Duet DRF

Operation
Manual
Duet DRF
High Resolution Digital Imaging System
100HDRF001

Operation Manual

Document N°° 62741393

i
 COPYRIGHT  1996-2013 BY THALES ELECTRON DEVICES S.A

This manual and the information contained herein are confidential and proprietary to
Thales Electron Devices S.A (“THALES”). Only Thales or its Licensees have the right to
use the information herein. Any unauthorized use, disclosure or reproduction is a violation
of the licenses and/or Thales’ proprietary rights and will be prosecuted to the full extent of
the law.

Windows XP is a registered trademark of Microsoft Corporation.

Pentium is a registered trademark of Intel Corporation.

DISCLAIMER

Neither Thales nor any of its worldwide subsidiaries shall be liable in any manner in
respect to bodily injury and/or property damage arising from this product or the use thereof
if the unit is not operated and maintained in strict compliance with instructions and safety
precautions contained herein, in all supplements hereto and according to all terms of
warranty and sale relevant to this product.

CAUTION
Federal Law restricts this device to sale by or on the order of a physician.

THALES ELECTRON DEVICES S.A.

460, rue du Pommarin - BP 122
38346 Moirans Cedex – France
Tel : +33 (0)4 76 57 52 80
Fax : +33 (0)4 76 57 40 85
mailto:[email protected]@thalesgroup.com

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 List of Revisions

This manual is part of the Duet DRF system.

REV. DATE DESCRIPTION CHAPTER PAGES

1.0 July 2009 First Release - Version 1.00 All All

1.1 March 2010 Updates 4.1, 4.1.2.4, 4.1.2.7, 6.5.2.4, 6.17.1.6,

6.17.2.4, 6.17.3, 6.17.4.3- 6.17.4.4,
6.17.4.9- 6.17.4.11, 6.20, 6.22.1, 6.22.1.3,
6.22.1.7, 6.2.3, 7.3.11, 7.3.11.1, 7.3.12.3,
9.3.1.1-9.3.1.4
1.2 May 2010 Update All All

1.3 July 2010 Update for software 1.05 3.2, 3.6, 4.1, 4.1.2.6, 4.1.2.7, 5.2.2, 5.3.1,
6, 6.11, 6.16, 6.17.1, 6.17.1.3, 6.17.1.4,
6.17.2.4, 6.17.3.2, 6.17.4.9, 6.17.4.10,
6.18, 6.19.3, 6.22, 8.22, 9.1, 9.1.2.1-
9.1.2.3, 9.3.1.4, 9.3.3.1, 9.3.4, 9.6
1.4 March 2011 Change of logo to Thales All All

1.5 August 2011 Update for Software 5.3.2, 6.6, 6.7, 6.8, 6.9, 6.28, 8.1, 8.2, 8.3, All
version 1.06 9.2.3, 9.2.4, 9.3.1
A August 2012 Updates for Software 1.1, 1.2.1, 1.3.1, 1.4, 1.4.11, 5.3.4, 5.3.5, All
version 1.07 and 5.3.6, 6.1, 6.8, 6.8.2, 6.24, 6.27,7.3.12,
IEC60601-1 3rd edition 9.2.1, 9.2.2, 9.3, 9.6
B April 2013 Update regulatory 1.5.1, 1.6.1, 1.6.4.1 11, 14,
compliance list 20

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 NOTICE TO USERS

Accident Reporting

The FDA Medical Device Reporting Regulation, 21 CFR 803 and the CE Council
Directive 93/42/EEC concerning Medical Devices require that
“the manufacturer of medical devices submit a report to the FDA or local competent
authorities whenever he becomes aware of information that reasonably suggests that one of
its installed devices:
1. may have caused or contributed to a death or serious injury, or
2. has malfunctioned and, if the malfunction recurs, is likely to cause or contribute to a
death or serious injury.”
In order for Thales to comply with these requirements, all users of this equipment,
operators and service technicians, are required to provide the Quality Assurance Manager
at Thales with the following information regarding all reportable events as soon as possible
1. Identification of the model and serial number.
2. Description of the event. Include whether any serious injury or death has occurred.
3. Identification of the person who is submitting the information including phone number
and fax number if available.

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 DUET DRF Operation Manual

TABLE OF CONTENTS

1 SAFETY & REGULATORY INFORMATION........................................................ 1

1.1 GENERAL GUIDELINES ............................................................................................ 1
1.2 GENERAL SAFETY GUIDELINES .............................................................................. 2
1.2.1 Electric Shock Hazard .................................................................................... 2
1.2.2 Electrical Fire ................................................................................................ 3
1.2.3 Explosion Hazard ........................................................................................... 3
1.2.4 Overheating Hazard ....................................................................................... 3
1.2.5 Implosion Hazard ........................................................................................... 3
1.3 SAFETY DEFINITION AND IEC SYMBOLS ................................................................ 4
1.3.1 IEC Symbols Used .......................................................................................... 4
1.4 SPECIFIC SAFETY GUIDELINES ............................................................................... 5
1.4.1 Radiation Hazard ........................................................................................... 6
1.4.2 System Self Test. ............................................................................................. 6
1.4.3 Calibration ..................................................................................................... 6
1.4.4 Distance Measurements ................................................................................. 7
1.4.5 Left/Right Marker ........................................................................................... 7
1.4.6 Data Safety ..................................................................................................... 8
1.4.7 Connectivity .................................................................................................... 8
1.4.8 Cleaning Instructions ..................................................................................... 9
1.4.9 Maintenance Precautions ............................................................................. 10
1.4.10 Disposal ........................................................................................................ 10
1.4.11 User Limitations ........................................................................................... 10
1.5 REGULATORY INFORMATION ................................................................................ 11
1.5.1 Standard Compliance ................................................................................... 11
1.5.2 CE Conformity .............................................................................................. 11
1.5.3 USA Regulations ........................................................................................... 12
1.6 EMC CONSIDERATIONS ........................................................................................ 14
1.6.1 General EMC precautions............................................................................ 14
1.6.2 Guidance and manufacturer’s declaration .................................................. 15
1.6.3 Installation recommendations ...................................................................... 19
1.6.4 Test conditions .............................................................................................. 20
2 SYSTEM DESCRIPTION ......................................................................................... 27
2.1 GENERAL INFORMATION ....................................................................................... 27
2.2 SYSTEM COMPONENTS ......................................................................................... 27

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DUET DRF Operation Manual

2.3 SYSTEM APPLICATIONS ........................................................................................28

2.4 POWER ON PROCEDURE ........................................................................................31
2.5 POWER OFF PROCEDURE ......................................................................................33
2.6 IMPORTANT NOTES PRIOR TO USAGE ...................................................................34
2.6.1 Equipment Hardware Familiarity ................................................................34
2.6.2 Care and Cleaning........................................................................................34
2.6.3 X-Ray Equipment Safety Precautions ...........................................................34
3 USING WINDOWS ....................................................................................................35
3.1 WORKING ENVIRONMENT.....................................................................................35
3.2 MOUSE ..................................................................................................................35
3.3 ICONS ....................................................................................................................36
3.4 WINDOW STRUCTURE ...........................................................................................36
3.5 USING THE SCROLL BAR .......................................................................................38
3.6 KEYBOARD............................................................................................................38
3.7 MENUS ..................................................................................................................39
3.8 DIALOG BOXES .....................................................................................................39
4 STATUS LINE AND APPLICATION TABS ..........................................................40
4.1 STATUS LINE .........................................................................................................40
4.1.1 Status Message .............................................................................................41
4.1.2 Status Indicators ...........................................................................................41
4.1.3 Date & Time .................................................................................................44
4.2 APPLICATION TABS ...............................................................................................45
5 PATIENT REGISTRATION ....................................................................................47
5.1 GENERAL INFORMATION .......................................................................................47
5.1.1 Accessing the Patient Registration Application ...........................................47
5.1.2 Patient Registration Screen ..........................................................................49
5.2 PATIENT AND STUDY DATA ..................................................................................50
5.2.1 Patient’s Demographic Information.............................................................50
5.2.2 Study Information .........................................................................................50
5.2.3 Other Information .........................................................................................51
5.3 PATIENT REGISTRATION .......................................................................................52
5.3.1 Manual Registration .....................................................................................52
5.3.2 Manually registering a RAD Patient ............................................................55
5.3.3 Registering an Urgent Patient ......................................................................56
5.3.4 Registration using DICOM Modality Work List (MWL) ..............................57
5.3.5 Registration using History Data Base (Completed) .....................................60
5.3.6 Registration from the “Suspended” List ......................................................61

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5.3.7 Modifying Patient Data ................................................................................ 62

5.4 MANAGING A PREPARED PATIENT LIST (A WAITING LIST) ................................. 62
5.4.1 Adding a Patient to the List .......................................................................... 62
5.4.2 Selecting a Patient from the List .................................................................. 64
5.4.3 Removing a Patient from the List ................................................................. 64
6 EXAMINATION SCREEN (ACQUISITION AND FLUOROSCOPY) ............... 67
6.1 ACCESSING THE EXAMINATION APPLICATION ..................................................... 67
6.2 EXPOSURE SETTINGS FOR RADIOGRAPHIC GENERATOR AND FLUORO SETTINGS 69
6.3 IMAGE LEFT/RIGHT LABELING ............................................................................. 70
6.4 APPLICATION TABS............................................................................................... 71
6.5 CURRENT TECHNIQUE AND PROTOCOL PARAMETERS.......................................... 73
6.5.1 Technique Type ............................................................................................. 73
6.5.2 Protocol ........................................................................................................ 73
6.6 FLUOROSCOPY ACQUISITION ................................................................................ 76
6.6.1 Saving Fluoro Images................................................................................... 76
6.6.2 To save real-time Fluoro images (Roadmap)............................................... 78
6.6.3 Fluoro Real time Tuner ................................................................................ 79
6.7 SPOT PULSE ACQUISITION .................................................................................... 80
6.7.1 Digital Spot Pulse Acquisition ..................................................................... 80
6.8 RAD PROTOCOL ................................................................................................... 83
6.8.1 Accept/Reject Mode ...................................................................................... 85
6.8.2 Direct Mode .................................................................................................. 86
6.9 CINE MODE .......................................................................................................... 87
6.10 DSA MODE ........................................................................................................... 88
6.11 TEST SHOT ACTIVATION ....................................................................................... 88
6.12 SINGLE IMAGE SELECTION .................................................................................... 91
6.13 MULTI IMAGE SELECTION ..................................................................................... 91
6.14 SELECTION OF ALL ACQUIRED IMAGES ................................................................ 91
6.15 GRAPHICS ............................................................................................................. 91
6.16 SCREEN LAYOUT................................................................................................... 92
6.17 PREVIEWING IMAGES PRIOR TO PRINTING ............................................................ 92
6.18 PRINTING THROUGH THE DEFAULT PRINTER ......................................................... 93
6.19 ADD TO CLIPBOARD .............................................................................................. 93
6.20 EXPORTING IMAGES .............................................................................................. 96
6.21 CLOSE EXAMINATION ........................................................................................... 96
6.22 PATIENT REGISTRATION ....................................................................................... 97
6.23 PATIENT DETAILS ................................................................................................. 97
6.24 EXAMINATION SCREEN MENU BAR ...................................................................... 99
6.24.1 Main .............................................................................................................. 99

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DUET DRF Operation Manual

6.24.2 Selection......................................................................................................102
6.24.3 View ............................................................................................................104
6.24.4 Processing ..................................................................................................106
6.24.5 FPD Handling ............................................................................................115
6.24.6 Help ............................................................................................................116
6.25 SERIES LIST .........................................................................................................116
6.26 BASIC IMAGE INFORMATION ...............................................................................116
6.27 POST PROCESSING TOOLS ...................................................................................118
6.28 TUNER OPERATION .............................................................................................122
6.29 WORK-STATION OPERATIONS ............................................................................125
6.29.1 Browsing the Current Patient Images ........................................................125
6.30 IN-ROOM OPERATIONS .......................................................................................126
6.30.1 Virtual Keypad ............................................................................................126
6.31 RIGHT-MOUSE MENU .........................................................................................133
6.32 MESSAGES OVERLAID ON THE IN ROOM MONITOR IMAGE ................................133
7 ARCHIVES AND DATABASES .............................................................................137
7.1 GENERAL INFORMATION .....................................................................................137
7.2 ACCESSING THE ARCHIVES MANAGER ...............................................................137
7.3 ARCHIVES MANAGER SCREEN ............................................................................138
7.3.1 Application Tabs .........................................................................................138
7.3.2 Databases ...................................................................................................138
7.3.3 Examination List .........................................................................................140
7.3.4 Single Image Selection ...............................................................................140
7.3.5 Multi Image Selection .................................................................................141
7.3.6 Selection of All Acquired Images ...............................................................141
7.3.7 Graphics .....................................................................................................141
7.3.8 Screen Layout .............................................................................................141
7.3.9 Previewing Images Prior to Printing .........................................................141
7.3.10 Exporting Images ........................................................................................141
7.3.11 Assign Images to Another Patient ..............................................................141
7.3.12 Menu Bar ....................................................................................................143
7.3.13 Patient Details ............................................................................................146
7.3.14 Visit Information .........................................................................................146
7.3.15 Image Information ......................................................................................146
7.3.16 Post Processing Tools ................................................................................146
7.3.17 Cine Mode (by clicking on the Post button) ...............................................146
7.3.18 DSA Mode (by clicking on the Post button) ...............................................147
8 PRINTING ................................................................................................................149

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8.1 PRINTING THROUGH THE DEFAULT PRINTER ....................................................... 149

8.2 PRINTING FROM THE PREVIEW SCREEN .............................................................. 149
8.2.1 Customize Jobs ........................................................................................... 151
8.2.2 True Size Printing ....................................................................................... 153
8.3 OFFLINE PRINTING MANAGER SCREEN .............................................................. 155
8.3.1 Printing List ................................................................................................ 156
8.3.2 Film Format................................................................................................ 156
8.3.3 Single Image Selection ............................................................................... 158
8.3.4 Multi Image Selection ................................................................................. 158
8.3.5 Selection of all Acquired Images ................................................................ 158
8.3.6 Graphics ..................................................................................................... 158
8.3.7 Screen Layout ............................................................................................. 158
8.3.8 Previewing Images Prior to Printing ......................................................... 158
8.3.9 Printing Images .......................................................................................... 158
8.3.10 Patient Details ............................................................................................ 159
8.3.11 Image Information ...................................................................................... 159
8.3.12 Post Processing Tools ................................................................................ 159
8.3.13 Application Tabs......................................................................................... 159
8.3.14 Menu Tab .................................................................................................... 159
9 SETTINGS ................................................................................................................ 164
9.1 GENERAL ............................................................................................................ 165
9.1.1 Serviceability .............................................................................................. 165
9.1.2 Accounts Management................................................................................ 168
9.1.3 Hospital Name ............................................................................................ 172
9.1.4 Operators (Technologists) .......................................................................... 173
9.1.5 Referring Physicians .................................................................................. 173
9.1.6 Performing Physicians ............................................................................... 173
9.1.7 Reject Reasons ............................................................................................ 174
9.2 VIEWING DEFINITIONS ........................................................................................ 174
9.2.1 Layouts ....................................................................................................... 175
9.2.2 Preset Zoom Factors .................................................................................. 176
9.2.3 Custom Headers ......................................................................................... 176
9.2.4 Custom Layouts .......................................................................................... 178
9.3 PROTOCOLS ......................................................................................................... 181
9.3.1 Edit Protocols ............................................................................................. 181
9.3.2 Edit Sequences ............................................................................................ 196
9.3.3 Body Part Examined ................................................................................... 203
9.3.4 Edit Examinations ...................................................................................... 205
9.3.5 Labels ......................................................................................................... 207

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9.3.6 Hospital Examination Names .....................................................................208

9.3.7 Auto Windowing..........................................................................................209
9.3.8 Edge Enhancement Fluoroscopy ................................................................213
9.3.9 Edge Enhancement Radiography ...............................................................214
9.3.10 Gamma Correction .....................................................................................215
9.4 DRC ....................................................................................................................216
9.5 PATIENT REGISTRATION .....................................................................................216
9.5.1 Registration Mandatory fields ....................................................................217
9.5.2 BarCode Reader (optional) ........................................................................218
9.6 DEVICES HANDLING ...........................................................................................218
9.6.1 Image Disk Zones .......................................................................................219
9.6.2 Export Devices ............................................................................................220
9.6.3 Burn CD/DVD ............................................................................................221
9.7 DICOM SERVICES ..............................................................................................222
9.7.1 Local Station Configuration .......................................................................222
9.7.2 Storage ........................................................................................................223
9.7.3 Printers .......................................................................................................228
9.7.4 Modality Worklist (MWL) ...........................................................................230
9.7.5 Modality Performed Procedure Steps (MPPS) ..........................................233
10 MISCELLANEOUS FEATURES .......................................................................237
10.1 PULSED FLUOROSCOPY .......................................................................................237
10.2 RS232 GENERATOR INTERFACE .........................................................................238
10.2.1 General Information ...................................................................................238
10.2.2 Duet DRF/Generator Synchronization .......................................................238
10.2.3 Acquisition Parameters ..............................................................................238
10.2.4 Sequence Validation ...................................................................................238

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1 SAFETY & REGULATORY INFORMATION

The safety precautions and regulatory information included in this Safety manual
are provided in the following sub-sections:
1.1 General Guidelines
1.2 General Safety Guidelines
1.3 Safety Definitions and IEC Symbols
1.4 Specific Safety Guidelines
1.5 Regulatory Information
1.6 EMC Considerations

1.1 General Guidelines

This product was designed and manufactured to ensure maximum safety of
operation and to meet all the safety requirements applicable to electronic medical
equipment. However, anyone attempting to operate the system must be fully
aware of potential safety hazards. It should be operated and maintained in strict
compliance with the following safety precautions and operating instructions
contained herein instructions contained herein
1. This product should be installed, maintained and serviced according to
THALES’s maintenance procedures and by THALES’s personnel or other
qualified maintenance personnel approved in writing by THALES.
Operation and maintenance should be done in strict compliance with the
operation instructions contained in the operation and maintenance manuals.
2. The system, in whole or in part, cannot be modified in any way without
written approval from THALES.
3. Authorize the personnel that operate the system according to the local
regulations. An authorized operator’s list should be maintained.
4. The owner must ensure that only properly trained and fully qualified
personnel are authorized to operate this equipment. Before first operation of
the system, verify that the personnel have read the operation manual and
fully understand it.

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DUET DRF Operation Manual

5. The manufacturer or vendor of the equipment makes no representation

however that the act of reading this manual renders the reader qualified to
operate, test or calibrate the system.
6. Prevent unauthorized personnel from accessing the system.
7. It is important that this operation manual should be kept at hand, studied
carefully and reviewed periodically by the authorized operators.
8. Do not use the system if unsafe conditions are known to exist. In the event of
hardware failure that could cause hazardous condition (smoke, fire, etc.) turn
the power off and unplug the main power cords.
9. If the product does not function properly, or if it fails to respond to the
controls described in this manual, stop operation, contact the nearest
THALES field service representative immediately, report the incident and
wait for further instructions.
10. The images and calculations provided by this system are intended as tools
for competent users. They are explicitly not to be regarded as a sole
incontrovertible basis for clinical diagnosis. Users are encouraged to study
the literature, and search their own professional conclusions regarding the
clinical utility of the system.
11. The Duet DRF system is only part of the entire X-ray room. Thus the
entire responsibility for compliance of the room to required medical
and other standards is the OEM or room integrator.

1.2 General Safety Guidelines

1.2.1 Electric Shock Hazard

CLASSIFICATION OF THE EQUIPMENT
According to the type of protection against electric shock
CLASS I EQUIPMENT
According to the degree of protection against ingress of water
ORDINARY EQUIPMENT
• A three conductor AC power cable is supplied with this system to provide the
appropriate electrical grounding. To minimize the shock hazard, the power
cable must be plugged into a UL approved three contact electrical outlet. Do

Safety
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 DUET DRF Operation Manual

not use an adapter to plug the system into a two-pronged (ungrounded) outlet.
• Do not operate the system if worn wires or open leads are detected.
• Do not remove or open system covers or plugs. The internal circuits of the
system use high voltages that can cause serious injury or death from an
electrical shock. The operator should never open the panels of the system.
• RCU and FPU include circuit breakers (CB) for mains power control. These
CB's are not for operational usage but for maintenance reasons.

