. Prescribe a PA and Lateral scout scan.

6. Gating is defaulted off for Scout Scans series unless enabled on in a custom protocol. To turn on
ECG Trace, click Gating.
If the system detects a valid ECG signal, the patients heart rate in BPM1 is displayed on the
Gating button. BPM displayed is a three-cycle average of the patient's heart rate. The ECG
waveform for the patient is displayed when Heart Rate Monitoring is on. Click ECG Trace to turn
off the display.
If the system detects no signal from the Cardiac Monitor, the button turns red and no BPM value
is displayed. In this scenario, reevaluate ECG connections to patient and monitor to gain ECG
signal before continuing.
7. Acquire the scout scans.
It is important to give the patient the same breathing instructions for the scout scans as are given
for the Cine Scan Type acquisition. The patient should be requested to take several breaths in
and out before holding breath while the actual scan is acquired. This helps provide a more
consistent heart rate during the acquisition of the SmartScore images.
8. Prescribe the Cine scan parameters for that scan data that will be used for calcium scoring in
SmartScore.
1Beats Per Minute
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Optima™ CT660
Cine scan parameters
Parameter Value
Scan Type
Cine
Recon Length Segment

On
SmartScore Pro
Trigger Delay = 70%
Gating
Images per R-R Interval = 1
Rotation Time 0.35 seconds
One inch below carina to Apex of heart, coverage = from the base to the apex of the
Start/End Location
heart
Thick/Speed 2.5 mm/8i (20 mm detector coverage)
Interval 20 mm
System automatically updates the value based on the number of images per R-to-R
Cine Duration
cardiac cycle and the time set between these neighboring images.
Gantry Tilt S0
SFOV Large
kV 120
Small patient = 300
mA Average patient = 430
Large patient = 450
Breath Hold Set to No
Prep/Group Delay Based on instructions selected for Voice/Lights/Timer
ISD 1.3 seconds
Voice/Lights/Timer Manual breathing instructions or user recorded message using hyperventilation.
DFOV 25 cm Do not change. DFOV 25 cm is required for processing data in SmartScore.
Recon Type Standard
9. From the ViewEdit screen, click Gating to display the SmartScore Pro screen.
10. From the SmartScore Pro screen, toggle it On. Review the parameters and make changes if needed.
Click Accept.
11. Proceed to scan.
If Confirm is not available, click Gating to turn it off, and click Accept. Click Gating, again, turn it
on, and click Accept. The Confirm button should now be available. Contact your local service
representative if you experience this issue.
Deliver identical breathing instructions for the scout and Cine scans. Instructions to breathe
in/out several times before the breath hold can provide a more consistent heart rate during the
scan.
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12. SmartScore images can be post processed from the AW1.
1Advantage Workstation
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Optima™ CT660
SmartStep
Prepare for an exam
SmartStep™ scanning mode is designed for use by the clinician during interventional procedures.
SmartStep uses the HHC1 and foot switch. The Radiologist or Physician usually inserts a needle or catheter
into a patient and then needs to see images showing the position of the needle or catheter.
Use this procedure to prepare the system for a SmartStep scan. During this phase, the foot pedal and HHC
are connected so that the clinician can make exposures, view images, and move the cradle during the
SmartStep exam.
1. From the gantry rear access plates, plug the foot switch and HHC device into the respective outlets.
Use the outlets on the gantry side from which the clinician works.
The foot pedal is active as long as the system is prepped and ready for scan. Do NOT make
unwanted exposures by accidentally stepping on the foot pedal.
Rear access plates are located on both sides of the gantry: hand switch outlet (1), foot switch outlet (2)
2. Position the ceiling suspended in-room display monitor so the clinician can view the images.
3. Prepare the patient and supplies (for example biopsy tray) for the procedure.
a. Follow your departmental procedure for patient preparation.

b. Give the patient breathing instructions.
1HandHeld Control
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SmartStep
Set up the scan
Once the patient has been prepared and set up for the interventional procedure, use this procedure to set
up the image acquisition in the SmartStep mode.
1. Select SmartStep from one of two locations: DynaPlan or click Create New Series.
2. From the Select New Series Type screen, click SmartStep.
3. From the Scan Parameter screen, click the SmartStep parameters and make a selection. Consider
this information when selecting the desired parameter:
Scan Type - select a full rotation of 0.8 or 1.0 second.

Slice Thickness - select 2.5 or 5.0 mm.
Select desired values for Start Location, Gantry Tilt, SFOV, kV, mA, Exposure Time (the time
before you must reset the timer), Bump Distance (the default is half the slice thickness).
The maximum Exposure Time that can be set at one time is 90 seconds.
If SmartStep is selected from the DynaPlan screen, parameters for SFOV and kVp are carried
over from the current scan.
4. From the Display Parameters screen, select the DFOV, R/L center, A/P center, and Recon Type. All
algorithms are available.
If you select Edge, the interventional image display time increases.

If SmartStep is selected from DynaPlan screen, parameters for, DFOV, R/L center, A/P center,
and Recon Type are carried over from the current scan.
5. From the ViewEdit screen, click Confirm.

Make sure that the Exam Rx desktop is selected. If the Exam Rx desktop is not selected, the
system will not transition into the SmartStep scan mode.
6. Click Continue in response to the warning message and to display the DynaPlan screen.
"WARNING: This series contains one or more groups with multiple scans at the same
tomographic plane, i.e., same location. Do you want to continue?"
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Optima™ CT660
SmartStep
Acquire a scan
All other desktops are NOT available during SmartStep scan.
Previously queued reconstructions will be paused until SmartStep is exited.
Prerequisite
Confirm that the foot switch and the HHC devices are plugged into the gantry.
If you want to enable the alignment lights during a SmartStep procedure, use the button on the HHC.
If the Alignment Light button is selected on the gantry controls, the gantry decelerates and stops.
The SmartStep Remaining Time and Accumulative Time message area update with each step of the
SmartStep scan procedure.
Scan
1. Press Prep from either the HHC or from the DynaPlan screen.
Screen messages:
"PRESS PREP"
"PREP in PROGRESS" once Prep is selected
2. From the HHC, press Move to Start Location.
The LED 1 is illuminated by the Move to Start Location button when the table is not at the
prescribed scan location for the first scan or at the last scanned location for subsequent scans.
3. Press the foot pedal to make a single rotation exposure. The Prep LED on the HHC flashes while the
system is prepping.
Screen messages:
"READY TO SCAN" indicates you can press foot pedal
"XRAY ON" displays when scan is active
4. Release the foot pedal when the exposure is finished. Following each rotation, you must release the
foot pedal before you can scan again.
Screen message:
"RELEASE PEDAL" displays if the exposure pedal is not released.
Cradle Release can be used to freely move the cradle in/out of the gantry.
The Cradle must be latched to make an exposure.
5. Repeat steps 1 to 3 as needed to complete the SmartStep scan.
6. View the SmartStep display monitor.
Three interventional viewports display that automatically update each time an exposure is made
with the foot pedal. The images are displayed superior to inferior.
A free viewport is displayed in which you can place an image.
1Light Emitting Diode
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Two timing windows.

Remaining Scan Time indicates the time left in the series before the Exposure Time must be
reset on the View Edit screen to continue scanning, click Confirm.
Accumulative time, which indicates the patient radiation exposure time. The time continues to
update as long as you stay in the same exam. Once you end the exam, the accumulative time
resets to zero.
The total accumulated exposure time for all SmartStep scan groups and Series is displayed on
the Dose Text page.
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Optima™ CT660
SmartStep
Display images
Interventional viewports
The three interventional viewports automatically update each time an exposure is made with the foot pedal.
Considerations
If images are not available after a step, the viewport is blank. Use the HHC and press Prior image
and then press Next image to display the missing images.
Screen Saved images are not added to the data base until the current SmartStep series has ended.
Add an image to the free viewport

1. Select the free viewport.
If you are using the HHC, press Change Focus.
If you are at the console using the mouse, click the free viewport to make it the primary focus.
2. From the SmartStep display panel, click List/Select.
3. From the browser, select the desired Exam, Series, and Image.
4. Click Accept and the images appears in the free viewport.
5. Select any tool from the SmartStep display panel to manipulate the image.
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SmartStep Display
Button Function
Roam Sets the right-mouse function to move the image on the screen.
Zoom Sets the right-mouse function to magnify/minify the image.
Measure Angle Measures the angle between structures.
User Annotation Used to enter text on an image viewport.
Explicitly Magnify Used to enter a specific magnification factor.
Measure Distance Measures the distance between two points.
Erase Removes annotated text from the screen.
Maintain Maintains graphics from image to image.
Flip/Rotate Changes the image orientation.
Display Normal Returns the image to its original state.
Grid On/Off Toggles the grid on/off.
Advances the image in the free viewport by one and reverses the images in the
Forward 1 Image
three interventional viewports by three.
Reverses the image in the free viewport by one and reverses the images in the
Backward 1 image
three interventional viewports by three.
Opens a browser from which you can select an exam, series, image for the Free
List/Select
viewport.
Screen save Saves the selected image and graphics to the data base.
Last Image Displays the last exposure image.
Messages appear in this area that prompt the clinician for each step in the Smart-
Message area
Step data acquisition.
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Optima™ CT660
VolumeShuttle (Axial)
Acquire a VolumeShuttle (Axial) scan
Use this procedure for prescribing a VolumeShuttle™ (Axial) acquisition. The VolumeShuttle (Axial) mode
provides increased coverage for CT Perfusion studies in the head by moving back and forth between two 40
mm locations.
Considerations
If the temporal sampling period extends beyond 3.2 seconds, there may be errors present in the
data when processed by CT Perfusion.

Make sure the patient is positioned securely in the head holder.
Wrap the table straps around the body to prevent the arms from dragging on the table that might
interfere with table travel in/out of the gantry.
3. Select a protocol from the GE or User library.
4. Acquire a scout.
5. Click Next Series.
7. For Scan Type, click Axial.
Scan Type is indicated as Axial-S on the ViewEdit screen.
8. For Rotation Time, click 0.5.
Rotation time should be 0.5 sec to meet temporal sampling requirements for perfusion
processing.
9. For Shuttle Mode, click On.
10. Click OK to exit Scan Type screen.
11. Set the Scan parameters, as needed.
For the Start/End Location, the coverage is limited to 80 mm.
The Number of Images is determined by the settings in Thick/Speed.
For Thick/Speed, set the parameters as needed and then click OK.
The Detector Coverage must be set to 40 mm.
Set the Slice Thickness to 5 mm. Prospectively only 2.5, 5, and 10 mm slices can be
reconstructed. Thinner slices can be created in Retro Recon.
Set the Coverage time or Number of Passes to the desired value to meet clinical
requirements. At least 13 passes are needed. The maximum number of passes is 99.
Set the SFOV, as needed.
For kV, click 80.
Set the mA to 400.
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Gantry Tilt is not allowed.

12. Set the Timing parameters, as needed.
Set the Prep Delay to 5.
13. Set the Reconstruction parameters, as needed.
14. Set the Filming parameters, as needed.
15. Click Confirm.
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Optima™ CT660

Acquire a Volume Helical Shuttle scan
Volume Helical Shuttle™ is licensed for use with a GE X-ray tube. Use of a third party X-ray tube will
require the purchase of an additional license for this feature.
Use this procedure for prescribing a Volume Helical Shuttle acquisition. Volume Helical Shuttle (VHS) mode
is a repetitive helical scan mode where the table continuously moves back and forth across the prescribed
area providing data that has temporal sampling information for each pass. With this temporal sampling
information, data can be processed to create time resolved CT angiography of the head, neck, and body as
well as perfusion studies. Volume Helical Shuttle is different from normal helical imaging in that data is
collected during acceleration and deceleration of the table.
Considerations
4D CTA scan range is 110 to 312.5 mm.
For perfusion studies, temporal sampling should not exceed 3.2 seconds, as there can be error
present in the data when processed by CT Perfusion. For perfusion in the body, scan range is 110 to
120mm at 0.5sec rotation and 110 to 140mm at 0.4 sec rotation.
Initial reconstruction is limited to 5 mm slice thickness with 10 mm interval. Contiguous data at
desired slice thickness must be created in Retro Recon.
ASiR can be used when acquiring data for 4D CTA.

3. Select a protocol from the GE or User library.
4. Acquire a scout.
5. Click Next Series.
7. For Scan Type, click Helical.
Scan Type is indicated as Helical-S on the ViewEdit screen.
8. Select a Rotation Time to meet your clinical goal.
Only 0.4 (pediatric only), 0.5, or 0.6 second rotation times are valid.
9. For Shuttle Mode, click On.
10. Click OK, to exit Scan Type screen.
11. Set the Scan parameters, as needed.
Prescribe a Start/End Location based on clinical goal.
The Number of Images is determined by the settings in Thick/Speed.
For Thick/Speed, set the parameters as needed and then click OK.
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The Detector coverage must be set to 40 mm.

Slice thickness is 5 mm.
Select pitch as needed for clinical goals. Only 0.984:1 and 1.375:1 pitches are available for
body SFOV. Only 0.984:1 pitch is available for head SFOV.
Set Coverage time or Number of Passes to desired value to meet clinical goals. At least 10
passes are needed, if the data is intended for processing with CT Perfusion. Total Coverage
Time is based on Time per Pass and Number of Pass cannot exceed 60 seconds.
Set the SFOV, as needed.
Set the kV, as needed.
Prescribe AutomA/SmartmA or Manual mA.
For AutomA/SmartmA, set Min/Max mA range and Noise Index.
For Manual mA, set the mA value.
Gantry Tilt is not allowed.
12. Set the Timing parameters, as needed.
Set the Prep Delay and Voice Lights Timer as desired.
13. Set the Reconstruction parameters, as needed.
14. Set the Filming parameters, as needed.
15. Click Confirm.
A message is displayed at End Exam or Next Series to go to RetroRecon and complete full range
reconstruction for Volume Helical Shuttle.
18. Create new images from scan data.
Each pass of data is saved in series with a unique identifier and description.
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Optima™ CT660

Xtream Injector allows a synchronized start of the system and an approved Injector.
Pressing the Start Scan button makes the scan and injector start simultaneously.
The injector CiA425 CAN interface must be verified by GE Medical Systems.
The injector is CiA425 compliant.
There are two classes of Xtream Injector.
Xtream Injector, which is the same as Class1 in CiA425, allows only ON/OFF.
Enhanced Xtream Injector, which is the same as Class4 in CiA425, allows synchronized start of the
system and setting injection parameters from the system.
The system and injector are operated independently after the start button is pressed on the system.
Indications for use

The GE Xtream Injector option is designed to facilitate contrast-enhanced CT1 imaging by connecting the
system with a compatible injector. When used, pressing one single start button at the system allows the
user to start the CT scan synchronized with the injector.
The GE Xtream Injector option is based on the protocol contained in the CiA425 standard and allows this
injector to operate with multiple GE Medical Systems systems that have the modified software and
hardware interface required for the CiA425 communication protocol built into them. This device is only the
communication protocol and bus interface needed to communicate with a 510(k) cleared injector that is
compatible with the CiA425 standard.
This option is only the communication protocol and bus interface needed to communicate with a
validated compatible OEM injector (availability may vary regionally).
Protocol considerations
Injection parameters can be included in scan protocols when the Enhanced Xtream injector option is
installed. Patient size and conditions should be taken into consideration for the parameters set in the
protocol.
1Computed Tomography
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Before you start

A cable from the injector must be connected to the gantry.
Confirm that the injector is connected to the system and power is on.
Set syringes as desired.
Preparation of the Injector must be done as described in the injector operator manual.
Use this procedure to set up the Xtream Injector after the patient and the injector are prepared. Review the
injector status messages.
1. Prepare the injector.
2. From the Series Level Functions area, click Xtream Injector.
If you have the Enhanced Xtream Injector option, then the Enhanced Xtream Injector screen
appears.
The button turns on which synchronizes the start of the scan and injector.
IV contrast is automatically turned on when Xtream Injector is turned on.
3. Set the desired injector parameters on either the injector or the Enhanced Xtream Injector screen.
From the Enhanced Xtream Injector screen, click Accept to send all selected parameters to the
injector.
4. From the ViewEdit screen, set the desired scan parameters.

5. Click Confirm.
If the Xtream Injector button is red, check and resolve the injector parameters on the system or
the Injector. Confirm is only active when both the system and the injector are ready.
Complete any required fields and note the injector status information on the Dynaplan screen.
6. Press Start Scan to simultaneously initiate scan and injection.
If you stop the scan or the system aborts the scan the injector does not stop.
If you stop the injector or the injector aborts, the system does not stop scanning.
If either of these scenarios occur, verify the remaining volume to be injected before resuming
the injection or scan. You may need to update parameters on the ViewEdit screen.
If you have the Enhanced Xtream Injector option, after you end the exam, a contrast report is
saved as Series 996.
5366492-1EN Rev 1 (February 2010) 9-263

Optima™ CT660

Click Xtream Injector from the Series Level Function area. The injector parameters can be defined in
protocol management.
5366492-1EN Rev 1 (February 2010) 9-264

Icon name Icon Description
The text fields and push buttons for parameter setting becomes
On/Off toggle
sensitive when it turns to ON.
Phase Up to six phases are available depending on the injector.
Injection delay can be set in increments of seconds.
0 - no delay prior to the injection of this phase.

1 to max- injection delay of the injector in seconds prior to
Inj. delay (sec.) the start of this phase. This is a timed pause.
* Hold- the injection for this phase is started from the injector
by pressing the start button. This is only valid for phases two
through five.
Type Allows type of injection selection.
Only available when Contrast Saline is selected in Type. The upper

frame is for Contrast, the lower frame if for Saline. The range is 1:99
and from 99:1.
Ratio (%)
When mixed phase is set from CT user interface, then the indication
of ratio on Injector Monitor is dismissed. If you want to set the ratio
on Injector Monitor, those buttons are displayed.
Ask GE service to set the unit for pressure: kPa, kg/cm2 or PSI
The pressure limit value is converted and stored in kPa. When
Pressure limit transferring this value between the system and the injector the
pressure limit value may update due to rounding in the conversion
back to PSI or kg/cm2.
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Optima™ CT660
Icon name Icon Description
Remaining
The system automatically displays the remaining volume of Contrast
contrast media /
Media and Saline.
remaining saline
Parameters in the injector parameters pop up are replaced by the

Get current
parameters currently prescribed on the injector user interface.
Add phase /
Adds or deletes a phase.
delete phase
Sends all parameters set on Enhanced Xtream Injector screen to the

injector and closes the screen.
Accept
If the injector has been armed, the injector will disarm when Accept
is selected.
Parameter values are not updated and remain at the values present
Cancel
when the pop up window is opened.
There is no Xtream Injector button for Scout scans or SmartStep.
5366492-1EN Rev 1 (February 2010) 9-266


There are several status of Xtream Injector.
Xtream injector status icons
Status but-
Condition
ton
Xtream Injector is turned off
Xtream Injector is turned on and injector is ready to start injection.
Xtream Injector is turned on and injector is not connected.

Xtream Injector is turned on and injector is not controllable from system.
Xtream Injector is on and injector is not verified by GE Healthcare.
Xtream Injector is turned on and injector is controllable from system, but not ready for
injection.
Enhanced Xtream injector status icons
Status but-
Condition
ton
Xtream Injector is turned off
Xtream Injector is turned on and injector is ready to start injection in new patient .
Xtream Injector is turned on and injector is not connected.

Xtream Injector is turned on and injector is not controllable from system.
Xtream Injector is on and injector is not verified by GE Healthcare.
Xtream Injector is turned on and the parameters on the injector monitor and the CT
console Xtream Injector user interface do not match. (Both Ready/ Not Ready to
inject). This condition also happens when setting the parameter is in progress.
Xtream Injector is turned on but the injector is not ready to inject. The parameters set
on the Injector monitor and the CT console Xtream Injector user interface match.
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Optima™ CT660

Contrast report
An Enhanced Xtream Injector contrast report detailing the contrast agent used, injection phase, delay,
phase type, rate, volume and duration is automatically saved once you select End Exam. The contrast Report
is saved as Series 996. It can be filmed, archived, and networked after the scan is completed. The values
saved for rate, volume and duration are the actual values achieved by the injector, not the prescribed
values.
Enhanced Xtream Injector contrast report text page
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Chapter 10: Cardiac
Chapter 10: Cardiac
Use this information to acquire and display cardiac images and ECG 1 traces.
Cardiac workflow
Cardiac workflow
Prepare the patient
Acquire a Scout scan
Attach the electrodes/leads to patient
Acquire a heart localizer scan (optional)
Acquire a manual bolus timing scan
Acquire a cardiac contrast enhanced scan
Save an ECG trace
Scan mode parameters

Select a cardiac Scan Type and Recon Mode
Set the ECG Gating parameters
Set the Pitch
Set the RR Interval and Phase Location
Override the monitor heart rate
Display an ECG trace on the scan monitor
Retro recon
Reconstruct basic cardiac scans
Edit the ECG trace retrospectively
Move a heart cycle's recon window
Insert, delete, or move a trigger
Remove heart cycle data
Display retro recon images
1Electrocardiogram/Electrocardiograph
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Optima™ CT660
Cardiac workflow
1. Prepare the patient.
2. Acquire a Scout scan.
3. Attach the electrodes/leads to patient
4. Acquire a heart localizer scan (optional).
5. Acquire a manual bolus timing scan
6. Acquire a cardiac contrast enhanced scan.
7. Create new images from cardiac scan data.
8. Display retro recon images
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Chapter 10: Cardiac
Cardiac workflow
Prepare the patient
Patient preparation is an extremely important step in a successful cardiac exam. Use these procedures to
get the patient ready for the cardiac exam.
Exam prep instructions

Fast ~ 4 hours prior to exam.
No caffeine 12 hours prior to exam.
No cardiovascular exercise prior to the exam.
Administration of Beta Blockers and/or Sublingual Nitroglycern Spray can be used according to your
site's policy.
Thoroughly explain all phases of the scan before you start the exam to keep the patient as calm as
possible.
Breathing instructions
Diagnostic cardiac images are dependent on the patient’s heart rate during the data acquisition; a calm
patient keeps the heart rate steady with a repeatable rhythm. Breathing instructions are therefore very
critical to a successful cardiac scan. Follow these breathing instruction guidelines:
Deliver the same instructions for each series, starting with the scout scan.
Program cardiac breathing instructions with Auto Voice to deliver consistent breathing instructions.
The voice instructions should be 10 seconds or longer so that the patient is breathed slowly.
Have 3 to 5 seconds of silence before you click the Stop recording button, after you say "take a
breath in and hold it." This gives the patient enough time to hold his breath before the scan starts
and for the heart rate to stabilize before the scan. This time prevents the patient from breathing
in during the first several slices, which results in image motion.
The Preset Delay in Auto Voice can be used to program an additional 1 to 7 seconds prior to X-
ray on, as needed per each patient.
The scan time for the contrast enhanced cardiac gated acquisition is approximately 5 to 8 seconds
to cover the entire heart. The heart rate stabilizes 2 to 7 seconds after a breath hold, therefore have
the patient start the breath hold 3 to 5 seconds prior to X-ray exposure. Watch the cardiac monitor
so that you can determine when the patient's heart rate stabilizes within the breath hold. Adjust
your breath hold instructions to achieve as stable of a heart rate as possible during the contrast
enhanced cardiac gated scan.
Per your physician and site's policy, deliver 2 to 4 liters of oxygen via nasal cannula, if the patient has
difficulty holding his breath. This can help lower the heart rate.
Practice the breathing instructions with the patient.
Consent forms
If your site requires a consent form, review the contents with the patient and get a signature.
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Optima™ CT660
IV setup and contrast

To conserve CT table time, setup the patient IV line outside the scan room.
Explain the contrast injection and potential effects, even if the patient has had a previous contrast
injection. Reassure the patient that what he feels during the injection is normal and to remain
relaxed during the scan. An informed patient is a calm, less anxious patient.
Have the injector loaded with contrast by a trained person authorized by your site. The total volume
and contrast strength is site dependent.
For single barrel injector's: load with contrast.
For dual barrel injector's: load a syringe with contrast media and prepare a saline syringe.
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Chapter 10: Cardiac
Cardiac workflow
Acquire a Scout scan
Use this procedure to setup the patient in the scan room and acquire a localizer for the cardiac protocol.
1. Bring the patient into the scan room.

2. Verify you have a signed consent form, if needed.
3. Transfer the patient to the CT table.
Position the patient supine, feet first.

Landmark the patient at the sternal notch.
4.
5. Enter the patient's information.
6. Start or connect the IV line to contrast tubing.
7. Review the contrast effects with the patient.
8. If you have not already attached the electrodes/leads to the patient, attach them.
For details see Attach the electrodes/leads to the patient.
Do not proceed to scan until you have an acceptable cardiac waveform and heart rate.
9. Secure both IV tubing and ECG cables. Make sure that the cables do not dangle from the table.
ECG lead wire movement during the scan can result in a degraded signal.
10. Review breathing instructions with the patient.

11. From the Protocol Selection screen, select a cardiac protocol that is based on the heart rate:
SnapShot Segment, SnapShot Burst, SnapShot Burst Plus, or SnapShot Pulse.
Gating is defaulted off for Scout Scans series unless enabled on in a custom protocol. To turn on
ECG Trace, click Gating.
12.
Click the Confirm icon.
14. Deliver the breathing instructions and table move instructions.
16. Proceed to the Acquire a heart localizer scan procedure.
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Cardiac workflow
Attach the electrodes/leads to patient
Use this procedure to prepare the patient for an ECG gated scan.
1. Connect the cardiac monitor to the CT system and the leads to the monitor.
2. Place arms above patient’s head and elevated by pillows or sponges.
Do NOT place the arms flat on the table or on the gantry. This position can limit vessel flow and
cause arm/shoulder motion. As the table moves into the gantry during the scan, it tends to cause
the patient to arch his back raising the chest and thus causing mis-registration artifacts.
3. With the patient's arms above his or her head, select RA and LA electrode placements over the
clavicles. Do NOT place any electrodes over muscle, scar tissue, or hair for the following reasons:
Muscle - the ECG can pick up muscle electrical activity due to the above head arm position. Help
the patient to relax his arms and reduce shoulder muscle fatigue.
Scar tissue - is denser than normal tissue, which makes it difficult to get a good signal. If the
patient has scar tissue in the shoulder area, then place the electrode out onto the patient's arm.
In the chest area, place the electrode where there is no scar tissue.
Hair - electrodes placed over a very hairy area do not allow good skin contact. If necessary, shave
a four-inch square area for the electrode placement.
4. To remove any lotion or oils, gently scrub the electrode location with cotton gauze until the skin is a
healthy pink. Do not use alcohol to prepare the electrode site.
5. With the patient in the scan position (arms above the head), apply the ECG electrodes and leads to
the patient no more than 5 to 10 minutes before the scan. Follow these guidelines:
Use GE recommended electrodes: Dyna/Trace1500 by ConMed. Electrode ordering information is

found on the top of the IVY monitor. Using other electrodes can result in gating errors that can
lead to non-diagnostic images.
Use electrodes made for short term monitoring (e.g., exercise monitoring). Do not use electrodes
used for long term monitoring.
ALWAYS use new ECG electrodes (radiotranslucent with silver/silver chloride) with a fresh gel
pad. Dry or expired electrodes can result in poor signal conduction that can cause intermittent
triggering.
Keep the leads as far away as possible from the scan field of view.
Place the two upper leads directly on the mid portion of the patient's clavicle. If needed to
produce a better signal, move the electrodes towards the arms.
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Recommended three lead placement. RA = US (white) EU (red); LA = US (black) EU (yellow), LL = US (red), EU (green)
6. Turn on the ECG monitor and confirm the connection is good between gantry/monitor/console.
Connect display in upper right corner of cardiac monitor indicates monitor is connected to CT system
7. Use the impendence check on the cardiac monitor to ensure that the electrode connection is good
and that the heart rate is between 30 to 220 BPM.
a. On the monitor, press Measure Impedance.
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Cardiac monitor, Measure Impedance button outlined in red at bottom of monitor and impedance value outlined in red at top
right of monitor.
b. All three electrode impedance values should be green and display OK, which indicates they are
under 50K ohms. If an electrode is out of range, the monitor displays the detected value and
flashes red and the impedance check has failed.
c. Reposition electrodes that are out of range and then re-check the impedance value. Do not
proceed until all values are less than 50K ohms.
8. Check the waveform. The more abnormal the waveform, the less chance for a successful cardiac
exam. A calm patient keeps the heart rate steady with a repeatable rhythm. A significantly varying
heart rate can result in non-diagnostic images. Ideally the heart rate variation should be within a 5
BPM variance during the entire scan. If the patient's heart rate variation is 10 BPM or more, consult
with a clinician to determine if the exam should be canceled.
Normal waveform
Noisy ECG trace with extra trigger at #4
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Elevated T-wave causing double trigger
ECG trace with irregular R-peak spacing creating an arrythmia at trigger #3
9. Complete these activities to improve the ECG trace.
Check the cable connections.

Position the monitor away from the table and gantry.
Consider an alternative electrode placement: remove electrodes, prep the patient again, apply
fresh electrodes, and repeat the impedance check.
Check default lead selection on the IVY monitor.
Alternative electrode placement. Left demonstrates lateral arm placement for elevated T-wave condition. Right demonstrates
central placement
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Cardiac workflow
Acquire a heart localizer scan (optional)
Use this procedure to define the start and end locations for the heart scans and location for a manual bolus
timing scan.
1. From the protocol, click Next Series.

2. Verify that Show Localizer is on. If it is off, turn it on.
3. Position the localizer lines to cover just the heart, approximately from one inch below the carina to
the apex of the heart. Minimizing the scan area helps to reduce the patient dose. For more details
about Graphic Rx, see Adjust the Graphic Rx.
Heart localizer
4. Set up low-dose helical (or a calcium scoring series) scan parameters.
120 kV, 0.6 seconds, 80 mA (100 mA for large patients) 1.375:1 pitch 55 table speed.
5. Evaluate the ECG waveform for heart rate stability.

a. From ViewEdit screen, click Gating.
b. From the Cardiac IQ Snapshot screen, confirm that Heart Rate Monitoring is On to display the
ECG trace.
c. Click Accept to close the Cardiac IQ Snapshot screen.
6.
8. Deliver breathing and table move instructions. Give the patient the same breathing instruction that
they have practiced.
10. Proceed to one of the following procedures.
Acquire a manual bolus timing scan and Acquire a cardiac contrast enhanced scan
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Cardiac workflow
Acquire a manual bolus timing scan
Use this procedure to calculate the bolus timing of when to start the contrast injection to capture the
arterial phase. Omit this step if SmartPrep is to be used.
1. From the protocol, click Next Series.

2. Place the localizer line one centimeter below the carina and just above the base of the heart, the
optimal location to find the ascending aorta for a timed contrast injection.
Localizer scan location for timed bolus injection
3. Evaluate the ECG waveform for heart rate stability.

a. From ViewEdit screen, click Gating.
b. From the Cardiac IQ Snapshot screen, confirm that Heart Rate Monitoring is On to display the
ECG trace.
c. Click Accept to close the Cardiac IQ Snapshot screen.
4.
5. Deliver breath hold instructions identical to the instructions you will use for the cardiac gated series.
See breathing instructions for more details.
7. Simultaneously start the injector and press Start Scan.
8. Observe the lowest average heart rate during the scan.
9. Click the viewport with the reconstructed test bolus images. Review the images and identify the
image with contrast in the ascending aorta.
10. From Exam Rx control panel, click the Measurements icon.
11. From the Measurements option, select MIROI.
12. From the MIROI Analysis screen, select Ellipse ROI.
13. Click and drag the ROI to the ascending aorta.
14. Size the ROI to fit completely inside the aorta.
15. Click OK.
16. Use the graph to calculate the bolus timing.
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MIROI graph, 1 = first tick mark, 2 = pre-scan delay time
a. Count each tick mark to the peak of the curve.

b. Multiply the number of tick marks × 2.
c. Add 5 seconds for prep group delay.
This time represents the time it takes for the contrast once injected to reach the aortic root
where the coronary arteries branch off (Time to Peak enhancement).
If you use the default protocol, image # 1 is at 5 seconds and the tick marks are 2 seconds
apart, as demonstrated in the graph.
d. Add 3 to 4 seconds to allow for filling of the distal coronary vessels.
In the example below, total time = 23 seconds. The value will be entered in the Prep Group Delay
fields on the Timing tab on the ViewEdit screen, for the contrast enhanced cardiac scan.
(7 tick marks × 2 = 14 seconds)
(+5 for prep group delay = 19 seconds for peak enhancement time)
(+ 4 for distal filling of vessels = 23 seconds)
17. Click Next Series to display the gated cardiac helical or cardiac cine protocol. Proceed to the
contrast enhanced cardiac scan.
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Cardiac workflow
Use this procedure to acquire the contrast enhanced cardiac scan. This is the final scan before transferring
the images to the Advantage Windows Workstation.
If there are any errors in the cardiac scan, reserve the scan data until the images are reconstructed
and reviewed.
1. Confirm the ECG trace is strong and stable.

