CR Mammography Solution CR 30-Xm - Service Manual

HEALTHCARE
Imaging Services Service Documentation

Document No: DD+DIS159.12E
CR Mammography Solution
based on CR 30-Xm
CR Mammography Solution
Service Manual
► Purpose of this Document
This document covers the information and mandatory tasks to set up a

CR Mammography Solution based on CR 30-Xm.
► Document History
Edition. Release Changes

Revision Date
1.0 07-2012 This document is the successor of DD+DIS283.11E,
LL-ID: 35929631
► Referenced Documents
Document Title
For a list of referenced documents see section 3.
DOCUMENT CONTROL NOTE:

The controlled version of this document is available from the Agfa HealthCare Library. Any printed copy of this document is uncontrolled.
Edition 1, Revision 0
07-2012 Printed in Germany Document Node ID: 36784739
eq_standard_e_template_v09
Agfa Company Confidential Copyright © 2012 Agfa HealthCare N.V.
DD+DIS159.12E CR Mammography Solution
► Manufacturer
Agfa HealthCare N.V.
Published by
Agfa-Gevaert HealthCare GmbH
Tegernseer Landstraße 161
D - 81539 München
Germany
Copyright  2012 Agfa HealthCare N.V.
All rights reserved.
Technical modifications reserved.
Agfa and the Agfa rhombus are trademarks of Agfa-Gevaert N.V., Belgium,
or its affiliates.
WARNING:
Improper operation or service activities may cause damage or injuries.
INSTRUCTION:
(1) Read the "Generic Safety Directions" document
(see Agfa HealthCare Library > General Info > Agfa HealthCare > Publications >
Service Manual) prior to attempting any operation, repair or maintenance task on
the equipment.
(2) Strictly observe all safety directions within the "Generic Safety Directions" and on
the product.
IMPORTANT:
The installation and service of the product(s) described herein is to be performed
by qualified personnel who are employed by Agfa HealthCare or one of its affiliates
or who are otherwise authorized by Agfa HealthCare or one of its affiliates to provide
such services.
NOTE:
To verify the latest version of a chapter of the Service Manual refer to the “Checklist for
Completeness” in the Agfa HealthCare Library.

Edition 1, Revision 0 CR Mammography Solution based on CR 30-Xm Page 2 of 68

07-2012 Agfa Company Confidential
LIST OF CONTENTS
1 SOLUTION OVERVIEW ...........................................................................................................5

1.1 Components..............................................................................................................................6
1.2 System Topologies versus Modality Alignment ........................................................................7
2 SAFETY DIRECTIONS.............................................................................................................8
3 PREREQUISITES.....................................................................................................................9
4 CR MAMMOGRAPHY SOLUTION SET-UP...........................................................................11
5 PREPARATION ......................................................................................................................12
5.1 Checklist for the Sales Representative...................................................................................12
5.2 Checklist for the Customer Representative ............................................................................14
5.3 Checklist for the Field Service Engineer.................................................................................18
5.4 Checklist for the Clinical Application Specialist ......................................................................20
6 INSTALLATION ......................................................................................................................21
6.1 Installation Checklist ...............................................................................................................21
7 CONFIGURATION..................................................................................................................23
7.1 Configuring the Central Monitoring System (optional)............................................................23
7.2 Checklist for Configuration of the Workstation........................................................................24
7.2.1 Configure the Operating System.............................................................................................25
7.2.2 Setup a Default Configuration for NX Application...................................................................25
7.2.3 Installation of the Start-up Exam Tree for CR Mammography................................................25
7.2.4 Device Configuration...............................................................................................................26
7.2.5 Configure the Examination Tree .............................................................................................42
7.2.6 Configure the User Interface (UI)............................................................................................49
7.2.7 Film Text Box Configuration....................................................................................................61
7.2.8 Activate the Configuration.......................................................................................................62
7.2.9 Monitor Calibration..................................................................................................................62
7.3 Digitizer ...................................................................................................................................62
7.4 Printer and Softcopy Station Configuration.............................................................................62


8 CUSTOMER TRAINING .........................................................................................................63

8.1 Checklist for Customer Training (Radiologist and Radiographer) ..........................................63
8.2 Additional Checklist for Radiographer Training ......................................................................66
9 CUSTOMIZATION (PROFESSIONAL SERVICES) ...............................................................68

9.1 Customization Checklist..........................................................................................................68


1 Solution Overview
The Agfa CR Mammography Solution consists of a digitizer, a set of cassettes and

image plates and a CR Mammography workstation. It supports softcopy stations and
Mammography printers as optional components.
The intended use and limitations of the CR Mammography Solution are described in
the CR Mammography System User Manual(s) 2344/2444 on Agfa HealthCare Library
(Intranet Link / Extranet Link - Intranet Link / Extranet Link).
Figure 1: Solution Overview
The CR Mammography Solution can be used in:

 X-ray rooms
 Outside X-ray rooms
 Private radiologist sites
 Clinic
 Imaging center
 Mobile Environment


The monitor of the CR Mammography workstation has not been approved for final
interpretation of examinations. Images shown on this monitor are for validation of
patient positioning purposes only.
Constancy Quality Control (QC) ensures that the performance level of an existing
CR Mammography Solution is still equivalent to the level defined during solution setup.
This is the responsibility of the customer.
An X-ray modality alignment is mandatory to use the CR Mammography Solution.
CAUTION:
Incorrect X-ray Modality setup can cause serious performance problems.
The solution components and the X-ray Modality have to be configured before
Mammography examinations will be performed.
The solution components have to be configured by an Agfa CR Mammography
specialist (FSE/CAS), whereas the X-ray Modality needs to be configured by the
modality service engineer, in presence of the Agfa CR Mammography specialist
(FSE/CAS).
FSE - Field Service Engineer
CAS - Clinical Application Specialist
1.1 Components
The components released for the CR Mammography Solution are listed in the
CR/DR Interoperability Matrix, see section 3.
The NX workstation and the CR 30-Xm Digitizer always belong together meaning that
each CR Digitizer has to be connected to one dedicated NX workstation.
The identification of the CR Mammography cassettes are done via Fast ID workflow,
this means no ID tablet is required: When the cassette is inserted into the CR Digitizer
the user enters the patient data at the NX workstation and it is transferred directly to
the digitizer.
IMPORTANT:
The deviations to the released configuration of the CR Mammography Solution have to
be reported in the Final Acceptance Certificate, which must be signed by the customer.


1.2 System Topologies versus Modality Alignment
In case the CR Mammography Solution based on CR 30-Xm is installed additionally to

an existing CR Mammography Solution on site, an additional modality alignment might
be required.
For the following scenarios, an additional X-ray modality alignment is mandatory:

 Scenario 1: One CR 30-Xm digitizer working with Agfa CR MM3.0T Mammo
cassettes and plates and one DX-M working with Agfa CR HM5.0 Mammo
Detectors.
cassettes and plates and one CR 75.0 / CR 25.0 working with CR MM 2.0
Cassettes.
An additional X-ray modality alignment means:

 Either 2 different channels are available in the same X-ray modality or
 2 different X-ray modalities are used.
For the following scenarios, no additional X-ray modality alignment is needed:

cassettes and plates and one DX-M working with Agfa CR MM3.0R Mammo
cassettes and plates.
cassettes and plates and one CR 75.0 / CR 25.0 / CR 85-X / CR 35-X working
with CR MM3.0 cassettes and plates.


