VitreaCoreEDUCATION REFERENCE GUIDE
VitreaCoreEDUCATION REFERENCE GUIDE
Copyright © 2004 - 2014 Vital Images, Inc. All rights reserved. Date of Publication January, 2014
VitreaWorkstation® protected by U.S. Patents 5,986,662; 6,130,671; 6,219,059; 7,031,504; 7,136,064; 7,362,329; 7,574,029;
7,590,272; 7,660,481;7,929,748;7,991,210; 8,214756; 8,249,687 Other Patents Pending in the U.S. and other countries.
VitreaAdvanced® protected by U.S. Patents 5,986,662; 6,130,671; 6,219,059; 7,031,504; 7,136,064; 7,362,329; 7,574,029;
7,590,272; 7,660,481;7,929,748;7,991,210; 8,214756; 8,249,687 Other Patents Pending in the U.S. and other countries.
VitreaCore® protected by U.S. Patents 5,986,662; 6,130,671; 6,219,059; 7,039,723; 7,136,064; 7,362,329; RE42,952;Other Patents
Pending in the U.S. and other countries.
This publication is valid for Vitrea Enterprise Suite 6.6 and later software versions.
No part of this work may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic or
mechanical, including photocopying and recording, or by any information storage or retrieval system without permission in writing from
Vital Images.
Trademarks
Vital Images, Vitrea, ViTAL, and ViTAL U are registered trademarks of Vital Images, Inc.
All other marks are property of their respective owners.
Restricted Rights Legend
If this software or documentation is delivered to the Department of Defense (DOD) of the U.S. Government, it is delivered with Restricted
Rights as follows:
Use, duplication or disclosure of the software by the U.S. Government is subject to restrictions as set forth in subparagraph (c)(l)(ii) of the
Rights in Technical Data and Computer Software clause at DFARS 252.227-7013.
If this software or documentation is delivered to any unit or agency of the U.S. Government other than DOD, it is delivered with Restricted
Rights and use, duplication or disclosure by the U.S. Government is subject to the restrictions as set forth in FAR 52.227-19 (b)(3). If the
software or documentation is delivered to NASA, it is delivered with Restricted Rights subject to the restrictions set forth in 18-52.227-
86(d) of the NASA FAR Supplement.
Limits of Liability and Disclaimer of Warranty
VITAL IMAGES SHALL HAVE NO LIABILITY OF ANY KIND FOR ANY DIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES BASED
ON ANY DEFECT, FAILURE OR MALFUNCTION OF THE SOFTWARE,OR USE OF ANY VITAL IMAGES DOCUMENTATION, WHETHER
THE CLAIM IS BASED UPON WARRANTY, CONTRACT, TORT OR OTHERWISE. VITAL IMAGES MAKES NO WARRANTY, EXPRESS OR
IMPLIED, INCLUDING BUT NOT LIMITED TO, ANY WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE
WHETHER ARISING FROM STATUTE, COMMON LAW, CUSTOM OR OTHERWISE.
Notice of Confidentiality
This software and the information in this software including, but not limited to, the ideas, concepts and know-how are proprietary,
confidential and trade secret to Vital Images, and the information contained therein shall be maintained as proprietary, confidential and
trade secret to Vital Images and shall not be copied or reproduced in any form whatsoever. This software and any information contained
therein shall not be disclosed to anyone other than authorized representatives of the user's employer, who is contractually obligated not to
disclose same without the express written consent of Vital Images. The user of this software and any information contained therein shall
not attempt to discern Vital Images' confidential and trade secret information and shall not reverse compile, disassemble, or otherwise
reverse engineer this software or any information contained therein.
Software License Notice
This software is a licensed product of and is distributed by Vital Images, and may only be used according to the terms of that license on
the system identified in the License Agreement. In the event of any conflict between these terms and the terms of any written agreement
or agreement assented to through electronic means with Vital Images, the terms of such written or assented agreement shall control.
MDSS GmbH
Schiffgraben 41
30175 Hannover, Germany
CELEO Pty Ltd. and Toshiba Australia Pty Ltd are authorized sponsors in Australia and act on behalf of Vital Images, Inc. in the
communication of safety-related incidents and regulatory matters with Therapeutic Goods Administration in Australia. Distributors are still
the first line of communication with their customers regarding service and complaints.
Manufactured by: Vital Images, Inc.; 5850 Opus Parkway, Suite 300; Minnetonka, MN, US; 55343; Phone 866.433.4624
VPMC-13235 A iii
Safety and Regulatory
Considerations
PLEASE REFER TO THE ABOUT VITAL IMAGES MEDICAL IMAGING
SOFTWARE DOCUMENT BEFORE USING THIS PRODUCT. This
document includes important information regarding general Vitrea Safety
and Regulatory considerations.
Contact Us
• For general, non-technical support questions, contact us through our
Web site: www.vitalimages.com.
• For customer technical support, contact us:
• In the U.S., call the Customer Support line at 1.800.208.3005.
• Outside the U.S., contact your Vital distributor.
• Send an email to [email protected].
• For a printed version of the Release Notes, Education and Reference
Guide, or Installation Guides, contact Customer Support at
1.800.208.3005.
Release Notes
Vitrea Release Notes contain late-breaking information not available at the
time the Education and Reference Guide was released. This document is
available from your System Administrator or from Vital Images.
iv
VPMC-13235 A
Table of Contents
Safety and Regulatory Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
Contact Us . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
Release Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
Introduction to VitreaCore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
VitreaCore Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
User Help. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Vital U . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
VitreaCore Windows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Study Directory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
The Viewer Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Viewer Window Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Visual Tab Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Analysis Tab Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Batch Tab Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
The Report Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Troubleshooting VitreaCore. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Select a Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
VitreaCore User Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Loading Studies into VitreaCore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
VitreaAdvanced Through the Data Manager . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Loading Studies into VES Through a PACS Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Common Tasks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Getting Started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Study Directory Tasks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Using the Patient List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Using the Data Manager. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Using DICOM Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Auto Export . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Queue Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
v
VPMC-13235 A
Viewer Window Tasks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Viewer Window Layout. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Using the Viewer Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Performing Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
Segmenting Objects. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Performing Vessel Probe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
2D Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Visual Control. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
MPR Imaging in VitreaCore Viewer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
3D Imaging in VitreaCore Viewer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Using 3D Presets and Anatomy Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
3D/MPR Right-Click Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Image Batches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Appendix I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
User Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Setting User Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Local Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Network Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Appendix II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Error Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Aorta. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Aorta Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Aorta Lesson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Additional Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
vi
VPMC-13235 A
Peripheral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Peripheral Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Peripheral Lesson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Additional Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Carotid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Carotid Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Carotid Lesson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
Additional Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Coronary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Coronary Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Coronary Lesson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
Additional Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194
Lung . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Lung Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Lung Lesson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212
Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
vii
VPMC-13235 A
viii
VPMC-13235 A
Introduction to VitreaCore
Contents
• VitreaCore Overview
• VitreaCore Windows
• Study Directory
• The Viewer Window
• The Report Window
• Troubleshooting VitreaCore
VitreaCore Overview
VitreaCore is a Web-based medical diagnostic aid that allows physicians
to use PCs or notebook computers to gain remote access to 2D, 3D, and
4D advanced visualization. The software enables you to measure, rotate,
and analyze images.
Introduction to VitreaCore 9
VPMC-13235 A
User Help
Click the Help tab at the bottom of the VitreaCore Viewer window to
access detailed user documentation for VitreaCore.
Vital U
10 Introduction to VitreaCore
VPMC-13235 A
Classroom Learning
Fundamentals for Advanced Visualization Software
Distance Learning
Register for a schedule of live webinars demonstrating Vital Images
software, while a physician or clinical applications instructor answers your
questions. You can also explore a library of recorded webinars at your
Introduction to VitreaCore 11
VPMC-13235 A
convenience. View the schedule of dates and topics or register at
vitalueducation.com.
Administrator Education
This course is designed for IT professionals, PACS Administrators, field
engineers or anyone who services, installs or supports Vital Images’
advanced visualization software. This course will teach your designated
Vital Images software administrator how to get the most out of VitreaCore
by fully integrating it with your medical imaging systems. For more
information, contact the Vital U education coordinator at 952.487.9559 or
e-mail [email protected].
On-site Learning
Any of our educational programs can be brought to your facility. Our
experienced applications instructors meet your learning needs by bringing
Vital U courses and hardware, if needed, to your site. On-site learning
customizes your education program to the specific workflow of your
physicians and technologists.
Customized Options
Packages include multi-user and multi-session formats to meet your
learning needs. To design your customized education program, contact
the Vital U education coordinator at 952.487.9559 or e-mail
[email protected].
VitreaCore Windows
Tabs
Navigate through the VitreaCore windows by selecting the appropriate tab
located at the bottom of the screen.
12 Introduction to VitreaCore
VPMC-13235 A
Study Directory
When you start VitreaCore, the Study Directory opens.
3 4 1
6
2
8
9 10
Callout Description
1 Software Version
2 Column Headers
NOTE: Click to sort. Click then type the first few letters
to search.
3 Conference Button
4 Preferences Button
5 Patient List
6 DICOM Query tab
7 Series/Snapshots/Reports/Applications Tabs
8 Data Manager
Introduction to VitreaCore 13
VPMC-13235 A
Callout Description
9 Server Load Indicator
Hover the cursor over the icon to display the amount of free
server memory, in gigabytes.
More black than white: More than 3.0 GB Server Memory
Black and white: Between 2.0 and 3.0 GB Server Memory
Orange: Between 1.0 GB and 2.0 GB Server Memory
Red: Less than 1.0 GB Server Memory
10 Network Speed Indicator
Hover the cursor over the icon to display the speed, or
throughput, of the network you are using.
Red: < 8.0 Mbps Network Speed
Black: >20.0 Mbps Network Speed
Icons Description
(Blue with blue arrow) Incoming/Processing
14 Introduction to VitreaCore
VPMC-13235 A
Icons Description
(Gray with red check mark) Published
Building DICOM study
Introduction to VitreaCore 15
VPMC-13235 A
Menu Item Description
Change Lock a study from deletion, or unlock a study you
Study Lock locked.
Worklist Filters
Use a predefined Worklist Filter to sort the Patient List, or define and save
your own filter.
Automatic Query
VitreaCore contains two automatic query/retrieve features:
16 Introduction to VitreaCore
VPMC-13235 A
• Set other Patient List preferences
User Types
Loading studies into VitreaCore depends on your user type. The user
types are determined by usernames and passwords. Your organization
assigns user types to individual usernames and passwords depending on
the role of the user.
Clinicians
• Access VitreaCore.
• Load and interact in VitreaCore workflows using the
Load button.
• Restore snapshots into VitreaCore.
Diagnostic Users
• Access both VitreaCore Viewer and VitreaAdvanced Viewer. The
VitreaCore Viewer is the default viewer.
• Load and interact in VitreaCore Viewer workflows using
the Load button.
• Load and interact in Advanced Viewer workflows
by right-clicking and selecting Load in Advanced
Viewer.
• Restore snapshots into Advanced Viewer.
Introduction to VitreaCore 17
VPMC-13235 A
Advanced Diagnostic Users
• Access both VitreaCore Viewer and VitreaAdvanced Viewer. The
Advanced Viewer is the default viewer.
• Load and interact in Advanced Viewer Workflows using
the Advanced Viewer button.
• Load and interact in VitreaCore Viewer workflows
by right-clicking and selecting Load.
• Restore snapshots into Advanced Viewer.
18 Introduction to VitreaCore
VPMC-13235 A
The Viewer Window
The Viewer window is the main working area in VitreaCore and includes
the tools necessary to complete your workflow.
3 2
1
Callout Description
Number
1 Viewer Window Layout Buttons
2 Analysis, Visual, and Batch Tabs
3 VitreaCore tools
4 In-view tools
5 Information area and Status Bar
Introduction to VitreaCore 19
VPMC-13235 A
2D and MPR Mouse Functions
OR
3D Mouse Functions
20 Introduction to VitreaCore
VPMC-13235 A
Mouse Button Press to:
Left + Middle click and drag Zoom
OR
Keyboard Shortcuts
Adjust views and perform other operations using keyboard shortcuts
Key Function
C Activate Cobb Angle tool
E Activate Ellipse tool
F Activate ROI tool
G Activate Angle tool
H Activate Crshair tool
I Switch to inverted view
M Activate Arrow (Marker) tool
P Activate Spine Labeling tool
R Activate Ruler tool
S Activate Snap tool
T Activate Text or Text/Arrow tool
W Activate Win/Lev tool
CTRL- Re-do last undone action
Y
CTRL- Undo last action (repeat to undo multiple actions)
Z
3D Keyboard Shortcuts
Key Function
S-I [F2] Rotate volume Superior to Inferior -- 180° azimuth, 90°
elevation, 0° twist
I-S [F3] Rotate volume Inferior to Superior -- 0°, -90°, 0°
Introduction to VitreaCore 21
VPMC-13235 A
Key Function
A-P [F4] Rotate volume Anterior to Posterior -- 0°, 0°, 0°
P-A [F5] Rotate volume Posterior to Anterior -- -180°, 0°, 0°
L-R [F6] Rotate volume Left to Right -- -90°, 0°, 0°
R-L [F7] Rotate volume Right to Left -- 90°, 0°, 0°
1 2
# Description
1 VitreaCore Tools
2 Segment Objects Area
22 Introduction to VitreaCore
VPMC-13235 A
Visual Tab Controls
Use the Visual tab controls to change the protocol, show or hide view
options, or change visibility settings.