For details, see Attach electrodes/leads to the patient.
Never initiate a cardiac gated scan if the ECG Trace is not displayed in the ECG Trace on the OC1.
The ECG Trace is essential for ECG R-Peak Editor use in Retro Recon.
2. Verify that Show Localizer is on. If it is off, turn it on. Position the scan lines cover the complete heart
from approximately one inch below the carina to the apex of the heart.
Adding scans outside this areas increases patient dose.
If a non contrast series was acquired, use this data to identify start and end locations.
3. From the ViewEdit screen, click Scan Type.
4. From the Scan Type screen, click Cardiac as scan type and select one of the available cardiac
modes.
5. Click Gating and based on the protocol, either the CardIQ SnapShot screen opens for cardiac
helical acquisition or the SnapShot Pulse screen opens for cardiac cine acquisitions.
6. Set the gating parameters based on the selected scan cardiac mode.
7. Select a small or large SFOV with Cardiac Helical and Cardiac Cine scans. If a Cardiac SFOV is
selected, dose is computed based on a 32 cm phantom.
Cardiac Small DFOV default is 25 cm; upper limit is 32 cm.

Cardiac Large DFOV default is 25 cm, upper limit is 50 cm.
8. If desired, set up the mA modulation.
ECG Modulation, when used with lower heart rates, provides the best dose saving opportunities.
As heart rates increase the potential for dose savings decreases.
Dose savings with mA modulation. Vertical scale = % dose savings, horizontal scale = heart rate, blue line = dose savings at 70
to 80%, pink line = dose savings at 40 to 80%
1Operator Console
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Full mA (1) applied during data collection used for reconstruction (2), and reduced mA for remainder of the cardiac cycle
It cannot be applied to prospectively gated SnapShot Pulse.

Set the start and end phases for the maximum mA to be delivered for the useful portion of the
cardiac cycle. As the Max mA phase range setting increases, the potential for dose savings
decreases.
For heart rates < 65 BPM, select full mA range from start phase of 70% to end phase of 80%.
For heart rates > 65 BPM, select full mA range from start phase of 40% to end phase of 80%.
Set the Minimum mA value to be used outside the useful portion of the cardiac cycle, which must
be more than 20% of the Maximum mA. Set the Maximum mA to be used. For the best dose
savings for heart rates above 100 BPM set the Minimum mA at a value that is 40% of the
Maximum mA.
9. Enter the prep delay that you determined from the MIROI timing bolus scan. The typical Prep delay
time is Peak + 9 seconds.
10. Recon 1 is the acquisition mode for the series. If needed, prescribe Recon 2 or 3.
11.
Click the Contrast icon and enter the contrast description and amount. Alternatively, click
Preset List below the syringe icon and select an item from the list. Click OK.
12. Program the contrast injector.
The protocol used varies depending on the contrast type, patient size, and injector capability.
Consider adjusting the volume of contrast on the second phase to insure a 6 second range from
the end of the contrast injection to the start of X-ray on. This delay time insures that if using
saline, you are getting the advantage of the saline bolus in the right chamber. Start scan too soon,
and you will not see enough saline flush through the SVC. Start scan too late and you will
completely flush out the right chambers.
The time delay from the end of the contrast injection (3) to the start of the scan (5) should not
exceed 6 seconds.
Skip to the next step if SmartPrep is selected.
Horizontal scale = time in seconds, 1 = 22 second prep delay, 2 = phase 1, 3 = phase 2, 4 = saline for ten seconds, 5 = X-ray on
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13. See SmartPrep for more details. Typical SmartPrep parameters for cardiac scans:
mA = 40 to 60
Monitoring Delay = 10.0 seconds
Monitoring ISD 1 = 1 second produces an image every 2 seconds
Enhancement threshold = 150
Diagnostic Delay = Auto Minimum or desired delay time
The minimum delay between Monitor and Scan phase is based on the Monitoring location
relative to the start location for the Scan phase.
SmartPrep Monitor Phase graph
14. Arm the injector.
15.
16. Give the patient the same breathing instruction as the previous series. See breathing instructions
for more details.
18. Simultaneously start the injector and press Start Scan.
1Inter-scan Delay
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Cardiac scan parameters

Select a cardiac Scan Type and Recon Mode
Use this information to select a cardiac scan type and recon mode.
Recon 1
Recon 1 is the acquisition mode for the series.
1. From the ViewEdit screen, click Scan Type.

2. From the Scan Type screen, click Cardiac as scan type and select one of the available cardiac
modes.
3. Make changes, as needed, to editable scan paramenters.
Enable Recon 2 or 3
Recon 2 and Recon 3 are only available if Cardiac Helical mode is selected: SnapShot Segment, SnapShot
Burst, or SnapShot Burst Plus.
1. From the ViewEdit screen, click the Recon tab.

2. From the Recon tab, click Show Recon 2 or 3.
3. Toggle the button under Recon Enabled to Y.
4. Make changes, as needed, to editable scan parameters.
5. From the Recon tab, click the button under Recon Option.
6. From the Recon Mode screen, select a cardiac recon mode and any other desired parameters.
Cardiac recon options for scan recon 2 and 3 or retro recon
Cardiac scan modes
SnapShot Segment
Use SnapShot Segment when the patient's heart rate ranges from 30 to 74 BPM. SnapShot Segment
image reconstruction is recommended for 64 slice systems with rotation speed of 0.35. It is single
sector reconstruction. Use the fastest gantry speed available to optimize the temporal resolution.
Images acquired with SnapShot Segment are annotated SSEG.
It is an acquisition and reconstruction method used to generate retrospectively ECG-gated images
using data from one cardiac cycle in a half-scan reconstruction technique.
SnapShot Segment, 1 = one cardiac cycle
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SnapShot Segment Plus
SnapShot Segment Plus is an advanced single sector cardiac reconstruction mode that can improve
reformatted and volume rendered images at cardiac cycle transitions. It can be applied to ECG-
gated cardiac helical acquisitions.
It can be selected as Recon 2 or 3 or in Retro Recon for single phase image generation.
When prescribed prospectively as Recon 2 or Recon 3 it is assigned a series number in the same
manner as all PMR reconstructions. Use of the SnapShot Segment Plus recon mode in retro recon
adds 30 to the series-numbering pattern.
SnapShot Burst
Use SnapShot Burst mode when the heart rate range is 75 to 113 BPM. It optimizes temporal
resolution across the image set based on the scan acquisition parameters. It is more susceptible to
artifacts from beat-to-beat variations.
Images are annotated SSB21 indicating that data from 2 cardiac cycles was used, or SSEG when the
acquisition parameters yield single sector images.
It is a reconstruction method used to create retrospectively gated images from up to two cardiac
cycles within the same phase of the heart cycle. Burst imaging produces images with improved
temporal resolution due to the combining of data from 2 cardiac cycles.
SnapShot Burst mode, 1 = heart cycle one, 2 = heart cycle two
SnapShot Burst Plus
Use SnapShot Burst Plus mode to improve temporal resolution for patients with a stable heart rate
that is 114 BPM or greater. The gantry rotation speed is automatically updated based on the heart
rate.
Click Gating from ViewEdit screen. From the Cardiac IQ SnapShot screen, type and Enter a BPM
value in the Heart Rate Override text area. The heart rate entered should be the lowest expected
heart rate to occur during the scan acquisition.
SnapShot Burst Plus images are annotated SSB4, SSB3, or SSB2, which indicate the number of
cardiac cycles that contributed to each image. Some images may be annotated SSEG 2 if parameters
varied such that only one cycle was available. If the patient HR varies unexpectedly during the scan,
resulting in ungated images, these axial images are annotated SEGM3.
SnapShot Burst Plus is an acquisition and reconstruction method used to generate retrospectively
ECG-gated images using data from up to 4 consecutive cardiac cycles.
1SnapShot Burst 2
2SnapShot Segment a single sector gated reconstruction
3Segment- an ungated scan
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SnapShot Burst mode, 1 = heart cycle one, 2 = heart cycle two, 3 = heart cycle three, 4 = heart cycle four
SnapShot Pulse
Use SnapShot Pulse mode for low dose imaging of the coronary arteries when functional information is not
required. SnapShot Pulse can also be used to image structures that are near to the heart and may be
affected by heart motion such as thoracic aorta's or pulmonary arteries.
SnapShot Pulse requires a stable HR in the range of 30 to 65 BPM for best coronary artery visualization.
SnapShot Pulse acquires images during a specified phase of the heart cycle. Use of padding provides
additional phase information to account for variation in heart rate. Padding adds time before and after the
targeted reconstruction phase. For example, adding 100 msec of padding adds 100 msec of X-ray on time
before and after the targeted phase location.
SnapShot Pulse acquired during one heart cycle, 1 = R-peak, 2 = padding (e.g. +/- 100 ms), 3 = center phase (e.g. 75%, 4 = half scan
Padding range = 0 to 200 ms. It is added to both sides of the center of the acquisition.
Padding defaults to the value listed in the table below, unless it is overridden by selecting this option under
the Gating button.
Heart Rate Dependent Padding Lookup table
Heart rate Padding in ms

30 to 39 BPM 175
40 to 49 BPM 150
50 to 59 BPM 125
> 59 BPM 100
SnapShot Pulse requires Sub 0.4 second option installed on 500 pounds table system.
1 = Cardiac gated helical, 2 = SnapShot Pulse, 3 = table move, 4 = X-ray on
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Padding and dose

SnapShot Pulse allows cardiac gated acquisitions with low and sub mSv doses. Use the default padding
parameters while gaining experience with the SnapShot Pulse acquisition mode to assess the capabilities,
limitation, and flexibility of the mode and the clinical needs of your practice. As you gain experience, use
these padding and dose guidelines with patients that have extremely stable heart rates, and at the
discretion of the supervising physician.
Helical and pulse acquisitions
Use appropriate mA values based on body habitus.

Lower kVp to 100 for small or pediatric patients.
Center patients correctly in the middle of the table and A/P in the gantry, which provides the most
effective and efficient use of the scan parameters.
Use Cardiac Small SFOV to provide dose reduction rather than Cardiac Large SFOV.
Pulse
Reduce padding value for patients with stable heart rates to maximize dose savings.
The default padding, which meets phase coverage for over 90% of patients, is set to cover ± 10% of
the patient's R-to-R interval.
Consider increasing the padding to accommodate patient heart rate variability during a breath hold,
when the heart rate may slow.
Manual padding override for dose reduction
1. To prescribe a padding value, click Gating.

2. From the SnapShot Pulse screen, click Padding Override On.
3. In the Dynamic Padding field, type desired millisecond padding value.
Zero ms, regardless of patient size, provides the greatest dose reduction. It results in only one
phase location for retrospective reconstruction. If there is heart rate variation during the
acquisition, it is possible that there may be degraded or ungated images reconstructed.
Adaptive gating
Adaptive Gating is a features within SnapShot Pulse. It is used to avoid scanning during unexpected
irregular beats. SnapShot Pulse should not be used when heart rate irregularity is present prior to
scanning. When it is on, the system continuously monitors the R-peak Triggers in real time. If the system
detects an irregular beat during a table move, the system pauses and avoids scanning during the irregular
beat and the compensatory beat that follows. The system then resumes scanning when the ECG trace
returns to normal.
1. To prescribe a Max # Beats to Avoid value, click Gating.

2. From the SnapShot Pulse screen, click Adaptive Gating On.
3. In the Max # Beats to Avoid field, type the desired number of beats to avoid during a SnapShot Pulse
scan. The more unexpected irregular beats that the system avoids, the longer the scan.
This mode should only be used to avoid an unexpected irregular beat; SnapShot Pulse should not
be used when heart rate irregularity is present prior to scanning.
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Set the ECG Gating parameters
When you click Gating from the ViewEdit screen, the screen that appears is dependent on the scan type
selected.
Gating button
Heart icon on the gantry display indicates the monitor is connected with the gantry.
The BPM heart rate shown on the console and the monitor is updated every three heart beats.
If the heart rate does not display and a red gating box displays, then follow these guidelines:
With Gating on, click ECG Trace to view the ECG trace on the scan monitor.
Check all connections between the cardiac monitor and the gantry.
Check electrode placement. Consider an alternative placement to improve the cardiac signal.
The gating button may turn red when the patient experiences a big jump in heart rate such as with a
PVC1. Typically, the system recovers and reads the signal. You may have to toggle the Gating Off/On
to get the heart rate signal synched again. Care should be taken in starting the scan if the patient
continues to have PVCs.
Scout
When Gating is On, the ECG trace is displayed. Gating is turned on with a scout scan to monitor the
waveform.
1Pre-Ventricular Contraction
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Gating On
Gating Off
Helical and Axial

Click Gating to display the CardIQ SnapShot screen. Select Heart Rate Monitoring On to monitor the
waveform. Click Accept to close the CardIQ SnapShot screen.
CardIQ SnapShot screen
Cine Segment
Click Gating to display the SmartScore Pro screen. Toggle it On.
SmartScore Pro screen
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R to R Interval displays the heart rate in beats per minute. It is updated based on an average over a
period of three cardiac cycles.
The Center R-Peak Delay (%) is defined as a percentage of time between two consecutive R-peaks.
The default value is 70%, which should be in the diastolic phase in order to minimize occurrence of
cardiac motion. The time, in milliseconds, is displayed directly below the Center R-Peak Delay (%) and
identifies the amount of time after the preceding R-peak that aligns with the Trigger Delay percent
for the patient's displayed heart rate.
The Time Between Images is the temporal interval in milliseconds that is prescribed between
images generated at the same image location. Select either 50 or 100 from the pop-up window.
Images per R to R Interval defines the number of images reconstructed per image location for each
heart cycle. Select either 1, 3, or 5 from the pop-up window. The selected number represents the
number of images that can be acquired, which is dependent on the patient's R-to-R interval. The
middle slice of the group is taken at the point of the Trigger Delay. The remaining images, if more
than one, are reconstructed at either 50 or 100 ms intervals before and after the middle image.
Click Accept to close the SmartScore Pro screen.
Cardiac Helical
Click Gating to display the CardIQ SnapShot screen. Toggle Cardiac Gating On.
CardIQ SnapShot screen
Heart Rate Override is a toggle. It should be turned On to override the automatically detected heart rate if
the heart rate falls 10 BPM or more during a breath hold. This ensures the proper pitch is used. Refer to
Pitch for more details.
Heart Rate - type in a BPM value to use with the Heart Rate Override.
R to R Interval displays the heart rate in beats per minute. It is updated based on an average over a period
of three cardiac cycles.
R-Peak Delay (%) controls the cardiac phase location of a given reconstruction. It refers to the center of the
reconstruction window in terms of a percentage distance between any two successive R-Peaks given from
the ECG.
Click Accept to close the CardIQ SnapShot screen
Cardiac Cine
Click Gating to display the SnapShot Pulse screen displays. Toggle Cardiac Gating On.
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SnapShot Pulse screen
R to R Interval displays the heart rate in beats per minute. It is updated based on an average over a
period of three cardiac cycles.
Center R-Peak Delay controls the cardiac phase location of a given reconstruction. It refers to the
center of the reconstruction window in terms of a percentage distance between any two successive
R-Peaks given from the ECG.
Padding Override is a toggle button. It can be turned On to extend the acquisition window before
and after the prescribed X-ray on period.
Dynamic Padding is only applicable to SnapShot Pulse scans and it is defaulted to the On state. It is
defined by an additional amount of time, in milliseconds, of X-ray coverage around the center phase
to allow for phase adjustments. The default value is approximately +/- 10% of the R-to-R cycle
duration.
Adaptive Gating is an irregular beat mode that is only applicable to SnapShot Pulse scans and
defaults to the On state. The acquisition dynamically adjusts if an irregular beat is detected when the
table is moving to the next location.
Maximum # Beats to Avoid represents the number of unexpected irregular beats you want the
system to avoid during a SnapShot Pulse scan. The more beats the system avoids, the longer the
duration of the scan. The default is 2.
Click Accept to close the SnapShot Pulse screen.
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Set the Pitch
Use this information to select pitch in cardiac helical acquisitions.
Pitch
Pitch is the ratio of table travel per rotation divided by the detector Z collimation. To avoid any gaps in a
cardiac image data set, the movement of the cradle and the X-ray tube need to be in sync with the heart
rate.
It is important to observe the patient's heart rate during a breath hold so the appropriate pitch is selected.
As the patient’s heart rate increases, the pitch increases.

As the patient’s heart rate decreases, the pitch decreases.
Cardiac Helical
Cardiac Helical is a low-pitch ECG-gated helical acquisition mode where the pitch value is set based on the
patient's heart rate. The range of pitch values varies based on both the gantry speed and the system
configuration. The patient's heart rate must be within the range of 30 to 200 BPM for the system to allow
scan confirmation.
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Set the RR Interval and Phase Location
Use this information to set the RR interval and phase location.
ECG waveform: 1 = RR interval, 2 = R-peak 75% default, 3 = reconstruction window
Systole, cardiac contraction, is from R-peak to T-wave.

Diastole, cardiac relaxation, is from T-wave to R-peak.
R to R interval
The RR interval is the time from the R peak of one heart cycle to the R peak of the next heart cycle. The R
peak is used to predict where the targeted phase for reconstruction occurs and then acquire/reconstruct
images at that period of time during the heart cycle.
Phase Location (R-Peak Delay (%)

The cardiac phase location is defined as a period in time in the cardiac cycle. The %R-Peak Delay parameter
(2) controls the cardiac phase location of a given reconstruction. (3) refers to the center of the
reconstruction window in terms of a percentage distance between any two successive R-peaks given from
the ECG.
The cardiac phase location is defined as the time interval from the R-wave to the center of the
reconstruction window (3). The %R-Peak Delay parameter (2) controls the cardiac phase location. It is an
editable field. The phase location can be changed to identify where the least amount of cardiac motion
occurs. For lower HR, the most common location is in diastole, typically around 75%, but as HR increases or
varies this location may change. It is not uncommon for higher HR to have better image quality in the
systolic portion, typically around 45%.
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Override the monitor heart rate
Auto heart rate detect scanning method is used for patients with a stable resting heart rate that is
maintained during breath hold and contrast injection as seen from the pre-scans. It is the default parameter
for most cardiac exams.
Use this procedure with cardiac helical acquisitions if the patient has a high heart rate variance, more than
10 BPM.
1. From the ViewEdit screen, view the BPM displayed on the Gating button.
2. From the CardIQ SnapShot screen, toggle Heart Rate Override On.
3. In the Heart Rate text field, type a minimum HR value that covers the lowest BPM expected to occur
during the scan and press Enter. This insures a low enough pitch is used for the acquisition.
Pitch table for 0.35 second/rotation gantry speed
HR range Gantry Speed Pitch

Snapshot Sement (SSEG)
30 to 40 BPM 0.35 0.16
41 to 49 BPM 0.35 0.18
50 to 57 BPM 0.35 0.20
58 to 65 BPM 0.35 0.22
66 to 74 BPM 0.35 0.24
Snapshot Burst (SSB)
75 to 85 BPM 0.35 0.20
86 to 95 BPM 0.35 0.22
96 to 113 BPM 0.35 0.24
Snapshot Burst Plus (SSB+)
114+ BPM 0.35 0.20
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Pitch table for 0.4 second/rotation gantry speed
HR range Gantry Speed Pitch

Snapshot Sement (SSEG)
30 to 42 BPM 0.4 0.18
43 to 49 BPM 0.4 0.2
50 to 59 BPM 0.4 0.23
60 to 64 BPM 0.4 0.26
Snapshot Burst (SSB)
65 to 71 BPM 0.4 0.2
72 to 81 BPM 0.475 0.22
82 to 96 BPM 0.4 0.23
Snapshot Burst Plus (SSB+)
97 to 105 BPM 0.475 0.2
106 to 113 BPM 0.45 0.22
114+ BPM 0.4 0.23
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Display an ECG trace on the scan monitor
Use these procedures to display an ECG waveform on the operator console.
ECG Viewer
The ECG Viewer may get hidden when switching desktops. Click Gating on/off or switch desktops to
restore the ECG Viewer.
1. Turn on the ECG trace.

a. From the ViewEdit screen, click Gating. From the Cardiac IQ SnapShot screen, toggle Heart Rate
Monitoring On to display the ECG trace.
b. If the active series is a cardiac series, click ECG Trace to toggle trace on/off.
c. For more information about ECG trace see Attach electrodes and leads.
2. To minimize/maximize the ECG trace screen, click the arrows next to the left side of the waveform
display.
3. For all series except scout, place the cursor in the ECG trace window, right-click to display the menu.
Select Hide Statistics to temporarily remove the waveform statistics.

Select Show Statistics to show the waveform statistics.
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Select Reset Statistics to reset or clear the current statistics if the patient's HR has changed. This
step may be desired if there has been a change in the patient's heart rate or if a modification of
the electrodes or leads has caused changes to the waveform.
Select Preferences to open the Stats Preference screen. From the Stats Preference screen select
values for any of the following options:
Stats Window to define the moving window of time during which the HR statistics are
calculated (Min, Avg, Max, Variation). HR is a real time 3-beat median heart rate. Minimum HR
is the minimum heart rate detected within the time frame you specify. Maximum HR is the
maximum heart rate detected with the time frame you specify. Average HR is the heart rate
averaged within the time frame you specify.
Irregular Beat Window (Secs) to define the moving window of time during which Irregular
Beats are counted and displayed in the ECG Viewer.
Show/Hide Statistics to set an on/off preference for every exam. This setting is different from
the Right mouse menu Show/Hide option that turns off the statistics for just the current exam.
High Variation (BPM) to specify a threshold above which, a High Variation warning appears in
the ECG Viewer. This heart rate variation metric is calculated based on the range of heart rate
values which occur during the Stats Time Window.
Click Apply.
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Cardiac Retro Recon

Use this procedure to reconstruct cardiac images at a different phase than what was prospectively
prescribed.
Cardiac Helical SnapShot exams allow reconstruction at any point in time along the ECG trace
because the entire R-to-R interval is acquired.
SnapShot Pulse exams allow reconstruction for only a portion of the R-to-R interval. The amount of
data acquired is controlled by the amount of padding prescribed. The larger the amount of padding
the more phases available for reconstruction. For exams with “0” padding, no extra phases are
available to reconstruct.
See Create new images from scan data for retrospective management details.
1.
From the scan monitor, click the Retro Recon icon.
2. From the Retro Recon list select screen, select the appropriate patient, exam, and series from the
available scan data list.
3. The most recently scanned examinations are at the top of the list.
4. Click Select Series. The screen displays all of the scan parameters available for retro reconstruction.
5. From the area under the Retro header, verify that Y is next to each group you want to reconstruct.
To turn off all groups, click Retro. From the pop-up window, click Yes or No. Alternatively, click an
individual group and toggle between Yes and No.
If more than one gated group is present in a series, only one group can be reconstructed at a
time. Each group has its own separate ECG trace, and if edits are necessary, editing one group
does not affect the other groups.
6. Optional: type the Retro Start and Retro End locations that fall within the range of the selected group.
Add an S (+) or I (-) prefix to the location.
7. Optional: Click Thick (mm) and enter a thickness that populates all groups.
If there is only one group in which you wish to change the thickness, or only one of multiple
groups, select the thickness area for that group.
The original detector configuration at which the patient was scanned affects how you can change
the slice thickness. The thickness in black is available for reconstruction.
For SnapShot Pulse, the only slice thickness is 0.625 mm.
8. Optional: Click Interval and enter an interval that populates all groups.
If there is only one group in which you wish to change the interval, or only one of multiple groups,
you may select the interval area for that group.
9. Optional: Click DFOV. Type and Enter a DFOV value.
The system defaults to the DFOV used for scan acquisition.
10. Optional: Click R/L Center and select an individual or all groups (top button). Type an off-set value.
Use one of the following methods to determine the off-set value:
From the Recon tab, click N under the Graphic Retro column to display the Graphic Retro control
panel on the display monitor. The cursor can be used to determine DFOV and R/L and A/P
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centers.
Place the real time cursor in an image and view the image's upper-left corner for the RAS
coordinates.
Click List/Select and select the exam and series from which you want to take the R/L values. The
series values are displayed in the browser menu.
11. Optional: Click A/P Center. Type an off-set value.

12. Optional: Click Recon Type and select the desired algorithm.
13. Optional: Click Recon Option.
Make desired selections from the Set the Recon Options.

SnapShot Segment recon uses a portion of data from the scan rotation, typically centered
according to the prescribed point in time during the ECG cardiac cycle. Segmented recon
provides an improved temporal resolution by using a smaller time window of data to reconstruct
an image. ECG gated segmented recon can help to reduce the pulsation motion present in the
chest and vessels due to the contraction of the heart.
14. From the ECG Editor, click the Rx icon for the global phase prescription method, which means that
the entered phase values are applied to all available heart cycles.
Global phase prescription is manipulation of the ECG trace on the cardiac retrospective recon
window. It allows you to select the phases of the cardiac cycle from which images are created. A
typical phase prescription is 70 to 80% in 5% intervals, which is applied to all available heart
cycles during X-ray on.
The image below has global prescription with a 70% start and end and a 0 interval, which means
that images are created from 70% of the whole exam. The blue highlighted area represents the
recon window for each available heart cycle. It is centered over 70% of the cardiac phase for the
R-to-R interval. The gray area represents the amount of padding that was used during the scan.
Cardiac retrospective recon window, blue = recon window, gray = padding
15. From the Prescription (Rx) screen, select the prescription type from the menu.
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Recon options
%R displays standard phase percent reconstruction

+ms displays absolute millisecond reconstruction
–ms displays reverse absolute millisecond reconstruction
16. Enter the Start phase, End phase, and Interval to reconstruct.
The recommended reconstruction phases using percentage recon are 70 to 80% with a 5%
increment. For cardiac helical scan, consider selecting reconstruct phases from 0 to 99%.
If you are acquiring a functional imaging exam for ejection fraction and wall motion, prescribe
phases from 5 to 95 in phase increments of 10% and consider reconstructing the data with a 1.25
mm thickness.
17. Click OK to close the Prescription Rx screen.
A DICOM1 compliant ECG trace is automatically saved after each retrospective image reconstruction
request. These traces are saved in a dedicated Series labeled as 599.
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Cardiac Retro Recon

Use these procedures to edit the ECG trace retrospectively. This allows you to relocate, change, or adjust
gating information such as trigger time and reconstruction window locations.
ECG Editor considerations

On the ECG trace secondary capture image generated in Retro recon, the following two texts are
overlapped for traces of scans 2 seconds or less: " Series Description" and "Not Intended for
Diagnostic Use". Only use the secondary capture image as a record of the trace used to generate
retrospective images - it is not to be used for diagnostic purposes.
If the accession number is not on the image header, it may cause the series to be listed as a
separate exam. If so, reconcile the exam on the PACS1.
The Reset button on ECG Editor may fail to return the trace to the original display. Click Reset again
to revert the trace back to the original setting.
The save trace feature in retro recon may omit the relaxed gating information on the trace and
capture only the blue reconstruction window. Click Confirm and regenerate the series, which
automatically captures a new trace record.
The system may not auto populate a zero value for the interval during ms +/- prescription. This may
create an image set with a phase interval that is not desired. Enter 0 in the interval text field for
specific ms prescription.
1.
Click the Retro Recon icon.
2. From the Retro Recon List, select the patient and series, click Select Series.
If the waveform does not display, click ECG Viewer. If you still do not see an ECG waveform
contact your service engineer to make sure the system is saving ECG Traces correctly.
3. Make edits on the trace.
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ECG Editor screen
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ECG trace edits
No. Description
Heart rate statistics are displayed during the acquisition: median HR updated every three beats,
1.
minimum, maximum, average heart rates and number of irregular beats.
Retro reconstructions parameters are: display recon type (% R-to-R or ms), start phase, end phase,
2.
and interval.
3. The trigger point on the ECG Trace for each RR1 interval is displayed in red.
Color sections represent the following:
blue section represents current prescribed location in the RR interval. Click and drag to any
location available for reconstruction. A text update provides real time RR interval location.
4.
diagonal red lines on blue recon window indicate heart rate irregularity detected.
orange areas indicate that Relaxed Phase Recon images are generated.
red areas indicate that ungated images will be generated.
5. Click the Rx icon to open the Prescription Rx window, from which you can prescribe
percent phase or millisecond reconstruction locations.
6.
Click the Save icon to save your modified trigger locations with exam information.
7.
Click the Restore icon to restore the original ECG Trace information for the acquisition.
8. Click the Measure icon to measure, in msec, the distance between two defined points on
the waveform. Place the cursor on the trace and click and drag right or left.
9.
Click the Magnify or the Minimize icon to magnify or minimize the ECG
waveform.
10. Click and drag the white box to view the desired portion of the waveform.
1The distance from one R-peak to the next R-peak in the PQRS waveform
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Cardiac Retro Recon

Use this procedure to move or reposition a single heart cycle’s recon window without changing the other
recon windows.
Reposition a heart cycle's recon window
Method 1
1. Place the cursor over the desired blue area and click, drag, and drop to the desired location.
This allows small adjustments to each heart cycle if the heart rate varies.
The white annotation in the reconstruction window indicates at which phase the heart cycle is
reconstructed.
ECG editor
Method 2
1. Place the cursor over the recon window you wish to move, and right-click Position Image Recon
Window.
2. Type and Enter the desired location as + or – milliseconds.
The recon window for selected heart cycle moves to the new location.
3. Click OK.
Methods 1 and 2
For all cardiac scan types, the recon window cannot be moved outside of its current R-to-R interval.
For SnapShot Pulse exams, the recon window cannot be moved outside of the padding.
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Chapter 10: Cardiac
Cardiac Retro Recon

Use this procedure if gating issues occur during the scan or if gating does not trigger at the correct point
along the ECG trace. Due to the prospectively gated nature of SnapShot Pulse scans, these procedures
may not improve the gating response for SnapShot Pulse acquisitions.
Insert, remove, or move a trigger to normalize a heart cycle when a trigger occurs at an undesirable
location. This can be due to abnormal ECG waveform patterns, external noise interference, and low
amplitude trace.
Remove image reconstruction window from one or more heart cycles to improve image quality
when an arrhythmia is present in the scan.
Manually move or adjust recon window of one or more heart cycles to help with varying heart rates.
Instead of using a global phase across all heart cycles, you can manually move just one recon
window.
Triggers are the red lines on the ECG trace that are typically located on the R-peak. They indicate where the gating occurred during the
scan.
1.
2. From the Retro Recon list select screen, select the patient, exam, and series from which you want to
manipulate the triggers. Click Select Series.
3. To insert a trigger, place the cursor anywhere on the ECG trace where you want to insert it and
right-click Insert Trigger.
An additional trigger or Red line appear on the ECG trace.