2 Safety Directions
CAUTION:
Incorrect X-ray Modality setup can cause serious performance problems.
The solution components and the X-ray Modality have to be configured before
Mammography examinations will be performed.
The solution components have to be configured by an Agfa CR Mammography
specialist (FSE/CAS), whereas the X-ray Modality needs to be configured by the
modality service engineer, in presence of the Agfa CR Mammography specialist
(FSE/CAS).
FSE - Field Service Engineer
CAS - Clinical Application Specialist
WARNING:
X-ray dose could be too high for the patient.
Do not use uncalibrated dosimeters.
Only order the Agfa recommended dosimeters.
WARNING:
X-ray dose could be too high for the patient.
It is mandatory to remove older versions of PMMA blocks you bought locally and
to use the ones delivered by Agfa, which are internally tested and approved.
This ensures that the measurement tolerances of the alignment procedure are fulfilled.


3 Prerequisites
REQUIRED TOOLS
 USB memory stick (checked to be virus-free), for Configuration purposes
 Cleaning Material:
Please refer to the CR 30-X/CR 30-Xm Plates and Cassettes User Manual to
order the appropriate cleaning material for the CR MM3.0T Mammo Cassettes.
See in the table below.
DOCUMENTS:
Document Hyperlink
a) Project Management Guide
for the CR Mammography Solution based Intranet Link / Extranet Link
on CR 30-Xm
b) CR Mammography Solution User
Intranet Link / Extranet Link
Manual(s),
document number UM 2344/2444
c) CR 30-X/CR 30-Xm Plates and Cassettes
User Manual, document number UM 2387
d) CR/DR Interoperability Matrix Intranet Link / Extranet Link
e) CR 30-Xm Digitizer Service Manual Intranet Link / Extranet Link
f) NX Service Manual
Agfa HealthCare Library 
version 2.0.8000/NX 3.0.8000 or higher,
Computed Radiography 
- Chapter 4 - Installation and Configuration
CR Workstation Software*
- Chapter 5 - Monitor Options
g) Electronic Licensing Management System -
Service Documentation
h) Connectivity Release Document for XRDI Agfa HealthCare Library  General
Software Info  Connectivity & Application*
i) Marketing Newsletter on Mammo XRG
Intranet Link*
connection with NX Mammo
j) Application Note - Correct Use of Musica
Mammo Image Processing for NX 2008 and Intranet Link / Extranet Link
higher
* Only applicable for Agfa Employees.
For external partners: Contact your local Agfa representative.


Document Hyperlink
k) Musica MCE (Micro Calcification
Enhancement) Image Processing Software Intranet Link / Extranet Link
document
l) CR Mammography ATP Service Manual
DD+DIS010.12E
m) CR Mammography ATP Tool – Version 5.2
or higher
n) Tools for the CR Mammography Solution
document
o) Application Note - Basic Manual Quality
Control Procedure Intranet Link / Extranet Link
DD+DIS 007.12E
p) Interface Status Report (ISR) Intranet Link*
Agfa Healthcare Library  General
Info  Connectivity & Application 
q) Connectivity Release Documents
To [Manufacturer]  Connectivity
Release Document *
* Only applicable for Agfa Employees.
For external partners: Contact your local Agfa representative.


4 CR Mammography Solution Set-up
Project Management X-Ray Device Set-up

Project Management Guide Connectivity Release Documents
(1) Perform Project Management (21) Set-up connectivity to X-Ray device
Preparation NX Workstation Installation (continued)

- CR Mammography Solution Service
Manual (this manual)
NX Service Manual
- CR 30-Xm Digitizer Service Manual
- NX Service Manual
(2) Prepare the installation (22) Configure general security and GUI
(23) Enable Service tools protection (optional)
Digitizer Installation (24) Activate configuration
(25) Configure NX Viewer
CR 30-Xm Digitizer Service Manual (if applicable)
(3) Check installation site prerequisites (26) Adjust Anti-virus settings (if applicable)
(4) Prepare tools and unpack digitizer (27) Generate FPF and upload to ELMS
(5) Check shipment completeness (28) Create backup of configuration data
(6) Connect digitizer to NX workstation (29) Perform NX Acceptance Test
(30) Connect additional system components
Digitizer Installation (continued)

CR 30-Xm Digitizer Service Manual
NX Workstation Installation (31) Configure digitizer for hospital network
(32) Check image quality of the digitizer
NX Service Manual
(7) Connect hardware (33) Confirm Installation Date of the digitizer
(8) Configure basic OS settings and network (34) Perform a backup
(9) Install UPS (optional) (35) Store the USB flash drive
(10) Update ID Tablet firmware (if required)
(11) Edit security settings X-Ray Modality Alignment and Solution ATP
(12) Create and configure users
CR Mammography ATP Service Manual
(13) Load licenses (36) Perform X-Ray modality alignment
(14) Activate NX (37) Perform Solution ATP
(15) Install monitor SW and calibrate monitor
(16) Enable or disable active licenses CR Mammo Solution Installation
(17) Configure users - CR Mammography Solution Service Manual
(this manual)
- Application Note - Basic Manual Quality
Control Procedure
(18) Import configuration settings (38) Perform Quality Control
(39) Perform Customer Training
NX Workstation Configuration
CR Mammography Solution Service Manual
(this manual) CR Mammo Solution Finalization
(19) Configure devices
CR Mammography ATP Service Manual
(20) Configure exam tree (40) Fill-in Final Acceptance Certificate


5 Preparation
Following checklists provide information to prepare the installation of a

CR Mammography Solution based on CR 30-Xm.
They contain information and instructions for all CR Mammography specialists,
including: Sales representative, Customer representative, Field Service Engineers
(FSEs) and Clinical Application Specialists (CASs).
5.1 Checklist for the Sales Representative
Checklist to be filled by Sales representative (page 1 of 2)

Order number: Date:
Goal:
 Installation, configuration and clinical application work can be performed and
won’t be delayed due to missing information.
 All customer expectations can be fulfilled.
 Local regulations can be fulfilled.
Topics: Done
Sales representative
Provide personal data:
 Name:
 Tel.:
 E-mail:
Hospital information
Ask the following about the Hospital:
 Hospital name:
 Department name:
 Hospital address:
 Contact person:
 Tel.:
 E-mail:
Check next page 


Checklist to be filled by Sales representative (page 2 of 2)

Sold components, services and licenses
Make a list of the components, services and licenses which are sold:
 Components:
 Services
(including Professional Services):
 Licenses:
Agfa claims and limitations

Ensure the customer is informed about:
 The different X-ray modality alignment procedures released for the
CR Mammography solution.
 The limitations of the CR Mammography Solution.
For details, refer to CR Mammography Solution User Manual,
refer to section 3.
 The Final Acceptance Certificate and its signing refer to the
CR Mammography ATP Service Manual, see section 3.
Local standards
Check upfront if the existing local standards are in line with the
Agfa modality alignment requirements.
Specific costs
Inform the customer about the eventual costs required by the
X-ray modality service engineer:
 To align the X-ray modality and
 To setup the X-ray connectivity between the X-ray modality
and the NX workstation.
Customer expectations
Collect customer expectations concerning the setup and time scheduling
including installation, configuration and trainings.
Open topics or questions
End


5.2 Checklist for the Customer Representative
Checklist to be filled by Customer representative (page 1 of 4)

Site: Date:
Goal:
 All customer expectations can be fulfilled.
 Local regulations can be fulfilled.
Topics: Done
Contact persons information
Provide the name and telephone number of the following contacts:
 Responsible radiologist, name: Tel.:
 Responsible radiographer, name: Tel.:
 Local Physicist, name: Tel.:
 RIS company & contact person, name: Tel.:
 Local IT security specialist, name: Tel.:
 Local Network specialist, name: Tel.:
 Local logistics specialist, name: Tel.:
Currently used solution

Collect the following data about the currently used solution:
 Digitizer:
o Type:
o Serial number:
o Software Version:
 CR Mammo Cassettes and Plates:

o Type:
o Format:
o Quantity per format:
Check next page 



 CR Mammography workstation
o Software version:
o Licenses:
o List of examinations, views, special projections
(examination tree):
 X-ray Modality
o Vendor:
o Type:
o Software Version:
o X-ray exposure parameters:
o Acceptance test report including the X-ray modality alignment
results (if available):
o Connectivity Set foreseen or available*:
 X-ray Modality (2, if applicable)

o Vendor:
o Type:
o Software Version:
o X-ray exposure parameters:
o Acceptance test report including the X-ray modality alignment
results (if available):
o Connectivity Set foreseen or available*:
 Film/screen solution
o Film, vendor and type:
o Screen, vendor & type:
o Chemistry, vendor and type:
 List of data printed in the data field of the film (if applicable):
Check next page 

* Remark: For ordering connectivity sets for the different X-ray modalities refer to the Marketing Newsletter
concerning X-ray Modality Connectivity, see to section 3.



