1

Table of Contents

1. Read first 4
1.1. Read first 5-7
1.2. Safety notes 8-9
2. Workflow 10
2.1. Symbols 11
2.1.1. Symbols 12
2.2. Lost & Found 13
2.2.1. Lost & Found 14
2.3. General Screens 15
2.3.1. Devices - Screen 16
2.3.2. Patient administration 17
2.3.3. Overview 18
2.3.4. Archive 19
2.3.5. Exit application 20
2.4. X-Ray Module 21
2.4.1. Workflow X-Ray Module step by step 22
2.4.1.1. Organ selection 23-24
2.4.1.2. Acquisition 25-26
2.4.1.3. Manual adjustment of acquisition values (optional) 27
2.4.1.4. Preview and protocol 28-29
2.4.1.5. Viewer 30
2.5. Sono/Video-Module 31
2.5.1. Sono/Video-Module step by step 32
2.5.1.1. Capture 33-40
2.5.1.2. Viewer - Video Viewer 41-44
2.5.1.3. Menu - Sono/Video Module 45-48
3. Viewer 49
3.1. Toolbars 50
3.1.1. Right Toolbar 51
3.1.1.1. Right Toolbar Overview 52-53
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3.1.1.2. Preview images 54

3.1.1.3. Rotation and mirror 55
3.1.1.4. Image enhancement 56-59
3.1.1.5. Organ filter 60
3.1.1.6. Measurement functions 61-66
3.1.1.7. Send to Diagnosis Worklist/Archive 67
3.1.2. Advanced Measurements 68
3.1.2.1. For all advanced measurements 69-70
3.1.2.2. Cobb Angle Measurement 71-72
3.1.2.3. Ullmann-Sharp Angle Measurement 73-74
3.1.2.4. Center Edge (CE) Angle of Wiberg 75-76
3.1.3. Top Toolbar 77
3.1.3.1. Top Toolbar Overview 78-80
3.1.3.2. Start viewer 81
3.1.3.3. Print selection 82
3.1.3.4. Export selection to disk 83-84
3.1.3.5. Get file(s) from archive 85
3.1.3.6. Send selection via e-mail 86
3.1.3.7. Create patient CD/DVD 87-90
3.1.3.8. Delete selected images 91-92
3.1.3.9. Select/Deselect all 93
3.1.3.10. Change of size 94
3.1.3.11. Display settings 95-96
3.2. Menu 97
3.2.1. File menu 98-102
3.2.2. Edit menu 103-108
3.2.3. Measurement menu 109-111
3.2.4. Filter menu 112
3.2.5. CT/MRI menu 113-114
3.2.6. Tools menu 115-118
3.2.7. Info menu 119-120
3.2.8. Settings menu 121-123
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3.3. Mammography module 124

3.3.1. Hanging protocols 125-127
4. Activation 128
4.1. Activation 129-138
5. Archiving CD and DVD 139
5.1. Archiving CD and DVD 140-145
6. Administration 146
6.1. Administrator Settings 147
6.1.1. Administrator Settings 148
6.1.2. General settings 149-153
6.1.3. Data Overlay 154-155
6.1.4. Measurements 156-157
6.1.5. Paths 158
6.1.6. CT Preset 159
6.1.7. Edit organ properties 160-165
6.1.8. Administrator - Close 166
7. Index 167-168
8. Revision History 169
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1 Read first
 5

1.1 Read first

Colenta DX Easy Imaging SOFTWARE - HUMAN MEDICINE - VERSION 2.10
First of all, thank you for choosing our product! This user guide explains the operation and potential applications of
our Colenta DX Easy Imaging software.
Please read all instructions carefully before initial operation.

Application
Colenta DX Easy Imaging software is designed for the generation of human X-ray images. Colenta DX Easy Imaging
is designed for projection radiography images; it is not intended for fluoroscopic/ radioscopic, angiographic, or
mammographic applications.
Colenta DX Easy Imaging is an acquisition program that functions with approved image sources (e.g. DR and CR
systems) on approved PC-based hardware. Colenta DX Easy Imaging works as diagnostic software under the
relevant standards and approved environmental and hardware conditions.
Images from various types of medical imaging equipment are imported and processed digitally in order to support
medical documentation. The images are to be transferred for diagnoses on a PC via Colenta DX Easy Imaging. The
following imaging systems are priorities: CR, CT, MRI, US.

Hardware and system requirements for Colenta DX Easy Imaging

Windows XP Professional 32bit with SP3
Windows7 Professional/Ultimate 32bit/64bit with SP1
Windows 8.1 Professional 32bit/64 bit
at least 2 GB of RAM
at least Intel DualCore
at least 10 GB of free hard disk space
graphics card with 24 bit color depth
graphics card with OpenGL version 1.1
installation of Windows Media Player version 9 or higher is rquired for video playback
minimal display resolution 1024 x 768
to set the option "AQS viewer should be extended over all monitors" it is required that all monitors
have the same size and resolution
a CD/DVD burner is required for burning created Patient CD/DVD's

This are the requirements for Colenta DX Easy Imaging software. For additional hardware, the system
requirements may vary

Legal regulations
Colenta DX Easy Imaging has been written and designed to provide the safety of an error-free workflow.
Colenta DX Easy Imaging has been designed to meet all safety requirements for medical devices.
There are no user-serviceable parts in this system. Colenta DX Easy Imaging is installed, maintained and repaired
by qualified staff in accordance with procedures and preventive-maintenance schedules. If your software does not
work as expected, please contact our support.
Colenta DX Easy Imaging may not be modified in any way, in whole or in part, without prior written consent
from Colenta Labortechnik GmbH & Co KG.
It is important that this user guide is read and verified regularly by authorized operators.
Non-authorized individuals have no access to the system.
 6

Intended users
Colenta DX Easy Imaging software can be operated by qualified staff in hospitals as well as private radiology and
partial radiology clinics. It must only be operated according to specifications and its intended use. It should only be
used by qualified and authorized individuals that have the ability to make X-ray images and that have been
instructed on the use of Colenta DX Easy Imaging. This user guide is written for trained users of Colenta products
and trained diagnostic X–ray clinical personnel that have received proper training. Those individuals that operate
the equipment as well as those having authority over the equipment are considered users.

X-AQS software in the following development form as: X-AQS,

X-PACS, X-AQS PACS.
X-AQS - a separate DICOM modality, which is used by default in medical practices and clinics as
monitoring- and control-workplace for existing external digital system units and in particular direct
radiography units where the relevant approved hardware combinations are found or can be installed.
Integrated is also the image optimization and image processing.
X-PACS - a configuration that is used only for viewing and archiving of X-ray images.
X-AQS PACS - fully integrated monitoring and control software of combined system consisting of Xray
unit, image-detector and if necessary digital imaging plate system, as well as swiveling arm or
Bucky table and/or wall stand. At the same time is performed the image optimization, image processing
and archiving of the finished X-ray images, if no foreign PACS system is given.

General functions of the X-AQS Software:

1. Transfer of organ-specific default values defined at different X-ray generators corresponding to the
appropriate manufacturer interfaces and for those provided by the manufacturers documentation. Taking
over the actual exposure parameters (e.g. mAs, kV, mA) after exposure from the generator.
2. Image acquisition of different image detector systems according to the relevant manufacturer
interfaces and for those provided by the manufacturers documentation.
3. If necessary, a separate or defined on the basis of organ-specific default values integrated control and
monitoring of different fully or partially motorized swiveling arm systems according to the appropriate
manufacturer interfaces and manufacturer specifications in terms of patient safety and to ensure those
provided by the manufacturers documentation.
4. Summary of the functions listed in points 1, 2 and 3 in a consistent and integrated process.
5. As a DICOM worklist capable and for the modalities control responsible integration software assures
receiving of the DICOM orders from foreign PACS systems as well as orders via its own integrated
PACS system and transmitting of the generated results (images) again according to the DICOM
standard back. The software also supports the GDT and BDT protocols and similar protocols such as
HL7 generated orders from practice management programs and hospital information systems.
6. The software pretends according to the incoming orders the values for the generator of X-ray
equipment and takes the control of swiveling arm . The operators can accept these default values or
change them before the generator and thus the image detector is triggered by a hand switch with these
default values. Before the release of the image the swiveling arm must be control in the desired position,
it must always be possible to adjust manually the swiveling arm system without default values (the
defaults are then discarded, but without discarding the requirements for generator and image detector).
7. The software receives raw images from the detector and performs image processing in accordance
with the in order specified organ-image parameters which then as fully processed images according to
the requirements of the orders be able to return to the trigger points.
8. The software displays a completely processed X-ray image and offers possibilities of its
postprocessing before the ready X-ray image occurs as a result to the client (to foreign PACS - system
or to own fully integrated PACS - system).
9. After the postprocessing the image can be send to the Diagnosis Worklist. In this way, it can still be
changed and edited without affecting the Archive. After the complete image processing and if it is no
longer needed for the current case, the image should be send to the Archive. The X-ray image from the
Archive can not be edited any more.