A recon window is also be added. Confirm that the recon window is in the desired location
before confirming image reconstruction.
4. To delete a trigger point on the ECG trace and to normalize the heart cycle, place the cursor on the
trigger or red line and right-click Delete Trigger.
5. To move a trigger, place the cursor over the trigger and click and drag it to the desired location.
R-peak-triggers can be moved only within the X-ray on range of recorded R-Peak-triggers (X-ray
on time).
SnapShot Pulse acquisitions have limited X-ray on during the cardiac cycle, which limit the
flexibility to adjust trigger locations. The X-ray on window cannot be repositioned after the scan
is complete. Cardiac helical scans have continuous X-ray on throughout the exam duration, thus
having a higher degree of flexibility to adjust the trigger points.
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Cardiac Retro Recon

Use this procedure to remove an image reconstruction window from one or more heart cycles from a
cardiac helical scan. This feature is not allowed for SnapShot Pulse scans due to its prospectively gated
nature. Removing any part of the exam results in an incomplete scan.
1.
2. From the Retro Recon list select screen, select the patient, exam, and series from which you want to
remove heart cycles. Click Select Series.
3. Place the cursor in the blue image reconstruction window of the ECG editor window, for one or more
heart cycles, and right click > Delete Image Recon Window.
ECG editor
4. The ECG trace updates, the recon window is no longer be visible, and the data from that heart cycle
is not included in the image reconstruction.
Updated ECG trace with removed data
An orange (relaxed phase) or red (ungated) area appears on the trace if the removed data results
in insufficient overlap in the z-axis to create gated images in the area where the recon window
was removed. It indicates the area where relaxed phase reconstruction images will be created.
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Chapter 10: Cardiac
The images are reconstructed as close to the requested phase as possible, with a maximum of a
20% phase offset.
Orange bar indicates a relaxed phase
Blue Gated images are always preferred. Relaxed Phase and Ungated images may cause
artifacts when viewing reformatted image volumes. The amount of overlapping data is based on
helical acquisition pitch.
5. Continue making any additional changes with the retro recon parameters as described in ECG
Editor in Retro Recon - Basic Reconstruction.
6. Click Confirm to reconstruct the images.
7. Review the images created from the edit ECG Trace process. Editing the trace changes the
reconstruction using the original scan data.
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Cardiac Retro Recon

Display retro recon images
Use this information to view retrospective reconstructed cardiac images. The following information is for
the default numbering system. If you want a new series number assigned, click New Series.
Single Phase image set

Retro SnapShot Segment – Series 104 (100 + original series #)
Retro SnapShot Pulse – Series 104 (100 + original series #)
Retro SnapShot Burst-2 – Series 124 (120 + original series #)
Retro Snapshot Burst Plus (3 or 4) - Series 144 (140 + original series #)
Retro Snapshot Segment Plus - Series 134 (130 + original series #)
Multiphase image set

When retro reconstructing a multi phase (MP) data set to the acquired slice thickness the series numbers
are as follows if the original series number is 4.
Retro SnapShot Segment – Series 504 (500 + original series #)

Retro SnapShot Pulse – Series 504 (500 + original series #
Retro SnapShot Burst-2 – Series 524 (520 + original series #)
Retro Snapshot Burst Plus (3 or 4) - Series 544 (540 + original series #)
Retro Snapshot Segment Plus - Series 534 (530 + original series #)
If images are Retro Reconstructed with a thicker slice, the series number has an additional 50 added
on.
Cardiac image annotation

SSEG (SnapShot Segment – single sector image)
SSEG+ (SnapShot Segment Plus - single sector image)
SSB2 (SnapShot Burst – two sector image)
SSB3 or SSB4 (Snapshot Burst Plus - up to three or four sector image)
SSCIN (SnapShot Pulse - single sector image)
SEGM (Ungated segmented image reconstruction)
SSR (SnapShot Relaxed Single Sector with adjusted phase location)
Edited cardiac image annotation

Image where the ECG trace has been edited, are annotated with an E placed before the scan type, e.g.,
E/SSEG or E/SSCIN.
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Chapter 10: Cardiac
Sample of an edited image
E/SSEG (SnapShot Segment - single sector image)

E/SSEG+ (SnapShot Segment Plus - single sector image)
E/SSB2 (SnapShot Burst - two sector image)
E/SSB3 or SSB4 (Snapshot Burst Plus - up to three or four sector image)
E/SSCIN (SnapShot Pulse - single sector image)
E/SEGM (Ungated segmented image reconstruction)
E/SSR (SnapShot Relaxed) - These images are always considered edited.
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Chapter 11: Retro reconstruction

This section provides the information you need to work with raw scan data for retro reconstructions.
Retro Recon
Create new images from scan data
Graphically prescribe Retro Recon
Find unreconstructed images
Pause/resume the Retro Recon queue
Remove data from the Retro Recon queue
Reserve/release acquired scan data
Save anonymous patient scan data
Save/restore scan data to/from a USB/DVD-RAM
Considerations
Recon Management may hang while trying to display the menu. Finish the current exam if scanning and
shutdown and restart the system to correct the problem.
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Create new images from scan data

Use this procedure to create new images retrospectively.
Retro Recon may not be able to recon the same image locations as prospective recon due to rounding
in the start and end location. To avoid this mismatch, prescribe start and end locations that are even
numbers.
1.
2. From the Retro Recon List Select screen, select the appropriate patient, exam, and series.
3. Click Select Series.
4. On the Retro Recon screen, type a new series description in the Series Description area if desired.
5. Click New Series Number to reconstruct images in a system-assigned new series number between
301 and 399.
If more than 399 series are already reconstructed, series 399 is repeated with a unique UID.
If not selected, the new series number will be original series number +100 (e.g., original series is
6, recon series is 106).
6. Click Retro to select all groups and click Yes or click Y for an individual group.
7. Type in Retro Start and Retro End locations.
Cine images do not need a S or I designation. All others do.
8. Click Image Thickness and type in the thickness.
9. Click Time.
For cine, VolumeShuttle (Axial), and Volume Helical Shuttle, specify a time period. For Volume
Helical Shuttle acquisitions, select individual passes or a range of passes.
10. Click Interval and type in an image interval.
11. Click DFOV and type in desired value.
12. Click R/L Center and/or A/P Center to set image offset.
Place the real time cursor in image to display the values in upper left corner of the image. You
may also click List/Select to highlight the correct exam and series or use Graphic Retro recon.
13. Click Recon Type and select one of the available algorithms.
14. Click Recon Option and select one of the options on the Recon Option screen.
For details, see the Set the Recon Options procedure.

Set the W/L, ASiR level, Flip/Rotate if enabled, and Cardiac Filter parameters.
15. Click Graphic Retro Y to graphically prescribe the reconstructions, one group at a time.
16. Click and drag the blue circle on the reference image to the desired location. The SFOV is indicated
by a red circle.
17. Click Confirm to generate images.
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Image Thickness, Image Interval, DFOV, R/L and A/P Center can be changed for the entire group or for
individual groups.
Segmenting uses 225° of data from different times within the rotation. Helical scans using 225° of
data, can be segmented. This is useful in segmenting out Aortic dissection artifact caused by the pulsation
of the vessel. Cine scans using 225° of data creates images with a shorter temporal resolution. This is
useful in following contrast through a tumor.
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Graphically prescribe Retro Recon

Use this procedure to graphically prescribe your retrospective reconstructions using an existing axial plane
image as a reference image.
1.
2. Click Graphic Retro so that the button reads Y.
3. Click and drag on the blue boxes (seen inside the red squares on the image below) to change the size
of the circle which represent the DFOV for your reconstruction.
4. Click on the + (seen inside the yellow square on the image below) to define the RL and AP centers for
your reconstruction.
5. Click Hide SFOV to hide the red circle which indicates the scan field of view.
6. Click Roam so you can click and drag the reference image.
7. Click Zoom to magnify the image.
Retro Recon Graphic prescription
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Find unreconstructed images

Use this procedure to find the images that have not been reconstructed.
1.
From the scan monitor, click the Recon Management icon.
2. On the Recon Management screen, click Delete Suspended Entries if you do not want to reconstruct
the images or Unsuspend Entries.
Unsuspend entries retries the reconstruction and places images in the correct exam and series if
reconstruction was successful.
Delete Suspended Entries displays a window to confirm deletion. Click OK to remove the
selected entry.
3. Click Update List to see images that may have been deleted or added.
4. Click Quit to exit.
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Pause/resume the Retro Recon queue

Use Pause Reconstruction Queue to stop and resume image reconstruction.
Pause
Images being prospectively reconstructed cannot be deleted from the queue. Images being produced
retrospectively can be removed from the queue.
1.
2. On the Recon Management screen, click Pause Queue.
The recon queue can always be paused or restarted.

Only the entries listed in the Retro queue can be deleted.
3. Click Quit to exit Recon Management screen.
Resume
The reconstruction queue is not automatically started, you must resume the queue for reconstruction to
restart.
1.
2. On the Recon Management screen, click Restart Queue.
3. Click Quit to exit Recon Management screen.
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Remove data from the Retro Recon queue

Use this procedure to remove data from the Retro Reconstruction queue.
1.
2. On the Recon Management screen, click Pause Queue.
3. Click Delete Retro Recon Entries.
4. On the Delete Retrospective Entries screen, click on each job you want to remove and click Delete
Selected.
Click Delete All to delete all data, independent of what you have selected.
If an entry is in reconstruction process, it may not delete. Restart the queue and try again.
Do not delete queued retros while scanning is active, scanning could stop.
5. Click Restart Queue.

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Reserve/release acquired scan data

Use this procedure to prevent or allow the deletion of raw scan data. These instructions cover reserving the
data. To release data, follow the same steps, except use the release buttons.
1.
2. On the Recon Management screen, click Reserve Scan data.
3. To reserve exams, click Reserve All Scanfiles, Select All Exams Listed or select individual exams.
If you Reserve All Scanfiles you cannot scan if the scan disk is full.
4. To reserve series, click Select All Series Listed or select individual series.
5. To reserve scans, click Select All Scanfiles Listed or select individual scans.
6. Click Reserve Selected Scanfiles.
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Save anonymous patient scan data

Use this procedure to save scan data with patient information removed. Raw data saved anonymously and
then restored will reconstruct with patient identifying information removed.
Scan must be idle when you start this procedure. This procedure can take from 60 seconds (helical
scan) to 1.5 hours (a single cardiac file) to save to DVD-RAM.
Make sure the selected scan files do not exceed the space available on the DVD 1-RAM2. Only one scan file
fits on one side of the DVD-RAM.
1. Place a DVD-RAM media into the DVD-RAM drive or connect a USB 3 device into the USB port on the
front of the media tower.
2.
From the scan monitor click the Recon Management icon.
3. From the Recon Management screen, select USB or DVD.
4. Click Save Scan Data.
5. Select the exam/series/scans you wish to save anonymously.
6. Click Save Selected Annon. Data.
8. Do not eject the device until the light is out on the DVD-RAM drive.
9. Once the save is complete to the USB device, exit Recon Management and disconnect the USB
device. Then, scanning can resume.
1Digital Versatile Disc

2Random Access Memory
3Universal Serial Bus
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Save/restore scan data to/from a USB/DVD-RAM
Considerations
The only validated USB drive is the Seagate 1 terabyte drive. If the device is not formatted correctly,
software asks if you want to format it. It takes about 1 minute per 100 GB, so a 1 terabyte device
takes 10 minutes to format.
As with Save/Restore to DVD-RAM, scanning is not possible until the save/restore of data is
complete. A helical scan file contains a large amount of data even though it is one scan file. It can
take up to 30 minutes or more to save. Since you are unable to scan patients while saving or
restoring Scan Data, make sure that you have ample time to complete the save or restore before
beginning.
Before saving or restoring scan data make sure the system is idle and no Archive, Network or
Filming is active. No other features should be accessed until the save or restore is complete.
Prerequisite
Make sure the selected scan files do not exceed the space available on the DVD-RAM.
Scan data can only be restored on the same system model that it was acquired on.
1. Verify that you have enough time to complete the save uninterrupted. You cannot scan while saving
scan files.
Saving a 60-second helical acquisition could take up to 1.0 to 1.5 hours on a DVD-RAM. Canceling
will only stop when the current scan save is finished.
2. Connect the external USB device to the USB port or insert the DVD-RAM.
3.
4. Select the USB or DVD.
5. Click Save Scan Data.
6. Select the exam you wish to save in the exam screen.
7. Select the individual scan files for the series in the series screen.
8. Select individual scans or click the scans you want to save by clicking Select All Scanfiles Listed.
9. Optional, click Save Selected Anon. Data to save the data with no patient information in the image
header.
10. Click Quit when the save is complete.
If cancel a Save or Restore of scan data, the cancel activates after the current scan file is saved or
restored.
If you are using an external USB hard drive, disconnect the USB device 1 minute after exiting
Recon Management and the software indicates that scan data save is complete. Do not leave the
USB drive connected once the transfer of scan data is complete.
Eject only after all the lights on the media are no longer illuminated. Scan File Save does not finish
even though the Saved File message is posted. The problem is due to the time takes to it unmount
the DVD. It may take 5 to 7 minutes or longer for the DVD to unmount. Please note: the save is
complete when the light on the DVD drive has turned green and then, the DVD is unmounted.
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Chapter 12: View images

The Exam Rx and ImageWorks applicaitons have a variety of display tools and contain a large viewing area
to display images.
Open Exam Rx
Open ImageWorks
Type an Accelerator command
Annotate an image
Annotation preferences
Cine loop
Compare Exams/Series/Images
Cross reference images on a scout
Density readings on multiple images
Density reading
Display normal
Edge and smoothing filters
Extended CT numbers
Exam, Series, Image selection
Flip/rotate
Grid preferences
Grid
Gray Scale Enhancement
GSPS
Hide, show, or remove graphics
Magnify or minify
Matte
Measure distance
Mouse preferences
Move images within a viewport
Next/prior viewport settings
Patient list in the browser
Primary and secondary viewport
Reference image
Reverse video
Report cursor
Screen save
Series binding preferences
Set images display
Set viewport preferences
Sort by exam or images
Text page
Tick mark preferences
W/L preset preferences
W/L images
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Considerations
If a power failure occurs during a prospective image reconstruction, any images reconstructed prior
to the power failure, are not displayed in the browser/patient list and are not in the data base. Type
an exam/series/image number in the Accelerator Line, and then select another exam from the
browser to refresh it. There may be a slight delay. If this action fails, reboot the system. If that fails,
use retro recon to generate the images. There is no need to rescan the patient.
In general, wait for a display action to complete before entering another command.
Many of the view image tasks can be executed through type-in commands. See Acceleration
commands for a list of commands.
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Open Exam Rx
Use this procedure to open Exam Rx, from which you can access multiple applications.
Considerations
If Flip/Rotate in Recon and Continuous Cursor are enabled on a system, the RAS coordinates that
display on the left side of the image have the Flip/Rotate annotation intermixed with the RAS
information. If Flip/Rotate was not applied to the image, there is a blank space in between the RAS
information.
If Graphic Retro does not display on Exam Rx, (it displays on ImageWorks instead), then toggle
Graphic Retro off/on.
Exam Rx may reset after a software problem indicated by display stopping or not accepting cursor
inputs. Wait for a few seconds for display to automatically reset and then re-display the images you
wish to work on.
Images may not be displayed after a switch between AutoView or Image Review layouts due to a
restart in the display process. Re-display the desired images in the viewport to continue.
1.
From the display monitor, click the Exam Rx icon.
Exam Rx does not automatically display the top level, but rather it displays the last feature used.
Therefore, click Back to return to the top level so you can execute the steps as described in the
View chapter.
2. If a scan is currently running, some viewports are filled with the images from the current scan.
3. Click on a viewport to make it active.
4.
If a scan is not active, select a viewport and click the List/Select icon to access the browser
from which you can select desired images and click Accept.
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Open ImageWorks
Use this procedure to open ImageWorks from which you can access the browser applications. This
procedures uses Viewer and Mini Viewer as an example.
If the browser title bar size is decreased, from the menu bar, select Application > Refresh or switch
desktop to redisplay the browser.
1.
From the display monitor, click the ImageWorks icon.
2. From the browser patient list, select the desired images.
3. From the browser list of applications, click Viewer or Mini Viewer.
4. Click a viewport to make it primary.
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Type an Accelerator command

The Accelerator Line (often referred to as the command line) provides a shortcut method for applying some
features or functions to all active viewports.
1. To see a list of applicable commands, type ? in the Accelerator Line and press Enter.
2. To use a command, type the command in the Accelerator Line and press Enter.
The command is applied to all viewports in focus. As next and prior images are selected, the
command applies to those images.
On the ImageWorks desktop, you can also click the command from the Help Command Line
menu.
Image selection from the accelerator line does not function if the primary viewport contains an
MIROI plot or Report Pixels chart. Use List Select to display a new image.
No text is entered in the Accelerator Line if the cursor is positioned over the Film Composer.
The table below presents the text you type is in bold face followed by an explanation. An X in the table
indicates the display application uses the command.
GRx
Exam Image
Command / Description Retro
Rx Works
Recon
ac
Applies custom annotation to the image displayed as defined by Display X X X
Preferences settings.
af
X X X
Restores full annotation to the image displayed.
agp <on/off> <N> -where N is a group number
Restores full annotation to the image displayed. agp <on/off> <N> -where
N is a group number With this feature, you can selectively turn off or on
specific image annotations on the screen. The N number corresponds to X X X
the annotation in the customize setting for annotation in User
Preferences. For example, to turn off right marker, type agp off 10. You
can type more than one number at a time.
an
X X X
Removes all annotation from the image displayed.
ang
Creates an angle type measurement cursor by explicitly describing the X X
end points of the lines that make up the cursor.
ap
Applies partial annotation to the image displayed as defined by Display X X X
Preferences dialogue box on Exam Rx screen.
arrow <on> or <off>
Displays or removes an arrow cursor from a text annotation box for user X
annotation.
blank
X
Removes image from the selected viewport, similar to a user text page.
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GRx
Exam Image
Rx Works
Recon
dist
X X
A measure distance line will appear on the screen.
e <examination number>
X X
The desired exam number as indicated on the system disk.
e <exam number> s <series number> i <image number>
X X
Exam, series, and image numbers as indicated on the system disk.
eag
X X
Removes all graphics from the selected image.
eg
X X
Removes selected graphics from the selected image.
el
X X
Creates an ellipse type measurement cursor.
ematte
Displays an elliptical black matte or mask around the image. Size is X X
adjustable with the mouse by a left click and drag on the blue crosshair.
Position is adjustable by a click and drag on the edge of the matte.
fac
Applies custom annotation to the images filmed as defined by Display X X
Preferences dialogue box on Exam Rx screen.
faf
X X
Restores full annotation to the images being filmed.
fagp <on/off> <N> -where N is a group number
With this feature, you can selectively turn off or on specific image
annotations for filming. The N number corresponds to the annotation in X X
the customize setting for annotation in User Preferences. For example, to
turn off right marker, type fagp off 10. You can type more than one
number at a time.
fan
X X
Removes all annotation from the images being filmed.
fap
Applies partial annotation to the images being filmed as defined by X X
Display Preferences dialogue box on Exam Rx screen.
fi <filter name> filter names: e1; e2; e21; e22; e23; e3; lung; (for edge
enhancement) s1; s11; s2; s21; s3; (for smoothing filters) and off
Apply/remove edge enhancement and smoothing filters on selected
images. Edge enhancement filter names are, from least sharpening to X X X
most: e1, e2, e3, lung; smoothing filters are named s1, s2, s3. Entering
the command fi e1 applies the least image sharpening,; entering fi lung
applies the most. For example: fi e1, fi e2, fi e3, fi lung, fi s1, fi s2, fi s3, fi
off.
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GRx
Exam Image
Rx Works
Recon
flr
X X X
Flips the image horizontally.
ftb
X X X
Flips the image vertically.
fo <rows>< columns>
For example: fo 4 3
Formats the display screen as specified by rows and columns. The above X
example displays images across the screen in 4 rows and 3 columns, or
common twelve-on-one.
freehand
Displays a small solid blue box that can be used to draw a freehand trace
for an ROI. You must click and drag the box to where you would like to X
start the trace. Then select the blue box while holding Shift on the
keyboard and move the mouse cursor around the screen to draw the
trace.
gse <filter name>
filter names: g1; g2; g3; off
Gray scale enhancement increases the apparent contrast of the image X X X
without changing the window/ level settings. Useful for enhancing low
contrast structures. For example: gse g1, gse g2, gse g3, gse off).
grid <on> or <off>
X X X
Displays or removes a ruled grid on the image.
hg
Hides all graphics on the selected image. The undo function is show X X
graphics.
i <image number>
Image number: the desired image number from within the displayed X X X
series. For example: i 27.
inv
X X
Reverses the black’s and white’s on the image.
mmg
Turns the right mouse button drag action into zooming (magnification) of X
the image.
mmr
Turns the right mouse button drag action into scrolling (pan, roam) of the X X X
image.
mmz
Turns the right mouse button drag action into zooming (magnification) of X X
the image.
ne X X
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GRx
Exam Image
Rx Works
Recon
Displays the first image of the next exam in the selected viewport, next
determined by the sort function applied to the List Select browser.
ns
Displays the first image of the next series from the displayed exam in the X X
selected viewport.
no
Restores the image display to display normal mode: removes all zoom, X X X
filter, pan, annotations etc. applied to the viewport. Displays the image
from the disk as created.
nori
X
Takes reference image OFF of selected image.
noria
X
Takes reference image OFF all images.
noxr
X X
Removes cross reference lines from the image display.
pa [<start> <end>] [<rate>]
Activates cine paging. For the start and end values, enter the first and last X
images you want to page thru. For rate, enter the number of images per
second to page through, with the maximum being 60.
pi <interval>
Allows you to set the interval for paging. The pa command must be used X
prior to setting paging interval.
pia <interval>
Allows you to set the interval for paging. The pa command must be used X
prior to setting paging interval.
pe
Displays the first image of the previous exam in the selected viewport, X X
previous determined by the sort function applied to the List Select
browser.
pm <spatial/temporal>
Allows you to change the mode for paging. Selecting temporal will display X
the images in a “loop” mode. Spatial will display images in a “back and
forth” mode.
pp
Sends the entire current display screen to the film composer and sets the X
film composer format to that of the current display format.
prs
Opens the print series dialogue box for the selected viewport, which is in
turn satisfied by mouse commands. By specifying options in the print X X
series box, a sequence of images may be sent automatically to the
printer, or current print jobs may be canceled by the operator. Desired
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GRx
Exam Image
Rx Works
Recon
image parameters must be set before calling the print series command -
zoom, window level, annotations etc. cannot be altered after the print
series dialogue box is opened.
ps
Displays first image of the previous series of the displayed exam in the X X
selected viewport.
prop <range>
range: a= all images in series; s = series; i = image range (1-15)
For example,: prop a or prop i 1-15)
Displays selected graphics on the specified images. The “i” is lower case
sensitive. In the first example, the graphic displays on all images called X X
into the viewport until cleared by another command (such as erase
graphics) or a different series is displayed in the viewport. In the second
example, the graphic is applied only to images 1 through 15 in the current
series.
quit
X
Closes the Viewer application and return to the Image Works browser.
rc
Displays (reports) current mouse cursor location in pixel coordinates, and X
a single pixel ROI reading.
rect
X X
Creates an rectangle type measurement cursor. Used for ROI.
ri
X
Puts a reference image on the selected image.
ria
X
Puts a reference image on all images.
rl
X X X
Rotates the image ninety degrees counter-clockwise.
rmatte
Displays a rectangular black matte or mask around the image. Size is X X
adjustable with the mouse by a click and drag on the blue crosshair.
Position is adjustable by a click and drag on the edge of the matte.
rp
Opens a Report Pixels dialogue box, and displays an ROI box cursor on the
image that is positioned on the area of interest by a left click and drag of X
the mouse. Size is not adjustable. Once in position, clicking ‘OK’ in the
dialogue box creates a pixel report consisting of density values for
individual pixels within the area delineated by the box cursor.
rr
X X X
Rotates the image ninety degrees clockwise.
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GRx
Exam Image
Rx Works
Recon
rs
X
Reset image to initial display parameters. It does not reset the W/L.
s <series number>
Series number: the desired series number from within the displayed X X
exam.
sb <on> <off>
Turns series binding on or off. With series binding on, the next image is
defined as the next image in the entire exam; at the end of any particular
series, the next image is the first image of the next series. At the end of X
the exam, a ‘next’ command will loop back to the first image of the exam.
With series binding off, at the end of a particular series, a ‘next’
command will loop back to the first image of the current series.
scnsave
Captures the selected image exactly as it is displayed, and creates a new
image with a series number of 99 on the system disk that includes all X X
graphics and display factors applied to the image and/or viewport at the
time of capture.
sg
Shows, or re-displays all graphics on the selected image which were X X
hidden with the hide graphics command.
siw
X X X
Applies default window width and level setting to the display.
spline
Deposits a small open blue box for creating a trace. Deposit blue box
where you want the trace to start. Then hold down the Shift key on the X
keyboard and click with the left mouse to deposit points. All the points will
connect to create a trace.
ss [<first image> <last image>]
Saves the image orientation, W/L values, graphics, and filter and GSE
values of a range of images that you can set. Typing ss by itself will save X
settings for the entire series. A Gray Scale Presentation State Object is
also created and saved to the Data base.
te
X X
Displays text page for the exam in the primary viewport.
tm <on> or <off>
Display or removes both horizontal and vertical tick marks (rulers) along X X X
the border of the image.
tmh <on> or <off>
Displays or removes horizontal tick marks (rulers) only, along the border X X X
of the image.
tmv <on> or <off>
X X X
Displays or removes vertical tick marks (rulers) only along the border of
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GRx
Exam Image
Rx Works
Recon
the image.
tpr
Displays a text page for the image in the primary viewport which lists all X X
the ROI cursors and their statistics.
ts
X X
Displays text page for the exam/series in the primary viewport.
ua
X X
Displays specified text in a user annotation field on the image.
up
X
Displays the User Preferences screen.
utp
Removes image from the selected viewport, creating a blank viewport for X X
user annotation or graphics.
wl <desired level>
X X X
Applies specified window level setting to the display.
ww <desired width>
X X X
Applies specified window width setting to the display.
xr <series number> <image set>: <interval>
series number: an appropriate series number to be cross referenced.
image set: a consecutive group of image numbers within the series. X X
interval: the interval of images to be filmed: 2 equals every other image, 3
equals every third image, etc.
xra <series number> <image set>: <interval>
Used to add additional cross referenced groups or series to a scout
which already has a cross reference on it. series number: an appropriate
series number to be cross referenced. image set: a consecutive group of X X
image numbers within the series. interval: the interval of scan plane lines
to be displayed: 2 equals every other image, 3 equals every third image,
etc.
zo <factor>
factor: magnification factor
Magnifies the image by the factor specified. For example, zo 1.5 displays X X X
the image one and one half times as large as its display normal size, or
150% larger in appearance.
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Annotate an image
Use these procedures to add annotation to your images, which allows you to comment for labeling
purposes or draw attention to a specific area of interest.
An active user annotation graphic does not film the box or arrow that is displayed on the screen.
Exam Rx
1. Open Exam Rx.
2.
Click the Routine Display icon.
3. Click a viewport to bring it in focus.
4. Click User Annotation.
5. Click on the image and type in desired text.
To move the annotation, click on the blue box and drag to a new location. To move the end of the
line, click and drag the arrowhead to a new location. To remove the line, click and drag into the
box.
6. Click User Annotation to add more annotation.
7. Click Erase to remove the primary (blue) annotation.
ImageWorks
1. Open ImageWorks.
2.
From the Viewer or Mini Viewer control panel, click the Annotation icon.
3. Click on the image and type in desired text.
To move the annotation, click on the blue box and drag to a new location. To move the end of the
line, click and drag the arrowhead to a new location. To remove the line, click and drag into the
box.
4. Click the Annotation icon to add more annotation.
5. Click Erase Annotation to remove the primary (blue) annotation.
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Set annotation preferences

Use this procedure to customize the default font size and the level of Film and Viewer image annotation.
1. Open ImageWorks.
2. From the Viewer control panel, click User Prefs.
3. On the User Preferences screen, click No annotation, Partial annotation, Full annotation, or
Custom annotation for either or both the screen and film area.
If you click Custom annotation, click Customize and select the specific annotation you want
displayed.
4. To view certain parameters in a larger font, click Customize Large Font and select the specific
annotation group to enlarge.
5. Click Apply to apply your selections for the current Viewer session or Save as Default to change
settings for all exams viewed on the screen or filmed from either Exam Rx or ImageWorks.
Screen and film annotation level accelerator commands are saved as defaults.
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Use this procedure to adjust W/L and page through images using the Bright Box. The trackball controls
single user versus multiple user mode.
Bright Box controls
Select next and prior image for single user mode

1. From Exam Rx, click a viewport to make it a primary viewport.
2. Press left bright box button (1) for prior image.
3. Press right bright box button (2) for next image.
Control window width and level in single user mode

1. Click an Exam Rx free viewport1 to make it a primary viewport.
2. Adjust the W/L by moving the trackball (3).
Left trackball movement = decreases window width

Right trackball movement = increases window width
Up trackball movement = increases window level
Down trackball movement = decreases window level
Oblique trackball movement = changes both window and level values
Control image page and W/L for second user mode

1. Click an Exam Rx free viewport to make it a primary viewport.
2. Double-click the Paging button (4) to enable paging.
3. Adjust image page by moving the trackball (3).
Up trackball movement = pages through the sequence from beginning to end
Down trackball movement = pages through the sequence from end to beginning
Page speed = rate at which you move the trackball
4. Press the Paging button to toggle to W/L mode and roll the trackball up/down to adjust WL and
right/left to adjust WW.
Up/Down trackball movement = changes the Window Level
1a viewport that is not used for AutoView or AutoFilm
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Right/Left trackball movement = changes Window Width

Oblique trackball movement = changes both WW and WL
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View images in a cine loop

Use this procedure to view images in a cine loop, which is useful for tracking flow in same-location scans
taken with contrast or with motion such as flexing an elbow.
1. Open ImageWorks.
2. From the Viewer or Mini Viewer control panel, click Paging to view the Paging controls.
3. Click and drag the scroll bars in the Start and End area to set the first and last images displayed.
4. Click and drag the FPS scroll bar to choose the number of frames per second that are displayed.
5. Select a viewing choice:
ClickTemporal to view images from start to end continuously (1-30, 1-30, 1-30, etc.)
Click Spatial to view images from start to finish and back again (1-30, 30-1, 1-30, etc.)
6. Click Go.
To change the series, click Select Series and select a new series.
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Compare exams/series/images
Use this procedure to display two sets of images simultaneously.
1. Open ImageWorks with the first set of exams, series, or images you want to compare.
2. From the Viewer control panel, click Compare.
3. Select the second of exams, series, or images from the browser.
4. Click Viewer.
5.
Click the Left Series or Right Series up and down arrows to move through the image
set.
6. Click one of the viewports to bring it in focus, and use the Page Up and Page Down keyboard keys to
simultaneously page up or down through both series.
7. Click Cancel Compare when done, or click Browser to return Patient List.
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Use MIROI density readings to calculate bolus timing

Use this procedure to calculate the bolus time for a contrast enhanced exam.
Considerations
The MIROI1 pop up may display but does not function if an AutoView or Cross reference viewport is in
primary focus. Place a Free or Auto Link viewport in primary focus and reselect the MIROI button to
continue.
Any Report Pixel or MIROI chart that is not screen saved, but is filmed shows the Exam Series and
Image as 1000/1/1 on the film composer icon if E/S/I is selected. This is the exam/series/image
number the system assigns to this chart display. The patients exam number is listed correctly on the
filmed image.
1. Open Exam Rx with the exam you want to analyze.

2. From Exam Rx Display control panel, click the Measurements icon.
3. From the Measurements option, select MIROI.
4. From the MIROI Analysis screen, select Ellipse ROI.
5. Click and drag the ROI to the anatomy of interest. Size the ROI to fit completely inside the aorta.
6. Click OK.
7. Use the graph to calculate the bolus timing.
MIROI graph, 1 = first tick mark, 2 = pre-scan delay time
1Multi-Image Region of Interest
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Measure a density reading

Use these procedures to obtain information on areas of anatomy and pathology.
Exam Rx
1. Open Exam Rx.
2.
Click the Measurements icon.
3. Click Box ROI, Ellipse ROI, or Trace ROI.
4. Position the cursor on the image and click to deposit the insertion point.
For Trace ROI, move the solid blue box to the start point. Press and hold Shift, and then click and
drag to define the area for the trace.
For Box ROI or Ellipse ROI, click and drag on the small box in the upper right corner of the ROI to
resize or click the ROI number and drag to a new location.
5. Click Erase to delete the blue (active) ROI.
ImageWorks
1. Open ImageWorks.
2. From the Viewer or Mini Viewer control panel, click Measure.
3. From the Measure menu, click Box ROI, Ellipse ROI, or Trace ROI.
4. Position the cursor on the image and click to deposit the insertion point.
For Trace ROI, move the solid blue box to the start point. Press and hold Shift, and then click and
drag to define the area for the trace.
For Box ROI or Ellipse ROI, click and drag on the small box in the upper-right corner of the ROI to
resize or click the ROI number and drag to a new location.
5. Click Erase All to erase all annotation or Erase Annotate icon to erase the active annotation.
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Display normal
Use this procedure to remove all filters, magnification factors, orientation changes and graphics .
Exam Rx
1. Open Exam Rx.
2.
3. Click Display Normal.
ImageWorks
1. Open ImageWorks.
2. From the Viewer or Mini Viewer control panel, click Display Normal.
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Use edge and smoothing filters

The edge and smoothing filters enhance anatomical structure without additional reconstruction time. The
edge enhancement filters sharpen the image. The smoothing filters decrease the appearance of noisy
images or enhance low contrast areas when filming soft tissue.
Considerations
Image filters are only saved with Saved State from ImageWorks.
Smoothing and edge filters are not additive. Only one filter may be applied to an image at a time.
Applying a new filter negates the previously applied values.
A new series is not created for the filtered images.
Filters are applied to image data only.
Exam Rx
1. Open Exam Rx.
2.
3. Click a review viewport to bring it in focus.
4. Click Proview and select a filter type.
Click E1, E2, E21, E22, E23, or E3 for edge enhancement.

