synedra View Personal - Λυκαβηττός · synedra View Personal ... Open SYNEDRA.DIR file ......

synedra View PersonalUser Manual

© 2010 synedra information technologiesAny and all information provided in this document may be subject to change at any time without notice.

Creation date: 22 July 2010Published: 29 July 2010

Author: Judith Sieberer <[email protected]>

Website: www.synedra.com

Product: synedra View PersonalProduct version: 1.1.0synedra AIM version 2.9 "Athene"

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Table of Contents

1. Notes ...................................................................................................................................... 11.1. What is new in synedra View Personal 1.1.0? .................................................................... 1

1.1.1. What is new in viewing and editing images? ............................................................ 11.1.2. What is new in copying and saving images? ............................................................ 21.1.3. What is new in viewing videos and multimedia? ....................................................... 21.1.4. What is new in the Stripe? ................................................................................... 21.1.5. What is new in the MPR view? ............................................................................. 21.1.6. New shortcuts ..................................................................................................... 21.1.7. What is new in the configuration (Extras - Settings...)? .............................................. 21.1.8. Technical news .................................................................................................... 3

1.2. Online Help .................................................................................................................. 31.3. Safety notes .................................................................................................................. 41.4. About synedra ............................................................................................................... 5

2. User Interface .......................................................................................................................... 62.1. Overview ...................................................................................................................... 62.2. Icon bar ........................................................................................................................ 62.3. Menu bar ..................................................................................................................... 72.4. Stripe ........................................................................................................................... 8

2.4.1. Show/ hide stripe ................................................................................................ 82.4.2. Hang documents to the Stripe ............................................................................... 82.4.3. View documents on a screen ................................................................................. 82.4.4. Grid ................................................................................................................... 92.4.5. Reset stripe ........................................................................................................ 9

2.5. Documenttree ................................................................................................................ 92.6. Tabs ........................................................................................................................... 10

3. Search and Load ..................................................................................................................... 113.1. Overview .................................................................................................................... 113.2. Command File - Open .................................................................................................. 113.3. Browser ...................................................................................................................... 113.4. Microsoft Windows Explorer .......................................................................................... 11

4. Preview ................................................................................................................................. 134.1. Overview .................................................................................................................... 134.2. Documents from the Documenttree ................................................................................ 134.3. Documents from the Save/Edit Selection .......................................................................... 13

5. Tools ..................................................................................................................................... 145.1. Overview .................................................................................................................... 145.2. How to use tools ......................................................................................................... 15

6. Copy and Save ....................................................................................................................... 176.1. Overview .................................................................................................................... 176.2. QuickGuide to saving documents .................................................................................... 176.3. Select documents for saving/editing ................................................................................ 18

6.3.1. From the Documenttree ...................................................................................... 186.3.2. Select an individual image for saving ..................................................................... 186.3.3. From the Browser .............................................................................................. 186.3.4. Remove documents from the Save/Edit Selection .................................................... 19

6.4. Save documents to the file system .................................................................................. 196.5. Copy an image with Drag & Drop .................................................................................. 206.6. Copy a document to the clipboard .................................................................................. 206.7. Save data anonymously ................................................................................................. 21

7. QuickStart Guide synedra Patient CD ......................................................................................... 237.1. Overview .................................................................................................................... 23

synedra View Personal

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7.2. CD Browser ................................................................................................................. 268. QuickStart Guide for downloading synedra View Personal from the Internet ..................................... 299. Keyboard shortcuts .................................................................................................................. 3110. Technical information ............................................................................................................. 35

10.1. System requirements ................................................................................................... 3510.2. Supported file formats ................................................................................................. 3510.3. Installation ................................................................................................................. 3610.4. Updates .................................................................................................................... 3610.5. Feedback ................................................................................................................... 37

11. DICOM Query Retrieve ......................................................................................................... 3811.1. Requirements ............................................................................................................. 38

11.1.1. Configuring the external archive ......................................................................... 3811.1.2. Configuring synedra View Personal ..................................................................... 38

11.2. DICOM Query/Retrieve Communication ........................................................................ 3911.3. Performing DICOM Query/Retrieve ............................................................................... 39

Index ........................................................................................................................................ 41A. MDD Directive 93/42/EEC ....................................................................................................... 42

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List of Figures

2.1. synedra View Personal user interface ......................................................................................... 62.2. Stripe ................................................................................................................................... 82.3. Documenttree ...................................................................................................................... 107.1. CD Browser ......................................................................................................................... 247.2. Example of a loaded CT scan ................................................................................................. 257.3. Toolbar ............................................................................................................................... 267.4. Open SYNEDRA.DIR file ........................................................................................................ 267.5. CD Browser ......................................................................................................................... 278.1. CT scan .............................................................................................................................. 298.2. Toolbar ............................................................................................................................... 30

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List of Tables

2.1. Icons from the icon bar .......................................................................................................... 65.1. Tools .................................................................................................................................. 149.1. Keyboard shortcuts ............................................................................................................... 319.2. Keyboard shortcuts for image viewing and editing ..................................................................... 3110.1. synedra View Personal hardware requirements ........................................................................ 3510.2. synedra View Personal operating system / software requirements ............................................... 3510.3. Supported file formats ......................................................................................................... 35

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1. Notes1.1. What is new in synedra View Personal 1.1.0?Module of the synedra AIM Version 2.9 "Athene"

These Release Notes summarize the major changes made in the latest release of synedra View Personal.

1.1.1. What is new in viewing and editing images?Measuring ultrasound scansMeasurements of ultrasound scans with calibration data in centimeters are now supported within the calibratedarea. Measurements outside this area are marked as 'invalid'.

New tool: Freehand measurementWith this tool you can draw lines and measure any lengths and surfaces.

Adjustable annotations

• Line width: The line width of annotations can now be configured under Extras - Settings...- Image text.

The line width of annotations can now be adjusted individually for each annotation with the help of the"Annotation" dialog (opened by double-clicking an annotation).

• Text color: The text color of annotations can now be adjusted individually for each annotation with the helpof the "Annotation" dialog (opened by double-clicking an annotation).

• Annotation text: The size of the annotation text can now be adjusted individually for each annotation withthe help of the "Annotation" dialog (opened by double-clicking an annotation).

Furthermore, the annotation text can now optionally be displayed or masked.

• Annotation circles can now be shown in dotted lines.

Creating several synchronization chainsSeveral synchronization chains can now be created by using the Link viewers tool. Those chains can besynchronized independently from one another.

Improved handling of multiframes

• Multiframes (e.g., images from the modality US) can now be displayed as sequences (1 sequence = 1 image).

• In the Documenttree, preview images are now available for sequences and avi files.

• In the Documenttree, preview images of sequences can be recognized by a specific icon, allowing todistinguish them from preview images of video files.

Measuring grey valuesGrey values in images other than CT scans can now be measured by using the Measure density/grey value tooland the Measure density/grey value average tool.

Measurements and annotations saved when changing viewing modeMeasurements and annotations are now stored in the buffer when changing the viewing mode. When goingback to the initial viewing mode, the measurments and annotations are restored.

Shtter tools

• With the new tool Shutter all images a shutter can be applied simultaneously to all images in a viewer.

• The display of rectangular shutters contained in the DICOM data is now supported (ShutterShapeRECTANGULAR).

New sorting criterion "Content Time"

Notes

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The new sorting criterion Content Time sorts DICOM images in ascending order based on the moment theywere taken (DICOM tags <ContentDate> and <ContentTime>). This criterion is automatically selected whendragging a DICOM study with several series into a viewer.

Masking sliders for scrollingThe sliders for scrolling can now be masked, leaving you more space to add further tools to the toolbar.

1.1.2. What is new in copying and saving images?Copying images to the clipboardWhen copying an image to the clipboard (by clicking the Copy icon or by using the <Strg>+<C> keyboardshortcut), image data alone are now copied to the clipboard. This means for images pasted in another application,the image data is pasted by default. However, you can still configure to copy image and text data to the clipboard.

Selecting a directory name for documents saved to the file systemThe "Comment" field in the Save/Edit Selection can now be used to specify a directory name for documentsthat are saved to the file system. Additionally, you can configure a time stamp which then becomes part of thedirectory name. This requires that you select "personal comment" as file name in the Save/Edit Selection.

1.1.3. What is new in viewing videos and multimedia?• The media player integrated in synedra View Personal is now used by default.

• DICOM MPEG2 videos can now be streamed directly from synedra AIM Archive.

• Videos can now be played on loop.

• Preview images for videos are now availabe in the Stripe and the Documenttree.

• Videos are now paused when the media player ist masked, and continued when the media player is displayedagain.

