GE Healthcare. CT/e 0459 * Operator Manual Revision 3. Copyright by General Electric Company

Transcription

1 GE Healthcare CT/e 0459 * Operator Manual Revision 3 Copyright by General Electric Company

2 WARNING X-RAY EQUIPMENT IS DANGEROUS TO BOTH PATIENT AND OPERATOR UNLESS MEASURES OF PROTECTION ARE STRICTLY OBSERVED Though this equipment is built to the highest standards of electrical and mechanical safety, the useful x-ray beam becomes a source of danger in the hands of the unauthorized or unqualified operator. Excessive exposure to x-radiation causes damage to human tissue. Therefore, adequate precautions must be taken to prevent unauthorized or unqualified persons from operating this equipment or exposing themselves or others to its radiation. Before operation, persons qualified and authorized to operate this equipment should be familiar with the Recommendations of the International Commission on Radiological Protection, contained in Annals Number 26 of the ICRP, and with applicable national standards.

3 Regulatory Requirements This product complies with regulatory requirements of the following: European Directive 93/42/EEC concerning medical devices The configurations delivered: without any option or accessory, or - exclusively with one or several options and/or accessories listed below, have been declared in compliance with the European Directive 93/42/EEC and therefore bear the CE marking: Green QSD 1990 Standard issued by MDD (Medical Devices Directorate, at the UK Department of Health). Medical Device Good Manufacturing Practice Manual issued by the FDA (Food and Drug Administration, United States Department of Health). Requirements from Underwriters Laboratories, Inc. (UL), independent laboratory. Requirements from Canadian Standards Association (CSA). Requirements from the International Electrotechnical Commission (IEC), international standards organization. General Electric Medical Systems, the manufacturer of this product, is ISO 9001 certified. i

4 EMC Performance This CT system may characteristically cause electromagnetic interference with other equipment, either through air or connecting cables. The term EMC ( ElectroMagnetic Compatibility ) means the capability of the equipment, which curbs electromagnetic influence from other equipment and at the same time does not affect other equipment with similar electromagnetic radiation from itself. This product is designed to fully comply with the group 1 EN : Edition 2 (2001) [ IEC :Edition 2 (2001)], Class A, in EMC regulations. In terms of EMC performance, limit value 12dB relaxation in electromagnetic interference of permanently-installed medical system used in a lead-shielded area, is applied to this product. CT/e system compliance below EMC Emissions and Immunity Declaration(See below Table 1 and 2) Table 1 EMC Emissions Declaration For CT/e The CT/e is intended for use in the electromagnetic environment specified below. The customer or the user of the CT/e should assure that it is used in such an environment. Emissions Test Compliance Electromagnetic Environment Guide RF emissions CISPR 11 RF emissions CISPR 11 Group 1 Class A The CT/e uses RF energy only for its internal function. Therefore, its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment. The CT/e, when installed in such a shielded location, is suitable for use in all establishments other than domestic and those directly connected to the public low-voltage power supply network that supplies buildings used for domestic purposes. ii

5 Table 2 EMC Immunity Declaration For CT/e The CT/e is intended for use in the electromagnetic environment specified below. The customer or the user of the CT/e should assure that it is used in such an environment. Immunity Test IEC Test Level Compliance Level Electromagnetic Environment Guidance Electrostatic discharge (ESD) IEC ± 6 KV contact ± 8 KV air ± 6 KV contact ± 8 KV air Floors should be wood, concrete, or ceramic tile. If floors are covered with synthetic material, the relative humidity should be at least 30%. Electrical fast transient/burst IEC ±2 KV for power supply lines ±1KV for input/ output lines ±2 KV for power supply lines ±1KV for input/output lines Mains power quality should be that of a typical commercial or hospital environment Surge IEC ± 1 KV line-line ± 2KV lineground ± 1 KV lineline ± 2KV lineground Mains power quality should be that of a typical commercial or hospital environment Voltage dips, short interruptions and voltage variations on power supply input lines IEC <5% U T (>95% dip in U T ) for 5 sec Mains power quality should be that of a typical commercial or hospital environment. If the user of the CT/e requires continued operation during power mains interruptions, it is recommended that the CT/e be powered from an uninterruptible power supply or a battery. Power frequency (50/ 60Hz) magnetic field IEC A/m 3 A/m Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment. Note : U T is the a.c. mains voltage prior to application of the test level. iii

6 Notice upon Installation of the Product Locate the equipment as far as possible from other electronic equipment. Be sure to use either any cables provided by GEYMS or ones designated by GEYMS. Wire these cables following these installation procedures. General Notice Designation of Peripheral Equipment Connectable to This Product Avoid using other equipment than designated. Failure to comply with this instruction may result in poor EMC performance of the product. Notice against User Modification Never modify this product. Unilateral user modification may cause degradation in EMC performance. Modifications of product include ; Changes in cable ( length, material, wiring etc.) Changes in system installation/layout Changes in system configuration/components Changes in means of fixing the system/parts ( cover open/close, cover screwing ) Operate the system with all covers closed. If you open any cover for some reason, be sure to shut it before starting/resuming operation. Operating the system with any cover open could affect EMC performance. iv

7 Countermeasures against EMC-related Issues Generally it is pretty difficult to grapple with EMC-related issues. It may take much time and cost. General countermeasures Electromagnetic interference with other equipment Electromagnetic interference may be alleviated by positioning other equipment far from the system. Electromagnetic interference could be mitigated by changing the relative location/installation angle between the system and other equipment. Electromagnetic interference may be eased by changing wiring locations of power/signal cables of other equipment. Electromagnetic influence could be reduced by altering the path of power supply for other equipment. Electromagnetic environment specified below Table 3 and Table 4. -v

8 Table 3 EMC Immunity Declaration For CT/e The CT/e is intended for use in the electromagnetic environment specified below. The customer or the user of the CT/e should assure that it is used in such an environment. Immunity Test Conducted RF IEC IEC Test Level 3 Vrms 150 khz to 80 MHz Compliance Level 3 V Electromagnetic Environment Guidance Protable and mobile RF communications equipment should be used no closer to any part of the CT/e, including cables, than the recommended separation distance calculated from the equation appropriate for the frequency of the transmitter. Recommended Separation Distance 3,5 d = ] 3 [ (see Table 4) P 3,5 d = [ ] P 80 MHz to 800 MHz (see Table 4) 3 Radiated RF IEC (alternative method: IEC ) 3 Vrms 80 MHz to 2,5 GHz 3 V/m 7 d = [ ] P 800 MHz to 2,5 GHz (see Table 4) 3 Where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer and d is the recommended separation distance in metres (m). Field strengths from fixed RF transmitters, as determined by an electromagnetic site survey, a should be less than the compliance level in each frequency range. b Interference may occur in the vicinity of equipment marked with the following symbol: -vi

9 a Field strengths from fixed transmitters, such as base stations for radio (cellular/ cordless) telephones and land mobile radios, amateur radio, AM and FM radio broadcast, and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which the CT/e is used exceeds the applicable RF compliance level above, the CT/e should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as re-orienting or relocating the CT/e. b Over the frequency range 150 khz to 80 MHz, field strengths should be less than 3V/ m. Note : These guidlines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects, and people. -vii

10 Table 4 Recommended separation distances between portable and mobile RF communications equipment and the CT/e The CT/e is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of the CT/e can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and the CT/e as recommended below, according to the maximum output power of the communications equipment. Rated Maximum Separation distance according to frequency of transmitter Output Power (P) if m Trabsnitter Watts (W) 150 khz to 80 MHz to 800 MHz to 80 MHz Separation Distance meters 800 MHz Separation Distance meters 2,5 GHz 3,5 3,5 7 d = [ ] P d = [ ] P d = [ ] P Separation Distance meters For transmitters rated at a maximum output power not listed above, the separation distance can be estimated using the equation in the corresponding column, where P is the maximum output power rating of the transmitters in watts (W) according to the transmitter manufacturer. Note : At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies. Note : These guidlines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects, and people. -viii

11 Notice on Service Ensure all screws are tight after servicing. Loose screws may cause the degradation in EMC performance. In case the high frequency gasket of this system is broken, replace it with a new one immediately. -ix

12 Blank page -x

13 Safety! WARNING! FAILURE TO FOLLOW THE OPERATING INSTRUCTIONS AND SAFETY PRECAUTIONS COULD RESULT IN INJURY TO THE PATIENT, YOURSELF, OR OTHERS. General Safety Keep the patient in view at all times. Never leave the patient unattended. Always stay alert to safety concerns involving the patient's condition and equipment operation. Check the lengths of all patient health lines (IV tubing, oxygen lines, etc.) and make sure they accommodate cradle travel. Position these lines so they cannot catch on anything within the patient vicinity or between the table and gantry during cradle travel or gantry tilt. Always follow the exam procedures provided in the operator manual. Verify correct entry of identification, patient positioning, and other patient data before proceeding with the exam. Incorrect procedures or patient data entry could cause misinterpretation of the exam results. Conduct Image Quality checks and follow the maintenance schedule outlined in your CT/e operator manual. Discontinue use of the equipment whenever you notice equipment damage, or a malfunction occurs. Do not use the equipment until qualified service personnel correct the problem. Never use the equipment unless all the protective covers are in place. Radiation Safety Use of controls or adjustments, or performance of procedures other than those specified herein may result in hazardous radiation exposure. Always use proper technique factors for each procedure to minimize X- Ray exposure while still producing the best diagnostic results. Be sure to have an operator wear X-ray protection vest when a work is needed near the gantry while X-ray is being emitted. v

14 Mechanical Safety Never open, or remove, the gantry covers. (Only qualified service personnel should remove covers.) Do not enter the scan room when the gantry covers have been opened or removed. Never allow a patient or staff member to enter the scan room when the gantry covers have been removed for maintenance or PM. (Never allow anyone but qualified service personnel to enter the scan room during gantry maintenance or PM.) To prevent the pinching or crushing of extremities, keep hands and feet away from the edge of the moving table top/cradle and its surrounding equipment. (Be especially careful when positioning patients who weigh more than 250 pounds.) Physically assist all patients on and off the table, and into position on the cradle. While a patient is being loaded onto a CT table from a gurney, make sure via the following measures that the gurney NEVER moves. Lock all the casters of the gurney. Hold the gurney very firmly. If the gurney moves while loading a patient, it may create a gap between the table and the gurney posing the danger of the patient falling through the gap. Return the gantry to the 0 upright position, latch the table, and set it at a comfortable height for patient loading and unloading. Avoid any patient contact with the CT gantry during gantry tilt and cradle movement (manual or software driven). Once again, pay close attention to large patients; make sure you don't pinch skin or extremities between the cradle and the gantry. The concentrated weight of short, heavy patients can cause the cradle to make contact with the gantry. Make sure you don't drive the cradle into the gantry cover, and make sure you don't pinch skin or extremities between the cradle and the gantry. Check the lengths of all patient health lines (IV tubing, oxygen lines, etc.) and make sure they accommodate cradle travel. Position these lines so they cannot catch on anything within the patient vicinity or between the table and gantry during cradle travel or gantry tilt. Do not use the table base as a foot rest. You could entrap and injure your foot while lowering the table. Don't place your hands inside the gantry cover when tilting the gantry. The gantry can pinch or crush your hands! Only use the cradle extender to support the patient's head or feet during a scan study. The cradle extender supports up to 75 pounds; the head holder vi

15 supports up to 30 pounds. Neither device supports the full weight of a patient. If you sit, stand or otherwise apply excessive pressure to these devices, they will break or come off the cradle, and may cause injury. Periodically check all accessories for damage and remove from service if damaged or cracked. Also check the accessory attachment plate fixed to the end of the cradle. Repair or replace if loose or damaged. The cradle has a maximum distributed load capacity of 400 lb. (180 kg). GE assures incremental accuracy and normal traverse speeds up to 400 pounds. Exceeding the 400 lb. (180 kg) maximum limit could result in degraded positioning performance, increased table lowering speed, equipment damage and/or injury. vii

16 Electrical Safety Avoid all contact with any electrical conductors. Wait at least 10 minutes after the last scan before you turn off [Main Power]. This gives the circulating oil sufficient time to cool the X-Ray tube. Laser Beam Safety The laser beam used for patient positioning can cause eye injuries. Instruct a patient not to stare into the laser beam. Software Safety Should a malfunction occur, or a patient condition develop that requires interrupting a scan series, push (Abort) on the right end of the OC scan panel to stop X-Ray. Wait for image annotation to complete before filming. If you press the exposure button too soon, the film records a composite of two different scans. DICOM protocol has a "dialect", which may cause some troubles like disappearances of some portion of image annotations, when connecting to the station where data transfer is not confirmed. Emergency Stop In the event of a hardware failure that could cause serious damage, such as smoke, fire or unintentional cradle movement, press one of the red [Emergency Stop] switches located on the operator console, at the gantry control panels, or on the X-ray Generator. Low power to the electronic components in the computer and data acquisition system remains ON. When Emergency Stop is applied, the moving cradle and tilting gantry may overrun by less than 10 mm and less than 0.5 degrees, respectively. GE provides training support. Contact your local GE sales representative to arrange training sessions to meet your needs. viii

17 Radio Waves Safety Never use the following devices near this equipment. Use of these devices near this equipment may induce erratic function of the equipment. Devices not to be used near this equipment Devices which intrinsically transmit radio waves such as; cellular phone, transceiver, mobile radio transmitter and radio-controlled toy, etc. Keep those devices power-off near this equipment. Note : Medical staff in charge of this equipment is required to instruct technicians, patients and other people who may be around the equipment to fully comply with the above regulation. Note : Your system also has a warning label on a console that warns of the above hazard. ix

18 IMPORTANT SAFETY INFORMATION As a manufacturer of CT systems, we would like to take a moment to remind all Technologists and Radiologists that clinical interpretation errors can be made due to motion artifacts in large vessels, i.e. Thoracic Aorta. These motion artifacts may emulate a vessel dissection. Interpretation errors may cause misdiagnosis or unnecessary surgery. Vessel motion artifacts have been documented in Radiology literature for some time. Motion artifacts in large vessels may be caused when using any manufacturer s CT scanner capable of scanning with 1 second or less rotation times. The pulsation of the vessel creates a double margin of the vessel emulating a dissection. The motion artifact is an interaction between the pulsation of the vessel and the rotation time of the scan. As an aide, we have updated the CT system with the following information to help rule out artifact or real pathology in clinical situations where a vessel dissection may be apparent. It has been documented in radiology literature that an artifact may occur in the chest that bears the double margin of the great vessels, which emulates a dissection of the vessel during 0.5 to 1.0 second scans. This can occur in axial or helical scans. If you have scanned axially or helically with a 0.5 to 1.0 second rotation time and observe this phenomenon, rescan the area with a 2 second axial scan to verify if it is artifact or patient pathology. Please ensure that the appropriate personnel in your CT Department are made aware of this notice. If you have any questions regarding this notice, please contact your local GE representative. If you would like to review additional information in the clinical literature please review the following publication: Gotway, Michael: Helical CT evaluation of the thoracic aorta. Applied Radiology: Sept. 2000, x

19 Warning Labels Labels on Keyboard The following labels are attached to the upper side of the keyboard. CAUTION Patient may be pinched between gantry and table during Prescribed Tilt. To avoid pinching, before using Prescribed Tilt, make sure that patient does not contact the gantry. CAUTION Press Stop Scan button to stop cradle motion or scanning. WARNING This X-ray unit may be dangerous to patient and operator unless safe exposure factors and instructions are observed. xi

20 The following label is attached at the rear side of the gantry pedestal. MADE FOR GENERAL ELECTRIC CO. MILWAUKEE WISCONSIN, U.S.A BY GE HANGWEI MEDICAL SYSTEMS CO.LTD No.2,NORTH YONG CHANGE STREET ECONOMIC-TECHNOLOGICAL DEVELOPMENT ZONE BEIJING, P.R.CHINA MODEL S/N MANUFACTURED DESC SOURCE: SOURCE: SOURCE: SOURCE: xxxxxxx yyyyyyy GANTRY 30A/200V~50/60Hz 30A/115V~50/60Hz 15A/115V~50/60Hz 50A/380~480V3~50/60Hz CLASS 1 COMPLIES WITH RADIATION PERFORMANCE STANDARDS, 21 CFR SUBCHAPTER J CAUTION : Use of controls or adjustments or performance of procedures other than those specified herein may result in hazardous radiation exposure. xii

21 Cradle Caution The following label is attached to the end of the cradle. CAUTION Do not grasp the side of the cradle. Accessory Caution The following labels are attached to the standard headholder and shallow head holder. CAUTION Accessory may fall and cause injury if not latched to cradle. Make sure that accessory is latched to underside of cradle. CAUTION Excessive weight can break accessory and cause injury. Do not load more than 34 Kg or 75 pounds. xiii

22 The following labels are attached to the coronal headholder. CAUTION Accessory may fall and cause injury if not latched to cradle. Make sure that accessory is latched to underside of cradle. CAUTION Excessive weight can break accessory and cause injury. Do not load more than 34 Kg or 75 pounds. CAUTION Do not hit the accessory against the gantry. Patient injury or equipment damage could result. The following labels are attached to the cradle extender. CAUTION Accessory may fall and cause injury if not latched to cradle. Make sure that accessory is latched to underside of cradle. CAUTION Excessive weight can break accessory and cause injury. Do not load more than 45 Kg or 99 pounds. xiv

23 Radio Wave Caution The following label is attached to the operator console. CAUTION Do not use the following devices near this equipment. Cellular phone, radio transceiver, mobile radio transmitter, radio-controlled toy, etc. Use of these devices near this equipment could cause this equipment to perform outside the published specifications. Keep power to these devices turned off when near this equipment. xv

24 Precaution for The CT System Disposal The elimination of machines and accessories must be in accordance with national regulations for waste processing. In the CT system there are certain materials used that could cause environmental hazards if disposed of improperly. Those materials include lead blocks in the gantry and oil in the tank and the X-ray tube. Be sure to contact GEMS service personnel prior to disposing of the CT system or any CT component to ensure safe and proper disposal. This symbol indicates that waste electrical and electronic equipment must not be disposed of as unsorted municipal waste and must be collected separately. Please contact an authorized representative of the manufacturer for information concerning the decommissioning of your equipment. Packing Materials The materials used to pack our equipment are recyclable. They must be collected and processed in accordance with the regulations in force for the country where the machines or accessories are unpacked. xvi

25 Technical documents GE will provide CT users with the following documents at their request to help them repair malfunction on their own. Diagrams Components part lists Descriptions Calibration instructions -xvii

26 Blank page -xviii

27 Chapter 1 SYSTEM Overview of CT System and Examination Overview General Procedures of CT Examination : Main Components Gantry Gantry Control Panel Gantry Display Panel Table Operator Console (OC) User Interface Mouse Keyboard Accessories Standard Accessories Optional Accessories Head Accessories Body Accessories System Power On/Off HIPAA Chapter 2 SCAN TOP LEVEL SCREEN Icon Selection Function of Each Icon New Patient Patient Schedule Select Patient View More Info Add Patient Edit Patient Delete Selected Delete All Preferences Protocol Management Auto Voice Record Protocol Management Retro Recon Recon Management Suspended Entries Recon Queue Management

28 Tube Warm-up Scanner Utilities Raw Data Function Save Rawdata to DVD Restore/Delete from DVD Reserve/Release Rawdata Initialize DVD User Calibration Chapter 3 DISPLAY TOP LEVEL SCREEN Primary/Secondary Viewport Focus Selection Image Display Layout Layouts Autoview Layouts Review Layouts Multiple Image Display (MID) List/Select Routine Display Roam / Zoom Explicit Magnify Flip/Rotate ProView GSE (Gray Scale Enhancement) Display Normal List / Select Ellipse ROI Measure Distance Grid Cross Reference User Annotation Exam Pg / Series Pg Hide/Show Graphics Erase Screen Save Measurements MIROI (Multiple Image ROI) Report Pixels Display Preference Annotation Levels Next/Prior Each Viewport

29 Next/Prior Series Binding Continuous Report Cursor Manual Film Composer Auto Film Composer Accelerator Bar Chapter 4 SCAN Patient Positioning New Patient Scout Scan Icons on Scout prescription screen Auto Store Auto Transfer Axial/Helical Scan Prescription Axial/Helical Prescription (View/Edit) Screen Continuous Scan Modes Prescribe Scan Parameters Prospective Multiple Reconstruction Prospective Multiple Reconstruction Icons of the Axial/Helical Scan Prescription screen (1) Icons of the Axial/Helical Scan Prescription screen (2) Show Localizer Show Localizer Auto ma Auto ma Auto ma Auto ma Auto ma Axial/Helical Scan in Progress Axial/Helical Scan End Priority Recon Next Series Repeat Series One More Repeat Last Group Biopsy Scan Biopsy Rx prescription Smart Addition 3

30 Chapter 5 FILMING AutoFilm Start New Sheet Continue Same Sheet Cancel Film Series AutoFilm Composer Manual Film Manual Film Composer Image removal from Film Composer Load images by drag and drop Load images by F1 function key Page filming by F2 function key MID (Multiple Image Display) filming by F3 function key 5-17 Series filming by F4 function key Chapter 6 QUALITY ASSURANCE Phantom Description QA Schedule Phantom Setup Scan the QA Phantom Test and Analysis of the Phantom Images Contrast Scale High Contrast Spatial Resolution Slice Thickness Positioning Light Accuracy (optional) Low Contrast Detectability Noise and Uniformity Typical Results and Allowable Variations Contrast Scale High Contrast Spatial Resolution Nominal Slice Thickness Low Contrast Detectability Noise and CT Number of Water Weighted CTDI 100 (CTDI W ) Dose and Performance Statement of Typical Technique CT Dose Index (CTDI) For Typical Technique At Various Positions On The Phantom Image CTDI Over A Range of Techniques Helical Dose For Typical Helical Technique

31 Dose and Performance Statement of Typical Technique CTDI 100 For Typical Technique At Various Positions On The Phantom Image CTDI 100 Over A Range of Techniques Dose and Sensitivity Profile at Phantom Center Image Performance Noise MTF Nominal Tomographic Section Thickness Sensitivity Profile Phantoms and Procedures Dose Performance Noise Modulation Transfer Function (MTF) Slice Sensitivity Deviations CTDI and CTDI W Typical Techniques Dose Profile Performance Chapter 7 TECHNICAL SPECIFICATIONS Component Identification Component Labels X-Ray Tube Assembly Information Diagnostic Source Assembly Leakage Technique Factors Minimum Inherent Filtration X-Ray Tube IEC Information X-ray Tube Housing X-ray Tube Insert X-ray Tube Assembly X-ray Tube Insert Information Nominal Anode Input Power Maximum Anode Heat Capacity Maximum Anode Heat Dissipation Anode Heating and Cooling Curves Single Load Rating Serial Load Ratings

32 Rotating Anode Supply Tube Assembly Information Tube Assembly Heating and Cooling Curves Leakage Radiation - Loading Factors Classification Transportation and Storage Transport Packaging Generator Specifications Main Power Supply Generator Rating and Duty Cycle Measurement Basis The Attenuation Equivalent Periodic Maintenance by Qualified Personnel Maintenance by CT Users Symbols and Classification Class 1 Equipment Type B Equipment Ordinary Equipment Operation Of Equipment Cleaning

33 SYSTEM Chapter 1 Overview of CT System and Examination Overview The CT/e computed tomography (CT) system consists of four major components and some peripheral gear. Four major components are the gantry, table, operator console(oc) and power distribution unit. The primary objective of this CT system is to obtain for medical diagnoses the two or three-dimensional images of internal structure of human body. General Procedures of CT Examination : 1. The operator prescribes the examination(scan) procedures at the OC while the patient is positioned on the table in the scan room. 2. As the operator initiates the scan procedures with the patient in the gantry aperture, the X-ray unit inside the gantry rotates around the patient body emitting the fan-shaped X-ray beam to the body. The X-ray penetrates the body and is received by the detector, then it is converted to the electrical data. 3. The data acquired in the above step is processed into the images by the computer at the OC. Then, the images are initially displayed on the CRT of the OC and subject to manipulation for analysis. The images can also be filmed later for diagnoses by a physician. 4. The image data can be saved in some electronic media like optical disk for later analysis and also be transferred to some other stations for remote diagnoses. 1-1

34 SYSTEM Main Components Gantry Emergency Button Display Panel Emergency Button Breath Navi Positioning Light Control Panel Positioning Light Function The gantry incorporates the X-ray tube unit, the HiLight detector and DAS (Data Acquisition System) inside. It also provides the following functions. Display Panel The display panel shows the readings of the gantry tilt, table height, position of land mark, latch status, scannable range and tilt range. Refer to the Gantry Display Panel page for the function descriptions. Emergency Button Pressing the emergency button stops every mechanical movement and the X- ray emission. Control Panel The control panel incorporates the several buttons to mainly control the movements of the gantry and table. Each front and rear cover has two control panels. Refer to the Gantry Control Panel page for the function descriptions. Positioning Light & Breath Navi The Halogen beam will be emitted through here that will be used to position a patient. Breath Navi gives the visual breathing instructions to a patient with hearing problem. 1-2

35 Gantry Specifications Aperture : 65 cm. Tilt : +/- 20 degrees Tilt speed : 1 degree/second Height to isocenter : 90 cm. Rotation speed : 360 degrees in 1.0, 1.5, 2.0, 3.0, 5.0 seconds X-ray Tube Specifications Anode heat storage capacity : 2.0 MHU Anode heat dissipation : 500 KHU/min. (maximum) Casing heat dissipation : 275 KHU/min. (constant) Focal size : 0.7 mm 0.6 mm HiLight Detector Specifications Channels : 720 SYSTEM 1-3

36 SYSTEM Gantry Control Panel Display Distance from Iso Center External Landmark Internal Landmark Tilt Range & Scannable Range Practice Positioning Light Fast Positioning Light Table Up Cradle In Table Down Cradle Out Fast Gantry Tilt Lamp Gantry Tilt Gantry Tilt Lamp Function The gantry control panel enables you to control the movement of the gantry, table or cradle with the following buttons. Cradle In/Out Use this to move the cradle toward or away from the gantry aperture. Table Up/Down Use this to move the table up or down. Fast Use this to increase the speed of cradle in/out. This does not apply to table up/ down. 1-4