1.2.2 Electrical Fire

• Conductive fluids that drain into the active circuit components of the system
may cause short circuits that can result in electrical fire. Therefore, do not
place fluids or food on any part of the system.
• Avoid electric shocks and burns caused by the use of the wrong type of fire
extinguisher; ensure that the fire extinguisher at the site has been approved
for use on electrically caused fires.

1.2.3 Explosion Hazard

• Do not operate the equipment in the presence of flammable or explosive
liquids, vapors or gases such as flammable anesthetic, oxygen or nitrous
oxide. Do not plug in or turn on the system if hazardous substances are
detected in the environment.
• If flammable substances are detected after the system has been turned on, do
not attempt to turn off the system or unplug it. Evacuate and ventilate the area
before turning the system off.

1.2.4 Overheating Hazard

Do not block the ventilation ports of the electronic equipment. Always maintain a
minimum clearance of 6 inches (15 cm) around the ventilation ports to prevent
overheating and damage to the electronic hardware.

1.2.5 Implosion Hazard

Cathode Ray Tube (CRT) might explode if struck or jarred. This may result in
flying pieces of glass and coating that can cause serious injury. Do not subject the
system to mechanical shocks.

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DUET DRF Operation Manual

1.3 Safety Definition and IEC Symbols

The safety instructions in this manual are used for the protection of the patient,
the operator and service personnel. They identify hazards that will or may cause
harm if instructions are ignored. The identified hazards are defined and classified
as follows

CAUTION
Cautions are used to identify conditions or actions for which a potential hazard
may exist, which will or can cause minor personal injury or property damage if
the instructions are ignored.

WARNING
Warnings are used to identify conditions or actions for which a specific hazard
is known to exist, which may cause severe personal injury, death or substantial
property damage if the instructions are ignored.

1.3.1 IEC Symbols Used

The system may have labels with one or more of the following symbols. These
symbols indicate the IEC standards to which the system conforms.

Symbol IEC Standard

Alternating Current

Protective Earth Point

Power ON

OFF/Power OFF

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 DUET DRF Operation Manual

Input

Output

Functional Earth Ground

Warning, Caution - Consult

Accompanying Documents

Electrical Shock Hazard

1.4 Specific Safety Guidelines

The specific safety guidelines refer to the following issues
1. Radiation
2. System Self test
3. Calibration
4. Distance Measurements
5. Left/Right Marker
6. Data Safety
7. Connectivity
8. Cleaning Instructions
9. Maintenance Precaution
10. Disposal
11. User Limitation

CAUTION
Always be alert when operating this equipment. In case of malfunction, do
not use this equipment until the problem is fixed by qualified personnel.

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DUET DRF Operation Manual

1.4.1 Radiation Hazard

The system is interfaced to x-ray generating equipment. Be certain to follow the
safety instructions and specifications for wearing proper lead shielding when in
the presence of x-ray generating equipment. All personnel must wear dosimeters
during all phases of installation, operation and maintenance of the system and the
equipment to which it is interfaced.
• Always be alert to the messages / icons which appear in the status area in the
lower right corner of the in-room monitor. These messages / icons indicate
the status of the x-ray (ON or OFF) and the displayed image (STATIC or
LIVE).

1.4.2 System Self Test.

DUET DRF runs a system self test automatically after power on. Each board is
tested sequentially and an appropriate Pass or Fail message is displayed on the
work-station monitor. After all tests are passed successfully, the system enters the
application. If an error is detected, the system self-test is aborted and the system
remains non operational until the failure is corrected.

CAUTION
The owner is responsible for ensuring that system self-test is
performed daily.
Do not try to use the system if system self-test fails.

1.4.3 Calibration
To ensure the optimal performances of the DUET DRF it is important to verify
that the system is calibrated.

CAUTION
The owner is responsible for ensuring that system calibration
is checked periodically in accordance with the requirements defined
in the DUET DRF Maintenance Manual.

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 DUET DRF Operation Manual

NOTE
Because DUET DRF is an integral part of the X-ray room, the user should be
aware that any change or calibration in one or more of the room components
may require re-calibration of the DUET DRF system.

1.4.4 Distance Measurements

Distance measurement in millimeters (mm) is possible only after distance
calibration has been performed using a reference object (see Study, Distance
Calibration). The operator is responsible for performing distance calibration with
a reference object and verifying the results of the distance calibration before
taking any distance measurements on an image.
In automatic distance calibration it is not allowed to change height and use
measurement according calibration.
In the Stitching option the user must perform distance calibration in the DUET
DRF before sending the images to stitching PC.

WARNINGS
1. The user should make sure that the measurements of the
distance calibration are correct
2. In automatic distance calibration it is not allowed to change
height and use measurements according to calibration

1.4.5 Left/Right Marker

CAUTION
The operator is responsible for the correct and clear marking of the left or right side
of the image to eliminate possible errors.

NOTE
The software includes an option to mark the image with L (left) or R (right)
indicator from acquisition phase through printing and archiving. If the operator
chose, for any reason, not to use the L / R markers, he must use an alternative
way (e.g. a piece of lead) to eliminate any possible mistake.

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DUET DRF Operation Manual

1.4.6 Data Safety

1.4.6.1 General
The owner should ensure continuous power supply to the system, with voltage
and current according to the product specifications. If power failures occur
regularly, UPS (Uninterrupted Power Supply) should be installed to avoid loss of
data.
After power up perform a fluoroscopy for short time to verify that the hardware
works properly.
1.4.6.2 Patient Registration
WARNING
It is mandatory to properly register a new patient’s and study’s
details before starting acquisition of data for that patient.
Failing to do so might result in mixing of patient’s data with the
data acquired for the previous patient. In case such a mix of
images occurs, a post acquisition split and reassign of images to
another patient can be preformed by a THALES expert via the
Re- Assign function (see Archive and databases, Select menu).

1.4.6.3 Images Back-up

WARNING
To prevent image loss and avoid the need of examination re-take,
it is important to back-up the images either by printing, sending
to a DICOM compliant storage server or by other backup means.
This should be done as a routine operation for every patient.

• It is the operator’s responsibility to back-up images of each patient.

• Do not accumulate images in the system without performing a backup.
• Keep the data print-outs away from direct sun / intensive light.

1.4.7 Connectivity
DUET DRF is designed to meet the requirements of the DICOM 3.0 standards. It
is the user’s responsibility to verify that when connected to other devices, the
interfacing shall comply with these standards.

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 DUET DRF Operation Manual

DUET DRF is compliant with the DICOM 3.0 connectivity standard and with
IHE (Integrating Healthcare Enterprise). For details see company website.

1.4.8 Cleaning Instructions

Use only soap and lukewarm water to clean the surfaces of the system. Do not
use detergents or organic solvents to clean the system. Strong detergents, alcohol
and organic cleaners may damage the finish and cause structural weakening. Do
not wet surfaces that are not closed or sealed, such as the keyboard.

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DUET DRF Operation Manual

1.4.9 Maintenance Precautions

• Do not place DUET DRF on a soft surface, which may reduce the airflow
through the bottom of the chassis.
• Do not open the enclosures, disconnect or connect any cables or accessories.
Only qualified THALES personnel are authorized to maintain and service the
system.
• Do not move the MPU module (PC) while it is running. Wait at least one
minute after it is turned off before moving.
• Do not use an adapter to plug the system into a two-pronged (ungrounded)
outlet.
• Do not place liquids or food on the monitors or keyboard.

1.4.10 Disposal
This product contains harmful materials such as lead. Improper disposal of this
product may result in environmental contamination. When disposing of this
equipment, contact your THALES representative. Do not dispose of any parts of
this equipment without consulting a THALES representative first. THALES
does not assume any responsibility for damage resulting from disposal of this
equipment without consulting THALES.

1.4.11 User Limitations

The software and databases described in this document are furnished under a
license agreement or nondisclosure agreement. The software and databases may
be used or copied only in accordance with the terms of the agreement.
No modifications, additions or deletions are allowed on DUET DRF work-
station. No operations should be performed other than those available through the
DUET DRF applications described in this manual.
THALES shall not be liable or obligated in respect to bodily injury and property
damage arising from the use of this software if such use is not in strict
compliance with instructions in the Operation Manual and in accordance with the
terms of warranty and sale of this software.

! WARNING
Connecting electrical equipment to multi socket outlet effectively leads

Safety
10
 DUET DRF Operation Manual

to creating an ME system and can result in an reduced level of safety

1.5 Regulatory Information

The use of this symbol indicates that this product should NOT be treated as
household waste.
By insuring that this product is disposed of correctly, you will help prevent
potential negative consequences for the environment and human health, which
could otherwise be caused by inappropriate waste handling of this product.

1.5.1 Standard Compliance

The equipment complies with the following standards
• IEC 60601-1: “Medical Electrical Equipment, General Requirements for
basic Safety and essential performance”. Ed.2 & Ed.3
• IEC 60601-1-2: International Standard – Medical electrical equipment,
Part 1: General requirements for safety, 2- Collateral standard:
Electromagnetic compatibility – Requirements and tests. Ed.2 & Ed.3
• IEC 60601-1-4: “General Requirements for Safety, Collateral Standard:
Safety Requirements for Programmable Electrical Medical Systems”.
• IEC 60601-1-6: General requirements for safety – Collateral standard:
Usability.
• ISO 15223: “Medical Devices – Symbols to be used with medical device
labels, labeling and information to be supplied”.
• IEC 60878: “Graphical symbols for electrical equipment in medical
practice”.
• ISO 14971: “Medical devices – Application of risk management to
medical devices”.

1.5.2 CE Conformity
This product conforms to the requirements of council directive 93/42/EEC
concerning Class IIB medical devices. The product bears the following CE mark
of conformity:

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DUET DRF Operation Manual

The name and address of the CE representative:

THALES ELECTRON DEVICES S.A.

460, rue du Pommarin - BP 122
38346 Moirans Cedex – France
Tel : +33 (0)4 76 57 52 80
Fax : +33 (0)4 76 57 40 85
[email protected]

1.5.3 USA Regulations

The system was cleared for sale in the USA by the FDA.

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 DUET DRF Operation Manual

NOTE: Concerning the WEEE Label

The following information is only for EU member states:
*For system products, this label may be attached to the main unit only.

Cautions for Disposing and Recycling

Weights (Kg)
Material Platinum
Lithium battery (button battery) on one of 0.00298
PC boards greater than 10 square 4.24
centimeters
LCD of surface greater than 100 square 4.24
0
centimeterscontained
Plastic brominated flame 0
retardantstube
Vacuum 0
Spring 0
Berylium 0
Selenium 0
Base oil 0
Mercury containing components 0
Contact details: 0
THALES ELECTRON DEVICES S.A.
460, rue du Pommarin - BP 122
38346 Moirans Cedex – France
Tel : +33 (0)4 76 57 52 80
Fax : +33 (0)4 76 57 40 85
[email protected]

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DUET DRF Operation Manual

1.6 EMC considerations

1.6.1 General EMC precautions

! WARNING

- Duet DRF system needs special precautions regarding EMC and needs to be
installed and put into service according to the EMC information provided in the
accompanying documents
- Portable and mobile RF communications equipment can affect Duet DRF
- The Duet DRF system should not be used adjacent to or stacked with other
equipment and that if adjacent or stacked use is necessary, the Duet DRF system
should be observed to verify normal operation in the configuration in which it
will be used
- The use of the accessories, transducers or cables with equipment and systems
other than those specified may result in increased emissions or decreased
immunity of the Duet DRF system. Accessories, transducers and cables are
specified in next Paragraph.
Note
Transducers and cables sold by manufacturer of medical equipment or systems as
replacement parts for internal components are not in the scope of the above
warning.

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 DUET DRF Operation Manual

1.6.2 Guidance and manufacturer’s declaration

1.6.2.1 Electromagnetic emission

Emissions test Compliance Electromagnetic environment - guidance

The Duet DRF system is intended for use in the electromagnetic environment
specified below. The customer or the user of the Duet DRF system should
assure that it is used in such an environment.

The Duet DRF system uses RF energy

RF EMISSIONS only for its internal function. Therefore,
CISPR 11 Group 1 its RF emissions are very low and are not
likely to cause any interference in nearby
electronic equipment
RF EMISSIONS
CISPR 11 Class A
The Duet DRF system is suitable for use
HARMONIC
in all establishments other than domestic
EMISSIONS Class A and those directly connected to the public
IEC 61000-3-2
low-voltage power supply network that
VOLTAGE
supplies buildings used for domestic
FLUCTUATIONS /
Complies purposes.
FLICKER EMISSIONS
IEC 61000-3-3

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DUET DRF Operation Manual

1.6.2.2 Electromagnetic immunity for all equipment and systems

Electromagnetic
Immunity test IEC 60601 level Compliance level environment -
guidance
The Duet DRF system is intended for use in the electromagnetic environment specified
below.
The customer or the user of the Duet DRF system should assure that it is used in
such an environment.

Floors should be wood,

concrete or ceramic tile.
Electrostatic discharge 6 kV contact 6 kV contact If floors are covered
(ESD), IEC 61000-4-2 with synthetic material,
8 kV air 8 kV air
the relative humidity
should be at least 30 %.
2 kV for power 2 kV for power Mains power quality
Electrical fast transient/ supply lines supply lines should be that of a
burst, IEC 61000-4-4 1 kV for input/output 1 kV for typical commercial or
lines input/output lines hospital environment
Mains power quality
1 kV line to line 1 kV line to line should be that of a
Surge, IEC 61000-4-5 typical commercial or
2 kV line to earth 2 kV line to earth
hospital environment.
Mains power quality
<5 % UT (>95 % dip <5 % UT (>95 %
should be that of a
in UT) dip in UT)
typical commercial or
for 0,5 cycle for 0,5 cycle
hospital environment. If
40 % UT (60 % dip in 40 % UT (60 % dip
Voltage dips, short the user of the
U T) in UT)
interruptions and equipment requires
for 5 cycles for 5 cycles
voltage variations on continued operation
70 % UT (30 % dip in 70 % UT (30 % dip
power supply input during power mains
U T) in UT)
lines interruptions, it is
for 25 cycles for 25 cycles
IEC 61000-4-11 recommended that the
<5 % UT (>95 % dip <5 % UT (>95 %
equipment be powered
in UT) dip in UT)
from an uninterruptible
for 5 s for 5 s
power supply or a
battery.

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 DUET DRF Operation Manual

Electromagnetic
Immunity test IEC 60601 level Compliance level environment -
guidance
Power frequency
magnetic fields should
Power frequency be at levels
(50/60 Hz) magnetic characteristic of a
3 A/m 3 A/m
field, typical location in a
IEC 61000-4-8 typical commercial or
hospital environment.
NOTE: UT is the AC mains voltage prior to application of the test level.

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DUET DRF Operation Manual

1.6.2.3 Electromagnetic immunity

Compliance Electromagnetic
Immunity test IEC 60601 level
level environment - guidance
The Duet DRF system is intended for use in the electromagnetic environment specified
below. The customer or the user of the Duet DRF system should assure that it is used
in such an environment.
Portable and mobile RF
communications equipment
should be used no closer to any
part of Duet DRF system
including cables, than the
recommended separation
distance calculated from the
equation applicable to the
frequency of the transmitter.
Conducted RF,
3 Vrms [V1] = 3 Vrms Recommended separation
IEC 61000-4-6
150 kHz to 80 MHz distance:
d = 1.2√P
Recommended separation
distance:
Radiated RF, 3 V/m
IEC 61000-4-3 [E1] = 3 V/m d = 1.2√P, 80 – 800 MHz range
80 MHz to 2.5 GHz
d = 2.3√P, 800 – 2500 MHz
range
NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is
affected by absorption and reflection from structures, objects and people.
NOTE 3: P is the maximum output power rating of the transmitter in watts (W) according to the
transmitter manufacturer and d is the recommended separation distance in meters (m).
NOTE 4: Field strengths from fixed RF transmitters, as determined by an electromagnetic site
survey, a should be less than the compliance level in each frequency range.b
NOTE 5: Interference may occur in the vicinity of equipment marked with the following symbol:

a
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless)
telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV

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 DUET DRF Operation Manual

broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic

environment due to fixed RF transmitters, an electromagnetic site survey should be considered.
If the measured field strength in the location in which the Duet DRF system is used exceeds the
applicable RF compliance level above, the Duet DRF system should be observed to verify
normal operation. If abnormal performance is observed, additional measures may be necessary,
such as re-orienting or relocating the Duet DRF system.
b
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.

1.6.3 Installation recommendations

Recommended separation distances between portable and mobile RF
communications equipment and the Duet DRF system

Separation distance according to frequency of transmitter,

m
Rated
maximum 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to
output power of 2,5 GHz
transmitter, W Outside ISM bands
d = 1.2√P
d = 1.2√P d = 2.3√P
The Duet DRF system is intended for use in an electromagnetic environment in which
radiated RF disturbances are controlled. The customer or the user of the Duet DRF
system can help prevent electromagnetic interference by maintaining a minimum
distance between portable and mobile RF communications equipment (transmitters)
and Duet DRF system as recommended below, according to the maximum output
power of the communications equipment.
0.01 0.12 0.12 0.23
0.1 0.38 0.38 0.73
1 1.2 1.2 2.3
10 3.8 3.8 7.3
100 12 12 23

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DUET DRF Operation Manual

NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic
propagation is affected by absorption and reflection from structures,
objects and people.
For transmitters rated at a maximum output power not listed above, the recommended
separation distance d in meters (m) can be determined using the equation applicable
to the frequency of the transmitter, where P is the maximum output power rating of
the transmitter in watts (W) according to the transmitter manufacturer.

1.6.4 Test conditions

1.6.4.1 Acceptance criteria for immunity tests

The system shall not have any abnormal phenomenon:

- The video image shall be displayed on the screen during the test without interruptions
- Mouse and keyboard shall operate properly
- No exception message shall appear on the screen

1.6.4.2 Cables and accessories

! WARNING

The use of accessories, transducers and cables other than those specified,
with the exception of transducers and cables sold by the manufacturer of the
Duet DRF system as replacement parts for internal components, may result in
increased emissions or decreased immunity of the Duet DRF system”

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 DUET DRF Operation Manual

1.6.4.2.1 Cables list

Port Port Connected Connector Qty Cable Cable

type type
Description From To Type Length

Power AC inlet RCU AC mains Non detachable 1 Shielded 25 m

IEC320-C14
Power AC outlet 1 RCU Splitter 1 Shielded 25 m
Power AC outlet 2 RCU Splitter IEC320-C14 1 Shielded 25 m
Ref monitor IEC320-C14
Power AC outlet 3 RCU 1 Shielded 25 m
terminals
2m
MPU WSM IEC320-C14 UN
Power AC power Splitter 1
ext. Shielded
IRM IEC320-C14 UN
Power AC power Splitter 1 2m
terminals Shielded
5m
Power WSM ext. Splitter WS monitor IEC320-C14 1 Shielded
GND Earth Earth UN
RCU Non detachable 1 25 m
terminal terminal Shielded
GND GND MPU UN
RCU Non detachable 1 25 m
Shielded
20 m
Power DC power RCU CIF DB-9 1 Shielded
20 m
GND GND CIF UN
RCU Non detachable 1
Shielded
20 m
Gen
Control Gen remote RCU DB-9 1 Shielded
terminals
20 m
Control MPU remote RCU MPU DB-9 1 Shielded
Signal Port A Gen 20 m
RCU DB-50 1 Shielded
terminals
Signal Port B Gen 20 m
RCU DB-15 1 Shielded
terminals
Signal Port C Gen 20 m
RCU DB-15 1 Shielded
terminals
Signal Port D Gen 20 m
RCU DB-9 1 Shielded
terminals
Signal Port E Gen 20 m
RCU DB-9 1 Shielded
terminals

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DUET DRF Operation Manual

Port Port Connected Connector Qty Cable Cable

type type
Description From To Type Length

Signal Port IOB-A Gen 20 m

RCU DB-15 1 Shielded
terminals
Signal Port IOB-M Gen 20 m
RCU DB-15 1 Shielded
terminals
Signal Port SPARE Gen 20 m
RCU DB-15 1 Shielded
I/O terminals
Signal Port SP2 Gen 20 m
RCU DB-15 1 Shielded
terminals
Signal Port DCF Gen 20 m
RCU DB-25 1 Shielded
terminals
Signal Port G1 Gen 20 m
RCU HR11-9BR-4S 1 Shielded
terminals
Signal Port G2 Gen 20 m
RCU HR11-9BR-4S 1 Shielded
terminals
Signal Port Rx/Tx RCU MPU ST Fiber optic 25 m
1
Signal Port DAP Not NA NA
RCU DB-15 1
connected
Signal Port TOB Not NA NA
RCU DB-25 1
connected
Signal Port F-1 Not NA NA
RCU DB-15 1
connected
Signal Keyboard Keyboard MPU PS/2 UN 5m
1 Shielded
Signal Mouse Mouse MPU USB UN 1m
1 Shielded
Signal VGA MPU WS monitor HDB-15 Shielded 5m
1
Signal DVI MPU WS monitor DVI Shielded 5m
1
Signal Audio Mic MPU Microphone Jack Shielded 2m
1
Signal USB MPU Speaker USB Shielded 2m
1
Signal Com 1 MPU Termination DB-9 Shielded 2m
1

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 DUET DRF Operation Manual

Port Port Connected Connector Qty Cable Cable

type type
Description From To Type Length

Signal Com 2 MPU Optical

DB-9 1 N/A N/A
converter
Signal Com 3 MPU Splitter DB-9 Shielded 0.1 m
1
Signal Com 4 MPU DAP DB-9 Shielded 10 m
1
Signal USB MPU Hard Disk USB Shielded 1m
1
Signal USB Card reader USB repeater USB Shielded 1m
1
Signal USB MPU Disk on key USB N/A N/A
1
Signal Image data MPU CIF HD-68 Shielded 25 m
1
Signal Video MPU 75 ohm BNC 4 Coaxial 30 m
termination
Signal LAN MPU Termination LAN Shielded 5m
1
Signal Communicati MPU KeyPad 1 Molex 5m
1 Shielded
on
Signal Communicati Molex 30 m
KeyPad 1 Keypad 2 1 Shielded
on
Power / Power/data CIF Camera Header Shielded 0.25 m
1
Signal *
Control Photo sensor CIF Camera Header Shielded 0.25 m
1
Signal AEC CIF 75 ohm BNC Coaxial 30 m
termination 1

Signal Parallel port MPU Termination DB-25 Shielded 2m

1
Signal USB MPU USB repeater USB Shielded 4m
1
**
Signal USB MPU USB repeater USB Shielded 4m
1
**

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DUET DRF Operation Manual

* The cable was covered with shielding braid.