Compatibility statement
 7

Colenta DX Easy Imaging software may only be used in combination with X-ray generating equipment (CR-systems,
X-ray generators and detector systems) that has been recognized as compatible by Colenta.

CE - Conformity
The construction of the product is consistent with Class IIb in respect to the EC Directive on medical devices
93/42/EEC, attachment II.
The Colenta quality management system:
product: Colenta DX Easy Imaging picture transfer and archiving system
type: Medigraf DR-CS
The product is developed, designed and manufactured in accordance with EC Directive 93/42/EEC under the
exclusive responsibility of

Colenta Labortechnik GmbH & Co KG

Neunkirchner Str. 117
A-2700 Wiener Neustadt, Austria

0483
The following harmonized standards are applied: EN ISO 14971:2009; DIN EN ISO 9241; EN ISO
13485:2003/AC:2007
The following national standards and specifications are applied: DIN 66001; DIN EN 62304; DIN 6878-1, DIN EN
ISO 9241
Technical documentation with risk analysis is available.
A risk management system in place.
A software maintenance plan, including a problem solving process, is institutionalized and integrated into the
configuration management process.
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1.2 Safety notes

Please, read the user guide carefully before using the system. All references and instructions must be followed
precisely.
The system may only be operated by qualified and trained staff that possess the appropriate X-ray qualifications and
that has received instruction on the operation of Colenta DX Easy Imaging.
The software is protected by an activation system, which is a form of copy protection to reduce illegal software
piracy. Without a successful activation, the software works for 30 days in a test mode (with full functionality). So
long as the software is not activated, it will show on each start a message box with the remaining days. When AQS is
started at the acquisition station, the user has the possibility to start an activation wizard, which guides the user
through the activation process. When the user performs a bigger hardware change or changes in his institution
scribor, a re-activation is necessary.
The software includes positioning images that show the positioning of the patient for X-ray acquisition. The
company Colenta Labortechnik GmbH & Co KG assumes no responsibility for the accuracy of positioning images in
the software.
Colenta DX Easy Imaging includes an electronic manual for measurements. Please note that the instructions don't
replace the professional capability of the physician. Colenta Labortechnik GmbH & Co KG assumes no responsibility
in case of made wrong measurements using this manual. The accuracy of the measurements depends on the proper
application of the measurement points and the knowledge of physician.
Functionality of the "Get File(s) from Archive" button in Viewer mode - using this button you can load only images
made in Version 1.06 or newer because of Archive-Image format changes. Please load older Archive-Images by the
Archive-Screen.
The help menu alone does not provide sufficient knowledge for the operation or testing of the system.
Modifications to the system configuration may not be made by the user. The functions of the Settings button (placed
on Exit Application - screen) are intended only for an authorized technicians or users with administrative rights.
The user guide can be accessed on the Exit Application-screen - Help-button.
In order to ensure safety, please read carefully the manuals of the connected devices before using the system. They
also contain instructions, warnings and safety instructions that must be followed.
If the product is not functioning properly or the operation of controls is not as described in this guide, proceed as
follows:
Follow the instructions of safety precautions in this manual
Do not continue working with the system
Immediately contact customer service, report the problem, and wait for instructions

Graphic Symbols
The following reference symbols are used in this guide and in the software:

- INFORMATION - Contains useful information and important instructions. If these instructions are not
followed, the software may malfunction.

- WARNING - Provides warnings and instructions for the safe use of the software.

- MESSAGEBOX-ERROR - Provides warnings and instructions for the safe use of the software.

- MESSAGEBOX-WARNING - Provides warnings and instructions for the safe use of the software.
 9

If these warnings are not followed, serious risks may result, e.g. image loss or the incorrect viewing of the image,
which could in turn put the patient at risk
NOTE!
The system status or potential possible error codes are indicated in the upper bar of the acquisition screen in three
colors:
Green = Ready
Red = Warning/Error
Yellow = Advice

Software Version
This guide describes the functions of the software version 2.10 Colenta DX Easy Imaging.
The Exit Application-screen displays following information:
Software Version
Contact details
Additional functions: X-Ray Protocol, SMPTE Protocol, Archive-DVD, License, Database Inspect,
Update, Settings, Help, Remote Control.
If you have questions about how to use the software, please call us!
Follow the instructions to avoid improper use and possibly voiding the warranty.

Testing and maintenance

All cable connectors must be tested before activating the system.
The PC must be tested once a year.
Our trained service department staff is readily available to assist you with all of your service needs. We will
recommend the best way to resolve any issues as quickly as possible. If you have questions or you need more
information, please feel free to contact us:
Colenta Labortechnik GmbH & Co KG
Neunkirchner Str. 117
A-2700 Wiener Neustadt, Austria

Tel: +43 - 2622 - 28 31 10

Fax: +43 - 2622 - 28 31 10
Email: office@colenta.at

Copyright and Trademark Law

All product names mentioned herein and, if applicable, protected by third party, labels and trademarks are subject
without restriction to the regulations of applicable trademark law and the ownership rights of the respective
registered copyright owner. Mere mention of a product does not infer that trademarks are not protected under third-
party rights. The copyright for any objects released by Colenta in this Help remains exclusively with Colenta
Labortechnik GmbH & Co KG, Wien. Any reproduction or use of such graphics and texts in other electronic or
printed publications is not permitted without the explicit consent of Colenta Labortechnik GmbH & Co KG, Wien.
All images used are samples and deviations from the respective products are therefore possible. Technical features
are subject to change. Images are examples only.
 10

2 Workflow
 11

2.1 Symbols
 12

2.1.1 Symbols
Depending on the device, which was used to create images/videos, there are different symbols displayed on every
thumbnail.

- Different video formats (e.g. AVI, ...)

- X-Ray images (AQS format, DICOM)

- Different image formats (e.g. JPEG, PNG, BMP, TIFF, ...)

 13

2.2 Lost & Found

 14

2.2.1 Lost & Found

This is the last device in every device configuration and is always located on the lower righht device spot. Images,
which can't be processed correctly due to technical problems (WLAN connection loss, power failure, etc.), are stored
here and can be assigned to a patient.
First, select the images you want to assign on the left side.
Click the arrow to the right
Click on "Start"
Now the images are sent to the viewer, wehere you can assign them to a patient and store them into the archive.
Please refer to the "Viewer" part of this manual for further instructions
 15

2.3 General Screens

 16

2.3.1 Devices - Screen

Your workflow depends on the device you are using. If you use more than one device, choose one of them
before you start working.
If you use more than one device, choose one of them if necessary before start working.
The devices are configured and set up when installing the AQS software by the technician.
The LOST & FOUND button - here are images which, because of technical problems (abort of the WiFi
connection, power failure) could not be processed correctly. Incorrect assigned images can later be
assigned in the right way.

