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GE Healthcare
Discovery CT750 HD
Learning and Reference Guide

GE Medical Systems does business as GE Healthcare
This product is certified as a LightSpeed Multislice CT Scanner.

The MHLW certified number is 21100BZY00104000
0459
Discovery CT750 HD
Operator Manual, English
5308208-1EN
Revision: 2
2008 General Electric Company
All rights reserved.
Revision History
REV
DATE
REASON FOR CHANGE
09-08
First Release for Discovery CT750 HD
10-08
Updated information from HII Logs
Discovery CT750 HD 5308208-1EN Rev. 2 (10-08)

2008 General Electric Company. All rights reserved.
i-1
Table of Contents
Revision History............................................................................................................................. i-1
Chapter 1: Product Manufacturer

Chapter 2: About This Guide
Purpose of This Guide................................................................................................................2-1
Prerequisite Skills.........................................................................................................................2-1
Chapter Format............................................................................................................................2-1
Introduction ...........................................................................................................................2-2
What Do I Need to Know About... ................................................................................2-2
How Do I... ...............................................................................................................................2-2
Graphic Conventions and Legend.......................................................................................2-2
Safety Notices ...............................................................................................................................2-4
Chapter 3: Safety
Introduction............................................................................................................................................3-1
What Do I Need to Know About....................................................................................................3-3
Warning Labels and Symbols................................................................................................3-3
General Safety Guidelines .......................................................................................................3-7
Radiation Safety...........................................................................................................................3-9
Authorized Users .................................................................................................................3-9
General Radiation Safety.............................................................................................. 3-10
Scans Acquired at the Same Tomographic Plane ............................................ 3-10
CTDIvol .................................................................................................................................. 3-12
X-Ray Tubes........................................................................................................................ 3-13
Electrical Safety......................................................................................................................... 3-13
Mechanical Safety.................................................................................................................... 3-14
General Mechanical Safety ......................................................................................... 3-14
Patient Positioning........................................................................................................... 3-15
Volume Shuttle .................................................................................................................. 3-19
Laser Safety ................................................................................................................................ 3-20
Reconstructed Image Orientation.................................................................................... 3-21
Data Safety.................................................................................................................................. 3-22
Application Specific Safety Topics.................................................................................... 3-24
Helical Scanning ............................................................................................................... 3-24
Cardiac Imaging ............................................................................................................... 3-25
Patient Preparation ......................................................................................................... 3-27
Lung Algorithm.................................................................................................................. 3-28
Autoscan .............................................................................................................................. 3-28
SmartStep Safety ............................................................................................................. 3-28

TOC-1
Interventional / Biopsy Scanning.............................................................................. 3-30

Radiation Therapy Planning........................................................................................ 3-30
Accuracy of Measurements ................................................................................................ 3-31
Measure Distance for Axial, Helical, and Cine Images ................................... 3-31
Measure Distance for Scout Images....................................................................... 3-31
Measure Angle................................................................................................................... 3-32
ROI........................................................................................................................................... 3-32
Reformat Plane Thickness............................................................................................ 3-33
Operator Console Ergonomics........................................................................................... 3-33
Posture .................................................................................................................................. 3-33
Equipment Adjustments................................................................................................ 3-33
Accessories.................................................................................................................................. 3-35
GE Approved Accessories............................................................................................. 3-35
IV Pole Safety...................................................................................................................... 3-36
Table Tray Safety.............................................................................................................. 3-36
Systems With Metal-Free Cradles and Accessories......................................... 3-36
Limited Access Room Configuration....................................................................... 3-37
Emergency Devices and Emergency Egress ............................................................... 3-38
Emergency Devices......................................................................................................... 3-38
Emergency Stop................................................................................................................ 3-38
System Emergency OFF Buttons using Main Disconnect Control............. 3-40
Emergency Patient Care During X-Ray ON: ......................................................... 3-40
Emergency Egress ........................................................................................................... 3-40
Maintenance and Cleaning.................................................................................................. 3-41
Cleaning Equipment (Bio Hazard) ..................................................................................... 3-42
Environmental Concerns ...................................................................................................... 3-42
Name and Concentration of Hazardous Substances ............................................. 3-43
Explanation of Pollution Control Label................................................................... 3-43
Precautions ......................................................................................................................... 3-45
Chapter 4: Imaging Pediatric and Small Patients

Introduction............................................................................................................................................4-1
Radiation Exposure Sensitivity ..............................................................................................4-2
Dose Reporting Considerations ............................................................................................4-3
Suggestions for Minimizing Unnecessary Dose............................................................4-4
Perform Only Necessary CT Examinations..............................................................4-4
Scan Only the Organ or Anatomical Region Indicated......................................4-5
Minimize Multi-phase Contrast CT Examinations ................................................4-5
Properly Center All Patients in the Gantry ...............................................................4-5
Lower mA Settings for Chest and Bone Imaging .................................................4-5
Scan signal-to-noise..........................................................................................................4-5
Consider Using In-plane Bismuth Shields................................................................4-5
Use Pediatric Positioning Accessories.......................................................................4-5

TOC-2
Make a Kid Friendly Environment................................................................................4-6

Guidelines for Adjusting Individual Exposure Parameters by Patient ................4-6
Adjust Parameters by Size, Age, Weight, Height, & Indications ....................4-6
Lower kVp ...............................................................................................................................4-6
AutomA ....................................................................................................................................4-7
Increase Pitch .......................................................................................................................4-7
Use Small SFOV Filters ......................................................................................................4-8
Optimize Pediatric Protocols for your Facility ................................................................4-9
Pediatric Protocols......................................................................................................................4-9
Color Coding for Kids Protocol Selection....................................................................... 4-10
Color Code Table....................................................................................................................... 4-11
Protocol Category Window.................................................................................................. 4-12
Chapter 5: Getting Started

Introduction............................................................................................................................................5-1
Hardware Components............................................................................................................5-4
Gantry Display ......................................................................................................................5-7
Internal Gantry Components...................................................................................... 5-10
Computer (Operator Console) .................................................................................... 5-14
Discovery CT750 HD Table............................................................................................... 5-16
Tape Strips.......................................................................................................................... 5-17
Monitors................................................................................................................................ 5-18
Keyboard and Scan Interface module ................................................................... 5-21
Mouse .................................................................................................................................... 5-24
Bright Box ............................................................................................................................ 5-25
Power Distribution Unit (PDU) ............................................................................................. 5-26
Users Conventions ................................................................................................................... 5-27
Tool Chest .................................................................................................................................... 5-30
HIPAA.............................................................................................................................................. 5-33
Understanding users and groups............................................................................. 5-34
Understanding groups and privileges.................................................................... 5-34
Product Network Filters - PNF ............................................................................................ 5-34
Software Download................................................................................................................. 5-35
OptiDose ....................................................................................................................................... 5-36
Dose Features & Technology * .................................................................................. 5-36
Dose Reports ...................................................................................................................... 5-38
How Do I................................................................................................................................................ 5-40
Shut Down and Start Up System....................................................................................... 5-41
Login and Logout ..................................................................................................................... 5-44
Configure HIPPA (EA3) Properties...................................................................................... 5-46
Configure Local Users ............................................................................................................ 5-51
Configure Local Users ........................................................................................................... 5-53

TOC-3
Add a Local User ............................................................................................................. 5-53

Change a User Password ............................................................................................ 5-55
Change a User Full Name ........................................................................................... 5-56
Remove a User ................................................................................................................. 5-57
Add or Remove a User from a Group .................................................................... 5-58
Change User Roles ......................................................................................................... 5-59
Locking / Unlocking a User ......................................................................................... 5-59
Force a User to Change Password on Next Login ........................................... 5-59
Some fields may not be selectable if the following conditions occur. .... 5-60
Configure Groups ..................................................................................................................... 5-61
Configure Groups .................................................................................................................... 5-62
Add a Local Group .......................................................................................................... 5-62
Add a Enterprise Group ................................................................................................ 5-63
Manage a Group ............................................................................................................. 5-65
Remove a Group .............................................................................................................. 5-65
Change Groups Roles ................................................................................................... 5-65
Add Memberships ........................................................................................................... 5-65
Remove Memberships .................................................................................................. 5-66
Configure Enterprise Tab ...................................................................................................... 5-67
Configure Enterprise Tab ..................................................................................................... 5-70
Auto Configuration ......................................................................................................... 5-70
Configure Enterprise Tab ..................................................................................................... 5-73
Manual Configuration ................................................................................................... 5-73
Use QuickSnap........................................................................................................................... 5-75
Use IQ Snap................................................................................................................................. 5-77
Use Anonymous Patient (Anon Pat. Level) .................................................................... 5-80
Chapter 6: Daily Maintenance

Introduction............................................................................................................................................6-1
Performing Tube Warm-Up ....................................................................................................6-2
Performing Daily Calibrations................................................................................................6-3
Performing Full System Calibrations ..................................................................................6-3
How Do I...................................................................................................................................................6-4
Perform Tube Warm-Up...........................................................................................................6-5
Perform Air Calibrations (FastCals)......................................................................................6-7

TOC-4
Chapter 7: Multi-Detector Information

Scintillator Material.....................................................................................................................7-2
Performix HD Tube and Hi-Definition Generator......................................................7-2
Hardware Components............................................................................................................7-2
Axial Detector Coverage/Beam Collimation...................................................................7-2
Axial Acquisition Modes............................................................................................................7-3
Axial User Interface ....................................................................................................................7-3
Axial Signal Collection ...............................................................................................................7-4
Axial Interval ..................................................................................................................................7-4
Helical Pitch and Scan Mode Definitions..........................................................................7-4
Helical Beam Collimation for Discovery CT750 HD .................................................7-4
......................................................................................................................................................................7-6
Helical User Interface for Discovery CT750 HD Systems......................................7-6
Guidelines For Building Protocols ........................................................................................7-6
Slice Profiles ...................................................................................................................................7-7
Cardiac Helical Slice Profiles..........................................................................................7-8
Chapter 8: Building Protocols

Introduction............................................................................................................................................8-1
Helical/Axial/Cine ........................................................................................................................8-2
High Resolution Mode (Hi Res)...............................................................................................8-3
Volume Shuttle (Axial) Mode (Option) .................................................................................8-4
Volume Helical Shuttle Mode (Option) ...............................................................................8-5
Prospective Multiple Reconstructions (PMR)................................................................ 8-10
Full and Plus Recon Modes .................................................................................................. 8-10
Building Protocols..................................................................................................................... 8-11
Using Protocols.......................................................................................................................... 8-11
Editing Protocols ....................................................................................................................... 8-12
Viewing Protocols..................................................................................................................... 8-12
System Options ......................................................................................................................... 8-12
Noise Index Values................................................................................................................... 8-12
AutomA.......................................................................................................................................... 8-13
Background ........................................................................................................................ 8-13
AutomA Theory.................................................................................................................. 8-15
AutomA FAQs ..................................................................................................................... 8-16
AutomA Interface............................................................................................................. 8-19
SmartmA....................................................................................................................................... 8-23
Pediatric Protocols................................................................................................................... 8-27
Protocol Numbers .................................................................................................................... 8-30
Anatomical Selector................................................................................................................ 8-31

TOC-5
ECG Trace (Option) ................................................................................................................... 8-31

IQ Enhance .................................................................................................................................. 8-32
Adaptive Statistical Iterative Reconstruction (ASIR) (Option)................................ 8-33
ASIR Image Annotation ................................................................................................. 8-35
Copy Forward............................................................................................................................. 8-36
Flip/Rotate in Recon ................................................................................................................ 8-37
Gemstone Spectral Imaging (Option).............................................................................. 8-38
How Do I................................................................................................................................................ 8-40
Build or Edit a Protocol........................................................................................................... 8-41
Record a Personalized AutoVoice.................................................................................... 8-60
Select Default Language for AutoVoice 1, 2, and 3.................................................. 8-62
Change Preset Delay for AutoVoice................................................................................. 8-65
Delete an AutoVoice................................................................................................................ 8-66
Copy and Paste Protocols .................................................................................................... 8-67
Delete a Protocol ...................................................................................................................... 8-70
Use ECG Trace............................................................................................................................ 8-72
Chapter 9: SmartPrep
Introduction............................................................................................................................................9-1
SmartPrep.......................................................................................................................................9-2
Setting SmartPrep Parameters.............................................................................................9-2
Scanning the Baseline Phase.................................................................................................9-2
Scanning the Monitor Phase..................................................................................................9-2
Scanning the Scan Phase........................................................................................................9-3
How Do I...................................................................................................................................................9-4
Set the SmartPrep Parameters .............................................................................................9-5
Scan the Baseline Phase..........................................................................................................9-9
Scan the Monitor Phase ........................................................................................................ 9-11
Scan the Scan Phase .............................................................................................................. 9-13
Chapter 10: VariSpeed

Introduction......................................................................................................................................... 10-1
What Do I Need to Know About................................................................................................. 10-2
VariSpeed ..................................................................................................................................... 10-2
How Do I................................................................................................................................................ 10-3
Use VariSpeed............................................................................................................................ 10-4

TOC-6
Chapter 11: Prospective Gating (SmartScore) (Option)

Introduction......................................................................................................................................... 11-1
Prospective Gating (SmartScore) ...................................................................................... 11-2
R to R interval ............................................................................................................................. 11-2
ECG (or EKG) Waveform......................................................................................................... 11-2
How Do I................................................................................................................................................ 11-5
Set the Exam Prescription for Prospective Gating (SmartScore)........................ 11-6
Chapter 12: Cardiac Imaging Discovery CT750 HD

Introduction......................................................................................................................................... 12-1
Prior to Scanning ...................................................................................................................... 12-3
Cardiac Helical .................................................................................................................. 12-6
SnapShot Segment.......................................................................................................... 12-8
SnapShot Segment Plus................................................................................................ 12-8
SnapShot Burst.................................................................................................................. 12-9
SnapShot Burst Plus........................................................................................................ 12-9
CardIQ SnapShot Window ........................................................................................ 12-10
SnapShot Pulse .............................................................................................................. 12-11
SnapShot Pulse Window............................................................................................ 12-13
Hi Res Mode ..................................................................................................................... 12-16
ECG (or EKG) Waveform ............................................................................................. 12-16
Auto Detection of Heart Rate .................................................................................. 12-18
Manual Detect Heart Rate ........................................................................................ 12-18
Pitch..................................................................................................................................... 12-19
Phase Location............................................................................................................... 12-19
% R-Peak Value.............................................................................................................. 12-19
SnapShot Mode Usage ............................................................................................... 12-20
ECG Modulated mA ...................................................................................................... 12-20
Scan Preparation................................................................................................................... 12-22
Patient Preparation .............................................................................................................. 12-24
Patient Skin Preparation & Electrode Placement........................................... 12-25
Alternate Electrode Positions for Signal Clarity............................................... 12-26
Scan Parameters Usage .................................................................................................... 12-26
Scout Scan........................................................................................................................ 12-27
Localizer Scan................................................................................................................. 12-27
Timing Bolus Scan......................................................................................................... 12-29
Contrast Enhanced Cardiac Acquisition............................................................. 12-31
Cardiac Series Retro Reconstruction Numbering .................................................. 12-35
Single Phase Image Set.............................................................................................. 12-35
Multiphase Image Set ................................................................................................. 12-35
Cardiac Images are annotated with either of the following:.................... 12-35

TOC-7
ECG Viewer/R-Peak Editor Overview............................................................................ 12-36

Adjust/Move Triggers .................................................................................................. 12-38
Insert Triggers................................................................................................................. 12-40
Delete Triggers ............................................................................................................... 12-41
Invert a Trace .................................................................................................................. 12-41
Measure Mode................................................................................................................ 12-42
Zoom In and Out............................................................................................................ 12-43
How Do I............................................................................................................................................. 12-44
Set Up a Patient...................................................................................................................... 12-45
Scan the Patient..................................................................................................................... 12-50
Scout Scans .................................................................................................................... 12-50
Scan the Patient .................................................................................................................... 12-52
Localizer Scan ................................................................................................................ 12-52
Timing Bolus Scans ..................................................................................................... 12-53
Contrast Enhanced Cardiac Scan ........................................................................ 12-55
Reconstruct Cardiac Scans............................................................................................... 12-61
Save ECG Trace ...................................................................................................................... 12-64
Edit ECG Trace/R-Peaks in ECG Viewer ...................................................................... 12-66
Adjust/Move Triggers ................................................................................................. 12-66
Insert Triggers ................................................................................................................ 12-70
Delete a Trigger ............................................................................................................ 12-74
Invert a Trace ................................................................................................................. 12-78
Save/Reset Trace Changes ..................................................................................... 12-82
Measure Distance on the Trace ............................................................................ 12-87
Zoom In or Out on a Trace ....................................................................................... 12-91
Chapter 13: Auto Applications (Option)

Introduction......................................................................................................................................... 13-1
Direct Multi Planar Reformat (DMPR)............................................................................... 13-2
Session Setup Window .................................................................................................. 13-3
Scanning with DMPR............................................................................................................... 13-5
DMPR Review Controller........................................................................................................ 13-7
DMPR Manual Batch Prescriptions................................................................................ 13-10
Neuro 3D Filter........................................................................................................................ 13-12
How Do I............................................................................................................................................. 13-13
Set the Direct3D Parameters in the Scan Prescription........................................ 13-14

TOC-8
Select Preset Curves for Direct3D.................................................................................. 13-15

Select Rendering Control Selections on the Direct3D Setup Screen............. 13-16
View Direct3D in the Review Mode ............................................................................... 13-17
Set the Direct MPR Parameters in the Scan Prescription ................................... 13-18
Set Neuro 3D filter Parameters in the Scan Prescription.................................... 13-19
Chapter 14: Performed Procedure Step (PPS) (Option)

Introduction......................................................................................................................................... 14-1
Performed Procedure Step (PPS) ....................................................................................... 14-2
How Do I................................................................................................................................................ 14-3
Use Performed Procedure Step (PPS).............................................................................. 14-4
Chapter 15: Exam Split (Option)

Introduction......................................................................................................................................... 15-1
Exam Split .................................................................................................................................... 15-2
Virtual Mode ....................................................................................................................... 15-2
Hard Mode........................................................................................................................... 15-2
How Do I................................................................................................................................................ 15-4
Perform an Exam Split After a Scan is Completed.................................................... 15-5
Using ConnectPro with Exam Split................................................................................... 15-9
Chapter 16: SmartStep (Option)

Introduction......................................................................................................................................... 16-1
SmartStep .................................................................................................................................... 16-2
Hand Held Controller (HHC) ................................................................................................. 16-3
SmartStep Display.................................................................................................................... 16-6
How Do I................................................................................................................................................ 16-8
Prepare for SmartStep ........................................................................................................... 16-9
Set Up SmartStep Mode ..................................................................................................... 16-11
Scan with SmartStep ........................................................................................................... 16-14
Display SmartStep Images................................................................................................ 16-17
Set Window/Level Presets for the HHC....................................................................... 16-20
Chapter 17: Scheduling Patients

Introduction......................................................................................................................................... 17-1
Patient Schedule....................................................................................................................... 17-2

TOC-9
Connect Pro................................................................................................................................. 17-2

New Records and Completed Records .......................................................................... 17-2
How Do I................................................................................................................................................ 17-3
Use the Bar Code Reader ..................................................................................................... 17-4
Update the Patient Schedule List...................................................................................... 17-7
Add a Patient to the Schedule............................................................................................ 17-9
Delete a Patient From the Schedule............................................................................. 17-11
Set Up Preferences in the Schedule.............................................................................. 17-12
Edit a Patient Schedule....................................................................................................... 17-15
Select a Patient from the Schedule............................................................................... 17-17
Check the Status of a Patient .......................................................................................... 17-19
View More Information About the Patient ................................................................. 17-20
Chapter 18: Biopsy Mode

Introduction......................................................................................................................................... 18-1
Biopsy Mode................................................................................................................................ 18-2
Biopsy Reference Scans ........................................................................................................ 18-2
How Do I................................................................................................................................................ 18-3
Use the Biopsy Mode .............................................................................................................. 18-4
Chapter 19: X-Y Table Accuracy Procedure

Introduction......................................................................................................................................... 19-1
Recommended workflow for RT ........................................................................................ 19-2
........................................................................................................................................................... 19-3
Clinical table lateral motion verification procedure
for PET-CT RT and CT-RT ....................................................................................................... 19-4
Set Up ................................................................................................................................... 19-4
Requirements..................................................................................................................... 19-4
Set Up Procedure ............................................................................................................. 19-4
for PET-CT RT and CT-RT ...................................................................................................... 19-6
Procedure ........................................................................................................................... 19-6
Results ................................................................................................................................... 19-7
for PET-CT RT and CT-RT ....................................................................................................... 19-9
Analysis of Results .......................................................................................................... 19-9
Clinical table elevation adjustment verification procedure
for PET-CT RT and CT-RT ................................................................................................... 19-11
Requirements.................................................................................................................. 19-11
Procedure ........................................................................................................................ 19-12

TOC-10

Analysis ............................................................................................................................. 19-14
Results ................................................................................................................................ 19-14
Chapter 20: Patient Setup and Scout Scan

Introduction......................................................................................................................................... 20-1
Positioning Patients................................................................................................................. 20-2
Using Protocols.......................................................................................................................... 20-2
Using Contrast ........................................................................................................................... 20-3
Setting Up a Patient without an ID#................................................................................ 20-3
Emperor Era Birth Year Entry .............................................................................................. 20-4
Preset Descriptions.................................................................................................................. 20-4
How Do I................................................................................................................................................ 20-5
Set Up Patient Information .................................................................................................. 20-6
Position the Patient............................................................................................................... 20-11
Selecting a Protocol ............................................................................................................. 20-13
Adjust the Localizer (Scout)............................................................................................... 20-15
Confirm the Localizer (Scout) ........................................................................................... 20-17
Chapter 21: Scan Series Setup

Introduction......................................................................................................................................... 21-1
Adjusting a Protocol ................................................................................................................ 21-2
Setting Scan Field of View and Display Field of View .............................................. 21-2
Using a Breath Hold Delay................................................................................................... 21-2
Working with the Optimizer................................................................................................. 21-3
How Do I................................................................................................................................................ 21-4
Set Scan Parameters .............................................................................................................. 21-5
Adjusting Graphic Rx............................................................................................................ 21-11
Set Timing Parameters ....................................................................................................... 21-13
Set Display Factors ............................................................................................................... 21-18
Repeat a Series....................................................................................................................... 21-25
Enter Contrast Descriptions ............................................................................................. 21-27
Chapter 22: Automatic Filming

Introduction......................................................................................................................................... 22-1
Autostart....................................................................................................................................... 22-2
Image Filters ............................................................................................................................... 22-2

TOC-11
Gray Scale Enhancement ..................................................................................................... 22-2

How Do I................................................................................................................................................ 22-4
Set the Film Parameters for Automatic Filming......................................................... 22-5
Set the Image Parameters for Automatic Filming .................................................... 22-6
Use the Filming Buttons on the Autofilm Viewport .................................................. 22-7
Manually Add an Image to the AutoFilm Composer................................................ 22-9
Chapter 23: Manually Filming Images

Introduction......................................................................................................................................... 23-1
Using the F Keys........................................................................................................................ 23-2
Setting Window Width and Level Presets..................................................................... 23-2
How Do I................................................................................................................................................ 23-3
Set Window Width and Window Level Preset Keys.................................................. 23-4
Set Manual Film Composer Parameters........................................................................ 23-5
Place Images in the Manual Film Composer ............................................................... 23-6
Set Print Series Parameters ................................................................................................. 23-7
Chapter 24: Managing Images

Introduction......................................................................................................................................... 24-1
Feature Status Area ................................................................................................................ 24-2
Anonymous Patient ................................................................................................................. 24-3
Archive........................................................................................................................................... 24-3
Network......................................................................................................................................... 24-4
Networking Terms ........................................................................................................... 24-4
WorkArounds.............................................................................................................................. 24-5
Data Export ................................................................................................................................. 24-6
CD/DVD Interchange (Option).......................................................................................... 24-10
Media Requirements:................................................................................................... 24-11
Operation Requirements: .......................................................................................... 24-11
How Do I............................................................................................................................................. 24-13
Set up a Remote Host.......................................................................................................... 24-14
Select an Archive Node....................................................................................................... 24-16
Set an Access to a Local Host and Set Up a Custom Search ........................... 24-17
Select an Archive Device ................................................................................................... 24-18
Prepare a New Storage Media for Use........................................................................ 24-20
Save Exam/Series/Images to a Storage Media ...................................................... 24-22
Retrieve Exams/Series/Images From a Storage Media....................................... 24-24
Restore Exam/Series/Images using CD/DVD Interchange Option................. 24-26

TOC-12
Save Exam/Series/Images using CD/DVD Interchange Option....................... 24-28

Transfer Exams/Series/Images to Another Computer......................................... 24-31
Retrieve Exams/Series/Images From Another Computer .................................. 24-33
Check Network History File............................................................................................... 24-36
Edit Patient Information ..................................................................................................... 24-38
Remove Patient Information From an Exam............................................................ 24-43
Delete Exams/Series/Images From the System...................................................... 24-45
Compose a Report in Data Export................................................................................. 24-47
Save a Report to CD-R......................................................................................................... 24-49
FTP a Report............................................................................................................................. 24-51
View a Report on a PC......................................................................................................... 24-52
Chapter 25: Viewing Images

Introduction......................................................................................................................................... 25-1
List/Select..................................................................................................................................... 25-2
Paging............................................................................................................................................ 25-2
Viewer and Mini-Viewer......................................................................................................... 25-2
How Do I................................................................................................................................................ 25-4
View a List of Scanned Patients......................................................................................... 25-5
View a Patients Scan ............................................................................................................. 25-6
Advance One Exam/Series/Image At a Time in Image Works ............................ 25-7
Scroll Through A Set of Images.......................................................................................... 25-8
View Images in a Cine Loop ................................................................................................ 25-9
Compare Exams/Series/Images..................................................................................... 25-10
View a Reference Image .................................................................................................... 25-11
Chapter 26: Image Display Viewing Area

Introduction......................................................................................................................................... 26-1
Autoview....................................................................................................................................... 26-2
Auto Link....................................................................................................................................... 26-2
Primary Viewport...................................................................................................................... 26-2
Secondary Viewport................................................................................................................ 26-3
Viewport........................................................................................................................................ 26-3
How Do I................................................................................................................................................ 26-4
Select a Single Image Display............................................................................................. 26-5
Select a Multiple Image Display......................................................................................... 26-6
Set Viewports for Images to Come Up in Order......................................................... 26-7
Set Viewports for Automatic Display of the Next Series ........................................ 26-8

TOC-13
Set a Primary Viewport .......................................................................................................... 26-9

Set a Secondary Viewport................................................................................................. 26-10
Chapter 27: Sort Examinations and Images

Introduction......................................................................................................................................... 27-1
Sorting Examinations ............................................................................................................. 27-3
Sort Examinations by Examination Number ....................................................... 27-3
Sort Examinations by Patient Name ....................................................................... 27-3
Sort Examinations by Date .......................................................................................... 27-3
Sort Examinations by Modality .................................................................................. 27-3
Sort Examinations by Archived Status ................................................................... 27-3
Sorting Images........................................................................................................................... 27-3
Sort Images by Image Number ................................................................................. 27-4
Sort Images by Location............................................................................................... 27-4
Sort Images by Echo....................................................................................................... 27-4
Sort Images by Trigger .................................................................................................. 27-4
Sort Images by Scan Time ........................................................................................... 27-4
How Do I................................................................................................................................................ 27-5
Sort Examinations .................................................................................................................... 27-6
Sort Images ................................................................................................................................. 27-7
Chapter 28: Image Manipulations

Introduction......................................................................................................................................... 28-1
Gray Scale Enhancement ..................................................................................................... 28-2
Using Proview or Image Filters .......................................................................................... 28-2
DICOM Gray Scale Presentation State Object (GSPS) .............................................. 28-2
Neuro 3D Filter........................................................................................................................... 28-3
How Do I................................................................................................................................................ 28-4
Change the Orientation of an Image .............................................................................. 28-5
Make Images Sharper or Smoother................................................................................. 28-6
Improve the Brain/Bone Interface.................................................................................... 28-7
Restore an Image to its Original State............................................................................ 28-8
Reverse the Video..................................................................................................................... 28-9
Apply Mattes to an Image ................................................................................................. 28-10
How Do I............................................................................................................................................. 28-11
Change the Orientation of an Image ........................................................................... 28-12
Make Images Sharper or Smoother.............................................................................. 28-13
Improve the Brain/Bone Interface................................................................................. 28-14
Restore an Image to its Original State......................................................................... 28-15
Apply Mattes to an Image ................................................................................................. 28-16

TOC-14
Create a Gray Scale Presentation State Object (GSPS)........................................ 28-17

View a Gray Scale Presentation State Object (GSPS)............................................ 28-18
Process Neuro 3D Images................................................................................................. 28-19
Chapter 29: Image Addition/Subtraction

Introduction......................................................................................................................................... 29-1
Image Addition .......................................................................................................................... 29-2
Image Subtraction ................................................................................................................... 29-2
Maximum Pixel Value Extraction....................................................................................... 29-2
Minimum Pixel Extraction ..................................................................................................... 29-2
Binding Series............................................................................................................................. 29-3
Accept Negative Pixels........................................................................................................... 29-3
The Difference Between "Proc" and "Comb"................................................................ 29-3
Ratio Slider Bar .......................................................................................................................... 29-3
How Do I................................................................................................................................................ 29-4
Add Images Together to Create a New Image........................................................... 29-5
Subtract Images to Create a New Image ..................................................................... 29-6
Combine Images from Different Series to Create a New Series ........................ 29-7
Use Existing Images to Create a New Image Using Only
the Maximum CT Number ................................................................................................... 29-8
the Minimum CT Number .................................................................................................... 29-9
Chapter 30: Magnifying Images

Introduction......................................................................................................................................... 30-1
How Do I................................................................................................................................................ 30-2
Move the Image Around on the Screen in Exam Rx................................................. 30-3
Make the Image Smaller or Larger Real Time in Exam Rx .................................... 30-4
Specify a Zoom Factor in Exam Rx................................................................................... 30-5
How Do I................................................................................................................................................ 30-6
Move the Image Around the Screen in Image Works ............................................. 30-7
Make the Image Smaller or Larger Real Time in Image Works .......................... 30-8
Chapter 31: Measuring Structures Within an Image

Introduction......................................................................................................................................... 31-1
How Do I................................................................................................................................................ 31-4

TOC-15
Chapter 32: Graphics, Text Pages and Commands

Introduction......................................................................................................................................... 32-1
Cross-referencing..................................................................................................................... 32-2
Screen Save................................................................................................................................. 32-2
Accelerator Line ........................................................................................................................ 32-2
User Preferences ...................................................................................................................... 32-2
How Do I................................................................................................................................................ 32-3
Annotate the Scout With Scan Lines............................................................................... 32-4
Type Text on the Image......................................................................................................... 32-5
Display the Exam Information............................................................................................ 32-6
Display the Parameters of a Scan Mode ....................................................................... 32-7
Hide or Show Graphics .......................................................................................................... 32-8
Remove Graphics From the Image .................................................................................. 32-9
Save an Image Screen ........................................................................................................ 32-10
Type in Specific Accelerator Line Commands.......................................................... 32-11
How Do I............................................................................................................................................. 32-12
Type Text on the Image...................................................................................................... 32-13
Display the Exam Information......................................................................................... 32-14
Display the Parameters of a Scan Mode .................................................................... 32-15
Hide or Show Graphics ....................................................................................................... 32-16
Remove Graphics From the Image ............................................................................... 32-17
Save an Image Screen ........................................................................................................ 32-18
Type in Specific Accelerator Command Lines.......................................................... 32-19
How Do I Edit Default Settings in the Image Works Desktop.................................... 32-20
Edit Default Settings for Annotation............................................................................. 32-21
Edit Default Settings for Grid Preferences ................................................................. 32-22
Edit Default Settings for W/L Presets ........................................................................... 32-23
Edit Default Settings for Right Mouse Button........................................................... 32-24
Edit Default Settings for Tick Marks .............................................................................. 32-25
Edit Default Settings for Series Binding....................................................................... 32-26
Edit Default Settings for Square Viewports............................................................... 32-27
Chapter 33: Managing Scan (Raw) Data

Introduction......................................................................................................................................... 33-1
Scan (Raw) Data........................................................................................................................ 33-2
Suspended Entries ................................................................................................................... 33-2
Saving Scan Data ..................................................................................................................... 33-2
Restoring Scan Data ............................................................................................................... 33-3
Reserving Scan Data............................................................................................................... 33-3

TOC-16
Releasing Scan Data............................................................................................................... 33-3

Graphic Retro ............................................................................................................................. 33-3
New Series Number for Retro Recon .............................................................................. 33-4
WorkArounds.............................................................................................................................. 33-4
How Do I................................................................................................................................................ 33-5
Create New Images From Scan Data ............................................................................. 33-6
Remove Images From the Reconstruction List ....................................................... 33-11
Look for Images that are not Reconstructed ........................................................... 33-13
Pause Images From Reconstructing ............................................................................ 33-15
Resume Image Reconstruction ...................................................................................... 33-16
Update the Reconstruction List ...................................................................................... 33-17
Save/Restore Scan Data to/from a USB/DVD-Ram .............................................. 33-18
Complete an Anonymous Scan Data Save ............................................................... 33-19
Reserve/Release Scan Data ............................................................................................. 33-20
Chapter 34: Reformat

Introduction......................................................................................................................................... 34-1
Safety ............................................................................................................................................. 34-3
Intended Use .............................................................................................................................. 34-4
User Profile .................................................................................................................................. 34-4
Important Notes........................................................................................................................ 34-4
Image reliability................................................................................................................. 34-4
Window Width and Level (W/L).................................................................................. 34-5
Volume Rendering ........................................................................................................... 34-5
Image quality ..................................................................................................................... 34-5
Segment Tools ................................................................................................................... 34-6
Measurements................................................................................................................... 34-6
Filming and Saving Images ......................................................................................... 34-7
Requirements for Reformat................................................................................................. 34-7
Red Annotation on the Image ............................................................................................ 34-8
Keyboard Shortcuts and Tips........................................................................................... 34-10
View Types................................................................................................................................ 34-10
Render Modes ......................................................................................................................... 34-12
Cut Planes and 3D Shutters.............................................................................................. 34-13
Main Control Panel................................................................................................................ 34-14
Advanced Processing .......................................................................................................... 34-17
Review Controller .................................................................................................................. 34-21
Measurements, Annotate and Save images ............................................................ 34-24
Display Tools............................................................................................................................ 34-25
Segment Tools ........................................................................................................................ 34-28
Film/Save Tools ...................................................................................................................... 34-32

TOC-17
Regions of Interest (ROI) ..................................................................................................... 34-34

Contextual Menu ................................................................................................................... 34-34
Volume Render (VR) .............................................................................................................. 34-36
Up ramp VR Adjustments .................................................................................................. 34-37
VR Tools...................................................................................................................................... 34-38
VR Advance Settings Menu............................................................................................... 34-41
Surface Rendering ................................................................................................................ 34-42
Film/Save Options ................................................................................................................. 34-43
How Do I............................................................................................................................................. 34-46
Reformat a Series.................................................................................................................. 34-47
Edit with the Active Annotation ...................................................................................... 34-48
Auto Select................................................................................................................................ 34-50
Paint on Slice ........................................................................................................................... 34-51
Create Different View Types............................................................................................. 34-53
Create a Curved View Type ..................................................................................... 34-53
Create a Profile View Type ....................................................................................... 34-56
Create a Histogram View Type .............................................................................. 34-58
Create an X Section View Type .............................................................................. 34-61
Prescribe a Multi Projection Volume Reformation (MPVR) ........................ 34-64
Regions of Interest (ROI) ..................................................................................................... 34-66
Manage Color Maps ............................................................................................................. 34-68
Modify the Opacity Ramp Settings................................................................................ 34-70
Work with Colors in VR........................................................................................................ 34-71
To Add Colors .................................................................................................................. 34-71
To Assign a Range of Numbers to a Color......................................................... 34-71
To Change a Color ........................................................................................................ 34-71
Zoom In or Zoom Out the Main VR Control Window............................................. 34-72
Attach/Detach Objects ....................................................................................................... 34-73
Create a Multi VR Object .................................................................................................... 34-74
Save or Film Batch Images ............................................................................................... 34-75
To create a set of 3D rotation images:................................................................ 34-76
To create set of parallel 2D images:..................................................................... 34-76
Set Up a Batch Oblique....................................................................................................... 34-77
Set up a Batch Rotation ..................................................................................................... 34-78
360-degree rotating 3D images............................................................................. 34-79
Radial planes on 2D views ........................................................................................ 34-79
Save Batch Images............................................................................................................... 34-80
Save Batch Curved Parallel Planes ............................................................................... 34-81
Save Rotating Batch Curved ............................................................................................ 34-82

TOC-18
Chapter 35: ASIR Review Application

Introduction......................................................................................................................................... 35-1
ASIR Review Application Requirements ......................................................................... 35-2
Reviewing ASIR Images ......................................................................................................... 35-3
ASIR Presentations .................................................................................................................. 35-3
Viewport Selection ................................................................................................................... 35-4
Image Standard Annotation ............................................................................................... 35-5
ASIR Noise Level Blending .................................................................................................... 35-5
ASIR Image Scrolling ............................................................................................................... 35-6
Image Controls .......................................................................................................................... 35-7
Mouse controls (applied to all viewports): ............................................................ 35-7
Right Mouse Button Menu............................................................................................ 35-8
Display Tools............................................................................................................................... 35-8
ROIs........................................................................................................................................ 35-9
Report Cursor Button ..................................................................................................... 35-9
ASIR Application Menu ........................................................................................................ 35-10
How Do I............................................................................................................................................. 35-12
Launch the ASIR Review Application............................................................................ 35-13
Exit the Application............................................................................................................... 35-14
Chapter 36: Gemstone Spectral Imaging Viewer (GSI)

Introduction......................................................................................................................................... 36-1
Gemstone Spectral Imaging Theory................................................................................ 36-3
Viewport selection.................................................................................................................... 36-3
Image standard annotation ................................................................................................ 36-3
Preliminary Assessment........................................................................................................ 36-5
Preliminary Assessment Presentations ........................................................................ 36-5
Preliminary Assessment Options/Features.................................................................. 36-5
Material Decomposition Tab............................................................................................... 36-6
Material Decomposition Presentations.......................................................................... 36-6
Material Decomposition Options/Features .................................................................. 36-7
Image controls........................................................................................................................... 36-8
Pan and zoom.................................................................................................................... 36-8
Window level .............................................................................................................................. 36-8
Scroll the image ........................................................................................................................ 36-8
Right Mouse Button Menu.................................................................................................... 36-9
Orientation Changes............................................................................................................ 36-10
Image Type Selection .......................................................................................................... 36-10

TOC-19
Material Decomposition Selection (MD Images Only) .......................................... 36-11

keV Selection (Monochromatic Images Only)........................................................... 36-12
Color-Overlay Opacity % Selection (Color-Overlay Images Only)................... 36-12
Color Overlay Layer Property Range Settings.......................................................... 36-13
Display Tools panel............................................................................................................... 36-13
Display Tools............................................................................................................................ 36-13
ROIs..................................................................................................................................... 36-13
Link/Unlink........................................................................................................................ 36-14
Report Cursor Button .................................................................................................. 36-14
File, View, Help Panel ........................................................................................................... 36-16
File Panel ................................................................................................................................... 36-16
View Panel ................................................................................................................................ 36-16
Help Panel................................................................................................................................. 36-17
Active Image Annotation Tool Tips................................................................................ 36-17
How Do I............................................................................................................................................. 36-18
Launching Gemstone Spectral Imaging Viewer (GSI)........................................... 36-19
Exiting The Gemstone Spectral Imaging Viewer (GSI)......................................... 36-20
Appendix A: Accelerator Line Commands

Introduction............................................................................................................................................A-1
Graphic Retro Recon..................................................................................................................A-1
Exam Rx ...........................................................................................................................................A-5
Image Works ..............................................................................................................................A-17
Appendix B: Legacy Precautions

System ..............................................................................................................................................B-1
Tube Warm Up/Fast Cal...........................................................................................................B-3
Scan ...................................................................................................................................................B-4
Patient Schedule.........................................................................................................................B-7
ConnectPro (Purchased Option) ...........................................................................................B-7
Performed Procedure Step (part of connect pro option) ..........................................B-7
Protocol Management ..............................................................................................................B-7
Reconstruction .............................................................................................................................B-8
Lung Algorithm.....................................................................................................................B-8
3000 Image Series ......................................................................................................................B-9
Display......................................................................................................................................B-9
Archive .....................................................................................................................................B-9
Network ...................................................................................................................................B-9
DentaScan/Add/Subtract................................................................................................B-9
Retro Recon....................................................................................................................................B-9
Recon Management................................................................................................................B-10

TOC-20
Volume Viewer (Option) .........................................................................................................B-11

CT Colon (Option) ......................................................................................................................B-11
SmartScore PRO Purchased Option.............................................................................B-11
Advanced Vessel Analysis (Option)...................................................................................B-11
Dentascan....................................................................................................................................B-11
BMD.................................................................................................................................................B-12
CardIQ Snapshot Purchased Option............................................................................B-12
Auto Transfer..............................................................................................................................B-12
Display (Applies to ExamRx Display and Image Works) .........................................B-13
Exam Rx Display........................................................................................................................B-14
Image Works Display..............................................................................................................B-15
Edit Patient Data.......................................................................................................................B-16
Filming ...........................................................................................................................................B-16
Network.........................................................................................................................................B-18
Image management............................................................................................................... B-20
Appendix C: Operator Messages

Introduction........................................................................................................................................... C-1

TOC-21
Product Manufacturer
Chapter 1
Product Manufacturer
This chapter lists the manufacturer of the Discovery CT750 HD product. The manufacturer
listed is authorized to CE mark the product listed.
Table 1-1 Discovery CT750 HD Product Manufacturer
Model Name
Discovery CT750 HD
Manufacturer (*)
Manufacturing Site
GE Medical Systems, LLC *

Manufacturer Address
3000, N. Grandview Blvd.
Waukesha, WI - 53188, USA
1-1
About This Guide
Chapter 2
About This Guide

This chapter explains the purpose and design of this Learning and Reference Guide. It is an
introduction to the guide, providing information on the purpose, prerequisite skills, guide
organization, chapter format, and graphic conventions that identify the visual symbols used
throughout the guide.
Purpose of This Guide

This guide is written for health care professionals (namely, the technologist) to provide the
necessary information relating to the proper operation of this system. The guide is intended
to teach you the system components and features necessary to use it to its maximum
potential. It is not intended to teach imaging or to make any type of clinical diagnosis.
This guide should be kept with the equipment at all times. It is important for you to
periodically review the procedures and safety precautions. It is important for you to read
and understand the contents of this guide before attempting to use this product.
Prerequisite Skills
This guide is not intended to teach imaging. It is necessary for you to have sufficient
knowledge to competently perform the various diagnostic imaging procedures within your
modality. This knowledge is gained through a variety of educational methods including
clinical working experience, hospital based programs, and as part of many college and
university programs.
Chapter Format
Each chapter contains a consistent format. This consistency provides uniformity for content
delivery and a better learning environment for you. Listed below are the components for
each chapter.

2-1
About This Guide
Introduction
The Introduction provides a short introduction to the chapter and a list of tasks to be
presented.
What Do I Need to Know About...

The What Do I Need to Know About... section lists and explains concepts necessary to
perform the tasks within the chapter.
How Do I...
The How Do I... section provides the detailed steps necessary to complete a given task.
These detailed steps not only provide the steps to complete a task, but also provide
additional information, as needed, related to a step.
Each task also includes a Quick Steps table. This Quick Steps table is intended to be used as
a quick reference by the experienced technologist and provides only the steps necessary to
complete a task. Be sure to read the detailed steps before using this table.
Graphic Conventions and Legend

The format of the page is such that you have room in the outer margin to make notes as
needed, except in the area where the In Brief table is located in the How Do I... section.
Table 2-1 describes the terminology used for the various mouse functions. Table 2-2
describes the conventions used when working with menus, buttons, text boxes and
keyboard keys.
Table 2-1 Conventions for Mouse Actions
Mouse Action
Description
Click
Clicking the left mouse button to select a

button or icon. The button can be pressed
in, not pressed in, or popped in/out.
Right-click
Clicking the right mouse button.
Middle-click
Clicking the middle mouse button.
Click and drag
Clicking and holding the left mouse button

down while dragging the cursor to the
desired location.

2-2
About This Guide

Mouse Action
Description
Right-click and drag
Clicking and holding the right mouse button

down while dragging the cursor to the
desired location.
Middle-click and drag
Clicking and holding the middle mouse

button down while dragging the cursor to
the desired location.
Double-click
Clicking the left mouse button twice in rapid

succession.
Triple-click
Clicking the left mouse button three times in

rapid succession.
Table 2-2 Conventions for Menus, Buttons, Text Boxes, and Keyboard Keys
Example
Describes
Select
Selecting an option in a check box or radial

button and selecting a tab.
Press Enter
Pressing a hard key on the keyboard.
Press and hold Shift
Pressing and holding down a hard key on

the keyboard.
Click [Viewer]
A button label or Interface button name.
Click
prior)
(Exam
Selecting an icon-based button.
In the Matrix text box,...
The name of text box in which you can

select or type text.
Type supine in the

Patient Position text box
(different font and bold)
Text you enter into a text box.
Select Sort > Sort by date
The pathway of selecting option(s) in a

pull-down menu.

2-3
About This Guide
Safety Notices
The following safety notices are used to emphasize certain safety instructions. This guide
uses the international symbol along with the danger, warning, or caution message. This
section also describes the purpose of a Note.
DANGER:
Danger is used to identify conditions or actions for which a specific hazard is

known to exist which will cause severe personal injury, death, or substantial
property damage if the instructions are ignored.
WARNING: Warning is used to identify conditions or actions for which a specific hazard
is known to exist which may cause severe personal injury, death, or
substantial property damage if the instructions are ignored.
CAUTION:
Caution is used to identify conditions or actions for which a potential hazard

may exist which will or can cause minor personal injury or property damage
if the instructions are ignored.
NOTE: A Note provides additional information that is helpful to you. It may emphasize certain
information regarding special tools or techniques, items to check before proceeding,
or factors to consider about a concept or task.

2-4
Safety
Chapter 3
Safety
Introduction
This chapter provides information about safety precautions and procedures. It is important
for you to read and understand the contents of this chapter so the correct precautions and
procedures are followed.
This manual should be kept near the console for easy access.
If necessary, additional training is available from a GE Applications Specialist. Contact your
institutions GE sales representative for additional information about further safety and
operational training.
TheDiscovery CT750 HD scanner complies with IEC 60601-1 and UL 60601-1.
The system is classified as a Class I, IPX0 equipment, not suitable for use in the presence of
a flammable anesthetic mixture with oxygen or nitrous oxide. It is rated for continuous
operation with intermittent loading. No sterilization is applied. The patient table cradle is
considered a Type B applied part.
The Discovery CT750 HD Computed Tomography X-ray system is intended to produce
cross-sectional images of the body by computer reconstruction of x-ray transmission data
taken at different angles and planes, including Axial, Cine, Helical (Volumetric), Cardiac,
Spectral, and Gated acquisitions for all ages. These images may be obtained either with or
without contrast. This device may include signal analysis and display equipment, patient
and equipment supports, components and accessories.
This device may include data and image processing to produce images in a variety of
trans-axial and reformatted planes. Further the images can be post processed to produce
additional imaging planes or analysis results.
The Discovery CT750 HD CT Scanner System is indicated for head, whole body, cardiac
and vascular X-ray Computed Tomography applications.
The device output is a valuable medical tool for the diagnosis of disease, trauma, or
abnormality and for planning, guiding, and monitoring therapy.

3-1
Safety
If the spectral imaging option is included on the system, the system can acquire CT images
using different kV levels of the same anatomical region of a patient in a single rotation from
a single source. The differences in the energy dependence of the attenuation coefficient of
the different materials provide information about the chemical composition of body
materials. This approach enables images to be generated at energies selected from the
available spectrum to visualize and analyze information about anatomical and pathological
structures.
United States Federal Regulation 21CFR 801.109
CAUTION:
Federal law restricts this device to sale by or on the order of a physician.

3-2
Safety
What Do I Need to Know About ...

The Learning and Reference Guide and Technical Reference Manual include information
required for the safe use of the equipment. This chapter summarizes the most important
safety issues. Some of the concepts you need to understand:
Warning Labels and Symbols
General Safety Guidelines
Radiation Safety
Electrical Safety
Mechanical Safety
Laser Safety
Reconstructed Image Orientation
Data Safety
Application Specific Safety Topics

Helical Scanning
Cardiac Imaging
Accuracy of Measurements
Operator Console Ergonomics
Accessories
Emergency Devices and Emergency Egress
Maintenance and Cleaning
Environmental Concerns
Name and Concentration of Hazardous Substances
Warning Labels and Symbols

This chapter addresses three safety classifications:
DANGER:
The most severe label describes conditions or actions which result in a specific
hazard. You will cause severe or fatal personal injury, or substantial property
damage if you ignore these instructions.
WARNING: This label identifies conditions or actions which result in a specific hazard.
You will cause severe personal injury, or substantial property damage if you
ignore these instructions.

3-3
Safety
CAUTION:
This label applies to conditions or actions that have potential hazard. You may
cause minor injury or property damage if you ignore these instructions.
This chapter uses the international symbol or icon along with the danger, warning or caution
message.
Table 3-1 IEC Standards
Symbol
IEC Standard
Alternating current
Protective earthing point
ON / Power
OFF / Power OFF
Input Power
Output Power
Type B Equipment
Functional Earth Ground

3-4
Safety
Symbol
IEC Standard (Continued)

Warning, Caution - consult accompanying documents
Electrical Shock Hazard
The following Warning Labels are used on the equipment:.

Figure 3-1 The following warning labels are located at the bottom of the gantry cover
Figure 3-2 Warning labels on the front of the gantry:

3-5
Safety
Figure 3-3 The following warning labels are located on the table
Figure 3-4 For Systems manufactured after June 10, 2006
WARNING: This x-ray unit may be dangerous to patient and operator unless safe
exposure factors, operating instructions and maintenance schedules are
observed. To be used by authorized personnel only.

3-6
Safety
General Safety Guidelines
This product was designed and manufactured to ensure maximum safety of operation.
It should be operated and maintained in strict compliance with the safety precautions,
warnings and operating instructions contained herein, and in any other documentation
specific to the product.
The system has been designed to meet all the safety requirements applicable to medical
equipment. However, anyone attempting to operate the system must be fully aware of
potential safety hazards.
The manufacturer or vendor of the equipment makes no representation, however, that

the act of reading this manual renders the reader qualified to operate, test or calibrate
the system.
The owner should make certain that only properly trained, fully qualified personnel are
authorized to operate the equipment. A list of authorized operators should be
maintained.
This manual should be kept at hand, studied carefully and reviewed periodically by the
authorized operators.
Unauthorized personnel should not be allowed access to the system.
Do not leave the patient unobserved at any time.
Become familiar with the functional hardware so that you can recognize serious
problems. Do not use the scanner if it appears damaged or fails. Wait for qualified
personnel to correct the problem.
If the product does not operate properly or if it fails to respond to the controls as
described in this manual, the operator should:
First ensure the safety of the patient.
Next ensure the protection of the equipment.
Evacuate the area as quickly as possible in any potentially unsafe situation.
Follow the safety precautions and procedures as specified in this manual.
Immediately contact the local service office, report the incident and await further
instructions.
The images and calculations provided by this system are intended as tools for the
competent user. They are explicitly not to be regarded as a sole incontrovertible basis for
clinical diagnosis. Users are encouraged to study the literature and reach their own
professional conclusions regarding the clinical utility of the system.
Understand the product specifications, system accuracy, and stability limitations. These
limitations must be considered before making any decision based on quantitative
values. In case of doubt, please consult your sales representative.
Make sure all covers are in place before you use the equipment. The covers protect you
and your patient from moving parts or electrical shock. The covers also protect the
equipment.
NOTE: Only qualified Service personnel should service the system with the covers off.

3-7
Safety
Do not block the ventilation ports of the electronic equipment. Always maintain at least
6 inches (15 cm) clearance around the ventilation ports to prevent overheating and
damage to the electronic hardware.
Use only GE approved equipment with this system.
Do not load any non GE approved software onto the computer.
Watch for the electromagnetic compatibility from other hardware. For more
information, refer to the Electromagnetic Compatibility section in Technical Reference
Manual, under the General Safety Guidelines.
WARNING: This system is intended for use by healthcare professionals only. This system
may cause radio interference or may disrupt the operation of nearby
equipment. It may be necessary to take mitigation measures, such as
reorienting or relocating the system or shielding the location.
WARNING: CT Scans may cause interference with implanted or externally worn electronic
medical devices such as pacemakers, defibrillators, neuro stimulators and
drug infusion pumps. The interference could cause operational changes or
malfunction of the electronic medical device.
Recommendations prior to scanning:
If practical try to move external devices out of the scan range.
Ask patients with neurostimulators to shut off the device temporarily while the scan
is performed.
Minimize the x-ray exposure to the electronic medical device.
Use the lowest possible x-ray tube current consistent with obtaining the required
image quality.
Do not scan directly over the electronic device for more than a few seconds.
NOTE: For procedures such as CT Perfusion or CT Interventional scans that require scanning
over the electronic medical device for more than a few seconds, attending staff
should be ready to take emergency measures to treat adverse reactions if they occur.
Recommendations after scanning
Have the patient turn the device back on if it had been turned off prior to scanning.
Have the patient check the device for proper functioning, even if the device was
turned off.
Advise patients to contact their healthcare provider as soon as possible if they
suspect their device is not functioning properly after a CT scan.

3-8
Safety
NOTE: Recommendations from FDA Preliminary Public Health Notification: Possible
Malfunction of Electronic Medical Devices Caused by Computed Tomography (CT)
Scanning date July 14, 2008.
Radiation Safety
WARNING: Improperly used X-Ray equipment may cause injury. Read and understand
the instructions in this book before you attempt to operate this equipment.
If you fail to follow safe X-Ray practices or ignore the advice presented in the
manual, you and your patient risk exposure to hazardous radiation.
CAUTION:
Prolonged exposure to x-ray in one spot may cause reddening or radiation

burns. Users must be aware of the techniques used and exposure time to
insure safe operation.
Authorized Users
This equipment incorporates a high degree of protection against X-Ray radiation outside the
useful beam. But this equipment can not substitute the essential requirement that every
user must take adequate precautions to prevent the possibility of any person carelessly,
unwisely, or unknowingly exposing themselves or others to radiation.
Everyone having anything to do with X-Ray equipment must receive proper training and
become fully acquainted with the recommendations of the National Council on Radiation
Protection and Measurements and the International Commission on Radiation Protection.
NCRP reports are available from:
NCRP Publications
7910 Woodmont Avenue
Room 1016
Bethesda, Maryland 20814
WARNING: Everyone having anything to do with X-Ray equipment must take adequate
steps to insure protection against injury.

3-9
Safety
All persons authorized to use the equipment must understand the dangers posed by X-Ray
exposure so that they can prevent any injury or damage that may result from such
exposure. GE Medical Systems urges you to use protective materials and devices to prevent
any injury or damage from X-Ray exposure.
General Radiation Safety
WARNING: Never scan a patient with unauthorized personnel in the scan room. Warn
visitors and patients about potential for harm if they fail to follow
instructions.
WARNING: Never calibrate, test the scanner, or warm the tube with patients or personnel
present in the scan room.
Stay behind a lead screen or lead glass shield during each X-Ray exposure.
Use technique factors prescribed by the radiologist or diagnostician. Use a dose that
produces the best diagnostic results with the least X-Ray exposure.
Amber indicator lights on the gantry display panel, and rear of the gantry, illuminate
during X-Ray exposure.
CAUTION:
Use of controls or adjustments, or performance of procedures other than

those specified herein, may result in hazardous radiation exposure.
Scans Acquired at the Same Tomographic Plane

IEC standard 60601-2-44 section 29.105 paragraph states that you must be warned when
scans are acquired at the same tomographic plane, i.e. same scan location. The need for the
warning is to make users aware of the potential dose that can be given to the patient when
acquiring scans at the same table location.
When acquiring scans in this mode:
Utilize the dose information displayed on the View Edit screen. The dose information
displayed is covered in the next section, CTDIvol.
An optional DICOM Structured Report (SR) Dose Report is saved in Series 997.
Use proper techniques for the application and anatomy you are scanning.

3-10
Safety
A warning message (Figure 3-5) is posted when [Confirm] is selected for the following scan
types:
SmartStep
SmartPrep Baseline and Monitor scans
Cine scans
Axial scans with zero table increment (interval)
VolumeShuttle (axial)
Volume Helical Shuttle
Figure 3-5 Warning Message when scanning on the same tomographic plane: Axial, Cine
and Helical
Figure 3-6 Warning Message when scanning on the same tomographic plane: Volume
Helical Shuttle

3-11
Safety
Figure 3-7 Warning Message when scanning on the same tomographic plane: Volume
(axial) Shuttle
After reading the message, if you wish to continue with the scan, click [Continue].
CTDIvol
As you setup the scan parameters from the view/edit screen, the Dose Information area at
the upper right of the scan monitor contains updated dose information. This dose
information is based on a measurement of the CTDI or CT Dose Index, which is the current
standard for CT dosimetry and performance. By using a measurement called CTDIvol, a
single value is provided to estimate the relative dose for an exam.
The CTDIvol is a weighted average measurement in a reference phantom. This dose is
expressed in milliGrays. For additional information on specific CTDIvol doses and their
calculations, refer to your Technical Reference manual.
The DLP or Dose Length Product is the product of the CTDIvol and the scan length for a
group of scans. This number can be summed over the entire exam to give an estimate of the
total dose. The value is expressed in milliGray centimeters.
The Projected Series DLP shows the DLP that would result from scanning the current group
or groups.
The Accumulated Exam DLP displays the total exam DLP up to the current point in time.
Scout dose is not included in the DLP totals since standards for reporting scout dose are not
yet defined. Scout dose is generally a very small part of the exam.
The dose information updates when technique values such as kV, mA, scan time, slice
thickness, and scan field of view are changed.
Dose information is saved as screen save image in Series 999 upon End Exam and Series
997 contains the DICOM Dose Structured Report.

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Safety
CAUTION:
Using accessories which are not GE options might affect dose and image
quality.
X-Ray Tubes
The scanner uses cooling and reconstruction algorithms specifically designed for GE X-Ray
tubes.
You risk three dangers when you do not use GE X-Ray tubes.
A non GE tube could overheat and explode if the cooling delays do not meet its design
requirements.
The images could exhibit reduced performance or artifacts if your x-ray tube fails to
conform with GE tube performance specifications.
Radiation leakage may exceed GE specifications when a non GE X-Ray tube is installed
in the scanner.
CAUTION:
We cannot guarantee performance or safety if you use a non GE X-Ray tube

because the cooling and reconstruction algorithms depend upon the tube
design. Radiation leakage may exceed GE specifications when a non GE X-Ray
tube is installed in the scanner.
Electrical Safety
DANGER:
ELECTRICAL SHOCK HAZARD. Avoid all contact with any electrical conductor.
Do not remove or open system covers or plugs. Internal circuits use high
voltage capable of causing serious injury.
An electrical hazard may exist if any light, monitor or visual indicator stays
on after the system is shut down. To prevent possible injury, turn off the
main power supply wall switch, and contact your service office immediately.

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Safety
DANGER:
NO USER SERVICEABLE PARTS. Refer service to qualified service personnel.

Only allow people who know the proper procedures, and use of the proper
tools, to install, adjust, repair, or modify the equipment.
To guarantee safe, reliable equipment performance, prepare the site
according to GE Medical Systems requirements. If you have any questions
about these requirements, contact GE Medical Systems.
Fuses blown within 36 hours of being replaced may indicate malfunctioning
electrical circuits within the system. Have the system checked by qualified
service personnel, and do not attempt to replace any fuse.
DANGER:
ELECTRICAL FIRE. Conductive fluids that seep into the active circuit
components of the system may cause short circuits that can result in
electrical fires. Therefore, do not place any liquid or food on any part of the
system.
To avoid electrical shocks or burns caused by the use of wrong type of fire
extinguisher, make sure that only fire extinguishers approved for use on
electrical fires are used.
Surplus length of power cords or other cables from mobile accessory units that may be
used with some patient scanning should be stored in safe and isolated areas, such as
individually in a figure eight at the base of stationary equipment. This discourages signal
interference and protects cables from damage due to traffic.
Mechanical Safety
General Mechanical Safety
Check for any obstruction around the equipment before attempting to move the table
and gantry. When performing table or gantry motions, always monitor the progress of
the motion.
Be especially careful when tilting the gantry or moving the table when the cradle
extender or head holder is in place to avoid driving these accessories into the gantry
covers.
The (Cradle Unlatch Indicator) is illuminated in green when the cradle is
unlocked. An unlocked cradle could potentially move unexpectedly.
The (Interference) light illuminates when the cradle has reached a travel limit or
encountered interference.
If the table reaches one of the limits while actively pressing the controls, the limit light
will turn off when the controls are released.

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Safety
Clear an interference by changing the gantry tilt, moving the cradle, or adjusting the
table height.
WARNING: Do not use the table base as a foot rest. You could entrap and injure your foot
while lowering the table. Do not place your hands between the table base and
the table side panels.
WARNING: Do not place your hands inside the gantry opening when tilting the gantry.
The gantry can pinch or crush your hands!
Patient Positioning
DANGER:
Do Not Place a Patient on the Table Weighing More Than the Upper Limit Of
500 Pounds. This Could Cause the Table to Fail and the Patient Could Fall.
Discovery CT750 HD Table load capacity:

Up to 500lb. (227kg) with . 25 mm positional accuracy guaranteed.
CAUTION:
Temporal sampling may be degraded due to changes in timing for the table
to move from location to location if proper positioning methods are not
followed. Make sure that the patient is securely positioned on the table and
their arms are not allowed to drag on the table or allow clothing, sheets or
blankets to get caught causing a table move problem.
CAUTION:
Volume (axial) Shuttle mode is intended for the neuro application of CT

Perfusion.
WARNING: Temporal interval for images exceeds 3.2 seconds. Use of this data for
processing of CT Perfusion maps may contain errors in the functional
information.
Temporal sampling for data acquired for use in CT Perfusion should not exceed 3.2 seconds
between data points for optimal results. As the temporal resolution increases an error in the
statistical accuracy of the information may be introduced.

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Safety
CAUTION:
When using the external laser alignment light for patient positioning
purposes, be aware that the patient's elevation may be slightly lower with the
cradle extended than with the cradle fully retracted. This is because the cradle
may bend slightly under a patient's weight. This difference should be taken
into consideration for applications where patient position information is
critical, such as radiation therapy planning. To minimize these affects, after
using the external laser alignment system to position the patient, advance
the patient to the CT scan plane. Turn on the CT alignment lights to determine
if they line up with the markers on the patient. If necessary, compensate for
the bend in the cradle by elevating the table. When the CT alignment lights
line up with the markers, set the landmark for the scan using the Internal laser
alignment light.
Please refer to X-Y Table Accuracy Procedure to assess the X-Y table accuracy
of your system.
CAUTION:
When using patient positioning accessories, make sure there are no areas,
which might cause a pinch point or interfere with patient tubing or IV.
CAUTION:
When using patient positioning accessories that are not GE options, make
sure there are no areas that might cause a pinch point or interfere with
patient tubing or IV.
CAUTION:
When using accessories, make sure all accessories are CT imaging

accessories. Do not use accessories from other modalities.
WARNING: None of the accessories support the full weight of a patient. If you sit, stand,
or otherwise apply excessive pressure to these devices, they break or come
off the cradle and may cause an injury.

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Safety
CAUTION:
Check to make sure the power injector has enough IV tubing to allow free
movement of the cradle. Make sure the unit itself does not interfere with table
travel.
Ensure excess tubing length is secured to the table top. DO NOT loop
additional IV tubing in the patient's fingers.
CAUTION:
The patient positioning straps provided with the system do not support the
full weight of the patient. Patient positioning straps should be used to aid in
patient positioning and are not meant to fully restrain the patient.
CAUTION:
Care should be taken to ensure the patient positioning straps, patient

clothing, or other material will not be caught during table motion.
Check the length of all patient health lines (IV tubing, oxygen line, etc.) and make sure
they accommodate cradle travel. Position these lines so they cannot catch on anything
within the patient vicinity or between the table and gantry during cradle travel or gantry
tilt.
The concentrated weight of short, heavy patients can cause the cradle to make contact
with the gantry.
Make sure you do not drive the cradle into the gantry cover.
Make sure you do not pinch the patient's skin or extremities between the cradle and
the gantry.
Avoid any patient contact with the gantry during tilt or cradle movement (manual or
software driven).
Return the gantry tilt to the 0 degree upright position, latch the cradle, and adjust the
table to a comfortable height for patient loading and unloading.
Latch the cradle before you load or unload the patient (the Cradle Unlatch indicator
illuminates when the cradle is unlatched).
Physically assist all patients on and off the table and into position on the cradle.
WARNING: To Prevent Pinching or Crushing of the Patient's Extremities, Keep the

Patient's Hands and Feet Away from the Edge of the Moving Table Top/cradle
and its Surrounding Equipment, or Between Table Base and Side Panels of the
Table. (Take Special Care when Positioning Physically Large Patients).

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Safety
WARNING: To Prevent Pinching or Crushing of the Patient Watch the Patient and
Equipment Carefully at All Times During Gantry Tilt or Table Movement. If
Unwanted Motion Occurs or Motion Does Not Stop, Press the Emergency Stop
Switches on the Console or Gantry.
Check the accessory attachment plate fixed to the end of the cradle. Repair or replace if
loose or damaged.
Use the cradle extender to support the patient's head or feet during a scan.
Figure 3-8 VT table
CAUTION:
If the table is lowered with anything in the red X area as indicated above, the
table could be damaged along with the equipment or object under the table.
CAUTION:
The foot pedals at the base of the table for loading and unloading patients
are always active. Care should be taken not to activate the foot pedals once
the patient has been positioned on the cradle and an exam started.
WARNING: The head holder may crack, possibly injuring the patient's head or neck, if the
patient tries to brace himself or herself on the head holder during positioning.
The head holder and cradle extender are only designed to support 75 pounds
(34kg). Ask the patient to move up into the head holder or manually help the
patient into position.
To move the patient out of the gantry in an emergency, the cradle can be manually
withdrawn by applying a minimum of 60 lbs (267 N) of force.

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Safety
CAUTION:
The patient head holder or table extender should be adequately secured to

ensure stability. If they not secured properly, degradation of image quality
may result due to introduced motion of the head holder or table extender.
CAUTION:
Use of any cradle extension accessories such as the table extension, head
holder, coronal head holder, and phantom holder are not accounted for in the
table gantry interference matrix. Therefore, additional care needs to be taken
to closely monitor any table up/down, in/out or gantry tilt movement to avoid
contact of the extended accessory with the gantry.
Volume Shuttle
CAUTION:
VolumeShuttle acquisition for head imaging should be performed with the

patient positioned head first into the gantry in the head holder, or with the
top of the head positioned 200 mm from the end of the cradle. Degraded
image quality may result if alternate positions are used due to excessive body
mass on an extended table.
NOTE: For Volume Helical Shuttle a message will be posted in the Real Time Information
Area and an Attention pop-up will be posted with the following messages:
"Table travel did not meet expected time for pass(es) during acquisition."
Additional information on the errors seen can be found in the GE System Log.
WARNING: Prospective reconstruction only allows a preview series to be reconstructed

at 5 mm thick with a 10 mm interval. All additional reconstructions need to
be done in Retro Recon.

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Safety
Figure 3-9 Message at End Exam for exams containing Volume Helical Shuttle
Laser Safety
A laser alignment light system is available in order to accurately define the patient scan
region.
WARNING: THE LASER BEAM CAN CAUSE EYE INJURY.

- Tell all patients to close their eyes before you switch ON the alignment
lights.
- Instruct your patients to keep their eyes closed until you turn OFF the
alignment lights.
NOTE: Closely monitor infants and infirm patients, and prevent them from accidentally
staring into the beam.
CAUTION:
THE DETECTOR AND DAS ROTATE TO POSITION THE ALIGNMENT LIGHTS OVER
THE LASER PORTS.
- Keep your hands away from the gantry opening.
- Make sure the gantry side covers are in place.
CAUTION:
Use of controls or adjustments, or performance of procedures other than

those specified herein, may result in hazardous radiation exposure.

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Safety
The indicator on the gantry display panel lights when you turn ON the alignment lights.
Warning labels regarding laser safety are provided on the gantry, as described in the
Warning Labels and Symbols section.
Reconstructed Image Orientation
CAUTION:
GE CT image reconstruction is in an orientation viewing from the patient's

feet. The reconstructed orientation is the orientation the image is installed in
the image data base and is the orientation images are networked with to a
remote viewing station.
Figure 3-10 Patient Orientation

A
P
Head First Supine
R
A
Head First Prone
P
L
L
P
Feet First Supine
R
A
Feet First Prone
The patient position information stored in the image header correctly reflects the orientation
(RAS) information for the patient. Viewing applications will correctly reflect Right (R), Left (L),
Anterior (A) and Posterior (P) of the patient.
The reconstructed image orientation may differ from preferred anatomical viewing
presentation in which the patient's Right is on the viewers Left and patient's Left is on the
viewers Right. For example when the patient is scanned Head First and Prone the patientss
Left is on the viewers Left and the patients Right is on the viewers Right. The image
presentation will need to be modified to display preferred anatomical viewing. Some
viewing stations may not have the capability to flip the image presentation, but if the
capability exists, you must use display tools such as Flip to change the presentation of the
image.

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Safety
Some remote viewing stations may have the capability to set default viewing protocols, this
is another tool that can be used to set an anatomical viewing presentation.
Post processing applications such as Direct MPR, Reformat and Volume Viewer
automatically orient images in anatomical viewing orientation. These applications create
axial images in anatomical viewing presentation. Please see Auto Applications (Option) for
more information. The system also provides the capability to create Gray Scale Presentation
State Objects (GSPS) to flip the image orientation.
Flip/Rotate in recon can be used to generate images where right/left or anterior/posterior
are flipped or where both R/L and A/P have been flipped to meet desired image display
preference. An Attention pop-up is displayed at Confirm for series where Flip/Rotate in recon
is selected. Attention: This scan prescription utilizes one of the reconstruction based image
flip and/or rotate options. Please ensure that this prescribed image orientation is displayed
appropriately on all remote viewing devices.
Figure 3-11 Flip Warning Message
Data Safety
To ensure data safety:
Verify and record the patient's identification before starting a scan.
Observe and record the patient's orientation, position and anatomical landmarks
before starting a scan. Ensure that the patient is positioned within the scan
parameters.
Maintain system image quality by performing Daily QA and other maintenance.
Connectivity - Always verify that the data transferred to another system has been correctly
received.

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Safety
WARNING: The system posts a warning message when expected disk space required to
store scan data from the prescribed exam is insufficient.
WARNING: The system posts a warning message when expected image space required
to store images from prescribed reconstruction is insufficient.
WARNING: The system posts a warning message when data was interpolated to generate
images.
WARNING: The system posts a warning message if there is a failure during the archive
of patient data.
WARNING: The system posts a warning message if there is a failure during the network
of patient image data.
WARNING: The system posts a warning message when a scan is aborted due to a failure
in the acquisition chain.
WARNING: The system posts a warning message when the system has low disk space.
This is due to a partition on the system disk getting too full. Removing images
will not help. Contact service to help with recovery. If you reboot the system
and see the message asking if you want to run storelog, select the option to
remove the logs.

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Safety
Application Specific Safety Topics

Helical Scanning
WARNING: Helical scanning has the inherent ability to produce artifacts when scanning
highly sloped anatomy (e.g. pediatric or adult heads). Factors which worsen
this effect are: faster table speeds, thicker image thickness, and gantry tilt.
In some cases these artifacts could be mistaken for a hemorrhage near the
cranium, or a thickening of the skull.
To reduce the occurrence of these artifacts you may prescribe slower table
speeds and/or thinner slices (such as 2.5mm) during helical scans near the
vertex of a pediatric or adult head.
WARNING: For helical scans, the Segment Recon Mode in Retrospective Recon may be
used to assess if there is an artifact or not. If questions still arise, then re-scan
the area with a two second Axial scan.
WARNING: It has been documented in radiology literature that an artifact may occur in
the chest that bears the double margin of the great vessels, which emulates
a dissection of the vessel during 0. 4- 1.0 second scans. This can occur in axial
or helical scans. If you have scanned axially with a 0. 4- 1.0 second rotation
time and observe this phenomenon, re-scan the area with a 2 second axial
scan to verify if it is artifact or patient pathology. Segment recon mode for
helical and cine acquisitions may be used in Retro recon to also assess if the
areas is artifact or pathology.

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Cardiac Imaging
Additional Cautions are included in the Cardiac Imaging Discovery CT750 HD chapter.
CAUTION:
A patient with any of the conditions listed below may require additional
attention. If patients are scanned with these conditions, the software may not
be able to detect the R-Peaks and the images therefore may be produced as
ungated segment images.
- Patients with multiple pre-contractions or extra systole (e.g. PVC, PAC)
- Patients with persistent or extreme arrhythmia
- Patients with bi-ventricular lead (dual chamber) pacemakers
CAUTION:
ECG signal clarity and integrity must be confirmed prior to performing

ECG-gated acquisitions. Items which may require adjustment of equipment
settings or positioning, or patient set-up include:
- External Interference
- Atypical Patient ECG (e.g. elevated T-Waves, low ECG amplitude or signal
strength)
- Suboptimal Patient Connection
ECG lead placement should follow recommended guidelines to optimize
results.
If the ECG lead is disconnected during the scan, or the heart rate drops
below 30 BPM, the images will be reconstructed as non-gated segment
images. This is done to avoid inaccuracy of the z-location of images where
necessary.
CAUTION:
The heart rate displayed on CT console is a 3-cycle average. You must review
the actual waveform pattern to determine ECG trace clarity, trigger location
and if any cycle to cycle variability or masked arrhythmias may be present in
order to adapt set up and conditions prior to proceeding with the scan
acquisition.
CAUTION:
Cardiac helical scan modes of SnapShot Segment, Burst, and Burst Plus are
optimized for specific heart rate ranges. Select the appropriate scan mode
for each patient's heart rate pattern. If the incorrect mode is selected,
temporal resolution may be insufficient and degraded image quality could
result.

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Safety
CAUTION:
SnapShot Pulse scan mode for coronary artery imaging is intended to be used
for patients with stable heart rates of 65 beats per minute or less. It is not
recommended to scan a patient with heart rates that are unstable or above
65 BPM with SnapShot Pulse as the temporal resolution may be inadequate
for freezing the motion of the heart and the increase the interscan delay
between exposures could lead to degraded image quality. Alternate imaging
modes of cardiac helical should be considered if optimal conditions for
SnapShot Pulse are not met. Cardiac helical modes should be considered if
patient does not meet the criteria for SnapShot Pulse.
CAUTION:
SnapShot Pulse should not be used for studies where function or full
multiphase analysis is needed. Settings may limit the cardiac phases
available to one or a few neighboring phases impacting the ability to analyze
heart motion or review cardiac phase locations outside the prescribed phase.
CAUTION:
Patient motion, respiration, beat-to-beat variability of heart rate, heart

motion, or significant change in heart rate over the scan duration could cause
an ECG gated acquisition to have degraded image quality. It is important to
explain to the patient the pattern of breathing instructions to expect, the
warm feeling that can be felt from the contrast injection and to position the
patient comfortably such that the arms will not move with respect to the body
during the scan.
Heart rate information and phase location will be updated to indicate any
movement of trigger locations since heart rate and phase values are
calculated based on time between consecutive triggers and are not
diagnostic values.
CAUTION:
AutomA and ECG Modulation are not valid with SnapShot Pulse acquisitions
due to prospective control of x-ray over the scan volume. Only Manual mA
values can be prescribed.

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Safety
Patient Preparation
CAUTION:
Ensure the ECG patches are not past expiration date and that the gel on the
pads is still moist for proper conduction of the ECG signal for successful
gating.
Practice hyperventilation breathing instructions with the patient.
It is important to explain to the patient the events that will occur during the acquisition
of the contrast enhanced cardiac data. Make sure to explain the warm feeling that may
occur during the injection of the contrast material.
Use hyperventilation technique for all the series in a cardiac exam. Practice the
hyperventilation instructions with the patient prior to scanning.
During the practice breath hold, make sure to watch the ECG trigger monitor to
determine the average heart rate, minimum heart rate, and ECG pattern during the
breath hold.
Position the patient's arm over the patient's head so they are comfortable and will not
move during the acquisition of data.
CAUTION:
If, during the scan, the heart rate drops significantly lower than the prescribed
heart rate, there is a potential for gaps in the gated image location. To avoid
image location gaps, a non-gated image is reconstructed for the period where
the patient heart rate dropped below the expected or confirmed heart rate
at the start of the exam. A non-gated image may have more motion and may
not be reconstructed at the prescribed phase.
CAUTION:
There is a possibility that the ECG signal may not be detected by the scanner
due to improper lead placements, or a lead falling off during the scan. It is
important to place new leads on the patient before the scan. Make sure the
leads are attached properly, and use only GE recommended ECG leads.
It is important to confirm ECG trace clarity before the scan.
CAUTION:
The heart rate displayed on the CT console is a 3-cycle average. You must
review the actual waveform pattern to determine ECG trace clarity, trigger
locations, and if any cycle to cycle variability or masked arrhythmias may be
present in order to adapt set up and conditions prior to proceeding with the
scan acquisition.

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CAUTION:
SnapShot Segment Plus is an alternate reconstruction mode which applies a

different weighting to data in the area of cardiac cycle transitions compared
to SnapShot Segment reconstruction mode. Image quality in these transition
areas should be reviewed carefully.
CAUTION:
Manual edits of the ECG gating R-Peak triggers may be performed

retrospectively in some ECG-gated exams as long as scan data exits on the
console. Images can be reconstructed with user modified gating triggers and
the original gating information can be retrieved after edits have been made.
Lung Algorithm
The Lung algorithm setting provides edge enhancement between structures with large
density differences, such as calcium and air, resulting in a sharper lung field when
compared to Standard algorithm.
For best image quality, prescribe a 5 mm scan thickness when you plan to use the Lung
algorithm. If you plan to prescribe a High Resolution Lung study with 3.75, 2.5, or
1.25 mm, use the Bone algorithm.
The Lung setting enhances the contrast of small objects. For best viewing and film
quality, select a window width of 1000 to 1500 and a window level of -500 to -600.
The Lung algorithm setting increases the CT number values at the edge of high contrast
objects. If you plan to take CT number measurements of vessels or nodules in the lung,
please check and compare your results with Standard algorithm images. (ROI and
Histogram functions use CT numbers.)
Remember: The edge enhancement provided by the Lung setting may not be
appropriate in some clinical cases. Please take individual viewing preferences into
account when you choose the Lung setting.
Autoscan
Press and release [Move to Scan] on the console to advance the cradle if AutoScan is
disabled.
If you select Auto Scan during one group Rx, it remains ON for every group in that series.
SmartStep Safety
The SmartStep option adds several components to the scan room. These are the In-Room
Monitor, Hand Held Control for table movement as well as image review, and the X-Ray
Control Foot switch.

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Each of the SmartStep components is connected to the system by a cable. When using the
system, ensure that the cables cannot catch on anything when the gantry or table is moved.
Table Float
During the scan the Clinician has the option to float the table between scans. When the
Table Float mode is selected, the table is unlatched and can be moved freely by anyone at
the bedside.
WARNING: Unintended table motion may cause a serious injury. Table may be bumped
or jarred during an interventional procedure. Care must be taken when
performing interventional procedures in the float mode. It is the clinician's
responsibility to ensure that they have control of the table when in this mode
of operation. Table must not be left unattended when in the float mode.
Ensure that the table is latched before leaving the table side.
SmartStep Scanning
SmartStep scanning allows multiple scans at one location for interventional procedures. The
system allows up to 90 seconds of scanning in one place. After 90 seconds, the operator
must prescribe a new scan to continue. The accumulated scan time from a procedure is
displayed in the In-Room Monitor.
CAUTION:
You can only expose the patient 90 seconds per confirm.
CAUTION:
Prolonged exposure to x-ray in one spot may cause reddening or radiation

burns. User must be aware of the techniques used and exposure time to insure
safe operation.
CAUTION:
The foot pedal is active if the system is in the "Prepped" state. Care should be
taken not to step on the foot pedal and make an unwanted exposure.
Clinician's working in the scan room should wear appropriate protective clothing. Lead
aprons, groin and thyroid protection, as well as protective eye wear are available through
the GE Accessories Catalog.

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Safety
Interventional / Biopsy Scanning
WARNING: When scanning for interventional (biopsy) studies the scan mode, image
thickness, number of images per rotation and the display layout used affect
the display of the images. It is recommended to use the Biopsy Mode provided
on the system. If manually prescribing biopsy scans, Axial 1i scan mode or
Helical scan mode with a slice thickness greater than 2.5 mm must be used.
Do not use Cine scan mode for interventional (Biopsy) imaging. Do not use an
Auto view layout with more than one Auto View image viewport.
Refer to Select a Multiple Image Display in the Image Display Viewing Area chapter
of the Learning and Reference Guide for more information on how to set up the
desired viewing options.
CAUTION:
The continuous AutoView layout format should not be used for display of
images during an interventional study because it does not allow for quick
review of images in a free viewport.
Choose one of the following for the best auto view layouts.
Figure 3-12 Auto View Layouts
Radiation Therapy Planning

Potential inaccuracy can occur in the positional display of your Discovery CT750 HD
scanner when the manual cradle release on VT 1700 and VT 2000 patient tables is used
inappropriately during Radiation Therapy simulation procedures.

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Safety
CAUTION:
The manual cradle release feature is intended for emergency egress and small
movements. In rare instances, if the cradle release is used to move a patient
out of the gantry, instead of using the table control buttons as specified in
the operator manual, a discrepancy of up to 6mm between the numerical
display on the gantry and the actual position of the table can be introduced.
Accuracy of Measurements
Measure Distance for Axial, Helical, and Cine Images
Measure error using the straight line distance graphic is less than two times the image pixel
size.
CAUTION:
Note that the measurements are accurate only if the trace segments are
longer than the slice interval.
Measure Distance for Scout Images

Accuracy of measurements for scout images in the "X" direction varies with object thickness
and distance from ISO center in the "Y" direction. Note the orientations of the "X" and "Y" in
Figure 3-13 below assume a scout scan plane of 0 degrees. If the scout plane is rotated then
the "X" and "Y" orientation changes accordingly.
For measurements of anatomy in the "X" direction that are at ISO center ("Y"):
The measure error using the straight line distance graphic is less than 5 % of the
measured distance plus 2 mm.
For measurements of anatomy in the "X" direction that are NOT at ISO ("Y"):
The measure error using the straight line distance graphic is less than 5 % of the
measured distance plus 2 mm plus 3 % of measured distance per centimeter from
ISO.
For measurements of anatomy in the "Z" direction:

Measure error using the straight line distance graphic is less than two times the
image pixel size.

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Figure 3-13 Scout Scan Plane
Measure Angle
Measurement accuracy using the angle graphic is equal to the displayed angle value +/- 10
degrees for an angle measured between segments which are five times larger than the
image pixel size. Accuracy improves as the length of the segments increases.
ROI
Area measurement accuracy using a region of interest graphic (rectangle, smooth curve,
ellipse or free draw) is equal to the displayed area +/- the circumference of the region
multiplied by (image pixel size)2/2. Mean and standard deviation values for the intensity of

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the pixels in the region are also affected by this accuracy. If the ROI is rotated, the area
measurement can vary up to 5%. Region of interest statistics are based on the pixels INSIDE
the graphic defining the region.
Reformat Plane Thickness

Reformat plane thickness equals 1 pixel.
If each axial pixel represents 0.5mm of anatomy, then the reformat plane thickness
equals 0.5mm.
If pixel size equals 0.9766mm (500mm/512), then the reformat plane represents a slice
of anatomy about one millimeter thick.
Operator Console Ergonomics

To optimally use your CT Scanner and reduce the chance of physical strain and fatigue, the
following steps are recommended regarding how you use your operator console.
Posture
Correct posture is very important. To ensure correct posture while sitting at your operator
console, follow these basic steps:
1. Face the monitors and keyboard without twisting your body.
2. Sit comfortably erect with the small of your back well supported.
3. Position your forearms parallel to the floor, with your wrists straight.
4. Position the screen so that your eyes are nearly level with the top of the screen.
5. Keep both feet flat on the footrest, with your thighs parallel to the floor.
If you cannot comfortably maintain this position while working at your operator console, you
should make the necessary adjustments to your operator console environment.
Equipment Adjustments
Chair
Adjusting the fit and height of your chair is very important for comfort. Follow these basic
guidelines:
1. Fit the backrest snugly against your back. People with shorter legs might need a back
cushion.
2. Set your chair height to position your forearms parallel with the floor when your hands
are placed on the keyboard. If your feet dangle, you need a footrest.

3-33
Safety
Keyboard
Keyboard height is also important. When typing:
Your wrists should be as straight as possible.
Your forearms should be parallel to the floor.
Your hands and fingers should float over the keys or mouse.
Screen
The recommended viewing distance from the screen is 18 - 28 inches (45 - 70

centimeters).
With your head straight, your eyes should be looking directly at the top of the screen.
You should look at the screen straight-on, not at an angle from the side, top or bottom.
Glare from the screen can disrupt your viewing and cause eyestrain. Do not face a
window, and position the screen at right angles to bright light sources.
Comfort
Comfort at your operator console indicates you've set up your work area correctly. However
even a well-designed area needs frequent adjustment, especially for different users. Take
the time when positioning yourself at your operator console to ensure your comfort.
It is also recommended that if you use the operator console for extended periods of use
(several hours at a time), that you take short breaks to get away from your operator console
and perform simple stretching exercises to reduce the chance of fatigue.
Other considerations:
Keep the patient in view at all times.
Never leave the patient unattended.
Stay alert to your patient's condition.
Use the speakers and microphones on the table, gantry, and console to stay in
constant communication, even while you sit at the console.
Follow the exam procedures explained in the Chapters 13 and 14 of the Learning and
Reference Manual. Carefully enter patient information and position before
proceeding.
CAUTION:
Incorrect data entries or procedures could result in misinterpretation or

misdiagnosis.

3-34
Safety
Accessories
WARNING: None of the accessories support the full weight of a patient. If you sit, stand,
or otherwise apply excessive pressure to these devices, they break or come
off the cradle and may cause injury. Note if an accessory breaks, use caution
when picking it up and do not continue to use.
WARNING: Accessories like arm boards and catheter bag holders are not secured to
gantry and may interfere with gantry if not positioned properly.
Use only GE approved equipment together with this system.
With each use check all accessories for damage and remove them from service if
damaged or cracked.
GE Approved Accessories
Table 3-2 Approved Accessories
Type
Cardiac Trigger Monitors
Respiratory Monitor
Partial UPS
Manufacturer
IVY 3150 - B
IVY 3100 - B with ethernet
Varian 1.7
Powerware 9355
Powerware 9330
External Hard Drive
Seagate FreeAgent
MOD Drive
Sony SMO-F551
Bar Code Reader
Opticon 6125
Hand Held 3800
Modem
Mult-Tech ZBA
Video Splitter
InLine IN3254
Monitor
NEC 1990Sxi
The placement of the IVY cardiac trigger monitor should be on the monitor stand. The
monitor should not be placed on the CT table. It should be positioned so that it is not
touching the CT table or gantry when it is in use.

3-35
Safety
IV Pole Safety
Care should be taken in the amount of weight and ensuring that the pole is tightened prior
to use.
CAUTION:
The IV pole may bend when excessive weight is placed on the pole. Ensure no
more than 4.5 kg or 10 lb. is placed on the IV pole.
CAUTION:
Ensure that the IV pole extension collar is tightened prior to use to avoid the
pole height to move on it's own.
Table Tray Safety

Care should be taken in the amount of weight and the objects that are placed on the tray.
CAUTION:
The maximum allowable weight on the table tray is 9kg or 19.8 lbs
CAUTION:
Objects that may be susceptible to tipping should be strapped down with the
Velcro strap provided.
Systems With Metal-Free Cradles and Accessories
CAUTION:
Prevent damage to metal-free accessories! Carefully examine the metal-free

clasp assembly on the accessory and the catch on the cradle before
attempting to attach the accessory for the first time.
To Latch an accessory:
Align the accessory tongue with the pocket at the end of the cradle.
Keep fingers clear of the cradle.
Push the tongue all the way into the pocket until it latches into place.
Rubber shims may have been installed on the head holder or foot extender to give it
a tighter fit. Please take care when latching the accessory to make sure that it is
completely latched. Push the latch forward until you hear a click. Verify that the latch
is fully latched.

3-36
Safety
To Unlatch an accessory:
Pinch the two L-shaped parts together and pull the accessory out of the cradle.
An alternate method is to apply a light force to the catch in the direction to pull the
accessory out of the cradle.
Proper operation:
Keep the accessory "tongue" and cradle pocket clean and free of fluids and debris.
Keep the latch and cradle pocket area clear of sheets, drapes, pads or any item that
could interfere with proper latching and cause damage.
Positioning
Positioning patient anatomy over the area where the head holder or cradle extension
attaches to the cradle may produce images where the contrast be between 2
adjacent rotations is different. Make sure the area of interest especially the head in
properly positioned in the head holder or on the cradle extension.
Limited Access Room Configuration
CAUTION:
Due to access limitations on the left side of the gantry, some procedures may
be affected when ancillary equipment is used. Assess the placement of the
equipment needed for the procedure before the placement of the patient on
the table. Access around the left side of the gantry may also be affected.

3-37
Safety
Emergency Devices and Emergency Egress

(Reference 21CFR 1020.33 ((f)(2)(ii))
Emergency Devices
The system has two types of Emergency buttons:
1. Emergency Stop- when pressed, all table and gantry motions are halted, generation of
X-rays is stopped, laser alignment lights are turned off. The system aborts any data
acquisition in progress, and attempts to save all data acquired prior to the abort. Use
the Emergency Stop button for patient related emergencies.
2. System Emergency Off Button- when pressed, the power to all system components is
removed, stopping all table and gantry motion and generation of X-rays. The system
aborts any acquisitions in progress, and data obtained prior to the abort can become
corrupt or lost. Use the System Emergency OFF button for catastrophic emergencies,
such as fire or earthquake.
CAUTION:
If you press the Emergency Stop or Emergency OFF buttons during a scan, the
system will abort the data acquisition.
Emergency Stop
NOTE: Every operator should take a few minutes to locate the Emergency Stops on his or
her system before he or she scans the first patient.
The system has five Emergency Stop buttons:
One on each control panel on the front of the gantry (Figure 3-14).

3-38
Safety
Figure 3-14 Front of gantry Emergency Stop Buttons
Cradle Release Handle
Two on the rear cover of the gantry.

One on the Acquisition Control (Figure 3-15).
Figure 3-15 Emergency Stop button on the Keyboard
Press an Emergency Stop button in the event of a patient related emergency or if the cradle,
table or gantry starts to move unexpectedly.
Once an Emergency Stop button is pressed, the Reset gantry key, on the gantry control
panel, flashes about once every two seconds.
Press the Reset gantry key to restore power to the gantry and table.
When Emergency Stop is applied, the moving cradle and tilting gantry may overrun by less
than 10 mm and less than 0.5 degrees respectively.

3-39
Safety
System Emergency OFF Buttons using Main Disconnect Control

In the event of a fire, flood, earthquake, or any other catastrophic emergency, all power to
the system should be turned off. Pressing the System Emergency OFF button immediately
removes all power to the system by removing power to the Main Disconnect Control (MDC).
Because the system has no time to save data, or shutdown in an orderly fashion, pressing
the System Emergency OFF button can corrupt system files or result in loss of patient data.
The facility designer determines the quantity and locations of the Emergency OFF buttons.
GE recommends placing an Emergency OFF button near the doorway of every room in the
system scan suite. Ask your supervisor to show you the location of all the Emergency OFF
buttons in the system suite. Follow facility guidelines to report an emergency.
Press the System Emergency OFF button (red, circular button located on the wall) in the
event of a catastrophic emergency, such as fire or earthquake.
Reset the Emergency OFF Button
1. Press the Start button on the Main Disconnect Control.
Power to the Power Distribution Unit (PDU), operator console and system electronics
will be restored.
2. Press the Reset gantry key on the gantry panel.
Power to the gantry drives, X-ray system and table drive will be restored.
Emergency Patient Care During X-Ray ON:
Press STOP SCAN to abort x-ray and stop gantry/table movement.
Press PAUSE SCAN to pause scanning after the current scan completes.
During an exam, the system pauses between scans if you Press any button on the
control panel other than the alignment lights. It stops X-Ray if you Press the same
button(s) during a scan.
Select Resume on the screen to continue the exam.
Emergency Egress
System operation may be stopped due to power failure or a safety event (something coming
into contact with the collision sensors), or the system may be halted by the operator in
response to emergency conditions.
The Cradle unlatch button should only be used in two situations.
1. In Emergency Egress situations.
2. When using the SmartStep scan type.

3-40
Safety
To safely remove the patient:
1. Press the Cradle Release gantry key or the Emergency Stop button (Figure 3-14) to
disengage the clutch
2. Pull the cradle to its out position, using the Cradle Lip or Cradle Handle (Figure 3-14).
3. Assist the patient off the table.
Maintenance and Cleaning

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

3-41
Safety
Cleaning Equipment (Bio Hazard)
CAUTION:
Blood Bourne Pathogens Procedure - Before any equipment is serviced or

returned to GEHC, the following criteria must be met:
Equipment used in a clinical setting must be cleaned and free of any blood and other
infectious substances.
Customers are responsible for the sanitary condition of the equipment. The
suggested equipment clean-up procedure for cleaning any fluids or matter
discovered in accessible areas or inside under direction of service are as follows:
Wear personal protective equipment.
Wear proper Nitrile gloves.
Before cleanup take note of sharp corners or objects that could cut the gloves. If
gloves tear, remove, wash hands thoroughly and re-glove.
Use cloth or paper towels along with cleaner, taking care not to splash.
Sanitize the area using common bleach diluted 10:1 or an Approved Cleaning
Agent listed in the Maintenance and Cleaning section. Clean any tools that come
in contact with body fluid.
Since viruses require moisture to remain active, dry the entire area.
When confident the area is clean and dry, place cleaning materials in a red
biohazard bag.
Remove gloves, turning them inside out, and put gloves in the biohazard plastic
bag. Seal and give the bag to appropriate personnel for disposal.
Environmental Concerns
This symbol indicates that the waste of electrical and electronic equipment
must not be disposed of as unsorted municipal waste and must be collected
separately. Please contact an authorized representative of the manufacturer for
information concerning the decommissioning of your equipment.

3-42
Safety
Name and Concentration of Hazardous Substances

Explanation of Pollution Control Label
This symbol indicates the product contains hazardous materials in excess
of the limits established by the Chinese standard SJ/T11363-2006
Requirements for Concentration Limits for Certain Hazardous Substances in
Electronic Information Products. The number in the symbol is the
Environment-friendly Use Period (EFUP), which indicates the period during
which the toxic or hazardous substances or elements contained in
electronic information products will not leak or mutate under normal operating conditions
so that the use of such electronic information products will not result in any severe
environmental pollution, any bodily injury or damage to any assets. The unit of the period is
"Year".
In order to maintain the declared EFUP, the product shall be operated normally according to
the instructions and environmental conditions as defined in the product manual, and
periodic maintenance schedules specified in Product Maintenance Procedures shall be
followed strictly.
Consumables or certain parts may have their own label with an EFUP value less than the
product. Periodic replacement of those consumables or parts to maintain the declared EFUP
shall be done in accordance with the Product Maintenance Procedures.
This product must not be disposed of as unsorted municipal waste, and must be collected
separately and handled properly after decommissioning.
Table 3-3 Table of hazardous substances' name and concentration
Component Name
Hazardous substances' name

(Pb)
(Hg)
(Cd)
(Cr(VI))
(PBB)
(PBDE)
Operator Console
Gantry
LCD Monitor
ECG Cardiac Trigger
Power Distribution Unit
Patient Table

3-43
Safety
Component Name
Hazardous substances' name

(Pb)
(Hg)
(Cd)
(Cr(VI))
(PBB)
(PBDE)
O: Indicates that this toxic or hazardous substance contained in all of the

homogeneous materials for this part is below the limit requirement in SJ/T11363-2006.
X: Indicates that this toxic or hazardous substance contained in at least one of the
homogeneous materials used for this part is above the limit requirement in
SJ/T11363-2006.
Data listed in the table represents best information available at the time of
publication
Applications of hazardous substances in this medical device are required to
achieve its intended clinical uses, and/or to provide better protection to human
beings and/or to environment, due to lack of reasonably (economically or
technically) available substitutes.
This product consists of devices that may contain mercury, which must be recycled or
disposed of in accordance with local, state, or country laws. (Within this system, the
backlight lamps in the monitor display contain mercury.)
The X-Ray Collimator contains the following potentially hazardous materials:
Lead: Lead salts are toxic and their ingestion may cause serious problems. The
manipulation/ handling of lead is subject to regulations.
The Performix HD X-Ray Tube Assembly contains potentially dangerous materials but
does not present any danger as long as it is neither opened nor disassembled.
WARNING: Do not discard the X-Ray Tube Assembly among industrial waste or domestic
garbage.
WARNING: A damaged X-ray Tube Assembly should not be dispatched through the
national postal service.
The X-Ray Tube Assembly contains the following potentially hazardous materials:
Lead: Lead salts are toxic and their ingestion may cause serious problems. The
manipulation/ handling of lead is subject to regulations.
Oil: Univolt 54 and Crosstrans 206 mineral oil are not toxic, but the prevailing
environmental regulations should be observed for their disposal or recuperation. For
example, it is forbidden to dispose of these oils in the wastewater or sewage system
or in the natural environment.

