iSite 3.5: System Preferences

1. iSite 3.5: System Preferences

2. Learning Objectives Understand the purpose and configuration of: • General Preferences • Window Window/Center • Image Processing • Filters • Annotations • DICOM Sources • Screen Overlay • Paper Printing

3. Learning Objectives (cont.) • iExport • iQuery • Organization Dictionary • Location Dictionary • Plug Ins • DICOM Print • Body Part Dictionary (iSite Radiology only) • Hanging Protocols (iSite Radiology only)

4. Table of Contents • General Preferences • Window Window/Center • Image Processing • Filters • Annotations • DICOM Sources • Screen Overlay • Paper Printing

5. Table of Contents (cont.) • iExport • iQuery • Organization Dictionary • Location Dictionary • Plug Ins • DICOM Print • Body Part Dictionary (iSite Radiology only) • Hanging Protocols (iSite Radiology only)

6. Preferences Dialog

7. System Preferences • System Preferences configure system-wide settings for every user • System and Machine Preferences are associated with the Security Codes ISTUSRPREF and ISTSUPPORT • System Preferences are typically only accessible by administrators and are not visible to standard users

8. Importing and Exporting Preferences • Importing and Exporting Preferences • Many preference settings can be imported and exported to facilitate setting up User and System Preferences • The User Preferences that can be imported and exported are Window Width/Center and Filters • The System Preferences that can be imported and exported are Window Width/Center, Filters, Annotation, DICOM Sources, Screen Overlays, Paper Printing, Organization Dictionary, Location Dictionary and Body Part Dictionary • Please note that importing preferences will override any preferences in the system

9. Preferences Dialog • Preferences can be accessed by selecting the ‘P’ icon in the upper-right corner of the iSite Control Strip

10. General Preferences

11. Logon Welcome Message • The ‘Logon welcome message’ may be configured with help desk information or may be used to notify users of scheduled maintenance of the system

12. Logon Welcome Message • The ‘Logon welcome message’ shown at left is displayed on the log-in page

13. Image/Series Linking • iSite System Administrators can set the number of degrees to allow for linking variance • This determines if a series can be linked with another series and this variance is configurable at a site level

14. Allow DICOM Query From Exam Timeline • The ‘Allow DICOM Query From Exam Timeline’ option permits users to perform a DICOM query from the Exam Timeline if the user has the Security Code ISTQUERY

15. Allow Exams to be Marked Read More Than Once • The ‘Allow Exams to be Marked Read More Than Once’ option permits users to “Mark Read” exams which have already been marked as read • The ‘Allow Exams to be Marked Read More Than Once’ is useful for over reads and peer review

16. Image Orientation • The ‘Image Orientation’ option allows iSite System Administrators to allow users to set their own flipping preferences for Axial CTs or always display Axial and Oblique CTs with the anatomical right on the left side of the image window

17. Image Orientation • Please note that the visibility of this option is dependent on the System Preferences set by your institution's iSite System Administrator

18. Image Orientation • Users who wish to automatically display axial and oblique CTs with the anatomical right displayed on the left, regardless of the initial orientation of the image, may select the “Axial/Oblique CT:…" box

19. Window Width/Center

20. Window Width/Center • Users may select the Window Width and Center dialog to add, modify or delete the default preset window width and center values display

21. Window Width/Center • The Add Window Width/Center may be used to create new Window Width/Center presets by establishing a name, indicating the Modality and setting the Width and Center

22. Window Width/Center • To edit a window width and center setting, “double click” a listing or highlight a listing and click the ‘Properties’ button • When you have finished making changes, click ‘Apply’ and then ‘OK’ to save and exit the Dialog box

23. Window Width/Center • Window Width/Center settings are mapped to the number keys in the order displayed here and in the Context Menu, so that users may apply a Window Width/Center setting easily while viewing images