• Series of sliced images and DICOM multiframes can now be saved as videos (.avi).

• The volume is now saved.

• Proprietary GE ViewPoint DICOM videos are now supported.

1.1.4. What is new in the Stripe?• The "Link displays" chain icon is new bigger, allowing users to recognize more easily if the "Link displays"

mode is on (linked chain) or off (broken chain).

• The keyboard shortcuts used to navigate in the Stripe have been modified due to technical reasons, i.e. <Strg>+<Image down> jumps to the next stripe field, <Strg>+<Image up> jumps to the previous stripe field.

1.1.5. What is new in the MPR view?With the new Save current view tool, which is available only in the MPR viewer, the current MPR view can betransferred to the Save/Edit Selection.

1.1.6. New shortcuts• <Strg>+<Image down> jumps to the next stripe field

• <Strg>+<Image up> jumps to the previous stripe field

1.1.7. What is new in the configuration (Extras - Settings...)?What is new in the section "Image text"?In the new area "Annotations", you can customize annotation settings, i.e. annotation text size, annotationline width.

Notes

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What is new in the section "View"?

• The new option Copy as an image and as text allows you to determine if image information only (default)or image and text information be copied to the clipboard.

• A further resolution, i.e. 1024*768, is now available for clipboard images. This resolution is suitable forprojectors and big monitors.

What is new in the section "Communication"?There are two new entries in the "Wep Update" area:

• Automatic installation for: With this entry you can determine which updates are installed automatically.There are three options available: No updates, Error corrections (bugfixes) and All updates.

• Max. download speed: With this entry you can determine the max. download speed for update downloads(to be specified either in per cent or in absolute numbers in Kb/s).

What is new in the section "Save"

• In the "File names" area, another pre-configured file name is now available, i.e. personal comment. Thisfile name allows you to specify an individual directory name in the "Comment" field from the Save/EditSelection for documents saved to the file system.

What is new in the section "Video"

• The option Play media on loop allows you to determine if videos are played on loop, i.e. repeatedly.

• With the option Play local media with integrated media player you can determine if media saved to the localfile system are played using the media player integrated in synedra View Personal.

1.1.8. Technical news• The update mechanism has been modified. With the configuration option Automatic update installation for

you can now determine if any updates / which updates are installed automatically.

• Only a single instance of synedra View Personal can now be launched per Windows user.

• synedra View Personal is now availabe as a 64 bit native application. When there is already a 32 bit synedraView Personal version installed on your computer, you need to deinstall this version before installing thenew version.

1.2. Online Helpsynedra View Personal is an application designed to view medical images, documents and videos. You have beengiven synedra View Personal either on a patient CD or you have freely downloaded1 it from the Internet.

Reference herein to any specific product by commercial name, trade name, designation of goods or otherwiseis only for the purpose of identification of the product. All commercial names, trade names and designations ofgoods are registered trademarks of their associated manufacturers and shall remain at all times the property oftheir associated manufacturers.

Information for users of patient CDsGo to the following sites for further information:

• QuickStart Guide for the synedra patient CD: Opening and viewing images from the CD

• Loading data from other patient CDs with the CD Browser

Information for download usersGo to the following sites for further information:

• QuickStart Guide for download from the Internet

1 http://download.synedra.com/

http://download.synedra.com/

http://download.synedra.com/

Notes

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• Searching and loading data: Loading data from the hard disc or other storage media

Notes

• Date format: synedra View uses the date format dd/mm/yyyy.

• Product documentation: Handbooks, training documentation, QuickStart Guides... on any of thesynedra AIM applications are available for our customers:

Click on the Documentation link in the application synedra Control at the top-right corner of theprogram window to download or view our product documentation.

1.3. Safety notes

Disclaimer

For legal reasons, we must point out that synedra View Personal may not be used for diagnosticpurposes. Under no circumstances may synedra View Personal be used for diagnostic imaging. synedraView Personal may be used for image viewing only.

Please note that only the German licence agreement is legally binding. Therefore, the licenceagreement is available only in German language.

Using the shutter tools

Data relevant for diagnositc imaging might be hidden when applying the shutter tools to DICOMimages!

Using the mask tool

Data relevant for diagnositc imaging might be hidden when applying the mask tool to DICOM images!

Applying image masks to series

Data relevant for diagnositc imaging might be hidden when applying an image mask to all images ofa DICOM series.

Using the rotation cube

When turning the rotation cube, the lateral navigation windows are not synchronized, leading to adifferent view in the main window 1 compared with the views in the lateral navigation windows.Therefore, the lateral windows are darkened as soon as you apply the rotation cube in the main window.

Inaccurate measurements

In synedra View Personal, inaccurate measurements can be due to the imaging modality or to the imagerecord (particularly with x-ray images).

Displaying slice position with localizers

A localizer, which is the line of intersection of two slices, provides no information on the angle betweenthe two slices. A localizer provides no information on how two slices are situated to one another.

"Zoom to Original Size" is only applied to the image currently edited

The "Zoom to original size" tool only applies to the image currently edited. In fact, further imageswithin the same DICOM series might have a different resolution despite their having the same zoomfactor. This zoom factor, however, does not correspond to the original size of the relevant image ifthere is a different resolution.

Notes

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This is particulary important when applying this tool to an image before further scrolling the series.

"Zoom to Comparable Size" is only applied to the images currently displayed

The "Zoom to comparable size" tool only refers to the images currently displayed. In fact, furtherimages within the same DICOM series might have a different resolution despite their having the samezoom factor. This zoom factor, however, does not correspond to the comparable size of the initial image.

This is particulary important when applying this tool to an image before further scrolling the series.

Viewing images from different patients

Basically, images from different patients can be displayed one next to the other on one or several screenseither by manual hanging with Drag & Drop or by using the Automatic hanging commands from thecontext menu in the Documenttree.

1.4. About synedra

synedra information technologies is an Austrian software vendor specialized in the field of medical informatics.We are experts in the development of multimedia PACS (Picture Archiving and Communication Systems) anduniversal archives for medical purposes.

For more information on synedra information technologies as well as on our product portfolio and references,please go to our website www.synedra.com2!

Contact informationYou can contact us via email or telephone.

• synedra information technologies GmbHFeldstrasse 1/13 | 6020 InnsbruckFon: +43 / (0)512 / 581505Fax: +43 / (0)512 / 581505-111E-mail: [email protected]

• Technical support:Our support team is available for you from Monday to Friday from 09.00 to 17.00 hours (except on holidays).Email: [email protected]

Service hotline for AIM administrators: +43 / (0)512 / 581505- 777

• Feedback form and service log: In synedra View Personal, go to ? - Feedback. Use the feedback form if youwish to get in touch with us. We will process your request and contact you if you wish. You can also adda service log to your message. This service log file contains system information on your computer settings,which will help our support team to solve any technical problem that might arise.

• User forum: Go to our website http://download.synedra.com to join the synedra View Personal user forum.After signing up, you can make contact with other users of our software and share your ideas and suggestionsregarding the use of synedra software.

• Suggestions and enquiries about this user manual : This user manual is constantly improved and updatedto keep up with the latest modifications and improvements of our software. If you have any suggestionsor requests, please contact us. Your feedback will assist us in the future in further enhancing the quality ofour documentation!

E-mail: [email protected]

2 https://www.synedra.com

https://www.synedra.com

mailto:[email protected]


http://download.synedra.com


https://www.synedra.com

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2. User Interface2.1. Overview

The clearly structured, intuitive synedra View Personal user interface is divided into six functional areas:

• Menu bar

• Icon bar

• Working area, including different tabcards, e.g. Search tab, Display, etc.

• Documenttree

• Stripe

Figure 2.1. synedra View Personal user interface

2.2. Icon bar

The icon bar consists of different icons providing easy access to the most frequently used commands. With thehelp of these icons you can easily and intuitively use synedra View Personal.

Icon Function Shortcut

Clear Documenttree F4

User Interface

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Icon Function Shortcut

File - open <Ctrl>+<O>

Login

Logout

Change password

Download in reduced quality(only visible after being activatedby the system administrator)

Copy <Ctrl>+<C>

Show/hide sidebar

Show/hide stripe <F3>

Fullscreen (only in Display) <F11>

Multiscreen <Shift>+<F11>

Toggle localizer display

Lightbox

Store case for presentation <F6>

Previous/Next case <F7>/<F8>

Previous/Next stripe field <Ctrl>+<PagUp/PgDown>

Remove localizer series fromDocumenttree

This icon can bedisplayed by meansof synedra Script.