** The cable was replaced with USB cable, model number UE-150, serial number
Z3750020AAP0106.

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 DUET DRF Operation Manual

1.6.4.2.2 Accessories list

Description Manufacturer Model number Serial number

Power Distribution CMT Medical
Duet DRF Prototype
Unit (RCU) Technologies
Main Processing
CPU Intel Duet DRF Prototype
Unit (MPU/PC)
Keypad 1, 2 RAFI RF-15 NA
WS Monitor View Sonic VS10772 PSB054902258
G83-
Keyboard Cherry G0028864
6105LANES/00
Mouse Microsoft XB02382-004 NA
Microphone Silver Line XT-MM201 NA
USB Speaker Logitech S-0194A NA
Hard Disk Western Digital WD16004017-005 WXE407420210
Hitachi-Omron
Card Reader V3TU-FK 060901743
Terminal Solution

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 DUET DRF Operation Manual

2 SYSTEM DESCRIPTION

2.1 General Information

The DUET DRF is a high-resolution digital imaging system designed for digital
spot imaging. It is designed to address R/F and DSA clinical applications and
produce images in digital format. The system is based on a PCI workstation
running Windows XP as its operating system.
The system allows the operator to acquire and display images, in various
resolutions (model dependent) on high-resolution monitors. Computerized
window, image inversion, edge-enhancement, zoom and subtraction features
enable the operator to view diagnostic details difficult to see using conventional
non-digital techniques. Large image sets can be efficiently reviewed and prepared
for archiving and filming using the DUET DRF‘s advanced image manipulation
capabilities.

2.2 System Components

The system comprises of the following main components:

• High-Resolution Dynamic Flat Panel Detector

- Frame transfer with up to 3000 x 3000 matrix size and a 16-bit
digitization depth

NOTE
All images are for demonstrative purposes only.

• System Computer
- PCI bus workstation based on a Pentium CPU
- Proprietary processing and display boards
- Internal hard disk drives
- Standard PC Keyboard and Optical Mouse
• Work-station monitor
- High-resolution, color or monochrome monitor
• In-room monitor

System Description 27
DUET DRF Operation Manual

- High-resolution monochrome monitor

• Keypads
• Laser Imager Interface
- DICOM 3.0 Print protocol
• Reference in-Room Monitor (optional)
- High-resolution 20-inch, b/w monitor
• Fast Network Interface
- DICOM 3.0 Compliant Connectivity services (IHE compliant)
• Additional Hard Disk (optional)

2.3 System Applications

The DUET DRF system simultaneously handles and displays images in

acquisition, viewing, processing and filming applications. All operations can be
applied to images being acquired or retrieved from storage devices.
Available applications are as follows:

Examination Enables different acquisition schemes for

continuous fluoro, single-pulse and pre-
programmed sequences.
Patient Registration Patient data is overlaid on the displayed images.
Archives Manager Selects and retrieves images for the applications,
copies and deletes images on archiving devices.
Processing Enables viewing, processing and manipulation of
images.
Printing Shows the film prior to printing and enables final
film layout and adjustments.

28 System Description
 DUET DRF Operation Manual

In addition, the following programs and accessories serve the main applications:

Graphic Aids Enable addition of text and graphic elements on images.

Windowing Sets the optimal brightness and contrast for the images.
Zoom and Pan Alters the size and position of images on the screen for
optimal viewing.
Filtration Enables different levels of post-processing enhancement
for optimum image quality.
Cine Automatically displays a rapid, continuous sequence of
images.
Save Stores images and studies in archives.
Queue Manager Displays and controls the order and priority of copying
images from one device to another.

System Description 29
 DUET DRF Operation Manual

2.4 Power On Procedure

The System Power ON and OFF procedure is a basic function of the Duet DRF
system, however it is important to power ON the system in the correct order to
enable proper boot-up of the entire system.
1 First apply power to the X-ray generator (if applicable).

2 Press the computer’s “Power On” button and wait till the Duet DRF’s
software loads.
The Duet DRF runs through a start-up sequence program that takes a few
minutes.

NOTE
If an error message is displayed during the start-up procedure, press the Reset
button once. If the malfunction persists, please contact Thales representative.

3 The Duet DRF welcome screen appears and the system runs a self-test.

4 The Duet DRF completes its start-up sequence.

5 The Patient Registration screen appears.

System Description 31
DUET DRF Operation Manual

WARNING
After power up, it is recommended to perform a short Test shot or a quick
fluoroscopy to verify that the hardware performs OK.

NOTE
Images cannot be acquired while the Patient Registration screen is displayed after
start-up.

32 System Description
 DUET DRF Operation Manual

2.5 Power Off Procedure

1 Select Shutdown from the drop down list from the “Main” menu”.

2 The system prompts for shutdown confirmation.

3 Click on OK to confirm.

4 Wait until Shutdown procedure is completed.

5 Log off the computer

NOTES
1. All applications running in the background are cancelled after shutdown
is confirmed.
2. Switch-off the X-ray generator (power supply to the DUET DRF system)
only after the following message appears on the workstation monitor “It
is now safe to turn off your computer”.
3. Always log off properly before shutting down the computer (RED
button)

System Description 33
DUET DRF Operation Manual

2.6 Important Notes Prior to Usage

2.6.1 Equipment Hardware Familiarity

Please note your Duet DRF system configuration (i.e. X-ray Generator, table
footswitch functions and general hardware use in the main imaging suite. It is
important to become familiar with all hardware prior to Duet DRF use to help
expedite procedures and provide optimal patient care and image quality. Your
local installer will be happy to provide you with this information.

2.6.2 Care and Cleaning

All surgical precautions and room cleaning protocols as well as equipment
cleaning and sterilization are the responsibility of the facility in which the
equipment is installed. Please use care when cleaning any equipment. Ask your
local installer about proper maintenance and cleaning of this equipment.

2.6.3 X-Ray Equipment Safety Precautions

Please note this equipment is capable of producing high energy x-rays which
require proper patient and personnel shielding. X-rays are produced under live
fluoroscopic acquisition as well as spot film (still X-ray imaging) acquisition.
Please refer to your local state and federal guidelines as well as consulting with a
Physicist for proper shielding information and advice.

34 System Description
 DUET DRF Operation Manual

3 USING WINDOWS

3.1 Working Environment

The DUET DRF operates under a windows-based mouse-driven graphical user

interface. You can access commands and operations by using the mouse to click
icons, buttons, tool bars, menus, dialog boxes and control panels.
Manipulations and operations in the DUET DRF are generally performed in the
following order:

1. Select the image(s) or other object(s) to be manipulated.

2. Select the operation to be performed.
3. Perform the operation using interactive manipulation.

3.2 Mouse

The mouse is a manual device that moves a pointer, which is used to select
objects on the screen. As the mouse is moved, the pointer follows in the same
direction, allowing the user to navigate through windows, menus and images.
This Operation Manual uses the following conventions for mouse functions:
• Click: Press and release the left mouse button. This is used to select menus
and images and to activate functions from icons.
• Middle-click: Press and drag the middle mouse button (wheel). This is used
to change Windowing contrast and brightness settings.
• Right-click: Press and release the right mouse button. This is used to open
secondary pop-up menus for certain options.
• Double-click: Press and release the left or middle mouse button twice in
quick succession. This is used to activate default operations. For example, in
the Storage Manager application, double-clicking a mini-image displays it in
full size mode.
• <Ctrl>+Click: Press and hold down the <Ctrl> key while clicking an image
or a list item. This allows you to select multiple items simultaneously.

Using Windows 35
DUET DRF Operation Manual

• Drag: Move the mouse while holding down the left or middle mouse buttons.
This is used to perform continuous operations, for example:
• To pan an image, drag the mouse up, down, left or right, using the left
mouse button.
• To select an editable text field, click the text and drag the mouse over the
text, using the left mouse button.
• To change Windowing contrast and brightness settings move the mouse up,
down, left or right, using the middle mouse button.
NOTE
Unless stated otherwise, all mouse operations described in this Operation
Manual refer to the left mouse button.

3.3 Icons

Icons are graphic symbols that represent programs, processes, commands and
devices.
To activate a program, process, command or device represented by an icon, click
the relevant icon.

3.4 Window Structure

The window consists of the following components:

• Applications bar
• Menu bar
• Tools area
• Work area
• Scroll bar
• Status line

36 Using Windows
 DUET DRF Operation Manual

Applications Scroll Bar

Menu Bar

Status line Work Area

Tools
The Applications bar enables the user to switch applications.
The Menu bar contains the menus used to access commands. All available commands
may be selected from menus.
The Tools area contains icons for the most frequently used commands.
The Work area is the large area where images and/or archive data are displayed.
The image Scroll bar along the right side of the working area is used to leaf through the
images.
The Status line, at the bottom of the screen, displays the operations in progress, their
status and short information messages (see Chapter 4)

Using Windows 37
DUET DRF Operation Manual

3.5 Using the Scroll Bar

• To scroll up or down one row of images, click the up or down arrow on the
scroll bar.
• To scroll up or down one page, click the scroll bar anywhere above or below
the slider.
• To scroll to any position, drag the slider in the scroll bar to the desired
position.

3.6 Keyboard

You can use the keyboard to leaf through images and control windowing settings
with the following keys:
To leaf through images:

To adjust windowing values for the active image:

• Use the UP, DOWN, LEFT and RIGHT ARROW keys. The window is
automatically updated on all selected images.

38 Using Windows
 DUET DRF Operation Manual

3.7 Menus

Each window has a menu bar that contains all the functions and operations
available in a particular application.

To open a menu:
• On the menu bar, click the name of the menu you wish to open.
A menu appears with the various commands. It remains open until you click
the desired option.
• If a command appears dimmed, it is unavailable.
• To close a menu:
Click the menu name or click anywhere outside the menu.

3.8 Dialog Boxes

Dialog boxes are used to enter parameter values or display system information.
Dialog boxes appear automatically when certain information is required.
Dialog boxes may include the following elements:
• Check box: Click the check box to select or clear an option. When the option
is selected, the box contains a check mark; when the option is cleared, the box
is blank.
• Text or number field: To enter information, click the field and type in the
information. Use the mouse or ARROW keys to move within a field.

To accept the modifications and close the dialog box:

• Click OK.

To cancel the modifications and close the dialog box:

• Click Cancel or Exit.

Using Windows 39
DUET DRF Operation Manual

4 Status Line and Application Tabs

4.1 Status Line

The status line appears at the bottom of the workstation screen.

The status line consists of the following elements:

a) Status Message
b) Status Indicators:
Appearing on the left hand side of the status line:

• - Photospot acquisition indicator

• - Fluoro acquisition indicator

• - FPD indicator
Appearing in the middle till the right hand side of the status line:

• - Acquisition Console

• - DICOM Store Queue

• - Print Queue

• - Local Storage size

• - Number of suspended patients

40 Status Line and Application Tabs

 DUET DRF Operation Manual

c) - Current Date & Time

4.1.1 Status Message

The status message, located on the left side of the status line, indicates the status,
according to the current operation.

4.1.2 Status Indicators

The status indicators provide useful information regarding on-going background
activities (e.g. Sending images to external storage or printing) and available disk
space. The following indicators are available:
4.1.2.1 Fluoro

The Fluoro icon indicates if fluoro acquisition is active.

A yellow Fluoro icon indicates that fluoro acquisition is inactive.

A highlighted Fluoro icon indicates that fluoro acquisition is active

4.1.2.2 Photospot

The Photospot icon indicates if photospot acquisition is active.

A yellow Fluoro icon indicates that fluoro acquisition is inactive.

A highlighted yellow Photospot icon indicates that photospot
acquisition is active

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4.1.2.3 DICOM Store Queue

The DICOM Store Queue icon indicates the status of background
copy operations.

A red DICOM Store Queue icon background indicates that a

problem has occurred in copying.

Click on the DICOM Store Queue icon to access the Queue Manager
dialog box.
See detailed description in para. 6.24.1.2 (Examination Application)
4.1.2.4 Print Queue

The Print Queue icon indicates print status.

• A red Print Queue icon background indicates that a printing

problem has occurred.

• Click on the Print Queue icon to access the Print Queue dialog
box .
See detailed description in para. 6.24.1.2 (Examination Application)

4.1.2.5 Local Storage Size

The Local Storage Size indicator displays the available
storage capacity on the local disk.
While in Archives or Printing applications, when moving the cursor over the
Local Storage indicator, an enlarged view of the information is displayed.

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• A red Storage icon background indicates that there is not enough available
space on the local disk to perform the acquisition.
• Acquisition remains disabled until adequate space becomes available.
• To free additional disk space, use the Databases delete procedure as described
in Storage and Databases, para 7.3.2

NOTE
Always check available space on the local disk before beginning the
acquisition procedure.

Information regarding image capacity includes number of images that can be

acquired, used disk space and free disk space. This information is updated
automatically.

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4.1.2.6 Number of suspended patients

This indicator shows the number of suspended patients currently

existing in the system.

4.1.3 Date & Time

The current date and time are constantly displayed on the right hand side of the
status line.
When moving the cursor over the date & time area, an enlarged view of the
information is displayed.

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4.2 Application Tabs

The application tabs, located on the left hand side of the screen, enables to easily
switch from one application to another.

Examination: Switches to the Examination (on-line) application.

Archives: Switches to the Archives (off-line) application, which also
enables the Viewing capabilities. The Database application is
also included.
Also includes the Patient Registration application.
Printing: Switches to the Printing application.
Settings: Switches to the Settings application.

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5 PATIENT REGISTRATION

5.1 General Information

The Patient Registration application is used for:
1. Registering a new patient.
2. Registering an urgent patient.
3. Retrieving patient details from the database.
4. Retrieving patient and study details from the Radiology Information
System (RIS) via Modality Work List (MWL) DICOM compliant
server (optional).
5. Managing a prepared Patient List.

5.1.1 Accessing the Patient Registration Application

a) Patient Registration screen is the default screen seen upon program
boot up.
b) The Patient Registration screen can also be accessed from other areas of
the Duet DRF program where the Patient Registration button appears in
the lower right side of the screen. To access Patient Registration screen
Click on the icon.

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c) The screen also automatically opens by pressing the “Close

Examination” button when the previous patient’s examination has been
completed.

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d) To access the Patient Registration application, click on the

button appearing on the bottom left side of the

Examination main screen.

5.1.2 Patient Registration Screen

When activating the Patient Registration application, its dialog-box takes

control over the whole screen, enabling to perform:

a) Manual Registration - see details in par. 5.3.1

b) Urgent Patient Registration - see details in par. 5.3.2
c) Registration using DICOM MWL (Optional) - see details in par. 5.3.3
e) Registration using “Completed” Data Base - see details in par. 5.3.5
f) Registration from the “Suspended” List - see details in par. 5.3.5

To exit Patient Registration (without performing new registration):

Click on the (Exit) on the right-top side of the screen.

• The system returns to the Examination application.
• Current patient data remains unchanged.

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5.2 Patient and Study Data

5.2.1 Patient’s Demographic Information

The Demographic Information includes the following fields:
• Patient ID
• Patient Name: Last Name, Middle Name, First Name, Title and Suffix.
• Date of Birth and Age (It is possible to fill in the Patient’s age and the
date of birth will be updated automatically).
• Gender

NOTES
1. Use the Settings application to determine the mandatory fields in
the Patient Information section.
2. The Patient ID field is always mandatory and must be completed
in order to register a new patient.
3. The order of the Date of birth fields is determined during
installation.
4. Use the <TAB> key or click on the field to move from one field to
the next.

5.2.2 Study Information

The Study Information includes the following fields:
• Technique – determines which examination technique is used (DR, DA,
DSA, RAD)

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• Protocol - this list box determines the protocol APR to be performed

• Additional fields: Operator’s Name, Accession No.,
Study Description, Performing Physician, Referring Physician,
Patient Comment, Medical Alerts

NOTES
The additional fields are non-mandatory.
Use the Settings utility to predefine a list of Study Physicians,
Referring Physicians and Operator’s Name

5.2.3 Other Information

Additional Information may be available (for viewing) via the
button, if the study details are received via the MWL
Server.

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5.3 Patient Registration

5.3.1 Manual Registration

1 Click on the button.

2 All fields for the current patient are cleared.
3 Type the appropriate information in each field, using the <TAB> key to
move between fields.
Patient’s Demographic Information:
a. In the ID field, enter the patient’s identification number
b. In the Last Name field, enter the patient’s family name.
c. In the Middle Name field, enter the patient’s middle name (if they possess one)
d. In the First Name field, enter the patient’s first name
e. In the Date of Birth field:
• In the yyyy field, using 4 digits, enter the patient’s year of birth.
• In the mm field, using 2 digits, enter the patient’s month of birth.

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• In the dd field, using 2 digits, enter the patient’s day of birth.

The patient’s age will automatically be calculated.
f. If necessary, enter the patient’s Title (Prof./Dr./Mr./Mrs/ etc.)
and Suffix (M.D./PhD./etc.)
g. Select the patient’s Gender: Male/Female/Other.
Study Information:
h. Select the required Technique from the drop down list.
i. Select the required Protocol from the drop down list
4 Enter the data (entering this data is optional) as follows:
a Accession Number is automatically set by the system and appears
after registration details are confirmed. A value can also be added
manually.
b In the Study Description field, enter a brief description of the study.
c In the Performing Physician field, select the name of the physician
performing the procedure from the drop down list.
d In the Referring Physician field, select the name of the physician
who referred the patient from the drop down list.
e In the Patient’s Comments field, enter a brief comment regarding
the patient’s condition.
f In the Medical Alerts field, enter any medical alert which is
relevant to the patient and is essential to notify other medical
personnel treating the patient.

NOTE
If the registration is performed via the DICOM MWL, the above
details are automatically filled in by the MWL server.

5 Verify the information and click on the button

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6 When there is a need to register a new patient, clicking on the

button will open the Patient Status dialog box:

7 If the previous patient has completed all required examinations, choose

Completed and then press OK.
8 If the previous patient has not completed all required examinations,
choose In Progress and then press OK;
• The previous patient appears in the Suspended Patients list box.

9 If the previous patient for some reason discontinued the examination,

choose Discontinued and then press OK (only relevant when the
MPPS option is available).
10 The Status of Previous Patient dialog box disappears.
11 The Study application is evoked, ready to acquire images for the new
registered patient.

