Siemens VB 13C Operator Manual

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C-arm keyboard

mAs mA min

ARCADIS Varic

VB 13C

Quick Guide

ROAD

SUB

MAP

top/lateral row of keys

Lift/lower C-arm

Switch ADR stop

on/off

Reset f luoroscopy time

bottom row of keys

Operating modes:

-Pulsed fluoroscopy

- Continuous fluoroscopy

Powe r m od e Enlarge live image

Noise reduction Image reversal

Open/close iris diap hragm

Open/close slot

diaphragm

System OF F Edge enhance-

B B

Reduce/increase kV and mA

Single-tank laser light localizer

Rotate image

SUB

- Subtraction

MAP

-Roadmap

-Digital radiography

left/right o r top/bottom

Rotate slot diaphragm

Radiation indicator Tube unit temperature

Operating modes:

ROAD

ment

A B

Enlarge stored images

Contrast adjustment left/rig ht monitor

Read images from

memory forward/ backward

Monitor split horizontal/vertical

Save im age

Print image

Monitor trolley symbol keypad

Brightne ss - Brightness +

Contrast - Contrast +

Scroll study back Scroll study

Scroll series back Scroll s eries

Scroll image back Scroll image

Switch between negative and positive image

Enter a study comment

Copy to film sheet Call up Patient

Call up the Patien t

Browser

for ward

Send to node 1

Mark an image

Registration

This product is provided with a CE marking in according with the regulations stated in Directive 93/42/EEC of June 14th, 1993 con

cerning medical devices. The CE marking applies only to medical devices which have been put on the market according to the above-mentioned EC Direc

tive.

The original language of this document is German.

This Quick Guide is available in German, English, French, Italian and Spanish.

ARCADIS Varic Quick Guide

Introduction

We welcome you as a user of the powerful ARCADIS Varic C-arm system from Siemens. This clearly laid out Quick Guide is intended to guide you through the operation of the sys tem.

The Quick Guide is valid only in conjunction with the Operator Manuals and the safety information they contain:

❏ Please observe the Operator Manual

and all supplements/addenda

❏ Please observe all safety information

The right-hand pages contain step-by-step instructions corresponding to the typical workflow in the OR.

The pages to the left contain illustrations and and supplemental notes.

The description focuses on easy and fast operation of the ARCADIS Varic from startup through to shutdown of the system including optional functions such as connection to a hospital network or subtraction.

More detailed and complete descriptions can be found in the ARCADIS Varic Operator Manual.

ARCADIS Varic Quick Guide

Basics

Input devices ........................................ 7

syngo user interface ............................. 9

syngo control elements ...................... 11

Product overview

C-arm system ..................................... 13

Monitor trolley ..................................... 17

Examination procedure

Preparing the system ......................... 19

Patient registration ............................. 21

Preparation in the Examination

task card ............................................ 23

Radiation release and dose display .... 25

High-contrast fluoroscopy

(Power Mode) .................................... 29

Image rotation and reversal ................ 31

Collimator setting ............................... 33

Changing the contrast ........................ 35

Saving images .................................... 37

Fluoro Loop/LSH (option) ................... 39

Ending the examination ..................... 39

Subtraction and Roadmap

Performing a subtraction scene ......... 41

Postprocessing a subtraction scene .... 43

Roadmap ............................................ 51

Postprocessing

Loading patient images into the

Viewing task card ............................... 53

Image display ..................................... 55

Measuring and annotations ................ 57

Image manipulation ............................ 61

ARCADIS Varic Quick Guide

Documentation

Printing ............................................... 65

Burning CDs ....................................... 75

Reports

Generating reports ............................. 77

Editing a LithoReport ......................... 79

Printing and exporting a report ........... 81

Connectivity

Send/Storage Commitment ............... 87

Get Worklist ....................................... 91

MPPS – Modality Performed

Procedure Step .................................. 93

Query/Retrieve ................................... 95

NaviLink 2D

Features ............................................. 97

Procedure ........................................... 97

Dismantling

Transport position ............................. 101

Switching off ..................................... 101

Cassette exposure (option)

Components .................................... 10 3

Preparing the exposure .................... 10 5

Exposure .......................................... 107

ARCADIS Varic Quick Guide

Basics

This chapter is addressed to syngo beginners and users with little computer experience.

(1) (2) (3)

(4)

(5)

Functions of the symbol keypad see foldout cover.

ARCADIS Varic Quick Guide

(6)

(7)

Basics

This chapter provides you with basic information on the input devices of the computer at the monitor trolley and on the syngo user interface.

Input devices

The mouse

(1) Left button

Single click: select/mark Double click: load data/program Button kept pressed: drag/move

(2) Middle button

Button kept pressed: windowing (change

(3) Right button

Single click: call up popup menu (context-sensitive)

brightness and contrast)

The keyboard

(4) Function keys

F1 = syngo Online Help

(5) Alphanumeric keypad

Text input, e.g. patient data

(6) Cursor keypad

Movement of the mouse pointer in texts

(7) Symbol keypad

Direct selection of important syngo functions (e.g. calling up Patient Registration or local database; image postprocessing functions)

ARCADIS Varic Quick Guide

Basics

(1)

(2)

(3)

(4)

After the ARCADIS Varic system has been switched on, the syngo user interface auto matically appears on the monitor trolley screens.

(5) (6)

(7)

(8)

(9)

ARCADIS Varic Quick Guide

Basics

syngo user interface

syngo consists of several stacked task cards. These are assigned to the individual steps of the workflow.

Ta s k c a rd s

(1) Menu bar

Calling up of main menus and submenus

(2) Tabs

Selection/switching of task cards

(3) Stack of subtask cards

Selection of processing tools and display functions Switching of subtask card via tab

(4) Status bar

Display of system messages

(5) Control area

Display of image and examination parameters, selection of functions (via subtask cards)

(6) Image area

Display and processing of images

Windows/Dialogs

Windows are called up separately or displayed automatically.

Windows can be closed again after processing.

