CR Pro Computed Radiography (CR) Scanner USER MANUAL January 22, 2007 Release 2.
Specifications and product and/or service offerings are subject to change without notice. The information in this book is provided for informational proposes only. It is subject to change without notice. Radlink, Inc. assumes no liability for any errors or inaccuracies that may appear in this book.
equipment or possibly adjacent surroundings. • POWER – There are two models of the CR Pro, a domestic and European Model. To avoid damaging your device, be sure the voltage selected matches the required voltage for your Model. CR Pro Domestic - 110 - 127VAC, 47 - 63Hz, 5.0A Accommodates most of North and South America and Eastern countries such as South Korea and Taiwan. CR Pro European – 197 - 240VAC, 47 - 63Hz, 3.0A Accommodates most of Europe, the Middle East and the Far East.
Electromagnetic Interference (EMI) is any signal or emission, radiated in free space or conducted along power or signal leads, that endangers the functioning ofa radio navigation or other safety service or seriously degrades, obstructs, or repeatedly interrupts a licensed radio communications service. Radio communication services include, but are not limited to, AM/FM commercial broadcast, television, cellular services, r adar, air-traffic control, pager and Personal Communication Services (PCS).
The CR Pro is fused for 5 amp domestic and 3 amp European. Fuses are located in the AC power input fixture on the back, bottom, right hand side of the CR Pro. FUSE – The input power is fused at the AC power input connector at the bottom, right rear of the CR Pro cabinet. The fuse(s) is located in a box directly above the input connector and is a integral part of the connector assembly. To remove the fuse box, perform the following: 1. Turn off power to the device. 2.
Preface Chapter 1: Software Setup and Configuration Chapter 2: Operating Instructions, Applications, Gain Tables and Calibration Preface • THANK YOU – For purchasing the Radlink CR Pro Computed Radiography Scanner. This manual will assist your certified CR Pro field service engineer in learning all the functions of your CR Pro, from installation through operation. Please read each section carefully.
• INSTALLATION – The CR Pro should only be install by a Radlink Certified CR Pro field service engineer. Please contact your Radlink authorized dealer.
Introduction The Radlink CR Pro is a radiological device, that scans erasable phosphor plates and transmits the image to an imaging onboard computer for review, archiving or forwarding to other facilities for further evaluation and archiving. The CR Pro handles plates of the following size: Inch Standard 10in x 12in (254.0mm x 304.8mm) 14in x 17in (355.6mm x 431.8mm) The CR Pro’s unique design makes it low maintenance as there are no mirrors or galvanometers which are subject to frequent adjustment.
Figure 1-1 – CR Pro Scanner On/Off Switch AC Input AC Line Filter USB Port Ethernet Port Figure 1-2 – CR Pro Scanner Rear View Chapter 2: Software Setup and Configuration 9
Radlink Software Installation All of the required CR Pro software, applications and driver's are installed at the factory. Radlink Application Installation Procedures Radlink Clean Install Procedures Note: The CR Pro is configured with the CR Pro Image Acquire software as part of the manufacturing process and is already installed. 1. Double click the “Double Click to Install Radlink” icon. This installs the Radlink application.
2. Double click the “Double Click to Install Radlink” Icon on the install CD. This installs the Radlink application. (Simply inserting the Radlink CD will cause the setup program to be automatically run on most machines). 3. The Radlink Database will need to be synchronized to your existing Image Archive. Open the Image Acquire Screen and Click “FileàDatabase Maintenance” menu item then click the “Sync. Database” button. 4. Periodically check www.radlink.com for software updates. Select Software Updates.
The X – Ray Techniques Figure 2-1 – Confirming The X – Ray Techniques Settings Body Part Major Grouping for display purposes. Size This can be “Small”, “Medium” or “Large” kVp The kVp setting at the X-Ray machine. mAs The milliamp-seconds setting at the X-Ray Machine Distance The distance between the X-Ray tube and the X-Ray cassette. Grid Grid type; Can be 103, 178, or no grid. Offset Gain Value Should be set to calculate the Gain. This is the Gain Value as computed from the above settings.