Click Lung for lung enhancement.
Click S1, S11,S2, S21, or S3 for smoothing.
5. Click Off to turn off enhancement.

6. Click Cancel to close Proview screen.
ImageWorks
1. Open ImageWorks.
2. From the Viewer or Mini Viewer screen control panel, click Image Enhance.
3. Under Filters, select a filter type.
Click E1, E2, or E3 for edge enhancement.

Click LU for lung enhancement.
Click S1, S2, or S3 for smoothing.
4. Click None from the Image Enhance menu or click Display Normal to turn off enhancement.
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View exam and series text page

Use these procedures to view patient and scan parameter information.
Exam Rx
Only 1,500 images can be saved in a Series Text page.
1. Open Exam Rx.
2.
3. Double-click the Review viewport to set it as the primary viewport.

4. Click Exam pg to view information about the exam or Series Pg to view information about the series.
5. To film, click Manual Film or AutoFilm to send to the desired film composer.
6. Use arrow keys to navigate between multiple pages.
7. Click Quit.
ImageWorks
1. Open ImageWorks.
2. From the Viewer or Mini Viewer screen control panel, click Text Page.
3. Click Exam Page to view information about the exam or Series Page to view information about the
series.
4. Click Manual Film to send to the film composer.
5. Click Screen Save to save the displayed information to series 98.
6. Use arrow keys to navigate between multiple pages.
7. Click Quit.
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Flip/rotate images
Use these procedures to change the direction of the displayed image.
Exam Rx
1. Open Exam Rx.
2.
3. From the Routine Display screen, click Flip/Rotate.
4. Double-click the Review viewport to set it as the primary viewport.
5. Choose an option to modify the image orientation.
Click FLR to flip left to right.

Click FTB to flip top to bottom.
Click FTB/FLR to flip top to bottom and left to right.
Click RR to rotate to the right (clockwise) or RL to rotate to the left (counter-clockwise).
6. Click Cancel to close the screen.

7. Click Display Normal to return images to their original orientation.
ImageWorks
1. Open ImageWorks.
2. From the Viewer or Mini Viewer screen, click Flip Rotate.
3. Select the arrow direction to change image orientation, which is applied to all images in the series.
Click the first set of arrows to flip left to right.

Click select the second set of arrows to flip top to bottom.
Click the third arrow to rotate image counter-clockwise.
Click the bottom arrow to rotate image clockwise.
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1 = flip left to right, 2 = top to bottom
1 = rotate clockwise, 2 = rotate counter clockwise
4. Click Display Normal to return images to their original orientation.
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Set grid preferences

Use this procedure to customize the default grid appearance.
1. Open ImageWorks.
2. From the Viewer or Mini Viewer screen control panel, click User Prefs.
3. On the User Preferences screen, under the Grid Prefs area, click Customize...
4. Click On or Off to set matrix line display.
5. Click Dotted or Solid to set line style.
6. Type in a numeric value for grid spacing, tick spacing, and tick length.
7. Click OK to make the changes.
8. Click Apply to apply your selections for the current image or Save as Default to change for all future
exams viewed.
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Add grid
Use these procedures to place a grid (matrix) over the primary image to measure anatomy or pathology on
an image.
Exam Rx
1. Open Exam Rx.
2. Click on a viewport to make it active.
3.
Click Routine Display or the Measurement icon.
4. Click Grid On/Off.
5. Click and drag the center point to move.
6. To remove the grid, click Grid On/Off or Erase.
ImageWorks
1. Open ImageWorks.
2.
From the Viewer or Mini Viewer screen control panel, click the Grid icon.
3. Click and drag the center point to move it.
4.
To remove the grid, click the Grid icon.
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Apply Gray Scale Enhancement

Use this procedure to improve the brain/bone interface and low contrast structures in the brain such as
gray/white matter.
Exam Rx
1. Open Exam Rx.
2.
3. Click GSE.
4. Click G1, G2, or G3.
5. Click Off to turn enhancement off.
6. Click Cancel to cancel out of GSE screen.
ImageWorks
1. Open ImageWorks.
2. From the Viewer or Mini Viewer screen control panel, click Image Enhance.
3. Under Gray Scale Enhancements, click G1, G2 or G3.
4. Click None from the Image Enhance menu or click Display Normal to turn off enhancement.
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Create and view GSPS objects

The gray scale presentation state is a DICOM1 object which saves a range of images along with the image
state and graphic annotations. The GSPS object can be displayed on the CT scanner or networked to a
remote host that supports DICOM GSPS.
Create a GSPS object

1. Open ImageWorks.
2. Modify the image using any of the following features:
Window Width and Window Level

Roam
Zoom
Flip
Rotate
Graphics such as ROI, measure distance, and image annotation
3. From the Viewer control panel, click Save State.
GSPS object will be saved as series 10,000 for the current exam.
View a GSPS object

1. Highlight the GSPS object in the browser.
2. From the browser list of applications, click Viewer.
3. Use the pull down to change the viewer format.
4. Select the + object buttons to view additional GSPS objects in the series.
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Hide, show, or remove graphics

Use these procedures to temporarily remove added annotation and graphic objects on an image then re-
display them.
Exam Rx
1. Open Exam Rx.
2.
3. Do one of the following:
Click Hide Graphics to temporarily hide from view all user-entered annotations such as ROIs and
text.
Click Show Graphics to display the previously hidden graphics.
Click Erase to delete the user-entered annotations.
ImageWorks
1. Open ImageWorks.
2. From the Viewer or Mini Viewer control panel, do one of the following:
Click Hide to temporarily hide from view all user-entered annotations such as ROIs and text.
Click Show to display the previously hidden graphics.
Click Erase All to delete all user-entered annotations or Erase Annotate icon to erase the active
annotation.
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Magnify or minify the image

Use these procedures to fit images in the viewport by making them larger or smaller. All images within a
series are set to the same size.
With the system configured in a language other than English, if a comma is entered in explicit magnify,
(i.e., 2, 3) the comma is not be interpreted as a decimal. The magnification factor is applied without the
decimal. In the example shown, 2, 3 the image would only be magnified 2X not 2.3X. Always enter a period
to designate a decimal and have the correct magnification applied.
Specify a zoom factor in Exam Rx

1. Open Exam Rx.
2.
3. Click Explicit Magnify and chose an explicit factor (0.5, 1.0, 1.5, 2.0) or type the desired magnification
factor (0.5 to 8.0) and press Enter.
Magnify or minify images in Exam Rx

1. Open Exam Rx.
2.
3. Click Zoom.
4. Click and drag the right mouse in the image to set the desired size.
The magnification factor is annotated on each image in the upper right side with the initials MF
(Mag Factor) and the value from 0.5 up to 8.0.
5. Click Display Normal to return the image to the original state.
Magnify or minify images in ImageWorks

1. Open ImageWorks.
2.
From the Viewer or Mini Viewer control panel, use the zoom controls to
magnify the image by:
typing a value
clicking and dragging the slide bar
clicking on the arrowheads on either side of the bar
3. Click Display Normal to return the image to the original state.
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Apply a Matte
Use the matte procedure to eliminate unwanted information on or around an image. There are two types of
matte: rectangular and elliptical. The size can be easily adjusted.
Place a matte
Exam Rx
1. Open Exam Rx.
2.
4. On the Accelerator line, type ematte for an elliptical matte or rmatte for a rectangular matte and
press Enter.
5. To duplicate the matte to all images in the series, make the matte active (blue outline) and in the
Accelerator Line, type prop a and press Enter.
ImageWorks
1. Open ImageWorks.
2. From the Viewer or Mini Viewer control panel, click Rect. Matte or type ematte in the Command
Line and press Enter.
3. To duplicate the matte to all images in the series, make the matte active (blue outline) and in the
Accelerator Line, type prop a and press Enter.
Move, resize, or delete a matte
From Exam Rx and ImageWorks
1. To resize the matte, click and drag on the blue crosshair in the upper-left corner of the matte.
2. To move the matte, click and drag anywhere outside the matte to reposition it.
3. To delete the matte, click Erase All or Display Normal.
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Measure distance
Use these procedures to activate a measure tool to obtain information, distances, and areas of anatomy or
pathology. Up to three measurement statistics can be displayed on a single image.
Exam Rx
1. Open Exam Rx.
2.
Click the Routine Display or Measurements icon.
3. Click Measure Distance.
4. Click and drag either end point to the start and end locations.
5. From the Command Line, type TPR and press Enter to view a text page ROI.
This is useful when more than three measurements are on a viewport.
You can film or screen save Text page ROI.
6. Click Erase to erase the active (blue) measurement.
ImageWorks
1. Select ImageWorks.
2. From the Viewer or Mini Viewer control panel, click Measure.
3. From the Measure menu, select the line segment icon.
4. Click and drag either end point of the start and end locations to adjust the line segment size.
5. From the Command Line, type TPR and press Enter to view a text page ROI.
This is useful when more than three measurements are on a viewport.
You can film or screen save Text page ROI.
6.
Click the Erase icon to erase the active (blue) measurement or Erase All to erase all display
objects.
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Set mouse preferences

Use this procedure to customize the control of the right mouse button.
1. Open ImageWorks.
2. From the Viewer control panel, click User Prefs.
3. On the User Preferences screen, select the desired function for the right mouse button.
Select Scrolling to have the right mouse button scroll an image.

Select Magnify glass to have the right mouse magnify an area on an image.
4. Click Apply to apply your selections for the current exam or Save as Default to change for all future
exams viewed in the Viewer or Mini Viewer.
In Exam Rx, it also sets the preferences for Roam (Scrolling selection) and Zoom (Magnifying
Glass selection).
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Move images within a viewport

Use these procedures to center images in a viewport for filming or viewing purposes. All images within a
series are moved.
Exam Rx
1. Open Exam Rx.
2.
3. Click Roam.
4. Click and drag the image with the right mouse and place the image in the desired location.
Image Works
1. Open ImageWorks.
2.
From the Viewer or Mini Viewer control panel, click the Scroll icon.
3. Move the cursor to the image and right-click and drag the image to the desired location.
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View patient list in the browser

Use this procedure to select a patient for image display.
1. Open Exam Rx.

3.
Click the List/Select icon.
4. From the browser, click the patient name, series, and image to view details about the exam.
5. Click Accept.
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Set a primary and secondary viewport

Use this procedure to control the primary, secondary, and active viewports.
1. Open Exam Rx.

2. Double-click an image to set as the primary viewport.
The viewport is active and the border becomes blue.
If no secondary viewports exist, manipulations done in this primary (active) viewport do not affect
the other viewports.
3. Single-click another image to set it as a new primary viewport and retain secondary focus on the
previous viewport.
The border turns yellow on the previous viewport and is blue on the newly selected image.
All manipulations done either in the primary or secondary viewport are reflected in the other
viewport.
4. Triple-click any viewport to make all viewports active.
Manipulations such as W/L are applied to all viewports.
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View a reference image

Use this procedure to show the image from which the primary image was prescribed in small viewport
within the image.
If a screen save is executed with reference image on, the reference image is saved with the same
W/L as the main image, regardless of the W/L displayed on the reference image.
1. Open ImageWorks.
2. Click on the viewport to which you want to apply a reference image.
The viewport display must be 512 × 512 or larger for the reference image to display.
3. From the Viewer or Mini Viewer control panel, click Reference Image.
4. Select an option for displaying the reference image:
Click All when using Print Series with Reference image to insure that the reference image is
filmed.
Click Selected On to only display a reference image on the primary viewport.
Click All Off or Selected Off to remove the reference image.
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Inverse the video display

Use this procedure to toggle the video display between black/white and white/black.
1. Open Exam Rx.

2. Click Display Preferences.
3. Click Inverse Video.
4. Click again to turn off.
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Report a cursor
Use this procedure to display cursor statistics and RAS1 coordinates for a single pixel.
1. Open Exam Rx.
2.
Click the Display Preferences icon.
3. Click Continuous Report Cursor.
4. Click again to turn off.
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Screen save
Use the Save Screen tool to take a snapshot of a viewport. The image is saved to series 99 with a series
type of SSAVE.The images can be archived and networked, and W/L and zoom are still adjustable. However,
these images have post processing restrictions, and any annotation on the image cannot be removed once
the screen has been saved.
Screen Save images created in Exam Rx or in the Viewer from ImageWorks are not PPS aware.
Images created in Reformat, 3D, and Navigator are not PPS aware. Image types INPR is posted in the PPS
column in the browser even though PPS is not enabled.
Exam Rx
1. Open Exam Rx.
2.
3. Click on the image you want to save.
4. Click Screen Save.
ImageWorks
1. Open ImageWorks.
2. From the Viewer control panel, click Screen Save.
3. From the Mini Viewer Command Line, type scnsave and press Enter.
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Set series binding preferences

Use this procedure to set the default series binding. Use Type an Accelerator command for series binding
on/off in Exam Rx.
1. Open ImageWorks.
2. On the Viewer control panel, click User Prefs.
3. On the User Preferences screen, click:
Series binding ON to page through all series in an exam.

Series binding OFF to page through only the current series in an exam.
exams viewed.
Series Binding accelerator commands are saved as defaults.
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Set image display
Use these procedure to set the layout format for the application display area.
Select a layout
1. Open Exam Rx.
2. Click Auto View Layout or Review Layout.
3. From the Auto View Layouts or Review Layouts screen, select a layout.
4. Place a review viewport in primary focus.
Multiple image display

1. Open Exam Rx.
2. Click Review Layouts.
3. Place a review viewport in primary focus.
4. Click Viewport format.
5. Click a multiple image display icon:
2-on-1 horizontal
2-on-1 vertical
4-on 1
Single image
Typically, use this procedure after you have setup a review viewport for MID.
1. Open Exam Rx.

2. Click Review Layout.
3. Place the MID viewport in primary focus.
4. Click Viewport format.
5. Click the 1-on-1 display icon.
1024×2024 matrix
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Select exam/series/image
Use these procedure to select images for display.
Soft keys in ImageWorks

1. Open ImageWorks.
Click the next icon to display the next image, series, or exam in the browser.
Click the prior icon to display the previous image, series, or exam in the browser.
Hold down either arrow on the slider, and the images scroll to the end.
Click and drag the slider to scroll to the desired image.
Place the cursor in the Image field, select the text, and type a new number.
The order in which the images are displayed depends on how the examinations and images are
sorted in the browser.
List/Select in Exam Rx
1. Open Exam Rx.
2. Click the List/Select icon.
3. Select the desired exam, series and images.
4. Click Accept.
Select images using the keyboard

The Page Up and Page Down keys allow you to review the next and prior images in a viewport or viewports
from the Exam Rx or Image Works desktops.
Press Page Down and the effect is the same as the Image Next (+) button.
Press Page Up and the effect is the same as the Image Prior (-) button.
Select images using the Accelerator Line

The Accelerator Line allows you to review the next and prior images in a viewport or viewports from the
Exam Rx or ImageWorks desktops. A review viewport must be set to MID for Exam Rx.
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Type an image number, with no prefix, and the image displays in the upper-left viewport. For
example, type 1 and press Enter.
Type e and the exam number to recall a specific exam.
Type s and the series number to recall a specific series.
Type e# s# i# to view a specific exam, series and image. For example, e7854 s2 i47 displays exam
7854, series 2, image 47. Note that there is a space between each number. You can also skip the
prefixes and type 7854 2 47 to display the information.
Type ns for next series or ps for prior series.
Type ne for next exam or pe for prior exam.
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Set viewport preferences

Use this procedure to set the square viewport default.
1. Open ImageWorks.
3. On the User preferences screen, select a viewport option:
Choose Square viewports ON to view image in the Viewer exactly as they will appear on the film.
Choose Square viewports OFF to display the images not filling the entire viewport. If an image is
magnified, only part of it will be seen on the film.
exams viewed.
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Sort by exam/series/images
Use this procedure to arrange the contents of the patient list.
ImageWorks
1.
2. From the browser menu bar, select Sort.
Exam Rx
1.
From the display monitor, click the Exam Rx icon.
2.
Click the List/Select icon.
3. From the browser menu bar, select Sort.
ImageWorks and Exam Rx

1. From the Sort menu, select the desired sort option for the exam:
exam number
patient name
date
modality
archive status
PPS status
2. Select the desired sort option for the series:
series number
PPS status
3. Select the desired sort option for the images:
image number
location
echo (MR)
trigger (MR)
scan time
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Set tick mark preferences

Use this procedure to define the default tick mark display.
ImageWorks
1. Open ImageWorks.
3. On the User preferences screen, under the Tick Marks area, select:
Vertical to show side tick marks
Horizontal to show bottom tick marks
exams viewed.
Side =Vertical tick marks on. Bottom = Horizontal tick marks on
Accelerator Line
On the Accelerator Line, type for ImageWorks, ExamRx and GRx Retro Recon (not case sensitive) :
TMV ON or TMV OFF to turn on or off the vertical tick marks.

TMH ON or TMH OFF to turn on or off horizontal tick marks.
TM ON or TM OFF to turn on or off both horizontal and vertical tick marks.
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Set next/prior viewport settings

Use these procedures to define your image and series display preferences in Exam Rx.
Image display
1. Open Exam Rx.
3. Click Next/Prior Each Viewport to advance the image display one image at a time (middle example)
when you use the page up/down keys.
If this feature is not on, the next four images are displayed (right example).
Left = MID display; Middle = Next/ Prior Each Viewport on; Right = Next/Prior Each Viewport = off
Series display
1. Open Exam Rx.
3. Click Next/Prior Each Viewport.
4. Click Series Binding On or Off to advance to the next series when you reach the end of the previous
series while using the page up/down keys.
If this feature is not on, you are returned to the first image of the currently viewed series.
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Set W/L preset preferences

Use this procedure to set the W/L preset values. See the Adjust the W/L procedure for details on applying
W/L.
1. Open ImageWorks.
3. Adjust window width and window level.
4. On the User preferences screen, select Modality > CT, MR, or PT.
5. Place your cursor in one of the title fields, type in a new name and press Enter.
6. Click Set current to use the values on the active viewport.
Alternatively, you can type in new values for window/width and window/level.
7. Click Save as defaults to store these values.
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Adjust the W/L

Use one of the following methods to adjust the W/L to control the image brightness and contrast.
Accelerator Line
1. Place the cursor on any viewport.
2. To change the window width, type: ww 500 or any desired value.
3. To change the window level, type: wl 250 or any desired value.
Keyboard
2. Press and hold or rapidly press and release the up/down arrow keys to increase/decrease the
window level.
3. Press and hold or rapidly press and release the left/right arrow keys to decrease/increase the
window width.
Arrow keys
Function keys
The F5 - F11 Function keys are used to apply preset W/L values in ImageWorks, Exam Rx and Reformat. The
W/L values are defined from the Viewer User Prefs.
1. Press Shift and one of the following keys to program a preset W/L: F6, F7, F8, F9, F10, F11.
2. Press one of the following keys to activate the preset window: F6, F7, F8, F9, F10, F11.
3. Press F5 to reset the window level to the previous setting.
Function keys
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Mouse
2. To adjust window width only, middle-click and drag the mouse:
to the right to widen the window width (make the image gray).
to the left to narrow the window width (make the image more black and white).
3. To adjust the window level, middle-click and drag the mouse:

up to make the image dark.
down to make the image bright.
4. Middle-click and drag diagonally to change window width and level simultaneously.
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Cross reference images on a scout

Use this feature to view lines on the scout image representing previously scanned locations.
1. Open Exam Rx.
2.
3. Click Cross Reference.
4. Type in the series number to post on the scout.
5. Select one of the following:
Image Numbers to Post

All
First/Last
6. If you selected a range of images, type in the increment of the lines to be displayed.
7. Click OK to post the lines on the Scout view.
8. Click Erase to remove the cross reference lines.
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Chapter 13: Display applications
The following display applications can be used with images after they have been acquired in Scan.
Add/subtract
Add/subtract images
Bind series
Create images with min/max values

Acquire a scan
Exam Split
Neuro 3D Filter
Create Neuro 3D images
Considerations
Add/Subtract
Applications such as DentaScan and Add/Subtract can only load 1,000 images. Hi-light the desired
image range of 1,000 images by selecting the first image desired, hold the shift key down and hi-
light the last image desired then select the desired range.
Add/Subtract images are displayed in the series type column as either Proc or Comb.
Proc is the result of processing pairs of images that have identical locations in the patient’s body.
Proc series can be used like any other series of acquisition images, i.e., geometrical
measurements, reformatting, 3D reconstructions, etc.
Comb is the result of a combination of images having different locations in the patient’s body.
The absolute anatomical coordinates accompanying Comb series are not accurate and therefore
only relative geometrical measurements (i.e., distance, angle, or area) made within a resulting
image are accurate.
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Add/Subtract
Add/subtract images
Use this procedure to create a new image set, for example add thin slices together or subtract pre/post
contrast series. The resulting images are annotated with the day on which the addition/subtraction was
performed.
1. Open ImageWorks.
2. From the browser list of applications, click Add/Sub.
3. Select the desired images.
If only one set is selected, each operation performed produces one resulting image.
If two sets are selected, images in the two sets are paired according to physical location in the
patient’s body. Unpaired images in either set are ignored.
4. On the Image Combination screen, click Select Set on the left.
5. If you are adding/subtracting two sets of images, select the second set of images, and click Select
Set on the right.
By default, equal weighting is applied to the two pixels in each pair, but you can change the
weighting via the Ratio slider.
Drag the slider to the left to increase the pixel weighting of the images on the left Select Set
button. Drag the slider to the right to increase the pixel weighting of the images on the right
Select Set button.
6. Click + (addition) or - (subtraction).
7. For subtraction, click Accept Negative Pixels unless you want the negative pixel values set to 0 in the
resulting image.
8. Typically, use the system provided series number.
9. Click = (equal) to generate the images in the exam defined by the left Select Set button.
10. Optional: Click New Save Series to repeat the add/subtract procedure with a new series number
and description.
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Add/Subtract
Bind series
Use this procedure to combine images from different series to create a new series. The resulting images
are annotated with the day on which the addition/subtraction was performed.
1. Open ImageWorks.
4. On the Image Combination menu, click Select Set on the left side of the menu.
5. Click Select Set on the right side of the menu.
6. Click Bind.
7. Typically, use the system provided series number, or type a new series description and number in
the Save Series text field.
8. Click = (equal) to generate the images in the exam defined by the left Select Set button.
and description.
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Add/Subtract
Create images with min/max values
Use this procedure to create a new image using only the minimum or maximum CT numbers. The resulting
images are annotated with the day on which the addition/subtraction was performed.
1. Open ImageWorks.
4. On the Image Combination menu, click Select Set on the left side of the menu.
5. Click Min (minimum) or Max (maximum).
6. Typically, use the system provided series number.
7. Click = (equal).
and description.
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Use this procedure to manually prescribe batch protocols if you have not selected auto batch when setting
up a DMPR session.
1. Acquire a scan.
2. Select up to five DMPR protocols.
3. Verify that the button under Auto Batch is Off.
4. Select Filming, Auto Store, and Auto Transfer as needed.
5. When reconstruction of the DMPR model is complete, click the Start Direct DMPR Review icon.
6. Click BatchRx.
7. From the Direct DMPR BatchRx control panel, select a protocol from the Protocol menu.
If you use a protocol, it propagates the batch prescription to the viewport with the Slice
Thickness, Spacing Between Views, FOV, and Number of Slices programmed in the protocol.
8. To change viewports, click the viewport in which you want use to prescribe your reformats, and then
click Oblique.
9. Set the parameters for Thickness, Spacing Between Views, FOV, and Number of Views.
10. Prescribe the Reformat range. For details on manipulating the DMPR image, see Manipulate DMPR
images.
11. Click Preview and then Apply to review the reformat prescription.
Click Pause to pause the review.

Click Resume to continue the review.
Click Stop to end the review.
12. Click Save and then Apply to save the prescribed DMPR reformat series.
The following actions can be applied together with Save:

Click Film to film the DMPR Reformat series based on camera selection and setup in Session
Setup.
Click Store to automatically archive the reformat series to designated archive device.
Click Show to view the reformat images as they are being created in the review viewport in
the lower-right corner of the viewport.
Click Transfer to network reformat images to Host selected in Session Setup.
13. Repeat steps 7 to 12 to create additional batch reformats.

14. Click Back to exit Direct MPR BatchRx.
15. Click Quit to close the DMPR session.
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Use the DMPR Review Controller to interact with the DMPR model.
DMPR Review Controller
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Review controller procedures
No. Function Icon Procedure

Click to minimize the review controller around the
1 Minimize
image viewport.
Click to activate zoom and then click and drag to
2 Zoom magnify or minify images.This affects all images in the
series.
Click to activate pan/roam mode. Place the cursor on
3 Pan/Roam the image and click and drag it to a new location.This
affects all images in the series.
Click to return the image to the original display

4 Display normal
parameters.
Click the arrow to view menu and select a render mode:
Average (the default) ,displays the average

density values of the slice taken along lines
perpendicular to it.
5 Render Mode
MIP displays the maximum density value of the
slice taken along lines perpendicular to it.
Min IP display the minimum density value of the
slice taken along the lines perpendicular to it.
Click the arrow to display the menu and select a

6 Measurements
measure tool.
Click to screen save the image in the primary viewport

7 Screen Save
as a secondary capture.
8 Save Click to save the image as a RFMT type.
Cine Paging Click to activate paging and click and drag the slider to
9
Speed change the speed and direction of the images.
Displays images in a continuous loop, for example, 1 to

10 Loop
30, 1 to 30, 1 to 30, etc.
Displays images in a rocking or back and forth motion,

11 Rock
for example, 1 to 30, 30 to 1, 1 to 30, etc.
Click and drag (1) to scroll images within the series.

12 Scroll Click and drag (2) the slider to change the slice
thickness of the images being displayed.
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Exam Split
Use this procedures to split a series into separate groups that can then be used for multiple reads and
billing. Exam Split is only available if your system has ConnectPro.
1. Complete an exam where multiple Requested Procedure ID or Accession Numbers have been
selected.
All Patient records that you wish to split, must be selected from the Patient Schedule when you
selected New Patient. You cannot add procedures after the exam is ended.
2.
3. From the browser, click the exam you wish to split.
4. Select the series to split.
5. From the browser list of applications, click Exam Split.
The Exam Split menu appears with the selected images displayed in the upper viewports. The
system may display every image or skip some images depending on the total number of images
selected.
If the exam you selected does not have Multiple Procedures, a dialog message is posted and
Exam Split exits.
6. From the Exam Split screen, click first image, press Shift, and click the last image to select the
desired range of images to be grouped together per procedure code.
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Example of the first slice highlighted for Exam Split range selection procedure
7. From the Procedures list area, select the desired procedure from the available list, which reflects
the procedures selected from Patient Schedule.
8. From the Exam Split control panel, click Add.
Add desired images to the procedure.
9. Adjust the W/L as needed in the exam area of the display.
To adjust the W/L use either the W/L Presets on the Exam Split control panel or use the mouse.
10. From the Exam Split control panel, click Host Selection.
11. Select the receiving host and click Save.
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The left column reads GSPS if configured in VES mode and it reads HES if configured in HES mode
12. From the list of procedures on the Exam Split control panel, select the procedures you wish to send
to the host and click Send.
To select multiple procedures, simultaneously press Shift and click each procedure.
For systems configured for VES, send exams prior to splitting and it sends GSPS objects.
For systems configured as HES, images are sent after splitting and sends a new series.
13. Click Browser to exit from Exam Split.
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Neuro 3D Filter
Create Neuro 3D images
Use this procedure to create images with a Neuro 3D Filter, which removes noise from an image while
preserving image resolution. Neuro 3D Filter is optimized for thin slice data that is intended for post
processing in Reformat to create Average and MIP1 images, Volume Rendering and 3D models for
Neurological studies such as Circle of Willis, carotids, sinuses, orbits, mandible, and helical brain.
1.
2. Select the desired exam/series/images. The selected series:
must have at least three non-duplicate location images

must be less than 500 images
must be a single group or multiple groups if the following parameters are the same : slice
thickness, interval, tilt, SFOV, DFOV, scan type, rotation, speed, image center, and algorithm. The
groups must be contiguous.
3. From the browser list of applications, click Neuro 3D Filter.

4. Click Low, Med, or High.
5. Series are numbered in the browser as follows:
Low filter = series number plus 30 (for example, series 427 becomes 457).
Medium filter = series number plus 40 (for example, series 427 becomes 467).
High filter = series number plus 50 (for example, series 427 becomes 477).
The series description is "3D Filtered".
6. Click Go.
7.
Click the Close icon to close the screen when filtering is complete.
1Maximum Intensity Projections
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Chapter 14: Reformat

Use the Reformat software, located on the ImageWorks desktop, to display and manipulate Reformat data
sets.
Safety
This section reviews important information for the safe and effective use of Volume Viewer. You must
understand this information completely before using Volume Viewer.
Indications for use

Volume Viewer 3.1 is a medical diagnosis software that allows the processing, review, analysis, and
communication of 3D reconstructed images and their relationship with originally acquired images for CT,
MR, X-ray Angio, and PET scanning devices. The combination of acquired images, reconstructed images,
annotations, and measurements performed by the clinician are intended to provide to the referring
physician clinically relevant information for diagnosis, surgery, and treatment planning.
User profile
As with any medical imaging process, only qualified personnel should use this equipment. You must be
aware of the limitations of the basic imaging modality and of ensuing image processing. This includes
understanding the limitations of the initial series acquisition, image processing technology used, and image
display methods.
Requirements for Reformat

Certain requirements need to be met before you can perform reformat.
A valid image set for reformat must have the same:

Matrix size
Display center
Orientation
Four or more images must be selected before selecting Reformat.
Tilt acquisitions are not supported for right and left decubitus patient orientation.
You cannot have two images with identical locations.
Spacing must be less than 10 mm.
The image set can only include axial, sagittal, or coronal images.
Different Display Field Of Views and Gantry Tilts can be loaded, however you have to select between
different sources of images to view them. The source annotation is located in the upper-left corner
of the image. You can change between sources by clicking on the red annotation.
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Reformat
Open Reformat
Use the Reformat Image Controls
Use the keyboard shortcuts
Use the right-click functions
Display
Modify red annotation
Review Controller screen
Annotate an image
Save preset annotation
Measure
Manage color maps
Add an ROI
Set ROI preferences
View types
Create a Curved view
Create an X Section Histogram view
Create an MPVR (Multi Projection Volume Reformation) view
Create a Profile view
Volume Render
Attach/detach objects
Cut planes
Work with colors
Autofit
Create a multi-VR object
Modify the opacity ramp
Zoom in/out
Segment
Combine segmented objects
Paint on slices
Add/Remove anatomy with Auto Select
Remove floaters
Threshold an image
Batch Film
Set up a batch oblique
Batch film images
Save a curved parallel plane or rotating curve batch
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Considerations
Volume Viewer may hang due to an error dialog that is hidden. To avoid this situation, do not switch
desktops until you start to see the model build.
If a message is displayed indicating images are too far apart or failed to build a reformat model for
series with a large number of images, wait several seconds and launch Reformat again. When the
series has a large number of images, the system may not have identified how many images are in
the series before Reformat tries to start.
Reformat does not include the slice location for axial images. If axial slice location is needed,
generate the images in DMPR or do PMR or Retro Recon of the data.
If the W/L1 values selected from the pull down menu in reformat do not match your W/L Users
Prefs, follow these steps:
1. Open ImageWorks.
2. Click User Preferences.
3. Review saved values and correct them if necessary. See Set W/L preset preferences.
4. If this does not resolve the issue contact your service representative.
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Open Reformat
1.
From the display monitor, click the Image Works icon.
2. From the browser, select the desired exam/series/images to reformat.
To select a subset of images, click on the first image and simultaneously press and hold the Shift,
select the last image.
To select specific images click on the image numbers and simultaneously press and hold Ctrl.
3. From the browser list of applications, click Reformat.
An oblique, axial, sagittal, and coronal are displayed in the four viewports.
My Tools tab can be customized to display any display icons. Therefore, the instructions in this
chapter are for accessing a particular icon from the tab on which it originated. On your system,
the icon may be on your My Tools tab.
4. Change the view type by selecting a view type from the red annotation.
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Use the Reformat Image Controls

The Image Controls display when you start Reformat.
Image Controls area
Click a button in the top row to set the action of the left mouse button when placed over the image.
Changing the selection on the icon updates the on-view menu selection.
The buttons can be in one of three states:
Selected (depressed)
Unselected (light blue)
Unavailable (grey)
Rotate freehand or page images
1.
Click the Rotation/Paging icon to activate a freehand rotation or to page through images.
2. Click and drag to rotate 3D/Oblique views and page axial/sagittal/coronal views.
No rotation handle is displayed on 3D/oblique views when this mode is selected.
Zoom (magnify) images
1.
Click the Zoom icon to activate zoom mode.
2. Click and drag to zoom the image in or out.
Pan (roam) images
1.
Click the Pan icon to activate a roaming mode.
2. Click and drag the image to move it up and down and left and right (only applicable if the image has
been zoomed in).
Select objects
1.
Click the Selection icon to activate the selection mode.
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W/L images
1.
Click the W/L icon to activate the W/L mode.
2. Click and drag over an image to adjust the window width (left-right motion) or the window level (up-
down motion).
Change the image orientation
Click an Image Orientation icon to change the plane or a 3D or oblique reformat image.
S = Superior I = Interior
A = Anterior P = Posterior
L = Left R = Right
Activate the Oblique mode
The Multiple Oblique Mode button left) displays three oblique planes defined by three adjustable color axis
(orange, green, blue).
1. Adjust any axis to update the two other oblique planes.

