3dimensions System User Guide
3dimensions System User Guide
User Guide
For Software Version 2.0
Part Number MAN-05085-002
Revision 002
May 2018
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© 2017-2018 Hologic, Inc. Printed in the USA. This manual was originally written in English.
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This product may be protected by one or more U.S. or foreign patents as identified at www.Hologic.com/patents.
3Dimensions System User Guide
Table of Contents
Table of Contents
List of Figures _________________________________________________________________ xi
1: Introduction __________________________________________________________________1
1.1 Intended Use............................................................................................................................................................ 1
1.1.1 Contraindications ..................................................................................................................................... 1
1.2 Potential Adverse Effects of Mammography Systems on Health .................................................................... 2
1.3 System Capabilities................................................................................................................................................. 2
1.4 About the Genius 3D Mammography Exam ...................................................................................................... 2
1.5 More Information About Tomosynthesis ............................................................................................................ 3
1.6 About C-View and Intelligent 2D ......................................................................................................................... 5
1.6.1 C-View and Intelligent 2D Software ...................................................................................................... 5
1.6.2 C-View and Intelligent 2D Warnings .................................................................................................... 5
1.6.3 C-View and Intelligent 2D Theory of Operation .................................................................................. 6
1.7 User Profiles............................................................................................................................................................. 6
1.7.1 Mammography Technologist .................................................................................................................. 6
1.7.2 Radiologist ................................................................................................................................................. 6
1.7.3 Medical Physicist ...................................................................................................................................... 7
1.8 Training Requirements .......................................................................................................................................... 7
1.9 Quality Control Requirements .............................................................................................................................. 7
1.10 Where to Find the Installation Instructions ......................................................................................................... 7
1.11 Where to Find Technical Description Information............................................................................................. 7
1.12 Warranty Statement ................................................................................................................................................ 8
1.13 Technical Support ................................................................................................................................................... 8
1.14 Product Complaints ................................................................................................................................................ 8
1.15 Hologic Cybersecurity Statement ......................................................................................................................... 8
1.16 Symbols .................................................................................................................................................................... 9
1.17 Descriptions of Warnings, Cautions, and Notes .............................................................................................. 10
1.18 Document Conventions ....................................................................................................................................... 10
6: Images ______________________________________________________________________69
6.1 Image Display Screen ........................................................................................................................................... 69
6.2 How to Set the Exposure Parameters ................................................................................................................. 70
6.2.1 Select the Image Acquisition Mode (Tomosynthesis Option) .......................................................... 70
6.2.2 Select the Exposure Mode ..................................................................................................................... 70
6.2.3 How to Use the AEC Sensor ................................................................................................................. 70
6.3 How to Acquire an Image.................................................................................................................................... 71
6.3.1 Conventional Imaging Sequence of Events......................................................................................... 72
6.3.2 Tomosynthesis Imaging Sequence of Events ...................................................................................... 72
6.3.3 How to Accept a Rejected Image .......................................................................................................... 73
6.3.4 How to Accept or Reject a Pended Image ........................................................................................... 73
6.4 How to Correct and Reprocess Implant Images ............................................................................................... 73
6.4.1 If the Image Is Not Accepted ................................................................................................................ 73
6.4.2 If the Image Is Accepted ........................................................................................................................ 73
6.5 How to Review the Images.................................................................................................................................. 74
6.5.1 Image Review Tools Tab........................................................................................................................ 75
6.5.2 Notices Tab .............................................................................................................................................. 76
6.5.3 Other Image Review Tools .................................................................................................................... 77
6.5.4 Slice Indicator .......................................................................................................................................... 78
6.6 How to Send the Images to the Output Devices............................................................................................... 78
6.7 How to Use I-View 2D Contrast ......................................................................................................................... 79
6.7.1 How to Configure Contrast Settings .................................................................................................... 82
7: Accessories __________________________________________________________________83
7.1 How to Install Accessories on the C-Arm ......................................................................................................... 83
7.2 Patient Face Shields .............................................................................................................................................. 84
7.2.1 How to Install and Remove the Retractable Face Shield................................................................... 84
7.2.2 How to Use the Retractable Face Shield .............................................................................................. 85
7.2.3 How to Install and Remove the Conventional Face Shield .............................................................. 86
7.3 Compression Paddles ........................................................................................................................................... 87
7.3.1 Routine Screening Paddles .................................................................................................................... 88
7.3.2 Contact and Spot Compression Paddles ............................................................................................. 89
7.3.3 Magnification Paddles ........................................................................................................................... 89
Index ________________________________________________________________________153
List of Figures
Figure 1: 3Dimensions™ System ................................................................................................................................... 11
Figure 2: C-arm Overview .............................................................................................................................................. 12
Figure 3: Emergency Off Switch Functionality ............................................................................................................ 17
Figure 4: Label Locations ................................................................................................................................................ 21
Figure 5: System Power Controls .................................................................................................................................. 23
Figure 6: Tubestand Controls and Indicators .............................................................................................................. 24
Figure 7: Tubehead Display ........................................................................................................................................... 25
