MOONRAY User Manual Rev34 20200122-71-150

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Software Guide
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A Sago Medica Company MOONRAY User Manual - Rev.34 - 2020/01/22

6 Software Guide MOONRAY User Manual - Rev.34 - 2020/01/22
6.1 Organizing Information

The Moonray system retains two types of information: text and images
(sequences).
• Textual information is collected in order to describe and document the
stored information. This information includes the patient’s personal
data, the doctor whom requested the exam, the doctor whom executed
the exam, the doctor whom read and interpreted the exam, etc. Other
data permits the system to univocally identify the exams carried out.
• The sequences represent the product stored from the images shown on
video during acquisition. The sequences produced are automatically in-
serted in a container called a series, which represents the exam’s “File”.
Every sequence belongs to a series and is characterized by the exposure
data, that is, the parameters used for its production, its name, its univo-
cal identifier number etc. All images are part of a series.
6.1.1 Series/Sequences
Every series is univocally identified with an “ID Series” number and contains
all the textual data relative to the exam.
The identification of a series is independent of the patient’s chart; therefore
a patient can appear in more than one series.
Every acquisition executed by activating one of the commands generates X-
Ray emissions producing images (frames), which are visualized on the video
and recorded in the permanent memory (hard drive) of the machine. These
are denominated sequences.
The sequences can have just one frame, several frames and mask frames,
according to mode set and the X-Ray command used to generate the se-
quence.
6.1.2 Anonymous Series

Upon start-up, the system automatically presents blank series which can
be recognized by the field “ID Series” which is “000000”, in other words
without the patient’s personal data, ready to receive the sequences. The
blank series is also presented every time the user opens a new series using
the “New Series” command, or closes the current series using the “Close
Series” command.
If there are no particular urgencies, we recommend inserting data before
beginning the exam, so as to make recognition of the series that one will
create easier. The user can edit the patient’s personal data at any moment,
both before and after the exam by recalling the series and editing it.
As soon as the patient’s personal data is inserted and confirmed, the series
passes from anonymous to identified.
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© Copyright SIMAD srl 2020
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MOONRAY User Manual - Rev.34 - 2020/01/22 6 Software Guide
6.1.3 Locked/Unlocked Series

When a series is created, it is always unlocked that is, it can receive sequen-
ces. If a series does not contain sequences, it can be re-opened to insert
new sequences.
A locked series is recognizable by the icon in Figure 20, visible in “Monitor
A”, which notifies the user of the locked X-Rays and therefore the sequences
contained can only be viewed and the system allows to add only sequence
those creation doesn’t require X-Ray emission.
Figure 20: “X-Ray Lock” Icon

Ch.
Closure of a series comes about when the user executes a “Close Series”
command. (See Table 18). 6
6.1.4 Work Planning
A list of exams to be made can be planned ahead of time, creating the seri-
es and filling in the patients’ personal data without inserting the sequences.
The series created this way will be memorized and will remain open and
ready to receive images. On the date of the exam, the operator will select
the series already prepared and will fill it with the exam’s images.
As already mentioned, as soon as a series receives at least a sequence and is
closed, a subsequent re-opening allows only revision of the images and the
system allows to add only sequence those creation doesn’t require X-Ray
emission.

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6.1.5 Apply/Remove a Search Filter

To carry out precise searches, the system offers the possibility to apply
search filters by utilizing a search form called “Filter Settings”.
To apply a filter:
1 fill in one or more fields with the chosen filter criteria
2 point and left click on the “apply filter” key.
Filling in a field, i.e. “Surname” Doe, the filter will only select the records
that have the name “Doe” inserted in the “Surname” field. If you fill in two
or more fields the number of records visualized on screen can diminish
because more information is given to enhance the search.
For example, the name “Doe” (without quotes) in the “Surname” field and
the name “John” (without quotes) in the “Name” field will produce only
John Doe’s exams (if present).
Apply Filter
Remove Filter
Figure 21: Search Window and Application Filers.
If the user closes the search window after having applied a filter with the
“Set Filter” form and opens it again, the form will show the preceding crite-
ria specified.
The “Remove Filter” command eliminates the filter criteria set.
6.1.6 Eliminating a Series/Sequence

To eliminate a series or a sequence, select the object and activate the
command “Eliminate” (see below). Eliminating a series or a sequence does
not automatically recuperate occupied space in the device’s hard drive. The
eliminated file is moved to the trash where it remains till the user decides to
expressly and permanently eliminate it.
To recuperate occupied space by the file you must first open the trash and
activate the command “Empty Trash” (see paragraph Database – Trash)
When you eliminate a series you also eliminate all its sequences.
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6.1.7 Recuperating a Series/ Sequence

As explained in the paragraph above “Eliminating a Series/Sequence”, the
files contained in the trash remain in the device’s permanent memory until
the user proceeds to empty the trash.
To visualize a series and/or sequences moved to “trash” you must reactivate
it with the command “Restore”. To do this, activate the trash view (see para-
graph Database – Trash), select the file you want to recover and activate the
command “Restore”.
6.1.8 Sequence Catalogue of an Exam in Progress

The image catalogue of an exam in progress is found on the left side of the
monitor “B” and views a list of the thumbnails of the images and/or of the
sequences present in the correctly selected exam for visualization.
When creating a new series (when you begin a new exam), the image catalo- Ch.
gue is empty and while the exam is in progress it fills with thumbnails of the
sequences generated by the emission of X-Rays and saved (both manually
or automatically) or snapshots are created with the command “capture
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snapshot”. Normally, the catalogue views only one column of thumbnails
(Column A in Figure 22): if there are a sufficient number of thumbnails in the
series, a vertical scroll bar activates on the right side of the catalogue with
which the user can scroll the images. Three keys are present on the upper
part of the catalogue (enlargements are shown in the lower part of Figure
22), which allow for expansion/reduction: pointing and left clicking on the
central key expands the catalogue to 2 columns, pointing and left clicking on
the key on the right, expands to the maximum amount of columns.
To request an image, the user must find it on the scroll bar and recall it by
positioning the pointer on the thumbnail and left clicking once.
The size of the catalogue is brought back automatically to 1 column if you
select and image to view on the monitor “B” or you activate X-Ray emission.
A B C
1 column 2 columns Expansion to maximum number of columns
Figure 22: Image Catalogue

Total pages: 218 Organizing Information 75
6.2 Input Peripherals

The user can interact with the Workstation software through the keyboard
and the incorporated trackball, which acts like a mouse.
The keyboard allows the user to edit fields and quickly activate several
commands (shortcuts found on the upper row of the keyboard) instead of
having to move a hand onto the trackball, position the pointer on the com-
mand and activate it by left or right clicking on the keys stationed below the
trackball.
Figure 19: “New” Workstation Keyboard
Send to Monitor B (Limited to

Moonray)
Take Snapshot
Activate the following recursive

filter level
Views/Hides Instruments
Decreases/Increases Window
Decreases/Increases Level
Activates the following mode
Go to the beginning
Play / Stop reproduction
Go to the end
Table 17: Keyboard Commands (Shortcuts)
The trackball on the right side of the keyboard allows the user to position
the pointer on the monitor and interact with the objects presented through
pressure on the right and left keys (click).
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6.3 Editing Data in a Field

To edit data in a field, position the pointer on the box containing the data
and left-click entering the “edit” mode which is indicated by the change of
the background of the field, as seen in Figure 23.
Figure 23
As soon as the data is modified, the save modification key goes from deacti-
vated to activated. (See Figure 24).
Save (deactivated)
Save (activated)
Ch.
6
Figure 24: Save Key
As can be seen in Figure 23, the characters that have already been typed
are automatically selected and typing any other character will result in the
elimination of the string of characters previously filled in.
• To move the cursor to the right or the left inside the field, use the arrow
keys “right” and “left” (see Figure 25)
• To eliminate characters that precede the cursor hit the “Backspace” key.
• To exit the “Edit” mode, point and left click the “Enter” key or right click
under the pointer in an area that does not contain modifiable fields.
Enter Backspace Left arrow Right arrow
Figure 25
To make modifications permanent, you must use the “Save” command iden-
tified by the “floppy” icon key. (Figure 24)

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6.4 Organizing Views

The system has been organized with overlapping views.
In the configurations with a double monitor, the left monitor always and
only shows the “Monitor A” view, which views the images coming from
acquisition. The right monitor has a principal view “Monitor B” and a series
of other views selectable with the corresponding tabs (Tab Strip).
To go from one view to the other you must position the pointer and click
on the tab that represents the name of the desired view. Additional forms
can be recalled by positioning the pointer and clicking on the corresponding
icon.
The system can offer other views that allow the user to interact with addi-
tional forms, which can be bought separately. The upper part of the right
monitor shows you the shortcuts to possible additional forms. (See Figure
26): in this case we have 3 additional forms.
Figure 26: Form Example
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6.4.1 Monitor “A” View
Moonray
Upon start-up, the multi-monitor system presents two principal views:
• Monitor A (Figure 31)
• Monitor B (Figure 34)
Monitor A, usually found on the left of the console, is intended to visualize
live images, that is, images obtained during acquisition.
Ch.
6
Figure 31: “Monitor A” View
“Monitor A” View:
• views and allows for selection of currently set work modes of the machi-
ne by using the keys present in the “Modality” area of the panel.
• Views the currently set X-Ray mode of the X-Ray console in the “X-Ray
Mode” area of the panel.
In the bottom left hand corner of Monitor A the boxes named “Disk”,
“Temp.” and “Signals” indicate the system status indicating respectively:
• How much space is available in the system’s permanent memory;
• The thermal status in real time of the X-Ray complex;
• Any possible alarm signals.
The central part of “Monitor A” visualizes the images during acquisition.
Initially it will appear black, but as soon as the fluoroscopy command or the
fluoroscopy+ command is activated, the images acquired or about to be
acquired will be viewed.
The upper and lower left sides of the images will be occupied by a series of
fields and their data

Total pages: 218 Organizing Views 79
Figure 32: “Monitor A” View
• In position 1 from top to bottom we can see: the progressive number of

the series, the patient’s data, “Surname”, “Name”, “Date of birth” and
the “Marked” status.
• Position 2 views the progressive number of the sequence.
• Position 3 views the data that characterizes the acquisition: date and
time of the acquisition, current intensity, voltage used for the genera-
tion of the X-Rays, the dose of radiation sustained by the patient during
acquisition of the sequence, the X-Ray mode used during acquisition and
the duration of the acquisition.
• Position 4 views the flip and rotation status currently applied to the
image.
Monitor A hides the tool keys during acquisition to lessen distractions as
much as possible to the user. They will newly be viewed when the fluoro-
scopy/fluoroscopy+ commands are released or when the pointer is brought
to the right or left area of the monitor or by press the key.
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Moonray Compact
Upon start-up the system presents the Monitor A view. To view Monitor B,
select the tab on the upper part of the screen (see Figure 33).
Ch.
6
Figure 33: Moonray Compact “Monitor A”