37 SYSTEM Gantry Tilt Use this to tilt the gantry toward or away from the cradle. WARNING! The touch sensor on the gantry cover works only during the remote tilt operation at the OC. It does not work when the tilt operation is done at the Control Panel. Gantry Tilt Lamp The system turns on this lamp when gantry tilt is needed. Positioning Light Use this to turn on or off the internal/external positioning lights. External Landmark Use this to move the anatomy beneath the external positioning light. Internal Landmark Use this to move the anatomy beneath the internal light to adjust scan location zero. Tilt Range & Scannable Range Use this to display the gantry tilt range and the scannable range at certain table height. Practice Use this to test the * Breath Navi function. (*Breath Navi is the small device attached to the edge of the gantry aperture that gives the visual breathing instructions to a patient with hearing problem.) Display Distance from Iso-Center Use this to display the distance between the iso-center and the top of the table. 1-5

38 SYSTEM Gantry Display Panel Distance from Iso Center (mm) Interference Distance from Landmark (mm) Tilt/Angle Range X ray On Function The gantry display panel shows the following readings and indications. X-ray On The X-ray On lamp illuminates during X-ray exposure. Tilt / Angle Range The Tilt/Angle Range field shows the reading of either the current tilt or the tilt range limits at the current table height/cradle extension. The numerical reading is preceded by either S (superior) or I (inferior). Distance from Landmark The Distance from Landmark field shows the reading of the distance (mm) between the landmark and the anatomy in the X-ray path. The numerical reading is preceded by either S (superior) or I (inferior). Distance from Iso-Center The Distance from Iso-Center field shows the reading of the distance (mm) between the iso-center and the top of the table. This is displayed when the Display Distance from Iso-Center button on the gantry panel is pressed. Interference The Interference lamp turns on when some mechanical interference occurs. 1-6

39 SYSTEM Table Function The table is used to load a patient for scanning. Cradle The cradle moves into or out of the gantry aperture. Latch Button The latch button is used to latch or unlatch the cradle. The unlatched cradle can be manually slid. The Display Panel shows whether the cradle is latched. Speaker The speaker is used to deliver oral instructions to a patient. Foot Switch(Option) The Foot switch is placed at the foot of the table. When the operator steps on it, the switch turns on and activates functional buttons on the gantry panel. 1-7

40 SYSTEM Table Specifications Vertical range : from 40 cm to 90 cm (cradle height from floor) Vertical elevation speed : 17 mm/second on average Maximum cradle travel : 1520mm Note : Table Height, Gantry Tilt, and scanning software determine the scannable range. Cradle travel speed : 20 mm/second (Slow mode), 100 mm/second (Fast mode) Cradle travel pitch : 0.5 mm Table load capacity : maximum 180 Kg 1-8

41 Operator Console (OC) SYSTEM Main Switch CD ROM Drive 5 MOD Drive 3.5 MOD Drive Function The operator console (OC) is mainly used for the operator to set up the scan procedures and process the resultant image data. Scan/Display Monitor The 17-inch monitor (21-inch optional) on the OC can be mainly used for two purposes, scanning patients and displaying images. Keyboard/Mouse Please refer to the User Interface on page Main Switch Please refer to the System Power On/Off on page CD-ROM Drive This drive is dedicated to service or application software installation. 3.5 MOD (Magnetic Optical Disk) Drive Raw data can be stored in 3.5-inch MOD. 5 MOD (Magnetic Optical Disk) Drive (option) Image data can be stored in 5-inch MOD Caution : It is highly recommended to always take back-up image data because of a possibility of medium breakdown. 1-9

42 SYSTEM If you installed the DVD-RAM drive, pls pay attention below drive s description: Main Switch DVD-RAM Drive 5 MOD Drive(Option) DVD-RAM Drive Raw data can be stored in DVD-RAM. 5 MOD (Magnetic Optical Disk) Drive (option) Image data can be stored in 5-inch MOD 1-10

43 User Interface SYSTEM The CT/e system employs the user interface that enables the operator to easily interact with the OC workstation. The user interface consists of a mouse and keyboard. Mouse Middle button Left button Right button General operations of the mouse are as follows: "Click" Press a button once then release it quickly. "Double / triple click" Click two/three times quickly. "Click and drag" Press and hold the button and move the mouse across the pad. Main functions of each button are as follows: Left button To select any of icon, item, function, etc. Middle button To change window width and/or level by moving the mouse left/right and/or up/ down respectively with the button pressed. Right button To scroll the image or modify the image zoom factor. 1-11

44 SYSTEM Keyboard The workstation includes a keyboard for entering text at on-screen prompts and numeric data in data entry fields. The upper part of the keyboard includes scan-related buttons and safety-related buttons. Move to Scan Stop Move Start Scan Pause X ray on Stop Scan Emergency Stop Mic. Volume Dial Talk Button Functions of each button and key are described on the following pages. 1-12

45 SYSTEM Scan-related buttons Move to Scan Press this button when lit to move the cradle to the prescribed scan start location. Stop Move Press this button to stop the cradle when it is traveling. Start Scan Press this button when lit to start scans. Pause Press this button to temporarily halt scans. Scans pause after completing the current one scan. Press Start Scan button to resume scans. X-ray on This button lights up during X-ray emission. Stop Scan Press this button to stop the current or halted scan. Emergency Stop This button cuts off the power to the equipment inside the scan room.all mechanical movements and X-ray radiation are halted. Note : This button affects the power neither to OC nor laser camera. 1-13

46 SYSTEM Communication button/dials Talk (Intercom) Hold down this button to give some verbal instructions to the patient during an exam. Volume Use these dials to adjust the voice volume of patient or operator. 1-14

47 Keyboard keys SYSTEM Function key F1, F2, F3 and F4 function keys are used for filming-related operations. Please refer to Chapter 5 [FILMING] for detailed information. F1 F2 F3 F4 Film Image Film Page Film MID Film Series F5 function key is used to return to the window width and level that have been used most recently F5 Previous W/L F5-11 function keys are used to preset the specific window width and level for specific anatomical areas. The procedure is as follows. F6 F7 F8 F9 F10 F11 Abdo Head Lung men Media stinum Spine Verte bra Drop on Auto Film 1. Firstly select the image as a primary one (green border) of which WW and WL you wish to register as default. 2. Press [Shift+F5~F11] to register those WW and WL as preset conditions. 1-15

48 SYSTEM Image Analysis related keys These keys are used for image analysis purposes. Please refer to Chapter 3 [DISPLAY TOP LEVEL SCREEN] for each key's function. Erase Disp Norm Ellipse ROI Trace Grid On/Off Meas Dist User Annot Zoom Roam Key top These keys are mainly used to input texts/numbers and display images. Enter Shift Prior Exam Prior Next Exam Next - [Enter] : Use this to conclude the entry. - [ / ] : Use these to move forward or backward through items on desktop. - [ / / / ] : Use these to adjust window level and width of images. - [Prior Exam/Prior] : Use this to return to prior exam or image. - [Next Exam/Next] : Use this to go to next exam or image. 1-16

49 Accessories SYSTEM The system utilizes the various accessories to facilitate the scan. Standard Accessories Cradle pad Cradle extender Standard head holder assembly Security straps Phantoms to calibrate and check performance Phantom holder Console chair Operator manual Optional Accessories Coronal head holder assembly Shallow head holder assembly Arm Support WARNING! Do not use any accessories other than those provided by GE. Use of other accessories may cause unexpected troubles or physical injuries. Also, if anything other than GE accessories is placed in the path of x-ray beams, it may affect image quality. 1-17

50 SYSTEM Head Accessories Standard Head Holder Assembly (Front side) (Back side) Label MADE FOR GENERAL ELECTRIC CO. MILWAUKEE, WISCONSIN BY GE YOKOGAWA MEDICAL SYSTEMS, LTD ASAHIGAOKA 4 CHOME, HINOSHI TOKYO, JAPAN MODEL SERIAL MANUFACTURED OCTOBER 1997 Head Holder Wedge Shallow Head Holder (option) (Back side) Label MADE FOR GENERAL ELECTRIC CO. MILWAUKEE, WISCONSIN BY GE YOKOGAWA MEDICAL SYSTEMS, LTD ASAHIGAOKA 4 CHOME, HINOSHI TOKYO, JAPAN MODEL SERIAL MANUFACTURED OCTOBER 1997 Head Strap Chin Strap Coronal Head Holder Assembly (option) Coronal Head Cushion Label MADE FOR GENERAL ELECTRIC CO. MILWAUKEE, WISCONSIN BY GE YOKOGAWA MEDICAL SYSTEMS, LTD ASAHIGAOKA 4 CHOME, HINOSHI TOKYO, JAPAN MODEL SERIAL MANUFACTURED OCTOBER 1997 Coronal Head Neck Pad 1-18

51 SYSTEM Standard Head Holder Assembly Standard Head Holder Use during normal head studies, with a supine patient. Use the head band, chin strap, and coil spacers (wedges) to secure the head in the proper position. The material is metal-free. Head Holder Cushion Place this cushion on the Standard head holder. Use it to cushion the head and hold it in position during the study. Two sizes are available. Head Band Place the wide area of the head band between the head holder and head holder cushion, with the straps hanging on either side of the head holder, before the patient lays on the table. Move the patient's head into position on the cushion, cross each end of the band over the forehead, and fasten the pad of Velcro "loops" to the "hooks" on the back of the head holder. Use the head band to position and stabilize the head during a study. Chin Band Center the hole in the band over the patient's chin, and fasten the pad of Velcro "loops" to the "hooks" on the back of the head holder. Use the chin band to position and stabilize the head during a study. Coronal Head Holder Assembly (option) Coronal Head Holder Use this head holder during direct coronal studies. The patient lays in the supine position, with the head tipped backward into the coronal head holder. Use the head band and chin strap to secure the head in the direct coronal position. The material is metal-free. Neck Pad Place this pad vertically in the Coronal head holder to cushion the rear head. WARNING! Be extremely careful to avoid contact between the coronal head holder and the gantry while lowering the table in the aperture. Patient injury to the neck or equipment damage could result. 1-19

52 SYSTEM Body Accessory Use Knee Pad Assembly Place the knee pad on the cradle. Rest the patient's legs, with knees slightly bent, on the knee pad -or- Rest the patient's head on the knee pad, and use the knee pad strap to secure the hands over the patient's head, to prevent catching the patient's fingers between the cradle and table surfaces. Knee Pad Strap Attaches to the three Velcro "loop" patches on the knee pad with Velcro "hooks"; use to secure the legs or arms to the knee pad. (See above) Cradle Pad Use during standard studies; attaches to the cradle with Velcro "hooks." Cradle Extender Attach the cradle extender to the end of the table nearest the gantry, to increase the overall cradle length, and position the body area of interest inside the scannable range. Use the extender to support the patient's head or feet during a body scan. The material is metal-free. 1-20

53 SYSTEM Security Strap Kit Body Strap A Use the 60 mm wide strap to position and secure the patient's head to the Head Cushion; or use as needed to secure blankets or clothing. Follow Body Strap B directions to attach and secure the straps. One set provided with system. Body Strap B Use the 150 mm wide straps to secure the body to the cradle, to reduce patient movement; to secure blankets or clothing, to prevent contact with the cradle surface; or, to cover and secure the patient's hands. Slide the nylon guide, opposite the Velcro ends of the straps, into the raceway attached to both side edges of the cradle. Slide the strap along the length of the cradle to position it over the patient, and fasten the Velcro ends together to secure the patient. Three sets provided with the system Body Strap C Use the 370 mm wide strap in the same manner as Body Strap B. One set provided with system. Extension Strap Use the extension strap with the corresponding body straps to secure large or obese patients. Attach Velcro "hooks" to "loops" on the body strap to increase the length. Each set of body straps has an extension strap; five provided with the system. 1-21

54 SYSTEM Body Accessories Knee Pad Cradle Pad Knee Pad Strap Cradle Extender (Back side) Cradle Extender Pad Label MADE FOR GENERAL ELECTRIC CO. MILWAUKEE, WISCONSIN BY GE YOKOGAWA MEDICAL SYSTEMS, LTD ASAHIGAOKA 4 CHOME, HINOSHI TOKYO, JAPAN MODEL SERIAL MANUFACTURED OCTOBER cm.. Body Strap Extender Strap (15cm..) 1-22

55 Attach/Detach Head Holder and Cradle Extender SYSTEM Prevent damage to metal-free accessories! Carefully examine the metal-free clasp assembly on the accessory and the catch on the cradle before attempting to attach the accessory for the first time. To attach an accessory: Make sure the clasp on the accessory is unlatched, and hanging freely.hold the clasp in the unlatched position while you attach the accessory. Align the accessory tongue with the pocket at the end of the cradle.keep fingers clear of the cradle. Slide the tongue all the way into the pocket until it rests snugly against the angled face of the cradle. Gently pull the clasp toward the floor and away from the gantry until it hooks the catch on the cradle. Push the hinged-end of the clasp toward the cradle until it snaps into place. To detach an accessory: Pull the hinged-end of the clasp toward the floor and away from the gantry until it snaps open and clears the catch. Gently slide the accessory toward the gantry until it clears the cradle.if the accessory offers any resistance, check to make sure the clasp cleared the catch on the cradle. 1-23

56 SYSTEM System Power On/Off How to turn on the system power (Usually power is on 24 hours a day.) 1. Turn on the main switch located on the lower right side of the OC. 2. The system will start up and the Scan/Display monitor on the OC will automatically proceed to its Top Level screen. How to turn off the system power (Usually power is on 24 hours a day.) 1. Click on the [Shutdown] icon on the upper left corner of the screen. Shutdown 2. The system will automatically proceed to the point where you can turn off the main switch. 1-24

57 HIPAA SYSTEM The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was signed by President Clinton on July 21, 1996 and has the general objectives to: Guarantee health insurance coverage of employees. Reduce health care fraud and abuse. Introduce/implement administrative simplifications in order to augment effectiveness and efficiency of the health care system in the United States. Protect the health information of individuals against access without consent or authorization. Within HIPAA there are Administrative Simplification regulations that, in early 2001, are in work. GE Medical Systems has a longstanding reputation of providing customizable, clinical solutions to protect the privacy and security of your organization's unique clinical workflow, as well as your patient's confidentiality. Our scanner, software and services already incorporate many of the core HIPAA requirements. We are committed to working with you, our customer, to provide additional value to help you meet the continuing HIPAA challenge. Please recognize the intended use of the product when determining how critical any privacy risk is, relative to patient care and safety. GE is very concerned with providing the best care to the patients; and in some cases we have determined that patient care is more important than the risk to privacy. In these cases we take every precaution to minimize the privacy risk. Security and Privacy are maintained across a Healthcare system. Any product that is placed into an uncontrolled environment will not be secure and can not protect privacy. As we design scanners we design them to be implemented in a "Secure Environment". A secure environment is based on multiple layers of security, a concept known as defense in depth. For example: a Best Practice that is gaining much attention places firewalls between departments, as well as at a DMZ, between all extranets, and the external Internet access point. In this example a radiology firewall may allow DICOM and HL7 traffic through, but no other protocols. These DICOM and HL7 protocols would be blocked at the DMZ and again at the Internet Firewall. HIPAA requires you to log on to the scanner and log off when you are done scanning for a period of time. If you do not log off the system will log you off and you will have to log back on. HIPAA can be set up for groups of users. You can be an Empowered, Admin, Operator or Service user. Empowered users can modify protocols and do service functions. Admin users can set up user and delete users. Operator users can perform all scanning functions. Service users can do everything. Note : HIPAA is an option that can be turned on or off by your Field Engineer. 1-25

58 SYSTEM Shut Down and Start Up the System To keep your system operating at optimal performance, you need to shut down and start up the system every 24 hours. 1. From the desktop selection area, click [Shutdown]. - A pop-up attention box appears. 2. From the pop-up attention box, select the option you wish to do. - Logout User allows enables you to login as a different user. NOTE: For information on how to Login and Logout, refer to: Login and Logout. - Restart brings the system all the way down to the power off point and then re-boots the system. - Shutdown brings the system all the way down to the power off prompt. You can then turn power off to the system. 3. Click [OK]. 4. If you selected Shutdown or Restart a series of menus and messages appear. - If Restart was selected the system automatically restarts the system. - If Shutdown was selected, turn off the OC power, if not already off with thepower switch on the front of the console and then turn the power switch on torestart the system. 5. To power up the system push the power switch on the front of the operator console and the system will automatically restart. 1-26

59 Login and Logout SYSTEM Use this procedure when you are going to scan on the system. You need to login to the scanner so the scanner knows which user you are. When you leave the system you should log off the system. This is for security purposes. 1. At the login screen select Login from the Operation pull down menu. NOTE: If you need to log in quickly for emergency purposes only, click [Emergency Login]. 2. From the Select User pull down click on your user name. - This name is assigned by your system administrator. 3. Click in the Password area and type in your password. 4. Click [OK]. 5. To logout of the system, click [Shutdown]. - The Shutdown window appears. 6. Click [Logout User]. 7. Click [OK]. - The system logs you out and waits for the next login. 1-27

60 SYSTEM Configure Users for the System To add users to the system for use, you must be a user with the administrative option added to your name in order to complete this procedure. Normal users do not have permission for this area. 1. At the Login window, select Login & Administer users from the Operation pull down menu. - For information on how to login to the system, refer to: Login and Logout 2. Select your user name from the Select User pull down menu. - You have to be an assigned administer to add or remove users from the system. 3. Enter your Password. 4. Click the [User, Groups, Permission] tab. - This brings up the HIPAA User Management Screen Figure Click [New User]. 6. From the pull down menu Click Add a New User. - Type in the information. - The user name must not contain any spaces. NOTE: The initial password is the user name the first time the new user logs in. The new user is then prompted to change their password. 7. Click all the boxes that apply to that user. - This will give them permission for different areas of the scanner. 1-28

61 8. Click [Password constraints]. - Click all the boxes that apply. SYSTEM NOTE: By entering 0 in the Max bad logins before account is locked text area this allows the user have unlimited bad password attempts. If you enter a number here and the user logs the number that you enter, the system locks that users out and the Admin user has to unlock that user. To unlock a user from bad password attempts, click [User, Groups, Permission] and select Lock User. Select the user name from the list and click [Unlock User]. Do not lock a user under the lock user tab. This is used for resetting maximum attempts locks. 9. Click [Exit Admin]. - This closes the Admin screen. 10. Click the Scan desktop. - This returns you to the scanning desktop. 1-29

62 SYSTEM Figure 3-1 HIPAA User Management Screen 1-30

63 Chapter 2 SCAN TOP LEVEL SCREEN After the system starts up, the following screen appears on the CRT as default Top Level screen. This screen will also appear when the [Scan] icon on the upper left corner is selected while in the either Display or Image Works mode. Scan 2-1

64 SCAN TOP LEVEL SCREEN Icon Selection When a certain icon is selected, it highlights in blue. Icons currently not available are displayed in gray. When the second icon is selected after the first one was selected, the first icon highlights in green and its upper right corner folds. Functions of each icon are described on the following pages. 2-2

65 SCAN TOP LEVEL SCREEN Function of Each Icon 1 This icon leads to the scan screen. Scan This icon leads to the Display screen. The icons on the Display screen are described in the later chapter. Display This contains Reformation, 3D, Network and other advanced image analysis applications. Refer to {Image Works} section. Image Works Use this to shut down the system. Shutdown This is only for service purpose. Users are not allowed to touch this. Service December 22 5:49 PM 512: : 595 This shows Date, Time and Disk capacity at each matrix. 2-3

66 SCAN TOP LEVEL SCREEN Function of Each Icon 2 To Current Messages Reconstruction Status This area shows the exam, series and image number of the exam that is currently being reconstructed. Archive Status This area shows the status of images being archived. Network Status This area shows the status of networking. Filming Status This area shows the status of filming. Current Messages Click here to open the Current Messages screen. 2-4

67 SCAN TOP LEVEL SCREEN New Patient New Patient icon is located at the left side of the screen. New Patient Function : Select this icon first to begin a new patient exam. Refer to the chapter 4 [Scan] for detailed information. 1. Click on the [New Patient] icon to open the following New Patient screen. Patient Information Protocol Selection Exam Number Accession Number Patient ID Patient Name Format:LastName^FirstName^Middle^Prefix^Suffix Birthdate Age mon day yr Sex Years Months Weeks Days Weight Kilograms Pounds Referring Physician Radiologist Operator History Exam Description Protocol Number Req.Proc.ID End Exam 2. Enter necessary patient information. Note : Patient ID must be put to proceed. (required) 3. Choose a desired scan protocol from the Default Protocol area located on the right side of the New Patient screen. 4. The system automatically proceeds to the View/Edit screen. 2-5

68 SCAN TOP LEVEL SCREEN Patient Schedule 1 Patient Schedule icon is located below the New Patient icon. Patient Schedule Function : Patient Schedule allows you to enter patient data ahead of time. Once it is time to perform a specific patient exam, you can select from the created list, enter the patient ID or requisition number to call up the patient data. 1. Click on [Patient Schedule] to open the following Schedule list. Patient Schedule Schedule Status Req.Number Patient ID Patient Name Date Time Exam Description C Joerge Bush 7/17/01 10:25AM C Collin Powel 7/23/01 11:04AM C Bin Ladin 9/11/01 8:54AM N Bill Clinton 9/21/01 1:30PM Quit Select Patient View More Info Add Patient Edit Patient Delete Selected Delete All Preferences Next Prior On the left side of the column under Status, there are two letters. C stands for Completed and N for New. The completed exam at the top of the list is the last completed exam. The only active functions at this point are [Quit], [Add Patient], [Delete All], [Preferences] and Next/Prior arrows. Note : Active icons have clear black characters on them whereas inactive icons have dim characters. 2. Once a patient is selected, the other icons become active. Functions of each icon are described on the following pages. 2-6

69 SCAN TOP LEVEL SCREEN Patient Schedule 2 Select Patient Select Patient Take the following steps to use [Select Patient]. 1. Select [New Patient]. 2. Select [Patient Schedule]. 3. Select the desired patient on the Schedule list. 4. Select [Select Patient]. The patient data will then be placed in the New Patient data area. Note : The patient data will also be called up by typing in the patient ID. View More Info View More Info While your CT/e system is connected with HIS/RIS and if your CT/e system has Connect Pro option, select [View More Info] to get more information on the patient. 2-7

70 SCAN TOP LEVEL SCREEN Add Patient Add Patient Patient Schedule 3 Select [Add Patient] to open the following menu to add patients to the schedule. Patient data, date and time of the exam and the protocol can be entered here. Schedule Patient Accession Number Patient ID Patient Name Format:LastName^FirstName^Middle^Prefix^Suffix Anatomical Selector Protocol Selection Birthdate Age mon day yr Sex Years Months Weeks Days Weight Kilograms Pounds Referring Physician Radiologist Operator History Exam Description Protocol Number Date Mon Day Yr Time Hour: Min Am/Pm Cancel Accept - Accession Number : (within 16 characters) - Patient ID : (within 16 characters) - Patient Name : (within 64 characters) - Sex : M (Male) or F (Female) - Birthdate : Year, Month, Day - Age : Years, Months, Weeks, Days - Weight : Kgs or Pounds 2-8

71 SCAN TOP LEVEL SCREEN Patient Schedule 4 - Reference Physician : (within 32 characters) - Radiologist : (within 32 characters) - Operator : (within 3 characters) - History : (within 60 characters) - Exam Description : (within 22 characters) - Protocol Number : (within 5 characters) - Date : Exam date, Year, Month, Day - Time : Exam time, Hour, Minute Edit Patient Edit Patient Select [Edit Patient] to bring up the Patient Information screen to edit patient data. 2-9

72 SCAN TOP LEVEL SCREEN Delete Selected Patient Schedule 5 Delete Selected [Delete Selected] allows you to delete specific patients from the Schedule list. 1. To delete only one patient, click on that patient's information, then select [Delete Selected]. 2. To delete multiple patients in order, click on one patient, then go to the last patient and press and hold the Shift key, then click on that patient. Then, select [Delete Selected]. To delete multiple patients out of order, press and hold the Control key, then click on the desired patients and select [Delete Selected]. 3. A confirmation message "Are you sure you want to delete selected patients?" appears. If OK, click on [OK]. Delete All Delete All [Delete All] allows you to delete all of the patients. 1. The following screen appears after selecting [Delete All]. Delete All All Completed All New All OK Cancel 2. Select [All Completed] to delete all scan-completed patients. Select [All New] to delete all new patients. Select [All] to delete both of the above patients. Note : The default is [All Completed]. 2-10

73 SCAN TOP LEVEL SCREEN Patient Schedule 6 Preferences Preferences [Preferences] allows you to set the sort order and delete time. 1. The following screen appears upon the selection of [Preferences]. Preferences Update Schedule Automatically? Yes No Sort By : Date/ Time Name ID Show update Parameters? Yes No Delete Completed Exams After: Days Edit Modality Use Study UID? Yes No Yes No worklist? Default Update Parameters Get Patient List For: This system All CT Systems All Systems With a Date Range: Today Days Before Today Days after Today All Dates OK Cancel 2. The patient list can be sorted by Date/Time, Name or ID. 3. If you want the system to automatically delete completed exams, you can click in the Days box and type in the number of days desired. The default is 0 (zero). 4. Select [OK] to conclude the entry. 2-11

74 SCAN TOP LEVEL SCREEN Protocol Management Protocol Management icon is located at the right side of the New Patient icon. Protocol Management Function : Protocol Management includes two functions, which are [Auto Voice Record] and [Protocol Management]. 1. The following screen appears upon the selection of [Protocol Management]. Auto Voice Record Protocol Management Quit 2. Select [Auto Voice Record] to set up Auto Voice or select [Protocol Management] Select [Quit] to quit. Functions of [Auto Voice Record] and [Protocol Management] are described on the following pages. 2-12

75 SCAN TOP LEVEL SCREEN Auto Voice Record 1 Function : This function allows you to give the patient recorded vocal instructions. 1. The following screen appears when you click on [Protocol Management] icon. Auto Voice Record Protocol Management Quit 2. The following Auto Voice Record screen appears upon the selection of [Auto Voice Record]. Language Selection English Auto Voice Record Name Suspension Inspiration Expiration Pre-Message Post-Message Name Pre-Message Post-Message Create New Message Message Management Record Stop 0.0 Play Delete Set Play Save Message Done Twenty protocols in all are available. The first three protocols are preset in the system and can not be changed. Other 17 protocols are programmable. 2-13

76 SCAN TOP LEVEL SCREEN Auto Voice Record 2 As for the first three protocols, there are nine language options. In order to choose any one of them, click on the [English] button on the Auto Voice Record menu on the previous page to open the following menu. AutoVoice Language Selection Englishñmale Englishñfemale Japanese French German Spanish Mexican Spanish Italian Korean Chinese Cancel You can select any one of them to listen to it. In order to select any one of them for the scan, you are required to do so through the [Auto Voice No.] button on the Scout (or Axial/Helical) Prescription Screen. (Refer to Chapter 4.) 3. To create a new Auto Voice instruction message, point and click in the Name area where you wish to put the protocol. Type in the name and press the Enter key. After pressing the Enter key, the Pre and Post Message areas become active. 4. Go to the Create New Messages area to create new instruction messages. Create New Messages Record Stop 0.0 Play Save Message The only active icon at this point is [Record]. 2-14