(7) Title bar

Name of window, "Close window" button

(8) Window content

Input and selection of data

(9) Softkeys/buttons

Confirmation or cancellation of actions and messages

ARCADIS Varic Quick Guide

Basics

(1) (2)

(3) (5)(4)

ARCADIS Varic Quick Guide

(6) (7)

(8) (10)(9)

Basics

syngo control elements

Control elements on the screen are easiest selected with the mouse.

Menus

(1) Main menu

Opens by pressing left mouse button

(2) Popup menu

Opens by pressing right mouse button The content depends on the mouse position ("mouse focus") on the screen

Input elements

(3) Text input field

(4) Selection list

Selection of preset parameters and data; opens via arrow

(5) Spin box

Setting of values with arrow keys

(6) Radio buttons

Only one option selectable

(7) Check box

Several options selectable

Icon buttons

(8) Dimmed

Function not selectable

(9) Inactive

Function selectable, but not active

(10) Active

Function activated

ARCADIS Varic Quick Guide

Product overview

(5) (6) (7)

As soon as you press the emergency stop button, motorized up and down movement of the C-arm system is disabled.

(4)

(1)

(2)

(3) (4)

(6)

ARCADIS Varic Quick Guide

Product overview

C-arm system

C-arm

(1) Image intensifier

(2) X-ray tube

(3) Holder for footswitch

(4) Locking brake

(5) Hand switch

(6) Steering lever

(7) Emergency stop button

Brakes, steering lever

(4) Locking brake

❏ Locking brake released in center position:

Move C-arm system

(6) Steering lever

❏ Steering lever straight:

Move C-arm system in any direction

❏ Steering lever crosswise:

Move C-arm system in transverse direction, e.g. parallel to the table

ARCADIS Varic Quick Guide

Product overview

(1)

130°

S T

O P

45cm

(2)

(3)

(4)

(5)

130°

S T

O P

S T

O P

190°

12,5°

ARCADIS Varic Quick Guide

Product overview

Moving the C-arm system

(1) Vertical travel (motorized)

Lift and lower C-arm up to 45 cm

(2) Orbital movement

Change between a.p. and lateral position

➭ Starting from the a.p. position vertical to

40° and horizontal to + 90°

(130° in total).

(3) Angulation

Rotate C-arm about support arm in vertical plane by up to 190° in both directions

(4) Horizontal travel

Move C-arm horizontally up to 20 cm

➭ Ideal for fine adjustments directly at the

OR-table.

(5) Swivel

Swivel C-arm about unit column in horizontal plane by up to 12.5° in each direction

➭ Ideal for fine adjustments directly at the

OR-table.

ARCADIS Varic Quick Guide

Product overview

(1)

(2) (3)

(4)

(5)

(6)

ARCADIS Varic Quick Guide

Description of keyboard see Basics chapter.

Product overview

Monitor trolley

(1) TFT flat screen monitors

(2) Keyboard

(3) Power on/off switch

(4) CD drive

(5) Direction locks on the back wheels

(6) Brakes on the front wheels

ARCADIS Varic Quick Guide

Examination procedure

(1)

(2)

(3)

If an additional access control mechanism is configured for the system, you have to log in with your name and password.

(4)

(5)

ARCADIS Varic Quick Guide

Examination procedure

Preparing the system

Connecting, switching on and booting

✧ Connect the monitor trolley connecting

cable to the C-arm system (1).

✧ If available, connect the network cable

(if

the system is connected to an information system or a navigation system or network printer) (2).

✧ Plug the power plug into the power outlet.

✧ Switch on the C-arm system at the moni-

tor trolley (3).

➭ The system boots.

Covering the C-arm with sterile covers

✧ If necessary, cover the C-arm, e.g. with

the two-part sterile cover (4).

✧ Attach the cover with the sterilizable

clamps (5).

ARCADIS Varic Quick Guide

Examination procedure

During operation, the window can be opened by pressing the Patient Registration icon button on the monitor trolley.

(1)

ARCADIS Varic Quick Guide

(2)

(3)

Examination procedure

Patient registration

First, the Patient Registration window (1) appears directly. (Here: maximal configuration)

✧ Enter the patient data into this mask (1).

At a minimum, the bold fields must be filled out.

✧ Using the mouse, click on the Exam (2)

button.

➭ The patient data appear in the

Examination task card (3).

➭ The unit is now ready to start an examina-

tion.

Alternatives

❏ Preregistration/Scheduler

The patient has already been registered in the Scheduler, from where it can be loaded into the Patient Registration card.

❏ Emergency

If the patient data are unknown, the patient is assigned a provisional number consisting of the date and the time of the entry. These data can later be corrected.

❏ Search

If an information network (e.g. hospital network) is connected, you can start a search for registered patients here.

ARCADIS Varic Quick Guide

Examination procedure

To select parameters, use the mouse to click the monitor trolley.

(1)

(2)

(3) (5)

(6)

(4)

ARCADIS Varic Quick Guide

(7)

If the optional laser light localizer is available, the object should be positioned with the laser light localizer, i.e. without radia tion, as far as possible for reasons of radiation protection.

(10)

(8)

(9)

Examination procedure

Preparation in the Examination task card

✧ Select the medical application area (1).

✧ Select the body region by clicking the

VPA

(Virtual Patient Anatomy) (2).

✧ Select the required application program (3).

➭ With the application program you simulta-

neously select a dose level (reduced, standard, increased). This is shown by a bar (4).

✧ Select the desired operating mode (5).

Alternative: Select/switch operating mode on the C-arm keyboard (see fold-out cover).

➭ The selected operating mode is shown as

a symbol (6).

➭ The readiness of the C-arm is shown in

the status bar (7).

Setting with the laser light localizer

Depending on the equipment, the l.I. side or the I.I. integrated laser light localizer is avail able next to the tube-side laser light localizer.

✧ Laser localizer on the I.I. side:

Press the button on the laser light localizer to turn it on and off (8).

✧ Tube-side (9) and I.I. integrated laser light

localizer: Press the button on the C-arm system (10) to turn it on and off.