6.4.2 “Monitor B” View
Figure 34: “Monitor B” View
The “Monitor B” view allows you to leaf through the images (sequences) of
the current exam (series) and to retrieve them onto the screen. Its principal
function is to be a reference monitor, used to confront the image on “Moni-
tor A” with the one on “Monitor B”.
As you can see in Figure 34, the sequence catalogue of the current series
is available on the left hand side of “Monitor B”. During the course of the
exam, the thumbnail of the last acquired sequence will be added to the
catalogue only after saving it (manually or automatically) and only if there is
sufficient free space to contain it.
The user can retrieve and view any sequence on the screen, by scrolling
down the list, locating it clicking on the image miniature.
The images viewed in the catalogue represent the thumbnail of the sequen-
ces and indicate the progressive number of the sequence on the bottom left
hand side and on the right, the icon of the mode used for its generation.
Send to Monitor A
The catalogue can be viewed with 2 or 5 columns, by activating the keys
found on the upper part of the catalogue.
Send to Monitor B
The image currently viewed in Monitor B can be sent to Monitor A and
vice-versa by utilizing the commands “Send to Monitor A” and “Send to
Monitor B”. Eliminate
The currently viewed sequence can be eliminated by activating the com- Figure 35: “Send” and “Elimina-
mand “Eliminate”. te” Commands
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6.4.3 View Commands - Image Interaction

Commands
Following is a list of the commands that can be activated from Monitors A
and B and from the “Clipboard” command, which will be explained, in the
following paragraphs.
Close Current Series Take a Snapshot
Highlight Yes/No Enlarge
Reduce Send to Monitor A
Send to Monitor B Add to print composer
Ch.
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Horizontal Flip Vertical Flip
Show/Hide - Brightness/
Invert white with black
Contrast
Show/Hide Marking Tool Show/Hide Measurement Tool
Edit Text Annotation Eliminate
Show X-Ray dose recap Send to Clipboard
Shutdown Deactivate X Rays (60601-2-43)
Table 18: Command buttons from “Monitor A”, “Monitor B” and “Clipboard” views
The deactivate X-Rays command is viewed in the bottom right hand corner
of Monitor A, inhibits X-Ray exposure. Point and left click to deactivate
emission, point and left click again to reactivate. (CEI EN 60601-2-43 - §
6.8.2 gg)

6.4.4 “Patient Data” View

This view allows for management of text data relative to the current open
series, which will be transposed onto the images.
The view presents two columns as seen in Figure 36:
• The “Field” column, which lists the name of the fields that contain the
data.
• The “Data” column, which lists the data corresponding to the field.
The dark grey area of some of the view boxes indicates that the user cannot
edit the data in that field, while the user can edit the boxes with a light
background.
The “Complete List of Fields” box views a complete list of the fields.
Figure 36: Complete List of Fields
The exit command is visible on the bottom right and is used by the user to
shutdown the system.
.
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6.4.5 Database - “View”

This view allows the Database to be consulted. To recall, position the poin-
ter on the “Database” tab and left click.
Ch.
6
Figure 37: Database Window
This view is divided into two parts:

• the upper part contains the sub-views accessible;
• the lower part contains the commands that can be activated in the
selected sub-views.
Each of the three sub-views can be activated with the corresponding tab in
Figure 38.
Figure 38
• The “Exams” sub-view lists the series contained in the system.

• The “Worklist” sub-view lists the series created but not yet filled by at
least one sequence.
• The “Recycle bin” sub-view manages the eliminated series and/or se-
quences.
Every sub-view includes an “Update” command (see Table 19), which upda-
tes the current sub-view by re-reading the internal database.

6.4.6 Database - “Exams”

The upper part of the “Exams” sub-view shows the list of the series that are
presently in the system in a decreasing order in respect to the data of the
“ID Series” field.
Left clicking on the name of the column can change orientation; you will
view the rearranged order according to the data of the specified field. Left
clicking on the same column changes the order in increasing or decreasing
order.
You can scroll the list both horizontally and vertically to see the columns
that are not visible in the series.
Left clicking on a line of the series list, a “Patient Data” box will appear in
which the patient’s data relative to the selected series is present and in the
“Sequence List” box, a list of the sequences that pertain to the selected
series.
You can select a sequence pertaining to the selected series by left clicking
on the desired line from the list of sequences. This action shows the image
thumbnail of the sequence in the “Thumbnail” box.
The commands of the sub-view “Exams” are listed in Table 19.
Open Send to Clipboard
Print Eliminate
Create dose report Open export
Show filter settings Open import
Mark the sequence Update sub-view
Table 19: Exam Commands
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“Open Series”
allows you to open a series created previously and not yet filled with a
sequence.
How to proceed:
1 Position the pointer on the line corresponding to the series you want to
open.
2 Select by left clicking.
3 Activate the command “Open”. If another series is already open, a message
will ask if you want to confirm closure of the open series by viewing the
message in figure 39.
Ch.
Figure 39 - Confirmation Window

6
If the user confirms the open command, the system unloads the current se-
ries, opens the selected series, switches to the “Monitor B” view and loads
the sequences of the series in the image catalogue.
Please note that if at least one sequence is present in the series that is being
opened the series is locked and cannot receive other acquisitions, allowing
the user to operate only in post-processing mode on sequences already
acquired.
‘Print’
sends the selected sequences to the print composer (see Print Composer).
Select the series that contains the sequences you want to print. In the “Se-
quence List” box, select one or more sequences, position the pointer on the
line that describes the sequence, and right click to select the sequence to
print. To select more than one line, repeat the previous step, and hold the
“CTRL” key on the keyboard to create the list of sequences to print. Position
the pointer on the “Print” command and left click to activate the print com-
poser, which will view the selected images ready to be printed.

‘Create a DAP report’

produces a DAP (Dose Area Product) report of the radiation sustained by
the patient during the exam. Select the series for which you wish to print
a DAP report, position the pointer on the line of the series, select it by left
clicking and activate the command by positioning the pointer on the corre-
sponding icon and left clicking. A window will be viewed which summaries
the data grouped by type of exposure. Confirm printing through the print
key, a document like the one in Figure 40 will be printed. For details see the
dedicated paragraph in “Print DAP Report”.
Figure 40 – Example DAP Report
‘Show filter settings’

the activated window allows you to specify the criteria to use to view the
series in the list of series (See Apply/Remove Filter).
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‘Earmark the sequence’

allows you to earmark sequences, which are particularly important in order
to be able to find them again easily at a later time.
To earmark a sequence
1 select it by positioning the pointer on the corresponding line in the “Se-
quence List” window,
2 left click activating the command. The content of the field of the selected
line will change and will read: “Highlighted by the user”.
To remove the earmark, repeat the last step on an earmarked line.
To mark a series or a sequence, just select the series or the sequence and
right click.
Ch.
6

‘Send to Clipboard’
allows the user to send the sequence selected to “Clipboard”. Select the se-
ries to which the sequence belongs, select the sequence to send by positio-
ning the pointer on the line, left clicking and activating the command.
‘Eliminate’
allows you to eliminate the series and/or the selected sequence. Before
moving the file or files to the trash, the system asks for confirmation.
To eliminate a series
1 select the series by positioning the pointer on the corresponding line
2 left clicking, activating the elimination.
To eliminate a sequence:
1 select a sequence by positioning the pointer on the corresponding line
2 left clicking, activating the elimination.
‘Update sub-view’
allows the user to refresh the current view with any modifications made in
other views. Activating this command, the system reloads all the data in the
database eliminating any filters set on the view.
‘Open export’
activates an additional form that allows the user to manage data export.
‘Open import’
activates an additional form that allows the user to manage data import.
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6.4.7 Database - “Scheduled”

This screenshot allows the user to visualize the series that have been crea-
ted but have not yet been filled.
The upper part of the screen is divided into two areas:
• the list of the scheduled series
• the currently selected series and its data
The group of commands that can be activated are shown in Table 20 below.
Open Series Set Filter
Eliminate Series DICOM Worklist
Table 20: Database - Scheduled Commands

Ch.
6
Figure 42: Database - Scheduled Window
“Open Series”
allows the user to open the series previously created and not yet filled with
a sequence.
Instructions:
1 position the pointer on the series to be opened
2 select with a left-click
3 activate the “open” command. If a series is already open when you give
the “open” command, a message will appear to ask if you want to close the
current series to open another.

“Set Filter”
allows the user to filter the elements shown in this screenshot. After acti-
vating this command, the set filter window will appear (See Apply/Remove
Filter).
“Eliminate Series”
allows the user to eliminate a series from the list of the scheduled exams
moving it to the trash. Sometimes an exam scheduled for a certain day can
be cancelled for various reasons making the created series useless.
Instructions:
1 select the series to be eliminated by positioning the pointer on the corre-
sponding line
2 left click once
3 activate the “eliminate” command; a message will appear to ask you to
confirm the elimination of the selected series.
“DICOM Worklist Use”

this command activates the DICOM Worklist on the devices that are equip-
ped with this option.
6.4.8 Database – “Recycle bin”

The sub-view below (See Figure 43) gives the user a view of all the files that
have been cancelled with the “Eliminate” command but that have not been
definitively eliminated from the system’s hard drive.
Restore
Empty Trash
Eliminate
Figure 43: Database Trash Window
This view is similar to the “Exams” sub-view with different commands that Table 21: Database – Trash
can be activated. (See Table 21). Commands
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“Restore”
is used to move the selected file back to the area which contains the other
files available to the user to be elaborated.
Instructions:
1 Select the series or the sequence to restore from the list by positioning the
pointer on the corresponding line
2 Select by left-clicking
3 Activate the “restore” command, a message will appear to ask you to con-
firm the command.
“Eliminate file”
used to eliminate single sequences of a series or entire series with all its
sequences.
Instructions: Ch.
1 Select the file to be definitely removed by positioning the pointer on the 6
corresponding line
2 Select by left-clicking
3 Activate the “eliminate file” command, a message will ask you to confirm.
After confirming, the space previously occupied by the file in the hard drive
has now been freed.
“Empty Trash”
removes all files found in the trash creating free space previously occupied
in the hard drive.
Instructions:
1 Activate the command by positioning the pointer on the corresponding key
2 Select by left-clicking, a message will appear for confirmation. If you
confirm, the view will be updated showing the list of the empty series and
sequences.