Table 2.1. Icons from the icon bar

Moving buttons in the icon bar:Groups of buttons are separated by vertical double bars. When moving the mouse over a double bar, the cursorturns into a cross with four arrow heads. Click on a group of buttons and move it while holding the left mousebutton down. Drop it where you want it to appear in the icon bar.

2.3. Menu bar

Situated at the top of the user interface, the menu bar contains all commands and settings relevant for the useof synedra View Personal.

User Interface

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2.4. Stripe

Figure 2.2. Stripe

Consisting of individual stripe fields, the stripe is situated in the lower part of the user interface. On startup, thenumber of stripe fields corresponds to the number of active displays (= screens) available. Basically, you can addan infinite number of stripe fields to hang and display further documents.

2.4.1. Show/ hide stripeTo maximize the area available for image viewing, there are different ways for you to hide the stripe.

Select View - Show/hide stripe from the menu bar.

Or click the "Show/hide stripe" button from the icon bar .

Or use the <F3> shortcut key.

TipAnother way to maximize the area available for image viewing is to hide the side bar. To do so, selectView - Show/hide side bar from the menu bar.

2.4.2. Hang documents to the StripeYou can hang documents either manually with your mouse or automatically with the help of a hanging commandor the hanging buttons.

How to hang documents manually:

1. Click on a loaded document from the Documenttree.

2. Hold down the mouse button while dragging the document into the first empty stripe field.

3. Drag & drop further documents to hang them in the next empty stripe fields.

How to hang documents automatically:

• Hanging commands: Right-click on a document loaded into the Documenttree. Select a hanging commandfrom the context menu.

• Double-click: Double-click on a document loaded into the Documenttree.

• Hanging buttons: Click one of the hanging buttons situated above the Documenttree.

2.4.3. View documents on a screenTo view a document on a screen, put a Display on the stripe field containing the document you wish to view.To do so, select the stripe field by a left mouse click.

User Interface

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TipThis stripe field will then be outlined in orange (active Display)/blue (inactive Display).

To activate a Display (e.g. Display 1)

select View - Activate Display (e.g. Display 1)or use the <1> shortcut key (to activate Display 1, n to activate Display n).

2.4.4. Grid

With the help of grids, you can flexibly subdivide all stripe fields or an individual stripe field into lines and columns.

How to apply a grid to all stripe fields:

Click the grid button . Select one of the pre-defined grids or use the mouse to define a grid:

1. Move the cursor to the Grid menu point.

2. Drag the cursor over the displayed grid.

3. Click with the left mouse button to apply this grid.

How to apply a grid to an individual stripe field:

1. With your mouse click on the small, downward-pointing arrow in the lower left corner of the stripe field.

TipThe arrow will become visible only after you have moved the pointer to the stripe field.

2. From the context menu, select the grid to be applied to this stripe field.

2.4.5. Reset stripe

To remove documents from the stripe, you can either clear the entire stripe or just an individual stripe field.

How to clear the stripe:

Select Edit - Reset stripe from the menu bar.

Or click the reset button .

Or use the <Ctrl>+<Shift>+<L> shortcut key.

How to clear an individual stripe field:

1. With your mouse click on the small, downward-pointing arrow in the upper left corner of a stripe field orright-click a stripe field.

2. Select the Clear stripe field command from the context menu displayed.

2.5. Documenttree

The Documenttree displays the pictures and/or series which have been loaded into RAM.

An entry is organized as a tree-structured hierarchy based on the levels patient - examination - series. Image textand colors can be customized under Extras - Settings... - Documenttree.

User Interface

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Figure 2.3. Documenttree

2.6. Tabs

The working area is sub-divided by tabcards into different areas. Click on the tabcards to switch between them,as you carry out different tasks.

• Click on the Display to view images.

• Click on the Preview tab to instantly view documents loaded into the Documenttree.

• The CD Browser displays the content of a patient CD/DVD.

• The Browser tab allows you to search images and Non-DICOM documents contained on your CD/DVD, thehard disc drive or any other storage medium.

• Use the Save/Edit Selection to prepare documents for export to CD/DVD or to the file system.

• The DICOM Dump tab is only displayed if the Show DICOM Dump option is activated (Extras - Settings... -Advanced). Here you can display text information derived from DICOM files.

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3. Search and Load3.1. Overview

There are different ways to search locally stored data (e.g. images, PDF files, videos). You can load data

• by selecting the File - Open command

• with the integrated Browser

• directly from the Microsoft Windows Explorer

• with the CD Browser (only patient CDs/DVDs).

3.2. Command File - OpenOne way to open locally stored files is the File - Open command.

1.Select File - Open... from the menu bar or click the Open button in the icon bar or use the <Ctrl>+<O> keyboard shortcut.

2. If required, select another file format from the Open-dialogue window. The following file formats areavailable: All files (*), graphical files (*.jpg *png *.gif *.bmp *.pnm *xbm), ZIP files (*.zip *.izf *.szf) andDICOM files (*.dcm *.dcm30 *.dicom).

3. With the mouse, select the file you would like to open.

4. Select Open from the dialogue window to load the file.

3.3. BrowserIf you do not access data stored in the archive, the Browser is a convenient means to access locally stored files.

You can conveniently search documents in the local file directory.Images are displayed as thumbnails.Furthermore, an image preview is available.

TipThe Browser can also be used as a web browser.

The Browser is sub-divided into different areas: file directory, thumbnail overview and image preview.

How to load images from the Browser:

1. Select the Browser tab.

2. Search for images you would like to open by browsing the available storage media (hard disc drives, CD/DVD, USB stick,...).

3. Double-click on a folder in the file directory to view the images contained as thumbnails.

4. Select a thumbnail by a simple mouse click. The image will be displayed in the image preview.

5. Depending on the intended use, either click the Load into Documentree button or the Select for saving/editing button.

3.4. Microsoft Windows ExplorerWith Microsoft Windows Explorer, you can conveniently open locally stored files in synedra View Personal.

Search and Load

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1. Open synedra View Personal as well as Microsoft Windows Explorer.

2. Search the relevant file in the Explorer file directory.

3. Select one or a number of files with a left mouse click. Then, drag & drop the selected file(s) in theDocumenttree on the left.

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4. Preview4.1. Overview

Use the Preview to instantly view multimedia data. A range of file formats can be displayed, including

• image formats: DICOM, JPG, PNG, GIF, TIF, BMP, PNM, XBM, XPM

• PDF documents

• videos: AVI, WAV, MPEG files

Displaying multimedia formats in the Preview requires an Active-X compatible PDF preview application, e.g.Adobe Reader, an Active-x compatible video application, e.g. Windows Media Player, and the correspondingcodecs on your computer. The Active-X components must be compatible with 64-bit operating systems whenused on 64-bit computers.

Notes

In System requirements - operating system /software requirements for synedra View Personal you willfind a number of tested and recommended program versions.

If a file format cannot be displayed in the Preview, the "Open with standard application..." dialogappears, allowing you to open files with a suitable external application.

Edit documents in the PreviewIn the Preview, right-click on a document to open the tool menu.

4.2. Documents from the DocumenttreeThe Preview always displays the currently selected indivudual file (or DICOM series) from the Documenttree.

How to display documents from the Documenttree:

With the Preview in the foreground, click with the left mouse button on a loaded document with a preview image.

NoteWhen loading PDF files or videos for the first time after startup, this process will take as long as startingthe plugin application, e.g. Adobe Reader in the background. The startup speed might vary, dependingon the memory space available and the number of opened programs.

4.3. Documents from the Save/Edit SelectionHow to display documents from the Save/Edit Selection:

Use the Preview to view documents from the Save/Edit Selection. Single-click an individual file from the list ofdocuments while the Save/Edit Selection is in the foreground (if required, click on the "+" icon to unfold thedocument).

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5. Tools5.1. Overview

synedra View Personal provides you with a range of tools specifically designed to view and edit images. In thischapter you will find:

• an overview of the most important tools

• information on how to use these tools

• information on how to activate them:

• from the tool menuOR from the toolbox

• from the toolbar

• with a keyboard shortcut (see the table below). For more information, refer to the chapter Keyboardshortcuts.

The table below contains, in alphabetical order, the most important tools.