Figure 2-2 – Destination Settings Destination Settings - The destination settings for networked DICOM devices are shown above. It also has a field called “State” that instructs the software whether or not to send a DICOM image from the CR Pro to selected destination(s). Unchecking the State does not turn off communications to the programmed satellite destinations. However; Again the state check box only controls output from the CR Pro to each selected destination.
#Retries – The router will give up and post an error alert if the transmission failed after the count of 10 retries have been attempted. The default is retry 10 times. Prompt on Send Failure? – An option to the router to not prompt on a s end failure but rather place the DICOM image in the canceled queue after a number of user defined retries. This is important for unattended operation.
Figure 2-3 – DICOM Ping Success Message If there are problems, the following message will be displayed: Figure 2-4 – DICOM Ping Error Message The most typical reason for the error message is incorrect IP and/or Port destination settings. The DICOM Ping button is also present in the Radlink Router destination settings. Router Settings The purpose of the Router Scheduler is to postpone DICOM transfers for example, after business hours.
When the check box is checked, the router will cease to send images except between the times selected. Figure 2-6 – Scheduler Settings In the above example, the router will only transfer images to the PACS hosts between 5:45 PM and 11:45 PM. Listener Port – The Listener Port is a port on the client machine that the Radlink Router listens to for “Send Status” button clicks. The Listener Port typically should not be changed.
Fire Wall Settings Figure 2-8 – Fire Wall Settings The firewall information contains proxy server IP information that is necessary for routing images through the Firewall, if one is present. The fire wall settings are also present in your Internet Explorer browser and can be found by clicking ToolsàOptions and clicking the connections notebook tab: Figure 2-9 – Internet Options Settings To locate the firewall IP settings, click “LAN Settings…”.
Figure 2-10 – LAN Settings Simply copy the Proxy server settings into the Radlink Fire Wall Settings. If no settings are present and you have a Firewall, contact your LAN administrator for the above settings. It should be noted that the protocols being utilized by the Radlink system are TCP and SOAP. The SOAP protocol uses an extended HTML packet header for communications. Some firewalls do not allow HTML extensions.
The fields on the “Patient Information Screen” can be set as “Required Fields” by the user of Image Acquire. The settings for required fields can be found by clicking the SettingsàRequired Fields on the Image acquire main screen: Figure 2-12 – Required Fields Menu Item The following settings screen then appears: Figure 2-13– Required Patient Info Fields The image acquire application will check for all fields checked above on the patient information screen to ensure that they have been completed.
Figure 2-14 – DICOM Save Study Compression Options The compression techniques supported are: noCompression – Save the image uncompressed. jpeg2000Lossless – Save the image using jpeg2000 wavelet lossless compression. The number of bits stored will automatically be the number of bits in the image at the time of the image save. The compression ratio to be expected is typically between 4 and 10 for jpeg2000 lossless compression.
All of the above compression algorithms are supported for creating DICOM Part 10 CD’s. However, the default viewer with CD creation is only able to recognize jpeg 8 bit lossy and uncompressed images. Overlay Settings Color and Font settings are provided for Calipers, Annotation, and Measurements.
Figure 2-17 - Color Picker Choose the desired color by clicking a color then click OK. The New Color button background color will then display the chosen color. One changes the fonts by clicking the button “Edit button in the Font column. The following screen then appears: Figure 2-18 – Font Picker The font picker displays all of the fonts, and font sizes in the system. Choose the desired font, font style, size, and font effects then click OK.
Figure 2-19 – Modified Overlay Settings One should then save the settings by clicking the save button. Radlink settings can be protected with a password.
Figure 2-22 – Password Login Screen The look and feel of the main display screen can be modified with the View Settings menu item: Show Buttons – This will either display or hide the buttons on the screen. This is normally turned on. Figure 2-23 – Screen Settings Show Patient Info – This displays or hides the patient information on the screen.
Show Caliper – This displays or hides the caliper on the image. Show Histogram – This displays or hides the histogram. This is normally turned off. Show Overlays – Overlays include the Annotation and measurements. This is normally turned off.