6.4.9 Print Composer

The print composer can be activated in the view showing the command
which allows you to choose a layout and print the images. The print com-
poser can be activated in each of the screenshots that has a thumbnail of
the sequence: “Monitor A”, “Monitor B”, Database – Exams and Database
– Trash. The print composer can be activated only if the thumbnail shows at
least one sequence.
Activating the “Print” command, the print composer window will be viewed.
The print composer can be DICOM compatible in those installations in which
the DICOM PRINT option is present.
Print
Figure 44: Print Icon
Figure 45: Print Composer Window
6.4.10 “Clipboard” View

The Clipboard view acts as a support feature for the other views:
• Monitor A. Where present and enabled, the Monitor A view can use the
Clipboard feature to show the video without acquired subtraction in
fluoroscopy+ mode, both in the DSA and the Roadmap mode.
• Monitor B. The view present in Monitor B can be sent to the Clipboard
view.
• Database View. You can view sequences of an exam in the Clipboard wi-
thout opening it directly, thus allowing you to confront previous exams
with images of the current exam.
The commands available in this view are a sub-group of the commands of
the Monitor B view.
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6.5 Sequence Acquisition

Acquisition of the sequences is the work phase in which a sequence, that is,
a series of images, is shown on video and possibly recorded in the perma-
nent memory.
6.5.1 Types of Fluoroscopy

To generate sequences, two types of commands are present:
• The “Fluoroscopy” command
• The “Fluoroscopy+” command
Represented in the listed symbols of:
1 Fluoroscopy Ch.
6
2 Fluoroscopy +
Table 22: “Fluoroscopy” Commands
The manual fluoroscopy commands have the same function as the “Fluoro-
scopy” pedal command.

Total pages: 218 Sequence Acquisition 95
6.5.2 Work Modes

Images can be GENERATED in four different work modes:
• “Fluoroscopy”,
• “DSA” (Digital Subtraction Angiography),
• “RM” (Roadmap)
• “CINE”,
The sequence GENERATING work mode currently set in the system can
be identified in the upper right hand corner of Monitor A in the “Mode”
window, this window contains an interactive key represented by an icon.
Position the pointer and left-click on this icon to move from one mode to
the next, i.e. if you are in the Fluoroscopy mode, pointing and left-clicking
will bring you to the DSA mode, then to the RM mode etc.
Description of the principal work

Symbols Available Commands:
modes
1 Fluoroscopy
2 DSA
3 RM
4 Cine
Table 24: Work Mode
96 Sequence Acquisition © Copyright SIMAD srl 2020

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6.5.3 Recursive Filter

The level of the digital recursive filter, shown in the “Filter” box in Monitor
A, under the “Mode” window in the upper right-hand corner of the screen,
influences the quality of the images shown on video and recorded.
The level of this filter allows you to reduce the noise effects inevitably pre-
sent in radiological images. The higher the level of the recursive filter, the
less the image will appear noisy. Consequently though, the higher the level
of the filter the more there will be a “drifting” effect on the image.
In low current Fluoroscopy (1 - 3 mA) the use of the recursive filter F0 or F1
is recommended only in cases in which a modest low level contrast thre-
shold on details is not determining in the current process, due to the low
dose emitted and therefore the low rapport signal/noise.
Moonray uses the F2 filter by default, for activities in which the use of a
lower filter is necessary; we recommend the use of anodic current superior Ch.
6
to 3mA.
The C-Arm is generally to be considered a supplementary radiological devi-
ce and the images produced are not valid for diagnostic purposes.
As indicated in Table 25, the recursive filter has four available levels.
1 Recursive Filter Level Deactivated
2 Recursive Filter at 50 %
3 Recursive Filter at 75 %
4 Recursive Filter at 87,5%
Table 25: Filters
To pass from one level to the other, point and left-click on the recursive
filter key.
6.5.4 Horizontal and Vertical Image Flipping

1 Horizontal Flipping
2 Vertical Flipping
Table 26: Image Flipping
This feature is found on the left-hand side of the screen in the fourth box
from the top denominated “Effects” in Monitor A and in the top right hand
corner of Monitor B. To activate flipping:
• Point and left-click on the icon number 1 will be flipped horizontally.
• Point and left-click on the icon number 2 will be flipped vertically.
If both types of flipping are applied, the image will appear as if it has been
rotated 180°.

Horizontal and
Without Flipping Horizontal Flipping Vertical Flipping
Vertical Flipping
Figure 46: Flipping Effects
Figure 46 shows the horizontal and vertical flipping effects.
6.5.5 Brightness and Contrast Setting

3 Show/Hide the Brightness /Contrast Window
Both Monitor A and Monitor B can be regulated independently with the

following features:
• brightness,
• contrast,
• image flipping
• negative of the images shown
To regulate brightness and contrast, point and click on the relative icon (key
number 3 above) of either Monitor A or Monitor B, depending which screen
you want to regulate; this action will show/hide the brightness/contrast
window (See Figure 47).
As seen in Figure 47, the window title bar indicates the monitor on which
one is working.
This window allows you to regulate the parameters, both with the sliders, if
you want to regulate quickly, or with the plus and minus keys located under
the sliders, if you want a finer setting.
• The “W” slider (Window) indicates the number of grays available to
visualize the image. Moving the slider upwards, the number of grays will
increase, moving the slider downwards; the number of grays will decrea-
se with a consequential increase in the contrast of the image.
• The “L” slider (Level) allows you to transform the grays of the image into
the grays indicated by the slider, e.g. an image with a range of grays in Figure 47: Brightness and Con-
the center of the gray scale can be made brighter by moving this slider trast Regulating Window
downwards or darker by moving it upwards.
• The “B” lever (Brightness) acts on all the levels of grays present: moving
this slider upwards, the image will be brighter, moving it downwards the
image will be darker.
The slide bars on the far right allow you to move the threshold of white and
black by diminishing the number of tones of gray visible in the image.
The Reset key brings the parameters to the settings specified by the user
while the “Undo” key allows you to restore the parameters previously set.
When regulating these parameters you must keep in mind that the settings
will be used for all the following sequences acquired.
6.5.6 Black/White Inversion

Total pages: 218
4 Black/white Inversion
To invert the grays, point and click on the relative icon (number 4 above) in
either Monitor A or B in the relative “Effects” window, the image will there-
fore be viewed in its negative form.
6.5.7 Image Clipboard

5 Write/Edit Text Annotation
Activating command number 5 by pointing and clicking on the relative win-

dow in both Monitor A and B allows the user to write or edit n Annotation
on each sequence for which the following window will open:
Ch.
6
Figure 48: Clipboard Window
Instructions:
1 Insert a comment
2 Confirm entry by pointing and left clicking on the OK key. The comment will
be saved in the database.
3 To cancel entry, point and left-click on the “Cancel” key.

6.5.8 Video Marking

6 View/Hide the video marking command window (See Figure 49).
With the Marking Tool (See Figure 49) the user can draw directly on the
image to create visual references that will remain visible till they are
explicitly cancelled or hidden.
Various types of markings can be drawn: symbols of various forms (See
Table 27), lines, circles, ellipses, text and numeric references. Symbols and
geometrical forms can be personalized in color and thickness. Text, which
can only be created inside a text box, can be personalized in character color,
character type, character size and background color which can also be
transparent.
The two work modes, create and edit, are recognizable by the form the
pointer takes (See “pointer” column in Table 27).
Command Pointer Description
B1 Edit
B2 Create text box Figure 49: Marking Tools

Figure 50: Marker Type Selector
B3 Create line
B4 Create ellipse
B5 Create Arrow
B6 Create Empty Bullet
B7 Create Solid Bullet
B8 Create Plus Sign
B9 Create Numbered Marker
B10 not assigned Undo Command
B11 not assigned Redo Command
B12 not assigned Eliminate Command
Table 27: Keys and Pointers for Marking

Total pages: 218
Creating a text box

Instructions:
1 Point and left-click on the B2 key as indicated in Table 27 to
activate the command.
2 Choose where you want to place the upper left-hand corner
of the box by pointing and left clicking on the image.
3 Choose the bottom right-hand corner of the box by left
clicking on the image.
4 An insert/edit text window will appear (See Figure 51).
5 Type the desired text and edit the background color, size, Figure 51: Marking Editor for Text Clipboard
font and other parameters if you wish to do so.
6 Confirm by pointing and left clicking on the OK key or cancel with the Cancel
key.
Ch.
All “create” commands will be aborted by a new X-Ray emission.
6
Creating a Marker
instructions
1 Point and left-click B3 to B9) in Table 27 to activate the desired marker.
2 Position the marker in the desired area by left clicking.
3 Complete the creation of the marker by left-clicking a second time (only for
markers B3, B4, B5 e B9).
Suggestion:
• When creating a line, pressing the Shift key on the keyboard will allow
you to create lines oriented at multiple 45° angles.
• When creating an ellipse, pressing the Ctrl key on the keyboard indicates
that the point in which the pointer is positioned will be the center of
the rectangle in which the ellipse will be contained. If the Ctrl key is not
pressed, then the position of the pointer will be a vertex of the rectangle
in which the ellipse will be placed. You can create a circle by pressing
and holding the Shift key.

Editing Markers
instructions
1 Point and left-click the B1 key to activate the command.
2 Select the items you want to edit with a selecting rectangle (position the
pointer, left-click and release in a different position from the original. All
the items whose tops fall inside this rectangle will be selected. The selected
items are recognizable by small black squares with white outlines (called
handles) visible on their upper part).
Editing position
instructions
1 Position the pointer on one of the selected items,
2 Press and hold the left key while moving the pointer till the items selected
have reached the desired position
3 Release the left key
Editing color and thickness.
Editing orientation/dimension
instructions
1 Position the pointer on a “handle”
2 Press and hold the Ctrl key, press and hold the left key
3 Orient and resize by moving the pointer
Editing the text Annotation:
instructions
1 Double click on the text Annotation you wish to edit
2 The interactive box as indicated in Figure 51 will appear to allow editing.
Eliminating Markers
instructions
1 Point and left-click on the B12 key
2 A confirmation message will appear asking you to confirm elimination. Only
the selected markers will be eliminated but if no markers are selected then
all the present markers will be eliminated.
Undo/Redo
instructions
1 Undo the last command by pointing and left clicking on the B10 key (see
Table 27).
2 Redo the last command by pointing and left clicking on the B11 key. Only
the last 8 commands can be manipulated.