Tool Icon Keyboard shortcut

Apply windowing

Arrow, circle, text

Delete density measurements

False colors

Fit size Shift+Z

Image administration - Change image description Ctrl+Shift+B

Image administration - Edit unedited image

Image administration - Edit unedited image with

Image administration - Select edited image for saving

Image administration - Select unedited image for saving

Layout

Magnifier *(star key)

Measure and annotate L, D

Measure angle

Measure density

Tools

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Tool Icon Keyboard shortcut

Measure density average D

Measure distance L

Pan V

Pointer A

Reset Backspace key

Restore Ctrl+Y

Rotate and flip

Scroll B, arrow keys

Shutter

Text display - Increase/Decrease annotation font size Ctrl + + / Ctrl + -

Text display - Increase/Decrease font size +/-

Text display - Show more/less information Ctrl + Shift + + / Ctrl + Shift + -

Text display - Show text T

Undo Ctrl+Z

Viewing properties - Always use interpolation (slow)

Window F

Window presets refer to chapter Keyboardshortcuts

Zoom Z

Zoom area Q

Zoom to comparable size Z

Zoom to original size Z

Zoom to 1:1 Ctrl+1

Table 5.1. Tools

5.2. How to use toolsPrior to image viewing, please carefully read the following remarks:

• Customize tool bar: The tool bar can be customized to fit your personal preferences. Right-click at the bottomof a viewer window to display a context menu containing all tools available. From the context menu, selectthe tools you want to add to the tool bar.

Tools

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• Undo modifications: There are a number of tools allowing you to undo one or all modifications: Reset, Undo,Restore, Clear.

• Standard tool: When dragging a series into the Display/the Preview, a tool is activated automatically. Thisis usually the Pointer tool. Other possible standard tools include Windowing, Zoom, Measure density. Go toExtras - Settings... - View to select another standard tool.

• Middle mouse button and scroll wheel: Go to Extras - Settings... - View to customize the use of the middlemouse button and the scroll wheel.

• Mouse cursor: The mouse pointer (cursor) changes its form after having selected a tool. Click on the neutralpointer icon from the tool bar to deactivate a tool.

• Enabled tools: Only those tools enabled for the image type displayed in the currently active viewer areselectable. Tools that are not enabled for a specific image type are automatically deactivated. Example: Whenopening a Non-DICOM image in the Display, e.g. a JPG image, the window tool is automatically deactivated,as the window tool can only be applied to DICOM images.

• Double-click maximizes image: Double-click an image to view it in one window (layout 1x1). Double-clickagain to restore the previously selected layout.

• Windowing while another tool is activated: With the arrow keys on your keyboard you can scroll a series atany time without first having to activate the scroll tool. Use the right/left arrow keys to scroll to the previous/next image, the Image up/down keys to scroll to the previous/next layout page, the <Pos1> and <End> keysto scroll to the beginning / the end of a series.

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6. Copy and Save6.1. OverviewIn synedra View Personal, there are different possibilities to copy and save images.

Copy images and text information to the clipboard

used to:

• insert an individual image into a presentation, e.g. in a PowerPoint presentation

• copy an individual image to an image editor (e.g. Adobe Photoshop) for further editing

• copy results of measurements as text to other applications for analysis and documentation purposes

Copy an image with Drag & Drop

used to:

• insert an individual image into a presentation, e.g. in a PowerPoint presentation

• copy an individual image to an image editor (e.g. Adobe Photoshop) for further editing

• Drag & Drop is a convenient means to copy images while in multiscreen mode, as several windows can beopened without their hiding each other.

Save an image/a document to the file system

used to:

• save an image as a JPG file

• save images to a USB stick

• save an image to share it with a colleague

• save an image as a TIF file for print on paper, e.g. for a publication

Anonymise data

used to:

• save images without patient information, e.g. to use them for research and teaching purposes

6.2. QuickGuide to saving documents

How to save documents:

1. In a first step, select the documents you want to save and deposit them in the Save/Edit Selection. To doso, you have several possibilities, depending on whether you want to save examinations, series or individualimages, see Select documents for saving/editing.

2. After having selected the documents, bring the Save/Edit Selection to the foreground. The Save/EditSelection displays the documents selected for saving and their respective file size. Use the Preview to obtaina preview of a document:

• Unfold a document (click the "+" icon) and select an individual file. This file will then be displayed inthe Preview.

Copy and Save

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3. Then, determine the other saving options, including the format in which the data will be saved, e.g. JPEG.

4. Click the Save/Archive button to save the documents.

Notes

• You can open locally stored data in synedra View Personal, e.g. to save a locally stored DICOMimage as a JPG.

• The saving process always runs in the background.

• Prior to saving, the application verifies if data would be overwritten, in which case synedra ViewPersonal gives you a warning.

6.3. Select documents for saving/editing

There are different possibilities to select documents for saving/editing. Each document to which you apply theSelect document for saving/editing command is deposited in the Save/Edit Selection.

6.3.1. From the Documenttree

In the Documenttree, you can select documents for saving/editing, i.e. at all levels of the tree structure:

• From the context menu: Right-click on a loaded document and select the Select for saving/editing command.Depending on the level at which the command is executed, documents are deposited in the Save/EditSelection.

• At the patient level: The command includes all loaded documents of the patient

• At the study/container level: The command includes all documents situated beneath the selectedexamination

• At the DICOM series level: The command includes all images of a series

• Individual Non-DICOM document: The command includes individual Non-DICOM files

6.3.2. Select an individual image for saving

In the Display, the Preview and the Browser, there are different tools to select an individual image for saving.

• Select unedited image for saving: Right-click the image and select Image administration - Select uneditedimage for saving.

TipIn the Display/the Preview, press <E> to activate the tool. In the toolbox, you can find the tool inthe Special tab.

• Select edited image for saving: Right-click the image and select Image administration - Select edited imagefor saving.

6.3.3. From the Browser

In the Browser, you can load files from the hard disc, a CD, etc. into the Save/Edit Selection:

• Select for saving/editing: Select a thumbnail in the Browser and click on the Select for saving button.

• Double-click: When the Save/Edit Selection is in the foreground, you can double-click on a thumbnail. Pleasenote: If the Documenttree is in the foreground, a double-click will cause the document to be loaded intothe Documenttree.

Copy and Save

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• Drag & Drop: When the Save/Edit Selection is in the foreground, you can drag a thumbnail in the Save/EditSelection while holding the mouse button down. Please note: If the Documenttree is in the foreground, adouble-click will result in the document to be loaded into the Documenttree.

6.3.4. Remove documents from the Save/Edit SelectionHow to remove an individual document selected for saving/editing:

1. Select the document in the Save/Edit Selection.

2. Click the Remove button. Use the <Ctrl> key to select and remove several documents simultaneously.

To remove all documents at the same time, click the Clear button.

TipGo to Extras - Settings... - Save and activate Clear automatically to automatically clear the list wheneveryou click the Save/Archive button.

6.4. Save documents to the file system

How to save documents to the file system:

1. Select the documents you want to save.

2. Bring the Save/Edit Selection to the foreground. The Save/Edit Selection displays all documents selected forsaving. Use the Preview tab to obtain a preview of a document:

• Unfold a document (by clicking on the "+" icon) and select a single file, which will then be displayedin the Preview tab.

3. Select the destination the files will be saved to:

• Destination: File system: export document

• Directory: Specify the path to the folder in which the files will be deposited.

• Anonymize data: If you tick this checkbox, data are anonymised when saving. For further information,please go to the chapter Save data anonymously.

4. Then, determine the other saving options:

• Filename: Select the pattern used to create the file names. The patterns are displayed as defined in theconfiguration. By default, these include the following:

• hierarchical: deposits the files in a file directory according to the following criteria: patient name andID - study description - series description

• flat: deposits all files in the selected directory without using a hierarchical structure

• without patient information: deposits the files in a file directory in the same way as in "hierarchical"without applying the real patient name.

• in studies: deposits the files in a file directory organised according to the study description

• in series: deposits the files in series in single directories named after a unique sequence of numbers.

• personal comment: Select this entry and add a personal comment in the "Comment" field belowwhich will then be used as file name.

• Format: Select a format by considering further use of the images.

• as is: keeps the format of the files selected for saving

Copy and Save

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• DICOM: image viewing requires a DICOM compatible Viewer. Advantage: Meta data, e.g.information about the examination and the patient, are not lost.

• JPG: useful for further use on the screen

• PNG: useful for further use on the screen

• TIF: useful for image printing on paper, e.g. for publications

• Quality: When you have selected JPG, use a slider to determine the compression level and thus the qualityof the images to be saved. The better the quality, the more memory per image is required. Please notethat for technical reasons, the resulting file size cannot be calculated prior to compression.

• Image text: If you tick this checkbox, the image text will be burned together with the image. Deactivatethe option to save images without patient information (anonymously). Measurements and annotationsare burned independently from the image (JPG, PNG, TIF) if they have been saved.

• Resolution: This option only affects the font size of image text in the saved images. The defaultresolution is 72 dpi. Increase the resolution if the image text is too small (useful for conventional x-ray studies with a high image resolution).