Chapter 3: Operating Instructions Startup To start the Radlink software suite, double click the Radlink Image Acquire Icon on the desktop or click StartàProgramsàStartupàRadlink Image Acquire from the start button. The Main screen will appear (Figure 3 - 1): To determine which release of Radlink software you are working with, click on Help on the top toolbar then click on About Radlink. The release level will be displayed.
CR Pro Phosphorus Plate Calibration Procedure Figure 3-1 – Calibrate Settings Screen Expose Plate – 3 phase and high-frequency X-ray machines. SID 72” - kVp 70 - mAs - 30 40" can also be used if 72" is impractical (e.g., because of the wall bucky, etc). - 3 phase and high-frequency X-ray machines, reduce the 30 mAs exposure by a factor of approx 3, which is approx 10 mAs.
40” - single-phase rectified generator, increase the 8 mAs by 1.5 * 8 = 12 mAs 40” - single-phase unrectified generator, increase the 8 mAs by 2.0 * 8 =16 mAs The calibration procedure just requires enough x-rays to create a uniform "flood field" exposure on the plate -- there is no "right" or "wrong" technique -- just guidelines for creating a uniform field. 1.
Figure - 3. 2 Image Acquire Main Screen To Acquire An Image - The Main Screen is composed of seven action buttons under the title imaging workflow. 1. Create Study 2. Create Series 3. Scan Image 4. QC Image 5. Change Info 6. Complete Study 7.
Figure 3 -3 - Patient Information Settings In this section you will enter the patient demographics: 1. 2. 3. 4. 5. 6. 7. 8. 9. The Patient ID. The Patient name, sex, and birth date. Study Date. Accession #. Study Description. Reason for Exam. History. Priority. Referring MD. One can also perform patient searches in the Modality Worklist.
Figure 3 -4 - Confirm X-ray technique In this section you will select: 1. The body part 2. The view 3. The patient's size 4. The technique – kVp and mAs 5. Grid Type – 178 (recommended) 6. Offset - Calculate to set the Gain value The Scan button The image is displayed line by line as it is scanned.
Figure 3 -5 - Image Scanning The scan button initiates scanning of the phosphor plate.
Figure 3 -6 - Image QC This window will enable image processing enhancements. Image information: Processing – Indicates the type of processing that has been applied to image.
Figure 3 -7 - Image Orientation The four Rotate and Flip buttons allow for different image positioning of the displayed x-ray. The Add Markers to Image buttons will ID image with the patient's Right and Left. The Custom Marker button will enter script to image – Personal Initials. The Image Dimensions buttons will enable Crop to enhance image.
Figure 3 -8 - Image Appearance The Auto WinLev button – Automatically determines the appropriate window width and level for the image. The Negative button – Inverts the greyscale to obtain a negative view of the image. The Delete button – Deletes the selected image. Warning: This permanently deletes the image such that it cannot be recovered. The Finish button – Saves the changes to the image, and closes the QC window. The Delete button will delete the selected image in the image series list.
When all DICOM transfers are completed manually adjusting the greyscale the list to the right side (Sending) will be blank: The W and L sliders are for Window (W) and Level (L) for the selected image settings. These settings are stored in the DICOM file header and are passed on to the PACS system. Compliant viewers will then open the DICOM image with these settings. The histogram below the window level sliders graphically displays the pixel distribution over the possible pixel values.
Figure 3 -10 - Directory Navigation Screen One navigates to the desired directory with the standard Windows File Open Dialog shown in Figure 3 - 9. Files can be sent directly from the archive or any other selected directory.
Figure 3 -13 - View Archive Screen A filter has been added to assist in the rapid search of the desired study. Simply type the first character or two of the patient name and/or the first character of the patient id to narrow the scope of the studies displayed. Figure 3 -14 - Using the Study Filter In the above example, the character “c” was typed into the patient name filter to narrow down the search to all patients whose name begins with “c”.
Figure 3 -15 - Destination Selection All of the destinations previously defined will be presented with check boxes. Check the destinations you wish to send the studies and click “Send”. The studies are then spooled to be sent to those destinations. To open and view DICOM images that have been previously sent to PACS hosts, one should select the menu item FileàOpen Archive. This will bring up a open Study dialog, pointed to the image Archive. To save an Exam, click the File à Save menu item.