Total pages: 218
Hide
In the marker tool window (See Figure 49) point and left-click on this key to
hide the markers, when you activate this key the on-screen key automatical-
ly becomes a “show” key.
Show
In the market tool window (See Figure 49) point and left-click on this key to
show the markers, when you activate this key the on-screen key automati-
cally becomes a “hide” key.
Point and left clicking any marker editing or creating key will make the
markers visible.
Ch.
6

6.5.9 Measuring Toolkit

7 Shows/Hides the Measuring Toolkit Window (See Figure 52)
The Measuring Toolkit (See Figure 52) allows you to draw directly on the
images, to create length measurements, angle measurements and write text
Annotations that will remain visible until they are explicitly cancelled or
hidden. See relative icon on Monitor A or B.
Command Pointer Description
B1 Edit
B2 Create Measurement Text Box
B3 Measure Length
B4 Measure Angle
B5 not assigned Undo last command
B6 not assigned Redo last command Figure 52 – Measuring Toolkit
B7 not assigned Eliminate
Table 28: Measuring Toolkit -- Icons and Pointers
When you open the Measuring Toolkit Feature, a disclaimer box will appear.
(See Figure 53)
Figure 53: Confirm conditions of use of the measuring toolkit
The disclaimer dialog message is viewed with every new series.

If the referral length sample is missing or if it is created and then cancelled,
only Pixel measures will be created.
Up to two length samples can be created; one on a percentage scale and
the other in French (Fr) or millimeters (mm).
Creating a length sample

instructions
1 Point and left-click on the ruler icon, then left click on the “R” key in Figure
52 Measuring Toolkit.
2 Select the sample’s unit of measure
3 Create a length measurement and fill in the corresponding length segment
factor in the on screen “factor” box next to the “R” key.

Total pages: 218
4 Deactivate the “R” key by pointing and clicking as before. The presence of
the length sample is recognizable from the double measurement factors,
one in Pixel and the other in mm or Fr.
After you have created a length sample for the specified unit of measure, it
will be inserted among the units of measure that can be selected for measu-
ring lengths.
The Fr unit of measure is directly tied to the mm unit of measure by a

constant. Therefore, if you save a length sample in mm it will also become
available in the Fr unit of measure and vice-versa.
The creation of the “length sample” for the unit of measure in % implicitly
becomes a value of 100%, which corresponds to the length of the segment
drawn on the screen, regardless of what the user indicates.
It is possible to create a series of length measurements without having a
“sample length”, later identify a “sample length” and change the unit of
measure of the length measures already created.
If a length sample is edited, all the measurements, which refer to that Ch.
sample, will be recalculated.
6
Measuring a segment’s length
instructions
1 Point and click on the B3 key as shown in Table 28 to activate this feature
(the pointer becomes the same shape as the icon in the corresponding
column).
2 Select the unit of measure you want to use for your segment by selecting
from the drop down menu labeled U.M. of the window in Figure 52.
3 Left click on the first extremity to measure. Move the pointer to the end of
the second extremity to measure and left-click to terminate the measure-
ment. The system creates a text measurement box which hosts the factor
of the measured length; this box will be positioned in the middle of the
measured segment and can be moved (see below).

Using an existing length segment as a new sample

instructions
1 Select a new length measurement
2 Point and left-click on the “R” key in the Measuring Toolkit, select the length
sample’s unit of measure.
3 Type the corresponding length factor of the measurement segment in the
“Value” box.
4 Deactivate the “R” key by pointing and left clicking. All the length measu-
rements in the units of measure of the sample already present are then
recalculated according to the new length sample.
Measuring an Angle
instructions
1 Point and left-click on the B4 icon as seen in Table 28 (the pointer becomes
the same shape as the corresponding column). To identify the angle you
want to measure, you must identify 2 segments (each identified with 2 dif-
ferent points). The measurement of the angle is carried out on the intersec-
tion of the rays where the two segments lie.
2 Bring the pointer in correspondence to the first point of the first segment
and left-click. Move the pointer onto the endpoint of the first segment and
left-click. You will note that during positioning a line will be drawn from the
first point to the second.
3 Position the pointer in correspondence to the first point of the second
segment and left-click. Move the pointer onto the endpoint of the second
segment and left-click.
4 The system will draw an intersection of the rays containing the two seg-
ments, number the vertex of the triangle with the letters Ai, Oi, Bi (where
i is substituted by a unique number) and inserts a tag with the highlighted
angle’s measurement and its complementary angle.
Angles can only be measured in degrees.

Total pages: 218
Editing a measurement
instructions
1 Point and click on the B1 icon as shown in Table 28 to activate this feature
2 select the objects to edit with a selection rectangle by positioning the poin-
ter
3 left-clicking and releasing in a different position from the first. All the
objects whose vertex falls within this rectangle will be selected. The selec-
ted items are recognizable by small black squares with white outlines (called
handles) visible on their upper part).
Editing position
instructions
1 Position the pointer on one of the selected items,
2 Press and hold the left key while moving the pointer till the items selected
have reached the desired position Ch.
3 Release the left key 6
Editing color
instructions
1 Position the pointer on the color box
2 left-click to open the drop-down menu,
3 click to select color (See Figure 52 – Marking Tools.)
Editing orientation/dimension:
instructions
1 Position the pointer on a “handle”
2 Press and hold the Ctrl key, press and hold the left key
3 Orient and resize by moving the pointer, if you resize a length measurement
then its corresponding value will be varied. If you resize an angle measure-
ment then the corresponding angle measure will be varied.
Editing the position of the text measurement box
instructions
1 Point on the rectangle of the text measurement box
2 press and hold the Ctrl key
3 press and hold the left key under the trackball
4 move the pointer to change position of the box.
5 Release the left key when the box has reached the desired position.
Editing the text Annotation:
instructions
Point and double click on the text Annotation you wish to edit, the edit box
will open as seen in Figure 51

Eliminate Measurements
instructions
1 Point and click on the B7 icon as shown in Table 28.
2 A confirmation of the command is requested. Only the selected measure-
ments will be eliminated. If none of the measurements are selected then all
the measurements will be eliminated.
Undo/Redo
Point and click on the B5 icon as shown in Table 28 to undo the last com-
mand. Point and click on the B6 icon to redo the last command. Only the
last 8 commands can be manipulated.
Hide
In the marker tool window (See Figure 49) point and left-click on this key to
hide the markers, when you activate this key the on-screen key automatical-
ly becomes a “show” key.
Show
In the market tool window (See Figure 49) point and left-click on this key to
show the markers, when you activate this key the on-screen key automati-
cally becomes a “hide” key.
If you have hidden any of the marking objects, left-clicking on any of the
editing buttons will show the previously created objects.

Total pages: 218
6.5.10 Saving Images

To select the “save” option according to the work mode you are using, left
click on the corresponding icon which identifies the type of work mode you
are using. (See Figure 54).
Save Options for Fluoroscopy
Save Options for Fluoroscopy +
Figure 54: Saving Options
The following options are available:
Symbol Saving Description Fluoroscopy Fluoroscopy+ Ch.
1 Saving Deactivated Yes Yes 6

2 Manual Yes Yes
3 Save only the last image Yes Yes
4 Save the entire sequence No Yes
5 Saving is impossible due to insufficient space Yes Yes
Table 29: Saving Option Commands
When the user selects to save manually (Icon 2), the sequence will be saved
in any case and at the end of the acquisition, the “Image” window in Moni-
tor A will view one of the two icons in Figure 55.
Save the last image Save the entire sequence
Figure 55: Save Commands
The last image acquired will be saved in the current series when clicking on
one of the two icons above. This acquisition will be lost if the machine is
turned off or if one of the two Fluoroscopy commands is activated before
clicking on one of the two “save” icons in Figure 55.
Icon number 5 in table 29 can signal insufficient available space and therefo-
re the impossibility to save.
Each time you save, the system creates a thumbnail of the image inside
the catalogue. This operation will slowly diminish the system’s resources
and will diminish its performance. To keep the system’s performance at its
best, we suggest you do not exceed 600 images. Once you reach the limit
of 1000 images the system will lock X-Ray emission.

6.5.11 Angular Position of the camera

The acquisition camera can rotate about 360° in order to correctly orient
the radiological images. A mechanical stopper prevents rotations above
360°.
“Monitor A” will show a small circle in the corner in which the camera is po-
sitioned and a rectangle where the rotation’s mechanical stopper is found.
(See – Figure 56 A).
The rotating activating command is found on the C-Arm Console (see §4
Using the Moonray). By activating this command, the angle of the camera
can now be manipulated with the knob located on the console itself.
• If the user activates the rotation command without emitting X-Rays, the
screen will visualize the angular position of the camera with an arrow
(See Figure 56 – B). To orient the camera, the arrow must be aligned with
the vertical axis of the image below. The arrow disappears about 150 ms
after the rotation arrest (See Figure 56 – C). When X-Rays are emitted,
the system brings the angular position indicator to the “twelve o’clock”
position to indicate that what is shown on the screen is the “top” of the
image. (See Figure 56 – D).
• If the user activates the camera rotation command while he is emitting
X-Rays, he will see the images produced by the camera rotate in real
time.
A – Position Markers B – Position Search C – Camera position D – Camera position after

before acquisition acquisition
Figure 56: Position Markers
6.5.12 Collimator Position Thumbnail

In the models in which this feature is available and activated, a thumbnail of
the position of the compensator filters and the iris diaphragm can be seen
without X-Ray emission. During collimator movement, a thumbnail of the
final position will appear onscreen (see below); the thumbnail will disappear
1 second after movement has arrested or after X-Ray emission has begun.
Thumbnail of the iris Position after X-Ray Thumbnail of the position Position after X-Ray
diaphragm position during emission of the compensator filters emission
movement during movement

Total pages: 218
The camera’s rotation does not cause the collimators to change their posi-
tion in respect to the anatomical part but will surely change their previous
position on screen. To see their new position, move them slightly and bring
them back to the desired position.
6.5.13 Digital Subtraction

When generating sequences in digital subtraction, a particular frame called
“mask” is first acquired and then subtracted from the images produced
during acquisition, so as to highlight those particular areas that differ from
the image of the mask itself (See Figure 57).
Ch.
6
M - Mask F - Frame Difference M - F
Figure 57
The mask frame, once acquired, will become visible by activating the “Mask
Catalogue” (See Figure 58) window with the key number 1 indicated in Table
30.
The mask frame is associated with every sequence produced in the digital
subtraction mode.
1 Shows/Hides the mask catalogue
2 Shows/Hides the subtraction settings
3 Adds the current frame to the mask catalogue
4 Activate/Deactivate subtraction
5 Activate/Deactivate the max opacity feature
Table 30: Digital Subtraction Commands
The digital subtraction settings can be edited through the “Subtraction

Settings” window which will appear when you point and click on number 2
of Table 30.
The mask to be used for digital subtraction can also be changed by adding a
new frame to the mask catalogue and using it in the place of the one gene-
rated automatically.
During viewing you can momentarily deactivate and later reactivate digital
subtraction by pointing and clicking key number 4 in Table 30.
The number 5 key in Table 30 allows you to select the max opacity function
of every pixel point of a sequence.