Figure 8: Compression Device ....................................................................................................................................... 25
Figure 9: Compression Device Display......................................................................................................................... 25
Figure 10: C-arm Control Panel ..................................................................................................................................... 26
Figure 11: Gantry Control Panel .................................................................................................................................... 26
Figure 12: Dual Function Footswitch ............................................................................................................................ 27
Figure 13: Universal Acquisition Workstation Controls and Displays .................................................................... 28
Figure 14: Turn to Reset the Emergency Off Switches................................................................................................ 29
Figure 15: Universal Acquisition Workstation Power Buttons ................................................................................. 29
Figure 16: Startup Screen ................................................................................................................................................ 30
Figure 17: Select an Operator (Log In) Screen.............................................................................................................. 31
Figure 18: C-arm Control Panel (left side shown) ....................................................................................................... 32
Figure 19: Emergency Off Switch Functionality .......................................................................................................... 44
Figure 20: Universal Acquisition Workstation Power Buttons ................................................................................. 44
Figure 21: An Example Select Function to Perform Screen ........................................................................................ 45
Figure 22: Taskbar............................................................................................................................................................ 46
Figure 23: Select Patient Screen...................................................................................................................................... 48
Figure 24: Enterprise Tab ................................................................................................................................................ 49
Figure 25: Add Patient Screen ........................................................................................................................................ 50
Figure 26: Split Patient Records Screen......................................................................................................................... 51
Figure 27: Select the Correct Procedure to Split Patient Records .............................................................................. 52
Figure 28: Filter Tab in the Patient Filter Screen.......................................................................................................... 53
Figure 29: Procedure Screen ........................................................................................................................................... 56
Figure 30: Paddle Shift Buttons...................................................................................................................................... 58
Figure 31: Procedure Info Dialog Box ........................................................................................................................... 58
Figure 32: Add Procedure Dialog Box .......................................................................................................................... 59
Figure 33: Add View Screen ........................................................................................................................................... 60
Figure 34: Edit View Screen............................................................................................................................................ 61
Figure 35: Output Groups Field ..................................................................................................................................... 63
Figure 36: An Example Custom Output Group........................................................................................................... 64
Figure 37: Select the Images for Export ........................................................................................................................ 65
Figure 38: Export Dialog Box ......................................................................................................................................... 66
Figure 39: Print Screen .................................................................................................................................................... 67
Figure 40: Image Display Screen.................................................................................................................................... 69
Figure 41: Exposure In Progress .................................................................................................................................... 71
Figure 42: Exposure Complete ....................................................................................................................................... 71
List of Tables
Table 1: System Labels .................................................................................................................................................... 22
Table 2: Compression Tests ............................................................................................................................................ 33
Table 3: C-arm Up and Down Movement .................................................................................................................... 34
Table 4: C-arm Counterclockwise Rotation.................................................................................................................. 36
Table 5: C-arm Clockwise Rotation ............................................................................................................................... 37
Table 6: C-arm Rotation Switch ..................................................................................................................................... 38
Table 7: Automatic C-arm Counterclockwise Rotation .............................................................................................. 39
Table 8: Automatic C-arm Clockwise Rotation ........................................................................................................... 40
Table 9: Automatic MLO Rotation ................................................................................................................................ 41
Table 10: C-arm Collimation .......................................................................................................................................... 42
Table 11: Shifting Paddle ................................................................................................................................................ 43
Table 12: Taskbar Menus ................................................................................................................................................ 46
Table 13: The Select Patient Screen ................................................................................................................................ 48
Table 14: Filter Tab Options (Require Access Privileges) ........................................................................................... 54
Table 15: The Procedure Screen ..................................................................................................................................... 57
Table 16: Procedure Groups ........................................................................................................................................... 59
Table 17: Available Accessories ..................................................................................................................................... 87
Table 18: User Preventive Maintenance...................................................................................................................... 108
Table 19: Service Engineer Preventive Maintenance ................................................................................................ 109
Table 20: Admin Screen Functions .............................................................................................................................. 111
Table 21: Radiologic Technologist Manager—System Tools Functions ................................................................. 123
Table 22: Maximum mA Setting as a Function of kV ............................................................................................... 135
Table 23: System Messages ........................................................................................................................................... 140
Table 24: 2D Dose (EUREF) .......................................................................................................................................... 149
Table 25: BT Dose (EUREF) .......................................................................................................................................... 149
Table 26: CEDM Dose (EUREF) ................................................................................................................................... 150
Chapter 1 Introduction
1:
Read all this information carefully before operating the system. Follow all warnings and
precautions as stated in this manual. Keep this manual available during procedures.
Physicians should tell patients about all potential risks and adverse events described in
this manual with respect to the operation of the system.
Note
Hologic configures some systems to meet specific requirements. Your system
configuration may not have all the options and accessories included in this manual.
Caution: Federal law restricts this device to sale by or on the order of a physician.