77 SCAN TOP LEVEL SCREEN Auto Voice Record 3 5. Once you are ready to record, select [Record]. Then, press the [Talk] button on the keyboard and speak the verbal instruction to the microphone. The time clock to the right will start. The maximum recording time is 20 seconds. 6. When finished with recording, select [Stop]. Select [Play] to listen to what was recorded. 7. To save the recorded message as a protocol, click on the Pre or Post Message box and select [Save Message]. 8. The Message Management area allows you to play or delete an existing Auto Voice protocol. To delete a protocol, select the protocol name and then select [Delete Set]. Message Management Play Delete Set Done To play a message, simply select the message box you wish to play and select [Play]. 9. To leave the Auto Voice Record menu, select [Done]. 2-15

78 SCAN TOP LEVEL SCREEN Protocol Management 1 Function : This function allows you to create, edit or delete scan protocols. 1. The following screen appears when you click on [Protocol Management] icon. Auto Voice Record Protocol Management Quit 2. The following screen appears upon the selection of [Protocol Management] on the above screen. This is the Adult Protocol menu. The Infant Protocol menu is also selected by clicking on the Infant tab. Protocol Management Infant tab Adult tab Quit 3. Select a protocol or an anatomic region to open the menu on the next page. 2-16

79 SCAN TOP LEVEL SCREEN Protocol Management 2 4. You can build up to 15 protocols for each anatomical region. Protocol Name Default New Duplicate Edit Delete Done Cancel 5. To duplicate (copy) an existing protocol, first choose the protocol and select [Duplicate]. Then, you may slightly modify it to create a new protocol that will have the similar parameters to the original protocol. 6. To edit or delete an existing protocol, first choose the protocol and select [Edit] or [Delete] respectively. 7. To create a new protocol, select [New]. 8. After selecting [New], enter the protocol name on the highlighted line and press the Enter key. To set a protocol as the default for the region, select the [Default] button next to the protocol. Only one protocol can become the default for the region. 9. Next, select the Series Type that will begin the protocol and click on [OK]. Select New Series Type Scout Axial OK Cancel The following Protocol Setup screen appears. 2-17

80 SCAN TOP LEVEL SCREEN Protocol Management 3 The following screen is an example of axial scan protocol setup. Protocol Parameters Setup Screen Protocol : Series: Anatomical Reference Series Description Auto Store Auto ma OFF Show Localizer Auto Transfer Auto Film Setup SmartRecon OFF Prior Next Add Group Split Current Group Delete Selected Group Scan Timing Recon Film Images Scan Type Start Loc. End Loc. No. of Images Thick (mm) Image Intíval Pitch Gantry Tilt SFOV kv ma CTDIvol DLP 1ñ8 Axial S50.0 S Body ñ15 Axial S10.0 I Body Smart Prep RX Cancel Create Prior Next Repeat Delete New Series Series Series Series Series Accept 10. In the above screen, the [Scan] icon parameters (Thick, Image Int'val, pitch, etc.) are supposed to be filled. In order to enter Timing, Recon and Film parameters, click on the [Timing], [Recon] and [Film] icon, respectively. The menus for Timing, Recon and Film are shown on the following pages. Prior/Next : Prior or Next key appears on the screen only when more than three groups are prescribed for one screen. 2-18

81 SCAN TOP LEVEL SCREEN Protocol Management 4 The following Timing menu will appear when you click on the [Timing] icon. Scan Timing Recon Film Prep Group (sec) ISD (sec) Breath Hold (sec) Breathe Time Auto Voice No. The following Recon menu will appear when you click on the [Recon] icon. Scan Timing Recon Film DFOV (cm) R/L Center (mm) A/P Center (mm) Recon Type Image Filter Matrix Size Motion Correct Special Filter Show Show Show Recon1 Recon2 Recon3 Y N N The following Film menu will appear when you click on the [Film] icon. Scan Timing Recon Film Auto Film Frame Format Interval Flip Width 1 Level 1 Mag Factor Rotate User Anno. GSE Recon 1 Film Set 1 Recon 1 Film Set 2 Recon 2 Film Set 1 Recon 2 Film Set 2 Recon 3 Film Set 1 Recon 3 Film Set

82 SCAN TOP LEVEL SCREEN Protocol Management 5 Select [Prior Series] to display the prior series protocols. Select [Next Series] to display the next series protocols. Select [Repeat Series] to add the same series protocols. Select [Delete Series] to delete the displayed series protocols. Refer to the Chapter 4 for the function of other icons or buttons. 11. After all the scout view parameters have been entered, select [Create New Series] button on the front page screen to create the next series. Then, the following screen appears. Select New Series Type Scout Axial Create Before Create After Cancel 12. Select the series type from [Scout] or [Axial]. Also, select [Create Before] or [Create After] to determine if the series will be put before or after the first series you built. 13. Again, enter scan parameters for the series selected. 14. After all the series and the parameters have been created, touch [Accept] button to save the protocol You will then return to the beginning so that you may choose to delete, edit or create a new protocol. Or you can select [Done] and then [Quit] to exit the protocol section. 2-20

83 SCAN TOP LEVEL SCREEN Retro Recon 1 Retro Recon icon is located below the Patient Schedule icon. Retro Recon Function : Retrospective reconstruction allows you to change the reconstruction parameters that were previously used for the exam. Through Retro Recon you are allowed to change DFOV(Display Field of View), AP(Anterior/Posterior) and RL(Right/Left) Centering, Recon Type, Matrix Size, Segmenting and Peristaltic Motion Correction for axial series. 1. First click on the [Retro Recon] icon. The following screen appears listing up to 1000 scan data. Click on the [Update] button to update the list or select [Quit] to exit. Retro Recon List Select Screen Retro Recon List Select Exams Patient ID Patient Name Exam # Date Time Suite Series Series # Series Description Landmark Prior Next Prior Next Quit Select Series Update 2. Point and click on the exam and series you wish to reconstruct retrospectively and then choose [Select Series] at the bottom center. The system automatically proceeds to the Retro Recon View/Edit screen. 2-21

84 SCAN TOP LEVEL SCREEN Retro Recon 2 3. After selecting [Select Series], the following screen appears displaying all of the groups in the selected series. Y(Yes) in the Retro column means that group will be reconstructed. If you do not wish to recon the group, simply point and click on the "Y" icon for the group to toggle it to N(No). When the [Images] tab is selected, the right side of the screen is as follows. Prior Next Images Recon Retro Scan Type Scan Start Location Scan End Location Retro Start Retro End No. of Images Image Gantry Interval Tilt SFOV Y Y Y Quit List Exams Confirm When the [Recon] tab is selected, the right side of the screen is as follows. Prior Next Images Recon Retro Scan Type Scan Scan Start End Location Location DFOV (cm.) R/L Center (mm) A/P Center (mm) Recon Type Image Filter Motion Correct Recon Mode Matrix Size Special Filter Graphic Retro Y N Y N Y N Quit List Exams Confirm [Image FLR] enables you to flip left/right the image by series. Image FLR 2-22

85 SCAN TOP LEVEL SCREEN Retro Recon 3 4. Enter the parameter changes and select [Confirm]. - Retro Start : Start location of retro recon - Retro End : End location of retro recon - Image Int'val : Image interval (in case of Helical) - DFOV : Display Field of View: 48mm (minimum)-sfov (maximum) - DFOV A/P R/L Center : Anterior/Posterior and Right/Left center of DFOV - Recon Type : SOFT, STND, STD+, DETL, CHEST, BONE, EDGE - Image Filter : Smooth (S1, S11, S2, S21, S3), Edge (E1, E2, E21, E22, E23), Lung (L1, L2, L3) - Motion Correct : Motion correction - Recon Mode : (See next page.) - Matrix Size : 256x256, 320x320, or 512x512 - Special Filter : ANR (Advanced Noise Reduction) (1 or 2), AAR (Advanced Artifact Reduction) (1 or 2) ANR filter allows you to reduce noise without compromising spatial resolution. It contributes to a decrease in standard deviation by approximately 10%, which may be equivalent to one-step decrease in ma. Note : ANR is compatible only with SOFT, STND, STD+. AAR filter allows you to reduce artifacts shown around arms. When you click on the [Special Filter] button or the each Special Filter field, the following menu appears. Select the desired Special Image Filter. None ANR 1 ANR 2 AAR 1 AAR 2 Cancel [ANR 2] has a stronger effect than [ANR 1]. Also, [AAR 2] has a stronger effect than [AAR 1]. Select either of them or select [None] not to use these filters. 2-23

86 SCAN TOP LEVEL SCREEN Retro Recon 4 - Graphic Retro : If you wish to display on the image the circle cursor to graphically prescribe the retro recon area instead of typing in DFOV, R/L Center and A/P Center, toggle N (No) on each field to Y (Yes). If the displayed circle cursor is too big to handle, type in the smaller enough DFOV to display the entire circle cursor, then change its size and location using one of four squares outside the cursor and the center dot of the cursor respectively to designate the recon area. 5. Select the [Recon Mode] button to open the following screen. (*Smart Helical Option is needed to have [Plus] button.) Recon Mode section allows you to edit the scan type and the amount of data for reconstruction. Recon Mode Axials: Full Helicals: Segment Full Plus Cines: Segment Full OK Cancel The scan types available to edit will be active. [Full] uses full-rotation data, whereas [Segment] uses partial-rotation data. *Smart Helical Option offers [Plus] function that uses 1.6-rotation data. Make the appropriate selection. 6. Click on the [Confirm] button to start retro recon. Newly retro-reconstructed images will be saved as a new series with "Retro" annotation. 7. If you need to retro-recon another exam/series, select [List Exams] button. Select [Quit] to exit. 2-24

87 SCAN TOP LEVEL SCREEN Recon Management 1 Recon Management icon is located at the right side of the Retro Recon icon. Recon Mgmt Function : Within the Recon Management function, you can have access to Suspended Entries and Recon Queue Management. 1. Select [Recon Mgmt] to open the following screen. Recon Management Suspended Entries Patient ID Exam # Series # Image # Type Delete Suspended Entries Unsuspended Update Entries List Prior Next Recon Queue Management: Pause Queue Restart Queue View Queue Entries Delete Retro Entries Quit Functions of each button are described on the following pages. 2-25

88 SCAN TOP LEVEL SCREEN Suspended Entries Recon Management 2 These are basically images that were not reconstructed for some reason and were placed in a Queue. [Delete Suspended Entries] Select this button to delete the suspended entries. Once the images are deleted, they can not be reconstructed prospectively, but they can be reconstructed retrospectively. [Unsuspended Entries] Select this button to try to reconstruct the images again after selecting image entries. [Update List] Select this button to update the Unsuspended Entries List if any entries need to be added while Recon Management was open. Recon Queue Management [Pause Queue] Select this button to stop the reconstruction process. This might be useful if you have just started a Retro Recon, but maybe incorrect parameters were entered. Instead of having the system reconstruct all of the incorrect images, you can select [Pause Queue] to stop the reconstruction and then delete the images that have not been yet reconstructed. [Restart Queue] Select this button to restart the reconstruction queue after you stopped it for some reason. [View Queue Entry] Select this button to display a menu that shows what is in the reconstruction queue. You can select [Cancel] to leave the View Queue function or select [Update List] to update the queue entries list. [Delete Retro Entries] Select this button to delete entries that remain in the reconstruction queue. This is used in conjunction with [Pause Queue]. 2-26

89 SCAN TOP LEVEL SCREEN Tube Warm-up Tube Warmup icon is located below the Retro Recon icon. Tube Warmup Function : Tube Warmup allows you to have access to the Tube Warm-up and Daily Calibration procedure. 1. Click on the [Tube Warmup] icon.the following screen will appear.[tube Warmup] button on the screen allows you to conduct only the tube warm-up procedure. [Daily Calibration] allows you to perform both the tube warm-up and daily calibration procedures.[daily Calibration]is selected by default. Tube Warmup Daily Calibration Tube Warmup Menu1 Warming up the tube as recommended will provide the high quality images and extend the life of the tube. Make sure that no one is in the scan room and the gantry aperture is clear during warmup. Cancel OK 2. Select the [Tube Warmup] button, the[ok]to proceed to the tube warmup procedure or select the [Cancel] button to exit. 2-27

90 SCAN TOP LEVEL SCREEN Tube Warmup 2 3. Upon selection of [OK],the following scan menu will appear.select [Confirm] to initiate the tube warm-up. Service Scan Service Tool: Warm up Scan Exam ID: Menu 2 Scan Type Axial Scan Time 5.0 seconds Voltage 120 kv Current 80 ma Thickness 1.0 mm Focus Large Remaining scan : 9 Press <Confirm> and <Start scan> to start scan Cancel Confirm 4. Several seconds after selecting [Confirm],the [Start Scan] button on the keyboard flashes.press it to start X-ray radiation. The system automatically performs four tube warm-up scans. Note : When you select the [Tube Warmup] button more than 30 hours later since the last daily calibration,the following message will be posted to urge you to perform daily calibration. Warning Please execute Daily Calibration to provide the high quality images. Do you continue the tube warmup? Yes No Selecting [Yes] leads you to Menu 2 and [No] to Menu

91 SCAN TOP LEVEL SCREEN Tube Warmup 3 5. When you select the [Daily Calibration] at Menu 1,Menu 2 will appear. Service Scan Service Tool: Warm up Scan Exam ID: Menu 2 Scan Type Axial Scan Time 2.0 seconds Voltage 120 kv Current 80 ma Thickness 1.0 mm Focus Large Remaining scan : 73 Press <Confirm> and <Start scan> to start scan Cancel Confirm Upon selection of [Confirm], the system first performs the same scan protocol as Tube Warmup and daily calibration later. 2-29

92 SCAN TOP LEVEL SCREEN Scanner Utilities 1 Raw Data Function Scanner Utilities icon is located at the right side of the Tube Warmup icon. Scanner Utilities Function : From Scanner Utilities you can have access to either Rawdata Funtion or User Calibration. Note : Make sure which drive do you installed in the system. If you install the MOD drive, Rawdata will save to 3.5 MOD; If you install the DVD drive, Rawdata will save to the DVD. Below is MOD drive, UIF appear as following: 1. Click on the [Scanner Utilities] icon. The following screen will appear. Scanner Utilities Rawdata Functions User Calibration Quit 2-30

93 SCAN TOP LEVEL SCREEN 2. Select [Rawdata Functions] to open the following default screen. This screen will also appear when you select [Save to MOD] from the pulldown menu of Function Selection. (See next page.) File Function Selection Rawdata Selection Select RawData Exam: Exam # Name Save Rawdata to MOD Date Reserve Exam No: Series # Type Acqus Reserve Patient Position Series No: Acqs # Type Rotation Azimuth Location Scan Time kv ma Thick Focus SFOV Reserve Date/Time Start Save 2-31

94 SCAN TOP LEVEL SCREEN Scanner Utilities 2 Raw Data Function File Exit Function Selection Save to MOD Restore/Delete from MOD Reserve/Release Initialize MOD Rawdate Selection Whole Exam Whole Series Individual Raw When you select the [File] button, the [Exit] button appears. Select [Exit] to exit from Rawdata Functions. When you select the [Function Selection] button, the pulldown menu appears which contains the [Save to MOD], [Restore/Delete from MOD], [Reserve/Release] and [Initialize MOD] buttons. When you select the [Rawdata Selection] button, the pulldown menu appears which contains the [Whole Exam], [Whole Series] and [Individual Raw] buttons. 2-32

95 Save Rawdata to MOD SCAN TOP LEVEL SCREEN Scanner Utilities 3 Raw Data Function When you select [Save to MOD] from the [Function Selection] pulldown menu, the following screen will appear. File Function Selection Rawdata Selection Select RawData Exam: Exam # Name Save Rawdata to MOD Date Reserve Exam No: Series # Type Acqus Reserve Patient Position Series No: Acqs # Type Rotation Azimuth Location Scan Time kv ma Thick Focus SFOV Reserve Date/Time Start Save 1. Select any of raw data that you wish to save to MOD (Magnetic Optical Disk). You can also use [Whole Exam], [Whole Series] or [Individual Raw] button from the [Rawdata Selection] pulldown menu. 2. After selecting the raw data, click on the [Start Save] button to start saving the raw data into the MOD. Note : Image data must be stored in other MOD(s) than the one for raw data. 2-33

96 SCAN TOP LEVEL SCREEN Restore/Delete from MOD Scanner Utilities 4 Raw Data Function When you select [Restore/Delete from MOD] from the [Function Selection] pulldown menu, the following screen appears. File Function Selection Rawdata Selection Restore/Delete from MOD Select RawData Exam: Exam No: Exam # Name Date Reserve Series # Type Acqus Reserve Patient Position Series No: Acqs # Type Rotation Azimuth Location Scan Time kv ma Thick Focus SFOV Reserve Date/Time Restore Delete 1. Select any of raw data that you wish to restore from MOD to the system disk, or that you wish to delete from MOD. You can also use [Whole Exam], [Whole Series] or [Individual Raw] button from the [Rawdata Selection] pulldown menu. 2. After selecting the raw data, click on the [ Restore] or [Delete]. 2-34

97 Reserve/Release Rawdata SCAN TOP LEVEL SCREEN Scanner Utilities 5 Raw Data Function When you select [Reserve/Release] from the [Function Selection] pulldown menu, the following screen will appear. File Function Selection Rawdata Selection Reserve/Release Rawdata Select RawData Exam: Exam No: Exam # Name Date Reserve Series # Type Acqus Reserve Patient Position Series No: Acqs # Type Rotation Azimuth Location Scan Time kv ma Thick Focus SFOV Reserve Date/Time Reserve Release 1. Select any of raw data that you wish to reserve or release. ( "Reserve" rawdata means to protect rawdata from being deleted. "Release" rawdata means to release the protection.) 2. After selecting the rawdata, select [Reserve] or [Release]. 2-35

98 SCAN TOP LEVEL SCREEN Initialize MOD Scanner Utilities 6 Raw Data Function Use this function to initialize completely new MODs. (Previously initialized MODs for image storage can not be initialized by this.) When you select [Initialize MOD] from the [Function Selection] pulldown menu, the following screen will appear. Initialize MOD Initialize MOD will take approximately 3ñ4 minutes. Press Yes to continue or No to quit. Yes No 1. Select [Yes] to start initializing the MOD. 2. Select [No] to exit. 2-36

99 SCAN TOP LEVEL SCREEN Raw Data Function Below is DVD drive, UIF appear as following: 1. Click on the[scanner Utilities] icon.the following screen will appear. Scanner Utilities Rawdata Functions User Calibration Quit 2. Select [Rawdata Function] to open the following default screen. This screen will also appear when you select [Save to DVD] from the pulldown menu of Function Selection.(See next page.) File Function Selection Rawdata Selection Select RawData Exam: Exam # Name Save Rawdata to DVD Date Reserve Exam No: Series # Type Acqus Reserve Patient Position Series No: Acqs # Type Rotation Azimuth Location Scan T ime kv ma Thick Focus SFOV Reserve Date/T ime Start Save 2-37

100 SCAN TOP LEVEL SCREEN Raw Data Function File Exit Function Selection Save to DVD Restore/Delete from DVD Reserve/Release Initialize DVD Rawdate Selection Whole Exam Whole Series Individual Raw When you select the [File] button, the [Exit] button appears. Select [Exit] to exit from Rawdata Functions. When you select the [Function Selection] button, the pulldown menu appears which contains the [Save to DVD], [Restore/Delete from DVD], [Reserve/Release] and [Initialize DVD] buttons. When you select the [Rawdata Selection] button, the pulldown menu appears which contains the [Whole Exam], [Whole Series] and [Individual Raw] buttons. 2-38

101 Save Rawdata to DVD SCAN TOP LEVEL SCREEN Raw Data Function When you select [Save to DVD] from the [Function Selection] pulldown menu, the following screen will appear. File Function Selection Rawdata Selection Select RawData Exam: Exam # Name Save Rawdata to DVD Date Reserve Exam No: Series # Type Acqus Reserve Patient Position Series No: Acqs # Type Rotation Azimuth Location Scan T ime kv ma Thick Focus SFOV Reserve Date/T ime Start Save 1. Select any of raw data that you wish to save to DVD (Digital Video Disk). You can also use [Whole Exam], [Whole Series] or [Individual Raw] button from the [Rawdata Selection] pulldown menu. 2. After selecting the raw data, click on the [Start Save] button to start saving the raw data into the DVD. Note : Image data must be stored in other MOD(s) than the one for raw data. 2-39

102 SCAN TOP LEVEL SCREEN Restore/Delete from DVD Raw Data Function When you select [Restore/Delete from DVD] from the [Function Selection] pulldown menu, the following screen appears. File Function Selection Rawdata Selection Restore/Delete from DVD Select RawData Exam: Exam No: Exam # Name Date Reserve Series # Type Acqus Reserve Patient Position Series No: Acqs # Type Rotation Azimuth Location Scan Time kv ma Thick Focus SFOV Reserve Date/Time Restore Delete 1. Select any of raw data that you wish to restore from DVD to the system disk, or that you wish to delete from DVD. You can also use [Whole Exam], [Whole Series] or [Individual Raw] button from the [Rawdata Selection] pulldown menu. 2. After selecting the raw data, click on the [ Restore] or [Delete]. 2-40

103 Reserve/Release Rawdata SCAN TOP LEVEL SCREEN Raw Data Function When you select [Reserve/Release] from the [Function Selection] pulldown menu, the following screen will appear. File Function Selection Rawdata Selection Reserve/Release Rawdata Select RawData Exam: Exam No: Exam # Name Date Reserve Series # Type Acqus Reserve Patient Position Series No: Acqs # Type Rotation Azimuth Location Scan Time kv ma Thick Focus SFOV Reserve Date/Time Reserve Release 1. Select any of raw data that you wish to reserve or release. ( "Reserve" rawdata means to protect rawdata from being deleted. "Release" rawdata means to release the protection.) 2. After selecting the rawdata, select [Reserve] or [Release]. 2-41

104 SCAN TOP LEVEL SCREEN Initialize DVD Raw Data Function When you select [Initialize DVD] from the [Function Selection] pulldown menu, the following screen will appear. Initialize DVD Initialize DVD will take approximately 3 ñ4 minutes. Press Yes to continue or No to quit. Yes No 1. Select [Yes] to start initializing the DVD. 2. Select [No] to exit. 2-42

105 SCAN TOP LEVEL SCREEN Scanner Utilities 7 User Calibration 1. Select [User Calibration] to open the following screen. Calibration Sequence kv Air Calibration Air & Phantom Calibration Cancel OK 2. Select either [Air Calibration] or [Air & Phantom Calibration]. Also, select kv from 120 or Select [OK] to perform calibration scans, or [Cancel] to cancel. 2-43

106 SCAN TOP LEVEL SCREEN Blank page 2-44

107 Chapter 3 DISPLAY TOP LEVEL SCREEN The following screen will appear when you click on the [Display] icon on the upper left corner of the screen while in the either Scan or Image Works mode. Display Image Area 3-1

108 DISPLAY TOP LEVEL SCREEN Primary/Secondary Viewport Focus Selection "Focus" means which viewport is active for image display. There are two kinds of focus, which are primary and secondary focuses. Primary focus viewport has a blue border, whereas the secondary focus viewport has a yellow border. Every image analysis or manipulation function is available in primary focus. Image analysis or manipulation functions available in the secondary focus are as follows: Window W/L, Magnification, Pan/Zoom, Flip/Rotate, Display Normal, and Erase Graphics. You can select the primary or secondary focus by clicking on the desired viewport as follows: Double click To select primary focus viewport and deselect other viewports Single click To select a new primary focus viewport and change the previous primary to secondary Triple click To select a new primary focus viewport and change all the other viewports to secondary 3-2

109 DISPLAY TOP LEVEL SCREEN Image Display Layout Layouts On the Display desktop, there is a choice between two layouts for viewing images. They are the Autoview Layouts and the Review Layouts. During scanning the Autoview Layouts will primarily be used. Click on the left side of this button to select Autoview Layouts and on the right side for Review Layouts. Autoview Layouts Clicking here with Autoview Layouts leads to the screen format choice from eight formats. Clicking here with Review Layouts leads to the screen format choice of five format for Full Screen or Viewport. Autoview Layouts Each layout is described on the following pages. 3-3

110 DISPLAY TOP LEVEL SCREEN Autoview Layouts 1 1. Select Autoview Layouts at the Exam Rx Display menu to open the Autoview Layouts menu. Autoview Layouts Autoview Layouts menu Scout Auto Auto View Film Auto Link Auto View Auto Link Auto Link Auto View Back 3-4

111 DISPLAY TOP LEVEL SCREEN Autoview Layouts 2 There are four different types of viewport for six other Autoview Layouts. Autoview This viewport always displays in real time the most recently reconstructed image. Next/Prior buttons do not work here. Auto Reference This viewport displays a Scout image with reference lines that show the locations of Autoview images. Front Scout and side Scout can be toggled by Next/Prior buttons. Auto Film This viewport displays an image for auto filming and occupies the upper left quadrant. This can be done by selecting the folded corner at the top right of the viewport. To return the viewport to the cross reference display, select the folded corner again. AL (Auto Link) While reconstruction is active, the lower right viewport will automatically display the first image of the series being currently reconstructed. The viewport will be annotated with AL to indicate that Auto Link is on. All display features and Next/ Prior can be used with Auto Link. Free This viewport can be used to display any image from other exam or series. 3-5

112 DISPLAY TOP LEVEL SCREEN Review Layouts Multiple Image Display (MID) Review Layouts can be used during scanning, but you will be unable to view the current autoviewed image or autofilming. 1. Display an image in primary focus viewport. 2. Select Review Layouts at the Exam Rx Display menu to open the Review Layouts menu. Review Layouts [Full Screen Format] [Viewport Format] Review Layouts menu 3. Select [Full Screen Format] to display the selected layout on the entire screen. Select [Viewport Format] to display the selected layout in primary focus viewport. 4. Select one of the four formats. 3-6