2. Click again to de-activate the Multiple Oblique mode, which keeps the orientations defined in oblique
viewports.
The Single Oblique Mode button (right) displays a line cursor in Reformat, which is used to define a new
plane.
1. Set the function of one viewport to Oblique.

2. Make another viewport primary and then click the Single Oblique Mode button.
A solid yellow line appears, which represents the plane of the Oblique reformat.
3. Place the cursor on the solid yellow line and click and drag it to tilt the yellow line to the desired
plane.
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Use the keyboard shortcuts

Keyboard
Keyboard shortcuts
Indicator/key Description
Press F1 − F4 for manual filming with the Manual Film Composer.
Film keys Press Shift and F3 simultaneously or press F12 to place images on the
AutoFilm composer.
Press F5 − F11 for preset Window Width and Window Level.
Preset Window Width /
Window Level Keys These presets are equivalent to the presets that are in ImageWorks Viewer
and Mini-Viewer.
Page Up / Page Down Press these keys to scan through the images in a viewport.
Keys
Window Width / Window Press these keys to change the WW/WL settings for images in the Exam Rx
Level Control Keys and ImageWorks desktops. The Up/Down arrow keys increase/decrease
the window level, respectively. The Right/Left arrow keys
increase/decrease the window width, respectively.
Tab Key Press Tab to swap between image control modes.

Space Bar Press the Space Bar to show/hide the MyTools palette.
Ctrl Key + moving the
Press Ctrl and simultaneously move the mouse to page through the slices.
mouse
Press Shift and simultaneously click to place the cursor at the mouse
Shift + click
location.
Press Shift and simultaneously click and drag to draw a trace line as you
Shift + click and drag
move the mouse.
Alt Press Alt and click to edit a trace area.
Alt + s Press Alt and s simultaneously to save the image as you name it.
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Use the right-click functions

Place the cursor over the viewport and right-click to display the on-view menu. Move the cursor down the
menu until your choice is selected.
Not all choices are available under all conditions.
Right-click menu selections
Command Description
Save Image Select to save the image in the active viewport.
Select to save the image in the active viewport. You can enter a series name or
Save Image As
use the system supplied default.
Select to save images in all four viewports. If one of the viewports is a 3D image,
Save Screen then that image is saved to series type PJN. The other viewports (axial, sagittal,
coronal or oblique) are saved to series type REFMT.
Select to toggle between removing or displaying the red 3D crosshair cursor. As
Hide / Show 3D
the 3D cursor is moved on one viewport, the other viewports update to correlate
cursor
with the 3D cursor position.
Shading Parameters Select to modify how a 3D view with surface shading is rendered.
Select to remove all annotation from the viewed images, including user entered
Hide Annotations
annotation.
Select to remove only a select set of annotations from the viewed image. Returns
Show Less / All
all annotation back on the image. User entered annotation is not affected by this
Annotations
choice.
Select to remove or restore the reference image on the viewer.
Reference images show the:
intersection between one of the baseline images (axial, coronal, or sagittal)

and the slice plane displayed in the view
Reference Image / orientation of the current viewing direction with respect to the reference
Hide Reference image by an arrow on the 3D view
Image
Reference image orientation indicators:
keep track of the orientation of a slice plane or view direction with respect
to the patient's body
simplify the paging operation of all 2D views and the adjustment of
orientation of oblique reformatted views
Create Trace Select to create a trace on the image.
Clear Trace Select to remove the entire trace.
Clear Last Point Select to clear the last point entered on a trace.
Lock / Unlock Cursor Select to constrain the 3D cursor to move only along the trace. Unlock cursor
to Trace restores free movement to the 3D cursor.
Select to enlarge the current view to the entire viewing area. Reset Size returns
Enlarge / Reset Size
the view to normal size.
Lock Orientation Select to prevent rotation. Unlock orientation restores rotation ability.
Select to center the 3D model in the field of view (3D views only). Note this
Center on FOV
operation centers the entire model, even if parts of it are invisible on the screen
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Command Description
due to operations such as cutting, thresholding, removing, etc.
Select to center the object defined by the current 3D cursor position in the field of
Center on Object
view. This is the default selection (3D views only).
Center on Cursor Select to center a zoomed image on the current 3D cursor position.
Reset Pointer Select to center the 3D cursor in the 3D field of view.
Restore Volume Select to reverse the view to the originally loaded image.
Left Mouse: Determines the function of the left mouse button. These selections correspond to
Paging/Rotation the settings of the quick access image controls. Change the selection on the
Roaming menu and the corresponding icon also changes.
Selection
Opacity/WW-WL
Delete Changes the characteristics of user-entered annotation displayed on an image.
Normal Cursor must be directly on the annotation to view this menu.
Italic
Bold
Small
Large
Delete ROI Deletes or duplicates ROIs or changes the viewing of ROI statistics.
Delete all ROIs Cursor must be centered on an active ROI to view this menu.
Duplicate
Hide/Show Statistics
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Display
Modify red annotation
All Red annotations on the image indicate adjustable fields. Red Numerical values can also be adjusted with
left/right-click to decrease/increase values. Other red annotations can be modified selecting options from
drop down list.
Red (active) annotation
Red annotation descriptions
No. Annotation Description

Plane or View Type
Click and select from drop down menu to change the plane or select a 3D
1
model.
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No. Annotation Description

Middle-click and drag horizontally to scroll through the 2D images or left-
2 Image Location
click to increment and right-click to decrement an image at a time.
Middle-click the drag horizontally to real-time magnify the image or left-
3 DFOV
click to increment and right-click to decrement the mag factor.
4 Image Roam Click and move the image within the viewport.
Middle-click and drag horizontally to real-time change the slice thickness or
5 Slice Thickness left-click to increment and right-click to decrement the slice thickness (2D
images).
Middle-click and drag horizontally to real-time change the W/L or left click
Window Width and
6 to increment and right-click to decrement the W/L. Left click to select prede-
Window Level
fined WW/WL setting.
7 Patient Name Click and select from the menu to show or hide the patient name.
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Display
Review Controller screen
The Review Controller screen contains the following selections.
Review Controller functions
No. Options Description

1 Set Paging Direction/Speed Start paging at the selected speed in the selected direction. The
farther away from the center line the faster the speed.
2 Loop Cine Displays the views in a continuous forward mode. When the system
reaches the last view, it starts up again with the first one.
3 Back/Forth Cine Displays the images in a continuous forward to backward

movement. When the system reaches the last image it reverses
direction. When used on a VR model, the (Auto Rock) button
activates the Tumble mode for this model.
4 Report Pixel Displays the houndsfield measurements for one pixel value in the
lower right corner of the viewport.
5 Add ROIs Allows you to add ROIs.
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No. Options Description
6 Distance tool Opens the panel which allows you to measure straight or curved
lines. Displays the measurement and the statistics in the lower
right corner of the viewport.
7 Create Annotation Opens up the panel, which allows you to create predefined
annotations on the views.
8 Scalpel Opens up the panel, which allows you to define any kind of cut of
the view you may need.
9 Enlarge/4-on-1 Enlarges the current view so that it takes up the entire viewing area
or return the view to its normal size.
10 Hide controller Closes the controller.
11 Image scroll Click and drag from the center (1) of the Scroll icon to selected
image.
Press the Ctrl to link the Location slider to the mouse cursor. To
move within the slices by moving the mouse up and down.
Release the Ctrl to unlink the location Slider from the mouse cursor.
12 Slice thickness Click and drag the outer bars (2) to modify the Slice Thickness of the
images within the active viewport. Slice thickness adjustment is not
available on 3D views.
13 Next/Prior bookmark Click to scroll to the next or prior bookmarked image.

A bookmark leaves a red annotation on the image.
Click to move between ROIs and report cursors deposited using the
Insert key on the keyboard.
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Display
Annotate an image
Use this procedure to add specific and unique annotation to an image or apply a pre-set annotation that is
saved on your system.
1. Open Reformat.
2. Click the Display tab.
3.
Click the Annotation icon .
4. On the Annotation screen, click the annotation type (simple, linked or measure).
5. Place the cursor on the image and click to deposit the cursor and default text.
6. Enter new text in the Annotation text screen.
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Display
Save preset annotation
Use this procedure to add a custom pre-set annotation to the Preset Annotation list.
1. Open Reformat.
2. From the Display tab, click the Annotation icon.
3. On the Annotate screen, type text in the Annotation Text field.
The preset name automatically fills in with part of the text from the annotation text field.
4. Change the preset name.

5. Select the text.
6. Press Backspace.
7. Type in a new name.
8. Click Use for other anatomy if you want the annotation available for other anatomies or Use for
other protocol if you want the annotation available for other protocols.
9. Click Save as preset to add annotation to preset annotation list.
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Display
Measure
Use these procedures to activate a measure tool to obtain information, distances, and areas of anatomy or
pathology.
1. Open Reformat.
3. Follow one of the measure procedures below.
Measure distance
1.
Click the Measure Distance icon.
2. Make one selection for each menu choice.
Measure:
From Volume (3D): to view the true distance in the 3D volume. Endpoints can be positioned at
different depths in the volume. Rotate 3D volumes to check the exact position.
Projection (2D): to view the length of the projection. When used in 3D images, the
measurement will correspond to the projected red distance in the plane of the screen.
Display:
On one Viewport: to view the measurement on only one viewport.

On all Viewports: to place a measurement on different slices or volumes of a multi-phase
scan at the same time.
On one slice: to view the measurement on only one slice.
On all slices: to view the measurement on all slices.
Along:
Straight line: to deposit the first and second point.
Curve: to measure along a curve by depositing multiple points on the image. Validate the
curved line with a right click.
3. Position cursor for start of measurement and move cursor to end point of measurement and click.
Measure angle
1.
Click the Measure Angle icon.
2. Click and drag the squares to adjust the three points.
Measure area
1.
Click the Measure Area icon.
2. Click and drag the squares to adjust the points around the region of interest.
3. Right-click to display results.
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Measure volume
1.
Click the Measure Volume icon.
2. Segment an object of interest.
3. Click the viewport of the segmented object.
4. Click any of the corners to size the volume.
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Display
Manage color maps
Use this procedure to manage color maps on reformatted images.
1. Open Reformat.
3.
Click the colored ROI icon.
4. Click the image to deposit the ROI.
5. Click the color ramp displayed on the left side of the image to open the Color Table screen.
6. Click the Statistics tab to view range percentages for each color.
7. Change the values of the ROI on the viewport.
a. Click the Configuration tab to change the values of the ROI on the viewport.
b. Click a value in the Min Value column, and enter a new value.
c. Do the same for the Max Value and Range name.
8. Select a color.
a. Click a color in the Color column to view the Select new color screen.
b. Drag and drop the cursor on the color wheel.
c. Click Apply.
9. Click Add orRemove to change the viewed colors.
10. Click Presets tab to load and save Color map presets.
11. Click Save to save setting adjusted in the Configuration tab.
12. To load a color map preset, select the color ramp from the list.
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Display
Add an ROI
Use this procedure to add an ROI on an image to obtain information, volumes, areas, and statistics of
anatomy or pathology. The ROI allows you to:
measure the pixel intensity value at a specific point on the image

display the area or volume
display the mean, standard deviation, and minimum and maximum pixel values within the ROI
1. Open Reformat.
2. Click the Display tab to view the ROI selections.
ROI selections
3. Click the desired ROI tool.
3D color ROI is available 1 color MR or multi-color CT.
4. Set the ROI statistics, default size, and display location on the ROI preferences screen.
5. Click the desired anatomy to deposit an ROI and view the measurements at the bottom of the image.
6. Adjust the size by clicking and dragging on an ROI corner.
To delete the ROI, right-click on the ROI and select Delete.
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Display
Set ROI preferences
Use this procedure to set the type of information displayed in the viewports for an ROI.
1. Open Reformat.
2. From the Main Control screen, click More Tools.
3. Click Display to view the measurement tools.
4. Select the desired view on which you want to place the ROI.
5. Click the ROI icon on the Review Controller to view the ROI preferences screen.
6. For a 3D ROI, one of the following options.
Click One Volume to view the VOI on only the viewport on which the VOI is displayed.
Click All Volumes to view the VOI and statistics on all viewports.
7. Click one or more Statistics option buttons to view any combination of minimum, maximum, average,
standard deviation and area (2D) or volume (3D).
8. Type in the Vertical and Horizontal direction fields: (2D) or ROI height, width and depth (3D). The
sphere VOI does not have a depth entry.
9. To hide the ROI statistics, click on the edge of the ROI to make it active, then at the center of the ROI,
right-click on the center dot, and select Hide/Show statistics.
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Reformat view types

View Type Function
Displays the volume in 3D with different rendering. Default rendering is High
3D density MIP. Other modes are available from the rendering mode red anno-
tation.
Volume
Rendered Displays the volume in 3D color rendering.
(VR)
Axial An image plane representing a cross-sectional slice of anatomy.
Sagittal An image plane dividing the body into left and right portions.
An image plane through the body, dividing it into anterior and posterior por-
Coronal
tions (lengthwise).
An image plane that has been tilted through the body rather than following
Oblique
the long axis. It can look like a axial image.
Oblique
A 3D image plane created by defining points along an anatomical feature.
3D
Curved An image plane created by defining points along an anatomical feature.
Profile A graph showing CT number intensity across a location.
A graph showing the percentage of occurrence and numerical statistics of
Histogram each voxel intensity value in an object and total object volume. It also deter-
(3D data) mines boundaries around a class of similar voxel intensities and can highlight
pixel values. Statistics are not valid if used on 2D data.
A histogram (graph) showing the percentage of occurrence and numerical
statistics, and area calculations in a user-defined surface area on a refor-
X Section
matted slice. It also determines boundaries around the class of similar pixel
intensity values in this area.
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Reformat view types

Create a Curved view
Use this procedure to display a reformat of a curved, complex view of tortuous vessels or organs. The
curved view does not need to lie along a single orthogonal or oblique plane but can follow anatomical lines.
1. Open Reformat.
2. In one of the viewports, right-click on the view type active annotation and select Curved.
3. On an axial, sagittal, or coronal image, press and hold Shift as you deposit points along the anatomy.
4. As you trace, the curved image updates automatically in the curved reformat viewport.
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Reformat view types

Create an X Section Histogram view
A histogram graph shows the percentage of occurrence of each voxel value, either in a user-defined
surface area on a reformatted slice (cross-section histogram) or in the entire 3D object (volume histogram).
It also determines boundaries around the class of similar voxel intensities.
1. Open Reformat.
2. In one of the viewports, right-click on the view type active annotation and select Histo or X Section.
If you select a view type of histogram, you will immediately view a volume histogram which
includes the entire 3D model. No other action is required. Place the cursor on the voxel reference
line and hold Shift. The image displays the range of voxel class boundary lines by highlighting
them in green.
If you select a view type of X Section, the view will display Undefined histogram until you start to
define the trace.
Both the volume and cross-section histograms contain the same information with the exception
of the name and measurement units. Cross-section histograms show total area, while volume
histograms show the total volume for the entire object without cut planes.
3. For a cross-section (X Section) histogram, in the viewport containing the anatomy of interest, press
Shift and simultaneously click the image to deposit points on the area of interest to create a trace.
4. Click Exit.
5. Click OK.
The histogram values and statistics are those of the current 3D model, not those of the original exam.
If the 3D model contains only a given range of voxel values, only voxels within that range will appear in the
histograms. Statistics and computed values of surface area or volume displayed on the histograms are
subject to the same accuracy limitations as other on-view measurements. This tool can be used for cross-
section and volume measurements of specific anatomic features if the feature to be measured can be
clearly defined by a range (class) of voxel values.
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Reformat view types

Create an MPVR (Multi Projection Volume Reformation) view
This user defined thick slab reformatted image is often used to see vessels in CTA scans.
1. Open Reformat.
2. Click the red annotation in the upper-left corner of the viewport and select 3D or MIP render mode.
The selections available are dependent on the view type.
MIP is used most often in CTA models to demonstrate the most intense voxels.
3. Click the Oblique Mode icon.

4. Click and drag the yellow line on the image.
5. Place the cursor over the red thickness annotation do one the following options.
Type the desired thickness and press Enter.

Middle-click and drag to the desired thickness.
6. Click Exit and OK to finish.
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Create a Profile view
A profile graph shows the voxel value along a 3D trace (profile). This allows you to analyze the voxel value
distribution of a 3D object in various ways, as an aid in setting up 3D processing (e.g., thresholding).
1. Open Reformat.
2. Select the Profile Layout preset, if available.
3. In one of the viewports, right-click the view type active annotation and select Profile.
4. On an axial, sagittal, or coronal image, press and hold Shift as you deposit points along the
anatomy.
As you trace, the profile view displays the pixel intensity along the trace.
5. On the profile view:
The horizontal axis is the position in millimeters along the trace and the vertical axis is the pixel
intensity values as a function of that position.
Press Shift to display the pixel intensity from the location of the 3D cursor. Click and drag the
white line to move it, which in turn, moves the cursor on the image.
The mean and standard deviation are displayed on the bottom.
6. Click Exit and OK to return to the browser.
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Volume Render
The Render modes consist of Volume Rendering, HD MIP, MIP, Min IP, Ray Sum, and Integral.
Render mode functions
Mode Function
Volume Exists only if the model was built using volume mode and is used to display the surface
Rendering of a model.
Displays the model using the High Definition Maximum Intensity Projection mode. The
HD MIP mode is identical to the MIP mode as described below, except that image definition is
greater but the system speed is slower.
Weighted MIP Displays MIP rendering enhancing front voxels and fading voxels in the back.
Displays the model using the Maximum Intensity Projection mode. In this mode, the
MIP density of each point on the screen is the maximum density along a line perpendicular
to the screen.
Displays the model using the Minimum Intensity Pixel mode. In this mode, the density
Min IP of each point on the screen in the minimum density along a line perpendicular to the
screen.
Displays the model by summing the model’s intensity along lines perpendicular to the
Ray Sum
screen. This mode simulates conventional radiography images.
Displays only the surface of the model, but the density of each surface point is equal to
Integral
the sum of densities along a shallow depth below the displayed surface point.
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Volume Render
Attach/detach objects
1. Open Reformat.
2. With a VR image displayed, click the VR tab.
3. Click Advanced VR Settings.
Read the text on the tab for more information.
VR tab
4. Click a color to activate.
5.
Click the Attach Mode icon.
6.
Click Attach at the bottom, center of the VR Controls
screen.
7. Adjust the opacity of the colored voxels by clicking on the colored box at the top of the ramp and
drag up or down.
8. Attach another color by repeating the steps above.
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Volume Render
Cut planes
When structures of interest are hidden on a 3D or VR view, use cut planes to display them prominently.
1. Open Reformat.
2. Move the 3D cursor to the location of where you want the cut plane reference point.
3. On a reformatted image, right-click on the No cut red annotation and select a plane cutting the 3D
view.
4. Rotate the view to 3D view to display structures of interest in cut area.

5. Select Cut planes off to deactivate.
Bottom: Left Anterior Superior Cut selected on 3D VR View
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Volume Render
Work with colors
Use the following procedures to apply colors to your images.
1. Open Reformat.

Advanced VR Settings screen
Add colors
1. Place the 3D cursor on the anatomy of interest.
2. Click Add.
Assign a range of colors

1. Click the box next to the word Color.
2. In the Transition area, click Step.
3. Adjust the diamonds between the colors to the desired value.
Change a color
1. Click the box next to the word Color.
2. Click the arrow on the Colors button.
3. Select a color, or click More Colors to display the color wheel.
4. On the color wheel, drag the black circle in the color wheel to the desired color.
5. Click Done.
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Volume Render
Autofit
Use this procedure to refine the VR opacity in an image.
1. Open Reformat.
3. Click Basic VR Settings.
4. Place the 3D cursor on the anatomy of interest in any multiplanar view.
5. Click AutoFit.
6. Hold down the middle mouse button and move the mouse up and down to refine the VR opacity.
7. Click Save New VR Settings to save setting as a new VR preset.
Autofit on a vessel (top); Autofit on the trachea (bottom)
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Volume Render
Create a multi-VR object
You can merge multiple objects into a multiple VR model into a single view or model to perform more
complex VR views with multiple object segmentation and visualization.
1. Open Reformat.
2. Click the Segment tab.
Segment tab
3. Select Auto Select.
4. Select the button corresponding to the structure to add (Small Vessel / Structure / Bone) and click
Add.
5. Click Yes to clear the upper left viewport.
6. From any 2D view, click and hold the left mouse button on the object you want to add.
A green filter will fill the object while this object is being reconstructed in the upper left viewport.
7.
Set left mouse to Select mode .
8. Drag the VR viewport and drop it on the top left viewport of the isolated object where “Drop here to
merge view” appears.
9. Click the VR tab.
VR tab
10. Click Multi Objects.

11. On the Multi-object screen, roll over Object 1 and Object 2. The corresponding object appears in the
left window.
12. Select one object and adjust its transparency.
13. Click on the eye to hide or show the corresponding object on the active viewport.
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Volume Render
Modify the opacity ramp
1. Open Reformat.

Transparency portion of Advanced VR setting screen
4. Click and drag the solid white boxes left or right to independently modify the upper or lower range of
the ramp.
5. Click and drag the lower white box to the right to remove soft tissue or noise from an image.
6. Click the white box at the top and drag up or down to modify the overall opacity of the rang. This
affects the opacity of all visible voxels.
7. Click the solid blue box on the rang and drag left or right to change the upper and lower values
applied to the ramp.
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Volume Render
Zoom in/out
1. Open Reformat.
4. Click and drag the red box in the lower window (which represents the scale of voxel values
displayed) left or right to shift the display.
5.
Click the zoom icons the upper right corner to zoom in and out of the image.
Or, click on top-right button (zoom display), and then click and drag on the main VR Control
Display (a red mask will appear) to define a range of interest.
6. Right-mouse click to return to the original histogram range.
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Segment
Combine segmented objects
Use this procedure to combine 3D segmented objects together.
1. Open Reformat.
2. Select and view the images to be used for combining objects.
All objects must originate from the same master volume.
4. Perform segmentation to generate objects to combine using any segmentation technique (threshold,
Auto Select, paint, etc.).
5. Display objects to combine in separate views.
6. Set the mouse mode to Select mode.
7. Double-click to isolate first view of interest.
8. Single-click to isolate second view of interest.
Views of interest display red and green borders. Other views should not have color borders.
To adjust red and green borders, click the view to set red, the other view will turn green.
9. Select an operation (results of the operation display in the red views).

10. Click Advanced Processing.
Click the Subtraction icon to remove all the voxels in the primary view that also exist in
the secondary view.
Before subtracting, make sure the borders of the view are displayed as: Red - Green = Red.
Click the Intersection icon to keep only the voxels that exist in the same location in both
objects.
Click the Addition icon to keep all the voxels that exist in either of the objects.
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Segment
Paint on slices
Use this procedure to draw contours of the structure of interest on different slices. The volume to keep will
be interpolated based of the defined contours.
1. Open Reformat.
3.
Click the Paint on slices icon.
4. Move the 3D cursor to the edge of the feature of interest.
5. If desired, click Edge Attraction to automatically refine the drawn contours, adjusting them to
nearby structure edges.
6. Press Shift and click to deposit the cursor.
7. Release Shift and click and drag the 3D cursor to define the area.
8. Release the left-mouse button to connect last point to first point.
9. Move to the next slice on which you want to paint.
It is not necessary to define contours on every slice.
The contours interpolates to the intermediate slices.
10. Repeat the process until your reach the last slice containing the structure to contour.
11. Click Apply.
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Segment
Add/Remove anatomy with Auto Select
Use this procedure to automatically remove anatomy from reformatted images.
1. Open Reformat.
3. Click Auto Select.
4. Select a tool for segmenting.
Click Any structure for vessels greater than 5 mm or soft tissue. Click and hold until area of
interest is filled.
Click Small vessel (if available) for vessels less than 5 mm. Click once to fill and track vessel.
Click Bones (if available) to segment bones.
5. Click Add or Remove depending on the desired outcome.
6. Scroll through the axial images at minimum slice thickness.
If any vessels are contoured in green, put the cursor on the missing vessel in the 2D view and
click and hold until the area of interest is filled.
7. Repeat steps to complete all missing vessels.
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Segment
Remove floaters
Filter Floaters removes small residual objects in the 3D model that can appear after thresholding, usually
resulting from noise in the original image set.
1. Open Reformat.
2. Perform a segmentation.
4. Click the Advanced Processing icon.
5. Click the view of interest and click Filter Floaters.
6. Click Filter Size and select Small, Medium, Large, or Custom.
7. Click Apply.
Left = no filter; Right = filter applied
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Segment
Threshold an image
Use this procedure to threshold the image and keep only voxels within a specified range of value.
1. Open Reformat.
3. Click Threshold.
4. On the Threshold screen, select the desired image from which you want to threshold.
5. Adjust the range of voxel values using either the sliders or typing in a minimum and maximum value.
6. Click Apply Threshold to display only the part of the 3D volume with voxel values inside the set
range.
7. To further refine segmentation, select the object on the viewport and click:
Remove Object to remove all voxels connected to the object.

Keep Object to remove all objects not connected to the object.
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Batch Film
Set up a batch oblique
Use Batch Oblique to define a set of oblique planes adjusting settings (range, angle, position) from a grid on
a reference image.
1. Open Reformat.
2. Click Film/Save tab.
3. Click Batch.
4. On the Batch screen, click the view to be used as the reference image.
5. Click the Oblique tab to display a grid used to define the oblique planes.
6. Enter a value for the Number of Images, Spacing Between Images, Slice Thickness, Mode (Average,
MIP, MIN, VR), and FOV.
7. Select the desired output mode from the menu.
Choose Print to send generated images to default printer (setup the Format and the display of a
Reference Image).
Choose Save to save generated images in a new series in the Browser.
Choose Print/Save to film the generated images from a default printer and save them in a new
series.
Choose Filmer Images to drop all generated images into the Filmer (AW only).
Choose Filmer Movie to drop the generated images in the Filmer as a movie to be exported as
MPEG or AVI.
8. Click OK.
The Spacing between views and slice thickness can be set independently of each other creating a
gap, contiguous or overlapped images.
Oblique tool: 1 = add slice handle, 2 = tilt handle, 3 = move handle
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Batch Film
Batch film images
Use this procedure to set up a batch rotation of images to film/save.
1. Open Reformat.
2. Click the Film/Save tab.
3. Click Batch.
4. On the Batch screen, click Rotate.
360-degree rotating 3D images
1. Click the appropriate arrow to indicate rotation direction.

Rotation direction
2. Type in the number of images or angle between images in the appropriate field.
Modifying one of these parameters updates the other.
3. Type in the FOV.
Reference Image).
series.
MPEG or AVI.
5. Click OK.
Radial planes on 2D views
1. Adjust the center of radial slices (A), first radial plane location (B), and the number of radial planes (C)
on the 2D reference image.
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Radial prescription
2. Enter the Number of Images, Spacing between Images, Slice Thickness, Rendering Mode, and FOV.
Reference Image).
series.
MPEG or AVI.
4. Click OK.
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Batch Film
Save a curved parallel plane or rotating curve batch
Use this procedure to set up a Loop batch for a curved parallel plane or rotating curved batch.
1. Open Reformat.
2. Click the Film/Save tab.
3. Click Batch.
4. On the Batch screen, click Loop.
5. Prescribe one of the following.
For a curved parallel plane batch:
Scroll to the first image to be saved and click Set Start.
Scroll to the last image to be saved and click Set End.
For a rotating curved batch:
Adjust the angle of the first image from the red Angle annotation on the curved viewport and
click Set Start.
Set the angle of the last image and click Set End.
6. Enter the number of images to be saved.
7. Press Enter.
8. To save the new series, set Output to Save.
9. Click OK.
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Chapter 15: Film
Chapter 15: Film

The Film Composer is the interface with your camera that allows you to automatically or manually film
images. The available film formats are determined by your camera. This section presents the procedures
necessary to successfully film images.
Automatic filming
Set the AutoFilm parameters
Automatically film images
AutoFilm recon troubleshooting tips
Manual filming
Manually film images
Set the Print Series parameters
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Set the AutoFilm parameters
Film parameters
Use this procedure to set the parameters on the film output for AutoFilm. For AutoFilm details, see
Automatically film images.
1. From the ViewEdit screen Series Level Function area, click AutoFilm Setup.
2. Make selections for the following parameters:
camera or printer
film format
The format built in the protocol may be changed due to an invalid condition.
Always check the format in AutoFilm setup before you Confirm the scan to make sure you
have the desired format.
image exposure direction
image frame size
number of film copies
Auto Print parameters
film composer display
scoutview image
scoutview image with reference lines
exam and/or series information
grayscale
film Dose report
3. Click OK.
Image parameters
Use this procedure to set the parameters on the viewing screen for AutoFilm.
1. From the ViewEdit screen, click the AutoFilm tab card.

2. Click Autofilming ON.
3. Make selections for the following parameters:
frame format for each film space

image interval
image flip
window width and level
magnification
image rotation
add image annotation
image filters
grayscale enhancement
4. Click OK.
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Chapter 15: Film
Considerations
Keep AutoFilm backlog to a minimum. Start AutoFilm as soon as possible to keep up on filming.
Start AutoFilm
AutoFilm, selected from the Filming tab on the ViewEdit screen, must be turned On to launch the
auto film process.
If AutoStart is not selected from AutoFilm Setup screen, click Start New Sheet. Start New Sheet
applies the parameters that are defined in AutoFilm Setup.
Alternatively, click Continue Same Sheet, which does not use the parameters defined in AutoFilm
setup, but instead uses the film parameters from the last time Start New Sheet was used - this
could be from a previous patient.
AutoFilm may fail to film when the AutoFilm viewport selection shows active and the AutoFilm
status shows paused. Toggle Pause in the AutoFilm viewport and click Start New Sheet or Continue
Same Sheet to restart filming.
Pause AutoFilm
From the AutoFilm active screen, click Pause Filming.
From the AutoFilm screen, click Continue Same Sheet to restart filming.
Delete a series from AutoFilm

From the AutoFilm screen, click Cancel Film Series.
Delete an exam from AutoFilm

From the AutoFilm screen, click Cancel Film Exam.
Add an image to the AutoFilm composer

1. When AutoFilm is either paused or finished, place the mouse cursor on the image or MID to be
filmed.
2. Press F12 to place a single image into the AutoFilm composer.
3. Press Shift F3 simultaneously to place an MID into the AutoFilm composer.
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AutoFilm recon troubleshooting tips

AutoFilm may fail to display images in the following situations:
If there is a recon problem.