Note
In Canada and Singapore, Tomosynthesis is not approved for screening, and must be
used in conjunction with a 2D image (either a FFDM image or 2D image generated from
the 3D image set).
1.1.1 Contraindications
There are no known contraindications.
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IMPORTANT:
Hologic strongly recommends that users make themselves familiar with local or
regional regulations. These regulations could impose restrictions on the different types
of clinical use. Because the regulations could evolve and change over time, periodic
review is recommended.
Warning:
Do not make a clinical decision or diagnosis from the C-View or Intelligent
2D images without reviewing the accompanying tomosynthesis image set.
Use the C-View or Intelligent 2D generated 2D images in the same way you would use
conventional digital mammography (2D) when performing a screening study employing
tomosynthesis.
• While reviewing the C-View or Intelligent 2D images for items or areas of interest,
compare to a prior digital mammogram (2D) if priors exist and then review the
related tomosynthesis images carefully.
• Carefully examine the entire tomosynthesis image set before making a clinical
decision.
Warning:
The appearance of a C-View or Intelligent 2D generated 2D image may differ
from that of a conventional digital mammography (2D) image, just as 2D film
and digital mammography (2D) images from different vendors may look
different.
Users should ensure they are adequately trained and are familiar with the appearance of
C-View and Intelligent 2D generated 2D images before using them in conjunction with
tomosynthesis image sets.
1.7.2 Radiologist
• Meets all requirements that apply to the location in which the Radiologist operates.
• Knows how to operate a computer and its peripherals.
1.16 Symbols
This section describes the Symbols on this system.
Symbol Description
Type B Applied Part
"OFF" (power)
"ON" (power)
Manufacturer
Date of Manufacture
Caution
Catalog number
Serial number
Part number
WARNING!
The procedures that you must follow accurately to prevent possible
dangerous or fatal injury.
Warning:
The procedures that you must follow accurately to prevent injury.
Caution:
The procedures that you must follow accurately to prevent damage to equipment,
loss of data, or damage to files in software applications.
Note
Notes show additional information.
Figure Legend
1. Tubestand (Gantry and C-arm)
2. Gantry
3. C-arm (Tube Arm and Compression Arm)
4. Universal Acquisition Workstation
Figure Legend
1. Tube Arm
2. Patient Face Shield
3. Compression Device
4. Image Receptor
5. Compression Arm
6. Patient Handle
7. C-arm Control Panel
WARNING!
Risk of electric shock. Only connect this equipment to supply mains
with Protective Earth.
WARNING!
For North American electrical safety requirements, use a Hospital
Grade receptacle to supply a correct Ground.
WARNING!
Electrical equipment used near flammable anesthetics can cause an
explosion.
WARNING!
To correctly isolate the system, attach only approved accessories or
options to the system. Only approved personnel can change the
connections.
WARNING!
Keep a 1.5 meter safe distance between the patient and any non-patient
devices.
Do not install non-patient system components (like the Workflow
Manager, a diagnostic review workstation, or a hard copy printer) in
the Patient Area.
WARNING!
Only trained Service Engineers authorized through Hologic can open
any of the panels. This system contains lethal voltages.
WARNING!
The user must correct problems before the system is used. Contact an
approved service representative for preventive maintenance.
WARNING!
After power failure, remove the patient from the system before you
apply power.
Warning:
This device contains dangerous material. Send decommissioned material to
Hologic or contact your service representative.
Warning:
C-arm movement is motorized.
Warning:
You increase the patient dose to high levels when you increase the AEC
exposure adjustment. You increase the image noise or decrease image quality
when you decrease the AEC exposure adjustment.
Warning:
Control the access to the equipment according to local regulations for
radiation protection.
Warning:
The disk drives installed in this system are a Class I Laser Product. Prevent
direct exposure to the beam. Hidden laser radiation exists if the case to a disk
drive is open.
Warning:
The bar code scanner installed in this system is a Class II Laser Product.
Prevent direct exposure to the beam. Hidden laser radiation exists if the cover
is opened.
Warning:
Keep your full body behind the radiation shield during the exposure.
Warning:
Do not move the C-arm while the system retrieves the image.
Warning:
If a paddle touches possible infectious materials, contact your Infection
Control Representative to remove contamination from the paddle.
Warning:
Do not leave the patient unattended during the procedure.
Warning:
Keep the hands of the patient away from all buttons and switches at all times.
Warning:
Place each footswitch in a position where, when used, they remain in reach of
the Emergency Off Switches.
Warning:
Position the footswitches to prevent accidental operation by a patient or
wheelchair.
Warning:
To prevent a higher radiation dose to the patient, only put approved
materials in the x-ray beam path.
Warning:
This system can be dangerous to the patient and the user. Always follow the
safety precautions for x-ray exposures.
Warning:
For exposures except magnification case studies, always use the Face Shield.
Warning:
The Face Shield does not protect the patient from radiation.