• Original size: If you tick this checkbox, the resolution (in pixel) of the image to be saved remainsunchanged.

• Width and Height: With these input fields you can adjust the size of an image to be saved. Please notethat when saving more than one image at a time, size specifications are applied to all images! In the Save/Edit Selection, select an image to view its original size. Click the Apply button to apply the pixel valuesto the Height and the Width fields. Then, you can enter new values. If the lock icon is locked, the width-to-height ration remains unchanged. If the lock icon is in unlocked, you can choose any ratio (additionalspace will be filled with black color).

6.5. Copy an image with Drag & Drop

How to copy an image by dragging it with the mouse (Drag & Drop):

1. In the Display/the Preview, click with the regular mouse pointer (activate the Pointer tool with <Esc> key)on the image you would like to copy. The selected image is outlined in bold.

2. Press the <T> key to hide the image text if you want to copy the image without showing patient andexamination data (anonymously).

3. Drag the image to the window of the target application by holding the left mouse button down.

4. Release the mouse button. The image is reproduced in its original size.

Note

• Images can be copied from each screen with Drag & Drop.

• Only image information can be copied using Drag & Drop.

• Images can be copied from the Display and the Preview with Drag & Drop.

• Please note that only one image at a time can be copied and pasted using Drag & Drop.

• Measurements and annotations are copied to the clipboard along with the image. Image text willonly be reproduced if it is displayed when copying the image (Show/Hide text with the <T> key).

6.6. Copy a document to the clipboard

Copy and Save

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With the help of a simple command, you can copy an individual image to the clipboard to insert it in otherprograms, e.g. Adobe Photoshop, Microsoft Word, MS Powerpoint etc.

Note

By default, synedra View Personal only copies image data to the clipboard. If you would like to copy textdata (e.g. measurement results and annotations) in addition to image data, go to Extras - Settings....- View and tick the option Copy as image and as text.

The input field clipboard tags allows you to configure which text data you would like to copyto the clipboard. By default, this includes <StudyDescription>, <SeriesDescription>,<DocumentNumber> , and <OverlayTexts>, with <OverlayTexts> including information aboutmeasurements and annotations.

Data are transferred to the target application not as a file, but coded as "Multi-MIME". synedra View Personalsupports all programs using the MIME standard, including Microsoft Word, MS PowerPoint and MS Visio aswell as Adobe Photoshop.

TipThe configuration of the target application determines in which form data are inserted, i.e. as an imageor as text.

How to copy and paste an image in another program, e.g. MS PowerPoint:

1. Open an image in the Display.

2. Select the image you would like to copy. The selected image is outlined in bold.

3. Press the <T> key to hide the image text, if you would like to copy the image without patient data(anonymously).

4.

Press <Ctrl>+<C> simultaneously or click the Copy icon from the icon bar or select the Edit - Copycommand from the menu bar.

5. Open the program in which you would like to insert the image, e.g. MS PowerPoint.

6. To insert the image, select a slide in PowerPoint. Then, press <Ctrl>+ <V> or select Edit - Paste.

How to determine in the target application if an image or text should be inserted:

Most programs have a conventional insert command (Edit - Paste or <Ctrl>+<V>). Depending on the program,this command may produce different results. Image processors, e.g. Adobe Photoshop, generally insert images,while word processors, e.g. Microsoft Word, typically insert text. Microsoft PowerPoint pastes the content of theclipboard as text if a text field is selected, and as an image if a slide is selected.

In many programs, an additional command is available (Edit - Paste Special), allowing you to determine the formin which you want to paste the content of the clipboard, i.e. as text or as an image (Bitmap).

If the target application does not paste the copied content in the desired way, select the Edit - Paste Specialcommand.

Notes

• Images can be copied from each screen to the clipboard.

• Only one image at a time can be copied and pasted using the Copy command.

• Go to Extras - Settings... - View to determine the resolution of the images copied to the clipboard.

6.7. Save data anonymously

Copy and Save

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Data can be anonymised when saving documents (to the file system, to a patient CD/DVD).

How to anonymise a document:

1. In the Save/Edit Selection, tick the Anonymise data checkbox.

2. Then, click the Save button to save the document.

In order to create new, anonymous documents, the anonymisation rules configured under Extras - Settings...- Save are applied. As far as Non-DICOM documents are concerned, these rules only affect the file name. Asfar as DICOM documents are concerned, personal information stored in the DICOM image is anonymized byapplying the rules configured. Information (DICOM tags) to which no rule applies is omitted.

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7. QuickStart Guide synedra Patient CD7.1. Overview

Normally, the synedra patient CD/DVD starts automatically when you insert it into the CD drive. The startupspeed depends entirely on the reading speed of the CD/DVD drive.

However, if the CD/DVD does not start automatically, select the start.hta startup file from the CD/DVD. Then,an HTML site is displayed, providing you with two basic options:

• Start from CD: When you select this option, synedra View Personal will be executed from your CD. Theapplication is not installed on your computer.

• Start & Install: When you select this option, synedra View Personal will be installed on your computer beforestartup. We recommend you to install synedra View Personal in the following situations:

• Startup speed: When you regularly receive synedra patient CDs, we recommend you to install synedraView Personal to reduce startup times.

• Updates: Once you've installed the application, updates are available whenever you insert a new patientCD and/or from the synedra Update Server http://update.synedra.com.

How to load data from CD:

1. Once you have started synedra View Personal, the CD Browser tab comes to the foreground, displayingthe content of the CD/DVD (because the SYNEDRA.DIR file is automatically loaded from your CD/DVD).If the CD/DVD contains several examinations, these are displayed in chronological order based on the dateof examination.

http://update.synedra.com

QuickStart Guide synedra Patient CD

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Figure 7.1. CD Browser

2. Determine the loading speed by ticking one of the checkboxes at the top of the CD browser:

• Loading priority: Faster (JPG format): will load DICOM data in a JPG compressed format. Due to thereduced data volume, loading times are markedly reduced.

• Loading priority: Slower (original format): will load DICOM data in their original format. Due to thelarger data volume, loading times are increased, but you can view the images without quality loss.

3. Click on a blue link to load the relevant document. The number of files to be loaded is indicated in brackets.The more files you load, the longer it takes to load them.

• Load all data of the patient

• Load complete examination

• Only load key images (of the patient): These links go to medical images which have been marked as"key images" by the producer of the CD/DVD. This marker can be used to highlight key images withinan extensive examination, so that they can be distinguished more easily by the receiver of the CD/DVD.Furthermore, clicking these links allows you to reduce loading times, as there is only a relatively smallnumber of key images on the CD/DVD.


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Click on a link to load data into the Documenttree on the left. In the Documenttree, an entry is organized as atree-structured hierarchy based on the following criteria: patient - examination - image series (or Non-DICOMdocument, e.g. a video or a PDF file):

Figure 7.2. Example of a loaded CT scan

The status bar at the bottom of the program window signalizes when loading is in progress: "x series in thewaiting list".

Then, the Preview tab comes to the foreground.

How to open individual documents:

In the Documenttree, click on an entry with a preview image. The selected document is displayed in the Preview.

How to view medical images:

Use the tools designed to view and edit medical images.

• Icons from the tool bar: Click on an icon in the toolbar at the bottom of the image, e.g. Zoom to zoom theimage. Click the image with the left mouse button. Move the mouse up and down while holding the leftmouse button down. Most of the other tools are used in the same way, i.e. by dragging with the mouse.

NoteThe tool bar can be customized to fit your personal preferences. Right-click at the bottom of theimage. From the context menu that pops up, select the tools you would like to add to the tool bar.

• Window/level sliders: Move the window/level sliders (toolbar) to modify brightness and contrast (Window/level) or to scroll (e.g. CTs).

• Tool menu: Right-click the image. The tool menu pops up, containing further tools available for imageviewing.

• Keyboard shortcuts: Most tools can be activated using a keyboard shortcut. In this user manual you will findan overview of the most important shortcuts. The tool menu specifies the keyboard shortcuts allowing youto activate tools. The tool box displays keyboard shortcuts as tool tips when moving the mouse over a tool.

• Reset function: Click on the image and press the backspace key to undo modifications to the image.


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Figure 7.3. Toolbar

7.2. CD Browser

Used to open patient CDs/DVDs, the CD Browser provides an overview of all data contained on the CD. Youcan open the synedra.dir file format to view synedra patient CDs and the dicomdir file format to view patientCDs from other vendors. You can also load and display individual DICOM files in the Browser, by selecting themenu command File-Open, or with Drag & Drop from the MS Windows Explorer.

