SECTION B

Basic Operations

This section provides basic information about using the DROC to acquire images and
send them to output devices. It also includes procedures for system starting up and
shutting down.

CONTENTS

SECTION B BASIC OPERATIONS ....................................................................................................... 1

STARTING UP AND LOGGING IN TO THE SYSTEM ....................................................................................... 2

CAPTURING IMAGES ................................................................................................................................. 5
LOGGING OFF THE DROC APPLICATION ................................................................................................ 29
POWER OFF THE SYSTEM........................................................................................................................ 30

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Starting Up and Logging in to the System

NOTE: Steps below only for reference. Steps may be changed according to your system
configuration.

To start up the system and prepare for acquiring patient images,

Steps：

1. Before power up the host system, please powers up the X-ray generator, detector
and all the other x-ray system components needed.

2. Make sure that the peripheral X-ray system components are on and working
properly.

3. Power up the Host PC and login the PC’s operating system

4. Log in to the DROC application.

The DROC HOST PC should be powered down once a day to ensure

a complete system reset. IF NOT, system performance deteriorates.

The Detector should be powered up at least half an hour before

intended use. If it is used sooner than half an hour after being
powered up, image quality may be affected.

The following subsections provide specific instructions for each of those steps:

Step 1: Powering up the X-ray generator, detector, etc

Please refer to the related instructions from corresponding manufacturers.

Step2: Checking the System

Once the X-ray generator is powered on, perform the following checks:

 Remove any patient supports or other objects so that they do not interfere with the
movement of the X-ray tube's suspension arm.
 Switch on the collimator’s light to ensure that the area to be exposed to the X-ray beam is

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illuminated.
 Check the releases, if applicable, on the X-ray tube's suspension arm, the Bucky, and
the table to ensure that the controls are operating properly.

You can now power up DROC.

Step3: Powering Up the Host PC

Power up the HOST PC and Log in to the PC's operating system;; if the monitor is not on,
press the power button on the monitor.

NOTE: Before you power on the DROC HOST PC, make sure the detector have completed their
startup sequence (wait at least several minutes after you power on the UPS).

Step 4: Login the DROC application

Start up the DROC application by double clicking the DROC shortcut on desktop. The login
window shows as below:

Figure 1：Log in window

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NOTE: The default password of login is the same to its name. Consult your System
Administrator if you do not know your log-in password. Passwords are case sensitive,
please ensure you have entered the correct password, if you enter false password
continually for three times, the application will be forced to exit.

To sign into the application, choose your level from Level Icon (Technician, Application,
Manager) and your name from the User Name drop-down list, enter your password, and

click button.

NOTE: In case you CAN NOT see this window, and a message box “No Dongle available or
Dongle is invalid! DROC System will exit!” shows up instead. Check your USB
license key to make sure it is well installed or contact our engineers for further support.

The initialization window will show the initialization status of the DROC, shown as below:

Figure 2：Initialization window

There are some initialization tasks of DROC system; the result of each task (successful or
failed) will be displayed one after another.

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Capturing Images

Overview for Capturing Images

The general workflow to acquire and send images to output devices involves the following
steps.

Steps:

1. Identifying the patient and Study;

2. Taking an exposure;

3. Viewing and accepting the image; Optionally, you can reject the image and re-capture
till an acceptable image is acquired;

4. After all images captured, the data will be transmitted to the default node. Alternatively,
users can send the images to other node or print the images;

5. Closing the patient/Study;

The following subsections provide specific instructions for each of those steps.

Step 1: Identifying the Patient and Study

Before capturing images, you must identify the patient with whom they are to be
associated. Proper identification ensures that the image data is associated with the
correct patient information.

Depending on the system configuration at your site, there are three ways to identify the
patient from whom you want to acquire images, as described below.

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Figure 3: Local window

All systems allow you to add/identify patients manually. Whether you are to acquire
images of a new patient or an existing one, you can add/identify manually by:

 Creating a new patient record in the local database.

 Selecting a patient from those previously created and stored in the worklist database.
For more information about how to manually specify the patient, refer to the following
topic “Creating a New Patient Locally”.