113 DISPLAY TOP LEVEL SCREEN List/Select 1 Selecting this function will give you a listing of the exams and other information about the exams on the system disk. 1. Select List / Select at the Exam Rx Display menu. List / Select 2. The following List/Select browser appears. Note : The List/Select browser does not appear when the system disk contains no data. A B Sort Examinations : Exam #47, May 05 92, SMITH, JON Exam Name Date Description Mod Fmt A Ser Type Imgs Description Mod 3145 J.Herman Jan CT 1 PROSP 18 CT 3512 B.Fox Dec CT Series Img Img Ctr Thck/SP Gntry SñI (mm) (mm) (deg) Img Ctr RñL 2 examinations Img Ctr AñP SFOV (cm) Res Matrix Midscn Archive one series S 50.0 S 45.0 S 40.0 S 35.0 S 30.0 S / 10.0/ 10.0/ 10.0/ 10.0/ 10.0/ +0.0 R5.0 A Lung R5.0 A Lung R5.0 A Lung R5.0 A Lung R5.0 A Lung R5.0 A Lung 512 No No No No No No Accept Number of images stored: 1101, Available disk space: x256 image(s), or x512 image(s). 60 images Cancel C A : Examination List B : Series List C : Image List 3-7

114 DISPLAY TOP LEVEL SCREEN List/Select 2 3. Select exam, series and image to display. 4. Click on the [Accept]. Once all images are loaded, the first image in the series will be displayed in a primary focus viewport (blue border). 5. Use [Next] or [Prior] key on the keyboard to go through images forward or backward. Click on the [Cancel] to exit without selecting anything. 3-8

115 DISPLAY TOP LEVEL SCREEN Routine Display 1 1. Select [Routine Display] at the Exam Rx menu. Routine Display 2. The following Routine Display menu will appear. Routine Display Roam Zoom Explic it Magnify Flip/ Rotate ProView GSE Display Normal List/ Select Ellipse Measure Grid ROI Distance On/Off Cross User Exam Pg Reference Annotation Series Pg Hide Graphics Erase Screen Save Back 3. Click on [Back] to return to Exam Rx menu. Function of each icon is described on the following pages. 3-9

116 DISPLAY TOP LEVEL SCREEN Roam / Zoom Routine Display 2 1. Place the desired image in primary focus viewport. 2. Select [Routine Display] at the Exam Rx menu to open the Routine Display menu. 3. Select [Roam] or [Zoom] on the Routine Display menu. 4. After selecting [Roam], place the mouse cursor over the image you wish to roam and hold down the right mouse button, then move the mouse to roam the image. When you release the mouse button, the image will be deposited on that point. Select [Display Normal] to return the image to its original position. After selecting [Zoom], place the mouse cursor over the image you wish to zoom and hold down the right mouse button, then move the mouse right (or up) to magnify or left (or down) to minify the image. When you release the mouse button, the image will retain the zoom and the magnification factor will be displayed at the bottom of the annotation on the upper right of the image. The valid magnification ranges are from 0.5 to 8 and from1.0 to 4.0 in a 1024 matrix viewport. Select [Display Normal] to return the image to its original size. 3-10

117 DISPLAY TOP LEVEL SCREEN Routine Display 3 Explicit Magnify This function allows you to numerically set an image magnification factor. 1. Select [Routine Display] and click on [Explicit Magnify] on the Routine Display menu. 2. The following Enter Magnification on Factor menu appears. Enter Magnification Factor Other: Valid magnification factors are between 0.5 and 8.0. Cancel 3. Select one of the preset magnification factors or type in your own. The valid ranges are from 0.5 to 8.0 and from1.0 to 4.0 in a 1024 matrix viewport. 4. This magnification will be applied to all viewports in focus. Select [Display Normal] to return the image to its original size. 3-11

118 DISPLAY TOP LEVEL SCREEN Routine Display 4 Flip/Rotate 1. Place the desired image in primary focus and select [Routine Display]. 2. Select [Flip/Rotate] on the Routine Display menu. 3. The following Flip/Rotate menu appears. FLIP: FLIP/ROTATE FLR FTB FTB/FLR ROTATE: RR RL Cancel 4. Select one from FLR (Flip Left to Right), FTB (Flip Top to Bottom), FTB/ FLR, RR (Rotate to Right) or RL (Rotate to Left). 5. This selection will be applied to all viewports in focus. Select [Display Normal] to return the image to its original orientation. 3-12

119 DISPLAY TOP LEVEL SCREEN Routine Display 5 ProView This function allows you to select an edge enhancement or smoothing filter to be applied to images. 1. Images must be in primary focus. 2. Select [ProView] on the Routine Display menu. 3. The following Select Image Filter menu appears. Select Image Filter Edge E1 E2 E21 E22 E23 E3 Lung Smooth S1 S11 S2 S21 S3 Off Cancel 4. Click on any button of the selections. The Edge enhancement filters are useful for filming bone windows. The Lung enhancement is designed specifically to film lung windows. E1 : Weak E2 : Moderate E3 : Intense Lung : Lung window Note : When a filter is applied, images are annotated as E1, E2, E3 or Lung above the vertical tickmark scale on the right side of the image. The Smooth filters are used to film soft tissue windows or when you need to decrease the appearance of noise on images. S1 : Minimum S2 : Moderate S3 : Maximum Off : Without filter Note : When a filter is applied, images are annotated as S1, S2 or S3 above the vertical tickmark scale on the right side of the image. Note : These filters can also be selected on the Auto Film Tab card. Note : These filters can not be applied to Scout images. 3-13

120 DISPLAY TOP LEVEL SCREEN Routine Display 6 GSE (Gray Scale Enhancement) This function allows you to alter the slope and gamma curve. This is useful in head studies to improve the gray-white matter differentiation. 1. Images must be in primary focus. 2. Select [GSE] on the Routine Display menu. 3. The following Gray Scale menu appears. Gray Scale G1 G2 G3 Off Cancel 4. Click on any of the selections. G1 : Weak G2 : Moderate G3 : Intense Off : No filter Note : When a filter is applied, the image is annotated as G1, G2 or G3 just above the vertical tickmark scale on the right side of the image. Note : These filters can also be selected on the Auto Film Tab card. Note : These filters can not be applied to Scout images. Display Normal 1. Images must be in primary focus. 2. Select [Display Normal] to return an image to its normal state if Roam/ Zoom, Explicit Magnify, Flip/Rotate and ProView are used. It will also erase graphics for Elliptical ROI, Measure Distance, Grid, Cross Reference and User Annotations. 3-14

121 DISPLAY TOP LEVEL SCREEN Routine Display 7 List / Select 1. When you select [List/Select], the browser appears. 2. You can then select an image to view in a viewport or viewports, depending on what is in focus. Simply select an Exam, Series and Image, then select [Accept]. Ellipse ROI 1. Images must be in primary focus. 2. Select [Ellipse ROI] to perform a Region Of Interest measurements. 3. The ellipse ROI cursor will be displayed in blue (active) on the image. To move the ROI cursor, place the mouse cursor in the center of the ellipse, then click and drag it with the left mouse button. The other way to move the ROI cursor is to place the mouse cursor on the number next to the ellipse or on the line, then click and drag it with the left mouse button. To change the size, click and drag the small box outside the ROI cursor. To rotate the ROI cursor, click and rotate the solid cursor on the line. 4. Place the mouse cursor out of the ellipse, then, click the left mouse button once to calculate the ROI of the ellipse. The ellipse ROI cursor turns white (inactive) and is deposited there. Note : Once the ellipse ROI cursor turns white, it can not be modified, but you can turn it blue again by placing the mouse cursor inside the ROI cursor and click the left mouse button once. Then, you can change the size and location of the ROI cursor again. The figures of the Mean, Standard Deviation and Area are displayed at the bottom right of the image. The ROI measurements can be done many times, but the system will display only the last three results on the image. Select [Erase] to erase the ROI. 3-15

122 DISPLAY TOP LEVEL SCREEN Measure Distance Routine Display 8 1. Images must be in primary focus. 2. Select [Measure Distance]. 3. A line with two small boxes at each end will appear in blue (active). 4. To move the line, place the mouse cursor on the line and hold down the left mouse button, then drag the line to a new location. To change the length of the line, place the mouse cursor over the small box and hold down the left mouse button, then drag the box until you get a desired length. 5. Place the mouse cursor out of the line, then, click the left mouse button once to calculate the length of the line. The line turns white (inactive) and is deposited there. Note : Once the line turns white, it can not be modified, but you can turn it blue again by placing the mouse cursor on the line and click the left mouse button once. Then, you can change the length and location of the line again. At the bottom right of the image area, a real time readout of the distance will be shown. The Distance measurement can be done many times, but the system will display only the last three results on the image. Select [Erase] to erase the line. Grid 1. Images must be in primary focus. 2. Select [Grid On/Off]. 3. The grid appears on the image. 4. To move the grid, first click left on the center of the grid. It becomes active (blue), then drag it to the desired position. To deposit the grid, click outside the grid. 5. To take the grid off, click on [Grid On/Off] again. 3-16

123 DISPLAY TOP LEVEL SCREEN Routine Display 9 Cross Reference This function allows you to display the cross reference lines on a Scout image. 1. Display a Scout image in primary focus. 2. Select [Cross Reference]. The following Post Reference Lines menu appears. Post Reference Lines Series Number Image Numbers All First/Last Increment OK Cancel 3. [Series Number] : Enter the desired series number. [Image Number] : Enter the desired image number. [All] : Select this for all images. [First/Last] : Select this to show only the first and last image line. [Increment] : Select this to show image lines with incremental interval. 4. Select [OK] to display the image lines on the Scout or select [Cancel] to exit. 3-17

124 DISPLAY TOP LEVEL SCREEN User Annotation Routine Display Images must be in primary focus. 2. Select [User Annotation] to show the following active (blue) arrow cursor on the image. 3. You can move both the box and arrow at once by placing the mouse cursor anywhere on the blue line, then click and hold down the left mouse button, then move it. You can move just the arrow or box by the same way except you would place the mouse cursor on just the area you wish to move instead of the blue line. 4. Type in the necessary information, then click the left mouse button outside the image area to conclude the type entry. Make sure when typing the annotation that the mouse cursor is inside the image area. 3-18

125 Exam Pg / Series Pg DISPLAY TOP LEVEL SCREEN Routine Display Select [Exam Pg] or [Series Pg] to open the exam page or series page of the exam in primary focus. 2. The following is an example. Text Page Box Pat. name: T. YOKOGAWA Pat. ID: Y8120 Age: 34 Sex: M Weight: 65 Kg Exam no: July Referred by: Radiologist: Operator: Exam Description: History: Contrast: Ser Images Ref Scan Range Type Series Description 2 18 OM S 50 I115 PROSP Recon SN I65 I350 PROSP Quit Manual Film Auto Film Use buttons on the lower right to go through pages. 3. Select [Manual Film] to put the page into Manual Film Composer or select [Auto Film] to put the page into Auto Film Composer. 4. Select [Quit] to exit from the page. 3-19

126 DISPLAY TOP LEVEL SCREEN Hide/Show Graphics Routine Display Select [Hide Graphics] to temporarily hide any graphics, annotation or measurement. 2. The [Hide Graphics] button works as a toggle. Once you have selected Hide, then the button changes to [Show Graphics], allowing you to show any graphics, annotation or measurement. Erase The Erase function allows you to erase annotations, cursors and measurements. To erase, simply click on [Erase]. If you have multiple annotations or cursors on the image, the erase function will erase the active one (blue). Screen Save Screen Save will save everything that is on the image in primary focus. 1. Images must be in primary focus. 2. Select [Screen Save]. Note : Screen Saved image will be kept under series number

127 DISPLAY TOP LEVEL SCREEN Measurements 1 [Measurements] provides access to the more advanced image measurements Measurements Clicking on [Measurements] opens the following menu. Box ROI Ellipse ROI Trace ROI Measure Distance Measure Angle Grid On/Off Hide Graphics Erase Screen Save MIROI Report Pixels Back 3-21

128 DISPLAY TOP LEVEL SCREEN MIROI (Multiple Image ROI) Measurements 2 This function gives a graphical representation of CT number change over time. This is useful for multiple scans done at one location or for segmented reconstruction of a scan. 1. Images must be in primary focus. 2. Select [MIROI] from the Measurements menu. The following menu appears. MIROI Analysis Image Range All Scale for HU Absolute Relative Define Region Ellipse ROI Box ROI Trace ROI OK Cancel 3. The first selection on the menu is Image Range. The default is All.If you wish to select certain image range, first click on [All] to turn it off, then type in the number range. 4. The next selection is Scale for HU (Hounsfield Units). The default is Relative, meaning the HU scale will display the first CT number as zero and display the difference in CT numbers from one scan to another. The Absolute scale will display the actual CT numbers and the difference from one scan to another. 5. Define Region selection allows you to choose the Ellipse, Box or Trace ROI. 6. Choose [OK] to continue or [Cancel] to cancel the function. Once you select [OK], the analysis will be automatically done with the resultinggraph displayed. You can use [Screen Save] to save the plotted graph. 3-22

129 DISPLAY TOP LEVEL SCREEN Measurements 3 Report Pixels This function allows you to get individual pixel values readings from a certain small area. 1. Select [Report Pixel] from the Measurements menu. 2. An 11x11 pixel box will appear along with the Report Pixels menu.the size of the pixel box can not be changed but you can move the box to the desired location by clicking and dragging on the letters RP or on the box itself. 3. Once you placed the box, select [OK]. Report Pixels Position Box and Select OK OK Cancel A graph like the following example will be displayed showing the pixel values within the box. ID: 8120 Report Pixels I 165 I 166 I 167 I 168 I 169 I 170 I 171 I 172 I 173 I 174 I 175 I 84 I 85 I 86 I 87 I 88 I 89 I 90 I 91 I 92 I 93 I You can save this chart by [Screen Save]. 3-23

130 DISPLAY TOP LEVEL SCREEN Display Preference 1 Display Preference provides access to functions that affect how images will be displayed. 1. Select [Display Preference] from the Exam Rx menu. Display Preference 2. The following Display Preference menu appears. Annotation Levels Maintain User Annotation (Not available) Auto Minify (Not available) Inverse Video Auto Enlarge (Not available) Next/Prior Each Viewport Next/Prior Series Binding Continuous Report Cursor Back 3-24

131 Annotation Levels DISPLAY TOP LEVEL SCREEN Display Preference 2 This function allows you to change the annotation levels of the screen and film. 1. Select [Annotation Levels] from the Display Preference menu. The following menu appears. Annotation Levels Screen No Annotation Partial Annotation Full Annotation Custom Annotation Film No Annotation Partial Annotation Full Annotation Custom Annotation Customize Save as default Customize Cancel 2. You can change the annotation level by clicking on the diamond or the words for Screen and Film. The selected choice will be highlighted in blue. - No Annotation : Only window width and level - Partial Annotation : Exam number, image number, anatomic reference, table location, patient name, date of exam, RAS coordinate, and the measuring scale - Full Annotation : All image annotations (Default) - Custom Annotation : Customized annotation 3-25

132 DISPLAY TOP LEVEL SCREEN Display Preference 3 3. Select [Customize] to review or edit the annotation levels of Advanced Annotation. The following menu appears. Customize 1. Hospital Name 2. Patient Name 3. Patient ID 4. ESI Information 5. Scan Time 6. Scan Parameters 7. View Parameters 8. Top Marker 9. Bottom Marker 10. Left Marker 11. Right Marker W. Windowing G. Graphic Annotation 14. Display Parameters 15. Filter 16. Date of Birth W. Windowing G. Graphic Annotation OK Cancel 4. Click on to select the items of annotation. 3-26

133 Next/Prior Each Viewport DISPLAY TOP LEVEL SCREEN Display Preference 4 This function is used with a multiple image display. With this function on, when you select to look at the next or prior set of images, you will only get one new image each time you select next or prior. With this function off, selecting the next or prior image in the multiple image display will give you a new set of images. The default is off. Next/Prior Series Binding With this function on, you can go to the next or prior series within an exam if you reach the end of a series using the next or prior image functions. With this function off, when you reach the end of a series, selecting nextimage will return you to the first image of that series. Continuous Report Cursor This function allows you to see the RAS coordinates when you place the mouse cursor on an image. When the function is on, place the mouse cursor on the area of interest. The coordinate readout will be displayed at the bottom of the image annotation, on the upper left of the viewport. You will notice a V, denoting the CT number of the one pixel located directly under the cursor. This information does not show up when filmed. 3-27

134 DISPLAY TOP LEVEL SCREEN Manual Film Composer Refer to the later chapter for the detailed function description. 1. Select [Manual Film Composer] from the Exam Rx Display menu. [Manual Film Composer] 2. The following Film Composer will appear. Film Composer Formats Laser Camera Options Clear Current status is : Print 3-28

135 DISPLAY TOP LEVEL SCREEN Auto Film Composer Refer to the later chapter for the detailed function description. 1. Select [Auto Film Composer] [Auto Film Composer] 2. The following Auto Film Composer will appear. Auto Film Clear Print 3-29

136 DISPLAY TOP LEVEL SCREEN Accelerator Bar 1 There is an Accelerator Bar at the bottom of the Exam Rx menu. Accelerator Bar You can type in here various commands to invoke various functions. Command Abbreviation Contents filter fi e1, e2, e3, s1, s2, s3, lung, off gray scale enhance gse g1, g2, g3, off exam e e<exam#> image i i<image#> next exam ne next series ns previous exam pe screen annotation none an screen annotation partial screen annotation full screen annotation custom annotation groups agp on(off) x x x auto fit afit flip left right flr flip top bottom ftb ap af ac 3-30

137 DISPLAY TOP LEVEL SCREEN Accelerator Bar 2 Command Abbreviation Contents rotate left rl rotate right rr normal no scroll sc <x pixel> <y pixel> window level wl window width ww set initial windowing siw zoom zo <factor> inverse iv angle ang <x1><y1><x2><y2><x3><y3> cross ref xr [s]<series#> cross ref append xra cross ref off noxr tick marks tm on, off tick mark vertical tmv on, off tick mark horizontal tmh on, off grid grid on, off user annot ua erase graphic eg erase all graphics eag hide graphics hg show graphics sg print series prs text page exam te text page series ts text page roi tpr 3-31

138 DISPLAY TOP LEVEL SCREEN Accelerator Bar 3 Command Abbreviation Contents mouse mode scroll mmr mouse mode zoom mmz user test utp page series binding sb on, off r image matte rmatte e image matte ematte screen save scnsave blank viewport blank report pixel rp 3-32

139 SCAN Chapter 4 Patient Positioning 1 The scan procedure starts with patient positioning. Image quality depends on proper patient positioning. Poor patient positioning may result in artifacts and inaccurate CT value. WARNING! Avoid patient injury! Use the security straps provided with the system to immobilize the patient. The security straps secure the patient to the table and prevent the patient from falling to the floor. Never leave a patient unattended while the patient is in the scan room. A violent patient may break the straps or become unsecured. Be extremely careful with patient IV or oxygen lines, patient's hands and feet and loose clothing to avoid patient injury during table travel. The cradle has a maximum distribution load capacity of 400 pounds (180 Kg). Exceeding this load limit could affect some mechanical performance. 4-1

140 SCAN Patient Positioning 2 1. In order to safely lay a patient on the cradle, make sure first that the cradle is locked. (Refer to Chapter 1 for the function of Gantry Display Panel.) Interference Distance from Iso Center (mm) Distance from Landmark (mm) Tilt/Angle Range X ray On 2. Press a Positioning Light button on the Gantry Control Panel to light a Halogen marker Panel.). (Refer to Chapter 1 for the function of Gantry Control 3. Match the Halogen marker to an anatomical landmark of the patient by using control buttons on the Gantry Control Panel. External beam 190 mm Internal beam Tomographic plane Patient positioning ends when the table location figure is displayed on the display panel. 4-2

141 Patient Positioning 3 SCAN Main landmarks for CT examination The following landmarks are usually used in CT examinations. OM GB EM SN XY CM UB IC SP GB : Glabella OM : Orbital Meatal line EM : External Auditory Meatus SN : Sternal Notch XY : Xyphoid CM : Costal Margin IC : Iliac Crest UB : Umbilicus SP : Symphysis Pubis 4-3

142 SCAN New Patient 1 Select [New Patient] to initiate a new examination. New Patient 1. Select [New Patient] to open the following Patient Information/Protocol Selection screen. Patient Information Protocol Selection Exam Number Accession Number Patient ID Patient Name Format:LastName^FirstName^Middle^Prefix^Suffix Birthdate Age mon day yr Sex Years Months Weeks Days Weight Kilograms Pounds Referring Physician Radiologist Operator History Exam Description Protocol Number Req.Proc.ID End Exam 2. Enter the patient demographic data. Note : As a minimum, the patient ID must be entered. - Exam Number : (within 12 characters) - Accession Number : (within 16 characters) - Patient ID : (within 16 characters) - Patient Name : (within 64 characters) 4-4

143 New Patient 2 SCAN - Sex : M (Male) or F (Female) - Birthdate : Year, Month, Day - Age : Years, Months, Weeks, Days - Weight : Kgs or Pounds - Referring Physician : (within 32 characters) - Radiologist : (within 32 characters) - Operator : (within 3 characters) - History : (within 60 characters) - Exam Description : (within 22 characters) - Protocol Number : (within 5 characters) Note : Patient Name and Exam Description will be posted in Image Works Browser. 3. Each of the ten anatomic regions contains 15 protocols. To select the default protocol for the region, point and click on the protocol next to the number. To view and select one of the 15 protocols for the region, point and click on the region itself on the full body icon. 4. When scanning a pediatric patient, the Pediatric Anatomical Selector is initiated by touching the pediatric icon. This will minify the Adult Anatomical Selector. Upon the selection of the protocol, the system automatically proceeds to the Scout prescription screen on the next page. 4-5

144 SCAN Scout Scan 1 Scout Prescription Screen When you finish entering the necessary data on the New Patient screen, the following screen will open for Scout scan prescription. Name : ID : Protocol : Exam: Series: Anatomical Reference Image Area Series Description Auto Store Auto T ransfer Add Scout Delete Selected Scout Scout Num Scan Type Start Loc. End Loc. kv ma Scout Plane Auto Voice No. 1 Scout 2 Scout End Exam Select New Protocol Next Series Create New Series Repeat Series One More Confirm Note : Make sure the patient's position in the protocol you have selected matches that on the CT table. Compare your patient's position with the onscreen picture in the upper left corner of the screen. Changes to the patient's position in the protocol can be made by Arrow icons on the picture. In order to reverse the position of Head-first or Feet-first, point and click on the icon. In order to change the position of Decubitus left/right or Supine/Prone, point and click on the or icon. Before entering or modifying any starting or ending locations for a Scout view, the system will determine if an anatomic reference point has been established. If it has not, the starting and ending location parameters will be highlighted in red. To proceed, you must establish an anatomic reference point by using the internal or external landmark buttons on the gantry control. 4-6

145 Scout Scan 2 SCAN Image Area : Images will be displayed here. This image area can be enlarged to full screen by clicking on the small square icon located in the upper right corner. Icons on Scout prescription screen Add Scout Add Scout Select this to add the same Scout as the last one. Delete Selected Scout Delete Selected Scout Select this to delete the selected Scout series. End Exam End Exam Select this to end the current exam. Select New Protocol Select New Protocol Select this to return to the Protocol Selection screen and choose a new protocol for a different region. Next Series Next Series Select this to choose a next series in the protocol. 4-7

146 SCAN Scout Scan 3 Create New Series Create New Series Select this to create a new series. Repeat Series Repeat Series Select this to repeat the current series. One More One More Select this to repeat the current Scout series. Confirm Confirm Select this icon to accept the prescription and proceed to X-ray radiation. This icon will change to the following [Pause] icon during the scan. Pause Pause Select this icon to temporarily halt the scan. This icon will change to the [Resume] icon shown below during the pause. Resume Resume Select this icon to resume the scan. 4-8

147 Scout Scan 4 SCAN 1. Enter or modify each parameter for a Scout scan. - [Scan Type] : Select Scout. - [Start Loc.] : Scan start location - [End Loc.] : Scan end location Note : Scout locations must be preceded with S (superior) or I (inferior). "Superior" means the direction towards patient's head from the zero mm location, namely reference point. "Inferior" means the direction towards patient's feet from the zero mm location. Scout scans are performed from the superior to the inferior regardless of the patient position. Note : The valid Scout scan range is between 50 and 700mm. - [kv] : 120,140 kv(default 120 kv) - [ma] : ma (at 120 kv), ma (at 140 kv) - [Scout Plane] : azimuth: 5-degree increment (However, to be able to graphically prescribe axial or helical scan locations, the Scout planes must be zero, 90, 180 or 270 degrees only.) Note : If the data field is highlighted in orange, it means the original data has been modified. Also, if the data field is highlighted in red, it means the system can not accept that entry. 2. After entering or modifying parameters, select [Confirm] to initiate a Scout scan. The following Scan Progress screen appears. Exam:128 Series:1 Number Type kv ma Plane Start End 001 Scout S65.0 I120.0 Scan Progress 0 10 Seconds S65.0 I120.0 Scanning Delay Timer Patient Handling Biopsy Rx End Exam Next Series Repeat Series One More Repeat Last Group Priority Recon Pause 4-9

148 SCAN Scout Scan 5 3. Press [Move to Scan] button on the key board when it flashes. Scan Related Buttons on the Keyboard Move to Scan Stop Move Start Scan Pause X ray on Stop Scan 4. Press [Start Scan] button when it is lit. The system automatically starts the prescribed Scout scan. Note : A scan will be automatically aborted unless you press [Stop Scan] within 30 seconds after it is lit. 5. After finishing the first Scout scan, you may select [Repeat Series] button on the Scan Progress screen to repeat the same Scout series. 6. If there is an axial series in the protocol you used, you can proceed to Axial/ Helical View/Edit screen by clicking on [Next Series] button on the Scan Progress screen. 7. If you need to return to the Scout prescription screen, select the following [Return to Rx] icon. Measurements of Distance and/or Angle on the Scout image do not necessarily yield accurate data. To avoid misdiagnosis do not use those data. End of Scout scan If you wish to end the exam after the Scout scan, select [End Exam] on the Scan Progress screen. 4-10

149 Auto Store SCAN Function : Auto Store enables you to automatically store images to the media just after reconstruction. First make sure that an archive medium is placed in the MOD drive. MOD Drive 1. Click on [Auto Store] on the Axial View/Edit screen. Name : ID : Protocol : Exam: Series: Anatomical Reference Series Description Auto Store Auto Store AutomA OFF Show Localizer Auto T ransfer Auto Film Setup Recon Area 2. When Auto Store is on, all series will be automatically stored into the MOD after you click on [End Exam]. 4-11