Solution requirements
Check that the following requirements and conditions are fulfilled:
 The X-ray modality maintained regularly
 Viewing box with shutters and a luminance of at least 3000 cd/m2
 Softcopy station display luminance of at least 450 cd/m2
 Viewing box and display not placed next to each other
 No light source (lamp or window) directed to the viewing box or
display screen
 Ambient light minimized (less than 50 lux (lumen/m2))
 Glare minimized
Professional services
Check that the following tasks must be ordered as professional Services:
 Additional acceptance testing (e.g. EUREF tests) beyond
Agfa Acceptance Test procedure
 Constancy Quality Control (QC) to be performed by Agfa
 Additionally optimization of Mammography image processing in the
workstation (from NX 2008 on)
Sketch of environment
Make a sketch of the involved rooms, e.g. X-ray room, reporting room.
2 remarks have to be taken in account:
 Existing equipment involved in the CR Mammography Solution and
the location of the new equipment should be marked.
 CR Mammography workstation shall be in the X-ray room in case
there will be connectivity with the X-ray modality (workflow
improvement).
Check next page 



Training classes for radiographers and radiologists
 Provide the names of radiographers (maximum 4) and
radiologists (maximum 2) to be trained:
 Radiographer
o Name:
o Name:
o Name:
o Name:
 Radiologists:
o Name:
o Name:
 Ensure that the trainees are experienced PC users and skilled in

performing Mammography examinations.
 Order additional services in case additional staff should be trained.
Remarks
End


5.3 Checklist for the Field Service Engineer
Checklist for the Field Service Engineer (page 1 of 2)

Site: Date:
Goal:
 All information is prepared to set up a new CR Mammography site.
Topics: Done
Agreement with the Modality Service Engineer
Define an agreement with the X-ray modality service engineer concerning:
 The implementation of the exposure parameters into the X-ray
modality as recommended by Agfa.
In case the modality alignment procedure based on PVIlog is done
by the X-ray modality service engineer, only verification from Agfa is
mandatory.
 The tasks assignment for the connectivity between the X-ray
modality and the workstation (optional).
Details can be found in the Marketing Newsletter concerning X-ray
Modality Connectivity, refer to section 3.
CR equipment
 In case of a pure Mammography environment (only Mammo X-ray
modality available), ensure that the Al-Filter is available.
 Define and plan the necessary soft- and hardware upgrades for the
components of the CR Mammography Solution.
 Ensure that the license configuration files will be generated and
available for the on site visit.
Check next page 


Checklist for the Field Service Engineer (page 2 of 2)

Documentation
Ensure the on-site access of the following documentation:
 Solution:
CR Mammography Solution based on CR 30-Xm Service Manual
(this manual)
 ATP:
CR Mammography ATP Service Manual, refer to section 3.
 Workstation:
Service Manual NX 2.0.8600 / 3.0.8600 or higher, refer to section 3.
 Digitizer:
Service Manual CR 30-Xm digitizer, refer to section 3.
 Printer and IMPAX:
Service Manuals of the released Mammography printers and/or
softcopy stations are referenced in Interface Status Report (ISR),
refer to section 3.
CR Mammography Toolkit
Ensure that:
 The CR Mammography toolkit has the latest status.
 All the measurement devices are calibrated.
Refer to Tools for the CR Mammography Solution document, for
details see section 3.
Professional Service
Inform sales representative about potential options to sell professional
service based on the experience of the site.
End


5.4 Checklist for the Clinical Application Specialist
Checklist for the Clinical Application Specialist

Site: Date:
Goal:
 All information is prepared to set up a new CR Mammography site.
Topics: Done
Print outs
Make print outs of:
 Checklist for radiologist training
 Checklist for radiographer training
Professional Service
Check for customer specific agreements.
Remarks
Explain the customer representative that with his/her signature on the Final
Acceptance Certificate he/she accepts the present conditions of the CR
Mammography Solution.
End


6 Installation
Following checklist provides the necessary steps for installing the CR Mammography
Solution based on CR 30-Xm.
These steps have to be performed by the CR Mammography Specialist (FSE)
6.1 Installation Checklist
Checklist for the Equipment Installation (page 1 of 2)

Site: Date:
Location:
Goal: The CR Mammography Solution is installed as specified.
Prerequisites:
 Trainings are completed for CR Mammography, CR Digitizer (CR 30-Xm) and
CR workstations.
 Preparation tasks are done as described in section 5.
Duration: up to 1.5 hours
Topics: Done
Cassettes and image plates
 Clean all Agfa CR MM3.0T Mammo Cassettes and Plates according
the instructions mentioned in the Agfa CR 30-X/CR 30-Xm Plates
and Cassettes User Manual, refer to section 3.
CR Workstation
 Check the software version: NX 2.0.8600/NX 3.0.8600 or higher
Mammography Printer and IMPAX (optional)

 Install the Mammography printer and/or softcopy stations according
to the Service Manual.
Service Manuals of the released Mammography printers and/or
softcopy stations are referenced in Interface Status Report (ISR),
refer to section 3.
Check next page 


Checklist for the Equipment Installation (page 2 of 2)

X-ray modality connectivity
 Ensure that the X-ray modality hard & software preparation, including
the installation of the manufacturer specific connectivity set, is done.
Supported connectivity sets for the different X-ray modalities are
described in the Marketing Newsletter concerning X-ray Modality
Connectivity, refer to section 3.
 Configure the license(s), the X-ray device and User interface in
CR Mammography workstation according the instructions described
in the Connectivity Release Documents, refer to section 3.
These documents contain the tasks assignment between the X-ray
modality service engineer and the Agfa CR Mammography
specialist.
Remarks
End


7 Configuration
IMPORTANT:
It is the responsibility of each country/region to optimize the default configuration
according to the local requirements and to re-use this configuration to avoid
unnecessary repetition of work in the field.
As a starting point, the Agfa default configuration has to be used.
Required time:
Approximately 60 minutes (without Central Monitoring System)
Staging Each new CR Mammography workstation will be staged to provide a basic

configuration to be able to start with a default.
The staging includes: Operating System, CR Mammography application software and
Factory default configuration
7.1 Configuring the Central Monitoring System (optional)
If the Central Monitoring System (CMS) for NX is implemented in the

CR Mammography Solution, the configuration has to be performed on the CMS station
and not on the NX side.
Refer to documents listed in section 3, NX Service Manual, Chapter 4 - Installation and
Configuration.
All properties of the NX configuration are taken by the CMS, except the User Interface.
This has to be configured separately on the CMS.
Therefore, the GenRad properties can not be used accidentally for CR Mammography.


