Centricity Web

Centricity Web

A web-based system for examining medical images on the Internet

Finding studies

Note: When you start Centricity Web, it will display the worklist you last viewed if accessed directly, or the patient folder from the patient selected if you are going in from Mindscape or ORCA.

Queries (only applicable if accessing Centricity Web Directly):

       Typing B* will search for all patient’s whose last name starts with a B.

       Typing Anders?n will search for Anderson or Andersen.

       The dash (-) can be used to query for a date range - 11012006-11302006 for example.

        Searches can be done from any column that is not grayed out.

       The data can be sorted by any of these columns, ascending or descending order.

       Clicking the sign at the beginning of the row expands the information to show how many series the study contains. Clicking the collapses this information.

How long it takes to retrieve images depends on where they are stored:

There are local images for this study. It will open quickly.

Part of the study is on PACS and ready to view.

Indicates there are no images in PACS for this study. They may be on a CD.

The study is in long-term storage on PACS and must be retrieved. It will take a few minutes to retrieve the images and open the study. Use the fetch Icon to pull up the study. You will need to hit the refresh button to see when the additional images become available from Archive.

Part of this study is in the PACS archive and must be retrieved.

The study is on a remote server and must be retrieved before it will be available to view. This may take some time with a large study.

Selecting a study to view:

       To view the entire study, double-click.

       Highlighting the study displays thumbnail images in the Pictorial Index on the left side of the window. This allows you to preview studies and select   particular images to view. Once the images are selected, the icon will display them.

        You can expand or collapse this area using the arrow.

        Using the Ctrl key, you can select multiple images to view or use the Shift key to select a contiguous range of images to view.

        Report and exam information can be viewed at the bottom of the window and also expands or collapses using the arrow.

        The Worklist button takes you back to the worklist.

        The Key icon displays only images marked in PACS as significant (or key). It will be grayed out if there are no key images in the selected study.

        Studies will open with a toolbar and display that are dependent on the modality.

        Use the historical exams icon to see a list of prior exams to display while still viewing current exam.

Clicking the down arrow by this icon will allow you to change the tool (icon) selection. Choices are Basic, Modality dependant, and All.

Maximizing your viewing area:

        Use your arrow icons to temporarily hide the Pictorial Index and Report window.

        There are 2 ways to maximize your viewing area.

       F11 on your keyboard will put Internet Explorer in full-screen mode. F11 again returns it to normal mode.

       The icon puts makes the Viewport full-screen. Clicking it again restores the normal screen. It also gives you access the icon to close the application and return to the log in window .

        One-up mode maximizes a single image. Double-click on the image to see it a maximum possible size. Double-click again to restore the window.

        Annotations (show/hide patient and image data):

       Show / hide study information. Only the image shows.

       Show / hide caliper.

Mouse Functionality:

A      The Scroll Wheel or middle mouse button

To change the magnification, hold the scroll wheel (or middle mouse button down and move the mouse

            Up = Zoom out

            Down = Zoom in

B       Use the Scroll wheel to scroll through images

Up = Backward

Down = Forward

C      The Left Mouse button

Click and drag to Pan the image

This button is also used to select images or actions. Used in conjunction with the Cntrl or Shift keys, you can select multiple images.

In Cine mode, drag the left mouse to manual cine. (Cine must be turned on for this to work.)

D      The Right Mouse button

Click and drag to adjust brightness and contrast.

            Up = Darkens

            Down = Brightens

            Right = decrease contrast

            Left = increase contrast

A single click initiates a pop-up menu.

VIEWPORT AREA:

Viewports contain images. It is called the viewport area because it is divided up into viewports each containing a single image. You can display a single viewport or an array of them. Various layouts are possible. The window will open with a default layout depending on the type of study. This layout can be changed.

To make a viewport active, click anywhere inside it and a yellow box will highlight the active viewport.

Series area:

Viewports can be set up to view up to 4 series of images at the same time. Series areas are divided by thick lines.

Within the Series area, you can view up to 24 images at the same time. This can be changed using the viewport layout icon.

The picture on the icon shows what setting is currently in use. The down arrow beside it allows you to select another layout. Use the Pictorial Index to select which images are displayed.

To browse through a series, click on one of the viewports and then hold down the mouse wheel, release it and turn the wheel to scroll through the series. The “arrow” icons also allow you to move through images.

Next

Previous

Scope:

The down arrow allows you to select the scope of changes. The Icon shows your selection. Choices are:

Scope Image – Only the currently selected image(s) will be affected

Scope Series – All the images in the same series will be affected

Scope Study – All the images in all the series in the study will be affected

Scope All – All studies currently open will be affected in the same way

This icon is used to “pin” an image which causes it to remain in place and unchanged while the images in the other viewports change. Click it again to “unpin” the image.