Each device has its onw settings that can be modified by using the button next to the corresponding
device button.
 17

2.3.2 Patient administration

Search for a patient by entering information into text fields.
When the desired patient is available in the list, mark it, and click START.
The NEW button adds a new patient.
The EDIT button changes or adds information of an existing patient.
The DELETE button (optional feature) deletes previously selected patient data from the list.
After selecting START, proceed with the workflow of the selected module in the Devices - Screen
(Section 2.3.1)
 18

2.3.3 Overview
If there was more than one item in the worklis,t all made acquisitions and videoswill be shown on
Overview-screen before Viewer mode.
You can select single image or all images to:
print selection
send selection via e-mail (installed and correctly configured e-mail program is required)
export selection to disk
create patient CD/DVD
start viewer
send to diagnosis worklist or archive
 19

2.3.4 Archive
All images from the Diagnosis Worklist or from Archive are shown.
Select the patient directly from the list or use the search function, click on the ARCHIVE button, mark
Show images from this patient only, choose the image or images and click the START button to open
them.
Click the DELETE button (optional feature) to delete the chosen images from the Diagnosis Worklist.
Images in Diagnosis Worklist can be edited (Viewer), the changes will be saved (Send to Diagnosis
Worklist)
Images in Archive can be edited (Viewer), the changes will not be saved
 20

2.3.5 Exit application

EXIT APPLICATION screen - Button with an X
Possible operations:
Click the X button located on right top corner and then click YES to close the application.
EXIT-screen contains the following tools:
X-Ray Protocol - prints X-Ray images protocol for selected period of time,
SMPTE Protocol - Protocol to the daily SMPTE test routine of the monitor,
Archive-DVD - visible only when archiving on CD/DVD is necessary,
License - AQS Activation System,
DB Inspect - for the database reorganization,
Update - updates the software if updates are available,
Settings - settings for technicians and administrator,
Help - software manual,
Remote Control - enables a direct remote access connection to support server.
 21

2.4 X-Ray Module

 22

2.4.1 Workflow X-Ray Module step by step

 23

2.4.1.1 Organ selection

Choose the desired bodypart of the patient to be scanned.
The patient information appears at the top of the screen.
Complete the empty field Refering Physician.
SERVICE button can be used for test.

Select an organ - choose the desired organs to be scanned (the second part of the worklist).
The selected organs appear on the worklist.
Click DELETE if you want to remove a selected organ from the worklist.
Click COMMENT, if you want to add a comment
Take an organ from the list and click acquisition to start the acquisition.
Click BACK to select a bodyparts again.
 24

After you have selected a bodypart and an organ, a worklist order for the acquisition is created. You can create an
unlimited number of orders. After the acquisition, the order is no longer shown in the worklist.
 25

2.4.1.2 Acquisition
The selected organs (worklist) are located on the left of the picture.
For each organ selected, a picture is provided showing how to perform the acquisition on the patient.

The state of the system is displayed in the upper bar:

Green = ready for acquisition
Red = warning or error
Yellow = important advice

Colenta DX Easy Imagingsoftware can be installed in two different configurations:

Configuration 1. - with generator control: The acquisition values are transmitted to the generator (the software
simulates the functionality of a generator control panel):

The acquisition is triggered with the hand switch. Afterwards, the image will be transferred directly to the software.
After processing, the image will be shown in the Protocol-screen (See Preview and protocol (Section
 26

2.4.1.4) for further information).

Configuration 2. - without generator control (there is no interaction between Colenta DX Easy Imaging and the
generator, a regular control panel is directly connected to the generator) :

Acquisition in combination with a CR system:

Click on Start and insert the cassette into the reader. After the scan process has finished, the CR
system automatically erases the cassette and the image is shown on the Protocol-screen
(See Preview and protocol (Section 2.4.1.4) for further information).
Acquisition in combination with a DR system:
The image will be sent directly to the software. After processing, the image will be shown on the
Protocol-screen (See Preview and protocol (Section 2.4.1.4) for further information).
 27

2.4.1.3 Manual adjustment of acquisition values (optional)

Configuration 1:
The acquisition values are transmitted to the generator via DX Easy Imaging (the software simulates the
funktionality of a generator control panel). After selecting an organ predefined acquisition parameters are
transmitted to the generator.
A generator interface window opens on the screen in which the acquisition parameters can be manually adjusted.
In the generator interface the, for this organ, predefined acquisition parameters will be shown. These can be
manually changed by the user. The changes will be immediately transmitted to the generator. You can select the type
of acquisition adjustment with the radio buttons Auto, mAs and mA/ms:
Selecting Auto allows only to adjust 1 parameter (adjusting the kV value by the user, acquisition automatic).
Selecting mAs allows to ajdust 2 parameters (adjusting kV and mAs by the user).
Selecting mA/ms allows to adjust 3 prarameters (adjusting kV, mAs and ms by the user).
With the radio buttons thin, normal, and thick, it is possible to select the body type of the patient:
Selecting thin decreases the tube voltage by 3 kV. The change will be shown in the input field kV.
Selecting normal don't change the tube voltage in any way.
Selecting thick increases the tube voltage by 3 kV. The change is shown in the input field kV.
In the input field kV the actual set tube voltage is shown. This value can be changed with the buttons " +" and " -" .
In the input field mAs the actual set " tube current over time product" is shown, if 2 parameter adjustment is
selected. This value can be changed with the " +" and " -" buttons.
In the input field mA the actual set tube current is shown, if 3 parameter adjustment is selected. This value can be
changed with the " +" and " -" buttons.
In the input field ms the actual set time is shown, if 3 parameter adjustment is selected. This value can be changed
with the " +" and " -" buttons. With the 3 measurement chamber buttons it is possible, if 1 parameter adjustment is
selected, to select the

left middle or right

measurement chamber plus a combination from 2 or 3 measurement chambers. If the button is lit, the
corresponding measurement chamber is selected.

With the button Grid is is possible to select, if the X-ray is taken

with or without
a moving grid.

The button Focus is used to select the

small or large
X-Ray tube focal spot.
 28

2.4.1.4 Preview and protocol

This screen appears when the scan process ends.
Click OK to approve the scanned image or REFUSE to reject it.
Click RETAKE (optional feature) to create the same worklist entry again (but the image before is saved).
OK button takes you to the acquisition screen to perform a new scan on the next selected organ from the
worklist. This process will continue until all selected organs have been scanned.

Shutter - image collimation for improved detection of exposed area (red frame) is fixed automatically in
the preview image and you can confirm it with OK button or you can also correct it by sliding lines and
points of shutter in a different ways. Non rectangular collimation can be done.
29
 30

2.4.1.5 Viewer
Viewer is done immediately after the scan.
The images can be changed using different functions: window leveling, filter, measurement, etc..
The image can be sent to the Diagnosis Worklist (before final diagnosis) or to the Archive (after final
diagnosis).
SEND TO DIAGNOSIS WORKLIST
Standalone Version - the image was sent to the Diagnosis Worklist. The physician can call up the image any time,
use it for diagnosis and save it with the changes again (resend to Diagnosis Worklist or to Archive).
Network Version - if multiple workstations have access to the Diagnosis Worklist, the images will appear on all
stations available on the network.
SEND TO ARCHIVE
After final diagnosis the images are stored in the database. It can be called up from the archive and processed, but
the new changes will not be saved.
 31

2.5 Sono/Video-Module
 32

2.5.1 Sono/Video-Module step by step

 33

2.5.1.1 Capture

Before starting recording, complete the empty fields: Description, Study-Description, Referring Physician, Operator.

Capture video - Starts video recording. The upper bar is red and the counter times the recording length
and displays it while recording.

Stop video capture - Stops video recording. The upper bar is green - the video is ready.
 34

Mirror button on, Mirror button Off - Mirrors image on the Y-axis (a.p. <-> p.a.). The
button remains pressed by mirrored image.

Turn left 90° - turns image 90° left

Capture still image - Takes a single image

Select capture device - A list of capture devices will appear for selection
 35

e.g.

Archive all - sends all images to the archive

Diagnosis Worklist - send all images to Diagnosis Worklist

Apply image processing filter - Application of histogram operations, such as brightness, contrast,
gamma.
The dialogue of manufacturer of the device will be called. Specific settings may differ from device to device, e.g.:
36
37
 38

Image format settings - It sets the image format: frame-rate, image dimensions and color depth,
etc.
 39

Use foot switch for video capture Use foot

switch for still image capture - Image capture using the foot switch control can be done in two ways:
Mode 1. - Press the foot switch to start recording, hold down during recording, release foot switch to end recording.
Mode 2. - Press and release the foot switch to start recording, press and release the foot switch to end recording

The selection of the mode can be configured by setup management.

1. Press Device-button
2. Choose the setting of current device

3. Mark the option Stop video record on foot switch release for Mode 1:
 40

4. Don't mark the option Stop video record on foot switch release for Mode 2

:
 41

2.5.1.2 Viewer - Video Viewer

Settings for videos

Settings for still images

 42

Additional features for Sono / Video Module:

Filter Button - Press the button to see only images or only videos displayed as
thumbnail on the left side of the Video-Viewer-screen.

Fit image size to desktop - The whole image is displayed with maximum size.