Warning:
Risk of entrapment. Make sure that the C-arm has 50 cm (20 inches) of
clearance to any object during C-arm rotation. Do not use Auto Rotation
when C-arm clearance is less than 50 cm (20 inches).
Caution:
The system is a medical device and not a normal computer. Only make approved
changes to the hardware or software. Install this device behind a firewall for network
security. The computer virus protection or network security for this medical device is
not supplied (for example, a computer firewall). The network security and anti-virus
provisions are the responsibility of the user.
Caution:
Do not turn off the Acquisition Workstation circuit breaker except in emergency. The
circuit breaker can turn off the Uninterruptible Power Supply (UPS) and risk data
loss.
Caution:
Risk of data loss. Do not put any magnetic media near or on devices that create any
magnetic fields.
Caution:
Do not use any heat source (like a heating pad) on the image receptor.
Caution:
To prevent possible damage from thermal shock to the Digital Image Receptor,
follow the recommended procedure to turn off the equipment.
Caution:
The display is calibrated for compliance to DICOM standards. Do not make any
brightness or contrast adjustments to the display.
Caution:
Use the least possible amount of cleaning fluids. The fluids must not flow or run.
Caution:
To prevent damage to the electronic components, do not use disinfectant sprays on
the system.
Note:
Hologic does not supply the Gantry power cable for some countries. If the power cable
is not supplied, the installed cable must meet the following requirements and all local
codes that apply: 3 conductor, 8 AWG (10 mm2) copper not more than 25 feet (7.62
meters) in length.
2.5 Interlocks
The 3Dimensions system has safety interlocks:
• C-arm vertical movement and rotation are disabled when compression force is
applied. A Service Engineer can configure the lockout force from 22 Newtons (5
pounds) to 45 Newtons (10 pounds).
• If the x-ray button or x-ray footswitch is released before the end of the exposure, the
exposure stops and an alarm message is displayed.
• When in Tomo mode, the system does not allow an exposure if the Grid is in the x-
ray field (Tomosynthesis option).
• Mirror and Filter position flags also prevent x rays when the Light Field Mirror or the
Filter Assembly is not correctly positioned.
2.6 Compliance
This section describes the mammography system compliance requirements and the
responsibilities of the manufacturer.
Caution:
Medical Electrical Equipment needs special precautions about EMC and must be
installed, put into service and used according to the EMC information provided.
Caution:
Portable and mobile RF communications can affect medical electrical equipment.
Caution:
The use of unauthorized accessories and cables can result in increased emissions or
decreased immunity. To keep the isolation quality for the system, attach only
approved Hologic accessories or options to the system.
Caution:
The Medical Electrical (ME) Equipment or ME System should not be used adjacent to
or stacked with other equipment. If adjacent or stacked use is necessary, make sure
that the ME Equipment or ME System operates correctly in this configuration.
Caution:
This system is intended for use by healthcare professionals only. This system may
cause radio interference or may disrupt the operation of nearby equipment. It may be
necessary to take mitigation measures, such as re-orienting or relocating the
equipment or shielding the location.
Caution:
Changes or modifications not expressly approved by Hologic could void your
authority to operate the equipment.
Caution:
This equipment has been tested and found to comply with the limits for a Class A
digital device, pursuant to part 15 of the FCC Rules. These limits are designed to
provide reasonable protection against harmful interference when the equipment is
operated in a commercial environment. This equipment generates, uses, and can
radiate radio frequency energy and, if not installed and used in accordance with the
instruction manual, may cause harmful interference to radio communications.
Operation of this equipment in a residential area is likely to cause harmful
interference in which case the user will be required to correct the interference at his
own expense.
Caution:
Based on ENCLOSURE PORT IMMUNITY to RF WIRELESS COMMUNICATIONS
EQUIPMENT test level per IEC 60601-1-2 ed. 4, this device shows susceptibility to
GMRS 460, FRS 460 transmission frequency. Provide a minimum separation of 30 cm
between GMRS and FRS radios and the system.
Caution:
This device complies with Industry Canada licence-exempt RSS standard(s).
Operation is subject to the following two conditions: (1) this device may not cause
interference, and (2) this device must accept any interference, including interference
that may cause undesired operation of the device.
Serialized Device
System Model
Electrical Shock Warning
4 5 8
Tomographic Mammography
Detector
Gantry Nameplate
9 10 11
12 13 14
Figure Legend
1. Gantry Power Circuit Breaker
2. Emergency Off Switch (two on the Gantry, one on the
Acquisition Workstation)
3. Acquisition Workstation Power Switch
4. Computer Power On/Reset Button
5. Uninterruptible Power Supply (UPS) Power Button
Figure Legend
1. Rotation Angle Displays (each side)
2. C-arm Control Panels (each side)
3. Compression Device
4. Emergency Off Switches (each side)
5. Compression Handwheels
6. Gantry Control Panels (each side)
7. Footswitch
8. Tubehead Display
Figure Legend
1. Manual Compression Handwheels
2. Paddle Shift Buttons
3. AEC Sensor Buttons
4. Compression Device Display
5. FAST Compression Mode Slide
6. Paddle Clamp
Figure 8: Compression Device
Figure Legend
1. MLO Rotation
2. C-arm Zero
3. Light Field Lamp
4. Motor Enable
5. Collimator Override
6. Clockwise C-arm Rotation
7. C-arm Up and Down
8. Counterclockwise C-arm Rotation
9. Compression Up
10. Compression Down
Figure 10: C-arm Control Panel
Figure Legend
1. Motor Enable
2. C-arm Zero
3. Clockwise C-arm Rotation
4. C-arm Up and Down
5. Counterclockwise C-arm Rotation
Warning:
Place each footswitch in a position where, when used, they remain in reach of
the Emergency Off Switches.