3-44
Safety
Your local GEMS field service will advise you on the suitable means of disposal.
The X-Ray Tube Assembly to be discarded should be forwarded to the GEMS Service
network, and it will be disposed of in a GEMS recycling center.
Precautions
Take all the necessary precautions for the personnel handling the recovery or destruction of
X-Ray Tube Assemblies, and in particular against the risks due to lead.
These personnel must be informed of the danger involved and of the necessity to observe
the safety measures.

3-45
Imaging Pediatric and Small Patients
Chapter 4
Imaging Pediatric and Small

Patients
Introduction
GE Healthcare strongly suggests reducing radiation dose to as low as reasonably
achievable (ALARA) in all patients, especially pediatric and small patients, whenever it is
determined that a CT scan is necessary. CT is an extremely valuable tool for diagnosing
injury and disease, but its use is not without risk. This chapter discusses the importance of
minimizing the radiation dose in small patients and children to as low as reasonably
achievable (ALARA).

4-1

This section presents the concepts necessary to understand Pediatric CT. The concepts you
need to understand are:
Radiation Exposure Sensitivity
Dose Reporting Considerations
Suggestions for Minimizing Unnecessary Dose

Perform Only Necessary CT Examinations
Scan Only the Organ or Anatomical Region Indicated
Properly Center All Patients in the Gantry
Lower mA Settings for Chest and Bone Imaging
Scan signal-to-noise
Consider Using In-plane Bismuth Shields
Use Pediatric Positioning Accessories
Make a Kid Friendly Environment
Minimize Multi-phase Contrast CT Examinations
Guidelines for Adjusting Individual Exposure Parameters by Patient

Adjust Parameters by Size, Age, Weight, Height, & Indications
Lower kVp
AutomA
Increase Pitch
Use Small SFOV Filters
Optimize Pediatric Protocols for your Facility
Pediatric Protocols
Color Coding for Kids Protocol Selection
Color Code Table
Protocol Category Window
Radiation Exposure Sensitivity

Radiation exposure is a concern in all people of all ages, however, pediatrics are more
sensitive to radiation exposure. Radiation risk is higher in young as they have more rapidly
dividing cells than adults. The younger the patient, the more sensitive they are.

4-2
Dose Reporting Considerations

It is widely understood and accepted that adult techniques should never be applied to small
patients or pediatrics since smaller objects have higher dose at the same technique. Figure
4-1 illustrates the sharp increases in relative dose as the part scanned gets smaller in size
using the same technique.
Another consideration about dose is since it is not possible to characterize dose given to
individual patients, the CT dose indices are provided to help make relative comparisons.
These dose index values can be used to compare CT systems and to help select appropriate
operating conditions for scanning. However, it is important to recognize that the dose
reported by these indices is inversely proportional to phantom size (see Figure 4-1). This
means that for the same scan technique, smaller phantoms (patients) will produce a higher
absorbed dose than larger phantom (patients). Therefore, it is critical to remember that the
body filter uses the 32 cm CTDI phantom and the head filter uses the 16 cm CTDI phantom
for dose reporting purposes (CTDIvol displayed in the Dose Information area on the ViewEdit
screen). Table 4-1 indicates the phantom size used for calculating dose for each Scan
Field-Of-View (SFOV).
In other words, when looking at the actual absorbed dose to the patient, understand that
the dose may be higher than reported if the part scanned is smaller than the phantom
tested. Keep this in mind when adjusting scan parameters to fit patients who are smaller
than the phantoms tested.
Figure 4-1 Relationship between dose and phantom size for head and body filters at 120kV.
Similar curves are obtained for the 80, 100, and 140 kVs.
120 kV
head filter
body filter
2.20
relative dose
2.00
1.80
1.60
1.40
1.20
1.00
0.80
15
20
25
30
35
phantom diameter (cm)

4-3

Table 4-1 CTDI phantom used dose report based on SFOV type
SFOV type
CTDI phantom
Ped Head
Ped Body
Small Head
16 cm Phantom
Head
Small Body
Medium Body
Large Body
Cardiac Small
32 cm Phantom
Cardiac Medium
Cardiac Large
Suggestions for Minimizing Unnecessary Dose

Everyone shares the responsibility of minimizing CT radiation dose. There are several steps
that can be taken to reduce the amount of radiation that pediatrics and small patients
receive from CT examinations.

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

4-4

Scan coverage should be limited to cover only the organ or anatomical region of the body
indicated to avoid unnecessary exposure.

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

Doing so will allow the bow tie filters to deliver dose where it is needed and filter more where
its not. This is especially important using automatic exposure control techniques such as
AutomA and SmartmA to further reduce unnecessary radiation exposure. Patients not
properly centered may be under or over exposed to radiation if the table height is set too
high or too low.

Consideration should be given to lower mA setting and higher Noise Indexes if AutomA is
used for musculoskeletal and chest/lung imaging. Higher resolution/dose imaging is
typically unnecessary for these types of studies or those studies where there is high inherent
contrast between the structures being imaged.
Limit the highest quality images requiring the highest radiation dose to very specific
indications such as angiography or visualizing small subtle lesions. Studies with higher noise
may be just as diagnostic and require lower dose.

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

If needed, papoose boards and neonatal immobilizers may be useful with certain patients.
These accessories are sometimes helpful in both securing and keeping the patient still,
resulting in less repeat exams and dose due to patient motion.

4-5
Make a Kid Friendly Environment

Pictures of animals on the wall or ceiling, stuffed animals, and games are all effective ways
to help pediatric or small patients feel less scared. Depending on their age, explain the
procedure so they know what to expect when they enter the scan room. This will aid in
patient cooperation and potentially less repeat studies and dose due to patient motion.
Guidelines for Adjusting Individual Exposure Parameters by

Patient
Adjust Parameters by Size, Age, Weight, Height, & Indications
The single most important thing you can do is to always use pediatric protocols based on
the age, weight, height, and indications to avoid over exposure. Recommended pediatric
color coded protocols are installed on the system and are arranged in colors according to
height and weight for easy selection. These protocols should be considered as a baseline
and we strongly encourage you to work with your radiologist and medical physicist to
determine the lowest possible dose at the image quality desired. Also consider the diameter
of the part being scanned as a final determination before scanning. For instance, the part
may be smaller or larger than what is indicated by the weight of the patient.
Lower kVp
Consider decreasing the kilovoltage to 80 or 100kVp for smaller patients. Significant
decreases in dose can be achieved with lower kVp selections, but decreases in kVp should
not be done without increasing the mA to maintain noise levels and contrast to noise ratios.
Lower kV selections also increase HU values so the window width for viewing images will
need to be increased to maintain a similar appearance. Since lower kVp selections lower
x-ray penetration, it is important to not use low kV selections on too large of a patient, which
can potentially result in compromised image quality. Work with your radiologist and medical
physicist to establish low kV protocols and patient size limits. Table 4-2 and Table 4-4 can be
used as guide for making adjustments to mAs for changes in kV in a protocol.
Table 4-2 kV and mAs Adjustment Factors
KV Adjustment Factor
kV
80
100
120
140
Factor
0.3
0.6
1.0
1.4
mAs ADJUSTMENT FACTOR = Rx mA * Rx single rotation time in seconds/ 260

NOTE: The kV and mA adjustment factors are estimated using a CTDI100 dose.

4-6

For example, keeping everything constant at a technique of 120kv at 150mA you would get:
100kV at 190mA
80kV at 250mA
140kV at 95mA
Figure 4-2
Maximum Patient Diameter Guide for low kV selection
50.0
Lateral Patient Diameter (cm)
80 kv
100 kv
45.0
120 kv
140 kv
40.0
35.0
30.0
25.0
0
100
200
300
400
500
600
700
800
900
mAs
To assure sufficient x-ray penetration, this chart is intended as a relative guide to the
maximum patient diameter that can be scanned based on a kV and mAs selection. It does
not indicate, a recommended technique factor (that is generally higher) since the technique
factor also depends on the image quality needed for the diagnostic task.
AutomA
If using AutomA, proper patient centering is critical. Double check and verify the table
height is centered to the patient. Raise or lower the table as needed before taking the
scouts. After the scouts are taken and prescription is done, verify the mA table calculations
before confirming the scan. Make sure minimum mA and maximum mA values are set
appropriately. See section on AutomA for more detail.
Increase Pitch
Increasing pitch will decrease the amount of radiation needed to cover the region indicated,
usually without compromising the diagnostic quality of the scan. Increasing pitch from 1.0
to 1.375:1 decreases dose by a factor of about 27%.

4-7

Table 4-3 Helical Travel and Scan Mode Adjustment Factors
Acquisition Mode Parameters for CTDI100 and CTDIw
Acq.
64 X 0.625
32 X 0.625
16 X 0.625
8 X 0.625
4 X 0.625
2 X 0.625
Helical mm/Rotation per

Pitch
and Acquisition Mode
(mm)
~0.5:1 ~0.9:1 1.375:1
20.62
39.37
55.00
10.62
19.37
27.50
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Axial and Cine

Slice Thickness
64i
*0.625
N/A
N/A
N/A
N/A
N/A
32i
*1.25
0.625
N/A
N/A
N/A
N/A
16i
2.50
1.25
0.625
N/A
N/A
N/A
(mm)
8i
5.00
2.5
1.25
0.625
N/A
N/A
4i
N/A
5
2.50
1.25
N/A
N/A
2i
N/A
N/A
5.00
2.50
1.25
N/A
1i
N/A
N/A
N/A
5.00
2.50
1.25
NOTE: *only avaible in Retro Recon
Use Small SFOV Filters

The smallest SFOV should be used whenever possible depending on the exam and size of
the patient. Matching the appropriate SFOV bowtie filter to the size of the patient will ensure
dose delivered where it is needed, and filtered where not needed.
Small SFOV Supports DFOVs up to 32 cm in diameter.
Ped Head SFOV supports DFOVs up to 32 cm in diameter and uses IBO processing to
correct for beam hardening effects. Ped Head is a field of view that is particularly
useful for infants 18 months or less in age.
Small Head SFOV should be used for patients from 1.5 years old to 10 years old.
Ped Body SFOV supports DFOVs up to 32 cm in diameter.
Both the Ped Body and Ped Head SFOVs are limited to 45kW. This limits the maximum mA
possible to 250 at 120kVp.

4-8
Optimize Pediatric Protocols for your Facility

Work with your team of radiologists, medical physicists, and CT technologists to evaluate
techniques that may reduce radiation dose and still provide adequate diagnostic
information. In addition to the recommended protocols installed on your system and
suggestions in this guide, these websites offer excellent sources of additional information on
how to optimize scanning protocols:
American College of Radiology (ACR): http://www.acr.org/
Society of Pediatric Radiology (SPR): http://www.pedrad.org/
National Cancer Institute (NCI): http://www.nci.nih.gov/aboutnci
Image Gently: http://www.imagegently.com/
FDA website: http://www.fda.gov/
Pediatric Protocols
The Pediatric protocol area was designed to help facilitate protocol selection for pediatric
patients by providing age based protocol areas for Head, Orbit and Miscellaneous and color
coding system for Neck, Upper Extremity, Chest, Abdomen, Spine and Pelvis. It is highly
recommended to place and select pediatric protocols from the pediatric selector based on
age, height and weight.
By entering the pediatric patient's weight in the New Patient screen, the system will
automatically select the appropriate color code area for the anatomical area selected.
After the patient information has been entered, click on the <Pediatric> button to bring up
the anatomical selection area. The anatomical areas are indicated by text.

4-9

Figure 4-3 Pediatric Selector
Color Coding for Kids Protocol Selection

Based on the Broselow-Luten Pediatric System, the Color Coding for Kids system was
developed to help the user select the correct pediatric CT protocol based on the height and
weight. The system divides the protocols into nine color zones based on height and weight,
and incrementally increases scan technique as the patients size increases. This
arrangement of protocols will assist the user in reducing the variations in pediatric protocol
selection. If the patient weight is unavailable, a Broselow-Luten Tape can also be used to
obtain the weight based on the length.
Once the anatomical area is selected, the rainbow bars (Figure 4-5) containing the Color
Coding for Kids weight based selections appear. Select the color category based on the size
of your patient, or verify that the correct color has been selected if a weight was entered.

4-10

The protocols in the selected color code are then displayed accordingly. If there is no
weight-specific protocol associated with the selected anatomical area, the Protocol
Category window appears (Figure 4-5). The default weight/color selector will show the
patient weight entered in the patient information screen, or the last weight/color selection (if
no patient information was entered).
NOTE: If you enter a patient weight on the patient information screen and select a
color/weight that is not consistent with the entered information, an error message
appears (Figure 4-4). You must acknowledge that you have chosen a protocol that
does NOT match the patient size.
Selectors on the color/weight bar are labeled with the zone ranges for weight and length,
with the word of the selected color and with the weight/color zone number as indicated in
Color Code Table 4-4
NOTE: Weight-specific protocols are enforced for all anatomical areas except Head, Orbit,
and Miscellaneous. Protocols in the Head and Orbit categories are usually defined
based on patient age as opposed to patient weight/height.
Color Code Table

Table 4-4 Color Code Table
Zone
Number
Zone
Color
Pink
6 - 7.5
13.2 - 16.5
59.5 - 66.5
Red
7.5 - 9.5
16.5 - 20.9
66.5 - 74
Purple
9.5 -11.5
20.9 - 25.4
74 - 84.5
Yellow
11.5 - 14.5
25.4 - 32.0
84.5 - 97.5
White
14.5 - 18.5
32.0 - 40.8
97.5 - 110
Blue
18.5 - 22.5
40.8 - 49.6
110 - 122
Orange
22.5 - 31.5
49.6 - 69.5
122 - 137
Green
31.5 - 40.5
69.5 - 89.3
137 - 150
Black
40.5 - 55
89.3 - 121.3
--
Zone Weight (kg) Zone Weight (lb)

Zone Length (cm)
4-11

Figure 4-4 Protocol Category Warning
Protocol Category Window

Figure 4-5 Protocol Category Window

4-12
Getting Started
Chapter 5
Getting Started
Introduction
The Getting Started chapter provides you with information about the hardware components
and users conventions, as well as the shutdown and startup procedures of the system. The
chapter is broken into three parts: hardware components, users conventions, and shutdown
and startup. The purpose of this chapter is to provide the necessary background information
about the system that may be important in understanding other topics presented in
subsequent chapters.
This chapter explains the process of shutting down and starting up the system. It provides
step-by-step instructions to learn how to:
Shut Down and Start Up System
Login and Logout
Configure HIPPA (EA3) Properties
Configure Local Users

Add a Local User
Change a User Password
Change a User Full Name
Remove a User
Add or Remove a User from a Group
Change User Roles
Locking / Unlocking a User
Force a User to Change Password on Next Login

5-1
Getting Started
Configure Groups
Add a Local Group
Add a Enterprise Group
Manage a Group
Remove a Group
Change Groups Roles
Configure Enterprise Tab

Add Memberships
Remove Memberships
Auto Configuration
Manual Configuration
Use QuickSnap
Use IQ Snap
Use Anonymous Patient (Anon Pat. Level)
As stated in the About This Guide chapter, it is necessary for you to have sufficient
knowledge to competently perform the various diagnostic imaging procedures in
Computerized Tomography. This guide is not intended to teach Computerized Tomography.

5-2
Getting Started

This section presents the concepts necessary to successfully set up a patient for scanning.
Some of the concepts you need to understand are:
Hardware Components
Breath Hold Light.
Internal Gantry Components
Computer (Operator Console)
Monitors
Mouse
Bright Box
Power Distribution Unit (PDU)
Users Conventions
Tool Chest
HIPAA
Understanding users and groups
Understanding groups and privileges
Product Network Filters - PNF
Software Download
OptiDose
Dose Features & Technology *

5-3
Getting Started
Hardware Components
Figure 5-1 Gantry Controls
12
13
14
15
11
5
4
16
17
7
18
9
10
Table 5-1 Gantry Control Panel Keys and Indicators

No.
1
Icon
Function
Description
Prep Delay
Timer
Displays a preparation delay before scan starts.
Stop Scan
When pressed, stops the prep display and X-ray

exposure, turns off the laser alignment lights, halts all
gantry and table motions and returns the QC pin source
to its shielded enclosure, if exposed. The cradle and
base also unlatch and need to be latched before
initiating a scan.
Scan Start
In the event that you want to stand by the gantry and

start the scan, you can press this button after you have
confirmed the prescription and the table has been
moved to the start scan location. Start Scan will flash for
30 seconds before it times out. Press the solid green
Start Scan button again to bring the system back to
ready to scan state.
Cradle In
When pressed, the cradle moves in, toward the gantry.

5-4
Getting Started
No.
Icon
Function
Table Up
When pressed, the table moves up and towards the

gantry. When the table moves up with the laser
alignment lights on, the cradle will adjust horizontally to
maintain the anatomic reference point.
Cradle Out
When pressed, the cradle moves out, away from the

gantry.
Cradle In or Out can be used to move the patient to
the scan location after clicking confirm. Cradle In or
Out LED will flash for 180 seconds before it times out.
Table Down
When pressed, the table moves down and away from

the gantry. When the table moves down with the laser
alignment lights on, the cradle will adjust horizontally to
maintain the anatomic reference point.
Fast Speed
When pressed in conjunction with Table Up/Down or

Cradle In/Out, causes those functions to operate at a
faster speed.
AutoVoice
Demo
(breath-hold
lights are
only used
during CT
scans)
See Figure
5-3.
1. Breathing Lights Demo- Pressing this allows you to

demonstrate to the patient how to use the breathing
lights and countdown timer.
11
Description
Blinking green breathe light indicates to get

ready to hold your breath.
Solid yellow light indicates to hold your breath.
Count down indicator counts down the seconds
to breathe time
Solid green breathe light indicates to breathe
Pressing allows you to view the current gantry tilt range
and scannable range, based on table position, on the
gantry display panel.
12
Tilt and
Table
Travel
Limits
NOTE: The Tilt and Table Travel Limits displayed are

calculated based on a limit and collision matrix
that takes into consideration the table height and
landmark location on the cradle when providing
the information displayed.

5-5
Getting Started
No.
Icon
Function
Internal
Landmark
2. Internal Landmark - Pressing (Internal Landmark)

establishes the tables reference point when
positioning the patient, using the internal laser
alignment light. This reference point is normally the
anatomic reference point to be used when
positioning the patient. For example, if the patients
anatomic reference point is the sternal notch, then
the sternal notch would be centered to the internal
laser alignment light, and you would press (Internal
Landmark). The gantry display would then show a
table location of 0 mm. The reason for the table
location of 0 mm is because the CT system
calculates its table location numbers based on the
internal laser alignment light. Either (Internal
Landmark) or (External Landmark) has to be used
before you can click [Confirm].
External
Landmark
Pressing (External Landmark) establishes the tables

reference point when positioning the patient, using the
external laser alignment light. This reference point is
normally the anatomic reference point to be used when
positioning the patient. For example, if the patients
anatomic reference point is the sternal notch, then the
sternal notch would be centered to the external laser
alignment light, then you would press (External
Landmark). The gantry display would then show a table
location approximately 240 mm, depending on table
characterization. The reason for these location numbers
is that the CT system calculates its table location
numbers based on the distance between the external
and internal laser alignment lights. Either (Internal
Landmark) or (External Landmark) has to be used before
you can click [Confirm].
13
14
Description

5-6
Getting Started
No.
Icon
Function
Laser
Alignment
Light
15
Description
A toggle which when pressed, turns all the laser
alignment lights on or off. These are used to help
establish landmark locations.
CAUTION:
For patient safety, always have patients

close their eyes anytime the laser
alignment lights are on.
NOTE: The laser alignment light switch is provided as an

alternative to beam attenuators.
Cradle
Lock/Release
16
Pressing (Cradle Lock) once unlocks the table cradle,

making it "free floating". This means that the cradle can
be moved freely with your hands. This can be useful to
move the patient out of the gantry in an emergency.
Pressing (Cradle Lock) a second time returns the cradle
to the locked position and the landmark established is
maintained.
NOTE: If Cradle Lock is used during a SmartStep
acquisition, the cradle must be locked state to
make an exposure.
17
Table
Collision
Sensor
Indicator /
Reset
(Reset) is used if (Emergency Stop) has been pushed,

(Reset) flashes approximately once every two seconds.
Pressing (Reset) re-engages the table and gantry.
If the power has been turned off to the gantry, the
Reset button must be pressed to restore full
communications to the gantry and console.
NOTE: If the table stops moving, clear the obstruction
and continue moving the table.
Home
18
3. Pressing (Home) simultaneously moves the cradle

out of the gantry and return the gantry tilt to zero
degrees. Once the cradle has been removed from
the gantry, the table begins to lower to its lowest
allowable limit.
Gantry Display
The gantry display (Figure 4-4), provides gantry and table status information. The numbers
above and below each indicator or status area on the gantry display figure correspond to
the numbers in Table 5-2.

5-7
Getting Started
Figure 5-2 Gantry Display
1 2 3
Figure 5-3 Breath Hold Light.
Breathe Light
Breath
Light
Hold Your
Count Down Indicator

Table 5-2 Control Buttons
The (Laser Light Indicator) is illuminated anytime

the laser alignment light has been turned on.
Normally, this light is only on when positioning a
patient.
1
Laser Light
Indicator
CAUTION:

For patient safety, it is important to

always have patients close their eyes
anytime the laser alignment light is
on.
5-8
Getting Started
Collision
Indicator
The (Collision) light illuminates when there is a

possibility that the table, cradle, and gantry
comes in contact with each other. There are
tilt/elevation collision sensors on the front and
rear covers at the top of the gantry opening. The
collision sensors are active during table elevation
and during tilting of the gantry. The light also
illuminates if there is ten pounds of resistance
during cradle motion in/out or when reaching the
travel limits of table, cradle, and gantry motion. In
the case of interference, you may need to raise or
lower the table, check the gantry tilt, or determine
if resistance is being caused by any patient
restraints, accessories, or by the patient. If you
need to tilt the gantry after a collision has been
detected, the gantry only tilts in 0.5 degree
increments. You can also check the Table
collision sensor indicator/reset button on the
front of the gantry. The light will go out if you
continue to hold the button.
Cradle
Unlocked
Indicator
The (Cradle Unlocked Indicator) is illuminated,

indicating the cradle is unlocked. When the cradle
is unlocked, it is "free floating".
Vertical
Height
Indicator
The (Vertical Height Indicator) displays the vertical

height of the table in relation to ISO center.
Horizontal
Cradle
Position
The (Horizontal Cradle Position) displayed is the

position of the cradle based on the established
anatomic reference of the patient. This reference
is established using the internal or external
landmarks. The number is preceded by an S if the
position is superior to the reference point or an I if
the position is inferior to the reference point.
Gantry Tilt
Indicator
The (Gantry Tilt Indicator) shows one of two

displays. One display, which is the normal display,
indicates the current gantry tilt. If the gantry tilt is
superior, the number is preceded with an S. If the
gantry tilt is inferior, the number is preceded with
an I.
Exposure
Indicator
The (Exposure Indicator) illuminates amber when

an actual exposure is taking place.
Heart
Indicator
The heart is lit whenever there is an ECG gating

signal seen by the scanner.

5-9
Getting Started
Lung
Indicator
The lung indicator is lit when there is an

respiratory gating signal captured by scanner
Internal Gantry Components

Table 5-3 Gantry Components
Component
Description
Performix HD Tube
The anode heat capacity with a Performix HD tube
is 8 million heat units (MHU) and the cooling rate is
1782 kilo heat units per minute (KHU/min).
Performix HD is limited to 100.2 kW.
HD High Voltage Tank
The high frequency generator is composed of the

inverter and high voltage tanks. Each tank occupies
one cubic foot in the gantry. Together the inverter
and high voltage provide 100.2 kilowatts (kW) of
power with Performix HD tube. The High Generator
provides control for focal spot and fast switching of
kVp and mA to support HiRes imaging and Gemstone
Spectral Imaging.
Gemstone Detector
The detector is comprised of a new Gemstone

scintillator material which provides extremely fast,
repeatable light response enabling high definition
technologies and 0.35 second rotation times. There
are 64 x 0.625mm channels. Located at the back of
the detector is the Data Acquisition System or DAS.
The Volara HD DAS capable of supporting up to
2496 views which has a direct correlation to image
quality.

5-10
Getting Started
Component
Description
10Gb Slip Ring
Slip Ring provides data communication path from

Detector/DAS to the Digital Interface Processor from
there to the system disk.
Figure 5-4 Right Rear Plug In Panel

4
Table 5-4 Right Rear Plug In Panel

Number
Description
Hand Held Control Connection
Foot Pedal Control Connection
Respiratory Gating Power Connection
Ethernet Connection for ECG Monitor
Cardiac Gating Trigger Connection

5-11
Getting Started
Number
Description
Cardiac Gating Power Connection
Respiratory Gating Trigger Connection
Figure 5-5 Left Rear Plug In Panel

4
Table 5-5 Left Rear Plug In Panel

Number
Description
Hand Held Control Connection
Foot Pedal Control Connection
Spare Power Outlet Connection
LCD Power Connection
Monitor Connection

5-12
Getting Started
Figure 5-6 Console Rear Plug In Panel
16
1
2
3
12
10
13
11
14
4
5
6
7
15
Table 5-6 Right Rear Plug In Panel

Number
Name
Description
J31
Respiratory Gating Monitor Connection (RMP)
J30
IVY Monitor (EKG) Connection
J29
Advantage Windows (AW) Connection
J28
Universal Power Supply (UPS) Connection
J27
System Interconnect (TGP) Connection
J26
Hospital Network (HSP) Connection
J25
System Interconnect (SlipRing) Connection
J24
Printer Connection
J22
Accessory Power Connection
10
J4
MOD Tower Power Outlet
11
J2
Monitor Power Outlet
12
J21
Accessory Power Connection
13
J5
SCSI Tower or the Peripheral Media Tower Outlet
14
J3
Monitor Power Outlet
15
J1
Console Power Connection
16
C83
Power Switch

5-13
Getting Started
CAUTION:
These Receptacles are not for General Use. The power consumption of both
accessories should not exceed 960 Watts.
DANGER:
Information on internal gantry components is provided for user education.

The gantry contains dangerous voltages and moving parts. TO PREVENT
ELECTRICAL SHOCK OR CRUSHING INJURIES, DO NOT REMOVE COVERS OR
ENTER THE GANTRY. ONLY TRAINED, QUALIFIED SERVICE PERSONEL MAY
REMOVE GANTRY OR OTHER EQUIPMENT COVERS.
Computer (Operator Console)

Figure 5-7 GOC6 PC Based Computer Console
1
2
3
4
5
The numbers on Figure 5-7 correlate to the numbers in Table 5-7.

5-14
Getting Started
The computer is located at the base of the console and it contains all the hardware
necessary to operate the system and perform image generation.
Xtream FXTM Technology
The operator console issues a PC based computer system running a Linux based operating
system.The system includes system, image and scan data disks and stores up to 250,000
512 images and with 1 terra byte for scan data files which supports approximate 1450
rotations for 1 second Hi Res acquisitions.
GRE Recon
The Global Reconstruction Engine (GRE) hardware provides reconstruction times of up to 16
images per second based on hardware configuration. The faster times enhance the
capabilities of SmartPrep to provide more precise timing in the delivery of contrast material
for a wide variety of examinations.
ASIR Recon
A second recon subsystem is available for reconstruction of Adaptive Statistical Iterative
Recon images. The ASIR recon hardware provides reconstruction times of up to 5 images a
second for Volume mode and up to 15 images a second for slice mode.
Applications on Operator Console (OC)
Common user interface with Advantage Windows for improved productivity. The OC now
supports an expanded list of Advanced Application packages such as Volume Viewer, CT
Perfusion 4- Multi-Organ or Neuro only, Advantage CTC Pro, AutoBone, CardIQ Xpress 2.0
Plus, AVA Xpress, Card EP, and Dentascan.
Volume Viewer is a prerequisite to support , CardEP, Advantage CTC Pro, AutoBone, CardIQ
Xpress 2.0 Plus, and AVA Xpress.
Located on the top of the console table top is a media tower with three drives and a
separate MOD drive.
Table 5-7 Device Descriptions
Device Name
Magnetic Optical
Disk Drive (MOD)
Description
Located at the top of the media tower is the MOD drive used
for image archiving and restoring. The MOD disks are
erasable and re-writable and 1.2 or 2.3 GB media can be
utilized. The MOD can store 1800 (1.2GB) or 6000 (2.3GB)
lossless JPEG compressed 512 x 512 matrix images per side.
Actual number may vary by stored image type.
NOTE: PC based systems only save images files to MOD, scan
data is saved to DVD RAM for these systems.

5-15
Getting Started
Device Name
Description
Digital Video
Disk Read/Write
(DVD-R/W)
The CD/DVD option (Interchange) in the Browser on the Image

Works desktop uses the DVD-R drive to write to CD-R or
DVD-R. The CD/DVD option can restore data from CD-R and
DVD-R. The Data Export option in the Browser on the Image
Works desktop can only save information to CD-R.
This drive can also be used to save ECG traces and to access
the electronic copies of the Learning and Reference Guide,
Technical Reference Manual, Applications Tips and
Precautions.
Located at the bottom of the media tower is the DVD drive

which supports writing to a DVD- RAM.
The DVD drive can be used to access the electronic copies of
the Operator Manual titled "The Learning and Reference
Guide".
The DVD-RAM is used for saving scan files, protocols and
service files to 9.4GB DVD-RAM media.
Located on the front of the console are connections for iLinq

and service computer functions.
There is also a connection port for an external USB drive
support for saving scan data.
This is intended to be used by trained service personnel only.
Digital Video
Disk-Random
Access Memory
(DVD-RAM)
Connections for
iLinq and service
computer
functions
Computer power
on/off switch
Located on the front of the console is the console power

on/off switch. If power is turned off via this switch and the
Main Disconnect Control A1 Power Panel (Breaker), then
power cannot be restarted to the computer unless the on/off
switch is turned on after power to the Main Disconnect
Control is restored.
NOTE: In a typical workflow the system would be shutdown
by clicking [Shutdown] on the right monitor prior to
disabling power.
Discovery CT750 HD Table

The table has a weight limit of 500 pounds (227 kg) with an incremental accuracy of 0.25
mm. The vertical range of the table is 43 to 99 centimeters. The scout view range is 1600
mm and the scan range is 1,700 mm for VT1700 table with the cradle extender. The scout
view range is 1900 mm and the scan range is 2,000 mm for VT2000 table with the cradle
extender for the. Discovery Table.

5-16
Getting Started
Table 5-8
Figure 5-8 Table Strips
Tape Strips
Tape Strips
Located underneath the table are the collision sensor strips. These strips are located in
areas where there is potential for the table to come into contact with foreign objects, such
as a wheel chair or a stretcher. If one of the tape strips is touched, the table and gantry
motion stops immediately. Raise the table and clear the obstruction. You can now continue
moving the table down.
Figure 5-9 Collision Sensor Strips
NOTE: The maximum scan range and gantry tilt depends on the table height. The mark on
the cradle for maximum scannable range is based on the table center at isocenter.
Make sure the patient is positioned within the scannable range and use the Tilt and
Table Travel Limit button on the gantry control panel to check limits.

5-17
Getting Started
CAUTION:
If the table is lowered with anything in the red X area as indicated in Figure
5-10, the table could be damaged along with the equipment or object under
the table.
Figure 5-10
NOTE: Discovery CT750 HD tape switches are only activated when downward motion of
the table elevation encounters an obstruction. They are not activated when touched.
CAUTION:
Use of any cradle extension accessories such as the table extension, head
holder, coronal head holder, and phantom holder are not accounted for in the
table gantry interference matrix. Therefore, additional care needs to be taken
to closely monitor any table up/down, in/out or gantry tilt movement to avoid
contact of the extended accessory with the gantry.
Monitors
There are two monitors for the system (Figure 5-11). The monitor on the left is the Scan
monitor and the monitor on the right is the Display/Image monitor.
Figure 5-11 Monitors
LCD Monitors

5-18
Getting Started
NOTE: If the power is turned off to the monitors by either console off or using the power off
button on the monitor, it takes 15 minutes for the monitors to stabilize to their set
brightness and contrast levels. During this warm-up time, do not make any
adjustments to the brightness or contrast levels.
1. Scan Monitor - The Scan monitor contains the user interface that controls all aspects of
scanning from entering patient information to ending the patient exam. The interface
also includes scan protocol control, scan data manipulation, and system maintenance,
such as tube warm-up and calibrations.
Top Level Features (from left to right):

New Patient - To start a new patient.
Patient Schedule - To pre-program patient information and to get information
from DICOM HIS/RIS.
Protocol Management - To create, edit, and delete scan and voice protocols.
Retro Recon - To reprocess scan data to create new images.
Recon Mgmt - To pause, resume, or delete reconstruction. Also used to
save/restore or reserve/release scan data.
Daily Prep - To perform tube warm-up, or fast calibrations.
Scanner Utilities - For Field Engineer to perform phantom calibrations.
Operator Console Message Area - Located above the buttons, it is a raised white
bar in the middle of the white line. Clicking on this bar gives you a list of various
messages related to the scan monitor.
NOTE: The details about each of the features, except the Operator Console Message Area,
is covered in various chapters in this manual.
2. Display/Image Monitor - The Display/Image monitor contains the desktop selection
area and the feature status area at the top left.
This section focuses more attention to the desktop selection area and the feature
status area. These areas are visible on all desktops except Learning Solutions.
The function buttons for the current desktop and the image display area are covered
elsewhere in this manual.

5-19
Getting Started
The numbers on the above picture correlate to the numbered explanations below.
2
3
4
5
6
7
1. Desktops - The desktops can be thought of as a work environment. When a desktop is
open, all the functions related to that desktop are placed on the display/image monitor.
The available desktop selections are:
Exam Rx - To view images as you scan, auto film, manual film, and to apply
measurements and other features to an image.
Image Works - To view other exams, archive, network, remove, manual film, apply
measurements and other features to an image, perform 2D reformations, and
access optional software features.
Learning Solutions - access to electronic based operator information - Learning
and Reference Guide.
iLinq - To gain on-line access to GE Online Center engineers and Answerline
Applications Specialists for the purpose of sending and receiving information
related to the scanner. Within this desktop, you also have access to the ten most
frequently asked questions and a searchable database.
Service - Used mostly by field engineers to save scan and/or voice protocols and
to perform system diagnostics.
Shutdown - To restart the system, shutdown for power cycle of the system, or
User log out for HIPAA
2. Feature Status Area - contains the following areas:

5-20
Getting Started
Date/Time/Image Space - Shows current date, time, and the remaining 512 and
256 matrix image space on the system disk.
Reconstruction - Shows the current or most recent exam, series, and image
reconstruction status. This status includes prospective or retrospective
reconstruction.
On the Xtream and Xtream FX systems, recon shows the exam, series, image range
and percent complete.
Archive - Shows the current or most recent exam, series, and image archive
status. This status includes Save or Restore.
Network - Shows the current or most recent exam, series, and image network
status. This status includes Send or Receive.
Filming - Shows the current or most recent filming status.
Current Message - This area serves two functions. First, when you click on the
area, you can see a list of the system messages. These messages are not
necessarily error messages but can simply be any informational message
generated by the system. The second purpose is to leave messages about the
system for the field engineer by using [Memo]. When you click [Memo], a pop-up
menu appears. Making sure the cursor is in the menu area, you can then type a
message, then click [Save]. The message now is a part of the log files. The field
engineer can look at this message at a later date by viewing the log file via [View
Log]. You can also view the error log through [View Log].
Keyboard and Scan Interface module

The keyboard and scan interface module exist of a typical alphanumeric keys, 10 number
keypad and buttons specific to initiating scan, remote tilt of the gantry and communication
with the patient.
Figure 5-12 Keyboard
2 10 11 12
9
3 4 5
6 7 8

5-21
Getting Started
1. Emergency Stop - In the event of an emergency situation, pressing emergency stop
stops all table and gantry motions, as well as any X-ray exposure in progress.
2. Exposure Indicator - The
exposure is taking place.
(Exposure Indicator) illuminate amber when an actual
3. Start Scan - The

(Start Scan) indicator flashes green once the tube has reached
exposure speed. Simply press the button to start the scan. Start Scan will flash for 30
seconds before timing out. Press the solid green Start Scan button again to bring the
system back to the ready state.
4. Pause Scan - Pressing
(Pause Scan) causes the system to pause scanning, once
the current scan is completed. You can resume the scan by selecting [Resume] from the
view/edit screen.
5. Stop Scan - Pressing
(Stop Scan) aborts the scan immediately. You can resume
the scan by selecting [Resume] from the view/edit screen.
6. Move to Scan - The
(Move to Scan) indicator flashes green indicating that the
system is ready for you to advance the cradle into the starting position. Simply press the
button to advance the cradle. Move to Scan will flash for 180 seconds before timing out.
7. Stop Move - Pressing
(Stop Move) stops cradle motion in/out. You can resume the
scan by selecting [Resume] from the view/edit screen.
8. Remote Tilt (Prescribed Tilt)- Press
until the prescribe tilt is achieved.
(Prescribed Tilt) and hold the button down
NOTE: The Remote Tilt button on the Scan Control Interface Module can be used to return
the gantry to zero once all the prescribed scans for the exam have been acquired.
9. Talk - Pressing
(Talk) and speaking towards the intercom above the
button allows you to communicate with the scan room.
WARNING: Be sure that the Gantry will not touch the patient during Remote Tilt
operation. Pinching or crushing may happen if the Gantry touches the patient.
10.Volume Control (operator to patient) - The (Volume Control Operator Voice
to Patient) dial is located just below the indicator on the front of the keyboard.
This dial controls the volume of the operators voice to the patient. An upward
adjustment of the dial increases the volume while a downward adjustment of
the dial decreases the volume. The dial does have numbers on it to let you
know what volume level you have set.

5-22
Getting Started
11.Volume Control (autovoice to gantry)-The (Volume Control Autovoice to
Gantry) dial is located just below the indicator on the front of the keyboard.
This dial controls the volume of the autovoice to the gantry. An upward
the dial decreases the volume. The dial does have numbers on it to let you
12.Volume Control (patient to operator) - The (Volume Control Patient to

Operator) dial is located just below the indicator on the front of the keyboard.
This dial controls the volume of the patients voice to the operator. An upward
the dial decreases the volume.The dial does have numbers on it to let you
13.Filming Keys - The F1-F4 function keys can be used for filming to the
Manual Film Composer. The F3 function key in conjunction with Shift, and the
F12 function key can be used for filming to the AutoFilm Composer.
Table 5-9 Function Keys
F Key
Description
F1
Film Image
F2
Film Screen
F3
Film MID
F4
Print Series
F12
Auto Film Image
Translated Text
14. Preset Window Width/Window Level Keys - The F5 - F11 function keys are used to
apply the preset WW/WL values stored in User Prefs in Image Works. The keys can be
used to set the WW/WL using the preset values in viewports on ExamRx, in the Viewer
and Mini-Viewer in Image Works and in Reformat.
Table 5-10 Function Keys
F Key
Window/Level
F5
Previous
F6
Abdomen
F7
Head
F8
Lung
F9
Mediastinum
F10
Spine

Translated Text
5-23
Getting Started
F Key
Window/Level
F11
Vertebra W/L
Translated Text
15. Page Up/Page Down - The Page Up and Page Down keys allow you to review the next
and prior images in a viewport or viewports from the Exam Rx or Image Works desktops.
16. Window Width/Window Level Control Keys - You can use these keys to manually
change the WW/WL settings for images in the Exam Rx and Image Works desktops. The
(Up/Down) keys increase/decrease the window level and the
(Left/Right) keys
decrease/increase the window width.
Mouse
The mouse is used extensively to make selections on the scan and display/image monitors.
It is a standard three button computer mouse that is set up to work with the system.
Figure 5-13 Mouse
left
right
middle
The three mouse buttons are referred to as the left, middle, and right mouse buttons. In this
manual, the term "click" refers to pressing and releasing the left mouse button. The term
"double click" refers to quickly clicking and releasing twice on the left mouse button. The
term "triple click" refers to quickly clicking and releasing three times on the left mouse
button.
Most of the selections required during the scan and review process require a single click on
the left mouse button. This is the primary button for selection. The middle mouse button is
used primarily for adjusting window width and window level. The right mouse button is used
infrequently for scrolling images, magnification, and for accessing hidden menus.
NOTE: For specific terminology and mouse descriptions used in this text, refer to Table 2-1
in the About This Guide chapter.

5-24
Getting Started
Bright Box
The Bright Box (Figure 5-14) is a separate piece of hardware that can be utilized to review
images without having to fully utilize the mouse or keyboard. Using the Bright Box allows
someone to review an image or images while someone else utilizes the mouse and
keyboard to set up or continue the scan series.
The Bright Box can be used only in the Exam Rx desktop with any "free" viewport. The term
"free" refers to a viewport that is not utilized for autoview or autofilm. It can be used in the
Autolink viewport, although, when the first image of another series is reconstructed, that
image is displayed in the viewport, taking the place of the series you are currently reviewing.
It is recommended to click the review screen, bottom left viewport, as a "free" viewport.
You can only work in one viewport at a time. Before you begin, you should put the desired
viewport in primary focus, with a double click in the viewport, so it does not affect the other
viewports.
NOTE: To get additional information about primary and secondary viewports, refer to the
Image Display Viewing Area chapter.
Figure 5-14 Bright Box
1. Prior Button - Pressing this button displays the prior image in the set. This button is
inactive while in the paging mode.
2. Next Button - Pressing this button displays the next image in the set. This button is
inactive while in the paging mode.
3. Trackball - The trackball has two functions. The first, while not in the paging mode,
adjusts the window width and window level of the image. Moving the trackball to the left
decreases the window width while moving it to the right increases the window width.

5-25
Getting Started
Moving the trackball down decreases the window level while moving it up increases the
window level. While in the paging mode, moving the trackball up pages through the
sequence from beginning to end at a rate dependent on the speed at which you move
the trackball. Moving the trackball down pages through the sequence from end to
beginning at a rate dependent on the speed at which you move the trackball.
4. Paging Button - The paging button is used to page through a sequence of images. Once
the viewport of interest is in primary focus, you can click the paging button twice to
initiate paging. You notice the letter "P" displayed in the lower right of the viewport
indicating the paging mode is active. Once you are in the paging mode, the next/prior
buttons are disabled and the trackball is used for paging through the sequence of
images. While in the paging mode, you can click once on the paging button to switch to
the window width and window level mode. This is designated by a "WL" replacing the "P"
in the lower right of the viewport. The trackball now controls the WW/WL settings.
Clicking the paging button again returns you to the paging mode. To exit the paging
mode, click twice on the paging button. The "P" in the lower right corner of the viewport
disappears indicating you are out of the paging mode.
Power Distribution Unit (PDU)

The PDU supplies power to various parts of the system which includes components in the
gantry, table and operator console. On the front of the PDU are controls to indicate that
power is on to the unit, a push button to turn power on/off to the gantry and table, and an
Emergency Stop button.
Figure 5-15 Front Panel of Power Distribution Unit
3
1

5-26
Getting Started
Function
Description
1. Power
Indicates power is On/Off to the unit
2. Gantry Enable
Enables/disables power to the gantry and table
3. Emergency Stop
When pressed, all table and gantry motions are halted,

generation of x-ray is stopped, laser alignment lights are
turned off. The system aborts any data collection
acquisition in progress and attempts to save all data
acquired prior to the abort. Use the Emergency Stop for
patient related emergency. The cradle and base also
unlatch and need to be latched before starting a scan.
Users Conventions
The following users conventions are used throughout the user interface. Most of them
apply to the process of scan set up.Functions that are active are highlighted in yellow.
Functions that are not available because another function is open are gray.

5-27
Getting Started
If one function is open and then a second is opened, the first open function is
highlighted with a folded corner, indicating the function is still open and active. The
second open function is the current active function.

5-28
Getting Started
Once a new patient exam has been started and you are setting up the scan parameters
from the view/edit screen, the scan parameters are listed in columns. You can change
parameters within the prescription by clicking the column heading or the parameter
value directly. Changing a prescription through the column heading changes that
parameter for all corresponding rows. To change a parameter in a specific group, click
the desired parameter below the column heading.
Parameter selections that have a raised button appearance, when selected, displays a
pop-up menu prompting you to click or type in the desired parameter.
Parameter selections that have a sunken/depressed, light background appearance,

when selected, allows you to type in the desired value.

5-29
Getting Started
When a parameter is highlighted orange, this indicates that a parameter has been
adjusted by the system from the original preset value. Changing one parameter may
affect other parameters. In this case, you may have more than one parameter
highlighted orange. (In this example, the scan type was changed from helical to axial.
The ISD changed, as well as parameters in the recon tab card. You will be able to
continue, however, you should review parameters to make sure they are as needed for
the clinical protocol.)
When a parameter is highlighted red, you cannot continue scanning until a correction is
made. (In this example, the techniques selected for the exam are too much for the
system to handle, so we need to change a parameter to continue.) Once the correction
is made, you can then continue.
When you input an invalid parameter, the system defaults to the closest value possible
and a brief message explaining this change displays in the scan message area. If you
wish to see the message again, click on the parameter that has been changed. (In this
example, 400 mA was input but the system changed the value to 380 mA.)
Tool Chest
The tool chest is located on the right monitor in the upper right corner of the screen on the
Image Works desktop. Many items can be selected from this area.

5-30
Getting Started
Figure 5-16 Tool Chest
1
2
3
4
5
6
7
8
9
10
Table 5-11 Tool Chest
Clicking this allows you to set the autovoice volume

levels in the scan room.
1
Autovoice Volume
Check Security
This area is used by your service personnel.
Unix Shell Left
Displays a unix shell on the left screen. This area is used

by your service personnel.
Unix Shell Right
Displays a unix shell on the right screen. This area is

used by your service personnel.
Turn On Extended HU
Clicking this turns on extended Houndsfield Units.

5-31
Getting Started
Clicking this take a snapshot of all the parameters you

have prescribed and information for processes touched
by the prescription. Use this when you are having
system issues for Service Personnel to recall the system
issues.
6
Quick Snap
CAUTION:
Do not use Quick Snap while you are

acquiring data.
Refer to: Use QuickSnap detailed steps on using the

feature.
Clicking on this after selecting a set of images that have
been made anonymous takes a snapshot of the images
and reserves the scan data file related to the images as
well as recon files for service to review.
7
IQ Snap
CAUTION:
Do not use IQ Snap while you are acquiring

data.
Refer to: Use IQ Snap detailed steps on using the

feature.
8
10
Save ECG Trace
Using blank media placed in the DVD R/W drive of the

Operator Console, you can click this button to save the
directory of existing latest 500 ECG files from specific
ECG-gated scan types directly to CD -R media.
Restart Show Loc
Use this feature if the Scout or lines do not appear in

Show Loc. If Restart Show Loc does not resolve the issue,
use crosshair to determine Start/End locations and R/L
and A/P centers for the current exam. A reboot of the
system will be needed before starting the next exam.
Annon Pat. Level
Clicking this determines if the anonymized patient

information is saved with full annotation or partial
annotation. This is a toggle button.The pop-up message
indicates current state and state to transition to.
Refer to: Use Anonymous Patient (Anon Pat. Level)
detailed steps on using the feature.

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Getting Started
HIPAA
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.
Administration Simplification regulations of HIPAA have been in effect since early
2001.
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 saved 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 contains the following permissions. You can have Administrator, GE Service,
Standard User, or Limited User. Standard User can perform scanning functions and modify
protocols. Administrator can set up and delete users. Limited users can perform all
scanning functions. GE Service can do all functions. You must have Administrator
permission to add or delete users.

5-33
Getting Started
When you are adding users for local databases, certain rules apply. You must use the
following parameters.
Users/Groups - Lower case letters and numbers only
Users/Groups - Can not start with a number
Users/Groups - No limit on length
Passwords - Must be at least one character long, no NULL
Passwords - Can contain uppercase letters, numbers, and special characters
Administrator and Limited User permissions have different abilities when logging on. The
Administrator permission can add users. The Standard User permission can scan and
modify protocols. The Limited User can only scan. Emergency User login has Limited User
permission.
NOTE: HIPAA is an option that can be turned on or off by your Field Engineer.
Understanding users and groups

Every person who has permission to use the system is a user. Users are set up by system
administrators. These administrators may be IT personnel in an enterprise environment, or a
site manager or lead tech in stand-alone environments. The administrator adds new users
and assigns the users to a group, which dictates the level of privileges a person will have.
For example, a person named Sue Smith could belong to a group called technologists,
radiologists, administrators, or any combination.
Understanding groups and privileges

The group to which a person belongs has privileges. If you do not have an enterprise system,
the assignment of group privileges will probably be limited to those who have administrator
privileges and those who don't. Additionally permission for protocol edit may be assigned to
groups. If your system is set up for enterprise login, your IT person or administrator will be
using more of the features.
Product Network Filters - PNF

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

5-34
Getting Started
Software Download
Software Download provides the capability for Broadband connected systems with a
Service Contract to automatically down load software updates to the scanner. These
updates can be configured to Auto Install or Manual install.
A pop up indicating that this capability is installed on the system will be displayed for the
first 3 weeks after a software load from cold at every reboot.
Figure 5-17 Automatic Software Update Window
As updates become available a pop up will be displayed informing you of the update.
Figure 5-18 Automatic Software Update download
A progress bar indicates the progress of the install.

5-35
Getting Started
OptiDose
For years GE has followed the ALARA principle (As Low As Reasonably Achievable) in helping
our customers optimize dose. GE has provided many tools to help the clinician minimize
dose while achieving clinically diagnostic image quality.
GE CT is a proven leader in delivering dose efficiency in every scanner category. GE has
achieved this position through a "total system" approach.
Here you will learn about just some of the features which contribute to our "total system"
approach. To learn much more about this subject, please ask for our comprehensive
brochure, Dose in Computed Tomography: Basics, Challenges, Solutions (01-7192) located
on our web site at: http://www.gemedicalsystems.com/rad/ct/optidose.html.
Dose Features & Technology *

Pediatric Protocols
A full range of pediatric protocols is available based upon a child's size, age, and weight to
tailor the dose or treatment to the size of the patient.
The Head and Orbit categories are aged based. The rest of the categories are height and
weight based protocols.
AutomA/SmartmA
AutomA/SmartmA modulates X-ray tube mA to account for specific patient anatomy
based upon data gathered from the scout image. The system will predict the optimal setting
for the exam and adjusts mA to these settings. This maintains the best image quality at the
lowest dose.
ECG Modulated mA
ECG modulated mA provides flexible prospective control of mA values over the cardiac cycle
for ECG-gated helical exams. This enables you to maintain optimal image quality for
vascular analysis coupled with dose savings for the remaining portions of each cardiac
cycle.
SmartHelical
SmartHelical is integrated into all GE CT systems. It decreases image noise and increases
image quality or allows a 20 35% decrease in mAs (with the same/original image quality).
Automated Reviewer for Faster R&D
This specialized reading tool automatically has reviewed millions of images to help GE
engineers optimize algorithms and pitch settings and is still in use today.
Presented as RSNA Paper 2001

5-36
Getting Started
Advanced Artifact Reduction (AAR)
A low-signal magnification tool that allows low-dose protocols to be used in highly
attenuating regions. AAR is automatically enabled as needed.
Advanced Noise Reduction (ANR)
A low-signal correction algorithm that allows low-dose protocols to be used in highly
attenuating regions. ANR is automatically enabled as needed.
HiLight Matrix Detector
The HiLight Matrix Detector material was developed by GE specifically for CT scanning,
offering a 99% absorption efficiency. It also offers the capability of more slices without
increasing dose.
No Post-Patient Collimation
GE uses only pre-patient collimation, providing 44-52% better detector efficiency in
sub-millimeter mode than our competitors.
Tracking Collimator
Developed originally for the LightSpeed systems, the tracking collimator keeps the beam
focused only on the active detector cells, and makes sub-millimeter scanning possible with
high dose efficiency.
Protocol Wizard
Automatically adjusts affected parameters to keep image noise constant, dose optimized
and within specifications of the scanner.
Prospective ECG Gating
Reduces dose in cardiac ECG-gated scanning for cardiac calcium scoring and contrast
enhanced cardiac angiography applications by triggering the X-Ray tube on only during a
specified cardiac phase or phase range for each cardiac cycles throughout the acquisition.
Neuro3D Filters
Noise reduction filters for thin slice acquisitions for applications where data will be
manipulated in 3D modes such as reformat or maximum intensity projections for neuro
applications.
Adaptive Statistical Iterative Recon (ASIR)
ASIR is a noise reduction reconstruction mode that can remove unwanted noise from
images allowing for reduction in dose and improvement in image quality.
NOTE: * Not all features are available on each system.

5-37
Getting Started
Dose Reports
CTDIvol, DLP (Dose Length Product), and Dose Efficiency is displayed during scan
prescription and provides patient dose information to you. The CTDIvol, DLP and Phantom
size used to calculated dose is automatically saved once you select End Exam. The Dose
Report is saved as Series 999. It can be filmed, archived, and networked after the scan is
completed.
A DICOM Structured Dose Report generates a CT Dose Report which can enable tracking of
dose for the patient by the hospital radiation tracking system/RIS/HIS. DICOM SR Dose
Report is saved as part of the patient's exam in Series 997. The DICOM SR Dose Report
cannot currently be opened on the scanner. It can be reviewed and printed using Reporting
Tool on the Advantage Windows workstation or any station that can read a DICOM
Structured Report format.
SmartStep accumulated exposure time is displayed on the Dose Text Page and the DICOM
Structured Dose Report.

5-38
Getting Started
Figure 5-19 Dose Information
Dose Information Area
Dose Text
Page
Scan Technique

5-39
Getting Started
How Do I...
This section provides the step by step instructions for shutting down and starting up the
system. Specifically, it describes how to:
Login and Logout

Add a Local User
Remove a User
Change User Roles
Configure Groups
Add a Local Group
Manage a Group
Remove a Group
Change Groups Roles

Add Memberships
Remove Memberships
Auto Configuration
Use QuickSnap
Use IQ Snap

5-40
Getting Started

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 if HIPAA is enabled.
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 software all the way down and then automatically reboots
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.

5-41
Getting Started
NOTE: The system has software and hardware installed called SmartID. This software verifies
the tube ID at startup. If the tube ID fails, the following screen appears. You may
continue scanning however, you do need to call your Field Engineer.
If Shutdown was selected, turn off the OC power, if not already off with the power
switch on the front of the console and then turn the power switch on to restart the
system.
Wait two minutes before cycling power on after a power interruption.
5. To power up the system push the power switch on the front of the operator console and
the system will automatically restart.
NOTE: The Discovery CT750 HD system has software and hardware installed called
SmartID. This software verifies the tube ID at startup. If the tube ID fails, the following
screen appears. You may continue scanning however, you do need to call your Field
Engineer.

5-42
Getting Started
Quick Steps: Shut Down and Start Up System

1.
2.
3.
4.
5.
From the desktop selection area, click [Shutdown].

From the pop-up attention box, select the option you wish to do if HIPAA is enabled.
Click [OK].
If you selected Shutdown or Restart a series of menus and messages appear.
To power up the system push the power switch on the front of the operator console
and the system will automatically restart.

5-43
Getting Started
Login and Logout

The login feature requires you to login to access the system and can be turned on or off by
your administrator or Field Engineer.
How your site uses this feature depends on if your site has a central user repository to which
the system is connected. Sites with networks are referred to as Enterprise systems, those
without are referred to as stand-alone systems. This feature can be used with either
configuration, although some features are more applicable to enterprise systems.
1. At the login screen, type your assigned login name.
This name is assigned by your system administrator.
NOTE: If you need to log in quickly for emergency purposes only, click [Emergency Login].
NOTE: Logging off does not prohibit other users from logging in. Logout is designed to
protect patient privacy, not stop approved users from logging in. When you or another
user logs back in, the system returns to its last known state.
2. Click in the Password area and type in your password.
3. Click [Login]
Figure 5-20 Login Window
4. To logout of the system, click [Shutdown].

The Shutdown window appears.

5-44
Getting Started
5. Click [Logout User].
6. Click [OK].
The system logs you out and waits for the next login.
Quick Steps: Login and Logout

1. At the login screen, type your assigned login name.
2. Logging off does not prohibit other users from logging in. Logout is designed to protect
patient privacy, not stop approved users from logging in. When you or another user
logs back in, the system returns to its last known state.
3. Click in the Password area and type in your password.
4. Click [Login]
5. To logout of the system, click [Shutdown].
6. Click [Logout User].
7. Click [OK].

5-45
Getting Started

After logging in, the component will display the Application Tab. On this tab, you will be able
to configure EA3 application properties.
1. Click the Service Desktop.
Figure 5-21
2. Click [Utilities].
Figure 5-22

5-46
Getting Started
3. Select EA3 Admin Browser.
This brings up the Administration Screen.

5-47
Getting Started
Figure 5-23 Administration Tab
4. Enter you Username and Password.

5. Click [Login].

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Getting Started
Figure 5-24 Applications Screen
6. Make your desired selections.

The following configurations can be made on this tab:
Enable Authorization - Whether or not to enable authorization. If authorization is
enabled, anyone logging in through EA3 (both local and enterprise users) must
have a role. Anyone without a role will be denied access if authorization is turned
on. Note that the role the user has doesn't matter for logging into EA3 (however,
some other EA3 client applications can decide which roles can login)
Emergency Logon Allowed - Whether or not to allow emergency access. If EA3 is
used in GUI mode, this decides whether or not to display the Emergency login
button. If this is disabled, emergency user access is prevented.
Emergency Roles - The roles assigned to the emergency user. The defaults allow
an admin to assign a Standard user role, Limited User role, or both roles.
Inactivity Timeout (minutes) - The amount of time (in minutes) that must elapse
without any mouse/keyboard, etc. activity before a timeout is generated. When a

5-49
Getting Started
timeout is generated, the EA3 logon screen is displayed. This value can be any
positive integer, or it can be 0. If the value is 0, this indicates NO inactivity timeout
(there will never be a timeout event regardless of how much time has elapsed).
Display Last Logon Name - Whether or not to display the username of the last
user that has logged in on the EA3 logon screen.
Administrator Message - Under certain circumstances / error conditions, the
user of EA3 is asked to contact an administrator. This field allows the
administrator to specify contact details for himself / herself and a custom
message.
Emergency Prompt - The text that will be displayed to any user logging in as
emergency. The user is asked to enter information (usually their actual user
name). This text is the text that will appear in that prompt for information.
7. Click [Apply Configuration].
To make a configuration change, make the necessary changes on the fields, and
click the Apply Configuration button. If there was a problem with making the
changes (such as an invalid value or a problem contacting the back-end Servlet) you
will see a message box indicating this error with a description of the error. If the
changes are successful, after the 'Apply Configuration' button is clicked, then you
will see a brief message indicating that the changes were applied in a green label. If
at any time, you want to revert your changes to what is currently saved on the
back-end, you can click the Restore Configuration button. This will undo any
changes that you have made that have not yet been saved by clicking the Apply
Configuration Button. (Once you click the 'Apply Configuration' button and get the
confirmation label, the changes have been applied).
Quick Steps: Configure HIPPA (EA3) Properties

1. Click the Service Desktop.
3. Select EA3 Admin Browser.
4. Enter you Username and Password.
5. Click [Login].
6. Make your desired selections.

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Getting Started

The second tab on the EA3 Administration Component is the Local Users tab. On this tab,
you can add users, remove users, change user group memberships, change user names,
change user passwords, lock / unlock users, force users to change their password on next
login, etc. Below is a screen-shot of the EA3 Administration Component Local Users Tab:
1. Select the Local Users tab.
Figure 5-25 Local Users Tab
2. Select the choices you wish to have selected.

Max Logon Attempts Before Lock - The number of failed login attempts a user can
make before their account is locked for a certain number of minutes. When a user
account is locked, that user will not be allowed to login, even if they provide the
correct username/password combination. Either the specified time must elapse
before the user can login again, or a user with ADMIN role must login to the EA3

5-51
Getting Started
Administration component to unlock the user. Note that locking only applies to local
users (enterprise user locking is managed by the enterprise server)
Minimum Password Length - The minimum length of a new password for a user.
Note that if a password is below the minimum password length already, setting this
value will have no effect on the password. For example if your password is 8
characters, and someone changes the minimum password length to 10 characters,
the 8 character password is still ok. However, next time the user changes their
password, they will have to choose a password that is 10 characters or greater. Note
that minimum password length only applies to local users (password length
restrictions for enterprise users are managed by the enterprise server)
Lock Duration (Minutes) - The number of minutes a user stays locked for if they
become locked because of failed login attempts.
Apply Configuration - Use the Apply Configuration button to save changes.
Restore Configuration - Use this button to undo any changes that have not been
saved yet. If there are any errors, you will get a popup box describing the error. If it is
successful, you will see a green label appear with confirmation information.
NOTE: Users can become locked in one of two ways.
The user enters too many incorrect passwords. In this case, the user will be locked
out for a certain amount of time, even with a correct password. Once the time has
elapsed, the user can attempt a login again. An administrator can unlock this user
before the lock duration time has elapsed by un checking Locked under the Local
User tab when a user is selected.
The administrator forcefully locks the user account. In this case, the lock duration
does not apply to a user who was forcefully locked by and administrator. They are
locked until the administration unlocks them.
3. Click [Apply Configurations].
Quick Steps: Configure Local Users

1. Select the Local Users tab.
2. Select the choices you wish to have selected.
3. Click [Apply Configurations].

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Getting Started
Add a Local User

Once a user is added, it is automatically highlighted in the Local Users list box on the
left-hand site, and it is 'in context'. Once a user is in context, all information and buttons in
the center panel (i.e. Username, Full Name, Roles, Change Name, Change Password, Remove
User, Groups list box, Add To Groups Button, and Remove From Groups button) refer to that
user.
1. Click [Add Local User].
When this button is clicked a popup panel is displayed.
2. Enter the new User ID (which must be unique).
3. Enter a Full Name.
4. Enter a Password.
5. Enter the Confirmed Password.
If any errors are encountered, you will receive an error messagebox. If you receive
the error messagebox, changes were not committed to the database, and you can
correct your errors and try again. Possible errors that can be encountered when
adding a user are:
User ID already exists in the local user database (Choose a different unique
username)
Password does not meet the minimum length requirements (Choose a longer
password)
Password and Confirm Password box do not match (Make sure the passwords
match)
6. Click [Add User].
Figure 5-26

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Getting Started
Quick Steps: Configure Local Users

1. Click [Add Local User].
2. Enter the new User ID (which must be unique).
3. Enter a Full Name.
4. Enter a Password.
5. Enter the Confirmed Password.
6. Click [Add User].

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Getting Started

You can select a user to be 'in context' by clicking on the user's id in the 'Local Users' list box
on the left side. Only one user can be in context at a time, and if you attempt to choose
multiple users, EA3 will select the top-most user that is selected. Once a user is 'in context',
you can make any necessary modifications to that user.
NOTE: When you first navigate to the Local Users tab, EA3 will put the first listed local user
'in context' automatically. If there are no local users then there will be no user in
context, and all of the buttons in the center panel will be disabled until a user is added.
1. Select User.
2. Click [Change Password].
This brings up a popup panel with two textboxes for the password.
3. Make changes to the password.
4. Click [Confirm Change].
If you do not want to make the change, simply click Cancel.
If the password doesn't meet the minimum length requirements, you will receive an
error messagebox. If this occurs, your changes were not saved. Simply make the
necessary corrections, and click Confirm Change again.
Figure 5-27 Change Password
Quick Steps: Change a User Password

1. Select User.
2. Click [Change Password].
3. Make changes to the password.

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Getting Started

1. Select User.
2. Click [Change Name].
3. Make changes to the name.
If you do not want to make the change, simply click the Cancel button.
Figure 5-28 Change Name
Quick Steps: Change a User Full Name

1. Select User.
2. Click [Change Name].
3. Make changes to the name.

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Getting Started
Remove a User
1. Select User.
2. Click [Remove User].
3. Click [Confirm Removal].
If you do not want to make the change, simply click the Cancel button.
Figure 5-29 Confirm Removal
Quick Steps: Remove a User

1. Select User.
2. Click [Remove User].
3. Click [Confirm Removal].

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Getting Started

All of the groups to which this user belongs are listed in the Groups list box.
1. Click [Add To Groups] or click [Remove From Groups].
This brings up a popup panel that lists all of the groups that this user is eligible to be
added to. If there are no groups that this user is eligible to be added to, you will get an
error message box instead of the popup panel. Once you get the popup panel, simply
select all of the groups to which you want to add this user (you can select as many as
you want at one time).
2. Click [Add Membership] or click [Remove Membership].
Figure 5-30 Add Groups
Figure 5-31 Remove Group
Quick Steps: Add or Remove a User from a Group

1. Click [Add To Groups] or click [Remove From Groups].
2. Click [Add Membership] or click [Remove Membership].

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Getting Started
Change User Roles

Users roles cannot be directly changed from the Local Users panel. Roles are actually
associated with groups, and users belong to groups. In order to change the roles for a user,
you must change the roles of a group to which that user belongs.

Once a user is in context, you can see if the user is locked by looking at the status of the
Locked checkbox in the bottom panel. If this is checked, then the user cannot login even with
a correct password.
1. To unlock the user, uncheck the checkbox, and click Apply Configuration button.
2. To lock a user, check the checkbox and click the Apply Configuration button.
NOTE: If Emergency User is enabled, you can still login through Emergency User while the
system is lock.

Often times if you are an administrator, you would like to force a user to change his or her
password the next time they login for security reasons. You can do this using EA3.
1. Select User
2. Check the Change Password on Next Login checkbox in the bottom panel.
If this is checked, then the user will be asked to change their password on the next
successful login.
NOTE: Once the user changes the password on the next login the check will be removed
from this user.

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Getting Started
Some fields may not be selectable if the following conditions occur.

For Users:
Permanent - If a user is permanent, they can never be removed. When a
permanent user is in context, the 'Remove User' button will be disabled.
Content Not Editable - If a user is flagged as this, then their group memberships
cannot be changed. When a 'content not editable' user is in context, the 'Add To
Groups', and Remove From Groups' buttons are disabled.
Password not changeable - If a user is flagged as this, then the password cannot
be changed, and the 'Change Password' button will be disabled.
For Groups:
Permanent - If a group is permanent, it can never be removed. When a
permanent group is in context, the 'Remove Group' button will be disabled.
Content Not Editable - If a group is flagged as this, then its group members
cannot be changed (neither added nor deleted). When a user belongs to a Content
Not Editable group, this user cannot be removed from the group (therefore, the
group name will not show up when you click 'Remove From Group'). When a user
does not belong to a Content Not Editable group, this user cannot be added to the
group (therefore, the group will not show up when you click 'Add To Group').
Role Not Editable - If a group is flagged as this, then the Roles associated with
that group cannot be changed. This property itself does not have a direct impact
on what you can do on the Local Users tab.

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Getting Started
Configure Groups
The third tab on the EA3 Administration Component is the Groups tab. On this tab, you can
add local groups, add enterprise groups, remove local groups, remove enterprise groups,
change group roles, and change group memberships.
1. Click [Groups].
Figure 5-32 Groups window
Quick Steps: Configure Groups

1. Click [Groups].

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Getting Started
Configure Groups
Add a Local Group

1. Click [Add Local Group].
2. Enter the new group's name (which must be unique).
If any errors are encountered, you will receive an error message box. If you receive
the error message box, changes were not saved to the database, and you can
adding a group are:
Group name already exists in the database
Application session timeout
Once a local group is added, it is automatically highlighted in the Local Groups list
box on the left-hand site, and it is highlighted. Once a group is highlighted, all
information and buttons in the center panel (i.e. Group Name, Remove Group Button,
Roles checkboxes, Apply Roles button, Group Members list box, Add Membership
button, and Remove Membership button) refer to that group.
Figure 5-33 Add Group
3. Click [Add Group].
Quick Steps: Add a Local Group

1. Click [Add Local Group].

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Getting Started
Configure Groups

Adding an Enterprise group is quite similar to adding a local group.
1. Click [Add Enterprise Group].
If any errors are encountered, you will receive an error message box. If you receive
the error message box, changes were not saved to the database, and you can
adding a group are:
Group name already exists in the database
Application session timeout
Adding an enterprise group doesn't actually add a group to the Enterprise directory
server. What it does is give EA3 the ability to manage roles for that group, which
should already exist on the Enterprise directory server. So, for example, if you add a
group 'All Employees' as an Enterprise group to EA3, and assign that group with the
STANDARD role, then any enterprise user that logs in through EA3 and belongs to the
'All Employees' group will have the STANDARD role.
You cannot manage the group memberships for Enterprise groups. This is managed
by the directory server, not EA3. Therefore, whenever an Enterprise group is in
context, both the 'Add Membership' and 'Remove Membership' buttons will be
blocked out. This doesn't mean that no one belongs to the Enterprise groups, just
that this is managed by the directory server and not EA3.
Once an enterprise group is added, it is automatically highlighted in the Enterprise
Groups list box on the left-hand site, and it is 'in context'. Once a group is in context,
all information and buttons in the center panel (i.e. Group Name, Remove Group
Button, Roles checkboxes, Apply Roles button, Group Members list box) refer to that
group.
Figure 5-34 Add Enterprise Group

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Getting Started
Quick Steps: Add a Enterprise Group

1. Click [Add Enterprise Group].

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Getting Started
Configure Groups
Manage a Group
You can select a group to be highlighted by clicking on the group's name in either the 'Local
Groups' or the 'Enterprise Groups' list box on the left side. Only one group can be
highlighted at a time, and if you attempt to choose multiple groups, EA3 will automatically
select the top-most group that is selected. Once a group is highlighted, you can make any
necessary modifications to that group.
NOTE: When you first navigate to the Groups tab, EA3 will put the first listed local group
highlighted automatically. If there are no local groups, then EA3 will put the first listed
enterprise group highlighted automatically. if there are no local groups or enterprise
groups, then there will be no group highlighted, and all of the buttons in the center
panel will be disabled until a group is added.
Remove a Group
1. Once a group is highlighted, click [Remove Group].
This brings up a popup panel asking you to confirm the removal of the group.
2. If you want to remove the group, click [Confirm Removal].
If you do not want to remove the group, simply click [Cancel].
Figure 5-35 Remove Group
Change Groups Roles

Once a group is highlighted, check or uncheck the checkboxes for the Roles you want to give
to this group, and click [Apply Roles]. There is a green label confirmation as usual for
successfully applied roles. If there is a failure on the back-end (i.e. a problem writing the roles
configuration changes), you will receive an error message box with information.
Add Memberships
1. Once a group is highlighted, click [Add Membership].
This brings up a popup panel that lists all of the users that are eligible to be added to
this group. If there are no users eligible to be added to this group, you will get an error
message box instead of the popup panel. Once you get the popup panel, simply

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Getting Started
select all of the users that you want to add to this group (you can select as many as
you want at one time).
2. Click [Add Membership].
Remove Memberships
1. Once a group is highlighted, click [Remove Membership].
This brings up a popup panel that lists all of the users that are eligible to be removed
from this group. If there are no users eligible to be removed from this group, you will
get an error message box instead of the popup panel. Once you get the popup panel,
simply select all of the users that you want to remove from this group (you can select
as many as you want at one time).
2. Click [Remove Membership].
Quick Steps: Add Memberships

1. Once a group is highlighted, click [Add Membership].
2. Click [Add Membership].
Quick Steps: Remove Memberships

1. Once a group is highlighted, click [Remove Membership].
2. Click [Remove Membership].

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Getting Started

The last tab on the EA3 Administration Component is the Enterprise tab. On this tab, you can
configure the properties necessary to make a connection to an Enterprise directory server
(i.e. MSAD, Novell, etc.).
The Enterprise Tab is used by the sites IT (Information Technology) or GE Service personnel.
It provides connectivity to the sites user database. If you do not have a network established
in your hospital or clinic, this tab will not be used.
Things to consider:
Utilize the enterprise capability whenever possible.
Make sure the enterprise groups are granular enough to restrict protocol edit access.
The inactivity timeout should be turned on.
1. Click Enterprise].

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Getting Started
Figure 5-36 Enterprise Tab
The following configurations can be made on the top box of this tab:
Enable Enterprise Authentication - Whether or not Enterprise users should be able
to log in. If this is unchecked, only local EA3 users will be able to log in. If this is
checked, both local users and enterprise EA3 users will be able to log in (although the
local EA3 user database will always be tried first).
Cache Enterprise Users - Whether or not Enterprise users should be cached once
they successfully login. If this is checked, then a local record of an Enterprise user is
kept. If at any time that user attempts to login again, and for some reason the
Enterprise directory server is not available (i.e. network problems), that user will be
granted access if they provide the correct password. If this is unchecked, then an
Enterprise user will be denied access in the case that the Enterprise directory server
cannot be reached. Note that hashed passwords are cached, the actual password is
not cached.
Enterprise Authentication Latency (Seconds) - The amount of time (in seconds) that
the EA3 login process should wait for a response from the Enterprise directory server.

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Getting Started
Often times, there is a network latency when connecting to servers, and it will be
different on different network configurations. If the amount of time is reached
without a response from the directory server, the EA3 login process will return a failed
login. A value of 5 seconds should be enough time to allow a properly configured
directory server to respond, without being too much of an annoyance to the user if
the directory server is down (i.e. they will only have to wait at a maximum 5 seconds
for the login attempt to return).
Applying configuration changes on the Enterprise tab top box are the same as
mentioned before for the Application tab. Use the Apply Configuration button to
commit changes, and the Restore Configuration button to undo any changes that
have not been saved yet. If there are any errors, you will get a popup box describing
the error.
Additionally, the actual connection to the Enterprise directory server can be made on
this tab. You will be modifying properties in the lower two boxes of the Enterprise tab.

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Getting Started
Auto Configuration
1. Click [Auto-detect Server Name].
This attempts to lookup the name of Server Name of the directory server.
In some environments, EA3 can try to auto-detect the Enterprise Directory Server.
This will only work in some environments (i.e. where DNS allows service lookups). This
is just a convenience feature, and will sometimes return with an alert that the
auto-detect could not find the server. It is not an error if that message is displayed,
simply continue with these steps to configure the Server.
2. Enter the Server Name or IP address of the Enterprise directory server that EA3 should
connect to, in the Server Configuration box.
NOTE: The system must be able to resolve any IP address or server name. This means the
system must either have DNS enabled or the system must have static information in
a hosts file (i.e. /etc/hosts).
3. Choose the Authentication type that the directory server supports.
If it is a Microsoft Active Directory Server, most likely you need to choose Kerberos. If it
is a Novell eDirectory Server, most likely you need to choose LDAP If you do not know,
check with the owner of the directory server for information.
If the enterprise server supports SSL connections, check the 'Use SSL' checkbox.
NOTE: If you use LDAP authentication without SSL, passwords will be sent in the clear. This
is not recommended, and the client is alerted if they attempt to configure this way.
With kerberos and non-SSL, the authentication is encrypted, but the LDAP traffic is
not.
4. Click [Test Connection].
This tests to see if the machine can connect to the directory server. If the connection
is successful, you will see a label with a 'CONNECTION OK' text next to the Test
Connection button.
If the connection is not successful, you will see a label with a 'CONNECTION BAD' text
next to the Test Connection button.
If the connection is bad, then there is a problem connecting to the directory server.
Possible problems are wrong IP/server name or the system does not have DNS
running / cannot resolve the IP address / server name.
Once the Test Connection procedure indicates that the connection is good,
5. Select the type of directory server (either Microsoft Active Directory, Novell eDirectory, or
orhter).

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Getting Started
6. Click [Generate Defaults] button.
This should populate the Realm Name, Format, DN, Login Attribute, First Name
Attribute, Last Name Attribute, and Group Attribute fields with default values for that
directory server type.
If the directory type is MSAD, both the realm name and the DN should be populated.
If the directory type is eDirectory, the realm name will be blank. If you are attempting
to configure a directory server that is not MSAD or Novell eDirectory, the
configuration will have to be done manually. You'll need to get the correct LDAP
property information from the owner of the directory server.
If this is a non-MSAD, non-eDirectory server, or is a server with a non-default
configuration, it is possible that you may need to change some properties manually.
See below for a definition of all of the properties that you can configure.
7. Enter a username and password of a user that resides on the directory server.
8. Click [Login].
You will see login result information in the Login Results section on the bottom of the
tab.
This will indicate if the login was successful or not.
Additionally, it will print out the First Name, Last Name, and any group memberships
for the user. You may get a warning if First Name, Last Name, or Group Memberships
were not found.
Getting this warning means 1 of two things:
The LDAP properties are mis-configured (i.e. First Name Attribute, Last Name
Attribute, and/or Group Attribute)
The user doesn't have a First Name, Last Name, or any Group Memberships
configured on the Enterprise directory server.
If you get these warnings, you may want to talk with the owner of the directory server
to make sure you have everything set up correctly.
If the test login succeeded and you are satisfied with the first name, last name, and
group membership information, then your Enterprise directory server is properly
configured.
This makes the configuration changes. Just like other tabs in the Administration
component, clicking Restore Configuration will undo any changed made that have
not yet been applied.

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Getting Started
Quick Steps: Auto Configuration

1. Click [Auto-detect Server Name].
2. Enter the Server Name or IP address of the Enterprise directory server that EA3
should connect to, in the Server Configuration box.
3. Choose the Authentication type that the directory server supports.
4. Click [Test Connection].
5. Select the type of directory server (either Microsoft Active Directory, Novell
eDirectory, or orhter).
6. Click [Generate Defaults] button.
7. Enter a username and password of a user that resides on the directory server.
8. Click [Login].

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Getting Started
As mentioned before, if you are connecting to a directory server that is not MSAD or Novell
eDirectory, or the directory server you are connecting to has a custom configuration, you
may need manually configure some of the properties. Here are definitions of all of the LDAP
configuration properties and what they do.
Format - This is either set to domain or dn. domain is the 'MSAD' way of doing LDAP
authentication (i.e <userId>@<realm name>). dn is the other way of doing LDAP
authentication, which eDirectory, and most other directory servers use (i.e.
loginAttribute=<userId>,<ldap base dn>). If you are connecting to a non-MSAD
directory server, it's pretty safe to say that you should use dn.
DN - This is the LDAP base DN of the LDAP server to which you are connecting.
Usually this is the fully qualified domain name separated by a bunch of 'DC='. For
example, if the fully qualified domain name of the directory server is 'example.com', it
is likely that the DN will be 'DC=example,DC=com'.
Login Attribute - This is the LDAP attribute that should be used for the unique
identifier of the user. This is what they will use as their user id to login. On MSAD this is
'sAMAccountName, and on eDirectory, it is usually 'cn'. This should be set to whatever
the directory server you are connecting to uses as a unique identifier.
First Name Attribute - This is the LDAP attribute that should be used for the first
name of the user.
Last Name Attribute - This is the LDAP attribute that should be used for the last
name of the user.
Group Attribute - This is the LDAp attribute that should be used to find group
memberships for the user. On MSAD, this is 'memberOf'.
NOTE: EA3 finds all instances of this attribute (not just the first, like it does for other
attributes). So if a user belongs to more than one group, EA3 will find all memberships.
NOTE: Regarding LDAP parameter configurations, EA3 finds the first instance of the
configured attribute for a user, except for Group Membership. So, if you configure the
First Name attribute to be an attribute that is listed multiple times, EA3 will assume
the first one found during an LDAP query is the correct First Name. For Group
Membership, EA3 will find all instances of that attribute.
Field Highlighting for changes

No changes are saved to EA3 on the Administration page unless you click an 'Apply
Configuration' button on the normal tabs or a 'Confirmation' button on a popup panel.
For the 'Apply Configuration' buttons, when they are clicked, and successfully
commit information to EA3, you will see a brief (5-second) label appear indicating
that the changes have been saved. The same things happen when you Restore

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Getting Started
Configuration (e.g. after you made some changes and want to revert back and you
haven't pressed 'Restore Configuration' yet.
NOTE: If you make changes on one tab (e.g. Application tab), and do not press Apply
Configuration, and then you navigate to another tab, your changes will be lost. The
next time you navigate to this tab, since the changes were never applied, you will see
the old configuration. So, after making changes on a tab, but before navigating to a
different tab, you must click Apply Configuration. Also, there are sometimes more
than one Apply Configuration button on a given tab, so make sure you click the one
associated with the data you changed (the buttons are grouped with the data they
manage in a bordered panel).
To help the you understand what fields you may have changed, any changed fields are
highlighted with green text / borders, and the Apply Configuration button that must be
pressed in order to commit the changes. Below in Figure 5-37 is demonstrating field
highlighting. You can see that several fields have changed, and you should click the Apply
Configuration button.
Figure 5-37 Highlighted Changes

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Getting Started
Use QuickSnap
QuickSnap provides the ability to collect data for trouble shooting system issues. QuickSnap
is found in the Tool Bar on Image Works desktop.
1. Click [QuickSnap].
This is located on the Image Works Desktop Toolbar.
Figure 5-38 Toolbar
Selecting QuickSnap displays a pop-up menu on the right monitor.

Figure 5-39

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Getting Started
2. Click [OK].
The pop-up menu goes away when the snap is complete.
3. Make note of the time and date of the QuickSnap for later use in debugging by the
service engineer.
CAUTION:
Do not initiate a QuickSnap if the system is actively collecting data with x-ray
on.
Quick Steps: Use QuickSnap

1. Click [QuickSnap].
2. Click [OK].
3. Make note of the time and date of the QuickSnap for later use in debugging by the
service engineer.

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Getting Started
Use IQ Snap
IQ Snap provides the ability to reserve the scan data files related to images with IQ issues for
further investigation.
CAUTION:
Do not initiate an IQ Snap while the system is actively scanning or

reconstructing data.
The maximum number of images that can be selected for IQ Snap is 500 images. All the
images need to be in the same series. If there are IQ issues in more than one series, each
series needs to be done separately.
The corresponding scan data files will be reserved for images in the anonymous exam. You
can verify the scan data is reserved by selecting Recon Mgnt; then selecting Release Scan
Data. For Helical, the scan data reserved is for the group or scan the group the images are
related to. For Axial mode, the scan data reserved will be the axial rotation the images are
related to. For Axial mode, you may want to select a group of images on either side of the
image where an IQ issue is seen to make sure enough scan data will be available later.
1. Select the images that you want to reserve the scan data files in the Browser on Image
Works desktop.
2. Make an anonymous series or a set of anonymous images for the series with IQ issues.
If the images selected are not anonymous, a pop-up will appear instructing you to
make the data anonymous.
Figure 5-40
3. Select the anonymous Exam in the Browser.

Selecting by exam or series will only save the first image in the list. In the Anonymous
Exam highlight all the images so they will be available for investigation of the issue.
4. Click [IQ Snap] on the Tool Bar in Image Works.

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Getting Started
Figure 5-41 Toolbar
The IQ Snap pop-up is displayed on left monitor.

Figure 5-42 IQ Snap Pop-Up Window
5. Click [OK].

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Getting Started
Quick Steps: Use IQ Snap

1. Select the images that you want to reserve the scan data files in the Browser on
Image Works desktop.
2. Make an anonymous series or a set of anonymous images for the series with IQ
issues.
3. Select the anonymous Exam in the Browser.
4. Click [IQ Snap] on the Tool Bar in Image Works.
5. Click [OK].

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Getting Started

Selecting Anon Pat. Level provides the ability to change the annotation level to Full or
Partial modes for Anonymous Patient by Exam, Series, or Image in Utilities on the Browser in
the Image Works desktop.
Table 5-12 Full or Partial Modes
Field
Full Mode
Partial Mode
Exam Number
ANON or ANONYMIZED
ANON or ANONYMIZED
Patient ID
ANON or ANONYMIZED
ANON or ANONYMIZED
Patient Name,
ANON or ANONYMIZED
ANON or ANONYMIZED
Exam Description
ANON or ANONYMIZED
Shown
Series Description
ANON or ANONYMIZED
Shown
Birthdate
Removed
Removed
Age
Removed
Removed
Weight
Removed
Removed
Operator Name
Removed
Removed
Site Name
Removed
Shown
Sex
Blank
Blank
Referring Physician
Blank
Blank
Accession Number
Blank
Blank
Full mode is the most HIPAA compliant mode.

Screen Save images such as Exam or Series Text pages or Dose Report text page are not
anonymized.
1. Click [Anon. Pat. Level].
Selecting Anon Pat. Level in the Tool Bar on Image Works will display one of two
messages depending on the current mode the software is set to.

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Getting Started
Figure 5-43 Full mode
2. Click [OK] to change from Full Level to Partial Level.

Click [Cancel] to remain at Full Anonymous Level.
3. Click [OK] to change from Partial Level to Full Level.
Click [Cancel] to remain at Partial Anonymous Level.
Figure 5-44 Partial mode

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Getting Started
Figure 5-45 Image examples
Quick Steps: Use Anonymous Patient (Anon Pat. Level)

1. Click [Anon. Pat. Level].
2. Click [OK] to change from Full Level to Partial Level.
3. Click [OK] to change from Partial Level to Full Level.

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Daily Maintenance
Chapter 6
Daily Maintenance
Introduction
This chapter explains preparing the system for daily use and calibrations. It contains the
step-by-step instructions to help you learn how to:
Perform Tube Warm-Up
Perform Air Calibrations (FastCals)
NOTE: When performing the tube warm-up or calibrations, it is essential that the gantry area
be clear of any objects. Any obstruction in the gantry most likely lead to artifacts in
scanned images.
CAUTION:
No personnel or patients should be in the area of the gantry during warm-up

or calibrations without adequate radiation safety precautions being utilized.
For important information regarding safety, please refer to the Safety chapter.

6-1
Daily Maintenance

This section presents the concepts necessary to successfully prepare the scanner for daily
use. Some of the concepts you need to understand are:
Performing Tube Warm-Up
Performing Daily Calibrations
Performing Full System Calibrations
Performing Tube Warm-Up

The system operates most efficiently within certain parameters. These parameters are
established by warming up the tube using a preset group of exposures. When the operator
performs a tube warm up at least once per 24 hour period and at any system prompt, the
tube warm-up reduces the possibility of artifacts and may aid in prolonging the life of the
tube.
NOTE: GE recommends that you warm up the tube after two hours of non-use. Only the tube
warm-up scans need to be done at this time. Tube warm-up scans are completed in
72 seconds.
Figure 6-1 Attention Message
NOTE: If the detectors are cold due to the A1 Power Panel (Breaker) being off, turn the system
on and wait two hours before performing a tube warm up. This allows the detectors
to return to their operating temperature.
NOTE: Failure to perform tube warm-ups when requested by the system may result in
serious damage to the tube and system.
NOTE: Failure to perform requested tube warm-up will result in reduction of the maximum
mA possible for the exam after a tube warm-up has been cancelled or skipped.

6-2
Daily Maintenance
Figure 6-2
Desired mAs can be achieved by changing rotation time (mAs = mA x rotation time).
Performing Daily Calibrations

The system requires that all kV and mA settings be within specific ranges. These ranges are
established and maintained by performing air calibrations. There are two types of
calibrations within the system. Air calibrations and generator calibrations. The air
calibrations and generator calibrations are done by you as part of the daily system
preparation following a tube warm-up procedure.
NOTE: If the detectors are not at operating temperature, a message will post indicating a
time when the detectors will be at operating temperature.
NOTE: If you experience a large shift in room temperature (+/-10 degrees), it is advised that
a FastCal be done to maintain optimum IQ and once the room temperature has
stabilized another FastCal should be run.
Performing Full System Calibrations

Full system calibrations are normally performed by a qualified engineer following a tube
change or as part of preventative maintenance. Generator calibrations are a detailed and
precise tool using phantoms, detectors, and exposure factors that affects image quality and
radiation dose.

6-3
Daily Maintenance
How Do I...
This section provides the step-by-step instructions for warming-up the tube and performing
air calibrations. Specifically, it describes how to:

6-4
Daily Maintenance

For optimum performance and consistent image quality, perform a tube warm up if your
system has been inactive for two or more hours. The system notifies you at the two hour
time limit with a warning dialog box. It is desirable to perform a tube warm-up procedure
along with fast calibrations once per 24 hours.
1. From the scan monitor, click [Daily Prep].
The screen changes and the system displays blue colored button features for Tube
Warm-Up and FastCals (air calibrations) in the upper left corner of the screen.
There is also a message area in the upper right corner of the screen.
2. Click [Tube Warm-Up].
The system displays a warning dialog box. This is because the tube cooling
algorithms are established for GE specific tubes. If any other tube is installed, you are
responsible.
NOTE: Refer to the Safety chapter regarding using non-GE-specific tubes.
3. Click [Accept & Run Tube Warm-up] to proceed.
The system displays a message area detailing each slice concerning kV, mA, slice
thickness and exposure duration.
NOTE: Make sure gantry area is clear of all objects and personnel.
4. Press Start Scan on the top of the keyboard.
The system automatically performs all tube warm-up scans.
The system returns to the Daily Prep menu when scans are completed.
5. Click [Quit] or proceed to Fast Calibrations.
Choosing quit ends the Daily Prep screen.

6-5
Daily Maintenance
Quick Steps: Perform Tube Warm-Up

1.
2.
3.
4.
5.
From the scan monitor, click [Daily Prep].

Click [Tube Warm-Up].
Click [Accept & Run Tube Warm-up] to proceed.
Press Start Scan on the top of the keyboard.
Click [Quit] or proceed to Fast Calibrations.

6-6
Daily Maintenance

Air calibrations, also called FastCals, must be performed following a tube warm-up
procedure. These calibrations ensure consistent image quality and radiation exposure.
1. After completing the tube warm-up, click [Fast Calibration].
Once Fast calibration is selected, the system performs a Check DAS converter
board/Check collimator cal. This assures that the correct DAS converter board is
installed.
For Discovery CT750 HD, a gantry balance check is automatically run upon
selecting FastCal. The balance check takes about 2 minutes. A pink pop-up is
displayed indicating the balance check is in-progress.
Once Fast Calibration is selected, the system performs a Check DAS converter
board/Check collimator cal. This assures that the correct DAS converter board is
installed and that collimator is calibrated.
NOTE: No objects can be allowed in gantry during FastCals. No phantoms are used during
this procedure.
2. Next the Mylar Window Check pop-up appears. Click [Confirm] and press Start Scan.
This procedure can take up to 10 minutes to complete.
The Mylar Window Check is run to make sure the window is clean. The Mylar Window
must be kept clean. Dirt, contrast material, and other matter could corrupt the
calibration files.
If a dirty Mylar Window is detected, a warning message appears (Figure 6-3) and you
must clean the window and click [Retry].
Click [Continue] if Mylar Window is clean and does not need attention.
The Warm-up 1 Scan List appears if the tube temperature is less than 200 degrees
Celsius.
The Warm-up 2 Scan List appears and the system does another set of warm-up scan
if the tube temperature is between 590 and 777 degree Celsius.
Next the Interconnectivity Map Scan List appears. This set of scans checks for
connectivity between DAS and Detector.
The system finishes the FastCal procedure by performing the actual FastCal air scans
from the Fast Calibration Scan List. The default is to perform the FastCal scans for 80,
100, 120 and 140 kVp for large and small focal spot.
3. Click on Quit to return to the Daily Prep Screen. Click Quit again to exit Daily Prep.

6-7
Daily Maintenance
Figure 6-3 Dirty Mylar Attention
Quick Steps: Perform Air Calibrations (FastCals)

1. After completing the tube warm-up, click [Fast Calibration].
2. Press Start Scan.
3. Next, the dirty Mylar Window check is done.
NOTE: If you experience any scan aborts with resumes during FastCal, be sure to notify your
Field Engineer.

6-8
Multi-Detector Information
Chapter 7
Introduction
This section explains the multiple detector hardware and detector configurations. The
step-by-step instructions to help you learn how to set these factors is located in Building
Protocols. It is important to understand how the detectors work in order to choose the
correct technical factors for the exam.What Do I Need to Know About...section presents the
concepts necessary to understand multi-detector utilization. The concepts you need to
understand are:
Scintillator Material
Performix HD Tube and Hi-Definition Generator
Hardware Components
Axial Detector Coverage/Beam Collimation
Axial Acquisition Modes
Axial User Interface
Axial Signal Collection
Axial Interval
Helical Pitch and Scan Mode Definitions
Helical Beam Collimation for Discovery CT750 HD
Helical User Interface for Discovery CT750 HD Systems
Guidelines For Building Protocols
Slice Profiles

7-1
Scintillator Material
The Gemstone scintillator material is created from garnet gemstones infused with a rare
earth phosphor composition. This new technology creates a material that has reduced after
glow, improved primary speed, high light out put and fast response to enable high resolution
scanning, sub second imaging and fast switching of energies during imaging.
Performix HD Tube and Hi-Definition Generator

The new tube and generator have been redesigned to allow dynamic in-plane (x-axis) focal
spot deflection and independent focal spot size control in both the X and Z Axis. Also, the
new tube and generator provide the capability to rapidly switch the energy from high to low
to enable the Gemstone Spectral Imaging capability.
Hardware Components
Changes have been made to several pieces of hardware that make this scanner different
from other scanners you may have used in the past. These changes are:
Collimator
The collimator contains two independently controlled tungsten cams. The rotation of
the cams provides continuously variable beam thickness and Z-axis position. The
collimator, also, contains three bowtie beam filters that filter and shape the beam to
optimize dose and image quality.
Scan Geometry
A shorter scan geometry allows for a 20% mAs reduction from HSA CT/i single slice
axial scan techniques. The gantry aperture is 70 cm. The Focal Spot to Isocenter
distance is 54 cm. The Focal Spot to Detector distance is 95 cm.
Matrix Detector
There are 64 detector cells in the Z direction. The 64 rows are 0.625 mm in the Z
direction. Each signal can be collected from an individual detector row or a
combination of detectors. Up to 64 signals can be taken from 64 detector cells (or
64 slices per rotation of the gantry).
Other Changes
Changes in the DAS, Slip Ring and Scan/Recon Unit have been made. There are also
new reconstruction algorithms for the multi-slice data.
Axial Detector Coverage/Beam Collimation

The Axial Detector Coverage/Beam Collimation for 64 slice system are:
1.25 mm, 2.5 mm, 5 mm, 10 mm, 20 mm, 40 mm beam collimation/detector
coverage (0.625 mm)

7-2
Axial Acquisition Modes

Table 7-1 Axial Acquisition Modes
Scan Mode
1i
2i
4i
8i
16i
32i
64i
2 X 0.625
1.25
N/A
N/A
N/A
N/A
N/A
N/A
4 X 0.625
2.5
1.25
N/A
N/A
N/A
N/A
N/A
8 X 0.625
5.0
2.5
1.25
N/A
N/A
N/A
N/A
16 X 0.625
N/A
5.0
2.5
1.25
0.625
N/A
N/A
32 X 0.625
N/A
N/A
5.0
2.5
1.25
0.625
N/A
64 X 0.625
N/A
N/A
N/A
5.0
2.5
1.25*
0.625*
NOTE: *only avaible in Retro Recon
Axial User Interface

The User Interface demonstrates slice thickness choices, number of images per rotation,
and retrospective options. The parameters selected to set the detector configuration
determine the slice thickness and speed determine the detector configuration.
Beam Collimation or detector coverage allows selection of 1.25 mm, 2.5 mm, 5.0 mm,
10 mm, 20 mm, or 40 mm.
Axial slice thickness choices range from 0.625 mm thick to 5 mm thick.
Number of images per rotation are 1i, 2i, 4i,8i, 16i, 32i, or 64iRetro recon choices are the
result of the slice thickness and number of images, i.e. selecting 32 images at 1.25 mm
slice thickness allows retro choices of 0.625 mm, 1.25 mm, 2.5 mm, and 5 mm.
Rotation Speed can be adjusted to optimize acquisition time. Rotation Speeds are 0.4.
0.5, 0.6, 0.7, 0.8, 0.9, 1.0, and 2.0 seconds.
For VolumeShuttle (axial), the number of passes and Coverage Time need to be
completed.
Button colors change to indicate options.

Light yellow color indicates current selections.
Dark blue with black text indicate available parameters.
Light gray with black text indicates available parameters choosing changes other
than displayed parameters.
Light gray with gray text indicate parameters not available.

7-3
Axial Signal Collection

Two, four, eight, sixteen, thirty-two, or sixty-four signals/channels are collected per gantry
rotation. Each of 2 to 64 signals are collected from an individual detector or combination of
detectors.
The number of detectors combined per signal/channel affects the maximum slice
thickness.
One, two, four, eight, sixteen, thirty-two, or sixty-four slices can be generated per
rotation.
The slice thickness can be changed retrospectively.
The beam collimation/detector configuration at the time of acquisition affects the

retrospective choices.
Multi-slice axial imaging is faster than single slice helical scanner using a 1:1 pitch.
Axial Interval
The interval is equal to the number of images per rotation times the detector thickness, i.e.,
in the 32 x 0.625 mode sixty-four images are generated, each 0.625 mm thick for a total
of20 mm of coverage per rotation. The interval per rotation would be 20 mm.
Helical Pitch and Scan Mode Definitions

Scan modes for helical are expressed in terms of pitch. Helical pitch is defined as the ratio of
table travel per rotation in millimeters divided by the beam collimation. Previous systems
expressed scan modes with names and defined pitch as table travel per rotation in
millimeters divided by the detector row width.
For example: 55/40mm = 1.375: 1
Table Speed (55) divided by the Beam Collimation (40 mm) equals a Pitch of 1.375
Table 7-2 Beam Collimations
Detector
configuration
Beam
collimation
System
32 X 0.625
20.0 mm
64
64 X 0.625
40.0 mm
64
Helical Beam Collimation for Discovery CT750 HD

The helical beam collimation for Discovery CT750 HD system are:
20 mm beam collimation x 0.625
40 mm beam collimation x 0.625

7-4
The following pitches are available for either system:
0.5:1 interleaved helices
0.9:1 interleaved helices
1.375:1 interspaced helices
Interleaved helices minimizes helical artifact, and gives the best detail. Interspaced helices
has more interpolated of data and increased helical artifact when compared to interleaved
mode.

7-5
These pitches are based on beam collimation with table speed in mm
32 x 0.625 (20mm beam collimation)

0.531:1 mode - 10.0 mm per rotation
64 x 0.625 (40mm beam collimation) (64 slice system only)

Helical User Interface for Discovery CT750 HD Systems

Parameter selections within the thickness/speed areas on the view edit screen determine
the detector configuration. There arefive main parameter selections for helical.
Detector Coverage determines the beam collimation in mm in Z direction.
Helical Thickness determines the prospective and retrospective image slice thickness.
Slice thickness choices range from 0.625mm to 5 mm.
Pitch / Speed determines the speed of the table per gantry rotation. There are four pitch
selections with associated table speed.
Rotation Time determines the rotation of the gantry.
For Volume Helical Shuttle, the number of passes and Coverage Time need to be
completed.
Button colors change to indicate options.