6.5.14 Mask Catalogue

The mask catalogue (See Figure 58) groups up to four masks pertai-
ning to the same sequence and allows the user to select a different
subtraction mask from the original.
As can be seen in Figure 58, the window views four different icons,
which correspond to the four functions listed in Table 31.
1 Eliminate the current mask
2 Eliminate all masks
3 Add mask from Clipboard

Figure 58
4 Send copy of mask to Clipboard
Table 31: Mask Catalogue Commands
• Key number 1 allows the user to remove the selected mask from the
catalogue; this command cannot be used on the original mask but only
on those created in post processing.
• Key number 2 eliminates all the masks present in the catalogue aside
from the original mask.
• Key number 3 is used when an image is present in “Clipboard” and
allows this image to be copied in the mask catalogue to be used as a
subtraction mask.
• Key number 4 allows you to send the currently selected mask to “Clipbo-
ard”.
6.5.15 Subtraction Settings

The digital subtraction settings can be varied with the options present in the
“Subtractions Settings” window below (See Figure 59).
Figure 59: Subtractions Settings Window
The window is subdivided as follows:

Total pages: 218
• The “Enhancement Type” window allows the user to choose an algori-

thm used to reinforce the effects of the digital subtraction specifying the
value in the “Enhancement Level” feature. A low reinforcement value
will produce a low contrast of the grays in the frame resulting from the
subtraction. The linear enhancement increases the contrast points of the
frame based on a linear law, while the type of logarithm enhancement
(where present and enabled) uses a logarithmic law which better enhan-
ces the grey values closer among themselves.
• The “Auto Sub” feature (where present and activated) can be used in the
DSA and Roadmap modes and automatically reactivates digital subtrac-
tion when the Fluoroscopy+ pedal is activated, regardless of the subtrac-
tion settings. If Auto Sub is not activated, acquisitions of sequences in
Fluoroscopy+ will be without digital subtraction.
• The “Video in Clipboard” box in Monitor B allows the user to view both
the images, without subtraction, coming from the camera and from
the Monitor A view simultaneously. This mode is deactivated when the
user confirms deactivation of this function after sending an image to the Ch.
Clipboard box from Monitor B or from the “Archive” view.
• The “transparency” feature allows you to mix the subtraction result
6
with the frame that has been subtracted (Land Marking). A 0% value will
show only the subtraction result frame on screen, a 100% value shows
only the frame without the mask subtraction; values in between increa-
se/decrease the influence of the two frames in the final result.
• The “shift” parameter allows you to shift the value of the grays of every
pixel in the subtraction frame so that the values that are nearly black will
be remapped to the applied shift.
• The box containing the X and Y coordinates (See Figure 59) allows the
user to edit the alignment of the mask used in the subtraction by using
the arrow buttons places horizontally and vertically (Pixel Shift). To clear
the alignment point and left click in the middle of the box.
• The “Reset” key brings the settings back to the default values of the
current work mode.
• The “ON/OFF” button exits the window.

6.5.16 Recording Speed

The Recording Speed of the frames/second can be chosen to diminish space
occupied by the sequence in the hard drive. The options are listed in Table
32.
1 25 Images/sec.
2 12 Images/sec.
3 8 Images/sec.
4 6 Images/sec.
5 4 Images/sec.
6 2 Images/sec.
7 1 Images/sec.
8 0,5 Images/sec
Table 32: Recording Speed
The default parameter can be personalized.

Total pages: 218
6.6 Generating images

Images are generated with X-Ray emission, when the user activates one of
the Fluoroscopy or Fluoroscopy+ commands (See Types of Fluoroscopy).
Figure 60 X-Ray Emission in Progress
Figure 61 Acquisition Preparation
Figure 62 X-Rays Locked
Figure 63 Limited Time Fluoroscopy Ch.

6
Figure 64 Cooling Pause
Figure 65 Reset
During X-Ray generation, the icon (X-Ray Emission in Progress – Figure 60)
will appear in Monitor A, which indicates emission of X-Rays.
An hourglass symbol will appear in the center of Monitor A during the first
few seconds while the preparation phase is in progress: when the prepara-
tion phase is complete, the symbol disappears and the fluoroscopic image
will appear (See Figure 61). If the user releases the Fluoroscopy or Fluoro-
scopy+ command before the preparation phase is complete, the radiological
image will not be visible.
If the icon in Figure 62 appears on Monitor A, the system locks any X-Ray
emission command.
When the user executes a high current Fluoroscopy+ emission, the icon
in Figure 63 appears and is “filled” to show the residual time available of
Fluoroscopy+ X-Rays.
The “Cooling Pause” icon in Figure 64 appears at the end of the high current
Fluoroscopy+ command to signal the impossibility to emit X-Rays till the
cooling pause has been completed.
The “Reset” icon in Figure 65 indicates that a reset command from the
C-Arm console of the X-Ray time limit has been activated because the time
limit of use of the C-Arm has been reached.

Total pages: 218 Generating images 115
6.7 Fluoroscopy
In the “Fluoroscopy” mode, the acquired sequences are shown on video and
only the last frame is saved.
To save the fluoroscopic images, take the following steps:
1 Select the “Fluoroscopy” mode.
2 Regulate the filter level, if necessary, by pointing and left-clicking on the
“Filter” window in Monitor A (See Recursive Filter).
3 Specify, if necessary, the image save mode (See Saving Images).
4 Place the device aimed on the anatomical part of interest until you reach
the desired position.
5 Activate the Fluoroscopy command until the image appears on Monitor A.
6 Regulate brightness and/or contrast of the image if necessary (See Regula-
ting Brightness/Contrast).
116 Fluoroscopy
Total pages: 218
6.8 DSA
In the DSA mode, Fluoroscopy produces sequences of fluoroscopic images
and, according to the settings, can only save the last frame of each sequen-
ce.
To save a sequence in digital subtraction you must activate the Fluoro-
scopy+ command and keep it activated.
To save a sequence in the DSA mode, take the following steps:
1 Select “DSA” mode.
2 Regulate the filter level, if necessary, by pointing and left clicking on the
3 Specify, if necessary, the image save mode (See Saving Images).
4 Center the anatomical part of interest and use the Fluoroscopy command to Ch.
verify the correct position.
5 Regulate brightness and/or contrast of the image if necessary (See Regula- 6
6 Begin digital subtraction by using the Fluoroscopy+ command. The following
is a step-by-step account of the procedure:
• automatic acquisition of the frame to subtract from the other frames
(mask frame)
• digital subtraction phase, signaled by the icon “Injection of Contrast
Liquid Possible” (See Figure 74). Injection of the contrast liquid.
• to obtain an adequate result the Fluoroscopy+ command must be held
active the entire time.
Contrast Liquid Injection with Injector (Figure 74) and without (Figure 75)
Figure 74 Figure 75
7 terminate digital subtraction by deactivating the Fluoroscopy+ command.

Acquisition terminates when the Fluoroscopy+ command is released, the
icon “X-Rays Locked” will appear for a few seconds on Monitor A (See Figure
62) which indicates an elaboration in progress of the system.
Between one Fluoroscopy+ command and another, digital subtraction can
be deactivated/reactivated. (See Digital Subtraction).
The activation of the injector is subordinated to the manual injection

approval command managed by the injector itself. In case of failure, an
accidental injector piloting or a failed injector piloting may occur.

Total pages: 218 DSA 117
6.9 Roadmap
This is a digital subtraction mode. The substantial difference between this
mode and DSA is that contrast liquid injection is necessary during the mask
creation phase. Both Fluoroscopy and Fluoroscopy+ commands can be
activated in this mode. The Fluoroscopy command produces sequences of
fluoroscopic images and, according to the settings used, can save only the
last frame of every sequence; furthermore, you can “reset” to reacquire the
digital subtraction mask.
The Fluoroscopy+ command activates the Roadmap function.
To save images in this mode take the following steps:
1 Select the “Roadmap” mode.
2 Regulate the filter level, if necessary, by pointing and left clicking on the
3 Specify, if necessary, the image save mode (See Saving Images) for both the
fluoroscopy commands.
4 Center the anatomical part of interest and use the Fluoroscopy command to
verify the correct position.
5 Regulate brightness and/or contrast of the image if necessary (See Regula-
6 Begin the mask frame formation phase by using the Fluoroscopy+ com-
mand. The following is a step-by-step account of the procedure:
• automatic acquisition of the frame to subtract from the other frames
(mask frame)
• digital subtraction phase, signaled by the icon “Injection of Contrast
Liquid Possible” (See Figure 74).
• Injection of the contrast liquid.
• Begin the subtraction phase by activating the “Fluoroscopy+” command.
The created mask will be used.
7 Terminate digital subtraction by deactivating the Fluoroscopy+ command
All the “Fluoroscopy+” commands activated after the mask subtraction ac-
quisition phase use the subtraction mask and subtract it from the acquired
frames.
Every time the “Fluoroscopy+” command is deactivated, digital subtraction
can also be deactivated with the command mode (See Digital Subtraction).
The use of the “Fluoroscopy” command brings the system back into a new
mask creation phase.
The activation of the injector is subordinated to the manual injection

approval command managed by the injector itself. In case of failure, an
accidental injector piloting or a failed injector piloting may occur.
118 Roadmap
Total pages: 218
6.10 Cine
This work mode is used to record fluoroscopic sequences and the “Fluoro-
scopy” command is used to record single frames while the “Fluoroscopy+”
command is used to record complete sequences.
To record images in the “Cine” work mode, take the following
steps:
1 Select the “Cine” mode.
2 Regulate the filter level, if necessary, by pointing and left-clicking on the
“Filter” window in Monitor A (See. Recursive Filter).
3 Specify, if necessary, the image saving mode (See Saving Images) for both
the fluoroscopy commands.
4 Center the anatomical part of interest and use the Fluoroscopy command to
verify the correct position Ch.
5 Begin acquisition by activating the “Fluoroscopy+” command. 6
6 Terminate acquisition by deactivating the “Fluoroscopy+” command.