1 2 3
# Description
1 Protocols button
2 View Options area
3 Object Visibility area
View Options
Option Description
Patient Info check box Show or hide patient info
Labels check box Show or hide labels
Measurements check Show or hide measurements in the views
box
TIP:Also shows or hides reference scale
on the right side of the 2D and MPR
views.
Full Crosshair check Show full crosshairs (including intersection) or
box partial crosshairs (not including intersection)
Show Segmentation Show results of segmentation in the MPR
check box views.
Show 3D Crosshair Show or hide the crosshairs in the 3D view
check box
Introduction to VitreaCore 23
VPMC-13235 A
Analysis Tab Controls
# Description
1 Vessel Probe area
Make batches and movies on the Batch tab of the Viewer window.
1 2 3
# Description
1 Batch creation buttons
2 Controls for setting Step Size and Number of Images
3 Batch output buttons
24 Introduction to VitreaCore
VPMC-13235 A
The Report Window
See the Distribute Findings - VitreaCore chapter for detailed information
about the Report Window.
Troubleshooting VitreaCore
All of the available 3D rendering sessions are currently in use.
Typically indicates that the image server(s) are busy processing user
requests for 3D images. Wait and try again later.
Indicates that you have loaded the maximum number of Studies (in the
Study Directory, there are check marks next to each loaded Study). You
cannot load any more studies until you unload one or more studies.
• After you click OK, the Close Studies dialog box displays, where you
can unload, or close, one or more open studies.
Introduction to VitreaCore 25
VPMC-13235 A
Not enough memory to load volume
Indicates that either the image server is busy processing user requests, or
that your image volume is too large to be processed. Wait and try again,
or, if the volume is too large, try reconstructing it.
Cause Suggestion
Missing or additional DICOM The snapshot is not restorable.
slices.
The volume build configuration Contact your administrator. The
has changed resulting in dataset has to be re-pushed to
different interpolation settings VIMS.
being used.
Other VIMS configuration Contact your administrator.
changes.
Indicates that there are more studies on the server than your system is
configured to retrieve.
26 Introduction to VitreaCore
VPMC-13235 A
• Limit your Study Directory results, if you a looking for a specific study.
• Change the Maximum worklist items setting in the User Preferences >
Study Directory dialog box.
Introduction to VitreaCore 27
VPMC-13235 A
28 Introduction to VitreaCore
VPMC-13235 A
Select a Study
Contents
NOTE: This module demonstrates the various scenarios for loading
studies into VitreaCore. Be sure you understand your user type as
each user type has specific access controls.
• VitreaCore User Types
• Loading Studies into VitreaCore
• VitreaAdvanced Through the Data Manager
• Loading Studies into VitreaCore Through a PACS Integration
Select a Study 29
VPMC-13235 A
Clinician Diagnostic Advanced
User Diagnostic
User
Vessel Probe N Y Y
DICOM query Y Y Y
(if configured
by System
Administrator)
Create evidence N Y Y
(snapshots, batches,
movies)
Delete evidence N Y Y
(snapshots, batches,
movies)
30 Select a Study
VPMC-13235 A
2. Select the Series tab.
TIP: To load multiple series, press CTRL and click all the series to load.
Select a Study 31
VPMC-13235 A
VitreaAdvanced Through the Data
Manager
See the VitreaAdvanced Course Modules for detailed VitreaAdvanced
workflows.
Use this procedure if the Study Directory contains the Data Manager.
Data Manager
32 Select a Study
VPMC-13235 A
Load a subset of the data:
TIP: If you do not see the application that applies to the workflow you
are using, double-click the Core 3D thumbnail and choose a
protocol and preset.
NOTE: Once the study loads, “Vitrea” displays in the upper-left corner.
Select a Study 33
VPMC-13235 A
Loading Studies into VES Through
a PACS Integration
There are two ways to load studies into VitreaCore through a PACS
integration.
Option 1
CAUTION: Verify that you have loaded the study you intended to load. If you
load a study that contains multiple series or contains 3D reconstructions, a
dialog box displays that asks you to select the series you want to load.
Make sure to respond to dialog box. If you do not, it is possible to return to
PACS and load a different study.
34 Select a Study
VPMC-13235 A
Option 2
1. Use the procedure below to load a study from the Data Manager.
TIP: The Data Manager displays at the bottom of the screen if Use
Data Manager is selected in the VES Administration Tool.
NOTE: If Auto-Sync Data is selected in the VES Administration Tool, the system
will automatically determine what (if any) study is missing and will automatically
begin retrieving the data.
Select a Study 35
VPMC-13235 A
2. On the Applications tab, perform one of the following:
• Select the appropriate application view and double-click to launch
the study.
TIP: This method of launching only loads the series that are defined as
“best candidates” and are pre-selected.
36 Select a Study
VPMC-13235 A
Common Tasks
Contents
• Getting Started
• Study Directory Tasks
• Viewer Window Tasks
• 2D Imaging
• MPR Imaging in VitreaCore Viewer
• 3D Imaging in VitreaCore Viewer
• Image Batches
• Appendix
Getting Started
Log into VitreaCore
1. On the client PC, launch Internet Explorer and enter the URL for the
VitreaCore server. If you do not know the URL, contact your System
Administrator.
Common Tasks 37
VPMC-13235 A
The VitreaCore system opens to the Patient List tab.
NOTE: If you receive the message shown below, there are more
studies on the server than your PC is configured to display. Either filter
the Patient List to limit the number of studies displayed, or go to the
User Preferences - Study Directory dialog box to increase the
maximum number of studies displayed.
38 Common Tasks
VPMC-13235 A
Using the Patient List
Use the Patient List to select images for review and manipulation. The
Patient List displays studies and series in the Patients/Studies Area.
Thumbnails of the images contained in the Studies display in the Series
tab. If VitreaCore is configured to automatically split series, the sub-series
list sorts the images within the selected series into categories.
CAUTION: Before you start processing, check the number of images on the
Patient List tab and make sure that the entire series or study was received
from the server.
TIP: To further filter the Study List, set the selection criteria for multiple
columns.
EXAMPLE:
1. Click in the field under the Modality header and select CT from
the dropdown list.
The Patient List displays only CT studies.
2 Click in the field under the Date of Last Study header and
select <2 days from the dropdown list.
Common Tasks 39
VPMC-13235 A
The Patient List displays only CT studies occurring in the last 2
days.
3 Click the Patient Name header.
The Patient List displays CT studies occurring in the last 2
days, sorted by patient name in ascending order.
4 Click the Patient Name header again.
The Patient List displays CT studies occurring in the last 2
days, sorted by patient name in descending order.
Click in the field below any searchable column header and select an
item from the dropdown list.
Select a value from a dropdown list for the following columns: Status,
Date of Last Study, Modality, and Gender.
40 Common Tasks
VPMC-13235 A
server configuration, and if you are logged on with radiologist privileges.
For information about configuring the VitreaCore server, contact your
System Administrator.
The Patient List sorts according to the criteria in the filter. If the List is
blank, or does not return the expected results, try another filter, or
create your own.
2. Select Save as New... from the Worklist Filters dropdown menu at the
top of the screen.
3. Edit the criteria in the Query Filter box, if needed, and enter a Filter
Name.
NOTE:The Query Filter box contains criteria that matches those in the
column headers.
4. Click Save.
The Filter is saved and is available the next time you select it from the
list.
5. Select the filter you just created from the Worklist Filters dropdown
menu.
Common Tasks 41
VPMC-13235 A
Conferencing
box displays.
TIP: The Conf button displays at the top of the Study Directory and at
the bottom of the other windows.
4. Click Join.
The Data Manager displays below the Patient List. The Data Manager
provides access to the Applications, Series, Snapshots, and Reports
available for the currently selected patient.
42 Common Tasks
VPMC-13235 A
• Load a study into an application
• Load one or more series into either 2D or 3D viewers
• Send a series or study to a DICOM device (see the DICOM section)
• Restore a snapshot
• Save a snapshot locally
• Load reports
The Data Manager displays the data available for the patient, in the
lower portion of the screen. This can include VitreaCore Series,
Snapshots, and Reports.
TIP: If you do not see the application that applies to the workflow you
are using, double-click the Gallery thumbnail and choose a
protocol and preset.
Common Tasks 43
VPMC-13235 A
Loading One or More Series
1. To select an individual series, click one of the thumbnails.
TIP: To select multiple contiguous series, click the first thumbnail of the
group, press and hold SHIFT, then click the last thumbnail of the
group. A checkmark displays in the corner of each thumbnail.
Restoring a Snapshot
1. Select the Snapshots tab.
Click the Restore Snapshot bar of the icon. The snapshot displays in
the Viewer tab.
3. In the dialog box, indicate the file location, file name, and file type.
CAUTION: Be careful when saving and working with these types of files.
Patient information is not included on the snapshot or movie. It is possible
to misrepresent or confuse these kind of snapshots or movies.
44 Common Tasks
VPMC-13235 A
Loading Reports
1. Select the Reports tab from the Data Manager.
The VitreaCore system consists of a server and one or multiple client PCs.
The client automatically queries the server at regular intervals to check for
new studies. At any time, export studies to, send queries to, and retrieve
studies from other DICOM servers or devices on the network. Manually
query and retrieve studies from within the VitreaCore server.
When you are finished working with a study on the client PC, export it to
other devices or servers on the network. Use the Save as DICOM File
option to save a newly worked up study to the server. If you have DICOM
forwarding set up for one or more devices on the network, the study you
are saving to the server is automatically exported to the devices set up for
forwarding.
2. Select a server or device from the Server dropdown list at the top of
the tab.
Common Tasks 45
VPMC-13235 A
3. Specify sort criteria in the query list columns, if desired.
NOTE: The newly retrieved studies display in the Patient List the next
time it is refreshed.
1. Click .
4. Click Import.
46 Common Tasks
VPMC-13235 A
Export Data to Media
Right-click the study and select Save to Media to launch export Media
Manager.
3. Click Export.
Common Tasks 47
VPMC-13235 A
Export to DICOM
Right-click the study and select DICOM Export to launch the DICOM
export manager.
NOTE: When DICOM data with empty PatientID is imported into the
VIMS Server, the StudyUID of the anonymized data will display as the
PatientID within VitreaCore.
48 Common Tasks
VPMC-13235 A
NOTE: If Anonymize Pvt Tags is selected, all private tags,
including Vital private tags needed for snapshot restore, are
removed from the study. Evidence does not display in the Report
tab of the Data Manager, but it does display as a 2D series on the
Series tab.
4. Click Export.
Auto Export
1. After you create your findings (snapshots or batches) and close the
study, the Auto Export Dialog displays.
2. From the Group dropdown menu, select the location where you want
to export the findings.
Option Description
Export Selected Export the selected snapshots and
batches.
Export All Export all snapshots and batches.
Skip Does not export the findings, but the
findings remain on VIMS.
Cancel Close the Auto Export Dialog without
exporting snapshots or batches.
Close the Auto Export Dialog without
exporting snapshots or batches.
Queue Management
Diagnostic and Advanced Diagnostic Users can see the status of activities
within the VIMS system as it relates to DICOM export, DICOM print, and
DICOM query and retrieve.
50 Common Tasks
VPMC-13235 A
Viewer Window Tasks
Overview
The Viewer window is the main area in which you view and manipulate
images. This window displays images in 2D and 3D formats.
2D Layout
This mode displays slices exactly as they were acquired by the scanner.
Use the and buttons next to the series number to move to the
previous or next series in the study, or click the dropdown next to the
series buttons to select a specific series. Also change the Viewport layout
to display multiple series at one time. The 2D layout allows you to:
3D Layout
Common Tasks 51
VPMC-13235 A
• Click the MPR Rotate button to move all MPR views one position
clockwise.