Warning:
Position the footswitches to prevent accidental operation by a patient or
wheelchair.
Note
The controls for the Universal Acquisition Workstation installed in a mobile
environment are the same as the controls for the Universal Acquisition Workstation.
1. Make sure that there are no obstructions to C-arm movement or to the view of the
Operator.
2. Make sure that all three Emergency Off switches are in the reset position (unpushed).
Figure Legend
1. Acquisition Workstation Power Switch
2. Computer Power On/Reset Button
3. UPS Power Button
5. Turn ON the Acquisition Workstation power switch (see the previous figure).
6. Press the computer power button (see the previous figure). The computer powers on
and the Startup screen opens on the Acquisition Workstation control monitor. The
Gantry then automatically powers on.
Note
The Startup screen includes a Shutdown button that turns off the system, and a Reboot
button that restarts the system.
Note
The system can require between five minutes and fifteen minutes to prepare for image
acquisition. The wait time depends on the detector power configuration. A timer in the
Taskbar displays the wait time before the system is ready. Do not acquire clinical or QC
images unless the System Status Icon indicates that the system is Ready.
4.2 Log In
1. Select the Log In button on the Startup screen.
2. The Select an Operator (Log In) screen opens and shows a list of Manager and
Technologist user names. If necessary, select the Show All button to list the Service,
Applications, and Physicist user names.
3. Choose an operator by selecting the applicable user name.
Note
If Quality Control tasks are due, the Select Function to Perform screen opens. You can
perform the quality tasks or you can select Skip.
Figure Legend
1. MLO Rotation
2. C-arm Zero
3. Light Field Lamp
4. Motor Enable
5. Collimator Override
6. Clockwise C-arm Rotation
7. C-arm Up and Down
8. Counterclockwise C-arm Rotation
9. Compression Up
10. Compression Down
Note
C-arm vertical movement and rotation are disabled when compression force
is applied. A Service Engineer can configure the lockout force from 22
Newtons (5 pounds) to 45 Newtons (10 pounds).
C-Arm Rotation
Table 4: C-arm Counterclockwise Rotation
Function Functional Test
Counterclockwise C-arm Press the Counterclockwise C-arm Rotation button (item 1) to start
Rotation counterclockwise C-arm rotation. C-arm movement stops when the
switch is released. To fine-tune the C-arm rotation in one degree
segments, hold the button down for a second, then let go quickly.
Repeat as necessary.
Warning:
Risk of entrapment. Make sure that the C-arm has 50 cm (20 inches) of
clearance to any object during C-arm rotation. Do not use Auto Rotation
when C-arm clearance is less than 50 cm (20 inches).
Note
To stop the C-arm automatic rotation movement, press any button or the Emergency
Stop switch.
Motor Enable Press the Motor Enable button and a Rotation button at
the same time to enable auto-rotation movement
clockwise or counterclockwise.
C-arm Zero Press the Motor Enable button and the C-arm Zero
button at the same time. Release the buttons. The machine
beeps and the C-arm returns automatically to the zero
position.
4.3.3 Collimation
Table 10: C-arm Collimation
Function Functional Test
Collimator Override The Collimator Override button changes the collimation
through the different x-ray fields.
Press the Light Field Lamp button to show the x-ray field,
then press the Collimator Override button to select an x-
ray field.
Light Field Lamp For compression paddles: Press the Light Field Lamp
button to see the x-ray field for two minutes.
For localization paddles: Press the Light Field Lamp
button to see the x-ray field for the configured amount of
time. The default time for biopsy or needle localization
paddles is ten minutes.
Press the Light Field Lamp button again to turn off the
light field lamp.
The light field lamp automatically illuminates with the
start of the Compression Down movement.
Note
Most paddles can be used with the Shifting Paddle function. The large 24 x 29 cm
Frameless Screening Paddle, the large 24 x 29 cm SmartCurve™ system paddle, and the
Magnification paddles are not compatible with the Shifting Paddle function.
Use the 18 x 24 cm Frameless Screening Paddle to test the Shifting Paddle function.
Figure Legend
1. Acquisition Workstation Power Switch
2. Computer Power On/Reset Button
3. UPS Power Button
Note
The Select Patient screen opens when no quality control tasks are scheduled to be done.