If your system supports HIS Worklist queries, you can retrieve patient information from a
Radiology Information System (RIS). Refer to the following topic “Query and Refresh” for
more information.

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If your system supports bar code scanning, you can use the bar code scanner to read the
patient ID or some other unique identifying number. If the ID is found in worklist (if this
feature is available) or in the local DROC patient database, the corresponding patient’s
study will be opened. If the ID is not found, you must enter that patient manually.

The patient/study list in the Worklist window is shown as below:

Figure 4: Worklist status bar

There are three status of the patient/study:

 SCHEDULED: A new patient/study with no image captured;

 IN PROGRESS: An existing patient/study has image/images being captured;
 COMPLETED: An existing patient/study with all the images captured.

You can capture images for the patient/study of SCHEDULED or IN PROGRESS status；
even can super-add images to a COMPLETED status patient/study as long as it still
existing in the Local database.

NOTE: As soon as the patient has been accomplished, it will be stored as PPACS data.
Meanwhile, the completed studies will still being stored in Worklist table for a certain
period after exposure, it depends on the Space Reclamation Strategy and individual
configuration. Users can pick up the patient still in the Worklist table and proceed on
capturing images. A Study existing in the PPACS database could not being superadded
images any more.

Creating a New Patient Locally

NOTE: Make sure you enter patient names and IDs correctly. Incorrect entries can cause
duplicate patient records for the same patient. As a result it will be more difficult to find
the patient in future search operations.

To add a new patient without a barcode, fill the information in New Patient page on
Worklist window.

The New Patient page is displayed below. Please note that, for your site, the fields in this
window may be different.

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Figure 5: New Patient Page

In this page, specify the patient information and determine the examination that patient is
going to take.

Fields labeled with an asterisk (*) are required to be filled in. You can switch to the next
field by pressing Tab key. After birthday entered, age is calculated and showed by system
automatically. The name will be displayed in the format LAST ^MIDDLE ^FIRST. If you
don’t want “^“ character to appear in name, you can input all content of name in Last
Name field.

To save patient information,

 Click Exam button. The patient information will be loaded on the Exam window for
technicians to capture images.
 Click Save To Local button. The patient information save to local worklist database
and system is still in Worklist window.

When specifying the protocol, click Add Protocol button, the Add Protocol window
shows like below.

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Figure 6: Add Protocol window

NOTE: UI at your site might be different from those described above.

 Select a Body Part from the left list, the corresponding protocol will be listed in the
upper right area. If select “Often Used” item in the left list, only protocols marked
“often used” display in the upper right area (The often used protocol is defined by
DROC configuration).
 Click the protocol to load the corresponding views into the lower right area.

To delete the view from the lower right area, click Delete Selected View

button, or click Clear Protocol button to delete all selected view.

To finish the protocol selection, click Ok button.

To cancel the protocol selection, click Cancel button.

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Emergency Patient Registration (Optional)

To add a patient for emergency, register the patient rapidly and skip all the filling tasks,
click the Emergency button in New Patient page. The system will register a patient
automatically with the name composed of prefix, current date and sequence number. The
sequence number increases 1 by each patient. The prefix of the name, default procedure
and other factors can be modified in Setting window(Refer to Section E：Emergency Setting
Part).Then DROC loads the Exam window directly for technicians to capture images of this
emergency patient.

Figure 7: Exam window for the emergency patient

Editing Patient Fundamental Information right after registration (Optional)

You can edit an emergency patient or locally registered patient fundamental information
before exposure (in fact any time you need as long as it is still in your local database).

Only the Manager can edit the information. (More details about user account, please refer to
relevant topic of Section E)

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1. From the Local page in the Worklist window, select the patient/Study whose
fundamental information you want to correct.

Figure 8: Patient selecting

2. Click Edit button, patient fundamental information editing page displays with the

original information:

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Figure 9: Patient Edit Dialog

3. Input the corrected patient information;

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Figure 10: Fundamental information correction

4. Click Accept button to save the correction, the information will be renewed and shown
in the Local page as:

Figure 11: After fundamental information correction

NOTE: As to a newly completed Study, the images will be transmitted to a default PACS node.
Once you have modified an item of captured image, the new information (for example, a
new name) will be written into the DICOM info. If this patient also exists in the History list,
you can find the related item shows the new information, too. This Editing operation is
only effective for local database data. It DOES NOT make any change of the images
already transmitted to the PACS node. We extremely recommend you to resend the
Study, which you just edited, to your desired destination.