Total pages: 218 Cine 119
6.11 Indicators, Alerts & Error Messages
6.11.1 Indicators
Figure 66: Hard Disk Space and Temperature Indicators
Hard Disk Space - Vertical Bar Indicator: The bar indicates the percentage of
available space for the images in the hard disk.
When the available space reaches the limit of 0%, the acquired images will
still be visualized on the Monitor A, but will not be saved, that is, they will
not be available for visualization at a later time. The user must always keep
a “reasonable” percentage of hard disk space available, which coincides
with his style of working and the use of the device. To free space on the
hard disk, take the following steps:
• To save a copy of the data, follow the procedure indicated in “Export
Data” and then proceed with the cancelation of the file from the Databa-
se and the Trash.
• If a copy of the data is not necessary, then proceed with cancelation
from the Database and the Trash.
Temperature – Vertical Bar Indicator: The bar indicates the monobloc tem-
perature.
During X-Ray emission, the monobloc’s temperature increases towards a
thermal saturation limit, when reached, X-Ray emission is disabled.
120 Indicators, Alerts & Error Messages

Total pages: 218
6.11.2 Alert/Error Messages

Monitor “A” interacts directly with the X-Ray generator and views a series of
icons which signal various alert/error conditions. The icons are listed below:
A1 Failed Dosimeter Calibration
A2 Temperature Limit Reached (limited to the Moonray 1K version)
A3 Dosimeter Malfunction
A4 Communication Time-Out
Ch.
A5 C-Arm Disconnected or Off
6
A6 C-Arm Continuous Use Time Limit Reached
A7 No mains power, the computer is powered by the UPS.
A8 The UPS batteries are low.
A9 The UPS batteries are not charging or are out of order.
A10 The UPS software control is deactivated.
Table 33: Monitor A - Alert/Error Messages
The alert message in Figure 67 informs the user that the examination in
progress has already reached 600 images and is therefore long. The messa-
ge does not implicate any variations to the machine operation but recom-
mends that the user end the current exam due to the elevated number of
images that have been stored in the exam.
To hide the message, left-click on the “OK” button or press the “Enter” key
on the keyboard.
Figure 67 – Elevated Number of Images Alert Message

Total pages: 218 Indicators, Alerts & Error Messages 121
The alert message in Figure 68 informs the user that X-Ray emission has
been locked because the system has reached the image limit of 1000 ima-
ges/sequence.
Figure 68 – X-Ray Emission Locked – Image per Sequence Limit Reached
122 Indicators, Alerts & Error Messages

Total pages: 218
6.12 UPS (Uninterruptible Power Source –

Optional)
The system is equipped with a UPS (generator) which disposes of a battery-
run autonomous electrical power system that can guarantee continuous
power to the computer and safeguard the data and the operating system
from accidental or voltage dip shutdowns.
This autonomous system does not allow the user to continue X-Ray emis-
sion but, in cases of voltage dips, the internal computer activates an auto-
shutdown procedure that protects data and images contained in the system
from possible damages.
When power is newly available to the system, the user must re-boot by
turning the startup key (this operation is possible only if the system hasn’t
begun the auto-shutdown procedure).
Ch.
When the UPS batteries are fully charged and efficient, the automatic shut- 6
down procedure will take about 3 minutes (can be configured differently).
When the UPS batteries are NOT fully charged and efficient, the automatic
shutdown procedure will take a relatively short period of time, about 10
seconds (can be configured differently).
Indicator lamps on the UPS:

• green lamp: power available
• yellow lamp: low batteries
• orange lamp: batteries charged
If the batteries are not fully charged and do not recharge in a reasonable
amount of time, the computer will signal the need for service to the user
but will nevertheless allow normal X-Ray emission.
Since low batteries do not guarantee ad adequate autonomy, in cases of
voltage dips, the internal computer software can suffer damages which
would then call for a new software installation.
Icon List:
No power supply: the computer is functioning on its own batteries.
The UPS batteries are not completely recharged. They might have lost power during a preceding black-
out or due to a long period of inactivity. They should be recharged after about 10 hours of use.
The UPS control system is deactivated. In case of power loss or battery malfunction the computer will
take no action, in other words, there will be no automatic shutdown.
Service request for the UPS system, the batteries are probably low and do not recharge.
Table 34: UPS Status Messages

Total pages: 218 UPS (Uninterruptible Power Source – Optional) 123
If the UPS is installed and activated, the icons in Table 34 will interact with
the user. See Figure 71 for on-screen location.
Figure 71: UPS Alert Icon Location
In case of power failure, a message will alert the user of the beginning of the
automatic shutdown procedures of the system (See Figure 72: Power Failure
Alert)
Figure 72: Power Failure Alert
124 UPS (Uninterruptible Power Source – Optional)

Total pages: 218
To deactivate the system’s shutdown procedure, point on any point of the

on-screen alert message and left-click. A confirmation message box will
appear to abort the automatic shutdown procedure (See Figure 73).
Ch.
6
Figure 73: Abort UPS Automatic Shutdown Box
If power supply does not return or if power returns but the device does not
startup after having turned the startup key, the computer will consume the
battery power completely and will potentially shutdown abnormally, dama-
ging the data and the installed software.
UPS Parameters in Software Settings:
Parameter Description
Enabled Activates the UPS status check function
COM port Selects the serial port which checks the UPS status
Delay before start service (sec) Indicates the delay, in seconds, before the UPS status is checked.
Check battery signal Checks/Ignores the low battery signal (DTR pin 4 com port)
Check power failure signal Checks/Ignores the power failure signal (DTR pin 7 com port).
Enables service request in case of low battery alert (See Table 34). The request
Ask assistance if Battery is Low
assistance icon never appears.
Delay before shutdown (sec) Indicates how many seconds the countdown will last.
The countdown will be shorter and will begin from this setting due to low
Short delay before shutdown (sec)
batteries.
Table 35: Configuration Parameters for the UPS Manager

Total pages: 218 UPS (Uninterruptible Power Source – Optional) 125
6.13 Print Composer

Every time the user sends an image print request currently shown on scre-
en, the print composer server is activated.
This feature has been designed to facilitate the collection and the availabi-
lity of the images the user needs, allowing him to print the images simulta-
neously to the exam execution. The images to be printed can be composed
by selecting them from almost every view.
6.13.1 Print Composer Description

The print composer window can be automatically hidden (not closed) by
pointing anywhere outside the window itself and left clicking. To reactivate
point and left-click on the shortcut key in the upper right-hand corner of
Monitor B or give another print command of an image.
Figure 76: “Print Server” Window
The print composer window contains the following:

• Print setting options in the left column.
• Thumbnail of the image to be printed in the center of the
page.
• Commands to leaf through the images ready for printing
• Page currently viewed indicator.
Images can be sent to the printer only if the print composer is
open.
Figure 77: “Print Composer” Window
126 Print Composer

Total pages: 218
6.13.2 Print Composer Settings

Print parameters can be set by utilizing the commands seen in Table 36.
Select printer
Select paper orientation
Set the number of cells of the image grid.
Text spacing setting

Ch.
Table 36: Print Setting Commands 6

Printer box -- specify which printer to use.
Orientation box – specify vertical or horizontal orientation (See Figure 78).
Vertical Horizontal
Figure 78: Print Orientation
Row x Column box – specify the grid to use for image impagination. If the
number of rows and columns is 1, one image per page will be printed, or 2
rows and 1 column, two images per page will be printed, or 3 rows and 1
column, 3 images will be printed or 2 rows and 2 columns, 4 images will be
printed. (See Figure 79).
Figure 79: Print Layout

Total pages: 218 Print Composer 127
6.13.3 Print Composer Commands

The print composer commands are shown in Table 37 below.
Print
User Preferences
Previous Page
Next Page
Exit
Table 37: Print Composer Commands
Print: Send pages to the printer

User Preferences: Activates the User Preference Window used to set advan-
ced printer settings. (See Figure 80).
Figure 80: User Preferences Window
• Heading box: if checked, places the desired heading on each page, i.e.
the name of the hospital and activates the character size option, see
Customizing in §6.24.
• Show image data box: if checked, prints the parameters used to Without filling Filling empty
acquire the sequence and activates the character size option. empty space space
• Show image Annotation: if checked, text Clipboard attached to

the image will be printed.
• Fill empty space printing: if checked the grid cells that do not con-
tain images are completely filled in black (see Figure 81) in order
to better evaluate images.
• Footnotes: when checked, footnotes can be entered in the input
field below that will be viewed at the bottom of every page. Figure 81: Fill Empty Space Printing
128 Print Composer

Total pages: 218
6.13.4 Impagination
Composing images
Once the print composer has been enabled with a “Print” command, further
images can be sent for printing before confirming from any of the following
views with another “Print command: Monitor A or B, Archives – Exams,
Archives – Recycle bin.
Setting the impagination grid

To increase the number of images present in every page, use the “Rows x
Columns” feature to edit the number of rows and/or columns of the grid in
which the images are aligned.
Repositioning an image Ch.

To move an image on the grid, position the pointer on the image to move,
press and hold the left key (the pointer’s form changes) and drag the image 6
to the desired position, release the left key. The images will exchange posi-
tions. (See Figure 82).
Repositioning an image Eliminating an image
Figure 82
Eliminating an image
To eliminate an image from a print composition, position the pointer on the
image to be eliminated, right-click on the image to open the context menu
and select the “Eliminate” command, confirm removal. (See Figure 82).