Quit this application - Exits the Viedo-Viewer-screen and returns to the Capture-screen.

Play / Pause - Starts, continues or pauses the video.

Stop - Stops the video. The next time the video starts from the beginning.
 43

Previous video frame - Stops video playing for viewing previous video frame(s).

Next video frame - Stops video playing for viewing next video frame(s).

Turn left 90° - Rotates the current video frame 90° to the left

Mirror - Reflects the current video frame on the Y-axis (a.p. <-> p.a.)

Set start cut label - Sets start cut label on the actual video position displayed on the lower
navigation bar. Igf the end cut label doesn't exist, it well be automatically set on the end of the video. If the end cut
label is smaller as the start cut label, it will be placed on the start cut label +1.

Set end cut label - Sets end cut label on the actual video position displayed on the lower navigation
bar. If the start cut label diesn't exist, it will be automatically set on the beginning of the video. If the start cut label is
bigger than the end cut label, it will be plaxed on the end cut label -1.

Cut - The beginning and the end of the video will be removed, so that only the area between the start
cut label and the end cut label will be preserved. To reverse the cut action, use a new button Reset video cut
displayed on the top toolbar next to the button Delete section.
 44

Reset video cut - All cut actions will be reversed. The cut labels will be removed. The video is
played again in full original length.

For some video formats the cut labels can be set only on key frames. On a key frame at the progress bar on
the top right side appears a "[k]".

Captue current video frame - Current video frame will be saved as a single image. The patient
data and acquisition data will be copied. The image is displayed on the left thumbnail bar.
 45

2.5.1.3 Menu - Sono/Video Module

Menu File
Open... - Loads an image
Save as... - Saves an active image in an image format supported by the software.
Copy current image - The feature works as a screenshot captor for the current image. You can
use any tool to paste the created screenshot and save it in a desired image format.
Close - Closes an active image
Export selection to disk - All selected images can be exported to external media or to a local
disk. You can export the images in original format, as DICOM and/or JPG and packed as a ZIP
archive.
Send selection via e-mail - All selected images can be attached to an e-mail (Colenta DX Easy
Imaging uses the set standard mail client from Windows. An installed and correctly configured e-
mail client is required to use this function)
Create patient CD/DVD To create a patient disc, choose images and/or videos to burn. After
you have selected the images, click the button and follow the instruction-steps displayed on the
screen.
Exit viewer - Exits the Video Viewer screem and returns to the Capture-screen.
Menu Video Navigation
Play all video files - Processing mode is started:
the Filter button is activated, so that only the videos as a "play|list" are visible on the
thumbnail list on the left side of the Video-Viewer screen.
the videos are played one after another, i.e. as soon one video is finished, it
automatically changes to the next video.
the play begins if a video is selected from the thumbnail list, otherwise with the
following video.
the play mode is stopped when the last video was played or the user clicks the Stop-
button
First video frame - Current video position is set to the first image
Last video frame - Current video position is set to the last image
Start cut label - Current video position is set to the start cut label, if there is any, if not to the
beginning of the video
End cut label - Current video position is set to the end cut label, if there is any, if not, to the end
of the video
Video frame... - You can set the video position in a dialogue via video frame number
Speed - You can change the speed of playing video in a dialogue, confirmation with OK, reset of
speed with NORM. Via this function, the video frames will not be skipped, i.e. the maximum speed
is limited by the computer performance.
Menu Info
File information - Information about an active file. You can't change the data.
 46

Patient data - Patient and Owner information for an active image. There is also the oppertunity
to enter manually any missing information. The changes are saved (DICOM, CD, email, print) and
adopted in scribor. No changes are possible at archived images.
 47

Acquisition Data - All information about an acquisition. There is also the opportunity to enter
manually any missing information or to change the existing entries. No changes are possible at
archived images.
 48

Assign new patient - An image can be assigned to a new patient.

Click YES to assign an image to a new patient from the patient list.
Click NO to abort the exchange of patient data
 49

3 Viewer
 50

3.1 Toolbars
 51

3.1.1 Right Toolbar

 52

3.1.1.1 Right Toolbar Overview

This toolbar contains the most used functions:
Preview image

<- 90° turn to the left

90° -> turn to the right

Turn 180° (flip)

Mirror

Start measuring

Window levewling (Gradation)

Apply organ filter

 53

Go back to original image

Send to Diagnosis Worklist (active image, all images)

Send to Archive (active image, all images)

 54

3.1.1.2 Preview images

The left side of the Viewer-screen shows images waiting for processing using the available tools (images before
sending to Diagnosis Worklist or Archive)

An image selected for processing displays on the screen as well as a small preview image on the right of the screen:
 55

3.1.1.3 Rotation and mirror

<- 90° to the left

Rotates the current image 90° to the left

90° -> to the right

Rotates the current image 90° to the rigth

Turn 180° (flip)

Rotates the current image 180°

Mirror

Reflects image on the Y-axis (a.p. <-> p.a.)

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3.1.1.4 Image enhancement

Go back to original image

Goes back to the original image after changes of filters, brightness, contrast, gradation or similar manipulations to
the X-ray image. The original image is restored or reloaded.
Window leveling (Gradation)

Dialogue box to set gradation curve of X-ray and DICOM images. Digital X-ray images can appear too dark or too
bright. They can be corrected with the X-ray Gradation Tool:

Example 1.
left side - standard image
right side - darker image
 57

Gradation Tool: Click the right vertical line and move the mouse to the left holding the mouse button
pressed. Release the mouse buttn.

Example 2.
left side - standard image
right side - brighter image
Gradation Tool: Click the left vertical line and move the mouse to the right holding the mouse button
pressed. Release the mouse button.

Example 3.
Slide upward - Curve turns down, high-contrast image (less greyscale).
 58

Example 4.
Slide downward - Curve nears a straight line, low-contrast image (more greyscale).

Dialogue box to set brightness, contrast and gamma value of images except X-ray images.
Changing the values using the slider:
59
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3.1.1.5 Organ filter

Apply organ filter

Organ-specific filters; individual gradation settings for X-rays with marked differences in density

Individual buttons can be defined, e.g.: To change the image with the Gradation (Window Leveling) function, open
the Organ Filter function, clock S by the Individual button - the individual setting will be scored. The R button
cancels the setting and it can then be redefined. The Original button restores the image to its initial state.
 61

3.1.1.6 Measurement functions

The following measurement functions are available:

- Set Reference

- Ratio

- Angle

- Distance

- Angle (open)

- Outline

- Radiograph Marker Left: Sets L Marker in an X-ray image on the selected position. The X-ray
markers are added to the image and cannot be deleted after sendig to archive. The function Measurement Overlay
oln/off allows you to fade the marker of the image in or out.

- Radiograph Marker Right: Sets R Marker in an X-ray image on the selected position. The X-ray
markers are added to the image and cannot be deleted after sendig to archive. The function Measurement Overlay
oln/off allows you to fade the marker of the image in or out.
 62

- Add Text: Adds a free text to the image.

- Advanced Measurement

To leave the current measurement click the Save button (the measurement is stored on the image), or the Cancel
button (the measurement is aborted), or ESC on the keyboard (choose another measurement)

- Cancel: Cancels all measurements and goes back to the Viewer-screen.

- Save: Saves the measurements and goes back to the Viewer-screen

Set Reference
For the Set Reference function, left-click to mark the beginning of the distance and second left-click to mark the
total distance.
Then a pop up windows will appear, where you can enter the length of your reference distance.
 63

Ratio
For the Ratio function, left click to mark the beginning of the distance and second left-click to mark the total
distance. Then draw a second line in the same way and you will be given the ratio of both lines (1:X)

Distance
- Distance measurement in the image
Application:
For the Distance function, left-click to mark the beginning of the distance and second left-click to mark the total
distance. The result of the measurement is shown on the image (mm).
This measurement and all others can be saved directly on the image (Save button - saves the measurements,
Measurement Overlay - fades the data of the documented measurements of the image in or out).
 64

Angle
- Angle in relation to a reference line
Application:
For the Angle function, select the first point and draw a base line; click the left mouse button one more time to
finish the base line. The final point of the base line is the starting point of the second line, called a reference line. To
finish a reference line, click the left mouse button. The interior and exterior angle between the lines with the
common point is shown on the image.
 65

Angle (open)
- Angle between two separately drawn lines
Application:
For the Angle (open) function, draw the first line with the left mouse button. Do the same for the second line. The
angles between the lines are shown on the image.