NOTE:
In order to complete the registration process, necessary information
can added later, by clicking on the button appearing
on the left hand side of the Examination screen.
To modify patient’s information also see “Modifying Patient Data”
(para. 5.3.7)

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WARNING
If the user forgot to register new patient and acquires images, the feature
“Assign Images to another patient” can be used. For detailed explanation, see
para. 7.3.11

5.3.2 Manually registering a RAD Patient

1 Fill in the Patient’s Demographic Details (as described in 5.3.1).

2 Select in the technique field: RAD from the drop down list. The
following screen opens. Note that the Protocol field changes to
Examination:

3 Select a body part region and then click on the desired body part. It will
now be added in the Examination field. Select other body parts as
needed.

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4 After clicking on OK, the window closes and the selected exams appear
in the Examinations field:

5 To remove an exam, move the cursor to the exam name, then click the X

at the upper right hand corner.

6 Click on .

7 The following Examination screen opens. The defined RAD Protocols

appear on the right side of the screen:

5.3.3 Registering an Urgent Patient

The urgent patient option enables to register a patient even if all of the

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patient’s details are not available.

A patient should be registered as an urgent patient when patient
information is unknown or there is insufficient time to complete a full
registration.
Necessary information can be added later to complete the registration
process, by activating the Modify Patient Details functionality.

NOTE
Urgent patient images cannot be transferred to backup devices nor to
the DICOM Storage server, before Patient details are updated.

To register an urgent patient:

8 Click on the button.

9 The urgent patient is assigned a temporary ID of the format

URGENTMM/DD/YY-INDEX

10 The system will define a general DR study.

11 The system is ready to acquire images for the new patient.

12 To modify Patient information see “Modifying Patient Data”(para.

5.3.7)

5.3.4 Registration using DICOM Modality Work List (MWL)

If DICOM Work List is available:
1 Click on the tab in the Patient Registration screen to
retrieve the MWL.

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The following window will open on the left side of the Patient Registration
screen:

2 Click on the button to query the Work list server by the

default query criteria.

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NOTE
The Search By button may be used to modify the default query criteria.

The following criteria may be selected:

• Station ID (default: Current Station)
• Modality (e.g. RF, XA)
• Date range for the query (default: Today)
• Patient ID
• Patient Name
• Accession Number

3 The results that match the query criteria are displayed.

Sorting the list according to any of the displayed criteria is available by
clicking on the appropriate title.
4 Select a single entry by double-clicking its line. The details of the
selected entry appear on the right side of the Patient Registration
screen.
5 The selected entry may be added to the “to do” list by clicking the
button.
6 If a single new patient / study is selected as described in (4) above,

verify the information and click on the button.

7 If the button is being used, close the tab
by clicking on the tab and select a new patient from
the list.
8 The order of the columns in the table can be changed by pressing on the
column’s header and dragging it to the desired location.
9 The table can be sorted any single column. Clicking on the column’s
header will sort it A to Z. Clicking again will revert the order from Z to
A.

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5.3.5 Registration using History Data Base (Completed)

1 Click on the tab.

The following dialog appears on the left side of the Patient Registration
screen, enabling searching in the History (Completed) database for
patients that were examined on this system:

2 Fill in the searching criteria and press the button.

The search results appear in the list.

3 Select a patient as described in the previous paragraph (step 4).

4 The order of the columns in the table can be changed by pressing on the
column’s header and dragging it to the desired location.
5 The table can be sorted any single column. Clicking on the column’s
header will sort it A to Z. Clicking again will revert the order from Z to
A.

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NOTES
• When receiving details from the Work list server, the patient’s demographic
data cannot be modified manually.
• Before adding a patient to the list, the Duet DRF checks that a patient with
the same ID and Accession number does not already exist in the list (including
the currently examined patient). Should this be the case, the following
warning message is issued:
A patient with the same ID exists in database. Please confirm additional
registration.
• Once a new patient has been registered, acquired images for the previous
patient can no longer be reviewed on either the in-room monitor or the
workstation monitor from the Examination application.
• Patient registration cannot be confirmed during acquisition.
• Patient registration cannot be confirmed unless all mandatory fields have been
completed.

5.3.6 Registration from the “Suspended” List

To select a patient from the “Suspended” list:

1 Double click on the patient name in the list; the patient’s name is
selected and the patient’s data appears in the Patient Information
section.
2 Verify the patient’s data

3 Click on the button to register the patient.

4 The order of the columns in the table can be changed by pressing on the
column’s header and dragging it to the desired location.

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5 The table can be sorted any single column. Clicking on the column’s
header will sort it A to Z. Clicking again will revert the order from Z to
A.

5.3.7 Modifying Patient Data

To modify data for the current patient:

1 Click on the field to be modified.

2 Select the text to be modified and type in the new information.

3 Verify the information and click on the button.

NOTES
• Changing the patient ID will result in the registration of a new patient.
• Modifications to the patient’s name, date of birth or gender will
automatically be recorded and displayed on all acquired images for the
selected patient.
• If the patient details are received from the Work list server, some details
cannot be modified manually.

5.4 Managing a Prepared Patient List (A Waiting List)

A Patient List can be prepared in advance by entering the data into the
Patient’s List.
Preparing a list in advance eliminates the need to register each patient
during the procedure, thereby saving time and increasing the overall
throughput of the operation room.

5.4.1 Adding a Patient to the List

There are two options of adding a patient to the list:

5.4.1.1 Manual adding a patient to the list

1 Click on the button; all fields for the current patient are
cleared.

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2 Fill in the appropriate information for each field. All mandatory fields
must be completed.

3 Verify the information and click on the button.

4 Patient details will be displayed in the list on the left side

of the screen.

5.4.1.2 Adding a patient using MWL (Modality Work List)

1 Click on the button. The patient work list will

appear.

2 Highlight the relevant patient and click on the button.

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NOTES
• Clicking on Exit [X] will result in exiting the Patient Registration
screen.
• Current patient data will relate to the last patient registered.
• Patients added to the list are not yet registered.

5.4.2 Selecting a Patient from the List

To select a patient from the list:

1 Click on the tab. A patient list will open.

2 Double click the patient name in the list; the patient name is selected
and patient data appears in the Patient Information section.
3 Verify the patient data.

4 Click on the button to register the patient.

5.4.3 Removing a Patient from the List

To remove a patient /patients from the list:

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1 Click on the patient’s name from the list. The patient’s name is
highlighted. Multiple names may also be selected by using a
combination of the left mouse buttons with “ctrl” / “shift” keys.

2 Click on the button and confirm the operation.

NOTE
Patients are automatically removed from the prepared Patient List when
they are registered.

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6 EXAMINATION SCREEN (Acquisition and Fluoroscopy)

The Examination application enables the user to view and manipulate acquired
Fluoroscopy and pulsed Radiography images.

NOTE
The Examination application is always available to the in-room operator (as
long as a patient is registered). The in-room monitor and the in-room keypad
enable the user to acquire images independent of the process being performed
at the workstation.

6.1 Accessing the Examination Application

The Examination application is the Duet DRF’s main working area.

The Examination screen automatically evokes when pressing the

button in the Patient Registration application.

To access the Examination application when another application is being used,

click on the tab on the upper left side of the screen.

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When Examination application is first opened after login, the default status is set
to Fluoroscopy with single-pulse acquisition enabled (the One Shot button is
selected) for DR technique and Sequence is enabled for DA/DSA technique.
The in-room monitor, as well as the working area of the workstation monitor, are
cleared and current patient data is displayed.

NOTES
1. Update the relevant patient information before starting the
Examination procedure.
2. Make sure there is sufficient local disk space prior to starting the
Examination procedure.

NOTE
Unless stated otherwise, all operations descriptions refer to the
workstation.

NOTE
Operator must be aware that images taken in conditions different than
those used for system calibration might show some image quality
degradation compared to the optimal conditions. Those conditions
include, but are not limited to, grid position, table tilting and source to
patient distance.

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6.2 Exposure Settings for Radiographic Generator and Fluoro

Settings

When choosing the button on the bottom toolbar, a dialog box with
acquisition control options will be displayed:

Pressing on the Generator option will open a virtual generator console, which
will give options for generator control changes for exposure:

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In this console, the generator parameters may be changed for the current
examination.
On the right-hand side of the screen, a virtual image acquisition keypad is
displayed. Pressing on the Image Control tab will open a virtual keypad, which
allows controlling image acquisition from the remote console.

6.3 Image Left/Right Labeling

This feature enables the Left or Right labeling of all acquired images.
To activate the image labeling feature

Click on the Processing menu Notes Insert Left or Right mark. A large
blinking L (or R) message appears on the main in-room monitor, indicating that
all new images will be marked with the L (or R) message respectively.
When acquiring a new image, a large L (or R) message is displayed on the image.
Labeling is maintained when images are transferred to other applications or to
other devices, and when images are printed.

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NOTES
You can also use the keypad to set the L (or R) labeling by pressing the

NEXT ( ) or PREVIOUS ( ) keys (see para. 6.30.1.5).

To clear the L (or R) labeling, use the Graphics menu in the Viewer and Film
Previewer applications.

6.4 Application Tabs

Examination - Activates the Examination (on-line) application screen.

(also includes the Patient Registration)

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Archives - Activates the Storage (off-line) application screen

Printing - Activates the offline Printing application screen
Settings - Activates the Settings application screen

NOTE:
The Application tabs are highlighted when the applications are activated.

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6.5 Current Technique and Protocol Parameters

6.5.1 Technique Type

This drop-down menu enables re-selection of the acquisition technique for the
current session.
Four techniques are available for digital radiography acquisitions
DR Fluoro and single pulse acquisitions.
(Digital Radiology) Non-subtracted sequences can also be
performed.
DA Fluoro and non-subtracted sequence
(Digital Angiography) * acquisitions. Single acquisitions can
also be performed.
DSA Fluoro and subtracted sequence
(Digital Subtracted Angiography) acquisitions. Single and non-
* subtracted sequence acquisitions can
also be performed.
RAD Single pulse acquisitions.

* Optional - available only in systems equipped with the Angio package.

6.5.2 Protocol
The preset study protocols for each available technique allow you to store
frequently repeated imaging parameters. This allows optimization of the imaging
technique and a specific anatomic view. Preset study protocols maintain full
control setting reproducibility and allows the efficient use of equipment and
personnel.
Different protocols can be prepared in advance, according to the anatomic area
examined, patient size, physician preference, etc. and programs can easily be
modified to suit your requirements.

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Parameters that may be preset for each different anatomic area are:
• Image level
• Edge enhancement
• Auto windowing/Manual windowing
• RBW – Reversed black & white
• Recursive filter
• Gamma correction
• DCF – Digital compensation filter

To program parameters for protocols see “Settings”, para. 9.3

6.5.2.1 Select Protocol
This drop-down menu enables selection of other defined protocols for the current
session.
6.5.2.2 Edit Protocol
This drop-down menu enables editing of the selected protocol for the current
session. For more details regarding editing protocols, see 9.3.1 (in Settings
Chapter).
6.5.2.3 Choosing the Protocol
The protocol is selected during Patient Registration but may be changed in
Examination application, before acquiring an image.
To change the protocol selection while in Examination application:

1 Open the Protocol list, located on the right side of the screen, by clicking the
arrow for a few seconds.

2 Scroll through the list of preset protocols.

3 Select the preferred protocol.

NOTE
The protocol type cannot be changed while acquiring an image.

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6.5.2.4 Changing the Current Protocol Parameters

You may change the current protocol parameters during the protocol.
In order to modify the current protocol parameters:

1 On the tool bar, click once quickly on the

protocol button; the Edit Protocol Type small screen will open:

NOTE
For further details regarding editing protocols, see 9.3.1 (in Settings Chapter)

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2 Select the box of the value to be modified.

3 Type or select the new value
4 Click OK to confirm the change or click Exit to return to the Examination
screen without modifying the current study

NOTES
1. Modifications made to the current study’s protocol are temporary.
On new patient registration or re-selection of this study, the original
protocol values are restored.
2. To permanently set up the protocol parameters, use the Settings
application.

6.6 Fluoroscopy Acquisition

This feature enables setting the desired parameters for fluoroscopy acquisition of
1024 x 1024 images at a rate of 30 frames per second, using the Fluoro-switch.
Activating the Fluoro-switch enables real-time Fluoroscopy images.
Acquired Fluoro images are displayed on the in-room monitor only. When the
Fluoro-switch is released, the last image acquired remains on the in-room monitor
(LIH).
Activating the Fluoro-switch enables real-time noise reduction. Different levels
of noise reduction can be applied to the acquired Fluoroscopy images (see
Settings application).
Acquired spot pulse images are automatically stored on the system’s hard disk,
regardless of the application active on the workstation.

Upon completion of acquisition the images may be processed and sent to PACS
or Print unless it was set to automatic sending to the PACS server.

NOTE
When the Fluoro-switch is activated, the Fluoro icon on the status line is
highlighted.

6.6.1 Saving Fluoro Images

Prior to activating the Fluoro Store option, click on the tab

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located on the right side of Examination screen.

Fluoro images can be saved on the system’s hard disk during or after Fluoro
acquisition.

Press the Save LIH key on the keypad. The LIH image is saved as a
standard single image.
To save sequence of fluoro images:

1 Press on the tab and then on the to activate the

Fluoro Store function.
2 During the procedure, press on the Save LIH key
3 The Fluoro images will be stored on the local disk as a sequence.
6.6.1.1 To save real-time Fluoro images
Determine the acquisition rate of the Fluoro images in the Edit Fluoro
Sequence dialog box.
1 Select the desired Fluoro Store parameters.
2 Click OK to confirm the selection.
3 During Fluoro, press the LIH key.
4 There are two types of F-Rec:
a) Prospective – Saves from the next acquired fluoro image (from moment
of flouro activation) as per the selected parameters (no. of frames and
duration.
b) Retrospective – Saves from last acquired fluoro image (from moment
of fluoro activation), as per the selected parameters (no. of frames and
duration).

NOTES
1. The Fluoro acquisition rate message appears on the in-room monitor
above the Fluoro-on icon .
2. To abort the Fluoro image acquisition, release the Fluoro switch.

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6.6.2 To save real-time Fluoro images (Roadmap)

Click on the key to activate the roadmap protocol. The following

small screen opens:

The message ‘Ready for Roadmap phase I’ is displayed on the main in-room-
monitor.
1 Click on Roadmap drop down box to select the desired Roadmap protocol.

2 Click on the Delete Mask button to delete the mask image

3 Clicking on the Edit button opens the following small screen:

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Click on OK to confirm changes.

Mask acquisition is performed during the next activation of the fluoro-switch.
When you release the fluoro-switch, the mask image is displayed in the non-
subtracted mode and the ‘Ready for Roadmap Phase II’ message is displayed.
The resulting mask is used during the reminder of the procedure.
When fluoro exposure is re-applied, the mask is subtracted, in real-time, from the
incoming fluoro images. The resulting subtracted images are displayed on the
main in-room-monitor. When you release the fluoro switch the subtracted
roadmap image along with the message ‘Ready for Roadmap Phase II’ are
displayed.
At this stage of the protocol the RAW/SUB key enables the user to toggle
between live and subtracted images.

NOTE
To permanently set up the Roadmap parameters, use the Settings application,
para. 9.3.1.4

6.6.3 Fluoro Real time Tuner

To access the Fluoro Real Time Tuner, click on the icon at the bottom of
the Examination/Archive screens. The following window will open:

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- Changes the Fluoro values of the current protocol.

- Saves the current image from the in-room monitor

- Exits to Examination screen without saving changes.

6.7 Spot Pulse Acquisition

6.7.1 Digital Spot Pulse Acquisition

This feature enables the acquisition of high-resolution 1024 x 1024 images, using
the exposure button/foot switch.
All spot pulse images acquired are displayed on the in-room monitor and in the
Study application screen on the workstation monitor, if the Examination
application is active.
Acquired spot pulse images are automatically stored on the system’s hard disk,
regardless of the application active on the workstation.

NOTE
When the exposure button is activated, the Photospot icon on the status
line turns highlighted yellow.

6.7.1.1 Single Pulse Acquisition (One Shot)

Activating the exposure button in this mode acquires a single image.

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To perform a single acquisition:

1. Click on the button.

NOTE
The single Acquisition mode can also be selected from the keypad

2. Activate the exposure button. Status messages on the in-room monitor and
the workstation monitors indicate that single pulse acquisition is activated.
6.7.1.2 Sequence Acquisition
Activating the exposure button in this mode will acquire a pre-programmed
number of images.
To perform a sequence acquisition:

1 Click on the button. The sequence name appears on

the in-room monitor.
NOTE
The sequence acquisition mode can also be selected from the keypad

2 Click on the drop down menu for

a few seconds to select the desired name for the current sequence.
3 Verify the validity of the timing parameters displayed in the Phases Table,
located on the right side of the Examination screen.
4 Activate the exposure button. Status messages on the in-room monitor and
the workstation monitor indicate that the sequence acquisition is activated.

6.7.1.2.1 Current Sequence Editing

Any number of sequences can be pre programmed (see “Settings”, para. 9.3.2).
To modify the current sequence displayed in the Sequence list:

Click once on the button. The Edit Sequence

Screen will open:

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1 Modify the values in the Phases table and click OK to save the changes or
Cancel to abort the changes.
2 Clicking on the Clear button enters default values in some of the editable
boxes and clears the Phases table.

NOTES
The modifications made to the sequence are valid only for the current session.
It will not be possible to modify the current sequence while sequence
acquisition is active.

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6.8 RAD Protocol

The RAD protocol enables acquisition of radiographic single images, for general
radiography and orthopedic applications.
After selecting the RAD technique during Patient Registration, the following
Examination screen opens: 1

4
1 Clicking on the one of the 5 patient size indicators chooses the exposure
conditions based on patient size selection (infant, child, thin, normal, large):

2 Clicking on the button enables to edit the parameters of the

current protocol.

3 Clicking on the button open the skeleton image, in order to enable

adding body parts to the examination (see section 5.3.2)
4 It is possible to manually change radiations levels appearing on the right hand
bottom side of the Examination screen.

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5 After acquiring an image, a √ mark will appear next to the protocol tab
indicating that the exposure has already been taken.

6 An image can be rejected (from the Examination screen only) by clicking on

the button appearing under the skeleton figure. A big red X will
then appear on the image. The image can also be rejected from the Selection
Menu (see section 6.24.2.4).
Clicking on the Reject from the Selection Menu (section 6.24.2.4), opens the
Image Reject Reasons window. Select the suitable reject reason from the drop
down list and click on OK.

Clicking on Custom opens a field in which the technician can manually add a
reject reason.

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6.8.1 Accept/Reject Mode

If RAD Accept/Reject mode is enabled, the following screen will appear after
acquiring an image requesting to Accept/Reject image and will not allow any
further acquisition.

Clicking on the Reject button forms a red X on the image

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At the same time, if “Automatically use default text” is marked in Reject Reasons
screen, a default reject reason is chosen and appears in the reject analysis reasons
which can be accessed from the Main menu, which requires an authorized
password. Once an image is rejected, it cannot be unrejected.
After the acquisition, the Tools tab is enabled. Before Accept or Reject, the
image may be processed, text may be added, etc.

6.8.2 Direct Mode

The Direct Mode enables operation of the X-ray generator exposures, while the
flat Panel Detector of Duet DRF is inactive. This allows for exposures for
devices such as a CR cassette. When the Direct Mode is activated, images will
not be acquired by Duet DRF. The generator’s X-ray settings can still be
determined by the Duet DRF X-ray control box.
To enable the Direct Mode, simply click on the Direct button

Note: the Direct Mode button appears only if enabled in the system’s settings
application. See section 9.3.1.4.

To return to the normal RAD mode, click on the Main button.

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6.9 CINE Mode

The CINE mode enables replay of images sequences that were acquired by Duet
DRF.
The Cine control box appears in the left hand upper side of both the Examination
and Archive screens.

1 The Sequences acquired appear in a folder / file hierarchy type. Clicking on the
folder icon loads the images onto the application and opens the sequence steps
list. Clicking on the Play button replays the entire sequence (or sequence step)
at the Live speed, which is the actual acquisition speed. The Play button will now
change to a Pause button . Pressing on the Pause button will pause the CINE
replay.

2 When CINE loop is running, drag the slider at the

bottom of the box right or left to speed up or slow down the replay speed.