Note
If you select the Skip button, the Select Patient screen opens. Refer to Select Patient Screen
on page 48 for information about this screen.
If you select the Admin button, the Admin screen opens. Refer to Admin Screen on page
111 for information about this screen.
Note
Quality Control tasks are available to complete at any time. Select the Admin button
then the Quality Control button to access the list of Quality Control tasks.
Item Description
1. Quick Search Search the selected tab for the Patient Name, Patient ID, or Accession #.
Item Description
2. Tabs The tabs at the top of the screen are configurable. A user with the correct
permissions can delete tabs and create new tabs.
x Scheduled tab shows the scheduled procedures.
x In Progress tab shows the procedures not complete.
x Completed tab shows the completed procedures.
x Current User tab shows the procedures for the current operator.
x Reject tab shows the procedures with rejected views.
x Pend tab shows the procedures with pending views.
x All tab shows all procedures for all users.
x Notices tab shows the patients with unviewed notices by default. Refer
to About the Notices Tab on page 50 for complete information.
x QC tab shows the Quality Control procedures.
x Enterprise tab is displayed if you have the Advanced Workflow Manager
on page 56. This tab shows the procedures acquired on all compatible
networked systems.
3. Buttons Many functions are accessed from this screen by selecting a particular
button:
x Open: Open the selected patient.
x New: Add a new patient — refer to Add a New Patient on page 50.
x Edit: Edit the patient information — refer to Edit the Patient Information
on page 51.
x Split: Remove the images from a procedure or a patient and move the
images to a different procedure or patient — refer to Split the Patient
Records on page 51.
x Delete: Delete the selected patient — refer to Delete a Patient on page 53.
x Filter: Use a Patient Filter — refer to Filters for Patients on page 53.
x Refresh Worklist: Update the Scheduled Patient Worklist information
— refer to Refresh the Worklist on page 55.
x Query Worklist: Search for a patient in the Modality Worklist — refer
to Query the Worklist on page 55.
x Admin: Access the Admin Screen — refer to Admin Screen on page 111.
x Log Out: Exit the system — refer to Log Out on page 55.
Note
You cannot split images for protected patients.
Note
Archived patient records still need correction on PACS or other archive systems after
using the Split function.
4. Select your search criteria (for example, Patient Name or Accession Number) using
the drop-down menu below the images.
5. Enter the same patient information and select the Search button (the magnifying
glass).
6. When the Patient name appears, select the correct procedure for the images.
7. If you want to archive the images, select Archive.
8. Select Split, then select OK to the Split Successful message.
7. If all images are being moved and you want to delete the incorrect patient from the
Patient List, check Delete Empty.
8. If you want to archive the images, select Archive.
9. Select Split, then select OK to the Split Successful message.
Note
The Technologists do not have permissions to delete patients.
Filter Tab
Use the Filter tab to change the filter options for the patient list. When you select or
cancel an option, the change shows in the Results area of the screen.
Note
You must have Manager level access to save these new filters to the selected tab in the
Select Patient screen. (Refer to Other Functions of the Filter Tab on page 54.)
Note
When you select a line in the results list then select the Open button, the Procedure
screen for the selected patient opens.
Change the current patient 1. Select a tab on the Select Patient screen.
filter parameters. 2. Select the Filter button.
3. Select the filter options.
4. Select the Save button.
5. Make sure the name of the tab you selected is in
the name box.
6. Select OK.
Create a new tab for the Select 1. Select a tab on the Select Patient screen.
Patient screen. 2. Select the Filter button.
3. Select the filter options for the tab.
4. Select the Save As button.
5. Enter a new name for the tab.
6. Select OK.
Delete a tab from the Select 1. Select a tab on the Select Patient screen.
Patient screen. 2. Select the Filter button.
3. Select the Delete button.
4. Select Yes in the confirmation dialog box.
Columns Tab
Use the Columns tab to add more search options (for example, Age, Gender, Notices) to
the filtered list. The options show as columns in the results area. To add more columns to
a filtered list, select the Columns tab then select the options.
Note
You must have Manager level access to save these new columns to the patient filter.
Note
When you select a line in the results list then select the Open button, the Procedure
screen for the selected patient opens.
5.3.10 Admin
Select the Admin button to access the Admin screen and the system administration
functions. Refer to System Administration Interface on page 111 for more information.
Item Description
1. Image Status The view icon shows the current selected view.
Implant Present button—select when the patient has an implant.
Accept button—select to accept the image.
Reject button—select to reject the image.
Pend button—select to save the image for future review.
2. Tabs Select the Generator tab to adjust the exposure techniques for the procedure.
Select the Tools tab to review the images.
Select the Biopsy tab to create targets.
Select the Contrast tab to perform I-View™ 2D Contrast procedures.
3. Buttons Many functions are accessed from this screen by selecting a particular button:
Add Procedure: Add a new patient.
Add View: Add a new view.
Edit View: Assign a different view to an image.
Archive/Export: Send images to an output.