Overview
Once you have an image loaded in the Viewer window, begin your
evaluation activities. The features described below control the visualization
settings that are used to display those images, and specify your Viewer
window image layout.
2. From the Protocols dropdown menu on the Visual control, select the
protocol you want to load.
The Protocol settings are applied to the 3D view.
52 Common Tasks
VPMC-13235 A
Switching Anatomy Protocols
If you want visualization settings different from the ones that are currently
loaded, switch to a different Anatomy Protocol at any time.
2. From the Protocols dropdown menu on the Visual control, select the
Protocol you want to load.
The Protocol settings are applied to the 3D image.
Common Tasks 53
VPMC-13235 A
Viewer Right-Click Menu
54 Common Tasks
VPMC-13235 A
Menu Item Description
Image Change the image properties of the viewport:
Properties • Invert — apply an inverted MIP rendering to the
MPRs
• Rotate Right 90 Degrees — rotate the selected
image 90°
• Rotate Left 90 Degrees — rotate the selected
image 90°
• Flip Horizontally — flip the selected image
along the horizontal center
• Flip Vertically — flip the selected image along
the vertical center
• Reset — reset the image to the default
properties
Interact Fast Set the 3D interaction rate.
(3D)
Lock 3D Lock the 3D image.
Save Image Save selected image as a Windows file.
Save Screen Save a screen capture:
Capture (For Whole Screen) as Windows File — save the
entire Viewer window as a Windows file.
Copy to Clipboard — paste the selected image into
another Windows application, such as Adobe
PhotoShop or Microsoft Word.
Print Print the image from the current viewport in secondary
capture format to any configured printer accessible
from your PC.
You cannot print DICOM images from VitreaCore.
Cine Start Available only in 2D mode when not cineing. For time-
series studies, auto-scroll through all time phases for a
position. For non-nuclear medicine, non time-series
studies, display all images in a continuous movie
mode.
Cine Stop Available only when cineing. Stops the cine action.
Common Tasks 55
VPMC-13235 A
Menu Item Description
Adjust Cine Available only when cineing. This dialog box allows you
Setting to adjust the settings of the currently-running cine.
Adjust these settings as needed before you save the
batch as a movie:
• OK button: make your changes and click OK
• Reset button: click to reset to default settings
• Range: x To: x: specify which run of frames you
want included
• fps Slider: control the number of frames that
display per second (fps)
• Pause between cine loops: check the box to
insert a pause (idle time) at the end of each cine
loop, before the cine plays again
• Delay (s): the length in seconds of the pause
between cine loops.
Save Cine to Available only when cineing. Save the cine as a
Movie File Windows .avi movie file to a location on your PC or
network. When you select this menu item, the
Windows Save As dialog box displays.
Adjusting Window/Level
1. Click .
Sculpting 3D Objects
1. Click .
2. In the viewport, click and drag to draw a freehand border. When you
sculpt:
• Eliminate anatomy from view by drawing a contour line around it.
• Isolate anatomy in the view by drawing a contour line around it.
3. After you create the contour line, Keep and Remove buttons display
Manual Sculpting
1. Click .
2. Click in the lower left corner of the Viewer window to 1-up the axial
MPR.
4. Draw contour lines around the anatomy you would like to include.
TIP: Scroll and draw a contour everywhere the anatomy changes size,
shape, or location.
TIP: When the Show Preview box is selected, it shows a preview in the
3D image.
6. Click in the lower left corner of the Viewer window to return to the
previous window.
Taking Snapshots
Capture images to export to PACS, add to a report, or restore workflow.
1. Click .
• Hold CTRL, then click in the view to take one snapshot of the whole
viewer.
58 Common Tasks
VPMC-13235 A
TIP: Patient information is automatically hidden when you take
snapshots.
Trimming Images
Trim lines display as rectangular boxes in all three MPR viewports, and are
color coded to the respective view:
• Sagittal: Blue
• Coronal: Green
• Axial: Red
All data outside the trim box is excluded. The 3D viewport (MIP/Volume
Rendering) displays the new 3D image, including only the anatomy within
the box.
1. Float the cursor over the trim line in the axial, sagittal, or coronal plane
(or multiple planes) until the cursor changes to dual arrows.
2. Click and drag the edge of the trim box to eliminate the anatomy you
do not want to see in the 3D image.
Labeling Images
Add text labels or arrowtations (arrow annotations) to an image, edit text
labels or arrowtations on an image, or delete text labels or arrowtations
from an image. After you have labeled or annotated several images, use a
variation of standard scrolling to scroll among only the labeled images.
The Label menu contains options for creating the following items:
• Text labels
• Text labels with arrows
• Arrows without text
• Spine labels
Common Tasks 59
VPMC-13235 A
• Customer-Defined Text
Once you choose a label tool, the cursor changes to a plus sign and a
symbol for the type of label. When you click on an image, the annotation
starts at the plus sign.
2. Click in the image and enter the text label in the text box.
4. Once you have placed the label, perform the following actions to
adjust it:
• Double-click on the text to edit it.
• Click and drag the arrow tip to reposition it.
• Click and drag the middle or end of the arrow to reposition the
entire arrow.
• Shorten or lengthen the arrow by clicking and dragging the end
point.
Place an Arrow
60 Common Tasks
VPMC-13235 A
• Click and drag the arrow tip to reposition it.
• Click and drag the middle or end of the arrow to reposition the
entire arrow.
• Shorten or lengthen the arrow by clicking and dragging the end
point.
2. Click the type of spine label in the left column in the dialog box: C
(cervical), T (thoracic), L (lumbar), S (sacral), / (fractions such as ½ or
¾, and labels such as C1/T1 and T12/L1).
The right column updates with labels C1-C7, for example, if you
selected C in the left column.
3. Select the Copy to similar images box if you are placing spine labels
on an image displayed in a key image viewport, and you want to apply
your labels to all other key images that are in the same plane of
acquisition (if any exist).
EXAMPLE If the key image window contains four sagittal images and two
axial images, and you add spine labels to one of the sagittal images, then
the same labels automatically display in the same position on the other
three sagittal images. You might need to reposition the labels slightly on the
other images.
EXAMPLE If you start with L2, the next label would be L1, and then T12,
T11, ... T1, C7, C6, ... C2, C1. If you continue past C1, the next label
would be S5, continuing up the spine.
Common Tasks 61
VPMC-13235 A
• Descending – the opposite order of ascending (above).
5. Click the first label you want to add, then click in the image where you
want to place the label.
6. To add the next label of the same type and in the same sequence (for
example, to add C2 after C1 with Ascending order checked), click the
image to place the next label.
7. To add a label out of sequence, click the first label you want to add,
then click in the image where you want to place the label.
8. In the dialog box, click the next label you want to add, then click the
image where you want to place the next label.
9. Keep clicking where you want the system to place the next label(s) in
the sequence you selected.
• To undo a label, click Undo.
• To move a label, click and drag it.
• To delete all labels you placed on the image(s), click Delete All
Labels.
• To delete an individual label, position the cursor on it, then press
DELETE.
When you are finished, click in the upper right corner of the dialog
box.
62 Common Tasks
VPMC-13235 A
• Double-click it to edit the label.
OR
Press and hold CTRL, then press the UP ARROW or DOWN ARROW
key.
Reformatting Labels
1. Right-click the label, then select Choose Text Font/Color.
The Font dialog box displays.
3. Click OK.
OR
3. Click outside the text box to accept the changes, or press Enter.
Common Tasks 63
VPMC-13235 A
3. Click OK.
OR
Click the label or arrow or float the cursor over the item you want to
delete, then press DELETE.
Reset Resets the volume to its original state, at the time you loaded it.
Undo Undo the last sculpt action. Does not undo or redo measurements,
labels, or other annotations.
Redo Recover the last sculpt action. Does not undo or redo
measurements, labels, or other annotations.
64 Common Tasks
VPMC-13235 A
Button Name Use
MPR • Average: A shading setting that displays data using the
Options average data values for all voxels in an image. This setting
is particularly useful for viewing coronal and sagittal views
of noisy images.
• Vol. Render: uses all voxel values.
The separate MPR Volume Render option gives you the
capability of viewing a 3D MIP rendered volume side-by-
side with MPR volume rendered images.
• MIP: A shading setting that displays data using only the
highest data values for each voxel of the image. MIP is a
good setting to use when competing features composed
of voxels with similar or higher values might be obscuring
the feature of interest.
Common Tasks 65
VPMC-13235 A
Button Name Use
Window/ Dropdown to select a preset window/level value
Level
Dropdown
Performing Measurements
66 Common Tasks
VPMC-13235 A
NOTE: You cannot perform ROI measurements on lossy images. Verify
the image is at full fidelity before performing this measurement.
Draw multiple rulers, angles, or contour lines on one image. If you perform
multiple measurements on an image, the results of the measurements are
stacked in the lower right corner of the viewer. Also delete, move, or
adjust existing measurements. Also move measurement results.
• Ruler
• Angle
• ROI-Ellipse
• ROI-Freehand
• Cobb Angle
• Delete All
Measuring Distance
2. Click the desired starting point to indicate the beginning of the line.
3. Click the desired end point to indicate the end of the line.
4. If necessary, move, delete, or adjust the line when you are finished.
The system displays the measured distance (in mm or pixels) in the
upper-left corner of the viewport.
Measuring Angles
1. Click a measurement tool dropdown arrow (for example, Ruler), then
select .
2. Click to deposit the first point, which is the end of the first line
segment.
Common Tasks 67
VPMC-13235 A
3. Click to deposit the second point, which is the intersection of the
angle.
4. Click to deposit the third point, which is the end of the second line
segment.
select .
• If necessary, move, delete, or adjust the lines when you are finished.
The Cobb Angle measurement displays in a text box in the lower right
hand corner of the viewport.
select ROI-Ellipse .
68 Common Tasks
VPMC-13235 A
2. Click and drag to draw an elliptical contour line, enclosing the ROI.
VitreaCore displays the average data value, standard deviation for the
data values, and the area inside the contour line in the upper-left
corner of the viewport.
select ROI-Freehand .
2. Click and drag to draw a freehand contour line, enclosing the ROI.
Press and hold CTRL and press the UP ARROW or DOWN ARROW
keys.
Float the cursor over the center of the ROI to select it, then press
DELETE.
Moving a Measurement
1. Float the cursor over the line segment until the cursor changes to a
four-way arrow.
Common Tasks 69
VPMC-13235 A
Adjusting the Length of the Line Segment
1. Float the cursor over the line segment until the end points change into
dots.
View Options
The toolbar area of the Viewer window contains View Options controls,
which determine the types of information and labels displayed on the
images and batches.
Option Description
Patient Info When checked, displays patient, hospital, and other
DICOM information.
Labels When checked, displays text and arrow annotations.
Measurements When checked, displays measurements made with the
Ruler tool options.
Full Crosshair When checked, displays full-length crosshairs that do
not meet in the center (to not obstruct the focal point).
Segmenting Objects
Common Tasks 71
VPMC-13235 A
• Select Vessel to segment vessels based on HU thresholds and
connectivity.
• Select Visible to segment any visibly distinct region.
Removing Fragments
72 Common Tasks
VPMC-13235 A
• Select the segmentation threshold bar to adjust the segmentation
thresholds. When the cursor is over the threshold limit, the cursor
changes to arrows so you can drag the bar.
Common Tasks 73
VPMC-13235 A
NOTE: If you select Semi-Transparent, even when Show Segmentation
box is checked, the MPR views do not show the background as semi-
transparent.
When you probe a vessel, the VitreaCore software traces the vessel
lumen, highlighting it with a vessel indicator line. The vessel indicator
displays in the 3D view.
74 Common Tasks
VPMC-13235 A
NOTE: Vessel Probe is not recommended for probing the aorta.
1. Click .
TIP: If the probe tool did not select enough of the vessel, extent it:
a. Click .
2D Imaging
Us the 2D formats to view slices as they were
acquired by the scanner.
Panning Images
1. Click and hold the mouse wheel button with the cursor on the image.
Common Tasks 75
VPMC-13235 A
Inverting/Rotating/Flipping Images
1. Right-click the image.
OR
• Press and hold CTRL, then press the UP ARROW or DOWN ARROW.
Only those images that contain labels or measurements display.
76 Common Tasks
VPMC-13235 A
Scrolling Automatically in 2D Views
• Click a button in the Cine Tools area.
Visual Control
Visual Control 2D
The Visual Control 2D apply to 2D images and scan images.
Control Function
For time-series studies, auto-scroll through all time
phases for a position. For non-nuclear medicine,
non time-series studies, display all images in a
Cine Tools continuous movie mode.