150 SCAN Auto Transfer Function : Auto Transfer enables you to automatically transfer reconstructed images to another view station. 1. Click on [Auto Transfer] on the Axial View/Edit screen to open the Auto Transfer Remote Host Selection menu. Auto Transfer Remote Host Selection Host 1 Host 2 Transfer By Exam Transfer By Exam Transfer By Image Transfer By Image Host 3 Host 4 Transfer By Exam Transfer By Exam Transfer By Image Transfer By Image AW 1 AW 2 AW 3 AW 4 MR 1 MR 2 OK Cancel Prior Next 2. After clicking on [Host x], select host(s) from the list to which you wish to transfer the data. You can select up to four hosts (Host1-Host4). 3. After selecting host(s), choose either [Exam] or [Image] as the unit of transfer data. Then, select [OK] to close the menu. 4. In case of [Exam] selection, the system automatically starts to transfer data immediately after selecting [End Exam], whereas in case of [Image] the system automatically starts to transfer data immediately after completion of reconstruction. Note : This function can be applied to only Scout and prospective images. Other types of images, such as 3D, retrospective, or screen-saved, should be manually transmitted. 4-12

151 Axial/Helical Scan Prescription 1 SCAN Axial/Helical Prescription (View/Edit) Screen After Scout scan, you may proceed to the following Axial/Helical Prescription screen to perform Axial, Helical or Cine scans. Name : ID : Protocol : Exam: Series: Anatomical Reference Image Area Series Description Auto Store AutomA OFF Show Localizer Auto T ransfer Auto Film Setup Recon Area SmartRecon OFF Prior Next Add Group Split Current Group Delete Selected Group Scan Timing Recon Film Images Scan Type Start Loc. End Loc. No. of Images Thick (mm) Image Intíval Pitch Gantry Tilt SFOV kv ma CTDIvol DLP Optimize not needed Preview Biopsy Rx Smart Prep RX End Exam Select New Protocol Next Create Repeat One Series New Series More Series Priority Recon Confirm Image Area : Images will be displayed here. This image area can be enlarged to full screen by clicking on the small square icon located in the upper right corner. Prior/Next : Prior or Next key appears on the screen only when more than three groups are prescribed. 4-13

152 SCAN Axial/Helical Scan Prescription 2 Continuous Scan Modes This CT system provides continuous multiple 360-degree scan modes called Helical or Cine. Helical Scan : Continuous multiple 360-degree data acquisition is achieved with continuous table travel. Images taken with this mode are annotated as HE (Helical). Cine Scan : Continuous multiple 360-degree data acquisition is achieved without table travel. Images taken with this mode are annotated as CI (Cine). Maximum Helical/Cine Duration : 30 seconds ( 60 seconds = optional) Clinical Benefits of Helical/Cine Scans Scan speed Since there is no interscan delay between each slice acquisition, scan speed is much faster than conventional axial scans. Faster scan also helps reduce the total amount of contrast agent. No misregistration of anatomy Since one scan sequence is performed during patient's breath hold, it contributes to very little misregistration of anatomy. 4-14

153 Axial/Helical Scan Prescription 3 SCAN Prescribe Scan Parameters 1. Enter the parameters or modify them in the protocol if necessary. The following screen appears as default or when you click on the [Scan] icon. The screen changes when you click on the [Timing], [Recon] or [Film] icon to each own parameters one. Add Group Split Current Group Delete Selected Group Scan Timing Recon Film Images Scan Type Start Loc. End Loc. No. of Images Thick (mm) Image Intíval Pitch Gantry Tilt SFOV kv ma CTDIvol DLP Optimize not needed Preview Biopsy Rx Smart Prep RX End Exam Select New Protocol Next Create Repeat One Series New Series More Series Priority Recon Confirm When you wish to use the common parameters for all scan groups as to Scan Type, Thick, Image Int'val, Pitch, Gantry Tilt, SFOV, kv or ma, click on each column head and then select the alternative. When you wish to select parameters separately for each group, click on each data field. Each parameter is described on the following page. 4-15

154 SCAN Axial/Helical Scan Prescription 4 - [Scan Type] : Click here to open the following menu. Select the desired Scan Type Scan Type Axial Helical Cine Rotation Time Rotation Length Segment Full Plus OK Scan Type : Axial, Helical, Cine Rotation Time (second) : Time needed for 360-degree rotation ( "3.0" & "5.0" unavailable for Helical) Rotation Length : Amount of data for one scan (SmartHelical offers [Plus] that uses 1.6-rotation data.) - [Start Loc.] : Scan start location preceded with S (Superior) or I (Inferior). 0.1 increment with Helical - [End Loc] : Scan end location preceded with S (Superior) or I (Inferior). 0.1 increment with Helical - [No. of Images] : The number of images will be automatically calculated in the end of data entry. - [Thick (mm)] : 1, 2, 3, 5, 7,10 mm - [Image Int'val] : Image interval - [Pitch] : The ratio between the slice thickness and the distance a cradle travels during one rotation time in Helical scan (by 0.1 pitch) - [Gantry Tilt] : # 20 degrees (by 0.5 degrees) - [SFOV] : Scan Field Of View: Ped-Head (18 cm), Head (25 cm), Small (25 cm), Medium (35 cm), Large (43 cm), Shoulder-L (43cm) - [kv] : 120, 140 kv - [ma] : ma (at 120 kv), ma (at 140 kv) 5 ma increment - [CTDIvol] : Dose index for each group will be automatically calculated and shown. 4-16

155 Axial/Helical Scan Prescription 5 SCAN 1. Click on the [Timing] icon to open the following time parameters menu. Scan Timing Recon Film Prep Group (sec) ISD (sec) Breath Hold (sec) Breathe Time (sec) Auto Voice No. Click on each parameter item and select or type in the value. - [Prep Group] : Delay time between pressing [Start Scan] button and the start of X-ray radiation (0-300 seconds) - [ISD] : Inter-scan delay (1-300 seconds) - [Breath Hold] : Duration in which a patient is required to hold breath - [Breathe Time] : Patient breathing time - [Auto Voice No.] : Auto Voice setting number 4-17

156 SCAN Axial/Helical Scan Prescription 6 1. Click on the [Recon] icon to open the following reconstruction parameters menu. Scan Timing Recon Film DFOV (cm) R/L Center (mm) A/P Center (mm) Recon Type Image Filter Matrix Size Motion Correct Special Filter Click on each parameter item and select or type in the value. - [DFOV] : Display Field of View: 48 mm to 430 mm (by 1 mm) - [R/L Center] : Reconstruction center in the right or left direction preceded with R (Right) or L (Left) - [A/P Center] : Reconstruction center in the anterior or posterior direction preceded with A (Anterior) or P (Posterior) - [Recon Type] : SOFT, STND, STD+, DETL, CHEST, BONE, EDGE - [Image Filters] : Smooth (S1, S11, S2, S21, S3), Edge (E1, E2, E21, E22, E23, E3), Lung (L1, L2, L3) - [Matrix Size] : , , or [Motion Correct] : Motion correction Show Show Show Recon1 Recon2 Recon3 Y N N Note : Motion Correct does not apply to the following cases. Helical/Cine scans, 18/25cm SFOV, BONE/EDGE Recon Type, and Segment Rotation Length 4-18

157 Axial/Helical Scan Prescription 7 SCAN - [Special Filter] : ANR (Advanced Noise Reduction) (1 or 2) AAR (Advanced Artifact Reduction) (1 or 2) ANR filter allows you to reduce noise without compromising spatial resolution. It contributes to a decrease in standard deviation by approximately 10%, which may be equivalent to one-step decrease in ma. Note : ANR is compatible only with SOFT, STND, STD+. AAR filter allows you to reduce artifacts shown around arms. When you click on the [Special Filter] button or the each Special Filter field, the following menu appears. Select the desired Special Image Filter. None ANR 1 ANR 2 AAR 1 AAR 2 Cancel [ANR 2] has a stronger effect than [ANR 1]. Also, [AAR 2] has a stronger effect than [AAR 1]. Select either of them or select [None] not to use this filter. - [Show Recon 1, 2, 3] : These buttons are used for prospective multiple reconstruction. 4-19

158 SCAN Axial/Helical Scan Prescription 8 4. Click on the [Film] icon to open the following menu for auto filming. You may skip this procedure if you do not use autofilm. Scan Timing Recon Film Auto Film Frame Format Interval Flip Width 1 Level 1 Mag Factor Rotate User Anno. GSE Recon 1 Film Set 1 Recon 1 Film Set 2 Recon 2 Film Set 1 Recon 2 Film Set 2 Recon 3 Film Set 1 Recon 3 Film Set 2 Click on each button to enter or select data. - [Auto Film] : Toggle between autofilm On and Off. - [Frame Format] : Four formats - [Interval] : 1-5 sheets - [Flip] : FTB (Flip to Bottom), FTB/FLR (Flip to Bottom/Flip to Left Right), FLR (Flip Left Right) - [Width 1] : First choice of window width (1-4096) - [Level 1] : First choice of window level (-1024 to 3072) - [Mag Factor] : times - [Rotate] : Left 90 degrees, right 90 degrees, 180 degrees - [User Anno] : User annotation - [GSE] : Gray Scale Enhancement (G1, G2, G3, Off) 4-20

159 Axial/Helical Scan Prescription 9 Prospective Multiple Reconstruction SCAN Function : This enables you to prospectively prescribe up to two additional reconstruction sets for each scan group within one series. Make sure that the [Recon] icon is selected on the right side of View/Edit screen to prescribe Prospective Multiple Reconstruction. Scan Timing Recon Film Recon Y/N DFOV (cm) R/L Center (mm) A/P Center (mm) Recon Type Image Filter Matrix Size Motion Correct Special Filter N N Show Show Show Recon1 Recon2 Recon3 Y N N There are three buttons at the bottom of the Recon menu. They are [Show Recon 1], [Show Recon 2] and [Show Recon 3]. [Show Recon1 Y] is highlighted in blue and contains recon parameters prescribed beforehand. 1. Select [Show Recon2 N] to prescribe the second recon set. 2. Once [Show Recon2 N ] is selected, there appears [Recon Y/N] column at the left end of the Recon menu. These parameters are default from Recon1. You may change some or all of those parameters. The altered parameters will become those of Recon2. Lastly, toggle N (No) to Y (Yes) to allow the group to be reconstructed with those parameters. [Show Recon2 N] will be changed to [Show Recon2 Y] and highlighted in blue. - [DFOV] : Display Field of View: 48mm (minimum) to used SFOV (maximum) (by 1 mm) - [R/L Center] : Reconstruction center in the right or left direction preceded with R (Right) or L (Left) - [A/P Center] : Reconstruction center in the anterior or posterior direction preceded with A (Anterior) or P (Posterior) 4-21

160 SCAN Axial/Helical Scan Prescription 10 Prospective Multiple Reconstruction - [Recon Type] : SOFT, STND, STD+, DETL, CHEST, BONE, EDGE or PERM - [Image Filters] : Smooth (S1, S11, S2, S21, S3), Edge (E1, E2, E21, E22, E23, E3), Lung (L1, L2, L3) - [Matrix Size] : 256 x 256, 320 x 320 or 512 x [Motion Correct] : Motion correction - [Special Filter] : ANR (Advanced Noise Reduction) (1 or 2) AAR (Advanced Artifact Reduction) (1 or 2) ANR filter allows you to reduce noise without compromising spatial resolution. It contributes to a decrease in standard deviation by approximately 10%, which may be equivalent to one-step decrease in ma. Note : ANR is compatible only with SOFT, STND, STD+. AAR filter allows you to reduce artifacts shown around arms. When you click on the [Special Filter] button or the each Special Filter field, the following menu appears. None ANR 1 ANR 2 AAR 1 AAR 2 Cancel [ANR 2] has a stronger effect than [ANR 1]. Also, [AAR 2] has a stronger effect than [AAR 1]. Select either of them or select [None] not to use this filter. When you need to return to the parameters of Recon1, simply select [Show Recon1]. 3. If you need to perform the third reconstruction, select [Show Recon3], then take the same steps as Recon2. 4. Select [Confirm] to initiate a scan. Note : During the scan, only the set of Recon1 will be reconstructed. In order to activate Recon2 or 3, select any of the following buttons. [End Exam], [Create New Series], [Next Series], [Select New Protocol], or [Repeat Series] 4-22

161 Axial/Helical Scan Prescription 11 SCAN Icons of the Axial/Helical Scan Prescription screen (1) Autofilm Setup Autofilm Setup Select this icon to open the following menu for autofilming. Autofilm Setup Destination Laser Camera Formats Size Auto Start Auto Print Normal Slide Yes Yes Copies Exam Page Series Page Yes Yes Film Direction Top to Bottom Scout XRef Scout Auto Film Composer e/s/i Show Grayscale Yes OK Cancel Please refer to the later chapter of Filming for detailed descriptions. Show Localizer Show Localizer Click this icon to display the Scout image with graphical lines that show the scan locations prescribed beforehand. You can graphically modify the start/end location, interval, image number, or DFOV. Those changes will be reflected on the scan prescription screen in orange color. Please refer to the later pages for detailed descriptions. 4-23

162 SCAN Axial/Helical Scan Prescription 12 Recon Area Recon Area Select this to display a circle cursor over the image, then change the size and location of the cursor to designate the recon area instead of typing in DFOV, R/L Center and A/P Center at the Axial/Prescription screen. Add Group Add Group First select a certain scan group, then click on this to add that group just after the current group. Split Current Group Split Current Group Select this to split the selected scan group. 1. First select the desired scan group you wish to split. 2. Then, click on the above icon to open the following menu. Split Group Enter location or image number OK Cancel 3. Enter the location or image number at which you wish to split the group. Then, select [OK]. Note : If you enter an invalid number, the warning message will appear. "Image number is outside of group image range." 4-24

163 Axial/Helical Scan Prescription 13 SCAN Delete Selected Group Delete Selected Group First, select a scan group that you wish to delete, then click on this. Biospy Rx Biopsy Rx Select this to prescribe Biopsy Rx. Refer to the later pages for the function description of Biopsy Rx. 4-25

164 SCAN Axial/Helical Scan Prescription 14 Optimize Rx Optimize Rx When the system decides that some change in scan techniques is needed to complete the entire scan, this icon lights up in red. At this point you may enter the following Technique Optimize screen by clicking on it. Technique Optimize screen example Tube cooling is needed at image ; 26 Optimize Method : Group by Group Upfront Delay (sec) ma Group Delay (sec) Image 1ñ ñ65 Tube cooling is needed at image : At the top of the screen the message appears that informs you at which image the tube cooling will be needed with the current scan techniques. In the above example it is 26. Optimize Method : Optimize Method tells you how the change in technique will occur. In the above example it says "Group by Group" meaning the technique must be changed by scan group. Also, in the above example, since the image 26 belongs to the first group, all the images in the first group from 1 to 45 are equally subject to changes in technique. The system will calculate and display up to three factors for the scans to be able to continue. Those three factors are; - Upfront Delay (sec) : Pre-scan delay - ma : Tube current used for that scan group - Group Delay (sec) : Delay time between scan groups Rectifying any one of those three factors will display a message "Tube cooling is No Longer Needed" enabling the system to continue scans. Notice : When the system estimates the cooling time to be more than 600 seconds, it shows "--" in the [Upfront Delay] box. Finally select [Optimize in Progress] highlighted in blue to exit. 4-26

165 Axial/Helical Scan Prescription 15 SCAN Preview Preview This function enables you to graphically view prior to the scan the interaction between scan process and the combination of Breath Hold and Breathe Time. When you click on this button after axial scan prescriptions, the following screen appears. Preview Screen Prior Next Images Type kv ma Time Thk Tilt Start End S80.0 S ñ010 Helical S0.0 S80.0 S30.0 Seconds 011ñ022 Helical S0.0 S10.0 I ñ027 Helical S0.0 I60.0 I85.0 S10.0 I50.0 I60.0 I85.0 Biopsy Rx Step Scroll If the prescribed scan sequence is too long for a displayed time scale, use Step or Scroll button to view the entire sequence for the corresponding time scale. (Step/Scroll buttons appear on the screen only when too long scan sequence is prescribed.) When more than three groups are prescribed, use Prior or Next key to go through the pages. (Prior or Next key appears on the screen only when more than three groups are prescribed.) 4-27

166 SCAN Axial/Helical Scan Prescription 16 Icons of the Axial/Helical Scan Prescription screen (2) End Exam End Exam Select this to end the current exam. Select New Protocol Select New Protocol Click on this to select another protocol. Next Series Next Series Click on this to select another series within the protocol. Please refer to the later page for the function description. Create New Series Create New Series Select this to open the following menu and create a new series that does not exist in a protocol. Select New Series Type Scout Axial ATTENTION: This will remove all unscanned groups. OK Cancel 4-28

167 Axial/Helical Scan Prescription 17 SCAN Repeat Series Repeat Series Select this to repeat the current series. Please refer to the later page for the function description. Priority Recon Priority Recon Select this to give the priority to a certain image to be reconstructed earlier than other images. Refer to the later page for the details. One More One More Select this to repeat the last one scan. Please refer to the later page for the function description. Confirm Confirm Select this icon to proceed to X-ray radiation after confirming all scan prescriptions. This icon will change to the [Pause] icon shown below during the scan. Pause Pause Select this icon to temporarily halt the scan. This icon will change to the [Resume] icon shown on the next page during the pause. 4-29

168 SCAN Axial/Helical Scan Prescription 18 Resume Resume Select this icon to resume the scan. Intravenous contrast icon IV Select this icon when you use intravenous contrast agent. Gastrointestinal contrast icon GI Select this icon when you use gastrointestinal contrast agent. 4-30

169 Axial/Helical Scan Prescription 19 Show Localizer SCAN Function : Show Localizer allows you to graphically show the prescribed scan lines on the Scout image. 1. Click on [Show Localizer] located on the upper left corner of the View/Edit screen. View/Edit screen Name : ID : Protocol : Exam: Series: Anatomical Reference Series Description Show Localizer Auto Store Auto T ransfer AutomA OFF Auto Film Setup Show Localizer Recon Area 2. The Scout image appears with lines that show prescribed scan locations. 4-31

170 SCAN Axial/Helical Scan Prescription 20 Show Localizer 3. In order to adjust the slice location, click and hold on the "X" mark in red, then drag the entire group horizontally to the desired location. 4. In order to adjust the DFOV center, click and hold on the "X" mark in blue with the Shift key pressed down, then drag the entire group vertically to the desired location. 5. In order to adjust the location of only one group, first doubleclick on the group to select, then do the above operation. (When you select a certain group by doubleclicking on it, it turns blue.) 6. In order to add or delete a slice at the top of the group, click and hold on the small blue solid square and move the mouse to the desired direction. If you wish to add or delete a slice at the bottom of the group, click and hold on the small blue hollow square and move the mouse to the desired direction. 7. In order to adjust the size of DFOV, click and hold on the small diamond, then extend it or contract it. 8. In order to adjust the gantry tilt, click and hold on the small circle, then tilt it to the desired angle. 4-32

171 Axial/Helical Scan Prescription 21 Auto ma SCAN Function : The Auto ma feature enables the system to reduce ma and patient dose with negligible effect on image quality. The system varies ma according to patient shape and a predetermined algorithm for scan location. Principle : The Auto ma feature requires an AP and LAT Scout scans to obtain information on X-ray attenuation. 0 degree Scout (AP) Tube Patient 90 degree Scout (LAT) Tube The system automatically increases ma at the scan locations where X-ray attenuation is relatively high and decreases ma at the scan locations where X- ray attenuation is relatively low. In the example below, the ma is set low at the start scan location (lung area), then the ma will increase at the location of liver area, then it will decline at the location of abdomen area. Start End ma 0 Start End Scan location 4-33

172 SCAN Axial/Helical Scan Prescription 22 Auto ma Prescribe Auto ma You must have two orthogonal Scout data taken at 120kV before prescribing the Auto ma. 1. Click on the [AutomA OFF] located on the upper left corner of the View/ Edit screen. (Default setting is "OFF".) View/Edit screen Name : ID : Protocol : Exam: Series: Anatomical Reference AutomA OFF Series Description Auto Store AutomA OFF Show Localizer Auto T ransfer Auto Film Setup Recon Area SmartRecon OFF 2. The following [Select AutomA Mode] menu appears. Select AutomA Mode Off IQ Normal LowDose MaxmA Cancel Select one of the four modes, IQ, Normal, LowDose or MaxmA. The menu disappears upon the selection. - [IQ] : Select this mode when high image quality is needed. The possible highest ma of this mode is the highest among IQ, Normal and LowDose modes. [AutomA OFF]will change to[automa IQ]. - [Normal] : This mode is most commonly recommended. [AutomA OFF] will change to [AutomA Normal]. 4-34

173 Axial/Helical Scan Prescription 23 SCAN Auto ma - [LowDose] : Select this mode when the lowest patient dose is required. The possible highest ma of this mode is the lowest among IQ, Normal and LowDose modes. [AutomA OFF] will change to [AutomA LowDose]. - [MaxmA] : Select this mode to define your own desired maximum ma other than IQ, Normal or LowDose mode. - [Off] : Select this when you wish to end any of AutomA modes after using it. - [Cancel] : Select this to cancel the AutomA mode. Automatic ma Range Selection In case of [IQ], [Normal] or [LowDose] mode: The system calculates proper Auto ma values and draws a chart like the below one (The chart is not displayed on the screen.). Based on this chart, the system automatically applies either one of the two ma ranges ( ma / 100- maximum ma ) to each scan group. ma AutomA calculation (example) Scan location Auto ma Clipping 1 (By system) The generator of this CT system has two ma-output ranges, which are [10-190mA] and [100-max.mA]. The system selects either one of them for a certain scan group. The two ranges do not alternate with each other within a single scan group. In some cases this causes the system-calculated ma to be clipped(cut) for a certain slice. The following are examples. Example 1 : With the [10-190mA] range selected, even if 210mA is calculated for a certain slice, only 190mA will be applied to the slice. In other words, ma values more than 190mA are clipped. Example 2 : With the [100-max.mA] range selected, even if 80mA is calculated for a certain slice, 100mA will be applied to the slice. In other words, ma values less than 100mA are clipped. 4-35

174 SCAN Axial/Helical Scan Prescription 24 Auto ma Auto ma Clipping 2 (By operator) The CT operator can intentionally set the upper limit of ma in the modes of IQ, Normal and LowDose. This feature is useful for tube cooling wait. Enter the desired ma value into the [ma] field. The following charts show the example of Clipping by Operator at 200mA. 300 Without Clipping (example) 250 ma Slice 300 Clipping by (example) 250 ma Slice Automatic Max ma Range Selection In case of [MaxmA] mode: Beased on the ma value prescribed at [MaxmA] mode, the system automatically selects either one of the two ma ranges as the below chart shows. ma input Automatically selected range max. 100-max. 4-36

175 Axial/Helical Scan Prescription 25 SCAN Auto ma The status of ON/OFF or mode of the AutomA feature is shown on the bottom of the Preview screen. 3. The following menu appears upon the selection of [ma] on the View/Edit screen. Enter the desired ma ma Table Cancel When [AutomA OFF] is posted, the [ma Table] key looks dim indicating it is not functionable. Select or enter the desired maximum ma. When any one of three modes (IQ, Normal, LowDose) is selected, all ma choice boxes look dim, whereas the [ma Table] key looks solid. Click on the [ma Table] key to open the following ma Table Information menu. ma Table Information Scan# ma OK (Example) The above menu shows the expected ma at each scan location. Click on [OK] to close the menu. 4-37

176 SCAN Axial/Helical Scan in Progress 1. Click on the [Confirm] icon after confirming all prescribed scan parameters. Select End Exam Select New Protocol Next Series Create New Series Repeat Series One More Priority Recon Confirm View/Edit screen Confirm 2. Press the [Move to Scan] button when lit, then, press the [Start Scan] button to start a scan. 3. The system automatically proceeds to the Scan Progress screen. Exam:285 Series:2 Images Type kv ma Time Thk Tilt Start End 001ñ010 Helical S0.0 S80.0 S30.0 Scan Progress S80.0 S30.0 Seconds 011ñ022 Helical S0.0 S10.0 I50.0 S10.0 I ñ027 Helical S0.0 I60.0 I85.0 Scanning Delay Timer Patient Handling I60.0 I85.0 Biopsy Rx ProjectedSeriesDLP: AccumulatedExamDLP: End Exam Next Series Repeat Series One More Repeat Last Group Priority Recon AutomA OFF Pause Note : A warning message will appear in the Patient Handling box if the the scanning object is off center. Note : A scan will be automatically aborted unless you press [Start Scan] within 30 seconds after it is lit. 4. The system automatically performs the prescribed axial or helical scan. You can monitor the progress of the scan on the above Scan Progress screen. 4-38

177 Axial/Helical Scan End SCAN Upon the completion of the scan, the message "All scans completed" will appear in the Scanning box of Scan Progress screen. If you wish to end the current exam here, take the following steps. 1. After the scan, click on [End Exam] located on the lower left corner of the Scan Progress screen. Exam:285 Series:2 Images Type kv ma Time Thk Tilt Start End 023ñ027 Helical S0.0 I60.0 I85.0 Scan Progress I60.0 I85.0 Seconds ProjectedSeriesDLP: AccumulatedExamDLP: Scanning All scans completed. Delay Timer Patient Handling Biopsy Rx End Exam Next Series Repeat Series One More Repeat Last Group Priority Recon AutomA OFF End Exam 2. Or, you may select "Return to View/Edit screen" icon located on the right side of Scan Progress screen to return to the View/Edit screen. Return to View/Edit screen 3. Select [End Exam] on the lower left corner of the View/Edit screen to end the current exam. The screen automatically returns to Top Level screen. 4-39

178 SCAN Priority Recon Function : Priority Recon allows you to designate and reconstruct an image earlier than any other image in the reconstruction queue. Upon the selection of this function, the system will start to reconstruct the designated image just after reconstructing the current image. 1. In the scan process, if you wish to reconstruct a certain image earlier than any other image, select [Priority Recon] located on the bottom right of Scan Progress screen. Exam:285 Series:2 Images Type kv ma Time Thk Tilt Start End 023ñ027 Helical S0.0 I60.0 I85.0 Scan Progress I60.0 I85.0 Seconds Scanning Delay Timer Patient Handling Biopsy Rx ProjectedSeriesDLP: AccumulatedExamDLP: End Exam Next Series Repeat Series One More Repeat Last Group Priority Recon AutomA OFF Pause Priority Recon The system starts to reconstruct the designated image just after completion of the current reconstruction. 2. After completion of the whole scan, if you wish to give the reconstruction priority to the lastly scanned image, select [Priority Recon] on the bottom right of the View/Edit screen. End Exam Select New Protocol Next Series Create New Series Repeat Series One More Priority Recon Confirm View/Edit screen Priority Recon 4-40