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Query and Refresh (Optional)

To search an exact patient

From the Query Panel in the Local/Worklist page, you can query a patient/Study by

various searching criteria such as Patient ID, Patient Name, Accession Number and date.

The Query panel is shown as below:

Figure 12: Query panel

Input the key information associated to the desired patient/Study, and then click Query

button. DROC application will search the local database, and then the result will be

displayed in the Local/Worklist page.

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Figure 13: Searching result list

If multiple patients/studies match the criteria, they will be listed in the Local/Worklist page.

You can locate the exact Study or patient to perform the next operation.

To manually refresh the Worklist from Radiology Information System (RIS)

If your site is connecting to RIS, DROC can retrieve the worklist in background and

automatically refresh the Worklist page. You can override this operation manually by

clicking the Query button.

To Delete an item from the Local/Worklist page (Optional)

Note: Only the Manager can delete the item.

Select the patient/Study that you want to delete from the Local/Worklist page; then click

Delete button. A dialogue box will show up.

To confirm deletion, click OK button.

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Figure 14: Delete Confirm Dialogue

NOTE: Only the local cached worklist item can be removed by this deleting operation. If
retrieved from RIS, it may appear again.

Step 2: Capturing Images

In this section X-ray exposure dose may be dangerous to the

patient or operator unless safe exposure factors and operating
instructions are observed.

Loading the desired patient/Study to Exam window

To load SINGLE Study:

 Double-click the item in the Local/Worklist page
 The Study is loaded in the Exam Window.

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Figure 15: Study loaded

To load MULTIPLE studies:

From the Local/Worklist page, select several Studies belongs to same patient by pressing

Ctrl + left click mouse; Click the Exam button in Next Step area; Studies relating to the

desired patient are loaded in the Exam Window:

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Figure 16: Exam window with two studies

NOTE: The UI in your site may not show the some buttons after its installation due to the
customization. Please refer to your support engineer for more details.

You can select a view by highlighting the view icon, and the Study Description will change

as well when you shift between views.

Adjusting Exposure Settings and capturing Sequence (Optional)

At the time the system is installed, default exposure settings and capturing sequences are

configured according to every specific view. You can use manual mode or photo timing

mode to adjust the default exposure settings.

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Figure 17: Exposure Control panel

Technically, you could simply use the default parameters. They should only be changed for

special circumstances, such as a very small person or pulmonary emphysema.

If you need to adjust the exposure parameters or capturing sequence, refer to Section C

Adjusting exposure parameters for detailed instructions.

Adding an Additional Procedure (Optional)

For one patient, you may want to open additional procedures, to include all images in the

same Study. For more information, refer to Section C “Working with Multiple Open

Procedures” for more information.

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Adding a View to a Procedure (Optional)

Figure 18 : Add Protocol

If you need to capture extra view image, you could add views to current procedure. Refer to

previous topic “Creating a New Patient Locally”.

Taking an Exposure

While taking an exposure behind the leaded wall, you must maintain verbal
communication with the patient and keep the patient within your sight at all
times.

If the X-ray tube heat index exceeds the maximum allowable limit, the X-ray
tube and generator will be disabled until the heat index drop to the safe level. If
this condition occurs, a message will be displayed and an audible beep will
sound.

Steps:

1. Check the detector state in Detector Status area. It shows three colors corresponding to
three detector states: green indicates “ready to exposure”, yellow indicates “preparing for
exposure”, red indicates “on exposure”. If the indicator turns into yellow, please wait until it
turns to green.

Figure 19: Detector Status—Ready to exposure

Figure 20: Detector Status— Preparing for exposure

Figure 21: Detector Status—On exposure

2. Optionally, to get higher quality image, you have to give the patient instructions, such as to
hold breath or do not move.