Outline
- The perimeter of the enclosed area
Application:
For the Outline function, start and finish the line by clicking the left mouse button. After that, close the area with
the right mouse button. The result is displayed directly on the image.
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3.1.1.7 Send to Diagnosis Worklist/Archive

Send to Diagnosis Worklist

Saves the current image waiting for diagnosis into the Diagnosis Worklist. After the image is saved
you can view it again, edit it in Viewer mode and every your change will be saved.

Saves all currently displayed images waiting for diagnosis into the Diagnosis Worklist.

Send to Archive

Saves a current image (image after diagnosis) into the Archive. After the image is saved you can view
it again, edit it in Viewer mode but the changes won't be saved.

Saves all currently displayed images (images after diagnosis) into the Archive.
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3.1.2 Advanced Measurements

 69

3.1.2.1 For all advanced measurements

- Calculate after all steps are completed to see the result of measurement.

Each measurement is referred to as an object. Use the buttons to edit, delete current object and delete all objects:

- Undo: Removes the measurements step by step.

- Redo: Restores the measurements step by step.

- Edit object: Click on object, change it and save the changes by double clicking the left mouse
button.

- Delete object: Click an object to delete it.

- Delete all objects at once: Click all desired objects to delete.

- Help: Electronic manual for measurements in veterinary medicine. Click the button Help and
choose the desired measurement. To go back to the measurements list click the link back to overview.

- Ends measurement mode.

To move objects click on it and move it in a desired direction.
The measurements are visible on the image or not - this is a function of the Measurement Overlay ON/OFF button
on the upper toolbar.
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3.1.2.2 Cobb Angle Measurement

Measurement of the scoliosis angle

Requirements:
Requuired radiograph: AP view of full spine.

Diagnostic significance:
A measurement used for evaluation of curves in scoliosis on an AP radiographic projection of the spine.

How to measure:
1. Draw line (line 1) along the superior endplate of the superior end vertebra.
2. Draw another line (line 2) along the interior endplate of the interior end vertebra.

Figure: Cobb angle measurement of a levoscoliosis.

Legend
1 = Line drawn parallel to the superior endplate of one vertebra above the fracture.
2 = Line drawn parallel to the interior endplate of the vertebra one level below the fracture.
 72

Cobb angle: Angle between line 1 and line 2 (or lines drawn perpendicular to them)
 73

3.1.2.3 Ullmann-Sharp Angle Measurement

Measurement of the acetabular cup angle

Requirements:
Required radiograph: pelvis overview.

Diagnostic significance:
A measurement used to recognize hip dysplasia.

How to measure:
1. Draw the connecting line AB (line 1) rom the most caudal point of Köhler's tear drop to the most lateral
acetabular arch.
2. Draw another line (line 2) from the parallel to horizontal film baseline to the identical point of tear drop.

Figure: Ullmann-Sharp angle measurement.

Legend
A = acetabulum roof
B = the most caudal point of Köhler's tear drop
 74

1 = connecting Line AB
2 = parallel to horizontal film baseline
3 = acetabular cup angle (Ullmann-Sharp angle) between line 1 and line 2
 75

3.1.2.4 Center Edge (CE) Angle of Wiberg

Measurement for determining the hip development

Requirements:
Required radiograph: pelvis overview.

Diagnostic significance:
A measurement used in the radiographic evaluation of the hip joint.

How to measure:
1. Draw line (line 3) perpendicular to a baseline that passes through the center of the femoral head (1).
2. Draw another line (line 2) connecting the center of the femoral head and the superior border of the
acetabulum.

Figure: CE Angle of Wiberg.

Legend
1 = center of the femoral head
 76

2 = connecting line to the superior border of the acetabulum

3 = vertical
4 = CE Angle
 77

3.1.3 Top Toolbar

 78

3.1.3.1 Top Toolbar Overview

in Overview-screen and Viewer mode.
The following functions from left to right:

Start viewer

Print selection

Export selection to disk

Get file(s) from archive

Send selection via e-mail

Create patient CD/DVD

Delete selected images

Select all

Deselect all
 79

Zoom original size

Zoom-display

Magnify

Scale down

Change display splitting

Dataoverlay on / off

Measurement overlay on / off

Soft shutter on / off

Fullscreen mode on / off

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End viewer
 81

3.1.3.2 Start viewer

Opens one or more selected images in Viewer mode.

If only one image needs an attention click double on it.
To select all images use the button Select all or to select a single image click Ctrl-key + left mouse button.
Selected images are highlighted in blue.

When having selected more than one image on a viewing station the viewer will open images in a matrix setup.
 82

3.1.3.3 Print selection

Prints images on an installed Windows printer.

Choose the image and then the Print Image function.
Then select the printer and press OK.
 83

3.1.3.4 Export selection to disk

All selected images can be exported to the external media or local disk. You can export the images in
original format, as DICOM or/and JPG and packed as a ZIP folder.

To anonymize the images use the button and mark which Patient/Owner/Clinic/Exposure information

should be anonymized. Confirm your selection with or abort with .

To save the new anonymization settings click and restore default settings click

.
84
 85

3.1.3.5 Get file(s) from archive

Archived images can be re-loaded into the program and compared with the actual images, for
example.
 86

3.1.3.6 Send selection via e-mail

All selected images can be attached to e-mail as files (Colenta DX Easy Imaging calls the Windows
standard mail client. E-mail software must therefore be installed and configured to use this function)

You can configure:

convert the files to DICOM or JPEG
attach zipped files
Note: If the attachment size is over 7 MB you will see automatically generated warning (e.g. if many videos are
selected).
 87

3.1.3.7 Create patient CD/DVD

To create a patient disc, choose images or/and videos to burn.

The following functions can be used to choose the images:
1. Select the patient from the patient list, click the Archive button, mark Show images from this patient
only, choose the images from Diagnosis Worklist or Archived Images and click Start button.
2. Choose the Get image(s) from Archive button in a Top Toolbar of Viewer-screen and choose desired
images.
3. Use the File Menu with the function Open or Open file from archive
You can burn images directly in Overview-screen or in Viewer-screen.

After you have selected the images, click the button and follow the instruction-steps displayed on the
screen:
 88

1. For a single image selection select with a mouse clock or for an all images selection use button

and then the button Add Files to carry selected images (highlighted in
blue) from the left side to the right side. Images available on the right side are ready to burn.

Use Remove Files to remove the images which shouldn't be burned.

2.

- Includes images in original image forman.

- The feature is deactivated, if you want to burn images only in JPEG or

DICOM forman

- Include additional images in JPEG, TIF or PNG format on patient CD/DVD.

- The feature is deactivated

- Include additional images in DICOM format on patient CD/DVD.

- The feature is deactivated.

3. Click button Start Burning and insert a blanc disc.

4. Burn process starts automatically:

 89

5. After burning process is completed, remove the disc.

Additional functions:

Anonymize settings - Use settings to select the entries for anonymization.

Anonymize - Makes personal data anonymous

Select all - Selects all images, selected images are highlighted in blue.

Deselect all - Deselects all selected images.

Change thumbnail size - There are 6 levels of sizing.

- Cancels all changes you made in this dialogue.

 90

- Saves all changes you made in this dialogue (you can add more images to the
CD/DVD later)
 91

3.1.3.8 Delete selected images

- Deletes an unwanted image in Overview-screen.

Select the image, click on the button:

and confirm the warning screen:

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 93

3.1.3.9 Select/Deselect all

- Select all: Selects all images in Overview-screen to enable the user easily send all images taken to
diagnosis worklist or the archive, e-mail all images, print all images or burn all images on CD/DVD.

- Deselect all: This feature is used to deselect all images in Overview-screen

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3.1.3.10 Change of size

Scale down and scale up

Scale down (-) and Magnify (+)

Change the image size in follofing steps: 25%, 50%, 100%, 200%, 300% and 400%
Important: 100% means that one pixel on the monitor equals one pixel in the image. It does
not mean one inch/cm on the monitor equals one inch/cm in reality.
Zoom original size (1 pixel in image = 1 pixel on screen)

Switch to the 100% presentation of the image; all pixels are displayed.
Important: 100% means that one pixel on the monitor equals one pixel in the image. It does
not mean one inch/cm on the monitor equals one inch/cm in reality.
Zoom - display

Actual zoom factor is displayed

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3.1.3.11 Display settings

Change display splitting

All downloaded images will be arranged after loading automatically. The order of the image display corresponds to
the order of the image load. It starts on the left side, goes down and continues in next column.
All downloaded images can be shown in a matrix (j-rows, k-columns). If there are more images loaded than fit into
the matrix, the screen continues to the right.
The following image matrix settings are available:

Display images tiled horizontally or vertically.