179 Next Series SCAN Function : Next Series allows you to directly proceed to a scan prescription screen if the next axial or helical series is included in the protocol. 1. Click on [Next Series] on the following scan end screen. Exam:285 Series:2 Images Type kv ma Time Thk Tilt Start End Helical S0.0 I60.0 I85.0 Scan Progress I60.0 I85.0 Seconds Scanning Delay Timer Patient Handling Biopsy Rx ProjectedSeriesDLP: AccumulatedExamDLP: All scans completed. End Exam Next Series Repeat Series One More Repeat Last Group Priority Recon AutomA OFF Next Series 2. The system automatically proceeds to the View/Edit screen that shows the parameters of the series in the protocol. You may modify parameters. View/Edit Screen Add Group Split Current Group Delete Selected Group Scan Timing Recon Film Images Scan Type Start Loc. End Loc. No. of Images Thick (mm) Image Intíval Gantry Tilt SFOV kv ma CTDIvol DLP Optimize not needed Preview Biopsy Rx ProjectedSeriesDLP: AccumulatedExamDLP: Smart Pre RX End Exam Select New Protocol Next Create Repeat One New Series Series Series More Priority Recon Confirm 3. After confirming the parameters, select [Confirm] to start scan. 4-41

180 SCAN Repeat Series Function : Repeat Series allows you to automatically proceed to the scan prescription screen for the most recent series. 1. Click on [Repeat Series] on the following scan end screen. Exam:285 Series:2 Images Type kv ma Time Thk Tilt Start End 023ñ027 Helical S0.0 I60.0 I85.0 Scan Progress I60.0 I85.0 Seconds ProjectedSeriesDLP: AccumulatedExamDLP: Scanning All scans completed Delay Timer Patient Handling Biopsy Rx End Exam Next Series Repeat Series One More Repeat Last Group Priority Recon AutomA OFF Repeat Series 2. There appears the following Select Previous Series menu which lists all the previously scanned series that have the same Patient Position /Orientation (supine/prone, head first/feet first) as the most recently scanned one. The most recently scanned series tops the list and gets highlighted. Select Previous Series Series 8 Series 7 Series 6 Series 5 Series 4 Series 3 Description of Series 8 Description of Series 7 Description of Series 6 Description of Series 5 Description of Series 4 Description of Series 3 Highlighted OK Cancel The list can show up to ten series on one screen. When it contains more than ten series, there appear(s) Prior and/or Next button on the screen. 4-42

181 Repeat Series 2 SCAN After selecting and highlighting any one of the series, select [OK] to confirm the selection. To cancel this step, click on [Cancel]. 1. After the selection of [OK], the system automatically proceeds to the View/ Edit screen that shows the parameters of the series chosen in the Select Previous Series menu. You may modify parameters here. View/Edit Screen Add Group Split Current Group Delete Selected Group Scan Timing Recon Film Images Scan Type Start Loc. End Loc. No. of Images Thick (mm) Image Intíval Gantry Tilt SFOV kv ma CTDIvol DLP Optimize not needed Preview Biopsy Rx ProjectedSeriesDLP: AccumulatedExamDLP: Smart Pre RX End Exam Select New Protocol Next Create Repeat One New Series Series Series More Priority Recon Confirm 2. After confirming the parameters, select [Confirm] to start scan. 4-43

182 SCAN One More Function : One More allows you to scan one more slice that will have exactly the same parameters as the most recently scanned image. 3. Click on [One More] on the following scan end screen. Exam:285 Series:2 Images Type kv ma Time Thk Tilt Start End 023ñ027 Helical S0.0 I60.0 I85.0 Scan Progress I60.0 I85.0 Seconds ProjectedSeriesDLP: AccumulatedExamDLP: Scanning Delay Timer All scans completed Patient Handling Biopsy Rx End Exam Next Series Repeat Series One More Repeat Last Group Priority Recon AutomA OFF One More 4. Press [Move to Scan] button when lit. 5. Then, press [Start Scan] button when lit to start a scan. 4-44

183 Repeat Last Group SCAN Function : Repeat Last Group allows you to scan the most recently scanned series again with the same condition. 1. Click on [Repeat Last Group] on the following scan end screen. Exam:285 Series:2 Images Type kv ma Time Thk Tilt Start End 023ñ027 Helical S0.0 I60.0 I85.0 Scan Progress I60.0 I85.0 Seconds Scanning Delay Timer Patient Handling Biopsy Rx ProjectedSeriesDLP: AccumulatedExamDLP: All scans completed End Exam Next Series Repeat Series One More Repeat Last Group Priority Recon AutomA OFF Repeat Last Group 2. Press [Move to Scan] button when lit. 3. Then, press [Start Scan] button when lit to start a scan. Note : Newly scanned images will have the same series number as the previous one. 4-45

184 SCAN Biopsy Scan 1 Function : The Biopsy Rx feature allows you to easily repeat the scan location during the biopsy procedures. Biopsy Rx prescription 1. Biopsy Rx can be accessed through the [Biopsy Rx] icon on the right side of Axial/Helical Prescription screen. Scan Timing Recon Film Thick (mm) Image Int val Gantry Tilt SFOV kv ma CTDIw (mgy) Optimize Rx Preview Biopsy Rx Biopsy Rx Repeat Series One More Priority Recon Confirm 2. The following screen appears upon the selection of [Biopsy Rx]. Biopsy Rx Biopsy Reference Superior Centered Inferior Biopsy Location Number of Images Get Alignment Light Location Gantry Tilt Internal External Thickness Helical Pitch Image Interval Confirm Biopsy Rx Cancel 4-46

185 Biopsy Scan 2 SCAN 3. In order to determine the reference centering location in a biopsy scan, select [Superior], [Centered] or [Inferior] at Biopsy Reference field. [Superior] means scanning from the landmark toward patient's head. [Centered] means scanning around the landmark. [Inferior] means scanning from the landmark toward patient's feet. 4. When the internal light is used, select [Internal], or, when the external light is used, select [External] at Get Alignment Light Location field. 5. Enter the following parameters. - Number of Images : - Gantry Tilt : - Thickness : - Helical Pitch : - Image Interval : 6. Click on the [Confirm Biopsy Rx] button. 7. Press [Move to Scan] button when it lights up. Then, press [Start Scan] to start the biopsy scans. 4-47

186 SCAN Smart Prep 1(Option) Function : The Smart Prep feature allows you to monitor contrast enhancement change during injection, to assure the acquisition of axial or helical scans while optimum levels of contrast are present. Three phases of Smart Prep Smart Prep consists of three phases, which are a Baseline, Monitor and Scan Phase. Baseline phase This phase requires one unenhanced scan through a particular area of anatomy that will be the point of interest to monitor. Monitor phase This phase requires the operator to take up to 20 scans at one location while the IV (introvenous) contrast is being administered. You will be able to watch these scans on the CRT as the scans are proceeding. Scan phase This phase performs your scan prescription that will be started by the operator when the optimum level of contrast enhancement is reached, either by visual evaluation or by a preset threshold selection. Parameters of Smart Prep Some of the parameters used during the Smart Prep prescription are preset and unchangeable. They are 256 matrix, Soft Tissue algorithm, 0.6 sec scan time and 10 mm slice thickness. Note : Because monitoring scans will not be used for diagnostic purposes, these techniques are used to make sure that the patient receive the minimal dose. Autovoice During the Smart Prep the Autovoice function will only be available after the scan phase is initiated. So, the operator may have to give oral breathing instructions through the intercom during Baseline and Monitor phase and at the beginning of Scan phase. Scout and scan prescription When you perform Smart Prep, the Prep Delay can be excluded from parameters. Even if you use it, Smart Prep will override it by putting SP in place of the number. 4-48

187 Smart Prep 2 Smart Prep prescription SCAN 1. Smart Prep can be accessed through the [Smart Prep] icon on the Axial/ Helical Prescription screen. Name : ID : Protocol : Exam: Series: Anatomical Reference Image Display Area Series Description Auto Store Auto T ransfer AutomA OFF Auto Film Setup Show Localizer Recon Area Prior Next Add Group Split Current Group Delete Selected Group Scan Timing Recon Film Images Scan Type Start Loc. End Loc. No. of Images Thick (mm) Interval (mm) Gantry Tilt SFOV kv ma CTDIvol DLP Optimize not needed Preview ProjectedSeriesDLP: AccumulatedExamDLP: Smart Prep RX Smart Prep End Exam Select New Protocol Create Next Repeat One New Series Series More Series Priority Recon Confirm 2. When the Smart Prep is not incorporated in the protocol,toggle the [Off] button to [On] on the Smart Prep screen. To [On] Smart Prep screen Smart Prep Off Monitor Location ma Monitoring Delay Monitoring ISD Enhancement Threshold ScanPhase Delay Show Localizer Accept Cancel Each parameter is described on the following page. 4-49

188 SCAN Smart Prep 3 3. Enter the following parameters for the Smart Prep prescription. - Monitor Location : Location of monitoring scan - ma : Tube current for Base Line and all Monitoring scans (40 100mA, by 5mA ) - Monitoring Delay : The delay before the Monitoring scan begins (0 60 seconds, by 0.1 sec.)this delay works in conjunction with the administration of IV contrast. - Monitoring ISD : The delay between each monitoring scan (3 60 seconds, by 0.1 sec.) - Enhancement Threshold : The difference in CT value between the Baseline ROI and the one at which you wish to start the Scan Phase. ( For example: If you want to start the scan phase when the CT value of the area of interst reaches 70, then assuming the Baseline ROI is 30, the Enhancement Threshold will be 40.) - Scan Phase Delay : The delay between the time you press [Start Scan] button and the time the actual scan begins(3 60 seconds, by 0.1 sec.) Note : The slice selection at Scan Phase may affect Scan Phase delay. The selection of 7/10mm with Helical or 7/10mm x 2i will affect the delay. This is because the selection of only up to 5mm x 2 is used at Monitoring Scan. - Show Localizer : Select this to display the Scout image with a line on it. With this line, you will be setting the location of the Baseline and subsequent Monitoring scans. Note : If there is the difference between Monitoring location and Scan Phase start location, the Scan Phase will be delayed due to the cradle travel. For example,it takes some four seconds for the cradle to travel 300mm 4-50

189 Smart Prep 4 SCAN 4. After completing all the entries,select [Accept].The system will return to the View/Edit screen. 5. Click on [Confirm] and press [Start Scan] when lit to initiate the Baseline scan. Scan Progress screen shows the Baseline group,monitor group and scan prescription. Exam:285 Series:2 Images Type kv ma Time Thk Tilt Start End Axial S0.0 S0.0 S0.0 Scan Progress S0.0 S Seconds Axial S0.0 S0.0 S Axial S0.0 S0.0 I10.0 S0.0 Scanning Delay Timer Patient Handling ProjectedSeriesDLP: AccumulatedExamDLP: End Exam Next Series Monitor Repeat Scan Priority Last Phase Phase Group Recon AutomA OFF Pause Note : When you select [Accept] on the Smart Prep prescription screen,the following timing menu shows SP in the Prep Group(delay)field,meaning the Smart Prep Monitoring delay has been set. Scan Timing Recon Film Prep Group (sec) ISD (sec) Breath Hold (sec) Breathe Time Auto Voice No. Group Time (sec) SP SP 4-51

190 SCAN Smart Prep 5 6. After the Baseline scan, its image will be displayed. Also, six display functions for Smart Prep will be presented. Smart Prep Display Zoom Display Normal Ellipse ROI Hide Graphics Erase Explicit Mag Baseline image Refer to the Chapter 3 [Display] for the each display function. 7. You can calculate up to three ROIs by selecting [Ellipse ROI]. 8. After calculating ROIs, click on [Monitor Phase] and inject simultaneously the IV contrast. 9. After you press the [Start Scan] button, the system will automatically proceed to the Monitoring scans through the Monitoring delay. The Display desktop screen will now look similar to the following one. Graph Most recently reconstructed image Time Baseline image In the lower right quadrant the Baseline image with ROIs is displayed. The lower left quadrant will be displaying in real time the time when each monitoring scan is acquired, based on the onset of the monitoring delay. It also displays each of the ROI values of that scan. The upper right quadrant will be displaying in real time the most recently reconstructed image. The upper left quadrant will be displaying in real time the enhancement threshold graph, comparing the ROI of each monitoring scan with the time from the start of the monitoring delay. If you did not take any ROI on the Baseline image,this quadrant will be blank. 4-52

191 SCAN Smart Prep 6 The Scan desktop screen will now look similar to the following one. Graph Most recently reconstructed image Preview 10. As the monitoring scans are being acquired, you can watch the lines climbing toward the enhancement threshold on the graph in the upper left quadrant. Upper left quadrant 4 T T: Threshold When the line depicting the ROI gets close to the threshold enhancement, select [Scan Phase] on the Scan Progress screen to initiate the Scan Phase. See the Note below. Note : If the scan location of Monitoring Phase does not match the start location of Scan Phase, the scan start will be delayed by the time the cradle takes to move. For example, it takes some four seconds for the cradle to move 300 mm. It is highly recommended that the scan location of Monitoring Phase match the start location of Scan Phase. Note : When the system initiates the Scan Phase, the real time calculation of the Smart Prep quadrant will stop. A screen save will be used for later inspection. 4-53

192 SCAN Blank page 4-54

193 Smart Addition (Option) 1 SCAN Function : The Smart Addition feature allows you to prospectively add two or more Axial/Helical images into one image. This is beneficial for brain studies since the added images will generate much less artifact particularly around posterior fossa area. Conditions/Restrictions The following conditions/restrictions must be met to use the Smart Addition option. Scan Type : Axial or Helical (360-degree data) Segment and Helical Plus incompatible with this option Available Helical pitch : This option can be applied to group by group. Only contiguous images (Interval = Thickness) to be added Possible thickness of added image : 2, 3, 4, 5, 6, 7, 10 mm Possible number of images to be added : 2, 3, 4, 5, 6, 7, 10 When Smart Addition is prescribed for [Recon 1], both [Recon 2] and [Recon 3] will be automatically designated for Smart Addition. Also, when Smart Addition is not prescribed for [Recon 1], Smart Addition can not be prescribed for [Recon 2] nor [Recon3]. Procedure 1. Click on the [ Thick (mm)] key in the Scan Tab menu. The Image Thickness selection menu opens (See next page). Thick Scan Timing Recon Film Thick (mm) Image Int val Pitch Gantry Tilt SFOV kv ma CTDIw (mgy) 4-55

194 SCAN Smart Addition 2 Fig.1 Image Thickness selection menu Select the desired Thickness (mm) Smart Addition Cancel Note : The Smart Addition key is not available unless your CT system has Smart Addition option installed. Also, even if your CT system has the Smart Addition option installed, the Smart Addition key remains dim (inactive) unless the right Scan Type is selected. 2. In order to activate the Smart Addition option, click on the [Smart Addition] key. Then, the Fig.2 Smart Addition Image Thickness selection menu opens. Fig.2 Smart Addition Image Thickness selection menu Select the desired Thickness (mm) Smart Addition Image Thickness (mm) Beam Thickness (mm) Multiplication Factor 5 OK Cancel On this menu select Beam Thickness (original image thickness) and Image Thickness (thickness of added images), then the Multiplication Factor (number of images to be added) is automatically determined. Since the Multiplication Factor is an integer, there are restrictions on the combination of Beam Thickness and Image Thickness. For example, when 2mm is selected as Beam Thickness, Image Thickness of 3, 5, and 7 are unavailable. The example of Fig.2 shows 1mm and 5mm are selected as Beam Thickness and Image Thickness, respectively. So, the Multiplication Factor is automatically set to

195 Smart Addition 3 SCAN 3. Click on [OK] to accept the selection. Then, the Fig.2 menu disappears and the selected thickness is posted in the [ Thickness] field on the View/Edit screen like the example below. Example 5 1x5 The example shows that Beam Thickness is 1mm, Multiplication Factor 5 and Image Thickness 5mm. Click on [Smart Addition] if you need to return to Fig.1 menu. Click on [Cancel] to remove the Fig.2 menu and return to the View/Edit screen. 4. Prescribe all the other parameters as well. [Interval] in Smart Addition means the interval between "added" images. The possible maximum value is the image thickness of added image and the possible minimum value is Beam Thickness. In the example below, 1mm silces are added by three images. When the possible maximum value of 3mm is set at [Interval], added images are combined like image numbers of [1, 2, 3], [4, 5, 6], [7, 8, 9] and [10, 11, 12]. In case of the possible minimum value of 1mm, added images are combined like [1, 2, 3], [2, 3, 4], [3, 4, 5] and [4, 5, 6]. Smart Addition Example : 1mm x 3 Interval : 3mm Image number Beam Thickness : 1mm 5. Proceed to the scan after entering all the necessary parameters. Added images have the image annotations of ADDx (x: Multiplication Factor) next to the slice thickness annotation. 4-57

196 SCAN Smart Addition Retro Recon (Option) 1 Function : With Smart Addition option images can be retrospectively added from the raw data obtained from the usual scans. Conditions/Restrictions Data obtained with 7mm or 10mm slice thickness can not be used. Recon Mode : Full Contiguous image data ( no overlap, no gap) Available Helical pitch : Two or more images data When the above conditions/restrictions are not completely observed, the keys under [ Thick (mm)] field in the Image tab are dimly displayed indicating Smart Addition retro recon is unavailable. Thick key Images Recon Retro Scan Type Scan Start Location Scan End Location Retro Start Retro End No. of Images Thick (mm) Image Interval Gantry Tilt SFOV Y Y Quit List Exams Confirm 4-58

197 Smart Addition Retro Recon 2 SCAN 1. After confirming the [Thick] key is boldly displayed (active), click on the [Thick] key to open the following Fig.1 Image Thickness selection menu. Fig.1 Image Thickness selection menu Select the desired Image Thickness Cancel Since the number of images to be added is an integer, the slice thickness of the added image depends on the beam thickness (thickness of original image). The chart below shows beam thickness and valid/invalid added image thickness. Beam Thickness Valid Thickness Invalid Thickness 1 mm 1, 2, 3, 4, 5, 6, 7, 10 mm - 2 mm 2, 4, 6, 10 mm 1, 3, 5, 7 mm 3 mm 3, 6 mm 1, 2, 3, 5, 7, 10 mm 5 mm 5, 10 mm 1, 2, 3, 4, 6, 7 mm On the real menu of Fig.1 the valid thickness numbers are displayed boldly whereas the invalid thickness numbers are displayed dimly depending on the beam thickness. 2. Select the desired image thickness from the Fig.1 menu or click on [Cancel]. 3. After entering all necessary parameters click on [Confirm] to start retrospective reconstruction of added images. Added images have the image annotations of ADDx (x: Multiplication Factor) next to the slice thickness annotation. 4-59

198 SCAN Blank page 4-60

199 FILMING AutoFilm 1 Chapter 5 Function : AutoFilm provides a wide variety of options so you can tailor the filming to a specific need for your scan protocol or edit the existing filming parameters as needed. There are two pieces to the AutoFilm setup. One is setting the parameters for the film, which can be accessed through [AutoFilm Setup] button on the View/ Edit screen. The other piece is setting the parameters for the image, which can be accessed through the [Film] tab card. View/Edit screen Name : ID : Protocol: Exam: Series: Anatomical Reference Series Description Auto Store Auto Transfer Auto Film Setup Show Localizer Recon Area AutoFilm Setup Film tab card Scan Timing Recon Film Auto Film Frame Format Interval Flip Width 1 Level 1 Mag Factor Rotate User Anno. GSE Recon 1 Film Set 1 Recon 1 Film Set 2 Recon 2 Film Set 1 Recon 2 Film Set 2 Recon 3 Film Set 1 Recon 3 Film Set 2 5-1

200 FILMING AutoFilm 2 1. To open the Autofilm Setup page, select the [AutoFilm Setup] icon at the top of the scan monitor while in the Axial/Helical series. These parameters will be set up per series or temporarily edited while in the protocol. Autofilm Setup Destination Laser Camera Formats Size Auto Start Auto Print Normal Slide Yes Yes Copies Exam Page Series Page Yes Yes Film Direction Top to Bottom Scout XRef Scout Auto Film Composer e/s/i Show Grayscale Yes OK Cancel Note : Once a scan has been acquired, you can not go back to the Autofilm Setup page, unless you select a new series or a new protocol. Description of each function is as follows; Format There are 11 options for film format. Click on one of them. Film Direction You can have the images filmed Top-to-Bottom or Bottom-to-Top. Click on the blue highlighted arrow to toggle. 5-2

201 AutoFilm 3 FILMING Destination This determines what type of printer the images will be filmed on. Click on buttons to select the destination (printer). The current destination is displayed in the message area. Size You can choose to film either in the normal setting or slide setting. Copies You can choose how many copies you want the camera to print. Select the number you want by either clicking in the box and typing in the number or clicking on arrows to increase or decrease the number. The valid range is from 1 to 99. Exam Page/Series Page This allows you to film the Exam Page and/or Series Page. Toggle between Yes and No. These pages will be filmed at the end of the film and will not be added to the film until a new series or [End Exam] is selected. Scout This allows you to autofilm a Scout image. Select Scout icon to open the following menu. Film Scout Scout Series Number Yes No Scout Number Magnification Factor Window Width Window Level Accept In order to autofilm a Scout image, select [Yes] first, then enter other parameters. Lastly select [Accept]. Note : The valid range for Magnification Factor is from 0.5 to 8.0. If a Scout image exceeds 500mm in length, the magnification factor must be less than 1.0 to view the entire Scout image. 5-3

202 FILMING AutoFilm 4 XRef-Scout This allows you to film a Scout image with cross-reference lines that show axial scan locations. Select [XRef-Scout] icon to open the following menu. Film Scout With Reference Scout Series Number Scout Number Magnification Factor Yes Window Width Window Level No Image Range All First/Last Accept At Image Range selection, select [All] for axial images and [First/Last] for the first and last axial image. Note : The valid range for Magnification Factor is from 0.5 to 8.0. If a Scout image exceeds 500mm in length, the magnification factor must be less than 1.0 to view the entire Scout image. After entering all parameters, select [Accept]. Show Gray Scale This allows you to choose whether to have the gray scale displayed on the film. Simply toggle between Yes and No. Note : This selection is not available if your laser camera interface is digital. Auto Film Composer This selection will determine which will be captured on the AutoFilm composer, an image itself or numbers of exam/series/image. Select either [Image] icon or [e/s/i] icon. 5-4

203 AutoFilm 5 FILMING Auto Start If you select [Auto Start] icon to Yes, the following menu will appear. You can select whether to have your film sets automatically start filming. Auto Start Film Sets Film Set 1 No Auto start Film Set 2 No Auto start Auto start New Sheet Auto start New Sheet Auto start Same Sheet Auto start Same Sheet Accept Cancel If you select [No Auto start] on the above menu, the system will not automatically start filming. In this case the operator is to decide when to start filming. If Autofilm is on and the Autofilm viewport is showing, once you start scanning, you can choose from one of the three options at the bottom of the Autofilm window. The following three icons are those options. Start New Sheet Start New Sheet [Start New Sheet] will start a new sheet of film with the format that has been selected from the Autofilm Setup page. Continue Same Sheet Continue Same Sheet [Continue Same Sheet] will continue filming on the current sheet in the Autofilm composer with the same format as the Autofilm composer. Cancel Film Series Cancel Film Series [Cancel Film Series] will stop Autofilm for that series. 5-5

204 FILMING AutoFilm 6 If you select [No Autostart] with autofilm on but the autofilm viewport is not shown, the following message will appear. Exam: 4 Series: 1 is ready for auto filming Show Film Viewport Cancel If you select [Show Film Viewport], the autofilm viewport will be displayed, then you can select [Start New Sheet], [Continue Same Sheet] or [Cancel Film Series]. Autofilm viewport Start New Sheet Continue Same Sheet Cancel Film Series If you select [Autostart New Sheet], the Autofilm process automatically uses [Start New Sheet] function. If you select [Autostart Same Sheet], the Autofilm process automatically uses [Continue Same Sheet] function. After making all the necessary selections, select [Accept] to continue or select [Cancel] to cancel. In both cases, the system returns to the Autofilm Setup page. Auto Print [Auto Print] is a toggle button between Yes and No. If you select Yes, then the last film of the exam will be automatically printed, whether the Autofilm composer is filled or not. If you select No, then you will need to select Print on the Autofilm composer. 2. On the Autofilm Setup page, select [OK] to accept all entries. Or, select [Cancel] to cancel. 5-6

205 AutoFilm 7 FILMING The Autofilm parameters for the images can be prescribed or modified by selecting the Film Tab Card on the View/Edit screen. 1. Click on the Film Tab Card to open the following menu for Autofilming parameters entry. You may skip this step if you do not intend to perform Autofilming. Film Tab Card Scan Timing Recon Film Auto Film Frame Format Interval Flip Width 1 Level 1 Mag Factor Rotate User Anno. GSE Recon 1 Film Set 1 Recon 1 Film Set 2 Recon 2 Film Set 1 Recon 2 Film Set 2 Recon 3 Film Set 1 Recon 3 Film Set 2 2. Click on each button and select or type in a parameter. Auto Film Select On or Off on the following menu after clicking on [Auto Film]. Auto Film On Off Cancel Frame Format Select one of the four formats in the following menu by clicking on it. MID Format Cancel Interval Select one of the five choices as to which image to film.1= every image, 2= every other image, 3= every third image, and so on. 5-7

206 FILMING AutoFilm 8 Flip Select one of the following options. [FTB] (Flip Top to Bottom), [FTB/FLR] (Flip Top to Bottom/Flip Left to Right), [FLR] (Flip Left to Right), [None] Flip FTB FTB/FLR FLR None Cancel Width 1 The first choice for window width (1 ~ 4096) Level 1 The first choice for window level (-1024 ~ 3072) Mag Factor Valid image magnification factor range is from 0.5 to 4.0 Rotate Right 90 degrees, left 90 degrees, or 180 degrees Rotation None Cancel User Anno(tation) Maximum four lines User Annotation Accept Cancel 5-8

207 AutoFilm 9 FILMING GSE (Gray Scale Enhancement) Select one of the four choices. Gray Scale G1 G2 G3 Off Cancel G1 : lowest contrast G2 : medium contrast G3 : highest contrast Off : no effect The name of the grayscale will be annotated just above the tick mark. 5-9

208 FILMING AutoFilm Composer Click on the [AutoFilm Composer] icon in the Display mode to display the following Autofilm Composer. You do not necessarily have to display this composer during autofilming. You can move the Autofilm Composer on the screen by holding the cursor anywhere in the title bar area, then dragging the composer to the desired location. Auto Film Pause Filming Clear Print Film format reflects the one prescribed on the AutoFilm Setup page. Each port can contain either an image or a set of exam, series and image number depending on the prescription on the AutoFilm Setup page. Click on the [AutoFilm Composer] icon again to remove the composer. 5-10