Total pages: 218 Print Composer 129
6.14 DICOM Print Composer

This is an optional feature that might not be present on the system you are
using.
Every time the user sends a print request to the system, the print composer
server is activated. If the DICOM server option is available, the available
print composer will appear equipped with the selecting functions on the
remote DICOM server printer and on the local printer. Activating the DICOM
print composer will automatically deactivate the standard print composer.
This feature has been designed to facilitate the collection and the availabi-
lity of the images the user needs, allowing him to print the images simulta-
neously to the exam execution.
The images to be printed can be composed by selecting them from almost
every view.
6.14.1 DICOM Print Composer Description

The print server is viewed in a window overlapping the current view.
The print composer window can be automatically hidden (not closed) by
pointing anywhere outside the window itself and left-clicking. To reactivate
point and left-click on the shortcut key in the upper right-hand corner of
Monitor B.
The print composer window contains the following:
• Print setting options in the left column.
• Thumbnail of the image to be printed in
the center of the page.
• Commands to leaf through the images
ready for printing
• Page currently viewed indicator.
Images can be sent to the printer only if the
print composer is open.
Figure 83: DICOM Print Composer Window
130 DICOM Print Composer

Total pages: 218
6.14.2 DICOM Print Composer Settings

Print parameters can be set by utilizing the commands seen in Table 38.
Select printer or print server
Select paper orientation and type of

algorithm to manipulate the image
Select film size and paper type
Row/Column settings on the image grid.
Number of copies
Ch.
Profile 6
Table 38: DICOM Print Composer Settings
Printer Name box -- specify which printer to use.

Magnification box – type of algorithm for image manipulation.
Film size box – select paper size.
Medium type – select type of paper.
Orientation box – specify vertical or horizontal orientation (See Table 39).
Vertical/portrait Horizontal/landscape
Table 39
Row x Column box – specify the grid to use for image impagination. If the
number of rows and columns is 1, one image per page will be printed, or 2
rows and 1 column, two images per page will be printed, or 3 rows and 1
column, 3 images will be printed or 2 rows and 2 columns, 4 images will be
printed. (See Figure 84).
Figure 84: Print Layout

Total pages: 218 DICOM Print Composer 131
6.14.3 DICOM Print Composer Commands

The DICOM print composer commands are shown in Table 40.
Print
Network Connection Test
Selected Server Connection Test
Previous Page
Next Page
Exit
Table 40: DICOM Print Composer Commands
“Print” – sends pages to the printer.

“Network test” executes a “ping” to the server that hosts the selected
DICOM node.
“DICOM test” executes an echo command in the selected DICOM node.
“Next page” moves the composer to the next page.
“Prev page” moves the composer to the previous page.

Total pages: 218
6.14.4 DICOM Impagination
Composing images
Once the print composer has been enabled with a “Print” command, further
images can be sent for printing before confirming from any of the following
views with another “Print command: Monitor A or B, Archives – Exams,
Archives – Recycle bin.
Setting the impagination grid

To increase the number of images present in every page, use the “Rows x
Columns” feature to edit the number of rows and/or columns of the grid in
which the images are aligned.
Repositioning an image Ch.
1
To move an image on the grid
position the pointer on the image to move
6
2 press and hold the left key (the pointer’s form changes) and drag the image
to the desired position
3 release the left key. The images will exchange positions. (See Figure 85).
Repositioning an image Eliminating an image
Figure 85
Eliminating an image
To eliminate an image from a print composition
1 position the pointer on the image to be eliminated
2 right-click on the image to open the context menu
3 select the “Eliminate” command
4 confirm removal. (See Figure 85).

Total pages: 218 DICOM Print Composer 133
6.14.5 Print Composer DICOM Log

The “DICOM Log message” box, lists error messages and operations execu-
ted.
Figure 86: DICOM Log Message Box
6.14.6 DICOM Remote Server Configuration

To add and administer remote servers, please request assistance and con-
sult the configuration documentation.

Total pages: 218
6.15 DICOM Work List

This is an optional interface, which might not be present in the system you
are using. The DICOM worklist gives you access to patients’ personal data
and other information relative to the exams to be carried out by simply con-
sulting the DICOM server and the work lists connected in a LAN network.
This feature was designed to facilitate patient data processing and other
important data normally processed by patient management personnel.
6.15.1 DICOM Worklist Description

The DICOM worklist is activated with the DICOM worklist icon found in the
ARCHIVE view under the “Planned” exams tab.
Ch.
Figure 87: DICOM Worklist Icon 6
Figure 88
Figure 89: “Worklist” Window
The DICOM worklist application is viewed in a window overlapping the

current view .
This box can be automatically hidden (not closed) by pointing anywhere
outside the window itself and left-clicking. To reactivate point and left-click
on the shortcut key in the upper right-hand corner of Monitor B. (See Figure
90) first icon on the left.

Total pages: 218 DICOM Work List 135
Figure 90: Shortcut Keys
The box contains the following commands:

• Select which DICOM worklist server to interrogate.
• Select the DICOM worklist server search criteria.
• Test remote server connection.
• Import data selected.
Data will not be imported in the local archive until the box is closed proper-
ly.
6.15.2 DICOM Worklist Search Criteria

The user proceeds by typing the search criteria in the input fields of the
DICOM worklist interface boxes. (See Table 41).
Select the period of time in which

the exam was performed
Select the patient’s name
Select patient ID
Select patient sex
Select the patient’s date of birth
Select the name of the local

workstation
Select mode
Select the scheduled performing

physician
Select the Requested Procedure ID
Select the requested procedure

description
Select the Accession number
Table 41: DICOM Search Criteria
136 DICOM Work List

Total pages: 218
6.15.3 DICOM Worklist Interface Commands

The commands are listed in Table 42.
Executes a data request that satisfies the

criteria indicated.
Done – Closes the current window
Views results of the search
Table 42: Worklist Interface Commands
“Worklist Query” - Executes a data request that satisfies the criteria indica-
ted.
“Done” Closes the current window.
Ch.
“View Result” Views results of the search.
6
6.15.4 DICOM Worklist – Import Patient Data
Activating the worklist interface

The DICOM worklist interface is activated with the DICOM worklist icon
found in the ARCHIVE view under the “Planned” exams tab.
Viewing remote data

Select the server which contains the data requested, input the selection
criteria so as to reduce the resulting list as much as possible. Point and left-
click on the “Worklist Query” command to view the list of data which satisfy
the criteria indicated. The data will be listed in the window which appears
above the “Worklist Query” key (See Table 42). If the window is not active,
point and left-click on the “View Result” icon (See Table 42).
The data will be listed in a window which appears above the Worklist Query
icon.
Importing the remote data on the local archive

Select the lines from the list that contain the data requested, point and
left-click on the “done” icon. (See Table 42). The box will disappear after a
few seconds and the data requested will be listed in the Archive>Scheduled.
If the data is not immediately visible point and left click on the “Worklist
Query” key again.
Figure 94

Total pages: 218 DICOM Work List 137
6.15.5 DICOM Worklist Log

The “DICOM Log Message” box, lists error messages and operations execu-
ted. Check to verify the operations executed and the errors found during
the data import phase.
To access the log use the dedicated keys.
6.15.6 DICOM Worklist – Configuring Remote Servers

6.16 Query Retrieve
The DICOM image viewer used in this mode is a free shareware version
and since the program’s traceability cannot be guaranteed, it cannot be
used to carry out diagnosis but simply as a search and consult feature of
existing studies.
6.16.1 QR Description
This interface is optional and might not be present in the system you are
using.
The Query Retrieve feature is useful to consult the DICOM image archives.
The Query Retrieve interface allows you to interrogate remote servers and
obtain lists of studies or exams already carried out. The list of exams can be
filtered according to diverse parameters:
• Patient’s Name
• Patient’s Surname
• Mode
• Executing Date
• Patient ID
• Etc.
Images that are located in remote servers can be selected, copied and retri-
eved into the local Moonray computer. The imported images can be viewed
with a DICOM image viewer which is a free shareware version and since the
program’s traceability cannot be guaranteed it cannot be used to carry out
diagnosis but simply as a search and consult feature of existing studies.
The query retrieve option is activated from the relative icon found in the
upper right-hand corner of the Moonray Digital Memory Interface.
Figure 96 Query Retrieve Icon
The user interface to access remote servers is seen in Figure 97).
138 Query Retrieve

Total pages: 218
Figure 97 QR Interface
Once the Query Retrieve interface is activated, the DICOM viewer becomes Ch.
available to view the imported exams. (See Figure 98).
6
Figure 98 DICOM Viewer

Total pages: 218 Query Retrieve 139
6.16.2 QR from Remote Servers

You can execute a Query Retrieve from a remote server as fol-
lows:
1 Select the DICOM server in the upper right-hand combo box of the DICOM
interface window (See Figure 97). If servers do not appear in the list, con-
tact the network administrator and input the data following the DICOM for
Moonray configuration procedures (See Table of Contents of this manual).
Once selected the desired server, input search criteria to pinpoint the list of
resulting exams.
Figure 99 Remote Server Selection
2 Point and left-click on the “Find” button to search the remote server.(See
Figure 100).
Figure 100 Remote Server Search
3 Select the desired images from the resulting list (See Figure 101).
Figure 101 List of results
4 Activate image import onto your local server by pointing and left-clicking
on the “retrieve” key. (See Figure 102 – Import Locally). The transfer feature
will be activated (See Figure 103 – Move Images) to copy the images from
the remote server to your local computer.
Figure 102 Import Locally
140 Query Retrieve

Total pages: 218
Figure 103 Move Images

Ch.
5 Point and left-click on the “move” button. When the process executes or if
there are errors, they will all be listed in the “DICOM log message” box. (See 6
Figure 103).
6 Once the copy has been transferred, point and left-click on the “Close”
button (Figure 103) If no other images need to be imported, close the QR
Interface (Figure 97) which will activate the DICOM image viewer (Figure
98). The studies can be consulted by pointing and left-clicking on the “next
study” and “previous study” buttons found on the upper corners of the
viewer (see Figure 104).
Figure 104
6.16.3 QR Interface Commands

Views the window containing data
information or error messages during
connection to remote servers.
Views the window containing the search
results from the remote servers.
Locally imports the selected images.
Deletes selected images. Only applicable to

locally saved images.