Light yellow color indicates current selection.
Dark blue with black text indicate available parameters.
Light gray with black text- Available parameters (choosing changes other
parameters)
Light gray with gray text- Not available
Guidelines For Building Protocols

Refer to known techniques or technique charts for proper techniques, as adequate
technical factors must be used to ensure image quality. The system is delivered containing
protocols that helps users learn adequate technical factors. The system automatically

7-6
updates mA based on changes made to rotation time, scan type, helical pitch, and slice
thickness to maintain equal image noise. There are many considerations for the anatomy
you are scanning. Timing is very important when administering contrast or for long breath
holds. Considerations are the slice thickness, coverage time, how you wish to view the data,
and what artifact can be tolerated. Trade-offs should be made to fit these considerations.
The basic rules are: Interleaved pitches will have less helical artifact especially when slice
thickness is equal to the detector. Interleaved pitches will have better slice profile when
thickness is equal to the detector.
Interspaced to Interleaved = 30% decrease in mAs.
Changing from Full to Plus recon allows a 15-20% decrease in mA.
Slice Profiles
Because the data for a helical image is weighted over more than one rotation, to provide the
best possible image quality the nominal image slice may differ slightly from your selection
dependent on table speed, pitch, and slice selection. The nominal FWHM slice widths are
given in the following table.
Table 7-3 Nominal Slice Thickness - Axial Scan Modes (FWHM in mm)
Aperture
(mm)
Selected Slice Thickness

64 Slice System
0.625
1.25
2.50
5.00
40.00
0.77
0.95
2.27
5.22
20.00
0.69
0.98
2.20
5.02
10.00
0.52
1.12
2.35
4.75
5.00
N/A
1.12
2.33
4.79
2.50
N/A
1.07
2.25
N/A
1.25
N/A
1.00
N/A
N/A
Table 7-4 Nominal Slice Thickness - Helical Scan Modes (FWHM in mm)
Aperture
(MM)
40
20
Aperture
(MM)
40
20
Pitch 0.5:1 "Full Mode"

0.625 1.25 2.5 3.75
5
0.68 1.09 2.25 3.59 5.01
0.66 1.08 2.22 3.52 5.01
Pitch 0.5:1 "Plus Mode"
0.625 1.25 2.5 3.75
5
0.99 1.40 2.78 4.20 5.90
0.98 1.40 2.72 4.11 6.01


0.625 1.25 2.5 3.75
5
1.12 2.33 3.87 5.07
1.10 2.39 3.84 5.13
0.625 1.25 2.5 3.75
5
0.98 1.39 3.00 4.53 5.86
0.98 1.38 2.88 4.64 6.00

0.625 1.25 2.5 3.75
5
1.14 2.34 3.87 5.01
1.12 2.33 3.97 5.13
0.625 1.25 2.5 3.75
5
0.98 1.39 2.77 4.71 5.98
0.98 1.38 2.75 4.68 6.07
7-7
Cardiac Helical Slice Profiles

Slice profile measurements for Cardiac helical scans are complicated by the fact that a
variable helical pitch is chosen based on the patients heart rate. For helical pitches greater
than 0.125, the full width half max of a slice collimated at 1.25 is approximately 1.6 mm. The
full width half max of a slice collimated at 2.5 mm is approximately 3.2 mm
Table 7-5 Nominal Slice-Thickness - Cardiac Scan Modes (FWHM in mm)
Selected Slice Thickness: Heart Rate 60 BPM
Aperture
(mm)
0.625
1.25
2.5
40
0.88
1.10
2.38

7-8
Building Protocols
Chapter 8
Building Protocols
Introduction
This chapter explains the process of building, viewing, and editing protocols. It contains the
Build or Edit a Protocol
Record a Personalized AutoVoice
Select Default Language for AutoVoice 1, 2, and 3.
Change Preset Delay for AutoVoice
Delete an AutoVoice
Copy and Paste Protocols
Delete a Protocol
Use ECG Trace
NOTE: A protocol must be selected in order to initiate the scanning sequence. Protocols are
used as a basis for routine or established procedures. Once chosen for use, any
protocol may have any factor modified as needed for individual case purposes. While
the individual case is being set up in the New Patient Area, any changes needed may
be made. This changes the protocol for that particular patient only, it does not change
the established protocol. The system comes with several common protocols ready
for you to use. If you wish to change the established protocols, you must follow the
directions outlined in this chapter for editing a protocol.

8-1
Building Protocols

This section presents the concepts necessary to successfully build and use protocols for
scanning. Some of the concepts you need to understand are:
Helical/Axial/Cine
Volume Shuttle (Axial) Mode (Option)
Volume Helical Shuttle Mode (Option)
Prospective Multiple Reconstructions (PMR)
Full and Plus Recon Modes
Building Protocols
Using Protocols
Editing Protocols
Viewing Protocols
System Options
Noise Index Values
AutomA
SmartmA
Pediatric Protocols
Protocol Numbers
Anatomical Selector
ECG Trace (Option)
IQ Enhance
Adaptive Statistical Iterative Reconstruction (ASIR) (Option)
Copy Forward
Flip/Rotate in Recon
Helical/Axial/Cine
Helical or spiral scanning is a method of acquiring images in a continuous data set. The
x-ray tube and Digital Acquisition System (DAS) expose and rotate continuously through 360
degrees while the patient is passed through the area of exposure at a set rate of movement
(pitch). The information gathered is then reconstructed into images of the prescribed slice
thickness and interval.
Axial scanning is the traditional step and shoot method of acquiring data. The x-ray tube
and DAS expose and rotate one 360 degree loop. The table and patient move a preset
distance (interval) and the process is repeated.

8-2
Building Protocols
Cine is a method of scanning that uses full or partial rotations of the gantry while gathering
input from one location over time. You may set the acquisition in groups expanding the time
to be scanned. This is especially beneficial when determining the function of anatomy and
physiology (i.e., hemangioma).
High Resolution Mode (Hi Res)

The high resolution mode (Hi Res) can be used to increase resolution in the x and y direction
for the entire field of view. When Hi Res is selected, the system enables focal spot deflection
for the x-ray beam in the x/y direction which will double the number of samples acquired.
This increased resolution can improve the resolution for smaller DFOV and for centered and
off-center field of view image. If large DFOVs are used, the increased resolution will not be
visualized as well compared to smaller pixel in a smaller DFOV.
The HD Standard, HD Detail, HD Bone, HD Edge, HD Bone Plus reconstruction algorithms for
non cardiac imaging and HD Standard, HD Standard Plus, HD Detail, HD Detail Plus and HD
Edge for cardiac imaging should be used to reconstruct data acquired in Hi Res mode to
visualize the improved resolution. The standard set of reconstruction algorithms are
compatible with Hi Res acquisitions, however, the inherent resolution will be reduced to
match non Hi Res acquisitions. The Hi Res modes supported are axial with 20mm detector
coverage, helical 0.531:1 pitch with 20mm detector coverage and 0.984:1 pitch with 40mm
detector coverage, Cardiac Snapshot Segment, Burst, Burst Plus and SnapShot Pulse
modes. Hi Res mode is not compatible with SmartPrep.
Figure 8-1 Hi Res Mode Selected

8-3
Building Protocols
Volume Shuttle (Axial) Mode (Option)

VolumeShuttle (Axial) Mode is a repetitive axial or helical scan mode where the table shuttles
back and forth between two adjacent locations with 40 mm detector coverage.
VolumeShuttle uses a special mode to achieve the minimum interscan delay possible for the
prescription. VolumeShuttle mode is used for perfusion studies of the brain.
Tilt is not allowed as it increases the ISD between the groups beyond the 3.2 second
recommended temporal sampling perfusion imaging. If the temporal sampling exceeds 3.2
seconds between data points for the prescription, a pop-up message is displayed indicating
that there may be errors present in the data when processed for CT Perfusion. Check the
rotation time and make sure it is set 0.4 seconds and the appropriate mAs is being
prescribed.
Prospectively only 2.5 mm and 5 mm slice thickness are supported for 40 mm detector
coverage. Thinner slices can be prescribed in Retro recon. For 64 slice systems, 0.625 and
1.25 mm slices can be prescribed in Retro Recon.
On the Thickness/Speed pop-up, prescribe the number of passes or the coverage time
needed to meet the injection protocol requirements used for CT Perfusion. If coverage time
is entered, the system will update the number of passes to meet the coverage time
specified.
The scan type is indicated as Axial-S when Axial Shuttle is selected on the View/Edit screen.
Figure 8-2 Axial Shuttle Mode Scan Type Window
NOTE: Only 40 mm detector coverage is allowed. If an incorrect detector coverage is

selection is identified when you confirm, Confirm is not allowed until the detector
coverage is set to 40 mm.

8-4
Building Protocols
Figure 8-3 Axial Shuttle View Edit Screen
Volume Helical Shuttle Mode (Option)

Volume Helical Shuttle is a repetitive helical scan mode where the table continuously moves
back and forth across a prescribed area where each pass of acquired data has temporal
time sampling information.
Volume Helical Shuttle uses a special acquisition mode that optimizes the table movement
for consistent performance across the requested number of passes.
Volume Helical Shuttle can be used to create time resolved CTA of the head, neck, body, and
Perfusion studies of the body.
The temporal sampling for a Volume Helical Shuttle series depends on the area covered,
rotation speed and pitch selected. A pop-up message will be given if the temporal sampling
exceeds 3.2 seconds. If the temporal sampling period extends beyond 3.2 seconds, there
may be errors present in the data when processed by CT Perfusion.
Volume Helical Shuttle is different from normal helical imaging in that data is collected
during deceleration and acceleration of the table as it traverses the prescribed area.
On the Thickness/Speed pop-up, prescribe the number of passes or the coverage time as
needed. The system will calculate the Time per Pass and Coverage Speed based on the pitch
and rotation time selected for the acquisition. Only 40mm detector coverage and 0.984:1
and 1.375:1 pitches are available with Volume Helical Shuttle. AutomA is compatible with
this mode.
The scan type is indicated as Helical-S when Helical Shuttle is selected on the View/Edit
screen.
Each pass of data is saved in the series with a unique identifier and description. There is the
potential to create large numbers of images with this acquisition mode, thus the first
reconstruction of Volume Helical Shuttle data is fixed at 5 mm with 10 mm interval.

8-5
Building Protocols
Prospective multiple reconstructions are not compatible with Volume Helical Shuttle. Retro
Recon is used to reconstruct the desired slices and spacing. A message is displayed at End
Exam if a Volume Helical Shuttle series was included in the exam instructing you to go to
Retro Recon and create any additional reconstructs that might be needed or to reserve the
scan data so it will not be overwritten before reconstructions can be done.
Images for Volume Helical Shuttle are assigned series number of 700 plus the original series
number.

8-6
Building Protocols
Figure 8-4 Volume Helical Shuttle Scan Type Window

8-7
Building Protocols
Figure 8-5 Image Thickness Window
Figure 8-6 Volume Helical Shuttle View Edit Screen

8-8
Building Protocols
Figure 8-7 Volume Helical Shuttle Warning Message at Confirm
Figure 8-8 Volume Helical Shuttle End of Scan Warning Message

8-9
Building Protocols
Prospective Multiple Reconstructions (PMR)

The system allows you to have additional reconstructions of your scan groups that uses all
or any portion of a group to change several of the scan parameters. These parameters
include Display Field of View (DFOV), Algorithms, Recon Modes, Window Width/ Window
Level, Image Center, Start and End Locations for each group, image interval, Slice Thickness,
and Series Description. Rather than relying on retrospective reconstruction for additional
data sets, you are able to create these sets prospectively
For Cardiac Helical acquisitions, PMR parameters include phase % and recon types of
SnapShot Segment, SnapShot Segment Plus, SnapShot Burst, SnapShot Burst Plus and
cardiac noise reduction filters - C1, C2, C3.
NOTE: PMR is not compatible with SnapShot Pulse or Volume Helical acquisitions.
Full and Plus Recon Modes

The system provides the ability to manage dose, slice profile, and helical artifact through the
Full and Plus recon modes. Full mode provides a thinner slice profile but requires 10-15%
more milliampere (mA) than Plus mode with equal image noise. Plus mode has up to a 20%
wider slice profile than Full, but requires 15-20% less mA with equal noise. At the same mA,
Plus mode provides reduced image noise. Reduction of helical artifacts can be seen with
Plus mode. Plus mode uses additional views of data to reconstruct an image. When
acquiring images in Plus mode, exposure time increases slightly to assure that enough
views are collected to reconstruct all image locations prescribed. Both modes can be used
prospectively and retrospectively including Prospective Multiple Reconstructions (PMR). Data
acquired in Plus mode can be retrospectively reconstructed in full mode or data acquired in
Full mode can be reconstructed in Plus mode.
In general, every data channel will contribute to at least one image during helical image
reconstruction. Some data channels are not used at the beginning and end of helical scan
due to the physics of multi-slice scanning and helical view weighting algorithms.
NOTE: Plus recon is only available for16 slice, 32 slice, 64slice helical scan types.
Table 8-1 Nominal Slice Thickness - Axial Scan Modes (FWHM in mm)
Aperture
(mm)

64 Slice System
0.625
1.25
2.50
5.00
40.00
0.77
0.95
2.27
5.22
20.00
0.69
0.98
2.20
5.02
10.00
0.52
1.12
2.35
4.75
5.00
N/A
1.12
2.33
4.79
2.50
N/A
1.07
2.25
N/A

8-10
Building Protocols
Aperture
(mm)
1.25

64 Slice System
0.625
1.25
2.50
5.00
N/A
1.00
N/A
N/A
Table 8-2 Nominal Slice Thickness - Helical Scan Modes (FWHM in mm)
Aperture
(MM)
40
20
Aperture
(MM)
40
20

0.625 1.25 2.5 3.75
5
0.68 1.09 2.25 3.59 5.01
0.66 1.08 2.22 3.52 5.01
0.625 1.25 2.5 3.75
5
0.99 1.40 2.78 4.20 5.90
0.98 1.40 2.72 4.11 6.01

0.625 1.25 2.5 3.75
5
1.12 2.33 3.87 5.07
1.10 2.39 3.84 5.13
0.625 1.25 2.5 3.75
5
0.98 1.39 3.00 4.53 5.86
0.98 1.38 2.88 4.64 6.00

0.625 1.25 2.5 3.75
5
1.14 2.34 3.87 5.01
1.12 2.33 3.97 5.13
0.625 1.25 2.5 3.75
5
0.98 1.39 2.77 4.71 5.98
0.98 1.38 2.75 4.68 6.07
Table 8-3 Nominal Slice-Thickness - Cardiac Scan Modes (FWHM in mm)

Selected Slice Thickness: Heart Rate 60 BPM
Aperture
(mm)
0.625
1.25
2.5
40
0.88
1.10
2.38
Building Protocols
The protocols are built using the Protocol Management feature. There are four protocol
selections to choose from: User, GE, Service, and Most Recent. The protocols contain all of
the scan parameters. User protocols can be built in either adult or pediatric models. There is
space for 90 protocols in each of the ten anatomical regions for adult protocols and 90
protocols for each color area of the pediatric protocols. There are nine different weight
classifications in each of the seven color areas plus three additional areas for you to build
pediatric protocols in. You have a total of 6,840 available user selected protocols to build.
Using Protocols
After entering the patient information in New Patient, you have several options for choosing
a protocol. There are four protocol selections to choose from: User, GE, Service, and Most
Recent. Once you choose the area you wish to get the protocol from, then you select an
anatomical area and the protocol you wish to use. Once the protocol is chosen, the
scanning sequence is activated. All parameters for scanning a patient can be set up in a
protocol. This saves you time when prescribing scan parameters for each patient.

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Editing Protocols
Once a protocol is chosen, any factor in the individual exam may be adjusted without
affecting the established protocol. If an established protocol has a factor or factors you wish
to permanently change, this can be done by clicking the [Protocol Management] button,
selecting the user tab and going to the appropriate area, entering or choosing the desired
value changes, and clicking on the [Accept] button. If your system has been configured for
HIPAA Login, you must have permission to accept any changes in Protocol Management.
Viewing Protocols
To view a protocol click the [Protocol Management] button, User or GE, then select the
appropriate area or protocol. Every series can then be viewed by using the [Next Series]
button. Values may be changed to see effects on other values or other available options.
When finished, the [Cancel] button cancels any possible changes made and closes the
window. It does not cancel the established protocol. The established protocol remains as it
was built.
System Options
There are several option packages that may be purchased and installed on your system
which include setting up various protocols. You need to have some understanding of their
functions if you are to use them in your protocols. These options include: , Prospective
Gating,Cardiac, and Auto Applications. For details on these options refer to the specific
chapters, SmartPrep VariSpeed, Prospective Gating (SmartScore) (Option), SmartStep
(Option),and Auto Applications (Option).
Noise Index Values

The system has three different tables of Noise Index values. Table 1 is configured to deliver
lower noise in the images at a higher mA value. Table 2 is configured to deliver average
noise in the images at a average mA value. Table 3 is configured to deliver higher noise in
the images at a lower mA value. The system defaults to Table 2 but can be modified by your
GE Service Engineer. The default Noise Index values for each table are optimized for the
anatomical area and slice thickness you choose to scan. The higher the Noise Index value,
the lower overall mA is required. These images are noisier with lower mA values. The lower
the Noise Index value, the higher the overall mA is required. These images have less noise.
The Noise Index value table is only used when building a protocol from Create New Series or
when Reset is selected in the Auto mA pop up.

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AutomA
Background
A significant factor in the quality of a CT image is the amount of x-ray quantum noise
contained in the scan data used to reconstruct the image. Most technologists know how the
choices of x-ray scan technique factors affect image noise. That is, noise decreases with the
inverse square root of the mAs and slice thickness. Noise also decreases approximately
inversely with kVp. For example, increasing the mA from 50 to 400 (a factor of 4) will
decrease quantum noise by a factor of the square root of 8. Quantum noise also increases
with increasing helical pitch; however, the exact relationship is dependent on the details of
the helical reconstruction process.
The most significant factor that influences the quantum noise in the scan data is the x-ray
attenuation of the patient section being scanned. The x-ray attenuation is related to the size
and tissue composition of the patient section. Figure 8-9 shows a distribution of patient
attenuation area values (PAA) for adult abdominal images that ranges from 19 to about 41
with a mean of 27.6 (for this patient sample set). The patient attenuation area (also called
the Patient Attenuation Indicator, PAI)1 is computed for the patient section as the square
root of the product of the sum of raw pixel attenuation values times the pixel area.
Figure 8-9 Adult abdominal patient distribution in terms of average patient attenuation
1.T Toth, Z.Ge, and M. Daley, "The influence of bowtie filter selection, patient size and patient centering on CT
dose and image quality", Poster SU-FF-I42, 2006 AAPM Conference (MedPhy, Vol 33, No.6, June 2006)

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Figure 8-10 Example small patient (PAI = 20) with factor of 5 noise increase (simulated)
For a given fixed scan technique, the quantum noise varies by about a factor of 5 from the
smallest to the largest patients attenuation (PAI range of 17 to 41). Figure 8-10 shows an
example of a five times noise increase simulated for a small patient (20 PAI). With a fixed mA
scan protocol, the technologist must select the mA using a qualitative estimate of the
patient attenuation. This may be accomplished using patients weight, diameter
measurements, body mass index, or just as a qualitative visual classification. Because these
methods provide very rough x-ray attenuation estimates and do not account for
attenuation changes within the patient region being scanned, the technologist must use a
high enough technique margin to avoid the possibility of compromising the diagnostic
quality of the images with too much noise. Since dose is inversely related to the square of
the noise, many patients are likely to be receiving more dose than necessary for the required
diagnostic quality using such manual methods.
Automatic tube current modulation: AutomA is an automatic tube current modulation
feature that can make necessary mA adjustments much more accurately than those
estimated for the patient by you and thereby can obtain a more consistent desired image
noise in spite of the wide range of patients. Since image noise variability is substantially
reduced, a significant overall patient dose reduction is possible with proper scan parameter
selection.
AutomA (Z-axis modulation) adjusts the tube current to maintain a user selected quantum
noise level in the image data. It regulates the noise in the final image to a level desired by
you. AutomA is the CT equivalent of the auto exposure control systems employed for many
years in conventional X-ray systems. The goal of AutomA is to make all images contain
similar x-ray quantum noise independent of patient size and anatomy.
The AutomA tube current modulation is determined from the attenuation and shape of
scout scan projections of the patient just prior to CT exam sequence.

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SmartmA (angular or xy modulation) has a different objective than Z-modulation. It adjusts
the tube current to minimize X-rays over angles that have less importance in reducing the
overall image noise content. In anatomy that is highly asymmetric, such as the shoulders,
x-rays are significantly less attenuated in antero-posterior (AP) direction than in the lateral
direction. Thus, the overwhelming abundance of AP x-rays can be substantially reduced
without a significant effect on overall image noise.
Angular modulation was first introduced on GE single slice scanners in 1994. 1, 2
AutomA Theory
AutomA is an automatic exposure control system that employs Z axis tube current
modulation and is available on all GE Multislice CT scanners. A noise index parameter allows
you to select the amount of X-ray noise that will be present in the reconstructed images.
Using a single patient scout exposure, the CT system computes the required mA to be used
based on the selected noise index setting. The noise index value will approximately equal
the standard deviation in the central region of the image when a uniform phantom (with the
patient's attenuation characteristics) is scanned and reconstructed using the standard
reconstruction algorithm.
Figure 8-11 Example noise variation with fixed mA and mA variation with AutomA with a
Noise Index setting
1. L. Kopka and M. Funke, "Automatically adapted CT tube current: Dose reduction and image quality in phantom
and patient studies," Radiology 197 (P), 292 (1995).
2. D. R. Jacobson, W. D. Foley, S. Metz, and A. L. Peterswen, "Variable milliampere CT: Effect on noise and low contrast detectability," Radiology 210(P), 326 (1996)

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The system determines the tube current using the patient's scout projection data and a set
of empirically determined noise prediction coefficients for a reference technique. The
reference technique is the selected kVp, and an arbitrary a 2.5 mm slice at 100 mAs for an
axial reconstruction using the standard reconstruction algorithm. The scout projections
contain density, size and shape information about the patient. The total projection
attenuation (projection area) contains the patient density and size information and the
amplitude and width of the projection contains the patient shape information. These patient
characteristics determine how much x-ray will reach the detector for a specified technique
and hence predict the image standard deviation due to x-ray noise for the standard
reconstruction algorithm.
To predict the image noise at a given z position for the reference technique, the projection
area and oval ratio are obtained from the patient's scout. The oval ratio is an estimate of the
patient asymmetry that is determined from the amplitude and width of the projection data.
The expected x-ray noise for the reference technique (reference noise) is then calculated as
a function of the projection area and oval ratio from the scout using polynomial coefficients
that were determined by a least squares fit of the noise measurements from a set of
phantoms representing a clinical range of patient sizes and shapes.
Knowing the reference noise and the difference between the reference technique and the
selected prescribed technique, the mA required to obtain the prescribed noise index is
calculated using well know x-ray physics equations. That is, the noise is inversely related to
the square root of the number of photons and the number of photons is proportional to the
slice thickness, slice acquisition time, and mA. In the GE AutomA design, an adjustment
factor for helical pitches is also incorporated in the calculation to account for noise
differences that scale between helical selections and the axial reference technique.
AutomA FAQs
1. What suggestions do you have for a new AutomA user?
If you are not familiar with the concept of noise index (image noise) you can use the
GE default protocols as a starting point or consult the literature until you find the
highest noise index value that provides acceptable diagnostic quality. Experiment by
scanning some phantoms with different noise index values to gain some confidence.
A 30 cm diameter water phantom or a 35 cm diameter low density polyethylene
phantom have an attenuation similar to the average adult abdominal patient (27.6
PA).
Check the mA table on the scan Rx menu to see what mA is actually being used. If
you see that it is frequently at the max mA range, consider increasing the noise index
or increase the max mA limit if it is not at the maximum limit of the x-ray generator.
Each dose step decrease will increases the Noise Index by 5% and reduces the mA in
the mA table about 10%.
If you normally reconstruct images with thin sections for 3D reformatting and thicker
slices for axial viewing it is important to understand that the first prospective
reconstructed slice thickness is used for calculating AutomA. Generally you would
want to set the noise index for the thicker slice images. For example, you might want

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a noise index of 10.0 for 5 mm thick images for viewing but you may also want 0.625
mm slices for 3D reformatting. If you prescribe the 0.625 mm slice recon first
followed by the 5 mm recon, AutomA will calculate the mA needed to obtain an
image noise of 10 for the 0.625 mm slices since it is prescribed first. In this case, to
avoid excessively high mA and high dose, you need to readjust the noise index using
the following approximation;
RxNoiseIndexthin = RxNoiseIndexthick
ViewingSliceThickness
FirstRxSliceThickness
Example:
28.3 = 10
5mm
0.625
2. Why is the standard deviation I measure in the image some times different than the
noise index I selected for the scan?
There are many factors that can account for this. But, first consider that the noise
index setting you make only causes the tube current to be adjusted so that the
system projects a similar X-ray intensity through the patient to the detector. Hence it
regulates the X-ray noise or quantum noise in the scan data. The noise in the image
depends on other factors as well. The selection of reconstruction algorithms,
reconstructed slice thickness selection (if different than your prospective selection),
and the use of image space filters will also change the noise in the image. In addition,
it is very difficult to make standard deviation measurements on patient data since
the standard deviation is affected by small CT number variations of the anatomy and
by patient motion or beam hardening artifacts. Even with uniform phantoms,
standard deviation measurements will produce some variability in measured results
because of the inherent nature of quantum statistics.
Another situation that can cause significant differences between the selected noise
index and the image standard deviation is when very large patients provide
insufficient detector signal. In these cases, electronic noise sources can become the
dominant image noise source instead of X-ray noise. In these cases at various
threshold levels, special projection data dependent filters begin to be applied to help
preserve image quality. The highest kVp is recommended when excessively large
patients are to be scanned.
Another factor is how well the patient is centered in the SFOV. Image noise can
increase significantly if the patient is mis-centered. This occurs because the bow ti
filter projects maximum x-rays intensity at isocenter since this is the region of
maximum attenuation if the patient is centered. If the patient is mis-centered, there
are fewer x-rays projected to the thickest part of the patient, and hence image noise
will increase. The optimum strategy is to find the highest noise index sufficient for the
clinical task and let AutomA select the mA without using significant constraints.

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3. Will I get a dose reduction when I use AutomA?
AutomA will use a dose that depends on the noise index you select and the size of the
patient you are scanning. If, you do not obtain a dose reduction over a population of
patients, you may have selected a lower noise index than you really need and this
results in higher mA values on average than your fixed mA protocols. One strategy to
avoid using more dose is to set the max mA parameter to the same level as your
fixed mA protocols. This will cap the maximum dose to the same level as your fixed
mA protocol. Hence, AutomA will never be allowed to use more dose then you
previously used. However, image noise will increase in regions where the mA is
limited by the max mA selection and the IQ will degrade with increasing patient size.
The optimum strategy is to find the highest noise index sufficient for the clinical task
and let AutomA select the mA without using significant mA limits
4. Why do my images seem noisier when I use AutomA?
AutomA will produce an x-ray intensity to maintain the noise index you select. Thus,
you may need to use a lower noise index. This may be the case if you find that the
average mA for your population of patients is generally lower than your previous
fixed mA protocols. This situation indicates you are using lower dose and hence
higher noise levels would be expected.
Certain patient images may also be noisier than your experience suggests. For
example, your experience tells you to expect significantly lower noise in thin patients
than obese patients. Since AutomA makes the image noise approximately the same
for all patients, you may have to re-learn what to expect. What is most important, is
to find the highest noise index that allows you to make a confident diagnosis for the
clinical problem since this results in the lowest patient dose.
If you desire somewhat lower noise in small patients, you may want to create Small,
Nominal, and Large patient protocols. You can use a slightly lower noise index for the
small patients and a slightly higher noise index for large patients.
A conditional noise limiting strategy you can employ, is to increase the low mA range
parameter. If you find that images are generally not acceptable to you below some
minimum mA value, then you may set this value as the low mA range limit. This will
prevent AutomA from using lower mA values than you desire. Note, however, that this
defeats the purpose of AutomA and causes the image noise to decrease below the
selected noise index and thereby increases the dose.
Yet another possibility for higher noise than you might expect is if you are looking at
multiple reconstructed images that have thinner slices than the prospective scan Rx
slice thickness. AutomA uses prospective slice thickness as a factor when the mA
table is generated. You need to be sure the noise index is set for the first prospective
image based on image thickness you will use for axial image viewing (see FAQ 1). This
caveat applies equally for fixed mA as well as AutomA scanning.
Higher noise images can also occur when patients are not well centered in the scan
field of view. The bowtie filter attenuation increases with distance away from
isocenter. Hence the thickest part of the patient should be approximately centered in
the scan field of view. Otherwise image noise will increase since the patient thickness

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adds to the bowtie filter thickness. This is especially important for highly asymmetric
anatomy such as through the shoulders. Again, this effect is no different with AutomA
than with fixed mA.
Recognize also that there are some obese patients that exceed the capabilities of the
tube and generator to satisfy the selected noise index. This is also no different than
fixed mA scanning. For such obese patients, one strategy is to select a higher kVp
setting when possible.
5. Why is the mA that is annotated on the image sometimes slightly different than the mA I
see in the mA table?
The mA displayed on the image is determined by measuring the generator mA during
the scan and averaging the measured result over the total number of views used to
reconstruct the image. The number of views used to produce the image may be more
than one gantry rotation for a helical scan. Hence the annotated value is a
combination of the mA table values that depends on how many views from each
rotation were used for the image. In addition, the generator is automatically
adjusting the filament current to account for changing conditions during the scan to
keep the mA within the desired tolerance of the commanded mA table. For example,
this is why you may see an mA value of 41 in the image where the mA table indicated
40.
6. I understand that noise in the image changes with reconstruction parameter selections,
but why is the noise sometimes different when I retro reconstruct the same scan data at
a different display field of view?
When you select a reconstruction algorithm, the system may sometimes re-adjust
the actual filter kernel. This readjustment will change the image standard deviation.
This will happen if the display field of view selection exceeds a certain size and is
especially apparent with higher resolution algorithms such as bone and edge. The
change in kernel is required when the DFOV selection makes the pixel size too large
to support the intended spatial resolution. This characteristic is independent of
AutomA.
AutomA Interface
AutomA is selected for a group of scans. When you select AutomA (Figure 8-14), this
enables the feature. The system uses the data collected from the most recent Scout
scanned for the exam.

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When possible, the kVp setting for the scout should be taken using the same kVp that the
axial or helical scan is taken.
Function
Description
Reference Noise Index
Default or baseline Noise Index for the given protocol. This

value can only be prescribed while in protocol
management.
Noise Index
Default or baseline Noise Index for the given protocol. Any

changes to Dose Steps, Slice Thickness or Noise index are
referenced to this value
Dose Steps
Adjusts Noise Index by steps of 5%. Dose steps can be

increased or decreased + values decrease image noise
thus increasing required mA. Minus values increase image
Noise index, thus decreasing required mA. A Dose step
value of 0 indicates that the prescribed Noise index is
equal to the Reference Noise index for the protocol.
Reset
Resets the Reference Noise Index to the GE Target Noise

Index Default for the anatomical area and slice thickness
chosen in the protocol.
The Noise Index value displayed is updated automatically as you change the Relative Dose.
The Noise Index change is relative to the Default Noise Index. You can prescribe your own
Noise Index value. The mA range area is used for entering a Min and Max mA value. The Max
mA value sets the clipping mA value. This mA value can also determine the focal spot size.
You need to enter the proper mA value for the focal spot size you wish to use.
Table 8-4
Table 8-5 Table of mA ranges by kV, Focal Spot Size and Scan Mode Type
Scan Mode
Normal
Hi-Res
kV
Small Focal Spot
Large Focal Spot
80
10-620
625-700
100
10-680
685-800
120
10-570
575-835
140
10-490
495-715
80
10-620
625-700
100
10-500
505-750
120
10-420
425-625
140
10-360
365-540
When AutomA is selected, the mA annotation on the view/edit screen is annotated with the
maximum mA in the mA range prescribed for the scan group. See Figure 8-12. You can view
the list of mA values that will be used for each rotation for the acquisition if you select [mA

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Table]. This is a read-only table showing the mA for each rotation or scan separated by
groups. Refer to Figure 8-13. AutomA is automatically turned off and can not be enabled if
the orientation for the series does not match the orientation for the scouts. The calculation
of the mA table is based on the last scout so the series much match the scout. If there is no
scout, AutomA will also be unavailable.
Manual mA
The Manual mA mode allows you to scan without enabling the AutomA mode. You can enter
a mA value for each group prescribed. When building protocols, make sure the Manual mA
value field has a reasonable mA entered in it even if the protocol will use AutomA in case
AutomA is turned off.
The Manual mA mode allows you to scan without enabling the AutomA mode. You can enter
a mA value for each group prescribed.
Figure 8-12 mA Annotation
Max mA Selected
Noise Index
Figure 8-13 mA Table

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Figure 8-14 mA Control Window

Default or baseline Noise Index for the given protocol. Any changes to Dose Steps, Slice
Thickness or Noise index are referenced to this value. This value can only be prescribed or
changed while in protocol management.
Noise Index
The noise level required for the study. As the Noise Index increases the required mA
decreases and image noise increases.
Dose Steps
Adjusts Noise Index by steps of 5%. Dose steps can be increased or decreased. Plus values
decrease image noise thus increasing required mA. Minus values increase Noise index, thus
decreasing required mA. A Dose step value of 0 indicates that the prescribed Noise index is
Reset
Reset returns the Reference Noise Index to the GE Target Noise Index default values for the
anatomical area and slice thickness chosen in the protocol. Reset is available while in
Protocol Management.

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SmartmA
SmartmA is variable mA in the X-Y direction. For each rotation along Z, the system calculates
each X and Y mA value from the ratio of the long and short axis of the patient and is shown
in the SmartmA head and body examples (Figure 8-15).
Figure 8-15 SmartmA Tables
Head Table
Body Table
The low and high mA are calculated from the long and short axis ratio. The SmartmA tables
(Figure 8-15) show examples of low and high mA values per scan.
The noise increase from using SmartmA compared to AutomA is no more than 7 %. The dose
reduction from using SmartmA is approximately 15 %.
Figure 8-16 Dose Tables
AutomA Dose Information

SmartmA Dose Information
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SmartmA modulates four times during a rotation. Because of this the mA varies four times
during each exposure. The mA ramp up time is about 100 milli-seconds.
Figure 8-17 Modulation Example
Quadrant 1
Quadrant 2
Quadrant 4
Quadrant 3
The images are annotated with a tilde sign (~) marking next to the noise index number
indicating SmartmA was used (Figure 8-18).
Figure 8-18 SmartmA Annotation
AutomA Annotation
SmartmA Annotation
NOTE: Make sure the Manual mA value in a protocol is a reasonable value even if the protocol
will use AutomA or SmartmA in case AutomA is turned off.
You can select SmartmA by clicking on the mA value on the view/edit screen.
NOTE: AutomA must be selected first, then SmartmA is available.
NOTE: AutomA and SmartmA will be disabled if patient orientation does not match the
orientation of the scout. Once the orientation for the series matches the scout,
AutomA and SmartmA can be selected.

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Figure 8-19 AutomA disabled message
Figure 8-20 View/Edit Screen
The mA control window opens and you can click on [SmartmA].

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Figure 8-21 SmartmA Control Window
Manual mA
The Manual mA mode allows you to scan without enabling the SmartmA mode. You can
enter a mA value for each group prescribed.
Default or baseline Noise Index for the given protocol. Any changes to Dose Steps, Slice
Thickness or Noise index are referenced to this value. The Reference Noise Index value can
only be prescribed while in protocol management.
Noise Index
The noise level required for the study. As the Noise index increases the required mA
decreases and image noise increases.
Dose Steps
Adjusts Noise Index by steps of 5%. Dose steps can be increased or decreased. Plus values
decrease image noise thus increasing required mA. Minus values increase Noise index, thus
decreasing required mA. A Dose step value of 0 indicates that the prescribed Noise index is
Reset
Reset returns the Reference Noise Index to the GE Target Noise Index default values for the
anatomical area and slice thickness chosen in the protocol. Reset is available while in
Protocol Management.

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Pediatric Protocols
The [Pediatric] button brings up a screen that allows you to select an anatomical area. The
anatomical areas are indicated by text.
Figure 8-22 Pediatric Selector
Once the anatomic area is selected, a window containing rainbow bars appears. This
indicates you are using weight based protocols designed for pediatrics. Choose the color
category for your patient and the protocol list is displayed accordingly. If there is no
weight-specific protocol associated with the selected anatomical area, the Protocol
Category window appears (Figure 8-25). The default weight/color selector will show the
patient weight entered in the patient information screen, or the last weight/color selection (if
no patient information was entered). If you enter a patient weight on the patient information
screen and select a color/weight selector that is not consistent with the entered information,
an error message appears (Figure 8-24) and you must acknowledge that you have chosen a
protocol that does not match the patient size. Selectors on the color/weight bar are labeled
with the zone ranges for weight and length, with the word of the selected color and with the
weight/color zone number as indicated in Table 8-6. Weight-specific protocols are enforced

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for all anatomical areas except head, orbit and miscellaneous. Protocols in the head and
orbit categories are usually defined based on patient age as opposed to patient
weight/height.
Table 8-6 Color Code Table
Zone
Number
Zone
Color
Pink
6 - 7.5
13.2 - 16.5
59.5 - 66.5
Red
7.5 - 9.5
16.5 - 20.9
66.5 - 74
Purple
9.5 -11.5
20.9 - 25.4
74 - 84.5
Yellow
11.5 - 14.5
25.4 - 32.0
84.5 - 97.5
White
14.5 - 18.5
32.0 - 40.8
97.5 - 110
Blue
18.5 - 22.5
40.8 - 49.6
110 - 122
Orange
22.5 - 31.5
49.6 - 69.5
122 - 137
Green
31.5 - 40.5
69.5 - 89.3
137 - 150
Black
40.5 - 55
89.3 - 121.3
--
Zone Weight (kg) Zone Weight (lb)

Zone Length (cm)
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Figure 8-23 Color Selector
Figure 8-24 Protocol Category Warning

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Figure 8-25 Protocol Category Window
Protocol Numbers
The protocol numbering systems enable you to easily enter a protocol number in the patient
information screen when you are setting up a scan. The first number indicates the protocol
area you are using. The second number indicates what weight zone you are using. This
shows up on pediatric protocols. The third number indicates which protocol you selected
out of that area. If only two numbers are displayed, this means you are using an adult
protocol and the second number indicates which protocol you selected from that area
(Figure 8-26).

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Figure 8-26 Protocol Numbers
Area Number
Color Weight Zone Number

For pediatric scans only
Protocol Number
GE Area Numbers
Adults
Peds
21-30
31-40
User Area Numbers
Adults
Peds
1-10
11-20
Anatomical Selector
The Anatomical Selector area lets you decide if you want to
use a GE defined, User defined, Service defined, or a Most
Recent protocol. GE defined protocols are a list of protocols
the factory installs on your system. These protocols have been
used by physicians and radiologists on this type of system and
have worked well. User protocols are a list of protocols that you and your radiologist or
physician have built into your system. These protocols are custom protocols that your
radiologist or physician likes to use. Service protocols are used when your GE Service
Engineer needs to perform routine maintenance on your system. The Most Recent protocol
tab is an area where the parameters from the last 90 exams scanned are stored. Protocols
under GE and Most Recent tabs cannot be modified or deleted, but they can be copied into
the user selector in any of the adult or pediatric anatomical areas.
ECG Trace (Option)

ECG Trace provides the capability to display and view the ECG waveform on the operator
console. The ECG waveform is sent to the operator console, when the IVY monitor is set in
the Ethernet mode, (not floppy mode) and an Ethernet cable connection exists between the
Ivy Monitor, gantry and Operator console. To check the mode of the IVY monitor, check the
switch on the back of the monitor and ensure it is in "Ethernet mode". IVY monitors that have
Ethernet capabilities include the: 3100, 3100-A, 3100-B, 3150, 3150-A, and 3150-B. The ECG
Trace display is defaulted to off for Scout Scans series unless enabled on in a custom
protocol. To turn on the ECG Trace display, select the ECG Trace button below the Gating
button on the operator console. The ECG Trace display can be minimized or expanded
(maximized) by clicking the size bar on the left side of the ECG Trace display.
The trigger point on the ECG Trace for each R-R interval will be displayed in red, the point or
percent in the R-R interval where the images are reconstructed is displayed in white, (Figure
8-28).

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ECG Traces can be saved to a CD-Rom using the Save ECG Trace feature in the Tool Bar on
the Image Works desktop. This can be done when the IVY monitor is connected to the
gantry, is also set in Ethernet mode, and the ECG Trace/Viewer option is installed. The ECG
Traces from the last 100 cardiac gated series can be saved to a CD-Rom, and the ECG
Traces from the last 500 cardiac gated series are stored on the CT system.
The ECG traces (waveforms) can be edited using the ECG Editor in Retro Recon, which
provides the capability to remove individual recon windows from one or more heart cycles,
insert, delete or move the R-peak trigger locations, and manually move or reposition a recon
window of one or more heart cycles. This can be useful to make modifications to the ECG
waveform in the event an irregular or unexpected arrhythmia that occurs during the
acquisition.
Figure 8-27 Trace Viewer (waveform display)
IQ Enhance
IQ Enhance is a special reconstruction process which can be prescribed to minimize
artifacts commonly seen in thin slice helical acquisitions. IQ Enhance is compatible with
0.625 mm and 1.25 mm slice thicknesses. Interval for acquisitions with IQ Enhance must be
equal to the slice thickness (0.625 mm or 1.25 mm) or an overlap of 50% (0.312 mm or 0.625
mm). IQ Enhance is selected in the Recon Options pop-up window.

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Figure 8-28 Image Enhance Images
An E is displayed on the image next to annotation for recon algorithm to indicate IQ

Enhance was enabled for the acquisition.
Image Enhance is not compatible with Axial or Cine scan types or cardiac gated
acquisitions.
On View Edit screen, an E is indicated on the screen to show that Image Enhance has been
enabled (Figure 8-29).
Figure 8-29 View Edit Screen
Adaptive Statistical Iterative Reconstruction (ASIR) (Option)

Adaptive Statistical Iterative Reconstruction (ASIR) is a reconstruction technique designed to
reduce noise in diagnostic images while preserving the structure details in the image. ASIR
noise reduction technique may allow for the reduction of the x-ray dose, up to 50 % in some
studies while maintaining image noise levels or be applied to improve images with an
unacceptable level of noise.

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Reconstruction of ASIR images can be prescribed prospectively for Recon1 or as a
prospective multi-recon (PMR) for Recon 2 or 3 or retrospectively in Retro Recon. If
reconstructing data retrospectively, a New Series should be selected for each reconstruction
of the data with ASIR applied.
ASIR is located on the Recon Tab under Recon Options. ASIR modes are None, Sliceand
Volume. Slice mode can be applied to acquisitions of any slice thicknesswhile Volume mode
can only be applied to Hi-Res acquisitions with 0.626mm slice thickness. Slice mode can be
applied to a range of slices where as Volume mode must be applied to the full range of
slices acquired in the acquisition. Volume mode will have a slower reconstruction
performance but overall better noise reduction quality and some helical artifact reduction
compared to Slice mode. Slice mode will have less impact on reconstruction time but will
have a lesser degree of noise reduction capability compare to Volume mode.
There are several constraints that apply to the acquisition of data where ASIR will be applied:
ASIR is not compatible with Cardiac Noise Reduction Filters (C1, C2, C3) or Neuro 3D
Filters (N1, N2, N3).
Volume mode is not compatible with IQ Enhance.
ASIR is not compatible with the Chest Recon Type.
ASIR is not compatible with any of the real time interactive image modes such as
SmartPrep (base line and monitor images), Biopsy mode, or SmartStep.
Volume mode image interval must equal to slice thickness (0.625) or up to 50%
(0.312mm) overlap.
In Volume mode, the minimum number of slice is 28. If the number of slices is less
than 28, only slice mode will be available. If the number of slices is reduced to less
than 28, the ASIR mode will be changed to Slice.
Volume mode reconstruction is always applied to the entire scan range.
Reconstruction of ASIR images involves defining the level of noise reduction desired for the
parameters used for various applications. Image reconstruction is a blending of the original
images and a percentage of an image with 100% noise reduction. There are 10 blending
levels available which are simply the amount of noise reduction based on the maximum of
the 100% image reconstructed with the original image data. It is expected that confidently
selecting the optimal amount of noise reduction and integrating the reduction in dose
possible will require some adapting on how this reconstruction technique works.
To assist you in reviewing the entire range of noise reduction levels quickly so desired ASIR
level image sets can be created retrospectively and adjustments be made to protocols for
dose reduction, an ASIR Review application can be selected on the Image Works desktop.
The ASIR Review application can be selected on the Image Works desktop for review of the
entire range of noise reduction levels. In ASIR Review, you can quickly determine the desired
ASIR level image sets should be created at and determine modification to protocols for dose
reductions. The ASIR Review application aids in the understanding and establishing the
optimal dose and desired noise level per protocol efficiently for your facility by your
physicians.

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NOTE: Images intended for use in the ASIR Review application must have the same slice
thickness, interval DFOV, R/L centers, A/P centers, scan range and Recon type.
NOTE: The maximum number of images per series that can be loaded into ASIR review is
1500.
NOTE: ASIR Review applications needs two sets of data. One reconstruction needs to be a
non-ASIR series and a series that has 100 % ASIR applied. ASIR Review application
will not accept other ASIR levels for example 50 %.
ASIR Image Annotation

ASIR level and mode are annotated on the image using character string which define the
mode and level in the upper right corner of the image next to the Recon Type used to
reconstruct the image.
The annotation logic is as follows:
SS - Slice mode ASIR
VS - Volume mode ASIR
10 - 10% which is the percent of the 100% ASIR image that was reconstructed with
the original to reduce the noise in the ASIR images.
For example: VS60 denotes ASIR mode selected was Volume, Statistical recon mode with
60% of the 100% ASIR was reconstructed with the original image.

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Table 8-7 Example of ASIR annotation:
Iterative Recon
Modes
S=Slice
V=Volume
Types
Levels
Example Annotation
10=10 %
SS10 = Slice Mode ASIR 10 %

VS10 = Volume Mode ASIR 10 %
20=20 %

30=30 %

40=40 %

50=50 %

60=60 %

70=70 %

80=80 %

90=90 %

100=100 %

S=Statistical
Copy Forward
Copy Forward provides the capability to define a set of parameters to be copied across
series for Recon 1 and into Recon 2 or 3. The Patient Position and Patient Entry can be
copied from the previous scanned series.Copy Forward is enabled in Protocol Management.
Enter a D or d into the Start/End, DFOV, R/L or A/P Center, interval (helical only) or tilt fields.
Fields where Copy Forward has been defined are outlined with a green box. To copy the
Patient Position and Patient Orientation select the Copy Patient Position, Patient Orientation,
and Anatomical Reference button. When the protocol is used in New Patient, the fields
where Copy Forward have been defined will be outlined in green. If copy forward for Patient
Position/Patient Orientation is selected, Copy Pt. Orient. Pt. Position Anat. Ref. will be
highlighted. When Copy Forward is used in PMR 2 or 3 for Start/End location, the system
keeps the range equal to that of Recon 1.

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Figure 8-30 Copy of Orientation Area
Figure 8-31 View Edit screen with Copy Forward selected in green
Flip/Rotate in Recon
The reconstructed orientation of an image can be changed from the default mode in Recon
by selecting one of the flip/rotate options.
Figure 8-32 Recon Option with Flip/Rotate enabled
Selection for Flip/Rotate are None, FLR (Flip Right/Left), FTB ( Flip Top/Bottom) and FLR/FTB
(Flip Right/left and Top/Bottom). The flip option selected is shown on the ViewEdiit screen.

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The default GE CT orientation is based on a view from patient's feet. The reconstructed
image orientation may differ from preferred anatomical viewing presentation where the
patient's Right is on the viewers Left and the patient's Left is on the viewers Right.
Flip/Rotate options are found in Recon Options. The RAS information annotated on the
image is applied according to the Flip R/L, Flip T/B or both Flip R/L and T/B selected for
reconstruction of the image. Annotation indication that Flip/Rotate selection was applied to
the reconstruction is displayed in the upper left corner of the image.
Flip/Rotate options cannot be selected for images being acquired in the decubitus patient
positions.
Upon Confirm, a pop-up message is displayed indicating Flip/Rotate was selected for the
exam to verify that images are displayed properly if sent to remote viewing stations.
Figure 8-33 Flip Message
Gemstone Spectral Imaging (Option)

Gemstone Spectral Imaging (GSI) is an optional acquisition, and reconstruction mode that
acquires data at two different energy levels enabling processing to separate data into
different energies.
GSI images may provide additional clinical information about material composition. In
addition, images generated by processing the two sets of data using the material
decomposition algorithm can reduce beam hardening and metal induced artifacts.
Key technologies used are fast kVp switching which allows the hardware to switch between
the different energies multiple times in the same rotation, material decomposition
reconstruction algorithms for generating material density and monochromatic images, and
a Spectral Imaging viewing tool for transforming images into other material basis or
monochromatic energies.

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The two x-ray energies are acquired in an interleaved fashion by rapidly synchronous
switching of the energy levels. The GSI mode is compatible with helical, axial, or CINE scan
modes. Because the two-energy levels are acquired almost simultaneously, patient or organ
motion related registration issues are eliminated.
The interleaved high- and low- energy views are separated as part of the image
reconstruction operation. The GSI reconstruction algorithm produces two complete highand low- energy sets. The projection-based material decomposition algorithm uses both the
high- and low- energy data to create material density and/or monochromatic images. The
material density pairs consist of iodine and water, calcium and iodine.

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How Do I...
This section provides the step-by-step instructions for building, viewing, or editing protocols.
Specifically, it describes how to:
Delete an AutoVoice
Delete a Protocol
Use ECG Trace

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Every scan must start by selecting a protocol. Protocols save time by using preset
established factors, allowing you to start the scanning sequence as soon as possible. All
aspects of the exam including scanning, filming, and storing images can be established as
part of your protocols. Use the following instructions to complete new protocols or edit
existing protocols within the system.
1. From the scan monitor, click [Protocol Management].
The AutoVoice and Protocol Management window appears.

2. From the window, click [Protocol Management].
You now see the anatomical selector.

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NOTE: There is space for 90 protocols in each of the Adult anatomical areas. In the Pediatric
anatomical areas, there is space for 90 protocols each in Head, Neck and
Miscellaneous. For the seven color coded Pediatric anatomical areas, there is space
for 90 protocols in each of the nine different weight classifications. You have a total
of 6,840 available user selected protocols to build. If you wish to create, edit, or view
protocols in the pediatric selector, click [PEDIATRIC]. To return to the adult protocols,
click on the adult model.
3. Click [User].
This is used to build custom protocols for your site.
4. Select an anatomical region.
A space for up to 90 protocols opens (there may be existing protocols listed).
You can click the arrow up or down to view a list of 15 protocols at a time.
You can use the scroll bar to move quickly through all 90 protocols.
5. Click [New] or [Edit].
Select [New] if you have not built this protocol before.
Select [Edit] if you are making changes to an existing protocol.
6. Select an open area in the list and enter the name of protocol.
Any name may be used. It is helpful if you choose a name that reflects what the
protocol is meant to be used for (e.g., Routine Head, Trauma Spine, Chest/Abd/Pelvis).
If the protocol being built is to be the default (most commonly used) protocol, click
[Set As Default]. Only one protocol in each list can be set as the default.
NOTE: Default protocols can not be set in the pediatric color coded areas.
7. Select the type of series to be built from the window that appears.
In most cases, a scout series is built first because this allows for more precise
scanning. A scout must be programmed first if it is to be displayed automatically with
Show Localizer.
Auto mA and Smart mA require a scout to be acquired in order to generate a mA
table.
8. Click [OK].
9. Set the proper patient position.
Place the mouse cursor at the head or foot of the model and click once to change
orientation. Place the mouse cursor over the abdomen area or the base of the table
and click once to rotate model 90 degrees.

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Figure 8-34 Patient Position
Select Copy Patient Orientation, Patient Position, Anatomical Reference as needed.

10. Select anatomical reference point.
Click [Anatomical Reference] and a window appears from which you may choose
one of the preset center points, or designate with a two letter abbreviation your
centering or 0 point.
11. Click [AutoStore] and/or [AutoTransfer].
Selecting [Auto Store] automatically transfers the image to a local storage device
such as Magnetic Optical Disk (MOD) media or remote storage device such as PACS,
when [End Exam] is selected.
Selecting [Auto Transfer] automatically sends images to one or up to four
destinations. The transfer can occur by image, by series or by exam
When selecting By Image, the transfer occurs in groups of 10 images. Only
prospective images are transferred when using this mode.
If transfer By Series is selected, the entire series is transferred when [Next Series]
or [End Exam] is clicked.
If transfer By Exam is selected, the entire exam is transferred when [End Exam] is
clicked. The series of images that are contained in the exam are transferred. This
means any Screen Save, Reformat, 3D, Navigator, Dentascan, Retrospective,
DMPR, Direct3D, Neuro3D Filter images created before the exam is ended are
transferred. The Dose Report is automatically sent when Auto Transfer By Exam
is selected.
Selecting [Dose Report Auto Transfer] automatically transfers the dose information
for both the Dose Report and the DICOM Structured Dose Report to up to four
different locations. [Dose Report Auto Transfer] is used to transfer the dose
information when Auto Transfer By Image and By Series are being used opposed to
By Exam.
NOTE: If you do not want the Dose Report and DICOM Structured Dose Report auto
transferred, select Auto Transfer By Image or By Series. Do not select Auto Transfer
by Exam.

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12. Set Scout Parameters.
NOTE: Scout Parameters include Scout Image number, Start and End Locations to set the
length of the scout, technique factors of kVp and mA, scout plane, AutoVoice and use
of the Window Width/Level feature. Selecting an individual cell under a parameter
column allows you to adjust only the factor in that group. Selecting the parameter
column from the top row highlights all of the factors directly below the selected
column and allows you to adjust that factor in all of the images.
The number of scouts may be added to or deleted by selecting the scout number and
using the [Add Scout] or [Delete Scout] buttons.
Start Loc./ End Loc. are to set the amount of anatomical coverage needed for the
scout. The S designation stands for superior (toward the head) from the center point.
The I designation stands for inferior (toward the feet) from the center point,
regardless if the patient is oriented head first or feet first to the gantry.
Technique Factors for scout images are set low because scouts are normally used for
planning purposes only. 120kV and a low mA are common factors.
Scout Plane designates what type of scout is being acquired. Zero designates an AP
(supine) or PA (prone) scout. Ninety designates a lateral scout.
AutoVoice is used if you want the system to give the patient breathing instructions
while the scouts are acquired.
Click [AutoVoice] and a window appears.
Click the desired pre-recorded message.
Select Pre Set Delay if desired.
NOTE: The Auto Voice language displayed at the time the systems is booted up is the
defaulted language set by your Field Engineer initially.
If the Auto Voice Language is changed to use one of the preset autovoice
multi-language messages, the system will return to the default language once you
have clicked on [End Exam].
Scout WW/WL is used to set the desired window levels of the scout when it displays
in the localizer.
Auto Transfer by Series automatically transfers the series to the selected
destination.

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Figure 8-35 Scout Window
13. Click [Create New Series].

A window appears.
In most cases, you do not need another scout series, although this is an option.
14. Click [Axial] and [Create After].
This places the axial (or helical) series to follow the scout series in the protocol.

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15. Set Scan Parameters.
NOTE: The Scan Parameters include Patient Position, Anatomical Reference point,
AutoFilm Setup, AutoStore, AutoTransfer, Show Localizer, and Series Description.
The data acquired for all other series is different than data acquired for scout images.
This means that features such as Patient Position and AutoVoice must be set or
activated again for this series.
If you want to copy the scanned patient orientation and position for the Scout to the
next series in a protocol, select [Copy Orientation].
Set the proper patient position by placing the cursor at the head or feet of the model
and click to change the head first/feet first orientation. Place the cursor over the
abdominal area of the model and click to rotate the model in 90 degree increments.
Click [Anatomical Reference] and a window appears where you can choose one of
the preset center points or designate with a two letter abbreviation your center or 0
point. This should be set the same as your scout images.
Click [AutoFilm Setup] and a window appears where you may establish how the
filming is going to be set up.
NOTE: refer to the Set the Film Parameters for Automatic Filming task for more details.
Set Auto Store/AutoTransfer. If these features were set for the scout image, they are
automatically set for this series. If they were not selected for the scout series, they
may be activated in this series and the scout image(s) are included in the
storage/transfer. Click [AutoStore] and it automatically sends the image data to the
system storage device. Click [AutoTransfer] and a window appears. Click the IP
address to which the images are to be sent, click [OK].
Click [Show Localizer]. This will display a scout image on the display monitor in a 1 on
1 format with graphic representation of the start and end locations as well as
displaying a line for each image that is reconstructed. This allows for graphically
adjusting the protocol (adding or deleting slices).

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16. Set Technical parameters.
NOTE: Technical Parameters include Scan Type (axial/helical/cine-full or segment/cardiac

helical or cine - Cardiac Option Volume Axial or Helical Shuttle Option Hi Res Mode),
Start and End Location, Number of Images, Thickness Speed (collimation), Image
Interval, Gantry Tilt, Scan Field of View (SFOV), kVp, mA, Total Exposure Time, Prep
Group, interscan delay (ISD), Breath-Hold, Breathe Time, Auto Voice,
Voice/Lights/Timer. Selecting an individual cell under the parameter column allows
you to adjust only the factor for that group. Selecting the parameter column from the
top row highlights and change the parameters in all groups.
The Scan Type can be Axial, Helical, or Cine. (Optional Cardiac, Axial Shuttle or Helical
Shuttle).
NOTE: Hi Res mode is supported for Discovery CT750 HD systems to enable high resolution
imaging for the x/y direction.
NOTE: If your scanner has CardIQ SnapShot and CardIQ Snapshot Cine cardiac options
installed, the Scan Types will include SnapShot Segment, SnapShot Burst, SnapShot
Burst Plus and SnapShot Pulse.
Axial scans may be acquired at gantry rotation times of 0.8 second, 1, or 2 seconds.
NOTE: If your system has the option VariSpeed installed the rotation times will include0.4
seconds, 0.5 seconds, 0.6 seconds, 0.7 seconds, and 0.9 seconds.
NOTE: If your system has the SnapShot option installed, the rotation times will include 0.425,
0.45, and 0.475 seconds. If your system has the sub 0.4 second option (0.35 sec.)
installed, the 0.35 and 0.37 second rotation times are added to the scan times
available.
Typically, axial scans are used for routine head studies using a two second rotation
time. Axial scans may also be done as a sub-millimeter (0.625 mm) slice or with a
single 1.25 mm slice, which is useful for studies such as Hi-Res chests.
Axial Scan Type supports Volume Shuttle Mode, an axial acquisition which moves
back and forth (shuttles) between locations. Volume Shuttle Mode provides wider
coverage for perfusion imaging.

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NOTE: If your scanner has Volume (axial) Shuttle or Volume Helical Shuttle option installed,
the Scan Types will include Shuttle mode.
Helical Scan Type support Volume Helical Shuttle mode, a helical acquisition mode
which moves back and forth (shuttles) across scan range for wider coverage for 4D
CTA or body perfusion imaging.
Helical scan type is used most frequently for a wide range of exam types.
Cine mode is used when one location needs to be scanned over a period of time such
as for a hemangioma.
Start and End Locations are set in millimeters superior to, and/or inferior from, the
anatomical reference point. The locations designate the points of anatomy to be
scanned. If specific numbers are known, select the correct button (Start or End) and
enter the value. The numbers must be preceded by the correct designation of S for
superior (towards the head) from the centering point, or I for Inferior (towards the
feet). The easiest way to set Start and/or End Locations is to graphically adjust
them. The slices are represented as a group of lines on the scout image. The start
location is demonstrated with a solid square in the middle of a line. The end location
is demonstrated by an open square box in the middle of a line.
To adjust, click and drag the appropriate square to the desired location. When the
mouse is released, the system automatically updates the value to the nearest
0.25 mm in the start or end location, depending on which value was adjusted. If
the entire group of lines is to be adjusted, click and drag the X annotation in the
center of the lines to move all the lines together.
+ and - may be used as a substitute for S and I. S equals + and I equals D or d can be used in the Start/End locations to copy the locations from the
previous scan.
The Number of Images is determined by the combination of Start and End Location,
Slice Thickness, and Image Interval and set automatically by the system.
If a specific number of images are needed, select that cell and enter the desired
value. The system automatically adjusts the End Location for you and highlight
the End Location area in orange to let you know a change was made to the
parameters.
For shuttle acquisitions, the number of passed or Coverage Time needs to be
entered.
To set the slice thickness and speed, click [Thick/Speed] and a window appears.
Choose a slice thickness of 0.625 mm, 1.25 mm, 2.5 mm, 3.75 mm, or 5.0 mm. For
axial scans, you choose between 1i, 2i, 4i, 8, 16i, 32i, or 64i depending on system
configuration. For helical, you choose between 32 row (20 mm beam) 32 row
(40 mm beam)or 64 row (40 mm beam) modes depending on system
configuration.

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NOTE: For details on the different modes, refer to the Multi-Detector Information chapter for
your system.
The Image Interval is for helical scans only and is automatically set to match the
slice thickness by the system. This is known as contiguous (back to back) scans. If an
overlap or spacing (skip) is desired, click the image interval cell and enter the correct
value.
D or d can be used in the Image Interval field to copy the locations from the
previous scan.
NOTE: If any of the values in Start/End Location, Number of Images, Slice Thickness, or Image
Interval are changed from the original value, the system automatically adjusts any
necessary values to maintain the scan. For example, if the number of images is
decreased, the system automatically adjusts the end location. The system highlights
any adjusted value in orange and changes any necessary graphic representations
on the scout. Refer to the Getting Started chapter for details.
The Gantry Tilt can be set manually or graphically to a maximum of 30 degrees in
half degree increments. The most common way to set the tilt is graphically. On a
lateral scout, you see circular handles on the Start and End locations.
Click and drag the circle to adjust the lines on the scout to the desired tilt. If a
specific tilt is wanted, select the feature button and enter the desired value.
C may be used in the Tilt field. Typing C enters the current gantry tilt in degrees.
D or d may be used to copy the tilt value from the prior series.
NOTE: Maximum degree of tilt depends on the height of the table and interaction with
interference (collision) matrix. Use the Tilt/Table Travel button on the gantry keypad
to observe the min/max values for gantry tilt and table travel for the current
landmark.
The SFOV choices for Discovery CT750 HD are Ped Head, Small Head, Head, and
Ped Body, Small Body, Medium Body, Large Body, Cardiac Small, Cardiac Medium,
Cardiac Large. The Ped Head, Small Head, Head are 32 cm in diameter with special
processing to correct for beam hardening effects. Ped Body is a diameter of 32cm.
Ped Head and Ped Body have a 30 kW limit. Small Body is 32 cm in diameter, Medium
Body, Cardiac Small (32 cm), Cardiac Medium (36 cm), Cardiac Large and Large Body
are 50 cm in diameter.

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To set the kVp, select [kV] and a window appears. The kVp values of 80, 100, 120, and
140 are displayed. Select the desired factor or cancel and the window closes. The
most common kV factor used for routine scanning is 120kV.
To set the mA, click [mA]. Any mA value in increments of 5 starting at 10 and going to
800 mA for 100 kW systems may be entered in Manual mA. AutomA can be selected
to provide consistent image quality.
To use AutomA, enter the AutomA values. Refer to AutomA for more information.
As with any x-ray exposure, mA x time is the mAs value. Appropriate exposure
values must be used to maintain image quality.
Select [SmartmA] if you wish to use this. A scout must exist and the orientation for
the series must match to be able to enable AutomA or SmartmA. For more
information on SmartmA refer to: SmartmA.
The Total Exposure Time is automatically set by the system and is determined by the
number of images and type of scan. This setting can only be changed by resetting
one of the other factors. The Total Exposure Time is useful for determining
breath-hold times, and contrast injection timing. If the scan type is helical, the
displayed Total Exposure Time is exactly what is shown. The Total Exposure Time lists
the x-ray on time only and does not reflect any ISD applied. When calculating
breath-hold times for axial scans, the ISD for each scan must be added to the
Exposure Time displayed to reflect the total amount of time the patient would need
to hold his/her breath.
The Prep Group feature is used to establish how long the system waits before turning
the x-ray on for a given group of scans. This delay can be used during initial contrast
injection, timing of auto voice instructions, or a delay to wait for structures to fill with
contrast.
To set the Prep Group, click the [Prep Group] parameter column or cell and enter
the appropriate value in seconds. The system starts to acquire the images after
the [Start Scan] button is selected and the Prep Group Delay counts down. It is
important to start the injection at the same time as starting the scan to insure
accuracy of when the IV bolus arrives in the appropriate anatomy. The valid
ranges for Prep Group delays are: 1st group 0- 300 seconds, group delay for axial
is 1-600 seconds and helical is 5-600 seconds.
When the scan type selected is Axial, the feature ISD (Interscan Delay) is available.
To set the ISD, click the ISD parameter column or cell and enter the appropriate
value in seconds. This feature allows time for the table to move the correct
amount of millimeters set for the Image Interval. It can also be used to help with
tube cooling by increasing the value, extending the time between exposures
allowing the heat units to dissipate. Typically, the ISD is set at 1 second so the

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exam is done as fast as possible. The valid range for ISD is 1-300 seconds. If
Helical or Cine scan type are selected, this feature is not available.
Breath-Hold is the setting for how long the patient must hold his/her breath for each
exposure.To set the breath-hold, click the [Breath-Hold] parameter column or cell
and enter the appropriate value in seconds. Breath-Hold and Breathe Time can be
used in conjunction in order to cluster scans within a group. The valid range for
Breath-Hold is N (None) or 0-60 seconds.
The Breathe Time is the setting to allow the patient to breathe normally between
breath holds.
To set the Breathe Time, click the [Breathe Time] parameter column or cell and
enter the appropriate value in seconds. If there is IV contrast being injected, it is
important to consider the appropriate length of this delay and its effect on patient
comfort. Breath-Hold and Breathe Time can be used in conjunction in order to
cluster scans within a group. The valid range for Breathe Time is N (None) or 0-60
seconds.
The Voice/Light/Timer feature is used so that the system will automatically give the
breathing instructions to the patient according to the Breath Hold, Breathe Time, and
Total Exposure Time. If the Total Exposure Time is less than the Breath Hold time, the
system uses only the time needed for the exposure. The Light and Timer features will
be visible on the gantry if these two features are selected for use. For more
information on the Voice/Light/Timer feature, see Set Timing Parameters. If the
Voice/Light/Timer feature was selected for the scout series, it must be selected for the
axial series as well.
17. Set Recon Parameters.

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NOTE: The Recon Parameters include DFOV, Right/Left Center (R/L), Anterior/Posterior
Center (A/P), Recon Type (algorithm), Matrix Size, Recon Mode, and Auto Applications.
The DFOV allows you to target a particular piece of anatomy for display on the
screen. The smallest DFOV is 5.0 cm. The maximum DFOV is always the same as the
selected SFOV.
The DFOV choices for a Discovery CT750 HD are: Ped Head (5 cm - 32 cm), Small
Head (5 cm - 32 cm), Head (5 cm - 32 cm), Ped Body (5 cm - 32 cm), Small Body (5 cm
- 50 cm), Medium Body (5 cm - 50 cm), Large Body (5 cm - 50 cm), Cardiac Small (5 cm
- 32 cm), Cardiac Medium (5 cm - 50 cm), and Cardiac Large (5 cm - 50 cm).
To set the DFOV value, click the [DFOV] parameter column or cell and enter a
specific value. The DFOV may also be set graphically by using the diamond
handles on the Show Localizer Image. Click and drag the diamonds to expand or
contract the DFOV. The system automatically updates the value in the feature
area.
D or d may be used to copy the DFOV from the previously scanned series.
The R/L Center allows you to offset the center of the image for display. This is useful
if the patient is not positioned normally or if an offset structure such as the spine or
kidney is what you want centered. The maximum offset for R/L Center is one half the
SFOV from isocenter selected (e.g. Head SFOV is 32cm so maximum offset R/L is
16cm or 160mm).
To set the R/L Center, click the [R/L] parameter column or cell and enter a value in
millimeters starting with the correct designation of R or L. The range of values can
be from 0 to one-half the SFOV. Typically, you would not want the offset to exceed
one-half the DFOV or the resulting image does not show a right or left marker, it
does show markers as R-R or L-L. The R/L Center may also be set graphically by
using the X annotation on the AP scout image reference lines. Hold down the Shift
key first, then click and drag the X to center over the area of interest.
+ and - may be substituted for R and L. R equals + and L equals -.
D or d may be used to copy the R/L value from the prior series.
The A/P Center works the same way as the Right/Left Center using the lateral scout
image. The maximum offset for A/P Center is one half the SFOV from isocenter
selected (e.g. Head SFOV is 32cm so maximum offset A/P is 16cm or 160mm).
+ and - may be substituted for A and P. A equals + and P equals -.
D or d may be used to copy the A/P value from the previously scanned series.
The Recon Type sets the algorithm for reconstruction of the images.
To set the Recon Type, click the [Recon Type] parameter column or cell and a
window appears.
Select the appropriate algorithm. This sets the algorithm for the primary or first
reconstruction. The algorithms going from left to right increase spatial resolution
and decrease low contrast detect ability. The Bone Plus algorithm can be used for

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Building Protocols
any study that normally used bone algorithm but is very useful in cases where the
Edge algorithm was used. This is because the Bone Plus algorithm has no
reconstruction penalty and is very close in standard deviation to Edge. The Chest
algorithm provides soft tissue resolution and contrast when viewing the images in
a soft tissue/mediastinal window width and window level and high resolution of
the lung tissue when viewing the images in a lung window width and window
level.
If Hi Res mode has been enabled, additional algorithms are available. They are
HD Standard, HD Detail, HD Bone, HD Edge, and HD Bone Plus for non cardiac
imaging. For cardiac imaging, the additional algorithms are HD Standard, HD
Standard Plus, HD Detail, HD Detail Plus and HD Edge.
These algorithms provide higher resolution when matched with data acquired in
Hi Res mode compared to the basic algorithms.

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NOTE: The system allows you to program up to three reconstructions of data and Cardiac
phases from one exposure. To set up the other reconstructions and phases (if needed),
click [Show Recon 2] and enter appropriate values in the parameter columns or cells.
The [Show Recon 3] button is now available if needed.
If you want to transfer Recon 2 and Recon 3 to another workstation, you can select
[Series Auto Transfer].
All three recons can be sent to a different place than set in the exam level transfer.
A Host window will pop-up.
Up to four locations can be selected.
The Matrix Size is a 512 matrix.

The Recon Options area is where you can select Recon Mode (Full or Plus), IQ
Enhance,and Cardiac Filters for the acquisition, select IQ Enhance, and set the
window width/levelfor Cardiac acquisitions select a Cardiac Filter, select Flip and
Rotate image orientation change to be applied to the images in reconstruction and
select the ASIR level to reduce image noise. For more information, refer to Full and
Plus Recon Modes covered earlier in this chapter.
IQ Enhance is a recon mode which can minimize helical artifacts seen in helical
thin slice images. Image Enhance is compatible with 0.625 and 1.25 mm slice
thicknesses. Intervals must be set equal to the slice thickness (0.625 or 1.25) or
half the slice thickness (0.312 or 0.625). IQ Enhance annotation is added to the left
side of the image.
NOTE: IQ Enhance is only available for Discovery CT750 HD system.

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Building Protocols
Recon Options window contains Recon Mode, Window Width and Window Level
settings, Cardiac Filters for noise reduction if scan type is set for Cardiac Helical or
Cardiac Cine, Flip/Rotate selection, and ASIR mode selection.
NOTE: Window Width and Window Level values entered in the Recon Option window is also
added to film Set 1 in the Auto Film Tab Card.
Window width/Level can be defined for the different groups on the Recon Tab.
If Helical scan type is selected, IQ Enhance will be available if the slice thickness is
0.625 mm or 1.25 mm and the interval for these slice thicknesses is equal to the slice
thickness (0.625 or 1.25) or one half the slice thickness (0.312 or 0.625).
Adaptive Statistical Iterative Reconstruction (ASIR) is where you can select the
desired noise reduction in your images. Click [Slice] or [Volume] and then select the
desired blending level. For more information, refer to Adaptive Statistical Iterative
Reconstruction (ASIR) (Option) covered earlier in this chapter.
Flip/Rotate is where you specify that image presentation be flipped/rotated from
system normal default presentation in recon opposed to apply to image in display.
If Cardiac scan type is selected, cardiac noise reduction filters C1, C2, C3 can be
selected to reduce noise in the images for SnapShot Segment, SnapShot Burst,
SnapShot Burst Plus, or SnapShot Pulse acquisitions.
The Auto Apps feature allows you to build 3D models with Direct 3D or to create thick
slice axials from thin data sets without image reconstruction while the scan is in
progress. If you have Direct Multi-Planar Reconstructions (DMPR) installed, it can be
used to create axial, sagittal, and coronal slices from thin data sets.Neuro 3D Filter
allows provides noise reduction filters Low/N1, Med/N2, High/N3 to reduce noise in
images while maintaining image quality. The 3D models from Direct 3D,reformatted
images from DMPRand filtered images from Neuro 3D Filter maybe filmed and saved.
For details, refer to the Auto Applications (Option) chapter.
18. Set the filming parameters.

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NOTE: The Filming Parameters include AutoFilm (On/Off), Frame Format, Interval, Flip,
Window Width, Window Level, Mag. Factor, Rotate, User Annotation, Filter, and GSE
(Gray Scale Enhancement).
The AutoFilm feature must be turned on if the system is to display and film images in
the AutoFilm Viewport on the Display Monitor. The system defaults to off, so in
building new protocols or editing existing protocols it must be turned on.
To turn AutoFilm on, click [AutoFilm] then click the [AutoFilm] parameter column
or cell, and click [YES].
NOTE: If the selection is left in the Off position, images have to be filmed manually. Refer to
the Manually Filming Images chapter.
The Frame Format sets how many images are placed in each frame of the film
composer. You have the option of choosing 1 on 1, 2 on 1 (vertical and horizontal), or
4 on 1 formatting. Any option chosen is used for the entire film series, there is no
option to change format once the filming starts.
The Interval is used to tell the system which images is to be filmed. For every image
reconstructed to be filmed, enter 1. For every other image, enter 2. For every third
image, enter 3 and so on. The range is 1-5.
The Flip feature allows you to flip images Top/Bottom, Left/Right or both. This is
helpful when a patient is scanned in a prone or hanging head (i.e., supine coronal)
position.
To set Flip, click the [Flip] parameter column or cell and a window appears from
which you can choose the appropriate option.
The Window Width allows you to set the width level for filming. The image appears in
the AutoFilm viewport with this setting. It may be used or adjusted in the filming
viewport.
To set the Window Width, click the [Width 1] parameter column or cell and enter
the value desired. This setting is also stored in the image header for transfer to a
network receiving station. The range is 3072.
If you have the Expanded CT Number Range enabled, the range is 32767.
The Window Level allows you to set the window level for filming. The image appears
in the AutoFilm Viewport with this setting. It may be used or adjusted in the filming
viewport.
To set the Window Level, click the [Level 1] parameter column or cell and enter
the desired value. This setting is also stored in the image header for transfer to a
network receiving station. The range is 3072.
If you have the Expanded CT Number Range enabled, the range is 32767.
NOTE: The system image display supports pixels with a range of -32,767 to 32,767.

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NOTE: For information on expanded CT number range, refer to: Enable Extended CT Number
Range or Disable Extended CT Number Range.
The Magnification Factor (Mag. Factor) allows you to establish a preset
magnification for each image for filming. The range is 0.5-2 (in 0.1 increments e.g.
1.1/1.2/1.3).
To set the Mag. Factor, click the [Mag. Factor] parameter column or cell and enter
the desired value.
The Rotate feature allows you to rotate images Right/Right or Right/left. This is
helpful if the patient is scanned in a decubitus position.
To set Rotate, click the [Rotate] parameter column or cell and a window appears
where you can choose the appropriate option.
The User Annotation (User Anno) feature allows you to place annotation(s) on each
image in a film series. This annotation appears in the middle of the cell above the
image. This is helpful to denote delayed studies or other unusual film sequences. It is
commonly used on spine studies to denote vertebral levels.
To set User Annotation, click the [User Annotation] parameter column or cell and a
window appears in which you can enter appropriate text.
The Filters feature allows you to use edge enhancement filters (to sharpen images)
or smoothing filters (to soften images) on every image in a film series.
To set Filters, click the [Filters] parameters column or cell and a window appears
where you can choose the appropriate option.
NOTE: For more information on filters and their use, refer to the Image Manipulations
chapter.
The Gray Scale Enhancement [GSE] feature allows you to change the gray scale
curve to enhance areas of low contrast such as the gray/white matter interface in
brain tissue, on every image in a film series.
To set the GSE click [GSE] parameter column or cell and a window appears from
which you can choose the appropriate option.
19. Use Additional Feature Buttons.
NOTE: These features cannot be built as a portion of a protocol. They can be used when
actually scanning a patient.
The Add Group feature allows you to insert another set of images following the prior
group with all of the same factors, except for Start/End location within the same
series. The start location of the new group automatically set contiguous to the end of

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Building Protocols
the prior group. The end location is determined by the number of slices, slice
thickness, and image interval.
To add additional groups, click [Add Group] and the new group is inserted. Every
click inserts another group.
The Split Current Group feature allows you to split a selected group into separate
groups. This is helpful for tube cooling issues or breath-holds.
To split a group, you must first highlight which group you wish to split by clicking
on the first box (with image numbers) at the start of the group. It highlights in a
bright blue color.
Click [Split Current Group] and a window appears from which you may choose to
split between selected slices or by location.
The Delete Selected Group feature allows you to remove an entire group from the
series.
To delete a group, you must first highlight the group to be deleted by clicking on
the first box (with image numbers) at the start of the group. It highlights in a bright
blue color.
Then click [Delete Selected Group] and the highlighted group is deleted.
The Smart Prep feature can be built into a protocol. Smart Prep is an excellent tool
for monitoring the peak enhancement of IV contrast injections. For details on the
SmartPrep option, refer to the SmartPrep chapter.

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Quick Steps: Build or Edit a Protocol

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
From the scan monitor, click [Protocol Management].

From the window, click [Protocol Management].
Click [User].
Select an anatomical region.
Click [New] or [Edit].
Select an open area in the list and enter the name of protocol.
Select the type of series to be built from the window that appears.
Click [OK].
Set the proper patient position.
Select anatomical reference point.
Click [AutoStore] and/or [AutoTransfer].
Set Scout Parameters.
Click [Create New Series].
Click [Axial] and [Create After].
Set Scan Parameters.
Set Technical parameters.
Set Recon Parameters.
Set the filming parameters.
Use Additional Feature Buttons.

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The system has three pre-recorded voice message sets in 9 selectable languages that
cannot be deleted. You may record up to 17 additional messages on your system. This
allows for consistent breathing instructions which assists in more precise timing in the
exam. Your system also comes equipped with microphones at the console and gantry for
communication with the patient.
1. From the Scan Monitor, click [Protocol Management].
A window appears with the choices of AutoVoice and Protocol Management.

2. Click [AutoVoice].
The AutoVoice menu appears with the three pre-recorded voice messages and 17
blank areas.
3. To record a message, select a blank area, enter a name and press Enter.
Every selection must have a name. You probably want to title it so it is easily
identifiable (i.e., Mary S. Inspiration), that way you know whose voice is being used
and the content of the message, especially if the message entered is in another
language.
4. Click [Record] and begin message.
Click and hold [Record] until you are ready to begin your message. Normally, you are
recording a pre-message first, e.g., Take in a breath and hold it. When you release
the mouse button, the recording starts as indicated by the clock to the right of the
[Record] button. Begin your message right away. Speak clearly toward the
microphone located on the computer keyboard. Click [Stop] as soon as you finish
speaking. The total time of the message is displayed in the clock. If you make a
mistake, simply click [Stop] and then repeat these steps.

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Building Protocols
NOTE: It is very important to try to start and stop the recording as quickly as possible to
avoid adding time to the beginning or end of a message.
5. Click [Pre-Message].
Select the [Pre-Message] button next to the name you just entered. This highlights
the feature in blue.
6. Click [Save Message].
This enters the message to the system and enters the time in the Pre-Message Area.
7. Click [Record] and begin Post-Message.
Repeat the steps to record a message for post instructions (e.g. Breathe normally).
8. Click [Post- Message].
This highlights the area in blue.
9. Click [Save Message].
This enters the message to the system and enters the time in the Post-Message area.
NOTE: If you wish to hear any recorded message, click on the selections Pre- or Postmessage to highlight it in blue. Go to the lower right corner of the screen to the
Message Management area and click play.
Quick Steps: Record a Personalized AutoVoice

1.
2.
3.
4.
5.
6.
7.
8.
9.
From the Scan Monitor, click [Protocol Management].

Click [AutoVoice].
To record a message, select a blank area, enter a name and press Enter.
Click [Record] and begin message.
Click [Pre-Message].
Click [Save Message].
Click [Record] and begin Post-Message.
Click [Post- Message].
Click [Save Message].

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Building Protocols

The system has three pre-recorded voice message sets in 9 selectable languages that
cannot be deleted. You can select the desired language to use on your scanner.
A window appears with the choices of AutoVoice and Protocol Management.

2. Click [Auto Voice Record].
The AutoVoice menu appears with the three pre-recorded voice messages and 17
blank areas.

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Building Protocols
3. Click [English-Male] and select the desired primary language from the AutoVoice
Language Selection window.
You can choose from nine different languages.

English-Male
English-Female
Japanese
French
German
Spanish
Mexican Spanish
Italian
Korean
Chinese
NOTE: The Auto Voice language displayed at the time the system is booted up is the
If the Auto Voice language is changed for the current exam, the system will return to
the default language once you have clicked End Exam.
4. Click [OK].

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Building Protocols
Quick Steps: Select Default Language for AutoVoice 1, 2, and 3.

2. Click [Auto Voice Record].
3. Click [English-Male] and select the desired primary language from the AutoVoice
Language Selection window.
4. Click [OK].

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Building Protocols

The Preset delay adds a delay between the completion of the Auto Voice Pre-scan message
and X-ray on. This delay can be set per protocol.
1. To set the preset delay before the auto voice message is played, click the time next to
Preset Delay Time.
2. Click the desired preset delay from the popup window.

3. Click [OK].
Quick Steps: Change Preset Delay for AutoVoice

1. To set the preset delay before the auto voice message is played, click the time next to
Preset Delay Time.
2. Click the desired preset delay from the popup window.
3. Click [OK].

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Building Protocols
Delete an AutoVoice
It may be necessary to remove old or unwanted messages from the system as employees
change or as different languages are required.
A window appears with the choices of AutoVoice or Protocol Management.
2. Click [AutoVoice].
The AutoVoice menu appears with three pre-recorded voice messages and any that
have been saved to the system.
NOTE: The three pre-recorded messages cannot be deleted.
3. Select the title of the message to be deleted.
This highlights the selection in blue.
4. Click [Delete Set].
Quick Steps: Delete an AutoVoice

1.
2.
3.
4.

Click [AutoVoice].
Select the title of the message to be deleted.
Click [Delete Set].

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Building Protocols

Use this procedure to copy protocols from the GE anatomical selector or Most Recent scans
into the User anatomical selection area. You can also copy a protocol within the User
anatomical selection window. Copy protocol can be used as a template to create different
protocols with minor adjustments.

2. Click [Protocol Management].
3. Select the anatomical selector you wish to copy from.

You can choose between GE, User, or Most Recent.
4. Select the protocol you wish to copy.
5. Click [Copy].

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Building Protocols
6. Select the anatomical selector you wish to paste to.
You can only paste to User protocol selector. The [Paste] button is not available for
the GE or Most Recent selectors.
7. Select the area you wish to paste to.
8. Click [Paste].
The protocol is now copied to this area.
You can now use or edit this protocol.
NOTE: If you copy a protocol from the Most Recent area, check features like; Smart Prep,
Show Localizer, and other choices are good choices for the protocol.
9. To change the name of the protocol, click on the protocol to be renamed.
10. Enter the new name.
The protocol is renamed.
11. Click [Done] to exit.

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Building Protocols
Quick Steps: Copy and Paste Protocols

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.

Click [Protocol Management].
Select the anatomical selector you wish to copy from.
Select the protocol you wish to copy.
Click [Copy].
Select the anatomical selector you wish to paste to.
Select the area you wish to paste to.
Click [Paste].
To change the name of the protocol, click on the protocol to be renamed.
Enter the new name.
Click [Done] to exit.

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Building Protocols
Delete a Protocol
Use this procedure to delete a protocol from your user defined list. This allows you to keep
your protocol list current by deleting any unnecessary protocols.

2. Click [Protocol Management].
3. Select the anatomical selector you wish to delete from.

You can only delete from the User or Service protocol selectors.
4. Select the protocol you wish to delete.
5. Click [Delete].
The protocol is deleted.
6. Click [Done] to exit.

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Building Protocols
Quick Steps: Delete a Protocol

1.
2.
3.
4.
5.
6.

Click [Protocol Management].
Select the anatomical selector you wish to delete from.
Select the protocol you wish to delete.
Click [Delete].
Click [Done] to exit.

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Building Protocols
Use ECG Trace

ECG Trace provides the capability to display and view the ECG waveform on the operator
console. The ECG waveform is sent from the IVY 3150B/3100-B with Ethernet cardiac
monitor when the IVY monitor is set in Ethernet mode and Ethernet cable connection exists
between Ivy Monitor, gantry and Operator Console. The ECG Trace display is defaulted to off
for Scout Scans unless display is turned on in the protocol. Select the ECG Trace button
below the Gating button to enable display of the ECG Trace.
The ECG Trace display can be minimized or expanded (maximized) by clicking on the arrow
on the left side of the display.
The trigger point on the ECG Trace for each R-R interval will be displayed in red, the point or
percent in the R-R where the images are reconstructed is displayed in white.
NOTE: The BPM heart rate shown on the console is updated every 3 heart beats. The BPM
heart rate shown on the IVY 3150B/IVY 3100B with EthernetI updates every 3 heart
beats.
1. From the scout View/Edit page, click [ECG Trace].
This will enable the trace.
Figure 8-36
2. Click the Minimize/Maximize icon.

3. Make sure the IVY 3150B/3100-B with Ethernet is to is set to ethernet mode.
If not, cycle power to the monitor after changing from data mode to ethernet mode.

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Building Protocols
Figure 8-37 ECG Viewer
Quick Steps: Use ECG Trace

1. From the scout View/Edit page, click [ECG Trace].
2. Click the Minimize/Maximize icon.
3. Make sure the IVY 3150B/3100-B with Ethernet is to is set to ethernet mode.

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SmartPrep
Chapter 9
SmartPrep
Introduction
This chapter explains SmartPrep. It contains the step-by-step instructions to help you learn
how to:
Set the SmartPrep Parameters
Scan the Baseline Phase
Scan the Monitor Phase
Scan the Scan Phase

9-1
SmartPrep

This section presents the concepts necessary to successfully utilize SmartPrep. Some of the
concepts you need to understand are:
SmartPrep
Setting SmartPrep Parameters
Scanning the Baseline Phase
Scanning the Monitor Phase
Scanning the Scan Phase
SmartPrep
SmartPrep is a standard option. It is a feature that allows intermittent monitoring of IV
Contrast enhancement in one particular section of anatomy that is in the area of interest.
The contrast flow is monitored by Low-Dose scans until the contrast enhancement reaches
the preferred point and the operator initiates the scan prescription.
If SmartPrep is enabled for a series, the system cancels the AutoView display for any images
in the recon queue when the SmartPrep series is started. These images are selected from
the browser for review once they have been reconstructed. Only images from the series with
SmartPrep and those after the SmartPrep series are displayed in AutoView viewport.
Setting SmartPrep Parameters

When utilizing SmartPrep parameters controlling scan location, time between images,
enhancement values, technique factors and time to start the study must be set. The values
may be set as part of any protocol utilizing SmartPrep, or they may be set for individual
SmartPrep scans. Some parameters such as matrix, algorithm and rotation time are not
adjustable.
Scanning the Baseline Phase

The first phase is the Baseline Phase. In this phase a single unenhanced image is acquired in
the anatomy where the monitoring occurs and the Region(s) of Interest (ROI) is established.
Scanning the Monitor Phase

The second phase is the Monitor Phase. Using the same location as the Baseline Phase, up
to 40 Low-Dose scans can be taken during the injection of IV Contrast. Using the established
ROI(s), the system displays a graph and the monitoring image to allow you to determine the
peak enhancement value.

9-2
SmartPrep
Scanning the Scan Phase

The third and last phase is the Scan Phase. This is the actual study as set in the scan
prescription. The Scan Phase is initiated by the operator when the IV enhancement,
determined by visual or preset Hounsfield unit, is achieved.

9-3
SmartPrep
How Do I...
This section provides the step-by-step instructions for Utilizing SmartPrep. Specifically, it
describes how to:
Scan the Scan Phase

9-4
SmartPrep

Setting the SmartPrep Parameters does not need to be done each time SmartPrep is used.
The parameters can be included in any protocol using SmartPrep. The system holds the last
values entered if SmartPrep is activated for an individual study. SmartPrep parameters
allow for checking the IV enhancement both visually and graphically.
1. After setting the scan Rx, on the view/edit screen click [SmartPrep Rx].
A pop up window appears with several areas to input ranges.

2. From the pop up window click [Off].
The system toggles to ON and highlights the area in yellow.

3. Click [Show Localizer].
This puts the scout image for your scan in the display monitor with a single line
annotated on the image.

9-5
SmartPrep
4. Set the Monitor Location.
This may be done graphically by clicking and dragging the red X on the line in the
scout image to the desired location.
The location can also be entered in the Monitor Location area once you have
determined the specific value. The value must have an S or I designation. (refer to
Report the Cursor Location and the Pixel Value on how to get value using cursor).
+ and - may be substituted for S and I. S equals + and I equals -.
NOTE: This location is very important as this is where the monitoring images are scanned
and where the ROI(s) are placed.
5. Enter the mA.
The system defaults to a low mA value.
To change the value select the mA area and enter the desired setting. You want to
use low mA to keep heat units to a minimum. The usual range is around 40 mA for
most studies.
6. Enter the Diagnostic Delay.
This value allows time for the table to move into the Scan Phase Start Location and to
ready the system for the Scan phase. This is generally set to minimum values
possible for arterial studies and 10 or greater seconds for venous/routine studies.
The Diagnostic Delay can be entered explicitly or the system can automatically
calculate the minimum value.
The Diagnostic Delay is entered in seconds. The range is 3-60 seconds in 0.1 second
increments.
For Explicit Manual entry of the Diagnostic Delay, the delay time selected needs to
meet clinical needs and include time for the initial breathing instructions to the
patient. Or, an AutoVoice Pre-Message can be selected. Selecting an AutoVoice
Pre-Message to be played prior to scanning in some case may increase the
Diagnostic Delay value to allow the message to be played.
When Auto Minimum Delay is selected, the diagnostic delay time is set automatically
to the minimum time possible.
The minimum delay possible is updated to adjust for table movement between the
Monitor location and the Scan Phase. If Scan Location is changed after the
SmartPrep Pop-up window is closed, the Diagnostic Delay time is automatically
updated to the minimum time possible when Auto Minimum Delay is on and if the
value for the Diagnostic Delay is less than the minimum value entered.
The value for the prescribed Diagnostic Delay is displayed in the attention message
pop-up at Confirm.

9-6
SmartPrep
Figure 9-1 Auto Minimum Diagnostic delay OFF message
Figure 9-2 Auto Minimum Diagnostic delay ON message
The Diagnostic Delay time is displayed in Prep Group for Group1 in Timing Tab along
with SP indication that SmartPrep is enabled.
Figure 9-3
7. If desired, select a Pre-Auto Voice Message to be played during the transition from
Monitor to Scan Phase.
The number for the AutoVoice to be played when AutoVoice Pre-Message is enable is
displayed on the button. The AutoVoice Message is selected on Timing Tab in Voice
Lights Timer.

9-7
SmartPrep
Figure 9-4
NOTE: If an AutoVoice Pre-Message is not enabled and the patient is required to hold their
breath for the acquisition once the scan phase is initiated, the operator must give the
first breathing instruction to the patient. The system automatically gives all other
instructions if AutoVoice has been set for the study.
When an AutoVoice Pre-Message is selected, review the Diagnostic Delay value to
make sure it is acceptable, as the delay value may have been extended to support
playing of the Pre Message.
8. Click [Continue] or [Cancel].
Selecting [Accept] confirms any changes to the SmartPrep parameters and returns
you to the view/edit screen.
Selecting [Cancel] returns you to the view/edit screen and closes the pop up window.
It does not cancel SmartPrep Rx.
Quick Steps: Set the SmartPrep Parameters

1.
2.
3.
4.
5.
6.
7.
After setting the scan Rx, on the view/edit screen click [SmartPrep Rx].
From the pop up window click [Off].
Click [Show Localizer].
Set the Monitor Location.
Enter the mA.
Enter the Diagnostic Delay.
If desired, select a Pre-Auto Voice Message to be played during the transition from
Monitor to Scan Phase.
8. Click [Continue] or [Cancel].

9-8
SmartPrep

The initial phase for SmartPrep is called the Baseline Phase. This phase is done prior to any
IV contrast injection in order to acquire a single image, that is used to establish the baseline
region of interest (ROI).
1. On the view/edit screen click [Confirm].
2. A warning message displays.
The value for the prescribed Diagnostic Delay displayed in the attention message
pop-up at Confirm.
3. Click [Continue].
The system displays the Scan Progress screen. The display shows the dynaplan for all
three phases, Baseline, Monitor, and Scan.

9-9
SmartPrep
4. On the keyboard press [Move to Scan].
This takes the table to the Monitoring Location.
5. On the keyboard press [Start Scan].
This acquires the baseline image at the monitoring location.
When the image is reconstructed, you see a one on one display of the image on the
display monitor. To the left of the image is six SmartPrep display features available to
use on the image. These features are Zoom (2x), Display Normal, Ellipse ROI, Hide
Graphics (toggle to hide/show graphics), Erase, Explicit Mag (range 0.5-2.0).
6. Place Ellipse ROI in an area of interest.
You can now put up to three ROIs on an area of interest by selecting the Ellipse ROI
feature from the SmartPrep display area. For example, if you are interested in
evaluating the liver parenchyma, put the ROI in the liver so that it is not touching any
vessels. If you are interested in evaluating a vessel, put the ROI on the vessel of
interest.
Quick Steps: Scan the Baseline Phase

1.
2.
3.
4.
5.
6.
7.
On the view/edit screen click [Confirm].

A warning message displays.
Click [Continue].
On the view/edit screen click [Confirm].
On the keyboard press [Move to Scan].
On the keyboard press [Start Scan].
Place Ellipse ROI in an area of interest.

9-10
SmartPrep

The Baseline phase acquires one non contrast scan and allows you to establish an area to
monitor contrast enhancement. The Monitor phase acquires images at the monitoring
location during the delivery of intravenous iodinated contrast material and graphically
displays the images, charts the enhancement thresholds and displays a clock with the time
since monitoring began.
1. On the Scan Progress screen click [Monitor Phase].
2. On the keyboard press [Start Scan] and start the injection of IV contrast at the same time.
The system waits the time set in the Monitoring Delay area and then begin acquiring
images at the time set for the inter-scan delay (ISD).
NOTE: There is a maximum of 40 monitoring images available.
3. On the Display Monitor watch the four on one display for the monitoring activities.
The upper left quadrant shows the baseline image with the ROI(s).
The upper right quadrant shows the real time monitoring image as it reconstructs
along with the ROI(s).
The lower left quadrant shows a real time enhancement threshold graph comparing
the ROIs of each monitoring scan versus the time from the start of the monitoring
delay.

9-11
SmartPrep
NOTE: On the graph is a horizontal line denoted by a T. This represents the numeric
enhancement threshold that was entered from the SmartPrep prescription. If an ROI
was not placed on the baseline image this line does not appear.
The lower right quadrant shows, in real time, the time that each monitoring scan was
acquired based on the beginning of the monitoring delay as well as showing the ROI
values for each scan.
The lower right quadrant also displays an elapsed time clock. This displays, in real
time, the time from when Start Scan was selected for the monitor phase until the
Scan Phase icon was selected. This is the inject to scan delay for this series of scans.
4. When the desired enhancement threshold is achieved click [Scan Phase].
The table moves to the scan prescription start location and, based on the Diagnostic
Delay selected, the scan prescription is started.
When the line representing the ROI of interest is close to or on the line denoting the
preset enhancement threshold value, you may click [Scan Phase] to initiate the scan
prescription.
You can also click [Scan Phase] based on your observation of the real time
monitoring images, if those images show adequate contrast in the area of interest.
NOTE: If all forty monitoring scans have been utilized it is necessary to use the Move To Scan
and Start Scan buttons on the keyboard to place the table in position and initiate the
scan prescription.
Quick Steps: Scan the Monitor Phase

1. On the Scan Progress screen click [Monitor Phase].
2. On the keyboard press [Start Scan] and start the injection of IV contrast at the same
time.
3. On the Display Monitor watch the four on one display for the monitoring activities.
4. When the desired enhancement threshold is achieved click [Scan Phase].