3 To return to the acquisition speed, press the Live button

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6.10 DSA Mode

The DSA Mode can be activated only after the CINE Mode has been activated.
Click on the button (located on the top right side of the
Examination screen) to access the DSA Mode.

6.11 Test Shot Activation

NOTES
The sequence acquisition process is terminated when the exposure button is
released.
During a multi-step sequence acquisition, pressing the TEST SHOT / NEXT

STEP key on the keypad or pressing <CTRL>+<ENTER> on the

keyboard will cause the system to jump to the next sequence step, regardless
of whether the current step has not been completed.

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6.11.1.1 Test Shot

For best results, a test shot should be performed before performing sequence
acquisition of a large set of images. This procedure will guarantee optimum
quality of the acquired sequence images.
To perform a test shot while in sequence acquisition mode

1 Select a pre-programmed sequence that includes test shot.

-or-
If a sequence which does not include a pre-programmed test shot was selected,
select the Test shot button on the right side of the Examination screen or press
the TEST SHOT key on the keypad.
2 After the test shot option has been selected, status messages on the in-room
monitor and on the workstation monitor indicate that the system is in the
“Ready for Test shot” acquisition mode.
3 Activate the exposure button to acquire a single image.
4 Release the exposure button. The system enters the “Ready for Sequence”
mode and, the Test Shot Evaluation screen appears

The system automatically calculates and displays the histogram of a default

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Region Of Interest (ROI) covering 50 percent of the height and width of the
image.
• To change the size of the ROI, click and drag the handles that appear near the
outline of the ROI.
• To change the position of the ROI, click and drag it.
Following the ROI histogram calculation, the system determines the setting for
optimum image quality. The system repeats the calculation each time the
position, shape and/or size of the ROI is changed.
For X-ray systems equipped with Automatic Exposure Control (AEC) the DUET
DRF automatically determines the setting for optimum image quality.
For X-ray systems without the AEC option, the DUET DRF determines the
recommended mAs setting for optimum image quality.

NOTE
Verify that the generator’s AEC is disabled when selecting any of the five manual
exposure controls, and that the generator’s mAs and II settings correspond to the
values programmed in the sequence.

NOTE
The operator is responsible for setting the X-ray generator to the recommended mAs
value. Be aware that the system does not check the accuracy of the mAs setting.

The following operations are available from the Test shot evaluation screen
• Click OK to return to the Examination screen, with the system ready to
perform sequence acquisition using the test shot results.
• Click Additional Test shot to return to the Examination screen, with the
system ready to perform an additional test shot using the test shot results.
• Click Cancel to return to the Examination screen, with the system ready to
perform a single acquisition. The overall sequence procedure is cancelled.

• In case of image overexposure, Overexposure message appears on the image.

The message appears blinking on the in-room monitor.

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Click Additional Test shot to perform another test shot.

-or-
Click OK to perform the sequence acquisition.
• In case of image underexposure, Underexposure message appears on the
image. The message appears blinking on the in-room monitor .
Click Additional Test shot to perform another test shot.
-or-
Click OK to perform the sequence acquisition.

NOTE
Pressing the exposure button while in the Test shot evaluation screen will result in
the acquisition of the pre-programmed sequence using the test shot results.

6.12 Single Image Selection

Clicking on the button enables to select a single image

6.13 Multi Image Selection

Clicking on the button enables to select several images.

6.14 Selection of All Acquired Images

Clicking on the button enables to select all acquired images.

6.15 Graphics

Clicking on the button enables to activate the graphics application

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6.16 Screen Layout

The following buttons enables selection of the desired screen layout:

a) Clicking on the button enables 1x1 screen layout

b) Clicking on the button enables 2x2 screen layout.

c) Clicking on the button for a few seconds opens the following

button, which enables to select the desire screen

layout by pressing on the arrows and clicking on the Apply button.

6.17 Previewing Images Prior to Printing

Clicking on the button will open the following Preview

screen, displaying the selected images:

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Clicking on returns the user to the Examination/Archive screens.

For detailed explanation on how to print from the Preview application, see section 8.2.

6.18 Printing through the default printer

Printing through the default printer is available from both the Examination and the

Archive screens. Pressing will send the selected images to

the default printer, using the default layout. The images are not previewed when
using this function.

6.19 Add to Clipboard

The Clipboard feature is a preview screen, which enables to select specific

images, and then view them, perform the Post-Processing and other required
operations. As opposed to the standard multi-image display screens, the
Clipboard features minimizes the number of images displayed, thus enables

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focusing on specific images. Printing can also take place from the Clipboard
screen.

In order to add images to the clipboard, from the Examination/Archive screens:

1 Check the box on the top left side of the required images.

2 Click on the button on the left side of the screen.

Only the selected images will now be displayed:

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NOTE: The image can also be added to the clipboard or removed from the
clipboard via the Selection menu:

To exit the Clipboard press the button.

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6.20 Exporting Images

1 Clicking on the button will open the following dialog box:

2 Select the desired image(s) to be exported to the external device and click on
OK to confirm.

6.21 Close Examination

The button enables to determine the Patient’s status:

Completed/In progress/Discontinued

1 Clicking on the Close Examination button when registering an Urgent patient

opens the following dialog box:

Confirming changing patient status closes the current examination.

2 Clicking on the Close Examination button opens the following dialog box:

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For further details, see “Patient Registration”, page 54

6.22 Patient Registration

This button activates the Patient Registration Application. For detailed description
see Chapter 5, Patient Registration.

6.23 Patient Details

The patient details are displayed on the upper left part of the screen.

Upon pressing the button, a detailed view of patient information is

displayed:

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NOTE
The above details can be viewed but not modified.
Use the “Modify Details” function in Archives application for that purpose.

In order to close the Patient Details, press on the button.

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6.24 Examination Screen Menu Bar

The examination screen Menu Bar includes the following tabs:

• Main
• Selection
• View
• Processing
• FPD Handling
• Help

6.24.1 Main

The Main menu includes the following management commands:

6.24.1.1 Go to

Go to enables activating one of the following applications:

• Patient Registration
• Archives

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• Printing
• Settings

6.24.1.2 Queue Manager

The Queue Manager is used to monitor and modify progress of the background
copying processes.
Clicking on Queue Manager opens the following Queue Manager dialog box:

• All available devices appear on the Queue Manager screen as tables. Click on
the desired tab to move from one device to another.
• A Job is a list of images that are sent to the Queue Manager and are in process
of being copied or placed in a hold status.
• Job Process displays selected images that were sent to the printer.
• Current Job displays all listed jobs that are to be printed.
• Saved Jobs displays all listed jobs that are in hold mode waiting to be printed.

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The following commands are available for jobs listed in the Current Jobs Queue

• Up - Moves a selected job up, to be copied before others in the queue.

• Down - Moves a selected job down, to be copied after others in the queue.
• Remove - Removes a selected job from the queue.
• Hold - Saves a selected job, in the Saved Jobs queue, to be copied later.

The following commands are available for jobs listed in the Saved Jobs Queue:

• Repeat - Restarts the copying process for a selected job that was on hold.
• Remove - Removes a selected job from the queue.

The following commands are available for the selected device:

• Pause - Temporarily interrupts the copying process of a selected job.

• Remove all - Removes all jobs from the current queue device(s) and Saved
Jobs queue.
• Continue - Resumes a copying process that has been interrupted.

The following operations are available for all devices:

• Pause all - Temporarily interrupts all copying processes for all devices.
• Continue all - Resumes all copying process that have been interrupted.
• Status - Indicates the status of the device to which an image has been copied.
• Exit - Closes the Queue Manager dialog box.

NOTE
The Queue Manager can also be activated by clicking either on the

or the buttons. (see Chapter 4 Status Line)

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6.24.1.3 Additional Storage Device

Selecting Additional Storage Device is available only when the External Hard
Drive option is installed. It enables operations for that device
6.24.1.4 Export Selection
Export Selection enables to manually choose a destination for images (stitching,
PACS storage device, etc.)
6.24.1.5 Examination

Selecting Examination enables two options:

• Suspend - Suspends the current examination
• Close - Closes the current examination
6.24.1.6 Pixel Spacing
Selecting Pixel Spacing will open a window that enables to set the physical size
of an image pixel, by typing the Table Top to Patient Distance. It is used for
cases like True Size printing.
6.24.1.7 Shutdown
Selecting Shutdown starts the shutdown procedure (for more details, see Power
Off Procedure, page 33)

6.24.2 Selection
The Selection menu includes the following commands

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6.24.2.1 Single Select

Single Select enables to select a single image.
6.24.2.2 Multi Select
Multi Select enables to select several images.
6.24.2.3 Select All Images
Select All Images enables to select all the images.
6.24.2.4 Selected Images

Selecting Selected Images will enable the following options:

• Reset to Acquired – Resets the selected image(s) to the acquired image(s)
• Save - Saves the selected image(s)
• Reject – Rejects selected image(s) for RAD patients only (appears only for
RAD images)
• Set as Representative – Sets the selected images as representative images (in
Cine Mode)
• Send to Printing - Adds the selected images to the “pending to print” list, for
offline printing purpose. See section 8.3
• Print - Sends selected image(s) to pre-defined DICOM printer
• Send to Storage Server - Sends selected image(s) to pre-defined DICOM
• Delete Selected – Deletes the selected image(s)

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• Send to Reference Monitor – Sends selected image(s) to reference monitor.

6.24.3 View
The View menu includes the following commands:

6.24.3.1 Information

Selecting Information enables three options:

• Patient Information - view of patient details (See para. 6.23)

• Visit Information – view details of patient’s visit. Selecting this opens the
following window (NOTE: Visit information can only be displayed via the
View Menu):

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• Image Information - view the selected image(s) information (See para. 6.26)

6.24.3.2 View Screen Layouts

a. View Format enables the selection of 1X 1 and 2X2 screen layouts.

b. User Selection – Can be defined from Settings application (View Definitions,
Default Screen Layout)
Clicking on the enables the user to select the desired screen
layout.

6.24.3.3 View Multi Format

Selecting Multi Format enables the following format options:

• 2 narrow
• 2 wide
• 3 narrow
• 3 wide
• 4 div.

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• 6 div.
• Ungroup

6.24.3.4 Sub Frame Mode

The Sub Frame Mode is available for sub-divided images only, in order to enable
operations on each sub-divided image separately

6.24.4 Processing
The Processing menu includes the following commands:

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6.24.4.1 Windowing

Selecting Windowing enables the following operations:

• RBW - Inverts gray levels of the selected image(s).
• Reset – Resets the parameters of the selected image(s) to the initial state.

6.24.4.2 Zoom
The Zoom sub-menu includes the following commands for magnifying a
displayed image:

• Apply - Applies the zoom factor to the selected image(s).

• X 1.25 - Magnifies the displayed image by a factor of 1.25.
• X 1.5 - Magnifies the displayed image by a factor of 1.5.
• X 1.75 - This mode magnifies the displayed image by a factor of 1.75.
• X 2- This mode magnifies the displayed image by a factor of 2.

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• X 2.25 - This mode magnifies the displayed image by a factor of 2.25.

• X 2.5 - This mode magnifies the displayed image by a factor of 2.5.
• X 2.75 - This mode magnifies the displayed image by a factor of 2.75.
• X 3 - This mode magnifies the displayed image by a factor of 3.
• X 3.25 - This mode magnifies the displayed image by a factor of 3.25.
• X 4 - This mode magnifies the displayed image by a factor of 4.
• 1 : 1 - This mode displays the real size of the image.
• Remove – Remove zoom factor from selected image(s).
6.24.4.3 Magnifying Glass
Magnifying Glass activates a local zoom, which can be moved across the image
to magnify a desired area.
6.24.4.4 Pan

Selecting the pan mode enables movement of the image so that the feature of
interest can be centered in the image frame.
Drag the image in the desired direction using the left mouse button.
Selecting Pan will enable two operations:
• Apply - activates the Pan mode.
• Remove – Exit from pan mode and returns to the original pan settings.

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6.24.4.5 Rotate/Flip

Selecting Rotate/Flip will enable the following operations:

• CW – Rotates the selected image(s) clockwise by 90 degrees.
• CCW – Rotates selected image(s) counter clockwise by 90 degrees.
• Up/Down – Flips the selected image(s) vertically.
• Left/Right – Flips the selected image(s) horizontally.
• Remove – Removes Rotate/Flip and returns to the original settings of
the selected image(s).
6.24.4.6 Shutters

Selecting Shutters will enable the following operations:

• Apply – Apply shutters to the selected image(s)
• Remove – Remove shutters from the selected image(s)
6.24.4.7 Notes Text Size

Selecting Notes Text Size enables to enlarge / reduce the font size of the
selected text. Each press on Notes Text Size cyclically enlarges the font size.

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6.24.4.8 Notes

Selecting Notes enables the following operations:

• Insert L Mark or Insert R Mark - This feature enables the Left or Right
labeling as of next acquired image.

NOTES
You can also use the keypad to set the L (or R) labeling by pressing

the NEXT ( ) or PREVIOUS ( ) keys. (see para. 6.30.1.5)

To clear the L (or R) labeling, see Delete Graphics, Notes

• Insert Text - Enables writing free text on the image:

After activation of the function, place the
cursor at the desired position on the image,
click on the left mouse button and write the
text.
• Insert Line - Enables drawing a line on the image:
After activation of the function, place the
cursor at the desired position on the image,
click on the left mouse button and draw the
line.

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• Insert Distance Line - Enables drawing a distance line on the

image: After activation of the function, place
the cursor at the desire position on the
image, click on the left mouse button and
draw the distance line.
• Insert Arrow - Enables drawing an arrow on the image:
After activation of the function, place the
cursor at the desired position on the image,
click on the left mouse button and draw the
arrow.
• Insert Ellipse - Enables drawing an ellipse:
After activation of the function, place the
cursor at the desired position on the image,
click on the left mouse button and draw the
ellipse.

• Insert Angle - Enables drawing an angle.

After activation of the function, place the
cursor at the desired position on the image,
click on the left mouse button and draw a
line, then, a second one. The angle between
the two lines is automatically calculated and
displayed.
• Insert Rectangle - Enables drawing a rectangle.
After activation of the function, place the
cursor at the desired position on the image,
click on the left mouse button and draw the
rectangle.

• Distance Calibration - Draws a line and calibrate its true length.

• Reset Distance Calibration – Resets the distance measurement
• Hide Notes - Temporarily hides notes in order to enable
clear view of the image
• Remove All Notes - Removes all graphic elements.

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6.24.4.9 Filters

Selecting Filters enables to apply several different types of filters on the

selected images:

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• Edge applies edge enhancement filters.

To apply an edge enhancement filter to images:

1 Select the images.

2 On the Processing menu, click on Filters, then on Edge and select the
appropriate filter; All selected images are processed accordingly.

• Smooth applies smoothing filters.

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To apply a smoothing filter to images

1 Select the images.

2 On the Processing menu, click on Filters, then on Smooth and select the
appropriate filter; All selected images are processed accordingly.

NOTE
Only one Filter, either Edge or Smooth may be performed on an image.

• DRC (Digital Range Compression Filter) – applies Digital Compression

Filter (DRC).

To apply a DRC to images

1 Select the images.

On the Processing menu, click DRC.
2 Select the appropriate filter and compression type and click on Apply and
then on OK to close the dialog box and process the active image.

• Remove Filters – cancels edge enhancement and smoothing filters that have
been applied to images.

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To cancel the edge and smoothing filters

2 Select the images.

3 From the Processing menu, click Remove Filters.

6.24.4.10 ROI Analysis

1 Click on the ROI Analysis to set the function
2 Draw square on the image on the desire location
3 The image ROI parameter will be displayed on the image
4 To clear the ROI parameters select the delete graphic function

6.24.5 FPD Handling

If during acquisition there is decrease of image quality, select the correct mode to
perform offset calibration only to requested modes. The calibration will take
couple of seconds and maybe perform during examination
6.24.5.1 Offset Current Mode
Selecting the Offset Current Mode performs FPD offset only for the current
active mode
6.24.5.2 Offset Selected Parameters
Selecting the Offset Selected Parameters enables performing FPD offset only to
the selected modes
6.24.5.3 Offset All Modes
Selecting the Offset All Modes performs FPD offset to all available modes
6.24.5.4 Reset FPD
Resets the Flat Panel Detector.

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6.24.6 Help

About – Displays version information

6.25 Series List

Can be seen on the left side of the Examination:

Displays the list of the series of the current study.

6.26 Basic Image Information

1 Image information can be seen on the left side of the Examination screen:

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This screen provides details regarding the acquired image(s) such as: date,
time, study type, size.
2 The following Backup Device Indicators appear on the bottom of the
screen:
Print - Highlights when the image(s) have been sent to DICOM
Printer.
Store - Highlights when the images) have been sent to DICOM
storage device.
Device - Highlights when the image(s) have been sent to an
additional storage device.
Commit- Highlights when the images) have been sent to DICOM
storage device and the device confirmed storage

3 Clicking on the button will open the following screen,

displaying complete information regarding the selected image:

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6.27 Post Processing Tools

The tools are the most frequently used commands in the Examination
application.

The described tools are shortcuts to menu functions. For detailed description of
each function, see the appropriate menu entry.

Clicking on the button located on the right side of the screen

opens the following:

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- Enables movement of the image so that the feature of interest can be

centered in the image frame. Applicable only in full screen (1x1)
layout

- Magnifies the displayed image, focusing on the center of the image.

- Magnifies the marked area to fit the entire page.

- Returns the selected image(s) zoom and pan to their original settings.

- Flips the selected image(s) vertically.

- Flips the selected image(s) horizontally.

- Rotates the selected image(s) counter clockwise by 90 degrees (rotates left)

- Rotates the selected image(s) clockwise by 90 degrees (rotates right)

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- Enables to create multi-format view mode.

- Cancels multi-format mode

- Enables to operate sub frame mode

- Enables setting shutters on a selected image.

- Inserts free text on the selected image(s)

- Draws an arrow on the selected images(s)

- Draws a line on the selected image(s) including length.

- Enlarges/reduces the font size of the selected text.

- Draws a line and calibrates its true length

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- Temporarily hides notes in order to enable a clear view of the image.

- Removes all graphic elements.

- Enables to place a pre-defined text on the image.

- The Tuner feature is activated from the Examination/Archive screens.

See section 6.28 for detailed explanation.

- Inverts the gray levels of the displayed image (RBW)

- Resets the images to their original acquisition state.

- Enables deletion of selected image(s).

- Enables to send selected image(s) to monitor.

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6.28 Tuner Operation

The Tuner feature is activated from the Examination/Archive screens and enables
following options:

a. To save the Post Processing changes on the current image.

b. To save the new parameters within the protocol of the image that the Tuner
was activated on.

In order to activate the Tuner feature:

1 Click on the button on the right side of the screen (in the Image
Processing section)

2 The following window opens on the left side of the screen, according to the
active image and the radiation type (Radio/Fluoro):

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Radiation type

Gamma
a) In Radio - Move the slider to determine the required level of
Contrast/Brightness
b) In Fluoro – Select +/- to determine the required level of Gamma

DRC
Select +/- according to the desired filter

Windowing
NOTE: Can only be applied on radio type
• Selecting VDT- is activated according to ROI
• Selecting OFF – The user changes the windowing values manually

ROI Shape (Rectangular/Circular)

NOTE: Is only activated in Radio type and can only be activated while

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Windowing option is in VDT.

- Enables to save only acquired images which are from the same
protocol, same technique and same mode (not subtracted
images)

- Updates the protocol without saving the acquired image.

- Enables to save the acquired image, but does not update the
protocol. (NOTE: Only filters and tools will be saved on to the
acquired image, not on subtracted images)

- Exits to Examination screen, without saving changes (if “Apply”

button was not pressed)

Clicking on the closes this window.

NOTE
When activating the Tuner feature, the system applies the
parameters of the recent image

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6.29 Work-Station Operations

Acquired photospot images are automatically displayed on the

workstation monitor, if the Examination application is active.
Study status messages are displayed on the left side of the status line.

6.29.1 Browsing the Current Patient Images

To retrieve current patient images, use the image scroll bar.
To select a specific series, click the series number in the Series Table. The first
image of that series will be retrieved.

NOTE
To review acquired images of previous patients, switch to the Archives

Manager application by clicking on the tab.

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6.30 In-Room Operations

The in-room operations include activating the relevant radiation switch,
observing the acquired images displayed on the in-room monitor and
manipulating or controlling the acquisition modes by using the in-room keypad.