If images have failed to install in the database.
If a large exam has not reconstructed all images and scanning is started on a new exam.
The following dialog is posted if AutoFilm cannot display images:
Exam XXX
Series X
Cannot find XX images
Skip Missing images, Continue, Cancel Film Series
When this situation occurs, complete one of the following activities:
1. Click Skip Missing images to skip the images that AutoFilm cannot find. For example if AutoFilm
filmed images 1 to 10 and you then got the message that 10 images were missing and selected Skip
Missing Images, AutoFilm would then start filming again with image 21.
2. Click Continue to look for the images again. If they are not found, the dialog is posted again. Before
selecting Continue verify:
recon is active
the images have been reconstructed
the images are able to be displayed
the missing images are not suspended or paused in the Recon Queue
If the images are suspended or paused in the recon queue, then restart recon before selecting
Continue.
3. Select Cancel Film Series to cancel AutoFilm for the series currently being automatically filmed.
Manually film the images. If you get this dialog because you have begun an exam while the previous
exam still has images to reconstruct, then select Continue, Pause AutoFilm, resume AutoFilm after
the exam, series, images from the previous exam have reconstructed.
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Chapter 15: Film
Manually film images
Considerations
If the composer is closed by selecting iconify icon in the upper right corner of the composer, it may
open when Confirm is selected for scanning.
It is best to resolve any paused queue entry as soon as possible.
Exam Rx
1. Exam Rx is open. Double click in one of the lower viewports.
2. From the display monitor, click List Select.
3. Select an Exam, Series and Image.
4. Click Accept.
5. Click Manual Film Composer.
ImageWorks
1.
2. From the browser patient list, select the desired images.
3. From the browser list of applications, click Viewer or Mini viewer.
4. Click a viewport to make it primary.
5. From the Viewer or Mini Viewer control panel, click Film Composer.
ImageWorks or Exam Rx
1. From the Manual Film Composer screen, complete the following:
a. Click a Format icon.

b. From the Options screen, click Options and enter a value for No. of copies. Select other options if
needed. Click Done.
2. Place the cursor over the image you want to film and use one of the following film methods:
Drag and drop the image to the desired film frame.

Film single image: press F1 and the currently active image is placed in the next available film
frame.
If the F1 key is used to film the Text Page ROI, Exam Text Page or Series Text Page, the text
pages are filmed to the film composer frame last selected in the text page pop-up. Use the
filming selections in the text page screens to film the information displayed.
Film page: start from an empty Film Composer. Set the image display to the desired format and
press F2. The Film Composer format changes to match the currently displayed format and places
all the images into the Film Composer.
Film multiple image display (MID): set the image display format to the number of views you want
displayed within each film frame and press F3. The next available film frame displays multiple
images - the number of images is based on the display format.
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Full Annotation instead of partial annotation is filmed when using F3 in ImageWorks desk top
even though full annotation is selected.
Film Series: press F4. From the Print Series screen, select Print Series Parameters and click Print
Series. It is not necessary to click Print and Clear to progress to the next screen.
Run Print Series from only one desktop at a time.
To cancel a Print Series request, press F4 and click Cancel All from Current Print Job screen.
3. When the Film Composer screen is ready for print, click Print.
4. To clear the Film Composer frames so that you can film a new set of images, click Clear and OK to
the message prompt.
Auto Print, Auto Clear and film direction can be set up from the Print Options screen.
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Chapter 15: Film
Set the Print Series parameters

Any portion of a series may be filmed using the Print Series (F4) key. This is a great time saving feature if,
for example, films are lost, duplicate copies are needed, or if auto filming was not utilized. All images need
to be filmed in the same window width and level. If multiple window widths and levels are needed (i.e., soft
tissue and bone) the Print Series can be used for each window width and level.
1. On the display monitor, click in one of the lower viewports.

2. Click List Select.
3. Select an exam, series, and image.
4. Click the Manual Film Composer icon.
5. Place the cursor in the image/series to be used for Print Series.
6. Press F4.
7. Set the Print Series parameters.
8. Click Print Series.
To cancel a Print Series request, press F4 and click Cancel from the Current Print Job.
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Chapter 16: Image Management

The ImageWorks desktop allows you to manage your acquired images. This section contains information
on image saving, restoring, deleting, and networking. It also includes procedures on making an anonymous
patient and editing patient data.
Archive
Set an archive node
Select an archive device
Save images to a remote archive host
Pause/resume the queue
Work-arounds
Remove
Remove exam/series/images from system
Network
Set up a remote host
Send images
Retrieve images
Access the local host and perform a custom search
Check network history file
CD/DVD Interchange
Save images to a CD/DVD
Restore images from a CD/DVD
View images on a PC or laptop
Data Export
Compose a report
Export a report
View a report on a PC
Delete items
Patient Data
Set the anonymize patient annotation level
Make a patient anonymous
Edit patient data
Install a SMPTE pattern
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Archive
Set an archive node
The archive save feature allows you to save large amounts of image data to a remote archive hosts. When
saving image data, the system makes a copy of the image data and does not remove the image data from
the main system disk. The ability to save images depends on the archive device type and the initial source of
the images.
Use this procedure to set a remote host archive node.
1.
2. From browser menu bar, select Network > Select Remote Host.
3. From the Remote Host Selection screen, select a host and click Update.
4. From the Remote Host Parameters screen, Archive Node area, click Auto > Yes or No.
A device that is used as an archive device must exist on the remote host list and be set up as an
archive node.
The system checks if the device is a Storage Commitment Provider. At system start up, a check is
done to assure that devices designated as a Storage Commitment device are sending a storage
commitment response. If no response is received, the Archive node setting is disabled.
Yes means that the device is responsible for archiving the images. When the remote device has
received and saved the images, a Y appears in the browser Archive column.
No means that the remote device is not an archive station.
5. Click Save.
6. On the Remote Host Selection screen, click OK to exit.
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Archive
Select an archive device
1.
2. From the browser menu bar, select Archive > Selected Archive Device.
3. From the Archive Device Selection screen select the following:
A device that is used as an archive device must exist on the remote host list and be set up as an
archive node.
A device from the active list. To make your selection the default device, click Set Default Device.
4. Click OK.
If Storage Commit has a large number of failures, the system may shutdown. Confirm that the PACS1
system is receiving images and negotiation for setting of the archive flag is successful.
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Archive
Save images to a remote archive host
Use this procedure to save exam, series, or images to a remote archive host.
1.
2. From the browser, select the exams, series, or images to be saved to a remote archive host.
3. From the browser menu bar, select Archive and then select the level at which you want to save:
Save examination, Save series, or Save images.
4. Click Ok to the confirmation prompt.
The exam is automatically placed in the archive queue and transferred to the selected archive
device.
The archive status in the Feature Status area is updated continuously during the archive process.
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Archive/Network/Film
Use this procedure to pause or resume the Archive, Network, or Film queue.
1.
2. From the browser menu bar, click Queue.
3. From the Queue menu, select the desired queue: Archive, Network or Filming.
When 200 or more entries are in the network queue, the list is slow to access.
4. From the Queue screen, select the desired exam, series, or images.
5. Select one of the following:
Pause to place the selected items in the list into a paused state.
Pause All to place all items in the list into a paused state.
Resume to initiate the job of the highlighted items in the list.
Resume All to initiate the jobs of all items in the list.
Clear to delete highlighted items from the list.
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Archive
Work-arounds
When archiving images, consider the following and use the work-arounds as necessary.
Images archived on an Advantage Windows system may fail to restore on the system. Use Network
to transfer images from the Advantage Windows to the system.
The feature status area or the browser may report an Exam has saved even though all images have
not been saved to a remote archive devise. Scroll through the images in the image window. Select
the images listed as Archive N and re-save them.
It is best to resolve any paused queue entry as soon as possible.
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Remove
Remove exam/series/images from system
It is recommended that you remove images when image space falls below 10,000 images. This ensures
there is room on the system disk to confirm scans and to install reconstructed images. Image space is
indicated in the status area.
1.
2. From the feature status area, confirm that scan and recon are idle.
Do not remove images while scanning, reconstructing, restoring or receiving images.

Removing images while the system is adding images to the data base may result in the following:
A system lock up, which may require a reboot. It may also result in a data base reset.
Image install timeouts that can then cause recon to shutdown and can cause the browser to
fail to respond.
A blank list in the browser.
The system should not be shutdown until the image space has been updated fully from the
remove.
The length of time to synchronize the database is proportional to the number of images being
removed. This guarantees that all images are reconstructed, displayed and installed into the
database without error and that image space is updated correctly.
3. From the browser, select the exams/series/images you wish to remove.
Confirm that the Archive column displays Y indicating that the images have been archived.
Simultaneously press Ctrl and click the desired exam/series/images to select a non-contiguous
list.
4. From the browser menu bar, select Remove.

5. From the Remove menu, select the remove level: exam, series, or image.
6. Click OK.
7. Click Yes.
On occasion, some images cannot be removed even though they are not locked for archive, network,
DMPR, AutoFilm, or displayed in a viewport. These files are unlocked after the next system reboot. Before
you remove images. Make sure the images are not in the archive or network queue. Check the AutoFilm
viewport to make sure there are no images waiting to be filmed. Use the command blank to remove an
image from a viewport.
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Network
Set up a remote host
Have the network IP address of the remote host readily available. Typically your site’s network
administrator has the IP information.
1.
2. From the browser tool bar, select Network > Select Remote Host.
3. From the Remote Host Selection screen, click Add.
4. From the Remote Host Parameters screen, enter the following information:
Host name - if the device is DICOM1, the name must match exactly to the name given to the
device. The Host name cannot contain the "%" symbol.
Network Address - contact your site’s Network Administrator.
Network Protocol - If the system is sending to this device, the device must be able to receive
DICOM images and the DICOM network protocol must be selected. PC based systems only allow
DICOM network protocol.
Port number - only required when using a DICOM protocol.Enter Port number 4006 for the
HiSpeed CT/i, ZX/i, LX/i, FX/i, DX/i, Advantage Windows. If you are adding a 3rd party workstation
or PACS system, your site’s Network Administrator can provide you with the port number.
AE Title - if the device is an Advantage Windows workstation or another GE Healthcare system,
the AE Title is the same as the Host name.
Comments - use as needed.
5. Click Save.
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Network
Send images
Use this procedure to quickly transfer images between your scanner, remote workstations, and other
image acquisition systems.
Some third party workstations may fail to receive scout images if the matrix size is greater than 512.
These stations do not support receiving matrix sizes greater than 512. If it is desired to have the scout
image on the workstation, Screen Save the scout and then transfer the screen save image to the
workstation.
1.
2. From the browser menu bar, select Network > Select a remote host.
3. From the Remote Host Selection screen, select the host and click OK.
4. Optional: From the browser menu bar, select Network > Ping DICOM host to confirm that the
remote host can receive images.
A prompt appears indicating that either the remote host is alive or there is a connection error.
Click OK to the confirmation prompt.
5. From the browser, select exam/series/images you want to send.
6. Select Network and the level at which you want to send: Send examination, Send series, Send
image.
7. Click OK on the confirmation prompt.
8. The network status in the Feature Status area is updated continuously during the transfer process.
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Network
Retrieve images
1.
2. From the browser menu bar, select Network > Select a remote host.
3. From the Remote Host Selection screen, select the host and click OK.
4. From the browser menu bar, select Network > Receive.
5. From the remote host's browser, select Search > Change Search Parameters.
6. From the Search parameters on a remote host screen, enter text to apply filters as needed and click
OK.
7. From the remote host's browser, select the exams, series, images you want to retrieve.
8. Click Get and the level at which you want to retrieve: Get examination, Get series, Get image.
9. Click OK on the confirmation prompt.
10. The network status in the Feature Status area is updated continuously during the transfer process.
11. From the remote browser menu bar, select Applications > Quit.
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Network
Access the local host and perform a custom search
Networks link image acquisition systems and workstations together, providing a way to quickly and easily
transfer images between your scanner, remote workstations, and other image acquisition systems. You
may view images supported by your scanner from any station, or view images from other stations
networked to your scanner.
Use this procedure to access the local host to send, query, or receive images and to perform a custom
search.
1.
2. From the browser menu bar, select Network > Select Remote Host.
3. From the Remote Host Selection screen, click Update.
4. From the Remote Host Parameters screen, in the Access to Local Host area:
Click Yes to allow your system to send, query or receive images.

Click No to lock out other systems from being able to send, query, or receive images from your
system.
5. From the Remote Host Parameters screen, in the Custom search? area, do one of the following.
Click On and when you select Network > Receive from the browser menu bar, a Search
Parameters window displays from which you can enter search parameters.
Click Off and the browser from the selected remote host displays.
6. Click Save to save all changes to the Remote Host Parameters screen.
7. Click OK.
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Network
Check network history file
1.
2. From the browser menu bar, select Network > Network History.
3. From the Network History Log screen, scroll through the file log to find the exam number of the
network history you wish to see.
Entries are listed how the job was queued for transfer. If by Exam, then only the exam number is
listed. If by Series, then the exam and series are listed. If by Image, then the exam, series, and
image are listed.
4. Type a specific exam/series/image number into the field.

5. Click Search.
The history file for all matches to the exam/series/images you typed displays.
6. Click End Search to go back to the first screen and execute another search or click Quit.
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CD/DVD Interchange
Save images to a CD/DVD
Use the CD/DVD interchange to save images on a CD-R or DVD-R in a DICOM format. A DICOM viewer is
stored on the media so the images can be viewed on a PC with Internet Explorer 6.0 or higher.
Considerations
Do not save images to CD-R1 or DVD-R2 while scanning. This may cause interscan delays to be
missed.
Saving to CD 3/DVD 4 while running FastCal can cause the browser to become blank, resulting in the
system having to rebuild the database.
CD/DVD cannot be selected as the default archive device.
Exam, series, or images will not be marked as archived.
Approximately 7,000 images can be stored to a 4.7 GB DVD-R.
1. Load a compatible CD/DVD into the DVD-RW drive.
Only CD-R or DVD-R media can be used. CD-R write speed should be at least 4X and a storage
size of 700 MB.
2.
3. From the browser list of applications, click CD/DVD.
4. From the browser, select the exams, series, or images to be saved to the CD/DVD.
5. From the CD/DVD Composer screen, select one of the following:
Select Add Exam to add all selected exams.

Select Add Series to add all series selected within an exam.
Select Clear to delete selections and start again.
6. Click Copy and Yes to the confirmation prompt.
Do not begin recording until all desired series have been added to the list. You cannot record
more data to the CD-R or DVD-R once you have started the recording process.
The message/progress bar displays messages and a progress bar that displays 100% when
recording is completed.
Error prompts may appear if the media is damaged, if the media is not blank, the files are too
large for a single media, etc.
Click OK to the Copy Completed Success prompt, which is not seen if you close CD/DVD screen
before save is completed.
1Compact Disc-Recordable
2Digital Versatile Disc-Recordable
3Compact Disc
4Digital Versatile Disc
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7. Click Quit to close the interface or leave the menu open to monitor the progress bar.
If you quit, the system continues to burn data to the CD/DVD in the background.
To redisplay the CD/DVD interface, click CD/DVD.
Stop is the only button that stops burning data.
8. If the CD does not automatically eject once the CD/DVD burn is completed, click CD/DVD and then
click Eject from the CD/DVD Composer screen.
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CD/DVD Interchange
Restore images from a CD/DVD
Use this procedure to restore exam/series/images from a CD/DVD to your system.
1. Place a CD/DVD into the DVD-RW drive.

Wait until the CD/DVD drive light turns off, which is an indication that the CD-R or DVD-R is
spinning up to speed.
The DVD-RW is housed in the media tower with the DVD-RAM that sits on the console.
2.
3. From the browser list of applications, click CD/DVD.
4. From the CD/DVD Composer screen, click Restore.
5. From the Restore screen, select exams, series, or images to be restored.
6. Click Local Disk and Yes to the transfer selected items.
A progress bar indicates the data transfer.

Click Stop to stop the restore process at any time while the system is restoring data. Any images
already transferred will be located on the hard drive. If you repeat steps 1 to 6, the system only
restores images that have not yet been transferred.
7. Click OK to the Restore Completed Success prompt. This prompt is not seen if you close the Restore
screen before completion.
8. Click Quit.
9. Click Eject from the CD/DVD Composer to remove the media from the drive.
10. Click Quit to close the CD/DVD Composer.
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CD/DVD Interchange
View images on a PC or laptop
The CD Viewer is automatically loaded onto a CD-R or DVD-R at is burned from the CD/DVD program. Use
these steps to view images from a CD/DVD inserted in your PC or laptop.
1. Load a recorded CD-R or DVD-R into the drive of your PC or laptop running Internet Explorer 6.0 or
higher.
The CD Viewer automatically launches.
2. Click I Agree to the Disclaimer of Warranties, Limitations of Liabilities prompt and OK to any
prompts.
3. Click the ? icon in the upper-right corner of the CD Viewer screen for details on image manipulation
instructions.
CD Viewer fails to launch on IE1 6.0 or higher

Use these steps to launch CD Viewer if it does not auto launch.
1. From Internet Explorer menu bar, click Tools > Internet Options.

2. Click Advanced tab.
3. From the Advanced tab, scroll to security settings.
4. Click the option box: Allow active content from CDs to run on My Computer.
5. If the CD still does not run, from your PC, click Start > Run.
6. Enter the command: e:\autorun.exe.
"e" represents the CD or DVD drive.
IE launches but posts error messages

If this error message, "This page requires scripting support. Please obtain IE 6.0 or higher or enable
scripting" then follow these steps.
1. Execute the steps 1 to 4 above.

2. A message displays at the top of the browser: To help protect your security, Internet Explorer has
restricted this file from showing active content that could access your computer. Click here for
options.
3. Click the message and then click Allow Blocked Content.
4. Click Yes to the subsequent pop-up confirmation messages.
5. If this error message, "Active content can harm your computer or disclose personal information. Are
you sure you want to allows CDs to run active content on your computer?" Click OK.
1Internet Explorer
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Data Export
Compose a report
1.
2. From the browser, select the series you want to export.
Only one series can be exported at a time.
3. From the browser list of applications, click Data Export.

Click Compose if it is not selected.
4. Review the images in the Compose image viewport.

Middle-click and drag to adjust the W/L1.
Right-click and drag to adjust zoom factor.
Click and drag to scroll.
Press Page Up or Page Down to navigate through the images.
Click Play to view the images in a cine loop.
5. Click the Conversion Format menu and select an image format for the currently selected data set
that is compatible with the movie player on your PC or laptop.
6. In the Image Range Selection area, choose your desired image range.
If you want a subset of the images, select Custom, and then type the range in the text box.
7. Move the Compression Factor slider to select a value.

The smaller the number, the higher the image quality and the larger the file size.
8. In the Annotation area, choose your desired annotation display format.

If you want the patient name to be displayed as Anonymous with the exam number, select
Anonymous.
9. Once you are satisfied with the image appearance (W/L, zoom, scroll), select Propagate Image
Operations.
10. Type a name for both the report and the folder (use no spaces or characters other than alpha
numeric).
11. Click Add to Report.
If you change your mind and decide not to add the data to the report, click Cancel from the
progress bar screen.
12. To add another data set to the report, repeat these steps.
13. Click the Export tab to export the report (for details see the Export a report procedure) or click Quit
to exit the Data Export application.
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Data Export
Export a report
This procedure assumes that you have composed a report in Data Export. If not, first complete the steps in
the Compose a report procedure.
1.
2. From the Patient List area, select the series you want to export. Only one series can be exported at a
time.
3. From browser list of applications, click Data Export.
4. Click the Export tab to open the Data Export Export screen.
5. In the Export Report Name list, select the desired report.
6. In the Folder Name, Type Name, and Image Name lists, select the desired data set.
7. Optional: Type a message in the Comment text field. Do not press Enter, the system will adjust the
text for the final report.
8. Choose a Conversion format, typically HTML.
9. Create a CD, if desired.
a. To burn the report to a CD, place a compatible CD-R into the DVD-RW drive.
This is not the drive housed in the computer cabinet but rather the box that houses the MOD
and CD/DVD drives located on the desk.
The only compatible media for Data Export is CD-R 700 MB with at least 4X write speed. DVD-
R is not supported. If a DVD-R is placed in the drive, the system will write to this media, but the
integrity of the data cannot be guaranteed and the time for the system to recognize the media
will be excessive.
b. Click Create CD.
Carefully seat the media in the drive. Wait until the drive has sensed the media and the drive
light goes off before clicking Create CD. If you click Create CD too quickly a "no media in the
drive" message displays.
c. Click OK to start the writing process.
A message displays while the CD is written. When the CD writing step is completed, the CD
ejects from the drive.
d. Click OK to the CD Written Successful prompt.

10. FTP the data, if desired.
a. Click Send FTP to send the data to an IP address.

b. Complete all the fields on the FTP window and click OK.
c. Click OK to the Successful File transfer prompt.
11. Click Quit.

Reports stay listed in the Export tab until you remove them.
Consider the length of time you need to keep the file in the program based on if you need to,
more than once, burn another CD or FTP the report again.
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Data Export
View a report on a PC
1. Place the CD in the CD drive of a PC or laptop running Windows 2000 or XP.
2. The CD launches automatically.
If it does not automatically start, click on the My Computer icon and open your CD or USB drive.
Click INDEX to open the file.
The report opens and displays from an Internet browser.
Use the scroll bar to view images.
Place the cursor over an image and click to magnify the image. Click the Back arrow on menu
bar to return to the report.
3. When finished viewing the report, select File > Close to close the Internet browser.
4. Remove the CD from the drive and store it.
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Data Export
Delete items
1. From the Data Export screen, click the Export tab.
2. From the Export tab, select an item on any of the lists (Report, Folder, Type, or Image).
3.
Click the Delete icon.
Items not deleted/removed remain on the list after you click Quit.
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Patient Data
Make a patient anonymous
Use this procedure to remove certain exam information and replace it anonymous information. An
Anonymous Patient can be created by exam, series, or image. To set the annotation level to Full or Partial,
see the Set the anonymize patient annotation level procedure.
1.
2. From the browser, select a patient's exam/series/images you want to be anonymous.
If Anonymous Patient is required for series that are still active in AutoFilm, wait until AutoFilm is
complete for the series before proceeding with Anonymous Patient.
3. From the Feature Status area, confirm that there is enough disk space to create an anonymous
exam. This is not done automatically by the application.
4. Make sure there is plenty of disk space before creating an anonymous patient exam.
5. From the browser menu bar, select Utilities.
6. From the Utilities menu, select the desired anonymous level: exam, series, or image.
7. Click OK.
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Patient Data
Edit patient data
Use this procedure to correct improperly entered patient information or add information that was
previously unavailable at the time the patient data was entered into the system.
Considerations
Use Edit Patient during idle times in network receive, active recon, or archive restore. The system
may hang if Edit Patient is started while the following operations are in progress:
Network Receive
Prospective or Retrospective reconstruction
Archive Restore
Film
You cannot edit contrast or patient weight.
Edit Patient will not update scan data files or completed patient information.
If you edit an exam that has a saved 3D model, the 3D model is deleted from the exam. If you edit an
exam and you have the 3D model selected when you select Edit Patient, you will not be able to edit
the exam.
There must be sufficient disk space available.
All images and post-processing (screen saves, reformat, 3D surface) should be done before editing.
All images created after the edit do NOT contain the edited information.
1.
2. From browser, select the exam to be edited.
Only one exam number can be selected.

The exam must be closed or ended.
Exams can be edited multiple times.

You can only edit exams that were created on your system.
Edit Patient is not accessible if the exam you want to edit is currently in use. An exam is currently
in use if New Patient, Network/Archive/Film queues, Save, 3D, Reformat, Denta Scan, Navigator,
Exam Rx viewport, AutoFilm queue, Viewer, or Mini Viewer is active. An error message displays.
To create a blank viewport in Exam Rx, select the viewport and type and Enter "blank" in the
Accelerator Line.
3. From the browser list of applications, click Edit Patient.
4. From the Edit Patient Application screen, click Edit Patient Data.
5. Read the cautions and then, click Accept to continue or cancel to exit.
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Edit Patient Data warning
Edit Patient Data additional reminders
6. From the Edit Patient Data screen, complete text fields.
Click the text you want to change and type new text.
To reset the values to the original text, click Reset All Values or Reset Selected Values and then
enter new text.
You must enter your name or initials (a minimum of three characters) in the Edited by text field.
The Exam Number text box is the ONLY field displayed that CANNOT be edited.
Edit Patient is not accessible if the exam you want to edit is currently in use.
7. Click Accept when you are satisfied with the changes.

8. Click Accept to the confirmation prompt.
A percentage countdown menu displays until the Edit Patient feature is closed and the Patient
Information Edit Log is updated.
It takes approximately one minute and 45 seconds to update a 100 image exam.
The original exam is replaced with the edited exam and is indicated by “e+1” in the description
field in the browser. The number indicates how many times the exam has been edited.
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Optima™ CT660
Patient Data
Install a SMPTE pattern
Use this procedure to install a SMPTE pattern to view BRH or quality assurance images. Once installed the
images are in exam 1000, which can be selected from the ImageWorks browser or List Select in Exam Rx.
The patient Name is listed as SMPTE.
1.
Click the Service icon.
2. Click Image Quality.
3. Click Install SMPTE Image.
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Chapter 17: Protocols

A protocol is a series of pre-programmed scan parameters used for imaging a particular part of the body.
Modifying a protocol allows you to make changes to existing protocols. You can make the modifications
without modifying the original or create a whole new protocol using an existing protocol as a base.
There are four protocol selections to build and use protocols.
GE: location for a set of predefined protocols, which can be copied and used but not modified.
User: location where a site can build their own set of protocols.
Service: location for protocols used by a service representative.
Most Recent: location where a copy of the last 90 protocols reside exactly as they were used.
User protocols can be built in either adult or pediatric models. There is space for 90 protocols in each of the
10 anatomical regions for adult protocols and 90 protocols for each color area of the pediatric protocols.
There are nine different weight classifications in each of the seven color areas, plus three additional areas
for you to build pediatric protocols. You have a total of 6,840 available user selected protocols to build.
Protocols
Build or edit a protocol
Set protocol as default
Copy and paste a protocol
Add an ECG Trace to a protocol
Delete a protocol
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Optima™ CT660
Build or edit a protocol

Use this procedure to complete a new protocol or change the established user protocols on the system.
If when you select a protocol, it displays the message, ”Can’t read selected protocol, please choose
another protocol, ” then the protocol is corrupt. Delete the protocol and rebuild it.
Consideration
Copy orientation and patient position is a feature that adjusts the patient orientation and position
based on the prior series. For example, if the patient orientation and position is supine feet first, and
the scout for the patient you are currently scanning, is prone, feet first, after the scout is acquired
and next series is selected, the orientation and position values set in the protocol are automatically
changed to the scout values.
Copy forward is a feature that allows you to duplicate the following scan parameters to recon 2 and
3 or the next series:
Start/End
Interval
Tilt
DFOV
R/L and A/P centers
To activate copy forward, type "d" or "D" in the parameter text field.
1.
From the Scan monitor, click the Protocol Management icon.
2. On the Auto Voice and Protocol Management screen, click Protocol Management.
3. On the Protocol Selection screen, click User.
If you wish to create or edit pediatric protocols, click Pediatric.
There is space for 90 protocols in each of the Adult anatomical areas.
For the color coded Pediatric anatomical areas, there is space for 90 protocols in each of the
different weight classifications. The Head, Orbit, and Miscellaneous are not color coded.
There is a total of 6,840 available user selected protocols to build.
4. Select an anatomical region.
Click the arrow up or down to view a list of 15 protocols at a time.
Click and drag the scroll bar to move quickly through all 90 protocols.
5. Click Edit if you are making changes to an existing protocol.
6. Select a blank protocol space, click New and type and Enter the name of protocol.
Any name may be used. It is helpful if you choose a name that reflects what the protocol is meant
to be used for (e.g., Routine Head, Trauma Spine, Chest/Abd/Pelvis).
The protocol name can be up to 60 characters.
The backslash (\) character should not be used.
7. The system defaults to Scout series the first time you are building/editing a protocol. For subsequent
series, click Create New Series and select the type of series to be built.
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In most cases, a scout series is built first because this allows for more precise scanning. A scout
must be programmed first if it is to be displayed automatically with Show Localizer.
AutomA and SmartmA require a scout to be acquired in order to generate a mA table.
8. Click OK.
9. Set the patient position.
Click the head or foot of the model to change patient orientation.
Click the abdomen area or the base of the table to rotate model 90°.
Click Copy Patient Orientation, Patient Position, Anatomical Reference, to copy the patient
orientation from the previously scanned series, regardless of what is in the protocol.
10. Click Anatomical Reference and assign a two letter abbreviation for the zero point (landmark). Click
OK to confirm your change or click Cancel to exit the Anatomical Reference screen with no change.
11. Select series parameters: archive, network, filming options, if desired.
Click AutoFilm setup to set the automatic filming parameters.
Click Auto Store to automatically transfers the image at an exam level to a remote storage
device such as PACS1 when the exam ends.
Click Auto Transfer to automatically send images at an exam or image level to one of up to four
destinations. Follow these steps for each host selection:
a. Select a host.
b. Select transfer by exam or image.
c. Click OK.
By Image: images are transferred in groups of 50. Only prospective images are transferred
when using this mode.
By Series (on the Recon tab for Scouts and Recon1,2,3): each series is transferred after it is
completed.
By Exam: the entire exam is transferred after it is completed with the End Exam operation.
Any Screen Save, Reformat, 3D, Navigator, Dentascan, Retrospective, DMPR or Neuro3D
Filter images created before the exam is ended are transferred. The Dose Report is
automatically sent when Auto Transfer By Exam is selected.
Click Dose Report Auto Transfer. From the Dose Report Auto Transfer screen complete the
following:
a. Select a host.
b. Click OK.
This automatically transfers the dose information for both the Dose Report and the DICOM2
Structured Dose Report to up to four different locations. This is used to transfer the dose
information when Auto Transfer By Image or By Series (on the Recon tab for Scouts and
Recon1,2,3) is selected.
12. Set the Scout parameters. Set the technique factors low.
Scout Parameters include Scout Image number, Start and End Locations to set the length of
the scout, technique factors of kVp and mA, scout plane, Auto Voice and use of the Window
Width/Level feature. Selecting an individual cell under a parameter column allows you to adjust

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Optima™ CT660
only the factor in that group. Selecting the parameter column from the top row highlights all of the
factors directly below the selected column and allows you to adjust that factor in all of the images.
Define the Start/End locations.

Select the kV.
Select the mA.
The Scout Plane designates what type of scout is being acquired. Only 0, 90, 180, and 270 can be
used with Show Localizer.
Choose an Auto Voice message.
The language is set by the service engineer.
Multiple languages are available for Auto Voice messages 1, 2, or 3.
Set the W/L.
13. Click Create New Series.
14. Click Axial and Create After.
15. Prescribe the parameters for the series.
a. Set the scan parameters.

b. Adjust the Graphic Rx.
c. Set the timing parameters.
If any of the values in Start/End Location, Number of Images, Slice Thickness, or Image Interval
are changed from the original value, the system automatically adjusts any necessary values to
maintain the signal to noise. For example, if the number of images is decreased, the system
automatically adjusts the end location. The system highlights any adjusted value in orange and
changes any necessary graphic representations on the scout.
d. Set up Auto Voice.

e. Set the recon parameters.
f. Set the film parameters.
g. Apply any additional scan features.
The data acquired for all other series is different than data acquired for scout images. This
means that features such as Patient Position and Auto Voice must be set or activated again
for this series.
If the patient orientation does not match the scout for the current series, AutomA/SmartmA
are not enabled.
Click Copy Orientation, Patient Position, Anatomical Reference, to copy the patient
orientation from the previously scanned series, regardless of what is in the protocol.
If Auto Store/AutoTransfer were set for the exam scout image, they are automatically set for
this series.
The Tab key should not be used when building protocols. If Tab and Cancel are selected while building
protocols, the protocol below the one being built could be deleted.
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Set protocol as default

Use this procedure to define a single, most commonly used protocol within a anatomical area as the
default.
1.
2. On the Auto Voice and Protocol Management screen, click Protocol Management.
3. On the Protocol Selection screen, click GE or User.
4. Click the desired anatomical body part to view the protocols.
5. From the Anatomical Protocol list, click a protocol and then click Set as Default.
Only one protocol in each list can be set as the default.