9-12
SmartPrep
Scan the Scan Phase

The Scan Phase is the start of the actual Scan Prescription following the Monitor Phase.
1. On the Scan Progress screen click [Scan Phase].
The table moves to the scan prescription start location and, based on the Diagnostic
Delay selected, the scan prescription is started.
The real time updating of information in the quadrants is stopped.
A screen save image of the quadrant is captured by the system for later review if
needed.
NOTE: The system places the baseline image, the monitoring images and the screen save
image with the exam in the browser. These images are denoted as series 200
prospective and screen save images. If an additional baseline image was acquired
these images are in series 201.
NOTE: If an AutoVoice Pre-Message is not enabled, the initial breathing instructions to the
patient for the start of the exam scan prescription must be delivered by the operator
during the Diagnostic Delay. The system then provides the rest of the breathing
instructions if Auto Voice has been selected.
Quick Steps: Scan the Scan Phase

1. On the Scan Progress screen click [Scan Phase].

9-13
VariSpeed
Chapter 10
VariSpeed
Introduction
This chapter explains the choices available in the option known as VariSpeed. VariSpeed
allows the system to operate at new sub-second rotation speeds. This chapter contains
Use VariSpeed

10-1
VariSpeed

This section presents the concept necessary to understand VariSpeed utilization. The
concept you will need to understand is:
VariSpeed
VariSpeed
VariSpeed is a option that allows the system to operate utilizing various sub-second rotation
times. The rotation times in this package are 0.5 seconds, 0.6 seconds, 0.7 seconds, and 0.9
seconds. The variability of the rotation times gives you the ability to adjust the parameters
for patient size and different applications. For scanning a medium or average sized patient
for an abdominal study, the 0.5 second rotation time provides adequate mAs for image
quality. For a larger patient you may need to use the 0.6 or 0.7 second rotation time. Both
studies would be completed using sub-second rotation times because of the flexibility in
having the various rotation times.

10-2
VariSpeed
How Do I...
This section provides the step-by-step instructions for using VariSpeed. Specifically, it
describes how to:
Use VariSpeed

10-3
VariSpeed
Use VariSpeed
VariSpeed is a purchasable option that allows the system to operate using various
sub-second rotation times. The rotation times in this package are 0.5 seconds, 0.6 seconds,
0.7 seconds, and 0.9 seconds. The variability of the rotation times gives you the ability to
adjust the parameters for patient size and different applications.
1. From the view/edit screen, click [Scan Type].
A pop up window appears.
2. Select rotation time from options listed.

All times will be available for axial.
The two second, three second, and four second times will be gray text and not
available for both helical and cine.
3. Click [Accept] or [Cancel].
[Accept] will utilize the selected parameters.
[Cancel] closes the pop up window. Any parameters set within the protocol will be
utilized.
Quick Steps: Use VariSpeed

1. From the view/edit screen, click [Scan Type].
2. Select rotation time from options listed.
3. Click [Accept] or [Cancel].

10-4
Prospective Gating (SmartScore) (Option)
Chapter 11
Prospective Gating (SmartScore)

(Option)
Introduction
This chapter outlines the process for setting up a prospectively gated unenhanced
(non-contrast) acquisition for calcium scoring. It contains the step-by-step instructions to
help you learn how to:
Set the Exam Prescription for Prospective Gating (SmartScore)
The procedure for using Prospective Gating (SmartScore) in conjunction with calcium
scoring includes the following operator and system actions:
Patient and ECG monitor set up
Cardiac exam prescription and confirmation
Automatic system preparation
Scanning initiation
Image transfer to Advantage Windows workstation
SmartScore on Advantage Windows workstation
The exam prescription is described here. Information on patient set up, ECG monitor set up,
image management, and scoring can be found in the separate SmartScore documentation.

11-1

This section presents the concept necessary to understand the use of Prospective Gating
(SmartScore). The concepts you need to understand are:
R to R interval
ECG (or EKG) Waveform

This feature is designed to acquire prospective ECG gating measurements, which provide
information that is valuable for scan timing. Using the measurements, the system
synchronizes the collection of data used for scoring with the cardiac cycle.
Specifically, prospective ECG gating measures the timing between patient heart
contractions in order to trigger scanning at moments of relaxation (diastolic phase of heart
action). Because the gating measurements determine scan timing, they improve the data
acquisition process. The quality of the resulting images is enhanced, and therefore fewer
images are required. Acquiring fewer images means less x-ray exposure for the patient.
Prospective Gating (SmartScore) requires the selection of cine scanning. Prospective gating
is not compatible with axial or helical scan types. It is limited to patients with a normal
resting heart rate of up to 90 beats per minute for best results with the calcium scoring
application. It also requires the use of an ECG monitor, which is connected to the system.
R to R interval
Images used for Prospective Gating (SmartScore) are acquired during the R to R interval. The
R to R interval is the time between maximum patient heart contractions (R wave peaks). For
example, the R to R interval is 660 milliseconds for a resting heart rate of 90 beats per
minute. See below for more information on the cardiac cycle.

The ECG (or EKG) waveform represents the electrical activity of the heart that correlates to
heart motion:
Cardiac contraction is called systole.
Cardiac relaxation is called diastole.

11-2

Three waveform elements are critical to cardiac gating:
P-wave
Represents depolarization of the atria and results in contraction or systole of the
atria.
QRS complex
Represents depolarization of the ventricles and results in contraction or systole of the
ventricles.
R-wave is used for triggering because of its strong electrical signal and correlation
of the muscle activity of the heart.
The R-R interval is the time between the peak of one R-wave and the peak of the
next. Each R-R interval represents the length of one cardiac cycle.
T-Wave
Represents re-polarization of the ventricles and results in relaxation or diastole of the
ventricles.
Figure 11-1 ECG with Triggers
Figure 11-2 ECG without Triggers

11-3
Ventricular systole extends from the R-peak to the T-Wave when the heart is contracting
and expelling blood.
Ventricular diastole extends from the T-Wave to the R-peak. During diastole, the
ventricles fill with blood.

11-4
How Do I...
This section provides the step-by-step instructions for using Prospective Gating
(SmartScore). Specifically, it describes how to:
Set the Exam Prescription for Prospective Gating (SmartScore)

11-5
Set the Exam Prescription for Prospective Gating

(SmartScore)
1. Set up the patient and monitor, and place ECG leads in recommended location on the
patient.
For more information refer to: Patient Skin Preparation & Electrode Placement.
NOTE: The GE recommended electrodes are Dyna/Trace1500 by ConMed.
Make sure a good signal is detected on the ECG monitor in the scan room.
Electrodes should be radiolucent with silver/silver chloride gel, with fresh gel adhere
to the patient and be able to maintain good contact during table movement.
Use Dyna/Trace1500 electrodes by ConMed. Information of where to order these
electrodes is found on the top of the IVY monitor.
Use electrodes made for short term monitoring (e.g. exercise monitoring). Do not use
electrodes used for long term monitoring.
2. Enter patient information on the New Patient screen.
3. Prescribe a PA (180 degree) and Lateral (90 degree) scout scan.
4. To verify that the scanner is receiving the ECG signal, click [Gating Off] on the view/edit
screen.
Figure 11-3 Gating Off

11-6
If the system detects a valid ECG signal, the patients heart rate in Beats Per Minute
(BPM) is displayed on the Gating button. BPM displayed is a 3 cycle average of the
patient's heart rate. The ECG waveform for the patient can be displayed by clicking
on [ECG Trace] after a BPM is displayed.
If the system detects no signal from the ECG monitor, the button turns red and no
BPM value is displayed. In this scenario, reevaluate ECG connections to patient and
monitor to gain ECG signal before continuing.
5. Perform the scout scan.

NOTE: It is important to give the patient the same breathing instructions for the scout scans
as are given for the Cine Scan Type acquisition. The patient should be requested to
take several breaths in and out before holding breath while the actual scan is
acquired. This helps provide a more consistent heart rate during the acquisition of
the SmartScore images.

11-7

6. Prescribe the cine scan parameters.
This is a prospectively gated acquisition where data is acquired during a specific part
or phase of the cardiac cycle. The images from the gated scan are used in the post
processing software SmartScore for calcium scoring.
Scan Type: Cine
Recon Length: Segment
Gating: On
Trigger Delay: 70%
Images per R-R Interval: 1
Rotation Time: 0.35 seconds
Start Location: One inch below carina
End Location: Apex of heart
Coverage: From the base of the heart to the apex.
Thick/Speed: 2.5mm/8i (20 mm detector coverage)
Interval: 20 mm
Cine Duration: System automatically updates the value based on the number of
images per R-to-R cardiac cycle and the time set between these neighboring
images.
Gantry Tilt: S0
SFOV: Large
kV: 120
mA:
Small patient 300
Average patient 430
Large patient 450
Breath Hold: Set to No
Prep/Group Delay: Based on instructions selected for Voice/Lights/Timer
ISD (sec): 1.3second
Voice/Lights/Timer: Manual breathing instructions or user recorded message
using hyperventilation.
DFOV: 25cm Do not change. DFOV 25cm is required for processing data in
SmartScore.
Recon Type: Standard

11-8

7. Click [Gating] to turn on Prospective Gating (SmartScore).
The SmartScore Pro (Prospective Gating (SmartScore)) screen is displayed.
8. On the SmartScore Pro pop up, click [Off] to turn gating on.
9. Review and/or change parameters on the SmartScore Pro pop up screen as necessary.
The R to R interval is displayed in BPM in the R to R Interval field.
The R to R interval is displayed in milliseconds directly below the BPM entry. The
R-to-R interval is updated based on an average over a period of 3 cardiac cycles.
The center R-Peak Delay (%) is defined as a percentage of time between 2
consecutive R-peaks. The default value is 70%, which should be in the diastolic phase
in order to minimize occurrence of cardiac motion. The time, in milliseconds,
displayed directly below the Center R-Peak Delay (%) identifies the amount of time
after the preceding R-peak that aligns with the Trigger Delay percent for the patient's
displayed heart rate.

11-9

Time Between Images is the temporal interval in milliseconds that is prescribed
between images generated at the same image location.
a) Select either [50] or [100] from the pop up menu.
Images per R-to-R Interval defines the number of images reconstructed per image
location for each heart cycle. You have a scan at that location that lasts X duration,
and out of that data you reconstruct images at a time interval of either 50 or 100
milliseconds.
b) Select either [1], [3], or [5] from the pop up menu.
The number of images that can be acquired depended upon the R to R Interval of the
patient.
The middle slice of the group is taken at the point of the Trigger Delay. The remaining
images, if more than one, are reconstructed at either 50ms or 100ms intervals before
and after the middle image.
If the point to begin data acquisition is too short for the hardware to start after the R
to R wave, the system skips one beat and begin in the next R to R wave.
10. Click [Accept] on the SmartScore Pro pop up menu to continue with Prospective Gating
(SmartScore) or click [Cancel].
NOTE: It is important to give the patient the same breathing instructions for the scout scans
as are given for the Cine Scan Type acquisition. The patient should be asked to take
several breaths in and out before holding breath while the actual scan is acquired.
This helps provide a more consistent heart rate during the acquisition of the
SmartScore images.

11-10
Quick Steps: Set the Exam Prescription for Prospective Gating

(SmartScore)
1. Set up the patient and monitor, and place ECG leads in recommended location on the
patient.
2. Enter patient information on the New Patient screen.
3. Prescribe a PA (180 degree) and Lateral (90 degree) scout scan.
screen.
5. Perform the scout scan.
6. Prescribe the cine scan parameters.
7. Click [Gating] to turn on Prospective Gating (SmartScore).
8. On the SmartScore Pro pop up, click [Off] to turn gating on.
9. Review and/or change parameters on the SmartScore Pro pop up screen as
necessary.
10. Click [Accept] on the SmartScore Pro pop up menu to continue with Prospective Gating
(SmartScore) or click [Cancel].

11-11
Cardiac Imaging Discovery CT750 HD
Chapter 12
Cardiac Imaging Discovery

CT750 HD
Introduction
This chapter explains the cardiac imaging (CI) scanning process for the Discovery CT750
HD system configuration for obtaining contrast enhanced cardiac imaging exams. It
contains the step-by-step instructions to help you learn how to:
Set Up a Patient
Scan the Patient

Scout Scans
Localizer Scan
Timing Bolus Scans
Contrast Enhanced Cardiac Scan
Reconstruct Cardiac Scans
Edit ECG Trace/R-Peaks in ECG Viewer

Adjust/Move Triggers
Insert Triggers
Delete a Trigger
Invert a Trace
Save/Reset Trace Changes
Measure Distance on the Trace
Zoom In or Out on a Trace
NOTE: The maximum number of images in a series is 3000 for prospective and retrospective
series. How images are put in different series based on how they are reconstructed.

12-1

This section presents the concepts necessary to successfully complete the Cardiac Imaging
process. Specifically you need to understand:
Cardiac Helical
SnapShot Segment
SnapShot Segment Plus
SnapShot Burst
SnapShot Burst Plus
CardIQ SnapShot Window
SnapShot Pulse
SnapShot Pulse Window
Hi Res Mode
Auto Detection of Heart Rate
Manual Detect Heart Rate
Pitch
Phase Location
% R-Peak Value
SnapShot Mode Usage
ECG Modulated mA
Scan Preparation
Patient Preparation
Patient Skin Preparation & Electrode Placement
Alternate Electrode Positions for Signal Clarity
Scan Parameters Usage

Scout Scan
Localizer Scan
Timing Bolus Scan
Cardiac Helical
Cardiac Series Retro Reconstruction Numbering

Single Phase Image Set
Multiphase Image Set
Cardiac Images are annotated with either of the following:

12-2
SEGM (Ungated segmented image reconstruction)

Insert Triggers
Delete Triggers
Invert a Trace
Measure Mode
Zoom In and Out
Prior to Scanning
Before initiating a scan, it is extremely important to check the ECG trace on the scanner
console and ECG trigger monitor to make sure the waveform is clean and ECG-gating is
triggering properly. In cardiac imaging, there is a dependency on the patient specific heart
rate as input to ECG gated exam completion.
ECG-gating is considered correct if the R-peak is pronounced and clearly distinguishable
from the remainder of the waveform (i.e. no other elevated segments) and the red trigger
line is shown on the R-peak of the QRS complex on the ECG waveform.
Use the impendence check button on the Ivy Monitor to verify that the electrode placement
and connection with the patient are good.
If these conditions are not met, reposition the electrodes as per recommendations in the
Patient Skin Preparation & Electrode Placement section of this guide.

12-3

Figure 12-1 ECG Trace
The figures below demonstrate varying electrocardiograms (ECG) similar to the waveforms
that could be seen from connecting the leads of the cardiac trigger monitor to the patient
for an ECG-gated CT acquisition. These show an expected normal or typical waveform
(Figure 12-2), a suboptimal noisy waveform (Figure 12-3), a suboptimal elevation in T-Wave
amplitude (Figure 12-4), and an irregular spacing between the R-Peaks creating an
arrhythmia (Figure 12-5).
Figure 12-2 Normal ECG Trace

12-4

Figure 12-3 Noisy ECG Trace
Figure 12-4 ECG Trace with Elevated T-Waves
Figure 12-5 ECG Trace with Arrhythmia
If the impendence check fails or if the waveform is noisy as shown in Figure 12-3 above,
please refer to Patient Skin Preparation & Electrode Placement to ensure the optimal
conditions are being met. Additionally, confirm all cables are properly connected and ECG
monitor is positioned away from the table and gantry.
If the waveform has elevated T-waves, as in Figure 1-7, do the following:
Confirm electrode placement, or
Try to place the electrodes more laterally on clavicles or on the arms, or
Use the Alternate Electrode Positions for Signal Clarity in Figure 12-19.
Refer to Patient Skin Preparation & Electrode Placement.
If this does not yield a more normal waveform (Figure 12-2), try changing the measurement
Lead on the ECG monitor from Lead 2 to Lead 1 or Lead 3.

12-5

Avoid scanning patients with known arrhythmias. If arrhythmias (including pre-ventricular
contractions, or extra systole), as seen in Figure 12-5, are seen when reviewing the ECG
trace prior to scanning, attempt to regulate the heart rhythm (e.g. practice breathing
instructions, calm the patient, or follow procedure established by your institution). It is not
advised to scan a patient with arrhythmias as image quality may be degraded.
If you do not see the RED line on the R-peak, but somewhere else, it is advised to make the
appropriate adjustments to the electrode placement, monitor settings and equipment to
ensure proper gating on the R-peak. The white area represents the Reconstruction window
of 75 % R to R interval used for the first set of images reconstructed.
Cardiac Helical
Cardiac Helical is a low-pitch ECG-gated helical acquisition mode where the pitch value is
set based on the patient's heart rate. The range of pitch values varies based on both the
gantry speed and the scanner configuration. The patient's heart rate must be within the
range of 40 -120 BPM for the system to allow scan confirmation.
NOTE: If Start Scan times out or you need to pause scan and resume, make sure to review
the patient's heart rate before you resume/reconfirm the scan. The heart rate may
have changed from the value you originally confirmed and a different pitch might be
used for the scan. In cardiac scanning, confirm the acquisition only when you are
ready to proceed.
Move to Scan is valid for 180 seconds while Start Scan is only valid for 30 seconds
before it times out.
The pitch selected is based on the patients heart rate on the console at the time that the
"confirm" button is selected on the view/edit screen. Therefore it is very important to be
aware of what the pitch is set to prior to confirming the scan. If you want to use a smaller
pitch other than what the scanner is detecting for the HR, you will need to use the HR
override button located in the gating area. The tables below (Table 12-1) represent the pitch
table overview for the various scanner configurations.

12-6

Table 12-1 Discovery CT750 HD with 0.35 sec./rotation gantry speed (64 slice)
HR Range
Gantry Speed
Pitch
Snapshot Segment (SSEG)

30-40 BPM
0.35
0.16
41-49 BPM
0.35
0.18
50-57 BPM
0.35
0.20
58-65 BPM
0.35
0.22
66-74 BPM
0.35
0.24
Snapshot Burst (SSB)

75-85 BPM
0.35
0.20
86-95 BPM
0.35
0.22
96-113 BPM
0.35
0.24
Snapshot Burst Plus (SSB+)

114+ BPM
0.35
0.20
NOTE: If the heart rate varies more than 10 BPM, use Heart Rate Override in the CardIQ
SnapShot pop-up and enter the minimum value in the HR Range which covers the
lowest BPM expected to occur during the scan to ensure a low enough pitch is used
for the acquisition.
Table 12-2 Discovery CT750 HD with 0.40 sec./rotation gantry speed (64 slice)
HR Range
Gantry Speed
Pitch
Snapshot Segment (SSEG)

30-42 BPM
0.40
0.18
43-49 BPM
0.40
0.20
50-59 BPM
0.40
0.23
60-69 BPM
0.40
0.26
Snapshot Burst (SSB)

70-80 BPM
0.40
0.20
81-94 BPM
0.40
0.22
Snapshot Burst Plus (SSB+)

95-104 BPM
0.45
0.20
105+ BPM
0.40
0.20

12-7

NOTE: If the heart rate varies more than 5 BPM, use Heart Rate Override in the CardIQ
SnapShot pop-up and enter the minimum value in the HR Range which covers the
lowest BPM expected to occur during the scan to ensure a low enough pitch is used
for the acquisition.
CAUTION:
If during the scan the heart rate drops significantly lower than the prescribed
heart rate, there is a potential for gaps in the gated image location. To avoid
image location gaps, a non-gated image is reconstructed for the period where
the patient heart rate dropped below the expected or confirmed heart rate
at the start of the exam. A non-gated image may have more motion and may
not be reconstructed at the prescribed phase.
SnapShot Segment
SnapShot Segment is an acquisition and reconstruction method used to generate
retrospectively ECG-gated images using data from one cardiac cycle in a half-scan
reconstruction technique.
SnapShot Segment image reconstruction is recommended for 64 slice systems with rotation
speed of 0.35 and patient's heart rate that is between 30-74 beats per minute (BPM).
The temporal resolution that results depends on the gantry speed used. For SnapShot
Segment single sector reconstruction, the fastest gantry speed available should be used in
order to optimize the temporal resolution.
Images acquired with SnapShot Segment are annotated SSEG.
SnapShot Segment Plus

SnapShot Segment Plus is an advanced single sector cardiac reconstruction mode which
can improve reformatted and volume rendered images at cardiac cycle transitions.
SnapShot Segment Plus can be selected in retro recon for single phase or multiphase image
generation. Use of the SnapShot Segment Plus recon mode in retro recon will add 30 to the
series numbering pattern.
SnapShot Segment Plus can be prescribed prospectively as Recon 2 or Recon 3 and will be
assigned series number the same manner as all PMR reconstructions.
This algorithm may be applied to ECG-gated cardiac helical acquisitions and generates
single sector images.

12-8
CAUTION:
SnapShot Segment Plus is an alternate reconstruction mode which applies a

different weighting to data in the area of cardiac cycle transitions compared
to SnapShot Segment reconstruction mode. Image quality in these transition
areas should be reviewed carefully.
SnapShot Burst
SnapShot Burst is a reconstruction method used to create retrospectively gated images
from two cardiac cycles within the same phase of the heart cycle. Burst imaging produces
images with improved temporal resolution due to the combining of data from 2 cardiac
cycles.
SnapShot Burst image reconstruction is recommended to be used for patient's whose heart
rate is higher than the SnapShot Segment range listed above. (Please see previous tables for
specific ranges at each scanner configuration.) The temporal resolution will vary depending
on the heart rate and scanner configuration. Please note, SnapShot Burst reconstruction will
optimize temporal resolution across the image set based on the scan acquisition
parameters. Resulting images will be annotated SSB2 indicating that data from 2 cardiac
cycles was used, or SSEG when resulting acquisition parameters yield single sector images.
SnapShot Burst Plus

SnapShot Burst Plus is an acquisition and reconstruction method used to generate
retrospectively ECG-gated images using data from up to 4 consecutive cardiac cycles. Burst
Plus imaging yields improved temporal resolution for patients with high and stable heart
rates.
SnapShot Burst Plus imaging may be useful for patient's with heart rates elevated beyond
the SnapShot Segment and SnapShot Burst heart rate ranges. (Please see charts above for
each scanner configuration.) The gantry rotation speed will be automatically updated based
on the heart rate. For SnapShot Burst Plus imaging it is required to enter a value in the Heart
Rate Override button on the view/edit screen. The heart rate entered should be the lowest
heart rate expected to occur during the scan acquisition.
SnapShot Burst Plus images will be annotated SSB4, SSB3, or SSB2 to indicate the number of
cardiac cycles that contributed to each image. Some images may be annotated SSEG if
parameters varied such that only one cycle was available.
NOTE: If the patient HR varies unexpectedly during the scan, and ungated images result,
these images will be annotated 'SEGM' on the axial images. In order to optimize
cardiac helical imaging results, always watch the patient heart rate during the
pre-scans and practice breath hold to ensure cardiac helical acquisition parameters
are optimized to meet the minimum expected heart rate.

12-9
CardIQ SnapShot Window

When you click [Gating], the CardIQ SnapShot window opens
Figure 12-6
Table 12-3 This table provides a description of each function in the CardIQ window.
Function
Descriptions
Heart Rate
Monitoring
This button toggles [On] or [Off]. This button defaults to [On] which allows
the scanner to capture the ECG signal. This needs to be on in order to do a
cardiac scan.
Heart Rate
Override
This button toggles [On] or [Off]. This is defaulted to [Off]. If you click [On],
you can manually enter the patients heart rate which forces the system to
override the detected heart rate and set the pitch to the heart rate you
entered.
NOTE: This is defaulted [On] for SnapShot Burst Plus scanning.
R to R
Interval
This displays the heart rate in beats per minute. This is updated based on
the average of 2 R to R intervals.
R-Peak
Delay
This controls the cardiac phase location of a given reconstruction. It refers

to the center of the reconstruction window in terms of a percentage
distance between any two successive R-Peaks given from the ECG.

12-10

Function
Descriptions
Heart Rate
Use this to manually enter a patients heart rate for patients whose heart
rates vary during breath holds. You can only enter a value when the Heart
Rate Override button has been toggled [On]. This is a mandatory entry for
SnapShot Burst Plus scanning.
[Accept]
This accepts the parameters that you entered and returns you to the view
edit screen.
[Cancel]
This closes the window without accepting any changes.
SnapShot Pulse
SnapShot Pulse is a prospectively ECG-gated Low-Dose acquisition mode to acquire
contrast enhanced cardiac images at a specific cardiac phase or phase range.
SnapShot Pulse requires the 0.35 second gantry speed, 100 kW generator, and 64 slice
patient scanning option be installed. SnapShot pulse is not available on 32 slice
configurations.
In a SnapShot Pulse acquisition, x-ray is on for the specified phase plus padding compared
to retrospectively ECG-gated cardiac helical scan where x-ray is on for the entire length of
the scan (Figure 12-7).
Figure 12-7 Cardiac gated helical and SnapShot Pulse acquisitions
SnapShot Pulse is an axial step and shoot mode used to acquire images during a specified
phase of the heart cycle with padding. Padding provides additional phase information to
account for variations in heart rate by adding time before and after the center phase of the
acquisition (e.g. adding 100 mSec before and after the 75% phase thus providing additional
phase information).
Figure 12-8 demonstrates SS-Pulse acquisition acquired during one heart cycle (complete
R-R interval).

12-11

Figure 12-8 SnapShot Pulse acquisition window, prescribed phase, and padding
SnapShot Pulse requires that 0.35 second gantry speed, 100.2 kW generator and 64 slice
patient scanning options be installed.
Padding is prescribed in the range of 0 - 200 milliseconds, and is added to both sides of the
center of the acquisition. Padding defaults to the value listed in the heart rate Dependent
Padding Lookup Table unless overridden. You may prescribe the desired amount of padding
if different than default. Click [Gating] to display the SnapShot Pulse pop-up. Click [Padding
Override] and enter desired millisecond padding. Maximum dose savings can be
accomplished by reducing padding value for patients with stable heart rates. The default
padding is set to cover 10% of the patient's R-to-R interval. This default value is set to
ensure adequate phase coverage for over 90% of patients. The patients heart rate may
become slower during the breath hold. You may want to increase the amount of padding
entered to accommodate this variability in the patient's heart rate.
Table 12-4 Heart Rate Dependent Padding Lookup Table
Heart Rate (HR) Dependent Padding
HR Range
Milli second Padding
30-39
175
40-49
150
50-59
125
>59
100

12-12
SnapShot Pulse Window

When you click [Gating], the SnapShot Pulse window opens.
Figure 12-9 SnapShot Pulse window
Table 12-5 This table provides a description of each function in the SnapShot Pulse window.
Function
Cardiac
Gating
Padding
Override
Descriptions
This button toggles [On] or [Off]. This button defaults to [On] which allows
the scanner to capture the ECG signal. This needs to be on in order to do a
cardiac scan.
This button toggles [On] or [Off]. It is defaulted to [Off] and can be used to
adjust the amount of overscan or padding around the center phase
NOTE: This is defaulted [On] for SnapShot Pulse scanning.
R to R
Interval
This displays the heart rate in beats per minute. This is updated based on
the average of two R to R intervals.
Center
R-Peak
Delay
This controls the cardiac phase location of a given reconstruction. It refers

to the center of the reconstruction window in terms of a percentage

12-13

Function
Descriptions
Dynamic
Padding
(mSec)
Dynamic Padding is applicable to SnapShot Pulse scans only and is

defaulted to On. It is defined by an additional amount of time, in
milliseconds, of X-ray coverage around the center phase to allow for
phase adjustments. The default value is approximately 10% of the R-to-R
cycle duration.
[Accept]
This accepts the parameters that you entered and returns you to the view
edit screen.
[Cancel]
This closes the window without accepting any changes.
Figure 12-10 SnapShot decision tree for coronary artery imaging
CAUTION:
SnapShot Pulse should not be used for studies where function or full
multiphase analysis is needed. Settings may limit the cardiac phases
available to one or a few neighboring phases impacting the ability to analyze
heart motion or review cardiac phase locations outside the prescribed phase.

12-14
WARNING: SnapShot Pulse scan mode should only be used for patients with stable heart
rates of 65 beats per minute (BPM) or less. It is not recommended to scan a
patient with heart rates that are unstable or above 65 BPM with this mode as
the temporal resolution may be inadequate for freezing the motion of the
heart and the increase in the interscan delay could lead to suboptimal image
quality. Alternate imaging modes such as cardiac helical should be
considered if the optimal conditions for SnapShot Pulse are not met.
CAUTION:
ECG signal clarity and integrity must be confirmed prior to performing

ECG-gated acquisitions. Items which may require adjustments of equipment
settings or positioning, or patient set-up include:
- External Interference
- Atypical Patient ECG (e.g. elevated T-Waves, low ECG amplitude or signal
strength)
- Suboptimal Patient Connection
ECG lead placement should follow recommended guidelines to optimize
results.
If the ECG lead becomes disconnected during the scan, or the heart rate
drops below 30 BPM, the images will be reconstructed as non-gated
segment images. This is done to avoid inaccuracy of the z-location of images
where necessary.
CAUTION:
Cardiac helical scan modes of SnapShot Segment, Burst, and Burst Plus are
optimized for specific heart rate ranges. Select the appropriate scan mode
for each patient's heart rate pattern. If the incorrect mode is selected,
temporal resolution may be insufficient and degraded image quality could
result.
CAUTION:
A patient with any of the conditions listed below may require additional
attention. If patients are scanned with these conditions, the software may not
be able to detect the R-Peaks and the images therefore may be produced as
ungated segment images.
- Patients with multiple pre-contractions or extra systole (e.g. PVC, PAC)
- Patients with persistent or extreme arrhythmia
- Patients with bi-ventricular lead (dual chamber) pacemakers

12-15
CAUTION:
Patient motion, respiration, beat-to-beat variability of heart rate, heart

motion, or significant change in heart rate over the scan duration could cause
an ECG gated acquisition to have degraded image quality. It is important to
explain to the patient the pattern of breathing instructions to expect, the
warm feeling that can be felt from the contrast injection and to position the
patient comfortably such that the arms will not move with respect to the body
during the scan.
NOTE: The images for cardiac gated acquisitions do not begin reconstruction until all the
data for the scan have been acquired.
Hi Res Mode
The Hi Res Mode is compatible with all the cardiac sequences. Hi Res Mode enables higher
resolution scanning for imaging cardiac structures. There are five Hi Res reconstruction
algorithms - HD Standard, HD Standard Plus, HD Detail, HD Detail Plus, HD Bone and HD
Edge. HD Detail or HD Detail Plus maybe useful when imaging patients with stents.

The ECG (or EKG) waveform represents the electrical activity of the heart that correlates to
heart motion.
Cardiac contraction is called systole.
Cardiac relaxation is called diastole.
The ECG Trace must be displayed on the console. If you do not see a trace, do not
attempt to scan any cardiac gated studies.
In order to be able to edit an ECG Trace in the ECG Viewer in Retro Recon, the system
must save the trace. If you do not see a trace in retro recon, contact service to verify the
system is saving ECG Traces. Without a saved ECG Trace, images may be reconstructed
as ungated.
Three waveform elements are critical to cardiac gating.
P-wave
Represents depolarization of the atria and results in contraction or systole of the
atria.
QRS complex
Represents depolarization of the ventricles and results in contraction or systole of the
ventricles.
R-wave is used for triggering because of its strong electrical signal and correlation
of the muscle activity of the heart.

12-16

The R to R interval (Figure 12-11) is the time between the peak of one R-wave and
the peak of the next. Each R to R interval represents the length of one cardiac
cycle.
T-Wave
Represents repolarization of the ventricles and results in relaxation or diastole of the
ventricles.
Figure 12-11 ECG with Triggers
Figure 12-12 ECG without Triggers
Ventricular systole extends from the R-Peak to the T-Wave when the heart is contracting
and expelling blood.
Ventricular diastole extends from the T-Wave to the next R-Peak. During diastole, the
ventricles fill with blood.
CAUTION:
There is a possibility that the ECG signal may not be detected by the scanner
due to improper lead placements or a lead falling off during the scan. It is
important to place new leads on the patient before the scan. Make sure the
leads are attached properly.
CAUTION:
Ensure the ECG patches are not past expiration date and that the gel on the
pads is still moist for proper conduction of the ECG signal for successful gating

12-17
CAUTION:
Manual edits of the ECG gating waveform may be performed retrospectively

in some ECG gated exams as long as scan data exits on the console. Images
can be reconstructed with user modified gating triggers and the original
gating information can be retrieved after edits have been made.
Auto Detection of Heart Rate

Automatic detection of heart rate can be performed in any ECG-gated scan mode, such as
cardiac helical or gated cine. When performing cardiac imaging, the scanner must be able
to detect the heart rate of the patient. This is accomplished by connecting the ECG monitor
to the scanner and applying ECG electrodes to the patient and enabling Gating on the
view/edit screen. Once the ECG monitor is on and the signal is being read from the patient,
the heart rate will be displayed on the scanner console and scan parameters, such as pitch
for helical or padding for SnapShot Pulse, will be optimized. The auto detect scanning
method is used for patients with a stable resting heart rate that is maintained during breath
hold and contrast injection as seen from the pre-scans, and is the default parameter for
most cardiac exams. Under the auto detection method, the Heart Rate Monitoring button
is [On] and the Heart Rate Override button is [Off].
SnapShot Pulse is an axial step and shoot acquisition and therefore does not use pitch.
SnapShot Pulse uses padding. Please refer SnapShot Segment Plus for a detailed description
of padding.
Manual Detect Heart Rate

Manual detect Heart Rate is an optional monitoring feature where you can decide to
manually enter (override) the heart rate instead of using the auto detected heart rate. The
heart rate you enter is based on the heart rate observed during practicing of breath holds
and pre-scans. For instance, if the heart rate is at 65 BPM at rest then changes to 55 BPM
while the patient is holding their breath, manual detect would be recommended. To enable
manual detect you must click on [Gating] and then toggle Heart Rate Override [On]. Enter
the desired heart rate in the Heart Rate text box. The default heart rate value for manual
detect is 0 BPM. Heart Rate Override should be used If the heart rate increases or decreases
more than 10 BPM for a breath hold. This entry is compulsory in SnapShot Burst Plus
scanning mode.
The heart rate entered in Heart Rate Override should always be the minimum value in HR
Range for the lowest heart rate expected for the patient which was seen during breath hold
practice, scouts acquisitions, localizer acquisitions, normal breathing or test bolus contrast
injection.

12-18
Pitch
Pitch is the ratio of table travel per rotation divided by the detector Z collimation. With
cardiac scans, the movement of the cradle and the x-ray tube needs to be in sync with the
heart rate to avoid any gaps in the image data set. As the patients heart rate increases, the
pitch increases for SnapShot Segment and Burst Mode. If the patients heart rate decreases,
the pitch decreases. This is why it is very important to understand the heart rate of the
patient during a breath hold so the appropriate pitch is selected.
Phase Location
The cardiac phase is defined as a point or period in time in the cardiac cycle. The location of
the cardiac phase is defined in a percentage of how far it is between R-Peaks (% R-Peak
Delay).
% R-Peak Value
The percent R-peak parameter controls the cardiac phase location of a given reconstruction
(Figure 12-13). It refers to the center of the reconstruction window in terms of a percentage
Figure 12-13 % R-Peak Value
R Peak 75% Default
Phase Location is defined

with respect to the Center
of recon window as a
percentage distance
between adjacent Rpeaks.
Reconstruction Window

12-19
SnapShot Mode Usage

There are different scanning modes you can choose from when scanning a cardiac exam
which are: SnapShot Segment, SnapShot, Burst, SnapShot Burst Plus or SnapShot Pulse.
For Discovery CT750 HD 64 slice scanner with 0.35 second rotation time, you should
choose SnapShot Segment when the patient's heart rate ranges from 30 to 74 bpm. When
the heart rate range is 75 to 113 bpm, SnapShot Burst should be selected. SnapShot Burst
Plus should be the selected mode when the heart rate is stable and greater than 114 bpm.
SnapShot Pulse could be used for stable heart rates of 30 to 65 BPM where functional
information is not needed.
You should be aware that a patients heart rate may change based on the breathing
instructions. It is important to hyperventilate the patient for all series including the scout and
timing bolus scan. The heart rate is displayed on the ECG monitor and the scanner once you
have clicked on [Gating].
ECG Modulated mA
ECG Modulation is a dose reduction feature that allows the user to specify a minimum and
maximum mA Range which is varied across the patient's cardiac cycle (R-to-R interval. A
phase percent range is specified for the Full mA range. ECG Modulation is only available in
cardiac helical modes (SnapShot Segment, SnapShot Burst and SnapShot Burst Plus).
NOTE: This feature is not applicable for the prospectively gated SnapShot Pulse scan mode.
In a stable heart rate this can lead to clinically relevant dose reduction for the patient by
implementing "full mA" for the useful portion of the cardiac cycle where images are to be
reconstructed and a reduced mA for the remainder of the cardiac cycle.
Figure 12-14 Full mA
Full mA
Recon
Recon
Recon
ECG
mA
There are four parameters to set for ECG dose modulation.

Start and End phase for full mA.
Min and Max mA Setting.

12-20

Set the start phase for full mA to be delivered in the useful portion of the cardiac cycle for
imaging (example 70%).
Set the End Phase for full mA to be delivered in the useful portion of the cardiac cycle for
imaging (example 80%).
Set the Min mA to be used outside the above phase range (no less than 20% of full mA can
be set, 40% of Max mA is the default).
Set the Max mA to be used within the above phase range.
There will be ramp up time factored in for the Min mA to alter to Max mA & vice versa by the
software.
Figure 12-15 mA Control Window
NOTE: For Heart Rates < 65 BPM, we recommend full mA range from 70 % to 80 %. For heart
rates > 65, we recommend full mA range from 40-80 %.
ECG modulated mA when used with lower heart rates provides the best dose saving
opportunities. As heart rates increase the potential for dose savings decreases. Additionally,
an increase in the Max mA phase range settings, the potential for dose savings will
decrease. Once the heart rate exceeds 100BPM, the maximum phase range capability for
ECG Modulation is 40-80%. Additionally, the best dose savings for heart rates above

12-21

100BPM may be achieved by setting the Minimum mA at a value that is 40% of the
Maximum mA rather than possible 20% of maximum which is allowed due to system
response times.For projected estimates of dose savings, see Figure 12-16.
Figure 12-16 Dose Savings
Scan Preparation
For single barrel injector's: Load with 80-100cc of contrast. (Please note: the total
volume and strength of contrast used is the site's discretion).
For dual barrel injector's: Load contrast syringe with 70-90cc of 300 to 350 strength
contrast media. (Please note: the total volume and strength of contrast used is the
site's discretion). Also load saline syringe with 50cc Saline.
Explain test to patient and have them sign a consent form if required at your site.
Have the patient lie supine on the table feet first.
Start IV line; make sure to explain the effects of the contrast to the patient. Even if the
patient has had a contrast injection before, reinforce how they will feel during the
scan. This step is CRITICAL as this will help minimize the patient's anxiety during the
injection of the contrast. Reassure them that what they will feel during the injection is
normal and they should try to remain relaxed during the scan.
Turn on the ECG machine, and ensure good connection to gantry and leads. To
confirm a good connection, check the upper right display area of the monitor, Figure
12-17.
Check that the Heart icon is illuminated on the gantry display.

12-22

Figure 12-17 ECG Machine showing connection to Gantry
ECG monitor showing valid

connection to the gantry on the
left and no connection on the right
If you do not have a good connection, check to make sure that the cable connecting
the ECG machine to the backside of the Gantry is plugged in properly, and the same
cable is connected to the ECG Machine. In case of low signal, please check electrode
placement and chose alternate position if needed. If there is "noise" within the ECG
wave, it is recommended that you DO NOT SCAN, until this condition is corrected.
Perform an impedance check to make sure that there is no issue with electrode
conductivity with the patient. If the impedance is good, the value for the lead will be
listed in green on the monitor. If the value is below the acceptable level, the value is
shown in red. If the impedance checks do not pass, re-prep and replace any of the
electrodes that do not pass.
Make sure excess IV tubing and excess ECG cable length is properly placed and
secured. Movement of the lead wires during scanning can degrade the gating signal.
To ensure patient safety and avoid disruption of the gating signal, any IV tubing and
the ECG cable length need to be secured properly.
Prior to the scan, have the patient practice the breathing instructions that will be
given during the exam. The scan time for the contrast enhanced cardiac gated
acquisition should be around 5-8 seconds to cover the entire heart. Recommended
breathing instructions include having the patient take a couple of breaths in and out
before holding their breath in order to increase their oxygen levels. Typical procedure
is to instruct the patient to take in one breath, blow it out, then take in another
breath, blow it out, then take in one more breath and hold their breath don't breathe.
Have the patient hold their breath for 20-30 seconds and then inform the patient to
breathe normally. Make sure to watch the ECG monitor during the breathing
instructions and take note of the patient's heart rate while they are holding their
breath. A patient's heart rate usually stabilizes a few seconds after they begin
holding their breath. Monitoring the heart rate during the breathing instructions

12-23

provides information of how long it takes to become stable and allows you to adjust
breathing instructions for the contrast enhanced acquisition to achieve as stable of
heart rate as possible during the contrast enhanced cardiac gated scan.
If the patient has difficulty holding their breath, you may place the patient on 2-4
liters of oxygen via nasal cannula (per a physician's orders, and the site's discretion).
Placing the patient on oxygen will also help to lower their heart rate.
It is recommended to have a cardiac voice programmed in the scanner to give
CONSISTENT breathing. When building this voice make sure to breathe your patient
SLOWLY. The breathing instructions should be no shorter than 10 seconds. When
recording the instructions, after you say take a breath in and hold it, make sure to
wait for 3-5 sec. (of silence) prior to clicking on the stop recording button. This will
give the patient enough time to hold their breath before the scan starts and for their
heart rate to stabilize before the scan, otherwise the patient may still be breathing in
during the first several slices which could lead to motion on your images.
The Preset Delay in Auto Voice can be used to program 1-7 seconds additional time
prior to x-ray on as needed for each patient to ensure the patient is holding their
breath.
Patient Preparation
Patient preparation is extremely important step in the production of gated cardiac images
due to the dependency on the patient's heart rate input via ECG monitor during the
acquisition of data. The procedure should be explained completely before the exam is
started. Inform the patient of the breathing instructions that you are giving and practice the
breathing instructions before the scan. Review the potential effects the patient may
experience as the contrast is being injected. Inform the patient of the four phases in the
exam and explain what will happen in each phase. This helps the patient understand what
to expect, what is expected of them and remain calm throughout the exam.
This keeps the heart rate at a normal rhythm if the patient is comfortable with what is
happening. If the heart rate changes drastically during the scan, the image quality is
compromised.
The heart rate stabilizes 2-7 seconds after a breath hold. To help alleviate issues at the
beginning of the scan, have the patients start to hold their breath 3-5 seconds prior to x-ray
On.
The key to success in cardiac imaging is a stable heart rate, ideally the heart rate variation
should be within 5 BPM during a scan. Patients with heart rate variations of 10 BPM or
greater should not be scanned.

12-24
Patient Skin Preparation & Electrode Placement

It is recommended that the electrodes/pads NOT be placed over muscle, scar tissue (from
surgery such as bypass etc.), or hair. Proper placement of the electrode is over the clavicles
after the arms have been raised over the patient's head with the arms positioned on an
elevated surface, such as pillows or support sponge. The patient's arms should NOT be
placed flat on the table or placed on the gantry due possible vessel flow limitations or
arm/shoulder motion that can result from these positions.
It is very important to have good skin contact. If patient has used any lotion or oils prior to
the study, you may have to scrub the area until slightly pink with a 4 x 4 gauze pad to ensure
good contact.
1. If placed over muscle, the ECG can pick up the electrical activity of the muscle due to the
patient holding their arm over their head. Whenever possible let the patient relax their
arms, so their shoulder muscles do not get fatigued.
2. Scar tissue is denser and will be more difficult to get a good signal. If the patient has
scar tissue in shoulder area, place the electrode out onto the patients arm. In the chest
area, place the electrode in an area with no scar tissue.
3. Placing the electrodes over a very hairy area will not allow good contact to the skin. If
necessary shave the area where the electrode is to be positioned.
Follow Figure 12-18 for proper Lead Placement using the IVY ECG Monitor: First raise the
patient's arms above their head, and then place the leads on the patient as shown. (If the
leads are placed with the patient's arms down, the leads may move position when you have
them raise their arms above their head for the scan. This can cause a low/weak signal to the
ECG machine, which could cause cardiac gating issues.)
Place the two upper leads directly on the mid portion of the patient's clavicle. The electrodes
can be moved lateral if needed to provide better signal. Refer to Figure 12-18 and Figure
12-19.
Figure 12-18 IVY Monitor Recommended 3 Lead Placement
RA
US - White
EU - Red
LA
US - Black
EU - Yellow
LL
US - Red
EU - Green
NOTE: Lead placement on the clavicles needs to be done with the arms over the head in
position to be used for scanning.

12-25
Alternate Electrode Positions for Signal Clarity

In case of low signal amplitude, undefined R-Peaks, or elevated P- or T-Waves indicating the
QRS peak is not noticeably stronger than the surrounding ECG waveform segments, these
alternate positions shown below may improve the ECG signal triggering.
Figure 12-19 Alternate Electrode Positions
Electrodes may be placed farther out on the arms or in this alternate position.
Use the impendence check on the IVY monitor to ensure the electrode connection is good,
after the patient has been positioned as needed for the cardiac study. If the impendence
check fails, remove electrodes and prep the patient again and replace with fresh electrodes.
Recheck impendence after preparing the patient.
Check to ensure the electrodes are not the wrong type, expired, dried out, or old.
The electrodes need to be radiotranslucent with a fresh gel pad (not dried out) to maintain
good electrical contact with the skin surface during table movement. Do not use patient
monitoring electrodes that may be available from other departments in your facility as
these are not suitable for short term ECG triggering. Patient Monitoring electrodes are not
suitable for ECG triggering. Recommended electrodes are listed below.
If a different type of electrode is used, there is a risk of errors in gating which could lead to
difficulties in gaining effective diagnosis from the cardiac exams or could even lead to
non-diagnostic results.
Scan Parameters Usage

Before scanning a patient, a cardiac protocol should be created. This saves time setting up a
patient for the cardiac scan. Once the patient preparation is complete, there are four steps
to acquire data for a ECG-gated contrast enhanced cardiac exam.
1. Scout scan

12-26

2. Localizer scan
3. Timing bolus scan
4. Cardiac Helical (SnapShot Segment, SnapShot Burst, SnapShot Burst Plus) or Cardiac
Cine (SnapShot Pulse)
Scout Scan
First, you acquire two scouts with the patient in the feet first supine position at 90 and 180
degrees. Refer to Table 12-6 for the parameters.
Table 12-6 Scout Parameters
Action
Parameters
Gating
On
Start Location
S60
End Location
I300
mA
40
kV
120
Auto Voice
Hyperventilation (You must record this before the

scan.) Have the patient take slow breaths in and
out and one final breath in and hold it. This is
known as hyperventilation.
Localizer Scan
Second, a series needs to be done to localize the heart to identify the level where the
coronary arteries originate and the base of the heart. (A Smart Score - coronary artery
calcium scoring - series can be done in place of the localizer scan.)
Table 12-7 Localizer Parameters
Action
Parameters
Gating
On
Scan Type
Helical
Rotation Time
0.4
Rotation Length
Full
Start Location
One inch below carina
End Location
Apex of heart
Number of images
40

12-27

Action
Parameters
Thickness/Speed
5 mm
Pitch
1.375:1/55 mm per rotation
Interval
5 mm
Gantry Tilt
SFOV
Small or Large
kV
120
mA
60 (100 for large patient)

0
If you are using manual breathing instruction or
autovoice the prep delay will adjust to the length
of the message.
Prep Delay
ISD
N/A
Breath Hold
Single Breath Hold
Breathe Time
Voice Lights Timer
Use Hyperventilation. Have the patient take slow

breaths in and out and one final breath in and hold
it. This is known as hyperventilation. (You will need
to record an auto voice message that provides
appropriate directions to the patient.) Manual
breathing instructions can be used as well.
DFOV
25 cm
Recon Type
Standard
Table 12-8 Smart Score Parameters if using Smart Score

Action
Parameters
Gating
On
Scan Type
Cine
Rotation Time
0.35 seconds (0.4 for standard configuration)
Rotation Length
Segment
Start Location
One inch below carina
End Location
Apex of heart
Number of images
This depends on scan range and number of images

per R-R prescribed.
Thickness/Speed
2.5 mm 8i (20 mm detector coverage)

12-28

Action
Parameters
Pitch
N/A
Interval
20 mm
Gantry Tilt
SFOV
Large
kV
120
mA for 0.35 second
Small Patient 300 mA

Medium Patient 430 mA
Large Patient 450 mA
mA for 0.4 second
Small Patient 250 mA

Medium Patient 375 mA
Large Patient 400 mA
Prep Delay
0 seconds
If using autovoice, prep delay will adjust to the length
of the message.
ISD
1.3 seconds
Breath Hold
Single Breath Hold
Breathe Time
Voice Lights Timer
Use Hyperventilation. Have the patient take slow

breaths in and out and one final breath in and hold it.
This is known as hyperventilation. (You will need to
record an auto voice message that provides
appropriate directions to the patient.) Manual
breathing instructions can be used as well.
DFOV
25 cm
Do not change. This DFOV is required to post process
in SmartView.
Recon Type
Standard
Reconstructions
Segment
Trigger Delay
70 %
Images per R - R Interval
Timing Bolus Scan

Third, a series has to be done to determine the optimum prep delay for the contrast
injection. This is often referred to as a Timing Bolus injection. Refer to Table 12-9 for the
parameters.

12-29

Timing Bolus is the recommended method for determining patient specific contrast flow for
cardiac scanning due to the high degree of confidence needed to capture the arterial phase
imaging at the ideal point in the contrast injection duration. Timing Bolus should be used for
each cardiac exam in order to calculate the contrast arrival time for each individual patient.
GE does not recommend use of SmartPrep for routine use with clinical patient cardiac
scanning.
Table 12-9 Timing Bolus Parameters
Action
Parameters
Gating
On
Scan Type
Axial
Rotation Time
1.0 second
Rotation Length
Full
Start Location and End Location
Aortic root near Left Main Artery Ostium
Number of images
12-15
Thickness/Speed
Pitch
N/A
Interval
Gantry Tilt
SFOV
Small or Large depending on patient size
kV
120
mA
50
Prep Delay
5 seconds
ISD
1.0 second
Breath Hold
Single Breath Hold
Breathe Time
Voice Lights Timer
Hyperventilation (You must record this before

the scan.)
DFOV
25 cm
Suggested Volume/Rate
15-20 cc at 5 cc per second
Recon Type
Standard

12-30
Contrast Enhanced Cardiac Acquisition

In the last step the main cardiac scan is acquired. Use one of the Cardiac scan modes
depending on heart rate and focus of the study. Refer to Table 29-6 for the parameters.
Table 12-10 Cardiac Gated Scan Parameters for 64 slice with 0.35sec gantry rotation speed
Cardiac
SnapShot Pulse
(Cine) Parameters
< - 65 BPM
Cardiac
SnapShot Segment
(Helical)
Parameters
30-74 BPM
Gating
On
On
On
On
Scan Type
SnapShot Pulse
(Cine)
SnapShot Segment
(Helical)
SnapShot Burst
(Helical)
SnapShot Burst
Plus (Helical)
Rotation
Time
0.35 seconds
0.35 seconds
0.35 seconds
0.35 or 0.37
seconds
Rotation
Length
Cine Segment
Cardiac Segment
Cardiac Segment
Cardiac Segment
Start
Location*
One inch below

carina and adjust
the scan time to
cover heart
One inch below

carina and adjust
the scan time to
cover heart
One inch below

carina and adjust
the scan time to
cover heart
One inch below

carina and adjust
the scan time to
cover heart
End Location
End at the apex of

the heart
End at the apex of

the heart
End at the apex of

the heart
End at the apex of

the heart
Thickness
0.625 mm
0.625 mm
0.625 mm
0.625 mm
Pitch
N/A
This is
automatically
selected by the
scanner based on
the heart rate.
Automatic
This is
automatically
selected by the
scanner based on
the heart rate
entered in Heart
Rate Override.
Interval
0.625 mm
0.625 mm
0.625 mm
0.625 mm
Gantry Tilt
SFOV
Cardiac Small
Cardiac Large
Cardiac Small
Cardiac Large
Cardiac Small
Cardiac Large
Cardiac Small
Cardiac Large
kV
120
120
120
120
mA
210-300
210-300
210-300
210-300
Action

Cardiac
SnapShot Burst
(Helical)
Parameters
75-113 BPM
Cardiac
SnapShot Burst
Plus (Helical)
Parameters
> 114 BPM
12-31
Action
(Continued)
Cardiac
SnapShot Pulse
(Cine) Parameters
< - 65 BPM
Cardiac
SnapShot Segment
(Helical)
Parameters
30-74 BPM
Cardiac
SnapShot Burst
(Helical)
Parameters
75-113 BPM
Cardiac
SnapShot Burst
Plus (Helical)
Parameters
> 114 BPM
Prep Delay
20 seconds is the
Default.
Replace with the
value determined
from Test Bolus
doing MIROI
calculation for
peak contrast
enhancement to
optimize Prep
Delay value for this
patient dependent
parameter.
20 seconds is the
Default.
Replace with the
value determined
from Test Bolus
doing MIROI
calculation for
peak contrast
enhancement to
optimize Prep
patient dependent
parameter.
20 seconds is the
Default.
Replace with the
value determined
from Test Bolus
doing MIROI
calculation for
peak contrast
enhancement to
optimize Prep
patient dependent
parameter.
20 seconds is the
Default.
Replace with the
value determined
from Test Bolus
doing MIROI
calculation for
peak contrast
enhancement to
optimize Prep
patient dependent
parameter.
Breath Hold
3 to 5 seconds
before x-ray starts
and continue thru
scan completion.
Typically <10
seconds.
3 to 5 seconds
before x-ray starts
and continue thru
scan completion.
Typically <10
seconds.
3 to 5 seconds
before x-ray starts
and continue thru
scan completion.
Typically <10
seconds.
3 to 5 seconds
before x-ray starts
and continue thru
scan completion.
Typically <10
seconds.
Voice Lights
Timer
Deep breath in,

blow it out, deep
breath in, blow it
out, deep breath in
and hold your
breath don't
breathe. (You must
record this before
the scan.)
Deep breath in,

blow it out, deep
breath in, blow it
out, deep breath in
and hold your
breath don't
breathe. (You must
record this before
the scan.))
Deep breath in,

blow it out, deep
breath in, blow it
out, deep breath in
and hold your
breath don't
breathe. (You must
record this before
the scan.)
Deep breath in,

blow it out, deep
breath in, blow it
out, deep breath in
and hold your
breath don't
breathe. (You must
record this before
the scan.)
Recon Option
SS-40
SS-40
SS-40
SS-40
DFOV
25 cm (adjustable)
25 cm (adjustable)
25 cm (adjustable)
25 cm (adjustable)
Algorithm
Stnd
Stnd
Stnd
Stnd
Suggested
Volume/Rate
75-100 cc at 5cc
per second
75-100 cc at 5cc
per second
75-100 cc at 5cc
per second
75-100 cc at 5cc
per second

12-32

Table 12-11 Hi Res Cardiac Gate Scan Parameters
Cardiac
SnapShot Pulse
(Cine) Parameters
< - 65 BPM
Cardiac
SnapShot Segment
(Helical)
Parameters
30-74 BPM
Gating
On
On
On
On
Scan Type
SnapShot Pulse
(Cine)
Hi Res ON
SnapShot Segment
(Helical)
Hi Res ON
SnapShot Burst
(Helical)
Hi Res ON
SnapShot Burst
Plus (Helical)
Hi Res ON
Rotation
Time
0.35 seconds
0.35 seconds
0.35 seconds
0.35 or 0.37
seconds
Rotation
Length
Cine Segment
Cardiac Segment
Cardiac Segment
Cardiac Segment
Start
Location*
One inch below

carina and adjust
the scan time to
cover heart
One inch below

carina and adjust
the scan time to
cover heart
One inch below

carina and adjust
the scan time to
cover heart
One inch below

carina and adjust
the scan time to
cover heart
End Location
End at the apex of

the heart
End at the apex of

the heart
End at the apex of

the heart
End at the apex of

the heart
Thickness
0.625 mm
0.625 mm
0.625 mm
0.625 mm
Pitch
N/A
This is
automatically
selected by the
scanner based on
the heart rate.
Automatic
This is
automatically
selected by the
scanner based on
the heart rate
entered in Heart
Rate Override.
Interval
0.625 mm
0.625 mm
0.625 mm
0.625 mm
Gantry Tilt
SFOV
Cardiac Small
Cardiac Large
Cardiac Small
Cardiac Large
Cardiac Small
Cardiac Large
Cardiac Small
Cardiac Large
kV
120
120
120
120
mA
350-500
350-500
350-500
350-500
Action

Cardiac
SnapShot Burst
(Helical)
Parameters
75-113 BPM
Cardiac
SnapShot Burst
Plus (Helical)
Parameters
> 114 BPM
12-33
Action
(Continued)
Cardiac
SnapShot Pulse
(Cine) Parameters
< - 65 BPM
Cardiac
SnapShot Segment
(Helical)
Parameters
30-74 BPM
Cardiac
SnapShot Burst
(Helical)
Parameters
75-113 BPM
Cardiac
SnapShot Burst
Plus (Helical)
Parameters
> 114 BPM
Prep Delay
20 seconds is the
Default.
Replace with the
value determined
from Test Bolus
doing MIROI
calculation for
peak contrast
enhancement to
optimize Prep
patient dependent
parameter.
20 seconds is the
Default.
Replace with the
value determined
from Test Bolus
doing MIROI
calculation for
peak contrast
enhancement to
optimize Prep
patient dependent
parameter.
20 seconds is the
Default.
Replace with the
value determined
from Test Bolus
doing MIROI
calculation for
peak contrast
enhancement to
optimize Prep
patient dependent
parameter.
20 seconds is the
Default.
Replace with the
value determined
from Test Bolus
doing MIROI
calculation for
peak contrast
enhancement to
optimize Prep
patient dependent
parameter.
Breath Hold
3 to 5 seconds
before x-ray starts
and continue thru
scan completion.
Typically <10
seconds.
3 to 5 seconds
before x-ray starts
and continue thru
scan completion.
Typically <10
seconds.
3 to 5 seconds
before x-ray starts
and continue thru
scan completion.
Typically <10
seconds.
3 to 5 seconds
before x-ray starts
and continue thru
scan completion.
Typically <10
seconds.
Voice Lights
Timer
Deep breath in,

blow it out, deep
breath in, blow it
out, deep breath in
and hold your
breath don't
breathe. (You must
record this before
the scan.)
Deep breath in,

blow it out, deep
breath in, blow it
out, deep breath in
and hold your
breath don't
breathe. (You must
record this before
the scan.))
Deep breath in,

blow it out, deep
breath in, blow it
out, deep breath in
and hold your
breath don't
breathe. (You must
record this before
the scan.)
Deep breath in,

blow it out, deep
breath in, blow it
out, deep breath in
and hold your
breath don't
breathe. (You must
record this before
the scan.)
Recon Option
VS-40
VS-40
VS-40
VS-40
DFOV
25 cm (adjustable)
25 cm (adjustable)
25 cm (adjustable)
25 cm (adjustable)
Algorithm
HD Stnd
HD Stnd
HD Stnd
HD Stnd
Suggested
Volume/Rate
75-100 cc at 5cc
per second
75-100 cc at 5cc
per second
75-100 cc at 5cc
per second
75-100 cc at 5cc
per second
NOTE: * Start location will need to be adjusted higher for patients who have by-pass graphs.

12-34
Cardiac Series Retro Reconstruction Numbering

Upon reviewing cardiac image series, or as routine processing, additional image sets may
be desired. These image sets can be generated from the existing cardiac scan file using the
Retro Recon option from the left monitor. In Retro Recon, you may adjust items such as the
cardiac phase location, recon location, slice thickness, recon kernel, recon filter, or recon
mode as applicable for the various acquisition types.
Retro reconstruction of cardiac gated data follows a default numbering scheme. If you want
a new series number assigned, click on New Series button otherwise images will be output
as describe below.
Single Phase Image Set
Retro SnapShot Segment Series 104 (100 + original series #)
Retro SnapShot Pulse Series 104 (100 + original series #)
Retro SnapShot Burst-2 Series 124 (120 + original series #)
Retro Snapshot Burst Plus (3 or 4) - Series 144 (140 + original series #)
Retro Snapshot Segment Plus - Series 134 (130 + original series #)
When retro reconstructing a multi phase (MP) data set to the acquired slice thickness the
series numbers are as follows if the original series number is 4.
Multiphase Image Set
Retro SnapShot Segment Series 504 (500 + original series #)
Retro SnapShot Pulse Series 504 (500 + original series #
Retro SnapShot Burst-2 Series 524 (520 + original series #)
Retro Snapshot Burst Plus (3 or 4) - Series 544 (540 + original series #)
Retro Snapshot Segment Plus - Series 534 (530 + original series #)
If images are Retro Reconstructed with a thicker slice, the series number has an additional
50 added on.
Cardiac Images are annotated with either of the following:
SSEG (SnapShot Segment single sector image)
SSEG+ (SnapShot Segment Plus - single sector image)
SSB2 (SnapShot Burst two sector image)
SSB3, or SSB4 (Snapshot Burst Plus - up to three or four sector image)
SSCIN (SnapShot Pulse - single sector image)
SEGM (Ungated segmented image reconstruction)

12-35
ECG Viewer/R-Peak Editor Overview

For Cardiac Helical or Cardiac Cine (SnapShot Pulse) ECG-gated acquisitions, this waveform
is stored during the acquisition and is available for review after the acquisition is complete.
For these gated series types where the scan data is still available on the scanner, Retro
Recon may be used to retrospectively review the gating information in the ECG
Viewer/R-Peak Editor window.
The ECG waveform is read from the ECG trigger (IVY) monitor and requires an Ethernet
connection between the ECG monitor and console to be active to display the trace on the
console. For Cardiac Helical ECG-gated acquisitions, this waveform is stored during the
acquisition and is available for review after the acquisition is complete. For these gated
series types where the scan data is still available on the scanner, Retro Recon may be used
to retrospectively review the gating information in the ECG Viewer/R-Peak Editor window.
The ECG Viewer button in Retro Recon provides R-Peak Editor capabilities to retrospectively
review and edit the triggering information on the ECG waveform. The amount of editing that
may be performed depends on the type of acquisition. There will be more flexibility with
cardiac helical exams due to the continuous X-ray on period than with SnapShot Pulse
exams where x-ray is turned on and off during the scan. Following is a description of the
ECG Viewer/R-peak Editor.
Figure 12-20 R-Peak Editor
1
5
7
8
9
Table 12-12 R-Peak Editor Functions

Number
Function
1
HR Range
Display
Displays patient's heart rate over the duration of the gated

acquisition scaled on a vertical axis.

12-36

Number
Function
2
Heart Rate
Curve
Displays patient's heart rate over the duration of the gated

acquisition on a horizontal axis that shows the changes in
time (seconds).
Trigger
The Red lines indicate the trigger locations.
Location
Areas highlighted in white represent prescribed location of the

percentage R-to-R interval to be reconstructed.
Save
Saves the user modified trigger locations for the acquisition

with exam information.
Restore
Restores the original trigger information for the acquisition.
Measure
Measures in msec the distance between two user defined

points on the waveform.
You can measure via clicking with the mouse and dragging
the mouse right or left on the trace.
Zoom In
Magnifies ECG waveform enabling you to make more precise

modifications if needed.
Zoom Out
Minimizes ECG waveform to enable you to see a larger portion

of the display.

12-37
The following instructions outline methods the user can employ to perform edits or
adjustments to the ECG trigger locations in the Retro Recon with ECG Viewer option
installed. Edits to the trigger information may not be needed for the majority of exams or for
routine use. Edits to the waveform may enable you to override the systems performance
and to reconstruct images using the edited trigger information. The series description for
series reconstructed with edited trigger points is annotated with ECG+ in order to know that
your interpretation of the trigger information was utilized.
Most edits can be made by right clicking with the mouse on the ECG Viewer display and
accessing the right click menu, or by the left click and drag operation.
Figure 12-21 Move Trigger Location
Old
Position
New
Position
Clicking on the R-Peak-trigger and dragging it to the desired position on the trace can move
triggers. R-Peak-triggers can be moved for the x-ray on range of recorded R-Peak-triggers
(x-ray on time).
NOTE: SnapShot Pulse acquisitions have limited X-ray on during the cardiac cycle, which
limit the flexibility to adjust trigger locations. The X-ray on window cannot be
repositioned after the scan is complete. Cardiac Helical (SnapShot Segment,
SnapShot Burst, SnapShot Burst Plus) acquisitions have continuous X-ray on period
throughout the scan duration. They have a higher degree of flexibility to adjust the
trigger points.

12-38

Figure 12-22 Right Click Options
1
2
3
4
Table 12-13 Right Click Options
Right Click
1. Insert Trigger
Inserts a Trigger Location at point on ECG trace
2. Delete Trigger
Removes a Trigger Location from ECG trace
3. Invert Trace
Inverts ECG Waveform for proper orientation
4. Undo
Allows user to undo only last action.

12-39
Insert Triggers
Figure 12-23 Insert Trigger
This is an example of a missing trigger.

Right click and select [Insert Trigger].
This is done to normalize a heart cycle.
Successfully added trigger for missed location.

12-40
Delete Triggers
Figure 12-24 Delete a Trigger
This is an example of an extra trigger.

Right click and select [Delete Trigger].
Successfully deleted trigger from extra location.
Invert a Trace
Figure 12-25 Invert a Trace
Inversion of the trace about the
baseline can be done when the
application is in the default edit
mode.
The trace can be inverted
repeatedly by clicking the invert
button.
You are allowed to edit triggers on
the inverted waveform and save
the triggers.
Inverted waveform are not saved.

12-41
Measure Mode
Figure 12-26 Measure Mode
Measurements can be done on the ECG trace

Measurement mode is enabled by clicking on the measure button.
Allows measurement of time between any two points on the ECG trace.
To measure on the trace, you need to click at a point on the trace and hold the
mouse button down and drag the mouse right or left on the trace.
The time between the point clicked and the current position is shown in real time as
the mouse is dragged. The time is displayed in seconds.
When the mouse is released the time and the "measurement line" is removed from
the trace application.
The mode returns to edit mode.

12-42
Zoom In and Out

Figure 12-27 Zoom In and Out
This enables you to adjust magnification setting of the ECG Trace can be enabled by clicking
on the [Zoom In] or [Zoom Out] buttons.
When the [Zoom In] button is clicked, you can zoom in by a fixed amount in the x direction
only. The [Zoom In] button can be clicked several times until the zoom in maximum is
reached of 5 times the size of the original trace.
When the [Zoom Out] button is clicked, you can zoom out by a fixed amount in the x
direction only. The [Zoom Out] button can be clicked several times until the [Zoom Out]
maximum is reached. The trace is loaded in the maximum zoomed out state.
The scale of the plot is set such that the selected region fills up the entire trace viewport.
You can scroll to any other part of the trace at the selected zoom level.
You can perform all editing of the trace at the selected zoom level.

12-43
How Do I...
This section provides the step-by-step instructions for cardiac imaging acquisitions.
Set Up a Patient
Scan the Patient

Scout Scans
Localizer Scan
Timing Bolus Scans


Insert Triggers
Delete a Trigger
Invert a Trace
Save ECG Trace

12-44
Set Up a Patient
Before bringing the patient in the scan room, make sure that you have everything ready. The
ECG monitor should be plugged in and connected to the gantry with the leads plugged into
the monitor. Have a supply of fresh unexpired ECG electrodes available. Make sure that the
cardiac protocol is built and ready to use. Have the injector loaded with contrast.
NOTE: Use electrodes made with silver/silver chloride (Ag/AgCl) gel on the pad. Do not use
other additional gels. We recommend using the electrodes that are shipped with the
system.
It is recommended to have the patient fast for ~4 hours prior to their appointment
due to the introduction of contrast media in this examination.
In addition the patient should be advised not to consume any caffeine containing
substances for 12 hours prior to the examination. These could raise the heart rate. An
example is coffee.
In order to keep the heart rate as low as possible the patient should also be advised
not to engage in any cardiovascular exercise prior to the examination.
Administration of Beta Blockers and/or Sublingual Nitroglycerin Spray can be used at
the sites discretion.
The key to cardiac imaging is a Stable Heart Rate, ideally less than 5 BPM variation,
but no more than 10 BPM variation for the most successful exams.
Explain the exam to the patient.
1. Load the injector.
For single barrel injector's: Load with 80-100cc of contrast.
NOTE: The total volume and strength of contrast used is the site's discretion.
For dual barrel injector's: Load contrast syringe with 70-90cc of 300 to 350 strength
contrast media.
NOTE: The total volume and strength of contrast used is the site's discretion. Also, load saline
syringe with 50cc Saline. Explain the exam to the patient.
2. Position the patient supine feet first on the cradle.
3. Start an IV line for the contrast injection.
4. Prepare the patient for lead placement.
a) Place arms above patients head.
b) Gently scrub the location with cotton gauze until the skin is a healthy pink.
Do not use alcohol.
c) If necessary, shave a four-square-inch area.

12-45

5. Apply the ECG electrodes and leads to the patient.
Use new ECG electrodes for the cardiac exam. Do not use existing electrodes on the
patient.
Attach the electrodes no more than 5-10 minutes before the scan.
Do not use dry or expired electrodes. They do not properly conduct the signal which
may cause intermittent triggering.
To apply the leads, place them according to Figure 12-29. Try to keep the leads away
from the scan field of view.
Once the leads are connected to the patient, make sure you have a valid ECG wave
and the heart rate is between 30-200 BPM.
Figure 12-28 IVY Monitor Recommended 3 Lead Placement
Alternate Electrode Positions for Signal Clarity for Ivy Monitors

In case of low signal or where QRS Peak is not noticeably stronger than the other ECG Wave
Segments, these alternate positions may improve ECG signal and detection.
Figure 12-29 Alternate Electrode Positions
Electrodes may be placed farther out on the arms or in this alternate position.

12-46

Check to ensure the electrodes are not the wrong type, expired or old
The electrodes need to be radiolucent and have fresh gel (not dried out). They should be
sticky enough to maintain good electrical contact with the skin surface during table motion.
Do not use Patient Monitoring electrodes that may be available from other departments in
your facility. Patient Monitoring electrodes are not suitable for ECG triggering.
Recommended electrodes are listed below.
NOTE: The GE recommended electrodes are Dyna/Trace1500 by ConMed
If a different type of electrode is used, there is a risk of errors in gating which could lead to
difficulties in gaining effective diagnosis from the cardiac exams or could even lead to
non-diagnostic results.
6. Turn on the ECG machine. Make sure there is good connection from the patient to the
ECG monitor and to the gantry and console.
To confirm good gantry connection, check the upper right display area of the monitor
to make sure it indicates Connected.
Figure 12-30 Monitor indicates it is connected
If you do not have a good connection, check to make sure that the cable
connecting the ECG machine to the backside of the Gantry is plugged in properly,
and the same cable is connected to the ECG Machine. In case of low signal, please
check electrode placement and chose alternate position if needed. If there is
"noise" within the ECG wave, it is recommended that you DO NOT SCAN, until this
condition is corrected.
7. Perform an impedance check to make sure that there is no issue with electrode
conductivity with the patient.
If the impedance is good, the value for the lead will be listed in green on the monitor.
If the value is below the acceptable level, the value is shown in red.
If the impedance check does not pass, re-prep and replace any of the electrodes that
do not pass.

12-47

8. Practice hyperventilation breathing instructions with the patient.
A hyperventilation technique is used on all scans prior and during the cardiac scan.
During the practice breath hold, make sure to watch the ECG monitor to determine
the average heart rate during the breath hold.
NOTE: If the patient has difficulty holding their breath for 10 seconds, it may be useful to put
the patient on two liters of oxygen at the physician's discretion. Prior to the Cardiac
Helical scan, have them take in a couple breaths and then perform the
hyperventilation breathing for the scan. Oxygen may also help lower the heart rate
NOTE: It is recommended to have a cardiac voice programmed in the scanner to give
CONSISTENT breathing. When building this voice make sure to breathe your patient
SLOWLY. The breathing instructions should be no shorter than 17 seconds. When
recording the instructions, after you say take a breath in, let it out, take a breath in,
let it out, take a breath in and hold it, make sure to wait for 3-5 seconds (of silence)
prior to clicking on the stop recording button. This will give the patient enough time
to hold their breath before the scan starts and for their heart rate to stabilize before
the scan, otherwise the patient may still be breathing in during the first several slices
which could lead to motion on your images. The Preset Delay in Auto Voice can be
used to add 1-7 seconds additional time prior to x-ray on as need for each patient to
make sure the patient is holding their breath. Typically the patient's heart rate
stabilizes in 3 to 5 seconds.
9. Explain the contrast injection.
Explain to the patient that during the cardiac helical scan, they will be receiving an
injection of contrast material which may make them feel very warm. This warm
feeling is a normal response during the injection.
NOTE: If patient are unaware that during the contrast injection they may feel very warm,
they may become anxious, causing the heart rate to increase beyond the ranges you
have prescribed the scan for.
The injector should only be used by trained personnel.
NOTE: Watch the ECG waveform for irregular heart beat patterns prior to acquiring the scan.
Irregular heart beat patterns can be the cause of degrade image quality.

12-48
Quick Steps: Set Up a Patient

1. Load the injector.
2. Position the patient supine feet first on the cradle.
3. Start an IV line for the contrast injection.
4. Prepare the patient for lead placement.
5. Apply the ECG electrodes and leads to the patient.
6. Turn on the ECG machine. Make sure there is good connection from the patient to the
ECG monitor and to the gantry and console.
7. Perform an impedance check to make sure that there is no issue with electrode
conductivity with the patient.
8. Practice hyperventilation breathing instructions with the patient.
9. Explain the contrast injection.

12-49
Scan the Patient

The following steps assume you have previously built a cardiac protocol. The parameters
were discussed earlier in the chapter. There are four scans series to do.
NOTE: The most accurate display of the heart rate is on the Operators Console.
Scout Scans
This series is scanned to localize the area that you need for scanning the cardiac series. This
description assumes you have selected the appropriate protocol based on the heart rate for
SnapShot Segment, SnapShot Burst, or SnapShot Burst Plus.
1. Landmark the patient at the sternal notch.
2. Click [New Patient] and enter the patient information.
3. Select the Cardiac protocol and accept it.
screen.
Figure 12-31
If the system detects a valid ECG signal, the patient's heart rate average in Beats Per
Minute (BPM) is displayed on the gating button. On the Console, the BPM is a 3 cycle
average of the R-R interval. On the ECG Monitor, the BPM value displayed is a 3 cycle
average for the IVY 3150-B or 3100-B with Ethernet.

12-50

5. To view the ECG waveform, click [ECG Trace].
If the system detects no signal from the ECG monitor, the button turns red and no
BPM value is displayed.
NOTE: Do not attempt to scan without a valid ECG trace.

6. [Confirm] the scout views, hyperventilate the patient.
NOTE: Watch the heart rate during the scan and note the lowest average heart rate.
It is important to give the patient the same breathing instruction for each series. The
patient should be requested to take two breaths in and out (hyperventilate) and to
hold the third breath before the actual scan is acquired. This helps provide a constant
heart rate during the cardiac scan.
Quick Steps: Scan the Patient-Scout Scans

1. Landmark the patient at the sternal notch.
2. Click [New Patient] and enter the patient information.
3. Select the Cardiac protocol and accept it.
screen.
5. [Confirm] the scout views, hyperventilate the patient.

12-51
Scan the Patient
Localizer Scan
This series is used to find your starting and ending locations for the heart.
1. Click [Next Series] from the protocol.
2. Click [Show Localizer] and position the scans so you scan from approximately one inch
below the carina to the apex of the heart.
NOTE: Pay close attention to where the position of the scan is taken. It should cover the
complete heart.
3. Set up Low-Dose helical scan parameters.
120kV, 0.4 sec., 60 mA (100mAfor large patients) 1.375:1 pitch 55 table speed.
4. Click [Accept].
5. Click [Confirm].
6. Give the patient the same breathing instruction that you have practiced with.
7. Press Move to scan.
Quick Steps: Localizer Scan

3. Set up Low-Dose helical scan parameters.
4. Click [Accept].
5. Click [Confirm].

12-52
Scan the Patient
Timing Bolus Scans

This scan series is scanned to figure out the contrast peak enhancement time.
1. Click [Next Series].
2. Place your localizer one centimeter below the carina and just above the base of the
heart.
3. Connect the injector to the patient and arm it.

NOTE: Make sure the injector is set to deliver 15-20 cc of contrast at a rate of 5 cc per second.
The injector should only be used by trained personnel.
4. [Confirm] the timing bolus scans, hyperventilate the patient.
5. Start the injector and press Start Scan at the same time.
NOTE: Watch the heart rate during the scan and note the lowest average heart rate.
When hyperventilating the patient for the timing bolus, it is recommended to instruct
the patient to breath in and out twice. Do not hyperventilate the patient too quickly
or this could raise the heart rate.
Press Start Scan and start the injector at the same time, and then have the patient
take a breath in and hold it.
6. Review the images and using MIROI find out where the peak enhancement occurred.
For more information on how to use MIROI, refer to the Measure Density Readings on
Multiple Images task.
Add 5-8 seconds to the peak enhancement to calculate the prep delay. Once you
have the time to peak enhancement value, add an additional 4 seconds to allow
filling of the distal coronary vessels. This number will be the Prep Delay for the
contrast enhanced cardiac scan.

12-53

Figure 12-32 MIROI graph
Quick Steps: Scan the Patient-Timing Bolus Scans

1. Click [Next Series].
2. Place your localizer one centimeter below the carina and just above the base of the
heart.
3. Connect the injector to the patient and arm it.
4. [Confirm] the timing bolus scans, hyperventilate the patient.
6. Review the images and using MIROI find out where the peak enhancement occurred.

12-54
Scan the Patient

This is the final scan before transferring the images to the Advantage Windows Workstation.
When the scan is complete, you may want to reserve the scan data until the images are
reconstructed and transferred to the workstation. For more information on how to reserve
scan data, refer to the Reserve/Release Scan Data task.
NOTE: Confirm the ECG trace is strong and there are no arrhythmias.
NOTE: Pay close attention to where the position of the scan is taken. It should cover the
complete heart. Be careful not to overscan the area
3. Click [Gating] and the CardIQ SnapShot window opens for Cardiac Helical acquisition or
the SnapShot Pulse window opens for Cardiac Cine acquisitions.

12-55

Figure 12-33 Card IQ Window
The auto detect mode is the default pitch selection method for SnapShot Segment
and SnapShot Burst and automatically set the pitch based on the patient's heart rate
when the scan is confirmed. If you have found that the heart rate is different during
the breath holds, you should enable Heart Rate Override and manually enter a heart
rate value to the minimum hear rate for the HR Range that contains the observed
value. The pitch chart tables in Table 12-15 and Table 12-15 represent an overview of
the pitches available for the various scanner configurations.

12-56

Figure 12-34 SnapShot Pulse Window
Use the default Dynamic Padding value or prescribe a padding value to account for
variation in heart rate during the scan. Padding is prescribed in milliseconds and is
added to either side of the center of the half-scan acquisition window. Turn the
Padding Override button to [On] to enable the Dynamic Padding field to accept
manual entries. The following, Table 12-14, lists the default and recommended
padding values for various heart rate ranges. The range for padding is from 0 to 200
msec.
Table 12-14
Heart Rate (HR) Dependent Padding
HR Range
Milli second Padding
30-39
175
40-49
150
50-59
125
60->
100

12-57

NOTE: Cardiac Small, Medium and Large SFOV can be used with Cardiac Helical and Cardiac
Cine scans. If a Cardiac SFOV is selected dose is computed based on a 32cm phantom.
For Cardiac Small, the default DFOV is 25cm; however, you can select a DFOV up to
32cm. For Cardiac Medium, the default DFOV is 25cm; however, you can select a DFOV
up to 36cm. For Cardiac Large, the default is 25cm; however, you can select as DFOV
up to 50cm.
NOTE: For information on which SnapShot mode to use, refer to SnapShot Mode Usage.
4. If you are going to manually enter the heart rate in SnapShot Segment mode, click [On]
in the Heart Rate Override box.
5. For Cardiac Helical modes, click in the Heart Rate box and type in the heart rate that
you want to use.
For SnapShot Pulse, click in the Dynamic Padding box and enter the amount of
padding you want to use.
This is defaulted [On] in SnapShot Burst Plus mode.
6. If desired, click [Recon 2] and [Recon 3] to enter parameters for a second and third
prospective reconstruction for Cardiac Helical acquisitions.
Recon 2 and Recon 3 are not available for SnapShot Pulse acquisitions.
7. Click the syringe icon and enter the contrast description and amount.
8. Click [Accept].
9. Enter the prep delay that you determined from the MIROI timing bolus scan.
10. Arm the injector with 5cc per second for 75-100 cc.
11. Click [Confirm].

12-58

Table 12-15 Pitch Chart for Discovery CT750 HD 64 slice for gantry rotation of 0.4 second.
Discovery CT750 HD 64 with maximum 0.35 sec./rotation gantry speed
HR Range
Gantry Speed
Recon/Scan Mode
Pitch
30-40 BPM
0.35
SnapShot Segment (SSEG)
0.16
41-49 BPM
0.35
0.18
49-57 BPM
0.35
0.20
58-65 BPM
0.35
0.22
66-74 BPM
0.35
0.24
75-85 BPM
0.35
SnapShot Burst (SSB)
0.20
86-95 BPM
0.35
0.22
96-113 BPM
0.35
0.24
114+ BPM
0.35
SnapShot Burst Plus (SSB+)
0.20
Table 12-16 Pitch Chart for Discovery CT750 HD 64 slice with 0.4 second gantry rotation
speed
Discovery CT750 HD 64 with maximum 0.40 sec./rotation gantry speed
HR Range
Gantry Speed
Recon/Scan Mode
Pitch
30-42 BPM
0.40
0.18
43-49 BPM
0.40
0.20
50-59 BPM
0.40
0.23
60-69 BPM
0.40
0.26
70-80 BPM
0.40
0.20
81-94 BPM
0.40
0.22
95-104 BPM
0.40
0.20
105+ BPM
0.40
0.20

12-59
Quick Steps: Scan the Patient-Contrast Enhanced Cardiac Scan

3. Click [Gating] and the CardIQ SnapShot window opens for Cardiac Helical acquisition
or the SnapShot Pulse window opens for Cardiac Cine acquisitions.
4. If you are going to manually enter the heart rate in SnapShot Segment mode, click
[On] in the Heart Rate Override box.
5. For SnapShot Pulse, click in the Dynamic Padding box and enter the amount of
padding you want to use.
6. If desired, click [Recon 2] and [Recon 3] to enter parameters for a second and third
prospective reconstruction for Cardiac Helical acquisitions.
7. Click the syringe icon and enter the contrast description and amount.
8. Click [Accept].
9. Enter the prep delay that you determined from the MIROI timing bolus scan.
10. Arm the injector with 5cc per second for 75-100 cc.

12-60

A cardiac scan is acquired throughout a patients R to R interval. This gives you the ability to
reconstruct the cardiac images at any phase of the R to R interval. If you would like to
reconstruct an image at different phase than what the image was acquired in, use the
following steps. To learn how to use Retro Recon, refer to the Managing Scan (Raw) Data
chapter.
1. Enter all the parameters for Retro Recon.
2. Click [Phase].
The phase window opens.

Figure 12-35 SnapShot Segment, SnapShot Burst, and SnapShot Burst Plus Phase Percent
Phase Entry allows you to change the percentage of R-to-R interval by entering in a
start and end phase and the phase increment. The recommended reconstruction

12-61

phases are 70 and 80% (with a 5% increment), but you can change the phase from 0
to 99%.
NOTE: If you are doing a functional imaging exam to acquire the ejection fraction and wall
motion, you should prescribe phases from 5 to 95 in phase increments of 10%.
NOTE: If you are doing a functional study for wall motion or ejection fraction, you may want
to reconstruct the data as 1.25 mm thick images.
Figure 12-36 SnapShot Pulse Phase Percent
Lists common
phases available for
reconstruction
This area displays
the phase ranges
covered for each
scan location in the
SnapShot Pulse
scan series.
Multiple scan
locations are
required to cover
the heart and each
may cover a unique
phase range if
heart rate
variations occur.
NOTE: You can only enter start and end phases within the acquired phase range displayed
in the SnapShot Pulse window.
3. Adjust the trigger points in the ECG waveform using R-Peak Editor in the ECG Viewer
window as needed.
For more information, refer to SEGM (Ungated segmented image reconstruction).

12-62

4. Check window level settings and filter settings in the Recon Options field.
For more information, refer to: Set Display Factors.
5. Click [Accept].
NOTE: Cardiac images are going to be produced routinely at 75% of the R to R interval. This
location displays the cardiac anatomy and vessels well. You might feel the right
coronary artery has too much motion at 75% and would like to reproduce the images
at end of systole (around 40% - 55% with 5% increments).
Quick Steps: Reconstruct Cardiac Scans

1. Enter all the parameters for Retro Recon.
2. Click [Phase].
3. Adjust the trigger points in the ECG waveform using R-Peak Editor in the ECG Viewer
window as needed.
4. Check window level settings and filter settings in the Recon Options field.
5. Click [Accept].

12-63
Save ECG Trace

Use this feature if you wish to save the ECG trace to a CD.
NOTE: You can save entire list of the most recent 500 ECG files to CD-Rom.
1. Click on the Image Works desktop.
2. Click on [Save ECG Traces] from the tool chest area.
This is located in the upper right corner of the display monitor.
A message appears.
3. Insert a blank CD-Rom in either of the DVD drives.

4. Click on [New Series Number] as needed.

12-64

5. Click [OK].
Wait for the next message to pop-up.
6. Remove the disk from the drive.
Quick Steps: Save ECG Trace

1. Click on the Image Works desktop.
2. Click on [Save ECG Traces] from the tool chest area.
3. Insert a blank CD-Rom in either of the DVD drives.
5. Click [OK].
6. Remove the disk from the drive.

12-65
The following instructions outline methods the user can employ to perform edits or
adjustments to the ECG trigger locations in the Retro Recon with ECG Viewer option
installed. Edits to the trigger information may not be needed for the majority of exams or for
routine use. Edits to the waveform may enable you to override the systems performance
and to reconstruct images using the edited trigger information. The series description for
series reconstructed with edited trigger points is annotated with ECG+ in order to know that
your interpretation of the trigger information was utilized.
Most edits can be made by right clicking with the mouse on the ECG Viewer display and
accessing the right click menu, or by the left click and drag operation.
1. From the scan monitor, click [Retro Recon].
The Retro Recon list select screen appears. All images with available scan data are
listed.
2. From the Retro Recon list select screen, select the appropriate patient, exam, and series.
The most recently scanned examination are at the top of the list.
The Retro Recon view/edit page appears, showing all of the scan parameters
available for retro reconstruction.
3. Click [Select Series].
5. Click [Retro] for all groups or click [Y] for an individual group.
If you select [Retro], a pop up window appears. Choose [Yes] or [No]. You may also
click on the individual group and toggle between [Y] and [N].
The system assumes all available data is to be reconstructed. If there are multiple
groups, you must determine which group(s) has data you wish to reconstruct.

12-66

Figure 12-37 Retro Recon Window
6. As needed, enter Retro Start and Retro End locations.

The locations must fall within the range of the selected group and must have S or I
designation.
Cine scans use the time range for the start and end locations and do not require the
S or I designations.
7. As needed, click [Image Thickness].
If you select [Image Thickness], a pop up window appears where you can then enter
the thickness. This changes the thickness in all groups. If there is only one group in
which you wish to change the thickness, or only one of multiple groups, you may
select the thickness area for that group.
The original detector configuration at which the patient was scanned affects how
you can change the slice thickness. The thickness in black is available for
reconstruction.
NOTE: For more information on detector configurations, refer to Multi-Detector Information
chapter.
8. As needed, click [Image Interval].
If you select [Image Interval], a pop up window appears where you can then enter
the interval. This changes the interval in all groups. If there is only one group in which
you wish to change the interval, or only one of multiple groups, you may select the
interval area for that group.
Interval is dependent on scan type of the group. Helical is image interval and Cine is
time interval. Axial does not apply and is insensitive.
9. As needed, click [DFOV].
System defaults to largest value of DFOV.
Select top button to change all groups or select an individual group.
Enter desired value.

12-67

10. As needed, click [R/L Center].
You are setting the value for Right/Left offset of the image. Right or left value can be
determined by placing the real time cursor in image and the value are displayed in
upper left corner of the image. You may also choose List/Select to highlight the
correct exam and series. All of the values for that series are displayed in the browser
menu.
11. As needed, click [A/P Center].
Same as above step. You are setting the value for anterior or posterior centering.
12. As needed, click [Recon Type].
A pop up window appears with all of the available algorithms from which you can
choose the appropriate algorithm.
For more information on Recon Options, refer to: Set Display Factors.
13. The [Matrix] is shown here for informational purposes only. You cannot change the
matrix size.
14. As needed, click [Recon Option].
The system defaults to a prospective setting. In the case of ECG gated acquisitions,
this setting is Segment.
NOTE: Segmented recon uses a portion of data from the scan rotation, typically centered
according to the prescribed point in time during the ECG cardiac cycle. Segmented
recon provides an improved temporal resolution by using a smaller time window of
data to reconstruct an image. ECG gated segmented recon can help to reduce the
pulsation motion present in the chest and vessels due to the contraction of the heart.
15. Click and drag the R-peak trigger to the desired position.
Clicking on the R-Peak-trigger and dragging it to the desired position on the trace
can move triggers.
R-Peak-triggers can be moved for the x-ray on range of recorded R-Peak-triggers
(x-ray on time).

12-68
Quick Steps: Adjust/Move Triggers

2. From the Retro Recon list select screen, select the appropriate patient, exam, and
series.
matrix size.
15. Click and drag the R-peak trigger to the desired position.

12-69
Insert Triggers
NOTE: Due to the prospectively gated nature of SnapShot Pulse scans, retro-recon is limited
to the data acquired during the scan. Therefore, inserting, adjusting or deleting
R-peak triggers in SnapShot Pulse acquisitions may not improve the gating
effectiveness for the scan.
listed.

12-70

designation.
reconstruction.
chapter.
menu.

12-71

matrix size.
15. Right click on the desired location in the ECG trace to open the pop-up window and
select [Insert Trigger].
Repeat this step as desired.
Figure 12-39 Insert Trigger
This is an example of a missing trigger.

Right click and select [Insert Trigger].
Successfully added trigger for missed location.

12-72

16. Click [Confirm] to generate images.
Quick Steps: Insert Triggers

series.
matrix size.
select [Insert Trigger].

12-73
Delete a Trigger
This is used to remove an extra trigger.
NOTE: Due to the prospectively gated nature of SnapShot Pulse scans, retro-recon is limited
to the data acquired during the scan. Therefore, deleting triggers in SnapShot Pulse
cases may not improve the gating response for these types of acquisitions.
listed.

12-74

designation.
reconstruction.
chapter.
menu.

12-75

matrix size.
select [Delete Trigger].
Figure 12-41 Delete a Trigger
This is an example of an extra trigger.

Right click and select [Delete Trigger].
Successfully deleted trigger from extra location.


12-76
Quick Steps: Delete a Trigger

series.
matrix size.
select [Delete Trigger].

12-77
Invert a Trace
Use this when you need to invert the ECG trace.
listed.

12-78

designation.
reconstruction.
chapter.
menu.

12-79

For more information on Recon Options, refer to:.
matrix size.
select [Invert Trace].
Figure 12-43 Invert a Trace
Inversion of the trace about the
baseline can be done when the
application is in the default edit
mode.
The trace can be inverted
repeatedly by clicking the invert
button.
You are allowed to edit triggers on
the inverted waveform and save
the triggers.
Inverted waveform are not saved.

12-80
Quick Steps: Invert a Trace

series.
matrix size.
select [Invert Trace].

12-81

Use this when you want to save or reset the changes that you have made to the trace.
listed.

12-82

designation.
reconstruction.
NOTE: For more information on detector configurations, refer to chapter.
menu.

12-83

matrix size.
15. Click [Save] or [Reset].
Save saves any changes that you have made to the trace.
16. Reset restores Remove the trace to disk from the original tracedrive.

12-84

Save
Restore


12-85
Quick Steps: Save/Reset Trace Changes

series.
matrix size.
15. Click [Save] or [Reset].

12-86

Use this when you want to measure the trace.
listed.

12-87

designation.
reconstruction.
NOTE: For more information on detector configurations, refer to chapter.
menu.

12-88

matrix size.
15. Click [Measure Mode].


12-89
Quick Steps: Measure Distance on the Trace

series.
matrix size.
15. Click [Measure Mode].

12-90

Use this when you want to zoom in or zoom out on the trace.
listed.

12-91

designation.
reconstruction.
chapter.
menu.

12-92

matrix size.
15. Click [Zoom In] or [Zoom Out].
Figure 12-49 Zoom In and Out

12-93

Quick Steps: Zoom In or Out on a Trace

series.
matrix size.
15. Click [Zoom In] or [Zoom Out].

12-94
Auto Applications (Option)
Chapter 13

Introduction
This chapter explains how to perform some basic tasks for the DirectMPR, and/or Neuro 3D
Filter options. Your system may have one or more of these options. This section contains the
Set the Direct MPR Parameters in the Scan Prescription
Set Neuro 3D filter Parameters in the Scan Prescription

13-1

This section presents concepts necessary to understand ways to perform Direct3D,Direct
MPRand/orNeuro 3D Filter. Some of the concepts you need to understand are:
Direct Multi Planar Reformat (DMPR)
Scanning with DMPR
DMPR Review Controller
DMPR Manual Batch Prescriptions
Neuro 3D Filter
Direct Multi Planar Reformat (DMPR)

Direct Multi-Planar Reconstruction three-dimensional images are used in surgical planning,
assessment of trauma, and CT angiography. They supplement other diagnostic information
and are quite useful in presenting complex anatomy.
Direct Multi-Planar Reformat provides capability to move from the usual 2D image review
mode to a prospective 3D image review mode in the axial, sagittal, coronal, and oblique
planes. DMPR provides opportunity to automatically create batch reformats using
predefined reformat protocols and network reformatted images to selected reading
location reducing total exam time and increasing technologist and radiologist productivity.
DMPR displays images in anatomical orientation where A is at the top, P is at the bottom, R is
on the left and L is on the right. For example, if you have a data set where the patient was
scanned prone, the image display will be automatically flipped to this orientation.
Direct Multi Planar Reformat (DMPR) allows reformat protocols to be prescribed
prospectively in a scan protocol. Productivity is improved by providing real time auto view
display of Oblique, Sagittal, and Coronal images in addition to the axial images. DMPR will be
beneficial for fast review of scan prescription. It can also be used with auto view for trauma
imaging and automated multiplanar reformat protocols. DMPR can be done on each group
separately or the groups can be combined into one DMPR session. To combine groups many
parameters must be identical within each group including:
slice thickness
interval
SFOV
DFOV
scan type
rotation speed
image center
algorithm

13-2

Each group must also be contiguous. DMPR sessions are limited to 2000 images. Additional
protocols can be added using Reformat application on the ImageWorks desktop.
NOTE: Any scans acquired after scanning has completed on the original scan group using
Add group or One More Scan will not be added to the DMPR session. Please remember
to include all of the desired coverage area in the original scan prescription.
Session Setup Window

The Session Setup window is where you can set up the protocols you wish to use and the
parameters for filming. You can also turn Auto Batch, Auto Store, and Auto Transfer on or
off.
Table 13-1 Session Window Parameters
Function
Icon
Description
Start New
Click this to start a new DMPR session.
Combine
Current
Combines the next group with the prior group. Parameters

for the groups to be combined are locked to the current
group prescription.
Off
Turns DMPR off for the series/group.
Single Step
Protocols
This area is where reformat protocols to be used in DMPR

are selected from list of available reformat protocols.
Up to 5 reformat protocols can be selected.
Use Next/Prior arrow buttons to move through the list of
available protocols.
Highlight protocol names and click OK to return to DMPR
Setup.
To remove a protocol from the DMPR Batch Protocol List,
highlight the protocol and then select [Remove Protocol].
NOTE: Remove Protocol only removes a protocol from the
Batch Protocol List, not from the system. Protocols
found in the Batch Protocol List can be modified
permanently in Reformat on Volume Viewer.
NOTE: The protocol name is used as the Series Description
name for any Batch and Auto Batch DMPR series
created.

13-3

Function
Icon
Description
This allows you to define camera, formats, and start
options for filming reformatted images to the Direct film
Composer.
Filming Setup
Automatically creates reformatted images based on the

Batch Protocol List once reconstruction is complete. In
Auto Batch, a special edge detection algorithm is used.
This edge detection algorithm detects the outer edge of
the anatomical structures and sets the reformat range
based on the object size and the window width (WW) and
window level (WL) of the images.
Set an appropriate WW and WL value for the image set.
Too narrow of a WW and WL may clip data and too wide
of a WW and WL may create blank images.
Auto Batch
NOTE: You will not have the ability to set the localizer lines
on the reference image.
Allows you to set up a protocol so the system will
automatically archive reformatted images to the default
archive device selected for the system after they are
created.
Auto Store

Select [On] to enable this feature or [Off] to disable the

feature.
13-4

Function
Icon
Description
Allows you to set up a protocol so the system will network
the formatted images to desired network location. Up to
four remote hosts can be selected. Use [Apply All] to copy
selected list of host to all the protocols prescribed.
Auto Transfer
Scanning with DMPR

Once DMPR setup is complete and confirm is selected, the DMPR session button will be
displayed in the display control area and the DMPR AutoView layout will become active after
4 images have been reconstructed. The DMPR layout will replace the currently selected
AutoView layout. The upper left viewport is used to display an Oblique image or the Auto
Film viewport accessed via the page turner (Figure 12-4).
In the DMPR AutoView layout display, an oblique image is displayed in the upper left
viewport, axial in the upper right viewport, sagittal in lower left viewport and coronal in the
lower left viewport.
During acquire mode for DMPR, you can interact with the oblique, sagittal and coronal
viewports by using the crosshair cursor. Click and drag in the viewport or use the review
controller.
NOTE: You will not be able switch to another auto view layout until reconstruction for the
DMPR session is complete. To review images for another exam while images are being
reconstructed, go tot the Image Works desktop and use the Viewer.