Cine forward , backward , and stop .
When Cine is active, the right mouse menu
changes to include these options:
• Cine Stop
• Adjust Cine Setting
• Save Cine to Movie File
Display the next series, if the current series is not
the last series in the study.
Display the previous series, if the current series is
not the first series in the study.
Se: 2 Displays when more than one series are loaded.
• Click the Series dropdown to select a different
series to populate within the viewer of focus.
The series descriptor text updates accordingly
to indicate the currently displayed series.
Common Tasks 77
VPMC-13235 A
View Options 2D
The View Options determine what patient data and annotations display on
the image.
Option Description
Patient Info When checked, displays patient, hospital, and
other DICOM information.
Labels When checked, displays text and arrow
annotations.
Measurements When checked, displays measurements made with
the Ruler tools.
Full Crosshair When checked, displays crosshairs that meet in the
center. Default displays crosshairs that do not meet
in the center, so as not to obstruct the focal point.
NOTE: Use the Global Lock button to lock and unlock the Zoom for
all images in the comparison. Lock the Window/Level for all images by
using the button arrow.
1. From the Study Directory, select two or more studies.
2. Click the Series tab and select two or more series (hold CTRL and
click on each desired image).
2. Decide which MPR view you want to use to rotate the other MPR
planes.
3. In the selected view, position the cursor over either of the crosshairs,
anywhere except where they cross.
Common Tasks 79
VPMC-13235 A
4. The crosshairs rotate around the intersection of the lines. Click and
drag either line to rotate the crosshairs around the intersection point to
define the oblique plane.
TIP: Drag the intersection to move the rotation point, and then rotate
the crosshairs.
After you rotate the crosshairs in one of the MPR views, the other two
MPR views display images at oblique angles, but the view where you
rotated the crosshairs continues to display slices in an orthogonal
plane.
NOTE: Rotate the crosshairs in more than one MPR view. If you do
this, none of the MPR views display images in an orthogonal plane.
Each MPR view can display images in any possible plane.
3. With the cursor in one of the MPR views, the cursor changes to the
oblique rotate tool .
80 Common Tasks
VPMC-13235 A
• Choose one view, called the Reference view, to define the curve.
Change one of the crosshairs to follow along a curve (vessel or spine).
• Use the Curved view to display the curved images.
• Use the Transverse view, perpendicular to the Curved view, to display
cross-sectional views with a blue box at the point where the curve
intersects the view.
1. Click .
4. Click one end of the crosshair to define the curve and drag it to the
start of the curve.
• This line is now the Curved line.
• The yellow line in the Curved view is the Centerline.
• The line intersecting the Centerline is the Transverse line. This line
is displayed in both Reference and Curved views.
• Boxes on both ends of the Curved line become solid.
• The view corresponding to the Transverse line is now labeled
Transverse in the lower right corner.
• In the Curved view, a short, straight line overlaps the Transverse
line at intersection of the Centerline and Transverse lines. This line
is the Measuring line.
5. Fine-tune:
• In the Reference view, click in the centerline and drag it to follow
the curved feature. An “X” is deposited on the line at each point
you click.
• In the Transverse view, click and drag the blue box (centerline) to
the desired location (center of the vessel, for instance).
6. When you reach the end of the curved area of interest, click and drag
the other end of the crosshair to the end of the curve.
Common Tasks 81
VPMC-13235 A
• Perform the double oblique rotation feature automatically. The
cursor automatically changes to the oblique rotate tool icon ,
allowing you to rotate the image around the centerline.
82 Common Tasks
VPMC-13235 A
• MIP — A shading setting that displays data using only the
highest data values for each voxel of the image. MIP is a good
setting to use when competing features composed of voxels
with similar or higher values might be obscuring the feature of
interest.
Common Tasks 83
VPMC-13235 A
Menu Item Description
Image Properties Manipulate the image. A dropdown menu displays the
following options:
• Invert: Invert the image grayscale settings, so
black turns white and vice versa. Click again to
restore original grayscale settings.
• Clockwise Rotation 90 degree: Rotate the image
clockwise by 90 degrees.
• Counter Clockwise Rotation 90 degree: Rotate
the image counter-clockwise by 90 degrees.
• Flip Horizontally: Flip the image horizontally
along the centerline.
• Flip Vertically: Flip the image vertically along the
centerline.
• Reset: Reset all operations, except Invert.
Hide Centerline Hide the centerline.
Lock 3D Lock the study in 3D.
Snapshot Take a snapshot of the current image and display it in
the Data Manager Snapshots tab.
Save Image Select to save the image.
Save Screen Save a screen capture of the current viewport in
Capture DICOM or Windows formats (or to the Windows
Clipboard).
Print Print the image from the current viewport in secondary
capture format to any configured printer.
Reset MPR Select to reset the MPR.
84 Common Tasks
VPMC-13235 A
3D Imaging in VitreaCore Viewer
In 3D imaging mode, manipulate images,
perform measurements, and define and display
multi-planar or oblique reformatted images.
Trim and sculpt to remove unwanted tissue. To
be viewable in 3D, a series must be CT or MR
and must meet specific image spacing and
orientation requirements. Use the tools
described below in 3D imaging mode.
Right Left
Inferior
Rotating 3D Images
3D image rotation is the default left mouse button behavior in 3D mode,
when the crosshair button is active. When you select one of the other
tools, the left mouse button then controls the function of that tool.
a. Click and hold the left mouse button until the arrows below the
icon disappear.
b. With the cursor on the 3D or slab image, click and drag the mouse
to move the 3D image in the corresponding direction.
NOTE: Network performance may affect the image rotation speed and
response time.
The button changes to the volume view, and the POI at the MPR
viewer crosshairs displays in the 3D view.
86 Common Tasks
VPMC-13235 A
Visual Control 3D
The Visual Control 3D contains Multi Planar Reformatted images in the
Sagittal, Coronal formats, as well as 3D volume and the original Axial
scans.
Control Function
Protocols Only for 3D views. Select a Protocol from the
dropdown menu. Anatomy Protocols contain
visualization settings (W/L, Opacity, and color
definitions) tailored for the type of exam you are
viewing.
Overview
When you load a volume or study, VitreaCore assigns an anatomy
protocol based on the study description. The protocol changes the color,
opacity, and window/level to highlight relevant data elements for that
exam type. The default protocols are starting points; change the protocol
to suit the exam type by selecting a new one from the Protocols pull down
menu.
Common Tasks 87
VPMC-13235 A
To select a protocol:
menu.
3D Right-Click Menu
The right-click menus in VitreaCore may differ slightly than the ones
shown, depending on various factors, including the type of study, the
imaging mode (2D or 3D) and your level of user privileges.
88 Common Tasks
VPMC-13235 A
Menu Item Description
Monitor Layout Select the type of layout. For example, 2 x
2.
Image Properties Manipulate the image. A dropdown menu
displays the following options:
• Rotate Right 90 degree: Rotate the
image clockwise by 90 degrees.
• Rotate Left 90 degree: Rotate the
image counter-clockwise by 90
degrees.
• Flip Horizontally: Flip the image
horizontally along the centerline.
• Flip Vertically: Flip the image vertically
along the centerline.
• Reset: Reset all operations, except
Invert.
Interact Fast Determines the speed with which the 3D
image rotates. To increase the rotation
speed, if “Interact Speed” is selected, the
image resolution is temporarily reduced to
increase speed. Once rotation is complete,
image quality is restored.
• Disable: No resolution reduction -
slowest
• Interact Speed 1: Fast
• Interact Speed 2: Faster
• Interact Speed 3: Fastest (most
reduction)
Lock 3D Lock the study in 3D.
Save Image Select to save the image.
Snapshot Take a snapshot of the current image and it
displays in the Data Manager Snapshots
tab.
Common Tasks 89
VPMC-13235 A
Menu Item Description
Save Screen Save a screen capture of the current
Capture viewport in DICOM or Windows formats (or
to the Windows Clipboard).
Print Print the image from the current viewport in
secondary capture format to any configured
printer.
Image Batches
Make batches of 3D images, which are a sequence of images you can
cine or save as a movie. Use the Viewer window to set up the window
format and orient the images to include in the batch. The images must be
of the same patient volume and format. Before you create the batch,
remove the patient information from the images.
On the Batch tab of the Viewer window, select the starting and ending
points for the sequence of images for the batch. Then, specify the
increment between the images you want to include or the number of
images, or the System can calculate those for you.
90 Common Tasks
VPMC-13235 A
Listed below are tips for planning your image sequence, for both image
batches and movie.
Use only one patient volume and one kind of format throughout the
digital movie or batch. For example, if you start with a 3D view of a
volume for Jane Doe, use that format and volume throughout.
Begin your image sequence with a familiar frame of reference for the
viewer.
EXAMPLE If the viewer can easily recognize a part of the anatomy from a
certain angle, such as a posterior pelvic view, start with the view at that
angle and then rotate the image and zoom in as needed to focus on a region
of interest.
Plan the sequence of images to convey the story you want to tell.
EXAMPLE One type of sequence begins with the entire image in a familiar
orientation, such as an anterior cardiac view. In subsequent images, as you
zoom in, parts of the anatomy fade away, revealing a particular region of
interest, such as a mitral valve prolapse.
Make smooth transitions-avoid changing too much at once.
Common Tasks 91
VPMC-13235 A
Throughout the creation of a batch, you must use the same patient
volume, format, format view (a view from any format that has a volume
view other than the single Volume format), and, for 3D views, you must
use the same volume mode, throughout the creation of a batch.
EXAMPLE If you start with a volume for Jane Doe and start with an image in
the MPR axial view in orthogonal mode, you cannot switch to John Doe, nor
can you change to sagittal view, oblique mode during the batch generation
process.
NOTE: The Number of Images value and the Step Size value are
inversely related to one another: as the step size decreases, the
number of images increases.
EXAMPLE The distance between the starting image and the ending image
in an MPR axial view batch is 25mm. The total number of images in the
batch is 75 images. You cannot slide the Number of Images field to 100
while keeping the Step Size value at 25mm. Instead, when you increase the
Number of Images to 100, VitreaCore automatically decreases the Step Size
to a value that is less than 25 millimeters.
Creating a 3D Batch
1. Load the series in the Viewer window or a viewport.
2. Click .
92 Common Tasks
VPMC-13235 A
The three MPR views display and the 3D view is rendered in the lower-
left viewport.
3. Evaluate the 3D view and determine the features and orientations you
want to include in the batch.
7. Orient the image to the next position you want included in the batch.
9. Set Via points on a number of images to make sure they are included
in the batch.
Common Tasks 93
VPMC-13235 A
13. Use the Viewer Window right-click menu to modify the layouts, save
and delete images, and create labels.
2. Click .
The three MPR views display and the 3D view displays in the lower-left
viewport.
6. Click the MPR image you want to use to create the batch.
A green check mark displays in the bottom of the image.
7. Scroll to the last image you want to include in the batch and click .
94 Common Tasks
VPMC-13235 A
10. Use the right-click menu in the Viewer window to modify the viewport
and image layouts, add labels, and cine.
Appendix I
User Preferences
Overview
Set user preferences in the User Preferences dialog box, which contains
the following options, based on your access privileges:
Common Tasks 95
VPMC-13235 A
Local Settings
Settings specific to the client PC. Any user can customize these settings.
Overview
All users can customize their own preferences in several areas. These
settings are activated each time the user logs in.
1. Click .
3. To change your email address, enter the new address in the Email
Address field.
96 Common Tasks
VPMC-13235 A
e. Click Save.
The Change Password dialog box closes. If you receive a Wrong
Password message, you have incorrectly entered your current
password. Re-enter your current password and try again.
1. Click .
2. In the left pane, under your User ID, click WW/WL Settings.
5. In the first WW/WL field, enter the Window Width (WW) setting.
6. In the second WW/WL field, enter the Window Level (WL) setting.
7. Click Save.
3. Click Save.
Common Tasks 97
VPMC-13235 A
Delete a custom preset
2. Click Delete.
NOTE: The changes you make here do not take effect until the next
time you log in.
1. Click .
Setting Description
Show Columns in Select the check box to the left of each column you
Study Directory want to include in the Study Directory.
Auto Query area
Auto Query specifies how often your workstation automatically queries
the server to update the Study Directory with new studies.
Auto Query Select the check box to enable Auto Query.
Time Span __ The number of minutes between the automatic
minutes DICOM queries your PC makes to the server.
Default is 1 minute.
98 Common Tasks
VPMC-13235 A
Setting Description
EXAMPLE If there were 400 studies on the server, and all searchable
columns of the Study Directory were set to display All, the Study
Directory would display only 300 of the 400 studies on the server.