Dataoverlay On / Off

Fades the configured image data in or out.

Measurement overlay On / Off

Fades the data from the documented measurements of the image in or out.

Soft shutter On / Off

Fades the selected X-ray shutter in or out.

Using the X-ray shutter, you can select one or more regions whose surroundings should be faded to black. The black
fading is visible only if shutter overlay is active. Previously superimposed regions can be changed or complemented
 96

as long as the image is not yet archived (See Menu Tools: X-ray Shutter Edit).

Fullscreen mode On ( Off

The image is displayed on the fullscreen and all toolbars are hidden. To exit this function, click on the
top border of the image and on this button again.

End viewer

The button is at the top right corner of the Viewer-screen. The button closes the Viewer-screen and
returns to the Overview-screen.
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3.2 Menu
 98

3.2.1 File menu

Open
Loads an image
Close
Closes an image
Save as...
Saves an active image format supported by the software (standard file \EXPORT)
Save as DICOM 8 bit
Saves an active image as an 8-bit grey value DICOM file.
Save as DICOM 12 bit
Saves an active image as an 12-bit grey value DICOM file.
Save as DICOM 16 bit
Saves an active image as an 16-bit grey value DICOM file.
Save image series as AVI (available as an option)
Creates an AVI (Audio Video Interleave) format movie film from a series of images on the Windows operating
system.
1. Click the menu File - Open to find and open the image series in AQS

2. Click the menu File - Save image series as AVI and save the file in a selected location
 99

3. You can open and play the AVI video file with any standard media player
Open file from archive
Loads and opens a selected file from the archive, e.g. for comparison with the current one.
Print
Prints images on an installed Windows printer. Choose the desired printer from the list and click OK button. For

this feature you can also choose the Print button in Viewer mode.
Print compilation
Prints several images on one sheet of paper as a collage
1. Select the images you wand to print and click Print Compilation

2. Choose the desired printer and click OK button

 100

3. Choose the desired overlay when printing more than one image

4. The print compilation screen appears:

 101

Buttons exist in this screen:

a. Select ROI - Region of interest.
b. All fit - Fit the image to the printed film size.
c. All 100% - Print the selected area in true size
d. Delete - Deletes the right image from the print preview area, when pressing the delete button again, the second
image will be deleted too.
e. Print - Sends the previewed images in print preview area to the printer
f. Cancel - Close print compilation screen and go back to image viewer screen.
5. Step sequence when using the Print Compilation Screen:
a. Click the desired view button to apply on the image (Select ROI, All fit or All 100%).
b. Click on the desired image thumbnail
c. The image will be viewed in another screen viewer and the selected area should be chosen, Left click will lock
the ROI tool on the image and will set the first image in the left chosen overlay
d. The selected area of the image will be viewed in the print preview area
e. Repeat the steps 1-3 for each image in case and overlay chosen with more than one image
f. Click the Print button to send the images to the printer
 102

Exit viewer
Ends the Viewer mode
 103

3.2.2 Edit menu

Copy
Copies an active image and transfers it into the cache
Paste
Adds an image from the cache
Undo
The filter functions applied to the picture are incrementally canceled
Reset image to original
All filter, brightness, contrast, window leveling changes and similar manipulations in the X-Ray
images are undone and the original view of the images is restored or the images are reloaded
Show difference image
Creates a comparison image from two X-ray images. First click on the contrast image and then on
the reference image.
Show inverse
Reverts the brightness and color values of the active image: bright fields become dark and vice
versa.
Example:
Original Image <-> Reversed Image
 104

Window leveling
Dialogue box is set to the gradation of X-rays. Default is Lin. If you want to change the weighting
of the grayscale values, you have to click on S-K. Then you will be able to change the curve with
the sliders (for more information please see Toolbars -> Right Toolbar -> Windows leveling
(Gradation))
 105

Dialogue box to set brightness, contrast and gamma value of images axcept X-ray images.
Change the values using the slider:
 106

Histogram equalize
Shows histogram over the whole image - contrast stretching on the whole available value area
Histogram equalize region
Select an area of an active image with the left mouse button to create the histogram in this area. It
is possible to select several areas for one histogram operation. Right-click the mouse button to exit
the function.
Assign new patient
If the patient data were wrong assignedto the image there is the possibility to exchange a patient
data. Press the Yes-button and select a right patient from the list.
 107

X-ray data
acquisition parameters (information from an X-ray protocol) and information about an X-ray
device. There is also the opportunity to enter manually any missing information or to change the
existing entries. No changes are possible at archived images.

Acquisition data
All information about an acquisition. There is also the opportunity to enter manually any missing
information or to change the existing entries. No changes are possible at archived images.
 108

Postprocess image again

If incorrect organ is displayed in the Viewer-screen, you can return to the body parts and organ
choice to reprocess the image
 109

3.2.3 Measurement menu

Start measuring editor

Leads to the available measurement functions (also as a symbol in the right toolbar ). Click first on this

feature and then on screen in any place. Click on to end measurement mode.

Densitometer
Measures the optical density in gray value images. The measuring area is 4x4 mm² or 20x20 pixels if no
measurements in the image are available. The relevant measurement is the average value of pixels. In addition, the
minimum and maximum pixel values are shown to allow conclusions to be drawn about acquisition parameters
Greyscale vor variable region
Measures the pixel value in gray value images. Use the left mouse button to mark the measurement area.
Line profile
Shows the intensity profile of the selected image line (only for technicians).
Presentation of the brightness distribution on a selected image line (re: original data, green: manipulated data).
Tip: The 'intensity profile line' considers only filters, but not corrections to the values to brightness, contrast and
gamma values, because they do not change the pixel value.
 110

Column profile
Shows the intensity profile of the selected image column (only for technicians).
Presentation of the brightness distribution on a selected image column (re: original data, green: manipulated data).
Tip: The 'intensity profile line' considers only filters, but not corrections to the values to brightness, contrast and
gamma values, because they do not change the pixel value.
111
 112

3.2.4 Filter menu

Chest filter
Optimizes images for chest acquisitions
Bone filter
Optimizes images for bone acquisitions
Tissue filter
Optimizes images for soft tissue acquisitions
Blood vessel filter
Optimizes images for blood vessel acquisitions
Organ filter
Organ-specific filters; individual gradation settings for X-rays with marked differences in
density

To preset the individual buttons: change the actual image with the gradation function and click
on S to save the settings. To delete saved settings for individual buttons, click R. The buttons are
now ready to preset with other settings. The Original button restores the image to its initial
staFilter
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3.2.5 CT/MRI menu

Show normal
Single CT- image view

Show Cine Mode

Shows image sequences in cine mode. If the image has no time information the image sequence
will be given with 5 images per second.
Show Collage Mode
Creates a CT-image collage. You can see all CT cuts displayed on the screen

CT Presets
Preset remote values for CT images.
 114

Houndsfield Values
Shows Hounsfield-Units (HU) if the relevant image information are available. Otherwiese the
respective pixel value will be shown. End with right mouse click
 115

3.2.6 Tools menu

Images in local cache
List of images in local image cache
Images waiting to archive
List of images in final archiving box
Images chossing by path
List of images in a specified search path

First open the search window for the Patient ID . Enter the ID of desired patient.
Click OK to see all available images of the patient. If the window remains empty, all images in the selected folder are
available for opening
In the image search path, you can define where to search for images, e.g.:

Delete images in import folder

Deletes all images in the import folder for external images (c:\aqs\medigraf\import).
Send image
Send active image to an external path
Send image (memory stick)
Copies the active image to a memory stick
Remove scribor data
Hides the scribor of X-rays. Removes patient data from the image so it can be printed or saved as anonymous in an
external image format.
X-ray shutter edit
Creates or alters image masking (shutter).
The X-ray shutter means windowing for electronic overlay and is part of the image Viewer functions. The image
areas outside the mask are blackened. The mask can also be printed.
Using this feature, you can set the shutter limits new even if you stored this image already
Open the desired image (Viewer mode, Diagnosis Worklist)
Select Tools Menu -> X-ray shutter edit
Set the new shutter limits though moving the white squares in different directions:
 116

Accept the shutter with OK in the upper left corner

Store the image (Diagnosis Worklist or Archive)

The Image in Diagnosis Worklist or Archive:
 117

Export selection to disk

All selected images can be exported to the extern media or local disk. You can export the images in original format,
as DICOM ar/and JPG and packed as a ZIP folder.