Total pages: 218 Query Retrieve 141
6.16.4 QR Server Selection Administration

Activates the QR on the local server installed
in the Moonray.
Activates the QR interface for the remote
server which can be selected from the drop-
down menu (See Figure 97).
6.16.5 QR Remote Server Configuration

142 Query Retrieve

Total pages: 218
6.17 Exporting
Export images and videos without being compressed and/or resized for
diagnostic purposes. Any image or video that is compressed or resized will
be labeled as such.
If the user wants to export images created during work sessions onto per-
manent or removable recording media he must close the series, access the
“Archive>Exams view and point and left click the “export” button. This key
activates a sequence export server.
The server views a list of the selected sequences from which you can specify
where and with which format the sequences are to be exported.
This feature was designed to facilitate collection and export of sequences.
Ch.
6.17.1 Export Description 6
The export server is viewed in a window overlapping the current view.
outside the window itself and left-clicking. To reactivate point and left-click
on the shortcut key in the upper right-hand corner of Monitor B. (See Figure
90) first icon on the left, or by sending another image to be exported.
Figure 105: Backup Server

Total pages: 218 Exporting 143
6.17.2 Selecting Export Format

The user can select one of the available export formats (See Table 43 – Ex-
port Formats). To use some of these formats an access key is necessary.
Select the “AVI” format
Select the “BITMAPPED” format
Select the “DICOM” format
Select the “SIMAD Property” format
Table 43: Export Formats
“AVI”
The AVI format is preferable when creating presentations and moving image
productions for demonstrative purposes.
“BMP”
It is useful for viewing and saving images composed of a single element,
therefore static images. It is preferable when creating presentations and
image production for demonstrative purposes. Images saved in this format
can easily be modified with retouching photographic programs.
“DICOM”
DICOM has the aim of regulating transfer formats of medical images and
data relative to patients and their clinical exams, a notably important aspect
when keeping in mind the PACS (Picture Archiving and Communication
System) and hospital information systems currently defused. The DICOM
format is preferable to exchange images, patient data for medical purposes.
The DICOM format is indicated for image exchange in the medical field, the
patient’s data and exposure data accompany the image and can be viewed
with an appropriate Workstation or PC which is equipped with dedicated
software to view said format.
“SIMAD”
The “SIMAD” proprietary format is used to save sequences created, preser-
ving the integrity of the information. Use this format when making copies
of work carried out so as to assure the possibility of reloading the saved
work onto the Workstation’s Digital Memory. The saved sequences cannot
be read with standard information instruments and the Digital Memory
Software must be utilized.
144 Exporting © Copyright SIMAD srl 2020

Total pages: 218
6.17.3 Export Destination Selection

The user can select the destination of the sequences exported contained in
the list below. The destination can be a DICOM server, a shared file in the lo-
cal network (if there is one) a removable media or a CD ROM (See Table 44).
CD ROM Select a CD ROM burner as a final export destination
DVD Select a DVD burner as a final export destination
DVD 2L Select a DVD dual layer burner as a final export destination
Removable Media Select a removable media as a final export destination
LAN Network Select a shared file in the LAN network as a final export destination
Ch.
DICOM Server Select a DICOM server as a final export destination 6

DICOM Server printer Select a DICOM server printer as a final export destination
Search LAN network Opens a window to search for a network destination
Table 44: Export Destination

6.17.4 Exporting Commands

The user activates or interrupts the export procedures with the commands
at his disposal in the user interface (See Table 45).
Begin export procedure activates export selected by the user
Interrupt export procedure interrupts export procedure activated by the user
used for setting parameters that influence the user interface presentation
and the characteristics of the output formats selected. Groups the
configuration parameters of the system subdivided in categories. (See Figure
User preferences 106). The categories are represented by tabs in the tab strip. The groups are
indicated in a single gray row which separates them from the preceding row.
The parameters are represented in two columns: the left column represents
the name of the parameter and the right column its value.
Exit exits the application and clears the export list
Table 45: Export Commands
6.17.5 Export Command Settings

Save Changes Saves changes.
applies the new settings to the views. Not all

Apply Changes settings can be reset without rebooting. It is
advisable to reboot the system.
resets parameters as they were set when the
Factory Settings machine was delivered. After activating, save
changes.
Exit Exits the setting window.
Table 46: Export Command Settings

Total pages: 218
6.17.6 Exporting – Sequence List View

The list of series and sequences selected by the user can be viewed
in a tree view denominated “Series” (See Figure 107). The root re-
presents the destination of the selected series (CD ROM : G:\).
The series are represented by yellow folders: pointing and left-
clicking on the parent node connected to the folder will make the
folder open showing a list of selected sequences by the user for that
series.
Next to the series you will find a progressive identification number
which is normally seen in the “Archive>Exams” view. Following you
will find the patient’s name, surname and date of birth.
The sequences are represented by small light blue symbols which Figure 107
identify the type of sequence generated; next to the symbol is a
progressive number of the sequence (inside parenthesis) and then the name
of the file containing the sequence. (See Figure 108). Ch.
Preview
6
Pointing and left-clicking on a sequence activates a preview of the sequence
in the preview window.
Viewing a Sequence
Select a sequence by pointing and left-clicking on the light blue icon which
represents the sequence to be viewed. Right-click to activate the drop
down menu containing the edit/view commands of the sequence. (See Figu-
re 108). If the sequences contains more than one frame, point and left-click
on the view key. The sequence will be viewed in the thumbnail window.
Enabling Digital Subtraction of a sequence

Select a sequence by pointing and left-clicking on the light blue icon which
represents the sequence to be viewed. Right-click to activate the drop down
menu containing the edit/view commands of the sequence. (See Figure
108). If the sequences contain more than one frame and a mask which can
be utilized to effect a digital subtraction, point and left-click on the enable
Figure 108
digital subtraction key.
Digital Subtraction
The sequence will be viewed in the thumbnail window or exported with the
enabled/disabled digital subtraction according to the user’s preference.
6.17.7 Editing the group of sequences-series to be

exported
Eliminate a sequence
Select a sequence to eliminate by pointing and left-clicking on the light blue
icon which represents the gsequence. Right-click to activate the drop down
menu containing the edit/view commands of the sequence. (See Figure
108). Point and left-click on the “remove” key.

Eliminate a series
Select a sequence to eliminate by pointing and left-clicking on the folder
which represents the sequence. Right-click to activate the command box
(See Figure 109) Point and left-click on the “remove” key.
6.17.8 Export to a LAN network

Connect Moonray to the LAN network only when post processing and not
during exposure sessions on a patient.
To export images utilizing the local network point and left-click on the
destination key “Export to Local Network”. (See Table 47).
Export to CD Figure 109
Export to DVD
Export to Double Layer DVD
Export to a DICOM printer
Export to Local Network
Export to Removable Media
Export to a DICOM Server
Table 47: Export Options
The configuration of the destination selection keys can vary as shown in

Figure 110.
Figure 110
Point and left-click on the “Search LAN Network (See Table 44) and select
the appropriate path. Point and left-click on the “Begin Export Process” key.
6.17.9 Export to DVD or CD

Where present, the system uses an advanced burning interface which inte-
grates perfectly with the export form (See Figure 105). In this case, the user
can see the progress of the export procedure directly in the message box
located in the bottom left-hand corner of the window.

Total pages: 218
6.18 Importing
To import sequences saved on a permanent device from another worksta-
tion which uses the Digital Memory software, access the “Archive>Exams”
view, point and left-click on the import key.
The key activates a search and import sequence server. The server views a
grid which will expose a list of available series for import, select the desired
series to transfer a copy of the series including the patients’ data, exposures
and sequences of the series.
6.18.1 Import Description

The export server is viewed in a window overlapping the current view.
outside the window itself and left-clicking. To reactivate, point and left-click Ch.
on the shortcut key in the upper right-hand corner of Monitor B. first icon
on the left or by sending another image to be exported. 6
Figure 113

Total pages: 218 Importing 149
6.18.2 Import Commands

The user activates or interrupts the import procedures with the commands
at his disposal in the user interface (See Table 48).
Begin
activates import selected by the user
Process
Abort
interrupts import procedure activated
Import
by the user
Process
Import begins the import procedure from the
Series remote source.
exits the application and clears the

Exit
import list
used for setting parameters
that influence the user interface
presentation and the characteristics of Figure 114
the output formats selected. Groups
the configuration parameters of the
system subdivided in categories.
(See Figure 114). The categories are
User
represented by tabs in the tab strip.
Preferences
The groups are indicated in a single
gray row which separates them from
the preceding row. The parameters
are represented in two columns: the
left column represents the name of
the parameter and the right column its
value.
Table 48: Import Commands
150 Importing
Total pages: 218

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6

A Sago Medica Company MOONRAY User Manual - Rev.34 - 2020/01/22

6.1 Organizing Information

6.1.2 Anonymous Series

72 Organizing Information

6.1.3 Locked/Unlocked Series

Figure 20: “X-Ray Lock” Icon

© Copyright SIMAD srl 2020

6.1.5 Apply/Remove a Search Filter

Figure 21: Search Window and Application Filers.

6.1.6 Eliminating a Series/Sequence

74 Organizing Information

6.1.7 Recuperating a Series/ Sequence

6.1.8 Sequence Catalogue of an Exam in Progress

1 column 2 columns Expansion to maximum number of columns

Figure 22: Image Catalogue

© Copyright SIMAD srl 2020

6.2 Input Peripherals

Figure 19: “New” Workstation Keyboard

Send to Monitor B (Limited to

Activate the following recursive

Activates the following mode

Table 17: Keyboard Commands (Shortcuts)

76 Input Peripherals

6.3 Editing Data in a Field

Enter Backspace Left arrow Right arrow

© Copyright SIMAD srl 2020

6.4 Organizing Views

Figure 26: Form Example

78 Organizing Views

6.4.1 Monitor “A” View

Figure 31: “Monitor A” View

© Copyright SIMAD srl 2020

Figure 32: “Monitor A” View

• In position 1 from top to bottom we can see: the progressive number of

80 Organizing Views

Figure 33: Moonray Compact “Monitor A”

© Copyright SIMAD srl 2020

6.4.2 “Monitor B” View

Figure 34: “Monitor B” View

82 Organizing Views

6.4.3 View Commands - Image Interaction

Close Current Series Take a Snapshot

Highlight Yes/No Enlarge

Reduce Send to Monitor A

Send to Monitor B Add to print composer

Show/Hide Marking Tool Show/Hide Measurement Tool

Edit Text Annotation Eliminate

Show X-Ray dose recap Send to Clipboard

Shutdown Deactivate X Rays (60601-2-43)

© Copyright SIMAD srl 2020

6.4.4 “Patient Data” View

Figure 36: Complete List of Fields

84 Organizing Views

6.4.5 Database - “View”

Figure 37: Database Window

This view is divided into two parts:

• The “Exams” sub-view lists the series contained in the system.

© Copyright SIMAD srl 2020

6.4.6 Database - “Exams”

Open Send to Clipboard

Create dose report Open export

Show filter settings Open import