ARCADIS Varic Quick Guide

Examination procedure

Exception: If the continuous fluoroscopy mode is set, pressing the left footswitch releases a single exposure.

(2)

(1)

(3)

ARCADIS Varic Quick Guide

Examination procedure

Radiation release and dose display

Radiation release with the footswitch

✧ Actuate the right footswitch to release

continuous fluoroscopy (1).

✧ Actuate the left footswitch to release the

set operating mode (2).

Radiation release with the hand switch

✧ Press the release button to release the

set operating mode (3).

ARCADIS Varic Quick Guide

Examination procedure

)

(

(4)

ADR stop is recommended, for example, for

❏ Thin objects, e.g. w rist (the movement

causes the object to slide out of the central beam, the image is underex posed)

❏ Metal (high density of the metal leads

to strong overexposure)

❏ Transition between thoracic and lumbar

spine (movement of the diaphragm/mid riff causes changes in the exposure).

(2) (3)

ARCADIS Varic Quick Guide

(5)(6) (7)

Examination procedure

Radiation time and dose display

(1) Display of accumulated fluoroscopic time

at the C-arm system

(2) Display of accumulated fluoroscopic time

at the monitor trolley (Examination task card)

(3) Display of accumulated dose at the moni-

tor trolley (with optional dose measuring chamber) Alternative: Display of air kerma values (preceding item: accumulated air kerma).

➭ After every five minutes of radiation, an

audible alarm sounds at the C-arm sys tem.

✧ To temporarily deactivate the warning sig-

nal, press the Reset fluoro time button on the C-arm system (4).

ADR stop, manual input of radiation parameters

All exposures are taken with automatic exposure control. This rule is turned off using

ADR

stop. The kV values can then be

selected manually.

✧ Select ADR stop at (5).

✧ If required, set a manual value with the

+/- buttons (6).

➭ kV and mA values are shown on the dis-

play at the C-arm system (7).

➭ As long as ADR stop is activated, the

manually set value remains unchanged.

ARCADIS Varic Quick Guide

Examination procedure

(1)

ARCADIS Varic Quick Guide

Examination procedure

High-contrast fluoroscopy (Power Mode)

Power Mode is an additional function that

can be selected for the fluoroscopy mode.

With Power Mode a higher contrast is achieved, but with a higher dose.

✧ Select the Power Mode function at the

C-arm system (1).

➭ If the Power Mode function is activated,

a continuous warning signal sounds dur ing fluoroscopy.

➭ The duration of the Power Mode function

is limited to 15

ARCADIS Varic Quick Guide

Examination procedure

The rotation is performed without radiation and can be observed on the monitor.

(3)

(4)

(1) (2)

ARCADIS Varic Quick Guide

(5)

Examination procedure

Image rotation and reversal

At the C-arm system

✧ Press one of the image rotation buttons

for the required direction of rotation (1).

➭ The angle of rotation in relation to the

starting position is shown (2).

✧ Press one of the image reversal buttons

to flip the image horizontally or vertically

➭ The next time radiation is released, the

fluoroscopy image is in exactly this posi tion.

At the monitor trolley

Image display and processing in the Viewing task card is possible only for stored images (e.g. single exposure).

(3).

✧ Activate the image rotation function (4).

✧ Rotate the image with the left mouse

(keep left mouse button pressed).

➭ Angle display in the control area (5):

First value = angle of rotation in relation to starting position Second value = angle of rotation in relation to last image setting

ARCADIS Varic Quick Guide

Examination procedure

(1) (3) (2)

(4)

ARCADIS Varic Quick Guide

(5)

Examination procedure

Collimator setting

For radiation protection reason collimators should be inserted. These can be set at the C-arm system.

(1) Moves the iris diaphragm into/out of the

beam path

(2) Rotates the semitransparent diaphragm

(3) Moves the semitransparent diaphragm

into/out of the beam path

The iris diaphragm is a multileaf collimator used for concentric collimation of the radia tion beam (4).

✧ Activate the iris diaphragm for small

objects, e.g. the wrists (1).

The semitransparent diaphragm acts as a density compensation. A diaphragm is moved close to the extremity on both sides. Apart from reducing radiation, this prevents overexposure at the edges of the extremities

✧ Rotate the semitransparent diaphragm

corresponding to the position of the object (2).

✧ Adapt the semitransparent diaphragm to

the size of the object (3).

(5).

ARCADIS Varic Quick Guide

Examination procedure

(3)(1) (2)

ARCADIS Varic Quick Guide

Examination procedure

Changing the contrast

If the image quality is insufficient, a different gray-level curve can be selected at the control panel of the C-arm system during the exami nation to change the contrast of the image (and all further images).

In addition, the edge enhancement of the live images can be changed.

✧ If necessary, repeatedly press the follow-

ing buttons to change between preset values:

(1) Change contrast left monitor

(Examination task card)

(2) Change contrast right monitor

(References task card)

(3) Change edge enhancement right monitor

(References task card)

ARCADIS Varic Quick Guide

Examination procedure

At the end of radiation, the image last acquired is displayed (LIH, Last Image Hold). If radiation is released again, the LIH image is overwritten.

(1)

ARCADIS Varic Quick Guide

(2)

(3) (4)

Examination procedure

Saving images

Single exposure

In this operating mode the generated images are automatically saved in the local database of the Patient Browser.

Fluoroscopy, pulsed fluoroscopy, subtraction, Roadmap

In these operating modes images are stored in the temporary image memory and over written by new images.

✧ To manually save the current image, press

one of the following buttons:

(1) Save image button on the hand switch

(2) Save image button on the C-arm system

➭ This image is displayed in the References

task card and stored in the local database.

Scrolling and printing

✧ Scroll through the stored images in the

References task card (3).

✧ Print out individual images from the

References task card with a local printer (option) (4).

ARCADIS Varic Quick Guide

Examination procedure

(3) (2) (4)

(1)

If Autoloop (option) is configured in the exam set used, review of the scene is started automatically at the end of radia tion.