To anonymize the images use the button and mark which Patient/Owner/Clinic/acquisition information

should be anonymized. Confirm your selection with or abort with .

To save the new anonymization settings click and to restore default settings click

.
 118

Send selection via e-mail

All selected images can be attached to e-mail as files (DX Easy Imaging calls the Windows standard mail client. E-
mail software must therefore be installed and configured to use this function)
You can configure:
convert the files to DICOM or JPEG
attach zipped files
Note: If the attachment size is over 7 MB you will see automatically generated warning (e.g. if many videos
are selected).
Create patient CD/DVD
Creates a viewer CD, please follow the instructions shown in the software - for more information please see Toolbars
-> Top Toolbar -> Create patient CD/DVD.

For this feature you can also click in Overview-screen or in Viewer-screen (top toolbar).
Show SMPTE image (Test)
Loads an SMPTE test image with 256 shades of grey and resolution of 1024x1024 pixels.
SMPTE Test
Documented test with SMPTE test image (necessary only for human medicine)
Loads an SMPTE test image with 256 shades of grey and a resolution of 1024x1024 pixels. Close the image and
answer the question if all test samples and the minimum contrast were visible. The outcome of the inquiry is
recorded in the SMPTELOG.TXT file in the MEDIGRAF folder with the computer name, date and time.
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3.2.7 Info menu

File information
Technical data for an active image.

Patient data
Patient and Owner information for active image. There is also the opportunity to enter manually
any missing information. The changes are saved (DICOM, CD, e-mail, print) and adopted in
Scribor. No changes are possible at archived images
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 121

3.2.8 Settings menu

ONLY FOR ADMINISTRATOR

See also Settings-button on Exit Application screen.
For more information please see the part Administrator Settings in Main Menu of this Help.

General Settings
Set as you need. The setting will apply on all workstations.

Data Overlay
Settings for data overlay. Select patient data available on an image (view and print) by ticking the relevant boxes. To
see the selected data on an image Data Overlay must be activated in the upper tool bar.
 122

Measurements
Settings for measurements: colors of the objects (contour, borders, filling), tooltip (on/off), font (type, size)

Paths
The option "send image to memory stick" in the menu "tools" of the Viewer refers to this setting
 123

CT Presets
Arrange some presets for viewing CT images
 124

3.3 Mammography module

 125

3.3.1 Hanging protocols

The mammography module is loaded automaticaly when opening mammographic images.
In this module, the user has access to some "Hanging Protocols", which are bound to the F4 to F8 keys.
Please note, that the viewer is opened in fullscreen mode, to gain access to the menu bars, move the mouse cursor to
the left, top or right border of the screen.
The details of the module is shown below:
1. Mammo compare (F4): In this option two data sets of mamography screening can be compared together for
the easy understanding of the progression. Many pages with different view combinations are available.
Scrolling is possible by pressing F4 repeatly.

2. Mammo M|M (F5): This protocol schows the right and left lateral views (ML, LM, MLO, LMO)
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3. Mammo C|C (F6): This protocol shows the right and left axial views (CC, FB)

4. Mammo C|C|M|M (F7): This protocol shows the axial views and the lateral views on left and right
respectively.
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5. Mammo C|C - M|M (F8): This protocol shows the axial views and the lateral views on top and bottom
respectively.
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4 Activation
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4.1 Activation
The activation system is a form of copy protection to reduce illegal software piracy.

Note: Without a successful activation, the software works for 30 days in an evaluation mode (with full functionality).
Warning: You can't start the software after evaluation period, if you don't activate it.

Important: If your system works with a software protection dingle, please insert the dongle in the USB port of your PC
before starting activation wizard.
As long as the software is not activated, it will show a message box with remaining evaluation time on each start.
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When AQS is started at the acquisition station, the user has the possibility to start an activation wizard, which guides the user
through the activation process:
Note: This is not possible from client workstations.

Click No if you want to start the activation process later (the software will start in evaluation mode)
Click Yes to continue the activation process
Select the first option REQUEST LICENCE, so that an "activation request file", which contains information about the user's
institution name, address and some information about the user's hardware, can be sent to Colenta. After that click on
CONTINUE:
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Enter your valid e-mail address and click on CONTINUE

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Click Cancel if you don't want to continue.

Click Back to go one step backwards
Click Edit if information about hardware code, institution name or institution address is wrong and you want to
change it. Use Edit button before sending licence request!
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Note: Your e-mail address must be entered correctly 2 times, because later the license key will be sent to this address.
Important: If you have received a licence key from your dealer, please enter it in the field "license key" to be sure that
activation process will be successfully completed.
If you are sure your e-mail address is correct, click on Continue.
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Important:
There are two possibilities to send this request:
1. Automatically via internet:
This is recommended, if an internet connection is available. The request file will be sent automatically:
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2. Save to file:
The request file will be saved on disk and must be transferred manually to another computer. This is recommended, if
there is no internet connection at the current computer.
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When you saved the file:

Please send the file licence_request.req as attachment to the following mail address:
activation@colenta.at
You don't need a subject or a message text in your mail.

Note: You will receive a mail with your personal licence key a few days after you have sent the request:
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After you have received e-mail from Colenta with the licence file (licence.lic), please copy it to your hard disk or a USB
device.
This file must be imported to DX Easy Imaging. This is only possible at the acquisition station, from where the request
was sent.
Please click the button LICENCE on the Exit Application screen, choose the second option in the activation wizard
IMPORT LICENCE and click on CONTINUE.

The dialogue box appears to select the licence file. The licence file must be imported from the same computer from
which the request was sent:
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Note: The acquisition station will verify on each start, if your license still matches with your hardware, institution
name and address.
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5 Archiving CD and DVD

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5.1 Archiving CD and DVD

Safety information and clarification of X-ray images archiving

Data backup is an operator responsibility and duty !

Data protection
The digital X-ray images have to be stored permanent in an appropriate way. We recommend the storage on suitable
optical media. For an additional security we recommend to create a working copy and a backup copy of this media.
The working copy remains in the practice and the backup copy will be taken to another established place.
The archiving program is set to generate 2 copies of CD/DVD by default.
To store the digital X-ray images on the hard disk of PCs is not enough and permanent save storage method. If a
hard disk would be damaged or destroyed by mechanical or electrical failure, the data on it may be irretrievably lost.
Other common problems for data loss from hard disks are crash or virus infection of the operating system, so the
computer will not boot.

X-ray images archiving - Germany

According to §28 of X-ray Ordinance the archiving of digitally stored X-ray images must be made on a medium that
insures the reproducibility pursuant to that rule even after up to 28 years by images of small children. Rest of X-ray
images must be kept 10 years after the last examination.

Storage media
Currently available are optical storage media in the form of CDs or DVDs which assure this long service life. In the
past only CD was called as a recording medium by decision-making bodies of the X-ray Ordinance.
If other media are used, then, except to ensure the durability of this media, must also be secured that there is
available a fully functional reproducing device. If not, the operator has to ensure that the data files are copied early
to current media.

Example for storage media

The manufacturer Colenta Labortechnik GmbH & Co KG recommends the DVDs " MCC/Verbatim DataLifePlus
DVD-R General" of Mitsubishi Chemical, in which an expected lifetime is more than 100 years.
To achieve the maximum durability of these DVDs, the following operations must be met:
A recorder with performance according to the specifications written on the blank.
The air does not contain any corrosive gases.
On the DVD-R surface are no scratches or fingerprints.
The temperature is 25 + / - 2 ° C.
The relative humidity is 55 + / - 5%.
The DVD-R is stored in a jewel case.
The DVD-R is not exposed to the sun or UV light.

X-ray images archiving - other countries

In every country is another X-ray Ordinance, which regulates the storage periods. Please inform yourself about the
X-ray Ordinance applies in your country and follow the instructions.