NOTE
The in-room monitor and the in-room keypad enable the user to acquire or
review images independent of the process being performed at the workstation.

6.30.1 Virtual Keypad

The DUET DRF image processing keypad is used to select acquisition modes
and review images acquired for the current patient.

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6.30.1.1 PATIENT
The PATIENT key enables the registration of a new patient from a
prepared Patient List (see par. 5.4).

To activate the function

1 Press the PATIENT key. The prepared Patient list appears on the in-room
monitor ; the ***current*** row, i.e. the current patient, is selected.

2 Use the or keys to scroll through the patient list.

3 Press the PATIENT key again to confirm the new patient registration. The in-
room monitor becomes blank and the patient information in the upper left
corner is updated according to the new patient data.

NOTES
• When the Patient List appears on the in-room monitor, an acquisition causes the
system to automatically exit the patient registration mode without changing the
current patient.
• You cannot access patient data simultaneously from both the in-room keypad
and the workstation monitor.

6.30.1.2 TEST SHOT / NEXT STEP

The TEST SHOT / NEXT STEP key has two different functions,
depending on whether the system is in the sequence acquisition mode.

• When the system is ready for a sequence acquisition, pressing the

TEST SHOT / NEXT STEP key before starting the acquisition
will result in the selection or clearing of the test shot option.
Use this key to
• Cancel the Testshot in sequences with this option
• Perform a Testshot, even though such an option was not included
in the selected sequence
• Force the system to perform an additional Testshot
• During sequence acquisition, the TEST SHOT / NEXT STEP
key allows the user to move ahead to the next step before

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completing the current one.

Note
If the Close Examination option is enabled, this key is assigned
to Close Examination functionality in lieu of Test Shot/Next
Step functionality.

6.30.1.3 SINGLE
The SINGLE key allows selection of the single pulse acquisition
mode.

6.30.1.4 SEQUENCE
The SEQUENCE key enables the selection of a new sequence from
the prepared sequence list.

To activate the function

1 Press the SEQUENCE key. The prepared Sequence list is displayed on the in-
room monitor; the ***current*** row, i.e. the current selected sequence is
selected.

2 Use the or keys to scroll through the Sequence list.

3 Press the SEQUENCE key again to confirm the new sequence selection. A
new “DR Sequence sequence name” message is displayed in the lower left
corner of the in-room monitor.

NOTES
When the Sequence list is displayed on the in-room monitor , any
acquisition will result in the system automatically leaving the sequence
selection mode without changing the current sequence.
You cannot access the Sequence list simultaneously from both the in-
room keypad and the workstation monitor.

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6.30.1.5 NEXT / PREVIOUS

The NEXT and PREVIOUS keys have two different functions.

• Enable selection of the next or previous patient or sequence when
the relevant menu is displayed on the in-room monitor .
• Enable the L or R labeling of the acquired images.

6.30.1.6 Save LIH

The Save LIH key saves real-time Fluoro image(s) or the currently
displayed Fluoroscopy or radiography image (LIH) into the Duet
DRF’s archive.

NOTES
• Real-time Fluoro images are catalogued as a standard sequence series.
• An LIH image is catalogued as a standard single image and saved in the Post
series, unless it has been previously saved.

The following five keys are used for reviewing the current patient images. When
these keys are pressed, the review mode (or Cine mode) is engaged.

NOTES
• The system will automatically return to acquisition mode when either the
Fluoro-switch or exposure button is pressed.
• The review functions are disabled during acquisition.

6.30.1.7 CINE
The CINE key enables automatic, cyclic display of all the images in
the current series.

To activate the CINE loop

1 Press the CINE key; the “CINE ON” message appears on the mid-left side of
the in-room monitor. Sequences are displayed at their native sequence
acquisition rate.

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2 Press the CINE key again to exit the automatic cine loop.

6.30.1.8 FORWARD / REVERSE

The FORWARD and the REVERSE keys display the next or previous
image in the current series.
Activation of these keys results in the display of the “REVIEW ON”
message on the mid-left side of the in-room monitor .

6.30.1.9 NEXT SERIES / PREVIOUS SERIES

The NEXT SERIES and the PREVIOUS SERIES keys allow the
user to scroll through the different series acquired for the current
patient.
Press the NEXT SERIES key to open the next series and the
PREVIOUS SERIES key to open the previous one.
Activation of these keys results in the display of the “REVIEW ON” message on
the mid-left side of the in-room monitor.

NOTES
When performing Bolus DSA it is possible to review via the Keypad,
Next/Previous Series belonging to current study only.
Review of all Next/Previous series is possible, provided that the current Bolus
DSA study is completed.
There are two methods for completing a Bolus DSA study:
• By selecting a different sequence via the workstation.
• By pressing the "new run" button in the gantry console.
Any of the above operations will "enable" the scroll through Next/Previous
series of all patients via the Keypad.

6.30.1.10 ZOOM
The ZOOM key magnifies the displayed image by a factor of 2,
focusing on the center of the image.
Press the ZOOM key again to exit zoom mode.

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6.30.1.11 NEGATIVE / POSITIVE

The NEGATIVE / POSITIVE key is used to invert the gray levels
of the displayed image.
Press the NEGATIVE / POSITIVE key again to return to the
original gray level display.
6.30.1.12 MASK
The MASK key enables the selection of the currently displayed image
as the mask for subsequent display of subtracted images (if the
subtraction mode is selected).
6.30.1.13 SUBTRACT
The SUBTRACT key enables the display of subtracted images on the
in-room monitor
Press the SUBTRACT key again to return to the normal display mode.

NOTE
If no mask has been selected, the first image of the current series is
automatically selected as a mask.

6.30.1.14 ROAD MAP - RAW / SUB

Press the ROADMAP key to activate the roadmap protocol. The
message ‘Ready for Roadmap phase I’ is displayed on the main in-
room-monitor.
Mask acquisition is performed during the next activation of the fluoro-
switch. When you release the fluoro-switch, the mask image is
displayed in the non-subtracted mode and the ‘Ready for Roadmap
Phase II’ message is displayed. The resulting mask is used during the
reminder of the procedure.
When fluoro exposure is re-applied, the mask is subtracted, in real-
time, from the incoming fluoro images. The resulting subtracted images
are displayed on the main in-room-monitor. When you release the
fluoro switch the subtracted roadmap image along with the message
‘Ready for Roadmap Phase II’ are displayed.
At this stage of the protocol the RAW/SUB key enables the user to
toggle between live and subtracted images.

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Press the ROADMAP key again to exit the roadmap protocol.

(See 6.6.2 for more details).
6.30.1.15 SELECT REF
Press the SELECT REF key to select a reference image from the
saved reference images list. Leaf through the saved ref images with the
FORWARD and REVERSE keys. While in SELECT REF mode you
can post process the ref images (Positive/Negative, Zoom, etc). Press
the SELECT REF key again to exit the SELECT REF mode.

6.30.1.16 SEND REF

Use SEND REF to store images for display as reference images on
the reference monitor. This function is used in Angio applications.
Press the SEND REF key to transfer the current image to the
reference monitor.
Images are transferred to the reference monitor “as is”, i.e.
subtracted, zoomed, panned, etc.
You can save all of the current patient images—even if the image is
not a part of the current study—as a reference image with the Select
as Reference option in the file menu of the Study, Archives or
Angio application.

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6.31 Right-Mouse Menu

Click the right-mouse button to access the following commands

6.32 Messages Overlaid on the In Room Monitor Image

The following main messages are overlaid on the image

Mid Left Area
• LIH mode/Review mode/Cine mode.

Upper Left Corner

• Patient name
• Patient ID
• Age, gender
• Physician’s name (if entered during Patient Registration).
• Accession Number (if enabled).
• Study#-series#-image #

Upper Right Corner

• Hospital/Clinic name

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• Study Date
• Study Time
• Image XX out of YY (in current series)
• Study name

Mid Right Area

• DAP (Dose Area Product) information (if applicable)
• Image Intensifier size

Lower Right Corner

• Low disk space (if relevant)
• Window values (brightness and contrast)

Lower Left Corner

• Remarks from Patient Registration screen
• Study type of the acquired image(s)

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Message / Icon Description

FLUORO
Fluoro Stabilization Period
Generator’s stabilization phase during Fluoroscopy.
Fluoro-on
Indicates that the Fluoro-switch is active and the generator
has reached the Fluoro stabilization phase.
Ready to Store The system is ready to save Fluoro images at a rate of XX
XX fps frames per second.
Press the Save LIH key to activate Fluoro sequence
acquisition.
Storing XX fps This blinking message indicates that Fluoro sequence
acquisition is being performed.

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Message / Icon Description

RADIO
DRSingle The system is in the ‘Ready for Single’ acquisition mode.
Press the exposure button to activate single pulse
acquisition.
Single Pulse ON
Indicates that a single pulse acquisition is being performed.
DRSequence The system is in the ‘Ready for Sequence’ acquisition
sequence name mode.
Press the exposure button to activate sequence acquisition.
Sequence Pulse On
Indicates that a sequence acquisition is being performed.
Step xx/yy Images of step XX (out of YY) steps of the current
acquired sequence are displayed.
DSA Testshot The system is in the ‘Ready for Testshot’ acquisition
mode.
Press the exposure button to activate a test shot image
acquisition.

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7 ARCHIVES and DATABASES

7.1 General Information

Use the Archives Manager to:

• Select and retrieve images from local and remote storage devices.
• Copy images from one device to another.
• Erase data, format and restore data from removable storage media.
• Transfer images to other applications.
• Off-line Review and Process of images.

7.2 Accessing the Archives Manager

To access the Archives Manager

Click on the tab.

NOTE
Archives Manager automatically displays the images of last reviewed study
when first turned on. If there’s no default study – the Database application is
activated automatically.

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7.3 Archives Manager Screen

When the Archives Manager opens, the following screen appears:

7.3.1 Application Tabs

See Examination Chapter – para. 6.4

7.3.2 Databases
When you first turn on the Archives Manager, the default selected study is
displayed. Use the Databases application in order to select / manipulate a study.
Clicking on Databases button enables accessing the databases of the Current
Reference or Today’s Studies. For example, clicking on the Today’s Studies tab
opens the following screen:

NOTE
Upon activation of Databases application, the “Today’s Studies” is
automatically displayed.

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You may select one or more entries from the list and perform the following
operations:
• Patient Study Details – for more details see para 5.2
(NOTE: This function is available for a single selection only)
• Remove Study – Removes selected study/ies from database.
• Send – Sends all images in the selected study/ies to the default DICOM
storage server.
• Burn – Burns all images in the selected study/ies to CD/DVD burner
(Optional).
• Export – Exports all images in the selected study/ies to a selected external
storage device.
• Export Bitmaps – Exports all images in the selected study/ies to a
USB device.
• Add – Add selected study/ies to the archives review screen. The selected
study/ies will be added to the study list.
• Review – Adds selected study/ies to the study list and returns to Archive
screen.
Clicking on the Search By button enables to search for a study according to:
Patient ID, Patient name, Accession No., Date Range, and Device type:

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7.3.3 Examination List

Study List displays the list of studies that were selected for display.
Clear – Clears the list
Remove – Removes a selected entry from the list.

7.3.4 Single Image Selection

See Examination Chapter, para. 6.12

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7.3.5 Multi Image Selection

See Examination Chapter, para. 6.13

7.3.6 Selection of All Acquired Images

See Examination Chapter, para. 6.14

7.3.7 Graphics
See Examination Chapter, para. 6.15

7.3.8 Screen Layout

See Examination Chapter, para. 6.16

7.3.9 Previewing Images Prior to Printing

See Examination Chapter, para. 6.17

7.3.10 Exporting Images

See Examination Chapter, para. 6.20

7.3.11 Assign Images to Another Patient

In case images were acquired by mistake on the name of the previous patient, or a
confusion between two patients occurred, it is possible to re-assign images to
another patient.
It is assumed that the new (“target”) patient to whom the images are going to be
assigned, is already registered in the Archives. Therefore, Patient Registration of
the new (“target”) patient is a pre-requisite to the whole operation described
hereafter.
This pre-registration operation should be done according to the Patient
Registration procedure detailed in chapter 5.

7.3.11.1 Selecting Images for Assigning to Another Patient

The operation of selecting images currently assigned to a patient/study and
assigning them to another patient/study is available from the Archive Manager
application by using the current images selection method and tools. (see
detailed description in par. 7.3.11 above).

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NOTES

The following restrictions applies to the selected images to be re-assigned to

another patient
• The selected images may be all or part of a complete study.
• Selected images must belong to the same study in the Local Archives
only.
• A series containing single images may be partially selected for
re-assignment.
• A sequence may be selected only as a whole for re-assignment.
• Images of current study cannot be reassigned.

• Images that are being displayed (used) in other applications cannot be

reassigned.

NOTE

It is highly recommended to temporarily backup the data prior to performing

this operation and backup again after the successful reassignment of the
selected images to the target patient.

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7.3.12 Menu Bar

The Archiving / Databases screen Menu Bar includes the following tabs:
• Main
• Selection
• View
• Processing
• Help
7.3.12.1 Main
The Main menu includes the following management commands:

7.3.12.1.1 Go to

Go to enables activating one of the following applications:

• Examination
• Databases

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• Printing
• Settings

7.3.12.1.2 Modify Patient Details

Selecting Modify Patient Details enables to modify the details inserted at the
time of the patient registration process. See “Modifying Patient Data” (para.
5.3.7)

7.3.12.1.3 Modify Examination Details

Selecting Modify Examination Details enables to modify the details of
examination inserted at the time of the patient registration process.

7.3.12.1.4 Queue Manager

See Examination Chapter, para. 6.24.1.2

7.3.12.1.5 Additional Storage Device

Selecting Additional Storage Device is available only when the External Hard
Drive option is installed. It enables operations for that device

7.3.12.1.6 Export Selection

Export Selection enables to manually choose a destination for images (stitching,
PACS storage device, etc.)

7.3.12.1.7 Export Images

7.3.12.1.8 Examination List

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7.3.12.1.9 Reject Analysis

Using this feature enables the X-Ray department administrator to periodically
issue reports indicating statistics of image rejection reasons.
A Reject analysis report can be generated at any time from the Duet DRF system,
only if there are rejected images. This report is displayed on the workstation
monitor. The report graphically displays the reject reasons. See example below.

7.3.12.1.10 Shutdown
7.3.12.2 Selection
See Examination Chapter, para. 6.24.2.
7.3.12.3 View

7.3.12.3.1 Information

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See Examination Chapter, para. 6.24.3.1

7.3.12.3.2 Screen Layouts

See Examination Chapter, para. 6.24.3.2

7.3.12.3.3 Multi Format

See Examination Chapter, para. 6.24.3.3

7.3.12.3.4 Sub Frame Mode

See Examination Chapter, para. 6.24.3.4

7.3.12.3.5 DR-View Mode

7.3.12.4 Processing
See Examination Chapter, para. 6.24.4
7.3.12.5 Help
See Examination Chapter, para. 6.24.6

7.3.13 Patient Details

See Examination Chapter, para. 6.23

7.3.14 Visit Information

See Examination Chapter, para. 6.24.3.1

7.3.15 Image Information

See Examination Chapter, para. 6.26

7.3.16 Post Processing Tools

See Examination Chapter, para. 6.27

7.3.17 Cine Mode (by clicking on the Post button)

See Examination Chapter, para. 6.9

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7.3.18 DSA Mode (by clicking on the Post button)

See Examination Chapter, para. 6.10

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8 PRINTING
The Duet DRF enables several different ways of printing images.
• Print selected images through the default printer
• Through the Preview application
• Using the offline Printing application

8.1 Printing through the default printer

Printing through the default printer is available from both the Examination and the

Archive screens. Pressing will send the selected images to

the default printer, using the default layout. The images are not previewed when
using this function.

8.2 Printing from the Preview Screen

The Preview Application is used to view, arrange and process images before they
are printed to film.
In Preview you can
• View the final film layout before printing.
• Edit the film layout prior to printing.
• Add/remove post operations to/from the printed images.
• Control the number of printed films.
• Use customized layouts and image ordering

From the Examination screen click on the button located on the

bottom of the screen. For more details, see para. 6.17, Examination Screen.
When the Preview opens, the following screen appears:

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The Film Format is displayed on the bottom right side of the Printing screen:

Clicking on returns the user to the Examination/Archive screens.

Clicking on sends the images as previewed to the selected

DICOM printer.

Print to : Selects to which printer the image will be sent to.

Orientation : Select: Landscape/Portrait
Film Size : Select the film size according the printer definition
Header : Determines whether the header will be with full details of the
patient

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(Detailed), or minimum details (Minimum)

Layout : Layout of images is determined according to the selected
orientation
Copies : Fill in the amount of copies required
Pages : Amount of pages to be printed

8.2.1 Customize Jobs

This application allows to use customized printing layouts, as well as to organize
the images at any desired order prior to printing. It can also use any standard
layout that is available in the system. Special layouts can be defined in the
Settings. See section 9.2.4 Custom Layouts.

1 Click on the button,

2 From Layout select the desired printing layout.
3 Click on left button on the thumbnails of the images on the right side of the
screen and drag it to the desired location in the layout, then release the mouse
button to drop. Repeat this action for all the required images.
4 Click on the button applies and saves the changes
5 Click on the button exits to the Preview without saving changes.

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8.2.2 True Size Printing

The True size Printing feature reflects true size of body part according to distance
calibration. By configuring a pre-assigned printer for printing in “True Size”
mode, the user may now send clinical images to such a printer, resulting in a 1:1
true size scale.

NOTE
The True Size option can be activated only if the printer supports
True Size mode

1 Click the button appearing in the Tools/Notes section.

2 Left click on the mouse and draw a line and calibrate the body part’s true
length.
3 The following window opens:

4 Fill in the distance in mm and click on APPLY button and then on the OK
button.
5 In the Preview screen Click on button opens a real
size view of the selected body part. Click on the button again exits the True
Size application.

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NOTE
1. The patient should be positioned as close to the Bucky as
possible in order to reach maximum accuracy in True Size printing.

2. Setting up the printer parameters according the Printer

conformance statement in the printer setting window: "printable
area" (Col x Raw), "Gap between Cells" for each Film size are an
essential factor in gaining maximum accuracy of True Size
Printing.

3. Typically (if the set-up is done properly), the error in

measurements is up to 1.5% but might be up to 4.5% in case of
improper settings or patient positioning.

4. Verification of the True Size printing was performed by

using Codonics printer , at film size of 17”x14”, 8"x10",
Results may vary when using other types of DICOM compliant
printers and films.

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8.3 Offline Printing Manager Screen

The Offline Printing feature is used to accumulate images to be printed, add them
to a “pending to print” list, and then have them printed offline.
Images can be added to the “pending to print” list from the Examination screen.
See section 6.24.2.4.

To access the Offline Printing click on the tab. Alternatively, from the
Examination and the Archives screens, click on the Main/Go to menu located on
the top of the screens and click on Printing.
When the Printing screen opens, the following screen appears:

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8.3.1 Printing List

Printing List displays the list of “pending to print” images that was previously
prepared
Clear – Clears the list
Remove – Removes a selected entry from the list.

8.3.2 Film Format

The Film Format is displayed on the bottom right side of the Printing screen:

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a. Print to
Select the desired DICOM from the drop down list.

b. Orientation
Select the suitable orientation format. (Portrait/Landscape)

c. Film Size
Select the suitable film size

d. Print Mode
Select the desired Print Mode (full text/maximum size)

e. Layout
Select the desired layout from the drop down list
(1x1/2x2/3x3/2x3/1x1/3x4x3x5x4x5)

f. Number of Copies
Click on the arrows to determine number of copies to be printed.

g. Customize Job
This application allows to use customized printing layouts, as well as to

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organize the images at any desired order prior to printing. It can also use any
standard layout that is available in the system. Special layouts can be defined
in the Settings. See section 8.2.1 for detailed explanation.

h. True size
The True size Printing feature reflects true size of body part according to distance
calibration. See section 8.2.2 for detailed explanation

8.3.3 Single Image Selection

See detailed description in para. 6.12, Examination Screen.

8.3.4 Multi Image Selection

See detailed description in para. 6.13, Examination Screen.

8.3.5 Selection of all Acquired Images

See detailed description in para. 6.14, Examination Screen.

8.3.6 Graphics

See detailed description in para. 6.15, Examination Screen.

8.3.7 Screen Layout

See detailed description in para. 6.16, Examination Screen.