How to open a synedra patient CD/DVD (contains a synedra.dir file):

1. Select the CD/DVD you would like to open: Click on the "Open patient CD..." button at the top of theCD Browser. Select the synedra.dir file, which is contained on the synedra patient CD/DVD, and then clickon Open.

Figure 7.4. Open SYNEDRA.DIR file

The CD Browser now displays the content of the patient CD/DVD. synedra patient CDs contain preview images,which can also be displayed in the CD Browser.

1. Determine loading speed: You can determine the loading speed with the help of the option Loading prioritysituated at the top of the CD Browser tab. There are two options available:

• Faster (JPG format): Image data are loaded in compressed form (JPG format). Data are loadedconsiderably faster because of reduced data volume. Consequently, shorter waiting times can be achieved.

• Slower (original format): Data are loaded in the original DICOM format. Waiting times are longer due toincreased data volume. If you wish to view data without quality loss, select this button.

2. Load data: Click on a link to load data into the Documenttree on the left:

• Load all data: This can take a considerable amount of time.

• Only load key images. Only the images marked as key images are loaded.


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Figure 7.5. CD Browser

The status bar at the bottom left corner of the program window signalizes that data loading is in progress:"x series in the waiting list".

3. View loaded documents:

• In the Documenttree, single-click on an entry with a preview image. The document is then displayed inthe Preview tab. The Preview can be used to instantly display medical images in DICOM format as wellas non-DICOM documents, e.g. PDF files or videos.

• In the Documenttree, double-click on an entry with a preview image. The document is then displayedin the Display.

How to open a patient CD from another vendor (contains a DICOMDIR file):

1. Select the CD/DVD you would like to open: Click on the "Open patient CD..." button at the top of the CDBrowser. Select the DICOMDIR file, which is contained on the CD, and then click Open.

The CD Browser displays the content of the patient CD/DVD.

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2. Load data: Click on the links to load data from the CD. The data are now loaded into the Documenttree onthe left. The status bar at the bottom left corner of the program window signalizes that loading process isin progress: "x series in the waiting list."

3. View loaded documents:

• In the Documenttree, click on an entry with a preview image. The document is then displayed in thePreview tab. The Preview can be used to display medical images in DICOM format as well as Non-DICOMdocuments, e.g. PDF files or videos.

• In the Documenttree, double-click on an entry with a preview image. The document is then displayedin the Display.

Note

• Change CD/DVD while the application is running: When a synedra patient CD is inserted whilesynedra View Personal is already running, the welcome page (start.hta) is not displayed. Instead,the CD Browser tab automatically comes to the foreground, and the content of the CD (synedra.dir)is displayed. The CD Browser is cleared when opening the drive, and the content preview isimmediately refreshed when changing the CD.

• Data display in the CD Browser can be different from data display in the Documenttree, which isconfigurable. In the CD Browser tabcard, files are basically displayed according to the followingcriteria:

• Patient: if the CD/DVD contains data from several different patients, these data are displayedin alphabetical order.

• Examinations: different examinations from one patient are displayed in chronologicallydescending order, based on the date of examination.

• DICOM series: different series within one examination are displayed in ascending order(DICOM tag <SeriesNumber>) based on their series number.

• Non-DICOM documents are displayed in alphabetical order based on their file names.

• As far as DICOMDIR files from other vendors are concerned, synedra View Personal supportsexclusively the display of entries (DirectoryRecords in compliance with the DICOM standard)regarding PATIENT, STUDY, SERIES and IMAGE. Other entries are not taken into account (e.g.Structured Reports etc.).

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8. QuickStart Guide for downloading synedra View Personalfrom the InternetYou have downloaded synedra View Personal from the Internet, installed and then started. You can now go onto load images or other documents which you would like to view and edit using synedra View Personal.

1. Open files:

• select the File - Open... command from the top left corner of the program window.

• with Drag & Drop: You can drag files from the Microsoft Windows Explorer into the Documenttree whileholding the left mouse button down.

2. Display documents:

Files are loaded and displayed in the Documenttree as documents with a preview image. In the next step,the Preview tab comes to the foreground, displaying the first document from the Documenttree.

Click on another entry with a preview image. The Preview always displays the currently selected document.

Figure 8.1. CT scan

The status bar at the bottom left corner of the program window indicates when loading is in progress: "xstudies and y series in the waiting list".

Next, the Preview tab comes to the foreground, displaying the first document from the Documenttree.

3. Display medical images:Use the tools designed to view and edit medical images:

• Icons from the toolbar: Click on an icon from the toolbar, e.g. Zoom to zoom the image. Click the imagewith the mouse. Then, move the mouse up and down while holding the left mouse button down. Theother tools are used in the same way, i.e. by dragging with the mouse.

• Window/level sliders from the toolbar: Move the window/level sliders to modify brightness and contrast(Window/level) or to scroll (e.g. CTs).

• Tool menu: Right-click the image. The tool menu appears, containing further tools available for imageviewing.

• Keyboard shortcuts: Most tools can be activated using a keyboard shortcut. This online help contains anoverview of all keyboard shortcuts available. The tool menu specifies the keyboard shortcuts allowingyou to activate tools. The tool box displays the relevant keyboard shortcut when moving the mouse overa tool.

QuickStart Guide for downloading synedra View Personal from the Internet

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• Reset function: Click the image and press the backspace key to undo modifications to the image.

Figure 8.2. Toolbar

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9. Keyboard shortcutssynedra View Personal supports a number of keyboard shortcuts (keyboard commands) which allow to performimportant functions. In the tables below, you will find an overview of the most important keyboard shortcutsavailable in synedra ViewPersonal.

The first table provides an overview of general keyboard shortcuts, which can also be accessed from the menubar or the icon bar.

The second table contains all keyboard shortcuts available for image viewing and editing.

Keyboardshortcut

Function Description

<Esc> Cancel Closes open dialogs.

<F1> Help Opens the Online Help

<F3> Show/hide stripe Shows and hides the stripe

<F4> Clear Documenttree Terminates loading in progress and removes all series from theDocumenttree

<F11> Fullscreen (De-)activates Fullscreen mode (only from the Display).

<Shift>+<F11> Multiscreen (De-)activates Multiscreen mode

<Alt>+<F11> Lightbox Displays a white background on the Displays 2-n, used for viewingx-ray images on a film.

<F12> Next patient Displays all loaded series of the next patient in the Display

<Shift>+<F12> Previous patient Displays all loaded series of the previous patient in the Display

<Ctrl>+<C> Copy Copies a selected image to the clipboard

<Ctrl>+<End> Last stripe field Jumps to the end of the stripe

<Ctrl>+<Pos1> First stripe field Jumps to the beginning of the stripe

<Ctrl>+<Enter> Save and Close Saves modified configuration options and closes the configurationmenu

<Ctrl>+<F> Find... To search text in DICOM/EXIF Dump

<Ctrl>+<Shift>+<L>

Clear stripe Removes all series from the stripe and thus from all viewers

<Ctrl>+<O> Open file Displays the dialog window to open locally stored files

Table 9.1. Keyboard shortcuts

Keyboard shortcut Function Description

<1> Activate Display 1

<2-4> Activate Display 2-4

Scroll by images

 Scroll Uses the cursor for scrolling

<right/left arrow keys> Scroll by image Scrolls to the next/previous image within a series

<Image up/down> Scroll by page Scrolls to the next/previous layout page

<Pos1> Scroll to beginning Scrolls to the beginning of a series

<End> Scroll to end Scrolls to the end of a series

Keyboard shortcuts

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Scroll by series

<Ctrl>+<Page Down> Next stripe field Jumps to the next stripe field

<Ctrl>+<Page Up> Previous stripe field Jumps to the previous stripe field

Markers

<Shift>+<right arrowkey>

Next marker Scrolls to the next image with a marker

<Shift>+<left arrowkey>

Previous marker Scrolls to the previous image with a marker

Zoom functions

<Z> Zoom Magnifies and reduces the size of an image

<Shift>+<Z> Fit size Adjusts the image to fit the current window

<Q> Zoom area Magnifies and reduces a selected image section

<Strg>+<1> Zoom to 1:1 Sets the zoom factor to 100 %

<*> Magnifier Activates the magnifier tool

Pan function

<V> Pan Uses the mouse cursor for panning

Synchronize

<Ctrl>+<G>, <A> Synchronize - ToggleSynchronizing all viewers

Synchronizes the Scroll, Window and/or Zoom and Pantools in all viewer fields where you have just hanged series.

<Ctrl>+<G>, <M> Synchronize - SynchronizeMPR

Synchronizes any modifications on rotation and position inopened MPR views.