Archiving system
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Archiving CD and DVD

Creating archive media is integrated into the AQS exit screen.

The button is only visible on the exit screen, when archiving is necessary. If
configured archive media can be burned on different PCs.

On mouse over the button the state is shown:

After clicking on the button Archive-DVD archive screen opens:

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Colenta DX Easy Imaging archiving system has several LED's, which indicate the following:
LED for inserted disc:
red LED / orange LED - no disc available
green LED - disc is inside the burning device
LED for amount of media to be archived (6 media = 1 DVD):
orange LED - no disc available
red LED - you don't have to burn. Archive folders are empty, it means there is nothing to burn
green LED - you can or have to burn. There are full folders in the database. The number in the
field indicates the folders to be burnt. You can burn if 6 CD folders are filled by inserted DVD or
1 CD folder by inserted CD.
Media No. to archive
the number indicates the CD folders that are already burnt.
Amount of finished copies
the number of copies already been burnt in this specific archiving process.
LED for ready
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red LED - not ready

orange LED - busy (by searching of drive or during burning process)
green LED - ready, disposed to burn (all of the conditions are met)
If you want to change amount of media copies take Menu File -> Settings:

Click Burn button to start burning process.

Click Exit button to close the screen after burning
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6 Administration
 147

6.1 Administrator Settings

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6.1.1 Administrator Settings

In the AQS Exit Application screen click on .

In the Authority Request window select and click Start.

In the Administrator menu one of the three options can be selected:
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6.1.2 General settings

Click on to open general settings:

Note: The globe symbol stands for global settings. The global settings will apply on all workstations.

Scribor
The Scribor refers to Institution Name and/or Institution Address, which can be changed.
WARNING: Please note that after changes your license will not be valid any more and you have to reactivate your
system.

Appearance
Sets a number of preview images per row in Overview screen - from 1 to 20.
Example:
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Hides or not the X-ray parameters on acquisition screen:

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Magnifier
Sets the horizontal size, vertical size and the zoom factor for the feature Magnify.
For magnify hold down the left mouse button and the left ALT on keyboard while moving the mouse.
The settings specify the size of the " magnifying box" (horizontal and vertical) as well as the factor by which the
corresponding part of an image is enlarged.

Create patient CD / DVD

Settings for creating patient CD / DVD.
Example:
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Crop images - DICOM images on CD / DVD will show only the cropped area of the original image.
Include lookup table (LUT) - The LUT will be processed into the DICOM image. The feature is needed when the
used DICOM viewer for the patient CD / DVD can not handle images with DICOM LUT.
Burn settings - The possibility to use burn robot for burning patient CD / DVD.
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6.1.3 Data Overlay

The feature is also available: Viewer-screen -> Menu Settings

All tags containing values and checked will be shown in images.
The following tags need further description:

Display date as: Set as you need

Font size 1/40 of image height: In some images the data overlay will be too big. Uncheck and set the size of data
overlay types to wanted value in mm. Types can be different for certain types of images.
Pribt only small scribor: If checked, printouts will not contain tags in an image itself. Only the global scribor will
be printed. Useful especially when printing collages.
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6.1.4 Measurements
The feature is also available: Viewer-screen -> Menu Settings

Font sizes

Widths: Size of text entered with

Measurement results: Size of results from

Enhanced measurement results: Size of results for all measurements from

Enhanced measurement description / help: Size of description and help text for all measurements from
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Colours
Text background and object border colour:
R - red fraction of RGB-value (0-255) for resulting color of stroke / background color.
G - green fraction of RGB-value (0-255) for resulting of for stroke / background color.
B - blue fraction of RGB-value (0-255) for resulting color of stroke / background color.
Text foreground and object filling colour:
R - red fraction of RGB-value (0-255) for resulting color of filling / font color.
G - green fraction of RGB-value (0-255) for resulting color of filling / font color.
B - blue fraction of RGB-value (0-255) for resulting color of filling / font color.

Widths
Object width: Object size, not bigger than 2.5; e.g. the blue part .
Border width: Border size, not bigger than 1.0; e.g. the red part .

Tooltips: Enable/disable tooltips for enhanced measurements.

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6.1.5 Paths

The option "Send image (Memory Stick)" in the menu Tools of the Viewer-screen refers to this setting.
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6.1.6 CT Preset

Arrange some presets for viewing CT images.

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6.1.7 Edit organ properties

Click on to open:

A) change settings of one organ

Edit organ properties

Choose the organ group and then the organ that should be changed. Click on

.
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The Administrator can change the settings of kV, mAs, receptor and acquisition technique.

Click on to activate your choice(s).

Edit processing settings

Choose the organgroup and then the organ that should be changed. Click on

.
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The administrator can change the predefined rotation and / or mirroring of an image. Click on to
activate your choice.

B) Create a button containing several single buttons and rearrange the buttons on the surface
In delivery state the organ selection looks like this. On the left side the view you get when clicking on

. On the right the current look of AQS organ buttons.

For example let's assume we want to put the overview VD and overview LL in one button so that we don't need to
click on both organ buttons when we need both images.

For that start with clicking on .

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In the then opening field enter the name of the

new button .
Then we need to fill the button with the organ we want to have in there. Select the organ on the left

then click . The organ goes to the right.

Repeat the step with the overview LL.

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When all organs are selected, click to finish the filling of the multi organ button.
Now the new multi organ button is on the bottom of the organ list.

With using Up repeatly the new button is moved to the top.

To get a nicer layout we create an empty button .

This new empty button is moved with Up to the second

position of the organ list .

The result is shown in the following comparison. (Remember to get actual the layout).
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6.1.8 Administrator - Close

Click on to close the Administrator Settings and go back to the Exit Application
screen of DX Easy Imaging.
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7 Index
Acquisition, 25-26
Activation, 129-138
Administrator - Close, 166
Administrator Settings, 148
Archive, 19
Archiving CD and DVD, 140-145
Capture, 33-40
Center Edge (CE) Angle of Wiberg, 75-76
Change of size, 94
Cobb Angle Measurement, 71-72
Create patient CD/DVD, 87-90
CT Preset, 159
CT/MRI menu, 113-114
Data Overlay, 154-155
Delete selected images, 91-92
Devices - Screen, 16
Display settings, 95-96
Edit menu, 103-108
Edit organ properties, 160-165
Exit application, 20
Export selection to disk, 83-84
File menu, 98-102
Filter menu, 112
For all advanced measurements , 69-70
General settings, 149-153
Get file(s) from archive, 85
Hanging protocols, 125-127
Image enhancement, 56-59
Info menu, 119-120
Lost & Found, 14
Manual adjustment of acquisition values (optional), 27
Measurement functions, 61-66
Measurement menu, 109-111
Measurements, 156-157
Menu - Sono/Video Module, 45-48
Organ filter, 60
Organ selection, 23-24
Overview, 18
Paths, 158
Patient administration, 17
Preview and protocol, 28-29
Preview images, 54
Print selection, 82
Read first, 5-7
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Revision History, 169

Right Toolbar Overview, 52-53
Rotation and mirror, 55
Safety notes, 8-9
Select/Deselect all, 93
Send selection via e-mail, 86
Send to Diagnosis Worklist/Archive, 67
Settings menu, 121-123
Start viewer, 81
Symbols, 12
Tools menu, 115-118
Top Toolbar Overview, 78-80
Ullmann-Sharp Angle Measurement, 73-74
Viewer, 30
Viewer - Video Viewer, 41-44
Workflow X-Ray Module step by step
Acquisition, 25-26
Manual adjustment of acquisition values (optional), 27
Organ selection, 23-24
Preview and protocol, 28-29
Viewer, 30
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8 Revision History

Version* Issue date

1.02 12.03.2010
1.04+1.06 23.09.2010
1.08 18.03.2011
1.10 27.06.2011
2.00 04.06.2012
2.02 23.11.2012
2.04 01.07.2013
2.06 12.11.2013
2.08 27.06.2014
2.10 12.11.2015
2.10** 02.12.2016
2.10** 01.03.2017
* Version - the version of the X-AQS software user manual is the same with the release version of the software. If
there are no relevant changes for the user in the new release version of the software, the version of the user manual
won't change.
** - the main version of the X-AQS software is the same, release version of the user manual was changed because of
changing of number of notified body and minor text changes.