Common Tasks 99
VPMC-13235 A
Setting Description
Compress Level Determines how much the 3D image is to be
for 3D Image: compressed. Higher compression results in faster
High __ Low image display but lower image quality.
Auto Export Select one of the auto export options:
Dialog • Ask to Save and Show
• Always Save and Never Show
• Never Save and Never Show
3. When you are finished configuring the Study Directory settings, click
Save.
The changes become active the next time you log in (log out of
VitreaCore and log back in to make the changes take effect).
1. Click .
Setting Description
Customized Text Annotation area
This area allows you to enter custom text labels you can use to annotate
images.
Add To add an annotation, click Add, enter text into
the Add New Text Annotation dialog box, and
click OK.
Delete To delete one of the annotations, select the
annotation and click Delete.
Delete All To delete all annotations without displaying a
confirmation request.
Up To move a frequently-used annotation up in the
list, select the annotation and click Up.
3. When you are done changing the Label settings, click Save.
NOTE: You can still change the appearance of the crosshairs for a
particular study when you are in the Viewer window. Change it here if
you want to change the default appearance for every study.
1. Click .
3. From the dropdown Category menu, select from the following options:
5. Select the desired font settings (font, style, size, effects, and color).
6. Click OK.
7. When you are satisfied with how the font looks in the preview window,
click Save.
3. Click Save.
The new Worklist Filter is saved and is available from the Worklist Filter
dropdown menu.
2. Click Delete.
The Filter is deleted and is no longer available from the Worklist Filter
dropdown menu.
Setting Description
Add To add a vessel name, click Add, enter text into the Add
New Pre-Defined Vessel Name dialog box, and click OK.
Delete To delete one of the vessel names, select the annotation
and click Delete.
Remove All To delete all vessel names.
Up To move a frequently-used vessel name up in the list,
select the annotation and click Up.
Down To move an infrequently-used vessel name down in the list,
select the annotation and click Down.
• When you are done changing the Label settings, click Save.
• LAN
• WAN
Output Settings
Enable or disable the option to save Windows files.
When you are done changing the background image streaming settings,
click Save.
NOTE: If you cannot check the Enable disc cache box, contact your
system administrator.
Network Speed
1. Click .
3. Enter a data packet size between 16 and 6144 and click Ping.
The system checks the network speed five times.
4. Make sure three or more network speeds fall within the acceptable
range. You should experience optimal system performance. If your
system still seems slow, contact your System Administrator or Vital
Images.
5. If fewer than three network speeds fall within the acceptable range,
your network infrastructure may be the cause of the slow
performance. Contact your System Administrator.
Appendix II
Error Messages
Cause Suggestion
Missing or additional DICOM The snapshot is not restorable.
slices.
The volume build configuration Contact your administrator. The
has changed resulting in dataset has to be re-pushed to
different interpolation settings VIMS.
being used.
Other VIMS configuration Contact your administrator.
changes.
Indicates that there are more studies on the server than your system is
configured to retrieve. You can:
106 Common Tasks
VPMC-13235 A
• Limit your Study Directory results, if you a looking for a specific study
• Change the Maximum worklist items setting in the User Preferences |
Study Directory dialog box.
Contents
• Distribute Findings Overview
• The Report Window
2
1
5 8
6 9
Callout Description
Number
1 Findings list
2 Filtering buttons
3 Findings tray
4 Findings management buttons
5 Templates layouts
6 Report management buttons
7 Report page
8 Report tools and navigation buttons
9 Report distribution buttons
Filtering Buttons
Click: To:
Display all snapshot, batch, and movie thumbnails for the
patient study.
Display only snapshots, batches, or movies not currently
included in the report.
Display only snapshots, batches, or movies currently
included in the report.
Findings Tray
Displays thumbnail images of snapshots, batches, and movies.
Click: To:
Restore a workflow back to the Viewer window. The
snapshot workflow will be restored.
Callout Description
1 Series List: a list of the selected findings and the
associated series information. Findings are listed in order
of how they were selected.
Click a header to sort the list by that field.
TIP:
To change the order of the series to be exported, select
a series description and drag it up or down.
Select: To:
Add All Select Add All to automatically place all snapshots at the
end of your report, or press CTRL and click to select
snapshots and drag to the report template.
Select All Select all of the snapshots, batches, and movies in the
Findings tray.
Delete Delete the selected snapshot, batch, or movie.
Export Export snapshots to DICOM.
Preview View the selected snapshot, batch, or movie.
Restore Restore a workflow to the Viewer window state to when
the snapshot was taken.
Series Modify the series description.
Description
TIP: Select the worksheet template that is appropriate for the study
you are working on.
Template Buttons
Use the Template buttons to change or add pages to the report.
Click: To:
Add a new page of the selected template to the end of
the report.
Replace the current report page with the selected
template/layout.
Copy the contents of the Report template to the
Windows clipboard. Paste the contents into a Word
document or another text program (email, 3rd party
reporting application).
NOTE: When you place an image in a frame, be sure that the margins
do not cut off important information such as anatomy or
measurements.
5. To edit text areas on the report, click any text with a rectangle, then
type new text.
Report Tools
Click: To:
Save a draft of the report.
TIP: To edit a label, click it, then click the text box.
3. To add new findings to a saved report, restore the report in the Report
tab. Use the Viewer tab to create new findings.
Report Navigation
Click: To:
Jump to first or last report page.
Report Distribution
Click To
Print a paper report for distribution.
# Description
1 1 The Export to: box displays a
multi-selection list of desired
export destination servers.
2 Series Options:
Series Description - Enter text in
this field to apply it as the series
description for all selected
2 snapshot/batches upon export.
1. Select the Data Manager tab. If you have taken snapshots, they are
saved on the Snapshots tray.
6. Click Export.
1. After you create your findings (snapshots or batches) and close the
study (or select the Study Directory tab), the Auto Export Dialog
displays.
2. Use the Group dropdown to select the location where you want to
export the findings.
3. Enter the clinician’s email address and any additional comments, and
click Send.
Contents
I Select Study
II Choose Protocol and Preset
III Perform Analysis
• Use 3D Trim
• Sculpt in 3D
• Perform a Manual Curved Reformat
• Spine Labeling
• Use Cobb Angles
• Take Snapshots
IV Distribute Findings
I. Select Study
Use 3D Trim
Trim lines display as rectangular boxes in all three MPR viewports, and are
color coded to the respective view:
• Sagittal: Blue
• Coronal: Green
• Axial: Red
1. Float the cursor over the trim line in the axial, sagittal, or coronal plane
(or multiple planes) until the cursor changes to dual arrows.
2. Drag the edge of the trim box to eliminate the anatomy you do not
want to see in the 3D image.
Sculpt in 3D
1. Click .
3. After creating the contour line, Keep and Remove buttons display
4. To display the results of the sculpting in an MPR view, select the Show
Segmentation check box in the Visual tab.
In Curved MPR mode , use one of the MPR views to define a curve,
so the curved images display in one of the other MPR views. This is useful
if you want to create an MPR image of a curved spine. In Curved MPR
mode, each of the three MPR views serves a unique purpose.
• Choose one view, called the Reference view, to define the curve.
Change one of the crosshairs to follow along the curve of the spine.
• Use the Curved view to display the curved images.
• Use the Transverse view, perpendicular to the Curved view, to display
cross-sectional views with a blue box at the point where the curve
intersects the view.
1. Click .
Spine Labeling
Use the Label button to place labels on the vertebrae using the semi-
automatic spine labeling tool.
1. Click the Label button and select Spine Labeling from the
dropdown menu.
2. Click one of the characters to enter the following types of spine labels:
• C – for cervical vertebrae
• T – for thoracic vertebrae
• L – for lumbar vertebrae
• S – for sacral vertebrae
• / - for specifying disk spaces such as C7/T1 and T12/L1.
camera.
4. To hide the patient information, clear the Patient Info check box in the
View Options area at the top of the screen. Select the check box to
show the patient information.
The snapshots you save in the Viewer window are saved to the Report
window.
1. Click .
2. Click in the lower left corner of the Viewer window to 1-up the
axial MPR.
4. Draw contour lines around the anatomy you would like to include.
TIP: Scroll and draw a contour everywhere the anatomy changes size,
shape, or location.
TIP: When the Show Preview box is selected, it shows a preview in the
3D image.
6. Click in the lower left corner of the Viewer window to return to the
previous window.
2. In one of the MPR views, position the cursor over one of the
crosshairs .
TIP: This view remains in Orthogonal mode, and the other two views
display images at oblique angles.
TIP: As you drag, the crosshairs rotate around their intersection point,
staying perpendicular to each other.
TIP: To move the crosshair intersection point, click the spot where you
want the crosshair to intersect.
Contents
I Select Study
II Choose Protocol and Preset
III Perform Analysis
• Segment the Aorta
• Probe Vessels
• Edit the Vessel Centerline
• Use the Object Management List
• Take Snapshots
IV Distribute Findings
Aorta Overview
The aorta, along with many other vessels and structures connected to it,
can be segmented from bone and other anatomy to make it easier to view
suspected aneurysms, stenosis, and other features.
VPMC-13235 A
Aorta Lesson
I. Select Study
2. Verify is selected.
138 Aorta
VPMC-13235 A
3. Click on the aorta in the 3D or 2D image.
Probe Vessels
After you set up the Viewer window to best visualize the vessel you want
to probe, use the Select button to probe the vessel.
Aorta 139
VPMC-13235 A
NOTE: The MPR views switch to Curved Reference mode and
display the probed vessel centerline.
a. In the Reference view, click and drag the desired centerline to the
desired position. Grab the desired boxes or create a new one by
clicking and dragging the centerline.
140 Aorta
VPMC-13235 A
b. With a Vessel Probe tool selected, press SPACEBAR to scroll
through the vessels in the Object Management list.
2. To rename a vessel:
b. In the New name field, enter the name for the vessel.
NOTE: The Show boxes only affect which vessels display if you have
selected an option on the Vessels tab in the Visibility Options area.
a. To display one vessel, clear the Show box for all other vessels.
b. To display all vessels you have probed, click Show All.
Take Snapshots
camera.
Aorta 141
VPMC-13235 A
NOTE: Snapshots taken in the Advanced Viewer are viewed from the
Snapshots tab located in the Data Manager tab at the bottom of the
screen.
4. To hide the patient information, select the Visual tab. Clear the Patient
Info check box in the View Options area at the top of the screen.
Select the check box to show the patient information.
The snapshots you save in the Viewer window are saved to the Report
window.
142 Aorta
VPMC-13235 A
Additional Procedures
Use the 3D MIP
This procedure allows you to assist in viewing calcifications.
5. Take a snapshot.
Manual Sculpt
1. Click .
2. Click in the lower left corner of the Viewer window to 1-up the
axial MPR.
TIP: Scroll and draw a contour everywhere the anatomy changes size,
shape, or location.
TIP: When the Show Preview box is selected, it shows a preview in the
3D image.
Aorta 143
VPMC-13235 A
6. Click in the lower left corner of the Viewer window to return to the
previous window.
Sculpt in 3D
1. Click .
3. When you are done creating the contour line, Keep and Remove
4. To display the results of the sculpting in an MPR view, select the Show
Segmentation checkbox in the Visual tab.
Exclude Bone
Use segmentation for keeping or removing segments of bone or other
visibly distinct segments.
1. Click .
This removes all visibly distinct regions that are smaller than the
number of cubic centimeters listed in the Segment Objects area.
Aorta 145
VPMC-13235 A
• Select one of these options from the Object
Visibility dropdown menu:
• To remove everything except the probed
vessel(s) from view, select Vessels Only.
• To display the probed vessels shaded in red, select Tinted
Vessels.
TIP: The bottom of the CPR contains two slider bars. The top one
allows you to rotate the CPR by dragging it left or right. The lower
bar allows you to add thickness to the CPR.
3. Click .
4. Click and drag across the width of the lumen, then release the mouse
button to end the ruler.
The ruler and the measurement (in millimeters) display in the cross-
sectional and CPR views.
NOTE: Draw rulers and measure in any cross-sectional view. Place only one
ruler per cross section.
NOTE: Draw only one ruler in each cross-sectional view or CPR view, but
redraw it as many times as necessary.
Optional To delete a ruler from a CPR view, scroll or change the
magnification.
• Scrolling or changing the magnification does not delete rulers
from the cross-sectional views. Rulers drawn in the cross-
sectional views remain in the CPR views. Rulers drawn on CPR
146 Aorta
VPMC-13235 A
views delete automatically if you rotate the CPR views, modify
the vessel boundaries, navigate along the vessel, or change
magnification.