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3. Press the Prep/Expose button to the first (prepare) position and hold till you hear a beep
from the generator which signifies ready. After that, press the button to the end.
Approximately a half to several seconds (the time interval depends on the characteristic of
the detector) will be cost during the whole process of exposure. At the time the exposure
starts, you will hear a sound.

4. After the tone stops, release the button.

5. Optionally, give the patient appropriate instructions to finish a circle of examination.

When the exposure is completed, the Preview window pops up and the raw captured image

displays in it. It will close automatically after several seconds. For more details of the other

buttons in Exam window, please refer to “Section C Additional Operations”

NOTES: Releasing the Prep/Expose button on the hand-switch before exposure beep will
cease the exposure process without any problem.
If there is any error occurs during the exposure, the Message Field under the
Exposure Status button will display the warning or error message.
If it is just a warning, the message disappears automatically after several
seconds.
If it is not an auto recoverable error, the message will remain. Click the Reset
button before performing subsequent exposure.

Figure 22: Reset button

NOTE: The UI in at your site may not show the Reset button after its installation. Please refer to
your support engineer on how to enable this button.

Step 3: Image Processing

After the exposure, the image is shown in Process window. The exposure information will be

shown round the corner of image. You can,

 Choose one post-process algorithm from ESA and Symphony (if available).

 Adjusting the ESA/Symphony Setting.

 Crop the image.

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 Enter a comment that accompanies the image when sending to a DICOM workstation

or printer.

 Add markers.

 Rotate or flip image, if required.

 View the image in full size.

 Accept the image or reject it.

Figure 23: Process window

The following topics explain how to perform these functions.

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Adjusting the ESA/SymphonyTM Setting

Figure 24: Image optimization panel

From the ESA/IT panel, you can change the current ESA/SymphonyTM setting by:

 Clicking on the drop-down list in the ESA panel and choosing a different setting.

 Pressing and holding the right button, and moving the mouse on image preview area,

the LUT is changed. Vertical movement changes window width of LUT, and horizontal

movement changes window level of LUT.

 Adjusting the image’s LUT settings by placing the pointer on the three rectangle

handles of the curve, pressing and holding the left mouse button, and dragging the

handle.

 ESA setting changes or LUT adjustments are typically not needed. For more

information about making LUT adjustments, refer to the topic “Changing the ESA

Setting or Adjusting the LUT” in Section C.

Cropping an Image

You can crop an image in order to cut the background and only save the area with useful

information. The cropping applies only to the image when it is sent to a DICOM printer or a

storage device. In DROC Configure page, the default crop size is set for each procedure.

When previewing image, the initial crop rectangular is positioned according to this size. If

DROC is capable of controlling the collimator’s movement, the collimator will receive the

position parameters from DROC and sets its field to the specified size before image taking;

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otherwise you have to do it manually. Furthermore, if DROC could be notified of the new

position of collimator adjustment manually, the size of crop rectangle will be updated

according to the new collimator field.

For more information, refer to the topic "Cropping an Image" in section C.

Adding Comments to an Image

You can add text comments to an image at the time of acquisition; the comment will be sent

to the DICOM devices which are chosen as output destination. There are already three

default comments provided for you to choose.

For more information, refer to the sub-topic “Adding Comments to an Image” of topic

“Working with Acquired Images” in Section C.

Selecting ESA or SymphonyTM (Optional)

For more information, refer to the sub-topic “Selecting ESA or SymphonyTM” of topic

“Working with Acquired Images” in Section C.

Adding Markers to an Image

You can add markers to an image which allows further information about the image (for

example, supine, upright, and so on), and the markers will be sent to the DICOM devices

which are chosen as an output destination. In DROC Configure page, you can configure

the default text and its position in the raw image for each view. For more information, refer to

the sub-topic “Adding Markers to an Image” of topic “Working with Acquired Images” in

Section C.

Rotating or Mirroring the Image (Optional)

You can rotate or mirror the image. For more information, refer to the sub-topic “Rotating or

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Mirroring the Image” of topic “Working with Acquired Images” in section C.

View the Image in Full Size

You can view the image in full size. For more information, refer to the topic “View the Image

in Full Size” under the topic “Working with Acquired Images” in Section C.