24. Image Processing

25. Image Processing • Edge Enhance: Uses a Laplacian method to increase the visibility of edges in the image • Edge Detection: Provides an alternative to the Edge Enhance tool, using a Sobel operator to increase the visibility of edges • Median Filtering: Uses a common filtering method to reduce noise in an image • CLAHE (Contrast Limited Adaptive Histogram Equalization): Uses an adaptive form of histogram equalization that enhances the contrast adaptively across the image

26. Image Processing • Image Processing Filters have several configurable parameters which may be configured by each individual user

27. Image Processing • Image Processing Filters can be applied manually (via a right mouse click option) • Any time an Image Processing Filter is applied to an image, iSite displays a “P ” (Processed) Icon in the meta data area of that image

28. Image Processing – Edge Enhance • ‘Edge Enhance’ is performed with a Laplacian operator to discriminate the edges; the result is scaled and added back into the original image data • A 5 point or 9 point operator may be selected

29. Image Processing – Edge Enhance • The intensity of ‘Edge Enhance’ is controlled by the “degree” parameter which can be “Light”, “Medium” or “Strong” • Edge Enhance is applicable to any monochrome image

30. Image Processing – Edge Enhance The image on the right side has the ‘Edge Enhance’ filter applied

31. Image Processing – Edge Detect • This class of algorithm accentuates the rising and falling components of edges • This is done with a Sobel operator; the result is scaled and added back into the original image data

32. Image Processing – Edge Detect • The intensity of ‘Edge Detect’ is controlled by the “degree” parameter which can be “Light”, “Medium” or “Strong”

33. Image Processing – Edge Detect The image on the right side has the ‘Edge Detect’ filter applied

34. Image Processing – Median Filter • ‘Median Filter’ is used as a noise reduction filter • Neighborhoods around each pixel are sampled and the central pixel is replaced with the median value of the neighborhood • A 3x3 or 5x5 filter may be selected

35. Image Processing – Median Filter The image on the right side has the ‘Median Filter’ applied

36. Image Processing - CLAHE • Contrast Limited Adaptive Histogram Equalization (CLAHE) is a variant of histogram equalization • The drawback of the general histogram equalization method is that the computation is performed across the entire image

37. Image Processing - CLAHE • In medical images, the local behavior of the histogram can be radically different than either the global, or non-local behavior • This class of method performs the histogram equalization on a parameterized region-by-region basis and stitches the results to prevent any boundary edges

38. Image Processing - CLAHE • The following parameters can be set via the “Preferences” • Contextual Region Dimension • Number Of Bins • Clip Limit • Map Level

39. Image Processing – CLAHE The image on the right side has ‘CLAHE’ applied

40. Filters

41. Filters • Filters allow you to create custom search criteria for Worklists

42. Filters • Filters can be used to create Reading Worklists to meet specific needs • Exercise care in creating filters so exams are not accidentally excluded • To create a filter click ‘Add’

43. Filters • This screen allows the user to generate a filter • Users are not required to fill in all the fields because the default for an empty field is ‘all’ • When you have finished making changes, click ‘Apply’ and then ‘OK’ to save and exit the Dialog box

44. Filters • The Filter shown will provide a worklist which includes: • “CARDIAC” subspecialty (as defined in the Exam Dictionary) • Unread • All Exam Statuses

45. Filters • The Filter shown will provide a worklist which includes: • “CR” and “DX” (DR) images for patients in • “Critical Care” Units • For Body Part “Chest” • “Stat” priority • “Unread Only” • “Completed” Exam Status

46. Filters • The Filter shown will provide a worklist which includes: • “CR” and “DX” (DR) images for patients in • “Outpatient” Units • For Subspecialty “BONE” • “Non-Stat” priority • All Exam Statuses, except “In Progress” • For 30 Days • Ordered by Dr.s Smith, Jones, or Davis

47. Annotations

48. Annotations • Image annotations may be added to an exam to identify key images or regions of interest • The ‘Annotations’ option allows the iSite System Administrator to create, edit and delete preset annotations

49. Annotations • Select the ‘Add’ button to add new image annotation presets

50. Annotations • Provide a name, which should be the annotation • Font styles and sizes may be selected • Arrows may be added for emphasis