7.2 Checklist for Configuration of the Workstation
Checkpoints: Section Done

(1) Configure the Operating System (OS) 7.2.1
(2) Setup default configuration for NX Application 7.2.2
(3) Installation of the Start-up exam tree for CR Mammography 7.2.3
(4) Device Configuration 7.2.4
Configure site settings 7.2.4.1
Configure workstation settings 7.2.4.2
Configure the Monitor 7.2.4.3
Configure the Digitizer 7.2.4.4
Configure the Printer and the View Box 7.2.4.5
Link cassette sizes with a film format 7.2.4.6
Configure Archive 7.2.4.7
Configure the Export destination 7.2.4.8
Configure the X-ray Device (optional) 7.2.4.9
Configure RIS (optional) 7.2.4.10

(5) Configure the Examination Tree 7.2.5
Generic hints 7.2.5.1
Overview of Exams, Exposures and Exposure groups 7.2.5.2
Exposure Types and fixed Parameters (Examination Group: 7.2.5.3

“Mammo”)
Exposures Types and variable Parameters (Examination Group: 7.2.5.4
“Mammo”)
Exposure Types and variable Parameters (Examination Group: 7.2.5.5
"System Diagnosis Mammo")
Configure Musica Mammo Image Processing 7.2.5.6
Configure Musica MCE (optional) 7.2.5.7

Create and configure Exposure Groups 7.2.5.8
(6) Configure the User Interface (UI) 7.2.6
Configure the Worklist Pane 7.2.6.1
Configure Examination Pane 7.2.6.2
Configure Editing Pane 7.2.6.3

(7) Film Text Box Configuration 7.2.7
(8) Activate the Configuration 7.2.8
(9) Calibration of the Monitor 7.2.9


7.2.1 Configure the Operating System
For the NX 2.0.8600 / NX 3.0.8600 and higher (Service Updates and Service Packs
inclusive), the configuration of the Operating System is described in the NX Service
Manual, Chapter 4 - Installation and Configuration.
See referenced documents in section 3.
7.2.2 Setup a Default Configuration for NX Application
For NX 2.0.8600 / NX 3.0.8600 and higher (Service Updates and Service Packs
inclusive), the Setup of a Default Configuration for NX Application is described in the
NX Service Manual, Chapter 4, - Installation and Configuration.
7.2.3 Installation of the Start-up Exam Tree for CR Mammography
The Start-up Exam Tree for the CR Mammography application is installed by default in
the Configuration Tool. If not, proceed as described below:
(1) Open the Configuration Tool.

(2) Go to: Exam  Import  Add Exams
(3) If not pre-selected, go to:
C:\AGFA\Healthcare\NX\bin\Factory Settings
(4) Select: Factory.Import.ExamTree.Mammo.xml
(5) Under Exam, expand the age group 17+ and look for the exam tree SYSTEM
DIAGNOSIS MAMMO. If present, delete it.
(6) Finally, go again to: Exam  Import  Add Exams and import the
Factory.Import.ExamTree.SystemDiagnosis.xml file.


7.2.4 Device Configuration
All following configuration tasks have to be done in the Configuration Tool.
7.2.4.1 Configure Site Settings
NOTE:
In case there is a connection to an IMPAX softcopy station in the CR Mammography
Solution, keep in mind that any adaptation of the site configuration like hospital name
and department name has to be synchronized with IMPAX.
(1) Go to: General  General Settings  Configure Site Settings

(2) Fill in the data of the customer.
Figure 2: Example of site settings
7.2.4.2 Configure Workstation Settings
(1) Go to:
General  General Settings  Configure Workstation
Settings
NOTE:
The IP address of the CR Mammography workstation is automatically transferred from
Windows level to the NX Workstation Settings.
(2) Fill in and select the data of the local installation, such as: Character Set
(3) Mark the checkbox <Enable Fast ID> and fill in the appropriate AE Title.


Figure 3: Character Set
7.2.4.3 Configure the Monitor
(1) Go to: Devices  Monitor

(2) By default, the settings of the monitor are already entered. If not, click on
<Modify> and select the appropriate Type, as shown in Figure 4.
Figure 4: Example of monitor configuration


7.2.4.4 Configure the Digitizer
(1) Go to: Devices  Digitizer

(2) Click on <New> and select the appropriate Type.
Figure 5: Adding a digitizer
(3) Enter:
 IP Address
 AE Title
 Default Router
 Subnet Mask


(4) And set the parameters for the Emergency Procedure.
Figure 6: Example of digitizer configuration
NOTE:
The Emergency Procedure settings have no impact on the Mammography application.
These are required settings for a faultless digitizer operation.
(5) Mark the checkbox for

<Fast ID>:
Figure 7: Fast ID enabled


7.2.4.5 Configure the Printer and the View Box
IMPORTANT:
If no printer is available on site, a dummy printer has to be configured to display the
images in the proper size in the Editing screen (refer to section 7.2.6.3).
NOTE:
The following procedure covers the default settings for the Agfa printers released
for CR Mammography.
For other vendors refer to the respective Connectivity Release Documents
as listed in the Interface Status Report (ISR). See referenced documents in section 3.
(1) Go to: Devices  Printer

(2) Click <New> to add a printer.
(3) Enter a Name and select a Type for the Printer. If the appropriate Type for the
printer can not be found, click on <Upload> to extend the list.
Figure 8: Adding a printer


(4) If a Mammography printer is selected, the settings are already entered by default.
Make sure the AE title is correct and enter the missing IP Address as
shown in Figure 9.
Figure 9: Example of printer configuration
NOTE:
It is supported to print two images on the 11 x 14 format.
Be aware that due to the True Size printing a certain part (opposite
side of the chest wall side) of the image is not printed and therefore
lost. Especially on the 24 x 30 images the diagnostic area can be
affected. For such films, configure the Text box with the mention
“Not for diagnostic”.
It is the responsibility of the customer to decide if the printed image
can be used for diagnose or not.


(5) Measure the view box Luminance (View Box Illumination) as follows:
 Switch on the view box and wait about 5 minutes.
 Remove any film from the view box.
 Collimate for a Mammography study (four films).
 Measure the luminance (View Box Illumination) in the center of this
area and in each corner 10 cm from the edges.
 Calculate the median of the measured values.
(6) Fill in the View Box Illumination as follows:
If luminance is > 4000 cd/m2  Enter 4000.

If luminance is between 3000  Enter the measured value.
and 4000 cd/m2
If luminance is < 3000 cd/m2  Enter the measured value and inform the
customer via the Final Acceptance
Certificate that the CR Mammography
Solution is configured outside the validated
parameters. Agfa does not take
responsibility in this case for the image
quality.
Figure 10: Example of View Box Settings
(7) Measure the view box Reflected Ambient Light as follows:

 Switch off the view box and put on a mammography film in the position
used for reporting.
 Measure the Reflected Ambient Light in the center of a film with
a distance of about 60 cm (normal reporting distance).


(8) Fill in the Reflected Ambient Light as follows:
If reflected ambient light is  Enter 1.

< 1 cd/m2
If reflected ambient light is  Enter the measured value and inform the
> 1 cd/m2 customer via the Final Acceptance Certificate
that the CR Mammography Solution is
configured outside the validated parameters.
Agfa does not take responsibility for the image
quality.
Figure 11: Example of Reflected Ambient Light
(9) In Image Sheet Settings, click <Advanced Settings>.