ARCADIS Varic Quick Guide

You can load the scene into the Viewing task card at any time and review it there.

If the MPPS option is installed, the

Modality Performed Procedure Step

window for performance documentation is now displayed automatically.

In the Configuration menu (Options > Configuration > Transfer), define the rules for auto transfer, e.g.:

❏ Required processing status ❏ Target addresses ❏ Data type

Examination procedure

Fluoro Loop/LSH (option)

In the fluoroscopy, subtraction and Roadmap modes, scenes can be reviewed and stored (Last Scene Hold) during the examination.

Reviewing a scene

After radiation is ended, the buttons for controlling the scene review are displayed.

(1) Start

(2) Stop

(3) Previous frame

(4) Next frame

Storing the scene

As soon as the scene has been reviewed, it can be stored.

✧ Select Patient > Save LSH Scene in the

main menu or press function key F9 on the keyboard.

➭ The current scene (up to 120 images) is

stored in the local database.

Ending the examination

✧ Call up Patient > End Exam in the main

menu.

➭ Patient and examination data are deleted

from the Examination card.

➭ If Automatic transfer is activated, the

examination images are automatically saved to CD-R or sent to the information system (option).

ARCADIS Varic Quick Guide

Subtraction and Roadmap

The Subtraction and Roadmap modes are an option for C-arms used in cardiac and vascular surgery.

(1)

(2)

(3)

ARCADIS Varic Quick Guide

Subtraction and Roadmap

Performing a subtraction scene

Contrast medium injected into the vessels helps to show vessels and changes of/in these vessels (e.g. aneurysms, ruptures).

Procedure

✧ Prepare the examination in the

Examination task card:

(1) Selection of the required application pro-

gram

(2) Selection of the Subtraction mode

✧ Trigger the subtraction scene with the left

footswitch or the hand switch.

The footswitch or hand switch must remain pressed during the entire series. If the series is interrupted, it must be started again from the beginning.

(3) The syringe symbol appears in the

Examination task card. The physician now injects the contrast medium.

➭ After a few seconds the syringe symbol

disappears again. The physician can end the contrast medium injection. The con trast medium bolus remains displayed.

ARCADIS Varic Quick Guide

Subtraction and Roadmap

If auto store is activated in the configuration menu, the images of a subtraction scene are automatically saved in the local database. They can then be retrieved for postprocessing at the end of the examina tion.

ARCADIS Varic Quick Guide

(1)

Subtraction and Roadmap

Postprocessing a subtraction scene

✧ First, load the subtraction scene from the

Patient Browser into the Viewing task card.

Pixelshift

Pixelshift allows you to make the mask and

fluoroscopy image coincide.

This function is used if the position of the patient has changed in the course of the series in relation to the position of the mask.

✧ Click the Pixelshift button (1).

➭ The mouse pointer appears as an arrow.

✧ Using the mouse, move the mask and flu-

oroscopy image so that one is on top of the other.

➭ In the lower image area it is indicated by

how many pixels the mask was shifted in the x-plane (= to the left or right) or the y-plane (= up or down).

ARCADIS Varic Quick Guide

Subtraction and Roadmap

(1)

ARCADIS Varic Quick Guide

(2)

Subtraction and Roadmap

Auto Pixelshift

This function allows automatic pixelshift for a selected region.

✧ Click the Auto Pixelshift button (1).

➭ The mouse pointer changes into a square.

✧ Move the square to the area in the image

where the misalignment can clearly be seen.

✧ Press the left mouse button.

➭ The mask and fluoroscopy image are

made to coincide optimally in the marked area.

➭ The shift of the mask in the x- and y-axis is

indicated in the bottom right image area.

Selecting a different mask

The selected application program defines which of the generated images is used as the mask in the subtraction series. This image is then subtracted from all following images.

✧ Click Mask Next or Mask Previous (2).

➭ The mask for this series is changed in indi-

vidual steps. This change is automatically adopted for the entire series.

ARCADIS Varic Quick Guide

Subtraction and Roadmap

(1)

(2)

ARCADIS Varic Quick Guide

Subtraction and Roadmap

Dual channel function

With this function the entire series is displayed unsubtracted during postprocessing in the Native task card (on the right-hand moni tor).

At the same time, the subtracted display is shown in the Viewing task card (on the left-hand monitor).

✧ Click the Dual channel function

button

(1).

➭ The entire series is additionally shown

unsubtracted on the right-hand monitor, even when scrolling through individual images of the series.

Native display in the Native task card

The image shown in the Native task card directly corresponds to the image of the series shown in the Viewing task card (2).

✧ Scroll through the individual images of the

series in the Viewing task card.

➭ The Native task card always shows the

corresponding image unsubtracted.

ARCADIS Varic Quick Guide

Subtraction and Roadmap

(1)

ARCADIS Varic Quick Guide

(2)

(5)

(6)

(3)

(4)

(7)

Subtraction and Roadmap

Landmark

The Landmark function allows you to subse- quently add an anatomical background for orientation purposes (0 to 30 %).

✧ Keeping the left mouse button pressed,

drag the bar to the required value (1).

Movie mode

The replay of the subtraction scene can be repeated in the Viewing task card.

✧ Select the required function with the

mouse:

(2) Scroll image back

(4) Stop the movie function

(5) Scroll image forward

(6) Replay series at half the speed

(7) Replay series in real time

(8) Replay series at double speed

ARCADIS Varic Quick Guide

Subtraction and Roadmap

During catheter placement the images are not automatically stored.

To manually save images, use the save button on the hand switch or C-arm system.

It is not necessary to create a subtraction scene if the Roadmap exam connects to a subtraction angiography. The existence of a subtraction screen is then indicated by a screen icon.

✧ In this case, press the ROADMAP but-

ton on the control panel once.

✧ Immediately start catheter positioning

under fluoroscopy control.

ARCADIS Varic Quick Guide

Subtraction and Roadmap

Roadmap

The Roadmap mode is also used in vascular surgery. This mode is used to place catheters in vessels under fluoroscopy.