Print: Print images.
Retrieve: Query the configured devices with the current patient information.
Paddle Shift: Bypass the default paddle position for the selected view.
Close Patient: Exit the patient and procedure.
Trash Can: Delete a view.
4. Thumbnails Select a tab to show the thumbnail views or the thumbnail images for that procedure.
Note
The Implant Present button is automatically selected if any procedure tabs contain an
ID view.
Available Procedures
The table that follows shows the major groups of procedures that are available on the
system.
Note
Some procedures in the list show only when the system is licensed for that procedure.
View Modifiers
ID = Implant Displaced
RL = Rolled Lateral
RM = Rolled Medial
RI = Rolled Inferior
RS = Rolled Superior
NP = Nipple in Profile
AC = Anterior Compression
IMF = Infra-Mammary Fold
AX = Axillary Tissue
2. Select the tab, then select the view. You can select a maximum of three View
Modifiers from the right panel of the screen.
3. Select the Add button. A thumbnail image of each selected view is added in the
bottom panel of the screen.
To Remove a View
• To remove a single view from the added list: select the view then select the trash can
icon.
• To remove all views from the added list: select the Clear button.
5.4.7 Retrieve
Select the Retrieve button to query the configured devices with the current patient
information. The Retrieve button performs the same function as the Query Retrieve
button in the Admin screen.
If there are images marked as Pend, a dialog box opens with the following options:
• Accept All and Close Complete
• Close Procedure In Progress
• Return to Procedure
If MPPS is activated, procedure status information is sent to the output devices when you
select Complete or Discontinue. You can also click and hold the tab above the thumbnail
images to resend a message about the procedure status during the procedure. A
Procedure Action dialog box opens with buttons to resend a status or to return to the
procedure.
Note
Tomosynthesis images are not sent to a print device in the selected Output Group. You
can print selected tomosynthesis images from the Print screen.
Note
Images are not sent if an Output Group is not selected.
5.7.1 Archive
1. Select the Archive/Export button.
2. Select the procedure or views in the On Demand Archive screen:
• Select All button selects all items that show in this screen.
• Clear button deselects items that are selected in this screen.
• Priors button shows previous procedures and views for this patient.
• Rejected button shows rejected views for this patient.
5.7.2 Export
1. Select the Archive/Export button (on the right side of the Procedure screen).
2. Select the images to export, then select the Export button.
3. In the Export dialog box, select the target from the drop-down menu of media
devices.
5.7.3 Print
1. From the Procedure screen, select the Print button to show the Print screen. See the
figure The Print Screen on page 67 to prepare your print data.
2. Select the film format from the film format area of the screen.
3. Select a thumbnail image.
4. Select the image mode (Conventional, Projection, or Reconstruction). The C-View
button shows if the system is licensed for C-View imaging.
5. Select the print preview area (item 16) in the Print screen. The image that shows in
this area is the image that prints on the film.
6. To put other images on the same multiformat film, repeat steps 3 through 5.
7. To print a different film format of the same images, select the New Film button (item
12), then complete steps 2 through 6.
8. Use the buttons in the top left area of the Print screen (item 1 through item 6) to hide
or show patient data, markings and annotations, and to change the orientation of the
image.
9. Select the Print button to print your films.
Figure Legend
7. Go to previous or next tomosynthesis slice or 18. Print tomosynthesis images (slices or projections)
projection (Tomosynthesis option). Tagged for Print (Tomosynthesis option).
8. Select Conventional, Projection, or 19. Return the Print screen to default settings.
Reconstruction views (Tomosynthesis option). 20. Open the Properties screen.
The C-View button shows if the system is 21. Show the printer IP address, AE Title, Port and
licensed for C-View imaging. capability for True Size print.
9. Select the printer options. 22. Start the print process.
10. View Thumbnail images. 23. Return to the Procedure screen.
11. Select the film format (number of tiles).
12. Create a new film.
Chapter 6 Images6:
Figure Legend
1. Patient information and exam date
2. Exposure information, including:
x Exposure techniques
x Patient dose
x C-arm angle
x Compression thickness and force
x Facility and technologist information
Warning:
Enhanced acquisition mode with combo mode imaging (DM + BT) can
produce radiation dose that is higher than the MQSA screening limit of 3.0
mGy and therefore should only be used in diagnostic evaluation.
x Manual The user selects the kV, mAs, Focal Spot, and Filter.
x AEC: Auto-Time The user selects the kV, Focal Spot, and Filter. The system
selects the mAs.
x AEC: Auto-kV The user selects the Focal Spot. The system selects the kV,
mAs, and Filter (Rhodium).
x AEC: Auto-Filter The user selects the Focal Spot. The system selects the kV,
mAs, and Filter.
4. When the x-ray is finished, the image appears on the Image Display monitor. The
Procedure screen automatically changes to the Tools tab.
Select one of the following options to complete the acquisition:
• Accept the image. The image transmits to output devices with all attributes.