Check that the settings are identical to the ones shown in Figure 12.
Figure 12: Example of Advanced Settings
(10) Click: <OK>


7.2.4.6 Link Cassette Sizes with a Film Format
(1) Go to: Devices  Printer

(2) Enter: Default Film Size
(3) In Print Sheet & Layout:
 Link the 24 x 30 cm Mammo cassette size with the film size 10IN x 12IN.
 Link the 18 x 24 cm Mammo cassette size with the film size 8IN x 10IN.
 Link all other cassette sizes with any available film size.
Figure 13: Example of Print Sheet and Layout
7.2.4.7 Configure Archive
NOTE:
The following procedure covers the default settings for the softcopy stations released
for CR Mammography. For other vendors refer to the respective Connectivity Release
Documents on Agfa HealthCare Library, see section 3.


(1) Go to: Devices  Archive

(2) Click <New> to add an archive.
(3) Enter the Name of the archive and select a Type.
(4) By default, the settings applicable for Agfa softcopy systems are already entered.
Only the IP Address is missing. Just double check that the fields are filled in as
shown in Figure 14.
Figure 14: Example of Archive settings
NOTE:
In case of non Agfa softcopy devices, select Generic as Type and configure the
device according the Connectivity documents.


NOTE:
In case of sending images to CAD systems, use MG for Processing or DX for
Processing as output types.
NOTE:
The feature Background darkening is implemented in the NX workstation. The role
of this feature is to enhance the breast details by darkening the background of the
image. The background darkening can be transmitted to the softcopy station.
To do so, following configurations are needed:
 Either the new attribute Pixel Padding Range Limit is supported in the
softcopy station.
 Or the option GSPS supported is checked on the NX (see Figure 14).
In both cases, the Output Type must be 15bit PVAL VOIT LUT.
NOTE:
For NX 2.0.8200 / NX 3.0.8200 and higher, the feature Musica MCE is implemented in
the NX workstation. The role of this feature is to enhance potential micro calcifications
on mammography images. The enhancement is only visible on a softcopy station.
To get the enhanced images on the softcopy station, check the box Accepts Musica
Micro Calcification Enhanced images (see Figure 14).
For details about the Musica MCE, refer to the Musica MCE (Micro Calcification
Enhancement) Image Processing Software document, see section 3.
(5) Go to: Devices  Archive and select Enable Archive Automation
Figure 15: Enable Archive Automation


7.2.4.8 Configure the Export Destination
(1) Go to: Devices  Export Destination

Default export destinations are already configured. If not, create one by clicking
on <New> and enter the appropriate settings as shown in Figure 16.
Figure 16: Example of Export Destination


NOTE:
It is possible to store more than one export destination with different export settings.
When exporting images, it is easily possible to switch between the different configured
destinations in the NX application Main Menu without having to change it in the
Configuration Tool.
Export functionality is only available with NX 3.0 Features License.
Figure 17: Export images in Main Menu


It is possible to use MG for Processing or DX for Processing as output types.

The image data are converted in LOG format, which is needed for some of the CR
Mammography QC manual procedure tests. The conversion formula (in LOG format) is
dependent on the digitizer type.
A default export destination is present for the Mammography physicist in case of QC
Mammo tests. Depending on the test performed, MG for Processing or DX for
processing is needed. It is recommended to check both to be able to export technical
and clinical images in a raw format:
Figure 18: Selecting SOP class
7.2.4.9 Configure the X-ray Device (optional)
Before starting the configuration of the X-ray device in the NX workstation, following
steps have to be performed:
Enable the License X-ray Mammo Modality connection in Configuration Tool

(1) Go to: Security  Manage License
(2) Check that the license X-ray Mammo Modality connection is enabled.
NOTE:
If the license X-ray Mammo Modality connection is not available, the XRDI Software
can not be installed.


(3) Following error pops up:
Figure 19: No matching license found
Check if the XRDI Software has been installed

(1) Stop the NX application by clicking <Exit NX> in the main menu.
(2) Go to: Start  Settings  Control Panel
(3) Select: Add/Remove Programs
(4) Check if the XRDI Software has been installed.
Figure 20: XRDI software installed on system
(5) If it is not there, install the XRDI software using the NX Starterkit DVD 1 as
explained below. Alternatively, download the XRDI software from the Agfa
HealthCare Library.


Install the XRDI Software

(1) Copy the XRDI software (.exe file) to the NX desktop.
(2) Double-click the file: XRDI.exe
(3) The setup wizard starts, click: <Next>
(4) The License agreement window pops up, click: <I agree>
(5) The Installing window appears; wait until the installation has ended.
(6) Click: <Next>
(7) The Installation complete window pops up, click: <Finish>.
(8) Reboot the PC.
IMPORTANT:
In case the XRDI software has to be upgraded:
 A new Application License file (ALF) is needed. Refer to CR Licensing - Service
Documentation, see referenced documents in section 3.
 The status of the license X-ray Mammo Modality connection has to be checked.
When performing the upgrade, the old XRDI software version is removed and the
new one is installed. This procedure disables the X-ray Mammo Modality
connection license and the connection status in the examination pane does not
appear.
Configure the X-ray modality

The configuration of the X-ray device on NX workstation and the configuration of the
X-ray modality are described in the respective Connectivity Release Documents in
Agfa Healthcare Library; see referenced documents in section 3.
Connect the X-ray modality on the NX workstation with a UPS

If the NX workstation is additionally connected to an Uninterruptible Power Supply
(UPS), the ports of the NX have to be configured as follows:
 COM 1 for the UPS (on Windows level)
 COM 2 for the X-ray device (in NX Configuration Tool under Devices X-ray)
IMPORTANT:
If the UPS will not be used anymore, remove the UPS software (on Windows level)
before connecting the X-ray device to the COM port. Otherwise all COM ports are
blocked.


Verify the Automatic Transmission of Exposure Parameters

After the *.alf license file is activated in the NX workstation, the automatic transmission
of exposure parameters should work.
Perform following steps to check the connectivity between NX and the X-ray modality:
(1) Open a new study with a dummy patient test.
(2) Choose any Mammo exposure type from the examination group.
(3) Expose a CR Mammo cassette in automatic mode.
(4) Check that the exposure parameters visible on the modality console are present
in the examination pane on the NX workstation for this dummy patient test.
7.2.4.10 Configure RIS (optional)
To configure the RIS in the NX workstation, refer to the NX Service Manual,

Chapter 4 - Installation and Configuration. See referenced documents in section 3.
7.2.5 Configure the Examination Tree
All following configuration tasks have to be done in the Configuration Tool.


7.2.5.1 Generic Hints
The default Examination Groups, Exposures and Exposure Groups have to be adapted
to the local requirements.
The image processing parameters can be adapted.
(1) Modify the Exposures in the Examination Group MAMMO according to the needs
of the customer, but only under certain conditions:
 All clinical Mammography studies must be processed with the
CR Mammography image processing.
This means they must make
use of the CR
Mammography image
processing packages.
Figure 21: Image Processing packages
For more details, refer to section 7.2.5.6, Configure Musica Mammo Image
Processing
 Do not use any entry under the Examination Group System Diagnosis
to build a new Examination Group or Exposure for Mammography. Those
are not linked with the dedicated CR Mammography image processing.
 In case of a connection with IMPAX softcopy station ensure that the
Examination Group contains a string which will identify the study as a
Mammography study. By default MAMMO should be shown.
The following table shows the mapping of the NX Examination Tree DICOM
parameters with the IMPAX DICOM fields.
No. Parameter on NX Parameter on IMPAX

(1) Examination Group Study description
(2) Exposure Type Series description
(3) Exposure Group Not sent

For more information refer to the DICOM Conformance Statement of the workstation.
 For non - Agfa PACS, check if View code and View modifier code
are used by the PACS for the hanging order. If so, synchronize them with
the PACS.