The examination comprises the following steps:

Generation of a subtraction scene

✧ Select the Roadmap operating mode in

the Examination task card.

The procedure is the same as that described in Section

❏ First, a mask is generated.

❏ Then, the vessel is filled with contrast

Catheter positioning in the vessel

❏ If radiation is released again, the catheter

Performing a subtraction scene.

medium and displayed using subtraction technique.

placement is shown in real time in the

Examination task card.

ARCADIS Varic Quick Guide

Postprocessing

2D images are postprocessed in the Viewing task card.

(1)

(2)

(3)

)

(

ARCADIS Varic Quick Guide

Postprocessing

Loading patient images into the Viewing task card

✧ Open the Viewing task card.

✧ Open the Patient B rows er with the

Call

up Patient Browser button on the

monitor trolley (1).

✧ Load the required series into the Viewing

task card with a double click (2).

✧ To load individual images, double-click on

the image symbol (3).

➭ The name of the patient is displayed in the

control area of the Viewing task card (4).

ARCADIS Varic Quick Guide

Postprocessing

(1)

ARCADIS Varic Quick Guide

(2)

(3) (4)

Postprocessing

Image display

In the View subtask card you can choose between different monitor layouts.

(1) Different screen divisions

(2) Hiding graphics and patient data in the

image area

(3) Stripe display:

the images are arranged next to each

other

(4) Stack display:

the individual images are arranged one on

top of the other

ARCADIS Varic Quick Guide

Postprocessing

(2)(1)

(3)

ARCADIS Varic Quick Guide

(4)

(5)

Postprocessing

Measuring and annotations

In the Tools subtask card images can be mea- sured and annotations can be added.

(1) Diaphragms

The subsequent simulation of diaphragms improves the visualization of fine struc tures that are difficult to see in the image

(2) Magnifying glass

Individual areas of the loaded image are shown enlarged

(3) Annotations

Entering annotations for image areas via the keyboard

(4) Calibrating and measuring distances

(5) Angle measurement

The angle between two straight lines to be drawn is indicated

ARCADIS Varic Quick Guide

Postprocessing

Distances cannot be measured directly in the images, since the position of the object in the beam path and thus the magnification effect is not clear. A performed first before a distance can be clearly determined.

(1)

(2)

(3)

calibration must be

ARCADIS Varic Quick Guide

The calibration object must be perpendicular to the central ray in the area of the structure to be measured (generally in the center of the measuring field to avoid I.I. distortion).

(4)

(5)

Postprocessing

Calibrating and measuring distances

❏ Calibrating (1st step)

✧ Activate the calibration function by click-

ing the corresponding button (1).

➭ A green line appears in the image area

which can be lengthened, shortened and positioned as desired with the mouse (2).

✧ Draw the line along a known distance (2).

➭ As soon as you release the mouse button,

a dialog box appears (3).

✧ Enter the known distance and confirm

with OK (3).

➭ The calibration is shown in the image

area. At the same time, a measuring scale appears on the right edge of the image.

❏ Measuring distances (2nd step)

✧ Activate the Distance function by clicking

the corresponding button (4).

✧ Using the left mouse button, draw a line

along the required structure.

➭ As soon as you release the left mouse

button, the distance from the start to the end point of this line is shown (5).

ARCADIS Varic Quick Guide

Postprocessing

(1)

(3)

(2)

(4)

ARCADIS Varic Quick Guide

(6)

(5)

Edge enhancement (3) means artificially increasing the difference between two gray levels.

Postprocessing

Image manipulation

Images can be postprocessed in the Image subtask card.

✧ Prior to postprocessing, activate the

required function by clicking the corre sponding button:

(1) Change of contrast

The contrast is changed in four defined steps

(2) Image rotation

Rotation with the left mouse button pressed

(3) Edge enhancement

Edge enhancement is increased/reduced in steps of ten

(4) Grayscale inversion

Change from positive to negative image

(5) Double/half image size

(6) Zoom/pan the image

Mouse at image edge: change image size Mouse in image center: pan image

ARCADIS Varic Quick Guide

Postprocessing

Windowing means changing the gray levels in an image and thus the brightness (center of the grayscale) and contrast (width of the grayscale) of the image.

(1)

(2)

ARCADIS Varic Quick Guide

(3)

(4)

Postprocessing

Windowing

❏ With buttons/softkeys

✧ Select the preset contrast levels by click-

ing the buttons (→ Page 61).

❏ With the keyboard of the monitor trolley:

✧ Select the brightness and contrast step

by step (1).

❏ With the mouse on the monitor trolley

✧ With the middle mouse button pressed,

move the mouse in the image (2). Up/down movement changes the brightness Movement to the left/right changes the contrast

Display of window values

Edge enhancement and gray values of the image are displayed in the lower image area:

(3) Edge enhancement

(4) Grayscale window

W = window width (contrast) C = window center (brightness)

ARCADIS Varic Quick Guide

Documentation

In radiology the terms "filming" (= printing process), "camera" (= output device) and "exposing" (= printing) are used for the printing of patient images. The syngo user interface uses corresponding terms.

(1) (2) (3)

(4)

(5)

ARCADIS Varic Quick Guide

Documentation

Printing

If the printing function is configured, the Filming task card additionally appears on the right monitor.

Here, the images to be printed are collected in film sheets, processed if necessary, and then sent to the printer as a film job.

Procedure

(1) Copying images to the film sheet:

– from the C-arm system – from the Viewing task card – from the Patient Bro wser

(2) Editing/checking the film sheet:

in the Film Preview dialog or in the Filming task card

(3) Printing the film job:

– on a local printer – on a network printer

With a local printer you can print individual images on paper or X-ray film directly in the

OR.

Printing in the network is possible if a network printer (e.g. central printer in the OR or the radiology department) is connected via the network connection (4).

Copying images to the film sheet from the C-arm system (for local printing)

✧ Press the Print key on the control panel of

the C-arm system (5).

➭ The image shown on the right monitor is

copied to the film sheet.

➭ The local printer is preset as output device

for the print job.