13-5

Figure 13-1 DMPR Viewer
Page Turner

13-6

To switch displays, click on Auto View or Review layout button, to switch back to DMPR click
on DMPR Icon.
AutoView
Review Layout
Buttons
DMPR Icon
DMPR Review Controller

The DMPR Review Controller provides means to interact with the DMPR model. The review
controller supports review and paging of the images, measurements and roam/zoom
capabilities. See Figure 12-5 for a description of all the icons.

13-7

Figure 13-2 Review Controller
2 3 4
6 7 8
10 11
12
Table 13-2 Review Controller Description

Function
1
Icon
Minimize
Zoom
Description
Clicking on this icon to minimize the review
controller around the image viewport.
This allows you to fit your images in the
viewport by making the images larger or
smaller as needed. Once you have made an
image larger or smaller, all of the images in the
series are displayed in the same adjusted size.
NOTE: This is a right mouse key function.
Pan/Roam
This allows you to pan/roam your images in the

viewport by clicking and dragging. Once you
have made an pan/roam an image, all of the
images in the series are displayed in the same
place.
NOTE: This is a right mouse key function.

13-8

Function
Icon
Description
Display Normal
Clicking display normal icon to return the

image to the original scan parameters.
Render Mode
Clicking on the pull down menu. You can select

between Average, MIP, and Min IP render
modes.
The default rendering mode is Average,
meaning it provides the average density
values of the slice taken along lines
perpendicular to it.
If you click MIP, meaning maximum intensity
projection, the image changes to display the
maximum density value of the slice taken
along lines perpendicular to it.
If you click Min IP, meaning minimum
intensity projection, the image changes to
display the minimum density value of the
slice taken along the lines perpendicular to it.
Measurements
Clicking on the pull down menu to select from

multiple tools in order to place measurements
on an image.
Screen Save
Screen Lock
Cine Paging Speed
This allows you to select the speed and

direction at which the images cine page.
Loop
Clicking Loop as the images play through the

cine loop they will start at the first image and
go to last image and continues to repeat in this
order until stopped.
Rock
Clicking Rock as the images play through the

cine loop. The images start at the first image
and scroll through to last image and then from
the last image back to the first image. This
repeats back and forth until stopped.
10
11

13-9

Function
12
Icon
Scroll Images
Description
Clicking and dragging up and down on the
middle of the slider. The images will scroll within
the series.
Click and drag on the outside bar of the slider
to change the slice thickness of the images
being displayed.
DMPR Manual Batch Prescriptions

Manual prescription of batch protocols can be done by not selecting auto batch. Once the
images have completed reconstruction click [Start Direct MPR Review] button at the
bottom of the left margin of the right monitor.
Figure 13-3 Enter DMPR Review
NOTE: Slider bar underneath represents the status of Auto Batch.

To toggle back to autoview, click on Autoview Layouts icon.
Figure 13-4 Autoview Layout Icon
NOTE: The right screen display can toggle between DMPR and 2D display. The focus outline
around the DMPR or Layout buttons will indicate the display which is currently active.
To toggle back to DMPR, click on [Continue Direct MPR Review].
Figure 13-5 Continue Direct MPR Review

13-10

Figure 13-6 Direct MPR BatchRx window
Protocol- preselected protocols from DMPR
setup in scan protocol will be listed here. *
Mode - Whether you have a cube on the oblique
viewport to move Oblique image or a Rotation
line on the axial, sagittal, and coronal images to
rotate the oblique image.
Thickness - The slice thickness of the manual
batch protocol.
Spacing between views - The interval of the
manual batch protocol.
FOV - The field of view for the manual batch
protocol. The axial FOV is based off the DFOV
and the sagittal and coronal is based off the
Z-axis length.
Number of Views - The number of images
that will be created in the manual batch
protocol.
Render mode:
Average - average intensity pixel
Min-IP - minimum intensity pixel
MIP - maximum intensity pixel
Preview - Ability to preview the images that
will be created in the manual batch protocol.
Save - Ability to save the images that will be
created in the manual batch protocol to the
system disk
Film - Ability to auto film that images that will
be created in the manual batch protocol.
Store - Auto stores batch to MOD.
Transfer - Auto Transfer images to Host
defined in DMPR set up.
Show - Shows reference image of batch
building.
Apply - Will initialize the preview, save, film of
the manual batch protocol.
Pause - Will pause the preview of the batch
images.
Stop - Stop the preview of the batch images.
NOTE: * The protocol name is used as the Series Description for any Batch and Auto Batch
DMPR series created.

13-11
Neuro 3D Filter
Neuro 3D Filter is a noise reduction filter optimized for thin slice data that is intended for
post processing in Reformat to create Average and MIP images, Volume Rendering and 3D
models for Neurological studies such as Circle of Willis, Carotids, Sinuses, Orbits, Mandible
and helical Brain. The Neuro 3D Filter can be used to reduce noise in images or reduce dose
while maintaining image quality. It may be possible to reduce dose by 10-30% and maintain
acceptable image noise level and image quality depending on the level of filtering selected.
Neuro 3D Filter removes noise from the image while preserving image resolution.
Retrospectively, Neuro 3D Filter is selected in the Browser on Image Works desktop. There
are three levels: Low, Medium and High. Images processed using Low are saved in a series
that is the original series number plus 30. Images processed using Medium are saved in a
series that is the original series number plus 40. Images processed using High are saved in a
series that is the original series number plus 50.
Neuro 3D Filter is only compatible with series that have a single group without repeated
image locations. It is not possible to select a subset of a series. A message will be displayed if
the series is not compatible with Neuro 3D Filter. Neuro 3D Filter is not compatible with ASIR.
Figure 13-7 Incompatibility Message
Figure 13-8 Invalid Data set Message
A minimum of three images are required for Neuro 3D Filter.

13-12
How Do I...
This section provides the step-by-step instructions for performing Auto Applications.

13-13
Set the Direct3D Parameters in the Scan Prescription

The Direct3D feature allows automatic display of volume rendered images from the 2D
images obtained from an axial or helical series. To implement this feature, Direct3D
parameters are set along with the other scan parameters in the scan prescription.
If your scan prescription contains multiple groups, Direct3D can be done on each group
separately or the groups can be combined into one Direct3D session. To combine groups
many parameters must be identical within each group including the slice thickness, interval,
SFOV, DFOV, scan type, rotation speed, image center, algorithm and peristaltic on or off. Each
group must also be consecutive. The maximum number of images per Direct3D session is
500.
NOTE: Direct3D can be turned ON and built into a protocol using Protocol Management.
Quick Steps: Set the Direct3D Parameters in the Scan Prescription

1. To set up Direct3D in the scan prescription, click the Recon tab on the view/edit screen,
then click [Off] under AutoApps.
2. A second pop up window appears with Session Type choices. Click [Direct 3D], and
[OK].
3. Click [Start New] to start a new Direct3D session.
4. For subsequent groups, you may choose [Combine Current] to add another group to
the current Direct3D session, or you may choose [Start New] again to start another
new Direct3D session.
5. To turn Direct3D off, click [Off].

13-14
Select Preset Curves for Direct3D

To perform Direct3D, volume rendering curves needs to be set prior to scanning. These
curves set opacity and color intensity values for rendering and there are specific curves that
can be used for each exam type or body part. The more curves that are selected initially, the
more flexibility you have when reviewing the Direct3D model.
Quick Steps: Select Preset Curves for Direct3D

1. On the Direct3D Setup screen, after selecting Start New or Combine Current, select
one of the Preset Curves or click [Unused].
2. On the Direct3D Curves Selection screen, click the curve(s) desired for the current
exam.
3. If you wish to remove a curve you have selected, click on the Direct3D Setup screen.
The Curve Selection window opens, and click [Remove Curve].
4. Under the Default column heading, click the default box to the left of the curve on the
Direct 3D Setup screen that you would like to be the default curve.
5. Opacity Index allows you to shift the center of the Direct3D curve along the CT number
scale. To set the opacity index, click the box next to the name of the curve desired and
type in a value.

13-15
Select Rendering Control Selections on the Direct3D

Setup Screen
There are several rendering control selections (image display factors) which can be set for
Direct3D.
Quick Steps: Select Rendering Control Selections on the Direct3D

Setup Screen
1. To set a Zoom Factor, click the box next to Zoom Factor and type in a value.
2. To set the Horizontal View Angle, click the box next to Horizontal View Angle and type
in a value.
3. To set the Vertical View Angle, click the box next to Vertical View Angle and type in a
value.
4. To set the Resolution, click the button below the Resolution heading. The button is a
toggle between Enhanced or Standard.
5. To set FOV Auto Scale, click the button below the heading to toggle between Yes and
No.
6. To set the Bounding Box, click the button below the heading to toggle between Yes
and No.
7. To set the User Annotation Level, click [Full], [Partial] or [None].
8. When you are ready to leave the Direct3D Setup screen, click [OK] to register your
selections or [Cancel] to exit without changes.

13-16
View Direct3D in the Review Mode

Direct3D builds a volume rendered session as the 2D images that make up the Direct3D
volume are reconstructed. In ExamRx Autoview, you can view the Direct3D volume after at
least four slices from the scan have been reconstructed.
Quick Steps: View Direct3D in the Review Mode

1. Click the page turner icon that is in the lower right corner of the upper right viewport.
2. On the bottom of the ExamRx display screen, click [Start Direct3D Review].
3. Change any desired parameters from the Interactive Review screen.
4. Selecting [Complete Model] from the Interactive Review screen returns the model to
the acquire mode and adds images to the model that have been reconstructed since
the interactive review session was started.

13-17

The DirectMPR (DMPR) feature allows automatic display of the images from a helical or axial
series in a 3D autoview format instead of a 2D autoview format. In DMPR, user can select a
set of reformat protocols to automatically or manually create reformatted images once
reconstruction is complete for the series.
If your scan prescription contains multiple groups, Direct MPR can be done on each group
separately or the groups can be combined into one DirectMPR session. To combine groups
many parameters must be identical within each group including the slice thickness, interval,
SFOV, DFOV, scan type, rotation speed, pitch, image center and algorithm. The maximum
number of images per DirectMPR session is 2000.
NOTE: Any scans acquired after scanning has completed on the original scan group using
Add Group or One More Scan will not be added to the DMPR session. Please
remember to include all of the desired coverage area in the original scan prescription.
Quick Steps: Set the Direct MPR Parameters in the Scan Prescription
1. Click on the Recon Tab.
2. Click [Off] in the Auto Apps column.
3. Click [DMPR].
4. Click [OK].
5. Click [Start New] to start a new DirectMPR session.
6. Click [Unused].
7. Click Next and Prior arrows to review all protocols in the list.
8. Click on the reformat protocols you wish to select.
9. Click [OK].
10. Click [Setup] to select the film composer format for filming.
11. Click [OK].
12. Click [Off] under Filming.
13. Click [Off] under Auto Batch.
14. Click [Off] under Auto Store.
15. Click [Off] under Auto Transfer.
16. Click [OK].

13-18

The Neuro 3D Filter is a noise reduction filter which can improve image quality for noisy
images or provide equivalent image quality at lower techniques and thus lower dose to the
patient. Neuro 3D will create a filtered series automatically once normal reconstruction is
complete for a series. The filtered series will be installed in the database and can be
networked to up to 4 destinations.
Quick Steps: Set Neuro 3D filter Parameters in the Scan Prescription

1. Click on the Recon Tab.
2. Click [Off] in the Auto Apps column.
3. Click [Neuro 3D].
4. Click [OK].
5. Select the desired host.
6. Click [OK].

13-19
Performed Procedure Step (PPS) (Option)
Chapter 14
Performed Procedure
Step (PPS) (Option)
Introduction
This chapter explains how to use the Performed Procedure Step (PPS) option. It contains the
Use Performed Procedure Step (PPS)

14-1

This section presents the concept necessary to understand Performed Procedure Step (PPS).
The concept you need to understand is:
Performed Procedure Step (PPS)

Performed Procedure Step is an OPTION. To use it you need a HIS/RIS system and PACS with
the Connect Pro option. It communicates to PACS and HIS/RIS that you have completed a
procedure. It improves transfer of data because it can provide a complete message when all
data has been transferred. The browser has a PPS column that lists the PPS status of each
exam. There are three states of exam status: COMP which means the exam is complete;
DISC which means the exam is discontinued and it cannot use PPS again; or INPR, which
means that the exam is still in progress.

14-2
How Do I...
This section provides the step-by-step instructions for utilizing the Performed Procedure
Step (PPS) feature. Specifically, it describes how to:

14-3

procedure. It improves transfer of data to PACS because it can provide a complete message
when all data has been transferred. The browser in Image Works has a PPS column that lists
the PPS status of each exam. There are three states of exam status: COMP, meaning the
exam is complete; DISC, meaning the exam is discontinued and it cannot use PPS again; or
INPR, which means that the exam is still in progress.
Quick Steps: Use Performed Procedure Step (PPS)

1. When an exam is completed, click [End Exam].
2. Click [Complete], [Discontinue], or [Defer].
3. If you chose to [Defer] the exam and the exam is completed, select the [Image Works]
desktop, select the exam from the browser list, then click [PPS] from the top of the
browser, and click [Complete] or [Discontinue] from the pop up window.

14-4
Exam Split (Option)
Chapter 15
Exam Split (Option)

Introduction
This chapter explains how to use the Exam Split (Option). It contains the step-by-step
instructions to help you learn how to:
Perform an Exam Split After a Scan is Completed
Using ConnectPro with Exam Split

15-1
Exam Split (Option)

This section presents the concept necessary to understand Exam Split (Option). The concept
you need to understand is:
Exam Split
Virtual Mode
Hard Mode
Exam Split
Provides you with the capability to "split" a series of patient images into separate groups.
These new smaller image groups can be networked to desired reading stations for multiple
"reads" and multiple billings on select patient exams.
Using the Exam Split option will allow for split images from a single acquisition and assign
them to a Requested Procedure ID or accession number retrospectively. On the ImageWorks
desktop using Exam Split, all the images of the scan will be loaded. Using left mouse key to
select the first image and shift, left mouse key simultaneously to choose the last image to
be sent to a specific exam procedure.
At scan time all Patient records that you wish to have available to split to must be selected
from the Patient Schedule when selecting New Patient. Your system will be configured in
one of two modes for Exam Split. The mode configured is dependent on the capabilities of
the system you are sending images to review.
Exam Split requires that the Connect Pro option be installed.
Virtual Mode
Your remote station must support Performed Procedure Step (PPS) and Gray Scale
Presentation State (GSPS). Images will be Auto Transferred to the Remote station. In Exam
Split ranges of images will be assigned to each accession number or procedure code and a
Gray Scale Presentation State (GSPS) object will be created and transferred when selected.
Hard Mode
Hard Exam Split will create a new series of images for each accession number or procedure
code ranges of images are assigned to. For this reason images will not be Auto Transferred
to the Remote Station.
Your GE Field Engineer will configure your site for the mode of Exam Split based on input
from your sites IT and PACS administration.

15-2
Exam Split (Option)

Figure 15-1 Exam Split window
Screen Format choices
See bottom blue square

Window/Level choices
Add or Delete Series
Select or Configure host
Comment Area
Hilight a range of images and click [Add], [Delete],

or [Delete All].
These layout buttons define how you want your
primary port displayed.
Procedure code list
Send or Click Browser to cancel and return to

Image Works
List of Requested Procedure ID or Accession Numbers

selected for the patient.

15-3
Exam Split (Option)
How Do I...
This section provides the step-by-step instructions for utilizing the Exam Split (Option).

15-4
Exam Split (Option)

Exam Split provides users with the capability to "split" a series of patient images into
separate groups and assign the groups of images to Requested Procedure ID or Accession
Numbers. These smaller groups of images can be used for multiple reads and multiple billing
for certain types of exams such as a Chest, Abdomen and Pelvis where there are multiple
procedures where multiple doctors will read a portion of the data.
1. Complete an exam with multiple Requested Procedure ID or Accession Numbers have
been selected.
2. Select the ImageWorks desktop.
3. Click on the exam you wish to split.
4. Select the series to split.
5. Click [Exam Split] from the side of the Browser.
The Exam Split menu will appear with the selected images displayed in the upper
viewports. The system may display every image or skip some images depending on
the total number of images selected.
If the exam you selected does not have Multiple Procedures, a dialog will be posted
and Exam Split will exit.
You must select all procedures you wish to split up front when scanning is done. You
cannot add them after the fact.

15-5
Exam Split (Option)

6. Select the images to be grouped together for a procedure.
Click to select first image and shift and click on the last image for the desired range
of images per procedure code.
7. Select desired Requested Procedure ID or Accession Number from the available list
which reflects the procedures selected from Patient Schedule for New Patient.
This is from the list of exams registered to this patient from ConnectPro.

15-6
Exam Split (Option)

8. Select the receiving host from the Host Config pull down.
Host Selection will show GSPS if configured in VES mode and HES if configured in HES
mode.
VES Mode
HES Mode
9. Adjust the Window Level if needed.
Set the window/level for the images using the mouse or W/L preference buttons.
10. Click [Add].
The images will be added to the procedure list.
11. Hilight the procedure or procedures you wish to send and click [Send].
Repeat until you have sent all procedures you have images added to.
The images are transferred to the desired host.
If the system is configured for VES, a GSPS object is sent to the remote station. If HES
mode is configured, a new series of images will be sent to the remote hosts.
You can select more than one procedure if you are sending them to the same
destination.
You can select the Browser to exit Exam Split before the images have completed
transferring. A pop up message will display after the transfer is complete.

15-7
Exam Split (Option)
Quick Steps: Perform an Exam Split After a Scan is Completed

1. Complete an exam with multiple Requested Procedure ID or Accession Numbers have
been selected.
2. Select the ImageWorks desktop.
3. Click on the exam you wish to split.
4. Select the series to split.
5. Click [Exam Split] from the side of the Browser.
6. Select the images to be grouped together for a procedure.
7. Select desired Requested Procedure ID or Accession Number from the available list
which reflects the procedures selected from Patient Schedule for New Patient.
8. Select the receiving host from the Host Config pull down.
9. Adjust the Window Level if needed.
10. Click [Add].
11. Hilight the procedure or procedures you wish to send and click [Send].

15-8
Exam Split (Option)

Using the ConnectPro option will allow for split images from a single acquisition and assign
them to a Requested Procedure ID or accession number retrospectively.
NOTE: When multiple accession numbers are selected, the last accession number will be
displayed on the image.
1. Select [New Patient].
This is located at the bottom of the left monitor.
2. Click [Patient Schedule].
The patient schedule list is displayed.

15-9
Exam Split (Option)

3. Select all of the patient exams.
You can do this by holding the ctrl key down while clicking on the different exams.
This will supply the accession numbers that is used for Exam Split after the images
have been reconstructed.
The last Patient record selected is the Exam Description displayed on the New Patient
Screen.
Up to 15 procedures can be selected.
4. Click [Select Patient].
Quick Steps: Using ConnectPro with Exam Split

1. Select [New Patient].
3. Select all of the patient exams.

15-10
SmartStep (Option)
Chapter 16
SmartStep (Option)
Introduction
SmartStep is a mode of scanning designed for interventional procedures. The Radiologist or
Physician usually inserts a needle or catheters into a patient and then need to see images
showing the position of the catheter or needle.
This chapter explains the SmartStep imaging process. It contains the step-by-step
Prepare for SmartStep
Set Up SmartStep Mode
Scan with SmartStep
Display SmartStep Images
Set Window/Level Presets for the HHC

16-1
SmartStep (Option)

This section presents the concepts necessary to successfully complete the Interventional
Imaging process. Specifically you need to understand:
SmartStep
Hand Held Controller (HHC)
SmartStep Display
SmartStep
SmartStep is a mode of scanning designed to be use by the Radiologist or Physician during
interventional procedures. The SmartStep is accomplished by using the integrated Hand
Held Controller (HHC) and foot switch.
The available slice thicknesses of SmartStep are: 2.5 mmand 5 mm. These are created from
using a 4X detector configuration. Detector rows one and two create image one. In the case
of 2.5 slice thickness, detector rows one, two, three, and four create image one. Detector
rows three, four, five and six create image two. Detector rows five, six, seven and eight
create image three. The configuration for 2.5 mm slice thickness is the 8 - 0.625 5 mm beam
collimation. The configuration for 5 mm slice thickness is the 16 - 0.625 10 mm beam
collimation. detector configuration.
Only the 0.8 second and 1 second full rotation scan times are available for SmartStep on
Discovery CT750 HD. All algorithms are available for reconstructions.

16-2
SmartStep (Option)
NOTE: Other desktops are unavailable during SmartStep.
Hand Held Controller (HHC)

During needle biopsies, the Radiologist or Physician controls radiation with the foot switch,
and uses HHC to view images on an in-room monitor. The HHC also provides alignment
light, move-to-scan and cradle micro positioning controls. The Radiologist or Physician also
has the option to release HHC control of the cradle, and use the cradle handle to manually
position the patient in the scan field of view.

16-3
SmartStep (Option)
Figure 16-1 Hand Held Controller
Alignment Light
Prep
Move to Start Location
Cradle Move In
Cradle Move Out
Bump In
Bump Out
Disabled
Cradle Release
Change Focus
Next Image
Prior Image
W/L Toggle
Table 16-1 Hand Held Controller Button Descriptions

Button Name
Prep
Button
Description
Prepares the system for x-ray acquisitions.

16-4
SmartStep (Option)
Button Name
Alignment Light
Move to Start
Location
Button
Description (Continued)
This button Enables the laser positioning lights.
This button positions the cradle to the start

location prescribed by you in the SmartStep
View/Edit screen.
Cradle Move In
The Cradle Move In button moves the cradle in

towards the gantry.
Cradle Move Out
The Cradle Move Out button moves the cradle

away from the gantry.
Bump In
Bump Out
Disabled
This moves the cradle a pre-defined bump

distance towards the gantry. The bump distance is
pre-defined on the View/Edit screen.
This moves the cradle a pre-defined bump
distance away from the gantry. The bump
distance is pre-defined on the View/Edit screen.
This button is disabled. It is not used for

SmartStep.
Cradle Release
This is a toggle button. It releases the cradle so it

can be moved using the cradle handle. Pressing
the button again latches the cradle.
Change Focus
This changes the primary focus window between

the interventional viewports and the free viewport.
Next Image
This displays the next image in the sequence of

images.

16-5
SmartStep (Option)
Button Name
Button
Description (Continued)
Prior Image
This displays the prior image in the sequence of

images.
W/L Toggle
This toggles between six different window level

settings.
SmartStep Display
SmartStep display provides three viewports for interventional images on the top of the
display window with a free viewport at the bottom of the display window. The free viewport
allows you to choose any image to be displayed by clicking on [List/Select]. The three
interventional viewports automatically update each time an exposure is made with the foot
pedal.
Figure 16-2 SmartStep window
First Image
Second Image
Third Image
Free Viewport
NOTE: Images in the interventional viewport are displayed superior to inferior in location.
NOTE: If images are not available after a step, the viewport will be blank. Use Prior image
on the Hand Held Control and then press Next image to display the missing images.

16-6
SmartStep (Option)
The Remaining time indicates how much time you have left in this series before you have to
go back to the View/Edit screen and click [Confirm] again. The Accumulative time indicates
how much time the patient has been exposed to radiation. This time will keep updating as
long as you stay in the same exam. Once you end the exam, the accumulative time resets to
zero.
NOTE: The total accumulated exposure time for all SmartStep scan groups and Series will
be displayed on the Dose Text page.
CAUTION:
You can only expose the patient 90 seconds per confirm.

16-7
SmartStep (Option)
How Do I...
This section provides the step-by-step instructions for using the SmartStep scan mode.
Scan with SmartStep

16-8
SmartStep (Option)

This section explains how to prepare for a SmartStep procedure. You must connect the foot
pedal and the Hand Held Control (HHC) devices to the gantry. These devices are used by the
Radiologist or Physician to prepare the system for exposures, make exposures, view images,
and to move the cradle.
Use this procedure to plug the HHC and foot pedal to the gantry in preparation for
SmartStep.
1. Locate on each side of the gantry the rear access plates to plug the switches into.
Hand Switch Outlet
Foot Switch Outlet
2. Plug the foot switch into the foot switch outlet.

This is located on either side of the gantrys rear base plate.
NOTE: The foot pedal is active as long as the system is prepped and ready for scan. Be careful
not to step on the foot pedal and make unwanted exposures.
3. Plug the HHC into the hand switch outlet.
This is located on either side of the gantrys rear base plate.
NOTE: It is best to plug the switches in on the same side of the patient where the Radiologist
or Physician will be doing the procedure from.
4. Position the in room display monitor so the doctors can view the images.
This display monitor is suspended from the ceiling and can be moved to either side of
the cradle.

16-9
SmartStep (Option)
5. Prepare the patient and supplies for the procedure.
Have your biopsy tray and other supplies ready for the Physician or Radiologist.
Prepare the patient for the procedure by creating a sterile area and explaining the
breathing instructions.
Quick Steps: Prepare for SmartStep

1. Locate on each side of the gantry the rear access plates to plug the switches into.
2. Plug the foot switch into the foot switch outlet.
3. Plug the HHC into the hand switch outlet.
4. Position the in room display monitor so the doctors can view the images.
5. Prepare the patient and supplies for the procedure.

16-10
SmartStep (Option)

Once the patient has been prepared and set up for the interventional procedure, you can
proceed with setting up for image acquisition in the SmartStep mode.
1. Select SmartStep from the Dynaplan screen or by clicking [Create New Series].
This following windows appears.
2. Click [SmartStep].
3. Click [Scan Type] and select [0.8 sec] or [1.0 sec].
You can choose between the 0.8 second full rotation or the 1.0 second full rotation
4. Click [Start Location] and enter the initial image location where you want to start.
5. Click [Slice Thickness] and select the desired slice thickness.
You can choose between 2.5 mm, or 5.0 mm.
6. Click [Gantry Tilt] and enter the desired tilt.

16-11
SmartStep (Option)
7. Click [SFOV] and enter the desired scan field of view.
8. Click [kV] and select the desired kV.
9. Click [mA] and select or enter the desired mA.
10. Click [Exposure Time] and enter the maximum exposure time.
This is a time that is entered before you have to reset the timer.
11. Click [Bump Distance] and enter the distance you want the cradle to bump in or out.
The default Bump Distance is half of the selected slice thickness.
12. Enter the display parameters for DFOV, R/L Center, A/P Center, and Recon Type.
All algorithms are available. If Edge is selected, the time to display the interventional
images will be increased.
A warning message appears.
14. Click [Continue].

The SmartStep dynaplan screen appears.

16-12
SmartStep (Option)
Quick Steps: Set Up SmartStep Mode

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Select SmartStep from the Dynaplan screen or by clicking [Create New Series].
Click [SmartStep].
Click [Scan Type] and select [0.8 sec] or [1.0 sec].
Click [Start Location] and enter the initial image location where you want to start.
Click [Slice Thickness] and select the desired slice thickness.
Click [Gantry Tilt] and enter the desired tilt.
Click [SFOV] and enter the desired scan field of view.
Click [kV] and select the desired kV.
Click [mA] and select or enter the desired mA.
Click [Exposure Time] and enter the maximum exposure time.
Click [Bump Distance] and enter the distance you want the cradle to bump in or out.
Enter the display parameters for DFOV, R/L Center, A/P Center, and Recon Type.
Click [Confirm].
Click [Continue].

16-13
SmartStep (Option)
Scan with SmartStep

This task explains the process of scanning with SmartStep. You must have the foot switch
and the hand held control devices plugged into the gantry.
NOTE: During SmartStep mode, filming, archive, and networking are not available.
SmartStep recon has the highest priority. Previously acquired recon queued images
are paused until SmartStep is complete.
1. Press the Prep button on the Hand Held Control (HHC) or click [Prep] on the dynaplan
screen.
The message area of the screen will indicate PRESS PREP.
Once the Prep button has been pressed or clicked, the screen will update to PREP IN
PROGRESS.
2. The system is ready for scans when the READY TO SCAN message indicator appears.

16-14
SmartStep (Option)
3. Step on the foot pedal to make an exposure in the SmartStep scanning mode.
The XRAY ON message indicator appears.
4. Release the foot pedal when the exposure is finished.

If you keep your foot on the exposure pedal, the message below is displayed.
SmartStep is a single rotation for each time the foot pedal is pressed.
NOTE: After each rotation, you must release foot peddle before you scan again.
5. Repeat steps 1-4 as many times as necessary while scanning in the SmartStep mode.

16-15
SmartStep (Option)
Quick Steps: Scan with SmartStep

1. Press the Prep button on the Hand Held Control (HHC) or click [Prep] on the dynaplan
screen.
2. The system is ready for scans when the READY TO SCAN message indicator appears.
3. Step on the foot pedal to make an exposure in the SmartStep scanning mode.
4. Release the foot pedal when the exposure is finished.
5. Repeat steps 1-4 as many times as necessary while scanning in the SmartStep mode.

16-16
SmartStep (Option)

There are a few basic image review functions available in the SmartStep mode. For more
information on how to use these display functions, refer to Measuring Structures Within an
Image, Magnifying Images and Graphics, Text Pages and Commands.
1. Change the primary focus to the free viewport.
Click on the free viewport
OR, using the HHC press the Change Focus button to activate the free viewport.
2. Click [List/Select] to display an image in the free viewport.
This opens a Browser for you to select an Exam, Series, and an Image.
3. Click [Accept].
This displays the selected image.
4. Perform the display functions as needed.
Click [Roam] or [Zoom] to set the right mouse button function.
Using the Right mouse key with [Roam] selected moves the image around the
screen.
Using the Right mouse key with [Zoom] selected makes the image bigger or
smaller
Click [Explicit Magnify] to enter a specific magnification factor.
Click [Flip/Rotate] to change the image orientation.
Click [Measure Angle] to measure the angle between structures.
Click [Measure Distance] to measure from point to point.
Click [Display Normal] to return the image to its original state.
Click [User Annotation] to enter text on the screen.
Click [Erase All] to remove any added text from the screen.
Click [Maintain] to maintain graphics from image to image.
Click [Grid On/Off] to display a grid or to turn the grid off. This is a toggle button.
Click [Screen Save] to capture the image with graphics added.
NOTE: Screen Saved images will not be added to the data base until the current SmartStep
series is ended.

16-17
SmartStep (Option)
Click [Forward 1] to advance the free viewports by one image, interventional 3

images.
Click [Backwards 1] to reverse the free displayed by one image, interventional 3
images.
Click [Last Image] to display the last exposed image.
Click [N/P each VP] to advance or reverse each image in each viewport by one.
Click [Page Forward] to advance all images displayed by one.
Click [Page Backward] to reverse all images displayed by one.
Click [Last Image] to view the last image scanned.
Figure 16-3 Display Functions

16-18
SmartStep (Option)
Quick Steps: Display SmartStep Images

1. Change the primary focus to the free viewport.
2. Click [List/Select] to display an image in the free viewport.
3. Click [Accept].
4. Perform the display functions as needed.

16-19
SmartStep (Option)

The Hand Held Control device has a window/level button that toggles between six different
window/level presets. To set the presets to your desired levels you must follow the following
steps.
1. Click [Display Prefs] from the Exam RX display screen.
This opens the display preferences screen.
The SmartStep window level preset window appears.
3. Enter the desired window width and level for all six locations.
NOTE: Keep the mouse inside the text box while typing the parameter.
4. Click [Save as defaults] to save the values entered.
Quick Steps: Set Window/Level Presets for the HHC

1. Click [Display Prefs] from the Exam RX display screen.
3. Enter the desired window width and level for all six locations.
4. Click [Save as defaults] to save the values entered.

16-20
SmartStep (Option)

16-21
Scheduling Patients
Chapter 17
Scheduling Patients
Introduction
This chapter explains how to schedule patients. It contains the step-by-step instructions to
Use the Bar Code Reader
Update the Patient Schedule List
Add a Patient to the Schedule
Delete a Patient From the Schedule
Set Up Preferences in the Schedule
Select a Patient from the Schedule
Check the Status of a Patient
View More Information About the Patient

17-1
Scheduling Patients

This section presents concepts necessary to understand ways to use Patient Schedule.
Patient Schedule
Connect Pro
New Records and Completed Records
Patient Schedule
Patient Schedule is a feature which allows patient information and exam protocols to be
pre-programmed in advance of patient arrival. At scan time, you can either select from the
created list, enter the patient ID number, enter the Accession number or use the optional Bar
Code Reader to call up patient information. Patient information can be easily added or
deleted from this list.
Connect Pro
Connect Pro is a purchasable option which retrieves critical patient information from your
HIS/RIS using a DICOM connection and sends it to your scanner. Connect Pro pulls
information from HIS/RIS and put it into Patient Schedule.
Connect Pro can also be customized to fit your departments needs by using "filters" to pull
only the information in which you are interested.
Connect Pro can collect more than just the standard demographic information about your
patients. It can also collect other information, such as allergies, pregnancy status, medical
alerts, or any other information about your patient.
New Records and Completed Records

In the patient schedule there is a column labeled Status. In the status column, an "N" or a "C"
is listed next to each patient entry. "N" stands for Not completed or New record. These are
exams that are scheduled in Patient Schedule, but are not yet completed. "C" stands for
Completed record. These exams were scheduled and have now been completed.
NOTE: If obtaining your patient using Connect Pro it is best to only have New Records in your
schedule list. Having Completed Records may cause inadvertent scanning of a
patients with the wrong accession number. Set Delete Completed Exams to 0 days in
the Connect Pro preferences. This setting assures that Completed Records are not
added to the Schedule List.

17-2
Scheduling Patients
How Do I...
This section provides the step-by-step instructions to utilize the Schedule Patient feature.

17-3
Scheduling Patients

The Bar Code Reader, which is used with the Connect Pro option, is a simple way to get
patient information. The patient information must be in the Patient Schedule list before
using this feature.
1. Click [New Patient].
2. Aim the Bar Code Reader at the bar code for either Accession number or Patient ID on
the patient requisition.
The patient information is pulled from the Patient Schedule list and automatically fill
into the fields on the Patient Information screen.
Table 17-1 Patient Information
Field Name
Parameters
Accession Number
Up to 16 characters
Patient ID
Up to 16 characters
Patient Name
Up to 32 characters
Sex
M (Male) or F (Female)
Birthdate
Months, Weeks, Days
Age
Years, Months, Weeks, Days
Weight
Kgs or Pounds
Reference Physician
Up to 32 characters
Radiologist
Up to 32 characters
Operator
Up to 3 characters
History
Up to 60 characters
Exam Description
Up to 22 characters
Protocol Number
Up to 5 characters
Req. Proc. ID
Up to 16 characters
Date
Exam Date Month, Day, Year
Time
Exam Time Hour, Minute

17-4
Scheduling Patients
3. Select desired protocol and begin exam.

NOTE: The Exam Description will be truncated to 22 characters when imported from a
HIS/RIS system. The Study description field (0008, 1030) in the DICOM header is
mapped to the Exam Description field on the Schedule Patient and New Patient
screens.

17-5
Scheduling Patients
NOTE: When entering the Patient ID, if more than one record with the same Patient ID is
found in the Patient schedule list a dialog displays notifying you of this. Be sure when
selecting the patient record that you have selected the correct entry for the scan
being performed. To avoid having multiple Patient Records with the same Patient ID
make sure to set the Delete Completed Exams preference to zero. This will assure that
only new records are in the Patient Schedule list.
Quick Steps: Use the Bar Code Reader

2. Aim the Bar Code Reader at the bar code for either Accession number or Patient ID on
the patient requisition.
3. Select desired protocol and begin exam.

17-6
Scheduling Patients

Update allows you to update your Patient Schedule list with information from HIS/RIS. The
Get Patient List For: section allows you to choose the system or systems you wish to pull
from the HIS/RIS schedule of patients. The With A Date Range: section allows you to pull
from certain dates.
2. Click [Update].
3. Under Get Patient List For:, click [This System], [All CT Systems], or [All Systems].
This System pulls the patient schedule for the current scanner you are on.
All CT Systems pulls the patient schedule for all of the CT systems on the HIS/RIS
connection.
All Systems pulls the patient schedule for all the systems on the HIS/RIS connection.
4. Select a Date Range.
Type in a From and To date. Be sure to follow the correct month/day/year format.

17-7
Scheduling Patients
5. If desired, type the Requested Proc. ID or Accession Number information into the
correct fields.
This is an additional way to pull patient information.
6. If desired, type the patients name information into the correct field.
This is a quick way to search for a patients name.
7. If desired, type the patients ID information into the correct field.
8. Click [Continue Update] to continue or [Cancel Update] to cancel without saving any
new selections.
Quick Steps: Update the Patient Schedule List

1.
2.
3.
4.
5.
Click [Patient Schedule].

Click [Update].
Under Get Patient List For:, click [This System], [All CT Systems], or [All Systems].
Select a Date Range.
If desired, type the Requested Proc. ID or Accession Number information into the
correct fields.
6. If desired, type the patients name information into the correct field.
7. If desired, type the patients ID information into the correct field.
8. Click [Continue Update] to continue or [Cancel Update] to cancel without saving any
new selections.

17-8
Scheduling Patients

Patient information can easily be added manually to the Patient Schedule list.
2. Click [Add Patient].
The Patient Schedule information screen appears (it looks similar to the New Patient
screen).
3. Enter the patient information.

a) If desired, add the number of the specific protocol under Protocol Number.
b) If desired, type in the date and time in the appropriate fields.
4. Click [Accept] to save changes and add patient information to the schedule list.
5. Click [Cancel] to return to the main Patient Schedule screen.

17-9
Scheduling Patients
Quick Steps: Add a Patient to the Schedule

1.
2.
3.
4.
5.

Click [Add Patient].
Enter the patient information.
Click [Accept] to save changes and add patient information to the schedule list.
Click [Cancel] to return to the main Patient Schedule screen.

17-10
Scheduling Patients

Patients can be deleted from the Patient Schedule list selectively or all at once.
2. Select the patient(s) to be removed.

a) For a single patient, click on patient name with left mouse.
b) For multiple patients in a row, use left mouse and click and drag to select patient
names.
c) For a more defined selection, press Control and click with left mouse on selected
patient names.
3. Click [Delete Selected] to delete the selected patient(s).
4. Click [Delete All] to delete all patients on the list.
Quick Steps: Delete a Patient From the Schedule

1.
2.
3.
4.

Select the patient(s) to be removed.
Click [Delete Selected] to delete the selected patient(s).
Click [Delete All] to delete all patients on the list.

17-11
Scheduling Patients

The Preferences feature allows the sort order to be set along with the delete time for entries
in the Patient Schedule list.
There are also several choices for use if you have the Connect Pro option.
2. Click [Preferences].
3. To sort exams, click [Date/Time], [Name], or [ID] to sort by.

17-12
Scheduling Patients
4. Set the number of days to delete exams.
Type in the number of days after which you would like the scanner to delete the
completed exams.
The number must be between 0-30.
A completed record is not added to the Patient Schedule list if number of days is set
to 0.
The system default is 3.
NOTE: It is important to set the Delete Completed Exams to zero when Patient Information
is updated from the HIS/RIS. This assures that Completed Accession numbers are
not inadvertently selected for scanning a second time causing Patient reconciliation
issues on the PACS system.
5. With the Connect Pro option, click [Yes] or [No] to Update Schedule Automatically.
Selecting Yes updates the schedule when you click Patient Schedule.
It updates based on the parameters selected in Update.
6. With the Connect Pro option, click [Yes] or [No] to Show Update Parameters.
Selecting Yes shows the Update screen every time the system starts to automatically
update.
This allows you to edit the Update parameters, if desired.
7. With the Connect Pro option, click [Yes] or [No] for Use Study UID?
Selecting Yes uses a study instance UID (Unique Identifier) from HIS/RIS.
By selecting No, the scanner assigns the study instance UID (Unique Identifier) to the
exam.
8. With the Connect Pro option, click [Yes] or [No] for Edit Modality Worklist?
Selecting [No] prevents you from editing any patient information from HIS/RIS.
Selecting [Yes] allows you to edit any patient information from HIS/RIS.
9. Click [OK] to accept entries, or [Cancel] to cancel out without accepting entries.

17-13
Scheduling Patients
NOTE: Preferences are not maintained between system software loads. Please update the
preferences after a software load has occurred.
Quick Steps: Set Up Preferences in the Schedule

1.
2.
3.
4.
5.
6.
7.
8.
9.

Click [Preferences].
To sort exams, click [Date/Time], [Name], or [ID] to sort by.
Set the number of days to delete exams.
With the Connect Pro option, click [Yes] or [No] to Update Schedule Automatically.
With the Connect Pro option, click [Yes] or [No] to Show Update Parameters.
With the Connect Pro option, click [Yes] or [No] for Use Study UID?
With the Connect Pro option, click [Yes] or [No] for Edit Modality Worklist?
Click [OK] to accept entries, or [Cancel] to cancel out without accepting entries.

17-14
Scheduling Patients
Edit a Patient Schedule

Patient information may be edited if entered incorrectly in the Patient Schedule list.
The Patient Schedule appears.
2. Select the desired patient from the list.

3. Click [Edit Patient].
4. Change patient information as needed.

The patient record cannot be edited if it came from HIS/RIS and Edit Modality
Worklist is set to [No].
5. Click [Accept].

17-15
Scheduling Patients
Quick Steps: Edit a Patient Schedule

1.
2.
3.
4.
5.

Select the desired patient from the list.
Click [Edit Patient].
Change patient information as needed.
Click [Accept].

17-16
Scheduling Patients

Patient Schedule allows patients to be easily selected at scan time.
3. Select the desired patient from the list.

All patient information fills into the New Patient screen.

5. Select the desired protocol to continue.
If a protocol was not previously chosen or if a different protocol is desired.

17-17
Scheduling Patients
6. Click [Enter] to begin.
NOTE: From the New Patient screen, you can also type in the patient ID, Accession number
or use the optional Bar Code Reader to select a patient. Make sure you have the
correct field selected for your entry.
Quick Steps: Select a Patient from the Schedule

1.
2.
3.
4.
5.
6.
Click [New Patient].

Select the desired patient from the list.
Click [Select Patient].
Select the desired protocol to continue.
Click [Enter] to begin.

17-18
Scheduling Patients

Patients listed in the Patient Schedule has an "N" in the status column if the exam is NOT
completed indicating it is a New Record. A "C" in the status column indicates the exam IS
completed.
The schedule list appears and the far right column is labeled Status.
N stands for an exam which is a New Record or is Not Completed.

C stands for an exam that is Completed.
2. Use the [Next] or [Prior] buttons in the lower right of the screen to scroll from page to
page.
Quick Steps: Check the Status of a Patient

2. Use the [Next] or [Prior] buttons in the lower right of the screen to scroll from page to
page.

17-19
Scheduling Patients

Use this feature with the Connect Pro option to view other valuable information about a
patient such as allergies, pregnancy status, and medical alerts. This information is pulled
from the HIS/RIS using a DICOM connection.
2. Select a patient from the list.

17-20
Scheduling Patients
3. Click [View More Info].
A screen appears with additional patient information.
4. Click [Cancel] to exit this screen.
Quick Steps: View More Information About the Patient

1.
2.
3.
4.

Select a patient from the list.
Click [View More Info].
Click [Cancel] to exit this screen.

17-21
Biopsy Mode
Chapter 18
Biopsy Mode
Introduction
This chapter explains how to use the biopsy mode. The biopsy mode improves the efficiency
of setting up and acquiring slices during a biopsy.
This chapter contains the step-by-step instructions to help you learn how to:
Use the Biopsy Mode

18-1
Biopsy Mode

This section presents the concepts necessary to successfully use the Biopsy Mode. The
Biopsy Mode
Biopsy Reference Scans
Biopsy Mode
The Biopsy Mode or Biopsy Rx improves the efficiency of setting up and acquiring slices
during a biopsy. All of the parameters required are available on one menu. You are able to
choose which direction the scanner acquires images from a centering point as well as how
many images to acquire. You can change slice thickness and/or interval. You can enter a
specific location for a slice and a gantry tilt, if required.
NOTE: AutomA is turned off when Biopsy Mode is entered. Review the Manual mA value
prescribed.
Biopsy Reference Scans

When you click [Biopsy Rx], you need to choose how the system scans based on the biopsy
location.
If you choose [Superior], the system makes the biopsy reference location the first scan, with
subsequent images acquired superiorly from that location.
If you choose [Centered], the system makes the biopsy reference location the center slice,
with the other images acquired above and below that location.
If you choose [Inferior], the system makes the biopsy reference location the first scan, with
subsequent images acquired inferiorly from that location.

18-2
Biopsy Mode
How Do I...
This section provides the step-by-step instructions for using the biopsy mode. Specifically, it
describes how to:
Use the Biopsy Mode

18-3
Biopsy Mode
Use the Biopsy Mode

The Biopsy Mode is a very useful function for routine biopsies. Prior to using the biopsy
mode, the scan type must be set. This determines the mode (Axial or Helical) for the biopsy
sequence.
NOTE: Technical factors such as scan type, kV, mA and rotation time used is determined
based on the last group scanned. If the AutoVoice feature was used in the prior group,
it is still on for the biopsy scans.
WARNING: When scanning for interventional (biopsy) studies the scan mode, image
thickness, number of images per rotation and the display layout used affect
the display of the images. It is recommended to use the Biopsy Mode provided
on the system. If manually prescribing biopsy scans, Axial 1i scan mode or
Helical scan mode with a slice thickness greater than 2.5 mm must be used.
Do not use Cine scan mode for interventional (Biopsy) imaging. Do not use an
Auto view layout with more than one Auto View image viewport.
Refer to Select a Multiple Image Display for more information on how to set up the
desired viewing options.
1. From the view/edit screen, click [Biopsy Rx].

18-4
Biopsy Mode
A pop up window appears containing all of the Biopsy Rx Parameters.
2. Set the Biopsy Reference.

The Biopsy Reference tells the system how to acquire images based on the Biopsy
Location. Selecting [Superior] means all images are acquired from the Biopsy
Location, superiorly. Selecting [Centered] means the system acquires images above,
at, and below the Biopsy Location. Selecting [Inferior] means the images are
acquired from the Biopsy Location, inferiorly.
NOTE: When using Centered, it is easier to program odd numbers of slices, i.e. 3,5,7, etc. This
allows the system to place even numbers above and below the reference location. If
you choose to use even numbers of slices, the system places the extra image in the
superior portion.
3. Enter Biopsy Location or click [Get Alignment Light Location].
If you have a specific location chosen from the localizer scans, you may enter that
location in the biopsy location field. Your other option is to move the table and center
the needle under the External or Internal laser light and then select the appropriate
designation in the Set Alignment Light selection depending on the laser used for
centering. This way is especially helpful once the needle or tube is placed.
4. Enter the Number of Images to be acquired for each pass.
You may enter any value.
5. Enter Gantry Tilt, if necessary.
6. Click [Thickness].
The slice thickness is 0.625 mm, 2.5 mm or 5.0 mm for axial scan mode only.

18-5
Biopsy Mode
7. Enter the Image Interval.
Image Interval is for helical scans only.This sets the distance between images.
Commonly for a biopsy, the interval is set to the same value as the slice thickness or
with minimal overlap.
8. Click [Confirm Biopsy Rx] or [Cancel].
Confirm Biopsy Rx activates the scan sequence to acquire images. Cancel cancels
the Biopsy Rx window and does not acquire images.
NOTE: The Biopsy Rx button is also available from the Dynaplan screen. All of the steps
remain the same. It is very useful to utilize this button, especially if a series of biopsy
images have been acquired previously. This is because the biopsy images remains in
the same series number and there is no need to return to the view/edit screen.
NOTE: Biopsy Images are not AutoFilmed. If a previous scan group had AutoFilm on, it is now
turned off. Any subsequent scans done has to turn AutoFilm back on.
NOTE: Check the mA prescribed. AutomA is automatically turned off in Biospy Mode. Review
the mA value to ensure it is appropriate for the type of scan being performed. Return
to the view/edit screen and adjust mA as needed.
Quick Steps: Use the Biopsy Mode

1.
2.
3.
4.
5.
6.
7.
8.
From the view/edit screen, click [Biopsy Rx].

Set the Biopsy Reference.
Enter Biopsy Location or click [Get Alignment Light Location].
Enter the Number of Images to be acquired for each pass.
Enter Gantry Tilt, if necessary.
Click [Thickness].
Enter the Image Interval.
Click [Confirm Biopsy Rx] or [Cancel].

18-6
X-Y Table Accuracy Procedure
Chapter 19

Introduction
This chapter explains the procedure to determine X-Y Table Accuracy. It contains the
Recommended workflow for RT
Clinical table lateral motion verification procedure for PET-CT RT and CT-RT
Set Up
Procedure
Analysis of Results
Clinical table elevation adjustment verification procedure for PET-CT RT and CT-RT
Procedure
Analysis

19-1
Recommended workflow for RT

1. Position patient on the table.
2. Cradle should be at the home position.
3. Select Internal landmark on the gantry controls.
4. After the patient is positioned on the table, drive the cradle between 890 mm to 850 mm
into the gantry bore and then back to the full-retracted position using the gantry
controls.
This centers the cradle.
Each in and out motion of the cradle is one cycle.
The cradle must cycle the number of times as determined in the Lateral Motion
Verification procedure.
NOTE: Determine the number of extension/retraction cycles needed based on testing.
5. Center a landmark on the RT tabletop using the sagittal room alignment laser line.
6. Using external room lasers position patient elevation as desired and place temporary
patient alignment marks on the skin.
7. Place radio-opaque fiducial markers on the temporary alignment marks.
8. Turn on CT gantry laser lights.
9. Move patient into the gantry such that the axial landmark location for imaging (For
example: sternal notch, .) placed in step 7 aligns with the axial internal gantry laser.
10. With the gantry lasers on, adjust the patient elevation until the gantry elevation laser
matches the patient alignment marks placed in step 7.
11. Establish the landmark as the scan reference with the gantry internal landmark button.
12. Conduct the CT exam with the landmark established in step 7.
13. Turn on the external room lasers.
14. Retract the patient and change elevation of table to match the patient alignment marks
placed in step 7.
15. Review the resulting images and confirm that the radio-opaque markers placed in step
7 align with the image coordinate iso-center.
16. Determine treatment Iso-center with simulation software such as Advantage Sim.
17. Shift room lasers as defined by simulation software.
18. Tattoo the patient for therapy.

19-2
Quick Steps: Recommended workflow for RT

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
Position patient on the table.

Cradle should be at the home position.
Select Internal landmark on the gantry controls.
After the patient is positioned on the table, drive the cradle between 890 mm to 850
mm into the gantry bore and then back to the full-retracted position using the gantry
controls.
Center a landmark on the RT tabletop using the sagittal room alignment laser line.
Using external room lasers position patient elevation as desired and place temporary
patient alignment marks on the skin.
Place radio-opaque fiducial markers on the temporary alignment marks.
Turn on CT gantry laser lights.
Move patient into the gantry such that the axial landmark location for imaging (For
example: sternal notch, .) placed in step 7 aligns with the axial internal gantry laser.
With the gantry lasers on, adjust the patient elevation until the gantry elevation laser
matches the patient alignment marks placed in step 7.
Establish the landmark as the scan reference with the gantry internal landmark
button.
Conduct the CT exam with the landmark established in step 7.
Turn on the external room lasers.
Retract the patient and change elevation of table to match the patient alignment
marks placed in step 7.
Review the resulting images and confirm that the radio-opaque markers placed in
step 7 align with the image coordinate iso-center.
Determine treatment Iso-center with simulation software such as Advantage Sim.
Shift room lasers as defined by simulation software.
Tattoo the patient for therapy.

19-3
Clinical table lateral motion verification procedure for

PET-CT RT and CT-RT
Set Up
The purpose of this procedure is to allow a clinical end-user to measure the amount of
lateral cradle motion between the room and gantry laser system and to determine how to
compensate for it in RT workflow for CT. This procedure should be done once by your site
physicist.
Requirements
One metric ruler (minimum 1.0 mm resolution)
RT tabletop
100 pounds of standard weights (25 pounds plates recommended)
Figure 19-1 Metric ruler aligned with laser on top of cradle top
Set Up Procedure
1. Install RT flat top on cradle.
2. If a PET/CT system, move table base to CT position.
3. Set elevation at 150 mm below ISO.
NOTE: When reading the metric scale, it is important to read to 0.5 mm.

19-4
Quick Steps: Clinical table lateral motion verification procedure for

PET-CT RT and CT-RT
Set Up
1. Install RT flat top on cradle.
2. If a PET/CT system, move table base to CT position.
3. Set elevation at 150 mm below ISO.

19-5

PET-CT RT and CT-RT
Procedure
Determine the number of cradle cycles required for cradle to be centered.
1. Move cradle to home - fully out of the bore.
2. Manually slide the front of the cradle to the left or right.
3. Apply four 25 pound weights to the RT flat top (refer to Figure 19-2) without moving the
cradle.
4. Place the metric ruler at the H2 location on the Flat Top.
5. Drive the cradle in using the gantry controls until ruler aligns with the overhead room
laser.
6. Center the ruler on a whole number - example Figure 19-1 shows the ruler center at
15cm.
This measurement will be called "Room 1" in the chart below and will equal 0.0 mm.
7. Define a coordinate system.
In figure 1 you can see a piece of paper which defines the left as positive, and right as
negative.
8. Turn on the gantry lasers and drive the cradle until the internal gantry laser aligns with
the long edge of the ruler.
9. Record the laser position on the ruler.
This measurement will be called "Scan Plane 1" in the chart below.
10. Drive the cradle out of the bore until the ruler aligns with the overhead room laser again.
This measurement will be called "Room 2" in the chart below.
12. Drive the Cradle fully out - to the home position.
13. Repeat steps 5-10, two more times.

19-6

Figure 19-2 Side view of table showing weight and ruler placement.
Results
Table 19-1 Use the chart below to record the results
Measurement Location
_____________________
Weight
_____________________
Room 1
_____________________ (mm)
Scan Plan 1
_____________________ (mm)
Room 2
_____________________ (mm)
Room 3
_____________________ (mm)
Scan Plane 2
_____________________ (mm)
Room 4
_____________________ (mm)
Room 5
_____________________ (mm)
Scan Plane 3
_____________________ (mm)
Room 6
_____________________ (mm)

19-7

PET-CT RT and CT-RT
Procedure
1. Move cradle to home - fully out of the bore.
2. Manually slide the front of the cradle to the left or right.
3. Apply four 25 pound weights to the RT flat top (refer to Figure 19-2) without moving the
cradle.
4. Place the metric ruler at the H2 location on the Flat Top.
5. Drive the cradle in using the gantry controls until ruler aligns with the overhead room
laser.
6. Center the ruler on a whole number - example Figure 19-1 shows the ruler center at
15cm.
7. Define a coordinate system.
8. Turn on the gantry lasers and drive the cradle until the internal gantry laser aligns with
the long edge of the ruler.
10. Drive the cradle out of the bore until the ruler aligns with the overhead room laser
again.
12. Drive the Cradle fully out - to the home position.
13. Repeat steps 5-10, two more times.

19-8

PET-CT RT and CT-RT
Analysis of Results
Below is a set of example data which will be used to discuss the interpretation of the results.
Table 19-2
Measurement Location
H2
Weight
100 pounds
Room 1
0.0 mm
Scan Plan 1
-1.5 mm
Room 2
-3.5 mm
Room 3
-3.5 mm
Scan Plane 2
-2.5 mm
Room 4
-4.5 mm
Room 5
-4.5 mm
Scan Plane 3
-4.0 mm
Room 6
-5.5 mm
1. From "Room 6", it can be seen that the initial cradle lateral shift was 5.5mm, therefore if
the cradle were not cycled prior to scanning, the offset at the scan plane relative to the
room lasers could be this large.
2. After one cycle (extend between 890 mm to 850 mm, then retract) the offset at the scan
plane improves by 3.5mm (in this case) and therefore the actual offset is 2.0 mm
(5.5-3.5).
NOTE: One cycle equals a cradle in and out motion.
Some systems may only require one cycle, others may require three cycles.
3. After 2 cycles the offset at the scan plane improves by 4.5mm (in this case) and therefore
the actual offset is 1.0 mm (5.5-4.5).
4. Depending upon the desired level of offset, this method can be used to determine the
number of cycles needed.

19-9

PET-CT RT and CT-RT
Analysis of Results
1. From "Room 6", it can be seen that the initial cradle lateral shift was 5.5mm, therefore if
the cradle were not cycled prior to scanning, the offset at the scan plane relative to the
room lasers could be this large.
2. After one cycle (extend between 890 mm to 850 mm, then retract) the offset at the
scan plane improves by 3.5mm (in this case) and therefore the actual offset is 2.0 mm
(5.5-3.5).
3. After 2 cycles the offset at the scan plane improves by 4.5mm (in this case) and
therefore the actual offset is 1.0 mm (5.5-4.5).
4. Depending upon the desired level of offset, this method can be used to determine the
number of cycles needed.

19-10
Clinical table elevation adjustment verification

procedure for PET-CT RT and CT-RT
The purpose of this procedure is to allow a clinical end-user to verify that the RT workflow for
CT simulation with table elevation adjustment between the room and gantry laser system is
working. Proper re-adjustment of table elevation, independent of weight distribution, is
verified by generation of post-elevation-adjustment images with images with less than
1.0 mm distance between image center and the QA device feature.
Requirements
Medtec CT Simulation Laser QA device phantom or equivalent device (Figure 19-3,
requires 2 IPPS Lok-Bars)
RT tabletop
100 pounds of standard weights (25 pounds plates recommended)
Figure 19-3 LEFT - MedTec RT alignment device - RIGHT: CT orthogonal reformat image of
laser QA device (abdomen window level).

19-11

Procedure
1. Position the weights and attach the QA device to notches near the center of the RT
cradle, as shown in Figure 19-4.
2. Set the table elevation such that the room sagittal laser light intersects the side
horizontal QA device lines and the room coronal laser light intersects the top QA device
lines. The sagittal laser light produces the line parallel to the RT tabletop on the side of
the device. An example of this alignment is shown in Figure 19-3 at left.
3. Initiate an Exam.
4. Acquire the scout over the range of the QA device.
5. Using the graphical Rx, set up an axial CT imaging scan which will produce between 10
and 20 mm of images at the thinnest slice width available.
6. Define the CT DFOV such that the pixels in the images produced are isotropic.
For example, with a scanner producing 0.625 mm slices, a 512x512 image with DFOV
32.0 cm will produce images with 0.6253 pixels.
The formula for pixel size is: Pixel size = DFOV in mm divided by 512.
7. Use the "Standard" CT recon filter.
8. Read and record the table elevation as reported on the gantry (Table 19-3).
9. Initiate the CT scan and image the QA device.
This image set represents the situation prior to elevation adjustment.
10. After the CT scanning is done, re-adjust the elevation of the table such that the gantry
sagittal laser lights align with the sagittal lines on the side of the QA device.
11. Read and record the table elevation in the results (Table 19-3).
12. Repeat the same CT scan series to produce the alignment-adjusted images.
Figure 19-4 Side view of QA device and weights placement.

19-12
Quick Steps: Clinical table elevation adjustment verification

Procedure
1. Position the weights and attach the QA device to notches near the center of the RT
cradle, as shown in Figure 19-4.
2. Set the table elevation such that the room sagittal laser light intersects the side
horizontal QA device lines and the room coronal laser light intersects the top QA device
lines. The sagittal laser light produces the line parallel to the RT tabletop on the side of
the device. An example of this alignment is shown in Figure 19-3 at left.
3. Initiate an Exam.
4. Acquire the scout over the range of the QA device.
5. Using the graphical Rx, set up an axial CT imaging scan which will produce between 10
and 20 mm of images at the thinnest slice width available.
6. Define the CT DFOV such that the pixels in the images produced are isotropic.
7. Use the "Standard" CT recon filter.
8. Read and record the table elevation as reported on the gantry (Table 19-3).
9. Initiate the CT scan and image the QA device.
10. After the CT scanning is done, re-adjust the elevation of the table such that the gantry
sagittal laser lights align with the sagittal lines on the side of the QA device.
11. Read and record the table elevation in the results (Table 19-3).
12. Repeat the same CT scan series to produce the alignment-adjusted images.

19-13

Analysis
1. Load the non-adjusted axial CT image series into a viewing tool with zoom and distance
measuring capability.
2. Scroll to the image where the horizontal feature in the QA device is best visualized in the
center QA feature.
3. Magnify the images to the highest possible zoom to show (a) the cross-hairs
representing image center can be seen and (b) the horizontal feature can be seen.
See Figure 19-5 for an example.
4. Using the measurement tool, determine the distance from image center to the center of
the QA feature.
5. Record the number in the results as "Pre-adjustment distance" (Table 19-3)
6. Repeat steps 1-4 for the adjusted-elevation image set.
7. Record the measurement under "Post-adjustment distance" (Table 19-3).
Figure 19-5 Example of measurement of QA feature offset from image center (red
cross-hairs). LEFT: image prior to elevation adjustment using gantry sagittal laser; RIGHT:
image following elevation adjustment. Green lines represent line drawn using measurement
tool, numerical report out is shown in red.
Results
NOTE: Post adjustment QA distance represents the accuracy of table vertical position
achievable with the workflow recommended in section one.

19-14

The post-adjustment image center to QA distance should be less than 1.0 mm, verifying that
the gantry lasers (with elevation adjustment) and room lasers both indicate image center,
using the QA feature location in the image as evidence.
Table 19-3
Table elevation - QA aligned to room laser
_____________________ (mm)
Table elevation - QA re-aligned to gantry laser
_____________________ (mm)
Image Center to QA pre-adjustment distance
_____________________ (mm)
Image Center to QA post-adjustment distance
_____________________ (mm)
Quick Steps: Clinical table elevation adjustment verification

Analysis
1. Load the non-adjusted axial CT image series into a viewing tool with zoom and
distance measuring capability.
2. Scroll to the image where the horizontal feature in the QA device is best visualized in
the center QA feature.
3. Magnify the images to the highest possible zoom to show (a) the cross-hairs
representing image center can be seen and (b) the horizontal feature can be seen.
4. Using the measurement tool, determine the distance from image center to the center
of the QA feature.
5. Record the number in the results as "Pre-adjustment distance" (Table 19-3)
6. Repeat steps 1-4 for the adjusted-elevation image set.
7. Record the measurement under "Post-adjustment distance" (Table 19-3).
NOTE: Post adjustment QA distance represents the accuracy of table vertical position
achievable with the workflow recommended in section one.

19-15
Patient Setup and Scout Scan
Chapter 20

Introduction
This chapter explains setting up the patient and completing a localizer (Scout) scan. It
Set Up Patient Information
Position the Patient
Selecting a Protocol
Adjust the Localizer (Scout)
Confirm the Localizer (Scout)

20-1

This section presents the concepts necessary to successfully set up a patient for scanning.
Positioning Patients
Using Protocols
Using Contrast
Setting Up a Patient without an ID#
Emperor Era Birth Year Entry
Preset Descriptions
Positioning Patients
Before placing patients in scanner, each day the accessories that may be used during the
day while scanning should be inspected such as the head holder, table extension, patient
positioning sponges and straps to make sure they are in good working condition. Positioning
pads and straps should be inspected and cleaned to prevent possibility of artifacts being
introduced due to foreign matter such as contrast on the surfaces of these items. Do not use
accessories that maybe broken or torn. Make sure patients are comfortable as possible on
the table or in the head holder. Use positioning spongers and pads along with positioning
straps to aid in the positioning of the patient to help them hold the position needed to
complete the exam. If patients are comfortable, they will be able cooperate and hold still
during the exam. If arm support or catheter bag hanger is used make sure they are placed
securely on the table to support the arm or hold the catheter bag. Monitor the location of
the arm support or catheter bag holder to prevent any collisions with the gantry.Make sure
any sheets, blankets and patient clothing or gowns are not allowed to get caught as the
table is moving. Use the positioning straps to help contain these items so they are not loose
or hanging off the cradle.Make sure to explain the procedure to the patient so they
understand what is going to happen and what to expect. This will reduce incidences of
patient moving because they are surprised by the position they are put in the gantry or the
movement of the table.
Using Protocols
All parameters for scanning a patient can be set up in a protocol. This saves the technologist
time when prescribing scan parameters for each patient. When a new patient is to be
scanned, the technologist types in the patient information and chooses a protocol. The
protocol may be adjusted on a per patient basis without permanently altering the original
set of parameters. Once the parameters are set and the prescription is confirmed, scanning
can begin.
NOTE: For information on building protocols, refer to the Building Protocols chapter.

20-2
Using Contrast
When IV contrast is to be used, make sure the injector or syringes of contrast are set up
before performing the localizer (scout) scan. The contrast (syringe) icon on the lower right
corner of the view/edit screen must be selected. When the icon is selected, there is a +C
annotation on the images next to the image number, indicating that IV contrast was used
for that exam.
Setting Up a Patient without an ID#

The patient ID# is the minimum amount of information required by the scanner to perform a
patient scan. If the patient does not have an ID#, a "?" or the word "trauma" may be typed
into the ID# field. Once an ID# is assigned to the patient, the exam information may be
edited using the Edit Patient feature.
NOTE: For information on performing Edit Patient Information, refer to Managing Images.

20-3
Emperor Era Birth Year Entry

Emperor year corresponds to a Japanese Emperor and year of his reign. Patients in Japan
may know their birth date only by this year format. Emperor year entry is available on your
system when it is configured in the yyyy/mm/dd date format. The Era codes are Heisel (H),
Showa (S), Taisho (T), Meiji (M). This information is entered in the birth date field on the New
Patient screen. For example, if your patient were born in the 26th year of Showa's reign you
would enter S26 for the year. This corresponds to a western year of 1951. The system will
store the converted birth year in the birth date field on the New Patient and Patient
Schedule screens and in the image header.
Preset Descriptions
The New Patient Screen has four different Preset selection that you can choose from. These
areas allow you to enter frequently used Physician, Radiologist, Operator initials, and Exam
Descriptions. This is a feature to expedite data entry.
You can Add, Delete and change the information in these areas. It is possible to Sort the
entries for the presets.

20-4
How Do I...
This section provides the step-by-step instructions for Setting Up A Patient And Completing
A Localizer (Scout) Scan. Specifically, it describes how to:

20-5

Use this procedure each time you start a new patient exam. It is best to setup the patient
information before you get the patient on the table. This reduces the amount of time the
patient has to be on the table, possibly in a difficult position. When entering the patient
information, the only field required for scanning is the patient ID. This task describes the
manual input of the data. The data can also be input by using Patient Schedule or a bar code
reader.
NOTE: For more information on Patient Schedule or a Bar code reader refer to Scheduling
Patients.
NOTE: The / and control characters are not valid for entries in the New Patient screen.
1. From the scan monitor, click [New Patient].
The Patient Information screen appears automatically displaying the new Exam
Number.
NOTE: The system assigns the exam number automatically. The maximum Exam number
for patient scanning is 49,999. The exam number will need to be reset by your Field
Engineer when the system reaches the maximum number.
Table 20-1 Patient Information
Field Name
Parameters
Accession Number
Up to 16 characters
Patient ID*
Up to 16 characters
Patient Name*
Up to 32 characters
Sex
M (Male) or F (Female)
Birthdate
Months, Weeks, Days
Age
Years, Months, Weeks, Days
Weight
Kgs or Pounds
Height
Feet, Inches, or Centimeters
Reference Physician*
Up to 32 characters
Radiologist
Up to 32 characters
Operator
Up to 3 characters
History
Up to 60 characters
Exam Description
Up to 22 characters

20-6

Field Name
Parameters
Protocol Number
Up to 5 characters
Req. Proc. ID
Up to 16 characters
Date
Exam Date Month, Day, Year
Time
Exam Time Hour, Minute
NOTE: * If this information was entered from a RIS system, these areas support up to 64
characters. If the patient is edited or manually entered then the character limits are
described in the table above.
Figure 20-1 Patient Information Screen.
2. From the Patient Information area, enter data into the appropriate fields.
You must enter the Patient ID to continue. The Protocol Selection area does not
become active until the Patient ID is entered.
When you are typing the patients name, for DICOM users, you have to type the last
name, first name, and middle initial with a "^" between names and initials.

20-7

NOTE: The Exam Description will be truncated to 22 characters when imported from a
HIS/RIS system. The Study description field (0008, 1030) in the DICOM header is
mapped to the Exam Description field on the Schedule Patient and New Patient
screens.
NOTE: If you have a network set up to transfer images and the protocol using the DICOM
language then you need to type in the information as described above.
CAUTION:
When entering Patient ID information the system may contain multiple

instances of the same Patient ID. Multiple schedule records can be due to
multiple procedures being ordered under separate accession numbers or
New and Completed records in the Patient schedule for the same Patient ID.
When entering the Patient ID verify that the correct Accession number and
Exam Description selected is what is desired. Scanning with an incorrect
accession number may cause problems reconciling exams on a PACS system.
Please see the Schedule Patients chapter for more information.
Make sure that you keep the mouse over the New Patient screen when typing.
Once you have entered data into a field, you can press Enter to go to the next text
box or you can click in the text box you wish to input data.
3. Click the preset buttons and select the desired information. Or, click on the field and
enter desired information.
Information is listed in the order it is entered with last entry displayed at the top of
the list.
If you click Referring Physician, Radiologist, Operator, or Exam Description, a
preset menu will appear allowing you to select which preset you wish to use.
To change a name from the list, click Referring Physician, Radiologist, Operator, or
Exam Description, select the name, enter new information, and click [Change].
To add a name to the list, click Referring Physician, Radiologist, Operator, or Exam
Description, type the name and click [Add].
To delete a name from the list, click Referring Physician, Radiologist, Operator, or
Exam Description, select the name and click [Delete].
To sort the list items for Exam Description, click [Sort]. The sort sequence is 1, 10,
100 to 9, 99, A to Z, a to z (Figure 20-2).
These Presets are saved across software loads from Save System State.
The maximum number of entries in the preset areas are 100.

20-8

Figure 20-2 Sorted List
Figure 20-3 Selectable Presets
4. When all of the desired patient information is completed, select the desired protocol
from the Anatomical Selector area.
You can select a protocol by either selecting a default protocol or by choosing a
specific body part, then selecting the protocol.

20-9

NOTE: You cannot set a default protocol for color coded areas in the pediatric protocols.
If you know the number of the protocol, you can type the number in at the bottom of
the patient information screen.
The protocol area is broken down into 10 adult protocols and 10 pediatric protocols.
Protocols 1-10 are adult protocol areas and 11-20 are pediatric protocol areas. In
each protocol area, you can have up to 90 different protocols for that area.
NOTE: It is important to set the Delete Completed Exams to zero when Patient Information
is updated from the HIS/RIS. This will assure that Completed Accession numbers are
not inadvertently selected for scanning a second time causing Patient reconciliation
issues on the PACS system.
NOTE: For more information on protocols, refer to Building Protocols.
Quick Steps: Set Up Patient Information

1. From the scan monitor, click [New Patient].
2. From the Patient Information area, enter data into the appropriate fields.
3. Click the preset buttons and select the desired information. Or, click on the field and
enter desired information.
4. When all of the desired patient information is completed, select the desired protocol
from the Anatomical Selector area.

20-10

It is best to prepare the scan room before bringing the patient into the room. Make sure that
you have all the necessary supplies and accessories.
1. Attach the head holder or foot extender to the end of the cradle towards the gantry.
2. Lay the patient on the table.
Make sure the patient is comfortable and properly immobilized as needed.
Always use the head holder straps with the head holder to immobilize the patients
head to prevent motion. When doing body scans, make sure that you have the body
straps connected to the cradle and wrapped around the patient.
CAUTION:
The patient positioning straps provided with the system do not support the
full weight of the patient. Patient positioning straps should be used to aid in
patient positioning and are not meant to fully restrain the patient.
3. Press the buttons on the gantry to raise the table up and in.
Always make sure that nothing is close to the table that may interfere with table
movement.
4. Position the laser lights so that they are lined up with the desired anatomical reference
and centered to the desired anatomy.
NOTE: A poorly positioned and centered patient can impact the mA values calculated for
AutomA/SmartmA.
CAUTION:
Make sure that you instruct the patient to look away from the laser lights. The
laser beam used for positioning can cause eye injury.
Do not position the patient with the laser lights in their eyes.
NOTE: Landmark setting for Patient Position Sensitive Study Types. When using the external
laser alignment light for patient positioning purposes, be aware that the patients
elevation may be slightly lower with the cradle extended than with the cradle fully
retracted. This is because the cradle may bend slightly under a patients weight.
NOTE: If the patient is not fully in the head holder, light and dark images may be seen at ends
of the beam collimation between two rotations especially if the gantry is tilted. Make
sure to fully position the patient's head in the head holder.

20-11

NOTE: This difference should be taken into consideration for applications where patient
position information is critical, such as radiation therapy planning. To minimize these
affects, after using the external laser alignment system to position the patient,
advance the patient to the CT scan plane. Turn on the CT alignment lights to
determine if they line up with the markers on the patient. If necessary, compensate
for the bend in the cradle by elevating the table. When the CT alignment lights line
up with the markers, re-set the landmark for the scan using the Internal laser
alignment light.
5. Press the desired landmark button (Required).
If you do not press the landmark button, confirm remains gray (unselectable) until the
landmark button has been pressed.
Quick Steps: Position the Patient

1.
2.
3.
4.
Attach the head holder or foot extender to the end of the cradle towards the gantry.
Lay the patient on the table.
Press the buttons on the gantry to raise the table up and in.
Position the laser lights so that they are lined up with the desired anatomical reference
and centered to the desired anatomy.
5. Press the desired landmark button (Required).

20-12
Selecting a protocol saves you a lot of time while maintaining a quality exam. It keeps exams
consistent because the exam is done the same way each time.
1. On the left monitor, place the mouse over the area that you want to scan and click on it.
A list of all the protocols that you built in this area of the protocol manager appears.
2. From the list, select the protocol that you want to use by clicking on it.
Figure 20-4 Protocol Selector

20-13
Quick Steps: Selecting a Protocol

1. On the left monitor, place the mouse over the area that you want to scan and click on
it.
2. From the list, select the protocol that you want to use by clicking on it.

20-14

Setting a landmark is very important. The landmark sets a known anatomical reference for
the radiologist which he/she correlate the anatomy. The landmark sets the zero location.
When scanning towards the patients head, you are scanning superior to the zero location.
When scanning towards the patients feet, you are scanning inferior to the zero location.
You should set the zero location to known anatomy. For example, when scanning a head,
the landmark or zero location is typically the orbital meatal line.
1. The orientation of the patient at the top of the screen should be the same as the
orientation of the patient that you are scanning.
Click on the body at the head or feet to change Head/Feet first orientation.
Click on the table or above the body to rotate the body at 90 degree increments.
2. Check the start/end locations, kV, mA and autovoice (if applicable).
Click on the box that you want to make changes to and type in the new parameter.
3. For systems with Smart Score Pro and Prospective Gating, when performing a Smart
Score exam, click [Gating].
The gating check button verifies that the scanner is receiving the ECG monitor signal.
Before this is possible you must set up the patient monitor.
If the button is red that means no signal has been detected by the system. The
system pops up a message instructing you to check the connection. Check to make
sure all of the ECG leads are connected to the patient and that power is on to the
monitor. Click [OK] to close the message box when you have checked everything. If
the gating check button is light blue you can proceed.
NOTE: For more information about gating and instructions on prescribing an exam that
includes gating measurements, refer to Prospective Gating (SmartScore) (Option) or
Cardiac Imaging Discovery CT750 HD chapter.

20-15
Quick Steps: Adjust the Localizer (Scout)

1. The orientation of the patient at the top of the screen should be the same as the
orientation of the patient that you are scanning.
2. Check the start/end locations, kV, mA and autovoice (if applicable).
3. For systems with Smart Score Pro and Prospective Gating, when performing a Smart
Score exam, click [Gating].

20-16

Now you are ready to scan the patient. Before you press the start scan button make sure
that no one is in the room.
1. On the left monitor, click [Confirm].
2. On the top of the keyboard, press [Move to Scan].
The button is flashing green.
If you need to stop the table movement, press [Stop Move].
3. Press [Start Scan].
The button is flashing green.
If you need to stop the scan, press [Stop Scan].
If you need to pause the current scan, press [Pause Scan]. This finishes the current
scan, then pause the next scan.
If you pause the scan a resume key pops up on the screen. Click [Resume] when you
are ready to scan.
4. Repeat steps 2 and 3 to take the second scout.
Quick Steps: Confirm the Localizer (Scout)

1.
2.
3.
4.
On the left monitor, click [Confirm].

On the top of the keyboard, press [Move to Scan].
Press [Start Scan].
Repeat steps 2 and 3 to take the second scout.

20-17
Scan Series Setup
Chapter 21
Scan Series Setup

Introduction
This chapter explains how to setup for the scan series. It contains the step-by-step
Set Scan Parameters
Adjusting Graphic Rx
Set Timing Parameters
Set Display Factors
Repeat a Series
Enter Contrast Descriptions

21-1
Scan Series Setup

This section presents the concepts necessary to successfully set up the scan series.
Concepts you need to understand are:
Adjusting a Protocol
Setting Scan Field of View and Display Field of View
Using a Breath Hold Delay
Working with the Optimizer
Adjusting a Protocol
Once a specific protocol is selected from the protocol manager, any of the parameters may
be modified on a per patient basis. This can be done without permanently altering the
original protocol.
Setting Scan Field of View and Display Field of View

Scan Field of View (SFOV) is the parameter that determines how much anatomy is scanned.
The SFOV should always be larger than the circumference of the patient, regardless of what
part is being imaged.
Display Field of View (DFOV) is the parameter that determines how much of the SFOV is
reconstructed into an image. DFOV can be less than or equal to the SFOV but cannot be
more than the SFOV. Within the DFOV a image center must be set. The center determines
upon which anatomy the DFOV is centered. The center is set using two parameters, R-L
center and A-P center. The R-L value centers the DFOV on the right and left axes of the
patient. The A-P value centers the DFOV on the anterior and posterior axes of the patient.
Entering a value other than zero off centers the image. This is most often referred to as
targeting the image. Off centering is used most on spine studies or for minor adjustments to
imperfections in centering the patient on the table. If large adjustments are needed, then
you should consider re-positioning the patient on the table.
Using a Breath Hold Delay

The Breath Hold parameter is the amount of time in seconds that your patient can hold their
breath. For better registration of the patients anatomy on the scan, use a longer Breath
Hold time. It is important that you practice with your patient to determine how long they can
hold their breath. Breath Hold, along with another parameter, Breathe Time, automatically
divides all of your prescribed scans into Breath Hold scanning clusters.

21-2
Scan Series Setup

Breathe Time is the amount of time, in seconds, you allow your patient to breathe in
between breath hold clusters. Typical Breath Hold and Breathe Times are 12 seconds and 12
seconds or 10 seconds and 10 seconds. But, again, practice with your patient.
Working with the Optimizer

If the system cannot complete the entire scan prescription with the technical parameters
that you have selected, the Optimize icon is highlighted in red. At this point, you can select
the Optimize icon to open the technique optimize screen.
The optimize screen calculates and displays in real time up to three factors that can be
changed to allow the system to continue.
One factor that can be changed is the up front delay, which can be changed by the amount
shown in the up front delay column. Remember, the up front delay is the time before you can
proceed with scanning. The start scan button does not light up until the up front delay
expires. The second factor is a change in the mA to what is displayed in the mA column. If
you choose this reduction, you may be reducing image quality. Make sure that you always
use enough mA to get the best image quality. The third potential change is to the group
delay. Again the valid parameter is shown in the group delay column. You need only to
select one of the parameters to continue. The selection is made by simply selecting the
parameter that you feel is best for that prescription.
If multiple groups are prescribed, the optimize screen updates for each group, allowing you
to make choices for each group.
Once you have made the choices which satisfy the system, without compromising image
quality, you then get a message that tube cooling is no longer needed and the Optimize in
Progress icon is highlighted in blue. You can select the icon to leave the technique optimize
screen and continue.

21-3
Scan Series Setup
How Do I...
This section provides the step-by-step instructions for setting up the scan series.
Set Scan Parameters
Set Display Factors
Repeat a Series

21-4
Scan Series Setup
Set Scan Parameters

Setting the scan parameters is a very important part of the scan. The screen on which you
input all of these parameters is called the View Edit screen. Remember that you have to
adjust the parameters according to the patients size and the anatomy that you are
scanning. These parameters determines the Image Quality that you achieve. Always make
sure that you remove any objects that might cause artifacts. The scout is a good place to
view objects that might cause artifacts.
1. From the scan monitor, click [Next Series].
This is located at the bottom of the scan monitor screen.
The screen on which you input all of these parameters is called the View Edit screen.
Next and prior series moves you around in the protocol. There may be times that you
want to skip a series in the protocol. For example, a series involving a patient that
was scanned for contrast only and your current series is built for no contrast.
2. The orientation of the patient at the top of the monitor should be the same as the scout.
If not, click on the picture of the patient.
There may be times that you change the patients position from the way that the
protocol was built. In that case, you have to change the patients orientation on the
screen each time you click [Next Series].
3. To set the scan parameters, start at the left side of the screen and work your way to the
right.
This enables you to check all of the parameters without skipping any.
4. Select the [Scan type] and choose the desired scan mode.

21-5
Scan Series Setup
There are six scan types on the system.

Axial is a step and shoot method. It can be combined with VolumeShuttle mode for
axial shuttle acquisitions.
Helical (sometimes called spiral) is continuous table movement while exposing the
patient.
When scanning in the interleaved mode 3,480 to 4,740 views are reconstructed.
The interleaved mode provides best image quality. It can be combined with
VolumeShuttle mode for helical shuttle acquisitions.
When scanning in the interspaced mode 2,584 to 4,008 views are reconstructed
Cine
Full is continuous exposure which supports table moves equal to the beam
collimation or no table move where the scans are taken at one table position.
Segment is a partial scan with continuous exposure.
Cardiac is either a helical gated scan or a cine gated scan. The combination with
cardiac gating helps to freeze motion of the heart and vascular structures.
Gemstone Spectral Imaging is a special acquisition mode where different kVp levels
are acquired in the same rotation to provide information about the chemical
composition of the body from the energies of the available spectrum to visualize
anatomical and pathological structures.
High Resolution mode can be combined with Axial, Helical, and Cardiac modes to
produce images with improved resolution in the x and y directions.
There are multiple Rotation Times on the system.

The times are: 0.8, 1.0, or 2.0 seconds.With the VariSpeed option, the times are:
0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, and 2.0.
With the 0.35 Second Rotation option, additional times are 0.35, 0.37, 0.42, 0.45,
and 0.47.
For GSI scan type, only 0.5sec and 1 sec rotation times are available.
There are two Rotation Lengths on the system.

The Rotation Lengths are Segment and Full.
Full Rotation is used most often.
Segment rotation is good for Cardiac scans.
NOTE: For more information on these scan types, rotation, and lengths, refer to Building
Protocols.

21-6
Scan Series Setup

5. Click [Thick Speed] and choose the detector coverage, the image thickness and images
per rotation you want.
This window contains selections for detector coverage, slice thickness, images per
rotation, pitches and table speed and rotation speeds. It also lists the slice thickness
Rotation can be adjusted in this window or in the Scan Type pop-up.
The system comes with 0. 625 mm, 1.25 mm, 2.5 mm, 3.75 mm, and 5 mm selections.
In the axial mode the number of images per rotation can be 1, 2, 4, 8, 16, or 32. The
choice for one determines the choices for the other. Some combinations are not
allowed. The choices you make for thickness and images per rotation determine the
available reconstruction thicknesses.
In the axial mode, the 1i mode, the High Resolution mode is available with 1.25 mm
thickness with one image per rotation. No other thickness can be reconstructed
prospectively or retrospectively.
In the helical mode, theDiscovery CT750 HDT helical pitches are 0.5x:1, 0.9x:1 and
1.375:1.
The pitch is the table travel in millimeters per rotation divided by the beam
collimation.
4 Row Interleaved provides a 40 % mAs reduction, and is 1.5 to 3 times faster than
single slice helical and has minimal helical artifacts, but interleaved pitch 0.5:1
provides only one third of the coverage compared to interspaced mode.
4 Row Interspaced provides data acquisition 2 to 6 times faster than single slice
helical, but requires more interpolation, more helical artifact, and only a 20% mAs
reduction.
NOTE: For more information on 2, 4, 8, 16, 32, or 64 row modes and multi detectors, refer to:
Multi-Detector Information.
The smaller the slice thickness, the more technique you need to use.
Thinner slice thickness gives you better detail.
For VolumeShuttle (Axial) and Volume Helical Shuttle, the number of passes or
coverage time will need to be entered. The number of passes determines the total
duration or coverage time for the scan and vise versa.
For Volume ASIR, the slice thickness needs to be 0.625 thickness.
6. Click [Interval mm] and type in the interval that you want.
In the Helical mode, the table moves in mm per rotation, while exposing the patient.
In the Axial mode the interval or spacing defaults to equal the number of images per
rotations multiplied by the slice thickness. The interval for axial scanning can be zero,

21-7
Scan Series Setup

equal to, or greater than the width of the detector configuration. Typical intervals
used are 10, 20, or 40 mm.
Axial interval with skip refers to a gap between scan groups. This can be useful, for
example, when performing a survey exam, such as a high resolution chest exam. For
the 1i 1.25 mm mode, the minimum scanning interval between slices is 5mm.
NOTE: For more information on axial interval with skip, refer to Multi-Detector Information.
In the Cine mode, for an interval greater than zero, scans is created at several
locations, and the end location changes. For an interval of zero, all 1i 1.25 mm
images are taken at the same location. For the single slice High Resolution Chest
Mode, the minimum scanning interval between slices is 5 mm. The usual interval is
10, 20, or 40 mm. You can change the interval when setting up prospective multiple
recons.
In Helical, the image interval defaults to equal the slice thickness. The interval
maximum is twice the slice thickness.
For Volume Helical Shuttle, the interval is set to 10 mm for the first reconstruction.
For VolumeShuttle (axial), the interval is set to 40 mm.
The Gantry Tilt can be set manually to a maximum of 30 degrees in half degree
increments.
Type C' to enter the "current degree" in tilt field on the view edit table instead typing
the value of current degree.
NOTE: You may adjust the gantry to the desired tilt and type C in the gantry tilt field. This
updates the tilt with the current gantry tilt. This is useful when scanning head studies
without taking a scout scan.

21-8
Scan Series Setup

8. Click [SFOV] and choose which field of view that you want.
The system comes with seven scan field of views.
Ped Head, Small Head, Head, Ped Body, Small Body, Medium Body, Large Body,
and Cardiac SFOVs.
Cardiac Small, Cardiac Medium, Cardiac Large
a) [Ped Head] is a field of view that is particularly useful for infants 18 months or less in
age. It allows you to enter up to a 32 cm field of view. The Ped Head is limited to
42kW.
b) The [Small Head] is for imaging small heads.
c) The [Head] scan field of view is for adult head scanning.
d) The [Ped Body] is a field of view that is useful for infants. It allows you to enter up to
32 cm field of view. Ped Body is limited to 42kW.
e) The [Small Body] scan field of view is particularly useful for extremities and the QA
phantom. It allows you to enter up to 32 cm field of view.
f) The [Medium Body] scan field of view is particularly useful for imaging bodies that
are less than 36 cm.
g) The [Large Body] scan field of view is particularly useful for all body work. If you
measure the anatomy that you are scanning and it measures over 25 cm, you need
to use the large scan field of view. It allows you to enter up to a 50 cm display field of
view.
h) The [Cardiac Small, Cardiac Medium, Cardiac Large] scan field of views are use with
cardiac scan types.
9. Click [kV] and choose which kV station that you want to use.
The system comes with four different kV stations.
These are examples for you to go by.
a) The 80kV station is particularly useful for Bone Mineral Densitomery and Perfusion
imaging in the brain.
b) The 100kV station is particularly useful for pediatric imaging.
c) The 120kV station is particularly useful for routine imaging of the chest, abdomen,
and pelvis areas.
d) The 140kV station is particularly useful for Posterior Fossa area, thick areas, and
heavy patients.
e) For GSI scan type, the kV stations are automatically set.

21-9
Scan Series Setup

10. Click [mA] and type in the mA selection that you want to use.
The system allows you to type in increments of 5 mA from 10 mA up to 800 mA for
the Performix HDtube.
You could also use Auto mA/Smart mA and set the minimum and maximum mA
range and the noise index (NI).
NOTE: If orientation for the last scout and series do not match, AutomA is automatically
turned off. AutomA can be enable once the orientation for the last scout and the series
match.
Figure 21-1
Quick Steps: Set Scan Parameters

1. From the scan monitor, click [Next Series].
2. The orientation of the patient at the top of the monitor should be the same as the
scout. If not, click on the picture of the patient.
3. To set the scan parameters, start at the left side of the screen and work your way to
the right.
4. Select the [Scan type] and choose the desired scan mode.
5. Click [Thick Speed] and choose the detector coverage, the image thickness and
images per rotation you want.
6. Click [Interval mm] and type in the interval that you want.
8. Click [SFOV] and choose which field of view that you want.
9. Click [kV] and choose which kV station that you want to use.
10. Click [mA] and type in the mA selection that you want to use.

21-10
Scan Series Setup
Adjusting the scan series graphically is the fastest way to set up for a scan series. If your
protocol is set up correctly, you do not have to make many changes; just adjust the lines
representing the series and confirm.
NOTE: Restart Show Loc in the Tool Bar can be used to restart Graphic Rx in the situation
where the Scout image has been reconstructed but does not appear in Show
Localizer.
NOTE: If the scout scan is still not shown in Show Localizer after selecting Restart Show Loc,
use the crosshair cursor on the scout to explicitly define the start/end location and
offsets.
2. This shows the scout with the graphic lines for you to adjust.While holding the shift key
down, click and drag the center red X to position the lines over the anatomy you wish to
cover.
This allows you to move the lines up and down on a lateral scout, as well as from side
to side on a AP scout. By moving the lines, you are adjusting the start and end
location, and the RAS (Right, Anterior, and Superior) coordinates.
3. Click and drag the solid box to the starting position.
This changes the starting point.
4. Click and drag the empty box to the ending position.
This changes the ending point.
If you hold the shift key down and drag either the solid or empty box, it adjusts both
the starting and ending locations at the same time.
5. Click and drag the diamond key to set the display field of view.
If you hold the shift key down and drag on the diamond key, it adjusts both sides of
the lines.
6. Click and drag the circle to adjust the tilt if needed.
If you tilt and change your mind, hold the shift key down and click on the circle. This
returns the tilt parameter to 0 degrees.
7. Select [Show] or [Hide] from the control panel.
If Hide Slices is visible then graphic mode is to show a line for each image reconned.
Hide Slices is the default at system boot up. Once you change the mode, it will
remain through all exams until you do a system restart or shutdown.
If Show Slices visible then graphic mode is to show a transparent area of coverage,
no lines displayed for slices.

21-11
Scan Series Setup

8. Review the values entered by Graphic Rx in the View/Edit screen to make sure they are
correct.
Figure 21-2 Graphic Options
Quick Steps: Adjusting Graphic Rx

2. This shows the scout with the graphic lines for you to adjust.While holding the shift key
down, click and drag the center red X to position the lines over the anatomy you wish
to cover.
3. Click and drag the solid box to the starting position.
4. Click and drag the empty box to the ending position.
5. Click and drag the diamond key to set the display field of view.
6. Click and drag the circle to adjust the tilt if needed.
7. Select [Show] or [Hide] from the control panel.
8. Review the values entered by Graphic Rx in the View/Edit screen to make sure they are
correct.

21-12
Scan Series Setup

Timing is a very important part of setting up the scan. The patients condition has a large
effect on timing. Make sure that you know how long the patient can hold his/her breath. This
helps when working with the Auto Voice.
It is very important to utilize injection delays. You can only inject once and you must get it
right the first time. Different anatomy enhances at different times. Check with your
radiologist for the right injection delays.
1. If the (Timing) card is not showing on top, select it. This is the card that looks like a stop
watch.
2. Click [Prep Group] and type in a injection delay if needed.

This can be used for giving contrast with a timed delay.
This can change to accommodate auto voice.
Valid ranges are:
Group 1 can be from 0 to 90 seconds.
Group 2 throughout the scan can be from 1 to 600 seconds, depending on scan
modes. Helical requires a 5 second delay and Cine requires a 1 second delay.
If you are using SmartPrep option, this field is replaced with SP and the time for the
Diagnostic Delay.
For more information on Smart Prep, refer to Smart Prep.
3. If scanning in the axial mode, click [ISD] (interscan delay) and type in a scan delay
between each axial scan.
This is the amount of time that you want to wait between each scan.
This can be useful when the optimizer is red. You can increase the ISD to allow for
more tube cooling.
4. Click [Breath Hold] and type in how long you want the patient to hold his/her breath.
Try to make this time as long as you can to avoid misregistration of anatomy.
5. Click [Breathe Time] and type in how long you want to give the patient to breathe in
between groups of scans.
Make sure that the patient can breathe but do not make the time gap between
breaths too long otherwise you loses the IV contrast.

21-13
Scan Series Setup

6. Click [Voice Lights Timer] and select which commands you want to use for breathing
instructions.
Three pre recorded voices are available in 9 languages. Which are user selectable.
Figure 21-3
NOTE: The Auto Voice language displayed at the time the systems is booted up is the
If the Auto Voice language is changed for the current exam, the system will return to
the default language once you have clicked End Exam.
You can record an additional 17 voice instructions. For more information on Auto
Voice, refer to the Record a Personalized AutoVoice section of this guide.
You can choose to select AutoVoice preset delay. For more information refer to:
You can choose to select Breathing lights and/or a timer.

21-14
Scan Series Setup

Figure 21-4 .
A pale yellow color window with a "N" indicates the breathing lights are selected only.
No auto voice is selected.
A pale yellow color window with a "T" in it indicates that the breathing lights are
selected with a countdown timer.
A pale yellow color window with a number and a "T" indicates that auto voice,
breathing lights, and the countdown timer are selected.
Figure 21-5
A blue color window with a number indicates that auto voice only is selected. No
breathing lights or delays will come on.

21-15
Scan Series Setup

7. Click [Preview].
The preview function allows you to view graphically how the combination of breath
hold and breathe time affects your system.
Here is an example of the preview screen. In the beginning, you can see that there is
a 45 second prep delay, followed by a axial cluster of six scans. At the end of the axial
cluster, there is a 10 second breathe time and the helical clusters begin.
If your exams preview graph exceeds the width of the screen, you can use the scroll
keys at the bottom of the screen.
Preview also displays a summary of all your scan groups.
8. To get out of the preview mode and start scanning, click Confirm.
If you want to go back to view edit and make changes, click [View Edit].

21-16
Scan Series Setup
Quick Steps: Set Timing Parameters

1. If the (Timing) card is not showing on top, select it. This is the card that looks like a stop
watch.
2. Click [Prep Group] and type in a injection delay if needed.
3. If scanning in the axial mode, click [ISD] (interscan delay) and type in a scan delay
between each axial scan.
4. Click [Breath Hold] and type in how long you want the patient to hold his/her breath.
5. Click [Breathe Time] and type in how long you want to give the patient to breathe in
between groups of scans.
6. Click [Voice Lights Timer] and select which commands you want to use for breathing
instructions.
7. Click [Preview].
8. To get out of the preview mode and start scanning, click Confirm.

21-17
Scan Series Setup
Set Display Factors

Most of these parameters are already set from the protocol, and from the adjustments that
you make with the graphic lines on the scouts.
When setting the display factors, it is important to know why you are scanning the patient
and what you are looking for. If you are looking for fractures, you might want to use certain
parameters instead, if you were looking for a mass, you would want to use a different set of
parameters.
You can reconstruct images three different ways and film images nine different ways.
NOTE: For more information on filming, refer to: Automatic Filming
1. Select the Display card.
This is the card that has a image of a chest on it.

This shows all of the display parameters.
2. Click [DFOV] and type in the patients measurements.
This can also be adjusted by utilizing the diamond keys on each side of the graphic
lines on the scout.
If you want to type in a measurement, measure the patient at the widest point and
add 2 cm. This shows all the anatomy and the soft tissue around the anatomy.
3. Click [R/L Center] and type the R/L (right/left) coordinates.
This can be adjusted on the scout by dragging the diamond keys in or out on an AP
scout.
This can also be found by placing the mouse over the image and looking at the R or L
read out at the bottom of the image.
NOTE: + may be used for R values and - may be used for L values for faster data entry using
the ten key pad.
4. Click [A/P Center] and type the A/P (anterior/posterior) coordinates.
This can be adjusted by dragging the diamond keys up and down on an lateral scout.
This can be found by placing the mouse over the image and looking at the A or P read
out at the bottom of the image.
NOTE: + may be uses for A values and - may be used for P values for faster data entry using
the ten key pad.

21-18
Scan Series Setup

NOTE: If D was selected in Protocol Management, DFOV, A/P Center, R/L Center for
reconstruction is updated automatically to the values used in the previous series.
Recon 2 and/or Recon 3 values are copied from Recon 1.
5. Click [Recon Type] and then select which algorithm you want to use.
The system comes with seven different algorithms.
a) Soft is particularly useful for tissues with similar densities, but not useful for
un-enhanced scans.
b) Std, short for standard, is particularly useful for routine exams like chest, abdomens,
and pelvis scans.
c) Lung is particularly useful for interstitial lung pathology.
d) Detail is particularly useful for post myelograms, where hybrid tissue detail and bone
edges are important.
e) Bone is particularly useful for High resolution exams and sharp bone detail.
f) Edge is particularly useful for small bone work in the head, as well as high resolution
scans.
g) Bone Plus is particularly useful for sub mm detailed head work.
h) Chest is particularly useful for when mediastinum and lung detail are desired.
i) In Hi Res mode, there are additional algorithms available. These algorithms provide
higher resolution detail with the same characteristics as the non Hi Res algorithms.
HD Standard
HD Detail
HD Bone
HD Edge
HD Bone Plus
Cardiac Hi Res mode imaging
HD Standard
HD Standard Plus
HD Detail
HD Detail Plus
HD Edge

21-19
Scan Series Setup

Figure 21-6 Non-Cardiac Scanning Mode
Figure 21-7 Cardiac Scanning Mode
6. The [Matrix Size] for CT images is always 512 matrix.