7.2.5.2 Overview of Exams, Exposures and Exposure Groups
ACTION:
Go to Exam or Exam Tree Configuration to get an overview of the available
Examination Groups and Exposure Types.
MAMMO SYSTEM DIAGNOSIS
Figure 22: Example for Examination Groups and Exposure Types


7.2.5.3 Exposure Types and fixed Parameters (Examination Group: Mammo)
The following list shows values for the parameters which shall not be changed for all
Clinical Mammography exposures:
Chapter Details
Generic  Age group: 17+
 Show Exposure in UI: Yes
Exposure settings  Auto flip lateral images: OFF
 Cassette orientation: Portrait
 Body Part: BREAST
 Anatomic Region: BREAST
 Automatically print image: YES
 Automatically archive image: YES
Image Processing  Collimation: OFF
 Display collimation border: No
 Package: Mammography*
Printer Settings  Film size: Default
 Scale mode: True size
 Textbox position **
* 5 packages are available, refer to section 7.2.5.6.
** The choice of the textbox position is described below.
Exposure Textbox position

L-CC Vertical - Right/Top
R-CC Vertical - Left/Top
L-MLO Vertical - Right/Top
R-MLO Vertical - Left/Top
L-ML Vertical - Right/Top
R-ML Vertical - Left/Top


7.2.5.4 Exposure Types and variable Parameters (Examination Group: “Mammo”)
The following list shows values for the parameters which can be changed for all
Clinical Mammography exposures.
Mandatory exposures:
Name View Code View Modifier Image Implant
Code Laterality present
L-CC cranio-caudal None Left No
R-CC cranio-caudal None Right No
L-MLO medio-lateral oblique None Left No
R-MLO medio-lateral oblique None Right No
L-ML medio-lateral None Left No
R-ML medio-lateral None Right No
Optional exposures:
L-LM latero- medial None Left No
R-LM latero- medial None Right No
L-LMO latero- medial None Left No
oblique
R-LMO latero- medial None Right No
oblique
L-XCC exaggerated None Left No
cranio-caudal
R-XCC exaggerated None Right No
cranio-caudal
L-CV cranio-caudal Cleavage Left No
R-CV cranio-caudal Cleavage Right No
L-Implant Displ. cranio-caudal Implant Left Yes
or displaced
Implant Displ. L-CC
R-Implant Displ. cranio-caudal Implant Right Yes
or displaced
Implant Displ. R-CC
Implant L-CC cranio-caudal None Left Yes
Implant R-CC cranio-caudal None Right Yes
Implant L-ML medio-lateral None Left Yes
oblique
Implant R-MLO medio-lateral None Right Yes
oblique



L-Mag or Mag-L cranio-caudal Magnification Left No
R-Mag or Mag-R cranio-caudal Magnification Right No
L-Spot or Spot-L cranio-caudal Spot Left No
compression
R- Spot or Spot-R cranio-caudal Spot Right No
compression
L-RL cranio-caudal Rolled lateral Left No
R-RL cranio-caudal Rolled lateral Right No
L-RM cranio-caudal Rolled medial Left No
R-RM cranio-caudal Rolled medial Right No
Needle Specimen (in cranio-caudal None Right No
mixed use
environment
"Specimen")
Stereotaxy cranio-caudal None Right No
Surgical Specimen cranio-caudal None Right No
(in mixed use
environment
"Post - op")
7.2.5.5 Exposure Types and variable Parameters

(Examination Group: System Diagnosis Mammo)
This Examination Group is editable (only certain parameters):

 The Name of the exam group or the exposure type can be altered (be aware that
special characters are not supported when sending images to PACS).
 The exposures can be copied within the same exam group.
 The archive and printer settings can be modified.
Other settings, such as view position, cassette orientation, speed class, erasure dose,
Musica 1 settings etc., remain un-editable.
7.2.5.6 Configure Musica Mammo Image Processing
Configure the Musica Mammo Image Processing as described in Application Note.



7.2.5.7 Configure Musica MCE (optional)
Configure the Musica Micro Calcification Enhancement (MCE) processing as described

in the Musica MCE (Micro Calcification Enhancement) Image Processing Software
document, see section 3.
7.2.5.8 Create and configure Exposure Groups
The following two exposure groups need to be defined with the corresponding
exposure types:
Exposure Group Exposure Types
4 views CC, MLO R-CC, L-CC, R-MLO, L-MLO

6 views CC, MLO, ML R-CC, L-CC, R-MLO, L-MLO, R-ML, L-ML
(1) Go to: Exam  Edit Exposure Groups

(2) Click on <New>, fill in a name for the new group and click: <OK>
(3) Select the newly created exposure group in the left column.
(4) Configure it with the appropriate exposure types as shown in Figure 23.
Figure 23: Configure Exposure groups
(5) Configure the second exposure group according to the table above.


7.2.6 Configure the User Interface (UI)
NOTE.
Some of the following configurations are only applicable with appropriate Features
licenses.
Described configurations are only recommendations; wishes of the customer must be
taken in account in any case.
7.2.6.1 Configure the Worklist Pane
For the UI of the Worklist pane in the NX workstation, no specific configuration task
with regard to CR Mammography application is necessary.
For details about the UI configuration of the Worklist pane, refer to NX Service
Manual, Chapter 4 – Installation and Configuration.
7.2.6.2 Configure the Examination Pane
Patient (1) Go to: General  General Settings  Predefined lists

Comments
(2) In Predefined lists, fill in the Patient Comments and click <Add>
after each entry. Following comments can be entered:
Figure 24: Example of Patient Comments


Result in User Interface:
Figure 25: Patient Comments in UI
Custom (1) Go to: General  General Settings  Custom Markers

Markers
(2) In Custom Markers, configure the available buttons (up to 10) as shown in
Figure 26.
To modify an already existing marker, select it in the list and update the fields
Name, Text and Size accordingly.
Proceed in the same way to add new marker.
Figure 26: Markers
(3) Go to:
User Interface  Examination Settings  Configure Tools
in Examination


(4) In Tools & Annotations, define which button will be displayed and on which
position in the UI:
Figure 27: Define buttons in UI
Figure 28: Position of Markers in UI


XRG (1) Go to:

Parameters User Interface  Examination Settings  Configure XRG
Parameters
(2) In XRG Parameters, fill in the XRG Parameters in the correct sequence as
shown in the Figure below:
Figure 29: Example of XRG Parameters
Figure 30: XRG parameters in UI


NOTE:
Only in case the X-ray parameters are entered manually:
 Configure the Target/filter combination.
 Ask the X-ray modality engineer for the available options.
Image (1) Go to: General  General Settings  Predefined lists

Comments
(2) In Predefined lists, fill in the Image Comments and click <Add> after each
entry. Following comments can be entered:
Figure 31: Image Comments


Figure 32: Image comments in UI
Edit Image (1) Go to:

Details User Interface  Examination Settings  Edit Image Details
(2) In Edit Image Details, fill in the fields in the correct sequence and check the
Image Comments option as shown in Figure 33.
Figure 33: Edit image details


Figure 34: Image details in UI
Mammo (1) Go to: General  General Settings  Mammo Code Settings

Codes
Settings
NOTE:
The mammo modifier codes are divided in:
 View modifier codes, and
 Reason for imaging
Their label (Text) can be customized, but their content (Meaning) is fixed.