ARCADIS Varic Quick Guide

Documentation

(2)

(1)

ARCADIS Varic Quick Guide

(3)

(4)

Documentation

Copying images to the film sheet from the Viewing task card

Print jobs can be created in the Viewing task card in parallel with image postprocessing.

✧ Click the patient image to be copied to the

film sheet (1).

✧ Then click Copy to Film Sheet (2).

Copying images to the film sheet from the Patient Browser

If the complete data record of a patient is to be printed on film, this can also be done directly from the Patient Browser.

✧ Click the series to be printed in the local

database of the Patient Browser (3).

✧ Copy the patient images to the film

sheet

(4).

ARCADIS Varic Quick Guide

Documentation

(1)

(2)

(3)

(4) (5)

(6)

(7)

(8)

ARCADIS Varic Quick Guide

Documentation

Checking the film job and printing from the film preview

✧ Click the Film Preview button in the

Patient Browser (1).

➭ A dialog box is opened which shows dif-

ferent functions for the film sheet:

(2) Dog ears for scrolling through the film

sheets

(3) Patient name

(4) Setting the number of copies of a film job

(5) Display of the status of individual film

jobs, e.g. "queued", "completed" etc.

(6) Deleting individual images from the film

sheet

(7) Sending the film job and exposing/print-

ing the film

(8) Automatic sending of a film job when film

sheet is full

✧ Click Expose to send the film job to the

printer/camera (7).

ARCADIS Varic Quick Guide

Documentation

(1)

(2)

ARCADIS Varic Quick Guide

(3)

(4)

(5)

(6) (7)

Documentation

Editing the film sheet in the Filming task card

✧ Click the Filming task card on the right

monitor (1).

❏ Layout

✧ Select the required film layout in the

Layout subtask card (2).

❏ Image display

✧ On the Images subtask card, select the

required display of the images on the film:

(3) Select text to be printed on film

All patient text (name, date of birth etc.), customized text or no text

(4) Show or hide graphics (e.g. distance,

angle measurements)

(5) Enlargement of the image so that the

shorter sides fill the film segment. Parts can be cut off from the longer sides.

(6) Adjust the image size to the film segment

(7) Return to the original image

ARCADIS Varic Quick Guide

Documentation

(1)

(2)

(3)

ARCADIS Varic Quick Guide

(4)

(10)

(9)

(5)

(6)

(7)

(8)

Documentation

❏ Camera/printer setting

✧ In the Camera subtask card, select a dif-

ferent camera/printer or film size, if necessary:

(1) Select the camera if several cameras are

configured

(2) Display of the film job status,

e.g.

"queued", "printed" etc.

(3) Select one of the film formats available in

the camera

❏ Zoom/Pan

✧ Activate the function by clicking the corre-

sponding button (4).

✧ Zoom/pan the image with the left mouse

button pressed. Mouse at image edge: change image size Mouse in image center: pan image

✧ If required, reset the image to the original

position and size (5).

Printing a film job from the Filming task card

✧ Set the number of copies (standard = 1

copy) (6).

✧ If necessary, delete individual images

from the film sheet (7).

✧ Send the film job to the camera manually (8)

or activate automatic exposure (9).

✧ If necessary, check the processing of the

film job (10).

➭ The status ("queued", "printed" etc.) of all

film jobs of the selected camera is shown.

ARCADIS Varic Quick Guide

Documentation

Only non-rewritable CDs, (CD-Rs), can be used. Rewritable CDs (CD-RWs) are not accepted.

The DICOM viewer is started directly from the CD; no files are installed on the com puter.

(1)

ARCADIS Varic Quick Guide

(2)

(1)

Documentation

Burning CDs

As your system is configured for multi-session, you can store your data to unrecorded CD-Rs, or CD-Rs that have already been writ ten to. The new data is added to the old data on the CD-R.

❏ DICOM Viewer

In the first session, a DICOM viewer is written to the CD together with the image data. This allows you to view the images stored on the CD on any computer.

Exporting workflow

✧ Click the patient(s) in the Patient

Browser (1).

✧ In the menu bar of the Patient Browser,

click Tr a n s f e r > Ex p o r t to . . . (2).

➭ The dialog window for data export is

opened.

✧ Select the CD-R as the target and click

Export (1).

➭ The export process starts. The CD is auto-

matically labeled with the date and time.

ARCADIS Varic Quick Guide

Reports

The prerequisite for both report types is the registration and examination of a patient. In

addition, for a LithoReport, the lithotripsy function must be enabled on your system and connected to the imaging system.

The radiation summary report is generated automatically based on the present exami nation data. It cannot be postprocessed.

(1)

(2)

(3)

ARCADIS Varic Quick Guide

Reports

Generating reports

If the reporting function is enabled on your system, important examination data are auto matically compiled into a structured report for documentation and treatment purposes.

Report types

❏ Radiation summary report

contains the accumulated values of the examination for the number of exposures, fluoroscopy time and dose area product

❏ LithoReport

contains the data on the diagnosis, treatment and postprocessing of an extracorporeal shockwave lithotripsy (ESWL) procedure

Using reports

You can read, print and send the reports and complete the automatically entered data in the LithoReport.

Managing reports

Reports are stored and managed in the Patient Browser as additional data objects in 2 formats. They can be selected via the rele vant icons like examination images:

(1) Report icon in the navigation area

(2) Report icon in the content area

Format: Structured Report (SR) To open the Report Editor

(3) Report icon in the content area

Format: Secondary Capture (SC) Loading e.g. into Viewing possible; PACS-compatible

ARCADIS Varic Quick Guide

Reports

(1)

(2)

A lithotripsy procedure is possible only after a patient has been registered.

When you start an ESWL treatment, the LithoReport editor is opened automatically with the new report.

In the Viewing task card you can open reports by clicking the relevant button on the Reporting subtask card.

ARCADIS Varic Quick Guide

(3)

(4)

In the STATUS area you can see the current processing and verification status. You can change these statuses only in the case of postprocessing reports (according to the work progress made).