<Ctrl>+<G>, <C> Synchronize - ToggleSynchronizing selectedviewer

Synchronizes the Scroll, Window and/or Zoom and Pantools in selected viewer fields, where you have hangedseries.

<Ctrl>+<G>, Synchronize - Synchronizescrolling

Activates the Scroll tool for all currently visible Displays

<Ctrl>+<G>, <F> Synchronize - Synchronizewindowing

Activates the Window tool for all currently visible Displays

<Shift>+<G>, <Q> Synchronize - Synchronizeimage portion

Synchronizes the Pan, Zoom, and Zoom area tool for allcurrently visible Displays

 Synchronize -Automatically correlateimage position

Automatically identicates all synchronized image sliceswithin an examination, sets all series to an approximatelycorresponding image slice position, and automaticallysynchronizes the series.

Window functions

<F> Window Uses the mouse cursor for windowing

<Shift>+<F> Window presets - default Resets window to the original value

<Ctrl>+<Alt>+<A> Window presets - Auto-windowing

Sets window values to the limit values of the imagehistogram

<Ctrl>+<W> <A> Window presets -Abdomen

Sets window to preset values (window: Abdomen)

Keyboard shortcuts

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<Ctrl>+<W> <S> Window presets - Skull Sets window to preset values (window: Skull)

<Ctrl>+<W> <L> Window presets - Lung Sets window to preset values (window: Lung)

<Ctrl>+<W> <M> Window presets -Mediastinum

Sets window to preset values (window: Mediastinum)

<Ctrl>+<W> <K> Window presets - Bone Sets window to preset values (window: Bone)

<Ctrl>+<W> <w> Window presets - Spine Sets window to preset values (window: Spine)

<Ctrl>+<W> Window presets -Postmyelo

Sets window to preset values (window: Postmyelo)

<Ctrl>+<W> <F> Window presets - Petrousportion

Sets window to preset values (window: (Petrous portion)

<Ctrl>+<W>+<F1 -F5>

Window presets - Default1-5

Sets window to user-defined values

Shutter function

<Del> Shutter Removes the currently selected shutter.

MPR function

<C> Show/hide rotation cube Shows and hides the rotation cube in MPR view

<Shift>+<1> Viewing properties -transversal, inferior >superior

<Shift>+<2> Viewing properties -coronal, anterior >posterior

<Shift>+<3> Viewing properties -sagittal, left > right

<Shift>+<4> Viewing properties -transversal, superior >inferior

<Shift>+<5> Viewing properties -coronal, posterior >anterior

<Shift>+<6> Viewing properties -sagittal, right > left

Measure & annotate

<L> Measure distance Activates the mouse cursor to measure a distance

<D> Measure density average Only for CTs: measures the average tissue density inHounsfield Units (HU)

<Del> Delete measurement/annotation

Removes the selected measurement/annotation

<Ctrl>+<S> Save measurements &annotations

Saves all measurements and annotations within a series

<Ctrl>+<Enter> Enter text - apply text With this keyboard shortcut, you can apply text which youhave entered into the input field of the Text tool, withoutbeing required to click the Apply button with the mouse.

Text display

Keyboard shortcuts

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<T> Show text Shows/ hides the image text in the Viewer, , Preview andMPR tabs.

<-> Decrease font size Reduces the font size of the image text in the Viewer

<+> Increase font size Increases the font size of the image text in the Viewer

<Ctrl>+<-> Decrease annotation fontsize

Reduces the font size for measurements and annotationsin the Viewer

<Ctrl>+<+> Increase annotation fontsize

Increases the font size for measurements and annotationsin the Viewer

<Ctrl>+<Shift>+<-> Show less information Displays the next smaller configured image text

<Ctrl>+<Shift>+<+> Show more information Displays the next bigger configured image text

Multiframe functions

<W> Scene quick select(Multiframe)

Opens the "Scene quick select" dialogue window to selectimage sequences

 Play and Pause(Multiframe)

Starts and interrupts the display of image sequences

Undo functions

<A> Pointer Resets tools to the regular mouse pointer

<Ctrl>+<Del> Clear viewer (remove aseries from the viewer)

Removes a series from the viewer and the correspondingAlternator field

<Ctrl>+<Z> Undo Undoes the last modification, with the exception ofmeasurements, annotations and markers...

<Ctrl>+<Y> Restore Restores a modification which has been made undone

<Backspace key> Reset Undoes all modifications applied to an image with theexception of measurements, annotations and markers...

Table 9.2. Keyboard shortcuts for image viewing and editing

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10. Technical information10.1. System requirements

Product: synedra View Personal 1.1.0

Disclaimer

synedra View Personal may be used for viewing purposes only. synedra View Personal is not intendedfor diagnostic purposes. For legal reasons, we must point out that it is not permitted to use synedraView Personal for diagnostic imaging.

Below are the minimum requirements your computer needs to run the application synedra View Personal.

Minimum requirements

Processor Intel DualCore or comparable

RAM 1 GB of RAM or better

Viewing Monitors TFT monitors with a contrast of greater than or equalto 400:1

Minimum resolution greater than or equal to1280*1024

Table 10.1. synedra View Personal hardware requirements

Windows XP 32 bit and 64 bit Windows 7 32 bit and 64 bit

Service Pack Service Pack 2 required --

Video support a Windows Media Player 10 or 11 Windows Media Player 12

PDF support Adobe Reader 9 Adobe Reader 9a In case of sound problems, make sure that a suitable audio/video codec is installed.

Table 10.2. synedra View Personal operating system / software requirements

10.2. Supported file formats

synedra View Personal is an application designed to display images and multimedia data.

Description File format

DICOM files dcm, dcm30, dicom

Joint Photographic Experts Group JPEG

Joint Photographic Experts Group 2000 JPEG 2000

Portable Network Graphics png

Graphics Interchange Format gif

Tag Image File Format tif

Canon RAW crw

Canon CR2 cr2

Nikon RAW nef

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Description File format

Adobe Digital Negative dng

Bitmap bmp

Portable AnyMap pnm

X BitMap Format xbm

X PixMap Format xpm

Portable Document Format pdf (in DICOM and native)

Audio Video Interleaved avi

Movin Picture Experts Group mpeg

Waveform Audio Format wav

Scalable Vector Graphics SVG 1.2

Moving Picture Experts Group MPEG-2 (in DICOM and native)*

Moving Picture Experts Group MPEG-4*

-- RealPlayer*

-- Quicktime*

Windows Media Video WMV

-- Flash*

Virtual Reality Modeling Language (for 3D models) WRL

Table 10.3. Supported file formats

Important

* For a correct display of file formats, see Section 10.1: “System requirements” (page 35).

Displaying multimedia formats (pdf, avi, mpeg, wav) in Preview requires the installation of an Active-Xcompatible PDF preview application, e.g. Adobe Reader, an Active-x compatible video application, e.g. WindowsMedia Player, and the corresponding codecs on your computer. The Active-X components must be compatiblewith 64-bit operating systems when used on 64-bit computers.

For any information on tested and recommended versions, see Section 10.1: “System requirements” (page35).

10.3. Installation

Installing synedra View Personal has two major advantages, namely:

• Startup speed: When you regularly receive synedra patient CDs, we recommend you to install synedra ViewPersonal to reduce startup times.

• Updates: Updates are available when you insert a new patient CD or via download from the Internet.

User update: If this option is enabled, automatic updates on the latest synedra View Personal versions areavailable even for users without administrator rights.

10.4. Updates

When you install synedra View Personal on your computer, there are three ways to obtain the latest programversions.

• With current patient CDs: When inserting a patient CD (or select the start.hta startup file from your CD/DVD), synedra View Personal compares the installed version with the version from the CD/DVD. When theCD/DVD contains a more recent version, this version is automatically offered for update (start.hta).

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• Automatic update function: Provided you do not use a proxy server, in which case synedra View Personal canconnect to the update server via HTTP (http://update.synedra.com), synedra View Personal automaticallyverifies on startup if a more recent version is available for download.

• Download from the Internet: On our web site http://download.synedra.com you can freely download currentprogram versions.

10.5. Feedback

Select the menu point ? -Feedback and use the feedback form provided to get in touch with us. We will processyour request and contact you if you wish.

You can also add a service log file to the feedback form. This log file records information on the hardware andprogram configuration as well as on network settings on your computer. This information helps us deal efficientlywith your enquiry, in particular if you would like to signal a program error. In that case, please send us a shortmessage describing how the error can be reproduced.