Figure 3 -16 - Selecting a Save Directory One navigates to the desired directory with the standard Windows File Open Dialog. To create a new directory for downloading, click “Make New Folder” . Figure 3-17 - Creating and renaming a folder. After creating the folder one should rename it and then navigate to it by clicking on it.
Figure 3-18 - Navigating to the newly created save directory After the folder is created and selected for save, as shown above, Click the OK button. To import and image into a study, click FileàImport. Navigate to the desired directory as shown in the above examples. Choose the file type you wish to import and select the file. If the file type is unknown, choose “all files” in the file type combo box.
In the above example, a JPG image called Sample has been selected for Import. Click Open to import the image. The image, as shown above, is then added to the exam. The image could be any standard JPG, PNG, TIF, etc. type image. The image could also be a scanned document that is to be inserted into the study for referring doctor exam documentation. When the exam is sent, via the Send button, the entire study, including the newly added image is sent as a package. One can also export any image in the study.
Figure 3-21 – Image Save Dialog Choose any file name desired and click save. Note that the File Type is predetermined and cannot be changed.
The “Sync. Database” button should be used to synchronize the database tables based upon the current image directory contents. This action can be lengthy depending upon the number of images in the archive. The progress bar on the screen with a “number of files” counter displays the current status of the database synchronizing process. The “Archive Directory” location can be changed by clicking the Folder Icon to the right.
Figure 3-23 – Radlink Print Menu Items The print menu items are arranged in two groups. The first group is for postscript printing. Using the postscript requires that the printer be correctly configured.
One should then select the printer using the combo box as shown above. To change the printer properties click Properties. The Properties dialog will permit you to change the print layout to “Landscape” or “Portrait” and also change other printer settings such as paper size, printer paper source, etc. One should then set the image layout. To do this select Print Layout: Figure 3-25 – Print Layout The print layout describes the image placement.
Figure 3-26 - DICOM Print Dialog The figure above shows the settings that can be made for the DICOM Printer. One selects the DICOM printer by selecting the printer from the printer Combo Box. New printers can be created by clicking the button “New”. A printer can be deleted by first selecting the printer to be deleted then clicking the button “Delete”. The Printer IP, Port and AE Title should now be entered. Note that the AE Title is typically case sensitive.
Copies: This is the number of copies to be printed. Permissible values are from 1- 100. Film Orientation: The permissible values are: LANDSCAPE PORTRAIT Film Size: The size of the film. Permissible values are: 4INX6IN 8INX10IN 85INX11IN 8.5INX11IN 10INX14IN 11INX14IN 14INX14IN 14INX17IN 24CMX24CM 24CMX30CM A4 Film Destination: This is typically the bin that the film will be deposited into.
Trim: This signifies whether or not to do cropping. Permissible values are: NO YES Min Density: Permissible values are from 1 to 399. Max Density: Permissible values are from 1 to 399. Empty Density: Permissible values are from 1 to 399. Border: This is the border color. Permissible values are: BLACK WHITE Polarity: This is whether the image is to be printed as a negative or normally.
The priority combo box sets the study priority that dictates its priority in the router send queue. This priority information is also passed along to PACS which will affect the priority of the study at that host. Use the Search button to perform a “Modality Worklist” patient search, a “Remote PACS” patient search, or a “Local Database” patient search. After the Patient Study Information is entered, then presses exit and performs image scans by pressing the scan button.
Figure 3-29 – Search Settings Screen The information below must be filled out. See your PACS administrator for the appropriate settings. Host Alias – A user chosen name of the PACS host. This name can be modified by selecting the text in the Host Alias combo box and retyping a new name. Changing the name will not impact Dicom communications. Its purpose is for a friendlier user interface. IP – Internet IP address. Usually a World Wide Web address, i.e. www.Radlink.com.
Figure 3-30– Radlink Open Archive Exams can be burned to CD with Radlink Image Acquire. The images scanned and saved by the Radlink Image Acquire application are burnable to CD using this facility.