Reports

Editing a LithoReport

Unlike in the case of the radiation summary report, you can enter or subsequently change part of the LithoReport data yourself.

Opening a report

✧ Select the required LithoReport in the

Patient Browser and select Reporting > Open Report.

✧ Select the required report in the dialog

window displayed.

LithoReport editor

The selected report is displayed in the LithoReport editor.

(1) Symbol buttons for printing a report

(2) Display of report status

Examination report (treatment in process) Postprocessing report (treatment finished)

(3) Open card

(4) Button bar

ARCADIS Varic Quick Guide

Reports

During an examination the LithoReport editor is automatically in edit mode.

(1)

(2)

To close the LithoReport editor, click OK.

With this button in the LithoReport editor you can call up the print preview of the report.

ARCADIS Varic Quick Guide

(3)

(4)

Reports

Completing and changing data

To modify data, you need to change into edit mode. This is, however, not possible if the report has already been completed (status “completed”).

✧ Click Edit (1).

✧ Make your changes in the Patient/

Diagnosis, Therapy, Summary, Postprocessing cards.

✧ To accept your changes, click Apply.

➭ The LithoReport editor remains open.

Printing and exporting a report

A r epor t ca n be expo rted onl y if it has reach ed the status “completed” and “verified”.

Printing

✧ Click this button in the LithoReport

editor

(3).

➭ The Print Report dialog window is

opened (4).

✧ If necessary, change the print settings.

✧ Confirm with OK.

➭ The report is printed.

ARCADIS Varic Quick Guide

Reports

Files in pdf format can be read and printed on other computers with the Acrobat Reader freeware program.

(1)

(2)

(3)

The program compiles all reports from the local database that meet your specified cri teria.

ARCADIS Varic Quick Guide

(4)

(5)

(6)

(7)

(8)

Reports

Exporting a report as pdf file

The report is saved as a pdf file in the CDR_OFFLINE directory. From there you can write the file to CD.

✧ Select the required report in the Patient

Browser and call up Reporting > Export

Report to....

✧ Select a suitable layout for the pdf file in

the dialog window displayed (1).

✧ Enter a name for the pdf file in the Result

field (2).

✧ Confirm with OK (3).

Exporting for statistical evaluations

Data from LithoReports can be exported in ASCII format. This text file is saved in the CDR_OFFLINE directory.

A r epor t ca n be expo rted onl y if it has reach ed the status “completed” and “verified”.

✧ Select the required report in the Patient

Browser and call up Reporting > Export

Statistics To....

✧ Enter your filter criteria in the three areas:

(4) Reports created between (period of time)

(5) Evaluation groups

(6) Evaluation parameters

✧ In the Result field, enter a name (ending

in “.txt”) for the export file (7).

✧ To start the export, click the Export

Statistics button (8).

ARCADIS Varic Quick Guide

Connectivity

Monitor trolley

ARCADIS Varic Quick Guide

Monitor trolley

Connectivity

ARCADIS can optionally be connected to a network. The following two variants are avail able:

DICOM System Basic Send/Receive + Storage Commitment, Print

(1) Send/Receive

Sending and receiving of patient images

(2) Storage Commitment

Requesting a confirmation that images have been securely stored after sending

(3) Print

Printing of patient images on X-ray films via a network

→ Page 65

DICOM System Advanced (in addition to the above-named functions)

(4) Worklist

Querying the worklist (all patients for a system) and loading the patient data

(5) MPPS = Modality Performed Procedure

Step Feedback to an information system about the status of a work process

(6) Query/Retrieve

Searching for images in the network (incl.

other modalities), importing of

images into the local database

ARCADIS Varic Quick Guide

Connectivity

You can also receive images from another system (CT, MR etc.) or workstation. For this, the images have to be actively sent from this system or workstation to ARCADIS.

(1)

(2)

ARCADIS Varic Quick Guide

(3)

(4)

Connectivity

Send/Storage Commitment

The Send to function allows you to archive patient images in an information system or to send them to another workstation for post processing.

Send to

✧ Open the Patient B rows er (1).

✧ Select the patient (or individual examina-

tions) whose data you want to send.

✧ Click the Send to... button (2).

✧ Select the network node (recipient) and

confirm with Send (3).

➭ The images are sent to the selected

address (information system or worksta tion).

Sending to a standard address

✧ Press the Send key on the keyboard of

the monitor trolley (4).

➭ The selected patient images are sent to

the first "standard" node configured by Siemens Service.

ARCADIS Varic Quick Guide

Connectivity

(1)

(2)

ARCADIS Varic Quick Guide

(3)

(4)

Connectivity

Tracking network processes

✧ Click the Network Status button (1).

➭ Current processes in the network are

shown (2).

Storage Commitment

If patient data are sent or archived in an information system, the Storage Commitment function requests a confirmation from the receiving station that images have been securely stored:

(3) Column for error messages

(4) Feedback in the status bar

("SV" = sent and verified)

➭ In the case of an error message, the data

in the Patient Browser must not yet be deleted, because they have not yet been properly saved or archived.

✧ Repeat the process again.

ARCADIS Varic Quick Guide

Connectivity

Get Worklist offers the advantage of a sim-

plified workflow:

In an information system the OR plan (i.e.

which patients are planned for a certain operating room or C-arm) can be prepared the day before and retrieved in the OR. Patients can then be retrieved quickly just before the procedure and the data can be transferred to the Examination task card. Patients no longer need to be registered manually.

The Get Worklist function also prevents the entry of incorrect patient data, since the data do not need to be entered manually.

ARCADIS Varic Quick Guide

(1)

To update the worklist again, initiate a new request to the information system by double-clicking on the Scheduler.

(2)

(4)

(3)

Connectivity

Get Worklist

The Get Worklist function contains a request for a worklist within an information system.

✧ Double-click the Scheduler in the Patient

Browser (1).

➭ A worklist with patients whose data are

present in XA format (data format for con ventional radiography) appears.

✧ Select the patient to be examined in the

Scheduler (2).

✧ Click the Patient Registration button (3).

➭ The Patient Registration window opens.