Go to the menu point ? -Service Log... to create and store the log file independently from the feedback form.

http://update.synedra.com

http://download.synedra.com

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11. DICOM Query RetrieveNoteTo use this function, the DICOM Q/R tab needs to be displayed: Go to Extras - Settings... - Advancedand activate the Show DICOM Query/Retrieve option.

The DICOM Q/R tab allows you to make a request to a DICOM archive and/or a modality and to transfer datafrom an external system to synedra View Personal.

11.1. RequirementsPrior to searching and loading data from an external system into synedra View Personal, you need to configurethe relevant settings to enable communication between synedra and the external archive.

11.1.1. Configuring the external archiveCalling AET Application Entity TitleTo begin with, synedra View Personal needs to be set up as a communication partner in the external system.This requires what is known as an Application Entity Title (AET). Depending on the configuration of the externalsystem, the synedra View Personal "Calling AET" might be required to follow a specific naming scheme or toconsider other specific settings. According to the DICOM standard, AETs may have no more than 16 characters.

Note for system administrators

To use DICOM Query/Retrieve to establish contact between synedra View Personal and an externalarchive (= not synedra AIM), it is not necessary to include this AET in synedra Control.

Receiving HostIn the external system, the receiving host needs to be configured for the Calling AET. This is the host name and/or the IP address of the computer from which synedra View Personal contacts the external system for a DICOMQuery/Retrieve request.

NotePlease note that each AET can be allocated to one receiving host only. This requires that each computerused for Query/Retrieve requests should have its own AET.

Receiving port "104"In the external system, a receiving port needs to be configured for the calling AET in addition to the receivinghost. synedra View Personal uses the "104" port as the default receiving port for DICOM Query/Retrieve.

11.1.2. Configuring synedra View PersonalGo to Extras - Settings... - Communication to configure synedra View Personal.

HostThis is where you enter the host name or the IP address of the external system. Several comma-separated hostscan be specified, if different external systems should be contacted. Host1,Host2,Host3

PortThis is where you enter the port on which the external system accepts DICOM Query/ Retrieverequests. Several comma-separated ports can be specified, if different external systems should be contacted.Port1,Port2,Port3

Server AETThis is where you enter what is known as "called AET", i.e. the AET of the external system.Several comma-separated AETS can be specified, if different external systems should be contacted.Called_AET1,Called_AET2,Called_AET3

Local AET

DICOM Query Retrieve

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This is where you enter what is known as the "calling AET", which you have previously set up for synedra ViewPersonal in the external system. Several comma-separated AETs can be specified, if different external systemsshould be contacted. Calling_AET1,Calling_AET2,Calling_AET3

11.2. DICOM Query/Retrieve CommunicationWhen there is a DICOM Query/Retrieve request, DICOM communication takes place between the clientapplication View Personal and an external DICOM system. synedra AIM archive is not required for that purpose;therefore, it is not necessary to specify the configuration settings (AETs, Hosts, Ports) in synedra Control.

TipHowever, for reasons of traceability, it is recommended to include the settings in synedra Control as well.

Three DICOM services are applied for that purpose: C-FIND, C-MOVE, and C-STORE. When the user enters arequest in the DICOM Q/R tab, the synedra View application will make a C-FIND request to the "called AET"of the external system by using the user's local "calling AET.

When the user launches the loading process (by double-clicking a DICOM object in the DICOM Q/R tab), e.g. toload a DICOM series from the external system, this request will be passed to the external system using C-MOVE.

For the actual data transfer, the DICOM standard provides a C-MOVE operation and a C-STORE operationinitiated by the external system.

11.3. Performing DICOM Query/RetrieveHow to make a request using DICOM Query/Retrieve:

1. Click on the DICOM Q/R tab.

2. From the DICOM archive selection menu, select the external system you want to contact.

3. Enter the search criteria known to you into the search fields. Then, click the Search button.

A patient name = Patients Name must be specified in such a way that it complies with the DICOM standard:

LastName^FirstName

NoteYou can use the * (asterisk) as a wildcard to replace any character.

Smith* searches for all patients whose last name is "Smith".

Data fields such as Patients Birth Date or Study Date, must be specified in a DICOM-compliant format, i.e.

YYYYMMDD, e.g. 20081231 for December 31, 2008

TipIn the DICOM/EXIF Dump tab you will find examples of how to enter search criteria in a DICOM-compliant format.

Important

The information (columns in the result list) returned depends entirely on the external system!

If a search fails, an error message appears, based on the ErrorComment DICOM informationreturned by the external system (called AET).

4. In the DICOM studies area, select an entry from the result list. In the DICOM series area below, detailedinformation on the series contained in the study selected above will then be displayed.

5. To load a DICOM object (study or series), double-click on an entry from the result list. By double-clicking ona result from the DICOM studies area above, the entire DICOM study (examination) will be loaded from the

DICOM Query Retrieve

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external system. By double-clicking on a result from the DICOM series area below, a DICOM series (as partof an examination) will be loaded from the external system into the Documenttree.

NoteThe loading process takes as long as it takes to load the entire document into the Documenttree.Removing loaded series from the Documenttree does not interrupt a loading process in progress.

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Index,

CCD Browser, 26Contact, 5Copy to clipboard, 20

DDate format, 4Deinstallation, 36Documenttree, 9Download, Drag & Drop, 20

FFeedback, 37Feedback form, 5File formats, 35

IIcon bar, 6Installation, 36

KKeyboard shortcuts,

LLoad data, 11

MMDD Directive 93/42/EEC, 42Menu bar, 7

PPatient CD, 23Preview, 13

SSafety notes, 4Save anonymously, 21Save documents, 17Save to file system, 19Search data, 11Select for saving/editing, 18Service log, 5, 37Stripe, 8synedra, 5System requirements, 35

TTabs, 10Technical support, 5Tools, 14

UUpdates, 36User Interface, 6

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A. MDD Directive 93/42/EEC1. MDD Directive 93/42/EEC

synedra View Personal as a module of the synedra AIM medical device

ImportantHas synedra View Personal not been delivered on a synedra patient CD, synedra View Personal isneither a medical device nor a component of a medical device, but a general viewing application thepurpose of which is non-medical. Hence, synedra View Personal is not to be classified pursuant to theMedical Devices Directive 93/42/EEC. This applies also to the delivery of synedra View Personl with asynedra demo CD, which is marked as such.

The product synedra View Personal is a module of the synedra AIM (Advanced Image Management) medicaldevice, in as much as it has been delivered together with confidential patient data on a synedra patient CD/DVD. synedra View Personal may be used to view images and patient-related data for information purposes,i.e. only after a diagnosis has been established which is based on the data delivered. It is not allowed to drawany diagnostic conclusions from images viewed with synedra View Personal, as synedra View Personal is notto be used for diagnostic purposes! In particular, the measurement functions in synedra View Personal are notintended for diagnostic purposes.

synedra AIM certified to the Medical Devices Directive 93/42/EEC

0297

Pursuant to the guidelines stated in Directive 93/42/EEC, annex IX, rule 10, synedra AIM (Advanced ImageManagement) is a Class IIb Medical Device intended for the hospital-wide acquisition, storage and distributionof medical multimedial patient data as well as for diagnostic imaging.

2010

Manufacturer:

synedra information technologies GmbHFeldstrasse 1/136020 InnsbruckAustria

Important

Please refer to the documentation on the synedra AIM medical device and its modules.

The use of each of the synedra AIM modules requires medical training. synedra AIM may only be usedby personnel who have undergone technical training. The operation and application of synedra AIMand its modules requires specific training.

When using synedra View Personal as a component of the synedra AIM medical device, please referto the documentation on the synedra AIM medical device and its modules.

synedra guarantees the operational capability of synedra AIM and/or its modules as a Class IIb Medical Devicepursuant to the guidelines stated in Directive 93/42/EEC exclusively under the condition that an effectivesoftware maintenance and support contract is in place between synedra and the customer concerned. In anycase, the operational capability of the current synedra AIM version as a medical device ends at the very latesttwo years after the version has been released.

Standards appliedThe following harmonised standards have been given consideration in the product life circle of synedra AIM:

MDD Directive 93/42/EEC

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EN ISO 13485:2003EN ISO 9001:2008EN ISO 14971:2007EN 62366:2007EN 62304:2006EN 60601:2007

Availability of synedra AIMsynedra AIM is a strategic system consisting of applications providing basic information and tools for thetreatment of patients. The system supports high availability service through the high stability of its components,extensive intern redundancy mechanisms and cluster capabilities.

However, synedra does not guarantee uninterruptible service in the sense of a life-sustaining system. In situationswhere a system failure might result in patients being put at risk, technical or organizational fallback measuresmust be provided.

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