OTHER TOOLS:

Remember, your mouse can also do some of this without selecting a tool.

Window level settings – selects standard presets. User your right mouse button to customize. The further you drag your mouse, the greater your changes.

Invert grayscale

ROI (Region of Interest) tool. Select a viewport and then click the icon. A rectangle appears in the selected viewport. To adjust the size, drag its edges or corners. To reposition, click inside it and drag. Right click and select Delete to remove, or drag the ROI outside the viewport.

Use the selections to change the image resolution.

        Left click on the image and drag to move it around (pan).

        The magnifying glass selection creates a magnifying glass above the viewport area, Use your mouse within the magnifying glass (holding down the left mouse button) and drag it over the viewports. Drag the slider to increase or decrease the magnification. Resize by dragging the edges or a corner.

        You can use multiple glasses at the same time.

        To window the magnifying glass area, right-click an area inside the magnifying glass and drag the cursor up and down.

        Close by clicking the “close” button in the top right corner.

Image Orientation. Allows you to flip or rotate the image.

Pixel lens – measures the pixel value at a particular point. To remove, right-click and select Delete or drag it off the viewport.

Distance measurement – click and drag the cross hairs to measure. Use Zoom for fine adjustment. Move the entire line by clicking on its center and dragging. To remove, right-click and select Delete or drag it off the viewport.

Angle measurement – drag the ends to change the angle. Drag one of the lines at its center to move the angle. Use Zoom for fine adjustment. (Cobb angle measurement works the same way.)

CINE LOOPS:

Cine loops are continuous displays of sequences of images in a viewport. There are several ways to use them.

Cine tools

.

Auto cine forward         and      Auto cine backward

Seldom used as it is too fast.

stops the cine.

Manual cine or pause cine. Selecting this allows you to use the scroll wheel on your mouse to control cine speed. If you don’t have a scroll wheel, you can drag the mouse in the viewport to move through images. Click again to turn off manual cine.

A wheel icon   appears in the upper left corner of the viewport when you start a cine.

Linking cine loops:

You can have a number of loops running at the same time. To create a link:

Create the manual cines you want to link together.

Click in the viewport with the starting image

Click the manual cine button     and you will see the wheel icon appear.

Repeat for the other series you want linked.

Select the cines by holding down the Ctrl key and clicking the viewports.

Adjust the offsets if necessary – you cannot do this once they are linked.

Use your mouse to align the images, then hold down the Ctrl key and click the Cine Link button.

Click the Cine Link button

If the cines are different lengths or the offset (phase) causes a gap, the viewport will appear black.

You can break the link by turning off one of the cines.

Using Profiles:

Profile – allows you to measure pixel values (density) along a line.

·         Click the two end points to adjust the beginning and end positions. Use Zoom for fine adjustment. Move the entire line by clicking on its center and dragging.

·         Right-click on the line and select “Show Info” to view a graph of the pixel values along the line.

·         To remove, right-click and select Delete or drag it off the viewport.

ROI’s (Region’s on Interest):

or

·         Click and drag to the desired location. Drag the borders to resize.

·         Right-click on the ROI and select Show Info to view statistics of the pixel values within the ROI.

·         To remove, right-click and select Delete or drag it off the viewport.

Shutters:

or

·         Shutters (masks) let you hide parts on images.

·         Click and drag to the desired location. Drag the borders to resize.

·         To remove, right-click and select Delete or drag it off the viewport.

Inverted window regions:

or

Inverts the window levels only within the parameters of the box or ellipse.

·         Click and drag to the desired location. Drag the borders to resize.

·         To remove, right-click and select Delete or drag it off the viewport.

Using Cutlines:

Cutlines are intersections between 2 planes. The images must be part of a CT or MR study.

To display cutlines on images:

1.      Right-click on the viewport and select Cutlines and a series from the pop-up menu.

2.      Or, click on the toolbar icon .

The first and last cutlines of a series are shown. To view a particular cutline, drag the cutline selector line (shown between the first and last cutline).

What happens when cutlines are turned on depends on the layout. If the layout is 1x1, cutlines are enabled for all images in the series. It is then possible to view 2 series in 2 series areas with cutlines on each other. In all other layouts, the active image is pinned before cutlines are generated. This allows you to reuse the other viewports in the series area for the intersected images.

Using cutlines to select images for display:

1.      Pin the viewport containing your cutlines.

2.      Click the cutline of the image to display it.

3.      The corresponding image will be displayed with as many subsequent images as will fit in the remaining viewports on your screen.

Multiple sets of cutlines:

You can show cutlines in more than one viewport at a time. For each viewport, right-click and select the appropriate cutlines you want to view.

Show / hide cutlines:

Right-click in a viewport and select Cutlines from the pop-up menu. Select the series you want to show or hide.

Turn off cutlines: Click the tool bar icon . All cutlines will turn off.