The 512 matrix size gives the best image resolution.
7. Click [Recon Option].
If the scan type is Helical the Recon Mode options are [Full] or [Plus]. For all other
scan modes, the Recon Mode is set to [Full] with no other options.
Window Width and Window Levels entered here is also added to Film Set 1.
If you are in the Cardiac scan mode, the Cardiac Filters are available. Select the filter
you wish to use.
If you wish to enable able ASIR, select Slice or Volume mode and the percent of noise
reduction desired.
If you want to flip or rotate the image in recon so the image will be reconstructed in
the orientation desired for viewing, select Flip Right/Left, Flip Top/Bottom or both Flip
Top/Bottom and Right/Left.

21-20
Scan Series Setup

Figure 21-8 Recon Options
IQ Enhance is a recon mode which can minimize helical artifacts seen in helical thin
slice images. Image Enhance is compatible with 0.625 and 1.25 mm slice thicknesses.
Intervals must be set equal to the slice thickness (0.625 or 1.25) or half the slice
thickness (0.312 or 0.625). IQ Enhance annotation is added to the left side of the
image.
An E is added to the annotation on the left side of the image to indicate IQ
Enhance was enabled.
NOTE: For Head and Ped Head only Plus mode is allowed prospectively for 0.625 and 1.25mm
slice thickness, but Helical Pitch of 1.375:1 or 1.75. Full mode is enabled with IQ
Enhance for scans with 0.625 mm and 1.25 mm thick from 16 X 0.625 and 16 X 1.25
detectors when the SFOV used is Head or Ped Head, and Helical Pitch of 0.562:1 or
0.938:1.

21-21
Scan Series Setup

8. If you want a second reconstruction, click [Show Recon 2], click [Recon Enabled] and
click [Yes].
You are able to change your start and end locations as long as they do not exceed
Recon 1.
You can also change the slice thickness, interval, DFOV, R/L, A/P, and Recon Type to a
different value than Recon 1.
If you want a different Series Description than Recon 1 enter the desired description
in the Series description field. If the description is blank, it will use the same
description as Recon 1 and add Recon 2 or Recon 3 to the beginning of the
description.
NOTE: If D was selected in Protocol Management for Start and End Locations, Interval, DFOV,
A/P Center, R/L Center, the reconstruction are updated automatically to the values
used in the previous series. Recon 2 and/or Recon 3 values are copied from Recon 1.
9. If you want a third reconstruction, click [Show Recon 3], click [Recon Enabled] and click
[Yes].
You are able to change your start and end locations as long as they do not exceed
Recon 1.
You can also change the slice thickness, interval, DFOV, R/L, A/P and Recon Type to a
different value than Recon 1 and turn it on.

21-22
Scan Series Setup

10. Click [Series Auto Transfer] if you want to transfer Recon 2 and Recon 3 to another
workstation.
A Host window will pop-up.
Up to four locations can be selected.
11. Select which Host you wish to network Recon 2 and Recon 3 to.
12. Click [OK].
The button will update to show the first host name.

21-23
Scan Series Setup
Quick Steps: Set Display Factors

1. Select the Display card.
2. Click [DFOV] and type in the patients measurements.
3. Click [R/L Center] and type the R/L (right/left) coordinates.
4. Click [A/P Center] and type the A/P (anterior/posterior) coordinates.
5. Click [Recon Type] and then select which algorithm you want to use.
6. The [Matrix Size] for CT images is always 512 matrix.
7. Click [Recon Option].
8. If you want a second reconstruction, click [Show Recon 2], click [Recon Enabled] and
click [Yes].
9. If you want a third reconstruction, click [Show Recon 3], click [Recon Enabled] and click
[Yes].
10. Click [Series Auto Transfer] if you want to transfer Recon 2 and Recon 3 to another
workstation.
11. Select which Host you wish to network Recon 2 and Recon 3 to.
12. Click [OK].

21-24
Scan Series Setup
Repeat a Series
Repeat Series now allows you to choose any series that has been scanned. When more than
one series has been scanned, a list of all scanned series will be displayed. Click on the series
that you wish to repeat. If only one series has been scanned, Repeat Series will not display
the Repeat Series pop-up. The state of Show Localizer on or off is remembered by the
system. If Show localizer state is on, it will be automatically displayed when you return to the
ViewEdit screen.
1. Click [Repeat Series].
This is located at the bottom of the View Edit screen.
The Series List window appears.

2. Select which series you want to repeat from the Series List.
3. Click [OK].

21-25
Scan Series Setup
Quick Steps: Repeat a Series

1. Click [Repeat Series].
2. Select which series you want to repeat from the Series List.
3. Click [OK].

21-26
Scan Series Setup

If you are using IV or GI contrast, you can enter the descriptions or select from a list of preset
descriptions.
When IV contrast is to be used, make sure the injector or syringes of contrast are set up
before performing the localizer (scout) scan. The contrast (syringe) icon on the lower right
corner of the view/edit screen must be selected. When the icon is selected, there is a +C
annotation on the images next to the image number, indicating that IV contrast was used
for that exam.
1. Click the Syringe or GI icon or click [Preset List] below the Syringe or GI icon.
Figure 21-9
The Contrast fields for manual entry of IV or Oral information appears.

The text entered into the manual text field will not be saved as a preset.
2. Click on the IV or Oral contrast text field and enter a description.
3. If you click [Preset List], select the desired contrast description from the preset list.
Figure 21-10 Preset Contrast Descriptions

21-27
Scan Series Setup

4. Click [Change], [Add], [Delete], or [Sort] if needed.
Change allows you to edit the current selected description.
Add allows you to add new descriptions.
Delete removes the selected description.
Sort allows you to sort the list items. The sort order is 1, 10, 100 to 9, 90, A to Z, a to z.
If Sort is not used, the entries are displayed with the last entry displayed at the top of
the list.
5. Click [OK].
Quick Steps: Enter Contrast Descriptions

1. Click the Syringe or GI icon or click [Preset List] below the Syringe or GI icon.
2. Click on the IV or Oral contrast text field and enter a description.
3. If you click [Preset List], select the desired contrast description from the preset list.
4. Click [Change], [Add], [Delete], or [Sort] if needed.
5. Click [OK].

21-28
Automatic Filming
Chapter 22
Automatic Filming
Introduction
This chapter explains how to perform some basic tasks for auto filming. It contains the
Set the Film Parameters for Automatic Filming
Set the Image Parameters for Automatic Filming
Use the Filming Buttons on the Autofilm Viewport
Manually Add an Image to the AutoFilm Composer

22-1
Automatic Filming

This section presents concepts necessary to understand ways to autofilm images. Some of
the concepts you need to understand are:
Autostart
Image Filters
Gray Scale Enhancement
Autostart
Autostart is a feature used in automatic filming where the filming can be set to start as soon
as images are taken and reconstructed. This is selected in autofilm setup and can be turned
on or off for each film set. The choices of No Autostart, Autostart New Sheet, and
Autostart Same Sheet are available. No Autostart tells the system not to auto start the
filming of the film set. Autostart New Sheet tells the system to auto start the film set using
a new sheet of film. Autostart Same Sheet tells the system to auto start the film set using
the existing sheet of film. If Autofilm is turned ON and No Autostart is selected, then
AutoFilm has to be started manually by you from the AutoFilm viewport. Having Autostart
ON adds to maximum AutoFilm efficiency.
Image Filters
There are several different display enhancement filters available on the system. The Edge
Enhancement filters are useful for filming bone windows, as they sharpens the image. There
are six levels of Edge Enhancement, E1, E21, E2, E22, E23, and E3. E1 applies the least
amount of enhancement and E3 applies the most. When these filters are used, the image is
annotated with E1, E2, E21, E22, E23, or E3.
The Lung Enhancement filter is designed specifically to use when filming lung windows.
When the Lung enhancement filter is applied, the image is annotated with the word Lung.
There are also five Smoothing filters, S1,S11, S2, S22 and S3, which are used when filming
soft tissue windows to decrease the appearance of noise in an image or enhance low
contrast areas. S1 applies the least amount of smoothing and S3 applies the most. When
these filters are used, the images is annotated with S1, S11, S2, S22 or S3.

Gray Scale Enhancement (GSE) is a display feature that changes the slope and gamma
curve of an image. It can be used in head studies to improve the bone/brain interface which
helps with gray/white matter differentiation. There are three levels of Gray Scale

22-2
Automatic Filming
Enhancement, G1, G2 and G3. G1 applies the least amount of enhancement and G3 applies
the most. When a filter is applied, the images is annotated with G1, G2, or G3 just above the
vertical tick mark scale on the right side of the image.

22-3
Automatic Filming
How Do I...
This section provides the step-by-step instructions for using autofilming. Specifically, it
describes how to:

22-4
Automatic Filming
Referen
ce)
Automatic filming is a feature in which the scanner automatically films an exam. Values for
filming like format, number of copies, W/L, etc., can be set up ahead of time in a protocol by
using the AutoFilm Setup button from the view/edit screen.
Quick Steps: Set the Film Parameters for Automatic Filming

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Click [AutoFilm Setup].

Select the desired camera or printer.
Select the desired film format from the choices listed.
Set the expose direction for the images.
Set the size of the image frame on film.
Set the number of film copies.
Set the autostart parameters.
Set the auto print parameters.
Set the display for the film composer.
Set parameters to place scoutview image on film.
Set parameters to place scoutview image with reference lines on film.
Set parameters to place exam and/or series information on film.
Set parameters to film the grayscale.
When done with all parameters, click [OK] or [Cancel] on the bottom of the AutoFilm
Setup window.

22-5
Automatic Filming

To use the AutoFilm feature, parameters must be set in AutoFilm Setup and then filming
must be turned on. This is done on the AutoFilm tab card, from the view/edit screen. If
AutoFilming is not turned on, autofilming does not occur.
Quick Steps: Set the Image Parameters for Automatic Filming

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
On the view/edit screen, click the AutoFilm tab card.

Turn autofilming ON.
Set the frame format for each film space.
Set the interval of the images to be filmed.
Set parameters to flip image on film.
Set parameters for window width and level.
Set parameters to magnify images to be filmed.
Set parameters to rotate images on film.
Add annotation to images to be filmed.
Add image filters to images to be filmed.
Add grayscale enhancement to images to be filmed.

22-6
Automatic Filming

There are several buttons you may need to use for autofilming which are located on the
AutoFilm viewport once scanning begins. These buttons allow you to further customize
autofilming.
When the first reconstructed image appears in the AutoFilm viewport, adjust the WW/WL as
needed.
1. Click [Start New Sheet] (if no autostart was selected in AutoFilm setup).
If AutoFilm is turned on for the series, but No Autostart was selected from AutoFilm
Setup, Start New Sheet must be used to start autofilming with a new sheet of film
and to apply the settings prescribed in AutoFilm Setup. Filming uses the format which
was selected from AutoFilm Setup.
2. To pause filming during AutoFilm, click [Pause Filming].
This temporarily pauses autofilming, which allows you to adjust the WW/WL or
perform display features such as ROI and measure distance.

22-7
Automatic Filming
3. To restart autofilming after using [Pause Filming], click [Continue Same Sheet].
This continues filming where you left off, on the same sheet of film.
You can also use Continue Same Sheet to start AutoFilm initially, instead of using
Start New Sheet. The only difference is that filming continues on the same sheet of
film that is already on the film composer, instead of using a new one.
Also, this keeps all of the settings used in the previous exam for autofilming.
4. Click [Cancel Film Series] to delete a series from filming.
This would be useful if there was a lot of patient motion and you did not want the
current series to be filmed.
5. Click [Cancel Film Exam] to delete an entire exam from filming.
Quick Steps: Use the Filming Buttons on the Autofilm Viewport

1.
2.
3.
4.
5.
Click [Start New Sheet] (if no autostart was selected in AutoFilm setup).
To pause filming during AutoFilm, click [Pause Filming].
To restart autofilming after using [Pause Filming], click [Continue Same Sheet].
Click [Cancel Film Series] to delete a series from filming.
Click [Cancel Film Exam] to delete an entire exam from filming.

22-8
Automatic Filming

There are times when you may want to manually add images to the AutoFilm composer. For
example, if you wanted to add an image with special graphics or a particular WW/WL, or if
you wanted to add a multiple image display (MID).
Quick Steps: Manually Add an Image to the AutoFilm Composer

1. When AutoFilm is either paused or finished, place the mouse cursor on the image or
MID to be filmed.
2. Press F12 on the keyboard to place a single image onto the AutoFilm composer.
3. Press Shift F3 to place an MID onto the AutoFilm composer.
4. Repeat as necessary.

22-9
Manually Filming Images
Chapter 23

Introduction
This chapter explains Manually Filming Images. It contains the step-by-step instructions to
Set Window Width and Window Level Preset Keys
Set Manual Film Composer Parameters
Place Images in the Manual Film Composer
Set Print Series Parameters
NOTE: In this chapter the feature that is utilized for filming is called a Film Composer and
has the designation of Auto or Manual Film Composer. These features are set as icons
on the display monitor. The icons do not need to be selected for the feature to operate.
It is beneficial in the early use of your system to select these icons and see how they
look when in operation.

23-1

This section presents the concepts necessary to successfully manually film images. Some of
the concepts you need to understand are:
Using the F Keys
Setting Window Width and Level Presets
Using the F Keys

The top row of the computer keyboard is composed of keys labeled F1-F12. The system has
preset functions built for filming images in the F1-F4 keys. The F1 key allows you to place a
single image in the manual film composer. The F2 key allows you to have the composer
automatically adjust to whatever format you are viewing images in and film those images
as a page. The F3 key allows you to film multiple images in a single cell of the composer. The
F4 allows you to film all the images in any one series. All of the images must be filmed in the
same window width and level when using this key. The F5-F11 keys are used for adjusting
the appearance of images by changing window widths and window levels (gray scale and
contrast). The F12 key is utilized with the auto film composer for transferring an image. Use
of the F Keys helps save time for the person doing manual filming.
Setting Window Width and Level Presets

The F5-F11 keys may each be programmed for a different window width and window level
setting. This gives the system a wide variety of appearances for specific image types. The
system comes with settings for each key already set. However, these may be easily adjusted
and programmed into the system according to your facilitys preferences. This allows you to
use a single key to adjust window widths and levels. The widths and levels may be
programmed to follow a template on the keyboard or set to any image type you choose.
when opened side by side) is that all of the format and options buttons are shown on the
Manual Film Composer and these buttons are not shown on the Auto Film Composer. All of
the options for Auto Film can be adjusted from the Auto Film Setup portion of the View Edit
Screen (refer to Set the Film Parameters for Automatic Filming for auto film setup details).

23-2
How Do I...
This section provides the step-by-step instructions for manually filming images. Specifically,
it describes how to:

23-3

The F5-F11 keys along the top of the computer keyboard are used to adjust window width
and level settings by simply touching the appropriate key. These window widths and levels
represent different gray scale and contrast values to better demonstrate the different types
of anatomy in a scan. These keys are set with values that may be adjusted as needed for
your facility.
Quick Steps: Set Window Width and Window Level Preset Keys
1.
2.
3.
4.
On the display monitor, double click one of the lower viewports.

From the display monitor, click [List Select].
From the pop up window select an exam and an image.
Enter the window width setting in the Accelerator Command Bar (gray bar in the lower
left corner of display screen, i.e. WW 400).
5. Enter the window level setting in the Accelerator Command Bar (i.e. WL 35).
6. Hold down [Shift] and press any F5-F11 key.
7. Repeat Steps 4, 5 and 6 to set any of the F5-F11 key settings.

23-4

Several settings are available on the Manual Film Composer and must be set by you. Once
these settings are established the system retains them until changed by you and then the
new settings are in the system. Any of the settings may be changed prior to the actual
printing of the images in the composer.
Quick Steps: Set Manual Film Composer Parameters

1.
2.
3.
4.
5.
Click [Manual Film Composer].,

Select Format.
Click [Options].
Select No. of Copies.
Click [Done].

23-5

All images to be filmed must be placed in a composer for transfer to the camera. This may
be done automatically or manually. This section deals with the Manual Film Composer.
Images may be placed in the composer individually or in series. See the note at the end of
this section for using the F2 key.
Quick Steps: Place Images in the Manual Film Composer

1.
2.
3.
4.
5.
6.
7.
On the display monitor, double click in one of the lower viewports.

From the pop up window, select an Exam, Series and Image.
Click [Accept] or [Cancel].
Click [Manual Film Composer].
Place cursor in the image to be filmed.
Click and drag the image or use F1 key.

23-6

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

1.
2.
3.
4.
5.
6.
7.
8.
9.
On the display monitor, click in one of the lower viewports.

Select an Exam, Series and Image.
Click Manual Film Composer icon.
Place the cursor in the image/series to be used for Print Series.
Press the F4 (Print Series) key.
Set Print Series Parameters.
Click [Print Series].
To cancel a Print Series request, Press the F4 key and [Cancel] from Current Print Job.

23-7
Managing Images
Chapter 24
Managing Images
Introduction
This chapter explains the process of managing Images. It provides step-by-step instructions
to learn how to:
Set up a Remote Host
Select an Archive Node
Set an Access to a Local Host and Set Up a Custom Search
Select an Archive Device
Prepare a New Storage Media for Use
Save Exam/Series/Images to a Storage Media
Retrieve Exams/Series/Images From a Storage Media
Save Exam/Series/Images using CD/DVD Interchange Option
Transfer Exams/Series/Images to Another Computer
Retrieve Exams/Series/Images From Another Computer
Check Network History File
Edit Patient Information
Remove Patient Information From an Exam
Delete Exams/Series/Images From the System
Compose a Report in Data Export
Save a Report to CD-R
FTP a Report
View a Report on a PC

24-1
Managing Images

This section presents the concepts necessary to successfully complete the process of
managing image data. Specifically you need to understand:
Feature Status Area
Anonymous Patient
Archive
Network
WorkArounds
Data Export
CD/DVD Interchange (Option)
Feature Status Area

The Feature Status Area displays the date, time and available system disk space. System
disk space availability is always on your console in the Feature Status Area. It reports how
many 256 x 2562 matrix and 512 x 5122 matrix images it can hold.
NOTE: It is recommended that you delete images when the image space falls below 200
images. This will ensure there is room on the system disk to confirm scans and to
install reconstructed images.
In the middle of the Feature Status Area is a row of icons. From top to bottom, the icons are
for image reconstruction, archive, network, and filming functions. To the right of these icons
is the current status.
Image Reconstruction Status

Text to the right of this icon indicates the percent completed for the exam, series, and
image range being reconstructed.

24-2
Managing Images
Archive Status
Text to the right of this icon indicates status of the images being archived.
Network Status
Text to the right of this icon indicates the status of the systems networking functions.
Filming Status
Text to the right of this icon indicates filming status of the images being filmed
Anonymous Patient
There may be times when you would want the name of a patient to be kept confidential. This
is when you want to create an Anonymous Patient. An Anonymous Patient can be created
by exam, series, or even a single image.
A few good reasons for using Anonymous patient would be:
Your radiologist wants to take the films to a conference.
You have scanned a test patient or volunteer and do not want the name displayed.
Anytime you do not want the patients name on films. For example, films that are in a
display or would be put in a show.
Anytime you send images to GE.
Anonymous Patient changes Patient Name, Patient ID, Exam Number, Exam, Description
and Series Description.
Archive
Archive is an off-line filing system for images. The archive feature allows you to save and
restore images to and from a media storage device or remote host. The archive system uses
a Magnetic Optical Disk (MOD) for storage. Images stored on an MOD are "off-line" meaning
that in order to display the images you must first restore them to the system disk. The MOD
is considered a local archive device. Communication from your system to the MOD is in a
DICOM format, so that the MOD listed in the archive window as a DICOM_MOD.
The archive function can read from and write to Maxoptix archive media. This is the
standard drive.
In addition to the Maxoptix MOD, images can be archived to a remote network host
providing the host is a Storage Commitment Class Provider.
Archive verifies the integrity of the data by performing a hardware check in the media drive.

24-3
Managing Images
Network
Networks link image acquisition systems and workstations together. By connecting these
compatible devices, you have the ability to transfer images between your scanner and
workstations and/or other image acquisition systems, quickly and easily.
Common situations for networking are:
To take advanced image manipulations such as 3D and reformatting images offline.
To provide a quick way for a radiologist to view films.
In order to understand the networking process, a few key terms are explained below.
Networking Terms
In the chart below you will find some terms that are associated with the process of
networking.
Term
Definition
Remote Host
Image acquisition system or workstation connected to the

network. Each host has its own network address.
Transfer
Moving of imaging data between stations.
Transmit/Send
Sending images from one station to another.
Transmit/Receive
Retrieving images from another station.
Auto Transfer by Exam
Automatic image transfer of a newly completed exam.
Auto Transfer by Series
Automatic image transfer of a newly completed series. The

series must be ended before the transfer begins.
Auto Transfer by Image
Automatic image transfer of images queued in groups of 50

images.

Performed Procedure Step is part of ConnectPro OPTION. To use it you need a HIS/RIS
system and PACS with the Connect Pro option. It sends communication back to PACS and
HIS/RIS that you have completed a procedure. It improves transfer of data because it can
provide a complete message when all data has been transferred. The browser will have a
PPS column that will list the PPS status of each exam. There are three states of exam status:
COMP, meaning the exam is complete; DISC, meaning the exam is discontinued and it
cannot use PPS again; or INPR, meaning that the exam is still in progress.

24-4
Managing Images
WorkArounds
Images archived on an Advantage Windows system may fail to restore on the
system. Use Network to transfer images from the Advantage Windows to the
scanner.
Even though the Sony MOD drive states that it is a 5.3 gb drive. The archive software
only supports a maximum size of 2.3 gb. 2.3 gb 512 bytes per sector is the preferred
archive media size to utilize on the system.
Archive may fail and slow the system when more than 200 images are queued by
image. To avoid this, try to archive by series if possible.
The system may report that the media is full even though the media has just been
labeled when Save by image is selected. To avoid this, Try selecting a smaller
range of images.
The feature status area or the browser may report an Exam has saved even though
all images have not been saved to MOD. Scroll through the images in the image
window. Highlight the images listed as Archive N and re-save them.
Restoring Exam, Series or images that already exist on the system disk will not post a
message that the images are restored or that they already exist. If you have restored
images, but get no message that they have been restored, verify that they don't
already exist on the system disk.
When the archive media gets close to being full, the system will always look to see if
the exam, series or image can fit on the MOD, if it is desired to have exams
sequentially on a MOD, place a new MOD in the drive when first notified the disk may
be full.
If Label is selected in Archive, finish the Label process; don't select cancel on the
Label pop up. Archive will be non functional, a system reboot will be necessary to
recover.
It's best to resolve any paused queue entry as soon as possible.
To minimize corruption of MODs, it is extremely important the MOD media be
detached and removed from the MOD drive before doing a shutdown or recycling
power to the system.
When restoring from a MOD, it is recommended to write protect the media before
placing it in the drive. If the system is unable to read the media, remove the write
protect and see if the system is able to perform a recovery of the media to access the
data.
If the MOD can not be detached or will not eject from the drive, do a shutdown and
eject the MOD once the message "Hit any key to start the system" is seen. Do not use
the screw to eject the disk.
If you get a time-out message when trying to access the MOD, the MOD drive may no
longer recognized by the system. Perform a shutdown to re-establish
communication between the system and the MOD drive.

24-5
Managing Images
Data Export
Data Export allows you to either store or FTP CT images as JPEG, PNG, AVI, MPEG or MOV
formats. The files can only be burned to a CD-R and only one report can be burned at a time.
Once a CD-R has been burned, you cannot add more reports at a later time. It is not a
rewritable process.
The JPEG, PNG, AVI, MPEG or MOV images can be viewed from a PC or laptop with a
Windows 2000 or XP operating system using Internet Explorer 5.5 or later.
There are two tabs on the Data Export window:
Compose tab allows you to define the compression factor, annotation level, W/L,
Zoom, scroll, and output format for the series you want to export.
Export tab allows you to view a list of all the examinations and series you have in the
Data Export program.
You can compose a series and then export it to either a CD or FTP site at a later
date.
Examinations and series stay in the Export program until they are actively deleted.
Figure 24-1 Data Export Window

24-6
Managing Images
Figure 24-2 Compose Tab
8
2
11
10
5
7
4
Table 24-1 Compose Tab Descriptions
#
1
Selection
Description
Selection
Displays patient name, examination and series number, number of images in the series,
file size of the images with current compression selection, and matrix size.
Conversion
Format
Allows you to select the image format for the currently selected data set. Format
choices include: JPEG, PNG, AVI, MPEG, and MOV. AVI, MPEG, and MOV are all movie type
formats. Choose the format that is compatible with the movie player on your PC or
laptop.
Compression
Factor
Only applies to JPEG and MPEGs. The lower the number, the less compression, the
higher the image quality but the larger the file. Image/Sec. is movie play back speed
and therefore it is only applicable for MPEG, AVI or MOV files.
Frame per
Second
Allow you to set how many frame to play per second. This option is only available when
you have selected a MPEG, AVI or MOV conversion format.
Image Range
Selection
Allows you to select the images you want to place in the designated folder. For example,
if you have a multi-phase series selected and all you want is the first phase in the MPEG,
then select the range of images representing phase 1 of your data set. The ability to
select a subset of images from the selected series is particularly important if you are
plan to FTP the files rather than burn a CD.
You can enter a interval to create a movie file of a specific interval of images. The valid
range for the interval is one minus the maximum number of images in the series.
Annotation
Allows you to set the level of annotation for the images: none, full, partial (a subset of
the full annotation) or custom which activates the [Customize] button that allows
specific annotation options.

24-7
Managing Images
#
Selection
Description
Propagate
Allows you to apply the image manipulations (W/L, zoom, scroll) you have performed on
all images forward from the currently displayed image.
Play/Stop
Click the [Play] button to preview the MPEG, AVI, or MOV file. Click the [Stop] button to
quit playing the movie.
Quit
Closes the Data Export window.
Image Area
Displays the current images by scrolling through them in a cine loop. Use the keyboard
Page Up and Page Down keys to move through the images manually.
NOTE: You must click on the image window and put it in focus before next/prior
will function.
9
Report Name
Appears at the top of the report once you execute the data export. It also appears in the
Export data list. Typically the patients name and type of file are entered as the Report
Name. There can be no spaces or characters other than AlphaNumeric.
Folder Name
The name of the folder to which you want to file the Report Name. From the Export tab,
you can view the data listed within each folder. The data within a folder is sorted by file
type. For example, if you added 10 JPEGs from the T1 series and 20 JPEGs from the T2
series you will see a list of 30 JPEGs in that folder. If you want these JPEGs separated,
you must place them in separate folders.
10
Anonymous
The images added to the report will have the patients name replaced with Anonymous
and the examination number.
10
Save State
Saves the image orientation, w/l values, roam and zoom values of a range of
images that you select.
11
+/- Series
This navigates through the series.
10
Add to Report
Adds the current data set to the report from which you can either burn the information
to a CD-R or FTP it to an IP address. A Data Conversion progress window appears once
you click the [Add to Report] button. Click the [Cancel] button if you want to stop the
data conversion.

24-8
Managing Images
Figure 24-3 Export Tab

24-9
Managing Images
Table 24-2 Export Tab Descriptions
Selection
Description
Report Name
List
Lists all the report names in the data base.
Delete Icon
Select an item in any of the list displays (Report, Folder, or Type) and click the Delete icon
to remove the item from the list. Items remain on the list after you Quit Data Export until
they have been deleted through this method.
Folder Name
List
Lists all the folders associated with the report name. Note the file size to make sure you
can FTP the file or store it on a single CD-R.
Move to
Allows you to move the currently highlighted item to a destination of your choice. For
example, you can highlight an item in the Type list and add it to a particular folder in the
Folder list. The size of the data that comprises each folder is listed.
Type Name
List
Lists the item types. If, for example, you added 20 T1 JPEG images to Folder 1 and then
added another 20 T2 JPEG images to Folder 1, the number of JPEGs in folder 1 is 40. The
quantity and size of each data type is listed.
Quit
Closes the Data Export window.
Report Name
The name of the report that you are going to export. Select the report from the menu.
Comment
Allows you to type in a comment that appears on the report. Do not apply a carriage
return when typing. The text wraps automatically when appropriate for the finished
report.
Conversion
Formats
Select one of the radio buttons to determine the file type. Typically select HTML.
10
[Create CD]
Click [Create CD] to start burning the report to the CD-R that is currently in your systems
CD/DVD drive. The following message appears once the system is ready to write to the
CD-R: CD writing operation cannot be cancelled after start,
Start CD Write Continue?
Click [OK] to continue. Once the write process is active the following prompt appears:
CDWriting is going on ...
When the system has successfully written the CD, the following prompt
appears: CD Writing successfully completed.
[Send FTP]
Click [Send FTP] to open the FTP window. Enter the information for all the text boxes. The
User Name, Password, and IP Address are for the FTP destination site. Selecting Save the
Settings only saves the Target Directory information. There must be a target directory at
the IP address to successfully transfer files.
CD/DVD Interchange (Option)

The Interchange option is used to write data to CD-R and DVD-R; or recall images from CD-R
or DVD-R in a Dicom format. CD/DVD cannot be selected as the default archive device.
Exam, series, or images will not be marked as archived. A DICOM viewer is stored on the
media so the images can be viewed on a PC. The media is write once and all selections must
be queued at the same time. Approximately 7000 images can be stored to a 4.7 gb DVD-R.
NOTE: If your FE is trying to load this option, it is listed in the options list as Copy Composer.

24-10
Managing Images
NOTE: CD/DVD Interchange feature is available for recording DICOM images onto below
media, but so far CD/DVD Interchange is not be considered as a way for long-term
images storage.
NOTE: Please pay attention to the following declarations about Media requirements and
Operation requirements when you use the CD/DVD Interchange function.
Media Requirements:
Only support single layered CD-R and DVD-R media. No other media types are
supported, including but not limited to DVD-RW.
Also, dual layered CD-R and DVD-R media are not supported.
Only support 650MB single layer CD-R media
Only support 4.7GB single layer DVD-R media
GEHC recommends using the following media brands have been qualified by GEHC
FCT:
Verbatim 4.7GB 4X commercial DVD-R media
Maxell 4.7GB 1X-4X Compatible DVD-R
SONY 650M CD-R
SONY 1X-4X Compatible 4.G media
TDK 4.7GB commercial DVD-R media
Other high quality CD-R and DVD-R media may also work but GEHC FCT has only
qualified the media types listed above.
Operation Requirements:
DVD-R only support single-session write mode, not support multi-session mode, cant
append write data on DVD-R have been burned.
DVD Interchange are NOT INTENDED for archive or backup purposes! These features
make only "temporary copies" for interchange purposes. GEHC requires cartridge
media for archive like MOD or future solutions. GEHC will not "recover" any
interchange media (it should just be burned again if necessary using patient data
restored from authorized/provided archive media).
Advise customer not to write DVD/CD during scan operations.
The first time CD/DVD media is read on a PC, the permissions for Internet Explorer
need to be set to "Allow active content from CDs to run on My Computer". Otherwise,
it will not be possible to read the media in Operation Requirements session.

24-11
Managing Images
Figure 24-4 CD/DVD Interchange Window
2
10
Table 24-3 Interchange Descriptions

Button Number
Description
Add Exam - Add Exam adds all exams selected.
Add Series - Add Series adds all series selected.
Copy - moves the files to the cd or DVD disk.
Eject - opens the DVD or CD tray.
Stop - quits the current process.
Option - opens the options window.
Restore - moves files from the DVD or CD to the local disk.
Quit - closes the CD/DVD interchange window.
List - Give a list of exams, series, and images to store or restore.
10
Clear - deletes the selected selection.

24-12
Managing Images
How Do I...
This section provides the step-by-step instructions for Managing Images. Specifically, it
describes how to:
Set an Access to a Local Host and Set Up a Custom Search
Restore Exam/Series/Images using CD/DVD Interchange Option
Save Exam/Series/Images using CD/DVD Interchange Option
FTP a Report

24-13
Managing Images

Your Field Engineer will usually have this set up for you. If you need to add additional remote
hosts to your system, you will need to have the network IP address provided by your sites
network administrator.
1. Click Network > Select Remote Host.
A pop up window will appear.
2. Click [Add].
The Remote Host Parameters table will appear.
3. Enter the Host name.

The Host name to be entered is the name of the device. If the device is DICOM, the
name must match exactly to the name given to the device.
4. Enter the Network Address.
You can get this information from you sites Network Administrator.
5. Select the Network Protocol.
The Network protocol consists of two choices: Advantage NET or DICOM. If the
system is sending to this device, the device must be able to receive DICOM images
and the DICOM network protocol must be selected.
NOTE: PC based systems only allow DICOM network protocol.

24-14
Managing Images
6. Enter the Port number.
For the HiSpeed CT/i, ZX/i, LX/i, FX/i, DX/i, Advantage Windows, and systems the port
number is 4006.
If you are adding a 3rd party workstation or PACS system, your sites Network
Administrator can provide you with the port number.
A port number is only required when using a DICOM protocol.
7. Enter the AE Title.
The AE Title is unique to the device. If the device is an Advantage Windows
workstation or another GE Healthcare system, the AE Title is the same as the Host
name.
8. Enter Comments.
The comment field allows you to input a comment.
Quick Steps: Set up a Remote Host

1. Click Network > Select Remote Host.
2. Click [Add].
3. Enter the Host name.
4. Enter the Network Address.
5. Select the Network Protocol.
6. Enter the Port number.
7. Enter the AE Title.
8. Enter Comments.

24-15
Managing Images

You will have to select if your current remote host is an archive node.
1. From Image Works, click Network > Select Remote Host.
A pop up window will appear.
2. Under Archive Node click [Auto], [Yes], or [No].

If [Auto] is selected, the system will automatically check if the device is a Storage
Commitment Provider.
If [Yes] is selected, the device is responsible for archiving the images. When the
device has received and saved the images, a notification message is displayed on
the scanner console and the Archive status for the exam is "Y" for archived.
If [No] is selected, the device will not be responsible for archiving.
NOTE: At system start up a check is done to assure that devices designated as Storage
Commitment devices are sending a storage commitment response. If no response is
received the Archive node setting will be disabled.
Quick Steps: Select an Archive Node

1. From Image Works, click Network > Select Remote Host.
2. Under Archive Node click [Auto], [Yes], or [No].

24-16
Managing Images
Set an Access to a Local Host and Set Up a Custom

Search
With this function you can lock out other systems so that they cannot send, query, or receive
images from your system.
1. Under Access to local host, click [Yes] or [No].
Click Yes if you want the device to be able to send to and/or query and receive
images from the scanner.
2. Select from the custom search window [On] or [Off].

This allows you to customize your patient listing on any remote browser to make it
easier when searching for specific patient types. When this feature is on and you
access the remote browser, the custom search entry box will initially display to allow
you to perform a custom search. This will eliminate the need of having to go into
Custom Search every time you manually network. This feature will default to off.
3. Click [Save] or [Cancel].
Do this when you are done entering all of the parameters on the remote host table.
[Save] will save the parameters and [Cancel] will close out this function.
Quick Steps: Set an Access to a Local Host and Set Up a Custom

Search
1. Under Access to local host, click [Yes] or [No].
2. Select from the custom search window [On] or [Off].
3. Click [Save] or [Cancel].

24-17
Managing Images

Before saving or restoring image data, the archive device needs to be selected. To save
images, the archive device can be the local MaxOptics MOD or a DICOM networked remote
device. To restore images the selected archive device must be a local device, such as the
MaxOptics MOD.
1. Click [Archive].
Archive can be accessed from the Image Works browser.
2. Click [Selected Archive Device].

This will open the Archive Device Selection window.

24-18
Managing Images
3. Select the Archive Destination.
Select from the list which device you want to use.
To select the default device, simply select the desired host/device, then click [Set
Default Device]. You will then see the default label in parenthesis next to that device.
4. Select Local or Remote.
This will show a list of local or remote devices.
5. Click [OK].
This will enable your selection.
Click [Cancel] to close the pop up window and disregard any changes made.
Quick Steps: Select an Archive Device

1. Click [Archive].
2. Click [Selected Archive Device].
3. Select the Archive Destination.
4. Select Local or Remote.
5. Click [OK].

24-19
Managing Images

Brand new MODs must be labeled before they are able to store image data. Also, use this
procedure to re-label a MOD that contains data that is no longer needed. When an MOD is
re-labeled, all existing data on it is permanently lost.
1. Insert the MOD into the MOD drive.
2. Select the [Image Works] desktop.
This is located in the upper left corner of the display monitor.
3. Click [Archive].
4. From the Archive menu, click [Label].

A window titled, "Format Window" pops up.
The archive device name is shown in the upper left corner of the Format Window.
The name reflects the MaxOptics MOD drive. This is set up during installation and
requires no intervention from you.
5. Enter media ID number by clicking on the text field and entering a value.
This value is the MOD label.

24-20
Managing Images
6. Click on the Comment field and enter comments from the keyboard.
Typically, information about the type of images, MOD side, or pertinent information is
entered.
The text in this field will appear at the bottom of the Archive Browser and the
Image Works browser.
The maximum number of characters allowed in this field is 160.
7. Click [Label].
This begins the labeling process.
A confirmation window pops up and asks you to "Please refer to the Operator Manual
for limitations regarding archive media exchange between GE Products".
8. Click [OK].
This will acknowledge the message.
Selecting [Cancel] in the Format Window will abort the labeling process.
Quick Steps: Prepare a New Storage Media for Use

3. Click [Archive].
4. From the Archive menu, click [Label].
5. Enter media ID number by clicking on the text field and entering a value.
6. Click on the Comment field and enter comments from the keyboard.
7. Click [Label].
8. Click [OK].

24-21
Managing Images

The archiving feature allows you to save large amounts of image data onto the local MOD or
remote archiving hosts. When saving/writing to archive media, the system makes a copy of
the image data and does not remove the image data from the main system disk. The ability
to save images depends on the archive device type and the initial source of the images.
1. With the desired MOD in the drive, select the [Image Works] desktop.
2. Select the exam(s), series, or image(s) to be saved to the disk.
To aid in this, Sort and Selection menu on the browser can be used.
3. Click [Archive].
4. Click [Save Examination], [Save Series], or [Save Images].
All items selected on the browser for saving are written onto the media in the
selected archive device.
Items being saved cannot be deleted from the system disk until the save process is
complete. This is indicated by the gray Remove menu title on the browser whenever
items being saved are selected.
5. Click [Detach].
To eject the MaxOptics MOD from the MOD drive, it must first be "detached" via
[Detach] in the Archive menu on the browser.
NOTE: If the MaxOptics MOD fails to detach and cannot be ejected, Click on [Shutdown] in
the upper right corner of the right monitor. When you see "OK to power off the system"
message, press the eject button on the MOD drive. The MOD will now eject.

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Managing Images
Quick Steps: Save Exam/Series/Images to a Storage Media

1. With the desired MOD in the drive, select the [Image Works] desktop.
3. Click [Archive].
4. Click [Save Examination], [Save Series], or [Save Images].
5. Click [Detach].

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Managing Images

When restoring/reading from archive media, the system makes a copy of the image data
and does not remove the image data from the archive media. Images must be restored to
be viewed. You cannot view images directly from archive media.
Determine which side of the MOD contains the images to be restored (side A or side
B) and insert into the MOD drive accordingly.
NOTE: You may refer to your GE logbook or other list to determine which side of the MOD
contains the images.
2. Click [Archive].
Verify that the selected archive device is the device needed for restoring.
NOTE: For additional information about selecting the device, refer to the "Selecting the
Archive Device" section earlier in this chapter.
3. Click [Restore].
An Archive browser appears on the screen. It displays the exams, series, and images
on the media of the selected device.
4. Select the exam(s), series, or image(s) to be restored from the disk.

To aid in this, Sort and Selection menu on the Archive browser can be used.
5. Click [Restore examination], [Restore series], or [Restore images].
The selection choice depends on what is to be restored.
6. Click [OK].
This will start the restoring process.
7. Click [Application].
This opens a pull down menu.
8. Click [Quit].
This will quit the Archive browser window.

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Managing Images
NOTE: You do not have to wait for the restore to be complete before quitting the Archive
browser window.
NOTE: Remember to [Detach] and replace the storage media when you are done restoring
a patients images.
Quick Steps: Retrieve Exams/Series/Images From a Storage Media

2. Click [Archive].
3. Click [Restore].
4. Select the exam(s), series, or image(s) to be restored from the disk.
5. Click [Restore examination], [Restore series], or [Restore images].
6. Click [OK].
7. Click [Application].
8. Click [Quit].

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Managing Images
Restore Exam/Series/Images using CD/DVD Interchange

Option
This is used to write or recall images from a CD-R or DVD-R in a Dicom format. CD/DVD
cannot be selected as the default archive device. Exam, series, or images will not be marked
as archived. A DICOM viewer is stored on the media so the images can be viewed on a PC.
The media is write once and all selections must be queued at the same time. Approximately
7000 images can be stored to a 4.7 gb DVD-R.
Only CD -R or DVD -R media can be used for CD/DVD Interchange. For CD -R write speed
should be at least 4X and storage size of 700 mb.
1. With the desired CD/DVD in the drive, select the [Image Works] desktop.
2. Click [CD/DVD].
The CD/DVD composer window appears.
3. Click [Restore].
The Restore window appears.
Figure 24-5 CD/DVD Restore Window
4. Select the exam(s), series, or image(s) to be restored to the disk.

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Managing Images
5. Click [Local Disk].
This copies the images onto your systems disk.
6. Click [Quit].
This closes the restore window.
7. Click [Eject].
8. To eject the CD/DVD from the CD/DVD drive.
Quick Steps: Restore Exam/Series/Images using CD/DVD

Interchange Option
2. Click [CD/DVD].
3. Click [Restore].
4. Select the exam(s), series, or image(s) to be restored to the disk.
5. Click [Local Disk].
6. Click [Quit].
7. Click [Eject].

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Managing Images
Save Exam/Series/Images using CD/DVD Interchange

Option
This is used to write or recall images from a CD-R or DVD-R in a Dicom format. CD/DVD
cannot be selected as the default archive device. Exam, series, or images will not be marked
as archived. A DICOM viewer is stored on the media so the images can be viewed on a PC.
The media is write once and all selections must be queued at the same time. Approximately
7000 images can be stored to a 4.7 gb DVD-R.
Only CD -R or DVD -R media can be used for CD/DVD Interchange. For CD -R write speed
should be at least 4X and storage size of 700 mb.
In order to view the information placed on media using CD/DVD interchange, the PC must
have Internet Explorer 5.0 or higher. The first time the reader of the Interchange media tries
to access the data, the security settings in Advanced Settings for Internet Explorer on the PC
must be set to "Allow active contents from CDs to run on My Computer.
To aid in this, Sort and Selection menu on the browser can be used.
To save an individual series, hilight the series you wish to save and click [Add Series].
3. If the whole exam is desired, then click [Add Exam].
4. Click [CD/DVD].
The CD/DVD composer window appears.
Select the exams, series, and images you wish to copy to the disk.

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Managing Images
5. Click [Add Exam], [Add Series], or [Clear].
[Add Exams] adds all of the exams that are selected.

[Add Series] adds all of the series that are selected.
[Clear] deletes all selections.

6. Click [Copy] or [Restore].
[Copy] burns the images into the disk.
[Restore] copies the images from the disk onto the systems disk.
7. Click [Yes] on the copy or restore confirmation window.

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Managing Images
8. The Interchange Media Browser appears.
This shows the selections and progress of storage.
A window appears stating Restore or Copy completed successfully.

9. Click [Ok].
10. Click [Eject].
To eject the CD/DVD from the CD/DVD drive.
Quick Steps: Save Exam/Series/Images to a Storage Media

3. If the whole exam is desired, then click [Add Exam].
4. Click [CD/DVD].
5. Click [Add Exam], [Add Series], or [Clear].
6. Click [Copy] or [Restore].
7. Click [Yes] on the copy or restore confirmation window.
8. The Interchange Media Browser appears.
9. Click [Ok].
10. Click [Eject].

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Managing Images

This is the way you can send exams/series/images to another computer. This is known as
sending images from one viewing station to another.
2. Select the exams/series/images from the browser that you wish to send.
To select individual exams, series, or images you must hold down the Ctrl key on your
keyboard as you select the images with left mouse.
3. Click [Network].
A list of choices will appear.
4. Click [Select remote host:].

This will pop-up a list of hosts to which the system can send images. Select the host
to which you want to send the images.
You will have to do this every time you start the system.
5. Click [OK].
Now that you have selected the remote host, you have the ability to ping the DICOM
host. This only functions when using the DICOM protocol. This can be done to make
sure your remote host and scanner can communicate. A box will pop up and if the
host you have selected is connecting with your system you will see a message that
says the host is "alive". If you get a message that there is a "connection error" it

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Managing Images
means that your system cannot communicate with the selected remote host. To ping
the DICOM host, Click Network > Ping DICOM Host.
6. Click [Network].
You will have to select this again.
7. Click [Send examination], [Send series], or [Send image].
This depends on what is to be sent.
Quick Steps: Transfer Exams/Series/Images to Another Computer

2. Select the exams/series/images from the browser that you wish to send.
3. Click [Network].
5. Click [OK].
6. Click [Network].
7. Click [Send examination], [Send series], or [Send image].

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Managing Images

In this section you will learn to get selected images from another system. This is known as
receiving images to your system.
2. Click [Network].
This will bring up a list of all the host connected to your system.
4. Select the host from which you want to receive images.
From the list select the host from which you want to receive images.
5. Click [OK].
This will return you to the browser.
6. Click [Network].
7. Click [Receive].
A remote browser will pop-up showing you what is on the system disk of the station
from which you want to receive exams/series/images.

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Managing Images
8. Click Search > Change Search Parameters.
This feature allows you to apply a filter in order to narrow down your patient list. You
may search by patient name, ID number, exam number, accession number, or exam
date.
9. Select exams/series/images from the browser that you wish to get.

To select individual exams, series or images, you must hold down the Ctrl key on your
keyboard as you select the images with left mouse.
10. Click [Get].
This will give you choices.
11. Click [Get examination], [Get series], or [Get images].
This will tell the system to go to that computer and get the selected images and copy
them to your disk. It will not remove the images from that disk.

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Managing Images
Quick Steps: Retrieve Exams/Series/Images From Another Computer

2. Click [Network].
4. Select the host from which you want to receive images.
5. Click [OK].
6. Click [Network].
7. Click [Receive].
8. Click Search > Change Search Parameters.
9. Select exams/series/images from the browser that you wish to get.
10. Click [Get].
11. Click [Get examination], [Get series], or [Get images].

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Managing Images

The network history feature provides a listing of successful DICOM image transfers to
network hosts. The listing may be sorted by Exam, Date, or Host Name.
2. Click [Network].
3. Select [Network History].
A window displays a list of entries of network transfers. Entries are listed how the job
was queued for transfer. If by Exam then only the exam number is listed. If by Series
the exam and series are listed. If by Image the exam, series, and image are listed.
4. If you want check for a specific transfer, enter the Exam, Exam and Series or Exam Series
Image in the search field.
Entries are added to the list at the level they were queued for transfer.

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Managing Images
5. A results window is displayed.
6. Click [End Search] to go back to the first screen.
Quick Steps: Check Network History File

2. Click [Network].
3. Select [Network History].
4. If you want check for a specific transfer, enter the Exam, Exam and Series or Exam
Series Image in the search field.
5. A results window is displayed.
6. Click [End Search] to go back to the first screen.

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Managing Images

Edit Patient is a function that allows you to edit certain patient information once the exam
has been completed. There are some things to keep in mind regarding Edit Patient. You can
only edit exams that were created on your system. You cannot edit contrast or weight. It
takes about one minute and 45 seconds to update a 100 image exam. Exams can be edited
multiple times.
NOTE: Make sure that you do any retrospective reconstructions before editing and do any
archiving, networking, and filming after editing the patient information.
There are some things that Edit Patient will not do. These things are:
Update scan data files
Update completed patient information
Edit contrast
Edit weight
You also need to remember that you cannot access Edit Patient if the exam you want to edit
is currently in use. An exam is currently in use if New Patient, Network Send, Archive Save,
3D, Reformat, Denta Scan, Navigator, Viewer, or Mini Viewer is active. Also, you cannot use
Edit Patient if the exam displayed is in a free or Autofilm viewport in the Exam RX desktop. If
you try to use Edit Patient when an exam is currently in use, which means the exam is on the
archive, film or network queue, the following message will appear.
About 3D and Edit Patient, there are a couple of things to remember. If you edit an exam
that has a saved 3D model, the 3D model are deleted from the exam. Also, if you want to edit
an exam, but you have the 3D model selected when you choose Edit Patient, you will not be
able to edit the exam.
1. Click [Image Works].
2. Select the exam number.
From the Image Works browser, highlight the exam to update.

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Managing Images
This is located on the right side of the browser.
4. Click [Edit Patient Images].

When the menu pops up, you can click [View Edit Log] or click [Edit Patient Images].

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Managing Images
5. Click [Accept].
This is a warning message to remind you of all the things that will happen.
If any of the things are of concern, click on [Cancel] and resolve the concern before
proceeding.
6. Click [Accept].
This is an additional reminders warning, letting you cancel if you need to.

You may now edit any of the fields.

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Managing Images
NOTE: You must enter at least three characters in the Edited By field to continue.
If you changed a field but wish to change it back to its original value, highlight the
field and click [Reset Selected Value].
If you have edited multiple fields but wish to change them back to their original
values, click [Reset All Original Values].
Click [Cancel] will cancel Edit Patient.

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Managing Images
8. Click [Accept].
The following menu will appear.
9. Click [Accept].
The old exam will now be removed and the new edited exam is created.
As the old exam is being removed and the new exam is being created, a percentage
countdown menu will appear. The closing Application portion of the countdown is
when the Edit Patient feature is being closed and the Patient Information Edit Log is
being updated.
NOTE: After the editing is complete, the new edited exam is listed on the browser. You can
distinguish edited exams from originals by looking at the description area on the
browser. Edited exams will show the letter "e" plus a number identifying how many
times the exam has been edited. "e+1" means the exam has been edited once. Also,
with edited exams, any description for that exam is pushed to the right on the browser
list to make room for the editing information.
Quick Steps: Edit Patient Information

1. Click [Image Works].
2. Select the exam number.
4. Click [Edit Patient Images].
5. Click [Accept].
6. Click [Accept].
8. Click [Accept].
9. Click [Accept].

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Managing Images

You are able to change the patient name to Anonymous by exam, series, or image. The level
of annotation for Anonymous Patient is controlled by Anonymous Patient Level in the Tool
Bar on Image Works desktop. This is done after the patient has been scanned, thus you
must enter a name when you start a [New Patient].
2. From the browser, select the patient you want to be anonymous.
If you want only specific series or images to be anonymous, carefully select only
those series or images desired.
A pull down menu will appear. This pull down menu will list three ways for creating an
anonymous patient, by exam, series, or image.
4. Click [Create anonymous patient by exam], [Create anonymous patient by series], or

[Create anonymous patient by image].
This will tell the machine which way you want to create the anonymous patient.
5. Click [OK] to start the create process.
Selecting [Cancel] will stop the process.

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Managing Images
Quick Steps: Remove Patient Information From an Exam

2. From the browser, select the patient you want to be anonymous.
4. Click [Create anonymous patient by exam], [Create anonymous patient by series], or
[Create anonymous patient by image].
5. Click [OK] to start the create process.

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Managing Images

Eventually, you will want to remove an image, series, or entire exam from the system image
disk to make room for others.
2. Select the exams/series/images from the browser that you wish to remove.
To select individual exams, series or images you must hold down the [Ctrl] key on
your keyboard as you select them with the left mouse.
3. Click [Remove].
It is important to confirm that examinations to be removed have been archived by
checking the status in the browser. Check under the examination area which should
have a "Y" in the archived column by the patients name meaning that the exam has
been Archived.
This will give you three choices.
4. Click [Remove examination], [Remove series], or [Remove image].
This depends on what is to be removed.
5. Click [OK].
This will cause a pop-up window to come up and ask you Are you sure?
6. Click [Yes].
NOTE: It is recommended that you delete images when image space falls below 10,000
images. This will ensure there is room on the system disk to confirm scans and to

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Managing Images
Quick Steps: Delete Exams/Series/Images From the System

2. Select the exams/series/images from the browser that you wish to remove.
3. Click [Remove].
4. Click [Remove examination], [Remove series], or [Remove image].
5. Click [OK].
6. Click [Yes].

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Managing Images

1. From the Browser, select the exam you wish to export
All series in the exam will be loaded into Data Export .
Only one series can be exported at a time.
2. Click [Data Export] from the Browser.
3. Select the Compose tab if that tab is not already selected.
See Figure 24-2 for more information.
4. Review the images in the Compose viewport.
Middle-click and drag to adjust W/L
Right-click and drag to adjust zoom factor.
Click and drag to scroll.
Click on the image to put in focus, then press the Page Up or Page Down keys on the
keyboard to navigate through the images.
Click [Play] to view the images in a cine loop.
Select the +/- Series buttons to navigate through all the series.
5. Once you are satisfied with the image appearance, display the first image in the series
and click Propagate Image Operations box.
6. Select the conversion format from the pull-down menu.
Selections include JPEG, PNG, AVI, MPEG, and MOV.
7. Select the desired image range.
If you want a subset of the images, click the Custom radio button and type the range
in the text box.
8. Select a compression factor.
The smaller the number, the higher the image quality and the larger the file size.
9. Select an Annotation option.
If you want the patient name to be displayed as Anonymous with the examination
number, click the Anonymous radio button.
10. Enter a name for both the report and the folder.
Use no spaces or characters other than alphanumeric.
11. Click [Add to Report].
If you change your mind and decide not to add the data to the report, click [Cancel]
from the progress bar window.

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Managing Images
12. Click [Quit] to exit the Data Export application.
Quick Steps: Compose a Report in Data Export

1. From the Browser, select the exam you wish to export
3. Select the Compose tab if that tab is not already selected.
4. Review the images in the Compose viewport.
5. Once you are satisfied with the image appearance, display the first image in the series
and click Propagate Image Operations box.
6. Select the conversion format from the pull-down menu.
7. Select the desired image range.
8. Select a compression factor.
9. Select an Annotation option.
10. Enter a name for both the report and the folder.
11. Click [Add to Report].
12. Click [Quit] to exit the Data Export application.

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Managing Images

2. Click the Export tab.
3. Select the desired report from the Export Report Name pull-down menu.
4. Select the desired data set from the Type Name list.
5. Optional: type a message in the Comment text box. Do not press carriage return while
entering your text, the system adjusts the text for the final report.
6. Select a Conversion format, typically html.
7. To burn the report to a CD, place a CD-R in the DVD R/W drive.
NOTE: This is not the drive housed in the computer cabinet but rather the box that houses
the MOD and CD/DVD drives located on the desk.
The only compatible media for Data Export is CD -R 700 mb with at least 4X write
speed. DVD-R is not supported. If DVD -R is placed in the drive, the system will write
to this media, but the integrity of the data cannot be guaranteed and the time for the
system to recognize the media will be excessive.
NOTE: Care must be taken when placing the CD media in the drive. Place the media squarely
in the drive. Wait until the drive has sensed the media and the drive light goes off
before clicking Create CD. If you click Create CD too quickly after placing the media
in the drive you will get a message no media in the drive.
8. Click [Create CD].
9. Click [Ok] to start the writing process.
A message displays while the CD is written.
When the CD writing step is complete, the CD ejects from the drive.
10. Click [Ok] to the CD Written Successful prompt.
11. Click [Quit] to exit Data Export.

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Managing Images
Quick Steps: Save a Report to CD-R

7. To burn the report to a CD, place a CD-R in the DVD R/W drive.
8. Click [Create CD].
9. Click [Ok] to start the writing process.
10. Click [Ok] to the CD Written Successful prompt.

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Managing Images
FTP a Report
1. Click [Data Export] from the Browser list.
7. Click [Send FTP] to send the data to an IP address.
8. Complete all the text boxes on the FTP window and click [OK].
9. Click [OK] to the Successful File transfer prompt.
Quick Steps: FTP a Report

1. Click [Data Export] from the Browser list.
7. Click [Send FTP] to send the data to an IP address.
8. Complete all the text boxes on the FTP window and click [OK].
9. Click [OK] to the Successful File transfer prompt.

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Managing Images
1. Place the CDROM in the CD drive of a PC or laptop running Windows 2000 or XP.
The CD launches automatically. If it does automatically start, open the CD by clicking
on your My Computer icon and open your CD drive. Click INDEX to open the file.
The report is opened and displayed from an Internet Browser.
2. Place the cursor over an image and click to magnify the image.
3. Click the Back arrow on your Internet Browser menu bar to return to the report.
4. When finished viewing the report, close your Internet Browser by clicking File > Close
from the menu bar.
5. Remove the CD-ROM from the CD drive and store it.
Quick Steps: View a Report on a PC

1. Place the CDROM in the CD drive of a PC or laptop running Windows 2000 or XP.
2. Place the cursor over an image and click to magnify the image.
3. Click the Back arrow on your Internet Browser menu bar to return to the report.
4. When finished viewing the report, close your Internet Browser by clicking File > Close
from the menu bar.
5. Remove the CD-ROM from the CD drive and store it.

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Chapter 25
Viewing Images
Introduction
This chapter explains how to view images. It contains the step-by-step instructions to help
you learn how to:
View a List of Scanned Patients
View a Patients Scan
Advance One Exam/Series/Image At a Time in Image Works
Scroll Through A Set of Images
View Images in a Cine Loop
Compare Exams/Series/Images
View a Reference Image

25-1
Viewing Images

This section presents the concepts necessary to successfully set up images for viewing.
Some of the concepts you need to understand:
List/Select
Paging
Viewer and Mini-Viewer
List/Select
The List/Select function is located in the Exam RX desktop. Selecting this function gives you a
listing of exams and other information about the exams. This list is known as the Browser.
The Browser is broken down into examinations, series, and images. The exam listing
includes the exam number, patient name, date, description of the exam, modality image
format, pps information, and the archive status by exam. The series area lists the series that
comprise the exam. The series number is listed here as well as the scan type, number of
images for that scan type, a description, what modality the images came from, pps
information, and the manufacturer of the system. The image list box contains all the
information related to images that comprise the highlighted series. In the list box, the
images numbers, table location, thickness and spacing, gantry tilt, RAS coordinates, Scan
field of view, Display field of view, Resolution, Matrix size, Mid scan time in seconds, and
Archive status are listed. This function provides a list of all the exams on the system disk for
viewing.
Paging
Paging allows you to rapidly view images at up to 60 frames per second. This function is
good for viewing scans taken at the same location with contrast to track flow or with motion
such as flexing a Elbow. There are two viewing choices in Paging. Temporal displays the
images in a loop from start to end location all the time as paging continues. Spatial goes
from the starting location to the ending location, then from the ending location to the
starting location, and continues the sequence.
Viewer and Mini-Viewer

The Viewer and Mini-Viewer are located on the Image Works desktop. This is the place from
which you can view images. All of the routine display functions are located here. The
difference between the Viewer and Mini-Viewer is a few functions. The Viewer has all the
same functions as the Mini-viewer. The Viewer, however, has the following additional
features: Compare, Film Series, Save Screen, and User Preferences.

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Viewing Images

procedure. It improves transfer of data because it can provide a complete message when all
data has been transferred. The browser has a PPS column that lists the PPS status of each
exam. There are three states of exam status: COMP, meaning the exam is complete; DISC,
meaning the exam is discontinued, and it cannot use PPS again; or, INPR, meaning that the
exam is still in progress.

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Viewing Images
How Do I...
This section provides the step-by-step instructions for Viewing Images. Specifically, it
describes how to:
Advance One Exam/Series/Image At a Time in Image Works

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Viewing Images

Use this procedure to update your log book and to keep track of all the patients that have
been scanned on the system.
NOTE: You can sort the way the list is displayed. For more information on sort, refer to: Sort
Examinations and Images.
Quick Steps: View a List of Scanned Patients

1. From the Display monitor, click [Exam RX].
2. From the left side of the screen, click [List/Select].

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Viewing Images

The List/Select button is used for displaying a patient and manipulating the images for
image review or filming.
Quick Steps: View a Patients Scan

1.
2.
3.
4.
5.
6.
From the Display Monitor, click [Exam RX].

From the left side of the screen, click [List/Select].
Select the patient name that you want to view.
Select the series that you want to view.
Select the image that you want to view.
Click [Accept].

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Viewing Images
Advance One Exam/Series/Image At a Time in Image

Works
There are a lot of different ways in which you can move from one exam, series, or image to
another.
The Accelerator Bar can be used to move from one exam, series, or image to another.
For more information on the Accelerator Line Commands, refer to the Appendix of this
manual.
NOTE: For more information on Next/Prior Series refer to: Image Display Viewing Area.
Quick Steps: Advance One Exam/Series/Image At a Time in Image

Works
1.
2.
3.
4.
5.
Select from the Browser the Exam, Series and Image that you want to page through.
Click [Viewer] or [Mini Viewer].
In [Image Works] you can move from one exam to another by selecting Exam [+] or [-].
You can move from one Series to another by selecting Series [+] or [-].
You can move from one image to another by selecting Image [+] or [-], or Clicking and
Dragging the scroll bar.

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Viewing Images

The Bright Box is a white box that can be moved around anywhere on the console. It has a
trackball in the middle of it, page up and page down button on each side, and a paging
button at the top of the trackball. This is a great way for the radiologist to view the images
on the screen. It is fast and requires little work for him/her. This feature only works in the
Exam RX desktop.
Quick Steps: Scroll Through A Set of Images

1.
2.
3.
4.
5.
6.
Double Click on the desired image for paging.

Using the Bright Box, Double Click on the top button.
Roll the Trackball up and down to scroll through the images.
Click on the top button and change the window level by moving the trackball.
Click on the top button and change back to paging mode.
To get out of this mode, Double Click on the top button.

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Viewing Images

This function allows you to view images up to 60 frames per second. This function is good for
viewing scans taken at the same location with contrast to track flow or with motion such as
flexing a elbow. This feature is found in the Image Works desktop.
Quick Steps: View Images in a Cine Loop

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Select from the Browser the Exam, Series and Image that you want to page through.
Click [Viewer] or [Mini Viewer].
Click on the viewport that you want to use for paging.
Click [Paging].
Click and Drag the scroll bar by Start and change the starting image number.
Click and Drag the scroll bar by End and change the ending image number.
Click and Drag the scroll bar by FPS (Frames Per Second) and change the FPS number.
Select Temporal or Spatial.
Click [Go].
Click [Stop].
If you want to page a new series, and you are in the viewer, click [Select Series].
Click [Cancel].

25-9
Viewing Images
The compare function allows you to compare images from the same series or a different
series from the current exam, or compare another exam to the current one displayed. This
feature is only available in the image works viewer.
Quick Steps: Compare Exams/Series/Images

1.
2.
3.
4.
5.
6.
Select the first Exam, Series, and Image that you want to compare on the screen.
Click [Viewer].
Click [Compare].
From the Browser, select the second Exam/Series/Image.
Click [Viewer].
Select the Left Series or Right Series Up and Down arrows to move through the image
set.
7. When you are finished comparing the Exams/Series/Images, click [Cancel Compare].

25-10
Viewing Images

Selecting the reference image button in image works only, allows you to place a reference
image on a selected viewport or all viewports. The reference image is displayed in the lower
right of the viewport or viewports. For the reference image to be displayed, the viewport
display must be 5122 x 5122 or larger.
NOTE: When using Print Series with Reference image on, make sure you have All selected
so all the images are filmed with reference image on.
NOTE: If a screen save is done with Reference image on, the Reference image will be saved
with the same WW and WL as the main image, regardless of the WW and WL
displayed on the Reference Image.
Quick Steps: View a Reference Image

1. Select from the Browser the Exam, Series and Image that you want to display a
reference image on.
2. Click [Viewer] or [Mini Viewer].
3. Click on the Viewport that you want to use for a reference image.
4. Click [Reference Image].
5. Click All, Selected, or Off.

25-11
Image Display Viewing Area
Chapter 26

Introduction
This chapter explains Setting up the Viewing Area for Image Display. It contains the
Select a Single Image Display
Select a Multiple Image Display
Set Viewports for Images to Come Up in Order
Set Viewports for Automatic Display of the Next Series
Set a Primary Viewport
Set a Secondary Viewport

26-1

This section presents the concepts necessary to successfully set up a viewing area for
image display. Some of the concepts you need to understand:
Autoview
Auto Link
Primary Viewport
Secondary Viewport
Viewport
Autoview
Auto View is used to automatically display the images on the screen as the images are
reconstructed by the computer. You have a choice between 8 Autoview layouts.
NOTE: If you are in the one on one layout or any of the multiple viewport layouts, you notice
a folded corner, in the top right corner. This allows you to see what is auto filming. It
toggles the screen each time you click on the folded corner. The folded corner is not
available on the autoview layouts that defaults to filming.
Auto Link
While reconstruction is active, and if you have a autoview port selected with auto link, the
lower right viewport automatically displays the first image of the series being currently
reconstructed. The viewport is annotated with "AL" at the bottom right corner of the image
to indicate that Auto Link is active. All display features and next/prior can be used with Auto
Link.
Primary Viewport
A viewport becomes active or receives primary focus by clicking on it. At that point, the
border around the image turns blue. When a viewport has received the primary focus, you
can choose List/Select and choose which exam you want to view. Also, you can window
level, magnify, and preform other image manipulation functions without effecting other
images currently displayed on the screen.

26-2
Secondary Viewport
When you click on another viewport and the border turns blue, the viewport that was
previously in focus receives secondary focus and has a yellow box around it. In effect, these
two viewports are linked together. A change in one of the viewports is reflected in the other
viewport. For example, changing the window width and window level in the primary image
also changes the window width and window level in the secondary focused image. To return
a single viewport in focus, double click on the viewport of interest, or to put all the images in
focus, triple click on a viewport.
Viewport
The screen can be divided into many different viewing areas. These viewing areas are called
Viewports.

26-3
How Do I...
This section provides the step-by-step instructions for Setting up a Viewing Area for Image
Display. Specifically, it describes how to:

26-4

You can choose between two one on one displays. The first one is a 1024 x 1024 matrix.
Keep in mind, if you select this layout, the entire screen is filled with the image. You notice
the image is annotated with a magnification factor of 2.0. This annotation is a result of the
change going from a 5122 matrix to a 10242 matrix. When the image is filmed, it is filmed in
a 512 matrix and no magnification factor is shown.
The second one on one display is a 768 x 768 matrix. The image covers 768 x 768 of the
entire display screen, but in effect, the entire screen is used.
Both of these formats can be chosen in either the Autoview Layout and/or the Review
Layout.
Quick Steps: Select a Single Image Display

1.
2.
3.
4.
Click the [Exam RX Desktop].

Click [Autoview Layout] or [Review Layout] to switch between desktops.
Click the [Autoview Layout] or [Review Layout] icon to change the screen format.
Click the one on one choice that you want to display.

26-5

There are six choices in Autoview Layout to choose from.
CAUTION:
This format should not be used for display of images during an interventional
study because it does not allow for quick review of images in a free viewport.
Quick Steps: Select a Multiple Image Display

1.
2.
3.
4.
Click the [Exam RX Desktop].

Click [Autoview Layout] or [Review Layout] to switch between desktops.
Click [Autoview Layout] or [Review Layout] icon.
Click the Layout choice.

26-6

The Next/Prior Each Viewport function is used in conjunction with a multiple image display.
This function determines how the images are sequenced when the Page up or Page down
buttons are used. For example with a 4 on 1 MID display, if the Next/Prior Each Viewport is
selected, each viewport advances one image. With this function off, the next 4 images
displays.
Quick Steps: Set Viewports for Images to Come Up in Order

1.
2.
3.
4.
Click the [Exam RX] Desktop.

Click [Display Preferences].
Click [Next/Prior Each Viewport].
Click [Back].

26-7

The Next/Prior Series Binding function is on, it takes you to first image of the next series or
prior series within an exam, if you reach the end of a series using the next or prior image
functions. With the Next/Prior Series Binding function off, when you reach the end of a
series, selecting the next image returns you to the first image of that series.
Quick Steps: Set Viewports for Automatic Display of the Next Series
1.
2.
3.
4.
Click the [Exam RX] Desktop.

Click [Next/Prior Series Binding].
Click [Back].

26-8

Quick Steps: Set a Primary Viewport
1. Click the [Exam RX] Desktop.
2. Double Click on the image that you want in primary focus.

26-9

The secondary viewport has a yellow frame around it. In effect, the blue and yellow
viewports are linked together. A change in one of the viewports is reflected in the other
viewport. For example, changing the window width and window level in the primary image
also changes the window width and window level in the secondary focused image.
Quick Steps: Set a Secondary Viewport

1. Click the [Exam RX] Desktop.
2. Double Click on the image that you want in secondary focus.
3. Single Click on the image that you want to link to.

26-10
Sort Examinations and Images
Chapter 27

Introduction
When working with a list of examinations or images, it can be helpful to sort the list by a
particular criteria, such as the scan date or a number. This chapter explains the process of
sorting examinations and images. It contains the step-by-step instructions to help you learn
how to:
Sort Examinations by:

Number
Patient name
Scan date
Modality
Archived status
Sort Images by:

Image number
Table location
Echo (MR images)
Trigger (MR images)
Scan time (MR images)

27-1

This section presents the concepts necessary to successfully sort examinations and images.
The concepts you need to understand are:
Sorting Examinations
Sorting Images

27-2
Sorting Examinations
When you look at the patient list on the browser, you want to know what examinations have
been completed. If you spend time looking for a patient to view, you may want to organize
your list to help you find examinations quickly. The list can be organized in many different
ways. The most common method is to sort the examinations by date.
Sort Examinations by Examination Number

This option sorts the examinations by number. The oldest exam is listed at the top and the
most recent exam is listed at the bottom of the Examination window.
Sort Examinations by Patient Name

This option sorts the examinations by patient name. The patients are listed in alphabetical
order, starting with A at the top of the list.
Sort Examinations by Date

This option sorts the examinations by the date and time on which they were scanned. This
method is used most often since it always lists the most recent patient scanned at the top of
the list. All of the other patients are listed in the order in which they were scanned.
Sort Examinations by Modality

This option sorts the list by modality. It arranges the examinations in alphabetical order by
the modality in which they were scanned.
Sort Examinations by Archived Status

This option sorts the examinations by the archived status. It may be useful to arrange the
patient list so that all of the archived examinations are at the top of the list and the
unarchived examinations are at the bottom of the list.
Sorting Images
Image organization is very important to the doctor when reviewing the exam. It may be
helpful to find out the order in which each doctor wants to view the images. The most
common method is to sort the images by their number, so the images are displayed in order
that they were acquired.

27-3
Sort Images by Image Number

This option sorts the images by image number and is used most often. The image list places
the lowest number at the top of the list and the highest number at the bottom of the list.
Sort Images by Location

This option sorts the images by the table location. This is a good method to use when you
scan out of order and you want to sort the images by the location that was scanned.
Sort Images by Echo

This method is used for MR images that have more than one echo.
Sort Images by Trigger

This method sorts the MR images by trigger delay.
Sort Images by Scan Time

This option sorts the MR images in a series by the scan time. The most recent scan time is at
the top of the list.

27-4
How Do I...
Anchor
This section provides the step-by-step instructions for sorting examinations and sorting
images. Specifically, it describes how to:
Sort Examinations by:

Number
Patient name
Scan date
Modality
Archived status
Sort Images by:

Image number
Table location
Echo (MR images)
Trigger (MR images)
Scan time (MR images)

27-5
Sort Examinations
Use this procedure when you want to change the order in which the examinations are listed
on your system.
Quick Steps: Sort Examinations

1. Select Sort from the display monitor.
2. Select the desired sort option from the Sort list.

27-6
Sort Images
Use this procedure when you want to change the order in which the images are listed on
your system.
Quick Steps:
1. Select Sort from the display monitor.
2. Select the desired sort option from the Sort list.

27-7
Image Manipulations
Chapter 28
Image Manipulations
Introduction
This chapter explains how to manipulate image data. The chapter is divided into two parts.
The first part lists how to perform all applicable functions from the Exam Rx desktop. The
second part lists how to perform all applicable functions from the Image Works desktop. It
In the Exam Rx desktop:
Change the Orientation of an Image
Make Images Sharper or Smoother
Improve the Brain/Bone Interface
Restore an Image to its Original State
Reverse the Video
Apply Mattes to an Image
In the Image Works desktop:
Create a Gray Scale Presentation State Object (GSPS)
View a Gray Scale Presentation State Object (GSPS)

28-1
Image Manipulations

This section presents concepts necessary to understand ways to manipulate images. Some
of the concepts you need to understand are:
Using Proview or Image Filters
DICOM Gray Scale Presentation State Object (GSPS)
Neuro 3D Filter

Gray Scale Enhancement is a display feature which changes the slope and gamma curve of
an image. It can be used in head studies to improve the bone/brain interface which helps
with gray/white matter differentiation. There are three levels of Gray Scale Enhancement,
G1, G2 and G3. G1 applies the least amount of enhancement and G3 applies the most.
When a filter is applied, the images are annotated with G1, G2, or G3 just above the vertical
tick mark scale on the right side of the image.
Using Proview or Image Filters

There are several different display enhancement filters (called Proview in the Exam Rx
desktop or Image Filters in the Image Works desktop) available on the system. The Edge
Enhancement filters are useful for filming bone windows, as they sharpen the image. There
are six levels of Edge Enhancement, E1, E2, E21, E22, E23, and E3. E1 applies the least
amount of enhancement and E3 applies the most. When these filters are used, the image is
annotated with E1, E2, E21, E22, E23, or E3.
The Lung Enhancement filter is designed specifically to use when filming lung windows.
When the Lung enhancement filter is applied, the image is annotated with the word Lung.
There are also five Smoothing filters, S1, S11, S2, S22, and S3, which are used when filming
soft tissue windows to decrease the appearance of noise in an image or enhance low
contrast areas. S1 applies the least amount of smoothing and S3 applies the most. When
these filters are used, the images is annotated with S1, S11, S2, S22, or S3.
DICOM Gray Scale Presentation State Object (GSPS)

DICOM Gray Scale Presentation State (GSPS) is a DICOM object which saves a range of
images, WW, WL, roam, zoom, image flip, and graphic annotations such as image
annotation and measurement graphics. This object is then sent to a review station along

28-2
Image Manipulations
with the source images. When the object is viewed, images are presented in the form that
was displayed on the scanner. GSPS object can only be viewed on systems that support
DICOM GSPS objects.
Neuro 3D Filter
Neuro 3D Filter is a noise reduction filter optimized for thin slice data that is intended for
and helical Brain. The Neuro 3D Filter can be used to reduce noise in images or reduce dose
while maintaining image quality. It may be possible to reduce dose by 10-30% and maintain
acceptable image noise level and image quality depending on the level of filtering selected.
Neuro 3D Filter removes noise from the image while preserving image resolution.
Retrospectively, Neuro 3D Filter is selected in the Browser on Image Works desktop. There
are 3 levels: Low, Medium and High. Images processed using Low are saved in a series that
is the original series number plus 30. Images processed using Medium are saved in a series
that is the original series number plus 40. Images processed using High are saved in a series
that is the original series number plus 50.
Neuro 3D Filter is only compatible with series that have a single group without repeated
image locations. It is not possible to select a subset of a series. A message will be displayed if
the series is not compatible with Neuro 3D Filter. Neuro 3D Filter is not compatible with ASIR.
Figure 28-1 Invalid Data set Message
A minimum of three images are required for Neuro 3D Filter.

28-3
Image Manipulations
How Do I...
This section provides the step-by-step instructions for manipulating images in the Exam RX
desktop. Specifically, it describes how to:
Reverse the Video
NOTE: All of these features are also available from the Accelerator Line Commands refer to
Appendix A.

28-4
Image Manipulations

Use this procedure to flip an image left to right, top to bottom, or both at the same time. You
can also rotate to the right or to the left 90 degrees.
Quick Steps: Change the Orientation of an Image

1.
2.
3.
4.
Put the image of interest in primary focus.

Click [Routine Display].
Click [Flip/Rotate].
Click [FLR] to flip image left to right, click [FTB] to flip image top to bottom or click
[FTB/FLR] to flip image both top to bottom and left to right.
5. Click [RR] to rotate image to the right (clockwise) or click [RL] to rotate image to the left
(counter-clockwise).
6. Click [Cancel] to cancel out of flip/rotate pop up window.
7. Click [Display Normal] to return images to their original orientation.

28-5
Image Manipulations

Using Proview is a great way to enhance anatomical structures without adding additional
reconstruction time.
The Edge Enhancement filters sharpen the image. There are seven levels of Edge
Enhancement, E1, E2, E21, E22, E23, E3 and Lung. E1 applies the least amount of
enhancement and E3 and Lung apply the most.
There are also five Smoothing filters, S1, S11, S2, S22, and S3, which are used when filming
soft tissue windows to decrease the appearance of noisy images or enhance low contrast
areas. S1 applies the least amount of smoothing and S3 applies the most. When these filters
are used, the images is annotated with S1, S11, S2, S22, or S3.
The Proview filter selected is applied to all images in the series when next and prior image
are used from the keyboard.
Quick Steps: Make Images Sharper or Smoother

1.
2.
3.
4.
5.
6.
7.
8.

Click [Proview].
Click [E1, E2, E21, E22, E23, or E3] for edge enhancement.
Click [Lung] for lung enhancement.
Click [S1,S11, S2, S21, or S3] for smoothing.
Click [Off] to turn enhancement off.
Click [Cancel] to cancel out of Proview pop up window.

28-6
Image Manipulations

Using Gray Scale Enhancement (GSE) is a great display tool to improve the brain/bone
interface which helps with gray/white matter differentiation without adding additional
reconstruction time.There are three levels of Gray Scale Enhancement, G1, G2 and G3. G1
applies the least amount of enhancement and G3 applies the most.
The GSE filter selected is applied to all images in the series when the next or prior image is
selected.
Quick Steps: Improve the Brain/Bone Interface

1.
2.
3.
4.
5.
6.

Click [GSE].
Click [G1, G2 or G3].
Click [Off] to turn enhancement off.
Click [Cancel] to cancel out of GSE pop up window.

28-7
Image Manipulations

Display Normal can be used to reset the image display to its original size and orientation.
This feature removes all filters, magnification factors, flip/rotate and graphics such as User
Annotation from selected images.
Quick Steps: Restore an Image to its Original State

1. Put the image of interest in primary focus.
2. Click [Routine Display].
3. Click [Display Normal].

28-8
Image Manipulations
Reverse the Video

Inverse Video changes the blacks to white, creating a negative image.
This is applied to all viewports.
Quick Steps: Reverse the Video

1.
2.
3.
4.

Click [Inverse Video].
Click [Inverse Video] again to turn feature off.

28-9
Image Manipulations

The Matte function eliminates unwanted information on or around an image. There are two
types of matte, rectangular and elliptical. The size can be easily adjusted.
In Exam Rx, this feature can only be accessed from the Accelerator Line.
Quick Steps: Apply Mattes to an Image

2. On the Accelerator Line, type ematte for an elliptical matte or rmatte for a rectangular
matte and click Enter.

28-10
Image Manipulations
How Do I...
This section provides the step-by-step instructions for manipulating images in the Image
Works Desktop. Specifically, it describes how to:
Process Neuro 3D Images
NOTE: These features can be accessed from either the Viewer or Mini Viewer in the Image
Works desktop, or the Accelerator Line Commands refer to Appendix A.

28-11
Image Manipulations

Use this procedure to flip an image left to right, top to bottom, or both at the same time. You
can also rotate to the right or to the left 90 degrees.
The flip or rotate selected is applied to all images in the series.
Quick Steps: Change the Orientation of an Image

1. While in the viewer or mini-viewer, put the image of interest in primary focus.
2. Click [Flip/Rotate].
3. Select the first set of arrows to flip image left to right, select the second set of arrows
to flip image top to bottom.
4. Select the third arrow to rotate image counter-clockwise or select the bottom arrow to
rotate image clockwise.
5. Click [Display Normal] to return images to their original orientation.

28-12
Image Manipulations

Using the Image Filters feature is a great way to enhance anatomical structures without
adding additional reconstruction time.
The Edge Enhancement filters sharpen the image. There are four levels of Edge
Enhancement, E1, E2, E3 and Lung. E1 applies the least amount of enhancement and E3 and
Lung apply the most.
There are also three Smoothing filters, S1, S2 and S3, which are used when filming soft
tissue windows to decrease the appearance of noisy images or enhance low contrast areas.
S1 applies the least amount of smoothing and S3 applies the most. When these filters are
used, the images is annotated with S1, S2 or S3.
The filter selected is applied to all images in the series when next and prior image are used
from the keyboard.
Quick Steps: Make Images Sharper or Smoother

1.
2.
3.
4.
5.
6.
While in the viewer or mini-viewer, put the image of interest in primary focus.
Click [Image Enhance].
Under Filters, click [E1, E2 or E3] for edge enhancement.
Under Filters, click [Lu] for lung enhancement.
Under Filters, click [S1, S2 or S3] for smoothing.
Click [Display Normal] to turn enhancement off.

28-13
Image Manipulations

Using Gray Scale Enhancement (GSE) is a great display tool to improve the brain/bone
interface which helps with gray/white matter differentiation without adding additional
reconstruction time.There are three levels of Gray Scale Enhancement, G1, G2 and G3. G1
applies the least amount of enhancement and G3 applies the most.
The GSE filter selected is applied to all images in the series.
Quick Steps: Improve the Brain/Bone Interface

1.
2.
3.
4.
Click [Image Enhance].
Under Gray Scale Enhancements, click [G1, G2 or G3].
Click [Display Normal] to turn enhancement off.

28-14
Image Manipulations

Display Normal can be used to reset the display to the normal or original size and
orientation.
Quick Steps: Restore an Image to its Original State

2. Click [Display Normal].

28-15
Image Manipulations

The Matte function eliminates unwanted information on or around an image. There are two
types of matte, rectangular and elliptical. The size can be easily adjusted.
Quick Steps: Apply Mattes to an Image

1.
2.
3.
4.
5.
Click [Rect. Matte].
Click and drag on the blue crosshair in the upper left corner of the matte to resize it.
Click and drag anywhere outside of the matte to re-position it.
Click [Erase All] to remove the matte.

28-16
Image Manipulations

GSPS saves image range, WW, WL, Roam, Zoom, rotate, Image Flip and Image graphics such
as Measure distance, ROI, Image Annotation. The GSPS object can then be networked to a
remote host that supports DICOM GSPS. GSPS Objects can also be displayed on the CT
scanner. GSPS object can only be created and viewed in the Image Works desktop.
This feature can only be accessed from the Accelerator Line.
Quick Steps: Create a Gray Scale Presentation State Object (GSPS)

2. Adjust the image to the desired presentation.
a) Set WW and WL
b) Image Roam
c) Image Zoom
d) Image Flip
e) Set rotate
f) Add graphics such as ROI, Measure distance and Image annotation
3. On the Accelerator Line, type ss and click Enter.

28-17
Image Manipulations

Quick Steps: View a Gray Scale Presentation State Object (GSPS)
1. Hilight the GSPS object in the Browser
2. Select [Viewer].
3. Use the pull down to change the viewer format.
4. Select the CPI object buttons to view additional GSPS objects in the series.

28-18
Image Manipulations
Process Neuro 3D Images

Neuro 3D is a noise reduction filter optimized for thin slice image data that is intended for
and helical Brain.
Three images are required for the Neuro 3D Filter option to process the image data.
Figure 28-2 Neuro 3D Window
Quick Steps: Process Neuro 3D Images

1. Click [Neuro 3D].
2. Click [Low], [Med], or [High].
3. Click [Go].
4. Click the door icon to close the window when the filtering is complete.

28-19
Image Addition/Subtraction
Chapter 29
Introduction
This chapter explains how to set up image addition and subtraction. It contains the
Add Images Together to Create a New Image
Subtract Images to Create a New Image
Combine Images from Different Series to Create a New Series
Use Existing Images to Create a New Image Using Only the Maximum CT Number
Use Existing Images to Create a New Image Using Only the Minimum CT Number

29-1

This section presents the concepts necessary to successfully complete image addition and
subtraction. Some of the concepts you need to understand are:
Image Addition
Image Subtraction
Maximum Pixel Value Extraction
Minimum Pixel Extraction
Binding Series
Accept Negative Pixels
The Difference Between "Proc" and "Comb"
Ratio Slider Bar
Image Addition
Image Addition is an operation that consists of adding image intensity values pixel by pixel.
This would be useful for adding thin slices together to get a thicker slice.
Image Subtraction
Image Subtraction is an operation that consists of subtracting image intensity values pixel
by pixel. This could be useful to evaluate contrasted vessels. Remember, patient movement
and breathing between the images can affect the quality of the subtraction.
Maximum Pixel Value Extraction

Maximum Pixel Value Extraction is an operation that consists of finding maximum image
intensity values pixel by pixel. This could be useful for contrasted vessels or calcifications.
Minimum Pixel Extraction

Minimum Pixel Value Extraction is an operation that consists of finding minimum image
intensity values pixel by pixel. This could be useful to evaluate soft tissue.

29-2
Binding Series
Binding Series is a new series that can be created which consists of copies of selected
images from one or more existing series. This could be useful if you had images in two
separate series and wanted to have them in one series to perform 3D or Reformat.
NOTE: Save State information is not maintained in the new series generated with Binding
Series.
Accept Negative Pixels

The Accept Negative Pixels function is available for either type of subtraction. This function,
when enabled, allows negative pixel values in the resulting image. If this function is not
enabled, all negative pixel values are set to zero.
The Difference Between "Proc" and "Comb"

The series resulting from operations in the Image Combination command window are
distinguished from other series in the browser via one of the following two indications in the
browser series list type column:
"Proc" appears in the browser series list type column if the images in the series are the
result of processing pairs of images have identical locations in the patients body.
"Comb" appears in the browser series list type column if the images in the series are the
result of a combination of images have different locations in the patients body.
NOTE: Since "Proc" series contains images resulting from processing pairs of images having
identical locations in the patients body, such series can be used like any other series
of acquisition images, i.e., geometrical measurements, reformatting, 3D
reconstructions, etc.
NOTE: Since "Comb" series contains images resulting from a combination of images having
different locations in the patients body, the absolute anatomical coordinates
accompanying these series (shown both in the browser and on the displayed images)
are not accurate. Only relative geometrical measurements (i.e., distance, angle, or
area) made within a resulting image are accurate.
Ratio Slider Bar

The Ratio Slider Bar is available during addition and subtraction when both of the Select Set
buttons are used. Dragging the slider bar to the left increases the pixel weighting of the
image or images on the left Select Set button. Dragging the slider bar to the right increases
the pixel weighting of the image or images on the right Select Set button. The Slider Bar
defaults to the middle to apply equal weighting.

29-3
How Do I...
This section provides the step-by-step instructions for image addition and subtraction.
Combine Images from Different Series to Create a New Series
Use Existing Images to Create a New Image Using Only the Maximum CT Number
Use Existing Images to Create a New Image Using Only the Minimum CT Number
NOTE: The Add/Sub feature can be accessed through the Image Works desktop from the
browser or from [Image Analysis] in the Viewer or Mini Viewer. The detailed steps in
this chapter assume that [Add/Sub] is accessed from the browser.

29-4

These steps assume you are using the browser in Image Works. This also assumes that you
are using both Select Set buttons.
If only one set is selected, each operation performed produces ONE resulting image.
If two sets are selected, images in the two sets are paired according to physical location in
the patients body. Unpaired images in either set are ignored. Each operation performed
produces ONE resulting image PER PAIR.
The images resulting from each operation are generated in the exam defined by the left
Select Set button.
Quick Steps: Add Images Together to Create a New Image

1.
2.
3.
4.
5.
6.
7.
8.
9.
From the display monitor, click [Image Works].

On the right side of the browser, click [Add/Sub].
From the browser, select the image or images you want to use.
Select from the Image Combination menu, [Select Set] on the left.
Again, from the browser, select the image or images you want to use.
Click [Select Set] on the right.
Click [+].
In the Save Series Box, type in the new series number.
Click [=].

29-5

These steps assume you are using the browser in Image Works. This also assumes you are
using both Select Set buttons.
If only one set is selected, each operation performed produces ONE resulting image.
If two sets are selected, images in the two sets are paired according to physical location in
the patients body. Unpaired images in either set are ignored. Each operation performed
produces ONE resulting image PER PAIR.
The images resulting from each operation are generated in the exam defined by the left
Select Set button.
Quick Steps: Subtract Images to Create a New Image

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

From the browser, select the image or images you want to use.
Again, from the browser, select the image or images you want to use.
Click [-].
Click [Accept Negative Pixels].
Click [=].

29-6
Combine Images from Different Series to Create a New

Series
Quick Steps: Combine Images from Different Series to Create a New

Series
1.
2.
3.
4.
5.
6.
7.
8.
9.

From the browser, select the series you want to use.
Again, from the browser, select the second series you want to use.
Click [Bind].
Click [=].

29-7

the Maximum CT Number
Quick Steps: Use Existing Images to Create a New Image Using Only
the Maximum CT Number
1.
2.
3.
4.
5.
6.
7.

From the browser, select the images you want to use.
Click [Max].
Click [=].

29-8

the Minimum CT Number
Quick Steps: Use Existing Images to Create a New Image Using Only
the Minimum CT Number
1.
2.
3.
4.
5.
6.
7.

From the browser, select the images you want to use.
Click from the Image Combination menu, [Select Set] on the left.
Click [Min].
Click [=].

29-9
Magnifying Images
Chapter 30
Magnifying Images
Introduction
This chapter explains Magnifying Images. It contains the step-by-step instructions to help
you learn how to:
Move the Image Around on the Screen in Exam Rx
Make the Image Smaller or Larger Real Time in Exam Rx
Specify a Zoom Factor in Exam Rx
Move the Image Around the Screen in Image Works
Make the Image Smaller or Larger Real Time in Image Works
NOTE: Because the features Roam, Zoom and Mag Factor are located in Exam Rx and
Images works. This chapter details their use in each area separately beginning with
Exam Rx.

30-1
Magnifying Images
How Do I...
This section provides the step-by-step instructions for magnifying images in Exam Rx.
Specifically, it describes:

30-2
Magnifying Images

Your system has a feature which allows you to keep images centered in a viewport for
filming or viewing purposes. This means that if a patient has an anatomical variance i.e.
scoliosis, has moved slightly, or if offset values were incorrectly entered, you are able to
move the image within the viewport. Once an image is moved, all the images in the series is
displayed in the same adjusted position. You must set the right mouse key for this function
to work.
NOTE: If the Roam button is already highlighted in blue, the right mouse key is set for Roam
and you do not need to reselect it.
Quick Steps: Move the Image Around on the Screen in Exam Rx

1.
2.
3.
4.
On the display monitor, click on the viewport where the image is located.
On the display monitor, click [Routine Display].
From the pop up window, click [Roam].
Click and drag on the image with the right mouse and place the image in the desired
location.

30-3
Magnifying Images

Your system has a feature that allows you to fit your images in the viewport by making the
images larger or smaller as needed. Once you have made an image larger or smaller, all of
the images in the series are displayed in the same adjusted size. You must set the right
mouse key for this function to work.
NOTE: If the Zoom button is already highlighted in blue, the right mouse key is set for Zoom
and you do not need to reselect it. Once you have made the image larger or smaller,
you can click on Roam and re-center the image if needed.
Quick Steps: Make the Image Smaller or Larger Real Time in Exam Rx
1.
2.
3.
4.
On the display monitor, click on the viewport where the image is located.
On the display monitor, click [Routine Display].
From the pop up window, click [Zoom].
Click and drag the right mouse in the image to set the desired size. The magnification
factor is annotated on each image in the upper right side with the initials MF (Mag
Factor) and the value from 0.5 up to 8.0.

30-4
Magnifying Images

Any image can be magnified after it has been reconstructed. In addition to using the Zoom
button, you can enter a specific magnification value to be applied to your image(s). Once a
magnification has been applied, all of the images in the series retains that magnification.
Quick Steps: Specify a Zoom Factor in Exam Rx

1.
2.
3.
4.
On the display monitor, click in the viewport with the image to be magnified.
From the display monitor, click [Routine Display].
From the pop up window, click [Explicit Magnify].
From the pop up window, select or enter the desired magnification factor.

30-5
Magnifying Images
How Do I...
This section provides the step-by-step instructions for magnifying images in Image Works.
Specifically, it describes:
Make the Image Smaller or Larger Real Time in Image Works

30-6
Magnifying Images

Your system has a feature which allows you to keep images centered in a viewport for
filming or viewing purposes. This means that if a patient has an anatomical variance i.e.
scoliosis, has moved slightly, or if offset values were incorrectly entered, you are able to
move the image within the viewport. Once an image is moved, all the following images are
displayed in the same adjusted position. You must set the right mouse key for this function
to work.
NOTE: If the button is already depressed, the right mouse key is already set for Roam and
you do not need to reselect it.
Quick Steps: Move the Image Around the Screen in Image Works
1.
2.
3.
4.
On the display monitor, click [Image Works].

Next to the Browser Menu, click [Viewer] or [Mini Viewer].
From the tools, select the button with the moving hand symbol.
Click and drag the right mouse in the image and place it in the desired location.

30-7
Magnifying Images
Make the Image Smaller or Larger Real Time in Image

Works
Your system has a feature which allows you to fit your images in the viewport by making the
images larger or smaller as needed. Once you have made an image larger or smaller, all of
the following images are displayed in the same adjusted size.
Quick Steps: Make the Image Smaller or Larger Real Time in Image
Works
1.
2.
3.
4.
On the display monitor, click [Image Works].

Next to the Browser Menu, click [Viewer] or [Mini Viewer].
Click in the viewport with the image to be magnified.
Choose from three options for magnification of images. Enter value, click and drag the
slide bar, or click on the arrowheads on either side of the bar.

30-8
Measuring Structures Within an Image
Chapter 31
Measuring Structures
Within an Image
Introduction
This chapter explains how to measure structures within an image. It contains the
In Exam Rx:
Get Density Readings
Measure from Point to Point
Overlay a Grid
Report the Cursor Location and the Pixel Value
In Image Works:
Measure Density Readings on Multiple Images
Measure From Point to Point
Enable Extended CT Number Range
Disable Extended CT Number Range
NOTE: Most of the features listed here are available for use in the Exam Rx and the Image
works desktops. Because of this, the chapter is divided into two parts. The first part
lists how to perform all applicable functions from the Exam Rx desktop. The second
part lists how to perform all applicable functions from the Image Works desktop.

31-1
Quick Steps: Get Density Readings

1.
2.
3.
4.
5.
6.

Click [Measurements].
Click [Box ROI], [Ellipse ROI], or [Trace ROI].
Position the cursor on the image where you want the ROI to be deposited.
Click to deposit the insertion point.
For Box ROI or Ellipse ROI, skip to Step 5. For Trace ROI, move the solid blue box to the
point you would like to start the trace. Press and hold Shift and then click and drag
with the left mouse key to define the area for the trace.
7. To change the size of the ROI, click and drag on the small box in the upper right corner
of the ROI. You may also click in the center of the ROI and drag it to a different location.
8. Click [Erase] to erase the active (blue) ROI.
Quick Steps: Measure from Point to Point

1.
2.
3.
4.

Click [Routine Display] or [Measurements].
Click [Measure Distance].
Click and drag with the left mouse key on either of the small boxes and move them to
the desired start and end points.
5. Click [Erase] to erase the active (blue) Measure Distance line.
Quick Steps: Overlay a Grid

1.
2.
3.
4.
5.

Click [Routine Display] or [Measurements].
Click [Grid On/Off].
To move the grid, click and drag from the center point.
To remove the grid, click [Grid On/Off] again or [Erase].
Quick Steps: Report the Cursor Location and the Pixel Value
1.
2.
3.
4.

Click [Continuous Report Cursor].
To turn off, click [Continuous Report Cursor] a second time.

31-2
Quick Steps: Measure Density Readings on Multiple Images

1.
2.
3.
4.
5.
6.
Perform the test scans at one location with a small bolus of contrast.
Click [Measurements].
Click [MIROI].
For "Image Range" click [All], or type in the range of images desired for monitoring.
For "Scale for HU", click [Absolute] or [Relative].
For "Define Region," select the type of ROI you would like to use (box, ellipse or trace).
Place the selected ROI over region of interest on image.
7. Click [OK].
8. To determine the prep delay needed for the actual exam, look at the peak on the
graph. You need to count the number of images it took get to that peak, the inter-scan
delay between each image, and the mini-prep delay used. Add those three things
together to determine the actual prep delay needed to produce images with
maximum enhancement.
9. Now set up images for the exam as needed, using the prep delay from the MIROI test.
Quick Steps: Enable Extended CT Number Range

1. From the Image Works desktop, click [Turn On Extend HU] located on the Tool Chest.
2. Click [OK] on the Attention pop-up window.
Quick Steps: Disable Extended CT Number Range

1. From the Image Works desktop, click [Turn Off Extend HU] located on the Tool Chest.
2. Click [OK] on the Attention pop-up window.

31-3
How Do I...
This section provides the step-by-step instructions for measuring structures within an image
in the Image Works desktop. Specifically, it describes how to:
Measure From Point to Point
Add a Grid
Quick Steps: Get Density Readings

2. Click [Measure].
3. Click [Box ROI] which is the square, [Ellipse ROI] which is the circle, or [Trace ROI] which
is either one of the half circles.
4. For Box ROI or Ellipse ROI, skip to Step 5. For Trace ROI, move the solid blue box to the
point you would like to start the trace. Press and hold Shift and then click and drag
with the left mouse key to define the area for the trace.
5. To change the size of the ROI, click and drag on the small box in the upper right corner
of the ROI. You may also click in the center of the ROI and drag it to a different location.
6. Click [Erase All] to erase all annotation.
Quick Steps: Measure From Point to Point

1.
2.
3.
4.

Click [Measure].
Select the line with the boxes on either end.
Click and drag with the left mouse key on either of the small boxes and move them to
the desired start and end points.
5. Click [Erase All] to erase all annotation.
Quick Steps: Add a Grid

1.
2.
3.
4.

Click (Grid).
To move the grid, click and drag from the center point.
To remove the grid, click (Grid) again.