209 Manual Film FILMING Function : Manual Film allows you to manually film images. The Manual Film Composer can be initiated from several locations including the Exam Rx Desktop, Image Works browser, Image Works viewer and Image Works miniviewer. Exam Rx Display menu [Autoview Layouts] [Review Layouts] hjjkk [Manual Film Composer] When you perform Manual Filming, you have to use one or two viewports in the Review Layouts, or one or two viewports in the bottom of the Autoview Layouts. 5-11

210 FILMING Manual Film Composer 1 Upon the selection of [Manual Film Composer], the following Manual Film Composer will appear. You can move the Manual Film Composer on the screen by holding the cursor anywhere in the title bar area, then dragging the composer to the desired location. Film Composer close button Formats Laser Camera Options Clear Print Current status is : Film Composer close button In order to close the Film Composer, click on the small button at the upper right corner of the composer, or click on the [Manual Film Composer] icon again. Laser Camera The destination of printing will be changed. If you wish to have a destination other than a laser camera, place the cursor over the word "Laser Camera", press and hold down the left mouse button to open a pull-down menu, then select a desired destination. Formats Click on any one of the eleven formats. It will be reflected on the composer. 5-12

211 Manual Film Composer 2 FILMING Options If you select the [Option] icon, the following Print options menu appears. Print options Slide format: Off Greyscale: Off Auto printing: Off Icon labels: image Number of copies: 1 Done Auto clear page: Off Expose order: Left/Right Top/Bottom Slide format: Off On Grayscale: Off On Auto printing: Off On Select On from the Slide format pull-down menu to employ a slide format. Note : If the selected printing machine does not support slide format, the Slide format button is shown in gray, indicating it is not usable. Select On from the Grayscale pull-down menu to print a grayscale onto a film. Note : If the selected printing machine does not support grayscale, the Grayscale button is shown in gray, indicating it is not usable. Select On from the Auto Printing pull-down menu to automatically start printing immediately after all the frames are filled. 5-13

212 FILMING Auto clear page: Off On Icon labels: Image Manual Film Composer 3 Select On from the Auto clear page pull-down menu to automatically clear all the frames after the completion of printing. Select either [E/S/I] or [Image] from the Icon labels pull-down menu to put either Exam/Series/Image number or Image itself, resepctively, into the frame. Number of copies: 1 Click on the [ ] or [ ] button to increase or decrease respectively the number of copies. Or, type in the desired number into the numerical entry field. Expose order: Left/Right Top/Bottom Right/Left Bottom/Top Done When filming function keys are being used, this selection will determine the order with which the images will be printed into the frames of the composer. Select [Done] to accept the entries and close the Print options window. 5-14

213 Manual Film Composer 4 FILMING If the Auto clear function is off under the Print options menu, Clear select [Clear] on the Film Composer to clear the page of images to start over or start a new sheet. The message "Clear the current page" will appear. Select [OK] to clear or click on [Cancel] to cancel. Note : If the Auto clear page is on, the Film Composer will automatically disappear after printing. If the Auto printing function is off under the Print options Print menu, select [Print] on the Film Composer to print the current page of images. The status line at the bottom of the composer will start the message "Printing..." and the images will be sent to the printing queue. Once the queue is filled with images, the printing will start. As the Film Composer communicates with the camera, the status is posted at the bottom of the composer, for example, "print queue empty", "printing", "film supply low", or "output device not connected". Note : Messages posted in green mean everything is OK. Messages in yellow are warnings. Messages in red mean a problem exists. Note : When there exists an arrow button in the message area, you can get the details by clicking on it. 5-15

214 FILMING Manual Film Composer 5 Image removal from Film Composer 1. If you wish to remove an image on the Film Composer window, click on that image. 2. There appears a message "Do you really want to delete this image?" 3. Select [Yes] to delete, or select [No] not to delete. Load images by drag and drop 1. In order to load an image onto the Film Composer, click and hold the cursor on the image, then drag it to an image frame, then release the cursor to deposit the image. 2. Repeat the above steps as needed. Load images by F1 function key Another way to load images onto the Film Composer is as follows. 1. Move the cursor onto the desired image and press the F1 key. 2. The image will be automatically placed into the next available frame Note : This method may be faster than the drag & drop method, however, you can not jump the frame. 5-16

215 Manual Film Composer 6 FILMING Page filming by F2 function key You can use this function to load one sheet of images onto the Film Composer. Note : The Film Composer must be empty beforehand. If it is not empty, use the [Clear] button to empty the Film Composer. 1. Move the cursor over any one of the displayed images and press the F2 key. 2. The displayed images will be loaded onto the Film Composer in order of the displayed images. Note : In order to perform page filming, the formats must be the same between the displayed images and the Film Composer. If the formats are different, the format of the Film Composer automatically turns to that of the displayed images as you press the F2 key. Note : When you are using the Viewer or Mini Viewer, you can also use the [Film Page <F2>] button to perform page filming. MID (Multiple Image Display) filming by F3 function key You can use this function to load the multiple image display onto one film frame. Note : When you perform MID filming, the image resolution will decrease a little bit compared with the page filming. 1. Move the cursor over any one of the displayed images and press the F3 key. 2. The displayed images will be loaded onto the Film Composer in order of the displayed images. Note : When you are using the Viewer or Mini Viewer, you can also use the [Film MID <F3>] button to perform MID filming. 5-17

216 FILMING Manual Film Composer 7 Series filming by F4 function key The following menu will appear when you press the F4 key. Format Use Film Composer Viewer Format Image Selection Interval: Print all Image Current Print Job No Current Job Cancel All Print Last Sheet No Print Series Close Format - Use Film Composer : Select this to use the same format as the current Film Composer. - Viewer Format : Select this to change the Film Composer format to that of Viewer Format. Image Selection This determines the number of images in the series for filming. Use the slide bar to set the number. Interval Print all Images : all images Current Print Job This area displays the list of jobs in the current queue. You can cancel all the jobs with [Cancel All]. 5-18

217 Manual Film Composer 8 FILMING Print Last Sheet This selection determines whether the last sheet will be printed before it is filled with images. After completing all entries, select [Print Series] to start series filming. Note : If you wish to cancel the filming after clicking on [Print Series], press F4 and click on [Cancel All]. 5-19

218 FILMING Blank page 5-20

219 QUALITY ASSURANCE Chapter 6 Overview In order to assure consistent image quality over the lifetime of the diagnostic radiology equipment, users must establish and actively maintain a regular Quality Assurance (QA) program. These procedures ask you to scan a known material (usually a phantom) under a prescribed set of conditions, and then compare your results to predicted or optimum values. Because you repeat these tests frequently, if not daily, you notice changes in image quality values before the problem becomes visible. If you do notice a degradation in image quality or a change in QA values you can schedule a site visit and let the service person or imaging physicist run more sophisticated tests. Their early intervention could prevent a major breakdown. User QA begins with baseline performance data obtained by performing the QA tests as soon as the system meets operating system specifications. Take the first set of baseline performance data right after installation and update it any time the system undergoes an upgrade or a major repair that affects image quality. An x-ray tube change is one example. Compare your daily QA checks against these baselines. The Quality Assurance program documents any change in image quality over time. Although you can save baseline images to visually compare with your daily QA checks, you don't have to. The numerical data supplied during the actual testing provides the necessary objective data for comparison. This section contains a sheet titled QA DATA FORM that you can copy and use to record this numerical data. 6-1

220 QUALITY ASSURANCE Phantom Description Use the Quality Assurance and Performance Phantom provided with your CT scanner to assess system performance and establish an ongoing Quality Assurance program. The phantom's design provides maximum performance information with minimum effort. This phantom measures six aspects of image quality. It contains three sections, each corresponding to a single scan plane. The following illustration contains a list of the sections and corresponding tests. Section 1 High Contrast Resolution Contrast Scale Slice Thickness Positioning Light Accuracy Section 2 Low Contrast Detectability Section 3 Noise and Uniformity QA Schedule The most effective Quality Assurance program involves obtaining basic performance data once a day, or at least 2-3 times per week. You must obtain data frequently and on a regular basis in order to detect any changes in system performance that might occur before it effects clinical image quality. At minimum, acquire a single 10mm scan of Sections 1 and 3 of the Performance Phantom each day. Select On from the Grayscale pull-down menu to print a Grayscale: grayscale onto a film. Off Note : If the selected printing machine does not support On grayscale, the Grayscale button is shown in gray, indicating it is not usable. 6-2

221 Phantom Setup QUALITY ASSURANCE Place the performance phantom on the phantom holder and level it. (Tape a small piece of cardboard or a washer to the phantom, if necessary to accomplish this.) Position the phantom using the laser alignment lights as follows: 1. Align the axial light to the circumferential line marking Section Align the coronal light to the horizontal lines on either side of the phantom. 3. Align the sagittal light (where it strikes the top of the phantom) to the vertical line on the face of the phantom. 4. Position the phantom and press the Internal Land button on the gantry. The performance phantom contains three sections. When you correctly follow the positioning instructions listed above, Section 1 corresponds to 0.0 mm table position, Section 2 (Low Contrast Detectability) to the 35.0 mm location and Section 3 (Noise and Uniformity) corresponds to the 50.0 mm location. Circumferential reference line Vertical reference line Horizontal reference line Horizontal reference line 6-3

222 QUALITY ASSURANCE Scan the QA Phantom Follow the normal Single Scan protocol. Scan three locations, one for each QA phantom section. If you set up the phantom as described on the previous page, prescribe scan location 0.0 for section 1 of the phantom, 35.0 for section 2 and 50.0 for section 3. Use the scan parameters suggested in Table 1. You can use other parameters, but the performance results won't match the data in this manual. TABLE 1 SOFTKEY PROMPT SCAN VALUE ECONSTRUCTION [NEW PATIENT] kv CAL FOV - 25cm [HEAD FIRST] ma Recon FOV - 25cm Time - 3 sec centered [HEAD] Thickness - 10mm* [SINGLE SCAN] Scan Mode - Single Recon Mode - Standard *Check image thickness and positioning light accuracy by acquiring a number of images and varying the slice thickness between scans. Test and Analysis of the Phantom Images Begin the analysis as soon as the Section 1 image display appears. Make copies of the form on the following page and record the QA results there. Keep previously recorded QA results and compare them to the most recent analysis for consistency. 6-4

223 Contrast Scale QUALITY ASSURANCE Section 1 of the phantom tests the contrast scale. CT assigns CT numbers, also called (HU) Houndsfield Units, to the attenuation values of X-Ray passing through a variety of material densities. The software makes the attenuation visible by assigning shades of gray to groups of numbers you select with Window Width/ Level functions during image Display. For test purposes, the CT values of water and acrylic in the phantom represent the standard against which you track your system's contrast scale over time. The test for contrast scale follows: 1. Display a circle cursor (approximately 1 cm in diameter) from [Ellipse ROI] on the image as shown in Figure 1. For consistency, use the same size cursor and location each time you perform this test. 2. Position the cursor on the Plexiglass block and click the left mouse button once to calculate the ROI. Record the mean CT number on the QA Data Form. (Standard deviation record optional.) 3. Position the cursor over the water section and click the left mouse button once to calculate the ROI. Record the mean CT number for water on the QA Data form. (Standard deviation record optional.) 4. Subtract water's CT number from Plexiglass' CT number and record the difference on the QA Data form. Position 1cm ROI over water Position 1 cm ROI over Plexiglas FIGURE 1 6-5

224 QUALITY ASSURANCE High Contrast Spatial Resolution Section 1 of the phantom contains six sets of bar patterns in a Plexiglass block that you use to test high contrast spatial resolution. Each pattern consists of sets of equally sized bars and spaces, in the following sizes: 1.6 mm, 1.3 mm, 1.0 mm, 0.8 mm, 0.6 mm, and 0.5 mm. Water fills the spaces and provides about 12% (120 HU) contrast. Examine the bar patterns to determine the limiting resolution, defined here as the smallest bar pattern in which you see all five bars. A more sensitive and quantitative method for assessing changes in system resolution involves measuring the standard deviation of the pixel values in a single or multiple bar pattern. ROI standard deviation provides a good indicator of system resolution and a sensitive method to detect changes in system resolution. The recommended procedure follows: 1. If necessary, click on [Erase] to remove previous ROI data. 2. Display and position a box cursor from [Box ROI] over the largest (1.6 mm) bar pattern. The cursor should fit within the bar pattern as shown in Figure 2. Adjust the size and position of the cursor as necessary. 3. Click the left mouse button once to calculate the ROI and record the standard deviation on the QA data form. 4. (Optional) Repeat this procedure for the 1.3, 1.0, and 0.8 mm bar patterns. Position box cursor over largest bar pattern, and size it until it fits over the pattern. Optional: repeat for 1.3mm pattern Optional: repeat for 1.0mm pattern Optional: repeat for 0.8mm pattern FIGURE 2 6-6

225 Slice Thickness QUALITY ASSURANCE Section 1 of the phantom also tests slice thickness. Both sides of the resolution block contain a pattern of air filled holes designed to demonstrate slice thickness. (See Figure 3.) Air filled holes FIGURE 3 The resolution block contains holes drilled 1 mm apart and aligned in the direction of slice thickness (perpendicular to scan plane). Each visible hole in the image represents 1 mm of beam thickness. The software assigns less negative CT numbers to partial hole images or holes located on the edge of the slice profile. To determine slice thickness, display the image at the recommended window level and width, and count the visible holes. Black holes in the image represent a full millimeter of slice thickness. Gray holes count as fractions of a millimeter; two equally gray holes count as a single 1 mm slice thickness. Recommended window width : 300. Recommended window level : -100 for 3.0 mm slices, 0 for 5.0 mm, and +50 for 10.0 mm slices. Your image may show less detail than this example. Adjust the window width and level, then count the lines, which represent the air filled holes. FIGURE 4 Each black line represents one millimeter of slice thickness. Gray lines represent fractions of a millimeter 6-7

226 QUALITY ASSURANCE Positioning Light Accuracy (optional) Refer to Figure 3 on the previous page: notice how the center hole in the hole patterns on both sides of the resolution block appear longer than the others. The manufacturers drilled the center holes deeper to help you identify them in the image. The center hole position corresponds precisely to the black line scribed on the circumference of the phantom. When you use an accurate Positioning light and align the phantom's circumferential line to the axial light, you'll see a symmetrical hole pattern around the center (longer) hole in the slice thickness pattern. See Figure 5. For best results, use the 1.0 mm slice thickness. Center hole position corresponds to black line around circumference of phantom Align black line on phantom to positioning light FIGURE 5 6-8

227 Low Contrast Detectability QUALITY ASSURANCE Section 2 of the QA phantom tests low contrast detectability, defined here as the smallest hole size visible for a given contrast level at a given dose. This phantom section contains a 0.75 mm thick polystyrene membrane suspended in water and pierced by a series of holes in the following sizes: 10.0 mm, 7.5 mm, 5.0 mm, 3.0 mm, and 1.5 mm. The difference in CT numbers between the water, and water plus plastic, equals the contrast in Houndsfield Units (HU). Divide the HU value by ten to obtain the contrast in percent. Measure the contrast between the plastic membrane and the surrounding water in the following manner: 1. If necessary, click on [Erase] to remove previous ROI data. 2. Display and position a box cursor from [Box ROI] over the image. Adjust the cursor to a rectangle, approximately 1/2 cm high by 5 cm long, as shown in Figure First position the cursor over the polystyrene membrane above the holes. Click the left mouse button once to calculate the ROI. Record the mean CT number in the Low Contrast resolution box on the QA Data Form. 4. Next place the cursor in the water section above the membrane and click the left mouse button once to calculate the ROI. Record the mean CT number. 5. Subtract the CT number of the water from the CT number of the membrane and record the difference. 6. Click on [Erase] to remove previous ROI data. 7. Repeat steps 3, 4, and 5. This time position the cursor below the membrane holes, then move it over the water area below the membrane. 8. Count and record the number of visible holes to determine contrast. A. Position box cursor over polystyrene membrane above holes, and take ROI. B. Position box cursor over water above membrane and, take ROI. Subtract B from A Count visible holes C. Position box cursor over polystyrene membrane below holes, and take ROI. FIGURE 6 D. Position box cursor over water below membrane, and take ROI. Subtract D from C 6-9

228 QUALITY ASSURANCE Noise and Uniformity Section 3 of the phantom tests noise and uniformity. Take a water-only scan in Section 3 to provide a uniform image by which to assess image CT number noise and uniformity. Enclose a region of interest, click the left mouse button once to calculate the ROI, and the software calculates and displays the standard deviation or noise of the pixels inside. The software often divides the HU noise values by 1000 (representing the contrast scale between air and water) and multiplies by 100 to convert HU to a percentage of water attenuation. The procedure for noise and uniformity testing follows: 1. If necessary, click on [Erase] to remove previous ROI data. 2. Place a circle cursor approximately 2 cm in diameter on the center of the image as shown in Figure 7. Adjust the size of the cursor as necessary. 3. Click the left mouse button once to calculate the ROI. Record the mean CT number and standard deviation on the QA Data Form. 4. (Optional) Repeat the above instructions placing the cursor at the 12 o'clock position and once again at the 3 o'clock position. Position circle cursor over the center of the image, and take ROI. Optional: Take an ROI at the 12 o clock position. Optional: Take an ROI at the 3 o clock position. FIGURE

229 QUALITY ASSURANCE Typical Results and Allowable Variations Because people determine clinical image quality, it remains subjective and difficult to define. GE expects the standards of allowable variation in image quality parameters to vary with the installation and image evaluator(s). GE encourages you to establish and follow a Quality Assurance (QA) program so you can discover any degradation of image quality before it effects clinical images. Over time, institutions use the QA procedure to establish a correlation between acceptable clinical image quality and acceptable variations in the image performance indices included in the program. This page contains suggested allowable variations; don't mistake them for absolutes. Compare any parameter variation to the maximum deviation specified in the next section called, Dose and Performance. Make sure you used the prescribed technique, then inform service when the variations reach the specified maximum deviation. Contrast Scale The difference in CT numbers between the Plexiglass resolution block and water should equal 118, with a suggested allowable variation of 10%. High Contrast Spatial Resolution The standard deviation for an ROI in the 1.6 mm bar pattern should equal 36 HU, with a suggested allowable variation of 20%. Nominal Slice Thickness Slice thickness should not vary from the expected value by more than 50% for thickness of 2.0mm or less and ± 1.0mm for thickness over 2.0mm, when evaluated according to instructions. Low Contrast Detectability Because this test relies upon the perceptual judgment of the person counting visible and well-defined holes, we can't suggest an allowable variation. Rather, we suggest you choose a single, barely visible hole and closely monitor that particular hole during subsequent testing for degradation in this image parameter. Noise and CT Number of Water When you correctly image and analyze the water section of the phantom, you should see a CT number for water of 0 ± 4 HU. Expect the noise in the center of the image to approximately equal 4.0, with a suggested variation of 20%. 6-11

230 QUALITY ASSURANCE Weighted CTDI 100 (CTDI W ) Explained below is information that relates image quality to radiation dose, as required by the IEC standard, in compliance with the IEC committee draft for vote of IEC , dated August 8, Please review this information. Head 300 mas (mgy) 1 mm 2 mm 3 mm 5 mm 7 mm 10 mm 120 kv kv Body 195 mas (mgy) 1 mm 2 mm 3 mm 5 mm 7 mm 10 mm 120 kv kv

231 Dose and Performance 1 QUALITY ASSURANCE Explained below is information that relates image quality to radiation dose, as required by the federal government, in compliance with Federal Regulations 21CFR (c). The dose measurement procedure is described in the Code of Federal Regulations 21CFR The Code of Federal Regulations can be obtained from the U.S. government printing office or can be viewed from the World Wide Web. Statement of Typical Technique HEAD BODY 25 cm Field of View (FOV) 43 cm FOV 120 kvp 120 kvp 150 ma 130 ma 2.0 sec scan time 1.5 sec scan time 10 mm slice thickness 10 mm slice thickness Large Focus Large Focus CT Dose Index (CTDI) For Typical Technique At Various Positions On The Phantom Image. B POSITION HEAD BODY A 4.7 rad 1.0 rad B 4.7 rad 1.6 rad E A C C 4.5 rad 1.7 rad D 4.4 rad 1.5 rad D E 4.7 rad 1.6 rad CTDI has no angular maximum near the surface for 360 scanning 6-13

232 QUALITY ASSURANCE CTDI Over A Range of Techniques Normalized to a value of 1 for typical technique and position A. (All other technique settings at typical value.) POSITION HEAD BODY 10 ma A ma A sec A sec A mm A mm A mm A mm A mm A kv A Explained below is information that relates image quality to radiation dose, as required by the federal government, in compliance with Federal Regulation 21CFR (c). Please review this information. Helical Dose For Typical Helical Technique HEAD BODY 25 cm Field of View (FOV) 43 cm FOV 120 kv 120 kv 150 ma 130 ma 2.0 sec scan time 1.5 sec scan time 10 mm slice thickness 10 mm slice thickness 10 mm interval 10 mm interval If the Helical mas, Slice Count and Intvl selection equals the Axial mas, Slice Count and Intvl selection, then Helical dose equals Axial dose. 6-14

233 Dose and Performance 2 QUALITY ASSURANCE Explained below is information that relates image quality to radiation dose, as required by the IEC standard, in compliance with the IEC committee draft for vote of IEC , dated August Statement of Typical Technique HEAD BODY 25 cm Field of View (FOV) 43 cm FOV 120 kv 120 kv 150 ma 130 ma 2.0 sec scan time 1.5 sec scan time 10 mm slice thickness 10 mm slice thickness Large Focus Large Focus CTDI 100 For Typical Technique At Various Positions On The Phantom Image. B POSITION HEAD BODY A 47 mgy 9 mgy B 49 mgy 17 mgy E A C C 47 mgy 18 mgy D 46 mgy 15 mgy D E 49 mgy 17 mgy CTDI100 has no angular maximum near the surface for 360 scanning 6-15

234 QUALITY ASSURANCE CTDI 100 Over A Range of Techniques Normalized to a value of 1 for typical technique and position A. (All other technique settings at typical value.) POSITION HEAD BODY 10 ma A ma A sec A sec A mm A mm A mm A mm A mm A kv A

235 QUALITY ASSURANCE Dose and Sensitivity Profile at Phantom Center 1.0 Axial, Body, Center, 120 kv, 130 ma, 10 mm, 1.5 sec Position (mm) Dose Profile Sensitivity Profile Axial, Body, Center, 120 kv, 130 ma, 7 mm, 1.5 sec Position (mm) Axial, Body, Center, 120 kv, 130 ma, 5 mm, 1.5 sec Position (mm)

236 QUALITY ASSURANCE 1.0 Axial, Body, Center, 120 kv, 130 ma, 3 mm, 1.5 sec Position (mm) Dose Profile Sensitivity Profile Axial, Body, Center, 120 kv, 130 ma, 2 mm, 1.5 sec Position (mm) Axial, Body, Center, 120 kv, 130 ma, 1 mm, 1.5 sec Position (mm)

237 QUALITY ASSURANCE 1.0 Axial, Head, Center, 120 kv, 150 ma, 10 mm, 2.0 sec Position (mm) Dose Profile Sensitivity Profile Axial, Head, Center, 120 kv, 150 ma, 7 mm, 2.0 sec Position (mm) Axial, Head, Center, 120 kv, 150 ma, 5 mm, 2.0 sec Position (mm)

238 QUALITY ASSURANCE 1.0 Axial, Head, Center, 120 kv, 150 ma, 3 mm, 2.0 sec Position (mm) Dose Profile Sensitivity Profile Axial, Head, Center, 120 kv, 150 ma, 2 mm, 2.0 sec Position (mm) Axial, Head, Center, 120 kv, 150 ma, 1 mm, 2.0 sec Position (mm)

239 Noise QUALITY ASSURANCE Image Performance At Typical Technique In Center Of Phantom Using Standard Algorithm HEAD BODY σ = 0.49 % σ = 0.47 % MTF (same conditions as above) 100 HEAD 100 BODY M OD 80 M OD 80 U L A 60 U L A 60 T I O N (%) T I O N (%) Line pairs/cm Line pairs/cm Nominal Tomographic Section Thickness HEAD BODY 10.0 mm 10.0 mm 7.0 mm 7.0 mm 5.0 mm 5.0 mm 3.0 mm 3.0 mm 2.0 mm 2.0 mm 1.0 mm 1.0 mm Sensitivity Profile See previous pages 6-21

240 QUALITY ASSURANCE Dose Phantoms and Procedures For best results, use the phantoms, dose profile and CTDI value calculation procedures recommended in the CDRH final draft of "Routine Compliance Testing for Computed Tomography X-Ray Systems" dated April 26, Also, for best results, use the phantoms and CTDIw value calculation procedures recommended in the IEC committee draft for vote of IEC , dated August 8, Performance Each test uses a 25 cm water-filled acrylic phantom Noise Noise equals the standard deviation of an array of pixels contained in 674 mm square region of interest (ROI) for Head and 2696 mm square ROI for Body. The software divides the standard deviation, expressed in Houndsfield Units, by 1000 (representing the contrast scale between air and water), then multiplies by 100 to give a value in percent. Modulation Transfer Function (MTF) A point spread function (PSF) image is obtained by scanning the GE performance phantom ( ) wire section. Software performs a two dimensional Fourier Transform on the PSF to obtain the MTF. Slice Use a wire ramp section of Catphan phantom, inclined 23 from the scan plane. Sensitivity 23 from the scan plane to obtain sensitivity profiles. 6-22

241 Deviations QUALITY ASSURANCE In order to come up with "the maximum deviation," manufacturers must imagine every possible situation, however unlikely, that might occur within the entire user community. Our statements of deviation include a maximum deviation to assure compliance with the regulation, as well as a statement of expected deviations (2σ) in the large majority of our systems. CTDI and CTDI W Typical Techniques The anticipated "maximum deviation" for CTDI and CTDIw equals ± 40%. The expected deviation equals ± 20%, except for the 40 ma or less and 1mm techniques, where variation increases (up to a factor of two) due to the inherent deviation in small values. Dose Profile Anticipate a "maximum deviation" of ± 30% or 2.0mm, whichever is larger, relating to dose profiles (FWHM). This value includes variability inherent in the measurement of dose profile with TLD chips. Performance Noise : The noise squared (σ2) in a CT image is inversely proportional to the x- ray dose used to make the image. The maximum deviation anticipated for image noise equals ± 30%. Expected deviation equals ± 10%. MTF : Expect deviations within ± 10% for values on the MTF curve generated with data gathered according protocol. Maximum deviations may reach ± 20% for other methodologies. Sensitivity Profile : Expect the full width slice half maximum sensitivity profiles to vary ± 20% or 1.0 mm, whichever is larger, when measured with a wire ramp section of Catphan phantom, inclined 23 from the scan plane. If you use other methodologies, the maximum deviation may reach 1.5 mm for all slice thicknesses, because these measurement errors have the greatest effect on thin slices. 6-23