Default protocols can not be set in the Pediatric color coded areas.
The default protocol is highlighted in yellow.
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Copy and paste a protocol

Use this procedure to copy protocols from the GE anatomical selector or Most Recent selector into the User
anatomical selection area. You can also copy a protocol within the User anatomical selector. Copy protocol
can be used as a template to create different protocols with minor adjustments.
1.
2. From the Auto Voice and Protocol Management screen, click Protocol Management.
3. From the Protocol Selection screen, click the anatomical selector you want to copy from (GE, User, or
Most Recent).
4. Select the protocol you want to copy.
5. Click Copy.
6. Click the anatomical selector to where you want to paste the protocol.
7. Click on an empty protocol list number and then click Paste.
8. Rename the protocol, if necessary.
a. Click the protocol.
b. Highlight the text and type and Enter a new name.
9. Click Done.
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Add an ECG Trace to a protocol

Use this procedure to enable an ECG Trace display for a cardiac protocol. The ECG Trace display defaults to
off for Scout scans unless enabled on in a custom protocol.
1. From the Scout ViewEdit screen, click Gating.
Click Gating for every series in which you want to view the ECG Trace. The system only performs
gating for the modes that are compatible with gating.
2. From the Gating screen, click Heart Rate Monitoring On and Accept.
3. Click ECG Trace.
4.
Click the Minimize/Maximize icon, as necessary. For cardiac modes, the trace is automatically
maximized.
5. Make sure the IVY 3150B/3100-B with Ethernet is to is set to Ethernet mode.
If not, cycle power to the monitor after changing from data mode to ethernet mode.
The BPM1 heart rate shown on the console is updated every three heart beats. The BPM heart rate
shown on the IVY 3150B/IVY 3100B with Ethernet updates every three heart beats.
The ECG Trace may prospectively display the projected reconstruction windows with a 2-to-4 heart
cycle ISD for SnapShot Pulse acquisitions when a padding value of 200 msec is used for patients with 65
BPM or less, although the scanner will acquire the data with only a 1 heart cycle ISD.
1Beats Per Minute
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Delete a protocol
Use this procedure to delete a protocol from your user defined list. This allows you to keep your protocol list
current by deleting any unnecessary protocols.
1.
2. From the Auto Voice and Protocol Management screen, click Protocol Management.
3. From the Protocol Selection screen, click the anatomical selector from where you want to delete a
protocol.
You can only delete from the User or Service protocol selectors.
4. Select the protocol you want to delete.
5. Click Delete.
6. Click OK to the confirmation prompt.
7. Click Done.
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Chapter 18: Data privacy

Globally, laws and requirements for patient data privacy have been enacted to protect the health
information of individuals against access without consent or authorization. Examples of global privacy
standards are:
HIPAA US
Data Protection Act UK
PIPEDA Canada
European Union Data Protection Direction EU
Data privacy
Open EA3
Configure local users
Add a local user
Add a local group
Add an enterprise group
Add or remove a user from a group
Change a user full name
Change a user password
Lock/unlock a user
Remove a user, group, or membership
Configure EA3 properties
Configure Enterprise tab
Auto Configuration
Manual Configuration
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Open EA3
Use this procedure to open EA3 user interface.
1.
From the display monitor, click the Service icon.
2.
From the Service desktop, click Utilities icon.
3. From the Utilities screen, click EA3 Admin Browser.
Utilities menu
4. From the EA3 Administration screen, type your Username and Password.
Consult your service engineer for user name and login.

EA3 Administration screen
5. Click Login.
6. From the Local Users or Group tab, select a group or user.
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Only one group and user can be in context at a time. If you choose multiple users, the system
selects the top user in your selected list. Once a user or group is in context, you can make any
necessary modifications to that user or group.
If there are no users or groups, then there no items in context. All of the buttons in the center
panel are disabled until a user or group is added.
Local User list and Group list
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Configure local users

Use this procedure to add or remove users, change user group memberships, change user names, change
user passwords, lock / unlock users, force users to change their password on next login, etc.
1. Open EA3.
2. From the Local Users tab, enter desired selections.
Max Logon Attempts Before Lock - the number of failed login attempts you can make before
your account is locked for a certain number of minutes. When your account is locked, you cannot
login, even if you provide the correct username/password combination. Either the specified time
must elapse before you login again, or a user with an ADMIN role must login to the EA3
Administration component to unlock you. Locking only applies to local users. Enterprise user
locking is managed by the enterprise server.
If the administrator forcefully locks your account, the lock duration does not apply. You are
locked until the administration unlocks you.
Minimum Password Length - the minimum length of a new password. If a password is below the
minimum length already, setting this value has no effect on the password. For example, if your
password is 8 characters, and someone changes the minimum password length to 10 characters,
the 8 character password is still okay. However, next time you change your password, you must
choose a password that is 10 characters or greater. The minimum password length feature only
applies to local users. Password length restrictions for enterprise users are managed by the
enterprise server.
Lock Duration (Minutes) - the number of minutes you stay locked if you become locked due to
failed login attempts.
You can become locked in one of two ways.
3. Click Apply Configuration to accept your configuration changes. Alternatively, click Restore
Configuration to undo any changes made that have not yet been saved.
If there was a problem with making the changes (such as an invalid value or a problem contacting
the back-end Servlet) an error message box appears with a description of the error.
If the changes are successful, then a brief message appears indicating that the changes were
applied in a green label.
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Add a local user

Use this procedure to add a local user.
1. Open EA3.
2. From the Local Users tab, click Add Local User.
3. From the pop-up panel, type information for each of the following:
A unique user ID
Full Name
Password
Confirm Password
If an error occurs, a message box displays, and your changes are not committed to the database.
Correct your errors and try again. Common errors include:
User name and password cannot be the same.
Password does not meet the minimum length requirements. Choose a longer password.
Password and Confirm Password box do not match. Make sure the passwords match.
Add User screen
4. Click Add User.
User restricted fields

Some fields and buttons on the Local User tab are not selectable under the following conditions. The
following roles, users or groups have one or more of these criteria and they cannot be modified. Roles:
limited user, standard user, GE service, administration. Users: root, ctuser, insite.
Permanent - if a user is permanent, he can never be removed. When a permanent user is in

context, the Remove User button is disabled.
Content Not Editable - if a user is flagged as this, then their group memberships cannot be
changed. When a 'content not editable' user is in context, the Add To Groups, and Remove From
Groups' buttons are disabled.
Password not changeable - if a user is flagged as this, then the password cannot be changed, and
the Change Password button is disabled.
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Add a local group

Use these procedures to add a group.
1. Open EA3.
2. From the Groups tab, click Add Local Group.
3. From the Add Local Group window, type and Enter a unique group name.
Group name already exists in the database
Application session timeout
Add Local Group
4. Click Add Group.
The group is highlighted in the Local Groups list box. All information and buttons in the center
panel refer to the highlighted group.
5. To change a group's roles, select the Roles option boxes and click Apply Roles.
A green label confirms the applied roles.

An error message box displays if it is unsuccessful.
Add memberships
1. Open EA3.
2. From the Local Users tab, click Add to Groups.
3. From the Groups tab, click select a group.
A popup panel lists all users that are eligible to be added from the highlighted group. Select users
you want to add from the group.
If no users are eligible to be added from this group, an error message box displays.
4. Click Add Membership.
Group restricted fields

Some fields and buttons on the Group tab are not selectable under the following conditions. The following
roles, users or groups have one or more of these criteria and they cannot be modified. Roles: limited user,
standard user, GE service, administration. Users: root, ctuser, insite.
Permanent - if a group is permanent, it can never be removed. When a permanent group is in

context, the Remove Group button is disabled.
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Content Not Editable - if a group is flagged as this, then its group memberships cannot be added or
deleted. When a user belongs to a Content Not Editable group, the user cannot be removed or
added from the group, therefore, the group name does not show up when you click Remove From
Group or Add to Group.
Password not changeable - if a group is flagged as this, then the roles associated with that group
cannot be changed. This property does not have a direct impact on what you can do on the Local
Users tab.
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Add an enterprise group

Use this procedure to add an enterprise group.
1. Open EA3.
2. From the Group tab, click Add Enterprise Group.
3. From the Add Enterprise Group pop-up window, type and Enter a unique group name.
Group name already exists in the database
Application session timeout
Add Enterprise Group
4. Click Add Group.
This action does not add an enterprise group, rather it provides EA3 the ability to manage roles
for that group that already exist on the Enterprise directory server. For example, if you add a
group All Employees as an Enterprise group to EA3, and assign that group with the STANDARD
role, then any enterprise user that logs in through EA3 and belongs to the All Employees group
has the STANDARD role.
You cannot manage the group memberships for Enterprise groups. This is managed by the
directory server, not EA3. Therefore, whenever an Enterprise group is in context, both the Add
Membership and Remove Membership buttons are blocked. This does not mean that no one
belongs to the Enterprise groups, but rather that this is managed by the directory server and not
EA3.
Once an enterprise group is added, it is automatically highlighted in the Enterprise Groups list box
and it is in context1.
1A HIPAA term meaning that all information and buttons in the center panel refer to the selected user or group.
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Add or remove a user from a group

Use this procedure to add or remove groups listed in the Groups list.
1. Open EA3.
2. Select the Local Users tab.
3. In the groups area, select a group to which you want to add/remove the users.
Add membership list
Remove membership list
4. Click Add Membership or click Remove Membership.

5. Select the users you want to add or remove.
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Change a user's full name

Use this procedure to change a user's name.
1. Open EA3.
2. From the Local Users tab, select a user.
3. Click Change Name.
4. From the Change Name window, type a new name.
Change Name
5. Click Confirm Change.
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Change a user's password

Use these procedures to change a user's password.
1. Open EA3.
3. Click Change Password.
4. From the Change Password window, enter a password and confirm the password.
A password can contain uppercase letters, numbers, and special characters.

An error message displays if the password does not meet the minimum length requirements.
The minimum requirement are displayed in the Minimum Password Length field located in the
top area of the Local Users tab. Change the password to an acceptable length.
Change Password window
5. Click Confirm Change to accept the new password or Cancel to exit without changing your
password.
Force a user to change password on next login

Use this procedure if you are an administrator to force a user to change his password.

2. From the bottom of the Local Users tab, select the Change Password on Next Login option.
3. Click Apply Configuration.
The next time the user logs in, he will be required to enter a new password.
Once the new password is entered, the Change Password on Next Login option is de-selected.
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Lock/unlock a user
Use this procedure to lock/unlock a user from login privileges.
1. Open EA3.
3. From the bottom of the Local Users tab, select the Locked toggle option.
When the Locked box is checked the user is locked from login even if he has a valid password.
If Emergency User is enabled on your system, the locked user can login as an Emergency User.
4. Click Apply Configuration.
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Remove a user, group, or membership

Use these procedures to remove items from the list.
Remove a user
1. Open EA3.
3. Click Remove User.
4. From the Confirm Removal window, click Confirm Removal.
Confirm Removal window
Remove a group
1. Open EA3.
2. From the Group tab, select a group.
3. Click Remove Group.
4. From the Confirm Removal window, click Confirm Removal.
Confirm Removal window
Remove a membership
1. Open EA3.
2. From the Group tab, select a group.
3. Click Remove Membership.
A panel lists all users that are eligible to be removed from the highlighted group. Select users
you want to remove from the group.
If no users are eligible to be removed from this group, an error message box displays.
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4. Click Remove Membership.
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Configure EA3 properties

Use this procedure to configure EA3 application properties.
1. Open EA3.
2. From the Applications screen, enter the desired selections.
Enable Authorization - enable or disable authorization. If authorization is enabled, anyone

logging in through EA3 (both local and enterprise users) must have a role. Anyone without a role
is denied access, if authorization is turned on. The User role does not matter for logging into EA3,
however, other EA3 client applications may restrict which roles can login.
Emergency Logon Allowed - enable or disable emergency access. If EA3 is used in GUI mode,
this entry decides whether or not to display the Emergency login button. If this is disabled,
emergency user access is prevented.
Emergency Roles - the roles assigned to the emergency user. The defaults allow an admin to
assign a Standard user role, Limited User role, or both roles.
Inactivity Timeout (minutes) - The minutes that must elapse without any mouse/keyboard, etc.
activity before a timeout is generated. When a timeout is generated, the EA3 logon screen is
displayed. This value can be any positive integer, or it can be 0. If the value is 0, this indicates NO
inactivity timeout; regardless of how much time has elapsed the system does not timeout.
Display Last Logon Name - enable or disable to display the username of the last user that has
logged in on the EA3 logon screen.
Administrator Message - under certain circumstances / error conditions, the user of EA3 is
asked to contact an administrator. This field allows the administrator to specify contact details
for himself / herself and a custom message.
Emergency Prompt - the text that is displayed to any user logging in as emergency. The user is
asked to enter information (usually their actual user name). This text appears in that prompt for
information.
If there was a problem with making the changes (such as an invalid value or a problem
contacting the back-end Servlet) an error message box appears with a description of the error.
If the changes are successful, then a brief message appears indicating that the changes were
applied in a green label.
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Configure the Enterprise tab

Use this procedure to configure the properties necessary to make a connection to an Enterprise directory
server (i.e., MSAD, Novell, etc.). The Enterprise tab is used by the site’s IT1 or GE Service personnel. It
provides connectivity to the site’s user database. If you do not have a network established in your hospital or
clinic, this tab is not used.
1. Open EA3.
2. From the Enterprise tab, enter desired selections.
Enable Enterprise Authentication - login authorization. If it is unchecked, only local EA3 users
can log in. If it is checked, both local users and enterprise EA3 users can log in and local EA3 user
database is tried first.
Cache Enterprise Users - enables Enterprise users to be cached once they successfully login. If
the Enterprise directory server is not available due to network or other issues the following
scenarios occur:
If it is checked, a local record of an Enterprise user is kep and the you can login.
If it is unchecked, an Enterprise user is denied access.
Hashed passwords are cached, the actual password is not cached.
Enterprise Authentication Latency (Seconds) - the time the EA3 login process wait for a
response from the Enterprise directory server. Often times, there is a network latency when
connecting to servers, which is dependent on your network configuration. If the amount of time is
reached without a response from the directory server, the EA3 login process returns a failed
login. A value of 5 seconds is typically enough time to allow a properly configured directory server
to respond, without causing undue user annoyance.
3. Modify properties in the lower two boxes of the Enterprise tab to make the Enterprise directory
server connection.
1Information Technology
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Auto Configuration
1. Open EA3.
2. From the Enterprise tab, click Auto-detect Server Name.
The system searches for the Server Name of the directory server.
If the DNS allows service lookups, EA3 executes an auto-detection with the Enterprise Directory
Server. If it cannot find the server, it is not an error. Continue with these steps to configure the
Server.
3. In the Server Configuration text field, type the Server Name or IP address of the Enterprise directory
server that EA3 should connect to.
The system must either have DNS enabled or the system must have static information in a hosts
file (i.e., /etc/hosts).
4. Select the Authentication type the directory server supports.
If it is a Microsoft Active Directory Server, typically select Kerberos. If it is a Novell eDirectory

Server, typically select LDAP. If you do not know, check with the owner of the directory server for
information.
If the enterprise server supports SSL connections, select the 'Use SSL' option.
If you use LDAP authentication without SSL, passwords are sent in the clear. This is not
recommended. An alert is posted for this configuration. With kerberos and non-SSL, the
authentication is encrypted, but the LDAP traffic is not.
5. Click Test Connection to test if the machine can connect to the directory server.
If the connection is successful, CONNECTION OK is displayed next to the Test Connection button.
If the connection is unsuccessful, CONNECTION BAD is displayed next to the Test Connection
button.
If the connection is bad, then there is a problem connecting to the directory server. Check the
following:
IP/server name
if system has DNS running
if the system can resolve the IP address / server name
Once the Test Connection procedure indicates that the connection is good.
6. Once the Test Connection is successful, select the type of directory server, either Microsoft Active
Directory, Novell eDirectory, or another.
7. Click Generate Defaults to populate the Realm Name, Format, DN, Login Attribute, First Name
Attribute, Last Name Attribute, and Group Attribute fields with default values for that directory
server type.
If the directory type is MSAD, both the realm name and the DN are populated.
If the directory type is eDirectory, the realm name is left blank. If you are configuring a directory
server that is not MSAD or Novell eDirectory, the configuration must be done manually. Get the
correct LDAP property information from the owner of the directory server.
If this is a non-MSAD, non-eDirectory server, or is a server with a non-default configuration,
manually change some properties, as needed.
8. Enter a username and password of a user that resides on the directory server.
9. Click Login and view the result information to see if the login is successful.
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The First Name, Last Name, and any group memberships for the user are printed. If First Name,
Last Name, or Group Memberships are not found, a warning is posted, which indicates that:
the LDAP properties are mis-configured (i.e., First Name Attribute, Last Name Attribute,
and/or Group Attribute).
the user does not have a First Name, Last Name, or any Group Memberships configured on
the Enterprise directory server.
If you get these warnings, talk with the owner of the directory server to verify you have
everything set up correctly.
If the test login succeeded and you are satisfied with the first name, last name, and group
membership information, then your Enterprise directory server is properly configured.
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Manual configuration
Use this information to connect to a directory server other than MSAD, Novell eDirectory, or any other
system that has a custom configuration. The following LDAP definitions are for configuration properties that
may need to be manually selected.
Format - set to domain or dn.
domain is the 'MSAD' way of doing LDAP authentication (i.e <userId>@<realm name>).
dn is the eDirectory, and most other directory servers use (i.e. loginAttribute=<userId>,<ldap base
dn>) way of doing LDAP authentication. If you are connecting to a non-MSAD directory server, more
than likely use dn.
DN - is the LDAP base DN of the LDAP server to which you are connecting. Typically this is the fully qualified
domain name separated by a bunch of 'DC='. For example, if the fully qualified domain name of the
directory server is 'example.com', it is likely that the DN is 'DC=example,DC=com'.
Login Attribute - is the LDAP attribute to be used for the unique user identifier, that is the user id to login.
Set it to the unique identifier your server uses.
On MSAD it is: sAMAccountName

On eDirectory, it is typically: cn
First Name Attribute - is the LDAP attribute that is used for the user's first name.
Last Name Attribute - is the LDAP attribute that is used for the user's last name.
Group Attribute - is the LDAp attribute that is used to find group memberships for the user. On MSAD, it is
'memberOf'.
EA3 finds all instances of this attribute (not just the first, like it does for other attributes). If a user
belongs to more than one group, EA3 finds all memberships.
Regarding LDAP parameter configurations, EA3 finds the first instance of the configured attribute for
a user, except for Group Membership. If you configure the First Name attribute to be an attribute that is
listed multiple times, EA3 assumes the first one found during an LDAP query is the correct First Name. For
Group Membership, EA3 finds all instances of that attribute.
Save changes
No changes are saved to EA3 on a tab unless you click Apply Configuration before you navigate to another
tab or click Confirmation on a popup panel. If there is more than one Apply Configuration button on a tab,
click the one associated with the data you changed (the buttons are grouped with the data they manage in
a bordered panel).
Click Apply Configuration or Restore Configuration and in 5 seconds a label appears indicating that the
changes have or have not been saved, respectively:
Enable Authorization
Limited User
Inactivity Timeout (Minutes)
Emergency Prompt
Apply Configuration
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Chapter 19: System Management

Use these procedures for system management level functions. Most of the procedures are accessed from
the Tool Chest.
ImageWorks Tool Chest (left), Service Tool Chest (right)

Open a Unix shell
Turn on/off extended CT numbers
Collect data with Quick Snap
Collect data with IQ Snap
Save an ECG trace
Restart Show Localizer
Export protocols
Set the screensaver timeout
Use iLinq
Download software
Apply Product Network filters
Leave a memo for service engineer
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1.
2. On the Tool Chest, click Auto Voice Volume.
3. Click and drag the right or left slider to adjust the Auto Voice volume levels in the scan room.
4. Make a selection:
a. Click Accept to accept the values but not save the values.
b. Click Save to save the values.
c. Click Default to reset the values to the system default values.
If Auto Voice cannot be heard, check the settings on Image Works. Click Auto Voice Volume on
ImageWorks desktop in the toolbar. Use the sliders to set the value between 50 to 85%, click Save, and then
Default to set the new saved value as the new default. Click Reset to reset the system default values.
Auto Voice may fail to function, especially during system simultaneity. Make sure that you can hear the
Auto Voice to recognize if Auto Voice has quit. Manually breathe the patient when this occurs.
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Open a Unix shell

Use this procedure to display a Unix shell on the left or right monitor. This area is used by your service
personnel.
1.
From the display monitor,click ImageWorks icon.
2. From the Tool Chest screen, click Unix Shell - Left or Unix Shell-Right to open a Command Line
window on the scan (left) or display (right) monitor.
3. Click File > Close Window or type exit to close the Unix shell window.
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Turn on/off extended CT numbers

Use this procedure to enable or disable extended CT number range.
DentaScan and BMD 1 are not supported in Extended CT Number, therefore do not use Extended CT
numbers with these applciations.
1. Verify that the system is idle and that all reconstructions are complete.
2.
3. From the Tool Chest, click Turn On Extend HU or Turn Off Extend HU.
The action that occurs is described on the button and does not reflect the state of the sytem.
4. Click OK on the message prompt.
The system automatically shuts down and reboots as part of the extended CT numbers
procedure.
1Bone Mineral Densitometry
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Collect data with Quick Snap

Use this procedure to collect necessary data for trouble shooting system issues.
Do not initiate a QuickSnap if the system is actively collecting data with X-ray on.
1.
2. From the Tool Chest, click Quick Snap.
3. Click OK to the message prompt located on the left monitor. The pop-up screen closes when the
snap is complete.
4. Record the time and date of the QuickSnap for debugging by the service engineer.
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Collect data with IQ Snap

Use this procedure to collect the necessary data for troubleshooting image quality issues.
Do not initiate an IQ Snap while the system is actively scanning or reconstructing data.
1.
2. From the browser, select all the images for the investigation.
3. Click Utilities.
4. Select Create anonymous patient by image, series, or exam.
Select up to 500 images in a single series.
5. Select the anonymous exam.
Maximum of 500 images.
6. From the Tool Chest, click IQ Snap.
If you did not make the images anonymous or did not select the anonymous exam, a pop-up
displays instructing you to make the images anonymous. You cannot proceed until the selected
images are anonymous.
7. Click OK to the warning and the message prompts located on the left monitor.
If you get a message at the end of IQ Snap that indicates it failed, contact service.
This message closes once the IQ Snap is complete.
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Save an ECG trace

Use this procedure to save the directory of the latest 500 cardiac gated series to CD. ECG Traces from the
last 500 cardiac gated series are stored on the CT system. Save an ECG trace is compatible with Cardiac
Gated scans only and not with ECG files for Cardiac Calcium Scoring.
1.
2. From the Tool Chest screen, click Save ECG Traces.
The CD/DVD tray opens and the system prompts you to place a blank CD media in the CD/DVD
drive.
3. Insert a CD in the tray.
4. Click OK to close the drive and initiate the save process.
The CD tray opens automatically when the save is complete.
5. Remove the CD.
6. Click OK to the message prompt, which closes the tray.
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Restart Show Localizer

Use this procedure if the Scout or the start and end location lines do not appear.
1.
2. From the Tool Chest screen, click Restart Show Loc.
3. Click OK to restart the Show Localizer.
4. If Restart Show Loc does not resolve the issue, use crosshair to determine Start/End locations and
R/L and A/P centers for the current exam.
5. Reboot the system before you start the next exam.
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Patient de-identification or anonymizing an exam electronically removes certain exam information and
replaces it with anonymous information. There are two levels to anonymizing patient information: Full and
Partial. Use this procedure to set the annotation level for patient anonymize.
1.
2. From the Tool Chest, click Anon. Pat. Level.
3. Respond to the message prompt that defines the currently active anonymous state.
Click OK to change the patient anonymous annotation level.
Click Cancel to keep the current patient anonymous annotation level.
4. Set the desired level: Full or Partial.
Full mode is the most HIPAA compliant mode.
ANON and the exam number are added to the Patient List.
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Export protocols
Use this procedure to export user protocols to a CD so that you can load the CD on a PC and print. The
format is excel.
The system must be idle when exporting protocols.
1.
2. From the Tool Chest screen, click Export Protocols.
3. The CD/DVD tray opens and the system prompts you to place a blank CD media in the CD/DVD drive.
4. Place a CD inserted in the tray.
5. Click OK to close the drive and initiate the save process.
The User adult and pediatric protocols are saved.
6. The CD tray opens automatically when the save is complete. Remove the CD and click OK to the
message prompt, which closes the tray.
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Set the screensaver timeout

Use this procedure to set the time period for the scan and display monitor screen saver to start.
1.
From the display monitor, click the Service icon.
2. From the Service browser, click the Service browser title bar to move it so you can see the service
Tool Chest.
3. From the Tool Chest, click Screensaver Time.
4. From the Set Screensaver Timeout screen, click and drag the slider to adjust the time that the
screensaver mode starts to between 5 to 60 minutes.
Click on either side of the slider grab bar to increment in steps of 1 minute.
The default is 30 minutes.
5. Click Save.
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Use iLinq
Use iLinq to access GE Online Center engineers and Answerline Applications Specialists.
The iLinq tools are designed so you can get information yourself, rather than having to always rely on a FE
or an Online Center Engineer. The Applications Self Help feature provides automated expert advice from a
database of application problems and solutions.
Answer questions - Top 10 FAQs.

Search the Knowledge Database.
Share the knowledge with co-workers by saving the results.
If InSite is running the Remote Safety test, New Patient does not open. To access New Patient:
call InSite and request they abort the test

navigate to the Service Desktop and select CleanUp option to cancel the test in progress
Launch iLinq
Click the iLinq icon to open the iLinq desktop.
Terminate iLinq remote connection

Use this procedure to terminate an iLinq connection when a GE representative initiated the connection.
1. Click New Patient.
A message is posted that the scan hardware resource is not available.
2. Wait three minutes and click New Patient again to begin scanning.
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Apply Product Network filters

Product Network filters allow you to place a site firewall in front of the CT scanner. Filters may be
configured to restrict which computers may access the system and which system services are allowed to
be controlled by other devices trying to access the operator console such as ftp, telnet and rlogin. This
access is determined by configuring IP addresses allowed to access the system. DICOM1 access to the
system can also be configured. The system default is for no services enabled, no IP addresses authorized
and DICOM port 4006 enabled.
Consult your Field Engineer and your IT Department in configuring PNF 2.

2Product Network Filters
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Download software
The Software Download feature allows systems that have a service contract with Broadband connected to
automatically down load software updates. These updates can be configured to Auto Install or Manual
install. A pop up indicating that this capability is installed on the system is displayed at every reboot for the
first 3 weeks after a software load from cold.
1. From the Automatic Software Updates screen, click Continue.

Automatic Software Update screen
2. As updates become available, from the Automatic Software Updates screen, click Install Later or
Install Now.
Automatic Software Update download screen
3. If Install Now is selected, view the progress bar, which indicates the install progress. If Install Later is
chosen, you will be asked again on the next reboot to install the software update.
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Leave a memo for service engineer

1. From the Feature Status area, click message area.
2. From the message screen, click Memo.
3. Place the cursor in the menu area and type and Enter a message.
4. Click Save.
The message displays in the log file.
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Appendix A: Operator messages

This appendix lists user messages that are posted to the user interface and have not been translated.
These message are displayed in one or more of the following areas.
Areas where messages are posted to the user interface

Message area (1) of the Feature Status Area on the
right monitor.
Attention pop up dialog.
Operator console message bar (1) on the ViewEdit

Real Time information area (1) of the scan progress screen of the left monitor.
screen on the left monitor
5366492-1EN Rev 1 (February 2010) Appendix A-1

Optima™ CT660
Untranslated messages
No. English operator message Translated operator message

Your patient orientation has changed from the
1. previous series. Please verify or change the
orientation if needed.
Tube Warm-up has been cancelled or skipped. Large
focus maximum mA of 120kV and 140kV will be
limited as follows for this exam.
2. 120kV: 440mA
140kV: 380mA
Select End Exam and run Tube Warm-up from Daily
Prep to enable the full mA range capability.
The table landmark has been changed. This changes
3. the location of all scans you have prescribed. Double
check all scans locations before you start scanning.
WARNING WARNING
This series contains one or more groups with multiple
4. scans at the same tomographic plane, i.e. same
location. Minimum diagnostic delay is seconds ± the
time of a monitor scan.
WARNING WARNING
This series contains one or more groups with multiple
scans at the same tomographic plane, i.e. same
5. location. Temporal interval for images exceeds 3.2
seconds. Use of this data for processing of CT
Perfusion maps may contain errors in the functional
information.
Biopsy has disabled automA. Please verify or change
6.
the mA as needed.
The dose for the new scan is greater than the
7.
maximal possible value. Do you wish to continue?
Unrecognized tube in use - Dose may vary. The
reported dose information is calculated based on
empirical observations of systems with GE Medical
8. Systems tubes.
GE cannot assure the accuracy of reported dose
information for any configurations that include tubes
other than GE Medical Systems tubes.
The detector is not at the proper temperature please
allow approximately __ minutes for the detector to
9. come to temperature. If you wish to proceed with this
scan select the "OK" button, however IQ maybe
degraded including image artifacts.

Auto mA has been disabled. It can be enabled again

10. once patient orientation matches with that of the last
scout series.
The prescribed mAs for Group % is greater than mAs
11.
limit for this tube, decrease mA to __ mA.
12. The scan database is corrupted.
If you continue to use the system you might
propagate the corruption. Please shutdown and
13.
restart the system in order to automatically recover
the database.
14. Please confirm that there is no beam obstruction.
The Daily Image Quality Check Test has detected a
condition that may result in an image with
15. unacceptable image quality. Please call GE Service
and request a more thorough evaluation of your
system's condition.
Multiple patient entries are found. Please select the
16. appropriate patient from the Select Schedule Patient
screen.
Failed to Acquire Scan Hardware. This is probably
because:
New Patient is started in the Exam Rx screen,

or
17. Some other tool is already scanning, or
The application firmware is not downloaded to
SBC, or
Some other problem with the scan hardware.
Please correct the problem and try again.

Hand Held Control Communication Failure: There has
been some communication error detected for the
18.
Hand Held Control Unit. Please Check the Connection
and reconfirm Rx.
Firmware reset occurred. Please wait until reset is
completed.
19. To continue, you may have to reset the landmark.
However, the new landmark could be different from
the previously set landmark.