8.3.8 Previewing Images Prior to Printing

See detailed description in para. 6.17, Examination Screen.

8.3.9 Printing Images

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Clicking on the button sends the selected image(s) to the chosen

DICOM printer.

8.3.10 Patient Details

See detailed description in para. 6.23, Examination Screen.

8.3.11 Image Information

See detailed description in para. 6.26, Examination Screen.

8.3.12 Post Processing Tools

See detailed description in para. 6.27, Examination Screen.

8.3.13 Application Tabs

See detailed description in para. 6.4, Examination Screen.

8.3.14 Menu Tab

See Examination Chapter, para. 6.24

8.3.14.1 Main
The Main menu includes the following management commands:

8.3.14.1.1 Go to

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Go to enables activating one of the following applications:

• Study
• Archives
• Databases

8.3.14.1.2 Queue Manager

The Queue Manager is used to monitor and modify progress of the background
copying processes See Examination, para. 6.24.1.2

8.3.14.1.3 Print

• Page – Prints a single selected page

• All – Prints all selected pages

8.3.14.1.4 Printing List

• Remove Selected – Removes selected image(s) from the film list

• Clear All – Clears all the selected image(s) from the film list

8.3.14.1.5 Shutdown
Selecting Shutdown starts the shutdown procedure (for more details, see
Power Off Procedure, para. 6.24.1.7 )
8.3.14.2 Selection
The Selection menu includes the following commands

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8.3.14.2.1 Single Select

See detailed description in para. 6.12 (Examination Application).

8.3.14.2.2 Multi Select

See detailed description in para. 6.13 (Examination Application).

8.3.14.2.3 Select All Images

See detailed description in para. 6.14 (Examination Application).

8.3.14.3 View

The View menu includes the following commands

8.3.14.3.1 Information

There are three types of information available:

• Patient Information
• Visit Information
• Image information

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8.3.14.3.2 Film Preview

Clicking on Film Preview opens the following screen:

8.3.14.3.3 Screen Layouts

See detailed description in para. 6.24.3.2 (Examination Application).

8.3.14.4 Processing
See detailed description in para. 6.24.4 (Examination Application)
8.3.14.5 Help
See detailed description in para. 6.24.6 (Examination Application).

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9 SETTINGS
The Settings application enables setting, modifying and save specific Duet DRF parameters
according to the clinic’s needs.

NOTE
Only operators who are familiar with the operation of the Duet DRF system
should perform changes. Failure to do so may result in improper operation of
the system.

To activate Settings, click on the button on the bottom left side of the screen.

The following tabs on the upper part of the screen enable selecting the needed group of parameters
and set it up according to the needs.

• General - par. 9.1

• Viewing Definitions - par. 9.2

• Protocol - par. 9.3

• Patient Registration - par. 9.4

• Devices Handling - par. 9.5

• DICOM Services - par. 9.6

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9.1 General

The following parameters can be set-up via General tab:

• Serviceability - par. 9.1.1
• Accounts Management - par. 9.1.2
• Hospital Name - par. 9.1.3
• Operators (Technologists) - par. 9.1.4
• Referring Physicians - par. 9.1.5
• Performing Physicians - par. 9.1.6
• Reject Reasons - par. 9.1.7

9.1.1 Serviceability
The Serviceability drop down menu enables performing the following settings operations:
• Adjust Clock
• Backup
• Backup / Restore Examination Data

9.1.1.1 Adjust Clock

Click on the Adjust Clock button. The Adjust Clock screen will open.

o Adjust the time by typing in the correct time: Hour (HH), minutes (MM) and seconds (SS)

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and click on the Update button.

o Update – Updates, exits and saves the changes.
o Exit - Aborts the function without saving changes.

9.1.1.2 Backup
The Backup function enables performing a backup of the main system parameters

• Choose the suitable backup drive and path

• Click on the Backup button
• Press on the Exit button to exit this function.

9.1.1.3 Backup / Restore Examination Data

This function enables a selective backup or restore of clinical protocols data.
Upon activating the Backup / Restore Examination Data function, the list of available protocols
is displayed, enabling selection of the protocols to be backed up.

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• Select Backup or Restore.

• Select the protocols to be backed up (or restored), by checking the suitable box.
• Select All - Select all the protocols and then click the Backup button.
• Deselect All - Cancels selection.
• Backup (or Restore) – Backups all the selected protocols.
• Click on the Exit button to exit this dialog box.

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9.1.2 Accounts Management

This function is used for managing the users’ accounts and access rights (in compliance with
HIPAA requirements).
Click on the Accounts Management button and select one of the following functions:
• Authorized Users and Access Rights
• Auto Mode Policies
• View and Export Log Files.

9.1.2.1 Authorized Users and Access Rights

The Authorized Users and Access Rights is used for defining the users that can access and
operate the Duet DRF, each defined by a Full Name, User Name, Password and Access Rights.

Note
The Authorized Users and Access Rights can be accessed only by an
authorized field engineer or System Administrator

The following table lists the Type of Users and corresponding Access Rights:
.

Type of User Access Rights

Field Engineer Access to all system resources.
Emergency • Does not require User Name or Password.
• Restricted to activation of Urgent Patient
acquisition and viewing the acquisition results.
A Full rights to perform DUET DRF operations
excluding the Authorized Users & Access Rights
function.
B Not allowed to delete data.
C Not allowed to delete images, print data and “Copy
to…” operations.

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Click on the Authorized Users and Access Rights button to update the list of authorized users
and access rights:

• Add - Adds an additional name to the authorized users list.

• Change Password - Changes password of the selected authorized user.
• Delete - Deletes a name from the authorized users list

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9.1.2.2 Auto Mode Policies

• Select All – Selects all the auto mode policies

• Deselect All – Cancels selection
• Update – Updates the selected auto mode policies.
• Click on the Exit button to exit this dialog box.

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9.1.2.3 View & Export Log Files

In order to view and export the Users History Log as well as other system log files, click on the
View and Export Log Files button. The following screen opens and displays the user’s history.

• Open - Enables to open and review any system log file.

• Export - Enables to save the user’s history into any selection destination.
• Click on the Exit button to exit this dialog box.

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9.1.3 Hospital Name

The Hospital Name function enables modifying the hospital / institution name.
Fill in or modify the hospital name in the text box.

• Update - Updates the hospital name.

• Exit - Closes this dialog box.

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9.1.4 Operators (Technologists)

This dialog-box enables preparing a pre-defined list of operators (Technologists) names.
Click on the Operators (Technologists) button. The set-up screen opens:

• Add - Adds an additional name to the list.

• Update - Updates the details of a name appearing in the list.
• Delete - Deletes a name from the list.
• Click on Exit to exit this dialog-box.

9.1.5 Referring Physicians

This function enables preparing a pre-defined list of Referring Physicians in a similar way as
described for the Operators’ names

9.1.6 Performing Physicians

This function enables preparing a pre-defined list of Performing Physicians in a similar way as
described for the Operators’ names

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9.1.7 Reject Reasons

This function enables defining the reasons for rejecting an acquired image.

• Add - Adds an additional reject reason to the list.

• Update - Updates the details of a reject reason appearing in the list.
• Delete - Deletes a reject reason from the list.
• Click on Exit to exit this dialog-box.

9.2 Viewing Definitions

The following parameters can be set-up via General tab:

• Layouts - par. 9.2.1
• Preset zoom factors - par. 9.2.2
• Custom headers - par. 9.2.3
• Custom layouts - par. 9.2.4
.

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9.2.1 Layouts
Click on the Layouts button to open the following dialog-box:

Select the desired screen layout for each application as well as the “User Defined Layout”.
In the Print Preview Available Layouts area mark the layouts you want to enable
• Update - Updates the Default Screen Layouts.
• Exit - Exits this dialog-box.

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9.2.2 Preset Zoom Factors

Click on the Preset Zoom Factors button to open the following dialog-box:

Select the desired Preset Zoom Factors for each application.

• Update - Updates the Preset Zoom Factors.
• Exit - Exits this dialog-box.

9.2.3 Custom Headers

The Custom Headers feature enables to customize the header or footer of the entire printed page
as well as for each image on the printed page. It can be applied to any custom layout printing.
Click on the Custom Headers button to open the following window:

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• Configure - Selects if to configure Page or Image.

• Default Location - Determines whether the information will be printed in the header or footer.
• Add Row – Adds a new row to be configured.
• Remove Row – To remove a header / footer row
Each item can be dragged from the list and dropped at the required position in the header / footer,
or removed from the header / footer simply by dragging it from the header / footer and dropped
back at the list area.
To activate a row, check the small box at the left of the row.

• Selecting Detailed / Minimal from the left side menu enables to define two sets of headers /
footers (one called Detailed, the other Minimal). Each can be selected for any custom layout.
See section 9.2.4.

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• Click on Done to save the custom header / footer.

9.2.4 Custom Layouts

The Custom Layouts feature enables to customize a layout for printing. This layout can be added
and be used on top of the existing standard default layouts. For using custom layout printing see
section 8.2.1 Customize Jobs. Click on the Custom Layouts button to open the following
window:

All existing custom layouts appear in the Custom Layouts box.

• Add New – Opens a new custom layout dialog.
• Delete – Deletes the highlighted custom layout.
• Edit – enables editing an existing custom layout.
• Rename - to enable renaming the highlighted layout.
• Film size – Selects the film size for the custom layout.

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• Orientation– Selects the orientation (Portrait / Landscape) of the custom layout.

• Page Information – To select the Detailed or Minimal header / footer row

The custom layout can contain several boxes, into which images can be drag and dropped during
printing preparation (see section 8.2.1 Customize Jobs). To set a box size, drag a corner or a side
of the highlighted box.

Drag the side to

increase / decrease
box size

When done, press Add Box to open another box. Set its size and continue adding more boxes until
it satisfies your custom layout. Each box can have a different size.

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Example of custom
layout with 3 boxes

• Click Save to save the boxes.

• To remove a box, highlight it by touching it with the cursor and click Remove Box.
• Click Done to save the custom layout.

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9.3 Protocols

Click on the Protocols tab to access the following functions:.

• Edit Protocols
• Edit Sequences
• Body Part Examined
• Edit Examination
• Labels
• Hospital Examination Names
• Auto Windowing
• Gamma Correction
• DRC

9.3.1 Edit Protocols

The protocol type feature enables the Duet DRF to automatically determine the dose parameters as
well as other post-processing parameters during acquisition.
The following techniques (types of protocols) are available when performing digital radiography
acquisitions:

DR Fluoro and single pulse acquisitions. Non-subtracted

(Digital Radiology) sequences can also be performed.

DA Fluoro and non-subtracted sequence acquisitions.

(Digital Angiography) * Single acquisitions can also be performed.
DSA Fluoro and subtracted sequence acquisitions. Single
(Digital Subtracted and non-subtracted sequence acquisitions can also
Angiography) * be performed.
RAD Single radiography exposures pulse acquisitions.
* Optional - available only in systems equipped with the Angio package.

For each study type created, you can define post-processing parameters according to the

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acquisition mode: Fluoroscopy or radiography (pulse).

Roadmap (if available) is treated as a separate protocol since it can be performed while in all
other techniques.

9.3.1.1 DR
When pressing on the DR button, the Edit DR Protocols screen opens:

• Add New– Adds a new DR protocol.

• Update - Updates a current DR protocol.
• Delete - Deletes a current DR protocol.
• Click on Exit to exit this dialog-box.

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A. General Section
Protocol List Displays all the protocols belonging to the DR technique.
There is always at least one study in the list.
• Click on a protocol in the list; the protocol’s parameters are displayed.
• Use the arrows to the right of the list to change the order of the protocols in the list.
• The first protocol in the list is the default protocol for the DR technique, if the
protocol field is not displayed in the Patient Registration screen (determined by an
installation parameter).
Protocol Displays the name of the protocol. Any alphanumeric value can be used.
Image level Indicates the increase (or decrease) of the iris aperture with respect to the calibration
level: -90% to +100% in 10% increments.
You can also enter any value within this range.
0% calibration level.
-90% maximum permitted decrease of the iris aperture.
+100% maximum permitted increase of the iris aperture.
Label List Displays a pre-defined label list for sequences
Sequence Displays the sequence that is automatically selected when the protocol is selected. This
sequence is taken from the DR sequence list (see Sequence Editing DR
Technique).

NOTE
If the original pre-programmed sequence is deleted from the DR
sequence list, the default DR sequence (first in the list) is used.

Cine loop Determines whether or not releasing the photospot-switch will result in automatically
entering a cine loop mode on the in-room monitor.
Range: 0 to 100 or endless.
You can select a value of 0-10 or endless from the list or edit any number up to 100.
A value of 0 indicates that no cine loop will be activated upon release of the exposure
button.

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NOTES
• The Cine loop parameter affects all sequences performed with
this protocol.
• The Cine loop parameter does not affect the sequence of Fluro
store images.

Auto filming Selects the filming mode for the protocol.

There are three filming options:
Manual Images are not automatically sent to printer.
Semi-automatic All acquired images are automatically transferred to the
Filming application.
Automatic All acquired images are automatically transferred to the Filming
application and printer for printing.
Default Resolution Defines default resolution (high/standard)

NOTES
• All post-processing operations are applied to the images sent
automatically to the Filming application or printer.
• Fluoro images are not automatically sent to the Filming
application or to the printer (installation dependent).
• The selected printer will be that of the first executed
protocol.

B. Fluoro Image Processing

Edge enhancement Determines the edge filter. Ten edge filters are available including ‘OFF’ (no
filter).
Smooth Filter Determines the smooth filter.
Recursive filter Determines the average factor
• Alpha = 0.0 indicates no average
• A higher alpha value indicates a higher average factor.
• You can enter any value between 0-0.9.
• Integrate2 indicates two-frame integration.
• Integrate3 indicates three-frame integration.

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Positive/Negative Determines the display polarity.

Positive indicates conversion of:
white
white, black
black.
Negative indicates conversion of:
white
black, black
white.

NOTE
This field is always positive for systems equipped with the
Intelligent AEC option (determined by an installation
parameter).

Gamma Correction Determines the Gamma correction curve for each output device according to
the polarity (negative/positive) of the displayed image. Different Gamma
correction curves including ‘NONE’ (no Gamma correction) are available. The
same positive and negative Gamma correction curves are applied to all the
devices.
IRM In-Room Monitor(s)
WS Work-Station Monitor
LI Laser Imager
NOTE
Independent device Gamma correction control can also be
performed (determined by installation parameter).

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C. Radiography Image Processing Parameters

Edge enhancement Determines the edge filter. Ten edge filters are available including ‘OFF’
(no filter):
Spatial Filter Determines the Spatial filters.
Auto Windowing Determines which auto windowing algorithm is performed. There are
five optional algorithms:
• A) There are three optional algorithms for the DR protocol: OFF, GP
(without e&c) and GP (with e&c)
• B) There are two optional algorithms for the DA and DSA protocols:
OFF GP and ON GP
W1, W2 Determines the default window values.
Range for W1: -4096 - 4095
Range for W2: 0 - 8191

ROI for Auto Windowing Determines the size, shape and position of the ROI (Region Of
Interest) used by the auto windowing procedure.
To display the ROI for Auto windowing dialog box, click on the ROI for Auto Windowing button:

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► A red border marks the ROI.

► Drag the mouse to change the size and/or position of the ROI.
► Select the Rectangular or Circle check box to determine the shape of the ROI.
► The default ROI for MAX Auto windowing is a circle with a radius
of 512 pixels. For the AVG Auto windowing the default ROI is a
rectangle of 400 pixels in the middle of the image.
► The ROI is displayed on an artificially produced white image.
► Click the II size tab located in the upper left corner to set a different
ROI for each image intensifier size.
► Click OK to temporarily record the changes.

NOTE
Changes are permanently stored in the study type
parameter data only after clicking the Update Study
or the Add New Study buttons in the DR Image
Processing dialog box.

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Lower, Upper Changes the target values of the auto-windowing algorithm.

Upper: increases the high target value
Lower: decreases the low target value
Range: -1023 - 1023, integer value

NOTE
These fields are valid only if the auto windowing
option is enabled.

W1, W2 Determines the default window values.

Range for W1: -4096 - 4095
Range for W2: 0 – 8191

NOTE
These fields are valid only if the auto windowing
option is enabled.

Positive/Negative See previous section

Gamma correction See previous section.
Post Processing DRC See previous section.

D. Control Buttons
Add New Adds a new protocol to the protocol list. The new protocol includes all
values currently displayed in the fields of the dialog box.
Delete Deletes the current selected protocol from the protocol list.

NOTE
If only one protocol appears in the list, the Delete
Protocol command is not available.

Update Updates the current selected protocol

Exit Closes the dialog box

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E. DICOM
Print Mode (Full Text/Maximum Size)
Print Destination
DICOM Store 1
DICOM Store 2
DICOM Store 3
Film Orientation (Landscape/Portrait)
Format (1X1, 2X2, 3X3, 2X3, 1X2, 3X4, 3X5, 4X5)

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9.3.1.2 DA
In order to edit the DA protocols, press on the DA button. The Edit DA Protocols
screen will open.

NOTE
The DA technique is optional. It is available only in systems
equipped with the Angiography package.

The procedure for editing the parameters of DA protocols is similar to editing the DR
protocol parameters, however there are 2 different items:

1 From the Radiography image processing section, select one of three Auto-
Windowing options:
OFF auto windowing is disabled
ON MAX MAX auto windowing algorithm is enabled
ON AVG AVG auto windowing algorithm is enabled
2 From the Label List options, the selected Label List will be automatically selected
when the protocol is selected (for details see Editing of Series Labels).
3 In order to edit the DA protocol, press on the DA button. The Edit protocols DA
screen will open:

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• Add New - Adds a new DA protocol.

• Update - Updates a current DA protocol.
• Delete - Deletes a current DA protocol.
• Click on Exit to exit this dialog-box.

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9.3.1.3 DSA
Press on the DSA button to open the Edit DSA Protocols dialog-box.

• Add New- Adds a new DSA protocol.

• Update - Updates a current DSA protocol.
• Delete - Deletes a current DSA protocol.
• Click on Exit to exit this dialog-box.

NOTE
The DSA technique is optional. It is available only in systems equipped with
the Angiography package.

The procedure for editing the DSA protocol parameters is similar to editing the DA protocol
parameters except for the addition of the Subtracted Radiography image processing section.

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Subtracted Radiography Image Processing Parameters

The DSA Subtracted Radiography image processing fields are similar to those of the DA
Radiography image processing fields, except for the following change:
Data transformation determines the subtraction algorithm: Linear or Logarithmic.

NOTE
Auto windowing is not available in the subtracted phase of the DSA protocol.

9.3.1.4 RAD
Pressing on the RAD button opens the Edit RAD Protocols dialog-box.

1 Select the Body Part from the dropdown list

2 Select the Protocol from the Protocol List
3 Select patient size from drop down list (Normal/Fat/Thin/Child/Infant)
4 To activate Direct Mode select Direct and check the Available box.
5 Select radiation values.

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• Add New- Adds a new RAD protocol.

• Update - Updates a current RAD protocol.
• Delete - Deletes a current RAD protocol.
• Click on Exit to exit this dialog-box.

9.3.1.5 Roadmap

NOTE
The Roadmap command is optional. It is available only in systems equipped
with either the Angiography and/or the Bolus packages.

Press on the Roadmap button to edit roadmap protocols.

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• Select the suitable Roadmap from the following drop down list:

• Update - Updates any additional data.

• Exit - Exits this dialog-box.

Five different Roadmap protocols are available and listed in the Roadmap protocols list. Each
Roadmap protocol includes image-processing settings as follows:
• Phase I (LIVE) - non-subtracted images
• Phase II (SUB) - subtracted images

a. Phase I (LIVE) Image Processing Parameters

The Fluoro image processing settings used in the Roadmap Phase I (LIVE) are those that have
been set for the current Fluoro protocol.
Select the Maximum opacification (when using contrast material injection) or Minimum
opacification (when using CO2 injection) to determine the Roadmap mask creation algorithm.

b. Phase II (SUB) Image Processing Parameters

The Phase II (SUB) image processing parameter fields are similar to those of the DSA
Subtracted Radiography image processing fields, except for the following:
% Subtraction: Determines the partial mask subtraction
Range: 30-100%, in 10% increments. The default value is 100%.
If the value is set to 100%, the anatomical background does not appear. The lower the percentage
value, the higher the anatomical background display.