(2) In Mammo Codes Settings, translate the attribute if required:

Select the code and translate the naming in Text:
Figure 35: Mammo Code Settings
Figure 36: Mammo Code Settings in UI


Reject (1) Go to:

Reason General  Workflow Management  Identification –
Examination
(2) In Examination, check the option Request a reject reason.
If required, enter a reject reason in the field Predefined reject reason and
click <Add>.
Figure 37: Request a reject reason
Figure 38: Select reject reason in UI
NOTE:
This feature is only available in case the licenses package NX Quality Assurance is
installed and the license NX_Repeat_Reject has been activated.


Compose (1) Go to:

Exam User Interface  Examination Settings  Configure Add
Image Pane
(2) In Compose Exams, select Age Group: 17+
(3) Arrange the Exposure groups and Exposures as shown in Figure 39.
Click on the button Edit if:
 Exposure types are missing or have to be adapted.
 Exposure groups have to be added/removed or adapted.
Figure 39: Compose Exam in Age group 17+
Figure 40: Exposure groups/Exposures in UI


7.2.6.3 Configure the Editing Pane
NOTE:
If no printer is available on site, a dummy printer has to be configured to display the
images in the proper size in the Editing pane (refer also to section 7.2.4.5).
Image (1) Go to:
Processing User Interface  Editing Settings  Configure Tools &
Tool Annotations
(2) In Tools & Annotations, look if the options are set according to table below.
Selection Palette
 Delete
 Select
 Revert to Original
Annotations Palette
 Left Marker  Predefined  Polygon  Rectangle PVI  Measure an
Text angle
 Right Marker  Arrow  Freehand  Rectangle EI  Measure a
distance
 Custom Markers  Rectangle  Perpendicular  Calibrate a line  Measure a leg
difference
 Free text  Circle  Line  Calibrate a  Measure
circle scoliosis
 Annotation Color  Calibrate ERMF
Transformation Palette
 Rotate Clockwise  Show /Hide
Square Marker
 Rotate Counter
Clockwise
 Flip
View Palette
 Zoom In  Reset Zoom  Enable/
Disable
Full Screen
 Zoom Out  Enable/
Disable Shutters
 Zoom to ROI  Enable/
Disable Split View
Image Processing Palette

 Window Level  Collimation  Invert Colli-  Burn
mation Area
 Undo Window Level  Collimation  Collimation  Invert
Rectangle Border
 Musica  Collimation  Histogram  Enable/Disable
Polygon Background
darkening


Figure 41: Annotations and tools in UI
Print mode (1) Go to:

User Interface  Editing Settings  Configure Normal Mode
& Print mode
(2) In General Settings, look if the options are set according to the figure below:
Figure 42: Configure Normal mode/Print mode
Figure 43: Toggle button in UI


7.2.7 Film Text Box Configuration
In case of connectivity to the X-ray modality (dedicated license) or in case the X-ray
exposure parameters will be entered manually, the default contents of the Film text box
have to be modified.
(1) Go to: Devices  Printer  Sheet/Image Text Box
(2) Create a default Mammo Text Box as recommended below:
 Text box Height is 15 mm.
 Text box Width is 160 mm.
 Text box is composed of 3 lines to be divided with the proportions and filled
in with the parameters shown in the table below.
Last name (0010,0010) Exposure Image creation date time

First name (0010,0010) type (0008,0030 - Date)
Label: -
Birthdate (0010,0030 - Date)
Comments (0010,4000) Image comments Department (008,1040) Institution

Name (0008,0080)
Station Name (0008,1010)
KV (0018,0060) Printer "SCALE"* Cassette Size

Label: kV Destination (0018,1403)
Exposure (0018,1152) View Box
Label: mAs Luminance
Thickness (0018,11A0) Ambient
Label: mm Luminance
Compression (0018,11A2)
Label: N
Anode mat. (0018,1191)
Label: /
Filter material (0018,7050)
* In Cell Settings, select Change Type = Scale
Figure 44: Example of film text box settings


7.2.8 Activate the Configuration
(1) Activate the configuration in tool menu: File  Activate Configuration
Result The configuration of the NX workstation is now completed.
7.2.9 Monitor Calibration
IMPORTANT:
The monitor calibration for a CR Mammography workstation can only be performed
on BARCO monitors.
For NX 2.0.8600 / NX 3.0.8600 or higher, the monitor calibration is described in detail

in the NX Service Manual, Chapter 5 - Monitor Options.
7.3 Digitizer
For Mammography application no specific digitizer configuration task has to be done.
7.4 Printer and Softcopy Station Configuration
Configure the Mammography printer and/or softcopy station(s) according to the

appropriate Service Manual.
Service Manuals of the released Mammography printers and/or softcopy stations are
referenced in Interface Status Report (ISR), see referenced documents in section 3.
Result The configuration of the CR Mammography Solution is now completed.


8 Customer Training
Following checklists describe the topics of the CR Mammography customer training.

They contain information and instructions for the CR Mammography specialist (CAS)
who carries out the trainings.
8.1 Checklist for Customer Training (Radiologist and Radiographer)
Checklist for Customer Training (page 1 of 3)

Site: Date:
Location:
Goal:
 Get users trained on the CR Mammography solution to view images.
 Avoid unnecessary retakes caused by lack of training.
 Perform a smooth transition from film/screen to CR application for
Mammography.
Prerequisite: The CR Mammography Solution is in operating condition.
Duration: up to 1.5 hours
Topics: Done
General
(1) Hand over and explain the CR Mammography Solution User Manual,
refer to section 3:
 The intended use
 The installation environment (such as in-room installation)
 The safety precautions and
 The limitations
(2) Inform that softcopy reporting is only supported for certain softcopy
stations.
Service Manuals of the released softcopy stations are referenced in
Interface Status Report (ISR), refer to section 3.
Check next page 



General (continued)
(3) Inform that film reporting is only supported for certain printers and
when printed from an Agfa CR Mammography workstation or certain
softcopy stations.
Service Manuals of the released Mammography printers are
referenced in Interface Status Report (ISR), refer to section 3.
(4) Inform that dedicated CR Mammography cassettes and image plates
are required (a mixture of different versions is not released).
(5) Explain the dependencies of X-ray dose/noise/density.
In a CR environment, increasing the X-ray dose reduces the noise in
the image but does not influence the density value. The density on
the printed film is staying the same.
This means concretely that an overexposed image looks like a
normal image and not darker as it was the case with film/screen
systems. Vise versa an underexposed image is noisy and not
brighter.
(6) Explain the use of W/L tool in case the processing fails to adapt the
image quality of CR Mammograms (such as contrast perception,
etc.).
(7) Explain the meaning and reliability of geometric measurement results
(true size and measured detail size, X-ray geometry magnification).
(8) Remain that lead markers shall be part of the image to avoid mix-up
of left/right body part.
(9) Inform that the overscan present on the chestwall side is only
removed for clinical images and not for technical images (typically in
case of Quality Control).
(10) Inform that the calculated EI values can not be used as exposure
indicator for the CR Mammography application.
For more details, please refer to: CR Mammography Solution User
Manual listed in section 3.
(11) Explain that in case of doubts about an artifact, the corresponding
study and cassette should be identified and checked.
Instruct the procedure to the customer as described in the
NX workstation Service Manual. For details refer to section 3.
(12) Ask customer / user to keep the images with open issues for the
escalation with the local NSO.
Check next page 