NOTE: The view you choose for the Reference view should be roughly
along the length of the vessel, or parallel to it.
In the Curved MPR view, Vitrea plots the Centerline and displays its
length (mm).
Aorta 147
VPMC-13235 A
• If necessary, adjust the centerline. In the Reference or Transverse
MPR views, click and drag to move any of the automatically-
plotted points to more closely trace the centerline.
• Use any of the methods described in Work with Crosshair Position
Indicators to reposition the crosshairs.
• As you move the crosshair position indicator, the system updates
the intersection of the Transverse line and Centerline in the Curved
MPR view.
.
• To change from 1-up format back to the original Viewer format,
click Minimize .
• To measure a distance between two points, such as between
bifurcations or the length of a stenosis, perform the following tasks:
• Probe the vessel.
• Scroll to the point where you want to start the measurement.
148 Aorta
VPMC-13235 A
• Scroll to the point where you want to end the measurement.
This automatically moves the Measuring line to the current
crosshair position. The Curved view now displays the distance
between these two points.
3. Repeat step 3.
Vitrea displays the current maximum and minimum diameter
measurements in green and red, respectively, in the curved reformat
views. Any other measurements display in cyan (light blue).
150 Aorta
VPMC-13235 A
Peripheral
Contents
I Select Study
II Choose Protocol and Preset
III Perform Analysis
• Trim Table on Axial View
• Segment Objects
• Remove Fragments
• Probe the Peripheral Arteries
• Take Snapshots
• Take Additional Snapshots
• Use 3D MIP Option
IV Distribute Findings
Peripheral Overview
Probe left and right peripheral arteries and review them for possible
plaque, stenosis, or aneurysm.
VPMC-13235 A
Peripheral Lesson
I. Select Study
Segment Objects
Use point-and-click segmentation to keep or remove segments of bone
or other visibly distinct segments such as soft tissue, stents or metal
plates, or even the scanner table.
152 Peripheral
VPMC-13235 A
1. Select Bone from the Segment Objects area.
2. Click on the image where you want to remove segments of the bone.
Remove Fragments
• Click .
This removes all visibly distinct regions smaller than the number of
cubic centimeters listed in the Segment Objects area.
Peripheral 153
VPMC-13235 A
OptionalClick and click a point farther along the probed
vessel.
a. Verify is active.
b. Click the vessel in either the 3D or MPR image.
Take Snapshots
camera.
154 Peripheral
VPMC-13235 A
Snapshots which include measurements, rulers, W/L, or segmentation
options are viewed from the Snapshots tab located in the Data
Manager tab at the bottom of the screen.
4. To hide the patient information, select the Visual tab. Clear the Patient
Info check box in the View Options area at the top of the screen.
Select the box to show the patient information.
The snapshots you save in the Viewer window are saved to the Report
window.
Additional Procedures
Perform a Curved Reference
This protocol is useful for Peripheral Artery viewing and analysis.
1. After the vessel is probed, select the image in MPR view (axial,
coronal, or sagittal).
Probe Vessels
After you set up the Viewer window to best visualize the vessel you want
to probe, use the Select button to probe the vessel.
156 Peripheral
VPMC-13235 A
2. On the Analysis tab, click .
Peripheral 157
VPMC-13235 A
2. To rename a vessel:
b. In the New name field, enter the name for the vessel.
NOTE: The Show boxes only affect which vessels display if you have
selected an option on the Vessels tab in the Visibility Options area.
a. To display one vessel, clear the Show box for all other vessels.
b. To display all vessels you have probed, click Show All.
a. View the data value (HU for CT) at a point by dragging on the
image using the Crshair tool.
b. Jump to a desired point-of-interest on the centerline by clicking on
the CPR view using the vessel probe tool.
c. Make region of interest measurements on the CPR views using the
ROI-Freehand tool.
d. Rotate the curved reformatted views about the axis of the vessel.
e. Zoom in and out of the CPR and cross-sectional views.
The cross-section corresponding to the point-of-interest will also contain:
158 Peripheral
VPMC-13235 A
• Horizontal and vertical markers indicating the orientation of the left
and right curved views.
When you probe a vessel, the software plots the centerline of the vessel
and displays one (or more) cross-sectional views and two CPR vessel
views.
Each ROI displays the Hounsfield Average Value as well as the Standard
Deviation of the region.
Peripheral 159
VPMC-13235 A
NOTE: The ROIs on CPR views are deleted automatically if you rotate
the view or navigate along the vessel.
• In the 3D view, a blue dot along the vessel indicator line represents
the crosshair position.
• The CPR views center on the crosshair position. The current
crosshair position in the MPR and 3D views is indicated by a blue
line in the middle of the ruler in the CPR views.
• In multiple-viewer Viewer window formats, with two CPR views
and only one cross-sectional view displayed, the cross-sectional
view corresponds to the current crosshair position.
• In 1-up Viewer window format, with two CPR views and multiple
cross-sectional views displayed, the current crosshair position is
located at 0 mm, and is highlighted with a white border. The
160 Peripheral
VPMC-13235 A
surrounding cross-sectional cuts are +1, +2, +3, -1, -2, -3, and so
on.
Manual Sculpt
1. Click .
2. Click in the lower left corner of the Viewer window to 1-up the
axial MPR.
4. Draw contour lines around the anatomy you would like to include.
Peripheral 161
VPMC-13235 A
TIP: Scroll and draw a contour any time the anatomy changes size,
shape, or location.
6. Click in the lower left corner of the Viewer window to return to the
previous window.
Sculpt 3D Objects
1. Click .
2. In the viewport, click and hold, and drag to draw a freehand border.
3. After you create the contour line, Keep and Remove buttons display
162 Peripheral
VPMC-13235 A
1. Right-click in the view, then click .
2. In one of the MPR views, position the cursor over one of the
crosshairs .
TIP: This view remains in Orthogonal mode, and the other two views
display images at oblique angles.
3. Drag the crosshair in the view while watching the other views.
TIP: As you drag, the crosshairs rotate around their intersection point,
staying perpendicular to each other.
TIP: To move the crosshair intersection point, click the spot where you
want the crosshair to intersect.
Automatic MIP
MIP (100 mm max thickness) - A shading setting that displays data using
only the highest data values for each voxel of the image. MIP is a good
setting to use when competing features composed of voxels with similar
or higher values might be obscuring the feature of interest.
With the separate MPR MIP option, view a volume rendering side by-side
with MPR MIP images.
Peripheral 163
VPMC-13235 A
Perform Automatic Curved Reformats
In performing curved reformats, choose one view, called the Reference
view, to define the curve. By selecting the Reference view, change one of
the crosshairs to follow along the curve of the vessel.
NOTE: The view you choose for the Reference view should be roughly
along the length of the vessel, or parallel to it.
In the Curved MPR view, Vitrea plots the Centerline and displays its
length (mm).
164 Peripheral
VPMC-13235 A
• As you move the crosshair position indicator, the system updates the
intersection of the Transverse line and Centerline in the Curved MPR
view.
1. To delete rulers from a CPR view, select the ruler and click Delete or
press DELETE.
NOTE: The active vessel displays in the current CPR and cross-
sectional views, is denoted by the vessel indicator (green) line in
Peripheral 165
VPMC-13235 A
the 3D view, and is selected (highlighted) in the Object
Management list on the Analysis tab.
Optional If the vessel you want to delete is not the active vessel,
click the vessel name in the Object Management list to make it
active.
b. Press DELETE.
NOTE: Other items not associated with the Vessel Probe option remain,
including arrows, annotations, and rulers drawn directly on 3D and MPR
images.
When the Show Segmentation box is selected, MPR views also show the
results of any segmentation done in the 3D view. If the Show
Segmentation box is cleared, the MPR views continue to display whole
MPR images, even if parts of the volume have been segmented.
166 Peripheral
VPMC-13235 A
Carotid
Contents
I Select Study
II Choose Protocol and Preset
III Perform Analysis
• Probe the Carotids
• Perform Stenosis Measurement
• Use the POI Box
IV Distribute Findings
Carotid Overview
Evaluate contrast filled carotid arteries by probing the left and right internal
and external carotid arteries. Calculate arterial stenosis and analyze the
following issues:
• Plaque
• Stenosis
• Patency
• Aneurysm
Carotid 167
VPMC-13235 A
Carotid Lesson
I. Select Study
Follow the instructions in the Select Study Chapter to load a carotid study.
2. Click .
a. Locate the internal and external carotid arteries and click the ves-
sel to probe, or scroll through any of the MPRs and click the vessel
to probe.
vessel.
168 Carotid
VPMC-13235 A
The Show and Vessel Segment table within the Analysis area
populate with data.
Carotid 169
VPMC-13235 A
• Vessels Only – Remove everything except the probed
vessel(s) from view.
TIP: On the bottom of the CPR views are two slider bars. The top one
allows you to rotate the CPR by dragging it left or right. The lower
bar allows you to add thickness to the CPR.
170 Carotid
VPMC-13235 A
4. Click .
5. Click and drag across the width of the lumen, then release to end the
ruler.
The ruler and the measurement (in millimeters) display in the cross-
sectional and CPR views.
NOTE: Draw rulers and measure in any cross-sectional view. Place only one
ruler per cross section.
Optional To delete a ruler from a CPR view, select the ruler and click
Delete or press DELETE.
• Scrolling or changing the magnification does not delete rulers
from the cross-sectional views. Rulers drawn in the cross-
sectional views remain in the CPR views. Rulers drawn on CPR
views delete automatically if you rotate the CPR views, modify
the vessel boundaries, navigate along the vessel, or change
magnification.
7. Repeat step 4.
VitreaCore displays the current maximum and minimum diameter
measurements in green and red, respectively, in the curved reformat
views. Any other measurements display in cyan (light blue).
Carotid 171
VPMC-13235 A
VitreaCore calculates the percentage of stenosis by comparing the
maximum (normal) and minimum (stenosed) measurements. The
percentage and the formula used to calculate it display at the bottom
of the right CPR view.
1. Click an area of interest in the 2D image and the POI box corresponds
to the intersection of the crosshairs.
2. To discontinue the POI evaluation, click the box in the bottom right of
3D 1-up image.
The snapshots you save in the Viewer window are saved to the Report
window.
172 Carotid
VPMC-13235 A
2. Follow the instructions in the Distribute Findings chapter to distribute
your findings.
Additional Procedures
Edit the Vessel Centerline
If you used Vessel Probe to probe a vessel, manually fine-tune the
centerline if needed.
The MPR views switch to Curved Reference mode and display the
probed vessel centerline.
a. In the Reference view, click and drag the desired centerline to the
desired position. Grab the desired boxes or create a new one by
clicking and dragging the centerline.
Carotid 173
VPMC-13235 A
Use the Object Management List
As you probe vessels, each new vessel segment is added as a line in the
Object Management list. VitreaCore automatically assigns each vessel
segment a sequential number.
2. To rename a vessel:
174 Carotid
VPMC-13235 A
b. Click Delete.
a. View the data value (HU for CT) at a point by dragging on the
image using the Crshair tool.
b. Jump to a desired point-of-interest on the centerline by clicking on
the curved view using the vessel probe tool.
c. Click .
When you probe a vessel, the VitreaCore software plots the centerline of
the vessel and displays one (or more) cross-sectional views and two CPR
vessel views.
Carotid 175
VPMC-13235 A
8 # Description
1 To move along the vessel:
Slide the scrollbar, click in the
vessel.
2 The blue lines indicate the
3 crosshair position, which also
8
corresponds to the active
cross-sectional view.
3 Cross-sectional view
4 CPR view 1: If you rotate the
2 1 3D volume until the vessel
showed the least curvature in
the 3D field of view. Also
displayed are horizontal and
vertical markers indicating the
orientation of the left and right
4 5 curved views.
5 CPR view 2: 90 degrees from
the first CPR view.
6 7 6 CPR Rendering Option: Click
on the control and select an
option from the dropdown
menu. The option is applied to
all CPR views.
7 CPR Thickness Slider: Drag
the CPR Thickness slider
right to increase or left to
decrease slice thickness in the
CPR views only.
8 Zoom In/Out:
• Click to zoom in
176 Carotid
VPMC-13235 A
Each ROI displays the Hounsfield Average Value as well as the Standard
Deviation of the region.
NOTE: The ROIs on CPR views are deleted automatically if you rotate
the view or navigate along the vessel.
• In the 3D view, a blue dot along the vessel indicator line represents
the cross-sectional position.