31-4
Graphics, Text Pages and Commands
Chapter 32
Graphics, Text Pages and

Commands
Introduction
This chapter explains how to perform some basic tasks using graphics, text pages and other
commands. It contains the step-by-step instructions to help you learn how to:
Annotate the Scout With Scan Lines
Type Text on the Image
Display the Exam Information
Display the Parameters of a Scan Mode
Hide or Show Graphics
Remove Graphics From the Image
Save an Image Screen
Type in Specific Accelerator Line Commands
NOTE: Most of the features listed here are available for use in the Exam Rx and the Image
Works desktops. Because of this, the chapter is divided into two parts. The first part
lists how to perform all applicable functions from the Exam Rx desktop. The second
part lists how to perform all applicable functions from the Image Works desktop.

32-1

This section presents some of the concepts necessary to understand ways to use graphics,
text pages and commands. Some of the concepts you need to understand are:
Cross-referencing
Screen Save
Accelerator Line
User Preferences
Cross-referencing
Cross-referencing is a feature which is used to correlate scanned locations on the scout.
You may select a scoutview and then choose to display lines on it which represent
previously scanned locations. This is useful to see which anatomy was covered in a
particular exam.
Screen Save
Screen Save is an electronic photograph of an image. Screen Save saves everything that is
on the image in primary focus. This includes any zoom, cursors, measurements, flip, or
annotation. You can use Screen Save to save images when anatomy or pathology has been
measured. The screen saved images are listed on the patient list browser as series number
99, and called SSave for the series type. When a screen saved image is displayed, the
window width and window level can be changed, but information cannot be removed.
Accelerator Line
The Accelerator Line, also known as the Command Line, allows commands to be typed
which can perform certain display functions. Typing these commands can act as a shortcut
to opening additional menus to access a function.
User Preferences
User Preferences is available for use in the Image Works desktop only. It allows you to
choose customized settings for annotation, tick marks, grid, right mouse button use, series
binding, square viewports and window/level presets. You may choose to apply your
selection for the present exam only, or you may choose to save your selection as a default.

32-2
How Do I...
This section provides the step-by-step instructions for using graphics, text pages and
commands in the Exam RX desktop. Specifically, it describes how to:
NOTE: These features can also be accessed from the accelerator line. For more information,
refer to: Accelerator Line Commands.

32-3

Cross-referencing is a feature which is used to correlate scanned locations on the scout.
You may select a scoutview and then choose to display lines on it which represent
previously scanned locations. This is useful to see which anatomy was covered in a
particular exam.
Quick Steps: Annotate the Scout With Scan Lines

1.
2.
3.
4.
5.
6.
7.
8.
Put the scoutview image of interest in primary focus.

Click [Cross Reference].
On the pop up window, select which series to post on the scout by typing in the series
number.
Select which images to post.
Next, type in the increment of the lines to be displayed if you selected a range of
images or [All] above.
When all the fields are completed, click [OK] or [Cancel].
To erase the cross reference lines, click [Erase].

32-4

The User Annotation feature allows you to type annotation on an image. This is useful for
typing things such as contrast type, needle gauge and injection rate.
Quick Steps: Type Text on the Image

1.
2.
3.
4.
5.
6.
7.
8.
Put the image that you want to type annotation on into primary focus.
Click [User Annotation].
Place mouse cursor over the image you are typing text onto.
Type the desired text and it appears in the blue box.
Adjust the box and attached arrow as needed.
Click [User Annotation] again to add additional annotation.
Click [Erase] to erase the primary (blue) annotation.

32-5

This feature is used to bring up a text page with exam information on it. This text page can
be filmed.
Quick Steps: Display the Exam Information

2. Click [Exam Page].
3. Click [Manual Film] or [Auto Film] to select the film composer you would like the exam
page to go to.
4. Click [Quit].

32-6

This feature brings up a text page with series information. This can be filmed.
Quick Steps: Display the Parameters of a Scan Mode

2. Click [Series Page].
3. Click [Manual Film] or [Auto Film] to select the film composer you would like the series
page to go to.
4. Click [Quit].

32-7

This feature allows you to temporarily hide graphics without erasing them. This applies to
graphics that you put on the image yourself, such as ROIs, user annotation, etc.
Quick Steps: Hide or Show Graphics

1. With added graphics on the image, click [Routine Display].
2. Click [Hide Graphics].
3. Click [Show Graphics] to show the hidden graphics.

32-8

This feature allows you to selectively erase annotations or graphics. When annotation is
initially selected it is active (blue). When a second annotation is selected, the newly selected
annotation is active and the first one becomes inactive (white).
Quick Steps: Remove Graphics From the Image

2. Click [Erase].

32-9

Turning
Graphics On
and Off (Hide)
Quick Steps: Save an Image Screen

2. Click [Screen Save].

32-10

to open additional menus to access a function. When a command is typed, it is applied to all
of the viewports in focus.
Quick Steps: Type in Specific Accelerator Line Commands

1. To see a list of applicable commands, refer to Appendix A or type? on the Command
Line and click Enter.
2. Once you have decided on a command, type the command on the Accelerator Line
and press Enter.

32-11
How Do I...
commands in the Image Works desktop. Specifically, it describes how to:
Type in Specific Accelerator Command Lines
NOTE: These features can also be accessed from the accelerator line. For more information,
refer to: Accelerator Line Commands.
NOTE: All of these features can be accessed from the Viewer in the Image Works desktop.

32-12

The User Annotation feature allows you to type annotation on an image. This is useful for
typing things such as contrast type, needle gauge and injection rate. This feature can also
be accessed from the Mini-Viewer.
Quick Steps: Type Text on the Image

1.
2.
3.
4.
5.
Put the image that you want to type annotation on into primary focus.
Click (Annotation).
Place the mouse cursor over the active viewport.
Type the desired text and it appears in the blue box.
Once the text is typed, you may click on the blue box and drag it to a different location.
You may also click on the arrow head and drag it to point to a specific structure, or you
can drag it into the box to make it disappear.
6. Click (Annotation) again to add additional annotation.
7. Click (Erase Annotation) to erase the primary (blue) annotation.

32-13

This feature brings up a text page with exam information on it from the Viewer. This text
page can be filmed and/or screen saved. Screen Saves are found in series number 99. This
page can also be accessed from the Mini-Viewer.
Quick Steps: Display the Exam Information

1.
2.
3.
4.
Click [Text Page].

Click [Exam Page].
Click [Manual Film] or [Screen Save].
Click [Quit].

32-14

This feature brings up a text page with series information from the Viewer. This text page
can be filmed and/or screen saved. Screen Saves are found in series number 99. This can be
filmed. This page can also be accessed from the Mini-Viewer.
Quick Steps: Display the Parameters of a Scan Mode

2. Click [Series Page].
3. Click [Manual Film] to place series page on the manual film composer, or click [Quit
Screen Save]..
4. Click [Quit].

32-15

This feature allows you to temporarily hide graphics without erasing them. This applies to
graphics that you put on the image yourself, such as ROIs, user annotation, etc. This can also
be accessed from the Mini-Viewer.
Quick Steps: Hide or Show Graphics

1. With added graphics on the image, click [Hide].
2. Click [Show] to show the hidden graphics.

32-16

This feature allows you to selectively erase annotations or graphics. When annotation is
initially selected it is active (blue). When a second annotation is selected, the newly selected
annotation is active and the first one becomes inactive (white). To activate the inactive
(white) annotation, just click on it. the Erase All feature can also be accessed from the
Mini-Viewer.
Quick Steps: Remove Graphics From the Image

2. Click [Erase].

32-17

Quick Steps: Save an Image Screen

1. Click [Screen Save].

32-18
Type in Specific Accelerator Command Lines

to open additional menus to access a function. When a command is typed, it is applied to all
of the viewports in focus. The Accelerator Line can also be accessed from the Mini-Viewer.
Quick Steps: Type in Specific Accelerator Command Lines

1. To see a list of applicable commands, refer to Appendix A or type ? on the Command
Line and click Enter.
2. Once you have decided on a command, type the command on the Accelerator Line or
click the command from the Help Command Line menu.

32-19
How Do I Edit Default Settings in the

Image Works Desktop
commands in the Image Works desktop. Specifically, it describes how to: edit the default
setting for all the graphics on the image.
Edit Default Settings for Annotation
Edit Default Settings for Grid Preferences
Edit Default Settings for W/L Presets
Edit Default Settings for Right Mouse Button
Edit Default Settings for Tick Marks
Edit Default Settings for Series Binding
Edit Default Settings for Square Viewports

32-20
Edit Default Settings for Annotation

The Annotation Level feature allows you to decide which annotation are included on your
image. There are 4 levels of annotation to choose from. This can be set separately for the
screen and for the film.
Quick Steps: Edit Default Settings for Annotation

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Click [User Prefs].

Click [No Annotation].
Or click [Partial Annotation].
Or click [Custom Annotation].
When you select custom, you must also click [Customize...].
Select which specific information you would like.
Click [Customize Large Font] if you wish to change the font size.
Select the desired selections.
When done with your selection, click [OK].
On the main User Prefs screen, click [Apply] or [Save as defaults].

32-21
Edit Default Settings for Grid Preferences

Use this feature to customize the size and spacing of a grid.
Quick Steps: Edit Default Settings for Grid Preferences

1.
2.
3.
4.
5.
6.
7.
8.
9.
Click [User Prefs].

Under Grid Prefs, click [Customize....].
For Matrix Lines, click [ON] or [OFF].
For Line Style, click [Dotted] or [Solid].
Type in the numeric value for grid spacing (in mm).
Type in the numeric value for tick spacing (in mm).
Type in the numeric value for tick length (in mm).
Click [OK] to make changes, or [Cancel] to cancel.
On the main User Prefs screen, click [Apply] or [Save as defaults].

32-22
Edit Default Settings for W/L Presets

Preset W/L settings can be selected for CT and MR images. These presets can be used from
the Viewer or Mini-Viewer.
NOTE: To Save Window Level presets for the Function Keys, refer to: Set Window Width and
Window Level Preset Keys
Quick Steps: Edit Default Settings for W/L Presets

1. To Save Window Level presets for the Function Keys, refer to: Set Window Width and
Window Level Preset Keys
2. Click either [CT] or [MR].
3. To change the title of a preset, type in the space for that title and type new title.
4. To change a value for w/width or w/level, type in the new value(s).
5. Click [Set current] to change the settings you just selected.
6. Click [Save as defaults].

32-23
Edit Default Settings for Right Mouse Button

Use the Right Mouse Button feature to change the functionality of the right mouse button.
Quick Steps: Edit Default Settings for Right Mouse Button

1. Click [Scrolling] to set the right mouse button to scroll.
2. Click [Magnify glass] to set the right mouse button to give you a magnified area at a
set factor when that button is pressed.
3. Click [Apply] or [Save as defaults].
4. Click [Close].

32-24
Edit Default Settings for Tick Marks

Use this feature to show or hide both horizontal and vertical tick marks on an image.
NOTE: Another way to set individual tick marks is to use the Accelerator Line and type TMV
ON or TMV OFF to turn the vertical tick mark ONLY on or off, or type TMH ON or TMH
OFF to turn the horizontal tick mark ONLY on or off.
Editing
Default
Settings in the
Image Works
Desktop (User
Preferences)
for Tick Marks
Quick Steps: Edit Default Settings for Tick Marks

1.
2.
3.
4.
5.
Click [User Prefs].

Click Vertical to show the side tick marks.
Click Horizontal to show the bottom tick marks.
Deselect Vertical and/or Horizontal to hide the tick marks.
Click [Apply] or [Save as defaults].

32-25
Edit Default Settings for Series Binding

Use Series binding to customize the way you page through images in an exam.
Quick Steps: Edit Default Settings for Series Binding

1.
2.
3.
4.
Click [User Prefs].

Click [Series binding ON] to page through ALL series in an exam.
Click [Series binding OFF] to page through ONLY the current series in an exam.

32-26
Edit Default Settings for Square Viewports

Square viewports is used to visualize a magnified image on film. With this feature turned on,
what you see in the viewport is what you get when the image is filmed.
Quick Steps: Edit Default Settings for Square Viewports

1.
2.
3.
4.
Click [User Prefs].

Click [Square viewports ON] to see the entire magnified image on film.
Click [Square viewports OFF] and the magnified image is only be partially seen on film.

32-27
Managing Scan (Raw) Data
Chapter 33

Introduction
This chapter explains how to manage your scan data. It contains the step-by-step
Create New Images From Scan Data
Look for Images that are not Reconstructed
Pause Images From Reconstructing
Resume Image Reconstruction
Update the Reconstruction List
Save/Restore Scan Data to/from a USB/DVD-Ram
Complete an Anonymous Scan Data Save
Reserve/Release Scan Data

33-1

This section presents the concepts necessary to manage scan data. Some of the concepts
you need to understand are:
Scan (Raw) Data
Suspended Entries
Saving Scan Data
Restoring Scan Data
Reserving Scan Data
Releasing Scan Data
Graphic Retro
New Series Number for Retro Recon
WorkArounds
Scan (Raw) Data

With each rotation of the gantry, x-rays are emitted that pass through a portion of anatomy
and strike the detectors. The signal from the detector is converted by the DAS to an analog
signal that is then part of the scan file. This information is known as the scan or raw data. It
contains all of the information gathered during an exposure.
Suspended Entries
Sometimes the system for a variety of reasons may not be able to complete the
reconstruction of a particular image. This data is then automatically placed in a queue,
where you can attempt to reconstruct it again or delete it.
Saving Scan Data

It may be necessary on occasion to retain the scan data for reconstruction at a later time or
for a diagnostic inspection of the system components. This is usually done if the scan data
must be kept for an indefinite period of time or if the scan data is being sent elsewhere for
diagnostic review.
The media scan data is saved to is dependent on your operator console type. PC based
systems save scan data to DVD-RAM media. The scan data can be stored to a DVD-RAM 9.4GB dual side cartridge.
For the Discovery CT750 HD with the GOC6 console, it is possible to save scan data to
DVD-RAM or external USB hard drive.

33-2
Restoring Scan Data

Scan data that has been stored on a MOD, or DVD-RAM or external USB hard drive can be
placed back onto the system disk. Once on the system disk, the scan data can be
reconstructed using any of the scan parameters, i.e., image interval (if acquired helically),
DFOV, A/P and R/L centers, or algorithm.
NOTE: Only scan data from a Discovery CT750 HD system can be restored on a Discovery
CT750 HD system.
Reserving Scan Data

The system temporarily saves the scan data in an electronic queue. These entries are
written over in order, with the oldest scans being written over first. Prior to this occurring,
you can have the system place a lock on a given scan file to prevent it from being
overwritten. The system then goes to the next oldest unlocked scan file to write over. It is
important to note that when the scan data files are reserved, the remaining number of
available scan files for use are reduced by the number reserved.
If you do reserve scan files, when you no longer need the scan data you should release the
scan files.
Releasing Scan Data

Scan data files that have been reserved may returned to the system for use by releasing the
lock set to reserve the scan data. Releasing the files increases the available scan data files
accordingly. The scan data files are written over in the usual manner.
Graphic Retro
Graphic Retro provides the capability to graphical prescribe your retrospective
reconstructions using an existing axial plane image as a reference image.
The outer blues boxes (seen inside the red squares on Figure 33-2) allow you to change the
size of the circle which represent the DFOV for your reconstruction and the + (seen inside the
yellow square on Figure 33-2) allows you to reposition the circle to define the RL and AP
Centers for your reconstruction.
The red circle indicates the scan field of view. You cannot reconstruct data outside of the red
circle. You can hide the red circle by clicking [Hide SFOV].
If needed you can click on Roam or Zoom, then click and drag the reference image to
desired position or magnify it.

33-3

Figure 33-1 Graphic Retro
New Series Number for Retro Recon

The system will automatically specify the series number for Retro Recon series. The number
assigned is 100 plus the series number. A new series number can be specified by selecting
New Series. The system will specify a series number between 301 to 399 in consecutive
order each time New Series is selected with an exam.
WorkArounds
Scan File save is not complete even though the Saved File message has been posted.
It takes time to transfer the file from the system to the DVD-RAM and unmount the
DVD-RAM. It can take up to an hour for the file to completely transfer. Do not try to
eject the DVD-RAM until the light has gone out on the DVD-RAM drive.

33-4
How Do I...
This section provides the step-by-step instructions for managing scan data. Specifically, it
describes how to:

33-5

The scan data contains all of the information gathered from each exposure, making it
possible to create images of the same anatomy presented in a different manner. Changes in
scan parameters and possibly reducing artifact due to motion are possible. These changes
take place after the original data is reconstructed and are known as retro recons.
The Retro Recon list select screen appears. All acquisitions with available scan data
are listed.
2. From the Retro Recon list select screen, select the appropriate patient, exam, and series
The most recently scanned examination is at the top of the list.
Figure 33-2 Retro Recon screen
4. Type a new series description in the Series Description area if desired.

5. Click [New Series Number] if you want the images reconstructed in a different series
number.
If [New Series Number] is not selected, the system will assign the series number as
original series + 100.
The system will display the series number images will be reconstructed in. If [New
Series Number] is selected, the system will assign a new series number from

33-6

301-399. if more than, 399 series are reconstructed, series 399 will be reassigned
again with an unique UID to separate it from the other series 399.
Figure 33-3 Retro Recon Screen with New Series Selected
6. Click [Retro] to select all groups or click [Y] for an individual group.
designation.
reconstruction.
chapter.
9. As needed, click [Time].
For Cine acquisitions, you can specify a period of time to be reconstructed
retrospectively opposed to the entire scan.
For Volume Helical Shuttle acquisitions, you can select individual passes or a range of
passes to be reconstructed.

33-7

Figure 33-4 Volume Helical Shuttle

System defaults to the DFOV used in the original prescription.
menu.
The Recon Type pop-up window appears with all of the available algorithms from
which you can choose the appropriate algorithm.
matrix size.

33-8

The Recon Option pop-up window appears.
System defaults either full or segment based on the prescription.
Select the Recon Mode, IQ Enhance, or Flip/Rotate orientation, enter Window Width
and Window Level, enable ASIR processing or a Cardiac Filter for noise reduction.
NOTE: Segmenting uses 225 degrees of data from different times within the rotation. Helical
scans using 225 degrees of data, can be segmented. This is useful in segmenting out
Aortic dissection artifact caused by the pulsation of the vessel. Cine scans using 225
degrees of data creates images with a shorter temporal resolution. This is useful in
following contrast through a tumor.
17. Click Graphic Retro [Y] to graphically prescribe the reconstructions.
This allows you to change the DFOV, R/L, and A/P centers.
This can only be turned on for one group at a time.
18. Click and drag the blue circle on the reference image to the desired location if desired.

33-9
Quick Steps: Create New Images From Scan Data

series.
4. Type a new series description in the Series Description area if desired.
5. Click [New Series Number] if you want the images reconstructed in a different series
number.
6. Click [Retro] to select all groups or click [Y] for an individual group.
9. As needed, click [Time].
matrix size.
16. As needed, click [Recon Mode].
17. Click Graphic Retro [Y] to graphically prescribe the reconstructions.
18. Click and drag the blue circle on the reference image to the desired location if desired.

33-10
Remove Images From the Reconstruction List

If any of the parameters prescribed for retro reconstruction of data are incorrect or if the
images are not needed, the recon queue can be paused and reconstruction jobs can be
deleted from the recon queue and will no longer be reconstructed.
1. From the scan monitor, click [Recon Mgmt].
Figure 33-5 Recon Mgmt Icon
The Recon Queue Management screen appears.
2. Click [Pause Queue].

The button is highlighted blue.
The Recon jobs are listed in the window to the right of the Recon Queue Management
buttons.
All Recon jobs are listed by Patient ID, Exam, Series and Image number range.
All recon jobs are paused, prospective and retrospective.
3. Click [Delete Retro Entries].
The Delete Retrospective Entries window appears listing all the recon jobs that are
Retro Recon entries.
4. Select each recon job you want to remove from the list.
5. Click [Delete Selected] or [Delete All].
This removes the images from the recon list.
If you want to delete all the Retrospective Entries on the list, select [Delete All].

33-11

6. Click [Restart Queue].
This enables Recon to start reconstructing remaining recon jobs for both Prospective
and Retrospective requests.
7. Click [Quit].
Quick Steps: Remove Images From the Reconstruction List

1. From the scan monitor, click [Recon Mgmt].
3. Click [Delete Retro Entries].
4. Select each recon job you want to remove from the list.
5. Click [Delete Selected] or [Delete All].
7. Click [Quit].

33-12

Occasionally for a variety of reasons, the system may fail to complete the reconstruction of
an image. The data is not lost, and you may have the system retry the reconstruction of the
image.
1. From the scan monitor, click [Recon Management].
The recon management page opens. If there is an unreconstructed image, it are

listed in the Suspended Entries window.
2. Select the suspended image(s).
The image(s) is listed by Patient ID, Exam, Series and Image number.
The system highlights selection(s).
3. Click [Delete Suspended Entries] or [Unsuspend Entries].
[Delete Suspended Entries] deletes the image(s) without attempting to reconstruct
the data. Use this if you do not wish the image(s) to be reconstructed.
[Unsuspend Entries] retries the reconstruction of the data. If successful, the system
places the image(s) in the correct exam and series.
a) The [Delete Suspended Entries] button has a pop up window to confirm or cancel
deletion. From the Attention Box, click [OK] to delete the selected entry. Click [Cancel]
to close the pop up window only; this does not cancel entry.

33-13

4. Click [Update List].
This allows the system to add any additional suspended entries that may have
occurred while using this feature.
Quick Steps: Look for Images that are not Reconstructed

1.
2.
3.
4.
From the scan monitor, click [Recon Management].

Select the suspended image(s).
Click [Delete Suspended Entries] or [Unsuspend Entries].
Click [Update List].

33-14

Images being prospectively reconstructed cannot be paused. Images being produced
retrospectively can be paused.
1. From the scan monitor click [Recon Management].
The recon management page opens.

Button is highlighted in blue.

Images in queue are listed in the window next to the pause button.
Images are listed by Patient ID, Exam, Series and Image number range.
All image reconstruction are paused, prospective and retrospective. However, several
images from the series may have already completed reconstruction. This is indicated
by the images appearing on the display monitor in the autoview viewport.
Quick Steps: Pause Images From Reconstructing

1. From the scan monitor click [Recon Management].

33-15

It is very important to restart the image queue if it has been paused for any reason. When
the queue is restarted, the images automatically begins reconstruction and be displayed on
the display monitor.
The recon management page opens.

The system automatically starts reconstruction of any images in the reconstruction

queue.
Quick Steps: Resume Image Reconstruction


33-16

If you wish to see any images that may have been added to the reconstruction queue while
utilizing this function, it is necessary to update the reconstruction list.
NOTE: If you exit the recon management screens and return, the list is updated
automatically.
Quick Steps: Update the Reconstruction List

2. Click [Update List].

33-17

Occasionally, it may be necessary for diagnostic analysis to place all of the information
contained in the scan data on to a DVD-RAM or External USB Hard Drive. You may also wish
to place special or difficult studies on a disk to allow reconstruction of the images in
different formats at a later time. If you have placed scans on a disk and wish to restore them
to the system disk, the steps are exactly the same as saving except you use the restore
buttons.
NOTE: If saving scanfiles for troubleshooting, always select Save Selected Anonymous Data
to remove patient identification to comply with HIPAA regulations.
NOTE: Make sure the selected scanfiles does not exceed the space available on the
DVD-RAM. For Discovery CT750 HD only one non Hi-Res helical scanfile will fit on
one side of the DVD-RAM. Most Hi Res scans and Cine full scan types cannot be saved
to DVD-RAM. For Axial scan types, 12 non-Hi Res scanfiles will fit on one side of a
DVD-RAM.
NOTE: It is very important to note that you cannot scan once you have selected [Save
Selected Scanfiles]. The system only allows scanning when the save is complete. If
you accept and then choose cancel the system only cancels when the current scan
save is finished. A scan could be a 60 second helical acquisition and could take up to
1.0 to 1.5 hours to complete the save process to DVD-RAM.
NOTE: Make sure to wait till the light is no longer illuminated on the media drive before trying
to eject the media.
NOTE: External USB Hard Drive needs to be connected before selecting Recon Management.
Do not disconnect the External USB Hard Drive until after you exit Recon
Management.
Quick Steps: Save/Restore Scan Data to/from a USB/DVD-Ram

1.
2.
3.
4.
5.
6.

Select the device you want to save Scan Data to, USB or DVD-Ram.
Click [Save Scan Data].
Select the exam you wish to save in the Exam window.
Select the individual scanfiles for the series you wish to save in the series window.
Select the scans you want to save by clicking [Select All Scanfiles Listed] or select
individual scan(s).
7. Click [Save Selected Anon. Data].
8. Click [Exit] when system has completed the save.

33-18

The system has the ability to save scan data with patient identifying information removed.
This has been added to address HIPAA concerns. Raw data saved anonymously and then
restored will reconstruct with patient identifying information removed. The Patient Name
and ID will be anonymized.
Quick Steps: Complete an Anonymous Scan Data Save

1.
2.
3.
4.
5.
6.
Place DVD-RAM media in the drive.

Click [Recon Management].
Click [Save Scan Data].
Select the Exam/Series/Scans you wish to save annoymously.
Click [Save Selected Annon. Data].
Click [Quit] to exit.

33-19

You may have the system protect selected scan files from being reused. Essentially, you
place a lock, or reserve, around the scan file that the system then bypasses and uses the
next unlocked or released scan file. When the scans are no longer needed, they may be
unlocked, or released, to the system for use. The steps to release are exactly the same as
reserving, except you use the release buttons.
Quick Steps: Reserve/Release Scan DataReserve/Release Scan Data

1.
2.
3.
4.
5.
6.
7.
8.

Click [Reserve Scan Data].
Select Exam or Exams you wish to reserve.
Click [Reserve All Scanfiles], [Select All Exams Listed] or select individual exam(s).
Click [Select All Series Listed] or select individual series.
Click [Select All Scanfiles Listed] or select individual scan(s).
Click [Reserve Selected Scanfiles].
Click [Quit] to exit.

33-20
Reformat
Chapter 34
Reformat
Introduction
The Reformat software is located in the Image Works desktop.
This chapter explains the process of using reformat. It provides step-by-step instructions to
learn how to:
Reformat a Series
Edit with the Active Annotation
Auto Select
Paint on Slice
Create Different View Types

Create a Curved View Type
Create a Profile View Type
Create a Histogram View Type
Create an X Section View Type
Regions of Interest (ROI)
Manage Color Maps
Modify the Opacity Ramp Settings
Work with Colors in VR
Zoom In or Zoom Out the Main VR Control Window
Attach/Detach Objects
Create a Multi VR Object
Save or Film Batch Images
Set Up a Batch Oblique
Set up a Batch Rotation

34-1
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Save Batch Images
Save Batch Curved Parallel Planes
Save Rotating Batch Curved

34-2
Reformat

This section presents the concepts necessary to successfully complete the process of
creating and managing image sets for reformat. Specifically you need to understand:
Safety
Intended Use
User Profile
Important Notes
Requirements for Reformat
Red Annotation on the Image
Keyboard Shortcuts and Tips
View Types
Render Modes
Cut Planes and 3D Shutters
Main Control Panel
Advanced Processing
Measurements, Annotate and Save images
Display Tools
Segment Tools
Film/Save Tools
Contextual Menu
Volume Render (VR)
Up ramp VR Adjustments
VR Tools
VR Advance Settings Menu
Surface Rendering
Film/Save Options
Safety
This section reviews important information for the safe and effective use of Volume Viewer.
The user must understand this information completely before using Volume viewer.

34-3
Reformat
Intended Use
Volume Viewer 3.1 is a medical diagnosis software that allows the processing, review,
analysis and communication of 3D reconstructed images and their relationship with
originally acquired images for CT, MR, X-Ray Angio and PET scanning devices. The
combination of acquired images, reconstructed images, annotations and measurements
performed by the clinician are intended to provide to the referring physician clinically
relevant information for diagnosis, surgery and treatment planning.
User Profile
As with any medical imaging process, only qualified personnel should use this equipment.
You must be aware of the limitations of the basic imaging modality and of ensuing image
processing. This includes understanding the limitations of the initial series acquisition, image
processing technology used, and image display methods.
Important Notes
Image reliability
CAUTION:
3D or slab Reconstructions provide additional supplemental information,

complementing diagnosis that should be based on classical techniques
WARNING: Non GE images acquired can be loaded in Volume Viewer but GE does not
guarantee the quality or reliability of any reconstruction, segmentation or
measurements performed on these images. Non-GE images can easily be
identified by the corresponding image annotation.
Follow the DICOM acquisition parameter guidelines listed in each
application user guide. Consult GE-published DICOM conformance
statement of Volume Viewer which is available on the GE Healthcare
website at
http://www.gehealthcare.com/usen/interoperability/dicom/products/works
tation_dicom.html.

34-4
Reformat
WARNING: Always correlate any information (cursor position, image orientation,

measurements, image quality) in any 3D reconstruction (reformatted plane,
oblique, MPVR, MIP, Volume Rendering, Navigator endoluminal views, Curved,
segmentations, measurements, tracking, saved images) with the original
data (acquisition or baseline images).
WARNING: A 3D view is a two-dimensional projection on the screen of the 3D Volume.

There is no indication on a 3D view of how deep inside the 3D volume a 3D
cursor is. Always check the accuracy and consistency of 3D coordinates by
checking cursor position on original data (acquisition images)
Window Width and Level (W/L)
WARNING: The window width and level (W/L) determine how clearly pathologies and
other anatomical structures can be discerned. Incorrect W/L settings may
result in pathologies and other essential anatomical structures not being
displayed correctly. As a single W/L cannot display all features present in an
exam, use several different setting, when necessary to explore all exam data
Volume Rendering
WARNING: When using Volume Rendering, incorrect setting of opacity curve, opacity
threshold, transparency setting when merging VR objects can result in
pathology or essential anatomies not being visible. Always correlate Volume
Rendering images with original images.
Image quality
WARNING: At all times, it remains the responsibility of the physician to determine

whether the inter- slice distance used for a particular exam is acceptable.
WARNING: Loading non-square pixels will results in bad quality image

34-5
Reformat
Segment Tools
WARNING: Before using any segmentation tool (threshold, scalpel, remove & keep object,
AutoSelect, floater filters) always make sure that it will not remove
pathologies or other essential anatomical structures.
WARNING: When using any Segmentation tools (AutoSelect, threshold, Paint on slice,
Quick Paint), check contours to check the reliability of the segmentation.
Make sure the contours match the correct segmentation and volumes Check
segmented volumes match contours.
Measurements
WARNING: Do not use 3D or slab views only to perform any measurements (distance,
angle, Region of Interest, Report Cursor, Area, Volume). Always check
measurement points position and refer to 2D baseline views (acquisition
images or reformatted images of minimal thickness) to confirm
measurements.
CAUTION:
The software calculates and displays measurements with a resolution of one

decimal (such as 0.1 mm, 0.1 degree, etc.). You should be aware that the real
measurement accuracy is generally less for a number of different reasons
(image resolution, acquisition conditions).
Distance, angle and area measurements are valid only if all trace segments
are longer than the inter- slice distance.
WARNING: Depending on WW/WL settings, objects may display differently. Check

WL/WW before depositing measurement points

34-6
Reformat
Filming and Saving Images
CAUTION:
When filming or saving images for diagnostic purposes, always make sure
the patient name and geometry information is displayed on all views and
match information on reference view.
CAUTION:
When saving images with a new series description, make sure this description
matches the saved images.
WARNING: Check with original datasets the reliability of segmentations and

measurements performed in Saved objects after post processing and
reloading
Requirements for Reformat

Certain requirements need to be met to have a valid image set in order to perform reformat.
They are as follows:
Matrix Size
Display Center
Orientation
(The above requirements need to be the same for all images in the set.)
There must be at least four images selected before selecting reformat.
Tilt acquisitions are not supported for right and left decubitus patient orientation.
You cannot have two images with identical locations.
Spacing must be less than 10 millimeters and the set should include only axial, sagittal
or coronal images.
Different Display Field Of Views (DFOV) and Gantry Tilts can be loaded however you have to
select between different sources of images to view them. The source annotation is located
in the upper left corner of the image (Figure 34-1). You can change between sources by
clicking on the red annotation.

34-7
Reformat
Figure 34-1 source Annotation
Red Annotation on the Image

All Red annotations on the image indicate adjustable fields.
Red Numerical values can also be adjusted with left/right click to decrease/increase value
Other red annotations can be modified selecting options from drop down list.
Figure 34-2

34-8
Reformat
Table 34-1 Red Annotation on the Image
1.
Plane or View
type:
Click and select from drop down menu to

change the plane or select a 3D model.
Image Location:
Press middle mouse button and drag horizontally to scroll

through the 2D
images or left-click to increment and right-click to decrement
an image at a time.
DFOV:
Press middle mouse button and drag horizontally to real-time

magnify the image or
left-click to increment and right-click to decrement the mag
factor.
Image Roam:
Press left mouse button and move the image within the
viewport.
Slice Thickness:
Middle-click and drag horizontally to real-time change the slice

thickness or
left click to increment and right-click to decrement the slice
thickness (2D images).
Window width
and level:
Press middle mouse button and drag horizontally to real-time

change the W/L or left click to increment and right-click to
decrement the W/L.
Left click to select predefined WW/WL setting.
Patient name:
Click and select from the menu to show or hide the patient
name
2.
3.
4.
5.
6.
7.

34-9
Reformat
Keyboard Shortcuts and Tips

Table 34-2 Keyboard Shortcuts
Indicator / Key
Description
Filming Keys
Use keys F1 F4 for manual filming with the Manual Film Composer.
The F3 key in conjunction with <Shift> and the F12 key can be used to
place images on the Autofilm composer.
Preset
Window
Width /
Window Level
Keys
Use keys F5 F11 for preset Window Width (WW) / Window Level (WL)
keys.
These presets are equivalent to the presets that are in the Viewer and
Mini-Viewer in Image Works.
Page Up /
Page Down
Keys and
Arrow Keys
Use these keys to scan through the images in a viewport.
Window
Width /
Window Level
Control Keys
Use these keys to change the WW/WL settings for images in the Exam
Rx and Image Works desktops.
The Up/Down arrow keys increase/decrease the window level,
respectively.
The Right/Left arrow keys increase/decrease the window width,
respectively.
Tab Key
Press the Tab key to swap between modes.
SpaceBar
Press the Space Bar to show/hide the MyTools palette.
Ctrl Key +
moving the
mouse
Pages through the slices.
Shift + Left
Click
Places the cursor at the mouse location.
Shift + Left
Click and
Drag
Draws a trace line as you move the mouse.
Alt
Allows you to click and edit your trace area.
Alt + + s
Save the image as you name it.
View Types
View type can be changed using the Red annotations on the images.

34-10
Reformat
Figure 34-3 View Types
Figure 34-4 Red View Type Annotation
Mode
Description
3D
The 3D mode displays the volume in 3D with different rendering. Default

rendering is High density MIP. Other modes are available from the
rendering mode red annotation detailed in section N2 below
VR
The Volume Rendering (VR) mode displays the volume in 3D color

rendering.
Axial
An axial is an image representing a cross-sectional slice of anatomy.
Sagittal
A sagittal is a lengthwise plane dividing the body into left and right
portions.
Coronal
A coronal is a lengthwise plane through the body, dividing it into anterior

and posterior portions.

34-11
Reformat
Mode
Description
Oblique
An oblique plane is a coronal or sagittal plane that has been tilted

through the body rather than following the long axis. It can look like a
axial image.
Oblique 3D
A Curved 3D image allows the definition of a complex, curved view. The

curved view does not need to lie along a single orthogonal or oblique
plane but can follow anatomical lines.
Curved
A Curved image allows the definition of a complex, curved view. The

curved view does not need to lie along a single orthogonal or oblique
plane but can follow anatomical lines.
Profile
Profile is a graph showing the CT number intensity across a location.
Histogram
The Volume Histogram view provides a variety of information, including

the ability to display a histogram showing the percentage of occurrence
of each voxel intensity value in an object. It also provides numerical
statistics about the voxel intensity values in a object plus the total object
volume. Also, it automatically determines boundaries around a class of
similar voxel intensities and can hilight pixel values. This function is
typically used when you have 3D data; otherwise, the volume
statistics are not valid.
X Section
An X Section view displays a histogram showing the percentage of

occurrence of each pixel intensity value in a user-defined surface area
on a reformatted slice. It also provides numerical statistics about the
pixel intensity values in this same surface area plus the calculations of
this area. It automatically determines boundaries around the class of
similar pixel intensity values in this area.
Render Modes
Render modes consist of Volume Rendering, HD MIP, MIP, Min IP, Ray Sum, and Integral (Table
34-3).
Figure 34-5 Render Modes
Table 34-3 Reformat Render Modes

Mode
Description
Exists only if the model was built using volume mode and is used to display the
Volume
Rendering surface of a model.

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Reformat
Mode
HD MIP
Weighted
MIP
MIP
Min IP
Ray Sum
Integral
Description
Displays the model using the High Definition Maximum Intensity Projection mode.
The mode is identical to the MIP mode as described below, except that image
definition is greater but the system speed is slower.
Displays MIP rendering enhancing front voxels and fading voxels in the back
Displays the model using the Maximum Intensity Projection mode. In this mode,
the density of each point on the screen is the maximum density along a line
perpendicular to the screen.
Displays the model using the Minimum Intensity Pixel mode. In this mode, the
density of each point on the screen in the minimum density along a line
perpendicular to the screen.
Displays the model by summing the models intensity along lines perpendicular to
the screen. This mode simulates conventional radiography images.
Displays only the surface of the model, but the density of each surface point is
equal to the sum of densities along a shallow depth below the displayed surface
point.
Cut Planes and 3D Shutters

When structures of interest are hidden on a 3D view, Cut planes and shutter tools can be
used to display them prominently.
Right click over No Cut and the cut plane menu appears. The cut plane location is defined by
the 3D cursor position. Move the 3D cursor to adjust cut plane location.

34-13
Reformat
Figure 34-6 Cut Planes
Main Control Panel

The principal controls in the Main Control Panel (Figure 34-7) are:

34-14
Reformat
Figure 34-7 Main Control Panel

34-15
Reformat
Icon
Description
The Image Controls provide the ability to change the function
of the Left Mouse Button to perform basic image
manipulation:
Page through slices
Rotate Volume
Zoom
Pan
Select a Viewport
Adjust Window Width and Level
Image Controls can be also adjusted via right-click
The [Single Oblique Mode] button (on the right) displays a
line cursor in Reformat that is used to define a new plane. Set
the function of one viewport to Oblique. Make another
viewport primary and then click on the [Single Oblique
Mode] button. A solid yellow line appears, which represents
the plane of the Oblique reformat. This line can be tilted to
display the desired anatomy: place the cursor on the solid
yellow line, hold on the left mouse button and drag to tilt the
yellow line to display the desired plane.
The [Multiple Oblique Mode] button (on the left) displays 3
oblique planes defined by 3 adjustable color axis (orange,
green, blue). Adjust any axis to update the 2 other oblique
planes. De-activating the Multiple Oblique mode (click again
on the button) will keep the orientations defined in oblique
viewports.
The Image Controls provide the ability to change the function
of the Left Mouse Button to perform basic image
manipulation:
Page through slices
Rotate Volume
Zoom
Pan
Select a Viewport
Adjust Window Width and Level
The Image Orientation buttons are used to change the plane
of a 3D or Oblique reformat image.
[S] = Superior
[I] = Inferior
[A] = Anterior
[P] = Posterior
[L] = Left
[R] = Right

34-16
Reformat
Icon
Description
Advanced mode gives access to all tools grouped under
tabs.
Click [Display Less Tools] to switch to basic mode
Basic mode where only My Tools palette is displayed.
This palette is customizable and contains most frequently used
tools.
Click [More Tools] to switch to Advanced mode.
My Tools palette is a customizable tools palette.
It is recommended to place in My Tools most frequently used
tools so they are all grouped together and accessible at any
time.
To remove a tool from My Tools palette, drag and drop the
tool outside the palette or right click on the tool and select
[Remove from My Tools].
To add a tool to My Tools palette, go to the tab where is the
tool to add, then drag and drop it to the My Tools palette or
right click on the tool and select [Add to My Tools] (for
example to add annotations preset tool, go to Display Tab)
My Tools tab can be floated anywhere in the interface grabbing
the top part of the tab. It can also be showed and hidden at
mouse location pressing the Space Bar.
Advanced Processing
Advanced Processing Tools are used to refined segmented objects or combine them using
Boolean operations
It is mandatory before using them to perform an initial segmentation with any of the
segmentation tools (threshold, AutoSelect, Paint, scalpel).
Open the [Segment] tab and click [Advanced Processing] to display the Advanced
Processing window.

34-17
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Figure 34-8 Advanced Processing
Table 34-4 Advanced Processing Tools

Description
Adjust the intensity of the operation setting number of
voxels processing operations.
Click the operation to perform:
1.
Basic image
[Dilate]: add one or more layers of voxels to the surface of

the current 3D model
[Erode]: remove one or more layers of voxels from the
surface of the current 3D model
[Close Gaps]: fill in the gaps to connect adjacent features.
Similar to dilate but takes place only where gap between
structures is small.
[Open Bridges]: remove residual bridges connecting
objects close together.
[Close Holes]: resets inner holes created by 3D threshold
[Extract Surface]: removes all voxel inside the object,
leaving only the surface

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Reformat
Description
Boolean operations can be used to combine 3D segmented
objects together.
All objects must originate from the same master volume.
Perform initial segmentation to generate objects to
combine using any segmentation technique (threshold,
AutoSelect, paint)
Display objects to combine in separate views
Isolate views to combine
Set mouse mode to Select mode
Double click to isolate first view of interest
Combine Segmented
objects
2.
Activate Select mouse

mode
Single click to isolate second view of interest Views of

interest should display red and green borders while
other views should not have color borders anymore
Select operation
Subtraction
Before subtracting images make sure the borders of the
views are displayed as follow:
To adjust red and green borders of the view, single click on

the view to set red, the other one will turn to green

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Description
Intersection
Keeps only the voxels common to the two selected models.
2.
Combine Segmented
objects
Addition
Keep all of the voxels that exist in either of the two selected
models.
Results of the operation displays in the red views

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Description
Filter Floaters is used to remove small fragments from a 3D
segmented object based on size (Small, Medium, Large or
user defined).
Click the view of interest and click [Filter Floaters].
3.
Filter Floaters
Click [Filter Size] and select Small, Medium, Large, or User
Defined and click [Apply].
Review Controller
One of the new features of Reformat is the existence of a Review Controller (Figure 34-9),
which allows you an on-view operation of the main controls provided for the software. Table
34-5 describes the functions of each of these controls.

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Figure 34-9 Review Controller
Using the Review Controller is the easiest way to view

images. All the viewing tools are in the margins for
easy access.
11
NOTE: These tools are available if you have the

viewport selected or if your cursor is over the
view.
10
1
4 5
6 7 8 9
14
12
13
Table 34-5 Review Controller Description

Number
1
Icon
Name
Description
Job Shuttle
Job Shuttle starts paging at selected speeds in a selected

direction. This is useful with Auto Loop and Auto Rock.
Auto Loop
Auto Loop allows you to have the views appear in a continuous

forward mode, in a loop movement. When the system reaches
the last view, it starts up again with the first one. Click to start
and stop.
Auto Rock
Auto Rock allows you to have the views appear in a continuous

forward to backward movement. When the system reaches the
last view in a forward movement, it starts up again backwards
and vice versa. Click to start and stop.

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Number
4
Icon
Name
Description
Report Pixel
Report Pixel gives you the houndsfield measurements for one

pixel value.
5
6
Distance
Tool
Selecting Distance Tool opens a panel that allows you to

execute distance measures for straight or curved lines.
Create
Annotation
Scalpel
Enlarge/
Split Views
Selecting Enlarge makes the current view take up the entire

viewing area. The icon then becomes Split Views for returning
the view to its normal size.
10
Hide
Controller
Hides the controller.
Selecting Annotation Tool opens a panel that allows you to use

predefined annotations on the views. You can also create new
annotations here.
Selecting Scalpel opens up a panel that allows you to define
any kind of cut of the view you may need.
Image location slider: The slider is used to review images. Click

and drag the Location Slider to move within the different slices.
Clicking once on the center bar of slider, or pressing the Control
keyboard key, will link the Location Slider to the mouse cursor.
You can then move within the slices just by moving the mouse
up and down. Clicking again on the Location Slider, or releasing
the Control keyboard key, then unlinks the Location Slider from
the mouse cursor.
Slice Thickness: Click and drag the outer bars to change the
slice thickness of the images within the active viewport.
11
Scroll to
Select Image
12
Scroll to
Next
Bookmark
Shows the next bookmarked image. A bookmark leaves a red

annotation on the image.
Scroll to
Prior
Bookmark
Shows the previous bookmarked image.A bookmark leaves a

red annotation on the image.
13

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Measurements, Annotate and Save images

Figure 34-10 Measurement Menu
Table 34-6 Measurement Icons

Icon
Description
Measure Distance
Report cursor that gives voxel

value
Measure inside a ROI that
gives
average voxel value inside a
Region of Interest
To Annotate an image, select
the tool:
To Save an image, select the

tool:
To Save a Batch of images,

select the
tool [Batch Film]:

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Display Tools
Figure 34-11 Display Tools
Table 34-7 Display Tools

Icon
Description
Report Cursor - Click the [Report Cursor] button to
display a RAS coordinate and vector ROI for the current
cursor position.
Elliptical and Rectangular 2D Region Of Interest

Displays statistics as average, minimum and
maximum voxel values within the ROI.
Ellipsoid and Rectangular 3D Region Of Interest

Displays statistics as average, minimum and
maximum voxel values within the ROI as well as
volume of the ROI.
3D Color Region of Interest Displays statistics as

average, minimum and maximum voxel values within
the ROI Also provides the ability to colorize voxels
inside the ROI based on ranges of voxel value.
Additional Statistics such as volume can be calculated
for each colored area.

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Icon
Description
Annotate - Click the [Annotation] button to display
annotation panel. Many of the options are linked to
measurement tools. For example, the Distance
Annotation allows you to link an annotation with a
measurement, (e.g., Stenosis: xx.x mm).
Click [Annotation] button.
Click Annotation type (simple annotation, linked
annotation, distance).
Click on the image where to deposit the annotation.
Perform measurement if annotation type is a
measure.
Enter text in the text area.
This can be saved as an annotation preset clicking on
[Save as preset]. By default, preset annotations are
saved under current anatomy and current protocol.
Check [Use for other anatomy] and /or [Use for other
protocol] to make them available from all anatomy
and/or all protocols.
Preset Annotations - Allows you to use preset
annotations.
Distance Measurement - Straight and Curved
measurements are selectable from this panel.
Click on the image to deposit the first and last points.
Projection (2D): 2D measurements are planar
projection measurements. When used in 3D images,
measurement will correspond to the projected red
distance in the plane of the screen.
From volume (3D): When using 3D measurements,
endpoints can be positioned at different depth in the
volume. It is necessary to rotate 3D volumes to
check the exact position of endpoints.
Straight-line measurement is selected by default.
Select curve in the [Along] section to make curved
measures, then deposit multiple points on the image
with left click and validate curved line with right click.
Angle Measurement Click on the image to deposit three points

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Icon
Description
Area Measurement
Click on the image to deposit points around the region
of interest. Right click to display results.
Volume Measurement
After an object of interest has been segmented, the
volume of this object can be assessed by clicking the
Volume Measurement tool and then by clicking the
viewport where is the segmented object.
Set Color
Select a Color Map or a Custom Color to apply it to all
non-VR viewports. A color map is available to invert
gray levels.
Trace
Click the button to be guided to create a Curved
reformation, a Profile or a XSection.
Rotate / Translate
To rotate and translate image from a specific angle or
distance. In Rotate tab, click in the center of the
sphere to switch to Anterior view.
Use Tumble mode to oscillate around displayed
angle.
When comparing several exams or series, volumes are
automatically linked.
Link/Unlink tool is used to manually adjust registration
of the volumes.
This tool is activated only when multiple volumes are
loaded
MPR/3D
Guides the user through the creation of MPR and 3D
views.
Adjustment of slabs thickness is possible from this
panel as well as selection of
rendering modes such as MIP, Average, MinIP and
Volume Rendering.

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Icon
Description
Display options
Allows to setup user display preferences such as:
Cursor shape and Trace type (Polygon, Smooth, Free
hand).
Show/Hide information:
Display slices locations on active viewport.
Display reference image, annotations.
Display exam/series scrolling section on top of the
left panel:
Display or hide ruler for distance references on
viewports.
Select Paging mode.
Contiguous: optimize paging speed when paging
thick slabs.
Continuous: (default) paging through all slices.
Segment Tools
Figure 34-12 Segment Tools

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Table 34-8 .Segment Tools
Icon
Name
Description
It is the most frequently used function for CTA and
MRA studies.
Select appropriate tool for the region to segment.
Use [Small Vessels] segmentation tool to
segment vessels under 5 mm.
Use [Any Structure] segmentation tool to

segment vessels above 5 mm or other
structures such as soft tissue.
Use [Bones] segmentation tool to selectively

segment Bones in a CT dataset. If available, use
[Auto-Remove Bones] for CTA dataset.
[Auto-Remove Bones] is activated by AutoBone
Option.
To segment vessels, you can Single click the

vessel of interest that is automatically grown.
For more precise segmentation, press left
mouse button until the section of interest of the
vessel is filled.
For other Structures than vessels, press left

mouse button until the pointed structure is filled.
Use [Pick from VR] segmentation tool to

segment any visible and isolated structure in
Volume rendering in a single click.
AutoSelect
Threshold
Threshold the image keeping only voxel within a

specified range of value.
Set the range of voxels to keep, using manual
adjustment or predefined Air, Bone thresholds
for CT.
Click on [Apply Threshold] to segment the
volume
Segmentation can be refined as follow:
Select [Remove Object] and click the
structure to remove. All voxels connected
to the selected structure are removed.
Select [Keep Object] and click on
structure of interest in order to keep it. All
structures that are not connected to it are
removed.

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Icon
Name
Description
Remove Object
Allows you to Remove, or Keep isolated objects as

well as display removed structures.
Scalpel
Draw structure to cut holding left mouse button,

then select if you want to cut inside or outside the
contours.
It is also possible to Double click in the view to
apply an inside cut. Depth of the cut can be
adjusted
Paint on Slice
Draw contours of the structure of interest on

different slices. Volume to keep will be interpolated
based of the defined contours.
Quick Paint
Paint structure of interest with adjustable brush

and press [Apply] to keep only painted structure.
Advanced
Processing
Consolidates many processes: dilate, erode, filters,

subtraction methods, close gaps/open bridges,
close holds, and extract surface.

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Figure 34-13
7
4
5
1
2
Table 34-9 Region Cut Definition Selections

Title
Description
[Clear]
Clears the latest trace.
[Cut Depth]
This section allows changing the scalpel from Infinite to

Restricted depth.
[Undo]
Allows you to undo the last operation performed. If the

View on which the last operation was performed is
changed, the possibility of undoing the last operation is
permanently lost.
[Cut Inside]
[Cut Outside]
Click and drag around the object of interest and then

click the appropriate button to either cut inside or
outside the trace. The trace may appear either red or
green.
[Cut on Trace]
Use this button to apply the cut along the trace.
[Keep Object]
Place the cursor on the object of interest, and click

[Keep Object] to keep all voxels attached to the object of
interest.
[Close]
Click to close the Region Cut Definition window.

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Film/Save Tools
Figure 34-14 Film/Save Tools
Table 34-10 Film/Save Tools

Icon
Description
[Batch Film]
Creates Rotation, Loop or Oblique batch images based
on your prescription.
[Movie]
Creates a comprehensive movie including different
rotations, zoom and pan of the volume.
[QTVR]
N/A in Reformat.
[Quick Export]
Exports in a single click a batch of rotations of a 3D
view or a full batch of contiguous images at displayed
thickness for 2D images.
NOTE: Video Export does not work on the Operators
Console.

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Icon
Description
Save Image
Saves clicked image using the current description
Default save format is Screen capture with the
following options:
[Color (VR images)]: saves VR images in Color.
[Color (non-VR images)]: saves non-VR images in
Color.
Due to DICOM format restrictions, Window Level and
Width of color images cannot be modified. It is then
recommended to unselect this option to be able to
perform windowing adjustments when reading saved
images in PACS or other viewers
[Save State]: Saves current status of Volume Viewer
(3D Model, displays, ROIs) at the same time as
saving the image. This Saved State can be used later
on to restored Volume Viewer State.
Check [Save as Reformatted or PJN] to Save images in
this format every time it is possible. Images saved
under these formats contain geometrical information
so that they can be reloaded in a 3D software and
freely windowed. Click the link [when possible] to
display the list of image types that can be saved as
Reformatted and PJN according to DICOM
requirements. [Color] and [Save State] options are not
compatible with Reformatted DICOM format. These
settings cannot apply to images saved as
Reformatted.
Uncheck the option [Save as Reformatted or PJN] to
benefit from [Color] and [Save State] capabilities every
time you save an image.
Save State
Saves current status of Volume Viewer (3D Model,
displays, ROIs) as an additional series of the exam.
Note: A One-Touch protocol entitled Save State will
appear in the Application field providing the ability to
restore Volume Viewer State.
Save/Recall
Opens a clipboard where to drag and drop objects to
store temporarily within current Volume Viewer
session. Drag and drop is only possible when in
[Select] mouse Mode.
Film/Save Options
Click to select save format type and other film options.

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ROI tools exist not only in 2D but also in 3D. Several shapes are available to measure a
Region Of Interest in any view plane/volume: circle, elliptic, rectangle and cubic for 3D ROIs.
Statistical information is provided such as Min, Max and Average Values within the ROI and
Standard Deviation of the ROI.
Contextual Menu
Right click on a view to display the contextual menu. The menu will differ according to the
type of viewport. Corresponding keyboard shortcuts, if applicable, are indicated between
brackets.
The contextual menu always contains the items described below (except when on curved
view, where less items are available).
Figure 34-15 Contextual Menu

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Table 34-11 Contextual Menu
Icon
Description
[Save Image] - To save the image as a DICOM image
[Save Image As] -To save the image and assign it a

description
[Save Screen] - To save all images displayed on the screen
as DICOM images
[Hide 3D cursor] - To remove the 3D cursor from the
screen.
Toggles back with Show 3D cursor
[Show All/Less Annotations] - To hide or show part of the
image annotations (scan parameters)
[Hide Annotations] - To hide all annotations including the
right and left markers
[Reference Image] -To display a small reference image
showing the plane orientation and position of current
image
[Create Trace] - To Create a new Trace
[Clear Last point] delete last point deposited
[Clear Trace] - Deletes the traced line.

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Icon
Description
[Lock cursor to trace] use this option to lock the 3D
cursor on the trace. When using shift key to move 3D
cursor, it will move along the trace on all views.
[Enlarge] -To change the view to Full Screen
[Reset Pointer] - To return the object back to the center of

the viewport. Use this tool when you have blank
viewports.
Left Mouse Button Modes Sets action of the left mouse

button. Active mode is indicated by -> sign.
Volume Render (VR)

Volume Rendering is a technique that uses the concept of Opacity. For different density
levels, each voxel transmits a certain amount of light, which is reflected on the following
voxel, and only the residual light reaches the following layer. The resulting image is the total
sum of the reflection from each layer of tissue through which the light has passed. The effect
of using Volume Rendering on a dataset is that it makes highly opaque objects more visible
and at the same time it makes less opaque objects more transparent.

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Figure 34-16 Opacity Curve with the up ramp shape
Up ramp VR Adjustments
To decrease background noise, increase the value of the lower threshold.
To increase visualization of soft tissues structures, decrease the value of the lower
threshold.
Max Opacity can be reduced: structures become more translucent.

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Figure 34-17 Values
VR Tools
VR tools display as soon as a Volume Rendering image is displayed. To display a VR image,
select VR from the top left red View Type image annotation.

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VR presets are provided for each anatomical

category.
When selected, the VR preset will apply to
the selected VR view (red border).
User defined VR Presets can be deleted by
clicking the trash button in the lower right
corner.
VR Presets

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[AutoFit] will automatically fit VR

parameters to display the structure pointed
by the 3D cursor.
Place the 3D cursor on the anatomy of
interest in any multiplanar view.
Basic VR
Settings
Click [AutoFit] to refine the VR opacity.

Click and drag the Middle Mouse button up
or down.
To save settings as new VR preset, click
[Save New VR Settings].
To access the Advanced VR Settings panel,
click [Advanced Settings].

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VR Advance Settings Menu

Figure 34-18 VR Controls
Item
Description
The ramp style defines opacity curve shape.

Step: surface type rendering displaying structures with high voxel values.
Up Ramp: displays structures with high values typically vessels and bone.
Down Ramp: displays structure with low values typically airways.
Plateau: displays structures within a given range.
Valley: use with cut plane to create endo-luminal view.
Attach mode: used to apply multiple plateau ramps attaching colors to
ranges of voxels values.
Red line: The vertical red line represents the numerical value of the voxel at the
location of the 3d cursor. Moving the 3d cursor on the image will change the
location of the red line in VR Controls.
Histogram displays voxels distribution (number of voxels per voxel value) in the
image. Peaks correspond to voxel values that are highly represented in the
image.
Shifts the Whole Ramp: click the solid blue box on the ramp and drag left or
right. This will change the upper and lower values of the ramp

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Item
Description
Ramp: The VR ramp represents the voxel opacity in the VR images as a function
of the voxel values. It means that voxels with identical value will have the same
opacity. 0% opacity (eye closed) renders voxels transparent and invisible. As
opacity increases, voxels become more and more visible and opaque. 100%
opacity (eye open) renders voxels as visible and opaque.
Solid White Boxes: Opacity threshold values. When using Up ramp shape: -Drag
the lower white box to the right to remove soft tissue from an exam to modify
the maximum opacity of voxels -Click the upper white box at the top of the
ramp and drag up or down to modify the opacity of all visible voxels.
The red box represents the scale of voxel values displayed in the main VR
Control window. Click and drag the box left or right to shift the display. Zoom in
or out with +/- in the upper right corner (see step 14). Right click on the main
control to return to the original zoom.
Color on/off: Check box to activate color. Uncheck the box to display VR in black
& white.
Active color: to select the active color, click the square color button below the
ramp (the triangle above the color gets black). Click the Active Color button to
change the color.
10
Brightness: the amount of light displayed in the model. Type in a value greater
than 100 to increase the light in the model.
11
Color Transition:
Smooth: shaded transition from one color to the next
Step: all voxels inside the value range display the same color. When Step is
selected small white diamonds indicating range borders will display. Grab the
diamonds o adjust precisely range of values that are assigned to each color.
12
Enhance Contours: turn on to enhance boundaries of structures. This is

specifically useful to display vessels or orthopedics cases.
13
Transparency slider: makes internal objects transparent and makes objects

boundaries more visible.
14
Zoom in or out to modify the range of voxel values displayed in the main VR
Control window.
Surface Rendering
Surface Rendering is similar to Volume Rendering except that it first separates the volume of
Interest (VOI) from the original data set and then it creates the rendered image.

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Figure 34-19 3D Surface Rendering visualization process.
Film/Save Options
To display [Film/Save Options] window, select [Filming Tools] > [Film/Save Options].

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Figure 34-20 Film/Save Options
Table 34-12 Film/Save Options

Icon
Description
Select a printer from the [Printer] drop

down list.

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Icon
Description
Sets the steps when adjusting FOV with
left/right mouse buttons on DFOV red
annotation. E.g. when setting 130mm, an
original DFOV of 37.5 cm will decrease will
left click to 26 cm, then 13 cm, then 6.5
cm.
Deactivate or activate this button to hide
or show the cursor on the saved or filmed
image.
[Rfmt] allows W/L adjustments,
measurements, and filtering of saved
images.
[SSave] saves in colors and forbids W/L
adjustments of saved images.
Select to film images along Z direction in

high definition
Saves VR images as color Screen Save.
Select this option to display pop-up

window to name created series every time
an image is saved.
Click [Close] to close the [Film/Save

Options] window.

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How Do I...
This section provides the step-by-step instructions for creating Reformatted images.
Reformat a Series
Auto Select
Paint on Slice

Manage Color Maps
Save Batch Images

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Reformat a Series
Using this procedure to reformat a series of images into a different plane for viewing and
filming.
1. Select ImageWorks desktop.
2. Select the Exam, Series, and Images that you desire to Reformat.
3. Click Reformat.
A Oblique, Axial, Saggittal, and Coronal are displayed.
4. Change the View Type by selecting the Red Annotation View Type and select the desired
View Type.
Quick Steps: Reformat a Series

1. Select ImageWorks desktop.
2. Select the Exam, Series, and Images that you desire to Reformat.
3. Click Reformat.
4. Change the View Type by selecting the Red Annotation View Type and select the
desired View Type.

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Any of the red annotated areas can be changed. If you place the mouse over a red
annotated area, a description of the button flashes.The following explains the function of all
of the red annotations.
1. Edit the image number.
On the axial image, place your mouse over the red image number, type in the image
number, and press Enter.
As you type, the number is displayed in a pop-up box. You must press Enter before
the computer accepts the new number.
Click over the red image number to increase the image number.
Right-click over the red image number to decrease the image number.
Middle-click and drag right over the red image number to increase and left to
decrease the image number.
2. Edit the Display Field of View (DFOV) number.
On the axial, sagittal, oblique and coronal images, place your mouse over the red
DFOV number type in the DFOV number, and press Enter.
This magnifies or minifies the image.
Click the red DFOV number to decrease the DFOV.
Right-click the red DFOV number to increase the DFOV.
Middle-click and drag right the red DFOV number to increase and left to decrease the
DFOV.
NOTE: You cannot increase more than the original DFOV. Changing the magnification only
affects the quadrant that you are in.
3. Roam the image.
On the sagittal, oblique, and coronal images, place your mouse over any red Right
Anterior Superior (RAS) coordinates, then click and drag to roam the image.
When you release the mouse button, the image is deposited at that point.
The other planes that are linked in green frames updates to the deposited point.
NOTE: Roam is not available on the original DFOV scanned axial image. It is available on a
magnified axial image or a scan that is longer in millimeters than the DFOV.
4. Hide or show the patients name.
On any view, place your mouse over the red patients name, click and hold the right
button, and click [Hide] to hide the patients name.

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To show the patient name again, click and hold the right button over the red asterisks
and click [Show] to show the patients name.
This affects all quadrants.
5. Edit the Window Width or Window Level numbers.
On any view, place your mouse over the red Window Width or Window Level
numbers. Type the new number and press Enter.
If you click on the Window Width or Window Level numbers a list of presets appears.
Select the one you desire.
Middle-click the red Window Width or Window Level numbers and drag right to
increase and left to decrease the Window Width or Level.
NOTE: Remember you can always use the middle mouse button to change the window width
and level.
Middle-click and drag from side to side to change the window width.
Middle-click and drag up and down to change the window level.
6. Click on the red annotation of the view type to change to a different view type.
Quick Steps: Edit with the Active Annotation

1.
2.
3.
4.
5.
6.
Edit the image number.

Edit the Display Field of View (DFOV) number.
Roam the image.
Hide or show the patients name.
Edit the Window Width or Window Level numbers.
Click on the red annotation of the view type to change to a different view type.

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Auto Select
Once your reformatted images are displayed you can Auto Select anatomy out of your
reformatted images.
1. Click [AutoSelect] to open the AutoSelect window.
2. Click [Small Vessels] or [Any Structure] from the AutoSelect panel.
[Any Structure] better works for large vessel (> 5mm)
[Small Vessel] is optimal for distal or medium to small vessels (< 5mm)
3. Scroll through the axial images at minimum slice thickness.
Check that no vessel of interest has a green contour. If vessels are contoured in
green,.
4. Place 3D cursor on missing vessel (2D view).
5. Click and hold to add the vessel.
6. Repeat steps to complete all missing vessels.
NOTE: [Small Vessels] will only be present in the menu if the workstation is equipped with
CardIQ or Autobone license. Otherwise use [Any Structure].
NOTE: When using [Small Vessels], you can click once on a vessel to track and fill
automatically the vessel.
7. Click [Apply].
Quick Steps: Auto Select

1. Click [AutoSelect] to open the AutoSelect window.
2. Click [Small Vessels] or [Any Structure] from the AutoSelect panel.
3. Scroll through the axial images at minimum slice thickness.
4. Place 3D cursor on missing vessel (2D view).
5. Click and hold to add the vessel.
6. Repeat steps to complete all missing vessels.
7. Click [Apply].

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Paint on Slice
The Paint tool is used to define manually a volume of interest which can be isolated from the
original 3D volume.
1. Select the [Segment] tab and click on
icon.
This displays the Paint on Slice window.

Figure 34-21 Paint on Slices Window
[Edge attraction] refines automatically the drawn contours adjusting them to the
nearby structure edges.
This may speed up the contouring process.
2. In the view, scroll to the first image containing the structure of interest
3. Place the 3D cursor where you want to begin the contour.
4. Press the shift key when the mouse cursor is at the right location.
5. Hold the left mouse button to draw the contours starting from the red cursor.
Release the left mouse button, to close the contour (connect last point to first point).
6. Page through the slices and draw contours in the new slices.
Repeat the process until your reach the last slice containing the structure to contour.
It is not necessary to define contours on every slice.
The contours interpolates to the intermediate slices.
All contours must be defined in the same view type (eg. Axial view). It is not possible
to combine contours from different view type (e.g. Axial and sagittal).

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7. Click [Apply].
Quick Steps: Paint on Slice

1. Select the [Segment] tab and click on icon.
2. In the view, scroll to the first image containing the structure of interest
3. Place the 3D cursor where you want to begin the contour.
4. Press the shift key when the mouse cursor is at the right location.
5. Hold the left mouse button to draw the contours starting from the red cursor.
6. Page through the slices and draw contours in the new slices.
7. Click [Apply].

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When you click Reformat, an oblique, axial, sagittal and Coronal image are displayed in a
4-on-1 format. This section is going to explain the other view types including: curved, profile,
histogram, and X Section.

The curved function is very useful for displaying a reformat of curved or tortuous vessels or
organs. The first thing you need to do is display the anatomy on which you wish to trace in
one of the other viewports.
1. From the display monitor, click [Image Works].
From the Browser, check all of the parameters to make sure that you have a valid
image set.
2. Select the [Exam/Series/Images] that you want to reformat.
You can select an exam and series, and all the images are included if you do not
select any images.
If you want a selected range of images, you have to select the first image that you
want to include, then find the last image in the range, and while holding down the
Shift key, select the last image. You could also click on the first image and drag
through the range of images.
To select specific images, you must hold down the Ctrl key on your keyboard as you
select the images with the left mouse.
You have to select at least four images for reformat to work.
3. Click [Reformat].
4. Click the red annotation in the upper left corner of the viewport and select [Curved].
The images will load into a curved format.
This changes the viewport to a blue color (Figure 34-22).

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Figure 34-22 Curved Reformat Viewport
5. Start tracing along the anatomy of interest.

You can trace on an axial, sagittal, or coronal image.
To create a trace, place the mouse cursor at the starting point, press and hold the
Shift key as you deposit points along the anatomy.
As you are tracing, the curved image updates automatically.
You can change the location of the reference images by clicking on the image
number or image location and continuing your trace on the next image.
6. To exit, click [Close].
A pop-up message asks you if you are sure you want to quit.
7. Click [Yes].
This takes you back to the Browser.

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Quick Steps: Create Different View Types-Create a Curved View Type

1.
2.
3.
4.
5.
6.
7.

Select the [Exam/Series/Images] that you want to reformat.
Click [Reformat].
Click the red annotation in the upper left corner of the viewport and select [Curved].
Start tracing along the anatomy of interest.
To exit, click [Close].
Click [Yes].

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Profile provides a grayscale graph along a trace. First create a trace on an axial, sagittal,
coronal or oblique view, then select Profile from the view type buttons.
1. From the display monitor click [Image Works].
image set.
You can select an exam and series, all the images are included if you do not select
any images.
want to include then find the last image in the range and while holding the Shift key
down select the last image. You could also click on the first image and drag through
the range of images.
To select specific images you must hold down the Ctrl key on your keyboard as you
You have to select at least four images for reformat to work.
4. Select the Profile Layout preset if available.
5. Click the red annotation in the upper left corner of the viewport and select [Profile].
6. Trace the anatomy of interest.
Create a trace on an axial, sagittal, coronal, or oblique view.
You now see the Profile view (Figure 34-23). It gives the intensities of the pixels along
the trace that you created. The horizontal axis of the profile view is the position in
millimeters along the trace and the vertical axis is the pixel intensity value as a
function of that position.
You can move your mouse over the Profile View and press Shift. Notice the pixel
intensity reference line on the graph. This line gives you the pixel intensity from the
location of the 3D cursor.
You can also move the line by clicking and dragging the line itself.
The value for the pixel intensity reference line can be seen at the bottom right of the
white line.

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At the bottom of the profile view are the pixel statistics of the trace. These values
represent the mean and standard deviation.
8. Click [Yes].
This takes you back to the Browser.
Figure 34-23 Profile View
Quick Steps: Create Different View Types-Create a Profile View Type

1.
2.
3.
4.
5.
6.
7.
8.
From the display monitor click [Image Works].

Click [Reformat].
Select the Profile Layout preset if available.
Click the red annotation in the upper left corner of the viewport and select [Profile].
Trace the anatomy of interest.
Click [Yes].

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The Volume Histogram View provides a variety of information. This information includes the
ability to display a histogram showing the percentage of occurrence of each voxel intensity
value in an object. It also provides numerical statistics about the voxel intensity value in an
object plus the total object of an object. Also, it automatically determines boundaries
around the class of similar voxel intensities. This function is typically used when you have
3D data. Otherwise, the volume statistics are not valid. Please keep this in mind on the
following descriptions of volume and class volume. Please note that the tolerance for error
in the total volume measurements is directly proportional to the surface area of the object.
1. From the display monitor, click [Image Works].
image set.
any images.
You have to select at least four images for Reformat to work.
4. Select the Histogram Layout preset if available.
5. Click the red annotation in the upper left corner of the viewport and select [Histogram].
The Volume Histogram then appears giving the statistics of the object in primary
focus (Figure 34-24).
The Vertical Axis displays the percentage of occurrence of the pixel values that are on
the horizontal axis. The horizontal axis displays the pixel value range of the object in
the viewport.
The statistics at the bottom of the histogram are referring to the voxel in the primary
view. The statistics in the upper right are referring to the class of voxel in a specific
area of the object defined by the two dotted green lines on the graph. These lines are

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referred to as the voxel class boundary lines. The solid white line corresponds to the
intensity of the voxel at the 3D cursor location in the object.
Remember, the voxel reference line references the voxel intensity at the 3D cursor.
The voxel class boundary lines reference the minimum and maximum intensities
around the 3D cursor.
6. If you place the mouse cursor on the voxel reference line and either click and hold the
left key or hold the Shift key, the image displays green enhancement.
This represents the range between the voxel class boundary lines. You can change
the range by clicking and dragging one or both of the boundary lines to display the
desired range. If the voxel reference line is not visible, simply place the mouse cursor
anywhere along the horizontal axis and press the Shift key.
The smoothing value is used to calculate the percentage of occurrence in relation to
the voxel intensity values. The default is 10, which means a range of plus or minus 10
is taken around each voxel intensity point on the horizontal axis. The greater the
smoothing value, the greater the smoothing effect on the histogram curve.
8. Click [Yes].
Figure 34-24 Histogram View

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Quick Steps: Create Different View Types-Create a Histogram View

Type
1.
2.
3.
4.
5.
6.

Click [Reformat].
Select the Histogram Layout preset if available.
Click the red annotation in the upper left corner of the viewport and select [Histogram].
If you place the mouse cursor on the voxel reference line and either click and hold the
left key or hold the Shift key, the image displays green enhancement.
8. Click [Yes].

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The Cross-section Histogram View provides a variety of information, including the
percentage of occurrence of each pixel intensity value in a user-defined surface area on a
reformatted slice. It also provides numerical statistics about the pixel intensity values in the
same surface area plus the calculation of this area. Also, it automatically determines
boundaries around a class of similar pixel intensity values in these areas. The tolerance for
error in the total area measurement is directly proportional to the perimeter of the object.
1. From the display monitor click, [Image Works].
image set.
any images.
You have to select at least four images for Reformat to work.
4. Select the X Section Layout preset if available.
Click the red annotation in the upper left corner of the viewport and select [X
Section].
5. Create a closed trace around the area of interest.
To create a trace, place the mouse cursor at the starting point and press and hold the
Shift key as you deposit points along the anatomy.
You need to define at least three points.
Make sure that the view is in primary focus.
The Cross Section View appears.
The vertical axis displays the percentage of occurrence of each pixel intensity value
in the traced area. The horizontal axis displays the intensity values in the traced area.

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The statistics at the bottom reference the entire defined area. The pixel class
statistics at the upper right reference a specified area within the defined area.
The pixel class boundary lines (the green dotted lines) represent the minimum and
maximum pixel intensity values that are part of the pixel class statistics.
The pixel reference line (the white line) corresponds to the intensity of the pixel at the
3D cursor location. The numeric value for this line can be seen to the right of the line
just above the horizontal axis. The pixel reference line can be moved by placing the
mouse cursor on the line, then clicking and dragging, or by placing the mouse cursor
on the graph and pressing the Shift key. If you move the 3D cursor on the image, this
moves the pixel reference line also.
The smoothing value is used to calculate the percentage of occurrence in relation to
the pixel intensity values. The default is 10, which means a range of plus or minus 10
is taken around each pixel intensity point on the horizontal axis. The greater the
smoothing value, the greater the smoothing effect on the cross-section curve.
7. Click [Yes].
Figure 34-25 X Section View

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Quick Steps: Create Different View Types-Create an X Section View

Type
1.
2.
3.
4.
5.
6.
7.
From the display monitor click, [Image Works].

Click [Reformat].
Select the X Section Layout preset if available.
Create a closed trace around the area of interest.
Click [Yes].

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Reformat
Prescribe a Multi Projection Volume Reformation (MPVR)

Multi Projection Volume Reformation can be defined as a thick slab reformatted image. You
can change the rendering mode to Average, Mip or Min IP. You can also change the
thickness of the slab that you want to display. MPVR can be used to see vessels in CTA scans.
1. From the Browser, select the exam, series and images that you want to include in your
model.
3. Select the MPVR Layout preset if available.
Click the red annotation in the upper right corner of the viewport and select [3D] or
[MIP].
4. Click [Oblique Mode].
5. Select the axial, sagittal, or coronal image and rotate the yellow line by clicking and
dragging it into the desired position.
6. Change the slice thickness in the oblique viewport to the desire thickness.
Place the mouse cursor over the red thickness annotation and type in the desired
thickness and press Enter.
7. Change the rendering mode.
Place the mouse over the red annotation word MIP and while holding down the right
mouse button, select which mode you desire.
MIP is used most often in CTA models to demonstrate all the voxels that have the
most intensity like calcium.
8. To quit, click [Close].
A pop-up window appears, click [Yes].

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Quick Steps: Create Different View Types-Prescribe a Multi Projection

Volume Reformation (MPVR)
1. From the Browser, select the exam, series and images that you want to include in your
model.
3. Select the MPVR Layout preset if available.
4. Click [Oblique Mode].
5. Select the axial, sagittal, or coronal image and rotate the yellow line by clicking and
dragging it into the desired position.
6. Change the slice thickness in the oblique viewport to the desire thickness.
7. Change the rendering mode.
8. To quit, click [Close].

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ROI tools exist not only in 2D but also in 3D. Several shapes are available to measure a
Region Of Interest in any view plane/volume: circle, elliptic, rectangle and cubic for 3D ROIs.
Statistical information is provided such as Min, Max and Average Values within the ROI and
Standard Deviation of the ROI.
Figure 34-26 ROI
When any ROI tool is selected, and prior to deposit it on the image, preferences for ROI
statistics can be set in lower left menu.
Where to display ROI (a)
Statistics to display (b)
Default ROI size (c)
Figure 34-27 Preference Menu
1. Click [More Tools].

This is located on the Main Control panel.
2. Click [Display].
This displays all of the measurement tools.

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3. Click on the desired ROI tool.
Refer to Figure 34-26.
3D Color ROI is available in one color for MR and in multicolor for CT.
4. Click on the desired anatomy to measure.
This deposits a ROI with the measurement displayed at the bottom of the image.
5. Grab a ROI corner and adjust the size to the structure.
Read the statistical data (Hounsfield units for CT) at the bottom of the viewport
(minimum, maximum, average and standard deviation).
6. Right click on a ROI to delete it.
Quick Steps: Regions of Interest (ROI)

1. Click [More Tools].
2. Click [Display].
3. Click on the desired ROI tool.
4. Click on the desired anatomy to measure.
5. Grab a ROI corner and adjust the size to the structure.
6. Right click on a ROI to delete it.

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Manage Color Maps

1. Click on the color bar (left side of viewport) to open Color Map table window.
Figure 34-28
2. Select [Statistics] tab to display detailed statistics for the current ROI.
Figure 34-29
3. Select [Configuration] tab to setup number of color ranges to be displayed [Add] /

[Remove] and thresholds by color.
A name can be attributed to each color range (e.g. parenchyma).
Figure 34-30
4. Select [Presets] tab to load and save Color Maps presets.

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Figure 34-31
5. Click [Save] to save settings adjusted in [Configuration] tab as a new Color Map preset.
6. Click [Remove] to delete Color Maps preset.
7. To load a Color Map preset, select the Color Ramp from dropdown list.
WARNING: Default Plaque Color Map preset is provided for information. You must check
and adjust Values and segment names.
Quick Steps: Manage Color Maps

1. Click on the color bar (left side of viewport) to open Color Map table window.
2. Select [Statistics] tab to display detailed statistics for the current ROI.
3. Select [Configuration] tab to setup number of color ranges to be displayed [Add] /
[Remove] and thresholds by color.
4. Select [Presets] tab to load and save Color Maps presets.
5. Click [Save] to save settings adjusted in [Configuration] tab as a new Color Map
preset.
6. Click [Remove] to delete Color Maps preset.
7. To load a Color Map preset, select the Color Ramp from dropdown list.

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1. To independently modify the upper or lower range of the ramp: click the solid white
boxes and drag left or right.
2. To remove soft tissue or noise from an exam, drag the lower white box to the right.
3. To modify the overall opacity of the ramp: Click the white box at the top of the ramp and
drag up or down.
Modifying the opacity affects the opacity of all visible voxels.
4. To move the whole ramp: click the solid blue box on the ramp and drag left or right.
This will change the upper and lower values the ramp is applied to.
Quick Steps: Modify the Opacity Ramp Settings

1. To independently modify the upper or lower range of the ramp: click the solid white
boxes and drag left or right.
2. To remove soft tissue or noise from an exam, drag the lower white box to the right.
3. To modify the overall opacity of the ramp: Click the white box at the top of the ramp
and drag up or down.
4. To move the whole ramp: click the solid blue box on the ramp and drag left or right.

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To Add Colors
1. Place the 3d cursor on the anatomy of interest.
2. In VR controls click [Add].
An additional color will place centered on the cursor location.
To Assign a Range of Numbers to a Color
1. Click on the color button to make it active.
2. Click [Step] in [Transition].
3. Adjust the diamonds between the colors to the desired value.
To Change a Color
1. Click the color button to make it active.
2. Click the Active Color button in the lower left corner of the VR controls menu.
3. Select a color, or click [More Colors] to display the color wheel.
4. In the color wheel, drag the black circle in the color wheel to the desired color.
5. Click [Done].
Quick Steps: Work with Colors in VR

To Add Colors
1. Place the 3d cursor on the anatomy of interest.
2. In VR controls click [Add].
To Assign a Range of Numbers to a Color
1. Click on the color button to make it active.
2. Click [Step] in [Transition].
3. Adjust the diamonds between the colors to the desired value.
To Change a Color
1. Click the color button to make it active.
2. Click the Active Color button in the lower left corner of the VR controls menu.
3. Select a color, or click [More Colors] to display the color wheel.
4. In the color wheel, drag the black circle in the color wheel to the desired color.
5. Click [Done].

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The red box in the lower window represents the scale of voxel values displayed in the main
VR Control display.
1. Click and drag the box left or right to shift the display.
2. Zoom in or out with in the upper right corner.
3. Or, click on top right button (zoom display) then click and drag on the main VR Control
Display.
A red mask will appear) to define a range of interest.
4. Right mouse click to return to the original histogram range.
Quick Steps: Zoom In or Zoom Out the Main VR Control Window

1. Click and drag the box left or right to shift the display.
2. Zoom in or out with in the upper right corner.
3. Or, click on top right button (zoom display) then click and drag on the main VR
Control Display.
4. Right mouse click to return to the original histogram range.

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1. Click a color to activate it.
2. Click the [Attach Mode] button
This is the last button in Ramp setting.
3. Click [Attach] color at the bottom, center of the VR Controls panel.
4. To adjust opacity of the voxels holding a color, click the colored box at the top of the
ramp and drag up or down.
5. To attach another color, select a color box, click [Attach], and modify its opacity.
Quick Steps: Attach/Detach Objects

1. Click a color to activate it.
2. Click the [Attach Mode] button
3. Click [Attach] color at the bottom, center of the VR Controls panel.
4. To adjust opacity of the voxels holding a color, click the colored box at the top of
the ramp and drag up or down.
5. To attach another color, select a color box, click [Attach], and modify its opacity.

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Volume Viewer allows the user to create multiple objects as multiple VR models that can be
merged into a single view or model for later review. This added functionality lets users
perform more complex VR views with multiple object segmentation and visualization.
1. Open [Segment] tab and select [AutoSelect].
2. Select the button corresponding to the structure to add (Small Vessel / Structure / Bone)
and click [Add].
3. Click [Yes] on the pop up window to clear the upper left viewport.
4. From any 2D view, click and hold the left mouse button on the object you want to add.
A green filter will fill the object while this object is being reconstructed in the upper
left viewport.
5. Set left mouse mode to [Select] mode.
6. Drag the VR viewport and drop it on the top left viewport of the isolated object where
Drop here to merge view appears.
7. Open [VR] tab and select [Multi Objects] tool.
Roll over [Object 1] and [Object 2] - the corresponding object appears in the left
window.
8. Select one object and adjust its transparency.
Click on the eye to hide or show the corresponding object on the active viewport.
Quick Steps: Create a Multi VR Object

1. Open [Segment] tab and select [AutoSelect].
2. Select the button corresponding to the structure to add (Small Vessel / Structure /
Bone) and click [Add].
3. Click [Yes] on the pop up window to clear the upper left viewport.
4. From any 2D view, click and hold the left mouse button on the object you want to
add.
5. Set left mouse mode to [Select] mode.
6. Drag the VR viewport and drop it on the top left viewport of the isolated object
where Drop here to merge view appears.
7. Open [VR] tab and select [Multi Objects] tool.
8. Select one object and adjust its transparency.

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1. Select [Film/Save] tab
2. Click [Batch].
3. Click [Loop].
This will create a series of 3D rotation or 2D images indicating first and last image.
To create a set of 3D rotation images:
1. Adjust a 3D view to first angle.
2. Click [Set Start].
3. Adjust a 3D view to last angle.
4. Click [Set End].
NOTE: To prescribe a 360-degree 3D rotation, set the same 3D image for the first and last
view.
To create set of parallel 2D images:
1. Page 2D images to first image.
3. Page 2D images to last image.
4. Click [Set End].
5. Set the [Number of Images] or the [Spacing between Images].
These parameters are linked to cover prescribed distance.
6. Click [Preview] to preview the batch.
NOTE: It is not possible to create a Batch protocol using the Loop mode.

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Quick Steps: Save or Film Batch Images

1. Select [Film/Save] tab
2. Click [Batch].
3. Click [Loop].
To create a set of 3D rotation images:
1. Adjust a 3D view to first angle.
3. Adjust a 3D view to last angle.
4. Click [Set End].
To create set of parallel 2D images:
1. Page 2D images to first image.
3. Page 2D images to last image.
4. Click [Set End].
5. Set the [Number of Images] or the [Spacing between Images].
6. Click [Preview] to preview the batch.

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Use Batch Oblique to define a set of oblique planes adjusting settings (range, angle, position)
from a grid on a reference image.
1. Click on the view to be used as the reference image.
2. Click the [Oblique] tab to display a grid used to define the oblique planes.
Figure 34-32 Oblique Graphic Lines
1 = extend range of oblique planes, 2 = adjust angle, 3 = move grid

3. Use left panel to adjust parameters.
[Number of images],
[Spacing between Images]
[Slice Thickness],
Rendering [Mode]
[FOV]
NOTE: The Spacing between views and slice thickness can be set independently of each
other creating a gap, contiguous or overlapped images.
Quick Steps: Set Up a Batch Oblique

1. Click on the view to be used as the reference image.
2. Click the [Oblique] tab to display a grid used to define the oblique planes.

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1. Click on view to be used as reference
2. Click the [Rotation] tab to define planes.
360-degree rotating 3D images
1. Click the appropriate arrow to indicate rotation direction.
2. Adjust the [Number of Images] or the [Angle between Images].
These parameters are linked. Entering a value for one will update the other.
3. Adjust the [FOV] as needed.
Figure 34-33
Radial planes on 2D views

1. Adjust center of radial slices (a), first radial plane location (b) and number of radial
planes (c) on the 2D reference image.
Figure 34-34

[Number of images],

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[Spacing between Images]
[Slice Thickness],
Rendering [Mode]
[FOV]
Quick Steps: Set up a Batch Rotation

1. Click on view to be used as reference
2. Click the [Rotation] tab to define planes.
360-degree rotating 3D images
3. Click the appropriate arrow to indicate rotation direction.
4. Adjust the [Number of Images] or the [Angle between Images].
5. Adjust the [FOV] as needed.
Radial planes on 2D views
1. Adjust center of radial slices (a), first radial plane location (b) and number of radial
planes (c) on the 2D reference image.

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Save Batch Images

1. From [Output] list, select output action.
[Print] sends generated images to default printer (setup the Format and the display
of a Reference Image).
[Save] saves generated images in a new series in the Browser.
[Print/Save] allows both filming the generated images on default printer images and
saving them in a new series.
[Filmer Images] drops all generated image into the Filmer (AW only).
[Filmer Movie] drops the generated images in the Filmer as a movie to be exported as
Mpeg or Avi.
2. Click [OK] to send Batch prescription to selected output.
Quick Steps: Save Batch Images

1. From [Output] list, select output action.
2. Click [OK] to send Batch prescription to selected output.

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1. From [Film/Save] tab, select [Batch].
2. Click [Loop].
Scroll the curved images to the first image to be saved.
Scroll the curved images to last image to be saved.
4. Click [Set End].
5. Enter number of images to be saved and press Enter.
6. To save a new series, set [Output] to [Save].
7. Click [OK].
Quick Steps: Save Batch Curved Parallel Planes

2. Click [Loop].
4. Click [Set End].
5. Enter number of images to be saved and press Enter.
6. To save a new series, set [Output] to [Save].
7. Click [OK].

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2. Click [Loop].
3. From Angle red annotation on curved viewport, adjust angle of the first image to be
saved.
Click [Set Start].
4. Set angle of the last image.
5. Click [Set End].
6. Enter number of images to be saved and press [Enter].
To save the new series, set [Output] to [Save].
7. Click [OK].
Quick Steps: Save Rotating Batch Curved

2. Click [Loop].
3. From Angle red annotation on curved viewport, adjust angle of the first image to
be saved.
4. Set angle of the last image.
5. Click [Set End].
6. Enter number of images to be saved and press [Enter].
7. Click [OK].

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ASIR Review Application
Chapter 35

Introduction
The Advanced Statistical Iterative Reconstruction (ASIR) application is a post-processing
technique designed to assist the clinician and you in determining the optimal noise level to
apply to ASIR reconstructed images. This selection could be based upon the desire to use
average or normal techniques to take advantage of the noise reduction capabilities of ASIR
or to maintain typical noise levels while lowering dose. This tool allows for the review of all
noise levels in axial, coronal, and sagittal planes so additional retrospective reconstructions
could be made and protocols adjusted if needed. This will aid the clinician in understanding
and pinpointing each facilitys optimal dose and desired noise levels per protocol quickly.
This chapter explains the steps and concepts necessary of how to use the ASIR Review
application successfully to review and visualize ASIR image sets at different noise levels. It
provides step-by-step instructions on:
Launch the ASIR Review Application
Exit the Application
NOTE: The ASIR Review application is NOT intended to create diagnostic images and are
annotated as Not For Diagnosis. Images viewed in this application should only be
used to determine desired noise levels for reconstruction and to assist in developing
protocols with ASIR reconstruction applied. Screen captures or additional
reconstructions at specific levels cannot be made using this tool. Screen captures or
additional reconstructions will need to be created on the console or in other
supported AW applications.

35-1

This section presents the concept necessary to understand ASIR Review Application. The
ASIR Review Application Requirements
Reviewing ASIR Images
ASIR Presentations
Viewport Selection
Image Standard Annotation
ASIR Noise Level Blending
ASIR Image Scrolling
Image Controls
Display Tools
ASIR Application Menu
ASIR Review Application Requirements

The ASIR Review application requires two series. One series without ASIR applied and one
series with 100 % ASIR to be able to load them for review. Additionally, the two series
selected for review must also:
Have the same exam number
Same slice thickness and number of images and in the case of Volume mode must be
0.625mm slice thickness
Contain images with the same scan range (start/end location)
Have same DFOV, RL and AP Centers and Recon Type.
The maximum number of images in each of the series is limited to 1000. The series
can only contain 1000 images, you can not selectively select a range of 1000 images
from a larger series.
Only the non-ASIR reconstructed series and the 100% ASIR level can be loaded for review.
The system will not accept series if there is not a non-ASIR series or if the ASIR series is at
level other than 100% such as 50%.
If you know you want to use the ASIR Review application, prescribe the non-ASIR series a
Recon 1 and the 100 % ASIR series as Recon 2. This will enable you to go directly into ASIR
Review once the data is reconstructed to determine the optimal blending level for that
protocol.

35-2
Reviewing ASIR Images

On the Image Works Browser, verify that an original non-ASIR series and a 100% ASIR series
have been reconstructed, both series have the same number of slices, and both are from
the same volume of images. If not, additional retrospective reconstructions will be
necessary to proceed.
ASIR Presentations
By default, you will now see 3 sets of axial images displayed in the ASIR Axial Presentation.
The original or non-ASIR series is in the upper left viewport.
The 100 % ASIR series is in the upper right viewport.
The lower viewport contains the ASIR blended images, displayed at the 50% default
noise level.
The noise blending level is annotated on the bottom right side of the ASIR blended viewport.
Other views can be displayed quickly by changing the presentation to ASIR Sagittal, ASIR
Coronal, or ASIR Blended by left clicking on the desired view.
The ASIR Blended presentation displays all 3 views (axial, sagittal, and coronal)
simultaneously in the desired ASIR blending level but does not contain the original non-ASIR
images or 100% blending images as a reference.

35-3

Figure 35-1 Presentation
Viewport Selection
The screen is divided into viewports that are selected by clicking the left mouse button (LMB)
anywhere in the viewport. When a viewport is selected it becomes active and is outlined
with a cyan border. To select an individual image in a viewport that contains multiple
images, click the LMB anywhere on the image. The border for that image will turn cyan to
indicate the image selected.

35-4
Image Standard Annotation

On-image standard annotation displays the unique annotation associated with the
individual image. All other information is included in the global screen header area displayed
at the top of the screen. Screen global header contains the following:
Patient Name
Patient ID
Exam Description
Series Description
Exam Date
Hospital Name
Manufacture Model
Exam Number
Series Number
Contrast Information
DFOV
Algorithm
Slice Thickness
Gantry Rotation
ASIR Noise Level Blending

There are several methods to interactively view the range of ASIR noise levels. The quickest
and easiest way is to place your mouse over the left side of the blended viewport next to the
RAS coordinates. This displays the blending bar.

35-5

Figure 35-2
Grab the bar with the left mouse and move to blend the image to the desired noise
level. The ASIR annotation displayed will change as levels are adjusted
simultaneously. Additionally, right or left mouse clicking on the red noise level
annotation changes the noise level up or down in 10 % increments per mouse click.
Click and hold the middle mouse button (MMB) on the red noise level annotation will
also interactively change the noise level by moving the mouse side to side. Lastly, a
desired value can also be typed in directly (in 10 % increments) by placing the mouse
over the red noise level annotation and typing in a value, ie. 70 %.
ASIR Image Scrolling

Place the mouse over the right side of any viewport next to the RAS coordinates. This will
display the image scroll bar.

35-6

Figure 35-3
Grab the bar with the left mouse to scroll through the volume of images. Click on the
up or down arrows to scroll image by image.
Image Controls
Other tools and menus are described below.
Mouse controls (applied to all viewports):

Left mouse: Click and drag the image to the desired position.
Figure 35-4 Roam
Middle mouse: Click and hold will change the Window width and level
Figure 35-5 WW/WL
Right mouse: Click and drag will Zoom the image

35-7

Figure 35-6 Zoom
Window leveling: Click and drag with the middle mouse button to change Window
width and level. Also, placing the mouse over the window level annotation and type
in the desired value to change.
Place the mouse over the window level annotation and type in desired value.
Window level presets: Click with left mouse on the window level annotation to
display the presets. Click on the desired preset.
Zoom: Right click and drag to zoom the image or type over DFOV active annotation
Roam: Click and drag the RAS coordinates to roam image.
Right Mouse Button Menu

Click and release the right mouse in any viewport to display this menu.
Enlarge: Displays a full one-on-one layout of the viewport selected. Perform function
again and select Reset size to bring layout back to previous layout.
Reset Pan Zoom: Resets any zooming or roaming applied to the image, bringing the
image back to its original state.
Reset W/L: Resets window width and window level changes to the original setting
Hide Annotation: Removes all image annotation from viewports. Perform function
again and select Show annotations to display all image annotation.
Show All Annotation: Clicking displays all image annotation on the viewports.
Perform function again and select Show Less Annotation to display less annotation
on the viewports.
Display Tools
The Display tab is organized into a set of functional buttons:
Report Cursor
ROIs
Copy
Paste
Cut
Annotation

35-8

NOTE: Statistical information obtained using these tools are for reference only. Any
statistical information needed for archiving or diagnostic purposes must be made on
the console, PACS system, or other supported AW application.
ROIs
Figure 35-7 ROI Button
The ROI button is used to deposit a region of interest for statistical measurements. To
activate, click on the ROI button and then deposit the cursor on the image by clicking and
dragging until desired size is achieved.
Click the ROI button on the display tab.
Copy ROI
Select the ROI to be copied and click the Copy button. The ROI remains on the image in the
selected state and is replicated on the system clipboard, which is not visible on the desktop.
This replaces previous entries in the clipboard.
Paste ROI
After copying the desired ROI; click on the image on which to paste it and click the Paste
button. Once an ROI has been copies and pasted it is now linked. To unlink the ROI use RMB
and select unlink from pull down menu.
Cut ROI
Select the ROI to be deleted and click the Cut button. The ROI is removed from the image
and placed on the system clipboard, which is not visible on the desktop. This replaces
previous entries in the clipboard.
Report Cursor Button

Use the report cursor button to measure and locate a voxel value under the cursor. To
activate, click on the report cursor button and then deposit the cursor on the image. The
voxel position and value is reported in the lower right corner of the viewport. The cursor may
be moved around the image by clicking on it and dragging.
Copy Report Cursor
Select the ROI to be copied and click the Report Cursor button. The cursor remains on the
image in the selected state and is replicated on the system clipboard, which is not visible on
the desktop. This replaces previous entries in the clipboard.

35-9

Paste Report Cursor
After copying the desired Report Cursor; click on the image on which to paste it and click the
Paste button.
Cut Report Cursor
Select the Report Cursor to be deleted and click the Cut button. The Report Cursor is
removed from the image and placed on the system clipboard, which is not visible on the
desktop. This replaces previous entries in the clipboard.
Cut, Copy, or Paste

Figure 35-8 Cut, copy, and paste icons
Whether cutting or copying annotation, the process for selecting it is the same. Position the
cursor over the desired annotation and click. To make multiple selections, press and hold the
Ctrl key while clicking on each annotation. Annotation that is selected is highlighted.
Cut annotation
Select the annotation to be deleted and click the Cut button. The annotation is removed
from the image and placed on the system clipboard, which is not visible on the desktop. This
replaces previous entries in the clipboard.
Copy annotation
Select the annotation to be copied and click the Copy button. The Annotation remains on
the image in the selected state and is replicated on the system clipboard, which is not visible
on the desktop. This replaces previous entries in the clipboard.
Paste annotation
After cutting or copying the desired annotation, click on the image on which to paste it and
click the Paste button.
Move annotation
Select the annotation then click and drag the annotation to a new location.
The annotation and its vertices are highlighted when selected. Cut, Copy, or Paste.
The Cut, Copy, or Paste buttons are also used for the Report Cursor and ROIs.
ASIR Application Menu

The ASIR Application Menu contains [File], [View], or [Help].

35-10

File
To Exit the application:
Click on [File] > [Quit].
Or click on the close icon in the lower left corner.
Figure 35-9 Close icon
View
Click [View] and check or uncheck the box.
Figure 35-10 View Menu
1
2
3
Table 35-1 View Menu
Number
Name
Function
View
Show/Hide Header
removes or shows global screen header across

the top of the viewports
Show Annotation
toggles on or off the on screen annotation from

the viewports
Expands the View menu
Help
Click [Help] to display more information about the ASIR Review application, including
the software version number and name.

35-11
How Do I...
This section provides the step-by-step instructions for utilizing the ASIR Review Application.

35-12

Verify on the image browser that an original non-ASIR series and a 100% ASIR series have
been reconstructed, both series have the same number of slices and both are from the
same volume of images. If not, additional retrospective reconstructions will be necessary to
proceed.
1. To begin the review, click [ImageWorks] and select the exam from the patient list that
you wish to view.
2. Select the original non-ASIR series, then press and hold the <ctrl> key on the keyboard
while clicking on the 100% ASIR blended series at the same time.
This action will highlight and select both series in the patient list for use in the ASIR
Review application.
3. Click [ASIR Review] on the right side of the ImageWorks screen.
This will launch the ASIR Review application.
Quick Steps: Launch the ASIR Review Application

1. To begin the review, click [ImageWorks] and select the exam from the patient list
that you wish to view.
2. Select the original non-ASIR series, then press and hold the <ctrl> key on the
keyboard while clicking on the 100% ASIR blended series at the same time.
3. Click [ASIR Review] on the right side of the ImageWorks screen.