CR Mammography Workstation
(1) Explain the different possibilities to handle X-ray exposure
parameters (manually and/or automatically) as described in
CR Mammography Solution Service Manual, refer
to section 3.
(2) Explain the different CR Mammography image processing packages.
Details can be found in the CR Mammography Solution Service
Manual, refer to section 3.
(3) Inform about the possible taste adjustment for the different CR
Mammography image processing packages.
Remark: The taste adjustment is a service task and can not be performed
by the customer. During the training session, the radiologist is informed
about the possibility to adjust the taste of the CR Mammography image
processing packages. However, the eventual adjustment has to be done on
request.
(4) Emphasize the true size function to avoid interpolation and not to
loose clinical details (e.g. micro-calcifications).
The positioning of the true size mammography image on the film is
done automatically.
It is supported to print two images on the 11 x 14 format.
Be aware that due to the True Size printing a certain part (opposite
side of the chest wall side) of the image is not printed and therefore
lost. Especially on the 24 x 30 images the diagnostic area can be
affected. For such films, configure the Text box with the mention
“Not for diagnostic”.
It is the responsibility of the customer to decide if the printed image
can be used for diagnose or not.
Quality Control (QC)
(1) If constancy Quality Control is requested, refer to Application Note -
Basic Manual Quality Control Procedure, DD+DIS 007.12E, see
section 3.
Acceptance Test Report
(1) Add the names of the trained customer / user to the report.
Film and Softcopy Reporting (optional)
(1) For customer / user training about CR Mammography film reporting
and softcopy reporting, refer to printer and softcopy stations
documentation in the Agfa HealthCare Library.
End


8.2 Additional Checklist for Radiographer Training
Additional Checklist for Radiographer Training (page 1 of 2)

Site: Date:
Location:
Goal: Enable radiographers to handle properly all components of the
CR Mammography Solution to be able to perform CR Mammograms.
Prerequisite: The CR Mammography Solution is in operating condition.
Duration: about 1 hour
Topics: Done
General
(1) If applicable, explain which AEC mode has to be used:
 When performing the exposures for the CR Mammography
application, the full automatic mode must be used (exceptions
implants, specimens, very small breasts).
 According the X-ray modality type installed on site, show the
corresponding mode on the console.
 If more than one channel is used on the X-ray modality, show
also the one to be selected when performing
CR Mammography exposures.
CR Mammography Cassettes (including image plates)

(1) Inform that each cassette has:
 A label
 A norm tube side marking to indicate the tube side
 Red triangles to indicate the chest wall
 A smaller size in comparison to CR GenRad cassette (to avoid
using GenRad in a Mammography stand)
(2) Inform that cassettes must be erased at least once per 48 hours to
avoid ghost or noise.
(3) Instruct how to clean/disinfect the CR MM3.0T Mammo cassettes
and image plates according the instructions listed in the
CR 30-X/CR 30-Xm Plates and Cassettes User Manual, UM 2387,
refer to section 3.
Check next page ->


Additional Checklist for Radiographer Training (page 2 of 2)

CR Mammography Cassettes (continued)
(4) Explain that a Mammography cassette cannot be used for GenRad
application and vice versa.
 The Mammography cassettes have a different absorption than
the GenRad cassettes.
 The Mammography cassettes have an additional chest
alignment mechanism compared to the GenRad cassettes.
 The Mammography cassettes are designed to be placed above
the AEC.
CR Mammography Workstation
(1) Explain the 2 mode options:
 Batch mode (without X-ray generator connection): perform all
needed exposures and read out afterwards.
 One-by one cassette mode (mandatory with X-ray generator
connection): read out each cassette directly after the exposure
to ensure that X-ray generator settings are correctly
transmitted.
(2) Demonstrate a standard workflow:
 Take 4 erased cassettes and perform the X-ray exposures.
 Identify each exposed cassette as follows:
o Enter patient data.
o Select mammography examination data matching with
the X-ray exposure.
o Set X-ray exposure settings (optional).
o Scan the cassettes.
o Wait for the resulting images in the workstation.
(3) Print the images:
 Choose true size mode only (best fit printing is not released for
reporting).
 Show also the option to zoom on an image via the mouse
wheel and make sure zoom is reset for printing.
(4) Transmit a study to the softcopy station.
End


9 Customization (Professional Services)
Following checklist describes the customization of the CR Mammography Solution and

connectivity's within the scope of Professional Services. It contains information and
instructions for the CR Mammography specialist (CAS).
9.1 Customization Checklist
Checklist for Customization

Order number: Date:
Goal: The CR Mammography Solution is customized according to the customer
requirements and the ordered professional services.
Prerequisites:
 Standard CR Mammography Solution is set up.
 CAS is familiar with the Sales contract including the Professional Services.
Topics: Done
Optimization of the Solution workflow
 Define the Mammography examinations together with the customer.
 Optimize the standard configuration exam tree (e.g. Exposure
groups to speed up the workflow, auto select a thumbnail etc.) in the
CR Mammography workstation accordingly.
Optimization of image quality
 Musica Settings:
Adapt the Brightness, Contrast and Sharpness tastes of Musica
Mammo according to the customer’s requests and the
recommendations mentioned in the Application Note, see section 3.
Adaptation of Musica MCE in the workstation
 Adapt the Musica MCE Density parameter according to the
customer’s requests.
Consulting on Quality Control
 Perform the local Constancy Quality Control procedure on a regular
base.
 Train the customer how to perform the local Constancy Quality
Control procedure (e.g. use mean pixel value measurement on the
NX workstation, use of phantoms etc.).
End



CR Mammography Solution CR 30-Xm - Service Manual

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HEALTHCARE

Imaging Services Service Documentation

► Purpose of this Document

This document covers the information and mandatory tasks to set up a

Edition. Release Changes

DOCUMENT CONTROL NOTE:

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Edition 1, Revision 0 CR Mammography Solution based on CR 30-Xm Page 2 of 68

1 SOLUTION OVERVIEW ...........................................................................................................5

1.2 System Topologies versus Modality Alignment ........................................................................7

5.2 Checklist for the Customer Representative ............................................................................14

5.3 Checklist for the Field Service Engineer.................................................................................18

5.4 Checklist for the Clinical Application Specialist ......................................................................20

7.2 Checklist for Configuration of the Workstation........................................................................24

7.2.1 Configure the Operating System.............................................................................................25

7.2.2 Setup a Default Configuration for NX Application...................................................................25

7.2.3 Installation of the Start-up Exam Tree for CR Mammography................................................25

7.2.4 Device Configuration...............................................................................................................26

7.2.5 Configure the Examination Tree .............................................................................................42

7.2.6 Configure the User Interface (UI)............................................................................................49

7.2.7 Film Text Box Configuration....................................................................................................61

7.2.8 Activate the Configuration.......................................................................................................62

7.2.9 Monitor Calibration..................................................................................................................62

7.3 Digitizer ...................................................................................................................................62

7.4 Printer and Softcopy Station Configuration.............................................................................62

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8 CUSTOMER TRAINING .........................................................................................................63

8.2 Additional Checklist for Radiographer Training ......................................................................66

9 CUSTOMIZATION (PROFESSIONAL SERVICES) ...............................................................68

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The Agfa CR Mammography Solution consists of a digitizer, a set of cassettes and

Figure 1: Solution Overview

The CR Mammography Solution can be used in:

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1.2 System Topologies versus Modality Alignment

In case the CR Mammography Solution based on CR 30-Xm is installed additionally to

For the following scenarios, an additional X-ray modality alignment is mandatory:

An additional X-ray modality alignment means:

For the following scenarios, no additional X-ray modality alignment is needed:

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4 CR Mammography Solution Set-up

Project Management X-Ray Device Set-up

Preparation NX Workstation Installation (continued)

Digitizer Installation (continued)

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Following checklists provide information to prepare the installation of a

5.1 Checklist for the Sales Representative

Checklist to be filled by Sales representative (page 1 of 2)

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