Optima™ CT660

Firmware reset occurred during scanning. The
current exam cannot be completed. You may obtain
information on completed scans by returning to
20. ViewEdit.
Please select |End Exam| when ready. |New Patient|
button will be available when the firmware reset is
complete.
21. Recon Self Test detected reconstruction errors.
You will not be able to scan because no calibration
information is available. Try pressing |End Exam|
22.
followed by |New Patient|. This will cause ScanRx to
attempt to read the calibration database again.
Cardiac hardware is malfunctioning and has been
23.
disabled.
Please check the connections and re-enable gating
24.
on the ViewEdit screen.
Can't perform cardiac gated scan. Cardiac hardware
is malfunctioning and has been disabled.
25.
Please check the connections and re-enable gating
on the ViewEdit screen.
WARNING
26. WARNING
Please remove any obstruction in the path of the
beam.
WARNING
WARNING
27. Converter boards have changed.
Please first run DAS Gain Cal before running
Collimator Cal.
WARNING WARNING
Collimator Cal failed but scanning can be done with
28.
the pre-existing valid calibration.
If this error repeats over several days call service.
Fast Cal continues.
WARNING WARNING
Clever Gain Air Calibration failed to get tracking
29.
Statistics. Tracking may have been turned off.
Exit Fastcal and try again. If this problem persist, call
service.
30. WARNING WARNING

Fastcal may not have been performed within the last


24 hours.
Image generation has been delayed! SmartPrep
cannot continue. Monitor phase scanning has been
paused. Please proceed to the scan phase by
31. selecting the "Scan Phase" button at your discretion.
The SmartPrep clock continues to show the elapsed
time since the contrast injection began. Use this clock
to determine when to proceed to the scan phase.
The Mylar Window check has detected that the
window is not clean. A dirty mylar window may affect
the calibration and cause Image Artifacts. Please
32. clean the mylar window. Hit Continue to go on with
FastCal without repeating the check or hit Retry to
repeat the check and confirm that the mylar window
is clean.
The DAS Gain Calibration has not been run since the
33.
DAS Converter boards were changed.
Please call the FE or GE Cares center for more
34.
information and help.
35. It has been over 96 hours since the fastcal was done.
36. Number of phase is over the allowable limit.
37. AutoStore to Archive Device Unavailable.
WARNING WARNING
38.
Scan Manager Configuration Has Non-Patient
Scanning Options Enabled!
WARNING WARNING
39.
Scan Manager Configuration Has Beam Tracking
Disabled! Scanner Is In High Dose Mode.
WARNING WARNING
Gantry Balance Check must be performed.
Pressing OK will cause 2 automatic gantry rotations
40. with 1 minute separations.
Make sure Gantry is clear of all obstructions and click
OK.
The Gantry Balance check process will take about 4
minutes.
Gantry Balance Check is executing. This process will
41.
take about 1 or 2 minutes.
Gantry Imbalance Condition Detected. Image Quality
42. May Be Compromised. Perform Gantry Balance or
Call GE Service.

Optima™ CT660

Gantry is out of Balance. Calibration is Aborted. Call
43.
Service.
Software has detected an invalid DAS configuration.
44. Please reconfig to correct. If condition persists after
Reconfig call GE Cares.
Reconstruction process has stopped. Scanning is
45. possible but no images will be made. Restart the
system. Please contact GE service.
Reconstruction times will be slower. Scanning can
46.
continue. Please contact GE service.
All of the images from a scan that is currently being
47.
reconstructed are suspended.
The Scanning Hardware is not available; please wait
for the hardware reset successful status posted in
the feature status area on the right monitor.
48.
If the hardware reset fails, then reset the scan
hardware from the Service Desktop System Resets
button.
A scan disk array failure was detected. Please call GE
Service to schedule repair of the scan disk array. To
continue scanner operation now, you may rebuild the
49. scan disk array with less storage capacity.
If you rebuild the scan disk array, all scan data on the
current disk array will be lost. Are you sure you want
to rebuild the scan disk array?
Unable to verify system functionality on startup.
Please power cycle the console.
50.
If the system fails to startup after the power cycle,
then please call GE Service.
Protocol file is corrupted. Please correct using
method below or contact your GE Service
Representative.
Restore protocols - this will replace all

protocols in "User"
51.
Using the most up to date copy of the Protocol
DVD disk or System State disk
From Service Desktop select "Utilities" then
"System State"
Now select "Protocols" and then "Restore".
An unrecognized X-ray tube has been installed on the
system.
52. GE Medical Systems cannot assure that the

system performance will conform to
specifications.
Advisory messages will be posted to the


operator about an unrecognized tube during
tube warm-up, during Fast Calibration, and in
the dose report.
The system has been configured to recognize a GE
Medical Systems Tube. A %s-day period from the
date of tube installation has been granted to allow
time to manually verify the tube identity. Please call
GE Medical Systems to dispatch a Field Service
Engineer (FSE) to verify the tube configuration. Please
allow a minimum of 10 days for the FSE to schedule
verification. Verification should take no more than 30
minutes. If a GE Medical Systems FSE does not verify
53. the tube identity within xx days, the system will revert
to an "unrecognized tube" status, resulting in the
following:
GE Medical Systems cannot assure that the

system performance will conform to
specifications.
Advisory messages will be posted to the
operator about an unrecognized tube during
system startup, during tube warm-up, during
Fast Calibration, and in the dose report.
Scan disk array performance is degraded by one or
more hard drive failures. Your scan data storage is
54.
reduced because of this. Please contact GE service to
have the disk array repaired as soon as possible.
Automatic Software Download & Install Capability
Exists for your scanner! This GE exclusive capability
leverages the power of your Insite Broadband
connection to deliver the latest software updates to
your system as soon as they are released. The
updates are downloaded automatically and the
option to automatically install them is provided during
system start-up. Only GEHC developed and validated
55. updates are distributed via this tool. For an overview
of this capability, Please review the Software
Download Topic on iLinq.
Automatic Software Updates Continue (time out after
20 seconds)
Try Again
Skip Install
please wait ....

Optima™ CT660

New software updates are available and ready to be
installed on your scanner. These software updates
provide system enhancements and corrections to
ensure optimal system performance and security. All
updates have been developed and validated
specifically for your hardware and software
configuration. By downloading these software
updates, you agree to and are bound by the Terms
and Conditions of Sale for GE Medical Systems
Products. The updates are expected to take
approximately to install. For additional information
regarding the updates: Contact your Customer
Service Center or choose "Install Later" (you will be
prompted on subsequent re-boots with this dialog),
go to iLinq, Under Software Updates review data for
updates.
If you have questions or concerns, please contact
your local Service Engineer or Customer Service
56. Center. Do you want to install software updates now?
The following patch(es): require a system reboot after

install. The reboot will occur in 10 seconds. 2005
General Electric Company:
Installing Software Updates...
Please wait while the system updates are installed...
Estimated time required to install updates is
approximately.
The software update installation started at __.
Update Installation Failed!
The following updates failed to install. Please restart
your system and initiate software update again, or
notify the GEHC On-Line Center that the install failed.
Revert back to the original configuration, skip
installation and notify GEHC On-Line Center that the
install failed and create dispatch for FE follow-up.
The detector is not at the proper temperature. If you
wish to proceed with this scan select the "OK" button,
57.
however IQ maybe degraded including image
artifacts. Please contact GE Service.
The detector is too hot.
58. No scanning allowed.
Please contact GE Service
A system communication failure has occurred which
59. will prevent scanning.
Please contact GE Service.
System has detected that firmware is down. This will
60.
prevent scanning.


ScanRx could not be started because it could not
communicate with scan database. The system has to
61.
be shut down and restarted. Please contact GE
service.
62. Patient placements in series are different.
63. The landmark is not set.
Patient orientation now differs from when last
64.
scanned.
65. A localizer(s) is invalid for this prescription.
66. Unable to locate existing Patient Information.
Failed to enable Hand Held Control Unit. Please
67.
Check connections.
Exposure Time was changed to System Maximum
68.
Allowable value.
Exposure Time was changed to Tube Cooling
69.
Maximum Allowable value.
Tube has reached the highest allowable temperature,
70.
Tube Cooling Optimization is required.
Table height has changed - No timing graph will be
71.
displayed in SmartPrep.
The SmartPrep timing graph will not display due to a
mismatch between the system and reconstruction
72.
engine clocks. After the exam is complete, contact
service to synchronize the clocks.
System rounded Patient Weight in pounds to the
73.
closest value in kilograms.
System adjusted patient weight to be within
74.
allowable weight range.
Scan Request is not possible due to tube cooling. No
75.
up front delay is possible.
The system will apply an up front delay prior to
76.
scanning.
Scan Request is not possible due to tube cooling.
77.
Lower mA or kV to enable scan.
Start/End location(s) were changed due to landmark
78.
position.
More than 2 hours have elapsed since the last scan.
79.
Tube needs warming.
The Smart Prep Baseline image failed. Please try
80.
again.
Can not start Monitor Phase while interacting with the
81.
Baseline image.

Optima™ CT660

Unable to set Alignment location. Landmark not set or
82.
table needs to be referenced.
Dose information database is uninitialized. Please
83.
see Error Log for Details.
Detector Temperature Is High. Image quality may be
84.
affected.
Detector Temperature Is Low. Image quality may be
85.
affected.
WARNING WARNING
86.
Backup Timer stopped scan. X-ray stayed on longer
than prescribed.
87. kV out of range. Potential for degraded image quality.

Auto Voice Malfunction: Auto Voice is disabled until
88.
scanning is stopped.
Gantry Controls Horizontal In button is non-
89.
functional. Unlatch cradle to position patient.
Gantry Controls Horizontal Out button is non-
90.
functional. Unlatch cradle to position patient.
Gantry Controls Internal Landmark button is non-
91.
functional. Use the External Landmark button.
Gantry Controls External Landmark button is non-
92.
functional. Use the Internal Landmark button.
Gantry Controls Landmark buttons are non-
93.
functional. Scanning cannot continue.
Gantry Controls Stop Scan button is non-functional.
94.
Use the Console Stop Scan button.
Gantry Controls Start Scan button is non-functional.
95.
Use the Console Start Scan button.
Auto Voice and Breathing lights are disabled due to
96.
operator intervention until scanning is stopped.
97. Cradle is released.
Gantry Controls Cradle Release button is non-
98.
functional.
99. Prep Delay: __ Seconds Remaining
100. Interscan Delay: __ Seconds Remaining
101. Tube Cooling Delay: __ Seconds Remaining
102. Operator Paused Scan.
103. Operator Stopped Scan.
104. Scanner Hardware Paused Scan.


105. Scanner Hardware Stopped Scan.
X-ray off scan is in progress. Press [Stop Scan] to stop
106.
scanning.
107. Prep Delay after [Start Scan] will be __ Seconds.
108. Cradle is released. Latch the cradle to scan.
Table is below the scanning minimum. Raise the table
109.
to scan.
110. Remote Tilt is Disabled due to Touch Sensor Collision.
Scan position prescribed is no longer valid. Please re-
111.
prescribe.
112. Cradle is released.
113. Cannot bring tube rotor up for __ seconds.
Application Startup stopped due to the failure of
114.
product name setting.
Software detected mismatched Table configuration.
115.
Please reconfig to correct Table configuration.
The X-ray and Drive power is disabled. Please walk
116. into the room and press the Reset button on the
Gantry Control Panel.
117. Please ensure there are no objects in the gantry bore.
118. Neuro3D Already Running.
System turned off Neuro3D prescription in the
119.
current series.
Unable to mount the CD-ROM, ie: either no CD in the
drive or the CD is not iso9660 format.
To start the Acrobat Reader without a CD, select the
120.
Continue button.
If you wish to correct the problem with the CD first,
select the Cancel button.
Algorithm prescribed is not allowed. System will
121.
choose a default algorithm.
The system defaults Display Field to match scan field
122.
of view.
The system adjusted Image Interval to the closest
123.
possible value.
System changed keV value to be within allowable
124.
range.
Energy Saving Mode setup is completed. Wait till
125.
system halted, then console power OFF.
Energy Saving Mode setup is FAILED. Setup date time
126.
again, or quit from Energy Saving Mode setup.

Optima™ CT660

Attention: When the system is turned on prior to the
power saving preset wake up time, scanning is
127.
disabled until the detector has reached proper
temperature.
WARNING WARNING
An unrecognized tube has been installed on
the system. Tube Cooling algorithms are
designed specifically for GE Medical Systems
tubes and the performance of the system
cannot be guaranteed with unrecognized
128. tubes.
Because of the high energy input allowed for
these tube units, failure to perform Tube
Warmup can result in destructive component
failure.
Contact your service representative if you
have questions about the tube compatibility
of this CT system.
Communication loss detected between scanner and
129. injector. Please turn off the injector and re-connect
the injector to scanner.
The parameters you prescribed on the scanner and
on the injector monitor are different. Please re-send
the parameters on the CT scanner to the injector by
130.
pressing the "Accept" button or press the "Get
Current" button to get the parameters currently set
on the injector.
Communication loss detected between scanner and
131. injector. Please turn off the injector and re-connect
the injector to the scanner.

Glossary
Glossary
2
2D
two-dimensional
3
3D
three-dimensional
A
A
Anterior
ALARA
As Low As Reasonably Achievable
AP
Anterior/Posterior
ASiR
Adaptive Statistical Iterative Reconstruction
AVG
Average
AW
Advantage Workstation
axial
divides anatomy into superior and inferior sections
B
BMD
Bone Mineral Densitometry
BPM
Beats Per Minute
C
CD
Compact Disc
CD-R
Compact Disc-Recordable
5366492-1EN Rev 1 (February 2010) Glossary-1

Optima™ CT660
CFR
Code of Federal Regulations
CISPR
International special committee on Radio Interference
CNR
Contrast-to-Noise Ratio
coronal
divides anatomy into anterior and posterior sections
CSA
Canadian Standards Association
CT
Computed Tomography
CTDI
Computed Tomography Dose Index
D
DAS
Data Acquisition System
DFOV
Display Field Of View
DICOM
Digital Imaging and COmmunications in Medicine
DLP
Dose Length Product
DMPR
Direct Multi Planar Reformat
DVD
Digital Versatile Disc
DVD-R
Digital Versatile Disc-Recordable
E
ECG
Electrocardiogram/Electrocardiograph
EFUP
Environment-Friendly Use Period
EHS
Environmental Health and Safety

Glossary
F
FBDIMM
Fully Buffered Dual Inline Memory Module
free viewport
a viewport that is not used for AutoView or AutoFilm
FTP
File Transfer Protocol
FWHM
Full Width Half Maximum
FWTM
Full Width Tenth Maximum
G
GI
Gastro-Intestinal
GRE
Global Reconstruction Engine
GSE
Gray Scale Enhancement
GSPS
Gray Scale Presentation State
H
HHC
HandHeld Control
HIPAA
Health Insurance Portability and Accountability Act
HIS/RIS
Hospital Information System / Radiology Information System
HU
Hounsfield Unit
HV
High Voltage
HVL
Half Value Layer

Optima™ CT660
I
ICRP
International Commission on Radiation Protection
ID
identification
IE
Internet Explorer
IEC
International Electrotechnical Commission
IGD
Inter-group Delay
in context
A HIPAA term meaning that all information and buttons in the center panel refer to the selected
user or group.
IPD
Inter-patient Delay
ISD
Inter-scan Delay
IT
Information Technology
IV
intravenous
K
keV
kiloelectron Volt
kVp
peak kiloVolt
L
L
Left
LCD
Low Contrast Detectability or Liquid Crystal Display
LED
Light Emitting Diode

Glossary
M
MAR
Metal Artifact Reduction
MHLW
Ministry of Health, Labour and Welfare
MINIP
Minimum Intensity Projections
MIP
Maximum Intensity Projections
MIROI
Multi-Image Region of Interest
MOD
Magnetic Optical Disk
MTF
Modulation Transfer Function
N
NCRP
National Council on Radiation Protection
O
OC
Operator Console
P
P
Posterior
PACS
Picture Archiving Communications System
PDU
PM
Planned Maintenance
PNF
Product Network Filters
PPS
Performed Procedure Step

Optima™ CT660
PVC
Pre-Ventricular Contraction
Q
QA
Quality Assurance
QC
Quality Check
QEF
Quality Equivalent Filtration
QSR
Quality System Regulation
R
R
Right
RAID
Redundant Array of Independent Disks
RAM
Random Access Memory
RAS
Right Anterior Superior
RF
Radio Frequency
ROIs
Region of Interest
ROM
Read Only Memory
RR
The distance from one R-peak to the next R-peak in the PQRS waveform
S
sagittal
divides the anatomy into right and left sections
SATA
Serial Advance Technology Attachment
SCIM
Scan Control Intercom Module

Glossary
SEGM
Segment- an ungated scan
SFOV
Scan Field Of View
SR
Structured Report
SSB2
SnapShot Burst 2
SSB4
SnapShot Burst Plus 4
SSEG
SnapShot Segment a single sector gated reconstruction
SSP
Slice Sensitivity Profile or SnapShot Pulse
U
UID
Unique Identifier
UL
Underwriters’ Laboratories
USB
Universal Serial Bus
V
VHS
VOI
Volume of Interest
W
W/L
Window Width and Window Level
WL
Window Level
WW
Window Width

Index
Index
A
about this manual 1-2
accelerator 12-324, 12-366
accessories 2-70
add 14-418
Add/Subtract 13-372, 13-372, 13-373
add images 13-373
bind series 13-374
Min/Max values 13-375
subtract images 13-373
algorithm 2-60
angle 2-67
annotate
Exam Rx 12-331
Film 8-222
ImageWorks 12-331
annotation
Reformat 14-392, 14-396, 14-397
anonymize 19-491
anonymous 16-452
applications
display 13-372
safety 2-59, 2-60
scan 9-235
archive
device 16-434
MOD 16-435
node 16-433
queue 16-436
ASiR 2-48
scan 9-237
Auto Scan 2-60
Auto Select 14-418
Auto Voice 8-205, 8-206, 8-225, 8-226, 8-227, 8-228, 19-484
AutoFilm 8-215, 15-425, 15-426, 15-427, 15-428
Autofit 14-412
AutomA 4-95, 8-198
axial 8-188, 9-258
5366492-1EN Rev 1 (February 2010) Index-1

Optima™ CT660
B
Bar Code Reader 2-70, 8-173
baseline 9-246
batch 14-421, 14-422, 14-424
bind 13-374
biopsy 2-61
Biopsy Mode 9-240
Bismuth shields 4-93
BMD 19-486
bolus 10-279, 12-337
breath hold 8-203, 8-204
Breathe Time 8-203, 8-204
Bright Box 5-107, 12-333
browser 12-354
C
calcium scoring 9-249
cancel 1-23
cardiac 10-269, 10-274, 10-292, 10-293, 10-294, 10-296
contrast scan 10-281
helical 10-292
localizer 10-278
manual bolus 10-279
monitor 2-70, 5-119
protocol 8-189
recon mode 10-284
safety 2-51
scan type 10-284
scout 10-273
setup 10-271
workflow 10-270
caution 1-2
CD
restore 16-446
save 16-444
view images 16-447
chair 2-68
cine 12-335
Cine Duration 8-199
cleaning 2-78, 2-79
color map 14-400, 14-411
Comb 13-372

Index
command 12-324
compare 12-336
computer 5-99, 16-447
configure
EA3 18-478, 18-480, 18-482
local users 18-467
ConnectPro 7-159, 8-184, 9-244, 13-379
console 1-4, 2-68, 5-99
contrast 8-178
conventions 1-3, 1-23
copy
protocol 17-461
curve 14-404, 14-424
cut planes 14-410
D
Daily Prep 1-21
danger 1-2
data
export 16-448, 16-449, 16-450, 16-451
patient 16-452, 16-453, 16-455, 19-491
privacy 18-464, 18-465, 18-467, 18-468, 18-469, 18-471, 18-472, 18-473, 18-474, 18-476, 18-479,
18-480, 18-482
safety 2-57
delete 16-438
AutoVoice 8-228
Data Export 16-451
protocol 17-463
schedule 7-163
density 12-338
DentaScan 13-372, 19-486
detector 5-139
DFOV 8-209
Direct Multi Planar Reformat
prescription 13-376
setup 9-241
display 13-372
FOV 8-209
monitor 1-5
normal 12-339
SmartPrep 9-248
SmartStep 9-256

Optima™ CT660
DMPR
prescription 13-376
setup 9-241
dose 4-92
download 19-496
DVD
restore 16-446
Retro Recon 11-319
save 16-444
view images 16-447
E
EA3 18-465, 18-467, 18-476, 18-478, 18-479, 18-480, 18-482
ECG 10-274, 10-296, 19-489
Trace 17-462
Viewer 10-296
edit
patient data 16-453
egress 2-75
electrical 2-41
electrodes 10-274
emergency 2-75, 8-183
Emergency Patient 1-15
end 8-184
enegy saving 6-150
engineer 19-497
Enhanced Xtream Injector 2-70, 2-73, 9-262
enterprise 18-471, 18-479
environment 2-80, 4-93
equipment 5-97
Bright Box 5-107, 12-333
cardiac monitor 5-119
cleaning 2-79
computer 5-99
detector 5-139
gantry 5-108, 5-115
HHC 5-136
keyboard 5-102
monitor 5-101
mouse 5-106
PDU 5-143
symbols 2-29
table 5-120, 5-122, 5-123, 5-124

Index
X-ray generator 5-144

X-ray tube 5-144
Exam Rx 1-9, 12-322
annotate 12-331
filters 12-340
Exam Split 9-244, 13-379
export
protocol 19-492
report 16-449
Extended CT Number 19-486
F
Feature Status 1-7
film 2-64, 15-425
AutoFilm 15-426, 15-427, 15-428
flip 8-218
Function keys 5-104
manual 15-429
queue 16-436
filters
Exam Rx 12-340
Film 8-223
flip 2-55, 8-218, 12-342
floaters 14-419
format
film 8-216
Function keys 5-104, 12-369
G
gantry 4-92, 5-115, 8-195
components 5-111
display 5-108
lights 5-110
GI 8-178
graphic
prescription 8-176
Retro Recon 11-313
Gray Scale Enhancement 8-224, 12-346
grid 12-344, 12-345
group
add/remove 18-472
enterprise 18-471

Optima™ CT660
local 18-469
remove 18-476
GSE 8-224, 12-346
GSPS 12-347
H
handheld controller 5-136, 5-138
hazard 2-81
HD MIP 14-408
heart rate 10-294
helical 2-60, 8-188, 8-189, 9-260
HHC 2-70, 5-136, 5-138
hide 12-348
histogram 14-405
history 16-443
host 16-439, 16-442
HU 19-486
I
iLinq 1-11, 19-494
image
display 12-361
management 16-432
network 16-441
reference 12-356
remove 16-438
restore 16-446
save 16-444
select 12-362
send 16-440
sort 12-365
Image Interval 8-194
ImageWorks 1-10, 12-323
annotate 12-331
compare 12-336
preferences 12-332
important 1-2
injector 9-262
Integral 14-408
Interscan Delay 8-202
inverse 12-357
IQSnap 19-488

Index
ISD 8-202
IV
contrast 8-178
pole 2-71, 5-123
K
keyboard 2-68, 5-102, 14-389
kVp 4-94, 8-197
L
language 1-24, 8-226
laptop 16-447
laser 2-54
leads 10-274
list 12-354
local user 18-467, 18-468
localizer 10-278
lock 18-475
login 6-146
logout 6-146
lung 2-60
M
mA 4-92, 8-198
magnify
Exam Rx 12-349
Film 8-220
ImageWorks 12-349
maintenance 2-78
manual 1-2
manual bolus 10-279, 12-337
measure 2-63, 2-66
density 12-338
distance 12-351
Reformat 14-398
mechanical 2-43
membership 18-476
memo 19-497
message 8-227
Min IP 14-408
Min/Max values 13-375

Optima™ CT660
minify
Exam Rx 12-349
ImageWorks 12-349
MIP 14-408
MIROI 12-337
MOD 2-70
save 16-435
monitor 9-246
cardiac 2-70, 5-119
computer 5-101
display 1-5
respiratory 2-70
scan 1-12
mouse 5-106, 12-352, 12-370
N
name 18-473
network 16-439, 16-440, 16-441
filters 19-495
history 16-443
host 16-442
queue 16-436
Neuro 3D 13-382
node 16-433
normal 12-339
note 1-2, 19-497
O
oblique 14-421
open
EA3 18-465
orientation 2-55
P
paint
Reformat 14-417
parameters
axial 8-188
film 8-214
helical 8-188
pediatric 4-94
recon 8-207

Index
scan 8-185, 8-199, 8-207, 8-214

timing 8-199
password 18-474
paste
protocol 17-461
patient
data 16-452, 16-453, 16-455, 19-491
information 8-171, 8-182
list 12-354
new 1-14
position 2-43, 4-93, 8-168
schedule 1-17, 7-155, 7-156, 7-157
pause 8-183, 11-315
PC 16-447, 16-450
PDU 5-143
pediatric 4-85, 4-91
dose 4-92
parameters 4-94
position 4-93
scan 4-91
Phase Location 10-293
pitch 4-95, 10-292
pollution 2-81
position 4-93, 8-168
posture 2-68
Power Distribution Unit 5-143
PPS 8-184
preferences
Accelator Line 12-366
ImageWorks 12-332, 12-344, 12-352, 12-360, 12-364, 12-366
Reformat 14-402
schedule 7-160
tick marks 12-366
W/L 12-368
prep 1-21
Prep Group 8-201
prescription
biopsy 9-240
DMPR 13-376
Graphic Rx 8-176
preset 8-182, 8-206
primary 12-355
Priority Recon 8-179

Optima™ CT660
privacy 18-464
Proc 13-372
Profile 14-407
protocol 17-456
build 17-457
cardiac 8-189
copy 17-461
default 17-460
delete 17-463
ECGTrace 17-462
edit 17-457
export 19-492
management 1-18
paste 17-461
Q
quality 2-65
queue 11-315, 11-316, 16-436
Quick Snap 19-487
R
radiation 2-36, 4-85
Ray Sum 14-408
recon 8-212, 8-213
cardiac 10-284
management 1-20
parameters 8-207
Recon Mode 10-284
Recon Options 8-213
Recon Type 8-212
reconstruction
Retro Recon 11-310
red 14-392
reference image 12-356
Reformat 2-67, 14-383, 14-386, 14-389, 14-390
annotation 14-392, 14-396, 14-397
Batch Film 14-421, 14-422, 14-424
Image Controls 14-387
measure 14-398
preferences 14-402
Segment 14-416, 14-417, 14-418, 14-419, 14-420
View Types 14-403, 14-404, 14-405, 14-407

Index
Volume Render 14-408, 14-409, 14-410, 14-411, 14-412, 14-413, 14-414, 14-415
regulatory 3-83
release 11-317
remote 16-439
remove 14-418
data 11-316, 16-438
graphics 12-348
patient 2-77
repeat 8-181
report
Data Export 16-448
PC 16-450
report cursor
Exam Rx 12-358
reserve 11-317
respiratory 2-70
restart 6-149, 19-490
restore
CD 16-446
DVD 16-446
Retro Recon 1-19, 11-310
graphic 11-313
queue 11-315, 11-316
save 11-318, 11-319
right-click 14-390
roam 12-353
ROI 2-67
Reformat 14-401, 14-402
rotate 2-55, 12-342
RR Interval 10-293
S
safety 1-2, 2-27, 2-28, 2-29, 2-33, 2-36, 2-60
save 2-64
CD 16-444
DVD 16-444
MOD 16-435
Retro Recon 11-318
screen 12-359
scan 8-164, 8-180
applications 9-235
ASiR 9-237
biopsy 9-240

Optima™ CT660
cardiac 10-281, 10-284

monitor 1-12
parameters 8-185, 8-188, 8-189, 8-199, 8-207, 8-214
pediatric 4-85, 4-91
setup 1-16
SmartPrep 9-246
SmartScore 9-249
SmartStep 9-254
stop 8-183
workflow 8-167
Scan Type 8-185, 10-284
schedule 7-155, 7-159
add patient 7-156
delete patient 7-163
edit 7-157
patient 1-17, 7-161
preferences 7-160
status 7-162
update 7-158
scout 8-174
cardiac 10-273
reference image 12-371
screen 2-68
save 12-359
saver 19-493
scroll
ImageWorks 12-353
secondary 12-355
segment 2-64, 14-416, 14-417, 14-419, 14-420
send 16-440
series 8-181
binding 12-360
page 12-341
service 19-497
setup
cardiac 10-271
DMPR 9-241
information 8-171
patient 8-168
pediatric 4-91
protocol 17-457
scan 1-16
SmartPrep 9-245

Index
SmartScan 9-253
SFOV 4-96, 8-196
shield 4-93
shortcuts 14-389
show 12-348
shutdown 6-145, 6-149
SmartmA 8-198
SmartPrep
display 9-248
scan 9-246
setup 9-245
SmartScore
considerations 9-249
scan 9-249
SmartStep 2-60, 2-61
considerations 9-256
display 9-256
preparation 9-252
scan 9-254
setup 9-253
SMPTE 16-455
software 19-496
sort 12-365
split 9-244, 13-379
standard 3-83
start 8-180
startup 6-145, 6-147
stop 8-183
system
energy saving 6-150
indication 3-84
management 19-483
restart 6-149
shutdown 6-145, 6-149
startup 6-145, 6-147
troubleshooting 1-26
use 3-84
T
table 2-61, 5-120
accuracy 5-124, 5-126, 5-129, 5-132, 5-135
IV pole 5-123
tray 2-72, 5-122

Optima™ CT660
text page 12-341

Thick Speed 8-192
threshold 14-420
time 19-493
timing 8-199
translations 1-24
treatment 2-62
troubleshooting
symbol 1-2
system 1-26
U
Unix 19-485
unlock 18-475
unreconstructed 11-314
USB 11-319
use 3-84
user
interface 1-23
lock 18-475
name 18-473
password 18-474
remove 18-476
unlock 18-475
utilities 1-22
V
video 12-357
viewport
Exam Rx 12-355
preferences 12-364
settings 12-367
Voice Lights Timer 8-205
volume 19-484
Volume Helical Shuttle 2-49, 9-260
Volume Render 14-408, 14-409, 14-410, 14-411, 14-412, 14-413, 14-414, 14-415
VolumeShuttle (Axial) 2-49, 9-258
W
W/L 2-65
Accelerator Line 12-369
arrow keys 5-105

Index
Bright Box 12-333

Film 8-219
Function keys 5-104, 12-369
HHC 5-138
keyboard 12-369
mouse 12-370
preferences 12-368
warning 1-2
Weighted MIP 14-408
workflow
Auto Voice 8-225
cardiac 10-270
pediatric 4-91
scan 8-167
X
X-ray
generator 5-144
tube 5-144
X Section 14-405
Xtream Injector 2-70, 2-73, 9-262
Z
zoom
Exam Rx 12-349
ImageWorks 12-349
Reformat 14-415


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Revision Date Reason for change

5366492-1EN Rev 1 (February 2010) ii

Chapter 2: Safety 2-27

5366492-1EN Rev 1 (February 2010) i

X-ray tubes 2-40

5366492-1EN Rev 1 (February 2010) ii

Chapter 3: Regulatory information 3-83

Chapter 4: Pediatrics and small patients 4-85

5366492-1EN Rev 1 (February 2010) iii

Use Small SFOV Filters 4-96

Chapter 5: Equipment 5-97

5366492-1EN Rev 1 (February 2010) iv

Chapter 7: Patient Schedule 7-155

Chapter 8: Scan 8-164

5366492-1EN Rev 1 (February 2010) v

Choose the Thick Speed options 8-192

Chapter 9: Scan applications 9-235

5366492-1EN Rev 1 (February 2010) vi

Chapter 10: Cardiac 10-269

5366492-1EN Rev 1 (February 2010) vii

Set the RR Interval and Phase Location 10-293

Chapter 11: Retro reconstruction 11-310

Chapter 12: View images 12-320

5366492-1EN Rev 1 (February 2010) viii

Chapter 13: Display applications 13-372

Chapter 14: Reformat 14-383

5366492-1EN Rev 1 (February 2010) ix

Use the Reformat Image Controls 14-387

5366492-1EN Rev 1 (February 2010) x

Chapter 15: Film 15-425

Chapter 16: Image Management 16-432

5366492-1EN Rev 1 (February 2010) xi

Compose a report 16-448

Chapter 17: Protocols 17-456

Chapter 18: Data privacy 18-464

Chapter 19: System Management 19-483

5366492-1EN Rev 1 (February 2010) xii

Appendix A: Operator messages Appendix A-1

5366492-1EN Rev 1 (February 2010) xiii

Chapter 1: Read me first

About this manual

5366492-1EN Rev 1 (February 2010) 1-1

About this manual

Safe and proper use notices

Important indicates information where adherence to procedures is crucial or where your

Purpose of this manual

5366492-1EN Rev 1 (February 2010) 1-2

Graphic conventions and legends

5366492-1EN Rev 1 (February 2010) 1-3

Operator Console applications

5366492-1EN Rev 1 (February 2010) 1-4

5366492-1EN Rev 1 (February 2010) 1-5

5366492-1EN Rev 1 (February 2010) 1-6

Feature Status area

5366492-1EN Rev 1 (February 2010) 1-7

Feature status icons and text areas

System status message area

5366492-1EN Rev 1 (February 2010) 1-8

Click the Exam Rx icon to open the Exam Rx desktop.

5366492-1EN Rev 1 (February 2010) 1-9

5366492-1EN Rev 1 (February 2010) 1-10