Accepting the Image

To accept the image, click the Accept button. The Process window closes and a thumbnail

(minimized view) of the image will be displayed in Exam window, as shown below. The

applied exposure parameters will also be found under its thumbnail image.

Figure 25: Exam window with image accepted

Once accept the image, that image is stored in DROC and is queued to be sent to default

output devices (Automatic sending function depends on your configuration). Now the image

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is successfully acquired.

By default, the next view to be exposed will be selected in image area automatically. If

needed, you can select a different view and adjust the exposure settings before acquiring

the next image.

For more information about these procedures, refer to Section C.

Rejecting the Image (Optional)

You may need to reject an image (for example, if the patient moved during the exposure).

To reject the image

Steps:

1. In the Process window, click the Reject button.

The Image Rejection Reason list displays, as shown below. In this list, you can select a
reason of the rejection.

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Figure 26: Reject Reason Window

2. Check the corresponding checkboxes to choose one or multiple reasons from the list
of default comments. If you check the Other Reason checkbox, you need to type the
reason in field under the checkbox.

3. Click the Reject button to save the rejection reason and reject the image.

Then the Rejection Reason Window and Process window will close then you can
recapture the image.

To dismiss the window and return to Process window without rejecting the image,
click the Cancel button.

Rejected images are stored in a designated reject bin storage area in DROC, and can be
discarded or resent to an output device.

NOTE: Rejected images can be manually deleted by the system administrator. And the system
will delete rejected images when it reclaims disk space.

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Step 4: Outputting Images manually (optional)

After captured, the images will be sent to default destinations or printers automatically. But
you can still re-send the images to different destinations or resend images from Output
window.

There are two types of output destinations: archive server for storage and printer for
printing. These two destinations (may contain zero or multiple nodes) can be configured for
all images belong to the same procedure. Furthermore, the film orientation, size and format
can be configured for each different procedure. When an exam is opened, these
configurations are loaded automatically. You can also change them manually for current
Study.

For more information, please refer to Section D: Working with Worklist Studies.

Step 5: Closing the Study/Patient

You can quit the Exam window to perform other operations, no matter whether all the

images are captured or not.

To quit the Exam window, click the button in Next Step area.

 If all of the images in the current study has being acquired, the status of this Study will

become Completed in Worklist window;

 Otherwise, the status will become In Progress in Worklist window.

You can pick up the incomplete Study from the Worklist window to proceed with the

exposures whenever you like.

NOTES: The fact that a Study is incomplete does not prevent the patient record and associated
images from being deleted which is part of the system's storage space reclamation
process. For more information about the reclamation, and how to protect a patient
record and associated images from being deleted, refer to Section E.
When Study is closed and no new patient is selected, the detector will perform offset
calibration; if no Study is opened for a period of time, the detector enters “sleep” mode
to save energy. To make detector could enter “sleep” mode when system is idle, don’t
leave a Study opened for a long time without taking exposure.

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Logging Off the DROC Application

To log off the DROC application, click the Exit button from the Menu Bar. The DROC Close

dialog displays.

Figure 27: DROC Exit dialog

Three options are available:

 Logoff：Switch to Login window to log in DROC with another user

 Exit：Close DROC

 Shutdown Computer：Power down the PC

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Power Off the System

Typically, you should leave the system components on. The DROC HOST PC, monitor, and
Detector are able to enter an energy-saving "sleep" mode1 when they are not used for a
period of time.

Recommended Power off Procedure Overview

To power off the system, it is recommended that you perform the power off tasks in the
following sequence,

Steps:

1. Shut down the DROC HOST PC.

Firstly close all the applications running in PC; then from the Start Menu, choose “Turn
off the computer” “Turn off”.

2. Power off the X-ray generator.

Powering off the X-ray generator also typically DOES power off the other X-ray
system components, such as X-ray tube, tube suspension arm, collimator, Bucky,
and table (if applicable).

The DROC HOST PC should be shut down once a day to ensure a

complete system reset. If this is not done, system performance may
deteriorate.

1
The “Sleep” mode is available for Trixell Detector.

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