242 QUALITY ASSURANCE DATE Quality Assurance DA TA FORM CONTRAST SCALE MEAN CT# HIGH CONTRAST SPATIAL SLICE THICK NESS ALIGN LOW CONTRAST RES- OLUTION STD. DEV Y/N TOP BOTTOM NOISE MEAN CT# MEAN STD CT# DEV PLEXIGLAS 1.6mm WATER WATER DIFFERENCE 1.3mm 1.0mm 0.8mm MEMBRANE DIFFERENCE HOLES PLEXIGLAS WATER DIFFERENCE 1.6mm 1.3mm 1.0mm 0.8mm WATER MEMBRANE DIFFERENCE HOLES PLEXIGLAS WATER DIFFERENCE 1.6mm 1.3mm 1.0mm 0.8mm WATER MEMBRANE DIFFERENCE HOLES PLEXIGLAS 1.6mm WATER WATER DIFFERENCE 1.3mm 1.0mm 0.8mm MEMBRANE DIFFERENCE HOLES 6-24

243 Chapter 7 TECHNICAL SPECIFICATIONS Component Identification Component Model Number Location of Name Plate CDRH Certified Gantry X X-Ray Tube Housing X-Ray Tube Insert Collimator X Table X Operator Console Rear lower center Yes Housing surface Yes G1 Housing surface No X PDU X Front of collimator Gantry side of pillar Rear lower right corner Rear lower right corner Yes Yes Yes Yes Generator Front of generator Yes Axial Headholder Coronal Headholder Water Phantom No No P9110LA On holding block No 42cm Phantom P9110LD On holding block No 7-1

244 TECHNICAL SPECIFICATIONS Component Labels MADE FOR GENERAL ELECTRIC CO. MADE FOR GENERAL ELECTRIC CO. MILWAUKEE WISCONSIN BY MILWAUKEE WISCONSIN BY GE Hangwei MEDICAL SYSTEMS, Co.LTD. GE Hangwei MEDICAL SYSTEMS, Co.LTD. No.2,North Yong Chang Street No.2,North Yong Chang Street Beijing Economic-Technological Development Zone,P.R.C Beijing Economic-Technological Development Zone,P.R.C MODEL (Note 1) SERIAL MANUFACTURED CLASS I SOURCE: (Note 2) A/ (Note 3) V ~(Note 4) HZ SOURCE: (Note 2) A/ (Note 3) V ~(Note 4) HZ SOURCE: (Note 2) A/ (Note 3) V ~(Note 4) HZ SOURCE: (Note 2) A/ (Note 3) V ~(Note 4) HZ MODEL (Note 5) SERIAL MANUFACTURED CLASS I VOLTS (Note 6) V~ AMPS MOMENTARY (Note 7) A AMPS CONTINUOUS (Note 8) A kva (Note 9) HZ (Note 10) COMPONENT (Note 1) MODEL NUMBER Gantry , X 50A 30A 30A 15A (Note 2) SUPPLY CURRENT (Note 3) SUPPLY VOLTAGE V 3~ 200V~ 115V~ 115V~ (Note 4) SUPPLY FREQUENCY 50/60Hz 50/60Hz 50/60Hz 50/60Hz Table , X 10A 115V~ 50/60 Hz Operator , X 20A 115V~ 50/60Hz Console (SYSTEM)* CT/e 60A 380 /400/ 415/440/ 460/ 480 V3~ 50/60 Hz COMPONENT (Note 5) MODEL NUMBER PDU X (Note 6) SUPPLY VOLTAGE 380/400/ 415/ 440/ 460/ 480V3~ (Note 7) SUPPLY CURRENT (Note 8) (Note 9) SUPPLY KVA CURRENT (Note 10) SUPPLY FREQUE NCY 60A 20A 50 KVA 50/60Hz 7-2

245 TECHNICAL SPECIFICATIONS X-Ray Tube Assembly Information Tube Unit Identification System/Tube Catalog No. Description graphite anode Housing Model Number Insert Model Number Insert Catalog No. MX135 CT TH1.1 X-Ray tube assembly G1 D0095G Improvements in the heat handling capabilities of this unit may result in new catalog and Model number assignments Diagnostic Source Assembly Leakage Technique Factors Tube Assembly Model No and CT Collimator Model No : 140 kv, 24 ma Minimum Inherent Filtration Minimum inherent filtration of 6.0 mm aluminum equivalent at 70 kv: Tube Unit: Tube Insert mm aluminum equivalent at 70 kv Tube Housing mm aluminum equivalent at 70 kv Collimator (lower plate) mm aluminum Collimator (upper plate) mm aluminum equivalent at 70 kv 7-3

246 TECHNICAL SPECIFICATIONS TARGET LODING in Kilowatts FOR EACH SCAN TECHNIQUE ma 120kV 140kV The following table lists cooling delay times (in seconds) used by the software before each scan. These times assume maximum anode or tube unit heat loading and include cycling the rotor for each scan. COOLING DELAY TIME at 120kV Scan Technique 120kV and Anode Cooling Delays 2.0 sec 3.0 sec 60mA mA mA mA mA mA COOLING DELAY TIME at 140 kv Scan Technique 140kV and Anode Cooling Delays 2.0 sec 3.0 sec 60mA mA mA mA mA

247 X-ray Tube Housing Model TECHNICAL SPECIFICATIONS X-Ray Tube IEC Information X-ray Tube Insert Model G1 X-ray Tube Assembly In accordance with IEC 637/1979, the complete X-Ray tube assembly carries two identification labels, one each for the housing and insert, marked with the model types and numbers listed above. X-ray Tube Insert Information Type General Electric INSERT Model G1 Focal spot 0.4mmW x 0.7mmL (NEMA standard) Target Material Tungsten/Rhenium Alloy Focal Track on graphite base Target Angle 7 Maximum Potential Difference 140 kv High Potential Generator : General Electric CT/e System Constant Potential X-Ray Tube Filament Supply : Maximum Voltage : 140kV Maximum Current : 160 ma 7-5

248 TECHNICAL SPECIFICATIONS Nominal Anode Input Power This tube accommodates GE CT/e Computed Tomography Systems with a nominal anode input power of 24 kw for 3 seconds. Maximum Anode Heat Capacity 2.0 MHU Maximum Anode Heat Dissipation 500kHU/min 7-6

249 TECHNICAL SPECIFICATIONS Anode Heating and Cooling Curves Cooling Curve Heating Curves Stored Heat (KJ) Time(sec) Time(min) Single Load Rating 24 kw for 3 seconds Serial Load Ratings Controlled by the CT/e system operating software Rotating Anode Supply Designed to operate on the CT/e system (See accompanying system documentation.) 7-7

250 TECHNICAL SPECIFICATIONS Tube Assembly Information Labels : The X-Ray Tube Assembly carries two identification labels. One label identifies the Model and serial numbers of components (X-Ray Tube and Housing), and provides the date and location of assembly manufacture. The second label provides the name of the manufacturer. A third label certifies compliance with USA Federal regulation 21 CFR Sub chapter J, and lists the data and place of assembly manufacture. Reference Axis : Normal to the window center. Target Angle : 7 0 Nominal Focal Spot Values : Focal Spot : 0.7 (W) x 0.4 (L) mm Focal Spot Modulation Transfer Functions : MTF for X-Ray Tube Assembly Standard magnification = 1.3 Width Length Frequency (lp/mm) Frequency (lp/mm) 7-8

251 Maximum Potential Difference : 140 kvp TECHNICAL SPECIFICATIONS Inherent Filtration 1.0 mm Al at 70 kv Tube 0.8 mm Al IEC 522/1976 Housing 0.2 mm Al Electrical Connections See curves and diagrams Emissions Characteristics Connection stator, Thermal and Pressure overload switches Principle Dimensions Length 21.1 inches (53.6 cm) Height 13.8 inches (35.0 cm) Depth 26.8 inches (68.1 cm) Weight 168 lbs (76.4 kg) (±10%) X-Ray Tube Conditioning The system software controls X-Ray tube conditioning. (See accompanying system documentation.) Maximum X-Ray Tube Assembly Heat Storage Capacity 2.0 MHU Continuous Heat Dissipation of X-Ray Tube Assembly X-Ray Tube and Heat Exchanger 275kHU/min 7-9

252 TECHNICAL SPECIFICATIONS Tube Assembly Heating and Cooling Curves Storage (kj) Tube Housing Heating Curves Time (s) 1kW 2 kw 3.4 kw Stored Heat(KJ) Tube Housing Cooling Curve Time(min) Note : Cooling and heating curves reflect maximum tube performance. System software monitors and controls tube operation. Leakage Radiation - Loading Factors Specified values of the loading factors determining measures for protective shielding of X-Ray Tube Assembly against leakage radiation according to IEC publication 407/1973 are 140 kv - 24 ma Classification IEC publication 536 /1978 and IEC Publication Class 1 Transportation and Storage -20 to +70 C, up to 95% Relative Humidity (non-condensing) Commercial airlines accept X-Ray tube insert/housing shipments Transport Packaging Transport ONLY in packaging supplied by General Electric 7-10

253 Main Power Supply TECHNICAL SPECIFICATIONS Generator Specifications Line voltage (no-load) 380, 400, 415, 440, 460 or 480 VAC 3-phase, 50 or 60 Hz ±0.2 Hz. Phase-to-phase balance within 3% of lowest phase-to-phase voltage. Line regulation 5% or less at maximum technique factor. Maximum line current demand, 100 Amps RMS (50/60 Hz) at 120 kv, 200 ma. Generator Rating and Duty Cycle kv Range : 80*, 120, 140 kv(80kv can not be used for scanning.) ma Range : 10 to 200 ma Maximum Technique : 140 kv 160 ma, 120 kv 200 ma Maximum Output Rating : 24 kw Generator Duty Cycle : Maximum Technique Factor Max. Duty Cycle 140kV and 160mA 9 % kv, ma, and Timer Accuracy Mode Condition Accuracy Kilovoltage : Axial 80 to 140kV ± 3 % Excluding initial 3 msec Milliamperage : Axial 10 to 200mA ± 5 % (or ± 1mA) Excluding initial 100 msec 7-11

254 TECHNICAL SPECIFICATIONS kv : Subject to an additional ± 3% and ± 2kV accuracy of instrumentation used for calibration and measurement. ma : Subject to an additional ± 5% or ± 1mA accuracy of instrumentation used for calibration and measurement. Exposure : Subject to an additional ± 3% accuracy of instrumentation used Time : for calibration and measurement. Note : Accuracy subject to the following conditions : 1. Line regulation 5% or less. 2. Line voltages within this specified range : 380, 400, 415, 440, 460 or 480 VAC +10% -15% (50 or 60Hz) 3. System powered for at least 30 minutes prior to measurements. 4. Line voltage variations caused by external loads should not exceed 1% or last longer than 0.5 second while scanning. Measurement Basis Tube Potential : Precision voltage divider, Model No G1 reduces high voltage generated across anode and cathode by 1000:1. Tube Potential equals the average kilovoltage generated during the exposure, excluding transients at the beginning and end. See Section 2 of the X-ray Alignment procedure in the Service documentation for the complete measurement procedure. Tube Current : Tube current equals the average milliamperage generated during x-ray exposure. See Section 2 of the X-Ray Alignment procedure in the Service documentation for the complete procedure. Scan Time : Exposure time intervals equal the time during which the kilovoltage equals or exceeds 75% of its peak value. Measure kilovoltage with a precision voltage divider and an oscilloscope. Use the time base of the oscilloscope to measure exposure duration. 7-12

255 TECHNICAL SPECIFICATIONS The Attenuation Equivalent Standard Head Holder : 0.3 mm aluminum equivalent at 100 kv Shallow Head Holder : 0.35 mm aluminum equivalent at 100 kv Coronal Head Holder : 0.8 mm aluminum equivalent at 100 kv Cradle : 0.8 mm aluminum equivalent at 100 kv Extender : 1.4 mm aluminum equivalent at 100 kv To obtain the optimum results, make sure nothing is left in the path of X-ray beam that may have adverse effects on examinations. 7-13

256 TECHNICAL SPECIFICATIONS Periodic Maintenance by Qualified Personnel Recommended PM frequency is 2 times a year for CT/e, CT ProSpeed AI/FI series scanners. The frequency may vary due to local ordinance and the usage of the system, the system availability etc. If you need more PMs, order extra copies of this document or copy the schedules.i Priority Code Pr (Priority) - Description 1 Safety and Rgulatory 2 Image Quality 3 Procedures that make the system unavailable for scanning 4 Procedures that can be performed while the customer is scanning Frequency Code Fr (Frequency) - S A Description Semi-Annually (every 6 months) Annually (every 12 months) Safety and Regulatory ITEM SUB- SYSTEM DESCRIPTION Pr Fr PM0101 System Verify Emergency OFF buttons (Gantry / Console / PDU) PM0102 System Check X-ray ON lights or buzzer/ operation of scan abort Annual PM Schedule A B 1 S 1 S PM0103 System Caution Label Check 1 S PM0105 System Check Error Logs 1 S PM0301 Gantry Check the number of Gantry revolutions 1 S PM0201 O.C Verify Audio Function 1 S PM0501 Table Check Head Holder 1 S PM0502 Table Check Table Cover 1 S PM0503 Table Gap between Table Cover and Cradle 1 S PM0504 Table Check Cradle Rail 1 S PM0505 Table Holder Stability Check 1 S PM0506 Table Check Touch Sensor operation 1 S PM0507 Table Verify Unlatch Function 1 S PM0508 Table Check Gantry / Table interlock 1 S PM0607 XG Check Parts 1 S 7-14

257 Image Quality TECHNICAL SPECIFICATIONS ITEM Annual PM SUB- DESCRIPTION Pr Fr Schedule SYSTEM A B PM0104 System Image Check (Image Performance) 2 S PM0302 Gantry Clean Mylar ring cover 2 S PM0401 DAS Check/Clean Detector face 2 S Subtotal 1:30 1:30 System Performance ITEM Annual PM SUB- DESCRIPTION Pr Fr Schedule SYSTEM A B PM0106 System Perform Filter Curve Test 3 A 0:15 PM0107 System Check Ground Cable Terminals 3 A 0:10 PM0108 System Check DAS Count 3 A 0:15 PM0109 System Image Performance 2 A 1:00 PM0202 O.C Clean Air Filter 3 S 0:10 0:10 PM0203 O.C Inspect FANs 3 S 0:10 0:10 PM0204 O.C Verify Mouse for smooth operation 3 S 0:10 0:10 PM0205 O.C Clean Display monitor/console exterior 4 S 0:15 0:15 PM0206 O.C Check Cables / Power Cable Terminals 3 S 0:10 0:10 PM0303 Gantry Verify cables and hardware are tight 3 S 0:20 0:20 PM0304 Gantry Gantry cover cleaning 4 S 0:10 0:10 PM0305 Gantry Check Positioning lights 3 S 0:10 0:10 PM0306 Gantry Check Gantry anchor / Gantry Isolation 3 A 0:05 PM0307 Gantry Main bearing grease-up 3 A 0:20 PM0308 Gantry Check drive belt for wear 3 A 0:05 PM0309 Gantry Check RF Shoe Position 3 A 0:10 0:10 PM0402 DAS Verify Detector Heater Control 3 S 0:05 0:05 PM0403 DAS Inspect FANs 3 S 0:05 0:05 PM0509 Table Clean Cradle tray / Table cover 4 S 0:15 0:15 PM0510 Table Check for Oil Leak 3 S 0:05 0:05 PM0511 Table Check Table anchors / Table isolation 3 A 0:05 PM0512 Table Inspect FANs 3 S 0:10 0:10 PM0513 Table Inspect Cradle Wire Tension 3 S 0:10 0:10 PM0601 XG Check/Clean Radiator FAN 3 S 0:10 0:10 PM0602 XG Check X-ray tube oil and HV connector 3 S 0:20 0:20 PM0603 XG Check HV Tank and HV connector 3 S 0:20 0:20 PM0604 XG Check Power cable connection 3 S 0:05 0:05 PM0605 XG Check Tube over heat safety 3 S 0:15 0:15 PM0606 XG Check KV and ma 3 A 1:00 PM0701 PDU Inspect FANs 3 S 0:05 0:05 PM0702 PDU Check Power Cable Terminals 3 A 0:05 PM0703 PDU Check Power Line Voltage 3 A 0:05 PM0801 MOD Dry Cleaning 3 S 0:05 0:05 Subtotal 4:15 7:00 Total 5:45 8:30 *1 : Option 7-15

258 TECHNICAL SPECIFICATIONS Maintenance by CT Users The following maintenance by CT users is highly recommended. Check at least once a week if those items function properly. Emergency stop : Press the button to confirm the system stops. Cradle latch operation : Press the button to confirm the cradles latches. Clean covers 7-16

259 TECHNICAL SPECIFICATIONS Symbols and Classification Symbol Publication Description ~ ~3 3N~ Three-phase alternating current Three-phase alternating current with neutral conductor Alternating Current Direct Current Protective earth (ground) Attention, consult ACCOMPANYING DOCUMENTS OFF (Power: disconnection from the mains) ON (Power: connection to the mains) Dangerous voltage Emergency Stop Warning sign RADIATION of LASER APPARATUS 7-17

260 TECHNICAL SPECIFICATIONS Symbol Publication Description Type B Applied Part X-Ray source assembly Emitting Stand by Start Table Set Abort Intercom (On Operator Console) Power ON Light ON Stand by Light OFF 7-18

261 TECHNICAL SPECIFICATIONS Symbol Description Microphone (Mic) Contrast Brightness 50 C System storage prior to installation: Maintain storage temperature between -10 C and +60 C (-14 to 140 F) System storage prior to installation: Maintain non-condensing storage humidity below 95% Humidity 10-90% Excluding Condensation Air Pressure hPa DO NOT store system longer than 90 days System storage and shipment Maintain Air Pressure between 750 and 1060hPa 7-19

262 TECHNICAL SPECIFICATIONS Class 1 Equipment Any permanently installed equipment containing operator or patient accessible surfaces must provide backup protection against electric shock, in case the BASIC INSULATION fails. In addition to BASIC INSULATION, Class 1 equipment contains a direct connection to a PROTECTIVE (EARTH) CONDUCTOR which prevents shocks when a person touches a broken piece of equipment or touches two different equipment surfaces simultaneously. Type B Equipment CLASS I, II, or III EQUIPMENT or EQUIPMENT with INTERNAL ELECTRICAL POWER SOURCES provide an adequate degree of protection against electric shock arising from (allowable) LEAKAGE CURRENTS or a breakdown in the reliability of the protective earth connection Ordinary Equipment Enclosed EQUIPMENT without protection against the ingress of water. Operation Of Equipment CONTINUOUS OPERATION WITH INTERMITTENT LOADING. Operation in which EQUIPMENT is connected continuously to the SUPPLY MAINS. The stated permissible loading time is so short that the long term onload operating temperature is not attained. The ensuing interval in loading is, however, not sufficiently long for cooling down to the long term no-load operating temperature. EQUIPMENT not suitable for use in the presence of a FLAMMABLE ANESTHETIC MIXTURE WITH AIR or WITH OXYGEN or NITROUS OXIDE. 7-20

263 TECHNICAL SPECIFICATIONS Cleaning The CT system is not waterproof. It is not designed to protect internal components against the ingress of liquid. Decontamination or cleanliness of the CT system (i.e. gantry, table, console and accessories) is the sole responsibility of the health care provider owning and/or operating the CT system. Tips for Cleaning : Use soft cloth damped with (hot) water to remove any dirt or stains. Even blood stains can be wiped off with damp soft cloth. Caution : Avoid chemical damage to surfaces. Some detergent or cleaning agent may damage the surface. Disclaimer : GEMS bears no responsibility for sterilization of system surfaces. GEMS shall not be held liable for any contagion which may have stemmed from contaminated stains on the system surfaces. 7-21

264 TECHNICAL SPECIFICATIONS Blank page 7-22

265 A Accelerator Bar, 3-30 Accessories, 1-15 Body Accessory Use, 1-18 Coronal Head Holder Assembly, 1-17 Security Strap Kit, 1-19 Standard Head Holder Assembly, 1-17 Auto Film Composer, 3-29 Auto Store, 4-11 Auto Transfer, 4-12 Autoview Layouts, 3-4 Axial/Helical Scan End, 4-39 Next Series, 4-41 One More, 4-44 Priority Recon, 4-40 Repeat Last Group, 4-45 Repeat Series, 4-42 Axial/Helical Scan in Progress, 4-38 Scan Progress screen, 4-38 Axial/Helical Scan Prescription, 4-13 [Film] icon, 4-20 [Recon] icon, 4-18 [Scan] icon, 4-15 [Timing] icon, 4-17 Add Group, 4-24 Auto ma, 4-33 Autofilm Setup, 4-23 Biopsy Rx, 4-25 Cine Scan, 4-14 Confirm, 4-29 Create New Series, 4-28 Delete Selected Group, 4-25 End Exam, 4-28 Gastrointestine contrast, 4-30 Helical Scan, 4-14 Introvenous contrast, 4-30 Next Series, 4-28 One More, 4-29 Optimize Rx, 4-26 Pause, 4-29 Preview, 4-27 Priority Recon, 4-29 Prospective Multiple Reconstruction, 4-21 Recon Area, 4-24 Repeat Series, 4-29 Resume, 4-30 Select New Prortocol, 4-28 Show Localizer, 4-23, 4-31 Show Recon 1,2,3, 4-19 Special Filter, 4-19 Split Current Group, 4-24 View/Edit Screen, 4-13 B Biopsy Scan, 4-46 C Control Panel, 1-4 Cradle In/Out, 1-4 External Landmark, 1-5 Fast, 1-4 Gantry Tilt, 1-5 Gantry Tilt Lamp, 1-5 Internal Landmark, 1-5 Positioning Light, 1-5 Practice, 1-5 Table Up/Down, 1-4 Tilt Range & Scannable Range, 1-5 D Daily Prep, Tube Warmup, 2-27 Display Panel, 1-6 Distance from Iso-Center, 1-6 Distance from Landmark, 1-6 Interference, 1-6 Tilt/Angle Range, 1-6

266 X-ray On, 1-6 Display Preference, 3-24 Annotation Levels, 3-25 Continuous Report Cursor, 3-27 Next/Prior Each Viewport, 3-27 Next/Prior Series Binding, 3-27 F FILMING, 5-1 AutoFilm, 5-1 Auto Film Composer, 5-4 Auto Print, 5-6 Auto Start, 5-5 Copies, 5-3 Destination, 5-3 Exam Page/Series Page, 5-3 Film Direction, 5-2 Format, 5-2 Scout, 5-3 Show Gray Scale, 5-4 Size, 5-3 XRef-Scout, 5-4 AutoFilm Composer, 5-10 Manual Film, 5-11 Manual Film Composer, 5-12 F1 function key, 5-16 F2 function key, 5-17 F3 function key, 5-17 F4 function key, 5-18 G Gantry, 1-2 Control Panel, 1-2 Detector Specifications, 1-3 Display Panel, 1-2 Emergency Button, 1-2 Gantry Specifications, 1-3 Positioning Light & Breath Navi, 1-2 X-ray Tube Specifications, 1-3 I Image Display Layout, 3-3 L List/Select, 3-7 M Manual Film Composer, 3-28 Measurements, 3-21 MIROI(Multiple Image ROI), 3-22 Report Pixels, 3-23 N New Patient, 2-5, 4-4 O Operator Console, 1-9 Keyboard/Mouse, 1-9 MOD Drive, 1-9 Scan/Display Monitor, 1-9 P Patient Positioning, 4-1 Landmarks, 4-3 Patient Schedule, 2-6 Add Patient, 2-8 Delete All, 2-10 Delete Selected, 2-10 Edit Patient, 2-9 Preference, 2-11 Select Patient, 2-7 View More Info, 2-7 Primary/Secondary Viewport, 3-2

267 Protocol Management, 2-12 Auto Voice Record, 2-13 Protocol Management, 2-16 [Film] icon, 2-18 [Recon] icon, 2-18 [Scan] icon, 2-18 [Timing] icon, 2-18 Q QUALITY ASSURANCE, 6-1 Dose and Performance, 6-13, 6-15 High Contrast Spatial Resolution, 6-6 Image Performance, 6-21 Low Contrast Detectability, 6-9 Noise and Uniformity, 6-10 Phantom Description, 6-2 Phantom Setup, 6-3 Scan the QA Phantom, 6-4 Slice Thickness, 6-7 Weighted CTDI, 6-12 R Recon Management, 2-25 Retro Recon, 2-21 Review Layouts, 3-6 Multiple Image Display (MID), 3-6 Routine Display, 3-9 Cross Reference, 3-17 Display Normal, 3-14 Ellipse ROI, 3-15 Erase, 3-20 Exam Pg/Series Pg, 3-19 Explicit Magnify, 3-11 Flip/Rotate, 3-12 Grid, 3-16 GSE, 3-14 Hide/Show Graphics, 3-20 List/Select, 3-15 Measure Distance, 3-16 ProView, 3-13 Roam/Zoom, 3-10 Screen Save, 3-20 User Annotation, 3-18 S Scanner Utilities, 2-28 Raw Data Function, 2-28 User Calibration, 2-34 Scout Scan, 4-6 Add Scout, 4-7 Confirm, 4-8 Create New Series, 4-8 Delete Selected Scout, 4-7 End Exam, 4-7 Next Series, 4-7 One More, 4-8 Pause, 4-8 Repeat Series, 4-8 Resume, 4-8 Scan Progress screen, 4-9 Select New Protocol, 4-7 System Power On/Off, 1-22 T Table, 1-7 Cradle, 1-7 Latch Button, 1-7 Speaker, 1-7 Table Specifications, 1-8 U User Interface, 1-10 Keyboard, 1-11 Communication button, 1-13 Keyboard keys, 1-13 Scan-related buttons, 1-12 Mouse, 1-10

268 REVISION HISTORY REV Date Primary Reason for Change 1 06/17/05 Updated Safety Information in the manuals 0 03/25/04 Initial release.

269

270 Manufacturer Address: No.2, North Yong Chang Road Beijing Economic&Technological Development Area Beijing P. R. China Tel: (86-10) Fax: (86-10) Imagination at work