• The CPR views are centered on the cross-sectional position. The
current cross-sectional position in the MPR and 3D views is
indicated by a blue line in the middle of the ruler in the CPR views.
• In the screen format that has the presents the MPRs and 3D views,
with two CPR views and only one cross-sectional view displayed,
the cross-sectional view corresponds to the where the reference
line is located in the CPR views.
Carotid 177
VPMC-13235 A
• In 1-up Viewer window format, with two CPR views and multiple
cross-sectional views displayed, the current crosshair position is
located at 0 mm, and is highlighted with a blue border. The
surrounding cross sections are +1, +2, +3, -1, -2, -3, and so on.
# Description
1 Current cross-sectional position
To move the cross-sectional position:
Slide the scrollbar, click in the vessel, roll the mouse wheel.
Manual Sculpt
1. Click .
2. Click in the lower left corner of the Viewer window to 1-up the
axial MPR.
178 Carotid
VPMC-13235 A
3. Scroll to the ostium of the common carotid.
4. Draw contour lines around the anatomy you would like to include.
TIP: Scroll and draw a contour any time the anatomy changes size,
shape, or location.
TIP: When the Show Preview box is selected, it shows a preview in the
3D image.
6. Click in the lower left corner of the Viewer window to return to the
previous window.
Sculpt 3D Objects
1. Click .
2. In the viewport, click and hold, and drag to draw a freehand border.
3. When you are done creating the contour line, Keep and Remove
4. To display the results of the sculpting in an MPR view, select the Show
Segmentation check box in the Visual tab.
Carotid 179
VPMC-13235 A
Oblique MPR Mode
In Oblique MPR mode, change orientation of the MPR views by rotating
the crosshairs in one or two of the MPR views.
2. In one of the MPR views, position the cursor over one of the
crosshairs .
TIP: This view remains in Orthogonal mode, and the other two views
display images at oblique angles.
3. Drag the crosshair in the view while watching the other views.
TIP: As you drag, the crosshairs rotate around their intersection point,
staying perpendicular to each other.
TIP: To move the crosshair intersection point, click the spot where you
want the crosshair to intersect.
Automatic MIP
MIP (100 mm max thickness) is a shading setting that displays data using
only the highest data values for each voxel of the image. MIP is a good
setting to use when competing features composed of voxels with similar
or higher values might be obscuring the feature of interest.
With the separate MPR MIP option, view a volume rendering side by-side
with MPR MIP images.
1. To delete rulers from a CPR view, select the ruler and click Delete or
press DELETE.
NOTE: The active vessel displays in the current CPR and cross-
sectional views, is denoted by the vessel indicator (green) line in the
3D view, and is selected (highlighted) in the Object Management list on
the Analysis tab.
Optional If the vessel you want to delete is not the active vessel,
click the vessel name in the Object Management list to make it
active.
b. Press DELETE.
NOTE: Other items not associated with the Vessel Probe option remain.
Carotid 181
VPMC-13235 A
Show Segmentation in MPR Views
Use the Show Segmentation box on the Visual tab to make the MPR
views reflect the results of segmentation done in the 3D view. Also, select
the Show Segmentation box if you want the Object Visibility to apply to
the MPR views. Visibility options on the Analysis tab of the Viewer window
enable you to control how images display region segmentation.
When the Show Segmentation box is selected, MPR views also show the
results of any segmentation done in the 3D view. If the Show
Segmentation box is cleared, the MPR views continue to display whole
MPR images, even if parts of the volume have been segmented.
In manual Oblique MPR mode, you change the orientation of the MPR
views by rotating the crosshairs in one or more of the MPR views, or by
using the oblique angle orientation tool.
With the Vessel Probe tools, perform automatic oblique reformats. After
you probe the vessel, the MPR views automatically update to display an
oblique view of the vessel as you scroll along the vessel centerline in the
CPR views.
4. Click and drag the Thickness slider in any MPR view to be sure you
see as much of the vessel as possible.
NOTE: For best results, set the thickness slider to the vessel diameter.
Carotid 183
VPMC-13235 A
The crosshair position automatically adjusts, and the oblique views
rotate so the view that is normally the Axial view is in the oblique plane
that gives the best view of the vessel.
184 Carotid
VPMC-13235 A
Coronary
Contents
I Select Study
II Choose Protocol and Preset
III Perform Analysis
• Review the Study
• Adjust the Window/Level
• Probe a Vessel
• Perform Stenosis Measurement
• Use the 3D and Curved Planar Reformatted views
• Explore the Lumen
• Apply Object Visibility
• Take Snapshots
IV Distribute Findings
Coronary Overview
Complete the procedures within this module to probe the coronaries, per-
form stenosis measurements, and explore the lumen.
Coronary 185
VPMC-13235 A
Coronary Lesson
I. Select Study
186 Coronary
VPMC-13235 A
recommended method for performing linear measurements is through the
placement of the ruler(s) in 2D images.
Function Procedure
Review anatomy, analyze Use the MPR views to review.
quality of study in the
axial, coronal, and
sagittal views
Display the different
• Orthogonal – This view displays in sagittal, coronal,
planes
and axial planes.
Two and four chamber long axis and short axis views of the
Left Ventricle are present in the display option.
1. Click .
Probe a Vessel
Complete the following procedure for the three main coronary vessels
(LAD, CX, RCA) and any branches.
After setting up the Viewer window to best visualize the vessel you want
to probe, use the Select button to probe the vessel.
TIP: For best results, select a point midway along the length of the
vessel.
Two CPR views and one cross-sectional view (or multiple cross-
sectional views in 1-up format) display.
Coronary 189
VPMC-13235 A
h. Click to take a snapshot of the 3D image.
The bottom of the CPR contains two slider bars. The top one
allows you to rotate the CPR by dragging it left or right. The lower
bar allows you to add thickness to the CPR.
4. Click .
5. Click and drag across the width of the lumen, then release the mouse
button to end the ruler.
6. The ruler and the measurement (in millimeters) display in the cross-
sectional and CPR views.
190 Coronary
VPMC-13235 A
NOTE: Draw rulers and measure in any cross-sectional view. Place
only one ruler per cross section.
Coronary 191
VPMC-13235 A
9. Repeat this procedure to draw as many rulers as you want.
The maximum diameter, minimum diameter, and percentage stenosis
update with each ruler you draw.
1. Click located in the lower left corner of 3D volume image. Click the
icon twice to see different cross-section views.
3. In the CPR view, move the bottom arrows L-R on the horizontal slide
bar to rotate the CPR views.
4. The vertical slide bar moves the CPR image proximal and distal to
view the enter vessel length.
5. Blue dot on 3D, the cross-section of vessel in blue box and blue line in
CPR track with movements.
6. Select the phase check boxes on the bottom to change phases and
review.
2. Click the plus/minus sign above the CPR views to magnify/minify the
image.
3. Select the crosshair and click and hold in lumen to evaluate plaque HU
characteristics.
192 Coronary
VPMC-13235 A
2. From Object Visibility, select Semi transparent Background and Tinted
Vessels.
3. Select Vessels only and rotate to display routine heart cath views.
Take Snapshots
4. To hide the patient information, clear the Patient Info check box in the
View Options area on the Visual tab. Select the box to show the
patient information.
The snapshots you save in the Viewer window are saved to the Report
window.
Coronary 193
VPMC-13235 A
Additional Procedures
Work with Cross-sectional and CPR Vessel Views
Perform the following operations on the reformatted views:
4. Rotate the curved reformatted views about the axis of the vessel.
When you probe a vessel, the VitreaCore software plots the centerline of
the vessel and displays one (or more) cross-sectional views and two CPR
vessel views.
194 Coronary
VPMC-13235 A
8 # Description
1 To move along the vessel:
Slide the scrollbar, click in the
vessel.
2 The blue lines indicate the
3 crosshair position, which also
8
corresponds to the active cross-
sectional view.
3 Cross-sectional view
4 CPR view 1: If you rotate the 3D
2 1 volume until the vessel showed
the least curvature in the 3D field
of view. The Left and Right CPR
views have colored borders that
correspond to the red and green
markers in the active Cross-
4 5 sectional view.
5 CPR view 2: 90 degrees from
the first CPR view.
6 7 6 CPR Rendering Option: Click on
the control and select an option
from the dropdown menu. The
option is applied to all CPR views.
7 CPR Thickness Slider: Drag the
CPR Thickness slider right to
increase or left to decrease slice
thickness in the CPR views only.
8 Zoom In/Out:
• Click to zoom in
Each ROI displays the Hounsfield Average Value as well as the Standard
Deviation of the region.
Coronary 195
VPMC-13235 A
NOTE: The ROIs on CPR views are deleted automatically if you rotate
the view or navigate along the vessel.
• In the 3D view, a blue dot along the vessel indicator line represents
the crosshair position.
• The CPR views center on the crosshair position. The current
crosshair position in the MPR and 3D views is indicated by a blue
line in the middle of the ruler in the CPR views.
• In multiple-viewer Viewer window formats, with two CPR views
and only one cross-sectional view displayed, the cross-sectional
view corresponds to the current crosshair position.
• In 1-up Viewer window format, with two CPR views and multiple
cross-sectional views displayed, the current crosshair position is
located at 0 mm, and is highlighted with a blue border. The
surrounding cross sections are +1, +2, +3, -1, -2, -3, and so on.
196 Coronary
VPMC-13235 A
NOTE: The cross-sectional views are always .5 mm apart, regardless of the
image acquisition thickness.
Manual Sculpt
1. Click .
2. Click in the lower left corner of the Viewer window to 1-up the
axial MPR.
4. Draw contour lines around the anatomy you would like to include.
Coronary 197
VPMC-13235 A
TIP: Scroll and draw a contour everywhere the anatomy changes size,
shape, or location.
TIP: When the Show Preview box is selected, it shows a preview in the
3D image.
6. Click in the lower left corner of the Viewer window to return to the
previous window.
Sculpt 3D Objects
1. Click .
2. In the viewport, click and hold, and drag to draw a freehand border.
3. After you create the contour line, Keep and Remove buttons display
4. To display the results of the sculpting in an MPR view, select the Show
Segmentation check box in the Visual tab.
198 Coronary
VPMC-13235 A
2. In one of the MPR views, position the cursor over one of the
crosshairs .
TIP: This view remains in Orthogonal mode, and the other two views
display images at oblique angles.
3. Drag the crosshair in the view while watching the other views.
TIP: As you drag, the crosshairs rotate around their intersection point,
staying perpendicular to each other.
TIP: To move the crosshair intersection point, click the spot where you
want the crosshair to intersect.
Automatic MIP
MIP (100 mm max thickness) – A shading setting that displays data using
only the highest data values for each voxel of the image. MIP is a good
setting to use when competing features composed of voxels with similar
or higher values might be obscuring the feature of interest.
With the separate MPR MIP option, view a volume rendering side-by-side
with MPR MIP images.
Coronary 199
VPMC-13235 A
Clear Vessel Probe Indicators and Rulers
Delete one or all rulers you have placed. Also, clear one or multiple or all
previously probed vessels, as well as all other views or measurements
associated with them.
1. To delete rulers from a CPR view, select the ruler and click Delete or
press DELETE.
NOTE: The active vessel displays in the current CPR and cross-
sectional views, is denoted by the vessel indicator (green) line in
the 3D view, and is selected (highlighted) in the Object
Management list on the Analysis tab.
Optional If the vessel you want to delete is not the active vessel,
click the vessel name in the Object Management list to make it
active.
b. Press DELETE.
Click .
NOTE: Other items not associated with the Vessel Probe option remain,
including arrows, annotations, and rulers drawn directly on 3D and MPR
images.
200 Coronary
VPMC-13235 A
the MPR views. Visibility options on the Analysis tab of the Viewer window
enable you to control how images display region segmentation.
When you select Show Segmentation box, MPR views also show the
results of any segmentation done in the 3D view. If the Show
Segmentation box is cleared, the MPR views continue to display whole
MPR images, even if parts of the volume have been segmented.
If you select Show Segmentation, and you have excluded a region in the
volume view, that region is not displayed in the MPR views.
Coronary 201
VPMC-13235 A
All of the viewports update simultaneously. The Phase X/X label
next to the slider bar updates as you scroll.
6 Rotate the 3D volume to position it for sculpting.
7 Sculpt the volume to isolate the heart.
8 Save any noteworthy images.
9 To watch the heart beat, right-click in the 3D viewport, and
select Cine Start.
• To save the cine as a movie, right-click, then select Save
Cine to Movie File.