Then click the Burn CD button. The system will prompt you for CD label information. This should be the label that is on the CD Case. If the label is to be saved into the Radlink database, click the “Save Into Database” button. The CD Label Database is used to retrieve studies from the CD Archive. If you do not wish to save the Label information into the database, then, click the button “Cancel”.
Figure 3-34 – Windows CD Prompt When the files are all added to the cd a CD Burner window will appear: Figure 3-35 CD Writing Wizard Enter a name for the CD and click “Next”.
When the burning process is finished, the CD will automatically eject. One can then view the exams by inserting the CD.
After navigating to the Exam on the CD, click OK. Then select the Exam to open and click Open Selected Study. One can choose their own viewer to be burned to the CD rather than the Radlink provided viewer by changing the settings in Image Acquire. The settings can be opened by clicking the menu item “Settingsà Dicom File Settings”.
To utilize a different viewer when burning a CD, enter the full path name of a viewer to burn rather than the Radlink provided viewer. Entering in the full path name is facilitated with the folder button to the right, which brings up a file navigation screen. The Image Acquire application can now save exams in Part 10 Format. This feature should not normally be used. To turn on the feature, check the “Part 10 Format” check box. All images saved by Image Acquire will then be saved in Part 10 Format.
After the client side settings are entered, click the “Ping” button . This will send a DICOM Ping to the PACS server to test connectivity. To set up the PACS server, a destination will need to be added. This is the destination corresponding to the Client machine that requested the study (the Radlink System). To do this on Centricity one first opens that application. Then select the menu item ConnectionàDestinations.
Figure 3-43 – Destination Identification The Connection parameters are: Figure 3-44 - Centricity Connection Parameters Note that the Host name is the IP address of the Radlink Image Acquire workstation. The port is the port specified in the Radlink settings described. The DICOM AE Title is the “Client Title” entered on the Radlink system. After the communications settings are entered, you can perform the Radlink Study Query Retrieve. Click the Query button to get a list of all studies on the PACS server.
letters of the patient name and/or the first character or two of the patient ID, and/or the study date from/to information.
Now proceed to the Modality setup screen by clicking on the “Modalities” tab. Figure 3-47 – Router Modalities Now enter the port information and default destinations for each of the modalities. routed. Figure 3-48 – Router Modalities The Name Combo box is the Radlink user defined name for the modality.
The Hosts list is a list of destinations that the Radlink system could forward the DICOM image to. To instruct the Radlink system to forward the image to a host destination, check the check box for that destination. The above figure shows a modality that has been configured to send to the destinations Radlink and LOCAL PACS. One could also send the image to the Dr. Jim Bob by selecting it as well in the above example.
All files being sent are routed through the DICOM Router. The status of the image may be viewed by displaying the Router Status window. To display the window, click on the Radlink Icon on the lower right corner of the computer screen. The status bar gives an instant look at which modality is currently sending to the Radlink Router, which PACS host the router is currently sending to, and how many images have been sent to the cancelled directory due to transmission problems.
Figure 3-50 – DICOM Router showing Resend and Delete Files Buttons on the Cancelled Screen Compression/Decompression is also supported by the Radlink Router. One should set the compression algorithm for each destination to perform the compression: Figure 3-51 – Radlink Router Destination Settings One can simply receive, archive, and not send an image sent to the Radlink Router.
Figure 3-52 – Radlink Router Modality Settings Images will then be received and archived, but not forwarded to any destination. Changing the priority of a study is accomplished by first clicking on the desired study then changing the priority by clicking on the “Study Priority” combo box and choosing one of the three priorities: Lastly, an interface for performing Radlink Archive Database Maintenance functions is provided.
The “Purge Files Older Than:” drop down list is the number of days that images will be retained in the Archive before being automatically deleted. This retention policy also applies to log file entries. Thus all logging entries older than that period will be removed as well. The “Sync. Database” button should be used to synchronize the database tables based upon the current image directory contents. This action can be lengthy depending upon the number of images in the archive.
The “Purge Old Files” button purges images and log file entries older than the retention period. This action is automatically performed upon Radlink application startup. It is also automatically performed once per day in unattended router operation.