• Reject the image. When the dialog box opens, select the reason for rejecting
the image. The Image Display screen closes. You can repeat the rejected view,
or select another view. If you select Reject, an "X" appears on the thumbnail
image.
• Pend the image. The image saves for future review. If you select Pend, a
question mark "?" appears on the thumbnail image.
Note
A manager user can configure the system to Auto-Accept or Auto-Pend new images.
Figure Legend
1. Image Review Tools - refer to Image Review Tools Tab on page 75.
2. Image Display Modes - refer to Display Modes on page 77.
3. Thumbnail Views and Thumbnail Images. Select any thumbnail image to display that
image on the Image Display monitor.
Figure Legend
1. The Zoom tool magnifies a section of the image.
2. The Ruler tool measures the distance between two
points.
3. The Crosshair tool displays a crosshair on the Image
Display screen.
4. The Demetalizer tool for processing tomosynthesis
images that contain metal objects.
5. The Window/Level tool changes the brightness and
contrast.
6. The Window/Level Fine Adjustment tool allows the
entry of specific window and level values.
7. The LUT Selection tool scrolls through available
Window/Level settings for a displayed image with LUTs
Figure 45: Image Review Tools
attached.
8. The AEC button displays the AEC Sensor areas used for
the exposure calculation. The sensor areas display on the
Image Display screen.
Figure Legend
1. The Oval tool draws an oval marking on the image.
2. The Ruler tool measures the distance between two points.
3. The Freehand tool draws a freehand marking on the image.
4. The Text tool adds a text note to the image without a marking.
5. The Arrow tool draws an arrow marking on the image.
6. The Markings tool shows or hides markings and annotations on an image.
7. The Send Notice tool sends a notice for the current image to the selected
destination.
8. The Send All Notices tool sends all notices for all images in the opened procedure
to the selected destination.
9. The Viewed tool changes the Patient Notices status to viewed.
Exposure Index
The Exposure Index is an image quality guide. When the Exposure Index indicates the
red or yellow area, review the selected image for noise and decide whether to reacquire
the image.
Display Modes
Use the buttons in the Display Modes area of the screen to select the type of view to show
on the Image Display monitor. You can change between conventional, generated 2D,
projections, and reconstructions to show the combination images.
Figure Legend
1. Conventional button shows conventional images.
2. Generated 2D button shows a conventional 2D image
Figure 48: Display Modes generated from the acquired tomographic image.
3. Projections button shows the 15° projection images.
4. Reconstructions button shows reconstructed slices.
Figure Legend
1. Up and Down arrows let you change between slices that
contain a lesion target and slices that are tagged for printing.
2. Up and Down arrows let you change between slices that
contain notices.
3. “H” (anatomical reference to head direction)
4. Slices that contain targets or are tagged for printing.
5. Slices that contain notices.
6. Scroll bar moves through the slices of the reconstruction.
7. “F” (anatomical reference to foot direction)
1. Select the Contrast tab to access the I-ViewTM 2D Contrast (CE2D) function.
2. Set the contrast settings. For more information, refer to How to Set the Contrast
Defaults on page 119.
Note
When you set contrast information, it appears in the DICOM header of the images.
3. To begin the contrast dose and start the timer, select the Start (arrow) button.
The timer begins in the Waiting Period, which appears with a yellow background.
Note
You can adjust the default length of time for the Waiting Period and Optimal Imaging
Period phases of the timer. Refer to How to Set the Contrast Defaults on page 119.
Note
The timer function does not allow you to stop the timer, only to start and reset it. The
timer stops only when you exit the patient procedures.
After the Waiting Period, the timer begins the Optimal Imaging Period, which
appears with a green background.
5. Select the low and high exposure buttons to acquire both low and high energy
images.
• Low: Conventional low-energy image
• Sub: Contrasted, subtracted image
• Low Sub: Shows both the low and sub screen images side-by-side in a split
screen.
Caution:
Using I-View 2D Contrast increases the recovery time the machine needs before more
images are acquired. When the x-ray tube status icon appears red ,a
recommended wait time is shown. This wait time lets the x-ray tube temperature
decrease to avoid damage that can void the x-ray tube warranty. Always make sure
that the x-ray tube status icon is green before starting an I-View 2D Contrast
procedure. If the x-ray tube status icon turns red during a procedure, complete the
procedure quickly using the minimum number of exposures.
Chapter 7 Accessories
7:
The system can perform screening or diagnostic applications with specified accessories.
This chapter describes how to use all possible system accessories.
Note
Hologic configures some systems to meet specific requirements. Your system
configuration may not have all the options and accessories included in this manual.
Figure Legend
1. Slot for Retractable Face Shield (Tomosynthesis option) or the Affirm® breast biopsy
guidance system (biopsy option)
2. Slot for 1.8x Mag Stand and Localization Crosshairs
3. Slot for 1.5x Mag Stand
Warning:
The Face Shield must be attached for all exposures except magnification case
studies.
Warning:
The Face Shield does not protect the patient from radiation.