202 Coronary
VPMC-13235 A
Circle of Willis
Contents
I Select Study
II Choose Protocol and Preset
III Perform Analysis
• View Circle of Willis in MPRs
• Use 3D Trim
• Manual Sculpt
• Use Point of Interest
• Use 3D MIP Option
• Take Snapshots
IV Distribute Findings
• Plaque
• Stenosis
• Patency
• Aneurysm
I. Select Study
3. Line the Coronal (green) line with basilar artery in the Sagittal MPR.
5. Scroll through coronal images to see Circle of Willis and other arterial
structures in the head.
Use 3D Trim
Trim lines display as rectangular boxes in all three MPR viewports, and are
color-coded to the respective view:
• Sagittal: Blue
• Coronal: Green
• Axial: Red
All data outside the trim box is excluded. The 3D viewport (MIP/Volume
Rendering) displays the new 3D image, including only the anatomy within
the box.
1. Float the cursor over the trim line in the axial, sagittal, or coronal plane
(or multiple planes) until the cursor changes to dual arrows.
2. Click and drag the edge of the trim box to eliminate the anatomy you
do not want to see in the 3D image.
Manual Sculpt
1. Click .
2. Click in the lower left corner of the Viewer window to 1-up the
axial MPR.
4. Draw contour lines around the anatomy you would like to include.
TIP: When the Show Preview box is selected, it shows a preview in the
3D image.
6. Click in the lower left corner of the Viewer window to return to the
previous window.
The button changes to the volume view, and the POI at the MPR
viewer crosshairs displays in the 3D view.
5. Take a snapshot.
Take Snapshots
camera.
4. To hide the patient information, clear the Patient Info check box in the
View Options area at the top of the screen. Select the box to show the
patient information.
The snapshots you save in the Viewer window are saved to the Report
window.
1. Click .
3. Click and hold down the left mouse button to draw around the
anatomy or object to sculpt.
4. After you create the contour line, Keep and Remove buttons display
6. Select .
Remove fragments removes all visibly distinct regions smaller than the
number of cubic centimeters listed in the Segment Objects area.
Contents
I Select Study
II Choose Protocol and Preset
III Perform Analysis
• Use MinIP
• Adjust Slice Thickness in MPR Views
• Adjust the Window/Level
• Take Snapshots
IV Distribute Findings
Lung Overview
Complete the procedures within this module to visualize and analyze air or
fluid within lung airways.
Lung 211
VPMC-13235 A
Lung Lesson
I. Select Study
Follow the instructions in the Select Study Chapter to load a lung study.
Use MinIP
This procedure enables you to modify MPR rendering options. MinIP is a
shading setting that displays data using only the lowest data values for
each voxel of the image. MinIP is a good setting to use when features
composed of similar or higher voxel values might be obscuring a feature
of interest composed of lower voxel values in a scanned image.
212 Lung
VPMC-13235 A
Adjust Slice Thickness in MPR Views
In the MPR viewports, the acquisition slice thickness displays in the lower
left corner. The current thickness setting displays to the left of the in-
1. Click .
Lung 213
VPMC-13235 A
Take Snapshots
camera.
4. To hide the patient information, clear the Patient Info check box in the
View Options area at the top of the screen. Select the box to show the
patient information.
The snapshots you save in the Viewer window are saved to the Report
window.
214 Lung
VPMC-13235 A
Index
Numerics Next 77
3D and Curved Planar Reformatted Oblique 66
views 192 Orthogonal 66
3D Button Prev 77
Viewport Window 66 Redo 64
3D menu 88 Reset 64
3D MIP 143 Undo 64
3D MIP Option 155, 206
3D Options C
Visual Tab 87 Change Font 102
3D Preset Choose Protocol and Preset 138
picking an anatomy protocol 87 Choose Protocol and Preset for Renal
3D Rendering button 143 Artery 145
3D Rendering dropdown 155 Cine
3D Trim 128, 205 Adjust Settings 56
Save to movie file 56
A Start 55
Adjust the MPR Slice Thickness 82, 213 Stop 55
Adjust the Rendering Option 82 Classroom Learning 11
Adjust Window/Level 75, 187, 213 Clear Vessel Probe Indicators and
Advanced Diagnostic Users 18 Rulers 165, 181, 200
Advanced Viewer button 18 Clinicians 17
Angle button 67 Clipboard button 118
annotation text Cobb Angle button 67, 68
predefined 101 Cobb Angles 132
Annotations Compare Multiple Series 78
Hide or Display 78 Compress Ratio
Append Page button 118 __ (20-100) 100
Applications tab 32, 43 Contact Us 12
Apply Object Visibility 145, 192 Coronal 128
Arrow button 60, 120 Create a 3D Batch 92
Auto Close 3D 99 Create an Image Batch 90
Auto Query 98 Create an MPR Batch 94
Automatic Artery/Vein Selection 95 Create an Oblique Image 79
Automatic MIP 163, 180, 199 Crosshair for Hounsfield Units (HUs) 56
Automatic Query 16 Crshair button 56
Axial 128 Curved MPR Mode 164
Customized Options 12
B Customized Templates 124, 126
Batch button 93
Batch Formats, Views, and Modes 91 D
Batch tab 93 Data Manager 42
Bone selection 71, 144 Default W/L 54
Button Delete All button 67
3D (Viewport Window) 66 Delete button 112, 116
Index 215
VPMC-13235 A
Delete Image button 120 orientation labels 85
Delete Page button 120 Image Layout
Delete Study 15 Select a different layout for the series 54
Diagnostic Tools 104 Invert option 76
Diagnostic Users 17 Invert/Rotate/Flip 76
DICOM Export button 122 MPR right-click menu 84
DICOM Transfer 45
Display a Point of Interest (POI) 86 K
Display the different planes 187 Keep button 72, 138, 208
Distance Learning 11 Keep/Remove buttons 57, 58, 129, 134,
Double Oblique Rotation 80, 135 143, 144, 162, 198, 206, 208
Keyboard Shortcuts 21
E
Edit Centerline button 139, 173 L
Edit or Delete Labels and Arrowtations 63 Label button 120
Edit the Vessel Centerline 139, 173 Label Images 59
email address Labels
changing 96 Hide or Display 71
Enable reference line for CT Scout View Options 71
images 99 Labels check box 23
End button 93 Less/More buttons 145
Enter Customer-Defined Text 62 Load button 17, 18, 31
Example Load in 2D 15
Default W/L 83 Log into VitreaCore 37
image orientation labels 86 logon password
maximum Study Directory limit 99 changing 96
W/L Presets 83
Exclude Bone 144 M
Explore the Lumen 192 Manual Curved Reformat 80
Export button 112, 116 Manual Sculpt 58, 134, 143, 161, 178,
Extend button 154, 168, 189 197, 205
Mark a Study as Read 16, 40
F Measurement button 67
Filter, Sort, and Search the Patient List 15 Measurements
Filtering Buttons 111 Hide or Display 71, 78
Findings List 111 View Options 71
Findings Management Buttons 112 Measurements check box 23
Findings Tray 111 MinIP option 65
First/Last Page button 121 MIP option 65
Flip Horizontally option 76 Mouse Functions 20
Flip Vertically option 76 MPR Rendering button 143
Fragm button 72, 145, 153, 209 MPR Rendering dropdown 155, 204, 212
Full Crosshair check box 23 MPR Thickness slider 204, 213
G N
Global Lock button 78 network speed
testing 104
I New Report button 118
Image Next Button 77
216 Index
VPMC-13235 A
Normal and Stenosed Diameter Rulers 149 Probe a Vessel 188
Number of Images slider 92 Probe the Carotids 168
Probe the Peripheral Arteries 153
O Probe Vessels 139, 156
Object Management List 140, 157, 174 Publish button 122
Object Visibility area 154, 189
Oblique Button 66 Q
Oblique mode button 204 Query button 46
Oblique MPR Mode 134, 162, 180, 198
On-site Learning 12 R
Orientation Labels Redo Button 64
image 85 Redo button 120
Orthogonal Button 66 Region of Interest Measurements 159,
Overview 176, 195
customize user settings 96 Remove button 72, 208
Remove Fragments 145, 153
P Rename button 141, 169, 189
Pan Images 75 Report Distribution 121
Patient Data Report Navigation 121
Hide or Display 78 Report Page 119
Patient Info Report Tools 120
View Options Controls 71 Report Window 25, 110
Patient Info check box 23 Reports tab 45
Patient Information Reset Button 64
Hide or Display 71 Reset option 76
Patient List 39 Restore button 112, 116, 120
Patient List Column Headers 15, 39 Restoring saved images (workflow)
Perform a Curved Reference 156 from Report window 115
Perform a Manual Curved Reformat 130 Review a 4D Cardiac Study 201
Perform Automatic Curved Reformats 147, Review the Heart Mode Images 187
164 Review the Study 187
Perform Measurements 64 Right-Click Menu 88
Perform Point-and-Click Region ROI-Ellipse button 67, 68
Segmentation 208 ROI-Freehand button 67, 69, 159, 195
Perform Stenosis Measurement 146, 170, Rotate 3D Images 86
190 Rotate Left 90 degree option 76
performance Rotate Right 90 degree option 76
testing network speed 104 Rotate/Flip
Ping 105 3D right-click menu 89
POI Box 172 Ruler button 67, 146
POI button 86
Point of Interest 206 S
Prev Button 77 Sagittal 128
Previous/Next button 121 Save
Print Cine to movie file 56
3D right-click menu 90 Screen Capture of viewport 55
Image 55 Save as DICOM File option 45
MPR right-click menu 84 Save button 120
Print button 122 Save query while quit 99
Index 217
VPMC-13235 A
Save Screen Capture Show/Hide 99
3D right-click menu 90
MPR right-click menu 84 T
Screen Capture Tabs 12
Save 55 Template Layouts 25, 117
screen fonts Text button 60
formatting the default 101 Text/Arrow button 60
Scroll Through Annotated Images 63 Thickness slider 143, 155
Scroll through Images 79 Time Span_minutes 98
Sculpt 3D Objects 57, 162, 179, 198 Tinted Foreground option 74
Sculpt button 57, 58, 129, 134, 143, 144, Tips for planning your image batches 90
161, 162, 197, 198, 205, 208 Transparent Foreground option 74
Sculpt in 3D 129, 144, 208 Transverse Line 165
Segment Objects 71, 152 Trim 3D Objects 59
Segment Objects area 153 Trim Table on Axial View 152
Segment the Aorta 138 Troubleshooting VitreaCore 25
Select Application Data option 43
Select button 120, 139, 153, 157, 168, U
188 Undo Button 64
Select MPR Options 82 Undo button 120
Semi-Transparent Background Use MinIP 212
option 74 User Preferences
Series tab 31 Customized Text Settings 100
Show 3D Crosshair check box 23 User Publications 10
Show All button 111 User Settings
Show All option 74 custom WW/WL 97
Show Cols in Study Directory 98 email address 96
Show Not Reported button 111 logon password 96
Show Reported button 111 Overview 96
Show Segmentation check box 23, 129, setting user-specific study directory
162, 201 screen preferences 98
Show Segmentation in MPR Views 166, User Types (Vitrea Enterprise Suite) 17
182, 200
Snap button 58 V
Snapshot Vessel selection 72
3D right-click menu 89 Via button 93
MPR right-click menu 84 View Circle of Willis in MPRs 204
Snapshots 58 View Options
Snapshots tab 44 Labels 71
Specialty Course for Advanced Visualization Measurements 71
Cardiac 12 Patient Info 71
Spine button 131 Viewer Options 78
Spine Labeling 131 Viewer Window
Spine Labeling button 61 Visual Tab 2D Functions 77
Start button 93 Visual Tab 3D Functions 87
Step Size slider 92 Viewer Window Layout
Study Directory 13 2D 51
setting user-specific preferences 98 Viewport Layout
Support Button Select a different hanging protocol 54
218 Index
VPMC-13235 A
Visible button 72
Visual Tab
2D Functions 77
Visual Tab 2D
Cine Tools 77
Next Button 77
Prev Button 77
Visual Tab 3D Functions 87
ViTAL U® 10
Vitrea Enterprise Study Directory 32
Vol. Render option 65
W
W/L Presets
MPR right-click menu 83
WinLev button 56, 187, 213
Word Report button 122
Work with Crosshair Position
Indicators 160, 196
Work with Cross-sectional and CPR Vessel
Views 158, 175, 194
Work with Cross-Sectional Position
Indicators 177
Worklist Filters 16
WW/WL
defining user-specific settings 97
Index 219
VPMC-13235 A
220 Index
VPMC-13235 A
5850 Opus Parkway, Suite 300 | Minnetonka, MN 55343 | 866.433.4624 | www.vitalueducation.com
VPMC-13235 A