RadLink Inc. CR Pro Computed Radiology Imaging Device DICOM Conformance Statement 1. Introduction This document provides conformance by the Radlink CR Pro Computed Radiology Imaging Device to the DICOM 3.0 standard as structured according to the specification set forth in DICOM Part 2. 1.1 References (1) ACR-NEMA V3.0 – Digital Imaging and Communications in Medicine (DICOM) v3.0 Final Draft 1993 Parts 1 through 9. 1.
2. Implementation Model The CR Pro 2.1 Application Data Flow Model The CR Pro, acting as a single Application Entity, digitizers an x-ray phosphor plate image as a Secondary Capture Image and transmits the image to a Server. DICOM Standard Interface Radlink CR Pro Radlink Image Express Application Server SCP SCU 2.2 Functional Definitions of Application Entities The CR Pro, acting as a Service Class User, sends Secondary Capture Image data to a Server via Storage User Class C-Store.
3.1 CR Pro Specifications 3.1.1 SCU Verification This AE provides standard conformance as an SCU to the DICOM V3.0 SOP class for Verification as shown in Table 1. Table 1: SOP Verification Classes SOP Class SOP Class UID Verification 1.2.840.10008.1.1 3.1.2 SCU Storage This AE provides standard conformance as an SCU to the DICOM V3.0 SOP class for Secondary Capture Image Storage as shown in Table 2. Table 2: SOP Storage Classes SOP Class SOP Class UID Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.
The Implementation Class UID for the CR Pro is as follows: 1.2.392.12345.( serial #).(year).(month).(day). (hour).(min).(sec).(millisec) 3.2.5 Association Initiation by Real World Activity Related Real World Activity is the issuance of an Association with a remote server when a Secondary Capture Image is to be sent. 3.2.5.1 SOP Specific Conformance - Verification This AE provides standard conformance as an SCU to the DICOM V3.0 SOP class for SOP Verification Classes as shown in Table 3.
Table 5: Non-Compressed Image Values Attribute Tag VR Value Specific Character (0008,0005) CS ISO_IR 100 Set SOP Class UID (0008,0016) UI 1.2.840.5.1.4.1.1.7 SOP Instance UID (0008,0018) UI 1.2.392.12345.( serial #).(year). (month).(day).(hour).(min).(sec). (millisec) Study Date (0008,0020) DA yyyy.mm.dd Study Time (0008,0030) TM hh.
Interpretation Rows Columns Bits Allocated Bits Stored High Bit Pixel Representation Pixel Data 3.2.5.3 (0028,0010) (0028,0011) (0028,0100) (0028,0101) (0028,0102) (0028,0103) US US US US US US 8 or16 8,16 7, 12, 15, or 16 0 (7FE0,0010) OW Presentation Context: Detached Study Management SOP Class The Presentation Context Shown In Table 6 Are supported by the Study Management AE in the support of Real World Activity 1.
The CR Pro application supports the following: Local Area Network (LAN); Wide Area Network (WAN); Ethernet 10BASE-T, 100BASE-T; Internet ,DSL; and CD-RW. 5 Extensions/Specializations/Privatizations Not currently applicable. 6 Configuration 6.1 AE Title/Presentation Address Mapping No title/presentation mapping information is required to be set for the AE address mapping. 6.
IS single Floating point double Integer string LO Long string LT Long text FD 64-bit binary floating point number. 8 Bytes Fixed A string representing a signed integer. At most 12 characters. A general purpose string of at most 64 characters. A text of at most 10240 characters. 12 Bytes Maximum OB Other byte string Byte data according to negotiated encoding. OW Other word string 16-bit word data according to negotiated encoding.
Column 1 Requirement Type Meaning Column 2 TAG 76 Column 3 Column 4 Element VR* Name
1 Required element, and null values are not allowed. The CTX always provides this element. 2 Required element, but null values are allowed. The CTX always provides this element, possibly with a null value. 3 Optional element. The CTX provides this element if this is configured. Even if configured a null value may be provided. 1C, 2C, 3C Conditional versions of 1, 2, 3. It is specified which conditions must be met in order to provide the element.