The data of the selected patient have already been entered.

✧ Click Exam in the Patient Registration

window (4).

➭ The data are transferred to the

Examination task card, and the examina tion can be started.

ARCADIS Varic Quick Guide

Connectivity

(1)

(2)

ARCADIS Varic Quick Guide

(3)

(4)

Connectivity

MPPS – Modality Performed Procedure Step

MPPS (Modality Performed Procedure Step) is a confirmation to an information system that a certain process (in this case the exam ination of a patient) has been completed.

Calling up MPPS after an examination

✧ Select Patient > End Examination in the

Examination task card (1).

➭ The MPPS dialog is displayed (2).

✧ If desired, enter information and com-

ments on the procedure (e.g. unusual occurrences, complications).

✧ To end the dialog, click Completed (3).

➭ The OR documentation is sent to the

information system, where it is archived.

➭ The patient is deleted in the Scheduler.

Calling up MPPS manually

If you have accidentally closed the patient by registering a new patient, you can open the MPPS dialog manually.

✧ Select Patient > Show MPPS in the

menu bar of the Patient Browser (4).

ARCADIS Varic Quick Guide

Connectivity

The Retrieve function is important above all for preoperative images that are needed for virtually any procedure.

(1)

ARCADIS Varic Quick Guide

(2)

(3)

(4)

Connectivity

Query/Retrieve

❏ Query

A query to an information system can be started. If the patient is already known to the information system, the existing images are displayed.

❏ Retrieve

Images can be imported into the local database and loaded into the Viewing task card.

✧ Click the Search button in the Patient

Browser (1).

➭ The search dialog opens (2).

✧ Enter the known patient data (unknown

data can be replaced by the * wildcard, e.g. A*).

✧ Start the search by clicking Search (3).

➭ The patient images present in the infor-

mation system are displayed.

✧ Click the Import button (4).

➭ The patient images are imported into the

local database from where they can be loaded into the Viewing task card.

ARCADIS Varic Quick Guide

NaviLink 2D

Communication is implemented either directly between the C-arm and the naviga tion system or through a hospital network. In the first case, the network cable from the C-arm is connected directly to the naviga tion system. In the second case it is plugged into the network socket in the OR

room.

(1)

Digital Radiography must be selected as operating mode. The navigation system does not accept images of other operating modes.

ARCADIS Varic Quick Guide

NaviLink 2D

Features

NaviLink 2D is a newly developed interface that enables the communication of 2D image data between ARCADIS Varic and a naviga tion system.

With the exception of the connection of the C-arm to the navigation system via the net work cable and the generation of images for navigation, the entire workflow takes place at the navigation system.

Procedure

Preparation

✧ Set up the C-arm and the navigation sys-

tem and start both systems.

✧ Enter the patient data.

✧ Establish direct communication with the

aid of a network cable.

➭ The readiness of the C-arm is indicated by

an icon in the status bar of the Examination task card (1).

✧ Select the examination parameters.

ARCADIS Varic Quick Guide

NaviLink 2D

Confirmation is required only if the image is to be used for navigation. All other images are only stored in the Patient Browser at the monitor trolley.

In general, 2 images are required.

ARCADIS Varic Quick Guide

All other work steps are performed at the navigation system. The C-arm is still used for postoperative follow-up exposures, for example. In very small rooms, however, it is often dismantled and taken out of the room.

NaviLink 2D

Procedure

✧ Release radiation.

➭ The image appears in the References

task card at the monitor trolley.

✧ Check the setting and image quality.

necessary, repeat the exposure.

✧ Confirm the selection of the image at the

navigation system by clicking Request image.

➭ The image is automatically transferred

from the C-arm to the navigation system.

✧ Make further exposures until you have

reached the desired number of images for navigation.

Final steps

✧ If necessary, dismantle the C-arm and

take it out of the room.

ARCADIS Varic Quick Guide

Dismantling

(2)(1) (3)

T O P

O P

(4)

(5)

To define the switch-on duration yourself, you can perform a full shut-down manually. To do so, select Options > End session in the main menu before turning the system off.

100

(6)

ARCADIS Varic Quick Guide

Siemens VB 13C Operator Manual

Specifications and Main Features

Frequently Asked Questions

User Manual

Introduction

Table of Contents

Basics

The mouse

The keyboard

syngo user interface

Ta s k c a rd s

Windows/Dialogs

syngo control elements

Menus

Input elements

Icon buttons

Product overview

C-arm system

C-arm

Brakes, steering lever

Moving the C-arm system

Monitor trolley

Examination procedure

Preparing the system

Connecting, switching on and booting

Covering the C-arm with sterile covers

Patient registration

Alternatives

Preparation in the Examination task card

Setting with the laser light localizer

Radiation release and dose display

Radiation release with the footswitch

Radiation release with the hand switch

Radiation time and dose display

ADR stop, manual input of radiation parameters

High-contrast fluoroscopy (Power Mode)

Image rotation and reversal

At the C-arm system

At the monitor trolley

Collimator setting

Changing the contrast

Saving images

Single exposure

Fluoroscopy, pulsed fluoroscopy, subtraction, Roadmap

Scrolling and printing

Fluoro Loop/LSH (option)

Reviewing a scene

Storing the scene

Subtraction and Roadmap

Performing a subtraction scene

Procedure

Postprocessing a subtraction scene

Pixelshift

Auto Pixelshift

Selecting a different mask

Dual channel function

Native display in the Native task card

Landmark

Movie mode

Roadmap

Generation of a subtraction scene

Catheter positioning in the vessel

Postprocessing

Loading patient images into the Viewing task card

Image display

Measuring and annotations

Calibrating and measuring distances

Image manipulation

Windowing

Display of window values

Documentation

Printing

Procedure

Copying images to the film sheet from the C-arm system (for local printing)

Copying images to the film sheet from the Viewing task card

Copying images to the film sheet from the Patient Browser

Checking the film job and printing from the film preview

Editing the film sheet in the Filming task card

Printing a film job from the Filming task card

Burning CDs