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NOTE
Only the Update Roadmap Protocol control button is available since you cannot
delete or add a Roadmap protocol.
9.3.2 Edit Sequences
• Each technique has a unique pre-programmed sequence list.
• Any number of sequences can be pre-programmed for each technique.
• Click on the Edit Sequences. The following menu options are available:
• DR
• DA
• DSA
9.3.2.1 DR
In order to edit the DR sequences, click on the DR button.

• Add New- Adds a DR sequence.

• Delete - Deletes a DR sequence.
• Update - Updates a current DR sequence.
• Click on Exit to exit this dialog-box.

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a. General Section
Preset Sequences list Displays all sequences belonging to the DR technique. There is always at
least one sequence in the list.
• Click a sequence in the list to select it; the sequence parameters are
displayed.
• Use the arrows to the right of the list to change the order of the
sequences in the list.
• The first sequence in the list is automatically engaged upon selecting a
DR protocol.
Sequence Name Displays the name of the sequence. You can enter any alphanumeric value.
Resolution Determines resolution (Standard/high)
II Size Determines image intensifier size. This field can be edited only in systems
where information regarding the II size is not available from the X-ray
system. If II size information is not available, choose the II size from the
list (list values are installation dependent).
Exposure Six different exposure levels are available: five for manual exposure
control and one for Automatic Exposure Control (AEC).
In manual exposure control, the Exposure parameter is determined
according to the size of the patient. Select ‘ultra low’ for slim patients and
‘ultra high’ for obese patients.
Testshot required Indicates if a test shot should be performed prior to the sequence
acquisition.
mAs for Testshot In manual exposure control, enter the recommended mAs (milliamper per
second) needed to perform the sequence or test shot (if required).
Range 1-100, integer value (parameter setting dependant).
Select a preset value from the list or enter the requested value.

NOTE
In AEC exposure mode this field is disabled
(dimmed).

Max Pulse Width Indicates the maximum permitted exposure width in milliseconds.
Use high values for obese patients and low values for slim patients.
Range: 20, 100, 250 mps, integer value

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NOTE
In case the Exon signal is available, the actual
exposure length is determined according to it (within
the maximum pulse width value).

Max Frame/Sec Displays max. frame per second.

b. Sequence Phases Programming

Each sequence is composed of up to eight steps (phases).
The following parameters are available for each step:
Delay Determines the delay time between consecutive phases.
Rate/sec Determines the acquisition frame rate.
Range: 0.33 – 15 fps.
0.0 indicates that no acquisition is performed for a specified duration of time
(delay phase).

NOTE
The actual maximum number of frames per second depends on the value
entered in the Max Pulse Width field.

Time (sec) Determines the phase duration in seconds.

Range: 0.0 - 60.0.
Frames Displays number of total frames of a phase.
Images Displays the number of images. This field is automatically calculated by the
system.
Inject This field is not available for sequences in the DR technique.
Subtract This field is not available for sequences in the DR technique.
To enter steps in the Phases table
1 Double-click the Rate/sec field for Step #1; the field is marked with a gray frame.
2 Enter the requested value.
3 Press the <TAB> key to move to the Time (sec) field; the field is marked with a gray frame.
4 Enter the requested value.

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5 Press the <TAB> key to move to the Rate/sec field for Step #2.
6 Repeat steps 2 - 5 to program all the sequence steps.

c. Control Buttons
Add Adds a new sequence to the Sequence list. The new sequence includes all
values currently displayed in the fields of the dialog box.

NOTE
A sequence is valid only if all editable field were
completed, and each step line entered is fully
completed.

Delete Deletes the current selected sequence from the Sequence list.

NOTE
If only one study appears in the list, the Delete
Sequence command is not available.

Update Updates the current selected sequence.

Clear Clears the Sequence Name and the Phases Table. Enters default values for
other editable fields.
Exit Exits the dialog box.

9.3.2.2 DA

NOTE
The DA technique is optional. It is available only in systems equipped with
the Angiography package.

Click on the DA button to edit the DA sequences:

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• Add - Adds a DA sequence.

• Delete - Deletes a DA sequence.
• Update - Updates a current DA sequence.
• Exit - Exit this dialog-box.

The procedure for editing DA sequence parameters is similar to editing DR sequence parameters,
except for the Inject field in the sequence Phases Table.
Inject Controls the automatic injection.
Y the System outputs the injector trigger signal at the beginning of the step.
N the System does not output the injector signal.

NOTE
The injector output signal is a trigger for the automatic injector. ONLY A
SINGLE INJECTOR TRIGGER IS POSSIBLE PER SEQUENCE (the first
step with ‘Y’ in the Inject field).

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9.3.2.3 DSA

NOTE
The DSA technique is optional. It is available only in systems equipped
with the Angiography package.

Click on the DSA button to edit the DSA sequences:

• Add - Adds a DSA sequence.

• Delete - Deletes a DSA sequence.
• Update - Updates a current DSA sequence.
• Exit - Exits this dialog-box.
The procedure for editing DSA sequence parameters is similar to editing DA sequence parameters
except for the Subtract field in the sequence Phases table.

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Subtract The mask is automatically subtracted from all images acquired in this step.
Y Subtraction is performed
N Subtraction is not performed

NOTE
The first step of any sequence is always acquired in the
non-subtracted mode.

a. Rules for Mask Selection

• If no injection is performed (i.e. the user chooses a manual injection), the mask is the last
image of the non-subtracted step preceding the first subtracted step.
• If the injection is performed in Step #1, the mask is the first image of Step #1.
• If the injection is performed in Step #2 or any subsequent step, the mask is either the last
image of the non-subtracted step preceding the ‘inject’ step, or the last image of the non-
subtracted step preceding the first subtracted step, whichever comes first.

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9.3.3 Body Part Examined

Click on the Body Part Examined button. The following dialog-box opens:

• Add - Adds body parts that are examined.

• Delete – Deletes body parts that are examined.
• Update – Updates body parts that are examined.
• Exit - Exits this dialog-box.

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9.3.3.1 RAD Protocols

When using RAD Protocols, clicking on the Body Part Examined and selecting RAD
Technique, opens the following screen:
1 Highlight a body part in a selected body region and click on Add. The following dialogue box
opens:

2 Add name of body part and click on Done. This option adds body parts that do not exist in the
system’s data.

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9.3.4 Edit Examinations

Click on the Edit Examinations button. The following dialog-box opens:

1 Click on Add. The two following lists (Body Part and Protocol) will open on the right side of
the screen:

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2 Selecting the body part from the dropdown list on the left column automatically shows the list
of relevant protocols pertaining to this body part.
3 Fill in the name this examination is to be called.

• Add - Adds to the examination list.

• Delete – Deletes from examination list.
• Update – Updates examinations.
• Exit - Exits this dialog-box.

NOTES
1. It is impossible to acquire an image from the Protocol Body Part that
was not defined in the Edit Examination in the Settings application.
2. The “Post” tab does not exist in the RAD technique, since there is no
Cine mode

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9.3.5 Labels
Click on the Labels button. The following dialog-box opens:

• Add - Adds to the list names.

• Delete – Deletes list names.
• Update – Updates list names.
• Exit - Exits this dialog-box.
In the left window it is possible to create and edit labels lists (which are associated with protocols.
In the right window it is possible to create and edit the labels in each one of the lists in the left
window.

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9.3.6 Hospital Examination Names

Click on the Hospital Examination Names button and use the following dialog box to edit and
match between Hospital examination names and Duet DRF clinical protocols.

• Add - Adds to the hospital examination names.

• Update – Updates the hospital examination names.
• Delete – Deletes the hospital examination names.
• Exit - Exits this dialog-box.

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9.3.7 Auto Windowing

Selecting Auto Windowing provides access to four alternatives:
• Positive (Max)
• Negative (Max)
• Positive (Avg)
• Negative (Avg)
9.3.7.1 Positive (Max)
Access the Auto Windowing Positive (Max.) data, by clicking on the Positive (Max) button. The
Auto Windowing Positive (Max) window will open:

• Update – Modifies the data as required and updates.

• Exit - Exits this dialog-box.

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9.3.7.2 Negative (Max)

Access the Auto Windowing Negative (Max.) data, by clicking on the Negative (Max) button.
The Auto Windowing Negative (Max) window will open.

• Update – Modifies the data as required and updates.

• Exit - Exit this dialog-box.

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9.3.7.3 Positive (Avg)

Access the Auto Windowing Positive (Avg.) data, by clicking on the Positive (Avg) button. The
Auto Windowing Positive (Avg.) window will open.

• Update – Modifies the data as required and updates.

• Exit - Exits this dialog-box.

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9.3.7.4 Negative (Avg)

Access the Auto Windowing Negative (Avg) data, by clicking on the Negative (Avg) button. The
Auto Windowing Negative (Avg) window will open.

• Update – Modifies the data as required and updates.

• Exit - Exits this dialog-box.

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9.3.8 Edge Enhancement Fluoroscopy

Access the Edge Enhancement Fluoroscopy data, by clicking on the Fluoroscopy button. The
Edge Enhancement window Fluoroscopy will open:

• Update – Modifies the data as required and updates.

• Exit - Exits this dialog-box.

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9.3.9 Edge Enhancement Radiography

Access the Edge Enhancement Radiography data, by clicking on the Radiography button. The
Edge Enhancement window Radiography will open:

• Update – Modifies the data as required and updates.

• Exit - Exits this dialog-box.

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9.3.10 Gamma Correction

Access the Gamma Correction data, by clicking on the Gamma Correction button. The Gamma
Correction window will open:

• Update – Modifies the data as required and updates.

• Exit - Exits this dialog-box.

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9.4 DRC

Access the DRC, by clicking on the DRC button. The DRC window will open:

• Update – Modifies the data as required and updates.

• Exit - Exits this dialog-box.

9.5 Patient Registration

The following settings of Patient Registration parameters are available by clicking the Patient
Registration tab:
• Registration Mandatory Fields
• BarCode Reader (optional)

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9.5.1 Registration Mandatory fields

Click on the Registration Mandatory Fields button to access the following fields:

Check-mark the relevant fields.

• Update - Updates the selection of the Registration Mandatory Fields.
• Exit - Exits this dialog-box.

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9.5.2 BarCode Reader (optional)

Click on the Barcode Reader button to access the Barcode Reader parameters:

Select the relevant options.

• Update - Updates the selection of the Barcode Reader Fields.
• Exit - Exit this dialog-box.

9.6 Devices Handling

The following Devices Handling options are available by clicking the Devices Handling tab:
• Image Disk Zones
• Export Devices
• Burn CD/DVD (Optional)

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9.6.1 Image Disk Zones

Click on the Image Disk Zones button in order to set-up the Image disk Zones values:

• Exit - Exits this dialog-box.

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9.6.2 Export Devices

Click on the Export Devices button to define the image format that will be stored to the USB
memory device.

• Update - Updates the image format selection.

• Exit - Exits this dialog-box.

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9.6.3 Burn CD/DVD

Click on the Burn CD/DVD button to determine which media type you wish to burn onto.

• Update - Updates the Media type selections.

• Exit - Exits this dialog-box.

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9.7 DICOM Services

The DICOM Services settings options enable controlling of DICOM services related parameters.
Click on the DICOM Services tab.
The following functions are available:
• Local Station Configuration
• Storage
• Printers
• Modality Worklist (MWL)
• Modality Performed Procedure Step (MPPS)

9.7.1 Local Station Configuration

The Local Station Configuration enables setting / modifying the DUET DRF station’s Name and
Location.
The Station Name is sent as tag (0008,1010) to DICOM Storage servers.
The Station Name and Station Location are sent as tags (0040,0242) and (0040,0243) respectively
to the MPPS Server.

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9.7.2 Storage
The functions under the DICOM Storage sub menu enable independent selection of the parameters
for each DICOM Storage server linked to the system.
Click on the Storage button. The following functions are available:
• General (Time Out Send)
• Attributes
• Body Part Examined
• Imager Pixel Spacing
• Storage Servers
• Burn Device
• Stitching
9.7.2.1 General

The Time-Out Send function enables to set-up the maximum time (in minutes) allowed from the
last acquisition until images are sent to a DICOM Storage Server in case Time-Out Send storage
mode of operation is selected for at least one Storage server.
• Click on the Time-Out Send button.
• In the dialog-box, fill in the time value (in minutes) or use the up/down arrows to update the
time value.

• Update - Updates the time-out to send settings

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• Exit - Exits this function.

NOTE
A Change in the Time-Out Send value is valid as of next Patient
Registration.

9.7.2.2 Attributes
The Attributes function enables controlling the DICOM attributes being sent with each image to
DICOM Storage servers.

All attributes are enabled by factory default settings. You may un-check an attribute according to
the specific needs of the PACS configuration.
• Update - Updates the selection of DICOM Store attributes.
• Exit - Exits this function.

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9.7.2.3 Storage Servers

The Storage Servers function enables to set up the DICOM Store post-processing parameters for
each of the configured servers.
Click on the Storage Servers button.
In the following dialog-box, select the server and set-up the storage mode and the desired post
processing options:

• Update - Updates the specific server’s parameters.

• Exit - Exits this function.

9.7.2.4 Burn Device(optional)

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The Burn Device function enables to set up the DICOM Store post-processing parameters for a
configured burn device.

• Update - Updates the burn device parameters.

• Exit - Exits this function.

9.7.2.5 Stitching

• Update - Updates the Stitching parameters.

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• Exit - Exits this function.

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9.7.3 Printers
The Printers function enables to set up the DICOM Print post-processing parameters for each of the
configured printer.
Click on the Printers button.
In the following dialog-box, select the printer and set-up the desired post processing options:

The available printing parameters are:

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• Imager Name Name of printer the selected images will be sent

to.

• Number of Copies Number of copies to be printed

• Print Priority Low/Med/High

• Medium Type Type of medium on which the print job will be

printed.

• Film Destination The destination to which the film will be sent.

• Film Size The supported film sizes as set in the

Configuration for the specific printer are
available. The selected film size is set as the
default one.

• Magnification Type Interpolation type used by the imager.

• Border Density Density of the film areas surrounding and

between images of the film.

• EmptyImage density Density of the image box area on the film that
contains no images.

• Minimum Density Minimum density of the images on the film.

• Maximum Density Maximum density of the images on the film.

• Trim Determines whether a trim box shall be printed

surrounding each image on the film.

• Smoothing Type Specifies the type of interpolation in the remote

printer.

• Configuration Identifies the present configuration of the

Information remote printer.

• Remote Connection Defines the timeout of communication with the

Timeout remote printer

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NOTE
The printing is a background operation controlled by the DICOM Print
Queue Manager

Upon completion of the parameters setting use Update & Exit keys to save the changes and exit.

• Update - Updates the specific printer’s parameters.

• Exit - Exit this function.

9.7.4 Modality Worklist (MWL)

The functions under the DICOM Modality Worklist (MWL) sub menu enable the settings of this
DICOM service’s parameters.
Click on the Modality Worklist (MWL) button.
The following functions are available:
• Settings
• Additional Stations Configuration
• Attributes

9.7.4.1 Settings

The Settings function enables the selection of the active MWL server as well as the character set
to be used.

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• Update - Updates the section.

• Exit - Exit this function.

9.7.4.2 Additional Stations Configuration

In case several systems are operating in a clinic and there’s a need to fetch the worklist of
another system to the Duet DRF, the additional systems (stations) Name and Location should be
defined. The MWL Stations definition dialog box enables setting and defining such additional
stations later to be used during MWL query.

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Use the Add button to add an additional system (station) to the list.
The following dialog-box appears, enabling setting the station parameters

The Update and Delete buttons may be used to modify a station’s parameters or to delete it from
the list.

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9.7.4.3 Attributes
The Attributes function enables controlling the DICOM attributes being sent with each image to
DICOM Storage servers.

All attributes are enabled by factory default settings. You may un-check an attribute according to
the specific needs of the MWL server’s configuration.
• Update - Updates the selection of DICOM MWL attributes.
• Exit - Exit this function.

9.7.5 Modality Performed Procedure Steps (MPPS)

The functions under the DICOM Modality Performed Procedure Steps (MPPS) sub menu
enable the settings of this DICOM service’s parameters.
Click on the Modality Performed Procedure Steps (MPPS) button.
The following functions are available:
• Settings
• Attributes N-CREATE
• Attributes N-SET

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NOTE
The attributes enables controlling the DICOM attributes being used by
the DICOM MPPS Service. They are separated into two commands
being sued by the MPPS service: N-SET and N-CREATE.

9.7.5.1 Settings
The Settings function enables the selection of the active MPPS server as well as the character set
to be used.

• Update - Updates the selection.

• Exit - Exit this function.

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9.7.5.2 Attributes N-CREATE

The Attributes N-CREATE function enables controlling the DICOM attributes being sent with
the MPPS N-CREATE command.

All attributes are enabled by factory default settings. You may un-check an attribute according to
the specific needs of the MPPS server’s configuration.
• Update - Updates the selection of MPPS N-CREATE attributes.
• Exit - Exit this function.

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9.7.5.3 Attributes N-SET

The Attributes N-SET function enables controlling the DICOM attributes being sent with the
MPPS N-SET command.

All attributes are enabled by factory default settings. You may un-check an attribute according to
the specific needs of the MPPS server’s configuration.
• Update - Updates the selection of MPPS N-SET attributes.
• Exit - Exit this function.

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10 MISCELLANEOUS FEATURES

The following options are installation dependent and may not be available in all
systems. If an option is not available, the option and all related messages do not
appear.
The topics included in this chapter are:
1. Pulsed Fluoroscopy - produced X-ray radiation as a series of short bursts.
2. RS232 Generator Interface - connects the Duet DRF, the X-ray generator and
the table.
3. DICOM Protocol – used for transferring images between digital diagnostic
imaging modalities and medical devices.
4. Removable Devices – cartridges connected to the Duet DRF system, and used
for exporting/importing images from/to the Duet DRF.

10.1 Pulsed Fluoroscopy

Unlike conventional Fluoroscopy, in which the X-ray generator is fired

continuously, in pulsed Fluoroscopy X-ray radiation is produced as a series of
short bursts (usually under 10 msec).
You can acquire pulsed Fluoroscopy for the Duet DRF models as follows:
a) For the Gold & Silver models - at rates of 30, 15, 10, 7.5, 3.75, 2 and 1
frames per second.
b) For the Platinum model – at rates of 15, 7.5, 3.7.5, 2.14 and 1 frames per
second.
Default edge filters, average factors, windowing parameter settings, display
polarity and gamma correction curves for pulsed Fluoroscopy acquisition can be
pre-programmed for each study type (see para. 9.3.1).

NOTE
The use of post processing parameters is identical for Fluoroscopy and pulsed
Fluoroscopy, i.e. all parameter settings in the Fluoro image processing section
(for each study type), are also activated for pulsed Fluoroscopy images.

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10.2 RS232 Generator Interface

10.2.1 General Information

The RS-232 Interface is the connector between the Duet DRF, the
X-ray generator and the table.
The RS-232 interface enables:
• synchronization of operation between the Duet DRF and the generator.
• receipt of image acquisition parameters on all acquired images.
• verification of pre-programmed sequences that can be performed.

10.2.2 Duet DRF/Generator Synchronization

Selecting techniques i.e. DR, DA, DSA, etc. on the Duet DRF should result in
automatically selecting the same technique on the generator and vise versa.

NOTES
Selecting techniques on the generator will result in selecting the first study in
the study list of the same technique in the Duet DRF.
Upon registering a new patient in the system, the requested technique is
automatically sent to the generator.

10.2.3 Acquisition Parameters

Image information such as kV, mA etc. is transferred to the
Duet DRF upon release of the fluoro switch or exposure button. This data is kept
in the image database and is displayed on the images.

NOTE
The acquisition parameters are sent to the HIS/RIS server when available.

10.2.4 Sequence Validation

Upon entering the ‘ready for sequence’ acquisition mode or selecting new
sequence, the Duet DRF sends all sequences data to the generator. The generator
checks the requested sequence data. In cases that are due to temporal conditions,
when the sequence cannot be performed, a relevant warning message is displayed
on the main in-room-monitor and the radiography acquisition is disabled. The

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warning message will automatically be removed when the generator internal

condition allows the sequence acquisition.

NOTES
In case of a communication error, a relevant error message will be displayed
in the status line.
In case communication is lost, acquisition might be performed in the regular
way, but the operator should manually synchronize between the Duet DRF
and the generator, i.e. selecting DSA in both cases.

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