35-13

1. Click on [File] > [Quit].
Or click on the close icon in the lower left corner.
Quick Steps: Exit the Application

1. Click on [File] > [Quit].

35-14
Gemstone Spectral Imaging Viewer (GSI)
Chapter 36
Gemstone Spectral Imaging

Viewer (GSI)
Introduction
The Gemstone Spectral Imaging (GSI) Viewer Software is located in the Image Works
desktop.
The Gemstone Spectral Imaging Viewer provides the primary visualization and
post-processing of Spectral image data, including material density (Material Basis),
monochromatic, and effective-Z images. It also provides simultaneous visualization of
multiple material types in a color overlay representation.
Applications span all facets of clinical scanning, including Neuro, Muscular-Skeletal, Body,
Cardiac, Spine, and Interventional CT studies.
This chapter explains the process of using the Gemstone Spectral Imaging Viewer to
visualize and post-processing material density (Material Basis), monochromatic, and
effective-Z images. It provides step-by-step instructions to learn how to:
Launching Gemstone Spectral Imaging Viewer (GSI)
Exiting The Gemstone Spectral Imaging Viewer (GSI)

36-1
What Do I Need to Know About...

The Gemstone Spectral Imaging (GSI) Viewer runs on the CT Console and is launched the
same way as other Image Works applications by selecting the GSI Viewer button. Only one
instance of the application can be operating at any given time.
Gemstone Spectral Imaging Theory
Viewport selection
Image standard annotation
Preliminary Assessment
Preliminary Assessment Presentations
Preliminary Assessment Options/Features
Material Decomposition Tab
Material Decomposition Options/Features
Image controls
Window level
Scroll the image
Orientation Changes
Image Type Selection
Material Decomposition Selection (MD Images Only)
keV Selection (Monochromatic Images Only)
Color-Overlay Opacity % Selection (Color-Overlay Images Only)
Color Overlay Layer Property Range Settings
Display Tools panel
Display Tools
File, View, Help Panel
File Panel
View Panel
Help Panel
Active Image Annotation Tool Tips

36-2
Gemstone Spectral Imaging Theory

Gemstone Spectral Imaging is a software feature that enables the acquisition,
reconstruction, and visualization of spectral or dual energy imaging. Spectral images may
provide additional clinical information about material composition. In addition, images
generated by the projection-based Material Decomposition (MD) algorithm have reduced
beam-hardening and metal induced artifacts.
The key technologies of the Gemstone Spectral Acquisition Imaging are as follows:
Fast energy Switching
Projection-based reconstruction algorithms for generating material density and
monochromatic images
A Dual Energy viewing tool for transforming images into other material basis or
monochromatic energies.
The two x-ray energies are acquired in an interleaved fashion by rapid synchronous
switching of the energy levels at the generator. Because the two energy levels are acquired
simultaneously, mis-registrations between the resulting two images due to patient or organ
motion are virtually eliminated. After acquiring data at the two targeted energy levels, the
energy dependant material attenuation can be leveraged to generate pairs of material
density (MD) images or monochromatic (Mono) images. These images may provide
additional diagnostic information, such as the differentiation of iodinated contrast from
calcified lesions. In addition, material density and monochromatic images may have
significantly reduced beam hardening and metal-induced artifacts.
Both axial and helical scan modes are supported with Gemstone Spectral Imaging. The
high- and low-energy view data are processed using a projection-based material
decomposition algorithm to generate the material density or monochromatic images.
Viewport selection
The screen is divided into viewports that are selected by clicking anywhere in the viewport.
When a viewport is selected it becomes active and is outlined with a cyan border. To select
an individual image in a viewport that contains multiple images, click anywhere on the
image. The border for that image will turn to cyan indicating the image is selected.
Image standard annotation

On-image standard annotation displays the unique annotation associated with the
individual image. This includes the location and associated indexes. All other information is
included in the global screen header area displayed at the top of the screen.

36-3

Screen global header contains the following:
Patient Name
Patient ID
Patient Age
Study Name
Series Name
Study Date
Hospital Name
Manufacturer Model
Exam Number
Series Number
Contrast Information
DFOV
Figure 36-1 Global Annotation Area and on-image standard annotation

36-4
Preliminary Assessment
The Preliminary Assessment tab is intended to be the first step in the two-step GSI
workflow. This feature performs a multi-planar volumetric review of the GSI exam series
inputs. The primary goal is to quickly assess the acquired reconstructed Spectral
Imaging Material Density (Material Basis) and/or low/high energy image series in a
multi-planar display.
Preliminary Assessment Presentations

Default Preliminary Assessment Presentations Available depending on what image series
have been used to launch the GSI Viewer:
Source Image Compare
Source High Energy
Source Low Energy
Material Density
Source & MD
Preliminary Assessment Options/Features

Options/feature available on the Preliminary Assessment tab are as follows:
Image controls (orientation, pan, zoom, window level, imaging paging change
orientation)
Tool bar functions: Report Cursor, ROIs, Copy, Paste, Cut, Link/Unlink, Annotation
(Described in tool bar section of manual)
Modify Presentation for display as desired per use (No User customization for this
feature at this time)
From the Screen Layout Tools tab change the presentation content clicking on one of
the available views and drag & drop onto the new desired location in the Current
Screen Layout.

36-5

Figure 36-2 Example screen for preliminary assessment
Material Decomposition Tab

The Material Decomposition tab is intended to be the second step in the two-step GSI
workflow. Within this tab there are various default Presentations Available (See List
Below). The primary goal with the Material Decomposition tab is to generate and review
Monochromatic images, Material basis image pairs, Effective-Z images, and to perform
color overlays of various materials.
Material Decomposition Presentations

Default Material Decomposition tab Presentations Available:
Compare
Mono-Source Compare
Monochromatic Compare
Monochromatic Reformat
Mono-Material Compare
Mono-Material Reformat
Color Overlay Reformat
Effective-Z Reformat

36-6
Material Decomposition Options/Features

Options/features available on the Material Decomposition tab are as follows:
Image controls: Orientation, image type, keV selection, material decomposition
selection, color overlay opacity % & color overlay range settings, pan, zoom, window
level, imaging paging change orientation (Described in Image Controls section of
manual)
Tool bar functions: Report Cursor, ROIs, Copy, Paste, Cut, Link/Unlink, Annotation
(Described in tool bar section of manual)
Modify Presentation for display(s) as desired per use (No User customization for this
feature at this time)
From the Screen Layout Tools tab change the presentation content clicking on one of
the available views and drag & drop onto the new desired location in the Current
Screen Layout.
Figure 36-3 Example screen for material decomposition tab

36-7
Image controls
Pan and zoom
Pan (move) the images in the viewport by clicking and dragging over the image to the
desired position. Zoom the images by pressing and holding the RMB and dragging the
cursor up and down in the viewport.
Window level
Window level the Gemstone Spectral images by pressing and holding the MMB and
then dragging the cursor up or down and/or right or left in the viewport. For more
precise adjustment, place the cursor over the W/L annotation in the viewport and type in
a new value. Alternatively, click RMB over W/L annotation and select from the list of
presets.
Figure 36-4 , Window Level Image Pull Down Menu
1
2
3
4
5
6
Table 36-1 Window Level Pull Down Menu
Number
Label
Function Key
Abdomen
(F5)
Head
(F6)
Lung
(F7)
Mediastinum
(F8)
Spine
(F9)
Vertebrae
(F10)
Scroll the image

Scroll the images using the vertical scroll bar on the right side of the viewport. The
scrollbar is hidden until the cursor is moved over that area of the viewport.

36-8

Figure 36-5 Scroll bar in the Spectral Imaging viewport
Locate any point of interest in the image by dragging the 3D Cursor in any view.
Figure 36-6 3D Cursor

Clicking the RMB on an image provides a convenient method to make changes to the
displayed images.
Figure 36-7 On Image RMB Menu
1
2
3
4
5
6
Table 36-2 On Image RMB Menu
Number
Name
Description
Enlarge
switches the image to full display/resets size back

to default setting

36-9

Number
Name
Description
Reset Pan Zoom
resets the currently applied pan/zoom level back

to the default level
Reset W/L
resets the currently applied window level back to

the default level
Hide Annotations
toggles off image annotation
Show Annotations
toggles on image annotation
Save Series
saves out image series from viewport to browser
Figure 36-8 Status bar indication when saving out Image Series
Orientation Changes
Changes in image orientation are possible from any imaging display viewport in both
the Preliminary Assessment & Material Decomposition Presentations. The following
orientations are available: Axial, Coronal, and Sagittal. Simply select the active
annotation and select desired orientation change from the drop down menu.
Figure 36-9 Orientation Drop Down Menu example
1
2
Number
Name
Axial
Sagittal
Description
is an image representing a cross-sectional slice of anatomy
is a lengthwise plane dividing the body into left and right
portions
Image Type Selection

Changes in image type are possible from any imaging display viewport in the Material
Decomposition Presentations Only. The following Image Types are available: Material
Basis (Image Pairs), Monochromatic images, Color Overlay, and Effective-Z

36-10

Figure 36-10 Image Type Drop Down Menu
1
2
3
4
Table 36-3
Number
Name
Description
Material Basis
Image Pairs that demonstrate material densities.
Monochromatic
Images that demonstrate a single spectral Kilo

Electron Volt (keV) (Monochromatic) energy.
Color Overlay
Images that demonstrate multiple material

densities in a single composite image
representation.
Effective Z
Images that demonstrate the material density

atomic number.
Material Basis Images Image Pairs that demonstrate material densities. These
types of images are no longer HU images. They are measured in either mg/cc (Water
& Calcium), or 0.1mg/cc (Iodine). The following MD Basis Image Pair Options are
available from active annotation drop down menus:
Water (Iodine)
Water (Calcium)
Iodine (Water)
Iodine (Calcium)
Calcium (Water)
Calcium (Iodine)
Material Decomposition Selection (MD Images Only)

To select different material decomposition imaging pairs simply click on the active
annotation and select desired MD image pairs from drop down menus.
Figure 36-11 MD Basis Image Unit Display Example
Monochromatic Images Images that demonstrate a single spectral Kilo Electron

Volt (keV) (Monochromatic) energy. Normal Computed Tomography (CT) Images

36-11

demonstrate a range of spectral energies with a selected peak kilo-voltage (kVp) or
(Polychromatic) energies.
Color Overlay Images Images that demonstrate multiple material densities in a
single composite image representation. The baseline image that the material
densities overlay is a monochromatic image with the keV energy user selectable
between 40 140 keVs. The color overlay material densities are displayed over the
monochromatic image. Each material is a separate transparent color overlay with
the color, opacity %, and saturation all user selectable.
Effective-Z Images Images that demonstrate the material density atomic number.
These types of images are no longer HU images.
keV Selection (Monochromatic Images Only)

To select different keV levels, move the mouse vertically while pressing MMB or move the
cursor over the keV annotation click and hold the MMB and drag left or right. For a more
precise adjustment, simply click on the annotation to decrease by 5 kev or RMB to increase
by 5 kev. It is also possible to type in desired keV simply by holding the mouse cursor over
the annotation and type in desired keV.
Figure 36-12 Monochromatic Active Annotation Selection Example
Color-Overlay Opacity % Selection (Color-Overlay Images Only)

To select different material opacity levels, move the mouse vertically while pressing
MMB or move the cursor over the keV annotation click and hold the MMB and drag left
or right. For a more precise adjustment, simply click on the annotation to decrease by
5% or RMB to increase by 5%. It is also possible to type in desired opacity simply by
holding the mouse cursor over the annotation and type in desired material opacity %.
Figure 36-13 Color Overlay Active Annotation Selection Example

36-12
Color Overlay Layer Property Range Settings

To make changes to material Layer properties, simply use the RMB and select from the
drop down menu the Layer Properties. Then on the Layer Properties scroll bar simply
select desired material density ranges to be displayed in color overlay image. To select
material density default settings see File Section of manual.
Display Tools panel

The tools panel provides common features designed to work across all steps in the GSI
Viewer. It is organized into two tabs:
Display Tools
Layout Tools
Display Tools
The Display tab is organized into a set of functional buttons:
Report Cursor
ROIs
Copy
Paste
Cut
Annotation
ROIs
Figure 36-14 ROI Button
The ROI button is used to deposit a region of interest for statistical measurements. To
activate, click on the ROI button and then deposit the cursor on the image by clicking and
dragging until desired size is achieved.
Click the ROI button on the display tab.

36-13

Copy ROI
Select the ROI to be copied and click the Copy button. The ROI remains on the image in the
selected state and is replicated on the system clipboard, which is not visible on the desktop.
This replaces previous entries in the clipboard.
Paste ROI
After copying the desired ROI; click on the image on which to paste it and click the Paste
button. Once an ROI has been copies and pasted it is now linked. To unlink the ROI use RMB
and select unlink from pull down menu.
Cut ROI
Select the ROI to be deleted and click the Cut button. The ROI is removed from the image
and placed on the system clipboard, which is not visible on the desktop. This replaces
previous entries in the clipboard.
Link/Unlink
Figure 36-15 Link/Unlink Button
The link/unlink button is used to toggle properties on and off between viewports. When the
viewports are linked, an image rendering function, such as W/L, Zoom, or Pan, etc. is applied
to each viewport by default. When unlinked, the functions will apply only to the active
viewport.
Report Cursor Button

Use the report cursor button to measure and locate a voxel value under the cursor. To
activate, click on the report cursor button and then deposit the cursor on the image. The
voxel position and value is reported in the lower right corner of the viewport. The cursor may
be moved around the image by clicking on it and dragging.
Copy Report Cursor
Select the ROI to be copied and click the Report Cursor button. The cursor remains on the
image in the selected state and is replicated on the system clipboard, which is not visible on
the desktop. This replaces previous entries in the clipboard.
Paste Report Cursor
After copying the desired Report Cursor; click on the image on which to paste it and click the
Paste button.

36-14

Cut Report Cursor
Select the Report Cursor to be deleted and click the Cut button. The Report Cursor is
removed from the image and placed on the system clipboard, which is not visible on the
desktop. This replaces previous entries in the clipboard.
Cut, Copy, or Paste

Whether cutting or copying annotation, the process for selecting it is the same. Position the
cursor over the desired annotation and click. To make multiple selections, press and hold the
Ctrl key while clicking on each annotation. Annotation that is selected is highlighted.
Cut annotation
Select the annotation to be deleted and click the Cut button. The annotation is removed
from the image and placed on the system clipboard, which is not visible on the desktop. This
replaces previous entries in the clipboard.
Copy annotation
Select the annotation to be copied and click the Copy button. The Annotation remains on
the image in the selected state and is replicated on the system clipboard, which is not visible
on the desktop. This replaces previous entries in the clipboard.
Paste annotation
After cutting or copying the desired annotation, click on the image on which to paste it and
click the Paste button.
Move annotation
Select the annotation then click and drag the annotation to a new location.
The annotation and its vertices are highlighted when selected. Cut, Copy, or Paste.
The Cut, Copy, or Paste buttons are also used for the Report Cursor and ROIs.

36-15
File, View, Help Panel

Figure 36-18
File Panel
The Display section of the File Panel allows the user to make changes relating to display
preferences and save new settings or reload default display settings.
The Dual Energy section of the File Panel allows the user to make changes relating to
Low/High Monochromatic Energy Levels and save new settings or reload default keV values.
The Materials section of the File Panel allows the user to make changes to the material
density color overlays and save new settings or reload default keV values.
View Panel
The View Menu provides the following functionality:
Table 36-4 View Panel Options
Number
Name
Function
View
Show/Hide Header
removes or shows global screen header across

the top of the viewports
Show Annotation
toggles on or off the on screen annotation from

the viewports
Expands the View menu
Figure 36-19 View Panel Options

1
2
3

36-16
Help Panel
The Help menu displays more information about the GSI viewer including the version
number and name.
Active Image Annotation Tool Tips

Link button: Relink selected ports properties
S/I: Middle mouse button drag to pan. Double click left to reset pan.
Ima: 123: Type in or Middle mouse button drag to scroll
DFOV: 45.ocm: Type in or Middle mouse button drag to set Display Field of View
KeV Monochromatic Energy level
Window Width/Level
45% Water / 50% Iodine Type in or Middle Mouse Button drag to change fusion blend
Layer Properties: Layer Properties menu allows user to set range of material density
that is displayed.

36-17
How Do I...
This section provides the step-by-step instructions for using the Gemstone Spectral Imaging
Viewer (GSI). Specifically, it describes how to:

36-18

1. Select the exam from the patient list.
2.
Select an appropriate series of images.

Valid selections are a pair of MD basis image series (e.g. Water, Iodine) or one
Monochromatic image series and one MD basis image series (e.g. 70kev, Water), and
low/high energy image series.
3. Select GSI Viewer in the applications box on the left hand side of the screen.
The images will display in the Gemstone Spectral Imaging Viewer application.
Figure 36-20 Exam and series selection
Quick Steps: Launching Gemstone Spectral Imaging Viewer (GSI)

1. Select the exam from the patient list.
2. Select an appropriate series of images.
3. Select GSI Viewer in the applications box on the left hand side of the screen.

36-19

1. To exit the GSI Viewer simply click on the GSI Viewer exit button.
Figure 36-21 GSI Viewer Exit Button
Quick Steps: Exiting The Gemstone Spectral Imaging Viewer (GSI)

1. To exit the GSI Viewer simply click on the GSI Viewer exit button.

36-20
Appendix A
Accelerator Line Commands

Introduction
The Accelerator Line will allow commands to be typed which can perform certain functions.
The accelerator line appears as a rectangular text box at the bottom of different desktops. A
flashing I- beam cursor will appear when the mouse cursor is placed in this area. Typing
commands can act as a shortcut to opening additional menus to access a function. When a
command is typed, and Enter is selected from the keyboard, that command will be applied
to all viewports in focus. As next and prior images are selected, the command will be applied
to all those images as well.
These commands are listed in two sections. First there is a list for commands that are valid
in Exam Rx. Next, there is a list of commands that are valid in Image Works.
For each command, the command name is listed first, under that is what should be typed
on the Accelerator line, and under that is an explanation, if needed.
Add to Index and Accelerator line commands in appendix A
Graphic Retro Recon

annotation custom
ac
Applies custom annotation to the image displayed as defined by Display Preferences
settings.

A-1
annotation full
af
Restores full annotation to the image displayed.
annotation groups
agp <on/off> <N> -where N is a group number
With this feature, you can selectively turn off or on specific image annotations on the
screen. The N number corresponds to the annotation in the customize setting for annotation
in User Preferences. For example, to turn off right marker, type agp off 10. You can type more
than one number at a time.
annotation none
an
Removes all annotation from the image displayed.
annotation partial
ap
Applies partial annotation to the image displayed as defined by Display Preferences
dialogue box on Exam Rx screen.
display normal or normal

no
Restores the image display to display normal mode: removes all zoom, filter, pan,
annotations etc. applied to the viewport. Displays the image from the disk as created.
filter
fi <filter name> filter names: e1; e2; e21; e22; e23; e3; lung; (for edge enhancement) s1;
s11; s2; s21; s3; (for smoothing filters) and off.
(i.e. fi e1, fi e2, fi e3, fi lung, fi s1, fi s2, fi s3, fi off)
Apply/remove edge enhancement and smoothing filters on selected image(s). Edge
enhancement filter names are, from least sharpening to most: e1, e2, e3, lung; smoothing
filters are named s1, s2, s3. Entering the command fi e1 applies the least image sharpening,;
entering fi lung applies the most.

A-2
flip left right

flr
Flips the image horizontally.
flip top bottom

ftb
Flips the image vertically.
gray scale enhancement

gse <filter name> filter names: g1; g2; g3; off
(i.e. gse g1, gse g2, gse g3, gse off)
Gray scale enhancement increases the apparent contrast of the image without changing
the window/ level settings. Useful for enhancing low contrast structures.
grid
grid <on> or <off>
(i.e. grid on, grid off)
Displays or removes a ruled grid on the image.
image
i <image number>
image number: the desired image number from within the displayed series.
(i.e. i 27 or 27)
Displays the specified image (27) of the current series in the selected viewport.
mouse mode roam

mmr
Turns the right mouse button drag action into scrolling (pan, roam) of the image.

A-3
mouse mode zoom

mmz
Turns the right mouse button drag action into zooming (magnification) of the image.
rotate left
rl
Rotates the image ninety degrees counter-clockwise.
rotate right
rr
Rotates the image ninety degrees clockwise.
set initial windowing

siw
Applies default window width and level setting to the display.
tick marks
tm <on> or <off>
(i.e. tm on, tm off)
Displays or removes both horizontal and vertical tick marks (rulers) along the border of the
image.
tick marks horizontal

tmh <on> or <off>
(i.e. tmh on, tmh off)
Displays or removes horizontal tick marks (rulers) only, along the border of the image.
tick marks vertical

tmv <on> or <off>
(i.e. tmv on, tmv off)

A-4
Displays or removes vertical tick marks (rulers) only along the border of the image.
window level
wl <desired level>
(i.e. wl 65)
Applies specified window level setting to the display.
window width
ww <desired width>
(i.e. ww 350)
Applies specified window width setting to the display.
zoom zo <factor>
factor: magnification factor
(i.e. zo 1.5)
Magnifies the image by the factor specified. In the above example the image is displayed
one and one half times as large as its display normal size, or 150% larger in appearance.
Exam Rx
angle
ang
Creates an angle type measurement cursor by explicitly describing the end points of the
lines that make up the cursor.
annotation custom
ac
settings.

A-5
annotation full
af
annotation groups
annotation none
an
annotation partial
ap
blank viewport
blank
Removes image from the selected viewport, similar to a user text page.

A-6
cross reference
xr <series number> <image set>: <interval>
series number: an appropriate series number to be cross referenced.

image set: a consecutive group of image numbers within the series.
interval: the interval of images to be filmed: 2 equals every other image, 3 equals
every third image, etc.
(i.e. xr s2 1-40:3)
Display cross referenced scan plane lines on a scout image. This command allows explicit
description of lines to be posted and their interval. The above examples will post every third
slice line between images one and forty in series two, beginning with image one.
cross reference append

xra <series number> <image set>: <interval>
Used to add additional cross referenced groups or series to a scout which already has a
cross reference on it.

interval: the interval of scan plane lines to be displayed: 2 equals every other
image, 3 equals every third image, etc.
cross references off

noxr
Removes cross reference lines from the image display.

no
Restores the image display to normal orientation and zoom.
distance
dist
A measure distance line will appear on the screen.

A-7
ellipse
el
Creates an ellipse type measurement cursor.
elliptical image matte

ematte
Displays an elliptical black matte or mask around the image. Size is adjustable with the
mouse by a left click and drag on the blue crosshair. Position is adjustable by a click and
drag on the edge of the matte.
erase all graphics

eag
Removes all graphics from the selected image.
erase graphics
eg
Removes selected graphics from the selected image.
exam
e <examination number>
examination number: the desired exam number as indicated on the system

disk.
(i.e. e 4578)
Displays the first image of the specified exam (4578) in the selected viewport.

A-8
exam series image

e <exam number> s <series number> i <image number>
<exam number> <series number> <image number>
exam, series and image numbers: As per system disk image numbering system.
(i.e. e 34 s2 i47
or 34 2 47)
Displays the image explicitly requested in the selected viewport. The first example displays
exam 34, series 2, image 47 in the selected viewport. The display command may be entered
without typing the e s i characters. By entering the numeric data, separated by spaces, in
the specified order, the image specified will display in the selected viewport. In the second
syntax example above, the same image will be displayed as in the first example.
film annotation custom

fac
Applies custom annotation to the images filmed as defined by Display Preferences dialogue
box on Exam Rx screen.
film annotation full

faf
Restores full annotation to the images being filmed.
film annotation groups

fagp <on/off> <N> -where N is a group number
With this feature, you can selectively turn off or on specific image annotations for filming.
The N number corresponds to the annotation in the customize setting for annotation in User
Preferences. For example, to turn off right marker, type agp off 10. You can type more than
one number at a time.
film annotation none

fan
Removes all annotation from the images being filmed.

A-9
film annotation partial

fap
Applies partial annotation to the images being filmed as defined by Display Preferences
filter
fi <filter name>
filter names: e1; e2; e21; e22; e23; e3; lung; (for edge enhancement) s1; s11;
s2; s21; s3; (for smoothing filters) and off.
filters are named s1, s2, s3. Entering the command fi e1 applies the least image
sharpening,; entering fi lung applies the most.
flip left right

flr
flip top bottom

ftb

gse <filter name>
filter names: g1; g2; g3; off


A-10
grid
grid <on> or <off>
hide graphics
hg
Hides all graphics on the selected image. The undo function is show graphics.
image
i <image number>
(i.e. i 27 or 27)
invert video
inv
Reverses the blacks and whites on the image.
mouse mode roam

mmr
mouse mode zoom

mmz

A-11
next exam
ne
Displays the first image of the next exam in the selected viewport, next determined by the
sort function applied to the List Select browser.
next series
ns
Displays the first image of the next series from the displayed exam in the selected viewport.
previous exam
pe
Displays the first image of the previous exam in the selected viewport, previous determined
by the sort function applied to the List Select browser.
previous series
ps
Displays first image of the previous series of the displayed exam in the selected viewport.
print series
prs
Opens the print series dialogue box for the selected viewport, which is in turn satisfied by
mouse commands. By specifying options in the print series box, a sequence of images may
be sent automatically to the printer, or current print jobs may be cancelled by the operator.
Desired image parameters must be set before calling the print series command - zoom,
window level, annotations etc. cannot be altered after the print series dialogue box is
opened.

A-12
propagate
prop <range>
range: a= all images in series; s = series; i = image range (1-15)

(i.e prop a
or prop i 1-15)
Displays selected graphics on the specified images. The i is lower case sensitive. In the first
example, the graphic will display on all images called into the viewport until cleared by
another command (such as erase graphics) or a different series is displayed in the viewport.
In the second example the graphic will be applied only to images 1 through 15 in the current
series.
rectangular image matte

rmatte
Displays a rectangular black matte or mask around the image. Size is adjustable with the
mouse by a left click and drag on the blue crosshair. Position is adjustable by a left click and
rectangle
rect
Creates an rectangle type measurement cursor. Used for ROI.
report pixel
rp
Opens a Report Pixels dialogue box, and displays an ROI box cursor on the image that is
positioned on the area of interest by a left click and drag of the mouse. Size is not adjustable.
Once in position, clicking OK in the dialogue box creates a pixel report consisting of density
values for individual pixels within the area delineated by the box cursor.
rotate left
rl

A-13
rotate right
rr
screen save
scnsave
Captures the selected image exactly as it is displayed, and creates a new image with a
series number of 99 on the system disk that includes all graphics and display factors applied
to the image and/or viewport at the time of capture.
series
s <series number>
series number: the desired series number from within the displayed exam.
(i.e. s 2)
Displays the first image of the specified series (2) of the current exam in the
selected viewport.
series binding
sb <on> <off>
Turns series binding on or off. With series binding on, the next image is defined as the next
image in the entire exam; at the end of any particular series, the next image is the first
image of the next series. At the end of the exam, a next command will loop back to the first
image of the exam. With series binding off, at the end of a particular series, a next
command will loop back to the first image of the current series.

siw
show graphics
sg
Shows, or re-displays all graphics on the selected image which were hidden with the hide
graphics command.

A-14
text page exam

te
Displays text page for the exam in the primary viewport.
text page region of interest

tpr
Displays a text page for the image in the primary viewport which lists all the ROI cursors and
their statistics.
text page series

ts
Displays text page for the exam/series in the primary viewport.
tick marks
tm <on> or <off>
image.

tmh <on> or <off>
tick marks vertical

tmv <on> or <off>

A-15
user annotation
ua
Displays specified text in a user annotation text box on the image.
user text page

utp
Removes image from the selected viewport, creating a blank viewport for user annotation
or graphics.
window level
wl <desired level>
(i.e. wl 65)
window width
ww <desired width>
(i.e. ww 350)
zoom
zo <factor>

(i.e. zo 1.5)

A-16
Image Works
angle
ang
Creates an angle type measurement cursor by explicitly describing the end points of the
lines that make up the cursor.
annotation custom
ac
dialogue
annotation full
af
annotation groups
annotation none
an
annotation partial
ap

A-17
arrow
arrow <on> or <off>
(i.e. arrow on)
Displays or removes an arrow cursor from a text annotation box for user annotation.
cross reference
xr <series number> <image set>: <interval>

interval: the interval of images to be filmed: 2 equals every other image, 3 equals
every third image, etc.
(i.e. xr s2 1-40:3)
Display cross referenced scan plane lines on a scout image. This command allows explicit
description of lines to be posted and their interval. The above examples will post every third
slice line between images one and forty in series two, beginning with image one.
cross reference append

xra <series number> <image set>: <interval>
Used to add additional cross referenced groups or series to a scout which already has a
cross reference on it.

interval: the interval of scan plane lines to be displayed: 2 equals every other
image, 3 equals every third image, etc.
cross references off

noxr
Removes cross reference lines from the image display.

no
Restores the image display to display normal mode: removes all zoom, filter, pan,
annotations etc. applied to the viewport. Displays the image from the disk as created.

A-18
distance
dist
A measure distance line will appear on the screen.
ellipse
el
Creates an ellipse type measurement cursor.
elliptical image matte

ematte
Displays an elliptical black matte or mask around the image. Size is adjustable with the
erase all graphics

eag
Removes all graphics from the selected image.
erase graphics
eg
Removes selected graphics from the selected image.
exam
e <examination number>
examination number: the desired exam number as indicated on the system disk.
(i.e. e 4578)
Displays the first image of the specified exam (4578) in the selected viewport.

A-19
exam series image

e <exam number> s <series number> i <image number>
<exam number> <series number> <image number>
exam, series and image numbers: As per system disk image numbering system.
(i.e. e 34 s2 i47
or 34 2 47)
Displays the image explicitly requested in the selected viewport. The first example displays
exam 34, series 2, image 47 in the selected viewport. The display command may be entered
without typing the e s i characters. By entering the numeric data, separated by spaces, in
the specified order, the image specified will display in the selected viewport. In the second
syntax example above, the same image will be displayed as in the first example.
film annotation custom

fac
Applies custom annotation to the images filmed as defined by Display Preferences dialogue
box on Exam Rx screen.
film annotation full

faf
Restores full annotation to the images being filmed.
film annotation groups

fagp <on/off> <N> -where N is a group number
With this feature, you can selectively turn off or on specific image annotations for filming.
The N number corresponds to the annotation in the customize setting for annotation in User
Preferences. For example, to turn off right marker, type agp off 10. You can type more than
one number at a time.
film annotation none

fan
Removes all annotation from the images being filmed.

A-20
film annotation partial

fap
Applies partial annotation to the images being filmed as defined by Display Preferences
filter
fi <filter name>
filter names: e1; e2; e3; lung; (for edge enhancement) s1; s2; s3; (for smoothing filters) and off.
filters are named s1, s2, s3. Entering the command fi e1 applies the least image
sharpening,; entering fi lung applies the most.
flip left right

flr
flip top bottom

ftb
format
fo <rows>< columns>
rows, columns: rows across and columns down the display screen.
(i.e. fo 4 3)
Format the display screen as specified by rows and columns. The above example displays
images across the screen in 4 rows and 3 columns, or common twelve-on-one.

A-21
freehand
freehand
Displays a small solid blue box that can be used to draw a freehand trace for an ROI. You
must click and drag the box to where you would like to start the trace. Then select the blue
box while holding Shift on the keyboard and move the mouse cursor around the screen to
draw the trace.

gse <filter name>
filter names: g1; g2; g3; off

grid
grid <on> or <off>
hide graphics
hg
Hides graphics on the selected image. The undo function is show graphics.
image
i <image number>
(i.e. i 27 or 27)
invert video
inv
Reverses the black and white on the image.

A-22
mouse mode magglass

mmg
mouse mode roam

mmr
next exam
ne
Displays the first image of the next exam in the selected viewport, next determined by the
sort function applied to the List Select browser.
next series
ns
Displays the first image of the next series from the displayed exam in the selected viewport.
paging
pa [<start> <end>] [<rate>]
Activates cine paging. For the start and end values, enter the first and last images you want
to page thru. For rate, enter the number of images per second to page through, with the
maximum being 60.
paging interval
pi <interval>
Allows you to set the interval for paging. The pa command must be used prior to setting
paging interval.

A-23
paging interval all

pia <interval>
Allows you to set the interval for paging. The pa command must be used prior to setting
paging interval.
paging mode
pm <spatial/temporal>
Allows you to change the mode for paging. Selecting temporal will display the images in a
loop mode. Spatial will display images in a back and forth mode.
previous exam
pe
Displays the first image of the previous exam in the selected viewport, previous determined
by the sort function applied to the List Select browser.
previous series
ps
Displays first image of the previous series of the displayed exam in the selected viewport.
print page
pp
Sends the entire current display screen to the film composer and sets the film composer
format to that of the current display format.
print series
prs
Opens the print series dialogue box for the selected viewport, which is in turn satisfied by
mouse commands. By specifying options in the print series box, a sequence of images may
be sent automatically to the printer, or current print jobs may be cancelled by the operator.
Desired image parameters must be set before calling the print series command - zoom,
window level, annotations etc. cannot be altered after the print series dialogue box is
opened.

A-24
propagate
prop <range>
range: a= all images in series; s = series; i = image range (1-15)

(i.e prop a
or prop i 1-15)
Displays selected graphics on the specified images. The i is lower case sensitive. In the first
example, the graphic will display on all images called into the viewport until cleared by
another command (such as erase graphics) or a different series is displayed in the viewport.
In the second example the graphic will be applied only to images 1 through 15 in the current
series.
quit
quit
Close the Viewer application and return to the Image Works browser.
rectangular image matte

rmatte
Displays a rectangular black matte or mask around the image. Size is adjustable with the
rectangle
rect
Creates an rectangle type measurement cursor. Used for ROI.
reference image
ri
Puts a reference image on the selected image.
reference image all

ria
Puts a reference image on all images.

A-25
reference image all off

noria
Takes reference image OFF all images
reference image off

nori
Takes reference image OFF of selected image.
report cursor
rc
Displays (reports) current mouse cursor location in pixel coordinates, and a single pixel ROI
reading.
report pixel
rp
Opens a Report Pixels dialogue box, and displays an ROI box cursor on the image that is
positioned on the area of interest by a left click and drag of the mouse. Size is not adjustable.
Once in position, clicking OK in the dialogue box creates a pixel report consisting of density
values for individual pixels within the area delineated by the box cursor.
reset
rs
Reset image to initial display parameters.
rotate left
rl
rotate right
rr

A-26
save state
ss [<first image> <last image>]
Saves the image orientation, w/l values, graphics, and filter and gse values of a range of
images that you can set. Typing ss by itself will save settings for the entire series. A Gray
Scale Presentation State Object is also created and saved to the Data base.
screen save
scnsave
Captures the selected image exactly as it is displayed, and creates a new image with series
number of 99 on the system disk that includes all graphics and display factors applied to the
image and/or viewport at the time of capture.
series
s <series number>
series number: the desired series number from within the displayed exam.
(i.e. s 2)
Displays the first image of the specified series (2) of the current exam in the selected
viewport.
series binding
sb <on> <off>
Turns series binding on or off. With series binding on, the next image is defined as the next
image in the entire exam; at the end of any particular series, the next image is the first
image of the next series. At the end of the exam, a next command will loop back to the first
image of the exam. With series binding off, at the end of a particular series, a next
command will loop back to the first image of the current series.

siw

A-27
show graphics
sg
Shows, or re-displays graphics on the selected image which were hidden with the hide
graphics command.
spline
spline
Deposits a small open blue box for creating a trace. Deposit blue box where you want the
trace to start. Then hold down the Shift key on the keyboard and click with the left mouse to
deposit points. All the points will connect to create a trace.
text page exam

te
Displays text page for the exam in the primary viewport.
text page region of interest

tpr
Displays a text page for the image in the primary viewport which lists all the ROI cursors and
their statistics.
text page series

ts
Displays text page for the exam/series in the primary viewport.
tick marks
tm <on> or <off>
image.

A-28

tmh <on> or <off>
tick marks vertical

tmv <on> or <off>
user annotation
ua
Displays a user annotation text box. Place mouse cursor over the box and type desired
annotation.
user preferences
up
Brings up the user preferences pop up window.
user text page

utp
Removes image from the selected viewport, creating a blank viewport for user annotation
or graphics.
window level
wl <desired level>
(i.e. wl 65)

A-29
window width
ww <desired width>
(i.e. ww 350)
zoom
zo <factor>

(i.e. zo 1.5)

A-30
Appendix B
Legacy Precautions
System
Run Shutdown and Restart daily.
The system may fail to start if system disk space needs to be recovered from unused
system files.
The following message will be posted in the Disk Management shell window:
The purpose of storelog is to recover system disk space by archiving and then removing core,
log, and data files that have been saved for their system troubleshooting diagnostic value.
Now they may be taking up too much space for the system to run properly. Removing these
system log files does not add image space, but should allow the application to start.
You are then directed to answer the following questions (be patient for the messages
to display):
Place the mouse cursor inside the black Disk Management window
1. Do you want to save system log files to removable media?
Type n and press the enter key
2. Do you want to remove the system log files?
Type y and press the enter key.
You will then see a message Please be patient, the system is now removing unwanted files.
The system then starts normally.
If the system fails to startup completely, select [Unix Shell] from the tool chest menu
in the upper right of the Scan Monitor place your cursor in the blue shell and type st.
If mouse selections fail, press the Escape key to clear backlogged requests.
The system may not show typed information on the New Patient or Viewedit screen.
The system will update after a short time.

B-1
The system may be slow to respond to keyboard entry and mouse clicks. If the
system fails to respond stop and let the events catch up.
The dynaplan screen may fail to update if Priority Recon is selected during scanning.
If you can no longer type in a field, move the cursor to the field and try clicking the
middle mouse to restore functionality. If this does not work, then a system shutdown
will be required.
The cursor may not move between the left and right screen. Wait a few seconds
without moving the cursor and try again.
Pressing the Space Bar after selecting all fields in New Patient, locks the patient
information fields and all the patient information fields become insensitive. Only the
delete and backspace key will be active.
Press the delete key to recover from this situation.
Entering \ and pressing the Enter key in the New Patient can cause the fields to
become insensitive.
Under heavy system operation, the message Unable to install image in the database
may be seen. Recon for the series will take longer due to unsuccessful install of
images to the database.
To install a SMPTE pattern, BRH or Quality assurance images for viewing, select the
following. Once installed the images will be available for viewing from the Image Works
browser or List Select in Exam RX. Both will be listed as Exam 1000, the patient name will
reflect if it is a QA image or a SMPTE pattern.
1. Click Service Desktop.
2. Click [Diagnostics].
3. Click [Display Processing].
4. Select [Install SMPTE Image].
In general, wait for a screen transition to take place before making another selection.
If the console becomes unresponsive for 2 minutes or more, shutdown the system
using the pink shutdown button and restart the system. If you cannot select the pink
shutdown button, turn off the console power switch, wait 10 seconds, then turn the
console power switch back on. The system should come up normally.
Protocol Management may not be selectable. Check that retro recon is selectable. If it
is not then the system will need to be rebooted.
Pop-up screens and menus may appear on the wrong monitor or may be displayed
split between the two monitors.
Windows such as the Film Composer that normally are restrained to the right or left
monitor can be dragged to the other monitor. Be careful not to get a Film Composer
hidden behind some screen if you move it to the other monitor.

B-2
If a blank viewport is seen where image annotation is displayed and W/L is

interactive but no image is seen, shutdown the system, recycle power and reboot the
system to clear this display issue.
If corrupted images are seen after applying an image filter such as enhance, smooth,
lung or gray scale, try rebooting the system and see if the image can be displayed
correctly. If not contact your GE service representative.
Tube Warm Up/Fast Cal

Run Tube Warm up after 2 hours of non-use. It is best to warm the tube as close as
possible to the time the next patient will be scanned. Dont warm the x-ray tube and
then wait 30 minutes without scanning.
Always check that the beam is clear when doing Fast Cal. In Fast Cal, the system
checks cleanliness of the Mylar Window. If the system suspects the Mylar Window
may be dirty to the point that it may cause a beam obstruction, a pop-up message
will be displayed. The operator will be instructed to clean the Mylar Window and
select [Retry].
Fast Cal must be run once every 24 hours.
Complete all portions of Fast Cal, Warm Up I, Warm Up 2, Gen Cal, Clever Gain, and
Fast Cal. This assures that the Air calibration and generator calibrations are up to
date on the system. Scan aborts may occur during Axial or Helical scanning. Always
be aware of the scan progress during an Exam and select Resume as soon as it is
posted to continue.

B-3
Scan
Scan aborts may occur during Axial or Helical scanning. Always be aware of the scan
progress during an Exam and select Resume as soon as it is posted to continue.
Scan may fail to confirm posting a message that not enough image space exists,
even though the image space shown in the Feature Status Area indicates there is
enough space. This is due to the fact that images are stored on the system disk in
more than one partition. Remove consecutive exams to free up image space for
confirm to proceed.
The system does not verify that the Pediatric protocol number typed in the Protocol
number field matches the Patient weight entered on New Patient. When typing in the
protocol number always verify that you are entering the correct protocol for the
weight category desired.
If Direct3D isenabled in DirectVIS under the Recon tab, Add Group will display some
fields as insensitive as it will be combined with the current Direct3D session. Turn
Direct3D off for the added group if you no longer wanted it to be included as part of
the Direct3D session. This will allow changes to any of the acquisition parameters.
Auto mA should not be used with Gating and Cine acquisitions even though it can be
selected. This includes scans that are done for Cardiac Scoring using Cine Segment.
The gating button may turn red when the patient experiences a big jump in heart
rate such as in a PVC. The system usually will recover and read the signal. Sometimes
you may have to toggle the gating button Off/On to get the heart rate signal synched
again. Care should be taken in starting the scan if the patient continues to have
PVCs.
When using the IVY monitor the heart rate posted may jump to over 200 after
confirming a scan and moving the table into the gantry. This may be caused by the
cables from the ECG monitor touching the gantry cover.
Always try to position cables for the ECG monitor away from the gantry.
To terminate an Insite connection on your system. Select [New Patient] a message
will be posted informing you that the scan hardware resource is not available. Wait 3
minutes and select [New Patient] again to begin scanning
In general, if a scan fails and a [Resume] is posted, click [Resume] to continue. Try
[Resume] again if the first [Resume] fails. If a failure still occurs, reset the scanning
hardware through System Resets in the Service desktop. If scan still fails to restart,
shutdown and Restart the system.
Auto Voice may fail to function, especially during system simultaneity. Make sure that
you can hear the Auto Voice to recognize if Auto Voice has quit, manually breathe the
patient when this occurs.
The Show Localizer scout image may fail to display or images may fail to recon and
may become suspended if scanning is started while remove images is in progress. To
avoid this dont remove images while an exam is in progress or scanning is active.
Remove images when the system is idle.

B-4
The Dynaplan screen may report incorrect status (i.e. a scan is removed before it is
actually scanned) when stop scan is selected. The screen will reset correctly after
Resume or back to view edit is selected.
Scan groups will not be contiguous if you switch from 2 or more Helical scan groups
column or row edit and the scan type is changed to Axial. If this change is made, then
verify the Start and End locations of each of your scan groups and adjust if needed.
The Cine time between images may change when other parameters are modified
within a protocol. Check the Cine time between images prior to confirming the scan
to verify it is the value you wish.
Tilt handles will not be visible on the screen if the DFOV is larger than 48. Use a DFOV
smaller than 48 to assure that the tilt handles are visible.
Show Localizer may fail to display the scout image if the Next Series is selected
before the scout images are reconstructed. Wait until the scout images are
reconstructed before selecting Next Series. If Next Series has already been selected,
toggle Show Localizer off and then on again.
Quickly changing desktops when Show Localizer has been selected for the next
series can cause a partial display of the scout in the Graphic Rx window to occur.
If Page Up or Page Down fails to change the displayed Show Localizer.
Try the following in order:
1.Turn Show Localizer button off then on.
2.Move the cursor off the image window and back on to the image to refresh
the screen if both of these fail then verify that you have a valid scout for
Show Localizer.
If an R, L or A, P value is more than half of the Display Field of View in mm. The image
annotation will not annotate R and L or A and P on the images. For example if the
DFOV is 10cm and the R value is 56mm then the image annotation will show R R. Use
a R-L or A-P value which is less than half of the DFOV in mm to avoid this.
A protocol may fail to display. The following message will be posted to the message
line on the lower center of the scan monitor Cant read selected protocol, please
choose another protocol. If this occurs the protocol is corrupt and will need to be
rebuilt. Delete the protocol and rebuild it.
The patient history field may be missing the last 9 characters when all 60 characters
have been entered and the patient record is either selected as a completed exam or
the Patient ID is entered and the system matches a completed exam.
Even weights entered in Patient Schedule may be rounded up to the next odd pound.
This occurs because weights are stored as kilogram units then converted back to
pounds.
During the acquisition of large data sets (1000-1500), there may be Auto film and
reconstruction performance issues. If either stops, check the queues and restart to
continue.

B-5
When selecting the Auto Voice field, the selected Auto Voice will be deselected. You
must reselect the desired Auto Voice message before exiting the Auto Voice screen.
When entering birth dates on the New Patient or Schedule Patient screens the
following rules apply:
2 digit years can only be entered if the birth year is in the current century for the
21st century - for the year 2000 forward.
Birth dates from any other century must be entered as 4 digits for example for the
year 1899 1999 all four digits must be entered.
Birth dates can only be entered for 150 years (Current year minus 150 years).
If InSite is running the Remote Safety test, New Patient will not open. New Patient
can be made available by either:
1.Calling InSite and request they abort the test.
2.Going to the Service Desktop and selecting |CleanUp| option to cancel the
test in progress.
PMR images may fail to recon if disk space is low. To recon the images, remove
images and restart the recon queue in Recon Management.
You may get the message Duplicate Scan Key, if a Scout Scan is aborted within the
first 20 to 75 mm of table travel or if a the prescribed length of the Scout is less than
75 mm. In order to proceed, an End Exam must be done and new exam started.
It may be possible to prescribe a recon range that is outside the recon 1 boundary.
This may occur is the start location is dragged below the recon end location in recon
2 or 3.
If a large number of scan files are reserved and there is a large recon queue, you may
see the message: Duplicate Scan Key unable to allocate scan file. There will be a
Resume at Start Scan. Either wait a few minutes for the recon queue to decrease or
release some of the reserved scan files.
Bands and lines may be seen in scout images if there is a tube spit or the reference
channel is blocked during the acquisition of a scout scan.
A zero interval axial series, if paused, will add another group equal to the remaining
number of images. Make sure to return to the View/Edit screen to delete this group to
avoid acquiring additional images.
Biopsy is not valid for a Thin Twin helical acquisition mode. If Biopsy is selected, the
Biopsy window does not open; however a group is added to the series at an
inadvertent location. Do not select Biopsy mode with Thin Twin helical scan mode.
If the message Can not read Cal Database, select [End Exam] and re-enter patient
information.
The table will take 10 mm to stop if the table is running at 100 mm/sec. when a patient
weighing 450 lbs. is on the table.

B-6
Patient Schedule
Close the preferences screen before switching between Patient Schedule and New
Patient.
The Patient Name, Patient ID, Accession Number and Requested Procedure ID can
only be edited if Allow to Edit MWL is set to yes in the Preference window.
The Patient Schedule button may not display the Work List from the HIS/RIS server if
the network is slow. Try again.
ConnectPro (Purchased Option)

Bar Codes will fail to be read by the Bar Code reader if the HIS/RIS system the bar
code was created on has a different language keyboard than the CT system. For
example, if your CT system has a French language keyboard then your HIS/RIS must
have a French language keyboard. If it is not possible to have the same language
keyboard on each system, then manually enter the Accession or Patient ID number
or select the desired patient from the Patient Schedule list to display the patient
information on the New Patient screen.
Patients selected from Modality Work List will be displayed with ^ (carets) to define
different DICOM fields. The carets are not displayed on the images.
Performed Procedure Step (part of connect pro option)

PPS will post the message Failed to Start if the remote server is down.
Screen Save images created in ExamRx or in the Viewer on the Image Works desktop
are not PPS aware in this release of software. Also, images created in Reformat, 3D,
and Navigator are not PPS aware. For these image types, INPR will be posted in the
PPS column in the Browser even though PPS is not enabled.
Complete PPS status for series in the order the series were created. PPS update will
fail if done in a different order.
The PPS server may stop and fail to send the request. You may have to select
Complete multiple times to get the series to update to the complete state.
Add Sub does not update images for PPS correctly
Protocol Management
Protocols, which contained a SmartStep series, cannot be selected or copied from
the Most Recent selector.
There is no default protocol for Pediatric areas Neck, Upper Extremity, Chest,
Abdomen, Spine, Pelvis, and Lower Extremity.

B-7
If the weight of a child is at the cross over point of a weight category, due to rounding
errors the correct weight category might not be selected. Please check the weight
based category selected against the label and the patients weight.
Reconstruction
If images fail to recon the following should be used in order:
Select [Recon Management], [Unsuspend Queue].
If the image still fails to recon
Select [Recon Management], [Restart Queue]
If this still fails Shutdown and reboot the system.
Lung Algorithm
Provides edge enhancement between structures with large density differences, such
as calcium and air.
Enhances the contrast of small objects. For best viewing and film quality, select a
window width of 1000 to 1500 and a window level of -500 to -600.
Increases CT number values at the edge of high contrast objects. When planning to
take CT number measurements of vessels or nodules in the lung, please check and
compare your results with Standard algorithm images. (ROI and Histogram functions
use CT numbers.)
The edge enhancement provided by Lung Algorithm may not be appropriate in some
clinical cases. Please take individual viewing preferences into account when you
choose Lung algorithm.
Image recon may fail and then shutdown.
If images fail to recon the following should be used in order:
Select [Recon Management], [Unsuspend Queue].
If the image still fails to recon
Select [Recon Management], [Restart Queue].
If this still fails Shutdown and reboot the system.
The dynaplan screen may fail to update if Priority Recon is selected during scanning
Retro recon may not be able to get the same image locations as prospective recon.
This is due to rounding in the start and end location. To avoid this mismatch prescribe
start and end locations that are even numbers.
Retro recon may show more images when using PMR than that recond during
prospective recon if Recon 2 or 3 with a slice thickness greater than Recon 1 is used.
This is due to the extra data acquired for recon of the thicker slices.

B-8
Retro recon list service exams from Fast Cal. Do not attempt to recon this data, the
SRU will shut down. These exams are listed with exams numbers that begin with
50,000.
SmartStep series are listed in Retro Recon but cannot be selected.
3000 Image Series

Display
Paging and image review with next prior may slow when reviewing large series.
Archive
An image series of 3,000 images can only fit on one side of a 2.3 gb MOD.
Auto Store will not save the exam if the media size attached is 1.2 gb.
If a 1.2 gb media is used for image archive and the image series is greater than 1,500
images archive will need to be queued by image. Select a range of images 1,500 or
less when archiving to 1.2 gb media.
If greater than 2,000 images are queued to save by image you may see the browser
disappear and reappear. While this is occurring it will be impossible to access the
browser. To avoid this queue less images at a time when saving by image.
Images may fail to save if saving large groups of images. Verify that all desired
images are saved before deleting them from the system disk.
Network
The network queue list will be slow to access. This is typically seen when 200 or more entries
exist.
DentaScan/Add/Subtract
These applications can only load 1,000 images. Hi-light the desired image range of 1,000
images by selecting the first image desired, hold the shift key down and hi-light the last
image desired then select the desired range.
Retro Recon
Two decimal points cannot be entered, i.e. 3.75 for image interval if column edit is
used. Edit each scan group (row) if an interval with 2 decimals is required.
If a 1 rotation 4i or 2i axial scan is prescribed using add group in ViewEdit with a
Superior to Inferior scan direction is retro reconned, the resulting images will be

B-9
reconned Inferior to Superior. The image locations are correct, but the image
numbers will not match the prospective images.
If you delete queued Retro images the image space reserved for those retro recons is
not given back. You will not get the space back until you reboot the system.
Only start Retro Recon when scanning is complete. Do not delete queued retros while
scanning is active, scanning could stop.
If maximum A-P or R-L offset is selected in Retro Recon, one image may fail to
reconstruct. Select an offset that is 0.5mm less than the maximum value allowed.
The start/end locations of a retro reconstruction may be different from Recon 1 and 2
and 3 when a PMR with a thicker slice than Recon 1 is prescribed for the series.
Retro Recon may hang and core. If the Retro recon screen fails to display or queue
retrospective images, retro recon has cored. Reboot the system to recover.
If an R, L or A, P value is more than half of the Display Field of View in mm. The image
annotation will not annotate R and L or A and P on the images. For example if the
DFOV is 10cm and the R value is 56 mm then the image annotation will show R R. Use
a R-L or A-P value which is less than half of the DFOV in mm to avoid this.
It may be possible to confirm a retro recon prescription with an invalid recon start
and end location that results in a recon suspend. To avoid this change image
thickness before changing image locations.
Recon Management
Scout queue entries can be selected in Delete Retro queue entries. Only select Scout
queue entries to delete if you are sure you do not need the scout image
reconstructed.
Before saving or restoring scan data make sure the system is idle and no Archive,
Network or Filming is active. No other features should be accessed until the save or
restore is complete.
Recon Management may hang while trying to display the menu. Finish the current
exam if scanning and shutdown and restart the system to correct the problem.
If you wish to cancel a Save or Restore scan data, the cancel button will cancel only
after the current scan file is saved or restored. A helical scan file contains a large
amount of data even though it is one scan file, that file can take up to 30 minutes or
more to save. You are unable to scan patients while saving or restoring Scan Data.
Make sure that you have ample time to complete the save or restore before
beginning.
Scan data save or restore is active when the dialog message indicating saving or
restoring scan file is displayed.
If saving scan data, after the save is complete select Restore Scan Files to verify the
data is stored.

B-10
Volume Viewer (Option)

The system may get extremely slow when saving a 3D or VR model using Save/Recall
Save Model. This could cause disruption to scanning. Do not start a model save
unless you have 10-20 minutes of free time.
Volume Viewer may not display on the ExamRx desktop. This will occur if you switch
back to the ExamRx desktop quickly after launching Volume Viewer
Volume Viewer may get hung up. This occurs due to a error dialog that is hidden. To
avoid this dont switch desktops until you start to see the model build in Volume
Viewer.
A 3D model may be missing data when it is initially displayed. Slightly rotate the
model to re-display all of the 3D data.
CT Colon (Option)
Rotate and translate is missing in the CTC and Virtual Dissection protocols
SmartScore PRO Purchased Option

and 0.5second rotation speeds are valid for Prospective Gating.
A back slash (/) in the Patient ID for SmartScore exams will cause the patient report to
fail to print or be stored to floppy.
If the Confirm button is not available, select the Gating button and turn gating off and
click on Accept. Select Gating button, again, and turn gating on and click on Accept.
The Confirm button should now be available. Contact your local service
representative if you experience this issue for further investigation.
Advanced Vessel Analysis (Option)

AVA defaults to inferior view instead of Anterior after processing AVA. Use the
anatomical buttons to change the view to Anterior
AVA lumen view may show wavy lines while rotating. When the rotation is stopped
the display will update.
Dentascan
Do not use Extended CT Number range for images that will be processed in Dentascan. This
application does not support Extended CT Number range.

B-11
BMD
Do not use Extended CT Number range for images that will be processed in BMD on an
Advantage Windows or Mindways system. These applications do not support Extended CT
Number range.
CardIQ Snapshot Purchased Option

If a lead falls off during acquisition, the heart rate annotation will be inaccurate for
the portion of the acquisition after the lead falls off. Images reconstructed for the
complete acquisition using Snapshot Segment will initially display correct BPM for the
period of time the leads were connected, and then ungated images will be displayed
followed by images annotated with abnormally high heart rate where the leads have
fallen off.
If the Gating button is displayed in red and heart rate is seen, this is most likely due to
loose connection of the cable at the connection to the ECG monitor or the scanner.
Make sure you see a heart rate before you begin the scout scan.
CardIQ Snapshot Segment annotation is not displayed on the images displayed on
the Advantage Windows workstation. The average heart rate and the percent of R-R
interval will not be seen. The Cardiac Helical scan type will be annotated as Axial.
Snapshot Segment images can be networked to a PACS system, however due to an
error in the DICOM header, they can be retrieved from the GE PathSpeed PACS system
but the image annotation is wrong.
Multiphase protocols of Vessel Analysis and Heart MP do not load the images
correctly. Load the images first using the Tree MP protocol and then select new
protocol and change to the desired protocol.
The Lumen view may display Hit space bar to display high resolution view This will
be needed with views 15mm or less.
WW and Wl of screen saved MIP views may not have correct contrast. Adjust the WW
and WL to improve the image.
Batch film will not film images in the Cardiac Short Axis protocol. The images will
need to be manually filmed.
Layout protocols must be created with single phase cardiac data sets. Once saved
they can be used with multiphase cardiac data sets.
Auto Transfer
A series may fail to Auto Transfer if [Next Series] then [Create New Series] is selected after a
scout scan is prescribed, but not scanned, i.e.; pause and return to view edit is selected.

B-12
Display (Applies to ExamRx Display and Image Works)

The Exam Rx List Select and Image Works browsers may in some cases not list an
exam, series or image. This may be seen after an interruption of power to the system
or the database may be updating slowly. The patient does not need to be rescanned.
Verify the following:
Type the Exam, Series, Image on the accelerator line to display the image,
Select another exam in the browser this will cause the browser to update,
The browser may update after a slight delay,
Reboot the system,
A second reboot may be needed if a power fail has occurred.
The browser may update slowly to reflect Screen Save images created in an exam. If
the Screen Save images is not listed in the browser wait for them to appear. The time
to appear may be up to 15 minutes if the Automatic Database check and recovery is
in progress when the Screen Save images are created.
In general, wait for a display action to complete before entering in another
command.
With the system configured in French or German language, if a comma is entered in
explicit magnify, i.e. 2,3 the comma will not be interpreted as a decimal. The
magnification factor is applied without the decimal. In the example shown, 2,3 the
image would only be magnified 2X not 2.3X. Always enter a period to designate a
decimal and have the correct magnification applied.
Cross Reference lines will post incorrectly if sort by image location is selected. Make
sure that sort by number is selected before posting Cross Reference lines.
Cross Reference lines may not post with some combinations of DFOV and RAS center.
RAS centers at the edge of the DFOV and small DFOVs will exhibit the problem. Retro
reconstruct the images to a larger DFOV if posting of the cutlines is desired.
Image annotation may overlap or not be fully shown if a 32 character patient name
is entered for 3D, Navigator, Reformat, MID formats, DentaScan images.
Text and Series pages only display 24 characters for Patient Name.
Text pages will not show foreign characters entered using the ALT GR key.
ROI and STD deviation numbers may be reported as zero after a Zoom is applied to
an image with a ROI posted. This is due to partial pixel contained in the ROI. Adjust
the size of the ROI to include full pixels and recalculate the ROI.
No text will be entered in the accelerator line if the mouse cursor is over the film
composer.
Some combinations or E/S/I will fail to display an image, if cap locks are on. To select
an exam series and image from the accelerator line use the following format when

B-13
cap locks is on: For example to select Exam 576 Series 2 image 3 type E576 2 3 on
the accelerator line.
Selection of an exam series or image may fail a second time after an exam series or
image is displayed. If the desired exam series or image does not display then select
the desired images from the browser.
Image location seen on the scanner may differ from that seen on an AW 3.1 system
for tilted images. reports the image location as iso-center of the image. AW 3.1
reports image location as the image center for the image. With tilted images there
will be a difference in the location numbers proportional to the off center distance
times the sin of the tilt angle. The image location can be reported as image center on
by using the Report Cursor function.
Plus recon mode is not annotated on the Series Text Page. Refer to the image
annotation for the Plus recon mode annotation.
An active user annotation graphic will not film the box or arrow that is displayed on
the screen.
Exam Rx Display
Display may reset its self after a software problem. You may see display stop or not
accept your mouse input. Wait for a few seconds and display will automatically
reset. You will have to re-display the images you wish to work on.
The MIROI pop up may display but will not function. This will occur if an Auto View or
Cross reference viewport is in primary focus (blue border) MIROI is not in these
viewport types. Place a Free or Auto Link viewport in primary focus and reselect the
MIROI button to continue.
Any Report Pixel or MIROI chart that is not screen saved, but is filmed will show the
Exam Series and Image as 1000/1/1 on the film composer icon if E/S/I is selected.
This is the exam/series/image number the system assigns to this chart display The
patients exam number is listed correctly on the filmed image.
Image selection from the accelerator line will not function if the primary viewport
contains a MIROI plot or Report Pixels chart. Use List Select to display a new image.
Any accelerator commands entered for Series Binding, Annotation levels for display
or filming will be saved as defaults
ExamRx Display may hang. In some cases switching to the Image Works desktop and
back to Exam Rx display may clear the problem. If this doesnt work then perform a
system shutdown and reboot the system.
Display may post the Print Series dialog and hang when switching layouts and using
the trackball. This may lock the cursor. A system power cycle will be needed to
recover.
The Trackball may fail to initialize properly at system reboot. Try rebooting the
system again to recover.

B-14
Images recond with Priority recon are not available in the Auto Link viewport.
Re-display the series to access these images.
MIROI may fail to produce a graph if next prior is selected while doing MIROI.
Re-display the series and begin again.
With paging active (P in the lower left corner of the image) the trackball may adjust
window width and window level in other viewports, verify the image has the correct
window level before filming the image.
The right mouse may fail to roam even when the state is set to roam. A system
shutdown may be required to clear this problem.
Display may crash when selecting a 3D object from the list select browser. When a 3D
object is selected, 3D should be selected from the browser.
Images may not be displayed after a switch between Auto View or Image Review
layouts. This is due to a restart in the display process. Re-display the desired images
in the viewport to continue.
Image Works Display

WW and WL adjustments will only be maintained on individually selected images if
the middle mouse button is used. If the accelerator line or Presets are used all images
will update regardless of primary or secondary focus of the images.
Any accelerator commands entered for Series Binding, Annotation levels for display
or filming will be applied and not held if the viewer is closed. Use User Preferences in
the viewer to save the settings as a default if desired.
Reference Image may select the wrong scout series, i.e. not the scout series the
images were prescribed from, if one or more scout series exists. If the wrong scout is
selected place the Reference Image viewport in primary focus and enter the scout
series number desired on the accelerator line.
Window/Level does not display stored value set in the Viewer when +/- series is used.
The W/L used is the same as the last series displayed.
Images created in Add/Sub are displayed with value of WW 4098 and WL 1024.
If paging is selected while the system is in Compare Mode, the upper left viewport is
left blank. Return to the Browser and select the desired series for paging and restart
the Viewer.
Accelerator Command Line entries for E/S/I do not act properly. The first image in the
series is always displayed instead of the requested image within the series.
Cross Reference line numbering along the top of a sagittal scout may be listed in
offset manor.
The new features in User Preferences on the Image Works desktop are not
translated.

B-15
The primary focus may change if the space bar is selected multiple times when
entering accelerator line commands. Verify that primary focus is on the image
desired.
Edit Patient Data

The system may hang if Edit Patient is started while the following operations are in
progress:
Network Receive
Prospective or Retrospective reconstruction is active
Archive Restore
To avoid this, confirm Edit Patient during idle times in network receive, active recon or
archive restore.
Patient age may be seen as zero in Edit Patient Data even though a birth date is
entered. Enter the birth date again and patient age will be calculated.
If duplicate accession numbers exist, Edit Patient Data will not allow the exam to be
modified.
If there is a space at beginning or end of the hospital, Edit Patient Data will fail.
Contact your field engineer to update the hospital name correctly in the system
reconfiguration.
Filming
Images or Auto Film control buttons may fail to display in the AutoFilm viewport. This
may occur after a switch between desktops. To display the images change to a
different AutoView layout, then switch back to your desired layout.
Dont let the auto film viewport back up with images to be filmed. Start Auto Film as
soon as possible to keep caught up on filming.
Any of the Auto Film control buttons may be activated when the cursor is over the
button and the space bar is selected. Place the cursor in the Auto Film viewport only
when needed to avoid this problem.
Auto Film may fail to film. This may occur when the Auto Film viewport selection
shows active and the Auto Film status shows paused. Toggle the [Pause] button in
the Auto Film viewport and select [Start New Sheet] or [Continue Same Sheet] to
restart filming.
Image settings such as WW WL and flip rotate, zoom, roam are not maintained
across all images when imitating F4 print series from a MID Viewport format. Use a
512 size viewport to initiate F4 Print Series.
Auto Film may stop and the Continue Same Sheet button will be displayed. The
Continue Same Sheet button will be active, but when selected will not restart filming.

B-16
Use Manual Film to complete filming the exam and reboot the system before starting
the next exam
If the F1 key is used to film the Text Page ROI, Exam Text Page and Series Text Page,
the text pages will be filmed to the film composer last selected in the pop-up for text
page. Use the filming selections in the text page screens to film the information
displayed.
The message Film formatting in progress. Please retry. May be seen when filming to
the Manual Film composer when the system is busy with other simultaneous
operations such as recon, network, auto film and scanning. Retry manual filming
when the system is less busy. A system reboot may be required to recover.
Auto Film may fail to display images if recon is having trouble reconstructing the
image or if images have failed to install in the database. This may also occur if a large
exam has not reconstructed all images and scanning is started on a new exam. The
following dialog will be posted if Auto Film cannot display images:
Exam 100
Series 2
Cannot find 10 images
Skip Missing imagesContinueCancel Film Series
You are presented with 3 choices:
1. Skip Missing images will skip the images that Auto Film cannot find. For
example if Auto Film had filmed images 1-10 and you then got the message
that 10 images were missing and selected Skip Missing Images, Auto Film
would then start filming again with image 21.
2. Continue will look for the images again, if they are not found then the dialog
will be posted again. Before selecting continue verify that recon is active, that
the images have been reconstructed, the missing images are not suspended
or paused in the Recon Queue and the images are able to be displayed. If the
images are suspended or paused in the recon queue, then unsuspend or
restart recon to reconstruct the images before selecting Continue.
3. Cancel Film Series will cancel Auto Film for the series currently being Auto
Filmed. The images will then need to be manually filmed.
If you get this dialog because you have begun an exam while the previous exam still
has images to reconstruct, then Select Continue and select Pause Auto Film, resume
Auto Film when the Exam Series and Images from the previous exam have
reconstructed.
When prescribing Mag factor for auto film, scout images if the scout is longer than
500 mm then use a magnification factor less than 1 to display the entire scout.
The manual film composer may display when confirm is selected for scanning if the
composer had been closed by selecting iconify in the upper right corner of the
composer.

B-17
Its best to run Print Series from only one desktop at a time.
Its best to resolve any paused queue entry as soon as possible.
Print Series may pause automatically under heavy system load.
If Anonymous Patient is selected for an exam where Auto Film is in progress, the
system may fail to cross reference the slices on the scout. If Anonymous Patient is
required for series that are still active in Auto Film, wait till Auto Film is complete for
the series before proceeding with Anonymous Patient.
To install a SMPTE pattern select the following. Once installed the images will be
available for viewing from the Image Works browser or List Select in Exam RX. And
will be listed as Exam 1000. The patient Name will be listed as SMPTE.
Click Service Desktop.
Click [Diagnostics].
Click [Display Processing].
Click [Install SMPTE Image].
Full Annotation instead of partial annotation will be filmed when using F3 (Film MID)
in the Image Works desk top when full annotation is selected.
The format built in a protocol may be changed when the protocol is used with a
message that the format was changed due to an invalid format, even though the
format is valid. Verify in Auto Film set up is the format you desire before confirming
scan.
For Multi-Image Display (MID) in AutoFilm, filters, gray scale and orientation
selections are applied only to the image in the upper left viewport. If there are an odd
number of images in the series, the filters, gray scale and image orientation is
applied to the first group only.
Network
images will not transfer if Advantage Net protocols is used. Always use DICOM
protocol to send images.
images cannot be sent to a HiLight Advantage, HiSpeed Advantage or CT
Independent console. These systems do not support DICOM receive.
Some 3rd party workstations may fail to receive scout images. This is due to the
matrix size of the scout image. These stations do not support receiving matrix sizes
greater than 512. Some scouts images have matrix sizes greater than 512. If it is
desired to have the scout image on the workstation, Screen Save the scout and then
transfer the screen save image to the workstation.
If you query a system from a CT/I or Advantage Windows system in Advantage Net,
only Advantage format image exams will be displayed, No exams will be shown.
Always query a system using DICOM protocol.

B-18
Lateral scouts displayed on an AW 3.1 system will initially display with zero rotation;
they should display with a 270-degree rotation. Rotate the image in the left direction
using the rl command on the command line to display the scout in the desired
format.
Images networked to a Advantage Windows 3.1 workstation running software
versions prior to 3.1_07 will display a DFOV less than what is displayed on the
scanner. This is due to the AW not taking in account the pixels under the focus border
of the viewport.
Images networked to a AW 3.1 will have the following annotation missing:
Accession number,
Date of Birth,
4i, 2i or 1i recon mode on Axial, Retro Axial or Axial Reformatted images,
Series type on Retro images,
Table Speed on Helical images,
Images are annotated +C when Oral Contrast is used. View the Series Text Page to
see if IV contrast was used.
CardIQ annotation for BPM and percent of R-R interval and scan type will
displayed as Axial.
The number of images indicated in a series may be incorrect on the remote browser
when a query is made from an AW or CT/I station.
Series types may be listed differently when images are networked to an Advantage
Windows 1.2, 2.0 or 3.1 system than that shown on the system
Exams with Swedish, German or French characters in any Patient Info field will not be
transferred to an Advantage Windows.
When using DICOM protocol, the entered host name must match in spelling and case
sensitive, otherwise a connection error message will be displayed.
Its best to resolve any paused queue entry as soon as possible.

B-19
Image management
Dont let image space fall below 200 images on a single disk system (130,000-image
storage). This will ensure there is room on the system disk to confirm scans and to
Remove images when scanning is idle. This will assure that all images are
reconstructed, displayed and installed into the database.
Exams that contain SmartStep may fail to remove. Reboot the system to remove the
lock on the SmartStep series.

B-20
Appendix C
Operator Messages
Introduction
This appendix lists user messages that are posted to the user interface. These message are
displayed in one or more of the following areas
Figure C-1 Attention pop up dialog

C-1
Figure C-2 Real Time information area of the scan progress screen on the left monitor
Real Time
Information
Area
Figure C-3 OC message bar on the View Edit screen of the left monitor
OC Message Bar

C-2
Figure C-4 Message area of the Feature Status Area on the right monitor
Message Area
The following table list the messages.

Table C-1 Warning Messages
Operator Message
Translation
Your patient orientation has changed from the

previous series. Please verify or change the
orientation if needed.
Tube Warm-up has been cancelled or skipped.
Maximum mA allowed will be limited for this
exam.
Small focal spot will be limited to 250 mA.
Large focal spot will be limited to 500 mA.
Select End Exam and run Tube Warm-up from
Daily Prep to enable the full mA range capability.
The table landmark has been changed. This
changes the location of all scans you have
prescribed. Double check all scans locations
before you start scanning.
WARNING: This series contains one or more

WARNING:
groups with multiple scans at the
same tomographic plane, i.e. same
location. Minimum diagnostic delay is
seconds the time of a monitor scan.
Do you wish to continue?

C-3
Operator Message
Translation
WARNING: This series contains one or more

WARNING:
groups with multiple scans at the
same tomographic plane, i.e. same
location. Temporal interval for
images exceeds 3 seconds. Use of this
data for processing of CT Perfusion
maps may contain errors in the
functional information.
Do you wish to continue?
Biopsy has disabled automA. Please verify or
change the mA as needed.
The dose for the new scan is greater than the
maximal possible value. Do you wish to continue?
Unrecognized tube in use - Dose may vary. The
reported dose information is calculated based on
empirical observations of systems with GE
Medical Systems tubes.
GE cannot assure the accuracy of reported dose
information for any configurations that include
tubes other than GE Medical Systems tubes.
The detector is not at the proper temperature
please allow approximately minutes for the
detector to come to temperature.
If you wish to proceed with this scan select the
"OK" button, however IQ maybe degraded
including image artifacts.
AutoMa has been disabled. It can be enabled
again once patient orientation matches with that
of the last scout series.
The prescribed mAs for Group % is greater than
mAs limit for this tube, decrease mA to mA.
The scan database is corrupted.
If you continue to use the system you might
propagate the corruption.
Please shutdown and restart the system in order
to automatically recover the database.
Please confirm that there is no beam obstruction.

C-4
Operator Message
Translation
The Daily Image Quality Check Test has detected

a condition that may result in an image with
unacceptable image quality.
Please call GE Service and request a more
thorough evaluation of your system's condition.
Multiple patient entries are found. Please select
the appropriate patient from the Select Schedule
Patient screen.
Failed to Acquire Scan Hardware.
This is probably because:
New Patient is started in the ExamRx screen, or
Some other tool is already scanning, or
The application firmware is not downloaded to
SBC, or
Some other problem with the scan hardware.
Please correct the problem and try again.
Held Control Communication Failure:
There has been some communication error
detected for the Hand Held Control Unit. Please
Check the Connection and reconfirm Rx.
Firmware reset occurred. Please wait until reset is
completed.
To continue, you may have to reset the landmark.
However, the new landmark could be different
from the previously set landmark.
Firmware reset occurred during scanning. The
current exam cannot be completed. You may
obtain information on completed scans by
returning to view/edit.
Please select end-exam when ready. New-patient
button will be available when the firmware reset
is complete.
Recon Self Test detected reconstruction errors.
You will not be able to scan because no
calibration information is available.
Try pressing |End Exam| followed by |New Patient|.
This will cause ScanRx to attempt to read the
calibration database again.
Cardiac hardware is malfunctioning and has
been disabled.
Please check the connections and re-enable
gating on the View/Edit screen.

C-5
Operator Message
Translation
Can't perform cardiac gated scan.

Cardiac hardware is malfunctioning and has
been disabled.
Please check the connections and re-enable
gating on the View/Edit screen.
WARNING: Please remove any obstruction in the WARNING:

path of the beam.
WARNING: Converter boards have changed.

Please first run DAS Gain Cal before
running Collimator Cal.
WARNING:
WARNING: Collimator Cal failed but scanning can WARNING:

be done with the pre-existing valid
calibration.
If this error repeats over several days
call service. Fast Cal continues
WARNING: Clever Gain Air Calibration failed to WARNING:

get tracking Statistics. Tracking may
have been turned off.
Exit Fastcal and try again. If this
problem persist, call service.
WARNING: Fastcal may not have been performed WARNING:

within the last 24 hours.
Image generation has been delayed! SmartPrep
cannot continue.
Monitor phase scanning has been paused.
Please proceed to the scan phase by selecting
the "Scan Phase" button at your discretion.
The SmartPrep clock continues to show the
elapsed time since the contrast injection began.
Use this clock to determine when to proceed to
the scan phase.

C-6
Operator Message
Translation
The Mylar Window check has detected that the

window is not clean.
A dirty mylar window may affect the calibration
and cause Image Artifacts. Please clean the mylar
window.
Hit Continue to go on with FastCal without
repeating the check or hit Retry to repeat the
check and confirm that the mylar window is
clean.
The DAS Gain Calibration has not been run since
the DAS Converter boards were changed.
Please call the FE or GE Cares center for more
information and help.
It has been over 96 hours since the fastcal was
done.
Zslope calibration fails robustness test. Please
call service.
Unable to determine if need to run auto mode
Zslope Calibration due to access to the
FastCal.cfg has failed.
Press the [OK] button to continue the Fastcal.
Please call service for Fastcal configure file
problem.
WARNING: Scan Manager Configuration Has

Non-Patient Scanning Options
Enabled!
WARNING:
WARNING: Scan Manager Configuration Has

WARNING:
Beam Tracking Disabled! Scanner Is In
High Dose Mode.

C-7
Operator Message
WARNING: Gantry Balance Check must be

performed.
Translation
WARNING:
Pressing OK will cause 2 automatic

gantry rotations with 1 minute
separations.
Make sure Gantry is clear of all
obstructions and click OK.
The Gantry Balance check process
will take about 4 minutes.
Gantry Balance Check is executing. This process
will take about 1 or 2 minutes.
Gantry Imbalance Condition Detected.
Image Quality May Be Compromised.
Perform Gantry Balance or Call GE Service
Gantry is out of Balance.
Calibration is Aborted.
Call Service.
Software has detected an invalid DAS
configuration. Please reconfig to correct. If
condition persists after Reconfig call GE Cares.
Reconstruction process has stopped.
Scanning is possible but no images will be made.
Restart the system.
Please contact GE service.
Reconstruction times will be slower.
Scanning can continue.
None of the Image Generation nodes are
functioning. The system is still operational.
However, recon performance may be degraded.
All of the images from a scan that is currently
being reconstructed are suspended.
The Scanning Hardware is not available; please
wait for the hardware reset successful status
posted in the feature status area on the right
monitor.
If the hardware reset fails, then reset the scan
hardware from the Service Desktop System
Resets button.

C-8
Operator Message
Translation
A scan disk array failure was detected.

Please call GE Service to schedule repair of the
scan disk array.
To continue scanner operation now, you may
rebuild the scan disk array with less storage
capacity.
If you rebuild the scan disk array, all scan data on
the current disk array will be lost.
Are you sure you want to rebuild the scan disk
array?
Unable to verify system functionality on startup.
Please power cycle the console.
If the system fails to startup after the power
cycle, then please call GE Service.
Protocol file is corrupted. Please correct using
method below or contact your GE Service
Representative.
Restore protocols - this will replace all
protocols in "User"
Using the most up to date copy of the Protocol
DVD disk or System State disk
From Service Desktop select "Utilities" then
"System State"
Now select "Protocols" and then "Restore".
An unrecognized X-Ray tube has been installed
on the system.
GE Medical Systems cannot assure that the
system performance will conform to
specifications.
Advisory messages will be posted to the
operator about an unrecognized tube during
tube warm-up, during Fast Calibration, and in
the dose report.

C-9
Operator Message
Translation
The system has been configured to recognize a

GE Medical Systems Tube. A %s-day period from
the date of tube installation has been granted to
allow time to manually verify the tube identity.
Please call GE Medical Systems to dispatch a
Field Service Engineer (FSE) to verify the tube
configuration. Please allow a minimum of 10 days
for the FSE to schedule verification. Verification
should take no more than 30 minutes. If a GE
Medical Systems FSE does not verify the tube
identity within %s days, the system will revert to
an "unrecognized tube" status, resulting in the
following:
GE Medical Systems cannot assure that the
system performance will conform to
specifications.
Advisory messages will be posted to the
operator about an unrecognized tube during
system startup, during tube warm-up, during
Fast Calibration, and in the dose report.
Scan disk array performance is degraded by one
or more hard drive failures. Your scan data
storage is reduced because of this.
Please contact GE service to have the disk array
repaired as soon as possible.

C-10
Operator Message
Translation
New software updates are available and ready to

be installed on your scanner. These software
updates provide system enhancements and
corrections to ensure optimal system
performance and security. All updates have been
developed and validated specifically for your
hardware and software configuration. By
downloading these software updates, you agree
to and are bound by the Terms and Conditions of
Sale for GE Medical Systems Products. The
updates are expected to take approximately to
install. For additional information regarding the
updates: Contact your Customer Service Center
or choose "Install Later" (you will be prompted on
subsequent re-boots with this dialog), go to iLinq,
Under Software Updates review data for updates.
If you have questions or concerns, please contact
your local Service Engineer or Customer Service
Center. Do you want to install software updates
now?
The following patch(es): require a system reboot
after install. The reboot will occur in 10 seconds.
2005 General Electric Company
Installing Software Updates...
Please wait while the system updates are
installed... Estimated time required to install
updates is approximately
The software update installation started at __.
Update Installation Failed!
The following updates failed to install.
Please restart your system and initiate software
update again, or notify the GEHC On-Line Center
that the install failed.
Revert back to the original configuration, skip
installation and notify GEHC On-Line Center that
the install failed and create dispatch for FE
follow-up.

C-11
Operator Message
Translation
Automatic Software Download & Install

Capability Exists for your scanner! This GE
exclusive capability leverages the power of your
Insite Broadband connection to deliver the latest
software updates to your system as soon as they
are released. The updates are downloaded
automatically and the option to automatically
install them is provided during system start-up.
Only GEHC developed and validated updates are
distributed via this tool. For an overview of this
capability, Please review the Software Download
Topic on iLinq.
Automatic Software Updates
Continue (time out after 20 seconds)
Try Again
Skip Install
please wait ....
The detector is not at the proper temperature. If
you wish to proceed with this scan select the "OK"
button, however IQ maybe degraded including
image artifacts.
Please contact GE Service.
The detector is too hot.
No scanning allowed.
Please contact GE Service
A system communication failure has occurred
which will prevent scanning.
Please contact GE Service.
System has detected that firmware is down.
This will prevent scanning.
ScanRx could not be started because it could not
communicate with scan database. The system
has to be shut down and restarted.
Patient placements in series are different.
The landmark is not set.
Patient orientation now differs from when last
scanned.
A localizer(s) is invalid for this prescription.

C-12
Operator Message
Translation
Unable to locate existing Patient Information.

Failed to enable Hand Held Control Unit. Please
Check connections.
Exposure Time was changed to System Maximum
Allowable value.
Exposure Time was changed to Tube Cooling
Maximum Allowable value
Tube has reached the highest allowable
temperature, Tube Cooling Optimization is
required.
Table height has changed - No timing graph will
be displayed in SmartPrep.
The SmartPrep timing graph will not display due
to a mismatch between the system and
reconstruction engine clocks. After the exam is
complete, contact service to synchronize the
clocks.
System rounded Patient Weight in pounds to the
closest value in kilograms.
System adjusted patient weight to be within
allowable weight range.
Scan Request is not possible due to tube cooling.
No up front delay is possible.
The system will apply an up front delay prior to
scanning.
Scan Request is not possible due to tube cooling.
Lower mA or kV to enable scan.
Start/End location(s) were changed due to
landmark position.
More than 2 hours have elapsed since the last
scan. Tube needs warming.
The Smart Prep Baseline image failed. Please try
again.
Can not start Monitor Phase while interacting
with the Baseline image.
Unable to set Alignment location. Landmark not
set or table needs to be referenced.

C-13
Operator Message
Translation
Dose information database is uninitialized. Please

see Error Log for Details.
Detector Temperature Is High. Image quality may
be affected.
Detector Temperature Is Low. Image quality may
be affected.
WARNING: Backup Timer stopped scan. X-ray

stayed on longer than prescribed.
WARNING:
kV out of range. Potential for degraded image

quality.
AutoVoice Malfunction:
AutoVoice is disabled
until scanning is stopped.
Gantry Controls Horizontal In button is
non-functional.
Unlatch cradle to position patient.
Gantry Controls Horizontal Out button is
non-functional.
Unlatch cradle to position patient.
Gantry Controls Internal Landmark button is
non-functional.
Use the External Landmark button.
Gantry Controls External Landmark button is
non-functional.
Use the Internal Landmark button.
Gantry Controls Landmark buttons are
non-functional.
Scanning cannot continue.
Gantry Controls Stop Scan button is
non-functional.
Use the Console Stop Scan button.
Gantry Controls Start Scan button is
non-functional.
Use the Console Start Scan button.
AutoVoice and Breathing lights are disabled due
to operator intervention until scanning is
stopped.
Cradle is released.

C-14
Operator Message
Translation
Gantry Controls Cradle Release button is

non-functional.
Prep Delay: __ Seconds Remaining
Interscan Delay: __ Seconds Remaining
Tube Cooling Delay: Seconds Remaining
Operator Paused Scan
Operator Stopped Scan
Scanner Hardware Paused Scan
Scanner Hardware Stopped Scan
X-ray off scan is in progress. Press [Stop Scan] to
stop scanning
Prep Delay after [Start Scan] will be __ Seconds
Cradle is released. Latch the cradle to scan.
Table is below the scanning minimum.
Raise the table to scan.
Remote Tilt is Disabled due to Touch Sensor
Collision.
Scan position prescribed is no longer valid. Please
re-prescribe.
Cradle is released.
Cannot bring tube rotor up for __ seconds.

C-15
Numerics
3D Option 34-1
A
Accelerator Line 32-2
Accelerator Line Commands 32-11
Accept Negative Pixels 29-3
Active Annotation 34-48
Add Images Together 29-5
Addition 29-2
Adjust Graphic Rx 21-11
Adjust the Localizer 20-15
Adjusting a Protocol 21-2
AE Title 24-15
Analysis 19-14
Analysis of Results 19-9
Anatomical Selector 8-31
Annotate Image 32-5
Annotate the Scout With Scan Lines 32-4
Anonymous Patient 24-3
Archive 24-3
Archive Device 24-18
Archive Exams/Series/Images 24-22, 24-26,
24-28
Archive Node 24-16

Auto 24-4
Auto Detect 12-18
Auto Link 26-2
Auto mA 8-13
Auto Voice 21-14
Autostart 22-2
Autoview 26-2
Axial 8-2
Axial Detector Configurations 7-2
Axial Signal Collection 7-4
B
Backwards 1 16-18
Bar Code Reader 17-4
Bind Series 29-3
Biopsy Location 18-5
Biopsy Mode 18-2
Biopsy Reference 18-5

Biopsy Reference Scans 18-2

Biopsy Rx 18-2, 18-4
Blue Frame 26-9
Brain/Bone Interface 28-7
Brain/Bone Interface in Image Works 28-14
Breath Hold 21-13
Breath Hold Delay 21-2
Breathe Time 21-13
Bright box 5-25
Build or Edit a Protocol 8-41
Building Protocol 8-11
C
Calibrations 6-3
Cancel Film Exam 22-8
Cancel Film Series 22-8
CardIQ SnapShot 12-26
Check Network History 24-36
Cine 8-2, 25-9
Cine Loop 25-9
procedure for PET-CT RT and CT-RT 19-11,
19-12, 19-14
Analysis 19-14
Procedure 19-12
Clinical table lateral motion verification
Analysis of Results 19-9
Comb 29-3
Comments 24-15
33-19
Completed Records 17-2

Confirm Biopsy Rx 18-6
Confirm the Localizer (Scout) 20-17
Connect Pro 17-2
Continue Same Sheet 22-8
Contrast 20-3
Copy and Paste Protocols 8-67
Copy Protocols 8-67
Create 24-43
Index-1
Create a New Image

Using Only the Maximum CT Number 29-8
Using Only the Minimum CT Number 29-9
Create Anonymous Patient 24-43
Create New Images from Scan Data 33-6
Cross Reference 32-2
CT Safety 3-7
CTDIw 3-12
Curved View Type 34-53
Custom Search 24-17
D
Delete a Protocol 8-70
Delete an AutoVoice 8-66
Delete Exams/Series/Images From the
System 24-45
DFOV 21-18
Direct Visualization 13-1
Direct3D 13-2
Curves selection 13-15
Display factors 13-16
Review mode 13-17
Selecting curves 13-15
Display
Exam Information 32-6
Parameters of a Scan Mode 32-7
Display Factors 21-18
Display Field of View 21-18
Display Normal 28-8
Display Normal in Image Works 28-15
Dose 3-12
Accumulated Exam DLP 3-12
Dose Length Product 3-12
Projected Series DLP 3-12
E
ECG 12-16
ECG Waveform 11-2
Edit 24-39
Edit a Patient Schedule 17-14
Edit Patient Information 24-38
Edited by Field 24-41
Editing Protocols 8-12

EKG 12-16
EKG Waveform 11-2
Era Year Entry 20-4
Exam Prescription for Prospective Gating 11-6
Exam Rx 5-20
F
F Keys 23-2
Fast Cals 6-7
Feature Status Area 24-2
Feature status area 5-20
Filming 24-3
Flip/Rotate 28-5
Flip/Rotate in Image Works 28-12
Forward 1 16-18
Full System Calibrations 6-3
G
Gantry
Display 5-7
Gantry controls 5-8
Gating Check 20-15
Get 24-34
Get Alignment Light Location 18-5
Get Examination 24-34
Get Images 24-34
Get Series 24-34
Graphic conventions 2-2
Graphic Rx 21-11
Gray Scale Enhancement 22-2, 28-2
Guidelines For mAs 7-6
H
Hand Held Controller Button Descriptions 16-4
Hardware Components 7-2
HD MIP Render Mode 34-13
Head SFOV 21-9
Helical Pitch and Scan Mode Definitions 7-4
HHC 16-3
Hide or Show Graphics 32-8
Host 24-14
How to 3D Images 34-46
Index-2
I
iLinq 5-20
Image 24-2
Addition 29-2
Matte 28-10
Sharp 28-6
Smooth 28-6
Subtraction 29-2
Image Filters 22-2, 28-2
Image in Image Works
Matte 28-16
Sharp 28-13
Smooth 28-13
Image Magnification 30-5
Image Orientation 28-5
Image Orientation in Image Works 28-12
Image Works 5-20
Make the image smaller or larger 30-8
Move the image around the screen 30-7
Scroll 30-7
Zoom 30-8
Integral Render Mode 34-13
Interscan Delay (ISD) 21-13
Interventional / Biopsy Scanning 3-30
Inverse Video 28-9
IPPS Lok-Bars 19-11
IVY Monitor Recommended 3 Lead Placement
12-25
K
kV 21-9
L
Label an MOD 24-20
Large SFOV 21-9
Lateral Motion Verification 19-2
Limited Access Room Configuration
3-37
Localizer 20-15
M
mA 21-10
Managing Images 24-1
Manual Detect 12-18
Manual Film Composer Parameters 23-5
Manually Add an Image to the AutoFilm
Composer 22-9
Matrix Size 8-54
Matte
ematte 28-10, 28-16
rmatte 28-10, 28-16
Maximum Pixel Value Extraction 29-2
Measure from Point to Point 31-2
MedTec RT alignment device 19-11
Min IP Render Mode 34-13
Minimum Pixel Extraction 29-2
Mini-Viewer 25-2
MIP Render Mode 34-13
Monitors 5-18
Mouse 5-24
Multiple Image Display 26-6
N
Negative Pixels 29-3
Network 24-3, 24-4, 24-14, 24-31, 24-32, 24-33,
24-36
Network History 24-36

Networking Terms 24-4
New Records 17-2
No Autostart 22-7
O
Optimizer 21-3
P
Paging 25-2
Patient Information 20-6
Patient Preparation 12-26
33-13

Index-3
Patient Schedule 17-2

Add a Patient to the Schedule 17-9
Check the Status of a Patient 17-19
Delete a Patient From the Schedule 17-11
Edit a Patient Schedule 17-15
Select a Patient from the Schedule 17-17
Set Up Preferences in the Schedule 17-12
Update Patient Schedule 17-7
17-20
Pause Filming 22-7

Pause Images from Reconstructing 33-15
Ped SFOV 21-9
Pediatric Protocols 8-27
Perform Air Calibrations 6-7
Perform Tube Warm-Up 6-5
Performed Procedure Step 14-2, 24-4, 25-3
Performed Procedure Step (PPS) 14-1, 15-1
Phase Location 12-19
Ping 24-32
Pitch 12-19
23-6
PMR 8-10
Port Number 24-15
Position the Patient 20-11
Power Distribution Unit 5-4
PPS 14-2, 24-4
Prep Delay 21-13
Prepare a storage media for use 24-20
Prerequisite Skills 2-1
Preset Window Width and Window Level Keys
23-4
Primary Viewport 26-9

Print Series 23-7
Proc 29-3
Procedure 19-6, 19-12
Prospective Gating 11-1, 11-2
Concepts 11-2
Setup exam prescription 11-6
Protect/Unprotect Scan Data 33-20
Protocol Management 8-41, 8-67, 8-70
Protocols 20-2

R
R to R interval 11-2
Ratio Slider Bar 29-3
Raw Data 33-2
Ray Sum Render Mode 34-13
Recommended workflow for RT 19-2
Reference Image 25-11
Reformat
Creating a Histogram View Type 34-58
Creating an X Section View Type 34-61
Releasing Scan Data 33-3
Remote 24-4
Remove Graphics From the Image 32-9
Remove Images from the Reconstruction List
33-17
Remove Patient Information from an Exam

24-43
Render Modes 34-12

Repeat a Series 21-25
Requirements 19-11
Reserving Scan Data 33-3
Reset 24-41
Restore 24-24
Restoring Raw Data 33-3
Restoring Scan Data 33-3
Results 19-7, 19-14
Resume Image Reconstruction 33-16
Retrieve Exams/Series/Images 24-24
Retrieve Exams/Series/Images from Another
Computer 24-33
Retro Recon 12-66, 12-70, 12-74, 12-78, 12-82,
12-87, 12-91, 33-6
R-Peak Value 12-19
S
Safety 3-1
Safety Notices 2-4
Save an Image Screen 32-10
Save/Restore Scan Data 33-18
Saving Raw Data 33-2
Saving Scan Data 33-2
Index-4
Scan
Baseline Phase 9-9
Monitor Phase 9-11
Scan Phase 9-13
Scan Data 33-2
Scan Parameters 12-26, 21-5
Scan Type 21-5
Scout 20-15
Screen Save 32-2
Scroll Through A Set of Images 25-8
Secondary Viewport 26-10
Select a Protocol 20-13
Select an Archive Device 24-18
Selecting an Image Set 34-66
Send
Exam, Series, Image 24-32
Send images to the Manual Film Composer
23-6
Series Binding 29-7

Set an Access to a Local Host 24-17
Set up a Remote Host 24-14
Set Viewports
Automatic display of next series 26-8
Images to display in order 26-7
Set Window/Level Presets for the HHC 16-20
Setting Scan Field of View and Display Field of
View 21-2
Setting Up a Patient without an ID# 20-3
Setup Patient Information 20-6
SFOV 21-9
Show Localizer 21-11
Show Recon 3 21-22
Shutdown 5-41
Side view of QA device and weights placement
19-12
Side view of table 19-7

Slice Profiles 7-7
Small SFOV 21-9
SmartPrep 9-2
Baseline Phase 9-2
Monitor Phase 9-2
Scan Phase 9-3
SmartPrep Parameters 9-2, 9-5

SmartStep 16-1
Backwards 1 16-18
Display 16-6
Display SmartStep Images 16-14, 16-17
Forward 1 16-18
Hand Held Controller (HHC) 16-3
Hand Held Controller Button Descriptions
16-4
Last Image 16-18

Prepare for SmartStep 16-9
Scan with SmartStep 16-14
16-20
SmartStep 16-3
SnapShot Cine Parameter 12-31, 12-33
Sort 27-6
Sorting 27-3
Specify a Zoom Factor 30-5
Start New Sheet 22-7
Startup 5-41
Subtract Images 29-6
Subtraction 29-2
Suspended Entries 33-2
System Options 8-12
T
Timing Bolus Scan for cardiac scanning 12-29
Timing Parameters 21-13
Transfer 24-4
Transfer Exams/Series/Images 24-31
Transmit 24-4
Tube Warm-Up 6-2
Type Text on the Image 32-5
U
Update the Reconstruction List 33-17
Use Performed Procedure Step 14-4, 15-5
Use VariSpeed 10-4
User Interface
Helical 7-6
User Preferences 32-2
Users conventions 5-26, 5-27
Index-5
V
VariSpeed 10-2
Video Reverse 28-9
View Edit 21-5
Viewer 25-2
Viewing Protocols 8-12
W
Window Width and Level Presets 23-2
Y
Yellow Frame 26-10

Index-6

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GE Healthcare

Learning and Reference Guide

This product is certified as a LightSpeed Multislice CT Scanner.

REASON FOR CHANGE

First Release for Discovery CT750 HD

Updated information from HII Logs

Discovery CT750 HD 5308208-1EN Rev. 2 (10-08)

Chapter 1: Product Manufacturer

Discovery CT750 HD 5308208-1EN Rev. 2 (10-08)

Interventional / Biopsy Scanning.............................................................................. 3-30

Chapter 4: Imaging Pediatric and Small Patients

Discovery CT750 HD 5308208-1EN Rev. 2 (10-08)

Make a Kid Friendly Environment................................................................................4-6

Chapter 5: Getting Started

Discovery CT750 HD 5308208-1EN Rev. 2 (10-08)

Add a Local User ............................................................................................................. 5-53

Chapter 6: Daily Maintenance

Discovery CT750 HD 5308208-1EN Rev. 2 (10-08)

Chapter 7: Multi-Detector Information

Chapter 8: Building Protocols

Discovery CT750 HD 5308208-1EN Rev. 2 (10-08)

ECG Trace (Option) ................................................................................................................... 8-31

Chapter 10: VariSpeed

Discovery CT750 HD 5308208-1EN Rev. 2 (10-08)

Chapter 11: Prospective Gating (SmartScore) (Option)

Chapter 12: Cardiac Imaging Discovery CT750 HD

Discovery CT750 HD 5308208-1EN Rev. 2 (10-08)

ECG Viewer/R-Peak Editor Overview............................................................................ 12-36

Chapter 13: Auto Applications (Option)

Discovery CT750 HD 5308208-1EN Rev. 2 (10-08)

Select Preset Curves for Direct3D.................................................................................. 13-15

Chapter 14: Performed Procedure Step (PPS) (Option)

Chapter 15: Exam Split (Option)

Chapter 16: SmartStep (Option)

Chapter 17: Scheduling Patients

Discovery CT750 HD 5308208-1EN Rev. 2 (10-08)

Connect Pro................................................................................................................................. 17-2

Chapter 18: Biopsy Mode

Chapter 19: X-Y Table Accuracy Procedure

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Clinical table elevation adjustment verification procedure

Chapter 20: Patient Setup and Scout Scan

Chapter 21: Scan Series Setup

Chapter 22: Automatic Filming

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Gray Scale Enhancement ..................................................................................................... 22-2

Chapter 23: Manually Filming Images

Chapter 24: Managing Images

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Save Exam/Series/Images using CD/DVD Interchange Option....................... 24-28

Chapter 25: Viewing Images

Chapter 26: Image Display Viewing Area

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Set a Primary Viewport .......................................................................................................... 26-9

Chapter 27: Sort Examinations and Images

Chapter 28: Image Manipulations

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Create a Gray Scale Presentation State Object (GSPS)........................................ 28-17

Chapter 29: Image Addition/Subtraction

Chapter 30: Magnifying Images

Chapter 31: Measuring Structures Within an Image

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Chapter 32: Graphics, Text Pages and Commands